|
Scope uretscp lithovue dig disp
|
$3,600.00 |
$3,600.00 |
$9,786.40 |
|
|
Scr c/v cyto,thinlayer,rescr
|
$78.40 |
$100.00 |
$164.80 |
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$57.60 |
$57.60 |
$57.60 |
|
|
Screening hepatitis c antibody high risk
|
$122.40 |
$122.40 |
$122.40 |
|
|
Screening Mammogram
|
$416.80 |
$459.20 |
$504.80 |
|
|
Screening prostate cancer PSA
|
$89.60 |
$117.60 |
$148.80 |
|
|
Screen pap by tech w md supv
|
$99.20 |
$99.20 |
$99.20 |
|
|
Screw cortex 2.0 x 10mm
|
$351.20 |
$5,359.20 |
$51,041.60 |
|
|
Scrotal (Testicle) Ultrasound
|
$693.60 |
$726.40 |
$923.20 |
|
|
Sec abd wall suture evisceration/dehsn 49900
|
$4,781.60 |
$4,781.60 |
$4,781.60 |
|
|
Sec art mech thrmbc non-intracranial add-on
|
$6,766.40 |
$6,766.40 |
$8,036.00 |
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$244.80 |
$244.80 |
$359.20 |
|
|
Sedimentation rate erythrocyte automated
|
$27.20 |
$31.20 |
$59.20 |
|
|
Select picture audiometry
|
$176.00 |
$176.00 |
$176.00 |
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$114.40 |
$124.80 |
$131.20 |
|
|
Semen analysis presence/motility
|
$50.40 |
$60.00 |
$101.60 |
|
|
Serial casting application 97139app
|
$96.00 |
$98.40 |
$255.20 |
|
|
Set radiation therapy field
|
$1,281.60 |
$1,281.60 |
$1,281.60 |
|
|
Set radiation therapy field
|
$2,047.20 |
$2,047.20 |
$2,047.20 |
|
|
Set radiation therapy field
|
$2,647.20 |
$2,647.20 |
$2,647.20 |
|
|
Sevelamer carbonate 800 mg tablet
|
$5.01 |
$5.01 |
$5.01 |
|
|
Sevelamer carbonate pdr 20mg
|
$13.45 |
$13.45 |
$13.45 |
|
|
Sever cranial nerve
|
$4,762.40 |
$4,762.40 |
$4,762.40 |
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$258.40 |
$258.40 |
$258.40 |
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$197.60 |
$197.60 |
$280.80 |
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$224.80 |
$224.80 |
$224.80 |
|
|
Sheath gldlight lasr 12fx50cm
|
$9,688.00 |
$9,688.00 |
$9,688.00 |
|
|
Shoe heel sach cushion type
|
$41.60 |
$41.60 |
$41.60 |
|
|
Shoe post-op mens m
|
$97.60 |
$97.60 |
$97.60 |
|
|
Shot (Injection into Muscle or Under the Skin)
|
$113.60 |
$126.40 |
$172.00 |
|
|
Shoulder AC Joint X-ray (both sides)
|
$337.60 |
$356.00 |
$461.60 |
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$260.80 |
$308.80 |
$408.80 |
|
|
Shoulder MRI (with and without contrast)
|
$3,819.20 |
$3,925.60 |
$4,187.20 |
|
|
Shoulder MRI (with contrast)
|
$3,223.20 |
$3,516.00 |
$3,850.40 |
|
|
Shoulder MRI (without contrast)
|
$2,675.20 |
$3,198.40 |
$3,374.40 |
|
|
Shoulder X-ray
|
$296.00 |
$378.40 |
$461.60 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$196.00 |
$282.40 |
$386.40 |
|
|
Shrinker prosth above knee
|
$151.20 |
$151.20 |
$151.20 |
|
|
Shrinker prosth below knee
|
$144.80 |
$144.80 |
$144.80 |
|
|
Shunt glaucoma baerveldt 350mm
|
$9,000.00 |
$9,000.00 |
$9,000.00 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$704.00 |
$704.00 |
$799.20 |
|
|
Sialography s&i
|
$623.20 |
$623.20 |
$636.80 |
|
|
Sickling rbc
|
$32.80 |
$80.80 |
$81.60 |
|
|
Signal avg ecg w or without ecg 93278
|
$569.60 |
$584.00 |
$653.60 |
|
|
Sincalide 5 mcg solution for injection
|
$405.22 |
$424.00 |
$424.00 |
|
|
Sinus CT scan (with and without contrast)
|
$2,388.00 |
$2,796.80 |
$3,063.20 |
|
|
Sinus CT scan (with contrast)
|
$2,045.60 |
$2,266.40 |
$2,778.40 |
|
|
Sinus CT scan (without contrast)
|
$1,618.40 |
$1,952.00 |
$2,199.20 |
|
|
Sinus/juglr venogram s&i
|
$2,495.20 |
$2,495.20 |
$4,001.60 |
|
|
Sinus X-ray (complete)
|
$404.00 |
$488.80 |
$936.00 |
|
|
Sinus X-ray (limited)
|
$227.20 |
$323.20 |
$364.80 |
|
|
Sirolimus, oral
|
$33.04 |
$33.04 |
$33.04 |
|
|
Skin Biopsy
|
$337.60 |
$337.60 |
$423.20 |
|
|
Skin split graft addl 100sq cm 15101
|
$2,428.00 |
$2,428.00 |
$2,428.00 |
|
|
Skull X-ray (1 to 3 views)
|
$287.20 |
$417.60 |
$483.20 |
|
|
Skull X-ray (complete)
|
$492.80 |
$564.80 |
$780.00 |
|
|
Skyla, 13.5 mg
|
$591.76 |
$591.76 |
$591.76 |
|
|
Sleep Study (Polysomnography)
|
$3,936.80 |
$4,141.60 |
$5,137.60 |
|
|
Sleep study unattended
|
$648.80 |
$740.00 |
$753.60 |
|
|
Sleeve fing rolyan med
|
$231.20 |
$231.20 |
$231.20 |
|
|
Sling pelv split sam med
|
$152.00 |
$152.00 |
$152.00 |
|
|
Sling suprapubic suburetheral
|
$2,000.80 |
$3,768.03 |
$19,810.40 |
|
|
Slitting of prepuce
|
$4,673.60 |
$4,673.60 |
$4,673.60 |
|
|
Slp eval non-spch gen comm dev
|
$376.80 |
$376.80 |
$388.00 |
|
|
Slp pure tone screening
|
$144.00 |
$144.00 |
$216.80 |
|
|
Slp ther svc non-spch gen
|
$296.00 |
$296.00 |
$307.20 |
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$761.60 |
$798.40 |
$958.40 |
|
|
Smear fluorescent and/or acid fast stain
|
$43.20 |
$52.00 |
$76.00 |
|
|
Smear gram stain
|
$27.20 |
$38.40 |
$74.40 |
|
|
Smear nasal eosinophil
|
$24.80 |
$43.20 |
$66.40 |
|
|
Smear special stain inclusion bodies/parasites
|
$48.00 |
$53.60 |
$98.40 |
|
|
Smear wet mount
|
$35.20 |
$38.40 |
$72.80 |
|
|
Sock fracture or equal each
|
$59.20 |
$59.20 |
$59.20 |
|
|
Sock wool above knee
|
$57.60 |
$57.60 |
$57.60 |
|
|
Sodium 24 hour urine
|
$28.80 |
$35.20 |
$80.80 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$40.00 |
$86.40 |
$148.40 |
|
|
Sodium chloride 0.9 % IV bolus
|
$40.00 |
$86.40 |
$360.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$48.00 |
$72.00 |
$600.00 |
|
|
Sodium chloride 3 % ivpb
|
$3.40 |
$3.55 |
$3.60 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$67.06 |
$83.60 |
$335.84 |
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$404.53 |
$404.53 |
$404.53 |
|
|
Sodium serum/plasma/whole blood
|
$29.60 |
$40.00 |
$58.40 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$94.28 |
$99.92 |
$188.50 |
|
|
Somatosensory testing
|
$1,148.80 |
$1,148.80 |
$1,148.80 |
|
|
So vest canvas/web pre ots
|
$273.60 |
$273.60 |
$273.60 |
|
|
Special physics consult
|
$1,398.40 |
$1,398.40 |
$1,398.40 |
|
|
Special radiation dosimetry
|
$985.60 |
$985.60 |
$985.60 |
|
|
Special radiation treatment
|
$3,699.20 |
$3,699.20 |
$3,699.20 |
|
|
Special teletx port plan
|
$2,856.00 |
$2,856.00 |
$2,856.00 |
|
|
Specific gravity body fluid
|
$12.80 |
$12.80 |
$12.80 |
|
|
Specimen fat stain
|
$44.80 |
$52.00 |
$56.00 |
|
|
Speech and Language Evaluation (comprehensive)
|
$340.80 |
$452.00 |
$506.40 |
|
|
Speech audiometry complete
|
$152.00 |
$152.00 |
$152.00 |
|
|
Speech recep thresh
|
$107.20 |
$107.20 |
$107.20 |
|
|
Speech Therapy Session (one-on-one)
|
$267.20 |
$311.20 |
$315.20 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,927.20 |
$1,927.20 |
$1,949.60 |
|
|
Spine X-ray (single view, one level)
|
$240.80 |
$344.00 |
$388.80 |
|
|
Spleen imaging
|
$986.40 |
$1,690.40 |
$2,154.40 |
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$44.80 |
$186.40 |
$498.40 |
|
|
Splint extn xsm w sof-stretch rolyan
|
$83.20 |
$83.20 |
$83.20 |
|
