|
Removal of hip foreign body 27087
|
$2,037.34 |
$2,037.34 |
$2,037.34 |
$4,313.40
|
|
Removal of scrotum lesion
|
$1,287.77 |
$1,287.77 |
$1,287.77 |
$2,507.31
|
|
Removal/replacement ppm generator dual lead system
|
$10,849.79 |
$10,849.79 |
$10,849.79 |
$12,384.25
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$56.12 |
$56.12 |
$56.12 |
$292.50
|
|
Removal sutr and stapl no anes
|
$64.86 |
$64.86 |
$64.86 |
$82.05
|
|
Removal sutr or stapl no anes
|
$60.03 |
$60.03 |
$60.03 |
$95.00
|
|
Remove hip foreign body 27086
|
$1,705.68 |
$1,705.68 |
$1,705.68 |
$2,094.26
|
|
Remove shoulder fb deep
|
$1,705.68 |
$1,705.68 |
$1,705.68 |
$3,278.34
|
|
Remove shoulder foreign body subq 23330
|
$447.58 |
$447.58 |
$447.58 |
$1,788.80
|
|
Remove vaginal foreign body 57415
|
$1,887.38 |
$1,887.38 |
$1,887.38 |
$3,762.53
|
|
Renal function panel
|
$112.01 |
$112.01 |
$112.01 |
$113.52
|
|
Repair blood vessel direct hand finger
|
$1,127.00 |
$1,127.00 |
$1,127.00 |
$3,898.50
|
|
Repair blood vessel dir lower extr
|
$434.47 |
$434.47 |
$434.47 |
$1,705.04
|
|
Repair blood vessel dir upper extr
|
$1,972.71 |
$1,972.71 |
$1,972.71 |
$3,879.03
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$144.90 |
$144.90 |
$144.90 |
$1,025.95
|
|
Repair dental ellis ii fx
|
$65.09 |
$65.09 |
$65.09 |
$442.48
|
|
Repair extns tendon finger without grft ea
|
$1,070.65 |
$1,070.65 |
$1,070.65 |
$2,224.00
|
|
Repair eyelid wound
|
$1,578.03 |
$1,578.03 |
$1,578.03 |
$2,760.73
|
|
Repair lip full thkns =<one-half vert height
|
$155.94 |
$155.94 |
$155.94 |
$1,308.00
|
|
Repair lip full thkns >one-half vert height/cmplx
|
$381.80 |
$381.80 |
$381.80 |
$1,928.07
|
|
Repair pm/icd lead dual
|
$4,174.27 |
$4,174.27 |
$4,174.27 |
$4,343.82
|
|
Repair pm/icd lead sgl
|
$4,174.27 |
$4,174.27 |
$4,174.27 |
$4,339.00
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$217.81 |
$217.81 |
$217.81 |
$1,006.50
|
|
Repair rpr lip full thickness vermilion only
|
$327.52 |
$327.52 |
$327.52 |
$1,224.63
|
|
Repair throat wound
|
$655.50 |
$655.50 |
$655.50 |
$1,915.20
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$60.49 |
$60.49 |
$60.49 |
$478.00
|
|
Replace duod/jej tube perc
|
$189.52 |
$189.52 |
$189.52 |
$1,354.54
|
|
Replace g/c tube perc
|
$201.25 |
$201.25 |
$201.25 |
$1,341.50
|
|
Reposition pm/icd lead
|
$1,567.22 |
$1,567.22 |
$1,567.22 |
$3,790.00
|
|
Repos lv lead pm/icd
|
$1,630.01 |
$1,630.01 |
$1,630.01 |
$3,724.63
|
|
#resp virpnl dfa-adenovirus
|
$35.19 |
$35.19 |
$35.19 |
$45.80
|
|
#resp virpnl dfa-parainfluenza
|
$28.29 |
$28.29 |
$28.29 |
$35.20
|
|
Resuscitation cardiopulmonary
|
$348.91 |
$348.91 |
$348.91 |
$764.40
|
|
Reticulocyte automated
|
$28.29 |
$28.29 |
$28.29 |
$52.57
|
|
Revision of cervix
|
$1,849.20 |
$1,849.20 |
$1,849.20 |
$3,721.00
|
|
Revsc opn/prq tib/pero stent
|
$9,180.22 |
$9,180.22 |
$9,180.22 |
$8,869.59
|
|
Rheumatoid factor quantitative
|
$35.19 |
$35.19 |
$35.19 |
$57.00
|
|
Rho d immune globulin inj
|
$121.90 |
$121.90 |
$121.90 |
$217.71
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$1,467.47 |
$1,467.47 |
$1,467.47 |
$2,429.37
|
|
Rmvl fb upr arm/elbow deep
|
$1,705.68 |
$1,705.68 |
$1,705.68 |
$3,638.88
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$454.48 |
$454.48 |
$454.48 |
$1,822.05
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$17,494.72 |
$17,494.72 |
$17,494.72 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$17,494.72 |
$17,494.72 |
$17,494.72 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$17,494.72 |
$17,494.72 |
$17,494.72 |
$24,844.79
|
|
Rmvl icd pulse gen only
|
$1,567.22 |
$1,567.22 |
$1,567.22 |
$3,977.32
|
|
Rmvl perm pm pulse gen
|
$3,182.05 |
$3,182.05 |
$3,182.05 |
$6,094.40
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$10,849.79 |
$10,849.79 |
$10,849.79 |
$14,929.60
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$10,331.60 |
$10,331.60 |
$10,331.60 |
$10,542.00
|
|
Rmvl subq card rhythm mntr
|
$846.63 |
$846.63 |
$846.63 |
$1,734.00
|
|
Rmvl tv pm lead dual
|
$1,630.01 |
$1,630.01 |
$1,630.01 |
$4,028.20
|
|
Rmvl tv pm lead sgl
|
$1,630.01 |
$1,630.01 |
$1,630.01 |
$4,031.69
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$2,010.71 |
$2,010.71 |
$2,010.71 |
$6,333.33
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$293.94 |
$293.94 |
$293.94 |
$188.50
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$480.01 |
$480.01 |
$480.01 |
$2,173.60
|
|
Rpl tun cvc wo subq port
|
$670.68 |
$670.68 |
$670.68 |
$3,687.00
|
|
Rsv assay w/optic
|
$39.56 |
$39.56 |
$39.56 |
$79.38
|
|
Rubella antibody igg
|
$14.26 |
$14.26 |
$14.26 |
$77.03
|
|
Rubeola antibody igg
|
$14.72 |
$14.72 |
$14.72 |
$80.00
|
|
Russell viper venom diluted
|
$37.95 |
$37.95 |
$37.95 |
$72.54
|
|
Rx metab gen seq alys pnl 6
|
$122.13 |
$122.13 |
$122.13 |
$1,008.79
|
|
Sarscov coronavirus ag ia
|
$42.78 |
$42.78 |
$42.78 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$115.23 |
$115.23 |
$115.23 |
$104.00
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$312.34 |
$312.34 |
$312.34 |
$662.00
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$235.29 |
$235.29 |
$235.29 |
$497.20
|
|
Scan duplex extremity veins unilateral/limited study
|
$285.43 |
$285.43 |
$285.43 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$229.31 |
$229.31 |
$229.31 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$312.80 |
$312.80 |
$312.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$312.34 |
$312.34 |
$312.34 |
$595.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$34.50 |
$34.50 |
$34.50 |
$85.15
|
|
Screening Mammogram
|
$109.25 |
$109.25 |
$109.25 |
$312.55
|
|
Screening prostate cancer PSA
|
$73.83 |
$73.83 |
$73.83 |
$100.63
|
|
Sedimentation rate erythrocyte automated
|
$28.29 |
$28.29 |
$28.29 |
$42.00
|
|
Semen analysis presence/motility
|
$28.98 |
$28.98 |
$28.98 |
$71.05
|
|
Sertraline (zoloft) - sendout
|
$50.14 |
$50.14 |
$50.14 |
$126.43
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$48.99 |
$48.99 |
$48.99 |
$284.88
|
|
Shoulder MRI (with and without contrast)
|
$1,109.52 |
$1,109.52 |
$1,109.52 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$1,034.08 |
$1,034.08 |
$1,034.08 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$1,034.08 |
$1,034.08 |
$1,034.08 |
$2,065.05
|
|
Shoulder X-ray
|
$112.24 |
$112.24 |
$112.24 |
$339.50
|
|
Sickling rbc
|
$49.68 |
$49.68 |
$49.68 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$132.45 |
$132.45 |
$132.45 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$884.35 |
$884.35 |
$884.35 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$808.68 |
$808.68 |
$808.68 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$688.16 |
$688.16 |
$688.16 |
$1,292.04
|
|
Sirolimus, oral
|
$279.97 |
$279.97 |
$279.97 |
$41.25
|
|
Skeletal muscle relaxant 1/2
|
$73.83 |
$73.83 |
$73.83 |
$83.85
|
|
Skel musc relaxant 3 or more
|
$85.33 |
$85.33 |
$85.33 |
$16.12
|
|
Skin Biopsy
|
$172.04 |
$172.04 |
$172.04 |
$360.34
|
|
Sleep Study (Polysomnography)
|
$1,229.35 |
$1,229.35 |
$1,229.35 |
$3,607.50
|
|
Sleep study unattended
|
$117.53 |
$117.53 |
$117.53 |
$580.87
|
|
Slitting of prepuce
|
$579.83 |
$579.83 |
$579.83 |
$3,365.50
|
|
Slp stdy unatnd w/anal
|
$123.05 |
$123.05 |
$123.05 |
$296.34
|
|
Smear fluorescent and/or acid fast stain
|
$24.38 |
$24.38 |
$24.38 |
$64.20
|
|
Smear gram stain
|
$36.57 |
$36.57 |
$36.57 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$20.47 |
$20.47 |
$20.47 |
$73.15
|
|
Smear wet mount
|
$21.62 |
$21.62 |
$21.62 |
$67.49
|
|
Sodium 24 hour urine
|
$21.62 |
$21.62 |
$21.62 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$137.54 |
$137.54 |
$137.54 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$126.96 |
$126.96 |
$126.96 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$47.61 |
$47.61 |
$47.61 |
$37.50
|