|
Rituximab-abbs 10 mg/ml intravenous solution
|
$4,322.45 |
$4,322.45 |
$4,322.45 |
$5,343.99
|
|
Rituximab-arrx 10 mg/ml intravenous solution
|
$6,244.76 |
$6,244.76 |
$6,244.76 |
$6,287.16
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$6,244.76 |
$6,244.76 |
$6,244.76 |
$5,309.20
|
|
Rmvl icd by tv extr
|
$1,718.10 |
$1,718.10 |
$1,718.10 |
$4,306.60
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$8,643.90 |
$8,643.90 |
$8,643.90 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$8,643.90 |
$8,643.90 |
$8,643.90 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$8,643.90 |
$8,643.90 |
$8,643.90 |
$24,844.79
|
|
Rmvl icd pulse gen only
|
$1,718.10 |
$1,718.10 |
$1,718.10 |
$3,977.32
|
|
Rmvl ndwellg tun pleural cath
|
$288.30 |
$288.30 |
$288.30 |
$1,156.80
|
|
Rmvl perm pm pulse gen
|
$3,804.60 |
$3,804.60 |
$3,804.60 |
$6,094.40
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$6,293.70 |
$6,293.70 |
$6,293.70 |
$14,929.60
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$2,658.30 |
$2,658.30 |
$2,658.30 |
$10,542.00
|
|
Rmvl subq card rhythm mntr
|
$595.20 |
$595.20 |
$595.20 |
$1,734.00
|
|
Rmvl tv pm lead dual
|
$1,718.10 |
$1,718.10 |
$1,718.10 |
$4,028.20
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$2,992.78 |
$2,992.78 |
$2,992.78 |
$6,333.33
|
|
Romiplostim 125 mcg subcutaneous solution
|
$5,629.36 |
$5,629.36 |
$5,629.36 |
$8,950.11
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$1,343.90 |
$1,343.90 |
$1,343.90 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$127.83 |
$127.83 |
$127.83 |
$188.50
|
|
Rotavirus antibody
|
$39.90 |
$39.90 |
$39.90 |
$125.01
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$350.10 |
$350.10 |
$350.10 |
$2,173.60
|
|
Rp loclzj tum 2+area 1+d img
|
$240.00 |
$240.00 |
$240.00 |
$1,310.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$350.10 |
$350.10 |
$350.10 |
$2,173.60
|
|
Rpl tun-cvad w subq port
|
$886.20 |
$886.20 |
$886.20 |
$4,647.04
|
|
Rpl tun cvc wo subq port
|
$886.20 |
$886.20 |
$886.20 |
$3,687.00
|
|
Rsv assay w/optic
|
$34.50 |
$34.50 |
$34.50 |
$79.38
|
|
Rubella antibody igg
|
$18.30 |
$18.30 |
$18.30 |
$77.03
|
|
Rubeola antibody igg
|
$21.60 |
$21.60 |
$21.60 |
$80.00
|
|
Russell viper venom diluted
|
$34.20 |
$34.20 |
$34.20 |
$72.54
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$2,569.54 |
$2,569.54 |
$2,569.54 |
$5,174.32
|
|
Sargramostim injection
|
$253.05 |
$253.05 |
$253.05 |
$609.00
|
|
Sarscov coronavirus ag ia
|
$74.10 |
$74.10 |
$74.10 |
$59.25
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$109.80 |
$109.80 |
$109.80 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$73.80 |
$73.80 |
$73.80 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$109.80 |
$109.80 |
$109.80 |
$750.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$58.50 |
$58.50 |
$58.50 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$130.80 |
$130.80 |
$130.80 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$260.70 |
$260.70 |
$260.70 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$130.80 |
$130.80 |
$130.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$130.80 |
$130.80 |
$130.80 |
$595.35
|
|
Sclerotherapy fluid collection pq w/img
|
$380.70 |
$380.70 |
$380.70 |
$2,114.45
|
|
Screening HIV antigen/antibody combination assay
|
$53.40 |
$53.40 |
$53.40 |
$42.30
|
|
Screening Mammogram
|
$70.20 |
$70.20 |
$70.20 |
$312.55
|
|
Screening prostate cancer PSA
|
$55.50 |
$55.50 |
$55.50 |
$100.63
|
|
Screw cortex 2.0 x 10mm
|
$7,492.50 |
$7,492.50 |
$7,492.50 |
$29,055.00
|
|
Sc ther infusion reset pump
|
$33.00 |
$33.00 |
$33.00 |
$140.15
|
|
Sec art mech thrmbc non-intracranial add-on
|
$1,047.30 |
$1,047.30 |
$1,047.30 |
$4,377.50
|
|
Sedimentation rate erythrocyte automated
|
$8.10 |
$8.10 |
$8.10 |
$42.00
|
|
Set radiation therapy field
|
$127.80 |
$127.80 |
$127.80 |
$762.40
|
|
Set radiation therapy field
|
$172.20 |
$172.20 |
$172.20 |
$1,157.38
|
|
Set radiation therapy field
|
$212.40 |
$212.40 |
$212.40 |
$1,636.36
|
|
Sewho erbs palsey design abd
|
$298.20 |
$298.20 |
$298.20 |
$988.40
|
|
Shoulder MRI (with and without contrast)
|
$814.50 |
$814.50 |
$814.50 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$533.10 |
$533.10 |
$533.10 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$530.70 |
$530.70 |
$530.70 |
$2,065.05
|
|
Shoulder X-ray
|
$131.10 |
$131.10 |
$131.10 |
$339.50
|
|
Sialography s&i
|
$113.10 |
$113.10 |
$113.10 |
$499.20
|
|
Sickling rbc
|
$41.40 |
$41.40 |
$41.40 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$133.39 |
$133.39 |
$133.39 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$519.00 |
$519.00 |
$519.00 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$346.50 |
$346.50 |
$346.50 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$346.50 |
$346.50 |
$346.50 |
$1,292.04
|
|
Sirolimus, oral
|
$10.53 |
$10.53 |
$10.53 |
$41.25
|
|
Skin Biopsy
|
$186.90 |
$186.90 |
$186.90 |
$360.34
|
|
Skin split graft addl 100sq cm 15101
|
$471.90 |
$471.90 |
$471.90 |
$1,793.40
|
|
Skin test unlisted antigen ea
|
$28.50 |
$28.50 |
$28.50 |
$48.57
|
|
Sleeve fing rolyan med
|
$74.10 |
$74.10 |
$74.10 |
$203.58
|
|
Sling suprapubic suburetheral
|
$3,949.50 |
$3,949.50 |
$3,949.50 |
$9,679.96
|
|
Slp pure tone screening
|
$14.10 |
$14.10 |
$14.10 |
$60.48
|
|
Smear fluorescent and/or acid fast stain
|
$14.10 |
$14.10 |
$14.10 |
$64.20
|
|
Smear gram stain
|
$12.90 |
$12.90 |
$12.90 |
$55.25
|
|
Smear nasal eosinophil
|
$12.30 |
$12.30 |
$12.30 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$18.00 |
$18.00 |
$18.00 |
$73.15
|
|
Smear wet mount
|
$12.30 |
$12.30 |
$12.30 |
$67.49
|
|
Sock fracture or equal each
|
$121.34 |
$121.34 |
$121.34 |
$74.51
|
|
Sodium 24 hour urine
|
$14.70 |
$14.70 |
$14.70 |
$48.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$18.63 |
$18.63 |
$18.63 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$242.52 |
$242.52 |
$242.52 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$14.40 |
$14.40 |
$14.40 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$187.46 |
$187.46 |
$187.46 |
$177.52
|
|
Soft interface below knee se
|
$269.43 |
$269.43 |
$269.43 |
$179.08
|
|
Somatropin injection
|
$830.53 |
$830.53 |
$830.53 |
$2,381.48
|
|
Special physics consult
|
$165.90 |
$165.90 |
$165.90 |
$725.00
|
|
Special radiation dosimetry
|
$67.20 |
$67.20 |
$67.20 |
$392.50
|
|
Special radiation treatment
|
$389.10 |
$389.10 |
$389.10 |
$1,986.00
|
|
Special teletx port plan
|
$198.90 |
$198.90 |
$198.90 |
$1,086.99
|
|
Specific gravity body fluid
|
$7.20 |
$7.20 |
$7.20 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$324.60 |
$324.60 |
$324.60 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$171.60 |
$171.60 |
$171.60 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$146.40 |
$146.40 |
$146.40 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$39.26 |
$39.26 |
$39.26 |
$68.25
|
|
Splint finger fold over sm
|
$39.58 |
$39.58 |
$39.58 |
$146.88
|
|
Splint finger frog med
|
$12.00 |
$12.00 |
$12.00 |
$38.08
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$1,647.30 |
$1,647.30 |
$1,647.30 |
$4,619.65
|
|
Split blood or products
|
$12.60 |
$12.60 |
$12.60 |
$127.48
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$471.90 |
$471.90 |
$471.90 |
$1,612.78
|
|
Srs linear based
|
$11,004.30 |
$11,004.30 |
$11,004.30 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$54.60 |
$54.60 |
$54.60 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$40.50 |
$40.50 |
$40.50 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$6,798.00 |
$6,798.00 |
$6,798.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$457.88 |
$457.88 |
$457.88 |
$2,520.08
|
