|
Screening hepatitis b non-obstetric high risk
|
$144.21 |
$144.21 |
$144.21 |
$53.04
|
|
Screening Mammogram
|
$329.67 |
$329.67 |
$329.67 |
$310.20
|
|
Screening prostate cancer PSA
|
$336.60 |
$336.60 |
$336.60 |
$98.28
|
|
Sc ther infusion reset pump
|
$214.50 |
$214.50 |
$214.50 |
$140.15
|
|
Sec art mech thrmbc non-intracranial add-on
|
$1,340.13 |
$1,340.13 |
$1,340.13 |
$4,389.60
|
|
Sedimentation rate erythrocyte automated
|
$6.27 |
$6.27 |
$6.27 |
$44.20
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$26.40 |
$26.40 |
$26.40 |
$51.98
|
|
Sevelamer carbonate 800 mg tablet
|
$58.92 |
$58.92 |
$58.92 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$67.04 |
$67.04 |
$67.04 |
$21.42
|
|
Sgmdsc w/band ligation
|
$983.40 |
$983.40 |
$983.40 |
$2,273.70
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$79.20 |
$79.20 |
$79.20 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$87.78 |
$87.78 |
$87.78 |
$268.47
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$120.45 |
$120.45 |
$120.45 |
$400.65
|
|
Shoulder MRI (with and without contrast)
|
$4,232.25 |
$4,232.25 |
$4,232.25 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$3,116.85 |
$3,116.85 |
$3,116.85 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,316.70 |
$1,316.70 |
$1,316.70 |
$2,110.00
|
|
Shoulder X-ray
|
$1,475.43 |
$1,475.43 |
$1,475.43 |
$343.70
|
|
Sialography s&i
|
$443.19 |
$443.19 |
$443.19 |
$495.00
|
|
Sickling rbc
|
$92.40 |
$92.40 |
$92.40 |
$54.00
|
|
Sigmoidoscopy and biopsy
|
$596.31 |
$596.31 |
$596.31 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$1,273.14 |
$1,273.14 |
$1,273.14 |
$1,073.68
|
|
Sigmoidoscopy for bleeding
|
$1,287.33 |
$1,287.33 |
$1,287.33 |
$1,891.20
|
|
Sigmoidoscopy/submucosal injection 45335
|
$1,287.33 |
$1,287.33 |
$1,287.33 |
$1,492.59
|
|
Sigmoidoscopy w/ablation
|
$1,573.44 |
$1,573.44 |
$1,573.44 |
$2,724.80
|
|
Sigmoidoscopy w/fb removal 45332
|
$1,274.46 |
$1,274.46 |
$1,274.46 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$1,883.31 |
$1,883.31 |
$1,883.31 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$1,457.94 |
$1,457.94 |
$1,457.94 |
$2,712.75
|
|
Sigmoidoscopy w/tumr remove
|
$596.31 |
$596.31 |
$596.31 |
$1,570.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$1,571.79 |
$1,571.79 |
$1,571.79 |
$1,885.20
|
|
Sig w/tndsc balloon dilation
|
$1,420.98 |
$1,420.98 |
$1,420.98 |
$1,670.25
|
|
Sincalide 5 mcg solution for injection
|
$305.83 |
$305.83 |
$305.83 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$684.09 |
$684.09 |
$684.09 |
$1,800.90
|
|
Sinus CT scan (with contrast)
|
$570.90 |
$570.90 |
$570.90 |
$1,562.50
|
|
Sinus CT scan (without contrast)
|
$464.64 |
$464.64 |
$464.64 |
$1,281.80
|
|
Sinus/juglr venogram s&i
|
$1,680.69 |
$1,680.69 |
$1,680.69 |
$2,517.48
|
|
Skin Biopsy
|
$189.09 |
$189.09 |
$189.09 |
$357.00
|
|
Skin full graft add-on 15241
|
$560.01 |
$560.01 |
$560.01 |
$675.58
|
|
Small bowel endoscopy
|
$1,287.99 |
$1,287.99 |
$1,287.99 |
$2,466.10
|
|
Small bowel endoscopy
|
$1,619.97 |
$1,619.97 |
$1,619.97 |
$2,244.82
|
|
Small bowel endoscopy
|
$1,895.19 |
$1,895.19 |
$1,895.19 |
$2,638.57
|
|
Small bowel endoscopy
|
$2,900.04 |
$2,900.04 |
$2,900.04 |
$2,590.33
|
|
Small bowel endoscopy
|
$1,619.97 |
$1,619.97 |
$1,619.97 |
$2,638.57
|
|
Small bowel endoscopy
|
$1,895.19 |
$1,895.19 |
$1,895.19 |
$2,871.70
|
|
Small bowel endoscopy
|
$1,876.05 |
$1,876.05 |
$1,876.05 |
$1,963.00
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$1,048.74 |
$1,048.74 |
$1,048.74 |
$2,389.40
|
|
Small bowel endoscopy 44365
|
$1,619.97 |
$1,619.97 |
$1,619.97 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$1,127.28 |
$1,127.28 |
$1,127.28 |
$2,413.20
|
|
Small bowel endoscopy br/wa
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$912.45 |
$912.45 |
$912.45 |
$2,638.57
|
|
Smear fluorescent and/or acid fast stain
|
$135.96 |
$135.96 |
$135.96 |
$64.35
|
|
Smear gram stain
|
$135.96 |
$135.96 |
$135.96 |
$55.35
|
|
Smear nasal eosinophil
|
$53.79 |
$53.79 |
$53.79 |
$45.57
|
|
Smear special stain inclusion bodies/parasites
|
$133.32 |
$133.32 |
$133.32 |
$68.85
|
|
Smear wet mount
|
$120.45 |
$120.45 |
$120.45 |
$66.30
|
|
Sodium 24 hour urine
|
$59.07 |
$59.07 |
$59.07 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$145.18 |
$145.18 |
$145.18 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$174.15 |
$174.15 |
$174.15 |
$44.34
|
|
Sodium chloride 0.9 % IV bolus
|
$483.95 |
$483.95 |
$483.95 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$35.32 |
$35.32 |
$35.32 |
$42.25
|
|
Sodium serum/plasma/whole blood
|
$77.88 |
$77.88 |
$77.88 |
$45.00
|
|
Special physics consult
|
$337.26 |
$337.26 |
$337.26 |
$702.24
|
|
Special radiation dosimetry
|
$186.12 |
$186.12 |
$186.12 |
$392.50
|
|
Specific gravity body fluid
|
$33.33 |
$33.33 |
$33.33 |
$21.55
|
|
Specimen fat stain
|
$191.73 |
$191.73 |
$191.73 |
$37.70
|
|
Sperm identification
|
$290.07 |
$290.07 |
$290.07 |
$101.55
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,754.94 |
$1,754.94 |
$1,754.94 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,565.52 |
$1,565.52 |
$1,565.52 |
$536.34
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$2,005.41 |
$2,005.41 |
$2,005.41 |
$4,619.65
|
|
Sputum specimen collection
|
$260.04 |
$260.04 |
$260.04 |
$171.52
|
|
Sr-89 stront chlor ther / mci
|
$2,252.91 |
$2,252.91 |
$2,252.91 |
$2,882.09
|
|
St analysis behavior qualitative voice/resonance
|
$461.67 |
$461.67 |
$461.67 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$205.59 |
$205.59 |
$205.59 |
$284.65
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$6,660.39 |
$6,660.39 |
$6,660.39 |
$21,568.80
|
|
Stent iliac/open or perc/uni/init 37221
|
$3,894.00 |
$3,894.00 |
$3,894.00 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$2,987.82 |
$2,987.82 |
$2,987.82 |
$9,114.32
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$5,085.96 |
$5,085.96 |
$5,085.96 |
$17,271.50
|
|
Sterile water/saline, 10 ml
|
$17.92 |
$17.92 |
$17.92 |
$13.32
|
|
St evaluate speech sound production
|
$289.74 |
$289.74 |
$289.74 |
$288.75
|
|
St evaluate speech sound production comprehensive/expressive
|
$444.18 |
$444.18 |
$444.18 |
$376.84
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$403.26 |
$403.26 |
$403.26 |
$373.50
|
|
St evaluation swallow function
|
$479.16 |
$479.16 |
$479.16 |
$311.36
|
|
Strapping of ankle and/or ft 29540
|
$188.10 |
$188.10 |
$188.10 |
$205.38
|
|
Strapping of hand or finger
|
$166.32 |
$166.32 |
$166.32 |
$177.45
|
|
Strapping of knee
|
$140.25 |
$140.25 |
$140.25 |
$205.20
|
|
Strep b assay w/optic
|
$172.59 |
$172.59 |
$172.59 |
$80.16
|
|
Strep b dna amp probe
|
$133.32 |
$133.32 |
$133.32 |
$122.43
|
|
Stress test pulmonary
|
$719.73 |
$719.73 |
$719.73 |
$311.40
|
|
Stress tte complete
|
$4,440.48 |
$4,440.48 |
$4,440.48 |
$1,784.25
|
|
St treatment speech individual
|
$334.29 |
$334.29 |
$334.29 |
$253.80
|
|
St treatment swallow dysfunction/oral
|
$161.70 |
$161.70 |
$161.70 |
$245.50
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$28.86 |
$28.86 |
$28.86 |
$50.22
|
|
Sugars single quant
|
$27.06 |
$27.06 |
$27.06 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$10,392.49 |
$10,392.49 |
$10,392.49 |
$7,727.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$50.79 |
$50.79 |
$50.79 |
$123.58
|
|
Surgical pathology level 1 gross examination only
|
$38.61 |
$38.61 |
$38.61 |
$80.60
|
|
Surgical pathology level 2 gross & microscopic examination
|
$66.66 |
$66.66 |
$66.66 |
$146.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$89.10 |
$89.10 |
$89.10 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$140.58 |
$140.58 |
$140.58 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$429.00 |
$429.00 |
$429.00 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$287.76 |
$287.76 |
$287.76 |
$730.20
|