|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$404.80 |
$404.80 |
$404.80 |
$188.50
|
|
Rozanolixizumab-noli 140 mg/ml subcutaneous solution
|
$23,286.44 |
$23,286.44 |
$23,286.44 |
$36,766.28
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$830.55 |
$830.55 |
$3,155.66 |
$2,331.08
|
|
Rp loclzj tum 2+area 1+d img
|
$1,531.95 |
$1,531.95 |
$7,356.59 |
$1,458.95
|
|
Rp loclzj tum spect w/ct 1
|
$2,659.65 |
$2,659.65 |
$6,338.63 |
$2,531.25
|
|
Rp loclzj tum spect w/ct 2
|
$5,042.80 |
$5,042.80 |
$11,076.14 |
$3,074.50
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$2,171.75 |
$2,171.75 |
$2,171.75 |
$2,182.05
|
|
Rpl tun-cvad w subq port
|
$9,171.40 |
$9,171.40 |
$9,171.40 |
$4,738.00
|
|
Rpl tun cvc wo subq port
|
$5,841.50 |
$5,841.50 |
$11,587.74 |
$4,201.80
|
|
Rpr blood vsl grf oth vein lo ex
|
$3,246.95 |
$3,246.95 |
$33,580.42 |
$5,836.04
|
|
Rp therapy unlisted px
|
$89.95 |
$89.95 |
$89.95 |
$320.85
|
|
Rsv assay w/optic
|
$50.75 |
$50.75 |
$50.75 |
$73.80
|
|
Rubella antibody igg
|
$104.30 |
$104.30 |
$104.30 |
$73.10
|
|
Rubeola antibody igg
|
$42.70 |
$42.70 |
$42.70 |
$79.68
|
|
Russell viper venom diluted
|
$77.35 |
$77.35 |
$311.00 |
$70.16
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$6,466.16 |
$6,466.16 |
$6,466.16 |
$6,466.16
|
|
Salmonella antibody
|
$476.00 |
$476.00 |
$476.00 |
$37.58
|
|
Sargramostim injection
|
$426.68 |
$426.68 |
$426.68 |
$708.27
|
|
Sarscov coronavirus ag ia
|
$73.85 |
$73.85 |
$73.85 |
$60.40
|
|
Sarscov & inf vir a&b ag ia
|
$86.10 |
$86.10 |
$86.10 |
$91.14
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,012.55 |
$1,012.55 |
$3,925.76 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$597.45 |
$597.45 |
$2,494.93 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$921.55 |
$921.55 |
$3,376.62 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$324.10 |
$324.10 |
$2,846.68 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$331.10 |
$331.10 |
$4,581.28 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$908.95 |
$908.95 |
$908.95 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,085.35 |
$1,085.35 |
$1,085.35 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$759.85 |
$759.85 |
$759.85 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$595.35 |
$595.35 |
$1,066.23 |
$601.70
|
|
Sclerotherapy fluid collection pq w/img
|
$1,336.65 |
$1,336.65 |
$1,336.65 |
$2,114.45
|
|
Scope uretscp lithovue dig disp
|
$3,317.43 |
$3,317.43 |
$46,221.00 |
$4,079.62
|
|
Screening Mammogram
|
$297.50 |
$297.50 |
$2,060.00 |
$303.55
|
|
Screening prostate cancer PSA
|
$1,273.95 |
$1,273.95 |
$1,273.95 |
$100.80
|
|
Screw cortex 2.0 x 10mm
|
$78,428.18 |
$78,428.18 |
$78,428.18 |
$28,563.75
|
|
Sc ther infusion reset pump
|
$632.44 |
$632.44 |
$632.44 |
$126.75
|
|
Sec art mech thrmbc non-intracranial add-on
|
$945.00 |
$945.00 |
$945.00 |
$4,565.60
|
|
Sedimentation rate erythrocyte automated
|
$48.30 |
$48.30 |
$48.30 |
$44.20
|
|
Semen analysis w/count
|
$685.77 |
$685.77 |
$685.77 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$1,441.44 |
$1,441.44 |
$1,441.44 |
$316.68
|
|
Serial casting application 97139app
|
$57.75 |
$57.75 |
$57.75 |
$67.42
|
|
Serpina1 gene
|
$700.70 |
$700.70 |
$700.70 |
$191.73
|
|
Set radiation therapy field
|
$2,797.20 |
$2,797.20 |
$5,265.00 |
$731.50
|
|
Set radiation therapy field
|
$4,615.45 |
$4,615.45 |
$8,925.00 |
$1,102.40
|
|
Set radiation therapy field
|
$4,662.00 |
$4,662.00 |
$17,784.00 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$83.08 |
$83.08 |
$83.08 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$345.91 |
$345.91 |
$345.91 |
$21.42
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$143.85 |
$143.85 |
$143.85 |
$235.13
|
|
Sheath gldlight lasr 12fx50cm
|
$5,212.99 |
$5,212.99 |
$5,212.99 |
$7,076.25
|
|
Shoe post-op mens m
|
$98.00 |
$98.00 |
$98.00 |
$42.87
|
|
Shoulder MRI (with and without contrast)
|
$3,419.50 |
$3,419.50 |
$3,419.50 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$2,775.15 |
$2,775.15 |
$6,060.01 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$1,790.25 |
$1,790.25 |
$1,790.25 |
$2,051.28
|
|
Shoulder X-ray
|
$558.60 |
$558.60 |
$558.60 |
$367.02
|
|
Shunt glaucoma baerveldt 350mm
|
$9,378.60 |
$9,378.60 |
$9,378.60 |
$4,709.25
|
|
Shuntogram nonvascular supervision & interpretation
|
$1,717.43 |
$1,717.43 |
$2,550.69 |
$345.00
|
|
Sialography s&i
|
$348.25 |
$348.25 |
$348.25 |
$462.40
|
|
Sickling rbc
|
$48.65 |
$48.65 |
$393.00 |
$53.55
|
|
Sigmoidoscopy and biopsy
|
$723.80 |
$723.80 |
$723.80 |
$1,351.63
|
|
Sigmoidoscopy/submucosal injection 45335
|
$723.80 |
$723.80 |
$723.80 |
$1,374.60
|
|
Signal avg ecg w or without ecg 93278
|
$279.30 |
$279.30 |
$279.30 |
$309.52
|
|
Sildenafil citrate, 25 mg
|
$128.36 |
$129.68 |
$359.00 |
$4.87
|
|
Sim ang w/prs cath rad emb
|
$9,938.95 |
$9,938.95 |
$9,938.95 |
$13,001.06
|
|
Sincalide 5 mcg solution for injection
|
$195.02 |
$195.02 |
$1,664.42 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$1,822.80 |
$1,822.80 |
$1,822.80 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$2,300.90 |
$2,300.90 |
$2,300.90 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$2,140.30 |
$2,881.55 |
$13,705.00 |
$2,489.25
|
|
Sirolimus, oral
|
$2,566.06 |
$2,566.06 |
$2,566.06 |
$42.11
|
|
Skin Biopsy
|
$285.95 |
$285.95 |
$285.95 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$2,948.75 |
$2,948.75 |
$16,176.00 |
$3,936.80
|
|
Sleep study unattended
|
$301.70 |
$301.70 |
$1,323.04 |
$595.50
|
|
Sleeve fing rolyan med
|
$284.00 |
$284.00 |
$284.00 |
$167.31
|
|
Sling arm deluxe w/pad xs
|
$288.00 |
$288.00 |
$288.00 |
$25.55
|
|
Sling suprapubic suburetheral
|
$26,511.45 |
$26,511.45 |
$26,511.45 |
$10,328.15
|
|
Slp eval non-spch gen comm dev
|
$1,127.71 |
$1,127.71 |
$1,127.71 |
$285.09
|
|
Slp pure tone screening
|
$117.00 |
$117.00 |
$117.00 |
$67.60
|
|
Slp ther svc non-spch gen
|
$560.68 |
$560.68 |
$560.68 |
$186.40
|
|
Sm-153 lexidron ther
|
$11,563.30 |
$11,563.30 |
$25,584.87 |
$11,563.30
|
|
Smear fluorescent and/or acid fast stain
|
$105.00 |
$105.00 |
$105.00 |
$64.20
|
|
Smear gram stain
|
$147.00 |
$147.00 |
$147.00 |
$57.85
|
|
Smear nasal eosinophil
|
$38.50 |
$38.50 |
$308.00 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$44.45 |
$44.45 |
$683.96 |
$64.35
|
|
Smear wet mount
|
$82.60 |
$82.60 |
$577.71 |
$68.63
|
|
Sodium 24 hour urine
|
$44.10 |
$44.10 |
$484.00 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$7.35 |
$7.35 |
$503.00 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$18.82 |
$175.25 |
$446.00 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$7.21 |
$7.21 |
$7.21 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$24.14 |
$24.14 |
$24.14 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$62.61 |
$62.61 |
$1,201.63 |
$84.80
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$269.10 |
$269.10 |
$269.10 |
$539.57
|
|
Sodium serum/plasma/whole blood
|
$39.20 |
$39.20 |
$484.00 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$150.27 |
$534.28 |
$699.00 |
$195.48
|
|
Somatosensory testing
|
$173.95 |
$173.95 |
$173.95 |
$583.80
|
|
Somatropin injection
|
$112.60 |
$112.60 |
$112.60 |
$2,381.48
|
|
Special physics consult
|
$348.60 |
$2,781.10 |
$6,842.00 |
$700.74
|
|
Special radiation dosimetry
|
$112.00 |
$112.00 |
$5,652.00 |
$445.50
|
|
Special radiation treatment
|
$3,141.95 |
$3,141.95 |
$19,583.00 |
$1,934.03
|
|
Special teletx port plan
|
$1,542.45 |
$1,542.45 |
$7,214.00 |
$1,046.65
|
|
Specific gravity body fluid
|
$22.40 |
$22.40 |
$121.00 |
$23.63
|
|
Specimen fat stain
|
$28.70 |
$28.70 |
$28.70 |
$32.76
|
