|
Scan duplex abd/pelvis/retroperitoneal limited
|
$697.20 |
$697.20 |
$697.20 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$670.35 |
$670.35 |
$670.35 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$697.20 |
$697.20 |
$697.20 |
$496.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$652.20 |
$652.20 |
$652.20 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$985.20 |
$985.20 |
$985.20 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,203.45 |
$1,203.45 |
$1,203.45 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,203.45 |
$1,203.45 |
$1,203.45 |
$595.35
|
|
Scope uretscp lithovue dig disp
|
$6,480.00 |
$6,480.00 |
$6,480.00 |
$4,490.64
|
|
Screening hepatitis c antibody high risk
|
$225.45 |
$225.45 |
$225.45 |
$99.66
|
|
Screening Mammogram
|
$313.35 |
$313.35 |
$313.35 |
$312.55
|
|
Screening prostate cancer PSA
|
$154.95 |
$154.95 |
$154.95 |
$99.20
|
|
Screw cortex 2.0 x 10mm
|
$43,892.40 |
$43,892.40 |
$43,892.40 |
$29,055.00
|
|
Sedimentation rate erythrocyte automated
|
$84.00 |
$84.00 |
$84.00 |
$42.00
|
|
Self-adher band w>=3" <5"/yd
|
$3.27 |
$3.27 |
$3.27 |
$2.07
|
|
Semen analysis w/count
|
$84.00 |
$84.00 |
$84.00 |
$56.44
|
|
Serial casting application 97139app
|
$103.50 |
$103.50 |
$103.50 |
$78.39
|
|
Sertraline (zoloft) - sendout
|
$106.95 |
$106.95 |
$106.95 |
$126.43
|
|
Sheath below knee
|
$65.84 |
$65.84 |
$65.84 |
$40.88
|
|
Sheath gldlight lasr 12fx50cm
|
$7,908.00 |
$7,908.00 |
$7,908.00 |
$6,570.70
|
|
Sheath laser cavaclear 14f
|
$8,896.50 |
$8,896.50 |
$8,896.50 |
$7,625.52
|
|
Shoe post-op mens m
|
$319.80 |
$319.80 |
$319.80 |
$52.20
|
|
Shoe wedge sach
|
$171.44 |
$171.44 |
$171.44 |
$171.44
|
|
Sho insert w arch toe filler
|
$1,343.14 |
$1,343.14 |
$1,343.14 |
$1,224.38
|
|
Shoulder MRI (with and without contrast)
|
$3,700.05 |
$3,700.05 |
$3,700.05 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$3,482.70 |
$3,482.70 |
$3,482.70 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$3,264.90 |
$3,264.90 |
$3,264.90 |
$2,065.05
|
|
Shoulder X-ray
|
$282.15 |
$282.15 |
$282.15 |
$339.50
|
|
Shrinker prosth above knee
|
$168.89 |
$168.89 |
$168.89 |
$168.89
|
|
Shrinker prosth below knee
|
$92.35 |
$92.35 |
$92.35 |
$104.95
|
|
Shrinker upper limb
|
$109.50 |
$109.50 |
$109.50 |
$109.50
|
|
Shunt glaucoma baerveldt 350mm
|
$4,740.00 |
$4,740.00 |
$4,740.00 |
$4,636.80
|
|
Sickling rbc
|
$88.20 |
$88.20 |
$88.20 |
$57.00
|
|
Sigmoidoscopy and biopsy
|
$547.05 |
$547.05 |
$547.05 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$547.05 |
$547.05 |
$547.05 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$748.50 |
$748.50 |
$748.50 |
$1,890.00
|
|
Sigmoidoscopy/submucosal injection 45335
|
$547.05 |
$547.05 |
$547.05 |
$1,444.83
|
|
Sigmoidoscopy w/ablation
|
$748.50 |
$748.50 |
$748.50 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$707.55 |
$707.55 |
$707.55 |
$1,388.56
|
|
Sigmoidoscopy w/plcmt stent
|
$3,571.80 |
$3,571.80 |
$3,571.80 |
$3,692.00
|
|
Sigmoidoscopy w/tumr remove
|
$748.50 |
$748.50 |
$748.50 |
$1,558.80
|
|
Sigmoidoscopy w/ultrasound
|
$748.50 |
$748.50 |
$748.50 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$748.50 |
$748.50 |
$748.50 |
$2,106.60
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$719.70 |
$719.70 |
$719.70 |
$1,664.40
|
|
Sig w/tndsc balloon dilation
|
$748.50 |
$748.50 |
$748.50 |
$1,901.90
|
|
Sinus CT scan (with and without contrast)
|
$2,312.25 |
$2,312.25 |
$2,312.25 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,767.90 |
$1,767.90 |
$1,767.90 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,666.95 |
$1,666.95 |
$1,666.95 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$4,833.30 |
$4,833.30 |
$4,833.30 |
$2,489.25
|
|
Sirolimus, oral
|
$41.25 |
$41.25 |
$41.25 |
$41.25
|
|
Skin barrier with flange
|
$1.65 |
$1.65 |
$1.65 |
$1.65
|
|
Sling arm deluxe w/pad xs
|
$188.84 |
$188.84 |
$188.84 |
$30.35
|
|
Sling pelv split sam med
|
$246.05 |
$246.05 |
$246.05 |
$150.00
|
|
Sling suprapubic suburetheral
|
$14,547.60 |
$14,547.60 |
$14,547.60 |
$9,679.96
|
|
Small bowel endoscopy
|
$2,045.40 |
$2,045.40 |
$2,045.40 |
$2,463.36
|
|
Small bowel endoscopy
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,244.82
|
|
Small bowel endoscopy
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,638.57
|
|
Small bowel endoscopy
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,389.40
|
|
Small bowel endoscopy
|
$2,045.40 |
$2,045.40 |
$2,045.40 |
$2,638.57
|
|
Small bowel endoscopy
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,842.50
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,389.40
|
|
Small bowel endoscopy/biopsy
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,413.20
|
|
Small bowel endoscopy/biopsy
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,244.82
|
|
Small bowel endoscopy/stent 44370
|
$3,571.80 |
$3,571.80 |
$3,571.80 |
$4,925.70
|
|
Smear fluorescent and/or acid fast stain
|
$150.15 |
$150.15 |
$150.15 |
$64.20
|
|
Smear gram stain
|
$91.35 |
$91.35 |
$91.35 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$206.70 |
$206.70 |
$206.70 |
$73.15
|
|
Smear wet mount
|
$132.15 |
$132.15 |
$132.15 |
$66.72
|
|
Socket insert w lock mech
|
$1,609.98 |
$1,609.98 |
$1,609.98 |
$1,544.50
|
|
Sock fracture or equal each
|
$78.08 |
$78.08 |
$78.08 |
$74.20
|
|
Sock wool above knee
|
$95.50 |
$95.50 |
$95.50 |
$51.18
|
|
Sodium 24 hour urine
|
$127.05 |
$127.05 |
$127.05 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$30.00 |
$30.00 |
$30.00 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$160.28 |
$160.28 |
$160.28 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$410.40 |
$410.40 |
$410.40 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$135.45 |
$135.45 |
$135.45 |
$45.50
|
|
Soft interface below knee se
|
$170.43 |
$170.43 |
$170.43 |
$179.08
|
|
Solid skin barrier
|
$2.84 |
$2.84 |
$2.84 |
$2.84
|
|
Solid skin barrier 6x6
|
$6.51 |
$6.51 |
$6.51 |
$6.51
|
|
Somatropin injection
|
$1,204.34 |
$1,204.34 |
$1,204.34 |
$2,381.48
|
|
Special supplies phys/qhp
|
$60.00 |
$60.00 |
$60.00 |
$60.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,776.65 |
$2,776.65 |
$2,776.65 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$454.65 |
$454.65 |
$454.65 |
$536.34
|
|
Splint extn xsm w sof-stretch rolyan
|
$87.92 |
$87.92 |
$87.92 |
$68.25
|
|
Splint finger frog med
|
$21.47 |
$21.47 |
$21.47 |
$38.08
|
|
Splint func pos polyflex ii med
|
$307.50 |
$307.50 |
$307.50 |
$61.64
|
|
Splint rstrc wrst/cmc right med
|
$88.81 |
$88.81 |
$88.81 |
$99.04
|
|
Split blood or products
|
$102.90 |
$102.90 |
$102.90 |
$127.48
|
|
Sputum specimen collection
|
$102.90 |
$102.90 |
$102.90 |
$180.00
|
|
Staph a dna amp probe
|
$155.25 |
$155.25 |
$155.25 |
$125.00
|
|
Static or dynami afo pre ots
|
$416.73 |
$416.73 |
$416.73 |
$284.60
|
|
Stent axios caut enh 15x10mm electrocaut
|
$42,000.00 |
$42,000.00 |
$42,000.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$12,150.00 |
$12,150.00 |
$12,150.00 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$26,820.30 |
$26,820.30 |
$26,820.30 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$1,599.00 |
$1,599.00 |
$1,599.00 |
$4,939.20
|
|
Strapping of ankle and/or ft 29540
|
$205.20 |
$205.20 |
$205.20 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$225.15 |
$225.15 |
$225.15 |
$154.50
|
|
Strapping of hand or finger
|
$225.15 |
$225.15 |
$225.15 |
$174.82
|
|
Strapping of knee
|
$205.20 |
$205.20 |
$205.20 |
$205.20
|
|
Strapping of toes 29550
|
$142.05 |
$142.05 |
$142.05 |
$164.70
|
