|
Rheumatoid factor qualitative
|
$52.56 |
$52.56 |
$52.56 |
$54.60
|
|
Rho d immune globulin inj
|
$91.63 |
$91.63 |
$91.63 |
$334.53
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$4,225.60 |
$4,225.60 |
$4,225.60 |
$10,693.54
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$3,800.76 |
$3,800.76 |
$3,800.76 |
$6,877.90
|
|
Rituximab-arrx 10 mg/ml intravenous solution
|
$1,505.28 |
$1,505.28 |
$1,505.28 |
$4,200.39
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$644.40 |
$644.40 |
$644.40 |
$7,582.77
|
|
Rmvl icd pulse gen only
|
$985.64 |
$985.64 |
$985.64 |
$4,114.00
|
|
Rmvl perm pm pulse gen
|
$5,672.45 |
$5,672.45 |
$5,672.45 |
$6,608.00
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$4,325.58 |
$4,325.58 |
$4,325.58 |
$10,427.04
|
|
Rmvl pq iabp
|
$4,563.41 |
$4,563.41 |
$4,563.41 |
$1,082.40
|
|
Rmvl pq vad left hrt vein sep session
|
$1,678.01 |
$1,678.01 |
$1,678.01 |
$2,722.30
|
|
Rmvl subq card rhythm mntr
|
$871.61 |
$871.61 |
$871.61 |
$1,991.00
|
|
Romiplostim 125 mcg subcutaneous solution
|
$1,872.88 |
$1,872.88 |
$1,872.88 |
$8,779.01
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$60.56 |
$60.56 |
$60.56 |
$180.55
|
|
Rp loclzj tum 2+area 1+d img
|
$662.76 |
$662.76 |
$662.76 |
$1,458.95
|
|
Rpl tun cvc wo subq port
|
$2,660.35 |
$2,660.35 |
$2,660.35 |
$4,201.80
|
|
Rsv assay w/optic
|
$46.20 |
$46.20 |
$46.20 |
$73.80
|
|
Rubella antibody igg
|
$55.86 |
$55.86 |
$55.86 |
$73.10
|
|
Rubeola antibody igg
|
$33.25 |
$33.25 |
$33.25 |
$79.68
|
|
Russell viper venom diluted
|
$56.97 |
$56.97 |
$56.97 |
$70.16
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$1,857.27 |
$1,857.27 |
$1,857.27 |
$6,466.16
|
|
Sarscov coronavirus ag ia
|
$60.20 |
$60.20 |
$60.20 |
$60.40
|
|
Sarscov & inf vir a&b ag ia
|
$60.20 |
$60.20 |
$60.20 |
$91.14
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,043.00 |
$1,043.00 |
$1,043.00 |
$1,012.55
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$657.30 |
$657.30 |
$657.30 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$553.00 |
$553.00 |
$553.00 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$330.05 |
$330.05 |
$330.05 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$747.25 |
$747.25 |
$747.25 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$740.95 |
$740.95 |
$740.95 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$548.45 |
$548.45 |
$548.45 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$494.48 |
$494.48 |
$494.48 |
$601.70
|
|
Screening Mammogram
|
$330.40 |
$330.40 |
$330.40 |
$303.55
|
|
Screening prostate cancer PSA
|
$89.67 |
$89.67 |
$89.67 |
$81.31
|
|
Screw cortex 2.0 x 10mm
|
$10,639.13 |
$10,639.13 |
$10,639.13 |
$28,440.67
|
|
Sec art mech thrmbc non-intracranial add-on
|
$998.87 |
$998.87 |
$998.87 |
$4,565.60
|
|
Sedimentation rate erythrocyte automated
|
$37.86 |
$37.86 |
$37.86 |
$44.20
|
|
Semen analysis w/count
|
$35.35 |
$35.35 |
$35.35 |
$56.44
|
|
Serial casting application 97139app
|
$55.65 |
$55.65 |
$55.65 |
$67.42
|
|
Set radiation therapy field
|
$1,797.60 |
$1,797.60 |
$1,797.60 |
$731.50
|
|
Set radiation therapy field
|
$2,966.25 |
$2,966.25 |
$2,966.25 |
$1,102.40
|
|
Set radiation therapy field
|
$2,995.95 |
$2,995.95 |
$2,995.95 |
$1,636.36
|
|
Shoulder MRI (with and without contrast)
|
$6,097.70 |
$6,097.70 |
$6,097.70 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$4,442.55 |
$4,442.55 |
$4,442.55 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$4,316.85 |
$4,316.85 |
$4,316.85 |
$2,051.28
|
|
Shoulder X-ray
|
$617.40 |
$617.40 |
$617.40 |
$367.02
|
|
Shunt glaucoma baerveldt 350mm
|
$8,268.75 |
$8,268.75 |
$8,268.75 |
$4,709.25
|
|
Shuntogram nonvascular supervision & interpretation
|
$341.67 |
$341.67 |
$341.67 |
$345.00
|
|
Sialography s&i
|
$561.96 |
$561.96 |
$561.96 |
$462.40
|
|
Sickling rbc
|
$9.45 |
$9.45 |
$9.45 |
$53.55
|
|
Sincalide 5 mcg solution for injection
|
$56.70 |
$56.70 |
$56.70 |
$409.96
|
|
Sinus CT scan (with and without contrast)
|
$3,552.85 |
$3,552.85 |
$3,552.85 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$2,936.15 |
$2,936.15 |
$2,936.15 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$2,467.15 |
$2,467.15 |
$2,467.15 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$3,364.90 |
$3,364.90 |
$3,364.90 |
$2,489.25
|
|
Skin Biopsy
|
$332.85 |
$332.85 |
$332.85 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$1,601.25 |
$1,601.25 |
$1,601.25 |
$3,936.80
|
|
Sleeve fing rolyan med
|
$167.00 |
$167.00 |
$167.00 |
$167.31
|
|
Sling suprapubic suburetheral
|
$5,084.56 |
$5,084.56 |
$5,084.56 |
$10,395.47
|
|
Slp eval non-spch gen comm dev
|
$114.03 |
$114.03 |
$114.03 |
$285.09
|
|
Slp ther svc non-spch gen
|
$84.42 |
$84.42 |
$84.42 |
$186.40
|
|
Smear fluorescent and/or acid fast stain
|
$19.25 |
$19.25 |
$19.25 |
$64.20
|
|
Smear gram stain
|
$54.03 |
$54.03 |
$54.03 |
$57.85
|
|
Smear nasal eosinophil
|
$12.92 |
$12.92 |
$12.92 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$94.19 |
$94.19 |
$94.19 |
$64.35
|
|
Smear wet mount
|
$60.27 |
$60.27 |
$60.27 |
$68.63
|
|
Sodium 24 hour urine
|
$81.04 |
$81.04 |
$81.04 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$23.60 |
$23.60 |
$23.60 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$23.88 |
$23.88 |
$23.88 |
$51.51
|
|
Sodium chloride 0.9 % IV bolus
|
$23.84 |
$23.84 |
$23.84 |
$46.35
|
|
Sodium chloride 3 % ivpb
|
$21.47 |
$21.47 |
$21.47 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$51.52 |
$51.52 |
$51.52 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$23.10 |
$23.10 |
$23.10 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$104.30 |
$104.30 |
$104.30 |
$223.86
|
|
Special physics consult
|
$282.80 |
$282.80 |
$282.80 |
$700.74
|
|
Special radiation dosimetry
|
$267.75 |
$267.75 |
$267.75 |
$445.50
|
|
Special radiation treatment
|
$2,992.02 |
$2,992.02 |
$2,992.02 |
$1,934.03
|
|
Special teletx port plan
|
$987.57 |
$987.57 |
$987.57 |
$1,046.65
|
|
Specific gravity body fluid
|
$5.67 |
$5.67 |
$5.67 |
$23.63
|
|
Speech evaluation complex
|
$352.80 |
$352.80 |
$352.80 |
$527.06
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$925.75 |
$925.75 |
$925.75 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$204.75 |
$204.75 |
$204.75 |
$559.96
|
|
Spleen imaging
|
$513.45 |
$513.45 |
$513.45 |
$539.70
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$201.81 |
$201.81 |
$201.81 |
$366.66
|
|
Splint func pos polyflex ii med
|
$22.11 |
$22.11 |
$22.11 |
$116.40
|
|
Split blood or products
|
$19.53 |
$19.53 |
$19.53 |
$148.98
|
|
St analysis behavior qualitative voice/resonance
|
$256.73 |
$256.73 |
$256.73 |
$300.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$14,634.20 |
$14,634.20 |
$14,634.20 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$13,340.25 |
$13,340.25 |
$13,340.25 |
$39,270.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$382.20 |
$382.20 |
$382.20 |
$1,206.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$2,572.62 |
$2,572.62 |
$2,572.62 |
$18,472.24
|
|
Stent iliac/open or perc/uni/init 37221
|
$3,707.87 |
$3,707.87 |
$3,707.87 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,080.70 |
$3,080.70 |
$3,080.70 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$14,634.20 |
$14,634.20 |
$14,634.20 |
$19,765.20
|
|
St evaluate speech sound production
|
$86.00 |
$86.00 |
$86.00 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$270.85 |
$270.85 |
$270.85 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$457.10 |
$457.10 |
$457.10 |
$406.40
|
|
St evaluation swallow function
|
$129.73 |
$129.73 |
$129.73 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$43.79 |
$43.79 |
$43.79 |
$248.05
|
|
Strapping of chest
|
$41.58 |
$41.58 |
$41.58 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$38.43 |
$38.43 |
$38.43 |
$171.00
|
