|
Pt application of modality traction mechanical
|
$48.15 |
$48.15 |
$48.15 |
$88.20
|
|
Pt evaluation high complexity patient/family
|
$178.20 |
$178.20 |
$178.20 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$143.01 |
$143.01 |
$143.01 |
$226.00
|
|
Pt evaluation moderate complexity patient/family
|
$155.88 |
$155.88 |
$155.88 |
$263.90
|
|
Pt re-evaluation patient/family
|
$120.24 |
$120.24 |
$120.24 |
$157.30
|
|
Pt repositioning canalith procedure(s) per day
|
$76.14 |
$76.14 |
$76.14 |
$123.92
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$49.68 |
$49.68 |
$49.68 |
$65.97
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$64.53 |
$64.53 |
$64.53 |
$85.68
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$62.55 |
$62.55 |
$62.55 |
$80.85
|
|
Pt wheelchair management each 15 minutes
|
$95.31 |
$95.31 |
$95.31 |
$85.00
|
|
Pulse ox continuous overnight monitoring
|
$230.58 |
$230.58 |
$230.58 |
$368.00
|
|
Pulse ox multiple
|
$54.18 |
$54.18 |
$54.18 |
$194.33
|
|
Puncture arterial withdrawal blood for diagnosis
|
$28.08 |
$28.08 |
$28.08 |
$127.50
|
|
Pyridoxine hcl 100 mg
|
$19.44 |
$19.44 |
$19.44 |
$43.24
|
|
Pyruvate
|
$55.44 |
$55.44 |
$55.44 |
$65.00
|
|
Pyruvate kinase
|
$102.78 |
$102.78 |
$102.78 |
$65.00
|
|
Quest t3 uptake
|
$142.11 |
$142.11 |
$142.11 |
$56.10
|
|
Rabies ig ht&sol human im/sc
|
$1,470.24 |
$1,470.24 |
$1,470.24 |
$5,401.91
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$6,561.63 |
$6,561.63 |
$6,561.63 |
$3,213.80
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$363.78 |
$363.78 |
$363.78 |
$2,014.64
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$9,810.27 |
$9,810.27 |
$9,810.27 |
$16,029.45
|
|
Ranibizumab injection
|
$3,907.35 |
$3,907.35 |
$3,907.35 |
$441.18
|
|
Rapid Strep Test
|
$105.66 |
$105.66 |
$105.66 |
$74.10
|
|
Ravulizumab-cwvz 100 mg/ml intravenous solution
|
$10,143.99 |
$10,143.99 |
$10,143.99 |
$35,836.29
|
|
Rbc count only automated
|
$9.72 |
$9.72 |
$9.72 |
$20.00
|
|
Red blood cells leukocytes reduced each unit
|
$295.56 |
$295.56 |
$295.56 |
$398.20
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$180.36 |
$180.36 |
$180.36 |
$489.60
|
|
Refill/maint pump/resvr syst
|
$288.09 |
$288.09 |
$288.09 |
$369.63
|
|
Remdesivir 100 mg intravenous powder for solution
|
$224.64 |
$224.64 |
$224.64 |
$1,864.71
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$315.54 |
$315.54 |
$315.54 |
$245.60
|
|
Renal function panel
|
$309.69 |
$309.69 |
$309.69 |
$110.10
|
|
Reptilase test
|
$150.66 |
$150.66 |
$150.66 |
$65.65
|
|
#resp virpnl dfa-adenovirus
|
$176.22 |
$176.22 |
$176.22 |
$48.00
|
|
#resp virpnl dfa-parainfluenza
|
$113.40 |
$113.40 |
$113.40 |
$35.20
|
|
Resuscitation cardiopulmonary
|
$406.71 |
$406.71 |
$406.71 |
$847.29
|
|
Resuscitation delivery/birthing room
|
$620.91 |
$620.91 |
$620.91 |
$797.29
|
|
Reticulocyte automated
|
$81.45 |
$81.45 |
$81.45 |
$54.60
|
|
Rheumatoid factor quantitative
|
$44.73 |
$44.73 |
$44.73 |
$58.00
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$17.82 |
$17.82 |
$17.82 |
$255.26
|
|
Risankizumab-rzaa 60 mg/ml intravenous solution
|
$394.74 |
$394.74 |
$394.74 |
$1,612.94
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$6.48 |
$6.48 |
$6.48 |
$2,233.44
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$1,177.93 |
$1,177.93 |
$1,177.93 |
$10,693.54
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$1,826.46 |
$1,826.46 |
$1,826.46 |
$6,877.90
|
|
Rituximab-arrx 10 mg/ml intravenous solution
|
$1,548.27 |
$1,548.27 |
$1,548.27 |
$4,200.39
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$31.05 |
$31.05 |
$31.05 |
$7,582.77
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$455.40 |
$455.40 |
$455.40 |
$7,269.05
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$31.32 |
$31.32 |
$31.32 |
$180.55
|
|
Rp loclzj tum spect w/ct 1
|
$1,880.82 |
$1,880.82 |
$1,880.82 |
$2,531.25
|
|
Rsv assay w/optic
|
$160.47 |
$160.47 |
$160.47 |
$73.80
|
|
Rubella antibody igg
|
$168.39 |
$168.39 |
$168.39 |
$73.10
|
|
Rubeola antibody igg
|
$115.20 |
$115.20 |
$115.20 |
$79.68
|
|
Russell viper venom diluted
|
$153.90 |
$153.90 |
$153.90 |
$70.16
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$869.40 |
$869.40 |
$869.40 |
$6,466.16
|
|
Salivary glnd img serial img
|
$701.73 |
$701.73 |
$701.73 |
$585.00
|
|
Salmonella antibody
|
$14.49 |
$14.49 |
$14.49 |
$37.58
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$610.74 |
$610.74 |
$610.74 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$389.61 |
$389.61 |
$389.61 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$716.76 |
$716.76 |
$716.76 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$269.46 |
$269.46 |
$269.46 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$279.00 |
$279.00 |
$279.00 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$649.62 |
$649.62 |
$649.62 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$335.34 |
$335.34 |
$335.34 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$561.06 |
$561.06 |
$561.06 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$395.73 |
$395.73 |
$395.73 |
$601.70
|
|
Scope uretscp lithovue dig disp
|
$4,490.64 |
$4,490.64 |
$4,490.64 |
$5,235.51
|
|
Screening Mammogram
|
$223.56 |
$223.56 |
$223.56 |
$303.55
|
|
Sedimentation rate erythrocyte automated
|
$28.44 |
$28.44 |
$28.44 |
$44.20
|
|
Semen analysis w/count
|
$27.09 |
$27.09 |
$27.09 |
$56.44
|
|
Shoulder MRI (with and without contrast)
|
$1,493.19 |
$1,493.19 |
$1,493.19 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$830.16 |
$830.16 |
$830.16 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$708.03 |
$708.03 |
$708.03 |
$2,051.28
|
|
Shoulder X-ray
|
$169.56 |
$169.56 |
$169.56 |
$367.02
|
|
Shuntogram nonvascular supervision & interpretation
|
$342.54 |
$342.54 |
$342.54 |
$345.00
|
|
Sickling rbc
|
$86.31 |
$86.31 |
$86.31 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$1,846.98 |
$1,846.98 |
$1,846.98 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,301.58 |
$1,301.58 |
$1,301.58 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,072.35 |
$1,072.35 |
$1,072.35 |
$1,279.50
|
|
Sleeve fing rolyan med
|
$167.31 |
$167.31 |
$167.31 |
$167.31
|
|
Sling arm deluxe w/pad xs
|
$15.48 |
$15.48 |
$15.48 |
$25.55
|
|
Slp eval non-spch gen comm dev
|
$135.00 |
$135.00 |
$135.00 |
$285.09
|
|
Slp pure tone screening
|
$18.09 |
$18.09 |
$18.09 |
$67.60
|
|
Slp ther svc non-spch gen
|
$139.95 |
$139.95 |
$139.95 |
$186.40
|
|
Smear fluorescent and/or acid fast stain
|
$129.69 |
$129.69 |
$129.69 |
$64.20
|
|
Smear gram stain
|
$90.63 |
$90.63 |
$90.63 |
$57.85
|
|
Smear nasal eosinophil
|
$90.63 |
$90.63 |
$90.63 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$68.85 |
$68.85 |
$68.85 |
$64.35
|
|
Smear wet mount
|
$115.92 |
$115.92 |
$115.92 |
$68.63
|
|
Sodium 24 hour urine
|
$50.04 |
$50.04 |
$50.04 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$31.05 |
$31.05 |
$31.05 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$25.49 |
$25.49 |
$25.49 |
$51.51
|
|
Sodium chloride 0.9 % IV bolus
|
$31.05 |
$31.05 |
$31.05 |
$46.35
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$20.83 |
$20.83 |
$20.83 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$44.10 |
$44.10 |
$44.10 |
$42.70
|
|
Specific gravity body fluid
|
$16.83 |
$16.83 |
$16.83 |
$23.63
|
|
Specimen fat stain
|
$32.76 |
$32.76 |
$32.76 |
$32.76
|
|
Speech evaluation complex
|
$583.02 |
$583.02 |
$583.02 |
$527.06
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$780.03 |
$780.03 |
$780.03 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$252.54 |
$252.54 |
$252.54 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$366.66 |
$366.66 |
$366.66 |
$366.66
|
|
Splint extn xsm w sof-stretch rolyan
|
$58.23 |
$58.23 |
$58.23 |
$41.58
|