|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$31.05 |
$31.05 |
$31.05 |
$7,582.77
|
|
R&l hrt cath chd abnl nt cnj
|
$4,925.61 |
$4,925.61 |
$4,925.61 |
$5,173.00
|
|
R&l hrt cath chd nml nt cnj
|
$4,925.61 |
$4,925.61 |
$4,925.61 |
$5,173.00
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$35,549.10 |
$35,549.10 |
$35,549.10 |
$26,561.92
|
|
Rmvl icd pulse gen only
|
$3,293.01 |
$3,293.01 |
$3,293.01 |
$4,114.00
|
|
Rmvl sq defib electrode
|
$3,293.01 |
$3,293.01 |
$3,293.01 |
$4,306.60
|
|
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
|
$230.67 |
$230.67 |
$230.67 |
$180.55
|
|
Routine footcare pt w lops
|
$125.64 |
$125.64 |
$125.64 |
$235.13
|
|
Rp loclzj tum spect w/ct 1
|
$1,645.38 |
$1,645.38 |
$1,645.38 |
$2,531.25
|
|
Rp loclzj tum spect w/ct 2
|
$1,755.90 |
$1,755.90 |
$1,755.90 |
$3,074.50
|
|
Rsv assay w/optic
|
$157.50 |
$157.50 |
$157.50 |
$73.80
|
|
Rubella antibody igg
|
$108.27 |
$108.27 |
$108.27 |
$73.10
|
|
Rubeola antibody igg
|
$97.02 |
$97.02 |
$97.02 |
$79.68
|
|
Russell viper venom diluted
|
$141.21 |
$141.21 |
$141.21 |
$70.16
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$869.40 |
$869.40 |
$869.40 |
$6,466.16
|
|
Salivary gland function exam
|
$267.48 |
$267.48 |
$267.48 |
$549.70
|
|
Salivary gland imaging
|
$797.67 |
$797.67 |
$797.67 |
$549.70
|
|
Salivary glnd img serial img
|
$917.28 |
$917.28 |
$917.28 |
$585.00
|
|
Salmonella antibody
|
$20.07 |
$20.07 |
$20.07 |
$37.58
|
|
Sargramostim injection
|
$15.93 |
$15.93 |
$15.93 |
$451.34
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,088.19 |
$1,088.19 |
$1,088.19 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$560.34 |
$560.34 |
$560.34 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$469.17 |
$469.17 |
$469.17 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$387.18 |
$387.18 |
$387.18 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$380.52 |
$380.52 |
$380.52 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$577.71 |
$577.71 |
$577.71 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,058.94 |
$1,058.94 |
$1,058.94 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$645.21 |
$645.21 |
$645.21 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$461.07 |
$461.07 |
$461.07 |
$601.70
|
|
Screening Mammogram
|
$243.90 |
$243.90 |
$243.90 |
$303.55
|
|
Sc ther infusion reset pump
|
$112.05 |
$112.05 |
$112.05 |
$126.75
|
|
Sedimentation rate erythrocyte automated
|
$101.25 |
$101.25 |
$101.25 |
$44.20
|
|
Select picture audiometry
|
$71.64 |
$71.64 |
$71.64 |
$81.12
|
|
Semen analysis w/count
|
$30.06 |
$30.06 |
$30.06 |
$56.44
|
|
Shoulder MRI (with and without contrast)
|
$2,041.20 |
$2,041.20 |
$2,041.20 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$1,757.61 |
$1,757.61 |
$1,757.61 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$1,103.76 |
$1,103.76 |
$1,103.76 |
$2,051.28
|
|
Shoulder X-ray
|
$367.02 |
$367.02 |
$367.02 |
$367.02
|
|
Shuntogram nonvascular supervision & interpretation
|
$308.79 |
$308.79 |
$308.79 |
$345.00
|
|
Sialography s&i
|
$399.42 |
$399.42 |
$399.42 |
$462.40
|
|
Sickling rbc
|
$69.03 |
$69.03 |
$69.03 |
$53.55
|
|
Simple cystometrogram 51725
|
$431.73 |
$431.73 |
$431.73 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$48.06 |
$48.06 |
$48.06 |
$409.96
|
|
Sinus CT scan (with and without contrast)
|
$1,526.76 |
$1,526.76 |
$1,526.76 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,389.24 |
$1,389.24 |
$1,389.24 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,292.04 |
$1,292.04 |
$1,292.04 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$980.28 |
$980.28 |
$980.28 |
$2,489.25
|
|
Sirolimus, oral
|
$17.55 |
$17.55 |
$17.55 |
$31.60
|
|
Skin test unlisted antigen ea
|
$55.89 |
$55.89 |
$55.89 |
$39.77
|
|
Sleep study attended
|
$427.05 |
$427.05 |
$427.05 |
$1,237.08
|
|
Sleep Study (Polysomnography)
|
$1,528.29 |
$1,528.29 |
$1,528.29 |
$3,936.80
|
|
Sleep study unattended
|
$311.13 |
$311.13 |
$311.13 |
$595.50
|
|
Sleeve fing rolyan med
|
$167.31 |
$167.31 |
$167.31 |
$167.31
|
|
Sling arm deluxe w/pad xs
|
$13.14 |
$13.14 |
$13.14 |
$25.55
|
|
Slp eval non-spch gen comm dev
|
$199.53 |
$199.53 |
$199.53 |
$285.09
|
|
Slp pure tone screening
|
$55.53 |
$55.53 |
$55.53 |
$67.60
|
|
Slp stdy unatnd w/anal
|
$206.82 |
$206.82 |
$206.82 |
$307.50
|
|
Slp ther svc non-spch gen
|
$139.95 |
$139.95 |
$139.95 |
$186.40
|
|
Smear fluorescent and/or acid fast stain
|
$88.74 |
$88.74 |
$88.74 |
$64.20
|
|
Smear gram stain
|
$58.05 |
$58.05 |
$58.05 |
$57.85
|
|
Smear nasal eosinophil
|
$30.96 |
$30.96 |
$30.96 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$63.27 |
$63.27 |
$63.27 |
$64.35
|
|
Smear wet mount
|
$70.02 |
$70.02 |
$70.02 |
$68.63
|
|
Sodium 24 hour urine
|
$74.61 |
$74.61 |
$74.61 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$31.05 |
$31.05 |
$31.05 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$20.88 |
$20.88 |
$20.88 |
$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
|
$80.73 |
$80.73 |
$80.73 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$46.26 |
$46.26 |
$46.26 |
$42.70
|
|
Specific gravity body fluid
|
$12.87 |
$12.87 |
$12.87 |
$23.63
|
|
Specimen fat stain
|
$25.11 |
$25.11 |
$25.11 |
$32.76
|
|
Speech audiometry complete
|
$27.81 |
$27.81 |
$27.81 |
$104.25
|
|
Speech evaluation complex
|
$284.94 |
$284.94 |
$284.94 |
$527.06
|
|
Speech recep thresh
|
$48.24 |
$48.24 |
$48.24 |
$90.60
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$794.52 |
$794.52 |
$794.52 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$793.44 |
$793.44 |
$793.44 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$433.89 |
$433.89 |
$433.89 |
$366.66
|
|
Splint extn xsm w sof-stretch rolyan
|
$58.23 |
$58.23 |
$58.23 |
$41.58
|
|
Splint finger frog med
|
$44.64 |
$44.64 |
$44.64 |
$21.50
|
|
Splint rstrc wrst/cmc right med
|
$74.97 |
$74.97 |
$74.97 |
$73.11
|
|
Split blood or products
|
$70.92 |
$70.92 |
$70.92 |
$148.98
|
|
St analysis behavior qualitative voice/resonance
|
$270.18 |
$270.18 |
$270.18 |
$300.00
|
|
Staph a dna amp probe
|
$313.92 |
$313.92 |
$313.92 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$258.21 |
$258.21 |
$258.21 |
$313.96
|
|
Stem cells total count
|
$108.72 |
$108.72 |
$108.72 |
$130.90
|
|
Stenger test speech
|
$75.60 |
$75.60 |
$75.60 |
$404.25
|
|
St evaluate speech sound production
|
$265.50 |
$265.50 |
$265.50 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$285.66 |
$285.66 |
$285.66 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$223.02 |
$223.02 |
$223.02 |
$406.40
|
|
St evaluation swallow function
|
$189.09 |
$189.09 |
$189.09 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$81.09 |
$81.09 |
$81.09 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$77.22 |
$77.22 |
$77.22 |
$171.00
|
|
Strapping of hand or finger
|
$102.69 |
$102.69 |
$102.69 |
$194.40
|
|
Strapping of hip
|
$9.63 |
$9.63 |
$9.63 |
$170.08
|
|
Strapping of knee
|
$75.42 |
$75.42 |
$75.42 |
$224.80
|
|
Strep b dna amp probe
|
$262.08 |
$262.08 |
$262.08 |
$139.20
|
|
Streptomycin injection
|
$9.27 |
$9.27 |
$9.27 |
$100.00
|
|
Streptozocin injection
|
$131.76 |
$131.76 |
$131.76 |
$954.71
|
|
Stress test pulmonary
|
$157.41 |
$157.41 |
$157.41 |
$327.20
|
