|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$226.05 |
$226.05 |
$226.05 |
$243.11
|
|
Rho d immune globulin 50 mcg
|
$75.20 |
$75.20 |
$75.20 |
$106.14
|
|
Rho(d) immune globulin h, sd
|
$10,755.18 |
$10,755.18 |
$10,755.18 |
$3,709.00
|
|
Rho d immune globulin inj
|
$255.60 |
$255.60 |
$255.60 |
$217.71
|
|
Ring barrier skin cx 1 9/16 adapt
|
$2.60 |
$2.60 |
$2.60 |
$2.60
|
|
Ring fx reform 11-13x17mm
|
$3,019.23 |
$3,019.23 |
$3,019.23 |
$1,509.75
|
|
Ring ostmy barr adapt 48mm
|
$3.81 |
$3.81 |
$3.81 |
$9.40
|
|
Risankizumab-rzaa 60 mg/ml intravenous solution
|
$19,415.72 |
$19,415.72 |
$19,415.72 |
$30,071.50
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$2,433.84 |
$2,433.84 |
$2,433.84 |
$2,429.37
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$9,301.22 |
$9,301.22 |
$9,301.22 |
$9,301.22
|
|
Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln
|
$13,021.63 |
$13,021.63 |
$13,021.63 |
$15,057.18
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$1,674.20 |
$1,674.20 |
$1,674.20 |
$5,343.99
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$1,419.27 |
$1,419.27 |
$1,419.27 |
$5,309.20
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$6,333.33 |
$6,333.33 |
$6,333.33 |
$6,333.33
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$4,820.04 |
$4,820.04 |
$4,820.04 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$534.96 |
$534.96 |
$534.96 |
$188.50
|
|
Rp loclzj tum spect w/ct 1
|
$3,199.20 |
$3,199.20 |
$3,199.20 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$3,199.20 |
$3,199.20 |
$3,199.20 |
$3,139.20
|
|
Rubella antibody igg
|
$123.30 |
$123.30 |
$123.30 |
$77.03
|
|
Rubeola antibody igg
|
$210.00 |
$210.00 |
$210.00 |
$80.00
|
|
Russell viper venom diluted
|
$372.30 |
$372.30 |
$372.30 |
$72.54
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$4,759.65 |
$4,759.65 |
$4,759.65 |
$5,174.32
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$724.65 |
$724.65 |
$724.65 |
$983.50
|
|
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
|
|
Scope uretscp lithovue dig disp
|
$6,480.00 |
$6,480.00 |
$6,480.00 |
$4,490.64
|
|
Screening prostate cancer PSA
|
$154.95 |
$154.95 |
$154.95 |
$100.63
|
|
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
|
|
Serial casting application 97139app
|
$103.50 |
$103.50 |
$103.50 |
$78.39
|
|
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 |
$105.12
|
|
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
|
$84.75 |
$84.75 |
$84.75 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$547.05 |
$547.05 |
$547.05 |
$1,351.63
|
|
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
|
|
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
|
|
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 nasal eosinophil
|
$78.30 |
$78.30 |
$78.30 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$206.70 |
$206.70 |
$206.70 |
$73.15
|
|
Smear wet mount
|
$132.15 |
$132.15 |
$132.15 |
$67.49
|
|
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 |
$74.51
|
|
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 |
$48.11
|
|
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 |
$45.60
|
|
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
|
|
Specific gravity body fluid
|
$19.50 |
$19.50 |
$19.50 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,776.65 |
$2,776.65 |
$2,776.65 |
$1,439.40
|
|
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 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$88.81 |
$88.81 |
$88.81 |
$99.04
|
|
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
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$610.35 |
$610.35 |
$610.35 |
$399.60
|
|
St evaluation swallow function
|
$457.80 |
$457.80 |
$457.80 |
$314.40
|
|
Strapping of elbow or wrist 29260
|
$225.15 |
$225.15 |
$225.15 |
$154.70
|
|
Strapping of hand or finger
|
$225.15 |
$225.15 |
$225.15 |
$174.82
|
|
Strep a ag ia
|
$141.00 |
$141.00 |
$141.00 |
$75.40
|
|
Streptomycin injection
|
$87.75 |
$87.75 |
$87.75 |
$138.30
|
