|
Special teletx port plan
|
$1,346.27 |
$1,346.27 |
$1,346.27 |
$1,086.99
|
|
Specific gravity body fluid
|
$28.32 |
$28.32 |
$28.32 |
$22.00
|
|
Specimen fat stain
|
$28.52 |
$28.52 |
$28.52 |
$35.10
|
|
Speech and Language Evaluation (comprehensive)
|
$505.93 |
$505.93 |
$505.93 |
$380.00
|
|
Speech audiometry complete
|
$137.93 |
$137.93 |
$137.93 |
$109.20
|
|
Speech evaluation complex
|
$409.97 |
$409.97 |
$409.97 |
$527.06
|
|
Speech recep thresh
|
$106.68 |
$106.68 |
$106.68 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$301.84 |
$301.84 |
$301.84 |
$248.84
|
|
Sperm antibody test
|
$74.27 |
$74.27 |
$74.27 |
$57.85
|
|
Sperm isolation complex
|
$272.32 |
$272.32 |
$272.32 |
$176.28
|
|
Sperm isolation simple
|
$239.21 |
$239.21 |
$239.21 |
$126.05
|
|
Sperm washing 58323
|
$174.22 |
$174.22 |
$174.22 |
$238.06
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$4,349.40 |
$4,349.40 |
$4,349.40 |
$3,245.23
|
|
Spinal bone allograftstructural 20931
|
$4,239.44 |
$4,239.44 |
$4,239.44 |
$266.40
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,010.48 |
$1,010.48 |
$1,010.48 |
$1,474.00
|
|
Spine X-ray (single view, one level)
|
$272.99 |
$272.99 |
$272.99 |
$251.40
|
|
Spirmtry w/brnchdil inf-2 yr
|
$117.09 |
$117.09 |
$117.09 |
$368.50
|
|
Spirometry up to 2 yrs old
|
$117.09 |
$117.09 |
$117.09 |
$242.25
|
|
Spleen imaging
|
$961.98 |
$961.98 |
$961.98 |
$679.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$392.09 |
$392.09 |
$392.09 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$83.19 |
$83.19 |
$83.19 |
$67.76
|
|
Splint finger 4 prong foam sm
|
$41.90 |
$41.90 |
$41.90 |
$34.00
|
|
Splint finger fold over sm
|
$157.15 |
$157.15 |
$157.15 |
$151.34
|
|
Splint finger frog med
|
$51.30 |
$51.30 |
$51.30 |
$38.08
|
|
Splint func pos polyflex ii med
|
$33.00 |
$33.00 |
$33.00 |
$61.64
|
|
Splint rstrc wrst/cmc right med
|
$107.85 |
$107.85 |
$107.85 |
$100.00
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$6,033.28 |
$6,033.28 |
$6,033.28 |
$4,687.20
|
|
Split blood or products
|
$217.64 |
$217.64 |
$217.64 |
$129.50
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$2,050.28 |
$2,050.28 |
$2,050.28 |
$1,612.78
|
|
Sprchoroidal spc njx rx agt
|
$4,624.43 |
$4,624.43 |
$4,624.43 |
$454.19
|
|
Sputum specimen collection
|
$120.46 |
$120.46 |
$120.46 |
$180.00
|
|
Srs linear based
|
$16,549.13 |
$16,549.13 |
$16,549.13 |
$14,124.25
|
|
Staggered spondaic word test
|
$263.71 |
$263.71 |
$263.71 |
$253.00
|
|
St analysis behavior qualitative voice/resonance
|
$376.38 |
$376.38 |
$376.38 |
$295.10
|
|
Staph a dna amp probe
|
$118.81 |
$118.81 |
$118.81 |
$125.00
|
|
Static or dynami afo pre ots
|
$217.65 |
$217.65 |
$217.65 |
$291.20
|
|
St cognitve performance testing healthcare professional each hour
|
$338.36 |
$338.36 |
$338.36 |
$281.00
|
|
Stem cells total count
|
$179.64 |
$179.64 |
$179.64 |
$184.00
|
|
Stenger test pure tone
|
$135.22 |
$135.22 |
$135.22 |
$77.84
|
|
Stenger test speech
|
$338.57 |
$338.57 |
$338.57 |
$404.25
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$45,173.71 |
$45,173.71 |
$45,173.71 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$50,985.00 |
$50,985.00 |
$50,985.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$6,120.24 |
$6,120.24 |
$6,120.24 |
$2,649.79
|
|
Stent bili rx wallflx 10x80 uncvr
|
$35,204.12 |
$35,204.12 |
$35,204.12 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$8,229.86 |
$8,229.86 |
$8,229.86 |
$4,673.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$20,498.09 |
$20,498.09 |
$20,498.09 |
$14,770.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$11,075.78 |
$11,075.78 |
$11,075.78 |
$8,985.00
|
|
Stent placemt retro carotid
|
$1,972.11 |
$1,972.11 |
$1,972.11 |
$5,328.00
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$29,957.43 |
$29,957.43 |
$29,957.43 |
$17,892.00
|
|
St evaluate speech sound production
|
$406.75 |
$406.75 |
$406.75 |
$289.20
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$519.26 |
$519.26 |
$519.26 |
$396.90
|
|
Stimulants synthetic
|
$95.66 |
$95.66 |
$95.66 |
$80.08
|
|
Stoma absorptive cover
|
$85.51 |
$85.51 |
$85.51 |
$85.51
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,719.11 |
$1,719.11 |
$1,719.11 |
$1,350.05
|
|
Storage/year embryo(s)
|
$420.61 |
$420.61 |
$420.61 |
$236.00
|
|
Storage/year oocyte(s)
|
$764.33 |
$764.33 |
$764.33 |
$236.00
|
|
Strapping of ankle and/or ft 29540
|
$302.39 |
$302.39 |
$302.39 |
$223.45
|
|
Strapping of chest
|
$196.93 |
$196.93 |
$196.93 |
$194.46
|
|
Strapping of elbow or wrist 29260
|
$216.94 |
$216.94 |
$216.94 |
$157.46
|
|
Strapping of hand or finger
|
$232.00 |
$232.00 |
$232.00 |
$177.45
|
|
Strapping of hip
|
$170.08 |
$170.08 |
$170.08 |
$164.70
|
|
Strapping of knee
|
$291.60 |
$291.60 |
$291.60 |
$205.20
|
|
Strapping of toes 29550
|
$215.28 |
$215.28 |
$215.28 |
$164.70
|
|
Strep a ag ia
|
$88.73 |
$88.73 |
$88.73 |
$75.40
|
|
Strep b dna amp probe
|
$179.57 |
$179.57 |
$179.57 |
$124.15
|
|
Stress test pulmonary
|
$613.00 |
$613.00 |
$613.00 |
$324.00
|
|
Stress tte complete
|
$2,879.71 |
$2,879.71 |
$2,879.71 |
$1,820.70
|
|
Str markers spec anal addl
|
$365.77 |
$365.77 |
$365.77 |
$479.17
|
|
Str markers specimen anal
|
$554.90 |
$554.90 |
$554.90 |
$751.50
|
|
Subdural tap fontanelle/sutur infant init 61000
|
$878.24 |
$878.24 |
$878.24 |
$878.24
|
|
Subq njx filling matrl 1cc/<
|
$717.28 |
$717.28 |
$717.28 |
$235.13
|
|
Subq njx fil matrl 5.1-10cc
|
$748.14 |
$748.14 |
$748.14 |
$988.00
|
|
Subsequent repair of nerve
|
$4,448.60 |
$4,448.60 |
$4,448.60 |
$4,448.60
|
|
Subtalar arthro w/deb
|
$2,777.50 |
$2,777.50 |
$2,777.50 |
$3,839.54
|
|
Subtalar arthro w/exc
|
$3,543.46 |
$3,543.46 |
$3,543.46 |
$7,907.11
|
|
Subtalar arthro w/fb rmvl
|
$3,406.76 |
$3,406.76 |
$3,406.76 |
$3,839.54
|
|
Subtalar arthro w/fusion
|
$8,407.18 |
$8,407.18 |
$8,407.18 |
$13,158.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$72.13 |
$72.13 |
$72.13 |
$54.80
|
|
Suction lipectomy head&neck
|
$4,827.13 |
$4,827.13 |
$4,827.13 |
$4,332.25
|
|
Suction lipectomy lwr extrem
|
$4,732.48 |
$4,732.48 |
$4,732.48 |
$5,661.00
|
|
Suction lipectomy trunk
|
$3,797.14 |
$3,797.14 |
$3,797.14 |
$4,385.50
|
|
Suction lipectomy upr extrem
|
$5,180.83 |
$5,180.83 |
$5,180.83 |
$4,544.00
|
|
Sugars multiple quant
|
$17.08 |
$17.08 |
$17.08 |
$44.19
|
|
Sugars single quant
|
$88.64 |
$88.64 |
$88.64 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$65,707.20 |
$65,707.20 |
$65,707.20 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$138.43 |
$138.43 |
$138.43 |
$82.46
|
|
Sulfonylurea screen qn-sendout
|
$241.66 |
$241.66 |
$241.66 |
$160.05
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$237.70 |
$237.70 |
$237.70 |
$126.63
|
|
Support clav 29.6-40.5in med
|
$175.89 |
$175.89 |
$175.89 |
$94.08
|
|
Surg dx exam anorectal
|
$2,814.85 |
$2,814.85 |
$2,814.85 |
$3,480.50
|
|
Surgery for urethra pouch
|
$4,892.98 |
$4,892.98 |
$4,892.98 |
$4,627.00
|
|
Surgery to stop leg growth
|
$4,294.43 |
$4,294.43 |
$4,294.43 |
$7,907.11
|
|
Surgery to stop leg growth
|
$4,294.43 |
$4,294.43 |
$4,294.43 |
$7,907.11
|
|
Surgical exposure prostate 55860
|
$3,891.34 |
$3,891.34 |
$3,891.34 |
$5,626.86
|
|
Surgical pathology level 1 gross examination only
|
$139.48 |
$139.48 |
$139.48 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$187.56 |
$187.56 |
$187.56 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$266.74 |
$266.74 |
$266.74 |
$181.31
|
|
Surgical pathology level 4 gross & microscopic examination
|
$474.00 |
$474.00 |
$474.00 |
$243.10
|
|
Surgical pathology level 5 gross & microscopic examination
|
$519.16 |
$519.16 |
$519.16 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$880.68 |
$880.68 |
$880.68 |
$720.75
|
