|
Set radiation therapy field
|
$963.20 |
$963.20 |
$963.20 |
$1,157.38
|
|
Set radiation therapy field
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$1,636.36
|
|
Sewhfo airplane without jnts cf
|
$935.20 |
$935.20 |
$935.20 |
$1,685.60
|
|
Sewhfo cap desgn w/jnt(s) cf
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$1,890.00
|
|
Sewhfo cap design without jnt cf
|
$935.20 |
$935.20 |
$935.20 |
$1,685.60
|
|
Sewho airplane w/jnt(s) cf
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$1,990.80
|
|
Sewho cap design w/jnt(s) cf
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$1,890.00
|
|
Sheath gldlight lasr 12fx50cm
|
$6,739.20 |
$6,739.20 |
$6,739.20 |
$6,570.70
|
|
Shoe metatarsal bar wedge ro
|
$24.80 |
$24.80 |
$24.80 |
$69.03
|
|
Shoe post-op mens m
|
$229.20 |
$229.20 |
$229.20 |
$52.20
|
|
Shoe sole wedge outside sole
|
$21.60 |
$21.60 |
$21.60 |
$77.00
|
|
Shoe wedge sach
|
$52.00 |
$52.00 |
$52.00 |
$171.44
|
|
Sho insert w arch toe filler
|
$315.20 |
$315.20 |
$315.20 |
$1,224.38
|
|
Shoulder MRI (with and without contrast)
|
$1,928.40 |
$1,928.40 |
$1,928.40 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$2,182.40 |
$2,182.40 |
$2,182.40 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$1,753.60 |
$1,753.60 |
$1,753.60 |
$2,065.05
|
|
Shoulder X-ray
|
$250.40 |
$250.40 |
$250.40 |
$339.50
|
|
Shrinker prosth above knee
|
$206.80 |
$206.80 |
$206.80 |
$168.89
|
|
Shrinker prosth below knee
|
$88.00 |
$88.00 |
$88.00 |
$105.12
|
|
Shunt glaucoma baerveldt 350mm
|
$5,052.00 |
$5,052.00 |
$5,052.00 |
$4,636.80
|
|
Shuntogram nonvascular supervision & interpretation
|
$386.40 |
$386.40 |
$386.40 |
$349.20
|
|
Sialidase enzyme assay
|
$31.20 |
$31.20 |
$31.20 |
$54.60
|
|
Sialography s&i
|
$718.00 |
$718.00 |
$718.00 |
$499.20
|
|
Sickling rbc
|
$13.20 |
$13.20 |
$13.20 |
$57.92
|
|
Silicon gel insert w/wo lock
|
$349.20 |
$349.20 |
$349.20 |
$840.00
|
|
Sim ang w/prs cath rad emb
|
$31,744.00 |
$31,744.00 |
$31,744.00 |
$18,145.20
|
|
Sincalide 5 mcg solution for injection
|
$120.96 |
$120.96 |
$120.96 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,163.20 |
$1,163.20 |
$1,163.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$911.60 |
$911.60 |
$911.60 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$3,522.40 |
$3,522.40 |
$3,522.40 |
$2,489.25
|
|
Sio rig pnl pelv/sac pre ots
|
$30.40 |
$30.40 |
$30.40 |
$418.75
|
|
Skeletal muscle relaxant 1/2
|
$122.00 |
$122.00 |
$122.00 |
$83.85
|
|
Skel musc relaxant 3 or more
|
$122.00 |
$122.00 |
$122.00 |
$16.12
|
|
Skin Biopsy
|
$288.80 |
$288.80 |
$288.80 |
$360.34
|
|
Skin test unlisted antigen ea
|
$68.00 |
$68.00 |
$68.00 |
$48.57
|
|
Sleep study attended
|
$572.00 |
$572.00 |
$572.00 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,611.20 |
$2,611.20 |
$2,611.20 |
$3,607.50
|
|
Sleep study unattended
|
$428.00 |
$428.00 |
$428.00 |
$580.87
|
|
Sling arm deluxe w/pad xs
|
$241.20 |
$241.20 |
$241.20 |
$30.35
|
|
Sling pelv split sam med
|
$241.20 |
$241.20 |
$241.20 |
$150.00
|
|
Sling suprapubic suburetheral
|
$16,991.60 |
$16,991.60 |
$16,991.60 |
$9,679.96
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$129.20 |
$129.20 |
$129.20 |
$129.20
|
|
Slp eval non-spch gen comm dev
|
$315.20 |
$315.20 |
$315.20 |
$285.09
|
|
Slp pure tone screening
|
$17.60 |
$17.60 |
$17.60 |
$60.48
|
|
Slp ther svc non-spch gen
|
$165.20 |
$165.20 |
$165.20 |
$188.50
|
|
Sm-153 lexidron ther
|
$25,860.40 |
$25,860.40 |
$25,860.40 |
$7,320.12
|
|
Smear fluorescent and/or acid fast stain
|
$13.20 |
$13.20 |
$13.20 |
$64.20
|
|
Smear gram stain
|
$11.20 |
$11.20 |
$11.20 |
$55.25
|
|
Smear nasal eosinophil
|
$12.00 |
$12.00 |
$12.00 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$15.20 |
$15.20 |
$15.20 |
$73.15
|
|
Smear wet mount
|
$21.60 |
$21.60 |
$21.60 |
$67.49
|
|
Smpd1 gene common variants
|
$91.20 |
$91.20 |
$91.20 |
$133.84
|
|
Snrpn/ube3a gene
|
$96.40 |
$96.40 |
$96.40 |
$231.85
|
|
So airplane w/wo joint cf
|
$658.00 |
$658.00 |
$658.00 |
$1,276.80
|
|
So cap design without jnts cf
|
$489.60 |
$489.60 |
$489.60 |
$606.35
|
|
Socket insert below knee
|
$216.80 |
$216.80 |
$216.80 |
$397.60
|
|
Socket insert without lock mech
|
$372.40 |
$372.40 |
$372.40 |
$1,192.50
|
|
Socket insert w lock mech
|
$447.20 |
$447.20 |
$447.20 |
$1,544.50
|
|
Sock fracture or equal each
|
$20.40 |
$20.40 |
$20.40 |
$74.51
|
|
Sodium 24 hour urine
|
$12.00 |
$12.00 |
$12.00 |
$48.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$4.88 |
$4.88 |
$4.88 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$12.00 |
$12.00 |
$12.00 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$1.39 |
$1.39 |
$1.39 |
$177.52
|
|
Soft interface below knee se
|
$50.80 |
$50.80 |
$50.80 |
$179.08
|
|
So vest canvas/web pre ots
|
$97.60 |
$97.60 |
$97.60 |
$256.54
|
|
Special physics consult
|
$466.00 |
$466.00 |
$466.00 |
$725.00
|
|
Special radiation dosimetry
|
$386.40 |
$386.40 |
$386.40 |
$392.50
|
|
Special radiation treatment
|
$1,454.40 |
$1,454.40 |
$1,454.40 |
$1,986.00
|
|
Special teletx port plan
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$1,086.99
|
|
Specific gravity body fluid
|
$4.40 |
$4.40 |
$4.40 |
$22.00
|
|
Specimen fat stain
|
$12.00 |
$12.00 |
$12.00 |
$35.10
|
|
Speech audiometry complete
|
$124.00 |
$124.00 |
$124.00 |
$109.20
|
|
Speech recep thresh
|
$112.40 |
$112.40 |
$112.40 |
$82.88
|
|
Sperm antibody test
|
$27.20 |
$27.20 |
$27.20 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,027.60 |
$2,027.60 |
$2,027.60 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$497.20 |
$497.20 |
$497.20 |
$543.26
|
|
Splint arm vnyl coated padded lft med
|
$225.20 |
$225.20 |
$225.20 |
$45.60
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$237.60 |
$237.60 |
$237.60 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$549.20 |
$549.20 |
$549.20 |
$68.25
|
|
Splint finger 4 prong foam sm
|
$18.40 |
$18.40 |
$18.40 |
$34.00
|
|
Splint finger frog med
|
$35.20 |
$35.20 |
$35.20 |
$38.08
|
|
Splint fing stax assort 1-7in
|
$3.60 |
$3.60 |
$3.60 |
$5.60
|
|
Splint func pos polyflex ii med
|
$160.00 |
$160.00 |
$160.00 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$253.60 |
$253.60 |
$253.60 |
$99.04
|
|
Split blood or products
|
$41.20 |
$41.20 |
$41.20 |
$127.48
|
|
Split flat caliper stirr & p
|
$54.00 |
$54.00 |
$54.00 |
$109.20
|
|
Srs linear based
|
$12,774.40 |
$12,774.40 |
$12,774.40 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$118.00 |
$118.00 |
$118.00 |
$297.60
|
|
Static or dynami afo pre ots
|
$420.80 |
$420.80 |
$420.80 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$189.20 |
$189.20 |
$189.20 |
$286.00
|
|
Stem cells total count
|
$95.60 |
$95.60 |
$95.60 |
$179.64
|
|
Stent axios caut enh 15x10mm electrocaut
|
$35,611.60 |
$35,611.60 |
$35,611.60 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$3,760.00 |
$3,760.00 |
$3,760.00 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$50,120.00 |
$50,120.00 |
$50,120.00 |
$20,962.50
|
|
Sterile needle
|
$648.00 |
$648.00 |
$648.00 |
$190.13
|
|
St evaluate speech sound production
|
$124.80 |
$124.80 |
$124.80 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$482.00 |
$482.00 |
$482.00 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$200.80 |
$200.80 |
$200.80 |
$399.60
|
|
St evaluation swallow function
|
$158.40 |
$158.40 |
$158.40 |
$314.40
|
