|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$1,777.20 |
$1,777.20 |
$1,777.20 |
$2,173.60
|
|
Rpl tun-cvad w subq port
|
$4,320.60 |
$4,320.60 |
$4,320.60 |
$4,647.04
|
|
Rpl tun cvc wo subq port
|
$4,344.60 |
$4,344.60 |
$4,344.60 |
$3,687.00
|
|
Rpm tx mgmt 1st 20 min
|
$54.60 |
$54.60 |
$54.60 |
$77.91
|
|
Rpm tx mgmt ea addl 20 min
|
$45.00 |
$45.00 |
$45.00 |
$101.25
|
|
Rpr blood vsl grf oth vein lo ex
|
$2,439.00 |
$2,439.00 |
$2,439.00 |
$5,983.35
|
|
Rpr nsl vlv collapse w/implt
|
$3,067.80 |
$3,067.80 |
$3,067.80 |
$7,606.40
|
|
Rsv assay w/optic
|
$39.00 |
$39.00 |
$39.00 |
$76.61
|
|
Rubella antibody igg
|
$77.40 |
$77.40 |
$77.40 |
$77.03
|
|
Rubeola antibody igg
|
$289.20 |
$289.20 |
$289.20 |
$80.00
|
|
Russell viper venom diluted
|
$293.40 |
$293.40 |
$293.40 |
$72.54
|
|
Salmonella antibody
|
$73.20 |
$73.20 |
$73.20 |
$37.58
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$139.20 |
$139.20 |
$139.20 |
$213.20
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$75.60 |
$75.60 |
$75.60 |
$109.85
|
|
Sbsq nursing facil care/day new problem 25 min
|
$96.60 |
$96.60 |
$96.60 |
$144.30
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,066.20 |
$1,066.20 |
$1,066.20 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$666.60 |
$666.60 |
$666.60 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$628.80 |
$628.80 |
$628.80 |
$750.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$163.20 |
$163.20 |
$163.20 |
$582.50
|
|
Scan duplex extremity veins unilateral/limited study
|
$721.20 |
$721.20 |
$721.20 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$822.60 |
$822.60 |
$822.60 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$651.60 |
$651.60 |
$651.60 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$651.60 |
$651.60 |
$651.60 |
$595.35
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$37.80 |
$37.80 |
$37.80 |
$57.60
|
|
Screening Mammogram
|
$198.60 |
$198.60 |
$198.60 |
$312.55
|
|
Screw cortex 2.0 x 10mm
|
$4,990.36 |
$4,990.36 |
$4,990.36 |
$29,055.00
|
|
Sec art mech thrmbc non-intracranial add-on
|
$7,528.80 |
$7,528.80 |
$7,528.80 |
$4,377.50
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$297.00 |
$297.00 |
$297.00 |
$237.19
|
|
Sedimentation rate erythrocyte automated
|
$66.00 |
$66.00 |
$66.00 |
$42.00
|
|
Semen analysis w/count
|
$108.00 |
$108.00 |
$108.00 |
$56.44
|
|
Serpina1 gene
|
$420.00 |
$420.00 |
$420.00 |
$195.65
|
|
Sevelamer carbonate 800 mg tablet
|
$3.00 |
$3.00 |
$3.00 |
$7.14
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$94.20 |
$94.20 |
$94.20 |
$284.88
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$55.20 |
$55.20 |
$55.20 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$70.80 |
$70.80 |
$70.80 |
$223.00
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$51.00 |
$51.00 |
$51.00 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$65.40 |
$65.40 |
$65.40 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$108.00 |
$108.00 |
$108.00 |
$289.30
|
|
Shoulder MRI (with and without contrast)
|
$3,183.00 |
$3,183.00 |
$3,183.00 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$3,243.60 |
$3,243.60 |
$3,243.60 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$3,243.60 |
$3,243.60 |
$3,243.60 |
$2,065.05
|
|
Shoulder X-ray
|
$486.60 |
$486.60 |
$486.60 |
$339.50
|
|
Shuntogram nonvascular supervision & interpretation
|
$60.00 |
$60.00 |
$60.00 |
$345.00
|
|
Sickling rbc
|
$85.20 |
$85.20 |
$85.20 |
$57.00
|
|
Sincalide 5 mcg solution for injection
|
$545.40 |
$545.40 |
$545.40 |
$309.04
|
|
Sinus CT scan (with and without contrast)
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,999.80 |
$1,999.80 |
$1,999.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$112.80 |
$112.80 |
$112.80 |
$2,489.25
|
|
Skin Biopsy
|
$61.20 |
$61.20 |
$61.20 |
$360.34
|
|
Sleep study attended
|
$2,011.80 |
$2,011.80 |
$2,011.80 |
$1,254.50
|
|
Sleep Study (Polysomnography)
|
$3,745.80 |
$3,745.80 |
$3,745.80 |
$3,598.50
|
|
Sling suprapubic suburetheral
|
$3,084.56 |
$3,084.56 |
$3,084.56 |
$9,679.96
|
|
Slp stdy unatnd w/anal
|
$494.40 |
$494.40 |
$494.40 |
$296.34
|
|
Smear fluorescent and/or acid fast stain
|
$201.60 |
$201.60 |
$201.60 |
$64.20
|
|
Smear gram stain
|
$37.20 |
$37.20 |
$37.20 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$132.60 |
$132.60 |
$132.60 |
$73.15
|
|
Sodium 24 hour urine
|
$105.00 |
$105.00 |
$105.00 |
$48.60
|
|
Sodium chloride 0.9 % IV bolus
|
$18.60 |
$18.60 |
$18.60 |
$45.56
|
|
Sodium chloride 3 % ivpb
|
$27.00 |
$27.00 |
$27.00 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$117.60 |
$117.60 |
$117.60 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$88.20 |
$88.20 |
$88.20 |
$45.50
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$927.00 |
$927.00 |
$927.00 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$468.00 |
$468.00 |
$468.00 |
$536.34
|
|
St analysis behavior qualitative voice/resonance
|
$438.00 |
$438.00 |
$438.00 |
$296.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$7,713.97 |
$7,713.97 |
$7,713.97 |
$32,403.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$5,115.60 |
$5,115.60 |
$5,115.60 |
$20,962.50
|
|
St evaluate speech sound production
|
$450.00 |
$450.00 |
$450.00 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$450.00 |
$450.00 |
$450.00 |
$376.84
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$775.80 |
$775.80 |
$775.80 |
$395.28
|
|
St evaluation swallow function
|
$592.20 |
$592.20 |
$592.20 |
$310.50
|
|
Strep b dna amp probe
|
$63.00 |
$63.00 |
$63.00 |
$120.90
|
|
St treatment speech individual
|
$277.80 |
$277.80 |
$277.80 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$232.20 |
$232.20 |
$232.20 |
$232.20
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$64.80 |
$64.80 |
$64.80 |
$52.31
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$5,785.80 |
$5,785.80 |
$5,785.80 |
$7,345.98
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$247.20 |
$247.20 |
$247.20 |
$112.74
|
|
Surgical pathology level 1 gross examination only
|
$203.40 |
$203.40 |
$203.40 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$358.20 |
$358.20 |
$358.20 |
$141.33
|
|
Surgical pathology level 3 gross & microscopic examination
|
$107.40 |
$107.40 |
$107.40 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$96.60 |
$96.60 |
$96.60 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,059.60 |
$1,059.60 |
$1,059.60 |
$477.24
|
|
Surgical pathology level 6 gross & microscopic examination
|
$4,461.60 |
$4,461.60 |
$4,461.60 |
$716.00
|
|
Susceptibility agar dilution per agent
|
$63.60 |
$63.60 |
$63.60 |
$45.00
|
|
Susceptibility mic per plate
|
$1,488.60 |
$1,488.60 |
$1,488.60 |
$106.20
|
|
Synvisc or synvisc-one
|
$90.60 |
$90.60 |
$90.60 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$36.00 |
$36.00 |
$36.00 |
$41.60
|
|
System pacing micra av
|
$16,334.64 |
$16,334.64 |
$16,334.64 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$9,933.08 |
$9,933.08 |
$9,933.08 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$348.60 |
$348.60 |
$348.60 |
$98.80
|
|
T3 (triiodothyronine) total
|
$199.80 |
$199.80 |
$199.80 |
$93.52
|
|
T4 (thyroxine) free
|
$185.40 |
$185.40 |
$185.40 |
$85.20
|
|
T4 (thyroxine) total
|
$189.00 |
$189.00 |
$189.00 |
$68.40
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$9.60 |
$9.60 |
$9.60 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$130.20 |
$130.20 |
$130.20 |
$121.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,698.00 |
$4,698.00 |
$4,698.00 |
$2,762.00
|
|
Talymed
|
$318.50 |
$318.50 |
$318.50 |
$3,411.49
|
|
Target gsa panel hmtlmph neop
|
$5,556.60 |
$5,556.60 |
$5,556.60 |
$2,246.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$132.60 |
$132.60 |
$132.60 |
$176.92
|
|
Tc-99m exametazime diag
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$2,033.20
|
