|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$574.56 |
$574.56 |
$574.56 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$654.36 |
$654.36 |
$654.36 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$661.77 |
$661.77 |
$661.77 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,584.60 |
$1,584.60 |
$1,584.60 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$792.30 |
$792.30 |
$792.30 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$792.30 |
$792.30 |
$792.30 |
$601.70
|
|
Scope plantar fasciotomy
|
$615.60 |
$615.60 |
$615.60 |
$3,821.05
|
|
Screening Colonoscopy (average risk)
|
$372.21 |
$372.21 |
$372.21 |
$1,278.72
|
|
Screening Colonoscopy (high risk)
|
$372.78 |
$372.78 |
$372.78 |
$1,575.00
|
|
Screening Mammogram
|
$309.51 |
$309.51 |
$309.51 |
$303.55
|
|
Screening prostate cancer PSA
|
$33.06 |
$33.06 |
$33.06 |
$100.80
|
|
Screen/visual acuity/bilat/quant 99173
|
$9.69 |
$9.69 |
$9.69 |
$28.86
|
|
Sedimentation rate erythrocyte automated
|
$11.40 |
$11.40 |
$11.40 |
$44.20
|
|
Semen analysis presence/motility
|
$20.52 |
$20.52 |
$20.52 |
$70.85
|
|
Semen analysis w/count
|
$29.07 |
$29.07 |
$29.07 |
$56.44
|
|
Sertraline (zoloft) - sendout
|
$55.29 |
$55.29 |
$55.29 |
$173.16
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$201.78 |
$201.78 |
$201.78 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$254.79 |
$254.79 |
$254.79 |
$286.89
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$296.40 |
$296.40 |
$296.40 |
$442.61
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$165.87 |
$165.87 |
$165.87 |
$258.40
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$226.29 |
$226.29 |
$226.29 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$268.47 |
$268.47 |
$268.47 |
$275.88
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$164.73 |
$164.73 |
$164.73 |
$311.25
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$223.44 |
$223.44 |
$223.44 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$266.76 |
$266.76 |
$266.76 |
$302.55
|
|
Sho arthrs srg bicp tenodsis
|
$1,516.77 |
$1,516.77 |
$1,516.77 |
$5,419.00
|
|
Sho arthrs srg capsulorraphy
|
$1,749.33 |
$1,749.33 |
$1,749.33 |
$5,419.00
|
|
Sho arthrs srg lmtd dbrdmt
|
$852.72 |
$852.72 |
$852.72 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$1,695.75 |
$1,695.75 |
$1,695.75 |
$5,419.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$966.15 |
$966.15 |
$966.15 |
$3,839.54
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$1,818.30 |
$1,818.30 |
$1,818.30 |
$6,839.00
|
|
Shoulder MRI (with and without contrast)
|
$2,533.08 |
$2,533.08 |
$2,533.08 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$2,442.45 |
$2,442.45 |
$2,442.45 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$2,348.40 |
$2,348.40 |
$2,348.40 |
$2,051.28
|
|
Shoulder X-ray
|
$153.90 |
$153.90 |
$153.90 |
$367.02
|
|
Sickling rbc
|
$17.10 |
$17.10 |
$17.10 |
$53.55
|
|
Sigmoidoscopy and biopsy
|
$67.26 |
$67.26 |
$67.26 |
$1,351.63
|
|
Sigmoidoscopy/submucosal injection 45335
|
$87.78 |
$87.78 |
$87.78 |
$1,374.60
|
|
Sinus CT scan (with and without contrast)
|
$834.48 |
$834.48 |
$834.48 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$670.32 |
$670.32 |
$670.32 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$548.91 |
$548.91 |
$548.91 |
$1,279.50
|
|
Skin Biopsy
|
$247.95 |
$247.95 |
$247.95 |
$382.80
|
|
Skin split graft addl 100sq cm 15101
|
$169.86 |
$169.86 |
$169.86 |
$460.00
|
|
Skyla, 13.5 mg
|
$771.78 |
$771.78 |
$771.78 |
$1,801.20
|
|
Sleep Study (Polysomnography)
|
$4,056.12 |
$4,056.12 |
$4,056.12 |
$3,936.80
|
|
Sleep study unattended
|
$726.18 |
$726.18 |
$726.18 |
$595.50
|
|
Sleeve fing rolyan med
|
$533.52 |
$533.52 |
$533.52 |
$197.40
|
|
Sling pelv split sam med
|
$144.21 |
$144.21 |
$144.21 |
$115.20
|
|
Slp pure tone screening
|
$26.22 |
$26.22 |
$26.22 |
$67.60
|
|
Smear fluorescent and/or acid fast stain
|
$35.91 |
$35.91 |
$35.91 |
$64.20
|
|
Smear gram stain
|
$33.06 |
$33.06 |
$33.06 |
$57.85
|
|
Smear nasal eosinophil
|
$18.24 |
$18.24 |
$18.24 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$22.80 |
$22.80 |
$22.80 |
$64.35
|
|
Smear wet mount
|
$33.63 |
$33.63 |
$33.63 |
$68.63
|
|
Snrpn/ube3a gene
|
$221.16 |
$221.16 |
$221.16 |
$228.80
|
|
Sodium 24 hour urine
|
$23.94 |
$23.94 |
$23.94 |
$48.50
|
|
Sodium chloride 0.9 % IV bolus
|
$1.14 |
$1.14 |
$1.14 |
$43.78
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$14.25 |
$14.25 |
$14.25 |
$84.80
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$109.44 |
$109.44 |
$109.44 |
$539.57
|
|
Sodium serum/plasma/whole blood
|
$19.38 |
$19.38 |
$19.38 |
$42.70
|
|
Specific gravity body fluid
|
$7.41 |
$7.41 |
$7.41 |
$23.63
|
|
Speech audiometry complete
|
$62.13 |
$62.13 |
$62.13 |
$104.25
|
|
Speech recep thresh
|
$41.04 |
$41.04 |
$41.04 |
$90.60
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$396.72 |
$396.72 |
$396.72 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$1,267.11 |
$1,267.11 |
$1,267.11 |
$380.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$164.16 |
$164.16 |
$164.16 |
$52.65
|
|
Splint finger frog med
|
$103.74 |
$103.74 |
$103.74 |
$27.95
|
|
St analysis behavior qualitative voice/resonance
|
$178.41 |
$178.41 |
$178.41 |
$300.00
|
|
Staph a dna amp probe
|
$108.87 |
$108.87 |
$108.87 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$212.61 |
$212.61 |
$212.61 |
$313.96
|
|
St evaluate speech sound production
|
$168.15 |
$168.15 |
$168.15 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$310.08 |
$310.08 |
$310.08 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$271.32 |
$271.32 |
$271.32 |
$406.40
|
|
St evaluation swallow function
|
$410.97 |
$410.97 |
$410.97 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$109.44 |
$109.44 |
$109.44 |
$248.05
|
|
Strep b dna amp probe
|
$118.56 |
$118.56 |
$118.56 |
$139.20
|
|
Stress test pulmonary
|
$164.16 |
$164.16 |
$164.16 |
$327.20
|
|
St treatment speech individual
|
$165.87 |
$165.87 |
$165.87 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$226.29 |
$226.29 |
$226.29 |
$261.60
|
|
Sulfonylurea screen qn-sendout
|
$127.68 |
$127.68 |
$127.68 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$53.58 |
$53.58 |
$53.58 |
$151.29
|
|
Surgical pathology level 1 gross examination only
|
$39.90 |
$39.90 |
$39.90 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$55.29 |
$55.29 |
$55.29 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$83.22 |
$83.22 |
$83.22 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$385.32 |
$385.32 |
$385.32 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$199.50 |
$199.50 |
$199.50 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$478.80 |
$478.80 |
$478.80 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$18.24 |
$18.24 |
$18.24 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$18.24 |
$18.24 |
$18.24 |
$34.48
|
|
Susceptibility mic per plate
|
$52.44 |
$52.44 |
$52.44 |
$94.38
|
|
Synvisc or synvisc-one
|
$14.82 |
$14.82 |
$14.82 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$14.25 |
$14.25 |
$14.25 |
$44.85
|
|
T3 (triiodothyronine) free
|
$50.16 |
$50.16 |
$50.16 |
$89.82
|
|
T3 (triiodothyronine) total
|
$51.87 |
$51.87 |
$51.87 |
$94.90
|
|
T4 (thyroxine) free
|
$50.16 |
$50.16 |
$50.16 |
$81.60
|
|
T4 (thyroxine) total
|
$38.19 |
$38.19 |
$38.19 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.59 |
$2.59 |
$2.59 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$40.47 |
$40.47 |
$40.47 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.64 |
$1.64 |
$1.64 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$213.18 |
$213.18 |
$213.18 |
$200.00
|