|
Antidepressants class 6/more
|
$0.95 |
$0.95 |
$0.95 |
$29.21
|
|
Antiepileptics nos 7/more
|
$0.76 |
$0.76 |
$0.76 |
$16.24
|
|
Antigen therapy services
|
$1.52 |
$1.52 |
$1.52 |
$73.84
|
|
Antigen therapy services
|
$1.52 |
$1.52 |
$1.52 |
$96.72
|
|
Antigen therapy services
|
$1.52 |
$1.52 |
$1.52 |
$70.07
|
|
Anti mog serum - sendout
|
$33.25 |
$33.25 |
$33.25 |
$159.03
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$2.29 |
$2.29 |
$2.29 |
$40.00
|
|
Ant instr 2-3 vert segm 22845
|
$448.40 |
$448.40 |
$448.40 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$466.64 |
$466.64 |
$466.64 |
$1,430.40
|
|
Antinuclear antibodies
|
$40.47 |
$40.47 |
$40.47 |
$89.40
|
|
Antinuclear antibodies titer
|
$39.14 |
$39.14 |
$39.14 |
$74.75
|
|
Antiphosphatidylserine antibody
|
$5.15 |
$5.15 |
$5.15 |
$60.00
|
|
Antipsychotics nos 1-3
|
$32.49 |
$32.49 |
$32.49 |
$142.42
|
|
Antipsychotics nos 7/more
|
$0.76 |
$0.76 |
$0.76 |
$16.24
|
|
Antistreptolysin o titer
|
$27.55 |
$27.55 |
$27.55 |
$51.45
|
|
Antithrombin iii activity
|
$2.36 |
$2.36 |
$2.36 |
$114.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$562.97 |
$562.97 |
$562.97 |
$4,155.20
|
|
Aortic dysfunction/dilation
|
$120.84 |
$120.84 |
$120.84 |
$992.40
|
|
Aortic dysfunction/dilation
|
$323.76 |
$323.76 |
$323.76 |
$1,485.21
|
|
Apc gene dup/delet variants
|
$40.58 |
$40.58 |
$40.58 |
$400.00
|
|
Apc gene full sequence
|
$143.85 |
$143.85 |
$143.85 |
$1,255.02
|
|
Apheresis plasma
|
$1,168.31 |
$1,168.31 |
$1,168.31 |
$3,192.96
|
|
Apheresis platelets
|
$1,035.69 |
$1,035.69 |
$1,035.69 |
$2,037.10
|
|
Apheresis rbc
|
$1,398.21 |
$1,398.21 |
$1,398.21 |
$3,146.15
|
|
Apheresis wbc
|
$1,035.69 |
$1,035.69 |
$1,035.69 |
$2,961.82
|
|
Apl(pml-rara) quant - sendout
|
$39.39 |
$39.39 |
$39.39 |
$465.60
|
|
Appendectomy
|
$409.07 |
$409.07 |
$409.07 |
$5,681.93
|
|
Appendectomy add-on 44955
|
$52.06 |
$52.06 |
$52.06 |
$187.32
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$557.08 |
$557.08 |
$557.08 |
$1,562.44
|
|
Appendix Removal (Laparoscopic)
|
$387.41 |
$387.41 |
$387.41 |
$6,904.15
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,104.09 |
$1,104.09 |
$1,104.09 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$35.15 |
$35.15 |
$35.15 |
$843.84
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$15.77 |
$15.77 |
$15.77 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,209.51 |
$2,209.51 |
$2,209.51 |
$3,271.80
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$240.16 |
$240.16 |
$240.16 |
$1,083.94
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$113.43 |
$113.43 |
$113.43 |
$498.81
|
|
Application clubfoot cast
|
$73.15 |
$73.15 |
$73.15 |
$297.33
|
|
Application finger splntstatic 29130
|
$76.76 |
$76.76 |
$76.76 |
$208.16
|
|
Application long leg splint 29505
|
$111.34 |
$111.34 |
$111.34 |
$338.25
|
|
Application lower leg splint 29515
|
$111.34 |
$111.34 |
$111.34 |
$334.20
|
|
Application multi layer compression below knee (both sides)
|
$179.93 |
$179.93 |
$179.93 |
$370.92
|
|
Application of cylinder cast 29365
|
$57.95 |
$57.95 |
$57.95 |
$421.50
|
|
Application of forearm cast 29075
|
$42.18 |
$42.18 |
$42.18 |
$339.30
|
|
Application of long arm cast 29065
|
$45.60 |
$45.60 |
$45.60 |
$395.00
|
|
Application of long leg cast
|
$69.73 |
$69.73 |
$69.73 |
$426.00
|
|
Application of long leg cast 29345
|
$65.55 |
$65.55 |
$65.55 |
$455.00
|
|
Application of paste boot 29580
|
$179.93 |
$179.93 |
$179.93 |
$331.74
|
|
Application short leg cast 29405
|
$39.33 |
$39.33 |
$39.33 |
$384.78
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$557.46 |
$557.46 |
$557.46 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$557.46 |
$557.46 |
$557.46 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$42.56 |
$42.56 |
$42.56 |
$895.00
|
|
Appl mltpln uni ext fixj sys
|
$749.17 |
$749.17 |
$749.17 |
$5,668.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$33.06 |
$33.06 |
$33.06 |
$66.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$28.12 |
$28.12 |
$28.12 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$10.26 |
$10.26 |
$10.26 |
$284.05
|
|
Appl patllr tdn bearing cast
|
$57.38 |
$57.38 |
$57.38 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$393.49 |
$393.49 |
$393.49 |
$5,855.00
|
|
Apply forearm splintdynamic 29126
|
$93.10 |
$93.10 |
$93.10 |
$246.18
|
|
Apply hand/wrist cast 29085
|
$45.41 |
$45.41 |
$45.41 |
$264.75
|
|
Apply interstit radiat compl
|
$1,290.86 |
$1,290.86 |
$1,290.86 |
$2,910.05
|
|
Apply intrcav radiat compl
|
$311.98 |
$311.98 |
$311.98 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$311.98 |
$311.98 |
$311.98 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$311.98 |
$311.98 |
$311.98 |
$1,207.14
|
|
Apply of finger splint 29131
|
$30.40 |
$30.40 |
$30.40 |
$170.95
|
|
Apply rem fixation device
|
$149.15 |
$149.15 |
$149.15 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$350.36 |
$350.36 |
$350.36 |
$555.00
|
|
Apply r&l pulm art bands
|
$1,009.09 |
$1,009.09 |
$1,009.09 |
$5,532.80
|
|
Apply short leg castambul type 29425
|
$36.29 |
$36.29 |
$36.29 |
$384.59
|
|
Aquaporin-4 antibody cba each
|
$57.00 |
$57.00 |
$57.00 |
$140.84
|
|
Aquaporin-4 antibody elisa
|
$2.19 |
$2.19 |
$2.19 |
$148.85
|
|
Aquatic exercise - group charge
|
$30.40 |
$30.40 |
$30.40 |
$86.40
|
|
Art byp aor celiac msn and renal 35631
|
$1,109.79 |
$1,109.79 |
$1,109.79 |
$5,701.80
|
|
Art byp aortofemoral 35647
|
$923.97 |
$923.97 |
$923.97 |
$2,358.00
|
|
Art byp aortoiliac 35637
|
$994.84 |
$994.84 |
$994.84 |
$2,942.40
|
|
Art bypass aorsubcl/carot/innom 35626
|
$974.32 |
$974.32 |
$974.32 |
$7,576.40
|
|
Art bypass aortobifemoral 35646
|
$1,023.72 |
$1,023.72 |
$1,023.72 |
$3,443.40
|
|
Art bypass aortobi-iliac 35638
|
$1,051.65 |
$1,051.65 |
$1,051.65 |
$3,525.00
|
|
Art bypass axillary-femoral 35621
|
$659.49 |
$659.49 |
$659.49 |
$2,208.60
|
|
Art bypass axill-fem-femoral 35654
|
$823.08 |
$823.08 |
$823.08 |
$3,058.80
|
|
Art bypass carotid-subclavian 35606
|
$708.51 |
$708.51 |
$708.51 |
$5,724.80
|
|
Art bypass common ipsi carotid 35601
|
$847.97 |
$847.97 |
$847.97 |
$1,958.50
|
|
Art bypass fem-ant-post tib/prl 35666
|
$778.43 |
$778.43 |
$778.43 |
$4,144.00
|
|
Art bypass femoral-femoral 35661
|
$654.74 |
$654.74 |
$654.74 |
$5,291.20
|
|
Art bypass femoral-popliteal 35656
|
$645.81 |
$645.81 |
$645.81 |
$4,717.50
|
|
Art bypass iliofemoral 35665
|
$707.37 |
$707.37 |
$707.37 |
$2,457.18
|
|
Art bypass subclav-subclavian 35612
|
$630.99 |
$630.99 |
$630.99 |
$2,272.80
|
|
Art byp axillary-axillary 35650
|
$614.65 |
$614.65 |
$614.65 |
$1,099.50
|
|
Art byp grft aor/carot/innom
|
$1,060.96 |
$1,060.96 |
$1,060.96 |
$1,507.68
|
|
Art byp grft aorcel/aormesen
|
$1,167.17 |
$1,167.17 |
$1,167.17 |
$7,865.20
|
|
Art byp grft aortbifemoral 35540
|
$1,459.58 |
$1,459.58 |
$1,459.58 |
$4,336.80
|
|
Art byp grft aortobi-iliac 35538
|
$1,396.50 |
$1,396.50 |
$1,396.50 |
$2,590.00
|
|
Art byp grft aortofemoral
|
$1,310.62 |
$1,310.62 |
$1,310.62 |
$2,431.00
|
|
Art byp grft aortoiliac
|
$1,246.97 |
$1,246.97 |
$1,246.97 |
$2,244.00
|
|
Art byp grft axillary-axilry
|
$686.47 |
$686.47 |
$686.47 |
$1,231.00
|
|
Art byp grft axill-brachial
|
$703.00 |
$703.00 |
$703.00 |
$1,320.00
|
|
Art byp grft axill/fem/fem
|
$904.59 |
$904.59 |
$904.59 |
$1,670.50
|
|
Art byp grft axill-femoral
|
$739.48 |
$739.48 |
$739.48 |
$1,728.11
|
|
Art byp grft brachial-brchl
|
$661.58 |
$661.58 |
$661.58 |
$1,948.80
|
|
Art byp grft brchl-ulnr-rdl
|
$740.62 |
$740.62 |
$740.62 |
$1,361.00
|
|
Art byp grft carotid-vertbrl
|
$800.66 |
$800.66 |
$800.66 |
$1,137.78
|
