|
Impact tooth remov part bony
|
$137.20 |
$137.20 |
$137.20 |
$1,840.30
|
|
Implant cartilage 10mm synthetic
|
$1,333.00 |
$1,333.00 |
$1,333.00 |
$8,184.00
|
|
Implant hormone pellet(s) 11980
|
$37.00 |
$37.00 |
$37.00 |
$315.75
|
|
Implant neuroelectrodes
|
$573.40 |
$573.40 |
$573.40 |
$18,334.40
|
|
Implant neuroelectrodes
|
$206.60 |
$206.60 |
$206.60 |
$7,766.27
|
|
Implant spine infusion pump
|
$264.80 |
$264.80 |
$264.80 |
$17,270.40
|
|
Implant ureth bulk agent
|
$136.60 |
$136.60 |
$136.60 |
$2,168.00
|
|
Impl neurostim electr perc
|
$286.20 |
$286.20 |
$286.20 |
$7,672.50
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$144.00 |
$144.00 |
$144.00 |
$1,072.00
|
|
Implnt spinl canal catheter 62350
|
$274.80 |
$274.80 |
$274.80 |
$5,095.20
|
|
In-111 autol wbc diag per dose
|
$1,178.80 |
$1,178.80 |
$1,178.80 |
$3,523.65
|
|
In-111 capromab pendet
|
$962.60 |
$962.60 |
$962.60 |
$3,141.45
|
|
In-111 oxyquinolin per 0.5 mci
|
$275.80 |
$275.80 |
$275.80 |
$2,581.82
|
|
In-111 pentetate dtpa / 0.5 mci
|
$636.20 |
$636.20 |
$636.20 |
$2,598.17
|
|
In-111 pentetreotide
|
$421.20 |
$421.20 |
$421.20 |
$5,201.00
|
|
In-111 satumomab pend
|
$1,518.20 |
$1,518.20 |
$1,518.20 |
$3,113.04
|
|
Inc dp bone crtx f/arm&/wrst
|
$417.60 |
$417.60 |
$417.60 |
$6,650.80
|
|
Inc dp opn b1 crtx hum/elbw
|
$366.00 |
$366.00 |
$366.00 |
$3,821.05
|
|
Incis 1 vertebral seg cerv
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$4,297.60
|
|
Incis 1 vertebral seg lumbar
|
$1,032.80 |
$1,032.80 |
$1,032.80 |
$3,628.80
|
|
Incis 1 vertebral seg thorac
|
$1,033.80 |
$1,033.80 |
$1,033.80 |
$3,619.20
|
|
Incis addl spine segment
|
$237.40 |
$237.40 |
$237.40 |
$880.00
|
|
Incise/drain eyelid lining
|
$290.00 |
$290.00 |
$290.00 |
$1,271.00
|
|
Incise flexor carpi radialis
|
$254.40 |
$254.40 |
$254.40 |
$3,839.54
|
|
Incise hand/finger tendon
|
$325.60 |
$325.60 |
$325.60 |
$2,007.15
|
|
Incise inner ear
|
$443.40 |
$443.40 |
$443.40 |
$2,186.08
|
|
Incise perq finger tendon 26060
|
$184.00 |
$184.00 |
$184.00 |
$1,893.86
|
|
Incise tear duct opening 68440
|
$89.40 |
$89.40 |
$89.40 |
$507.20
|
|
Incise thigh tendon & fascia
|
$343.40 |
$343.40 |
$343.40 |
$3,839.54
|
|
Incise wrist/forearm tendon
|
$313.40 |
$313.40 |
$313.40 |
$3,786.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,322.20 |
$1,322.20 |
$1,322.20 |
$2,056.93
|
|
Incision & drainage open of deep abscess (subfascial) pos
|
$667.80 |
$667.80 |
$667.80 |
$2,312.00
|
|
Incision/fixation of femur
|
$942.80 |
$942.80 |
$942.80 |
$5,275.40
|
|
Incision of achilles tendon
|
$479.20 |
$479.20 |
$479.20 |
$3,172.80
|
|
Incision of anal sphincter
|
$108.20 |
$108.20 |
$108.20 |
$3,245.23
|
|
Incision of breast lesion
|
$485.00 |
$485.00 |
$485.00 |
$2,560.80
|
|
Incision of burn scab initi
|
$131.00 |
$131.00 |
$131.00 |
$494.40
|
|
Incision of eardrum
|
$136.40 |
$136.40 |
$136.40 |
$552.75
|
|
Incision of eardrum
|
$107.40 |
$107.40 |
$107.40 |
$3,827.50
|
|
Incision of facial nerve
|
$349.80 |
$349.80 |
$349.80 |
$2,685.07
|
|
Incision of finger tendon
|
$332.00 |
$332.00 |
$332.00 |
$1,893.86
|
|
Incision of foot fascia
|
$2,622.00 |
$2,622.00 |
$2,622.00 |
$4,570.33
|
|
Incision of foot tendon 28234
|
$293.40 |
$293.40 |
$293.40 |
$2,116.27
|
|
Incision of gallbladder 47480
|
$596.20 |
$596.20 |
$596.20 |
$1,650.00
|
|
Incision of heel bone
|
$455.80 |
$455.80 |
$455.80 |
$5,339.00
|
|
Incision of hip tendon
|
$700.80 |
$700.80 |
$700.80 |
$3,460.88
|
|
Incision of hip tendon
|
$379.60 |
$379.60 |
$379.60 |
$3,839.54
|
|
Incision of hip tendons
|
$1,454.00 |
$1,454.00 |
$1,454.00 |
$3,839.54
|
|
Incision of knee joint
|
$566.80 |
$566.80 |
$566.80 |
$3,976.00
|
|
Incision of metatarsal
|
$287.20 |
$287.20 |
$287.20 |
$4,176.43
|
|
Incision of metatarsal
|
$405.60 |
$405.60 |
$405.60 |
$3,591.33
|
|
Incision of midfoot bones
|
$431.20 |
$431.20 |
$431.20 |
$6,839.00
|
|
Incision of neck of femur
|
$841.80 |
$841.80 |
$841.80 |
$4,651.40
|
|
Incision of palm tendon
|
$334.40 |
$334.40 |
$334.40 |
$3,821.05
|
|
Incision of prostate
|
$330.80 |
$330.80 |
$330.80 |
$4,081.37
|
|
Incision of rectal abscess
|
$1,510.60 |
$1,510.60 |
$1,510.60 |
$3,245.23
|
|
Incision of small bowel 44010
|
$575.40 |
$575.40 |
$575.40 |
$1,362.00
|
|
Incision of spinal nerve 64772
|
$389.40 |
$389.40 |
$389.40 |
$2,310.83
|
|
Incision of tendon & muscle
|
$4,200.40 |
$4,200.40 |
$4,200.40 |
$5,624.45
|
|
Incision of tendon sheath
|
$252.80 |
$252.80 |
$252.80 |
$2,211.05
|
|
Incision of thigh
|
$577.80 |
$577.80 |
$577.80 |
$3,016.00
|
|
Incision of thigh
|
$697.60 |
$697.60 |
$697.60 |
$3,798.60
|
|
Incision of thigh tendon
|
$2,911.80 |
$2,911.80 |
$2,911.80 |
$4,491.50
|
|
Incision of thigh tendon
|
$322.20 |
$322.20 |
$322.20 |
$3,839.54
|
|
Incision of thigh tendons
|
$2,831.00 |
$2,831.00 |
$2,831.00 |
$4,844.84
|
|
Incision of tibia
|
$519.00 |
$519.00 |
$519.00 |
$7,907.11
|
|
Incision of toe tendons 28011
|
$1,301.00 |
$1,301.00 |
$1,301.00 |
$2,119.12
|
|
Incision of tongue fold
|
$1,017.20 |
$1,017.20 |
$1,017.20 |
$1,792.50
|
|
Incision of urethra
|
$65.80 |
$65.80 |
$65.80 |
$2,899.60
|
|
Incision tendon sheath
|
$862.20 |
$862.20 |
$862.20 |
$3,073.20
|
|
Incisn of toe tndn
|
$168.40 |
$168.40 |
$168.40 |
$2,627.96
|
|
Incisn windpipe
|
$202.20 |
$202.20 |
$202.20 |
$3,810.50
|
|
Induced ab 1+vag supp d&c
|
$330.60 |
$330.60 |
$330.60 |
$1,194.40
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$283.40 |
$283.40 |
$283.40 |
$1,881.75
|
|
Induced abortion d&c
|
$149.60 |
$149.60 |
$149.60 |
$3,762.53
|
|
Induced abortion dilat&evac
|
$248.80 |
$248.80 |
$248.80 |
$4,446.00
|
|
Infect ag drug suscept pheno predict
|
$48.38 |
$48.38 |
$48.38 |
$323.20
|
|
Infect ag eia influenza a or b ea
|
$30.40 |
$30.40 |
$30.40 |
$71.50
|
|
Infect ag genotype na dna hepatitis b
|
$70.60 |
$70.60 |
$70.60 |
$405.30
|
|
Infect ag genotype na hiv-1 other region
|
$31.18 |
$31.18 |
$31.18 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$84.64 |
$84.64 |
$84.64 |
$603.75
|
|
Infect ag ia direct hiv-1 antgn
|
$33.00 |
$33.00 |
$33.00 |
$91.70
|
|
Infect ag ia optc obs influenza
|
$23.60 |
$23.60 |
$23.60 |
$72.93
|
|
Infect ag if influenza a
|
$3.21 |
$3.21 |
$3.21 |
$41.30
|
|
Infect ag if influenza b
|
$2.45 |
$2.45 |
$2.45 |
$40.08
|
|
Infect ag if legionella pneumophila
|
$2.02 |
$2.02 |
$2.02 |
$72.58
|
|
Infect ag if nos ea
|
$2.02 |
$2.02 |
$2.02 |
$74.88
|
|
Infect ag if pneumocystis carinii
|
$2.80 |
$2.80 |
$2.80 |
$66.00
|
|
Infect ag if varicella zoster
|
$2.02 |
$2.02 |
$2.02 |
$70.70
|
|
Infect ag na hpv high-risk types
|
$82.00 |
$82.00 |
$82.00 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$257.20 |
$257.20 |
$257.20 |
$219.70
|
|
Infect ag na influenza revr/amp ea type
|
$19.20 |
$19.20 |
$19.20 |
$158.06
|
|
Infect ag na orthopoxvirus amp prb each
|
$17.00 |
$17.00 |
$17.00 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$1,110.80 |
$1,110.80 |
$1,110.80 |
$835.80
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$68.20 |
$68.20 |
$68.20 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$48.40 |
$48.40 |
$48.40 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$2.02 |
$2.02 |
$2.02 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$1.72 |
$1.72 |
$1.72 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$22.60 |
$22.60 |
$22.60 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$2.89 |
$2.89 |
$2.89 |
$100.02
|
