|
Angio trnslmnl balloon same artery ini
|
$223.80 |
$223.80 |
$223.80 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ini
|
$193.20 |
$193.20 |
$193.20 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$474.20 |
$474.20 |
$474.20 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$355.20 |
$355.20 |
$355.20 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$323.20 |
$323.20 |
$323.20 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$345.80 |
$345.80 |
$345.80 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$392.80 |
$392.80 |
$392.80 |
$3,839.54
|
|
Ankle X-ray
|
$283.00 |
$283.00 |
$283.00 |
$351.45
|
|
Anl sp inf pmp w/mdreprg&fil
|
$95.60 |
$95.60 |
$95.60 |
$627.94
|
|
Annual alcohol screen 15 min
|
$9.00 |
$9.00 |
$9.00 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$45.80 |
$45.80 |
$45.80 |
$147.60
|
|
Annual Physical, Established Patient (age 40-64)
|
$52.00 |
$52.00 |
$52.00 |
$160.14
|
|
Annual Physical, New Patient (age 18-39)
|
$51.40 |
$51.40 |
$51.40 |
$143.25
|
|
Annual Physical, New Patient (age 40-64)
|
$63.20 |
$63.20 |
$63.20 |
$167.25
|
|
Anora (draw only)
|
$20.80 |
$20.80 |
$20.80 |
$33.00
|
|
Anoscopy
|
$55.00 |
$55.00 |
$55.00 |
$1,278.72
|
|
Anoscopy ablation lesion 46615
|
$62.00 |
$62.00 |
$62.00 |
$3,245.23
|
|
Anoscopy and biopsy
|
$1,108.20 |
$1,108.20 |
$1,108.20 |
$1,395.28
|
|
Anoscopy and dilation 46604
|
$449.40 |
$449.40 |
$449.40 |
$1,621.60
|
|
Anoscopy remove fb 46608
|
$57.00 |
$57.00 |
$57.00 |
$1,443.20
|
|
Anoscopy remove lesion 46610
|
$54.80 |
$54.80 |
$54.80 |
$3,723.75
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$64.20 |
$64.20 |
$64.20 |
$3,816.64
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$421.00 |
$421.00 |
$421.00 |
$5,463.96
|
|
Antibody bacterium, not elsewhere specified
|
$14.06 |
$14.06 |
$14.06 |
$57.81
|
|
Antibody elution rbc reference
|
$213.40 |
$213.40 |
$213.40 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$3.44 |
$3.44 |
$3.44 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$7.96 |
$7.96 |
$7.96 |
$216.60
|
|
Antibody id rbc panel
|
$659.80 |
$659.80 |
$659.80 |
$274.83
|
|
Antibody influenza virus
|
$10.80 |
$10.80 |
$10.80 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$2.29 |
$2.29 |
$2.29 |
$48.57
|
|
Antibody screen rbc
|
$37.60 |
$37.60 |
$37.60 |
$100.00
|
|
Anticoag mgmt pt warfarin
|
$5.60 |
$5.60 |
$5.60 |
$26.40
|
|
Antidepressant not specified
|
$13.00 |
$13.00 |
$13.00 |
$62.79
|
|
Antidepressants class 6/more
|
$1.00 |
$1.00 |
$1.00 |
$29.21
|
|
Antiepileptics nos 7/more
|
$0.80 |
$0.80 |
$0.80 |
$16.24
|
|
Antigen therapy services
|
$18.40 |
$18.40 |
$18.40 |
$73.84
|
|
Antigen therapy services
|
$34.00 |
$34.00 |
$34.00 |
$83.72
|
|
Antigen therapy services
|
$48.60 |
$48.60 |
$48.60 |
$96.72
|
|
Antigen therapy services
|
$52.80 |
$52.80 |
$52.80 |
$70.07
|
|
Antigen therapy services
|
$5.40 |
$5.40 |
$5.40 |
$64.39
|
|
Anti mog serum - sendout
|
$35.00 |
$35.00 |
$35.00 |
$159.03
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$2.41 |
$2.41 |
$2.41 |
$40.00
|
|
Ant instr 2-3 vert segm 22845
|
$472.00 |
$472.00 |
$472.00 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$491.20 |
$491.20 |
$491.20 |
$1,430.40
|
|
Antinuclear antibodies
|
$50.60 |
$50.60 |
$50.60 |
$89.40
|
|
Antinuclear antibodies titer
|
$184.80 |
$184.80 |
$184.80 |
$74.75
|
|
Antiphosphatidylserine antibody
|
$17.60 |
$17.60 |
$17.60 |
$60.00
|
|
Antipsychotics nos 1-3
|
$3.03 |
$3.03 |
$3.03 |
$142.42
|
|
Antipsychotics nos 7/more
|
$0.80 |
$0.80 |
$0.80 |
$16.24
|
|
Antistreptolysin o titer
|
$1.30 |
$1.30 |
$1.30 |
$51.45
|
|
Antithrombin iii activity
|
$2.49 |
$2.49 |
$2.49 |
$114.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$592.60 |
$592.60 |
$592.60 |
$4,155.20
|
|
Aortic dysfunction/dilation
|
$127.20 |
$127.20 |
$127.20 |
$992.40
|
|
Aortic dysfunction/dilation
|
$340.80 |
$340.80 |
$340.80 |
$1,485.21
|
|
Appendectomy
|
$430.60 |
$430.60 |
$430.60 |
$5,681.93
|
|
Appendectomy add-on 44955
|
$54.80 |
$54.80 |
$54.80 |
$187.32
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$586.40 |
$586.40 |
$586.40 |
$1,562.44
|
|
Appendix Removal (Laparoscopic)
|
$407.80 |
$407.80 |
$407.80 |
$6,904.15
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,008.60 |
$2,008.60 |
$2,008.60 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$517.00 |
$517.00 |
$517.00 |
$843.84
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$517.00 |
$517.00 |
$517.00 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,472.20 |
$2,472.20 |
$2,472.20 |
$3,271.80
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$741.60 |
$741.60 |
$741.60 |
$1,083.94
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$599.80 |
$599.80 |
$599.80 |
$498.81
|
|
Appl body cast sho to hips
|
$195.60 |
$195.60 |
$195.60 |
$509.60
|
|
Appl cast figure-of-eight
|
$79.60 |
$79.60 |
$79.60 |
$314.28
|
|
Application clubfoot cast
|
$102.80 |
$102.80 |
$102.80 |
$297.33
|
|
Application finger splntstatic 29130
|
$30.40 |
$30.40 |
$30.40 |
$208.16
|
|
Application long leg splint 29505
|
$67.20 |
$67.20 |
$67.20 |
$338.25
|
|
Application lower leg splint 29515
|
$241.00 |
$241.00 |
$241.00 |
$334.20
|
|
Application multi layer compression below knee (both sides)
|
$202.80 |
$202.80 |
$202.80 |
$370.92
|
|
Application of cylinder cast 29365
|
$90.60 |
$90.60 |
$90.60 |
$421.50
|
|
Application of forearm cast 29075
|
$64.80 |
$64.80 |
$64.80 |
$339.30
|
|
Application of long arm cast 29065
|
$71.20 |
$71.20 |
$71.20 |
$395.00
|
|
Application of long leg cast
|
$102.20 |
$102.20 |
$102.20 |
$426.00
|
|
Application of long leg cast 29345
|
$98.20 |
$98.20 |
$98.20 |
$455.00
|
|
Application of paste boot 29580
|
$354.60 |
$354.60 |
$354.60 |
$331.74
|
|
Application short leg cast 29405
|
$243.00 |
$243.00 |
$243.00 |
$384.78
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,347.20 |
$1,347.20 |
$1,347.20 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,523.20 |
$1,523.20 |
$1,523.20 |
$2,164.64
|
|
Appl long leg cast brace
|
$119.20 |
$119.20 |
$119.20 |
$468.00
|
|
Appl mltpln uni ext fixj sys
|
$788.60 |
$788.60 |
$788.60 |
$5,668.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$38.40 |
$38.40 |
$38.40 |
$66.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$26.00 |
$26.00 |
$26.00 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$10.80 |
$10.80 |
$10.80 |
$284.05
|
|
Appl patllr tdn bearing cast
|
$60.40 |
$60.40 |
$60.40 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$414.20 |
$414.20 |
$414.20 |
$5,855.00
|
|
Apply forearm splintdynamic 29126
|
$58.20 |
$58.20 |
$58.20 |
$246.18
|
|
Apply hand/wrist cast 29085
|
$71.00 |
$71.00 |
$71.00 |
$264.75
|
|
Apply interstit radiat compl
|
$1,822.00 |
$1,822.00 |
$1,822.00 |
$2,910.05
|
|
Apply of finger splint 29131
|
$39.80 |
$39.80 |
$39.80 |
$170.95
|
|
Apply rem fixation device
|
$157.00 |
$157.00 |
$157.00 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$286.20 |
$286.20 |
$286.20 |
$555.00
|
|
Apply r&l pulm art bands
|
$1,062.20 |
$1,062.20 |
$1,062.20 |
$5,532.80
|
|
Apply short leg castambul type 29425
|
$236.40 |
$236.40 |
$236.40 |
$384.59
|
|
App topical fluoride varnish
|
$8.80 |
$8.80 |
$8.80 |
$27.20
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$586.16 |
$586.16 |
$586.16 |
$955.43
|
|
Aquaporin-4 antibody cba each
|
$60.00 |
$60.00 |
$60.00 |
$140.84
|
|
Aquaporin-4 antibody elisa
|
$2.31 |
$2.31 |
$2.31 |
$148.85
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$38.80 |
$38.80 |
$38.80 |
$100.00
|
