|
In-111 autol wbc diag per dose
|
$8,554.56 |
$8,554.56 |
$8,554.56 |
$3,523.65
|
|
In-111 capromab pendet
|
$2,182.32 |
$2,182.32 |
$2,182.32 |
$3,141.45
|
|
In-111 ibritumomab tiux dx
|
$7,633.36 |
$7,633.36 |
$7,633.36 |
$4,748.02
|
|
In-111 oxyquinolin per 0.5 mci
|
$7,380.84 |
$7,380.84 |
$7,380.84 |
$2,581.82
|
|
In-111 pentetate dtpa / 0.5 mci
|
$4,666.65 |
$4,666.65 |
$4,666.65 |
$2,598.17
|
|
In-111 pentetreotide
|
$11,753.28 |
$11,753.28 |
$11,753.28 |
$5,201.00
|
|
In-111 satumomab pend
|
$3,113.04 |
$3,113.04 |
$3,113.04 |
$3,113.04
|
|
Inactivated je vacc im
|
$518.36 |
$518.36 |
$518.36 |
$481.34
|
|
Inc dp bone crtx f/arm&/wrst
|
$7,588.00 |
$7,588.00 |
$7,588.00 |
$6,650.80
|
|
Inc dp opn b1 crtx hum/elbw
|
$7,285.60 |
$7,285.60 |
$7,285.60 |
$3,821.05
|
|
Incise diaphragm nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,421.48
|
|
Incise/drain eyelid lining
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$1,271.00
|
|
Incise flexor carpi radialis
|
$5,112.80 |
$5,112.80 |
$5,112.80 |
$3,839.54
|
|
Incise hand/finger tendon
|
$6,137.60 |
$6,137.60 |
$6,137.60 |
$2,007.15
|
|
Incise hip/thigh nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,500.80
|
|
Incise hip/thigh nerve
|
$11,922.40 |
$11,922.40 |
$11,922.40 |
$3,086.40
|
|
Incise inner ear
|
$4,457.60 |
$4,457.60 |
$4,457.60 |
$2,186.08
|
|
Incise inner ear nerve
|
$8,181.60 |
$8,181.60 |
$8,181.60 |
$5,339.00
|
|
Incise inner eye adhesions
|
$2,951.20 |
$2,951.20 |
$2,951.20 |
$1,202.90
|
|
Incise inner eye adhesions
|
$7,117.60 |
$7,117.60 |
$7,117.60 |
$2,698.92
|
|
Incise inner eye adhesions
|
$9,161.60 |
$9,161.60 |
$9,161.60 |
$2,940.80
|
|
Incise inner eye adhesions
|
$2,329.60 |
$2,329.60 |
$2,329.60 |
$2,524.45
|
|
Incise inner eye adhesions
|
$7,229.60 |
$7,229.60 |
$7,229.60 |
$4,760.49
|
|
Incise inner eye strands
|
$7,184.80 |
$7,184.80 |
$7,184.80 |
$3,905.20
|
|
Incise nerve back of head
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,685.07
|
|
Incise perq finger tendon 26060
|
$5,112.80 |
$5,112.80 |
$5,112.80 |
$1,893.86
|
|
Incise skull/brain surgery
|
$11,922.40 |
$11,922.40 |
$11,922.40 |
$7,181.20
|
|
Incise skull for treatment
|
$11,922.40 |
$11,922.40 |
$11,922.40 |
$7,181.20
|
|
Incise sperm duct pouch
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$2,656.59
|
|
Incise tear duct opening 68440
|
$1,741.60 |
$1,741.60 |
$1,741.60 |
$507.20
|
|
Incise tendon(s) & muscle(s)
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$7,968.80
|
|
Incise thigh tendon & fascia
|
$8,013.60 |
$8,013.60 |
$8,013.60 |
$3,839.54
|
|
Incise wrist/forearm tendon
|
$9,805.60 |
$9,805.60 |
$9,805.60 |
$3,786.00
|
|
Incision anal septum infant
|
$7,425.60 |
$7,425.60 |
$7,425.60 |
$3,481.77
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$5,056.80 |
$5,056.80 |
$5,056.80 |
$2,056.93
|
|
Incision of achilles tendon
|
$6,137.60 |
$6,137.60 |
$6,137.60 |
$3,172.80
|
|
Incision of achilles tendon
|
$2,839.20 |
$2,839.20 |
$2,839.20 |
$3,561.39
|
|
Incision of anal sphincter
|
$4,844.00 |
$4,844.00 |
$4,844.00 |
$3,245.23
|
|
Incision of ankle bone
|
$8,758.40 |
$8,758.40 |
$8,758.40 |
$7,913.97
|
|
Incision of bile duct 47420
|
$2,788.80 |
$2,788.80 |
$2,788.80 |
$2,788.80
|
|
Incision of breast lesion
|
$7,072.80 |
$7,072.80 |
$7,072.80 |
$2,560.80
|
|
Incision of brow nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,685.07
|
|
Incision of burn scab initi
|
$1,321.60 |
$1,321.60 |
$1,321.60 |
$494.40
|
|
Incision of cheek nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,772.37
|
|
Incision of chin nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,421.48
|
|
Incision of eardrum
|
$873.60 |
$873.60 |
$873.60 |
$552.75
|
|
Incision of eardrum
|
$7,873.60 |
$7,873.60 |
$7,873.60 |
$3,827.50
|
|
Incision of esophagus
|
$3,914.40 |
$3,914.40 |
$3,914.40 |
$1,851.20
|
|
Incision of eye
|
$9,161.60 |
$9,161.60 |
$9,161.60 |
$4,190.40
|
|
Incision of eye
|
$7,184.80 |
$7,184.80 |
$7,184.80 |
$3,986.00
|
|
Incision of eyelid
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$1,488.50
|
|
Incision of facial nerve
|
$7,106.40 |
$7,106.40 |
$7,106.40 |
$2,685.07
|
|
Incision of fibula
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,839.54
|
|
Incision of finger tendon
|
$6,260.80 |
$6,260.80 |
$6,260.80 |
$1,893.86
|
|
Incision of foot fascia
|
$8,618.40 |
$8,618.40 |
$8,618.40 |
$4,570.33
|
|
Incision of foot tendon 28234
|
$5,616.80 |
$5,616.80 |
$5,616.80 |
$2,116.27
|
|
Incision of heel bone
|
$19,756.80 |
$19,756.80 |
$19,756.80 |
$5,339.00
|
|
Incision of hip tendon
|
$8,741.60 |
$8,741.60 |
$8,741.60 |
$3,460.88
|
|
Incision of hip tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Incision of hip tendon
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$7,907.11
|
|
Incision of hip tendons
|
$4,502.40 |
$4,502.40 |
$4,502.40 |
$3,839.54
|
|
Incision of iris
|
$5,476.80 |
$5,476.80 |
$5,476.80 |
$2,698.92
|
|
Incision of iris
|
$4,916.80 |
$4,916.80 |
$4,916.80 |
$2,698.92
|
|
Incision of jaw joint
|
$8,181.60 |
$8,181.60 |
$8,181.60 |
$4,558.89
|
|
Incision of jaw nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,421.48
|
|
Incision of knee joint
|
$7,425.60 |
$7,425.60 |
$7,425.60 |
$3,976.00
|
|
Incision of lymph channels
|
$11,121.60 |
$11,121.60 |
$11,121.60 |
$4,570.46
|
|
Incision of metatarsal
|
$9,363.20 |
$9,363.20 |
$9,363.20 |
$4,176.43
|
|
Incision of metatarsal
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$6,839.00
|
|
Incision of metatarsal
|
$4,496.80 |
$4,496.80 |
$4,496.80 |
$3,591.33
|
|
Incision of metatarsals
|
$15,943.20 |
$15,943.20 |
$15,943.20 |
$7,907.11
|
|
Incision of midfoot bones
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$6,839.00
|
|
Incision of palm tendon
|
$9,049.60 |
$9,049.60 |
$9,049.60 |
$3,821.05
|
|
Incision of prostate
|
$5,986.40 |
$5,986.40 |
$5,986.40 |
$4,081.37
|
|
Incision of rectal abscess
|
$9,979.20 |
$9,979.20 |
$9,979.20 |
$3,245.23
|
|
Incision of sperm duct
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$4,081.37
|
|
Incision of spinal nerve 64772
|
$7,106.40 |
$7,106.40 |
$7,106.40 |
$2,310.83
|
|
Incision of tendon & muscle
|
$5,376.00 |
$5,376.00 |
$5,376.00 |
$5,624.45
|
|
Incision of tendon sheath
|
$7,616.00 |
$7,616.00 |
$7,616.00 |
$2,211.05
|
|
Incision of thigh tendon
|
$6,137.60 |
$6,137.60 |
$6,137.60 |
$4,491.50
|
|
Incision of thigh tendon
|
$7,588.00 |
$7,588.00 |
$7,588.00 |
$3,839.54
|
|
Incision of thigh tendons
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,844.84
|
|
Incision of thigh tendons
|
$9,105.60 |
$9,105.60 |
$9,105.60 |
$3,839.54
|
|
Incision of thigh tendons
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,499.12
|
|
Incision of tibia
|
$12,286.40 |
$12,286.40 |
$12,286.40 |
$7,907.11
|
|
Incision of tibia & fibula
|
$13,148.80 |
$13,148.80 |
$13,148.80 |
$13,148.80
|
|
Incision of toe tendons 28011
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$2,119.12
|
|
Incision of tongue fold
|
$5,364.80 |
$5,364.80 |
$5,364.80 |
$1,792.50
|
|
Incision of tongue nerve
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,421.48
|
|
Incision of urethra
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$2,874.36
|
|
Incision of urethra
|
$10,343.20 |
$10,343.20 |
$10,343.20 |
$5,626.86
|
|
Incision of urethra
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$2,899.60
|
|
Incision of urethra
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$2,874.36
|
|
Incision of windpipe
|
$7,756.00 |
$7,756.00 |
$7,756.00 |
$6,465.11
|
|
Incision of windpipe
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$5,855.00
|
|
Incision of wrist capsule
|
$9,105.60 |
$9,105.60 |
$9,105.60 |
$3,821.05
|
|
Incision secondary cataract
|
$1,724.80 |
$1,724.80 |
$1,724.80 |
$2,492.56
|
|
Incision tendon sheath
|
$3,096.80 |
$3,096.80 |
$3,096.80 |
$3,073.20
|
|
Incisn of toe tndn
|
$4,972.80 |
$4,972.80 |
$4,972.80 |
$2,627.96
|
|
Incisn windpipe
|
$5,605.60 |
$5,605.60 |
$5,605.60 |
$3,810.50
|
