|
Antigen therapy services
|
$261.52 |
$261.52 |
$261.52 |
$101.40
|
|
Antigen therapy services
|
$250.32 |
$250.32 |
$250.32 |
$96.72
|
|
Antigen therapy services
|
$250.32 |
$250.32 |
$250.32 |
$130.00
|
|
Antigen therapy services
|
$165.20 |
$165.20 |
$165.20 |
$70.07
|
|
Antigen therapy services
|
$201.60 |
$201.60 |
$201.60 |
$54.60
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$6.57 |
$6.57 |
$6.57 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$6.04 |
$6.04 |
$6.04 |
$3.67
|
|
Anti-inhibitor
|
$8.97 |
$8.97 |
$8.97 |
$8.33
|
|
Anti mog serum - sendout
|
$26.25 |
$26.25 |
$29.68 |
$110.58
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$1.81 |
$1.81 |
$21.84 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$29.68 |
$29.68 |
$29.68 |
$36.37
|
|
Ant instr 2-3 vert segm 22845
|
$382.50 |
$382.50 |
$7,240.80 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$398.10 |
$398.10 |
$398.10 |
$1,430.40
|
|
Antinuclear antibodies
|
$53.20 |
$53.20 |
$628.50 |
$91.68
|
|
Antinuclear antibodies titer
|
$22.65 |
$22.65 |
$49.28 |
$79.95
|
|
Antiphosphatidylserine antibody
|
$4.07 |
$4.07 |
$58.24 |
$58.24
|
|
Antipsychotics nos 1-3
|
$25.65 |
$25.65 |
$80.08 |
$153.45
|
|
Antipsychotics nos 4-6
|
$16.24 |
$16.24 |
$16.24 |
$36.00
|
|
Antipsychotics nos 7/more
|
$0.60 |
$0.60 |
$16.24 |
$16.24
|
|
Antistreptolysin o screen
|
$71.12 |
$71.12 |
$71.12 |
$58.56
|
|
Antistreptolysin o titer
|
$33.60 |
$33.60 |
$129.15 |
$52.06
|
|
Antithrombin iii activity
|
$1.87 |
$1.87 |
$157.92 |
$114.00
|
|
Antithrombin iii injection
|
$13.29 |
$13.29 |
$13.29 |
$11.85
|
|
Antithrombin recombinant
|
$9.22 |
$9.22 |
$9.22 |
$9.22
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$8,845.92 |
$8,845.92 |
$8,845.92 |
$7,544.81
|
|
Antithymocyte globuln rabbit
|
$1,958.74 |
$1,958.74 |
$1,958.74 |
$2,111.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$4,155.20 |
$4,155.20 |
$4,155.20 |
$4,155.20
|
|
Ant sgm img ir flrscn angrph
|
$436.80 |
$436.80 |
$436.80 |
$286.00
|
|
Ant sgm img i&r speclr mic
|
$504.00 |
$504.00 |
$504.00 |
$182.95
|
|
Ant thrc vrt body tethrg <7
|
$414.40 |
$414.40 |
$414.40 |
$4,508.80
|
|
Ant thrc vrt body tethrg 8+
|
$414.40 |
$414.40 |
$414.40 |
$4,968.00
|
|
Aoi transducer/actuator repl
|
$0.56 |
$0.56 |
$0.56 |
$0.56
|
|
Aortic dysfunction/dilation
|
$95.40 |
$95.40 |
$1,153.60 |
$982.80
|
|
Aortic dysfunction/dilation
|
$255.60 |
$255.60 |
$3,085.60 |
$1,485.21
|
|
Aortic hemiarch graft 33866
|
$2,609.60 |
$2,609.60 |
$2,609.60 |
$2,260.80
|
|
Apc gene dup/delet variants
|
$980.00 |
$980.00 |
$980.00 |
$400.00
|
|
Apc gene full sequence
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$1,102.34
|
|
Apc gene known fam variants
|
$638.40 |
$638.40 |
$638.40 |
$308.00
|
|
Aphakia prosth service temp
|
$256.48 |
$256.48 |
$256.48 |
$70.29
|
|
Apheresis immunoads slctv
|
$12,952.80 |
$12,952.80 |
$12,952.80 |
$5,686.40
|
|
Apheresis plasma
|
$6,473.60 |
$6,473.60 |
$6,473.60 |
$3,192.96
|
|
Apheresis platelets
|
$1,584.80 |
$1,584.80 |
$1,584.80 |
$2,195.00
|
|
Apheresis rbc
|
$8,411.20 |
$8,411.20 |
$8,411.20 |
$3,128.45
|
|
Apheresis wbc
|
$4,838.40 |
$4,838.40 |
$4,838.40 |
$2,961.82
|
|
Apl(pml-rara) quant - sendout
|
$31.10 |
$31.10 |
$548.80 |
$465.60
|
|
Apomorphine hydrochloride
|
$174.99 |
$174.99 |
$174.99 |
$174.99
|
|
Appendectomy
|
$10,886.40 |
$10,886.40 |
$10,886.40 |
$5,681.93
|
|
Appendectomy add-on 44955
|
$45.45 |
$45.45 |
$6,372.80 |
$206.40
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$479.25 |
$479.25 |
$479.25 |
$1,644.60
|
|
Appendix Removal (Laparoscopic)
|
$335.55 |
$335.55 |
$22,680.00 |
$6,463.42
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$4,844.00 |
$4,844.00 |
$4,844.00 |
$2,154.21
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$873.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$232.96 |
$232.96 |
$232.96 |
$512.20
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$9,469.60 |
$9,469.60 |
$9,469.60 |
$3,767.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$800.80 |
$800.80 |
$800.80 |
$508.18
|
|
Appl bdy cst sho to hip 1thi
|
$683.20 |
$683.20 |
$683.20 |
$353.60
|
|
Appl bdy cst sho to hip b th
|
$772.80 |
$772.80 |
$772.80 |
$561.60
|
|
Appl bdy cst sho to hip head
|
$834.40 |
$834.40 |
$834.40 |
$561.60
|
|
Appl body cast sho to hips
|
$1,321.60 |
$1,321.60 |
$1,321.60 |
$468.00
|
|
Appl cast figure-of-eight
|
$772.80 |
$772.80 |
$772.80 |
$314.28
|
|
Appl cast plaster velpeau
|
$772.80 |
$772.80 |
$772.80 |
$314.28
|
|
Appl cast shoulder spica
|
$772.80 |
$772.80 |
$772.80 |
$468.00
|
|
Appl halo type body cast
|
$772.80 |
$772.80 |
$772.80 |
$561.60
|
|
Appl hip spica cast1&1/2
|
$778.40 |
$778.40 |
$778.40 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$890.40 |
$890.40 |
$890.40 |
$499.20
|
|
Application clubfoot cast
|
$63.00 |
$63.00 |
$683.20 |
$290.40
|
|
Application finger splntstatic 29130
|
$132.30 |
$132.30 |
$436.80 |
$208.50
|
|
Application halo femoral
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,350.00
|
|
Application halo pelvic
|
$5,112.80 |
$5,112.80 |
$5,112.80 |
$1,893.86
|
|
Application long leg splint 29505
|
$232.95 |
$232.95 |
$526.40 |
$356.85
|
|
Application lower leg splint 29515
|
$232.95 |
$232.95 |
$532.00 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$879.20 |
$879.20 |
$879.20 |
$359.10
|
|
Application of body cast
|
$772.80 |
$772.80 |
$772.80 |
$557.18
|
|
Application of body cast
|
$772.80 |
$772.80 |
$772.80 |
$390.73
|
|
Application of cylinder cast 29365
|
$890.40 |
$890.40 |
$890.40 |
$431.08
|
|
Application of forearm cast 29075
|
$66.15 |
$66.15 |
$761.60 |
$347.20
|
|
Application of long arm cast 29065
|
$177.30 |
$177.30 |
$772.80 |
$401.40
|
|
Application of long leg cast
|
$61.05 |
$61.05 |
$828.80 |
$426.00
|
|
Application of long leg cast 29345
|
$66.15 |
$66.15 |
$800.80 |
$464.51
|
|
Application of paste boot 29580
|
$616.00 |
$616.00 |
$616.00 |
$328.20
|
|
Application short leg cast 29405
|
$66.15 |
$66.15 |
$778.40 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$4,844.00 |
$4,844.00 |
$4,844.00 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$4,844.00 |
$4,844.00 |
$4,844.00 |
$2,189.70
|
|
Applicator tag rfid localizer 12gx7cm
|
$48,300.00 |
$48,300.00 |
$48,300.00 |
$895.00
|
|
Appl long leg cast brace
|
$772.80 |
$772.80 |
$772.80 |
$420.00
|
|
Appl mltpln uni ext fixj sys
|
$9,878.40 |
$9,878.40 |
$9,878.40 |
$5,668.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$45.00 |
$45.00 |
$69.44 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$32.85 |
$32.85 |
$104.72 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$75.60 |
$75.60 |
$75.60 |
$49.92
|
|
Appl multlay comprs arm/hand
|
$716.80 |
$716.80 |
$716.80 |
$284.05
|
|
Appl patllr tdn bearing cast
|
$66.15 |
$66.15 |
$890.40 |
$396.75
|
|
Appl unipln uni ext fixj sys
|
$344.55 |
$344.55 |
$15,019.20 |
$5,754.10
|
|
Apply finger cast 29086
|
$823.20 |
$823.20 |
$823.20 |
$238.15
|
|
Apply forearm splintdynamic 29126
|
$120.45 |
$120.45 |
$800.80 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$40.20 |
$40.20 |
$823.20 |
$275.80
|
|
Apply interstit radiat compl
|
$308.10 |
$308.10 |
$3,880.80 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$4,328.80 |
$4,328.80 |
$4,328.80 |
$1,773.02
|
|
Apply intrcav radiat interm
|
$4,328.80 |
$4,328.80 |
$4,328.80 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$4,502.40 |
$4,502.40 |
$4,502.40 |
$1,246.70
|
