|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,275.36 |
$1,275.36 |
$1,275.36 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$1,275.36 |
$1,275.36 |
$1,275.36 |
$3,461.40
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,275.36 |
$1,275.36 |
$1,275.36 |
$1,300.71
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,275.36 |
$1,275.36 |
$1,275.36 |
$508.18
|
|
Application finger splntstatic 29130
|
$749.57 |
$749.57 |
$749.57 |
$226.20
|
|
Application long leg splint 29505
|
$1,832.84 |
$1,832.84 |
$1,832.84 |
$370.00
|
|
Application lower leg splint 29515
|
$1,085.16 |
$1,085.16 |
$1,085.16 |
$365.60
|
|
Application multi layer compression below knee (both sides)
|
$1,171.32 |
$1,171.32 |
$1,171.32 |
$393.75
|
|
Application of forearm cast 29075
|
$1,608.74 |
$1,608.74 |
$1,608.74 |
$386.10
|
|
Application of long arm cast 29065
|
$1,340.40 |
$1,340.40 |
$1,340.40 |
$414.20
|
|
Application of long leg cast 29345
|
$2,126.33 |
$2,126.33 |
$2,126.33 |
$511.68
|
|
Application of paste boot 29580
|
$1,083.19 |
$1,083.19 |
$1,083.19 |
$336.00
|
|
Application short leg cast 29405
|
$924.50 |
$924.50 |
$924.50 |
$397.33
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,140.13 |
$2,140.13 |
$2,140.13 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$5,218.16 |
$5,218.16 |
$5,218.16 |
$2,164.64
|
|
Appl multlay comprs arm/hand
|
$480.37 |
$480.37 |
$480.37 |
$339.69
|
|
Apply finger cast 29086
|
$941.91 |
$941.91 |
$941.91 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$812.49 |
$812.49 |
$812.49 |
$263.20
|
|
Apply intrcav radiat compl
|
$9,394.74 |
$9,394.74 |
$9,394.74 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$7,147.27 |
$7,147.27 |
$7,147.27 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$7,147.27 |
$7,147.27 |
$7,147.27 |
$1,001.00
|
|
Apply short leg castambul type 29425
|
$1,824.67 |
$1,824.67 |
$1,824.67 |
$460.92
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$3,153.78 |
$3,153.78 |
$3,153.78 |
$943.40
|
|
Aquaporin-4 antibody cba each
|
$143.52 |
$143.52 |
$143.52 |
$114.60
|
|
Aquaporin-4 antibody elisa
|
$114.22 |
$114.22 |
$114.22 |
$155.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$224.34 |
$224.34 |
$224.34 |
$100.00
|
|
Aquatic exercise - group charge
|
$180.07 |
$180.07 |
$180.07 |
$91.68
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$810.50 |
$810.50 |
$810.50 |
$1,301.04
|
|
Arterial blood draw/perc 36620
|
$461.78 |
$461.78 |
$461.78 |
$500.82
|
|
Artery x-rays arm/leg 75710-26
|
$5,386.57 |
$5,386.57 |
$5,386.57 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$11,581.13 |
$11,581.13 |
$11,581.13 |
$4,029.72
|
|
Artery x-rays lungs
|
$7,243.11 |
$7,243.11 |
$7,243.11 |
$3,724.63
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$2,468.16 |
$2,468.16 |
$2,468.16 |
$588.53
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$2,434.27 |
$2,434.27 |
$2,434.27 |
$471.34
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$2,365.59 |
$2,365.59 |
$2,365.59 |
$715.37
|
|
Aspirate bladder/sprapubic cath 51102
|
$3,080.04 |
$3,080.04 |
$3,080.04 |
$3,199.51
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$2,067.65 |
$2,067.65 |
$2,067.65 |
$1,306.50
|
|
Assay dir meas fr estradiol
|
$87.90 |
$87.90 |
$87.90 |
$75.11
|
|
Assay of interleukin-6 (il-6)
|
$101.57 |
$101.57 |
$101.57 |
$77.35
|
|
Assay of salicylate
|
$244.61 |
$244.61 |
$244.61 |
$104.00
|
|
Assay of somatostatin
|
$260.56 |
$260.56 |
$260.56 |
$165.75
|
|
Assay toxin or antitoxin
|
$246.76 |
$246.76 |
$246.76 |
$77.55
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$540.06 |
$540.06 |
$540.06 |
$312.00
|
|
Ast/sgot
|
$102.25 |
$102.25 |
$102.25 |
$46.20
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$33,080.81 |
$33,080.81 |
$33,080.81 |
$31,198.64
|
|
Athrectomy fem/pop/unilateral 37225
|
$10,113.33 |
$10,113.33 |
$10,113.33 |
$19,624.54
|
|
Atropine 0.1 mg/ml injection syringe
|
$244.84 |
$244.84 |
$244.84 |
$43.85
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$7,639.78 |
$7,639.78 |
$7,639.78 |
$7,713.54
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$30,559.08 |
$30,559.08 |
$30,559.08 |
$11,040.83
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$666.29 |
$666.29 |
$666.29 |
$356.00
|
|
Azacitidine injection
|
$451.62 |
$451.62 |
$451.62 |
$1,042.91
|
|
Azithromycin 500 mg intravenous solution
|
$196.33 |
$196.33 |
$196.33 |
$55.63
|
|
#bac vag cand-c. albicans naa
|
$282.87 |
$282.87 |
$282.87 |
$109.20
|
|
B cells total count
|
$471.64 |
$471.64 |
$471.64 |
$128.13
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$9,162.37 |
$9,162.37 |
$9,162.37 |
$6,471.19
|
|
Benign lesion paring 2-4
|
$528.30 |
$528.30 |
$528.30 |
$280.20
|
|
#_benzodiazconfur
|
$306.63 |
$306.63 |
$306.63 |
$100.75
|
|
Benztropine 1 mg/ml injection solution
|
$280.76 |
$280.76 |
$280.76 |
$116.84
|
|
Beta 2 glycoprotein 1 antibody iga
|
$152.78 |
$152.78 |
$152.78 |
$92.82
|
|
Beta-2 microglobulin
|
$202.26 |
$202.26 |
$202.26 |
$86.40
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$296.55 |
$296.55 |
$296.55 |
$70.37
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$10,069.21 |
$10,069.21 |
$10,069.21 |
$5,250.00
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$2,143.22 |
$2,143.22 |
$2,143.22 |
$4,868.42
|
|
Bevacizumab injection
|
$1,786.58 |
$1,786.58 |
$1,786.58 |
$697.32
|
|
Bilateral n block inj occipital 64405
|
$1,483.37 |
$1,483.37 |
$1,483.37 |
$825.60
|
|
Bilirubin direct
|
$125.96 |
$125.96 |
$125.96 |
$49.31
|
|
Bilirubin total
|
$201.83 |
$201.83 |
$201.83 |
$51.50
|
|
Biopsy abdominal mass
|
$4,742.90 |
$4,742.90 |
$4,742.90 |
$1,917.33
|
|
Biopsy bone trocar/needle superficial
|
$5,846.62 |
$5,846.62 |
$5,846.62 |
$1,760.00
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$3,324.23 |
$3,324.23 |
$3,324.23 |
$3,211.00
|
|
Biopsy muscle percutaneous needle
|
$6,221.82 |
$6,221.82 |
$6,221.82 |
$1,877.40
|
|
Biopsy needle liver percutaneous
|
$5,066.23 |
$5,066.23 |
$5,066.23 |
$2,020.70
|
|
Biopsy needle lymph node superficial
|
$3,619.87 |
$3,619.87 |
$3,619.87 |
$1,879.09
|
|
Biopsy of salivary gland 42400
|
$2,332.01 |
$2,332.01 |
$2,332.01 |
$1,152.50
|
|
Biopsy renal percutaneous trocar/needle (both sides)
|
$4,600.97 |
$4,600.97 |
$4,600.97 |
$2,211.08
|
|
Biopsy/soft tissue/neck or thorax 21550
|
$7,218.26 |
$7,218.26 |
$7,218.26 |
$2,310.84
|
|
Bladder irrigate/lavage/instill 51700
|
$1,273.91 |
$1,273.91 |
$1,273.91 |
$440.70
|
|
Blood Clotting (PT/INR) Test
|
$152.78 |
$152.78 |
$152.78 |
$52.46
|
|
Blood Clotting (PTT) Test
|
$309.30 |
$309.30 |
$309.30 |
$73.15
|
|
Blood Count (CBC) Test
|
$327.19 |
$327.19 |
$327.19 |
$74.34
|
|
Blood Count (CBC) Test (without differential)
|
$261.47 |
$261.47 |
$261.47 |
$62.15
|
|
Blood Culture Test
|
$353.45 |
$353.45 |
$353.45 |
$145.60
|
|
Blood draw capillary 36416
|
$34.12 |
$34.12 |
$34.12 |
$22.40
|
|
Blood gases ph venous
|
$181.68 |
$181.68 |
$181.68 |
$61.75
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$162.42 |
$162.42 |
$162.42 |
$57.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$107.44 |
$107.44 |
$107.44 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$101.27 |
$101.27 |
$101.27 |
$33.85
|
|
Blood smear interpretation
|
$70.41 |
$70.41 |
$70.41 |
$79.20
|
|
Blood smear microscopic w manual differential wbc count
|
$84.95 |
$84.95 |
$84.95 |
$37.05
|
|
Blood typing abo
|
$252.57 |
$252.57 |
$252.57 |
$83.03
|
|
Blood typing ag donor ea ag
|
$342.81 |
$342.81 |
$342.81 |
$166.80
|
|
Blood typing rbc ag non abo/rh ea
|
$86.70 |
$86.70 |
$86.70 |
$181.74
|
|
Blood typing rh (d)
|
$236.80 |
$236.80 |
$236.80 |
$57.10
|
|
Blood typing rh phenotype complete reference
|
$149.46 |
$149.46 |
$149.46 |
$77.25
|
|
Bone Density Scan (DEXA)
|
$438.87 |
$438.87 |
$438.87 |
$395.00
|
|
Bone imaging multiple areas
|
$32,996.23 |
$32,996.23 |
$32,996.23 |
$1,210.00
|
|
Bone/joint imaging ltd area
|
$2,730.72 |
$2,730.72 |
$2,730.72 |
$1,151.16
|
|
Bone marrow imaging ltd
|
$2,661.80 |
$2,661.80 |
$2,661.80 |
$728.85
|
|
Bone marrow interpretation
|
$810.43 |
$810.43 |
$810.43 |
$436.00
|
|
Bone survey-lead poisoning
|
$1,306.81 |
$1,306.81 |
$1,306.81 |
$370.18
|