|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$599.04 |
$599.04 |
$599.04 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,015.13 |
$2,015.13 |
$2,015.13 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$498.81 |
$498.81 |
$498.81 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$498.81 |
$498.81 |
$498.81 |
$512.20
|
|
Appl hip spica cast 1 leg
|
$336.96 |
$336.96 |
$336.96 |
$499.20
|
|
Application clubfoot cast
|
$166.92 |
$166.92 |
$166.92 |
$303.00
|
|
Application finger splntstatic 29130
|
$614.64 |
$614.64 |
$614.64 |
$208.50
|
|
Application long leg splint 29505
|
$614.64 |
$614.64 |
$614.64 |
$338.25
|
|
Application lower leg splint 29515
|
$540.54 |
$540.54 |
$540.54 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$460.98 |
$460.98 |
$460.98 |
$375.06
|
|
Application of cylinder cast 29365
|
$336.96 |
$336.96 |
$336.96 |
$431.08
|
|
Application of forearm cast 29075
|
$1,219.53 |
$1,219.53 |
$1,219.53 |
$358.20
|
|
Application of long arm cast 29065
|
$1,219.53 |
$1,219.53 |
$1,219.53 |
$396.77
|
|
Application of long leg cast
|
$304.98 |
$304.98 |
$304.98 |
$435.54
|
|
Application of long leg cast 29345
|
$1,363.83 |
$1,363.83 |
$1,363.83 |
$455.00
|
|
Application of paste boot 29580
|
$614.64 |
$614.64 |
$614.64 |
$340.11
|
|
Application short leg cast 29405
|
$893.10 |
$893.10 |
$893.10 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$2,026.32 |
$2,026.32 |
$2,026.32 |
$981.75
|
|
Appl long leg cast brace
|
$304.98 |
$304.98 |
$304.98 |
$468.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$62.01 |
$62.01 |
$62.01 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$67.86 |
$67.86 |
$67.86 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$49.92 |
$49.92 |
$49.92 |
$54.61
|
|
Appl multlay comprs arm/hand
|
$339.69 |
$339.69 |
$339.69 |
$289.60
|
|
Apply finger cast 29086
|
$614.64 |
$614.64 |
$614.64 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$326.82 |
$326.82 |
$326.82 |
$255.20
|
|
Apply halo w/removal cranial
|
$3,259.23 |
$3,259.23 |
$3,259.23 |
$1,367.60
|
|
Apply hand/wrist cast 29085
|
$214.89 |
$214.89 |
$214.89 |
$271.80
|
|
Apply interstit radiat compl
|
$3,329.04 |
$3,329.04 |
$3,329.04 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$1,815.45 |
$1,815.45 |
$1,815.45 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$1,338.48 |
$1,338.48 |
$1,338.48 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$1,338.48 |
$1,338.48 |
$1,338.48 |
$1,269.97
|
|
Apply of finger splint 29131
|
$73.32 |
$73.32 |
$73.32 |
$177.45
|
|
Apply rem fixation device
|
$3,818.10 |
$3,818.10 |
$3,818.10 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$1,910.61 |
$1,910.61 |
$1,910.61 |
$555.00
|
|
Apply short leg castambul type 29425
|
$301.86 |
$301.86 |
$301.86 |
$404.74
|
|
Apply surf ldr radionuclide
|
$251.55 |
$251.55 |
$251.55 |
$282.80
|
|
App mltpln uni xtrnl fix xch
|
$1,845.48 |
$1,845.48 |
$1,845.48 |
$3,526.50
|
|
#aptt mix-1:1 incubated
|
$213.72 |
$213.72 |
$213.72 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$231.66 |
$231.66 |
$231.66 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$76.44 |
$76.44 |
$76.44 |
$100.75
|
|
Aquatic exercise - group charge
|
$63.57 |
$63.57 |
$63.57 |
$87.45
|
|
Ar gene charac alleles
|
$225.42 |
$225.42 |
$225.42 |
$287.70
|
|
Ar gene full gene sequence
|
$495.69 |
$495.69 |
$495.69 |
$331.49
|
|
Ar gene known famil variant
|
$304.59 |
$304.59 |
$304.59 |
$304.59
|
|
Arm CT Scan (with contrast, both arms)
|
$1,268.28 |
$1,268.28 |
$1,268.28 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,150.11 |
$1,150.11 |
$1,150.11 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$370.89 |
$370.89 |
$370.89 |
$426.00
|
|
Arterial blood draw/perc 36620
|
$449.67 |
$449.67 |
$449.67 |
$478.96
|
|
Artery-vein nonautograft
|
$7,236.06 |
$7,236.06 |
$7,236.06 |
$7,236.06
|
|
Artery xray each vessel 7577426
|
$1,978.08 |
$1,978.08 |
$1,978.08 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$2,944.11 |
$2,944.11 |
$2,944.11 |
$4,618.71
|
|
Artery x-rays adrenal gland
|
$2,464.41 |
$2,464.41 |
$2,464.41 |
$3,320.35
|
|
Artery x-rays adrenals
|
$2,600.91 |
$2,600.91 |
$2,600.91 |
$3,764.59
|
|
Artery x-rays arm/leg 75710-26
|
$1,971.06 |
$1,971.06 |
$1,971.06 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$2,554.50 |
$2,554.50 |
$2,554.50 |
$3,860.40
|
|
Artery x-rays chest
|
$2,137.59 |
$2,137.59 |
$2,137.59 |
$2,895.07
|
|
Artery x-rays lung
|
$2,921.88 |
$2,921.88 |
$2,921.88 |
$3,296.15
|
|
Artery x-rays lung
|
$2,138.37 |
$2,138.37 |
$2,138.37 |
$2,427.50
|
|
Artery x-rays lungs
|
$3,392.61 |
$3,392.61 |
$3,392.61 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$2,944.11 |
$2,944.11 |
$2,944.11 |
$4,306.40
|
|
Artery x-rays spine
|
$2,944.11 |
$2,944.11 |
$2,944.11 |
$4,792.33
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$753.87 |
$753.87 |
$753.87 |
$609.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,005.42 |
$1,005.42 |
$1,005.42 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,156.35 |
$1,156.35 |
$1,156.35 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$603.33 |
$603.33 |
$603.33 |
$494.40
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$854.88 |
$854.88 |
$854.88 |
$699.00
|
|
Ascenda two piece catheter
|
$23,612.07 |
$23,612.07 |
$23,612.07 |
$22,792.00
|
|
Ashkenazi jewish assoc dis
|
$3,459.30 |
$3,459.30 |
$3,459.30 |
$2,693.42
|
|
Asp core fat pad
|
$514.41 |
$514.41 |
$514.41 |
$1,123.50
|
|
Asp & inj bone cyst
|
$1,834.56 |
$1,834.56 |
$1,834.56 |
$1,060.40
|
|
Aspirate bladder/sprapubic cath 51102
|
$3,162.90 |
$3,162.90 |
$3,162.90 |
$3,226.20
|
|
Aspirate/inj ganglion cyst 20612
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$441.30
|
|
Aspirate pleura without imaging 32554
|
$2,511.99 |
$2,511.99 |
$2,511.99 |
$1,195.15
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,834.56 |
$1,834.56 |
$1,834.56 |
$1,250.04
|
|
Aspir/inj thyroid cyst 60300
|
$1,847.43 |
$1,847.43 |
$1,847.43 |
$872.50
|
|
Assay acid phosphatase
|
$38.22 |
$38.22 |
$38.22 |
$38.22
|
|
Assay alkaline phosphatase
|
$57.72 |
$57.72 |
$57.72 |
$42.60
|
|
Assay dir meas fr estradiol
|
$58.50 |
$58.50 |
$58.50 |
$68.00
|
|
Assay myeloperoxidase
|
$74.39 |
$74.39 |
$74.39 |
$97.41
|
|
Assay of adp & amp
|
$412.62 |
$412.62 |
$412.62 |
$169.65
|
|
Assay of blood lipoprotein
|
$123.63 |
$123.63 |
$123.63 |
$70.50
|
|
Assay of breath ethanol
|
$83.07 |
$83.07 |
$83.07 |
$52.62
|
|
Assay of chloramphenicol
|
$78.00 |
$78.00 |
$78.00 |
$70.56
|
|
Assay of endocrine hormone
|
$314.73 |
$314.73 |
$314.73 |
$143.20
|
|
Assay of feces porphyrins
|
$272.22 |
$272.22 |
$272.22 |
$134.38
|
|
Assay of feces/urobilinogen
|
$20.67 |
$20.67 |
$20.67 |
$24.90
|
|
Assay of galactose
|
$577.20 |
$577.20 |
$577.20 |
$47.26
|
|
Assay of glutathione
|
$24.18 |
$24.18 |
$24.18 |
$76.14
|
|
Assay of interleukin-6 (il-6)
|
$47.19 |
$47.19 |
$47.19 |
$79.00
|
|
Assay of lap enzyme
|
$111.15 |
$111.15 |
$111.15 |
$72.00
|
|
Assay of leflunomide
|
$107.64 |
$107.64 |
$107.64 |
$92.50
|
|
Assay of osteocalcin
|
$93.60 |
$93.60 |
$93.60 |
$93.60
|
|
Assay of pregnanetriol
|
$55.77 |
$55.77 |
$55.77 |
$85.15
|
|
Assay of procainamide
|
$36.66 |
$36.66 |
$36.66 |
$114.91
|
|
Assay of procainamide w/metab
|
$196.17 |
$196.17 |
$196.17 |
$73.80
|
|
Assay of progesterone
|
$532.35 |
$532.35 |
$532.35 |
$261.31
|
|
Assay of PSA complexed
|
$298.74 |
$298.74 |
$298.74 |
$64.28
|
|
Assay of quinine
|
$78.00 |
$78.00 |
$78.00 |
$29.60
|