|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,424.00 |
$2,424.00 |
$2,424.00 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,079.40 |
$1,079.40 |
$1,079.40 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$414.60 |
$414.60 |
$414.60 |
$498.81
|
|
Application finger splntstatic 29130
|
$774.00 |
$774.00 |
$774.00 |
$208.16
|
|
Application long leg splint 29505
|
$762.00 |
$762.00 |
$762.00 |
$338.25
|
|
Application lower leg splint 29515
|
$828.00 |
$828.00 |
$828.00 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$392.40 |
$392.40 |
$392.40 |
$373.20
|
|
Application of forearm cast 29075
|
$617.40 |
$617.40 |
$617.40 |
$339.30
|
|
Application of long arm cast 29065
|
$260.40 |
$260.40 |
$260.40 |
$395.00
|
|
Application of paste boot 29580
|
$471.00 |
$471.00 |
$471.00 |
$331.74
|
|
Application short leg cast 29405
|
$821.40 |
$821.40 |
$821.40 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,179.60 |
$1,179.60 |
$1,179.60 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,179.60 |
$1,179.60 |
$1,179.60 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$307.80 |
$307.80 |
$307.80 |
$744.90
|
|
Appl modality 1/> areas paraffin bath 97018
|
$52.80 |
$52.80 |
$52.80 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$52.80 |
$52.80 |
$52.80 |
$75.60
|
|
Appl multlay comprs arm/hand
|
$367.80 |
$367.80 |
$367.80 |
$292.60
|
|
Apply hand/wrist cast 29085
|
$184.80 |
$184.80 |
$184.80 |
$259.20
|
|
Apply of finger splint 29131
|
$821.40 |
$821.40 |
$821.40 |
$168.00
|
|
Apply rigid leg cast 29445
|
$1,097.40 |
$1,097.40 |
$1,097.40 |
$555.00
|
|
#aptt mix-1:1 incubated
|
$265.20 |
$265.20 |
$265.20 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$714.60 |
$714.60 |
$714.60 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$108.00 |
$108.00 |
$108.00 |
$100.00
|
|
Aquatic exercise - group charge
|
$39.60 |
$39.60 |
$39.60 |
$85.80
|
|
Arterial blood draw/perc 36620
|
$604.20 |
$604.20 |
$604.20 |
$485.69
|
|
Artery xray each vessel 7577426
|
$1,458.60 |
$1,458.60 |
$1,458.60 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$3,911.40 |
$3,911.40 |
$3,911.40 |
$4,446.00
|
|
Artery x-rays arm/leg 75710-26
|
$3,579.60 |
$3,579.60 |
$3,579.60 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$4,044.00 |
$4,044.00 |
$4,044.00 |
$3,729.00
|
|
Artery x-rays lung
|
$3,037.80 |
$3,037.80 |
$3,037.80 |
$3,279.12
|
|
Artery x-rays lungs
|
$4,207.20 |
$4,207.20 |
$4,207.20 |
$3,535.57
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,113.00 |
$1,113.00 |
$1,113.00 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,263.60 |
$1,263.60 |
$1,263.60 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$970.80 |
$970.80 |
$970.80 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,091.40 |
$1,091.40 |
$1,091.40 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$1,020.60 |
$1,020.60 |
$1,020.60 |
$699.00
|
|
Aspirate bladder/sprapubic cath 51102
|
$1,642.80 |
$1,642.80 |
$1,642.80 |
$3,162.72
|
|
Aspirate pleura without imaging 32554
|
$1,675.20 |
$1,675.20 |
$1,675.20 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,988.40 |
$1,988.40 |
$1,988.40 |
$1,226.87
|
|
Aspir/inj thyroid cyst 60300
|
$1,835.40 |
$1,835.40 |
$1,835.40 |
$850.78
|
|
Assay free hydroxyproline
|
$238.20 |
$238.20 |
$238.20 |
$57.60
|
|
Assay neurflmnt light chain
|
$1,806.60 |
$1,806.60 |
$1,806.60 |
$380.00
|
|
Assay of breath ethanol
|
$16.80 |
$16.80 |
$16.80 |
$47.30
|
|
Assay of glutathione
|
$124.20 |
$124.20 |
$124.20 |
$76.14
|
|
Assay of interleukin-6 (il-6)
|
$72.60 |
$72.60 |
$72.60 |
$79.97
|
|
Assay of leflunomide
|
$381.00 |
$381.00 |
$381.00 |
$100.65
|
|
Assay of procainamide w/metab
|
$204.00 |
$204.00 |
$204.00 |
$70.50
|
|
Assay of prostaglandin
|
$101.40 |
$101.40 |
$101.40 |
$218.50
|
|
Assay of salicylate
|
$205.20 |
$205.20 |
$205.20 |
$95.00
|
|
Assay of tyrosine
|
$126.00 |
$126.00 |
$126.00 |
$60.00
|
|
Assay of urine sulfate
|
$16.80 |
$16.80 |
$16.80 |
$29.04
|
|
Assay phosphohexose enzymes
|
$86.40 |
$86.40 |
$86.40 |
$105.00
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$300.00 |
$300.00 |
$300.00 |
$292.50
|
|
Assistive tech assessment, ot
|
$90.60 |
$90.60 |
$90.60 |
$96.08
|
|
Ast/sgot
|
$79.20 |
$79.20 |
$79.20 |
$45.65
|
|
Audit/dast 15-30 min
|
$172.20 |
$172.20 |
$172.20 |
$67.83
|
|
Audit/dast over 30 min
|
$252.00 |
$252.00 |
$252.00 |
$109.20
|
|
Aud rehab postling hear loss
|
$138.60 |
$138.60 |
$138.60 |
$213.85
|
|
Aud rehab pre-ling hear loss
|
$168.60 |
$168.60 |
$168.60 |
$168.60
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$5,343.60 |
$5,343.60 |
$5,343.60 |
$7,109.05
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$8,971.80 |
$8,971.80 |
$8,971.80 |
$10,384.40
|
|
Avul nail plate addl
|
$303.60 |
$303.60 |
$303.60 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$520.20 |
$520.20 |
$520.20 |
$318.75
|
|
Baclofen eval charges
|
$106.20 |
$106.20 |
$106.20 |
$85.00
|
|
Bacterial meningitis antigen
|
$82.80 |
$82.80 |
$82.80 |
$66.30
|
|
Bacterial vaginosis pcr
|
$804.60 |
$804.60 |
$804.60 |
$278.40
|
|
#bac vag cand-c. albicans naa
|
$129.00 |
$129.00 |
$129.00 |
$105.00
|
|
B cells total count
|
$483.00 |
$483.00 |
$483.00 |
$131.30
|
|
Benign lesion paring 2-4
|
$216.60 |
$216.60 |
$216.60 |
$257.50
|
|
Benign lesion paring 4+
|
$277.20 |
$277.20 |
$277.20 |
$287.00
|
|
#_benzodiazconfur
|
$186.60 |
$186.60 |
$186.60 |
$114.40
|
|
Beta 2 glycoprotein 1 antibody iga
|
$427.80 |
$427.80 |
$427.80 |
$78.50
|
|
Beta-2 microglobulin
|
$385.80 |
$385.80 |
$385.80 |
$85.94
|
|
Beta-amyloid 1-42
|
$333.00 |
$333.00 |
$333.00 |
$312.50
|
|
Bfb train 1st 15min cntct 90912
|
$61.80 |
$61.80 |
$61.80 |
$173.55
|
|
Bfb train ea addl 15 min 90913
|
$42.60 |
$42.60 |
$42.60 |
$92.82
|
|
Bilateral n blobk inj pudendal 64430
|
$1,148.40 |
$1,148.40 |
$1,148.40 |
$1,460.90
|
|
Bilateral n block inj occipital 64405
|
$1,291.20 |
$1,291.20 |
$1,291.20 |
$768.60
|
|
Bilateral n block inj trigeminal 64400
|
$1,001.40 |
$1,001.40 |
$1,001.40 |
$556.40
|
|
Bilicheck
|
$66.60 |
$66.60 |
$66.60 |
$28.80
|
|
Bilirubin direct
|
$74.40 |
$74.40 |
$74.40 |
$50.00
|
|
Bilirubin total
|
$106.20 |
$106.20 |
$106.20 |
$52.57
|
|
Biopsy abdominal mass
|
$2,110.20 |
$2,110.20 |
$2,110.20 |
$1,718.60
|
|
Biopsy bone trocar/needle superficial
|
$2,272.80 |
$2,272.80 |
$2,272.80 |
$1,770.73
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$1,743.60 |
$1,743.60 |
$1,743.60 |
$2,716.95
|
|
Biopsy muscle percutaneous needle
|
$1,529.40 |
$1,529.40 |
$1,529.40 |
$1,629.60
|
|
Biopsy needle liver percutaneous
|
$2,103.60 |
$2,103.60 |
$2,103.60 |
$1,892.80
|
|
Biopsy needle lymph node superficial
|
$2,865.00 |
$2,865.00 |
$2,865.00 |
$1,878.14
|
|
Biopsy of salivary gland 42400
|
$2,719.20 |
$2,719.20 |
$2,719.20 |
$1,145.90
|
|
Biopsy renal percutaneous trocar/needle (both sides)
|
$2,478.00 |
$2,478.00 |
$2,478.00 |
$2,086.50
|
|
Biopsy skin incisional single lesion
|
$370.20 |
$370.20 |
$370.20 |
$657.66
|
|
Biopsy/soft tissue/neck or thorax 21550
|
$2,362.20 |
$2,362.20 |
$2,362.20 |
$2,462.35
|
|
Biotinidase - quest
|
$37.20 |
$37.20 |
$37.20 |
$71.02
|
|
Bladder irrigate/lavage/instill 51700
|
$682.20 |
$682.20 |
$682.20 |
$408.00
|
|
Bld prd mix
|
$108.00 |
$108.00 |
$108.00 |
$139.21
|
|
Blood Clotting (PT/INR) Test
|
$71.40 |
$71.40 |
$71.40 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$79.20 |
$79.20 |
$79.20 |
$73.44
|
|
Blood Count (CBC) Test
|
$101.40 |
$101.40 |
$101.40 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$64.80 |
$64.80 |
$64.80 |
$61.80
|
