|
Angio trnslmnl balloon same vein ea addl
|
$6,390.60 |
$6,390.60 |
$6,390.60 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$7,986.60 |
$7,986.60 |
$7,986.60 |
$8,466.00
|
|
Ankle X-ray
|
$531.00 |
$531.00 |
$531.00 |
$353.60
|
|
Anl sp inf pmp w/mdreprg&fil
|
$897.60 |
$897.60 |
$897.60 |
$627.94
|
|
Anora (draw only)
|
$75.00 |
$75.00 |
$75.00 |
$33.58
|
|
Anoscopy and biopsy
|
$946.20 |
$946.20 |
$946.20 |
$1,395.28
|
|
Antibody bacterium, not elsewhere specified
|
$345.60 |
$345.60 |
$345.60 |
$57.81
|
|
Antibody elution rbc reference
|
$105.60 |
$105.60 |
$105.60 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$575.40 |
$575.40 |
$575.40 |
$130.00
|
|
Antibody htlv-i
|
$219.00 |
$219.00 |
$219.00 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$218.30
|
|
Antibody id rbc panel
|
$226.80 |
$226.80 |
$226.80 |
$274.56
|
|
Antibody influenza virus
|
$273.60 |
$273.60 |
$273.60 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$51.60 |
$51.60 |
$51.60 |
$48.57
|
|
Antibody screen rbc
|
$327.00 |
$327.00 |
$327.00 |
$100.00
|
|
Antibody tetanus
|
$210.00 |
$210.00 |
$210.00 |
$53.95
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$30.60 |
$30.60 |
$30.60 |
$37.05
|
|
Antinuclear antibodies
|
$71.40 |
$71.40 |
$71.40 |
$89.40
|
|
Antinuclear antibodies titer
|
$82.80 |
$82.80 |
$82.80 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$396.60 |
$396.60 |
$396.60 |
$65.97
|
|
Antistreptolysin o screen
|
$104.40 |
$104.40 |
$104.40 |
$62.00
|
|
Antistreptolysin o titer
|
$168.00 |
$168.00 |
$168.00 |
$51.45
|
|
Antithrombin iii activity
|
$193.80 |
$193.80 |
$193.80 |
$114.00
|
|
Aortic dysfunction/dilation
|
$7,307.40 |
$7,307.40 |
$7,307.40 |
$1,008.00
|
|
Apheresis plasma
|
$4,702.20 |
$4,702.20 |
$4,702.20 |
$3,188.50
|
|
Apheresis wbc
|
$4,561.80 |
$4,561.80 |
$4,561.80 |
$2,968.80
|
|
Apl(pml-rara) quant - sendout
|
$852.00 |
$852.00 |
$852.00 |
$482.95
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,626.60 |
$1,626.60 |
$1,626.60 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,071.60 |
$1,071.60 |
$1,071.60 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$687.00 |
$687.00 |
$687.00 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,719.80 |
$2,719.80 |
$2,719.80 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,071.60 |
$1,071.60 |
$1,071.60 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$687.00 |
$687.00 |
$687.00 |
$498.81
|
|
Application finger splntstatic 29130
|
$406.20 |
$406.20 |
$406.20 |
$208.16
|
|
Application long leg splint 29505
|
$377.40 |
$377.40 |
$377.40 |
$338.25
|
|
Application lower leg splint 29515
|
$456.00 |
$456.00 |
$456.00 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$450.60 |
$450.60 |
$450.60 |
$373.20
|
|
Application of forearm cast 29075
|
$260.40 |
$260.40 |
$260.40 |
$339.30
|
|
Application of long arm cast 29065
|
$260.40 |
$260.40 |
$260.40 |
$395.00
|
|
Application of long leg cast
|
$403.80 |
$403.80 |
$403.80 |
$426.00
|
|
Application of long leg cast 29345
|
$307.80 |
$307.80 |
$307.80 |
$455.00
|
|
Application of paste boot 29580
|
$518.40 |
$518.40 |
$518.40 |
$331.74
|
|
Application short leg cast 29405
|
$902.40 |
$902.40 |
$902.40 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,323.60 |
$1,323.60 |
$1,323.60 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,323.60 |
$1,323.60 |
$1,323.60 |
$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
|
$557.40 |
$557.40 |
$557.40 |
$292.60
|
|
Apply hand/wrist cast 29085
|
$184.80 |
$184.80 |
$184.80 |
$259.20
|
|
Apply interstit radiat compl
|
$2,296.20 |
$2,296.20 |
$2,296.20 |
$2,910.05
|
|
Apply intrcav radiat compl
|
$2,719.80 |
$2,719.80 |
$2,719.80 |
$1,773.02
|
|
Apply intrcav radiat interm
|
$2,463.00 |
$2,463.00 |
$2,463.00 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$2,203.20 |
$2,203.20 |
$2,203.20 |
$1,207.44
|
|
Apply rigid leg cast 29445
|
$1,014.60 |
$1,014.60 |
$1,014.60 |
$555.00
|
|
Apply surf ldr radionuclide
|
$297.00 |
$297.00 |
$297.00 |
$251.55
|
|
#aptt mix-1:1 incubated
|
$342.60 |
$342.60 |
$342.60 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$816.00 |
$816.00 |
$816.00 |
$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
|
$320.40 |
$320.40 |
$320.40 |
$485.69
|
|
Artery xray each vessel 7577426
|
$1,825.20 |
$1,825.20 |
$1,825.20 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$5,324.40 |
$5,324.40 |
$5,324.40 |
$4,446.00
|
|
Artery x-rays arm/leg 75710-26
|
$5,977.80 |
$5,977.80 |
$5,977.80 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$8,965.20 |
$8,965.20 |
$8,965.20 |
$3,729.00
|
|
Artery x-rays lungs
|
$2,148.60 |
$2,148.60 |
$2,148.60 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$5,899.20 |
$5,899.20 |
$5,899.20 |
$4,134.14
|
|
Artery x-rays spine
|
$6,811.80 |
$6,811.80 |
$6,811.80 |
$4,306.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$2,502.60 |
$2,502.60 |
$2,502.60 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$2,502.60 |
$2,502.60 |
$2,502.60 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$1,184.40 |
$1,184.40 |
$1,184.40 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,068.60 |
$1,068.60 |
$1,068.60 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$2,502.60 |
$2,502.60 |
$2,502.60 |
$699.00
|
|
Asp core fat pad
|
$1,806.60 |
$1,806.60 |
$1,806.60 |
$939.95
|
|
Asp & inj w/heparin pleurx cath
|
$1,107.60 |
$1,107.60 |
$1,107.60 |
$1,432.00
|
|
Aspirate/inj ganglion cyst 20612
|
$662.40 |
$662.40 |
$662.40 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$1,344.60 |
$1,344.60 |
$1,344.60 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,627.80 |
$1,627.80 |
$1,627.80 |
$1,226.87
|
|
Aspiration peritonsillar abscess
|
$286.20 |
$286.20 |
$286.20 |
$431.20
|
|
Aspir/inj thyroid cyst 60300
|
$1,806.60 |
$1,806.60 |
$1,806.60 |
$850.78
|
|
Asp pq spinal cord cyst/syrinx
|
$1,444.20 |
$1,444.20 |
$1,444.20 |
$1,270.92
|
|
Assay neurflmnt light chain
|
$1,806.60 |
$1,806.60 |
$1,806.60 |
$380.00
|
|
Assay of glutathione
|
$125.40 |
$125.40 |
$125.40 |
$76.14
|
|
Assay of interleukin-6 (il-6)
|
$82.80 |
$82.80 |
$82.80 |
$79.97
|
|
Assay of leflunomide
|
$432.00 |
$432.00 |
$432.00 |
$100.65
|
|
Assay of prostaglandin
|
$105.00 |
$105.00 |
$105.00 |
$218.50
|
|
Assay of salicylate
|
$144.00 |
$144.00 |
$144.00 |
$95.00
|
|
Assay of somatostatin
|
$979.20 |
$979.20 |
$979.20 |
$165.00
|
|
Assay of thiocyanate
|
$226.20 |
$226.20 |
$226.20 |
$65.00
|
|
Assay of tyrosine
|
$169.20 |
$169.20 |
$169.20 |
$60.00
|
|
Assay of urine sulfate
|
$93.00 |
$93.00 |
$93.00 |
$29.04
|
|
Assay phosphatidylglycerol
|
$303.60 |
$303.60 |
$303.60 |
$134.16
|
|
Assay phosphohexose enzymes
|
$87.00 |
$87.00 |
$87.00 |
$105.00
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$300.00 |
$300.00 |
$300.00 |
$292.50
|
|
Assess cyst contrast inject
|
$1,263.60 |
$1,263.60 |
$1,263.60 |
$447.33
|
|
Assist-bilat spinal disk surgery add-on 63035
|
$11,880.60 |
$11,880.60 |
$11,880.60 |
$920.00
|
|
Assistive tech assessment, ot
|
$90.60 |
$90.60 |
$90.60 |
$96.08
|
|
Ast/sgot
|
$138.60 |
$138.60 |
$138.60 |
$45.65
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$145.20 |
$145.20 |
$145.20 |
$186.60
|
