|
Amp metatarsal w/toe single 28810
|
$724.80 |
$724.80 |
$724.80 |
$4,271.00
|
|
Amputate lower leg at knee
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$3,342.87
|
|
Amputate thigh through femur 27590
|
$2,087.40 |
$2,087.40 |
$2,087.40 |
$3,342.87
|
|
Amputation follow-up surgery
|
$1,034.40 |
$1,034.40 |
$1,034.40 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$2,241.60 |
$2,241.60 |
$2,241.60 |
$2,241.60
|
|
Amputation leg; tib/fib f/u 27886
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$1,461.89
|
|
Amputation of forearm
|
$1,770.60 |
$1,770.60 |
$1,770.60 |
$7,413.38
|
|
Amputation of forearm
|
$1,744.80 |
$1,744.80 |
$1,744.80 |
$7,413.38
|
|
Amputation of hand
|
$1,773.00 |
$1,773.00 |
$1,773.00 |
$2,006.40
|
|
Amputation of lower leg
|
$2,223.00 |
$2,223.00 |
$2,223.00 |
$3,342.87
|
|
Amputation of midtarsal 28800
|
$1,091.40 |
$1,091.40 |
$1,091.40 |
$2,285.40
|
|
Amputation thru metatarsal
|
$1,234.20 |
$1,234.20 |
$1,234.20 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$467.40 |
$467.40 |
$467.40 |
$3,998.20
|
|
Amputation toe metatarsophalangeal joint
|
$570.00 |
$570.00 |
$570.00 |
$3,839.54
|
|
Amylase
|
$217.20 |
$217.20 |
$217.20 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$159.60 |
$159.60 |
$159.60 |
$80.08
|
|
Anal/urinary muscle study
|
$533.40 |
$533.40 |
$533.40 |
$407.00
|
|
Anal/urinary muscle study
|
$576.00 |
$576.00 |
$576.00 |
$576.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$493.80 |
$493.80 |
$493.80 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$556.20 |
$556.20 |
$556.20 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$556.20 |
$556.20 |
$556.20 |
$230.40
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$865.20 |
$865.20 |
$865.20 |
$122.20
|
|
Anaplsma phgcytophlm amp prb
|
$37.80 |
$37.80 |
$37.80 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$254.40 |
$254.40 |
$254.40 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,073.60 |
$2,073.60 |
$2,073.60 |
$2,626.65
|
|
An fluoro guide for cvp
|
$693.60 |
$693.60 |
$693.60 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$11,563.20 |
$11,563.20 |
$11,563.20 |
$5,341.83
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,744.20 |
$4,744.20 |
$4,744.20 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$11,563.20 |
$11,563.20 |
$11,563.20 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,726.80 |
$4,726.80 |
$4,726.80 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$11,526.60 |
$11,526.60 |
$11,526.60 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$1,518.60 |
$1,518.60 |
$1,518.60 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$957.00 |
$957.00 |
$957.00 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$974.40 |
$974.40 |
$974.40 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$1,240.20 |
$1,240.20 |
$1,240.20 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$1,593.60 |
$1,593.60 |
$1,593.60 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$1,946.40 |
$1,946.40 |
$1,946.40 |
$7,913.97
|
|
Ankle X-ray
|
$649.80 |
$649.80 |
$649.80 |
$353.60
|
|
Anora (draw only)
|
$132.60 |
$132.60 |
$132.60 |
$33.58
|
|
Antibody bacterium, not elsewhere specified
|
$286.80 |
$286.80 |
$286.80 |
$57.81
|
|
Antibody elution rbc reference
|
$262.80 |
$262.80 |
$262.80 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$442.20 |
$442.20 |
$442.20 |
$130.00
|
|
Antibody htlv-i
|
$178.80 |
$178.80 |
$178.80 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$1,069.20 |
$1,069.20 |
$1,069.20 |
$218.30
|
|
Antibody id rbc panel
|
$285.00 |
$285.00 |
$285.00 |
$274.56
|
|
Antibody influenza virus
|
$236.40 |
$236.40 |
$236.40 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$42.00 |
$42.00 |
$42.00 |
$48.57
|
|
Antibody screen rbc
|
$277.20 |
$277.20 |
$277.20 |
$100.00
|
|
Antibody tetanus
|
$189.00 |
$189.00 |
$189.00 |
$53.95
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$28.20 |
$28.20 |
$28.20 |
$37.05
|
|
Antinuclear antibodies
|
$194.40 |
$194.40 |
$194.40 |
$89.40
|
|
Antinuclear antibodies titer
|
$138.00 |
$138.00 |
$138.00 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$344.40 |
$344.40 |
$344.40 |
$65.97
|
|
Antistreptolysin o titer
|
$141.60 |
$141.60 |
$141.60 |
$51.45
|
|
Antithrombin iii activity
|
$246.60 |
$246.60 |
$246.60 |
$114.00
|
|
Aortic circulation assist 33971
|
$1,381.80 |
$1,381.80 |
$1,381.80 |
$1,719.20
|
|
Aortic dysfunction/dilation
|
$6,978.00 |
$6,978.00 |
$6,978.00 |
$1,008.00
|
|
Apheresis plasma
|
$2,580.60 |
$2,580.60 |
$2,580.60 |
$3,188.50
|
|
Apheresis platelets
|
$2,360.40 |
$2,360.40 |
$2,360.40 |
$2,042.95
|
|
Apheresis rbc
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$3,146.15
|
|
Apheresis wbc
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$2,968.80
|
|
Apl(pml-rara) quant - sendout
|
$735.60 |
$735.60 |
$735.60 |
$482.95
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,661.40 |
$1,661.40 |
$1,661.40 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$727.80 |
$727.80 |
$727.80 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$646.20 |
$646.20 |
$646.20 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,737.20 |
$2,737.20 |
$2,737.20 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$646.20 |
$646.20 |
$646.20 |
$498.81
|
|
Appl hip spica cast1&1/2
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$765.60 |
$765.60 |
$765.60 |
$499.20
|
|
Application finger splntstatic 29130
|
$238.20 |
$238.20 |
$238.20 |
$208.16
|
|
Application long leg splint 29505
|
$303.00 |
$303.00 |
$303.00 |
$338.25
|
|
Application lower leg splint 29515
|
$454.20 |
$454.20 |
$454.20 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$438.00 |
$438.00 |
$438.00 |
$373.20
|
|
Application of cylinder cast 29365
|
$765.60 |
$765.60 |
$765.60 |
$420.00
|
|
Application of forearm cast 29075
|
$765.60 |
$765.60 |
$765.60 |
$339.30
|
|
Application of long arm cast 29065
|
$765.60 |
$765.60 |
$765.60 |
$395.00
|
|
Application of long leg cast
|
$403.80 |
$403.80 |
$403.80 |
$426.00
|
|
Application of long leg cast 29345
|
$765.60 |
$765.60 |
$765.60 |
$455.00
|
|
Application of paste boot 29580
|
$468.60 |
$468.60 |
$468.60 |
$331.74
|
|
Application short leg cast 29405
|
$765.60 |
$765.60 |
$765.60 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,661.40 |
$1,661.40 |
$1,661.40 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,661.40 |
$1,661.40 |
$1,661.40 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$307.80 |
$307.80 |
$307.80 |
$744.90
|
|
Appl mltpln uni ext fixj sys
|
$1,035.60 |
$1,035.60 |
$1,035.60 |
$5,668.20
|
|
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
|
$391.80 |
$391.80 |
$391.80 |
$292.60
|
|
Appl unipln uni ext fixj sys
|
$553.80 |
$553.80 |
$553.80 |
$5,801.00
|
|
Apply forearm splintdynamic 29126
|
$397.20 |
$397.20 |
$397.20 |
$246.18
|
|
Apply halo w/removal cranial
|
$989.40 |
$989.40 |
$989.40 |
$1,367.60
|
|
Apply hand/wrist cast 29085
|
$348.60 |
$348.60 |
$348.60 |
$259.20
|
|
Apply intrcav radiat compl
|
$3,555.60 |
$3,555.60 |
$3,555.60 |
$1,773.02
|
|
Apply intrcav radiat interm
|
$2,471.40 |
$2,471.40 |
$2,471.40 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$1,207.44
|
|
Apply of finger splint 29131
|
$299.40 |
$299.40 |
$299.40 |
$168.00
|
|
Apply rem fixation device
|
$1,563.00 |
$1,563.00 |
$1,563.00 |
$2,021.04
|
|
Apply rigid leg cast 29445
|
$762.60 |
$762.60 |
$762.60 |
$555.00
|
|
Apply short leg castambul type 29425
|
$765.60 |
$765.60 |
$765.60 |
$381.00
|
|
App mltpln uni xtrnl fix 1st
|
$1,996.20 |
$1,996.20 |
$1,996.20 |
$20,355.21
|
