|
Amputation of forearm
|
$1,744.80 |
$1,744.80 |
$1,744.80 |
|
|
Amputation of hand
|
$1,773.00 |
$1,773.00 |
$1,773.00 |
|
|
Amputation of leg at hip
|
$4,000.80 |
$4,000.80 |
$4,000.80 |
|
|
Amputation of leg at hip
|
$6,192.00 |
$6,192.00 |
$6,192.00 |
|
|
Amputation of lower leg
|
$2,916.80 |
$2,916.80 |
$2,916.80 |
|
|
Amputation of lower leg
|
$2,223.00 |
$2,223.00 |
$2,223.00 |
|
|
Amputation of midtarsal 28800
|
$1,071.60 |
$1,071.60 |
$2,681.60 |
|
|
Amputation thru metatarsal
|
$1,234.20 |
$1,451.40 |
$3,622.40 |
|
|
Amputation toe interphalangeal joint
|
$467.40 |
$7,468.30 |
$9,734.00 |
|
|
Amputation toe metatarsophalangeal joint
|
$570.00 |
$3,598.37 |
$7,008.48 |
|
|
Amylase
|
$31.25 |
$123.84 |
$301.60 |
|
|
Anabolic steroid 1 or 2
|
$42.48 |
$169.80 |
$394.20 |
|
|
Anabolic steroid 3 or more
|
$27.20 |
$27.20 |
$27.20 |
|
|
Ana ds-dna
|
$38.16 |
$128.80 |
$378.95 |
|
|
Analgesics non-opioid 3-5
|
$12.00 |
$58.32 |
$85.14 |
|
|
Analgesics non-opioid 6/more
|
$12.00 |
$12.00 |
$214.80 |
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$36.00 |
$171.05 |
$550.00 |
|
|
Anal pressure record
|
$544.80 |
$1,057.00 |
$2,092.32 |
|
|
Anal/urinary muscle study
|
$90.00 |
$340.80 |
$666.00 |
|
|
Anal/urinary muscle study
|
$479.40 |
$617.40 |
$923.04 |
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$120.00 |
$338.40 |
$970.00 |
|
|
Analysis gene f2 20210g>a variant
|
$50.00 |
$310.20 |
$948.00 |
|
|
Analysis gene f5 leiden variant
|
$41.25 |
$340.00 |
$994.40 |
|
|
Analysis nerve
|
$111.21 |
$477.50 |
$540.80 |
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$113.60 |
$411.60 |
$865.20 |
|
|
Analysis tumor
|
$181.50 |
$248.80 |
$274.80 |
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$119.40 |
$494.90 |
$861.60 |
|
|
Anaplsma phgcytophlm amp prb
|
$37.20 |
$81.20 |
$270.72 |
|
|
Anastamo/extrahep bil duct/gi trac 47760
|
$4,216.80 |
$4,216.80 |
$37,248.39 |
|
|
Anastamo/roux-en-y/extrahep bil/gi 47780
|
$4,623.60 |
$4,623.60 |
$6,068.00 |
|
|
Anastomosis of facial/other nerve 64868
|
$2,004.60 |
$2,004.60 |
$2,004.60 |
|
|
Anca screen with reflex to titer -quest
|
$37.50 |
$207.36 |
$800.80 |
|
|
An cholangiogram percutaneous compl
|
$917.83 |
$2,730.20 |
$16,057.30 |
|
|
Androstanediol
|
$67.20 |
$196.70 |
$196.70 |
|
|
An fluoro guide for cvp
|
$162.50 |
$673.60 |
$1,859.20 |
|
|
Angio balloon ctrl dialysis seg add-on
|
$231.60 |
$5,606.64 |
$27,252.00 |
|
|
Angioplasty fem/pop unilat 37224
|
$745.20 |
$9,074.45 |
$73,347.44 |
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$544.20 |
$6,290.00 |
$41,207.04 |
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$1,750.00 |
$6,798.40 |
$166,195.88 |
|
|
Angioscopy
|
$363.20 |
$363.20 |
$363.20 |
|
|
Angiotensin ii
|
$43.40 |
$43.40 |
$55.00 |
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$32.40 |
$864.00 |
$5,594.57 |
|
|
Angio tib/peroneal/init ves/unila 37228
|
$910.80 |
$13,054.80 |
$111,805.40 |
|
|
Angio trnslmnl balloon same artery ea addl
|
$870.00 |
$3,962.70 |
$10,653.50 |
|
|
Angio trnslmnl balloon same artery ini
|
$3,000.00 |
$9,209.90 |
$60,111.38 |
|
|
Angio trnslmnl balloon same vein ea addl
|
$775.00 |
$2,550.00 |
$65,123.06 |
|
|
Angio trnslmnl balloon same vein ini
|
$2,933.40 |
$8,322.00 |
$56,159.87 |
|
|
Anidulafungin injection
|
$72.98 |
$72.98 |
$432.58 |
|
|
Ankle arthroscopy/surgery
|
$938.40 |
$39,204.77 |
$95,445.67 |
|
|
Ankle arthroscopy/surgery
|
$3,268.80 |
$36,056.93 |
$85,064.52 |
|
|
Ankle arthroscopy/surgery
|
$957.00 |
$2,481.60 |
$20,561.41 |
|
|
Ankle arthroscopy/surgery
|
$974.40 |
$15,431.32 |
$42,380.27 |
|
|
Ankle arthroscopy/surgery
|
$1,240.20 |
$20,212.92 |
$58,488.70 |
|
|
Ankle arthroscopy/surgery
|
$787.80 |
$28,602.63 |
$59,073.93 |
|
|
Ankle arthroscopy/surgery
|
$1,946.40 |
$5,096.00 |
$105,799.95 |
|
|
Ankle X-ray
|
$137.50 |
$449.35 |
$983.20 |
|
|
Ankle X-ray (2 views, both ankles)
|
$85.47 |
$385.92 |
$862.40 |
|
|
Anl sp inf pmp w/mdreprg&fil
|
$200.00 |
$553.20 |
$3,734.99 |
|
|
Annual alcohol screen 15 min
|
$23.40 |
$23.40 |
$40.00 |
|
|
Annual nursing fac assessmnt
|
$184.80 |
$184.80 |
$184.80 |
|
|
Annual Physical, Established Patient (age 18-39)
|
$114.60 |
$148.50 |
$226.80 |
|
|
Annual Physical, Established Patient (age 40-64)
|
$114.60 |
$167.75 |
$246.00 |
|
|
Annual Physical, New Patient (age 18-39)
|
$144.00 |
$174.60 |
$274.20 |
|
|
Annual Physical, New Patient (age 40-64)
|
$137.40 |
$229.20 |
$272.80 |
|
|
Anodyne therapy charges pt
|
$12.80 |
$25.20 |
$57.75 |
|
|
Anogenital exam child w imag
|
$345.60 |
$345.60 |
$345.60 |
|
|
Anora (draw only)
|
$16.80 |
$48.96 |
$132.60 |
|
|
Anorectal myomectomy
|
$906.40 |
$906.40 |
$906.40 |
|
|
Anoscopy
|
$496.00 |
$496.00 |
$496.00 |
|
|
Anoscopy ablation lesion 46615
|
$310.20 |
$3,845.00 |
$17,067.68 |
|
|
Anoscopy and biopsy
|
$423.00 |
$2,254.70 |
$20,858.42 |
|
|
Anoscopy and dilation 46604
|
$1,110.00 |
$3,705.80 |
$14,841.00 |
|
|
Anoscopy control bleeding 46614
|
$242.40 |
$361.60 |
$36,203.34 |
|
|
Anoscopy remove fb 46608
|
$340.20 |
$564.60 |
$1,313.97 |
|
|
Anoscopy remove lesion 46610
|
$445.20 |
$445.20 |
$8,036.34 |
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$498.60 |
$755.20 |
$17,838.93 |
|
|
Ans parasymp & symp w/tilt
|
$205.10 |
$205.10 |
$329.60 |
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$1,302.00 |
$29,629.42 |
$68,498.80 |
|
|
Anthrax vaccine sc or im
|
$156.80 |
$156.80 |
$156.80 |
|
|
Antibody
|
$30.00 |
$36.60 |
$38.40 |
|
|
Antibody bacterium, not elsewhere specified
|
$11.25 |
$117.50 |
$408.80 |
|
|
Antibody elution rbc reference
|
$55.00 |
$185.00 |
$504.60 |
|
|
Antibody htlv/hiv confirm test
|
$45.00 |
$130.00 |
$649.60 |
|
|
Antibody htlv-i
|
$39.60 |
$121.80 |
$260.80 |
|
|
Antibody htlv-ii
|
$28.00 |
$177.10 |
$177.10 |
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$48.57 |
$349.30 |
$1,566.40 |
|
|
Antibody id rbc panel
|
$88.75 |
$294.00 |
$690.90 |
|
|
Antibody influenza virus
|
$11.75 |
$126.72 |
$365.76 |
|
|
Antibody lymphocytic choriomeningitis
|
$23.43 |
$45.60 |
$166.20 |
|
|
Antibody screen rbc
|
$37.50 |
$137.20 |
$383.40 |
|
|
Antibody tetanus
|
$17.82 |
$115.92 |
$394.80 |
|
|
Anticoag mgmt pt warfarin
|
$26.40 |
$26.40 |
$26.40 |
|
|
Antidepressant not specified
|
$50.00 |
$85.14 |
$252.00 |
|
|
Antidepressants class 3-5
|
$72.14 |
$85.14 |
$118.08 |
|
|
Antidepressants class 6/more
|
$72.14 |
$72.14 |
$85.14 |
|
|
Antidepressant tricyclic 3-5
|
$23.20 |
$23.20 |
$85.14 |
|
|
Antiepileptics nos 4-6
|
$12.80 |
$12.80 |
$79.92 |
|
|
Antiepileptics nos 7/more
|
$12.80 |
$12.80 |
$12.80 |
|
|
Antigen therapy services
|
$92.00 |
$92.00 |
$92.00 |
|
|
Antigen therapy services
|
$168.80 |
$168.80 |
$168.80 |
|
