|
Antigen therapy services
|
$169.60 |
$169.60 |
$169.60 |
|
|
Antigen therapy services
|
$247.20 |
$247.20 |
$247.20 |
|
|
Antigen therapy services
|
$328.80 |
$328.80 |
$328.80 |
|
|
Antigen therapy services
|
$43.20 |
$43.20 |
$43.20 |
|
|
Antigen therapy services
|
$32.80 |
$32.80 |
$32.80 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.64 |
$2,169.28 |
$8,296.40 |
|
|
Antihemophilic viii/vwf comp
|
$5.77 |
$1,366.03 |
$1,366.03 |
|
|
Anti-inhibitor
|
$4.68 |
$10,270.62 |
$32,352.07 |
|
|
Anti mog serum - sendout
|
$14.52 |
$207.35 |
$1,357.92 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$23.76 |
$80.00 |
$694.40 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$10.50 |
$68.60 |
$101.50 |
|
|
Ant instr 2-3 vert segm 22845
|
$1,378.20 |
$1,378.20 |
$1,748.00 |
|
|
Ant instrumentation/4-7 vert seg 22846
|
$1,430.40 |
$1,430.40 |
$1,816.80 |
|
|
Antinuclear antibodies
|
$30.03 |
$107.10 |
$266.40 |
|
|
Antinuclear antibodies titer
|
$18.00 |
$83.40 |
$378.95 |
|
|
Antiphosphatidylserine antibody
|
$20.00 |
$100.10 |
$494.40 |
|
|
Antipsychotics nos 1-3
|
$37.50 |
$207.20 |
$345.00 |
|
|
Antipsychotics nos 4-6
|
$36.00 |
$36.00 |
$36.00 |
|
|
Antipsychotics nos 7/more
|
$9.36 |
$9.36 |
$12.80 |
|
|
Antistreptolysin o screen
|
$25.00 |
$59.40 |
$220.00 |
|
|
Antistreptolysin o titer
|
$31.25 |
$79.20 |
$206.40 |
|
|
Antithrombin iii activity
|
$32.85 |
$168.60 |
$454.30 |
|
|
Antithrombin iii injection
|
$7.08 |
$1,652.82 |
$11,506.95 |
|
|
Antithrombin recombinant
|
$20,834.10 |
$20,834.10 |
$20,834.10 |
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$611.95 |
$8,977.01 |
$30,500.05 |
|
|
Antithymocyte globuln rabbit
|
$777.63 |
$777.63 |
$7,087.50 |
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$1,776.00 |
$34,232.03 |
$64,878.79 |
|
|
Ant sgm img ir flrscn angrph
|
$322.40 |
$322.40 |
$322.40 |
|
|
Ant sgm img i&r speclr mic
|
$90.40 |
$90.40 |
$367.50 |
|
|
Ant thrc vrt body tethrg <7
|
$4,508.80 |
$4,508.80 |
$4,508.80 |
|
|
Ant thrc vrt body tethrg 8+
|
$4,968.00 |
$4,968.00 |
$4,968.00 |
|
|
Aortic Aneurysm Screening Ultrasound
|
$127.50 |
$587.40 |
$1,445.60 |
|
|
Aortic circulation assist 33971
|
$1,381.80 |
$1,450.80 |
$20,121.12 |
|
|
Aortic dysfunction/dilation
|
$1,008.00 |
$6,278.40 |
$10,606.40 |
|
|
Aortic dysfunction/dilation
|
$2,700.80 |
$3,275.30 |
$3,275.30 |
|
|
Aortic hemiarch graft 33866
|
$2,064.60 |
$2,064.60 |
$2,260.80 |
|
|
Apc gene dup/delet variants
|
$239.58 |
$462.00 |
$1,665.36 |
|
|
Apc gene full sequence
|
$831.93 |
$1,801.80 |
$1,801.80 |
|
|
Apc gene known fam variants
|
$268.80 |
$268.80 |
$268.80 |
|
|
Aphakia prosth service temp
|
$25.60 |
$25.60 |
$25.60 |
|
|
Apheresis immunoads slctv
|
$4,250.00 |
$8,842.40 |
$11,237.40 |
|
|
Apheresis plasma
|
$800.00 |
$2,340.60 |
$81,630.50 |
|
|
Apheresis platelets
|
$275.20 |
$2,195.00 |
$6,998.40 |
|
|
Apheresis rbc
|
$277.60 |
$4,222.20 |
$18,099.90 |
|
|
Apheresis wbc
|
$1,765.23 |
$4,558.40 |
$6,998.40 |
|
|
Apl(pml-rara) quant - sendout
|
$440.00 |
$721.00 |
$1,239.70 |
|
|
Appendectomy
|
$1,209.60 |
$1,209.60 |
$26,789.59 |
|
|
Appendectomy add-on 44955
|
$159.60 |
$159.60 |
$51,693.34 |
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$1,644.60 |
$1,644.60 |
$2,149.60 |
|
|
Appendix Removal (Laparoscopic)
|
$1,126.80 |
$30,072.48 |
$36,730.77 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$480.00 |
$2,700.00 |
$4,291.24 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$132.60 |
$1,079.40 |
$2,142.72 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$63.70 |
$799.20 |
$3,603.20 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$625.00 |
$3,428.40 |
$7,907.76 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$151.90 |
$1,575.00 |
$4,686.40 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$160.05 |
$900.00 |
$2,623.20 |
|
|
Appl bdy cst sho to hip 1thi
|
$682.40 |
$682.40 |
$682.40 |
|
|
Appl bdy cst sho to hip b th
|
$748.00 |
$748.00 |
$748.00 |
|
|
Appl bdy cst sho to hip head
|
$696.00 |
$696.00 |
$696.00 |
|
|
Appl body cast sho to hips
|
$608.00 |
$608.00 |
$608.00 |
|
|
Appl cast figure-of-eight
|
$237.60 |
$237.60 |
$237.60 |
|
|
Appl cast plaster velpeau
|
$298.40 |
$298.40 |
$298.40 |
|
|
Appl cast shoulder spica
|
$530.40 |
$530.40 |
$530.40 |
|
|
Appl halo type body cast
|
$808.80 |
$808.80 |
$808.80 |
|
|
Appl hip spica cast1&1/2
|
$540.00 |
$654.40 |
$1,146.00 |
|
|
Appl hip spica cast 1 leg
|
$590.40 |
$590.40 |
$765.60 |
|
|
Application clubfoot cast
|
$535.00 |
$535.00 |
$718.40 |
|
|
Application finger splntstatic 29130
|
$43.75 |
$203.20 |
$774.00 |
|
|
Application halo femoral
|
$2,318.40 |
$2,318.40 |
$2,318.40 |
|
|
Application halo pelvic
|
$1,260.80 |
$1,260.80 |
$1,260.80 |
|
|
Application long leg splint 29505
|
$87.50 |
$370.00 |
$827.20 |
|
|
Application lower leg splint 29515
|
$87.50 |
$370.00 |
$1,195.20 |
|
|
Application multi layer compression below knee (both sides)
|
$87.50 |
$390.60 |
$930.96 |
|
|
Application of body cast
|
$650.40 |
$650.40 |
$650.40 |
|
|
Application of body cast
|
$700.00 |
$700.00 |
$700.00 |
|
|
Application of cylinder cast 29365
|
$235.20 |
$401.80 |
$765.60 |
|
|
Application of forearm cast 29075
|
$143.75 |
$307.50 |
$907.20 |
|
|
Application of long arm cast 29065
|
$143.75 |
$347.20 |
$879.20 |
|
|
Application of long leg cast
|
$403.80 |
$403.80 |
$968.40 |
|
|
Application of long leg cast 29345
|
$264.55 |
$410.40 |
$774.00 |
|
|
Application of paste boot 29580
|
$87.50 |
$438.48 |
$2,097.60 |
|
|
Application short leg cast 29405
|
$143.75 |
$434.70 |
$1,391.40 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$295.20 |
$1,800.00 |
$4,291.24 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$12.33 |
$1,800.00 |
$3,951.36 |
|
|
Applicator tag rfid localizer 12gx7cm
|
$36.20 |
$307.80 |
$540.00 |
|
|
Appl long leg cast brace
|
$769.60 |
$769.60 |
$769.60 |
|
|
Appl mltpln uni ext fixj sys
|
$1,035.60 |
$1,563.00 |
$2,767.20 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$29.04 |
$70.40 |
$202.32 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$29.60 |
$75.60 |
$337.68 |
|
|
Appl modality 1+lllt po pain
|
$17.50 |
$72.05 |
$72.05 |
|
|
Appl multlay comprs arm/hand
|
$155.10 |
$343.20 |
$557.40 |
|
|
Appl patllr tdn bearing cast
|
$556.80 |
$556.80 |
$556.80 |
|
|
Appl unipln uni ext fixj sys
|
$553.80 |
$1,470.40 |
$15,430.32 |
|
|
Apply finger cast 29086
|
$185.00 |
$257.60 |
$382.40 |
|
|
Apply forearm splintdynamic 29126
|
$112.20 |
$307.44 |
$806.40 |
|
|
Apply halo w/removal cranial
|
$503.28 |
$1,486.80 |
$1,599.60 |
|
|
Apply hand/wrist cast 29085
|
$144.54 |
$246.40 |
$471.10 |
|
|
Apply interstit radiat compl
|
$1,529.88 |
$3,970.00 |
$5,336.80 |
|
|
Apply intrcav radiat compl
|
$669.24 |
$2,784.00 |
$3,555.60 |
|
|
Apply intrcav radiat interm
|
$464.97 |
$2,113.80 |
$2,550.00 |
|
