|
Angioplasty/iliac/init ves/unilat 37220
|
$19,150.80 |
$19,150.80 |
$19,150.80 |
$12,766.07
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$17,925.60 |
$17,925.60 |
$17,925.60 |
$8,640.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$41.85 |
$41.85 |
$41.85 |
$44,765.71
|
|
Angio tib/peroneal/init ves/unila 37228
|
$20,332.80 |
$20,332.80 |
$20,332.80 |
$14,806.05
|
|
Angio trnslmnl balloon same artery ea addl
|
$31,842.00 |
$31,842.00 |
$31,842.00 |
$5,855.20
|
|
Angio trnslmnl balloon same artery ini
|
$34,078.20 |
$34,078.20 |
$34,078.20 |
$9,966.40
|
|
Angio trnslmnl balloon same vein ea addl
|
$13,763.40 |
$13,763.40 |
$13,763.40 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$13,763.40 |
$13,763.40 |
$13,763.40 |
$8,766.15
|
|
Anidulafungin injection
|
$209.79 |
$209.79 |
$209.79 |
$209.79
|
|
Ankle X-ray
|
$392.40 |
$392.40 |
$392.40 |
$311.92
|
|
Anora (draw only)
|
$61.80 |
$61.80 |
$61.80 |
$36.00
|
|
Antibody
|
$18.00 |
$18.00 |
$18.00 |
$29.40
|
|
Antibody bacterium, not elsewhere specified
|
$30.60 |
$30.60 |
$30.60 |
$57.85
|
|
Antibody elution rbc reference
|
$365.40 |
$365.40 |
$365.40 |
$156.24
|
|
Antibody htlv/hiv confirm test
|
$223.80 |
$223.80 |
$223.80 |
$154.85
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$434.40 |
$434.40 |
$434.40 |
$216.24
|
|
Antibody id rbc panel
|
$316.80 |
$316.80 |
$316.80 |
$250.90
|
|
Antibody influenza virus
|
$142.20 |
$142.20 |
$142.20 |
$63.33
|
|
Antibody screen rbc
|
$178.20 |
$178.20 |
$178.20 |
$99.99
|
|
Antibody tetanus
|
$180.60 |
$180.60 |
$180.60 |
$74.53
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.12 |
$3.12 |
$3.12 |
$2.69
|
|
Anti-inhibitor
|
$3.67 |
$3.67 |
$3.67 |
$3.44
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$21.60 |
$21.60 |
$21.60 |
$48.57
|
|
Antinuclear antibodies
|
$224.40 |
$224.40 |
$224.40 |
$97.50
|
|
Antinuclear antibodies titer
|
$197.40 |
$197.40 |
$197.40 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$194.40 |
$194.40 |
$194.40 |
$72.15
|
|
Antistreptolysin o titer
|
$130.20 |
$130.20 |
$130.20 |
$58.50
|
|
Antithrombin iii activity
|
$441.00 |
$441.00 |
$441.00 |
$135.20
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$6,946.62 |
$6,946.62 |
$6,946.62 |
$6,946.62
|
|
Apl(pml-rara) quant - sendout
|
$411.60 |
$411.60 |
$411.60 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,895.20 |
$3,895.20 |
$3,895.20 |
$2,078.20
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$831.00 |
$831.00 |
$831.00 |
$1,057.11
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$657.60 |
$657.60 |
$657.60 |
$552.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$7,917.60 |
$7,917.60 |
$7,917.60 |
$2,978.25
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$781.80 |
$781.80 |
$781.80 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$318.60 |
$318.60 |
$318.60 |
$549.08
|
|
Application finger splntstatic 29130
|
$48.60 |
$48.60 |
$48.60 |
$208.16
|
|
Application multi layer compression below knee (both sides)
|
$294.00 |
$294.00 |
$294.00 |
$384.80
|
|
Application of paste boot 29580
|
$441.60 |
$441.60 |
$441.60 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$4,803.00 |
$4,803.00 |
$4,803.00 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$4,803.00 |
$4,803.00 |
$4,803.00 |
$2,087.50
|
|
Appl modality 1/> areas paraffin bath 97018
|
$39.00 |
$39.00 |
$39.00 |
$69.44
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$64.80 |
$64.80 |
$64.80 |
$71.50
|
|
Apply forearm splintdynamic 29126
|
$170.40 |
$170.40 |
$170.40 |
$245.40
|
|
Apply of finger splint 29131
|
$75.60 |
$75.60 |
$75.60 |
$177.45
|
|
Apply rigid leg cast 29445
|
$695.40 |
$695.40 |
$695.40 |
$593.57
|
|
#aptt mix-1:1 incubated
|
$420.00 |
$420.00 |
$420.00 |
$157.30
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$64.80 |
$64.80 |
$64.80 |
$90.52
|
|
Aquatic exercise - group charge
|
$36.00 |
$36.00 |
$36.00 |
$86.90
|
|
Argatroban nonesrd use 1mg
|
$840.62 |
$840.62 |
$840.62 |
$881.10
|
|
Aripiprazole injection
|
$118.52 |
$118.52 |
$118.52 |
$21.79
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$167.54 |
$167.54 |
$167.54 |
$292.80
|
|
Arterial blood draw/perc 36620
|
$3,285.00 |
$3,285.00 |
$3,285.00 |
$529.19
|
|
Artery xray each vessel 7577426
|
$2,323.80 |
$2,323.80 |
$2,323.80 |
$1,749.69
|
|
Artery xray of abdomen 75726-26
|
$3,103.80 |
$3,103.80 |
$3,103.80 |
$4,252.60
|
|
Artery x-rays arm/leg 75710-26
|
$1,968.00 |
$1,968.00 |
$1,968.00 |
$3,341.00
|
|
Artery x-rays arms/legs 75716-26
|
$3,936.00 |
$3,936.00 |
$3,936.00 |
$3,860.40
|
|
Artery x-rays chest
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$2,498.28
|
|
Artery xrays of pelvis 75736 26
|
$2,248.80 |
$2,248.80 |
$2,248.80 |
$3,993.41
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$932.40 |
$932.40 |
$932.40 |
$543.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,013.40 |
$1,013.40 |
$1,013.40 |
$948.00
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,136.40 |
$1,136.40 |
$1,136.40 |
$882.70
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,035.60 |
$1,035.60 |
$1,035.60 |
$687.20
|
|
Artiss fibrin sealant
|
$342.99 |
$342.99 |
$342.99 |
$888.14
|
|
Aspirate pleura without imaging 32554
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,710.60 |
$1,710.60 |
$1,710.60 |
$1,219.50
|
|
Assay acid phosphatase
|
$118.80 |
$118.80 |
$118.80 |
$38.81
|
|
Assay of galactose
|
$36.60 |
$36.60 |
$36.60 |
$49.21
|
|
Assay of neonatal thyroxine
|
$21.60 |
$21.60 |
$21.60 |
$13.33
|
|
Assay of osteocalcin
|
$188.40 |
$188.40 |
$188.40 |
$126.75
|
|
Assay of salicylate
|
$36.00 |
$36.00 |
$36.00 |
$83.85
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$156.60 |
$156.60 |
$156.60 |
$300.80
|
|
Assess cyst contrast inject
|
$692.40 |
$692.40 |
$692.40 |
$447.33
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$116.40 |
$116.40 |
$116.40 |
$43.55
|
|
Asses tinnit/pitch/loud/match/mask 92625
|
$94.80 |
$94.80 |
$94.80 |
$176.93
|
|
Ast/sgot
|
$104.40 |
$104.40 |
$104.40 |
$43.40
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$16,692.06 |
$16,692.06 |
$16,692.06 |
$19,405.49
|
|
Athrectomy fem/pop/unilateral 37225
|
$24,986.40 |
$24,986.40 |
$24,986.40 |
$21,960.96
|
|
Athrectomy tib/pero/unilat/ini ves 37229
|
$24,986.40 |
$24,986.40 |
$24,986.40 |
$21,960.96
|
|
Atropine 0.1 mg/ml injection syringe
|
$43.85 |
$43.85 |
$43.85 |
$25.04
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$691.80 |
$691.80 |
$691.80 |
$200.40
|
|
Audiometry air + bone
|
$132.60 |
$132.60 |
$132.60 |
$178.81
|
|
Auditory function 60 min
|
$149.40 |
$149.40 |
$149.40 |
$210.40
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$23,842.80 |
$23,842.80 |
$23,842.80 |
$7,713.54
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$23,244.00 |
$23,244.00 |
$23,244.00 |
$11,566.33
|
|
Automated diff wbc count
|
$72.00 |
$72.00 |
$72.00 |
$33.80
|
|
Avul nail plate addl
|
$251.40 |
$251.40 |
$251.40 |
$239.85
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$613.80 |
$613.80 |
$613.80 |
$356.00
|
|
Azacitidine injection
|
$11.01 |
$11.01 |
$11.01 |
$201.43
|
|
Azathioprine 50 mg tablet
|
$2.03 |
$2.03 |
$2.03 |
$2.18
|
|
Azithromycin 500 mg intravenous solution
|
$65.10 |
$65.10 |
$65.10 |
$22.94
|
|
Aztreonam 1 gram solution for injection
|
$177.56 |
$177.56 |
$177.56 |
$157.83
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$1,667.48 |
$1,667.48 |
$1,667.48 |
$1,062.64
|
|
Baclofen eval charges
|
$61.80 |
$61.80 |
$61.80 |
$84.35
|
|
Bacterial meningitis antigen
|
$274.20 |
$274.20 |
$274.20 |
$66.30
|
|
Bacterial vaginosis pcr
|
$434.40 |
$434.40 |
$434.40 |
$314.60
|
|
#bac vag cand-c. albicans naa
|
$139.20 |
$139.20 |
$139.20 |
$132.72
|
|
Bartonella dna pcr-sendout
|
$282.60 |
$282.60 |
$282.60 |
$234.50
|
|
Basic vestibular evaluation
|
$996.60 |
$996.60 |
$996.60 |
$372.00
|
|
Bausch health Ultrasound surg
|
$630.00 |
$630.00 |
$630.00 |
$1,170.40
|
