|
Angio trnslmnl balloon same artery ini
|
$32,272.80 |
$32,272.80 |
$32,272.80 |
$9,966.40
|
|
Angio trnslmnl balloon same vein ea addl
|
$11,611.80 |
$11,611.80 |
$11,611.80 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$11,611.80 |
$11,611.80 |
$11,611.80 |
$8,766.15
|
|
Anidulafungin injection
|
$209.79 |
$209.79 |
$209.79 |
$209.79
|
|
Ankle X-ray
|
$392.40 |
$392.40 |
$392.40 |
$311.92
|
|
Anodyne therapy charges pt
|
$40.20 |
$40.20 |
$40.20 |
$41.02
|
|
Anora (draw only)
|
$53.40 |
$53.40 |
$53.40 |
$36.00
|
|
Antibody
|
$21.00 |
$21.00 |
$21.00 |
$29.40
|
|
Antibody bacterium, not elsewhere specified
|
$136.20 |
$136.20 |
$136.20 |
$57.85
|
|
Antibody elution rbc reference
|
$358.20 |
$358.20 |
$358.20 |
$156.24
|
|
Antibody htlv/hiv confirm test
|
$258.00 |
$258.00 |
$258.00 |
$154.85
|
|
Antibody htlv-i
|
$30.60 |
$30.60 |
$30.60 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$350.40 |
$350.40 |
$350.40 |
$216.24
|
|
Antibody id rbc panel
|
$283.80 |
$283.80 |
$283.80 |
$250.90
|
|
Antibody influenza virus
|
$164.40 |
$164.40 |
$164.40 |
$63.33
|
|
Antibody screen rbc
|
$147.60 |
$147.60 |
$147.60 |
$99.99
|
|
Antibody tetanus
|
$164.40 |
$164.40 |
$164.40 |
$74.53
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.12 |
$3.12 |
$3.12 |
$2.69
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$21.60 |
$21.60 |
$21.60 |
$48.57
|
|
Antinuclear antibodies
|
$220.20 |
$220.20 |
$220.20 |
$97.50
|
|
Antinuclear antibodies titer
|
$179.40 |
$179.40 |
$179.40 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$179.40 |
$179.40 |
$179.40 |
$72.15
|
|
Antistreptolysin o screen
|
$128.40 |
$128.40 |
$128.40 |
$57.20
|
|
Antistreptolysin o titer
|
$169.20 |
$169.20 |
$169.20 |
$58.50
|
|
Antithrombin iii activity
|
$237.60 |
$237.60 |
$237.60 |
$135.20
|
|
Apheresis plasma
|
$3,752.40 |
$3,752.40 |
$3,752.40 |
$3,411.50
|
|
Apl(pml-rara) quant - sendout
|
$383.40 |
$383.40 |
$383.40 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,541.40 |
$1,541.40 |
$1,541.40 |
$2,078.20
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$1,057.11
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$691.80 |
$691.80 |
$691.80 |
$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
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$336.00 |
$336.00 |
$336.00 |
$549.08
|
|
Application finger splntstatic 29130
|
$141.60 |
$141.60 |
$141.60 |
$208.16
|
|
Application multi layer compression below knee (both sides)
|
$674.40 |
$674.40 |
$674.40 |
$384.80
|
|
Application of paste boot 29580
|
$309.60 |
$309.60 |
$309.60 |
$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
|
$58.80 |
$58.80 |
$58.80 |
$69.44
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$84.60 |
$84.60 |
$84.60 |
$71.50
|
|
Apply forearm splintdynamic 29126
|
$214.80 |
$214.80 |
$214.80 |
$245.40
|
|
Apply rigid leg cast 29445
|
$695.40 |
$695.40 |
$695.40 |
$593.57
|
|
#aptt mix-1:1 incubated
|
$374.40 |
$374.40 |
$374.40 |
$157.30
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$67.20 |
$67.20 |
$67.20 |
$90.52
|
|
Aquatic exercise - group charge
|
$55.20 |
$55.20 |
$55.20 |
$86.90
|
|
Argatroban nonesrd use 1mg
|
$889.62 |
$889.62 |
$889.62 |
$881.10
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$167.54 |
$167.54 |
$167.54 |
$292.80
|
|
Arterial blood draw/perc 36620
|
$1,519.20 |
$1,519.20 |
$1,519.20 |
$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
|
$1,198.80 |
$1,198.80 |
$1,198.80 |
$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)
|
$1,382.40 |
$1,382.40 |
$1,382.40 |
$687.20
|
|
Artiss fibrin sealant
|
$342.99 |
$342.99 |
$342.99 |
$888.14
|
|
Aspirate pleura without imaging 32554
|
$1,343.40 |
$1,343.40 |
$1,343.40 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,968.00 |
$1,968.00 |
$1,968.00 |
$1,219.50
|
|
Aspir/inj thyroid cyst 60300
|
$850.80 |
$850.80 |
$850.80 |
$833.29
|
|
Assay acid phosphatase
|
$85.80 |
$85.80 |
$85.80 |
$38.81
|
|
Assay of chloramphenicol
|
$203.40 |
$203.40 |
$203.40 |
$78.00
|
|
Assay of fluoride
|
$155.40 |
$155.40 |
$155.40 |
$115.83
|
|
Assay of galactose
|
$40.80 |
$40.80 |
$40.80 |
$49.21
|
|
Assay of lap enzyme
|
$125.40 |
$125.40 |
$125.40 |
$82.20
|
|
Assay of neonatal thyroxine
|
$23.40 |
$23.40 |
$23.40 |
$13.33
|
|
Assay of osteocalcin
|
$195.60 |
$195.60 |
$195.60 |
$126.75
|
|
Assay of procainamide w/metab
|
$160.20 |
$160.20 |
$160.20 |
$63.07
|
|
Assay of salicylate
|
$36.00 |
$36.00 |
$36.00 |
$83.85
|
|
Assay of thiocyanate
|
$124.20 |
$124.20 |
$124.20 |
$55.25
|
|
Assay phosphatidylglycerol
|
$59.40 |
$59.40 |
$59.40 |
$133.56
|
|
Assay toxin or antitoxin
|
$58.80 |
$58.80 |
$58.80 |
$70.92
|
|
Assess cyst contrast inject
|
$692.40 |
$692.40 |
$692.40 |
$447.33
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$99.00 |
$99.00 |
$99.00 |
$43.55
|
|
Ast/sgot
|
$99.60 |
$99.60 |
$99.60 |
$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
|
$22,107.60 |
$22,107.60 |
$22,107.60 |
$21,960.96
|
|
Athrectomy tib/pero/unilat/ini ves 37229
|
$22,107.60 |
$22,107.60 |
$22,107.60 |
$21,960.96
|
|
Atomic absorption
|
$250.80 |
$250.80 |
$250.80 |
$47.17
|
|
Atropine 0.1 mg/ml injection syringe
|
$43.85 |
$43.85 |
$43.85 |
$25.04
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$649.80 |
$649.80 |
$649.80 |
$200.40
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$22,415.40 |
$22,415.40 |
$22,415.40 |
$7,713.54
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$21,852.00 |
$21,852.00 |
$21,852.00 |
$11,566.33
|
|
Autologous blood process
|
$620.40 |
$620.40 |
$620.40 |
$262.50
|
|
Automated diff wbc count
|
$23.40 |
$23.40 |
$23.40 |
$33.80
|
|
Av fistula revision
|
$13,399.20 |
$13,399.20 |
$13,399.20 |
$7,651.38
|
|
Avul nail plate addl
|
$466.80 |
$466.80 |
$466.80 |
$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
|
$2.18 |
$2.18 |
$2.18 |
$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)
|
$2,302.55 |
$2,302.55 |
$2,302.55 |
$1,062.64
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$191.55 |
$191.55 |
$191.55 |
$191.55
|
|
Baclofen eval charges
|
$73.80 |
$73.80 |
$73.80 |
$84.35
|
|
Bacterial meningitis antigen
|
$148.80 |
$148.80 |
$148.80 |
$66.30
|
|
Bacterial vaginosis pcr
|
$259.80 |
$259.80 |
$259.80 |
$314.60
|
|
#bac vag cand-c. albicans naa
|
$147.60 |
$147.60 |
$147.60 |
$132.72
|
