|
Application long leg splint 29505
|
$414.40 |
$414.40 |
$414.40 |
$338.25
|
|
Application lower leg splint 29515
|
$345.60 |
$345.60 |
$345.60 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$464.52 |
$464.52 |
$464.52 |
$375.06
|
|
Application of body cast
|
$650.40 |
$650.40 |
$650.40 |
$561.60
|
|
Application of body cast
|
$700.00 |
$700.00 |
$700.00 |
$561.60
|
|
Application of cylinder cast 29365
|
$592.00 |
$592.00 |
$592.00 |
$431.08
|
|
Application of forearm cast 29075
|
$416.00 |
$416.00 |
$416.00 |
$358.20
|
|
Application of long arm cast 29065
|
$462.40 |
$462.40 |
$462.40 |
$396.77
|
|
Application of long leg cast
|
$689.60 |
$689.60 |
$689.60 |
$435.54
|
|
Application of long leg cast 29345
|
$657.60 |
$657.60 |
$657.60 |
$455.00
|
|
Application of paste boot 29580
|
$310.40 |
$310.40 |
$310.40 |
$340.11
|
|
Application short leg cast 29405
|
$388.80 |
$388.80 |
$388.80 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,261.65 |
$1,261.65 |
$1,261.65 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,261.65 |
$1,261.65 |
$1,261.65 |
$2,164.64
|
|
Appl long leg cast brace
|
$769.60 |
$769.60 |
$769.60 |
$468.00
|
|
Appl mltpln uni ext fixj sys
|
$2,767.20 |
$2,767.20 |
$2,767.20 |
$5,855.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$77.81 |
$77.81 |
$77.81 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$88.85 |
$88.85 |
$88.85 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$409.60 |
$409.60 |
$409.60 |
$289.60
|
|
Appl patllr tdn bearing cast
|
$556.80 |
$556.80 |
$556.80 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$1,470.40 |
$1,470.40 |
$1,470.40 |
$5,810.00
|
|
Apply finger cast 29086
|
$382.40 |
$382.40 |
$382.40 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$376.00 |
$376.00 |
$376.00 |
$255.20
|
|
Apply halo w/removal cranial
|
$1,201.60 |
$1,201.60 |
$1,201.60 |
$1,367.60
|
|
Apply hand/wrist cast 29085
|
$459.20 |
$459.20 |
$459.20 |
$271.80
|
|
Apply interstit radiat compl
|
$1,941.60 |
$1,941.60 |
$1,941.60 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$1,484.80 |
$1,484.80 |
$1,484.80 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$1,043.20 |
$1,043.20 |
$1,043.20 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$780.80 |
$780.80 |
$780.80 |
$1,269.97
|
|
Apply of finger splint 29131
|
$254.40 |
$254.40 |
$254.40 |
$177.45
|
|
Apply rem fixation device
|
$580.00 |
$580.00 |
$580.00 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$884.60 |
$884.60 |
$884.60 |
$555.00
|
|
Apply short leg castambul type 29425
|
$374.40 |
$374.40 |
$374.40 |
$404.74
|
|
Apply srs headframe add-on
|
$719.20 |
$719.20 |
$719.20 |
$585.00
|
|
Apply surf ldr radionuclide
|
$243.20 |
$243.20 |
$243.20 |
$282.80
|
|
App mdlty 1+hubbrd tnk ea 15
|
$64.00 |
$64.00 |
$64.00 |
$141.39
|
|
App mltpln uni xtrnl fix 1st
|
$2,937.60 |
$2,937.60 |
$2,937.60 |
$16,139.55
|
|
App mltpln uni xtrnl fix xch
|
$4,927.20 |
$4,927.20 |
$4,927.20 |
$3,526.50
|
|
App topical fluoride varnish
|
$27.20 |
$27.20 |
$27.20 |
$27.20
|
|
#aptt mix-1:1 incubated
|
$88.80 |
$88.80 |
$88.80 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$76.00 |
$76.00 |
$76.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$48.57 |
$48.57 |
$48.57 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$48.57 |
$48.57 |
$48.57 |
$150.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$106.87 |
$106.87 |
$106.87 |
$100.75
|
|
Aquatic exercise - group charge
|
$127.38 |
$127.38 |
$127.38 |
$87.45
|
|
Aqueous shunt eye w/graft
|
$5,656.00 |
$5,656.00 |
$5,656.00 |
$6,105.79
|
|
Aqueous shunt eye without graft
|
$5,356.80 |
$5,356.80 |
$5,356.80 |
$6,105.79
|
|
Arch supp att to shoe metata
|
$76.80 |
$76.80 |
$76.80 |
$75.23
|
|
Ar gene charac alleles
|
$153.56 |
$153.56 |
$153.56 |
$287.70
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$5.72 |
$5.72 |
$5.72 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$6,203.04 |
$6,203.04 |
$6,203.04 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,773.32 |
$1,773.32 |
$1,773.32 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$491.12 |
$491.12 |
$491.12 |
$426.00
|
|
Art byp aor celiac msn and renal 35631
|
$9,028.80 |
$9,028.80 |
$9,028.80 |
$5,926.00
|
|
Art byp aortofemoral 35647
|
$7,550.40 |
$7,550.40 |
$7,550.40 |
$2,358.00
|
|
Art byp aortoiliac 35637
|
$4,039.20 |
$4,039.20 |
$4,039.20 |
$2,942.40
|
|
Art bypass aorsubcl/carot/innom 35626
|
$7,764.80 |
$7,764.80 |
$7,764.80 |
$7,576.40
|
|
Art bypass aortobifemoral 35646
|
$4,188.00 |
$4,188.00 |
$4,188.00 |
$3,443.40
|
|
Art bypass aortobi-iliac 35638
|
$4,256.00 |
$4,256.00 |
$4,256.00 |
$3,525.00
|
|
Art bypass axillary-femoral 35621
|
$5,352.00 |
$5,352.00 |
$5,352.00 |
$2,208.60
|
|
Art bypass axill-fem-femoral 35654
|
$3,342.40 |
$3,342.40 |
$3,342.40 |
$3,058.80
|
|
Art bypass carotid-subclavian 35606
|
$5,724.80 |
$5,724.80 |
$5,724.80 |
$5,724.80
|
|
Art bypass fem-ant-post tib/prl 35666
|
$6,216.00 |
$6,216.00 |
$6,216.00 |
$4,735.49
|
|
Art bypass femoral-femoral 35661
|
$5,291.20 |
$5,291.20 |
$5,291.20 |
$5,291.20
|
|
Art bypass femoral-popliteal 35656
|
$5,273.60 |
$5,273.60 |
$5,273.60 |
$5,273.60
|
|
Art bypass iliofemoral 35665
|
$5,729.60 |
$5,729.60 |
$5,729.60 |
$2,933.07
|
|
Art byp grft aorcel/aormesen
|
$9,489.60 |
$9,489.60 |
$9,489.60 |
$7,865.20
|
|
Art byp grft aortbifemoral 35540
|
$11,902.40 |
$11,902.40 |
$11,902.40 |
$5,098.80
|
|
Art byp grft aortorenal
|
$8,297.60 |
$8,297.60 |
$8,297.60 |
$8,297.60
|
|
Art byp grft axill-femoral
|
$5,971.20 |
$5,971.20 |
$5,971.20 |
$1,728.11
|
|
Art byp grft brachial-brchl
|
$5,540.80 |
$5,540.80 |
$5,540.80 |
$2,298.12
|
|
Art byp grft fem-femoral 35558
|
$6,004.80 |
$6,004.80 |
$6,004.80 |
$2,477.40
|
|
Art byp grft fem-popliteal 35556
|
$6,835.20 |
$6,835.20 |
$6,835.20 |
$2,806.20
|
|
Art byp grft subclav-brchial
|
$5,868.80 |
$5,868.80 |
$5,868.80 |
$1,696.81
|
|
Art byp pop-tibl-prl-other 35571
|
$6,467.20 |
$6,467.20 |
$6,467.20 |
$4,244.00
|
|
Arterial blood draw/perc 36620
|
$383.17 |
$383.17 |
$383.17 |
$478.96
|
|
Artery by graft; iliofemoral 35565
|
$6,387.20 |
$6,387.20 |
$6,387.20 |
$1,875.00
|
|
Artery to vein shunt
|
$1,171.20 |
$1,171.20 |
$1,171.20 |
$4,316.00
|
|
Artery transpose/endovas taa
|
$3,854.40 |
$3,854.40 |
$3,854.40 |
$3,854.40
|
|
Artery-vein nonautograft
|
$1,629.60 |
$1,629.60 |
$1,629.60 |
$7,236.06
|
|
Artery xray each vessel 7577426
|
$426.40 |
$426.40 |
$426.40 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$515.20 |
$515.20 |
$515.20 |
$4,618.71
|
|
Artery x-rays adrenal gland
|
$476.80 |
$476.80 |
$476.80 |
$3,320.35
|
|
Artery x-rays adrenals
|
$494.40 |
$494.40 |
$494.40 |
$3,764.59
|
|
Artery x-rays arm/leg 75710-26
|
$541.60 |
$541.60 |
$541.60 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$566.40 |
$566.40 |
$566.40 |
$3,860.40
|
|
Artery x-rays chest
|
$473.60 |
$473.60 |
$473.60 |
$2,895.07
|
|
Artery x-rays lung
|
$491.20 |
$491.20 |
$491.20 |
$3,296.15
|
|
Artery x-rays lung
|
$472.80 |
$472.80 |
$472.80 |
$2,427.50
|
|
Artery x-rays lungs
|
$531.20 |
$531.20 |
$531.20 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$470.40 |
$470.40 |
$470.40 |
$4,306.40
|
|
Artery x-rays spine
|
$604.80 |
$604.80 |
$604.80 |
$4,792.33
|
|
Arthrd ant dfrm 4-7 vrt sgm
|
$4,958.40 |
$4,958.40 |
$4,958.40 |
$4,958.40
|
|
Arthrd ant ntrbd min dsc crv
|
$3,013.60 |
$3,013.60 |
$3,013.60 |
$10,629.07
|
|
Arthrd ant ntrbd min dsc lum
|
$3,720.00 |
$3,720.00 |
$3,720.00 |
$3,720.00
|
|
Arthrd ant ntrbd min dsc thc
|
$4,013.60 |
$4,013.60 |
$4,013.60 |
$4,013.60
|
|
Arthrd ant ntrbdy cervical
|
$4,080.80 |
$4,080.80 |
$4,080.80 |
$9,951.20
|
|
Arthrd cmbn 1ntrspc lumbar
|
$4,459.20 |
$4,459.20 |
$4,459.20 |
$8,434.40
|
|
Arthrd dst rad/ul jt sgm rsc
|
$4,809.60 |
$4,809.60 |
$4,809.60 |
$8,446.00
|
|
Arthrd elbow jt autog graft
|
$4,929.60 |
$4,929.60 |
$4,929.60 |
$15,152.74
|
