|
Antigen therapy services
|
$43.20 |
$43.20 |
$2,850.00 |
|
|
Antigen therapy services
|
$32.80 |
$32.80 |
$32.80 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.64 |
$5,144.60 |
$5,144.60 |
|
|
Antihemophilic viii/vwf comp
|
$2.25 |
$2.25 |
$2.25 |
|
|
Anti-inhibitor
|
$10,270.62 |
$10,270.62 |
$10,270.62 |
|
|
Anti mog serum - sendout
|
$48.57 |
$48.57 |
$551.40 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$40.30 |
$48.57 |
$227.00 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$30.60 |
$48.57 |
$162.50 |
|
|
Ant instr 2-3 vert segm 22845
|
$1,312.80 |
$1,748.00 |
$70,421.43 |
|
|
Ant instrumentation/4-7 vert seg 22846
|
$1,362.00 |
$1,816.80 |
$91,251.78 |
|
|
Antinuclear antibodies
|
$29.40 |
$96.80 |
$280.00 |
|
|
Antinuclear antibodies titer
|
$40.32 |
$58.20 |
$338.00 |
|
|
Antiphosphatidylserine antibody
|
$48.57 |
$48.57 |
$131.95 |
|
|
Antipsychotics nos 1-3
|
$72.14 |
$72.14 |
$183.30 |
|
|
Antipsychotics nos 4-6
|
$36.00 |
$36.00 |
$36.00 |
|
|
Antipsychotics nos 7/more
|
$12.80 |
$12.80 |
$12.80 |
|
|
Antistreptolysin o screen
|
$14.95 |
$48.75 |
$86.10 |
|
|
Antistreptolysin o titer
|
$42.90 |
$48.57 |
$104.58 |
|
|
Antithrombin iii activity
|
$32.85 |
$135.20 |
$262.20 |
|
|
Antithrombin iii injection
|
$7.08 |
$41.79 |
$9,274.05 |
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$6,148.03 |
$14,664.50 |
$14,664.50 |
|
|
Antithymocyte globuln rabbit
|
$1,718.43 |
$2,686.73 |
$3,442.40 |
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$1,691.40 |
$2,172.80 |
$32,651.55 |
|
|
Ant sgm img ir flrscn angrph
|
$322.40 |
$322.40 |
$322.40 |
|
|
Ant sgm img i&r speclr mic
|
$90.40 |
$90.40 |
$90.40 |
|
|
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
|
$112.80 |
$367.72 |
$807.00 |
|
|
Aortic circulation assist 33971
|
$1,381.80 |
$1,719.20 |
$2,302.00 |
|
|
Aortic dysfunction/dilation
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
|
|
Aortic dysfunction/dilation
|
$2,700.80 |
$2,700.80 |
$2,700.80 |
|
|
Aortic hemiarch graft 33866
|
$1,966.20 |
$2,260.80 |
$2,966.00 |
|
|
Apc gene dup/delet variants
|
$400.00 |
$400.00 |
$400.00 |
|
|
Apc gene full sequence
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
|
|
Apc gene known fam variants
|
$268.80 |
$268.80 |
$268.80 |
|
|
Aphakia prosth service temp
|
$25.60 |
$25.60 |
$25.60 |
|
|
Apheresis immunoads slctv
|
$3,155.88 |
$4,728.80 |
$5,561.12 |
|
|
Apheresis plasma
|
$1,643.20 |
$1,873.80 |
$3,814.40 |
|
|
Apheresis platelets
|
$275.20 |
$275.20 |
$4,326.79 |
|
|
Apheresis rbc
|
$277.60 |
$277.60 |
$4,683.23 |
|
|
Apheresis wbc
|
$280.80 |
$280.80 |
$2,089.08 |
|
|
Apl(pml-rara) quant - sendout
|
$465.60 |
$465.60 |
$778.05 |
|
|
Appendectomy
|
$830.40 |
$1,576.80 |
$2,298.00 |
|
|
Appendectomy add-on 44955
|
$107.04 |
$206.40 |
$800.30 |
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$1,134.24 |
$2,149.60 |
$3,134.00 |
|
|
Appendix Removal (Laparoscopic)
|
$780.96 |
$1,472.80 |
$51,418.66 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$464.16 |
$1,233.05 |
$4,291.24 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$129.12 |
$492.66 |
$1,758.10 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$43.68 |
$582.19 |
$2,082.60 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$422.88 |
$2,531.76 |
$7,073.49 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$111.36 |
$851.85 |
$2,350.95 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$33.12 |
$464.86 |
$9,857.02 |
|
|
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
|
$654.40 |
$654.40 |
$654.40 |
|
|
Appl hip spica cast 1 leg
|
$590.40 |
$590.40 |
$590.40 |
|
|
Application clubfoot cast
|
$718.40 |
$718.40 |
$718.40 |
|
|
Application finger splntstatic 29130
|
$129.00 |
$203.20 |
$653.00 |
|
|
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
|
$122.40 |
$414.40 |
$736.45 |
|
|
Application lower leg splint 29515
|
$150.78 |
$345.60 |
$581.00 |
|
|
Application multi layer compression below knee (both sides)
|
$98.40 |
$599.72 |
$5,805.00 |
|
|
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 |
$592.00 |
$592.00 |
|
|
Application of forearm cast 29075
|
$113.76 |
$416.00 |
$1,463.00 |
|
|
Application of long arm cast 29065
|
$163.80 |
$462.40 |
$1,407.25 |
|
|
Application of long leg cast
|
$633.75 |
$689.60 |
$689.60 |
|
|
Application of long leg cast 29345
|
$177.12 |
$657.60 |
$2,148.00 |
|
|
Application of paste boot 29580
|
$99.60 |
$310.40 |
$4,029.00 |
|
|
Application short leg cast 29405
|
$151.62 |
$388.80 |
$1,335.10 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$216.48 |
$1,261.65 |
$23,202.15 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$208.32 |
$1,877.29 |
$16,080.20 |
|
|
Applicator tag rfid localizer 12gx7cm
|
$43.80 |
$1,572.56 |
$4,281.57 |
|
|
Appl long leg cast brace
|
$769.60 |
$769.60 |
$769.60 |
|
|
Appl mltpln uni ext fixj sys
|
$1,563.00 |
$2,767.20 |
$112,432.88 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$13.60 |
$93.79 |
$2,705.00 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$29.60 |
$66.60 |
$223.98 |
|
|
Appl multlay comprs arm/hand
|
$75.84 |
$409.60 |
$440.20 |
|
|
Appl patllr tdn bearing cast
|
$556.80 |
$556.80 |
$556.80 |
|
|
Appl unipln uni ext fixj sys
|
$1,470.40 |
$1,470.40 |
$2,051.00 |
|
|
Apply finger cast 29086
|
$101.76 |
$382.40 |
$382.40 |
|
|
Apply forearm splintdynamic 29126
|
$138.60 |
$376.00 |
$376.00 |
|
|
Apply halo w/removal cranial
|
$1,201.60 |
$1,201.60 |
$1,201.60 |
|
|
Apply hand/wrist cast 29085
|
$124.80 |
$459.20 |
$1,317.55 |
|
|
Apply interstit radiat compl
|
$1,941.60 |
$1,941.60 |
$4,997.75 |
|
|
Apply intrcav radiat compl
|
$1,247.82 |
$1,484.80 |
$3,066.60 |
|
|
Apply intrcav radiat interm
|
$1,043.20 |
$1,043.20 |
$1,735.00 |
|
|
Apply intrcav radiat simple
|
$780.80 |
$780.80 |
$880.20 |
|
|
Apply of finger splint 29131
|
$94.20 |
$254.40 |
$310.80 |
|
|
Apply rem fixation device
|
$580.00 |
$580.00 |
$580.00 |
|
|
Apply rigid leg cast 29445
|
$205.80 |
$654.76 |
$20,467.00 |
|
|
Apply short leg castambul type 29425
|
$121.44 |
$374.40 |
$1,446.90 |
|
