|
Angioplasty fem/pop unilat 37224
|
$6,341.00 |
$6,341.00 |
$6,341.00 |
$8,600.40
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,363.00 |
$6,363.00 |
$6,363.00 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$6,658.00 |
$6,658.00 |
$6,658.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,858.00 |
$3,858.00 |
$3,858.00 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$6,174.00 |
$6,174.00 |
$6,174.00 |
$8,359.11
|
|
Ankle X-ray
|
$984.00 |
$984.00 |
$984.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$856.00 |
$856.00 |
$856.00 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$998.00 |
$998.00 |
$998.00 |
$630.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$271.00 |
$271.00 |
$271.00 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$271.00 |
$271.00 |
$271.00 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$311.00 |
$311.00 |
$311.00 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$311.00 |
$311.00 |
$311.00 |
$167.25
|
|
Anora (draw only)
|
$35.00 |
$35.00 |
$35.00 |
$35.00
|
|
Antibody elution rbc reference
|
$78.00 |
$78.00 |
$78.00 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$229.00 |
$229.00 |
$229.00 |
$131.56
|
|
Antibody htlv-i
|
$12.00 |
$12.00 |
$12.00 |
$49.53
|
|
Antibody htlv-ii
|
$47.00 |
$47.00 |
$47.00 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$283.00 |
$283.00 |
$283.00 |
$224.00
|
|
Antibody id rbc panel
|
$414.00 |
$414.00 |
$414.00 |
$291.75
|
|
Antibody screen rbc
|
$70.00 |
$70.00 |
$70.00 |
$108.55
|
|
Antidepressant not specified
|
$133.00 |
$133.00 |
$133.00 |
$72.14
|
|
Antigen therapy services
|
$74.00 |
$74.00 |
$74.00 |
$74.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$86.00 |
$86.00 |
$86.00 |
$38.50
|
|
Antinuclear antibodies
|
$125.00 |
$125.00 |
$125.00 |
$90.00
|
|
Antinuclear antibodies titer
|
$97.00 |
$97.00 |
$97.00 |
$80.04
|
|
Antipsychotics nos 1-3
|
$164.00 |
$164.00 |
$164.00 |
$136.61
|
|
Antistreptolysin o titer
|
$67.00 |
$67.00 |
$67.00 |
$54.00
|
|
Antithrombin iii activity
|
$56.00 |
$56.00 |
$56.00 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$608.00 |
$608.00 |
$608.00 |
$394.55
|
|
Apheresis plasma
|
$2,153.52 |
$2,153.52 |
$2,153.52 |
$3,226.34
|
|
Apheresis rbc
|
$2,788.54 |
$2,788.54 |
$2,788.54 |
$3,290.80
|
|
Apheresis wbc
|
$2,277.00 |
$2,277.00 |
$2,277.00 |
$3,347.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,125.00 |
$2,125.00 |
$2,125.00 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$160.00 |
$160.00 |
$160.00 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$98.00 |
$98.00 |
$98.00 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,692.00 |
$4,692.00 |
$4,692.00 |
$3,593.46
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$82.00 |
$82.00 |
$82.00 |
$512.20
|
|
Appl hip spica cast 1 leg
|
$332.00 |
$332.00 |
$332.00 |
$499.20
|
|
Application clubfoot cast
|
$232.00 |
$232.00 |
$232.00 |
$303.00
|
|
Application finger splntstatic 29130
|
$219.00 |
$219.00 |
$219.00 |
$208.50
|
|
Application long leg splint 29505
|
$289.00 |
$289.00 |
$289.00 |
$338.25
|
|
Application lower leg splint 29515
|
$384.00 |
$384.00 |
$384.00 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$358.00 |
$358.00 |
$358.00 |
$375.06
|
|
Application of forearm cast 29075
|
$276.00 |
$276.00 |
$276.00 |
$358.20
|
|
Application of long arm cast 29065
|
$605.00 |
$605.00 |
$605.00 |
$396.77
|
|
Application of long leg cast
|
$383.00 |
$383.00 |
$383.00 |
$435.54
|
|
Application of long leg cast 29345
|
$413.00 |
$413.00 |
$413.00 |
$455.00
|
|
Application of paste boot 29580
|
$508.00 |
$508.00 |
$508.00 |
$340.11
|
|
Application short leg cast 29405
|
$413.00 |
$413.00 |
$413.00 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,671.00 |
$2,671.00 |
$2,671.00 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,958.00 |
$1,958.00 |
$1,958.00 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$15.00 |
$15.00 |
$15.00 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$57.00 |
$57.00 |
$57.00 |
$75.98
|
|
Apply forearm splintdynamic 29126
|
$181.00 |
$181.00 |
$181.00 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$232.00 |
$232.00 |
$232.00 |
$271.80
|
|
Apply interstit radiat compl
|
$1,758.00 |
$1,758.00 |
$1,758.00 |
$2,901.80
|
|
Apply rigid leg cast 29445
|
$340.00 |
$340.00 |
$340.00 |
$555.00
|
|
Apply short leg castambul type 29425
|
$248.00 |
$248.00 |
$248.00 |
$404.74
|
|
Apply surf ldr radionuclide
|
$299.00 |
$299.00 |
$299.00 |
$282.80
|
|
App topical fluoride varnish
|
$56.00 |
$56.00 |
$56.00 |
$27.20
|
|
Aqmbf pet rest & rx stress
|
$6,343.00 |
$6,343.00 |
$6,343.00 |
$974.40
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$76.00 |
$76.00 |
$76.00 |
$100.75
|
|
Aquatic exercise - group charge
|
$87.00 |
$87.00 |
$87.00 |
$87.45
|
|
Arm CT Scan (with contrast, both arms)
|
$5,476.00 |
$5,476.00 |
$5,476.00 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,076.00 |
$1,076.00 |
$1,076.00 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$677.00 |
$677.00 |
$677.00 |
$426.00
|
|
Arterial blood draw/perc 36620
|
$171.00 |
$171.00 |
$171.00 |
$478.96
|
|
Artery xray each vessel 7577426
|
$2,692.00 |
$2,692.00 |
$2,692.00 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$7,607.00 |
$7,607.00 |
$7,607.00 |
$4,618.71
|
|
Artery x-rays arm/leg 75710-26
|
$5,305.00 |
$5,305.00 |
$5,305.00 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$6,102.00 |
$6,102.00 |
$6,102.00 |
$3,860.40
|
|
Artery x-rays chest
|
$4,566.00 |
$4,566.00 |
$4,566.00 |
$2,895.07
|
|
Artery x-rays lung
|
$5,306.00 |
$5,306.00 |
$5,306.00 |
$3,296.15
|
|
Artery x-rays lungs
|
$5,306.00 |
$5,306.00 |
$5,306.00 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$7,607.00 |
$7,607.00 |
$7,607.00 |
$4,306.40
|
|
Artery x-rays spine
|
$7,607.00 |
$7,607.00 |
$7,607.00 |
$4,792.33
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$752.00 |
$752.00 |
$752.00 |
$609.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$959.00 |
$959.00 |
$959.00 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$387.00 |
$387.00 |
$387.00 |
$494.40
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$777.00 |
$777.00 |
$777.00 |
$699.00
|
|
Asp core fat pad
|
$3,309.00 |
$3,309.00 |
$3,309.00 |
$1,123.50
|
|
Asp & inj bone cyst
|
$2,499.00 |
$2,499.00 |
$2,499.00 |
$1,060.40
|
|
Asp & inj w/heparin pleurx cath
|
$1,632.00 |
$1,632.00 |
$1,632.00 |
$1,546.46
|
|
Aspirate bladder/sprapubic cath 51102
|
$2,108.00 |
$2,108.00 |
$2,108.00 |
$3,226.20
|
|
Aspirate/inj ganglion cyst 20612
|
$600.00 |
$600.00 |
$600.00 |
$441.30
|
|
Aspirate pleura without imaging 32554
|
$1,472.00 |
$1,472.00 |
$1,472.00 |
$1,195.15
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,137.00 |
$1,137.00 |
$1,137.00 |
$1,250.04
|
|
Aspiration peritonsillar abscess
|
$1,118.00 |
$1,118.00 |
$1,118.00 |
$431.20
|
|
Aspir/inj thyroid cyst 60300
|
$1,808.00 |
$1,808.00 |
$1,808.00 |
$872.50
|
|
Assay of breath ethanol
|
$45.00 |
$45.00 |
$45.00 |
$52.62
|
|
Assay of salicylate
|
$51.00 |
$51.00 |
$51.00 |
$96.50
|
|
Assay of thiocyanate
|
$43.00 |
$43.00 |
$43.00 |
$73.71
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$420.00 |
$420.00 |
$420.00 |
$300.00
|
|
Assess cyst contrast inject
|
$630.00 |
$630.00 |
$630.00 |
$453.04
|
|
Assistive tech assessment, ot
|
$133.00 |
$133.00 |
$133.00 |
$90.60
|
|
Ast/sgot
|
$20.00 |
$20.00 |
$20.00 |
$45.90
|
|
Audiometry air + bone
|
$417.00 |
$417.00 |
$417.00 |
$185.15
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$18,408.00 |
$18,408.00 |
$18,408.00 |
$7,109.05
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$19,957.00 |
$19,957.00 |
$19,957.00 |
$10,415.40
|
