|
Amphetamines 5 or more
|
$238.00 |
$238.00 |
$238.00 |
$90.48
|
|
Amylase
|
$29.00 |
$29.00 |
$29.00 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$25.00 |
$25.00 |
$25.00 |
$80.08
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$68.75 |
$68.75 |
$68.75 |
$117.01
|
|
Anal/urinary muscle study
|
$458.00 |
$458.00 |
$458.00 |
$407.00
|
|
Anal/urinary muscle study
|
$575.00 |
$575.00 |
$575.00 |
$602.80
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$390.00 |
$390.00 |
$390.00 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$746.00 |
$746.00 |
$746.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$453.00 |
$453.00 |
$453.00 |
$249.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$166.00 |
$166.00 |
$166.00 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$375.00
|
|
An cholangiogram percutaneous compl
|
$10,472.00 |
$10,472.00 |
$10,472.00 |
$2,480.94
|
|
An fluoro guide for cvp
|
$606.00 |
$606.00 |
$606.00 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$7,779.00 |
$7,779.00 |
$7,779.00 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$17,519.00 |
$17,519.00 |
$17,519.00 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$17,519.00 |
$17,519.00 |
$17,519.00 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$18,412.00 |
$18,412.00 |
$18,412.00 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$35,038.00 |
$35,038.00 |
$35,038.00 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ini
|
$17,199.00 |
$17,199.00 |
$17,199.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$6,824.00 |
$6,824.00 |
$6,824.00 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$17,199.00 |
$17,199.00 |
$17,199.00 |
$8,359.11
|
|
Ankle X-ray
|
$371.00 |
$371.00 |
$371.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$358.61 |
$358.61 |
$358.61 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,031.00 |
$1,031.00 |
$1,031.00 |
$630.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$191.00 |
$191.00 |
$191.00 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$191.00 |
$191.00 |
$191.00 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$218.00 |
$218.00 |
$218.00 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$218.00 |
$218.00 |
$218.00 |
$167.25
|
|
Anodyne therapy charges pt
|
$23.00 |
$23.00 |
$23.00 |
$42.00
|
|
Antibody bacterium, not elsewhere specified
|
$70.30 |
$70.30 |
$70.30 |
$57.85
|
|
Antibody elution rbc reference
|
$81.00 |
$81.00 |
$81.00 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$141.74 |
$141.74 |
$141.74 |
$131.56
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$285.50 |
$285.50 |
$285.50 |
$224.00
|
|
Antibody id rbc panel
|
$374.00 |
$374.00 |
$374.00 |
$291.75
|
|
Antibody screen rbc
|
$99.99 |
$99.99 |
$99.99 |
$108.55
|
|
Antidepressant not specified
|
$134.00 |
$134.00 |
$134.00 |
$72.14
|
|
Antigen therapy services
|
$154.00 |
$154.00 |
$154.00 |
$74.00
|
|
Antinuclear antibodies
|
$113.00 |
$113.00 |
$113.00 |
$90.00
|
|
Antinuclear antibodies titer
|
$87.00 |
$87.00 |
$87.00 |
$80.04
|
|
Antipsychotics nos 1-3
|
$85.96 |
$85.96 |
$85.96 |
$136.61
|
|
Antistreptolysin o titer
|
$60.00 |
$60.00 |
$60.00 |
$54.00
|
|
Antithrombin iii activity
|
$51.00 |
$51.00 |
$51.00 |
$115.15
|
|
Ant sgm img i&r speclr mic
|
$484.00 |
$484.00 |
$484.00 |
$286.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$432.00 |
$432.00 |
$432.00 |
$394.55
|
|
Apheresis plasma
|
$13,154.00 |
$13,154.00 |
$13,154.00 |
$3,226.34
|
|
Apheresis platelets
|
$3,693.00 |
$3,693.00 |
$3,693.00 |
$2,195.00
|
|
Apheresis rbc
|
$4,939.00 |
$4,939.00 |
$4,939.00 |
$3,290.80
|
|
Apl(pml-rara) quant - sendout
|
$425.00 |
$425.00 |
$425.00 |
$513.00
|
|
Appl hip spica cast1&1/2
|
$851.00 |
$851.00 |
$851.00 |
$501.28
|
|
Application clubfoot cast
|
$617.24 |
$617.24 |
$617.24 |
$303.00
|
|
Application finger splntstatic 29130
|
$366.00 |
$366.00 |
$366.00 |
$208.50
|
|
Application long leg splint 29505
|
$554.00 |
$554.00 |
$554.00 |
$338.25
|
|
Application lower leg splint 29515
|
$554.00 |
$554.00 |
$554.00 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$1,256.91 |
$1,256.91 |
$1,256.91 |
$375.06
|
|
Application of forearm cast 29075
|
$969.00 |
$969.00 |
$969.00 |
$358.20
|
|
Application of long arm cast 29065
|
$951.00 |
$951.00 |
$951.00 |
$396.77
|
|
Application of long leg cast 29345
|
$951.00 |
$951.00 |
$951.00 |
$455.00
|
|
Application of paste boot 29580
|
$951.50 |
$951.50 |
$951.50 |
$340.11
|
|
Application short leg cast 29405
|
$951.00 |
$951.00 |
$951.00 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$5,738.00 |
$5,738.00 |
$5,738.00 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$5,738.00 |
$5,738.00 |
$5,738.00 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$122.00 |
$122.00 |
$122.00 |
$69.00
|
|
Apply forearm splintdynamic 29126
|
$451.00 |
$451.00 |
$451.00 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$580.00 |
$580.00 |
$580.00 |
$271.80
|
|
Apply rigid leg cast 29445
|
$951.00 |
$951.00 |
$951.00 |
$555.00
|
|
Apply short leg castambul type 29425
|
$951.00 |
$951.00 |
$951.00 |
$404.74
|
|
Apply surf ldr radionuclide
|
$422.00 |
$422.00 |
$422.00 |
$282.80
|
|
App topical fluoride varnish
|
$559.00 |
$559.00 |
$559.00 |
$27.20
|
|
Aqaprn-4 antb flo cytmtry ea
|
$175.00 |
$175.00 |
$175.00 |
$231.66
|
|
Aqmbf pet rest & rx stress
|
$803.00 |
$803.00 |
$803.00 |
$974.40
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$103.00 |
$103.00 |
$103.00 |
$100.75
|
|
Aquatic exercise - group charge
|
$72.00 |
$72.00 |
$72.00 |
$87.45
|
|
Arm CT Scan (with contrast, both arms)
|
$2,619.00 |
$2,619.00 |
$2,619.00 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$2,207.00 |
$2,207.00 |
$2,207.00 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$455.00 |
$455.00 |
$455.00 |
$426.00
|
|
Arterial blood draw/perc 36620
|
$556.00 |
$556.00 |
$556.00 |
$478.96
|
|
Artery xray each vessel 7577426
|
$2,375.00 |
$2,375.00 |
$2,375.00 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$7,097.00 |
$7,097.00 |
$7,097.00 |
$4,618.71
|
|
Artery x-rays arm/leg 75710-26
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$3,860.40
|
|
Artery x-rays chest
|
$9,614.00 |
$9,614.00 |
$9,614.00 |
$2,895.07
|
|
Artery x-rays lung
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$3,296.15
|
|
Artery x-rays lungs
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$6,675.00 |
$6,675.00 |
$6,675.00 |
$4,306.40
|
|
Artery x-rays spine
|
$15,621.00 |
$15,621.00 |
$15,621.00 |
$4,792.33
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$609.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$2,585.00 |
$2,585.00 |
$2,585.00 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,113.00 |
$1,113.00 |
$1,113.00 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$927.00 |
$927.00 |
$927.00 |
$494.40
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$699.00
|
|
Asp core fat pad
|
$3,545.00 |
$3,545.00 |
$3,545.00 |
$1,123.50
|
|
Asp & inj w/heparin pleurx cath
|
$5,588.00 |
$5,588.00 |
$5,588.00 |
$1,546.46
|
|
Aspirate bladder/sprapubic cath 51102
|
$2,641.00 |
$2,641.00 |
$2,641.00 |
$3,226.20
|
|
Aspirate/inj ganglion cyst 20612
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$441.30
|
|
Aspirate pleura without imaging 32554
|
$2,747.00 |
$2,747.00 |
$2,747.00 |
$1,195.15
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$2,652.00 |
$2,652.00 |
$2,652.00 |
$1,250.04
|
|
Aspiration peritonsillar abscess
|
$640.00 |
$640.00 |
$640.00 |
$431.20
|
|
Aspir/inj thyroid cyst 60300
|
$2,525.00 |
$2,525.00 |
$2,525.00 |
$872.50
|
|
Asp pq spinal cord cyst/syrinx
|
$3,015.00 |
$3,015.00 |
$3,015.00 |
$1,330.50
|
|
Assay of leflunomide
|
$76.82 |
$76.82 |
$76.82 |
$92.50
|
