|
Apheresis rbc
|
$1,726.48 |
$2,788.54 |
$4,939.00 |
|
|
Apheresis wbc
|
$1,726.48 |
$2,141.53 |
$2,277.00 |
|
|
Apl(pml-rara) quant - sendout
|
$232.40 |
$425.00 |
$1,335.20 |
|
|
Appendectomy
|
$8,901.75 |
$8,901.75 |
$8,901.75 |
|
|
Appendectomy add-on 44955
|
$114.00 |
$114.00 |
$114.00 |
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$1,243.77 |
$1,243.77 |
$1,243.77 |
|
|
Appendico-vesicostomy
|
$1,632.03 |
$1,632.03 |
$1,632.03 |
|
|
Appendix Removal (Laparoscopic)
|
$8,312.83 |
$8,312.83 |
$8,312.83 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,394.82 |
$2,125.00 |
$5,281.36 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$73.17 |
$159.00 |
$5,281.36 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$32.47 |
$96.00 |
$3,489.92 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,227.26 |
$4,667.00 |
$5,281.36 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$58.95 |
$1,140.00 |
$5,281.36 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$21.75 |
$82.00 |
$3,489.92 |
|
|
Appl bdy cst sho to hip 1thi
|
$231.14 |
$231.14 |
$231.14 |
|
|
Appl bdy cst sho to hip b th
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl bdy cst sho to hip head
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl body cast sho to hips
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl cast figure-of-eight
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl cast plaster velpeau
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl cast shoulder spica
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl halo cranial 6+pins
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
|
|
Appl halo type body cast
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl hip spica cast1&1/2
|
$384.59 |
$851.00 |
$851.00 |
|
|
Appl hip spica cast 1 leg
|
$319.00 |
$319.00 |
$384.59 |
|
|
Application clubfoot cast
|
$223.45 |
$258.00 |
$617.24 |
|
|
Application finger splntstatic 29130
|
$112.80 |
$243.00 |
$366.00 |
|
|
Application halo femoral
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Application halo pelvic
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
|
|
Application long leg splint 29505
|
$191.00 |
$267.00 |
$575.20 |
|
|
Application lower leg splint 29515
|
$191.00 |
$354.00 |
$554.00 |
|
|
Application multi layer compression below knee (both sides)
|
$189.90 |
$322.00 |
$1,256.91 |
|
|
Application of body cast
|
$384.59 |
$384.59 |
$384.59 |
|
|
Application of body cast
|
$384.59 |
$384.59 |
$384.59 |
|
|
Application of cylinder cast 29365
|
$384.59 |
$384.59 |
$384.59 |
|
|
Application of forearm cast 29075
|
$273.00 |
$384.59 |
$969.00 |
|
|
Application of long arm cast 29065
|
$384.59 |
$544.00 |
$951.00 |
|
|
Application of long leg cast
|
$383.00 |
$426.00 |
$538.40 |
|
|
Application of long leg cast 29345
|
$372.00 |
$384.59 |
$1,104.00 |
|
|
Application of paste boot 29580
|
$190.00 |
$457.00 |
$951.50 |
|
|
Application short leg cast 29405
|
$282.24 |
$384.59 |
$951.00 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,016.25 |
$2,657.00 |
$5,738.00 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,016.25 |
$1,958.00 |
$5,738.00 |
|
|
Applicator tag rfid localizer 12gx7cm
|
$3,428.88 |
$3,428.88 |
$3,428.88 |
|
|
Appl long leg cast brace
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl mltpln uni ext fixj sys
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$8.43 |
$15.00 |
$122.00 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$16.63 |
$57.00 |
$70.40 |
|
|
Appl modality 1+lllt po pain
|
$51.36 |
$51.36 |
$51.36 |
|
|
Appl multlay comprs arm/hand
|
$215.20 |
$223.45 |
$223.45 |
|
|
Appl patllr tdn bearing cast
|
$384.59 |
$384.59 |
$384.59 |
|
|
Appl unipln uni ext fixj sys
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Apply finger cast 29086
|
$181.00 |
$223.45 |
$223.45 |
|
|
Apply forearm splintdynamic 29126
|
$181.00 |
$201.00 |
$451.00 |
|
|
Apply halo w/removal cranial
|
$2,211.05 |
$2,211.05 |
$2,375.52 |
|
|
Apply hand/wrist cast 29085
|
$223.45 |
$258.00 |
$666.40 |
|
|
Apply interstit radiat compl
|
$957.68 |
$1,758.00 |
$1,953.00 |
|
|
Apply intrcav radiat compl
|
$534.24 |
$957.68 |
$957.68 |
|
|
Apply intrcav radiat interm
|
$734.16 |
$759.77 |
$759.77 |
|
|
Apply intrcav radiat simple
|
$571.76 |
$759.77 |
$759.77 |
|
|
Apply of finger splint 29131
|
$81.12 |
$81.12 |
$81.12 |
|
|
Apply rem fixation device
|
$1,344.00 |
$2,211.05 |
$2,211.05 |
|
|
Apply rigid leg cast 29445
|
$248.00 |
$384.59 |
$951.00 |
|
|
Apply r&l pulm art bands
|
$2,339.86 |
$2,339.86 |
$2,339.86 |
|
|
Apply short leg castambul type 29425
|
$248.00 |
$345.45 |
$951.00 |
|
|
Apply srs headframe add-on
|
$228.05 |
$228.05 |
$228.05 |
|
|
Apply surf ldr radionuclide
|
$140.29 |
$332.00 |
$422.00 |
|
|
App mdlty 1+hubbrd tnk ea 15
|
$47.04 |
$47.04 |
$47.04 |
|
|
App mltpln uni xtrnl fix 1st
|
$37,310.30 |
$37,310.30 |
$37,310.30 |
|
|
App mltpln uni xtrnl fix xch
|
$2,545.26 |
$2,545.26 |
$2,545.26 |
|
|
App skn cll ssp f/n/g/hf 1st
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
|
|
App skn cl ssp agrft t/a/l 1
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
|
|
App topical fluoride varnish
|
$56.00 |
$62.00 |
$559.00 |
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1.82 |
$2.36 |
$2.36 |
|
|
#aptt mix-1:1 incubated
|
$48.42 |
$48.42 |
$431.20 |
|
|
Aqaprn-4 antb flo cytmtry ea
|
$52.07 |
$175.00 |
$1,080.80 |
|
|
Aqmbf pet rest & rx stress
|
$39.90 |
$803.00 |
$6,343.00 |
|
|
Aquaporin-4 antibody cba each
|
$16.63 |
$16.63 |
$16.63 |
|
|
Aquaporin-4 antibody elisa
|
$7.99 |
$15.91 |
$15.91 |
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$37.13 |
$76.00 |
$144.00 |
|
|
Aquatic exercise - group charge
|
$24.64 |
$72.00 |
$91.87 |
|
|
Aqueous shunt eye w/graft
|
$7,316.99 |
$7,316.99 |
$7,316.99 |
|
|
Aqueous shunt eye without graft
|
$7,316.99 |
$7,316.99 |
$7,316.99 |
|
|
Architect ecm px fx 1 sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Arch supp att to shoe long/m
|
$69.03 |
$69.03 |
$69.03 |
|
|
Arch supp att to shoe metata
|
$53.93 |
$53.93 |
$53.93 |
|
|
Arch suprt att to sho longit
|
$53.93 |
$53.93 |
$53.93 |
|
|
Arformoterol non-comp unit
|
$0.99 |
$0.99 |
$0.99 |
|
|
Argatroban dialysis, auromed
|
$2.01 |
$2.01 |
$2.01 |
|
|
Argatroban esrd dialysis 1mg
|
$0.84 |
$0.84 |
$0.84 |
|
|
Argatroban nonesrd (accord)
|
$2.50 |
$2.50 |
$2.50 |
|
|
Argatroban nonesrd (auromed)
|
$2.01 |
$2.01 |
$2.01 |
|
|
Argatroban nonesrd use 1mg
|
$0.84 |
$0.84 |
$4.05 |
|
|
Ar gene charac alleles
|
$189.06 |
$189.06 |
$189.06 |
|
|
Ar gene full gene sequence
|
$415.86 |
$415.86 |
$415.86 |
|
|
Ar gene known famil variant
|
$255.58 |
$255.58 |
$255.58 |
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$4.61 |
$4.61 |
$4.61 |
|
|
Arm CT Scan (with contrast, both arms)
|
$479.72 |
$2,619.00 |
$5,476.00 |
|
|
Arm CT Scan (without contrast, both arms)
|
$143.75 |
$1,151.00 |
$2,500.00 |
|
|
Arm or Leg Ultrasound (limited, left side)
|
$129.25 |
$606.00 |
$1,069.60 |
|