|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$440.70 |
$440.70 |
$440.70 |
$2,978.25
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$601.90 |
$601.90 |
$601.90 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$241.80 |
$241.80 |
$241.80 |
$549.08
|
|
Application finger splntstatic 29130
|
$146.90 |
$146.90 |
$146.90 |
$208.50
|
|
Application long leg splint 29505
|
$233.35 |
$233.35 |
$233.35 |
$338.25
|
|
Application lower leg splint 29515
|
$194.35 |
$194.35 |
$194.35 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$154.05 |
$154.05 |
$154.05 |
$384.80
|
|
Application of long arm cast 29065
|
$188.50 |
$188.50 |
$188.50 |
$404.63
|
|
Application of paste boot 29580
|
$254.80 |
$254.80 |
$254.80 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$296.40 |
$296.40 |
$296.40 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$114.40 |
$114.40 |
$114.40 |
$2,087.50
|
|
Appl modality 1/> areas paraffin bath 97018
|
$59.15 |
$59.15 |
$59.15 |
$70.65
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$58.50 |
$58.50 |
$58.50 |
$72.80
|
|
Apply forearm splintdynamic 29126
|
$178.75 |
$178.75 |
$178.75 |
$249.60
|
|
Apply of finger splint 29131
|
$170.95 |
$170.95 |
$170.95 |
$177.45
|
|
Apply rigid leg cast 29445
|
$294.45 |
$294.45 |
$294.45 |
$593.57
|
|
#aptt mix-1:1 incubated
|
$124.80 |
$124.80 |
$124.80 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$248.30 |
$248.30 |
$248.30 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$227.50 |
$227.50 |
$227.50 |
$114.60
|
|
Aquaporin-4 antibody elisa
|
$175.50 |
$175.50 |
$175.50 |
$151.45
|
|
Aquatic exercise - group charge
|
$109.20 |
$109.20 |
$109.20 |
$87.60
|
|
Argatroban nonesrd use 1mg
|
$342.39 |
$342.39 |
$342.39 |
$881.10
|
|
Arterial blood draw/perc 36620
|
$508.95 |
$508.95 |
$508.95 |
$529.19
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$295.75 |
$295.75 |
$295.75 |
$567.78
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$430.30 |
$430.30 |
$430.30 |
$968.00
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$434.20 |
$434.20 |
$434.20 |
$882.70
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$141.70 |
$141.70 |
$141.70 |
$451.48
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$364.65 |
$364.65 |
$364.65 |
$696.00
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$240.50 |
$240.50 |
$240.50 |
$699.00
|
|
Aspirate/inj ganglion cyst 20612
|
$146.25 |
$146.25 |
$146.25 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$439.40 |
$439.40 |
$439.40 |
$1,212.00
|
|
Assay of adp & amp
|
$139.75 |
$139.75 |
$139.75 |
$169.65
|
|
Assay of estrogen
|
$247.00 |
$247.00 |
$247.00 |
$185.60
|
|
Assay of interleukin-6 (il-6)
|
$129.35 |
$129.35 |
$129.35 |
$87.60
|
|
Assay of leflunomide
|
$151.45 |
$151.45 |
$151.45 |
$112.70
|
|
Assay of osteocalcin
|
$96.85 |
$96.85 |
$96.85 |
$133.20
|
|
Assay of prostaglandin
|
$243.10 |
$243.10 |
$243.10 |
$183.60
|
|
Assay of salicylate
|
$108.55 |
$108.55 |
$108.55 |
$93.60
|
|
Assay of thiocyanate
|
$76.70 |
$76.70 |
$76.70 |
$54.71
|
|
Assay of tyrosine
|
$69.55 |
$69.55 |
$69.55 |
$56.00
|
|
Assay of urine sulfate
|
$31.85 |
$31.85 |
$31.85 |
$34.70
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$238.55 |
$238.55 |
$238.55 |
$302.50
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$50.70 |
$50.70 |
$50.70 |
$43.55
|
|
Ast/sgot
|
$59.80 |
$59.80 |
$59.80 |
$43.40
|
|
Atropine 0.1 mg/ml injection syringe
|
$17.31 |
$17.31 |
$17.31 |
$27.91
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$150.80 |
$150.80 |
$150.80 |
$200.40
|
|
Autologous blood process
|
$273.00 |
$273.00 |
$273.00 |
$262.50
|
|
Avul nail plate addl
|
$105.95 |
$105.95 |
$105.95 |
$244.70
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$250.90 |
$250.90 |
$250.90 |
$356.00
|
|
Azithromycin 500 mg intravenous solution
|
$14.06 |
$14.06 |
$14.06 |
$25.03
|
|
Baclofen eval charges
|
$91.00 |
$91.00 |
$91.00 |
$85.00
|
|
Bacterial meningitis antigen
|
$89.70 |
$89.70 |
$89.70 |
$66.30
|
|
Bacterial vaginosis pcr
|
$206.05 |
$206.05 |
$206.05 |
$314.60
|
|
#bac vag cand-c. albicans naa
|
$90.35 |
$90.35 |
$90.35 |
$146.90
|
|
B cells total count
|
$129.35 |
$129.35 |
$129.35 |
$131.30
|
|
#_benzodiazconfur
|
$93.60 |
$93.60 |
$93.60 |
$99.45
|
|
Beta 2 glycoprotein 1 antibody iga
|
$107.25 |
$107.25 |
$107.25 |
$109.60
|
|
Beta-2 microglobulin
|
$97.50 |
$97.50 |
$97.50 |
$84.00
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$9.98 |
$9.98 |
$9.98 |
$62.45
|
|
Bilateral n block inj trigeminal 64400
|
$376.35 |
$376.35 |
$376.35 |
$544.80
|
|
Bilirubin direct
|
$63.70 |
$63.70 |
$63.70 |
$42.90
|
|
Bilirubin total
|
$67.60 |
$67.60 |
$67.60 |
$49.60
|
|
Binder abdominal lg 12 x 62-74
|
$59.15 |
$59.15 |
$59.15 |
$57.20
|
|
Biofeedback, pt
|
$107.90 |
$107.90 |
$107.90 |
$148.66
|
|
Biopsy external ear 69100
|
$198.90 |
$198.90 |
$198.90 |
$416.52
|
|
Biopsy skin incisional single lesion
|
$242.45 |
$242.45 |
$242.45 |
$674.00
|
|
Biotinidase - quest
|
$64.35 |
$64.35 |
$64.35 |
$88.00
|
|
Bladder irrigate/lavage/instill 51700
|
$348.40 |
$348.40 |
$348.40 |
$417.95
|
|
Blood Clotting (PT/INR) Test
|
$53.30 |
$53.30 |
$53.30 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$73.45 |
$73.45 |
$73.45 |
$68.25
|
|
Blood Count (CBC) Test
|
$66.30 |
$66.30 |
$66.30 |
$66.60
|
|
Blood Count (CBC) Test (without differential)
|
$65.65 |
$65.65 |
$65.65 |
$56.40
|
|
Blood Culture Test
|
$166.40 |
$166.40 |
$166.40 |
$112.20
|
|
Blood draw capillary 36416
|
$135.85 |
$135.85 |
$135.85 |
$22.08
|
|
Blood gases ph venous
|
$67.60 |
$67.60 |
$67.60 |
$60.00
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$51.35 |
$51.35 |
$51.35 |
$57.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$35.75 |
$35.75 |
$35.75 |
$32.50
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$35.75 |
$35.75 |
$35.75 |
$33.15
|
|
Blood occult peroxidase activity qualitative gastric
|
$32.50 |
$32.50 |
$32.50 |
$31.20
|
|
Blood smear microscopic w manual differential wbc count
|
$52.65 |
$52.65 |
$52.65 |
$35.31
|
|
Blood typing abo
|
$49.40 |
$49.40 |
$49.40 |
$73.51
|
|
Blood typing ag donor ea ag
|
$83.85 |
$83.85 |
$83.85 |
$131.95
|
|
Blood typing rbc ag non abo/rh ea
|
$98.15 |
$98.15 |
$98.15 |
$148.59
|
|
Blood typing rh (d)
|
$49.40 |
$49.40 |
$49.40 |
$52.73
|
|
Bone Density Scan (DEXA)
|
$352.95 |
$352.95 |
$352.95 |
$381.19
|
|
Bone imaging multiple areas
|
$1,233.05 |
$1,233.05 |
$1,233.05 |
$962.78
|
|
Bone/joint imaging ltd area
|
$979.55 |
$979.55 |
$979.55 |
$941.85
|
|
Bone marrow interpretation
|
$153.40 |
$153.40 |
$153.40 |
$542.03
|
|
Bone survey-lead poisoning
|
$405.60 |
$405.60 |
$405.60 |
$356.85
|
|
Boot j walker l
|
$24.70 |
$24.70 |
$24.70 |
$267.84
|
|
Boot walker genesis full shell 3-strap s
|
$58.50 |
$58.50 |
$58.50 |
$179.82
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$161.85 |
$161.85 |
$161.85 |
$107.25
|
|
Borrelia miyamotoi amp prb
|
$159.90 |
$159.90 |
$159.90 |
$95.45
|
|
Bowel imaging
|
$993.85 |
$993.85 |
$993.85 |
$1,082.69
|
|
Brace afo lg left 6607
|
$92.30 |
$92.30 |
$92.30 |
$70.65
|
|
Brace ank aftr bioskn med lg
|
$32.50 |
$32.50 |
$32.50 |
$58.20
|
|
Brace ank air stirrup univ
|
$27.30 |
$27.30 |
$27.30 |
$56.65
|
|
Brace knee hing pat open med
|
$27.95 |
$27.95 |
$27.95 |
$433.29
|
|
Brace m arm board
|
$8.45 |
$8.45 |
$8.45 |
$110.54
|
|
Brace oths wrist hnd fngr without
|
$115.05 |
$115.05 |
$115.05 |
$120.25
|
