|
Angioplasty fem/pop unilat 37224
|
$29,652.83 |
$29,652.83 |
$29,652.83 |
$10,522.96
|
|
Angio tib/peroneal/init ves/unila 37228
|
$55,541.12 |
$55,541.12 |
$55,541.12 |
$14,806.05
|
|
Angio trnslmnl balloon same vein ini
|
$21,415.92 |
$21,415.92 |
$21,415.92 |
$8,766.15
|
|
Ankle arthroscopy/surgery
|
$21,142.80 |
$21,142.80 |
$21,142.80 |
$3,594.44
|
|
Ankle X-ray
|
$522.60 |
$522.60 |
$522.60 |
$325.59
|
|
Antibody bacterium, not elsewhere specified
|
$61.10 |
$61.10 |
$61.10 |
$57.85
|
|
Antibody elution rbc reference
|
$144.95 |
$144.95 |
$144.95 |
$163.80
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$203.45 |
$203.45 |
$203.45 |
$218.30
|
|
Antibody id rbc panel
|
$163.80 |
$163.80 |
$163.80 |
$265.05
|
|
Antibody screen rbc
|
$74.75 |
$74.75 |
$74.75 |
$102.60
|
|
Antibody tetanus
|
$58.50 |
$58.50 |
$58.50 |
$82.20
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2,000.70 |
$2,000.70 |
$2,000.70 |
$3.12
|
|
Anti mog serum - sendout
|
$529.75 |
$529.75 |
$529.75 |
$154.84
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$44.85 |
$44.85 |
$44.85 |
$58.00
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$18.20 |
$18.20 |
$18.20 |
$48.57
|
|
Antinuclear antibodies
|
$235.95 |
$235.95 |
$235.95 |
$97.60
|
|
Antinuclear antibodies titer
|
$80.60 |
$80.60 |
$80.60 |
$79.95
|
|
Antistreptolysin o titer
|
$159.90 |
$159.90 |
$159.90 |
$58.50
|
|
Antithrombin iii activity
|
$244.40 |
$244.40 |
$244.40 |
$135.20
|
|
Antithrombin iii injection
|
$4,475.25 |
$4,475.25 |
$4,475.25 |
$6.36
|
|
Apheresis plasma
|
$2,529.80 |
$2,529.80 |
$2,529.80 |
$3,486.60
|
|
Apl(pml-rara) quant - sendout
|
$329.55 |
$329.55 |
$329.55 |
$465.60
|
|
Appendix Removal (Laparoscopic)
|
$21,071.58 |
$21,071.58 |
$21,071.58 |
$6,604.91
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$3,225.30 |
$3,225.30 |
$3,225.30 |
$1,051.25
|
|
Application of paste boot 29580
|
$20.80 |
$20.80 |
$20.80 |
$331.74
|
|
Appl modality 1/> areas paraffin bath 97018
|
$42.25 |
$42.25 |
$42.25 |
$70.15
|
|
Apply forearm splintdynamic 29126
|
$124.80 |
$124.80 |
$124.80 |
$249.60
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1,506.96 |
$1,506.96 |
$1,506.96 |
$7.80
|
|
#aptt mix-1:1 incubated
|
$347.75 |
$347.75 |
$347.75 |
$157.30
|
|
Aquaporin-4 antibody cba each
|
$64.35 |
$64.35 |
$64.35 |
$113.91
|
|
Aquatic exercise - group charge
|
$137.15 |
$137.15 |
$137.15 |
$87.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$623.76 |
$623.76 |
$623.76 |
$347.75
|
|
Artery-vein nonautograft
|
$31,155.49 |
$31,155.49 |
$31,155.49 |
$6,325.50
|
|
Artery xray of abdomen 75726-26
|
$4,737.85 |
$4,737.85 |
$4,737.85 |
$4,294.50
|
|
Artery x-rays arm/leg 75710-26
|
$4,737.85 |
$4,737.85 |
$4,737.85 |
$3,458.54
|
|
Artery x-rays arms/legs 75716-26
|
$4,737.85 |
$4,737.85 |
$4,737.85 |
$3,936.00
|
|
Artery x-rays lung
|
$4,737.85 |
$4,737.85 |
$4,737.85 |
$3,150.00
|
|
Artery x-rays lungs
|
$4,737.85 |
$4,737.85 |
$4,737.85 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$4,716.40 |
$4,716.40 |
$4,716.40 |
$3,993.41
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$139.75 |
$139.75 |
$139.75 |
$567.78
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$46.80 |
$46.80 |
$46.80 |
$882.70
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$28.60 |
$28.60 |
$28.60 |
$451.48
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$36.40 |
$36.40 |
$36.40 |
$696.00
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$36.40 |
$36.40 |
$36.40 |
$699.00
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$35,853.41 |
$35,853.41 |
$35,853.41 |
$3,594.44
|
|
Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah)
|
$36,222.13 |
$36,222.13 |
$36,222.13 |
$1,060.80
|
|
Aspirate bladder/sprapubic cath 51102
|
$14,096.04 |
$14,096.04 |
$14,096.04 |
$3,162.90
|
|
Aspirate pleura without imaging 32554
|
$10,100.35 |
$10,100.35 |
$10,100.35 |
$1,212.00
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$2,622.75 |
$2,622.75 |
$2,622.75 |
$1,219.50
|
|
Assay of adp & amp
|
$228.15 |
$228.15 |
$228.15 |
$169.65
|
|
Assay of breath ethanol
|
$76.70 |
$76.70 |
$76.70 |
$45.76
|
|
Assay of feces porphyrins
|
$506.35 |
$506.35 |
$506.35 |
$175.50
|
|
Assay of interleukin-6 (il-6)
|
$89.70 |
$89.70 |
$89.70 |
$85.20
|
|
Assay of leflunomide
|
$122.20 |
$122.20 |
$122.20 |
$112.70
|
|
Assay of osteocalcin
|
$167.70 |
$167.70 |
$167.70 |
$133.20
|
|
Assay of prostaglandin
|
$230.10 |
$230.10 |
$230.10 |
$186.20
|
|
Assay of salicylate
|
$187.85 |
$187.85 |
$187.85 |
$83.85
|
|
Assay of thiocyanate
|
$34.45 |
$34.45 |
$34.45 |
$55.25
|
|
Assay of tyrosine
|
$34.45 |
$34.45 |
$34.45 |
$56.00
|
|
Assay of urine sulfate
|
$31.20 |
$31.20 |
$31.20 |
$33.84
|
|
Assess cyst contrast inject
|
$1,655.48 |
$1,655.48 |
$1,655.48 |
$447.33
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$111.15 |
$111.15 |
$111.15 |
$44.20
|
|
Ast/sgot
|
$117.00 |
$117.00 |
$117.00 |
$43.40
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$19,405.49 |
$19,405.49 |
$19,405.49 |
$18,202.87
|
|
Atropine 0.1 mg/ml injection syringe
|
$16.25 |
$16.25 |
$16.25 |
$24.19
|
|
Autologous blood op salvage
|
$750.75 |
$750.75 |
$750.75 |
$904.98
|
|
Autolog prp diab wound ulcer
|
$3,773.90 |
$3,773.90 |
$3,773.90 |
$2,026.46
|
|
Av fusion direct any site
|
$27,931.51 |
$27,931.51 |
$27,931.51 |
$4,044.69
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$41.60 |
$41.60 |
$41.60 |
$356.00
|
|
Azacitidine injection
|
$80.92 |
$80.92 |
$80.92 |
$1,053.92
|
|
Azathioprine 50 mg tablet
|
$4.87 |
$4.87 |
$4.87 |
$2.18
|
|
Azithromycin 500 mg intravenous solution
|
$20.15 |
$20.15 |
$20.15 |
$27.12
|
|
Aztreonam 1 gram solution for injection
|
$185.90 |
$185.90 |
$185.90 |
$158.89
|
|
Baclofen eval charges
|
$90.35 |
$90.35 |
$90.35 |
$85.00
|
|
Bacterial meningitis antigen
|
$125.45 |
$125.45 |
$125.45 |
$66.30
|
|
Bacterial vaginosis pcr
|
$296.40 |
$296.40 |
$296.40 |
$314.60
|
|
#bac vag cand-c. albicans naa
|
$39.00 |
$39.00 |
$39.00 |
$137.80
|
|
Balloon dilate urtrl strix
|
$17,778.75 |
$17,778.75 |
$17,778.75 |
$1,958.25
|
|
Basic vestibular evaluation
|
$597.35 |
$597.35 |
$597.35 |
$372.00
|
|
B cells total count
|
$217.10 |
$217.10 |
$217.10 |
$131.30
|
|
Belimumab 120 mg intravenous solution
|
$3,584.70 |
$3,584.70 |
$3,584.70 |
$4,800.85
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$4,027.72 |
$4,027.72 |
$4,027.72 |
$58.21
|
|
Benztropine 1 mg/ml injection solution
|
$73.12 |
$73.12 |
$73.12 |
$97.50
|
|
Beta 2 glycoprotein 1 antibody iga
|
$76.05 |
$76.05 |
$76.05 |
$109.60
|
|
Beta-2 microglobulin
|
$154.70 |
$154.70 |
$154.70 |
$84.00
|
|
Beta-amyloid 1-40
|
$378.95 |
$378.95 |
$378.95 |
$312.00
|
|
Beta-amyloid 1-42
|
$378.95 |
$378.95 |
$378.95 |
$312.00
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$8.94 |
$8.94 |
$8.94 |
$52.65
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$5,187.91 |
$5,187.91 |
$5,187.91 |
$2,946.69
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$4,543.01 |
$4,543.01 |
$4,543.01 |
$1,708.52
|
|
B-hexosaminidase ea assay
|
$31.20 |
$31.20 |
$31.20 |
$104.25
|
|
Bilateral n block inj occipital 64405
|
$266.50 |
$266.50 |
$266.50 |
$822.40
|
|
Bilateral n block inj trigeminal 64400
|
$266.50 |
$266.50 |
$266.50 |
$537.60
|
|
Bile duct endoscopy add-on 47550
|
$29,118.95 |
$29,118.95 |
$29,118.95 |
$929.64
|
|
Bilicheck
|
$9.10 |
$9.10 |
$9.10 |
$25.20
|
|
Bilirubin direct
|
$86.45 |
$86.45 |
$86.45 |
$43.60
|
|
Bilirubin total
|
$105.30 |
$105.30 |
$105.30 |
$49.77
|
|
Biopsy abdominal mass
|
$5,334.80 |
$5,334.80 |
$5,334.80 |
$1,874.89
|
|
Biopsy, bone open deep
|
$6,225.05 |
$6,225.05 |
$6,225.05 |
$3,370.52
|
|
Biopsy external ear 69100
|
$36.40 |
$36.40 |
$36.40 |
$416.52
|
