|
Angio trnslmnl balloon same vein ea addl
|
$4,395.27 |
$4,395.27 |
$4,395.27 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$7,739.79 |
$7,739.79 |
$7,739.79 |
$8,689.20
|
|
Ankle X-ray
|
$244.75 |
$244.75 |
$244.75 |
$339.44
|
|
Anoscopy remove fb 46608
|
$950.95 |
$950.95 |
$950.95 |
$1,208.35
|
|
Antibody bacterium, not elsewhere specified
|
$140.25 |
$140.25 |
$140.25 |
$57.89
|
|
Antibody elution rbc reference
|
$163.90 |
$163.90 |
$163.90 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$397.10 |
$397.10 |
$397.10 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$605.00 |
$605.00 |
$605.00 |
$220.73
|
|
Antibody id rbc panel
|
$206.80 |
$206.80 |
$206.80 |
$291.75
|
|
Antibody influenza virus
|
$149.60 |
$149.60 |
$149.60 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$112.75 |
$112.75 |
$112.75 |
$53.96
|
|
Antibody screen rbc
|
$63.80 |
$63.80 |
$63.80 |
$105.00
|
|
Antidepressant not specified
|
$154.55 |
$154.55 |
$154.55 |
$89.50
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$14.30 |
$14.30 |
$14.30 |
$50.88
|
|
Antinuclear antibodies
|
$46.75 |
$46.75 |
$46.75 |
$91.70
|
|
Antinuclear antibodies titer
|
$33.00 |
$33.00 |
$33.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$117.70 |
$117.70 |
$117.70 |
$74.20
|
|
Antistreptolysin o titer
|
$35.20 |
$35.20 |
$35.20 |
$57.96
|
|
Antithrombin iii activity
|
$302.50 |
$302.50 |
$302.50 |
$115.23
|
|
Apc gene full sequence
|
$918.50 |
$918.50 |
$918.50 |
$1,076.40
|
|
Apheresis plasma
|
$5,800.74 |
$5,800.74 |
$5,800.74 |
$3,411.50
|
|
Apheresis rbc
|
$5,629.80 |
$5,629.80 |
$5,629.80 |
$3,348.50
|
|
Apl(pml-rara) quant - sendout
|
$691.90 |
$691.90 |
$691.90 |
$465.60
|
|
Appendectomy
|
$6,402.19 |
$6,402.19 |
$6,402.19 |
$4,881.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$547.58 |
$547.58 |
$547.58 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,031.42 |
$1,031.42 |
$1,031.42 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$257.59 |
$257.59 |
$257.59 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,358.76 |
$5,358.76 |
$5,358.76 |
$3,150.00
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,031.42 |
$1,031.42 |
$1,031.42 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$245.05 |
$245.05 |
$245.05 |
$508.18
|
|
Application clubfoot cast
|
$421.08 |
$421.08 |
$421.08 |
$303.00
|
|
Application finger splntstatic 29130
|
$289.08 |
$289.08 |
$289.08 |
$216.80
|
|
Application long leg splint 29505
|
$937.20 |
$937.20 |
$937.20 |
$340.80
|
|
Application lower leg splint 29515
|
$412.50 |
$412.50 |
$412.50 |
$355.85
|
|
Application multi layer compression below knee (both sides)
|
$752.40 |
$752.40 |
$752.40 |
$397.00
|
|
Application of paste boot 29580
|
$448.80 |
$448.80 |
$448.80 |
$331.74
|
|
Application short leg cast 29405
|
$269.28 |
$269.28 |
$269.28 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,000.72 |
$3,000.72 |
$3,000.72 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,758.28 |
$2,758.28 |
$2,758.28 |
$2,120.95
|
|
Appl modality 1/> areas paraffin bath 97018
|
$59.28 |
$59.28 |
$59.28 |
$69.55
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$62.11 |
$62.11 |
$62.11 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$467.28 |
$467.28 |
$467.28 |
$339.69
|
|
Apply finger cast 29086
|
$95.70 |
$95.70 |
$95.70 |
$225.29
|
|
Apply forearm splintdynamic 29126
|
$426.36 |
$426.36 |
$426.36 |
$263.10
|
|
Apply interstit radiat compl
|
$7,309.59 |
$7,309.59 |
$7,309.59 |
$2,877.50
|
|
Apply of finger splint 29131
|
$189.42 |
$189.42 |
$189.42 |
$177.45
|
|
Apply rigid leg cast 29445
|
$524.04 |
$524.04 |
$524.04 |
$608.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$80.18 |
$80.18 |
$80.18 |
$98.90
|
|
Aquatic exercise - group charge
|
$203.26 |
$203.26 |
$203.26 |
$87.60
|
|
Arterial blood draw/perc 36620
|
$446.22 |
$446.22 |
$446.22 |
$505.60
|
|
Artery xray each vessel 7577426
|
$1,886.28 |
$1,886.28 |
$1,886.28 |
$1,752.53
|
|
Artery xray of abdomen 75726-26
|
$5,216.64 |
$5,216.64 |
$5,216.64 |
$4,337.45
|
|
Artery x-rays arm/leg 75710-26
|
$2,816.88 |
$2,816.88 |
$2,816.88 |
$3,439.84
|
|
Artery x-rays arms/legs 75716-26
|
$3,649.14 |
$3,649.14 |
$3,649.14 |
$3,844.10
|
|
Artery x-rays lung
|
$2,235.42 |
$2,235.42 |
$2,235.42 |
$2,921.88
|
|
Artery x-rays lungs
|
$4,470.84 |
$4,470.84 |
$4,470.84 |
$3,686.58
|
|
Artery xrays of pelvis 75736 26
|
$3,719.76 |
$3,719.76 |
$3,719.76 |
$4,086.49
|
|
Artery x-rays spine
|
$3,113.00 |
$3,113.00 |
$3,113.00 |
$4,306.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$364.10 |
$364.10 |
$364.10 |
$567.78
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$344.30 |
$344.30 |
$344.30 |
$976.09
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$173.31 |
$173.31 |
$173.31 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$353.10 |
$353.10 |
$353.10 |
$454.65
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$646.80 |
$646.80 |
$646.80 |
$698.58
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$62.57 |
$62.57 |
$62.57 |
$686.37
|
|
Arthroplasty finger joint 26535
|
$571.45 |
$571.45 |
$571.45 |
$3,839.54
|
|
Asp core fat pad
|
$54.45 |
$54.45 |
$54.45 |
$1,214.75
|
|
Aspirate bladder/sprapubic cath 51102
|
$3,789.72 |
$3,789.72 |
$3,789.72 |
$3,162.90
|
|
Aspirate pleura without imaging 32554
|
$1,573.44 |
$1,573.44 |
$1,573.44 |
$1,249.21
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$1,273.63
|
|
Aspiration peritonsillar abscess
|
$65.84 |
$65.84 |
$65.84 |
$508.13
|
|
Aspir/inj thyroid cyst 60300
|
$1,905.42 |
$1,905.42 |
$1,905.42 |
$833.29
|
|
Assay acid phosphatase
|
$44.55 |
$44.55 |
$44.55 |
$38.22
|
|
Assay of breath ethanol
|
$40.15 |
$40.15 |
$40.15 |
$45.76
|
|
Assay of interleukin-6 (il-6)
|
$104.50 |
$104.50 |
$104.50 |
$77.35
|
|
Assay of osteocalcin
|
$59.95 |
$59.95 |
$59.95 |
$97.21
|
|
Assay of procainamide w/metab
|
$396.00 |
$396.00 |
$396.00 |
$61.20
|
|
Assay of somatostatin
|
$271.15 |
$271.15 |
$271.15 |
$165.75
|
|
Assay of thiocyanate
|
$100.65 |
$100.65 |
$100.65 |
$57.00
|
|
Assay of tyrosine
|
$221.65 |
$221.65 |
$221.65 |
$56.10
|
|
Assay of urine sulfate
|
$31.90 |
$31.90 |
$31.90 |
$31.35
|
|
Assay phosphatidylglycerol
|
$82.50 |
$82.50 |
$82.50 |
$87.20
|
|
Assay toxin or antitoxin
|
$120.45 |
$120.45 |
$120.45 |
$72.75
|
|
Assess cyst contrast inject
|
$290.40 |
$290.40 |
$290.40 |
$447.33
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$23.65 |
$23.65 |
$23.65 |
$49.80
|
|
Ast/sgot
|
$36.85 |
$36.85 |
$36.85 |
$45.65
|
|
Athrectomy fem/pop/unilateral 37225
|
$10,836.13 |
$10,836.13 |
$10,836.13 |
$19,875.58
|
|
Athrectomy tib/pero/unilat/ini ves 37229
|
$10,836.13 |
$10,836.13 |
$10,836.13 |
$19,892.81
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$6,152.96 |
$6,152.96 |
$6,152.96 |
$7,629.60
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$12,023.25 |
$12,023.25 |
$12,023.25 |
$10,578.36
|
|
Autologous blood process
|
$416.35 |
$416.35 |
$416.35 |
$234.27
|
|
Automated diff wbc count
|
$39.05 |
$39.05 |
$39.05 |
$34.39
|
|
Avul nail plate addl
|
$124.08 |
$124.08 |
$124.08 |
$230.02
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$289.08 |
$289.08 |
$289.08 |
$342.55
|
|
Baclofen eval charges
|
$77.35 |
$77.35 |
$77.35 |
$86.14
|
|
Bacterial meningitis antigen
|
$133.65 |
$133.65 |
$133.65 |
$68.40
|
|
Bacterial vaginosis pcr
|
$254.65 |
$254.65 |
$254.65 |
$298.04
|
|
Bactericidal level serum
|
$123.20 |
$123.20 |
$123.20 |
$82.50
|
|
Bartonella dna pcr-sendout
|
$276.65 |
$276.65 |
$276.65 |
$196.20
|
|
Benign lesion paring 2-4
|
$295.68 |
$295.68 |
$295.68 |
$275.49
|
|
Benign lesion paring 4+
|
$347.16 |
$347.16 |
$347.16 |
$287.00
|
