|
Application halo pelvic
|
$1,771.43 |
$1,771.43 |
$1,771.43 |
$2,211.05
|
|
Application long leg splint 29505
|
$174.65 |
$174.65 |
$174.65 |
$338.25
|
|
Application lower leg splint 29515
|
$174.65 |
$174.65 |
$174.65 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$174.65 |
$174.65 |
$174.65 |
$375.06
|
|
Application of body cast
|
$293.96 |
$293.96 |
$293.96 |
$561.60
|
|
Application of body cast
|
$293.96 |
$293.96 |
$293.96 |
$561.60
|
|
Application of cylinder cast 29365
|
$293.96 |
$293.96 |
$293.96 |
$431.08
|
|
Application of forearm cast 29075
|
$293.96 |
$293.96 |
$293.96 |
$358.20
|
|
Application of long arm cast 29065
|
$293.96 |
$293.96 |
$293.96 |
$396.77
|
|
Application of long leg cast
|
$293.96 |
$293.96 |
$293.96 |
$435.54
|
|
Application of long leg cast 29345
|
$293.96 |
$293.96 |
$293.96 |
$455.00
|
|
Application of paste boot 29580
|
$174.65 |
$174.65 |
$174.65 |
$340.11
|
|
Application short leg cast 29405
|
$293.96 |
$293.96 |
$293.96 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$2,164.64
|
|
Appl long leg cast brace
|
$293.96 |
$293.96 |
$293.96 |
$468.00
|
|
Appl mltpln uni ext fixj sys
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$5,855.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$7.89 |
$7.89 |
$7.89 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$14.87 |
$14.87 |
$14.87 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$43.44 |
$43.44 |
$43.44 |
$54.61
|
|
Appl multlay comprs arm/hand
|
$174.65 |
$174.65 |
$174.65 |
$289.60
|
|
Appl patllr tdn bearing cast
|
$293.96 |
$293.96 |
$293.96 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$5,810.00
|
|
Apply finger cast 29086
|
$174.65 |
$174.65 |
$174.65 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$142.67 |
$142.67 |
$142.67 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$174.65 |
$174.65 |
$174.65 |
$271.80
|
|
Apply interstit radiat compl
|
$767.95 |
$767.95 |
$767.95 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$767.95 |
$767.95 |
$767.95 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$640.29 |
$640.29 |
$640.29 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$640.29 |
$640.29 |
$640.29 |
$1,269.97
|
|
Apply of finger splint 29131
|
$65.75 |
$65.75 |
$65.75 |
$177.45
|
|
Apply rem fixation device
|
$1,771.43 |
$1,771.43 |
$1,771.43 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$293.96 |
$293.96 |
$293.96 |
$555.00
|
|
Apply short leg castambul type 29425
|
$293.96 |
$293.96 |
$293.96 |
$404.74
|
|
Apply surf ldr radionuclide
|
$121.20 |
$121.20 |
$121.20 |
$282.80
|
|
App mdlty 1+hubbrd tnk ea 15
|
$45.89 |
$45.89 |
$45.89 |
$141.39
|
|
App mltpln uni xtrnl fix 1st
|
$20,355.21 |
$20,355.21 |
$20,355.21 |
$16,139.55
|
|
App mltpln uni xtrnl fix xch
|
$1,771.43 |
$1,771.43 |
$1,771.43 |
$3,526.50
|
|
App skn cll ssp f/n/g/hf 1st
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$3,567.20
|
|
App skn cl ssp agrft t/a/l 1
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$3,567.20
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1.77 |
$1.77 |
$1.77 |
$955.43
|
|
#aptt mix-1:1 incubated
|
$35.09 |
$35.09 |
$35.09 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$37.73 |
$37.73 |
$37.73 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$12.05 |
$12.05 |
$12.05 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$11.53 |
$11.53 |
$11.53 |
$150.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$46.97 |
$46.97 |
$46.97 |
$100.75
|
|
Aquatic exercise - group charge
|
$22.65 |
$22.65 |
$22.65 |
$87.45
|
|
Aqueous shunt eye w/graft
|
$5,711.08 |
$5,711.08 |
$5,711.08 |
$6,105.79
|
|
Aqueous shunt eye without graft
|
$5,711.08 |
$5,711.08 |
$5,711.08 |
$6,105.79
|
|
Argatroban nonesrd (accord)
|
$1.82 |
$1.82 |
$1.82 |
$218.25
|
|
Argatroban nonesrd (auromed)
|
$1.45 |
$1.45 |
$1.45 |
$40.30
|
|
Argatroban nonesrd use 1mg
|
$0.74 |
$0.74 |
$0.74 |
$881.10
|
|
Ar gene charac alleles
|
$137.00 |
$137.00 |
$137.00 |
$287.70
|
|
Ar gene full gene sequence
|
$301.35 |
$301.35 |
$301.35 |
$331.49
|
|
Ar gene known famil variant
|
$185.20 |
$185.20 |
$185.20 |
$304.59
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$3.33 |
$3.33 |
$3.33 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$395.29 |
$395.29 |
$395.29 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$117.70 |
$117.70 |
$117.70 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$117.70 |
$117.70 |
$117.70 |
$426.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$5.86 |
$5.86 |
$5.86 |
$1,303.25
|
|
Artery to vein shunt
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$4,316.00
|
|
Artery-vein nonautograft
|
$5,983.35 |
$5,983.35 |
$5,983.35 |
$7,236.06
|
|
Artery xray of abdomen 75726-26
|
$5,983.35 |
$5,983.35 |
$5,983.35 |
$4,618.71
|
|
Artery x-rays adrenal gland
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$3,320.35
|
|
Artery x-rays adrenals
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$3,764.59
|
|
Artery x-rays arm/leg 75710-26
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$3,860.40
|
|
Artery x-rays chest
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$2,895.07
|
|
Artery x-rays lung
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$3,296.15
|
|
Artery x-rays lung
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$2,427.50
|
|
Artery x-rays lungs
|
$3,483.84 |
$3,483.84 |
$3,483.84 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$5,983.35 |
$5,983.35 |
$5,983.35 |
$4,306.40
|
|
Artery x-rays spine
|
$5,983.35 |
$5,983.35 |
$5,983.35 |
$4,792.33
|
|
Arthrd ant ntrbd min dsc crv
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$10,629.07
|
|
Arthrd ant ntrbdy cervical
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$9,951.20
|
|
Arthrd cmbn 1ntrspc lumbar
|
$20,355.21 |
$20,355.21 |
$20,355.21 |
$8,434.40
|
|
Arthrd dst rad/ul jt sgm rsc
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$8,446.00
|
|
Arthrd elbow jt autog graft
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$15,152.74
|
|
Arthrd glenohumeral jt w/grf
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$15,226.08
|
|
Arthrd pst tq 1ntrspc lum
|
$20,355.21 |
$20,355.21 |
$20,355.21 |
$4,627.00
|
|
Arthrd si jt perq/min nvas
|
$20,355.21 |
$20,355.21 |
$20,355.21 |
$15,959.91
|
|
Arthrd si jt prq wo tfxj dev
|
$20,355.21 |
$20,355.21 |
$20,355.21 |
$21,762.05
|
|
Arthrd wrist complete wo grf
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$7,992.89
|
|
Arthrd wrist lmtd without b1 grf
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$8,159.00
|
|
Arthrd wrist with autograft
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$6,605.25
|
|
Arthrd wrist w/sliding graft
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$5,419.00
|
|
Arthrd wrst iliac/oth agrft
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$7,389.50
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$326.73 |
$326.73 |
$326.73 |
$609.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$766.52 |
$766.52 |
$766.52 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$326.73 |
$326.73 |
$326.73 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$326.73 |
$326.73 |
$326.73 |
$494.40
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$326.73 |
$326.73 |
$326.73 |
$699.00
|
|
Arthrodesis big toe joint 28760
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$7,807.24
|
|
Arthrodesis elbw joint local
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$8,453.60
|
|
Arthrodesis glenohumeral jt
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$7,807.24
|
|
Arthrodesis pantalar
|
$20,355.21 |
$20,355.21 |
$20,355.21 |
$15,372.00
|
|
Arthrodesis subtalar
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$13,057.20
|
|
Arthrodesis triple
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$12,151.68
|
|
Arthroplasty finger joint 26535
|
$3,591.33 |
$3,591.33 |
$3,591.33 |
$4,160.64
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$3,591.33 |
$3,591.33 |
$3,591.33 |
$4,627.00
|