|
Appl modality 1+lllt po pain
|
$42.90 |
$42.90 |
$42.90 |
$49.92
|
|
Appl multlay comprs arm/hand
|
$172.45 |
$172.45 |
$172.45 |
$237.60
|
|
Appl patllr tdn bearing cast
|
$290.25 |
$290.25 |
$290.25 |
$426.75
|
|
Appl unipln uni ext fixj sys
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$4,933.64
|
|
Apply finger cast 29086
|
$172.45 |
$172.45 |
$172.45 |
$213.97
|
|
Apply forearm splintdynamic 29126
|
$140.87 |
$140.87 |
$140.87 |
$245.40
|
|
Apply hand/wrist cast 29085
|
$172.45 |
$172.45 |
$172.45 |
$264.75
|
|
Apply interstit radiat compl
|
$758.25 |
$758.25 |
$758.25 |
$2,910.05
|
|
Apply intrcav radiat compl
|
$758.25 |
$758.25 |
$758.25 |
$1,484.80
|
|
Apply intrcav radiat interm
|
$632.20 |
$632.20 |
$632.20 |
$1,338.48
|
|
Apply intrcav radiat simple
|
$632.20 |
$632.20 |
$632.20 |
$796.97
|
|
Apply of finger splint 29131
|
$64.92 |
$64.92 |
$64.92 |
$177.45
|
|
Apply rem fixation device
|
$1,749.06 |
$1,749.06 |
$1,749.06 |
$1,839.77
|
|
Apply rigid leg cast 29445
|
$290.25 |
$290.25 |
$290.25 |
$593.57
|
|
Apply short leg castambul type 29425
|
$290.25 |
$290.25 |
$290.25 |
$384.59
|
|
Apply surf ldr radionuclide
|
$119.67 |
$119.67 |
$119.67 |
$251.55
|
|
App mltpln uni xtrnl fix 1st
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$16,139.55
|
|
App mltpln uni xtrnl fix xch
|
$1,749.06 |
$1,749.06 |
$1,749.06 |
$1,858.61
|
|
App skn cll ssp f/n/g/hf 1st
|
$1,999.13 |
$1,999.13 |
$1,999.13 |
$2,837.09
|
|
App skn cl ssp agrft t/a/l 1
|
$1,999.13 |
$1,999.13 |
$1,999.13 |
$2,837.09
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1.77 |
$1.77 |
$1.77 |
$4.20
|
|
#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 |
$113.91
|
|
Aquaporin-4 antibody elisa
|
$11.53 |
$11.53 |
$11.53 |
$138.87
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$46.97 |
$46.97 |
$46.97 |
$90.52
|
|
Aquatic exercise - group charge
|
$22.65 |
$22.65 |
$22.65 |
$86.90
|
|
Aqueous shunt eye w/graft
|
$5,638.94 |
$5,638.94 |
$5,638.94 |
$5,656.00
|
|
Aqueous shunt eye without graft
|
$5,638.94 |
$5,638.94 |
$5,638.94 |
$5,638.94
|
|
Argatroban nonesrd (accord)
|
$1.82 |
$1.82 |
$1.82 |
$1.82
|
|
Argatroban nonesrd (auromed)
|
$1.45 |
$1.45 |
$1.45 |
$668.52
|
|
Argatroban nonesrd use 1mg
|
$0.74 |
$0.74 |
$0.74 |
$881.10
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$3.33 |
$3.33 |
$3.33 |
$9,918.02
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$5.86 |
$5.86 |
$5.86 |
$292.80
|
|
Artery to vein shunt
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$3,486.86
|
|
Artery-vein nonautograft
|
$5,907.78 |
$5,907.78 |
$5,907.78 |
$6,325.50
|
|
Artery xray of abdomen 75726-26
|
$5,907.78 |
$5,907.78 |
$5,907.78 |
$4,252.60
|
|
Artery x-rays adrenal gland
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$3,263.92
|
|
Artery x-rays adrenals
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$3,483.84
|
|
Artery x-rays arm/leg 75710-26
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$3,341.00
|
|
Artery x-rays arms/legs 75716-26
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$3,860.40
|
|
Artery x-rays chest
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$2,498.28
|
|
Artery x-rays lung
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$2,921.88
|
|
Artery x-rays lung
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$2,138.37
|
|
Artery x-rays lungs
|
$3,439.84 |
$3,439.84 |
$3,439.84 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$5,907.78 |
$5,907.78 |
$5,907.78 |
$3,993.41
|
|
Artery x-rays spine
|
$5,907.78 |
$5,907.78 |
$5,907.78 |
$4,094.60
|
|
Arthrd ant ntrbd min dsc crv
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$7,875.25
|
|
Arthrd ant ntrbdy cervical
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$7,023.52
|
|
Arthrd cmbn 1ntrspc lumbar
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$7,664.80
|
|
Arthrd dst rad/ul jt sgm rsc
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,907.11
|
|
Arthrd elbow jt autog graft
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$14,241.77
|
|
Arthrd glenohumeral jt w/grf
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$14,241.77
|
|
Arthrd pst tq 1ntrspc lum
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$6,318.00
|
|
Arthrd si jt perq/min nvas
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$15,959.91
|
|
Arthrd si jt prq wo tfxj dev
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$21,657.23
|
|
Arthrd wrist complete wo grf
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,907.11
|
|
Arthrd wrist lmtd without b1 grf
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,192.28
|
|
Arthrd wrist with autograft
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$6,605.25
|
|
Arthrd wrist w/sliding graft
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,913.97
|
|
Arthrd wrst iliac/oth agrft
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$7,389.50
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$322.61 |
$322.61 |
$322.61 |
$543.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$756.84 |
$756.84 |
$756.84 |
$948.00
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$322.61 |
$322.61 |
$322.61 |
$882.70
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$322.61 |
$322.61 |
$322.61 |
$451.48
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$322.61 |
$322.61 |
$322.61 |
$687.20
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$322.61 |
$322.61 |
$322.61 |
$650.37
|
|
Arthrodesis big toe joint 28760
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$5,886.74
|
|
Arthrodesis elbw joint local
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,907.11
|
|
Arthrodesis glenohumeral jt
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,870.12
|
|
Arthrodesis pantalar
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$16,139.55
|
|
Arthrodesis subtalar
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$5,560.13
|
|
Arthrodesis triple
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$10,629.07
|
|
Arthroplasty finger joint 26535
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,821.05
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,594.44
|
|
Arthro/shoul surg; w/spacer
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$14,241.77
|
|
Arthrotomy carpometacarpal joint 26070
|
$1,749.06 |
$1,749.06 |
$1,749.06 |
$1,771.43
|
|
Arthrotomy/elbow/exp/drain/rmv fb 24000
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,545.97
|
|
Arthrotomy glenhumrl jt w/bx
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$2,620.80
|
|
Arthrotomy glenohumeral jt
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$4,474.76
|
|
Arthrotomy strnclav joint
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,195.20
|
|
Arthrp ntrcrp/crp/mtcr ntrps
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,821.05
|
|
Arthrp ntrcrpl/crp/mtcrp ssp
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,389.10
|
|
Arthrp prostc dstl scph crpl
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,907.11
|
|
Arthrp w/prostc dstl rds
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$10,629.07
|
|
Arthrp w/prostc dstl ulna
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$16,139.55
|
|
Arthrp w/prostc dst rds&crps
|
$20,098.12 |
$20,098.12 |
$20,098.12 |
$18,190.19
|
|
Arthrp w/prostc lunate
|
$14,061.89 |
$14,061.89 |
$14,061.89 |
$14,061.89
|
|
Arthrp w/prostc trapezium
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$7,400.25
|
|
Arthrs kne srg drlg ost diss
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$6,260.32
|
|
Arthrt acrmclv/strnclav jt
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,594.44
|
|
Arthrt ac sc jt exp/rmvl fb
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,591.33
|
|
Arthrt elbow w/synovectomy
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,591.33
|
|
Arthrt elbw capsl exc rls
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,591.33
|
|
Arthrt elbw jt expl bx rmvl
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,594.44
|
|
Arthrt elbw synovial bx only
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,719.72
|
|
Arthrt gh jt expl/drg/rmv fb
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,591.33
|
|
Arthrt glenhumrl jt w/expl
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$5,147.20
|
|
Arthrt hip expl/rmv loose/fb
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$5,705.27
|
|
Arthrt rdcrpl/midcarpl jt
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,591.33
|
