|
Implant spinal canal cath
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,913.97
|
|
Implant spine infusion pump
|
$20,914.85 |
$20,914.85 |
$20,914.85 |
$17,262.84
|
|
Implant spine infusion pump
|
$20,914.85 |
$20,914.85 |
$20,914.85 |
$17,270.40
|
|
Impl neurostim electr perc
|
$7,766.27 |
$7,766.27 |
$7,766.27 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$7,578.32 |
$8,965.93 |
$8,965.93 |
$5,095.20
|
|
Impl oi implt sk tc esp<100
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$22,958.00
|
|
Impl oi implt sk tc esp>=100
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$15,226.08
|
|
Impl oi implt skull perq esp
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$13,525.50
|
|
Impltj ntrstrml crnl rng seg
|
$4,760.49 |
$4,760.49 |
$4,760.49 |
$5,683.61
|
|
Imported lipodox inj
|
$528.86 |
$528.86 |
$528.86 |
$528.86
|
|
Impres&prep auricular prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$6,557.24
|
|
Impres&prep def obt prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,558.89
|
|
Impres&prep facial prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$5,028.40
|
|
Impres&prep intrm obt prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Impres&prep mndbl res prosth
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,966.64
|
|
Impres&prep nasal prosth
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,966.64
|
|
Impres&prep oral surg splint
|
$274.80 |
$274.80 |
$274.80 |
$1,751.20
|
|
Impres&prep orbital prosth
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$7,000.36
|
|
Impres&prep paltl aug prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Impres&prep paltl lft prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Impres&prep sp aid prosth
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,054.40
|
|
Impres&prep surg obt prosth
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$2,945.12
|
|
Imuglucerase injection
|
$43.62 |
$43.62 |
$43.62 |
$3,399.59
|
|
In-111 autol wbc diag per dose
|
$1,031.39 |
$1,031.39 |
$1,031.39 |
$3,493.75
|
|
In-111 capromab pendet
|
$1,730.29 |
$1,730.29 |
$1,730.29 |
$3,141.45
|
|
In-111 ibritumomab tiux dx
|
$798.02 |
$798.02 |
$798.02 |
$4,748.02
|
|
In-111 oxyquinolin per 0.5 mci
|
$772.64 |
$831.46 |
$831.46 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$715.29 |
$745.62 |
$745.62 |
$2,598.17
|
|
In-111 pentetreotide
|
$1,914.61 |
$1,914.61 |
$1,914.61 |
$5,294.90
|
|
Inc deep opng b1 crtx thorax
|
$3,342.87 |
$3,342.87 |
$3,342.87 |
$1,091.20
|
|
Inc dp bone crtx f/arm&/wrst
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,311.00
|
|
Inc dp opn b1 crtx hum/elbw
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Incis 1 vertebral seg cerv
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$4,297.60
|
|
Incis 1 vertebral seg lumbar
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$3,628.80
|
|
Incis 1 vertebral seg thorac
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$3,619.20
|
|
Incise diaphragm nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,310.83
|
|
Incise/drain eyelid lining
|
$1,146.13 |
$1,146.13 |
$1,146.13 |
$1,271.00
|
|
Incise flexor carpi radialis
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Incise hand/finger tendon
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,007.15
|
|
Incise hip/thigh nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,500.80
|
|
Incise hip/thigh nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$3,086.40
|
|
Incise inner ear
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$2,186.08
|
|
Incise inner ear nerve
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$5,289.89
|
|
Incise inner eye adhesions
|
$649.19 |
$649.19 |
$649.19 |
$1,202.90
|
|
Incise inner eye adhesions
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,698.92
|
|
Incise inner eye adhesions
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,940.80
|
|
Incise inner eye adhesions
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,526.64
|
|
Incise inner eye adhesions
|
$4,760.49 |
$4,760.49 |
$4,760.49 |
$4,760.49
|
|
Incise inner eye strands
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$3,905.20
|
|
Incise nerve back of head
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,685.07
|
|
Incise perq finger tendon 26060
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,211.05
|
|
Incise skull/brain surgery
|
$7,578.32 |
$8,965.93 |
$8,965.93 |
$7,181.20
|
|
Incise skull for treatment
|
$7,578.32 |
$7,578.32 |
$7,578.32 |
$7,181.20
|
|
Incise sperm duct pouch
|
$2,424.12 |
$2,424.12 |
$2,424.12 |
$2,424.12
|
|
Incise tear duct opening 68440
|
$353.74 |
$353.74 |
$353.74 |
$841.43
|
|
Incise tendon(s) & muscle(s)
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,913.97
|
|
Incise thigh tendon & fascia
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Incise wrist/forearm tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Incision anal septum infant
|
$3,245.23 |
$3,245.23 |
$3,245.23 |
$3,245.23
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,917.33 |
$1,917.33 |
$1,917.33 |
$2,089.40
|
|
Incision & drainage open of deep abscess (subfascial) pos
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$2,312.00
|
|
Incision/fixation of femur
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$5,275.40
|
|
Incision of achilles tendon
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$3,318.90
|
|
Incision of achilles tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,591.33
|
|
Incision of anal sphincter
|
$3,245.23 |
$3,245.23 |
$3,245.23 |
$3,245.23
|
|
Incision of ankle bone
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,905.00
|
|
Incision of breast lesion
|
$1,917.33 |
$1,917.33 |
$1,917.33 |
$2,577.85
|
|
Incision of brow nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,685.07
|
|
Incision of burn scab initi
|
$472.79 |
$472.79 |
$472.79 |
$494.40
|
|
Incision of cheek nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,685.07
|
|
Incision of chin nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,685.07
|
|
Incision of eardrum
|
$274.80 |
$274.80 |
$274.80 |
$548.25
|
|
Incision of eardrum
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Incision of esophagus
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$1,851.20
|
|
Incision of eye
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$3,986.00
|
|
Incision of eye
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$4,306.85
|
|
Incision of eyelid
|
$1,146.13 |
$1,146.13 |
$1,146.13 |
$1,835.60
|
|
Incision of facial nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,685.07
|
|
Incision of fibula
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Incision of finger tendon
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,893.86
|
|
Incision of foot fascia
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,599.40
|
|
Incision of foot tendon 28234
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,116.27
|
|
Incision of heel bone
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,855.00
|
|
Incision of hip bone
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$7,413.38
|
|
Incision of hip bones
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$7,413.38
|
|
Incision of hip tendon
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$3,885.29
|
|
Incision of hip tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Incision of hip tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Incision of hip tendons
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,865.95
|
|
Incision of iris
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,685.92
|
|
Incision of iris
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,698.92
|
|
Incision of jaw joint
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,558.89
|
|
Incision of jaw nerve
|
$2,310.83 |
$2,310.83 |
$2,310.83 |
$2,310.83
|
|
Incision of knee joint
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,976.00
|
|
Incision of lymph channels
|
$4,531.42 |
$4,531.42 |
$4,531.42 |
$4,570.46
|
|
Incision of metatarsal
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$4,561.60
|
|
Incision of metatarsal
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,311.00
|
|
Incision of metatarsal
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,594.44
|
|
Incision of metatarsals
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,811.00
|
|
Incision of midfoot bones
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,855.00
|