|
Antithrombin iii injection
|
$3.85 |
$3.85 |
$3.85 |
$11.85
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$3,968.45 |
$3,968.45 |
$3,968.45 |
$8,214.07
|
|
Antithymocyte globuln rabbit
|
$956.74 |
$956.74 |
$956.74 |
$2,111.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$4,155.20
|
|
Ant sgm img ir flrscn angrph
|
$152.54 |
$152.54 |
$152.54 |
$322.40
|
|
Ant sgm img i&r speclr mic
|
$152.54 |
$152.54 |
$152.54 |
$286.00
|
|
Ant thrc vrt body tethrg <7
|
$17,913.59 |
$17,913.59 |
$17,913.59 |
$4,508.80
|
|
Ant thrc vrt body tethrg 8+
|
$17,913.59 |
$17,913.59 |
$17,913.59 |
$4,968.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$125.84 |
$125.84 |
$125.84 |
$394.55
|
|
Aortic dysfunction/dilation
|
$504.00 |
$504.00 |
$504.00 |
$1,153.60
|
|
Aortic dysfunction/dilation
|
$1,350.19 |
$1,350.19 |
$1,350.19 |
$1,700.16
|
|
Apc gene dup/delet variants
|
$200.00 |
$200.00 |
$200.00 |
$462.00
|
|
Apc gene full sequence
|
$780.00 |
$780.00 |
$780.00 |
$1,255.20
|
|
Apc gene known fam variants
|
$280.00 |
$280.00 |
$280.00 |
$319.20
|
|
Aphakia prosth service temp
|
$70.29 |
$70.29 |
$70.29 |
$81.12
|
|
Apheresis immunoads slctv
|
$5,544.24 |
$5,544.24 |
$5,544.24 |
$5,794.21
|
|
Apheresis plasma
|
$1,939.86 |
$1,939.86 |
$1,939.86 |
$3,226.34
|
|
Apheresis platelets
|
$517.34 |
$517.34 |
$517.34 |
$2,195.00
|
|
Apheresis rbc
|
$1,939.86 |
$1,939.86 |
$1,939.86 |
$3,290.80
|
|
Apheresis wbc
|
$1,939.86 |
$1,939.86 |
$1,939.86 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$207.31 |
$207.31 |
$207.31 |
$513.00
|
|
Appendectomy
|
$7,383.87 |
$7,383.87 |
$7,383.87 |
$5,681.93
|
|
Appendix Removal (Laparoscopic)
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$7,202.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,114.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,332.25 |
$4,332.25 |
$4,332.25 |
$3,593.46
|
|
Appl bdy cst sho to hip 1thi
|
$186.72 |
$186.72 |
$186.72 |
$353.60
|
|
Appl bdy cst sho to hip b th
|
$314.28 |
$314.28 |
$314.28 |
$561.60
|
|
Appl bdy cst sho to hip head
|
$314.28 |
$314.28 |
$314.28 |
$561.60
|
|
Appl body cast sho to hips
|
$314.28 |
$314.28 |
$314.28 |
$509.60
|
|
Appl cast figure-of-eight
|
$314.28 |
$314.28 |
$314.28 |
$314.28
|
|
Appl cast plaster velpeau
|
$314.28 |
$314.28 |
$314.28 |
$314.28
|
|
Appl cast shoulder spica
|
$314.28 |
$314.28 |
$314.28 |
$486.03
|
|
Appl halo cranial 6+pins
|
$1,642.82 |
$1,642.82 |
$1,642.82 |
$2,211.05
|
|
Appl halo type body cast
|
$314.28 |
$314.28 |
$314.28 |
$561.60
|
|
Appl hip spica cast1&1/2
|
$314.28 |
$314.28 |
$314.28 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$314.28 |
$314.28 |
$314.28 |
$499.20
|
|
Application clubfoot cast
|
$186.72 |
$186.72 |
$186.72 |
$303.00
|
|
Application finger splntstatic 29130
|
$152.54 |
$152.54 |
$152.54 |
$208.50
|
|
Application halo femoral
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,499.12
|
|
Application halo pelvic
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,211.05
|
|
Application long leg splint 29505
|
$186.72 |
$186.72 |
$186.72 |
$338.25
|
|
Application lower leg splint 29515
|
$186.72 |
$186.72 |
$186.72 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$186.72 |
$186.72 |
$186.72 |
$375.06
|
|
Application of body cast
|
$314.28 |
$314.28 |
$314.28 |
$561.60
|
|
Application of body cast
|
$314.28 |
$314.28 |
$314.28 |
$561.60
|
|
Application of cylinder cast 29365
|
$314.28 |
$314.28 |
$314.28 |
$431.08
|
|
Application of forearm cast 29075
|
$314.28 |
$314.28 |
$314.28 |
$358.20
|
|
Application of long arm cast 29065
|
$314.28 |
$314.28 |
$314.28 |
$396.77
|
|
Application of long leg cast
|
$314.28 |
$314.28 |
$314.28 |
$435.54
|
|
Application of long leg cast 29345
|
$314.28 |
$314.28 |
$314.28 |
$455.00
|
|
Application of paste boot 29580
|
$186.72 |
$186.72 |
$186.72 |
$340.11
|
|
Application short leg cast 29405
|
$314.28 |
$314.28 |
$314.28 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,164.64
|
|
Appl long leg cast brace
|
$314.28 |
$314.28 |
$314.28 |
$468.00
|
|
Appl mltpln uni ext fixj sys
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$5,855.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$7.18 |
$7.18 |
$7.18 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$13.59 |
$13.59 |
$13.59 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$46.45 |
$46.45 |
$46.45 |
$54.61
|
|
Appl multlay comprs arm/hand
|
$186.72 |
$186.72 |
$186.72 |
$289.60
|
|
Appl patllr tdn bearing cast
|
$314.28 |
$314.28 |
$314.28 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,810.00
|
|
Apply finger cast 29086
|
$186.72 |
$186.72 |
$186.72 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$152.54 |
$152.54 |
$152.54 |
$255.20
|
|
Apply halo w/removal cranial
|
$1,642.82 |
$1,642.82 |
$1,642.82 |
$1,367.60
|
|
Apply hand/wrist cast 29085
|
$186.72 |
$186.72 |
$186.72 |
$271.80
|
|
Apply interstit radiat compl
|
$821.03 |
$821.03 |
$821.03 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$821.03 |
$821.03 |
$821.03 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$684.54 |
$684.54 |
$684.54 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$684.54 |
$684.54 |
$684.54 |
$1,269.97
|
|
Apply of finger splint 29131
|
$70.29 |
$70.29 |
$70.29 |
$177.45
|
|
Apply rem fixation device
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$314.28 |
$314.28 |
$314.28 |
$555.00
|
|
Apply short leg castambul type 29425
|
$314.28 |
$314.28 |
$314.28 |
$404.74
|
|
Apply surf ldr radionuclide
|
$129.58 |
$129.58 |
$129.58 |
$282.80
|
|
App mdlty 1+hubbrd tnk ea 15
|
$40.04 |
$40.04 |
$40.04 |
$141.39
|
|
App mltpln uni xtrnl fix 1st
|
$27,721.73 |
$27,721.73 |
$27,721.73 |
$16,139.55
|
|
App mltpln uni xtrnl fix xch
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$3,526.50
|
|
App skn cll ssp f/n/g/hf 1st
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$3,567.20
|
|
App skn cl ssp agrft t/a/l 1
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$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
|
$42.02 |
$42.02 |
$42.02 |
$100.75
|
|
Aquatic exercise - group charge
|
$20.26 |
$20.26 |
$20.26 |
$87.45
|
|
Aqueous shunt eye w/graft
|
$6,105.79 |
$6,105.79 |
$6,105.79 |
$6,105.79
|
|
Aqueous shunt eye without graft
|
$6,105.79 |
$6,105.79 |
$6,105.79 |
$6,105.79
|
|
Architect ecm px fx 1 sq cm
|
$127.14 |
$127.14 |
$127.14 |
$171.12
|
|
Argatroban nonesrd (accord)
|
$4.20 |
$4.20 |
$4.20 |
$218.25
|
|
Argatroban nonesrd (auromed)
|
$1.49 |
$1.49 |
$1.49 |
$40.30
|
|
Argatroban nonesrd use 1mg
|
$1.26 |
$1.26 |
$1.26 |
$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
|
$3.23 |
$3.23 |
$3.23 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$422.61 |
$422.61 |
$422.61 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$125.84 |
$125.84 |
$125.84 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$125.84 |
$125.84 |
$125.84 |
$426.00
|