|
Antibody tetanus
|
$78.00 |
$78.00 |
$78.00 |
$54.15
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$73.84
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$83.72
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$101.40
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$96.72
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$130.00
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$74.00
|
|
Antigen therapy services
|
$1.98 |
$1.98 |
$1.98 |
$64.39
|
|
Anti mog serum - sendout
|
$63.18 |
$63.18 |
$63.18 |
$131.95
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$63.18 |
$63.18 |
$63.18 |
$39.00
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$63.18 |
$63.18 |
$63.18 |
$42.00
|
|
Ant instr 2-3 vert segm 22845
|
$446.82 |
$446.82 |
$446.82 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$465.52 |
$465.52 |
$465.52 |
$1,430.40
|
|
Antinuclear antibodies
|
$63.96 |
$63.96 |
$63.96 |
$90.00
|
|
Antinuclear antibodies titer
|
$58.50 |
$58.50 |
$58.50 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$85.02 |
$85.02 |
$85.02 |
$67.60
|
|
Antistreptolysin o screen
|
$3.96 |
$3.96 |
$3.96 |
$57.28
|
|
Antistreptolysin o titer
|
$39.00 |
$39.00 |
$39.00 |
$53.60
|
|
Antithrombin iii activity
|
$62.40 |
$62.40 |
$62.40 |
$114.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$538.12 |
$538.12 |
$538.12 |
$4,155.20
|
|
Ant sgm img ir flrscn angrph
|
$21.34 |
$21.34 |
$21.34 |
$286.00
|
|
Ant sgm img i&r speclr mic
|
$12.98 |
$12.98 |
$12.98 |
$286.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$467.22 |
$467.22 |
$467.22 |
$395.20
|
|
Aortic circulation assist 33971
|
$430.54 |
$430.54 |
$430.54 |
$1,719.20
|
|
Aortic hemiarch graft 33866
|
$556.82 |
$556.82 |
$556.82 |
$2,260.80
|
|
Aortic suspension
|
$601.70 |
$601.70 |
$601.70 |
$1,414.87
|
|
Apheresis immunoads slctv
|
$53.90 |
$53.90 |
$53.90 |
$5,794.21
|
|
Apheresis plasma
|
$57.20 |
$57.20 |
$57.20 |
$3,226.34
|
|
Apheresis platelets
|
$66.22 |
$66.22 |
$66.22 |
$2,195.00
|
|
Apheresis rbc
|
$64.68 |
$64.68 |
$64.68 |
$3,290.80
|
|
Apheresis wbc
|
$68.20 |
$68.20 |
$68.20 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$136.84 |
$136.84 |
$136.84 |
$513.00
|
|
Appendectomy
|
$397.98 |
$397.98 |
$397.98 |
$5,419.00
|
|
Appendectomy add-on 44955
|
$51.26 |
$51.26 |
$51.26 |
$187.32
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$543.18 |
$543.18 |
$543.18 |
$1,557.59
|
|
Appendico-vesicostomy
|
$773.96 |
$773.96 |
$773.96 |
$1,632.03
|
|
Appendix Removal (Laparoscopic)
|
$374.22 |
$374.22 |
$374.22 |
$6,904.15
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$137.28 |
$137.28 |
$137.28 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$34.32 |
$34.32 |
$34.32 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$3,210.48 |
$3,210.48 |
$3,210.48 |
$505.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$8,566.74 |
$8,566.74 |
$8,566.74 |
$3,619.35
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$6,424.86 |
$6,424.86 |
$6,424.86 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$3,210.48 |
$3,210.48 |
$3,210.48 |
$514.00
|
|
Appl bdy cst sho to hip 1thi
|
$104.50 |
$104.50 |
$104.50 |
$353.60
|
|
Appl bdy cst sho to hip b th
|
$117.04 |
$117.04 |
$117.04 |
$561.60
|
|
Appl bdy cst sho to hip head
|
$108.46 |
$108.46 |
$108.46 |
$561.60
|
|
Appl body cast sho to hips
|
$89.76 |
$89.76 |
$89.76 |
$480.00
|
|
Appl cast figure-of-eight
|
$43.56 |
$43.56 |
$43.56 |
$314.28
|
|
Appl cast plaster velpeau
|
$58.52 |
$58.52 |
$58.52 |
$314.28
|
|
Appl cast shoulder spica
|
$86.02 |
$86.02 |
$86.02 |
$480.00
|
|
Appl halo cranial 6+pins
|
$556.16 |
$556.16 |
$556.16 |
$1,642.82
|
|
Appl halo type body cast
|
$123.64 |
$123.64 |
$123.64 |
$561.60
|
|
Appl hip spica cast1&1/2
|
$621.66 |
$621.66 |
$621.66 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$98.78 |
$98.78 |
$98.78 |
$499.20
|
|
Application clubfoot cast
|
$69.30 |
$69.30 |
$69.30 |
$302.40
|
|
Application finger splntstatic 29130
|
$301.86 |
$301.86 |
$301.86 |
$208.50
|
|
Application halo femoral
|
$300.96 |
$300.96 |
$300.96 |
$4,499.12
|
|
Application halo pelvic
|
$326.70 |
$326.70 |
$326.70 |
$1,893.86
|
|
Application long leg splint 29505
|
$368.94 |
$368.94 |
$368.94 |
$340.56
|
|
Application lower leg splint 29515
|
$368.94 |
$368.94 |
$368.94 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$368.94 |
$368.94 |
$368.94 |
$375.06
|
|
Application of body cast
|
$100.10 |
$100.10 |
$100.10 |
$557.18
|
|
Application of body cast
|
$112.42 |
$112.42 |
$112.42 |
$561.60
|
|
Application of cylinder cast 29365
|
$54.12 |
$54.12 |
$54.12 |
$420.00
|
|
Application of forearm cast 29075
|
$621.66 |
$621.66 |
$621.66 |
$365.30
|
|
Application of long arm cast 29065
|
$621.66 |
$621.66 |
$621.66 |
$399.00
|
|
Application of long leg cast
|
$65.56 |
$65.56 |
$65.56 |
$426.00
|
|
Application of long leg cast 29345
|
$621.66 |
$621.66 |
$621.66 |
$455.00
|
|
Application of paste boot 29580
|
$368.94 |
$368.94 |
$368.94 |
$340.11
|
|
Application short leg cast 29405
|
$621.66 |
$621.66 |
$621.66 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$4,280.64 |
$4,280.64 |
$4,280.64 |
$2,140.13
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$4,280.64 |
$4,280.64 |
$4,280.64 |
$2,164.64
|
|
Appl long leg cast brace
|
$64.02 |
$64.02 |
$64.02 |
$468.00
|
|
Appl mltpln uni ext fixj sys
|
$702.90 |
$702.90 |
$702.90 |
$5,840.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$27.30 |
$27.30 |
$27.30 |
$68.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$49.92 |
$49.92 |
$49.92 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$114.66 |
$114.66 |
$114.66 |
$57.60
|
|
Appl multlay comprs arm/hand
|
$9.68 |
$9.68 |
$9.68 |
$284.05
|
|
Appl patllr tdn bearing cast
|
$53.68 |
$53.68 |
$53.68 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$371.80 |
$371.80 |
$371.80 |
$5,810.00
|
|
Apply finger cast 29086
|
$30.58 |
$30.58 |
$30.58 |
$238.15
|
|
Apply forearm splintdynamic 29126
|
$301.86 |
$301.86 |
$301.86 |
$258.65
|
|
Apply halo w/removal cranial
|
$321.86 |
$321.86 |
$321.86 |
$1,367.60
|
|
Apply hand/wrist cast 29085
|
$42.02 |
$42.02 |
$42.02 |
$267.20
|
|
Apply interstit radiat compl
|
$287.54 |
$287.54 |
$287.54 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$284.46 |
$284.46 |
$284.46 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$188.76 |
$188.76 |
$188.76 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$126.28 |
$126.28 |
$126.28 |
$1,246.70
|
|
Apply of finger splint 29131
|
$21.56 |
$21.56 |
$21.56 |
$175.20
|
|
Apply rem fixation device
|
$148.94 |
$148.94 |
$148.94 |
$2,207.18
|
|
Apply rigid leg cast 29445
|
$621.66 |
$621.66 |
$621.66 |
$555.00
|
|
Apply r&l pulm art bands
|
$1,001.88 |
$1,001.88 |
$1,001.88 |
$5,532.80
|
|
Apply short leg castambul type 29425
|
$33.66 |
$33.66 |
$33.66 |
$404.74
|
|
Apply srs headframe add-on
|
$92.40 |
$92.40 |
$92.40 |
$299.00
|
|
Apply surf ldr radionuclide
|
$37.40 |
$37.40 |
$37.40 |
$282.80
|
|
App mltpln uni xtrnl fix 1st
|
$720.06 |
$720.06 |
$720.06 |
$16,139.55
|
|
App skn cll ssp f/n/g/hf 1st
|
$78.32 |
$78.32 |
$78.32 |
$3,567.20
|
|
App skn cl ssp agrft t/a/l 1
|
$78.32 |
$78.32 |
$78.32 |
$3,567.20
|
|
App topical fluoride varnish
|
$6.38 |
$6.38 |
$6.38 |
$27.20
|
|
#aptt mix-1:1 incubated
|
$23.32 |
$23.32 |
$23.32 |
$157.30
|