|
Angio trnslmnl balloon same vein ea addl
|
$4,339.13 |
$4,339.13 |
$4,339.13 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$8,766.15 |
$8,766.15 |
$8,766.15 |
$8,359.11
|
|
Anidulafungin injection
|
$106.53 |
$106.53 |
$106.53 |
$312.30
|
|
Ankle X-ray
|
$274.50 |
$274.50 |
$274.50 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$219.60 |
$219.60 |
$219.60 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,328.93 |
$1,328.93 |
$1,328.93 |
$630.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$114.75 |
$114.75 |
$114.75 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$160.73 |
$160.73 |
$160.73 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$143.25 |
$143.25 |
$143.25 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$188.15 |
$188.15 |
$188.15 |
$167.25
|
|
Anodyne therapy charges pt
|
$64.18 |
$64.18 |
$64.18 |
$42.00
|
|
Anora (draw only)
|
$40.88 |
$40.88 |
$40.88 |
$35.00
|
|
Anoscopy and biopsy
|
$376.60 |
$376.60 |
$376.60 |
$2,288.00
|
|
Anoscopy remove fb 46608
|
$408.55 |
$408.55 |
$408.55 |
$1,375.98
|
|
Antibody bacterium, not elsewhere specified
|
$61.45 |
$61.45 |
$61.45 |
$57.85
|
|
Antibody elution rbc reference
|
$109.25 |
$109.25 |
$109.25 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$154.85 |
$154.85 |
$154.85 |
$131.56
|
|
Antibody htlv-i
|
$142.98 |
$142.98 |
$142.98 |
$49.53
|
|
Antibody htlv-ii
|
$46.15 |
$46.15 |
$46.15 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$174.60 |
$174.60 |
$174.60 |
$224.00
|
|
Antibody id rbc panel
|
$179.58 |
$179.58 |
$179.58 |
$291.75
|
|
Antibody influenza virus
|
$63.33 |
$63.33 |
$63.33 |
$54.00
|
|
Antibody screen rbc
|
$112.80 |
$112.80 |
$112.80 |
$108.55
|
|
Antibody tetanus
|
$61.98 |
$61.98 |
$61.98 |
$54.15
|
|
Antidepressant not specified
|
$89.50 |
$89.50 |
$89.50 |
$72.14
|
|
Antidepressants class 6/more
|
$29.68 |
$29.68 |
$29.68 |
$25.35
|
|
Antiepileptics nos 7/more
|
$19.73 |
$19.73 |
$19.73 |
$16.24
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$22.50 |
$22.50 |
$22.50 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$22.50 |
$22.50 |
$22.50 |
$3.67
|
|
Anti-inhibitor
|
$22.50 |
$22.50 |
$22.50 |
$8.33
|
|
Anti mog serum - sendout
|
$32.78 |
$32.78 |
$32.78 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$116.60 |
$116.60 |
$116.60 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$116.60 |
$116.60 |
$116.60 |
$42.00
|
|
Antinuclear antibodies
|
$198.60 |
$198.60 |
$198.60 |
$90.00
|
|
Antinuclear antibodies titer
|
$30.38 |
$30.38 |
$30.38 |
$80.04
|
|
Antipsychotics nos 1-3
|
$153.75 |
$153.75 |
$153.75 |
$136.61
|
|
Antipsychotics nos 7/more
|
$13.50 |
$13.50 |
$13.50 |
$16.24
|
|
Antistreptolysin o titer
|
$44.40 |
$44.40 |
$44.40 |
$54.00
|
|
Antithrombin iii activity
|
$306.48 |
$306.48 |
$306.48 |
$115.15
|
|
Antithrombin iii injection
|
$22.68 |
$22.68 |
$22.68 |
$11.85
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$7,704.70 |
$7,704.70 |
$7,704.70 |
$8,214.07
|
|
Antithymocyte globuln rabbit
|
$2,251.45 |
$2,251.45 |
$2,251.45 |
$2,111.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$428.73 |
$428.73 |
$428.73 |
$394.55
|
|
Apheresis plasma
|
$3,613.00 |
$3,613.00 |
$3,613.00 |
$3,226.34
|
|
Apheresis rbc
|
$3,666.50 |
$3,666.50 |
$3,666.50 |
$3,290.80
|
|
Apheresis wbc
|
$3,723.00 |
$3,723.00 |
$3,723.00 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$1,054.55 |
$1,054.55 |
$1,054.55 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,733.00 |
$1,733.00 |
$1,733.00 |
$2,114.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$549.08 |
$549.08 |
$549.08 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$741.18 |
$741.18 |
$741.18 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$741.18 |
$741.18 |
$741.18 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$549.08 |
$549.08 |
$549.08 |
$512.20
|
|
Appl hip spica cast1&1/2
|
$501.28 |
$501.28 |
$501.28 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$688.90 |
$688.90 |
$688.90 |
$499.20
|
|
Application clubfoot cast
|
$468.00 |
$468.00 |
$468.00 |
$303.00
|
|
Application finger splntstatic 29130
|
$191.88 |
$191.88 |
$191.88 |
$208.50
|
|
Application long leg splint 29505
|
$261.83 |
$261.83 |
$261.83 |
$338.25
|
|
Application lower leg splint 29515
|
$228.33 |
$228.33 |
$228.33 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$268.90 |
$268.90 |
$268.90 |
$375.06
|
|
Application of body cast
|
$557.18 |
$557.18 |
$557.18 |
$561.60
|
|
Application of forearm cast 29075
|
$425.55 |
$425.55 |
$425.55 |
$358.20
|
|
Application of long arm cast 29065
|
$404.63 |
$404.63 |
$404.63 |
$396.77
|
|
Application of long leg cast
|
$444.75 |
$444.75 |
$444.75 |
$435.54
|
|
Application of long leg cast 29345
|
$511.68 |
$511.68 |
$511.68 |
$455.00
|
|
Application of paste boot 29580
|
$168.53 |
$168.53 |
$168.53 |
$340.11
|
|
Application short leg cast 29405
|
$393.98 |
$393.98 |
$393.98 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$549.08 |
$549.08 |
$549.08 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$549.08 |
$549.08 |
$549.08 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$600.00 |
$600.00 |
$600.00 |
$981.75
|
|
Appl long leg cast brace
|
$861.48 |
$861.48 |
$861.48 |
$468.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$83.28 |
$83.28 |
$83.28 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$75.98 |
$75.98 |
$75.98 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$64.18 |
$64.18 |
$64.18 |
$54.61
|
|
Appl multlay comprs arm/hand
|
$164.23 |
$164.23 |
$164.23 |
$289.60
|
|
Apply finger cast 29086
|
$179.90 |
$179.90 |
$179.90 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$187.83 |
$187.83 |
$187.83 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$279.40 |
$279.40 |
$279.40 |
$271.80
|
|
Apply interstit radiat compl
|
$3,837.98 |
$3,837.98 |
$3,837.98 |
$2,901.80
|
|
Apply of finger splint 29131
|
$160.23 |
$160.23 |
$160.23 |
$177.45
|
|
Apply rigid leg cast 29445
|
$770.05 |
$770.05 |
$770.05 |
$555.00
|
|
Apply short leg castambul type 29425
|
$501.40 |
$501.40 |
$501.40 |
$404.74
|
|
App mltpln uni xtrnl fix xch
|
$707.58 |
$707.58 |
$707.58 |
$3,526.50
|
|
#aptt mix-1:1 incubated
|
$225.48 |
$225.48 |
$225.48 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$413.30 |
$413.30 |
$413.30 |
$231.66
|
|
Aqmbf pet rest & rx stress
|
$920.63 |
$920.63 |
$920.63 |
$974.40
|
|
Aquaporin-4 antibody cba each
|
$302.25 |
$302.25 |
$302.25 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$215.98 |
$215.98 |
$215.98 |
$150.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$56.83 |
$56.83 |
$56.83 |
$100.75
|
|
Aquatic exercise - group charge
|
$138.00 |
$138.00 |
$138.00 |
$87.45
|
|
Argatroban nonesrd (accord)
|
$218.25 |
$218.25 |
$218.25 |
$218.25
|
|
Argatroban nonesrd (auromed)
|
$463.25 |
$463.25 |
$463.25 |
$40.30
|
|
Argatroban nonesrd use 1mg
|
$762.90 |
$762.90 |
$762.90 |
$881.10
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$6,387.85 |
$6,387.85 |
$6,387.85 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$1,687.88 |
$1,687.88 |
$1,687.88 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,607.53 |
$1,607.53 |
$1,607.53 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$479.30 |
$479.30 |
$479.30 |
$426.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$2,384.85 |
$2,384.85 |
$2,384.85 |
$1,303.25
|
|
Art bypass femoral-femoral 35661
|
$11,863.93 |
$11,863.93 |
$11,863.93 |
$5,291.20
|
|
Art bypass femoral-popliteal 35656
|
$5,921.35 |
$5,921.35 |
$5,921.35 |
$5,273.60
|
|
Arterial blood draw/perc 36620
|
$763.13 |
$763.13 |
$763.13 |
$478.96
|
