|
Ankle X-ray (2 views, both ankles)
|
$395.20 |
$395.20 |
$395.20 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,344.85 |
$1,344.85 |
$1,344.85 |
$630.96
|
|
Annual alcohol screen 15 min
|
$133.90 |
$133.90 |
$133.90 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$203.45 |
$203.45 |
$203.45 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$149.50 |
$149.50 |
$149.50 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$119.60 |
$119.60 |
$119.60 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$165.10 |
$165.10 |
$165.10 |
$167.25
|
|
Anora (draw only)
|
$38.35 |
$38.35 |
$38.35 |
$35.00
|
|
Anoscopy and dilation 46604
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$1,645.43
|
|
Antibody bacterium, not elsewhere specified
|
$57.85 |
$57.85 |
$57.85 |
$57.85
|
|
Antibody elution rbc reference
|
$768.30 |
$768.30 |
$768.30 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$87.10 |
$87.10 |
$87.10 |
$131.56
|
|
Antibody htlv-i
|
$40.95 |
$40.95 |
$40.95 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$82.55 |
$82.55 |
$82.55 |
$224.00
|
|
Antibody id rbc panel
|
$1,613.30 |
$1,613.30 |
$1,613.30 |
$291.75
|
|
Antibody lymphocytic choriomeningitis
|
$57.85 |
$57.85 |
$57.85 |
$46.58
|
|
Antibody screen rbc
|
$43.55 |
$43.55 |
$43.55 |
$108.55
|
|
Antidepressant not specified
|
$23.40 |
$23.40 |
$23.40 |
$72.14
|
|
Antidepressants class 6/more
|
$23.40 |
$23.40 |
$23.40 |
$25.35
|
|
Antiepileptics nos 7/more
|
$20.80 |
$20.80 |
$20.80 |
$16.24
|
|
Antigen therapy services
|
$89.70 |
$89.70 |
$89.70 |
$73.84
|
|
Antigen therapy services
|
$89.70 |
$89.70 |
$89.70 |
$83.72
|
|
Antigen therapy services
|
$139.10 |
$139.10 |
$139.10 |
$101.40
|
|
Antigen therapy services
|
$139.10 |
$139.10 |
$139.10 |
$96.72
|
|
Antigen therapy services
|
$139.10 |
$139.10 |
$139.10 |
$130.00
|
|
Antigen therapy services
|
$80.60 |
$80.60 |
$80.60 |
$74.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$4.00 |
$4.00 |
$4.00 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$3.32 |
$3.32 |
$3.32 |
$3.67
|
|
Anti-inhibitor
|
$6.32 |
$6.32 |
$6.32 |
$8.33
|
|
Anti mog serum - sendout
|
$53.95 |
$53.95 |
$53.95 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$53.95 |
$53.95 |
$53.95 |
$38.50
|
|
Antinuclear antibodies
|
$53.95 |
$53.95 |
$53.95 |
$90.00
|
|
Antinuclear antibodies titer
|
$50.05 |
$50.05 |
$50.05 |
$80.04
|
|
Antipsychotics nos 7/more
|
$23.40 |
$23.40 |
$23.40 |
$16.24
|
|
Antistreptolysin o titer
|
$32.50 |
$32.50 |
$32.50 |
$54.00
|
|
Antithrombin iii activity
|
$53.30 |
$53.30 |
$53.30 |
$115.15
|
|
Antithrombin iii injection
|
$10.74 |
$10.74 |
$10.74 |
$11.85
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$2,487.13 |
$2,487.13 |
$2,487.13 |
$8,214.07
|
|
Antithymocyte globuln rabbit
|
$2,685.05 |
$2,685.05 |
$2,685.05 |
$2,111.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$477.10 |
$477.10 |
$477.10 |
$394.55
|
|
Apheresis plasma
|
$6,126.90 |
$6,126.90 |
$6,126.90 |
$3,226.34
|
|
Apl(pml-rara) quant - sendout
|
$929.50 |
$929.50 |
$929.50 |
$513.00
|
|
Appendix Removal (Laparoscopic)
|
$17,444.70 |
$17,444.70 |
$17,444.70 |
$7,202.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$7,138.95 |
$7,138.95 |
$7,138.95 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$7,138.95 |
$7,138.95 |
$7,138.95 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$512.20
|
|
Application clubfoot cast
|
$471.90 |
$471.90 |
$471.90 |
$303.00
|
|
Application finger splntstatic 29130
|
$385.45 |
$385.45 |
$385.45 |
$208.50
|
|
Application long leg splint 29505
|
$471.90 |
$471.90 |
$471.90 |
$338.25
|
|
Application lower leg splint 29515
|
$471.90 |
$471.90 |
$471.90 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$471.90 |
$471.90 |
$471.90 |
$375.06
|
|
Application of cylinder cast 29365
|
$794.30 |
$794.30 |
$794.30 |
$431.08
|
|
Application of forearm cast 29075
|
$794.30 |
$794.30 |
$794.30 |
$358.20
|
|
Application of long arm cast 29065
|
$794.30 |
$794.30 |
$794.30 |
$396.77
|
|
Application of long leg cast 29345
|
$794.30 |
$794.30 |
$794.30 |
$455.00
|
|
Application of paste boot 29580
|
$471.90 |
$471.90 |
$471.90 |
$340.11
|
|
Application short leg cast 29405
|
$794.30 |
$794.30 |
$794.30 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$107.90 |
$107.90 |
$107.90 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$131.95 |
$131.95 |
$131.95 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$471.90 |
$471.90 |
$471.90 |
$289.60
|
|
Apply forearm splintdynamic 29126
|
$385.45 |
$385.45 |
$385.45 |
$255.20
|
|
Apply interstit radiat compl
|
$3,111.55 |
$3,111.55 |
$3,111.55 |
$2,901.80
|
|
Apply of finger splint 29131
|
$177.45 |
$177.45 |
$177.45 |
$177.45
|
|
Apply rigid leg cast 29445
|
$794.30 |
$794.30 |
$794.30 |
$555.00
|
|
Apply short leg castambul type 29425
|
$794.30 |
$794.30 |
$794.30 |
$404.74
|
|
App mdlty 1+hubbrd tnk ea 15
|
$150.80 |
$150.80 |
$150.80 |
$141.39
|
|
App mltpln uni xtrnl fix xch
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$3,526.50
|
|
App skn cll ssp f/n/g/hf 1st
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$3,567.20
|
|
App skn cl ssp agrft t/a/l 1
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$3,567.20
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$60.27 |
$60.27 |
$60.27 |
$955.43
|
|
#aptt mix-1:1 incubated
|
$157.30 |
$157.30 |
$157.30 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$169.00 |
$169.00 |
$169.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$53.95 |
$53.95 |
$53.95 |
$138.16
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$211.90 |
$211.90 |
$211.90 |
$100.75
|
|
Aquatic exercise - group charge
|
$152.10 |
$152.10 |
$152.10 |
$87.45
|
|
Argatroban nonesrd use 1mg
|
$1,106.49 |
$1,106.49 |
$1,106.49 |
$881.10
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$2,328.61 |
$2,328.61 |
$2,328.61 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$477.10 |
$477.10 |
$477.10 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$477.10 |
$477.10 |
$477.10 |
$426.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$117.62 |
$117.62 |
$117.62 |
$1,303.25
|
|
Art bypass carotid-subclavian 35606
|
$18,484.05 |
$18,484.05 |
$18,484.05 |
$5,724.80
|
|
Art bypass femoral-femoral 35661
|
$13,756.60 |
$13,756.60 |
$13,756.60 |
$5,291.20
|
|
Art bypass subclav-subclavian 35612
|
$3,066.70 |
$3,066.70 |
$3,066.70 |
$2,272.80
|
|
Art byp grft fem-popliteal 35556
|
$1,073.80 |
$1,073.80 |
$1,073.80 |
$2,806.20
|
|
Arterial blood draw/perc 36620
|
$967.85 |
$967.85 |
$967.85 |
$478.96
|
|
Artery xray each vessel 7577426
|
$2,718.30 |
$2,718.30 |
$2,718.30 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$24,244.35 |
$24,244.35 |
$24,244.35 |
$4,618.71
|
|
Artery x-rays adrenal gland
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,320.35
|
|
Artery x-rays arm/leg 75710-26
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,860.40
|
|
Artery x-rays chest
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$2,895.07
|
|
Artery x-rays lung
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,296.15
|
|
Artery x-rays lung
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$2,427.50
|
|
Artery x-rays lungs
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,660.60
|
