|
Appl unipln uni ext fixj sys
|
$1,346.22 |
$1,346.22 |
$1,346.22 |
$5,754.10
|
|
Apply forearm splintdynamic 29126
|
$104.76 |
$104.76 |
$104.76 |
$244.00
|
|
Apply hand/wrist cast 29085
|
$209.52 |
$209.52 |
$209.52 |
$258.00
|
|
Apply short leg castambul type 29425
|
$163.62 |
$163.62 |
$163.62 |
$381.00
|
|
App topical fluoride varnish
|
$9.18 |
$9.18 |
$9.18 |
$27.20
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$795.33 |
$795.33 |
$795.33 |
$1,073.43
|
|
Arterial blood draw/perc 36620
|
$124.74 |
$124.74 |
$124.74 |
$462.39
|
|
Artery x-rays arm/leg 75710-26
|
$297.54 |
$297.54 |
$297.54 |
$3,439.84
|
|
Arthrd wrst iliac/oth agrft
|
$1,999.62 |
$1,999.62 |
$1,999.62 |
$6,411.60
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$180.36 |
$180.36 |
$180.36 |
$588.53
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$184.68 |
$184.68 |
$184.68 |
$882.70
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$169.56 |
$169.56 |
$169.56 |
$459.50
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$204.12 |
$204.12 |
$204.12 |
$715.00
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$1,549.53 |
$1,549.53 |
$1,549.53 |
$4,240.08
|
|
Arthrotomy/elbow/exp/drain/rmv fb 24000
|
$1,091.61 |
$1,091.61 |
$1,091.61 |
$3,839.54
|
|
Arthrotomy hip w/drainage
|
$1,959.66 |
$1,959.66 |
$1,959.66 |
$3,549.00
|
|
Arthrp ntrcrp/crp/mtcr ntrps
|
$1,903.23 |
$1,903.23 |
$1,903.23 |
$4,499.12
|
|
Arthrt ac sc jt exp/rmvl fb
|
$1,183.14 |
$1,183.14 |
$1,183.14 |
$3,594.44
|
|
Arthrt gh jt expl/drg/rmv fb
|
$1,514.70 |
$1,514.70 |
$1,514.70 |
$3,839.54
|
|
Arthrt rdcrpl/midcarpl jt
|
$1,189.62 |
$1,189.62 |
$1,189.62 |
$3,821.05
|
|
Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah)
|
$1,531.98 |
$1,531.98 |
$1,531.98 |
$4,035.20
|
|
Aspirate bladder/sprapubic cath 51102
|
$307.80 |
$307.80 |
$307.80 |
$3,162.90
|
|
Aspirate/inj ganglion cyst 20612
|
$137.16 |
$137.16 |
$137.16 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$449.82 |
$449.82 |
$449.82 |
$1,132.59
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$231.12 |
$231.12 |
$231.12 |
$1,219.50
|
|
Aspir/inj thyroid cyst 60300
|
$216.54 |
$216.54 |
$216.54 |
$844.00
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$41.04 |
$41.04 |
$41.04 |
$23,233.77
|
|
Atropine 0.1 mg/ml injection syringe
|
$26.34 |
$26.34 |
$26.34 |
$52.65
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$104.76 |
$104.76 |
$104.76 |
$186.60
|
|
Audiometry air + bone
|
$80.46 |
$80.46 |
$80.46 |
$181.65
|
|
Auditory function 60 min
|
$165.24 |
$165.24 |
$165.24 |
$210.40
|
|
Autgrft implnt knee w/scope
|
$2,211.84 |
$2,211.84 |
$2,211.84 |
$5,855.00
|
|
Autolog prp diab wound ulcer
|
$1,433.70 |
$1,433.70 |
$1,433.70 |
$2,164.64
|
|
Avul nail plate addl
|
$72.09 |
$72.09 |
$72.09 |
$180.00
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$240.84 |
$240.84 |
$240.84 |
$318.75
|
|
Azacitidine injection
|
$83.11 |
$83.11 |
$83.11 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$1.71 |
$1.71 |
$1.71 |
$3.59
|
|
Azithromycin 500 mg intravenous solution
|
$22.11 |
$22.11 |
$22.11 |
$36.48
|
|
Bartholin gland cyst/marsupializat 56440
|
$379.08 |
$379.08 |
$379.08 |
$3,982.44
|
|
Basic vestibular evaluation
|
$202.50 |
$202.50 |
$202.50 |
$325.00
|
|
Belatacept 250 mg intravenous solution
|
$1,458.00 |
$1,458.00 |
$1,458.00 |
$2,036.75
|
|
Belimumab 120 mg intravenous solution
|
$49.14 |
$49.14 |
$49.14 |
$4,243.90
|
|
Bendamustine 25 mg/ml intravenous solution (belrapzo)
|
$30.24 |
$30.24 |
$30.24 |
$4,107.38
|
|
Benign lesion paring 2-4
|
$171.72 |
$171.72 |
$171.72 |
$252.00
|
|
Benign lesion paring 4+
|
$187.38 |
$187.38 |
$187.38 |
$284.76
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$64.26 |
$64.26 |
$64.26 |
$65.00
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$90.18 |
$90.18 |
$90.18 |
$5,767.97
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$3,617.00 |
$3,617.00 |
$3,617.00 |
$3,194.09
|
|
Bevacizumab-bvzr 25 mg/ml intravenous solution
|
$3,179.87 |
$3,179.87 |
$3,179.87 |
$1,630.99
|
|
Bilateral n block inj occipital 64405
|
$120.15 |
$120.15 |
$120.15 |
$762.76
|
|
Bilateral n block inj trigeminal 64400
|
$233.82 |
$233.82 |
$233.82 |
$521.00
|
|
Bile duct endoscopy add-on 47550
|
$349.11 |
$349.11 |
$349.11 |
$996.45
|
|
Biopsy abdominal mass
|
$245.43 |
$245.43 |
$245.43 |
$1,724.47
|
|
Biopsy, bone open deep
|
$707.40 |
$707.40 |
$707.40 |
$3,642.33
|
|
Biopsy bone trocar/needle superficial
|
$273.24 |
$273.24 |
$273.24 |
$1,770.73
|
|
Biopsy cervixsingle/multiple 57500
|
$315.36 |
$315.36 |
$315.36 |
$1,266.48
|
|
Biopsy external ear 69100
|
$198.72 |
$198.72 |
$198.72 |
$349.40
|
|
Biopsy eyelid & lid margin
|
$390.96 |
$390.96 |
$390.96 |
$771.52
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$157.41 |
$157.41 |
$157.41 |
$2,747.00
|
|
Biopsy lower leg soft tissue
|
$574.56 |
$574.56 |
$574.56 |
$1,905.43
|
|
Biopsy lower leg soft tissue 27610
|
$1,362.96 |
$1,362.96 |
$1,362.96 |
$3,821.05
|
|
Biopsy muscle percutaneous needle
|
$179.28 |
$179.28 |
$179.28 |
$1,629.75
|
|
Biopsy needle liver percutaneous
|
$274.32 |
$274.32 |
$274.32 |
$1,897.20
|
|
Biopsy needle lymph node superficial
|
$361.26 |
$361.26 |
$361.26 |
$1,854.76
|
|
Biopsy of lip 40490
|
$256.50 |
$256.50 |
$256.50 |
$327.00
|
|
Biopsy of nail unit 11755
|
$255.96 |
$255.96 |
$255.96 |
$841.23
|
|
Biopsy of penis 54100
|
$255.96 |
$255.96 |
$255.96 |
$1,917.33
|
|
Biopsy of salivary gland 42400
|
$111.24 |
$111.24 |
$111.24 |
$1,145.90
|
|
Biopsy of salivary glnd;incisional 42405
|
$639.36 |
$639.36 |
$639.36 |
$2,301.60
|
|
Biopsy of upper nose/throat
|
$450.90 |
$450.90 |
$450.90 |
$3,589.62
|
|
Biopsy of urethra
|
$334.26 |
$334.26 |
$334.26 |
$2,889.10
|
|
Biopsy/removal lymph nodes
|
$1,823.58 |
$1,823.58 |
$1,823.58 |
$4,196.54
|
|
Biopsy renal percutaneous trocar/needle (both sides)
|
$372.60 |
$372.60 |
$372.60 |
$2,086.50
|
|
Biopsy roof of mouth
|
$306.18 |
$306.18 |
$306.18 |
$1,752.89
|
|
Biopsy skin incisional single lesion
|
$321.84 |
$321.84 |
$321.84 |
$674.00
|
|
Biopsy/soft tissue/neck or thorax 21550
|
$487.62 |
$487.62 |
$487.62 |
$2,363.40
|
|
Biopsy tongue anterior two-thirds
|
$391.50 |
$391.50 |
$391.50 |
$1,148.15
|
|
Biopsy vaginal mucosa xtnsv
|
$306.72 |
$306.72 |
$306.72 |
$3,474.84
|
|
Biopsy vestibule of mouth 40808
|
$354.24 |
$354.24 |
$354.24 |
$622.00
|
|
Bladder irrigate/lavage/instill 51700
|
$159.30 |
$159.30 |
$159.30 |
$400.00
|
|
Block brachial plexus w/cath plmt w/img
|
$204.12 |
$204.12 |
$204.12 |
$1,463.50
|
|
Block femoral nerve cont infusion cath w/img
|
$214.38 |
$214.38 |
$214.38 |
$1,647.60
|
|
Block paracervical nrv
|
$274.59 |
$274.59 |
$274.59 |
$948.00
|
|
Block plantar digital nerve
|
$104.76 |
$104.76 |
$104.76 |
$501.85
|
|
Block tap inj(s) w/wo img bi
|
$362.88 |
$362.88 |
$362.88 |
$1,340.40
|
|
Block tap inj(s) w/wo img uni
|
$139.59 |
$139.59 |
$139.59 |
$847.60
|
|
Blood smear interpretation
|
$83.70 |
$83.70 |
$83.70 |
$71.76
|
|
Bone acellular derm matrix 2x4cm 0.4-1.0mm allomend-cost per sq cm-8sq cm
|
$7,123.68 |
$7,123.68 |
$7,123.68 |
$19,830.72
|
|
Bone biopsy open superficial
|
$292.14 |
$292.14 |
$292.14 |
$3,900.26
|
|
Bone Density Scan (DEXA)
|
$35.10 |
$35.10 |
$35.10 |
$395.00
|
|
Bone/joint imaging ltd area
|
$109.62 |
$109.62 |
$109.62 |
$979.55
|
|
Bone marrow;aspiration only 38220
|
$183.06 |
$183.06 |
$183.06 |
$1,587.30
|
|
Bone marrow biopsyneedle/trocar 38221
|
$253.80 |
$253.80 |
$253.80 |
$1,664.84
|
|
Bone marrow interpretation
|
$79.65 |
$79.65 |
$79.65 |
$521.60
|
|
Bone survey-lead poisoning
|
$235.98 |
$235.98 |
$235.98 |
$370.22
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$85.32 |
$85.32 |
$85.32 |
$2,915.40
|
|
Bowel imaging
|
$118.80 |
$118.80 |
$118.80 |
$1,065.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$261.36 |
$261.36 |
$261.36 |
$2,785.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$211.68 |
$211.68 |
$211.68 |
$2,121.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$212.76 |
$212.76 |
$212.76 |
$1,884.20
|