|
Ans parasymp & symp w/tilt
|
$54.74 |
$54.74 |
$54.74 |
$368.50
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$396.52 |
$396.52 |
$396.52 |
$5,813.46
|
|
Antibody
|
$11.04 |
$11.04 |
$11.04 |
$38.40
|
|
Antibody bacterium, not elsewhere specified
|
$84.70 |
$84.70 |
$84.70 |
$57.85
|
|
Antibody elution rbc reference
|
$1,128.05 |
$1,128.05 |
$1,128.05 |
$179.52
|
|
Antibody htlv/hiv confirm test
|
$13.34 |
$13.34 |
$13.34 |
$131.28
|
|
Antibody htlv-i
|
$60.06 |
$60.06 |
$60.06 |
$49.53
|
|
Antibody htlv-ii
|
$92.40 |
$92.40 |
$92.40 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$120.89 |
$120.89 |
$120.89 |
$220.73
|
|
Antibody id rbc panel
|
$2,367.75 |
$2,367.75 |
$2,367.75 |
$291.75
|
|
Antibody influenza virus
|
$89.32 |
$89.32 |
$89.32 |
$54.06
|
|
Antibody lymphocytic choriomeningitis
|
$8.74 |
$8.74 |
$8.74 |
$46.58
|
|
Antibody screen rbc
|
$351.89 |
$351.89 |
$351.89 |
$109.80
|
|
Antibody tetanus
|
$97.02 |
$97.02 |
$97.02 |
$54.15
|
|
Antidepressant not specified
|
$753.83 |
$753.83 |
$753.83 |
$72.14
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$73.84
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$83.72
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$101.40
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$96.72
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$130.00
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$74.00
|
|
Antigen therapy services
|
$2.07 |
$2.07 |
$2.07 |
$64.39
|
|
Anti-inhibitor
|
$1,370.92 |
$1,370.92 |
$1,370.92 |
$8.33
|
|
Anti mog serum - sendout
|
$79.31 |
$79.31 |
$79.31 |
$131.95
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$79.31 |
$79.31 |
$79.31 |
$39.00
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$79.31 |
$79.31 |
$79.31 |
$42.00
|
|
Ant instr 2-3 vert segm 22845
|
$467.13 |
$467.13 |
$467.13 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$486.68 |
$486.68 |
$486.68 |
$1,430.40
|
|
Antinuclear antibodies
|
$80.08 |
$80.08 |
$80.08 |
$90.00
|
|
Antinuclear antibodies titer
|
$73.15 |
$73.15 |
$73.15 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$106.26 |
$106.26 |
$106.26 |
$67.60
|
|
Antipsychotics nos 1-3
|
$753.83 |
$753.83 |
$753.83 |
$137.80
|
|
Antistreptolysin o screen
|
$4.14 |
$4.14 |
$4.14 |
$57.28
|
|
Antistreptolysin o titer
|
$48.51 |
$48.51 |
$48.51 |
$53.60
|
|
Antithrombin iii activity
|
$78.54 |
$78.54 |
$78.54 |
$114.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$562.58 |
$562.58 |
$562.58 |
$4,155.20
|
|
Ant sgm img ir flrscn angrph
|
$22.31 |
$22.31 |
$22.31 |
$286.00
|
|
Ant sgm img i&r speclr mic
|
$13.57 |
$13.57 |
$13.57 |
$286.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$583.66 |
$583.66 |
$583.66 |
$395.20
|
|
Aortic circulation assist 33971
|
$450.11 |
$450.11 |
$450.11 |
$1,719.20
|
|
Aortic hemiarch graft 33866
|
$582.13 |
$582.13 |
$582.13 |
$2,260.80
|
|
Aortic suspension
|
$629.05 |
$629.05 |
$629.05 |
$1,414.87
|
|
Apheresis immunoads slctv
|
$56.35 |
$56.35 |
$56.35 |
$5,794.21
|
|
Apheresis plasma
|
$59.80 |
$59.80 |
$59.80 |
$3,226.34
|
|
Apheresis platelets
|
$69.23 |
$69.23 |
$69.23 |
$2,195.00
|
|
Apheresis rbc
|
$67.62 |
$67.62 |
$67.62 |
$3,290.80
|
|
Apheresis wbc
|
$71.30 |
$71.30 |
$71.30 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$606.76 |
$606.76 |
$606.76 |
$513.00
|
|
Appendectomy
|
$416.07 |
$416.07 |
$416.07 |
$5,419.00
|
|
Appendectomy add-on 44955
|
$53.59 |
$53.59 |
$53.59 |
$187.32
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$567.87 |
$567.87 |
$567.87 |
$1,557.59
|
|
Appendico-vesicostomy
|
$809.14 |
$809.14 |
$809.14 |
$1,632.03
|
|
Appendix Removal (Laparoscopic)
|
$391.23 |
$391.23 |
$391.23 |
$6,904.15
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$143.52 |
$143.52 |
$143.52 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$35.88 |
$35.88 |
$35.88 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$4,014.78 |
$4,014.78 |
$4,014.78 |
$505.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$10,712.24 |
$10,712.24 |
$10,712.24 |
$3,619.35
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$8,034.18 |
$8,034.18 |
$8,034.18 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$4,014.78 |
$4,014.78 |
$4,014.78 |
$514.00
|
|
Appl bdy cst sho to hip 1thi
|
$109.25 |
$109.25 |
$109.25 |
$353.60
|
|
Appl bdy cst sho to hip b th
|
$122.36 |
$122.36 |
$122.36 |
$561.60
|
|
Appl bdy cst sho to hip head
|
$113.39 |
$113.39 |
$113.39 |
$561.60
|
|
Appl body cast sho to hips
|
$93.84 |
$93.84 |
$93.84 |
$480.00
|
|
Appl cast figure-of-eight
|
$45.54 |
$45.54 |
$45.54 |
$314.28
|
|
Appl cast plaster velpeau
|
$61.18 |
$61.18 |
$61.18 |
$314.28
|
|
Appl cast shoulder spica
|
$89.93 |
$89.93 |
$89.93 |
$480.00
|
|
Appl halo cranial 6+pins
|
$581.44 |
$581.44 |
$581.44 |
$1,642.82
|
|
Appl halo type body cast
|
$129.26 |
$129.26 |
$129.26 |
$561.60
|
|
Appl hip spica cast1&1/2
|
$115.92 |
$115.92 |
$115.92 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$103.27 |
$103.27 |
$103.27 |
$499.20
|
|
Application clubfoot cast
|
$72.45 |
$72.45 |
$72.45 |
$302.40
|
|
Application finger splntstatic 29130
|
$377.30 |
$377.30 |
$377.30 |
$208.50
|
|
Application halo femoral
|
$314.64 |
$314.64 |
$314.64 |
$4,499.12
|
|
Application halo pelvic
|
$341.55 |
$341.55 |
$341.55 |
$1,893.86
|
|
Application long leg splint 29505
|
$461.23 |
$461.23 |
$461.23 |
$340.56
|
|
Application lower leg splint 29515
|
$461.23 |
$461.23 |
$461.23 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$461.23 |
$461.23 |
$461.23 |
$375.06
|
|
Application of body cast
|
$104.65 |
$104.65 |
$104.65 |
$557.18
|
|
Application of body cast
|
$117.53 |
$117.53 |
$117.53 |
$561.60
|
|
Application of cylinder cast 29365
|
$56.58 |
$56.58 |
$56.58 |
$420.00
|
|
Application of forearm cast 29075
|
$776.93 |
$776.93 |
$776.93 |
$365.30
|
|
Application of long arm cast 29065
|
$776.93 |
$776.93 |
$776.93 |
$399.00
|
|
Application of long leg cast
|
$68.54 |
$68.54 |
$68.54 |
$426.00
|
|
Application of long leg cast 29345
|
$776.93 |
$776.93 |
$776.93 |
$455.00
|
|
Application of paste boot 29580
|
$461.23 |
$461.23 |
$461.23 |
$340.11
|
|
Application short leg cast 29405
|
$776.93 |
$776.93 |
$776.93 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$5,352.27 |
$5,352.27 |
$5,352.27 |
$2,140.13
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$5,352.27 |
$5,352.27 |
$5,352.27 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$293.02 |
$293.02 |
$293.02 |
$938.52
|
|
Appl long leg cast brace
|
$66.93 |
$66.93 |
$66.93 |
$468.00
|
|
Appl mltpln uni ext fixj sys
|
$734.85 |
$734.85 |
$734.85 |
$5,840.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$34.65 |
$34.65 |
$34.65 |
$68.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$62.37 |
$62.37 |
$62.37 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$143.22 |
$143.22 |
$143.22 |
$57.60
|
|
Appl multlay comprs arm/hand
|
$10.12 |
$10.12 |
$10.12 |
$284.05
|
|
Appl patllr tdn bearing cast
|
$56.12 |
$56.12 |
$56.12 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$388.70 |
$388.70 |
$388.70 |
$5,810.00
|
|
Apply finger cast 29086
|
$31.97 |
$31.97 |
$31.97 |
$238.15
|
|
Apply forearm splintdynamic 29126
|
$377.30 |
$377.30 |
$377.30 |
$258.65
|
|
Apply halo w/removal cranial
|
$336.49 |
$336.49 |
$336.49 |
$1,367.60
|
