|
Rbc irradiated each unit
|
$662.30 |
$662.30 |
$662.30 |
$560.00
|
|
Rbc mechanical fragility
|
$6.76 |
$6.76 |
$6.76 |
$21.60
|
|
Rbc osmotic fragility
|
$47.36 |
$47.36 |
$47.36 |
$75.04
|
|
Rbc serum pretx incubj drugs
|
$2,524.14 |
$2,524.14 |
$2,524.14 |
$234.00
|
|
Rcnst bfrnt sp orb rm&lw fhd
|
$1,604.98 |
$1,604.98 |
$1,604.98 |
$6,547.81
|
|
Rcnstj forehead w/autograft
|
$1,236.04 |
$1,236.04 |
$1,236.04 |
$6,048.05
|
|
Rcnstj forehead with grafts
|
$1,106.56 |
$1,106.56 |
$1,106.56 |
$6,048.05
|
|
Rcnstj mdfc lefort i 1 w/grf
|
$1,125.28 |
$1,125.28 |
$1,125.28 |
$6,048.05
|
|
Rcnstj mdfc lefort i 2 w/grf
|
$1,174.94 |
$1,174.94 |
$1,174.94 |
$6,048.05
|
|
Rcnstj mdfc lefort iii w/i
|
$1,567.54 |
$1,567.54 |
$1,567.54 |
$6,048.05
|
|
Rcnstj mdfc lefort iii without i
|
$1,412.84 |
$1,412.84 |
$1,412.84 |
$6,048.05
|
|
Rcnstj mdfc lefrtii w/b1 grf
|
$1,311.96 |
$1,311.96 |
$1,311.96 |
$6,048.05
|
|
Rcnst mdfc lfrtiii advm w/i
|
$2,038.66 |
$2,038.66 |
$2,038.66 |
$6,048.05
|
|
Rcnst mdfc lfrtiii advm wo i
|
$1,879.54 |
$1,879.54 |
$1,879.54 |
$6,048.05
|
|
Rdctj forehead cntrg only
|
$550.16 |
$550.16 |
$550.16 |
$3,837.72
|
|
Rdctj forehead cntrg&prostc
|
$668.98 |
$668.98 |
$668.98 |
$6,547.81
|
|
Rdctj forehead cntrg&setback
|
$793.26 |
$793.26 |
$793.26 |
$6,839.00
|
|
Realignment of knee
|
$702.00 |
$702.00 |
$702.00 |
$4,732.80
|
|
Realignment of knee
|
$705.12 |
$705.12 |
$705.12 |
$4,681.60
|
|
Realignment of tendons
|
$482.30 |
$482.30 |
$482.30 |
$3,839.54
|
|
Realignment of thigh bone
|
$948.48 |
$948.48 |
$948.48 |
$7,413.38
|
|
Rebuild eardrum structures
|
$777.40 |
$777.40 |
$777.40 |
$6,839.00
|
|
Rebuild eardrum structures
|
$756.86 |
$756.86 |
$756.86 |
$6,547.81
|
|
Rebuild eardrum structures
|
$1,012.70 |
$1,012.70 |
$1,012.70 |
$6,771.20
|
|
Rebuild outer ear canal
|
$801.06 |
$801.06 |
$801.06 |
$6,017.08
|
|
Rebuild outer ear canal
|
$1,120.60 |
$1,120.60 |
$1,120.60 |
$7,000.36
|
|
Rechanneling of artery
|
$14,081.46 |
$14,081.46 |
$14,081.46 |
$2,697.60
|
|
Rechanneling of artery
|
$3,862.06 |
$3,862.06 |
$3,862.06 |
$495.50
|
|
Rechanneling of artery
|
$13,536.08 |
$13,536.08 |
$13,536.08 |
$2,213.55
|
|
Rechanneling of artery
|
$15,102.66 |
$15,102.66 |
$15,102.66 |
$1,800.00
|
|
Rechanneling of artery 35305
|
$10,280.82 |
$10,280.82 |
$10,280.82 |
$3,029.35
|
|
Rechanneling of artery 35341
|
$12,724.30 |
$12,724.30 |
$12,724.30 |
$4,439.00
|
|
Rechanneling w/graft tibioperoneal trunk artery 35304
|
$10,698.92 |
$10,698.92 |
$10,698.92 |
$6,219.20
|
|
Rechanneling w/wo patch graft abd aorta 35331
|
$13,203.82 |
$13,203.82 |
$13,203.82 |
$2,912.40
|
|
Rechanneling w/wo patch graft deep profunda fem art 35372
|
$13,413.98 |
$13,413.98 |
$13,413.98 |
$9,706.55
|
|
Rechanneling w/wo patch grf axillary-brachial 35321
|
$10,280.82 |
$10,280.82 |
$10,280.82 |
$3,155.50
|
|
Recipient nephrectomy
|
$705.90 |
$705.90 |
$705.90 |
$1,392.38
|
|
Reconst lwr jaw w/fixation
|
$1,035.32 |
$1,035.32 |
$1,035.32 |
$5,339.00
|
|
Reconst lwr jaw w/graft
|
$1,034.02 |
$1,034.02 |
$1,034.02 |
$6,547.81
|
|
Reconst lwr jaw without fixation
|
$968.76 |
$968.76 |
$968.76 |
$6,547.81
|
|
Reconst lwr jaw without graft
|
$894.92 |
$894.92 |
$894.92 |
$6,547.81
|
|
Reconst major injured chest 32820
|
$1,008.54 |
$1,008.54 |
$1,008.54 |
$3,236.80
|
|
Reconst pectus excavatum/carinatum opn 21740
|
$745.42 |
$745.42 |
$745.42 |
$2,510.40
|
|
Reconstr lwr jaw segment
|
$736.06 |
$736.06 |
$736.06 |
$6,547.81
|
|
Reconstr lwr jaw w/advance
|
$741.52 |
$741.52 |
$741.52 |
$4,349.80
|
|
Reconstruct ankle joint
|
$705.90 |
$705.90 |
$705.90 |
$4,881.00
|
|
Reconstruct bronchus
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$2,000.38
|
|
Reconstruct cleft foot
|
$807.30 |
$807.30 |
$807.30 |
$8,453.60
|
|
Reconstruct cleft palate
|
$674.96 |
$674.96 |
$674.96 |
$5,493.56
|
|
Reconstruct cleft palate
|
$702.52 |
$702.52 |
$702.52 |
$4,558.89
|
|
Reconstruct cleft palate
|
$784.42 |
$784.42 |
$784.42 |
$6,523.41
|
|
Reconstruct cleft palate
|
$511.94 |
$511.94 |
$511.94 |
$6,547.81
|
|
Reconstruct cleft palate
|
$421.46 |
$421.46 |
$421.46 |
$6,547.81
|
|
Reconstruct cleft palate
|
$713.44 |
$713.44 |
$713.44 |
$6,547.81
|
|
Reconstruct cranial bone
|
$1,539.98 |
$1,539.98 |
$1,539.98 |
$6,048.05
|
|
Reconstruct cranial bone
|
$1,674.66 |
$1,674.66 |
$1,674.66 |
$6,048.05
|
|
Reconstruct cranial bone
|
$1,800.76 |
$1,800.76 |
$1,800.76 |
$6,048.05
|
|
Reconstruct elbow joint
|
$664.56 |
$664.56 |
$664.56 |
$7,807.24
|
|
Reconstruct elbow joint
|
$741.52 |
$741.52 |
$741.52 |
$20,355.21
|
|
Reconstruct elbow joint
|
$779.48 |
$779.48 |
$779.48 |
$14,241.77
|
|
Reconstruct elbow lat ligmnt
|
$813.28 |
$813.28 |
$813.28 |
$7,907.11
|
|
Reconstruct elbow med ligmnt
|
$813.28 |
$813.28 |
$813.28 |
$10,385.60
|
|
Reconstruct extra finger
|
$769.08 |
$769.08 |
$769.08 |
$3,591.33
|
|
Reconstruct finger joint
|
$530.92 |
$530.92 |
$530.92 |
$3,839.54
|
|
Reconstruct finger joint
|
$580.58 |
$580.58 |
$580.58 |
$4,326.00
|
|
Reconstruct head of radius
|
$474.76 |
$474.76 |
$474.76 |
$11,148.00
|
|
Reconstruct head of radius
|
$504.14 |
$504.14 |
$504.14 |
$9,878.40
|
|
Reconstruction ankle joint
|
$816.92 |
$816.92 |
$816.92 |
$10,617.00
|
|
Reconstruction knee
|
$522.86 |
$522.86 |
$522.86 |
$7,222.25
|
|
Reconstruction knee
|
$822.38 |
$822.38 |
$822.38 |
$8,814.96
|
|
Reconstruction knee
|
$927.16 |
$927.16 |
$927.16 |
$10,629.07
|
|
Reconstruction of anus
|
$455.26 |
$455.26 |
$455.26 |
$3,245.23
|
|
Reconstruction of bile ducts 47800
|
$1,137.50 |
$1,137.50 |
$1,137.50 |
$2,201.98
|
|
Reconstruction of eyelid
|
$514.54 |
$514.54 |
$514.54 |
$3,786.00
|
|
Reconstruction of eyelid
|
$661.96 |
$661.96 |
$661.96 |
$4,194.40
|
|
Reconstruction of eyelid
|
$660.14 |
$660.14 |
$660.14 |
$4,462.45
|
|
Reconstruction of eyelid
|
$487.76 |
$487.76 |
$487.76 |
$3,398.40
|
|
Reconstruction of hip socket
|
$951.34 |
$951.34 |
$951.34 |
$13,116.76
|
|
Reconstruction of hip socket
|
$809.12 |
$809.12 |
$809.12 |
$2,710.40
|
|
Reconstruction of jaw
|
$685.88 |
$685.88 |
$685.88 |
$6,547.81
|
|
Reconstruction of jaw
|
$618.02 |
$618.02 |
$618.02 |
$6,547.81
|
|
Reconstruction of jaw
|
$584.22 |
$584.22 |
$584.22 |
$6,839.00
|
|
Reconstruction of jaw
|
$817.18 |
$817.18 |
$817.18 |
$6,720.89
|
|
Reconstruction of jaw joint
|
$765.70 |
$765.70 |
$765.70 |
$7,000.36
|
|
Reconstruction of jaw joint
|
$735.80 |
$735.80 |
$735.80 |
$6,839.00
|
|
Reconstruction of jaw joint
|
$1,176.76 |
$1,176.76 |
$1,176.76 |
$15,372.00
|
|
Reconstruction of lower jaw
|
$728.26 |
$728.26 |
$728.26 |
$6,523.41
|
|
Reconstruction of midface
|
$1,142.70 |
$1,142.70 |
$1,142.70 |
$6,048.05
|
|
Reconstruction of mouth
|
$459.94 |
$459.94 |
$459.94 |
$6,553.49
|
|
Reconstruction of mouth
|
$449.02 |
$449.02 |
$449.02 |
$6,553.49
|
|
Reconstruction of mouth
|
$637.00 |
$637.00 |
$637.00 |
$6,839.00
|
|
Reconstruction of mouth
|
$861.90 |
$861.90 |
$861.90 |
$6,839.00
|
|
Reconstruction of mouth
|
$882.18 |
$882.18 |
$882.18 |
$6,740.73
|
|
Reconstruction of nail bed
|
$137.54 |
$137.54 |
$137.54 |
$2,164.64
|
|
Reconstruction of nose
|
$1,013.74 |
$1,013.74 |
$1,013.74 |
$5,925.35
|
|
Reconstruction of nose
|
$1,037.66 |
$1,037.66 |
$1,037.66 |
$6,966.64
|
|
Reconstruction of orbit
|
$906.10 |
$906.10 |
$906.10 |
$6,547.81
|
|
Reconstruction of throat
|
$572.00 |
$572.00 |
$572.00 |
$6,553.49
|
|
Reconstruction of urethra
|
$713.44 |
$713.44 |
$713.44 |
$6,015.75
|
|
Reconstruction of urethra
|
$822.12 |
$822.12 |
$822.12 |
$2,856.00
|
