|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,955.20 |
$2,955.20 |
$2,955.20 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$76.80 |
$76.80 |
$76.80 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$88.80 |
$88.80 |
$88.80 |
$75.98
|
|
Apply hand/wrist cast 29085
|
$259.20 |
$259.20 |
$259.20 |
$271.80
|
|
Aqaprn-4 antb flo cytmtry ea
|
$190.40 |
$190.40 |
$190.40 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$124.00 |
$124.00 |
$124.00 |
$100.75
|
|
Arm CT Scan (with contrast, both arms)
|
$2,087.20 |
$2,087.20 |
$2,087.20 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,811.20 |
$1,811.20 |
$1,811.20 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$595.20 |
$595.20 |
$595.20 |
$426.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$528.80 |
$528.80 |
$528.80 |
$609.00
|
|
Aspirate bladder/sprapubic cath 51102
|
$3,744.80 |
$3,744.80 |
$3,744.80 |
$3,226.20
|
|
Aspirate pleura without imaging 32554
|
$948.00 |
$948.00 |
$948.00 |
$1,195.15
|
|
Assay dir meas fr estradiol
|
$68.00 |
$68.00 |
$68.00 |
$68.00
|
|
Assay of salicylate
|
$161.60 |
$161.60 |
$161.60 |
$96.50
|
|
Assay of urine sulfate
|
$14.40 |
$14.40 |
$14.40 |
$28.20
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$378.40 |
$378.40 |
$378.40 |
$300.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$88.00 |
$88.00 |
$88.00 |
$46.80
|
|
Ast/sgot
|
$85.60 |
$85.60 |
$85.60 |
$45.90
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$9,817.68 |
$9,817.68 |
$9,817.68 |
$22,528.65
|
|
Atropine 0.1 mg/ml injection syringe
|
$60.27 |
$60.27 |
$60.27 |
$53.24
|
|
Automated diff wbc count
|
$54.40 |
$54.40 |
$54.40 |
$36.30
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$351.20 |
$351.20 |
$351.20 |
$326.27
|
|
Azacitidine injection
|
$1,002.44 |
$1,002.44 |
$1,002.44 |
$1,047.73
|
|
Azathioprine 50 mg tablet
|
$1.20 |
$1.20 |
$1.20 |
$3.44
|
|
Azithromycin 500 mg intravenous solution
|
$62.34 |
$62.34 |
$62.34 |
$37.53
|
|
Azithromycin dihydrate, oral
|
$32.55 |
$32.55 |
$32.55 |
$46.31
|
|
Aztreonam 1 gram solution for injection
|
$103.43 |
$103.43 |
$103.43 |
$157.30
|
|
Baclofen eval charges
|
$126.40 |
$126.40 |
$126.40 |
$87.50
|
|
Bacterial meningitis antigen
|
$83.20 |
$83.20 |
$83.20 |
$66.30
|
|
Balance and Coordination Retraining (each 15 minutes)
|
$126.40 |
$126.40 |
$126.40 |
$102.20
|
|
B cells total count
|
$113.60 |
$113.60 |
$113.60 |
$132.48
|
|
Belatacept 250 mg intravenous solution
|
$1,498.26 |
$1,498.26 |
$1,498.26 |
$2,036.75
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$2,866.43 |
$2,866.43 |
$2,866.43 |
$4,898.13
|
|
Beta 2 glycoprotein 1 antibody iga
|
$148.80 |
$148.80 |
$148.80 |
$82.55
|
|
Beta-2 microglobulin
|
$83.20 |
$83.20 |
$83.20 |
$85.20
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$66.48 |
$66.48 |
$66.48 |
$65.00
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$3,107.03 |
$3,107.03 |
$3,107.03 |
$5,737.97
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$2,763.19 |
$2,763.19 |
$2,763.19 |
$3,496.79
|
|
Bilateral n block inj trigeminal 64400
|
$537.60 |
$537.60 |
$537.60 |
$587.60
|
|
Bilirubin direct
|
$76.00 |
$76.00 |
$76.00 |
$51.35
|
|
Bilirubin total
|
$49.60 |
$49.60 |
$49.60 |
$54.60
|
|
Biotinidase - quest
|
$68.00 |
$68.00 |
$68.00 |
$64.40
|
|
Bladder Catheter Insertion (simple)
|
$276.80 |
$276.80 |
$276.80 |
$232.30
|
|
Bladder irrigate/lavage/instill 51700
|
$400.00 |
$400.00 |
$400.00 |
$412.80
|
|
Bld prd mix
|
$156.00 |
$156.00 |
$156.00 |
$140.25
|
|
Bln 30frx10mmx12cm renal nephromax
|
$801.60 |
$801.60 |
$801.60 |
$5,330.60
|
|
Bln dil 900ml preperitnl
|
$1,287.20 |
$1,287.20 |
$1,287.20 |
$1,320.21
|
|
Blood Clotting (PT/INR) Test
|
$91.20 |
$91.20 |
$91.20 |
$53.30
|
|
Blood Clotting (PTT) Test
|
$110.40 |
$110.40 |
$110.40 |
$74.00
|
|
Blood Count (CBC) Test
|
$148.00 |
$148.00 |
$148.00 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$140.00 |
$140.00 |
$140.00 |
$62.28
|
|
Blood count spun microhematocrit
|
$45.60 |
$45.60 |
$45.60 |
$25.00
|
|
Blood Culture Test
|
$164.00 |
$164.00 |
$164.00 |
$146.16
|
|
Blood draw capillary 36416
|
$29.60 |
$29.60 |
$29.60 |
$20.00
|
|
Blood Draw (Venipuncture)
|
$25.60 |
$25.60 |
$25.60 |
$21.66
|
|
Blood gases o2 saturation direct measurement
|
$325.60 |
$325.60 |
$325.60 |
$226.50
|
|
Blood gases ph venous
|
$146.40 |
$146.40 |
$146.40 |
$64.60
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$57.60 |
$57.60 |
$57.60 |
$57.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$69.60 |
$69.60 |
$69.60 |
$33.15
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$51.20 |
$51.20 |
$51.20 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$69.60 |
$69.60 |
$69.60 |
$34.98
|
|
Blood smear microscopic w manual differential wbc count
|
$68.00 |
$68.00 |
$68.00 |
$38.35
|
|
Blood Transfusion
|
$1,028.80 |
$1,028.80 |
$1,028.80 |
$989.60
|
|
Blood typing abo
|
$84.80 |
$84.80 |
$84.80 |
$86.45
|
|
Blood typing ag donor ea ag
|
$104.00 |
$104.00 |
$104.00 |
$207.60
|
|
Blood typing rbc ag non abo/rh ea
|
$186.40 |
$186.40 |
$186.40 |
$211.90
|
|
Blood typing rh (d)
|
$66.40 |
$66.40 |
$66.40 |
$57.60
|
|
Bone Age X-ray (hand and wrist)
|
$365.60 |
$365.60 |
$365.60 |
$252.75
|
|
Bone Density Scan (DEXA)
|
$594.40 |
$594.40 |
$594.40 |
$407.94
|
|
Bone imaging multiple areas
|
$1,476.80 |
$1,476.80 |
$1,476.80 |
$1,194.00
|
|
Bone/joint imaging ltd area
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,037.40
|
|
Bone survey-lead poisoning
|
$580.80 |
$580.80 |
$580.80 |
$387.00
|
|
Boot softgait shrt m
|
$151.20 |
$151.20 |
$151.20 |
$139.20
|
|
Boot walker genesis full shell 3-strap s
|
$128.80 |
$128.80 |
$128.80 |
$439.09
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$152.00 |
$152.00 |
$152.00 |
$93.60
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$2,235.28 |
$2,235.28 |
$2,235.28 |
$2,915.40
|
|
(both sides) smear without diff wbc count
|
$31.20 |
$31.20 |
$31.20 |
$30.68
|
|
Bowel imaging
|
$1,610.40 |
$1,610.40 |
$1,610.40 |
$1,074.00
|
|
Brace ank air stirrup univ
|
$239.20 |
$239.20 |
$239.20 |
$108.67
|
|
Brace ankle stablizing lg
|
$104.00 |
$104.00 |
$104.00 |
$122.82
|
|
Brace back pinnacle tlso 464
|
$4,224.00 |
$4,224.00 |
$4,224.00 |
$2,632.87
|
|
Brace knee extender plus 22-30in
|
$339.20 |
$339.20 |
$339.20 |
$767.20
|
|
Brace knee hing pat open med
|
$108.80 |
$108.80 |
$108.80 |
$214.50
|
|
Brace knee support neoprene padded open patella med
|
$180.80 |
$180.80 |
$180.80 |
$215.70
|
|
Brace m arm board
|
$116.00 |
$116.00 |
$116.00 |
$162.50
|
|
Brace or Splint Fitting and Training (each 15 minutes)
|
$136.00 |
$136.00 |
$136.00 |
$105.30
|
|
Brace oths wrist hnd fngr without
|
$53.60 |
$53.60 |
$53.60 |
$257.45
|
|
Brace wrist classic lft sm
|
$72.80 |
$72.80 |
$72.80 |
$89.04
|
|
Brain image w/flow 4 + views
|
$1,801.60 |
$1,801.60 |
$1,801.60 |
$1,330.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,762.40 |
$3,762.40 |
$3,762.40 |
$2,772.11
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,040.80 |
$3,040.80 |
$3,040.80 |
$2,136.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,723.20 |
$2,723.20 |
$2,723.20 |
$1,897.53
|
|
Brain MRI (with and without contrast)
|
$3,860.00 |
$3,860.00 |
$3,860.00 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$3,142.40 |
$3,142.40 |
$3,142.40 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$2,892.00 |
$2,892.00 |
$2,892.00 |
$1,948.00
|
|
Breastbone (Sternum) X-ray
|
$368.80 |
$368.80 |
$368.80 |
$274.65
|
|
Breast punct aspir cyst, bil
|
$1,182.40 |
$1,182.40 |
$1,182.40 |
$871.80
|
|
Breath recording infant
|
$1,108.00 |
$1,108.00 |
$1,108.00 |
$1,164.00
|
|
Bronchial allergy tests
|
$856.80 |
$856.80 |
$856.80 |
$746.46
|
|
Budesonide non-comp unit
|
$12.69 |
$12.69 |
$12.69 |
$20.52
|
