|
Amniocentesisdiagnostic 59000
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$942.60
|
|
Amniocentesis therapeutic
|
$980.00 |
$980.00 |
$980.00 |
$791.05
|
|
Amobarbital 125 mg inj
|
$2,038.73 |
$2,038.73 |
$2,038.73 |
$1,283.59
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$339.60 |
$339.60 |
$339.60 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$373.00 |
$373.00 |
$373.00 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$325.98 |
$325.98 |
$325.98 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$357.52 |
$357.52 |
$357.52 |
$54.57
|
|
Amputation toe interphalangeal joint
|
$2,777.60 |
$2,777.60 |
$2,777.60 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$3,418.40 |
$3,418.40 |
$3,418.40 |
$3,839.54
|
|
Anal/urinary muscle study
|
$367.20 |
$367.20 |
$367.20 |
$407.00
|
|
Anal/urinary muscle study
|
$760.00 |
$760.00 |
$760.00 |
$602.80
|
|
Analysis tumor
|
$208.80 |
$208.80 |
$208.80 |
$248.80
|
|
Anastrozole 1 mg
|
$1.36 |
$1.36 |
$1.36 |
$22.40
|
|
An cholangiogram percutaneous compl
|
$3,182.40 |
$3,182.40 |
$3,182.40 |
$2,480.94
|
|
An fluoro guide for cvp
|
$1,046.40 |
$1,046.40 |
$1,046.40 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$10,480.00 |
$10,480.00 |
$10,480.00 |
$5,728.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$2,797.96 |
$2,797.96 |
$2,797.96 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ea addl
|
$9,336.00 |
$9,336.00 |
$9,336.00 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$14,820.00 |
$14,820.00 |
$14,820.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$7,196.00 |
$7,196.00 |
$7,196.00 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$12,636.00 |
$12,636.00 |
$12,636.00 |
$8,359.11
|
|
Anidulafungin injection
|
$309.88 |
$309.88 |
$309.88 |
$312.30
|
|
Ankle X-ray
|
$467.20 |
$467.20 |
$467.20 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$297.60 |
$297.60 |
$297.60 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$849.60 |
$849.60 |
$849.60 |
$630.96
|
|
Anodyne therapy charges pt
|
$101.60 |
$101.60 |
$101.60 |
$42.00
|
|
Anogenital exam child w imag
|
$171.20 |
$171.20 |
$171.20 |
$277.99
|
|
Anoscopy remove fb 46608
|
$1,610.40 |
$1,610.40 |
$1,610.40 |
$1,375.98
|
|
Antibody id rbc panel
|
$86.40 |
$86.40 |
$86.40 |
$291.75
|
|
Antibody screen rbc
|
$14.29 |
$14.29 |
$14.29 |
$108.55
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$1.92 |
$1.92 |
$1.92 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$0.36 |
$0.36 |
$0.36 |
$3.67
|
|
Anti-inhibitor
|
$1.77 |
$1.77 |
$1.77 |
$8.33
|
|
Antithrombin iii injection
|
$2.72 |
$2.72 |
$2.72 |
$11.85
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$5,344.19 |
$5,344.19 |
$5,344.19 |
$8,214.07
|
|
Antithymocyte globuln rabbit
|
$2,171.17 |
$2,171.17 |
$2,171.17 |
$2,111.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$623.20 |
$623.20 |
$623.20 |
$394.55
|
|
Apheresis plasma
|
$4,280.80 |
$4,280.80 |
$4,280.80 |
$3,226.34
|
|
Apheresis platelets
|
$3,672.80 |
$3,672.80 |
$3,672.80 |
$2,195.00
|
|
Apheresis rbc
|
$4,264.00 |
$4,264.00 |
$4,264.00 |
$3,290.80
|
|
Apheresis wbc
|
$4,450.40 |
$4,450.40 |
$4,450.40 |
$3,347.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,586.40 |
$3,586.40 |
$3,586.40 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,968.80 |
$1,968.80 |
$1,968.80 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,712.00 |
$1,712.00 |
$1,712.00 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,147.20 |
$5,147.20 |
$5,147.20 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,744.80 |
$2,744.80 |
$2,744.80 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,850.40 |
$1,850.40 |
$1,850.40 |
$512.20
|
|
Application clubfoot cast
|
$364.00 |
$364.00 |
$364.00 |
$303.00
|
|
Application finger splntstatic 29130
|
$291.20 |
$291.20 |
$291.20 |
$208.50
|
|
Application long leg splint 29505
|
$285.60 |
$285.60 |
$285.60 |
$338.25
|
|
Application lower leg splint 29515
|
$273.60 |
$273.60 |
$273.60 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$414.40 |
$414.40 |
$414.40 |
$375.06
|
|
Application of forearm cast 29075
|
$341.60 |
$341.60 |
$341.60 |
$358.20
|
|
Application of long arm cast 29065
|
$388.80 |
$388.80 |
$388.80 |
$396.77
|
|
Application of long leg cast 29345
|
$468.80 |
$468.80 |
$468.80 |
$455.00
|
|
Application of paste boot 29580
|
$260.80 |
$260.80 |
$260.80 |
$340.11
|
|
Application short leg cast 29405
|
$358.40 |
$358.40 |
$358.40 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,012.80 |
$3,012.80 |
$3,012.80 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,972.80 |
$2,972.80 |
$2,972.80 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$684.80 |
$684.80 |
$684.80 |
$981.75
|
|
Appl modality 1/> areas paraffin bath 97018
|
$98.40 |
$98.40 |
$98.40 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$108.00 |
$108.00 |
$108.00 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$68.80 |
$68.80 |
$68.80 |
$54.61
|
|
Appl unipln uni ext fixj sys
|
$6,059.20 |
$6,059.20 |
$6,059.20 |
$5,810.00
|
|
Apply hand/wrist cast 29085
|
$286.40 |
$286.40 |
$286.40 |
$271.80
|
|
Apply interstit radiat compl
|
$5,296.80 |
$5,296.80 |
$5,296.80 |
$2,901.80
|
|
Apply rigid leg cast 29445
|
$690.40 |
$690.40 |
$690.40 |
$555.00
|
|
Apply short leg castambul type 29425
|
$392.00 |
$392.00 |
$392.00 |
$404.74
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1,061.32 |
$1,061.32 |
$1,061.32 |
$955.43
|
|
Aqmbf pet rest & rx stress
|
$420.80 |
$420.80 |
$420.80 |
$974.40
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$128.00 |
$128.00 |
$128.00 |
$100.75
|
|
Aquatic exercise - group charge
|
$120.80 |
$120.80 |
$120.80 |
$87.45
|
|
Argatroban esrd dialysis 1mg
|
$3,535.95 |
$3,535.95 |
$3,535.95 |
$934.80
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$5,803.14 |
$5,803.14 |
$5,803.14 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$3,130.40 |
$3,130.40 |
$3,130.40 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$2,455.20 |
$2,455.20 |
$2,455.20 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$471.20 |
$471.20 |
$471.20 |
$426.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,520.60 |
$1,520.60 |
$1,520.60 |
$1,303.25
|
|
Art bypass fem-ant-post tib/prl 35666
|
$10,245.60 |
$10,245.60 |
$10,245.60 |
$4,735.49
|
|
Art bypass femoral-femoral 35661
|
$10,245.60 |
$10,245.60 |
$10,245.60 |
$5,291.20
|
|
Art byp grft fem-popliteal 35556
|
$9,152.80 |
$9,152.80 |
$9,152.80 |
$2,806.20
|
|
Art byp pop-tibl-prl-other 35571
|
$9,152.80 |
$9,152.80 |
$9,152.80 |
$4,244.00
|
|
Arterial blood draw/perc 36620
|
$372.00 |
$372.00 |
$372.00 |
$478.96
|
|
Artery xray each vessel 7577426
|
$2,919.20 |
$2,919.20 |
$2,919.20 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$7,335.20 |
$7,335.20 |
$7,335.20 |
$4,618.71
|
|
Artery x-rays arm/leg 75710-26
|
$5,683.20 |
$5,683.20 |
$5,683.20 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$6,377.60 |
$6,377.60 |
$6,377.60 |
$3,860.40
|
|
Artery x-rays chest
|
$4,090.40 |
$4,090.40 |
$4,090.40 |
$2,895.07
|
|
Artery x-rays lung
|
$5,423.20 |
$5,423.20 |
$5,423.20 |
$3,296.15
|
|
Artery x-rays lung
|
$3,603.20 |
$3,603.20 |
$3,603.20 |
$2,427.50
|
|
Artery x-rays lungs
|
$5,523.20 |
$5,523.20 |
$5,523.20 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$6,247.20 |
$6,247.20 |
$6,247.20 |
$4,306.40
|
|
Artery x-rays spine
|
$6,616.00 |
$6,616.00 |
$6,616.00 |
$4,792.33
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$899.20 |
$899.20 |
$899.20 |
$609.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,535.20 |
$1,535.20 |
$1,535.20 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,490.40 |
$1,490.40 |
$1,490.40 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$540.00 |
$540.00 |
$540.00 |
$494.40
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$1,112.80 |
$1,112.80 |
$1,112.80 |
$699.00
|
|
Arthrotomy carpometacarpal joint 26070
|
$3,155.20 |
$3,155.20 |
$3,155.20 |
$1,893.86
|
|
Ascenda two piece catheter
|
$21,767.20 |
$21,767.20 |
$21,767.20 |
$22,792.00
|
