|
Application multi layer compression below knee (both sides)
|
$381.60 |
$382.40 |
$414.40 |
|
|
Application of forearm cast 29075
|
$211.20 |
$259.20 |
$366.40 |
|
|
Application of long arm cast 29065
|
$253.60 |
$264.00 |
$388.80 |
|
|
Application of long leg cast 29345
|
$432.80 |
$432.80 |
$468.80 |
|
|
Application of paste boot 29580
|
$247.20 |
$260.80 |
$348.80 |
|
|
Application short leg cast 29405
|
$256.00 |
$280.80 |
$358.40 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,850.40 |
$2,965.60 |
$3,012.80 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,871.20 |
$2,955.20 |
$3,042.40 |
|
|
Applicator tag rfid localizer 12gx7cm
|
$328.80 |
$328.80 |
$684.80 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$74.40 |
$89.60 |
$107.20 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$80.80 |
$99.20 |
$112.80 |
|
|
Appl modality 1+lllt po pain
|
$64.80 |
$68.80 |
$72.80 |
|
|
Appl multlay comprs arm/hand
|
$289.60 |
$289.60 |
$289.60 |
|
|
Appl unipln uni ext fixj sys
|
$6,059.20 |
$6,059.20 |
$6,059.20 |
|
|
Apply forearm splintdynamic 29126
|
$276.00 |
$276.00 |
$286.40 |
|
|
Apply hand/wrist cast 29085
|
$171.20 |
$259.20 |
$286.40 |
|
|
Apply interstit radiat compl
|
$5,296.80 |
$5,296.80 |
$5,296.80 |
|
|
Apply of finger splint 29131
|
$183.20 |
$183.20 |
$188.80 |
|
|
Apply rigid leg cast 29445
|
$690.40 |
$690.40 |
$690.40 |
|
|
Apply short leg castambul type 29425
|
$241.60 |
$252.00 |
$392.00 |
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$597.90 |
$597.90 |
$1,061.32 |
|
|
#aptt mix-1:1 incubated
|
$352.80 |
$352.80 |
$352.80 |
|
|
Aqaprn-4 antb flo cytmtry ea
|
$190.40 |
$190.40 |
$406.40 |
|
|
Aqmbf pet rest & rx stress
|
$420.80 |
$420.80 |
$420.80 |
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$124.00 |
$128.00 |
$128.00 |
|
|
Aquatic exercise - group charge
|
$115.20 |
$117.60 |
$120.80 |
|
|
Argatroban esrd dialysis 1mg
|
$533.84 |
$533.84 |
$3,535.95 |
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$5,803.14 |
$5,803.14 |
$5,803.14 |
|
|
Arm CT Scan (with contrast, both arms)
|
$2,087.20 |
$2,145.60 |
$3,130.40 |
|
|
Arm CT Scan (without contrast, both arms)
|
$1,811.20 |
$1,943.20 |
$2,455.20 |
|
|
Arm or Leg Ultrasound (limited, left side)
|
$449.60 |
$505.60 |
$601.60 |
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,520.60 |
$1,520.60 |
$1,520.60 |
|
|
Art bypass fem-ant-post tib/prl 35666
|
$10,245.60 |
$10,245.60 |
$10,245.60 |
|
|
Art bypass femoral-femoral 35661
|
$10,245.60 |
$10,245.60 |
$10,245.60 |
|
|
Art byp grft fem-popliteal 35556
|
$9,152.80 |
$9,152.80 |
$9,152.80 |
|
|
Art byp pop-tibl-prl-other 35571
|
$9,152.80 |
$9,152.80 |
$9,152.80 |
|
|
Arterial blood draw/perc 36620
|
$372.00 |
$372.00 |
$718.40 |
|
|
Artery xray each vessel 7577426
|
$2,589.60 |
$2,589.60 |
$2,919.20 |
|
|
Artery xray of abdomen 75726-26
|
$6,733.60 |
$6,733.60 |
$7,335.20 |
|
|
Artery x-rays arm/leg 75710-26
|
$4,728.80 |
$4,728.80 |
$5,683.20 |
|
|
Artery x-rays arms/legs 75716-26
|
$5,520.00 |
$5,520.00 |
$6,377.60 |
|
|
Artery x-rays chest
|
$4,090.40 |
$4,090.40 |
$4,090.40 |
|
|
Artery x-rays lung
|
$4,458.40 |
$4,458.40 |
$5,423.20 |
|
|
Artery x-rays lung
|
$3,179.20 |
$3,179.20 |
$3,603.20 |
|
|
Artery x-rays lungs
|
$5,461.60 |
$5,461.60 |
$5,523.20 |
|
|
Artery xrays of pelvis 75736 26
|
$5,938.40 |
$5,938.40 |
$6,247.20 |
|
|
Artery x-rays spine
|
$6,430.40 |
$6,430.40 |
$6,616.00 |
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$477.60 |
$504.00 |
$899.20 |
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,535.20 |
$1,535.20 |
$1,535.20 |
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$671.20 |
$901.60 |
$1,490.40 |
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$446.40 |
$471.20 |
$540.00 |
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$1,112.80 |
$1,112.80 |
$1,112.80 |
|
|
Arthrotomy carpometacarpal joint 26070
|
$3,155.20 |
$3,155.20 |
$3,155.20 |
|
|
Ascenda two piece catheter
|
$21,767.20 |
$21,767.20 |
$21,767.20 |
|
|
Asp core fat pad
|
$2,631.20 |
$2,631.20 |
$3,706.40 |
|
|
Asp & inj bone cyst
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
|
|
Asp & inj w/heparin pleurx cath
|
$7,878.40 |
$7,878.40 |
$7,878.40 |
|
|
Aspirate bladder/sprapubic cath 51102
|
$3,744.80 |
$4,007.20 |
$5,252.80 |
|
|
Aspirate/inj ganglion cyst 20612
|
$229.60 |
$365.60 |
$585.60 |
|
|
Aspirate pleura without imaging 32554
|
$749.60 |
$948.00 |
$1,053.60 |
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,287.20 |
$1,287.20 |
$1,841.60 |
|
|
Aspiration peritonsillar abscess
|
$738.40 |
$738.40 |
$738.40 |
|
|
Aspir/inj thyroid cyst 60300
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
|
|
Assay dir meas fr estradiol
|
$68.00 |
$68.00 |
$68.00 |
|
|
Assay of breath ethanol
|
$25.60 |
$25.60 |
$25.60 |
|
|
Assay of feces porphyrins
|
$122.40 |
$122.40 |
$122.40 |
|
|
Assay of salicylate
|
$60.80 |
$93.60 |
$161.60 |
|
|
Assay of sialic acid
|
$120.00 |
$120.00 |
$120.00 |
|
|
Assay of tyrosine
|
$38.40 |
$38.40 |
$38.40 |
|
|
Assay of urine sulfate
|
$14.40 |
$14.40 |
$56.80 |
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$304.00 |
$387.20 |
$419.20 |
|
|
Assess cyst contrast inject
|
$792.00 |
$792.00 |
$885.60 |
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$37.60 |
$41.60 |
$88.00 |
|
|
Ast/sgot
|
$25.60 |
$53.60 |
$85.60 |
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$9,817.68 |
$11,471.60 |
$25,944.32 |
|
|
Atropine 0.1 mg/ml injection syringe
|
$60.27 |
$60.71 |
$314.52 |
|
|
Audiometry air + bone
|
$200.00 |
$200.00 |
$200.00 |
|
|
Augment injectable kit 3.0cc
|
$10,055.20 |
$10,055.20 |
$10,055.20 |
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$3,913.60 |
$3,913.60 |
$6,625.60 |
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$11,730.40 |
$11,730.40 |
$13,374.40 |
|
|
Autologous blood process
|
$219.65 |
$219.65 |
$219.65 |
|
|
Automated diff wbc count
|
$27.20 |
$33.60 |
$54.40 |
|
|
Av fistula revision
|
$13,840.00 |
$13,840.00 |
$13,840.00 |
|
|
Avul nail plate addl
|
$112.00 |
$144.80 |
$160.00 |
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$261.60 |
$351.20 |
$432.80 |
|
|
Azacitidine injection
|
$229.64 |
$1,002.44 |
$1,838.68 |
|
|
Azathioprine 50 mg tablet
|
$1.20 |
$1.20 |
$1.30 |
|
|
Azithromycin 500 mg intravenous solution
|
$62.22 |
$62.34 |
$316.72 |
|
|
Azithromycin dihydrate, oral
|
$20.60 |
$24.50 |
$58.52 |
|
|
Aztreonam 1 gram solution for injection
|
$77.81 |
$93.44 |
$355.29 |
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$1,973.55 |
$1,973.55 |
$1,973.55 |
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$369.96 |
$369.96 |
$369.96 |
|
|
Baclofen eval charges
|
$86.40 |
$125.60 |
$2,172.00 |
|
|
Bacterial meningitis antigen
|
$72.80 |
$83.20 |
$121.60 |
|
|
Bacterial vaginosis pcr
|
$237.60 |
$296.80 |
$329.60 |
|
|
Balance and Coordination Retraining (each 15 minutes)
|
$120.00 |
$126.40 |
$128.80 |
|
|
Balloon dilate urtrl strix
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
|
|
Barium Enema (Colon X-ray, barium and air)
|
$1,121.60 |
$1,186.40 |
$1,545.60 |
|
|
Barium Enema (Colon X-ray, barium only)
|
$858.40 |
$988.00 |
$1,073.60 |
|
|
Barium Swallow (Esophagus X-ray)
|
$632.80 |
$647.20 |
$841.60 |
|
