|
Antidepressant tricyclic 3-5
|
$13.20 |
$13.20 |
$13.20 |
$23.20
|
|
Antiepileptics nos 4-6
|
$11.10 |
$11.10 |
$11.10 |
$12.80
|
|
Antiepileptics nos 7/more
|
$11.10 |
$11.10 |
$11.10 |
$18.85
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$1,724.74 |
$1,724.74 |
$1,724.74 |
$6.10
|
|
Anti-inhibitor
|
$10,171.61 |
$10,171.61 |
$10,171.61 |
$8.33
|
|
Anti mog serum - sendout
|
$28.95 |
$28.95 |
$28.95 |
$115.80
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$28.20 |
$28.20 |
$28.20 |
$44.31
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$29.70 |
$29.70 |
$29.70 |
$36.60
|
|
Antinuclear antibodies
|
$21.15 |
$21.15 |
$21.15 |
$91.70
|
|
Antinuclear antibodies titer
|
$19.50 |
$19.50 |
$19.50 |
$79.95
|
|
Antiphosphatidylserine antibody
|
$27.15 |
$27.15 |
$27.15 |
$65.97
|
|
Antipsychotics nos 1-3
|
$11.10 |
$11.10 |
$11.10 |
$153.75
|
|
Antipsychotics nos 4-6
|
$11.10 |
$11.10 |
$11.10 |
$36.00
|
|
Antipsychotics nos 7/more
|
$25.80 |
$25.80 |
$25.80 |
$18.85
|
|
Antistreptolysin o screen
|
$10.05 |
$10.05 |
$10.05 |
$58.30
|
|
Antistreptolysin o titer
|
$12.75 |
$12.75 |
$12.75 |
$52.50
|
|
Antithrombin iii activity
|
$20.70 |
$20.70 |
$20.70 |
$114.00
|
|
Antithrombin iii injection
|
$9.78 |
$9.78 |
$9.78 |
$12.34
|
|
Aortic dysfunction/dilation
|
$646.80 |
$646.80 |
$646.80 |
$992.40
|
|
Aortic dysfunction/dilation
|
$1,732.65 |
$1,732.65 |
$1,732.65 |
$1,525.60
|
|
Apc gene dup/delet variants
|
$96.75 |
$96.75 |
$96.75 |
$400.00
|
|
Apc gene full sequence
|
$96.75 |
$96.75 |
$96.75 |
$1,255.02
|
|
Apheresis plasma
|
$638.85 |
$638.85 |
$638.85 |
$3,291.00
|
|
Apl(pml-rara) quant - sendout
|
$363.00 |
$363.00 |
$363.00 |
$466.44
|
|
Appendix Removal (Laparoscopic)
|
$2,401.65 |
$2,401.65 |
$2,401.65 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$272.10 |
$272.10 |
$272.10 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$137.55 |
$137.55 |
$137.55 |
$908.05
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$26.25 |
$26.25 |
$26.25 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$860.70 |
$860.70 |
$860.70 |
$3,767.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$137.55 |
$137.55 |
$137.55 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$26.25 |
$26.25 |
$26.25 |
$545.25
|
|
Appl cast figure-of-eight
|
$60.30 |
$60.30 |
$60.30 |
$314.28
|
|
Appl hip spica cast 1 leg
|
$120.75 |
$120.75 |
$120.75 |
$499.20
|
|
Application clubfoot cast
|
$68.40 |
$68.40 |
$68.40 |
$303.00
|
|
Application finger splntstatic 29130
|
$51.60 |
$51.60 |
$51.60 |
$216.80
|
|
Application long leg splint 29505
|
$77.85 |
$77.85 |
$77.85 |
$356.85
|
|
Application lower leg splint 29515
|
$64.65 |
$64.65 |
$64.65 |
$354.00
|
|
Application multi layer compression below knee (both sides)
|
$110.40 |
$110.40 |
$110.40 |
$377.25
|
|
Application of forearm cast 29075
|
$130.20 |
$130.20 |
$130.20 |
$365.30
|
|
Application of long arm cast 29065
|
$120.75 |
$120.75 |
$120.75 |
$404.63
|
|
Application of long leg cast
|
$120.75 |
$120.75 |
$120.75 |
$444.00
|
|
Application of long leg cast 29345
|
$93.75 |
$93.75 |
$93.75 |
$481.25
|
|
Application of paste boot 29580
|
$60.30 |
$60.30 |
$60.30 |
$331.74
|
|
Application short leg cast 29405
|
$99.60 |
$99.60 |
$99.60 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$373.50 |
$373.50 |
$373.50 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$373.50 |
$373.50 |
$373.50 |
$2,189.70
|
|
Appl modality 1/> areas paraffin bath 97018
|
$18.75 |
$18.75 |
$18.75 |
$66.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$25.20 |
$25.20 |
$25.20 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$65.85 |
$65.85 |
$65.85 |
$297.50
|
|
Appl patllr tdn bearing cast
|
$120.75 |
$120.75 |
$120.75 |
$429.00
|
|
Apply finger cast 29086
|
$43.95 |
$43.95 |
$43.95 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$133.35 |
$133.35 |
$133.35 |
$263.10
|
|
Apply hand/wrist cast 29085
|
$54.90 |
$54.90 |
$54.90 |
$279.40
|
|
Apply interstit radiat compl
|
$501.75 |
$501.75 |
$501.75 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$489.15 |
$489.15 |
$489.15 |
$1,773.02
|
|
Apply intrcav radiat interm
|
$420.90 |
$420.90 |
$420.90 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$382.50 |
$382.50 |
$382.50 |
$1,269.97
|
|
Apply of finger splint 29131
|
$32.70 |
$32.70 |
$32.70 |
$171.00
|
|
Apply rigid leg cast 29445
|
$129.75 |
$129.75 |
$129.75 |
$581.40
|
|
Apply short leg castambul type 29425
|
$120.75 |
$120.75 |
$120.75 |
$452.20
|
|
Apply surf ldr radionuclide
|
$74.25 |
$74.25 |
$74.25 |
$251.55
|
|
App topical fluoride varnish
|
$5.85 |
$5.85 |
$5.85 |
$37.70
|
|
#aptt mix-1:1 incubated
|
$61.50 |
$61.50 |
$61.50 |
$146.25
|
|
Aqaprn-4 antb flo cytmtry ea
|
$28.20 |
$28.20 |
$28.20 |
$220.00
|
|
Aqmbf pet rest & rx stress
|
$1,187.10 |
$1,187.10 |
$1,187.10 |
$920.63
|
|
Aquaporin-4 antibody cba each
|
$28.20 |
$28.20 |
$28.20 |
$121.45
|
|
Aquaporin-4 antibody elisa
|
$34.20 |
$34.20 |
$34.20 |
$138.87
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$40.95 |
$40.95 |
$40.95 |
$100.00
|
|
Aquatic exercise - group charge
|
$16.80 |
$16.80 |
$16.80 |
$87.45
|
|
Argatroban esrd dialysis 1mg
|
$735.55 |
$735.55 |
$735.55 |
$934.80
|
|
Ar gene full gene sequence
|
$236.70 |
$236.70 |
$236.70 |
$331.49
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$0.15 |
$0.15 |
$0.15 |
$6,286.51
|
|
Arterial blood draw/perc 36620
|
$183.60 |
$183.60 |
$183.60 |
$492.05
|
|
Artery xray each vessel 7577426
|
$332.55 |
$332.55 |
$332.55 |
$1,865.50
|
|
Artery xray of abdomen 75726-26
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$4,402.30
|
|
Artery x-rays adrenal gland
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,476.40
|
|
Artery x-rays adrenals
|
$2,036.70 |
$2,036.70 |
$2,036.70 |
$3,764.59
|
|
Artery x-rays arm/leg 75710-26
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$1,425.75 |
$1,425.75 |
$1,425.75 |
$3,729.00
|
|
Artery x-rays chest
|
$452.10 |
$452.10 |
$452.10 |
$2,628.15
|
|
Artery x-rays lung
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,286.20
|
|
Artery x-rays lung
|
$492.60 |
$492.60 |
$492.60 |
$2,451.75
|
|
Artery x-rays lungs
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,706.68
|
|
Artery xrays of pelvis 75736 26
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$4,306.90
|
|
Artery x-rays spine
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$4,294.50
|
|
Art expos/graft artery perfusion 33987
|
$370.50 |
$370.50 |
$370.50 |
$370.50
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$267.00 |
$267.00 |
$267.00 |
$588.53
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$241.50 |
$241.50 |
$241.50 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$245.85 |
$245.85 |
$245.85 |
$956.00
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$89.55 |
$89.55 |
$89.55 |
$471.34
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$295.05 |
$295.05 |
$295.05 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$178.20 |
$178.20 |
$178.20 |
$716.94
|
|
Aspa gene
|
$157.80 |
$157.80 |
$157.80 |
$140.00
|
|
Asp & inj bone cyst
|
$294.75 |
$294.75 |
$294.75 |
$974.90
|
|
Aspirate bladder/sprapubic cath 51102
|
$909.45 |
$909.45 |
$909.45 |
$3,162.90
|
|
Aspirate/inj ganglion cyst 20612
|
$254.40 |
$254.40 |
$254.40 |
$436.10
|
|
Aspirate pleura without imaging 32554
|
$706.80 |
$706.80 |
$706.80 |
$1,249.21
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$511.95 |
$511.95 |
$511.95 |
$1,266.72
|
|
Aspir/inj thyroid cyst 60300
|
$168.60 |
$168.60 |
$168.60 |
$914.34
|
|
Assay acid phosphatase
|
$12.90 |
$12.90 |
$12.90 |
$38.22
|
