|
Amputation thru metatarsal
|
$2,463.56 |
$2,463.56 |
$2,463.56 |
$3,791.82
|
|
Amputation toe interphalangeal joint
|
$2,436.91 |
$2,436.91 |
$2,436.91 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$1,464.01 |
$1,464.01 |
$1,464.01 |
$3,777.93
|
|
Amylase
|
$22.00 |
$22.00 |
$22.00 |
$93.00
|
|
Ana ds-dna
|
$286.38 |
$286.38 |
$286.38 |
$65.52
|
|
Anal/urinary muscle study
|
$208.97 |
$208.97 |
$208.97 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$113.79 |
$113.79 |
$113.79 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$99.83 |
$99.83 |
$99.83 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$59.22 |
$59.22 |
$59.22 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$149.75 |
$149.75 |
$149.75 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$616.74 |
$616.74 |
$616.74 |
$2,426.60
|
|
An fluoro guide for cvp
|
$369.28 |
$369.28 |
$369.28 |
$509.60
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,241.48 |
$2,241.48 |
$2,241.48 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$5,223.63 |
$5,223.63 |
$5,223.63 |
$9,462.03
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$12,065.23 |
$12,065.23 |
$12,065.23 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$3,712.68 |
$3,712.68 |
$3,712.68 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$115.34 |
$115.34 |
$115.34 |
$5,128.65
|
|
Angio tib/peroneal/init ves/unila 37228
|
$6,875.02 |
$6,875.02 |
$6,875.02 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,123.01 |
$3,123.01 |
$3,123.01 |
$5,741.00
|
|
Angio trnslmnl balloon same artery ini
|
$6,245.60 |
$6,245.60 |
$6,245.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,123.01 |
$3,123.01 |
$3,123.01 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$6,245.60 |
$6,245.60 |
$6,245.60 |
$8,745.10
|
|
Ankle X-ray
|
$357.86 |
$357.86 |
$357.86 |
$350.85
|
|
Anl sp inf pmp w/mdreprg&fil
|
$473.34 |
$473.34 |
$473.34 |
$693.75
|
|
Antibody bacterium, not elsewhere specified
|
$32.58 |
$32.58 |
$32.58 |
$57.85
|
|
Antibody elution rbc reference
|
$133.67 |
$133.67 |
$133.67 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$206.85 |
$206.85 |
$206.85 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$63.03 |
$63.03 |
$63.03 |
$218.30
|
|
Antibody id rbc panel
|
$187.39 |
$187.39 |
$187.39 |
$291.75
|
|
Antibody influenza virus
|
$41.46 |
$41.46 |
$41.46 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$54.57 |
$54.57 |
$54.57 |
$53.96
|
|
Antibody screen rbc
|
$119.29 |
$119.29 |
$119.29 |
$105.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$152.37 |
$152.37 |
$152.37 |
$7.00
|
|
Antihemophilic viii/vwf comp
|
$151.41 |
$151.41 |
$151.41 |
$3.32
|
|
Anti-inhibitor
|
$155.12 |
$155.12 |
$155.12 |
$7.00
|
|
Anti mog serum - sendout
|
$296.10 |
$296.10 |
$296.10 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$24.54 |
$24.54 |
$24.54 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$24.54 |
$24.54 |
$24.54 |
$40.00
|
|
Antinuclear antibodies
|
$34.69 |
$34.69 |
$34.69 |
$91.70
|
|
Antinuclear antibodies titer
|
$120.56 |
$120.56 |
$120.56 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$144.25 |
$144.25 |
$144.25 |
$74.20
|
|
Antistreptolysin o titer
|
$49.07 |
$49.07 |
$49.07 |
$57.85
|
|
Antithrombin iii activity
|
$32.15 |
$32.15 |
$32.15 |
$106.85
|
|
Antithrombin iii injection
|
$159.84 |
$159.84 |
$159.84 |
$10.74
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$6,605.14 |
$6,605.14 |
$6,605.14 |
$7,544.81
|
|
Aortic circulation assist 33971
|
$5,866.17 |
$5,866.17 |
$5,866.17 |
$1,719.20
|
|
Aortic dysfunction/dilation
|
$878.15 |
$878.15 |
$878.15 |
$653.18
|
|
Aortic dysfunction/dilation
|
$2,352.73 |
$2,352.73 |
$2,352.73 |
$1,485.21
|
|
Apheresis plasma
|
$2,499.93 |
$2,499.93 |
$2,499.93 |
$3,498.41
|
|
Apheresis platelets
|
$1,725.00 |
$1,725.00 |
$1,725.00 |
$2,302.65
|
|
Apheresis rbc
|
$1,725.00 |
$1,725.00 |
$1,725.00 |
$3,497.90
|
|
Apheresis wbc
|
$1,875.16 |
$1,875.16 |
$1,875.16 |
$3,342.71
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,889.52 |
$2,889.52 |
$2,889.52 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,444.97 |
$1,444.97 |
$1,444.97 |
$908.05
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,444.97 |
$1,444.97 |
$1,444.97 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,923.27 |
$5,923.27 |
$5,923.27 |
$3,461.40
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,976.23 |
$2,976.23 |
$2,976.23 |
$1,300.71
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,444.97 |
$1,444.97 |
$1,444.97 |
$508.18
|
|
Application finger splntstatic 29130
|
$68.95 |
$68.95 |
$68.95 |
$226.20
|
|
Application multi layer compression below knee (both sides)
|
$267.34 |
$267.34 |
$267.34 |
$393.75
|
|
Application of paste boot 29580
|
$249.57 |
$249.57 |
$249.57 |
$336.00
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,889.52 |
$2,889.52 |
$2,889.52 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,889.52 |
$2,889.52 |
$2,889.52 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$245.77 |
$245.77 |
$245.77 |
$938.52
|
|
Appl modality 1/> areas paraffin bath 97018
|
$69.38 |
$69.38 |
$69.38 |
$68.00
|
|
Apply forearm splintdynamic 29126
|
$54.15 |
$54.15 |
$54.15 |
$263.20
|
|
Apply interstit radiat compl
|
$1,306.23 |
$1,306.23 |
$1,306.23 |
$2,901.80
|
|
Apply of finger splint 29131
|
$68.95 |
$68.95 |
$68.95 |
$177.45
|
|
Apply rigid leg cast 29445
|
$170.05 |
$170.05 |
$170.05 |
$608.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$451.68 |
$451.68 |
$451.68 |
$1,091.17
|
|
#aptt mix-1:1 incubated
|
$185.70 |
$185.70 |
$185.70 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$296.10 |
$296.10 |
$296.10 |
$231.66
|
|
Aqmbf pet rest & rx stress
|
$2,518.97 |
$2,518.97 |
$2,518.97 |
$558.66
|
|
Aquaporin-4 antibody cba each
|
$243.23 |
$243.23 |
$243.23 |
$114.60
|
|
Aquaporin-4 antibody elisa
|
$139.59 |
$139.59 |
$139.59 |
$155.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$123.10 |
$123.10 |
$123.10 |
$100.00
|
|
Aquatic exercise - group charge
|
$91.80 |
$91.80 |
$91.80 |
$91.68
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,849.31 |
$1,849.31 |
$1,849.31 |
$1,642.18
|
|
Art byp aortofemoral 35647
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$7,550.40
|
|
Art bypass axillary-femoral 35621
|
$4,597.59 |
$4,597.59 |
$4,597.59 |
$5,352.00
|
|
Art bypass carotid-subclavian 35606
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$5,724.80
|
|
Art bypass fem-ant-post tib/prl 35666
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$6,216.00
|
|
Art bypass femoral-femoral 35661
|
$4,597.59 |
$4,597.59 |
$4,597.59 |
$5,291.20
|
|
Art bypass femoral-popliteal 35656
|
$4,597.59 |
$4,597.59 |
$4,597.59 |
$5,273.60
|
|
Art bypass iliofemoral 35665
|
$4,191.51 |
$4,191.51 |
$4,191.51 |
$5,729.60
|
|
Art byp grft axill-brachial
|
$4,597.59 |
$4,597.59 |
$4,597.59 |
$3,217.23
|
|
Art byp grft brachial-brchl
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$5,540.80
|
|
Art byp grft fem-femoral 35558
|
$4,597.59 |
$4,597.59 |
$4,597.59 |
$6,004.80
|
|
Art byp grft fem-popliteal 35556
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$4,735.49
|
|
Art byp ilioiliac 35663
|
$4,295.15 |
$4,295.15 |
$4,295.15 |
$1,854.00
|
|
Art byp pop-tibl-prl-other 35571
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$6,467.20
|
|
Arterial blood draw/perc 36620
|
$1,284.23 |
$1,284.23 |
$1,284.23 |
$500.82
|
|
Artery by graft; iliofemoral 35565
|
$4,510.03 |
$4,510.03 |
$4,510.03 |
$6,387.20
|
|
Artery transpose/endovas taa
|
$4,257.50 |
$4,257.50 |
$4,257.50 |
$3,854.40
|
|
Artery-vein nonautograft
|
$5,133.53 |
$5,133.53 |
$5,133.53 |
$6,325.50
|
|
Artery xray each vessel 7577426
|
$1,524.92 |
$1,524.92 |
$1,524.92 |
$1,865.50
|
|
Artery xray of abdomen 75726-26
|
$2,239.79 |
$2,239.79 |
$2,239.79 |
$4,658.99
|
|
Artery x-rays arm/leg 75710-26
|
$2,084.55 |
$2,084.55 |
$2,084.55 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$3,502.44 |
$3,502.44 |
$3,502.44 |
$4,029.72
|
|
Artery x-rays chest
|
$1,285.92 |
$1,285.92 |
$1,285.92 |
$2,628.15
|
