|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$449.60 |
$449.60 |
$449.60 |
$498.81
|
|
Application finger splntstatic 29130
|
$65.92 |
$65.92 |
$65.92 |
$208.16
|
|
Application long leg splint 29505
|
$79.68 |
$79.68 |
$79.68 |
$338.25
|
|
Application lower leg splint 29515
|
$79.68 |
$79.68 |
$79.68 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$159.36 |
$159.36 |
$159.36 |
$373.20
|
|
Application of cylinder cast 29365
|
$137.28 |
$137.28 |
$137.28 |
$420.00
|
|
Application of long leg cast 29345
|
$137.28 |
$137.28 |
$137.28 |
$455.00
|
|
Application of paste boot 29580
|
$79.68 |
$79.68 |
$79.68 |
$331.74
|
|
Application short leg cast 29405
|
$137.28 |
$137.28 |
$137.28 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$878.08 |
$878.08 |
$878.08 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$878.08 |
$878.08 |
$878.08 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$11.52 |
$11.52 |
$11.52 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$11.52 |
$11.52 |
$11.52 |
$75.60
|
|
Apply forearm splintdynamic 29126
|
$65.92 |
$65.92 |
$65.92 |
$246.18
|
|
Apply of finger splint 29131
|
$65.92 |
$65.92 |
$65.92 |
$168.00
|
|
Apply rigid leg cast 29445
|
$137.28 |
$137.28 |
$137.28 |
$555.00
|
|
Apply short leg castambul type 29425
|
$137.28 |
$137.28 |
$137.28 |
$381.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$844.86 |
$844.86 |
$844.86 |
$955.43
|
|
Aqaprn-4 antb flo cytmtry ea
|
$103.36 |
$103.36 |
$103.36 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$16.00 |
$16.00 |
$16.00 |
$100.00
|
|
Aquatic exercise - group charge
|
$11.52 |
$11.52 |
$11.52 |
$85.80
|
|
Argatroban nonesrd use 1mg
|
$556.19 |
$556.19 |
$556.19 |
$866.80
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,391.86 |
$1,391.86 |
$1,391.86 |
$1,313.89
|
|
Arterial blood draw/perc 36620
|
$550.08 |
$550.08 |
$550.08 |
$485.69
|
|
Artery xray each vessel 7577426
|
$243.84 |
$243.84 |
$243.84 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$2,728.96 |
$2,728.96 |
$2,728.96 |
$4,446.00
|
|
Artery x-rays adrenal gland
|
$372.48 |
$372.48 |
$372.48 |
$3,439.84
|
|
Artery x-rays arm/leg 75710-26
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$3,729.00
|
|
Artery x-rays chest
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$2,870.00
|
|
Artery x-rays lung
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$3,279.12
|
|
Artery x-rays lung
|
$265.28 |
$265.28 |
$265.28 |
$2,451.75
|
|
Artery x-rays lungs
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$2,728.96 |
$2,728.96 |
$2,728.96 |
$4,134.14
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$789.76 |
$789.76 |
$789.76 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$346.24 |
$346.24 |
$346.24 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$185.28 |
$185.28 |
$185.28 |
$889.20
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$789.76 |
$789.76 |
$789.76 |
$715.37
|
|
Aspirate bladder/sprapubic cath 51102
|
$658.56 |
$658.56 |
$658.56 |
$3,162.72
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$627.20 |
$627.20 |
$627.20 |
$1,226.87
|
|
Aspir/inj thyroid cyst 60300
|
$347.20 |
$347.20 |
$347.20 |
$850.78
|
|
Assay neurflmnt light chain
|
$412.48 |
$412.48 |
$412.48 |
$380.00
|
|
Assay of galactose
|
$10.24 |
$10.24 |
$10.24 |
$49.21
|
|
Assay of salicylate
|
$23.04 |
$23.04 |
$23.04 |
$95.00
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$58.24 |
$58.24 |
$58.24 |
$292.50
|
|
Assess cyst contrast inject
|
$42.88 |
$42.88 |
$42.88 |
$447.33
|
|
Assistive tech assessment, ot
|
$13.76 |
$13.76 |
$13.76 |
$96.08
|
|
Ast/sgot
|
$16.00 |
$16.00 |
$16.00 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$12,270.77 |
$12,270.77 |
$12,270.77 |
$23,166.53
|
|
Atropine 0.1 mg/ml injection syringe
|
$43.73 |
$43.73 |
$43.73 |
$51.28
|
|
Autologous blood process
|
$187.52 |
$187.52 |
$187.52 |
$262.50
|
|
Automated diff wbc count
|
$20.80 |
$20.80 |
$20.80 |
$38.28
|
|
Avelumab 20 mg/ml intravenous solution
|
$2,352.17 |
$2,352.17 |
$2,352.17 |
$3,683.86
|
|
Avul nail plate addl
|
$279.36 |
$279.36 |
$279.36 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$242.88 |
$242.88 |
$242.88 |
$318.75
|
|
Azacitidine injection
|
$1,985.65 |
$1,985.65 |
$1,985.65 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$0.27 |
$0.27 |
$0.27 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$11.21 |
$11.21 |
$11.21 |
$35.06
|
|
Aztreonam 1 gram solution for injection
|
$95.62 |
$95.62 |
$95.62 |
$157.30
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$2,059.41 |
$2,059.41 |
$2,059.41 |
$1,800.33
|
|
Baclofen eval charges
|
$20.16 |
$20.16 |
$20.16 |
$85.00
|
|
Balloon dilate urtrl strix
|
$96.96 |
$96.96 |
$96.96 |
$2,118.00
|
|
B cells total count
|
$34.56 |
$34.56 |
$34.56 |
$131.30
|
|
Bcg live 50 mg intravesical suspension
|
$192.67 |
$192.67 |
$192.67 |
$378.28
|
|
Belatacept 250 mg intravenous solution
|
$1,057.71 |
$1,057.71 |
$1,057.71 |
$2,036.75
|
|
Belimumab 120 mg intravenous solution
|
$2,353.44 |
$2,353.44 |
$2,353.44 |
$4,243.90
|
|
Bendamustine 100 mg intravenous powder for solution
|
$3,240.92 |
$3,240.92 |
$3,240.92 |
$4,844.85
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$2,697.83 |
$2,697.83 |
$2,697.83 |
$4,702.68
|
|
Benign lesion paring 2-4
|
$242.88 |
$242.88 |
$242.88 |
$257.50
|
|
Benign lesion paring 4+
|
$242.88 |
$242.88 |
$242.88 |
$287.00
|
|
Benztropine 1 mg/ml injection solution
|
$116.16 |
$116.16 |
$116.16 |
$103.20
|
|
Beta 2 glycoprotein 1 antibody iga
|
$13.76 |
$13.76 |
$13.76 |
$78.50
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$21.01 |
$21.01 |
$21.01 |
$64.15
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$3,476.44 |
$3,476.44 |
$3,476.44 |
$5,705.92
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$3,043.64 |
$3,043.64 |
$3,043.64 |
$3,291.73
|
|
Bevacizumab-bvzr 25 mg/ml intravenous solution
|
$2,675.80 |
$2,675.80 |
$2,675.80 |
$2,508.56
|
|
Bfb train 1st 15min cntct 90912
|
$50.88 |
$50.88 |
$50.88 |
$173.55
|
|
Bfb train ea addl 15 min 90913
|
$50.88 |
$50.88 |
$50.88 |
$92.82
|
|
Bilicheck
|
$11.84 |
$11.84 |
$11.84 |
$28.80
|
|
Bilirubin direct
|
$5.76 |
$5.76 |
$5.76 |
$50.00
|
|
Bilirubin total
|
$5.44 |
$5.44 |
$5.44 |
$52.57
|
|
Biopsy abdominal mass
|
$495.04 |
$495.04 |
$495.04 |
$1,718.60
|
|
Biopsy bone trocar/needle superficial
|
$495.04 |
$495.04 |
$495.04 |
$1,770.73
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$1,026.24 |
$1,026.24 |
$1,026.24 |
$2,716.95
|
|
Biopsy muscle percutaneous needle
|
$339.20 |
$339.20 |
$339.20 |
$1,629.60
|
|
Biopsy needle liver percutaneous
|
$495.04 |
$495.04 |
$495.04 |
$1,892.80
|
|
Biopsy needle lymph node superficial
|
$495.04 |
$495.04 |
$495.04 |
$1,878.14
|
|
Biopsy of salivary gland 42400
|
$347.20 |
$347.20 |
$347.20 |
$1,145.90
|
|
Biopsy renal percutaneous trocar/needle (both sides)
|
$495.04 |
$495.04 |
$495.04 |
$2,086.50
|
|
Biopsy skin incisional single lesion
|
$362.56 |
$362.56 |
$362.56 |
$657.66
|
|
Biospy of bladder
|
$130.56 |
$130.56 |
$130.56 |
$813.15
|
|
Biotinidase - quest
|
$5.44 |
$5.44 |
$5.44 |
$71.02
|
|
Bivalirudin
|
$1,033.55 |
$1,033.55 |
$1,033.55 |
$1,033.55
|
|
Bld prd mix
|
$57.92 |
$57.92 |
$57.92 |
$139.21
|
|
Bleomycin 15 unit solution for injection
|
$141.78 |
$141.78 |
$141.78 |
$215.36
|
|
Blinatumomab 35 mcg intravenous solution
|
$5,611.10 |
$5,611.10 |
$5,611.10 |
$10,187.42
|
|
Bln 1.2 mono emrg 15x1.2
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$8,530.55
|
|
Bln 30frx10mmx12cm renal nephromax
|
$6,016.00 |
$6,016.00 |
$6,016.00 |
$5,169.58
|
|
Bln dil 900ml preperitnl
|
$740.19 |
$740.19 |
$740.19 |
$1,427.17
|
|
Bln press regulation 71-80cm
|
$12,074.40 |
$12,074.40 |
$12,074.40 |
$13,796.54
|