|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$974.05 |
$974.05 |
$974.05 |
$2,154.21
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$206.08 |
$206.08 |
$206.08 |
$873.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$76.13 |
$76.13 |
$76.13 |
$512.20
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$1,604.94 |
$1,604.94 |
$1,604.94 |
$3,767.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$206.08 |
$206.08 |
$206.08 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$76.13 |
$76.13 |
$76.13 |
$508.18
|
|
Application finger splntstatic 29130
|
$97.98 |
$97.98 |
$97.98 |
$208.50
|
|
Application long leg splint 29505
|
$43.01 |
$43.01 |
$43.01 |
$356.85
|
|
Application lower leg splint 29515
|
$43.01 |
$43.01 |
$43.01 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$54.05 |
$54.05 |
$54.05 |
$359.10
|
|
Application of cylinder cast 29365
|
$81.42 |
$81.42 |
$81.42 |
$431.08
|
|
Application of forearm cast 29075
|
$75.44 |
$75.44 |
$75.44 |
$347.20
|
|
Application of long leg cast 29345
|
$75.44 |
$75.44 |
$75.44 |
$464.51
|
|
Application of paste boot 29580
|
$61.64 |
$61.64 |
$61.64 |
$328.20
|
|
Application short leg cast 29405
|
$75.44 |
$75.44 |
$75.44 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$974.05 |
$974.05 |
$974.05 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$974.05 |
$974.05 |
$974.05 |
$2,189.70
|
|
Applicator tag rfid localizer 12gx7cm
|
$34.96 |
$34.96 |
$34.96 |
$895.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$37.95 |
$37.95 |
$37.95 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$39.79 |
$39.79 |
$39.79 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$37.95 |
$37.95 |
$37.95 |
$289.60
|
|
Apply forearm splintdynamic 29126
|
$106.03 |
$106.03 |
$106.03 |
$255.20
|
|
Apply of finger splint 29131
|
$106.03 |
$106.03 |
$106.03 |
$160.23
|
|
Apply rigid leg cast 29445
|
$125.58 |
$125.58 |
$125.58 |
$555.00
|
|
Apply short leg castambul type 29425
|
$159.16 |
$159.16 |
$159.16 |
$404.74
|
|
Aqaprn-4 antb flo cytmtry ea
|
$15.87 |
$15.87 |
$15.87 |
$204.00
|
|
Aquaporin-4 antibody cba each
|
$9.20 |
$9.20 |
$9.20 |
$114.20
|
|
Aquaporin-4 antibody elisa
|
$8.74 |
$8.74 |
$8.74 |
$138.87
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$25.30 |
$25.30 |
$25.30 |
$100.00
|
|
Aquatic exercise - group charge
|
$72.45 |
$72.45 |
$72.45 |
$87.15
|
|
Argatroban nonesrd (accord)
|
$126.37 |
$126.37 |
$126.37 |
$218.25
|
|
Argatroban nonesrd (auromed)
|
$51.06 |
$51.06 |
$51.06 |
$40.30
|
|
Argatroban nonesrd use 1mg
|
$131.52 |
$131.52 |
$131.52 |
$881.10
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$363.84 |
$363.84 |
$363.84 |
$1,520.60
|
|
Arterial blood draw/perc 36620
|
$235.06 |
$235.06 |
$235.06 |
$461.78
|
|
Artery xray each vessel 7577426
|
$641.47 |
$641.47 |
$641.47 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$1,795.15 |
$1,795.15 |
$1,795.15 |
$4,294.50
|
|
Artery x-rays arm/leg 75710-26
|
$1,259.02 |
$1,259.02 |
$1,259.02 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$1,810.79 |
$1,810.79 |
$1,810.79 |
$3,724.63
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$277.61 |
$277.61 |
$277.61 |
$588.53
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$495.65 |
$495.65 |
$495.65 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$110.86 |
$110.86 |
$110.86 |
$459.50
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$291.64 |
$291.64 |
$291.64 |
$696.00
|
|
Asp core fat pad
|
$56.12 |
$56.12 |
$56.12 |
$1,123.50
|
|
Aspirate/inj ganglion cyst 20612
|
$71.07 |
$71.07 |
$71.07 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$251.62 |
$251.62 |
$251.62 |
$1,215.00
|
|
Aspiration peritonsillar abscess
|
$70.15 |
$70.15 |
$70.15 |
$507.13
|
|
Assay acid phosphatase
|
$25.76 |
$25.76 |
$25.76 |
$38.22
|
|
Assay dir meas fr estradiol
|
$22.54 |
$22.54 |
$22.54 |
$68.00
|
|
Assay of breath ethanol
|
$25.07 |
$25.07 |
$25.07 |
$45.76
|
|
Assay of galactose
|
$5.29 |
$5.29 |
$5.29 |
$50.05
|
|
Assay of interleukin-6 (il-6)
|
$13.34 |
$13.34 |
$13.34 |
$77.35
|
|
Assay of leflunomide
|
$17.71 |
$17.71 |
$17.71 |
$92.50
|
|
Assay of lrh hormone
|
$229.31 |
$229.31 |
$229.31 |
$196.29
|
|
Assay of procainamide
|
$20.70 |
$20.70 |
$20.70 |
$82.80
|
|
Assay of procainamide w/metab
|
$19.32 |
$19.32 |
$19.32 |
$67.50
|
|
Assay of salicylate
|
$17.71 |
$17.71 |
$17.71 |
$95.00
|
|
Assay of urine sulfate
|
$16.79 |
$16.79 |
$16.79 |
$28.80
|
|
Assay toxin or antitoxin
|
$88.78 |
$88.78 |
$88.78 |
$75.90
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$15.18 |
$15.18 |
$15.18 |
$46.14
|
|
Ast/sgot
|
$54.28 |
$54.28 |
$54.28 |
$46.59
|
|
Athrectomy fem/pop/unilateral 37225
|
$11,358.78 |
$11,358.78 |
$11,358.78 |
$16,875.93
|
|
Athrectomy tib/pero/unilat/ini ves 37229
|
$11,358.78 |
$11,358.78 |
$11,358.78 |
$15,443.36
|
|
Atropine 0.1 mg/ml injection syringe
|
$48.58 |
$48.58 |
$48.58 |
$53.00
|
|
Audit/dast 15-30 min
|
$20.24 |
$20.24 |
$20.24 |
$76.65
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$2,046.77 |
$2,046.77 |
$2,046.77 |
$7,412.00
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$5,104.62 |
$5,104.62 |
$5,104.62 |
$10,423.05
|
|
Autoimmune rheumatoid arthr anl 12 mrk ia
|
$627.44 |
$627.44 |
$627.44 |
$924.72
|
|
Avul nail plate addl
|
$22.31 |
$22.31 |
$22.31 |
$219.45
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$48.99 |
$48.99 |
$48.99 |
$318.75
|
|
Azacitidine injection
|
$198.89 |
$198.89 |
$198.89 |
$1,033.25
|
|
Azathioprine 50 mg tablet
|
$4.59 |
$4.59 |
$4.59 |
$3.25
|
|
Azathioprine parenteral
|
$359.06 |
$359.06 |
$359.06 |
$484.20
|
|
Azithromycin 500 mg intravenous solution
|
$14.99 |
$14.99 |
$14.99 |
$36.36
|
|
Aztreonam 1 gram solution for injection
|
$87.58 |
$87.58 |
$87.58 |
$157.83
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$532.61 |
$532.61 |
$532.61 |
$1,576.90
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$28.09 |
$28.09 |
$28.09 |
$158.07
|
|
Baclofen eval charges
|
$73.83 |
$73.83 |
$73.83 |
$86.14
|
|
Bacterial meningitis antigen
|
$95.22 |
$95.22 |
$95.22 |
$63.21
|
|
Bacterial vaginosis pcr
|
$71.30 |
$71.30 |
$71.30 |
$258.96
|
|
Bartonella dna pcr-sendout
|
$342.93 |
$342.93 |
$342.93 |
$196.80
|
|
Bebtelovimab injection
|
$349.14 |
$349.14 |
$349.14 |
$468.05
|
|
Bendamustine 100 mg intravenous powder for solution
|
$1,021.31 |
$1,021.31 |
$1,021.31 |
$5,217.53
|
|
Bendamustine 25 mg/ml intravenous solution (belrapzo)
|
$1,409.63 |
$1,409.63 |
$1,409.63 |
$2,757.97
|
|
Benign lesion paring 2-4
|
$122.13 |
$122.13 |
$122.13 |
$264.85
|
|
Benign lesion paring 4+
|
$78.66 |
$78.66 |
$78.66 |
$291.85
|
|
#_benzodiazconfur
|
$170.89 |
$170.89 |
$170.89 |
$112.49
|
|
Benztropine 1 mg/ml injection solution
|
$39.90 |
$39.90 |
$39.90 |
$102.90
|
|
Beta 2 glycoprotein 1 antibody iga
|
$30.13 |
$30.13 |
$30.13 |
$80.87
|
|
Beta-2 microglobulin
|
$43.01 |
$43.01 |
$43.01 |
$84.00
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$63.84 |
$63.84 |
$63.84 |
$65.00
|
|
Bilateral n blobk inj pudendal 64430
|
$317.63 |
$317.63 |
$317.63 |
$1,489.35
|
|
Bilateral n block inj occipital 64405
|
$186.53 |
$186.53 |
$186.53 |
$783.90
|
|
Bilateral n block inj trigeminal 64400
|
$87.17 |
$87.17 |
$87.17 |
$551.20
|
|
Bilirubin direct
|
$47.84 |
$47.84 |
$47.84 |
$50.00
|
|
Bilirubin total
|
$48.76 |
$48.76 |
$48.76 |
$50.92
|
|
Biopsy cervixsingle/multiple 57500
|
$500.25 |
$500.25 |
$500.25 |
$1,268.54
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$595.93 |
$595.93 |
$595.93 |
$2,747.00
|
|
Biopsy of rectum wall anal approach 45100
|
$765.67 |
$765.67 |
$765.67 |
$3,245.23
|
|
Biotinidase - quest
|
$7.13 |
$7.13 |
$7.13 |
$68.00
|
