|
Angio trnslmnl balloon same vein ini
|
$1,845.03 |
$1,845.03 |
$1,845.03 |
$8,466.00
|
|
Anidulafungin injection
|
$214.68 |
$214.68 |
$214.68 |
$312.30
|
|
Ankle X-ray
|
$144.21 |
$144.21 |
$144.21 |
$353.60
|
|
Antibody bacterium, not elsewhere specified
|
$14.85 |
$14.85 |
$14.85 |
$57.81
|
|
Antibody elution rbc reference
|
$62.70 |
$62.70 |
$62.70 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$81.84 |
$81.84 |
$81.84 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$57.75 |
$57.75 |
$57.75 |
$218.30
|
|
Antibody id rbc panel
|
$595.65 |
$595.65 |
$595.65 |
$274.56
|
|
Antibody screen rbc
|
$24.75 |
$24.75 |
$24.75 |
$100.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.81 |
$3.81 |
$3.81 |
$6.10
|
|
Anti-inhibitor
|
$6.24 |
$6.24 |
$6.24 |
$8.33
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$7.92 |
$7.92 |
$7.92 |
$37.05
|
|
Antinuclear antibodies
|
$11.55 |
$11.55 |
$11.55 |
$89.40
|
|
Antinuclear antibodies titer
|
$10.56 |
$10.56 |
$10.56 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$123.09 |
$123.09 |
$123.09 |
$65.97
|
|
Antistreptolysin o titer
|
$19.47 |
$19.47 |
$19.47 |
$51.45
|
|
Antithrombin iii activity
|
$39.27 |
$39.27 |
$39.27 |
$114.00
|
|
Antithrombin iii injection
|
$10.62 |
$10.62 |
$10.62 |
$12.34
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$5,692.15 |
$5,692.15 |
$5,692.15 |
$7,704.70
|
|
Antithymocyte globuln rabbit
|
$1,259.00 |
$1,259.00 |
$1,259.00 |
$2,111.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,412.07 |
$1,412.07 |
$1,412.07 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,258.62 |
$1,258.62 |
$1,258.62 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$463.65 |
$463.65 |
$463.65 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$1,812.03 |
$1,812.03 |
$1,812.03 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,258.62 |
$1,258.62 |
$1,258.62 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$463.65 |
$463.65 |
$463.65 |
$498.81
|
|
Application finger splntstatic 29130
|
$67.98 |
$67.98 |
$67.98 |
$208.16
|
|
Application long leg splint 29505
|
$82.17 |
$82.17 |
$82.17 |
$338.25
|
|
Application lower leg splint 29515
|
$82.17 |
$82.17 |
$82.17 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$164.34 |
$164.34 |
$164.34 |
$373.20
|
|
Application of cylinder cast 29365
|
$141.57 |
$141.57 |
$141.57 |
$420.00
|
|
Application of long leg cast 29345
|
$141.57 |
$141.57 |
$141.57 |
$455.00
|
|
Application short leg cast 29405
|
$141.57 |
$141.57 |
$141.57 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$905.52 |
$905.52 |
$905.52 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$905.52 |
$905.52 |
$905.52 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$11.88 |
$11.88 |
$11.88 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$11.88 |
$11.88 |
$11.88 |
$75.60
|
|
Apply forearm splintdynamic 29126
|
$67.98 |
$67.98 |
$67.98 |
$246.18
|
|
Apply interstit radiat compl
|
$2,505.36 |
$2,505.36 |
$2,505.36 |
$2,910.05
|
|
Apply of finger splint 29131
|
$67.98 |
$67.98 |
$67.98 |
$168.00
|
|
Apply rigid leg cast 29445
|
$141.57 |
$141.57 |
$141.57 |
$555.00
|
|
Apply short leg castambul type 29425
|
$141.57 |
$141.57 |
$141.57 |
$381.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$871.27 |
$871.27 |
$871.27 |
$955.43
|
|
Aqaprn-4 antb flo cytmtry ea
|
$106.59 |
$106.59 |
$106.59 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$16.50 |
$16.50 |
$16.50 |
$100.00
|
|
Aquatic exercise - group charge
|
$11.88 |
$11.88 |
$11.88 |
$85.80
|
|
Argatroban nonesrd use 1mg
|
$573.57 |
$573.57 |
$573.57 |
$866.80
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,435.35 |
$1,435.35 |
$1,435.35 |
$1,313.89
|
|
Arterial blood draw/perc 36620
|
$567.27 |
$567.27 |
$567.27 |
$485.69
|
|
Artery xray each vessel 7577426
|
$251.46 |
$251.46 |
$251.46 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$2,814.24 |
$2,814.24 |
$2,814.24 |
$4,446.00
|
|
Artery x-rays adrenal gland
|
$384.12 |
$384.12 |
$384.12 |
$3,439.84
|
|
Artery x-rays arm/leg 75710-26
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,729.00
|
|
Artery x-rays chest
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$2,870.00
|
|
Artery x-rays lung
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,279.12
|
|
Artery x-rays lung
|
$273.57 |
$273.57 |
$273.57 |
$2,451.75
|
|
Artery x-rays lungs
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$2,814.24 |
$2,814.24 |
$2,814.24 |
$4,134.14
|
|
Artery x-rays spine
|
$2,814.24 |
$2,814.24 |
$2,814.24 |
$4,306.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$814.44 |
$814.44 |
$814.44 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$357.06 |
$357.06 |
$357.06 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$191.07 |
$191.07 |
$191.07 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$407.22 |
$407.22 |
$407.22 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$814.44 |
$814.44 |
$814.44 |
$715.37
|
|
Ascenda two piece catheter
|
$21,872.40 |
$21,872.40 |
$21,872.40 |
$22,951.20
|
|
Aspirate bladder/sprapubic cath 51102
|
$679.14 |
$679.14 |
$679.14 |
$3,162.72
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$646.80 |
$646.80 |
$646.80 |
$1,226.87
|
|
Aspir/inj thyroid cyst 60300
|
$358.05 |
$358.05 |
$358.05 |
$850.78
|
|
Assay neurflmnt light chain
|
$425.37 |
$425.37 |
$425.37 |
$380.00
|
|
Assay of galactose
|
$10.56 |
$10.56 |
$10.56 |
$49.21
|
|
Assay of interleukin-6 (il-6)
|
$46.20 |
$46.20 |
$46.20 |
$79.97
|
|
Assay of osteocalcin
|
$55.11 |
$55.11 |
$55.11 |
$92.50
|
|
Assay of procainamide
|
$15.18 |
$15.18 |
$15.18 |
$114.91
|
|
Assay of procainamide w/metab
|
$44.55 |
$44.55 |
$44.55 |
$70.50
|
|
Assay of salicylate
|
$23.76 |
$23.76 |
$23.76 |
$95.00
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$60.06 |
$60.06 |
$60.06 |
$292.50
|
|
Assess cyst contrast inject
|
$44.22 |
$44.22 |
$44.22 |
$447.33
|
|
Assistive tech assessment, ot
|
$14.19 |
$14.19 |
$14.19 |
$96.08
|
|
Ast/sgot
|
$16.50 |
$16.50 |
$16.50 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$12,654.24 |
$12,654.24 |
$12,654.24 |
$23,166.53
|
|
Atropine 0.1 mg/ml injection syringe
|
$45.10 |
$45.10 |
$45.10 |
$51.28
|
|
Augment injectable kit 3.0cc
|
$5,449.95 |
$5,449.95 |
$5,449.95 |
$7,469.28
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$666.60 |
$666.60 |
$666.60 |
$7,109.05
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$2,632.08 |
$2,632.08 |
$2,632.08 |
$10,384.40
|
|
Autologous blood process
|
$193.38 |
$193.38 |
$193.38 |
$262.50
|
|
Automated diff wbc count
|
$21.45 |
$21.45 |
$21.45 |
$38.28
|
|
Avelumab 20 mg/ml intravenous solution
|
$2,425.67 |
$2,425.67 |
$2,425.67 |
$3,683.86
|
|
Avul nail plate addl
|
$288.09 |
$288.09 |
$288.09 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$250.47 |
$250.47 |
$250.47 |
$318.75
|
|
Azacitidine injection
|
$2,047.71 |
$2,047.71 |
$2,047.71 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$0.28 |
$0.28 |
$0.28 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$11.56 |
$11.56 |
$11.56 |
$35.06
|
|
Aztreonam 1 gram solution for injection
|
$98.61 |
$98.61 |
$98.61 |
$157.30
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$2,123.76 |
$2,123.76 |
$2,123.76 |
$1,800.33
|
|
Baclofen eval charges
|
$20.79 |
$20.79 |
$20.79 |
$85.00
|
|
Bacterial meningitis antigen
|
$62.70 |
$62.70 |
$62.70 |
$66.30
|
|
Balloon dilate urtrl strix
|
$99.99 |
$99.99 |
$99.99 |
$2,118.00
|
|
B cells total count
|
$42.24 |
$42.24 |
$42.24 |
$131.30
|
|
Bcg live 50 mg intravesical suspension
|
$198.69 |
$198.69 |
$198.69 |
$378.28
|