|
Antipsychotics nos 1-3
|
$1,116.35 |
$1,116.35 |
$1,116.35 |
$142.42
|
|
Antistreptolysin o screen
|
$653.34 |
$653.34 |
$653.34 |
$60.00
|
|
Antistreptolysin o titer
|
$659.02 |
$659.02 |
$659.02 |
$51.45
|
|
Antithrombin iii activity
|
$1,184.52 |
$1,184.52 |
$1,184.52 |
$114.00
|
|
Apheresis plasma
|
$12,607.97 |
$12,607.97 |
$12,607.97 |
$3,192.96
|
|
Apheresis platelets
|
$2,568.30 |
$2,568.30 |
$2,568.30 |
$2,037.10
|
|
Apheresis rbc
|
$8,806.99 |
$8,806.99 |
$8,806.99 |
$3,146.15
|
|
Appl multlay comprs arm/hand
|
$581.77 |
$581.77 |
$581.77 |
$284.05
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$283.99 |
$283.99 |
$283.99 |
$100.00
|
|
Arformoterol non-comp unit
|
$205.86 |
$205.86 |
$205.86 |
$25.00
|
|
Artery transpose/endovas taa
|
$9,920.04 |
$9,920.04 |
$9,920.04 |
$3,854.40
|
|
Artery xray each vessel 7577426
|
$2,088.15 |
$2,088.15 |
$2,088.15 |
$1,846.10
|
|
Artery xray of abdomen 75726-26
|
$15,527.73 |
$15,527.73 |
$15,527.73 |
$4,446.00
|
|
Artery x-rays chest
|
$9,341.43 |
$9,341.43 |
$9,341.43 |
$2,793.00
|
|
Artery x-rays spine
|
$26,842.81 |
$26,842.81 |
$26,842.81 |
$4,306.40
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,282.32 |
$1,282.32 |
$1,282.32 |
$715.37
|
|
Aspirate pleura without imaging 32554
|
$2,719.90 |
$2,719.90 |
$2,719.90 |
$1,195.15
|
|
Assay acid phosphatase
|
$968.64 |
$968.64 |
$968.64 |
$38.22
|
|
Assay alkaline phosphatase
|
$900.46 |
$900.46 |
$900.46 |
$45.00
|
|
Assay blood catecholamines
|
$1,698.66 |
$1,698.66 |
$1,698.66 |
$144.52
|
|
Assay of adp & amp
|
$1,935.85 |
$1,935.85 |
$1,935.85 |
$169.65
|
|
Assay of estrogen
|
$1,397.56 |
$1,397.56 |
$1,397.56 |
$208.74
|
|
Assay of lap enzyme
|
$967.22 |
$967.22 |
$967.22 |
$73.50
|
|
Assay of lrh hormone
|
$1,232.15 |
$1,232.15 |
$1,232.15 |
$189.50
|
|
Assay of neonatal thyroxine
|
$548.24 |
$548.24 |
$548.24 |
$19.06
|
|
Assay of procainamide
|
$832.29 |
$832.29 |
$832.29 |
$114.91
|
|
Assay of procainamide w/metab
|
$940.24 |
$940.24 |
$940.24 |
$70.50
|
|
Assay of progesterone
|
$1,447.28 |
$1,447.28 |
$1,447.28 |
$285.19
|
|
Assay of prostaglandin
|
$3,222.64 |
$3,222.64 |
$3,222.64 |
$222.04
|
|
Assay of salicylate
|
$340.39 |
$340.39 |
$340.39 |
$95.00
|
|
Assay of sialic acid
|
$752.75 |
$752.75 |
$752.75 |
$92.50
|
|
Assay of thiocyanate
|
$980.00 |
$980.00 |
$980.00 |
$63.72
|
|
Assay phosphatidylglycerol
|
$1,227.13 |
$1,227.13 |
$1,227.13 |
$134.16
|
|
Assay toxin or antitoxin
|
$784.00 |
$784.00 |
$784.00 |
$75.90
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$1,419.50 |
$1,419.50 |
$1,419.50 |
$292.50
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$97.50 |
$97.50 |
$97.50 |
$50.70
|
|
Ast/sgot
|
$515.56 |
$515.56 |
$515.56 |
$45.60
|
|
Athrectomy tib/pero/unilat/ini ves 37229
|
$119,494.07 |
$119,494.07 |
$119,494.07 |
$15,188.25
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$996.37 |
$996.37 |
$996.37 |
$186.60
|
|
Azacitidine injection
|
$19.11 |
$19.11 |
$19.11 |
$1,047.73
|
|
Azathioprine 50 mg tablet
|
$37.05 |
$37.05 |
$37.05 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$901.66 |
$901.66 |
$901.66 |
$35.22
|
|
Aztreonam 1 gram solution for injection
|
$447.40 |
$447.40 |
$447.40 |
$157.30
|
|
Baclofen eval charges
|
$381.80 |
$381.80 |
$381.80 |
$84.15
|
|
Bactericidal level serum
|
$1,359.21 |
$1,359.21 |
$1,359.21 |
$121.80
|
|
Balloon dilate urtrl strix
|
$15,829.48 |
$15,829.48 |
$15,829.48 |
$2,082.30
|
|
Barrier film 1.0ml wipe
|
$34.00 |
$34.00 |
$34.00 |
$17.66
|
|
Barrier film 28ml spray no stng cavilon
|
$214.00 |
$214.00 |
$214.00 |
$19.50
|
|
Becaplermin 0.01% gel 15 gm
|
$10,618.70 |
$10,618.70 |
$10,618.70 |
$47.04
|
|
Behavior counsel obesity 15min medicare g0447
|
$100.31 |
$100.31 |
$100.31 |
$102.47
|
|
Belt ostomy lg 34-65in
|
$34.00 |
$34.00 |
$34.00 |
$7.45
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$189.66 |
$189.66 |
$189.66 |
$4,702.68
|
|
Benztropine 1 mg/ml injection solution
|
$544.84 |
$544.84 |
$544.84 |
$103.27
|
|
Beta-2 microglobulin
|
$1,414.61 |
$1,414.61 |
$1,414.61 |
$85.20
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$188.02 |
$188.02 |
$188.02 |
$64.15
|
|
Bile acids cholylglycine
|
$980.00 |
$980.00 |
$980.00 |
$125.58
|
|
Bilicheck
|
$102.25 |
$102.25 |
$102.25 |
$28.00
|
|
Bilirubin direct
|
$445.96 |
$445.96 |
$445.96 |
$49.86
|
|
Bilirubin total
|
$471.54 |
$471.54 |
$471.54 |
$52.00
|
|
Biodfence dryflex, 1cm
|
$44,618.00 |
$44,618.00 |
$44,618.00 |
$4,528.16
|
|
Biofeedback, pt
|
$260.12 |
$260.12 |
$260.12 |
$118.25
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$7,020.75 |
$7,020.75 |
$7,020.75 |
$2,747.00
|
|
Biopsy of heart lining
|
$19,813.64 |
$19,813.64 |
$19,813.64 |
$3,640.00
|
|
Biotinidase - quest
|
$974.32 |
$974.32 |
$974.32 |
$70.56
|
|
Biovance 1 square cm
|
$32,621.00 |
$32,621.00 |
$32,621.00 |
$7,928.07
|
|
Bleomycin 15 unit solution for injection
|
$4,773.20 |
$4,773.20 |
$4,773.20 |
$220.45
|
|
Blood Clotting (PT/INR) Test
|
$683.15 |
$683.15 |
$683.15 |
$52.80
|
|
Blood Clotting (PTT) Test
|
$646.23 |
$646.23 |
$646.23 |
$72.64
|
|
Blood Count (CBC) Test (without differential)
|
$769.80 |
$769.80 |
$769.80 |
$61.11
|
|
Blood Culture Test
|
$1,116.35 |
$1,116.35 |
$1,116.35 |
$145.60
|
|
Blood gases o2 saturation direct measurement
|
$290.23 |
$290.23 |
$290.23 |
$213.60
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$84.21 |
$84.21 |
$84.21 |
$57.00
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$366.43 |
$366.43 |
$366.43 |
$32.50
|
|
Blood occult peroxidase activity qualitative gastric
|
$257.07 |
$257.07 |
$257.07 |
$33.85
|
|
Blood smear microscopic w manual differential wbc count
|
$257.07 |
$257.07 |
$257.07 |
$38.61
|
|
Blood typing abo
|
$548.24 |
$548.24 |
$548.24 |
$83.03
|
|
Blood typing ag donor ea ag
|
$590.84 |
$590.84 |
$590.84 |
$190.00
|
|
Blood typing rbc ag non abo/rh ea
|
$590.84 |
$590.84 |
$590.84 |
$196.95
|
|
Blood typing rh (d)
|
$502.78 |
$502.78 |
$502.78 |
$57.00
|
|
Blood typing rh phenotype complete reference
|
$921.77 |
$921.77 |
$921.77 |
$82.50
|
|
Bone Density Scan (DEXA)
|
$1,413.21 |
$1,413.21 |
$1,413.21 |
$395.00
|
|
Bone imaging multiple areas
|
$8,699.40 |
$8,699.40 |
$8,699.40 |
$1,194.00
|
|
Bone/joint imaging ltd area
|
$5,398.81 |
$5,398.81 |
$5,398.81 |
$1,006.56
|
|
Bone marrow imaging ltd
|
$5,398.81 |
$5,398.81 |
$5,398.81 |
$811.00
|
|
Bone marrow interpretation
|
$795.37 |
$795.37 |
$795.37 |
$542.03
|
|
Bone survey-lead poisoning
|
$590.20 |
$590.20 |
$590.20 |
$387.00
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$345.14 |
$345.14 |
$345.14 |
$92.88
|
|
(both sides) smear without diff wbc count
|
$83.68 |
$83.68 |
$83.68 |
$30.68
|
|
Bowel imaging
|
$3,438.13 |
$3,438.13 |
$3,438.13 |
$1,065.00
|
|
Brace adj motion lerman type
|
$759.00 |
$759.00 |
$759.00 |
$281.75
|
|
Brace afo lg left 6607
|
$2,258.00 |
$2,258.00 |
$2,258.00 |
$461.76
|
|
Brace ank aftr bioskn med lg
|
$191.00 |
$191.00 |
$191.00 |
$190.72
|
|
Brace ankle joint dflxn assist
|
$1,631.00 |
$1,631.00 |
$1,631.00 |
$142.89
|
|
Brace halo bremer l2830
|
$3,093.00 |
$3,093.00 |
$3,093.00 |
$195.59
|
|
Brace kafo dbl upright cust
|
$7,201.00 |
$7,201.00 |
$7,201.00 |
$3,609.22
|
|
Brace knee postop tscope xl
|
$1,619.00 |
$1,619.00 |
$1,619.00 |
$901.93
|
|
Brace m arm board
|
$6,028.00 |
$6,028.00 |
$6,028.00 |
$121.10
|
|
Brace oths wrist hnd fngr without
|
$743.00 |
$743.00 |
$743.00 |
$245.00
|
|
Brachy source iodine-125 nonstranded
|
$333.00 |
$333.00 |
$333.00 |
$68.20
|
|
Braf gene
|
$3,429.99 |
$3,429.99 |
$3,429.99 |
$422.40
|
