|
Ammonia
|
$44.63 |
$44.63 |
$44.63 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$314.48 |
$314.48 |
$314.48 |
$942.60
|
|
Amniocentesis therapeutic
|
$130.38 |
$130.38 |
$130.38 |
$778.57
|
|
Amniotic fluid scan
|
$36.58 |
$36.58 |
$36.58 |
$33.15
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$819.88 |
$819.88 |
$819.88 |
$3,835.20
|
|
Amphetamines 5 or more
|
$3.68 |
$3.68 |
$3.68 |
$101.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$12.88 |
$12.88 |
$12.88 |
$130.08
|
|
Amphotericin b lipid complex
|
$30.62 |
$30.62 |
$30.62 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$14.15 |
$14.15 |
$14.15 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$5.25 |
$5.25 |
$5.25 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$4.20 |
$4.20 |
$4.20 |
$51.93
|
|
Amputation toe interphalangeal joint
|
$131.78 |
$131.78 |
$131.78 |
$3,691.20
|
|
Amputation toe metatarsophalangeal joint
|
$1,014.30 |
$1,014.30 |
$1,014.30 |
$3,777.93
|
|
Amylase
|
$62.13 |
$62.13 |
$62.13 |
$93.00
|
|
Anal/urinary muscle study
|
$17.50 |
$17.50 |
$17.50 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$47.25 |
$47.25 |
$47.25 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$127.75 |
$127.75 |
$127.75 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$141.93 |
$141.93 |
$141.93 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$14.70 |
$14.70 |
$14.70 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$45.33 |
$45.33 |
$45.33 |
$411.45
|
|
An cholangiogram percutaneous compl
|
$536.03 |
$536.03 |
$536.03 |
$2,626.65
|
|
An fluoro guide for cvp
|
$284.03 |
$284.03 |
$284.03 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,697.28 |
$2,697.28 |
$2,697.28 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$6,084.05 |
$6,084.05 |
$6,084.05 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$4,271.40 |
$4,271.40 |
$4,271.40 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$1,720.43 |
$1,720.43 |
$1,720.43 |
$6,513.10
|
|
Angiotensin ii
|
$114.80 |
$114.80 |
$114.80 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$40.23 |
$40.23 |
$40.23 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$4,649.58 |
$4,649.58 |
$4,649.58 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,462.48 |
$1,462.48 |
$1,462.48 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$2,355.50 |
$2,355.50 |
$2,355.50 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,462.48 |
$1,462.48 |
$1,462.48 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$1,697.85 |
$1,697.85 |
$1,697.85 |
$8,689.20
|
|
Anl sp inf pmp w/mdreprg&fil
|
$202.48 |
$202.48 |
$202.48 |
$693.75
|
|
Annual alcohol screen 15 min
|
$4.20 |
$4.20 |
$4.20 |
$35.08
|
|
Annual Physical, Established Patient (age 18-39)
|
$19.08 |
$19.08 |
$19.08 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$22.40 |
$22.40 |
$22.40 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$26.25 |
$26.25 |
$26.25 |
$188.15
|
|
Anogenital exam child w imag
|
$11.20 |
$11.20 |
$11.20 |
$195.96
|
|
Anora (draw only)
|
$14.35 |
$14.35 |
$14.35 |
$36.00
|
|
Anoscopy control bleeding 46614
|
$333.90 |
$333.90 |
$333.90 |
$1,405.05
|
|
Anoscopy remove fb 46608
|
$333.90 |
$333.90 |
$333.90 |
$1,208.35
|
|
Antibody elution rbc reference
|
$107.63 |
$107.63 |
$107.63 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$26.60 |
$26.60 |
$26.60 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$141.23 |
$141.23 |
$141.23 |
$220.73
|
|
Antibody id rbc panel
|
$206.33 |
$206.33 |
$206.33 |
$291.75
|
|
Antibody influenza virus
|
$32.73 |
$32.73 |
$32.73 |
$53.95
|
|
Antibody screen rbc
|
$40.60 |
$40.60 |
$40.60 |
$105.00
|
|
Antidepressant not specified
|
$3.68 |
$3.68 |
$3.68 |
$89.50
|
|
Antigen therapy services
|
$3.15 |
$3.15 |
$3.15 |
$60.75
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$0.19 |
$0.19 |
$0.19 |
$3.12
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$34.30 |
$34.30 |
$34.30 |
$45.82
|
|
Antinuclear antibodies
|
$45.68 |
$45.68 |
$45.68 |
$91.70
|
|
Antistreptolysin o screen
|
$20.65 |
$20.65 |
$20.65 |
$59.40
|
|
Antistreptolysin o titer
|
$34.83 |
$34.83 |
$34.83 |
$57.96
|
|
Antithrombin iii activity
|
$97.30 |
$97.30 |
$97.30 |
$115.23
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,109.33 |
$1,109.33 |
$1,109.33 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$273.18 |
$273.18 |
$273.18 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$124.25 |
$124.25 |
$124.25 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$968.63 |
$968.63 |
$968.63 |
$3,150.00
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$219.45 |
$219.45 |
$219.45 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$82.78 |
$82.78 |
$82.78 |
$508.18
|
|
Application finger splntstatic 29130
|
$37.80 |
$37.80 |
$37.80 |
$216.80
|
|
Application long leg splint 29505
|
$106.93 |
$106.93 |
$106.93 |
$340.80
|
|
Application lower leg splint 29515
|
$128.28 |
$128.28 |
$128.28 |
$355.85
|
|
Application multi layer compression below knee (both sides)
|
$250.60 |
$250.60 |
$250.60 |
$397.00
|
|
Application of forearm cast 29075
|
$67.55 |
$67.55 |
$67.55 |
$379.20
|
|
Application of long arm cast 29065
|
$82.60 |
$82.60 |
$82.60 |
$404.63
|
|
Application of long leg cast
|
$42.53 |
$42.53 |
$42.53 |
$406.75
|
|
Application of long leg cast 29345
|
$103.08 |
$103.08 |
$103.08 |
$511.68
|
|
Application of paste boot 29580
|
$161.70 |
$161.70 |
$161.70 |
$331.74
|
|
Application short leg cast 29405
|
$106.58 |
$106.58 |
$106.58 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$463.58 |
$463.58 |
$463.58 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$413.88 |
$413.88 |
$413.88 |
$2,120.95
|
|
Apply forearm splintdynamic 29126
|
$153.65 |
$153.65 |
$153.65 |
$263.10
|
|
Apply hand/wrist cast 29085
|
$57.75 |
$57.75 |
$57.75 |
$272.46
|
|
Apply interstit radiat compl
|
$1,121.93 |
$1,121.93 |
$1,121.93 |
$2,877.50
|
|
Apply intrcav radiat compl
|
$892.15 |
$892.15 |
$892.15 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$686.70 |
$686.70 |
$686.70 |
$1,338.48
|
|
Apply intrcav radiat simple
|
$468.65 |
$468.65 |
$468.65 |
$1,001.00
|
|
Apply of finger splint 29131
|
$42.70 |
$42.70 |
$42.70 |
$177.45
|
|
Apply rigid leg cast 29445
|
$138.78 |
$138.78 |
$138.78 |
$608.00
|
|
Apply short leg castambul type 29425
|
$110.60 |
$110.60 |
$110.60 |
$408.75
|
|
Argatroban nonesrd use 1mg
|
$87.50 |
$87.50 |
$87.50 |
$881.10
|
|
Arterial blood draw/perc 36620
|
$47.08 |
$47.08 |
$47.08 |
$505.60
|
|
Artery xray each vessel 7577426
|
$311.50 |
$311.50 |
$311.50 |
$1,752.53
|
|
Artery xray of abdomen 75726-26
|
$1,694.88 |
$1,694.88 |
$1,694.88 |
$4,337.45
|
|
Artery x-rays adrenal gland
|
$591.68 |
$591.68 |
$591.68 |
$3,320.35
|
|
Artery x-rays adrenals
|
$2,525.43 |
$2,525.43 |
$2,525.43 |
$3,706.68
|
|
Artery x-rays arm/leg 75710-26
|
$1,491.18 |
$1,491.18 |
$1,491.18 |
$3,439.84
|
|
Artery x-rays arms/legs 75716-26
|
$1,625.23 |
$1,625.23 |
$1,625.23 |
$3,844.10
|
|
Artery x-rays chest
|
$580.65 |
$580.65 |
$580.65 |
$2,587.20
|
|
Artery x-rays lung
|
$668.15 |
$668.15 |
$668.15 |
$2,921.88
|
|
Artery x-rays lung
|
$515.73 |
$515.73 |
$515.73 |
$2,332.57
|
|
Artery x-rays lungs
|
$917.53 |
$917.53 |
$917.53 |
$3,686.58
|
|
Artery xrays of pelvis 75736 26
|
$2,531.90 |
$2,531.90 |
$2,531.90 |
$4,086.49
|
|
Artery x-rays spine
|
$1,087.10 |
$1,087.10 |
$1,087.10 |
$4,306.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$241.85 |
$241.85 |
$241.85 |
$567.78
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$340.20 |
$340.20 |
$340.20 |
$976.09
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$387.98 |
$387.98 |
$387.98 |
$910.79
|