|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,033.56 |
$2,033.56 |
$3,840.60 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$576.30 |
$576.30 |
$1,051.25 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$213.00 |
$213.00 |
$759.40 |
$512.20
|
|
Appl cast figure-of-eight
|
$278.22 |
$278.22 |
$278.22 |
$314.28
|
|
Appl cast plaster velpeau
|
$278.22 |
$278.22 |
$278.22 |
$314.28
|
|
Appl cast shoulder spica
|
$278.22 |
$278.22 |
$278.22 |
$486.03
|
|
Appl hip spica cast 1 leg
|
$895.29 |
$895.29 |
$895.29 |
$499.20
|
|
Application finger splntstatic 29130
|
$154.65 |
$154.65 |
$319.57 |
$208.50
|
|
Application long leg splint 29505
|
$356.85 |
$356.85 |
$465.08 |
$338.25
|
|
Application lower leg splint 29515
|
$192.60 |
$192.60 |
$412.36 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$192.60 |
$192.60 |
$491.36 |
$375.06
|
|
Application of cylinder cast 29365
|
$431.08 |
$431.08 |
$431.08 |
$431.08
|
|
Application of forearm cast 29075
|
$306.75 |
$306.75 |
$331.13 |
$358.20
|
|
Application of long arm cast 29065
|
$356.85 |
$356.85 |
$401.40 |
$396.77
|
|
Application of long leg cast
|
$387.37 |
$387.37 |
$387.37 |
$435.54
|
|
Application of long leg cast 29345
|
$337.05 |
$337.05 |
$464.51 |
$455.00
|
|
Application of paste boot 29580
|
$192.60 |
$331.74 |
$883.07 |
$340.11
|
|
Application short leg cast 29405
|
$339.15 |
$339.15 |
$397.33 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,189.70 |
$2,189.70 |
$3,014.19 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,189.70 |
$2,189.70 |
$2,413.96 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$738.00 |
$738.00 |
$22,932.00 |
$981.75
|
|
Appl long leg cast brace
|
$375.00 |
$375.00 |
$375.00 |
$468.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$84.96 |
$96.30 |
$112.00 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$103.50 |
$103.50 |
$103.50 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$45.00 |
$45.00 |
$45.00 |
$54.61
|
|
Appl multlay comprs arm/hand
|
$185.10 |
$185.10 |
$185.10 |
$289.60
|
|
Apply forearm splintdynamic 29126
|
$401.08 |
$401.08 |
$407.55 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$294.90 |
$294.90 |
$368.08 |
$271.80
|
|
Apply interstit radiat compl
|
$867.00 |
$1,162.45 |
$7,265.06 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$1,107.14 |
$1,107.14 |
$1,107.14 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$3,384.04 |
$3,384.04 |
$3,384.04 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$796.97 |
$796.97 |
$796.97 |
$1,269.97
|
|
Apply of finger splint 29131
|
$154.65 |
$154.65 |
$199.61 |
$177.45
|
|
Apply rigid leg cast 29445
|
$339.15 |
$339.15 |
$585.31 |
$555.00
|
|
Apply short leg castambul type 29425
|
$486.39 |
$486.39 |
$486.39 |
$404.74
|
|
Apply surf ldr radionuclide
|
$130.96 |
$130.96 |
$130.96 |
$282.80
|
|
App mdlty 1+hubbrd tnk ea 15
|
$556.89 |
$556.89 |
$556.89 |
$141.39
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1,179.71 |
$1,179.71 |
$4,219.50 |
$955.43
|
|
Aqaprn-4 antb flo cytmtry ea
|
$202.11 |
$350.00 |
$525.09 |
$231.66
|
|
Aqmbf pet rest & rx stress
|
$134.48 |
$134.48 |
$134.48 |
$974.40
|
|
Aquaporin-4 antibody cba each
|
$225.00 |
$375.00 |
$2,221.80 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$163.00 |
$232.50 |
$2,221.80 |
$150.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$90.52 |
$90.52 |
$113.70 |
$100.75
|
|
Aquatic exercise - group charge
|
$112.00 |
$112.00 |
$327.15 |
$87.45
|
|
Arformoterol non-comp unit
|
$24.24 |
$24.24 |
$117.27 |
$24.24
|
|
Argatroban esrd dialysis 1mg
|
$775.00 |
$934.80 |
$1,489.62 |
$934.80
|
|
Argatroban nonesrd use 1mg
|
$516.44 |
$516.44 |
$1,648.48 |
$881.10
|
|
Arm CT Scan (with contrast, both arms)
|
$1,925.50 |
$1,925.50 |
$2,394.81 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,675.00 |
$1,675.00 |
$1,991.85 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$277.80 |
$471.39 |
$506.50 |
$426.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$330.00 |
$1,176.12 |
$8,592.14 |
$1,303.25
|
|
Art bypass femoral-popliteal 35656
|
$3,542.40 |
$3,542.40 |
$3,542.40 |
$5,273.60
|
|
Arterial blood draw/perc 36620
|
$205.20 |
$696.03 |
$3,519.81 |
$478.96
|
|
Artery xray each vessel 7577426
|
$1,369.00 |
$1,964.64 |
$10,541.53 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$3,267.30 |
$4,515.50 |
$14,597.57 |
$4,618.71
|
|
Artery x-rays adrenal gland
|
$1,749.50 |
$2,001.74 |
$6,385.35 |
$3,320.35
|
|
Artery x-rays adrenals
|
$1,827.00 |
$2,924.46 |
$6,385.35 |
$3,764.59
|
|
Artery x-rays arm/leg 75710-26
|
$3,144.82 |
$3,480.00 |
$4,886.50 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$3,232.20 |
$3,570.38 |
$3,583.00 |
$3,860.40
|
|
Artery x-rays chest
|
$1,629.33 |
$1,749.50 |
$6,220.53 |
$2,895.07
|
|
Artery x-rays lung
|
$1,831.50 |
$3,150.00 |
$5,010.57 |
$3,296.15
|
|
Artery x-rays lung
|
$1,704.33 |
$2,104.00 |
$6,231.70 |
$2,427.50
|
|
Artery x-rays lungs
|
$1,998.50 |
$1,998.50 |
$3,535.57 |
$3,660.60
|
|
Artery xrays of pelvis 75736 26
|
$3,267.30 |
$3,607.50 |
$20,607.36 |
$4,306.40
|
|
Artery x-rays spine
|
$3,267.30 |
$4,136.50 |
$20,607.36 |
$4,792.33
|
|
Art expos/graft artery perfusion 33987
|
$4,871.70 |
$4,871.70 |
$4,871.70 |
$446.41
|
|
Arthrd si jt perq/min nvas
|
$16,475.00 |
$16,475.00 |
$16,475.00 |
$15,959.91
|
|
Arthrd si jt prq wo tfxj dev
|
$16,475.00 |
$16,475.00 |
$16,475.00 |
$21,762.05
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$588.53 |
$588.53 |
$926.10 |
$609.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,045.65 |
$1,045.65 |
$1,107.19 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$441.30 |
$441.30 |
$1,123.56 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$361.05 |
$361.05 |
$602.98 |
$494.40
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$447.75 |
$447.75 |
$807.56 |
$699.00
|
|
Arthroplasty finger joint 26535
|
$4,858.65 |
$4,858.65 |
$4,858.65 |
$4,160.64
|
|
Arthrotomy carpometacarpal joint 26070
|
$1,551.05 |
$1,551.05 |
$1,551.05 |
$1,893.86
|
|
Arthrp w/prostc dst rds&crps
|
$18,190.19 |
$18,190.19 |
$18,190.19 |
$18,190.19
|
|
Arthrt elbw synovial bx only
|
$3,719.72 |
$3,719.72 |
$3,719.72 |
$3,821.05
|
|
Artificial larynx
|
$76.20 |
$76.20 |
$76.20 |
$713.44
|
|
Artiss fibrin sealant
|
$2,195.53 |
$2,195.53 |
$2,195.53 |
$1,501.22
|
|
Ascenda two piece catheter
|
$20,548.50 |
$20,548.50 |
$24,064.92 |
$22,792.00
|
|
Ashkenazi jewish assoc dis
|
$357.79 |
$357.79 |
$357.79 |
$2,693.42
|
|
Aspa gene
|
$43.50 |
$43.50 |
$43.50 |
$133.84
|
|
Asp core fat pad
|
$2,338.20 |
$2,338.20 |
$6,123.65 |
$1,123.50
|
|
Asp & inj w/heparin pleurx cath
|
$442.95 |
$442.95 |
$6,577.60 |
$1,546.46
|
|
Aspirate bladder/sprapubic cath 51102
|
$3,009.45 |
$3,009.45 |
$3,872.67 |
$3,226.20
|
|
Aspirate/inj ganglion cyst 20612
|
$433.07 |
$433.07 |
$441.30 |
$441.30
|
|
Aspirate pleura without imaging 32554
|
$1,049.55 |
$1,347.27 |
$5,208.01 |
$1,195.15
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$526.50 |
$526.50 |
$1,526.97 |
$1,250.04
|
|
Aspiration peritonsillar abscess
|
$678.00 |
$678.00 |
$4,889.81 |
$431.20
|
|
Aspir/inj thyroid cyst 60300
|
$833.29 |
$833.29 |
$1,053.00 |
$872.50
|
|
Assay acid phosphatase
|
$7.00 |
$214.20 |
$459.84 |
$38.22
|
|
Assay dir meas fr estradiol
|
$304.50 |
$304.50 |
$2,062.06 |
$68.00
|
|
Assay free hydroxyproline
|
$2,107.25 |
$2,107.25 |
$2,107.25 |
$57.60
|
|
Assay myeloperoxidase
|
$15.36 |
$24.50 |
$24.50 |
$97.41
|
|
Assay neurflmnt light chain
|
$897.75 |
$897.75 |
$897.75 |
$380.00
|
|
Assay of adp & amp
|
$231.17 |
$231.17 |
$2,145.97 |
$169.65
|
|
Assay of androsterone
|
$19.00 |
$19.00 |
$382.72 |
$114.00
|
|
Assay of breath ethanol
|
$52.62 |
$71.00 |
$71.00 |
$52.62
|
|
Assay of chloramphenicol
|
$120.60 |
$120.60 |
$406.60 |
$70.56
|
|
Assay of corticosterone
|
$23.00 |
$23.00 |
$23.00 |
$55.20
|
