|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$3,101.50 |
$3,101.50 |
$3,101.50 |
$549.08
|
|
Appl bdy cst sho to hip 1thi
|
$367.00 |
$367.00 |
$367.00 |
$353.60
|
|
Appl bdy cst sho to hip b th
|
$367.00 |
$367.00 |
$367.00 |
$561.60
|
|
Appl bdy cst sho to hip head
|
$198.00 |
$198.00 |
$198.00 |
$561.60
|
|
Appl body cast sho to hips
|
$367.00 |
$367.00 |
$367.00 |
$480.00
|
|
Appl cast figure-of-eight
|
$198.00 |
$198.00 |
$198.00 |
$314.28
|
|
Appl cast plaster velpeau
|
$198.00 |
$198.00 |
$198.00 |
$314.28
|
|
Appl cast shoulder spica
|
$367.00 |
$367.00 |
$367.00 |
$468.00
|
|
Appl halo type body cast
|
$198.00 |
$198.00 |
$198.00 |
$561.60
|
|
Appl hip spica cast1&1/2
|
$367.00 |
$367.00 |
$367.00 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$367.00 |
$367.00 |
$367.00 |
$499.20
|
|
Application clubfoot cast
|
$167.50 |
$167.50 |
$167.50 |
$303.00
|
|
Application finger splntstatic 29130
|
$445.00 |
$445.00 |
$445.00 |
$219.00
|
|
Application long leg splint 29505
|
$375.50 |
$375.50 |
$375.50 |
$356.85
|
|
Application lower leg splint 29515
|
$443.00 |
$443.00 |
$443.00 |
$355.85
|
|
Application multi layer compression below knee (both sides)
|
$598.00 |
$598.00 |
$598.00 |
$377.25
|
|
Application of body cast
|
$367.00 |
$367.00 |
$367.00 |
$557.18
|
|
Application of body cast
|
$367.00 |
$367.00 |
$367.00 |
$390.73
|
|
Application of forearm cast 29075
|
$299.50 |
$299.50 |
$299.50 |
$367.65
|
|
Application of long arm cast 29065
|
$395.00 |
$395.00 |
$395.00 |
$404.63
|
|
Application of long leg cast 29345
|
$367.00 |
$367.00 |
$367.00 |
$486.03
|
|
Application of paste boot 29580
|
$598.00 |
$598.00 |
$598.00 |
$331.74
|
|
Application short leg cast 29405
|
$367.00 |
$367.00 |
$367.00 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,101.50 |
$3,101.50 |
$3,101.50 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,101.50 |
$3,101.50 |
$3,101.50 |
$2,189.70
|
|
Appl long leg cast brace
|
$367.00 |
$367.00 |
$367.00 |
$468.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$66.50 |
$66.50 |
$66.50 |
$66.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$71.00 |
$71.00 |
$71.00 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$275.00 |
$275.00 |
$275.00 |
$297.50
|
|
Appl patllr tdn bearing cast
|
$367.00 |
$367.00 |
$367.00 |
$429.00
|
|
Apply forearm splintdynamic 29126
|
$169.00 |
$169.00 |
$169.00 |
$259.20
|
|
Apply hand/wrist cast 29085
|
$191.00 |
$191.00 |
$191.00 |
$279.40
|
|
Apply interstit radiat compl
|
$2,957.00 |
$2,957.00 |
$2,957.00 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$1,813.50 |
$1,813.50 |
$1,813.50 |
$1,773.02
|
|
Apply intrcav radiat interm
|
$1,592.00 |
$1,592.00 |
$1,592.00 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$1,376.00 |
$1,376.00 |
$1,376.00 |
$1,269.97
|
|
Apply of finger splint 29131
|
$250.00 |
$250.00 |
$250.00 |
$171.00
|
|
Apply rigid leg cast 29445
|
$523.00 |
$523.00 |
$523.00 |
$585.31
|
|
Apply short leg castambul type 29425
|
$277.50 |
$277.50 |
$277.50 |
$452.20
|
|
Apply surf ldr radionuclide
|
$246.00 |
$246.00 |
$246.00 |
$251.55
|
|
Aquaporin-4 antibody cba each
|
$401.00 |
$401.00 |
$401.00 |
$116.80
|
|
Aquaporin-4 antibody elisa
|
$380.50 |
$380.50 |
$380.50 |
$138.87
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$80.50 |
$80.50 |
$80.50 |
$100.00
|
|
Aquatic exercise - group charge
|
$84.00 |
$84.00 |
$84.00 |
$87.23
|
|
Arterial blood draw/perc 36620
|
$997.00 |
$997.00 |
$997.00 |
$495.00
|
|
Artery xray each vessel 7577426
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$1,865.50
|
|
Artery xray of abdomen 75726-26
|
$4,898.50 |
$4,898.50 |
$4,898.50 |
$4,412.00
|
|
Artery x-rays adrenal gland
|
$2,798.50 |
$2,798.50 |
$2,798.50 |
$3,476.40
|
|
Artery x-rays adrenals
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$3,764.59
|
|
Artery x-rays arm/leg 75710-26
|
$2,325.50 |
$2,325.50 |
$2,325.50 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$2,905.50 |
$2,905.50 |
$2,905.50 |
$3,729.00
|
|
Artery x-rays chest
|
$1,736.00 |
$1,736.00 |
$1,736.00 |
$2,628.15
|
|
Artery x-rays lung
|
$4,898.50 |
$4,898.50 |
$4,898.50 |
$3,286.20
|
|
Artery x-rays lung
|
$2,427.50 |
$2,427.50 |
$2,427.50 |
$2,480.86
|
|
Artery x-rays lungs
|
$4,898.50 |
$4,898.50 |
$4,898.50 |
$3,707.88
|
|
Artery xrays of pelvis 75736 26
|
$4,898.50 |
$4,898.50 |
$4,898.50 |
$4,369.50
|
|
Artery x-rays spine
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$4,294.50
|
|
Art expos/graft artery perfusion 33987
|
$155.00 |
$155.00 |
$155.00 |
$370.50
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$423.00 |
$423.00 |
$423.00 |
$588.53
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$629.50 |
$629.50 |
$629.50 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$656.00 |
$656.00 |
$656.00 |
$956.00
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$459.50 |
$459.50 |
$459.50 |
$471.34
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$553.50 |
$553.50 |
$553.50 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$459.50 |
$459.50 |
$459.50 |
$716.94
|
|
Arthrodesis glenohumeral jt
|
$5,484.50 |
$5,484.50 |
$5,484.50 |
$6,839.00
|
|
Arthrotomy/elbow/exp/drain/rmv fb 24000
|
$3,704.00 |
$3,704.00 |
$3,704.00 |
$3,839.54
|
|
Art pressure waveform analys
|
$55.00 |
$55.00 |
$55.00 |
$55.00
|
|
Ascenda two piece catheter
|
$11,042.04 |
$11,042.04 |
$11,042.04 |
$22,713.60
|
|
Aspa gene
|
$142.50 |
$142.50 |
$142.50 |
$140.00
|
|
Asp core fat pad
|
$680.00 |
$680.00 |
$680.00 |
$1,189.32
|
|
Asp & inj w/heparin pleurx cath
|
$1,088.00 |
$1,088.00 |
$1,088.00 |
$1,434.00
|
|
Aspirate bladder/sprapubic cath 51102
|
$2,337.50 |
$2,337.50 |
$2,337.50 |
$3,199.51
|
|
Aspirate/inj ganglion cyst 20612
|
$308.00 |
$308.00 |
$308.00 |
$436.10
|
|
Aspirate pleura without imaging 32554
|
$1,298.00 |
$1,298.00 |
$1,298.00 |
$1,272.70
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$988.50 |
$988.50 |
$988.50 |
$1,267.59
|
|
Aspiration peritonsillar abscess
|
$282.50 |
$282.50 |
$282.50 |
$548.80
|
|
Aspir/inj thyroid cyst 60300
|
$1,077.50 |
$1,077.50 |
$1,077.50 |
$914.34
|
|
Asp pq spinal cord cyst/syrinx
|
$817.50 |
$817.50 |
$817.50 |
$1,322.40
|
|
Assay acid phosphatase
|
$96.50 |
$96.50 |
$96.50 |
$38.22
|
|
Assay dir meas fr estradiol
|
$36.50 |
$36.50 |
$36.50 |
$70.20
|
|
Assay of adp & amp
|
$189.50 |
$189.50 |
$189.50 |
$149.50
|
|
Assay of androsterone
|
$385.50 |
$385.50 |
$385.50 |
$95.93
|
|
Assay of chloramphenicol
|
$96.00 |
$96.00 |
$96.00 |
$58.50
|
|
Assay of glutathione
|
$222.00 |
$222.00 |
$222.00 |
$75.00
|
|
Assay of interleukin-6 (il-6)
|
$228.00 |
$228.00 |
$228.00 |
$77.35
|
|
Assay of lap enzyme
|
$251.00 |
$251.00 |
$251.00 |
$72.00
|
|
Assay of leflunomide
|
$265.00 |
$265.00 |
$265.00 |
$92.50
|
|
Assay of osteocalcin
|
$265.50 |
$265.50 |
$265.50 |
$93.00
|
|
Assay of procainamide w/metab
|
$31.00 |
$31.00 |
$31.00 |
$63.07
|
|
Assay of prostaglandin
|
$218.50 |
$218.50 |
$218.50 |
$218.50
|
|
Assay of salicylate
|
$96.50 |
$96.50 |
$96.50 |
$95.00
|
|
Assay of sialic acid
|
$86.00 |
$86.00 |
$86.00 |
$86.00
|
|
Assay of somatostatin
|
$333.50 |
$333.50 |
$333.50 |
$165.60
|
|
Assay of thiocyanate
|
$76.00 |
$76.00 |
$76.00 |
$62.72
|
|
Assay of urine sulfate
|
$32.50 |
$32.50 |
$32.50 |
$30.00
|
|
Assay toxin or antitoxin
|
$10.00 |
$10.00 |
$10.00 |
$75.90
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$152.00 |
$152.00 |
$152.00 |
$292.50
|
|
Assess cyst contrast inject
|
$308.00 |
$308.00 |
$308.00 |
$456.33
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$20.00 |
$20.00 |
$20.00 |
$47.60
|
|
Ast/sgot
|
$65.50 |
$65.50 |
$65.50 |
$45.60
|
