|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$934.75 |
$934.75 |
$934.75 |
$498.81
|
|
Application finger splntstatic 29130
|
$205.00 |
$205.00 |
$205.00 |
$208.16
|
|
Application long leg splint 29505
|
$256.50 |
$256.50 |
$256.50 |
$338.25
|
|
Application lower leg splint 29515
|
$311.00 |
$311.00 |
$311.00 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$355.00 |
$355.00 |
$355.00 |
$373.20
|
|
Application of forearm cast 29075
|
$423.00 |
$423.00 |
$423.00 |
$339.30
|
|
Application of long arm cast 29065
|
$423.00 |
$423.00 |
$423.00 |
$395.00
|
|
Application of paste boot 29580
|
$692.00 |
$692.00 |
$692.00 |
$331.74
|
|
Application short leg cast 29405
|
$423.00 |
$423.00 |
$423.00 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,713.75 |
$1,713.75 |
$1,713.75 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,271.67 |
$1,271.67 |
$1,271.67 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$527.50 |
$527.50 |
$527.50 |
$744.90
|
|
Appl mltpln uni ext fixj sys
|
$5,132.33 |
$5,132.33 |
$5,132.33 |
$5,668.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$39.00 |
$39.00 |
$39.00 |
$66.00
|
|
Apply short leg castambul type 29425
|
$423.00 |
$423.00 |
$423.00 |
$381.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$543.68 |
$543.68 |
$543.68 |
$955.43
|
|
Aqaprn-4 antb flo cytmtry ea
|
$390.00 |
$390.00 |
$390.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$142.50 |
$142.50 |
$142.50 |
$138.16
|
|
Aquatic exercise - group charge
|
$66.00 |
$66.00 |
$66.00 |
$85.80
|
|
Arterial blood draw/perc 36620
|
$137.00 |
$137.00 |
$137.00 |
$485.69
|
|
Artery-vein nonautograft
|
$15,039.00 |
$15,039.00 |
$15,039.00 |
$6,396.89
|
|
Artery xray each vessel 7577426
|
$1,668.00 |
$1,668.00 |
$1,668.00 |
$1,844.46
|
|
Artery x-rays arm/leg 75710-26
|
$5,676.50 |
$5,676.50 |
$5,676.50 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$5,676.50 |
$5,676.50 |
$5,676.50 |
$3,729.00
|
|
Arthrd si jt perq/min nvas
|
$7,561.00 |
$7,561.00 |
$7,561.00 |
$15,372.00
|
|
Arthrd si jt prq wo tfxj dev
|
$7,847.50 |
$7,847.50 |
$7,847.50 |
$21,762.05
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,098.00 |
$1,098.00 |
$1,098.00 |
$608.40
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$554.00 |
$554.00 |
$554.00 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$507.00 |
$507.00 |
$507.00 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,108.00 |
$1,108.00 |
$1,108.00 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$332.00 |
$332.00 |
$332.00 |
$699.00
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$7,691.00 |
$7,691.00 |
$7,691.00 |
$4,240.08
|
|
Arthrotomy carpometacarpal joint 26070
|
$3,891.00 |
$3,891.00 |
$3,891.00 |
$1,893.86
|
|
Arthrp ntrcrp/crp/mtcr ntrps
|
$8,035.50 |
$8,035.50 |
$8,035.50 |
$4,627.00
|
|
Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah)
|
$2,614.33 |
$2,614.33 |
$2,614.33 |
$4,194.13
|
|
Artiss fibrin sealant
|
$449.90 |
$449.90 |
$449.90 |
$1,583.11
|
|
Ascvd rsk mng clin stf pr mo
|
$104.00 |
$104.00 |
$104.00 |
$109.46
|
|
Asp core fat pad
|
$3,765.75 |
$3,765.75 |
$3,765.75 |
$939.95
|
|
Aspirate bladder/sprapubic cath 51102
|
$5,335.50 |
$5,335.50 |
$5,335.50 |
$3,162.72
|
|
Aspirate/inj ganglion cyst 20612
|
$928.50 |
$928.50 |
$928.50 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$721.50 |
$721.50 |
$721.50 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,517.50 |
$1,517.50 |
$1,517.50 |
$1,226.87
|
|
Aspir/inj thyroid cyst 60300
|
$625.50 |
$625.50 |
$625.50 |
$850.78
|
|
Asp pq spinal cord cyst/syrinx
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$1,270.92
|
|
Assay dir meas fr estradiol
|
$36.00 |
$36.00 |
$36.00 |
$67.44
|
|
Assay of androsterone
|
$195.00 |
$195.00 |
$195.00 |
$194.79
|
|
Assay of corticosterone
|
$176.50 |
$176.50 |
$176.50 |
$56.80
|
|
Assay of interleukin-6 (il-6)
|
$95.00 |
$95.00 |
$95.00 |
$79.97
|
|
Assay of leflunomide
|
$122.50 |
$122.50 |
$122.50 |
$100.65
|
|
Assay of neonatal thyroxine
|
$9.00 |
$9.00 |
$9.00 |
$19.06
|
|
Assay of osteocalcin
|
$22.00 |
$22.00 |
$22.00 |
$92.50
|
|
Assay of procainamide w/metab
|
$86.50 |
$86.50 |
$86.50 |
$70.50
|
|
Assay of prostaglandin
|
$300.00 |
$300.00 |
$300.00 |
$218.50
|
|
Assay of salicylate
|
$46.00 |
$46.00 |
$46.00 |
$95.00
|
|
Assay of sialic acid
|
$175.00 |
$175.00 |
$175.00 |
$92.50
|
|
Assay of tyrosine
|
$338.00 |
$338.00 |
$338.00 |
$60.00
|
|
Assay of urine sulfate
|
$24.00 |
$24.00 |
$24.00 |
$29.04
|
|
Ast/sgot
|
$25.50 |
$25.50 |
$25.50 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$23,178.72 |
$23,178.72 |
$23,178.72 |
$23,166.53
|
|
Atomic absorption
|
$226.00 |
$226.00 |
$226.00 |
$71.50
|
|
Atropine 0.1 mg/ml injection syringe
|
$67.59 |
$67.59 |
$67.59 |
$51.28
|
|
Augment injectable kit 3.0cc
|
$1,414.86 |
$1,414.86 |
$1,414.86 |
$7,469.28
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$952.50 |
$952.50 |
$952.50 |
$7,109.05
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$15,643.00 |
$15,643.00 |
$15,643.00 |
$10,384.40
|
|
Autolog prp diab wound ulcer
|
$2,477.00 |
$2,477.00 |
$2,477.00 |
$2,164.64
|
|
Autolog prp not diab ulcer
|
$2,229.00 |
$2,229.00 |
$2,229.00 |
$2,164.64
|
|
Automated diff wbc count
|
$13.13 |
$13.13 |
$13.13 |
$38.28
|
|
Avelumab 20 mg/ml intravenous solution
|
$15,488.32 |
$15,488.32 |
$15,488.32 |
$3,683.86
|
|
Av fusion direct any site
|
$11,255.50 |
$11,255.50 |
$11,255.50 |
$4,804.00
|
|
Avul nail plate addl
|
$130.50 |
$130.50 |
$130.50 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$2,976.00 |
$2,976.00 |
$2,976.00 |
$318.75
|
|
Azacitidine injection
|
$133.45 |
$133.45 |
$133.45 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$1.45 |
$1.45 |
$1.45 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$6.05 |
$6.05 |
$6.05 |
$35.06
|
|
Aztreonam 1 gram solution for injection
|
$101.29 |
$101.29 |
$101.29 |
$157.30
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$532.00 |
$532.00 |
$532.00 |
$1,800.33
|
|
Bacterial meningitis antigen
|
$52.50 |
$52.50 |
$52.50 |
$66.30
|
|
Bacterial vaginosis pcr
|
$355.00 |
$355.00 |
$355.00 |
$278.40
|
|
#bac vag cand-c. albicans naa
|
$102.50 |
$102.50 |
$102.50 |
$105.00
|
|
Bard marquee Ultrasound biopsy device
|
$802.31 |
$802.31 |
$802.31 |
$1,535.40
|
|
Bartholin gland cyst/marsupializat 56440
|
$8,156.00 |
$8,156.00 |
$8,156.00 |
$4,350.00
|
|
Bartonella dna pcr-sendout
|
$188.00 |
$188.00 |
$188.00 |
$195.66
|
|
Basiliximab
|
$10,097.50 |
$10,097.50 |
$10,097.50 |
$8,045.59
|
|
B cells total count
|
$174.01 |
$174.01 |
$174.01 |
$131.30
|
|
Bcg live 50 mg intravesical suspension
|
$351.05 |
$351.05 |
$351.05 |
$378.28
|
|
Bckdhb gene
|
$339.50 |
$339.50 |
$339.50 |
$190.40
|
|
Behavior counsel obesity 15min medicare g0447
|
$108.00 |
$108.00 |
$108.00 |
$102.47
|
|
Belatacept 250 mg intravenous solution
|
$4,146.26 |
$4,146.26 |
$4,146.26 |
$2,036.75
|
|
Belimumab 120 mg intravenous solution
|
$139.50 |
$139.50 |
$139.50 |
$4,243.90
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$8,164.32 |
$8,164.32 |
$8,164.32 |
$4,702.68
|
|
#_benzodiazconfur
|
$166.00 |
$166.00 |
$166.00 |
$114.40
|
|
Benztropine 1 mg/ml injection solution
|
$25.33 |
$25.33 |
$25.33 |
$103.20
|
|
Beta 2 glycoprotein 1 antibody iga
|
$274.00 |
$274.00 |
$274.00 |
$78.50
|
|
Beta-2 microglobulin
|
$240.00 |
$240.00 |
$240.00 |
$85.94
|
|
Beta-amyloid 1-42
|
$431.00 |
$431.00 |
$431.00 |
$312.50
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$34.34 |
$34.34 |
$34.34 |
$64.15
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$7,172.46 |
$7,172.46 |
$7,172.46 |
$5,705.92
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$15,431.04 |
$15,431.04 |
$15,431.04 |
$3,291.73
|
|
Bevacizumab-bvzr 25 mg/ml intravenous solution
|
$3,327.44 |
$3,327.44 |
$3,327.44 |
$2,508.56
|
|
Bevacizumab injection
|
$4.50 |
$4.50 |
$4.50 |
$202.85
|
