|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$45.00 |
$45.00 |
$45.00 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$113.00 |
$113.00 |
$113.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$113.00 |
$113.00 |
$113.00 |
$230.40
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$39.50 |
$39.50 |
$39.50 |
$396.48
|
|
Anaplsma phgcytophlm amp prb
|
$110.00 |
$110.00 |
$110.00 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$20.50 |
$20.50 |
$20.50 |
$103.20
|
|
An fluoro guide for cvp
|
$414.50 |
$414.50 |
$414.50 |
$515.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$7.00 |
$7.00 |
$7.00 |
$3,080.85
|
|
Ankle arthroscopy/surgery
|
$487.50 |
$487.50 |
$487.50 |
$3,797.90
|
|
Ankle X-ray
|
$173.00 |
$173.00 |
$173.00 |
$353.60
|
|
Annual alcohol screen 15 min
|
$9.00 |
$9.00 |
$9.00 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$85.50 |
$85.50 |
$85.50 |
$141.00
|
|
Annual Physical, Established Patient (age 40-64)
|
$93.00 |
$93.00 |
$93.00 |
$158.76
|
|
Annual Physical, New Patient (age 18-39)
|
$94.00 |
$94.00 |
$94.00 |
$143.25
|
|
Annual Physical, New Patient (age 40-64)
|
$114.50 |
$114.50 |
$114.50 |
$165.10
|
|
Anora (draw only)
|
$12.00 |
$12.00 |
$12.00 |
$33.58
|
|
Anoscopy and dilation 46604
|
$71.00 |
$71.00 |
$71.00 |
$1,621.60
|
|
Antibody bacterium, not elsewhere specified
|
$32.50 |
$32.50 |
$32.50 |
$57.81
|
|
Antibody elution rbc reference
|
$148.50 |
$148.50 |
$148.50 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$455.00 |
$455.00 |
$455.00 |
$218.30
|
|
Antibody id rbc panel
|
$269.00 |
$269.00 |
$269.00 |
$274.56
|
|
Antibody screen rbc
|
$72.00 |
$72.00 |
$72.00 |
$100.00
|
|
Antibody tetanus
|
$10.00 |
$10.00 |
$10.00 |
$53.95
|
|
Anticoag mgmt pt warfarin
|
$12.50 |
$12.50 |
$12.50 |
$26.40
|
|
Antigen therapy services
|
$3.00 |
$3.00 |
$3.00 |
$70.07
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$10.00 |
$10.00 |
$10.00 |
$37.05
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$76.50 |
$76.50 |
$76.50 |
$40.00
|
|
Antinuclear antibodies
|
$66.00 |
$66.00 |
$66.00 |
$89.40
|
|
Antinuclear antibodies titer
|
$56.50 |
$56.50 |
$56.50 |
$77.00
|
|
Antistreptolysin o titer
|
$5.00 |
$5.00 |
$5.00 |
$51.45
|
|
Antithrombin iii activity
|
$68.50 |
$68.50 |
$68.50 |
$114.00
|
|
Apl(pml-rara) quant - sendout
|
$165.00 |
$165.00 |
$165.00 |
$482.95
|
|
Appendix Removal (Laparoscopic)
|
$672.50 |
$672.50 |
$672.50 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$231.00 |
$231.00 |
$231.00 |
$2,114.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$26.00 |
$26.00 |
$26.00 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$201.00 |
$201.00 |
$201.00 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$46.00 |
$46.00 |
$46.00 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$17.50 |
$17.50 |
$17.50 |
$498.81
|
|
Application finger splntstatic 29130
|
$184.00 |
$184.00 |
$184.00 |
$208.16
|
|
Application long leg splint 29505
|
$231.00 |
$231.00 |
$231.00 |
$338.25
|
|
Application lower leg splint 29515
|
$231.00 |
$231.00 |
$231.00 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$156.00 |
$156.00 |
$156.00 |
$373.20
|
|
Application of cylinder cast 29365
|
$92.50 |
$92.50 |
$92.50 |
$420.00
|
|
Application of forearm cast 29075
|
$65.50 |
$65.50 |
$65.50 |
$339.30
|
|
Application of long arm cast 29065
|
$72.00 |
$72.00 |
$72.00 |
$395.00
|
|
Application of long leg cast 29345
|
$103.50 |
$103.50 |
$103.50 |
$455.00
|
|
Application of paste boot 29580
|
$156.00 |
$156.00 |
$156.00 |
$331.74
|
|
Application short leg cast 29405
|
$62.00 |
$62.00 |
$62.00 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$708.00 |
$708.00 |
$708.00 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$86.50 |
$86.50 |
$86.50 |
$2,164.64
|
|
Appl multlay comprs arm/hand
|
$15.00 |
$15.00 |
$15.00 |
$292.60
|
|
Apply forearm splintdynamic 29126
|
$50.50 |
$50.50 |
$50.50 |
$246.18
|
|
Apply hand/wrist cast 29085
|
$71.00 |
$71.00 |
$71.00 |
$259.20
|
|
Apply rigid leg cast 29445
|
$103.00 |
$103.00 |
$103.00 |
$555.00
|
|
Apply short leg castambul type 29425
|
$56.50 |
$56.50 |
$56.50 |
$381.00
|
|
App topical fluoride varnish
|
$9.50 |
$9.50 |
$9.50 |
$27.20
|
|
#aptt mix-1:1 incubated
|
$111.50 |
$111.50 |
$111.50 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$390.00 |
$390.00 |
$390.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$125.00 |
$125.00 |
$125.00 |
$138.16
|
|
Arterial blood draw/perc 36620
|
$782.50 |
$782.50 |
$782.50 |
$485.69
|
|
Arthrd si jt perq/min nvas
|
$6,540.00 |
$6,540.00 |
$6,540.00 |
$15,372.00
|
|
Arthrd si jt prq wo tfxj dev
|
$6,540.00 |
$6,540.00 |
$6,540.00 |
$21,762.05
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$294.00 |
$294.00 |
$294.00 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$52.00 |
$52.00 |
$52.00 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$527.50 |
$527.50 |
$527.50 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$294.00 |
$294.00 |
$294.00 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$470.50 |
$470.50 |
$470.50 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$294.00 |
$294.00 |
$294.00 |
$699.00
|
|
Arthrodesis subtalar
|
$820.50 |
$820.50 |
$820.50 |
$13,057.20
|
|
Arthrt ac sc jt exp/rmvl fb
|
$613.00 |
$613.00 |
$613.00 |
$3,786.00
|
|
Arthrt rdcrpl/midcarpl jt
|
$590.00 |
$590.00 |
$590.00 |
$3,839.54
|
|
Asp core fat pad
|
$507.50 |
$507.50 |
$507.50 |
$939.95
|
|
Aspirate/inj ganglion cyst 20612
|
$42.00 |
$42.00 |
$42.00 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$614.50 |
$614.50 |
$614.50 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$73.00 |
$73.00 |
$73.00 |
$1,226.87
|
|
Asp pq spinal cord cyst/syrinx
|
$381.50 |
$381.50 |
$381.50 |
$1,270.92
|
|
Assay alkaline phosphatase
|
$39.50 |
$39.50 |
$39.50 |
$51.60
|
|
Assay dir meas fr estradiol
|
$36.00 |
$36.00 |
$36.00 |
$67.44
|
|
Assay neurflmnt light chain
|
$225.00 |
$225.00 |
$225.00 |
$380.00
|
|
Assay of androsterone
|
$195.00 |
$195.00 |
$195.00 |
$194.79
|
|
Assay of corticosterone
|
$176.50 |
$176.50 |
$176.50 |
$56.80
|
|
Assay of neonatal thyroxine
|
$8.50 |
$8.50 |
$8.50 |
$19.06
|
|
Assay of osteocalcin
|
$22.00 |
$22.00 |
$22.00 |
$92.50
|
|
Assay of salicylate
|
$100.00 |
$100.00 |
$100.00 |
$95.00
|
|
Assay of tyrosine
|
$338.00 |
$338.00 |
$338.00 |
$60.00
|
|
Assay of urine sulfate
|
$11.00 |
$11.00 |
$11.00 |
$29.04
|
|
Ast/sgot
|
$48.50 |
$48.50 |
$48.50 |
$45.65
|
|
Atomic absorption
|
$226.00 |
$226.00 |
$226.00 |
$71.50
|
|
Attach bladder/urethra simple 51840
|
$709.00 |
$709.00 |
$709.00 |
$1,712.00
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$72.00 |
$72.00 |
$72.00 |
$186.60
|
|
Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body
|
$2,453.00 |
$2,453.00 |
$2,453.00 |
$7,109.05
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$4,834.00 |
$4,834.00 |
$4,834.00 |
$10,384.40
|
|
Avul nail plate addl
|
$17.50 |
$17.50 |
$17.50 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$342.00 |
$342.00 |
$342.00 |
$318.75
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$354.50 |
$354.50 |
$354.50 |
$1,800.33
|
|
Bacterial vaginosis pcr
|
$96.50 |
$96.50 |
$96.50 |
$278.40
|
|
#bac vag cand-c. albicans naa
|
$124.00 |
$124.00 |
$124.00 |
$105.00
|
|
Balloon dilate urtrl strix
|
$182.00 |
$182.00 |
$182.00 |
$2,118.00
|
|
Bartholin gland cyst/marsupializat 56440
|
$187.50 |
$187.50 |
$187.50 |
$4,350.00
|
|
Bartonella dna pcr-sendout
|
$175.00 |
$175.00 |
$175.00 |
$195.66
|
