|
Antibody influenza virus
|
$30.50 |
$30.50 |
$30.50 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$25.50 |
$25.50 |
$25.50 |
$48.57
|
|
Antibody screen rbc
|
$96.00 |
$96.00 |
$96.00 |
$100.00
|
|
Antibody tetanus
|
$87.00 |
$87.00 |
$87.00 |
$53.95
|
|
Anticoag mgmt pt warfarin
|
$21.50 |
$21.50 |
$21.50 |
$26.40
|
|
Antidepressant not specified
|
$18.50 |
$18.50 |
$18.50 |
$61.80
|
|
Antidepressants class 3-5
|
$5.00 |
$5.00 |
$5.00 |
$59.46
|
|
Antidepressants class 6/more
|
$18.50 |
$18.50 |
$18.50 |
$29.21
|
|
Antiepileptics nos 4-6
|
$5.00 |
$5.00 |
$5.00 |
$16.24
|
|
Antiepileptics nos 7/more
|
$18.50 |
$18.50 |
$18.50 |
$16.24
|
|
Antigen therapy services
|
$58.00 |
$58.00 |
$58.00 |
$73.84
|
|
Antigen therapy services
|
$58.00 |
$58.00 |
$58.00 |
$83.72
|
|
Antigen therapy services
|
$86.00 |
$86.00 |
$86.00 |
$101.40
|
|
Antigen therapy services
|
$86.00 |
$86.00 |
$86.00 |
$96.72
|
|
Antigen therapy services
|
$86.00 |
$86.00 |
$86.00 |
$130.00
|
|
Antigen therapy services
|
$7.00 |
$7.00 |
$7.00 |
$70.07
|
|
Anti mog serum - sendout
|
$430.00 |
$430.00 |
$430.00 |
$159.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$38.50 |
$38.50 |
$38.50 |
$37.05
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$71.50 |
$71.50 |
$71.50 |
$40.00
|
|
Ant instr 2-3 vert segm 22845
|
$4,552.33 |
$4,552.33 |
$4,552.33 |
$1,748.00
|
|
Antinuclear antibodies
|
$88.50 |
$88.50 |
$88.50 |
$89.40
|
|
Antinuclear antibodies titer
|
$165.00 |
$165.00 |
$165.00 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$343.00 |
$343.00 |
$343.00 |
$65.97
|
|
Antipsychotics nos 7/more
|
$18.50 |
$18.50 |
$18.50 |
$16.24
|
|
Antistreptolysin o titer
|
$47.00 |
$47.00 |
$47.00 |
$51.45
|
|
Antithrombin iii activity
|
$75.50 |
$75.50 |
$75.50 |
$114.00
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$7,575.08 |
$7,575.08 |
$7,575.08 |
$4,155.20
|
|
Aortic dysfunction/dilation
|
$3,299.00 |
$3,299.00 |
$3,299.00 |
$1,008.00
|
|
Aortic dysfunction/dilation
|
$3,299.00 |
$3,299.00 |
$3,299.00 |
$1,485.21
|
|
Apl(pml-rara) quant - sendout
|
$1,214.00 |
$1,214.00 |
$1,214.00 |
$482.95
|
|
Appendectomy
|
$19,253.00 |
$19,253.00 |
$19,253.00 |
$5,681.93
|
|
Appendectomy add-on 44955
|
$6,238.33 |
$6,238.33 |
$6,238.33 |
$189.55
|
|
Appendix Removal (Laparoscopic)
|
$14,007.50 |
$14,007.50 |
$14,007.50 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$874.00 |
$874.00 |
$874.00 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,702.00 |
$1,702.00 |
$1,702.00 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$159.50 |
$159.50 |
$159.50 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$2,574.05 |
$2,574.05 |
$2,574.05 |
$498.81
|
|
Application clubfoot cast
|
$601.00 |
$601.00 |
$601.00 |
$297.33
|
|
Application finger splntstatic 29130
|
$153.50 |
$153.50 |
$153.50 |
$208.16
|
|
Application long leg splint 29505
|
$196.50 |
$196.50 |
$196.50 |
$338.25
|
|
Application lower leg splint 29515
|
$349.00 |
$349.00 |
$349.00 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$609.00 |
$609.00 |
$609.00 |
$373.20
|
|
Application of cylinder cast 29365
|
$318.00 |
$318.00 |
$318.00 |
$420.00
|
|
Application of forearm cast 29075
|
$318.00 |
$318.00 |
$318.00 |
$339.30
|
|
Application of long arm cast 29065
|
$318.00 |
$318.00 |
$318.00 |
$395.00
|
|
Application of long leg cast
|
$318.00 |
$318.00 |
$318.00 |
$426.00
|
|
Application of long leg cast 29345
|
$318.00 |
$318.00 |
$318.00 |
$455.00
|
|
Application of paste boot 29580
|
$411.50 |
$411.50 |
$411.50 |
$331.74
|
|
Application short leg cast 29405
|
$318.00 |
$318.00 |
$318.00 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,964.92 |
$3,964.92 |
$3,964.92 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,166.00 |
$3,166.00 |
$3,166.00 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$720.00 |
$720.00 |
$720.00 |
$744.90
|
|
Appl mltpln uni ext fixj sys
|
$2,651.67 |
$2,651.67 |
$2,651.67 |
$5,668.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$49.00 |
$49.00 |
$49.00 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$43.50 |
$43.50 |
$43.50 |
$75.60
|
|
Appl multlay comprs arm/hand
|
$309.50 |
$309.50 |
$309.50 |
$292.60
|
|
Appl patllr tdn bearing cast
|
$318.00 |
$318.00 |
$318.00 |
$420.21
|
|
Appl unipln uni ext fixj sys
|
$9,569.00 |
$9,569.00 |
$9,569.00 |
$5,801.00
|
|
Apply finger cast 29086
|
$365.50 |
$365.50 |
$365.50 |
$238.15
|
|
Apply forearm splintdynamic 29126
|
$157.50 |
$157.50 |
$157.50 |
$246.18
|
|
Apply hand/wrist cast 29085
|
$3,222.42 |
$3,222.42 |
$3,222.42 |
$259.20
|
|
Apply interstit radiat compl
|
$1,047.50 |
$1,047.50 |
$1,047.50 |
$2,910.05
|
|
Apply rigid leg cast 29445
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$555.00
|
|
Apply short leg castambul type 29425
|
$318.00 |
$318.00 |
$318.00 |
$381.00
|
|
App topical fluoride varnish
|
$21.50 |
$21.50 |
$21.50 |
$27.20
|
|
Aqaprn-4 antb flo cytmtry ea
|
$585.00 |
$585.00 |
$585.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$142.50 |
$142.50 |
$142.50 |
$138.16
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$83.00 |
$83.00 |
$83.00 |
$100.00
|
|
Aquatic exercise - group charge
|
$39.50 |
$39.50 |
$39.50 |
$85.80
|
|
Aqueous shunt eye w/graft
|
$9,703.50 |
$9,703.50 |
$9,703.50 |
$5,716.03
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,002.54 |
$1,002.54 |
$1,002.54 |
$1,313.89
|
|
Art bypass femoral-femoral 35661
|
$2,552.00 |
$2,552.00 |
$2,552.00 |
$5,291.20
|
|
Arterial blood draw/perc 36620
|
$498.50 |
$498.50 |
$498.50 |
$485.69
|
|
Artery-vein nonautograft
|
$18,249.00 |
$18,249.00 |
$18,249.00 |
$6,396.89
|
|
Artery xray each vessel 7577426
|
$1,070.50 |
$1,070.50 |
$1,070.50 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$10,014.50 |
$10,014.50 |
$10,014.50 |
$4,446.00
|
|
Artery x-rays arm/leg 75710-26
|
$6,131.00 |
$6,131.00 |
$6,131.00 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$5,783.00 |
$5,783.00 |
$5,783.00 |
$3,729.00
|
|
Artery x-rays chest
|
$5,783.50 |
$5,783.50 |
$5,783.50 |
$2,870.00
|
|
Artery x-rays lung
|
$5,146.50 |
$5,146.50 |
$5,146.50 |
$3,279.12
|
|
Artery x-rays lung
|
$2,870.00 |
$2,870.00 |
$2,870.00 |
$2,451.75
|
|
Artery x-rays lungs
|
$5,149.00 |
$5,149.00 |
$5,149.00 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$5,039.50 |
$5,039.50 |
$5,039.50 |
$4,134.14
|
|
Artery x-rays spine
|
$5,417.00 |
$5,417.00 |
$5,417.00 |
$4,306.40
|
|
Arthrd ant ntrbdy cervical
|
$39,348.50 |
$39,348.50 |
$39,348.50 |
$9,951.20
|
|
Arthrd cmbn 1ntrspc lumbar
|
$19,081.00 |
$19,081.00 |
$19,081.00 |
$8,434.40
|
|
Arthrd pst tq 1ntrspc lum
|
$25,013.50 |
$25,013.50 |
$25,013.50 |
$4,627.00
|
|
Arthrd si jt perq/min nvas
|
$9,012.00 |
$9,012.00 |
$9,012.00 |
$15,372.00
|
|
Arthrd wrst iliac/oth agrft
|
$27,216.00 |
$27,216.00 |
$27,216.00 |
$6,413.60
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,297.00 |
$1,297.00 |
$1,297.00 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$993.00 |
$993.00 |
$993.00 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$2,800.00 |
$2,800.00 |
$2,800.00 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$2,871.75 |
$2,871.75 |
$2,871.75 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$6,576.83 |
$6,576.83 |
$6,576.83 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$351.50 |
$351.50 |
$351.50 |
$699.00
|
|
Arthrodes/ant/cerv below c2 ea add 22552
|
$3,273.80 |
$3,273.80 |
$3,273.80 |
$952.80
|
|
Arthrodesis/combine app/ea add 22634
|
$5,528.15 |
$5,528.15 |
$5,528.15 |
$1,193.60
|
|
Arthrodesis/post interbdy/ea add 22632
|
$5,528.15 |
$5,528.15 |
$5,528.15 |
$768.00
|
