|
Antiepileptics nos 4-6
|
$5.00 |
$5.00 |
$5.00 |
|
|
Antiepileptics nos 7/more
|
$5.00 |
$5.00 |
$18.50 |
|
|
Antigen therapy services
|
$51.00 |
$54.00 |
$645.00 |
|
|
Antigen therapy services
|
$51.00 |
$54.00 |
$93.50 |
|
|
Antigen therapy services
|
$75.50 |
$83.00 |
$960.00 |
|
|
Antigen therapy services
|
$75.50 |
$83.00 |
$1,020.00 |
|
|
Antigen therapy services
|
$75.50 |
$83.00 |
$115.50 |
|
|
Antigen therapy services
|
$3.00 |
$7.00 |
$225.00 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.60 |
$6,372.00 |
$8,357.94 |
|
|
Antihemophilic viii/vwf comp
|
$0.50 |
$0.50 |
$0.50 |
|
|
Anti-inhibitor
|
$2.00 |
$2.00 |
$2.00 |
|
|
Anti mog serum - sendout
|
$228.50 |
$785.00 |
$785.00 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$10.00 |
$23.75 |
$256.00 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$13.60 |
$68.00 |
$178.00 |
|
|
Ant instr 2-3 vert segm 22845
|
$3,944.08 |
$4,552.33 |
$11,239.83 |
|
|
Ant instrumentation/4-7 vert seg 22846
|
$2,380.95 |
$2,380.95 |
$6,549.19 |
|
|
Antinuclear antibodies
|
$19.20 |
$70.00 |
$310.20 |
|
|
Antinuclear antibodies titer
|
$16.50 |
$56.50 |
$165.00 |
|
|
Antiphosphatidylserine antibody
|
$24.00 |
$86.50 |
$343.00 |
|
|
Antipsychotics nos 1-3
|
$295.00 |
$295.00 |
$295.00 |
|
|
Antipsychotics nos 7/more
|
$5.00 |
$5.00 |
$18.50 |
|
|
Antistreptolysin o screen
|
$17.00 |
$17.00 |
$33.50 |
|
|
Antistreptolysin o titer
|
$5.00 |
$20.50 |
$47.00 |
|
|
Antithrombin iii activity
|
$26.00 |
$65.60 |
$306.00 |
|
|
Antithrombin iii injection
|
$12,476.40 |
$12,476.40 |
$12,476.40 |
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$891.00 |
$917.50 |
$7,575.08 |
|
|
Ant sgm img i&r speclr mic
|
$345.00 |
$345.00 |
$345.00 |
|
|
Aortic dysfunction/dilation
|
$3,299.00 |
$3,299.00 |
$3,299.00 |
|
|
Aortic dysfunction/dilation
|
$3,299.00 |
$3,299.00 |
$3,299.00 |
|
|
Apheresis plasma
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
|
|
Apheresis rbc
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
|
|
Apheresis wbc
|
$1,773.00 |
$1,773.00 |
$1,989.00 |
|
|
Apl(pml-rara) quant - sendout
|
$165.00 |
$165.00 |
$1,214.00 |
|
|
Appendectomy
|
$691.50 |
$710.50 |
$19,253.00 |
|
|
Appendectomy add-on 44955
|
$89.50 |
$89.50 |
$6,238.33 |
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$945.00 |
$971.00 |
$1,553.60 |
|
|
Appendico-vesicostomy
|
$38,325.50 |
$38,325.50 |
$38,325.50 |
|
|
Appendix Removal (Laparoscopic)
|
$672.50 |
$8,701.60 |
$17,304.38 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$231.00 |
$246.50 |
$4,572.50 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$57.50 |
$62.00 |
$4,572.50 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$26.00 |
$585.17 |
$2,266.50 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$201.00 |
$398.00 |
$4,498.75 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$46.00 |
$159.50 |
$4,498.75 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$17.50 |
$585.50 |
$5,591.75 |
|
|
Appl bdy cst sho to hip b th
|
$5,315.00 |
$5,315.00 |
$5,315.00 |
|
|
Appl body cast sho to hips
|
$9,341.50 |
$9,341.50 |
$9,341.50 |
|
|
Appl halo cranial 6+pins
|
$6,998.00 |
$6,998.00 |
$6,998.00 |
|
|
Appl hip spica cast1&1/2
|
$4,718.34 |
$4,718.34 |
$4,718.34 |
|
|
Appl hip spica cast 1 leg
|
$6,461.50 |
$6,461.50 |
$6,461.50 |
|
|
Application clubfoot cast
|
$187.00 |
$191.50 |
$3,694.00 |
|
|
Application finger splntstatic 29130
|
$127.50 |
$189.50 |
$241.50 |
|
|
Application long leg splint 29505
|
$107.00 |
$250.00 |
$419.00 |
|
|
Application lower leg splint 29515
|
$155.50 |
$278.00 |
$4,883.13 |
|
|
Application multi layer compression below knee (both sides)
|
$26.00 |
$355.00 |
$609.00 |
|
|
Application of body cast
|
$6,158.00 |
$6,158.00 |
$6,158.00 |
|
|
Application of cylinder cast 29365
|
$91.50 |
$268.00 |
$493.50 |
|
|
Application of forearm cast 29075
|
$64.20 |
$321.50 |
$959.00 |
|
|
Application of long arm cast 29065
|
$72.00 |
$342.00 |
$8,000.00 |
|
|
Application of long leg cast
|
$318.00 |
$391.50 |
$961.00 |
|
|
Application of long leg cast 29345
|
$103.50 |
$321.00 |
$580.80 |
|
|
Application of paste boot 29580
|
$156.00 |
$396.00 |
$829.00 |
|
|
Application short leg cast 29405
|
$62.00 |
$363.50 |
$6,712.50 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$97.00 |
$2,203.00 |
$5,549.33 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$86.50 |
$2,051.00 |
$3,346.50 |
|
|
Applicator tag rfid localizer 12gx7cm
|
$418.05 |
$512.00 |
$720.00 |
|
|
Appl long leg cast brace
|
$392.50 |
$392.50 |
$392.50 |
|
|
Appl mltpln uni ext fixj sys
|
$1,184.50 |
$1,895.20 |
$9,820.26 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$28.00 |
$49.00 |
$140.40 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$37.50 |
$52.00 |
$127.00 |
|
|
Appl multlay comprs arm/hand
|
$15.00 |
$24.00 |
$309.50 |
|
|
Appl patllr tdn bearing cast
|
$315.00 |
$321.50 |
$454.00 |
|
|
Appl unipln uni ext fixj sys
|
$623.00 |
$1,078.50 |
$10,191.00 |
|
|
Apply finger cast 29086
|
$187.00 |
$191.50 |
$365.50 |
|
|
Apply forearm splintdynamic 29126
|
$50.50 |
$157.50 |
$250.00 |
|
|
Apply halo w/removal cranial
|
$1,958.00 |
$1,958.00 |
$1,958.00 |
|
|
Apply hand/wrist cast 29085
|
$71.00 |
$156.00 |
$3,222.42 |
|
|
Apply interstit radiat compl
|
$568.00 |
$1,047.50 |
$4,807.00 |
|
|
Apply intrcav radiat compl
|
$854.00 |
$854.00 |
$1,207.00 |
|
|
Apply intrcav radiat interm
|
$701.00 |
$701.00 |
$1,207.00 |
|
|
Apply intrcav radiat simple
|
$701.00 |
$701.00 |
$1,207.00 |
|
|
Apply of finger splint 29131
|
$82.00 |
$120.50 |
$168.00 |
|
|
Apply rem fixation device
|
$1,076.00 |
$1,076.00 |
$1,076.00 |
|
|
Apply rigid leg cast 29445
|
$103.00 |
$442.50 |
$1,144.00 |
|
|
Apply short leg castambul type 29425
|
$56.50 |
$318.00 |
$1,902.00 |
|
|
Apply srs headframe add-on
|
$299.00 |
$299.00 |
$299.00 |
|
|
App topical fluoride varnish
|
$3.00 |
$9.50 |
$21.50 |
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$543.67 |
$543.67 |
$543.68 |
|
|
#aptt mix-1:1 incubated
|
$111.50 |
$111.50 |
$178.40 |
|
|
Aqaprn-4 antb flo cytmtry ea
|
$390.00 |
$390.00 |
$780.00 |
|
|
Aqmbf pet rest & rx stress
|
$224.00 |
$224.00 |
$252.00 |
|
|
Aquaporin-4 antibody cba each
|
$125.00 |
$187.50 |
$926.50 |
|
|
Aquaporin-4 antibody elisa
|
$560.00 |
$560.00 |
$661.00 |
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$65.50 |
$138.50 |
$323.20 |
|
|
Aquatic exercise - group charge
|
$32.00 |
$61.50 |
$260.00 |
|
|
Aqueous shunt eye w/graft
|
$3,427.00 |
$3,698.00 |
$10,784.00 |
|
|
Ar gene charac alleles
|
$871.00 |
$871.00 |
$871.00 |
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$5,747.27 |
$5,747.27 |
$5,747.27 |
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$76.89 |
$76.89 |
$1,002.54 |
|
|
Art byp aortofemoral 35647
|
$1,643.00 |
$1,657.00 |
$2,651.20 |
|
|
Art byp aortoiliac 35637
|
$1,785.50 |
$1,839.00 |
$2,942.40 |
|
