|
Ankle arthroscopy/surgery
|
$4,733.60 |
$4,733.60 |
$4,733.60 |
|
|
Ankle arthroscopy/surgery
|
$7,468.80 |
$7,468.80 |
$7,468.80 |
|
|
Ankle arthroscopy/surgery
|
$859.56 |
$859.56 |
$859.56 |
|
|
Ankle arthroscopy/surgery
|
$878.94 |
$878.94 |
$3,549.60 |
|
|
Ankle arthroscopy/surgery
|
$996.36 |
$996.36 |
$6,108.80 |
|
|
Ankle X-ray
|
$103.74 |
$315.48 |
$630.00 |
|
|
Ankle X-ray (2 views, both ankles)
|
$50.73 |
$315.48 |
$601.04 |
|
|
Anl sp inf pmp w/mdreprg&fil
|
$66.25 |
$625.00 |
$734.58 |
|
|
Annual Physical, Established Patient (age 18-39)
|
$107.50 |
$189.81 |
$307.50 |
|
|
Annual Physical, Established Patient (age 40-64)
|
$67.50 |
$174.90 |
$292.00 |
|
|
Annual Physical, New Patient (age 18-39)
|
$212.61 |
$347.50 |
$356.00 |
|
|
Annual Physical, New Patient (age 40-64)
|
$75.00 |
$240.54 |
$370.40 |
|
|
Anodyne therapy charges pt
|
$17.49 |
$37.40 |
$37.50 |
|
|
Anogenital exam child w imag
|
$109.18 |
$109.18 |
$109.18 |
|
|
Anora (draw only)
|
$8.55 |
$12.54 |
$88.32 |
|
|
Anoscopy
|
$225.78 |
$225.78 |
$1,169.60 |
|
|
Anoscopy ablation lesion 46615
|
$228.43 |
$228.43 |
$228.43 |
|
|
Anoscopy and biopsy
|
$361.46 |
$361.46 |
$1,364.80 |
|
|
Anoscopy and dilation 46604
|
$628.80 |
$628.80 |
$1,188.79 |
|
|
Anoscopy control bleeding 46614
|
$154.76 |
$154.76 |
$2,140.60 |
|
|
Anoscopy remove fb 46608
|
$359.34 |
$1,208.35 |
$1,539.12 |
|
|
Anoscopy remove lesion 46610
|
$355.10 |
$355.10 |
$2,179.20 |
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$420.82 |
$420.82 |
$471.20 |
|
|
Antibody
|
$27.03 |
$36.30 |
$129.80 |
|
|
Antibody bacterium, not elsewhere specified
|
$21.45 |
$53.53 |
$277.20 |
|
|
Antibody elution rbc reference
|
$92.22 |
$150.00 |
$211.39 |
|
|
Antibody htlv/hiv confirm test
|
$67.84 |
$110.00 |
$312.18 |
|
|
Antibody htlv-i
|
$10.26 |
$14.31 |
$120.00 |
|
|
Antibody htlv-ii
|
$15.96 |
$22.26 |
$23.94 |
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$111.72 |
$247.50 |
$617.10 |
|
|
Antibody id rbc panel
|
$105.60 |
$195.00 |
$471.02 |
|
|
Antibody influenza virus
|
$12.10 |
$62.50 |
$167.44 |
|
|
Antibody lymphocytic choriomeningitis
|
$17.25 |
$33.92 |
$73.92 |
|
|
Antibody screen rbc
|
$45.58 |
$95.48 |
$227.63 |
|
|
Antibody tetanus
|
$54.59 |
$60.00 |
$159.20 |
|
|
Anticoag mgmt pt warfarin
|
$37.05 |
$37.05 |
$37.05 |
|
|
Antidepressant not specified
|
$29.70 |
$50.00 |
$188.32 |
|
|
Antidepressants class 3-5
|
$156.00 |
$156.00 |
$156.00 |
|
|
Antidepressants class 6/more
|
$131.45 |
$131.45 |
$156.00 |
|
|
Antidepressant tricyclic 3-5
|
$87.45 |
$87.45 |
$156.00 |
|
|
Antiepileptics nos 4-6
|
$73.26 |
$73.26 |
$156.00 |
|
|
Antiepileptics nos 7/more
|
$156.00 |
$156.00 |
$156.00 |
|
|
Antigen therapy services
|
$30.74 |
$30.74 |
$30.74 |
|
|
Antigen therapy services
|
$60.42 |
$60.42 |
$60.42 |
|
|
Antigen therapy services
|
$56.18 |
$56.18 |
$56.18 |
|
|
Antigen therapy services
|
$84.80 |
$84.80 |
$84.80 |
|
|
Antigen therapy services
|
$115.54 |
$115.54 |
$115.54 |
|
|
Antigen therapy services
|
$18.70 |
$18.70 |
$18.70 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$0.04 |
$2.76 |
$4.20 |
|
|
Anti mog serum - sendout
|
$69.85 |
$202.50 |
$952.38 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$19.80 |
$30.00 |
$190.70 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$12.54 |
$105.00 |
$105.00 |
|
|
Ant instr 2-3 vert segm 22845
|
$3,884.00 |
$3,884.00 |
$3,884.00 |
|
|
Ant instrumentation/4-7 vert seg 22846
|
$3,884.00 |
$3,884.00 |
$3,884.00 |
|
|
Antinuclear antibodies
|
$45.03 |
$95.00 |
$245.03 |
|
|
Antinuclear antibodies titer
|
$27.36 |
$85.00 |
$273.68 |
|
|
Antiphosphatidylserine antibody
|
$18.81 |
$47.50 |
$162.06 |
|
|
Antipsychotics nos 1-3
|
$34.20 |
$200.00 |
$293.15 |
|
|
Antipsychotics nos 4-6
|
$156.00 |
$156.00 |
$156.00 |
|
|
Antipsychotics nos 7/more
|
$15.18 |
$15.18 |
$156.00 |
|
|
Antistreptolysin o screen
|
$10.07 |
$79.75 |
$96.00 |
|
|
Antistreptolysin o titer
|
$17.10 |
$70.00 |
$391.74 |
|
|
Antithrombin iii activity
|
$25.65 |
$129.36 |
$523.11 |
|
|
Antithrombin iii injection
|
$3.71 |
$5.35 |
$8.12 |
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$5,124.00 |
$5,124.00 |
$13,547.33 |
|
|
Antithymocyte globuln rabbit
|
$3,894.76 |
$3,894.76 |
$3,894.76 |
|
|
Ant thrc vrt body tethrg <7
|
$4,504.80 |
$4,504.80 |
$4,504.80 |
|
|
Ant thrc vrt body tethrg 8+
|
$4,964.00 |
$4,964.00 |
$4,964.00 |
|
|
Aoi transducer/actuator repl
|
$5,783.20 |
$5,783.20 |
$5,783.20 |
|
|
Aortic Aneurysm Screening Ultrasound
|
$106.15 |
$380.00 |
$950.10 |
|
|
Aortic circulation assist 33971
|
$6,088.00 |
$6,088.00 |
$6,088.00 |
|
|
Aortic dysfunction/dilation
|
$1,525.60 |
$2,284.26 |
$7,488.90 |
|
|
Aortic dysfunction/dilation
|
$1,525.60 |
$4,645.45 |
$4,850.03 |
|
|
Aortic suspension
|
$9,415.20 |
$9,415.20 |
$9,415.20 |
|
|
Apc gene dup/delet variants
|
$905.52 |
$905.52 |
$905.52 |
|
|
Apc gene full sequence
|
$729.85 |
$905.52 |
$2,340.19 |
|
|
Apc gene known fam variants
|
$840.07 |
$840.07 |
$840.07 |
|
|
Apheresis immunoads slctv
|
$4,920.00 |
$4,920.00 |
$13,561.80 |
|
|
Apheresis plasma
|
$2,347.26 |
$2,985.00 |
$5,041.30 |
|
|
Apheresis platelets
|
$2,395.00 |
$2,395.00 |
$2,395.00 |
|
|
Apheresis rbc
|
$2,985.00 |
$2,985.00 |
$2,985.00 |
|
|
Apheresis wbc
|
$2,985.00 |
$2,985.00 |
$2,985.00 |
|
|
Apl(pml-rara) quant - sendout
|
$438.31 |
$540.00 |
$1,829.56 |
|
|
Appendectomy
|
$3,041.60 |
$3,041.60 |
$3,041.60 |
|
|
Appendectomy add-on 44955
|
$182.40 |
$182.40 |
$879.20 |
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$3,387.20 |
$3,387.20 |
$3,387.20 |
|
|
Appendix Removal (Laparoscopic)
|
$1,072.74 |
$1,072.74 |
$5,593.60 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$249.10 |
$2,112.66 |
$2,112.66 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$73.14 |
$786.06 |
$786.06 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$24.38 |
$232.65 |
$323.40 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$234.79 |
$4,228.62 |
$4,228.62 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$67.84 |
$638.22 |
$638.22 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$25.97 |
$223.85 |
$342.54 |
|
|
Appl cast figure-of-eight
|
$200.80 |
$200.80 |
$200.80 |
|
|
Appl cast plaster velpeau
|
$239.20 |
$239.20 |
$239.20 |
|
|
Appl cast shoulder spica
|
$396.80 |
$396.80 |
$396.80 |
|
|
Appl hip spica cast1&1/2
|
$530.70 |
$530.70 |
$670.00 |
|
|
Appl hip spica cast 1 leg
|
$530.70 |
$530.70 |
$530.70 |
|
|
Application clubfoot cast
|
$631.20 |
$631.20 |
$631.20 |
|
|
Application finger splntstatic 29130
|
$25.97 |
$142.50 |
$399.85 |
|
