|
11-desoxycortisol - sendout
|
$152.86 |
$152.86 |
$152.86 |
$87.50
|
|
17-ketosteroids
|
$140.24 |
$140.24 |
$140.24 |
$44.88
|
|
1st hosp/birthing center care per day nml nb 99460
|
$143.95 |
$143.95 |
$143.95 |
$172.80
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,385.32 |
$1,385.32 |
$1,385.32 |
$1,656.80
|
|
24 hr ambulatory b/p monitor
|
$251.54 |
$251.54 |
$251.54 |
$320.45
|
|
2nd order venous cath
|
$3,610.58 |
$3,610.58 |
$3,610.58 |
$1,720.80
|
|
5' nucleotidase - sendout
|
$36.66 |
$36.66 |
$36.66 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$51.20 |
$51.20 |
$51.20 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$158.79 |
$158.79 |
$158.79 |
$151.20
|
|
99382 initial comp preventive med 1 to 4 years new
|
$166.21 |
$166.21 |
$166.21 |
$147.49
|
|
99383 initial comp preventive med 5 to 11 years new
|
$172.15 |
$172.15 |
$172.15 |
$162.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$143.21 |
$143.21 |
$143.21 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$152.86 |
$152.86 |
$152.86 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$152.11 |
$152.11 |
$152.11 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$166.21 |
$166.21 |
$166.21 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$194.41 |
$194.41 |
$194.41 |
$176.03
|
|
Aa graft w/bp/aortic root replace 33863
|
$4,758.45 |
$4,758.45 |
$4,758.45 |
$7,697.60
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$6,367.11 |
$6,367.11 |
$6,367.11 |
$3,998.03
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$218.89 |
$218.89 |
$218.89 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$3,667.71 |
$3,667.71 |
$3,667.71 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$2,383.31 |
$2,383.31 |
$2,383.31 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$3,210.64 |
$3,210.64 |
$3,210.64 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$4,014.22 |
$4,014.22 |
$4,014.22 |
$2,727.40
|
|
Abd/low ext cath addl
|
$4,014.22 |
$4,014.22 |
$4,014.22 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$3,531.18 |
$3,531.18 |
$3,531.18 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$3,071.88 |
$3,071.88 |
$3,071.88 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,718.69 |
$2,718.69 |
$2,718.69 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,749.33 |
$3,749.33 |
$3,749.33 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$3,711.49 |
$3,711.49 |
$3,711.49 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$2,549.52 |
$2,549.52 |
$2,549.52 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$2,285.36 |
$2,285.36 |
$2,285.36 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$1,472.87 |
$1,472.87 |
$1,472.87 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,264.37 |
$1,264.37 |
$1,264.37 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$2,103.57 |
$2,103.57 |
$2,103.57 |
$1,248.00
|
|
Ablate arrhythmia add on
|
$16,128.86 |
$16,128.86 |
$16,128.86 |
$7,717.80
|
|
Ablate atria lmtd endo 33265
|
$2,068.70 |
$2,068.70 |
$2,068.70 |
$3,312.80
|
|
Ablate atria x10sv add-on 33258
|
$987.61 |
$987.61 |
$987.61 |
$1,585.60
|
|
Ablate bone tumor(s) cryo perq 20983
|
$525.34 |
$525.34 |
$525.34 |
$8,096.90
|
|
Ablate bone tumor(s) perq
|
$8,392.77 |
$8,392.77 |
$8,392.77 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$11,150.78 |
$11,150.78 |
$11,150.78 |
$9,836.16
|
|
Ablate pulm tumor perq rf
|
$9,198.58 |
$9,198.58 |
$9,198.58 |
$7,911.80
|
|
Ablation cardiac vagal inputs atrium
|
$485.27 |
$485.27 |
$485.27 |
$2,948.40
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$348.00 |
$348.00 |
$348.00 |
$339.18
|
|
Ablation cryo thigh/knee
|
$362.10 |
$362.10 |
$362.10 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$326.48 |
$326.48 |
$326.48 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$2,770.63 |
$2,770.63 |
$2,770.63 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$4,512.11 |
$4,512.11 |
$4,512.11 |
$3,287.87
|
|
Acetazolamide 500 mg solution for injection
|
$103.88 |
$103.88 |
$103.88 |
$137.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$159.53 |
$159.53 |
$159.53 |
$306.22
|
|
Acne surgery 10040
|
$166.21 |
$166.21 |
$166.21 |
$265.20
|
|
Aco ccm; at least 20 min 99490aco
|
$77.91 |
$77.91 |
$77.91 |
$109.46
|
|
Aco cmplx chron care addl 20 min 99489aco
|
$77.91 |
$77.91 |
$77.91 |
$64.74
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$140.98 |
$140.98 |
$140.98 |
$177.84
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$347.26 |
$347.26 |
$347.26 |
$350.73
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$33.39 |
$33.39 |
$33.39 |
$44.40
|
|
Acup 1/> w/estim 1st 15 min
|
$51.94 |
$51.94 |
$51.94 |
$47.33
|
|
Acup 1/> wo estim 1st 15 min
|
$48.23 |
$48.23 |
$48.23 |
$42.90
|
|
Acute hepatitis panel
|
$141.37 |
$141.37 |
$141.37 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$8.91 |
$8.91 |
$8.91 |
$467.94
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$94.98 |
$94.98 |
$94.98 |
$64.45
|
|
#acylcarnitineprfl
|
$391.78 |
$391.78 |
$391.78 |
$87.72
|
|
Adenosine 3 mg/250 ml bag for osm
|
$142.47 |
$142.47 |
$142.47 |
$217.04
|
|
Adenovirus antibody,serum - quest
|
$120.95 |
$120.95 |
$120.95 |
$60.00
|
|
Adh-sendout
|
$267.87 |
$267.87 |
$267.87 |
$109.28
|
|
Adj gastric band via subq port
|
$742.00 |
$742.00 |
$742.00 |
$1,952.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$3.71 |
$3.71 |
$3.71 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$218.89 |
$218.89 |
$218.89 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$416.27 |
$416.27 |
$416.27 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$774.65 |
$774.65 |
$774.65 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$385.84 |
$385.84 |
$385.84 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$392.52 |
$392.52 |
$392.52 |
$267.43
|
|
Administration immunization 1 vaccine
|
$153.60 |
$153.60 |
$153.60 |
$70.00
|
|
Administration immunization each additional component
|
$23.01 |
$23.01 |
$23.01 |
$27.20
|
|
Administration immunization each additional vaccine
|
$153.60 |
$153.60 |
$153.60 |
$46.23
|
|
Administration immunization first component each vaccine
|
$40.07 |
$40.07 |
$40.07 |
$45.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$25.23 |
$25.23 |
$25.23 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$17.81 |
$17.81 |
$17.81 |
$33.60
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$11,122.58 |
$11,122.58 |
$11,122.58 |
$14,346.62
|
|
Adrenal cortex & medulla img
|
$2,499.80 |
$2,499.80 |
$2,499.80 |
$1,818.05
|
|
Advance care planning each additional 30 min 99498
|
$110.56 |
$110.56 |
$110.56 |
$128.10
|
|
_afb id by dna probe rflx ast
|
$163.24 |
$163.24 |
$163.24 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$39.33 |
$39.33 |
$39.33 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$471.17 |
$471.17 |
$471.17 |
$289.60
|
|
Agalsidase beta 35 mg intravenous solution
|
$27,675.86 |
$27,675.86 |
$27,675.86 |
$14,467.53
|
|
Air injection into abdomen 49400
|
$665.58 |
$665.58 |
$665.58 |
$545.00
|
|
Albumin body fluid quantitative each specimen
|
$86.08 |
$86.08 |
$86.08 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$500.85 |
$500.85 |
$500.85 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$304.97 |
$304.97 |
$304.97 |
$292.50
|
|
Albumin, human 5 % intravenous solution
|
$233.73 |
$233.73 |
$233.73 |
$248.88
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$91.27 |
$91.27 |
$91.27 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$28.20 |
$28.20 |
$28.20 |
$43.45
|
|
Alkaline phosphatase
|
$37.10 |
$37.10 |
$37.10 |
$46.50
|
|
Allergen egg white ige
|
$170.43 |
$170.43 |
$170.43 |
$39.78
|
|
Allergy injections; 2 or more 95117
|
$17.81 |
$17.81 |
$17.81 |
$47.20
|
|
Allergy injection; single 95115
|
$15.59 |
$15.59 |
$15.59 |
$42.75
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,580.68 |
$2,580.68 |
$2,580.68 |
$51.00
|
|
Alpha-fetoprotein amniotic
|
$114.27 |
$114.27 |
$114.27 |
$90.03
|
|
Alpha-fetoprotein tumor marker
|
$163.24 |
$163.24 |
$163.24 |
$103.60
|
|
Alprostadil for injection
|
$276.77 |
$276.77 |
$276.77 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$30,343.35 |
$30,343.35 |
$30,343.35 |
$9,600.63
|