|
17-ketosteroids
|
$20.13 |
$20.13 |
$20.13 |
$44.88
|
|
2019-ncov diagnostic p
|
$0.01 |
$0.01 |
$0.01 |
$49.37
|
|
3d recon without postprocess indpndt
|
$270.50 |
$270.50 |
$270.50 |
$425.10
|
|
5' nucleotidase - sendout
|
$22.67 |
$22.67 |
$22.67 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$13.25 |
$13.25 |
$13.25 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$35.66 |
$35.66 |
$35.66 |
$151.20
|
|
99383 initial comp preventive med 5 to 11 years new
|
$54.51 |
$54.51 |
$54.51 |
$162.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$32.86 |
$32.86 |
$32.86 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$32.86 |
$32.86 |
$32.86 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$32.61 |
$32.61 |
$32.61 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$51.20 |
$51.20 |
$51.20 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$63.17 |
$63.17 |
$63.17 |
$176.03
|
|
Abdominal CT scan (with and without contrast)
|
$916.67 |
$916.67 |
$916.67 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$840.77 |
$840.77 |
$840.77 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$790.34 |
$790.34 |
$790.34 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$1,242.94 |
$1,242.94 |
$1,242.94 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$1,195.06 |
$1,195.06 |
$1,195.06 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$1,195.06 |
$1,195.06 |
$1,195.06 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$721.82 |
$721.82 |
$721.82 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$367.03 |
$367.03 |
$367.03 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$249.61 |
$249.61 |
$249.61 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$407.27 |
$407.27 |
$407.27 |
$1,248.00
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$168.87 |
$168.87 |
$168.87 |
$339.18
|
|
Ablation of upper extremity nerves rf
|
$416.95 |
$416.95 |
$416.95 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$1,188.69 |
$1,188.69 |
$1,188.69 |
$3,053.18
|
|
Absorpt drg >16 <=48 without bdr
|
$5.55 |
$5.55 |
$5.55 |
$6.60
|
|
Absorpt drg > 48 sq in without b
|
$10.83 |
$10.83 |
$10.83 |
$12.46
|
|
Acetazolamide 500 mg solution for injection
|
$61.77 |
$61.77 |
$61.77 |
$120.90
|
|
Acetone qualitative
|
$13.76 |
$13.76 |
$13.76 |
$48.00
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$70.81 |
$70.81 |
$70.81 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$58.08 |
$58.08 |
$58.08 |
$190.20
|
|
Aco depression screen annual medicare g0444aco
|
$13.25 |
$13.25 |
$13.25 |
$38.28
|
|
Acute hepatitis panel
|
$42.79 |
$42.79 |
$42.79 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$65.51 |
$65.51 |
$65.51 |
$62.48
|
|
#acylcarnitineprfl
|
$57.31 |
$57.31 |
$57.31 |
$87.72
|
|
Adapter b 8 channel 10cm
|
$775.57 |
$775.57 |
$775.57 |
$5,695.04
|
|
Adenosine 3 mg/250 ml bag for osm
|
$41.00 |
$41.00 |
$41.00 |
$268.50
|
|
Adh-sendout
|
$11.21 |
$11.21 |
$11.21 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$154.25 |
$154.25 |
$154.25 |
$172.86
|
|
Administration immunization 1 vaccine
|
$53.49 |
$53.49 |
$53.49 |
$70.00
|
|
Administration immunization each additional vaccine
|
$14.52 |
$14.52 |
$14.52 |
$46.23
|
|
Administration vaccine hepatitis b
|
$33.63 |
$33.63 |
$33.63 |
$54.60
|
|
Administration vaccine influenza virus
|
$56.29 |
$56.29 |
$56.29 |
$48.35
|
|
Administration vaccine pneumococcal
|
$56.29 |
$56.29 |
$56.29 |
$49.50
|
|
Albumin body fluid quantitative each specimen
|
$6.88 |
$6.88 |
$6.88 |
$48.00
|
|
Albumin, human 25 % intravenous solution
|
$10.97 |
$10.97 |
$10.97 |
$117.82
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$31.59 |
$31.59 |
$31.59 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$19.11 |
$19.11 |
$19.11 |
$43.45
|
|
Alginate dressing <=16 sq in
|
$12.55 |
$12.55 |
$12.55 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$28.06 |
$28.06 |
$28.06 |
$41.71
|
|
Alginate drsg wound filler
|
$9.03 |
$9.03 |
$9.03 |
$14.32
|
|
Alkaline phosphatase
|
$13.76 |
$13.76 |
$13.76 |
$46.50
|
|
Allergen egg white ige
|
$19.62 |
$19.62 |
$19.62 |
$39.78
|
|
Allergy injection; single 95115
|
$3.57 |
$3.57 |
$3.57 |
$42.75
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$2,674.43 |
$2,674.43 |
$2,674.43 |
$6,606.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$1,195.90 |
$1,195.90 |
$1,195.90 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,235.00 |
$2,235.00 |
$2,235.00 |
$1,253.92
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$2,104.34 |
$2,104.34 |
$2,104.34 |
$4,906.77
|
|
Alpha-fetoprotein tumor marker
|
$46.36 |
$46.36 |
$46.36 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$330.07 |
$330.07 |
$330.07 |
$15,857.45
|
|
Alt/sgpt
|
$25.22 |
$25.22 |
$25.22 |
$49.00
|
|
Aluminum - quest
|
$9.43 |
$9.43 |
$9.43 |
$83.05
|
|
Amino acids quant 2-5
|
$34.13 |
$34.13 |
$34.13 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$56.11 |
$56.11 |
$56.11 |
$39.15
|
|
Aminolevulinic acid delta
|
$33.88 |
$33.88 |
$33.88 |
$85.15
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.47 |
$8.47 |
$8.47 |
$58.57
|
|
Ammonia
|
$31.08 |
$31.08 |
$31.08 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$247.57 |
$247.57 |
$247.57 |
$963.79
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,240.90 |
$1,240.90 |
$1,240.90 |
$3,969.00
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$476.80 |
$476.80 |
$476.80 |
$434.39
|
|
Ampicillin 1 gram solution for injection
|
$53.69 |
$53.69 |
$53.69 |
$63.06
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$56.63 |
$56.63 |
$56.63 |
$56.63
|
|
Amputation toe interphalangeal joint
|
$1,522.35 |
$1,522.35 |
$1,522.35 |
$3,839.54
|
|
Amylase
|
$32.61 |
$32.61 |
$32.61 |
$93.00
|
|
Ana ds-dna
|
$38.97 |
$38.97 |
$38.97 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$36.43 |
$36.43 |
$36.43 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$36.68 |
$36.68 |
$36.68 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$32.10 |
$32.10 |
$32.10 |
$226.60
|
|
Analysis nerve
|
$78.96 |
$78.96 |
$78.96 |
$223.19
|
|
Analysis tumor
|
$17.83 |
$17.83 |
$17.83 |
$240.00
|
|
Anaplsma phgcytophlm amp prb
|
$22.42 |
$22.42 |
$22.42 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$30.57 |
$30.57 |
$30.57 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$257.00 |
$257.00 |
$257.00 |
$2,426.60
|
|
An fluoro guide for cvp
|
$175.75 |
$175.75 |
$175.75 |
$509.60
|
|
Ankle X-ray
|
$128.12 |
$128.12 |
$128.12 |
$350.85
|
|
Annual alcohol screen 15 min
|
$14.27 |
$14.27 |
$14.27 |
$36.22
|
|
Annual Physical, Established Patient (age 18-39)
|
$51.71 |
$51.71 |
$51.71 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$57.06 |
$57.06 |
$57.06 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$64.44 |
$64.44 |
$64.44 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$70.81 |
$70.81 |
$70.81 |
$188.15
|
|
Antibody elution rbc reference
|
$17.07 |
$17.07 |
$17.07 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$53.49 |
$53.49 |
$53.49 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$57.31 |
$57.31 |
$57.31 |
$218.30
|
|
Antibody id rbc panel
|
$58.59 |
$58.59 |
$58.59 |
$291.75
|
|
Antibody screen rbc
|
$27.77 |
$27.77 |
$27.77 |
$105.00
|
|
Antidepressant not specified
|
$19.11 |
$19.11 |
$19.11 |
$89.50
|
|
Anti mog serum - sendout
|
$110.80 |
$110.80 |
$110.80 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$8.16 |
$8.16 |
$8.16 |
$50.88
|
|
Antinuclear antibodies
|
$32.86 |
$32.86 |
$32.86 |
$91.70
|
|
Antinuclear antibodies titer
|
$8.41 |
$8.41 |
$8.41 |
$80.25
|