|
11-desoxycortisol - sendout
|
$4.68 |
$4.68 |
$4.68 |
$84.56
|
|
17-hydroxypregnenolone
|
$3.65 |
$3.65 |
$3.65 |
$87.50
|
|
17-ketosteroids
|
$5.35 |
$5.35 |
$5.35 |
$49.54
|
|
1st hosp/birthing center care per day nml nb 99460
|
$42.48 |
$42.48 |
$42.48 |
$152.50
|
|
2d tte w or without fol w/con,co
|
$40.86 |
$40.86 |
$40.86 |
$1,155.75
|
|
2nd order venous cath
|
$1,788.12 |
$1,788.12 |
$1,788.12 |
$1,548.00
|
|
3-d radiotherapy plan
|
$1,650.24 |
$1,650.24 |
$1,650.24 |
$4,937.00
|
|
3d recon without postprocess indpndt
|
$352.98 |
$352.98 |
$352.98 |
$469.20
|
|
5% dextrose and 0.45% saline
|
$13.41 |
$13.41 |
$13.41 |
$48.00
|
|
5% dextrose with potassium
|
$45.90 |
$45.90 |
$45.90 |
$85.20
|
|
5' nucleotidase - sendout
|
$1.78 |
$1.78 |
$1.78 |
$47.72
|
|
88334 ap bill cytologic exam each additional site
|
$52.20 |
$52.20 |
$52.20 |
$94.50
|
|
99381 initial comp preventive med less than 1 year new
|
$31.14 |
$31.14 |
$31.14 |
$134.93
|
|
99382 initial comp preventive med 1 to 4 years new
|
$39.06 |
$39.06 |
$39.06 |
$131.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$33.30 |
$33.30 |
$33.30 |
$113.40
|
|
99391 periodic comp preventive med less than 1 year est
|
$24.30 |
$24.30 |
$24.30 |
$113.40
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$27.18 |
$27.18 |
$27.18 |
$130.20
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$27.00 |
$27.00 |
$27.00 |
$115.22
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$29.70 |
$29.70 |
$29.70 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$36.72 |
$36.72 |
$36.72 |
$160.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$290.10 |
$290.10 |
$290.10 |
$3,390.19
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$1.92 |
$1.92 |
$1.92 |
$53.95
|
|
Abciximab injection
|
$354.77 |
$354.77 |
$354.77 |
$2,443.52
|
|
Abd aorta w/runoff s&i
|
$3,294.00 |
$3,294.00 |
$3,294.00 |
$3,522.35
|
|
Abd/low ext cath 1st
|
$1,565.64 |
$1,565.64 |
$1,565.64 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$2,009.88 |
$2,009.88 |
$2,009.88 |
$2,038.85
|
|
Abd/low ext cath 3rd
|
$2,868.84 |
$2,868.84 |
$2,868.84 |
$2,570.00
|
|
Abd/low ext cath addl
|
$2,949.48 |
$2,949.48 |
$2,949.48 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$1,833.66 |
$1,833.66 |
$1,833.66 |
$1,951.30
|
|
Abdominal CT scan (with contrast)
|
$1,467.18 |
$1,467.18 |
$1,467.18 |
$1,642.50
|
|
Abdominal CT scan (without contrast)
|
$1,173.96 |
$1,173.96 |
$1,173.96 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,305.34 |
$3,305.34 |
$3,305.34 |
$2,992.50
|
|
Abdominal MRI (with contrast)
|
$2,644.02 |
$2,644.02 |
$2,644.02 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$2,115.72 |
$2,115.72 |
$2,115.72 |
$1,979.51
|
|
Abdominal paracentesis w/image guidance
|
$835.92 |
$835.92 |
$835.92 |
$1,631.70
|
|
Abdominal Ultrasound (complete)
|
$811.80 |
$811.80 |
$811.80 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$500.22 |
$500.22 |
$500.22 |
$591.60
|
|
Abdominoplasty 15830
|
$105.84 |
$105.84 |
$105.84 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$898.92 |
$898.92 |
$898.92 |
$1,145.00
|
|
Abl1 gene
|
$133.40 |
$133.40 |
$133.40 |
$668.85
|
|
Ablate arrhythmia add on
|
$3,042.00 |
$3,042.00 |
$3,042.00 |
$6,898.92
|
|
Ablate heart dysrhythm focus
|
$5,126.58 |
$5,126.58 |
$5,126.58 |
$9,522.05
|
|
Ablation cardiac vagal inputs atrium
|
$966.24 |
$966.24 |
$966.24 |
$2,030.15
|
|
Ablation cryo thigh/knee
|
$136.08 |
$136.08 |
$136.08 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$169.38 |
$169.38 |
$169.38 |
$808.50
|
|
Abrasion lesions add-on
|
$11.16 |
$11.16 |
$11.16 |
$100.00
|
|
Abrasion lesion single
|
$90.72 |
$90.72 |
$90.72 |
$340.86
|
|
Abscess drain retroperitoneal surg code
|
$1,651.86 |
$1,651.86 |
$1,651.86 |
$2,903.45
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$224.10 |
$224.10 |
$224.10 |
$2,341.52
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$21.30 |
$21.30 |
$21.30 |
$81.07
|
|
Acetaminophen 120 mg rectal suppository
|
$6.66 |
$6.66 |
$6.66 |
$57.20
|
|
Acetaminophen level
|
$138.78 |
$138.78 |
$138.78 |
$111.00
|
|
Acetazolamide 500 mg solution for injection
|
$29.81 |
$29.81 |
$29.81 |
$113.40
|
|
Acetone qualitative
|
$56.16 |
$56.16 |
$56.16 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$1.55 |
$1.55 |
$1.55 |
$62.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$109.34 |
$109.34 |
$109.34 |
$232.95
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$79.20 |
$79.20 |
$79.20 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$62.82 |
$62.82 |
$62.82 |
$171.03
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$130.68 |
$130.68 |
$130.68 |
$344.10
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$51.30 |
$51.30 |
$51.30 |
$39.20
|
|
Acoustic refl threshold tst
|
$32.40 |
$32.40 |
$32.40 |
$91.20
|
|
Acup 1/> w/estim 1st 15 min
|
$24.12 |
$24.12 |
$24.12 |
$49.40
|
|
Acup 1/> w/estim ea addl 15
|
$20.34 |
$20.34 |
$20.34 |
$69.78
|
|
Acup 1/> without estim ea add 15
|
$18.36 |
$18.36 |
$18.36 |
$52.79
|
|
Acup 1/> wo estim 1st 15 min
|
$22.14 |
$22.14 |
$22.14 |
$45.75
|
|
Acute hepatitis panel
|
$283.86 |
$283.86 |
$283.86 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$227.48 |
$227.48 |
$227.48 |
$39.40
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$62.37 |
$62.37 |
$62.37 |
$63.05
|
|
Adapter b 8 channel 10cm
|
$546.84 |
$546.84 |
$546.84 |
$6,142.50
|
|
Adding walker to prev cast
|
$18.00 |
$18.00 |
$18.00 |
$216.00
|
|
Adenosine 3 mg/250 ml bag for osm
|
$64.86 |
$64.86 |
$64.86 |
$210.75
|
|
Adenovirus antibody,serum - quest
|
$14.22 |
$14.22 |
$14.22 |
$63.00
|
|
Adh-sendout
|
$8.10 |
$8.10 |
$8.10 |
$109.16
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$13.79 |
$13.79 |
$13.79 |
$181.12
|
|
Admin ecg contrast agent
|
$36.00 |
$36.00 |
$36.00 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$159.12 |
$159.12 |
$159.12 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$159.12 |
$159.12 |
$159.12 |
$298.11
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$396.54 |
$396.54 |
$396.54 |
$639.20
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$810.72 |
$810.72 |
$810.72 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$750.78 |
$750.78 |
$750.78 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$810.72 |
$810.72 |
$810.72 |
$259.20
|
|
Administration immunization 1 vaccine
|
$59.94 |
$59.94 |
$59.94 |
$66.51
|
|
Administration immunization each additional vaccine
|
$11.88 |
$11.88 |
$11.88 |
$46.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$17.10 |
$17.10 |
$17.10 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$10.26 |
$10.26 |
$10.26 |
$30.00
|
|
_afb id by dna probe rflx ast
|
$102.42 |
$102.42 |
$102.42 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$18.46 |
$18.46 |
$18.46 |
$295.70
|
|
Air conduction bilat
|
$130.86 |
$130.86 |
$130.86 |
$122.40
|
|
Albumin body fluid quantitative each specimen
|
$28.26 |
$28.26 |
$28.26 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$83.20 |
$83.20 |
$83.20 |
$222.61
|
|
Albumin, human 25 % intravenous solution
|
$31.77 |
$31.77 |
$31.77 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$76.32 |
$76.32 |
$76.32 |
$234.36
|
|
Albumin, human 5 % intravenous solution
|
$35.69 |
$35.69 |
$35.69 |
$296.32
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$40.68 |
$40.68 |
$40.68 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$34.92 |
$34.92 |
$34.92 |
$40.00
|
|
Alkaline phosphatase
|
$32.04 |
$32.04 |
$32.04 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$7.25 |
$7.25 |
$7.25 |
$48.00
|
|
Allergen egg white ige
|
$30.42 |
$30.42 |
$30.42 |
$37.05
|
|
Allergen specific ige qual multi scrn ea
|
$1.43 |
$1.43 |
$1.43 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$3,996.00 |
$3,996.00 |
$3,996.00 |
$8,519.80
|