|
11-desoxycortisol - sendout
|
$77.17 |
$77.17 |
$77.17 |
$87.50
|
|
17-hydroxypregnenolone
|
$77.17 |
$77.17 |
$77.17 |
$87.50
|
|
17-ketosteroids
|
$13.27 |
$13.27 |
$13.27 |
$44.88
|
|
2d tee w or without fol w/con,in
|
$2,648.57 |
$2,648.57 |
$2,648.57 |
$1,525.28
|
|
2d tte w or without fol w/con,co
|
$1,020.09 |
$1,020.09 |
$1,020.09 |
$1,108.76
|
|
2nd order venous cath
|
$836.05 |
$836.05 |
$836.05 |
$1,720.80
|
|
3d ech img cgen car anomal
|
$1,186.38 |
$1,186.38 |
$1,186.38 |
$632.45
|
|
3d recon without postprocess indpndt
|
$235.25 |
$235.25 |
$235.25 |
$425.10
|
|
5' nucleotidase - sendout
|
$6.27 |
$6.27 |
$6.27 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$59.83 |
$59.83 |
$59.83 |
$97.65
|
|
99391 periodic comp preventive med less than 1 year est
|
$45.13 |
$45.13 |
$45.13 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$50.20 |
$50.20 |
$50.20 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$52.23 |
$52.23 |
$52.23 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$56.28 |
$56.28 |
$56.28 |
$147.92
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,281.50 |
$2,281.50 |
$2,281.50 |
$3,998.03
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$6.09 |
$6.09 |
$6.09 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$6,662.49 |
$6,662.49 |
$6,662.49 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$949.62 |
$949.62 |
$949.62 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$841.12 |
$841.12 |
$841.12 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$1,001.33 |
$1,001.33 |
$1,001.33 |
$2,727.40
|
|
Abd/low ext cath addl
|
$590.66 |
$590.66 |
$590.66 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$2,844.78 |
$2,844.78 |
$2,844.78 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$3,129.21 |
$3,129.21 |
$3,129.21 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,844.78 |
$2,844.78 |
$2,844.78 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,898.13 |
$4,898.13 |
$4,898.13 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$4,261.34 |
$4,261.34 |
$4,261.34 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$2,939.08 |
$2,939.08 |
$2,939.08 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,438.36 |
$1,438.36 |
$1,438.36 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$1,770.45 |
$1,770.45 |
$1,770.45 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,361.81 |
$1,361.81 |
$1,361.81 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$819.82 |
$819.82 |
$819.82 |
$1,248.00
|
|
Abl1 gene
|
$330.67 |
$330.67 |
$330.67 |
$614.25
|
|
Ablate arrhythmia add on
|
$4,213.68 |
$4,213.68 |
$4,213.68 |
$7,717.80
|
|
Ablate bone tumor(s) cryo perq 20983
|
$5,563.82 |
$5,563.82 |
$5,563.82 |
$8,096.90
|
|
Ablate bone tumor(s) perq
|
$10,792.01 |
$10,792.01 |
$10,792.01 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$9,480.90 |
$9,480.90 |
$9,480.90 |
$9,836.16
|
|
Ablation cardiac vagal inputs atrium
|
$9,300.92 |
$9,300.92 |
$9,300.92 |
$2,948.40
|
|
Ablation of upper extremity nerves rf
|
$393.94 |
$393.94 |
$393.94 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$3,921.65 |
$3,921.65 |
$3,921.65 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$102.93 |
$102.93 |
$102.93 |
$89.91
|
|
Acetazolamide 500 mg solution for injection
|
$114.08 |
$114.08 |
$114.08 |
$137.80
|
|
Acetone qualitative
|
$78.59 |
$78.59 |
$78.59 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$11.67 |
$11.67 |
$11.67 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$798.53 |
$798.53 |
$798.53 |
$306.22
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$196.72 |
$196.72 |
$196.72 |
$206.14
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$133.85 |
$133.85 |
$133.85 |
$160.50
|
|
Aco depression screen annual medicare g0444aco
|
$72.00 |
$72.00 |
$72.00 |
$32.97
|
|
Acute hepatitis panel
|
$16.74 |
$16.74 |
$16.74 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$33.97 |
$33.97 |
$33.97 |
$467.94
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$123.21 |
$123.21 |
$123.21 |
$64.45
|
|
#acylcarnitineprfl
|
$38.03 |
$38.03 |
$38.03 |
$87.72
|
|
Adapter b 8 channel 10cm
|
$3,275.73 |
$3,275.73 |
$3,275.73 |
$6,875.44
|
|
Adenosine 3 mg/250 ml bag for osm
|
$894.35 |
$894.35 |
$894.35 |
$217.04
|
|
Adh-sendout
|
$22.82 |
$22.82 |
$22.82 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$639.33 |
$639.33 |
$639.33 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$317.39 |
$317.39 |
$317.39 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$1,489.06 |
$1,489.06 |
$1,489.06 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,489.06 |
$1,489.06 |
$1,489.06 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$833.51 |
$833.51 |
$833.51 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$277.84 |
$277.84 |
$277.84 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$645.92 |
$645.92 |
$645.92 |
$267.43
|
|
Administration immunization 1 vaccine
|
$83.15 |
$83.15 |
$83.15 |
$70.00
|
|
Administration immunization each additional vaccine
|
$48.17 |
$48.17 |
$48.17 |
$46.23
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$4,363.25 |
$4,363.25 |
$4,363.25 |
$14,346.62
|
|
Aep hearing status deter i&r
|
$195.71 |
$195.71 |
$195.71 |
$305.73
|
|
_afb id by dna probe rflx ast
|
$215.48 |
$215.48 |
$215.48 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$75.96 |
$75.96 |
$75.96 |
$289.60
|
|
Airway resistance by impulse oscillometry 94728
|
$320.43 |
$320.43 |
$320.43 |
$279.73
|
|
Albumin body fluid quantitative each specimen
|
$86.70 |
$86.70 |
$86.70 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$491.29 |
$491.29 |
$491.29 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$507.00 |
$507.00 |
$507.00 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$111.46 |
$111.46 |
$111.46 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$57.30 |
$57.30 |
$57.30 |
$43.45
|
|
Aldesleukin injection
|
$5,066.46 |
$5,066.46 |
$5,066.46 |
$6,538.20
|
|
Alkaline phosphatase
|
$96.33 |
$96.33 |
$96.33 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$18.76 |
$18.76 |
$18.76 |
$56.35
|
|
Allergen egg white ige
|
$28.90 |
$28.90 |
$28.90 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$4.05 |
$4.05 |
$4.05 |
$26.95
|
|
Allograft 160mg placental salera mini membrane
|
$4,259.82 |
$4,259.82 |
$4,259.82 |
$4,906.77
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,201.94 |
$7,201.94 |
$7,201.94 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$7,201.94 |
$7,201.94 |
$7,201.94 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$12,173.07 |
$12,173.07 |
$12,173.07 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$15,826.01 |
$15,826.01 |
$15,826.01 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,259.82 |
$4,259.82 |
$4,259.82 |
$4,898.43
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$2,518.78 |
$2,518.78 |
$2,518.78 |
$5,381.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1,936.74 |
$1,936.74 |
$1,936.74 |
$5,538.22
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,518.78 |
$2,518.78 |
$2,518.78 |
$4,814.57
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$10.65 |
$10.65 |
$10.65 |
$51.00
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$50.20 |
$50.20 |
$50.20 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$4.06 |
$4.06 |
$4.06 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$3,760.42 |
$3,760.42 |
$3,760.42 |
$9,600.63
|
|
Alt/sgpt
|
$138.92 |
$138.92 |
$138.92 |
$49.00
|
|
Aluminum - quest
|
$6.12 |
$6.12 |
$6.12 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$196.21 |
$196.21 |
$196.21 |
$431.84
|
|
Ambl bp mntr w/sw a/r
|
$93.80 |
$93.80 |
$93.80 |
$318.96
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$31.95 |
$31.95 |
$31.95 |
$44.00
|
|
Amino acids quant 2-5
|
$111.06 |
$111.06 |
$111.06 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$2,372.76 |
$2,372.76 |
$2,372.76 |
$45.50
|
|
Aminolevulinic acid delta
|
$22.37 |
$22.37 |
$22.37 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$28.90 |
$28.90 |
$28.90 |
$43.72
|