|
17-hydroxypregnenolone
|
$19.98 |
$19.98 |
$19.98 |
$87.50
|
|
2d tee w or without fol w/con,in
|
$1,969.37 |
$1,969.37 |
$1,969.37 |
$1,525.28
|
|
3d recon without postprocess indpndt
|
$882.45 |
$882.45 |
$882.45 |
$425.10
|
|
5' nucleotidase - sendout
|
$8.23 |
$8.23 |
$8.23 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$16.65 |
$16.65 |
$16.65 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$114.56 |
$114.56 |
$114.56 |
$151.20
|
|
99382 initial comp preventive med 1 to 4 years new
|
$121.22 |
$121.22 |
$121.22 |
$147.49
|
|
99383 initial comp preventive med 5 to 11 years new
|
$133.87 |
$133.87 |
$133.87 |
$162.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$96.57 |
$96.57 |
$96.57 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$114.56 |
$114.56 |
$114.56 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$115.22 |
$115.22 |
$115.22 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$139.20 |
$139.20 |
$139.20 |
$147.92
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$8.00 |
$8.00 |
$8.00 |
$52.25
|
|
Abd exp/postop hem/throm/infec 35840
|
$2,063.27 |
$2,063.27 |
$2,063.27 |
$2,938.40
|
|
Abdominal CT scan (with and without contrast)
|
$9,055.61 |
$9,055.61 |
$9,055.61 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$6,462.87 |
$6,462.87 |
$6,462.87 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$4,340.99 |
$4,340.99 |
$4,340.99 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$9,470.52 |
$9,470.52 |
$9,470.52 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$8,801.19 |
$8,801.19 |
$8,801.19 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$6,201.80 |
$6,201.80 |
$6,201.80 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,631.70 |
$1,631.70 |
$1,631.70 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$2,016.65 |
$2,016.65 |
$2,016.65 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,575.76 |
$1,575.76 |
$1,575.76 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$2,215.12 |
$2,215.12 |
$2,215.12 |
$1,248.00
|
|
Abl1 gene
|
$279.72 |
$279.72 |
$279.72 |
$614.25
|
|
Ablate bone tumor(s) perq
|
$8,878.45 |
$8,878.45 |
$8,878.45 |
$9,812.40
|
|
Abscess drain retroperitoneal surg code
|
$307.70 |
$307.70 |
$307.70 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$154.59 |
$154.59 |
$154.59 |
$89.91
|
|
Acetone qualitative
|
$135.87 |
$135.87 |
$135.87 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$15.32 |
$15.32 |
$15.32 |
$64.50
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$293.04 |
$293.04 |
$293.04 |
$206.14
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$195.81 |
$195.81 |
$195.81 |
$160.50
|
|
Aco depression screen annual medicare g0444aco
|
$51.29 |
$51.29 |
$51.29 |
$32.97
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$130.54 |
$130.54 |
$130.54 |
$44.40
|
|
Acoustic refl threshold tst
|
$28.64 |
$28.64 |
$28.64 |
$83.79
|
|
Acup 1/> w/estim 1st 15 min
|
$111.23 |
$111.23 |
$111.23 |
$47.33
|
|
Acute hepatitis panel
|
$322.35 |
$322.35 |
$322.35 |
$284.70
|
|
Acute venous thrombus image
|
$5,656.34 |
$5,656.34 |
$5,656.34 |
$873.75
|
|
Adh-sendout
|
$29.97 |
$29.97 |
$29.97 |
$109.28
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$1,009.66 |
$1,009.66 |
$1,009.66 |
$2,837.09
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$263.72 |
$263.72 |
$263.72 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$369.63 |
$369.63 |
$369.63 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$634.70 |
$634.70 |
$634.70 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,154.85 |
$1,154.85 |
$1,154.85 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,096.91 |
$1,096.91 |
$1,096.91 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$343.66 |
$343.66 |
$343.66 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$343.66 |
$343.66 |
$343.66 |
$267.43
|
|
Administration immunization 1 vaccine
|
$135.87 |
$135.87 |
$135.87 |
$70.00
|
|
Administration immunization each additional component
|
$22.65 |
$22.65 |
$22.65 |
$27.20
|
|
Administration immunization each additional vaccine
|
$139.86 |
$139.86 |
$139.86 |
$46.23
|
|
Administration immunization first component each vaccine
|
$45.29 |
$45.29 |
$45.29 |
$45.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$19.98 |
$19.98 |
$19.98 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$19.98 |
$19.98 |
$19.98 |
$33.60
|
|
Adrenal cortex & medulla img
|
$7,377.95 |
$7,377.95 |
$7,377.95 |
$1,818.05
|
|
Advance care planning each additional 30 min 99498
|
$131.21 |
$131.21 |
$131.21 |
$128.10
|
|
_afb id by dna probe rflx ast
|
$33.39 |
$33.39 |
$33.39 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$419.58 |
$419.58 |
$419.58 |
$38.58
|
|
Albumin body fluid quantitative each specimen
|
$55.28 |
$55.28 |
$55.28 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$587.42 |
$587.42 |
$587.42 |
$277.87
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$79.92 |
$79.92 |
$79.92 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$51.29 |
$51.29 |
$51.29 |
$43.45
|
|
Alkaline phosphatase
|
$38.63 |
$38.63 |
$38.63 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$7.62 |
$7.62 |
$7.62 |
$56.35
|
|
Allergen egg white ige
|
$19.41 |
$19.41 |
$19.41 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$4.90 |
$4.90 |
$4.90 |
$26.95
|
|
Allergy injections; 2 or more 95117
|
$34.64 |
$34.64 |
$34.64 |
$47.20
|
|
Allergy injection; single 95115
|
$25.31 |
$25.31 |
$25.31 |
$42.75
|
|
Allgrft implnt knee w/scope
|
$2,273.06 |
$2,273.06 |
$2,273.06 |
$6,286.40
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,277.39 |
$7,277.39 |
$7,277.39 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$9,461.87 |
$9,461.87 |
$9,461.87 |
$8,295.72
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$3,310.02 |
$3,310.02 |
$3,310.02 |
$3,621.72
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$66.60 |
$66.60 |
$66.60 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$295.04 |
$295.04 |
$295.04 |
$103.60
|
|
Alt/sgpt
|
$56.61 |
$56.61 |
$56.61 |
$49.00
|
|
Aluminum - quest
|
$8.04 |
$8.04 |
$8.04 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$159.84 |
$159.84 |
$159.84 |
$431.84
|
|
Amiodarone 50 mg/ml intravenous solution
|
$113.21 |
$113.21 |
$113.21 |
$50.85
|
|
Ammonia
|
$226.44 |
$226.44 |
$226.44 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$1,965.37 |
$1,965.37 |
$1,965.37 |
$963.79
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,108.23 |
$1,108.23 |
$1,108.23 |
$3,969.00
|
|
Amp metatarsal w/toe single 28810
|
$579.42 |
$579.42 |
$579.42 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$1,642.36 |
$1,642.36 |
$1,642.36 |
$3,996.20
|
|
Amputation leg; tib/fib f/u 27886
|
$1,144.19 |
$1,144.19 |
$1,144.19 |
$3,206.40
|
|
Amputation thru metatarsal
|
$1,334.00 |
$1,334.00 |
$1,334.00 |
$3,791.82
|
|
Amputation toe interphalangeal joint
|
$684.65 |
$684.65 |
$684.65 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$733.27 |
$733.27 |
$733.27 |
$3,777.93
|
|
Amylase
|
$129.21 |
$129.21 |
$129.21 |
$93.00
|
|
Ana ds-dna
|
$20.17 |
$20.17 |
$20.17 |
$65.52
|
|
Analysis gene f2 20210g>a variant
|
$109.38 |
$109.38 |
$109.38 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$122.17 |
$122.17 |
$122.17 |
$226.60
|
|
Analysis tumor
|
$61.34 |
$61.34 |
$61.34 |
$240.00
|
|
Anca screen with reflex to titer -quest
|
$41.87 |
$41.87 |
$41.87 |
$103.20
|
|
An fluoro guide for cvp
|
$157.18 |
$157.18 |
$157.18 |
$509.60
|
|
Angiotensin ii
|
$79.26 |
$79.26 |
$79.26 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,321.35 |
$1,321.35 |
$1,321.35 |
$6,048.00
|
|
Ankle arthroscopy/surgery
|
$1,114.22 |
$1,114.22 |
$1,114.22 |
$6,193.84
|
|
Ankle arthroscopy/surgery
|
$889.78 |
$889.78 |
$889.78 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$859.14 |
$859.14 |
$859.14 |
$3,839.54
|
|
Annual alcohol screen 15 min
|
$17.99 |
$17.99 |
$17.99 |
$33.00
|
|
Anora (draw only)
|
$39.96 |
$39.96 |
$39.96 |
$36.36
|