|
2nd order venous cath
|
$1,516.20 |
$1,516.20 |
$1,516.20 |
$1,720.80
|
|
3d ech img cgen car anomal
|
$222.60 |
$222.60 |
$222.60 |
$632.45
|
|
3d recon without postprocess indpndt
|
$334.95 |
$334.95 |
$334.95 |
$425.10
|
|
88334 ap bill cytologic exam each additional site
|
$40.25 |
$40.25 |
$40.25 |
$97.65
|
|
Abd/low ext cath 1st
|
$1,532.30 |
$1,532.30 |
$1,532.30 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$524.30 |
$524.30 |
$524.30 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$537.95 |
$537.95 |
$537.95 |
$2,727.40
|
|
Abd/low ext cath addl
|
$190.75 |
$190.75 |
$190.75 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$1,920.10 |
$1,920.10 |
$1,920.10 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$1,802.15 |
$1,802.15 |
$1,802.15 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,532.65 |
$1,532.65 |
$1,532.65 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$2,061.15 |
$2,061.15 |
$2,061.15 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$1,874.95 |
$1,874.95 |
$1,874.95 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,552.25 |
$1,552.25 |
$1,552.25 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$942.20 |
$942.20 |
$942.20 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$519.05 |
$519.05 |
$519.05 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$917.00 |
$917.00 |
$917.00 |
$1,248.00
|
|
Ablate inf turbinate superf 30801
|
$1,027.25 |
$1,027.25 |
$1,027.25 |
$2,122.56
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$250.25 |
$250.25 |
$250.25 |
$339.18
|
|
Ablation of upper extremity nerves rf
|
$183.40 |
$183.40 |
$183.40 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$5,992.00 |
$5,992.00 |
$5,992.00 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$35.14 |
$35.14 |
$35.14 |
$89.91
|
|
Acetaminophen level
|
$167.30 |
$167.30 |
$167.30 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$105.09 |
$105.09 |
$105.09 |
$137.80
|
|
Acetone qualitative
|
$30.80 |
$30.80 |
$30.80 |
$48.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$74.56 |
$74.56 |
$74.56 |
$306.22
|
|
Acetylcysteine non-comp unit
|
$7.69 |
$7.69 |
$7.69 |
$29.01
|
|
Acne surgery 10040
|
$242.20 |
$242.20 |
$242.20 |
$265.20
|
|
Acute hepatitis panel
|
$220.15 |
$220.15 |
$220.15 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$34.08 |
$34.08 |
$34.08 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$6,875.44 |
$6,875.44 |
$6,875.44 |
$6,875.44
|
|
Adding walker to prev cast
|
$242.20 |
$242.20 |
$242.20 |
$205.38
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,198.46 |
$1,198.46 |
$1,198.46 |
$217.04
|
|
Adjmt/revj ext fixj sys anes
|
$3,983.00 |
$3,983.00 |
$3,983.00 |
$7,907.11
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,247.00 |
$2,247.00 |
$2,247.00 |
$2,837.09
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$254.14 |
$254.14 |
$254.14 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$152.25 |
$152.25 |
$152.25 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$124.60 |
$124.60 |
$124.60 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$676.55 |
$676.55 |
$676.55 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$364.70 |
$364.70 |
$364.70 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$201.60 |
$201.60 |
$201.60 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$201.60 |
$201.60 |
$201.60 |
$267.43
|
|
Administration immunization 1 vaccine
|
$46.20 |
$46.20 |
$46.20 |
$70.00
|
|
Administration immunization each additional vaccine
|
$46.20 |
$46.20 |
$46.20 |
$46.23
|
|
Aep neurodiagnostic i&r
|
$271.95 |
$271.95 |
$271.95 |
$509.00
|
|
Aep thrshld est mlt freq i&r
|
$851.90 |
$851.90 |
$851.90 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$53.90 |
$53.90 |
$53.90 |
$105.00
|
|
After cataract laser surgery
|
$2,432.50 |
$2,432.50 |
$2,432.50 |
$1,464.80
|
|
Albumin body fluid quantitative each specimen
|
$71.75 |
$71.75 |
$71.75 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$121.13 |
$121.13 |
$121.13 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$123.48 |
$123.48 |
$123.48 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$26.60 |
$26.60 |
$26.60 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$71.75 |
$71.75 |
$71.75 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$0.61 |
$0.61 |
$0.61 |
$9.93
|
|
Albuterol non-comp con
|
$0.70 |
$0.70 |
$0.70 |
$9.93
|
|
Albuterol non-comp unit
|
$0.61 |
$0.61 |
$0.61 |
$9.43
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$71.40 |
$71.40 |
$71.40 |
$94.90
|
|
Alkaline phosphatase
|
$107.10 |
$107.10 |
$107.10 |
$46.50
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$3,985.24 |
$3,985.24 |
$3,985.24 |
$5,579.34
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$21,510.09 |
$21,510.09 |
$21,510.09 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$8,403.84 |
$8,403.84 |
$8,403.84 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$22,984.85 |
$22,984.85 |
$22,984.85 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$17,109.79 |
$17,109.79 |
$17,109.79 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,232.06 |
$4,232.06 |
$4,232.06 |
$4,898.43
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,783.40 |
$5,783.40 |
$5,783.40 |
$5,381.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,191.43 |
$4,191.43 |
$4,191.43 |
$5,538.22
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$4,814.57 |
$4,814.57 |
$4,814.57 |
$4,814.57
|
|
Alpha-fetoprotein tumor marker
|
$103.60 |
$103.60 |
$103.60 |
$103.60
|
|
Alprostadil for injection
|
$597.56 |
$597.56 |
$597.56 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$31,630.68 |
$31,630.68 |
$31,630.68 |
$9,600.63
|
|
Alt/sgpt
|
$109.20 |
$109.20 |
$109.20 |
$49.00
|
|
Amantadine (symmetrel)-sendout
|
$31.21 |
$31.21 |
$31.21 |
$188.65
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$44.05 |
$44.05 |
$44.05 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$34.91 |
$34.91 |
$34.91 |
$45.50
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$70.52 |
$70.52 |
$70.52 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$103.94 |
$103.94 |
$103.94 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$34.05 |
$34.05 |
$34.05 |
$50.85
|
|
Ammonia
|
$161.00 |
$161.00 |
$161.00 |
$123.48
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$3,969.00
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$135.63 |
$135.63 |
$135.63 |
$135.63
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$382.55 |
$382.55 |
$382.55 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$34.94 |
$34.94 |
$34.94 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$35.07 |
$35.07 |
$35.07 |
$57.38
|
|
Amp metatarsal w/toe single 28810
|
$2,377.90 |
$2,377.90 |
$2,377.90 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$2,150.75 |
$2,150.75 |
$2,150.75 |
$3,839.54
|
|
Amylase
|
$118.30 |
$118.30 |
$118.30 |
$93.00
|
|
Ana ds-dna
|
$21.00 |
$21.00 |
$21.00 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$167.30 |
$167.30 |
$167.30 |
$117.01
|
|
Anca screen with reflex to titer -quest
|
$95.68 |
$95.68 |
$95.68 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,277.80 |
$2,277.80 |
$2,277.80 |
$2,426.60
|
|
An fluoro guide for cvp
|
$695.80 |
$695.80 |
$695.80 |
$509.60
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,573.45 |
$4,573.45 |
$4,573.45 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$5,334.35 |
$5,334.35 |
$5,334.35 |
$9,462.03
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$5,334.35 |
$5,334.35 |
$5,334.35 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$2,620.80 |
$2,620.80 |
$2,620.80 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$611.74 |
$611.74 |
$611.74 |
$6,048.00
|
|
Angio tib/peroneal/init ves/unila 37228
|
$8,910.30 |
$8,910.30 |
$8,910.30 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$2,392.60 |
$2,392.60 |
$2,392.60 |
$5,741.00
|
|
Angio trnslmnl balloon same artery ini
|
$5,980.80 |
$5,980.80 |
$5,980.80 |
$9,074.63
|