|
2d tee w or without fol w/con,in
|
$705.25 |
$705.25 |
$705.25 |
$1,525.28
|
|
2d tte w or without fol w/con,co
|
$705.25 |
$705.25 |
$705.25 |
$1,108.76
|
|
2nd order venous cath
|
$524.65 |
$524.65 |
$524.65 |
$1,720.80
|
|
3d ech img cgen car anomal
|
$214.20 |
$214.20 |
$214.20 |
$632.45
|
|
3-d radiotherapy plan
|
$3,606.05 |
$3,606.05 |
$3,606.05 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$182.70 |
$182.70 |
$182.70 |
$425.10
|
|
88334 ap bill cytologic exam each additional site
|
$71.05 |
$71.05 |
$71.05 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$5,571.10 |
$5,571.10 |
$5,571.10 |
$3,998.03
|
|
Abd aorta w/runoff s&i
|
$2,310.35 |
$2,310.35 |
$2,310.35 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$1,380.05 |
$1,380.05 |
$1,380.05 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$1,509.20 |
$1,509.20 |
$1,509.20 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$1,677.20 |
$1,677.20 |
$1,677.20 |
$2,727.40
|
|
Abd/low ext cath addl
|
$322.00 |
$322.00 |
$322.00 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$2,833.60 |
$2,833.60 |
$2,833.60 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,543.45 |
$2,543.45 |
$2,543.45 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,042.60 |
$2,042.60 |
$2,042.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,801.40 |
$2,801.40 |
$2,801.40 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$2,022.65 |
$2,022.65 |
$2,022.65 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$1,922.90 |
$1,922.90 |
$1,922.90 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$756.35 |
$756.35 |
$756.35 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$627.20 |
$627.20 |
$627.20 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$574.70 |
$574.70 |
$574.70 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$738.15 |
$738.15 |
$738.15 |
$1,248.00
|
|
Ablat 1/+thyr ndul addl prq rf
|
$35.00 |
$35.00 |
$35.00 |
$1,370.00
|
|
Ablate arrhythmia add on
|
$225.40 |
$225.40 |
$225.40 |
$7,717.80
|
|
Ablate bone tumor(s) cryo perq 20983
|
$10,658.90 |
$10,658.90 |
$10,658.90 |
$8,096.90
|
|
Ablate bone tumor(s) perq
|
$11,723.95 |
$11,723.95 |
$11,723.95 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$4,309.20 |
$4,309.20 |
$4,309.20 |
$9,836.16
|
|
Ablate inf turbinate superf 30801
|
$1,657.95 |
$1,657.95 |
$1,657.95 |
$2,122.56
|
|
Ablate pulm tumor perq crybl
|
$16,377.90 |
$16,377.90 |
$16,377.90 |
$9,977.40
|
|
Ablate pulm tumor perq rf
|
$14,786.45 |
$14,786.45 |
$14,786.45 |
$7,911.80
|
|
Ablation cardiac vagal inputs atrium
|
$3,516.10 |
$3,516.10 |
$3,516.10 |
$2,948.40
|
|
Ablation cryo abd perit om
|
$1,052.80 |
$1,052.80 |
$1,052.80 |
$2,555.80
|
|
Ablation cryo adrenal tumor
|
$2,450.00 |
$2,450.00 |
$2,450.00 |
$6,904.15
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$501.55 |
$501.55 |
$501.55 |
$339.18
|
|
Ablation of upper extremity nerves rf
|
$278.60 |
$278.60 |
$278.60 |
$825.60
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$4,998.00 |
$4,998.00 |
$4,998.00 |
$3,396.00
|
|
Abobotulinumtoxina
|
$2,507.07 |
$2,507.07 |
$2,507.07 |
$1,066.88
|
|
Abscess drain retroperitoneal surg code
|
$1,894.90 |
$1,894.90 |
$1,894.90 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$630.00 |
$630.00 |
$630.00 |
$3,287.87
|
|
Access thoracic lymph duct
|
$347.90 |
$347.90 |
$347.90 |
$879.45
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$86.28 |
$86.28 |
$86.28 |
$89.91
|
|
Acetaminophen level
|
$87.15 |
$87.15 |
$87.15 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$105.37 |
$105.37 |
$105.37 |
$137.80
|
|
Acetone qualitative
|
$144.55 |
$144.55 |
$144.55 |
$48.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$395.25 |
$395.25 |
$395.25 |
$306.22
|
|
Acetylcysteine non-comp unit
|
$7.69 |
$7.69 |
$7.69 |
$29.01
|
|
Acne surgery 10040
|
$256.55 |
$256.55 |
$256.55 |
$265.20
|
|
Acup 1/> w/estim 1st 15 min
|
$23.80 |
$23.80 |
$23.80 |
$47.33
|
|
Acup 1/> wo estim 1st 15 min
|
$23.80 |
$23.80 |
$23.80 |
$42.90
|
|
Acute hepatitis panel
|
$210.70 |
$210.70 |
$210.70 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$68.32 |
$68.32 |
$68.32 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$6,875.44 |
$6,875.44 |
$6,875.44 |
$6,875.44
|
|
Adding walker to prev cast
|
$163.10 |
$163.10 |
$163.10 |
$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
|
$4,291.70 |
$4,291.70 |
$4,291.70 |
$7,907.11
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,131.85 |
$2,131.85 |
$2,131.85 |
$2,837.09
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$201.78 |
$201.78 |
$201.78 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$275.10 |
$275.10 |
$275.10 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$275.10 |
$275.10 |
$275.10 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$984.90 |
$984.90 |
$984.90 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$564.55 |
$564.55 |
$564.55 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$275.10 |
$275.10 |
$275.10 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$349.30 |
$349.30 |
$349.30 |
$267.43
|
|
Administration immunization 1 vaccine
|
$22.75 |
$22.75 |
$22.75 |
$70.00
|
|
Administration immunization each additional vaccine
|
$22.75 |
$22.75 |
$22.75 |
$46.23
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$14,346.62 |
$14,346.62 |
$14,346.62 |
$14,346.62
|
|
Adrenal cortex & medulla img
|
$2,182.95 |
$2,182.95 |
$2,182.95 |
$1,818.05
|
|
Aep thrshld est mlt freq i&r
|
$635.60 |
$635.60 |
$635.60 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$84.35 |
$84.35 |
$84.35 |
$105.00
|
|
Air conduction bilat
|
$87.85 |
$87.85 |
$87.85 |
$116.22
|
|
Air injection into abdomen 49400
|
$366.10 |
$366.10 |
$366.10 |
$545.00
|
|
Albumin body fluid quantitative each specimen
|
$81.90 |
$81.90 |
$81.90 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$156.21 |
$156.21 |
$156.21 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$179.34 |
$179.34 |
$179.34 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$77.70 |
$77.70 |
$77.70 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$96.60 |
$96.60 |
$96.60 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$0.61 |
$0.61 |
$0.61 |
$9.93
|
|
Albuterol non-comp con
|
$0.61 |
$0.61 |
$0.61 |
$9.93
|
|
Albuterol non-comp unit
|
$0.61 |
$0.61 |
$0.61 |
$9.43
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$127.05 |
$127.05 |
$127.05 |
$94.90
|
|
Aldesleukin injection
|
$15,640.46 |
$15,640.46 |
$15,640.46 |
$6,538.20
|
|
Alkaline phosphatase
|
$75.25 |
$75.25 |
$75.25 |
$46.50
|
|
Allograft 160mg placental salera mini membrane
|
$27.96 |
$27.96 |
$27.96 |
$4,906.77
|
|
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
|
$54.95 |
$54.95 |
$54.95 |
$103.60
|
|
Alprostadil for injection
|
$465.63 |
$465.63 |
$465.63 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$31,630.68 |
$31,630.68 |
$31,630.68 |
$9,600.63
|
|
Alt/sgpt
|
$81.90 |
$81.90 |
$81.90 |
$49.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$147.00 |
$147.00 |
$147.00 |
$431.84
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$88.09 |
$88.09 |
$88.09 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$34.91 |
$34.91 |
$34.91 |
$45.50
|