|
2d tee w or without fol w/con,in
|
$2,039.80 |
$2,039.80 |
$2,039.80 |
$1,525.28
|
|
2nd order venous cath
|
$205.80 |
$205.80 |
$205.80 |
$1,720.80
|
|
3d ech img cgen car anomal
|
$284.20 |
$284.20 |
$284.20 |
$632.45
|
|
3-d radiotherapy plan
|
$1,157.10 |
$1,157.10 |
$1,157.10 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$131.60 |
$131.60 |
$131.60 |
$425.10
|
|
Abd aorta w/runoff s&i
|
$3,587.50 |
$3,587.50 |
$3,587.50 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$192.15 |
$192.15 |
$192.15 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$192.15 |
$192.15 |
$192.15 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$192.15 |
$192.15 |
$192.15 |
$2,727.40
|
|
Abd/low ext cath addl
|
$321.30 |
$321.30 |
$321.30 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$1,385.65 |
$1,385.65 |
$1,385.65 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$1,291.50 |
$1,291.50 |
$1,291.50 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,123.50 |
$1,123.50 |
$1,123.50 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,054.10 |
$3,054.10 |
$3,054.10 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$2,648.45 |
$2,648.45 |
$2,648.45 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$2,242.45 |
$2,242.45 |
$2,242.45 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,120.70 |
$1,120.70 |
$1,120.70 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$1,149.40 |
$1,149.40 |
$1,149.40 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$629.65 |
$629.65 |
$629.65 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$1,486.80 |
$1,486.80 |
$1,486.80 |
$1,248.00
|
|
Ablate arrhythmia add on
|
$3,400.60 |
$3,400.60 |
$3,400.60 |
$7,717.80
|
|
Ablate heart dysrhythm focus
|
$4,108.65 |
$4,108.65 |
$4,108.65 |
$9,836.16
|
|
Ablate inf turbinate superf 30801
|
$1,159.20 |
$1,159.20 |
$1,159.20 |
$2,122.56
|
|
Ablation cardiac vagal inputs atrium
|
$621.60 |
$621.60 |
$621.60 |
$2,948.40
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$227.15 |
$227.15 |
$227.15 |
$339.18
|
|
Ablation of upper extremity nerves rf
|
$295.75 |
$295.75 |
$295.75 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$6,010.20 |
$6,010.20 |
$6,010.20 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$1,717.10 |
$1,717.10 |
$1,717.10 |
$3,287.87
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$34.62 |
$34.62 |
$34.62 |
$89.91
|
|
Acetaminophen level
|
$163.80 |
$163.80 |
$163.80 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$114.46 |
$114.46 |
$114.46 |
$137.80
|
|
Acetone qualitative
|
$60.20 |
$60.20 |
$60.20 |
$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
|
$140.00 |
$140.00 |
$140.00 |
$265.20
|
|
Acute hepatitis panel
|
$161.00 |
$161.00 |
$161.00 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$33.57 |
$33.57 |
$33.57 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$6,875.44 |
$6,875.44 |
$6,875.44 |
$6,875.44
|
|
Adding walker to prev cast
|
$140.00 |
$140.00 |
$140.00 |
$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
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$7,907.11
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$3,146.85 |
$3,146.85 |
$3,146.85 |
$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
|
$55.65 |
$55.65 |
$55.65 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$80.15 |
$80.15 |
$80.15 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$604.80 |
$604.80 |
$604.80 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$604.80 |
$604.80 |
$604.80 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$77.35 |
$77.35 |
$77.35 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$77.35 |
$77.35 |
$77.35 |
$267.43
|
|
Administration immunization 1 vaccine
|
$25.90 |
$25.90 |
$25.90 |
$70.00
|
|
Administration immunization each additional vaccine
|
$25.90 |
$25.90 |
$25.90 |
$46.23
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$14,346.62 |
$14,346.62 |
$14,346.62 |
$14,346.62
|
|
_afb id by dna probe rflx ast
|
$21.35 |
$21.35 |
$21.35 |
$105.00
|
|
Albumin body fluid quantitative each specimen
|
$76.30 |
$76.30 |
$76.30 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$247.74 |
$247.74 |
$247.74 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$129.36 |
$129.36 |
$129.36 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$85.75 |
$85.75 |
$85.75 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$42.35 |
$42.35 |
$42.35 |
$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
|
$1.04 |
$1.04 |
$1.04 |
$9.43
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$223.65 |
$223.65 |
$223.65 |
$94.90
|
|
Aldesleukin injection
|
$15,640.46 |
$15,640.46 |
$15,640.46 |
$6,538.20
|
|
Alkaline phosphatase
|
$47.25 |
$47.25 |
$47.25 |
$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-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,881.60 |
$1,881.60 |
$1,881.60 |
$51.00
|
|
Alpha-fetoprotein tumor marker
|
$115.50 |
$115.50 |
$115.50 |
$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
|
$57.40 |
$57.40 |
$57.40 |
$49.00
|
|
Amantadine (symmetrel)-sendout
|
$31.21 |
$31.21 |
$31.21 |
$188.65
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$47.38 |
$47.38 |
$47.38 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$35.21 |
$35.21 |
$35.21 |
$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
|
$84.18 |
$84.18 |
$84.18 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$302.06 |
$302.06 |
$302.06 |
$50.85
|
|
Ammonia
|
$98.70 |
$98.70 |
$98.70 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$402.15 |
$402.15 |
$402.15 |
$963.79
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$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 lipid complex
|
$377.26 |
$377.26 |
$377.26 |
$337.94
|
|
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
|
$87.20 |
$87.20 |
$87.20 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$35.46 |
$35.46 |
$35.46 |
$57.38
|
|
Amp metatarsal w/toe single 28810
|
$3,930.50 |
$3,930.50 |
$3,930.50 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$3,777.93
|
|
Amylase
|
$144.20 |
$144.20 |
$144.20 |
$93.00
|
|
Ana ds-dna
|
$23.80 |
$23.80 |
$23.80 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$163.80 |
$163.80 |
$163.80 |
$117.01
|
|
Anca screen with reflex to titer -quest
|
$95.68 |
$95.68 |
$95.68 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$3,987.20 |
$3,987.20 |
$3,987.20 |
$2,426.60
|