|
11-desoxycortisol - sendout
|
$55.25 |
$55.25 |
$55.25 |
$91.85
|
|
17-hydroxypregnenolone
|
$55.25 |
$55.25 |
$55.25 |
$92.65
|
|
17-ketosteroids
|
$42.90 |
$42.90 |
$42.90 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$2,717.65 |
$2,717.65 |
$2,717.65 |
$1,724.25
|
|
2nd order venous cath
|
$1,651.65 |
$1,651.65 |
$1,651.65 |
$1,532.04
|
|
3-d radiotherapy plan
|
$4,367.35 |
$4,367.35 |
$4,367.35 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$796.25 |
$796.25 |
$796.25 |
$508.13
|
|
5' nucleotidase - sendout
|
$33.80 |
$33.80 |
$33.80 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$42.25 |
$42.25 |
$42.25 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,840.80 |
$3,840.80 |
$3,840.80 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$41.60 |
$41.60 |
$41.60 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$5,202.60 |
$5,202.60 |
$5,202.60 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$2,106.65 |
$2,106.65 |
$2,106.65 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,743.30 |
$1,743.30 |
$1,743.30 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$1,427.40 |
$1,427.40 |
$1,427.40 |
$2,475.45
|
|
Abd/low ext cath addl
|
$1,327.30 |
$1,327.30 |
$1,327.30 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,149.85 |
$1,149.85 |
$1,149.85 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$463.45 |
$463.45 |
$463.45 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,904.85 |
$2,904.85 |
$2,904.85 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,507.70 |
$2,507.70 |
$2,507.70 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,261.35 |
$2,261.35 |
$2,261.35 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,599.05 |
$3,599.05 |
$3,599.05 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,599.05 |
$3,599.05 |
$3,599.05 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$3,270.80 |
$3,270.80 |
$3,270.80 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,102.10 |
$2,102.10 |
$2,102.10 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$1,046.50 |
$1,046.50 |
$1,046.50 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$574.60 |
$574.60 |
$574.60 |
$318.20
|
|
Abdominal X-ray (single view)
|
$516.10 |
$516.10 |
$516.10 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,602.90 |
$1,602.90 |
$1,602.90 |
$1,148.40
|
|
Abl1 gene
|
$835.25 |
$835.25 |
$835.25 |
$683.20
|
|
Ablate arrhythmia add on
|
$14,510.60 |
$14,510.60 |
$14,510.60 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$15,605.85 |
$15,605.85 |
$15,605.85 |
$9,332.05
|
|
Ablate pulm tumor perq rf
|
$14,036.75 |
$14,036.75 |
$14,036.75 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$1,609.40 |
$1,609.40 |
$1,609.40 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$5,653.70 |
$5,653.70 |
$5,653.70 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$15,769.65 |
$15,769.65 |
$15,769.65 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$447.20 |
$447.20 |
$447.20 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$1,996.80 |
$1,996.80 |
$1,996.80 |
$3,050.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$19.50 |
$19.50 |
$19.50 |
$72.74
|
|
Acetaminophen 120 mg rectal suppository
|
$1,063.27 |
$1,063.27 |
$1,063.27 |
$146.76
|
|
Acetaminophen level
|
$220.35 |
$220.35 |
$220.35 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$152.24 |
$152.24 |
$152.24 |
$122.55
|
|
Acetone qualitative
|
$105.30 |
$105.30 |
$105.30 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$33.67 |
$33.67 |
$33.67 |
$218.79
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$345.15 |
$345.15 |
$345.15 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$16.90 |
$16.90 |
$16.90 |
$38.50
|
|
Acup 1/> w/estim 1st 15 min
|
$93.60 |
$93.60 |
$93.60 |
$56.16
|
|
Acup 1/> wo estim 1st 15 min
|
$79.30 |
$79.30 |
$79.30 |
$53.50
|
|
Acute hepatitis panel
|
$364.00 |
$364.00 |
$364.00 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$370.65 |
$370.65 |
$370.65 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$9.75 |
$9.75 |
$9.75 |
$64.45
|
|
#acylcarnitineprfl
|
$228.80 |
$228.80 |
$228.80 |
$121.55
|
|
Adalimumab injection
|
$7,690.44 |
$7,690.44 |
$7,690.44 |
$6,853.40
|
|
Adapter b 8 channel 10cm
|
$16,818.10 |
$16,818.10 |
$16,818.10 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$62.39 |
$62.39 |
$62.39 |
$271.98
|
|
Adenovirus ag ia
|
$161.20 |
$161.20 |
$161.20 |
$53.95
|
|
Adenovirus antibody,serum - quest
|
$143.65 |
$143.65 |
$143.65 |
$58.00
|
|
Adh-sendout
|
$104.65 |
$104.65 |
$104.65 |
$118.79
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$4,986.15 |
$4,986.15 |
$4,986.15 |
$3,397.11
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$65.85 |
$65.85 |
$65.85 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$267.80 |
$267.80 |
$267.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$267.80 |
$267.80 |
$267.80 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$846.95 |
$846.95 |
$846.95 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$543.40 |
$543.40 |
$543.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$237.90 |
$237.90 |
$237.90 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$312.65 |
$312.65 |
$312.65 |
$256.49
|
|
Administration immunization each additional vaccine
|
$104.65 |
$104.65 |
$104.65 |
$47.40
|
|
Administration vaccine hepatitis b
|
$154.70 |
$154.70 |
$154.70 |
$53.00
|
|
Administration vaccine influenza virus
|
$105.30 |
$105.30 |
$105.30 |
$51.07
|
|
Administration vaccine pneumococcal
|
$104.65 |
$104.65 |
$104.65 |
$49.68
|
|
_afb id by dna probe rflx ast
|
$173.55 |
$173.55 |
$173.55 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$18.85 |
$18.85 |
$18.85 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$321.10 |
$321.10 |
$321.10 |
$300.00
|
|
Air injection into abdomen 49400
|
$809.25 |
$809.25 |
$809.25 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$281.45 |
$281.45 |
$281.45 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$9.75 |
$9.75 |
$9.75 |
$244.70
|
|
Albumin, human 5 % intravenous solution
|
$9.75 |
$9.75 |
$9.75 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$128.05 |
$128.05 |
$128.05 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$46.80 |
$46.80 |
$46.80 |
$43.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$341.90 |
$341.90 |
$341.90 |
$96.00
|
|
Aldesleukin injection
|
$11,756.52 |
$11,756.52 |
$11,756.52 |
$9,030.11
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$79,320.64 |
$79,320.64 |
$79,320.64 |
$47,974.31
|
|
Alkaline phosphatase
|
$219.05 |
$219.05 |
$219.05 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$332.80 |
$332.80 |
$332.80 |
$48.57
|
|
Allergen egg white ige
|
$228.15 |
$228.15 |
$228.15 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$18.85 |
$18.85 |
$18.85 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$15,351.70 |
$15,351.70 |
$15,351.70 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$386.10 |
$386.10 |
$386.10 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$7,875.40 |
$7,875.40 |
$7,875.40 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$6,155.50 |
$6,155.50 |
$6,155.50 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$899.60 |
$899.60 |
$899.60 |
$4,677.40
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$14,838.85 |
$14,838.85 |
$14,838.85 |
$1,225.35
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$20.83 |
$20.83 |
$20.83 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$237.90 |
$237.90 |
$237.90 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$51.35 |
$51.35 |
$51.35 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$556.56 |
$556.56 |
$556.56 |
$15,857.45
|
|
Alt/sgpt
|
$87.10 |
$87.10 |
$87.10 |
$47.50
|
|
Aluminum - quest
|
$79.95 |
$79.95 |
$79.95 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$343.85 |
$343.85 |
$343.85 |
$411.45
|
