|
11-desoxycortisol - sendout
|
$192.60 |
$192.60 |
$192.60 |
$87.50
|
|
17-hydroxypregnenolone
|
$149.40 |
$149.40 |
$149.40 |
$89.25
|
|
3-d radiotherapy plan
|
$6,799.80 |
$6,799.80 |
$6,799.80 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$2,160.60 |
$2,160.60 |
$2,160.60 |
$485.00
|
|
5' nucleotidase - sendout
|
$163.20 |
$163.20 |
$163.20 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$97.20 |
$97.20 |
$97.20 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$4,703.40 |
$4,703.40 |
$4,703.40 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$2,369.40 |
$2,369.40 |
$2,369.40 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$2,644.80 |
$2,644.80 |
$2,644.80 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$2,851.20 |
$2,851.20 |
$2,851.20 |
$2,486.97
|
|
Abdominal CT scan (with and without contrast)
|
$2,814.60 |
$2,814.60 |
$2,814.60 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,716.20 |
$2,716.20 |
$2,716.20 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,434.80 |
$2,434.80 |
$2,434.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,682.20 |
$3,682.20 |
$3,682.20 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$3,193.80 |
$3,193.80 |
$3,193.80 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$3,134.40 |
$3,134.40 |
$3,134.40 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$2,278.80 |
$2,278.80 |
$2,278.80 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$720.00 |
$720.00 |
$720.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$720.00 |
$720.00 |
$720.00 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,463.00 |
$2,463.00 |
$2,463.00 |
$1,145.40
|
|
Abl1 gene
|
$1,014.60 |
$1,014.60 |
$1,014.60 |
$682.50
|
|
Ablation cardiac vagal inputs atrium
|
$1,253.40 |
$1,253.40 |
$1,253.40 |
$1,960.80
|
|
Ablation of upper extremity nerves rf
|
$621.00 |
$621.00 |
$621.00 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$2,881.20 |
$2,881.20 |
$2,881.20 |
$2,957.17
|
|
Acetaminophen level
|
$276.00 |
$276.00 |
$276.00 |
$107.62
|
|
Acetone qualitative
|
$51.00 |
$51.00 |
$51.00 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$157.80 |
$157.80 |
$157.80 |
$64.50
|
|
Acetylcholinesterase assay
|
$183.60 |
$183.60 |
$183.60 |
$113.00
|
|
Aco depression screen annual medicare g0444aco
|
$58.80 |
$58.80 |
$58.80 |
$38.28
|
|
Acute hepatitis panel
|
$510.00 |
$510.00 |
$510.00 |
$292.00
|
|
#acylcarnitineprfl
|
$236.40 |
$236.40 |
$236.40 |
$125.40
|
|
Adenovirus antibody,serum - quest
|
$100.20 |
$100.20 |
$100.20 |
$63.00
|
|
Adh-sendout
|
$253.80 |
$253.80 |
$253.80 |
$109.28
|
|
Admin ecg contrast agent
|
$252.60 |
$252.60 |
$252.60 |
$119.00
|
|
Administration chemotherapy IV infusion each additional hour
|
$486.00 |
$486.00 |
$486.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$309.60 |
$309.60 |
$309.60 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$706.80 |
$706.80 |
$706.80 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$457.80 |
$457.80 |
$457.80 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$250.20 |
$250.20 |
$250.20 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$250.20 |
$250.20 |
$250.20 |
$257.40
|
|
Administration immunization 1 vaccine
|
$62.40 |
$62.40 |
$62.40 |
$69.21
|
|
Administration immunization each additional vaccine
|
$39.60 |
$39.60 |
$39.60 |
$47.40
|
|
Administration vaccine hepatitis b
|
$46.20 |
$46.20 |
$46.20 |
$54.40
|
|
Administration vaccine influenza virus
|
$48.60 |
$48.60 |
$48.60 |
$50.43
|
|
Administration vaccine pneumococcal
|
$55.20 |
$55.20 |
$55.20 |
$50.43
|
|
_afb org id by sequencing rflx ast-sendout
|
$349.20 |
$349.20 |
$349.20 |
$315.00
|
|
Afo molded ankle gauntlet
|
$169.20 |
$169.20 |
$169.20 |
$765.51
|
|
Afo rig ant tib tcf/= custom
|
$3,423.00 |
$3,423.00 |
$3,423.00 |
$1,877.15
|
|
Albumin body fluid quantitative each specimen
|
$148.80 |
$148.80 |
$148.80 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$61.80 |
$61.80 |
$61.80 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$116.40 |
$116.40 |
$116.40 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$174.60 |
$174.60 |
$174.60 |
$93.60
|
|
Alcohol/subs interv 15-30mn
|
$75.00 |
$75.00 |
$75.00 |
$51.52
|
|
Alcohol/subs interv >30 min
|
$139.80 |
$139.80 |
$139.80 |
$190.13
|
|
Alkaline phosphatase
|
$76.80 |
$76.80 |
$76.80 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$429.60 |
$429.60 |
$429.60 |
$48.00
|
|
Allergen egg white ige
|
$162.60 |
$162.60 |
$162.60 |
$38.00
|
|
Allergy Skin Testing
|
$47.40 |
$47.40 |
$47.40 |
$47.44
|
|
Allograft amnioexcel plus 17mm disk
|
$1,177.20 |
$1,177.20 |
$1,177.20 |
$2,250.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$691.80 |
$691.80 |
$691.80 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$444.60 |
$444.60 |
$444.60 |
$4,677.40
|
|
Alpha-fetoprotein tumor marker
|
$207.60 |
$207.60 |
$207.60 |
$106.00
|
|
Alt/sgpt
|
$106.20 |
$106.20 |
$106.20 |
$47.45
|
|
Aluminum - quest
|
$189.00 |
$189.00 |
$189.00 |
$83.05
|
|
Amino acid screen, urine
|
$502.80 |
$502.80 |
$502.80 |
$102.00
|
|
Amitriptyline (elavil) -sendout
|
$90.00 |
$90.00 |
$90.00 |
$87.45
|
|
Ammonia
|
$165.00 |
$165.00 |
$165.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,026.00 |
$1,026.00 |
$1,026.00 |
$942.60
|
|
Amphetamine confirm urine -sendout
|
$193.80 |
$193.80 |
$193.80 |
$92.61
|
|
Amphetamines 5 or more
|
$252.60 |
$252.60 |
$252.60 |
$82.96
|
|
Amylase
|
$206.40 |
$206.40 |
$206.40 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$394.20 |
$394.20 |
$394.20 |
$80.08
|
|
Analysis gene f2 20210g>a variant
|
$948.00 |
$948.00 |
$948.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$447.60 |
$447.60 |
$447.60 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$39.00 |
$39.00 |
$39.00 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$173.40 |
$173.40 |
$173.40 |
$103.20
|
|
An fluoro guide for cvp
|
$684.60 |
$684.60 |
$684.60 |
$515.00
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,304.40 |
$4,304.40 |
$4,304.40 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$5,091.00 |
$5,091.00 |
$5,091.00 |
$9,074.63
|
|
Ankle X-ray
|
$468.60 |
$468.60 |
$468.60 |
$353.60
|
|
Antibody bacterium, not elsewhere specified
|
$40.20 |
$40.20 |
$40.20 |
$57.81
|
|
Antibody elution rbc reference
|
$208.20 |
$208.20 |
$208.20 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$252.00 |
$252.00 |
$252.00 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$349.80 |
$349.80 |
$349.80 |
$218.30
|
|
Antibody id rbc panel
|
$256.20 |
$256.20 |
$256.20 |
$274.56
|
|
Antibody influenza virus
|
$208.80 |
$208.80 |
$208.80 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$130.20 |
$130.20 |
$130.20 |
$48.57
|
|
Antibody screen rbc
|
$157.80 |
$157.80 |
$157.80 |
$100.00
|
|
Antibody tetanus
|
$62.40 |
$62.40 |
$62.40 |
$53.95
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$28.80 |
$28.80 |
$28.80 |
$37.05
|
|
Antinuclear antibodies
|
$169.20 |
$169.20 |
$169.20 |
$89.40
|
|
Antinuclear antibodies titer
|
$124.80 |
$124.80 |
$124.80 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$303.60 |
$303.60 |
$303.60 |
$65.97
|
|
Antistreptolysin o titer
|
$122.40 |
$122.40 |
$122.40 |
$51.45
|
|
Antithrombin iii activity
|
$196.20 |
$196.20 |
$196.20 |
$114.00
|
|
Aortic dysfunction/dilation
|
$6,278.40 |
$6,278.40 |
$6,278.40 |
$1,008.00
|
|
Apheresis plasma
|
$4,023.00 |
$4,023.00 |
$4,023.00 |
$3,188.50
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,626.60 |
$1,626.60 |
$1,626.60 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,079.40 |
$1,079.40 |
$1,079.40 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$444.60 |
$444.60 |
$444.60 |
$463.65
|
