|
11-desoxycortisol - sendout
|
$261.00 |
$261.00 |
$261.00 |
$87.50
|
|
17-hydroxypregnenolone
|
$202.20 |
$202.20 |
$202.20 |
$89.25
|
|
1st hosp/birthing center care per day nml nb 99460
|
$129.60 |
$129.60 |
$129.60 |
$161.60
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,743.60 |
$1,743.60 |
$1,743.60 |
$1,656.80
|
|
2nd order venous cath
|
$1,399.20 |
$1,399.20 |
$1,399.20 |
$1,543.85
|
|
3-d radiotherapy plan
|
$9,318.60 |
$9,318.60 |
$9,318.60 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$2,392.20 |
$2,392.20 |
$2,392.20 |
$485.00
|
|
5' nucleotidase - sendout
|
$167.40 |
$167.40 |
$167.40 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$234.00 |
$234.00 |
$234.00 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$3,640.80 |
$3,640.80 |
$3,640.80 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$3,092.40 |
$3,092.40 |
$3,092.40 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$3,063.60 |
$3,063.60 |
$3,063.60 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$3,181.80 |
$3,181.80 |
$3,181.80 |
$2,486.97
|
|
Abd/low ext cath addl
|
$484.80 |
$484.80 |
$484.80 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$2,626.80 |
$2,626.80 |
$2,626.80 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,119.20 |
$2,119.20 |
$2,119.20 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,839.20 |
$2,839.20 |
$2,839.20 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$2,685.00 |
$2,685.00 |
$2,685.00 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,405.40 |
$2,405.40 |
$2,405.40 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,968.60 |
$1,968.60 |
$1,968.60 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$1,034.40 |
$1,034.40 |
$1,034.40 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$952.20 |
$952.20 |
$952.20 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,555.20 |
$1,555.20 |
$1,555.20 |
$1,145.40
|
|
Abl1 gene
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$682.50
|
|
Ablate arrhythmia add on
|
$8,904.60 |
$8,904.60 |
$8,904.60 |
$6,898.92
|
|
Ablate heart dysrhythm focus
|
$5,330.40 |
$5,330.40 |
$5,330.40 |
$9,522.05
|
|
Ablation cardiac vagal inputs atrium
|
$2,038.80 |
$2,038.80 |
$2,038.80 |
$1,960.80
|
|
Ablation of upper extremity nerves rf
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$4,128.60 |
$4,128.60 |
$4,128.60 |
$2,957.17
|
|
Acetaminophen level
|
$168.00 |
$168.00 |
$168.00 |
$107.62
|
|
Acetone qualitative
|
$61.80 |
$61.80 |
$61.80 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$157.80 |
$157.80 |
$157.80 |
$64.50
|
|
Acetylcholinesterase assay
|
$328.80 |
$328.80 |
$328.80 |
$113.00
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$481.80 |
$481.80 |
$481.80 |
$345.15
|
|
Acoustic immitance testing
|
$222.00 |
$222.00 |
$222.00 |
$158.50
|
|
Acoustic refl threshold tst
|
$160.20 |
$160.20 |
$160.20 |
$102.05
|
|
Actigraphy testing
|
$454.20 |
$454.20 |
$454.20 |
$218.05
|
|
Acute hepatitis panel
|
$295.20 |
$295.20 |
$295.20 |
$292.00
|
|
#acylcarnitineprfl
|
$320.40 |
$320.40 |
$320.40 |
$125.40
|
|
Adenovirus antibody,serum - quest
|
$58.80 |
$58.80 |
$58.80 |
$63.00
|
|
Adh-sendout
|
$384.60 |
$384.60 |
$384.60 |
$109.28
|
|
Adj gastric band via subq port
|
$891.00 |
$891.00 |
$891.00 |
$1,609.80
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$1,152.60 |
$1,152.60 |
$1,152.60 |
$3,146.85
|
|
Administration chemotherapy IV infusion each additional hour
|
$151.20 |
$151.20 |
$151.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$151.20 |
$151.20 |
$151.20 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$728.40 |
$728.40 |
$728.40 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$545.40 |
$545.40 |
$545.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$441.60 |
$441.60 |
$441.60 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$441.60 |
$441.60 |
$441.60 |
$257.40
|
|
Administration immunization 1 vaccine
|
$84.00 |
$84.00 |
$84.00 |
$69.21
|
|
Administration immunization each additional vaccine
|
$56.40 |
$56.40 |
$56.40 |
$47.40
|
|
Administration vaccine hepatitis b
|
$52.20 |
$52.20 |
$52.20 |
$54.40
|
|
Administration vaccine influenza virus
|
$101.40 |
$101.40 |
$101.40 |
$50.43
|
|
Administration vaccine pneumococcal
|
$117.00 |
$117.00 |
$117.00 |
$50.43
|
|
Aep hearing status deter i&r
|
$382.80 |
$382.80 |
$382.80 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$759.60 |
$759.60 |
$759.60 |
$576.80
|
|
Aep thrshld est mlt freq i&r
|
$820.80 |
$820.80 |
$820.80 |
$605.15
|
|
_afb id by dna probe rflx ast
|
$233.40 |
$233.40 |
$233.40 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$395.40 |
$395.40 |
$395.40 |
$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
|
|
Air conduction bilat
|
$160.20 |
$160.20 |
$160.20 |
$133.00
|
|
Albumin body fluid quantitative each specimen
|
$186.60 |
$186.60 |
$186.60 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$61.80 |
$61.80 |
$61.80 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$147.00 |
$147.00 |
$147.00 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$355.20 |
$355.20 |
$355.20 |
$93.60
|
|
Alkaline phosphatase
|
$175.80 |
$175.80 |
$175.80 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$432.60 |
$432.60 |
$432.60 |
$48.00
|
|
Allergen egg white ige
|
$186.00 |
$186.00 |
$186.00 |
$38.00
|
|
Allergy Skin Testing
|
$47.40 |
$47.40 |
$47.40 |
$47.44
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$715.20 |
$715.20 |
$715.20 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$459.00 |
$459.00 |
$459.00 |
$4,677.40
|
|
Alpha-fetoprotein amniotic
|
$186.00 |
$186.00 |
$186.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$281.40 |
$281.40 |
$281.40 |
$106.00
|
|
Alt/sgpt
|
$138.60 |
$138.60 |
$138.60 |
$47.45
|
|
Aluminum - quest
|
$190.20 |
$190.20 |
$190.20 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$690.60 |
$690.60 |
$690.60 |
$434.00
|
|
Amino acid screen, urine
|
$666.00 |
$666.00 |
$666.00 |
$102.00
|
|
Amino acids quant 2-5
|
$283.20 |
$283.20 |
$283.20 |
$104.00
|
|
Aminolevulinic acid delta
|
$298.20 |
$298.20 |
$298.20 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$165.00 |
$165.00 |
$165.00 |
$87.45
|
|
Ammonia
|
$174.60 |
$174.60 |
$174.60 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$700.80 |
$700.80 |
$700.80 |
$942.60
|
|
Amniotic fluid scan
|
$214.80 |
$214.80 |
$214.80 |
$49.01
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,573.60 |
$3,573.60 |
$3,573.60 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$356.40 |
$356.40 |
$356.40 |
$92.61
|
|
Amphetamines 5 or more
|
$298.20 |
$298.20 |
$298.20 |
$82.96
|
|
Amylase
|
$256.80 |
$256.80 |
$256.80 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$194.40 |
$194.40 |
$194.40 |
$80.08
|
|
Anal/urinary muscle study
|
$873.60 |
$873.60 |
$873.60 |
$576.00
|
|
Analysis gene f2 20210g>a variant
|
$644.40 |
$644.40 |
$644.40 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$644.40 |
$644.40 |
$644.40 |
$230.40
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$720.60 |
$720.60 |
$720.60 |
$396.48
|
|
Anaplsma phgcytophlm amp prb
|
$40.80 |
$40.80 |
$40.80 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$309.00 |
$309.00 |
$309.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,437.80 |
$2,437.80 |
$2,437.80 |
$2,626.65
|
|
An fluoro guide for cvp
|
$336.00 |
$336.00 |
$336.00 |
$515.00
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,390.60 |
$6,390.60 |
$6,390.60 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$7,986.60 |
$7,986.60 |
$7,986.60 |
$9,074.63
|
