|
11-desoxycortisol - sendout
|
$154.70 |
$154.70 |
$154.70 |
$88.89
|
|
17-hydroxypregnenolone
|
$161.00 |
$161.00 |
$161.00 |
$90.90
|
|
17-ketosteroids
|
$67.20 |
$67.20 |
$67.20 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$1,848.70 |
$1,848.70 |
$1,848.70 |
$1,665.35
|
|
2d tte w or without fol w/con,co
|
$1,997.10 |
$1,997.10 |
$1,997.10 |
$1,278.75
|
|
2nd order venous cath
|
$550.90 |
$550.90 |
$550.90 |
$1,497.85
|
|
3-d radiotherapy plan
|
$18,459.70 |
$18,459.70 |
$18,459.70 |
$4,965.20
|
|
3d recon without postprocess indpndt
|
$865.20 |
$865.20 |
$865.20 |
$505.05
|
|
5' nucleotidase - sendout
|
$96.60 |
$96.60 |
$96.60 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$32,669.23 |
$32,669.23 |
$32,669.23 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,421.72 |
$4,421.72 |
$4,421.72 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$53.90 |
$53.90 |
$53.90 |
$53.90
|
|
Abd aorta w/runoff s&i
|
$4,862.90 |
$4,862.90 |
$4,862.90 |
$3,587.50
|
|
Abd/low ext cath 1st
|
$1,453.90 |
$1,453.90 |
$1,453.90 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$36,773.54 |
$36,773.54 |
$36,773.54 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$51,744.16 |
$51,744.16 |
$51,744.16 |
$2,417.40
|
|
Abd/low ext cath addl
|
$51,744.16 |
$51,744.16 |
$51,744.16 |
$963.76
|
|
Abdominal CT scan (with and without contrast)
|
$3,658.90 |
$3,658.90 |
$3,658.90 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$3,201.10 |
$3,201.10 |
$3,201.10 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,385.50 |
$4,385.50 |
$4,385.50 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,770.20 |
$3,770.20 |
$3,770.20 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$3,700.20 |
$3,700.20 |
$3,700.20 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,969.44 |
$1,969.44 |
$1,969.44 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$1,772.40 |
$1,772.40 |
$1,772.40 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,604.40 |
$1,604.40 |
$1,604.40 |
$581.10
|
|
Abl1 gene
|
$869.40 |
$869.40 |
$869.40 |
$683.20
|
|
Ablat 1/+thyr ndul addl prq rf
|
$3,192.00 |
$3,192.00 |
$3,192.00 |
$1,155.50
|
|
Ablate arrhythmia add on
|
$17,618.30 |
$17,618.30 |
$17,618.30 |
$6,828.51
|
|
Ablate bone tumor(s) cryo perq 20983
|
$11,918.90 |
$11,918.90 |
$11,918.90 |
$9,238.00
|
|
Ablate bone tumor(s) perq
|
$3,942.40 |
$3,942.40 |
$3,942.40 |
$9,437.59
|
|
Ablate pulm tumor perq crybl
|
$17,677.67 |
$17,677.67 |
$17,677.67 |
$9,612.46
|
|
Ablate pulm tumor perq rf
|
$4,677.40 |
$4,677.40 |
$4,677.40 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$37,655.10 |
$37,655.10 |
$37,655.10 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$10,561.60 |
$10,561.60 |
$10,561.60 |
$2,312.80
|
|
Ablation cryo adrenal tumor
|
$12,087.60 |
$12,087.60 |
$12,087.60 |
$6,948.75
|
|
Ablation cryo pq liver tumor(s)
|
$28,930.60 |
$28,930.60 |
$28,930.60 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$23,921.80 |
$23,921.80 |
$23,921.80 |
$826.80
|
|
Ablation of upper extremity nerves rf
|
$47,961.20 |
$47,961.20 |
$47,961.20 |
$832.50
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$3,546.90 |
$3,546.90 |
$3,546.90 |
$2,884.00
|
|
Abortion (mpr)
|
$606.90 |
$606.90 |
$606.90 |
$587.60
|
|
Abscess drain retroperitoneal surg code
|
$4,100.24 |
$4,100.24 |
$4,100.24 |
$2,999.34
|
|
Access thoracic lymph duct
|
$346.50 |
$346.50 |
$346.50 |
$828.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$200.90 |
$200.90 |
$200.90 |
$73.44
|
|
Acetaminophen level
|
$229.60 |
$229.60 |
$229.60 |
$111.00
|
|
Acetazolamide 500 mg solution for injection
|
$288.40 |
$288.40 |
$288.40 |
$122.55
|
|
Acetone qualitative
|
$82.60 |
$82.60 |
$82.60 |
$47.50
|
|
Acetylcholine receptor modulating antibody
|
$358.40 |
$358.40 |
$358.40 |
$66.28
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$562.27 |
$562.27 |
$562.27 |
$224.98
|
|
Acoustic immitance testing
|
$305.90 |
$305.90 |
$305.90 |
$157.30
|
|
Acute hepatitis panel
|
$323.40 |
$323.40 |
$323.40 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$1,340.85 |
$1,340.85 |
$1,340.85 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$424.90 |
$424.90 |
$424.90 |
$64.15
|
|
#acylcarnitineprfl
|
$233.80 |
$233.80 |
$233.80 |
$118.85
|
|
Adapter b 8 channel 10cm
|
$3,880.81 |
$3,880.81 |
$3,880.81 |
$6,142.50
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,269.80 |
$1,269.80 |
$1,269.80 |
$272.57
|
|
Adenovirus ag ia
|
$78.40 |
$78.40 |
$78.40 |
$53.95
|
|
Adh-sendout
|
$172.90 |
$172.90 |
$172.90 |
$114.50
|
|
Adj gastric band via subq port
|
$22,791.30 |
$22,791.30 |
$22,791.30 |
$1,609.80
|
|
Adjustment gastric band
|
$498.40 |
$498.40 |
$498.40 |
$207.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$544.25 |
$544.25 |
$544.25 |
$197.05
|
|
Administration chemotherapy IV infusion each additional hour
|
$322.00 |
$322.00 |
$322.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$301.70 |
$301.70 |
$301.70 |
$298.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,088.50 |
$1,088.50 |
$1,088.50 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$455.70 |
$455.70 |
$455.70 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$189.70 |
$189.70 |
$189.70 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$189.70 |
$189.70 |
$189.70 |
$254.40
|
|
Administration immunization 1 vaccine
|
$56.00 |
$56.00 |
$56.00 |
$67.60
|
|
Administration immunization each additional component
|
$25.90 |
$25.90 |
$25.90 |
$29.20
|
|
Administration immunization each additional vaccine
|
$62.30 |
$62.30 |
$62.30 |
$46.89
|
|
Administration immunization first component each vaccine
|
$53.20 |
$53.20 |
$53.20 |
$46.40
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$75.60 |
$75.60 |
$75.60 |
$42.00
|
|
Administration vaccine hepatitis b
|
$51.80 |
$51.80 |
$51.80 |
$51.80
|
|
Administration vaccine influenza virus
|
$56.00 |
$56.00 |
$56.00 |
$48.73
|
|
Administration vaccine pneumococcal
|
$62.30 |
$62.30 |
$62.30 |
$48.73
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$65.80 |
$65.80 |
$65.80 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$35,071.05 |
$35,071.05 |
$35,071.05 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$3,778.60 |
$3,778.60 |
$3,778.60 |
$1,951.60
|
|
Aep thrshld est mlt freq i&r
|
$888.30 |
$888.30 |
$888.30 |
$664.50
|
|
_afb id by dna probe rflx ast
|
$162.40 |
$162.40 |
$162.40 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$22.40 |
$22.40 |
$22.40 |
$34.74
|
|
_afb org id by sequencing rflx ast-sendout
|
$331.10 |
$331.10 |
$331.10 |
$293.02
|
|
Ag detect nos ia single
|
$74.90 |
$74.90 |
$74.90 |
$74.79
|
|
Air conduction bilat
|
$44.80 |
$44.80 |
$44.80 |
$130.86
|
|
Albumin body fluid quantitative each specimen
|
$91.70 |
$91.70 |
$91.70 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$929.07 |
$929.07 |
$929.07 |
$235.92
|
|
Albumin (human), 5%, 250 ml
|
$772.27 |
$772.27 |
$772.27 |
$246.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$79.10 |
$79.10 |
$79.10 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$163.10 |
$163.10 |
$163.10 |
$42.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$212.10 |
$212.10 |
$212.10 |
$94.90
|
|
Alkaline phosphatase
|
$68.60 |
$68.60 |
$68.60 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$137.20 |
$137.20 |
$137.20 |
$48.57
|
|
Allergen egg white ige
|
$395.50 |
$395.50 |
$395.50 |
$37.20
|
|
Allergen specific ige qual multi scrn ea
|
$29.40 |
$29.40 |
$29.40 |
$24.00
|
|
Allergy injection; single 95115
|
$54.60 |
$54.60 |
$54.60 |
$45.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$970.98 |
$970.98 |
$970.98 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$4,654.18 |
$4,654.18 |
$4,654.18 |
$507.30
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$1,459.23 |
$1,459.23 |
$1,459.23 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$89.48 |
$89.48 |
$89.48 |
$21,790.11
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$16,821.48 |
$16,821.48 |
$16,821.48 |
$4,677.40
|
