|
17-ketosteroids
|
$107.80 |
$107.80 |
$107.80 |
$55.00
|
|
3d recon without postprocess indpndt
|
$1,082.90 |
$1,082.90 |
$1,082.90 |
$485.00
|
|
5' nucleotidase - sendout
|
$128.80 |
$128.80 |
$128.80 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$77.70 |
$77.70 |
$77.70 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$14,321.30 |
$14,321.30 |
$14,321.30 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$2,245.60 |
$2,245.60 |
$2,245.60 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$2,486.97
|
|
Abdominal CT scan (with and without contrast)
|
$2,569.00 |
$2,569.00 |
$2,569.00 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,118.20 |
$2,118.20 |
$2,118.20 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$1,265.60 |
$1,265.60 |
$1,265.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,674.60 |
$4,674.60 |
$4,674.60 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$4,249.70 |
$4,249.70 |
$4,249.70 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,876.30 |
$2,876.30 |
$2,876.30 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,969.10 |
$1,969.10 |
$1,969.10 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$819.00 |
$819.00 |
$819.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$819.00 |
$819.00 |
$819.00 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,054.50 |
$2,054.50 |
$2,054.50 |
$1,145.40
|
|
Ablation cardiac vagal inputs atrium
|
$774.20 |
$774.20 |
$774.20 |
$1,960.80
|
|
Acetaminophen level
|
$252.00 |
$252.00 |
$252.00 |
$107.62
|
|
Acetone qualitative
|
$49.70 |
$49.70 |
$49.70 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$101.50 |
$101.50 |
$101.50 |
$64.50
|
|
Acute hepatitis panel
|
$620.90 |
$620.90 |
$620.90 |
$292.00
|
|
#acylcarnitineprfl
|
$203.70 |
$203.70 |
$203.70 |
$125.40
|
|
Adh-sendout
|
$331.10 |
$331.10 |
$331.10 |
$109.28
|
|
Administration chemotherapy IV infusion each additional hour
|
$49.70 |
$49.70 |
$49.70 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$232.40 |
$232.40 |
$232.40 |
$657.12
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$170.10 |
$170.10 |
$170.10 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$165.90 |
$165.90 |
$165.90 |
$257.40
|
|
Administration immunization 1 vaccine
|
$68.60 |
$68.60 |
$68.60 |
$69.21
|
|
Administration immunization each additional vaccine
|
$11.90 |
$11.90 |
$11.90 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$28.70 |
$28.70 |
$28.70 |
$48.00
|
|
Aep hearing status deter i&r
|
$306.60 |
$306.60 |
$306.60 |
$305.73
|
|
_afb id by dna probe rflx ast
|
$168.70 |
$168.70 |
$168.70 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$61.60 |
$61.60 |
$61.60 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$707.00 |
$707.00 |
$707.00 |
$315.00
|
|
Airway resistance by impulse oscillometry 94728
|
$739.20 |
$739.20 |
$739.20 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$70.70 |
$70.70 |
$70.70 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$70.00 |
$70.00 |
$70.00 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$62.30 |
$62.30 |
$62.30 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$260.40 |
$260.40 |
$260.40 |
$93.60
|
|
Alkaline phosphatase
|
$61.60 |
$61.60 |
$61.60 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$152.60 |
$152.60 |
$152.60 |
$48.00
|
|
Allergen egg white ige
|
$51.80 |
$51.80 |
$51.80 |
$38.00
|
|
Alpha-fetoprotein tumor marker
|
$177.80 |
$177.80 |
$177.80 |
$106.00
|
|
Alt/sgpt
|
$65.80 |
$65.80 |
$65.80 |
$47.45
|
|
Aminolevulinic acid delta
|
$221.20 |
$221.20 |
$221.20 |
$85.15
|
|
Ammonia
|
$110.60 |
$110.60 |
$110.60 |
$119.70
|
|
Amylase
|
$108.50 |
$108.50 |
$108.50 |
$89.04
|
|
Analysis gene f2 20210g>a variant
|
$586.60 |
$586.60 |
$586.60 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$527.10 |
$527.10 |
$527.10 |
$230.40
|
|
Anca screen with reflex to titer -quest
|
$170.80 |
$170.80 |
$170.80 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$16,057.30 |
$16,057.30 |
$16,057.30 |
$2,626.65
|
|
An fluoro guide for cvp
|
$399.00 |
$399.00 |
$399.00 |
$515.00
|
|
Angio trnslmnl balloon same artery ini
|
$11,973.50 |
$11,973.50 |
$11,973.50 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$823.90 |
$823.90 |
$823.90 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$13,170.50 |
$13,170.50 |
$13,170.50 |
$8,466.00
|
|
Ankle X-ray
|
$441.00 |
$441.00 |
$441.00 |
$353.60
|
|
Anodyne therapy charges pt
|
$32.20 |
$32.20 |
$32.20 |
$42.00
|
|
Antibody bacterium, not elsewhere specified
|
$147.00 |
$147.00 |
$147.00 |
$57.81
|
|
Antibody elution rbc reference
|
$492.10 |
$492.10 |
$492.10 |
$175.50
|
|
Antibody htlv-i
|
$130.90 |
$130.90 |
$130.90 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$349.30 |
$349.30 |
$349.30 |
$218.30
|
|
Antibody id rbc panel
|
$690.90 |
$690.90 |
$690.90 |
$274.56
|
|
Antibody screen rbc
|
$261.10 |
$261.10 |
$261.10 |
$100.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$64.40 |
$64.40 |
$64.40 |
$37.05
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$101.50 |
$101.50 |
$101.50 |
$40.00
|
|
Antinuclear antibodies
|
$142.10 |
$142.10 |
$142.10 |
$89.40
|
|
Antinuclear antibodies titer
|
$72.10 |
$72.10 |
$72.10 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$173.60 |
$173.60 |
$173.60 |
$65.97
|
|
Antistreptolysin o titer
|
$106.40 |
$106.40 |
$106.40 |
$51.45
|
|
Antithrombin iii activity
|
$152.60 |
$152.60 |
$152.60 |
$114.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,713.50 |
$3,713.50 |
$3,713.50 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$181.30 |
$181.30 |
$181.30 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$63.70 |
$63.70 |
$63.70 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$7,431.90 |
$7,431.90 |
$7,431.90 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$151.90 |
$151.90 |
$151.90 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,761.20 |
$1,761.20 |
$1,761.20 |
$498.81
|
|
Application finger splntstatic 29130
|
$323.40 |
$323.40 |
$323.40 |
$208.16
|
|
Application long leg splint 29505
|
$396.20 |
$396.20 |
$396.20 |
$338.25
|
|
Application lower leg splint 29515
|
$396.20 |
$396.20 |
$396.20 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$320.60 |
$320.60 |
$320.60 |
$373.20
|
|
Application of paste boot 29580
|
$320.60 |
$320.60 |
$320.60 |
$331.74
|
|
Application short leg cast 29405
|
$606.20 |
$606.20 |
$606.20 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,713.50 |
$3,713.50 |
$3,713.50 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,649.10 |
$3,649.10 |
$3,649.10 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$59.50 |
$59.50 |
$59.50 |
$66.00
|
|
Apply rigid leg cast 29445
|
$539.00 |
$539.00 |
$539.00 |
$555.00
|
|
Aqaprn-4 antb flo cytmtry ea
|
$409.50 |
$409.50 |
$409.50 |
$231.66
|
|
Aquaporin-4 antibody elisa
|
$96.60 |
$96.60 |
$96.60 |
$148.80
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$166.60 |
$166.60 |
$166.60 |
$100.00
|
|
Aquatic exercise - group charge
|
$86.10 |
$86.10 |
$86.10 |
$85.80
|
|
Arterial blood draw/perc 36620
|
$95.90 |
$95.90 |
$95.90 |
$485.69
|
|
Artery xray each vessel 7577426
|
$403.90 |
$403.90 |
$403.90 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$23,375.80 |
$23,375.80 |
$23,375.80 |
$4,446.00
|
|
Artery x-rays arm/leg 75710-26
|
$14,321.30 |
$14,321.30 |
$14,321.30 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$6,610.10 |
$6,610.10 |
$6,610.10 |
$3,729.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$673.40 |
$673.40 |
$673.40 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,405.60 |
$1,405.60 |
$1,405.60 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$673.40 |
$673.40 |
$673.40 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$636.30 |
$636.30 |
$636.30 |
$465.00
|
