|
11-desoxycortisol - sendout
|
$195.00 |
$195.00 |
$195.00 |
$84.56
|
|
17-hydroxypregnenolone
|
$151.80 |
$151.80 |
$151.80 |
$85.15
|
|
17-ketosteroids
|
$157.80 |
$157.80 |
$157.80 |
$49.45
|
|
1st hosp/birthing center care per day nml nb 99460
|
$103.80 |
$103.80 |
$103.80 |
$172.80
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,147.20 |
$1,147.20 |
$1,147.20 |
$1,656.80
|
|
2nd order venous cath
|
$2,241.00 |
$2,241.00 |
$2,241.00 |
$1,780.00
|
|
3-d radiotherapy plan
|
$6,525.60 |
$6,525.60 |
$6,525.60 |
$4,937.00
|
|
3d recon without postprocess indpndt
|
$2,244.60 |
$2,244.60 |
$2,244.60 |
$469.20
|
|
5' nucleotidase - sendout
|
$163.20 |
$163.20 |
$163.20 |
$50.00
|
|
88334 ap bill cytologic exam each additional site
|
$69.60 |
$69.60 |
$69.60 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$184.20 |
$184.20 |
$184.20 |
$151.20
|
|
99382 initial comp preventive med 1 to 4 years new
|
$150.60 |
$150.60 |
$150.60 |
$143.40
|
|
99383 initial comp preventive med 5 to 11 years new
|
$333.60 |
$333.60 |
$333.60 |
$141.60
|
|
99391 periodic comp preventive med less than 1 year est
|
$104.40 |
$104.40 |
$104.40 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$151.80 |
$151.80 |
$151.80 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$213.60 |
$213.60 |
$213.60 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$113.40 |
$113.40 |
$113.40 |
$145.80
|
|
99397 periodic comp preventive med 65+ years est
|
$124.20 |
$124.20 |
$124.20 |
$167.25
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$127.20 |
$127.20 |
$127.20 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$5,484.00 |
$5,484.00 |
$5,484.00 |
$3,683.78
|
|
Abd/low ext cath 1st
|
$1,949.40 |
$1,949.40 |
$1,949.40 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$3,963.60 |
$3,963.60 |
$3,963.60 |
$2,255.84
|
|
Abd/low ext cath 3rd
|
$4,082.40 |
$4,082.40 |
$4,082.40 |
$2,662.40
|
|
Abd/low ext cath addl
|
$2,406.00 |
$2,406.00 |
$2,406.00 |
$965.25
|
|
Abdominal CT scan (with and without contrast)
|
$2,681.40 |
$2,681.40 |
$2,681.40 |
$1,997.40
|
|
Abdominal CT scan (with contrast)
|
$2,355.00 |
$2,355.00 |
$2,355.00 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,576.60 |
$3,576.60 |
$3,576.60 |
$3,045.84
|
|
Abdominal MRI (with contrast)
|
$2,955.00 |
$2,955.00 |
$2,955.00 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$2,871.00 |
$2,871.00 |
$2,871.00 |
$2,010.62
|
|
Abdominal paracentesis w/image guidance
|
$1,413.60 |
$1,413.60 |
$1,413.60 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$729.00 |
$729.00 |
$729.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$729.00 |
$729.00 |
$729.00 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$913.20 |
$913.20 |
$913.20 |
$1,170.40
|
|
Abl1 gene
|
$1,085.40 |
$1,085.40 |
$1,085.40 |
$682.50
|
|
Ablate arrhythmia add on
|
$10,738.20 |
$10,738.20 |
$10,738.20 |
$6,913.20
|
|
Ablate bone tumor(s) cryo perq 20983
|
$2,362.80 |
$2,362.80 |
$2,362.80 |
$8,512.80
|
|
Ablate bone tumor(s) perq
|
$9,102.00 |
$9,102.00 |
$9,102.00 |
$9,773.01
|
|
Ablate heart dysrhythm focus
|
$10,516.20 |
$10,516.20 |
$10,516.20 |
$9,556.83
|
|
Ablate pulm tumor perq crybl
|
$8,307.60 |
$8,307.60 |
$8,307.60 |
$9,970.50
|
|
Ablate pulm tumor perq rf
|
$8,455.80 |
$8,455.80 |
$8,455.80 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$304.80 |
$304.80 |
$304.80 |
$2,183.34
|
|
Ablation cryo abd perit om
|
$5,364.00 |
$5,364.00 |
$5,364.00 |
$2,566.58
|
|
Ablation cryo adrenal tumor
|
$1,427.40 |
$1,427.40 |
$1,427.40 |
$6,904.15
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$1,351.20 |
$1,351.20 |
$1,351.20 |
$438.36
|
|
Ablation cryo pq liver tumor(s)
|
$8,307.60 |
$8,307.60 |
$8,307.60 |
$8,581.80
|
|
Ablation cryo thigh/knee
|
$1,566.60 |
$1,566.60 |
$1,566.60 |
$2,909.50
|
|
Ablation of upper extremity nerves rf
|
$657.00 |
$657.00 |
$657.00 |
$900.00
|
|
Abscess drain retroperitoneal surg code
|
$3,520.80 |
$3,520.80 |
$3,520.80 |
$3,051.36
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$1,694.40 |
$1,694.40 |
$1,694.40 |
$2,670.25
|
|
Acetaminophen level
|
$135.60 |
$135.60 |
$135.60 |
$117.01
|
|
Acetone qualitative
|
$97.20 |
$97.20 |
$97.20 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$157.80 |
$157.80 |
$157.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$223.20 |
$223.20 |
$223.20 |
$107.63
|
|
Acne surgery 10040
|
$125.40 |
$125.40 |
$125.40 |
$265.20
|
|
Aco ccm; at least 20 min 99490aco
|
$215.40 |
$215.40 |
$215.40 |
$108.93
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$567.00 |
$567.00 |
$567.00 |
$381.70
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$56.40 |
$56.40 |
$56.40 |
$42.28
|
|
Acoustic immitance testing
|
$178.20 |
$178.20 |
$178.20 |
$158.50
|
|
Acoustic refl threshold tst
|
$257.40 |
$257.40 |
$257.40 |
$102.05
|
|
Actigraphy testing
|
$519.00 |
$519.00 |
$519.00 |
$218.05
|
|
Acute hepatitis panel
|
$523.80 |
$523.80 |
$523.80 |
$283.47
|
|
Acute venous thrombus image
|
$1,251.60 |
$1,251.60 |
$1,251.60 |
$1,144.80
|
|
#acylcarnitineprfl
|
$434.40 |
$434.40 |
$434.40 |
$110.25
|
|
Adenovirus antibody,serum - quest
|
$47.40 |
$47.40 |
$47.40 |
$63.00
|
|
Adh-sendout
|
$280.20 |
$280.20 |
$280.20 |
$109.28
|
|
Adj gastric band via subq port
|
$598.80 |
$598.80 |
$598.80 |
$1,684.80
|
|
Admin ecg contrast agent
|
$162.60 |
$162.60 |
$162.60 |
$187.59
|
|
Administration chemotherapy IV infusion each additional hour
|
$471.00 |
$471.00 |
$471.00 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$393.60 |
$393.60 |
$393.60 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$471.00 |
$471.00 |
$471.00 |
$676.55
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$399.00 |
$399.00 |
$399.00 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$151.80 |
$151.80 |
$151.80 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$254.40 |
$254.40 |
$254.40 |
$265.50
|
|
Administration immunization 1 vaccine
|
$73.80 |
$73.80 |
$73.80 |
$67.70
|
|
Administration immunization each additional vaccine
|
$78.00 |
$78.00 |
$78.00 |
$46.23
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$51.60 |
$51.60 |
$51.60 |
$51.60
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$45.60 |
$45.60 |
$45.60 |
$33.60
|
|
Administration vaccine hepatitis b
|
$54.60 |
$54.60 |
$54.60 |
$54.60
|
|
Administration vaccine influenza virus
|
$49.20 |
$49.20 |
$49.20 |
$48.35
|
|
Administration vaccine pneumococcal
|
$56.40 |
$56.40 |
$56.40 |
$49.40
|
|
Aep hearing status deter i&r
|
$196.20 |
$196.20 |
$196.20 |
$303.05
|
|
Aep neurodiagnostic i&r
|
$663.00 |
$663.00 |
$663.00 |
$571.55
|
|
Aep thrshld est mlt freq i&r
|
$663.00 |
$663.00 |
$663.00 |
$590.25
|
|
_afb id by dna probe rflx ast
|
$183.00 |
$183.00 |
$183.00 |
$89.70
|
|
_afb org id by sequencing rflx ast-sendout
|
$334.80 |
$334.80 |
$334.80 |
$289.60
|
|
Air conduction bilat
|
$126.60 |
$126.60 |
$126.60 |
$138.00
|
|
Air injection into abdomen 49400
|
$357.60 |
$357.60 |
$357.60 |
$531.49
|
|
Airway resistance by impulse oscillometry 94728
|
$194.40 |
$194.40 |
$194.40 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$138.60 |
$138.60 |
$138.60 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$298.80 |
$298.80 |
$298.80 |
$218.40
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$61.80 |
$61.80 |
$61.80 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$108.60 |
$108.60 |
$108.60 |
$40.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$273.60 |
$273.60 |
$273.60 |
$94.90
|
|
Alkaline phosphatase
|
$128.40 |
$128.40 |
$128.40 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$441.60 |
$441.60 |
$441.60 |
$48.57
|
|
Allergen egg white ige
|
$178.80 |
$178.80 |
$178.80 |
$36.60
|
|
Allergy Skin Testing
|
$48.60 |
$48.60 |
$48.60 |
$53.43
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$605.40 |
$605.40 |
$605.40 |
$879.80
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$378.00 |
$378.00 |
$378.00 |
$4,677.40
|
