|
11-desoxycortisol - sendout
|
$224.40 |
$224.40 |
$224.40 |
$87.50
|
|
17-hydroxypregnenolone
|
$174.60 |
$174.60 |
$174.60 |
$89.25
|
|
1st hosp/birthing center care per day nml nb 99460
|
$168.60 |
$168.60 |
$168.60 |
$161.60
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,569.00 |
$1,569.00 |
$1,569.00 |
$1,656.80
|
|
2nd order venous cath
|
$3,099.00 |
$3,099.00 |
$3,099.00 |
$1,543.85
|
|
3d ech img cgen car anomal
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$460.00
|
|
3-d radiotherapy plan
|
$6,105.60 |
$6,105.60 |
$6,105.60 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$3,091.80 |
$3,091.80 |
$3,091.80 |
$485.00
|
|
5' nucleotidase - sendout
|
$166.20 |
$166.20 |
$166.20 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$155.40 |
$155.40 |
$155.40 |
$97.65
|
|
Aa graft w/bp/aortic root replace 33863
|
$4,468.80 |
$4,468.80 |
$4,468.80 |
$7,697.60
|
|
Abd aorta w/runoff s&i
|
$4,020.60 |
$4,020.60 |
$4,020.60 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$1,568.40 |
$1,568.40 |
$1,568.40 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,449.60 |
$1,449.60 |
$1,449.60 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$1,806.60 |
$1,806.60 |
$1,806.60 |
$2,486.97
|
|
Abd/low ext cath addl
|
$516.60 |
$516.60 |
$516.60 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$2,215.20 |
$2,215.20 |
$2,215.20 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,099.40 |
$2,099.40 |
$2,099.40 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,480.60 |
$3,480.60 |
$3,480.60 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$3,303.00 |
$3,303.00 |
$3,303.00 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$3,091.80 |
$3,091.80 |
$3,091.80 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,312.20 |
$1,312.20 |
$1,312.20 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$1,345.20 |
$1,345.20 |
$1,345.20 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$1,434.00 |
$1,434.00 |
$1,434.00 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,021.20 |
$1,021.20 |
$1,021.20 |
$1,145.40
|
|
Abl1 gene
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$682.50
|
|
Ablate arrhythmia add on
|
$12,295.20 |
$12,295.20 |
$12,295.20 |
$6,898.92
|
|
Ablate atria w/bypass exten 33256
|
$2,772.60 |
$2,772.60 |
$2,772.60 |
$4,732.00
|
|
Ablate atria without bypass ext
|
$2,332.80 |
$2,332.80 |
$2,332.80 |
$2,335.42
|
|
Ablate atria x10sv add-on 33258
|
$927.00 |
$927.00 |
$927.00 |
$1,585.60
|
|
Ablate bone tumor(s) perq
|
$9,481.80 |
$9,481.80 |
$9,481.80 |
$9,350.33
|
|
Ablate heart dysrhythm focus
|
$5,523.60 |
$5,523.60 |
$5,523.60 |
$9,522.05
|
|
Ablate heart dysrhythm focus
|
$2,087.40 |
$2,087.40 |
$2,087.40 |
$2,095.28
|
|
Ablate heart dysrhythm focus
|
$2,299.20 |
$2,299.20 |
$2,299.20 |
$2,323.08
|
|
Ablate heart dysrhythm focus
|
$2,312.40 |
$2,312.40 |
$2,312.40 |
$7,519.20
|
|
Ablation cardiac vagal inputs atrium
|
$538.20 |
$538.20 |
$538.20 |
$1,960.80
|
|
Ablation cryo abd perit om
|
$3,688.20 |
$3,688.20 |
$3,688.20 |
$2,312.80
|
|
Ablation cryo adrenal tumor
|
$4,393.80 |
$4,393.80 |
$4,393.80 |
$6,904.15
|
|
Ablation cryo thigh/knee
|
$460.20 |
$460.20 |
$460.20 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$1,508.40 |
$1,508.40 |
$1,508.40 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$2,883.00 |
$2,883.00 |
$2,883.00 |
$2,957.17
|
|
Acetaminophen level
|
$326.40 |
$326.40 |
$326.40 |
$107.62
|
|
Acetone qualitative
|
$70.20 |
$70.20 |
$70.20 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$160.80 |
$160.80 |
$160.80 |
$64.50
|
|
Acetylcholinesterase assay
|
$264.00 |
$264.00 |
$264.00 |
$113.00
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$652.20 |
$652.20 |
$652.20 |
$345.15
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$145.20 |
$145.20 |
$145.20 |
$41.67
|
|
Actigraphy testing
|
$679.20 |
$679.20 |
$679.20 |
$218.05
|
|
Acute hepatitis panel
|
$1,036.20 |
$1,036.20 |
$1,036.20 |
$292.00
|
|
Acute venous thrombus image
|
$1,721.40 |
$1,721.40 |
$1,721.40 |
$1,426.73
|
|
#acylcarnitineprfl
|
$276.00 |
$276.00 |
$276.00 |
$125.40
|
|
Adenovirus antibody,serum - quest
|
$135.60 |
$135.60 |
$135.60 |
$63.00
|
|
Adh-sendout
|
$335.40 |
$335.40 |
$335.40 |
$109.28
|
|
Adj gastric band via subq port
|
$1,517.40 |
$1,517.40 |
$1,517.40 |
$1,609.80
|
|
Adjmt/revj ext fixj sys anes
|
$1,113.00 |
$1,113.00 |
$1,113.00 |
$8,412.89
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$3,469.80 |
$3,469.80 |
$3,469.80 |
$3,146.85
|
|
Admin ecg contrast agent
|
$406.20 |
$406.20 |
$406.20 |
$119.00
|
|
Administration chemotherapy IV infusion each additional hour
|
$575.40 |
$575.40 |
$575.40 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$1,150.20 |
$1,150.20 |
$1,150.20 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,150.20 |
$1,150.20 |
$1,150.20 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$434.40 |
$434.40 |
$434.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$474.00 |
$474.00 |
$474.00 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$474.00 |
$474.00 |
$474.00 |
$257.40
|
|
Administration immunization 1 vaccine
|
$77.40 |
$77.40 |
$77.40 |
$69.21
|
|
Administration immunization each additional vaccine
|
$63.60 |
$63.60 |
$63.60 |
$47.40
|
|
Administration vaccine influenza virus
|
$58.80 |
$58.80 |
$58.80 |
$50.43
|
|
Administration vaccine pneumococcal
|
$69.60 |
$69.60 |
$69.60 |
$50.43
|
|
Aep hearing status deter i&r
|
$246.60 |
$246.60 |
$246.60 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$614.40 |
$614.40 |
$614.40 |
$576.80
|
|
Aep thrshld est mlt freq i&r
|
$614.40 |
$614.40 |
$614.40 |
$605.15
|
|
_afb id by dna probe rflx ast
|
$254.40 |
$254.40 |
$254.40 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$388.80 |
$388.80 |
$388.80 |
$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
|
$169.80 |
$169.80 |
$169.80 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$73.20 |
$73.20 |
$73.20 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$132.60 |
$132.60 |
$132.60 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$307.80 |
$307.80 |
$307.80 |
$93.60
|
|
Alkaline phosphatase
|
$79.80 |
$79.80 |
$79.80 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$445.20 |
$445.20 |
$445.20 |
$48.00
|
|
Allergen egg white ige
|
$171.60 |
$171.60 |
$171.60 |
$38.00
|
|
Allergy Skin Testing
|
$57.60 |
$57.60 |
$57.60 |
$47.44
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$775.80 |
$775.80 |
$775.80 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$469.80 |
$469.80 |
$469.80 |
$4,677.40
|
|
Alpha-fetoprotein amniotic
|
$162.00 |
$162.00 |
$162.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$258.00 |
$258.00 |
$258.00 |
$106.00
|
|
Alt/sgpt
|
$118.80 |
$118.80 |
$118.80 |
$47.45
|
|
Aluminum - quest
|
$164.40 |
$164.40 |
$164.40 |
$83.05
|
|
Alveoloplasty each quadrant
|
$183.60 |
$183.60 |
$183.60 |
$3,892.00
|
|
Amino acid screen, urine
|
$632.40 |
$632.40 |
$632.40 |
$102.00
|
|
Amino acids quant 2-5
|
$249.00 |
$249.00 |
$249.00 |
$104.00
|
|
Aminolevulinic acid delta
|
$244.20 |
$244.20 |
$244.20 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$128.40 |
$128.40 |
$128.40 |
$87.45
|
|
Ammonia
|
$186.60 |
$186.60 |
$186.60 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$916.80 |
$916.80 |
$916.80 |
$942.60
|
|
Amniotic fluid scan
|
$178.20 |
$178.20 |
$178.20 |
$49.01
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,297.60 |
$3,297.60 |
$3,297.60 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$276.00 |
$276.00 |
$276.00 |
$92.61
|
|
Amphetamines 5 or more
|
$241.20 |
$241.20 |
$241.20 |
$82.96
|
