|
11-desoxycortisol - sendout
|
$184.50 |
$184.50 |
$184.50 |
$87.50
|
|
2d tee w or without fol w/con,in
|
$1,816.50 |
$1,816.50 |
$1,816.50 |
$1,624.70
|
|
2nd order venous cath
|
$1,211.00 |
$1,211.00 |
$1,211.00 |
$1,543.85
|
|
3-d radiotherapy plan
|
$6,552.50 |
$6,552.50 |
$6,552.50 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$466.00 |
$466.00 |
$466.00 |
$485.00
|
|
5' nucleotidase - sendout
|
$137.00 |
$137.00 |
$137.00 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$114.00 |
$114.00 |
$114.00 |
$97.65
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$35.52 |
$35.52 |
$35.52 |
$127.20
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,551.25 |
$3,551.25 |
$3,551.25 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$72.00 |
$72.00 |
$72.00 |
$53.95
|
|
Abd/low ext cath 1st
|
$1,623.00 |
$1,623.00 |
$1,623.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,015.50 |
$1,015.50 |
$1,015.50 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$1,015.50 |
$1,015.50 |
$1,015.50 |
$2,486.97
|
|
Abd/low ext cath addl
|
$1,015.50 |
$1,015.50 |
$1,015.50 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$942.50 |
$942.50 |
$942.50 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$812.00 |
$812.00 |
$812.00 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$671.50 |
$671.50 |
$671.50 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$1,070.50 |
$1,070.50 |
$1,070.50 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$926.00 |
$926.00 |
$926.00 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$868.00 |
$868.00 |
$868.00 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,968.00 |
$1,968.00 |
$1,968.00 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$435.00 |
$435.00 |
$435.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$459.00 |
$459.00 |
$459.00 |
$590.00
|
|
Ablate arrhythmia add on
|
$9,467.00 |
$9,467.00 |
$9,467.00 |
$6,898.92
|
|
Ablate bone tumor(s) cryo perq 20983
|
$6,749.00 |
$6,749.00 |
$6,749.00 |
$8,453.60
|
|
Ablate bone tumor(s) perq
|
$8,436.50 |
$8,436.50 |
$8,436.50 |
$9,350.33
|
|
Ablate heart dysrhythm focus
|
$11,965.50 |
$11,965.50 |
$11,965.50 |
$9,522.05
|
|
Ablate pulm tumor perq crybl
|
$7,276.50 |
$7,276.50 |
$7,276.50 |
$9,591.75
|
|
Ablation cardiac vagal inputs atrium
|
$3,747.50 |
$3,747.50 |
$3,747.50 |
$1,960.80
|
|
Ablation cryo pq liver tumor(s)
|
$6,010.00 |
$6,010.00 |
$6,010.00 |
$8,581.80
|
|
Abobotulinumtoxina
|
$3,044.50 |
$3,044.50 |
$3,044.50 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$3,942.00 |
$3,942.00 |
$3,942.00 |
$2,957.17
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$51.09 |
$51.09 |
$51.09 |
$74.96
|
|
Acetaminophen level
|
$143.50 |
$143.50 |
$143.50 |
$107.62
|
|
Acetazolamide 500 mg solution for injection
|
$144.00 |
$144.00 |
$144.00 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$102.00 |
$102.00 |
$102.00 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$183.44 |
$183.44 |
$183.44 |
$216.00
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$529.00 |
$529.00 |
$529.00 |
$345.15
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$34.50 |
$34.50 |
$34.50 |
$41.67
|
|
Acoustic immitance testing
|
$139.50 |
$139.50 |
$139.50 |
$158.50
|
|
Acute hepatitis panel
|
$356.00 |
$356.00 |
$356.00 |
$292.00
|
|
Acyclovir 400 mg tablet
|
$1,842.37 |
$1,842.37 |
$1,842.37 |
$45.06
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$101.88 |
$101.88 |
$101.88 |
$63.48
|
|
#acylcarnitineprfl
|
$163.00 |
$163.00 |
$163.00 |
$125.40
|
|
Adalimumab injection
|
$9,382.48 |
$9,382.48 |
$9,382.48 |
$6,853.40
|
|
Adapter b 8 channel 10cm
|
$1,999.20 |
$1,999.20 |
$1,999.20 |
$5,695.04
|
|
Adenosine 3 mg/250 ml bag for osm
|
$543.55 |
$543.55 |
$543.55 |
$255.41
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$410.47 |
$410.47 |
$410.47 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$485.50 |
$485.50 |
$485.50 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$380.00 |
$380.00 |
$380.00 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$980.50 |
$980.50 |
$980.50 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$571.00 |
$571.00 |
$571.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$253.50 |
$253.50 |
$253.50 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$304.00 |
$304.00 |
$304.00 |
$257.40
|
|
Administration immunization 1 vaccine
|
$83.50 |
$83.50 |
$83.50 |
$69.21
|
|
Administration immunization each additional vaccine
|
$65.00 |
$65.00 |
$65.00 |
$47.40
|
|
Administration vaccine hepatitis b
|
$55.50 |
$55.50 |
$55.50 |
$54.40
|
|
Administration vaccine influenza virus
|
$83.50 |
$83.50 |
$83.50 |
$50.43
|
|
Administration vaccine pneumococcal
|
$48.00 |
$48.00 |
$48.00 |
$50.43
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$14.50 |
$14.50 |
$14.50 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$15,780.15 |
$15,780.15 |
$15,780.15 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$703.95 |
$703.95 |
$703.95 |
$229.69
|
|
Aep hearing status deter i&r
|
$261.50 |
$261.50 |
$261.50 |
$305.73
|
|
Aep thrshld est mlt freq i&r
|
$2,430.50 |
$2,430.50 |
$2,430.50 |
$605.15
|
|
Afamelanotide implant, 1 mg
|
$60,749.40 |
$60,749.40 |
$60,749.40 |
$78,638.30
|
|
Agalsidase beta 35 mg intravenous solution
|
$17,255.38 |
$17,255.38 |
$17,255.38 |
$14,475.20
|
|
Air conduction bilat
|
$257.00 |
$257.00 |
$257.00 |
$133.00
|
|
Albumin body fluid quantitative each specimen
|
$41.00 |
$41.00 |
$41.00 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$482.51 |
$482.51 |
$482.51 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$262.82 |
$262.82 |
$262.82 |
$243.59
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$32.00 |
$32.00 |
$32.00 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$21.00 |
$21.00 |
$21.00 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$194.00 |
$194.00 |
$194.00 |
$93.60
|
|
Aldesleukin injection
|
$2,830.85 |
$2,830.85 |
$2,830.85 |
$9,030.11
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$0.01 |
$0.01 |
$0.01 |
$47,974.31
|
|
Alkaline phosphatase
|
$32.00 |
$32.00 |
$32.00 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$61.50 |
$61.50 |
$61.50 |
$48.00
|
|
Allergen egg white ige
|
$54.00 |
$54.00 |
$54.00 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$20.00 |
$20.00 |
$20.00 |
$43.75
|
|
Allergy injection; single 95115
|
$16.00 |
$16.00 |
$16.00 |
$42.75
|
|
Allergy Skin Testing
|
$2.10 |
$2.10 |
$2.10 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$10.00 |
$10.00 |
$10.00 |
$445.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,687.41 |
$13,687.41 |
$13,687.41 |
$5,401.92
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$11,215.90 |
$11,215.90 |
$11,215.90 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$35,921.86 |
$35,921.86 |
$35,921.86 |
$23,373.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$4,370.56 |
$4,370.56 |
$4,370.56 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$7,046.40 |
$7,046.40 |
$7,046.40 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,478.40 |
$5,478.40 |
$5,478.40 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$11,490.25 |
$11,490.25 |
$11,490.25 |
$4,561.83
|
|
All tstg perq&iq drugs/biol
|
$7.52 |
$7.52 |
$7.52 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$3.15 |
$3.15 |
$3.15 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$12.50
|
|
Alpha-fetoprotein tumor marker
|
$132.00 |
$132.00 |
$132.00 |
$106.00
|
|
Alprostadil for injection
|
$327.86 |
$327.86 |
$327.86 |
$519.93
|
|
Als 1
|
$1,905.50 |
$1,905.50 |
$1,905.50 |
$892.32
|
|
Als1-emergency
|
$2,150.00 |
$2,150.00 |
$2,150.00 |
$929.40
|
|
Als 2
|
$2,251.50 |
$2,251.50 |
$2,251.50 |
$1,288.56
|
|
Alteplase 100 mg infusion from pyxis vial
|
$21,257.00 |
$21,257.00 |
$21,257.00 |
$15,857.45
|
|
Alt/sgpt
|
$28.00 |
$28.00 |
$28.00 |
$47.45
|
|
Aluminum - quest
|
$130.50 |
$130.50 |
$130.50 |
$83.05
|
