|
17-ketosteroids
|
$129.60 |
$129.60 |
$129.60 |
$55.00
|
|
2nd order venous cath
|
$1,548.00 |
$1,548.00 |
$1,548.00 |
$1,532.04
|
|
3-d radiotherapy plan
|
$5,404.20 |
$5,404.20 |
$5,404.20 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$467.40 |
$467.40 |
$467.40 |
$508.13
|
|
5' nucleotidase - sendout
|
$178.80 |
$178.80 |
$178.80 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$93.00 |
$93.00 |
$93.00 |
$100.10
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$136.20 |
$136.20 |
$136.20 |
$53.95
|
|
Abciximab injection
|
$2,432.72 |
$2,432.72 |
$2,432.72 |
$2,443.52
|
|
Abd aorta w/runoff s&i
|
$3,084.00 |
$3,084.00 |
$3,084.00 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$3,114.60 |
$3,114.60 |
$3,114.60 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$3,456.60 |
$3,456.60 |
$3,456.60 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$3,894.60 |
$3,894.60 |
$3,894.60 |
$2,475.45
|
|
Abd/low ext cath addl
|
$2,772.60 |
$2,772.60 |
$2,772.60 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,126.80 |
$1,126.80 |
$1,126.80 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$662.40 |
$662.40 |
$662.40 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$885.00 |
$885.00 |
$885.00 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,282.40 |
$2,282.40 |
$2,282.40 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$523.80 |
$523.80 |
$523.80 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$523.80 |
$523.80 |
$523.80 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$281.40 |
$281.40 |
$281.40 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$281.40 |
$281.40 |
$281.40 |
$418.63
|
|
Abdominal X-ray (single view)
|
$251.40 |
$251.40 |
$251.40 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,212.60 |
$1,212.60 |
$1,212.60 |
$1,148.40
|
|
Ablate arrhythmia add on
|
$7,395.60 |
$7,395.60 |
$7,395.60 |
$6,828.51
|
|
Ablate bone tumor(s) cryo perq 20983
|
$4,136.40 |
$4,136.40 |
$4,136.40 |
$9,290.70
|
|
Ablate bone tumor(s) perq
|
$4,368.60 |
$4,368.60 |
$4,368.60 |
$9,511.44
|
|
Ablate heart dysrhythm focus
|
$10,047.60 |
$10,047.60 |
$10,047.60 |
$9,332.05
|
|
Ablate pulm tumor perq crybl
|
$14,502.00 |
$14,502.00 |
$14,502.00 |
$9,970.50
|
|
Ablate pulm tumor perq rf
|
$10,224.60 |
$10,224.60 |
$10,224.60 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$3,771.60 |
$3,771.60 |
$3,771.60 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$5,949.60 |
$5,949.60 |
$5,949.60 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$7,126.20 |
$7,126.20 |
$7,126.20 |
$8,581.80
|
|
Abscess drain retroperitoneal surg code
|
$2,813.40 |
$2,813.40 |
$2,813.40 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$1,706.40 |
$1,706.40 |
$1,706.40 |
$2,314.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$41.82 |
$41.82 |
$41.82 |
$72.74
|
|
Acetaminophen level
|
$35.40 |
$35.40 |
$35.40 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$60.38 |
$60.38 |
$60.38 |
$122.55
|
|
Acetone qualitative
|
$43.80 |
$43.80 |
$43.80 |
$46.80
|
|
Acetylcholinesterase assay
|
$127.20 |
$127.20 |
$127.20 |
$107.63
|
|
Acetylcysteine non-comp unit
|
$29.01 |
$29.01 |
$29.01 |
$31.21
|
|
Aco ccm; at least 20 min 99490aco
|
$60.00 |
$60.00 |
$60.00 |
$102.47
|
|
Actigraphy testing
|
$295.80 |
$295.80 |
$295.80 |
$234.00
|
|
Acute hepatitis panel
|
$367.20 |
$367.20 |
$367.20 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$48.72 |
$48.72 |
$48.72 |
$64.45
|
|
#acylcarnitineprfl
|
$181.20 |
$181.20 |
$181.20 |
$121.55
|
|
Acylcarnitines qual
|
$55.20 |
$55.20 |
$55.20 |
$45.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$199.72 |
$199.72 |
$199.72 |
$271.98
|
|
Adenovirus ag ia
|
$42.00 |
$42.00 |
$42.00 |
$53.95
|
|
Adenovirus antibody,serum - quest
|
$81.60 |
$81.60 |
$81.60 |
$58.00
|
|
Adh-sendout
|
$177.00 |
$177.00 |
$177.00 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$639.08 |
$639.08 |
$639.08 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$293.40 |
$293.40 |
$293.40 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$432.60 |
$432.60 |
$432.60 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$927.00 |
$927.00 |
$927.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$525.60 |
$525.60 |
$525.60 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$244.20 |
$244.20 |
$244.20 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$293.40 |
$293.40 |
$293.40 |
$256.49
|
|
Administration immunization each additional vaccine
|
$61.80 |
$61.80 |
$61.80 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$45.00 |
$45.00 |
$45.00 |
$48.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$59.76 |
$59.76 |
$59.76 |
$11,350.31
|
|
_afb id by dna probe rflx ast
|
$177.60 |
$177.60 |
$177.60 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$88.20 |
$88.20 |
$88.20 |
$34.72
|
|
Aflibercept injection
|
$3,893.02 |
$3,893.02 |
$3,893.02 |
$2,738.00
|
|
Afo molded plas rig ant tib
|
$3,302.40 |
$3,302.40 |
$3,302.40 |
$2,022.34
|
|
After cataract laser surgery
|
$1,837.20 |
$1,837.20 |
$1,837.20 |
$1,373.11
|
|
Airway resistance by impulse oscillometry 94728
|
$307.80 |
$307.80 |
$307.80 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$67.20 |
$67.20 |
$67.20 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$552.05 |
$552.05 |
$552.05 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$471.44 |
$471.44 |
$471.44 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$470.97 |
$470.97 |
$470.97 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$66.00 |
$66.00 |
$66.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$24.60 |
$24.60 |
$24.60 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$9.18 |
$9.18 |
$9.18 |
$5.67
|
|
Albuterol non-comp unit
|
$9.59 |
$9.59 |
$9.59 |
$5.40
|
|
Alkaline phosphatase
|
$43.80 |
$43.80 |
$43.80 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$51.00 |
$51.00 |
$51.00 |
$48.57
|
|
Allergen egg white ige
|
$119.40 |
$119.40 |
$119.40 |
$38.00
|
|
Allergy Skin Testing
|
$105.60 |
$105.60 |
$105.60 |
$47.44
|
|
Allograft amnioexcel plus 17mm disk
|
$14,566.20 |
$14,566.20 |
$14,566.20 |
$497.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$6,964.20 |
$6,964.20 |
$6,964.20 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$4,291.20 |
$4,291.20 |
$4,291.20 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$12,390.60 |
$12,390.60 |
$12,390.60 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$5,725.80 |
$5,725.80 |
$5,725.80 |
$858.66
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$2,169.60 |
$2,169.60 |
$2,169.60 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$10,199.40 |
$10,199.40 |
$10,199.40 |
$1,225.35
|
|
All tstg perq&iq drugs/biol
|
$66.00 |
$66.00 |
$66.00 |
$64.80
|
|
Alpha-fetoprotein amniotic
|
$123.60 |
$123.60 |
$123.60 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$212.40 |
$212.40 |
$212.40 |
$106.00
|
|
Alprostadil for injection
|
$228.18 |
$228.18 |
$228.18 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$2,680.50 |
$2,680.50 |
$2,680.50 |
$15,857.45
|
|
Alt/sgpt
|
$25.80 |
$25.80 |
$25.80 |
$47.50
|
|
Aluminum - quest
|
$87.00 |
$87.00 |
$87.00 |
$83.05
|
|
Amifostine
|
$2,072.95 |
$2,072.95 |
$2,072.95 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$44.00 |
$44.00 |
$44.00 |
$39.84
|
|
Amino acid screen, urine
|
$58.80 |
$58.80 |
$58.80 |
$77.00
|