|
11-desoxycortisol - sendout
|
$58.80 |
$58.80 |
$58.80 |
$91.85
|
|
17-ketosteroids
|
$81.00 |
$81.00 |
$81.00 |
$55.00
|
|
1st hosp/birthing center care per day nml nb 99460
|
$194.40 |
$194.40 |
$194.40 |
$161.60
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,854.60 |
$1,854.60 |
$1,854.60 |
$1,656.80
|
|
24 hr ambulatory b/p monitor
|
$285.00 |
$285.00 |
$285.00 |
$313.04
|
|
2nd order venous cath
|
$1,720.80 |
$1,720.80 |
$1,720.80 |
$1,532.04
|
|
3d recon without postprocess indpndt
|
$264.00 |
$264.00 |
$264.00 |
$508.13
|
|
5' nucleotidase - sendout
|
$37.80 |
$37.80 |
$37.80 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$78.00 |
$78.00 |
$78.00 |
$100.10
|
|
99381 initial comp preventive med less than 1 year new
|
$151.20 |
$151.20 |
$151.20 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$164.40 |
$164.40 |
$164.40 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$162.00 |
$162.00 |
$162.00 |
$131.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$113.40 |
$113.40 |
$113.40 |
$117.72
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$130.20 |
$130.20 |
$130.20 |
$132.30
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$129.00 |
$129.00 |
$129.00 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$145.80 |
$145.80 |
$145.80 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$184.20 |
$184.20 |
$184.20 |
$164.73
|
|
Aa graft w/bp/aortic root replace 33863
|
$6,141.00 |
$6,141.00 |
$6,141.00 |
$7,697.60
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,774.97 |
$2,774.97 |
$2,774.97 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$43.80 |
$43.80 |
$43.80 |
$53.95
|
|
Abciximab injection
|
$2,400.32 |
$2,400.32 |
$2,400.32 |
$2,443.52
|
|
Abd aorta w/runoff s&i
|
$188.40 |
$188.40 |
$188.40 |
$3,629.42
|
|
Abd exp/postop hem/throm/infec 35840
|
$2,227.20 |
$2,227.20 |
$2,227.20 |
$2,659.14
|
|
Abd/low ext cath 1st
|
$2,121.00 |
$2,121.00 |
$2,121.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,953.00 |
$1,953.00 |
$1,953.00 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$416.40 |
$416.40 |
$416.40 |
$2,475.45
|
|
Abd/low ext cath addl
|
$550.80 |
$550.80 |
$550.80 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$701.40 |
$701.40 |
$701.40 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$411.60 |
$411.60 |
$411.60 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,659.60 |
$1,659.60 |
$1,659.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,077.60 |
$1,077.60 |
$1,077.60 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,073.80 |
$3,073.80 |
$3,073.80 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$1,061.40 |
$1,061.40 |
$1,061.40 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$1,544.40 |
$1,544.40 |
$1,544.40 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,102.20 |
$1,102.20 |
$1,102.20 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$708.60 |
$708.60 |
$708.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$438.00 |
$438.00 |
$438.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$183.60 |
$183.60 |
$183.60 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$252.00 |
$252.00 |
$252.00 |
$418.63
|
|
Abdominal X-ray (single view)
|
$154.80 |
$154.80 |
$154.80 |
$260.00
|
|
Abdominoplasty 15830
|
$2,235.60 |
$2,235.60 |
$2,235.60 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$931.20 |
$931.20 |
$931.20 |
$1,148.40
|
|
Ablate atria lmtd endo 33265
|
$2,634.60 |
$2,634.60 |
$2,634.60 |
$2,738.40
|
|
Ablate atria w/bypass exten 33256
|
$3,813.00 |
$3,813.00 |
$3,813.00 |
$4,732.00
|
|
Ablate atria x10sv add-on 33258
|
$1,275.60 |
$1,275.60 |
$1,275.60 |
$1,585.60
|
|
Ablate atria x10sv endo 33266
|
$3,594.00 |
$3,594.00 |
$3,594.00 |
$11,873.55
|
|
Ablate bone tumor(s) cryo perq 20983
|
$834.00 |
$834.00 |
$834.00 |
$9,290.70
|
|
Ablate inf turbinate submuc 30802
|
$565.20 |
$565.20 |
$565.20 |
$2,060.00
|
|
Ablate inf turbinate superf 30801
|
$442.80 |
$442.80 |
$442.80 |
$1,944.80
|
|
Ablation cryo abd perit om
|
$1,858.80 |
$1,858.80 |
$1,858.80 |
$2,312.80
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$1,291.80 |
$1,291.80 |
$1,291.80 |
$441.09
|
|
Ablation cryo pq liver tumor(s)
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$373.80 |
$373.80 |
$373.80 |
$857.60
|
|
Ablation of upper extremity nerves rf
|
$206.40 |
$206.40 |
$206.40 |
$832.50
|
|
Abobotulinumtoxina
|
$948.50 |
$948.50 |
$948.50 |
$1,541.21
|
|
Abrasion lesions add-on
|
$48.00 |
$48.00 |
$48.00 |
$100.00
|
|
Abscess drain retroperitoneal surg code
|
$1,956.60 |
$1,956.60 |
$1,956.60 |
$3,050.40
|
|
Absorpt drg >16 <=48 without bdr
|
$6.60 |
$6.60 |
$6.60 |
$6.40
|
|
Absorpt drg <=16 sq in without b
|
$8.40 |
$8.40 |
$8.40 |
$5.60
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$177.60 |
$177.60 |
$177.60 |
$2,314.00
|
|
Acetaminophen 120 mg rectal suppository
|
$7.20 |
$7.20 |
$7.20 |
$146.76
|
|
Acetaminophen level
|
$111.00 |
$111.00 |
$111.00 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$77.07 |
$77.07 |
$77.07 |
$122.55
|
|
Acetone qualitative
|
$43.80 |
$43.80 |
$43.80 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$75.60 |
$75.60 |
$75.60 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$306.72 |
$306.72 |
$306.72 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$10.48 |
$10.48 |
$10.48 |
$31.21
|
|
Acne surgery 10040
|
$194.40 |
$194.40 |
$194.40 |
$265.20
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$284.40 |
$284.40 |
$284.40 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$190.20 |
$190.20 |
$190.20 |
$160.69
|
|
Aco ccm; at least 20 min 99490aco
|
$80.40 |
$80.40 |
$80.40 |
$102.47
|
|
Aco ccm; ea addl 20 min 99439aco
|
$51.60 |
$51.60 |
$51.60 |
$87.20
|
|
Aco cmplx chron care addl 20 min 99489aco
|
$87.00 |
$87.00 |
$87.00 |
$64.74
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$171.00 |
$171.00 |
$171.00 |
$177.99
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$279.00 |
$279.00 |
$279.00 |
$341.00
|
|
Aco depression screen annual medicare g0444aco
|
$23.40 |
$23.40 |
$23.40 |
$39.32
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$48.60 |
$48.60 |
$48.60 |
$38.50
|
|
Acute hepatitis panel
|
$163.80 |
$163.80 |
$163.80 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$98.15 |
$98.15 |
$98.15 |
$64.45
|
|
#acylcarnitineprfl
|
$235.80 |
$235.80 |
$235.80 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$760.80 |
$760.80 |
$760.80 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$590.89 |
$590.89 |
$590.89 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$48.00 |
$48.00 |
$48.00 |
$58.00
|
|
Adhesiolysis tube ovary 58740
|
$1,701.60 |
$1,701.60 |
$1,701.60 |
$1,620.60
|
|
Adh-sendout
|
$205.80 |
$205.80 |
$205.80 |
$118.79
|
|
Adj gastric band via subq port
|
$1,609.80 |
$1,609.80 |
$1,609.80 |
$1,666.86
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$1,816.80 |
$1,816.80 |
$1,816.80 |
$3,397.11
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$518.35 |
$518.35 |
$518.35 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$85.20 |
$85.20 |
$85.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$109.80 |
$109.80 |
$109.80 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$402.00 |
$402.00 |
$402.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$154.20 |
$154.20 |
$154.20 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$128.40 |
$128.40 |
$128.40 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$174.60 |
$174.60 |
$174.60 |
$256.49
|
|
Administration immunization each additional component
|
$24.60 |
$24.60 |
$24.60 |
$29.20
|
|
Administration immunization each additional vaccine
|
$30.60 |
$30.60 |
$30.60 |
$47.40
|
|
Administration immunization first component each vaccine
|
$40.20 |
$40.20 |
$40.20 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$39.00 |
$39.00 |
$39.00 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$20.40 |
$20.40 |
$20.40 |
$30.24
|
