|
Acoustic refl threshold tst
|
$36.00 |
$36.00 |
$36.00 |
$102.05
|
|
Acromp/acromionectomy prtl
|
$3,012.80 |
$3,012.80 |
$3,012.80 |
$3,839.54
|
|
Acth stimulation panel
|
$218.40 |
$218.40 |
$218.40 |
$218.40
|
|
Acth stimulation panel
|
$173.60 |
$173.60 |
$173.60 |
$173.60
|
|
Actigraphy testing
|
$323.20 |
$323.20 |
$323.20 |
$234.00
|
|
Actinotherapy uv light
|
$422.84 |
$422.84 |
$422.84 |
$105.60
|
|
Acup 1/> w/estim 1st 15 min
|
$97.60 |
$97.60 |
$97.60 |
$56.16
|
|
Acup 1/> w/estim ea addl 15
|
$74.40 |
$74.40 |
$74.40 |
$57.98
|
|
Acup 1/> without estim ea add 15
|
$62.40 |
$62.40 |
$62.40 |
$43.00
|
|
Acup 1/> wo estim 1st 15 min
|
$84.00 |
$84.00 |
$84.00 |
$53.50
|
|
Acute hepatitis panel
|
$120.00 |
$120.00 |
$352.30 |
$284.95
|
|
Acute venous thrombus image
|
$702.40 |
$702.40 |
$702.40 |
$1,426.73
|
|
Acyclovir 400 mg tablet
|
$64.85 |
$64.85 |
$64.85 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.85 |
$0.85 |
$10.40 |
$64.45
|
|
#acylcarnitineprfl
|
$64.28 |
$64.28 |
$84.50 |
$121.55
|
|
Acylcarnitines qual
|
$64.28 |
$64.28 |
$64.28 |
$45.60
|
|
Adapter b 8 channel 10cm
|
$19,860.90 |
$19,860.90 |
$19,860.90 |
$5,109.58
|
|
Adding walker to prev cast
|
$216.00 |
$216.00 |
$216.00 |
$216.00
|
|
Adenosine 3 mg/250 ml bag for osm
|
$13.00 |
$13.00 |
$695.70 |
$271.98
|
|
Adenovirus ag ia
|
$30.40 |
$30.40 |
$30.40 |
$53.95
|
|
Adenovirus antibody,serum - quest
|
$48.57 |
$48.57 |
$48.57 |
$58.00
|
|
Adenovirus assay w/optic
|
$44.00 |
$44.00 |
$44.00 |
$59.80
|
|
Adhesiolysis tube ovary 58740
|
$2,226.40 |
$2,226.40 |
$2,226.40 |
$1,620.60
|
|
Adh-sendout
|
$72.80 |
$72.80 |
$109.28 |
$118.79
|
|
Adjmt/revj ext fixj sys anes
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
$8,261.40
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,287.20 |
$2,287.20 |
$20,816.35 |
$3,397.11
|
|
Adjustment gastric band
|
$56.00 |
$56.00 |
$56.00 |
$207.51
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$2.64 |
$2.64 |
$78.60 |
$193.40
|
|
Admin ecg contrast agent
|
$72.80 |
$72.80 |
$72.80 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$95.55 |
$95.55 |
$122.28 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$123.20 |
$123.20 |
$123.20 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$561.60 |
$561.60 |
$587.88 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$364.00 |
$364.00 |
$587.88 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$122.28 |
$122.28 |
$122.28 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$135.20 |
$135.20 |
$135.20 |
$256.49
|
|
Administration immunization each additional component
|
$27.20 |
$27.20 |
$40.00 |
$29.20
|
|
Administration immunization each additional vaccine
|
$29.00 |
$29.00 |
$109.12 |
$47.40
|
|
Administration immunization first component each vaccine
|
$46.40 |
$46.40 |
$55.00 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$39.65 |
$39.65 |
$46.40 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$23.40 |
$23.40 |
$27.20 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$39.00 |
$39.00 |
$46.40 |
$44.80
|
|
Administration vaccine hepatitis b
|
$57.20 |
$57.20 |
$90.93 |
$53.00
|
|
Administration vaccine influenza virus
|
$52.74 |
$52.74 |
$78.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$52.74 |
$52.74 |
$57.20 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$36.40 |
$36.40 |
$46.40 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$40.80 |
$40.80 |
$19,916.25 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
$1,987.70
|
|
Adrenalectomy expl w/exc retro tumor 60545
|
$6,081.60 |
$6,081.60 |
$6,081.60 |
$5,441.80
|
|
Adrenalin epinephrine inject
|
$10.13 |
$10.13 |
$10.13 |
$231.47
|
|
Advance care planning each additional 30 min 99498
|
$134.40 |
$134.40 |
$134.40 |
$110.56
|
|
Aep hearing status deter i&r
|
$204.00 |
$204.00 |
$204.00 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$198.40 |
$198.40 |
$198.40 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$270.40 |
$270.40 |
$270.40 |
$635.00
|
|
_afb id by dna probe rflx ast
|
$50.40 |
$50.40 |
$50.40 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$38.58 |
$38.58 |
$38.58 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$289.60 |
$289.60 |
$370.50 |
$300.00
|
|
Aflibercept injection
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$2,738.00
|
|
Afluria vacc, 3 yrs & >, im
|
$18.40 |
$18.40 |
$18.40 |
$18.40
|
|
Afo molded to patient plasti
|
$1,220.80 |
$1,220.80 |
$1,220.80 |
$697.20
|
|
Afo tibial fracture rigid
|
$1,698.40 |
$1,698.40 |
$1,698.40 |
$1,489.57
|
|
Afo tibial fracture soft
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$1,060.02
|
|
After cataract laser surgery
|
$1,640.00 |
$1,640.00 |
$1,640.00 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$348.18 |
$348.18 |
$18,756.30 |
$14,475.20
|
|
Air conduction bilat
|
$71.20 |
$71.20 |
$71.20 |
$134.00
|
|
Air injection into abdomen 49400
|
$360.80 |
$360.80 |
$360.80 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$88.00 |
$88.00 |
$88.00 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$33.57 |
$33.57 |
$161.85 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$162.56 |
$162.56 |
$162.56 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$3,314.25 |
$3,314.25 |
$3,314.25 |
$234.94
|
|
Albumin, human 5 % intravenous solution
|
$31.08 |
$31.08 |
$332.50 |
$275.16
|
|
Albumin ischemia modified
|
$85.60 |
$85.60 |
$85.60 |
$85.60
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$25.72 |
$25.72 |
$189.80 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$33.57 |
$33.57 |
$347.10 |
$43.00
|
|
Albuterol comp con
|
$12.80 |
$12.80 |
$12.80 |
$12.80
|
|
Albuterol comp unit
|
$0.80 |
$0.80 |
$0.80 |
$0.80
|
|
Albuterol ipratrop non-comp
|
$0.80 |
$0.80 |
$0.80 |
$5.67
|
|
Albuterol non-comp con
|
$0.80 |
$0.80 |
$0.80 |
$6.07
|
|
Albuterol non-comp unit
|
$0.60 |
$0.60 |
$0.60 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$72.14 |
$72.14 |
$94.90 |
$96.00
|
|
Alcohols biomarkers 3/more
|
$72.14 |
$72.14 |
$72.14 |
$16.24
|
|
Alcohol/sub misuse assess
|
$31.20 |
$31.20 |
$31.20 |
$31.20
|
|
Alcohol/subs interv 15-30mn
|
$64.80 |
$64.80 |
$64.80 |
$56.70
|
|
Alcohol/subs interv >30 min
|
$120.80 |
$120.80 |
$120.80 |
$190.13
|
|
Aldosterone suppression eval
|
$315.20 |
$315.20 |
$315.20 |
$315.20
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$89,232.75 |
$89,232.75 |
$89,232.75 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$20.80 |
$20.80 |
$20.80 |
$16.56
|
|
Alkaline phosphatase
|
$33.57 |
$33.57 |
$769.60 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$48.57 |
$48.57 |
$91.00 |
$48.57
|
|
Allergen egg white ige
|
$48.57 |
$48.57 |
$53.95 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$48.57 |
$48.57 |
$48.57 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$31.20 |
$31.20 |
$31.20 |
$45.00
|
|
Allergy injection; single 95115
|
$27.20 |
$27.20 |
$27.20 |
$46.80
|
|
Allergy Skin Testing
|
$12.80 |
$12.80 |
$12.80 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$16.00 |
$16.00 |
$16.00 |
$423.37
|
|
Allgrft implnt knee w/scope
|
$6,286.40 |
$6,286.40 |
$6,286.40 |
$6,411.60
|
|
Allograft 160mg placental salera mini membrane
|
$43.26 |
$43.26 |
$43.26 |
$5,835.10
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$424.66 |
$424.66 |
$424.66 |
$5,399.16
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$3,961.09 |
$3,961.09 |
$3,961.09 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$3,663.49 |
$3,663.49 |
$3,663.49 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$159.49 |
$159.49 |
$159.49 |
$20,311.34
|
