|
Brace back pinnacle lo 627 lumbar
|
$869.63 |
$869.63 |
$869.63 |
$863.91
|
|
Brace back pinnacle tlso 464
|
$405.55 |
$405.55 |
$405.55 |
$2,632.87
|
|
Brace back t-lso custom
|
$2,912.40 |
$2,912.40 |
$2,912.40 |
$3,536.74
|
|
Brace back vista 464 tlso
|
$475.16 |
$475.16 |
$475.16 |
$1,579.91
|
|
Brace cust back lso
|
$1,821.40 |
$1,821.40 |
$1,821.40 |
$966.00
|
|
Brace fx hum ovr shldr lg
|
$103.61 |
$103.61 |
$103.61 |
$560.00
|
|
Brace fx hum ovr shldr sm
|
$682.51 |
$682.51 |
$682.51 |
$620.54
|
|
Brace halo bremer l2830
|
$195.59 |
$195.59 |
$195.59 |
$195.59
|
|
Brace kafo dbl upright cust
|
$2,418.37 |
$2,418.37 |
$2,418.37 |
$3,609.22
|
|
Brace knee 32in univ t-scope short lt/rt
|
$272.60 |
$272.60 |
$272.60 |
$698.32
|
|
Brace knee extender plus 22-30in
|
$1,503.03 |
$1,503.03 |
$1,503.03 |
$767.20
|
|
Brace knee hing pat open med
|
$47.55 |
$47.55 |
$47.55 |
$214.50
|
|
Brace knee playmaker ii x-rom hook and loop xl
|
$901.84 |
$901.84 |
$901.84 |
$411.01
|
|
Brace knee postop tscope xl
|
$288.59 |
$288.59 |
$288.59 |
$901.93
|
|
Brace knee support neoprene padded open patella med
|
$176.49 |
$176.49 |
$176.49 |
$215.70
|
|
Brace m arm board
|
$45.37 |
$45.37 |
$45.37 |
$162.50
|
|
Brace ortho exos 28-50in sm
|
$243.55 |
$243.55 |
$243.55 |
$1,332.80
|
|
Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr
|
$476.06 |
$476.06 |
$476.06 |
$1,759.07
|
|
Brace oths wrist hnd fngr without
|
$432.84 |
$432.84 |
$432.84 |
$257.45
|
|
Brace tlso flex cust
|
$1,982.56 |
$1,982.56 |
$1,982.56 |
$573.43
|
|
Brace wrist classic lft sm
|
$78.86 |
$78.86 |
$78.86 |
$89.04
|
|
Brachy source i-125 injection
|
$182.00 |
$182.00 |
$182.00 |
$106.60
|
|
Brachy source iodine-125 nonstranded
|
$115.00 |
$115.00 |
$115.00 |
$70.85
|
|
Brachy source palladium
|
$288.70 |
$288.70 |
$288.70 |
$173.70
|
|
Brachy source palladium-103 nonstranded
|
$275.00 |
$275.00 |
$275.00 |
$126.83
|
|
Brachy source yttrium-90
|
$60,990.00 |
$60,990.00 |
$60,990.00 |
$30,879.20
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,500.55 |
$2,500.55 |
$2,500.55 |
$1,897.53
|
|
Brain MRI (with and without contrast)
|
$3,606.85 |
$3,606.85 |
$3,606.85 |
$2,854.80
|
|
Brain MRI (without contrast)
|
$2,297.10 |
$2,297.10 |
$2,297.10 |
$1,948.00
|
|
Bra surgical elizabeth pink sm
|
$161.28 |
$161.28 |
$161.28 |
$127.73
|
|
Breastbone (Sternum) X-ray
|
$191.10 |
$191.10 |
$191.10 |
$274.65
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$39,510.50 |
$39,510.50 |
$39,510.50 |
$22,383.57
|
|
Brush provox 4-10mm
|
$27.23 |
$27.23 |
$27.23 |
$170.91
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$15.15 |
$15.15 |
$15.15 |
$23.92
|
|
Bundled special stain group 1 microorganisms
|
$222.30 |
$222.30 |
$222.30 |
$159.00
|
|
Bundled special stain group 2
|
$175.50 |
$175.50 |
$175.50 |
$173.40
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$741.00 |
$741.00 |
$741.00 |
$32.47
|
|
Bur rotalink 2.15mm
|
$4,849.42 |
$4,849.42 |
$4,849.42 |
$7,887.38
|
|
Bx skin punch ea sep/ addl les
|
$196.00 |
$196.00 |
$196.00 |
$230.75
|
|
Bx skin tangential ea sep/ addl les
|
$53.30 |
$53.30 |
$53.30 |
$206.00
|
|
Bx vulva or perineum/1 lesion 56605
|
$621.64 |
$621.64 |
$621.64 |
$1,110.40
|
|
Cabazitaxel 10 mg/ml (first dilution) intravenous solution
|
$44,159.55 |
$44,159.55 |
$44,159.55 |
$27,013.07
|
|
Cable cath 22-pin diag
|
$8,141.09 |
$8,141.09 |
$8,141.09 |
$4,946.50
|
|
Cable centrimag pressure
|
$123,355.44 |
$123,355.44 |
$123,355.44 |
$9,015.12
|
|
Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er
|
$21,398.90 |
$21,398.90 |
$21,398.90 |
$13,247.32
|
|
Caffeine citrate 20 mg/ml inj for po
|
$46.00 |
$46.00 |
$46.00 |
$46.09
|
|
Calaspargase pegol-mknl 750 unit/ml intravenous solution
|
$77,352.35 |
$77,352.35 |
$77,352.35 |
$48,025.40
|
|
Calcium 24 hour urine
|
$69.55 |
$69.55 |
$69.55 |
$53.00
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$36.80 |
$36.80 |
$36.80 |
$48.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$52.50 |
$52.50 |
$52.50 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$83.00 |
$83.00 |
$83.00 |
$91.60
|
|
Calcium ionized
|
$105.30 |
$105.30 |
$105.30 |
$90.00
|
|
Calcium total
|
$63.70 |
$63.70 |
$63.70 |
$50.00
|
|
Calprotectin fecal
|
$160.55 |
$160.55 |
$160.55 |
$170.00
|
|
Camisole mastectomy wht/l post-surg gental touch
|
$78.94 |
$78.94 |
$78.94 |
$78.94
|
|
Cannula ercp contour 5-4-3 tip
|
$36,313.87 |
$36,313.87 |
$36,313.87 |
$44,000.00
|
|
Cap nerve 2x15mm
|
$24,158.39 |
$24,158.39 |
$24,158.39 |
$18,466.88
|
|
Cap trach decann 15mm
|
$3,283.80 |
$3,283.80 |
$3,283.80 |
$3,238.70
|
|
Carbamazepine total therapeutic drug level
|
$124.15 |
$124.15 |
$124.15 |
$122.85
|
|
Carbon dioxide
|
$35.75 |
$35.75 |
$35.75 |
$44.00
|
|
Carboplatin 10 mg/ml desensitization
|
$459.90 |
$459.90 |
$459.90 |
$196.00
|
|
Carboxyhemoglobin quantitative
|
$118.30 |
$118.30 |
$118.30 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$165.75 |
$165.75 |
$165.75 |
$145.20
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$260.65 |
$260.65 |
$260.65 |
$249.60
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$235.30 |
$235.30 |
$235.30 |
$204.54
|
|
Cardiolipin antibody iga
|
$151.45 |
$151.45 |
$151.45 |
$107.25
|
|
Carfilzomib 10 mg intravenous solution
|
$11,354.40 |
$11,354.40 |
$11,354.40 |
$6,306.47
|
|
Carmustine 100 mg intravenous powder for solution
|
$3,449.25 |
$3,449.25 |
$3,449.25 |
$1,854.00
|
|
Carotid Artery Ultrasound (Duplex)
|
$719.55 |
$719.55 |
$719.55 |
$1,024.32
|
|
Cassette provox xtraflow hme
|
$2.67 |
$2.67 |
$2.67 |
$2.67
|
|
Cataract Surgery
|
$9,136.24 |
$9,136.24 |
$9,136.24 |
$5,044.00
|
|
Cath 2lum 14.5frx43cm maxid kt mahurkar
|
$1,555.72 |
$1,555.72 |
$1,555.72 |
$830.58
|
|
Cath ablat bi-d d-d 8fr 115cm
|
$4,378.40 |
$4,378.40 |
$4,378.40 |
$6,606.72
|
|
Cath ablt clsfast 7fx100cmx
|
$1,894.35 |
$1,894.35 |
$1,894.35 |
$2,808.00
|
|
Cath ablt rx lasr 2.0mm turbo
|
$4,679.08 |
$4,679.08 |
$4,679.08 |
$6,540.75
|
|
Cath access del ds spyscop 2.0
|
$4,008.97 |
$4,008.97 |
$4,008.97 |
$5,212.99
|
|
Cath acuity innr ic130 6f 63cm
|
$41,900.62 |
$41,900.62 |
$41,900.62 |
$9,931.73
|
|
Cath acunav ge 10frx90cm
|
$5,014.47 |
$5,014.47 |
$5,014.47 |
$6,475.07
|
|
Cath adherent clot 10mm 6f 10
|
$13,681.13 |
$13,681.13 |
$13,681.13 |
$19,800.55
|
|
Cath baloon occl urnry 34f 7x2x65
|
$4,539.55 |
$4,539.55 |
$4,539.55 |
$6,882.20
|
|
Cath bi-dir df smarttouch
|
$4,908.31 |
$4,908.31 |
$4,908.31 |
$8,461.48
|
|
Cath blazer dx/20 2-10-2 space
|
$2,737.87 |
$2,737.87 |
$2,737.87 |
$4,212.11
|
|
Cath council tip 16fr 5cc
|
$40.07 |
$40.07 |
$40.07 |
$40.96
|
|
Cath cv dl inj 7fx16cm
|
$10,827.10 |
$10,827.10 |
$10,827.10 |
$4,488.99
|
|
Cath del ampltz 12f 45d 80cm
|
$1,762.57 |
$1,762.57 |
$1,762.57 |
$2,393.00
|
|
Cath entrl fd nutri 5fr 40cm
|
$44.43 |
$44.43 |
$44.43 |
$18.40
|
|
Cath epdrl brevi-stf 12in .043
|
$1,561.66 |
$1,561.66 |
$1,561.66 |
$1,928.17
|
|
Catheterization collection of specimen single patient all places of service
|
$70.20 |
$70.20 |
$70.20 |
$40.95
|
|
Cath ext adhere actv m 28mm
|
$0.59 |
$0.59 |
$0.59 |
$1.81
|
|
Cath follower heyman 20f
|
$234.78 |
$234.78 |
$234.78 |
$128.00
|
|
Cath groshong MRI 8fr plstc port
|
$1,758.92 |
$1,758.92 |
$1,758.92 |
$1,690.71
|
|
Cath hawkone s directional
|
$4,862.62 |
$4,862.62 |
$4,862.62 |
$7,076.25
|
|
Cath hemodial 55cm 15.5fr dual lumen straight stacked adlt
|
$1,270.57 |
$1,270.57 |
$1,270.57 |
$1,270.57
|
|
Cath imag ivus pv 8.5fx90 .035
|
$3,489.04 |
$3,489.04 |
$3,489.04 |
$4,680.00
|
|
Cath infuse micro 150cm rapidtransit
|
$1,380.83 |
$1,380.83 |
$1,380.83 |
$13.23
|
|
Cath intrdsc spnecth 8 pin
|
$2,045.54 |
$2,045.54 |
$2,045.54 |
$1,994.50
|
|
Cath malecot 28fr 4-wing ltx
|
$5,636.22 |
$5,636.22 |
$5,636.22 |
$2,549.50
|
|
Cath occl flo-rester 2.25x12mm cor internal vessel occluder
|
$13,846.69 |
$13,846.69 |
$13,846.69 |
$19,384.20
|
|
Cath pezzer 34fr drain bardex propor head mushrm ltx
|
$23.92 |
$23.92 |
$23.92 |
$64.06
|
|
Cath ptca pcltxl agent 3x20mm
|
$7,730.61 |
$7,730.61 |
$7,730.61 |
$11,167.20
|
