|
11-desoxycortisol - sendout
|
$57.20 |
$57.20 |
$57.20 |
$91.85
|
|
17-hydroxypregnenolone
|
$63.05 |
$63.05 |
$63.05 |
$92.65
|
|
1st hosp/birthing center care per day nml nb 99460
|
$230.00 |
$230.00 |
$230.00 |
$161.60
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$2,315.00 |
$2,315.00 |
$2,315.00 |
$1,656.80
|
|
2d tee w or without fol w/con,in
|
$2,018.90 |
$2,018.90 |
$2,018.90 |
$1,724.25
|
|
3-d radiotherapy plan
|
$6,149.65 |
$6,149.65 |
$6,149.65 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$432.90 |
$432.90 |
$432.90 |
$508.13
|
|
5' nucleotidase - sendout
|
$626.60 |
$626.60 |
$626.60 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$221.65 |
$221.65 |
$221.65 |
$100.10
|
|
99381 initial comp preventive med less than 1 year new
|
$185.00 |
$185.00 |
$185.00 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$198.00 |
$198.00 |
$198.00 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$210.00 |
$210.00 |
$210.00 |
$131.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$170.00 |
$170.00 |
$170.00 |
$117.72
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$185.00 |
$185.00 |
$185.00 |
$132.30
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$185.00 |
$185.00 |
$185.00 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$214.68 |
$214.68 |
$214.68 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$247.00 |
$247.00 |
$247.00 |
$164.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$7,377.95 |
$7,377.95 |
$7,377.95 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$65.00 |
$65.00 |
$65.00 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$6,602.05 |
$6,602.05 |
$6,602.05 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$33,491.13 |
$33,491.13 |
$33,491.13 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$20,456.62 |
$20,456.62 |
$20,456.62 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$2,639.65 |
$2,639.65 |
$2,639.65 |
$2,475.45
|
|
Abd/low ext cath addl
|
$414.05 |
$414.05 |
$414.05 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$2,088.00 |
$2,088.00 |
$2,088.00 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,976.00 |
$1,976.00 |
$1,976.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,569.10 |
$1,569.10 |
$1,569.10 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,027.65 |
$1,027.65 |
$1,027.65 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$1,643.20 |
$1,643.20 |
$1,643.20 |
$2,967.00
|
|
Abdominal MRI (without contrast)
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$4,430.50 |
$4,430.50 |
$4,430.50 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$954.85 |
$954.85 |
$954.85 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$825.00 |
$825.00 |
$825.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$330.85 |
$330.85 |
$330.85 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$308.75 |
$308.75 |
$308.75 |
$418.63
|
|
Abdominal X-ray (single view)
|
$241.80 |
$241.80 |
$241.80 |
$260.00
|
|
Abdominoplasty 15830
|
$66,369.15 |
$66,369.15 |
$66,369.15 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$265.00 |
$265.00 |
$265.00 |
$1,148.40
|
|
Abl1 gene
|
$863.85 |
$863.85 |
$863.85 |
$683.20
|
|
Ablate arrhythmia add on
|
$2,813.20 |
$2,813.20 |
$2,813.20 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$7,927.40 |
$7,927.40 |
$7,927.40 |
$9,332.05
|
|
Ablate inf turbinate submuc 30802
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$2,060.00
|
|
Ablation cardiac vagal inputs atrium
|
$28,997.45 |
$28,997.45 |
$28,997.45 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$3,505.45 |
$3,505.45 |
$3,505.45 |
$2,312.80
|
|
Ablation ire liver 1+ tumor(s) w/image pq
|
$21,177.00 |
$21,177.00 |
$21,177.00 |
$17,286.00
|
|
Abscess drain retroperitoneal surg code
|
$5,056.35 |
$5,056.35 |
$5,056.35 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$3,671.20 |
$3,671.20 |
$3,671.20 |
$2,314.00
|
|
Acetaminophen 120 mg rectal suppository
|
$35,263.45 |
$35,263.45 |
$35,263.45 |
$146.76
|
|
Acetazolamide 500 mg solution for injection
|
$202.20 |
$202.20 |
$202.20 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$45.50 |
$45.50 |
$45.50 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$244.95 |
$244.95 |
$244.95 |
$218.79
|
|
Acne surgery 10040
|
$226.00 |
$226.00 |
$226.00 |
$265.20
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$424.00 |
$424.00 |
$424.00 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$332.00 |
$332.00 |
$332.00 |
$160.69
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$247.00 |
$247.00 |
$247.00 |
$177.99
|
|
Aco depression screen annual medicare g0444aco
|
$54.00 |
$54.00 |
$54.00 |
$39.32
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$22.10 |
$22.10 |
$22.10 |
$38.50
|
|
Actinotherapy uv light
|
$29.90 |
$29.90 |
$29.90 |
$105.60
|
|
Acute hepatitis panel
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$1.00 |
$1.00 |
$1.00 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$10.40 |
$10.40 |
$10.40 |
$64.45
|
|
#acylcarnitineprfl
|
$84.50 |
$84.50 |
$84.50 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$19,860.90 |
$19,860.90 |
$19,860.90 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$695.70 |
$695.70 |
$695.70 |
$271.98
|
|
Adh-sendout
|
$72.80 |
$72.80 |
$72.80 |
$118.79
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$3,397.11
|
|
Adjustment gastric band
|
$11,347.60 |
$11,347.60 |
$11,347.60 |
$207.51
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$78.60 |
$78.60 |
$78.60 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$588.25 |
$588.25 |
$588.25 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$1,834.95 |
$1,834.95 |
$1,834.95 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$25,241.75 |
$25,241.75 |
$25,241.75 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$12,719.95 |
$12,719.95 |
$12,719.95 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$138.45 |
$138.45 |
$138.45 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$280.15 |
$280.15 |
$280.15 |
$256.49
|
|
Administration immunization each additional component
|
$40.00 |
$40.00 |
$40.00 |
$29.20
|
|
Administration immunization each additional vaccine
|
$29.00 |
$29.00 |
$29.00 |
$47.40
|
|
Administration immunization first component each vaccine
|
$55.00 |
$55.00 |
$55.00 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$50.46 |
$50.46 |
$50.46 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$30.23 |
$30.23 |
$30.23 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$48.19 |
$48.19 |
$48.19 |
$44.80
|
|
Administration vaccine hepatitis b
|
$703.00 |
$703.00 |
$703.00 |
$53.00
|
|
Administration vaccine influenza virus
|
$688.00 |
$688.00 |
$688.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$1,663.00 |
$1,663.00 |
$1,663.00 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$56.37 |
$56.37 |
$56.37 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$19,916.25 |
$19,916.25 |
$19,916.25 |
$11,350.31
|
|
Advance care planning each additional 30 min 99498
|
$107.90 |
$107.90 |
$107.90 |
$110.56
|
|
Agalsidase beta 35 mg intravenous solution
|
$18,756.30 |
$18,756.30 |
$18,756.30 |
$14,475.20
|
|
Albumin body fluid quantitative each specimen
|
$42.90 |
$42.90 |
$42.90 |
$47.45
|
|
Albumin, human 25 % intravenous solution
|
$5,435.70 |
$5,435.70 |
$5,435.70 |
$234.94
|
|
Albumin, human 5 % intravenous solution
|
$332.50 |
$332.50 |
$332.50 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$72.80 |
$72.80 |
$72.80 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$2.64 |
$2.64 |
$2.64 |
$5.67
|
|
Albuterol non-comp unit
|
$1.00 |
$1.00 |
$1.00 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$94.90 |
$94.90 |
$94.90 |
$96.00
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$89,232.75 |
$89,232.75 |
$89,232.75 |
$47,974.31
|
|
Alkaline phosphatase
|
$40.95 |
$40.95 |
$40.95 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$674.00 |
$674.00 |
$674.00 |
$48.57
|
|
Allergen egg white ige
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$38.00
|