|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1.78 |
$244.95 |
$463.79 |
|
|
Acetylcysteine non-comp unit
|
$10.48 |
$10.48 |
$24.16 |
|
|
Acid perfusion of esophagus
|
$304.00 |
$304.00 |
$304.00 |
|
|
Acne surgery 10040
|
$54.72 |
$269.60 |
$329.55 |
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$270.60 |
$304.00 |
$424.00 |
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$70.85 |
$239.20 |
$1,177.15 |
|
|
Aco ccm; at least 20 min 99490aco
|
$76.80 |
$115.20 |
$115.20 |
|
|
Aco ccm; ea addl 20 min 99439aco
|
$49.20 |
$87.20 |
$87.20 |
|
|
Aco cmplx chron care addl 20 min 99489aco
|
$82.80 |
$132.80 |
$132.80 |
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$162.60 |
$247.20 |
$247.20 |
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$144.06 |
$350.73 |
$793.00 |
|
|
Aco depression screen annual medicare g0444aco
|
$22.20 |
$40.00 |
$1,456.00 |
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$15.12 |
$37.60 |
$94.90 |
|
|
Acoustic immitance testing
|
$48.60 |
$74.40 |
$74.40 |
|
|
Acoustic refl threshold tst
|
$23.40 |
$36.00 |
$49.87 |
|
|
Acromp/acromionectomy prtl
|
$3,012.80 |
$3,012.80 |
$61,503.24 |
|
|
Acth stimulation panel
|
$218.40 |
$218.40 |
$218.40 |
|
|
Acth stimulation panel
|
$173.60 |
$173.60 |
$173.60 |
|
|
Actigraphy testing
|
$141.54 |
$323.20 |
$323.20 |
|
|
Actinotherapy uv light
|
$29.90 |
$154.05 |
$682.54 |
|
|
Acup 1/> w/estim 1st 15 min
|
$97.60 |
$97.60 |
$109.99 |
|
|
Acup 1/> w/estim ea addl 15
|
$74.40 |
$74.40 |
$74.40 |
|
|
Acup 1/> without estim ea add 15
|
$62.40 |
$62.40 |
$62.40 |
|
|
Acup 1/> wo estim 1st 15 min
|
$84.00 |
$84.00 |
$109.99 |
|
|
Acute hepatitis panel
|
$120.00 |
$316.55 |
$1,619.00 |
|
|
Acute venous thrombus image
|
$702.40 |
$702.40 |
$702.40 |
|
|
Acyclovir 400 mg tablet
|
$1.00 |
$33.77 |
$417.63 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.62 |
$10.40 |
$98.15 |
|
|
#acylcarnitineprfl
|
$51.20 |
$64.28 |
$235.80 |
|
|
Acylcarnitines qual
|
$64.28 |
$64.28 |
$64.28 |
|
|
Adalimumab injection
|
$6,465.76 |
$6,465.76 |
$6,465.76 |
|
|
Adapter b 8 channel 10cm
|
$201.92 |
$19,860.90 |
$30,555.23 |
|
|
Adding walker to prev cast
|
$216.00 |
$216.00 |
$216.00 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$9.38 |
$590.89 |
$695.70 |
|
|
Adenovirus ag ia
|
$30.40 |
$30.40 |
$77.91 |
|
|
Adenovirus antibody,serum - quest
|
$48.00 |
$48.57 |
$107.40 |
|
|
Adenovirus assay w/optic
|
$44.00 |
$44.00 |
$44.00 |
|
|
Adhesiolysis tube ovary 58740
|
$1,620.60 |
$2,226.40 |
$2,705.00 |
|
|
Adh-sendout
|
$72.80 |
$109.28 |
$312.00 |
|
|
Adj gastric band via subq port
|
$653.94 |
$1,533.00 |
$1,609.80 |
|
|
Adjmt/revj ext fixj sys anes
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$1,730.40 |
$2,287.20 |
$20,816.35 |
|
|
Adjustment gastric band
|
$56.00 |
$56.00 |
$11,347.60 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1.60 |
$78.60 |
$801.38 |
|
|
Admin ecg contrast agent
|
$60.96 |
$72.80 |
$139.44 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$85.20 |
$146.31 |
$588.25 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$100.20 |
$146.31 |
$1,834.95 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$238.56 |
$543.40 |
$25,241.75 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$141.00 |
$488.88 |
$12,719.95 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$91.44 |
$128.40 |
$461.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$96.60 |
$159.60 |
$417.00 |
|
|
Administration immunization each additional component
|
$20.40 |
$27.20 |
$312.44 |
|
|
Administration immunization each additional vaccine
|
$25.20 |
$58.05 |
$142.59 |
|
|
Administration immunization first component each vaccine
|
$38.40 |
$46.40 |
$66.00 |
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$37.20 |
$46.40 |
$72.00 |
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$19.20 |
$27.20 |
$54.40 |
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$33.00 |
$46.40 |
$61.32 |
|
|
Administration vaccine hepatitis b
|
$31.20 |
$75.71 |
$33,066.51 |
|
|
Administration vaccine influenza virus
|
$31.20 |
$78.00 |
$688.00 |
|
|
Administration vaccine pneumococcal
|
$31.20 |
$58.54 |
$1,663.00 |
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$27.95 |
$46.40 |
$56.53 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$40.80 |
$13,076.26 |
$19,916.25 |
|
|
Adrenal cortex & medulla img
|
$1,010.40 |
$1,010.40 |
$2,970.52 |
|
|
Adrenalectomy expl w/exc retro tumor 60545
|
$2,211.00 |
$6,081.60 |
$6,081.60 |
|
|
Adrenalin epinephrine inject
|
$4.73 |
$35.19 |
$551.41 |
|
|
Advance care planning each additional 30 min 99498
|
$107.90 |
$134.40 |
$178.00 |
|
|
Aep hearing status deter i&r
|
$204.00 |
$204.00 |
$1,366.71 |
|
|
Aep neurodiagnostic i&r
|
$198.40 |
$537.95 |
$571.55 |
|
|
Aep thrshld est mlt freq i&r
|
$270.40 |
$537.95 |
$1,288.95 |
|
|
_afb id by dna probe rflx ast
|
$50.40 |
$50.40 |
$114.66 |
|
|
#afb mycobacteria suscep. #1
|
$24.36 |
$38.58 |
$38.58 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$289.60 |
$289.60 |
$514.50 |
|
|
Aflibercept injection
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
|
|
Afluria vacc, 3 yrs & >, im
|
$18.40 |
$18.40 |
$18.40 |
|
|
Afo molded to patient plasti
|
$1,220.80 |
$1,220.80 |
$1,220.80 |
|
|
Afo rig ant tib tcf/= custom
|
$470.36 |
$470.36 |
$3,504.96 |
|
|
Afo sing upright with adjust s
|
$16.20 |
$16.80 |
$16.80 |
|
|
Afo tib fx semi-rigid l2114
|
$15.60 |
$16.20 |
$16.20 |
|
|
Afo tibial fracture rigid
|
$6.00 |
$1,698.40 |
$1,698.40 |
|
|
Afo tibial fracture soft
|
$7.20 |
$1,052.00 |
$1,052.00 |
|
|
After cataract laser surgery
|
$495.36 |
$1,640.00 |
$1,640.00 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$345.44 |
$18,756.30 |
$18,756.30 |
|
|
Air conduction bilat
|
$14.30 |
$71.20 |
$213.85 |
|
|
Air injection into abdomen 49400
|
$224.40 |
$360.80 |
$1,032.20 |
|
|
Airway resistance by impulse oscillometry 94728
|
$53.34 |
$103.80 |
$458.40 |
|
|
Ak sleeve susp neoprene/equa
|
$846.24 |
$846.24 |
$846.24 |
|
|
Albumin body fluid quantitative each specimen
|
$18.20 |
$42.90 |
$219.00 |
|
|
Albumin (human), 25%, 50ml
|
$109.48 |
$157.59 |
$347.15 |
|
|
Albumin, human 25 % intravenous solution
|
$200.00 |
$871.00 |
$5,435.70 |
|
|
Albumin (human), 5%, 250 ml
|
$234.36 |
$273.42 |
$322.92 |
|
|
Albumin, human 5 % intravenous solution
|
$20.48 |
$217.50 |
$332.50 |
|
|
Albumin ischemia modified
|
$85.60 |
$85.60 |
$85.60 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$25.72 |
$57.20 |
$189.80 |
|
|
Albumin serum plasma or whole blood
|
$27.95 |
$53.41 |
$40,341.40 |
|
|
Albuterol comp con
|
$12.80 |
$12.80 |
$12.80 |
|
|
Albuterol comp unit
|
$0.80 |
$0.80 |
$0.80 |
|
|
Albuterol ipratrop non-comp
|
$0.80 |
$0.80 |
$6.62 |
|
|
Albuterol non-comp con
|
$0.80 |
$0.80 |
$4.80 |
|
|
Albuterol non-comp unit
|
$0.60 |
$1.00 |
$2,386.00 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$72.14 |
$94.90 |
$3,207.25 |
|
