|
2d tee w or without fol w/con,in
|
$1,063.40 |
$1,063.40 |
$1,063.40 |
$1,870.05
|
|
3-d radiotherapy plan
|
$7,381.40 |
$7,381.40 |
$7,381.40 |
$5,005.80
|
|
3d recon without postprocess indpndt
|
$425.75 |
$425.75 |
$425.75 |
$455.83
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,649.67 |
$3,649.67 |
$3,649.67 |
$3,649.67
|
|
Abd aorta w/runoff s&i
|
$2,639.00 |
$2,639.00 |
$2,639.00 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$17,868.36 |
$17,868.36 |
$17,868.36 |
$2,954.86
|
|
Abd/low ext cath 3rd
|
$8,367.25 |
$8,367.25 |
$8,367.25 |
$3,554.85
|
|
Abdominal CT scan (with and without contrast)
|
$2,223.00 |
$2,223.00 |
$2,223.00 |
$1,997.40
|
|
Abdominal CT scan (with contrast)
|
$1,931.80 |
$1,931.80 |
$1,931.80 |
$1,678.00
|
|
Abdominal CT scan (without contrast)
|
$1,714.70 |
$1,714.70 |
$1,714.70 |
$1,290.90
|
|
Abdominal MRI (with and without contrast)
|
$2,420.60 |
$2,420.60 |
$2,420.60 |
$2,713.80
|
|
Abdominal MRI (with contrast)
|
$1,676.35 |
$1,676.35 |
$1,676.35 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$2,122.25 |
$2,122.25 |
$2,122.25 |
$1,883.70
|
|
Abdominal paracentesis w/image guidance
|
$1,688.70 |
$1,688.70 |
$1,688.70 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$753.35 |
$753.35 |
$753.35 |
$733.85
|
|
Abdominal Ultrasound (limited)
|
$471.90 |
$471.90 |
$471.90 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$957.47 |
$957.47 |
$957.47 |
$1,145.00
|
|
Ablate arrhythmia add on
|
$19,434.35 |
$19,434.35 |
$19,434.35 |
$9,995.45
|
|
Ablate inf turbinate submuc 30802
|
$16,470.48 |
$16,470.48 |
$16,470.48 |
$1,126.32
|
|
Ablation cardiac vagal inputs atrium
|
$4,050.15 |
$4,050.15 |
$4,050.15 |
$6,281.60
|
|
Ablation of upper extremity nerves rf
|
$22,776.94 |
$22,776.94 |
$22,776.94 |
$1,408.20
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$45.63 |
$45.63 |
$45.63 |
$47.25
|
|
Acetaminophen level
|
$196.30 |
$196.30 |
$196.30 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$185.73 |
$185.73 |
$185.73 |
$97.26
|
|
Acetylcholine receptor modulating antibody
|
$245.70 |
$245.70 |
$245.70 |
$93.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$224.98 |
$224.98 |
$224.98 |
$406.77
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$63.05 |
$63.05 |
$63.05 |
$44.80
|
|
Actinotherapy uv light
|
$96.20 |
$96.20 |
$96.20 |
$111.15
|
|
Acute hepatitis panel
|
$378.30 |
$378.30 |
$378.30 |
$310.20
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$47.53 |
$47.53 |
$47.53 |
$63.47
|
|
Adenosine 3 mg/250 ml bag for osm
|
$276.02 |
$276.02 |
$276.02 |
$97.58
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$93.96 |
$93.96 |
$93.96 |
$163.25
|
|
Administration chemotherapy IV infusion each additional hour
|
$399.10 |
$399.10 |
$399.10 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$299.00 |
$299.00 |
$299.00 |
$319.15
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$307.45 |
$307.45 |
$307.45 |
$735.00
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$286.00 |
$286.00 |
$286.00 |
$464.40
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$121.55 |
$121.55 |
$121.55 |
$224.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$135.85 |
$135.85 |
$135.85 |
$267.43
|
|
Administration immunization 1 vaccine
|
$59.80 |
$59.80 |
$59.80 |
$66.51
|
|
Administration immunization each additional component
|
$52.00 |
$52.00 |
$52.00 |
$27.20
|
|
Administration immunization each additional vaccine
|
$35.10 |
$35.10 |
$35.10 |
$46.23
|
|
Administration immunization first component each vaccine
|
$52.00 |
$52.00 |
$52.00 |
$46.00
|
|
Administration vaccine hepatitis b
|
$16.25 |
$16.25 |
$16.25 |
$38.25
|
|
Administration vaccine influenza virus
|
$52.00 |
$52.00 |
$52.00 |
$37.05
|
|
Administration vaccine pneumococcal
|
$52.00 |
$52.00 |
$52.00 |
$38.25
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$11,874.55 |
$11,874.55 |
$11,874.55 |
$59.76
|
|
After cataract laser surgery
|
$1,531.10 |
$1,531.10 |
$1,531.10 |
$1,380.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$18,341.71 |
$18,341.71 |
$18,341.71 |
$27,295.80
|
|
Albumin body fluid quantitative each specimen
|
$42.25 |
$42.25 |
$42.25 |
$42.90
|
|
Albumin (human), 25%, 50ml
|
$380.25 |
$380.25 |
$380.25 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$292.58 |
$292.58 |
$292.58 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$72.80 |
$72.80 |
$72.80 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$33.15 |
$33.15 |
$33.15 |
$41.90
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$171.60 |
$171.60 |
$171.60 |
$78.00
|
|
Alkaline phosphatase
|
$40.95 |
$40.95 |
$40.95 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$72.80 |
$72.80 |
$72.80 |
$56.35
|
|
Allergen egg white ige
|
$46.15 |
$46.15 |
$46.15 |
$41.38
|
|
Alpha-fetoprotein tumor marker
|
$126.10 |
$126.10 |
$126.10 |
$124.20
|
|
Alprostadil for injection
|
$715.48 |
$715.48 |
$715.48 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$442.33 |
$442.33 |
$442.33 |
$285.00
|
|
Alt/sgpt
|
$47.45 |
$47.45 |
$47.45 |
$44.68
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$92.91 |
$92.91 |
$92.91 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$195.19 |
$195.19 |
$195.19 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$37.57 |
$37.57 |
$37.57 |
$42.92
|
|
Amitriptyline (elavil) -sendout
|
$152.75 |
$152.75 |
$152.75 |
$96.35
|
|
Ammonia
|
$112.45 |
$112.45 |
$112.45 |
$96.53
|
|
Amphetamine confirm urine -sendout
|
$100.10 |
$100.10 |
$100.10 |
$93.61
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,385.21 |
$1,385.21 |
$1,385.21 |
$434.39
|
|
Ampicillin 1 gram solution for injection
|
$30.02 |
$30.02 |
$30.02 |
$77.40
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$29.57 |
$29.57 |
$29.57 |
$45.34
|
|
Amylase
|
$91.00 |
$91.00 |
$91.00 |
$83.20
|
|
Analysis gene f2 20210g>a variant
|
$415.35 |
$415.35 |
$415.35 |
$249.03
|
|
Analysis gene f5 leiden variant
|
$447.20 |
$447.20 |
$447.20 |
$263.90
|
|
Anaplsma phgcytophlm amp prb
|
$147.55 |
$147.55 |
$147.55 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$182.00 |
$182.00 |
$182.00 |
$112.45
|
|
Anidulafungin injection
|
$806.51 |
$806.51 |
$806.51 |
$209.79
|
|
Ankle arthroscopy/surgery
|
$18,591.70 |
$18,591.70 |
$18,591.70 |
$3,591.33
|
|
Ankle arthroscopy/surgery
|
$22,466.94 |
$22,466.94 |
$22,466.94 |
$3,594.44
|
|
Ankle X-ray
|
$444.60 |
$444.60 |
$444.60 |
$327.20
|
|
Anodyne therapy charges pt
|
$24.05 |
$24.05 |
$24.05 |
$41.02
|
|
Anora (draw only)
|
$22.75 |
$22.75 |
$22.75 |
$36.00
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$17,818.22 |
$17,818.22 |
$17,818.22 |
$4,760.24
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$328.25 |
$328.25 |
$328.25 |
$227.00
|
|
Antibody id rbc panel
|
$245.05 |
$245.05 |
$245.05 |
$265.05
|
|
Antibody screen rbc
|
$102.05 |
$102.05 |
$102.05 |
$101.09
|
|
Anti mog serum - sendout
|
$183.30 |
$183.30 |
$183.30 |
$154.84
|
|
Antinuclear antibodies
|
$138.45 |
$138.45 |
$138.45 |
$98.25
|
|
Antinuclear antibodies titer
|
$109.20 |
$109.20 |
$109.20 |
$79.95
|
|
Antistreptolysin o titer
|
$76.70 |
$76.70 |
$76.70 |
$60.00
|
|
Antithrombin iii activity
|
$174.20 |
$174.20 |
$174.20 |
$135.20
|
|
Apl(pml-rara) quant - sendout
|
$378.30 |
$378.30 |
$378.30 |
$484.25
|
|
Appendix Removal (Laparoscopic)
|
$15,471.26 |
$15,471.26 |
$15,471.26 |
$6,604.91
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$287.95 |
$287.95 |
$287.95 |
$1,051.25
|
|
Application finger splntstatic 29130
|
$209.95 |
$209.95 |
$209.95 |
$208.50
|
|
Appl modality 1/> areas paraffin bath 97018
|
$42.90 |
$42.90 |
$42.90 |
$71.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$56.55 |
$56.55 |
$56.55 |
$75.98
|
|
Apply forearm splintdynamic 29126
|
$209.95 |
$209.95 |
$209.95 |
$265.00
|
|
Apply interstit radiat compl
|
$3,213.60 |
$3,213.60 |
$3,213.60 |
$2,910.05
|
|
Apply of finger splint 29131
|
$209.95 |
$209.95 |
$209.95 |
$177.45
|
|
Apply rigid leg cast 29445
|
$202.80 |
$202.80 |
$202.80 |
$608.00
|