|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$2,132.40 |
$2,132.40 |
$2,132.40 |
$3,080.85
|
|
Angio trnslmnl balloon same artery ini
|
$8,550.60 |
$8,550.60 |
$8,550.60 |
$9,074.63
|
|
Ankle X-ray
|
$531.60 |
$531.60 |
$531.60 |
$353.60
|
|
Annual Physical, Established Patient (age 18-39)
|
$118.80 |
$118.80 |
$118.80 |
$141.00
|
|
Annual Physical, Established Patient (age 40-64)
|
$121.20 |
$121.20 |
$121.20 |
$158.76
|
|
Annual Physical, New Patient (age 18-39)
|
$115.80 |
$115.80 |
$115.80 |
$143.25
|
|
Annual Physical, New Patient (age 40-64)
|
$139.80 |
$139.80 |
$139.80 |
$165.10
|
|
Anora (draw only)
|
$19.20 |
$19.20 |
$19.20 |
$33.58
|
|
Antibody bacterium, not elsewhere specified
|
$22.80 |
$22.80 |
$22.80 |
$57.81
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$492.00 |
$492.00 |
$492.00 |
$218.30
|
|
Antibody id rbc panel
|
$200.40 |
$200.40 |
$200.40 |
$274.56
|
|
Antibody screen rbc
|
$90.60 |
$90.60 |
$90.60 |
$100.00
|
|
Antidepressant not specified
|
$31.80 |
$31.80 |
$31.80 |
$61.80
|
|
Antinuclear antibodies
|
$304.80 |
$304.80 |
$304.80 |
$89.40
|
|
Antistreptolysin o titer
|
$28.20 |
$28.20 |
$28.20 |
$51.45
|
|
Antithrombin iii activity
|
$219.60 |
$219.60 |
$219.60 |
$114.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$973.20 |
$973.20 |
$973.20 |
$463.65
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$973.20 |
$973.20 |
$973.20 |
$498.81
|
|
Application finger splntstatic 29130
|
$203.40 |
$203.40 |
$203.40 |
$208.16
|
|
Application long leg splint 29505
|
$203.40 |
$203.40 |
$203.40 |
$338.25
|
|
Application lower leg splint 29515
|
$406.80 |
$406.80 |
$406.80 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$382.20 |
$382.20 |
$382.20 |
$373.20
|
|
Application of forearm cast 29075
|
$463.20 |
$463.20 |
$463.20 |
$339.30
|
|
Application of long arm cast 29065
|
$145.80 |
$145.80 |
$145.80 |
$395.00
|
|
Application of paste boot 29580
|
$391.80 |
$391.80 |
$391.80 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,358.40 |
$1,358.40 |
$1,358.40 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,426.20 |
$1,426.20 |
$1,426.20 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$140.40 |
$140.40 |
$140.40 |
$66.00
|
|
Apply rigid leg cast 29445
|
$781.80 |
$781.80 |
$781.80 |
$555.00
|
|
Aquatic exercise - group charge
|
$130.80 |
$130.80 |
$130.80 |
$85.80
|
|
Argatroban nonesrd use 1mg
|
$2,065.20 |
$2,065.20 |
$2,065.20 |
$866.80
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$8,145.60 |
$8,145.60 |
$8,145.60 |
$6,387.85
|
|
Arterial blood draw/perc 36620
|
$127.20 |
$127.20 |
$127.20 |
$485.69
|
|
Artery x-rays arm/leg 75710-26
|
$3,111.60 |
$3,111.60 |
$3,111.60 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$4,980.00 |
$4,980.00 |
$4,980.00 |
$3,729.00
|
|
Artery xrays of pelvis 75736 26
|
$2,410.80 |
$2,410.80 |
$2,410.80 |
$4,134.14
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$956.40 |
$956.40 |
$956.40 |
$608.40
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$580.80 |
$580.80 |
$580.80 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$496.20 |
$496.20 |
$496.20 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$947.40 |
$947.40 |
$947.40 |
$715.37
|
|
Aspirate bladder/sprapubic cath 51102
|
$2,670.60 |
$2,670.60 |
$2,670.60 |
$3,162.72
|
|
Aspirate pleura without imaging 32554
|
$1,974.00 |
$1,974.00 |
$1,974.00 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$933.00 |
$933.00 |
$933.00 |
$1,226.87
|
|
Assay of interleukin-6 (il-6)
|
$687.00 |
$687.00 |
$687.00 |
$79.97
|
|
Assay of osteocalcin
|
$210.60 |
$210.60 |
$210.60 |
$92.50
|
|
Assay of somatostatin
|
$626.40 |
$626.40 |
$626.40 |
$165.00
|
|
Assay toxin or antitoxin
|
$529.20 |
$529.20 |
$529.20 |
$75.90
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$768.00 |
$768.00 |
$768.00 |
$292.50
|
|
Ast/sgot
|
$122.40 |
$122.40 |
$122.40 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$29,607.60 |
$29,607.60 |
$29,607.60 |
$23,166.53
|
|
Atropine 0.1 mg/ml injection syringe
|
$30.60 |
$30.60 |
$30.60 |
$51.28
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$172.80 |
$172.80 |
$172.80 |
$186.60
|
|
Autoimmune rheumatoid arthr anl 12 mrk ia
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$925.10
|
|
Avelumab 20 mg/ml intravenous solution
|
$5,670.00 |
$5,670.00 |
$5,670.00 |
$3,683.86
|
|
Avul nail plate addl
|
$42.60 |
$42.60 |
$42.60 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$279.60 |
$279.60 |
$279.60 |
$318.75
|
|
Azacitidine injection
|
$1,333.80 |
$1,333.80 |
$1,333.80 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$3.60 |
$3.60 |
$3.60 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$25.20 |
$25.20 |
$25.20 |
$35.06
|
|
Aztreonam 1 gram solution for injection
|
$295.20 |
$295.20 |
$295.20 |
$157.30
|
|
Baclofen eval charges
|
$70.80 |
$70.80 |
$70.80 |
$85.00
|
|
Bacterial meningitis antigen
|
$116.40 |
$116.40 |
$116.40 |
$66.30
|
|
Bacterial vaginosis pcr
|
$120.00 |
$120.00 |
$120.00 |
$278.40
|
|
Bcg live 50 mg intravesical suspension
|
$12.00 |
$12.00 |
$12.00 |
$378.28
|
|
Bcg vaccine percut
|
$177.60 |
$177.60 |
$177.60 |
$297.83
|
|
Belimumab 120 mg intravenous solution
|
$137.40 |
$137.40 |
$137.40 |
$4,243.90
|
|
Bendamustine 25 mg/ml intravenous solution (belrapzo)
|
$10,440.60 |
$10,440.60 |
$10,440.60 |
$4,107.38
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$8,248.20 |
$8,248.20 |
$8,248.20 |
$4,702.68
|
|
Benign lesion paring 2-4
|
$279.60 |
$279.60 |
$279.60 |
$257.50
|
|
Benztropine 1 mg/ml injection solution
|
$217.80 |
$217.80 |
$217.80 |
$103.20
|
|
Beta 2 glycoprotein 1 antibody iga
|
$42.60 |
$42.60 |
$42.60 |
$78.50
|
|
Beta-2 microglobulin
|
$171.00 |
$171.00 |
$171.00 |
$85.94
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$15.90 |
$15.90 |
$15.90 |
$64.15
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$10,628.40 |
$10,628.40 |
$10,628.40 |
$5,705.92
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$9,482.40 |
$9,482.40 |
$9,482.40 |
$3,291.73
|
|
Bevacizumab-bvzr 25 mg/ml intravenous solution
|
$9,008.40 |
$9,008.40 |
$9,008.40 |
$2,508.56
|
|
Bilateral n block inj occipital 64405
|
$144.00 |
$144.00 |
$144.00 |
$768.60
|
|
Bilirubin direct
|
$88.20 |
$88.20 |
$88.20 |
$50.00
|
|
Bilirubin total
|
$133.80 |
$133.80 |
$133.80 |
$52.57
|
|
Biopsy abdominal mass
|
$2,041.80 |
$2,041.80 |
$2,041.80 |
$1,718.60
|
|
Biopsy, bone open deep
|
$3,254.40 |
$3,254.40 |
$3,254.40 |
$3,684.24
|
|
Biopsy bone trocar/needle superficial
|
$1,901.40 |
$1,901.40 |
$1,901.40 |
$1,770.73
|
|
Biopsy cervixsingle/multiple 57500
|
$90.60 |
$90.60 |
$90.60 |
$1,266.48
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$6,585.00 |
$6,585.00 |
$6,585.00 |
$2,716.95
|
|
Biopsy needle liver percutaneous
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$1,892.80
|
|
Biopsy needle lymph node superficial
|
$3,237.00 |
$3,237.00 |
$3,237.00 |
$1,878.14
|
|
Biopsy renal percutaneous trocar/needle (both sides)
|
$1,380.60 |
$1,380.60 |
$1,380.60 |
$2,086.50
|
|
Biopsy skin incisional single lesion
|
$310.20 |
$310.20 |
$310.20 |
$657.66
|
|
Biopsy/soft tissue/neck or thorax 21550
|
$2,700.60 |
$2,700.60 |
$2,700.60 |
$2,462.35
|
|
Bivalirudin
|
$1,834.20 |
$1,834.20 |
$1,834.20 |
$1,033.55
|
|
Bladder irrigate/lavage/instill 51700
|
$398.40 |
$398.40 |
$398.40 |
$408.00
|
|
Bln 1.2 mono emrg 15x1.2
|
$8,290.80 |
$8,290.80 |
$8,290.80 |
$8,530.55
|
|
Bln 30frx10mmx12cm renal nephromax
|
$4,851.00 |
$4,851.00 |
$4,851.00 |
$5,169.58
|
|
Bln dil 900ml preperitnl
|
$385.36 |
$385.36 |
$385.36 |
$1,427.17
|
|
Bln inpact admiral 4x150x130cm
|
$5,821.20 |
$5,821.20 |
$5,821.20 |
$4,816.50
|
|
Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd
|
$88.20 |
$88.20 |
$88.20 |
$5,175.00
|
|
Blood Clotting (PT/INR) Test
|
$132.60 |
$132.60 |
$132.60 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$293.40 |
$293.40 |
$293.40 |
$73.44
|
|
Blood Count (CBC) Test
|
$108.60 |
$108.60 |
$108.60 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
