|
1st psyc collab care mgmt
|
$215.90 |
$215.90 |
$215.90 |
$109.46
|
|
1st/sbsq psyc collab care
|
$107.95 |
$107.95 |
$107.95 |
$107.43
|
|
2d tee w or without fol w/con,in
|
$2,213.30 |
$2,213.30 |
$2,213.30 |
$1,724.25
|
|
2nd order venous cath
|
$1,077.10 |
$1,077.10 |
$1,077.10 |
$1,532.04
|
|
3d ech img cgen car anomal
|
$744.15 |
$744.15 |
$744.15 |
$511.60
|
|
3d recon without postprocess indpndt
|
$614.05 |
$614.05 |
$614.05 |
$508.13
|
|
5' nucleotidase - sendout
|
$31.00 |
$31.00 |
$31.00 |
$50.05
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,614.34 |
$3,614.34 |
$3,614.34 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$33.35 |
$33.35 |
$33.35 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$2,987.65 |
$2,987.65 |
$2,987.65 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$1,513.00 |
$1,513.00 |
$1,513.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$2,000.40 |
$2,000.40 |
$2,000.40 |
$2,475.45
|
|
Abd/low ext cath addl
|
$333.50 |
$333.50 |
$333.50 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,465.45 |
$1,465.45 |
$1,465.45 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$409.75 |
$409.75 |
$409.75 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,953.20 |
$2,953.20 |
$2,953.20 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,306.60 |
$2,306.60 |
$2,306.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,920.60 |
$1,920.60 |
$1,920.60 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,085.40 |
$3,085.40 |
$3,085.40 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,864.05 |
$2,864.05 |
$2,864.05 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,001.60 |
$2,001.60 |
$2,001.60 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,826.80 |
$1,826.80 |
$1,826.80 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$1,453.60 |
$1,453.60 |
$1,453.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$738.30 |
$738.30 |
$738.30 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$712.70 |
$712.70 |
$712.70 |
$418.63
|
|
Abdominal X-ray (single view)
|
$459.75 |
$459.75 |
$459.75 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,405.45 |
$2,405.45 |
$2,405.45 |
$1,148.40
|
|
Ablation cryo abd perit om
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$2,312.80
|
|
Ablation cryo thigh/knee
|
$840.55 |
$840.55 |
$840.55 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$2,528.95 |
$2,528.95 |
$2,528.95 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$5,288.30 |
$5,288.30 |
$5,288.30 |
$3,050.40
|
|
Acetaminophen level
|
$502.25 |
$502.25 |
$502.25 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$307.43 |
$307.43 |
$307.43 |
$122.55
|
|
Acetone qualitative
|
$13.40 |
$13.40 |
$13.40 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$31.35 |
$31.35 |
$31.35 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,073.68 |
$1,073.68 |
$1,073.68 |
$218.79
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$454.85 |
$454.85 |
$454.85 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$74.20 |
$74.20 |
$74.20 |
$38.50
|
|
Acoustic immitance testing
|
$264.60 |
$264.60 |
$264.60 |
$158.50
|
|
Acoustic refl threshold tst
|
$105.30 |
$105.30 |
$105.30 |
$102.05
|
|
Actigraphy testing
|
$508.80 |
$508.80 |
$508.80 |
$234.00
|
|
Actinotherapy uv light
|
$103.85 |
$103.85 |
$103.85 |
$105.60
|
|
Acup 1/> without estim ea add 15
|
$80.95 |
$80.95 |
$80.95 |
$43.00
|
|
Acup 1/> wo estim 1st 15 min
|
$94.50 |
$94.50 |
$94.50 |
$53.50
|
|
Acute hepatitis panel
|
$776.15 |
$776.15 |
$776.15 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$130.53 |
$130.53 |
$130.53 |
$64.45
|
|
#acylcarnitineprfl
|
$81.75 |
$81.75 |
$81.75 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$100.00 |
$100.00 |
$100.00 |
$5,109.58
|
|
Adh-sendout
|
$297.15 |
$297.15 |
$297.15 |
$118.79
|
|
Adj gastric band via subq port
|
$1,530.35 |
$1,530.35 |
$1,530.35 |
$1,666.86
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1,967.15 |
$1,967.15 |
$1,967.15 |
$193.40
|
|
Admin ecg contrast agent
|
$305.90 |
$305.90 |
$305.90 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$322.60 |
$322.60 |
$322.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$214.60 |
$214.60 |
$214.60 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$811.20 |
$811.20 |
$811.20 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$467.00 |
$467.00 |
$467.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$194.40 |
$194.40 |
$194.40 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$286.10 |
$286.10 |
$286.10 |
$256.49
|
|
Administration immunization each additional vaccine
|
$134.25 |
$134.25 |
$134.25 |
$47.40
|
|
Administration vaccine hepatitis b
|
$134.25 |
$134.25 |
$134.25 |
$53.00
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$103.90 |
$103.90 |
$103.90 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$15,242.28 |
$15,242.28 |
$15,242.28 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$726.62 |
$726.62 |
$726.62 |
$231.47
|
|
Advance care planning each additional 30 min 99498
|
$191.65 |
$191.65 |
$191.65 |
$110.56
|
|
Aep thrshld est mlt freq i&r
|
$151.15 |
$151.15 |
$151.15 |
$635.00
|
|
_afb id by dna probe rflx ast
|
$59.60 |
$59.60 |
$59.60 |
$104.50
|
|
Air conduction bilat
|
$145.80 |
$145.80 |
$145.80 |
$134.00
|
|
Albumin body fluid quantitative each specimen
|
$96.75 |
$96.75 |
$96.75 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$564.61 |
$564.61 |
$564.61 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$878.38 |
$878.38 |
$878.38 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$62.85 |
$62.85 |
$62.85 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$50.90 |
$50.90 |
$50.90 |
$43.00
|
|
Alkaline phosphatase
|
$36.75 |
$36.75 |
$36.75 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$46.65 |
$46.65 |
$46.65 |
$48.57
|
|
Allergen egg white ige
|
$23.65 |
$23.65 |
$23.65 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$23.70 |
$23.70 |
$23.70 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$85.00 |
$85.00 |
$85.00 |
$45.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$8,800.00 |
$8,800.00 |
$8,800.00 |
$9,900.02
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$1,411.85 |
$1,411.85 |
$1,411.85 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,294.00 |
$1,294.00 |
$1,294.00 |
$858.66
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$440.93 |
$440.93 |
$440.93 |
$1,225.35
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$71.05 |
$71.05 |
$71.05 |
$106.00
|
|
Alprostadil for injection
|
$1,574.06 |
$1,574.06 |
$1,574.06 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$21,013.50 |
$21,013.50 |
$21,013.50 |
$15,857.45
|
|
Alt/sgpt
|
$126.85 |
$126.85 |
$126.85 |
$47.50
|
|
Aluminum - quest
|
$70.75 |
$70.75 |
$70.75 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$150.85 |
$150.85 |
$150.85 |
$179.70
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$87.02 |
$87.02 |
$87.02 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$114.17 |
$114.17 |
$114.17 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$210.94 |
$210.94 |
$210.94 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$450.90 |
$450.90 |
$450.90 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$173.56 |
$173.56 |
$173.56 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$35.65 |
$35.65 |
$35.65 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$9,089.58 |
$9,089.58 |
$9,089.58 |
$9,084.45
|
|
Ammonia
|
$427.95 |
$427.95 |
$427.95 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,909.80 |
$1,909.80 |
$1,909.80 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$5,652.55 |
$5,652.55 |
$5,652.55 |
$3,786.00
|