|
2nd order venous cath
|
$2,294.32 |
$2,294.32 |
$2,294.32 |
$2,414.40
|
|
3-d radiotherapy plan
|
$1,890.00 |
$1,890.00 |
$1,890.00 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$146.16 |
$146.16 |
$146.16 |
$443.20
|
|
5' nucleotidase - sendout
|
$11.76 |
$11.76 |
$11.76 |
$64.80
|
|
88334 ap bill cytologic exam each additional site
|
$12.88 |
$12.88 |
$12.88 |
$93.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$11.11 |
$11.11 |
$11.11 |
$53.95
|
|
Abciximab injection
|
$406.00 |
$406.00 |
$406.00 |
$1,084.06
|
|
Abd aorta w/runoff s&i
|
$1,867.04 |
$1,867.04 |
$1,867.04 |
$3,483.84
|
|
Abd/low ext cath 1st
|
$4,442.48 |
$4,442.48 |
$4,442.48 |
$2,954.86
|
|
Abd/low ext cath 2nd
|
$2,439.36 |
$2,439.36 |
$2,439.36 |
$2,941.25
|
|
Abd/low ext cath 3rd
|
$2,208.08 |
$2,208.08 |
$2,208.08 |
$3,522.75
|
|
Abd/low ext cath addl
|
$963.76 |
$963.76 |
$963.76 |
$909.22
|
|
Abdominal CT scan (with and without contrast)
|
$1,067.92 |
$1,067.92 |
$1,067.92 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$977.20 |
$977.20 |
$977.20 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$911.68 |
$911.68 |
$911.68 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$1,434.72 |
$1,434.72 |
$1,434.72 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$1,230.32 |
$1,230.32 |
$1,230.32 |
$1,789.65
|
|
Abdominal paracentesis w/image guidance
|
$1,773.52 |
$1,773.52 |
$1,773.52 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$388.64 |
$388.64 |
$388.64 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$243.60 |
$243.60 |
$243.60 |
$574.53
|
|
Abd paracentesis/w/o image guide 49082
|
$1,066.80 |
$1,066.80 |
$1,066.80 |
$1,144.26
|
|
Abl1 gene
|
$336.00 |
$336.00 |
$336.00 |
$600.00
|
|
Ablate arrhythmia add on
|
$6,548.64 |
$6,548.64 |
$6,548.64 |
$7,717.80
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,814.80 |
$7,814.80 |
$7,814.80 |
$7,896.23
|
|
Ablate heart dysrhythm focus
|
$5,651.52 |
$5,651.52 |
$5,651.52 |
$8,936.20
|
|
Ablation cardiac vagal inputs atrium
|
$2,461.76 |
$2,461.76 |
$2,461.76 |
$4,519.45
|
|
Ablation cryo abd perit om
|
$931.28 |
$931.28 |
$931.28 |
$2,566.58
|
|
Ablation cryo pq liver tumor(s)
|
$8,504.16 |
$8,504.16 |
$8,504.16 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$680.40 |
$680.40 |
$680.40 |
$1,435.20
|
|
Abscess drain retroperitoneal surg code
|
$4,126.64 |
$4,126.64 |
$4,126.64 |
$3,053.18
|
|
Acetone qualitative
|
$44.24 |
$44.24 |
$44.24 |
$43.80
|
|
Acetylcholinesterase assay
|
$112.00 |
$112.00 |
$112.00 |
$104.40
|
|
Acoustic immitance testing
|
$143.92 |
$143.92 |
$143.92 |
$157.30
|
|
Acoustic refl threshold tst
|
$49.84 |
$49.84 |
$49.84 |
$90.13
|
|
Adenovirus antibody,serum - quest
|
$5.12 |
$5.12 |
$5.12 |
$63.00
|
|
Adh-sendout
|
$94.08 |
$94.08 |
$94.08 |
$152.10
|
|
Administration chemotherapy IV infusion each additional hour
|
$84.00 |
$84.00 |
$84.00 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$239.68 |
$239.68 |
$239.68 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$175.84 |
$175.84 |
$175.84 |
$454.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$107.52 |
$107.52 |
$107.52 |
$267.43
|
|
Administration immunization 1 vaccine
|
$42.00 |
$42.00 |
$42.00 |
$65.00
|
|
Administration immunization each additional vaccine
|
$40.32 |
$40.32 |
$40.32 |
$45.50
|
|
Administration vaccine hepatitis b
|
$24.08 |
$24.08 |
$24.08 |
$37.10
|
|
Administration vaccine influenza virus
|
$24.08 |
$24.08 |
$24.08 |
$38.25
|
|
Administration vaccine pneumococcal
|
$24.08 |
$24.08 |
$24.08 |
$38.25
|
|
Adrenal cortex & medulla img
|
$978.88 |
$978.88 |
$978.88 |
$1,642.08
|
|
Aep hearing status deter i&r
|
$164.08 |
$164.08 |
$164.08 |
$308.40
|
|
Aep neurodiagnostic i&r
|
$310.24 |
$310.24 |
$310.24 |
$570.16
|
|
Aep thrshld est mlt freq i&r
|
$310.24 |
$310.24 |
$310.24 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$49.84 |
$49.84 |
$49.84 |
$105.00
|
|
Air conduction bilat
|
$50.96 |
$50.96 |
$50.96 |
$140.87
|
|
Airway resistance by impulse oscillometry 94728
|
$85.68 |
$85.68 |
$85.68 |
$276.66
|
|
Albumin body fluid quantitative each specimen
|
$10.08 |
$10.08 |
$10.08 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$54.32 |
$54.32 |
$54.32 |
$277.87
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$29.12 |
$29.12 |
$29.12 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$8.40 |
$8.40 |
$8.40 |
$40.00
|
|
Alkaline phosphatase
|
$15.85 |
$15.85 |
$15.85 |
$43.80
|
|
Allergen egg white ige
|
$6.72 |
$6.72 |
$6.72 |
$41.00
|
|
Allograft amnioexcel plus 17mm disk
|
$152.88 |
$152.88 |
$152.88 |
$2,959.72
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$1,377.04 |
$1,377.04 |
$1,377.04 |
$1,377.04
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$126.00 |
$126.00 |
$126.00 |
$30,615.48
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$13,434.40 |
$13,434.40 |
$13,434.40 |
$3,035.85
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1,834.56 |
$1,834.56 |
$1,834.56 |
$4,304.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1,338.40 |
$1,338.40 |
$1,338.40 |
$6,075.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$582.40 |
$582.40 |
$582.40 |
$2,752.20
|
|
Alpha-fetoprotein amniotic
|
$38.64 |
$38.64 |
$38.64 |
$94.25
|
|
Alpha-fetoprotein tumor marker
|
$61.04 |
$61.04 |
$61.04 |
$110.40
|
|
Alt/sgpt
|
$8.40 |
$8.40 |
$8.40 |
$43.55
|
|
Aluminum - quest
|
$22.40 |
$22.40 |
$22.40 |
$114.40
|
|
Alys cplx sp/pn npgt w/prgrm
|
$184.24 |
$184.24 |
$184.24 |
$417.47
|
|
Ambl bp mntr w/sw a/r
|
$176.96 |
$176.96 |
$176.96 |
$320.45
|
|
Amino acid screen, urine
|
$55.44 |
$55.44 |
$55.44 |
$64.28
|
|
Aminolevulinic acid delta
|
$21.28 |
$21.28 |
$21.28 |
$95.80
|
|
Amitriptyline (elavil) -sendout
|
$9.68 |
$9.68 |
$9.68 |
$87.60
|
|
Ammonia
|
$39.20 |
$39.20 |
$39.20 |
$96.53
|
|
Amniocentesisdiagnostic 59000
|
$582.40 |
$582.40 |
$582.40 |
$876.60
|
|
Amniotic fluid scan
|
$6.72 |
$6.72 |
$6.72 |
$33.15
|
|
Amphetamine confirm urine -sendout
|
$5.60 |
$5.60 |
$5.60 |
$93.61
|
|
Amylase
|
$16.24 |
$16.24 |
$16.24 |
$83.20
|
|
Ana ds-dna
|
$32.48 |
$32.48 |
$32.48 |
$69.03
|
|
Anal pressure record
|
$316.96 |
$316.96 |
$316.96 |
$1,077.44
|
|
Anal/urinary muscle study
|
$417.76 |
$417.76 |
$417.76 |
$575.00
|
|
Analysis gene f2 20210g>a variant
|
$124.32 |
$124.32 |
$124.32 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$124.88 |
$124.88 |
$124.88 |
$253.11
|
|
Anca screen with reflex to titer -quest
|
$94.08 |
$94.08 |
$94.08 |
$111.20
|
|
An cholangiogram percutaneous compl
|
$1,331.68 |
$1,331.68 |
$1,331.68 |
$2,417.63
|
|
An fluoro guide for cvp
|
$202.72 |
$202.72 |
$202.72 |
$469.17
|
|
Angio balloon ctrl dialysis seg add-on
|
$8,133.44 |
$8,133.44 |
$8,133.44 |
$5,935.00
|
|
Angioplasty fem/pop unilat 37224
|
$9,136.40 |
$9,136.40 |
$9,136.40 |
$11,517.60
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$9,136.40 |
$9,136.40 |
$9,136.40 |
$12,766.07
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$8,810.48 |
$8,810.48 |
$8,810.48 |
$8,640.60
|
|
Angio tib/peroneal/init ves/unila 37228
|
$9,136.40 |
$9,136.40 |
$9,136.40 |
$14,806.05
|
|
Angio trnslmnl balloon same artery ea addl
|
$10,768.24 |
$10,768.24 |
$10,768.24 |
$5,855.20
|
|
Angio trnslmnl balloon same artery ini
|
$14,132.72 |
$14,132.72 |
$14,132.72 |
$9,966.40
|
|
Angio trnslmnl balloon same vein ea addl
|
$10,768.24 |
$10,768.24 |
$10,768.24 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$13,697.60 |
$13,697.60 |
$13,697.60 |
$8,766.15
|
|
Ankle X-ray
|
$221.20 |
$221.20 |
$221.20 |
$311.92
|
|
Antibody bacterium, not elsewhere specified
|
$16.80 |
$16.80 |
$16.80 |
$57.85
|
|
Antibody elution rbc reference
|
$60.48 |
$60.48 |
$60.48 |
$156.24
|
