|
2d tee w or without fol w/con,in
|
$908.98 |
$908.98 |
$908.98 |
$1,570.80
|
|
2d tte w or without fol w/con,co
|
$874.67 |
$874.67 |
$874.67 |
$1,165.05
|
|
3-d radiotherapy plan
|
$1,395.90 |
$1,395.90 |
$1,395.90 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$174.84 |
$174.84 |
$174.84 |
$443.20
|
|
88334 ap bill cytologic exam each additional site
|
$14.10 |
$14.10 |
$14.10 |
$93.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$14.06 |
$14.06 |
$14.06 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$1,013.79 |
$1,013.79 |
$1,013.79 |
$3,483.84
|
|
Abd/low ext cath addl
|
$349.68 |
$349.68 |
$349.68 |
$909.22
|
|
Abdominal CT scan (with and without contrast)
|
$1,220.59 |
$1,220.59 |
$1,220.59 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$1,135.05 |
$1,135.05 |
$1,135.05 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$770.33 |
$770.33 |
$770.33 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$420.18 |
$420.18 |
$420.18 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$349.21 |
$349.21 |
$349.21 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$277.30 |
$277.30 |
$277.30 |
$1,789.65
|
|
Abdominal Ultrasound (complete)
|
$405.14 |
$405.14 |
$405.14 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$184.24 |
$184.24 |
$184.24 |
$574.53
|
|
Ablate arrhythmia add on
|
$536.27 |
$536.27 |
$536.27 |
$7,717.80
|
|
Ablate bone tumor(s) cryo perq 20983
|
$6,786.80 |
$6,786.80 |
$6,786.80 |
$7,896.23
|
|
Ablate heart dysrhythm focus
|
$5,658.33 |
$5,658.33 |
$5,658.33 |
$8,936.20
|
|
Ablation cardiac vagal inputs atrium
|
$1,122.83 |
$1,122.83 |
$1,122.83 |
$4,519.45
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$576.22 |
$576.22 |
$576.22 |
$2,919.60
|
|
Acetazolamide 500 mg solution for injection
|
$44.18 |
$44.18 |
$44.18 |
$94.47
|
|
Acetone qualitative
|
$21.62 |
$21.62 |
$21.62 |
$43.80
|
|
Acetylcholinesterase assay
|
$107.63 |
$107.63 |
$107.63 |
$104.40
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$135.30 |
$135.30 |
$135.30 |
$320.66
|
|
Acute hepatitis panel
|
$89.30 |
$89.30 |
$89.30 |
$294.45
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.99 |
$0.99 |
$0.99 |
$48.72
|
|
#acylcarnitineprfl
|
$40.19 |
$40.19 |
$40.19 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$119.26 |
$119.26 |
$119.26 |
$97.50
|
|
Adenovirus antibody,serum - quest
|
$37.13 |
$37.13 |
$37.13 |
$63.00
|
|
Adenovirus assay w/optic
|
$10.34 |
$10.34 |
$10.34 |
$44.00
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$47.20 |
$47.20 |
$47.20 |
$163.25
|
|
Aep neurodiagnostic i&r
|
$502.90 |
$502.90 |
$502.90 |
$570.16
|
|
Aep thrshld est mlt freq i&r
|
$502.90 |
$502.90 |
$502.90 |
$573.65
|
|
Airway resistance by impulse oscillometry 94728
|
$66.27 |
$66.27 |
$66.27 |
$276.66
|
|
Albumin body fluid quantitative each specimen
|
$7.52 |
$7.52 |
$7.52 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$31.41 |
$31.41 |
$31.41 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$97.70 |
$97.70 |
$97.70 |
$253.48
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$11.28 |
$11.28 |
$11.28 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$7.99 |
$7.99 |
$7.99 |
$40.00
|
|
Alkaline phosphatase
|
$12.22 |
$12.22 |
$12.22 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$12.69 |
$12.69 |
$12.69 |
$56.35
|
|
Allergen egg white ige
|
$52.76 |
$52.76 |
$52.76 |
$41.00
|
|
Allograft amnioexcel plus 17mm disk
|
$311.14 |
$311.14 |
$311.14 |
$2,959.72
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$476.58 |
$476.58 |
$476.58 |
$1,377.04
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$237.82 |
$237.82 |
$237.82 |
$9,702.00
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$8,384.33 |
$8,384.33 |
$8,384.33 |
$30,615.48
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,021.78 |
$1,021.78 |
$1,021.78 |
$3,035.85
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,021.78 |
$1,021.78 |
$1,021.78 |
$2,752.20
|
|
Alpha-fetoprotein amniotic
|
$24.91 |
$24.91 |
$24.91 |
$94.25
|
|
Alpha-fetoprotein tumor marker
|
$29.61 |
$29.61 |
$29.61 |
$110.40
|
|
Alprostadil for injection
|
$87.64 |
$87.64 |
$87.64 |
$522.85
|
|
Alteplase 100 mg infusion from pyxis vial
|
$65.51 |
$65.51 |
$65.51 |
$189.60
|
|
Alt/sgpt
|
$5.64 |
$5.64 |
$5.64 |
$43.55
|
|
Aluminum - quest
|
$13.31 |
$13.31 |
$13.31 |
$114.40
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$32.58 |
$32.58 |
$32.58 |
$36.30
|
|
Amino acids quant 2-5
|
$9.40 |
$9.40 |
$9.40 |
$148.20
|
|
Aminolevulinic acid delta
|
$19.89 |
$19.89 |
$19.89 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$13.99 |
$13.99 |
$13.99 |
$40.47
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.58 |
$8.58 |
$8.58 |
$15.32
|
|
Ammonia
|
$41.36 |
$41.36 |
$41.36 |
$96.53
|
|
Amniotic fluid scan
|
$4.23 |
$4.23 |
$4.23 |
$33.15
|
|
Amphetamine confirm urine -sendout
|
$49.54 |
$49.54 |
$49.54 |
$93.61
|
|
Ampicillin 1 gram solution for injection
|
$48.68 |
$48.68 |
$48.68 |
$30.28
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$20.54 |
$20.54 |
$20.54 |
$37.60
|
|
Amylase
|
$16.03 |
$16.03 |
$16.03 |
$83.20
|
|
Ana ds-dna
|
$7.57 |
$7.57 |
$7.57 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$61.57 |
$61.57 |
$61.57 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$69.09 |
$69.09 |
$69.09 |
$253.11
|
|
Anca screen with reflex to titer -quest
|
$34.78 |
$34.78 |
$34.78 |
$111.20
|
|
An fluoro guide for cvp
|
$129.25 |
$129.25 |
$129.25 |
$469.17
|
|
Angio trnslmnl balloon same vein ea addl
|
$5,606.63 |
$5,606.63 |
$5,606.63 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$16,330.62 |
$16,330.62 |
$16,330.62 |
$8,766.15
|
|
Anidulafungin injection
|
$1.66 |
$1.66 |
$1.66 |
$209.79
|
|
Ankle X-ray
|
$266.02 |
$266.02 |
$266.02 |
$311.92
|
|
Antibody bacterium, not elsewhere specified
|
$63.92 |
$63.92 |
$63.92 |
$57.85
|
|
Antibody elution rbc reference
|
$80.37 |
$80.37 |
$80.37 |
$156.24
|
|
Antibody htlv/hiv confirm test
|
$41.36 |
$41.36 |
$41.36 |
$154.85
|
|
Antibody htlv-i
|
$70.50 |
$70.50 |
$70.50 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$155.10 |
$155.10 |
$155.10 |
$216.24
|
|
Antibody id rbc panel
|
$55.46 |
$55.46 |
$55.46 |
$250.90
|
|
Antibody influenza virus
|
$21.15 |
$21.15 |
$21.15 |
$63.33
|
|
Antibody screen rbc
|
$53.11 |
$53.11 |
$53.11 |
$99.99
|
|
Antibody tetanus
|
$13.63 |
$13.63 |
$13.63 |
$74.53
|
|
Antinuclear antibodies
|
$12.69 |
$12.69 |
$12.69 |
$97.50
|
|
Antinuclear antibodies titer
|
$11.75 |
$11.75 |
$11.75 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$11.28 |
$11.28 |
$11.28 |
$72.15
|
|
Antistreptolysin o screen
|
$2.82 |
$2.82 |
$2.82 |
$57.20
|
|
Antistreptolysin o titer
|
$7.52 |
$7.52 |
$7.52 |
$58.50
|
|
Antithrombin iii activity
|
$11.28 |
$11.28 |
$11.28 |
$135.20
|
|
Apc gene dup/delet variants
|
$94.00 |
$94.00 |
$94.00 |
$468.75
|
|
Apc gene full sequence
|
$366.60 |
$366.60 |
$366.60 |
$1,560.00
|
|
Apc gene known fam variants
|
$131.60 |
$131.60 |
$131.60 |
$268.80
|
|
Application finger splntstatic 29130
|
$112.80 |
$112.80 |
$112.80 |
$208.16
|
|
Application long leg splint 29505
|
$329.00 |
$329.00 |
$329.00 |
$325.60
|
|
Application lower leg splint 29515
|
$311.61 |
$311.61 |
$311.61 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$867.15 |
$867.15 |
$867.15 |
$384.80
|
|
Application of paste boot 29580
|
$650.48 |
$650.48 |
$650.48 |
$331.74
|
|
Appl modality 1/> areas paraffin bath 97018
|
$28.67 |
$28.67 |
$28.67 |
$69.44
|
|
Apply rigid leg cast 29445
|
$755.76 |
$755.76 |
$755.76 |
$593.57
|
