|
5% dextrose and 0.45% saline
|
$14.00 |
$14.00 |
$14.00 |
$48.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$853.60 |
$853.60 |
$853.60 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,673.60 |
$2,673.60 |
$2,673.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,364.00 |
$2,364.00 |
$2,364.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,928.80 |
$1,928.80 |
$1,928.80 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,850.40 |
$3,850.40 |
$3,850.40 |
$2,967.00
|
|
Abdominal MRI (without contrast)
|
$2,804.80 |
$2,804.80 |
$2,804.80 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,092.80 |
$2,092.80 |
$2,092.80 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$940.80 |
$940.80 |
$940.80 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$743.20 |
$743.20 |
$743.20 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$437.60 |
$437.60 |
$437.60 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$706.40 |
$706.40 |
$706.40 |
$418.63
|
|
Abdominal X-ray (single view)
|
$357.60 |
$357.60 |
$357.60 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,398.40 |
$1,398.40 |
$1,398.40 |
$1,148.40
|
|
Ablation cryo thigh/knee
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$531.95
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$148.25 |
$148.25 |
$148.25 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$43.36 |
$43.36 |
$43.36 |
$31.21
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$68.00 |
$68.00 |
$68.00 |
$38.50
|
|
Acyclovir 400 mg tablet
|
$622.03 |
$622.03 |
$622.03 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$51.17 |
$51.17 |
$51.17 |
$64.45
|
|
Adenosine 3 mg/250 ml bag for osm
|
$51.72 |
$51.72 |
$51.72 |
$271.98
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$60.12 |
$60.12 |
$60.12 |
$193.40
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$225.60 |
$225.60 |
$225.60 |
$212.80
|
|
Administration immunization each additional vaccine
|
$64.80 |
$64.80 |
$64.80 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$67.20 |
$67.20 |
$67.20 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$61.60 |
$61.60 |
$61.60 |
$30.24
|
|
Albumin (human), 25%, 50ml
|
$52.25 |
$52.25 |
$52.25 |
$244.70
|
|
Albuterol ipratrop non-comp
|
$11.68 |
$11.68 |
$11.68 |
$5.67
|
|
Albuterol non-comp unit
|
$11.39 |
$11.39 |
$11.39 |
$5.40
|
|
Als 1
|
$1,514.40 |
$1,514.40 |
$1,514.40 |
$853.44
|
|
Als1-emergency
|
$1,857.60 |
$1,857.60 |
$1,857.60 |
$1,103.37
|
|
Als 2
|
$2,438.40 |
$2,438.40 |
$2,438.40 |
$1,288.56
|
|
Alteplase 100 mg infusion from pyxis vial
|
$232.00 |
$232.00 |
$232.00 |
$15,857.45
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$87.20 |
$87.20 |
$87.20 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$49.48 |
$49.48 |
$49.48 |
$55.86
|
|
Ampicillin 1 gram solution for injection
|
$54.54 |
$54.54 |
$54.54 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$52.99 |
$52.99 |
$52.99 |
$54.57
|
|
Anastrozole 1 mg
|
$5.16 |
$5.16 |
$5.16 |
$22.40
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$187.20 |
$187.20 |
$187.20 |
$2,979.43
|
|
Ankle X-ray
|
$513.60 |
$513.60 |
$513.60 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$348.00 |
$348.00 |
$348.00 |
$282.96
|
|
Anoscopy remove fb 46608
|
$2,742.40 |
$2,742.40 |
$2,742.40 |
$1,375.98
|
|
Aortic Aneurysm Screening Ultrasound
|
$488.00 |
$488.00 |
$488.00 |
$394.55
|
|
Application finger splntstatic 29130
|
$287.20 |
$287.20 |
$287.20 |
$208.50
|
|
Application long leg splint 29505
|
$375.20 |
$375.20 |
$375.20 |
$338.25
|
|
Application lower leg splint 29515
|
$369.60 |
$369.60 |
$369.60 |
$340.20
|
|
Application of forearm cast 29075
|
$330.40 |
$330.40 |
$330.40 |
$358.20
|
|
Application of long arm cast 29065
|
$386.40 |
$386.40 |
$386.40 |
$396.77
|
|
Application of paste boot 29580
|
$203.20 |
$203.20 |
$203.20 |
$340.11
|
|
Application short leg cast 29405
|
$378.40 |
$378.40 |
$378.40 |
$393.98
|
|
Appl modality 1/> areas paraffin bath 97018
|
$84.80 |
$84.80 |
$84.80 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$117.60 |
$117.60 |
$117.60 |
$75.98
|
|
Apply forearm splintdynamic 29126
|
$205.60 |
$205.60 |
$205.60 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$282.40 |
$282.40 |
$282.40 |
$271.80
|
|
Apply short leg castambul type 29425
|
$394.40 |
$394.40 |
$394.40 |
$404.74
|
|
Aquatic exercise - group charge
|
$78.40 |
$78.40 |
$78.40 |
$87.45
|
|
Arm CT Scan (with contrast, both arms)
|
$2,151.20 |
$2,151.20 |
$2,151.20 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,744.80 |
$1,744.80 |
$1,744.80 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$238.40 |
$238.40 |
$238.40 |
$426.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$657.60 |
$657.60 |
$657.60 |
$609.00
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$956.00 |
$956.00 |
$956.00 |
$910.79
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$666.40 |
$666.40 |
$666.40 |
$494.40
|
|
Aspirate pleura without imaging 32554
|
$1,394.40 |
$1,394.40 |
$1,394.40 |
$1,195.15
|
|
Atropine 0.1 mg/ml injection syringe
|
$54.94 |
$54.94 |
$54.94 |
$53.24
|
|
Avul nail plate addl
|
$173.60 |
$173.60 |
$173.60 |
$189.10
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$421.60 |
$421.60 |
$421.60 |
$326.27
|
|
Azathioprine 50 mg tablet
|
$5.24 |
$5.24 |
$5.24 |
$3.44
|
|
Azithromycin 500 mg intravenous solution
|
$54.76 |
$54.76 |
$54.76 |
$37.53
|
|
Azithromycin dihydrate, oral
|
$36.00 |
$36.00 |
$36.00 |
$46.31
|
|
Baclofen eval charges
|
$98.40 |
$98.40 |
$98.40 |
$87.50
|
|
Balance and Coordination Retraining (each 15 minutes)
|
$132.80 |
$132.80 |
$132.80 |
$102.20
|
|
Bartholin gland cyst/marsupializat 56440
|
$3,033.60 |
$3,033.60 |
$3,033.60 |
$4,479.26
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$54.74 |
$54.74 |
$54.74 |
$65.00
|
|
Bilateral n block inj occipital 64405
|
$871.20 |
$871.20 |
$871.20 |
$820.97
|
|
Bilateral n block inj trigeminal 64400
|
$676.00 |
$676.00 |
$676.00 |
$587.60
|
|
Biofeedback, pt
|
$264.80 |
$264.80 |
$264.80 |
$127.05
|
|
Bladder Catheter Insertion (simple)
|
$283.20 |
$283.20 |
$283.20 |
$232.30
|
|
Bladder irrigate/lavage/instill 51700
|
$548.00 |
$548.00 |
$548.00 |
$412.80
|
|
Bln 30frx10mmx12cm renal nephromax
|
$582.92 |
$582.92 |
$582.92 |
$5,330.60
|
|
Blood Transfusion
|
$936.80 |
$936.80 |
$936.80 |
$989.60
|
|
Bls-emergency
|
$1,725.60 |
$1,725.60 |
$1,725.60 |
$892.32
|
|
Bone Age X-ray (hand and wrist)
|
$432.80 |
$432.80 |
$432.80 |
$252.75
|
|
Bone Density Scan (DEXA)
|
$530.40 |
$530.40 |
$530.40 |
$407.94
|
|
Bone imaging multiple areas
|
$1,450.40 |
$1,450.40 |
$1,450.40 |
$1,194.00
|
|
Bone/joint imaging ltd area
|
$1,358.40 |
$1,358.40 |
$1,358.40 |
$1,037.40
|
|
Brace or Splint Fitting and Training (each 15 minutes)
|
$134.40 |
$134.40 |
$134.40 |
$105.30
|
|
Brace oths wrist hnd fngr without
|
$387.35 |
$387.35 |
$387.35 |
$257.45
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,830.40 |
$3,830.40 |
$3,830.40 |
$2,772.11
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,181.60 |
$3,181.60 |
$3,181.60 |
$2,136.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$3,235.20 |
$3,235.20 |
$3,235.20 |
$1,897.53
|
|
Brain MRI (with and without contrast)
|
$3,930.40 |
$3,930.40 |
$3,930.40 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$3,405.60 |
$3,405.60 |
$3,405.60 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$3,083.20 |
$3,083.20 |
$3,083.20 |
$1,948.00
|
|
Breastbone (Sternum) X-ray
|
$365.60 |
$365.60 |
$365.60 |
$274.65
|
|
Bronchial challenge
|
$568.00 |
$568.00 |
$568.00 |
$820.05
|
|
Budesonide non-comp unit
|
$19.88 |
$19.88 |
$19.88 |
$20.52
|
|
Bundled special stain group 1 microorganisms
|
$217.60 |
$217.60 |
$217.60 |
$159.00
|
|
Bundled special stain group 2
|
$178.40 |
$178.40 |
$178.40 |
$173.40
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$49.08 |
$49.08 |
$49.08 |
$32.47
|