|
24 hr ambulatory b/p monitor
|
$291.20 |
$291.20 |
$291.20 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$1,073.60 |
$1,073.60 |
$1,073.60 |
$1,724.25
|
|
2d tte w or without fol w/con,co
|
$1,239.20 |
$1,239.20 |
$1,239.20 |
$1,284.00
|
|
2nd order venous cath
|
$2,975.20 |
$2,975.20 |
$2,975.20 |
$1,532.04
|
|
3-d radiotherapy plan
|
$6,372.00 |
$6,372.00 |
$6,372.00 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$652.80 |
$652.80 |
$652.80 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$14.00 |
$14.00 |
$14.00 |
$48.00
|
|
Abd aorta w/runoff s&i
|
$4,911.20 |
$4,911.20 |
$4,911.20 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$4,575.20 |
$4,575.20 |
$4,575.20 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,626.40 |
$1,626.40 |
$1,626.40 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$1,943.20 |
$1,943.20 |
$1,943.20 |
$2,475.45
|
|
Abd/low ext cath addl
|
$279.20 |
$279.20 |
$279.20 |
$913.75
|
|
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 (with contrast)
|
$3,464.80 |
$3,464.80 |
$3,464.80 |
$2,240.00
|
|
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
|
|
Ablate arrhythmia add on
|
$12,404.00 |
$12,404.00 |
$12,404.00 |
$6,828.51
|
|
Ablate bone tumor(s) perq
|
$8,528.80 |
$8,528.80 |
$8,528.80 |
$9,511.44
|
|
Ablate heart dysrhythm focus
|
$13,548.00 |
$13,548.00 |
$13,548.00 |
$9,332.05
|
|
Ablation cardiac vagal inputs atrium
|
$2,545.60 |
$2,545.60 |
$2,545.60 |
$2,260.30
|
|
Ablation cryo retro lymph node
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$857.60
|
|
Ablation of upper extremity nerves rf
|
$2,996.80 |
$2,996.80 |
$2,996.80 |
$832.50
|
|
Abobotulinumtoxina
|
$862.51 |
$862.51 |
$862.51 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$3,945.60 |
$3,945.60 |
$3,945.60 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$3,893.60 |
$3,893.60 |
$3,893.60 |
$2,314.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$50.51 |
$50.51 |
$50.51 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$81.15 |
$81.15 |
$81.15 |
$122.55
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$83.09 |
$83.09 |
$83.09 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$59.76 |
$59.76 |
$59.76 |
$31.21
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$487.20 |
$487.20 |
$487.20 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$68.00 |
$68.00 |
$68.00 |
$38.50
|
|
Actigraphy testing
|
$135.20 |
$135.20 |
$135.20 |
$234.00
|
|
Acyclovir 400 mg tablet
|
$742.65 |
$742.65 |
$742.65 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$50.71 |
$50.71 |
$50.71 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$3,816.00 |
$3,816.00 |
$3,816.00 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$77.96 |
$77.96 |
$77.96 |
$271.98
|
|
Adjustment gastric band
|
$1,698.40 |
$1,698.40 |
$1,698.40 |
$207.51
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$87.89 |
$87.89 |
$87.89 |
$193.40
|
|
Admin ecg contrast agent
|
$162.40 |
$162.40 |
$162.40 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$95.20 |
$95.20 |
$95.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$218.40 |
$218.40 |
$218.40 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$443.20 |
$443.20 |
$443.20 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$251.20 |
$251.20 |
$251.20 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$225.60 |
$225.60 |
$225.60 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$182.40 |
$182.40 |
$182.40 |
$256.49
|
|
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
|
|
Administration vaccine influenza virus
|
$40.80 |
$40.80 |
$40.80 |
$51.07
|
|
Aep hearing status deter i&r
|
$360.80 |
$360.80 |
$360.80 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$613.60 |
$613.60 |
$613.60 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$613.60 |
$613.60 |
$613.60 |
$635.00
|
|
Aflibercept injection
|
$1,930.00 |
$1,930.00 |
$1,930.00 |
$2,738.00
|
|
Afo tibial fracture rigid
|
$466.10 |
$466.10 |
$466.10 |
$1,489.57
|
|
Albumin (human), 25%, 50ml
|
$74.25 |
$74.25 |
$74.25 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$74.25 |
$74.25 |
$74.25 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$73.56 |
$73.56 |
$73.56 |
$275.16
|
|
Albuterol ipratrop non-comp
|
$11.81 |
$11.81 |
$11.81 |
$5.67
|
|
Albuterol non-comp con
|
$21.20 |
$21.20 |
$21.20 |
$6.07
|
|
Albuterol non-comp unit
|
$12.83 |
$12.83 |
$12.83 |
$5.40
|
|
Allograft amnioexcel plus 17mm disk
|
$436.80 |
$436.80 |
$436.80 |
$497.95
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$546.12 |
$546.12 |
$546.12 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$550.20 |
$550.20 |
$550.20 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$559.20 |
$559.20 |
$559.20 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$840.56 |
$840.56 |
$840.56 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$6,624.00 |
$6,624.00 |
$6,624.00 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$477.71 |
$477.71 |
$477.71 |
$1,225.35
|
|
Alloskin
|
$150.00 |
$150.00 |
$150.00 |
$582.40
|
|
Alprostadil for injection
|
$145.26 |
$145.26 |
$145.26 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$4,197.25 |
$4,197.25 |
$4,197.25 |
$15,857.45
|
|
Alveoloplasty each quadrant
|
$3,572.00 |
$3,572.00 |
$3,572.00 |
$3,892.00
|
|
Ambl bp mntr w/software
|
$201.60 |
$201.60 |
$201.60 |
$178.20
|
|
Ambl bp mntr w/sw a/r
|
$306.40 |
$306.40 |
$306.40 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$51.44 |
$51.44 |
$51.44 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$45.16 |
$45.16 |
$45.16 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$55.98 |
$55.98 |
$55.98 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$76.51 |
$76.51 |
$76.51 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$51.64 |
$51.64 |
$51.64 |
$55.86
|
|
Amniocentesisdiagnostic 59000
|
$820.00 |
$820.00 |
$820.00 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$6,092.80 |
$6,092.80 |
$6,092.80 |
$3,786.00
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$232.31 |
$232.31 |
$232.31 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$50.85 |
$50.85 |
$50.85 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$73.05 |
$73.05 |
$73.05 |
$54.57
|
|
Amputate metacarpal bone 26910
|
$4,796.00 |
$4,796.00 |
$4,796.00 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$5,446.40 |
$5,446.40 |
$5,446.40 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$5,394.40 |
$5,394.40 |
$5,394.40 |
$3,839.54
|
|
Anal/urinary muscle study
|
$356.00 |
$356.00 |
$356.00 |
$407.00
|
|
Analysis tumor
|
$265.60 |
$265.60 |
$265.60 |
$248.80
|
|
Anastrozole 1 mg
|
$5.63 |
$5.63 |
$5.63 |
$22.40
|
