|
17-hydroxypregnenolone
|
$61.15 |
$61.15 |
$61.15 |
$92.65
|
|
2d tee w or without fol w/con,in
|
$2,886.86 |
$2,886.86 |
$2,886.86 |
$1,724.25
|
|
2nd order venous cath
|
$410.03 |
$410.03 |
$410.03 |
$1,532.04
|
|
3d ech img cgen car anomal
|
$131.82 |
$131.82 |
$131.82 |
$511.60
|
|
3-d radiotherapy plan
|
$3,912.83 |
$3,912.83 |
$3,912.83 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$1,265.43 |
$1,265.43 |
$1,265.43 |
$508.13
|
|
4-bar link above knee w/swng
|
$3,553.93 |
$3,553.93 |
$3,553.93 |
$1,864.80
|
|
88334 ap bill cytologic exam each additional site
|
$38.53 |
$38.53 |
$38.53 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,880.49 |
$2,880.49 |
$2,880.49 |
$3,138.72
|
|
Abd/low ext cath 1st
|
$812.78 |
$812.78 |
$812.78 |
$2,015.85
|
|
Abd/low ext cath addl
|
$436.46 |
$436.46 |
$436.46 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$2,356.31 |
$2,356.31 |
$2,356.31 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$979.33 |
$979.33 |
$979.33 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,824.98 |
$1,824.98 |
$1,824.98 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,368.81 |
$1,368.81 |
$1,368.81 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$912.46 |
$912.46 |
$912.46 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,465.11 |
$3,465.11 |
$3,465.11 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,118.53 |
$3,118.53 |
$3,118.53 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,772.11 |
$2,772.11 |
$2,772.11 |
$2,048.36
|
|
Abdominal pad
|
$179.14 |
$179.14 |
$179.14 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$1,133.61 |
$1,133.61 |
$1,133.61 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$610.34 |
$610.34 |
$610.34 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$508.65 |
$508.65 |
$508.65 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$208.99 |
$208.99 |
$208.99 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$139.33 |
$139.33 |
$139.33 |
$418.63
|
|
Abdominal X-ray (single view)
|
$313.66 |
$313.66 |
$313.66 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$456.90 |
$456.90 |
$456.90 |
$1,148.40
|
|
Abduct control hip semi-flex
|
$456.74 |
$456.74 |
$456.74 |
$456.74
|
|
Abduction bar jointed adjust
|
$529.14 |
$529.14 |
$529.14 |
$453.55
|
|
Abduction bar-straight
|
$248.75 |
$248.75 |
$248.75 |
$173.60
|
|
Abduction rotation bar shoe
|
$192.47 |
$192.47 |
$192.47 |
$164.98
|
|
Abduct rotation bar without shoe
|
$176.01 |
$176.01 |
$176.01 |
$150.86
|
|
Ablate heart dysrhythm focus
|
$8,334.76 |
$8,334.76 |
$8,334.76 |
$9,332.05
|
|
Ablate pulm tumor perq crybl
|
$340.48 |
$340.48 |
$340.48 |
$9,970.50
|
|
Ablation cryo abd perit om
|
$2,419.82 |
$2,419.82 |
$2,419.82 |
$2,312.80
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$287.95 |
$287.95 |
$287.95 |
$441.09
|
|
Ablation of upper extremity nerves rf
|
$1,023.96 |
$1,023.96 |
$1,023.96 |
$832.50
|
|
Above elbow prosth tiss shap
|
$6,934.65 |
$6,934.65 |
$6,934.65 |
$3,855.60
|
|
Above knee cushion socket
|
$1,536.30 |
$1,536.30 |
$1,536.30 |
$742.00
|
|
Above knee flex cover system
|
$2,360.85 |
$2,360.85 |
$2,360.85 |
$1,268.40
|
|
Above knee hydracadence
|
$4,994.14 |
$4,994.14 |
$4,994.14 |
$2,755.20
|
|
Above knee leather socket
|
$1,430.41 |
$1,430.41 |
$1,430.41 |
$697.20
|
|
Above knee manual lock
|
$703.58 |
$703.58 |
$703.58 |
$492.80
|
|
Above knee wood socket
|
$1,236.76 |
$1,236.76 |
$1,236.76 |
$666.40
|
|
Abscess drain retroperitoneal surg code
|
$1,149.23 |
$1,149.23 |
$1,149.23 |
$3,050.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$34.11 |
$34.11 |
$34.11 |
$72.74
|
|
Acetaminophen level
|
$54.43 |
$54.43 |
$54.43 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$101.49 |
$101.49 |
$101.49 |
$122.55
|
|
Acetone qualitative
|
$19.26 |
$19.26 |
$19.26 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$89.04 |
$89.04 |
$89.04 |
$67.50
|
|
Acetylcholinesterase assay
|
$52.47 |
$52.47 |
$52.47 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$444.04 |
$444.04 |
$444.04 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$12.56 |
$12.56 |
$12.56 |
$31.21
|
|
Acid perfusion of esophagus
|
$755.27 |
$755.27 |
$755.27 |
$587.30
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$209.10 |
$209.10 |
$209.10 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$21.62 |
$21.62 |
$21.62 |
$38.50
|
|
Acoustic immitance testing
|
$46.14 |
$46.14 |
$46.14 |
$158.50
|
|
Acoustic refl threshold tst
|
$77.45 |
$77.45 |
$77.45 |
$102.05
|
|
Actigraphy testing
|
$298.14 |
$298.14 |
$298.14 |
$234.00
|
|
Acup 1/> w/estim 1st 15 min
|
$94.98 |
$94.98 |
$94.98 |
$56.16
|
|
Acup 1/> w/estim ea addl 15
|
$47.54 |
$47.54 |
$47.54 |
$57.98
|
|
Acup 1/> without estim ea add 15
|
$42.67 |
$42.67 |
$42.67 |
$43.00
|
|
Acup 1/> wo estim 1st 15 min
|
$85.18 |
$85.18 |
$85.18 |
$53.50
|
|
Acute hepatitis panel
|
$85.90 |
$85.90 |
$85.90 |
$284.95
|
|
Acute venous thrombus image
|
$1,114.68 |
$1,114.68 |
$1,114.68 |
$1,426.73
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$91.96 |
$91.96 |
$91.96 |
$64.45
|
|
#acylcarnitineprfl
|
$18.70 |
$18.70 |
$18.70 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$2,704.80 |
$2,704.80 |
$2,704.80 |
$5,109.58
|
|
Additional switch, ext power
|
$867.10 |
$867.10 |
$867.10 |
$490.00
|
|
Add le poly knee custom kafo
|
$412.72 |
$412.72 |
$412.72 |
$353.76
|
|
Adenosine 3 mg/250 ml bag for osm
|
$654.76 |
$654.76 |
$654.76 |
$271.98
|
|
Adh-sendout
|
$189.67 |
$189.67 |
$189.67 |
$118.79
|
|
Adjustment gastric band
|
$207.59 |
$207.59 |
$207.59 |
$207.51
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$591.63 |
$591.63 |
$591.63 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$177.46 |
$177.46 |
$177.46 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$177.46 |
$177.46 |
$177.46 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$439.60 |
$439.60 |
$439.60 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$208.38 |
$208.38 |
$208.38 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$119.06 |
$119.06 |
$119.06 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$119.11 |
$119.11 |
$119.11 |
$256.49
|
|
Administration immunization each additional vaccine
|
$20.61 |
$20.61 |
$20.61 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$28.28 |
$28.28 |
$28.28 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$10.08 |
$10.08 |
$10.08 |
$30.24
|
|
Administration vaccine hepatitis b
|
$11.87 |
$11.87 |
$11.87 |
$53.00
|
|
Administration vaccine influenza virus
|
$14.78 |
$14.78 |
$14.78 |
$51.07
|
|
Administration vaccine pneumococcal
|
$14.50 |
$14.50 |
$14.50 |
$49.68
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$10,332.71 |
$10,332.71 |
$10,332.71 |
$11,350.31
|
|
Aep hearing status deter i&r
|
$151.31 |
$151.31 |
$151.31 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$760.65 |
$760.65 |
$760.65 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$760.65 |
$760.65 |
$760.65 |
$635.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$174.22 |
$174.22 |
$174.22 |
$300.00
|
|
Afo molded ankle gauntlet
|
$948.75 |
$948.75 |
$948.75 |
$765.51
|
|
Afo molded plas rig ant tib
|
$2,359.39 |
$2,359.39 |
$2,359.39 |
$2,022.34
|
|
Afo molded to patient plasti
|
$1,023.62 |
$1,023.62 |
$1,023.62 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$1,875.66 |
$1,875.66 |
$1,875.66 |
$1,843.53
|
|
Afo sing bar clasp attach sh
|
$589.51 |
$589.51 |
$589.51 |
$589.51
|
|
Afo sing solid stirrup calf
|
$848.68 |
$848.68 |
$848.68 |
$728.50
|
|
Afo sing upright with adjust s
|
$863.52 |
$863.52 |
$863.52 |
$740.16
|
|
Afo spiral molded to pt plas
|
$1,616.50 |
$1,616.50 |
$1,616.50 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$599.70 |
$599.70 |
$599.70 |
$599.70
|
