|
17-hydroxypregnenolone
|
$66.02 |
$66.02 |
$66.02 |
$92.65
|
|
3d recon without postprocess indpndt
|
$1,573.32 |
$1,573.32 |
$1,573.32 |
$508.13
|
|
4-bar link above knee w/swng
|
$2,675.51 |
$2,675.51 |
$2,675.51 |
$1,864.80
|
|
88334 ap bill cytologic exam each additional site
|
$39.59 |
$39.59 |
$39.59 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,793.16 |
$2,793.16 |
$2,793.16 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,118.88 |
$1,118.88 |
$1,118.88 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$805.78 |
$805.78 |
$805.78 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,589.34 |
$1,589.34 |
$1,589.34 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,192.13 |
$1,192.13 |
$1,192.13 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$794.70 |
$794.70 |
$794.70 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,027.75 |
$3,027.75 |
$3,027.75 |
$2,967.00
|
|
Abdominal MRI (without contrast)
|
$2,422.17 |
$2,422.17 |
$2,422.17 |
$2,048.36
|
|
Abdominal pad
|
$131.15 |
$131.15 |
$131.15 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$931.62 |
$931.62 |
$931.62 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$566.94 |
$566.94 |
$566.94 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$472.42 |
$472.42 |
$472.42 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$257.66 |
$257.66 |
$257.66 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$171.81 |
$171.81 |
$171.81 |
$418.63
|
|
Abdominal X-ray (single view)
|
$257.66 |
$257.66 |
$257.66 |
$260.00
|
|
Abduct control hip semi-flex
|
$334.32 |
$334.32 |
$334.32 |
$456.74
|
|
Abduction bar jointed adjust
|
$398.38 |
$398.38 |
$398.38 |
$453.55
|
|
Abduction bar-straight
|
$182.00 |
$182.00 |
$182.00 |
$173.60
|
|
Abduction rotation bar shoe
|
$140.90 |
$140.90 |
$140.90 |
$164.98
|
|
Abduct rotation bar without shoe
|
$128.80 |
$128.80 |
$128.80 |
$150.86
|
|
Ablate pulm tumor perq crybl
|
$377.16 |
$377.16 |
$377.16 |
$9,970.50
|
|
Ablation cryo abd perit om
|
$2,293.54 |
$2,293.54 |
$2,293.54 |
$2,312.80
|
|
Ablation of upper extremity nerves rf
|
$987.90 |
$987.90 |
$987.90 |
$832.50
|
|
Above elbow prosth tiss shap
|
$5,352.48 |
$5,352.48 |
$5,352.48 |
$3,855.60
|
|
Above knee cushion socket
|
$1,156.57 |
$1,156.57 |
$1,156.57 |
$742.00
|
|
Above knee flex cover system
|
$1,777.33 |
$1,777.33 |
$1,777.33 |
$1,268.40
|
|
Above knee hydracadence
|
$3,987.70 |
$3,987.70 |
$3,987.70 |
$2,755.20
|
|
Above knee leather socket
|
$1,076.88 |
$1,076.88 |
$1,076.88 |
$697.20
|
|
Above knee manual lock
|
$529.70 |
$529.70 |
$529.70 |
$492.80
|
|
Above knee wood socket
|
$931.06 |
$931.06 |
$931.06 |
$666.40
|
|
Abscess drain retroperitoneal surg code
|
$801.47 |
$801.47 |
$801.47 |
$3,050.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$32.32 |
$32.32 |
$32.32 |
$72.74
|
|
Acetaminophen level
|
$58.80 |
$58.80 |
$58.80 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$96.07 |
$96.07 |
$96.07 |
$122.55
|
|
Acetone qualitative
|
$23.13 |
$23.13 |
$23.13 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$96.15 |
$96.15 |
$96.15 |
$67.50
|
|
Acetylcholinesterase assay
|
$67.98 |
$67.98 |
$67.98 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$429.35 |
$429.35 |
$429.35 |
$218.79
|
|
Acute hepatitis panel
|
$102.70 |
$102.70 |
$102.70 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$42.97 |
$42.97 |
$42.97 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$2,258.65 |
$2,258.65 |
$2,258.65 |
$5,109.58
|
|
Additional switch, ext power
|
$652.79 |
$652.79 |
$652.79 |
$490.00
|
|
Add le poly knee custom kafo
|
$302.06 |
$302.06 |
$302.06 |
$353.76
|
|
Adenosine 3 mg/250 ml bag for osm
|
$634.38 |
$634.38 |
$634.38 |
$271.98
|
|
Adh-sendout
|
$252.22 |
$252.22 |
$252.22 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$217.38 |
$217.38 |
$217.38 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$126.17 |
$126.17 |
$126.17 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$126.17 |
$126.17 |
$126.17 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$306.66 |
$306.66 |
$306.66 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$132.22 |
$132.22 |
$132.22 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$84.73 |
$84.73 |
$84.73 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$84.73 |
$84.73 |
$84.73 |
$256.49
|
|
Administration immunization each additional vaccine
|
$15.40 |
$15.40 |
$15.40 |
$47.40
|
|
Administration vaccine influenza virus
|
$14.34 |
$14.34 |
$14.34 |
$51.07
|
|
Administration vaccine pneumococcal
|
$11.31 |
$11.31 |
$11.31 |
$49.68
|
|
_afb org id by sequencing rflx ast-sendout
|
$214.98 |
$214.98 |
$214.98 |
$300.00
|
|
Afo molded ankle gauntlet
|
$714.28 |
$714.28 |
$714.28 |
$765.51
|
|
Afo molded plas rig ant tib
|
$1,776.21 |
$1,776.21 |
$1,776.21 |
$2,022.34
|
|
Afo molded to patient plasti
|
$770.62 |
$770.62 |
$770.62 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$1,412.10 |
$1,412.10 |
$1,412.10 |
$1,843.53
|
|
Afo sing bar clasp attach sh
|
$443.74 |
$443.74 |
$443.74 |
$589.51
|
|
Afo sing solid stirrup calf
|
$638.96 |
$638.96 |
$638.96 |
$728.50
|
|
Afo sing upright with adjust s
|
$650.10 |
$650.10 |
$650.10 |
$740.16
|
|
Afo spiral molded to pt plas
|
$1,217.05 |
$1,217.05 |
$1,217.05 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$451.47 |
$451.47 |
$451.47 |
$599.70
|
|
Afo supramalleolar custom
|
$890.46 |
$890.46 |
$890.46 |
$1,182.83
|
|
Afo tib fx cast molded to pt
|
$1,819.22 |
$1,819.22 |
$1,819.22 |
$2,118.14
|
|
Afo tib fx cast plaster mold
|
$1,247.34 |
$1,247.34 |
$1,247.34 |
$1,656.82
|
|
Afo tib fx semi-rigid l2114
|
$999.94 |
$999.94 |
$999.94 |
$817.60
|
|
Afo tibial fracture rigid
|
$1,219.62 |
$1,219.62 |
$1,219.62 |
$1,489.57
|
|
Afo tibial fracture soft
|
$798.34 |
$798.34 |
$798.34 |
$1,060.02
|
|
Afo w/ankle joint, prefab
|
$741.72 |
$741.72 |
$741.72 |
$741.72
|
|
After cataract laser surgery
|
$891.86 |
$891.86 |
$891.86 |
$1,373.11
|
|
Ak 4 bar ling w/hydraul swig
|
$3,863.16 |
$3,863.16 |
$3,863.16 |
$3,673.60
|
|
Ak 4 bar link w/fric swing
|
$2,539.82 |
$2,539.82 |
$2,539.82 |
$2,228.80
|
|
Ak/bk self-aligning unit ea
|
$887.15 |
$887.15 |
$887.15 |
$618.80
|
|
Ak flex inner socket ext fra
|
$2,254.73 |
$2,254.73 |
$2,254.73 |
$1,352.40
|
|
Ak/knee disartic acrylic soc
|
$692.61 |
$692.61 |
$692.61 |
$495.60
|
|
Ak/knee disartic pelvic band
|
$147.50 |
$147.50 |
$147.50 |
$185.56
|
|
Ak/knee disartic pelvic join
|
$310.58 |
$310.58 |
$310.58 |
$280.00
|
|
Ak/knee disartic silesian ba
|
$189.22 |
$189.22 |
$189.22 |
$221.57
|
|
Ak open end sach
|
$5,475.57 |
$5,475.57 |
$5,475.57 |
$4,928.00
|
|
Ak pelvic control belt light
|
$209.44 |
$209.44 |
$209.44 |
$201.60
|
|
Ak pelvic control belt pad/l
|
$285.99 |
$285.99 |
$285.99 |
$334.90
|
|
Ak sleeve susp neoprene/equa
|
$257.10 |
$257.10 |
$257.10 |
$351.23
|
|
Ak univ multiplex sys frict
|
$2,329.38 |
$2,329.38 |
$2,329.38 |
$1,587.60
|
|
Albumin body fluid quantitative each specimen
|
$185.81 |
$185.81 |
$185.81 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$172.73 |
$172.73 |
$172.73 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$330.29 |
$330.29 |
$330.29 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$41.05 |
$41.05 |
$41.05 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$121.07 |
$121.07 |
$121.07 |
$43.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$30.07 |
$30.07 |
$30.07 |
$96.00
|
|
Alginate dressing <=16 sq in
|
$13.44 |
$13.44 |
$13.44 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$28.56 |
$28.56 |
$28.56 |
$43.72
|
|
Alkaline phosphatase
|
$60.59 |
$60.59 |
$60.59 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$117.21 |
$117.21 |
$117.21 |
$48.57
|
