|
Biopsy/soft tissue/neck or thorax 21550
|
$545.82 |
$545.82 |
$992.40 |
$2,462.35
|
|
Bivalirudin
|
$537.65 |
$537.65 |
$977.54 |
$1,033.55
|
|
Bladder irrigate/lavage/instill 51700
|
$82.28 |
$82.28 |
$149.60 |
$408.00
|
|
Bleomycin 15 unit solution for injection
|
$114.33 |
$114.33 |
$207.86 |
$215.36
|
|
Bln 30frx10mmx12cm renal nephromax
|
$37.40 |
$37.40 |
$68.00 |
$5,169.58
|
|
Block plantar digital nerve
|
$545.16 |
$545.16 |
$991.20 |
$530.40
|
|
Block tap inj(s) w/wo img bi
|
$148.72 |
$148.72 |
$270.40 |
$1,340.40
|
|
Block tap inj(s) w/wo img uni
|
$143.22 |
$143.22 |
$260.40 |
$847.60
|
|
Blood Clotting (PT/INR) Test
|
$4.18 |
$4.18 |
$7.60 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$20.02 |
$20.02 |
$36.40 |
$73.44
|
|
Blood Count (CBC) Test
|
$7.04 |
$7.04 |
$12.80 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$4.18 |
$4.18 |
$7.60 |
$61.80
|
|
Blood Culture Test
|
$49.06 |
$49.06 |
$89.20 |
$145.80
|
|
Blood draw capillary 36416
|
$8.36 |
$8.36 |
$15.20 |
$20.00
|
|
Blood gases ph venous
|
$9.24 |
$9.24 |
$16.80 |
$64.60
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$9.68 |
$9.68 |
$17.60 |
$57.42
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$7.92 |
$7.92 |
$14.40 |
$33.15
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$3.30 |
$3.30 |
$6.00 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$1.10 |
$1.10 |
$2.00 |
$34.00
|
|
Blood smear microscopic w manual differential wbc count
|
$2.64 |
$2.64 |
$4.80 |
$38.61
|
|
Blood split unit
|
$83.38 |
$83.38 |
$151.60 |
$250.00
|
|
Blood typing abo
|
$31.24 |
$31.24 |
$56.80 |
$83.03
|
|
Blood typing ag donor ea ag
|
$133.54 |
$133.54 |
$242.80 |
$190.80
|
|
Blood typing rbc ag non abo/rh ea
|
$120.78 |
$120.78 |
$219.60 |
$199.50
|
|
Blood typing rh (d)
|
$18.26 |
$18.26 |
$33.20 |
$57.14
|
|
Bone Density Scan (DEXA)
|
$79.20 |
$79.20 |
$144.00 |
$397.28
|
|
Bone marrow;aspiration only 38220
|
$673.86 |
$673.86 |
$1,225.20 |
$1,508.78
|
|
Bone marrow biopsyneedle/trocar 38221
|
$673.86 |
$673.86 |
$1,225.20 |
$1,570.80
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$121.00 |
$121.00 |
$220.00 |
$94.80
|
|
Borrelia miyamotoi amp prb
|
$24.86 |
$24.86 |
$45.20 |
$68.88
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$366.34 |
$366.34 |
$666.07 |
$2,825.96
|
|
Bowel imaging
|
$300.08 |
$300.08 |
$545.60 |
$1,065.00
|
|
Brach/thor cath 1st
|
$115.94 |
$115.94 |
$210.80 |
$1,751.55
|
|
Brach/thor cath 2nd
|
$801.46 |
$801.46 |
$1,457.20 |
$1,940.40
|
|
Brach/thor cath 3rd
|
$801.46 |
$801.46 |
$1,457.20 |
$2,079.00
|
|
Brach/thor cath addl
|
$801.46 |
$801.46 |
$1,457.20 |
$868.00
|
|
Brachy source yttrium-90
|
$10,192.16 |
$10,192.16 |
$18,531.20 |
$29,856.80
|
|
Braf gene
|
$93.94 |
$93.94 |
$170.80 |
$427.50
|
|
Brain image w/flow 4 + views
|
$183.04 |
$183.04 |
$332.80 |
$1,330.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$444.18 |
$444.18 |
$807.60 |
$2,785.50
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$252.78 |
$252.78 |
$459.60 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$358.82 |
$358.82 |
$652.40 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$310.86 |
$310.86 |
$565.20 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$262.68 |
$262.68 |
$477.60 |
$1,977.27
|
|
Brcassure comprehensive panel-sendout
|
$1,048.52 |
$1,048.52 |
$1,906.40 |
$2,287.20
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$561.88 |
$561.88 |
$1,021.60 |
$3,043.44
|
|
Breast punct aspir cyst, bil
|
$239.14 |
$239.14 |
$434.80 |
$847.00
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$22.00 |
$22.00 |
$40.00 |
$23.92
|
|
Bundled special stain group 1 microorganisms
|
$24.20 |
$24.20 |
$44.00 |
$160.80
|
|
Bundled special stain group 2
|
$13.86 |
$13.86 |
$25.20 |
$173.46
|
|
Buprenorphine hydrochloride
|
$66.97 |
$66.97 |
$121.76 |
$41.79
|
|
Buprenorphine oral 1mg
|
$22.00 |
$22.00 |
$40.00 |
$10.50
|
|
Busulfan injection
|
$610.57 |
$610.57 |
$1,110.12 |
$783.10
|
|
Butorphanol tartrate 1 mg
|
$67.77 |
$67.77 |
$123.22 |
$39.09
|
|
Bx bone trocar/ndl deep
|
$836.88 |
$836.88 |
$1,521.60 |
$2,271.01
|
|
Bx breast 1st lesion strtctc
|
$298.54 |
$298.54 |
$542.80 |
$3,601.35
|
|
Bx breast add lesion strtctc
|
$150.04 |
$150.04 |
$272.80 |
$1,800.68
|
|
Bx breast add lesion Ultrasound imag
|
$573.76 |
$573.76 |
$1,043.20 |
$1,692.64
|
|
Bx breast perq without image 19100
|
$341.00 |
$341.00 |
$620.00 |
$1,312.15
|
|
Bx pancreas pq ndl
|
$673.86 |
$673.86 |
$1,225.20 |
$1,588.50
|
|
Bx thyroid/percutan core needle 60100
|
$309.32 |
$309.32 |
$562.40 |
$964.62
|
|
C1 esterase inhibitor func - sendout
|
$89.10 |
$89.10 |
$162.00 |
$96.72
|
|
Cabergoline, oral 0.25mg
|
$3.57 |
$3.57 |
$6.49 |
$65.85
|
|
Cad breast MRI w/r&i
|
$23.10 |
$23.10 |
$42.00 |
$122.40
|
|
Caffeine citrate 20 mg/ml inj for po
|
$107.05 |
$107.05 |
$194.63 |
$47.78
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$1,831.70 |
$1,831.70 |
$3,330.36 |
$2,111.64
|
|
Calcium 24 hour urine
|
$51.48 |
$51.48 |
$93.60 |
$53.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$117.48 |
$117.48 |
$213.60 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$55.11 |
$55.11 |
$100.20 |
$91.60
|
|
Calcium ionized
|
$28.60 |
$28.60 |
$52.00 |
$90.00
|
|
Calcium total
|
$6.60 |
$6.60 |
$12.00 |
$50.00
|
|
Calprotectin fecal
|
$55.00 |
$55.00 |
$100.00 |
$169.95
|
|
Capecitabine, oral, 50 mg
|
$21.45 |
$21.45 |
$38.99 |
$59.42
|
|
Carbamazepine free
|
$25.08 |
$25.08 |
$45.60 |
$59.15
|
|
Carbamazepine total therapeutic drug level
|
$39.82 |
$39.82 |
$72.40 |
$120.25
|
|
Carbohydrate deficient transf - sendout
|
$17.82 |
$17.82 |
$32.40 |
$139.00
|
|
Carbon dioxide
|
$6.82 |
$6.82 |
$12.40 |
$44.00
|
|
Carboplatin 10 mg/ml desensitization
|
$137.72 |
$137.72 |
$250.40 |
$186.10
|
|
Carboxyhemoglobin quantitative
|
$20.02 |
$20.02 |
$36.40 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$61.16 |
$61.16 |
$111.20 |
$144.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$103.18 |
$103.18 |
$187.60 |
$244.00
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$71.94 |
$71.94 |
$130.80 |
$196.50
|
|
Cardiolipin antibody iga
|
$28.38 |
$28.38 |
$51.60 |
$105.00
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$327.14 |
$327.14 |
$594.80 |
$1,396.00
|
|
Caregiver training strategies&tq 1st 30 minutes
|
$34.32 |
$34.32 |
$62.40 |
$99.60
|
|
Caregiver training strategies&tq ea addl 15 min
|
$17.16 |
$17.16 |
$31.20 |
$51.50
|
|
Carmustine 100 mg intravenous powder for solution
|
$915.86 |
$915.86 |
$1,665.19 |
$1,731.00
|
|
Carotid Artery Ultrasound (Duplex)
|
$143.88 |
$143.88 |
$261.60 |
$1,018.68
|
|
Car-t admn autologous
|
$220.00 |
$220.00 |
$400.00 |
$722.40
|
|
Casiri and imdev repeat
|
$159.28 |
$159.28 |
$289.60 |
$540.00
|
|
Caspofungin acetate
|
$750.65 |
$750.65 |
$1,364.82 |
$615.86
|
|
Catheterization collection of specimen single patient all places of service
|
$2.20 |
$2.20 |
$4.00 |
$40.95
|
|
Catheter stripping venous
|
$1,031.80 |
$1,031.80 |
$1,876.00 |
$3,193.94
|
|
Cathj umbilical vein dx/ther nb
|
$280.72 |
$280.72 |
$510.40 |
$254.80
|
|
Cath left heart/lv gram
|
$1,253.78 |
$1,253.78 |
$2,279.60 |
$7,685.82
|
|
Cath lt/rt pulm art
|
$1,202.30 |
$1,202.30 |
$2,186.00 |
$1,281.93
|
|
Cath place 1st order venous 36011
|
$801.46 |
$801.46 |
$1,457.20 |
$1,377.75
|
|
Cath plc art ang/grft lt/rt hr
|
$3,042.16 |
$3,042.16 |
$5,531.20 |
$11,645.40
|
|
Cath plc art/angio/rt hrt cath
|
$2,416.26 |
$2,416.26 |
$4,393.20 |
$9,954.00
|
|
Cath right heart w/o2 sat & card
|
$1,463.00 |
$1,463.00 |
$2,660.00 |
$6,406.86
|
