|
11-desoxycortisol - sendout
|
$78.00 |
$105.30 |
$133.25 |
|
|
17-hydroxypregnenolone
|
$44.20 |
$85.15 |
$171.75 |
|
|
1st hosp/birthing center care per day nml nb 99460
|
$108.75 |
$108.75 |
$143.00 |
|
|
24 hr ambulatory b/p monitor
|
$319.15 |
$319.15 |
$319.15 |
|
|
2d tee w or without fol w/con,in
|
$1,435.85 |
$1,870.05 |
$2,277.60 |
|
|
2d tte w or without fol w/con,co
|
$1,404.00 |
$1,404.00 |
$2,486.25 |
|
|
2nd order venous cath
|
$10,858.01 |
$10,858.01 |
$18,837.58 |
|
|
3d ech img cgen car anomal
|
$47.45 |
$47.45 |
$47.45 |
|
|
3-d radiotherapy plan
|
$31,252.00 |
$31,252.00 |
$35,483.71 |
|
|
3d recon without postprocess indpndt
|
$215.15 |
$545.35 |
$904.80 |
|
|
5' nucleotidase - sendout
|
$60.45 |
$66.95 |
$81.25 |
|
|
88334 ap bill cytologic exam each additional site
|
$84.50 |
$100.75 |
$34,751.15 |
|
|
99381 initial comp preventive med less than 1 year new
|
$73.50 |
$73.50 |
$73.50 |
|
|
99382 initial comp preventive med 1 to 4 years new
|
$79.50 |
$79.50 |
$79.50 |
|
|
99383 initial comp preventive med 5 to 11 years new
|
$80.25 |
$80.25 |
$80.25 |
|
|
99391 periodic comp preventive med less than 1 year est
|
$61.50 |
$61.50 |
$61.50 |
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$73.50 |
$73.50 |
$73.50 |
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$75.00 |
$75.00 |
$75.00 |
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$90.75 |
$90.75 |
$90.75 |
|
|
99397 periodic comp preventive med 65+ years est
|
$80.25 |
$80.25 |
$80.25 |
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,158.52 |
$3,128.29 |
$3,910.36 |
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$60.45 |
$76.05 |
$245.05 |
|
|
Abd aorta w/runoff s&i
|
$2,503.15 |
$2,503.15 |
$3,450.20 |
|
|
Abd/low ext cath 1st
|
$21,135.46 |
$21,135.46 |
$43,665.35 |
|
|
Abd/low ext cath 2nd
|
$11,723.59 |
$11,723.59 |
$25,262.32 |
|
|
Abd/low ext cath 3rd
|
$19,668.45 |
$19,668.45 |
$55,583.02 |
|
|
Abd/low ext cath addl
|
$21,308.35 |
$21,308.35 |
$54,881.35 |
|
|
Abdominal CT scan (with and without contrast)
|
$83.25 |
$2,070.25 |
$2,377.05 |
|
|
Abdominal CT scan (with contrast)
|
$74.25 |
$1,329.90 |
$1,954.55 |
|
|
Abdominal CT scan (without contrast)
|
$69.75 |
$1,075.10 |
$1,552.85 |
|
|
Abdominal MRI (with and without contrast)
|
$132.00 |
$2,225.60 |
$3,729.70 |
|
|
Abdominal MRI (with contrast)
|
$1,450.15 |
$2,174.90 |
$3,268.20 |
|
|
Abdominal MRI (without contrast)
|
$86.25 |
$1,381.90 |
$2,797.60 |
|
|
Abdominal paracentesis w/image guidance
|
$498.55 |
$523.25 |
$3,554.67 |
|
|
Abdominal Ultrasound (complete)
|
$47.25 |
$806.65 |
$1,362.40 |
|
|
Abdominal Ultrasound (limited)
|
$35.25 |
$493.35 |
$1,060.15 |
|
|
Abd paracentesis/w/o image guide 49082
|
$399.75 |
$447.20 |
$594.75 |
|
|
Ablate arrhythmia add on
|
$7,899.45 |
$7,899.45 |
$7,899.45 |
|
|
Ablate bone tumor(s) cryo perq 20983
|
$3,772.60 |
$3,772.60 |
$3,772.60 |
|
|
Ablate bone tumor(s) perq
|
$3,801.85 |
$3,801.85 |
$3,801.85 |
|
|
Ablate heart dysrhythm focus
|
$14,461.20 |
$14,461.20 |
$14,844.70 |
|
|
Ablate inf turbinate submuc 30802
|
$11,606.87 |
$11,606.87 |
$11,606.87 |
|
|
Ablate inf turbinate superf 30801
|
$101.25 |
$101.25 |
$101.25 |
|
|
Ablate pulm tumor perq crybl
|
$19,550.68 |
$19,550.68 |
$19,550.68 |
|
|
Ablate pulm tumor perq rf
|
$7,425.60 |
$7,425.60 |
$7,425.60 |
|
|
Ablation cardiac vagal inputs atrium
|
$4,519.45 |
$4,519.45 |
$23,396.75 |
|
|
Ablation cryo abd perit om
|
$837.20 |
$2,096.25 |
$3,052.40 |
|
|
Ablation cryo adrenal tumor
|
$3,201.90 |
$3,201.90 |
$3,201.90 |
|
|
Ablation cryo pq liver tumor(s)
|
$16,901.28 |
$16,901.28 |
$16,901.28 |
|
|
Ablation cryo retro lymph node
|
$386.10 |
$386.10 |
$18,690.79 |
|
|
Ablation cryo thigh/knee
|
$130.65 |
$130.65 |
$130.65 |
|
|
Ablation of upper extremity nerves rf
|
$265.85 |
$1,238.90 |
$25,922.82 |
|
|
Abobotulinumtoxina
|
$1,722.70 |
$1,722.70 |
$1,722.70 |
|
|
Abscess drain retroperitoneal surg code
|
$6,356.12 |
$6,356.12 |
$6,822.47 |
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$6,991.40 |
$6,991.40 |
$6,991.40 |
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$32.64 |
$32.64 |
$45.63 |
|
|
Acetaminophen level
|
$133.25 |
$146.90 |
$207.35 |
|
|
Acetazolamide 500 mg solution for injection
|
$120.00 |
$130.00 |
$169.00 |
|
|
Acetone qualitative
|
$10.50 |
$48.75 |
$66.95 |
|
|
Acetylcholine receptor modulating antibody
|
$39.65 |
$171.60 |
$245.70 |
|
|
Acetylcholinesterase assay
|
$42.90 |
$140.40 |
$620.75 |
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$160.95 |
$173.06 |
$464.80 |
|
|
Acne surgery 10040
|
$40.95 |
$152.10 |
$171.00 |
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$198.00 |
$198.00 |
$198.00 |
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$120.00 |
$120.00 |
$120.00 |
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$142.50 |
$248.30 |
$419.90 |
|
|
Aco depression screen annual medicare g0444aco
|
$19.50 |
$19.50 |
$19.50 |
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$25.35 |
$26.65 |
$61.75 |
|
|
Actinotherapy uv light
|
$36.40 |
$105.30 |
$147.55 |
|
|
Acup 1/> w/estim 1st 15 min
|
$40.30 |
$40.30 |
$94.90 |
|
|
Acup 1/> wo estim 1st 15 min
|
$67.60 |
$67.60 |
$67.60 |
|
|
Acute hepatitis panel
|
$189.00 |
$325.00 |
$438.75 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$34.01 |
$36.56 |
$63.47 |
|
|
#acylcarnitineprfl
|
$105.30 |
$149.50 |
$205.40 |
|
|
Acylcarnitines qual
|
$309.40 |
$309.40 |
$309.40 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$16.55 |
$48.06 |
$212.32 |
|
|
Adh-sendout
|
$107.25 |
$151.45 |
$185.90 |
|
|
Adj gastric band via subq port
|
$1,874.60 |
$1,874.60 |
$1,874.60 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$3.00 |
$98.60 |
$183.76 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$16.90 |
$307.45 |
$451.75 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$65.65 |
$298.35 |
$362.70 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$307.45 |
$429.65 |
$1,000.35 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$211.25 |
$306.80 |
$484.90 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$105.95 |
$182.00 |
$240.50 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$132.60 |
$182.00 |
$707.20 |
|
|
Administration immunization 1 vaccine
|
$20.25 |
$67.60 |
$108.55 |
|
|
Administration immunization each additional component
|
$0.65 |
$1.30 |
$25.35 |
|
|
Administration immunization each additional vaccine
|
$12.00 |
$46.80 |
$70.85 |
|
|
Administration immunization first component each vaccine
|
$23.25 |
$30.55 |
$63.05 |
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$34.45 |
$40.50 |
$41.60 |
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$20.25 |
$20.25 |
$29.90 |
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$37.50 |
$37.50 |
$37.50 |
|
|
Administration vaccine hepatitis b
|
$35.10 |
$46.80 |
$59.80 |
|
|
Administration vaccine influenza virus
|
$9.00 |
$46.80 |
$76.05 |
|
|
Administration vaccine pneumococcal
|
$14.25 |
$46.80 |
$70.85 |
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$32.25 |
$32.25 |
$32.25 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$6,750.28 |
$10,121.53 |
$17,354.18 |
|
|
Adrenal cortex & medulla img
|
$2,639.65 |
$2,639.65 |
$2,867.15 |
|
|
Advance care planning each additional 30 min 99498
|
$74.10 |
$74.10 |
$76.70 |
|
|
Aep hearing status deter i&r
|
$234.65 |
$234.65 |
$1,045.85 |
|