|
11-desoxycortisol - sendout
|
$122.40 |
$122.40 |
$122.40 |
$87.50
|
|
17-hydroxypregnenolone
|
$64.00 |
$64.00 |
$64.00 |
$87.50
|
|
17-ketosteroids
|
$189.60 |
$189.60 |
$189.60 |
$55.00
|
|
1st hosp/birthing center care per day nml nb 99460
|
$136.80 |
$136.80 |
$136.80 |
$172.80
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,314.40 |
$1,314.40 |
$1,314.40 |
$1,656.80
|
|
2d tee w or without fol w/con,in
|
$1,011.20 |
$1,011.20 |
$1,011.20 |
$1,665.35
|
|
2d tte w or without fol w/con,co
|
$1,011.20 |
$1,011.20 |
$1,011.20 |
$1,108.76
|
|
3d recon without postprocess indpndt
|
$326.40 |
$326.40 |
$326.40 |
$425.10
|
|
5' nucleotidase - sendout
|
$60.00 |
$60.00 |
$60.00 |
$64.28
|
|
99381 initial comp preventive med less than 1 year new
|
$163.20 |
$163.20 |
$163.20 |
$165.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$171.20 |
$171.20 |
$171.20 |
$164.40
|
|
99383 initial comp preventive med 5 to 11 years new
|
$177.60 |
$177.60 |
$177.60 |
$162.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$146.40 |
$146.40 |
$146.40 |
$138.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$156.00 |
$156.00 |
$156.00 |
$146.81
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$156.00 |
$156.00 |
$156.00 |
$150.52
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$170.40 |
$170.40 |
$170.40 |
$167.25
|
|
99397 periodic comp preventive med 65+ years est
|
$200.00 |
$200.00 |
$200.00 |
$176.40
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,675.71 |
$2,675.71 |
$2,675.71 |
$93.21
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$51.20 |
$51.20 |
$51.20 |
$52.20
|
|
Abdominal CT scan (with and without contrast)
|
$1,735.20 |
$1,735.20 |
$1,735.20 |
$1,951.30
|
|
Abdominal CT scan (with contrast)
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$1,314.40 |
$1,314.40 |
$1,314.40 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$2,933.60 |
$2,933.60 |
$2,933.60 |
$2,631.20
|
|
Abdominal MRI (with contrast)
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$1,623.20 |
$1,623.20 |
$1,623.20 |
$1,806.35
|
|
Abdominal paracentesis w/image guidance
|
$1,271.20 |
$1,271.20 |
$1,271.20 |
$1,655.36
|
|
Abdominal Ultrasound (complete)
|
$431.20 |
$431.20 |
$431.20 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$355.20 |
$355.20 |
$355.20 |
$574.53
|
|
Abdominoplasty 15830
|
$1,765.60 |
$1,765.60 |
$1,765.60 |
$5,093.44
|
|
Abd paracentesis/w/o image guide 49082
|
$745.60 |
$745.60 |
$745.60 |
$1,145.00
|
|
Abl1 gene
|
$1,009.60 |
$1,009.60 |
$1,009.60 |
$600.00
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,867.20 |
$7,867.20 |
$7,867.20 |
$7,896.23
|
|
Ablate inf turbinate submuc 30802
|
$416.80 |
$416.80 |
$416.80 |
$1,639.57
|
|
Ablate inf turbinate superf 30801
|
$329.60 |
$329.60 |
$329.60 |
$1,849.50
|
|
Ablation cryo pq liver tumor(s)
|
$9,201.60 |
$9,201.60 |
$9,201.60 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$617.60 |
$617.60 |
$617.60 |
$2,114.45
|
|
Ablation of upper extremity nerves rf
|
$511.20 |
$511.20 |
$511.20 |
$1,609.00
|
|
Abobotulinumtoxina
|
$1,091.48 |
$1,091.48 |
$1,091.48 |
$406.62
|
|
Abscess drain retroperitoneal surg code
|
$2,996.80 |
$2,996.80 |
$2,996.80 |
$3,053.18
|
|
Acetaminophen level
|
$106.40 |
$106.40 |
$106.40 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$168.86 |
$168.86 |
$168.86 |
$97.26
|
|
Acetone qualitative
|
$118.40 |
$118.40 |
$118.40 |
$46.20
|
|
Acetylcholinesterase assay
|
$47.20 |
$47.20 |
$47.20 |
$92.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$176.68 |
$176.68 |
$176.68 |
$339.66
|
|
Acetylcysteine non-comp unit
|
$46.47 |
$46.47 |
$46.47 |
$29.01
|
|
Acne surgery 10040
|
$171.20 |
$171.20 |
$171.20 |
$234.00
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$246.40 |
$246.40 |
$246.40 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$194.40 |
$194.40 |
$194.40 |
$160.69
|
|
Aco ccm; at least 20 min 99490aco
|
$92.80 |
$92.80 |
$92.80 |
$108.93
|
|
Aco ccm; ea addl 20 min 99439aco
|
$69.60 |
$69.60 |
$69.60 |
$51.60
|
|
Aco cmplx chron care addl 20 min 99489aco
|
$108.80 |
$108.80 |
$108.80 |
$64.74
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$202.40 |
$202.40 |
$202.40 |
$177.84
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$289.60 |
$289.60 |
$289.60 |
$385.45
|
|
Aco depression screen annual medicare g0444aco
|
$27.20 |
$27.20 |
$27.20 |
$32.97
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$25.60 |
$25.60 |
$25.60 |
$44.40
|
|
Acoustic immitance testing
|
$48.00 |
$48.00 |
$48.00 |
$157.30
|
|
Acromp/acromionectomy prtl
|
$916.80 |
$916.80 |
$916.80 |
$3,786.00
|
|
Actinotherapy uv light
|
$49.60 |
$49.60 |
$49.60 |
$104.65
|
|
Acup 1/> w/estim 1st 15 min
|
$79.20 |
$79.20 |
$79.20 |
$45.75
|
|
Acute hepatitis panel
|
$173.60 |
$173.60 |
$173.60 |
$310.20
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$74.74 |
$74.74 |
$74.74 |
$49.22
|
|
#acylcarnitineprfl
|
$53.60 |
$53.60 |
$53.60 |
$92.00
|
|
Adding walker to prev cast
|
$65.60 |
$65.60 |
$65.60 |
$187.33
|
|
Adenosine 3 mg/250 ml bag for osm
|
$103.29 |
$103.29 |
$103.29 |
$119.26
|
|
Adenovirus antibody,serum - quest
|
$144.80 |
$144.80 |
$144.80 |
$63.00
|
|
Adh-sendout
|
$103.20 |
$103.20 |
$103.20 |
$150.00
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$2,837.09
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$460.78 |
$460.78 |
$460.78 |
$186.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$128.00 |
$128.00 |
$128.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$108.00 |
$108.00 |
$108.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$613.60 |
$613.60 |
$613.60 |
$673.60
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$216.80 |
$216.80 |
$216.80 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$53.60 |
$53.60 |
$53.60 |
$211.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$128.00 |
$128.00 |
$128.00 |
$260.00
|
|
Administration immunization 1 vaccine
|
$52.00 |
$52.00 |
$52.00 |
$65.00
|
|
Administration immunization each additional component
|
$13.60 |
$13.60 |
$13.60 |
$27.20
|
|
Administration immunization each additional vaccine
|
$52.00 |
$52.00 |
$52.00 |
$46.23
|
|
Administration immunization first component each vaccine
|
$34.40 |
$34.40 |
$34.40 |
$46.00
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$16.80 |
$16.80 |
$16.80 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$16.80 |
$16.80 |
$16.80 |
$33.60
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$29.60 |
$29.60 |
$29.60 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$5,239.98 |
$5,239.98 |
$5,239.98 |
$69.82
|
|
Advance care planning each additional 30 min 99498
|
$106.40 |
$106.40 |
$106.40 |
$131.21
|
|
_afb id by dna probe rflx ast
|
$243.20 |
$243.20 |
$243.20 |
$99.00
|
|
#afb mycobacteria suscep. #1
|
$264.80 |
$264.80 |
$264.80 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$300.00 |
$300.00 |
$300.00 |
$300.00
|
|
Air conduction bilat
|
$60.00 |
$60.00 |
$60.00 |
$112.50
|
|
Air injection into abdomen 49400
|
$525.60 |
$525.60 |
$525.60 |
$494.65
|
|
Albumin body fluid quantitative each specimen
|
$12.00 |
$12.00 |
$12.00 |
$42.90
|
|
Albumin (human), 25%, 50ml
|
$196.16 |
$196.16 |
$196.16 |
$290.52
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$59.20 |
$59.20 |
$59.20 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$23.20 |
$23.20 |
$23.20 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$5.92 |
$5.92 |
$5.92 |
$9.18
|
|
Albuterol non-comp con
|
$22.42 |
$22.42 |
$22.42 |
$23.19
|
|
Albuterol non-comp unit
|
$12.66 |
$12.66 |
$12.66 |
$8.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$140.00 |
$140.00 |
$140.00 |
$78.00
|
|
Alcohol/sub misuse assess
|
$24.80 |
$24.80 |
$24.80 |
$27.11
|
|
Alcohol/subs interv >30 min
|
$99.20 |
$99.20 |
$99.20 |
$177.84
|
|
Alkaline phosphatase
|
$52.80 |
$52.80 |
$52.80 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$306.40 |
$306.40 |
$306.40 |
$56.35
|
