|
Brain MRA (blood vessel MRI, without contrast)
|
$2,882.59 |
$2,882.59 |
$2,882.59 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$4,013.88 |
$4,013.88 |
$4,013.88 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$3,211.27 |
$3,211.27 |
$3,211.27 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$3,211.27 |
$3,211.27 |
$3,211.27 |
$1,977.27
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$2,703.31 |
$2,703.31 |
$2,703.31 |
$3,043.44
|
|
Breast punct aspir cyst, bil
|
$268.09 |
$268.09 |
$268.09 |
$847.00
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$9,745.86 |
$9,745.86 |
$9,745.86 |
$22,383.57
|
|
Bronch ebus ivntj perph les 31654
|
$1,225.08 |
$1,225.08 |
$1,225.08 |
$1,943.20
|
|
Bronchial challenge
|
$957.82 |
$957.82 |
$957.82 |
$777.60
|
|
Bronchoscopy dilate/fx repr
|
$2,420.28 |
$2,420.28 |
$2,420.28 |
$5,137.60
|
|
Bundled special stain group 1 microorganisms
|
$66.40 |
$66.40 |
$66.40 |
$160.80
|
|
Bundled special stain group 2
|
$56.44 |
$56.44 |
$56.44 |
$173.46
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$2.10 |
$2.10 |
$2.10 |
$32.88
|
|
Buprenorphine hydrochloride
|
$10.00 |
$10.00 |
$10.00 |
$41.79
|
|
Buprenorphine oral 1mg
|
$14.09 |
$14.09 |
$14.09 |
$10.50
|
|
Bur rotalink 2.15mm
|
$10,313.34 |
$10,313.34 |
$10,313.34 |
$7,817.85
|
|
Butorphanol tartrate 1 mg
|
$7.19 |
$7.19 |
$7.19 |
$39.09
|
|
Bx breast 1st lesion mr imag
|
$1,878.29 |
$1,878.29 |
$1,878.29 |
$3,256.00
|
|
Bx breast 1st lesion strtctc
|
$1,790.31 |
$1,790.31 |
$1,790.31 |
$3,601.35
|
|
Bx breast add lesion mr imag
|
$1,463.29 |
$1,463.29 |
$1,463.29 |
$1,649.29
|
|
Bx breast add lesion strtctc
|
$943.71 |
$943.71 |
$943.71 |
$1,800.68
|
|
Bx breast add lesion Ultrasound imag
|
$1,568.70 |
$1,568.70 |
$1,568.70 |
$1,692.64
|
|
Bx breast perq without image 19100
|
$356.07 |
$356.07 |
$356.07 |
$1,312.15
|
|
Bx/curett of cervix w/scope 57454
|
$285.52 |
$285.52 |
$285.52 |
$515.50
|
|
Bx/exc lymph node/open/deep cervic 38510
|
$1,216.78 |
$1,216.78 |
$1,216.78 |
$4,531.42
|
|
Bx/exc lymph node/open/superfic 38500
|
$771.07 |
$771.07 |
$771.07 |
$4,184.94
|
|
Bx liver with other
|
$228.25 |
$228.25 |
$228.25 |
$543.40
|
|
Bx of breast open 19101
|
$763.60 |
$763.60 |
$763.60 |
$4,531.42
|
|
Bx skin tangential ea sep/ addl les
|
$24.07 |
$24.07 |
$24.07 |
$203.70
|
|
Bx vag mucos smpl (sep proc)
|
$350.26 |
$350.26 |
$350.26 |
$1,059.00
|
|
Bx vulva or perineum/1 lesion 56605
|
$1,017.58 |
$1,017.58 |
$1,017.58 |
$1,127.00
|
|
C-1 esterase, berinert
|
$2,886.84 |
$2,886.84 |
$2,886.84 |
$7,466.16
|
|
C1 esterase inhibitor func - sendout
|
$90.47 |
$90.47 |
$90.47 |
$96.72
|
|
Cabazitaxel 10 mg/ml (first dilution) intravenous solution
|
$9,391.90 |
$9,391.90 |
$9,391.90 |
$27,723.08
|
|
Cable cath 22-pin diag
|
$5,322.38 |
$5,322.38 |
$5,322.38 |
$4,946.50
|
|
Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er
|
$889.40 |
$889.40 |
$889.40 |
$12,338.18
|
|
Cadd pump refill
|
$514.60 |
$514.60 |
$514.60 |
$360.00
|
|
Caffeine citrate 20 mg/ml inj for po
|
$7.88 |
$7.88 |
$7.88 |
$47.78
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$313.14 |
$313.14 |
$313.14 |
$2,111.64
|
|
Calcium 24 hour urine
|
$22.41 |
$22.41 |
$22.41 |
$53.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$0.61 |
$0.61 |
$0.61 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$0.07 |
$0.07 |
$0.07 |
$91.60
|
|
Calcium ionized
|
$32.37 |
$32.37 |
$32.37 |
$90.00
|
|
Calcium total
|
$19.09 |
$19.09 |
$19.09 |
$50.00
|
|
Calprotectin fecal
|
$401.72 |
$401.72 |
$401.72 |
$169.95
|
|
Canakinumab injection
|
$14,212.69 |
$14,212.69 |
$14,212.69 |
$35,959.82
|
|
Candida dna
|
$53.95 |
$53.95 |
$53.95 |
$62.50
|
|
Cannula ercp contour 5-4-3 tip
|
$12,910.65 |
$12,910.65 |
$12,910.65 |
$34,218.66
|
|
Cap nerve 2x15mm
|
$27,383.99 |
$27,383.99 |
$27,383.99 |
$18,466.88
|
|
Capsaicin 8% patch
|
$712.52 |
$712.52 |
$712.52 |
$4,719.65
|
|
Capsulotomy mpj ea joint (sep proc)
|
$1,135.44 |
$1,135.44 |
$1,135.44 |
$3,545.97
|
|
Cap trach decann 15mm
|
$4,616.46 |
$4,616.46 |
$4,616.46 |
$2,597.62
|
|
Carbamazepine free
|
$146.08 |
$146.08 |
$146.08 |
$59.15
|
|
Carbamazepine total therapeutic drug level
|
$150.23 |
$150.23 |
$150.23 |
$120.25
|
|
Carbon dioxide
|
$18.26 |
$18.26 |
$18.26 |
$44.00
|
|
Carboplatin 10 mg/ml desensitization
|
$1.38 |
$1.38 |
$1.38 |
$186.10
|
|
Carboxyhemoglobin quantitative
|
$170.98 |
$170.98 |
$170.98 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$52.29 |
$52.29 |
$52.29 |
$144.00
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$2,300.76 |
$2,300.76 |
$2,300.76 |
$2,626.88
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$299.63 |
$299.63 |
$299.63 |
$244.00
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$299.63 |
$299.63 |
$299.63 |
$196.50
|
|
Cardiolipin antibody iga
|
$73.04 |
$73.04 |
$73.04 |
$105.00
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$1,550.44 |
$1,550.44 |
$1,550.44 |
$1,396.00
|
|
Caregiver training strategies&tq 1st 30 minutes
|
$48.97 |
$48.97 |
$48.97 |
$99.60
|
|
Caregiver training strategies&tq ea addl 15 min
|
$48.97 |
$48.97 |
$48.97 |
$51.50
|
|
Carfilzomib 10 mg intravenous solution
|
$2,718.13 |
$2,718.13 |
$2,718.13 |
$6,877.19
|
|
Carmustine 100 mg intravenous powder for solution
|
$1,174.81 |
$1,174.81 |
$1,174.81 |
$1,731.00
|
|
Carotene
|
$18.26 |
$18.26 |
$18.26 |
$45.24
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,557.91 |
$1,557.91 |
$1,557.91 |
$1,018.68
|
|
Carpal Tunnel Release Surgery
|
$1,019.24 |
$1,019.24 |
$1,019.24 |
$3,608.80
|
|
Car seat/bed test 60 minutes
|
$360.22 |
$360.22 |
$360.22 |
$111.28
|
|
Car seat/bed test additional 30 minutes
|
$180.11 |
$180.11 |
$180.11 |
$65.00
|
|
Casiri and imdev repeat
|
$684.75 |
$684.75 |
$684.75 |
$540.00
|
|
Caspofungin acetate
|
$45.54 |
$45.54 |
$45.54 |
$615.86
|
|
Cath 2lum 14.5frx43cm maxid kt mahurkar
|
$490.41 |
$490.41 |
$490.41 |
$830.58
|
|
Cath ablat bi-d d-d 8fr 115cm
|
$2,661.19 |
$2,661.19 |
$2,661.19 |
$6,545.59
|
|
Cath ablt clsfast 7fx100cmx
|
$2,156.97 |
$2,156.97 |
$2,156.97 |
$2,808.00
|
|
Cath ablt rx lasr 2.0mm turbo
|
$6,386.85 |
$6,386.85 |
$6,386.85 |
$6,463.80
|
|
Cath access del ds spyscop 2.0
|
$5,471.78 |
$5,471.78 |
$5,471.78 |
$5,212.99
|
|
Cath acuity innr ic130 6f 63cm
|
$9,885.06 |
$9,885.06 |
$9,885.06 |
$9,236.50
|
|
Cath acunav ge 10frx90cm
|
$7,594.50 |
$7,594.50 |
$7,594.50 |
$6,433.20
|
|
Cath adherent clot 10mm 6f 10
|
$33,415.80 |
$33,415.80 |
$33,415.80 |
$18,560.00
|
|
Cath baloon occl urnry 34f 7x2x65
|
$6,941.38 |
$6,941.38 |
$6,941.38 |
$6,552.00
|
|
Cath bi-dir df smarttouch
|
$6,536.25 |
$6,536.25 |
$6,536.25 |
$8,282.05
|
|
Cath blazer dx/20 2-10-2 space
|
$4,468.61 |
$4,468.61 |
$4,468.61 |
$4,012.78
|
|
Cath council tip 16fr 5cc
|
$26.56 |
$26.56 |
$26.56 |
$40.96
|
|
Cath cv dl inj 7fx16cm
|
$2,433.28 |
$2,433.28 |
$2,433.28 |
$3,889.06
|
|
Cath del ampltz 12f 45d 80cm
|
$4,845.30 |
$4,845.30 |
$4,845.30 |
$2,337.00
|
|
Cath epdrl brevi-stf 12in .043
|
$2,111.28 |
$2,111.28 |
$2,111.28 |
$1,911.42
|
|
Catheterization collection of specimen single patient all places of service
|
$150.23 |
$150.23 |
$150.23 |
$40.95
|
|
Cath groshong MRI 8fr plstc port
|
$2,834.27 |
$2,834.27 |
$2,834.27 |
$1,653.00
|
|
Cath hawkone s directional
|
$7,746.39 |
$7,746.39 |
$7,746.39 |
$6,996.60
|
|
Cath hemodial 55cm 15.5fr dual lumen straight stacked adlt
|
$2,054.25 |
$2,054.25 |
$2,054.25 |
$1,768.00
|
|
Cath imag ivus pv 8.5fx90 .035
|
$2,734.02 |
$2,734.02 |
$2,734.02 |
$4,160.00
|
|
Cath impl vasc access portal
|
$173.11 |
$173.11 |
$173.11 |
$150.00
|
|
Cath indw foley 3 way
|
$59.37 |
$59.37 |
$59.37 |
$38.52
|
|
Cath infuse micro 150cm rapidtransit
|
$23.25 |
$23.25 |
$23.25 |
$13.23
|
|
Cath insertion tray w/bag
|
$66.31 |
$66.31 |
$66.31 |
$33.56
|
|
Cath malecot 28fr 4-wing ltx
|
$2,122.44 |
$2,122.44 |
$2,122.44 |
$2,173.58
|
|
Cath occl flo-rester 2.25x12mm cor internal vessel occluder
|
$29,581.20 |
$29,581.20 |
$29,581.20 |
$19,384.20
|
