|
11-desoxycortisol - sendout
|
$98.28 |
$98.28 |
$98.28 |
$87.50
|
|
17-hydroxypregnenolone
|
$88.20 |
$88.20 |
$88.20 |
$89.25
|
|
17-ketosteroids
|
$357.84 |
$357.84 |
$357.84 |
$55.00
|
|
1st psyc collab care mgmt
|
$93.24 |
$93.24 |
$93.24 |
$109.46
|
|
3d recon without postprocess indpndt
|
$538.44 |
$538.44 |
$538.44 |
$485.00
|
|
5' nucleotidase - sendout
|
$70.56 |
$70.56 |
$70.56 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$151.20 |
$151.20 |
$151.20 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$6,134.90 |
$6,134.90 |
$6,134.90 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$16.80 |
$16.80 |
$16.80 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$2,802.24 |
$2,802.24 |
$2,802.24 |
$3,569.56
|
|
Abdominal CT scan (with and without contrast)
|
$3,669.12 |
$3,669.12 |
$3,669.12 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,957.64 |
$2,957.64 |
$2,957.64 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,736.72 |
$2,736.72 |
$2,736.72 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,229.40 |
$4,229.40 |
$4,229.40 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$3,679.20 |
$3,679.20 |
$3,679.20 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,918.16 |
$2,918.16 |
$2,918.16 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,097.88 |
$1,097.88 |
$1,097.88 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$965.16 |
$965.16 |
$965.16 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$511.56 |
$511.56 |
$511.56 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$878.64 |
$878.64 |
$878.64 |
$1,145.40
|
|
Ablate bone tumor(s) cryo perq 20983
|
$6,027.00 |
$6,027.00 |
$6,027.00 |
$8,453.60
|
|
Ablate pulm tumor perq crybl
|
$7,396.20 |
$7,396.20 |
$7,396.20 |
$9,591.75
|
|
Ablation cardiac vagal inputs atrium
|
$285.60 |
$285.60 |
$285.60 |
$1,960.80
|
|
Ablation cryo abd perit om
|
$2,367.96 |
$2,367.96 |
$2,367.96 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$5,585.16 |
$5,585.16 |
$5,585.16 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$65.52 |
$65.52 |
$65.52 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$1,656.48 |
$1,656.48 |
$1,656.48 |
$2,957.17
|
|
Abscess imaging ltd area
|
$1,305.36 |
$1,305.36 |
$1,305.36 |
$1,098.00
|
|
Abscess imaging whole body
|
$1,666.56 |
$1,666.56 |
$1,666.56 |
$1,457.72
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$185.64 |
$185.64 |
$185.64 |
$74.96
|
|
Acetaminophen level
|
$437.64 |
$437.64 |
$437.64 |
$107.62
|
|
Acetazolamide 500 mg solution for injection
|
$159.90 |
$159.90 |
$159.90 |
$122.55
|
|
Acetone qualitative
|
$49.56 |
$49.56 |
$49.56 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$170.52 |
$170.52 |
$170.52 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$795.06 |
$795.06 |
$795.06 |
$216.00
|
|
Acne surgery 10040
|
$95.76 |
$95.76 |
$95.76 |
$260.49
|
|
Aco ccm; at least 20 min 99490aco
|
$147.00 |
$147.00 |
$147.00 |
$102.38
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$311.64 |
$311.64 |
$311.64 |
$345.15
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$30.24 |
$30.24 |
$30.24 |
$41.67
|
|
Actigraphy testing
|
$293.16 |
$293.16 |
$293.16 |
$218.05
|
|
Acute hepatitis panel
|
$645.96 |
$645.96 |
$645.96 |
$292.00
|
|
Acyclovir 400 mg tablet
|
$67.54 |
$67.54 |
$67.54 |
$45.06
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$83.58 |
$83.58 |
$83.58 |
$63.48
|
|
Adapter b 8 channel 10cm
|
$4,061.29 |
$4,061.29 |
$4,061.29 |
$5,695.04
|
|
Adenosine 3 mg/250 ml bag for osm
|
$368.81 |
$368.81 |
$368.81 |
$255.41
|
|
Adenovirus ag ia
|
$133.56 |
$133.56 |
$133.56 |
$53.95
|
|
Adenovirus antibody,serum - quest
|
$138.60 |
$138.60 |
$138.60 |
$63.00
|
|
Adh-sendout
|
$152.04 |
$152.04 |
$152.04 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1,373.78 |
$1,373.78 |
$1,373.78 |
$181.12
|
|
Admin ecg contrast agent
|
$106.68 |
$106.68 |
$106.68 |
$119.00
|
|
Administration chemotherapy IV infusion each additional hour
|
$441.84 |
$441.84 |
$441.84 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$320.04 |
$320.04 |
$320.04 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$417.48 |
$417.48 |
$417.48 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$320.04 |
$320.04 |
$320.04 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$190.68 |
$190.68 |
$190.68 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$190.68 |
$190.68 |
$190.68 |
$257.40
|
|
Administration immunization 1 vaccine
|
$99.96 |
$99.96 |
$99.96 |
$69.21
|
|
Administration immunization each additional vaccine
|
$244.44 |
$244.44 |
$244.44 |
$47.40
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$26,152.52 |
$26,152.52 |
$26,152.52 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$2,249.52 |
$2,249.52 |
$2,249.52 |
$1,818.05
|
|
Adrenalin epinephrine inject
|
$83.58 |
$83.58 |
$83.58 |
$229.69
|
|
_afb id by dna probe rflx ast
|
$196.56 |
$196.56 |
$196.56 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$55.44 |
$55.44 |
$55.44 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$804.72 |
$804.72 |
$804.72 |
$315.00
|
|
Afo tibial fracture soft
|
$127.94 |
$127.94 |
$127.94 |
$1,060.02
|
|
After cataract laser surgery
|
$866.88 |
$866.88 |
$866.88 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$28,950.39 |
$28,950.39 |
$28,950.39 |
$14,475.20
|
|
Air conduction bilat
|
$157.08 |
$157.08 |
$157.08 |
$133.00
|
|
Albumin body fluid quantitative each specimen
|
$75.60 |
$75.60 |
$75.60 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$270.15 |
$270.15 |
$270.15 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$468.72 |
$468.72 |
$468.72 |
$243.59
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$117.60 |
$117.60 |
$117.60 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$91.56 |
$91.56 |
$91.56 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$335.16 |
$335.16 |
$335.16 |
$93.60
|
|
Alginate dressing <=16 sq in
|
$6.47 |
$6.47 |
$6.47 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$61.74 |
$61.74 |
$61.74 |
$43.72
|
|
Alginate drsg wound filler
|
$34.57 |
$34.57 |
$34.57 |
$15.79
|
|
Alkaline phosphatase
|
$99.96 |
$99.96 |
$99.96 |
$46.40
|
|
Allergen egg white ige
|
$101.64 |
$101.64 |
$101.64 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$47.04 |
$47.04 |
$47.04 |
$43.75
|
|
Allergy injection; single 95115
|
$296.52 |
$296.52 |
$296.52 |
$42.75
|
|
Allergy Skin Testing
|
$472.08 |
$472.08 |
$472.08 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$664.44 |
$664.44 |
$664.44 |
$445.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$4,347.00 |
$4,347.00 |
$4,347.00 |
$5,401.92
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,257.60 |
$7,257.60 |
$7,257.60 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$11,585.70 |
$11,585.70 |
$11,585.70 |
$6,414.50
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$9,346.18 |
$9,346.18 |
$9,346.18 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$7,938.00 |
$7,938.00 |
$7,938.00 |
$4,725.00
|
|
All tstg perq&iq drugs/biol
|
$37.80 |
$37.80 |
$37.80 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$37.80 |
$37.80 |
$37.80 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$83.58 |
$83.58 |
$83.58 |
$12.50
|
|
Alpha-fetoprotein amniotic
|
$144.48 |
$144.48 |
$144.48 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$175.56 |
$175.56 |
$175.56 |
$106.00
|
|
Alprostadil for injection
|
$505.39 |
$505.39 |
$505.39 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$35,667.87 |
$35,667.87 |
$35,667.87 |
$15,857.45
|
|
Alt/sgpt
|
$128.52 |
$128.52 |
$128.52 |
$47.45
|
|
Aluminum - quest
|
$128.52 |
$128.52 |
$128.52 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$341.88 |
$341.88 |
$341.88 |
$169.80
|
|
Amifostine
|
$12,570.99 |
$12,570.99 |
$12,570.99 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$83.58 |
$83.58 |
$83.58 |
$39.84
|
