|
Brain MRI (with and without contrast)
|
$945.63 |
$945.63 |
$945.63 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$678.53 |
$678.53 |
$678.53 |
$2,264.60
|
|
Brain MRI (without contrast)
|
$615.46 |
$615.46 |
$615.46 |
$1,946.40
|
|
Brca1&2 gene full seq alys
|
$514.80 |
$514.80 |
$514.80 |
$770.25
|
|
Brca1&2 gen ful dup/del alys
|
$642.65 |
$642.65 |
$642.65 |
$806.24
|
|
Brca1 dna gene analy known fam var
|
$412.78 |
$412.78 |
$412.78 |
$517.85
|
|
Brca1 gene full dup/del alys
|
$331.49 |
$331.49 |
$331.49 |
$331.49
|
|
Brca1 gene full seq alys
|
$311.17 |
$311.17 |
$311.17 |
$311.17
|
|
Brca2 dna gene analy full seq analy
|
$203.63 |
$203.63 |
$203.63 |
$222.14
|
|
Brca2 dna gene analy known fam var
|
$412.78 |
$412.78 |
$412.78 |
$487.83
|
|
Brca2 gene full dup/del alys
|
$311.17 |
$311.17 |
$311.17 |
$311.17
|
|
Brcassure ashkenazi panel-sendout
|
$484.00 |
$484.00 |
$484.00 |
$528.00
|
|
Brcassure comprehensive panel-sendout
|
$2,007.37 |
$2,007.37 |
$2,007.37 |
$2,299.75
|
|
Breast augmentation 19325
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,110.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,012.38
|
|
Breast punct aspir cyst, bil
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$832.60
|
|
Breast reconstruction 19357
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$8,977.64
|
|
Breast reduction
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,311.00
|
|
Breath test analysis c-14
|
$103.85 |
$103.85 |
$103.85 |
$197.34
|
|
Breath tst attain/anal c-14
|
$12.17 |
$12.17 |
$12.17 |
$70.00
|
|
Bronch/asp/tracheobronch tree/subs 31646
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$856.00
|
|
Bronch ebus samplng 1/2 node
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,452.00
|
|
Bronch ebus samplng 3/> node
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,126.62
|
|
Bronchial brush biopsy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$673.60
|
|
Bronchial challenge
|
$344.05 |
$344.05 |
$344.05 |
$845.00
|
|
Bronchial valve init insert
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,839.00
|
|
Bronchial valve remov addl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,040.67
|
|
Bronchial valve remov init
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,341.75
|
|
Bronchoscopy bronch stents
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,741.00
|
|
Bronchoscopy clear airways 31645
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,626.00
|
|
Bronchoscopy dilate/fx repr
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,530.60
|
|
Bronchoscopy dilate w/stent
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,768.75
|
|
Bronchoscopy/lung bx each 31628
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,799.90
|
|
Bronchoscopy/needle bx each 31629
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,435.00
|
|
Bronchoscopy revise stent
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,208.01
|
|
Bronchoscopy treat blockage
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,362.99
|
|
Bronchoscopy w/biopsy(s) 31625
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,256.75
|
|
Bronchoscopy w/fb removal 31635
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,666.55
|
|
Bronchoscopy w/markers
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$7,565.43
|
|
Bronchoscopy w/tumor excise
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,080.94
|
|
Bronch thermoplsty 1 lobe
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$7,284.83
|
|
Bronch thermoplsty 2/> lobes
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$7,565.43
|
|
Bronch w/balloon occlusion
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$7,668.85
|
|
Bronch w/debrdmt subgltc & uppr trach
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$329.45
|
|
Br punct aspir ea add, l
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$387.96
|
|
Bundled special stain group 1 microorganisms
|
$69.44 |
$69.44 |
$69.44 |
$165.47
|
|
Bundled special stain group 2
|
$78.08 |
$78.08 |
$78.08 |
$170.65
|
|
Buprenorphine and metabolite - sendout
|
$29.28 |
$29.28 |
$29.28 |
$99.72
|
|
Buttock fasciotomy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,339.00
|
|
Buttock fasciotomy w/dbrdmt
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,509.30
|
|
Bx arm/elbow soft tissue supf 24065
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,935.63
|
|
Bx bone trocar/ndl deep
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,264.77
|
|
Bx breast 1st lesion mr imag
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,231.90
|
|
Bx breast 1st lesion strtctc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,735.03
|
|
Bx breast add lesion mr imag
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,550.54
|
|
Bx breast add lesion strtctc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,657.50
|
|
Bx breast add lesion Ultrasound imag
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,708.85
|
|
Bx breast perq without image 19100
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,381.90
|
|
Bx breast pq tomo guide
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,492.16
|
|
Bx/curett of cervix w/scope 57454
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$565.80
|
|
Bx/exc lymph node/open/deep cervic 38510
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,238.48
|
|
Bx/exc lymph node/open/superfic 38500
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,135.34
|
|
Bx leg/ankle soft tissue deep 27614
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,225.86
|
|
Bx muscle
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,874.89
|
|
Bx nasopharynx/unknown pri lesion 42806
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,544.29
|
|
Bx of breast open 19101
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,390.01
|
|
Bx of cervix w/scope leep 57460
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,786.00
|
|
Bx pancreas pq ndl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,761.70
|
|
Bx perianal mass
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,369.03
|
|
Bx pleura pq ndl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,672.80
|
|
Bx prst8 ndl sat sampling
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,096.52
|
|
Bx shoulder tissues deep 23066
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,018.43
|
|
Bx shoulder tissues supf 23065
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,903.40
|
|
Bx/soft tis/forearm/wrist/superfic 25065
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,793.38
|
|
Bx soft tiss pelvis+hip area supf 27040
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,793.38
|
|
Bx soft tiss pelvis/hip deep 27041
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,271.01
|
|
Bx soft tissue back/flank deep 21925
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,929.85
|
|
Bx soft tissue back/flank supf 21920
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,907.07
|
|
Bx spinal cord pq ndl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,080.80
|
|
Bx thigh/knee soft tiss supf 27323
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,037.79
|
|
Bx thyroid/percutan core needle 60100
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,037.37
|
|
Bx vag mucos smpl (sep proc)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,255.00
|
|
Bx vulva or perineum/1 lesion 56605
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,117.94
|
|
Bypass temp external fem-fem
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,650.40
|
|
C1 esterase inhibitor func - sendout
|
$13.20 |
$13.20 |
$13.20 |
$109.80
|
|
Cacna1a gene full gene seq
|
$930.90 |
$930.90 |
$930.90 |
$846.27
|
|
Cadd pump refill
|
$223.36 |
$223.36 |
$223.36 |
$340.33
|
|
Calcium 24 hour urine
|
$6.63 |
$6.63 |
$6.63 |
$52.00
|
|
Calcium ionized
|
$15.05 |
$15.05 |
$15.05 |
$86.45
|
|
Calcium total
|
$5.68 |
$5.68 |
$5.68 |
$49.40
|
|
Calculi urinary-sendout
|
$14.16 |
$14.16 |
$14.16 |
$68.05
|
|
Calculus analysis qual
|
$12.74 |
$12.74 |
$12.74 |
$35.30
|
|
Calprotectin fecal
|
$21.59 |
$21.59 |
$21.59 |
$170.00
|
|
Campylobacter antibody
|
$14.43 |
$14.43 |
$14.43 |
$67.60
|
|
Candida dna
|
$22.06 |
$22.06 |
$22.06 |
$66.05
|
|
Cannula declotting 36861
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,271.13
|
|
Canthotomy 67715
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,175.20
|
|
Capsular contracture release
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,743.15
|
|
Capsulotomy; interphalangeal joint, each joint (separate proc)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,958.40
|
|
Capsulotomy mpj ea joint (sep proc)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,591.33
|
