|
11-desoxycortisol - sendout
|
$41.00 |
$41.00 |
$41.00 |
$87.50
|
|
17-hydroxypregnenolone
|
$41.00 |
$41.00 |
$41.00 |
$87.50
|
|
17-ketosteroids
|
$38.00 |
$38.00 |
$38.00 |
$44.88
|
|
3d ech img cgen car anomal
|
$718.00 |
$718.00 |
$718.00 |
$632.45
|
|
3-d radiotherapy plan
|
$16,353.00 |
$16,353.00 |
$16,353.00 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$246.00 |
$246.00 |
$246.00 |
$425.10
|
|
5' nucleotidase - sendout
|
$18.00 |
$18.00 |
$18.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$132.00 |
$132.00 |
$132.00 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$151.20
|
|
99382 initial comp preventive med 1 to 4 years new
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$147.49
|
|
99383 initial comp preventive med 5 to 11 years new
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$162.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$176.03
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,990.72 |
$4,990.72 |
$4,990.72 |
$3,627.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$26.00 |
$26.00 |
$26.00 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$12,810.00 |
$12,810.00 |
$12,810.00 |
$3,724.63
|
|
Abdominal CT scan (with and without contrast)
|
$4,895.00 |
$4,895.00 |
$4,895.00 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$4,593.00 |
$4,593.00 |
$4,593.00 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$3,207.00 |
$3,207.00 |
$3,207.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$5,324.00 |
$5,324.00 |
$5,324.00 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$3,705.00 |
$3,705.00 |
$3,705.00 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$4,576.00 |
$4,576.00 |
$4,576.00 |
$1,975.74
|
|
Abdominal Ultrasound (complete)
|
$1,460.00 |
$1,460.00 |
$1,460.00 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$604.43
|
|
Abl1 gene
|
$951.00 |
$951.00 |
$951.00 |
$614.25
|
|
Abobotulinumtoxina
|
$1,804.25 |
$1,804.25 |
$1,804.25 |
$1,773.50
|
|
Abortion
|
$7,364.00 |
$7,364.00 |
$7,364.00 |
$935.20
|
|
Abortion (mpr)
|
$979.00 |
$979.00 |
$979.00 |
$571.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$0.14 |
$0.14 |
$0.14 |
$74.96
|
|
Acetazolamide 500 mg solution for injection
|
$92.86 |
$92.86 |
$92.86 |
$120.90
|
|
Acetone qualitative
|
$54.00 |
$54.00 |
$54.00 |
$48.00
|
|
Acetylcholinesterase assay
|
$113.00 |
$113.00 |
$113.00 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$2.51 |
$2.51 |
$2.51 |
$306.72
|
|
Acetylcysteine non-comp unit
|
$12.68 |
$12.68 |
$12.68 |
$29.01
|
|
Aco depression screen annual medicare g0444aco
|
$107.00 |
$107.00 |
$107.00 |
$38.28
|
|
Acute hepatitis panel
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$10.14 |
$10.14 |
$10.14 |
$41.63
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.95 |
$0.95 |
$0.95 |
$62.48
|
|
#acylcarnitineprfl
|
$477.00 |
$477.00 |
$477.00 |
$87.72
|
|
Adenosine 3 mg/250 ml bag for osm
|
$17.88 |
$17.88 |
$17.88 |
$268.50
|
|
Adenovirus ag ia
|
$225.00 |
$225.00 |
$225.00 |
$31.20
|
|
Adenovirus antibody,serum - quest
|
$117.00 |
$117.00 |
$117.00 |
$60.00
|
|
Adh-sendout
|
$38.00 |
$38.00 |
$38.00 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$310.05 |
$310.05 |
$310.05 |
$172.86
|
|
Administration chemotherapy IV infusion each additional hour
|
$317.00 |
$317.00 |
$317.00 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$317.00 |
$317.00 |
$317.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,657.00 |
$1,657.00 |
$1,657.00 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$317.00 |
$317.00 |
$317.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$889.00 |
$889.00 |
$889.00 |
$267.43
|
|
Administration immunization 1 vaccine
|
$342.00 |
$342.00 |
$342.00 |
$70.00
|
|
Administration immunization each additional component
|
$18.00 |
$18.00 |
$18.00 |
$27.20
|
|
Administration immunization each additional vaccine
|
$190.00 |
$190.00 |
$190.00 |
$46.23
|
|
Administration immunization first component each vaccine
|
$44.00 |
$44.00 |
$44.00 |
$45.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$48.00 |
$48.00 |
$48.00 |
$48.00
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$117.00 |
$117.00 |
$117.00 |
$41.15
|
|
Administration vaccine hepatitis b
|
$342.00 |
$342.00 |
$342.00 |
$54.60
|
|
Administration vaccine influenza virus
|
$208.00 |
$208.00 |
$208.00 |
$48.35
|
|
Administration vaccine pneumococcal
|
$342.00 |
$342.00 |
$342.00 |
$49.50
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$117.00 |
$117.00 |
$117.00 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$22,011.71 |
$22,011.71 |
$22,011.71 |
$12,791.80
|
|
Adrenalin epinephrine inject
|
$2.84 |
$2.84 |
$2.84 |
$79.80
|
|
_afb id by dna probe rflx ast
|
$163.00 |
$163.00 |
$163.00 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$193.00 |
$193.00 |
$193.00 |
$289.60
|
|
Aflibercept injection
|
$129,500.00 |
$129,500.00 |
$129,500.00 |
$1,263.12
|
|
Agalsidase beta 35 mg intravenous solution
|
$26,091.56 |
$26,091.56 |
$26,091.56 |
$15,667.45
|
|
Albumin body fluid quantitative each specimen
|
$78.00 |
$78.00 |
$78.00 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$2.39 |
$2.39 |
$2.39 |
$256.84
|
|
Albumin, human 25 % intravenous solution
|
$3.83 |
$3.83 |
$3.83 |
$117.82
|
|
Albumin (human), 5%, 250 ml
|
$0.48 |
$0.48 |
$0.48 |
$258.00
|
|
Albumin, human 5 % intravenous solution
|
$1.81 |
$1.81 |
$1.81 |
$125.99
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$260.00 |
$260.00 |
$260.00 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$57.00 |
$57.00 |
$57.00 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$0.33 |
$0.33 |
$0.33 |
$7.43
|
|
Albuterol non-comp con
|
$27.27 |
$27.27 |
$27.27 |
$9.25
|
|
Albuterol non-comp unit
|
$0.32 |
$0.32 |
$0.32 |
$5.28
|
|
Aldesleukin injection
|
$19,430.15 |
$19,430.15 |
$19,430.15 |
$8,460.48
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$81,959.19 |
$81,959.19 |
$81,959.19 |
$30,370.93
|
|
Alkaline phosphatase
|
$80.00 |
$80.00 |
$80.00 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$6.00 |
$6.00 |
$6.00 |
$56.35
|
|
Allergen egg white ige
|
$6.00 |
$6.00 |
$6.00 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$10.00 |
$10.00 |
$10.00 |
$26.95
|
|
Allergy injections; 2 or more 95117
|
$208.00 |
$208.00 |
$208.00 |
$47.20
|
|
Allergy injection; single 95115
|
$51.00 |
$51.00 |
$51.00 |
$42.75
|
|
Allergy Skin Testing
|
$382.00 |
$382.00 |
$382.00 |
$47.44
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,598.07 |
$1,598.07 |
$1,598.07 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$135.00 |
$135.00 |
$135.00 |
$187.20
|
|
Alpha-fetoprotein amniotic
|
$142.00 |
$142.00 |
$142.00 |
$90.03
|
|
Alpha-fetoprotein tumor marker
|
$259.00 |
$259.00 |
$259.00 |
$103.60
|
|
Alprostadil for injection
|
$424.09 |
$424.09 |
$424.09 |
$522.85
|
|
Alteplase 100 mg infusion from pyxis vial
|
$28,799.19 |
$28,799.19 |
$28,799.19 |
$15,857.45
|
|
Alt/sgpt
|
$38.00 |
$38.00 |
$38.00 |
$49.00
|
|
Aluminum - quest
|
$18.00 |
$18.00 |
$18.00 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$455.00 |
$455.00 |
$455.00 |
$188.65
|
|
Ambl bp mntr w/sw a/r
|
$329.00 |
$329.00 |
$329.00 |
$318.96
|
|
Amifostine
|
$3,508.81 |
$3,508.81 |
$3,508.81 |
$2,507.10
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$3.68 |
$3.68 |
$3.68 |
$44.00
|
