|
24 hr ambulatory b/p monitor
|
$213.69 |
$213.69 |
$213.69 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$2,171.79 |
$2,171.79 |
$2,171.79 |
$1,724.25
|
|
5' nucleotidase - sendout
|
$93.18 |
$93.18 |
$93.18 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$150.33 |
$150.33 |
$150.33 |
$100.10
|
|
99381 initial comp preventive med less than 1 year new
|
$97.57 |
$97.57 |
$97.57 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$105.12 |
$105.12 |
$105.12 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$112.19 |
$112.19 |
$112.19 |
$131.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$88.72 |
$88.72 |
$88.72 |
$117.72
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$97.57 |
$97.57 |
$97.57 |
$132.30
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$105.12 |
$105.12 |
$105.12 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$113.92 |
$113.92 |
$113.92 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$141.30 |
$141.30 |
$141.30 |
$164.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$84.02 |
$84.02 |
$84.02 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$577.15 |
$577.15 |
$577.15 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$219.69 |
$219.69 |
$219.69 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,105.10 |
$2,105.10 |
$2,105.10 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,591.83 |
$1,591.83 |
$1,591.83 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,283.98 |
$1,283.98 |
$1,283.98 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,121.77 |
$3,121.77 |
$3,121.77 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,773.42 |
$2,773.42 |
$2,773.42 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,427.68 |
$2,427.68 |
$2,427.68 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,655.23 |
$2,655.23 |
$2,655.23 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$759.63 |
$759.63 |
$759.63 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$569.95 |
$569.95 |
$569.95 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$300.59 |
$300.59 |
$300.59 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$300.59 |
$300.59 |
$300.59 |
$418.63
|
|
Abdominal X-ray (single view)
|
$231.22 |
$231.22 |
$231.22 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,431.99 |
$1,431.99 |
$1,431.99 |
$1,148.40
|
|
Abl1 gene
|
$637.30 |
$637.30 |
$637.30 |
$683.20
|
|
Ablation cryo thigh/knee
|
$617.08 |
$617.08 |
$617.08 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$884.14 |
$884.14 |
$884.14 |
$832.50
|
|
Abobotulinumtoxina
|
$13.96 |
$13.96 |
$13.96 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$1,419.04 |
$1,419.04 |
$1,419.04 |
$3,050.40
|
|
Acetaminophen level
|
$41.58 |
$41.58 |
$41.58 |
$116.80
|
|
Acetone qualitative
|
$13.73 |
$13.73 |
$13.73 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$23.50 |
$23.50 |
$23.50 |
$67.50
|
|
Acne surgery 10040
|
$433.89 |
$433.89 |
$433.89 |
$265.20
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$94.69 |
$94.69 |
$94.69 |
$160.69
|
|
Acute hepatitis panel
|
$294.57 |
$294.57 |
$294.57 |
$284.95
|
|
#acylcarnitineprfl
|
$35.83 |
$35.83 |
$35.83 |
$121.55
|
|
Adh-sendout
|
$108.04 |
$108.04 |
$108.04 |
$118.79
|
|
Administration chemotherapy IV infusion each additional hour
|
$189.26 |
$189.26 |
$189.26 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$297.60 |
$297.60 |
$297.60 |
$668.98
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$184.33 |
$184.33 |
$184.33 |
$212.80
|
|
Administration immunization each additional vaccine
|
$47.76 |
$47.76 |
$47.76 |
$47.40
|
|
Administration immunization first component each vaccine
|
$38.99 |
$38.99 |
$38.99 |
$46.40
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$69.28 |
$69.28 |
$69.28 |
$44.80
|
|
Administration vaccine hepatitis b
|
$36.93 |
$36.93 |
$36.93 |
$53.00
|
|
Administration vaccine influenza virus
|
$46.20 |
$46.20 |
$46.20 |
$51.07
|
|
Administration vaccine pneumococcal
|
$36.93 |
$36.93 |
$36.93 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$69.28 |
$69.28 |
$69.28 |
$41.45
|
|
_afb id by dna probe rflx ast
|
$254.46 |
$254.46 |
$254.46 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$15.53 |
$15.53 |
$15.53 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$235.64 |
$235.64 |
$235.64 |
$300.00
|
|
Aflibercept injection
|
$1,272.91 |
$1,272.91 |
$1,272.91 |
$2,738.00
|
|
Albumin body fluid quantitative each specimen
|
$37.56 |
$37.56 |
$37.56 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$65.91 |
$65.91 |
$65.91 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$64.08 |
$64.08 |
$64.08 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$42.34 |
$42.34 |
$42.34 |
$43.00
|
|
Alcohol/subs interv 15-30mn
|
$63.45 |
$63.45 |
$63.45 |
$56.70
|
|
Alkaline phosphatase
|
$37.56 |
$37.56 |
$37.56 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$21.00 |
$21.00 |
$21.00 |
$48.57
|
|
Allergen egg white ige
|
$82.50 |
$82.50 |
$82.50 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$31.69 |
$31.69 |
$31.69 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$73.29 |
$73.29 |
$73.29 |
$45.00
|
|
Allergy injection; single 95115
|
$46.94 |
$46.94 |
$46.94 |
$46.80
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,082.92 |
$2,082.92 |
$2,082.92 |
$858.66
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$7.82 |
$7.82 |
$7.82 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$318.44 |
$318.44 |
$318.44 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$127.60 |
$127.60 |
$127.60 |
$15,857.45
|
|
Alt/sgpt
|
$54.88 |
$54.88 |
$54.88 |
$47.50
|
|
Aluminum - quest
|
$72.80 |
$72.80 |
$72.80 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$251.95 |
$251.95 |
$251.95 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$302.33 |
$302.33 |
$302.33 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$323.00 |
$323.00 |
$323.00 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$2.79 |
$2.79 |
$2.79 |
$39.84
|
|
Aminolevulinic acid delta
|
$155.79 |
$155.79 |
$155.79 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$194.06 |
$194.06 |
$194.06 |
$87.45
|
|
Ammonia
|
$115.64 |
$115.64 |
$115.64 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$183.40 |
$183.40 |
$183.40 |
$93.61
|
|
Amphetamines 5 or more
|
$163.59 |
$163.59 |
$163.59 |
$90.48
|
|
Amputation toe metatarsophalangeal joint
|
$7,342.63 |
$7,342.63 |
$7,342.63 |
$3,839.54
|
|
Amylase
|
$55.23 |
$55.23 |
$55.23 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$121.35 |
$121.35 |
$121.35 |
$117.01
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$251.95 |
$251.95 |
$251.95 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$369.70 |
$369.70 |
$369.70 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$421.61 |
$421.61 |
$421.61 |
$249.60
|
|
Anaplsma phgcytophlm amp prb
|
$71.68 |
$71.68 |
$71.68 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$463.60 |
$463.60 |
$463.60 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$6,531.56 |
$6,531.56 |
$6,531.56 |
$2,480.94
|
|
Ankle X-ray
|
$219.69 |
$219.69 |
$219.69 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$276.64 |
$276.64 |
$276.64 |
$282.96
|
|
Annual alcohol screen 15 min
|
$110.16 |
$110.16 |
$110.16 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$179.43 |
$179.43 |
$179.43 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$312.87 |
$312.87 |
$312.87 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$126.78 |
$126.78 |
$126.78 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$155.01 |
$155.01 |
$155.01 |
$167.25
|
|
Anodyne therapy charges pt
|
$41.71 |
$41.71 |
$41.71 |
$42.00
|
|
Anora (draw only)
|
$39.89 |
$39.89 |
$39.89 |
$35.00
|
|
Anoscopy and biopsy
|
$2,425.93 |
$2,425.93 |
$2,425.93 |
$2,288.00
|