|
17-hydroxypregnenolone
|
$130.30 |
$130.30 |
$130.30 |
$92.65
|
|
24 hr ambulatory b/p monitor
|
$208.05 |
$208.05 |
$208.05 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$2,118.99 |
$2,118.99 |
$2,118.99 |
$1,724.25
|
|
3-d radiotherapy plan
|
$6,059.93 |
$6,059.93 |
$6,059.93 |
$5,002.69
|
|
5' nucleotidase - sendout
|
$170.72 |
$170.72 |
$170.72 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$166.49 |
$166.49 |
$166.49 |
$100.10
|
|
99381 initial comp preventive med less than 1 year new
|
$111.92 |
$111.92 |
$111.92 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$113.80 |
$113.80 |
$113.80 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$113.80 |
$113.80 |
$113.80 |
$131.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$104.24 |
$104.24 |
$104.24 |
$117.72
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$99.89 |
$99.89 |
$99.89 |
$132.30
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$99.89 |
$99.89 |
$99.89 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$113.80 |
$113.80 |
$113.80 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$143.32 |
$143.32 |
$143.32 |
$164.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$83.80 |
$83.80 |
$83.80 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$585.39 |
$585.39 |
$585.39 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$493.40 |
$493.40 |
$493.40 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,016.38 |
$2,016.38 |
$2,016.38 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,500.13 |
$1,500.13 |
$1,500.13 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,410.27 |
$1,410.27 |
$1,410.27 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,681.82 |
$3,681.82 |
$3,681.82 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,551.74 |
$2,551.74 |
$2,551.74 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,387.53 |
$2,387.53 |
$2,387.53 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,693.16 |
$2,693.16 |
$2,693.16 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$690.13 |
$690.13 |
$690.13 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$649.75 |
$649.75 |
$649.75 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$362.23 |
$362.23 |
$362.23 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$541.59 |
$541.59 |
$541.59 |
$418.63
|
|
Abdominal X-ray (single view)
|
$300.13 |
$300.13 |
$300.13 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,156.76 |
$1,156.76 |
$1,156.76 |
$1,148.40
|
|
Abl1 gene
|
$751.69 |
$751.69 |
$751.69 |
$683.20
|
|
Ablation cryo thigh/knee
|
$625.90 |
$625.90 |
$625.90 |
$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
|
$2,777.39 |
$2,777.39 |
$2,777.39 |
$3,050.40
|
|
Acetaminophen level
|
$49.04 |
$49.04 |
$49.04 |
$116.80
|
|
Acetone qualitative
|
$21.71 |
$21.71 |
$21.71 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$27.72 |
$27.72 |
$27.72 |
$67.50
|
|
Acne surgery 10040
|
$440.09 |
$440.09 |
$440.09 |
$265.20
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$96.04 |
$96.04 |
$96.04 |
$160.69
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$313.20 |
$313.20 |
$313.20 |
$341.00
|
|
Acute hepatitis panel
|
$175.89 |
$175.89 |
$175.89 |
$284.95
|
|
#acylcarnitineprfl
|
$42.26 |
$42.26 |
$42.26 |
$121.55
|
|
Adh-sendout
|
$127.43 |
$127.43 |
$127.43 |
$118.79
|
|
Administration chemotherapy IV infusion each additional hour
|
$191.97 |
$191.97 |
$191.97 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$328.37 |
$328.37 |
$328.37 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$301.84 |
$301.84 |
$301.84 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$475.14 |
$475.14 |
$475.14 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$186.97 |
$186.97 |
$186.97 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$258.41 |
$258.41 |
$258.41 |
$256.49
|
|
Administration immunization each additional vaccine
|
$16.54 |
$16.54 |
$16.54 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$44.26 |
$44.26 |
$44.26 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$53.45 |
$53.45 |
$53.45 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$70.27 |
$70.27 |
$70.27 |
$44.80
|
|
Administration vaccine hepatitis b
|
$26.93 |
$26.93 |
$26.93 |
$53.00
|
|
Administration vaccine influenza virus
|
$43.43 |
$43.43 |
$43.43 |
$51.07
|
|
Administration vaccine pneumococcal
|
$43.43 |
$43.43 |
$43.43 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$70.27 |
$70.27 |
$70.27 |
$41.45
|
|
#afb mycobacteria suscep. #1
|
$18.31 |
$18.31 |
$18.31 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$277.93 |
$277.93 |
$277.93 |
$300.00
|
|
Aflibercept injection
|
$1,272.91 |
$1,272.91 |
$1,272.91 |
$2,738.00
|
|
After cataract laser surgery
|
$1,542.77 |
$1,542.77 |
$1,542.77 |
$1,373.11
|
|
Albumin body fluid quantitative each specimen
|
$60.81 |
$60.81 |
$60.81 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$81.63 |
$81.63 |
$81.63 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$83.39 |
$83.39 |
$83.39 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$59.96 |
$59.96 |
$59.96 |
$43.00
|
|
Alcohol/subs interv 15-30mn
|
$64.35 |
$64.35 |
$64.35 |
$56.70
|
|
Alkaline phosphatase
|
$63.43 |
$63.43 |
$63.43 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$44.93 |
$44.93 |
$44.93 |
$48.57
|
|
Allergen egg white ige
|
$31.28 |
$31.28 |
$31.28 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$74.33 |
$74.33 |
$74.33 |
$45.00
|
|
Allergy injection; single 95115
|
$47.61 |
$47.61 |
$47.61 |
$46.80
|
|
Allergy Skin Testing
|
$45.18 |
$45.18 |
$45.18 |
$47.44
|
|
All tstg perq&iq drugs/biol
|
$36.75 |
$36.75 |
$36.75 |
$64.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$7.82 |
$7.82 |
$7.82 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$375.59 |
$375.59 |
$375.59 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$127.60 |
$127.60 |
$127.60 |
$15,857.45
|
|
Alt/sgpt
|
$69.08 |
$69.08 |
$69.08 |
$47.50
|
|
Aluminum - quest
|
$85.86 |
$85.86 |
$85.86 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$255.55 |
$255.55 |
$255.55 |
$411.45
|
|
Ambl bp mntr w/sw a/r
|
$327.61 |
$327.61 |
$327.61 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$2.79 |
$2.79 |
$2.79 |
$39.84
|
|
Amitriptyline (elavil) -sendout
|
$214.92 |
$214.92 |
$214.92 |
$87.45
|
|
Ammonia
|
$97.30 |
$97.30 |
$97.30 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$203.11 |
$203.11 |
$203.11 |
$93.61
|
|
Amphetamines 5 or more
|
$192.95 |
$192.95 |
$192.95 |
$90.48
|
|
Amputation toe interphalangeal joint
|
$4,184.13 |
$4,184.13 |
$4,184.13 |
$4,196.50
|
|
Amylase
|
$73.00 |
$73.00 |
$73.00 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$134.39 |
$134.39 |
$134.39 |
$117.01
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$255.55 |
$255.55 |
$255.55 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$141.15 |
$141.15 |
$141.15 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$330.53 |
$330.53 |
$330.53 |
$249.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$255.55 |
$255.55 |
$255.55 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$84.54 |
$84.54 |
$84.54 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$301.01 |
$301.01 |
$301.01 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$6,624.86 |
$6,624.86 |
$6,624.86 |
$2,480.94
|
|
An fluoro guide for cvp
|
$292.32 |
$292.32 |
$292.32 |
$525.85
|
|
Ankle X-ray
|
$256.69 |
$256.69 |
$256.69 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$285.35 |
$285.35 |
$285.35 |
$282.96
|
|
Annual alcohol screen 15 min
|
$111.74 |
$111.74 |
$111.74 |
$40.00
|