|
Acth stimulation panel
|
$78.26 |
$78.26 |
$78.26 |
|
|
Actigraphy testing
|
$70.29 |
$70.29 |
$193.78 |
|
|
Actinotherapy uv light
|
$46.45 |
$46.45 |
$201.00 |
|
|
Acup 1/> w/estim 1st 15 min
|
$28.98 |
$28.98 |
$29.55 |
|
|
Acup 1/> wo estim 1st 15 min
|
$28.98 |
$28.98 |
$29.55 |
|
|
Acute hepatitis panel
|
$47.63 |
$47.63 |
$1,002.00 |
|
|
Acute venous thrombus image
|
$1,544.85 |
$1,544.85 |
$1,544.85 |
|
|
Acyclovir 400 mg tablet
|
$10.14 |
$10.14 |
$13.20 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.95 |
$0.95 |
$370.80 |
|
|
#acylcarnitineprfl
|
$16.87 |
$16.87 |
$554.00 |
|
|
Acylcarnitines qual
|
$16.49 |
$16.49 |
$16.49 |
|
|
Adapt behavior tx phys/qhp
|
$190.13 |
$190.13 |
$190.13 |
|
|
Adapter b 8 channel 10cm
|
$128.43 |
$128.43 |
$536.40 |
|
|
Adaptive behavior tx by tech
|
$109.46 |
$109.46 |
$109.46 |
|
|
Adding walker to prev cast
|
$186.72 |
$186.72 |
$186.72 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$17.88 |
$17.88 |
$155.40 |
|
|
Adenovirus ag ia
|
$11.98 |
$11.98 |
$225.00 |
|
|
Adenovirus antibody,serum - quest
|
$12.87 |
$12.87 |
$343.80 |
|
|
Adenovirus assay w/optic
|
$21.76 |
$21.76 |
$21.76 |
|
|
Adh-sendout
|
$33.94 |
$33.94 |
$151.17 |
|
|
Adj gastric band via subq port
|
$1,109.47 |
$1,109.47 |
$2,211.34 |
|
|
Adjmt/revj ext fixj sys anes
|
$8,453.60 |
$8,453.60 |
$14,590.10 |
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,164.64 |
$2,164.64 |
$2,699.50 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$0.51 |
$0.62 |
$400.00 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$61.08 |
$84.22 |
$1,224.00 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$61.08 |
$84.22 |
$907.00 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$266.40 |
$392.51 |
$4,373.00 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$71.31 |
$392.51 |
$1,344.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$61.08 |
$84.22 |
$1,344.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$61.08 |
$84.22 |
$1,344.00 |
|
|
Administration immunization each additional component
|
$18.00 |
$18.00 |
$29.00 |
|
|
Administration immunization each additional vaccine
|
$12.00 |
$47.76 |
$190.00 |
|
|
Administration immunization first component each vaccine
|
$38.99 |
$67.74 |
$83.37 |
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$44.26 |
$84.22 |
$86.17 |
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$30.00 |
$53.45 |
$90.69 |
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$67.74 |
$69.28 |
$117.00 |
|
|
Administration vaccine hepatitis b
|
$12.00 |
$54.60 |
$342.00 |
|
|
Administration vaccine influenza virus
|
$12.00 |
$54.60 |
$208.00 |
|
|
Administration vaccine pneumococcal
|
$12.00 |
$54.60 |
$342.00 |
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$67.74 |
$69.28 |
$117.00 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$40.45 |
$40.45 |
$22,011.71 |
|
|
Adrenal cortex & medulla img
|
$1,544.85 |
$1,544.85 |
$5,590.00 |
|
|
Adrenalin epinephrine inject
|
$2.84 |
$2.84 |
$176.40 |
|
|
Advance care planning each additional 30 min 99498
|
$175.00 |
$175.00 |
$175.00 |
|
|
Adv prim care mgmt lvl 1
|
$35.25 |
$35.25 |
$38.28 |
|
|
Adv prim care mgmt lvl 2
|
$35.25 |
$35.25 |
$38.28 |
|
|
Adv prim care mgmt lvl 3
|
$109.46 |
$109.46 |
$109.46 |
|
|
Aep hearing status deter i&r
|
$200.40 |
$368.50 |
$450.99 |
|
|
Aep neurodiagnostic i&r
|
$368.50 |
$368.50 |
$848.11 |
|
|
Aep thrshld est mlt freq i&r
|
$368.50 |
$368.50 |
$848.11 |
|
|
Afamelanotide implant, 1 mg
|
$2,873.33 |
$2,873.33 |
$2,873.33 |
|
|
_afb id by dna probe rflx ast
|
$20.05 |
$20.05 |
$254.46 |
|
|
#afb mycobacteria suscep. #1
|
$7.31 |
$7.31 |
$85.20 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$115.36 |
$115.36 |
$513.81 |
|
|
Aff2 gen aly detc abnl allel
|
$137.00 |
$137.00 |
$137.00 |
|
|
Aff2 gen alys charac alleles
|
$274.83 |
$274.83 |
$274.83 |
|
|
Aflibercept injection
|
$821.98 |
$821.98 |
$129,500.00 |
|
|
Afo molded ankle gauntlet
|
$872.39 |
$872.39 |
$1,073.71 |
|
|
Afo molded to patient plasti
|
$1,126.12 |
$1,126.12 |
$1,385.99 |
|
|
Afo rig ant tib tcf/= custom
|
$1,899.72 |
$1,899.72 |
$2,338.11 |
|
|
Afo tib fx cast molded to pt
|
$2,326.17 |
$2,326.17 |
$2,862.98 |
|
|
Afo tib fx semi-rigid l2114
|
$1,387.25 |
$1,387.25 |
$1,707.38 |
|
|
After cataract laser surgery
|
$649.19 |
$649.19 |
$3,275.00 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$223.52 |
$223.52 |
$26,091.56 |
|
|
Air conduction bilat
|
$58.80 |
$152.54 |
$152.54 |
|
|
Air injection into abdomen 49400
|
$163.09 |
$163.09 |
$163.09 |
|
|
Airway resistance by impulse oscillometry 94728
|
$123.00 |
$185.15 |
$934.83 |
|
|
Albumin body fluid quantitative each specimen
|
$7.78 |
$7.78 |
$87.00 |
|
|
Albumin (human), 25%, 50ml
|
$2.39 |
$65.91 |
$408.60 |
|
|
Albumin, human 25 % intravenous solution
|
$3.83 |
$21.23 |
$21.23 |
|
|
Albumin (human), 5%, 250 ml
|
$0.48 |
$53.08 |
$266.40 |
|
|
Albumin, human 5 % intravenous solution
|
$1.81 |
$1.81 |
$1.81 |
|
|
Albumin ischemia modified
|
$33.94 |
$33.94 |
$33.94 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$5.78 |
$5.78 |
$260.00 |
|
|
Albumin serum plasma or whole blood
|
$4.95 |
$4.95 |
$62.00 |
|
|
Albuterol ipratrop non-comp
|
$0.33 |
$0.33 |
$1.60 |
|
|
Albuterol non-comp con
|
$0.80 |
$27.27 |
$27.27 |
|
|
Albuterol non-comp unit
|
$0.32 |
$0.32 |
$0.80 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$17.27 |
$17.27 |
$17.27 |
|
|
Alcohol/sub misuse assess
|
$28.98 |
$28.98 |
$29.55 |
|
|
Alcohol/subs interv 15-30mn
|
$35.25 |
$38.28 |
$102.21 |
|
|
Alcohol/subs interv >30 min
|
$190.13 |
$190.13 |
$190.13 |
|
|
Aldesleukin injection
|
$5,301.26 |
$5,301.26 |
$19,430.15 |
|
|
Aldosterone suppression eval
|
$125.50 |
$125.50 |
$125.50 |
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$2,337.69 |
$2,337.69 |
$81,959.19 |
|
|
Alginate drsg >16 <=48 sq in
|
$70.20 |
$70.20 |
$70.20 |
|
|
Alkaline phosphatase
|
$5.18 |
$5.18 |
$90.00 |
|
|
Allergen alpha lactalbumin ige
|
$6.00 |
$17.93 |
$79.88 |
|
|
Allergen egg white ige
|
$5.22 |
$5.22 |
$82.50 |
|
|
Allergen specific ige qual multi scrn ea
|
$7.97 |
$7.97 |
$35.51 |
|
|
Allergy injections; 2 or more 95117
|
$54.60 |
$54.60 |
$308.00 |
|
|
Allergy injection; single 95115
|
$46.69 |
$54.60 |
$142.53 |
|
|
Allergy Skin Testing
|
$45.18 |
$1,203.94 |
$1,203.94 |
|
|
Allg patch or app # of tests 95044
|
$96.00 |
$1,203.94 |
$1,203.94 |
|
|
Allgrft implnt knee w/scope
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Allograft amnioexcel plus 17mm disk
|
$127.14 |
$127.14 |
$127.14 |
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$127.14 |
$127.14 |
$9,274.20 |
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$127.14 |
$127.14 |
$2,082.92 |
|