|
17-hydroxypregnenolone
|
$69.60 |
$69.60 |
$69.60 |
|
|
2d tee w or without fol w/con,in
|
$2,391.20 |
$2,391.20 |
$2,582.40 |
|
|
2d tte w or without fol w/con,co
|
$1,649.60 |
$1,649.60 |
$1,649.60 |
|
|
2nd order venous cath
|
$2,414.40 |
$2,414.40 |
$2,995.20 |
|
|
3-d radiotherapy plan
|
$1,606.40 |
$1,606.40 |
$6,372.00 |
|
|
3d recon without postprocess indpndt
|
$443.20 |
$616.00 |
$634.40 |
|
|
5% dextrose and 0.45% saline
|
$40.00 |
$40.00 |
$60.00 |
|
|
88334 ap bill cytologic exam each additional site
|
$48.00 |
$53.60 |
$148.80 |
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,477.38 |
$1,564.95 |
$1,836.72 |
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$56.80 |
$56.80 |
$56.80 |
|
|
Abd aorta w/runoff s&i
|
$4,083.20 |
$4,083.20 |
$4,222.40 |
|
|
Abd/low ext cath 1st
|
$3,668.80 |
$3,668.80 |
$5,070.40 |
|
|
Abd/low ext cath 2nd
|
$3,803.20 |
$3,803.20 |
$3,882.40 |
|
|
Abd/low ext cath 3rd
|
$5,203.20 |
$5,203.20 |
$6,646.40 |
|
|
Abd/low ext cath addl
|
$590.40 |
$590.40 |
$3,369.60 |
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,160.80 |
$1,160.80 |
$1,219.20 |
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$804.80 |
$834.40 |
$857.60 |
|
|
Abdominal CT scan (with and without contrast)
|
$2,371.20 |
$2,938.40 |
$3,026.40 |
|
|
Abdominal CT scan (with contrast)
|
$1,778.40 |
$2,397.60 |
$2,469.60 |
|
|
Abdominal CT scan (without contrast)
|
$1,481.60 |
$1,749.60 |
$2,175.20 |
|
|
Abdominal MRI (with and without contrast)
|
$3,226.40 |
$3,634.40 |
$4,209.60 |
|
|
Abdominal MRI (with contrast)
|
$2,579.20 |
$2,579.20 |
$3,443.20 |
|
|
Abdominal MRI (without contrast)
|
$2,191.20 |
$2,392.00 |
$3,204.00 |
|
|
Abdominal paracentesis w/image guidance
|
$1,876.00 |
$1,876.00 |
$2,214.40 |
|
|
Abdominal Ultrasound (complete)
|
$582.40 |
$582.40 |
$905.60 |
|
|
Abdominal Ultrasound (limited)
|
$489.60 |
$489.60 |
$766.40 |
|
|
Abdominal X-ray (2 views)
|
$179.20 |
$216.80 |
$452.00 |
|
|
Abdominal X-ray Series (acute, with chest view)
|
$205.60 |
$512.80 |
$532.80 |
|
|
Abdominal X-ray (single view)
|
$144.80 |
$174.40 |
$369.60 |
|
|
Abd paracentesis/w/o image guide 49082
|
$1,397.60 |
$1,397.60 |
$1,416.00 |
|
|
Abduction bar jointed adjust
|
$540.00 |
$540.00 |
$540.00 |
|
|
Ablate arrhythmia add on
|
$16,202.40 |
$16,202.40 |
$17,395.20 |
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,464.00 |
$7,464.00 |
$11,095.20 |
|
|
Ablate bone tumor(s) perq
|
$8,679.20 |
$8,679.20 |
$10,452.00 |
|
|
Ablate heart dysrhythm focus
|
$10,754.40 |
$10,754.40 |
$12,222.40 |
|
|
Ablate pulm tumor perq crybl
|
$10,713.60 |
$10,713.60 |
$10,713.60 |
|
|
Ablate pulm tumor perq rf
|
$11,579.20 |
$11,579.20 |
$11,579.20 |
|
|
Ablation cardiac vagal inputs atrium
|
$3,540.80 |
$3,540.80 |
$19,647.20 |
|
|
Ablation cryo abd perit om
|
$4,437.60 |
$4,437.60 |
$5,116.80 |
|
|
Ablation cryo adrenal tumor
|
$6,372.00 |
$6,372.00 |
$10,800.00 |
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$4,294.40 |
$4,294.40 |
$4,294.40 |
|
|
Ablation cryo pq liver tumor(s)
|
$9,189.60 |
$9,189.60 |
$10,048.80 |
|
|
Ablation cryo retro lymph node
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
|
|
Ablation cryo thigh/knee
|
$412.80 |
$412.80 |
$5,550.40 |
|
|
Ablation of upper extremity nerves rf
|
$1,415.20 |
$1,415.20 |
$2,323.20 |
|
|
Abobotulinumtoxina
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
|
|
Abscess drain retroperitoneal surg code
|
$3,080.00 |
$3,080.00 |
$3,772.80 |
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$4,908.00 |
$4,908.00 |
$7,096.80 |
|
|
Access thoracic lymph duct
|
$3,072.80 |
$3,072.80 |
$3,072.80 |
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$15.20 |
$34.80 |
$107.84 |
|
|
Acetaminophen level
|
$51.20 |
$51.20 |
$51.20 |
|
|
Acetazolamide 500 mg solution for injection
|
$59.20 |
$59.20 |
$130.12 |
|
|
Acetone qualitative
|
$27.20 |
$27.20 |
$27.20 |
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$74.04 |
$347.41 |
$631.84 |
|
|
Acetylcysteine non-comp unit
|
$21.50 |
$25.84 |
$41.42 |
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$45.60 |
$45.60 |
$52.00 |
|
|
Acoustic immitance testing
|
$153.60 |
$153.60 |
$153.60 |
|
|
Acoustic refl threshold tst
|
$148.80 |
$148.80 |
$148.80 |
|
|
Actigraphy testing
|
$80.00 |
$80.00 |
$360.00 |
|
|
Acute hepatitis panel
|
$217.60 |
$217.60 |
$217.60 |
|
|
Acyclovir 400 mg tablet
|
$17.19 |
$32.95 |
$217.63 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$28.09 |
$28.92 |
$242.49 |
|
|
#acylcarnitineprfl
|
$49.60 |
$49.60 |
$49.60 |
|
|
Adapter b 8 channel 10cm
|
$2,560.00 |
$2,560.00 |
$3,124.00 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$28.02 |
$30.12 |
$558.12 |
|
|
Adj gastric band via subq port
|
$552.00 |
$552.00 |
$2,177.60 |
|
|
Adjustment gastric band
|
$255.20 |
$255.20 |
$1,456.00 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$10.00 |
$31.41 |
$237.24 |
|
|
Admin ecg contrast agent
|
$294.40 |
$294.40 |
$294.40 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$162.40 |
$162.40 |
$373.60 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$331.20 |
$331.20 |
$391.20 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$700.80 |
$700.80 |
$1,012.80 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$384.00 |
$384.00 |
$545.60 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$168.80 |
$168.80 |
$230.40 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$222.40 |
$280.80 |
$283.20 |
|
|
Administration immunization each additional vaccine
|
$36.00 |
$36.00 |
$75.20 |
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$59.20 |
$59.20 |
$86.40 |
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$33.60 |
$33.60 |
$70.40 |
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$51.20 |
$51.20 |
$51.20 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$4,917.76 |
$4,917.76 |
$4,917.76 |
|
|
Adrenalin epinephrine inject
|
$206.20 |
$206.20 |
$206.20 |
|
|
Aep hearing status deter i&r
|
$299.20 |
$299.20 |
$304.00 |
|
|
Aep neurodiagnostic i&r
|
$422.40 |
$422.40 |
$466.40 |
|
|
Aep thrshld est mlt freq i&r
|
$422.40 |
$422.40 |
$427.20 |
|
|
_afb id by dna probe rflx ast
|
$100.00 |
$100.00 |
$100.00 |
|
|
Aflibercept injection
|
$2,974.80 |
$2,974.80 |
$2,974.80 |
|
|
Afo molded to patient plasti
|
$779.47 |
$779.47 |
$779.47 |
|
|
Afo rig ant tib tcf/= custom
|
$2,712.56 |
$2,712.56 |
$2,712.56 |
|
|
Afo spiral molded to pt plas
|
$722.49 |
$722.49 |
$722.49 |
|
|
Afo tibial fracture rigid
|
$463.20 |
$463.20 |
$463.20 |
|
|
Afo w/ankle joint, prefab
|
$255.57 |
$255.57 |
$255.57 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$9,106.11 |
$9,106.11 |
$9,106.11 |
|
|
Air conduction bilat
|
$88.80 |
$88.80 |
$88.80 |
|
|
Air injection into abdomen 49400
|
$812.00 |
$812.00 |
$942.40 |
|
|
Airway resistance by impulse oscillometry 94728
|
$485.60 |
$485.60 |
$485.60 |
|
|
Albumin body fluid quantitative each specimen
|
$30.40 |
$30.40 |
$30.40 |
|
|
Albumin (human), 25%, 50ml
|
$108.12 |
$109.92 |
$271.44 |
|
|
Albumin (human), 5%, 250 ml
|
$139.20 |
$139.20 |
$175.40 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$57.60 |
$57.60 |
$57.60 |
|
|
Albumin serum plasma or whole blood
|
$31.20 |
$31.20 |
$31.20 |
|
