|
2d tee w or without fol w/con,in
|
$2,391.20 |
$2,391.20 |
$2,391.20 |
$1,724.25
|
|
2nd order venous cath
|
$2,995.20 |
$2,995.20 |
$2,995.20 |
$1,532.04
|
|
3-d radiotherapy plan
|
$1,606.40 |
$1,606.40 |
$1,606.40 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$443.20 |
$443.20 |
$443.20 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$148.80 |
$148.80 |
$148.80 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,836.72 |
$1,836.72 |
$1,836.72 |
$3,138.72
|
|
Abd aorta w/runoff s&i
|
$4,222.40 |
$4,222.40 |
$4,222.40 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$3,668.80 |
$3,668.80 |
$3,668.80 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$3,803.20 |
$3,803.20 |
$3,803.20 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$6,646.40 |
$6,646.40 |
$6,646.40 |
$2,475.45
|
|
Abd/low ext cath addl
|
$590.40 |
$590.40 |
$590.40 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,217.60 |
$1,217.60 |
$1,217.60 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$804.80 |
$804.80 |
$804.80 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,371.20 |
$2,371.20 |
$2,371.20 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,778.40 |
$1,778.40 |
$1,778.40 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,481.60 |
$1,481.60 |
$1,481.60 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,226.40 |
$3,226.40 |
$3,226.40 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,579.20 |
$2,579.20 |
$2,579.20 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,191.20 |
$2,191.20 |
$2,191.20 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,876.00 |
$1,876.00 |
$1,876.00 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$647.20 |
$647.20 |
$647.20 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$493.60 |
$493.60 |
$493.60 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$179.20 |
$179.20 |
$179.20 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$205.60 |
$205.60 |
$205.60 |
$418.63
|
|
Abdominal X-ray (single view)
|
$144.80 |
$144.80 |
$144.80 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,397.60 |
$1,397.60 |
$1,397.60 |
$1,148.40
|
|
Ablate arrhythmia add on
|
$17,395.20 |
$17,395.20 |
$17,395.20 |
$6,828.51
|
|
Ablate bone tumor(s) cryo perq 20983
|
$11,095.20 |
$11,095.20 |
$11,095.20 |
$9,290.70
|
|
Ablate bone tumor(s) perq
|
$10,452.00 |
$10,452.00 |
$10,452.00 |
$9,511.44
|
|
Ablate heart dysrhythm focus
|
$10,754.40 |
$10,754.40 |
$10,754.40 |
$9,332.05
|
|
Ablate pulm tumor perq crybl
|
$10,713.60 |
$10,713.60 |
$10,713.60 |
$9,970.50
|
|
Ablate pulm tumor perq rf
|
$11,579.20 |
$11,579.20 |
$11,579.20 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$3,540.80 |
$3,540.80 |
$3,540.80 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$5,116.80 |
$5,116.80 |
$5,116.80 |
$2,312.80
|
|
Ablation cryo adrenal tumor
|
$10,800.00 |
$10,800.00 |
$10,800.00 |
$6,948.75
|
|
Ablation cryo pq liver tumor(s)
|
$9,189.60 |
$9,189.60 |
$9,189.60 |
$8,581.80
|
|
Ablation cryo thigh/knee
|
$412.80 |
$412.80 |
$412.80 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$1,415.20 |
$1,415.20 |
$1,415.20 |
$832.50
|
|
Abobotulinumtoxina
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$3,772.80 |
$3,772.80 |
$3,772.80 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$7,096.80 |
$7,096.80 |
$7,096.80 |
$2,314.00
|
|
Access thoracic lymph duct
|
$3,072.80 |
$3,072.80 |
$3,072.80 |
$828.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$107.84 |
$107.84 |
$107.84 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$59.20 |
$59.20 |
$59.20 |
$122.55
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$347.41 |
$347.41 |
$347.41 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$41.42 |
$41.42 |
$41.42 |
$31.21
|
|
Actigraphy testing
|
$360.00 |
$360.00 |
$360.00 |
$234.00
|
|
Acyclovir 400 mg tablet
|
$217.63 |
$217.63 |
$217.63 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$35.32 |
$35.32 |
$35.32 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$3,124.00 |
$3,124.00 |
$3,124.00 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$124.80 |
$124.80 |
$124.80 |
$271.98
|
|
Adj gastric band via subq port
|
$552.00 |
$552.00 |
$552.00 |
$1,666.86
|
|
Adjustment gastric band
|
$255.20 |
$255.20 |
$255.20 |
$207.51
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$10.00 |
$10.00 |
$10.00 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$228.80 |
$228.80 |
$228.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$331.20 |
$331.20 |
$331.20 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$767.20 |
$767.20 |
$767.20 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$464.80 |
$464.80 |
$464.80 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$168.80 |
$168.80 |
$168.80 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$222.40 |
$222.40 |
$222.40 |
$256.49
|
|
Administration immunization each additional vaccine
|
$75.20 |
$75.20 |
$75.20 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$86.40 |
$86.40 |
$86.40 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$70.40 |
$70.40 |
$70.40 |
$30.24
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$4,917.76 |
$4,917.76 |
$4,917.76 |
$11,350.31
|
|
Aep hearing status deter i&r
|
$304.00 |
$304.00 |
$304.00 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$466.40 |
$466.40 |
$466.40 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$427.20 |
$427.20 |
$427.20 |
$635.00
|
|
Afo tibial fracture rigid
|
$463.20 |
$463.20 |
$463.20 |
$1,489.57
|
|
Air injection into abdomen 49400
|
$942.40 |
$942.40 |
$942.40 |
$525.60
|
|
Albumin (human), 25%, 50ml
|
$256.00 |
$256.00 |
$256.00 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$175.40 |
$175.40 |
$175.40 |
$252.77
|
|
Albuterol ipratrop non-comp
|
$2.88 |
$2.88 |
$2.88 |
$5.67
|
|
Albuterol non-comp con
|
$58.92 |
$58.92 |
$58.92 |
$6.07
|
|
Albuterol non-comp unit
|
$3.40 |
$3.40 |
$3.40 |
$5.40
|
|
Allograft 160mg placental salera mini membrane
|
$35.73 |
$35.73 |
$35.73 |
$5,835.10
|
|
Allograft amnioexcel plus 17mm disk
|
$457.60 |
$457.60 |
$457.60 |
$497.95
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$453.38 |
$453.38 |
$453.38 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$456.77 |
$456.77 |
$456.77 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$518.00 |
$518.00 |
$518.00 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$804.01 |
$804.01 |
$804.01 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,104.00 |
$5,104.00 |
$5,104.00 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$396.59 |
$396.59 |
$396.59 |
$1,225.35
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$829.00 |
$829.00 |
$829.00 |
$13.14
|
|
Alprostadil for injection
|
$70.61 |
$70.61 |
$70.61 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$9,173.77 |
$9,173.77 |
$9,173.77 |
$15,857.45
|
|
Alys cplx sp/pn npgt w/prgrm
|
$545.60 |
$545.60 |
$545.60 |
$411.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$57.43 |
$57.43 |
$57.43 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$27.49 |
$27.49 |
$27.49 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$32.68 |
$32.68 |
$32.68 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$105.92 |
$105.92 |
$105.92 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$27.85 |
$27.85 |
$27.85 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$3,466.44 |
$3,466.44 |
$3,466.44 |
$9,084.45
|
|
Amniocentesisdiagnostic 59000
|
$1,288.00 |
$1,288.00 |
$1,288.00 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$4,928.80 |
$4,928.80 |
$4,928.80 |
$3,786.00
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$68.40 |
$68.40 |
$68.40 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$126.14 |
$126.14 |
$126.14 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$59.96 |
$59.96 |
$59.96 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$97.47 |
$97.47 |
$97.47 |
$54.57
|
|
Amputation toe interphalangeal joint
|
$4,956.80 |
$4,956.80 |
$4,956.80 |
$4,196.50
|
