|
2d tee w or without fol w/con,in
|
$2,582.40 |
$2,582.40 |
$2,582.40 |
$1,724.25
|
|
2d tte w or without fol w/con,co
|
$1,649.60 |
$1,649.60 |
$1,649.60 |
$1,284.00
|
|
2nd order venous cath
|
$2,414.40 |
$2,414.40 |
$2,414.40 |
$1,532.04
|
|
3-d radiotherapy plan
|
$6,372.00 |
$6,372.00 |
$6,372.00 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$634.40 |
$634.40 |
$634.40 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$48.00 |
$48.00 |
$48.00 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,667.05 |
$1,667.05 |
$1,667.05 |
$3,138.72
|
|
Abd aorta w/runoff s&i
|
$4,083.20 |
$4,083.20 |
$4,083.20 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$5,070.40 |
$5,070.40 |
$5,070.40 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$3,882.40 |
$3,882.40 |
$3,882.40 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$5,203.20 |
$5,203.20 |
$5,203.20 |
$2,475.45
|
|
Abd/low ext cath addl
|
$3,369.60 |
$3,369.60 |
$3,369.60 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$857.60 |
$857.60 |
$857.60 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$3,026.40 |
$3,026.40 |
$3,026.40 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,469.60 |
$2,469.60 |
$2,469.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,175.20 |
$2,175.20 |
$2,175.20 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,209.60 |
$4,209.60 |
$4,209.60 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,443.20 |
$3,443.20 |
$3,443.20 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$3,204.00 |
$3,204.00 |
$3,204.00 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,214.40 |
$2,214.40 |
$2,214.40 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$905.60 |
$905.60 |
$905.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$766.40 |
$766.40 |
$766.40 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$452.00 |
$452.00 |
$452.00 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$512.80 |
$512.80 |
$512.80 |
$418.63
|
|
Abdominal X-ray (single view)
|
$369.60 |
$369.60 |
$369.60 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,416.00 |
$1,416.00 |
$1,416.00 |
$1,148.40
|
|
Abduction bar jointed adjust
|
$540.00 |
$540.00 |
$540.00 |
$453.55
|
|
Ablate arrhythmia add on
|
$16,202.40 |
$16,202.40 |
$16,202.40 |
$6,828.51
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,464.00 |
$7,464.00 |
$7,464.00 |
$9,290.70
|
|
Ablate bone tumor(s) perq
|
$8,679.20 |
$8,679.20 |
$8,679.20 |
$9,511.44
|
|
Ablate heart dysrhythm focus
|
$12,222.40 |
$12,222.40 |
$12,222.40 |
$9,332.05
|
|
Ablation cardiac vagal inputs atrium
|
$19,647.20 |
$19,647.20 |
$19,647.20 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$4,437.60 |
$4,437.60 |
$4,437.60 |
$2,312.80
|
|
Ablation cryo adrenal tumor
|
$6,372.00 |
$6,372.00 |
$6,372.00 |
$6,948.75
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$4,294.40 |
$4,294.40 |
$4,294.40 |
$441.09
|
|
Ablation cryo pq liver tumor(s)
|
$10,048.80 |
$10,048.80 |
$10,048.80 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
$857.60
|
|
Ablation cryo thigh/knee
|
$5,550.40 |
$5,550.40 |
$5,550.40 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$2,323.20 |
$2,323.20 |
$2,323.20 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$3,080.00 |
$3,080.00 |
$3,080.00 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$4,908.00 |
$4,908.00 |
$4,908.00 |
$2,314.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$34.80 |
$34.80 |
$34.80 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$130.12 |
$130.12 |
$130.12 |
$122.55
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$631.84 |
$631.84 |
$631.84 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$25.84 |
$25.84 |
$25.84 |
$31.21
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$52.00 |
$52.00 |
$52.00 |
$38.50
|
|
Acoustic immitance testing
|
$153.60 |
$153.60 |
$153.60 |
$158.50
|
|
Acoustic refl threshold tst
|
$148.80 |
$148.80 |
$148.80 |
$102.05
|
|
Actigraphy testing
|
$80.00 |
$80.00 |
$80.00 |
$234.00
|
|
Acyclovir 400 mg tablet
|
$32.95 |
$32.95 |
$32.95 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$242.49 |
$242.49 |
$242.49 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$2,560.00 |
$2,560.00 |
$2,560.00 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$558.12 |
$558.12 |
$558.12 |
$271.98
|
|
Adj gastric band via subq port
|
$2,177.60 |
$2,177.60 |
$2,177.60 |
$1,666.86
|
|
Adjustment gastric band
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$207.51
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$237.24 |
$237.24 |
$237.24 |
$193.40
|
|
Admin ecg contrast agent
|
$294.40 |
$294.40 |
$294.40 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$373.60 |
$373.60 |
$373.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$391.20 |
$391.20 |
$391.20 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$545.60 |
$545.60 |
$545.60 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$230.40 |
$230.40 |
$230.40 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$283.20 |
$283.20 |
$283.20 |
$256.49
|
|
Administration immunization each additional vaccine
|
$63.20 |
$63.20 |
$63.20 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$82.40 |
$82.40 |
$82.40 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$56.80 |
$56.80 |
$56.80 |
$30.24
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$51.20 |
$51.20 |
$51.20 |
$41.45
|
|
Adrenalin epinephrine inject
|
$206.20 |
$206.20 |
$206.20 |
$231.47
|
|
Aep hearing status deter i&r
|
$299.20 |
$299.20 |
$299.20 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$422.40 |
$422.40 |
$422.40 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$422.40 |
$422.40 |
$422.40 |
$635.00
|
|
Aflibercept injection
|
$2,974.80 |
$2,974.80 |
$2,974.80 |
$2,738.00
|
|
Afo molded to patient plasti
|
$779.47 |
$779.47 |
$779.47 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,712.56 |
$2,712.56 |
$2,712.56 |
$1,843.53
|
|
Afo spiral molded to pt plas
|
$722.49 |
$722.49 |
$722.49 |
$1,450.86
|
|
Afo w/ankle joint, prefab
|
$255.57 |
$255.57 |
$255.57 |
$741.72
|
|
Agalsidase beta 35 mg intravenous solution
|
$9,106.11 |
$9,106.11 |
$9,106.11 |
$14,475.20
|
|
Air conduction bilat
|
$88.80 |
$88.80 |
$88.80 |
$134.00
|
|
Air injection into abdomen 49400
|
$812.00 |
$812.00 |
$812.00 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$485.60 |
$485.60 |
$485.60 |
$297.00
|
|
Albumin (human), 25%, 50ml
|
$271.44 |
$271.44 |
$271.44 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$139.20 |
$139.20 |
$139.20 |
$252.77
|
|
Albuterol ipratrop non-comp
|
$1.30 |
$1.30 |
$1.30 |
$5.67
|
|
Albuterol non-comp con
|
$21.60 |
$21.60 |
$21.60 |
$6.07
|
|
Albuterol non-comp unit
|
$66.26 |
$66.26 |
$66.26 |
$5.40
|
|
Allograft 160mg placental salera mini membrane
|
$46.77 |
$46.77 |
$46.77 |
$5,835.10
|
|
Allograft amnioexcel plus 17mm disk
|
$866.60 |
$866.60 |
$866.60 |
$497.95
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$577.03 |
$577.03 |
$577.03 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$581.34 |
$581.34 |
$581.34 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$671.04 |
$671.04 |
$671.04 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$950.20 |
$950.20 |
$950.20 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$6,032.00 |
$6,032.00 |
$6,032.00 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$504.75 |
$504.75 |
$504.75 |
$1,225.35
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$739.68 |
$739.68 |
$739.68 |
$13.14
|
|
Alprostadil for injection
|
$322.36 |
$322.36 |
$322.36 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$13,143.43 |
$13,143.43 |
$13,143.43 |
$15,857.45
|
|
Alveoloplasty each quadrant
|
$3,453.60 |
$3,453.60 |
$3,453.60 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$665.60 |
$665.60 |
$665.60 |
$411.45
|
