|
11-desoxycortisol - sendout
|
$152.00 |
$152.00 |
$152.00 |
$84.56
|
|
17-hydroxypregnenolone
|
$152.00 |
$152.00 |
$152.00 |
$88.20
|
|
1st hosp/birthing center care per day nml nb 99460
|
$99.50 |
$99.50 |
$99.50 |
$172.80
|
|
1st psyc collab care mgmt
|
$101.00 |
$101.00 |
$101.00 |
$109.46
|
|
1st/sbsq psyc collab care
|
$70.00 |
$70.00 |
$70.00 |
$111.20
|
|
2nd order venous cath
|
$190.00 |
$190.00 |
$190.00 |
$1,543.85
|
|
3d recon without postprocess indpndt
|
$414.00 |
$414.00 |
$414.00 |
$469.20
|
|
5' nucleotidase - sendout
|
$8.00 |
$8.00 |
$8.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$42.50 |
$42.50 |
$42.50 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$101.50 |
$101.50 |
$101.50 |
$132.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$98.50 |
$98.50 |
$98.50 |
$126.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$109.50 |
$109.50 |
$109.50 |
$111.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$90.00 |
$90.00 |
$90.00 |
$107.10
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$106.50 |
$106.50 |
$106.50 |
$115.50
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$98.00 |
$98.00 |
$98.00 |
$113.40
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$109.50 |
$109.50 |
$109.50 |
$128.40
|
|
99397 periodic comp preventive med 65+ years est
|
$122.50 |
$122.50 |
$122.50 |
$160.73
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$82.72 |
$82.72 |
$82.72 |
$53.95
|
|
Abd exp/postop hem/throm/infec 35840
|
$1,375.50 |
$1,375.50 |
$1,375.50 |
$2,659.14
|
|
Abd/low ext cath 1st
|
$256.00 |
$256.00 |
$256.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$274.50 |
$274.50 |
$274.50 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$320.50 |
$320.50 |
$320.50 |
$2,486.97
|
|
Abdominal CT scan (with and without contrast)
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$1,992.00
|
|
Abdominal CT scan (with contrast)
|
$1,160.50 |
$1,160.50 |
$1,160.50 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$951.50 |
$951.50 |
$951.50 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,156.00 |
$2,156.00 |
$2,156.00 |
$2,999.67
|
|
Abdominal MRI (without contrast)
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$907.00 |
$907.00 |
$907.00 |
$1,655.36
|
|
Abdominal Ultrasound (complete)
|
$449.00 |
$449.00 |
$449.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$377.50 |
$377.50 |
$377.50 |
$581.94
|
|
Abdominoplasty 15830
|
$1,292.00 |
$1,292.00 |
$1,292.00 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$868.50 |
$868.50 |
$868.50 |
$1,145.00
|
|
Ablate bone tumor(s) perq
|
$6,540.00 |
$6,540.00 |
$6,540.00 |
$9,350.33
|
|
Ablation cryo abd perit om
|
$571.00 |
$571.00 |
$571.00 |
$2,312.80
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$763.50 |
$763.50 |
$763.50 |
$441.09
|
|
Ablation cryo retro lymph node
|
$118.50 |
$118.50 |
$118.50 |
$806.85
|
|
Ablation cryo thigh/knee
|
$532.50 |
$532.50 |
$532.50 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$675.50 |
$675.50 |
$675.50 |
$808.50
|
|
Abobotulinumtoxina
|
$13.00 |
$13.00 |
$13.00 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$206.00 |
$206.00 |
$206.00 |
$2,996.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$6.00 |
$6.00 |
$6.00 |
$75.72
|
|
Acetaminophen level
|
$124.00 |
$124.00 |
$124.00 |
$103.75
|
|
Acetazolamide 500 mg solution for injection
|
$15.50 |
$15.50 |
$15.50 |
$122.55
|
|
Acetone qualitative
|
$29.50 |
$29.50 |
$29.50 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$50.00 |
$50.00 |
$50.00 |
$62.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$57.15 |
$57.15 |
$57.15 |
$216.00
|
|
Acne surgery 10040
|
$52.00 |
$52.00 |
$52.00 |
$260.49
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$209.00 |
$209.00 |
$209.00 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$165.00 |
$165.00 |
$165.00 |
$167.04
|
|
Aco ccm; at least 20 min 99490aco
|
$152.00 |
$152.00 |
$152.00 |
$102.38
|
|
Aco ccm; ea addl 20 min 99439aco
|
$152.00 |
$152.00 |
$152.00 |
$87.00
|
|
Aco cmplx chron care addl 20 min 99489aco
|
$235.00 |
$235.00 |
$235.00 |
$64.74
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$278.00 |
$278.00 |
$278.00 |
$177.99
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$174.50 |
$174.50 |
$174.50 |
$345.15
|
|
Aco depression screen annual medicare g0444aco
|
$36.00 |
$36.00 |
$36.00 |
$38.28
|
|
Acromp/acromionectomy prtl
|
$708.00 |
$708.00 |
$708.00 |
$3,839.54
|
|
Acup 1/> w/estim 1st 15 min
|
$40.50 |
$40.50 |
$40.50 |
$51.94
|
|
Acup 1/> wo estim 1st 15 min
|
$40.50 |
$40.50 |
$40.50 |
$45.75
|
|
Acute hepatitis panel
|
$163.50 |
$163.50 |
$163.50 |
$286.05
|
|
Adenosine 3 mg/250 ml bag for osm
|
$11.37 |
$11.37 |
$11.37 |
$235.74
|
|
Adh-sendout
|
$31.00 |
$31.00 |
$31.00 |
$109.28
|
|
Adj gastric band via subq port
|
$943.50 |
$943.50 |
$943.50 |
$1,666.86
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$788.50 |
$788.50 |
$788.50 |
$3,262.50
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$4.00 |
$4.00 |
$4.00 |
$183.76
|
|
Admin ecg contrast agent
|
$41.50 |
$41.50 |
$41.50 |
$111.44
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$391.00 |
$391.00 |
$391.00 |
$657.12
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$45.00 |
$45.00 |
$45.00 |
$207.94
|
|
Administration immunization 1 vaccine
|
$40.00 |
$40.00 |
$40.00 |
$69.00
|
|
Administration immunization each additional component
|
$10.00 |
$10.00 |
$10.00 |
$27.95
|
|
Administration immunization each additional vaccine
|
$26.00 |
$26.00 |
$26.00 |
$46.80
|
|
Administration immunization first component each vaccine
|
$25.00 |
$25.00 |
$25.00 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$37.00 |
$37.00 |
$37.00 |
$48.00
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$39.00 |
$39.00 |
$39.00 |
$41.45
|
|
Administration vaccine hepatitis b
|
$21.00 |
$21.00 |
$21.00 |
$54.50
|
|
Administration vaccine influenza virus
|
$31.50 |
$31.50 |
$31.50 |
$49.50
|
|
Administration vaccine pneumococcal
|
$29.50 |
$29.50 |
$29.50 |
$49.17
|
|
Adrenalin epinephrine inject
|
$2.07 |
$2.07 |
$2.07 |
$216.27
|
|
Advance care planning each additional 30 min 99498
|
$78.00 |
$78.00 |
$78.00 |
$108.00
|
|
_afb id by dna probe rflx ast
|
$32.50 |
$32.50 |
$32.50 |
$93.52
|
|
Aflibercept injection
|
$847.00 |
$847.00 |
$847.00 |
$3,153.84
|
|
After cataract laser surgery
|
$327.00 |
$327.00 |
$327.00 |
$1,373.11
|
|
Air conduction bilat
|
$127.50 |
$127.50 |
$127.50 |
$130.86
|
|
Albumin body fluid quantitative each specimen
|
$3.50 |
$3.50 |
$3.50 |
$45.18
|
|
Albumin (human), 25%, 50ml
|
$52.50 |
$52.50 |
$52.50 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$66.00 |
$66.00 |
$66.00 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$46.50 |
$46.50 |
$46.50 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$1.00 |
$1.00 |
$1.00 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$37.50 |
$37.50 |
$37.50 |
$91.00
|
|
Alcohol/subs interv 15-30mn
|
$36.00 |
$36.00 |
$36.00 |
$51.52
|
|
Alkaline phosphatase
|
$33.50 |
$33.50 |
$33.50 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$189.00 |
$189.00 |
$189.00 |
$47.65
|
|
Allergen egg white ige
|
$255.00 |
$255.00 |
$255.00 |
$37.05
|
|
Allergy injections; 2 or more 95117
|
$48.50 |
$48.50 |
$48.50 |
$43.75
|
|
Allergy injection; single 95115
|
$61.50 |
$61.50 |
$61.50 |
$42.75
|
|
Allergy Skin Testing
|
$4.50 |
$4.50 |
$4.50 |
$47.44
|
|
Allograft amnioexcel plus 17mm disk
|
$119.50 |
$119.50 |
$119.50 |
$2,386.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$0.01 |
$0.01 |
$0.01 |
$9,018.12
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$4,677.40
|
|
All tstg perq&iq drugs/biol
|
$58.50 |
$58.50 |
$58.50 |
$64.80
|
|
Alpha-fetoprotein amniotic
|
$28.50 |
$28.50 |
$28.50 |
$96.20
|
