|
11-desoxycortisol - sendout
|
$63.00 |
$63.00 |
$63.00 |
$82.50
|
|
17-hydroxypregnenolone
|
$53.40 |
$53.40 |
$53.40 |
$78.00
|
|
17-ketosteroids
|
$28.80 |
$28.80 |
$28.80 |
$42.90
|
|
2nd order venous cath
|
$798.60 |
$798.60 |
$798.60 |
$1,548.00
|
|
3d recon without postprocess indpndt
|
$959.40 |
$959.40 |
$959.40 |
$454.23
|
|
5' nucleotidase - sendout
|
$37.20 |
$37.20 |
$37.20 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$118.80 |
$118.80 |
$118.80 |
$92.82
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$6,696.00 |
$6,696.00 |
$6,696.00 |
$3,627.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$25.80 |
$25.80 |
$25.80 |
$52.20
|
|
Abd aorta w/runoff s&i
|
$5,169.60 |
$5,169.60 |
$5,169.60 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$3,182.40 |
$3,182.40 |
$3,182.40 |
$2,146.30
|
|
Abd/low ext cath 2nd
|
$2,167.80 |
$2,167.80 |
$2,167.80 |
$2,167.80
|
|
Abd/low ext cath 3rd
|
$1,682.40 |
$1,682.40 |
$1,682.40 |
$2,545.00
|
|
Abd/low ext cath addl
|
$197.40 |
$197.40 |
$197.40 |
$905.00
|
|
Abdominal CT scan (with and without contrast)
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
$1,951.30
|
|
Abdominal CT scan (with contrast)
|
$1,385.40 |
$1,385.40 |
$1,385.40 |
$1,632.95
|
|
Abdominal CT scan (without contrast)
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,318.20
|
|
Abdominal pad
|
$196.11 |
$196.11 |
$196.11 |
$196.11
|
|
Abdominal paracentesis w/image guidance
|
$2,508.60 |
$2,508.60 |
$2,508.60 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$914.40 |
$914.40 |
$914.40 |
$756.60
|
|
Abdominal Ultrasound (limited)
|
$635.40 |
$635.40 |
$635.40 |
$603.33
|
|
Abduct control hip semi-flex
|
$499.86 |
$499.86 |
$499.86 |
$499.86
|
|
Abduction bar jointed adjust
|
$595.67 |
$595.67 |
$595.67 |
$595.67
|
|
Abduction rotation bar shoe
|
$210.65 |
$210.65 |
$210.65 |
$210.65
|
|
Abduct rotation bar without shoe
|
$192.62 |
$192.62 |
$192.62 |
$192.62
|
|
Abl1 gene
|
$780.00 |
$780.00 |
$780.00 |
$632.80
|
|
Ablate bone tumor(s) cryo perq 20983
|
$13,236.60 |
$13,236.60 |
$13,236.60 |
$8,384.20
|
|
Ablate bone tumor(s) perq
|
$13,236.60 |
$13,236.60 |
$13,236.60 |
$9,773.01
|
|
Ablation of upper extremity nerves rf
|
$2,352.00 |
$2,352.00 |
$2,352.00 |
$1,055.60
|
|
Abscess drain retroperitoneal surg code
|
$3,358.80 |
$3,358.80 |
$3,358.80 |
$3,053.18
|
|
Access thoracic lymph duct
|
$2,742.00 |
$2,742.00 |
$2,742.00 |
$879.45
|
|
Acetaminophen level
|
$159.00 |
$159.00 |
$159.00 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$142.14 |
$142.14 |
$142.14 |
$114.46
|
|
Acetone qualitative
|
$36.60 |
$36.60 |
$36.60 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$15.30 |
$15.30 |
$15.30 |
$300.00
|
|
Acetylcysteine non-comp unit
|
$34.08 |
$34.08 |
$34.08 |
$29.01
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Acute hepatitis panel
|
$243.00 |
$243.00 |
$243.00 |
$284.70
|
|
#acylcarnitineprfl
|
$181.20 |
$181.20 |
$181.20 |
$95.94
|
|
Adapter b 8 channel 10cm
|
$10,034.36 |
$10,034.36 |
$10,034.36 |
$5,782.66
|
|
Add le poly knee custom kafo
|
$451.68 |
$451.68 |
$451.68 |
$451.68
|
|
Adenovirus antibody,serum - quest
|
$90.00 |
$90.00 |
$90.00 |
$64.35
|
|
Adh-sendout
|
$186.00 |
$186.00 |
$186.00 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$257.82 |
$257.82 |
$257.82 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$540.60 |
$540.60 |
$540.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$533.40 |
$533.40 |
$533.40 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$513.60 |
$513.60 |
$513.60 |
$644.28
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$489.00 |
$489.00 |
$489.00 |
$439.45
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$46.80 |
$46.80 |
$46.80 |
$207.94
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$343.20 |
$343.20 |
$343.20 |
$260.00
|
|
Adrenal cortex & medulla img
|
$2,254.20 |
$2,254.20 |
$2,254.20 |
$1,818.05
|
|
_afb org id by sequencing rflx ast-sendout
|
$213.00 |
$213.00 |
$213.00 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,067.98 |
$1,067.98 |
$1,067.98 |
$1,067.98
|
|
Afo molded plas rig ant tib
|
$2,437.93 |
$2,437.93 |
$2,437.93 |
$2,412.47
|
|
Afo molded to patient plasti
|
$1,019.72 |
$1,019.72 |
$1,019.72 |
$825.89
|
|
Afo rig ant tib tcf/= custom
|
$2,111.34 |
$2,111.34 |
$2,111.34 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$663.56 |
$663.56 |
$663.56 |
$663.56
|
|
Afo sing solid stirrup calf
|
$955.35 |
$955.35 |
$955.35 |
$955.35
|
|
Afo sing upright with adjust s
|
$972.01 |
$972.01 |
$972.01 |
$696.71
|
|
Afo spiral molded to pt plas
|
$1,819.66 |
$1,819.66 |
$1,819.66 |
$1,819.66
|
|
Afo sprng wir drsflx calf bd
|
$675.05 |
$675.05 |
$675.05 |
$675.05
|
|
Afo supramalleolar custom
|
$1,331.42 |
$1,331.42 |
$1,331.42 |
$1,331.42
|
|
Afo tib fx cast plaster mold
|
$1,864.98 |
$1,864.98 |
$1,864.98 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$1,823.68 |
$1,823.68 |
$1,823.68 |
$1,514.10
|
|
Afo tibial fracture soft
|
$1,193.71 |
$1,193.71 |
$1,193.71 |
$855.63
|
|
Afo, walk boot type, cus fab
|
$3,754.63 |
$3,754.63 |
$3,754.63 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$1,511.55 |
$1,511.55 |
$1,511.55 |
$969.02
|
|
After cataract laser surgery
|
$1,411.20 |
$1,411.20 |
$1,411.20 |
$1,380.00
|
|
Ak/knee disartic pelvic band
|
$185.56 |
$185.56 |
$185.56 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$230.77 |
$230.77 |
$230.77 |
$230.77
|
|
Ak sleeve susp neoprene/equa
|
$418.06 |
$418.06 |
$418.06 |
$418.06
|
|
Albumin body fluid quantitative each specimen
|
$101.40 |
$101.40 |
$101.40 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$210.06 |
$210.06 |
$210.06 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$209.82 |
$209.82 |
$209.82 |
$251.66
|
|
Albumin, human 5 % intravenous solution
|
$209.82 |
$209.82 |
$209.82 |
$169.14
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$36.00 |
$36.00 |
$36.00 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$29.40 |
$29.40 |
$29.40 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$6.62
|
|
Albuterol non-comp con
|
$3.00 |
$3.00 |
$3.00 |
$5.61
|
|
Albuterol non-comp unit
|
$3.00 |
$3.00 |
$3.00 |
$5.11
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$139.80 |
$139.80 |
$139.80 |
$95.94
|
|
Alkaline phosphatase
|
$35.40 |
$35.40 |
$35.40 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$48.60 |
$48.60 |
$48.60 |
$50.00
|
|
Allergen egg white ige
|
$13.80 |
$13.80 |
$13.80 |
$36.82
|
|
Allergen specific ige qual multi scrn ea
|
$24.60 |
$24.60 |
$24.60 |
$24.00
|
|
Allograft 160mg placental salera mini membrane
|
$6,611.20 |
$6,611.20 |
$6,611.20 |
$5,481.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,037.12 |
$13,037.12 |
$13,037.12 |
$5,000.92
|
|
Allograft amnioexcel plus 17mm disk
|
$16,359.20 |
$16,359.20 |
$16,359.20 |
$2,747.07
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$12,541.67 |
$12,541.67 |
$12,541.67 |
$10,223.11
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,174.10 |
$10,174.10 |
$10,174.10 |
$6,773.79
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,185.43 |
$46,185.43 |
$46,185.43 |
$24,912.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$31,006.47 |
$31,006.47 |
$31,006.47 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$26,239.58 |
$26,239.58 |
$26,239.58 |
$5,380.65
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,775.26 |
$24,775.26 |
$24,775.26 |
$3,604.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,121.96 |
$8,121.96 |
$8,121.96 |
$4,624.54
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$9,276.62 |
$9,276.62 |
$9,276.62 |
$1,432.84
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$175.20 |
$175.20 |
$175.20 |
$164.45
|
|
Alpha-fetoprotein amniotic
|
$35.40 |
$35.40 |
$35.40 |
$76.05
|
|
Alpha-fetoprotein tumor marker
|
$60.60 |
$60.60 |
$60.60 |
$99.00
|
