|
11-desoxycortisol - sendout
|
$63.00 |
$63.00 |
$63.00 |
$84.56
|
|
17-hydroxypregnenolone
|
$53.40 |
$53.40 |
$53.40 |
$85.15
|
|
17-ketosteroids
|
$36.60 |
$36.60 |
$36.60 |
$49.45
|
|
2nd order venous cath
|
$798.60 |
$798.60 |
$798.60 |
$1,809.60
|
|
3d recon without postprocess indpndt
|
$1,007.40 |
$1,007.40 |
$1,007.40 |
$467.95
|
|
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 |
$94.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$25.80 |
$25.80 |
$25.80 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$5,169.60 |
$5,169.60 |
$5,169.60 |
$3,683.78
|
|
Abd/low ext cath 1st
|
$3,182.40 |
$3,182.40 |
$3,182.40 |
$2,412.00
|
|
Abd/low ext cath 2nd
|
$2,167.80 |
$2,167.80 |
$2,167.80 |
$2,271.00
|
|
Abd/low ext cath 3rd
|
$1,682.40 |
$1,682.40 |
$1,682.40 |
$2,662.40
|
|
Abd/low ext cath addl
|
$197.40 |
$197.40 |
$197.40 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$1,385.40 |
$1,385.40 |
$1,385.40 |
$1,655.50
|
|
Abdominal CT scan (without contrast)
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,358.76
|
|
Abdominal pad
|
$196.11 |
$196.11 |
$196.11 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$2,508.60 |
$2,508.60 |
$2,508.60 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$914.40 |
$914.40 |
$914.40 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$635.40 |
$635.40 |
$635.40 |
$604.80
|
|
Abduct control hip semi-flex
|
$499.86 |
$499.86 |
$499.86 |
$358.29
|
|
Abduction bar jointed adjust
|
$595.67 |
$595.67 |
$595.67 |
$426.96
|
|
Abduction rotation bar shoe
|
$210.65 |
$210.65 |
$210.65 |
$150.99
|
|
Abduct rotation bar without shoe
|
$192.62 |
$192.62 |
$192.62 |
$138.07
|
|
Abl1 gene
|
$780.00 |
$780.00 |
$780.00 |
$668.85
|
|
Ablate bone tumor(s) cryo perq 20983
|
$13,236.60 |
$13,236.60 |
$13,236.60 |
$8,512.80
|
|
Ablate bone tumor(s) perq
|
$13,236.60 |
$13,236.60 |
$13,236.60 |
$9,773.01
|
|
Ablation cryo abd perit om
|
$1,447.20 |
$1,447.20 |
$1,447.20 |
$2,566.58
|
|
Ablation cryo retro lymph node
|
$1,550.40 |
$1,550.40 |
$1,550.40 |
$826.80
|
|
Ablation cryo thigh/knee
|
$37,064.92 |
$37,064.92 |
$37,064.92 |
$3,068.00
|
|
Ablation of upper extremity nerves rf
|
$58,371.26 |
$58,371.26 |
$58,371.26 |
$961.20
|
|
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
|
|
Acetone qualitative
|
$36.60 |
$36.60 |
$36.60 |
$46.20
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$24.06 |
$24.06 |
$24.06 |
$281.55
|
|
Acetylcysteine non-comp unit
|
$71.22 |
$71.22 |
$71.22 |
$29.01
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Acute hepatitis panel
|
$243.00 |
$243.00 |
$243.00 |
$278.33
|
|
#acylcarnitineprfl
|
$181.20 |
$181.20 |
$181.20 |
$110.25
|
|
Adapter b 8 channel 10cm
|
$10,034.36 |
$10,034.36 |
$10,034.36 |
$6,142.50
|
|
Adding walker to prev cast
|
$312.00 |
$312.00 |
$312.00 |
$216.00
|
|
Add le poly knee custom kafo
|
$451.68 |
$451.68 |
$451.68 |
$323.75
|
|
Adenosine 3 mg/250 ml bag for osm
|
$28.20 |
$28.20 |
$28.20 |
$272.57
|
|
Adenovirus antibody,serum - quest
|
$90.00 |
$90.00 |
$90.00 |
$63.00
|
|
Adh-sendout
|
$186.00 |
$186.00 |
$186.00 |
$109.71
|
|
Adj gastric band via subq port
|
$22,284.43 |
$22,284.43 |
$22,284.43 |
$1,684.80
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$866.52 |
$866.52 |
$866.52 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$540.60 |
$540.60 |
$540.60 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$533.40 |
$533.40 |
$533.40 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$513.60 |
$513.60 |
$513.60 |
$690.21
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$489.00 |
$489.00 |
$489.00 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$343.20 |
$343.20 |
$343.20 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$343.20 |
$343.20 |
$343.20 |
$264.82
|
|
_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 |
$724.73
|
|
Afo molded plas rig ant tib
|
$2,437.93 |
$2,437.93 |
$2,437.93 |
$1,903.70
|
|
Afo molded to patient plasti
|
$1,019.72 |
$1,019.72 |
$1,019.72 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,111.34 |
$2,111.34 |
$2,111.34 |
$1,366.56
|
|
Afo sing bar clasp attach sh
|
$663.56 |
$663.56 |
$663.56 |
$475.62
|
|
Afo sing solid stirrup calf
|
$955.35 |
$955.35 |
$955.35 |
$684.77
|
|
Afo sing upright with adjust s
|
$972.01 |
$972.01 |
$972.01 |
$576.41
|
|
Afo spiral molded to pt plas
|
$1,819.66 |
$1,819.66 |
$1,819.66 |
$1,304.29
|
|
Afo sprng wir drsflx calf bd
|
$675.05 |
$675.05 |
$675.05 |
$458.09
|
|
Afo supramalleolar custom
|
$1,331.42 |
$1,331.42 |
$1,331.42 |
$954.34
|
|
Afo tib fx cast plaster mold
|
$1,864.98 |
$1,864.98 |
$1,864.98 |
$1,336.78
|
|
Afo tibial fracture rigid
|
$1,823.68 |
$1,823.68 |
$1,823.68 |
$1,541.40
|
|
Afo tibial fracture soft
|
$1,193.71 |
$1,193.71 |
$1,193.71 |
$1,052.00
|
|
Afo, walk boot type, cus fab
|
$3,754.63 |
$3,754.63 |
$3,754.63 |
$2,288.00
|
|
Afo w/ankle joint, prefab
|
$1,511.55 |
$1,511.55 |
$1,511.55 |
$567.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$33,814.68 |
$33,814.68 |
$33,814.68 |
$14,042.75
|
|
Air injection into abdomen 49400
|
$526.80 |
$526.80 |
$526.80 |
$531.49
|
|
Ak/knee disartic pelvic band
|
$185.56 |
$185.56 |
$185.56 |
$158.05
|
|
Ak/knee disartic silesian ba
|
$230.77 |
$230.77 |
$230.77 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$418.06 |
$418.06 |
$418.06 |
$246.40
|
|
Albumin body fluid quantitative each specimen
|
$101.40 |
$101.40 |
$101.40 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$315.84 |
$315.84 |
$315.84 |
$218.40
|
|
Albumin (human), 5%, 250 ml
|
$331.68 |
$331.68 |
$331.68 |
$242.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$36.00 |
$36.00 |
$36.00 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$29.40 |
$29.40 |
$29.40 |
$39.78
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$5.85
|
|
Albuterol non-comp con
|
$3.00 |
$3.00 |
$3.00 |
$5.00
|
|
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 |
$94.90
|
|
Alkaline phosphatase
|
$16.80 |
$16.80 |
$16.80 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$48.60 |
$48.60 |
$48.60 |
$48.57
|
|
Allergen egg white ige
|
$13.80 |
$13.80 |
$13.80 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$24.60 |
$24.60 |
$24.60 |
$24.01
|
|
Allograft 160mg placental salera mini membrane
|
$6,611.20 |
$6,611.20 |
$6,611.20 |
$666.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,037.12 |
$13,037.12 |
$13,037.12 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$16,359.20 |
$16,359.20 |
$16,359.20 |
$3,380.36
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$12,541.67 |
$12,541.67 |
$12,541.67 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,174.10 |
$10,174.10 |
$10,174.10 |
$5,213.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,185.43 |
$46,185.43 |
$46,185.43 |
$22,984.85
|
|
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 |
$4,732.60
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,775.26 |
$24,775.26 |
$24,775.26 |
$4,037.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,121.96 |
$8,121.96 |
$8,121.96 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$9,276.62 |
$9,276.62 |
$9,276.62 |
$1,707.62
|
