|
11-desoxycortisol - sendout
|
$78.00 |
$78.00 |
$78.00 |
$87.50
|
|
17-hydroxypregnenolone
|
$146.25 |
$146.25 |
$146.25 |
$85.15
|
|
17-ketosteroids
|
$161.20 |
$161.20 |
$161.20 |
$44.00
|
|
24 hr ambulatory b/p monitor
|
$486.85 |
$486.85 |
$486.85 |
$319.15
|
|
2d tee w or without fol w/con,in
|
$1,897.35 |
$1,897.35 |
$1,897.35 |
$1,570.80
|
|
2d tte w or without fol w/con,co
|
$1,726.40 |
$1,726.40 |
$1,726.40 |
$1,088.36
|
|
2nd order venous cath
|
$2,438.80 |
$2,438.80 |
$2,438.80 |
$1,809.60
|
|
3d ech img cgen car anomal
|
$319.15 |
$319.15 |
$319.15 |
$669.00
|
|
3-d radiotherapy plan
|
$8,195.20 |
$8,195.20 |
$8,195.20 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$204.75 |
$204.75 |
$204.75 |
$427.34
|
|
5' nucleotidase - sendout
|
$2,265.90 |
$2,265.90 |
$2,265.90 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$204.10 |
$204.10 |
$204.10 |
$97.65
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$88.40 |
$88.40 |
$88.40 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$88.40 |
$88.40 |
$88.40 |
$176.03
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,934.18 |
$4,934.18 |
$4,934.18 |
$3,634.61
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$195.00 |
$195.00 |
$195.00 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$7,290.40 |
$7,290.40 |
$7,290.40 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$1,225.90 |
$1,225.90 |
$1,225.90 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$3,050.58
|
|
Abd/low ext cath addl
|
$590.20 |
$590.20 |
$590.20 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$2,456.35 |
$2,456.35 |
$2,456.35 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,234.05 |
$2,234.05 |
$2,234.05 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,029.30 |
$2,029.30 |
$2,029.30 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,840.20 |
$3,840.20 |
$3,840.20 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$3,491.15 |
$3,491.15 |
$3,491.15 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$3,172.00 |
$3,172.00 |
$3,172.00 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$1,133.60 |
$1,133.60 |
$1,133.60 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$795.60 |
$795.60 |
$795.60 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$529.10 |
$529.10 |
$529.10 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$1,170.28
|
|
Abl1 gene
|
$776.75 |
$776.75 |
$776.75 |
$609.93
|
|
Ablate arrhythmia add on
|
$5,088.85 |
$5,088.85 |
$5,088.85 |
$7,417.15
|
|
Ablate bone tumor(s) cryo perq 20983
|
$5,090.80 |
$5,090.80 |
$5,090.80 |
$7,896.23
|
|
Ablate bone tumor(s) perq
|
$11,705.20 |
$11,705.20 |
$11,705.20 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$20,716.80 |
$20,716.80 |
$20,716.80 |
$10,008.58
|
|
Ablate pulm tumor perq crybl
|
$7,187.70 |
$7,187.70 |
$7,187.70 |
$9,977.40
|
|
Ablate pulm tumor perq rf
|
$6,843.20 |
$6,843.20 |
$6,843.20 |
$6,904.15
|
|
Ablation cardiac vagal inputs atrium
|
$2,955.55 |
$2,955.55 |
$2,955.55 |
$3,587.65
|
|
Ablation cryo abd perit om
|
$1,591.20 |
$1,591.20 |
$1,591.20 |
$2,555.80
|
|
Ablation cryo adrenal tumor
|
$952.90 |
$952.90 |
$952.90 |
$6,904.15
|
|
Ablation cryo pq liver tumor(s)
|
$2,133.30 |
$2,133.30 |
$2,133.30 |
$8,080.50
|
|
Ablation cryo retro lymph node
|
$155.35 |
$155.35 |
$155.35 |
$859.50
|
|
Ablation cryo thigh/knee
|
$2,117.70 |
$2,117.70 |
$2,117.70 |
$386.10
|
|
Ablation of upper extremity nerves rf
|
$1,244.10 |
$1,244.10 |
$1,244.10 |
$987.60
|
|
Abltj mal prst8 tiss hifu
|
$3,368.30 |
$3,368.30 |
$3,368.30 |
$5,077.94
|
|
Abscess drain retroperitoneal surg code
|
$3,140.80 |
$3,140.80 |
$3,140.80 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$13,722.80 |
$13,722.80 |
$13,722.80 |
$3,263.74
|
|
Acetaminophen level
|
$113.75 |
$113.75 |
$113.75 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$102.37 |
$102.37 |
$102.37 |
$133.60
|
|
Acetone qualitative
|
$52.00 |
$52.00 |
$52.00 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$181.35 |
$181.35 |
$181.35 |
$65.60
|
|
Acetylcholinesterase assay
|
$230.75 |
$230.75 |
$230.75 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$27.66 |
$27.66 |
$27.66 |
$323.77
|
|
Acute hepatitis panel
|
$217.75 |
$217.75 |
$217.75 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$42.25 |
$42.25 |
$42.25 |
$50.70
|
|
#acylcarnitineprfl
|
$111.80 |
$111.80 |
$111.80 |
$105.60
|
|
Adapter b 8 channel 10cm
|
$514.46 |
$514.46 |
$514.46 |
$1,638.00
|
|
Adenosine 3 mg/250 ml bag for osm
|
$50.05 |
$50.05 |
$50.05 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$172.25 |
$172.25 |
$172.25 |
$63.00
|
|
Adh-sendout
|
$222.30 |
$222.30 |
$222.30 |
$109.28
|
|
Adj gastric band via subq port
|
$1,964.30 |
$1,964.30 |
$1,964.30 |
$1,874.60
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$4,458.80 |
$4,458.80 |
$4,458.80 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$604.50 |
$604.50 |
$604.50 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$419.25 |
$419.25 |
$419.25 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$828.10 |
$828.10 |
$828.10 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$476.45 |
$476.45 |
$476.45 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$155.35 |
$155.35 |
$155.35 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$375.05 |
$375.05 |
$375.05 |
$264.00
|
|
Administration immunization 1 vaccine
|
$24.70 |
$24.70 |
$24.70 |
$70.52
|
|
Administration immunization each additional vaccine
|
$24.70 |
$24.70 |
$24.70 |
$46.23
|
|
Administration vaccine hepatitis b
|
$24.70 |
$24.70 |
$24.70 |
$51.35
|
|
Administration vaccine influenza virus
|
$24.70 |
$24.70 |
$24.70 |
$49.50
|
|
Administration vaccine pneumococcal
|
$24.70 |
$24.70 |
$24.70 |
$51.11
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$20.80 |
$20.80 |
$20.80 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$17,264.68 |
$17,264.68 |
$17,264.68 |
$11,874.55
|
|
Adrenal cortex & medulla img
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$1,780.19
|
|
_afb id by dna probe rflx ast
|
$153.40 |
$153.40 |
$153.40 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$198.25 |
$198.25 |
$198.25 |
$289.60
|
|
Air conduction bilat
|
$102.05 |
$102.05 |
$102.05 |
$106.50
|
|
Air injection into abdomen 49400
|
$1,735.50 |
$1,735.50 |
$1,735.50 |
$531.49
|
|
Albumin body fluid quantitative each specimen
|
$107.90 |
$107.90 |
$107.90 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$155.45 |
$155.45 |
$155.45 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$160.10 |
$160.10 |
$160.10 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$52.65 |
$52.65 |
$52.65 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$6.50 |
$6.50 |
$6.50 |
$43.50
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$130.00 |
$130.00 |
$130.00 |
$93.60
|
|
Alkaline phosphatase
|
$6.50 |
$6.50 |
$6.50 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$302.25 |
$302.25 |
$302.25 |
$56.35
|
|
Allergen egg white ige
|
$117.65 |
$117.65 |
$117.65 |
$41.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,686.93 |
$7,686.93 |
$7,686.93 |
$6,555.62
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$7,958.47 |
$7,958.47 |
$7,958.47 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$567.03 |
$567.03 |
$567.03 |
$905.18
|
|
All tstg perq&iq drugs/biol
|
$196.30 |
$196.30 |
$196.30 |
$64.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,659.38 |
$1,659.38 |
$1,659.38 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$207.35 |
$207.35 |
$207.35 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$106.60 |
$106.60 |
$106.60 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$45.50 |
$45.50 |
$45.50 |
$99.00
|
|
Alprostadil for injection
|
$367.90 |
$367.90 |
$367.90 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$23,242.18 |
$23,242.18 |
$23,242.18 |
$2,600.22
|
