|
11-desoxycortisol - sendout
|
$412.20 |
$412.20 |
$412.20 |
$84.56
|
|
17-hydroxypregnenolone
|
$320.40 |
$320.40 |
$320.40 |
$85.15
|
|
17-ketosteroids
|
$135.00 |
$135.00 |
$135.00 |
$46.20
|
|
24 hr ambulatory b/p monitor
|
$279.60 |
$279.60 |
$279.60 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$1,286.40 |
$1,286.40 |
$1,286.40 |
$1,591.63
|
|
3d ech img cgen car anomal
|
$1,120.20 |
$1,120.20 |
$1,120.20 |
$532.35
|
|
3d recon without postprocess indpndt
|
$616.20 |
$616.20 |
$616.20 |
$480.00
|
|
5' nucleotidase - sendout
|
$48.60 |
$48.60 |
$48.60 |
$46.53
|
|
88334 ap bill cytologic exam each additional site
|
$97.20 |
$97.20 |
$97.20 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$127.80 |
$127.80 |
$127.80 |
$53.68
|
|
Abd aorta w/runoff s&i
|
$5,487.60 |
$5,487.60 |
$5,487.60 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$1,750.20 |
$1,750.20 |
$1,750.20 |
$2,121.00
|
|
Abd/low ext cath 2nd
|
$1,710.60 |
$1,710.60 |
$1,710.60 |
$2,158.00
|
|
Abd/low ext cath 3rd
|
$1,515.00 |
$1,515.00 |
$1,515.00 |
$2,639.65
|
|
Abdominal CT scan (with and without contrast)
|
$2,245.20 |
$2,245.20 |
$2,245.20 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,629.60 |
$1,629.60 |
$1,629.60 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$1,605.00 |
$1,605.00 |
$1,605.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,215.40 |
$3,215.40 |
$3,215.40 |
$3,045.84
|
|
Abdominal MRI (with contrast)
|
$2,523.00 |
$2,523.00 |
$2,523.00 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$2,677.80 |
$2,677.80 |
$2,677.80 |
$2,047.72
|
|
Abdominal pad
|
$408.38 |
$408.38 |
$408.38 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$2,158.80 |
$2,158.80 |
$2,158.80 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$600.00
|
|
Abd paracentesis/w/o image guide 49082
|
$865.20 |
$865.20 |
$865.20 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$889.27 |
$889.27 |
$889.27 |
$499.86
|
|
Abduction bar jointed adjust
|
$969.36 |
$969.36 |
$969.36 |
$595.67
|
|
Abduction rotation bar shoe
|
$438.66 |
$438.66 |
$438.66 |
$150.99
|
|
Abduct rotation bar without shoe
|
$401.12 |
$401.12 |
$401.12 |
$192.62
|
|
Abl1 gene
|
$772.80 |
$772.80 |
$772.80 |
$668.85
|
|
Ablate arrhythmia add on
|
$8,300.40 |
$8,300.40 |
$8,300.40 |
$6,913.20
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,825.80 |
$7,825.80 |
$7,825.80 |
$8,512.80
|
|
Ablation cardiac vagal inputs atrium
|
$614.40 |
$614.40 |
$614.40 |
$2,260.30
|
|
Ablation of upper extremity nerves rf
|
$669.60 |
$669.60 |
$669.60 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$2,404.80 |
$2,404.80 |
$2,404.80 |
$2,903.45
|
|
Acetaminophen level
|
$96.60 |
$96.60 |
$96.60 |
$116.80
|
|
Acetone qualitative
|
$23.40 |
$23.40 |
$23.40 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$176.40 |
$176.40 |
$176.40 |
$112.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$12.78 |
$12.78 |
$12.78 |
$244.95
|
|
Acetylcysteine non-comp unit
|
$60.66 |
$60.66 |
$60.66 |
$31.21
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Acute hepatitis panel
|
$147.00 |
$147.00 |
$147.00 |
$281.09
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$42.24 |
$42.24 |
$42.24 |
$64.45
|
|
#acylcarnitineprfl
|
$276.60 |
$276.60 |
$276.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$11,659.61 |
$11,659.61 |
$11,659.61 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$803.56 |
$803.56 |
$803.56 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$23.46 |
$23.46 |
$23.46 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$89.40 |
$89.40 |
$89.40 |
$60.00
|
|
Adh-sendout
|
$208.80 |
$208.80 |
$208.80 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$179.40 |
$179.40 |
$179.40 |
$171.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$289.80 |
$289.80 |
$289.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$126.00 |
$126.00 |
$126.00 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$469.20 |
$469.20 |
$469.20 |
$646.80
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$241.80 |
$241.80 |
$241.80 |
$439.55
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$310.20 |
$310.20 |
$310.20 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$192.00 |
$192.00 |
$192.00 |
$264.70
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$19,801.32 |
$19,801.32 |
$19,801.32 |
$11,350.31
|
|
_afb id by dna probe rflx ast
|
$111.60 |
$111.60 |
$111.60 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$111.60 |
$111.60 |
$111.60 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$130.80 |
$130.80 |
$130.80 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,240.96 |
$1,240.96 |
$1,240.96 |
$765.51
|
|
Afo molded plas rig ant tib
|
$2,832.79 |
$2,832.79 |
$2,832.79 |
$2,011.42
|
|
Afo molded to patient plasti
|
$1,339.58 |
$1,339.58 |
$1,339.58 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,453.31 |
$2,453.31 |
$2,453.31 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$974.06 |
$974.06 |
$974.06 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,255.01 |
$1,255.01 |
$1,255.01 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,276.90 |
$1,276.90 |
$1,276.90 |
$696.71
|
|
Afo spiral molded to pt plas
|
$2,114.39 |
$2,114.39 |
$2,114.39 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$990.94 |
$990.94 |
$990.94 |
$483.88
|
|
Afo supramalleolar custom
|
$1,547.07 |
$1,547.07 |
$1,547.07 |
$1,162.69
|
|
Afo tib fx cast plaster mold
|
$2,167.05 |
$2,167.05 |
$2,167.05 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$2,119.05 |
$2,119.05 |
$2,119.05 |
$1,464.20
|
|
Afo tibial fracture soft
|
$1,387.05 |
$1,387.05 |
$1,387.05 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$4,362.76 |
$4,362.76 |
$4,362.76 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$1,756.37 |
$1,756.37 |
$1,756.37 |
$567.00
|
|
Ak/knee disartic pelvic band
|
$386.42 |
$386.42 |
$386.42 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$480.58 |
$480.58 |
$480.58 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$743.75 |
$743.75 |
$743.75 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$39.00 |
$39.00 |
$39.00 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$262.50 |
$262.50 |
$262.50 |
$219.08
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$49.80 |
$49.80 |
$49.80 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$37.80 |
$37.80 |
$37.80 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$5.28
|
|
Albuterol non-comp con
|
$3.00 |
$3.00 |
$3.00 |
$5.61
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$146.40 |
$146.40 |
$146.40 |
$94.90
|
|
Alkaline phosphatase
|
$73.80 |
$73.80 |
$73.80 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$55.20 |
$55.20 |
$55.20 |
$46.80
|
|
Allergen egg white ige
|
$27.00 |
$27.00 |
$27.00 |
$33.66
|
|
Allergen specific ige qual multi scrn ea
|
$48.00 |
$48.00 |
$48.00 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$39.00 |
$39.00 |
$39.00 |
$42.00
|
|
Allergy injection; single 95115
|
$72.60 |
$72.60 |
$72.60 |
$42.75
|
|
Allograft 160mg placental salera mini membrane
|
$7,682.00 |
$7,682.00 |
$7,682.00 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$15,148.72 |
$15,148.72 |
$15,148.72 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$19,008.88 |
$19,008.88 |
$19,008.88 |
$2,677.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$14,573.02 |
$14,573.02 |
$14,573.02 |
$11,121.17
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$11,821.98 |
$11,821.98 |
$11,821.98 |
$5,913.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$53,666.00 |
$53,666.00 |
$53,666.00 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$36,028.53 |
$36,028.53 |
$36,028.53 |
$715.20
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$30,489.55 |
$30,489.55 |
$30,489.55 |
$4,677.40
|
