|
11-desoxycortisol - sendout
|
$358.20 |
$358.20 |
$358.20 |
$84.56
|
|
17-hydroxypregnenolone
|
$279.60 |
$279.60 |
$279.60 |
$85.15
|
|
17-ketosteroids
|
$117.00 |
$117.00 |
$117.00 |
$46.20
|
|
2nd order venous cath
|
$69,313.93 |
$69,313.93 |
$69,313.93 |
$1,635.60
|
|
3-d radiotherapy plan
|
$5,494.80 |
$5,494.80 |
$5,494.80 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$1,281.00 |
$1,281.00 |
$1,281.00 |
$480.00
|
|
5' nucleotidase - sendout
|
$176.40 |
$176.40 |
$176.40 |
$45.90
|
|
88334 ap bill cytologic exam each additional site
|
$151.20 |
$151.20 |
$151.20 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$83.40 |
$83.40 |
$83.40 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$83.40 |
$83.40 |
$83.40 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$83.40 |
$83.40 |
$83.40 |
$116.00
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$24,924.00 |
$24,924.00 |
$24,924.00 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$100.80 |
$100.80 |
$100.80 |
$53.60
|
|
Abd aorta w/runoff s&i
|
$8,482.20 |
$8,482.20 |
$8,482.20 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$69,660.06 |
$69,660.06 |
$69,660.06 |
$2,121.00
|
|
Abd/low ext cath 2nd
|
$62,801.83 |
$62,801.83 |
$62,801.83 |
$2,158.00
|
|
Abd/low ext cath 3rd
|
$68,795.60 |
$68,795.60 |
$68,795.60 |
$2,639.65
|
|
Abd/low ext cath addl
|
$59,806.91 |
$59,806.91 |
$59,806.91 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$4,587.60 |
$4,587.60 |
$4,587.60 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$3,990.00 |
$3,990.00 |
$3,990.00 |
$1,664.40
|
|
Abdominal CT scan (without contrast)
|
$3,469.80 |
$3,469.80 |
$3,469.80 |
$1,358.76
|
|
Abdominal pad
|
$225.67 |
$225.67 |
$225.67 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$2,788.80 |
$2,788.80 |
$2,788.80 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$805.80 |
$805.80 |
$805.80 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$1,238.40 |
$1,238.40 |
$1,238.40 |
$600.00
|
|
Abdominoplasty 15830
|
$179,123.72 |
$179,123.72 |
$179,123.72 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$974.40 |
$974.40 |
$974.40 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$575.20 |
$575.20 |
$575.20 |
$499.86
|
|
Abduction bar jointed adjust
|
$685.45 |
$685.45 |
$685.45 |
$595.67
|
|
Abduction rotation bar shoe
|
$242.39 |
$242.39 |
$242.39 |
$150.99
|
|
Abduct rotation bar without shoe
|
$221.65 |
$221.65 |
$221.65 |
$192.62
|
|
Abl1 gene
|
$908.40 |
$908.40 |
$908.40 |
$668.85
|
|
Ablate arrhythmia add on
|
$7,186.80 |
$7,186.80 |
$7,186.80 |
$6,913.20
|
|
Ablate bone tumor(s) cryo perq 20983
|
$11,558.40 |
$11,558.40 |
$11,558.40 |
$8,512.80
|
|
Ablate bone tumor(s) perq
|
$55,120.89 |
$55,120.89 |
$55,120.89 |
$9,773.01
|
|
Ablate heart dysrhythm focus
|
$11,323.80 |
$11,323.80 |
$11,323.80 |
$9,480.90
|
|
Ablate inf turbinate submuc 30802
|
$41,480.68 |
$41,480.68 |
$41,480.68 |
$1,752.89
|
|
Ablate pulm tumor perq crybl
|
$8,442.00 |
$8,442.00 |
$8,442.00 |
$9,785.28
|
|
Ablate pulm tumor perq rf
|
$6,182.40 |
$6,182.40 |
$6,182.40 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$483.60 |
$483.60 |
$483.60 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$1,433.40 |
$1,433.40 |
$1,433.40 |
$2,535.72
|
|
Ablation cryo thigh/knee
|
$46,848.37 |
$46,848.37 |
$46,848.37 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$669.60 |
$669.60 |
$669.60 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$4,842.60 |
$4,842.60 |
$4,842.60 |
$2,903.45
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$718.20 |
$718.20 |
$718.20 |
$2,670.25
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$77.94 |
$77.94 |
$77.94 |
$80.14
|
|
Acetaminophen level
|
$137.40 |
$137.40 |
$137.40 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$721.80 |
$721.80 |
$721.80 |
$113.40
|
|
Acetone qualitative
|
$75.60 |
$75.60 |
$75.60 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$168.00 |
$168.00 |
$168.00 |
$108.35
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$61.74 |
$61.74 |
$61.74 |
$244.95
|
|
Acetylcysteine non-comp unit
|
$138.72 |
$138.72 |
$138.72 |
$31.21
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Acromp/acromionectomy prtl
|
$46,503.43 |
$46,503.43 |
$46,503.43 |
$3,839.54
|
|
Acute hepatitis panel
|
$583.20 |
$583.20 |
$583.20 |
$281.05
|
|
Acute venous thrombus image
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$1,113.43
|
|
Acyclovir 400 mg tablet
|
$24.54 |
$24.54 |
$24.54 |
$51.36
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$304.92 |
$304.92 |
$304.92 |
$64.45
|
|
#acylcarnitineprfl
|
$263.40 |
$263.40 |
$263.40 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$11,546.73 |
$11,546.73 |
$11,546.73 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$519.76 |
$519.76 |
$519.76 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$113.52 |
$113.52 |
$113.52 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$85.20 |
$85.20 |
$85.20 |
$60.00
|
|
Adh-sendout
|
$221.40 |
$221.40 |
$221.40 |
$109.28
|
|
Adj gastric band via subq port
|
$2,446.80 |
$2,446.80 |
$2,446.80 |
$1,666.86
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$24,302.76 |
$24,302.76 |
$24,302.76 |
$2,995.08
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1,076.64 |
$1,076.64 |
$1,076.64 |
$171.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$600.60 |
$600.60 |
$600.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$600.60 |
$600.60 |
$600.60 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$644.28
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$617.40 |
$617.40 |
$617.40 |
$439.45
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$617.40 |
$617.40 |
$617.40 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$841.20 |
$841.20 |
$841.20 |
$264.00
|
|
Administration immunization 1 vaccine
|
$54.60 |
$54.60 |
$54.60 |
$66.51
|
|
Administration immunization each additional vaccine
|
$26.40 |
$26.40 |
$26.40 |
$46.23
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$44.40 |
$44.40 |
$44.40 |
$48.00
|
|
Administration vaccine influenza virus
|
$34.20 |
$34.20 |
$34.20 |
$48.35
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$54,386.58 |
$54,386.58 |
$54,386.58 |
$11,350.31
|
|
_afb id by dna probe rflx ast
|
$100.20 |
$100.20 |
$100.20 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$126.00 |
$126.00 |
$126.00 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$160.80 |
$160.80 |
$160.80 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,228.94 |
$1,228.94 |
$1,228.94 |
$765.51
|
|
Afo molded plas rig ant tib
|
$2,805.37 |
$2,805.37 |
$2,805.37 |
$2,011.42
|
|
Afo molded to patient plasti
|
$1,173.41 |
$1,173.41 |
$1,173.41 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$3,170.73 |
$3,170.73 |
$3,170.73 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$763.57 |
$763.57 |
$763.57 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,099.34 |
$1,099.34 |
$1,099.34 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,118.51 |
$1,118.51 |
$1,118.51 |
$696.71
|
|
Afo spiral molded to pt plas
|
$2,093.92 |
$2,093.92 |
$2,093.92 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$776.80 |
$776.80 |
$776.80 |
$483.88
|
|
Afo supramalleolar custom
|
$1,532.09 |
$1,532.09 |
$1,532.09 |
$1,162.69
|
|
Afo tib fx cast plaster mold
|
$2,146.07 |
$2,146.07 |
$2,146.07 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$2,098.54 |
$2,098.54 |
$2,098.54 |
$1,464.20
|
|
Afo tibial fracture soft
|
$1,373.62 |
$1,373.62 |
$1,373.62 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$4,320.52 |
$4,320.52 |
$4,320.52 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$1,739.37 |
$1,739.37 |
$1,739.37 |
$567.00
|
|
Air injection into abdomen 49400
|
$637.20 |
$637.20 |
$637.20 |
$526.80
|
|
Ak/knee disartic pelvic band
|
$213.53 |
$213.53 |
$213.53 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$265.55 |
$265.55 |
$265.55 |
$156.80
|
