|
11-desoxycortisol - sendout
|
$45.60 |
$45.60 |
$45.60 |
$84.56
|
|
17-hydroxypregnenolone
|
$100.80 |
$100.80 |
$100.80 |
$85.15
|
|
17-ketosteroids
|
$43.20 |
$43.20 |
$43.20 |
$46.20
|
|
3-d radiotherapy plan
|
$11,319.60 |
$11,319.60 |
$11,319.60 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$500.40 |
$500.40 |
$500.40 |
$480.00
|
|
5' nucleotidase - sendout
|
$23.40 |
$23.40 |
$23.40 |
$45.90
|
|
88334 ap bill cytologic exam each additional site
|
$61.80 |
$61.80 |
$61.80 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$7,951.50 |
$7,951.50 |
$8,091.00 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$114.60 |
$114.60 |
$114.60 |
$53.60
|
|
Abd aorta w/runoff s&i
|
$5,328.60 |
$5,328.60 |
$5,328.60 |
$3,569.56
|
|
Abdominal CT scan (with and without contrast)
|
$1,306.20 |
$1,306.20 |
$1,344.00 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$1,208.40 |
$1,208.40 |
$1,208.40 |
$1,664.40
|
|
Abdominal CT scan (without contrast)
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$1,358.76
|
|
Abdominal pad
|
$296.95 |
$296.95 |
$296.95 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$1,655.40 |
$1,655.40 |
$1,655.40 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$980.40 |
$980.40 |
$980.40 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$909.60 |
$909.60 |
$909.60 |
$600.00
|
|
Abdominoplasty 15830
|
$26,299.52 |
$26,299.52 |
$61,508.00 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$11,537.58 |
$11,537.58 |
$11,537.58 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$756.91 |
$756.91 |
$756.91 |
$499.86
|
|
Abduction bar jointed adjust
|
$901.99 |
$901.99 |
$901.99 |
$595.67
|
|
Abduction rotation bar shoe
|
$318.97 |
$318.97 |
$318.97 |
$150.99
|
|
Abduct rotation bar without shoe
|
$291.67 |
$291.67 |
$291.67 |
$192.62
|
|
Abl1 gene
|
$1,071.60 |
$1,071.60 |
$1,071.60 |
$668.85
|
|
Ablate bone tumor(s) cryo perq 20983
|
$11,272.80 |
$11,272.80 |
$11,272.80 |
$8,512.80
|
|
Ablate bone tumor(s) perq
|
$11,994.00 |
$11,994.00 |
$11,994.00 |
$9,773.01
|
|
Ablate inf turbinate submuc 30802
|
$25,210.40 |
$25,210.40 |
$34,364.35 |
$1,752.89
|
|
Ablation cryo thigh/knee
|
$5,069.52 |
$5,069.52 |
$5,069.52 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$868.80 |
$868.80 |
$42,076.84 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$6,579.48 |
$6,579.48 |
$6,579.48 |
$2,903.45
|
|
Acetaminophen level
|
$130.80 |
$130.80 |
$130.80 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$170.10 |
$170.10 |
$177.66 |
$113.40
|
|
Acetone qualitative
|
$25.80 |
$25.80 |
$25.80 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$91.80 |
$91.80 |
$91.80 |
$108.35
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$13.44 |
$13.44 |
$27.84 |
$244.95
|
|
Acetylcysteine non-comp unit
|
$99.60 |
$99.60 |
$133.38 |
$31.21
|
|
Acute hepatitis panel
|
$357.60 |
$357.60 |
$357.60 |
$281.05
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$23.22 |
$23.22 |
$63.48 |
$64.45
|
|
#acylcarnitineprfl
|
$165.60 |
$165.60 |
$165.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$15,194.36 |
$15,194.36 |
$15,194.36 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$683.95 |
$683.95 |
$683.95 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$16.20 |
$16.20 |
$30.90 |
$271.98
|
|
Adenovirus ag ia
|
$54.60 |
$54.60 |
$54.60 |
$42.00
|
|
Adenovirus antibody,serum - quest
|
$117.60 |
$117.60 |
$117.60 |
$60.00
|
|
Adh-sendout
|
$253.20 |
$253.20 |
$253.20 |
$109.28
|
|
Adj gastric band via subq port
|
$16,903.95 |
$16,903.95 |
$16,903.95 |
$1,666.86
|
|
Adjmt/revj ext fixj sys anes
|
$45,814.07 |
$45,814.07 |
$45,814.07 |
$7,913.97
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$646.02 |
$646.02 |
$646.02 |
$171.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$157.80 |
$157.80 |
$157.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$213.00 |
$213.00 |
$213.00 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,235.40 |
$1,235.40 |
$1,235.40 |
$644.28
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$439.45
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$961.80 |
$961.80 |
$961.80 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$961.80 |
$961.80 |
$961.80 |
$264.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$18,671.52 |
$18,671.52 |
$32,555.34 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$54,565.10 |
$54,565.10 |
$54,565.10 |
$231.47
|
|
_afb id by dna probe rflx ast
|
$97.20 |
$97.20 |
$97.20 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$82.20 |
$82.20 |
$82.20 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$260.40 |
$260.40 |
$260.40 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,617.17 |
$1,617.17 |
$1,617.17 |
$765.51
|
|
Afo molded plas rig ant tib
|
$2,437.93 |
$2,437.93 |
$2,437.93 |
$2,011.42
|
|
Afo molded to patient plasti
|
$1,544.09 |
$1,544.09 |
$1,544.09 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,111.34 |
$2,111.34 |
$2,111.34 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$1,004.78 |
$1,004.78 |
$1,004.78 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,446.62 |
$1,446.62 |
$1,446.62 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,471.85 |
$1,471.85 |
$1,471.85 |
$696.71
|
|
Afo spiral molded to pt plas
|
$1,819.66 |
$1,819.66 |
$1,819.66 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$1,022.19 |
$1,022.19 |
$1,022.19 |
$483.88
|
|
Afo supramalleolar custom
|
$1,331.42 |
$1,331.42 |
$1,331.42 |
$1,162.69
|
|
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 |
$1,464.20
|
|
Afo tibial fracture soft
|
$1,807.55 |
$1,807.55 |
$1,807.55 |
$1,060.02
|
|
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 |
$567.00
|
|
Ak/knee disartic pelvic band
|
$280.98 |
$280.98 |
$280.98 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$349.45 |
$349.45 |
$349.45 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$633.05 |
$633.05 |
$633.05 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$13.80 |
$13.80 |
$13.80 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$486.00 |
$486.00 |
$507.60 |
$219.30
|
|
Albumin (human), 5%, 250 ml
|
$486.00 |
$486.00 |
$507.60 |
$227.91
|
|
Albumin, human 5 % intravenous solution
|
$262.26 |
$262.26 |
$262.26 |
$296.32
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$40.80 |
$40.80 |
$40.80 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$95.40 |
$95.40 |
$95.40 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$5.19
|
|
Albuterol non-comp unit
|
$4.50 |
$4.50 |
$6.00 |
$5.11
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$139.20 |
$139.20 |
$139.20 |
$94.90
|
|
Alkaline phosphatase
|
$43.20 |
$43.20 |
$43.20 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$67.20 |
$67.20 |
$67.20 |
$46.80
|
|
Allergen egg white ige
|
$52.80 |
$52.80 |
$52.80 |
$33.50
|
|
Allergen specific ige qual multi scrn ea
|
$32.40 |
$32.40 |
$32.40 |
$24.00
|
|
Allograft 160mg placental salera mini membrane
|
$10,010.89 |
$10,010.89 |
$10,010.89 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$19,741.24 |
$19,741.24 |
$19,741.24 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$24,771.64 |
$24,771.64 |
$24,771.64 |
$2,677.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$18,991.01 |
$18,991.01 |
$18,991.01 |
$11,121.17
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$15,405.96 |
$15,405.96 |
$15,405.96 |
$5,913.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$69,935.50 |
$69,935.50 |
$69,935.50 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$46,951.01 |
$46,951.01 |
$46,951.01 |
$715.20
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$39,732.83 |
$39,732.83 |
$39,732.83 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$37,515.51 |
$37,515.51 |
$37,515.51 |
$3,604.00
|
