|
3d recon without postprocess indpndt
|
$67.25 |
$67.25 |
$67.25 |
$455.83
|
|
5' nucleotidase - sendout
|
$38.94 |
$38.94 |
$38.94 |
$65.84
|
|
88334 ap bill cytologic exam each additional site
|
$36.45 |
$36.45 |
$36.45 |
$94.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$75.85 |
$75.85 |
$75.85 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$1,093.17 |
$1,093.17 |
$1,093.17 |
$1,951.30
|
|
Abdominal CT scan (with contrast)
|
$1,019.81 |
$1,019.81 |
$1,019.81 |
$1,610.00
|
|
Abdominal CT scan (without contrast)
|
$954.97 |
$954.97 |
$954.97 |
$1,238.25
|
|
Abdominal MRI (with and without contrast)
|
$1,188.35 |
$1,188.35 |
$1,188.35 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$954.14 |
$954.14 |
$954.14 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$979.02 |
$979.02 |
$979.02 |
$1,830.00
|
|
Abdominal paracentesis w/image guidance
|
$1,165.69 |
$1,165.69 |
$1,165.69 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$526.79 |
$526.79 |
$526.79 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$362.60 |
$362.60 |
$362.60 |
$586.52
|
|
Abd paracentesis/w/o image guide 49082
|
$881.16 |
$881.16 |
$881.16 |
$1,144.26
|
|
Abl1 gene
|
$328.67 |
$328.67 |
$328.67 |
$663.30
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,143.04 |
$7,143.04 |
$7,143.04 |
$7,896.23
|
|
Ablate bone tumor(s) perq
|
$6,487.77 |
$6,487.77 |
$6,487.77 |
$9,773.01
|
|
Ablate pulm tumor perq rf
|
$6,899.39 |
$6,899.39 |
$6,899.39 |
$10,651.33
|
|
Ablation cryo pq liver tumor(s)
|
$5,790.50 |
$5,790.50 |
$5,790.50 |
$8,581.80
|
|
Abscess drain retroperitoneal surg code
|
$864.04 |
$864.04 |
$864.04 |
$3,053.18
|
|
Acetone qualitative
|
$40.15 |
$40.15 |
$40.15 |
$46.80
|
|
Acute hepatitis panel
|
$125.62 |
$125.62 |
$125.62 |
$297.70
|
|
#acylcarnitineprfl
|
$250.95 |
$250.95 |
$250.95 |
$110.25
|
|
Adenovirus antibody,serum - quest
|
$25.72 |
$25.72 |
$25.72 |
$63.00
|
|
Adh-sendout
|
$86.03 |
$86.03 |
$86.03 |
$152.10
|
|
Administration chemotherapy IV infusion each additional hour
|
$71.78 |
$71.78 |
$71.78 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$246.51 |
$246.51 |
$246.51 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$123.95 |
$123.95 |
$123.95 |
$454.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$65.86 |
$65.86 |
$65.86 |
$267.43
|
|
Administration immunization 1 vaccine
|
$29.05 |
$29.05 |
$29.05 |
$65.00
|
|
Administration immunization each additional vaccine
|
$27.66 |
$27.66 |
$27.66 |
$46.23
|
|
Adrenal cortex & medulla img
|
$716.04 |
$716.04 |
$716.04 |
$1,642.08
|
|
#afb mycobacteria suscep. #1
|
$12.03 |
$12.03 |
$12.03 |
$38.58
|
|
Air injection into abdomen 49400
|
$209.33 |
$209.33 |
$209.33 |
$525.00
|
|
Airway resistance by impulse oscillometry 94728
|
$269.36 |
$269.36 |
$269.36 |
$307.80
|
|
Albumin body fluid quantitative each specimen
|
$39.50 |
$39.50 |
$39.50 |
$42.81
|
|
Albumin (human), 25%, 50ml
|
$138.05 |
$138.05 |
$138.05 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$38.30 |
$38.30 |
$38.30 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$28.21 |
$28.21 |
$28.21 |
$40.00
|
|
Alkaline phosphatase
|
$27.29 |
$27.29 |
$27.29 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$24.48 |
$24.48 |
$24.48 |
$56.35
|
|
Allergen egg white ige
|
$36.82 |
$36.82 |
$36.82 |
$41.00
|
|
Alpha-fetoprotein amniotic
|
$54.95 |
$54.95 |
$54.95 |
$100.20
|
|
Alpha-fetoprotein tumor marker
|
$69.84 |
$69.84 |
$69.84 |
$115.70
|
|
Alt/sgpt
|
$31.73 |
$31.73 |
$31.73 |
$44.68
|
|
Aluminum - quest
|
$81.49 |
$81.49 |
$81.49 |
$114.40
|
|
Alys cplx sp/pn npgt w/prgrm
|
$183.89 |
$183.89 |
$183.89 |
$417.47
|
|
Aminolevulinic acid delta
|
$48.14 |
$48.14 |
$48.14 |
$95.80
|
|
Ammonia
|
$60.31 |
$60.31 |
$60.31 |
$96.53
|
|
Amniocentesisdiagnostic 59000
|
$368.15 |
$368.15 |
$368.15 |
$876.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,922.98 |
$1,922.98 |
$1,922.98 |
$3,730.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$28.90 |
$28.90 |
$28.90 |
$178.45
|
|
Amputate metacarpal bone 26910
|
$3,227.33 |
$3,227.33 |
$3,227.33 |
$3,591.33
|
|
Amylase
|
$30.16 |
$30.16 |
$30.16 |
$84.50
|
|
Anal/urinary muscle study
|
$403.02 |
$403.02 |
$403.02 |
$575.00
|
|
Analysis gene f2 20210g>a variant
|
$219.13 |
$219.13 |
$219.13 |
$244.00
|
|
Analysis gene f5 leiden variant
|
$219.13 |
$219.13 |
$219.13 |
$253.11
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$142.54 |
$142.54 |
$142.54 |
$411.45
|
|
Anca screen with reflex to titer -quest
|
$118.40 |
$118.40 |
$118.40 |
$112.45
|
|
An cholangiogram percutaneous compl
|
$375.64 |
$375.64 |
$375.64 |
$2,417.63
|
|
An fluoro guide for cvp
|
$49.12 |
$49.12 |
$49.12 |
$484.45
|
|
Ankle X-ray
|
$269.73 |
$269.73 |
$269.73 |
$325.59
|
|
Anogenital exam child w imag
|
$71.50 |
$71.50 |
$71.50 |
$195.96
|
|
Anoscopy remove fb 46608
|
$496.91 |
$496.91 |
$496.91 |
$1,278.72
|
|
Antibody bacterium, not elsewhere specified
|
$57.81 |
$57.81 |
$57.81 |
$57.85
|
|
Antibody elution rbc reference
|
$107.12 |
$107.12 |
$107.12 |
$163.80
|
|
Antibody htlv/hiv confirm test
|
$85.75 |
$85.75 |
$85.75 |
$154.85
|
|
Antibody htlv-i
|
$41.44 |
$41.44 |
$41.44 |
$49.53
|
|
Antibody htlv-ii
|
$66.60 |
$66.60 |
$66.60 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$218.30 |
$218.30 |
$218.30 |
$218.30
|
|
Antibody id rbc panel
|
$90.47 |
$90.47 |
$90.47 |
$258.40
|
|
Antibody influenza virus
|
$53.19 |
$53.19 |
$53.19 |
$63.33
|
|
Antibody lymphocytic choriomeningitis
|
$64.01 |
$64.01 |
$64.01 |
$57.85
|
|
Antibody screen rbc
|
$34.13 |
$34.13 |
$34.13 |
$102.05
|
|
Antibody tetanus
|
$87.41 |
$87.41 |
$87.41 |
$76.05
|
|
Antinuclear antibodies
|
$43.48 |
$43.48 |
$43.48 |
$97.60
|
|
Antinuclear antibodies titer
|
$60.87 |
$60.87 |
$60.87 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$55.13 |
$55.13 |
$55.13 |
$79.20
|
|
Antistreptolysin o titer
|
$47.27 |
$47.27 |
$47.27 |
$58.50
|
|
Antithrombin iii activity
|
$107.67 |
$107.67 |
$107.67 |
$135.20
|
|
Antithymocyte globuln rabbit
|
$942.89 |
$942.89 |
$942.89 |
$996.39
|
|
Apheresis plasma
|
$4,467.75 |
$4,467.75 |
$4,467.75 |
$3,498.41
|
|
Apheresis platelets
|
$1,629.39 |
$1,629.39 |
$1,629.39 |
$2,195.00
|
|
Apheresis rbc
|
$2,015.21 |
$2,015.21 |
$2,015.21 |
$2,896.50
|
|
Apheresis wbc
|
$3,793.52 |
$3,793.52 |
$3,793.52 |
$2,906.15
|
|
Apl(pml-rara) quant - sendout
|
$300.35 |
$300.35 |
$300.35 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,255.13 |
$1,255.13 |
$1,255.13 |
$2,078.20
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$504.77 |
$504.77 |
$504.77 |
$1,057.11
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$185.56 |
$185.56 |
$185.56 |
$552.00
|
|
Application finger splntstatic 29130
|
$201.47 |
$201.47 |
$201.47 |
$208.50
|
|
Application long leg splint 29505
|
$190.37 |
$190.37 |
$190.37 |
$338.25
|
|
Application lower leg splint 29515
|
$251.42 |
$251.42 |
$251.42 |
$345.60
|
|
Application of forearm cast 29075
|
$386.10 |
$386.10 |
$386.10 |
$375.00
|
|
Application of paste boot 29580
|
$255.30 |
$255.30 |
$255.30 |
$331.74
|
|
Application short leg cast 29405
|
$349.47 |
$349.47 |
$349.47 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,192.42 |
$1,192.42 |
$1,192.42 |
$2,109.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$21.55 |
$21.55 |
$21.55 |
$72.80
|
|
Apply hand/wrist cast 29085
|
$168.17 |
$168.17 |
$168.17 |
$264.75
|
|
Apply rem fixation device
|
$657.03 |
$657.03 |
$657.03 |
$1,858.61
|
|
Aquatic exercise - group charge
|
$32.75 |
$32.75 |
$32.75 |
$87.60
|
