|
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
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$59.44 |
$59.44 |
$59.44 |
$2,158.52
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$75.85 |
$75.85 |
$75.85 |
$53.95
|
|
Abciximab injection
|
$1,084.06 |
$1,084.06 |
$1,084.06 |
$1,084.06
|
|
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 abd perit om
|
$2,576.13 |
$2,576.13 |
$2,576.13 |
$2,566.58
|
|
Ablation cryo adrenal tumor
|
$2,897.47 |
$2,897.47 |
$2,897.47 |
$7,045.00
|
|
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
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$23.24 |
$23.24 |
$23.24 |
$45.63
|
|
Acetazolamide 500 mg solution for injection
|
$50.27 |
$50.27 |
$50.27 |
$97.26
|
|
Acetone qualitative
|
$40.15 |
$40.15 |
$40.15 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$320.66 |
$320.66 |
$320.66 |
$332.51
|
|
Acne surgery 10040
|
$81.96 |
$81.96 |
$81.96 |
$234.00
|
|
Acute hepatitis panel
|
$125.62 |
$125.62 |
$125.62 |
$297.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$11.99 |
$11.99 |
$11.99 |
$48.72
|
|
#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
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$0.51 |
$0.51 |
$0.51 |
$136.99
|
|
Administration chemotherapy IV infusion each additional hour
|
$71.78 |
$71.78 |
$71.78 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$77.70 |
$77.70 |
$77.70 |
$319.15
|
|
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 hormonal
|
$56.89 |
$56.89 |
$56.89 |
$222.14
|
|
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
|
|
Administration vaccine hepatitis b
|
$35.34 |
$35.34 |
$35.34 |
$38.25
|
|
Administration vaccine influenza virus
|
$21.83 |
$21.83 |
$21.83 |
$38.25
|
|
Administration vaccine pneumococcal
|
$21.83 |
$21.83 |
$21.83 |
$38.25
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$69.82 |
$69.82 |
$69.82 |
$59.76
|
|
#afb mycobacteria suscep. #1
|
$12.03 |
$12.03 |
$12.03 |
$38.58
|
|
Aflibercept injection
|
$2,738.00 |
$2,738.00 |
$2,738.00 |
$2,738.00
|
|
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, human 25 % intravenous solution
|
$36.72 |
$36.72 |
$36.72 |
$36.72
|
|
Albumin (human), 5%, 250 ml
|
$551.82 |
$551.82 |
$551.82 |
$292.58
|
|
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
|
|
Aldesleukin injection
|
$2,310.41 |
$2,310.41 |
$2,310.41 |
$5,301.26
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$27,257.23 |
$27,257.23 |
$27,257.23 |
$3,012.68
|
|
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-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$13.14 |
$13.14 |
$13.14 |
$13.14
|
|
Alpha-fetoprotein amniotic
|
$54.95 |
$54.95 |
$54.95 |
$100.20
|
|
Alpha-fetoprotein tumor marker
|
$69.84 |
$69.84 |
$69.84 |
$115.70
|
|
Alteplase 100 mg infusion from pyxis vial
|
$5,084.26 |
$5,084.26 |
$5,084.26 |
$285.00
|
|
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
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$36.30 |
$36.30 |
$36.30 |
$36.30
|
|
Aminolevulinic acid delta
|
$48.14 |
$48.14 |
$48.14 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$16.58 |
$16.58 |
$16.58 |
$41.59
|
|
Amiodarone 50 mg/ml intravenous solution
|
$58.46 |
$58.46 |
$58.46 |
$42.92
|
|
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 in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$47.45 |
$47.45 |
$47.45 |
$130.08
|
|
Amphotericin b lipid complex
|
$270.17 |
$270.17 |
$270.17 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$28.90 |
$28.90 |
$28.90 |
$178.45
|
|
Ampicillin 1 gram solution for injection
|
$14.69 |
$14.69 |
$14.69 |
$44.25
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$14.42 |
$14.42 |
$14.42 |
$43.20
|
|
Amputate metacarpal bone 26910
|
$3,227.33 |
$3,227.33 |
$3,227.33 |
$3,591.33
|
|
Amputation toe interphalangeal joint
|
$2,179.86 |
$2,179.86 |
$2,179.86 |
$3,594.44
|
|
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
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$44,765.71 |
$44,765.71 |
$44,765.71 |
$44,765.71
|
|
Anidulafungin injection
|
$81.60 |
$81.60 |
$81.60 |
$116.22
|
|
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
|
