|
11-desoxycortisol - sendout
|
$493.80 |
$493.80 |
$493.80 |
$91.85
|
|
17-hydroxypregnenolone
|
$307.20 |
$307.20 |
$307.20 |
$92.65
|
|
17-ketosteroids
|
$343.20 |
$343.20 |
$343.20 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$848.40 |
$848.40 |
$848.40 |
$1,724.25
|
|
2d tte w or without fol w/con,co
|
$848.40 |
$848.40 |
$848.40 |
$1,284.00
|
|
2nd order venous cath
|
$438.00 |
$438.00 |
$438.00 |
$1,532.04
|
|
3d ech img cgen car anomal
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$511.60
|
|
3-d radiotherapy plan
|
$4,344.00 |
$4,344.00 |
$4,344.00 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$697.20 |
$697.20 |
$697.20 |
$508.13
|
|
5' nucleotidase - sendout
|
$243.00 |
$243.00 |
$243.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$91.20 |
$91.20 |
$91.20 |
$100.10
|
|
99382 initial comp preventive med 1 to 4 years new
|
$117.00 |
$117.00 |
$117.00 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$97.20 |
$97.20 |
$97.20 |
$131.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$82.80 |
$82.80 |
$82.80 |
$117.72
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$98.40 |
$98.40 |
$98.40 |
$132.30
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$82.80 |
$82.80 |
$82.80 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$86.40 |
$86.40 |
$86.40 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$103.20 |
$103.20 |
$103.20 |
$164.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$258.40 |
$258.40 |
$258.40 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$115.80 |
$115.80 |
$115.80 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$4,443.00 |
$4,443.00 |
$4,443.00 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$948.00 |
$948.00 |
$948.00 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$1,129.20 |
$1,129.20 |
$1,129.20 |
$2,475.45
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,265.40 |
$1,265.40 |
$1,265.40 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$3,476.40 |
$3,476.40 |
$3,476.40 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,772.60 |
$2,772.60 |
$2,772.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,010.40 |
$4,010.40 |
$4,010.40 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,689.00 |
$1,689.00 |
$1,689.00 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$916.80 |
$916.80 |
$916.80 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$690.60 |
$690.60 |
$690.60 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$327.00 |
$327.00 |
$327.00 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$504.00 |
$504.00 |
$504.00 |
$418.63
|
|
Abdominal X-ray (single view)
|
$538.20 |
$538.20 |
$538.20 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$971.40 |
$971.40 |
$971.40 |
$1,148.40
|
|
Abl1 gene
|
$3,217.80 |
$3,217.80 |
$3,217.80 |
$683.20
|
|
Ablate arrhythmia add on
|
$5,650.20 |
$5,650.20 |
$5,650.20 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$4,569.60 |
$4,569.60 |
$4,569.60 |
$9,332.05
|
|
Ablate pulm tumor perq crybl
|
$24,227.40 |
$24,227.40 |
$24,227.40 |
$9,970.50
|
|
Ablation cryo abd perit om
|
$122.40 |
$122.40 |
$122.40 |
$2,312.80
|
|
Ablation of upper extremity nerves rf
|
$825.60 |
$825.60 |
$825.60 |
$832.50
|
|
Abobotulinumtoxina
|
$61.20 |
$61.20 |
$61.20 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$4,627.80 |
$4,627.80 |
$4,627.80 |
$3,050.40
|
|
Absorpt drg >16<=48 in w/bdr
|
$1.80 |
$1.80 |
$1.80 |
$5.99
|
|
Absorpt drg <=16 sq in w/bdr
|
$0.60 |
$0.60 |
$0.60 |
$13.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$2.40 |
$2.40 |
$2.40 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$256.80 |
$256.80 |
$256.80 |
$122.55
|
|
Acetone qualitative
|
$59.40 |
$59.40 |
$59.40 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$274.80 |
$274.80 |
$274.80 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,044.60 |
$1,044.60 |
$1,044.60 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$92.80 |
$92.80 |
$92.80 |
$31.21
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$417.00 |
$417.00 |
$417.00 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$20.40 |
$20.40 |
$20.40 |
$38.50
|
|
Acute hepatitis panel
|
$762.60 |
$762.60 |
$762.60 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$13.20 |
$13.20 |
$13.20 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$74.40 |
$74.40 |
$74.40 |
$64.45
|
|
#acylcarnitineprfl
|
$222.60 |
$222.60 |
$222.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$496.20 |
$496.20 |
$496.20 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$382.20 |
$382.20 |
$382.20 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$91.80 |
$91.80 |
$91.80 |
$58.00
|
|
Adhesive, liquid or equal
|
$2,338.80 |
$2,338.80 |
$2,338.80 |
$14.40
|
|
Adh-sendout
|
$311.40 |
$311.40 |
$311.40 |
$118.79
|
|
Adj gastric band via subq port
|
$3,526.20 |
$3,526.20 |
$3,526.20 |
$1,666.86
|
|
Adjmt/revj ext fixj sys anes
|
$4,493.40 |
$4,493.40 |
$4,493.40 |
$8,261.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$120.00 |
$120.00 |
$120.00 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$223.20 |
$223.20 |
$223.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$223.20 |
$223.20 |
$223.20 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$808.20 |
$808.20 |
$808.20 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$508.20 |
$508.20 |
$508.20 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$223.20 |
$223.20 |
$223.20 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$223.20 |
$223.20 |
$223.20 |
$256.49
|
|
Administration immunization each additional component
|
$48.60 |
$48.60 |
$48.60 |
$29.20
|
|
Administration immunization each additional vaccine
|
$12.00 |
$12.00 |
$12.00 |
$47.40
|
|
Administration immunization first component each vaccine
|
$234.60 |
$234.60 |
$234.60 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$12.00 |
$12.00 |
$12.00 |
$48.00
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$24.00 |
$24.00 |
$24.00 |
$44.80
|
|
Administration vaccine hepatitis b
|
$12.00 |
$12.00 |
$12.00 |
$53.00
|
|
Administration vaccine influenza virus
|
$12.00 |
$12.00 |
$12.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$12.00 |
$12.00 |
$12.00 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$24.00 |
$24.00 |
$24.00 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$139.20 |
$139.20 |
$139.20 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$1,703.40 |
$1,703.40 |
$1,703.40 |
$1,987.70
|
|
Aep neurodiagnostic i&r
|
$243.60 |
$243.60 |
$243.60 |
$583.80
|
|
Afamelanotide implant, 1 mg
|
$6,227.40 |
$6,227.40 |
$6,227.40 |
$78,638.30
|
|
_afb id by dna probe rflx ast
|
$141.00 |
$141.00 |
$141.00 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$1,507.80 |
$1,507.80 |
$1,507.80 |
$300.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$27,295.80 |
$27,295.80 |
$27,295.80 |
$14,475.20
|
|
Albumin body fluid quantitative each specimen
|
$63.60 |
$63.60 |
$63.60 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$304.00 |
$304.00 |
$304.00 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$682.40 |
$682.40 |
$682.40 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$349.20 |
$349.20 |
$349.20 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$66.60 |
$66.60 |
$66.60 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$13.80 |
$13.80 |
$13.80 |
$5.67
|
|
Albuterol non-comp con
|
$5.00 |
$5.00 |
$5.00 |
$6.07
|
|
Albuterol non-comp unit
|
$10.00 |
$10.00 |
$10.00 |
$5.40
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$364.80 |
$364.80 |
$364.80 |
$47,974.31
|
