|
1st psyc collab care mgmt
|
$72.00 |
$72.00 |
$72.00 |
$109.46
|
|
1st/sbsq psyc collab care
|
$36.00 |
$36.00 |
$36.00 |
$107.43
|
|
2nd order venous cath
|
$1,577.00 |
$1,577.00 |
$1,577.00 |
$1,497.85
|
|
3-d radiotherapy plan
|
$5,649.00 |
$5,649.00 |
$5,649.00 |
$4,965.20
|
|
3d recon without postprocess indpndt
|
$372.00 |
$372.00 |
$372.00 |
$505.05
|
|
88334 ap bill cytologic exam each additional site
|
$106.50 |
$106.50 |
$106.50 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$4,429.00 |
$4,429.00 |
$4,429.00 |
$3,587.50
|
|
Abd/low ext cath 1st
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,160.50 |
$1,160.50 |
$1,160.50 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$2,417.40
|
|
Abd/low ext cath addl
|
$1,453.50 |
$1,453.50 |
$1,453.50 |
$963.76
|
|
Abdominal CT scan (with and without contrast)
|
$3,308.50 |
$3,308.50 |
$3,308.50 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,333.00 |
$2,333.00 |
$2,333.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,724.50 |
$1,724.50 |
$1,724.50 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,705.50 |
$4,705.50 |
$4,705.50 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$4,575.00 |
$4,575.00 |
$4,575.00 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$4,278.50 |
$4,278.50 |
$4,278.50 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,041.00 |
$2,041.00 |
$2,041.00 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$1,088.00 |
$1,088.00 |
$1,088.00 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$973.00 |
$973.00 |
$973.00 |
$581.10
|
|
Abl1 gene
|
$755.50 |
$755.50 |
$755.50 |
$683.20
|
|
Ablate arrhythmia add on
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$11,372.00 |
$11,372.00 |
$11,372.00 |
$9,476.33
|
|
Ablation cardiac vagal inputs atrium
|
$2,817.00 |
$2,817.00 |
$2,817.00 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$2,260.00 |
$2,260.00 |
$2,260.00 |
$2,312.80
|
|
Ablation of upper extremity nerves rf
|
$263.50 |
$263.50 |
$263.50 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$3,973.50 |
$3,973.50 |
$3,973.50 |
$2,999.34
|
|
Acetaminophen level
|
$139.00 |
$139.00 |
$139.00 |
$111.00
|
|
Acetone qualitative
|
$45.00 |
$45.00 |
$45.00 |
$47.50
|
|
Acetylcholine receptor modulating antibody
|
$100.00 |
$100.00 |
$100.00 |
$66.28
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$83.00 |
$83.00 |
$83.00 |
$344.10
|
|
Acute hepatitis panel
|
$684.00 |
$684.00 |
$684.00 |
$284.70
|
|
Adapter b 8 channel 10cm
|
$4,979.00 |
$4,979.00 |
$4,979.00 |
$6,142.50
|
|
Adh-sendout
|
$102.00 |
$102.00 |
$102.00 |
$114.50
|
|
Administration chemotherapy IV infusion each additional hour
|
$248.00 |
$248.00 |
$248.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$248.00 |
$248.00 |
$248.00 |
$298.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$778.50 |
$778.50 |
$778.50 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$367.50 |
$367.50 |
$367.50 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$135.50 |
$135.50 |
$135.50 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$180.00 |
$180.00 |
$180.00 |
$254.40
|
|
Administration immunization 1 vaccine
|
$96.00 |
$96.00 |
$96.00 |
$67.60
|
|
Administration immunization each additional vaccine
|
$98.00 |
$98.00 |
$98.00 |
$46.89
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$22.00 |
$22.00 |
$22.00 |
$42.00
|
|
Administration vaccine hepatitis b
|
$65.50 |
$65.50 |
$65.50 |
$51.80
|
|
Administration vaccine influenza virus
|
$59.00 |
$59.00 |
$59.00 |
$48.73
|
|
Administration vaccine pneumococcal
|
$59.00 |
$59.00 |
$59.00 |
$48.73
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$22.00 |
$22.00 |
$22.00 |
$41.45
|
|
Adrenal cortex & medulla img
|
$2,324.50 |
$2,324.50 |
$2,324.50 |
$1,951.60
|
|
Aep neurodiagnostic i&r
|
$224.50 |
$224.50 |
$224.50 |
$583.80
|
|
_afb id by dna probe rflx ast
|
$262.50 |
$262.50 |
$262.50 |
$104.50
|
|
Afo supramalleolar custom
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$1,182.83
|
|
Air injection into abdomen 49400
|
$747.50 |
$747.50 |
$747.50 |
$520.00
|
|
Airway resistance by impulse oscillometry 94728
|
$850.50 |
$850.50 |
$850.50 |
$289.20
|
|
Albumin body fluid quantitative each specimen
|
$92.50 |
$92.50 |
$92.50 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$342.00 |
$342.00 |
$342.00 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$80.50 |
$80.50 |
$80.50 |
$42.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$122.00 |
$122.00 |
$122.00 |
$94.90
|
|
Alginate dressing <=16 sq in
|
$53.00 |
$53.00 |
$53.00 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$83.50 |
$83.50 |
$83.50 |
$43.72
|
|
Alkaline phosphatase
|
$110.50 |
$110.50 |
$110.50 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$170.00 |
$170.00 |
$170.00 |
$48.57
|
|
Allergen egg white ige
|
$51.00 |
$51.00 |
$51.00 |
$37.20
|
|
Allograft 160mg placental salera mini membrane
|
$45.00 |
$45.00 |
$45.00 |
$6,022.57
|
|
Allograft amnioexcel plus 17mm disk
|
$341.50 |
$341.50 |
$341.50 |
$507.30
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,013.50 |
$7,013.50 |
$7,013.50 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$382.00 |
$382.00 |
$382.00 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$226.00 |
$226.00 |
$226.00 |
$21,790.11
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$571.50 |
$571.50 |
$571.50 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$885.50 |
$885.50 |
$885.50 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$12,488.00 |
$12,488.00 |
$12,488.00 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$451.50 |
$451.50 |
$451.50 |
$1,777.39
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$205.50 |
$205.50 |
$205.50 |
$189.15
|
|
Alpha-fetoprotein tumor marker
|
$343.50 |
$343.50 |
$343.50 |
$103.80
|
|
Alt/sgpt
|
$153.00 |
$153.00 |
$153.00 |
$47.40
|
|
Amantadine (symmetrel)-sendout
|
$311.00 |
$311.00 |
$311.00 |
$179.70
|
|
Aminolevulinic acid delta
|
$104.00 |
$104.00 |
$104.00 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$166.00 |
$166.00 |
$166.00 |
$84.56
|
|
Ammonia
|
$321.50 |
$321.50 |
$321.50 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,745.50 |
$1,745.50 |
$1,745.50 |
$923.50
|
|
Amphetamines 5 or more
|
$80.50 |
$80.50 |
$80.50 |
$90.48
|
|
Amylase
|
$152.00 |
$152.00 |
$152.00 |
$89.04
|
|
Anal pressure record
|
$1,511.00 |
$1,511.00 |
$1,511.00 |
$946.24
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$143.50 |
$143.50 |
$143.50 |
$335.85
|
|
Analysis gene f2 20210g>a variant
|
$231.50 |
$231.50 |
$231.50 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$452.50 |
$452.50 |
$452.50 |
$237.60
|
|
Analysis nerve
|
$126.50 |
$126.50 |
$126.50 |
$262.40
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$45.50 |
$45.50 |
$45.50 |
$123.84
|
|
Anca screen with reflex to titer -quest
|
$243.50 |
$243.50 |
$243.50 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$2,874.50 |
$2,874.50 |
$2,874.50 |
$2,494.35
|
|
An fluoro guide for cvp
|
$661.50 |
$661.50 |
$661.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$15,488.00 |
$15,488.00 |
$15,488.00 |
$5,500.00
|
|
Angioplasty fem/pop unilat 37224
|
$14,770.50 |
$14,770.50 |
$14,770.50 |
$8,835.00
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$14,770.50 |
$14,770.50 |
$14,770.50 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$14,770.50 |
$14,770.50 |
$14,770.50 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$14,770.50 |
$14,770.50 |
$14,770.50 |
$10,513.36
|
|
Angio trnslmnl balloon same artery ea addl
|
$9,958.50 |
$9,958.50 |
$9,958.50 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$25,731.00 |
$25,731.00 |
$25,731.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$23,846.50 |
$23,846.50 |
$23,846.50 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$25,731.00 |
$25,731.00 |
$25,731.00 |
$8,466.00
|
|
Ankle X-ray
|
$359.00 |
$359.00 |
$359.00 |
$352.80
|
