|
17-hydroxypregnenolone
|
$76.00 |
$76.00 |
$76.00 |
$90.90
|
|
2nd order venous cath
|
$879.50 |
$879.50 |
$879.50 |
$1,497.85
|
|
3-d radiotherapy plan
|
$1,021.50 |
$1,021.50 |
$1,021.50 |
$4,965.20
|
|
3d recon without postprocess indpndt
|
$5,040.50 |
$5,040.50 |
$5,040.50 |
$505.05
|
|
88334 ap bill cytologic exam each additional site
|
$45.00 |
$45.00 |
$45.00 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$3,247.50 |
$3,247.50 |
$3,247.50 |
$3,587.50
|
|
Abd/low ext cath 1st
|
$1,772.00 |
$1,772.00 |
$1,772.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,169.00 |
$1,169.00 |
$1,169.00 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$997.50 |
$997.50 |
$997.50 |
$2,417.40
|
|
Abd/low ext cath addl
|
$1,189.50 |
$1,189.50 |
$1,189.50 |
$963.76
|
|
Abdominal CT scan (with and without contrast)
|
$5,056.00 |
$5,056.00 |
$5,056.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$3,779.00 |
$3,779.00 |
$3,779.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$3,078.50 |
$3,078.50 |
$3,078.50 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,824.00 |
$3,824.00 |
$3,824.00 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,824.00 |
$3,824.00 |
$3,824.00 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$3,009.50 |
$3,009.50 |
$3,009.50 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,533.50 |
$2,533.50 |
$2,533.50 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$2,404.50 |
$2,404.50 |
$2,404.50 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$2,272.00 |
$2,272.00 |
$2,272.00 |
$581.10
|
|
Abd paracentesis/w/o image guide 49082
|
$1,656.00 |
$1,656.00 |
$1,656.00 |
$1,145.00
|
|
Abl1 gene
|
$674.50 |
$674.50 |
$674.50 |
$683.20
|
|
Ablate bone tumor(s) perq
|
$5,056.50 |
$5,056.50 |
$5,056.50 |
$9,437.59
|
|
Ablation cardiac vagal inputs atrium
|
$3,592.50 |
$3,592.50 |
$3,592.50 |
$2,260.30
|
|
Ablation cryo pq liver tumor(s)
|
$3,045.00 |
$3,045.00 |
$3,045.00 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$2,962.50 |
$2,962.50 |
$2,962.50 |
$2,999.34
|
|
Acetaminophen level
|
$186.50 |
$186.50 |
$186.50 |
$111.00
|
|
Acetone qualitative
|
$171.50 |
$171.50 |
$171.50 |
$47.50
|
|
Acetylcholine receptor modulating antibody
|
$100.00 |
$100.00 |
$100.00 |
$66.28
|
|
Acute hepatitis panel
|
$282.50 |
$282.50 |
$282.50 |
$284.70
|
|
#acylcarnitineprfl
|
$159.00 |
$159.00 |
$159.00 |
$118.85
|
|
Adapter b 8 channel 10cm
|
$4,101.00 |
$4,101.00 |
$4,101.00 |
$6,142.50
|
|
Adh-sendout
|
$105.00 |
$105.00 |
$105.00 |
$114.50
|
|
Administration chemotherapy IV infusion each additional hour
|
$161.00 |
$161.00 |
$161.00 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$321.50 |
$321.50 |
$321.50 |
$647.50
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$250.50 |
$250.50 |
$250.50 |
$254.40
|
|
Administration immunization 1 vaccine
|
$79.50 |
$79.50 |
$79.50 |
$67.60
|
|
Administration immunization each additional vaccine
|
$79.50 |
$79.50 |
$79.50 |
$46.89
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$21.00 |
$21.00 |
$21.00 |
$42.00
|
|
Administration vaccine hepatitis b
|
$38.00 |
$38.00 |
$38.00 |
$51.80
|
|
Administration vaccine influenza virus
|
$79.00 |
$79.00 |
$79.00 |
$48.73
|
|
Administration vaccine pneumococcal
|
$119.50 |
$119.50 |
$119.50 |
$48.73
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$21.00 |
$21.00 |
$21.00 |
$41.45
|
|
Adrenal cortex & medulla img
|
$4,881.50 |
$4,881.50 |
$4,881.50 |
$1,951.60
|
|
_afb id by dna probe rflx ast
|
$236.00 |
$236.00 |
$236.00 |
$104.50
|
|
Afo supramalleolar custom
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$1,182.83
|
|
Airway resistance by impulse oscillometry 94728
|
$555.50 |
$555.50 |
$555.50 |
$289.20
|
|
Albumin body fluid quantitative each specimen
|
$231.00 |
$231.00 |
$231.00 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$277.50 |
$277.50 |
$277.50 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$135.00 |
$135.00 |
$135.00 |
$42.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$432.50 |
$432.50 |
$432.50 |
$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
|
$330.50 |
$330.50 |
$330.50 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$170.00 |
$170.00 |
$170.00 |
$48.57
|
|
Allergen egg white ige
|
$46.00 |
$46.00 |
$46.00 |
$37.20
|
|
Allograft 160mg placental salera mini membrane
|
$31.50 |
$31.50 |
$31.50 |
$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
|
$8,300.00 |
$8,300.00 |
$8,300.00 |
$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
|
$238.00 |
$238.00 |
$238.00 |
$189.15
|
|
Alpha-fetoprotein tumor marker
|
$467.50 |
$467.50 |
$467.50 |
$103.80
|
|
Alt/sgpt
|
$330.50 |
$330.50 |
$330.50 |
$47.40
|
|
Alys cplx sp/pn npgt w/prgrm
|
$576.00 |
$576.00 |
$576.00 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$373.00 |
$373.00 |
$373.00 |
$179.70
|
|
Aminolevulinic acid delta
|
$107.50 |
$107.50 |
$107.50 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$79.00 |
$79.00 |
$79.00 |
$84.56
|
|
Ammonia
|
$374.50 |
$374.50 |
$374.50 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$745.00 |
$745.00 |
$745.00 |
$923.50
|
|
Amphetamines 5 or more
|
$80.50 |
$80.50 |
$80.50 |
$90.48
|
|
Amylase
|
$284.50 |
$284.50 |
$284.50 |
$89.04
|
|
Anal pressure record
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$946.24
|
|
Analysis gene f2 20210g>a variant
|
$366.50 |
$366.50 |
$366.50 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$611.50 |
$611.50 |
$611.50 |
$237.60
|
|
Analysis nerve
|
$148.50 |
$148.50 |
$148.50 |
$262.40
|
|
Anca screen with reflex to titer -quest
|
$219.00 |
$219.00 |
$219.00 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$2,235.00 |
$2,235.00 |
$2,235.00 |
$2,494.35
|
|
An fluoro guide for cvp
|
$1,164.50 |
$1,164.50 |
$1,164.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$5,728.50 |
$5,728.50 |
$5,728.50 |
$5,500.00
|
|
Angioplasty fem/pop unilat 37224
|
$6,899.50 |
$6,899.50 |
$6,899.50 |
$8,835.00
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$6,956.50 |
$6,956.50 |
$6,956.50 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$14,315.50 |
$14,315.50 |
$14,315.50 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$6,247.00 |
$6,247.00 |
$6,247.00 |
$10,513.36
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,901.50 |
$3,901.50 |
$3,901.50 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$3,901.50 |
$3,901.50 |
$3,901.50 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$2,372.00 |
$2,372.00 |
$2,372.00 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$2,372.00 |
$2,372.00 |
$2,372.00 |
$8,466.00
|
|
Ankle X-ray
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
$352.80
|
|
Anora (draw only)
|
$223.00 |
$223.00 |
$223.00 |
$35.00
|
|
Anterior thoracic extension
|
$525.00 |
$525.00 |
$525.00 |
$496.80
|
|
Antibody elution rbc reference
|
$189.50 |
$189.50 |
$189.50 |
$175.50
|
|
Antibody htlv-i
|
$56.50 |
$56.50 |
$56.50 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$600.50 |
$600.50 |
$600.50 |
$219.30
|
|
Antibody id rbc panel
|
$417.00 |
$417.00 |
$417.00 |
$290.21
|
|
Antibody influenza virus
|
$149.00 |
$149.00 |
$149.00 |
$53.90
|
