|
11-desoxycortisol - sendout
|
$70.40 |
$70.40 |
$70.40 |
|
|
17-hydroxypregnenolone
|
$69.60 |
$69.60 |
$69.60 |
|
|
2d tee w or without fol w/con,in
|
$3,110.40 |
$3,110.40 |
$3,110.40 |
|
|
2nd order venous cath
|
$2,421.60 |
$2,421.60 |
$3,410.40 |
|
|
3-d radiotherapy plan
|
$7,427.20 |
$7,427.20 |
$7,427.20 |
|
|
3d recon without postprocess indpndt
|
$593.60 |
$602.40 |
$893.60 |
|
|
5% dextrose and 0.45% saline
|
$40.00 |
$86.40 |
$148.40 |
|
|
5' nucleotidase - sendout
|
$96.80 |
$96.80 |
$96.80 |
|
|
88334 ap bill cytologic exam each additional site
|
$60.00 |
$67.20 |
$117.60 |
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,718.76 |
$2,288.00 |
$4,019.00 |
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$56.80 |
$56.80 |
$56.80 |
|
|
Abd aorta w/runoff s&i
|
$4,628.00 |
$4,628.00 |
$4,833.60 |
|
|
Abd/low ext cath 1st
|
$2,797.60 |
$2,797.60 |
$2,995.20 |
|
|
Abd/low ext cath 2nd
|
$2,120.80 |
$2,120.80 |
$3,446.40 |
|
|
Abd/low ext cath 3rd
|
$3,314.40 |
$3,314.40 |
$4,012.80 |
|
|
Abd/low ext cath addl
|
$1,226.40 |
$1,226.40 |
$1,264.80 |
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,120.80 |
$1,183.20 |
$1,623.20 |
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$820.80 |
$868.80 |
$984.00 |
|
|
Abdominal CT scan (with and without contrast)
|
$2,209.60 |
$2,796.00 |
$3,160.00 |
|
|
Abdominal CT scan (with contrast)
|
$2,384.00 |
$2,656.00 |
$3,044.00 |
|
|
Abdominal CT scan (without contrast)
|
$1,718.40 |
$2,214.40 |
$2,429.60 |
|
|
Abdominal MRI (with and without contrast)
|
$3,804.00 |
$3,937.60 |
$4,865.60 |
|
|
Abdominal MRI (with contrast)
|
$3,056.80 |
$3,154.40 |
$3,488.80 |
|
|
Abdominal MRI (without contrast)
|
$2,850.40 |
$2,978.40 |
$3,511.20 |
|
|
Abdominal paracentesis w/image guidance
|
$1,840.00 |
$1,892.80 |
$1,980.00 |
|
|
Abdominal Ultrasound (complete)
|
$877.60 |
$965.60 |
$1,129.60 |
|
|
Abdominal Ultrasound (limited)
|
$705.60 |
$748.80 |
$824.80 |
|
|
Abdominal X-ray (2 views)
|
$280.80 |
$387.20 |
$484.00 |
|
|
Abdominal X-ray Series (acute, with chest view)
|
$358.40 |
$571.20 |
$628.00 |
|
|
Abdominal X-ray (single view)
|
$227.20 |
$307.20 |
$395.20 |
|
|
Abd paracentesis/w/o image guide 49082
|
$1,070.40 |
$1,170.40 |
$1,499.20 |
|
|
Ablat 1/+thyr ndul addl prq rf
|
$4,207.20 |
$4,207.20 |
$4,207.20 |
|
|
Ablate arrhythmia add on
|
$14,762.40 |
$14,762.40 |
$14,762.40 |
|
|
Ablate bone tumor(s) cryo perq 20983
|
$12,567.20 |
$12,567.20 |
$12,567.20 |
|
|
Ablate bone tumor(s) perq
|
$11,271.20 |
$11,271.20 |
$11,768.00 |
|
|
Ablate heart dysrhythm focus
|
$15,506.40 |
$15,506.40 |
$15,506.40 |
|
|
Ablate pulm tumor perq crybl
|
$12,778.40 |
$12,778.40 |
$12,778.40 |
|
|
Ablate pulm tumor perq rf
|
$10,904.80 |
$10,904.80 |
$11,995.20 |
|
|
Ablation cardiac vagal inputs atrium
|
$1,594.40 |
$1,594.40 |
$18,356.80 |
|
|
Ablation cryo abd perit om
|
$9,032.80 |
$9,032.80 |
$9,210.40 |
|
|
Ablation cryo adrenal tumor
|
$8,333.60 |
$8,333.60 |
$8,333.60 |
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$3,445.60 |
$3,445.60 |
$4,594.40 |
|
|
Ablation cryo pq liver tumor(s)
|
$10,228.00 |
$10,228.00 |
$10,228.00 |
|
|
Ablation cryo retro lymph node
|
$2,548.80 |
$2,548.80 |
$2,845.60 |
|
|
Ablation cryo thigh/knee
|
$3,812.80 |
$4,324.80 |
$5,760.80 |
|
|
Ablation of upper extremity nerves rf
|
$2,614.40 |
$2,614.40 |
$4,342.40 |
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$8,415.20 |
$8,415.20 |
$8,415.20 |
|
|
Abobotulinumtoxina
|
$1,307.51 |
$1,307.51 |
$1,307.51 |
|
|
Abscess drain retroperitoneal surg code
|
$3,902.40 |
$3,902.40 |
$5,676.00 |
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$4,374.40 |
$4,374.40 |
$4,374.40 |
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$75.72 |
$138.76 |
$329.44 |
|
|
Acetaminophen level
|
$43.20 |
$53.60 |
$161.60 |
|
|
Acetazolamide 500 mg solution for injection
|
$78.55 |
$78.55 |
$340.70 |
|
|
Acetone qualitative
|
$28.00 |
$31.20 |
$48.00 |
|
|
Acetylcholine receptor modulating antibody
|
$65.60 |
$65.60 |
$95.20 |
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$90.84 |
$90.84 |
$659.28 |
|
|
Acetylcysteine non-comp unit
|
$10.12 |
$23.87 |
$43.42 |
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$273.60 |
$412.80 |
$428.00 |
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$33.60 |
$44.80 |
$55.20 |
|
|
Acoustic immitance testing
|
$100.00 |
$100.00 |
$100.00 |
|
|
Acute hepatitis panel
|
$231.20 |
$265.60 |
$344.00 |
|
|
Acyclovir 400 mg tablet
|
$4.10 |
$212.11 |
$402.12 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$61.59 |
$62.48 |
$355.04 |
|
|
#acylcarnitineprfl
|
$49.60 |
$49.60 |
$52.80 |
|
|
Adapter b 8 channel 10cm
|
$6,390.40 |
$6,390.40 |
$6,390.40 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$61.59 |
$61.59 |
$347.66 |
|
|
Adh-sendout
|
$120.00 |
$164.00 |
$240.80 |
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$5,828.00 |
$5,828.00 |
$5,828.00 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$22.86 |
$32.31 |
$52.96 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$197.60 |
$292.00 |
$393.60 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$337.60 |
$386.40 |
$426.40 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$673.60 |
$768.00 |
$988.80 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$369.60 |
$496.80 |
$588.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$212.80 |
$232.80 |
$376.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$220.00 |
$297.60 |
$328.80 |
|
|
Administration immunization each additional component
|
$29.60 |
$29.60 |
$29.60 |
|
|
Administration immunization each additional vaccine
|
$40.80 |
$55.20 |
$105.60 |
|
|
Administration immunization first component each vaccine
|
$47.20 |
$47.20 |
$47.20 |
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$32.80 |
$35.20 |
$104.00 |
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$31.20 |
$32.80 |
$88.80 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$8,200.70 |
$8,200.70 |
$8,200.70 |
|
|
Aep hearing status deter i&r
|
$144.00 |
$144.00 |
$356.80 |
|
|
Aep neurodiagnostic i&r
|
$551.20 |
$551.20 |
$551.20 |
|
|
Aep thrshld est mlt freq i&r
|
$417.60 |
$417.60 |
$564.80 |
|
|
_afb id by dna probe rflx ast
|
$65.60 |
$69.60 |
$80.00 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$308.00 |
$308.00 |
$308.00 |
|
|
Afo w/ankle joint, prefab
|
$141.60 |
$141.60 |
$141.60 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$22,036.92 |
$22,036.92 |
$22,036.92 |
|
|
Air conduction bilat
|
$140.80 |
$140.80 |
$140.80 |
|
|
Air injection into abdomen 49400
|
$967.20 |
$967.20 |
$1,367.20 |
|
|
Albumin body fluid quantitative each specimen
|
$25.60 |
$36.00 |
$48.00 |
|
|
Albumin (human), 25%, 50ml
|
$124.15 |
$175.03 |
$670.80 |
|
|
Albumin (human), 5%, 250 ml
|
$86.60 |
$86.60 |
$360.80 |
|
|
Albumin, human 5 % intravenous solution
|
$359.60 |
$359.60 |
$359.60 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$43.20 |
$96.80 |
$141.60 |
|
|
Albumin serum plasma or whole blood
|
$31.20 |
$40.00 |
$83.20 |
|
|
Albuterol ipratrop non-comp
|
$1.28 |
$4.00 |
$4.82 |
|
|
Albuterol non-comp con
|
$3.60 |
$18.37 |
$70.17 |
|
|
Albuterol non-comp unit
|
$1.76 |
$4.16 |
$5.40 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$84.00 |
$98.40 |
$161.60 |
|
