|
3d recon without postprocess indpndt
|
$593.60 |
$593.60 |
$593.60 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$60.00 |
$60.00 |
$60.00 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$67.20 |
$67.20 |
$67.20 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,162.20 |
$2,162.20 |
$2,162.20 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$820.80 |
$820.80 |
$820.80 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,209.60 |
$2,209.60 |
$2,209.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,384.00 |
$2,384.00 |
$2,384.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,718.40 |
$1,718.40 |
$1,718.40 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,804.00 |
$3,804.00 |
$3,804.00 |
$2,967.00
|
|
Abdominal MRI (without contrast)
|
$2,850.40 |
$2,850.40 |
$2,850.40 |
$2,048.36
|
|
Abdominal Ultrasound (complete)
|
$934.40 |
$934.40 |
$934.40 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$720.80 |
$720.80 |
$720.80 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$280.80 |
$280.80 |
$280.80 |
$318.20
|
|
Abdominal X-ray (single view)
|
$227.20 |
$227.20 |
$227.20 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,170.40 |
$1,170.40 |
$1,170.40 |
$1,148.40
|
|
Ablation cryo thigh/knee
|
$3,812.80 |
$3,812.80 |
$3,812.80 |
$531.95
|
|
Acetaminophen level
|
$78.40 |
$78.40 |
$78.40 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$78.55 |
$78.55 |
$78.55 |
$122.55
|
|
Acetone qualitative
|
$31.20 |
$31.20 |
$31.20 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$90.84 |
$90.84 |
$90.84 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$23.87 |
$23.87 |
$23.87 |
$31.21
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$428.00 |
$428.00 |
$428.00 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$43.20 |
$43.20 |
$43.20 |
$38.50
|
|
Acute hepatitis panel
|
$248.00 |
$248.00 |
$248.00 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$302.12 |
$302.12 |
$302.12 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$61.85 |
$61.85 |
$61.85 |
$64.45
|
|
#acylcarnitineprfl
|
$52.80 |
$52.80 |
$52.80 |
$121.55
|
|
Adenosine 3 mg/250 ml bag for osm
|
$61.59 |
$61.59 |
$61.59 |
$271.98
|
|
Adh-sendout
|
$120.00 |
$120.00 |
$120.00 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$32.48 |
$32.48 |
$32.48 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$197.60 |
$197.60 |
$197.60 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$673.60 |
$673.60 |
$673.60 |
$668.98
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$224.00 |
$224.00 |
$224.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$227.20 |
$227.20 |
$227.20 |
$256.49
|
|
_afb id by dna probe rflx ast
|
$65.60 |
$65.60 |
$65.60 |
$104.50
|
|
Albumin body fluid quantitative each specimen
|
$40.00 |
$40.00 |
$40.00 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$163.34 |
$163.34 |
$163.34 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$86.60 |
$86.60 |
$86.60 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$49.60 |
$49.60 |
$49.60 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$36.80 |
$36.80 |
$36.80 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$3.60 |
$3.60 |
$3.60 |
$5.67
|
|
Albuterol non-comp con
|
$3.60 |
$3.60 |
$3.60 |
$6.07
|
|
Albuterol non-comp unit
|
$4.56 |
$4.56 |
$4.56 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$93.60 |
$93.60 |
$93.60 |
$96.00
|
|
Alkaline phosphatase
|
$28.80 |
$28.80 |
$28.80 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$66.40 |
$66.40 |
$66.40 |
$48.57
|
|
Allergen egg white ige
|
$31.20 |
$31.20 |
$31.20 |
$38.00
|
|
Alpha-fetoprotein tumor marker
|
$81.60 |
$81.60 |
$81.60 |
$106.00
|
|
Alprostadil for injection
|
$229.97 |
$229.97 |
$229.97 |
$511.41
|
|
Als1-emergency
|
$1,412.80 |
$1,412.80 |
$1,412.80 |
$1,103.37
|
|
Als 2
|
$1,836.00 |
$1,836.00 |
$1,836.00 |
$1,288.56
|
|
Alt/sgpt
|
$34.40 |
$34.40 |
$34.40 |
$47.50
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$68.68 |
$68.68 |
$68.68 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$130.12 |
$130.12 |
$130.12 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$61.29 |
$61.29 |
$61.29 |
$55.86
|
|
Ammonia
|
$102.40 |
$102.40 |
$102.40 |
$119.70
|
|
Ampicillin 1 gram solution for injection
|
$61.95 |
$61.95 |
$61.95 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$62.66 |
$62.66 |
$62.66 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$496.00 |
$496.00 |
$496.00 |
$262.99
|
|
Amylase
|
$36.00 |
$36.00 |
$36.00 |
$90.00
|
|
Analysis gene f2 20210g>a variant
|
$280.00 |
$280.00 |
$280.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$252.00 |
$252.00 |
$252.00 |
$249.60
|
|
Anastrozole 1 mg
|
$1.20 |
$1.20 |
$1.20 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$111.20 |
$111.20 |
$111.20 |
$101.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$100.96 |
$100.96 |
$100.96 |
$2,979.43
|
|
Ankle X-ray
|
$272.00 |
$272.00 |
$272.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$252.00 |
$252.00 |
$252.00 |
$282.96
|
|
Anodyne therapy charges pt
|
$64.00 |
$64.00 |
$64.00 |
$42.00
|
|
Anora (draw only)
|
$40.80 |
$40.80 |
$40.80 |
$35.00
|
|
Anoscopy remove fb 46608
|
$1,443.20 |
$1,443.20 |
$1,443.20 |
$1,375.98
|
|
Antibody bacterium, not elsewhere specified
|
$31.20 |
$31.20 |
$31.20 |
$57.85
|
|
Antibody htlv/hiv confirm test
|
$178.40 |
$178.40 |
$178.40 |
$131.56
|
|
Antibody id rbc panel
|
$340.00 |
$340.00 |
$340.00 |
$291.75
|
|
Antibody screen rbc
|
$58.40 |
$58.40 |
$58.40 |
$108.55
|
|
Antibody tetanus
|
$104.80 |
$104.80 |
$104.80 |
$54.15
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$54.40 |
$54.40 |
$54.40 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$54.40 |
$54.40 |
$54.40 |
$42.00
|
|
Antinuclear antibodies
|
$63.20 |
$63.20 |
$63.20 |
$90.00
|
|
Antinuclear antibodies titer
|
$56.00 |
$56.00 |
$56.00 |
$80.04
|
|
Antistreptolysin o titer
|
$53.60 |
$53.60 |
$53.60 |
$54.00
|
|
Antithrombin iii activity
|
$145.60 |
$145.60 |
$145.60 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$500.00 |
$500.00 |
$500.00 |
$394.55
|
|
Apheresis platelets
|
$3,225.60 |
$3,225.60 |
$3,225.60 |
$2,195.00
|
|
Application finger splntstatic 29130
|
$204.80 |
$204.80 |
$204.80 |
$208.50
|
|
Application long leg splint 29505
|
$286.40 |
$286.40 |
$286.40 |
$338.25
|
|
Application lower leg splint 29515
|
$264.80 |
$264.80 |
$264.80 |
$340.20
|
|
Application of forearm cast 29075
|
$259.20 |
$259.20 |
$259.20 |
$358.20
|
|
Application of long arm cast 29065
|
$310.40 |
$310.40 |
$310.40 |
$396.77
|
|
Application of long leg cast 29345
|
$432.80 |
$432.80 |
$432.80 |
$455.00
|
|
Application of paste boot 29580
|
$247.20 |
$247.20 |
$247.20 |
$340.11
|
|
Application short leg cast 29405
|
$280.80 |
$280.80 |
$280.80 |
$393.98
|
|
Appl modality 1/> areas paraffin bath 97018
|
$74.40 |
$74.40 |
$74.40 |
$69.00
|
|
Appl modality 1+lllt po pain
|
$64.80 |
$64.80 |
$64.80 |
$54.61
|
|
Arm CT Scan (with contrast, both arms)
|
$2,503.20 |
$2,503.20 |
$2,503.20 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,943.20 |
$1,943.20 |
$1,943.20 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$544.00 |
$544.00 |
$544.00 |
$426.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$477.60 |
$477.60 |
$477.60 |
$609.00
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$446.40 |
$446.40 |
$446.40 |
$494.40
|
|
Aspirate pleura without imaging 32554
|
$749.60 |
$749.60 |
$749.60 |
$1,195.15
|
