|
2d tee w or without fol w/con,in
|
$3,110.40 |
$3,110.40 |
$3,110.40 |
$1,724.25
|
|
2nd order venous cath
|
$3,410.40 |
$3,410.40 |
$3,410.40 |
$1,532.04
|
|
3-d radiotherapy plan
|
$7,427.20 |
$7,427.20 |
$7,427.20 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$893.60 |
$893.60 |
$893.60 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$130.88 |
$130.88 |
$130.88 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$72.00 |
$72.00 |
$72.00 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,019.00 |
$4,019.00 |
$4,019.00 |
$3,138.72
|
|
Abd aorta w/runoff s&i
|
$4,628.00 |
$4,628.00 |
$4,628.00 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$2,995.20 |
$2,995.20 |
$2,995.20 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$3,446.40 |
$3,446.40 |
$3,446.40 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$4,012.80 |
$4,012.80 |
$4,012.80 |
$2,475.45
|
|
Abd/low ext cath addl
|
$1,264.80 |
$1,264.80 |
$1,264.80 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$871.20 |
$871.20 |
$871.20 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,667.20 |
$2,667.20 |
$2,667.20 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$3,044.00 |
$3,044.00 |
$3,044.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,257.60 |
$2,257.60 |
$2,257.60 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,865.60 |
$4,865.60 |
$4,865.60 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,056.80 |
$3,056.80 |
$3,056.80 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$3,511.20 |
$3,511.20 |
$3,511.20 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,961.60 |
$1,961.60 |
$1,961.60 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$1,129.60 |
$1,129.60 |
$1,129.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$824.80 |
$824.80 |
$824.80 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$400.80 |
$400.80 |
$400.80 |
$318.20
|
|
Abdominal X-ray (single view)
|
$395.20 |
$395.20 |
$395.20 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,254.40 |
$1,254.40 |
$1,254.40 |
$1,148.40
|
|
Ablat 1/+thyr ndul addl prq rf
|
$4,207.20 |
$4,207.20 |
$4,207.20 |
$1,155.50
|
|
Ablate arrhythmia add on
|
$14,762.40 |
$14,762.40 |
$14,762.40 |
$6,828.51
|
|
Ablate bone tumor(s) cryo perq 20983
|
$12,567.20 |
$12,567.20 |
$12,567.20 |
$9,290.70
|
|
Ablate bone tumor(s) perq
|
$11,271.20 |
$11,271.20 |
$11,271.20 |
$9,511.44
|
|
Ablate heart dysrhythm focus
|
$15,506.40 |
$15,506.40 |
$15,506.40 |
$9,332.05
|
|
Ablate pulm tumor perq crybl
|
$12,778.40 |
$12,778.40 |
$12,778.40 |
$9,970.50
|
|
Ablate pulm tumor perq rf
|
$10,904.80 |
$10,904.80 |
$10,904.80 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$18,356.80 |
$18,356.80 |
$18,356.80 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$9,032.80 |
$9,032.80 |
$9,032.80 |
$2,312.80
|
|
Ablation cryo adrenal tumor
|
$8,333.60 |
$8,333.60 |
$8,333.60 |
$6,948.75
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$4,594.40 |
$4,594.40 |
$4,594.40 |
$441.09
|
|
Ablation cryo pq liver tumor(s)
|
$10,228.00 |
$10,228.00 |
$10,228.00 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$2,845.60 |
$2,845.60 |
$2,845.60 |
$857.60
|
|
Ablation cryo thigh/knee
|
$5,760.80 |
$5,760.80 |
$5,760.80 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$4,342.40 |
$4,342.40 |
$4,342.40 |
$832.50
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$8,415.20 |
$8,415.20 |
$8,415.20 |
$3,055.20
|
|
Abobotulinumtoxina
|
$1,307.51 |
$1,307.51 |
$1,307.51 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$5,676.00 |
$5,676.00 |
$5,676.00 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$4,374.40 |
$4,374.40 |
$4,374.40 |
$2,314.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$329.44 |
$329.44 |
$329.44 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$340.70 |
$340.70 |
$340.70 |
$122.55
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$659.28 |
$659.28 |
$659.28 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$10.12 |
$10.12 |
$10.12 |
$31.21
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$273.60 |
$273.60 |
$273.60 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$49.60 |
$49.60 |
$49.60 |
$38.50
|
|
Acoustic immitance testing
|
$100.00 |
$100.00 |
$100.00 |
$158.50
|
|
Acyclovir 400 mg tablet
|
$10.74 |
$10.74 |
$10.74 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$355.04 |
$355.04 |
$355.04 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$6,390.40 |
$6,390.40 |
$6,390.40 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$347.66 |
$347.66 |
$347.66 |
$271.98
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$5,828.00 |
$5,828.00 |
$5,828.00 |
$3,397.11
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$52.96 |
$52.96 |
$52.96 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$393.60 |
$393.60 |
$393.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$426.40 |
$426.40 |
$426.40 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$768.00 |
$768.00 |
$768.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$496.80 |
$496.80 |
$496.80 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$376.00 |
$376.00 |
$376.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$328.80 |
$328.80 |
$328.80 |
$256.49
|
|
Administration immunization each additional vaccine
|
$105.60 |
$105.60 |
$105.60 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$104.00 |
$104.00 |
$104.00 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$88.80 |
$88.80 |
$88.80 |
$30.24
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$8,200.70 |
$8,200.70 |
$8,200.70 |
$11,350.31
|
|
Aep hearing status deter i&r
|
$356.80 |
$356.80 |
$356.80 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$551.20 |
$551.20 |
$551.20 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$564.80 |
$564.80 |
$564.80 |
$635.00
|
|
Afo w/ankle joint, prefab
|
$141.60 |
$141.60 |
$141.60 |
$741.72
|
|
Agalsidase beta 35 mg intravenous solution
|
$22,036.92 |
$22,036.92 |
$22,036.92 |
$14,475.20
|
|
Air conduction bilat
|
$140.80 |
$140.80 |
$140.80 |
$134.00
|
|
Air injection into abdomen 49400
|
$1,367.20 |
$1,367.20 |
$1,367.20 |
$525.60
|
|
Albumin (human), 25%, 50ml
|
$670.80 |
$670.80 |
$670.80 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$360.80 |
$360.80 |
$360.80 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$359.60 |
$359.60 |
$359.60 |
$275.16
|
|
Albuterol ipratrop non-comp
|
$1.28 |
$1.28 |
$1.28 |
$5.67
|
|
Albuterol non-comp con
|
$30.80 |
$30.80 |
$30.80 |
$6.07
|
|
Albuterol non-comp unit
|
$1.76 |
$1.76 |
$1.76 |
$5.40
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$33,418.71 |
$33,418.71 |
$33,418.71 |
$47,974.31
|
|
Allograft amnioexcel plus 17mm disk
|
$1,331.20 |
$1,331.20 |
$1,331.20 |
$497.95
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$1,196.80 |
$1,196.80 |
$1,196.80 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$1,038.40 |
$1,038.40 |
$1,038.40 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,491.20 |
$1,491.20 |
$1,491.20 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$253.60 |
$253.60 |
$253.60 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$8,280.00 |
$8,280.00 |
$8,280.00 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$562.40 |
$562.40 |
$562.40 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$901.34 |
$901.34 |
$901.34 |
$1,225.35
|
|
All tstg perq&iq drugs/biol
|
$66.40 |
$66.40 |
$66.40 |
$64.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,576.00 |
$1,576.00 |
$1,576.00 |
$13.14
|
|
Alprostadil for injection
|
$403.72 |
$403.72 |
$403.72 |
$511.41
|
|
Als1-emergency
|
$1,534.40 |
$1,534.40 |
$1,534.40 |
$1,103.37
|
|
Alteplase 100 mg infusion from pyxis vial
|
$23,176.60 |
$23,176.60 |
$23,176.60 |
$15,857.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$328.64 |
$328.64 |
$328.64 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$315.41 |
$315.41 |
$315.41 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$319.88 |
$319.88 |
$319.88 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$325.60 |
$325.60 |
$325.60 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$324.66 |
$324.66 |
$324.66 |
$55.86
|