|
17-ketosteroids
|
$129.98 |
$129.98 |
$129.98 |
$57.20
|
|
2d tte w or without fol w/con,co
|
$1,108.76 |
$1,108.76 |
$1,108.76 |
$1,165.05
|
|
2nd order venous cath
|
$699.66 |
$699.66 |
$699.66 |
$2,414.40
|
|
3-d radiotherapy plan
|
$1,717.29 |
$1,717.29 |
$1,717.29 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$77.70 |
$77.70 |
$77.70 |
$443.20
|
|
5' nucleotidase - sendout
|
$86.81 |
$86.81 |
$86.81 |
$64.80
|
|
88334 ap bill cytologic exam each additional site
|
$10.79 |
$10.79 |
$10.79 |
$93.00
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$79.68 |
$79.68 |
$79.68 |
$66.33
|
|
Abd aorta w/runoff s&i
|
$1,015.11 |
$1,015.11 |
$1,015.11 |
$3,483.84
|
|
Abd/low ext cath 1st
|
$3,609.77 |
$3,609.77 |
$3,609.77 |
$2,954.86
|
|
Abd/low ext cath 2nd
|
$4,550.93 |
$4,550.93 |
$4,550.93 |
$2,941.25
|
|
Abd/low ext cath 3rd
|
$4,743.48 |
$4,743.48 |
$4,743.48 |
$3,522.75
|
|
Abd/low ext cath addl
|
$1,129.08 |
$1,129.08 |
$1,129.08 |
$909.22
|
|
Abdominal CT scan (with and without contrast)
|
$1,020.09 |
$1,020.09 |
$1,020.09 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$874.37 |
$874.37 |
$874.37 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$784.19 |
$784.19 |
$784.19 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$1,248.42 |
$1,248.42 |
$1,248.42 |
$2,629.50
|
|
Abdominal MRI (without contrast)
|
$943.95 |
$943.95 |
$943.95 |
$1,789.65
|
|
Abdominal paracentesis w/image guidance
|
$1,668.08 |
$1,668.08 |
$1,668.08 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$226.28 |
$226.28 |
$226.28 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$227.54 |
$227.54 |
$227.54 |
$574.53
|
|
Abd paracentesis/w/o image guide 49082
|
$1,299.92 |
$1,299.92 |
$1,299.92 |
$1,144.26
|
|
Ablate arrhythmia add on
|
$441.21 |
$441.21 |
$441.21 |
$7,717.80
|
|
Ablate bone tumor(s) perq
|
$5,017.23 |
$5,017.23 |
$5,017.23 |
$9,773.01
|
|
Ablate heart dysrhythm focus
|
$6,179.09 |
$6,179.09 |
$6,179.09 |
$8,936.20
|
|
Ablation cryo adrenal tumor
|
$1,710.84 |
$1,710.84 |
$1,710.84 |
$7,045.00
|
|
Ablation cryo pq liver tumor(s)
|
$3,958.92 |
$3,958.92 |
$3,958.92 |
$8,581.80
|
|
Abscess drain retroperitoneal surg code
|
$1,587.32 |
$1,587.32 |
$1,587.32 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$4.64 |
$4.64 |
$4.64 |
$45.63
|
|
Acetaminophen level
|
$153.39 |
$153.39 |
$153.39 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$94.47 |
$94.47 |
$94.47 |
$94.47
|
|
Acetone qualitative
|
$36.99 |
$36.99 |
$36.99 |
$43.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1.68 |
$1.68 |
$1.68 |
$320.66
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$273.98 |
$273.98 |
$273.98 |
$385.45
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$45.56 |
$45.56 |
$45.56 |
$45.60
|
|
Actinotherapy uv light
|
$102.66 |
$102.66 |
$102.66 |
$110.50
|
|
Acute hepatitis panel
|
$322.85 |
$322.85 |
$322.85 |
$294.45
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$5.67 |
$5.67 |
$5.67 |
$48.72
|
|
#acylcarnitineprfl
|
$223.80 |
$223.80 |
$223.80 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$14.97 |
$14.97 |
$14.97 |
$97.50
|
|
Adenovirus antibody,serum - quest
|
$231.30 |
$231.30 |
$231.30 |
$63.00
|
|
Adh-sendout
|
$109.16 |
$109.16 |
$109.16 |
$152.10
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$56.70 |
$56.70 |
$56.70 |
$163.25
|
|
Administration chemotherapy IV infusion each additional hour
|
$63.68 |
$63.68 |
$63.68 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$286.37 |
$286.37 |
$286.37 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$378.63 |
$378.63 |
$378.63 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$190.89 |
$190.89 |
$190.89 |
$454.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$81.69 |
$81.69 |
$81.69 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$92.25 |
$92.25 |
$92.25 |
$267.43
|
|
Administration immunization 1 vaccine
|
$43.88 |
$43.88 |
$43.88 |
$65.00
|
|
Administration immunization each additional vaccine
|
$43.89 |
$43.89 |
$43.89 |
$45.50
|
|
Administration vaccine influenza virus
|
$43.88 |
$43.88 |
$43.88 |
$38.25
|
|
Administration vaccine pneumococcal
|
$43.88 |
$43.88 |
$43.88 |
$38.25
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$84.48 |
$84.48 |
$84.48 |
$59.76
|
|
Albumin body fluid quantitative each specimen
|
$42.81 |
$42.81 |
$42.81 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$123.36 |
$123.36 |
$123.36 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$123.36 |
$123.36 |
$123.36 |
$253.48
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$71.75 |
$71.75 |
$71.75 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$27.45 |
$27.45 |
$27.45 |
$40.00
|
|
Aldesleukin injection
|
$11,931.21 |
$11,931.21 |
$11,931.21 |
$5,301.26
|
|
Alkaline phosphatase
|
$27.60 |
$27.60 |
$27.60 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$152.36 |
$152.36 |
$152.36 |
$56.35
|
|
Allergen egg white ige
|
$127.83 |
$127.83 |
$127.83 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$10.88 |
$10.88 |
$10.88 |
$39.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$474.06 |
$474.06 |
$474.06 |
$13,768.09
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$55.92 |
$55.92 |
$55.92 |
$30,615.48
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$386.03 |
$386.03 |
$386.03 |
$3,035.85
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$136.82 |
$136.82 |
$136.82 |
$4,304.40
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$963.90 |
$963.90 |
$963.90 |
$2,752.20
|
|
Alpha-fetoprotein tumor marker
|
$80.12 |
$80.12 |
$80.12 |
$110.40
|
|
Alteplase 100 mg infusion from pyxis vial
|
$189.51 |
$189.51 |
$189.51 |
$189.60
|
|
Alt/sgpt
|
$71.16 |
$71.16 |
$71.16 |
$43.55
|
|
Aluminum - quest
|
$75.56 |
$75.56 |
$75.56 |
$114.40
|
|
Amantadine (symmetrel)-sendout
|
$315.47 |
$315.47 |
$315.47 |
$175.50
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$3.08 |
$3.08 |
$3.08 |
$36.30
|
|
Aminolevulinic acid delta
|
$129.15 |
$129.15 |
$129.15 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$23.91 |
$23.91 |
$23.91 |
$40.47
|
|
Amiodarone 50 mg/ml intravenous solution
|
$14.91 |
$14.91 |
$14.91 |
$15.32
|
|
Ammonia
|
$48.83 |
$48.83 |
$48.83 |
$96.53
|
|
Amniocentesisdiagnostic 59000
|
$509.51 |
$509.51 |
$509.51 |
$876.60
|
|
Amniotic fluid scan
|
$181.43 |
$181.43 |
$181.43 |
$33.15
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$107.46 |
$107.46 |
$107.46 |
$107.46
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$132.84 |
$132.84 |
$132.84 |
$94.57
|
|
Ampicillin 1 gram solution for injection
|
$7.35 |
$7.35 |
$7.35 |
$30.28
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$9.24 |
$9.24 |
$9.24 |
$37.60
|
|
Amylase
|
$85.65 |
$85.65 |
$85.65 |
$83.20
|
|
Analysis gene f2 20210g>a variant
|
$589.58 |
$589.58 |
$589.58 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$52.58 |
$52.58 |
$52.58 |
$253.11
|
|
An cholangiogram percutaneous compl
|
$1,391.54 |
$1,391.54 |
$1,391.54 |
$2,417.63
|
|
An fluoro guide for cvp
|
$210.39 |
$210.39 |
$210.39 |
$469.17
|
|
Angio balloon ctrl dialysis seg add-on
|
$8,839.52 |
$8,839.52 |
$8,839.52 |
$5,935.00
|
|
Angioplasty fem/pop unilat 37224
|
$11,392.58 |
$11,392.58 |
$11,392.58 |
$11,517.60
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$11,215.05 |
$11,215.05 |
$11,215.05 |
$12,766.07
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$5,566.25 |
$5,566.25 |
$5,566.25 |
$8,640.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$3,755.70 |
$3,755.70 |
$3,755.70 |
$44,765.71
|
|
Angio tib/peroneal/init ves/unila 37228
|
$10,274.52 |
$10,274.52 |
$10,274.52 |
$14,806.05
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,854.49 |
$6,854.49 |
$6,854.49 |
$5,855.20
|
|
Angio trnslmnl balloon same artery ini
|
$6,854.49 |
$6,854.49 |
$6,854.49 |
$9,966.40
|
|
Angio trnslmnl balloon same vein ea addl
|
$8,838.89 |
$8,838.89 |
$8,838.89 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$8,838.89 |
$8,838.89 |
$8,838.89 |
$8,766.15
|
