|
2d tee w or without fol w/con,in
|
$396.33 |
$396.33 |
$396.33 |
$1,624.70
|
|
2d tte w or without fol w/con,co
|
$396.33 |
$396.33 |
$396.33 |
$1,155.75
|
|
2nd order venous cath
|
$197.34 |
$197.34 |
$197.34 |
$1,543.85
|
|
3-d radiotherapy plan
|
$1,071.84 |
$1,071.84 |
$1,071.84 |
$5,002.69
|
|
5' nucleotidase - sendout
|
$64.02 |
$64.02 |
$64.02 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$18.81 |
$18.81 |
$18.81 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,743.19 |
$1,743.19 |
$1,743.19 |
$3,128.29
|
|
Abd aorta w/runoff s&i
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$158.40 |
$158.40 |
$158.40 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$161.70 |
$161.70 |
$161.70 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$164.01 |
$164.01 |
$164.01 |
$2,486.97
|
|
Abd/low ext cath addl
|
$167.64 |
$167.64 |
$167.64 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$653.07 |
$653.07 |
$653.07 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$435.60 |
$435.60 |
$435.60 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$435.60 |
$435.60 |
$435.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$833.58 |
$833.58 |
$833.58 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$586.41 |
$586.41 |
$586.41 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$586.41 |
$586.41 |
$586.41 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$586.74 |
$586.74 |
$586.74 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$295.02 |
$295.02 |
$295.02 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$160.71 |
$160.71 |
$160.71 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$463.98 |
$463.98 |
$463.98 |
$1,145.40
|
|
Abl1 gene
|
$68.31 |
$68.31 |
$68.31 |
$682.50
|
|
Ablate arrhythmia add on
|
$1,973.40 |
$1,973.40 |
$1,973.40 |
$6,898.92
|
|
Ablate heart dysrhythm focus
|
$1,815.00 |
$1,815.00 |
$1,815.00 |
$9,522.05
|
|
Ablate pulm tumor perq rf
|
$1,733.82 |
$1,733.82 |
$1,733.82 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$1,387.98 |
$1,387.98 |
$1,387.98 |
$1,960.80
|
|
Ablation cryo abd perit om
|
$463.98 |
$463.98 |
$463.98 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$2,593.80 |
$2,593.80 |
$2,593.80 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$223.08 |
$223.08 |
$223.08 |
$806.85
|
|
Abobotulinumtoxina
|
$990.24 |
$990.24 |
$990.24 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$823.02 |
$823.02 |
$823.02 |
$2,957.17
|
|
Acetaminophen level
|
$65.67 |
$65.67 |
$65.67 |
$107.62
|
|
Acetone qualitative
|
$14.85 |
$14.85 |
$14.85 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$113.52 |
$113.52 |
$113.52 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$123.15 |
$123.15 |
$123.15 |
$216.00
|
|
Acute hepatitis panel
|
$148.50 |
$148.50 |
$148.50 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$57.82 |
$57.82 |
$57.82 |
$63.48
|
|
Adapter b 8 channel 10cm
|
$1,157.06 |
$1,157.06 |
$1,157.06 |
$5,695.04
|
|
Adenosine 3 mg/250 ml bag for osm
|
$413.38 |
$413.38 |
$413.38 |
$255.41
|
|
Adh-sendout
|
$46.20 |
$46.20 |
$46.20 |
$109.28
|
|
Administration chemotherapy IV infusion each additional hour
|
$36.30 |
$36.30 |
$36.30 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$41.91 |
$41.91 |
$41.91 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$166.98 |
$166.98 |
$166.98 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$166.98 |
$166.98 |
$166.98 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$48.18 |
$48.18 |
$48.18 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$48.18 |
$48.18 |
$48.18 |
$257.40
|
|
Administration immunization 1 vaccine
|
$36.30 |
$36.30 |
$36.30 |
$69.21
|
|
Administration immunization each additional vaccine
|
$33.99 |
$33.99 |
$33.99 |
$47.40
|
|
Administration vaccine hepatitis b
|
$33.99 |
$33.99 |
$33.99 |
$54.40
|
|
Administration vaccine influenza virus
|
$33.99 |
$33.99 |
$33.99 |
$50.43
|
|
Administration vaccine pneumococcal
|
$33.99 |
$33.99 |
$33.99 |
$50.43
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$7,179.03 |
$7,179.03 |
$7,179.03 |
$11,350.31
|
|
Aep neurodiagnostic i&r
|
$235.62 |
$235.62 |
$235.62 |
$576.80
|
|
_afb org id by sequencing rflx ast-sendout
|
$115.50 |
$115.50 |
$115.50 |
$315.00
|
|
Afo rig ant tib tcf/= custom
|
$2,473.35 |
$2,473.35 |
$2,473.35 |
$1,877.15
|
|
Agalsidase beta 35 mg intravenous solution
|
$8,803.09 |
$8,803.09 |
$8,803.09 |
$14,475.20
|
|
Air injection into abdomen 49400
|
$119.79 |
$119.79 |
$119.79 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$7.92 |
$7.92 |
$7.92 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$323.77 |
$323.77 |
$323.77 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$252.77 |
$252.77 |
$252.77 |
$243.59
|
|
Albumin, human 5 % intravenous solution
|
$75.83 |
$75.83 |
$75.83 |
$296.32
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$7.92 |
$7.92 |
$7.92 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$15.84 |
$15.84 |
$15.84 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$39.93 |
$39.93 |
$39.93 |
$93.60
|
|
Alkaline phosphatase
|
$16.50 |
$16.50 |
$16.50 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$45.54 |
$45.54 |
$45.54 |
$48.00
|
|
Allergen egg white ige
|
$46.20 |
$46.20 |
$46.20 |
$38.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$5,857.50 |
$5,857.50 |
$5,857.50 |
$6,414.50
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,275.35 |
$2,275.35 |
$2,275.35 |
$874.65
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,153.25 |
$2,153.25 |
$2,153.25 |
$1,495.63
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$0.69 |
$0.69 |
$0.69 |
$12.50
|
|
Alpha-fetoprotein tumor marker
|
$38.61 |
$38.61 |
$38.61 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$9,897.23 |
$9,897.23 |
$9,897.23 |
$15,857.45
|
|
Alt/sgpt
|
$16.50 |
$16.50 |
$16.50 |
$47.45
|
|
Aluminum - quest
|
$22.11 |
$22.11 |
$22.11 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$56.68 |
$56.68 |
$56.68 |
$39.84
|
|
Amino acids quant 2-5
|
$48.18 |
$48.18 |
$48.18 |
$104.00
|
|
Aminolevulinic acid delta
|
$48.84 |
$48.84 |
$48.84 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$46.24 |
$46.24 |
$46.24 |
$45.02
|
|
Amiodarone 50 mg/ml intravenous solution
|
$471.47 |
$471.47 |
$471.47 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$4,100.83 |
$4,100.83 |
$4,100.83 |
$7,994.03
|
|
Ammonia
|
$48.51 |
$48.51 |
$48.51 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$465.96 |
$465.96 |
$465.96 |
$942.60
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$95.83 |
$95.83 |
$95.83 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$357.98 |
$357.98 |
$357.98 |
$543.85
|
|
Ampicillin 1 gram solution for injection
|
$21.08 |
$21.08 |
$21.08 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$19.47 |
$19.47 |
$19.47 |
$53.86
|
|
Amylase
|
$21.45 |
$21.45 |
$21.45 |
$89.04
|
|
Anal/urinary muscle study
|
$377.19 |
$377.19 |
$377.19 |
$576.00
|
|
Analysis gene f2 20210g>a variant
|
$55.44 |
$55.44 |
$55.44 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$49.50 |
$49.50 |
$49.50 |
$230.40
|
|
Analysis nerve
|
$118.14 |
$118.14 |
$118.14 |
$274.49
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$63.69 |
$63.69 |
$63.69 |
$396.48
|
|
An cholangiogram percutaneous compl
|
$1,810.71 |
$1,810.71 |
$1,810.71 |
$2,626.65
|
|
An fluoro guide for cvp
|
$67.65 |
$67.65 |
$67.65 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,845.03 |
$1,845.03 |
$1,845.03 |
$5,341.83
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,408.44 |
$1,408.44 |
$1,408.44 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$1,408.44 |
$1,408.44 |
$1,408.44 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,845.03 |
$1,845.03 |
$1,845.03 |
$4,390.75
|
