|
2d tee w or without fol w/con,in
|
$1,018.08 |
$1,018.08 |
$1,018.08 |
$1,525.28
|
|
2nd order venous cath
|
$509.46 |
$509.46 |
$509.46 |
$1,720.80
|
|
3d ech img cgen car anomal
|
$463.68 |
$463.68 |
$463.68 |
$632.45
|
|
3-d radiotherapy plan
|
$14,992.74 |
$14,992.74 |
$14,992.74 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$2,062.62 |
$2,062.62 |
$2,062.62 |
$425.10
|
|
88334 ap bill cytologic exam each additional site
|
$184.80 |
$184.80 |
$184.80 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$9,371.39 |
$9,371.39 |
$9,371.39 |
$3,998.03
|
|
Abd aorta w/runoff s&i
|
$7,103.46 |
$7,103.46 |
$7,103.46 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$641.76 |
$641.76 |
$641.76 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$2,571.24 |
$2,571.24 |
$2,571.24 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$399.00 |
$399.00 |
$399.00 |
$2,727.40
|
|
Abd/low ext cath addl
|
$459.48 |
$459.48 |
$459.48 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$3,554.88 |
$3,554.88 |
$3,554.88 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,843.82 |
$2,843.82 |
$2,843.82 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,133.18 |
$2,133.18 |
$2,133.18 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$441.31 |
$4,884.18 |
$4,884.18 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$4,307.10 |
$4,307.10 |
$4,307.10 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$3,908.94 |
$3,908.94 |
$3,908.94 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$4,367.58 |
$4,367.58 |
$4,367.58 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$1,259.58 |
$1,259.58 |
$1,259.58 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$908.04 |
$908.04 |
$908.04 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$1,467.48 |
$1,467.48 |
$1,467.48 |
$1,248.00
|
|
Ablate arrhythmia add on
|
$13,392.96 |
$13,392.96 |
$13,392.96 |
$7,717.80
|
|
Ablate bone tumor(s) perq
|
$5,719.14 |
$5,719.14 |
$5,719.14 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$7,660.38 |
$7,660.38 |
$7,660.38 |
$9,836.16
|
|
Ablate inf turbinate superf 30801
|
$1,955.10 |
$1,955.10 |
$1,955.10 |
$2,122.56
|
|
Ablate pulm tumor perq rf
|
$6,585.18 |
$6,585.18 |
$6,585.18 |
$7,911.80
|
|
Ablation cardiac vagal inputs atrium
|
$183.12 |
$183.12 |
$183.12 |
$2,948.40
|
|
Ablation cryo adrenal tumor
|
$14,442.12 |
$14,442.12 |
$14,442.12 |
$6,904.15
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$315.84 |
$315.84 |
$315.84 |
$339.18
|
|
Ablation cryo pq liver tumor(s)
|
$14,412.72 |
$14,412.72 |
$14,412.72 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$393.96 |
$393.96 |
$393.96 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$5,045.46 |
$5,045.46 |
$5,045.46 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$62.91 |
$69.30 |
$100.25 |
$89.91
|
|
Acetazolamide 500 mg solution for injection
|
$214.51 |
$215.07 |
$293.24 |
$137.80
|
|
Acetone qualitative
|
$26.46 |
$26.46 |
$26.46 |
$48.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$231.15 |
$231.15 |
$281.55 |
$306.22
|
|
Acetylcysteine non-comp unit
|
$46.99 |
$131.58 |
$131.58 |
$29.01
|
|
Acne surgery 10040
|
$254.52 |
$254.52 |
$254.52 |
$265.20
|
|
Acute hepatitis panel
|
$1,241.10 |
$1,241.10 |
$1,351.56 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$61.33 |
$139.46 |
$210.26 |
$64.45
|
|
Adapt behavior tx phys/qhp
|
$17.22 |
$17.22 |
$17.22 |
$190.13
|
|
Adapter b 8 channel 10cm
|
$9,071.66 |
$9,071.66 |
$9,071.66 |
$6,875.44
|
|
Adding walker to prev cast
|
$205.38 |
$205.38 |
$205.38 |
$205.38
|
|
Adenosine 3 mg/250 ml bag for osm
|
$56.70 |
$56.70 |
$1,438.26 |
$217.04
|
|
Adjmt/revj ext fixj sys anes
|
$9,584.82 |
$9,584.82 |
$9,584.82 |
$7,907.11
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,501.10 |
$2,501.10 |
$2,501.10 |
$2,837.09
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$165.09 |
$717.03 |
$717.03 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$610.68 |
$610.68 |
$610.68 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$453.60 |
$453.60 |
$453.60 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$828.66 |
$828.66 |
$828.66 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$304.92 |
$304.92 |
$304.92 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$251.16 |
$251.16 |
$251.16 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$325.08 |
$325.08 |
$325.08 |
$267.43
|
|
Administration immunization 1 vaccine
|
$124.11 |
$124.11 |
$124.32 |
$70.00
|
|
Administration immunization each additional vaccine
|
$23.52 |
$23.64 |
$23.64 |
$46.23
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$124.32 |
$124.32 |
$124.32 |
$41.15
|
|
Administration vaccine influenza virus
|
$124.32 |
$124.32 |
$124.32 |
$49.40
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$17,506.29 |
$17,506.29 |
$17,506.29 |
$14,346.62
|
|
Adrenal cortex & medulla img
|
$1,661.52 |
$1,661.52 |
$1,661.52 |
$1,818.05
|
|
Aep neurodiagnostic i&r
|
$1,058.82 |
$1,058.82 |
$1,058.82 |
$509.00
|
|
Aep thrshld est mlt freq i&r
|
$2,807.28 |
$2,807.28 |
$2,807.28 |
$573.65
|
|
Agalsidase beta 35 mg intravenous solution
|
$40,378.30 |
$40,378.30 |
$40,378.30 |
$14,467.53
|
|
Air injection into abdomen 49400
|
$1,401.96 |
$1,401.96 |
$1,401.96 |
$545.00
|
|
Albumin body fluid quantitative each specimen
|
$51.24 |
$51.24 |
$51.24 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$264.43 |
$318.84 |
$505.66 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$956.12 |
$956.12 |
$1,070.13 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$177.24 |
$177.24 |
$177.24 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$133.98 |
$133.98 |
$133.98 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$5.67 |
$7.36 |
$7.36 |
$9.93
|
|
Albuterol non-comp con
|
$34.33 |
$34.33 |
$34.33 |
$9.93
|
|
Albuterol non-comp unit
|
$4.62 |
$18.52 |
$18.52 |
$9.43
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$0.00 |
$0.00 |
$0.00 |
$8,173.80
|
|
Alkaline phosphatase
|
$103.32 |
$103.32 |
$103.32 |
$46.50
|
|
Allergen egg white ige
|
$51.24 |
$51.24 |
$51.24 |
$39.78
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$5,705.38 |
$5,705.38 |
$5,705.38 |
$5,579.34
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$28,035.16 |
$28,035.16 |
$28,035.16 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$11,021.04 |
$11,021.04 |
$11,021.04 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$29,442.76 |
$29,442.76 |
$29,442.76 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$22,300.03 |
$22,300.03 |
$22,300.03 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$6,058.74 |
$6,058.74 |
$6,058.74 |
$4,898.43
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$7,740.23 |
$7,740.23 |
$7,740.23 |
$5,381.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$6,000.56 |
$6,000.56 |
$6,000.56 |
$5,538.22
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$6,587.41 |
$6,587.41 |
$6,587.41 |
$4,814.57
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$16,335.47 |
$16,335.47 |
$16,335.47 |
$51.00
|
|
Alpha-fetoprotein tumor marker
|
$158.34 |
$158.34 |
$158.34 |
$103.60
|
|
Alprostadil for injection
|
$1,219.67 |
$1,219.67 |
$1,219.67 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,358.41 |
$1,358.41 |
$45,243.16 |
$9,600.63
|
|
Alt/sgpt
|
$216.72 |
$216.72 |
$216.72 |
$49.00
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$56.70 |
$56.70 |
$94.94 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$57.19 |
$57.19 |
$64.58 |
$45.50
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$101.89 |
$101.89 |
$143.93 |
$43.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$56.70 |
$56.70 |
$69.30 |
$50.85
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$16,703.54 |
$16,703.54 |
$16,703.54 |
$15,167.75
|
|
Ammonia
|
$388.08 |
$388.08 |
$388.08 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$827.40 |
$827.40 |
$827.40 |
$963.79
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$4,192.86 |
$4,192.86 |
$4,192.86 |
$3,969.00
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$123.53 |
$123.53 |
$276.83 |
$135.63
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$780.81 |
$780.81 |
$780.81 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$56.70 |
$240.03 |
$240.03 |
$68.44
|