|
Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd
|
$16,577.68 |
$16,577.68 |
$16,577.68 |
$5,175.00
|
|
Block brachial plexus w/cath plmt w/img
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,535.00
|
|
Block femoral nerve cont infusion cath w/img
|
$1,382.70 |
$1,382.70 |
$1,382.70 |
$1,595.00
|
|
Block paracervical nrv
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$948.00
|
|
Block plantar digital nerve
|
$493.65 |
$493.65 |
$493.65 |
$515.00
|
|
Block tap inj(s) w/wo img bi
|
$1,340.40 |
$1,340.40 |
$1,340.40 |
$1,340.40
|
|
Block tap inj(s) w/wo img uni
|
$670.35 |
$670.35 |
$670.35 |
$897.95
|
|
Blood clot lysis time
|
$52.50 |
$52.50 |
$52.50 |
$40.80
|
|
Blood Clotting (PT/INR) Test
|
$119.10 |
$119.10 |
$119.10 |
$52.46
|
|
Blood Clotting (PTT) Test
|
$130.65 |
$130.65 |
$130.65 |
$71.85
|
|
Blood Count (CBC) Test
|
$134.70 |
$134.70 |
$134.70 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$120.30 |
$120.30 |
$120.30 |
$60.50
|
|
Blood Culture Test
|
$239.10 |
$239.10 |
$239.10 |
$143.88
|
|
Blood gases ph venous
|
$75.90 |
$75.90 |
$75.90 |
$61.92
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$103.50 |
$103.50 |
$103.50 |
$32.50
|
|
Blood smear microscopic w manual differential wbc count
|
$39.60 |
$39.60 |
$39.60 |
$37.80
|
|
Blood typing abo
|
$132.60 |
$132.60 |
$132.60 |
$83.03
|
|
Blood typing ag donor ea ag
|
$268.20 |
$268.20 |
$268.20 |
$179.30
|
|
Blood typing rbc ag non abo/rh ea
|
$215.85 |
$215.85 |
$215.85 |
$190.00
|
|
Blood typing rh (d)
|
$84.90 |
$84.90 |
$84.90 |
$57.10
|
|
Blood typing rh phenotype complete reference
|
$166.20 |
$166.20 |
$166.20 |
$81.90
|
|
Bone filler cerament 10cc
|
$20,079.90 |
$20,079.90 |
$20,079.90 |
$14,423.77
|
|
Bone tendon board add on
|
$7,857.60 |
$7,857.60 |
$7,857.60 |
$6,606.72
|
|
Bone void filler nanoss 10cc
|
$3,816.00 |
$3,816.00 |
$3,816.00 |
$3,816.00
|
|
Boot cast sandal rocker med
|
$12.89 |
$12.89 |
$12.89 |
$12.89
|
|
Boot j walker l
|
$249.08 |
$249.08 |
$249.08 |
$195.00
|
|
Boot mlti podous univ xlg
|
$290.80 |
$290.80 |
$290.80 |
$235.98
|
|
Boot softgait shrt m
|
$57.84 |
$57.84 |
$57.84 |
$120.58
|
|
Boot walker genesis full shell 3-strap s
|
$543.44 |
$543.44 |
$543.44 |
$448.06
|
|
Boot walker genesis mid-calf full shell s
|
$571.17 |
$571.17 |
$571.17 |
$173.88
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$135.60 |
$135.60 |
$135.60 |
$92.88
|
|
Brace adj motion lerman type
|
$281.75 |
$281.75 |
$281.75 |
$281.75
|
|
Brace afo dbl upright cust
|
$834.17 |
$834.17 |
$834.17 |
$834.17
|
|
Brace afo lg left 6607
|
$590.28 |
$590.28 |
$590.28 |
$461.76
|
|
Brace afopos solid ankle cust
|
$1,087.89 |
$1,087.89 |
$1,087.89 |
$1,087.89
|
|
Brace afo spiral prefab
|
$2,443.82 |
$2,443.82 |
$2,443.82 |
$1,549.31
|
|
Brace ank aftr bioskn med lg
|
$302.88 |
$302.88 |
$302.88 |
$170.80
|
|
Brace ank air stirrup univ
|
$242.51 |
$242.51 |
$242.51 |
$108.67
|
|
Brace ankle joint dflxn assist
|
$127.56 |
$127.56 |
$127.56 |
$129.78
|
|
Brace ankle stablizing lg
|
$219.56 |
$219.56 |
$219.56 |
$113.10
|
|
Brace back epic lo 627
|
$206.47 |
$206.47 |
$206.47 |
$497.68
|
|
Brace back epic lso 637
|
$635.40 |
$635.40 |
$635.40 |
$635.40
|
|
Brace back epic tslo 456
|
$1,631.36 |
$1,631.36 |
$1,631.36 |
$1,558.20
|
|
Brace back pinnacle tlso 464
|
$3,586.88 |
$3,586.88 |
$3,586.88 |
$2,283.03
|
|
Brace back t-lso custom
|
$3,859.13 |
$3,859.13 |
$3,859.13 |
$3,517.55
|
|
Brace back vista 464 tlso
|
$2,463.00 |
$2,463.00 |
$2,463.00 |
$1,282.55
|
|
Brace fx hum ovr shldr sm
|
$874.04 |
$874.04 |
$874.04 |
$578.69
|
|
Brace halo bremer l2830
|
$175.82 |
$175.82 |
$175.82 |
$193.72
|
|
Brace kafo dbl upright cust
|
$3,609.22 |
$3,609.22 |
$3,609.22 |
$3,609.22
|
|
Brace knee extender plus 22-30in
|
$977.19 |
$977.19 |
$977.19 |
$552.15
|
|
Brace knee hing pat open med
|
$331.00 |
$331.00 |
$331.00 |
$210.60
|
|
Brace knee playmaker ii x-rom hook and loop xl
|
$1,015.62 |
$1,015.62 |
$1,015.62 |
$411.01
|
|
Brace knee support neoprene padded open patella med
|
$200.15 |
$200.15 |
$200.15 |
$215.70
|
|
Brace m arm board
|
$78.65 |
$78.65 |
$78.65 |
$121.10
|
|
Brace ortho exos 28-50in sm
|
$2,857.40 |
$2,857.40 |
$2,857.40 |
$923.62
|
|
Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr
|
$337.40 |
$337.40 |
$337.40 |
$1,555.57
|
|
Brace oths wrist hnd fngr without
|
$147.60 |
$147.60 |
$147.60 |
$231.80
|
|
Brace tlso flex cust
|
$573.43 |
$573.43 |
$573.43 |
$573.43
|
|
Brace wrist classic lft sm
|
$153.83 |
$153.83 |
$153.83 |
$80.69
|
|
Brachytx, non-str, ha, i-125
|
$615.00 |
$615.00 |
$615.00 |
$180.24
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$2,830.05 |
$2,830.05 |
$2,830.05 |
$2,785.50
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$2,612.85 |
$2,612.85 |
$2,612.85 |
$2,101.40
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,394.15 |
$2,394.15 |
$2,394.15 |
$1,897.53
|
|
Brain MRI (with and without contrast)
|
$2,830.05 |
$2,830.05 |
$2,830.05 |
$2,830.05
|
|
Brain MRI (with contrast)
|
$2,504.25 |
$2,504.25 |
$2,504.25 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$2,504.25 |
$2,504.25 |
$2,504.25 |
$1,944.15
|
|
Bra surgical elizabeth pink sm
|
$159.78 |
$159.78 |
$159.78 |
$130.99
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$22,377.96 |
$22,377.96 |
$22,377.96 |
$22,377.96
|
|
Bronchoscopy clear airways 31645
|
$1,034.70 |
$1,034.70 |
$1,034.70 |
$2,672.16
|
|
Bronchoscopy/lung bx each 31628
|
$2,229.00 |
$2,229.00 |
$2,229.00 |
$3,877.44
|
|
Bronchoscopy/needle bx each 31629
|
$2,229.00 |
$2,229.00 |
$2,229.00 |
$4,012.00
|
|
Bronchoscopy w/biopsy(s) 31625
|
$1,034.70 |
$1,034.70 |
$1,034.70 |
$2,168.40
|
|
Bundled special stain group 1 microorganisms
|
$466.35 |
$466.35 |
$466.35 |
$161.46
|
|
Bundled special stain group 2
|
$243.00 |
$243.00 |
$243.00 |
$169.60
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$13.48 |
$13.48 |
$13.48 |
$33.85
|
|
Buprenorphine hydrochloride
|
$37.27 |
$37.27 |
$37.27 |
$42.08
|
|
Bur rotalink 2.15mm
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$7,754.17
|
|
Butorphanol tartrate 1 mg
|
$22.58 |
$22.58 |
$22.58 |
$37.50
|
|
C-1 esterase, berinert
|
$15,198.21 |
$15,198.21 |
$15,198.21 |
$7,466.16
|
|
C-1 esterase, cinryze
|
$11,590.13 |
$11,590.13 |
$11,590.13 |
$7,483.77
|
|
Cable cath 22-pin diag
|
$6,192.00 |
$6,192.00 |
$6,192.00 |
$4,946.50
|
|
Cad breast MRI w/r&i
|
$187.20 |
$187.20 |
$187.20 |
$136.08
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$669.02 |
$669.02 |
$669.02 |
$2,132.00
|
|
Calcium 24 hour urine
|
$90.00 |
$90.00 |
$90.00 |
$52.08
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$99.54 |
$99.54 |
$99.54 |
$64.49
|
|
Calcium ionized
|
$160.50 |
$160.50 |
$160.50 |
$88.00
|
|
Calcium total
|
$158.10 |
$158.10 |
$158.10 |
$50.00
|
|
Candida skin test
|
$63.90 |
$63.90 |
$63.90 |
$58.76
|
|
Cannula ercp contour 5-4-3 tip
|
$68,400.00 |
$68,400.00 |
$68,400.00 |
$36,313.87
|
|
Cap nerve 2x15mm
|
$15,606.00 |
$15,606.00 |
$15,606.00 |
$24,158.39
|
|
Cap trach decann 15mm
|
$10,560.00 |
$10,560.00 |
$10,560.00 |
$3,120.00
|
|
Carbamazepine total therapeutic drug level
|
$352.50 |
$352.50 |
$352.50 |
$115.05
|
|
Carbidopa levodopa ent 100ml
|
$243.99 |
$243.99 |
$243.99 |
$243.99
|
|
Carbon dioxide
|
$168.00 |
$168.00 |
$168.00 |
$44.88
|
|
Carboplatin 10 mg/ml desensitization
|
$167.78 |
$167.78 |
$167.78 |
$195.06
|
|
Carboxyhemoglobin quantitative
|
$126.30 |
$126.30 |
$126.30 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$150.00 |
$150.00 |
$150.00 |
$142.50
|
|
Cardiolipin antibody iga
|
$31.20 |
$31.20 |
$31.20 |
$105.00
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$913.95 |
$913.95 |
$913.95 |
$1,396.00
|
|
Carfilzomib 10 mg intravenous solution
|
$6,193.76 |
$6,193.76 |
$6,193.76 |
$6,306.47
|
