|
11-desoxycortisol - sendout
|
$27.90 |
$27.90 |
$27.90 |
$84.56
|
|
17-hydroxypregnenolone
|
$40.05 |
$40.05 |
$40.05 |
$85.15
|
|
17-ketosteroids
|
$22.50 |
$22.50 |
$22.50 |
$49.45
|
|
2019-ncov diagnostic p
|
$10.35 |
$10.35 |
$10.35 |
$49.57
|
|
2d tee w or without fol w/con,in
|
$595.80 |
$595.80 |
$595.80 |
$1,633.60
|
|
2d tte w or without fol w/con,co
|
$183.75 |
$183.75 |
$183.75 |
$1,131.69
|
|
2nd order venous cath
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$1,809.60
|
|
3-d radiotherapy plan
|
$1,404.15 |
$1,404.15 |
$1,404.15 |
$4,953.00
|
|
3d recon without postprocess indpndt
|
$559.65 |
$559.65 |
$559.65 |
$467.95
|
|
5' nucleotidase - sendout
|
$19.35 |
$19.35 |
$19.35 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$29.55 |
$29.55 |
$29.55 |
$94.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$21.00 |
$21.00 |
$21.00 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,683.78
|
|
Abd/low ext cath 1st
|
$813.30 |
$813.30 |
$813.30 |
$2,412.00
|
|
Abd/low ext cath 2nd
|
$894.75 |
$894.75 |
$894.75 |
$2,271.00
|
|
Abd/low ext cath 3rd
|
$984.15 |
$984.15 |
$984.15 |
$2,662.40
|
|
Abd/low ext cath addl
|
$393.60 |
$393.60 |
$393.60 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$617.10 |
$617.10 |
$617.10 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$587.70 |
$587.70 |
$587.70 |
$1,655.50
|
|
Abdominal CT scan (without contrast)
|
$559.65 |
$559.65 |
$559.65 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$3,004.50
|
|
Abdominal MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$604.95 |
$604.95 |
$604.95 |
$1,981.20
|
|
Abdominal paracentesis w/image guidance
|
$324.60 |
$324.60 |
$324.60 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$101.55 |
$101.55 |
$101.55 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$96.45 |
$96.45 |
$96.45 |
$604.80
|
|
Abd paracentesis/w/o image guide 49082
|
$407.25 |
$407.25 |
$407.25 |
$1,179.75
|
|
Abl1 gene
|
$285.45 |
$285.45 |
$285.45 |
$668.85
|
|
Ablat 1/+thyr ndul addl prq rf
|
$366.15 |
$366.15 |
$366.15 |
$1,155.50
|
|
Ablate arrhythmia add on
|
$513.90 |
$513.90 |
$513.90 |
$6,913.20
|
|
Ablate bone tumor(s) cryo perq 20983
|
$13,934.40 |
$13,934.40 |
$13,934.40 |
$8,512.80
|
|
Ablate heart dysrhythm focus
|
$3,730.80 |
$3,730.80 |
$3,730.80 |
$9,556.83
|
|
Ablation cryo abd perit om
|
$3,139.50 |
$3,139.50 |
$3,139.50 |
$2,566.58
|
|
Ablation of upper extremity nerves rf
|
$2,473.80 |
$2,473.80 |
$2,473.80 |
$961.20
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$732.45 |
$732.45 |
$732.45 |
$2,964.48
|
|
Abscess drain retroperitoneal surg code
|
$1,161.30 |
$1,161.30 |
$1,161.30 |
$3,053.18
|
|
Acetaminophen level
|
$24.00 |
$24.00 |
$24.00 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$84.41 |
$84.41 |
$84.41 |
$122.55
|
|
Acetone qualitative
|
$7.95 |
$7.95 |
$7.95 |
$46.20
|
|
Acetylcholine receptor modulating antibody
|
$21.15 |
$21.15 |
$21.15 |
$61.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$458.52 |
$458.52 |
$458.52 |
$281.55
|
|
Acetylcysteine non-comp unit
|
$5.70 |
$5.70 |
$5.70 |
$29.01
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$94.35 |
$94.35 |
$94.35 |
$384.15
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$5.25 |
$5.25 |
$5.25 |
$42.75
|
|
Acute hepatitis panel
|
$80.70 |
$80.70 |
$80.70 |
$278.33
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$27.51 |
$27.51 |
$27.51 |
$64.45
|
|
#acylcarnitineprfl
|
$28.50 |
$28.50 |
$28.50 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$479.28 |
$479.28 |
$479.28 |
$272.57
|
|
Adenovirus ag ia
|
$20.10 |
$20.10 |
$20.10 |
$40.70
|
|
Adh-sendout
|
$30.75 |
$30.75 |
$30.75 |
$109.71
|
|
Adj gastric band via subq port
|
$331.80 |
$331.80 |
$331.80 |
$1,684.80
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$309.82 |
$309.82 |
$309.82 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$58.95 |
$58.95 |
$58.95 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$126.90 |
$126.90 |
$126.90 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$260.40 |
$260.40 |
$260.40 |
$690.21
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$184.05 |
$184.05 |
$184.05 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$53.55 |
$53.55 |
$53.55 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$88.05 |
$88.05 |
$88.05 |
$264.82
|
|
Administration immunization 1 vaccine
|
$25.50 |
$25.50 |
$25.50 |
$67.20
|
|
Administration immunization each additional vaccine
|
$14.70 |
$14.70 |
$14.70 |
$46.23
|
|
Administration vaccine hepatitis b
|
$13.35 |
$13.35 |
$13.35 |
$54.60
|
|
Administration vaccine influenza virus
|
$15.30 |
$15.30 |
$15.30 |
$48.00
|
|
Administration vaccine pneumococcal
|
$13.35 |
$13.35 |
$13.35 |
$49.17
|
|
Aep hearing status deter i&r
|
$66.30 |
$66.30 |
$66.30 |
$303.05
|
|
Aep thrshld est mlt freq i&r
|
$125.55 |
$125.55 |
$125.55 |
$590.25
|
|
_afb id by dna probe rflx ast
|
$35.10 |
$35.10 |
$35.10 |
$89.70
|
|
#afb mycobacteria suscep. #1
|
$9.45 |
$9.45 |
$9.45 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$201.90 |
$201.90 |
$201.90 |
$289.60
|
|
Afo molded to patient plasti
|
$248.55 |
$248.55 |
$248.55 |
$697.20
|
|
After cataract laser surgery
|
$251.55 |
$251.55 |
$251.55 |
$1,411.20
|
|
Airway resistance by impulse oscillometry 94728
|
$42.90 |
$42.90 |
$42.90 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$9.00 |
$9.00 |
$9.00 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$54.19 |
$54.19 |
$54.19 |
$218.40
|
|
Albumin (human), 5%, 250 ml
|
$34.77 |
$34.77 |
$34.77 |
$242.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$9.75 |
$9.75 |
$9.75 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$8.70 |
$8.70 |
$8.70 |
$39.78
|
|
Albuterol ipratrop non-comp
|
$1.09 |
$1.09 |
$1.09 |
$5.85
|
|
Albuterol non-comp con
|
$1.09 |
$1.09 |
$1.09 |
$5.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$22.20 |
$22.20 |
$22.20 |
$94.90
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$29,977.90 |
$29,977.90 |
$29,977.90 |
$44,547.57
|
|
Alkaline phosphatase
|
$9.15 |
$9.15 |
$9.15 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$28.50 |
$28.50 |
$28.50 |
$48.57
|
|
Allergen egg white ige
|
$9.15 |
$9.15 |
$9.15 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$13.80 |
$13.80 |
$13.80 |
$24.01
|
|
Allergy injections; 2 or more 95117
|
$12.90 |
$12.90 |
$12.90 |
$44.25
|
|
Allergy injection; single 95115
|
$6.00 |
$6.00 |
$6.00 |
$42.75
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$25,702.08 |
$25,702.08 |
$25,702.08 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$304.95 |
$304.95 |
$304.95 |
$1,115.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$186.21 |
$186.21 |
$186.21 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$346.95 |
$346.95 |
$346.95 |
$1,707.62
|
|
Alloskin
|
$1,843.45 |
$1,843.45 |
$1,843.45 |
$582.40
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$112.80 |
$112.80 |
$112.80 |
$175.20
|
|
Alpha-fetoprotein tumor marker
|
$29.40 |
$29.40 |
$29.40 |
$102.00
|
|
Alprostadil for injection
|
$189.90 |
$189.90 |
$189.90 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$11,037.54 |
$11,037.54 |
$11,037.54 |
$14,503.48
|
|
Alt/sgpt
|
$9.30 |
$9.30 |
$9.30 |
$44.68
|
|
Aluminum - quest
|
$42.30 |
$42.30 |
$42.30 |
$81.49
|
|
Amantadine (symmetrel)-sendout
|
$7.05 |
$7.05 |
$7.05 |
$178.10
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$59.94 |
$59.94 |
$59.94 |
$38.68
|
|
Aminolevulinic acid delta
|
$28.80 |
$28.80 |
$28.80 |
$74.10
|
