|
17-hydroxypregnenolone
|
$33.60 |
$33.60 |
$33.60 |
$88.20
|
|
2d tte w or without fol w/con,co
|
$1,535.40 |
$1,535.40 |
$1,535.40 |
$1,155.75
|
|
3d recon without postprocess indpndt
|
$597.00 |
$597.00 |
$597.00 |
$469.20
|
|
5' nucleotidase - sendout
|
$69.60 |
$69.60 |
$69.60 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$184.20 |
$184.20 |
$184.20 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$7,207.50 |
$7,207.50 |
$7,207.50 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$65.40 |
$65.40 |
$65.40 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$2,364.00 |
$2,364.00 |
$2,364.00 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$2,067.00 |
$2,067.00 |
$2,067.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$2,095.80 |
$2,095.80 |
$2,095.80 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$2,442.00 |
$2,442.00 |
$2,442.00 |
$2,486.97
|
|
Abd/low ext cath addl
|
$1,092.60 |
$1,092.60 |
$1,092.60 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$3,406.80 |
$3,406.80 |
$3,406.80 |
$1,992.00
|
|
Abdominal CT scan (with contrast)
|
$2,822.40 |
$2,822.40 |
$2,822.40 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$1,533.60 |
$1,533.60 |
$1,533.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$6,756.60 |
$6,756.60 |
$6,756.60 |
$2,999.67
|
|
Abdominal MRI (without contrast)
|
$4,209.00 |
$4,209.00 |
$4,209.00 |
$2,048.36
|
|
Abdominal pad
|
$346.15 |
$346.15 |
$346.15 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$1,890.60 |
$1,890.60 |
$1,890.60 |
$1,655.36
|
|
Abdominal Ultrasound (complete)
|
$1,350.60 |
$1,350.60 |
$1,350.60 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$620.40 |
$620.40 |
$620.40 |
$581.94
|
|
Abdominoplasty 15830
|
$36,500.75 |
$36,500.75 |
$36,500.75 |
$6,442.80
|
|
Abd paracentesis/w/o image guide 49082
|
$1,447.20 |
$1,447.20 |
$1,447.20 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$882.31 |
$882.31 |
$882.31 |
$499.86
|
|
Abduction bar jointed adjust
|
$1,051.42 |
$1,051.42 |
$1,051.42 |
$595.67
|
|
Abduction rotation bar shoe
|
$371.81 |
$371.81 |
$371.81 |
$210.65
|
|
Abduct rotation bar without shoe
|
$339.99 |
$339.99 |
$339.99 |
$192.62
|
|
Abl1 gene
|
$992.40 |
$992.40 |
$992.40 |
$668.85
|
|
Ablation cardiac vagal inputs atrium
|
$400.20 |
$400.20 |
$400.20 |
$1,960.80
|
|
Ablation cryo thigh/knee
|
$6,977.05 |
$6,977.05 |
$6,977.05 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$25,335.19 |
$25,335.19 |
$25,335.19 |
$808.50
|
|
Acetaminophen level
|
$72.00 |
$72.00 |
$72.00 |
$103.75
|
|
Acetazolamide 500 mg solution for injection
|
$286.80 |
$286.80 |
$286.80 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$218.40 |
$218.40 |
$218.40 |
$62.50
|
|
Acetylcholinesterase assay
|
$61.80 |
$61.80 |
$61.80 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$24.31 |
$24.31 |
$24.31 |
$216.00
|
|
Acetylcysteine non-comp unit
|
$74.93 |
$74.93 |
$74.93 |
$31.21
|
|
Acne surgery 10040
|
$475.20 |
$475.20 |
$475.20 |
$260.49
|
|
Acute hepatitis panel
|
$264.00 |
$264.00 |
$264.00 |
$286.05
|
|
#acylcarnitineprfl
|
$162.00 |
$162.00 |
$162.00 |
$125.00
|
|
Adapter b 8 channel 10cm
|
$17,711.61 |
$17,711.61 |
$17,711.61 |
$5,695.04
|
|
Add le poly knee custom kafo
|
$797.26 |
$797.26 |
$797.26 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$57.36 |
$57.36 |
$57.36 |
$235.74
|
|
Adh-sendout
|
$203.40 |
$203.40 |
$203.40 |
$109.28
|
|
Adj gastric band via subq port
|
$4,100.40 |
$4,100.40 |
$4,100.40 |
$1,666.86
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$26,299.39 |
$26,299.39 |
$26,299.39 |
$3,262.50
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$796.80 |
$796.80 |
$796.80 |
$183.76
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$502.20 |
$502.20 |
$502.20 |
$657.12
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$95.40 |
$95.40 |
$95.40 |
$257.40
|
|
Administration immunization 1 vaccine
|
$60.00 |
$60.00 |
$60.00 |
$69.00
|
|
Administration immunization each additional vaccine
|
$63.00 |
$63.00 |
$63.00 |
$46.80
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$16,517.07 |
$16,517.07 |
$16,517.07 |
$11,350.31
|
|
Aep hearing status deter i&r
|
$303.00 |
$303.00 |
$303.00 |
$303.05
|
|
_afb id by dna probe rflx ast
|
$112.80 |
$112.80 |
$112.80 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$31.80 |
$31.80 |
$31.80 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$657.60 |
$657.60 |
$657.60 |
$300.22
|
|
Afo molded ankle gauntlet
|
$1,885.09 |
$1,885.09 |
$1,885.09 |
$1,067.98
|
|
Afo molded plas rig ant tib
|
$4,303.18 |
$4,303.18 |
$4,303.18 |
$2,412.47
|
|
Afo molded to patient plasti
|
$1,799.90 |
$1,799.90 |
$1,799.90 |
$710.45
|
|
Afo rig ant tib tcf/= custom
|
$3,726.72 |
$3,726.72 |
$3,726.72 |
$1,654.77
|
|
Afo sing bar clasp attach sh
|
$1,171.25 |
$1,171.25 |
$1,171.25 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,686.28 |
$1,686.28 |
$1,686.28 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,715.69 |
$1,715.69 |
$1,715.69 |
$696.71
|
|
Afo spiral molded to pt plas
|
$3,211.88 |
$3,211.88 |
$3,211.88 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$1,191.53 |
$1,191.53 |
$1,191.53 |
$675.05
|
|
Afo supramalleolar custom
|
$2,350.09 |
$2,350.09 |
$2,350.09 |
$1,331.42
|
|
Afo tib fx cast plaster mold
|
$3,291.87 |
$3,291.87 |
$3,291.87 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$3,218.96 |
$3,218.96 |
$3,218.96 |
$1,654.77
|
|
Afo tibial fracture soft
|
$2,107.00 |
$2,107.00 |
$2,107.00 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$6,627.28 |
$6,627.28 |
$6,627.28 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$2,668.03 |
$2,668.03 |
$2,668.03 |
$795.02
|
|
After cataract laser surgery
|
$2,672.93 |
$2,672.93 |
$2,672.93 |
$1,373.11
|
|
Ak/knee disartic pelvic band
|
$327.53 |
$327.53 |
$327.53 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$407.34 |
$407.34 |
$407.34 |
$202.75
|
|
Ak sleeve susp neoprene/equa
|
$737.92 |
$737.92 |
$737.92 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$68.40 |
$68.40 |
$68.40 |
$45.18
|
|
Albumin (human), 25%, 50ml
|
$501.90 |
$501.90 |
$501.90 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$527.00 |
$527.00 |
$527.00 |
$245.11
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$73.80 |
$73.80 |
$73.80 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$64.80 |
$64.80 |
$64.80 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$10.20 |
$10.20 |
$10.20 |
$5.40
|
|
Albuterol non-comp unit
|
$10.20 |
$10.20 |
$10.20 |
$5.61
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$67.20 |
$67.20 |
$67.20 |
$91.00
|
|
Alkaline phosphatase
|
$55.80 |
$55.80 |
$55.80 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$60.60 |
$60.60 |
$60.60 |
$47.65
|
|
Allergen egg white ige
|
$41.40 |
$41.40 |
$41.40 |
$37.05
|
|
Allograft 160mg placental salera mini membrane
|
$11,669.40 |
$11,669.40 |
$11,669.40 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$23,011.78 |
$23,011.78 |
$23,011.78 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$28,875.56 |
$28,875.56 |
$28,875.56 |
$2,386.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$17,958.26 |
$17,958.26 |
$17,958.26 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$81,521.72 |
$81,521.72 |
$81,521.72 |
$23,373.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$54,729.40 |
$54,729.40 |
$54,729.40 |
$989.09
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$46,315.37 |
$46,315.37 |
$46,315.37 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$43,730.71 |
$43,730.71 |
$43,730.71 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$14,336.04 |
$14,336.04 |
$14,336.04 |
$4,561.83
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$16,374.12 |
$16,374.12 |
$16,374.12 |
$1,495.63
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$330.60 |
$330.60 |
$330.60 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$104.40 |
$104.40 |
$104.40 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$134.40 |
$134.40 |
$134.40 |
$103.74
|
|
Alprostadil for injection
|
$1,214.17 |
$1,214.17 |
$1,214.17 |
$519.93
|
