|
11-desoxycortisol - sendout
|
$147.93 |
$147.93 |
$147.93 |
$88.89
|
|
17-hydroxypregnenolone
|
$177.58 |
$177.58 |
$177.58 |
$90.90
|
|
17-ketosteroids
|
$59.77 |
$59.77 |
$59.77 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$989.39 |
$989.39 |
$989.39 |
$1,665.35
|
|
2d tte w or without fol w/con,co
|
$1,113.10 |
$1,113.10 |
$1,113.10 |
$1,278.75
|
|
3d ech img cgen car anomal
|
$362.58 |
$362.58 |
$362.58 |
$490.50
|
|
3d recon without postprocess indpndt
|
$568.34 |
$568.34 |
$568.34 |
$505.05
|
|
5' nucleotidase - sendout
|
$57.19 |
$57.19 |
$57.19 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$51.04 |
$51.04 |
$51.04 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$152.21 |
$152.21 |
$152.21 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$162.53 |
$162.53 |
$162.53 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$158.66 |
$158.66 |
$158.66 |
$116.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$152.21 |
$152.21 |
$152.21 |
$113.40
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$162.53 |
$162.53 |
$162.53 |
$130.20
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$158.66 |
$158.66 |
$158.66 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$172.85 |
$172.85 |
$172.85 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$219.71 |
$219.71 |
$219.71 |
$160.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,528.14 |
$2,528.14 |
$2,528.14 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$31.70 |
$31.70 |
$31.70 |
$53.90
|
|
Abd aorta w/runoff s&i
|
$2,847.18 |
$2,847.18 |
$2,847.18 |
$3,587.50
|
|
Abdominal CT scan (with and without contrast)
|
$2,021.07 |
$2,021.07 |
$2,021.07 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,880.07 |
$1,880.07 |
$1,880.07 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,535.39 |
$1,535.39 |
$1,535.39 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,624.34 |
$2,624.34 |
$2,624.34 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$1,924.51 |
$1,924.51 |
$1,924.51 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$1,364.66 |
$1,364.66 |
$1,364.66 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$729.83 |
$729.83 |
$729.83 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$622.55 |
$622.55 |
$622.55 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$401.65 |
$401.65 |
$401.65 |
$581.10
|
|
Abd paracentesis/w/o image guide 49082
|
$379.52 |
$379.52 |
$379.52 |
$1,145.00
|
|
Abl1 gene
|
$325.62 |
$325.62 |
$325.62 |
$683.20
|
|
Ablate arrhythmia add on
|
$5,030.66 |
$5,030.66 |
$5,030.66 |
$6,828.51
|
|
Ablate bone tumor(s) perq
|
$4,406.81 |
$4,406.81 |
$4,406.81 |
$9,437.59
|
|
Ablate heart dysrhythm focus
|
$3,735.97 |
$3,735.97 |
$3,735.97 |
$9,476.33
|
|
Ablation cardiac vagal inputs atrium
|
$5,917.92 |
$5,917.92 |
$5,917.92 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$659.27 |
$659.27 |
$659.27 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$3,734.85 |
$3,734.85 |
$3,734.85 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$288.71 |
$288.71 |
$288.71 |
$826.80
|
|
Ablation of upper extremity nerves rf
|
$623.75 |
$623.75 |
$623.75 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$1,660.71 |
$1,660.71 |
$1,660.71 |
$2,999.34
|
|
Access thoracic lymph duct
|
$1,173.97 |
$1,173.97 |
$1,173.97 |
$828.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$71.46 |
$71.46 |
$71.46 |
$73.44
|
|
Acetaminophen level
|
$85.59 |
$85.59 |
$85.59 |
$111.00
|
|
Acetazolamide 500 mg solution for injection
|
$68.76 |
$68.76 |
$68.76 |
$122.55
|
|
Acetone qualitative
|
$28.71 |
$28.71 |
$28.71 |
$47.50
|
|
Acetylcholine receptor modulating antibody
|
$9.21 |
$9.21 |
$9.21 |
$66.28
|
|
Acetylcholinesterase assay
|
$108.79 |
$108.79 |
$108.79 |
$108.79
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$568.09 |
$568.09 |
$568.09 |
$224.98
|
|
Acetylcysteine non-comp unit
|
$7.15 |
$7.15 |
$7.15 |
$31.21
|
|
Acne surgery 10040
|
$80.88 |
$80.88 |
$80.88 |
$265.20
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$210.84 |
$210.84 |
$210.84 |
$344.10
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$20.32 |
$20.32 |
$20.32 |
$37.70
|
|
Actinotherapy uv light
|
$69.84 |
$69.84 |
$69.84 |
$105.60
|
|
Acute hepatitis panel
|
$230.44 |
$230.44 |
$230.44 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$1,066.54 |
$1,066.54 |
$1,066.54 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$851.34 |
$851.34 |
$851.34 |
$64.15
|
|
#acylcarnitineprfl
|
$24.53 |
$24.53 |
$24.53 |
$118.85
|
|
Adapter b 8 channel 10cm
|
$20,591.88 |
$20,591.88 |
$20,591.88 |
$6,142.50
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,445.83 |
$1,445.83 |
$1,445.83 |
$272.57
|
|
Adh-sendout
|
$180.16 |
$180.16 |
$180.16 |
$114.50
|
|
Adj gastric band via subq port
|
$702.22 |
$702.22 |
$702.22 |
$1,609.80
|
|
Adjustment gastric band
|
$702.22 |
$702.22 |
$702.22 |
$207.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$193.40 |
$193.40 |
$193.40 |
$197.05
|
|
Admin ecg contrast agent
|
$102.78 |
$102.78 |
$102.78 |
$111.47
|
|
Administration chemotherapy IV infusion each additional hour
|
$173.74 |
$173.74 |
$173.74 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$178.19 |
$178.19 |
$178.19 |
$298.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$445.47 |
$445.47 |
$445.47 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$231.65 |
$231.65 |
$231.65 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$249.08 |
$249.08 |
$249.08 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$249.08 |
$249.08 |
$249.08 |
$254.40
|
|
Administration immunization 1 vaccine
|
$40.93 |
$40.93 |
$40.93 |
$67.60
|
|
Administration immunization each additional vaccine
|
$40.52 |
$40.52 |
$40.52 |
$46.89
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$38.79 |
$38.79 |
$38.79 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$23.37 |
$23.37 |
$23.37 |
$30.24
|
|
Administration vaccine hepatitis b
|
$41.34 |
$41.34 |
$41.34 |
$51.80
|
|
Administration vaccine influenza virus
|
$40.52 |
$40.52 |
$40.52 |
$48.73
|
|
Administration vaccine pneumococcal
|
$40.52 |
$40.52 |
$40.52 |
$48.73
|
|
_afb id by dna probe rflx ast
|
$103.78 |
$103.78 |
$103.78 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$25.74 |
$25.74 |
$25.74 |
$34.74
|
|
_afb org id by sequencing rflx ast-sendout
|
$238.39 |
$238.39 |
$238.39 |
$293.02
|
|
Afo tib fx semi-rigid l2114
|
$50.60 |
$50.60 |
$50.60 |
$817.60
|
|
Agalsidase beta 35 mg intravenous solution
|
$37,500.11 |
$37,500.11 |
$37,500.11 |
$14,475.20
|
|
Air injection into abdomen 49400
|
$245.45 |
$245.45 |
$245.45 |
$520.00
|
|
Albumin body fluid quantitative each specimen
|
$24.54 |
$24.54 |
$24.54 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$4,356.63 |
$4,356.63 |
$4,356.63 |
$235.92
|
|
Albumin (human), 5%, 250 ml
|
$363.06 |
$363.06 |
$363.06 |
$246.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$38.20 |
$38.20 |
$38.20 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$23.01 |
$23.01 |
$23.01 |
$42.40
|
|
Alcohol/subs interv 15-30mn
|
$47.35 |
$47.35 |
$47.35 |
$54.00
|
|
Alcohol/subs interv >30 min
|
$94.69 |
$94.69 |
$94.69 |
$189.21
|
|
Aldesleukin injection
|
$10,269.97 |
$10,269.97 |
$10,269.97 |
$9,030.11
|
|
Alginate dressing <=16 sq in
|
$11.84 |
$11.84 |
$11.84 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$18.32 |
$18.32 |
$18.32 |
$43.72
|
|
Alkaline phosphatase
|
$21.98 |
$21.98 |
$21.98 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$29.23 |
$29.23 |
$29.23 |
$48.57
|
|
Allergen egg white ige
|
$25.07 |
$25.07 |
$25.07 |
$37.20
|
|
Allergen specific ige qual multi scrn ea
|
$20.71 |
$20.71 |
$20.71 |
$24.00
|
|
Allg patch or app # of tests 95044
|
$411.95 |
$411.95 |
$411.95 |
$423.37
|
|
Allograft 160mg placental salera mini membrane
|
$5,204.33 |
$5,204.33 |
$5,204.33 |
$6,022.57
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,955.95 |
$7,955.95 |
$7,955.95 |
$9,018.12
|