|
11-desoxycortisol - sendout
|
$171.18 |
$171.18 |
$171.18 |
$88.89
|
|
17-hydroxypregnenolone
|
$205.50 |
$205.50 |
$205.50 |
$90.90
|
|
17-ketosteroids
|
$69.17 |
$69.17 |
$69.17 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$1,144.95 |
$1,144.95 |
$1,144.95 |
$1,665.35
|
|
2d tte w or without fol w/con,co
|
$1,288.11 |
$1,288.11 |
$1,288.11 |
$1,278.75
|
|
3d ech img cgen car anomal
|
$419.59 |
$419.59 |
$419.59 |
$490.50
|
|
3d recon without postprocess indpndt
|
$657.70 |
$657.70 |
$657.70 |
$505.05
|
|
5' nucleotidase - sendout
|
$66.18 |
$66.18 |
$66.18 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$59.06 |
$59.06 |
$59.06 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$176.14 |
$176.14 |
$176.14 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$188.09 |
$188.09 |
$188.09 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$183.60 |
$183.60 |
$183.60 |
$116.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$176.14 |
$176.14 |
$176.14 |
$113.40
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$188.09 |
$188.09 |
$188.09 |
$130.20
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$183.60 |
$183.60 |
$183.60 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$200.02 |
$200.02 |
$200.02 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$254.26 |
$254.26 |
$254.26 |
$160.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,925.61 |
$2,925.61 |
$2,925.61 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$36.69 |
$36.69 |
$36.69 |
$53.90
|
|
Abd aorta w/runoff s&i
|
$3,294.82 |
$3,294.82 |
$3,294.82 |
$3,587.50
|
|
Abdominal CT scan (with and without contrast)
|
$2,338.83 |
$2,338.83 |
$2,338.83 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,175.66 |
$2,175.66 |
$2,175.66 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,776.78 |
$1,776.78 |
$1,776.78 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,036.94 |
$3,036.94 |
$3,036.94 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,227.09 |
$2,227.09 |
$2,227.09 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$1,579.21 |
$1,579.21 |
$1,579.21 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$844.58 |
$844.58 |
$844.58 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$720.43 |
$720.43 |
$720.43 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$464.79 |
$464.79 |
$464.79 |
$581.10
|
|
Abd paracentesis/w/o image guide 49082
|
$439.18 |
$439.18 |
$439.18 |
$1,145.00
|
|
Abl1 gene
|
$376.82 |
$376.82 |
$376.82 |
$683.20
|
|
Ablate arrhythmia add on
|
$5,821.59 |
$5,821.59 |
$5,821.59 |
$6,828.51
|
|
Ablate bone tumor(s) perq
|
$5,099.66 |
$5,099.66 |
$5,099.66 |
$9,437.59
|
|
Ablate heart dysrhythm focus
|
$4,323.35 |
$4,323.35 |
$4,323.35 |
$9,476.33
|
|
Ablation cardiac vagal inputs atrium
|
$6,848.35 |
$6,848.35 |
$6,848.35 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$762.92 |
$762.92 |
$762.92 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$4,322.05 |
$4,322.05 |
$4,322.05 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$334.10 |
$334.10 |
$334.10 |
$826.80
|
|
Ablation of upper extremity nerves rf
|
$721.82 |
$721.82 |
$721.82 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$1,921.81 |
$1,921.81 |
$1,921.81 |
$2,999.34
|
|
Access thoracic lymph duct
|
$1,358.54 |
$1,358.54 |
$1,358.54 |
$828.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$82.69 |
$82.69 |
$82.69 |
$73.44
|
|
Acetaminophen level
|
$99.05 |
$99.05 |
$99.05 |
$111.00
|
|
Acetazolamide 500 mg solution for injection
|
$79.56 |
$79.56 |
$79.56 |
$122.55
|
|
Acetone qualitative
|
$33.22 |
$33.22 |
$33.22 |
$47.50
|
|
Acetylcholine receptor modulating antibody
|
$10.65 |
$10.65 |
$10.65 |
$66.28
|
|
Acetylcholinesterase assay
|
$125.89 |
$125.89 |
$125.89 |
$108.79
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$657.40 |
$657.40 |
$657.40 |
$224.98
|
|
Acetylcysteine non-comp unit
|
$8.27 |
$8.27 |
$8.27 |
$31.21
|
|
Acne surgery 10040
|
$93.60 |
$93.60 |
$93.60 |
$265.20
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$243.99 |
$243.99 |
$243.99 |
$344.10
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$23.51 |
$23.51 |
$23.51 |
$37.70
|
|
Actinotherapy uv light
|
$80.82 |
$80.82 |
$80.82 |
$105.60
|
|
Acute hepatitis panel
|
$266.67 |
$266.67 |
$266.67 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$1,234.22 |
$1,234.22 |
$1,234.22 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$985.18 |
$985.18 |
$985.18 |
$64.15
|
|
#acylcarnitineprfl
|
$28.39 |
$28.39 |
$28.39 |
$118.85
|
|
Adapter b 8 channel 10cm
|
$23,829.40 |
$23,829.40 |
$23,829.40 |
$6,142.50
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,673.15 |
$1,673.15 |
$1,673.15 |
$272.57
|
|
Adh-sendout
|
$208.48 |
$208.48 |
$208.48 |
$114.50
|
|
Adj gastric band via subq port
|
$812.63 |
$812.63 |
$812.63 |
$1,609.80
|
|
Adjustment gastric band
|
$812.63 |
$812.63 |
$812.63 |
$207.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$223.81 |
$223.81 |
$223.81 |
$197.05
|
|
Admin ecg contrast agent
|
$118.93 |
$118.93 |
$118.93 |
$111.47
|
|
Administration chemotherapy IV infusion each additional hour
|
$201.05 |
$201.05 |
$201.05 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$206.21 |
$206.21 |
$206.21 |
$298.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$515.51 |
$515.51 |
$515.51 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$268.07 |
$268.07 |
$268.07 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$288.24 |
$288.24 |
$288.24 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$288.24 |
$288.24 |
$288.24 |
$254.40
|
|
Administration immunization 1 vaccine
|
$47.36 |
$47.36 |
$47.36 |
$67.60
|
|
Administration immunization each additional vaccine
|
$46.89 |
$46.89 |
$46.89 |
$46.89
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$44.89 |
$44.89 |
$44.89 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$27.04 |
$27.04 |
$27.04 |
$30.24
|
|
Administration vaccine hepatitis b
|
$47.84 |
$47.84 |
$47.84 |
$51.80
|
|
Administration vaccine influenza virus
|
$46.89 |
$46.89 |
$46.89 |
$48.73
|
|
Administration vaccine pneumococcal
|
$46.89 |
$46.89 |
$46.89 |
$48.73
|
|
_afb id by dna probe rflx ast
|
$120.10 |
$120.10 |
$120.10 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$29.79 |
$29.79 |
$29.79 |
$34.74
|
|
_afb org id by sequencing rflx ast-sendout
|
$275.87 |
$275.87 |
$275.87 |
$293.02
|
|
Afo tib fx semi-rigid l2114
|
$58.55 |
$58.55 |
$58.55 |
$817.60
|
|
Agalsidase beta 35 mg intravenous solution
|
$43,395.98 |
$43,395.98 |
$43,395.98 |
$14,475.20
|
|
Air injection into abdomen 49400
|
$284.04 |
$284.04 |
$284.04 |
$520.00
|
|
Albumin body fluid quantitative each specimen
|
$28.40 |
$28.40 |
$28.40 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$5,041.60 |
$5,041.60 |
$5,041.60 |
$235.92
|
|
Albumin (human), 5%, 250 ml
|
$420.14 |
$420.14 |
$420.14 |
$246.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$44.20 |
$44.20 |
$44.20 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$26.62 |
$26.62 |
$26.62 |
$42.40
|
|
Alcohol/subs interv 15-30mn
|
$54.79 |
$54.79 |
$54.79 |
$54.00
|
|
Alcohol/subs interv >30 min
|
$109.58 |
$109.58 |
$109.58 |
$189.21
|
|
Aldesleukin injection
|
$11,884.64 |
$11,884.64 |
$11,884.64 |
$9,030.11
|
|
Alginate dressing <=16 sq in
|
$13.70 |
$13.70 |
$13.70 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$21.20 |
$21.20 |
$21.20 |
$43.72
|
|
Alkaline phosphatase
|
$25.44 |
$25.44 |
$25.44 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$33.83 |
$33.83 |
$33.83 |
$48.57
|
|
Allergen egg white ige
|
$29.01 |
$29.01 |
$29.01 |
$37.20
|
|
Allergen specific ige qual multi scrn ea
|
$23.96 |
$23.96 |
$23.96 |
$24.00
|
|
Allg patch or app # of tests 95044
|
$476.71 |
$476.71 |
$476.71 |
$423.37
|
|
Allograft 160mg placental salera mini membrane
|
$6,022.57 |
$6,022.57 |
$6,022.57 |
$6,022.57
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$9,206.80 |
$9,206.80 |
$9,206.80 |
$9,018.12
|