|
11-desoxycortisol - sendout
|
$147.34 |
$147.34 |
$147.34 |
$88.89
|
|
17-hydroxypregnenolone
|
$176.88 |
$176.88 |
$176.88 |
$90.90
|
|
17-ketosteroids
|
$59.54 |
$59.54 |
$59.54 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$985.48 |
$985.48 |
$985.48 |
$1,665.35
|
|
2d tte w or without fol w/con,co
|
$1,108.70 |
$1,108.70 |
$1,108.70 |
$1,278.75
|
|
3d ech img cgen car anomal
|
$361.15 |
$361.15 |
$361.15 |
$490.50
|
|
3d recon without postprocess indpndt
|
$566.10 |
$566.10 |
$566.10 |
$505.05
|
|
5' nucleotidase - sendout
|
$56.96 |
$56.96 |
$56.96 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$50.84 |
$50.84 |
$50.84 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$151.61 |
$151.61 |
$151.61 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$161.89 |
$161.89 |
$161.89 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$158.03 |
$158.03 |
$158.03 |
$116.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$151.61 |
$151.61 |
$151.61 |
$113.40
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$161.89 |
$161.89 |
$161.89 |
$130.20
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$158.03 |
$158.03 |
$158.03 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$172.17 |
$172.17 |
$172.17 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$218.85 |
$218.85 |
$218.85 |
$160.73
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,518.14 |
$2,518.14 |
$2,518.14 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$31.58 |
$31.58 |
$31.58 |
$53.90
|
|
Abd aorta w/runoff s&i
|
$2,835.92 |
$2,835.92 |
$2,835.92 |
$3,587.50
|
|
Abdominal CT scan (with and without contrast)
|
$2,013.08 |
$2,013.08 |
$2,013.08 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,872.64 |
$1,872.64 |
$1,872.64 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,529.32 |
$1,529.32 |
$1,529.32 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,613.97 |
$2,613.97 |
$2,613.97 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$1,916.91 |
$1,916.91 |
$1,916.91 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$1,359.26 |
$1,359.26 |
$1,359.26 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$726.95 |
$726.95 |
$726.95 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$620.09 |
$620.09 |
$620.09 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$400.06 |
$400.06 |
$400.06 |
$581.10
|
|
Abd paracentesis/w/o image guide 49082
|
$378.02 |
$378.02 |
$378.02 |
$1,145.00
|
|
Abl1 gene
|
$324.33 |
$324.33 |
$324.33 |
$683.20
|
|
Ablate arrhythmia add on
|
$5,010.78 |
$5,010.78 |
$5,010.78 |
$6,828.51
|
|
Ablate bone tumor(s) perq
|
$4,389.40 |
$4,389.40 |
$4,389.40 |
$9,437.59
|
|
Ablate heart dysrhythm focus
|
$3,721.21 |
$3,721.21 |
$3,721.21 |
$9,476.33
|
|
Ablation cardiac vagal inputs atrium
|
$5,894.53 |
$5,894.53 |
$5,894.53 |
$2,260.30
|
|
Ablation cryo abd perit om
|
$656.66 |
$656.66 |
$656.66 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$3,720.09 |
$3,720.09 |
$3,720.09 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$287.57 |
$287.57 |
$287.57 |
$826.80
|
|
Ablation of upper extremity nerves rf
|
$621.29 |
$621.29 |
$621.29 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$1,654.14 |
$1,654.14 |
$1,654.14 |
$2,999.34
|
|
Access thoracic lymph duct
|
$1,169.33 |
$1,169.33 |
$1,169.33 |
$828.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$71.18 |
$71.18 |
$71.18 |
$73.44
|
|
Acetaminophen level
|
$85.25 |
$85.25 |
$85.25 |
$111.00
|
|
Acetazolamide 500 mg solution for injection
|
$68.48 |
$68.48 |
$68.48 |
$122.55
|
|
Acetone qualitative
|
$28.59 |
$28.59 |
$28.59 |
$47.50
|
|
Acetylcholine receptor modulating antibody
|
$9.17 |
$9.17 |
$9.17 |
$66.28
|
|
Acetylcholinesterase assay
|
$108.36 |
$108.36 |
$108.36 |
$108.79
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$565.84 |
$565.84 |
$565.84 |
$224.98
|
|
Acetylcysteine non-comp unit
|
$7.12 |
$7.12 |
$7.12 |
$31.21
|
|
Acne surgery 10040
|
$80.56 |
$80.56 |
$80.56 |
$265.20
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$210.01 |
$210.01 |
$210.01 |
$344.10
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$20.24 |
$20.24 |
$20.24 |
$37.70
|
|
Actinotherapy uv light
|
$69.56 |
$69.56 |
$69.56 |
$105.60
|
|
Acute hepatitis panel
|
$229.53 |
$229.53 |
$229.53 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$1,062.32 |
$1,062.32 |
$1,062.32 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$847.97 |
$847.97 |
$847.97 |
$64.15
|
|
#acylcarnitineprfl
|
$24.44 |
$24.44 |
$24.44 |
$118.85
|
|
Adapter b 8 channel 10cm
|
$20,510.50 |
$20,510.50 |
$20,510.50 |
$6,142.50
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,440.12 |
$1,440.12 |
$1,440.12 |
$272.57
|
|
Adh-sendout
|
$179.45 |
$179.45 |
$179.45 |
$114.50
|
|
Adj gastric band via subq port
|
$699.45 |
$699.45 |
$699.45 |
$1,609.80
|
|
Adjustment gastric band
|
$699.45 |
$699.45 |
$699.45 |
$207.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$192.64 |
$192.64 |
$192.64 |
$197.05
|
|
Admin ecg contrast agent
|
$102.37 |
$102.37 |
$102.37 |
$111.47
|
|
Administration chemotherapy IV infusion each additional hour
|
$173.05 |
$173.05 |
$173.05 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$177.49 |
$177.49 |
$177.49 |
$298.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$443.71 |
$443.71 |
$443.71 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$230.73 |
$230.73 |
$230.73 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$248.09 |
$248.09 |
$248.09 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$248.09 |
$248.09 |
$248.09 |
$254.40
|
|
Administration immunization 1 vaccine
|
$40.77 |
$40.77 |
$40.77 |
$67.60
|
|
Administration immunization each additional vaccine
|
$40.36 |
$40.36 |
$40.36 |
$46.89
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$38.64 |
$38.64 |
$38.64 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$23.28 |
$23.28 |
$23.28 |
$30.24
|
|
Administration vaccine hepatitis b
|
$41.17 |
$41.17 |
$41.17 |
$51.80
|
|
Administration vaccine influenza virus
|
$40.36 |
$40.36 |
$40.36 |
$48.73
|
|
Administration vaccine pneumococcal
|
$40.36 |
$40.36 |
$40.36 |
$48.73
|
|
_afb id by dna probe rflx ast
|
$103.37 |
$103.37 |
$103.37 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$25.64 |
$25.64 |
$25.64 |
$34.74
|
|
_afb org id by sequencing rflx ast-sendout
|
$237.45 |
$237.45 |
$237.45 |
$293.02
|
|
Afo tib fx semi-rigid l2114
|
$50.40 |
$50.40 |
$50.40 |
$817.60
|
|
Agalsidase beta 35 mg intravenous solution
|
$37,351.90 |
$37,351.90 |
$37,351.90 |
$14,475.20
|
|
Air injection into abdomen 49400
|
$244.48 |
$244.48 |
$244.48 |
$520.00
|
|
Albumin body fluid quantitative each specimen
|
$24.45 |
$24.45 |
$24.45 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$4,339.42 |
$4,339.42 |
$4,339.42 |
$235.92
|
|
Albumin (human), 5%, 250 ml
|
$361.62 |
$361.62 |
$361.62 |
$246.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$38.04 |
$38.04 |
$38.04 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$22.92 |
$22.92 |
$22.92 |
$42.40
|
|
Alcohol/subs interv 15-30mn
|
$47.16 |
$47.16 |
$47.16 |
$54.00
|
|
Alcohol/subs interv >30 min
|
$94.32 |
$94.32 |
$94.32 |
$189.21
|
|
Aldesleukin injection
|
$10,229.38 |
$10,229.38 |
$10,229.38 |
$9,030.11
|
|
Alginate dressing <=16 sq in
|
$11.79 |
$11.79 |
$11.79 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$18.25 |
$18.25 |
$18.25 |
$43.72
|
|
Alkaline phosphatase
|
$21.89 |
$21.89 |
$21.89 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$29.12 |
$29.12 |
$29.12 |
$48.57
|
|
Allergen egg white ige
|
$24.97 |
$24.97 |
$24.97 |
$37.20
|
|
Allergen specific ige qual multi scrn ea
|
$20.62 |
$20.62 |
$20.62 |
$24.00
|
|
Allg patch or app # of tests 95044
|
$410.32 |
$410.32 |
$410.32 |
$423.37
|
|
Allograft 160mg placental salera mini membrane
|
$5,183.76 |
$5,183.76 |
$5,183.76 |
$6,022.57
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,924.50 |
$7,924.50 |
$7,924.50 |
$9,018.12
|