|
11-desoxycortisol - sendout
|
$128.80 |
$128.80 |
$128.80 |
$87.50
|
|
17-hydroxypregnenolone
|
$100.80 |
$100.80 |
$100.80 |
$87.59
|
|
17-ketosteroids
|
$56.40 |
$56.40 |
$56.40 |
$55.00
|
|
2nd order venous cath
|
$490.80 |
$490.80 |
$490.80 |
$1,543.85
|
|
3d ech img cgen car anomal
|
$540.00 |
$540.00 |
$540.00 |
$532.35
|
|
3-d radiotherapy plan
|
$3,672.40 |
$3,672.40 |
$3,672.40 |
$5,005.80
|
|
3d recon without postprocess indpndt
|
$818.80 |
$818.80 |
$818.80 |
$500.40
|
|
5' nucleotidase - sendout
|
$49.20 |
$49.20 |
$49.20 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$34.40 |
$34.40 |
$34.40 |
$97.20
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$52.80 |
$52.80 |
$52.80 |
$53.90
|
|
Abd aorta w/runoff s&i
|
$8,830.00 |
$8,830.00 |
$8,830.00 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
$2,024.74
|
|
Abd/low ext cath 3rd
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$2,570.00
|
|
Abd/low ext cath addl
|
$597.20 |
$597.20 |
$597.20 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$1,342.80 |
$1,342.80 |
$1,342.80 |
$1,975.00
|
|
Abdominal CT scan (with contrast)
|
$1,342.80 |
$1,342.80 |
$1,342.80 |
$1,647.25
|
|
Abdominal CT scan (without contrast)
|
$630.80 |
$630.80 |
$630.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$3,004.50
|
|
Abdominal MRI (with contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$1,302.80 |
$1,302.80 |
$1,302.80 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,384.80 |
$1,384.80 |
$1,384.80 |
$1,655.40
|
|
Abdominal Ultrasound (complete)
|
$420.80 |
$420.80 |
$420.80 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$420.80 |
$420.80 |
$420.80 |
$586.52
|
|
Abd paracentesis/w/o image guide 49082
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,150.00
|
|
Abduction bar jointed adjust
|
$192.00 |
$192.00 |
$192.00 |
$529.14
|
|
Abduction bar-straight
|
$94.00 |
$94.00 |
$94.00 |
$173.60
|
|
Abduction rotation bar shoe
|
$54.40 |
$54.40 |
$54.40 |
$164.98
|
|
Abduct rotation bar without shoe
|
$49.60 |
$49.60 |
$49.60 |
$176.01
|
|
Abl1 gene
|
$1,073.20 |
$1,073.20 |
$1,073.20 |
$683.20
|
|
Ablate arrhythmia add on
|
$3,136.40 |
$3,136.40 |
$3,136.40 |
$6,898.92
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,987.20 |
$7,987.20 |
$7,987.20 |
$9,238.00
|
|
Ablate bone tumor(s) perq
|
$9,030.00 |
$9,030.00 |
$9,030.00 |
$9,437.59
|
|
Ablate heart dysrhythm focus
|
$10,726.00 |
$10,726.00 |
$10,726.00 |
$9,523.83
|
|
Ablate pulm tumor perq rf
|
$8,513.20 |
$8,513.20 |
$8,513.20 |
$6,904.15
|
|
Ablation cardiac vagal inputs atrium
|
$261.20 |
$261.20 |
$261.20 |
$2,183.34
|
|
Ablation cryo abd perit om
|
$2,954.80 |
$2,954.80 |
$2,954.80 |
$2,312.80
|
|
Ablation cryo adrenal tumor
|
$4,263.20 |
$4,263.20 |
$4,263.20 |
$6,904.15
|
|
Ablation cryo pq liver tumor(s)
|
$7,361.20 |
$7,361.20 |
$7,361.20 |
$8,581.80
|
|
Ablation cryo retro lymph node
|
$857.60 |
$857.60 |
$857.60 |
$826.80
|
|
Ablation of upper extremity nerves rf
|
$669.60 |
$669.60 |
$669.60 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$1,280.40 |
$1,280.40 |
$1,280.40 |
$2,999.34
|
|
Absorpt drg <=16 sq in w/bdr
|
$34.00 |
$34.00 |
$34.00 |
$5.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$490.80 |
$490.80 |
$490.80 |
$2,314.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$2.18 |
$2.18 |
$2.18 |
$73.33
|
|
Acetaminophen level
|
$6.80 |
$6.80 |
$6.80 |
$106.86
|
|
Acetazolamide 500 mg solution for injection
|
$124.90 |
$124.90 |
$124.90 |
$122.55
|
|
Acetone qualitative
|
$20.00 |
$20.00 |
$20.00 |
$46.20
|
|
Acetylcholine receptor modulating antibody
|
$7.20 |
$7.20 |
$7.20 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1.10 |
$1.10 |
$1.10 |
$226.00
|
|
Actinotherapy uv light
|
$59.60 |
$59.60 |
$59.60 |
$105.60
|
|
Acute hepatitis panel
|
$210.40 |
$210.40 |
$210.40 |
$291.00
|
|
Acyclovir 400 mg tablet
|
$92.68 |
$92.68 |
$92.68 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.66 |
$0.66 |
$0.66 |
$64.45
|
|
#acylcarnitineprfl
|
$74.40 |
$74.40 |
$74.40 |
$124.60
|
|
Adapter b 8 channel 10cm
|
$33,014.00 |
$33,014.00 |
$33,014.00 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$116.00 |
$116.00 |
$116.00 |
$409.30
|
|
Adenosine 3 mg/250 ml bag for osm
|
$8.87 |
$8.87 |
$8.87 |
$268.50
|
|
Adenovirus antibody,serum - quest
|
$56.80 |
$56.80 |
$56.80 |
$58.00
|
|
Adh-sendout
|
$149.60 |
$149.60 |
$149.60 |
$109.28
|
|
Adj gastric band via subq port
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,666.86
|
|
Adjustment gastric band
|
$591.20 |
$591.20 |
$591.20 |
$130.50
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$48.70 |
$48.70 |
$48.70 |
$181.12
|
|
Admin ecg contrast agent
|
$92.00 |
$92.00 |
$92.00 |
$119.00
|
|
Administration chemotherapy IV infusion each additional hour
|
$123.60 |
$123.60 |
$123.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$123.60 |
$123.60 |
$123.60 |
$307.45
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$564.80 |
$564.80 |
$564.80 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$508.40 |
$508.40 |
$508.40 |
$439.45
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$122.40 |
$122.40 |
$122.40 |
$207.94
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$122.40 |
$122.40 |
$122.40 |
$257.05
|
|
Administration immunization 1 vaccine
|
$108.00 |
$108.00 |
$108.00 |
$69.00
|
|
Administration immunization each additional vaccine
|
$33.20 |
$33.20 |
$33.20 |
$47.40
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$286.00 |
$286.00 |
$286.00 |
$44.80
|
|
Administration vaccine hepatitis b
|
$79.20 |
$79.20 |
$79.20 |
$54.00
|
|
Administration vaccine influenza virus
|
$24.40 |
$24.40 |
$24.40 |
$49.40
|
|
Administration vaccine pneumococcal
|
$96.80 |
$96.80 |
$96.80 |
$49.50
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$286.00 |
$286.00 |
$286.00 |
$41.45
|
|
Aep neurodiagnostic i&r
|
$426.40 |
$426.40 |
$426.40 |
$595.00
|
|
Aep thrshld est mlt freq i&r
|
$546.00 |
$546.00 |
$546.00 |
$664.50
|
|
_afb id by dna probe rflx ast
|
$88.40 |
$88.40 |
$88.40 |
$96.99
|
|
#afb mycobacteria suscep. #1
|
$11.60 |
$11.60 |
$11.60 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$86.80 |
$86.80 |
$86.80 |
$300.00
|
|
Afo molded ankle gauntlet
|
$275.60 |
$275.60 |
$275.60 |
$765.51
|
|
Afo molded plas rig ant tib
|
$612.00 |
$612.00 |
$612.00 |
$2,022.34
|
|
Afo molded to patient plasti
|
$311.20 |
$311.20 |
$311.20 |
$757.77
|
|
Afo rig ant tib tcf/= custom
|
$1,988.00 |
$1,988.00 |
$1,988.00 |
$1,877.15
|
|
Afo supramalleolar custom
|
$344.00 |
$344.00 |
$344.00 |
$1,162.69
|
|
Afo tib fx semi-rigid l2114
|
$347.60 |
$347.60 |
$347.60 |
$817.60
|
|
Afo tibial fracture rigid
|
$417.20 |
$417.20 |
$417.20 |
$1,489.57
|
|
Afo tibial fracture soft
|
$283.20 |
$283.20 |
$283.20 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$935.60 |
$935.60 |
$935.60 |
$2,859.19
|
|
Afo w/ankle joint, prefab
|
$286.80 |
$286.80 |
$286.80 |
$741.72
|
|
Air conduction bilat
|
$126.00 |
$126.00 |
$126.00 |
$134.00
|
|
Albumin body fluid quantitative each specimen
|
$28.00 |
$28.00 |
$28.00 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$103.46 |
$103.46 |
$103.46 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$88.96 |
$88.96 |
$88.96 |
$248.58
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$25.60 |
$25.60 |
$25.60 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$22.00 |
$22.00 |
$22.00 |
$42.84
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$71.60 |
$71.60 |
$71.60 |
$94.90
|
|
Alginate drsg >16 <=48 sq in
|
$58.40 |
$58.40 |
$58.40 |
$43.72
|
