|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$28.00 |
$28.00 |
$28.00 |
$33.15
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$31.50 |
$31.50 |
$31.50 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$12.00 |
$12.00 |
$12.00 |
$34.00
|
|
Blood smear interpretation
|
$24.00 |
$24.00 |
$24.00 |
$71.76
|
|
Blood smear microscopic w manual differential wbc count
|
$25.50 |
$25.50 |
$25.50 |
$38.61
|
|
Blood typing abo
|
$44.50 |
$44.50 |
$44.50 |
$83.03
|
|
Blood typing ag donor ea ag
|
$41.00 |
$41.00 |
$41.00 |
$190.80
|
|
Blood typing rbc ag non abo/rh ea
|
$76.50 |
$76.50 |
$76.50 |
$199.50
|
|
Blood typing rh (d)
|
$44.50 |
$44.50 |
$44.50 |
$57.14
|
|
Blue light cysto imag agent
|
$0.01 |
$0.01 |
$0.01 |
$1,898.40
|
|
Bone biopsy open superficial
|
$153.50 |
$153.50 |
$153.50 |
$3,786.00
|
|
Bone Density Scan (DEXA)
|
$318.50 |
$318.50 |
$318.50 |
$397.28
|
|
Bone/joint imaging ltd area
|
$430.50 |
$430.50 |
$430.50 |
$1,013.50
|
|
Bone marrow;aspiration only 38220
|
$72.00 |
$72.00 |
$72.00 |
$1,508.78
|
|
Bone marrow biopsyneedle/trocar 38221
|
$71.50 |
$71.50 |
$71.50 |
$1,570.80
|
|
Bone marrow harvest autolog
|
$208.00 |
$208.00 |
$208.00 |
$5,544.24
|
|
Bone marrow interpretation
|
$48.00 |
$48.00 |
$48.00 |
$542.03
|
|
Boot walker genesis full shell 3-strap s
|
$601.00 |
$601.00 |
$601.00 |
$453.47
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$27.50 |
$27.50 |
$27.50 |
$94.80
|
|
Borrelia miyamotoi amp prb
|
$201.06 |
$201.06 |
$201.06 |
$68.88
|
|
Bowel imaging
|
$526.00 |
$526.00 |
$526.00 |
$1,065.00
|
|
Bpg axillary-pop/-tibial
|
$1,415.00 |
$1,415.00 |
$1,415.00 |
$1,847.50
|
|
Bpg ilio-celiac
|
$1,944.50 |
$1,944.50 |
$1,944.50 |
$2,002.50
|
|
Bpg ilio-mesenteric
|
$2,121.50 |
$2,121.50 |
$2,121.50 |
$2,192.00
|
|
Bpg iliorenal
|
$1,902.50 |
$1,902.50 |
$1,902.50 |
$1,960.00
|
|
Bpg pop-tibl/-prnl artery
|
$1,198.50 |
$1,198.50 |
$1,198.50 |
$1,977.60
|
|
Bpg subclavian-axillary
|
$1,186.50 |
$1,186.50 |
$1,186.50 |
$1,221.00
|
|
Brach/thor cath 1st
|
$223.00 |
$223.00 |
$223.00 |
$1,751.55
|
|
Brach/thor cath 2nd
|
$289.00 |
$289.00 |
$289.00 |
$1,940.40
|
|
Brach/thor cath 3rd
|
$361.00 |
$361.00 |
$361.00 |
$2,079.00
|
|
Brach/thor cath addl
|
$56.00 |
$56.00 |
$56.00 |
$868.00
|
|
Braf gene
|
$390.00 |
$390.00 |
$390.00 |
$427.50
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$2,785.50
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$795.00 |
$795.00 |
$795.00 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$2,296.00 |
$2,296.00 |
$2,296.00 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$1,159.50 |
$1,159.50 |
$1,159.50 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$1,384.50 |
$1,384.50 |
$1,384.50 |
$1,977.27
|
|
Brcassure comprehensive panel-sendout
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$2,287.20
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$2,506.00 |
$2,506.00 |
$2,506.00 |
$3,043.44
|
|
Breast punct aspir cyst, bil
|
$801.50 |
$801.50 |
$801.50 |
$847.00
|
|
Breast reduction
|
$1,149.00 |
$1,149.00 |
$1,149.00 |
$7,126.06
|
|
Bronchial challenge
|
$590.50 |
$590.50 |
$590.50 |
$777.60
|
|
Bronchoscopy clear airways 31645
|
$151.00 |
$151.00 |
$151.00 |
$2,653.80
|
|
Bronchoscopy/lung bx each 31628
|
$179.50 |
$179.50 |
$179.50 |
$3,877.44
|
|
Bronchoscopy w/biopsy(s) 31625
|
$169.00 |
$169.00 |
$169.00 |
$2,168.40
|
|
Bronchoscopy w/fb removal 31635
|
$180.50 |
$180.50 |
$180.50 |
$2,445.96
|
|
Bronch w/debrdmt subgltc & uppr trach
|
$156.50 |
$156.50 |
$156.50 |
$571.00
|
|
Br punct aspir ea add, l
|
$21.50 |
$21.50 |
$21.50 |
$358.00
|
|
Bundled special stain group 1 microorganisms
|
$45.00 |
$45.00 |
$45.00 |
$160.80
|
|
Bundled special stain group 2
|
$305.00 |
$305.00 |
$305.00 |
$173.46
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$10.00 |
$10.00 |
$10.00 |
$32.88
|
|
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet
|
$2.89 |
$2.89 |
$2.89 |
$14.27
|
|
Buprenorphine and metabolite - sendout
|
$37.79 |
$37.79 |
$37.79 |
$82.82
|
|
Buprenorphine oral 1mg
|
$1.97 |
$1.97 |
$1.97 |
$10.50
|
|
Butorphanol tartrate 1 mg
|
$51.96 |
$51.96 |
$51.96 |
$39.09
|
|
Bx arm/elbow soft tissue supf 24065
|
$167.50 |
$167.50 |
$167.50 |
$1,935.63
|
|
Bx breast 1st lesion mr imag
|
$194.50 |
$194.50 |
$194.50 |
$3,256.00
|
|
Bx breast 1st lesion strtctc
|
$177.50 |
$177.50 |
$177.50 |
$3,601.35
|
|
Bx breast add lesion mr imag
|
$97.00 |
$97.00 |
$97.00 |
$1,649.29
|
|
Bx breast add lesion strtctc
|
$89.00 |
$89.00 |
$89.00 |
$1,800.68
|
|
Bx breast add lesion Ultrasound imag
|
$1,087.50 |
$1,087.50 |
$1,087.50 |
$1,692.64
|
|
Bx breast perq without image 19100
|
$74.00 |
$74.00 |
$74.00 |
$1,312.15
|
|
Bx breast pq tomo guide
|
$12.50 |
$12.50 |
$12.50 |
$4,531.42
|
|
Bx/curett of cervix w/scope 57454
|
$551.00 |
$551.00 |
$551.00 |
$515.50
|
|
Bx/exc lymph node/open/deep cervic 38510
|
$443.00 |
$443.00 |
$443.00 |
$4,531.42
|
|
Bx/exc lymph node/open/superfic 38500
|
$284.00 |
$284.00 |
$284.00 |
$4,184.94
|
|
Bx liver with other
|
$113.00 |
$113.00 |
$113.00 |
$543.40
|
|
Bx muscle
|
$102.50 |
$102.50 |
$102.50 |
$1,917.33
|
|
Bx of breast open 19101
|
$248.00 |
$248.00 |
$248.00 |
$4,531.42
|
|
Bx of cervix w/scope leep 57460
|
$169.50 |
$169.50 |
$169.50 |
$3,876.00
|
|
Bx perianal mass
|
$59.50 |
$59.50 |
$59.50 |
$1,540.50
|
|
Bx prostate trnsrctl u/s guid
|
$156.50 |
$156.50 |
$156.50 |
$4,050.75
|
|
Bx skin incisnl ea sep/add l les
|
$31.50 |
$31.50 |
$31.50 |
$249.60
|
|
Bx skin punch ea sep/ addl les
|
$244.17 |
$244.17 |
$244.17 |
$227.13
|
|
Bx skin tangential ea sep/ addl les
|
$182.50 |
$182.50 |
$182.50 |
$203.70
|
|
Bx/soft tis/forearm/wrist/superfic 25065
|
$162.50 |
$162.50 |
$162.50 |
$1,917.33
|
|
Bx vag mucos smpl (sep proc)
|
$1,262.50 |
$1,262.50 |
$1,262.50 |
$1,059.00
|
|
Bx vulva or perineum/1 lesion 56605
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$1,127.00
|
|
Bx vulva or perineum/ea add lesion 56606
|
$30.50 |
$30.50 |
$30.50 |
$465.09
|
|
Bypass graft/av fist patency
|
$173.50 |
$173.50 |
$173.50 |
$868.40
|
|
Bypass graft patency/patch
|
$213.50 |
$213.50 |
$213.50 |
$1,050.40
|
|
Bypass temp external fem-fem
|
$638.50 |
$638.50 |
$638.50 |
$1,806.00
|
|
C1 esterase inhibitor func - sendout
|
$262.50 |
$262.50 |
$262.50 |
$96.72
|
|
Cabgsingle artery graft 33533
|
$1,994.00 |
$1,994.00 |
$1,994.00 |
$4,567.20
|
|
Cabg venous & art 1 vein graft 33517
|
$199.50 |
$199.50 |
$199.50 |
$602.00
|
|
Cabg venous & art 2 vein graft 33518
|
$439.50 |
$439.50 |
$439.50 |
$1,764.80
|
|
Cabg venous & art 3 vein graft 33519
|
$579.50 |
$579.50 |
$579.50 |
$1,071.60
|
|
Cable cath 22-pin diag
|
$503.00 |
$503.00 |
$503.00 |
$4,946.50
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$847.50 |
$847.50 |
$847.50 |
$2,111.64
|
|
Calcium 24 hour urine
|
$28.50 |
$28.50 |
$28.50 |
$53.00
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$20.52 |
$20.52 |
$20.52 |
$45.49
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$22.05 |
$22.05 |
$22.05 |
$64.49
|
|
Calcium ionized
|
$71.50 |
$71.50 |
$71.50 |
$90.00
|
|
Calcium total
|
$30.50 |
$30.50 |
$30.50 |
$50.00
|
|
Calprotectin fecal
|
$30.00 |
$30.00 |
$30.00 |
$169.95
|
|
Cannula declotting 36861
|
$148.50 |
$148.50 |
$148.50 |
$5,855.00
|
|
Cannula ercp contour 5-4-3 tip
|
$4,132.50 |
$4,132.50 |
$4,132.50 |
$34,218.66
|
|
Cantharidin top, applicator
|
$944.00 |
$944.00 |
$944.00 |
$1,113.94
|
|
Canthotomy 67715
|
$2,643.50 |
$2,643.50 |
$2,643.50 |
$2,956.50
|
|
Capsaicin 8% patch
|
$2,693.01 |
$2,693.01 |
$2,693.01 |
$4,719.65
|
