|
3d recon without postprocess indpndt
|
$189.81 |
$189.81 |
$189.81 |
$425.10
|
|
99381 initial comp preventive med less than 1 year new
|
$181.26 |
$181.26 |
$181.26 |
$151.20
|
|
99382 initial comp preventive med 1 to 4 years new
|
$189.24 |
$189.24 |
$189.24 |
$147.49
|
|
99383 initial comp preventive med 5 to 11 years new
|
$193.23 |
$193.23 |
$193.23 |
$162.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$149.91 |
$149.91 |
$149.91 |
$135.00
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$165.30 |
$165.30 |
$165.30 |
$135.00
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$170.43 |
$170.43 |
$170.43 |
$129.00
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$181.26 |
$181.26 |
$181.26 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$220.59 |
$220.59 |
$220.59 |
$176.03
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$79.80 |
$79.80 |
$79.80 |
$3,998.03
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$111.72 |
$111.72 |
$111.72 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$1,006.05 |
$1,006.05 |
$1,006.05 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$845.88 |
$845.88 |
$845.88 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$595.65 |
$595.65 |
$595.65 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,357.52 |
$2,357.52 |
$2,357.52 |
$2,933.60
|
|
Abdominal MRI (without contrast)
|
$1,721.40 |
$1,721.40 |
$1,721.40 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,455.78 |
$1,455.78 |
$1,455.78 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$791.16 |
$791.16 |
$791.16 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$593.94 |
$593.94 |
$593.94 |
$604.43
|
|
Abobotulinumtoxina
|
$11.40 |
$11.40 |
$11.40 |
$1,066.88
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$1.14 |
$1.14 |
$1.14 |
$89.91
|
|
Acetaminophen level
|
$33.06 |
$33.06 |
$33.06 |
$117.01
|
|
Acetone qualitative
|
$25.08 |
$25.08 |
$25.08 |
$48.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$5.21 |
$5.21 |
$5.21 |
$306.22
|
|
Acetylcysteine non-comp unit
|
$2.78 |
$2.78 |
$2.78 |
$29.01
|
|
Acne surgery 10040
|
$260.49 |
$260.49 |
$260.49 |
$265.20
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$273.60 |
$273.60 |
$273.60 |
$206.14
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$220.02 |
$220.02 |
$220.02 |
$160.50
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$42.75 |
$42.75 |
$42.75 |
$44.40
|
|
Acup 1/> w/estim 1st 15 min
|
$54.15 |
$54.15 |
$54.15 |
$47.33
|
|
Acup 1/> wo estim 1st 15 min
|
$49.59 |
$49.59 |
$49.59 |
$42.90
|
|
Acute hepatitis panel
|
$192.66 |
$192.66 |
$192.66 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.30 |
$0.30 |
$0.30 |
$64.45
|
|
#acylcarnitineprfl
|
$63.84 |
$63.84 |
$63.84 |
$87.72
|
|
Adenosine 3 mg/250 ml bag for osm
|
$2.35 |
$2.35 |
$2.35 |
$217.04
|
|
Adh-sendout
|
$99.18 |
$99.18 |
$99.18 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1.71 |
$1.71 |
$1.71 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$127.11 |
$127.11 |
$127.11 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$245.67 |
$245.67 |
$245.67 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$558.03 |
$558.03 |
$558.03 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$430.92 |
$430.92 |
$430.92 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$128.82 |
$128.82 |
$128.82 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$274.17 |
$274.17 |
$274.17 |
$267.43
|
|
Administration immunization 1 vaccine
|
$66.12 |
$66.12 |
$66.12 |
$70.00
|
|
Administration immunization each additional component
|
$18.24 |
$18.24 |
$18.24 |
$27.20
|
|
Administration immunization each additional vaccine
|
$40.47 |
$40.47 |
$40.47 |
$46.23
|
|
Administration immunization first component each vaccine
|
$26.22 |
$26.22 |
$26.22 |
$45.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$17.10 |
$17.10 |
$17.10 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$15.39 |
$15.39 |
$15.39 |
$33.60
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$26.79 |
$26.79 |
$26.79 |
$41.15
|
|
Administration vaccine hepatitis b
|
$47.88 |
$47.88 |
$47.88 |
$51.11
|
|
Administration vaccine influenza virus
|
$66.12 |
$66.12 |
$66.12 |
$49.40
|
|
Administration vaccine pneumococcal
|
$66.12 |
$66.12 |
$66.12 |
$51.07
|
|
Advance care planning each additional 30 min 99498
|
$145.92 |
$145.92 |
$145.92 |
$128.10
|
|
Aep hearing status deter i&r
|
$482.79 |
$482.79 |
$482.79 |
$305.73
|
|
_afb id by dna probe rflx ast
|
$63.27 |
$63.27 |
$63.27 |
$105.00
|
|
Aflibercept injection
|
$1,263.12 |
$1,263.12 |
$1,263.12 |
$821.98
|
|
Agalsidase beta 35 mg intravenous solution
|
$257.64 |
$257.64 |
$257.64 |
$14,467.53
|
|
Air conduction bilat
|
$56.43 |
$56.43 |
$56.43 |
$116.22
|
|
Airway resistance by impulse oscillometry 94728
|
$215.46 |
$215.46 |
$215.46 |
$279.73
|
|
Albumin body fluid quantitative each specimen
|
$21.66 |
$21.66 |
$21.66 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$113.33 |
$113.33 |
$113.33 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$112.60 |
$112.60 |
$112.60 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$31.35 |
$31.35 |
$31.35 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$19.38 |
$19.38 |
$19.38 |
$43.45
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$30.78 |
$30.78 |
$30.78 |
$94.90
|
|
Alkaline phosphatase
|
$19.95 |
$19.95 |
$19.95 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$59.28 |
$59.28 |
$59.28 |
$56.35
|
|
Allergen egg white ige
|
$18.24 |
$18.24 |
$18.24 |
$39.78
|
|
Allergy injections; 2 or more 95117
|
$30.78 |
$30.78 |
$30.78 |
$47.20
|
|
Allergy injection; single 95115
|
$23.37 |
$23.37 |
$23.37 |
$42.75
|
|
Alpha-fetoprotein tumor marker
|
$59.28 |
$59.28 |
$59.28 |
$103.60
|
|
Alprostadil for injection
|
$7.98 |
$7.98 |
$7.98 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$146.07 |
$146.07 |
$146.07 |
$9,600.63
|
|
Alt/sgpt
|
$20.52 |
$20.52 |
$20.52 |
$49.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$336.87 |
$336.87 |
$336.87 |
$431.84
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$36.61 |
$36.61 |
$36.61 |
$43.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$3.89 |
$3.89 |
$3.89 |
$50.85
|
|
Amitriptyline (elavil) -sendout
|
$66.12 |
$66.12 |
$66.12 |
$101.17
|
|
Ammonia
|
$57.00 |
$57.00 |
$57.00 |
$123.48
|
|
Amphetamine confirm urine -sendout
|
$194.94 |
$194.94 |
$194.94 |
$94.50
|
|
Amphetamines 5 or more
|
$62.13 |
$62.13 |
$62.13 |
$93.60
|
|
Ampicillin 1 gram solution for injection
|
$3.31 |
$3.31 |
$3.31 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$6.38 |
$6.38 |
$6.38 |
$57.38
|
|
Amputation toe interphalangeal joint
|
$1,798.92 |
$1,798.92 |
$1,798.92 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$1,739.64 |
$1,739.64 |
$1,739.64 |
$3,777.93
|
|
Amylase
|
$48.45 |
$48.45 |
$48.45 |
$93.00
|
|
Ana ds-dna
|
$43.32 |
$43.32 |
$43.32 |
$65.52
|
|
Anal/urinary muscle study
|
$666.33 |
$666.33 |
$666.33 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$203.49 |
$203.49 |
$203.49 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$164.73 |
$164.73 |
$164.73 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$82.65 |
$82.65 |
$82.65 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$197.79 |
$197.79 |
$197.79 |
$396.48
|
|
Anastamo/extrahep bil duct/gi trac 47760
|
$3,885.69 |
$3,885.69 |
$3,885.69 |
$5,524.80
|
|
Anca screen with reflex to titer -quest
|
$26.22 |
$26.22 |
$26.22 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,161.44 |
$2,161.44 |
$2,161.44 |
$2,426.60
|
|
An fluoro guide for cvp
|
$372.21 |
$372.21 |
$372.21 |
$509.60
|
|
Anidulafungin injection
|
$3.76 |
$3.76 |
$3.76 |
$209.79
|
|
Ankle arthroscopy/surgery
|
$859.56 |
$859.56 |
$859.56 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$878.94 |
$878.94 |
$878.94 |
$3,839.54
|