|
24 hr ambulatory b/p monitor
|
$163.02 |
$163.02 |
$163.02 |
$320.45
|
|
2nd order venous cath
|
$4,878.63 |
$4,878.63 |
$4,878.63 |
$1,720.80
|
|
3d ech img cgen car anomal
|
$871.53 |
$871.53 |
$871.53 |
$632.45
|
|
3-d radiotherapy plan
|
$3,467.88 |
$3,467.88 |
$3,467.88 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$86.07 |
$86.07 |
$86.07 |
$425.10
|
|
5' nucleotidase - sendout
|
$22.80 |
$22.80 |
$22.80 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$39.33 |
$39.33 |
$39.33 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$93.21 |
$93.21 |
$93.21 |
$3,998.03
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$75.81 |
$75.81 |
$75.81 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$1,818.30 |
$1,818.30 |
$1,818.30 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$6,426.75 |
$6,426.75 |
$6,426.75 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$6,485.46 |
$6,485.46 |
$6,485.46 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$10,213.26 |
$10,213.26 |
$10,213.26 |
$2,727.40
|
|
Abd/low ext cath addl
|
$1,275.09 |
$1,275.09 |
$1,275.09 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$522.69 |
$522.69 |
$522.69 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$439.47 |
$439.47 |
$439.47 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$309.51 |
$309.51 |
$309.51 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$1,451.79 |
$1,451.79 |
$1,451.79 |
$2,933.60
|
|
Abdominal MRI (without contrast)
|
$772.92 |
$772.92 |
$772.92 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$977.55 |
$977.55 |
$977.55 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$428.64 |
$428.64 |
$428.64 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$410.97 |
$410.97 |
$410.97 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$909.15 |
$909.15 |
$909.15 |
$1,248.00
|
|
Abl1 gene
|
$513.00 |
$513.00 |
$513.00 |
$614.25
|
|
Ablate arrhythmia add on
|
$3,754.02 |
$3,754.02 |
$3,754.02 |
$7,717.80
|
|
Ablate heart dysrhythm focus
|
$11,532.24 |
$11,532.24 |
$11,532.24 |
$9,836.16
|
|
Abscess drain retroperitoneal surg code
|
$5,802.60 |
$5,802.60 |
$5,802.60 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$948.48 |
$948.48 |
$948.48 |
$3,287.87
|
|
Acetaminophen level
|
$22.23 |
$22.23 |
$22.23 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$83.31 |
$83.31 |
$83.31 |
$137.80
|
|
Acetone qualitative
|
$17.10 |
$17.10 |
$17.10 |
$48.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$6.14 |
$6.14 |
$6.14 |
$306.22
|
|
Acetylcysteine non-comp unit
|
$9.58 |
$9.58 |
$9.58 |
$29.01
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$34.20 |
$34.20 |
$34.20 |
$44.40
|
|
Acute hepatitis panel
|
$130.53 |
$130.53 |
$130.53 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.32 |
$0.32 |
$0.32 |
$64.45
|
|
#acylcarnitineprfl
|
$43.32 |
$43.32 |
$43.32 |
$87.72
|
|
Adenosine 3 mg/250 ml bag for osm
|
$3.33 |
$3.33 |
$3.33 |
$217.04
|
|
Adh-sendout
|
$67.26 |
$67.26 |
$67.26 |
$109.28
|
|
Administration chemotherapy IV infusion each additional hour
|
$153.33 |
$153.33 |
$153.33 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$298.11 |
$298.11 |
$298.11 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$672.03 |
$672.03 |
$672.03 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$507.30 |
$507.30 |
$507.30 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$139.65 |
$139.65 |
$139.65 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$331.17 |
$331.17 |
$331.17 |
$267.43
|
|
Administration immunization 1 vaccine
|
$70.11 |
$70.11 |
$70.11 |
$70.00
|
|
Administration immunization each additional vaccine
|
$43.32 |
$43.32 |
$43.32 |
$46.23
|
|
Administration vaccine hepatitis b
|
$45.60 |
$45.60 |
$45.60 |
$51.11
|
|
Administration vaccine influenza virus
|
$71.82 |
$71.82 |
$71.82 |
$49.40
|
|
Administration vaccine pneumococcal
|
$51.30 |
$51.30 |
$51.30 |
$51.07
|
|
Aep hearing status deter i&r
|
$482.79 |
$482.79 |
$482.79 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$418.95 |
$418.95 |
$418.95 |
$509.00
|
|
Aep thrshld est mlt freq i&r
|
$418.95 |
$418.95 |
$418.95 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$42.75 |
$42.75 |
$42.75 |
$105.00
|
|
Air injection into abdomen 49400
|
$607.62 |
$607.62 |
$607.62 |
$545.00
|
|
Airway resistance by impulse oscillometry 94728
|
$215.46 |
$215.46 |
$215.46 |
$279.73
|
|
Albumin body fluid quantitative each specimen
|
$14.82 |
$14.82 |
$14.82 |
$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
|
$21.09 |
$21.09 |
$21.09 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$13.11 |
$13.11 |
$13.11 |
$43.45
|
|
Albuterol non-comp con
|
$1.21 |
$1.21 |
$1.21 |
$9.93
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$21.09 |
$21.09 |
$21.09 |
$94.90
|
|
Alkaline phosphatase
|
$13.68 |
$13.68 |
$13.68 |
$46.50
|
|
Allergen egg white ige
|
$12.54 |
$12.54 |
$12.54 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$35.91 |
$35.91 |
$35.91 |
$26.95
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$144.21 |
$144.21 |
$144.21 |
$3,621.72
|
|
Alpha-fetoprotein tumor marker
|
$39.90 |
$39.90 |
$39.90 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$160.74 |
$160.74 |
$160.74 |
$9,600.63
|
|
Alt/sgpt
|
$13.68 |
$13.68 |
$13.68 |
$49.00
|
|
Aluminum - quest
|
$61.56 |
$61.56 |
$61.56 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$525.54 |
$525.54 |
$525.54 |
$431.84
|
|
Ambl bp mntr w/sw a/r
|
$161.88 |
$161.88 |
$161.88 |
$318.96
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$5.84 |
$5.84 |
$5.84 |
$44.00
|
|
Aminolevulinic acid delta
|
$54.72 |
$54.72 |
$54.72 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$17.23 |
$17.23 |
$17.23 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$9.66 |
$9.66 |
$9.66 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$3.88 |
$3.88 |
$3.88 |
$50.85
|
|
Amitriptyline (elavil) -sendout
|
$45.03 |
$45.03 |
$45.03 |
$101.17
|
|
Ammonia
|
$38.76 |
$38.76 |
$38.76 |
$123.48
|
|
Amphetamine confirm urine -sendout
|
$132.24 |
$132.24 |
$132.24 |
$94.50
|
|
Amphetamines 5 or more
|
$42.18 |
$42.18 |
$42.18 |
$93.60
|
|
Ampicillin 1 gram solution for injection
|
$4.52 |
$4.52 |
$4.52 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$6.84 |
$6.84 |
$6.84 |
$57.38
|
|
Amylase
|
$33.06 |
$33.06 |
$33.06 |
$93.00
|
|
Ana ds-dna
|
$29.07 |
$29.07 |
$29.07 |
$65.52
|
|
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
|
$72.39 |
$72.39 |
$72.39 |
$122.20
|
|
Anaplsma phgcytophlm amp prb
|
$59.85 |
$59.85 |
$59.85 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$17.67 |
$17.67 |
$17.67 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,105.01 |
$2,105.01 |
$2,105.01 |
$2,426.60
|
|
An fluoro guide for cvp
|
$133.95 |
$133.95 |
$133.95 |
$509.60
|
|
Angio balloon ctrl dialysis seg add-on
|
$6,300.21 |
$6,300.21 |
$6,300.21 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$19,841.13 |
$19,841.13 |
$19,841.13 |
$9,462.03
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$16,503.78 |
$16,503.78 |
$16,503.78 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$13,083.21 |
$13,083.21 |
$13,083.21 |
$6,513.10
|
|
Angio tib/peroneal/init ves/unila 37228
|
$27,474.00 |
$27,474.00 |
$27,474.00 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$11,913.00 |
$11,913.00 |
$11,913.00 |
$5,741.00
|
|
Angio trnslmnl balloon same artery ini
|
$23,826.00 |
$23,826.00 |
$23,826.00 |
$9,074.63
|
