|
3d ech img cgen car anomal
|
$460.00 |
$460.00 |
$460.00 |
$460.00
|
|
3-d radiotherapy plan
|
$5,300.00 |
$5,300.00 |
$5,300.00 |
$4,953.00
|
|
3d recon without postprocess indpndt
|
$255.00 |
$255.00 |
$255.00 |
$467.95
|
|
5' nucleotidase - sendout
|
$62.50 |
$62.50 |
$62.50 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$57.50 |
$57.50 |
$57.50 |
$94.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$62.50 |
$62.50 |
$62.50 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,655.50
|
|
Abdominal CT scan (without contrast)
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,265.00 |
$3,265.00 |
$3,265.00 |
$3,004.50
|
|
Abdominal MRI (without contrast)
|
$2,110.00 |
$2,110.00 |
$2,110.00 |
$1,981.20
|
|
Abdominal paracentesis w/image guidance
|
$690.00 |
$690.00 |
$690.00 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$515.00 |
$515.00 |
$515.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$387.50 |
$387.50 |
$387.50 |
$604.80
|
|
Abd paracentesis/w/o image guide 49082
|
$560.00 |
$560.00 |
$560.00 |
$1,179.75
|
|
Abl1 gene
|
$805.00 |
$805.00 |
$805.00 |
$668.85
|
|
Ablat 1/+thyr ndul addl prq rf
|
$1,775.00 |
$1,775.00 |
$1,775.00 |
$1,155.50
|
|
Ablation of upper extremity nerves rf
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$961.20
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$3,550.00 |
$3,550.00 |
$3,550.00 |
$2,964.48
|
|
Abscess drain retroperitoneal surg code
|
$2,890.00 |
$2,890.00 |
$2,890.00 |
$3,053.18
|
|
Absorpt drg <=16 sq in without b
|
$5.00 |
$5.00 |
$5.00 |
$5.00
|
|
Absorpt drg > 48 sq in without b
|
$7.50 |
$7.50 |
$7.50 |
$7.76
|
|
Acetaminophen level
|
$157.50 |
$157.50 |
$157.50 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$31.33 |
$31.33 |
$31.33 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$62.50 |
$62.50 |
$62.50 |
$61.80
|
|
Acetylcholinesterase assay
|
$157.50 |
$157.50 |
$157.50 |
$106.70
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$420.00 |
$420.00 |
$420.00 |
$384.15
|
|
Actigraphy testing
|
$295.00 |
$295.00 |
$295.00 |
$218.05
|
|
Acute hepatitis panel
|
$322.50 |
$322.50 |
$322.50 |
$278.33
|
|
#acylcarnitineprfl
|
$225.00 |
$225.00 |
$225.00 |
$110.25
|
|
Adenovirus antibody,serum - quest
|
$77.50 |
$77.50 |
$77.50 |
$63.00
|
|
Adh-sendout
|
$170.00 |
$170.00 |
$170.00 |
$109.71
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$13.45 |
$13.45 |
$13.45 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$235.00 |
$235.00 |
$235.00 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$235.00 |
$235.00 |
$235.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$470.00 |
$470.00 |
$470.00 |
$690.21
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$272.50 |
$272.50 |
$272.50 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$147.50 |
$147.50 |
$147.50 |
$264.82
|
|
Administration immunization 1 vaccine
|
$32.50 |
$32.50 |
$32.50 |
$67.20
|
|
Administration immunization each additional vaccine
|
$15.00 |
$15.00 |
$15.00 |
$46.23
|
|
Adrenalin epinephrine inject
|
$5.72 |
$5.72 |
$5.72 |
$92.03
|
|
Aep hearing status deter i&r
|
$147.50 |
$147.50 |
$147.50 |
$303.05
|
|
_afb id by dna probe rflx ast
|
$80.00 |
$80.00 |
$80.00 |
$89.70
|
|
_afb org id by sequencing rflx ast-sendout
|
$785.00 |
$785.00 |
$785.00 |
$289.60
|
|
Airway resistance by impulse oscillometry 94728
|
$240.00 |
$240.00 |
$240.00 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$47.50 |
$47.50 |
$47.50 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$91.24 |
$91.24 |
$91.24 |
$218.40
|
|
Albumin (human), 5%, 250 ml
|
$108.98 |
$108.98 |
$108.98 |
$242.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$62.50 |
$62.50 |
$62.50 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$37.50 |
$37.50 |
$37.50 |
$39.78
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$112.50 |
$112.50 |
$112.50 |
$94.90
|
|
Alginate dressing <=16 sq in
|
$11.17 |
$11.17 |
$11.17 |
$18.03
|
|
Alginate drsg >16 <=48 sq in
|
$20.00 |
$20.00 |
$20.00 |
$40.60
|
|
Alginate drsg wound filler
|
$15.12 |
$15.12 |
$15.12 |
$15.42
|
|
Alkaline phosphatase
|
$65.00 |
$65.00 |
$65.00 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$15.00 |
$15.00 |
$15.00 |
$48.57
|
|
Allergen egg white ige
|
$25.00 |
$25.00 |
$25.00 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$12.50 |
$12.50 |
$12.50 |
$24.01
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$304.74 |
$304.74 |
$304.74 |
$5,213.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$236.60 |
$236.60 |
$236.60 |
$1,115.40
|
|
Alpha-fetoprotein tumor marker
|
$110.00 |
$110.00 |
$110.00 |
$102.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$216.13 |
$216.13 |
$216.13 |
$14,503.48
|
|
Alt/sgpt
|
$62.50 |
$62.50 |
$62.50 |
$44.68
|
|
Amantadine (symmetrel)-sendout
|
$312.50 |
$312.50 |
$312.50 |
$178.10
|
|
Aminolevulinic acid delta
|
$70.00 |
$70.00 |
$70.00 |
$74.10
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$5.09 |
$5.09 |
$5.09 |
$150.15
|
|
Amitriptyline (elavil) -sendout
|
$92.50 |
$92.50 |
$92.50 |
$92.50
|
|
Ammonia
|
$85.00 |
$85.00 |
$85.00 |
$114.40
|
|
Amniocentesisdiagnostic 59000
|
$272.50 |
$272.50 |
$272.50 |
$943.50
|
|
Amphetamine confirm urine -sendout
|
$95.00 |
$95.00 |
$95.00 |
$93.61
|
|
Amphetamines 5 or more
|
$92.50 |
$92.50 |
$92.50 |
$87.75
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$13.21 |
$13.21 |
$13.21 |
$58.36
|
|
Amylase
|
$67.50 |
$67.50 |
$67.50 |
$83.20
|
|
Analysis gene f2 20210g>a variant
|
$112.50 |
$112.50 |
$112.50 |
$207.48
|
|
Analysis gene f5 leiden variant
|
$142.50 |
$142.50 |
$142.50 |
$219.13
|
|
Anaplsma phgcytophlm amp prb
|
$107.50 |
$107.50 |
$107.50 |
$88.00
|
|
Anca screen with reflex to titer -quest
|
$157.50 |
$157.50 |
$157.50 |
$100.32
|
|
An cholangiogram percutaneous compl
|
$945.00 |
$945.00 |
$945.00 |
$2,624.13
|
|
An fluoro guide for cvp
|
$460.00 |
$460.00 |
$460.00 |
$510.17
|
|
Ankle X-ray
|
$630.00 |
$630.00 |
$630.00 |
$351.20
|
|
Antibody bacterium, not elsewhere specified
|
$57.50 |
$57.50 |
$57.50 |
$57.85
|
|
Antibody elution rbc reference
|
$150.00 |
$150.00 |
$150.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$110.00 |
$110.00 |
$110.00 |
$114.40
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$247.50 |
$247.50 |
$247.50 |
$218.30
|
|
Antibody id rbc panel
|
$195.00 |
$195.00 |
$195.00 |
$283.80
|
|
Antibody screen rbc
|
$100.00 |
$100.00 |
$100.00 |
$102.05
|
|
Antidepressant not specified
|
$50.00 |
$50.00 |
$50.00 |
$72.14
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$30.00 |
$30.00 |
$30.00 |
$42.35
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$105.00 |
$105.00 |
$105.00 |
$36.60
|
|
Antinuclear antibodies
|
$95.00 |
$95.00 |
$95.00 |
$90.00
|
|
Antinuclear antibodies titer
|
$85.00 |
$85.00 |
$85.00 |
$77.00
|
|
Antipsychotics nos 1-3
|
$200.00 |
$200.00 |
$200.00 |
$153.45
|
|
Antistreptolysin o titer
|
$70.00 |
$70.00 |
$70.00 |
$55.44
|
|
Antithrombin iii activity
|
$155.00 |
$155.00 |
$155.00 |
$112.70
|
|
Apl(pml-rara) quant - sendout
|
$540.00 |
$540.00 |
$540.00 |
$465.60
|
|
Application finger splntstatic 29130
|
$142.50 |
$142.50 |
$142.50 |
$225.29
|
|
Application long leg splint 29505
|
$287.50 |
$287.50 |
$287.50 |
$363.00
|
|
Application lower leg splint 29515
|
$225.00 |
$225.00 |
$225.00 |
$363.10
|
|
Application multi layer compression below knee (both sides)
|
$212.50 |
$212.50 |
$212.50 |
$378.35
|
|
Application of forearm cast 29075
|
$215.00 |
$215.00 |
$215.00 |
$370.80
|
