Updated 07/10/2023		
		
Item Number	Item Description	Charge Amount
0187-0010-50	SODIUM BENZOATE-SOD PHENYLACET 10-10 % IV SOLN	"$273,964.20"
0169-7013-01	"TRETTEN 2,500 UNIT IV SOLR"	"$245,400.00"
0169-7113-11	"TRETTEN 2,500 UNIT IV SOLR"	"$245,400.00"
13811-705-50	SODIUM BENZOATE-SOD PHENYLACET 10-10 % IV SOLN	"$219,000.00"
50633-210-11	"GLUCARPIDASE 1,000 UNIT IV SOLR"	"$209,418.00"
0003-2328-22	IPILIMUMAB 200 MG/40 ML (5 MG/ML) IV SOLN	"$189,184.32"
57894-061-03	USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRG	"$152,982.72"
50419-208-01	"RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) IV SOLN"	"$146,294.64"
72694-954-01	PEGASPARGASE 750 UNIT/ML INJ SOLN	"$133,454.76"
0008-0100-01	INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR	"$124,470.24"
50242-150-01	OCRELIZUMAB 30 MG/ML IV SOLN	"$106,780.68"
99988-000-34	NM YTTRIUM Y-90 IBRITUMOMAB (ZEVALIN) <=40MCI	"$105,000.00"
HC62808514	CLIP DELIVERY SYSTEM MITRACLIP	"$97,500.00"
99988-000-42	NM SIR-SPHERES Y-90 RESIN MICROSPHERES	"$96,000.00"
99988-000-43	NM THERASPHERE Y-90 GLASS MICROSPHERES	"$96,000.00"
47783-101-01	ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLN	"$94,001.89"
75987-130-15	TEPROTUMUMAB-TRBW 500 MG IV SOLR	"$91,098.60"
66302-014-01	DINUTUXIMAB 3.5 MG/ML IV SOLN	"$86,097.60"
HC44502946	REVAS FEMPOP TLA&STENT&ATHER-B	"$81,964.00"
0024-5824-11	CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN	"$75,153.96"
HC62806963	SENSOR PULMONARY ARTERY PRESS IMPL WIRELESS SYS	"$74,588.00"
0169-7205-01	"NOVOSEVEN RT 5 MG (5,000 MCG) IV SOLR"	"$74,400.00"
0169-7215-11	"NOVOSEVEN RT 5 MG (5,000 MCG) IV SOLR"	"$74,400.00"
99999-033-30	BOTULISM IMMUNE GLOBULIN INJECTION	"$68,760.00"
HC44503068	REVAS TIB/PERO TLA&STNT&ATHR-B	"$66,132.00"
99999-035-68	EPIFIX SKIN GRAFT ( 7X7 CM )	"$65,802.00"
HC62226915	KIT ABALATION (MAZE)	"$65,000.00"
HC62808886	STENT THORACIC SG AC CONFORM(TAG®GORE®)	"$64,253.00"
71104-944-01	"ALPROLIX 3,000 UNIT IV SOLR"	"$62,100.00"
HC62807417	STENT ENDOPRSTH TAA              AF	"$61,750.00"
25682-007-01	SEBELIPASE ALFA 2 MG/ML IV SOLN	"$61,260.00"
HC44702835	COMP EP EVAL W/INDUC&ABLAT 3D MAP ECHO S&I PVI AFIB	"$59,850.00"
50242-917-01	"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN"	"$59,091.84"
HC44502888	REVASC FEM POP W/TLA&ATHER-BI	"$59,063.00"
HC62806849	STENT ENDOPRSTH TAA              AE	"$58,500.00"
51144-050-01	BRENTUXIMAB VEDOTIN 50 MG IV SOLR	"$58,200.00"
HC44703056	TAVR/TAVI W/ PROSTH; TRANSAPICAL EXP (LT THORAC)	"$57,742.00"
HC44703809	EV REPAIR STENT PLACE COARCT AORTA ACROSS MAJOR SIDE BRANCHES	"$57,475.00"
HC44703171	OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; AORTO-BI-ILIAC PRO	"$57,306.00"
HC44703189	OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; AORTO-BIFEM PRO	"$57,306.00"
71336-1000-1	PATISIRAN (LIPID COMPLEX) 2 MG/ML IV SOLN	"$57,000.00"
HC44703163	OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; TUBE PRO	"$56,821.00"
HC44703106	TEVAR W/ LT SUBCLAV; INITIAL ENDO& DIST EXTS CELIAC	"$56,732.00"
HC62807748	M: GENRTR NRSTM HI FREQU RE-CHRG&CHRGR	"$56,635.00"
61755-008-01	CEMIPLIMAB-RWLC 50 MG/ML IV SOLN	"$56,527.38"
HC44702934	REPAIR VISC AORTA FEVAR(PROX&DIST);4 PROSTH	"$56,354.00"
HC44502912	REVASC FEM POP W/TLA&STENT-BI	"$55,834.00"
HC44703460	REPAIR AORTA ASCENDING ENDOVSC STENT GRAFT	"$55,784.00"
HC62808530	GENERATOR PULSE NEUROSTIM(INSPIRE®)	"$55,575.00"
HC62808365	DEVICE CLOSURE LAA (WATCHMAN)	"$55,250.00"
HC62807243	STENT ENDOPRSTH TAA              AD	"$55,250.00"
HC44702926	REPAIR VISC AORTA FEVAR(PROX&DIST);3 PROSTH	"$55,084.00"
0008-4510-01	GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR	"$54,580.50"
68727-745-05	DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR	"$54,150.00"
68727-745-02	DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR	"$54,150.00"
HC44503035	REVAS TIB/PERO W/TLA&STENT-BI	"$53,328.00"
HC44702918	REPAIR VISC AORTA FEVAR(PROX&DIST);2 PROSTH	"$53,273.00"
HC44503001	REVAS TIB/PERO W/TLA & ATHER-BI	"$53,224.00"
HC44702900	REPAIR VISC AORTA FEVAR(PROX&DIS);1 PROSTH	"$52,852.00"
50242-085-27	ALTEPLASE 100 MG IV SOLR	"$52,802.16"
50242-085-25	ALTEPLASE 100 MG IV SOLR	"$52,802.16"
HC44703353	EV REPAIR INFRARENAL AORTA&/ILIAC GRAFT AORTO-BI-ILIAC ~RUPT	"$52,065.00"
HC62807987	STENT ENDOPRSTH TAA              AC	"$52,000.00"
HC44703114	TEVAR; INITIAL ENDO & DIST EXTS TO CELIAC	"$51,680.00"
HC44703338	EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORTO-UNI-ILIAC ~RUPT	"$51,605.00"
HC44702827	COMP EP EVAL W/INDUC&ABLAT 3D MAP TX VT	"$51,300.00"
HC44703049	TAVR/TAVI W/ PROSTH; TRANSAORTIC EXP (STERNO)	"$51,052.00"
HC44504611	THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI BI	"$51,013.00"
HC44503183	REVAS TIB/PER EA+TLA&ATH&STN-B	"$50,959.00"
HC62807185	DIVERTER FLOW NEUROVASC(PIPELINE FLX 35)F	"$50,310.00"
57894-503-01	"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLN"	"$50,197.05"
HC44703817	EV REPAIR STENT PLACE COARCT AORTA NOT CROSSING MAJOR SIDE BRANCHES	"$49,115.00"
HC44502763	REVASC ILIAC W/TLA & STENT-BI	"$49,111.00"
HC44504041	EMBOLIZE TUMOR/ORGAN/INFARCT W/S&I	"$48,879.00"
HC62808134	G130136 KIT STENTS ENDOPRSTH ASC AORTA	"$48,750.00"
HC62808118	STENT ENDOPRSTH TAA IDE G040175	"$48,750.00"
HC62806930	STENT ENDOPRSTH TAA              AB	"$48,750.00"
HC62806641	DIVERTER FLOW NEUROVASC(PIPELINE LG)E	"$48,734.00"
HC45401601	MRI GUIDED US STEREOTACT ABLAT INTRACRAN LESION	"$48,687.00"
HC44504058	EMBOLIZE VES HEMORRG/LYMPH EXTRAVW/S&I	"$48,548.00"
HC44703015	TAVR/TAVI W/ PROSTH; OPEN FEM ARTERY	"$48,373.00"
60923-284-10	ETEPLIRSEN 50 MG/ML IV SOLN	"$48,000.00"
HC44702892	REPAIR VISC AORTA FEVAR; 4+PROSTH	"$47,756.00"
HC44503290	ATHER'TRLUML ILIAC EAVES W/S&I-B	"$47,482.00"
0003-2327-11	IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN	"$47,296.20"
64406-008-01	NATALIZUMAB 300 MG/15 ML IV SOLN	"$47,135.07"
64764-300-20	VEDOLIZUMAB 300 MG IV SOLR	"$46,279.38"
HC62807177	DIVERTER FLOW NEUROVASC(PIPELINE FLX 16)D	"$46,215.00"
HC44702884	REPAIR VISC AORTA FEVAR; 3 PROSTH	"$46,150.00"
HC44703031	TAVR/TAVI W/ PROSTH; OPEN ILIAC ARTERY	"$45,947.00"
58468-0225-1	CAPLACIZUMAB-YHDP 11 MG INJ KIT	"$45,552.00"
58468-0227-1	CAPLACIZUMAB-YHDP 11 MG INJ SOLR	"$45,552.00"
HC44502938	REVAS FEMPOP TLA&STENT&ATHER-L	"$45,538.00"
HC44502920	REVAS FEMPOP TLA&STENT&ATHER-R	"$45,538.00"
HC62808068	STENT ENDOPRSTH AAA              AA	"$45,500.00"
HC62808076	STENT ENDOPRSTH TAA              AA	"$45,500.00"
HC62802988	DEVICE FLOW DIVERSION PIPELINE	"$45,175.00"
HC44702876	REPAIR VISC AORTA FEVAR; 2 PROSTH	"$44,943.00"
HC44703619	TRANSCATH INTRACARD SHUNT(TIS) STENT ICF CONGENTL INCLUDE IMAGI; 1ST SHUNT (FONTANE)	"$44,674.00"
HC62806633	DIVERTER FLOW NEUROVASC(PIPELINE SM)C	"$44,525.00"
HC44503159	REVAS TIB/PER EA+V TLA&STENT-B	"$44,358.00"
HC44501005	INSERTION-TIPS	"$44,030.00"
HC44703023	TAVR/TAVI W/ PROSTH; OPEN AXILLARLY ARTERY	"$43,774.00"
HC44702868	REPAIR VISC AORTA FEVAR;1 PROSTH	"$43,735.00"
HC62805270	DEVICE EMBOLIZATION NEURO(PIPELINE)	"$43,225.00"
HC62808639	OXYGENATOR ECMO CIRCUIT CARDIOHELP	"$42,900.00"
HC44504033	EMBOLIZE ARTERIAL(ANY MALFORMTN)W/S&I	"$42,773.00"
HC44702819	COMP EP EVAL W/INDUC&ABLAT 3D MAP TX SVT	"$42,750.00"
50242-070-01	"OBINUTUZUMAB 1,000 MG/40 ML IV SOLN"	"$42,736.32"
HC44502821	REVAS ILIAC EA+VES W/TLA&STENT-B	"$42,397.00"
HC62806245	SYSTEM PERFUSION VENOUS(ANGIOVAC)	"$42,250.00"
0003-3734-13	NIVOLUMAB 240 MG/24 ML IV SOLN	"$41,489.57"
50242-918-01	ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN	"$41,364.29"
58468-0040-1	AGALSIDASE BETA 35 MG IV SOLR	"$41,357.70"
HC44503266	ATHER'TRLUML BRACH EAVES W/S&I-B	"$41,307.00"
HC44703221	PERC LT ATRIAL APPEND CLOSURE (LARIAT)	"$41,241.00"
HC44503217	ATHER' TRLUML RENAL ART&S&I-BI	"$40,885.00"
HC44503126	REVASC TIB/PERO EA+VES W/TLA-B	"$40,871.00"
HC62808217	DEVICE NEUROVASC PULSERIDER H160002	"$40,625.00"
HC44703312	EV REPAIR INFRARENAL AORTA DEPLOY GRAFT A-A ~RUPT	"$40,306.00"
HC44703585	TMVR MITRACLIP INITIAL PROTH	"$40,207.00"
99999-035-67	EPIFIX SKIN GRAFT ( 5X6 CM )	"$40,038.00"
50242-108-01	"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLN"	"$39,459.49"
HC44703007	TAVR/TAVI W/ PROSTH; PERC FEM ARTERY	"$39,445.00"
25682-001-01	ECULIZUMAB 300 MG/30 ML IV SOLN	"$39,137.94"
HC44703379	EV REPAIR ILIAC GRFT ILIO-ILIAC AORTIC BI DIST UNILAT ~RUPT	"$39,005.00"
HC62808050	STENT ENDOPRSTH AAA               Y	"$39,000.00"
HC44700433	INSERT/REPLC SYSTM T-ICD DUAL W/LDS	"$38,960.00"
0002-7678-01	RAMUCIRUMAB 10 MG/ML IV SOLN	"$38,819.10"
HC44703122	TEVAR; PLCMT PROX EXT PROTH; INITIAL	"$38,574.00"
55513-190-01	PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRG	"$38,507.94"
55513-192-01	PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYIN	"$38,507.94"
HC44703718	PERC REPAIR TRNSCTH TRICUSPID VALVE 1ST PROSTHESIS	"$38,475.00"
25682-025-01	RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN	"$38,424.01"
44206-439-40	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$38,256.00"
44206-439-93	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$38,256.00"
0944-2719-30	IMMUN GLOB G(IGG)-GLY-IGA OV50 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLN	"$38,070.00"
HC44701662	PERC CLOSURE OF VSD W/IMPLANT	"$37,996.00"
HC44501864	REVISION-TIPS	"$37,961.00"
HC44503662	VERT/THOR CAROTID STENT 1ST LT	"$37,513.00"
HC44503670	VERT/THOR CAROTID STENT 1ST RT	"$37,513.00"
48818-001-01	PRALATREXATE 20 MG/ML (1 ML) IV SOLN	"$37,448.22"
50242-037-06	TENECTEPLASE 50 MG INJ SOLR (MHS)	"$37,313.16"
HC62808597	CATH LITHOTRIPSY CORONARY TRANSLUM INTRAVASC	"$37,008.00"
HC44703270	PPVI PERC TRANSCATH PV IMPLANT W/STENTING	"$36,947.00"
64193-425-02	"FEIBA NF 1,750-3,250 UNIT IV SOLR"	"$36,900.00"
HC44703346	EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORT-BI-ILIAC NONRUPT	"$36,791.00"
HC44700441	INSERT/REPLC SYSTM T-ICD SNGL W/LD	"$36,312.00"
HC44504025	EMBOLIZE VENOUS (ANY MALFORMTN)W/S&I	"$36,237.00"
0078-0690-61	"OFATUMUMAB 1,000 MG/50 ML IV SOLN"	"$36,202.20"
HC44701415	PLCMT CORON CATH;R&L HRT&GRFT	"$36,056.00"
HC44501880	STENT PLAC INTRACRANIAL	"$36,001.00"
HC44501583	PTA INTRACRANIAL	"$35,852.00"
HC62228895	SYSTEM FLOWTRIEVER®	"$35,750.00"
HC44703601	TRANSCATH ATRIAL SEPT(TAS)CONGENTL INCLED ALL IMAG(RASHKIND)	"$35,739.00"
HC44502730	REVASC ILIAC W/TLA INITL VES-BI	"$35,676.00"
HC44502854	REVASC FEM POP W/TLA-BI	"$35,439.00"
HC44504157	SEL CATH  IC CAROTID &ANG IC W/SI BI	"$35,131.00"
HC44500601	CAROTID STENT W/EMBOL PROT LT	"$35,023.00"
HC44500619	CAROTID STENT W/EMBOL PROT RT	"$35,023.00"
HC44502698	CAROTID STENT W/O EMBO PROT LT	"$35,023.00"
HC44502706	CAROTID STENT W/O EMBO PROT RT	"$35,023.00"
HC44700698	PERC BALLOON VALVPLSTY MITRAL	"$34,911.00"
HC44503050	REVAS TIB/PERO TLA&STNT&ATHR-L	"$34,802.00"
HC44503043	REVAS TIB/PERO TLA&STNT&ATHR-R	"$34,802.00"
50242-145-01	PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN	"$34,674.02"
HC44703320	EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORT-UNIILIAC NONRUPT	"$34,614.00"
HC47200811	"SRS LINR ACCL TX 1 SESSN,CMPLT(CRANIAL)"	"$34,488.00"
HC47200837	"SRS ROBOTIC TX 1 SESSN, CMPLT(CRANIAL)"	"$34,488.00"
HC44701399	PLCMT CORON CATH;LT HRT&GRAFTS	"$34,129.00"
HC44703551	REVASCULARIZATION LITHOTRIPSY INTRAVASC W/STENT & ATHERECT	"$33,953.00"
HC38420188	ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS	"$33,871.00"
HC38420196	ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER	"$33,871.00"
HC44702280	PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LC	"$33,837.00"
HC44702272	PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LD	"$33,837.00"
HC44702264	PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LM	"$33,837.00"
HC44702298	PERC COR CHRON REVAS ATHR/STNT/A;SNGL-RC	"$33,837.00"
HC44702306	PERC COR CHRON REVAS ATHR/STNT/A;SNGL-RI	"$33,837.00"
HC44702736	PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LC	"$33,837.00"
HC44702728	PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LD	"$33,837.00"
HC44702710	PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LM	"$33,837.00"
HC44702744	PERC COR CHRONC REVAS ATHR/DES/A;SNGL-RC	"$33,837.00"
HC44702751	PERC COR CHRONC REVAS ATHR/DES/A;SNGL-RI	"$33,837.00"
HC25001413	TRAUMA ACTVTN I CMPREN	"$33,823.00"
HC44703148	TEVAR; PLCMT OF DISTAL EXTS PROTH(S) DELAYED	"$33,737.00"
HC44703700	PERC TRANSCATH INTRATRIAL SEPTAL SHUNT	"$33,730.00"
HC44500544	PERC DILATATION INTRACRANIAL VASOSPASM EA ADD VES DIFF TERRITORY+	"$33,527.00"
HC44702033	PERC COR ATHR+STENT/ANGIOP; SNGL-LC	"$33,509.00"
HC44702025	PERC COR ATHR+STENT/ANGIOP; SNGL-LD	"$33,509.00"
HC44702017	PERC COR ATHR+STENT/ANGIOP; SNGL-LM	"$33,509.00"
HC44702041	PERC COR ATHR+STENT/ANGIOP; SNGL-RC	"$33,509.00"
HC44702058	PERC COR ATHR+STENT/ANGIOP; SNGL-RI	"$33,509.00"
HC44702488	PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LC	"$33,509.00"
HC44702470	PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LD	"$33,509.00"
HC44702462	PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LM	"$33,509.00"
HC44702496	PERC COR ATHR+STENT(DES)ANGIOP; SNGL-RC	"$33,509.00"
HC44702504	PERC COR ATHR+STENT(DES)ANGIOP; SNGL-RI	"$33,509.00"
HC44502979	REVAS TIB/PERO W/TLA 1ST VES-BI	"$33,459.00"
0074-3346-03	LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT	"$33,372.90"
0026-3787-75	"KOGENATE FS 3,000 (+/-) UNIT IV SOLR"	"$33,300.00"
0008-1279-01	TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR	"$33,292.44"
HC44702231	PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LC	"$33,206.00"
HC44702223	PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LD	"$33,206.00"
HC44702215	PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LM	"$33,206.00"
HC44702249	PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-RC	"$33,206.00"
HC44702256	PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-RI	"$33,206.00"
HC44702686	PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LC	"$33,206.00"
HC44702678	PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LD	"$33,206.00"
HC44702660	PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LM	"$33,206.00"
HC44702694	PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-RC	"$33,206.00"
HC44702702	PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-RI	"$33,206.00"
50242-087-01	ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR	"$33,069.90"
69853-0102-1	"FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR"	"$33,000.00"
HC44701407	PLCMT CORON CATH;R&L HRT CATH	"$32,967.00"
HC44502870	REVASC FEM POP W/TLA&ATHER-LT	"$32,813.00"
HC44502862	REVASC FEM POP W/TLA&ATHER-RT	"$32,813.00"
HC44504173	SEL CATH VERTEBRAL &ANG VRT W/SI BI	"$32,726.00"
HC62806831	STENT ENDOPRSTH AAA               W	"$32,500.00"
HC62806922	STENT ENDOPRSTH TAA               W	"$32,500.00"
HC62808738	KIT THROMBECTOMY/EMBOLECTOMY        Z	"$32,485.00"
99207-240-05	EDETATE CALCIUM DISODIUM 200 MG/ML INJ SOLN	"$32,312.79"
0944-3046-10	"ADVATE 3,000 (+/-) UNIT IV SOLR"	"$32,220.00"
0944-3046-11	"ADVATE 3,000 (+/-) UNIT IV SOLR"	"$32,220.00"
HC44502045	TRANSCATH EMBOLIZ PERC-CNS	"$32,216.00"
0310-1730-30	BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRG	"$32,105.28"
HC44701621	INSRT ICD W/EXSTNG MULTI LEADS	"$32,001.00"
HC62808720	KIT THROMBECTOMY/EMBOLECTOMY        Y	"$31,835.00"
HC38420311	INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS	"$31,754.00"
HC44502052	TRANSCATH EMBOLIZ PERC-NON CNS	"$31,641.00"
HC44701654	REMV&REPLC SYSTM ICD LEAD MULTI	"$31,610.00"
HC44702975	INSERT/REPLC SYSTM ICD PERM&SUBQ LD	"$31,297.00"
13533-800-40	IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) INJ SOLN	"$31,228.80"
13533-800-41	IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) INJ SOLN	"$31,228.80"
HC44700680	PERC BALLOON VALVPLSTY AORTIC	"$31,111.00"
HC44502904	REVASC FEM POP W/TLA&STENT-LT	"$31,020.00"
HC44502896	REVASC FEM POP W/TLA&STENT-RT	"$31,020.00"
HC44504769	"THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ; &PTA,STENT(S)OF PDS"	"$31,009.00"
HC44502797	REVASC ILIAC EA+VES W/TLA-BI	"$30,966.00"
0006-3026-01	PEMBROLIZUMAB 25 MG/ML IV SOLN	"$30,806.16"
0006-3026-02	PEMBROLIZUMAB 25 MG/ML IV SOLN	"$30,806.16"
50474-710-79	CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYKT	"$30,598.08"
HC44700714	PERC CLOSURE OF ASD W/IMPLANT	"$30,584.00"
HC44701837	PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LC	"$30,483.00"
HC44701829	PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LD	"$30,483.00"
HC44701811	PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LM	"$30,483.00"
HC44701845	PERC COR ANGIOP/ATHRECT; SNGL CA/BR-RC	"$30,483.00"
HC44701852	PERC COR ANGIOP/ATHRECT; SNGL CA/BR-RI	"$30,483.00"
HC44504827	TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL BILAT	"$30,366.00"
HC44503092	REVASC TIB/PERO EA+VES W/TLA-B	"$30,206.00"
25010-210-27	ETHACRYNATE SODIUM 50 MG IV SOLR	"$30,087.96"
73607-011-11	ARTESUNATE 110 MG IV SOLR	"$29,880.00"
HC44504140	SEL CATH CC/INOM &ANGIO IC W/S&I BI	"$29,849.00"
0169-7202-01	"NOVOSEVEN RT 2 MG (2,000 MCG) IV SOLR"	"$29,760.00"
0169-7212-11	"NOVOSEVEN RT 2 MG (2,000 MCG) IV SOLR"	"$29,760.00"
HC44700706	PERC BALLOON VALVPLSTY PULM	"$29,744.00"
HC44703304	EV REPAIR INFRARENAL AORTA DEPLOY GRAFT A-A NON-RUPT	"$29,669.00"
HC25002676	TRAUMA ACT' I W/O CC SERVICE	"$29,633.00"
0024-5151-75	RASBURICASE 7.5 MG IV SOLR	"$29,574.30"
0024-5151-74	RASBURICASE 7.5 MG IV SOLR	"$29,574.30"
HC44700813	PLACEMENT COIL  SEPTUM	"$29,520.00"
HC44502995	REVAS TIB/PERO W/TLA & ATHER-LT	"$29,508.00"
HC44502987	REVAS TIB/PERO W/TLA & ATHER-RT	"$29,508.00"
HC44503027	REVAS TIB/PERO W/TLA&STENT-LT	"$29,406.00"
HC44503019	REVAS TIB/PERO W/TLA&STENT-RT	"$29,406.00"
HC62803317	STENT ENDOPRSTH AAA               V	"$29,250.00"
HC44702132	PERC CABG REVAS ATHR/STENT/ANG; SNGL-LC	"$29,045.00"
HC44702124	PERC CABG REVAS ATHR/STENT/ANG; SNGL-LD	"$29,045.00"
HC44702116	PERC CABG REVAS ATHR/STENT/ANG; SNGL-LM	"$29,045.00"
HC44702140	PERC CABG REVAS ATHR/STENT/ANG; SNGL-RC	"$29,045.00"
HC44702587	PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LC	"$29,045.00"
HC44702579	PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LD	"$29,045.00"
HC44702561	PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LM	"$29,045.00"
HC44702595	PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-RC	"$29,045.00"
HC44702603	PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-RI	"$29,045.00"
HC44700383	INSERT PACER DUAL CHAMBER	"$28,699.00"
71104-806-01	"ELOCTATE 2,000 UNIT IV SOLR"	"$28,560.00"
HC44702389	PERC COR DES STENT(S)/ANGIOP; SNGL-LC	"$28,257.00"
HC44702371	PERC COR DES STENT(S)/ANGIOP; SNGL-LD	"$28,257.00"
HC44702363	PERC COR DES STENT(S)/ANGIOP; SNGL-LM	"$28,257.00"
HC44702397	PERC COR DES STENT(S)/ANGIOP; SNGL-RC	"$28,257.00"
HC44702405	PERC COR DES STENT(S)/ANGIOP; SNGL-RI	"$28,257.00"
HC44701936	PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LC	"$28,224.00"
HC44701928	PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LD	"$28,224.00"
HC44701910	PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LM	"$28,224.00"
HC44701944	PERC COR STENT(S)/ANGIOP; SNGL CA/BR-RC	"$28,224.00"
HC44701951	PERC COR STENT(S)/ANGIOP; SNGL CA/BR-RI	"$28,224.00"
HC44703783	RT & LT HRT CATH CONGEN DEFECT INCLUDE IMAGE; ABNRML NATIVE CONNECT	"$28,215.00"
50242-053-06	RITUXIMAB 10 MG/ML IV CONC	"$28,185.60"
0074-3663-03	LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT	"$28,005.84"
HC44504629	THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI LT	"$27,937.00"
HC44504637	THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI RT	"$27,937.00"
HC44701373	PLCMT CORON CATH;GRAFTS&RT HRT	"$27,914.00"
HC44701647	REMV&REPLC SYSTM ICD LEAD DUAL	"$27,867.00"
HC44701613	INSRT ICD W/EXSTNG DUAL LEAD	"$27,835.00"
HC44701381	PLCMT CORON CATH;LT HRT CATH	"$27,747.00"
HC44504066	REVAS OTHR PERIPH1ST ART W/STNT W-S&I	"$27,739.00"
HC44703544	REVASCULARIZATION LITHOTRIPSY INTRAVASC & ATHERECT	"$27,699.00"
HC44703577	EV REPAIR NON-AORTOILIAC DEPLOY GRAFT ILIAC CATH UNILAT NON-RUPT	"$27,626.00"
HC44504553	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES BI"	"$27,530.00"
HC38420220	ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS	"$27,454.00"
HC44703098	PERC CLOSURE OF PDA TRANSCATH	"$27,439.00"
HC44703775	RT & LT HRT CATH CONGEN DEFECT INCLUDE IMAGE;NRML NATIVE CONNECT	"$27,170.00"
HC46502118	ABLAT RENAL TUMOR(S) PERC CRYO	"$27,140.00"
HC46502126	ABLATION RENAL TUMOR(S) PERC; CRYO LT	"$27,140.00"
HC46502134	ABLATION RENAL TUMOR(S) PERC; CRYO RT	"$27,140.00"
HC44504942	PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-BIL	"$27,084.00"
HC44701605	REMV&REPL PACER MULTI LEAD SYS	"$27,080.00"
55513-160-01	BLINATUMOMAB 35 MCG IV KIT	"$26,954.28"
55513-150-01	BLINATUMOMAB 35 MCG IV SOLR	"$26,954.28"
HC44503175	REVAS TIB/PER EA+TLA&ATH&STN-L	"$26,829.00"
HC44503167	REVAS TIB/PER EA+TLA&ATH&STN-R	"$26,829.00"
58394-637-03	"BENEFIX 3,000 UNIT IV SOLR"	"$26,820.00"
HC44703536	REVASCULARIZATION LITHOTRIPSY INTRAVASC W/STENT	"$26,805.00"
HC44502755	REVASC ILIAC W/TLA & STENT-LT	"$26,794.00"
HC44502748	REVASC ILIAC W/TLA & STENT-RT	"$26,794.00"
HC44703767	LT HRT CATH CONGEN DEFECTS INCLUDE IMAG; NRML/ABNRML NATIVE CONNECT'	"$26,648.00"
HC44703361	EV REPAIR ILIAC GRFT ILIO-ILIAC AORTC BI DIST UNILAT NONRUPT	"$26,605.00"
50242-044-13	ALTEPLASE (FOR STROKE) INFUSION (50 MG VIAL)	"$26,401.08"
50242-044-06	ALTEPLASE 50 MG IV SOLR	"$26,401.08"
HC44504751	"THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ;&PTA OF PDS"	"$26,362.00"
68727-900-01	ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN	"$26,340.00"
68727-900-03	ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN	"$26,340.00"
HC44701332	RT & LT HEART CATH;LT VENT S&I	"$26,266.00"
55513-222-01	ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLR	"$26,237.94"
HC44504884	TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL BILAT	"$26,218.00"
HC44700490	INSRT ICD W/EXISTNG SNGL LEAD	"$26,190.00"
HC44700508	INSRT/RPLC DUAL ICD GENERATOR	"$26,190.00"
HC44701191	UPGRADE W/ ADD LV LEAD	"$26,185.00"
HC44700144	COMP EP EVAL W/ INDUC ARRHYTHM	"$26,149.00"
HC44703825	PTA NATIVE/RECURRENT COARCTATION AORTA	"$26,125.00"
HC44503282	ATHER'TRLUML ILIAC EAVES W/S&I-L	"$26,068.00"
HC44503274	ATHER'TRLUML ILIAC EAVES W/S&I-R	"$26,068.00"
HC44703080	"TAVR/TAVI; BYPASS OPEN CENTRAL A&V(AORTA,RA,PA)+"	"$25,953.00"
HC47200324	PLC BRACHY CATH W/PART MAST BIL	"$25,927.00"
HC44703759	RT HRT CATH CONGEN DEFECTS INCLUDE IMAG;ABNRML NATIVE CONNECT'	"$25,891.00"
HC44701365	PLCMT CORON CATH;RT HRT CATH	"$25,707.00"
HC44703742	RT HRT CATH CONGEN DEFECTS INCLUDE IMAG;NRML NATIVE CONNECT	"$25,501.00"
24338-050-08	CARMUSTINE IN POLIFEPROSAN 7.7 MG IMPL WAFR	"$25,485.14"
0944-2718-20	IMMUN GLOB G(IGG)-GLY-IGA OV50 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLN	"$25,380.00"
63459-104-50	RITUXIMAB-ABBS 10 MG/ML IV SOLN	"$25,366.50"
HC47200357	PLC MAMMOSITE AFTER DOS BIL	"$25,351.00"
HC44702991	REMV&REPLC SUBQ ICD GEN ONLY	"$25,328.00"
HC44701639	REMV&REPLC SYSTM ICD LEAD SINGL	"$25,328.00"
HC44504587	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH BI"	"$25,254.00"
70114-101-01	PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRG	"$25,050.00"
HC44701597	REMV&REPL PACER DUAL LEAD SYS	"$24,946.00"
HC62806716	DEVICE REVSC/THROMBCT(CAPTUR/SOLITAIR/TREVO)E	"$24,830.00"
HC47200845	"SRS ROBOTIC FX EA 1-5 SESS,CMPLT"	"$24,828.00"
50633-120-11	DIGOXIN IMMUNE FAB 40 MG IV SOLR	"$24,798.00"
50633-121-11	DIGOXIN IMMUNE FAB 40 MG IV SOLR	"$24,798.00"
HC44703072	TAVR/TAVI; BYPASS OPEN PERIPH A&V(F/I/A)+	"$24,795.00"
HC47200829	"SRS LINR ACCL FX 1-5 SESSNS,CMPLT"	"$24,572.00"
HC44703197	"OPEN ILIAC FOR ILIAC OR AORTIC ENDOGRAFT, UNI"	"$24,542.00"
HC62808209	STENT NEUROVASC CODMAN ENTRPRS H060001	"$24,528.00"
HC44701738	PERC COR ANGIOPLST; SNGL CA/BRCH-LC	"$24,471.00"
HC44701720	PERC COR ANGIOPLST; SNGL CA/BRCH-LD	"$24,471.00"
HC44701712	PERC COR ANGIOPLST; SNGL CA/BRCH-LM	"$24,471.00"
HC44701746	PERC COR ANGIOPLST; SNGL CA/BRCH-RC	"$24,471.00"
HC44701753	PERC COR ANGIOPLST; SNGL CA/BRCH-RI	"$24,471.00"
HC44700078	COMB RT & LT CATH FOR ANOMAL	"$24,392.00"
HC62806740	KIT LIQ EMBOL ANEURYSM(ONYX HD-500)H060003	"$24,359.00"
HC62808944	BONE GRAFT FILLER VOID 18ML(CERAMENT®BONESUPPORT®)	"$24,310.00"
69468-151-04	URIDINE TRIACETATE 10 GRAM ORAL GRPK	"$24,078.00"
69468-151-10	URIDINE TRIACETATE 10 GRAM ORAL GRPK	"$24,078.00"
HC44700375	INSERT PACER VENT SNGL CHAMBER	"$24,063.00"
HC44701183	UPGRADE PACER  SNGL-DUAL	"$24,002.00"
HC44504280	VERTEBRAL AUGMNT 1BODY W/GUIDE;LUMBAR	"$23,959.00"
67457-187-50	ALLOPURINOL SODIUM 500 MG IV SOLR	"$23,922.36"
0002-8400-01	TERIPARATIDE 20 MCG/DOSE (600MCG/2.4ML) SUBCUTANEOUS PNIJ	"$23,799.66"
HC44703478	PERC CLOSURE LAA (WATCHMAN)	"$23,794.00"
0002-7623-01	PEMETREXED DISODIUM 500 MG IV SOLR	"$23,782.38"
HC62807193	STENT NEUROVASC WINGSPAN H050001	"$23,709.00"
HC44504082	REVAS OTHR PERIPH1ST VEIN W/STNT W-S&I	"$23,690.00"
0078-0331-84	BASILIXIMAB 20 MG IV SOLR	"$23,596.44"
HC62211834	DEVICE THROMBECT MECH NEURO       D	"$23,563.00"
HC62808191	STENT NEUROVASC NEUROFORM ATLAS  H020002	"$23,563.00"
HC62217369	KIT DEVICE RETRIEVAL NEURO FB     S	"$23,400.00"
HC62806823	STENT ENDOPRSTH AAA               S	"$23,400.00"
HC62807201	STENT NEUROVASC LVIS MICROVENTION H130005	"$23,400.00"
0143-9533-01	ALLOPURINOL SODIUM 500 MG IV SOLR	"$23,400.00"
HC44503142	REVAS TIB/PER EA+V TLA&STENT-L	"$23,349.00"
HC44503134	REVAS TIB/PER EA+V TLA&STENT-R	"$23,349.00"
HC62808712	STENT COAT/COVRD W/O DEL SYS       V	"$23,000.00"
55513-132-01	TRASTUZUMAB-ANNS 420 MG IV SOLR	"$22,849.08"
0006-3025-01	BEZLOTOXUMAB 25 MG/ML IV SOLN	"$22,800.00"
0006-3025-00	BEZLOTOXUMAB 25 MG/ML IV SOLN	"$22,800.00"
68682-012-27	ETHACRYNATE SODIUM 50 MG IV SOLR	"$22,794.00"
68682-012-50	ETHACRYNATE SODIUM 50 MG IV SOLR	"$22,794.00"
HC46502902	REVASC LITHOTRIP ARTHERECTOMY TIBIA/PERONEAL ENDOVASC W/STENT	"$22,785.00"
HC46502910	PERC AV FISTULA TISSUE W/MAGNETIC AV CATH	"$22,785.00"
HC62228796	SYSTEM ENDOAVF WAVELINQ™	"$22,750.00"
HC44504272	VERTEBRAL AUGMNT 1BODY W/GUIDE;THORACIC	"$22,724.00"
HC44700128	COMB RT&LT THRU OPEN F/ANOMAL	"$22,715.00"
HC44701324	"LEFT HEART CATH; LT VENT,W/S&I"	"$22,607.00"
HC44701589	REMV&REPL PACER SINGL LEAD SYS	"$22,516.00"
HC44700367	INSERT PACER ATRIAL SNGL CHAMB	"$22,508.00"
HC44703528	REVASCULARIZATION LITHOTRIPSY INTRAVASC	"$22,338.00"
HC47200381	PLC MAMMOSITE ON DOS BIL	"$22,333.00"
HC44503258	ATHER'TRLUML BRACH EAVES W/S&I-L	"$22,314.00"
HC44503241	ATHER'TRLUML BRACH EAVES W/S&I-R	"$22,314.00"
HC44701357	PLCMT CORON CATH;BYPASS GRAFTS	"$22,290.00"
HC91200138	R&B NICU-NURSERY LEVEL IV	"$22,235.00"
67457-845-50	TRASTUZUMAB-DKST 420 MG IV SOLR	"$22,183.56"
67457-847-44	TRASTUZUMAB-DKST 420 MG IV SOLR	"$22,183.56"
HC44503209	ATHER' TRLUML RENAL ART&S&I-LT	"$22,133.00"
HC44503191	ATHER' TRLUML RENAL ART&S&I-RT	"$22,133.00"
HC62808852	KIT CATH INDIGO 12 THROMB 12FR HTORQ[PENUMBRA]	"$22,133.00"
HC44703411	TRANSCATH DELIVERY ENHANCED FIXATION DEVICE	"$22,117.00"
HC44502813	REVAS ILIAC EA+VES W/TLA&STENT-L	"$22,073.00"
HC44502805	REVAS ILIAC EA+VES W/TLA&STENT-R	"$22,073.00"
HC46502894	REVASC LITHOTRIP ARTHERECTOMY TIBIA/PERONEAL ENDOVASC	"$21,891.00"
HC44503233	ATHER' TRLUML ABD AORTA W/S&I	"$21,884.00"
HC62808654	DEVICE ENDOSCOPE UGI IMAGING ILLUM DISP	"$21,866.00"
HC44701118	RT HRT CATH FOR CONGEN ANOMAL	"$21,829.00"
99999-035-66	EPIFIX SKIN GRAFT ( 4X4 CM )	"$21,702.00"
HC44504165	SEL CATH SUBC/INOM &ANG VRT W/SI BI	"$21,623.00"
HC44700102	COMB RT & LT THRU SEPT F/ANOM	"$21,520.00"
HC44503118	REVASC TIB/PERO EA+VES W/TLA-L	"$21,514.00"
HC44503100	REVASC TIB/PERO EA+VES W/TLA-R	"$21,514.00"
0069-0249-01	RITUXIMAB-PVVR 10 MG/ML IV SOLN	"$21,504.00"
0944-3045-10	"ADVATE 2,000 (+/-) UNIT IV SOLR"	"$21,480.00"
0944-3045-11	"ADVATE 2,000 (+/-) UNIT IV SOLR"	"$21,480.00"
HC46502886	REVASC LITHOTRIP TIBIA/PERONEAL ENDOVASC W/STENT	"$21,444.00"
HC44501237	OCCL BALLOON TEMP HEAD/NECK	"$21,330.00"
HC44700037	CATH ABLAT AV NODE HEART BLOCK	"$21,232.00"
HC44700359	INSERT LV LEAD AT INIT IMPLNT+	"$21,222.00"
HC38420295	ECMO/ECLS REMOVAL OF CENTRAL CANNULA 6 YRS & OLDER	"$21,170.00"
HC62802657	VALVE HANCOCK II MEDTRONIC	"$21,158.00"
HC44703627	TRANSCATH INTRACARD SHUNT(TIS) STENT CONGENTL INCLUDE IMAGE; EA ADDL+	"$20,976.00"
HC25002700	TRAUMA ACT' I W/O P-H ALERT	"$20,969.00"
HC38420287	ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS	"$20,938.00"
HC44504322	ABLATION LIVER TUMOR(S) PERC; CRYO	"$20,934.00"
HC62807722	M: BODY VERTEBRAL REPLACEMENT	"$20,930.00"
HC74200056	OR TIME INITIAL HR LEVEL 6 (MCAL 1ST HOUR)	"$20,875.00"
HC44503605	PLCMNT IVC FILTER /S&I/IMAGE	"$20,796.00"
HC44703064	TAVR/TAVI; BYPASS PERC PERIPH A&V(FEM)+	"$20,779.00"
HC44701340	PLCMT CORONARY CATH(ANGIO/S&I)	"$20,766.00"
HC45400918	MR UP EXT JNT W&W/O CONT BILAT	"$20,727.00"
50242-088-01	ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR	"$20,668.68"
63833-617-02	"HUMATE-P 1,000-2,400 UNIT IV SOLR"	"$20,592.00"
63833-627-01	"HUMATE-P 1,000-2,400 UNIT IV SOLR"	"$20,592.00"
HC44700904	PTA PULMONARY ARTERY SNGL	"$20,574.00"
HC46502878	REVASC LITHOTRIP TIBIA/PERONEAL ENDOVASC	"$20,551.00"
HC62807771	M: HIP FEM MODULAR COMPONENT	"$20,498.00"
63833-825-02	C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT	"$20,494.50"
HC44504132	SEL CATH CC/INOM &ANGIO EXCC W/S&I BI	"$20,492.00"
HC44703395	PLACMNT DELAY DISTL/PROX EXTSN INFRARENL AA ILIAC:INT'L VSSL	"$20,452.00"
0024-5860-01	CLOFARABINE 1 MG/ML IV SOLN	"$20,424.60"
0069-0306-01	TRASTUZUMAB-QYYP 420 MG IV SOLR	"$20,346.48"
0069-0305-01	TRASTUZUMAB-QYYP 420 MG IV SOLR	"$20,346.48"
HC44700136	COMP EP EVAL W/O IND ARRHYTH	"$20,309.00"
HC44703155	"OPEN ILIAC FOR ENDOGRAFT OR OCCLUSION, UNI"	"$20,248.00"
99999-035-69	EPIFIX SKIN GRAFT ( 6X16 CM )	"$20,160.00"
13533-318-05	RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN	"$20,113.14"
13533-318-50	RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN	"$20,113.14"
13533-618-10	RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML IM SOLN	"$20,113.14"
13533-618-11	RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML IM SOLN	"$20,113.14"
HC38420238	ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER	"$20,111.00"
HC38420329	REMOVAL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS	"$20,111.00"
HC44504520	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST BI"	"$20,076.00"
HC25001421	TRAUMA ACTVTN II INTRM	"$20,068.00"
50242-103-01	POLATUZUMAB VEDOTIN-PIIQ 30 MG IV SOLR	"$20,057.16"
HC44503639	LIGATION INFERIOR VENA CAVA	"$20,019.00"
HC44504744	"THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ"	"$20,018.00"
HC62808704	STENT COAT/COVRD W/O DEL SYS       U	"$20,000.00"
0173-0892-42	MEPOLIZUMAB 100 MG/ML SUBCUTANEOUS SYRG	"$19,952.04"
HC44702330	PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LC+	"$19,910.00"
HC44702322	PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LD+	"$19,910.00"
HC44702314	PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LM+	"$19,910.00"
HC44702348	PERC COR CHRON REVAS ATHR/STNT/A;ADDL-RC+	"$19,910.00"
HC44702355	PERC COR CHRON REVAS ATHR/STNT/A;ADDL-RI+	"$19,910.00"
HC44702785	PERC COR CHRON REVAS ATHR/DES/A;ADDL-LC+	"$19,910.00"
HC44702777	PERC COR CHRON REVAS ATHR/DES/A;ADDL-LD+	"$19,910.00"
HC44702769	PERC COR CHRON REVAS ATHR/DES/A;ADDL-LM+	"$19,910.00"
HC44702793	PERC COR CHRON REVAS ATHR/DES/A;ADDL-RC+	"$19,910.00"
HC44702801	PERC COR CHRON REVAS ATHR/DES/A;ADDL-RI+	"$19,910.00"
HC44502722	REVASC ILIAC W/TLA INITL VES-LT	"$19,815.00"
HC44502714	REVASC ILIAC W/TLA INITL VES-RT	"$19,815.00"
HC44702082	PERC COR ATHR+STENT/ANGIOP; ADDL-LC+	"$19,697.00"
HC44702074	PERC COR ATHR+STENT/ANGIOP; ADDL-LD+	"$19,697.00"
HC44702066	PERC COR ATHR+STENT/ANGIOP; ADDL-LM+	"$19,697.00"
HC44702090	PERC COR ATHR+STENT/ANGIOP; ADDL-RC+	"$19,697.00"
HC44702108	PERC COR ATHR+STENT/ANGIOP; ADDL-RI+	"$19,697.00"
HC44702538	PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LC+	"$19,697.00"
HC44702520	PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LD+	"$19,697.00"
HC44702512	PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LM+	"$19,697.00"
HC44702546	PERC COR ATHR+STENT(DES)ANGIOP; ADDL-RC+	"$19,697.00"
HC44702553	PERC COR ATHR+STENT(DES)ANGIOP; ADDL-RI+	"$19,697.00"
HC44502847	REVASC FEM POP W/TLA-LT	"$19,689.00"
HC44502839	REVASC FEM POP W/TLA-RT	"$19,689.00"
63833-387-02	"KCENTRA 1,000 UNIT (800-1240 UNIT) IV SOLR"	"$19,584.00"
63833-397-01	"KCENTRA 1,000 UNIT (800-1240 UNIT) IV SOLR"	"$19,584.00"
HC44502524	PERC DILATATION INTRACRANIAL VASSOSPASM INITIAL VESSEL -LT	"$19,555.00"
HC44502532	PERC DILATATION INTRACRANIAL VASSOSPASM INITIAL VESSEL -RT	"$19,555.00"
HC44503829	SEL CATH  IC CAROTID &ANG IC W/SI LT	"$19,520.00"
HC44503837	SEL CATH  IC CAROTID &ANG IC W/SI RT	"$19,520.00"
HC62228440	DEVICE REVASC/THROMBCT(EMBOTRAP)	"$19,500.00"
HC62807409	STENT ENDOPRSTH AAA               P	"$19,500.00"
HC44504850	TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + BILAT	"$19,487.00"
HC44504124	ABLAT PULM TUMOR(S) PERC UNILAT W/IMG GUID; CRYO	"$19,406.00"
HC45400561	MR UP EXT(NON JNT) W&W/O BIL	"$19,391.00"
HC44701316	PERC IMPLANT NEURO ELEC; PERIP	"$19,373.00"
HC91200137	R&B NICU-NURSERY LEVEL III	"$19,360.00"
0173-0881-01	MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLR	"$19,286.94"
HC38420162	ECMO/ECLS INSERT PERIPH CANNULA OPEN BIRTH-AGE 5	"$19,285.00"
HC38420170	ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN	"$19,285.00"
0074-3799-02	ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS SYKT	"$19,229.49"
0074-4339-02	ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS PNKT	"$19,229.49"
59572-962-10	ROMIDEPSIN 10 MG/2 ML IV SOLR	"$19,191.90"
59572-984-01	ROMIDEPSIN 10 MG/2 ML IV SOLR	"$19,191.90"
50633-110-12	CROTALIDAE POLYVAL IMMUNE FAB INJ SOLR	"$19,188.00"
44206-438-20	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$19,128.00"
44206-438-92	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$19,128.00"
50242-061-01	BEVACIZUMAB 25 MG/ML IV SOLN	"$19,126.56"
HC44501765	REM & REPLAC URETERAL STENT BI	"$19,045.00"
HC44504736	"ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I: PDS PTA,STENT(S)"	"$18,998.00"
59676-610-01	TRABECTEDIN 1 MG IV SOLR	"$18,955.38"
HC62808845	KIT CATH INDIGO 12 THROMB 8FR XTORQ[PENUMBRA]	"$18,883.00"
67457-675-02	CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN	"$18,792.60"
42023-205-01	CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN	"$18,786.00"
HC44703734	INSERT PERC VAD INC S&I TRANSSEPTL PUNC; LEFT HEART	"$18,715.00"
HC44703247	INSERT ELECTRODE DEFIBRILLATOR SUBQ	"$18,654.00"
0944-2700-06	IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN	"$18,628.80"
0944-2700-12	IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN	"$18,628.80"
HC45400223	MR LO EXT(NON JNT)W&W/O CON BI	"$18,618.00"
HC44502961	REVAS TIB/PERO W/TLA 1ST VES-LT	"$18,588.00"
HC44502953	REVAS TIB/PERO W/TLA 1ST VES-RT	"$18,588.00"
HC44700409	INSERT/EXTRAC/RET/REPOS D TV LEADS	"$18,518.00"
HC44701886	PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LC+	"$18,458.00"
HC44701878	PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LD+	"$18,458.00"
HC44701860	PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LM+	"$18,458.00"
HC44701894	PERC COR ANGIOP/ATHRECT; ADDL CA/BR-RC+	"$18,458.00"
HC44701902	PERC COR ANGIOP/ATHRECT; ADDL CA/BR-RI+	"$18,458.00"
60574-4113-1	PALIVIZUMAB 100 MG/ML IM SOLN	"$18,447.90"
66658-231-01	PALIVIZUMAB 100 MG/ML IM SOLN	"$18,447.90"
HC47200183	IMRT TX PLAN	"$18,388.00"
HC74200049	OR TIME INITIAL HR LEVEL 5 (MCAL 1ST HOUR)	"$18,362.00"
HC62210687	SYSTEM MICRODELIVERY FOR STENT	"$18,334.00"
HC62808837	KIT CATH INDIGO 7 LIGHT XTORQ PLUS[PENUMBRA]	"$18,233.00"
HC62802970	STENT NEUROVASCULAR               O	"$18,200.00"
99999-038-94	POLIHEXANIDE (PURAPLY AM) 6X9 CM EACH TOPICAL SHEET	"$18,144.00"
HC44701571	INSRT PACER ONLY;EXST MULTI LD	"$18,092.00"
HC62806955	WAND ASPIRATION/IRRIG NEUROVASC	"$18,054.00"
HC44503936	PLCMNT GRAFT FEM-FEM-AAA REP+	"$18,017.00"
58394-636-03	"BENEFIX 2,000 UNIT IV SOLR"	"$17,880.00"
HC62807862	STENT EXTENDER ENDOGRAFT TAA      O	"$17,875.00"
63459-391-20	BENDAMUSTINE 100 MG IV SOLR	"$17,830.80"
0037-0066-06	MESALAMINE 4 GRAM/60 ML RECTAL ENEM	"$17,830.80"
99999-038-98	POLIHEXANIDE (PURAPLY) 6X9 CM EACH TOPICAL SHEET	"$17,682.00"
HC44701977	PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LD+	"$17,607.00"
HC44701969	PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LM+	"$17,607.00"
HC44701993	PERC COR STENT(S)/ANGIOP; ADDL CA/BR-RC+	"$17,607.00"
HC44702009	PERC COR STENT(S)/ANGIOP; ADDL CA/BR-RI+	"$17,607.00"
HC44702439	PERC COR DES STENT(S)/ANGIOP; ADDL-LC+	"$17,607.00"
HC44702421	PERC COR DES STENT(S)/ANGIOP; ADDL-LD+	"$17,607.00"
HC44702413	PERC COR DES STENT(S)/ANGIOP; ADDL-LM+	"$17,607.00"
HC44702447	PERC COR DES STENT(S)/ANGIOP; ADDL-RC+	"$17,607.00"
HC44702454	PERC COR DES STENT(S)/ANGIOP; ADDL-RI+	"$17,607.00"
HC44701985	PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LC+	"$17,588.00"
HC44702181	PERC CABG REVAS ATHR/STENT/ANG; ADDL-LC+	"$17,571.00"
HC44702173	PERC CABG REVAS ATHR/STENT/ANG; ADDL-LD+	"$17,571.00"
HC44702165	PERC CABG REVAS ATHR/STENT/ANG; ADDL-LM+	"$17,571.00"
HC44702199	PERC CABG REVAS ATHR/STENT/ANG; ADDL-RC+	"$17,571.00"
HC44702207	PERC CABG REVAS ATHR/STENT/ANG; ADDL-RI+	"$17,571.00"
HC44702637	PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LC+	"$17,571.00"
HC44702629	PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LD+	"$17,571.00"
HC44702611	PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LM+	"$17,571.00"
HC44702645	PERC CABG REVAS ATHR/DES/ANGPL; ADDL-RC+	"$17,571.00"
HC44702652	PERC CABG REVAS ATHR/DES/ANGPL; ADDL-RI+	"$17,571.00"
HC44501823	REMOVE URETERAL STENT BIL	"$17,458.00"
HC44900041	ABLATE BONE TUMOR(S) PERQ W/CT;RF	"$17,457.00"
HC44901049	ABLATE BONE TUMOR(S) PERQ W/CT;CRYO	"$17,438.00"
0955-1746-01	CLOFARABINE 1 MG/ML IV SOLN (MCH)	"$17,400.00"
HC44503860	SEL CATH VERTEBRAL &ANG VRT W/SI LT	"$17,333.00"
HC44503878	SEL CATH VERTEBRAL &ANG VRT W/SI RT	"$17,333.00"
0003-3774-12	NIVOLUMAB 100 MG/10 ML IV SOLN	"$17,287.32"
HC38420154	ECMO/ECLS INSERT PERIPH CANNULA PERC BIRTH-AGE 5	"$17,253.00"
HC38420147	ECMO INSERT PERIPH CANNULA PERC W/FLUORO	"$17,253.00"
HC44702157	PERC CABG REVAS ATHR/STENT/ANG; SNGL-RI	"$17,243.00"
HC44500007	ABLATION RENAL TUMOR(S) PERC; RF	"$17,185.00"
HC44500015	ABLATION RENAL TUMOR(S) PERC; RF LT	"$17,185.00"
HC44500023	ABLATION RENAL TUMOR(S) PERC; RF RT	"$17,185.00"
0009-7224-02	"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN"	"$17,177.34"
0009-7224-01	"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN"	"$17,177.34"
HC62200076	ABLATION DEVICE(CARDIAC TISS)	"$17,164.00"
HC44700474	INSRT PACER ONLY;W/EXIST DUAL LEAD	"$17,140.00"
HC44502789	REVASC ILIAC EA+VES W/TLA-LT	"$17,111.00"
HC44502771	REVASC ILIAC EA+VES W/TLA-RT	"$17,111.00"
5985700305	HUMAN REGENERATIVE TISSUE MTRX 2 X 3 CM TOPICAL SHEE	"$17,100.00"
HC45400314	MR LOW EXT(JNT)W&W/O CONT BIL	"$17,074.00"
HC62806005	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AT	"$16,900.00"
HC62807631	M: COLLAR STEM HIP	"$16,900.00"
HC62808092	STENT EXTENDER ENDOGRAFT AAA     AD	"$16,900.00"
49411-052-08	AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLN	"$16,805.20"
HC44503597	SEL CATH&RENAL ANGIO2NDW/S&I-B	"$16,767.00"
99988-000-23	NM IN-111 PENTETREOTIDE (OCTREOSCAN)	"$16,750.50"
55513-207-01	BEVACIZUMAB-AWWB 25 MG/ML IV SOLN	"$16,745.38"
HC62800800	RECORDER CARDIAC EVENT(MEDTRONIC LINQ)	"$16,722.00"
HC74200031	OR TIME INITIAL HR LEVEL 4 (MCAL 1ST HOUR)	"$16,668.00"
HC91200136	R&B NICU-NURSERY LEVEL II	"$16,638.00"
HC44504298	VERTEBRAL AUGMNT 1BODY W/GUIDE;EA ADD'L L	"$16,602.00"
HC44504595	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH LT"	"$16,574.00"
HC44504603	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH RT"	"$16,574.00"
HC46501086	INSERT PERITONEAL CATH TUNNELED W/PORT	"$16,501.00"
HC44504488	ENDOVASC INFUS CRANIAL(NON-THROMB)INIT'L TRRT	"$16,449.00"
HC44504116	PERC TRNSCTH RENAL SYMP DENRV W/IMG BI	"$16,411.00"
76075-101-01	CARFILZOMIB 60 MG IV SOLR	"$16,387.68"
HC44501484	TLA AORTA W/S&I:INITIAL	"$16,313.00"
HC44504355	"PLCMT STNT BIL PERC EA(CHOLANG,BLN DIL,S&I)EXIST ACC"	"$16,308.00"
HC44501906	THROMBECTOMY MECH PRIM ART LT(NONCOR/CRNL)	"$16,301.00"
HC44501914	THROMBECTOMY MECH PRIM ART RT(NONCOR/CRNL)	"$16,301.00"
HC91400496	R&B ICU PEDS - INTENSIVE PPE ISOLATION	"$16,298.00"
HC25002684	TRAUMA ACT' II W/O CC SERVICE	"$16,261.00"
62935-454-44	LEUPROLIDE (6 MONTH) 45 MG SUBCUTANEOUS SYRG	"$16,260.78"
62935-453-45	LEUPROLIDE (6 MONTH) 45 MG SUBCUTANEOUS SYRG	"$16,260.78"
HC62229000	CATH THROMBECTOMY                AZ	"$16,250.00"
HC44503084	REVASC TIB/PERO EA+VES W/TLA-L	"$16,218.00"
HC44503076	REVASC TIB/PERO EA+VES W/TLA-R	"$16,218.00"
HC44503803	SEL CATH CC/INOM &ANGIO IC W/S&I LT	"$16,135.00"
HC44503811	SEL CATH CC/INOM &ANGIO IC W/S&I RT	"$16,135.00"
0944-3054-02	"ADVATE 1,500 (+/-) UNIT IV SOLR"	"$16,110.00"
HC62219258	DEVICE DELIVERY SUTURE INCL LARIAT	"$16,088.00"
HC45600079	PET W/CT WHOLE BODY	"$16,042.00"
HC91000208	R&B TRAUMA ICU	"$15,987.00"
HC44504801	TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL LEFT	"$15,983.00"
HC44504819	TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL RIGHT	"$15,983.00"
HC44703130	TEVAR; PLCMT PROX EXT PROTH; EACH ADD'L+	"$15,963.00"
HC62802996	RECORDER CARDC EVNT(BIOTRONIK BIOMNTR 2AF)	"$15,925.00"
HC44504918	TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + BILAT	"$15,912.00"
43598-309-20	CLOFARABINE 1 MG/ML IV SOLN	"$15,847.68"
55513-730-01	DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLN	"$15,828.07"
23155-261-41	CARMUSTINE 100 MG IV SOLR	"$15,824.34"
HC47200704	RADIOTHERAPY PLAN 3D W/VOL HISTOGRAM	"$15,782.00"
HC46502431	"PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC BI"	"$15,696.00"
HC44701100	"RIGHT HEART CATH; MSRMT, CO"	"$15,647.00"
HC47201173	TRANSPERINEAL PLCMNT BIODEGRADABLE MATERIAL	"$15,627.00"
13533-800-24	IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJ SOLN	"$15,614.40"
HC62806021	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AS	"$15,600.00"
HC62807268	STENT COV W/DEL SYS PVD           M	"$15,600.00"
HC62806815	STENT ENDOPRSTH AAA               M	"$15,600.00"
HC46500971	INS TUN VEN ACS DEV W/PORT<5YR	"$15,588.00"
HC46501029	INS VEN ACS DEV 2SITES W/PORT	"$15,547.00"
HC44701787	PERC COR ANGIOPLST; ADDL CA/BRCH-LC+	"$15,543.00"
HC44701779	PERC COR ANGIOPLST; ADDL CA/BRCH-LD+	"$15,543.00"
HC44701761	PERC COR ANGIOPLST; ADDL CA/BRCH-LM+	"$15,543.00"
HC44701795	PERC COR ANGIOPLST; ADDL CA/BRCH-RC+	"$15,543.00"
HC44701803	PERC COR ANGIOPLST; ADDL CA/BRCH-RI+	"$15,543.00"
HC91400096	R&B PEDIATRIC INTENSIVE CARE	"$15,488.00"
HC44503563	SEL CATH&RENAL ANGIO1STW/S&I-B	"$15,454.00"
0944-7553-02	"VONVENDI 1,300 (+/-) UNIT RANGE IV SOLR"	"$15,444.00"
HC46500989	INS TUN CV ACCESS DEV W/PORT 5YRS+	"$15,430.00"
99999-045-94	NM GA-68 GALLIUM GOZETOTIDE PSMA-11	"$15,275.00"
HC45600061	PET W/CT SKULL BASE-MID THIGH	"$15,256.00"
73594-9310-1	FERRIC DERISOMALTOSE 100 MG IRON/ML IV SOLN	"$15,229.20"
HC44703288	INSERT/REPLACE TRANSCATH PACER LEADLESS RV	"$15,202.00"
HC46500005	ABLATION LIVER TUMOR(S) PERC; RF	"$15,200.00"
HC26000059	DELIVERY VAGINAL TWINS	"$15,200.00"
67457-546-20	CLOFARABINE 1 MG/ML IV SOLN (MCH)	"$15,196.92"
HC44504181	SEL CATH EX CAROTID&ANG EC W/SI BI+	"$15,144.00"
HC44504926	PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-LT	"$15,049.00"
HC44504934	PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-RT	"$15,049.00"
HC44503498	PHLEBCT VEIN/EXT >20 STAB-LT	"$15,011.00"
HC44503480	PHLEBCT VEIN/EXT >20 STAB-RT	"$15,011.00"
HC44700466	INSRT PACER ONLY;W/EXIST SNGL LEAD	"$14,996.00"
HC44504371	"PLCMT STNT BIL PERC EA&CATH(CHOLANG,BLN DIL,S&I)NEW ACC"	"$14,962.00"
0169-7201-01	NOVOSEVEN 1MG/ML INJ POST-CARDIAC SURGERY (LBM)	"$14,880.00"
0169-7211-11	"NOVOSEVEN RT 1 MG (1,000 MCG) IV SOLR"	"$14,880.00"
HC23001118	PERC IMPLANT'N NEUROSTIM ELEC	"$14,857.00"
63459-348-04	BENDAMUSTINE 25 MG/ML IV SOLN	"$14,842.80"
55292-811-55	DACTINOMYCIN 0.5 MG IV SOLR	"$14,841.30"
HC27001890	EGD PARTIAL/COMPL EG FUNDOPLASTY	"$14,777.00"
HC44501989	THROMBECTOMY VENOUS LT	"$14,743.00"
HC44501997	THROMBECTOMY VENOUS RT	"$14,743.00"
57894-502-20	DARATUMUMAB 20 MG/ML IV SOLN	"$14,731.20"
HC47201132	HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 12+ CHANN	"$14,730.00"
0069-0342-01	BEVACIZUMAB-BVZR 25 MG/ML IV SOLN	"$14,721.60"
HC46501706	BX/RMVL LYMPH NODE(S)-OPEN BI	"$14,713.00"
HC44503720	THROMBOLYSIS ART OTHER NONCOR/CRNL+S&I1ST DAY	"$14,703.00"
0409-0801-01	PENTOSTATIN 10 MG IV SOLR	"$14,634.42"
HC91000404	R&B ICU - INTENSIVE PPE ISOLATION	"$14,632.00"
HC91200404	R&B IICU - INTENSIVE PPE ISOLATION	"$14,632.00"
HC44504199	SEL CATH EA IC CRTD/VERT&ANG W/SI BI+	"$14,627.00"
HC62808423	RECORDER CARDIAC EVENT(ABBOTT/BOSTON SCI)	"$14,625.00"
HC62808449	MONITOR CARDIAC ECG	"$14,625.00"
HC44700417	INSERT/EXTRAC/RET/REPOS S TV LEAD	"$14,617.00"
HC44504868	TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL LEFT	"$14,570.00"
HC44504876	TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL RIGHT	"$14,570.00"
65597-406-01	FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR	"$14,547.00"
HC44504561	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES LT"	"$14,488.00"
HC44504579	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES RT"	"$14,488.00"
HC46501482	REPLC TUNNELED CV ACS DEV W/PUMP	"$14,468.00"
0078-0883-61	CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN	"$14,463.42"
HC44701068	REPOS PREV PLCD LV SYSTEM ELEC	"$14,387.00"
HC74200023	OR TIME INITIAL HR LEVEL 3 (MCAL 1ST HOUR)	"$14,356.00"
70408-239-32	NITROFURANTOIN 25 MG/5 ML ORAL SUSP	"$14,353.92"
HC44504348	"PLCMT CATH BIL DRN PERC(CHOLANG,S&I)INT/EXT"	"$14,329.00"
HC62807326	STENT COVRD W/DEL SYS(AXIOS)     AE	"$14,300.00"
HC62806807	STENT ENDOPRSTH AAA               L	"$14,300.00"
HC44702942	INSERT PERC VAD INC S&I ARTERIAL ONLY; LEFT HEART	"$14,290.00"
HC44703635	INSERT VAD PERCUT INC S&I VENOUS ONLY RIGHT	"$14,290.00"
69932-001-30	FLUCICLOVINE F18 10 MCI (370 MBQ) IV SOLN	"$14,241.50"
HC47200100	ABLAT PULM TUMOR(S) PERC UNILAT  W/IMG GUID; RF	"$14,208.00"
HC46500997	INS TUN VEN ACS DEV W/SQ PUMP	"$14,149.00"
HC23000326	IMPLNT/REV/REPOS TUN EPI CATH	"$14,124.00"
HC44503514	ENDOVENOUS ABLAT RADIO FREQ WS&I; INITIAL VEIN	"$14,083.00"
HC44503761	TRANSCATH RETRIEVAL PERC FB W/S&I	"$14,068.00"
HC45400629	MR UP EXT (JNT) W/CONT BIL	"$14,050.00"
HC38420097	ECMO INITIATION VENO-ARTERIAL	"$14,036.00"
HC46501078	INSERT PERITONEAL CATH TUNNELED W/IMAGING	"$14,026.00"
HC47200365	PLC MAMMOSITE AFTER DOS LT	"$13,956.00"
HC47200373	PLC MAMMOSITE AFTER DOS RT	"$13,956.00"
HC44503753	THROMBOLYSIS NONCOR END OF TX	"$13,956.00"
HC44500486	ASP/DECOMP PERC DISKECTOMY	"$13,950.00"
55513-111-01	DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG	"$13,932.00"
50242-137-01	TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN	"$13,834.80"
HC25001439	TRAUMA ACTVTN III LMTD	"$13,808.00"
HC44504975	PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-BIL	"$13,768.00"
HC62802053	STENT ENDOPRSTH TIPS(VIATORR)     K	"$13,650.00"
HC45400280	MR LOW EXT(JNT)W/CONT BIL	"$13,648.00"
HC45400538	MR UP EXT(NON JNT)W/CONT BIL	"$13,646.00"
HC44501732	"REM & REPLAC EXT URET CATH(IMG,S&I) BI"	"$13,597.00"
76478-501-50	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	"$13,542.00"
24201-010-50	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	"$13,542.00"
HC91000204	R&B INTENSIVE CARE	"$13,524.00"
HC62808936	BONE GRAFT FILLER VOID 10ML(CERAMENT®BONESUPPORT®)	"$13,520.00"
25021-676-50	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	"$13,500.00"
HC46501474	REPLC TUNNELED CV ACS DEVICE W/PORT	"$13,449.00"
HC44503225	ATHER' TRLUML VISERCL EA & S&I	"$13,442.00"
HC44900710	CTA UPPER EXT W/CONTRAST-BILAT	"$13,414.00"
HC46502498	"EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) BI"	"$13,379.00"
HC23001449	INJ  L/S F W/IMAGE 1ST LVL BIL	"$13,372.00"
0597-0197-05	IDARUCIZUMAB 2.5 GRAM/50 ML IV SOLN	"$13,351.20"
HC46502464	"CONVERT NEPH CATH -> NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST BI"	"$13,298.00"
HC46502407	"PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) BI"	"$13,288.00"
HC44504074	REVAS OTHR PERIPH +ART W/STNT W-S&I	"$13,279.00"
73380-4700-1	MOXETUMOMAB PASUDOTOX-TDFK 1 MG IV SOLR	"$13,242.00"
HC44700151	COMP EP EVAL W/LT ATRIAL PACE+	"$13,216.00"
HC44701548	INCISE FEMEROL; DELIVERY EVS PROTH	"$13,196.00"
55135-132-01	SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR	"$13,130.70"
HC45400199	MR LOW EXT(NON JNT)W/CONT BIL	"$13,129.00"
55513-221-01	ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLR	"$13,119.00"
HC62808027	M: CAGE ACETABULAR	"$13,056.00"
HC44503746	THROMBOLYSIS NONCOR+S&I SUB DAY	"$13,032.00"
HC44503738	THROMBOLYSIS VEN NONCOR+S&I1ST DAY	"$13,029.00"
HC62204656	M: SYSTEM NEURO STEALTH	"$13,023.00"
HC47200332	PLC BRACHY CATH W/PART MAST LT	"$13,020.00"
HC47200340	PLC BRACHY CATH W/PART MAST RT	"$13,020.00"
HC43001239	ABLATION CRYO BREAST MALIG TUMOR(S) &IMAG UNILAT	"$13,000.00"
HC62806799	STENT ENDOPRSTH AAA               K	"$13,000.00"
HC62212063	CATH ANGIOG PERIPH CTO CROSSING  AQ	"$13,000.00"
HC44502318	ENDOVENOUS ABLAT LASER WS&I; INITIAL VEIN	"$12,943.00"
69344-101-01	INDOMETHACIN 25 MG/5 ML ORAL SUSP	"$12,927.40"
HC46500963	INS TUN VEN ACS DEV 2 SITES	"$12,926.00"
HC44700243	IMPLANT CARDIAC RHYTHM MONITOR SQ & PROGRAMMING	"$12,925.00"
HC44504330	"PLCMT CATH BIL DRN PERC(CHOLANG,S&I)EXTRNL"	"$12,908.00"
HC44900660	CTA LOW EXT BILAT	"$12,904.00"
HC44504728	ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I; PDS PTA	"$12,891.00"
HC46502365	TENOTOMY THIGH MULTIPLE TENDONS	"$12,829.00"
HC44504363	"PLCMT STNT BIL PERC EA(CHOLANG,BLN DIL,S&I)NEW ACC"	"$12,811.00"
HC38420089	ECMO INITIATION VENO-VENOUS	"$12,702.00"
0944-2717-10	IMMUN GLOB G(IGG)-GLY-IGA OV50 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLN	"$12,690.00"
HC45401254	MRA LOW EXT W&W/O CONT BILAT	"$12,685.00"
HC44703239	RIGHT HEART CATH; W/SENSOR PULM ARTERY W/S&I	"$12,629.00"
HC45400256	MR LOW EXT(JNT) W/O CONT BIL	"$12,566.00"
HC45400504	MR UP EXT(NON JNT) W/O CONT BIL	"$12,560.00"
HC44701050	REPAIR LEADS TV DUAL PACER/ICD	"$12,553.00"
HC25002692	TRAUMA ACT' III W/O CC SERVICE	"$12,537.00"
HC44700482	INSRT/REPL TEMP DUAL PACER	"$12,449.00"
0944-2659-08	IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR	"$12,440.40"
0944-2658-04	IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR	"$12,440.40"
50458-563-01	PALIPERIDONE PALMITATE 156 MG/ML IM SYRG	"$12,395.34"
HC62806302	CATH ATHERCTMY ROTATNL(DIAMNDBCK) D	"$12,350.00"
HC62806898	STENT ENDOPRSTH PVD(VIABAHN)      J	"$12,350.00"
HC62205752	PROBE ABLATION  CRYO              I	"$12,350.00"
24338-260-08	NIMODIPINE 60 MG/10 ML ORAL SOLN	"$12,333.01"
HC45600046	PET WHOLE BODY TUMOR IMAGING	"$12,325.00"
HC44504256	VERTEBROPLASTY 1BODY/GUIDE;LUMBOSACRAL	"$12,319.00"
HC46500302	BIOPSY NEEDLE RENAL-BILAT	"$12,282.00"
HC44504090	REVAS OTHR PERIPH +VEIN W/STNT W-S&I	"$12,255.00"
HC44503621	REMOV IVC FILTER/S&I/IMG GUIDE	"$12,246.00"
HC45400348	MR L-SPINE W&W/O CONTRAST	"$12,235.00"
HC44502631	INSERT PLEURAL CATH TUNNELD LT	"$12,219.00"
HC44502623	INSERT PLEURAL CATH TUNNELD RT	"$12,219.00"
0009-0283-01	GELATIN ABSORBABLE IMPL FILM	"$12,209.88"
0003-2291-11	ELOTUZUMAB 300 MG IV SOLR	"$12,184.02"
HC44504249	VERTEBROPLASTY 1BODY/GUIDE;CERVICOTHORACIC	"$12,161.00"
HC45400470	MR T-SPINE W&W/O CONTRAST	"$12,146.00"
HC45600012	PET BRAIN METABOLIC EVAL	"$12,145.00"
HC44700425	INSERT/REPLAC TEMP PACER	"$12,137.00"
HC45400165	MR LOW EXT(NON JNT)W/O CONT BIL	"$12,113.00"
HC47201124	HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 2-12 CHANN	"$12,105.00"
HC46501060	INSERT PERITONEAL CATH TUNNELED FOR DIALYSIS; OPEN	"$12,081.00"
13533-318-03	RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN	"$12,067.92"
13533-318-30	RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN	"$12,067.92"
HC74200015	OR TIME INITIAL HR LEVEL 2 (MCAL 1ST HOUR)	"$12,067.00"
HC45400082	MR CHEST W&W/O CONTRAST	"$12,053.00"
HC44700540	INTRACARDIAC EP 3D MAPPING+	"$12,032.00"
70257-126-11	VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN	"$12,025.20"
70257-126-51	VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN	"$12,025.20"
HC44503613	REPOS IVC FILTER/S&I/IMG GUIDE	"$12,022.00"
HC44503845	SEL CATH SUBC/INOM &ANG VRT W/SI LT	"$12,015.00"
HC44503852	SEL CATH SUBC/INOM &ANG VRT W/SI RT	"$12,015.00"
HC44701035	REMOVE DUAL LEAD	"$12,009.00"
13533-602-50	THROMBATE III 500 (+/-) UNIT IV SOLR	"$12,000.00"
HC23001357	INJ CER/THOR F/IMAGE SNG LVLBI	"$11,999.00"
57894-350-01	GOLIMUMAB 12.5 MG/ML IV SOLN	"$11,995.15"
HC44502003	THROMBECTOMY VEIN REPEAT LT	"$11,988.00"
HC44502011	THROMBECTOMY VEIN REPEAT RT	"$11,988.00"
HC44500551	PERC DILATATION INTRACRANIAL VASOSPASM EA ADD VES SAME TERRITORY+	"$11,971.00"
9978000199	"CULT SKIN SUBST, HUMAN-BOVINE TOPICAL DISK"	"$11,970.00"
HC44501922	THROMBECT MECH PRIM ART ADD LT(NONCOR/CRNL)+	"$11,967.00"
HC44501930	THROMBECT MECH PRIM ART ADD RT(NONCOR/CRNL)+	"$11,967.00"
99999-041-54	IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN	"$11,943.75"
HC46501003	INS TUN VEN CATH W/O PORT<5	"$11,934.00"
HC45600053	PET  W/CT LIMITED AREA	"$11,926.00"
HC45600038	PET SKULL BASE TO MID-THIGH	"$11,916.00"
HC44503787	SEL CATH CC/INOM &ANGIO EXCC W/S&I LT	"$11,906.00"
HC44503795	SEL CATH CC/INOM &ANGIO EXCC W/S&I RT	"$11,906.00"
HC46501516	REPLC PICC LINE W/ SQ PORT	"$11,896.00"
HC23001134	DESTR C/T FAC JOINT SNGL W/IMG-B	"$11,894.00"
HC46500948	INS PICC LINE W/PORT<5YR	"$11,887.00"
HC46500955	INS PICC LINE W/PORT>5YR	"$11,887.00"
HC46501011	INS TUN CV ACS CATH W/O PORT 5YRS+	"$11,815.00"
HC44701043	REPAIR LEAD TV SNGL PACER/ICD	"$11,813.00"
HC44701084	RELOCATE SKIN POCKET ICD	"$11,734.00"
HC62225677	CATH EP DIAG/ABLAT 3D/VECT       AB	"$11,700.00"
HC62225693	CATH TRANSLUM ANGIO LASER         Z	"$11,700.00"
HC44500213	ANGIO EXTREMITY BILAT	"$11,677.00"
HC44701076	REPOSITION PACER/ICD LEAD RT HRT	"$11,668.00"
HC44501435	PHLEBCT VEIN/EXT 10-20 STAB-LT	"$11,665.00"
HC44501443	PHLEBCT VEIN/EXT 10-20 STAB-RT	"$11,665.00"
13533-603-20	THROMBATE III 500 (+/-) UNIT IV SOLR	"$11,640.00"
43598-541-25	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$11,625.00"
43598-683-25	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$11,625.00"
17156-021-01	INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) IV SOLN	"$11,622.81"
HC44504306	PERC SACRAL AUGMT UNILAT W/ GUIDANCE&BX	"$11,617.00"
HC44504314	PERC SACRAL AUGMT BILAT W/ GUIDANCE&BX	"$11,617.00"
HC46502381	"FASCIOTOMY, FOOT AND/OR TOE"	"$11,592.00"
HC44701001	REMOV ICD LEADS EXTRACTN TRANSVENOS	"$11,590.00"
HC62807649	M: IMPLANT TARSI SINUS	"$11,590.00"
HC44702850	ABLAT ADD'L ATRIUM A FIB POST PVI+	"$11,570.00"
HC38420279	ECMO/ECLS REMOVAL PRPH CANNULA OPEN 6 YRS & OLDER	"$11,559.00"
HC46501573	THORACENTESIS W/TUBE W/ IMAG BI	"$11,553.00"
HC62228168	ORTH WHFO EXT POWERED ELECTRIC CUSTOM	"$11,528.00"
HC91400095	R&B PEDS STEPDOWN/DOU	"$11,524.00"
HC44702843	ABLAT NON1 DEG INCL RPT DX INDUC ARRHM+	"$11,501.00"
99999-035-47	INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN (INSULIN )	"$11,484.00"
49401-102-01	BELIMUMAB 400 MG IV SOLR	"$11,443.92"
68516-4604-2	"ALPHANATE 1,500 (600 VWF) UNIT/10 ML IV SOLR"	"$11,430.00"
67457-297-50	ETHACRYNATE SODIUM 50 MG IV SOLR	"$11,400.00"
HC62803325	STENT ENDOPRSTH AAA               I	"$11,375.00"
HC62808373	M: BONE GRAFT MATRIX(FIBERGRAFT BG)	"$11,375.00"
99999-041-43	NM GA-68 GALLIUM DOTATATE	"$11,375.00"
69488-001-40	KIT FOR PREP OF GA 68-DOTATATE 40 MCG IV SOLR	"$11,375.00"
HC83000786	THER APHER W/EXTRACORP IMMUNO/ADSORP/FILTRATION	"$11,357.00"
HC44901023	CTA ABDOMEN+PELVIS	"$11,350.00"
HC44700169	COMP EP EVAL W/LT VENT PACE+	"$11,342.00"
0008-1030-04	SIROLIMUS 1 MG/ML ORAL SOLN	"$11,332.08"
0008-1030-06	SIROLIMUS 1 MG/ML ORAL SOLN (MCH)	"$11,332.08"
HC45400884	MRI CARDIAC W/STRESS IMG W/CON	"$11,331.00"
HC45400595	MR UP EXT(JNT) W/O CONT BIL	"$11,319.00"
HC45400405	MR PELVIS W&W/O CONTRAST	"$11,309.00"
HC23001159	DESTR L/S FAC JOINT SNGL W/IMG-B	"$11,297.00"
HC45400009	MR ABDOMEN W&W/O CONTRAST	"$11,292.00"
HC45401536	MR ABDOMEN(MRCP)W&W/O CONTRAST	"$11,292.00"
HC47200399	PLC MAMMOSITE ON DOS LT	"$11,285.00"
HC47200407	PLC MAMMOSITE ON DOS RT	"$11,285.00"
HC12800017	THER APHER W/EXTRACORP IMMUNO/ADSORP/FILTRATION	"$11,283.00"
HC44701092	RELOCATE SKIN POCKET PACEMAKER	"$11,262.00"
HC44504108	PERC TRNSCTH RENAL SYMP DENRV W/IMG UNILAT	"$11,254.00"
HC62800172	CATH ATHERECTOMY DIRECTIONAL      H	"$11,245.00"
HC44501948	THROMBECTOMY ART 2ND LT(NONCOR/CRNL)	"$11,214.00"
HC44501955	THROMBECTOMY ART 2ND RT(NONCOR/CRNL)	"$11,214.00"
HC62227988	EMBOLIZATION PROTECTIVE SYSTEM (TCAR) X	"$11,213.00"
HC46501375	REMOVE PERITONEAL CATH TUNNELED	"$11,169.00"
HC46502332	"TENOTOMY SHOULDER AREA, MULT TENDNS"	"$11,168.00"
HC44504538	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST LT"	"$11,153.00"
HC44504546	"PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST RT"	"$11,153.00"
HC44703296	REMOVE TRANSCATH PACER LEADLESS RV INCL ALL IMAGING	"$11,125.00"
0074-3642-03	LEUPROLIDE 7.5 MG IM SYKT	"$11,124.36"
57894-054-27	USTEKINUMAB 130 MG/26 ML IV SOLN	"$11,123.58"
0026-3785-55	"KOGENATE FS 1,000 (+/-) UNIT IV SOLR"	"$11,100.00"
HC62204003	KIT KYPHOPAK 1ST FRACTURE         E	"$11,099.00"
0008-1179-01	TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR	"$11,097.48"
HC44500270	ANGIO PULMONARY BILAT	"$11,096.00"
HC44502060	TRANSCATH EMBOLIZATION S&I	"$11,077.00"
HC51061141	OSTEOTOMY TIBIA	"$11,060.00"
HC38420261	ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS	"$11,051.00"
HC62806294	CATH ATHERCTMY ROTATNL(DIAMNDBCK) B	"$11,050.00"
HC62225669	CATH EP DIAG/ABLAT 3D/VECT       AA	"$11,050.00"
HC62805544	CATH THROMBOLYSIS/RX DELIVERY    AN	"$11,050.00"
HC62803838	STENT DES CORO COV W/DEL SYS      X	"$11,050.00"
HC62806880	STENT ENDOPRSTH PVD(VIABAHN)      H	"$11,050.00"
HC62808084	STENT EXTENDER ENDOGRAFT AAA      X	"$11,050.00"
HC62807318	STENT TRACHEOBRONC COV W/DEL SYS  L	"$11,050.00"
HC62805650	DEVICE ABLAT COOL-TIP NONVASC    AN	"$11,050.00"
HC62807094	PROBE ABLATION CRYO               H	"$11,050.00"
HC62806724	CATH EP/ABLATION COOL-TIP         T	"$11,050.00"
HC62213335	CATH ATHERECTOMY ROTATNL (STEALTH)	"$11,034.00"
HC44700219	EP FOLLOW UP POST THERAPY	"$11,029.00"
67979-001-01	VALRUBICIN 40 MG/ML INTRAVESICAL SOLN	"$11,020.65"
HC23000730	INJ FORAMN EPI LMBR INTLW/S&I-B	"$11,010.00"
HC46500369	BX VERTEBRAL BODY; OPEN THORACIC	"$10,987.00"
HC62808548	LEAD SENSING RESPIRATORY(INSPIRE®)	"$10,969.00"
HC45400371	MR ORBIT/FACE&OR NECK W&WO CON	"$10,959.00"
HC46501540	THORACENTESIS ASP W/ IMG GUID-BILAT	"$10,925.00"
HC45400900	MR UPPER EXT JNT W&W/O CONT LT	"$10,904.00"
HC45400892	MR UPPER EXT JNT W&W/O CONT RT	"$10,904.00"
HC44700623	LIGATION /BANDING A/V FISTULA	"$10,893.00"
70257-310-51	"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJ SOLN"	"$10,863.84"
70257-310-04	"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJ SOLN"	"$10,863.84"
HC62802111	STENT PV SELF EXP CVRD/DEL SPX	"$10,855.00"
HC44503571	SEL CATH&RENAL ANGIO2NDW/S&I-L	"$10,830.00"
HC44503589	SEL CATH&RENAL ANGIO2NDW/S&I-R	"$10,830.00"
HC44504785	"PLACEMENT STENT(S)CDS VIA DIALYSIS CIRCUIT WS&I, PTA+"	"$10,816.00"
HC44700987	REMVL PERM PACER PULSE GN ONLY	"$10,799.00"
HC25002718	TRAUMA ACT' II W/O P-H ALERT	"$10,787.00"
HC44504264	VERTEBROPLASTY1BODY/GUIDE; EA ADD'L VBODY	"$10,777.00"
HC46502340	"TENOTOMY ELBOW, LATERAL OR MEDIAL"	"$10,763.00"
HC45400116	MR C-SPINE W&W/O CONTRAST	"$10,741.00"
0944-3053-02	"ADVATE 1,000 (+/-) UNIT IV SOLR"	"$10,740.00"
0944-3053-03	"ADVATE 1,000 (+/-) UNIT IV SOLR"	"$10,740.00"
HC45401197	MRA LOW EXT W/CONT BILAT	"$10,739.00"
HC44504835	TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + LT	"$10,730.00"
HC44504843	TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + RT	"$10,730.00"
HC62807979	STENT ENDOPRSTH LEG ILIAC         G	"$10,725.00"
HC46502100	DRAIN CYSTS OVA UNI/BIL ABD APPR	"$10,696.00"
HC21000195	BX BONE OPEN; SUPERFICIAL	"$10,679.00"
HC46502399	DIVSN PLANTR FASCIA&MUSCLE(STEINDLER STRIP)	"$10,665.00"
HC46501458	REPLC CATH ONLY CV ACESS W/PORT	"$10,623.00"
HC62807888	M: MATRIX VIAFLOW WOUND FLOWABLE 2ML	"$10,566.00"
HC62808910	DEVICE FUSION SI JOINT(IFUSE SI-BONE®)K	"$10,565.00"
HC45400058	MR BRAIN W&W/O CONTRAST	"$10,552.00"
HC44501898	THROMBEC VC/ILIAC FEMPOP INCSN	"$10,500.00"
HC44500031	ANGIO ADRENAL BILAT	"$10,497.00"
HC44700664	MAP TACHYCARDIA SITES NON 3D+	"$10,478.00"
HC44700789	PERC TRANSLUM COR THROMBECTMY+	"$10,469.00"
HC46501953	PERC CHOLECYSTOSTOMY WCATH/S&I	"$10,467.00"
HC23001167	DESTR L/S FAC JOINT ADDL W/IMG-B	"$10,419.00"
HC62802087	STENT CAROTID	"$10,400.00"
HC62802103	STENT ENDOPRSTH PVD(VIABAHN)      G	"$10,400.00"
HC62805551	CATH EP/ABLATION COOL-TIP         S	"$10,400.00"
HC62226030	M: MODEL CUSTOM CRANIOMAXILLOFACIAL	"$10,400.00"
0517-0710-01	FOMEPIZOLE 1 GRAM/ML IV SOLN	"$10,389.66"
44087-3535-1	AVELUMAB 20 MG/ML IV SOLN	"$10,368.72"
99999-044-64	POLIHEXANIDE (PURAPLY AM) 4X4 CM EACH TOPICAL SHEET	"$10,368.00"
HC23000672	INJ FORAMN EPI C/T INTLW/S&I-BI	"$10,367.00"
HC46000709	SEL CATH AB/PEL/LOEXT1ST OR BI	"$10,363.00"
HC44703262	REPOSIT ELECTRODE DEFIBRILLATOR SUBQ	"$10,357.00"
HC44703205	"OPEN BRACHIAL FOR ILIAC OR AORTIC ENDOGRAFT, UNI"	"$10,332.00"
HC44900538	CT UPPER EXT W&W/O CONT BILAT	"$10,298.00"
63833-616-02	"HUMATE-P 500-1,200 UNIT IV SOLR"	"$10,296.00"
HC47201090	"IMRT TX DELIVERY, GUIDE&TRACK CMPLX"	"$10,284.00"
HC44504793	EMBOLIZATION DIALYSIS CIRCUIT VEIN(S)WS&I+	"$10,269.00"
HC46502373	TENOTOMY ACHILLES TENDON *DS	"$10,266.00"
62856-600-01	DECITABINE 50 MG IV SOLR	"$10,266.00"
HC44700458	INSERTION OF IABP PERCUTANEOUS	"$10,247.00"
HC62808902	DEVICE FUSION SI JOINT(IFUSE SI-BONE®)J	"$10,230.00"
HC44900231	CT LOW EXT W&W/O CONT BILAT	"$10,206.00"
HC45400579	MR UP EXT(NON JNT) W&W/O LT	"$10,205.00"
HC45400587	MR UP EXT(NON JNT) W&W/O RT	"$10,205.00"
HC44900991	CT ABD & PELVIS W/O&W CONTRAST	"$10,202.00"
HC45600020	PET LIMITED AREA	"$10,181.00"
47335-050-40	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$10,174.80"
HC46500393	BX DEEP PELV/HIP-SC BIL	"$10,130.00"
63833-386-02	KCENTRA 500 UNIT (400-620 UNIT) IV SOLR	"$10,118.40"
HC62213327	PACK LAP GASTRIC BY-PASS	"$10,117.00"
HC62802129	STENT DES CORO COV W/DEL SYS      V	"$10,075.00"
HC62806864	STENT ENDOPRSTH AAA               F	"$10,075.00"
HC74200239	BEDSIDE/OTHER SURG INITIAL HR 6 (MCAL 1ST HOUR)	"$10,065.00"
57970-100-01	DALBAVANCIN 500 MG IV SOLN	"$10,062.00"
HC45401593	MR BREASTS W/O&W CONTR & CAD (BILAT) [COMM&MCAL]	"$10,045.00"
HC45400231	MR LO EXT(NON JNT)W&W/O CON LT	"$10,041.00"
HC45400249	MR LO EXT(NON JNT)W&W/O CON RT	"$10,041.00"
HC62802947	EMBOLIC LIQUID ONYX PER VIAL(LOW VIS)	"$10,027.00"
HC44501773	REM & REPLAC URETERAL STENT LT	"$10,022.00"
HC44501781	REM & REPLAC URETERAL STENT RT	"$10,022.00"
HC38420105	ECMO DAILY MNGMT EA DAY VENO-VENO	"$10,013.00"
HC45600004	PET ASSESS MYOCARD VIABILITY	"$10,013.00"
HC44900173	CT GUIDE STEREOTACTIC LOC	"$10,004.00"
HC62808340	KIT SPRAYER & POWDER HEMOSTATIC	"$10,000.00"
0024-5915-02	DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PNIJ	"$9,994.60"
0024-5915-00	DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PNIJ	"$9,994.60"
0024-5914-01	DUPILUMAB 300 MG/2 ML SUBCUTANEOUS SYRG	"$9,994.60"
HC46501466	REPLC TUNNELED CV ACS DEVICE W/O PORT/PUMP	"$9,965.00"
HC44703569	EV REPAIR AORTOILIAC DEPLOY GRAFT ILIAC CATH UNILAT RUPT/NON-RUPT+	"$9,957.00"
HC74200007	OR TIME INITIAL HR LEVEL 1 (MCAL 1ST HOUR)	"$9,939.00"
HC44503779	PLACE CATH THOR AORTA&ANGIO W/S&I	"$9,932.00"
HC23000250	DESTRUCT OTHER PERIPH SNGL BI	"$9,901.00"
HC91000044	R&B STEP DOWN/DOU INTERMD ICU	"$9,897.00"
HC44501450	PLACEMT OF CHOLEDOCHAL STENT	"$9,885.00"
HC45400322	MR LOW EXT(JNT)W&W/O CONT LT	"$9,858.00"
HC45400330	MR LOW EXT(JNT)W&W/O CONT RT	"$9,858.00"
HC44504413	"PLCMT ACC BILTREE->SB4ENDO PERC(CHOLANG,S&I) NEW ACC"	"$9,827.00"
HC44504686	ABLATION UTERINE FIBROID(S) TRANSCERV W US GUIDE; RF	"$9,805.00"
HC62211065	CATHETER ENDOCLAMP	"$9,799.00"
HC44900264	CT LOW EXT W/CONTRAST BILAT	"$9,795.00"
HC44701027	REMOVE SINGLE LEAD	"$9,791.00"
HC46501219	MECH REMOV PERICATH OBSTR MAT CV	"$9,781.00"
60574-4114-1	PALIVIZUMAB 50 MG/0.5 ML IM SOLN	"$9,769.68"
66658-230-01	PALIVIZUMAB 50 MG/0.5 ML IM SOLN	"$9,769.68"
HC62808894	DEVICE FUSION SI JOINT(IFUSE SI-BONE®)I	"$9,750.00"
HC62806757	CATH THROMBECTOMY                AL	"$9,750.00"
HC62210679	DEVICE RETRIEVAL NEURO FB         F	"$9,750.00"
HC62806872	STENT ENDOPRSTH PVD(VIABAHN)      F	"$9,750.00"
HC62808100	STENT EXTENDER ENDOGRAFT AAA      V	"$9,750.00"
HC62804836	CLIP LEFT ATRIAL APPENDAGE-LAA    B	"$9,750.00"
HC62228812	SET NEURO MRI GUIDED ABLATE (INSIGHTEC®)	"$9,750.00"
HC38420113	ECMO DAILY MNGMT EA DAY VENO-ART	"$9,739.00"
HC62805387	CATH ATHERECTOMY ROTATNL (PREDATOR)	"$9,734.00"
HC44703452	OPEN AXILL/SUBCLV ART CONDUIT DELIVER PROTH /BYPASS UNILAT+	"$9,730.00"
HC44500700	CTA ABD AORTA/ILIOFEM RUNOFF	"$9,686.00"
49281-790-20	TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SOLN	"$9,635.22"
HC62217013	KIT SPINAL ACCESS DISPOSBL       AB	"$9,620.00"
63020-049-01	BORTEZOMIB 3.5 MG INJ SOLR	"$9,618.00"
63323-721-10	BORTEZOMIB 3.5 MG IV SOLR (IV ONLY) (MHS)	"$9,617.88"
60923-363-02	ETEPLIRSEN 50 MG/ML IV SOLN	"$9,600.00"
HC45401221	MRA LOW EXT W/O CONT BILAT	"$9,591.00"
HC47200852	CT GUIDANCE SRS LOCALIZATION	"$9,574.00"
HC45400710	MRA NECK W&W/O CONTRAST	"$9,573.00"
44206-437-10	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$9,564.00"
44206-437-91	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$9,564.00"
HC44503548	SEL CATH&RENAL ANGIO1STW/S&I-L	"$9,561.00"
HC44503555	SEL CATH&RENAL ANGIO1STW/S&I-R	"$9,561.00"
8541000101	"CULT SKIN SUBST, HUMAN-BOVINE 2 X 3 "" TOPICAL SHEE"	"$9,540.00"
HC38420253	ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER	"$9,527.00"
HC44700995	REMOVAL ICD GENERATOR ONLY	"$9,523.00"
HC44504389	"CONVRT CATH DRN BIL EXT->INT-EXT PERC(CHOLANG,S&I)"	"$9,520.00"
HC74200171	OR TIME INIT'L HR CASE CX LEVEL 6 (MCAL 1ST HOUR)	"$9,484.00"
68817-134-50	PACLITAXEL-PROTEIN BOUND 100 MG IV SUSR	"$9,480.36"
HC38420139	ECMO REPSN OPEN A&/V PERC W/FLUOR=5Y	"$9,463.00"
HC38420212	ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER	"$9,463.00"
HC45401338	MRA SPINE W/O & W/ CONTRAST	"$9,447.00"
HC46500088	ASP/INJ RENAL CYST/PELVIS BI	"$9,443.00"
HC46500351	BIOPSY TRANSCATHETER	"$9,435.00"
HC62807110	CATH ABLATION CARDIAC	"$9,425.00"
HC62804968	STENT BILIARY COVRD W/DELSYS      V	"$9,425.00"
HC44900561	CT UPPER EXT W/CONTRAST BILAT	"$9,417.00"
HC91200242	R&B HIGH RISK PERINATAL	"$9,398.00"
HC62808829	CATH INDIGO 8 THROMB 8FR TORQ/XTORQ[PENUMBRA]	"$9,393.00"
HC44900595	CT UPPER EXT W/O CONTRAST BIL	"$9,389.00"
HC46502324	"TENOTOMY SHOULDER AREA, SNGL TENDON"	"$9,370.00"
HC74200221	BEDSIDE/OTHER SURG INITIAL HR 5 (MCAL 1ST HOUR)	"$9,370.00"
HC46500047	ASP BLADDER W/INSERT SUPRAPUB	"$9,361.00"
50242-132-01	TRASTUZUMAB 150 MG IV SOLR	"$9,350.10"
0074-3641-03	LEUPROLIDE 3.75 MG IM SYKT	"$9,335.22"
HC45400686	MRA HEAD W&W/O CONTRAST	"$9,332.00"
HC45600095	"PET ANY SITE, NOS"	"$9,303.00"
HC44504694	ENDOVENOUS ABLAT MECHANOCHEM WS&I; INITIAL VEIN	"$9,295.00"
HC62802061	STENT CORO COVRD W/DEL SYS	"$9,263.00"
HC62808019	SPACER HYDROGEL PROSTATE-RECTUM	"$9,263.00"
70127-100-01	CANNABIDIOL 100 MG/ML ORAL SOLN	"$9,240.00"
70127-100-10	CANNABIDIOL 100 MG/ML ORAL SOLN	"$9,240.00"
HC23001142	DESTR C/T FAC JOINT +LVL W/IMG-B	"$9,232.00"
HC46502357	TENOTOMY THIGH SINGLE TENDON	"$9,208.00"
HC46500450	BX LYMPH NODE(S)-SUPERFCL-BIL	"$9,196.00"
HC91000243	R&B TELEMETRY CARE	"$9,193.00"
HC44501831	REMOVE URETERAL STENT LT	"$9,189.00"
HC44501849	REMOVE URETERAL STENT RT	"$9,189.00"
HC46502597	BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) BILAT	"$9,178.00"
HC82204504	BONE MARROW DX; BX(S) & ASP(S) BILAT	"$9,178.00"
HC46501268	PERC PLACEMENT DU/J TUBE W/FLUORO	"$9,159.00"
HC44504959	PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-LT	"$9,159.00"
HC44504967	PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-RT	"$9,159.00"
HC62208590	KIT HEART LASER CO2	"$9,133.00"
66993-489-83	DACTINOMYCIN 0.5 MG IV SOLN (MCH)	"$9,109.32"
HC62805478	CATH PTCA BALLOON NON-LASER      AD	"$9,100.00"
HC62800255	CATH BRACHY TX SEED ADMIN         K	"$9,100.00"
HC62804695	SYSTEM DRAIN PLEURAL/PERIT (ASPIRA)	"$9,100.00"
HC62805080	CATH EP DIAG/ABLAT 3D/VECT        X	"$9,100.00"
HC62807136	CATH THROMBECTOMY                AI	"$9,100.00"
HC62228036	CATH INTRACARDIAC ECHO/UTZ        H	"$9,100.00"
HC62804950	STENT BILIARY COVRD W/DELSYS      U	"$9,100.00"
HC62800529	CATH TRANSLUM ANGIO LASER         U	"$9,100.00"
HC62200068	ABLATION DEVICE	"$9,100.00"
HC62210661	DEVICE CLOT SEPARATOR NEURO      AD	"$9,100.00"
HC62802962	COIL NEUROVASCULAR               AR	"$9,100.00"
HC62805858	INTRO/SHEATH EP LASER            AH	"$9,100.00"
HC62805585	CATH EP/ABLATION COOL-TIP         Q	"$9,100.00"
HC62214051	CLAMP ABLATION (ISOL SYNERGY)	"$9,100.00"
HC62806492	PROBE ABLATION                   AT	"$9,100.00"
HC45400827	MRI CARDIAC FOR MORPH W/CON	"$9,099.00"
HC44900983	CT ABDOMEN & PELVIS W/CONTRAST	"$9,075.00"
HC46500559	BX SFT TISS PELV/HIP-BIL	"$9,074.00"
0173-0665-18	ATOVAQUONE 750 MG/5 ML ORAL SUSP	"$9,035.46"
0187-3012-20	PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRP	"$9,022.00"
HC62227293	DEVICE TIF (ESOPHYX)	"$9,019.00"
HC44703866	PERC TRANSLUM CORONARY LITHOTRIPSY +	"$9,000.00"
70710-1478-1	FOMEPIZOLE 1 GRAM/ML IV SOLN	"$9,000.00"
HC47201116	HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 1 CHANNEL	"$8,992.00"
HC44703593	TMVR MITRACLIP ADD'L PROTH+	"$8,978.00"
HC27001320	ERCP W/STENT REMV&XCH BILI/PANC DUCT	"$8,975.00"
HC46502449	"PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC LT"	"$8,971.00"
HC46502456	"PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC RT"	"$8,971.00"
HC45400843	MRI CARDIAC MORPH W/STRESS W/O	"$8,954.00"
58394-635-03	"BENEFIX 1,000 UNIT IV SOLR"	"$8,940.00"
HC62224993	MOLDS/FORMS CEMENT FEM&TIB KNEE	"$8,938.00"
99999-033-70	CHLOROTHIAZIDE 25 MG / ML SYRINGE	"$8,931.00"
HC45201399	NM TUMOR LOCALIZE SPECT CT  2+ AREAS 1 DAY//SNGL AREA 2+DAYS	"$8,907.00"
HC36001139	BRONCH W/EBUS SAMPLING 3/> NODES	"$8,889.00"
HC62800164	CATH ATHERECTOMY DIRECTIONAL      E	"$8,887.00"
0781-3006-42	LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH)	"$8,870.40"
39822-2100-2	DACTINOMYCIN 0.5 MG IV SOLR	"$8,850.00"
39822-2100-1	DACTINOMYCIN 0.5 MG IV SOLR	"$8,850.00"
HC62807086	KIT KYPHOPAK 1ST FRACTURE         C	"$8,840.00"
HC46001277	"INJ ANTEGRAD COMP(NEPH/URET'GRM,S&I)NEW ACCESS BI"	"$8,835.00"
HC44504892	TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + LT	"$8,833.00"
HC44504900	TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + RT	"$8,833.00"
HC26000042	DELIVERY VAGINAL	"$8,802.00"
70860-218-10	CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN	"$8,790.00"
10019-957-01	CYCLOPHOSPHAMIDE 2 GRAM IV SOLR	"$8,790.00"
10019-957-11	CYCLOPHOSPHAMIDE 2 GRAM IV SOLR	"$8,790.00"
HC46501276	PERC PLCMNT GT TUBE W/FLUORO	"$8,782.00"
HC62805460	CATH INTRACARDIAC ECHO/UTZ        F	"$8,775.00"
HC62804943	STENT BILIARY COVRD W/DELSYS      T	"$8,775.00"
HC62226402	RETRACTOR MIS SPINAL              T	"$8,775.00"
HC44002863	MYELOGRAPHY INJ W/S&I; =/>2SPINALREGIONS	"$8,768.00"
HC36800837	BRONCH W/EBUS SAMPLING 3/> NODES	"$8,763.00"
HC44700896	PROG STIM/PACING POST MEDS+	"$8,752.00"
67457-513-05	DACTINOMYCIN 0.5 MG IV SOLR	"$8,748.42"
HC62808811	CATH INDIGO SEPARATOR TUBING 7-8FR[PENUMBRA]	"$8,743.00"
HC46502548	"TENOTOMY  PERC, TOE; MULTIPLE TENDONS"	"$8,738.00"
HC44502276	VENOGRAM RENAL BILAT	"$8,722.00"
HC74200213	BEDSIDE/OTHER SURG INITIAL HR 4 (MCAL 1ST HOUR)	"$8,672.00"
HC27000017	"ANORECTAL WALL BX,ANAL APPROAC"	"$8,647.00"
60505-6230-4 	PACLITAXEL-PROTEIN BOUND 100 MG IV SUSR	"$8,646.06"
0074-1940-63	RITONAVIR 80 MG/ML ORAL SOLN	"$8,641.44"
0085-1328-01	POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP	"$8,637.30"
55513-954-01	PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN	"$8,633.10"
HC74200163	OR TIME INIT'L HR CASE CX LEVEL 5 (MCAL 1ST HOUR)	"$8,606.00"
55513-710-01	DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRG	"$8,604.84"
HC45201217	MIBI SPECT MULTI STUDY W/WM&EF	"$8,597.00"
HC23002009	ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE BIL	"$8,591.00"
HC91400094	R&B PEDIATRIC ACUTE	"$8,580.00"
HC46502787	INSERT PICC <5 YR AGE W/IMAGING	"$8,575.00"
66733-958-23	CETUXIMAB 2 MG/ML IV SOLN (MCH)	"$8,570.40"
HC44500445	AORTOGRAM ABD W/ RUN OFF	"$8,561.00"
HC38420303	ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS	"$8,553.00"
HC44703726	PERC REPAIR TRNSCTH TRICUSPID VALVE ADDL PROSTHESIS+	"$8,550.00"
HC45401320	MRA SPINE W/ CONTRAST	"$8,532.00"
HC91200241	R&B L&D PP OBSTETRICS CARE	"$8,532.00"
10599-003-01	"MOMETASONE 1,350 MCG SINU IMPL"	"$8,522.28"
HC44700912	PTA PULMONARY ARTERY EA ADDL+	"$8,514.00"
HC44500668	CHOLANGIOGRAM W/STONE REMVL	"$8,477.00"
HC44701423	PUNCTURE TRANSEPTL (LT HC) +	"$8,474.00"
HC62807730	M: DISC INVERVERTEBRAL ARTIFICIAL	"$8,450.00"
HC62800297	CATH EP DIAG/ABLAT 3D/VECT        W	"$8,450.00"
HC62804646	STENT DES CORO COV W/DEL SYS      T	"$8,450.00"
HC62804448	STENT TRACHEOBRONC COV W/DEL SYS  H	"$8,450.00"
HC62802954	STENT NEUROVASCULAR               D	"$8,450.00"
HC62805288	STENT NON-COAT/NON-COV W-DEL     AJ	"$8,450.00"
HC62225685	CATH TRANSLUM ANGIO LASER         T	"$8,450.00"
HC62219183	CATH CTO-CROSSER	"$8,450.00"
HC62212659	CATH MICRO CTO/REPRFNS(ENTEER/5MAX ACE)AJ	"$8,450.00"
HC62807078	COIL NEUROVASC(TARGET XL 360 SOFT)AJ	"$8,450.00"
HC44503886	SEL CATH EX CAROTID&ANG EC W/SI LT+	"$8,416.00"
HC44503894	SEL CATH EX CAROTID&ANG EC W/SI RT+	"$8,416.00"
99999-038-93	POLIHEXANIDE (PURAPLY AM) 5X5 CM EACH TOPICAL SHEET	"$8,400.00"
25021-676-20	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	"$8,400.00"
HC44504777	PTA CDS VIA DIALYSIS CIRCUIT WS&I +	"$8,397.00"
HC46501250	PERC PLACEMENT CEC TUBE W/FLUORO	"$8,371.00"
HC45400355	MR L-SPINE W/CONTRAST	"$8,365.00"
HC44500379	ANGIO SPINAL SELECTIVE  LT	"$8,360.00"
HC44500387	ANGIO SPINAL SELECTIVE  RT	"$8,360.00"
HC44900298	CT LOW EXT W/O CONTRAST BILAT	"$8,355.00"
HC36800118	BRONCH W/DESTRUCT TUMOR/STEN	"$8,349.00"
HC36000875	BRONCH W/DESTRUCT TUMOR/STEN	"$8,349.00"
99999-035-65	EPIFIX SKIN GRAFT ( 2X3 CM )	"$8,346.00"
HC44502177	VENOGRAM ADRENAL BILAT	"$8,344.00"
HC44503530	ENDOVENOUS ABLAT RADIO FREQ WS&I; ADDL VEIN+	"$8,340.00"
HC44500437	ANGIO VISCERAL	"$8,320.00"
HC83000760	THERAPEUTIC APHERESIS PLASMA	"$8,314.00"
HC44700607	IVUS/OCT CORONARY VESS/GRAFT INIT	"$8,314.00"
HC45401122	MR BREASTS W/O&W CONTRAST (BILAT)	"$8,308.00"
HC12800041	THERAPEUTIC APHERESIS PLASMA	"$8,294.00"
HC62808290	STENT TRANSCAROTID COV W/DEL SYS	"$8,288.00"
HC62807144	STENT NON-COAT/NON-COV W-DEL     AI	"$8,288.00"
0004-0261-29	MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR	"$8,284.80"
HC36001121	BRONCH W/EBUS SAMPLING 1/2 NODES	"$8,283.00"
HC36800829	BRONCH W/EBUS SAMPLING 1/2 NODES	"$8,283.00"
HC44504397	"EXCHNG CATH DRN BIL EXT->INT-EXT PERC(CHOLANG,S&I)"	"$8,280.00"
HC27001338	ERCP W/STENT PLACE BILI/PANC DUCT EA	"$8,276.00"
HC23001662	INJ ANES/STEROID INTERCOSTAL ADDL EA BI	"$8,262.00"
HC83000745	THERAPEUTIC APHERESIS RBC'S	"$8,238.00"
HC45400652	MRA CHEST W&W/O CONTRAST	"$8,214.00"
HC45400488	MR T-SPINE W/CONTRAST	"$8,207.00"
69452-223-84	RUFINAMIDE 40 MG/ML ORAL SUSP	"$8,199.96"
HC12800066	THERAPEUTIC APHERESIS RBC'S	"$8,199.00"
62484-0020-2	MERCAPTOPURINE 20 MG/ML ORAL SUSP	"$8,188.20"
62484-0020-1	MERCAPTOPURINE 20 MG/ML ORAL SUSP	"$8,188.20"
HC62214473	CHARGER BATTERY NEUROSTIM         B	"$8,187.00"
99999-038-97	POLIHEXANIDE (PURAPLY) 5X5 CM EACH TOPICAL SHEET	"$8,184.00"
55513-141-01	TRASTUZUMAB-ANNS 150 MG IV SOLR	"$8,160.42"
HC62808985	CATH PTA W/BALLOON RX(DCB)        M	"$8,157.50"
HC46502183	PERC BX BREAST W/LOC DEV MR 1ST LESN	"$8,148.00"
HC45400017	MR ABDOMEN W/ CONTRAST	"$8,140.00"
HC45600103	PET BREAST CA INTL/ SURG PLAN	"$8,135.00"
62935-223-05	LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG	"$8,130.42"
62935-221-04	LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG	"$8,130.42"
HC44503902	SEL CATH EA IC CRTD/VERT&ANG W/SI LT+	"$8,128.00"
HC44503910	SEL CATH EA IC CRTD/VERT&ANG W/SI RT+	"$8,128.00"
HC62210364	DEVICE ELECTROSURG ABLAT ENDOVASC	"$8,125.00"
HC62209309	DECOMPRESSION SYSTEM-IO-FLEX	"$8,125.00"
68516-3202-2	"PROFILNINE 1,000 (+/-) UNIT IV SOLR"	"$8,100.00"
68516-3205-2	"PROFILNINE 1,000 (+/-) UNIT IV SOLR"	"$8,100.00"
HC83000752	THERAPEUTIC APHERESIS PLATELET	"$8,092.00"
HC44900504	CT T-SPINE W&W/O  CONTRAST	"$8,090.00"
HC44504710	ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I	"$8,089.00"
HC62207154	SYSTEM STEALTH ALL	"$8,069.00"
HC62802095	STENT COAT/COVRD W/O DEL SYS	"$8,060.00"
HC62802855	STENT COLONIC/DUOD NOCOV&DEL	"$8,060.00"
HC12800058	THERAPEUTIC APHERESIS PLATELET	"$8,053.00"
HC44502334	ENDOVENOUS ABLAT LASER WS&I; ADDL VEIN+	"$8,025.00"
HC44700185	EP EVAL ICD LEADS AT IMPLANT	"$7,985.00"
HC44703254	REMOVE ELECTRODE DEFIBRILLATOR SUBQ	"$7,978.00"
HC62224647	CATH DUODENOSCP DIGTL ACCESS/DELVRY	"$7,963.00"
67457-991-15	TRASTUZUMAB-DKST 150 MG IV SOLR	"$7,947.96"
HC62803192	DEVICE MECH' OCCLUDE(COIL/PLUG)	"$7,947.00"
HC44002855	MYELOGRAPHY INJ W/S&I; LUMBOSAC	"$7,938.00"
HC25002726	TRAUMA ACT' III W/O P-H ALERT	"$7,921.00"
HC44900322	CT L-SPINE W&W/O  CONTRAST	"$7,916.00"
HC44700573	INTRAVENTRICULAR PACING	"$7,913.00"
HC44501211	MISC VASCULAR SURGICAL PROC	"$7,897.00"
HC41000118	POLYSMNGRPH CPAP/BIPAP <6Y/O ATTD	"$7,871.00"
HC46502803	INSERT PICC>5 YR AGE W/IMAGING	"$7,864.00"
HC46501391	REMVL TUN CV ACS DEVICE W/ SQ PORT	"$7,852.00"
HC23000763	INJ FORAMN EPI LMBR ADD+S&I-BI	"$7,828.00"
13533-800-71	IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJ SOLN	"$7,807.20"
13533-800-72	IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJ SOLN	"$7,807.20"
HC46500146	BX BONE TROCAR/NEEDLE; DEEP	"$7,801.00"
HC62800875	M: CATH VENTRICULAR NEURO	"$7,800.00"
HC62805072	CATH EP DIAG/ABLAT 3D/VECT        V	"$7,800.00"
HC62202775	CATH EP DIAG/MAPPING<20 ELECT     V	"$7,800.00"
HC62808183	STENT DES CORO COV GRAFTMASTER H000001	"$7,800.00"
HC62806211	STENT DES CORO COV W/DEL SYS      S	"$7,800.00"
HC62807953	STENT ENDOPRSTH AAA               C	"$7,800.00"
HC62802756	STENT ESOPHAGEAL;CVRD;DEL         C	"$7,800.00"
HC62808571	STENT FULLY COVERED VIABIL	"$7,800.00"
HC62804430	STENT TRACHEOBRONC COV W/DEL SYS  G	"$7,800.00"
HC62803770	STENT NON-COAT/NON-COV W-DEL     AH	"$7,800.00"
HC62807060	COIL NEUROVASCULAR               AP	"$7,800.00"
HC62807011	PROBE ABLATION CRYO               C	"$7,800.00"
HC62227137	PROBE ABLATION                   AS	"$7,800.00"
68516-4613-2	"ALPHANATE 1,000 (400 VWF) UNIT/10 ML IV SOLR"	"$7,800.00"
55150-220-99	EPTIFIBATIDE 2 MG/ML IV SOLN	"$7,800.00"
50474-870-15	BRIVARACETAM 10 MG/ML ORAL SOLN	"$7,792.20"
HC44002848	MYELOGRAPHY INJ W/S&I; THORACIC	"$7,786.00"
HC46500674	CHANGE PERC GT TO GJ TUBE W/FLUORO	"$7,784.00"
HC45201068	NM TUMOR LOCALIZE PLNR WHOLE BODY 2+ DAYS	"$7,769.00"
0002-7669-01	RAMUCIRUMAB 10 MG/ML IV SOLN	"$7,763.82"
HC46502506	"EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) LT"	"$7,756.00"
HC46502514	"EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) RT"	"$7,756.00"
HC23001308	INJ S-I JOINT ANESTH W/IMAG BI	"$7,748.00"
HC46501912	BX LYMPH NODE(S) DEEP CERV-*DS	"$7,742.00"
HC46501755	BX LYMPH NODE(S) DEEP CERVICAL	"$7,742.00"
HC46501714	BX/RMVL LYMPH NODE(S)-OPEN LT	"$7,742.00"
HC46501722	BX/RMVL LYMPH NODE(S)-OPEN RT	"$7,742.00"
HC44900975	CT ABDOMEN & PELVIS W/O CONTRAST	"$7,736.00"
HC62803671	CATH ABLAT TISS COOL-TIP(HALO 360)I	"$7,719.00"
HC43000009	ABLATION CRYO BREAST FIBROADENOMA EA W/US	"$7,714.00"
HC74200155	OR TIME INIT'L HR CASE CX LEVEL 4 (MCAL 1ST HOUR)	"$7,714.00"
HC46001079	SEL CATH AB/PEL/LOEXT3RD OR	"$7,678.00"
HC46000808	SEL CATH AB/PEL/LOEXT3RD OR LT	"$7,678.00"
HC46000816	SEL CATH AB/PEL/LOEXT3RD OR RT	"$7,678.00"
HC45201381	NM TUMOR LOCALIZE SPECT 2+ AREAS 1 DAY//SNGL AREA 2+DAYS	"$7,678.00"
HC45600087	"PET MELANOMA, NON-COV INDCTNS"	"$7,678.00"
HC47201082	"IMRT TX DELIVERY,GUIDE&TRACK SIMPLE"	"$7,651.00"
HC43001072	BREAST PROCEDURE UNSPECIFIED	"$7,644.00"
62856-389-01	ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN	"$7,644.00"
HC44700201	EP EVAL T-ICD W/PROGRAMMING	"$7,642.00"
HC62807755	M: GRAFT REPAIR NERVE	"$7,639.00"
HC62808159	STENT COV W/DEL SYS PVD           B	"$7,638.00"
HC62210240	CANNULA ECMO	"$7,638.00"
HC62806989	CATH BI-CAVAL PERFUSION	"$7,638.00"
0003-2187-13	ABATACEPT (WITH MALTOSE) 250 MG IV SOLR	"$7,628.82"
HC44002830	MYELOGRAPHY INJ W/S&I; CERVICAL	"$7,619.00"
HC44700516	INTRA-ATRIAL PACING	"$7,617.00"
HC41000084	POLYSMNGRPH 4+STGS <6 Y/O ATTD	"$7,609.00"
HC46502415	"PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) LT"	"$7,596.00"
HC46502423	"PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) RT"	"$7,596.00"
HC44503688	VERT/THOR CAROTID STENT+LT	"$7,592.00"
HC44503696	VERT/THOR CAROTID STENT+RT	"$7,592.00"
0143-9280-01	MITOMYCIN 40 MG IV SOLR	"$7,584.00"
16729-116-38	MITOMYCIN 40 MG IV SOLR	"$7,583.76"
16729-248-38	MITOMYCIN 40 MG IV SOLR	"$7,583.76"
HC46501417	REPAIR CV ACCESS CATH W/PORT	"$7,576.00"
HC44501799	REMOVE NEPHROSTOMY TUBE BIL	"$7,567.00"
HC27000991	GI TRACT CAPSULE ENDO IMAG ESOPH THRU ILEUM	"$7,565.00"
HC46001269	INJ CHOLANGIO PERC/S&I;NEW ACCESS	"$7,543.00"
HC41500885	EEG W/VIDEO MONITOR CONT EA 12-26HR	"$7,538.00"
HC44700532	INTRACARDIAC ECHO +	"$7,525.00"
HC62228002	LOOP PLASMA	"$7,524.00"
HC44702959	REM PERC VAD DEVICE-SEP SETTING ARTERIAL/AV; LEFT HEART	"$7,516.00"
HC44900637	CTA ABDOMEN	"$7,508.00"
99999-044-63	POLIHEXANIDE (PURAPLY AM) 3X4 CM EACH TOPICAL SHEET	"$7,500.00"
HC45400363	MR L-SPINE W/O CONTRAST	"$7,488.00"
HC41000050	POLYSOMNOGRAPHY CPAP/BIPAP 6&> ATTD	"$7,478.00"
99988-000-27	IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN	"$7,475.00"
HC45401262	MRA ABDOMEN W&W/O CONTRAST	"$7,470.00"
HC62204342	KIT VERTEBROPLASTY DISP	"$7,449.00"
HC21000492	I&D POST OP WOUND INF COMP'	"$7,438.00"
HC38420121	ECMO REPSN PERIF A&/V PERC W/FLUOR=5Y	"$7,431.00"
HC38420204	ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER	"$7,431.00"
HC38420246	ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS	"$7,431.00"
HC23001803	ASP/INJ JOINT LRG W/UTZ GUIDE-BILAT	"$7,429.00"
HC41000035	POLYSOMNOGRAPHY 4+ STAGES 6&> ATTD	"$7,425.00"
HC46000923	SEL CATH THOR/BRAC 3RD ORD LT	"$7,405.00"
HC46000931	SEL CATH THOR/BRAC 3RD ORD RT	"$7,405.00"
HC45400637	MR UP EXT (JNT) W/CONT LT	"$7,393.00"
HC45400645	MR UP EXT (JNT) W/CONT RT	"$7,393.00"
HC44701431	INJ PRO CATH;CORON CONGNTL HRT	"$7,385.00"
HC47200639	TRANSCATH PLCMNT RAD DEL DEVIC	"$7,380.00"
HC45400728	MRA NECK W/ CONTRAST	"$7,376.00"
HC44504207	XRAY TEVAR W/ LT SUBCLAV; INT'L ENDO& DIST EXTS CELIAC S&I	"$7,362.00"
HC27000918	ESOPHAGEAL REFLUX W/PH ELECTR	"$7,353.00"
HC45401247	MRA LOW EXT W&W/O CONT LT	"$7,353.00"
HC45401239	MRA LOW EXT W&W/O CONT RT	"$7,353.00"
HC27001346	ERCP W/ABLAT TUMR/POLYP/LESN GUIDEWIRE	"$7,350.00"
HC46502829	INSERT/DRILL SUBDUR/VENTRIC CATH	"$7,349.00"
HC45400413	MR PELVIS W/CONTRAST	"$7,348.00"
67684-1901-2	ETHIODIZED OIL 480 MG IODINE/ML INJ OIL	"$7,344.00"
HC46501037	INSERT CT(OPEN) W/DRAIN SYSTEM BIL	"$7,336.00"
HC44500478	AORTOGRAM THOR W/ SERIAL(ARCH)	"$7,333.00"
HC44900702	CTA PELVIS	"$7,330.00"
HC62808803	CATH INDIGO THROMB 6FR L135CM[PENUMBRA]	"$7,329.00"
HC23001837	INJ DX/THER CERVICAL/THORACIC W/IMAG	"$7,323.00"
66621-0790-2	ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR	"$7,320.00"
66621-0790-1	ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR	"$7,320.00"
HC44500221	ANGIO EXTREMITY UE OR LE LT	"$7,298.00"
HC44500239	ANGIO EXTREMITY UE OR LE RT	"$7,298.00"
HC45400090	MR CHEST W/CONTRAST	"$7,291.00"
HC44700193	EP EVAL ICD LEADS/GEN AT IMPLA	"$7,289.00"
HC46502811	REPLC PICC LINE W/O SQ PORT/PUMP W/IMAGING	"$7,288.00"
HC44900132	CT C-SPINE W&W/O  CONTRAST	"$7,279.00"
HC45400066	MR BRAIN W/CONTRAST	"$7,278.00"
24201-010-20	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	"$7,261.56"
76478-501-20	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	"$7,261.32"
HC44900959	CCTA HEART EVAL W/3D IMAGE	"$7,261.00"
HC44900645	CTA CHEST	"$7,259.00"
HC46502308	PERC DRAIN CATH W/IMAG; PERITONEAL/RETROPERIT	"$7,257.00"
0517-0650-01	FERRIC CARBOXYMALTOSE 50 IRON MG/ML IV SOLN	"$7,254.45"
HC27000744	ERCP W/LITHOTRIPSY	"$7,246.00"
HC38420055	PERFUSION CARDIOASSIST INL' 2HR	"$7,229.00"
67877-673-62	RUFINAMIDE 40 MG/ML ORAL SUSP	"$7,214.64"
HC23001779	ASP/INJ JOINT MED W/UTZ GUIDE-BILAT	"$7,213.00"
HC45400496	MR T-SPINE W/O CONTRAST	"$7,200.00"
HC74200205	BEDSIDE/OTHER SURG INITIAL HR 3 (MCAL 1ST HOUR)	"$7,198.00"
HC44500759	ENDO BILI W/DILAT W/ STENT	"$7,194.00"
HC45400751	MRA PELVIS W/O & W/ CONTRAST	"$7,188.00"
HC45400546	MR UP EXT(NON JNT)W/CONT LT	"$7,184.00"
HC45400553	MR UP EXT(NON JNT)W/CONT RT	"$7,184.00"
50242-040-62	OMALIZUMAB 150 MG SUBCUTANEOUS SOLR	"$7,183.26"
50242-215-01	OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRG	"$7,183.26"
HC45400207	MR LOW EXT(NON JNT)W/CONT LT	"$7,183.00"
HC45400215	MR LOW EXT(NON JNT)W/CONT RT	"$7,183.00"
HC45400298	MR LOW EXT(JNT)W/CONT LT	"$7,183.00"
HC45400306	MR LOW EXT(JNT)W/CONT RT	"$7,183.00"
HC62808977	CATH PTA W/BALLOON RX(DCB)        K	"$7,182.50"
59338-775-01	FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN	"$7,161.73"
HC44501740	"REM & REPLAC EXT URET CATH(IMG,S&I) LT"	"$7,158.00"
HC44501757	"REM & REPLAC EXT URET CATH(IMG,S&I) RT"	"$7,158.00"
HC62800180	CATH ATHERECTOMY ROTATIONAL      AH	"$7,150.00"
HC62805502	CATH EP DIAG/ABLAT 3D/VECT        U	"$7,150.00"
HC62806187	CATH THROMBECTOMY                AH	"$7,150.00"
HC62804638	STENT DES CORO COV W/DEL SYS      R	"$7,150.00"
HC62804422	STENT TRACHEOBRONC COV W/DEL SYS  F	"$7,150.00"
HC62802186	STENT NON-COAT/NON-COV W-DEL     AG	"$7,150.00"
HC62217906	CATH MICRO NEURO (AXS CATALYST)  AH	"$7,150.00"
HC62802939	COIL NEUROVASCULAR               AO	"$7,150.00"
HC62300462	STABILIZER ENDOWRIST ROBOTIC	"$7,150.00"
HC46000550	INTRO CATHETER AORTA	"$7,144.00"
HC45400389	MR ORBIT/FACE&OR NECK W/CONTR	"$7,128.00"
HC44700011	BUNDLE OF HIS RECORDING	"$7,124.00"
HC44500452	AORTOGRAM ABDOMINAL	"$7,116.00"
HC44700524	INTRA-ATRIAL RECORDING	"$7,106.00"
HC45400025	MR ABDOMEN W/O CONTRAST	"$7,075.00"
HC45400033	MR ABDOMEN(MRCP)W/O CONTRAST	"$7,075.00"
HC45400124	MR C-SPINE W/CONTRAST	"$7,062.00"
HC25000209	INSERT/REPLAC TEMP PACER; SNGL	"$7,060.00"
HC44900728	CTA UPPER EXT W/CONTRAST-LT	"$7,060.00"
HC44900736	CTA UPPER EXT W/CONTRAST-RT	"$7,060.00"
HC44900512	CT T-SPINE W/ CONTRAST	"$7,051.00"
HC25004268	I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP BIL	"$7,048.00"
HC44900009	CT ABDOMEN W&W/O CONTRAST	"$7,045.00"
HC27001353	ERCP W/BALLN DIL BILI/PANC DUCT/AMP EA	"$7,043.00"
HC27001452	ESOPHSCPY W/ABLAT TUMR/LESN(S(DILATE)~FO	"$7,030.00"
HC27001478	ESOPHSCPY W/STENT (DIL PRE-POST) ~FO	"$7,011.00"
57894-030-01	INFLIXIMAB 100 MG IV SOLR	"$7,006.92"
HC46502472	"CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST LT"	"$7,000.00"
HC46502480	"CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST RT"	"$7,000.00"
68727-800-01	DEFIBROTIDE 80 MG/ML IV SOLN	"$6,984.00"
68727-800-02	DEFIBROTIDE 80 MG/ML IV SOLN	"$6,984.00"
10454-712-10	"RIMABOTULINUMTOXINB 10,000 UNIT/2 ML IM SOLN"	"$6,972.00"
HC27000793	ERCP W/STONE(S) REMOVAL	"$6,962.00"
66689-307-08	MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR	"$6,960.00"
67877-230-22	MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR	"$6,960.00"
HC74200148	OR TIME INIT'L HR CASE CX LEVEL 3 (MCAL 1ST HOUR)	"$6,958.00"
HC46501094	INSERT PICC <5 YR AGE W/O IMAGING	"$6,946.00"
HC44703445	OPEN AXILLARY/SUBCLAV ART EXPOSE DELIVER EV PROTH UNILATL+	"$6,936.00"
HC27001361	ERCP W/STENT/FB REMOV BILI/PANC DUCT	"$6,935.00"
HC47200167	HYPERTHERMIA PROBE 6+ APPS	"$6,927.00"
HC27000777	ERCP W/SPHINCTER/PAPILLOTOMY	"$6,926.00"
HC27000751	ERCP W/PRES MEAS SPHINC(ODDI)	"$6,926.00"
HC44701670	INSERT IMPLANTED MONITOR DEVIC	"$6,925.00"
HC46502290	PERC DRAIN CATH W/IMAG; VISCERAL	"$6,925.00"
HC44900330	CT L-SPINE W/ CONTRAST	"$6,919.00"
50242-136-01	TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN	"$6,917.40"
0003-3772-11	NIVOLUMAB 40 MG/4 ML IV SOLN	"$6,914.95"
HC46501490	REPLC NON-TUN CV ACS CATH W/O PORT/PUMP	"$6,893.00"
66993-062-72	ATOVAQUONE 750 MG/5 ML ORAL SUSP	"$6,890.94"
HC47200258	"INTERSTITIAL RADIATION, COMPLEX"	"$6,884.00"
HC23001001	INJ SUPERIOR HYPOGASTRIC PLEXS	"$6,866.00"
HC44701449	INJ PRO CATH;AORTOCORON GRAFTS	"$6,866.00"
HC46000493	INTRO CATH FALLOPIAN TUBE	"$6,863.00"
HC25004292	REMOVE FB DEEP THIGH/KNEE AREA BIL	"$6,852.00"
HC91000123	R&B ONCOLOGY	"$6,852.00"
HC47201074	BRACHYTX ISODOSE W/DOSIMETRY;CMPLX	"$6,843.00"
10511-3001-2	HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLR	"$6,840.00"
HC62806625	COIL EMBOLIZ(3D PRIME BARE SUPER SFT)AN	"$6,825.00"
HC44900678	CTA LOW EXT LT	"$6,824.00"
HC44900686	CTA LOW EXT RT	"$6,824.00"
55513-223-01	ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLR	"$6,821.94"
HC44500262	ANGIO PELVIC	"$6,819.00"
HC45401346	MRA SPINE W/O CONTRAST	"$6,812.00"
HC44900108	CT CHEST DX W&W/O CONTRAST	"$6,811.00"
16714-345-01	MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR	"$6,802.56"
HC45400835	MRI CARDIAC MORPH W/O CONT	"$6,797.00"
HC46502142	PERC BX BREAST W/LOC DEV SG 1ST LESN	"$6,795.00"
HC44504496	ENDOVASC INFUS CRANIAL(NON-THROMB)ADD TRRT+	"$6,773.00"
HC44900462	CT PELVIS W&W/O CONTRAST	"$6,773.00"
HC27000728	ERCP W/BIOPSY	"$6,768.00"
HC62808928	BONE GRAFT FILLER VOID 5ML(CERAMENT®BONESUPPORT®)	"$6,760.00"
HC62805064	CATH EP DIAG/ABLAT 3D/VECT        Q	"$6,760.00"
HC62217898	SET PIN DISTRACTORS-COUNT 10      B	"$6,754.00"
HC62211081	CATHETER SINUS ENDO PLEDGE	"$6,744.00"
HC45400041	MR BONE MARROW BLOOD SUPPLY	"$6,736.00"
HC23001266	DESTR L/S FAC JOINT SINGL W/IMG-L	"$6,735.00"
HC23001274	DESTR L/S FAC JOINT SNGL W/IMG-R	"$6,735.00"
HC21000351	DBRD SKIN MUSL/BONE TO 20SQCM	"$6,729.00"
0781-3255-94	CYCLOPHOSPHAMIDE 2 GRAM IV SOLR	"$6,724.38"
HC36000289	VENT DAY INIT-JET VENT	"$6,713.00"
HC44900140	CT C-SPINE W/ CONTRAST	"$6,705.00"
HC45401106	MR BREASTS W/O CONTRAST (BILAT)	"$6,702.00"
HC46502530	"TENOTOMY  PERC, TOE; SINGLE TENDON"	"$6,698.00"
HC44504645	EMBOLIZATION/OCCLUSION URETERAL  LT	"$6,696.00"
HC44504652	EMBOLIZATION/OCCLUSION URETERAL  RT	"$6,696.00"
HC27000686	ERCP DIAGNOSTIC (W/SPEC)	"$6,695.00"
HC23001431	INJ  L/S F W/IMAGE 1ST LVL LT	"$6,688.00"
HC23001423	INJ  L/S F W/IMAGE 1ST LVL RT	"$6,688.00"
HC46502084	BX PROSTATE STEREO/TEMPLAT W/IMG	"$6,682.00"
HC36000263	VENT DAY INITIAL-ADULT	"$6,679.00"
HC36000271	VENT DAY INITIAL-INFANT	"$6,679.00"
HC36000297	VENT DAY INIT-OSCIL&/OR HI FRQ	"$6,679.00"
HC46500245	BIOPSY LIVER(NEEDLE/PERCUTAN)	"$6,659.00"
HC27001437	EGD W/STENT (DIL&GUIDEWIRE)	"$6,651.00"
HC46501821	BX NECK/THORAX SOFT TISSUE*DS	"$6,648.00"
HC46501730	BX NECK/THORAX SOFT TISSUE-SC	"$6,648.00"
HC46500344	BIOPSY TRANSCATHETER RAD S&I	"$6,637.00"
HC45400694	MRA HEAD W/CONTRAST	"$6,629.00"
HC46502266	PERC PLC BRST LOC DEV MR 1ST LESN	"$6,624.00"
HC44503928	PLCMNT DEV ENDOVAS OCCLUD ART ILIAC+	"$6,618.00"
HC46502928	ABLATION PERC CRYO UPPER EXTREMITY NERVE INCLD IMAG	"$6,612.00"
HC46502936	ABLATION PERC CRYO LOWER EXTREMITY NERVE INCLDE IMAG	"$6,612.00"
HC23000748	INJ FORAMN EPI LMBR INTLW/S&I-L	"$6,612.00"
HC23000755	INJ FORAMN EPI LMBR INTLW/S&I-R	"$6,612.00"
HC44703437	OPEN FEMORAL ART CONDUIT DELIVER EV PROTH / BYPASS UNILATL+	"$6,609.00"
HC44500890	INJ CHEMONUCLEOLYSIS	"$6,609.00"
HC45400421	MR PELVIS W/O CONTRAST	"$6,606.00"
HC62204011	KIT KYPHOPAK ADD'L FRACTURE	"$6,578.00"
HC44702967	REPOSIT PERC VAD DEVICE INC S&I; LEFT OR RIGHT HEART DEVICE	"$6,563.00"
HC82204520	BONE MARROW DX; BX(S) ONLY BILAT	"$6,561.00"
HC27001411	EGD HEAT ESO SPHINC/GASTRIC CARDIA~FO	"$6,551.00"
HC44701126	RT VENTRICULAR RECORDING	"$6,549.00"
HC62806567	CATH BALLOON NEURO(HYPERFORM)     I	"$6,549.00"
HC45201233	MIBI PLANAR MULT STUDY W/WM&EF	"$6,547.00"
HC23000680	INJ FORAMN EPI C/T INTL W/S&I-L	"$6,530.00"
HC23000698	INJ FORAMN EPI C/T INTL W/S&I-R	"$6,530.00"
HC44502201	VENOGRAM CAVAL INFERIOR	"$6,528.00"
HC46502316	PERC DRAIN W/IMAG; PERIT/RETROPERIT TRANSVAG/RECTAL	"$6,518.00"
HC83000737	THERAPEUTIC APHERESIS WBC'S	"$6,516.00"
HC44500767	ENDO BILI W/DILAT W/O STENT	"$6,508.00"
0078-0435-61	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$6,502.80"
HC45400439	MR SPECTROSCOPY	"$6,501.00"
HC62208913	CATH PTCA BALLOON NON-LASER CRYO  Z	"$6,500.00"
HC62805494	CATH EP DIAG/ABLAT 3D/VECT        T	"$6,500.00"
HC62800354	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AG	"$6,500.00"
HC62800511	CATH THROMBECTOMY                AG	"$6,500.00"
HC62803853	STENT DES CORO COV W/DEL SYS      Q	"$6,500.00"
HC62807961	STENT ENDOPRSTH LEG ILIAC         A	"$6,500.00"
HC62808431	STENT EXTENDER ENDOGRAFT AAA      Q	"$6,500.00"
HC62807854	STENT EXTENDER ENDOGRAFT AAA      Q	"$6,500.00"
HC62804414	STENT TRACHEOBRONC COV W/DEL SYS  E	"$6,500.00"
HC62804604	STENT CORO BARE METAL W/DEL       K	"$6,500.00"
HC62807235	STENT NON-COAT/NON-COV W-DEL     AF	"$6,500.00"
HC62202809	EMBOLIZATION PROTECTIVE SYSTEM    Q	"$6,500.00"
HC62805643	DEVICE ABLAT COOL-TIP NONVASC    AG	"$6,500.00"
HC62212519	CATH MICRO NEURO(ARC132)         AA	"$6,500.00"
HC62212667	CATHETER MICRO CTO(VIANCE)       AG	"$6,500.00"
HC62806732	COIL EMBOLIZ(PRIME 3D ES)        AM	"$6,500.00"
HC62807052	COIL NEUROVASC(TARGET 360 NANO)  AM	"$6,500.00"
HC62219027	RETRACTOR MIS SPINAL              Q	"$6,500.00"
HC62219753	KIT VITRECTOMY PROBE              Z	"$6,500.00"
HC62220363	SHIM DEVICE ACCESS SPINAL        AK	"$6,500.00"
HC21000963	"APPY SKIN SUB T,A,L 1ST 100SQ~LC"	"$6,495.00"
HC46001061	SEL CATH AB/PEL/LOEXT2ND OR	"$6,490.00"
HC46000741	SEL CATH AB/PEL/LOEXT2ND OR LT	"$6,490.00"
HC46000758	SEL CATH AB/PEL/LOEXT2ND OR RT	"$6,490.00"
HC62204649	M: SYSTEM NERVE RESPONSE	"$6,490.00"
HC46501367	REMOV TUNNELED CV ACS CATH W/O PORT/PUMP	"$6,489.00"
HC62210653	DEVICE EMBOLIC PROTECT NEURO	"$6,484.00"
HC45401056	MR BREAST W/O& W/ CONTRAST LT	"$6,482.00"
HC45401049	MR BREAST W/O& W/ CONTRAST RT	"$6,482.00"
HC25004623	REMOVE FB FOOT; DEEP BIL	"$6,481.00"
HC25004383	I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP BIL	"$6,477.00"
HC27000983	GI TRACT CAPSULE ENDO IMAG ESOPHAGUS ONLY	"$6,470.00"
HC44901031	CT CEREBRAL PERF ANALYSIS	"$6,463.00"
50242-138-01	TOCILIZUMAB 162 MG/0.9 ML SUBCUTANEOUS SYRG	"$6,456.18"
HC62220785	OXYGENATOR ECMO PEDS	"$6,452.00"
HC45400660	MRA CHEST W/CONTRAST	"$6,447.00"
HC46502860	PERC BX CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS	"$6,438.00"
HC45401577	MR BREAST W/O& W/ CONTR & CAD LT [COMM&MCAL]	"$6,434.00"
HC45401585	MR BREAST W/O& W/ CONTR & CAD RT [COMM&MCAL]	"$6,434.00"
76310-017-01	AMIFOSTINE CRYSTALLINE 500 MG IV SOLR	"$6,428.44"
76310-017-50	AMIFOSTINE CRYSTALLINE 500 MG IV SOLR	"$6,428.44"
HC44900652	CTA HEAD	"$6,427.00"
HC23000706	INJ FORAMN EPI C/T ADD+W/S&I-BI	"$6,426.00"
0004-0039-09	VALGANCICLOVIR 50 MG/ML ORAL SOLR	"$6,421.01"
59676-340-01	"EPOETIN ALFA 40,000 UNIT/ML INJ SOLN"	"$6,414.00"
59676-340-00	"EPOETIN ALFA 40,000 UNIT/ML INJ SOLN"	"$6,414.00"
HC46501763	BIOPSY NEEDLE RENAL	"$6,402.00"
HC46500310	BIOPSY NEEDLE RENAL-LT	"$6,402.00"
HC46500328	BIOPSY NEEDLE RENAL-RT	"$6,402.00"
HC45400108	MR CHEST W/O CONTRAST	"$6,400.00"
HC46500690	CHANGE URETEROSTOMY TUBE LT	"$6,377.00"
HC46500708	CHANGE URETEROSTOMY TUBE RT	"$6,377.00"
HC62202791	EMBOLIC PROTECT SYSTEM CAROTID	"$6,371.00"
67457-220-00	ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN	"$6,365.34"
67457-220-05	ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN	"$6,365.34"
HC12800074	THERAPEUTIC APHERESIS WBC'S	"$6,360.00"
HC44500049	ANGIO ADRENAL LT	"$6,359.00"
HC44500056	ANGIO ADRENAL RT	"$6,359.00"
HC46502167	PERC BX BREAST W/LOC DEV US 1ST LESN	"$6,355.00"
HC44703643	REMOVE VAD PERCUT VENOUS RIGHT	"$6,351.00"
HC46501292	INS NO TUN CV ACCESS CATH 5YRS+	"$6,351.00"
0944-2716-05	IMMUN GLOB G(IGG)-GLY-IGA OV50 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLN	"$6,345.00"
52652-2001-6	METHOTREXATE 2.5 MG/ML ORAL SOLN	"$6,340.68"
HC62210695	DEVICE CLOSURE NEUROVASCULAR	"$6,338.00"
HC45400462	MR TMJ(S)	"$6,337.00"
HC23001969	DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE BI	"$6,336.00"
HC27000801	ESOPH DILATION OVER GUIDE WIRE	"$6,335.00"
49452-7680-2	TETRACAINE HCL (BULK) MISC POWD	"$6,330.00"
HC44504660	DILAT BALLOON STRICTURE URETERAL  LT	"$6,323.00"
HC44504678	DILAT BALLOON STRICTURE URETERAL  RT	"$6,323.00"
69238-1594-6	SIROLIMUS 1 MG/ML ORAL SOLN	"$6,315.84"
69238-1594-3	SIROLIMUS 1 MG/ML ORAL SOLN	"$6,315.84"
60505-6197-2	SIROLIMUS 1 MG/ML ORAL SOLN	"$6,315.84"
HC46500542	BX PROSTATE NDL/PUNCH SGL/MULT	"$6,314.00"
HC45400074	MR BRAIN W/O CONTRAST	"$6,311.00"
HC62808795	CATH INDIGO THROMB L140CM[PENUMBRA]	"$6,305.00"
HC44900694	CTA NECK	"$6,302.00"
HC91000163	R&B ISOLATION/PRECAUTIONARY	"$6,300.00"
50419-423-01	LEVONORGESTREL 20 MCG/24 HOURS (7 YRS) 52 MG INTRAUTERINE IUD	"$6,295.44"
HC44900520	CT T-SPINE W/O CONTRAST	"$6,288.00"
HC44703510	INTRAPRCDRL CORONARY FFR ANGIO W/3D MAP+	"$6,285.00"
HC45401270	MRA ABDOMEN W/CONT	"$6,284.00"
17156-251-08	PENTETATE INDIUM DISOD. IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLN	"$6,282.25"
HC23001340	INJ CER/THOR F/IMAGE SNG LVLLT	"$6,278.00"
HC23001332	INJ CER/THOR F/IMAGE SNG LVLRT	"$6,278.00"
HC44500288	ANGIO PULMONARY LT	"$6,277.00"
HC44500296	ANGIO PULMONARY RT	"$6,277.00"
HC45201209	MIBI SPECT SNG STUDY W/WM & EF	"$6,273.00"
HC74200197	BEDSIDE/OTHER SURG INITIAL HR 2 (MCAL 1ST HOUR)	"$6,272.00"
HC23001472	INJ  L/S F W/IMAGE 2ND LVL BIL	"$6,266.00"
HC23001225	DESTR C/T FAC JOINT SINGL W/IMG-L	"$6,258.00"
HC23001233	DESTR C/T FAC JOINT SNGL W/IMG-R	"$6,258.00"
HC44900348	CT L-SPINE W/O CONTRAST	"$6,258.00"
HC44900546	CT UPPER EXT W&W/O CONTRAST LT	"$6,258.00"
HC44900553	CT UPPER EXT W&W/O CONTRAST RT	"$6,258.00"
HC47200092	BRACHYTX INSERT UTERINE TANDEM	"$6,253.00"
HC44900157	CT C-SPINE W/O CONTRAST	"$6,252.00"
HC45400173	MR LOW EXT(NON JNT)W/O CONT LT	"$6,243.00"
HC45400181	MR LOW EXT(NON JNT)W/O CONT RT	"$6,243.00"
HC62805106	CATH EP DX 20+ ELECTRODES         O	"$6,240.00"
HC44502250	VENOGRAM HEPATIC W/HEMO EVAL	"$6,206.00"
HC44702983	EVAL EP ICD/LEAD SUBQ	"$6,202.00"
HC36000321	VENT DAY SUBSQ-JET VENT	"$6,199.00"
HC44504447	"REMOV CALC DUCT(S)BIL&/GB PERC(DESTRCT,S&I)+"	"$6,197.00"
HC44900439	CT ORBIT/SELLA/EAR W&W/O CONT	"$6,197.00"
HC62806559	CATH BALLOON NEURO(HYPERGLIDE/SCEPTER XC)H	"$6,192.00"
0052-4330-01	ETONOGESTREL 68 MG SDRM IMPL	"$6,183.84"
78206-145-01	ETONOGESTREL 68 MG SDRM IMPL	"$6,183.84"
HC62806369	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AF	"$6,175.00"
HC62807128	CATH THROMBECTOMY                AD	"$6,175.00"
HC62803762	STENT NON-COAT/NON-COV W-DEL     AE	"$6,175.00"
HC62211743	CATH GUIDING DEFLECTABLE          Z	"$6,175.00"
HC62807169	COIL EMBOLIZ(PRIME/HYPERSOFT 3D) AL	"$6,175.00"
HC62225644	CATH EP/ABLATION COOL-TIP         L	"$6,175.00"
HC25000050	ED LEVEL VI - CRITICAL	"$6,174.00"
HC36800886	PERC BX CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS	"$6,160.00"
HC36001170	PERC BX CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS	"$6,160.00"
HC62226501	CHARGER BATTERY NEUROSTIM         B	"$6,156.00"
HC46501102	INSERT PICC >5 YR AGE W/O IMAGING	"$6,153.00"
HC25004417	CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC BIL	"$6,150.00"
HC45400132	MR C-SPINE W/O CONTRAST	"$6,147.00"
HC45201373	NM TUMOR LOCALIZE SPECT CT  SNGL AREA 1 DAY	"$6,143.00"
HC47200860	PLACE DEVICE/MARKER OTHER SITES(NON-PROST)	"$6,136.00"
HC45400264	MR LOW EXT(JNT) W/O CONT LT	"$6,135.00"
HC45400272	MR LOW EXT(JNT) W/O CONT RT	"$6,135.00"
HC27000520	EGD W/TRANS DRAIN/STENT CYST(EUS) ~FO	"$6,129.00"
HC46502191	PERC BX BREAST W/LOC DEV MR ADDL LESN+	"$6,117.00"
HC62808761	CATH INDIGO THROMB SEPARATOR 8 L150CM[PENUMBRA]	"$6,110.00"
HC44500171	ANGIO EA ADD'L VESSEL +	"$6,109.00"
HC62208178	VALVULTOME	"$6,107.00"
HC23000946	INJ ANES/STEROID NERVE PUDENDAL BIL	"$6,099.00"
HC36000305	VENT DAY SUBSEQUENT-ADULT	"$6,096.00"
HC36000313	VENT DAY SUBSEQUENT-INFANT	"$6,096.00"
HC36000339	VENT DAY SUBSQ-OSCIL&/OR HI FR	"$6,096.00"
HC25004441	CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC BIL	"$6,091.00"
HC44502219	VENOGRAM CAVAL SUPERIOR	"$6,081.00"
HC46501581	THORACENTESIS W/TUBE W/ IMAG LT	"$6,076.00"
HC46501599	THORACENTESIS W/TUBE W/ IMAG RT	"$6,076.00"
HC45400603	MR UP EXT(JNT) W/O CONT LT	"$6,076.00"
HC45400611	MR UP EXT(JNT) W/O CONT RT	"$6,076.00"
HC44701480	INJ PRO CATH; PULM ANGIO	"$6,056.00"
HC45400512	MR UP EXT(NON JNT) W/O CONT LT	"$6,047.00"
HC45400520	MR UP EXT(NON JNT) W/O CONT RT	"$6,047.00"
HC36800076	BRONCH W/NDL ASP BX(S) INITIAL	"$6,042.00"
HC36000834	BRONCH W/NDL ASP BX(S);INITIAL	"$6,042.00"
HC44504215	XRAY TEVAR; INITIAL ENDO & DIST EXTS TO CELIAC S&I	"$6,036.00"
HC45400397	MR ORBIT/FACE&OR NECK W/O CONT	"$6,034.00"
HC47200597	"SPECIAL RAD TX;IRRAD,ENDO,CONE"	"$6,021.00"
HC46000907	SEL CATH THOR/BRAC 2ND ORD LT	"$6,020.00"
HC46000915	SEL CATH THOR/BRAC 2ND ORD RT	"$6,020.00"
0085-1381-01	TEMOZOLOMIDE 100 MG IV SOLR	"$6,018.66"
10122-510-03	PORACTANT ALFA 240 MG/3 ML INTRATRACH SUSP	"$6,018.61"
HC47200910	PLCMNT INTERSTIT DEV ABD/PELV	"$6,017.00"
HC44900249	CT LOW EXT W&W/O CONTRAST LT	"$6,014.00"
HC44900256	CT LOW EXT W&W/O CONTRAST RT	"$6,014.00"
HC62204458	BEAD LC MICROSPHERE PER VIAL	"$6,000.00"
HC46501284	PLCMNT CENTRAL VEN CATH<5 YR	"$5,988.00"
HC44900207	CT HEAD W&W/O CONTRAST	"$5,987.00"
HC44900470	CT PELVIS W/ CONTRAST	"$5,986.00"
HC62221692	KIT SPINAL ACCESS DISPOSBL        M	"$5,980.00"
HC21000385	I&D HEMATOMA OR FLUID COLL	"$5,976.00"
HC74200130	OR TIME INIT'L HR CASE CX LEVEL 2 (MCAL 1ST HOUR)	"$5,976.00"
54288-105-15	ETHYL ALCOHOL 99 % INTRAARTER SOLN	"$5,970.00"
54288-105-02	ETHYL ALCOHOL 99 % INTRAARTER SOLN	"$5,970.00"
HC44900405	CT NECK SOFT TISSUE W&W/O CONT	"$5,968.00"
HC45401205	MRA LOW EXT W/O CONT RT	"$5,968.00"
HC44900017	CT ABDOMEN W/ CONTRAST	"$5,961.00"
HC27001536	ESOPHSCPY W/LES(S) REMOV HOT BX ~FO	"$5,953.00"
HC45401213	MRA LOW EXT W/O CONT  LT	"$5,949.00"
HC44703387	PLACMNT EXTNSN PROTH ILIAC ART/PROX RENAL EV PER VESSEL TX+	"$5,939.00"
58468-0070-1	LARONIDASE 2.9 MG/5 ML IV SOLN	"$5,938.74"
HC44504462	IVUS VESSEL INIT'L NONCORON W/EXAM+	"$5,933.00"
67457-210-05	CIDOFOVIR 75 MG/ML IV SOLN	"$5,932.32"
HC44501468	PORTOGRAM W/ HEMODYNAMIC EVAL	"$5,919.00"
67457-211-02	FOMEPIZOLE 1 GRAM/ML IV SOLN	"$5,916.00"
0024-5150-10	RASBURICASE 1.5 MG IV SOLR	"$5,914.88"
0024-5150-11	RASBURICASE 1.5 MG IV SOLR	"$5,914.88"
HC45400702	MRA HEAD W/O CONTRAST	"$5,913.00"
HC45400736	MRA NECK W/O CONTRAST	"$5,913.00"
HC46001053	SEL CATH AB/PEL/LOEXT1ST OR	"$5,900.00"
HC27000603	ENTEROSCOPY W/ABLATION	"$5,887.00"
HC27000629	ENTEROSCOPY W/BLEED CONTROL	"$5,885.00"
HC45400678	MRA CHEST W/O CONTRAST	"$5,877.00"
HC44502284	VENOGRAM RENAL LT	"$5,865.00"
HC44502292	VENOGRAM RENAL RT	"$5,865.00"
HC25004508	CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP BIL	"$5,855.00"
HC44502185	VENOGRAM ADRENAL LT	"$5,854.00"
HC44502193	VENOGRAM ADRENAL RT	"$5,854.00"
HC44900074	CT CHEST DX HI RESOLUTION W/ CNTRST	"$5,850.00"
HC62807037	CATH ATHERECTOMY ROTATIONAL      AE	"$5,850.00"
HC62214804	CATH PTCA BALLOON NON-LASER       Y	"$5,850.00"
HC62802566	CATH EP DIAG/MAPPING<20 ELECT     R	"$5,850.00"
HC62805726	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AE	"$5,850.00"
HC62224761	CATH THROMBECTOMY                AC	"$5,850.00"
HC62807896	M: STEM ELBOW	"$5,850.00"
HC62803846	STENT DES CORO COV W/DEL SYS      O	"$5,850.00"
HC62806971	STENT BILIARY COVRD W/DELSYS      K	"$5,850.00"
HC62807300	STENT TRACHEOBRONC COV W/DEL SYS  C	"$5,850.00"
HC62802152	STENT CORO BARE METAL W/DEL       J	"$5,850.00"
HC62802046	STENT NON-COAT/NON-COV W-DEL     AD	"$5,850.00"
HC62802921	COIL NEUROVASC(TARGET 360 SOFT/ULTRA)AK	"$5,850.00"
HC62807284	CATH PTA W/BALLOON RX(DCB)        H	"$5,850.00"
HC62211198	STABILIZER HEART OCTOPUS          O	"$5,850.00"
HC62219019	RETRACTOR MIS SPINAL              O	"$5,850.00"
HC62226782	GUIDE DRILL                       W	"$5,850.00"
HC62806617	COIL EMBOLIZATION(3D/SMART)      AK	"$5,850.00"
HC62807102	PROBE LITHOTRIPTOR ELECTRHYDRLC  AE	"$5,850.00"
HC46000717	SEL CATH AB/PEL/LOEXT1ST OR LT	"$5,846.00"
HC46000725	SEL CATH AB/PEL/LOEXT1ST OR RT	"$5,846.00"
HC27001601	ILEOSCOPY STOMA W/STENT(W/DILATE)	"$5,843.00"
HC44701472	INJ PRO CATH; SUPRAVALVULAR	"$5,836.00"
58468-0080-1	ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR	"$5,832.78"
HC44701456	INJ PRO CATH; LT VENT / ATRIUM	"$5,825.00"
HC62808787	CATH INDIGO THROMB 6FRXL135CM[PENUMBRA]	"$5,820.00"
0310-0720-10	FULVESTRANT 250 MG/5 ML IM SYRG	"$5,817.15"
25021-462-74	FULVESTRANT 250 MG/5 ML IM SYRG	"$5,817.15"
HC25003864	CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN-BIL	"$5,793.00"
HC46001301	"INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS BI"	"$5,784.00"
HC46501359	PUNCTURE CISTERN/LAT CERVICAL C1-C2 W/INJ	"$5,781.00"
HC36800878	BRONCHOSCOPY FIDUCIAL PLMT SGL/MULTI	"$5,772.00"
HC36001162	BRONCHOSCOPY FIDUCIAL PLMT SGL/MULTI	"$5,772.00"
HC44000560	DISKOGRAPHY-CERVICAL/THORACIC	"$5,772.00"
HC23001852	INJ W/CATH PLCMT EPI CERV/THOR W/IMAG	"$5,766.00"
HC62228150	ORTH WHFO DYNAMIC FLEX HINGE CABLE DRIVEN CUSTOM	"$5,759.00"
HC46501557	THORACENTESIS ASP W/ IMG GUID-LT	"$5,751.00"
HC46501565	THORACENTESIS ASP W/ IMG GUID-RT	"$5,751.00"
HC46000857	SEL CATH SEGMNT PULM ART BILAT	"$5,751.00"
HC27001833	EGD W/EUS ESOPH->DUOD/SURG ALT STOMCH JEJUN ~FO	"$5,730.00"
HC45400744	MRA PELVIS W/ CONTRAST	"$5,730.00"
HC27000868	ESOPHAG REFLUX W/NASAL ELEC>1H	"$5,725.00"
HC23001506	INJ  L/S F /IMAGE 3RD+& LVL BI	"$5,720.00"
HC44900447	CT ORBIT/SELLA/EAR W/ CONTRAST	"$5,713.00"
99988-000-44	NM IN-111 LABELED AUTOLOGOUS WBC PER STUDY	"$5,687.50"
HC27001544	ESOPHSCPY W/OPTICAL ENDOMICRO ~FO	"$5,678.00"
0069-0809-01	INFLIXIMAB-DYYB 100 MG IV SOLR	"$5,677.68"
0003-0371-13	BELATACEPT 250 MG IV SOLR	"$5,677.32"
66794-157-02	"BACLOFEN 40,000 MCG/20ML (2,000 MCG/ML) INTRATHECAL SOLN"	"$5,670.84"
70257-563-20	"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLN"	"$5,670.84"
70257-563-01	"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLN"	"$5,670.84"
HC44900116	CT CHEST DX W/ CONTRAST	"$5,670.00"
HC44701464	INJ PRO CATH; RT VENT / ATRIUM	"$5,668.00"
HC46502852	NEUROENDOSCOPY PLACE CATH/DRAIN INTRACRANIAL	"$5,665.00"
HC46502563	BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S)	"$5,663.00"
HC46502589	BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) LT	"$5,663.00"
HC46502571	BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) RT	"$5,663.00"
HC82204496	BONE MARROW DX; BX(S) & ASP(S) LT	"$5,663.00"
HC82204488	BONE MARROW DX; BX(S) & ASP(S) RT	"$5,663.00"
HC47200159	HYPERTHERMIA PROBE 1-5 APPS	"$5,651.00"
HC23001993	ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE	"$5,649.00"
HC23002017	ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE LT	"$5,649.00"
HC23002025	ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE RT	"$5,649.00"
HC47200415	PLCMNT INTERSTIT DEV PROSTATE	"$5,639.00"
50242-051-21	RITUXIMAB 10 MG/ML IV CONC	"$5,637.12"
HC21000724	DBRD SKN MUSL/BON EA ADD20CM/<	"$5,635.00"
HC46500401	BX DEEP PELV/HIP-SC LT	"$5,630.00"
HC46500419	BX DEEP PELV/HIP-SC RT	"$5,630.00"
HC25003625	REMOVE FB UPPER ARM/ELBOW DEEP-BIL	"$5,623.00"
59365-5128-1	COPPER 380 SQUARE MM INTRAUTERINE IUD	"$5,622.00"
HC62803291	SYSTEM PORT EVACUATING SUBDURAL	"$5,613.00"
HC73000184	DIALYSIS URGENT/NON-ROUTINE ESRD (OP)	"$5,598.00"
HC23000318	EPIDUROLYSIS PROCEDURE	"$5,596.00"
HC46501425	REPLACE PERC DU/J TUBE W/FLUORO	"$5,579.00"
HC25004474	CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP BIL	"$5,569.00"
HC46501433	REPLACE PERC G-J TUBE W/FLUORO	"$5,569.00"
0026-3783-35	KOGENATE FS 500 (+/-) UNIT IV SOLR	"$5,550.00"
HC27001817	EGD W/EUS FNA/BX ESOPH/STOMCH/DUOD~FO	"$5,548.00"
HC21000245	DEBRID/REMVL OPEN FX &BONE	"$5,544.00"
HC23001381	INJ CER/THOR F/IMAGE 2ND LVLBI	"$5,544.00"
HC36800506	BRONCHOSCOPY W/FB REMOVAL	"$5,542.00"
HC36000859	BRONCHOSCOPY W/FB REMOVAL	"$5,541.00"
HC44900215	CT HEAD W/CONTRAST	"$5,537.00"
HC91200135	R&B NEWBORN CARE-BOARDER	"$5,537.00"
HC36800068	BRONCH W/LUNG BX; SINGLE LOBE	"$5,533.00"
HC36000925	BRONCH W/LUNG BX;SINGLE LOBE	"$5,533.00"
HC62805718	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AD	"$5,525.00"
HC62806229	CATH THROMBECTOMY/REPERFUS(3MAX) AD	"$5,525.00"
HC62803820	STENT DES CORO COV W/DEL SYS      N	"$5,525.00"
HC62803697	CATH ABLATION THERMO HALO        AD	"$5,525.00"
HC62220124	KIT MONITORING NERVE(S) SPINAL    M	"$5,525.00"
HC62806609	COIL EMBOLIZ(PRIME/NYLON HELIX)  AJ	"$5,525.00"
HC44500312	ANGIO PULMONARY NON SELECT LT	"$5,524.00"
HC44500320	ANGIO PULMONARY NON SELECT RT	"$5,524.00"
HC91000331	R&B STANDARD	"$5,513.00"
HC91200131	R&B STANDARD-WOMEN	"$5,513.00"
HC23001860	INJ W/CATH PLCMT EPI LUMBAR W/IMAG	"$5,511.00"
HC41000001	SLEEP STUDY - MSLT/MWT	"$5,510.00"
HC27001585	ESOPHSCPY W/INJ SUBMUCOSAL ~FO	"$5,502.00"
HC45401288	MRA ABDOMEN W/O CONT	"$5,502.00"
HC27000033	ANOSCOPY W/ABLATION	"$5,489.00"
HC45201225	MIBI PLANAR SNG STUDY W/WM &EF	"$5,483.00"
HC27000595	ENTEROSCOPY W/ PERC JEJUN TUBE	"$5,482.00"
HC23001282	DESTR L/S FAC JOINT ADDL W/IMG-L	"$5,480.00"
HC23001290	DESTR L/S FAC JOINT ADDL W/IMG-R	"$5,480.00"
HC27000678	ENTEROSCOPY(ILEUM) W/BLEED CON	"$5,476.00"
HC36800035	BRONCH DIAG W/LAVAGE	"$5,467.00"
HC36000883	BRONCH DIAG W/LAVAGE	"$5,467.00"
HC25004094	CLOSED TX THUMB FX DISLOC W/MAN(BENNETT)BIL	"$5,460.00"
HC62805684	CATH EP DX 20+ ELECTRODES         L	"$5,460.00"
HC45401031	MR BREAST W/O CONTRAST LT	"$5,459.00"
HC45401023	MR BREAST W/O CONTRAST RT	"$5,459.00"
HC44504421	"DILATE DUCT(S)BIL /AMPULLA PERC(IMG,S&I);EA+"	"$5,446.00"
HC44703403	PLACMNT DELAY DISTL/PRX EXTSN INFRARENL AA ILIAC:ADD'L VSSL+	"$5,439.00"
HC25003807	CLOSED TX RAD&ULN SHAFT FX W/MAN-BIL	"$5,438.00"
HC44502359	VENOUS SAMPLING THRU CATH	"$5,437.00"
HC36800019	BRONCH W/BRONCHIAL/ENDO BX(S)	"$5,434.00"
HC36000917	BRONCH W/BRONCHIAL/ENDO BX(S)	"$5,434.00"
HC44900488	CT PELVIS W/O CONTRAST	"$5,434.00"
HC45401437	MRA UPPER EXT W/O&W/CONT LT	"$5,429.00"
HC45401403	MRA UPPER EXT W/O&W/CONT RT	"$5,429.00"
HC46501441	REPLACE PERC GT/CEC TUBE W/FLUORO	"$5,427.00"
HC36800027	BRONCH DIAG W/BRUSHING	"$5,422.00"
HC36000867	BRONCH DIAG W/BRUSHING	"$5,422.00"
HC46000964	SEL VENOUS CATH 1ST ORD BI	"$5,421.00"
HC27001403	EGD W/ABLAT TUMR/POLYP/LESN(DIL&GIDEWR)~FO	"$5,421.00"
HC21001003	APPY SKIN SUB HED/HND/FT 1ST100SQ~LC	"$5,419.00"
HC23000292	DESTRUCT CELIAC PLEXUS	"$5,415.00"
HC42000125	ECHO 2D CMPLT W/SPEC&CLR DOPLR	"$5,411.00"
HC44700250	INDUCTION OF ARRHYTHMIA	"$5,408.00"
HC23000995	INJ STELLATE GANGLION	"$5,406.00"
HC27000819	ESOPH DILATION UNGUIDED	"$5,401.00"
HC23001845	INJ SINGLE LUMBAR/SACRAL W/IMAG	"$5,401.00"
HC25003898	CLOSED TX CARPAL SCAPHOID FX W/MAN-BIL	"$5,393.00"
HC83000638	GRANULOCYT PHERESIS EA UNIT-OS	"$5,380.00"
HC45401189	MRA LOW EXT W/CONT LT	"$5,373.00"
HC45401171	MRA LOW EXT W/CONT RT	"$5,373.00"
HC42000745	TEE COMPLETE W/WO CONTRAST	"$5,370.00"
0944-3052-02	ADVATE 500 (+/-) UNIT IV SOLR	"$5,370.00"
0944-3052-03	ADVATE 500 (+/-) UNIT IV SOLR	"$5,370.00"
HC27000611	ENTEROSCOPY W/BIOPSY	"$5,368.00"
HC44900363	CT MAXILLO FACIAL W&W/O CONT	"$5,368.00"
HC27001387	ESOPHSCPY W/DILAT ESOPH RETROGR ~FO	"$5,367.00"
HC46501342	PUNCTURE CISTERN/LAT CERVICAL C1-C2 W/O INJ	"$5,364.00"
HC44000578	DISKOGRAPHY-LUMBAR	"$5,351.00"
58468-0160-1	ALGLUCOSIDASE ALFA 50 MG IV SOLR	"$5,350.50"
66220-160-10	CONIVAPTAN IN 5 % DEXTROSE 20 MG/100 ML IV SOLN	"$5,347.80"
HC42000778	ECHO 2D RX STRESS;CONT EKG W/WO CONTR	"$5,343.00"
HC44502300	VENOGRAM SINUS/JUGULAR	"$5,342.00"
HC25003948	CLOSED TX CARPAL BONE FX W/M EA BONE-BIL	"$5,331.00"
HC45400769	MRA PELVIS W/O CONTRAST	"$5,331.00"
HC44900579	CT UPPER EXT W/CONTRAST LT	"$5,327.00"
HC44900587	CT UPPER EXT W/CONTRAST RT	"$5,327.00"
HC44700557	INTRAVASC DOPPLER INIT VESSEL+	"$5,324.00"
HC44501872	SPLENOPORTOGRAM	"$5,320.00"
HC44900082	CT CHEST DX HI RESOLUTION W/O CNTRST	"$5,316.00"
HC42000158	ECHO 2D DOP SPEC&CLR W/CON	"$5,312.00"
HC46001251	INJ CHOLANGIO PERC/S&I;EXIST ACCESS	"$5,300.00"
HC45200995	NM TUMOR LOCALIZE SPECT SNGL AREA 1 DAY	"$5,297.00"
54643-5647-0	"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN"	"$5,288.70"
HC46500567	BX SFT TISS PELV/HIP-LT	"$5,288.00"
HC46500575	BX SFT TISS PELV/HIP-RT	"$5,288.00"
HC44502227	VENOGRAM EPIDURAL	"$5,286.00"
HC44700177	ENDOMYOCARDIAL BIOPSY	"$5,285.00"
HC46500211	BX BONE TROC/NEEDLE; SUPERFICIAL	"$5,282.00"
HC27000108	ANOSCOPY W/SNARE MULTI REMVL	"$5,282.00"
HC62802780	BEAD DC MICROSPHERE PER VIAL	"$5,282.00"
HC27000587	ENTEROSCOPY TO ILEUM W/BIOPSY	"$5,281.00"
5985700310	HUMAN REGENERATIVE TISSUE MTRX 1.5 X 2 CM TOPICAL SHEE	"$5,280.00"
HC27000579	ENTEROSCOPY TO ILEUM	"$5,279.00"
HC46000881	SEL CATH THOR/BRAC 1ST ORD LT	"$5,267.00"
HC46000899	SEL CATH THOR/BRAC 1ST ORD RT	"$5,267.00"
HC47200084	BRACHYTX INSERT HEYMAN CAPSULE	"$5,260.00"
HC23001092	INJ/INF NEUROLYTIC CERV/THOR	"$5,258.00"
HC44900272	CT LOW EXT W/CONTRAST LT	"$5,254.00"
HC44900280	CT LOW EXT W/CONTRAST RT	"$5,254.00"
HC46500294	BIOPSY NEEDLE PANCREAS	"$5,251.00"
HC91800055	R&B PSYCHIATRIC	"$5,246.00"
HC27000561	ENTEROSCPY (NOT ILEUM)INCL COLLECTN	"$5,245.00"
HC23000516	INJ CELIAC PLEXUS	"$5,239.00"
HC27001445	EGD W/EUS ESOPH/STOMCH/DUOD ~FO	"$5,237.00"
HC46500286	BIOPSY NEEDLE ABD/RETROMASS	"$5,231.00"
HC25003740	CLOSED TX RADIAL SHAFT FX W/MANIP-BIL	"$5,220.00"
HC27001593	ILEOSCOPY THRU STOMA DILATN BALLOON	"$5,220.00"
HC74200114	OR TIME ADD'L 15MIN LVL 6 (MCAL 1ST SUBSQNT 0.5 HR)	"$5,219.00"
HC74200478	OR TIME ADD'L 15MIN LVL 6  (MCAL 2ND SUBSQNT 0.5 HR)	"$5,219.00"
HC47201041	TELETX ISODOSE W/DOSIMETRY;COMPLEX	"$5,218.00"
HC26000034	DELIVERY OF PLACENTA	"$5,216.00"
0781-3154-01	FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN	"$5,214.85"
HC27001031	ILEOSCOPY THRU STOMA W/BIOPSY(S)	"$5,214.00"
HC44900124	CT CHEST DX W/O CONTRAST	"$5,205.00"
HC23000839	INJ ANES/STEROID INTERCOSTAL ADDL EA	"$5,200.00"
HC44900025	CT ABDOMEN W/O CONTRAST	"$5,200.00"
HC62214796	CATH PTA ANGIOPLS BALLOON NON-LSR Y	"$5,200.00"
HC62805114	CATH PTCA BALLOON NON-LASER       X	"$5,200.00"
HC62800305	CATH EP DX <20 ELECTRODES         Y	"$5,200.00"
HC62803812	STENT DES CORO COV W/DEL SYS      M	"$5,200.00"
HC62803929	STENT CORO BARE METAL W/DEL       I	"$5,200.00"
HC62807458	STENT NON-COAT/NON-COV W-DEL     AC	"$5,200.00"
HC62805635	DEVICE ABLAT COOL-TIP NONVASC     I	"$5,200.00"
HC62211461	CATH GUID NEURO/PERIPH(DI058X115/NAVIEN)W	"$5,200.00"
HC62806260	CATH PTA W/BALLOON RX(DCB)        F	"$5,200.00"
HC62805577	CATH EP/ABLATION COOL-TIP         I	"$5,200.00"
HC62228077	MOLD/FORM CEMENT SPACER FEMORAL	"$5,200.00"
HC62806591	COIL EMBOLIZ(HELIX BARE SUPER SFT)AI	"$5,200.00"
HC62807045	COIL NEUROVASCULAR(TARGET SOFT)  AC	"$5,200.00"
HC46502092	PARACENTESIS ABD W/IMAGING GUIDE	"$5,198.00"
HC91600029	R&B REHABILITATION	"$5,198.00"
HC27000488	EGD W/PEG PLACEMENT ~FO	"$5,187.00"
HC44502235	VENOGRAM EXTREMITY BILAT	"$5,185.00"
HC46500385	BLOOD PATCH (INJ EPIDURAL)	"$5,180.00"
HC82204512	BONE MARROW DX; ASP(S) ONLY BILAT	"$5,163.00"
HC36800043	BRONCHOSCOPY DIAGNOSTIC	"$5,161.00"
HC91000066	R&B DETOXIFICATION	"$5,160.00"
HC27001502	ESOPHSCPY W/BAND VARICES ~FO	"$5,155.00"
15054-0500-1	ABOBOTULINUMTOXINA 500 UNIT IM SOLR	"$5,154.00"
HC36000826	BRONCH DIAGNOSTIC	"$5,152.00"
HC27000637	ENTEROSCOPY W/CONVRT PEG>JEJUN	"$5,149.00"
HC44502268	VENOGRAM HEPATIC W/O HEMO EVAL	"$5,149.00"
63833-615-02	HUMATE-P 250-600 UNIT IV SOLR	"$5,148.00"
HC47200902	PLCMNT INTERSTIT DEV THORACIC	"$5,146.00"
HC44900223	CT HEAD W/O CONTRAST	"$5,146.00"
HC42000786	ECHO 2D RX STRESS; CONT EKG	"$5,144.00"
HC27001825	EGD W/EUS FNA/BX ESOPH->DUOD/SURG ALT STOMCH JEJUN~FO	"$5,143.00"
HC44900413	CT NECK SOFT TISSUE W/ CONT	"$5,138.00"
HC44700235	ESOPHAGEAL RECORDING W/PACING	"$5,128.00"
HC27001742	COLONOSCOPY FLEX W/PLACE STENT	"$5,126.00"
HC23000979	INJ DX/THER CERVICAL/THORACIC W/O IMAG	"$5,126.00"
HC44900454	CT ORBIT/SELLA/EAR W/O CONTRAS	"$5,126.00"
HC23001076	INJ W/CATH PLCMT EPI LUMBAR W/O IMAG	"$5,123.00"
HC27000421	EGD W/CONTOL BLEED ~FO	"$5,121.00"
HC42000505	TEE COMPLETE	"$5,101.00"
HC46000824	SEL CATH PULMONARY ART BILAT	"$5,095.00"
HC27001783	"M: UNLISTED PROCEDURE, COLON"	"$5,083.00"
HC41500521	CENTRAL MOTOR EVOK UP& LWR LIMBS	"$5,075.00"
63459-103-10	RITUXIMAB-ABBS 10 MG/ML IV SOLN	"$5,073.30"
0023-5858-01	LEVONORGESTREL 20.1 MCG/24 HRS (6 YRS) 52 MG INTRAUTERINE IUD	"$5,070.60"
HC46502282	PERC DRAIN CATH W/IMAG; SOFT TISSUE	"$5,066.00"
59762-0935-3	VORICONAZOLE 200 MG/5 ML ORAL SUSR (MCH)	"$5,065.65"
HC27000405	EGD W/BANDING  ESOPH/GASTRIC ~FO	"$5,049.00"
HC46001285	"INJ ANTEGRAD COMP(NEPH/URET'GRM,S&I)NEW ACCESS LT"	"$5,049.00"
HC46001293	"INJ ANTEGRAD COMP(NEPH/URET'GRM,S&I)NEW ACCESS RT"	"$5,049.00"
HC42000059	CARDIOVERSION EXTERNAL	"$5,044.00"
HC27000447	EGD W/DILATION GASTRIC OUTLET ~FO	"$5,042.00"
HC45200987	NM TUMOR LOCALIZE PLNR WHOLE BODY 1 DAY	"$5,040.00"
HC46502035	BX SOFT TISS THIGH/KNEE;SUP BI	"$5,037.00"
HC26000018	AMNIOCENTESIS FLUID REDUCTION	"$5,037.00"
HC46500252	BIOPSY MUSCLE PERC NEEDLE	"$5,035.00"
HC25001165	PLCMNT CENTRAL VEN CATH>5 YR	"$5,031.00"
HC47200977	TREATMENT DEVICES MLC FOR IMRT	"$5,018.00"
HC25003716	REMOVE FB FOREARM DEEP-BIL	"$5,017.00"
HC25002759	INSERT PICC >5 YR AGE W/ IMAGING	"$5,007.00"
HC44504439	"BX(S) BILTREE PERC SNGL/MULTI(IMG,S&I)+"	"$5,006.00"
HC27000645	ENTEROSCOPY W/FRN BDY(S) REMOVAL	"$5,005.00"
HC27000553	ENDO SM INTEST POUCH (KOCK) W/BX(S)	"$5,003.00"
10122-620-01	CANGRELOR 50 MG IV SOLR	"$5,001.82"
10122-620-10	CANGRELOR 50 MG IV SOLR	"$5,001.82"
HC44504405	"REMOVE CATH DRN BIL PERC(CHOLANG,S&I)"	"$5,001.00"
59572-405-00	LENALIDOMIDE 5 MG ORAL CAP	"$4,999.35"
HC44701019	REMOVE CARDIAC RHYTHM MONITOR SQ	"$4,997.00"
HC27001460	ESOPHSCPY W/BALLN DIL=30MM (W-FLUOR) ~FO	"$4,992.00"
HC27000397	EGD W/BALLOON DILATION <30MM  ~FO	"$4,985.00"
HC27001288	ENDO PANCREATOSCOPY DUCT(S) +	"$4,985.00"
HC41000019	SLEEP STUDY ATTENDED	"$4,985.00"
HC46502225	PERC PLC BRST LOC DEV SG 1ST LESN	"$4,982.00"
HC27000454	EGD W/FOREIGN BODY(S) REMOVAL ~FO	"$4,977.00"
HC46501771	ASP/INJ RENAL CYST/PELVIS	"$4,976.00"
HC46500096	ASP/INJ RENAL CYST/PELVIS LT	"$4,976.00"
HC46500104	ASP/INJ RENAL CYST/PELVIS RT	"$4,976.00"
HC45401411	MRA UPPER EXT W/CONT LT	"$4,968.00"
HC45401387	MRA UPPER EXT W/CONT RT	"$4,968.00"
HC44703494	PERICARDIAL DRAIN 0-5YR W/ANOMOLY INCL FLUORO &/US	"$4,966.00"
HC74200353	BEDSIDE/OTHER SURGICAL CANCEL LVL 6	"$4,959.00"
HC62806195	FILTER VENA CAVA (E.G.CELECT)     I	"$4,957.00"
HC23001126	REMOVE EPIDURAL/INTRATH CATH	"$4,951.00"
HC27001023	ILEOSCOPY THRU STOMA INCL COLLECTN	"$4,950.00"
HC23000268	DESTRUCT OTHER PERIPH SNGL LT	"$4,950.00"
HC23000276	DESTRUCT OTHER PERIPH SNGL RT	"$4,950.00"
HC27001809	ESOPHSCPY W/EUS FNA/BX ~FO	"$4,944.00"
HC62806484	CATH BRACHY TX SEED ADMIN         C	"$4,940.00"
HC62800321	CATH EP DX 20+ ELECTRODES         J	"$4,940.00"
HC27001551	ESOPHSCPY W/DIL OVER GUIDEWIRE ~FO	"$4,934.00"
11704-370-01	HYDROXOCOBALAMIN 5 GRAM IV SOLR	"$4,927.92"
HC74200189	BEDSIDE/OTHER SURG INITIAL HR 1 (MCAL 1ST HOUR)	"$4,919.00"
HC62802137	STENT PV BARE METAL W/O DEL SYS	"$4,908.00"
HC44900603	CT UPPER EXT W/O CONTRAST LT	"$4,906.00"
HC44900611	CT UPPER EXT W/O CONTRAST RT	"$4,906.00"
HC21000799	"APPY SKIN SUB T,A,L 1ST 100SQ~HC"	"$4,903.00"
HC44900371	CT MAXILLO FACIAL W/ CONTRAST	"$4,902.00"
HC27001080	SIGMOIDOSCOPY FLEX BLEED CONT	"$4,901.00"
50474-001-48	LEVETIRACETAM 100 MG/ML ORAL SOLN	"$4,884.20"
HC45401544	MRI FETAL INCL PLACENTA PLVC IF PRF; SINGLE 1ST GESTATION	"$4,875.00"
HC62214788	CATH PTCA BALLOON NON-LASER       W	"$4,875.00"
HC62806351	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AA	"$4,875.00"
HC62803937	STENT DES CORO COV W/DEL SYS      L	"$4,875.00"
HC62807151	STENT NON-COAT/NON-COV W-DEL     AB	"$4,875.00"
HC62219332	EMBOLIZATN PROTECT SYSTEM(EZ)     L	"$4,875.00"
HC62805627	DEVICE ABLAT COOL-TIP NONVASC     H	"$4,875.00"
HC62805692	CATH GUIDING NEURO(DI058X125)    V	"$4,875.00"
HC62229018	INTRODUCER/SHEATH                  AF	"$4,875.00"
HC62806682	STENT URETERAL ENDOPYELOTOMY     AB	"$4,875.00"
HC62806252	CATH PTA W/BALLOON RX(DCB)        E	"$4,875.00"
HC62216262	STABILIZER HEART OCTOPUS          L	"$4,875.00"
HC62219423	KIT MONITORING NERVE(S) SPINAL    K	"$4,875.00"
HC62226238	DRILL/DRILL BITS SINGLE USE      AR	"$4,875.00"
HC62806583	COIL EMBOLIZ(AXIUM HELIX BARE)   AH	"$4,875.00"
HC23000987	INJ DX/THER LUMBAR/SACRAL W/O IMAG	"$4,872.00"
HC27000660	ENTEROSCOPY W/REMOV BY SNARE	"$4,866.00"
HC45201290	HEPATOBIL SYS IMAGW/RX(&QUANT)	"$4,863.00"
HC23001241	DESTR C/T FAC JOINT +LVL W/IMG-L	"$4,862.00"
HC23001258	DESTR C/T FAC JOINT +LVL W/IMG-R	"$4,862.00"
HC44700615	IVUS/OCT CORONARY VES/GRFT EA ADL+	"$4,859.00"
HC46502274	PERC PLC BRST LOC DEV MR ADDL LESN+	"$4,857.00"
HC27001718	SIGMOIDOSCOPY FLEX  W/RESECT MUCOSL	"$4,856.00"
HC44504470	IVUS VESSEL ADD'L NONCORON W/EXAM++	"$4,843.00"
HC46500468	BX LYMPH NODE(S)-SUPERFCL-LT	"$4,840.00"
HC46500476	BX LYMPH NODE(S)-SUPERFCL-RT	"$4,840.00"
HC46501813	BX LYMPH NODE(S)SUPERFICIAL*DS	"$4,840.00"
HC46501748	BX LYMPH NODE(S)SUPERFICIAL-SC	"$4,840.00"
HC23000300	DESTRUCT INTERCOSTAL NERVE	"$4,840.00"
HC23001068	INJ W/CATH PLCMT EPI CERV/THOR W/O IMAG	"$4,839.00"
HC26000026	BREECH VERSION EXTERNAL MANIP	"$4,832.00"
HC27000439	EGD W/DIL OVER GUIDEWIRE ~FO	"$4,820.00"
HC27001734	COLONOSCOPY FLEX ABLAT TUMR/POLYP/LESN GUIDEWIRE	"$4,813.00"
HC44900942	CT HEART CONGEN EVAL /3D IMAGE	"$4,813.00"
58406-010-01	ETANERCEPT 25 MG/0.5 ML (0.5) SUBCUTANEOUS SYRG	"$4,807.38"
58406-055-01	ETANERCEPT 25 MG/0.5 ML SUBCUTANEOUS SOLN	"$4,807.38"
58406-425-41	ETANERCEPT 25 MG (1 ML) SUBCUTANEOUS SOLR	"$4,807.38"
58406-010-04	ETANERCEPT 25 MG/0.5 ML (0.5) SUBCUTANEOUS SYRG	"$4,807.35"
58406-055-04	ETANERCEPT 25 MG/0.5 ML SUBCUTANEOUS SOLN	"$4,807.35"
58406-425-34	ETANERCEPT 25 MG (1 ML) SUBCUTANEOUS SOLR	"$4,807.35"
HC27000496	EGD W/SCLEROTHERAPY ~FO	"$4,802.00"
HC27001379	EGD W/RESECT SUBMUCOSAL ~FO	"$4,802.00"
0591-2579-20	VALGANCICLOVIR 50 MG/ML ORAL SOLR	"$4,801.63"
27241-159-19	VALGANCICLOVIR 50 MG/ML ORAL SOLR	"$4,801.63"
13533-636-50	HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN	"$4,801.38"
13533-636-05	HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN	"$4,801.38"
HC42000513	TEE CONGENITAL COMPLETE	"$4,801.00"
HC36000123	CPAP/BIPAP DAILY MGMT	"$4,801.00"
HC44900306	CT LOW EXT W/O CONTRAST LT	"$4,800.00"
HC44900314	CT LOW EXT W/O CONTRAST RT	"$4,800.00"
HC25001157	PLCMNT CENTRAL VEN CATH<5 YR	"$4,784.00"
HC41500877	EEG W/VIDEO MONITOR INTERMT EA 12-26HR	"$4,784.00"
44206-436-05	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$4,782.00"
44206-436-90	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	"$4,782.00"
50242-060-01	BEVACIZUMAB 25 MG/ML CHEMO INTRAVITREAL SOLN	"$4,781.64"
HC25003591	REMOVE FB UPPER ARM/ELBOW SQ-BIL	"$4,777.00"
HC46502209	PERC PLC BRST LOC DEV MAMMO 1ST LESN	"$4,776.00"
HC46502845	PUNCTURE SPINAL TX CSF WITH FLUORO/CT[NOT W/MRI OR US]	"$4,774.00"
HC27000298	COLONOSCOPY W/DILATION/BALLOON	"$4,770.00"
58394-013-01	XYNTHA 500 (+/-) UNIT IV SOLN	"$4,770.00"
HC27001569	ESOPHSCPY W/BALLOON DILATION <30MM ~FO	"$4,763.00"
HC27001494	ESOPHSCPY W/TUMR/LES REMOV W/SNARE  ~FO	"$4,760.00"
0002-7640-01	PEMETREXED DISODIUM 100 MG IV SOLR	"$4,756.50"
HC25005703	AMPUTATE FINGER/THUMB SGL W/CLOSURE	"$4,756.00"
50222-260-06	CALCIPOTRIENE 0.005 % TOPICAL CREAM	"$4,750.56"
HC44501476	PORTOGRAM W/O HEMODYNAMIC EVAL	"$4,745.00"
HC27001841	SIGMOIDOSCOPY FLEX W/EUS&FNA/BX	"$4,744.00"
HC44900165	CT GUIDE NEEDLE PLACEMENT	"$4,729.00"
HC91500125	R&B HOSPICE	"$4,725.00"
HC23000938	INJ PARAVERT SYMPATH NERVE	"$4,722.00"
HC27000082	ANOSCOPY W/HOT BIOPSY	"$4,721.00"
HC27001882	CHEMODENERVATION ANAL MUSCLE	"$4,718.00"
HC47201009	DELIV TX ELCTRN INTRAOP SNGL SESS	"$4,713.00"
HC27000892	ESOPH GASTROESOPH REFLUX PH STDY-LONG	"$4,706.00"
70720-950-36	GOSERELIN 3.6 MG SUBCUTANEOUS IMPL	"$4,701.66"
HC62290432	WOUND FILLER DRY COLLAGEN (VENTRIS MED)          AF	"$4,700.00"
HC45200037	NM ADRENAL IMAGING	"$4,699.00"
HC27000470	EGD W/INJ SUBMUCOSAL ~FO	"$4,694.00"
HC44700227	ESOPHAG REC ATRIAL ELECTROGRAM	"$4,692.00"
HC44900421	CT NECK SOFT TISSUE W/O CONT	"$4,689.00"
HC44500882	INJ ART OCCLUS AVM SPINAL	"$4,687.00"
HC47200993	DELIV TX XRAY INTRAOP SNGL SESSION	"$4,681.00"
HC62227707	KIT CASS KNEE 2 POD IASSIST	"$4,680.00"
HC27001700	SIGMOIDOSCOPY FLEX  W/PLACE STENT	"$4,679.00"
HC27001429	EGD W/DIL BALLN =30MM (FLUORO) ~FO	"$4,678.00"
HC45400157	MR GUIDANCE ABLATION PARENCHYMAL TISSUE	"$4,668.00"
HC23001654	INJ ANES/STEROID INTERCOSTAL ADDL EA LT	"$4,662.00"
HC23001647	INJ ANES/STEROID INTERCOSTAL ADDL EA RT	"$4,662.00"
HC74200122	OR TIME INIT'L HR CASE CX LEVEL 1 (MCAL 1ST HOUR)	"$4,654.00"
HC44504223	XRAY TEVAR; PLCMT PROX EXT PROTH S&I	"$4,653.00"
HC44504231	XRAY TEVAR; PLCMT OF DISTAL EXTS PROTH(S) DELAYED S&I	"$4,653.00"
HC27001957	ESOPHAGUS BALLOON DISTENTION PROVOC STUDY	"$4,652.00"
43598-283-35	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$4,650.00"
43598-682-35	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$4,650.00"
HC44901106	CT BREAST 3D RENDER UNILAT W&W/O CONTRAST	"$4,648.00"
HC21000831	APPY SKIN SUB HED/HND/FT 1ST100SQ~HC	"$4,648.00"
HC27001486	ESOPHSCPY W/CONTROL BLEED  ~FO	"$4,648.00"
HC27001510	ESOPHSCPY W/FRN BDY(S)REMOVAL ~FO	"$4,647.00"
HC25001116	INSERT PICC >5 YR AGE W/O IMAGING	"$4,637.00"
HC44900926	CT COLONOGRAPHY DX VIRTUAL W/ CONTRAST	"$4,637.00"
HC23000425	INJ ANES/STEROID NERVE SCIATIC BIL	"$4,635.00"
HC44901007	CT ABD & PELVIS W/O CONST LTD	"$4,619.00"
HC27001767	COLONOSCOPY FLEX W/DECOMP&PLACE TUBE	"$4,618.00"
HC44504454	"SCLEROTX FLUID (CYST) PERC(IMAG,S&I)"	"$4,617.00"
HC74200346	BEDSIDE/OTHER SURGICAL CANCEL LVL 5	"$4,617.00"
HC27001064	REPOSIT GASTRO FEED TUBE(PEG)	"$4,616.00"
HC47201066	BRACHYTX ISODOSE W/DOSIMETRY;INTRM	"$4,615.00"
HC62211073	CATHETER ENDOVENT PULMONARY	"$4,615.00"
44087-0044-3	INTERFERON BETA-1A (ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRG	"$4,614.35"
44087-0044-9	INTERFERON BETA-1A (ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRG	"$4,614.35"
HC42000810	TEE GUIDE TRANSCATH INTVNTN INCL US	"$4,614.00"
HC42000760	TEE MONITORING COMPLT W/WO CONTR	"$4,607.00"
HC27000652	ENTEROSCOPY W/HOT BIOPSY	"$4,599.00"
HC45400140	MR IMAG GUIDE NEEDLE PLACEMENT	"$4,595.00"
HC74200106	OR TIME ADD'L 15MIN LVL 5 (MCAL 1ST SUBSQNT 0.5 HR)	"$4,591.00"
HC74200460	OR TIME ADD'L 15MIN LVL 5  (MCAL 2ND SUBSQNT 0.5 HR)	"$4,591.00"
HC46502613	INSERT MIDLINE CATH >3 YR AGE	"$4,589.00"
HC27001874	SIGMOIDOSCOPY FLEX W/EUS	"$4,589.00"
HC27001627	COLONOSCOPY STOMA W/PLCMNT STENT	"$4,583.00"
HC27000280	COLONOSCOPY W/BLEED CONTROL	"$4,581.00"
HC23001639	INJ ANES/STEROID BRACHIAL PLEXUS BI	"$4,581.00"
HC45401429	MRA UPPER EXT W/O CONT LT	"$4,579.00"
HC45401395	MRA UPPER EXT W/O CONT RT	"$4,579.00"
55566-8403-1	DEGARELIX 120 MG SUBCUTANEOUS SOLR	"$4,572.54"
HC27000306	COLONOSCOPY W/FB(S) REMOVAL	"$4,572.00"
HC47200696	TREATMENT SIMULATION COMPLEX	"$4,559.00"
HC62804042	FILTER VENA CAVA                  H	"$4,558.00"
HC62214770	CATH PTCA BALLOON NON-LASER       V	"$4,550.00"
HC62806708	CATH EP DIAG/ABLAT 3D/VECT        N	"$4,550.00"
HC62227657	CATH INTRACARDIAC ECHO/UTZ RPRSD  F	"$4,550.00"
HC62228358	SET SHEATH DILATOR (TRUSEAL WATCHMAN)	"$4,550.00"
HC62226352	PROGRAMMER NEUROSTIM PAT          H	"$4,550.00"
HC62228721	SLEEP REMOTE(INSPIRE®)	"$4,550.00"
HC62803911	STENT CORO BARE METAL W/DEL       H	"$4,550.00"
HC62806526	STENT NON-COAT/NON-COV W-DEL     AA	"$4,550.00"
HC62225628	CATH TRANSLUM ANGIO LASER         K	"$4,550.00"
HC62806237	CATH PTA W/BALLOON RX(DCB)        D	"$4,550.00"
HC62210646	CATH BALLOON NEURO(SCEPTER)       B	"$4,550.00"
HC62800347	CATH EP/ABLATION COOL-TIP         G	"$4,550.00"
HC62219001	RETRACTOR MIS SPINAL              K	"$4,550.00"
HC62802913	COIL NEUROVASC(HELIX/ULTRA HELICAL)AA	"$4,550.00"
HC62806575	COIL EMBOLIZATION                AG	"$4,550.00"
HC46501235	PERITONEAL LAVAGE W-W/O IMAG GUIDE	"$4,549.00"
HC44503704	DEST SUPERIOR HYPOGASTR PLEXUS	"$4,547.00"
HC27001692	SIGMOIDSCPY FL W/ABLAT LESN(S)GUIDEWIRE	"$4,546.00"
HC42000240	ECHO 2D STRESS TRDMLW/EKG W/CON	"$4,544.00"
HC27001395	ESOPHSCPY W/RESECT MUCOSAL ~FO	"$4,543.00"
HC27001635	COLONOSCOPY STOMA W/RESECT MUCOSL	"$4,540.00"
HC27001759	COLONOSCOPY FLEX W/RESECTN MUCOSL	"$4,538.00"
HC45201258	PULM VENTILATION & PERF IMAG	"$4,538.00"
HC41500513	SOMATOSENSORY UPPER& LWR LIMBS	"$4,526.00"
HC25000043	ED LEVEL V - COMPREHENSIVE	"$4,526.00"
0527-5160-82	MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR	"$4,524.48"
HC46500864	EXCHANGE EXISTING DRAIN CATH	"$4,523.00"
HC27001726	SIGMOIDOSCOPY FLEX  W/LIGATION BAND	"$4,522.00"
HC25001074	INSERT CT(OPEN) W/DRAIN SYSTEM BIL	"$4,516.00"
HC27000272	COLONOSCOPY W/BIOPSY	"$4,508.00"
55111-556-10	DECITABINE 50 MG IV SOLR	"$4,500.00"
0143-9565-01	THIOTEPA 15 MG INJ SOLR	"$4,500.00"
0078-0110-22	CYCLOSPORINE 100 MG/ML ORAL SOLN (MCH)	"$4,499.10"
HC27001148	SIGMOIDSCPY FLEX W/DILAT 1+/>STRICT	"$4,479.00"
HC46501789	THORACENTESIS ASP W/O IMAG GUIDE	"$4,477.00"
HC44504702	ENDOVENOUS ABLAT MECHANOCHEM WS&I; ADDL VEIN+	"$4,476.00"
HC27001916	CHANGE GT TUBE W/REV TRACT W/O IMAGE/ENDO INCL REMVL	"$4,472.00"
HC44900181	CT GUIDANCE ABLATION PARENCHYMAL TISSUE	"$4,469.00"
HC47200225	INTRACAVITARY TREATMT COMPLEX	"$4,461.00"
HC27000884	ESOPH MOTILTY/MANO STDY/I&R;2D	"$4,458.00"
63459-390-08	BENDAMUSTINE 25 MG IV SOLR	"$4,457.70"
HC42000752	TEE CONGENITAL COMPLT W/WO CONTR	"$4,457.00"
HC44500460	AORTOGRAM ABDOMINAL LTD	"$4,456.00"
HC62204227	KIT ROTALINK	"$4,454.00"
HC45200094	NM BONE SCAN 3 PHASE	"$4,450.00"
HC62209101	CT ELECTRODE SPRSLIM 2.0 CM EA	"$4,449.00"
HC45201340	NM PARATHYRD SCN W/SPECT & CT	"$4,448.00"
23155-216-31	CIDOFOVIR 75 MG/ML IV SOLN	"$4,440.00"
HC27000215	COLONOSCOPY STOMA W/BLEED CONT	"$4,439.00"
HC46501508	REPLC PICC LINE W/O SQ PORT/PUMP &W/O IMAGING	"$4,432.00"
HC47201025	MOTION RESPIRATORY MGNT SIMULATION+	"$4,431.00"
HC27001866	COLONOSCOPY FLEX W/EUS	"$4,429.00"
HC51002681	REPAIR FISTULA ANAL W/PLUG	"$4,426.00"
HC46501524	REPOSITION CV CATH UNDER FLUORO	"$4,417.00"
0078-0683-61	NELARABINE 250 MG/50 ML IV SOLN	"$4,412.10"
HC27000173	COLONOSCOPY DX (INCL COLLECTION)	"$4,410.00"
HC27001007	HEMORRHOIDECTOMY/BANDING	"$4,409.00"
HC46501383	REMVL INTRALUMIN OBST VEN DEV	"$4,403.00"
HC27000462	EGD W/TUMR/LES REMOV HOT BX~FO	"$4,398.00"
HC51002665	REMOVE HEMORRHOID INT&EXT GROUPS 2+	"$4,397.00"
10019-956-01	CYCLOPHOSPHAMIDE 1 GRAM IV SOLR	"$4,395.00"
10019-956-16	CYCLOPHOSPHAMIDE 1 GRAM IV SOLR	"$4,395.00"
70860-218-05	CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN	"$4,395.00"
50742-520-05	CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN	"$4,395.00"
HC45200532	NM LYMPH GLAND/NODES IMAGING	"$4,391.00"
HC27001619	COLONOSCOPY STOMA W/ABLAT LESN GUIDEWIRE	"$4,389.00"
HC62212287	FORCEP BIOPSY URETEROSCOP DISP	"$4,388.00"
HC45200839	NM THYROID CA METS BODY SCAN	"$4,384.00"
HC43000827	INCISION BREAST LESION-LT	"$4,382.00"
HC43000819	INCISION BREAST LESION-RT	"$4,382.00"
HC45200433	NM KIDNEY FLW/FUNC MULTI STUDY	"$4,377.00"
HC46501185	MANOMETRIC STDY VIA NEPHRO BI	"$4,367.00"
HC45200219	NM CARDIAC BP IMAG GATED MULTI	"$4,367.00"
HC23001746	ASP/INJ JOINT SM W/UTZ GUIDE-BILAT	"$4,365.00"
HC62228622	KIT ROTAPRO	"$4,363.00"
HC46500716	CIRCUMCISION PROCEDURE	"$4,358.00"
HC47200142	HYPERTHERMIA EXTERNAL DEEP	"$4,358.00"
HC36000891	BRONCH THERAPEUTIC INIT (PER DOS)	"$4,357.00"
HC36800092	BRONCH THERAPEUTIC INIT (PER DOS)	"$4,356.00"
HC44703486	PERICARDIAL DRAIN 6+YR W/O ANOMOLY INCL FLUORO &/US	"$4,355.00"
16714-900-01	ATOVAQUONE 750 MG/5 ML ORAL SUSP	"$4,354.56"
HC27000330	COLONOSCOPY W/SNARE TECH	"$4,351.00"
58394-634-03	BENEFIX 500 UNIT IV SOLR	"$4,350.00"
HC25000597	EMERGENCY DELIVERY VAGINAL	"$4,348.00"
HC41500844	EEG W/VIDEO MONITOR INTERMT 2-12 HR	"$4,342.00"
HC44901098	CT BREAST 3D RENDER BILAT W/CONTRAST	"$4,337.00"
HC45201365	NM GASTRIC EMPTY SML BWL&COLON>1DAY	"$4,334.00"
HC27000355	EGD COMPLETE DX W/ BRUSH/SPEC ~FO	"$4,329.00"
HC44700029	CARDIOVERSION INTERNAL	"$4,326.00"
HC27000538	EGD W/TUMR/LES REMOV W/SNARE~FO	"$4,324.00"
HC44700797	PERICARDIOCENTESIS INCL IMAGING	"$4,320.00"
HC45201274	QUANT DIFF PULM PERF& VENT	"$4,320.00"
HC27001858	COLONOSCOPY FLEX W/EUS FNA/BX	"$4,318.00"
HC36800100	BRONCH THERAPEUTIC SUBSEQ (PER DOS)	"$4,316.00"
HC36000909	BRONCH THERAPEUTIC SUBSEQ (PER DOS)	"$4,316.00"
HC27000249	COLONOSCOPY STOMA W/SNARE TECH	"$4,308.00"
HC41500703	EEG PHARMACOLOGICAL/PHYSICAL ACTIVATION	"$4,302.00"
HC27000413	EGD W/BIOPSY(S) ~FO	"$4,300.00"
HC27001528	ESOPHSCPY W/INJ SCLERO VARICES ~FO	"$4,299.00"
HC42000232	ECHO 2D STRESS PHARMOCOLOGIC	"$4,294.00"
HC62216809	BALLOON VERTEBRAL	"$4,290.00"
66733-948-23	CETUXIMAB 100 MG/50 ML IV SOLN	"$4,285.20"
HC21000450	GRAFTING SNGL/MULT UP TO 2CM	"$4,282.00"
HC45200193	NM CARDIAC BP 1ST PASS(EF)MULT	"$4,282.00"
HC62210257	OXYGENATOR ECMO	"$4,281.00"
HC27000009	ANORECTAL MANOMETRY	"$4,280.00"
0781-4003-32	LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH)	"$4,276.80"
HC44502649	REPOSIT NASO/ORO GFT THRU DUOD	"$4,276.00"
HC74200338	BEDSIDE/OTHER SURGICAL CANCEL LVL 4	"$4,272.00"
52817-815-08	AMINOCAPROIC ACID 25 % ORAL SYRP (MCH)	"$4,268.84"
HC44900389	CT MAXILLO FACIAL W/O CONTRAST	"$4,268.00"
HC27001577	ESOPHSCPY W/BIOPSY(S) ~FO	"$4,266.00"
HC42000935	CTA CORO FFR ANLYSIS FLUID DYNAMICS&HYPEREMIA MAX SIM W/DATA MODEL	"$4,265.00"
HC62205083	OFF PUMP SUCTION SYS-STABILZER	"$4,265.00"
99988-000-30	NM TC-99M EXAMETAZIME LABELED WBC PER STUDY (CERETEC)	"$4,264.00"
HC45401130	MR BREASTS W/O&W CONTRST LTD (BILAT)	"$4,261.00"
HC42000521	TEE MONITORING COMPLETE	"$4,259.00"
69800-4203-1	"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN"	"$4,257.12"
69800-4203-2	"HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN"	"$4,257.12"
HC46502696	FNA ASP BX W/MR; FIRST LESION	"$4,245.00"
HC27000512	EGD W/TRANSENDO TUBE/CATH PLC ~FO	"$4,243.00"
HC27000322	COLONOSCOPY W/INJ SUBMUCOSAL	"$4,240.00"
HC46502241	PERC PLC BRST LOC DEV US 1ST LESN	"$4,239.00"
HC41500851	EEG W/VIDEO MONITOR CONT 2-12 HR	"$4,239.00"
HC46501409	REPAIR CV ACCESS CATH	"$4,236.00"
47335-936-40	LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH)	"$4,234.02"
HC27001155	SIGMOIDOSCOPY FLEX W/FB(S) REMOV	"$4,234.00"
HC47200894	STEREOTACTIC BODY RAD THER	"$4,229.00"
HC23001951	DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE	"$4,225.00"
HC23001977	DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE LT	"$4,225.00"
HC23001985	DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE RT	"$4,225.00"
HC62214762	CATH PTCA BALLOON NON-LASER       U	"$4,225.00"
HC62806914	STENT EXTENDER ENDOGRAFT AAA      J	"$4,225.00"
HC62219324	EMBOLIZATION PROTECTIVE SYSTEM    J	"$4,225.00"
HC62805619	DEVICE ABLAT COOL-TIP NONVASC     F	"$4,225.00"
HC62210638	CATH GUIDING REPERFUS(MARKSMAN)   T	"$4,225.00"
HC62208665	FIBER LASER - GREEN LIGHT         T	"$4,225.00"
HC62214465	CHARGER BATTERY NEUROSTIM         A	"$4,225.00"
HC62215744	BLADE SHAVER                     AH	"$4,225.00"
HC62218540	KIT MONITORING NERVE(S) SPINAL    J	"$4,225.00"
HC62228085	MOLD/FORM CEMENT STEM HIP	"$4,225.00"
HC62807219	COIL NEUROVASCULAR               AD	"$4,225.00"
HC23001175	INJ S-I JOINT ANESTH W/IMAG LT	"$4,223.00"
HC23001183	INJ S-I JOINT ANESTH W/IMAG RT	"$4,223.00"
HC42000083	ECHO CONGENITAL COMPLETE	"$4,219.00"
HC42000257	ECHO 2D STRESS TREADMILL	"$4,219.00"
HC46502837	LUMBAR PUNCTR DX WITH FLUORO/CT [NOT W/MRI OR US]	"$4,212.00"
HC46000014	INJ AIR/CONTRAST PERITONEAL CAVITY	"$4,207.00"
HC27001775	COLONOSCOPY FLEX  W/LIGATION BAND	"$4,206.00"
HC45200276	NM CISTERNOGRAM	"$4,206.00"
HC44200665	AMNIOCENTESIS	"$4,205.00"
HC27001171	SIGMOIDOSCOPY FLEX W/SNARE	"$4,203.00"
HC45200110	NM BONE SCAN WHOLE BODY	"$4,203.00"
HC23001100	INJ/INF NEUROLYTIC LUMB/SACRAL	"$4,201.00"
HC27001676	COLONOSCOPY STOMA W/EUS FNA/BX COLON	"$4,200.00"
HC45201332	NM PARATHYRD SCN W/SPECT W-W/O SUBTR	"$4,196.00"
HC27000207	COLONOSCOPY STOMA W/BIOPSY	"$4,195.00"
HC27000231	COLONOSCOPY STOMA W/HOT BIOPSY	"$4,188.00"
55513-206-01	BEVACIZUMAB-AWWB 25 MG/ML IV SOLN	"$4,186.39"
HC45200417	NM KIDNEY IMAG FLOW/FUNCTION	"$4,185.00"
99999-038-65	EPIFIX SKIN GRAFT ( 4X4.5 CM )	"$4,185.00"
HC23000771	INJ FORAMN EPI LMBR ADDLWS&I+L	"$4,180.00"
HC23000789	INJ FORAMN EPI LMBR ADDLWS&I+R	"$4,180.00"
HC62203807	KIT CRANIOPLASTIC RESIN	"$4,173.00"
HC62807805	M: SPACER HUMERAL SHOULDER	"$4,168.00"
HC74200098	OR TIME ADD'L 15MIN LVL 4 (MCAL 1ST SUBSQNT 0.5 HR)	"$4,167.00"
HC74200452	OR TIME ADD'L 15MIN LVL 4  (MCAL 2ND SUBSQNT 0.5 HR)	"$4,167.00"
HC26000000	AMNIOCENTESIS	"$4,165.00"
HC62805940	CATH EP DX <20 ELECTRODES         U	"$4,160.00"
HC62214580	KIT SPINAL ACCESS DISPOSBL(MAXCESS)	"$4,160.00"
HC45200342	NM GASTROINTESTINAL BLOOD LOSS	"$4,156.00"
HC23001605	INJ CERVICAL PLEXUS BLOCK BIL	"$4,140.00"
HC27001056	INJ SCLEROTHERAPY HEMORRHOIDS	"$4,137.00"
HC23001811	ASP/INJ JOINT LRG W/UTZ GUIDE-LT	"$4,130.00"
HC23001829	ASP/INJ JOINT LRG W/UTZ GUIDE-RT	"$4,130.00"
HC27001650	COLONOSCOPY STOMA W/DILATN BALLOON	"$4,130.00"
99999-041-47	NM TC-99M EXAMETAZIME (CERETEC) MHS	"$4,126.85"
HC27000546	ENDO SM INTST POUCH(KOCK)DX INCL COLLECT	"$4,125.00"
HC43000066	BREAST BX CORE W/O GUIDE-BI	"$4,123.00"
HC27001668	COLONOSCOPY STOMA W/EXAM US COLON	"$4,119.00"
HC46502175	PERC BX BREAST W/LOC DEV US ADDL LESN+	"$4,115.00"
HC27000314	COLONOSCOPY W/HOT BIOPSY	"$4,113.00"
61958-0403-1	TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWD	"$4,100.76"
HC45200136	NM BRAIN IMAG MIN'4 STATC W/VF	"$4,096.00"
HC82202532	BONE MARROW DX; BX(S) ONLY	"$4,094.00"
HC82200825	BONE MARROW DX; BX(S) ONLY LT	"$4,094.00"
HC82200817	BONE MARROW DX; BX(S) ONLY RT	"$4,094.00"
0009-5136-01	LINEZOLID 100 MG/5 ML ORAL SUSR	"$4,091.40"
HC23000094	ASP/INJ JOINT LRG W/O UTZ GUIDE-BILAT	"$4,087.00"
HC44901080	CT BREAST 3D RENDER BILAT W/O CONTRAST	"$4,082.00"
HC23000904	INJ ANES/STEROID NERVE/BRNCH PERIPH BIL	"$4,081.00"
HC46501334	PUNC SHUNT/RES FOR ASP/INJ	"$4,078.00"
HC84201292	RESP VIRUS 12-25 TRGTS(RVP PNL)	"$4,077.00"
HC44501807	REMOVE NEPHROSTOMY TUBE LT	"$4,075.00"
HC44501815	REMOVE NEPHROSTOMY TUBE RT	"$4,075.00"
HC73000226	PERITONITIS TREATMENT	"$4,072.00"
HC62801030	FILTER VENA CAVA (E.G.GUNTHER)    G	"$4,070.00"
47335-049-40	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$4,069.80"
HC23000714	INJ FORAMN EPI C/T ADD+ W/S&I-L	"$4,068.00"
HC23000722	INJ FORAMN EPI C/T ADD+ W/S&I-R	"$4,068.00"
0074-1040-08	BERACTANT IN 0.9 %SOD.CHLORIDE 25 MG/ML INTRATRACH SUSP	"$4,067.28"
HC44500908	INJ PERC EXT PSEUDOANEUR BILAT	"$4,067.00"
HC62220322	ORTHOTIC TLSO 4MOD SACRO-SCAP PRE	"$4,066.00"
99988-000-01	NM TC-99M EXAMETAZIME 1-30 MCI (CERETEC)	"$4,063.90"
HC62808233	M: BEARING TIBIAL	"$4,063.00"
HC46501987	BONE MARROW DX; BIOPSY(SIES) ONLY	"$4,054.00"
HC46501995	BONE MARROW DX; BIOPSY(SIES) ONLY LT	"$4,054.00"
HC46502001	BONE MARROW DX; BIOPSY(SIES) ONLY RT	"$4,054.00"
HC36800324	"TEST EXERC CARIOPULM INCL VENT,CO2,O2,EKG"	"$4,054.00"
HC62228689	PROBE ABLATION  CRYO              A	"$4,050.00"
HC45200300	NM GASTRIC EMPTYING	"$4,046.00"
HC42000703	ECHO CONGENITAL CMPLT W/ORWO FOL CONTR	"$4,043.00"
HC44703502	PERICARDIAL DRAIN W/CATH & CT GUIDANCE	"$4,033.00"
0054-0319-50	LINEZOLID 100 MG/5 ML ORAL SUSR (MCH)	"$4,031.10"
HC41000076	POLYSMN CPAP/BIPAP6&>ATTD REDCD SVC	"$4,025.00"
13533-318-01	RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN	"$4,022.64"
13533-318-10	RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN	"$4,022.64"
HC51002913	CYSTOURETHRSCPY&/PYELOSCPY W/BX&/FULG	"$4,018.00"
HC51003119	DESTROY LESION(S) VULVA EXTENSIVE	"$4,018.00"
HC51003341	CONIZATION CERVIX LOOP ELECTRD	"$4,018.00"
HC62219548	PROBE LITHOTRIPTOR ELECTRHYDRLC   Y	"$4,011.00"
HC73000267	DIALYSIS CVVH (CONT VENOVENOUS) QD	"$4,010.00"
HC27001163	SIGMOIDOSCOPY FLEX W/HOT BX	"$4,005.00"
HC27001684	COLONOSCOPY STOMA W/DECOMP&PLACE TUBE	"$4,001.00"
HC27000223	COLONOSCOPY STOMA W/FRN BDY(S)REMOV	"$3,997.00"
52652-9001-1	TOPIRAMATE 25 MG/ML ORAL SOLN	"$3,990.23"
HC46502217	PERC PLC BRST LOC DEV MAMMO ADDL LESN+	"$3,989.00"
HC89019988	FHL2 PRF1 GENE MUTATION-CN	"$3,984.00"
0338-0063-01	"DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP"	"$3,978.00"
HC44900934	CT HEART EVAL W/ 3D IMAGE	"$3,974.00"
HC27000256	COLONOSCOPY THRU STOMA INCL COLLECTN	"$3,966.00"
70710-1726-1	NELARABINE 250 MG/50 ML IV SOLN	"$3,966.00"
HC47201157	HDR ELECTRONIC BRACHYTHERAPY INTERSTIT/INTRACAV	"$3,963.00"
HC62223359	DEVICE SUTURE ENDO                R	"$3,962.00"
HC27001114	SIGMOIDOSCOPY FLEX INJ SUBMCSL	"$3,961.00"
HC27001643	COLONOSCOPY STOMA W/INJ SUBMUCOSL	"$3,956.00"
HC46501177	PUNCTURE SPINAL TX DRAIN CSF [NOT W/FLUORO/CT]	"$3,950.00"
HC46501169	LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO ]	"$3,946.00"
HC25000183	FB REMOVAL SQ COMPLEX	"$3,938.00"
59762-1308-1	LINEZOLID 100 MG/5 ML ORAL SUSR (MCH)	"$3,935.70"
HC45201282	HEPATOBILIARY SYSTEM IMAGING	"$3,933.00"
HC41000092	POLYSMNGRPH 4+STG<6Y/O ATTD RDC SVC	"$3,923.00"
HC36800001	BRONCHOSCOPY THRU ESTAB TRACH	"$3,919.00"
HC36000818	BRONCHOSCOPY THRU ESTAB TRACH	"$3,919.00"
HC25004243	I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP LT	"$3,915.00"
HC25004250	I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP RT	"$3,915.00"
HC23001787	ASP/INJ JOINT MED W/UTZ GUIDE-LT	"$3,913.00"
HC23001795	ASP/INJ JOINT MED W/UTZ GUIDE-RT	"$3,913.00"
HC44502615	REMOVAL PLEURAL CATH W/CUFF LT	"$3,909.00"
HC44502607	REMOVAL PLEURAL CATH W/CUFF RT	"$3,909.00"
13533-800-20	IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJ SOLN	"$3,903.60"
HC62807680	M: STEM INTERPHALANGEAL	"$3,900.00"
HC62211768	CATH BALLOON PTA         S	"$3,900.00"
HC62214754	CATH PTCA BALLOON NON-LASER       T	"$3,900.00"
HC62211669	CATH DRAINAGE                     Y	"$3,900.00"
HC62804687	CATH EP DIAG/MAPPING<20 ELECT     L	"$3,900.00"
HC62216270	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP Y	"$3,900.00"
HC62224779	CATH THROMBECTOMY/EMBOLECTOMY     V	"$3,900.00"
HC62800404	CATH INTRACARDIAC ECHO/UTZ RPRSD  E	"$3,900.00"
HC62208798	CATH INTRACARDIAC ECHO/UTZ        C	"$3,900.00"
HC62806013	INTRO/SHEATH STEERABLE NON-PEEL   I	"$3,900.00"
HC62218623	DEVICE RETRIEVAL                  I	"$3,900.00"
HC62804620	STENT DES CORO COV W/DEL SYS      I	"$3,900.00"
HC62803903	STENT CORO BARE METAL W/DEL       G	"$3,900.00"
HC62803689	CATH ABLAT TISS(E.G.HALO 60/90)   E	"$3,900.00"
HC62224837	CATH GUIDE REPERFUS(DAC/FLOWGATE) S	"$3,900.00"
HC62800131	CATH ABLAT VASC NON CARDIAC	"$3,900.00"
HC62204607	RECHARGER BATTERY NRST RPLCMNT	"$3,900.00"
HC62227152	DRILL/DRILL BITS SINGLE USE      AO	"$3,900.00"
HC62210943	SET CPS CIRCUIT PERFUSION	"$3,900.00"
HC62215454	KIT DECOMPRESSION SPINAL          D	"$3,900.00"
HC62217492	KIT CONCENTRATOR PLATELETS        X	"$3,900.00"
HC62218532	KIT MONITORING NERVE(S) SPINAL    I	"$3,900.00"
HC62218995	RETRACTOR MIS SPINAL              I	"$3,900.00"
HC62219449	KIT SPINAL ACCESS DISPOSBL        F	"$3,900.00"
HC62222096	OXYGENATOR PEDIATRIC              I	"$3,900.00"
HC62806856	HEMOSTATIC GEL/GELFOAM/PAD        Y	"$3,900.00"
99988-000-35	NM TC-99M SUCCIMER (DMSA)	"$3,900.00"
69097-285-37	DECITABINE 50 MG IV SOLR	"$3,900.00"
68516-4612-1	ALPHANATE 500 (200 VWF) UNIT/5 ML IV SOLR	"$3,900.00"
HC73000085	DIALYSIS CRRT W/SNGL EVAL(IP)	"$3,899.00"
HC27001130	SIGMOIDOSCOPY FLEX W/BIOPSY	"$3,890.00"
HC45200425	NM KIDNEY IMAG FLW/FUNC W/PHAR	"$3,885.00"
HC62210794	KIT INTRAOP PERFUSION (SPY)	"$3,884.00"
HC25001058	ASP BLADDER W/INSERT SUPRAPUB	"$3,879.00"
HC46502670	FNA ASP BX W/CT; FIRST LESION	"$3,872.00"
HC45200540	NM MECKEL'S/BOWEL IMAGING	"$3,872.00"
HC27001098	SIGMOIDOSCOPY FL W/DECOMP&PLAC TUBE	"$3,867.00"
HC27000926	ESOPHSCPY DX- BRUSH/WASH ~FO	"$3,858.00"
HC25000324	THORACOTOMY	"$3,854.00"
58914-301-80	NITROGLYCERIN 0.4 % (W/W) RECTAL OINT	"$3,844.44"
HC21000344	DBRD SKIN MUSCL UP TO 20 SQCM	"$3,843.00"
0591-1159-30	ACYCLOVIR 5 % TOPICAL OINT	"$3,839.94"
HC44900835	CT COLONOGRAPHY DX VIRTUAL W/O CONTRAST	"$3,832.00"
HC46000998	SEL VENOUS CATH 2ND+ORDR LT	"$3,825.00"
HC46001004	SEL VENOUS CATH 2ND+ORDR RT	"$3,825.00"
HC45200029	CSF FLOW W/ VENTRICULOGRAPHY	"$3,825.00"
HC62228580	STAPLER INTERNAL EEA	"$3,825.00"
HC51061034	"CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST BI"	"$3,823.00"
HC51061067	"EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) BI"	"$3,823.00"
HC47200217	INTRACAVITARY TREATMT INTERMED	"$3,822.00"
HC51002673	REPAIR FISTULA ANAL W/GLUE	"$3,815.00"
HC44701159	THROMBOLYSIS INTRACORONARY INF WANGIO	"$3,814.00"
HC25002874	DEBRIDE/REMOVL OPEN FX&/DISLOC SQ T/M/BONE	"$3,807.00"
HC25004276	REMOVE FB DEEP THIGH/KNEE AREA LT	"$3,807.00"
HC25004284	REMOVE FB DEEP THIGH/KNEE AREA RT	"$3,807.00"
HC45401114	MR BREASTS W/O CONTRAST LTD (BILAT)	"$3,804.00"
HC21000989	APPY SKIN SUB HEAD/HND/FT 1ST25SQ~LC	"$3,803.00"
HC43000140	MAMMO DUCTO/GALACTO INJ-BI	"$3,801.00"
HC41500828	EEG W/O VID MONITOR CONT EA 12-26HR	"$3,796.00"
HC82200320	BONE MARROW DX; ASP(S) ONLY	"$3,794.00"
HC82200809	BONE MARROW DX; ASP(S) ONLY LT	"$3,794.00"
HC82200791	BONE MARROW DX; ASP(S) ONLY RT	"$3,794.00"
16729-108-11	MITOMYCIN 20 MG IV SOLR	"$3,791.88"
16729-247-11	MITOMYCIN 20 MG IV SOLR	"$3,791.88"
HC46501797	INSERT CT(OPEN) W/DRAIN SYSTEM	"$3,786.00"
HC44701175	TILT TABLE EVALUATION	"$3,785.00"
HC27000041	ANOSCOPY W/BIOPSY	"$3,781.00"
HC62808779	CATH INDIGO THROMB 3.4&5FR[PENUMBRA]	"$3,780.00"
63261-250-21	ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN	"$3,774.00"
HC62804406	COIL EMBOLIZ(AXIUM PRIME 3D 3MM) AD	"$3,770.00"
HC23000649	INJ ANES/STEROID NERVE FEMORAL BIL	"$3,760.00"
HC46500120	BONE MARROW DX; ASPIRATION(S) ONLY	"$3,756.00"
HC46501961	BONE MARROW DX; ASPIRATION(S) ONLY LT	"$3,756.00"
HC46501979	BONE MARROW DX; ASPIRATION(S) ONLY RT	"$3,756.00"
HC84201409	IADNA-DNA/RNA PROBE TQ 12-25 GI PCR	"$3,749.00"
HC46501045	INSERT CT(OPEN) W/DRAIN SYSTEM LT	"$3,740.00"
HC46501052	INSERT CT(OPEN) W/DRAIN SYSTEM RT	"$3,740.00"
HC45200904	THYROID METS IMAG W/ADD STUDIES	"$3,738.00"
HC62804471	KIT KYPHOPLASTY BALLOON AUGMENTATN	"$3,738.00"
99999-038-64	EPIFIX SKIN GRAFT ( 3X3.5 CM )	"$3,735.00"
0023-1145-01	ONABOTULINUMTOXINA 100 UNIT INJ SOLR	"$3,732.00"
HC23000821	INJ ANES/STEROID NERVE INTERCOSTAL SINGL	"$3,717.00"
HC46502159	PERC BX BREAST W/LOC DEV SG ADDL LESN+	"$3,715.00"
67457-177-50	DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLN	"$3,711.60"
42799-217-01	OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC	"$3,705.67"
HC62209176	DEVICE ABLATION GYN KIT	"$3,704.00"
HC46501227	PARACENTESIS ABD W/O IMAGING GUIDE	"$3,699.00"
HC21000500	I&D POLINIDAL CYST: COMPLICATE	"$3,688.00"
HC46500625	CHANGE CYSTOSTOMY; COMPLICATED	"$3,686.00"
HC45201035	NM VENOGRAM(THROMBOSIS)BILAT	"$3,685.00"
HC45200284	NM CSF LEAKAGE IMAGING	"$3,685.00"
HC27002377	COLONOS' SCREEN NOT HI RISK (Q120MO)	"$3,685.00"
HC27000066	ANOSCOPY W/DILATION	"$3,684.00"
HC74200320	BEDSIDE/OTHER SURGICAL CANCEL LVL 3	"$3,684.00"
57894-502-05	DARATUMUMAB 20 MG/ML IV SOLN	"$3,682.80"
0069-0315-01	BEVACIZUMAB-BVZR 25 MG/ML IV SOLN	"$3,680.40"
HC23001928	INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE BI	"$3,680.00"
HC27001239	COLONOS' SCREEN HI RISK (Q48MO)	"$3,680.00"
HC51003176	DESTROY LESION(S) VAGINAL EXTENSIVE	"$3,678.00"
HC51003291	COLPOSCPY CERV W/CONIZ LOOP ELECTRD	"$3,678.00"
HC21000948	"APPY SKIN SUB T,A,L 1ST 25SQ~LC"	"$3,675.00"
HC27000694	ERCP DIAGNOSTIC DC'D PROC	"$3,667.00"
HC45200128	NM BRAIN IMAG 4<VWS W/VASCFLOW	"$3,667.00"
HC91200134	R&B NEWBORN CARE	"$3,661.00"
HC44900496	CT PELVIS W/O CONTRAST LTD	"$3,660.00"
HC62804034	FILTER VENA CAVA  (E.G. ALN)      F	"$3,660.00"
62756-352-40	"OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN"	"$3,659.70"
HC46001244	INJECTION SINUS TRACT; THERAPEUTIC	"$3,658.00"
HC27001908	INSTILL FECAL MICROBIOTA (FMT)	"$3,658.00"
HC62805098	CATH EP DX 20+ ELECTRODES         E	"$3,640.00"
HC62216502	KIT SPINAL ACCESS DISPOSBL        E	"$3,640.00"
HC62804398	COIL EMBOLIZATION                AC	"$3,640.00"
HC44001485	KNEE ARTHROGRAM BILAT	"$3,637.00"
HC25003120	LAC REPAIR INTMD S/A/T/EXT >30.0CM	"$3,636.00"
HC25005927	PARACENTESIS EYE W/REMOVAL AQUEOUS BIL	"$3,636.00"
HC25005638	DRAIN EXTERNAL EAR LESION COMPLEX BIL	"$3,636.00"
HC23001084	INJ/INF NEUROLYTIC AGNT SUBARACH	"$3,635.00"
HC21000971	"APPY SKIN SUB T,A,L EA+ 100SQ~LC"	"$3,628.00"
HC45200201	NM CARDIAC BP IMAG GATED SNGLE	"$3,624.00"
HC27001106	SIGMOIDOSCOPY FLEX DIAGNOSTIC	"$3,622.00"
0078-0669-13	OFATUMUMAB 100 MG/5 ML IV SOLN	"$3,620.22"
HC47200662	TREATMENT DEVICES COMPLEX	"$3,619.00"
HC23001696	INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS BI	"$3,616.00"
HC47200118	CT RAD THER PLANNING	"$3,613.00"
HC46500609	BX THYROID NEEDLE CORE	"$3,604.00"
14789-015-05	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$3,600.00"
14789-015-07	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$3,600.00"
HC25004367	I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP LT	"$3,594.00"
HC25004375	I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP RT	"$3,594.00"
50242-214-01	OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRG	"$3,591.60"
HC74200080	OR TIME ADD'L 15MIN LVL 3 (MCAL 1ST SUBSQNT 0.5 HR)	"$3,590.00"
HC74200445	OR TIME ADD'L 15MIN LVL 3  (MCAL 2ND SUBSQNT 0.5 HR)	"$3,590.00"
HC44700391	INSERT SWAN-GANZ CATHETER	"$3,589.00"
HC44504504	PERC PLCMT TISS SOFT DEV 1ST LESN	"$3,582.00"
HC23000060	ASP/INJ JOINT MED W/O UTZ GUIDE-BILAT	"$3,578.00"
HC62806278	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP X	"$3,575.00"
HC62800586	DEVICE THROMBECTOMY/EMBOLECTOMY   X	"$3,575.00"
HC62219365	GUIDEWIRE                        AE	"$3,575.00"
HC62219274	DEVICE RETRIEVAL                  H	"$3,575.00"
HC62219829	PROGRAMMER NEUROSTIM PAT          H	"$3,575.00"
HC62803754	STENT NON-COAT/NON-COV W-DEL      X	"$3,575.00"
HC62219316	EMBOLIZATN PROTECT SYSTEM(SPIDER) H	"$3,575.00"
HC62805593	CATH ANGIO/GUID NEURO/PERIPH(DAC44)R	"$3,575.00"
HC62224829	CATH GUIDNG(PX400/SILICONE/STRYKER BLLN)R	"$3,575.00"
HC62200688	TAMP BONE KYPHOPLASTY             J	"$3,575.00"
HC62802384	INTRO/SHEATH EP FIXED PEEL       AN	"$3,575.00"
HC62219795	KIT PERFUSION                     D	"$3,575.00"
HC62226659	TAP SURGICAL                      X	"$3,575.00"
0703-5054-01	DESMOPRESSIN 4 MCG/ML INJ SOLN	"$3,571.20"
69918-901-10	DESMOPRESSIN 4 MCG/ML INJ SOLN	"$3,571.20"
HC44900033	CT ABDOMEN W/O CONTRAST LTD	"$3,566.00"
62756-529-40	DESMOPRESSIN 4 MCG/ML INJ SOLN	"$3,565.20"
63323-637-10	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$3,564.00"
63323-637-03	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$3,564.00"
HC23001415	INJ CER/THR F/IMAGE 3RD+&LVLBI	"$3,562.00"
HC84201631	DNA/RNA MENINGITIS/ENCEPHALITIS PCR	"$3,559.00"
HC27000090	ANOSCOPY W/SNARE SINGLE REMVL	"$3,558.00"
HC46000261	INJ DISKOGRAM LUMBAR EA LVL	"$3,557.00"
HC27000900	ESOPHAGEAL REFLUX W/NASAL ELEC	"$3,541.00"
HC46500898	FIX G/COLON TUBE W/ DEVICE W/FLUORO	"$3,532.00"
63323-132-12	MITOXANTRONE 2 MG/ML IV CONC	"$3,514.68"
59572-102-01	AZACITIDINE 100 MG INJ SOLR	"$3,511.44"
HC62808753	CATH INDIGO THROMB SEPARATOR 6FR L175CM[PENUMBRA]	"$3,510.00"
HC62804380	COIL EMBOLIZATION                AB	"$3,510.00"
13533-634-02	TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML IM SYRG	"$3,505.32"
HC44200145	US DUPLEX ART LOW EXT COMP BIL	"$3,500.00"
HC47201058	BRACHYTX ISODOSE W/DOSIMETRY; SIMPL	"$3,497.00"
HC21000542	PREP SITE TRUNK/EXT<100SQCM	"$3,495.00"
HC44500395	ANGIO THRU EXISTING CATH	"$3,495.00"
HC45200086	NM BONE SCAN MULTI AREA	"$3,492.00"
HC45200185	NM CARDIAC BP 1ST PASS(EF)SNGL	"$3,492.00"
HC45201043	NM VENOUS THROMBOSIS PEPTIDE	"$3,486.00"
HC21001011	APPY SKIN SUB HED/HND/FT EA+100SQ~LC	"$3,486.00"
10454-711-10	"RIMABOTULINUMTOXINB 5,000 UNIT/ML IM SOLN"	"$3,486.00"
HC44503712	INJ SCLEROTHERAPY LYMPHOCELE	"$3,478.00"
HC62802467	INTRODUCER KYPHOPLASTY OSTEO	"$3,478.00"
HC41500471	WADA TEST	"$3,474.00"
HC62800263	CATH CORONARY SINUS	"$3,458.00"
HC23001886	INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE BI	"$3,457.00"
HC41000126	POLYSMN CPAP/BIPAP<6 ATTD REDCD SVC	"$3,453.00"
HC62806948	KIT ANEURYSM ENCAPSULTNG NEUROVASC	"$3,452.00"
HC23000458	INJ ANES/STEROID NERVE SUPRASCAP BI	"$3,444.00"
HC45200144	NM BRAIN IMAG MIN'4 STATIC VWS	"$3,444.00"
HC45200979	NM TUMOR LOCALIZE PLNR 2+AREAS 1+DAYS//1AREA 2+ DAYS	"$3,437.00"
49401-101-01	BELIMUMAB 120 MG IV SOLR	"$3,433.32"
HC45200243	NM CARDIAC SCAN SPECT	"$3,422.00"
HC45401551	MRI FETAL PLACENTAL PLVC IF PRF; EA ADDL+	"$3,412.00"
HC47200589	SPECIAL TELETHERAPY PORT PLAN	"$3,411.00"
HC62217849	CLOSURE WND EXPANDER TISSUE       B	"$3,410.00"
HC51003283	COLPOSCPY CERV W/BX(S)LOOP ELECTRD	"$3,390.00"
3877900689	CITRIC ACID (BULK) MISC POWD	"$3,390.00"
HC45200524	PULM PERFUSION IMAGING	"$3,384.00"
HC62804026	FILTER VENA CAVA (E.G.ELITE)      E	"$3,380.00"
HC62217005	KIT SPINAL ACCESS DISPOSBL        D	"$3,380.00"
HC62804372	COIL EMBOLIZATION                AA	"$3,380.00"
HC51003085	VASECTOMY BILAT/UNILAT(SEP PROCEDURE)	"$3,379.00"
HC25003872	CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN LT	"$3,378.00"
HC25003880	CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN RT	"$3,378.00"
HC42000729	ECHO 2D CMPLT W/O SPC&DOP W/WO CONTR	"$3,375.00"
45802-608-01	CALCITRIOL 3 MCG/GRAM TOPICAL OINT	"$3,373.80"
14789-600-10	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$3,373.44"
14789-600-07	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$3,373.44"
HC47200720	US GUIDE RAD ELEMENT APP	"$3,373.00"
HC46502258	PERC PLC BRST LOC DEV US ADDL LESN+	"$3,372.00"
HC41000043	POLYSOMNOGRAPHY 4+ STG 6&> REDCD SVC	"$3,365.00"
0781-3244-94	CYCLOPHOSPHAMIDE 1 GRAM IV SOLR	"$3,362.16"
HC23001753	ASP/INJ JOINT SM W/UTZ GUIDE-LT	"$3,355.00"
HC23001761	ASP/INJ JOINT SM W/UTZ GUIDE-RT	"$3,355.00"
HC25004482	CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP LT	"$3,336.00"
HC25004490	CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP RT	"$3,336.00"
54879-027-10	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$3,330.00"
HC46501920	ADJUST GASTRIC BAND VIA PORT	"$3,328.00"
HC25000035	ED LEVEL IV - EXTENDED	"$3,321.00"
HC45200060	NM BONE MARROW WHOLE BODY	"$3,320.00"
HC44901072	CT BREAST 3D RENDER UNILAT W&W/O CONTRAST	"$3,317.00"
HC25003633	REMOVE FB UPPER ARM/ELBOW DEEP LT	"$3,313.00"
HC25003641	REMOVE FB UPPER ARM/ELBOW DEEP RT	"$3,313.00"
HC25004391	CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC LT	"$3,313.00"
HC25004409	CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC RT	"$3,313.00"
HC46502654	FNA ASP BX W/FLUORO; FIRST LESION	"$3,312.00"
HC46502233	PERC PLC BRST LOC DEV SG ADDL LESN+	"$3,305.00"
HC45201357	NM GASTRIC EMPTYING SMALL BOWEL	"$3,301.00"
0781-9158-94	BIVALIRUDIN 250 MG IV SOLR	"$3,300.00"
0781-9158-95	BIVALIRUDIN 250 MG IV SOLR	"$3,300.00"
HC46001319	"INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS LT"	"$3,298.00"
HC46001327	"INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS RT"	"$3,298.00"
HC25004425	CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC LT	"$3,297.00"
HC25004433	CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC RT	"$3,297.00"
HC44504017	ANGIO IL/FEM DURING HRTCATH&/CORO W/S&I	"$3,289.00"
HC45200227	NM CARDIAC BP SPECT REST WM/EF	"$3,285.00"
HC44001642	MYELOGRAM ENTIRE SPINE CANAL	"$3,281.00"
HC44200913	TCD ICA VASOREACTIVITY STUDY	"$3,274.00"
HC45200508	NM LIVER/SPLEEN IMAGING STATIC	"$3,267.00"
HC25005711	AMPUTATE FINGER/THUMB SGL W/CLOSURE LT	"$3,264.00"
HC25005729	AMPUTATE FINGER/THUMB SGL W/CLOSURE RT	"$3,264.00"
HC27000074	ANOSCOPY W/FB REMOVAL	"$3,264.00"
HC44502136	TRANSHEP DIL BILI W/O-W STENT	"$3,256.00"
HC47200688	TREATMENT SIMULATION INTERMED	"$3,254.00"
HC62806690	MARKER TISSUE 3D	"$3,250.00"
HC62214747	CATH PTA ANGIOPLS BALLOON NON-LSR S	"$3,250.00"
HC62805056	CATH PTCA BALLOON NON-LASER       R	"$3,250.00"
HC62800339	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP W	"$3,250.00"
HC62808316	M: HIP FEM MODULAR COMPONENT ADAPTER	"$3,250.00"
HC62807623	M: INSERT HIP	"$3,250.00"
HC62808407	STENT DES CORO COV W/DEL SYS      G	"$3,250.00"
HC62804935	STENT BILIARY COVRD W/DELSYS      C	"$3,250.00"
HC62803895	STENT CORO BARE METAL W/DEL       F	"$3,250.00"
HC62210380	EMBOLIC PROTECT SYSTEM; VASC      G	"$3,250.00"
HC62210620	CATH ANGIO(BNCHMRK/ECHELN/EXCELSR/DAC57/HEADWY)Q	"$3,250.00"
HC62211842	CATH MICRO'P'VASC INJECT SOL/COIL P	"$3,250.00"
HC62220280	SYSTEM DELIVERY LEAD              M	"$3,250.00"
HC62201462	CATH INTRA AORTIC BALLOON         D	"$3,250.00"
HC62205422	KIT PERFUSION                     C	"$3,250.00"
HC62209861	CATHETER MICRO CTO (CORSAIR)      W	"$3,250.00"
HC62215462	KIT HARVESTING BONE GRAFT         W	"$3,250.00"
HC62218508	ENDO STAPLER                     AQ	"$3,250.00"
HC62220116	KIT MONITORING NERVE(S) SPINAL    G	"$3,250.00"
HC62223672	SYSTEM DETACHMENT COIL/PLUG (MVP)	"$3,250.00"
HC62224167	SET SHEATH DILATOR	"$3,250.00"
HC62225487	KIT PROCESSING MARROW BONE	"$3,250.00"
HC62225891	GUIDE DRILL                       W	"$3,250.00"
HC62226121	DRILL/DRILL BITS SINGLE USE      AM	"$3,250.00"
HC62226261	KIT DILATOR SPINAL	"$3,250.00"
HC62226584	PIN/WIRE FIXATION TEMPORARY      AW	"$3,250.00"
HC62804364	COIL EMBOLIZATION                 Z	"$3,250.00"
HC62806773	POUCH/ENVELOPE PACEMAKER          G	"$3,250.00"
HC62807938	SEALANT TISSUE HYDROGEL ET	"$3,250.00"
HC21000773	"APPY SKIN SUB T,A,L 1ST 25SQ~HC"	"$3,248.00"
HC41500133	EEG MONITORING 61-119MINUTES	"$3,248.00"
HC81701781	GENOTYPE DNA/RNA HEPATITIS C	"$3,247.00"
HC62228648	APPLIER CLIP CLOSURE ANASTOMOSIS	"$3,247.00"
HC62217880	SET PIN DISTRACTORS-COUNT 10      A	"$3,244.00"
70257-330-51	"RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT (300 MCG)/1.3 ML INJ SOLN"	"$3,238.98"
70257-330-11	"RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT (300 MCG)/1.3 ML INJ SOLN"	"$3,238.98"
59148-021-50	TOLVAPTAN 30 MG ORAL TAB	"$3,237.86"
66220-315-22	TELAVANCIN 750 MG IV SOLR	"$3,235.66"
66220-315-11	TELAVANCIN 750 MG IV SOLR	"$3,235.62"
HC25002742	INSERT PICC <5 YR AGE W/ IMAGING	"$3,234.00"
HC62804828	CLIP LEFT ATRIAL APPENDAGE-LAA    A	"$3,234.00"
HC62209432	KIT LOCATABLE GUIDE (LARGE)	"$3,234.00"
HC62217260	PUNCH ATHROSCOPIC ROTARY	"$3,234.00"
HC45200797	NM SHUNT EVALUATION	"$3,225.00"
HC21000336	DEBRID SKIN&SUBQ UP TO 20 SQCM	"$3,224.00"
52652-4001-1	ENALAPRIL MALEATE 1 MG/ML ORAL SOLN	"$3,222.00"
HC41500117	EEG CEREBRAL SILENCE	"$3,220.00"
HC23000953	INJ ANES/STEROID NERVE PUDENDAL LT	"$3,210.00"
HC23000961	INJ ANES/STEROID NERVE PUDENDAL RT	"$3,210.00"
HC62212527	INTRODUCER/SHEATH                 Y	"$3,210.00"
HC46502704	FNA ASP BX W/MR; EACH ADD'L LESION	"$3,209.00"
59676-320-04	"EPOETIN ALFA 20,000 UNIT/ML INJ SOLN"	"$3,207.00"
59676-320-00	"EPOETIN ALFA 20,000 UNIT/ML INJ SOLN"	"$3,207.00"
HC44200103	US DUPLEX ABD/PEL FLOW COMP	"$3,204.00"
HC12800082	TRANSFUSION BLOOD &/OR COMPNTS	"$3,203.00"
HC46000972	SEL VENOUS CATH 1ST ORD LT	"$3,201.00"
HC46000980	SEL VENOUS CATH 1ST ORD RT	"$3,201.00"
0409-8300-10	BIVALIRUDIN 250 MG IV SOLR	"$3,197.41"
0409-8300-20	BIVALIRUDIN 250 MG IV SOLR	"$3,197.41"
HC44700565	INTRAVASC DOPPLER ADDL VESSEL+	"$3,197.00"
HC25002908	DEBRIDE SKIN MUSL/BONE; FIRST 20SQCM OR LESS	"$3,194.00"
HC21000815	APPY SKIN SUB HEAD/HND/FT 1ST25SQ~HC	"$3,192.00"
55513-209-91	FILGRASTIM 480 MCG/0.8 ML INJ SYRG	"$3,188.58"
55513-209-01	FILGRASTIM 480 MCG/0.8 ML INJ SYRG	"$3,188.58"
HC51002780	INJECT ENDOSCOPIC MATERIAL IMPLANT	"$3,187.00"
HC12800090	TRANSFUSION EXCHANGE BLOOD NOT NEWBORN	"$3,186.00"
HC25006180	BREECH VERSION EXTERNAL MANIP	"$3,184.00"
HC41500794	EEG W/O VID MONITOR CONT 2-12HR	"$3,184.00"
0085-4331-01	POSACONAZOLE 300 MG/16.7 ML IV SOLN	"$3,182.65"
50383-286-16	LEVOFLOXACIN 250 MG/10 ML ORAL SOLN	"$3,182.40"
HC47200134	HYPERTHERMIA EXTERNAL SUPERFCL	"$3,182.00"
47335-178-40	OXALIPLATIN 100 MG IV SOLR	"$3,180.00"
13533-705-01	"PROLASTIN-C 1,000 MG (+/-)/20 ML IV SOLN"	"$3,180.00"
13533-705-11	"PROLASTIN-C 1,000 MG (+/-)/20 ML IV SOLN"	"$3,180.00"
HC62217310	DEVICE CHECK NEURO SURG SPINAL	"$3,176.00"
63323-659-03	INDOMETHACIN SODIUM 1 MG IV SOLR	"$3,173.64"
0944-2715-25	IMMUN GLOB G(IGG)-GLY-IGA OV50 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLN	"$3,172.50"
HC42000133	ECHO 2D CMPLT W/O SPEC&CLR DOP	"$3,172.00"
0003-0852-22	DASATINIB 100 MG ORAL TAB	"$3,168.62"
63323-648-10	LEVOTHYROXINE 500 MCG IV SOLR	"$3,167.46"
52652-5001-1	AMLODIPINE BENZOATE 1 MG/ML ORAL SUSP	"$3,164.40"
HC25003534	CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC-BIL	"$3,163.00"
HC25001173	THORACENTESIS ASP W/O IMG GUID-BIL	"$3,151.00"
70860-454-10	DESMOPRESSIN 4 MCG/ML INJ SOLN	"$3,150.00"
HC25003922	CLOSED TX CARPAL BONE FX W/M EA BONE LT	"$3,138.00"
HC25003930	CLOSED TX CARPAL BONE FX W/M EA BONE RT	"$3,138.00"
HC42000828	ECG EXT TELEM MCT>24HRS-30DAYS TECH ATTEND TIME;CONNECT&TRANS	"$3,134.00"
HC42000190	ECHO FETAL CARDIOVASCULAR	"$3,132.00"
67546-212-21	NITAZOXANIDE 100 MG/5 ML ORAL SUSR	"$3,132.00"
HC25001207	THORACENTESIS W/TUBE W/O IMAG BI	"$3,121.00"
HC51003333	ABLATION LASER CERVIX	"$3,121.00"
HC25003906	CLOSED TX CARPAL SCAPHOID FX W/MAN LT	"$3,120.00"
HC25003914	CLOSED TX CARPAL SCAPHOID FX W/MAN RT	"$3,120.00"
HC62805932	CATH EP DX <20 ELECTRODES         Q	"$3,120.00"
HC62806179	CATH EP DX 20+ ELECTRODES         C	"$3,120.00"
HC62807607	M: CLIP JOINT SMALL	"$3,120.00"
HC62225800	DEVICE SUTURING ENDOSCPC OVERSTITCH O	"$3,120.00"
HC62804356	COIL EMBOLIZATION                 Y	"$3,120.00"
61958-2902-1	REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN	"$3,120.00"
61958-2901-2	REMDESIVIR 100 MG IV SOLR	"$3,120.00"
61958-2901-1	REMDESIVIR 100 MG IV SOLR	"$3,120.00"
HC25005208	REPAIR LIP FULL THICK; OVER 1/2 VERTICAL HT/COMPLEX	"$3,114.00"
HC82202862	PROSTATE NEEDLE BX ANY METHD	"$3,112.00"
HC44501203	MECH REMOV PERICTH CEN VEN S&I	"$3,111.00"
HC25004458	CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP LT	"$3,108.00"
HC25004466	CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP RT	"$3,108.00"
HC25003724	REMOVE FB FOREARM DEEP LT	"$3,105.00"
HC25003732	REMOVE FB FOREARM DEEP RT	"$3,105.00"
HC62228853	TEMPLATE BRACHYTHERAPY            Y	"$3,100.00"
15054-0530-6	ABOBOTULINUMTOXINA 300 UNIT IM SOLR	"$3,093.00"
HC25003815	CLOSED TX RAD&ULN SHAFT FX W/MAN LT	"$3,090.00"
HC25003823	CLOSED TX RAD&ULN SHAFT FX W/MAN RT	"$3,090.00"
HC74200312	BEDSIDE/OTHER SURGICAL CANCEL LVL 2	"$3,090.00"
HC62214457	SUTURE SET FOOT/ANKLE	"$3,088.00"
HC45201175	RADIOPHARM' TX; ORAL ADMIN	"$3,086.00"
HC62217831	CLOSURE WND EXPANDER TISSUE       A	"$3,085.00"
HC45200409	NM KIDNEY IMAGING W/VASC FLOW	"$3,084.00"
HC45201324	NM THYROID SCAN & UPTAKE SNG/MULT MSRMT [W/VASC FLOW IF PERF]	"$3,083.00"
HC51002889	CYSTOSCOPY W/INSERT STENT URETER INDW	"$3,080.00"
HC25006198	DELIVERY OF PLACENTA	"$3,080.00"
HC45200052	NM BONE MARROW MULTI AREA	"$3,078.00"
0049-3160-44	VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSR	"$3,075.75"
HC44703429	PERCUT ACCESS & CLOSE FEMORAL ARTERY DELIVERY GRAFT+	"$3,072.00"
0074-3956-46	LOPINAVIR-RITONAVIR 400-100 MG/5 ML ORAL SOLN	"$3,072.00"
HC82202169	ELECTRON MICROSCOPY	"$3,069.00"
HC45200516	NM LIVER/SPLEEN W/VASC FLOW	"$3,066.00"
HC46502068	BIOPSY PLEURA NEEDLE	"$3,062.00"
HC46500526	BX PLEURA NDL-LT	"$3,062.00"
HC46500534	BX PLEURA NDL-RT	"$3,062.00"
HC79200044	SURGERY MINOR 1ST 30 MIN	"$3,061.00"
42023-182-01	ARGATROBAN 100 MG/ML IV SOLN	"$3,060.00"
HC44200251	US DUPLEX VEIN EXT COMP BILAT	"$3,058.00"
HC25000944	I&D PERIANAL ABSCESS	"$3,055.00"
HC46000832	SEL CATH PULMONARY ART LT	"$3,053.00"
HC46000840	SEL CATH PULMONARY ART RT	"$3,053.00"
10122-510-01	PORACTANT ALFA 120 MG/1.5 ML INTRATRACH SUSP	"$3,052.20"
HC23001464	INJ  L/S F W/IMAGE 2ND LVL LT	"$3,051.00"
HC23001456	INJ  L/S F W/IMAGE 2ND LVL RT	"$3,051.00"
51525-0442-8	FELBAMATE 600 MG/5 ML ORAL SUSP	"$3,048.77"
63323-562-10	BIVALIRUDIN 250 MG IV SOLR	"$3,048.00"
HC23000367	INJ ANES/STEROID NERVE AXILLARY BIL	"$3,046.00"
HC45200649	NM PARATHYROID PLANAR IMAG+SUBTR	"$3,045.00"
HC45201167	RADIOLABEL MONONCLON ANTIBODY	"$3,045.00"
HC25003757	CLOSED TX RADIAL SHAFT FX W/MANIP LT	"$3,044.00"
HC25003765	CLOSED TX RADIAL SHAFT FX W/MANIP RT	"$3,044.00"
HC46001111	INJ ARTHRO HIP W/ANESTH-SC BIL	"$3,044.00"
HC42000646	ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS; TRANSMIT/ANYS	"$3,040.00"
99999-042-06	AMNIOBAND MEMBRANE (3X4 CM)	"$3,037.50"
HC21000567	PREP SITE/SCR F/N/HF/G<100SQCM	"$3,033.00"
HC47200175	HYPERTHERMIA INTRACAVITARY	"$3,033.00"
0069-0971-95	DOXYCYCLINE CALCIUM 50 MG/5 ML ORAL SYRP	"$3,028.15"
10019-075-87	"ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP"	"$3,023.40"
HC23001571	INJ ANES/STEROID NERVE OCCIPITL GREAT BI	"$3,021.00"
HC74200072	OR TIME ADD'L 15MIN LVL 2 (MCAL 1ST SUBSQNT 0.5 HR)	"$3,016.00"
HC74200437	OR TIME ADD'L 15MIN LVL 2  (MCAL 2ND SUBSQNT 0.5 HR)	"$3,016.00"
HC46000691	PERC PORTAL VEIN CATH	"$3,012.00"
HC47201033	TELETX ISODOSE W/ DOSIMETRY;SIMPLE	"$3,010.00"
HC62209143	BLANKET TEMP MNGMNT SYSTEM/BOX	"$3,010.00"
HC51003192	BX VAGINA EXTENSIVE INCL CYSTS	"$3,002.00"
0143-9674-01	ARGATROBAN 100 MG/ML IV SOLN	"$3,000.00"
67457-195-01	MELPHALAN HCL 50 MG IV SOLR	"$3,000.00"
59148-070-91	BUSULFAN 60 MG/10 ML IV SOLN	"$3,000.00"
HC46000675	INTRO OF CATH SVC OR IVC	"$2,998.00"
HC23001373	INJ CER/THOR F/IMAGE 2ND LVLLT	"$2,996.00"
HC23001365	INJ CER/THOR F/IMAGE 2ND LVLRT	"$2,996.00"
HC45200078	NM BONE SCAN LTD AREA	"$2,994.00"
HC46500336	BIOPSY NEEDLE SALIVARY GLAND	"$2,992.00"
HC46502639	FNA ASP BX W/US; FIRST LESION	"$2,990.00"
HC62216973	PIN/WIRE FIXATION TEMPORARY      AV	"$2,990.00"
HC62222443	TUBE INSERTN LEAD ELECTRODE SINGLE	"$2,990.00"
HC62804349	COIL EMBOLIZATION                 X	"$2,990.00"
HC46000246	INJ SINUS TRACT; DIAGNOSTIC (SINOGRAM)	"$2,986.00"
HC25004078	CLOSED TX THUMB FX DISLOC W/MAN(BENNETT)LT	"$2,986.00"
HC25004086	CLOSED TX THUMB FX DISLOC W/MAN(BENNETT)RT	"$2,986.00"
63323-379-05	"OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN"	"$2,981.28"
HC44002541	WRIST ARTHROGRAM BILAT	"$2,981.00"
HC83000836	THER APHERESIS PLASMA CX/ABORT	"$2,980.00"
HC46000543	INTRO CATH RT HEART/PUL ART	"$2,978.00"
HC62210984	PACK PERFUSION - ADULT	"$2,974.00"
HC23001498	INJ  L/S F /IMAGE 3RD+& LVL LT	"$2,970.00"
HC23001480	INJ  L/S F /IMAGE 3RD+& LVL RT	"$2,970.00"
HC41500430	SOMATOSENSORY UPPER LIMBS	"$2,970.00"
5985700315	HUMAN REGENERATIVE TISSUE MTRX 14 MM TOPICAL SHEE	"$2,970.00"
HC12800025	THER APHERESIS PLASMA CX/DC'D	"$2,966.00"
HC44200608	TRANSCRANIAL DOPPLER STUDY COMP	"$2,966.00"
HC62804018	FILTER VENA CAVA(DENLI-ECLPS-MERIDN) D	"$2,965.00"
HC62208608	SYSTEM VEIN HARVESTING	"$2,961.00"
HC41500869	EEG W/VIDEO UNMONITOR EA 12-26 HR	"$2,958.00"
HC62803713	KIT CATH HEMO DIAL SHORT TERM     V	"$2,958.00"
HC46000436	INJ VENOGRAM EXTREMITY- BILAT	"$2,950.00"
0078-0274-22	CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN	"$2,943.90"
HC44502243	VENOGRAM EXTREMITY UNILAT LT	"$2,943.00"
HC44503431	VENOGRAM EXTREMITY UNILAT RT	"$2,943.00"
HC45200722	NM RADIONUCLIDE VOIDING CYSTO	"$2,943.00"
HC44501013	INTRALUMIN OBST VEN DEV S&I	"$2,942.00"
69097-522-35	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$2,940.00"
HC51003168	DESTROY LESION(S) VAGINAL SIMPLE	"$2,939.00"
HC42000711	ECHO CNGNTL LTD OR F/U W/WO CONTR	"$2,930.00"
HC62800107	CATH PTA ANGIOPLS BALLOON NON-LSR R	"$2,925.00"
HC62800099	CATH PTCA BALLOON NON-LASER       Q	"$2,925.00"
HC62201181	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP V	"$2,925.00"
HC62805601	CATH THROMBECTOMY/EMBOLECTOMY     V	"$2,925.00"
HC62300223	CATH INTRACARDIAC ECHO/UTZ RPRSD  C	"$2,925.00"
HC62219381	INTRO/SHEATH STEERABLE NON-PEEL   F	"$2,925.00"
HC62228408	SHEATH STEERBL GUIDE SUREFLEX (WATCHMAN)	"$2,925.00"
HC62218631	DEVICE RETRIEVAL                  F	"$2,925.00"
HC62219811	PROGRAMMER NEUROSTIM PAT          F	"$2,925.00"
HC62804927	STENT BILIARY COVRD W/DELSYS      B	"$2,925.00"
HC62803747	STENT NON-COAT/NON-COV W-DEL      V	"$2,925.00"
HC62216957	KIT MONITORING NERVE(S) SPINAL    F	"$2,925.00"
HC62217914	PASSER SUTURE ORTHOPAEDIC        AA	"$2,925.00"
HC62226113	DRILL/DRILL BITS SINGLE USE      AL	"$2,925.00"
HC62226642	TAP SURGICAL                      V	"$2,925.00"
HC62805767	FIBRIN SEALANT                    S	"$2,925.00"
HC73000127	HEMODIALYSIS W/SNGL EVAL(IP)	"$2,923.00"
68546-325-12	GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRG	"$2,916.00"
HC41500166	EEG ROUTINE(AWAKE&ASLEEP)	"$2,911.00"
HC47201165	BRACHYTX INSERT VAG RAD AFTRLOAD DEVICE	"$2,910.00"
HC25003187	LAC REPAIR INTMD N/H/F/GEN >30.0CM	"$2,908.00"
HC27000058	ANOSCOPY W/BLEED CONTROL	"$2,908.00"
HC23001712	N BLOCK INJ PLANTAR DIGIT (MOTONS) BIL	"$2,907.00"
HC47201108	GUIDANCE RADIAJ TX DLVR (TRACKING)	"$2,903.00"
HC46000865	SEL CATH SEGMNT PULM ART LT	"$2,902.00"
HC46000873	SEL CATH SEGMNT PULM ART RT	"$2,902.00"
HC44200160	US DUPLEX ART UP EXT COMP BIL	"$2,902.00"
HC77400067	ANESTHESIA INITIAL HR	"$2,901.00"
HC32010373	OT-EVAL SWALLOW CINE/FLUORO 180MIN	"$2,899.00"
HC33010240	ST-EVAL SWALLOW CINE/FLUORO 180MIN	"$2,899.00"
HC44701167	THROMBOLYSIS CORONARY IV INFUSION	"$2,895.00"
HC51002905	CYSTOURETHRSCPY&/PYELOSCPY FLEX DX	"$2,893.00"
HC45200896	NM THYROID CA METS LTD AREA	"$2,893.00"
HC21000237	DEBRID/REMVL OPEN FX MUSCLE	"$2,890.00"
HC21000559	PREP TRUNK/EXT EA ADDL 100SQCM	"$2,890.00"
HC41500620	STUDIES NERVE CONDUCTN 13/> STUDIES	"$2,890.00"
HC51002897	CYSTOURETHRSCPY W/TX URETER STRICT	"$2,888.00"
HC51003101	DESTROY LESION(S) VULVA SIMPLE	"$2,888.00"
67877-636-33	TOLVAPTAN 30 MG ORAL TAB	"$2,883.15"
67877-636-02	TOLVAPTAN 30 MG ORAL TAB	"$2,883.15"
HC73000044	DIALYSIS CCPD W/SNGL EVAL(IP)	"$2,881.00"
76310-024-25	FOSCARNET 24 MG/ML IV SOLN	"$2,880.00"
76310-024-15	FOSCARNET 24 MG/ML IV SOLN	"$2,880.00"
HC21000229	DEBRID/REMVL OPEN FX SKIN/SBQ	"$2,873.00"
HC45200490	NM LIVER IMAGING W/VASC FLOW	"$2,870.00"
HC36000933	BRONCH W/LUNG BX; EA ADD'L+	"$2,868.00"
HC36800480	BRONCH W/LUNG BX; EACH ADD'L+	"$2,868.00"
HC62804331	COIL EMBOLIZ(BARR PLAT DETACH)    W	"$2,860.00"
HC25003369	REMOVE FB MUSCLE/TNDON SHEATH DEEP/COMP	"$2,858.00"
55150-218-99	EPTIFIBATIDE 0.75 MG/ML IV SOLN	"$2,850.00"
57894-160-01	INFLIXIMAB 100 MG IV SOLR	"$2,850.00"
0472-1992-08	NITROFURANTOIN 25 MG/5 ML ORAL SUSP	"$2,848.32"
HC45200151	NM BRAIN IMAG VASC FLOW ONLY	"$2,847.00"
HC45200268	NM CARDIAC SHUNT DETECTION	"$2,845.00"
HC62228176	ORTH WHO W/NONTORSION JOINTS CUSTOM	"$2,844.00"
HC62219357	GUIDE TRANSPORTAL ACL	"$2,844.00"
HC45200730	NM RED CELL SURVIVAL	"$2,843.00"
HC83000521	PLATELET HLA LR APHER/PHER	"$2,843.00"
HC36800498	BRONCH W/NDL ASP BX(S) EA ADDL+	"$2,839.00"
HC36000842	BRONCH W/NDL ASP BX; EA ADD'L+	"$2,839.00"
25021-189-84	FOSCARNET 24 MG/ML IV SOLN	"$2,836.50"
HC46502043	BX SOFT TISS THIGH/KNEE;SUP LT	"$2,834.00"
HC46502050	BX SOFT TISS THIGH/KNEE;SUP RT	"$2,834.00"
HC41500422	SOMATOSENSORY LOWER LIMBS	"$2,834.00"
HC44901064	CT BREAST 3D RENDER UNILAT W/CONTRAST	"$2,832.00"
HC46502688	FNA ASP BX W/CT; EACH ADD'L LESION	"$2,831.00"
HC47200530	"RAD TREATMENT DELVR, = 1MEV;CMPLX"	"$2,827.00"
HC51002871	CYSTOSCOPY W/REM STNT/FB/CALC COMPLIC	"$2,826.00"
HC45200813	NM TESTICULAR IMAGING W/FLOW	"$2,819.00"
HC44001030	HIP ARTHROGRAM BILAT	"$2,817.00"
68134-201-16	NAPROXEN 125 MG/5 ML ORAL SUSP (MCH)	"$2,817.00"
60505-4705-0	TOLVAPTAN 30 MG ORAL TAB	"$2,812.31"
HC46000394	"INJ PROCEDURE MYELOGRAPHY, LUMBAR"	"$2,810.00"
HC46500112	ASP/INJ THYROID CYST	"$2,809.00"
10019-055-61	"ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP"	"$2,806.50"
HC25003427	CLOSED TX NOSE FX W/ STABILIZATION	"$2,806.00"
54643-9015-2	"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN"	"$2,804.40"
54643-5650-2	"MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN"	"$2,804.40"
0409-1113-01	INDOMETHACIN SODIUM 1 MG IV SOLR	"$2,801.52"
HC45401072	MR BREAST W/O&W CONTRAST LTD LT	"$2,801.00"
HC45401064	MR BREAST W/O&W CONTRAST LTD RT	"$2,801.00"
HC26000125	TRANSABDOMINAL AMNIOINFUSION	"$2,799.00"
61570-260-10	QUINUPRISTIN-DALFOPRISTIN 500 MG IV SOLR	"$2,796.05"
HC45401569	MR ELASTOGRAPHY	"$2,795.00"
HC45200656	NM PERITON VEN SHUNT PATENCY	"$2,795.00"
HC46501938	PERC ASP INTERDISCAL DX	"$2,788.00"
55513-004-04	DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/ML INJ SOLN	"$2,786.40"
55513-023-04	DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJ SYRG	"$2,786.40"
55513-023-01	DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJ SYRG	"$2,786.40"
HC45200326	NM GASTRIC REFLUX STUDY	"$2,781.00"
HC62228135	ORTH EWHO W/NONTORSION JOINT(S) CUSTOM	"$2,779.00"
HC44200996	US OB EVAL PLUS FETAL ANATOMIC DETAIL 1ST GEST	"$2,775.00"
0026-3782-25	KOGENATE FS 250 (+/-) UNIT IV SOLR	"$2,775.00"
HC44500809	ERCP BILIARY&PANCREATIC SYSTEM	"$2,773.00"
HC51003093	BX PROSTATE NDL/PUNCH SGL/MULT	"$2,770.00"
0597-0024-02	IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHALATION MIST	"$2,767.51"
HC41500174	EEG SLEEP(ONLY)	"$2,767.00"
50242-135-01	TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN	"$2,766.96"
HC62228770	NEEDLE 22G SPIN FLEX®(ALWAYS-ON TIP TRACKED®)	"$2,764.00"
HC62211818	CATH ANGIO MICRO(DIAG/MARTHN/EXCLSR)Q	"$2,763.00"
HC62228366	KIT TRANSSEPTAL (WATCHMAN)	"$2,763.00"
HC73000002	DIALYSIS CAPD W/SNGL EVAL(IP)	"$2,762.00"
68382-470-01	INDOMETHACIN SODIUM 1 MG IV SOLR	"$2,760.00"
HC21000849	APPY SKIN SUB HED/HND/FT EA+100SQ~HC	"$2,759.00"
HC25003476	CLOSED TX CLAVICLE FX W/MANIP-BIL	"$2,757.00"
HC45200961	NM TUMOR LOCALIZE PLNR SGL AREA 1 DAY	"$2,757.00"
HC62803283	KIT MONITOR PRESSURE ICP	"$2,751.00"
HC62223946	SYSTEM COLLECTION/TRANSFER FAT	"$2,750.00"
HC45200250	NM CARDIAC SCAN W/EF 1ST PASS	"$2,745.00"
HC83000554	PLATELETPHER LR IRRAD EA UNIT	"$2,743.00"
49452-4050-2	LIDOCAINE HCL (BULK) 100 % MISC POWD	"$2,742.00"
55566-2800-1	DINOPROSTONE 10 MG VAGINAL INSR	"$2,741.94"
55566-2800-0	DINOPROSTONE 10 MG VAGINAL INSR	"$2,741.94"
5846800901	HYLAN G-F 20 16 MG/2 ML INTRAARTIC SYRG	"$2,739.24"
5846800902	HYLAN G-F 20 16 MG/2 ML INTRAARTIC SYRG	"$2,739.24"
HC21000807	"APPY SKIN SUB T,A,L EA+ 100SQ~HC"	"$2,738.00"
HC44000107	ANKLE ARTHROGRAM BILAT	"$2,737.00"
HC62208806	CATH INTRAVASC ULTRASOUND	"$2,737.00"
HC62800412	CATH IVUS PV LARGE VESSEL	"$2,737.00"
HC62800420	CATH IVUS PV SMALL VESSEL	"$2,737.00"
HC44001956	SHOULDER ARTHROGRAM BILAT	"$2,734.00"
0085-1366-03	TEMOZOLOMIDE 100 MG ORAL CAP	"$2,733.60"
HC51061042	"CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST LT"	"$2,731.00"
HC51061059	"CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST RT"	"$2,731.00"
HC51061075	"EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) LT"	"$2,731.00"
HC51061083	"EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) RT"	"$2,731.00"
HC62224571	DEVICE SUTURE ENDOSCOPIC          O	"$2,730.00"
HC44200319	US GUIDE COMP REPR PSEUDOANEUR	"$2,728.00"
0009-3794-01	IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN	"$2,727.18"
0009-3794-22	IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN	"$2,727.18"
HC25002841	I&D HEMATOMA/SEROMA/FLUID COLLECTION	"$2,727.00"
HC25005455	INJ ANES/STEROID NERVE/BRNCH PERIPH BIL	"$2,727.00"
HC44200301	US GUIDANCE INTRAOPERATIVE	"$2,724.00"
27437-206-03	CEFIXIME 200 MG/5 ML ORAL SUSR	"$2,722.20"
HC44200186	US DUPLEX CAROTID COMP BILAT	"$2,719.00"
HC41500810	EEG W/O VID MONITOR INTERMT EA 12-26HR	"$2,716.00"
60505-4704-0	TOLVAPTAN 15 MG ORAL TAB	"$2,710.97"
62935-753-75	LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRG	"$2,710.14"
HC25004144	CLOSED TX ARTICULAR FX W/MANIP EA	"$2,710.00"
HC25000068	CRITICAL CARE EA ADDL 30 MIN	"$2,706.00"
HC21000716	DBRD SKN MUSCL EA ADD 20SQCM/<	"$2,704.00"
HC25004599	REMOVE FB FOOT; SUBC BIL	"$2,701.00"
HC25004607	REMOVE FB FOOT; DEEP LT	"$2,701.00"
HC25004615	REMOVE FB FOOT; DEEP RT	"$2,701.00"
62559-153-04	OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC	"$2,700.31"
HC25001108	INSERT PICC <5 YR AGE W/O IMAGING	"$2,700.00"
14789-011-01	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$2,700.00"
14789-011-07	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$2,700.00"
99999-042-05	AMNIOBAND MEMBRANE (2X4 CM)	"$2,700.00"
HC41500182	ELECTROCORTICOGRAM IN SURGERY	"$2,699.00"
HC25006115	AMNIOCENTESIS	"$2,698.00"
HC62802897	SEALANT PULMONARY (PROGEL)	"$2,698.00"
HC62228978	ORTHOSIS LUMBAR SACRAL SAGCOR RIGID ANT/POST FRAME/PANEL PREFB CUST	"$2,697.00"
HC44001626	MYELOGRAM LUMBOSACRAL	"$2,694.00"
HC45200482	NM LIVER IMAGING STATIC ONLY	"$2,691.00"
HC62205703	PINS CRW HEAD DISP	"$2,688.00"
99999-038-92	POLIHEXANIDE (PURAPLY AM) 2X4 CM EACH TOPICAL SHEET	"$2,688.00"
0944-3051-02	ADVATE 250 (+/-) UNIT IV SOLR	"$2,685.00"
HC62228390	SHEATH TRANSSEPTAL GUIDE KIT(WATCHMAN)	"$2,682.00"
17478-503-05	ETHANOL (ETHYL ALCOHOL) 98 % INJ SOLN	"$2,680.53"
0143-9564-01	PHENTOLAMINE 5 MG INJ SOLR	"$2,674.98"
0143-9564-10	PHENTOLAMINE 5 MG INJ SOLR	"$2,674.95"
0078-0569-61	INTERFERON BETA-1B 0.3 MG SUBCUTANEOUS SOLR	"$2,673.06"
63323-371-10	DAPTOMYCIN 500 MG IV SOLR	"$2,672.88"
63323-871-15	DAPTOMYCIN 500 MG IV SOLR	"$2,672.88"
HC42000737	ECHO 2D LMTD W/O SPEC&DOP W/WO CONTR	"$2,671.00"
0597-0087-17	IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHALATION HFAA	"$2,669.76"
HC44901056	CT BREAST 3D RENDER UNILAT W/O CONTRAST	"$2,664.00"
HC39001151	PHP MENTAL HEALTH TX<24HR	"$2,664.00"
HC45201266	QUANT DIFF PULM PERF	"$2,663.00"
HC45201241	PULM VENTILATION IMAGING	"$2,662.00"
HC41500414	SOMATOSENSORY HEAD/TRUNK	"$2,661.00"
HC62208905	BALLOON VALVULOPLASTY	"$2,657.00"
HC45200169	NM BRAIN IMAGING 4< STATIC VWS	"$2,656.00"
HC73000168	HEMOPERFUSION	"$2,655.00"
HC42000075	CV STRESS TEST PHARMACOLOGIC	"$2,655.00"
HC45200235	NM CARDIAC SCAN	"$2,653.00"
HC21000575	PREP SITE F/N/HF/G EA +100SQCM	"$2,652.00"
0069-1309-01	"EPOETIN ALFA-EPBX 40,000 UNIT/ML INJ SOLN"	"$2,647.20"
0069-1309-04	"EPOETIN ALFA-EPBX 40,000 UNIT/ML INJ SOLN"	"$2,647.20"
HC62807813	M: LINER SHOULDER	"$2,646.00"
13533-335-12	IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH)	"$2,643.90"
13533-335-13	IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH)	"$2,643.90"
67871-4790-6	ETHANOLAMINE OLEATE 5 % IV SOLN	"$2,642.02"
HC25004631	CLOSED TX TARSAL FX; W/MANIPLTN EA	"$2,642.00"
HC44001634	MYELOGRAM THORACIC	"$2,642.00"
HC45201316	NM THYROID SCAN IMAGE ONLY [W/VASC FLOW IF PERF]	"$2,638.00"
HC44500866	GUIDE PERC DRAIN W/CATH PLCMNT	"$2,637.00"
HC44200582	TCD EMBOLI DETECT W/ IV MICROBUBBLE	"$2,637.00"
61314-326-01	FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG	"$2,633.88"
61314-326-10	FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG	"$2,633.88"
HC46500062	ASP&INJ BONE CYST	"$2,630.00"
HC46500732	CT ASP&INJ BONE CYST-LT	"$2,630.00"
HC46500740	CT ASP&INJ BONE CYST-RT	"$2,630.00"
HC45200383	NM INTRAVASCULAR RAD TX	"$2,630.00"
HC62220421	KNIFE ANNULOTOMY (MAXCESS)	"$2,630.00"
HC46000469	INJECTION HIP ARTHROGRAM BIL	"$2,625.00"
8213000013	"PORCINE SUBMUCOSA, MESHED 5 X 7 CM TOPICAL SHEE"	"$2,625.00"
HC41500224	EMG 4 EXTREMITY	"$2,617.00"
99999-038-96	POLIHEXANIDE (PURAPLY) 2X4 CM EACH TOPICAL SHEET	"$2,616.00"
63323-140-10	CLADRIBINE 10 MG/10 ML IV SOLN	"$2,610.00"
0955-1021-04	DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN	"$2,610.00"
HC44500791	ERCP BILIARY DUCT SYSTEM	"$2,606.00"
HC62211776	CATH PTA ANGIOPLS BALLOON NON-LSR Q	"$2,600.00"
HC62214739	CATH PTCA BALLOON NON-LASER       P	"$2,600.00"
HC62208731	CATH BALLOON SINUPLASTY           J	"$2,600.00"
HC62212188	CATH BALLOON SINUPLASTY SYSTEM    J	"$2,600.00"
HC62800230	CATH BALLOON THERMACHOICE         U	"$2,600.00"
HC62805700	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP U	"$2,600.00"
HC62204318	KIT TRANSJUGULAR VENOUS ACCESS	"$2,600.00"
HC62800503	CATH THROMBECTOMY/EMBOLECTOMY     U	"$2,600.00"
HC62803333	DEVICE CLOSURE VASCULAR PLUG      U	"$2,600.00"
HC62806674	INTRO/SHEATH STEERABLE NON-PEEL   E	"$2,600.00"
HC62808399	STENT DES CORO COV W/DEL SYS      E	"$2,600.00"
HC62804919	STENT BILIARY COVRD W/DELSYS      A	"$2,600.00"
HC62803887	STENT CORO BARE METAL W/DEL       E	"$2,600.00"
HC62807441	STENT NON-COAT/NON-COV W-DEL      U	"$2,600.00"
HC62223854	SYSTEM DELIVERY LEAD              K	"$2,600.00"
HC62800396	CATH INTRA AORTIC BALLOON         C	"$2,600.00"
HC62802376	INTRO/SHEATH EP FIXED PEEL       AK	"$2,600.00"
HC62222633	INTRO/SHEATH EP FIXED NON-PEEL    S	"$2,600.00"
HC62226675	INTRODUCER/SHEATH                 X	"$2,600.00"
HC62227145	KIT EXTRACT RESURFAC HIP	"$2,600.00"
HC62200233	ASPIRATOR ULTRASONIC SURG         E	"$2,600.00"
HC62200498	BIO GLUE W/APPLICATOR	"$2,600.00"
HC62216254	STABILIZER HEART OCTOPUS          E	"$2,600.00"
HC62218474	LEAD DELIVERY SYSTEM              J	"$2,600.00"
HC62219589	SHIM DEVICE ACCESS SPINAL        AE	"$2,600.00"
HC62219746	KIT VITRECTOMY PROBE              N	"$2,600.00"
HC62220272	KIT MONITORING NERVE(S) SPINAL    E	"$2,600.00"
HC62220462	MOLD/FORM CEMENT TIBIAL KNEE	"$2,600.00"
HC62221676	GUIDE DRILL TRANSTIBIAL FEMORAL   U	"$2,600.00"
HC62223144	FIBER LASER                       M	"$2,600.00"
HC62223243	PROBE DOPPLER NEURO	"$2,600.00"
HC62223565	DRILL/DRILL BITS SINGLE USE      AK	"$2,600.00"
HC62223961	TAP SURGICAL                      U	"$2,600.00"
HC62224241	SYSTEM DELIVERY SEPTAL DEFECT     U	"$2,600.00"
HC62226451	TIP DISSECTOR MICRO ULTRSONC (SONOPET)	"$2,600.00"
HC62227590	REAMER                           AK	"$2,600.00"
HC62227871	KIT ARTHROSCOPY DISPSBLS          Y	"$2,600.00"
HC62804315	COIL EMBOLIZATION                 U	"$2,600.00"
HC62806765	POUCH/ENVELOPE PACEMAKER          E	"$2,600.00"
HC62807920	SEALANT TISSUE HYDROGEL	"$2,600.00"
HC51061117	CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN	"$2,596.00"
HC44001618	MYELOGRAM CERVICAL	"$2,594.00"
HC44900355	CT LTD OR LOCALIZED F/U STUDY	"$2,589.00"
HC51003358	DILAT CANAL CERV INSTRMNT(SEP PROC)	"$2,586.00"
HC62802822	PROGRAMMER IDD TX (CONTROL)	"$2,584.00"
HC45200391	NM KIDNEY IMAGING MORPHOLOGY	"$2,580.00"
HC45201415	NM MYOCARDIAL SYMPATHETIC INNERV IMAGE	"$2,578.00"
HC21000476	I&D ABSCESS COMPLICATED MULT	"$2,578.00"
HC44900090	CT CHEST/LUNG LOW DOSE SCREENING	"$2,575.00"
HC46000626	INTRO NDL/CATH EXT ART UE OR LE LT	"$2,573.00"
HC46000634	INTRO NDL/CATH EXT ART UE OR LE RT	"$2,573.00"
HC44500726	PERC DIL URETER/URETHRA S&I-LT	"$2,570.00"
HC44500734	PERC DIL URETER/URETHRA S&I-RT	"$2,570.00"
25767-735-49	CUSTODIOL HTK SOLUTION	"$2,568.00"
HC46500757	CYSTOGRAM COMPLEX	"$2,566.00"
HC46001095	INJ ARTHRO/CT/MRI SHOULDER-BIL	"$2,565.00"
HC27001221	SIGMOIDOSCOPY FLEX SCRN (Q48MO)	"$2,565.00"
HC46001012	VENOUS CATH ORGAN BLD SIMPLE	"$2,564.00"
HC84201839	RESP BACTERIA/VIRAL 22 TRGT SARS-COV-2 QUAL RT-PCR(PNL RP2.1)	"$2,563.00"
HC27001189	"M: UNLISTED PROCEDURE, ESOPH"	"$2,561.00"
HC39001169	PARTIAL HOSPITALIZATION SERV	"$2,560.00"
HC25003419	CLOSED TX NOSE FX W/O STABILIZATION	"$2,559.00"
HC46001103	INJ ARTHROGRAM ELBOW-SC BIL	"$2,558.00"
HC46000402	INJ OF GT/COLON TUBE; PATENCY W/IMAG	"$2,554.00"
HC31001845	PT-EVAL HIGH COMPLEXITY 45MIF2F 180MIN	"$2,552.00"
0173-0720-20	FLUTICASONE PROPIONATE 220 MCG/ACTUATION INHALATION HFAA	"$2,551.97"
HC21000393	ESCHAROTOMY; FULL THICK BURN	"$2,550.00"
HC51002848	CYSTOURETHROSCOPY W/DIL BLADDER	"$2,549.00"
HC45200755	NM SALIVARY GLAND W/SER IMAG	"$2,549.00"
HC41500612	STUDIES NERVE CONDUCTN11-12 STUDIES	"$2,547.00"
HC27001247	ESOPH MOTILTY STDY/STIM/PERF2D	"$2,546.00"
HC25001017	CARDIOVERSION EXTERNAL	"$2,546.00"
HC21000955	"APPY SKIN SUB T,A,L EA +25SQ~LC"	"$2,545.00"
HC45201001	NM VASCULAR BLOOD FLOW	"$2,541.00"
HC27000157	CHANGE GT TUBE W/O IMAGE/ENDO	"$2,538.00"
HC25001066	BLOOD PATCH (INJ EPIDURAL)	"$2,538.00"
HC12400123	CHEMO ADMIN PLEURAL CAV W/THORACENTESIS	"$2,536.00"
HC43000629	PUNCTURE ASP CYST BREAST-LT	"$2,535.00"
HC43000546	PUNCTURE ASP CYST BREAST-RT	"$2,535.00"
HC23001530	INJ ANES/STEROID NERVE TRIGEML BRNCH EA BI	"$2,535.00"
HC62203906	KIT HEMOSEEL(SEAL)	"$2,535.00"
HC23000433	INJ ANES/STEROID NERVE SCIATIC LT	"$2,524.00"
HC23000441	INJ ANES/STEROID NERVE SCIATIC RT	"$2,524.00"
HC46502605	INSERT MIDLINE CATH <3 YR AGE	"$2,522.00"
HC32010365	OT-EVAL SWALLOW CINE/FLUORO 150MIN	"$2,520.00"
HC33010232	ST-EVAL SWALLOW CINE/FLUORO 150MIN	"$2,520.00"
HC62805130	M:IMPLANT UROLIFT TIE-BACK (EACH)	"$2,519.00"
68094-101-20	PHENTOLAMINE 5 MG INJ SOLR	"$2,518.80"
51224-012-20	PHENTOLAMINE 5 MG INJ SOLR	"$2,518.80"
51167-661-01	TEZACAFTOR-IVACAFTOR 100-150 MG (D)/ 150 MG (N) ORAL TBSQ	"$2,517.60"
51167-113-01	TEZACAFTOR-IVACAFTOR 50-75 MG (D)/ 75 MG (N) ORAL TBSQ	"$2,517.60"
HC51002855	CYSTOURETHROSCOPY W/DIL STRIC URETH	"$2,515.00"
24208-535-35	GANCICLOVIR 0.15 % OPHT GEL	"$2,510.16"
HC62804000	FILTER VENA CAVA (E.G.OPTEASE)    C	"$2,509.00"
HC46500054	ASP PERC SPINAL CORD CYST	"$2,508.00"
HC51002863	CYSTOSCOPY W/REMV STENT/FB/CALC SIMPL	"$2,504.00"
HC74200296	BEDSIDE/OTHER SURG ADD'L 15MIN 6 (MCAL 1ST SUBSQNT 0.5 HR)	"$2,504.00"
HC74200536	BEDSIDE/OTHER SURG ADD'L 15MIN 6 (MCAL 2ND SUBSQNT 0.5 HR)	"$2,504.00"
HC44000230	BONE SURVEY COMPLETE	"$2,501.00"
HC51062776	CLOSED TX CARPAL BONE FX W/MNPLTN EA BONE	"$2,500.00"
HC44000628	ELBOW ARTHROGRAM BILAT	"$2,500.00"
0046-0872-21	CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM	"$2,496.78"
HC42000067	CV STRESS TEST TREADMILL	"$2,496.00"
HC45200375	NM INTRACAV RADIOAC COLLOID TX	"$2,492.00"
HC51002830	CYSTOURETHROSCOPY W/BX(S)	"$2,487.00"
HC74200064	OR TIME ADD'L 15MIN LVL 1 (MCAL 1ST SUBSQNT 0.5 HR)	"$2,486.00"
HC74200429	OR TIME ADD'L 15MIN LVL 1  (MCAL 2ND SUBSQNT 0.5 HR)	"$2,486.00"
HC78600004	PACU I 1ST HOUR (INITIAL)	"$2,483.00"
HC41500042	CENTRAL MOTOR EVOKED UP LIMBS	"$2,481.00"
HC36001147	TRANSENDOSCOPIC EBUS DURING BRONCH DX OR TX FOR PERIPH NODE(S)+	"$2,479.00"
HC36800845	TRANSENDOSCOPIC EBUS DURING BRONCH DX OR TX FOR PERIPH NODE(S)+	"$2,479.00"
0131-5410-72	LACOSAMIDE 10 MG/ML ORAL SOLN	"$2,478.00"
HC45200318	NM GASTRIC MUCOSA IMAGING	"$2,475.00"
59212-423-04	PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML ORAL ELIX	"$2,471.76"
HC44200590	TCD EMBOLI DETECT W/O IV MICROBUBBL	"$2,471.00"
HC62210752	CATH ACCESS DUODENOSCOPE	"$2,470.00"
HC62804307	COIL EMBOLIZATION                 T	"$2,470.00"
65162-686-90	FELBAMATE 600 MG/5 ML ORAL SUSP	"$2,469.06"
HC46500070	ASP/INJ HYDROCELE	"$2,468.00"
HC47200670	TREATMENT SIMULATION SIMPLE	"$2,468.00"
HC21000708	DBRD SKIN&SUBQ EA ADD 20SQCM/<	"$2,467.00"
HC25005372	DRAIN ABSCESS WALL SCROTAL	"$2,463.00"
HC45200292	NM ESOPHAGEAL MOTILITY	"$2,461.00"
HC44200004	US ABDOMEN	"$2,460.00"
HC45401015	MR BREAST W/O CONTRAST LTD LT	"$2,459.00"
HC45401007	MR BREAST W/O CONTRAST LTD RT	"$2,459.00"
HC45200748	NM RED CELL VOL SNGL SAMPLE	"$2,457.00"
0407-1414-98	IOHEXOL 350 MG IODINE/ML IV SOLN	"$2,454.00"
HC43000041	BREAST BX CORE W/O GUIDE-LT	"$2,450.00"
HC43000058	BREAST BX CORE W/O GUIDE-RT	"$2,450.00"
63323-132-10	MITOXANTRONE 2 MG/ML IV CONC	"$2,445.96"
HC83000562	PLATELETPHER LR/CMV-/IRRAD/U	"$2,439.00"
HC51002731	CYSTOSTOMY(I&D BLADDER)W/W-OUT DRAIN	"$2,438.00"
HC62807433	POLYMER FILLER RING GRAFT/STENT	"$2,438.00"
HC62225024	SET REMOVAL NUCLEUS SPINAL	"$2,431.00"
HC62802764	ADAPT/EXT PACING LEAD SPX	"$2,425.00"
HC44200053	ART STDY BILAT U/L 3/> LVL CMP	"$2,423.00"
60505-0402-5	PAROXETINE HCL 10 MG/5 ML ORAL SUSP	"$2,421.00"
99999-042-04	AMNIOBAND MEMBRANE (2X2 CM)	"$2,418.75"
HC62228127	ORTH EWHO RIGID W/O JOINTS CUSTOM	"$2,418.00"
HC62209259	SYSTEM ANASTOMOSIS DEVICE	"$2,418.00"
HC62220702	KIT ACCESSORY PROSTHESIS PENILE	"$2,412.00"
0078-0357-52	OXCARBAZEPINE 300 MG/5 ML ORAL SUSP (MCH)	"$2,412.00"
HC23000037	ASP/INJ JOINT SM W/O UTZ GUIDE-BILAT	"$2,410.00"
HC36000222	INTUBATION	"$2,407.00"
HC46500765	DECLOTTING IVAD W/THROMBOLYTIC	"$2,407.00"
HC62226105	DRILL/DRILL BITS SINGLE USE      AJ	"$2,405.00"
HC36800134	BRONCHIAL PROVOCATION EVAL	"$2,404.00"
67457-630-10	EPTIFIBATIDE 2 MG/ML IV SOLN	"$2,400.00"
HC62803879	STENT CORO BARE METAL W/DEL       D	"$2,397.00"
HC41500034	CENTRAL MOTOR EVOKED LOW LIMBS	"$2,394.00"
47781-578-07	DEXRAZOXANE HCL 500 MG IV SOLR	"$2,394.00"
72611-716-01	DEXRAZOXANE HCL 500 MG IV SOLR	"$2,394.00"
HC44200129	"US DUPLEX AORTA,IVC,ILIAC COMP"	"$2,388.00"
HC74200304	BEDSIDE/OTHER SURGICAL CANCEL LVL 1	"$2,381.00"
HC41500604	STUDIES NERVE CONDUCTN 9-10 STUDIES	"$2,380.00"
63323-659-09	INDOMETHACIN SODIUM 1 MG IV SOLR	"$2,376.00"
HC51002822	CYSTOURETHROSCOPY W/CATH URETERAL	"$2,373.00"
HC62212832	GUIDEWIRE                        AA	"$2,373.00"
HC62803994	FILTER VENA CAVA  (E.G.TRAPEASE)  B	"$2,373.00"
0074-7269-50	CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN	"$2,371.80"
HC74200411	OR TIME ADD'L 15MIN CASE CX 6 (MCAL 1ST SUBSQNT 0.5 HR)	"$2,370.00"
HC74200635	OR TIME ADD'L 15MIN CASE CX 6 (MCAL 2ND SUBSQNT 0.5 HR)	"$2,370.00"
HC44002368	TOMOGRAM BILAT	"$2,359.00"
HC23001910	INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE	"$2,357.00"
HC23001936	INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE LT	"$2,357.00"
HC23001944	INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE RT	"$2,357.00"
HC42000091	ECHO CONGENITAL LTD OR F/U	"$2,357.00"
HC21000153	ASPIRATION OF ABCESS/CYST	"$2,352.00"
HC44503464	DECLOT IVAD BY THROMBOLYTIC LT	"$2,351.00"
HC44503472	DECLOT IVAD BY THROMBOLYTIC RT	"$2,351.00"
HC46000253	INJ DISKOGRAM CS/TS EA LVL	"$2,351.00"
HC51003853	REPAIR CIRCUMCISION INCOMPLETE	"$2,350.00"
HC47200654	TREATMENT DEVICES INTERMEDIATE	"$2,347.00"
71740-112-30	POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN	"$2,345.94"
HC62800313	CATH EP DX <20 ELECTRODES         N	"$2,340.00"
HC62210760	PROBE BILIARY DIRECT VISUAL	"$2,340.00"
HC62214069	SET AUTOTRANSFUS(CONSTAVAC CBCII)AP	"$2,340.00"
HC62218490	ENDO STAPLER                     AJ	"$2,340.00"
HC62224639	REAMER                           AJ	"$2,340.00"
HC62226592	PROBE SPINAL DISPOSABLE          AC	"$2,340.00"
HC62804299	COIL EMBOLIZATION                 S	"$2,340.00"
HC41500109	EEG AWAKE AND DROWSY	"$2,339.00"
HC25005869	I&D ABSCESS RECTAL	"$2,338.00"
HC23000102	ASP/INJ JOINT LRG W/O UTZ GUIDE-LT	"$2,336.00"
HC23000110	ASP/INJ JOINT LRG W/O UTZ GUIDE-RT	"$2,336.00"
67457-217-20	METHADONE 10 MG/ML INJ SOLN	"$2,333.88"
HC45200664	NM PLASMA VOL MULTI SAMPLE	"$2,333.00"
HC51002764	ASP BLADDER W/INSERT SUPRAPUB	"$2,332.00"
HC74200288	BEDSIDE/OTHER SURG ADD'L 15MIN 5 (MCAL 1ST SUBSQNT 0.5 HR)	"$2,330.00"
HC74200528	BEDSIDE/OTHER SURG ADD'L 15MIN 5 (MCAL 2ND SUBSQNT 0.5 HR)	"$2,330.00"
60793-702-10	"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML IM SYRG"	"$2,328.36"
60793-702-04	"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML IM SYRG"	"$2,328.36"
HC62808746	CATH INDIGO THROMB SEPARATOR L190CM[PENUMBRA]	"$2,325.00"
HC62228788	KIT SPIN PERC®(ALWAYS-ON TIP TRACKED®)	"$2,325.00"
HC62211180	RETRACTOR HEART POSITIONER	"$2,322.00"
HC51002988	INSERT STENT URETHRAL PROSTATIC TEMP	"$2,317.00"
HC45200714	RADIOPHARM' TX; IV ADMIN	"$2,314.00"
HC45200045	NM BONE MARROW LTD AREA	"$2,311.00"
0781-3158-94	BIVALIRUDIN 250 MG IV SOLR	"$2,310.00"
0781-3158-95	BIVALIRUDIN 250 MG IV SOLR	"$2,310.00"
39822-0151-1	LIOTHYRONINE 10 MCG/ML IV SOLN	"$2,310.00"
HC44200392	US OB >1ST TRI/1ST GEST	"$2,309.00"
HC45200805	NM SPLEEN SCAN IMAGING ONLY	"$2,306.00"
71914-162-04	PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML ORAL ELIX	"$2,304.00"
HC44503449	DECLOTTING VASC ACCES/CATH LT	"$2,303.00"
HC44503456	DECLOTTING VASC ACCES/CATH RT	"$2,303.00"
0173-0859-10	FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE INHALATION DSDV	"$2,302.92"
HC23000391	INJ ANES/STEROID BRACHIAL PLEXUS	"$2,298.00"
HC23001621	INJ ANES/STEROID BRACHIAL PLEXUS LT	"$2,298.00"
HC23001613	INJ ANES/STEROID BRACHIAL PLEXUS RT	"$2,298.00"
HC44001451	KNEE 4 OR MORE VWS BILAT	"$2,296.00"
HC46501193	MANOMETRIC STDY VIA NEPHRO LT	"$2,294.00"
HC46501201	MANOMETRIC STDY VIA NEPHRO RT	"$2,294.00"
HC25003351	REMOVE FB MUSCLE/TENDON SHEATH SIMPLE	"$2,290.00"
HC82202300	ELECTRON MICROSCOPY REDUCE SVC	"$2,288.00"
46287-020-04	SPIRONOLACTONE 25 MG/5 ML ORAL SUSP	"$2,286.84"
HC73000275	DIALYSIS URGENT ESRD(OP)CANCEL	"$2,285.00"
3877905519	SODIUM BENZOATE (BULK) MISC POWD	"$2,280.00"
49281-860-10	POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP	"$2,279.58"
49281-860-78	POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP	"$2,279.58"
HC47200803	RADIOPHARM' TX; IV ADMIN	"$2,279.00"
HC62214721	CATH PTA ANGIOPLS BALLOON NON-LSR P	"$2,275.00"
HC62805965	CATH PTCA ANGIOPLASTY NON-LASER   O	"$2,275.00"
HC62806153	CATH BALLOON DUCT LACRIMAL        T	"$2,275.00"
HC62800214	CATH BALLOON PYLORIC              T	"$2,275.00"
HC62208715	CATH BALLOON SINUPLASTY           I	"$2,275.00"
HC62805510	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP T	"$2,275.00"
HC62800289	CATH THROMBECTOMY/EMBOLECTOMY     T	"$2,275.00"
HC62226154	CATH INTRACARDIAC ECHO/UTZ RPRSD  B	"$2,275.00"
HC62212824	GUIDEWIRE                         Z	"$2,275.00"
HC62222088	DEVICE RETRIEVAL                  D	"$2,275.00"
HC62801733	PORT INDWELLING W/CATH            M	"$2,275.00"
HC62804612	STENT DES CORO COV W/DEL SYS      D	"$2,275.00"
HC62807003	STENT NON-COAT/NON-COV W-DEL      T	"$2,275.00"
HC62211735	CATH GUIDING DEFLECTABLE          T	"$2,275.00"
HC62210612	CATH MICRO NEURO(HEADWAY/MAGIC)   N	"$2,275.00"
HC62219464	SYSTEM DELIVERY LEAD              J	"$2,275.00"
HC62223458	INTRODUCER/SHEATH                 W	"$2,275.00"
HC62218177	KIT REPAIR PORT ACCESS LAP-BAND   D	"$2,275.00"
HC62218482	ENDO STAPLER                     AI	"$2,275.00"
HC62219738	KIT VITRECTOMY PROBE              M	"$2,275.00"
HC62220264	KIT MONITORING NERVE(S) SPINAL    D	"$2,275.00"
HC62223136	FIBER LASER                       L	"$2,275.00"
HC62223953	TAP SURGICAL                      T	"$2,275.00"
HC62224506	PROBE LITHOTRIPTOR KIDNEY         T	"$2,275.00"
HC62225784	SYSTEM DRESSING WOUND NEG PRES    T	"$2,275.00"
HC62226097	DRILL/DRILL BITS SINGLE USE      AI	"$2,275.00"
HC62226576	KIT DELIVERY GRAFT	"$2,275.00"
HC62226618	RETRACTOR MIS SPINAL              D	"$2,275.00"
HC62227038	ELECTRODE BIPOLAR ENDO	"$2,275.00"
HC62227970	PASSER SUTURE	"$2,275.00"
68382-997-01	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$2,274.30"
68382-997-10	ARSENIC TRIOXIDE 1 MG/ML IV SOLN	"$2,274.30"
58160-964-12	"RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR"	"$2,274.24"
58160-966-01	"RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR"	"$2,274.24"
50632-010-01	"RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR"	"$2,274.24"
50632-013-01	"RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR"	"$2,274.24"
HC45201019	NM VENOGRAM(THROMBOS)UNILAT LT	"$2,269.00"
HC45201027	NM VENOGRAM(THROMBOS)UNILAT RT	"$2,269.00"
HC23000912	INJ ANES/STEROID NERVE/BRNCH PERIPH LT	"$2,266.00"
HC23000920	INJ ANES/STEROID NERVE/BRNCH PERIPH RT	"$2,266.00"
HC44500692	CORPORA CAVERNOSGRAPHY	"$2,262.00"
HC41500067	DBS CORTICAL MAP INITIAL HR	"$2,261.00"
0575-6200-30	DIAZOXIDE 50 MG/ML ORAL SUSP	"$2,260.80"
HC44500916	INJ PERC EXT PSEUDOANEUR LT	"$2,258.00"
HC44500924	INJ PERC EXT PSEUDOANEUR RT	"$2,258.00"
HC38420071	PERFUSION CARDIOASSIST DC'D PROC	"$2,258.00"
HC62209358	APPLIER PORT RAPIDPORT EZ	"$2,258.00"
24338-132-13	ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR	"$2,257.20"
24338-134-02	ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR	"$2,257.20"
HC44200236	US DUPLEX PENILE VESSEL COMP	"$2,253.00"
HC44001345	IVP ROUTINE	"$2,251.00"
72205-031-01	DECITABINE 50 MG IV SOLR	"$2,250.00"
25021-231-20	DECITABINE 50 MG IV SOLR	"$2,250.00"
HC62219167	CATH ATRIOSEPTISTOTOMY	"$2,243.00"
HC44000206	"XR COLON DOUBLE CONTRAST INC SCOUT,DELAYED"	"$2,241.00"
58394-633-03	BENEFIX 250 UNIT IV SOLR	"$2,235.00"
HC21000997	APPY SKIN SUB HEAD/HND/FT EA+25SQ~LC	"$2,234.00"
HC44701233	INSTILL FIBRIN CT INIT' DAY LT	"$2,233.00"
HC44701217	INSTILL FIBRIN CT INIT' DAY RT	"$2,233.00"
HC47200209	INTRACAVITARY TREATMT SIMPLE	"$2,233.00"
HC62208814	CATH PACING TRANSESOPHAGEAL	"$2,232.00"
HC44000008	3D RENDER W/ INDEPNDNT WORKSTN	"$2,228.00"
HC62208236	DRAIN PLEURAL W/VAC BOTTLE	"$2,223.00"
HC47200316	PHYSICS CONSULT SPECIAL	"$2,222.00"
HC21000302	DEBRIDE SKIN EXT UP TO 10% BSA	"$2,220.00"
10019-939-50	CYCLOPHOSPHAMIDE 1 GRAM IV SOLR	"$2,220.00"
10019-939-01	CYCLOPHOSPHAMIDE 1 GRAM IV SOLR	"$2,220.00"
HC62217724	AWL SPINAL SINGLE PATIENT USE     X	"$2,210.00"
HC62229109	GUIDE PIN ORTHO                   U	"$2,210.00"
HC62804281	COIL EMBOLIZ(CONCERTO HELIX NYLON)R	"$2,210.00"
HC62803861	STENT CORO BARE METAL W/DEL       C	"$2,207.00"
HC25005315	I&D ABSCESS SUBMUCSL RECTUM	"$2,206.00"
HC51003861	FRENULOTOMY PENIS	"$2,204.00"
HC44001295	INTRODUCE TUBE GASTROINTESTINAL LONG	"$2,201.00"
70860-218-03	CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN	"$2,197.50"
10019-955-01	CYCLOPHOSPHAMIDE 500 MG IV SOLR	"$2,197.50"
10019-955-50	CYCLOPHOSPHAMIDE 500 MG IV SOLR	"$2,197.50"
HC51001360	CLOSED TX KNEE FX(S)	"$2,196.00"
HC41500463	VISUAL EVOKED RESP CNS/FLASH	"$2,192.00"
49281-752-22	TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN	"$2,191.68"
49281-752-98	TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN	"$2,191.68"
HC38420014	COLLECT AUTOLOGUS BLD INL' 2 HR	"$2,191.00"
HC44504512	PERC PLCMT TISS SOFT DEV ADDL LESN+	"$2,189.00"
0078-0686-15	ELTROMBOPAG 50 MG ORAL TAB	"$2,184.34"
0078-0686-55	ELTROMBOPAG 50 MG ORAL TAB	"$2,184.33"
58181-3041-5	LOMUSTINE 40 MG ORAL CAP (MCH)	"$2,183.34"
HC46502662	FNA ASP BX W/FLUORO; EACH ADD'L LESION	"$2,180.00"
HC36000255	TRACH TUBE CHANGE	"$2,180.00"
42023-118-01	TRIMETHOBENZAMIDE 100 MG/ML IM SOLN	"$2,178.60"
HC62212816	GUIDEWIRE                         Y	"$2,178.00"
HC44200038	US ART NONINVAS REST/STRES LEA	"$2,176.00"
HC62217385	DEVICE FIXATION TACKER(LAP)	"$2,176.00"
HC12400115	INITIATE PROLONG CHEMO INFUSION PORTBL PUMP &F/U VISIT	"$2,175.00"
HC44500650	PERC DRAINAGE TUBE/CATH	"$2,172.00"
HC51002814	CYSTOURETHROSCOPY(SEPARATE PROC)	"$2,163.00"
HC45200334	NM GASTROINTEST PROTEIN LOSS	"$2,162.00"
HC41500000	AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R	"$2,162.00"
HC41500547	AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R	"$2,162.00"
HC44200541	US RETROPERITONEAL COMPLETE	"$2,160.00"
HC83000513	PLATELET PHERESIS EA UNIT	"$2,160.00"
17478-380-20	METHADONE 10 MG/ML INJ SOLN	"$2,160.00"
HC44200269	US DUPLEX VEIN EXT UNILAT/LTD	"$2,159.00"
HC74200270	BEDSIDE/OTHER SURG ADD'L 15MIN 4 (MCAL 1ST SUBSQNT 0.5 HR)	"$2,157.00"
HC74200510	BEDSIDE/OTHER SURG ADD'L 15MIN 4 (MCAL 2ND SUBSQNT 0.5 HR)	"$2,157.00"
HC83000547	PLATELET PHERESIS IRRD EA UNIT	"$2,154.00"
HC41500216	EMG 3 EXTREMITY	"$2,153.00"
0456-2700-01	CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR	"$2,152.86"
0456-2700-10	CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR	"$2,152.85"
HC62203021	ENDOSCOPIC SYSTEM	"$2,150.00"
HC62227004	DEVICE INFLATN ACCESS ABD	"$2,150.00"
HC46001046	INJ PERC EXT PSEUDOANEUR	"$2,146.00"
HC62227186	REAMER                           AG	"$2,145.00"
HC62218987	DRILL/DRILL BITS SINGLE USE      AH	"$2,145.00"
HC62224845	KIT PLACEMENT SHUNT ELECTROMAGNETIC	"$2,145.00"
HC44002079	"XR SMALL BOWEL W/DOUBLE CONTRAST INC SCOUT,SERIAL"	"$2,144.00"
HC32010357	OT-EVAL SWALLOW CINE/FLUORO 120MIN	"$2,143.00"
HC33010224	ST-EVAL SWALLOW CINE/FLUORO 120MIN	"$2,143.00"
HC74200403	OR TIME ADD'L 15MIN CASE CX 5 (MCAL 1ST SUBSQNT 0.5 HR)	"$2,141.00"
HC74200627	OR TIME ADD'L 15MIN CASE CX 5 (MCAL 2ND SUBSQNT 0.5 HR)	"$2,141.00"
0009-0856-08	CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN	"$2,137.23"
0009-0856-05	CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN	"$2,137.23"
0472-0082-16	ACYCLOVIR 200 MG/5 ML ORAL SUSP	"$2,137.01"
50383-810-16	ACYCLOVIR 200 MG/5 ML ORAL SUSP	"$2,137.01"
0378-8712-73	ACYCLOVIR 200 MG/5 ML ORAL SUSP	"$2,137.01"
HC47200498	"RAD TREATMENT DELVR, = 1MEV;INTRMED"	"$2,137.00"
HC83000067	PLATELET LR APHER/PHER EA UNIT	"$2,137.00"
HC62213756	KIT VITREORETINAL PERFLUORON 7ML	"$2,131.00"
HC25006123	AMNIOCENTESIS FLUID REDUCTION	"$2,129.00"
65250-266-20	BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP	"$2,127.12"
65250-266-09	BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP	"$2,127.12"
HC31001837	PT-EVAL HIGH COMPLEXITY 45MIF2F 150MIN	"$2,126.00"
HC36800290	PNEUMOGRAM 12-24HR REC INFANT	"$2,125.00"
HC62228614	WOUND FILLER GEL(PLUROGEL)-14.1OZ	"$2,124.00"
0641-6040-01	MORPHINE (PF) 25 MG/ML INJ SOLN	"$2,121.96"
HC41500802	EEG W/O VID UNMONITOR EA 12-26HR	"$2,121.00"
0781-7117-35	CALCIPOTRIENE 0.005 % TOPICAL CREAM	"$2,120.76"
16714-885-02	ACYCLOVIR 5 % TOPICAL OINT	"$2,117.88"
HC62228572	DEVICE EXCHANGE	"$2,113.00"
HC62806500	PROBE TEMPERATURE ESOPHAGEAL	"$2,113.00"
HC62205745	PRESSURE WIRE	"$2,113.00"
HC62223581	SEALER VESSEL LAPAROSCOPIC	"$2,113.00"
HC21000781	"APPY SKIN SUB T,A,L EA +25SQ~HC"	"$2,112.00"
HC46000683	"INJ PROC;TRACER, SENTINEL NODE"	"$2,108.00"
HC44001311	IVP DRIP OR BOLUS W/TOMO	"$2,107.00"
HC25002833	I&D POLINIDAL CYST; COMPLICATED	"$2,106.00"
0006-3823-10	CASPOFUNGIN 70 MG IV SOLR	"$2,105.28"
HC25000225	TRACHEOSTOMY	"$2,105.00"
0187-0658-20	DIAZEPAM 5-7.5-10 MG RECTAL KIT	"$2,104.50"
HC23000557	INJ CERVICAL PLEXUS BLOCK	"$2,104.00"
HC23001597	INJ CERVICAL PLEXUS BLOCK LT	"$2,104.00"
HC23001589	INJ CERVICAL PLEXUS BLOCK RT	"$2,104.00"
HC23001878	INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE	"$2,102.00"
HC23001894	INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE LT	"$2,102.00"
HC23001902	INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE RT	"$2,102.00"
HC25005935	PARACENTESIS EYE W/REMOVAL AQUEOUS LT	"$2,102.00"
HC25005943	PARACENTESIS EYE W/REMOVAL AQUEOUS RT	"$2,102.00"
HC62228846	TEMPLATE BRACHYTHERAPY            U	"$2,100.00"
42658-010-01	CLADRIBINE 10 MG/10 ML IV SOLN	"$2,100.00"
0143-9871-01	CLADRIBINE 10 MG/10 ML IV SOLN	"$2,100.00"
25021-830-82	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$2,100.00"
HC25003252	LAC REPAIR INTMD F/E/E/N/L/MM  >30.0CM	"$2,097.00"
0703-4636-01	STREPTOZOCIN 1 GRAM IV SOLR	"$2,095.38"
HC62803309	CATH VENTRICL EXT DRAIN/MONITR	"$2,093.00"
HC23000482	INJ ANES/STEROID NERVE VAGUS	"$2,088.00"
HC83001206	PLATELET LR PHER EA UNIT	"$2,088.00"
HC83001008	PLATELET LR PHER EA UNIT -SB	"$2,088.00"
25021-309-82	"ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP"	"$2,087.40"
HC41500596	STUDIES NERVE CONDUCTN 7-8 STUDIES	"$2,084.00"
HC62204763	MORCELLATOR	"$2,084.00"
HC25000175	FB REMOVAL SQ SIMPLE	"$2,083.00"
HC41500141	EEG MONITORING 41-60MINUTES	"$2,080.00"
HC62215496	PROBE SPINAL DISPOSABLE          AA	"$2,080.00"
HC62226485	WAND LARYNGEAL	"$2,080.00"
HC62804273	COIL EMBOLIZATION                 Q	"$2,080.00"
HC79200036	"MUSCLE TEST, FOUR LIMBS"	"$2,074.00"
HC44200384	US KIDNEY TRANSPLANT W/DOPLER	"$2,073.00"
69344-102-33	INDOMETHACIN 50 MG RECTAL SUPP	"$2,070.00"
HC62808951	DEVICE SUTURE ENDO X-TACK	"$2,067.00"
42023-104-05	TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN	"$2,066.46"
0469-0420-99	ISAVUCONAZONIUM SULFATE 372 MG IV SOLR	"$2,064.12"
HC41500786	EEG W/O VID MONITOR INTERMIT 2-12HR	"$2,059.00"
HC26000117	POSTPARTUM CARE	"$2,058.00"
0517-6560-01	SELENIUM 60 MCG/ML IV SOLN	"$2,058.00"
0517-6560-25	SELENIUM 60 MCG/ML IV SOLN	"$2,058.00"
0517-6560-05	SELENIUM 60 MCG/ML IV SOLN	"$2,058.00"
50458-295-15	ITRACONAZOLE 10 MG/ML ORAL SOLN	"$2,056.50"
HC25005174	DRAIN ABSCESS LYMPH NODE/LYMPHADENITIS; SIMPLE	"$2,056.00"
HC25000027	ED LEVEL III - INTERMEDIATE	"$2,056.00"
HC44500932	INJ SCLEROTHERAPY MULT VEINS-LT	"$2,055.00"
HC44500940	INJ SCLEROTHERAPY MULT VEINS-RT	"$2,055.00"
HC42000141	ECHO 2D LMTD W/O SPEC&CLR /DOP	"$2,054.00"
HC47201017	MANAGE RAD TREATMENT INTRAOP	"$2,049.00"
HC62204029	KIT LASER VEIN ABLATION	"$2,049.00"
HC62211149	OXYGENATOR PEDIATRIC              C	"$2,048.00"
HC62220108	ACCESS PORTL TRANSJUG INTRAHEP HSKL	"$2,048.00"
HC77400141	ANESTHESIA INIT'L HR CASE CX	"$2,046.00"
HC44002277	TMJ ARTHROGRAM BILAT	"$2,044.00"
0046-0749-05	CONJUGATED ESTROGENS 25 MG INJ SOLR	"$2,041.86"
HC46502647	FNA ASP BX W/US; EACH ADD'L LESION	"$2,039.00"
HC44501229	PLACE TUBE NASO/ORO-GASTRIC BY MD W/FLUORO	"$2,039.00"
HC62219688	DILATOR SPINE/NERVE NEUROVISION	"$2,038.00"
HC51003077	DRAIN ABSCESS WALL SCROTAL	"$2,034.00"
HC44001758	PYELOGRAM RETROGRADE	"$2,034.00"
HC33000373	ST-SWALLOWING EVAL 180MIN	"$2,034.00"
16714-859-01	CYCLOPHOSPHAMIDE 500 MG IV SOLR	"$2,033.34"
HC44000222	BONE LENGTH STUDIES	"$2,033.00"
HC26000190	L&D EVAL LEVEL V - COMPREHENSV	"$2,033.00"
HC21000401	EXCISION OF NAIL/MATRIX PERM	"$2,030.00"
HC44200525	US PELVIC(NON OB)	"$2,030.00"
HC32001745	OT-EVAL HIGH COMPLEXITY 45MF2F 180MIN	"$2,030.00"
HC51003895	BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S)	"$2,028.00"
0006-3822-10	CASPOFUNGIN 50 MG IV SOLR	"$2,026.26"
HC45201308	NM THYROID UPTAKE (PROBE) ONLY SNGL/MULT QNT MSRMT	"$2,025.00"
HC62802814	BALLOON HDR APPLICATOR	"$2,022.00"
HC62807789	M: PIN CABLE	"$2,022.00"
HC12200259	INITIATE PROLONG THERA INFUSION VIA PUMP	"$2,021.00"
HC44200335	US HEAD	"$2,017.00"
HC62216932	ENDO STAPLER                     AE	"$2,015.00"
HC62223557	DRILL/DRILL BITS SINGLE USE      AG	"$2,015.00"
HC62227582	REAMER                           AH	"$2,015.00"
0006-3061-00	FOSAPREPITANT 150 MG IV SOLR	"$2,007.78"
0006-3061-01	FOSAPREPITANT 150 MG IV SOLR	"$2,007.78"
HC12400065	CHEMO ADMIN CNS W/SPINAL PUNCTURE	"$2,006.00"
65862-752-50	CEFIXIME 200 MG/5 ML ORAL SUSR	"$2,004.60"
55513-924-91	FILGRASTIM 300 MCG/0.5 ML INJ SYRG	"$2,002.20"
HC25005604	DRAIN EXTERNAL EAR LESION SIMPLE BIL	"$2,000.00"
HC25005620	DRAIN EXTERNAL EAR LESION COMPLEX LT	"$2,000.00"
HC25005612	DRAIN EXTERNAL EAR LESION COMPLEX RT	"$2,000.00"
99999-000-19	DINOPROSTONE (PROSTIN E2) 3 MG VAGINAL SUPPOSITORY	"$1,997.28"
68462-564-35	MUPIROCIN CALCIUM 2 % TOPICAL CREAM	"$1,994.76"
51672-1370-2	MUPIROCIN CALCIUM 2 % TOPICAL CREAM	"$1,994.76"
16714-055-02	MUPIROCIN CALCIUM 2 % TOPICAL CREAM	"$1,994.76"
HC21000468	I&D ABSCESS SIMPLE SNGL	"$1,993.00"
HC43000157	MAMMO DUCTO/GALACTO INJ-LT	"$1,992.00"
HC43000165	MAMMO DUCTO/GALACTO INJ-RT	"$1,992.00"
HC12400057	INITIATE PROLONG CHEMO INFUSION VIA PUMP	"$1,992.00"
HC62220546	CUTTER LAPAROSCOPIC               S	"$1,990.00"
55513-478-01	"EPOETIN ALFA 20,000 UNIT/ML INJ SOLN"	"$1,989.60"
HC44900827	CT COLONOGRAPHY SCREEN VIRTUAL W&WO CONTRAST	"$1,988.00"
HC45200003	CARDIAC BLOOD POOL 1ST PASS+	"$1,988.00"
HC25000092	CPR	"$1,986.00"
HC21000161	ASPIRATION OF ABCESS/CYST-ADDL	"$1,984.00"
HC62219944	KNIFE BAYONET                     K	"$1,983.00"
HC44701241	INSTILL FIBRIN CT SUB' DAY LT	"$1,978.00"
HC44701225	INSTILL FIBRIN CT SUB' DAY RT	"$1,978.00"
HC51003036	BIOPSY PENIS(SEPARATE PROC)	"$1,978.00"
HC46000774	SEL CATH AB/PEL/LOEX 2ND+ORD LT	"$1,976.00"
HC46000782	SEL CATH AB/PEL/LOEX 2ND+ORD RT	"$1,976.00"
HC46001087	SEL CATH AB/PEL/LOEX2ND+ORDERT	"$1,976.00"
HC62800115	BALLOON TAMPONADE UTERINE	"$1,976.00"
HC62800123	BALLOON UTERINE	"$1,976.00"
16714-767-01	CEFIXIME 200 MG/5 ML ORAL SUSR	"$1,972.50"
HC44200418	US OB 1ST TRI/1ST GEST	"$1,967.00"
HC41500836	EEG W/VIDEO UNMONITOR 2-12 HR	"$1,967.00"
HC25001082	INSERT CT(OPEN) W/DRAIN SYSTEM LT	"$1,966.00"
HC25001090	INSERT CT(OPEN) W/DRAIN SYSTEM RT	"$1,965.00"
HC83001248	PLATELET PHERESIS PATHOGEN REDUCED EA UNIT	"$1,963.00"
HC62211255	SYSTEM DELIVERY SEPTAL DEFECT	"$1,963.00"
HC62211263	SYSTEM EXCHANGE SEPTAL DEFECT	"$1,963.00"
HC12400008	CHEMO ADMIN IV INITIAL HR	"$1,961.00"
78206-127-01	MOMETASONE-FORMOTEROL 100-5 MCG/ACTUATION INHALATION HFAA	"$1,959.67"
0469-0871-30	ADENOSINE IV INFUSION	"$1,959.66"
HC25002866	DEBRIDE/REMOVL OPEN FX SKIN/SBQ	"$1,958.00"
HC36800084	BRONCH THERAPEUTIC DC'D PROC	"$1,958.00"
HC36800514	BRONCH THERAPEUTIC DC'D PROC	"$1,958.00"
HC36000958	BRONCH THERAPEUTIC DC'D PROC	"$1,958.00"
HC38420006	REMOVAL IABP DEVICE; PERC	"$1,954.00"
HC44000768	FEMUR 2/> VIEWS BILAT	"$1,951.00"
HC62214713	CATH PTCA BALLOON NON-LASER       N	"$1,950.00"
HC62224928	CATH BALLOON DIL NON VASCULAR     S	"$1,950.00"
HC62805957	CATH EP/ABLAT NOT COOL-TIP/3D/V MAP S	"$1,950.00"
HC62807599	KIT CATH HEMO/PERI DIALYS LG TRM  S	"$1,950.00"
HC62805973	INTRO/SHEATH STEERABLE NON-PEEL   C	"$1,950.00"
HC62210604	GUIDEWIRE(MIRAGE/X-CELERATOR)     X	"$1,950.00"
HC62205976	DEVICE RETRIEVAL                  C	"$1,950.00"
HC62803739	STENT NON-COAT/NON-COV W-DEL      S	"$1,950.00"
HC62805528	CATH GUIDING CARDIAC              S	"$1,950.00"
HC62210596	CATH THROMBECT DELIV INCL NEURO   M	"$1,950.00"
HC62223755	SYSTEM DELIVERY LEAD              I	"$1,950.00"
HC62225057	INTRO/SHEATH EP FIXED NON-PEEL    Q	"$1,950.00"
HC62227129	INTRODUCER/SHEATH                 V	"$1,950.00"
HC62805668	INTRO/SHEATH EP LASER             P	"$1,950.00"
HC62203302	FIBRIN SEALANT                    P	"$1,950.00"
HC62215082	BLADE CUP                        AB	"$1,950.00"
HC62215447	KIT DECOMPRESSION SPINAL          C	"$1,950.00"
HC62216924	ENDO STAPLER                     AD	"$1,950.00"
HC62217328	RETRACTOR MIS SPINAL              C	"$1,950.00"
HC62217716	AWL SPINAL SINGLE PATIENT USE     V	"$1,950.00"
HC62218169	KIT REPAIR PORT ACCESS LAP-BAND   C	"$1,950.00"
HC62218227	CATH DIAGNOSTIC                   S	"$1,950.00"
HC62219936	DISSECTOR ULTRASONIC CORDLESS	"$1,950.00"
HC62220256	KIT MONITORING NERVE(S) SPINAL    C	"$1,950.00"
HC62220876	BLADE INCISIONAL                  V	"$1,950.00"
HC62221890	TAP SURGICAL                      S	"$1,950.00"
HC62222666	TUBING ASPIRATOR ULTRASONIC       S	"$1,950.00"
HC62222880	PAIN PUMP W/ SYSTEM               S	"$1,950.00"
HC62223086	TUBING ASPIRATOR (SONASTAR)       S	"$1,950.00"
HC62223623	SNARE                             S	"$1,950.00"
HC62223771	DISSECTOR BALLOON ENDOSCOPIC      F	"$1,950.00"
HC62224613	SEALER VESSEL ROBOTIC	"$1,950.00"
HC62224795	HANDPIECE VESSEL SEALER DEVICE    F	"$1,950.00"
HC62225438	GRASPER TWIN ENDOSCOPIC	"$1,950.00"
HC62225727	SHEARS COAGULATING HARMONIC       T	"$1,950.00"
HC62225735	ASPIRATOR ULTRASONIC SURG         C	"$1,950.00"
HC62226329	PIN/WIRE FIXATION TEMPORARY      AM	"$1,950.00"
HC62226493	CABLE LIGHT MIS SPINAL DISP	"$1,950.00"
HC62227632	CANNULA PERFUSION RETROGRADE	"$1,950.00"
HC62227954	SYSTEM DRESSING WOUND NEG PRES S	"$1,950.00"
HC62804265	COIL EMBOLIZATION                 P	"$1,950.00"
HC62807342	CLIP ENDOSCOPIC                   S	"$1,950.00"
HC44200624	US TRANSRECT PROSTATE VOL STDY	"$1,949.00"
HC44200749	US GUIDE FNA LT	"$1,949.00"
HC44200756	US GUIDE FNA RT	"$1,949.00"
HC44200764	US GUIDE PLCMNT LT	"$1,949.00"
HC44200707	US GUIDE PLCMNT NEEDLE LOC	"$1,949.00"
HC44200780	US GUIDE PLCMNT NEEDLE LOC LT	"$1,949.00"
HC44200798	US GUIDE PLCMNT NEEDLE LOC RT	"$1,949.00"
HC44200772	US GUIDE PLCMNT RT	"$1,949.00"
0173-0717-22	FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION INHALATION HFAA	"$1,947.36"
HC21000690	APPLY MULTILAY COMPRS BK BIL	"$1,943.00"
HC36800050	BRONCH DIAGNOSTIC DC'D PROC	"$1,943.00"
HC36000941	BRONCH DIAGNOSTIC DC'D PROC	"$1,943.00"
HC51010148	DESTRUCT OTHER PERIPH NERV/BRNCH BI	"$1,940.00"
67457-657-25	"ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP"	"$1,938.00"
25021-308-84	"ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP"	"$1,938.00"
63323-526-03	ARGATROBAN 100 MG/ML IV SOLN	"$1,938.00"
HC44200152	US DUPLEX ART LOW EXT UNILAT/LTD	"$1,931.00"
HC73000176	HEMOPERFUSION DRY RUN	"$1,931.00"
HC44200566	US SCROTUM	"$1,930.00"
HC43000371	US GUIDE FNA	"$1,930.00"
HC25001512	PARACENTESIS ABD W/ IMAGING	"$1,929.00"
11980-180-10	PREDNISOLONE ACETATE 1 % OPHT DRPS	"$1,924.86"
HC42000919	ECG EXT HOLTER >7DAYS-15DAYS; SCANNING ANYS W/REPORT	"$1,923.00"
HC62228697	DEVICE SUTURE CAPIO	"$1,920.00"
HC44200111	US DUPLEX ABD/PEL FLOW LTD	"$1,919.00"
HC74200395	OR TIME ADD'L 15MIN CASE CX 4 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,919.00"
HC74200619	OR TIME ADD'L 15MIN CASE CX 4 MCAL (2ND SUBSQNT 0.5 HR)	"$1,919.00"
HC46500617	CHANGE CYSTOSTOMY TUBE; SIMPLE	"$1,918.00"
HC44001493	KNEE ARTHROGRAM LT	"$1,918.00"
HC44001501	KNEE ARTHROGRAM RT	"$1,918.00"
HC25000894	ASP/INJ LARGE JOINT-BILAT	"$1,917.00"
43598-698-58	CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN	"$1,913.94"
43598-698-11	CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN	"$1,913.94"
43598-917-11	CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN	"$1,913.94"
43598-917-58	CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN	"$1,913.94"
HC73000234	DIALYSIS CRRT CANCEL-MED NEC	"$1,911.00"
HC42000331	ECG EXT HOLTER UP TO 48HRS; SCANNING ANYS & REPORT	"$1,910.00"
HC21000914	APPLY MULTILAY COMPRS UPREX B	"$1,908.00"
HC23000656	INJ ANES/STEROID NERVE FEMORAL LT	"$1,908.00"
HC23000664	INJ ANES/STEROID NERVE FEMORAL RT	"$1,908.00"
HC62209150	KIT TISSUE EXPANDER	"$1,908.00"
HC25005737	CLOSED TX HIP FX W/MANIP BIL	"$1,905.00"
HC42000166	ECHO DOPPLER COMPLETE	"$1,904.00"
HC12200325	IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON)	"$1,904.00"
0944-2724-03	"HYALURONIDASE, HUMAN RECOMB. 2,400 UNIT/15 ML SUBCUTANEOUS SOLN"	"$1,903.50"
HC36800894	BRONCH W/COMPTR-ASST IMAGE-GUIDE NAVIGATE+	"$1,903.00"
HC36001188	BRONCH W/COMPTR-ASST IMAGE-GUIDE NAVIGATE+	"$1,903.00"
0781-3056-70	ISONIAZID 100 MG/ML INJ SOLN	"$1,901.16"
HC43000736	US GUIDE CYST ASPIRATION LT	"$1,900.00"
HC43000744	US GUIDE CYST ASPIRATION RT	"$1,900.00"
HC89022792	TARGETED GENOME PNL SEQ 51/>GENES-AU	"$1,900.00"
HC44200178	US DUPLEX ART UP EXT UNILAT/LTD	"$1,900.00"
72769-181-01	PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN	"$1,899.96"
72769-181-03	PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN	"$1,899.96"
61364-181-03	PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN	"$1,899.96"
0065-8531-10	CIPROFLOXACIN-HYDROCORTISONE 0.2-1 % OTIC DRPS	"$1,895.22"
59572-220-16	THALIDOMIDE 200 MG ORAL CAP	"$1,895.03"
70408-644-34	THEOPHYLLINE 80 MG/15 ML ORAL ELIX	"$1,892.95"
HC44200640	US TRANSVAGINAL(NON OB)	"$1,887.00"
HC44001428	KNEE 3 VIEWS BILAT	"$1,885.00"
HC62213616	REAMER                            AF	"$1,885.00"
HC62216916	ENDO STAPLER                     AC	"$1,885.00"
HC62218979	DRILL/DRILL BITS SINGLE USE      AF	"$1,885.00"
HC44000131	ANKLE COMP MIN 3 VWS BILAT	"$1,880.00"
HC44200368	US INFANT HIPS(DYNAMIC)	"$1,880.00"
HC44201002	US OB EVA PLUS FETAL ANATOMIC DETAIL EA ADL GEST+	"$1,875.00"
HC32001570	OT-EVAL DRIVING REHAB/W	"$1,874.00"
HC23001407	INJ CER/THR F/IMAGE 3RD+&LVLLT LT	"$1,873.00"
HC23001399	INJ CER/THR F/IMAGE 3RD+&LVLRT RT	"$1,873.00"
HC44002509	UROGRAPHY ANTEGRADE	"$1,872.00"
99999-042-14	VANCOMYCIN 250 MG / 5 ML ORAL SYRINGE	"$1,872.00"
HC25005349	HEMORRHOIDECTOMY/BANDING	"$1,870.00"
0085-2223-01	MOMETASONE-FORMOTEROL 50-5 MCG/ACTUATION INHALATION HFAA	"$1,868.10"
HC36800852	TEST EXERC BRONCHOSPASM INCL SPIR&POX W/O ECG	"$1,864.00"
0065-0246-10	BETAXOLOL 0.25 % OPHT DRPS	"$1,863.18"
HC51002657	I&D ABSCESS RECTAL	"$1,863.00"
HC21000294	DEBRIDE P-THICK BURN LG>10%BSA	"$1,861.00"
HC74200262	BEDSIDE/OTHER SURG ADD'L 15MIN 3 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,860.00"
HC74200502	BEDSIDE/OTHER SURG ADD'L 15MIN 3 (MCAL 2ND SUBSQNT 0.5 HR)	"$1,860.00"
0054-3722-63	PREDNISONE 5 MG/5 ML ORAL SOLN	"$1,860.00"
HC21000765	COMPARTM'L PRESSURE MEASURM'NT	"$1,859.00"
HC25006164	TRANSABDOMINAL AMNIOINFUSION	"$1,858.00"
13517-100-30	DIAZOXIDE 50 MG/ML ORAL SUSP	"$1,857.78"
55513-021-04	DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJ SYRG	"$1,857.60"
55513-021-01	DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJ SYRG	"$1,857.60"
HC41000068	POLYSMNGRPH 4+STG6&> ATTD DISCONT'	"$1,857.00"
HC43000611	PUNC ASP CYST BREAST EA ADD+LT	"$1,856.00"
HC43000553	PUNC ASP CYST BREAST EA ADD+RT	"$1,856.00"
HC43000322	PUNC CYST ASP BREAST ADD'L	"$1,856.00"
HC46502621	INJECT URETEROGRAPH VIA ILEAL CONDUIT	"$1,856.00"
HC62212808	GUIDEWIRE                         W	"$1,853.00"
HC44002905	SPINE ENTIRE SKULL-SACRUM 6/> VIEWS	"$1,852.00"
0169-3687-12	INSULIN DETEMIR U-100 100 UNIT/ML SUBCUTANEOUS SOLN	"$1,848.84"
HC46000287	INJ FOR CYSTOGRAM	"$1,847.00"
HC47200308	PHYSICS CONSULT CONTINUOUS	"$1,847.00"
HC62228986	STYLET PROBE NAVIGATION	"$1,846.00"
HC23001688	INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS LT	"$1,845.00"
HC23000797	INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS NERVE	"$1,845.00"
HC23001670	INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS RT	"$1,845.00"
0085-4350-01	INTERFERON ALFA-2B 10 MILLION UNIT (1 ML) INJ SOLR	"$1,843.80"
HC62228747	BRUSH(ALWAYS-ON TIP TRACKED®)	"$1,843.00"
HC62228754	FORCEPS(ALWAYS-ON TIP TRACKED®)	"$1,843.00"
HC62228762	NEEDLE 19G HISTO(ALWAYS-ON TIP TRACKED®)	"$1,843.00"
HC24000093	HBO TX EA 1/2 HR COMPLEX/M	"$1,842.00"
HC44200616	TRANSCRANIAL DOPPLER STUDY LTD	"$1,837.00"
HC23000466	INJ ANES/STEROID NERVE SUPRASCAP LT	"$1,836.00"
HC23000474	INJ ANES/STEROID NERVE SUPRASCAP RT	"$1,836.00"
HC62219902	CANNULA ARTHRSCPC ROTATING        K	"$1,836.00"
HC25003245	LAC REPAIR INTMD F/E/E/N/L/MM 20.1-30.0CM	"$1,834.00"
HC44200137	"US DUPLEX AORTA,IVC,ILIAC UNI/LTD"	"$1,833.00"
HC44200343	US HEAD/NECK SOFT TISSUE	"$1,830.00"
49502-500-02	EPINEPHRINE 0.3 MG/0.3 ML INJ ATIN	"$1,825.83"
49502-501-02	EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN	"$1,825.83"
49502-501-01	EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN	"$1,825.83"
11994-011-04	PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP	"$1,824.55"
11994-011-01	PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP	"$1,824.55"
HC23001050	INJ(S);TRIGGER POINT 3/>MUSCLES	"$1,822.00"
HC46001137	INJ ARTHROGRAM ANKLE-SC BIL	"$1,821.00"
68682-652-20	DIAZEPAM 5-7.5-10 MG RECTAL KIT	"$1,820.28"
68682-655-20	DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT	"$1,820.28"
HC62806161	CATH EP DX <20 ELECTRODES         L	"$1,820.00"
HC62213608	REAMER                            AE	"$1,820.00"
HC62216908	ENDO STAPLER                     AB	"$1,820.00"
HC62226204	BLADE SHAVER                      AC	"$1,820.00"
HC62804257	COIL EMBOLIZATION                 O	"$1,820.00"
HC25004029	DRAIN ABSCESS FINGER COMPLEX	"$1,818.00"
HC25005794	CLOSED TX ANKLE FX W/MANIP BIL	"$1,818.00"
HC44000917	FOOT COMP MIN 3 VWS BILAT	"$1,818.00"
HC46000238	INJ CORPORA CAVERNOSOGRAM	"$1,812.00"
HC43000710	US GUIDE BREAST CORE BIOPSY LT	"$1,812.00"
HC36800217	HIGH ALTD SIM TEST W/O2TI-HAST	"$1,812.00"
HC43000728	US GUIDE BREAST CORE BIOPSY RT	"$1,811.00"
HC44000198	"XR COLON SINGLE CONTRAST INC SCOUT,DELAYED"	"$1,809.00"
HC25002734	CHANGE GT TUBE W/REV TRACT W/O IMAGE ENDO INCL REMVL	"$1,808.00"
HC44200350	US HYSTEROSONOGRAPHY	"$1,806.00"
HC62211172	KIT PERFUSION - PEDS	"$1,804.00"
HC21000823	APPY SKIN SUB HEAD/HND/FT EA+25SQ~HC	"$1,802.00"
HC51003317	CURETTAGE ENDOCERVICAL (ECC)	"$1,801.00"
HC44000651	ELBOW COMP MIN 3 VWS BILAT	"$1,801.00"
HC44200194	US DUPLEX CAROTID UNILAT LT	"$1,801.00"
HC44200202	US DUPLEX CAROTID UNILAT RT	"$1,801.00"
0169-3685-12	INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN	"$1,800.72"
70121-1003-1	EPTIFIBATIDE 0.75 MG/ML IV SOLN	"$1,800.00"
14789-900-07	PROCAINAMIDE 500 MG/ML INJ SOLN	"$1,800.00"
14789-900-02	PROCAINAMIDE 500 MG/ML INJ SOLN	"$1,800.00"
14789-901-10	PROCAINAMIDE 100 MG/ML INJ SOLN	"$1,800.00"
14789-901-07	PROCAINAMIDE 100 MG/ML INJ SOLN	"$1,800.00"
23155-186-31	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$1,800.00"
55111-688-52	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$1,800.00"
63323-966-00	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$1,800.00"
0187-4302-02	SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN	"$1,800.00"
99999-041-49	NM TC-99M MACROAGGREG (MAA) MHS	"$1,798.71"
HC31002140	PT-APPLIC CAST SHORT LEG WALK BILAT	"$1,798.00"
0187-5100-01	PIMECROLIMUS 1 % TOPICAL CREAM	"$1,794.24"
HC41000027	SLEEP STUDY ATTENDED DISCNT'D	"$1,791.00"
11994-011-16	PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP	"$1,790.76"
67457-366-10	IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN	"$1,789.80"
HC47200001	BASIC DOSIMETRY CALCULATION	"$1,789.00"
HC41500588	STUDIES NERVE CONDUCTN 5-6 STUDIES	"$1,789.00"
HC62805031	CATH MAPPING PH ESOPHAGEAL	"$1,788.00"
HC62226766	FORCEPS BIOPSY MICRO(MORAY)	"$1,788.00"
HC44001006	HAND COMPLETE MIN 3 VWS BILAT	"$1,787.00"
63323-658-20	CHLOROTHIAZIDE SODIUM 500 MG IV SOLR	"$1,786.20"
HC25001215	THORACENTESIS W/TUBE W/O IMAG LT	"$1,784.00"
HC25001223	THORACENTESIS W/TUBE W/O IMAG RT	"$1,784.00"
HC23000003	ANALYSIS IMPLANTED PUMP W/PROG	"$1,784.00"
HC43000991	US BREAST; COMPLETE BILATERAL	"$1,783.00"
70727-497-25	NETARSUDIL 0.02 % OPHT DROP	"$1,782.60"
HC44001980	SHOULDER COMP MIN 2VWS BILAT	"$1,782.00"
HC44002574	WRIST COMP MIN 3 VWS BILAT	"$1,782.00"
HC44000685	ENEMA THERAPEUTIC CONTRAST/AIR	"$1,782.00"
0074-4382-20	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,782.00"
0074-4382-93	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,782.00"
HC32000127	OT-EVAL SWALLOW CINE/FLUORO 90MIN	"$1,779.00"
HC33000191	ST-EVAL SWALLOW CINE/FLUORO 90MIN	"$1,779.00"
71837-5843-5	SARGRAMOSTIM 250 MCG INJ SOLR	"$1,778.88"
71837-5843-1	SARGRAMOSTIM 250 MCG INJ SOLR	"$1,778.88"
HC31002157	PT-APPLIC CAST LONG LEG BILAT	"$1,778.00"
HC62219043	PORT INSTRMNT MULTI LAPAROSCPC	"$1,777.00"
99999-038-91	POLIHEXANIDE (PURAPLY AM)  2X2 CM EACH TOPICAL SHEET	"$1,776.00"
66490-650-20	DIAZEPAM 2.5 MG RECTAL KIT	"$1,774.08"
HC51003630	ANOSCOPY W/DILATION	"$1,774.00"
HC12400107	INTRAPERITONEAL CHEMO THERAPY	"$1,774.00"
HC51003648	ANOSCOPY W/BIOPSY	"$1,773.00"
HC62804653	FILTER VENA CAVA                  A	"$1,772.00"
99999-033-52	RADIESSE INJECTABLE IMPLANT	"$1,770.00"
43598-674-50	CEFIXIME 200 MG/5 ML ORAL SUSR	"$1,769.40"
HC44500957	INJ SCLEROTHERAPY SNGL VEIN-LT	"$1,766.00"
HC44500965	INJ SCLEROTHERAPY SNGL VEIN-RT	"$1,766.00"
HC44200012	US ABDOMEN LTD	"$1,765.00"
65162-087-74	ITRACONAZOLE 10 MG/ML ORAL SOLN	"$1,763.10"
0173-0388-79	BECLOMETHASONE DIPROP (AQ) 42 MCG (0.042 %) NASL SPRY	"$1,760.10"
HC44200228	US DUPLEX HEMODIALYSIS ACCESS	"$1,760.00"
0003-0524-11	DASATINIB 70 MG ORAL TAB	"$1,758.07"
0003-0528-11	DASATINIB 50 MG ORAL TAB	"$1,758.07"
HC12400131	CHEMO INJECT(S) SUBARACHNOID/INTRAVENT VIA RESEVOIR	"$1,758.00"
HC62217401	SEALER BIPOLAR AQUAMANTYS	"$1,758.00"
HC44001329	IVP INFUSION DRIP OR BOLUS	"$1,755.00"
HC62213590	REAMER                            AD	"$1,755.00"
HC62216890	ENDO STAPLER                     AA	"$1,755.00"
HC62218961	DRILL/DRILL BITS SINGLE USE      AE	"$1,755.00"
HC62220041	PROBE SPINAL DISPOSABLE           V	"$1,755.00"
68682-045-50	TIMOLOL MALEATE 0.5 % OPHT DRPD	"$1,754.64"
HC23000375	INJ ANES/STEROID NERVE AXILLARY LT	"$1,753.00"
HC23000383	INJ ANES/STEROID NERVE AXILLARY RT	"$1,753.00"
HC41000100	POLYSMNGRPH 4+STGS <6 DISCONT	"$1,752.00"
46287-009-01	ISONIAZID 50 MG/5 ML ORAL SOLN	"$1,751.05"
HC25001181	THORACENTESIS ASP W/O IMG GUID-LT	"$1,751.00"
HC25001199	THORACENTESIS ASP W/O IMG GUID-RT	"$1,751.00"
HC44200244	US DUPLEX PENILE VESSEL F/U OR LTD	"$1,750.00"
HC44200285	US FETAL BIO PROFILE W/NST	"$1,748.00"
HC51002756	ASPIRATION OF BLADDER TROCAR	"$1,743.00"
HC44001337	IVP LIMITED	"$1,741.00"
HC32000481	OT-SWALLOWING EVAL 120MIN	"$1,741.00"
0169-7501-11	INSULIN ASPART U-100 100 UNIT/ML SUBCUTANEOUS SOLN	"$1,736.16"
HC44500817	ERCP PANCREATIC DUCT SYSTEM	"$1,735.00"
0173-0887-14	FLUTICASONE-UMECLIDIN-VILANTER 100-62.5-25 MCG INHALATION DSDV	"$1,733.42"
HC74200387	OR TIME ADD'L 15MIN CASE CX 3 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,731.00"
HC74200601	OR TIME ADD'L 15MIN CASE CX 3 (MCAL 2ND SUBSQNT 0.5 HR)	"$1,731.00"
HC41500208	EMG 2 EXTREMITY	"$1,728.00"
HC44002996	HIPS BILAT MIN5VWS(W/PELVS WHN PRFRMD)	"$1,726.00"
HC44000818	FISTULA/SINUS ABSCESS STUDY	"$1,724.00"
HC62212790	GUIDEWIRE(AVIGO/NEURVSCLR SFT TIP)V	"$1,723.00"
HC62205018	NEEDLE STEREOTACTIC BX	"$1,723.00"
0002-8824-01	INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SUBCUTANEOUS INPN	"$1,722.60"
0002-8824-27	INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SUBCUTANEOUS INPN	"$1,722.60"
HC25000084	ASPIRATION OF BLADDER TROCAR	"$1,721.00"
HC62217088	SHIM DEVICE ACCESS SPINAL         X	"$1,720.00"
HC27001262	GASTRIC INTUB ASP DX;MULT SPEC	"$1,716.00"
HC44200574	US SPINAL CANAL & CONTENT	"$1,716.00"
HC44200020	US GUIDANCE ABLATION PARENCHYMAL TISSUE	"$1,715.00"
0002-7511-01	INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP	"$1,708.20"
0002-7512-01	INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (50-50) SUBCUTANEOUS SUSP	"$1,708.20"
HC46001335	INJ CONTRAST KNEE ARTHRO/CT/MRI	"$1,708.00"
HC25003609	REMOVE FB UPPER ARM/ELBOW SQ LT	"$1,707.00"
HC25003617	REMOVE FB UPPER ARM/ELBOW SQ RT	"$1,707.00"
HC51061513	REMOVE IMPLANT SUPERFICIAL	"$1,706.00"
HC45401312	MR CARDIAC VELOCITY FLOW MAP +	"$1,706.00"
HC47200456	"RAD TREATMENT DELVR, = 1MEV;SIMPLE"	"$1,705.00"
HC32001737	OT-EVAL HIGH COMPLEXITY 45MF2F 150MIN	"$1,705.00"
0088-2500-33	INSULIN GLULISINE U-100 100 UNIT/ML SUBCUTANEOUS SOLN	"$1,703.70"
HC36800399	SPIROMETRY W/PRE&POST BRONCHO	"$1,702.00"
HC36001063	SPIROMETRY W/PRE&POST BRONCHO	"$1,702.00"
0088-2220-33	INSULIN GLARGINE 100 UNIT/ML SUBCUTANEOUS SOLN	"$1,701.36"
0088-5021-01	INSULIN GLARGINE 100 UNIT/ML SUBCUTANEOUS SOLN	"$1,701.36"
HC12200333	IV INFUSION MONOCLONAL ABX BAMLANIVIMAB/ETESEVIMAB	"$1,700.00"
HC12200408	IV INFUSE MONOCLONAL ABX SOTROVIMAB	"$1,700.00"
69251-201-01	CIPROFLOXACIN 6 % (6 MG/0.1 ML) ITYM SUSP	"$1,699.20"
HC62223235	KIT HEMORRHOID SLIDE ONE	"$1,699.00"
0469-3051-30	AMPHOTERICIN B LIPOSOME 50 MG IV SUSR	"$1,698.30"
HC62808142	I:FECAL MICROBIOTA (FMP250)	"$1,698.00"
HC51061000	REMOVE NEPHROSTOMY TUBE BIL	"$1,695.00"
HC42000182	ECHO DOPPLER COLOR FLOW	"$1,692.00"
70436-027-80	EPTIFIBATIDE 0.75 MG/ML IV SOLN	"$1,692.00"
50242-064-01	ERLOTINIB 150 MG ORAL TAB	"$1,690.28"
HC46000030	INJ ARTHRO HIP W/ANESTH-LT	"$1,690.00"
HC46000048	INJ ARTHRO HIP W/ANESTH-RT	"$1,690.00"
HC44200947	US MAPPING VESSEL HEMODIALYSIS; COMPLT BILAT	"$1,690.00"
HC62206677	SPHINCTEROTOME W/WIRE             M	"$1,690.00"
HC62213582	REAMER                            AC	"$1,690.00"
HC62216759	PIN/WIRE FIXATION TEMPORARY      AL	"$1,690.00"
HC62216882	ENDO STAPLER                      Z	"$1,690.00"
HC62220405	FIT TALAR LOCKING TRIAL	"$1,690.00"
HC62220595	SHEARS COAGULATING HARMONIC       R	"$1,690.00"
HC62228317	STAPLER SINGLE USE ROBOTIC	"$1,690.00"
HC62804240	COIL EMBOLIZATION                 N	"$1,690.00"
HC62805221	HEMOSTAT VITAGEL SURGICAL	"$1,690.00"
HC42000224	ECHO FETAL F/U OR REPEAT	"$1,689.00"
HC25001041	THROMBOLYSIS CORONARY IV INFUSION	"$1,689.00"
HC36800209	HIGH ALTITUDE SIM' TEST- HAST	"$1,689.00"
0703-4680-01	MITOXANTRONE 2 MG/ML IV CONC	"$1,688.47"
HC23001043	INJ(S);TRIGGER POINT 1-2MUSCLES	"$1,687.00"
HC51003234	COLPOSCOPY VAG W/BX(S)VAGINA/CERVIX	"$1,687.00"
HC62207139	SYSTEM DALL MILES CABLE GRIP	"$1,685.00"
HC46000378	INJ FOR RETRO URETHROCYSTO	"$1,683.00"
HC83000539	PLATELET LR CMV NEG APHER/PHER	"$1,683.00"
0781-3233-94	CYCLOPHOSPHAMIDE 500 MG IV SOLR	"$1,681.14"
HC44200400	US OB >1ST TRI ADD'L GEST+	"$1,680.00"
HC33000365	ST-SWALLOWING EVAL 120MIN	"$1,678.00"
HC36800258	O2 UPTAKE COMPLETE	"$1,677.00"
HC62210927	CANNULA ENDO ARTERIAL	"$1,677.00"
HC46500930	"INJ W/FLUOR, EVAL CV ACCESS DEVICE"	"$1,676.00"
HC44200632	US TRANSRECTAL	"$1,676.00"
HC29000312	TREADMILL STRESS TEST	"$1,676.00"
HC44001204	HYSTEROSALPINGOGRAM	"$1,674.00"
HC23000086	ASP/INJ JOINT MED W/O UTZ GUIDE-RT	"$1,672.00"
HC44001287	INTRALUMINAL DILATION O/STRICT	"$1,671.00"
HC23000078	ASP/INJ JOINT MED W/O UTZ GUIDE-LT	"$1,670.00"
HC62223490	ORTHOTIC ANKLE FOOT TIBIAL FX RT	"$1,669.00"
HC21000591	DEBRIDE OPN WND 1ST 20SQCM OR<	"$1,667.00"
HC62224449	INJECTOR GUN CEMENT	"$1,662.00"
25021-179-16	DAPTOMYCIN 350 MG IV SOLR	"$1,662.00"
25021-179-15	DAPTOMYCIN 350 MG IV SOLR	"$1,662.00"
65174-270-30	KIT FOR OF PREP TC-99M-ALBUMIN 2.5 MG IV SOLR	"$1,661.34"
HC62223177	DEVICE ILLUMINATION MAST	"$1,661.00"
HC62807672	M: STEM ANKLE TIBIAL	"$1,658.00"
HC62217302	STRIPPER TENDON	"$1,658.00"
HC62224282	DEVICE FIXATION SOFT TISSUE	"$1,658.00"
HC21000286	DEBRIDE P-THICK BURN 5-10% BSA	"$1,656.00"
HC41500554	VESTIBULAR COMPREHENSIVE EVAL	"$1,656.00"
HC26000109	INSERTION CERVICAL DILATOR	"$1,655.00"
HC44701555	PHYSIOLOGIC EXERCISE STUDY+	"$1,654.00"
99999-035-30	INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP)	"$1,653.48"
0254-1010-19	DIAZOXIDE 50 MG/ML ORAL SUSP	"$1,653.12"
0023-2181-05	KETOROLAC 0.5 % OPHT DROP	"$1,652.58"
63323-196-06	FLUDARABINE 50 MG IV SOLR	"$1,651.62"
HC25003237	LAC REPAIR INTMD F/E/E/N/L/MM 12.6-20CM	"$1,651.00"
HC44701209	EXTRA PUMP TIME/.5 HR	"$1,650.00"
HC62228473	BASKET RETRIEVAL BILIARY (SPYGLASS)	"$1,650.00"
55111-652-37	BIVALIRUDIN 250 MG IV SOLR	"$1,650.00"
55111-652-07	BIVALIRUDIN 250 MG IV SOLR	"$1,650.00"
HC44000438	CHOLANGIOGRAM INTRAOPERATIVE	"$1,649.00"
0002-7510-01	INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN	"$1,648.20"
61314-318-10	FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG	"$1,646.18"
61314-318-01	FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG	"$1,646.16"
HC62203849	KIT DISSECTOR HYDRO PUMP	"$1,646.00"
50484-010-30	COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOPICAL OINT	"$1,645.56"
0143-9247-01	DEXRAZOXANE HCL 250 MG IV SOLR	"$1,645.56"
70515-712-01	CICLESONIDE 160 MCG/ACTUATION INHALATION HFAA	"$1,645.24"
70515-711-01	CICLESONIDE 80 MCG/ACTUATION INHALATION HFAA	"$1,645.24"
HC51003390	X-RAY PERC DIL URETER/URETHRA	"$1,645.00"
HC25004235	CLOSED TX HIP DISLOC POST ARTHROPLASTY BIL	"$1,643.00"
HC25004326	CLOSED TX KNEE DISLOC; NO ANESTH BIL	"$1,643.00"
0173-0719-20	FLUTICASONE PROPIONATE 110 MCG/ACTUATION INHALATION HFAA	"$1,642.97"
HC25005760	CLOSED TX FIBULA DISTAL FX W/MANIP BIL	"$1,642.00"
HC44003036	PERITONEOGRAM S&I	"$1,640.00"
HC62226758	WOUND FILLER DRY COLLAGEN           S	"$1,640.00"
0409-1103-01	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,639.20"
0409-1103-11	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,639.20"
HC51060978	"INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS BI"	"$1,639.00"
HC51061588	ECHO CONGENITAL COMPLETE	"$1,638.00"
99999-001-79	CHARGE-ADULT 3 IN 1 ADMIX 3000ML	"$1,638.00"
HC25003179	LAC REPAIR INTMD N/H/F/GEN 20.1-30	"$1,637.00"
HC25005224	REMOVE FB VESTIBULE MOUTH; SIMPLE	"$1,637.00"
HC47200126	HANDLING/LOADING RAD SOURCE	"$1,636.00"
0093-3541-43	ESTRADIOL 0.01 % (0.1 MG/GRAM) VAGINAL CREAM	"$1,632.26"
HC21001086	WOUND VAC TX W/ DISP ASST/INSTR >50SQ CM SESSION	"$1,632.00"
63323-192-02	FLUDARABINE 50 MG/2 ML IV SOLN	"$1,631.28"
0409-1140-01	ARGATROBAN 100 MG/ML IV SOLN	"$1,630.14"
0009-5138-02	LINEZOLID 600 MG ORAL TAB	"$1,626.07"
HC44200814	US EXTREMITY NON VASC CMPLT-LT	"$1,625.00"
HC44200806	US EXTREMITY NON VASC CMPLT-RT	"$1,625.00"
HC62220140	OVERTUBE ENDOSCOPIC               D	"$1,625.00"
HC62807466	GOLD SEED MARKER FIDUCIAL DELVRY SYS(DSF2201)	"$1,625.00"
HC62223417	CATH PTA ANGIOPLS BALLOON NON-LSR N	"$1,625.00"
HC62211867	CATH PTCA ANGIOPLASTY NON-LASER   M	"$1,625.00"
HC62211560	CATH BALLOON SINUPLASTY           G	"$1,625.00"
HC62216767	CATH EP DIAG/ABLAT 3D/VECT        E	"$1,625.00"
HC62220215	CATH THROMBECTOMY/EMBOLECTOMY     R	"$1,625.00"
HC62204599	PROGRAMMER NEUROSTIM PAT          B	"$1,625.00"
HC62801725	PORT INDWELLING W/CATH            K	"$1,625.00"
HC62808357	STENT NON-COAT/NON-COV W-DEL      R	"$1,625.00"
HC62800370	CATH GUIDING                      R	"$1,625.00"
HC62223383	CATH MICRO NEURO(ENVOY/REBAR)     L	"$1,625.00"
HC62218292	CATH INTRODUCER PEEL-AWAY        AB	"$1,625.00"
HC62224456	INTRO/SHEATH EP FIXED NON-PEEL    P	"$1,625.00"
HC62223912	INTRODUCER/SHEATH(NEURON MAX)     U	"$1,625.00"
HC62220314	ORTHOTIC KNEE W/JNTS PRFB CUSTM   O	"$1,625.00"
HC62204268	KIT TIPS	"$1,625.00"
HC62212485	HANDPIECE VESSEL SEALER DEVICE    C	"$1,625.00"
HC62213079	BLADE SHAVER                      Z	"$1,625.00"
HC62213574	REAMER                            AB	"$1,625.00"
HC62216874	ENDO STAPLER                      Y	"$1,625.00"
HC62217484	KIT CONCENTRATOR PLATELETS        R	"$1,625.00"
HC62218185	HEMOSTATIC GEL/GELFOAM/PAD        R	"$1,625.00"
HC62218219	CATH DIAGNOSTIC                   R	"$1,625.00"
HC62218953	DRILL/DRILL BITS SINGLE USE      AD	"$1,625.00"
HC62219720	KIT VITRECTOMY PROBE              K	"$1,625.00"
HC62219837	HAND ACCESS DEVICE                G	"$1,625.00"
HC62220223	CLIP STIMULATION NERVE            I	"$1,625.00"
HC62220439	PUSHER KNOT ENDO                  L	"$1,625.00"
HC62221106	KIT CRICOTHYROTOMY EMERGENCY      R	"$1,625.00"
HC62221882	TAP SURGICAL                      R	"$1,625.00"
HC62222187	NEEDLE BX HIP TAPERED COBALT/FNA(SHARKCORE)	"$1,625.00"
HC62222328	PROBE ABLATION                    R	"$1,625.00"
HC62222377	ASPIRATOR ULTRASONIC SURG         B	"$1,625.00"
HC62223995	TOOL ACCESSORY PCMKR	"$1,625.00"
HC62224712	ELECTRODE NEEDLE UROLOGICAL HF	"$1,625.00"
HC62224977	PROBE LITHOTRIPTOR                R	"$1,625.00"
HC62225776	SYSTEM DRESSING WOUND NEG PRES    R	"$1,625.00"
HC62225883	GUIDE DRILL                       R	"$1,625.00"
HC62226022	COUNTERSINK                       R	"$1,625.00"
HC62226733	MOLD/FORM CEMENT	"$1,625.00"
HC62227319	ELECTRODE BIPOLAR ENDO            D	"$1,625.00"
HC62227459	GUIDE COMPONENT KNEE CUSTOM PATIENT	"$1,625.00"
HC62227624	NOTCHER TUNNEL                    R	"$1,625.00"
HC62227681	ELECTRODE MONOPOLAR BALL	"$1,625.00"
HC62227772	SET TUBING HARVESTER GRAFT ENDO	"$1,625.00"
HC62805155	SET NEEDLE TARGETING W/WIRE       X	"$1,625.00"
HC62805759	FIBRIN SEALANT                    O	"$1,625.00"
HC62806997	CATH SWAN GANZ/THERMODILUTION     R	"$1,625.00"
HC62807334	CLIP ENDOSCOPIC                   R	"$1,625.00"
HC25003542	CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC LT	"$1,624.00"
HC25003559	CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC RT	"$1,624.00"
HC25005190	REPAIR LIP FULL THICK; TO HALF VERTICAL HT	"$1,623.00"
0703-2045-01	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,623.00"
0703-2045-03	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,623.00"
63323-418-20	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,623.00"
HC44001550	LUMBAR SPINE W/BEND MIN 6 VWS	"$1,622.00"
16729-259-38	EPTIFIBATIDE 0.75 MG/ML IV SOLN	"$1,620.00"
HC25000654	LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO]	"$1,618.00"
63713-019-85	MICROFIBRIL. COLLAGEN HEMOSTAT 1 GRAM TOPICAL MISC	"$1,616.87"
HC12200267	SC INFUSION THERAPY INITIAL UP TO 1HR	"$1,614.00"
HC36800126	TEST BRONCHIAL INHAL CHALLENGE W/HISTAMINE	"$1,611.00"
HC79200028	"MUSCLE TEST, THREE LIMBS"	"$1,611.00"
HC62210778	FORCEPS BILIARY BX (SPYBITE)	"$1,609.00"
HC62221056	KIT CANISTER BIOPSY CARTILAGE	"$1,609.00"
HC62228374	NEEDLE TRANSSEPTAL NRG (WATCHMAN)	"$1,609.00"
HC26000083	FETAL CONTRACTION STRESS TEST	"$1,608.00"
HC26000075	FETAL CONTRACT/NIPPLE STIM	"$1,608.00"
HC44002558	WRIST ARTHROGRAM LT	"$1,608.00"
HC44002566	WRIST ARTHROGRAM RT	"$1,608.00"
HC44002491	URETHROCYSTOGRAM VOIDING	"$1,607.00"
HC44200483	US OB TRANSVAGINAL	"$1,607.00"
HC44000826	FLUORO GUIDE NDL PLCMT	"$1,607.00"
HC25003294	LAC REPAIR CMPLX S/A/L 2.6-7.5 CM	"$1,604.00"
HC51010841	BONE MARROW DX; BIOPSY(SIES) ONLY	"$1,604.00"
HC41500232	EMG FACIAL BILAT	"$1,604.00"
59676-310-00	"EPOETIN ALFA 10,000 UNIT/ML INJ SOLN"	"$1,603.50"
59676-310-01	"EPOETIN ALFA 10,000 UNIT/ML INJ SOLN"	"$1,603.50"
59676-310-02	"EPOETIN ALFA 10,000 UNIT/ML INJ SOLN"	"$1,603.44"
HC25000936	CHANGE GT TUBE W/O IMAGE/ENDO	"$1,603.00"
75826-127-04	PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML ORAL ELIX	"$1,600.56"
HC44002061	"XR SMALL BOWEL W/SINGLE CONTRAST INC SCOUT,SERIAL"	"$1,600.00"
HC62204136	KIT PERITONEAL DRAINAGE ACCESS	"$1,600.00"
HC44900066	CT BONE DENSITY STDY AXIAL SKL	"$1,597.00"
HC44002236	TIBIA & FIBULA (LEG) 2 VWS BIL	"$1,594.00"
HC62212782	GUIDEWIRE(CHIKAI)                 U	"$1,593.00"
16714-763-01	CALCIPOTRIENE 0.005 % TOPICAL CREAM	"$1,591.92"
HC44002442	"XR UGI W/DOUBLE CONTRAST INC SCOUT,DELAYED"	"$1,590.00"
HC25005216	DRAIN ABSCESS/LESION MOUTH; SIMPLE	"$1,589.00"
HC44900744	CT HEART W/CORO CALC W/O CON	"$1,588.00"
99999-002-47	INDOMETHACIN 0.5MG/1ML SYRINGE	"$1,586.82"
HC46000444	INJ VENOGRAM EXTREMITY-LT	"$1,582.00"
HC46000451	INJ VENOGRAM EXTREMITY-RT	"$1,582.00"
HC23001720	N BLOCK INJ PLANTAR DIGIT (MOTONS) LT	"$1,582.00"
HC23001738	N BLOCK INJ PLANTAR DIGIT (MOTONS) RT	"$1,582.00"
HC41500927	AUDITORY EVOKED AEP THRESHOLD EST MULT FREQ W/I&R	"$1,582.00"
HC41500935	AUDITORY EVOKED AEP NEURODIAGNOSTIC W/I&R	"$1,582.00"
HC62802806	CAPSULE ENDOSCOPY (PILL CAM)	"$1,580.00"
HC62229091	GUIDE PIN ORTHO                   S	"$1,580.00"
67457-436-50	DOXORUBICIN 50 MG IV SOLR	"$1,578.18"
HC25005844	REMOVE CATH CV TUNNELED W/O PORT/PUMP	"$1,573.00"
HC27000850	ESOPH RFLUX W/PH ELECTR DISCTD	"$1,573.00"
HC62203435	FORCEPS GRASPING	"$1,573.00"
HC27001965	ESOPHAG REFLUX W/NASAL ELEC>1H DISCON'D	"$1,572.00"
HC44200046	ART STDY BILAT U/L 1-2 LVL LTD	"$1,570.00"
HC44200871	ART STDY SNG U/L 3/> LVL CMP-L	"$1,570.00"
HC44200863	ART STDY SNG U/L 3/> LVL CMP-R	"$1,570.00"
HC25000639	PARACENTESIS ABD W/O IMAGING	"$1,569.00"
HC32000473	OT-SWALLOWING EVAL 90MIN	"$1,568.00"
HC44000834	FLUORO GUIDE SPINE INJ(NONFRMN	"$1,565.00"
67457-198-98	REMIFENTANIL 5 MG IV SOLR	"$1,564.89"
67457-198-10	REMIFENTANIL 5 MG IV SOLR	"$1,564.89"
HC79200051	SURGERY MINOR ADD'L 15 MIN	"$1,563.00"
0517-0374-05	METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN	"$1,562.58"
0517-0374-01	METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN	"$1,562.58"
HC25003229	LAC REPAIR INTMD F/E/E/N/L/MM 7.6-12.5CM	"$1,561.00"
HC25003344	LAC REPAIR CMPLX E/N/E/L 2.6-7.5 CM	"$1,561.00"
HC62205844	PROBE PERCUTANEOUS	"$1,561.00"
HC51060580	DESTROY MUSCLE(S) LARYNX BI	"$1,560.00"
HC62800883	CATHETER PERITONEAL              AH	"$1,560.00"
HC62800891	CATHETER PLEURAL/KIT	"$1,560.00"
HC62805924	CATH EP DX <20 ELECTRODES         K	"$1,560.00"
HC62206081	SET AMPLATZ	"$1,560.00"
HC62800792	CAPSULE PH (IMPLANT)              I	"$1,560.00"
HC62203294	FIBER LASER                       K	"$1,560.00"
HC62203476	SCALPEL SHEARS HARMONIC	"$1,560.00"
HC62206313	SET LIVER BIOPSY	"$1,560.00"
HC62211974	SPHINCTEROTOME CANNULATING        L	"$1,560.00"
HC62213061	BLADE SHAVER                      X	"$1,560.00"
HC62213566	REAMER                            AA	"$1,560.00"
HC62216866	ENDO STAPLER                      X	"$1,560.00"
HC62217708	AWL SPINAL SINGLE PATIENT USE     S	"$1,560.00"
HC62218946	DRILL/DRILL BITS SINGLE USE      AC	"$1,560.00"
HC62226139	KIT ACCESSORY                     P	"$1,560.00"
HC74200254	BEDSIDE/OTHER SURG ADD'L 15MIN 2 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,559.00"
HC74200494	BEDSIDE/OTHER SURG ADD'L 15MIN 2 (MCAL 2ND SUBSQNT 0.5 HR)	"$1,559.00"
HC44002616	"XR UGI W/SNGLE CONTRAST INC SCOUT,DELAYED"	"$1,557.00"
HC62804596	STENT CORO BARE METAL W/DEL       B	"$1,556.00"
HC25000951	INCISION EXTERNAL HEMORRHOID	"$1,555.00"
HC27000843	ESOPH RFLUX PH STDY-LNG DISCTD	"$1,553.00"
HC24000101	HBO TX EA 1/2 HR INTERMEDIAT/M	"$1,553.00"
HC44000248	BONE SURVEY INFANT	"$1,552.00"
HC33000357	ST-SWALLOWING EVAL 90MIN	"$1,552.00"
HC25005000	APPLY CAST LONG LEG BILATERAL	"$1,550.00"
HC21000484	I&D POLINIDAL CYST: SIMPLE	"$1,548.00"
0186-0370-28	BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION INHALATION HFAA	"$1,545.66"
HC25005513	REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD BIL	"$1,545.00"
HC44002897	SPINE ENTIRE SKULL-SACRUM 4-5 VIEWS	"$1,542.00"
0186-0916-12	BUDESONIDE 180 MCG/ACTUATION INHALATION AEPB	"$1,541.34"
99999-039-44	INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML SUBCUTANEOUS SOLN	"$1,540.49"
HC43000561	DUCTOGRAM MULTI DUCT(S) LT	"$1,540.00"
HC43000579	DUCTOGRAM MULTI DUCT(S) RT	"$1,540.00"
HC43000116	DUCTOGRAM/GALACTOGRAM MULTI	"$1,540.00"
HC27000140	BREATH HYDROGEN TEST	"$1,540.00"
HC44001048	HIP ARTHROGRAM LT	"$1,539.00"
HC44001055	HIP ARTHROGRAM RT	"$1,539.00"
HC44002384	TOMOGRAM UNILAT LT	"$1,539.00"
HC44002392	TOMOGRAM UNILAT RT	"$1,539.00"
HC44200095	US CHEST	"$1,539.00"
HC44200293	US FETAL BIO PROF W/O NST(INTL)	"$1,539.00"
HC62803804	COIL EMBOLIZATION FIBERED         M	"$1,537.00"
HC46502753	BIOPSY INCISIONAL SKIN; SINGLE INITIAL LESION	"$1,536.00"
HC44003077	XR ESOPHAGUS W/DOUBLE CONSTRST INC SCOUT&DELAYS	"$1,536.00"
HC89023782	CYTOGENO NEO SNP MICROARRAY ONCOLOGY-AU	"$1,535.00"
68682-650-20	DIAZEPAM 2.5 MG RECTAL KIT	"$1,534.50"
HC51002624	PUNCTURE ASP CYST BREAST	"$1,534.00"
HC25005323	PROCTOSIGMOIDOSCOPY RIGID W/REMOVE FB	"$1,531.00"
99999-035-28	INSULIN GLULISINE 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP)	"$1,530.66"
HC44000016	3D RENDER W/O INDENDNPT WORKSTN	"$1,530.00"
HC62229125	BLADE TREPHINE                    S	"$1,530.00"
HC44002400	TRANSCERV CATH FALLOPIAN TUBES	"$1,529.00"
68462-585-40	APREPITANT 125 MG ORAL CAP	"$1,528.25"
68462-585-76	APREPITANT 125 MG ORAL CAP	"$1,528.25"
0781-2323-68	APREPITANT 125 MG ORAL CAP	"$1,528.25"
0781-2323-06	APREPITANT 125 MG ORAL CAP	"$1,528.25"
HC25005034	APPLY CAST SHORT LEG BILATERAL	"$1,528.00"
HC51002368	EXCISN/FULGURATN POLYP(S) URETHRAL	"$1,528.00"
HC62221684	KIT ARTHROSCOPY DISPSBLS          T	"$1,528.00"
HC78600053	PACU II 1ST HOUR (INITIAL)	"$1,527.00"
HC46000949	SEL CATH THOR/BRAC+ 2ND/3RD LT	"$1,526.00"
HC46000956	SEL CATH THOR/BRAC+ 2ND/3RD RT	"$1,526.00"
HC62228200	ORTH WHO W/NONTORSION JOINT(S) PREFAB CUSTOM	"$1,525.00"
HC62228218	ORTH WHO NONTORSION JOINT(S) PREFAB OTS	"$1,525.00"
HC44900884	CT BODY SCAN NK/CH/ABD/PEL/HRT	"$1,524.00"
HC44000842	FLUORO CV ACCESS CATH REPLACE/RMVL	"$1,521.00"
HC47200647	TREATMENT DEVICES SIMPLE	"$1,521.00"
HC62802798	SYSTEM SEAL HEART STRING	"$1,521.00"
HC46500906	FNA ASP BX W/O GUIDE; FIRST LESION	"$1,518.00"
HC82202524	FNA ASP BX W/O GUIDE; FIRST LESION	"$1,518.00"
HC44001964	SHOULDER ARTHROGRAM LT	"$1,516.00"
HC44001972	SHOULDER ARTHROGRAM RT	"$1,516.00"
HC41500570	STUDIES NERVE CONDUCTN 3-4 STUDIES	"$1,515.00"
HC62219399	KIT ABLATION VEIN LASER	"$1,515.00"
HC44502029	THROMBOLYSIS CEREBRAL/IV  RT	"$1,514.00"
HC44502037	THROMBOLYSIS CEREBRAL/IV LT	"$1,514.00"
HC44200210	US DUPLEX CAROTID LTD	"$1,512.00"
HC51061604	ECHO 2D CMPLT W/SPEC&CLR DOPLR	"$1,508.00"
HC44000347	CERVICAL SPINE COMP 6/> VWS	"$1,507.00"
HC47200571	SPECIAL DOSIMETRY	"$1,507.00"
HC12400099	ADMIN CHEMO INTRA ARTERIAL INJ	"$1,507.00"
HC38000261	APPLY BODY CAST; FULL ADULT	"$1,506.00"
HC44000255	BONE SURVEY LTD	"$1,506.00"
42023-103-01	EPINEPHRINE HCL 1 MG/ML NASL SOLN	"$1,503.36"
42023-168-01	EPINEPHRINE 1 MG/ML INJ SOLN	"$1,503.36"
HC89020333	CYTOGENOMIC SNP MICROARRAY-FETAL-AU	"$1,502.50"
0469-6501-89	REGADENOSON 0.4 MG/5 ML IV SYRG	"$1,501.50"
16729-224-05	DECITABINE 50 MG IV SOLR	"$1,500.00"
25021-408-51	EPTIFIBATIDE 0.75 MG/ML IV SOLN	"$1,500.00"
55390-253-01	MITOMYCIN 40 MG IV SOLR	"$1,500.00"
25021-827-61	IBANDRONATE 3 MG/3 ML IV SYRG	"$1,499.99"
25021-822-73	IBANDRONATE 3 MG/3 ML IV SYRG	"$1,499.99"
HC23000334	INJ ANES/STEROID NERVE OCCIPITAL GREAT	"$1,499.00"
HC23001563	INJ ANES/STEROID NERVE OCCIPITL GREAT LT	"$1,499.00"
HC23001555	INJ ANES/STEROID NERVE OCCIPITL GREAT RT	"$1,499.00"
HC32001794	OT-ENDOSCOPIC EVAL SWALLOW	"$1,499.00"
HC33000159	ST-ENDOSCOPIC EVAL SWALLOW	"$1,499.00"
HC62213053	BLADE SHAVER                      W	"$1,495.00"
HC62213558	REAMER                            Z	"$1,495.00"
HC62216858	ENDO STAPLER                      W	"$1,495.00"
HC62218938	DRILL/DRILL BITS SINGLE USE      AB	"$1,495.00"
HC62220355	RETRACTOR DISPOSABLE              N	"$1,495.00"
0078-0799-75	CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS	"$1,494.54"
50242-063-01	ERLOTINIB 100 MG ORAL TAB	"$1,494.40"
HC25004888	APPLY CAST; SHOULDER TO HAND (LONG ARM) BILAT	"$1,492.00"
HC25000191	INSERT NEEDLE INTRAOSSEOUS INF	"$1,492.00"
HC44002467	UGI W/O KUB	"$1,491.00"
0075-0626-03	ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLN	"$1,488.47"
HC28000156	EXTERNAL COUNTERPULSATION/TX	"$1,488.00"
HC74200379	OR TIME ADD'L 15MIN CASE CX 2 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,487.00"
HC74200593	OR TIME ADD'L 15MIN CASE CX 2 (MCAL 2ND SUBSQNT 0.5 HR)	"$1,487.00"
HC44200558	US RETROPERITONEAL LTD	"$1,485.00"
HC83001214	RBC DEGLYCEROLIZED EA UNIT	"$1,485.00"
HC83000059	RBC'S DEGLYCEROLIZED EA UNIT	"$1,485.00"
0173-0697-04	FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE INHALATION DSDV	"$1,483.78"
HC44001212	INFANT LOW EXT MIN 2VWS BILAT	"$1,483.00"
HC46000428	INJ PROC SPLENOPORTOGRAM	"$1,482.00"
HC23001704	EXAM CSF PUMP (MISC PROC)	"$1,482.00"
HC82202458	MORPH STDY ISH CAT QNT/SPEC INTL SNGL PROBE CEP17	"$1,482.00"
HC82202441	MORPH STDY ISH CAT QNT/SPEC INTL SNGL PROBE HER2	"$1,482.00"
HC25005679	ASP/INJ JOINT/BURSA MAJOR W/US-BIL	"$1,481.00"
HC25003278	LAC REPAIR CMPLX TRUNK 2.6-7.5 CM	"$1,477.00"
HC44001394	KNEE 2 VIEWS BILAT	"$1,476.00"
HC45200912	NM THYROID METS UPTAKE (+)	"$1,476.00"
HC31001787	PT-EVAL HIGH COMPLEXITY 45MIF2F 120MIN	"$1,476.00"
67157-101-50	ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN	"$1,476.00"
HC44900629	CT WHOLE BODY SCREEN	"$1,475.00"
HC44000115	ANKLE ARTHROGRAM LT	"$1,474.00"
HC44000123	ANKLE ARTHROGRAM RT	"$1,474.00"
67457-524-33	IBANDRONATE 3 MG/3 ML IV SYRG	"$1,470.01"
HC51010866	THORACENTESIS W/TUBE W/IMAGING	"$1,470.00"
HC51003788	LYSIS ADHESIONS POST-CIRCUMCISION	"$1,470.00"
HC26000182	L&D EVAL LEVEL IV - EXTENDED	"$1,470.00"
HC62213749	KIT VITREORETINAL PERFLUORON 5ML	"$1,470.00"
HC62200985	CANNULA ARTERIAL                  V	"$1,470.00"
64950-362-04	COCAINE 4 % NASL SOLN	"$1,470.00"
HC25003328	LAC REPAIR CMPLX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM	"$1,469.00"
HC82202193	NERVE TEASING	"$1,468.00"
HC44200376	US INFANT HIPS LTD/STATIC	"$1,467.00"
HC62222203	SYRINGE BONE MARROW ASPIRATION 30CC	"$1,466.00"
HC42000315	ECG EXT HOLTER W/CONNECT UP TO 48HRS; RECORD	"$1,463.00"
HC62808167	DEVICE REPAIR SUTURE MENISCAL	"$1,463.00"
HC62212774	GUIDEWIRE(SYNCHRO/TRANSEND)       T	"$1,463.00"
HC62214440	KIT ARTHROSCOPY DISPSBLS          R	"$1,463.00"
HC46000063	INJ ARTHRO/CT/MRI SHOULDER-LT	"$1,462.00"
HC46000071	INJ ARTHRO/CT/MRI SHOULDER-RT	"$1,462.00"
HC38000279	APPLY BODY CAST; FULL CHILD	"$1,461.00"
HC46000477	INJECTION HIP ARTHROGRAM LT	"$1,460.00"
HC46000485	INJECTION HIP ARTHROGRAM RT	"$1,460.00"
HC12200341	IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) REPEAT	"$1,460.00"
HC12200382	IV INFUSE MONOCLONAL TOCILIZUMAB >2YEARS INITIAL	"$1,460.00"
HC12200390	IV INFUSE MONOCLONAL TOCILIZUMAB >2YEARS DOSE 2ND	"$1,460.00"
16729-115-05	MITOMYCIN 5 MG IV SOLR	"$1,459.62"
67457-518-05	MITOMYCIN 5 MG IV SOLR	"$1,459.62"
HC41500406	SINUSOIDAL VERT ROTATION(VORT)	"$1,459.00"
59584-138-01	CANDIDA ALBICANS SKIN TEST FDA STANDARD INTRADERMAL ALRG	"$1,458.00"
67157-101-51	ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN	"$1,458.00"
HC25000860	ASP/INJ MED JOINT-BILAT	"$1,456.00"
3877917798	SIMPLE SYRUP ORAL SYRP	"$1,455.00"
58914-170-14	SUCRALFATE 100 MG/ML ORAL SUSP	"$1,454.04"
HC25003161	LAC REPAIR INTMD N/H/F/GEN 12.6-20	"$1,454.00"
HC25003211	LAC REPAIR INTMD F/E/E/N/L/MM 5.1-7.5CM	"$1,454.00"
HC25003286	LAC REPAIR CMPLX S/A/L 1.1-2.5 CM	"$1,454.00"
HC25004565	CLOSED TX ANKLE DISLOC; NO ANES BIL	"$1,454.00"
HC25005182	REPAIR LIP FULL THICK; VERMILION ONLY	"$1,454.00"
HC25005547	REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP BIL	"$1,454.00"
HC27000181	COLONOSCOPY DIAGNOSTIC DC'D	"$1,452.00"
HC44001766	REMOV FB ESOPHAGEAL W/BALLOON	"$1,451.00"
HC32000465	OT-DYSPHAGIA EVAL 75 MIN/MC	"$1,451.00"
HC62808035	SYSTEM REFLECTOR RADAR LOCALIZ(SCOUT)	"$1,450.00"
HC62802558	KIT QUINTON MAHURKAR CATH	"$1,448.00"
HC89023634	GENOMIC SNP MICROARRAY POC-AU	"$1,447.50"
HC62210323	BALLOON EXPANDER AAA STENT	"$1,447.00"
HC25005653	THROMBOLYSIS CEREBRAL IV INFUSION	"$1,445.00"
HC25003062	CLOSURE SUPERFCL WOUND DEHISC W/PACKING	"$1,443.00"
HC25000100	CRICOTHYROIDOSTOMY	"$1,443.00"
HC25003336	LAC REPAIR CMPLX E/N/E/L 1.1-2.5 CM	"$1,442.00"
HC44000867	FLUOROSCOPY < 1HR	"$1,442.00"
HC21001078	WOUND VAC TX W/ DISP ASST/INSTR <50SQ CM SESSION	"$1,442.00"
99999-040-16	TOLVAPTAN 15 MG ORAL PARTIAL TAB	"$1,441.56"
HC44000883	FOOT 2 VIEWS BILAT	"$1,441.00"
HC44002822	SWALLOW FUNC W/CINE/VIDEO	"$1,441.00"
HC44002152	XR SWALLOW FUNC W/CINE/VIDEO INC SCOUT&DELAYES	"$1,441.00"
25021-455-05	"OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN"	"$1,440.00"
0703-3343-01	"OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN"	"$1,440.00"
0641-6178-01	"OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN"	"$1,440.00"
55150-191-83	IBANDRONATE 3 MG/3 ML IV SYRG	"$1,440.00"
0168-0204-37	LIDOCAINE 5 % TOPICAL OINT	"$1,440.00"
HC62204334	KIT TWIST DRILL DISP	"$1,438.00"
HC44701688	FLUORO GUIDANCE UNLISTED PROCEDURE	"$1,437.00"
HC46500773	DEST CUTANEOUS VASCULAR LESION	"$1,436.00"
HC25003567	CLOSED TX SHOULDR DSLC W/MAN W/O ANES-BIL	"$1,436.00"
HC62228119	ORTH ELBOW ADJUST POSITION LOCK PREFAB CUSTOM	"$1,434.00"
25208-002-02	TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) IV SOLN	"$1,434.00"
99999-001-78	CHARGE-ADULT 3 IN 1 ADMIX 2500ML	"$1,434.00"
HC25003260	LAC REPAIR CMPLX TRUNK 1.1-2.5 CM	"$1,430.00"
HC62213046	BLADE SHAVER                      V	"$1,430.00"
HC62213541	REAMER                            Y	"$1,430.00"
HC62216189	SPHINCTEROTOME CANNULATING        K	"$1,430.00"
HC62216734	PIN/WIRE FIXATION TEMPORARY      AJ	"$1,430.00"
HC62216841	ENDO STAPLER                      V	"$1,430.00"
HC62217427	DEVICE LIGATOR                    M	"$1,430.00"
HC62217690	AWL SPINAL SINGLE PATIENT USE     R	"$1,430.00"
HC62218920	DRILL/DRILL BITS SINGLE USE      AA	"$1,430.00"
HC62804232	COIL EMBOLIZATION                 L	"$1,430.00"
HC27001791	ESOPHSCPY DX- BRSH/WSH~FO DISCONT'D	"$1,428.00"
HC46000501	INTRO CATH HYSTERO	"$1,428.00"
HC33000340	ST-SWALLOWING EVAL 75MIN	"$1,428.00"
HC44200897	US FETAL BPP W/O NST(EA ADD'L)+	"$1,427.00"
HC44200327	US GUIDE VASC ACCESS	"$1,425.00"
HC43001023	US BREAST; LIMITED BILATERAL	"$1,424.00"
HC36000784	PULSE OX NOCTURNAL STUDY	"$1,424.00"
HC62205810	PROBE HEMOSTASIS (BICAP)          K	"$1,424.00"
68546-317-30	GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRG	"$1,422.80"
HC44001303	XR INTRO GI TUBE IMAGING S&I	"$1,422.00"
HC36800357	PULSE OX NOCTURNAL STUDY	"$1,422.00"
HC32001711	OT-EVAL HIGH COMPLEXITY 45MF2F 120MIN	"$1,422.00"
HC46000121	INJ ARTHROGRAM ELBOW-LT	"$1,421.00"
HC46000139	INJ ARTHROGRAM ELBOW-RT	"$1,421.00"
HC51003309	BX(S)CERVIX / EXCISE LESION(SEP PROC)	"$1,421.00"
HC44000354	CERVICAL SPINE 4/5VWS	"$1,420.00"
HC44200533	US PELVIC(NON OB)LTD OR F/U	"$1,420.00"
HC25003112	LAC REPAIR INTMD S/A/T/EXT 20.1-30CM	"$1,419.00"
HC25004359	CLOSED TX PATELLAR DISLOC; NO ANESTH BIL	"$1,419.00"
HC25004797	CLOSED TX TARSAL DISLOC; NO ANES BIL	"$1,419.00"
HC25004912	APPLY CAST; ELBOW TO FINGER (SHORT ARM) BILAT	"$1,419.00"
66794-155-02	"BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SOLN"	"$1,417.80"
70257-560-20	BACLOFEN 500 MCG/ML INTRATHECAL SOLN	"$1,417.80"
70257-560-01	BACLOFEN 500 MCG/ML INTRATHECAL SOLN	"$1,417.80"
8213100037	"PORCINE SUBMUCOSA, FENESTRATED 3 X 7 CM TOPICAL SHEE"	"$1,417.50"
HC38000212	APPLY CMPRSSN BOOT/WRAP(UNNA)BI	"$1,416.00"
HC44001568	LUMBAR SPINE SERIES MIN 4VWS	"$1,416.00"
HC25003484	CLOSED TX CLAVICLE FX W/MANIP LT	"$1,415.00"
HC25003492	CLOSED TX CLAVICLE FX W/MANIP RT	"$1,415.00"
0172-7313-20	CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN (MCH)	"$1,414.80"
HC77400091	BEDSIDE/OTHER ANESTH' INITIAL HR	"$1,412.00"
HC33000746	ST-NASOPHARYNGOSCOPY	"$1,411.00"
HC25005331	SIGMOIDOSCOPY FLEX W/REMOVE FB	"$1,410.00"
HC44200467	"US OB NUCHAL MEAS, 1ST GEST"	"$1,410.00"
63323-762-10	TOPOTECAN 4 MG IV SOLR	"$1,410.00"
67457-619-10	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$1,410.00"
43598-331-11	ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK	"$1,410.00"
HC25003153	LAC REPAIR INTMD N/H/F/GEN 7.6-12.5	"$1,409.00"
HC27001254	GASTRIC INTUB ASP DX;SNGL SPEC	"$1,408.00"
HC44001246	INFANT UP EXTREM MIN 2VW BILAT	"$1,406.00"
HC41500125	EEG INTRAOP NON-INTRACRANIAL	"$1,405.00"
HC62212501	ELECTRODE UROLOGICAL/ELECTROSURGICL	"$1,404.00"
HC25003799	CLOSED TX ULNA SHAFT FX W/MANIP-BIL	"$1,403.00"
54643-9015-8	"MVI, ADULT NO.4, VIT K, 1 OF 2 3,300 UNIT- 150 MCG/5 ML IV SOLN"	"$1,402.20"
54643-9015-9	"MVI, ADULT NO.4, VIT K, 2 OF 2 600 MCG-60 MCG- 5 MCG/5 ML IV SOLN"	"$1,402.20"
HC89020929	ANSER IFX MEAS OF SER INFLIXIMAB-PR	"$1,400.00"
HC89022776	ANSER VDZ MEAS OF SER VEDOLIZUMAB-PR	"$1,400.00"
HC62228739	SENSORS TRACKER VPAD®	"$1,400.00"
HC44200673	US GUIDANCE AMNIOCENTESIS	"$1,398.00"
HC62208673	GUIDEWIRE                         S	"$1,398.00"
HC62216247	SHEARS COAGULATING HARMONIC       Q	"$1,398.00"
HC25001025	PERICARDIOCENTESIS INCL IMAGING	"$1,397.00"
0005-1971-05	PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	"$1,396.56"
HC25004573	REMOVE FB FOOT; SUBC LT	"$1,395.00"
HC25004581	REMOVE FB FOOT; SUBC RT	"$1,395.00"
HC62209556	SYSTEM SINUS ILLUMINATION	"$1,395.00"
HC44002483	URETHROCYSTOGRAM RETROGRADE	"$1,393.00"
HC25003104	LAC REPAIR INTMD S/A/T/EXT 12.6-20CM	"$1,386.00"
HC25004714	CLOSED TX BIG TOE FX; W/MANIPULTN BIL	"$1,385.00"
HC44000594	ELBOW 2 VWS BILAT	"$1,385.00"
HC25004532	CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES BIL	"$1,383.00"
HC27000835	ESOPH MOTILITY/MANO' DISCONT'D	"$1,383.00"
0069-0338-01	SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN	"$1,382.33"
HC62808878	TUBE GJ GASTRO/JEJUN LOWPRO	"$1,382.00"
HC44002046	SKULL COMPLETE MIN 4 VWS	"$1,381.00"
HC62211040	CANNULA VENOUS FEMORAL            Q	"$1,381.00"
HC62213632	CANNULA AORTIC FILTERING	"$1,381.00"
HC62227301	FASTENERS TIF(SEROSAFUSE CARTRIDGE)	"$1,381.00"
HC51010973	PUNC SHUNT/RES FOR ASP/INJ	"$1,379.00"
63323-194-20	IDARUBICIN 1 MG/ML IV SOLN	"$1,378.20"
HC43001148	MAMMO DX W/SPC VWS W/CAD BIL	"$1,378.00"
HC84201805	RESP VIRUS 6-11 TARGETS (PNL)	"$1,378.00"
HC25002825	I&D POLINIDAL CYST; SIMPLE	"$1,377.00"
HC25003096	LAC REPAIR INTMD S/A/T/EXT 7.6-12.5CM	"$1,377.00"
HC25003310	LAC REPAIR CMPLX F/C/C/M/N/AX/G/H/F 1.1-2.5CM	"$1,377.00"
HC25003674	CLOSED TX ELBOW DISLOC W/O ANES-BIL	"$1,377.00"
HC51010858	THORACENTESIS W/TUBE W/O IMAG	"$1,376.00"
HC25002858	DEBRIDE ECZEM/INFCT SKIN UP TO 10% BSA	"$1,374.00"
HC46502738	BIOPSY PUNCH SKIN; SINGLE INITIAL LESION	"$1,374.00"
HC44001360	KNEE 1 VIEW BILAT	"$1,373.00"
HC79200010	"MUSCLE TEST, TWO LIMBS"	"$1,372.00"
HC62219217	CATH MICROCATHETER NEUROVASC      K	"$1,372.00"
HC73000259	DIALYSIS CCPD CANCEL-MED NEC	"$1,371.00"
0065-0648-35	TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT OINT	"$1,369.26"
0078-0876-01	TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT OINT	"$1,369.26"
HC44000941	FOREARM BILAT	"$1,369.00"
27808-086-02	HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12	"$1,367.92"
HC25003203	LAC REPAIR INTMD F/E/E/N/L/MM 2.6-5.0CM	"$1,367.00"
HC46500914	FNA ASP BX W/O GUIDE; EACH ADD'L LESION	"$1,366.00"
HC82202219	FNA ASP BX W/O GUIDE; EACH ADD'L LESION	"$1,366.00"
70842-160-10	MINOCYCLINE 100 MG IV SOLR	"$1,365.60"
70842-160-01	MINOCYCLINE 100 MG IV SOLR	"$1,365.60"
HC62212451	INTRODUCER/SHEATH                 T	"$1,365.00"
HC62213038	BLADE SHAVER                      U	"$1,365.00"
HC62213533	REAMER                            X	"$1,365.00"
HC62218912	DRILL/DRILL BITS SINGLE USE       Z	"$1,365.00"
HC44200954	US MAPPING VESSEL HEMODIALYSIS; COMPLT UNILAT	"$1,364.00"
17478-080-50	CAPREOMYCIN 1 GRAM INJ SOLR	"$1,363.86"
0054-0386-63	HYDROMORPHONE 1 MG/ML ORAL LIQD	"$1,362.24"
68180-202-03	CEFIXIME 100 MG/5 ML ORAL SUSR	"$1,361.10"
HC32000457	OT-SWALLOWING EVAL 60MIN	"$1,361.00"
0469-3016-01	TACROLIMUS 5 MG/ML IV SOLN	"$1,360.69"
65628-208-10	VANCOMYCIN 50 MG/ML ORAL SOLR	"$1,359.00"
HC51003663	HEMORRHOIDECTOMY/BANDING	"$1,357.00"
HC51003671	INJ SCLEROTHERAPY HEMORRHOIDS	"$1,357.00"
HC51003655	ANOSCOPY W/FB REMOVAL	"$1,357.00"
HC51060556	DESTROY MUSCLE(S) NECK NO LARYNX BI	"$1,357.00"
62542-301-16	HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12	"$1,356.56"
62542-301-17	HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12	"$1,356.56"
HC33000332	ST-SWALLOWING EVAL 60MIN	"$1,356.00"
HC62222179	CANNULA PERFUSION W/FILTER        Q	"$1,356.00"
HC25000217	REPAIR NAIL BED	"$1,355.00"
HC25003971	CLOSED TX WRIST DSLOC 1/> BONES W/MAN-BIL	"$1,355.00"
0005-1971-02	PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	"$1,354.09"
0005-1971-01	PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	"$1,354.09"
HC33000266	ST-SPEECH THERAPY 120MIN/MW	"$1,352.00"
HC62217872	SET PIN DISTRACTORS-COUNT 2       B	"$1,352.00"
HC44001923	SHOULDER 1 VIEW BILATERAL	"$1,351.00"
HC83000604	RBC/FRZ/DEGLYC/WSHD/LR/IRRAD	"$1,350.00"
99999-041-55	POLIHEXANIDE (PURAPLY AM) 1.6 CM EACH TOPICAL DISC	"$1,350.00"
76329-9060-0	EPINEPHRINE 1 MG/ML INJ SOLN	"$1,350.00"
9029703	GELATIN ABSORBABLE OPHT FILM	"$1,349.39"
HC32000119	OT-EVAL SWALLOW CINE/FLUORO 60MIN	"$1,349.00"
HC33000183	ST-EVAL SWALLOW CINE/FLUORO 60MIN	"$1,349.00"
HC43000686	DUCTOGRAM SINGLE LT	"$1,348.00"
HC43000694	DUCTOGRAM SINGLE RT	"$1,348.00"
HC43000108	DUCTOGRAM/GALACTOGRAM SINGLE	"$1,348.00"
HC42000174	ECHO DOPPLER F/U OR LTD*	"$1,347.00"
HC62219290	DILATOR RENAL AMPLATZ	"$1,347.00"
0013-8303-04	LATANOPROST 0.005 % OPHT DROP	"$1,345.44"
0781-6186-67	CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS	"$1,345.10"
HC44000545	CYSTOGRAM	"$1,345.00"
70954-151-10	NAPROXEN 125 MG/5 ML ORAL SUSP	"$1,344.00"
HC12400149	CHEMO ADMIN INTRA ARTERIAL INFUSION UP TO 1 HR	"$1,343.00"
HC62222997	ELECTRODE BIPOLAR HYSTERO TWIZZEL	"$1,343.00"
52015-080-01	FIDAXOMICIN 200 MG ORAL TAB	"$1,342.56"
HC44000974	HAND 2 VIEWS BILAT	"$1,342.00"
HC27001205	M:GI LAB MISC PROCEDURE	"$1,342.00"
50383-286-08	LEVOFLOXACIN 25 MG/ML ORAL LIQUID	"$1,340.40"
HC25003146	LAC REPAIR INTMD N/H/F/GEN 2.6-7.5	"$1,340.00"
HC44001170	HUMERUS BILAT	"$1,340.00"
HC32000531	OT-SWALLOWING THERAPY  90 MIN	"$1,339.00"
HC46000212	INJ CONT-ASSESS CYST VIA CATH	"$1,338.00"
HC51002947	DILAT STRICTR URETHRL FLFRM MALE INT'L	"$1,338.00"
HC41000127	HOME SLEEP STUDY/T II MIN' 7CH	"$1,337.00"
17478-307-03	AZITHROMYCIN 1 % OPHT DROP	"$1,336.26"
HC73000200	HEMODIALYSIS CANCEL-MED NEC	"$1,336.00"
HC12400032	CHEMO ADMIN IVP SNGL/INIT'LINJ	"$1,336.00"
8065183150	CHONDROITIN SULF-SOD HYALURON 3 %-4 %(0.5 ML) 1 % (0.55 ML) INTRAOCULAR SYRG	"$1,335.12"
0456-0400-10	CEFTAROLINE FOSAMIL 400 MG IV SOLR	"$1,334.42"
0456-0600-10	CEFTAROLINE FOSAMIL 600 MG IV SOLR	"$1,334.42"
0456-0400-01	CEFTAROLINE FOSAMIL 400 MG IV SOLR	"$1,334.40"
0456-0600-01	CEFTAROLINE FOSAMIL 600 MG IV SOLR	"$1,334.40"
HC62208707	CATH GUIDE F S OR M SINUPLASTY	"$1,333.00"
HC24000010	HBO TX EA 1/2 HR BASIC/M	"$1,333.00"
HC25004201	CLOSED TX HIP DISLOC TRAUMIC BIL	"$1,331.00"
HC73000242	DIALYSIS CAPD CANCEL-MED NEC	"$1,330.00"
HC33000167	ST-EVAL RX SP GEN DEVC; 1ST HR	"$1,329.00"
51672-4118-6	FLUOROURACIL 5 % TOPICAL CREAM	"$1,328.16"
HC44002517	WRIST 2 VIEWS BILAT	"$1,328.00"
HC38000071	APPLY CAST RIGID TOTAL LEG	"$1,327.00"
HC44000636	ELBOW ARTHROGRAM LT	"$1,327.00"
HC44000644	ELBOW ARTHROGRAM RT	"$1,327.00"
78206-127-02	MOMETASONE-FORMOTEROL 100-5 MCG/ACTUATION INHALATION HFAA	"$1,326.55"
78206-126-02	MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION INHALATION HFAA	"$1,326.55"
HC25006206	POSTPARTUM CARE	"$1,325.00"
HC51061596	ECHO CONGENITAL LTD OR F/U	"$1,325.00"
HC44900892	CT BODY SCAN NK/CH/ABD/PEL	"$1,325.00"
0527-1961-74	COCAINE 4 % NASL SOLN	"$1,323.00"
0527-1971-74	COCAINE 4 % NASL SOLN	"$1,323.00"
HC26000174	L&D EVAL LEVEL III - INTERMED	"$1,322.00"
HC43001122	MAMMO DX W/CAD BILAT	"$1,319.00"
HC38000303	APPLY SPICA HIP1 1/2 OR 2 LEGS	"$1,318.00"
0069-0293-01	FILGRASTIM-AAFI 300 MCG/ML INJ SOLN	"$1,314.00"
0069-0293-10	FILGRASTIM-AAFI 300 MCG/ML INJ SOLN	"$1,314.00"
0173-0715-22	FLUTICASONE PROPION-SALMETEROL 45-21 MCG/ACTUATION INHALATION HFAA	"$1,313.04"
0173-0716-22	FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION INHALATION HFAA	"$1,313.04"
HC33001074	ST EVAL SOUND W/LANG COMP&EXPRESS 180MIN/M	"$1,312.00"
HC33000431	ST-SWALLOWING THERAPY 90 MIN	"$1,312.00"
HC25004003	CLOSED TX DISTL RADIOULNAR DISLOC W/M-BIL	"$1,310.00"
HC42000901	ECG EXT HOLTER W/CONNECT >7DAYS-15DAYS; RECORDING	"$1,310.00"
99999-038-95	POLIHEXANIDE (PURAPLY) 2X2 CM EACH TOPICAL SHEET	"$1,308.00"
0781-3253-94	AZACITIDINE 100 MG INJ SOLR	"$1,307.40"
HC44000073	ANKLE 2 VIEWS BILAT	"$1,304.00"
HC62228143	"ORTH WHFO, RIGID W/O JOINTS CUSTOM"	"$1,304.00"
0409-6510-01	VANCOMYCIN 10 GRAM IV SOLR	"$1,303.38"
0409-1319-01	VANCOMYCIN 10 GRAM IV SOLR	"$1,303.38"
HC62228416	ORTH WHFO W/NONTORSION JOINT(S) CUSTOM	"$1,303.00"
HC23000029	ASP & INJ GANGLION CYST	"$1,301.00"
HC25000985	INTUBATION	"$1,300.00"
HC62220132	OVERTUBE ENDOSCOPIC               C	"$1,300.00"
HC62217559	KIT TUBE TRACH PEDS/NEO NO CUFF   Q	"$1,300.00"
HC62204359	KIT W/ TRACH PERCUTANEOUS         F	"$1,300.00"
HC62800065	CATH PTA ANGIOPLS BALLOON NON-LSR M	"$1,300.00"
HC62212642	CATH PTCA BALLOON NON-LASER       L	"$1,300.00"
HC62212006	CATH BALLOON SIZING HALO ESOPH    Q	"$1,300.00"
HC62805916	CATH EP DX <20 ELECTRODES         J	"$1,300.00"
HC62800453	CATH QUINTON                      Q	"$1,300.00"
HC62220207	CATH THROMBECTOMY/EMBOLECTOMY     Q	"$1,300.00"
HC62800578	DEVICE CLOSURE VASCULAR           Q	"$1,300.00"
HC62219050	DEVICE RETRIEVAL VASC             A	"$1,300.00"
HC62806138	PORT INDWELLING W/CATH            J	"$1,300.00"
HC62221635	CATH GUIDING EXTENSION(GUIDEZILLA)Q	"$1,300.00"
HC62800388	CATH INFUSION                     Q	"$1,300.00"
HC62211859	KIT/SYS CATH MICRO'P'VASC INJ/COIL DEL	"$1,300.00"
HC62218284	CATH INTRODUCER PEEL-AWAY        AA	"$1,300.00"
HC62800552	CATH OCCLUSION                    Q	"$1,300.00"
HC39001177	INTENSIVE OUTPT PSYCHIA PER DIEM	"$1,300.00"
HC62227160	BLADE INCISIONAL                  T	"$1,300.00"
HC62200381	BAND LIGATOR	"$1,300.00"
HC62205497	KIT VITRECTOMY PROBE              J	"$1,300.00"
HC62205638	PAIN PUMP W/ SYSTEM               Q	"$1,300.00"
HC62210414	KIT CASS KNEE NAVITRAKER	"$1,300.00"
HC62213020	BLADE SHAVER                      T	"$1,300.00"
HC62213525	REAMER                            W	"$1,300.00"
HC62215405	DEVICE SUTURE ENDOSCOPIC          K	"$1,300.00"
HC62216171	SPHINCTEROTOME CANNULATING        J	"$1,300.00"
HC62216726	PIN/WIRE FIXATION TEMPORARY       AI	"$1,300.00"
HC62216940	TAMP BONE KYPHOPLASTY             C	"$1,300.00"
HC62217245	BLADE MILL BONE	"$1,300.00"
HC62217443	FORCEPS BIPOLAR DISPOSABLE        Q	"$1,300.00"
HC62217682	AWL SPINAL SINGLE PATIENT USE     Q	"$1,300.00"
HC62218466	ENDO STAPLER                      T	"$1,300.00"
HC62218599	STAPLE CARTRG/ENDO RELOAD         Q	"$1,300.00"
HC62218904	DRILL/DRILL BITS SINGLE USE       Y	"$1,300.00"
HC62219241	CUTTER SUTURE INCL SURECUT        Q	"$1,300.00"
HC62219373	HOOK MARKING ORTHO	"$1,300.00"
HC62219555	PROBE SPINAL DISPOSABLE           O	"$1,300.00"
HC62221601	CANNULA CEMENT BONE               Q	"$1,300.00"
HC62221874	TAP SURGICAL                      Q	"$1,300.00"
HC62222310	DEVICE BIOPSY BREAST              Q	"$1,300.00"
HC62222393	GUIDE DRILL                       Q	"$1,300.00"
HC62222518	WAND ARTHRO                       Q	"$1,300.00"
HC62222989	DISSECTOR BALLOON ENDOSCOPIC      D	"$1,300.00"
HC62223615	SNARE                             Q	"$1,300.00"
HC62223698	NEEDLE BONE MARROW                Q	"$1,300.00"
HC62223938	PATCH 3D REFERENCE EP	"$1,300.00"
HC62224324	APPLIER CLIP ENDO                 Q	"$1,300.00"
HC62224332	TUNNELER SURGICAL                 Q	"$1,300.00"
HC62225040	NEEDLE ASPIRAT(EUS SLIMLIN 19GA)  Q	"$1,300.00"
HC62225347	CANNULA ARTHROSCOPIC              Q	"$1,300.00"
HC62225420	ANCHOR CLIP ENDOSCOPIC	"$1,300.00"
HC62225768	KIT DRESSING WOUND NEG PRESSURE   N	"$1,300.00"
HC62226014	COUNTERSINK                       Q	"$1,300.00"
HC62226147	ELECTRODE RESECTOSCOPE            N	"$1,300.00"
HC62226386	RETRACTOR DISPOSABLE              M	"$1,300.00"
HC62226394	RETRACTOR MIS SPINAL              B	"$1,300.00"
HC62226691	EXTENDER TAB SPINAL	"$1,300.00"
HC62226907	HANDPIECE VESSEL SEALER DEVICE    B	"$1,300.00"
HC62227368	CUTTER SEALER BIPOLAR ULTRASONIC	"$1,300.00"
HC62228457	KIT SUTURE WIRE LASSO	"$1,300.00"
HC62802905	PARTICLES EMBOLIZATION            Q	"$1,300.00"
HC62804224	COIL EMBOLIZATION                 K	"$1,300.00"
HC62807359	CLIP ENDOSCOPIC                   Q	"$1,300.00"
HC25002817	I&D ABSCESS; COMPLICATED/MULT	"$1,299.00"
HC82200551	INTERPHASE IN-SITU HYBRI 25-99	"$1,299.00"
HC23001019	INJ(S);SNGL TNDON ORIGN/INSERT	"$1,296.00"
HC42000018	ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS;HOOK&RECORD	"$1,295.00"
61703-343-65	MITOXANTRONE 2 MG/ML IV CONC	"$1,294.20"
HC47200613	APPLY LOW DOSE RADIONUCLIDE SOURCE	"$1,294.00"
HC62210232	FILTER CONT VENOVENOUS HEMO'EA	"$1,294.00"
0078-0841-01	CIPROFLOXACIN HCL 0.3 % OPHT OINT	"$1,286.17"
0065-0644-35	TOBRAMYCIN 0.3 % OPHT OINT	"$1,286.17"
0065-0654-35	CIPROFLOXACIN HCL 0.3 % OPHT OINT	"$1,286.17"
HC21000278	DEBRIDE P-THICK BURN SM<5%BSA	"$1,286.00"
HC26000091	FETAL NON-STRESS TEST	"$1,286.00"
HC38420063	PERFUSION CARDIO' EA ADDL .5HR	"$1,286.00"
HC36800779	PFT/LUNG VOL INFANT-2Y/O	"$1,286.00"
67457-342-10	VANCOMYCIN 10 GRAM IV SOLR	"$1,284.06"
HC62223532	CANNULA ENDOSCOPIC SPINAL	"$1,284.00"
70594-048-01	VANCOMYCIN 10 GRAM IV SOLR	"$1,284.00"
25767-735-45	CUSTODIOL HTK SOLUTION	"$1,284.00"
HC83504449	ANATOMIC CONSULT; COMP. REV-CS	"$1,283.00"
HC62228838	CATH MEASUREMENT ENDOFLIP	"$1,283.00"
HC44002954	HIP (W/PELVIS WHN PRFRMD) 4/>VWS LT	"$1,281.00"
HC44002962	HIP (W/PELVIS WHN PRFRMD) 4/>VWS RT	"$1,281.00"
HC62223466	ORTHOTIC LMBR1-5SAG PNL ANT/POST CSTM	"$1,281.00"
HC27000363	EGD DIAGNOSTIC DISCONTINUED PROC	"$1,280.00"
0069-0550-38	SUNITINIB 12.5 MG ORAL CAP	"$1,279.26"
HC42000893	ECG EXT HOLTER >48HRS-7DAYS; SCANNING ANYS W/REPORT	"$1,279.00"
HC23000045	ASP/INJ JOINT SM W/O UTZ GUIDE-LT	"$1,278.00"
HC43001098	MAMMO SCREEN W/IMP W/CAD BIL	"$1,277.00"
HC62217732	PUNCH SPINAL	"$1,277.00"
HC31000367	PT-EVAL HIGH COMPLEXITY 45MF2F 90MIN	"$1,276.00"
HC32000291	OT-EVAL HIGH COMPLEXITY 45MF2F 90MIN	"$1,276.00"
HC51003184	BX VAGINA SIMPLE	"$1,275.00"
63323-314-61	VANCOMYCIN 10 GRAM IV SOLR	"$1,275.00"
63323-314-68	VANCOMYCIN 10 GRAM IV SOLR	"$1,275.00"
42023-164-25	VASOPRESSIN 20 UNIT/ML IV SOLN	"$1,274.26"
42023-164-01	VASOPRESSIN 20 UNIT/ML IV SOLN	"$1,274.26"
42023-164-10	VASOPRESSIN 20 UNIT/ML IV SOLN	"$1,274.26"
HC25005240	LAC REPAIR MOUTH; >2.5 CM/COMPLEX	"$1,274.00"
HC25005299	REMOVE FB PHARYNX	"$1,274.00"
HC25005430	IINJ ANES/STEROID NERVE/BRNCH PERIPH LT	"$1,274.00"
HC25005448	INJ ANES/STEROID NERVE/BRNCH PERIPH RT	"$1,274.00"
HC23001035	INJ ANES/STEROID NERVE TRIGEML BRNCH EA	"$1,273.00"
HC23001522	INJ ANES/STEROID NERVE TRIGEML BRNCH EA LT	"$1,273.00"
HC23001514	INJ ANES/STEROID NERVE TRIGEML BRNCH EA RT	"$1,273.00"
HC44200491	US OPHTH B-SCAN	"$1,273.00"
HC38000436	APPLY CAST RISSER JACKET BODY; WITH HEAD	"$1,272.00"
HC51002707	PARACENTESIS ABD W/IMAGING GUIDE	"$1,272.00"
HC51010833	BONE MARROW DX; ASPIRATION(S) ONLY	"$1,270.00"
HC62800784	CABLE DALL MILES	"$1,270.00"
0944-2723-03	"HYALURONIDASE, HUMAN RECOMB. 1,600 UNIT/10 ML SUBCUTANEOUS SOLN"	"$1,269.00"
HC46502555	INJECT URETEROGRAPH VIA URETEROS/CATH	"$1,268.00"
HC32001281	OT-RE-EVAL EST POC  90MIN	"$1,268.00"
HC62212766	GUIDEWIRE                         R	"$1,268.00"
HC62214044	DEVICE PRESS BONE (HENSLER)	"$1,268.00"
HC25003054	CLOSURE SUPERFCL WOUND DEHISC SIMPLE	"$1,267.00"
99999-045-41	TEMOZOLOMIDE 10 MG/ML ORAL LIQUID (COMPOUND)	"$1,266.66"
HC42000208	ECHO FETAL DOPPLER COMPLETE	"$1,265.00"
69238-1503-1	ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR	"$1,264.80"
0085-7206-07	MOMETASONE-FORMOTEROL 100-5 MCG/ACTUATION INHALATION HFAA	"$1,264.56"
0085-4610-05	MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION INHALATION HFAA	"$1,264.56"
HC25002890	DEBRIDE SKIN MUSCLE; FIRST 20SQCM OR LESS	"$1,263.00"
HC21000203	CAUTERIZE W/CHEM; GRAN TISSUE	"$1,263.00"
HC25004680	CLOSED TX BIG TOE FX; NO MANIPULTN BIL	"$1,261.00"
69097-805-40	AZACITIDINE 100 MG INJ SOLR	"$1,260.00"
HC44900876	CT BODY SCAN ABD/CHEST/PEL/HRT	"$1,259.00"
17478-605-10	DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP	"$1,257.66"
HC25002916	EXCISION OF NAIL/MATRIX PERM	"$1,257.00"
HC44001873	SCAPULA BILATERAL	"$1,257.00"
HC25000357	EXPLORE WOUND	"$1,256.00"
HC62211271	AUTO TRANSFUSION SUPPLIES	"$1,256.00"
HC23001027	INJ(S);SINGLE TENDON/SHEATH	"$1,255.00"
HC25004763	CLOSED TX SESAMOID FX BILAT	"$1,255.00"
HC44200459	US OB LIMITED FETUS(S)	"$1,254.00"
HC41500059	DBS CORTICAL MAP EA ADDL' HRS	"$1,254.00"
HC81101982	DRUG TST DEFNTV 22/>RX CLSS W/METBLTS/DAY	"$1,254.00"
HC23000052	ASP/INJ JOINT SM W/O UTZ GUIDE-RT	"$1,253.00"
HC83000299	AUTOL/DD BLD/COMPON PROC/STOR	"$1,253.00"
HC62802509	INTRODUCER SUPRAPUB FOLEY CATH	"$1,253.00"
65162-686-88	FELBAMATE 600 MG/5 ML ORAL SUSP	"$1,252.80"
HC44000040	XR ABDOMEN COMPLETE (2/> IMAGES) W/CXR	"$1,251.00"
HC44000693	XR ESOPHAGUS W/SNGLE CONSTRST INC SCOUT&DELAYS	"$1,251.00"
HC77400109	ANESTHESIA MAC INITIAL HOUR	"$1,251.00"
HC51000552	INSERT PICC <5 YR AGE W/O IMAGING	"$1,250.00"
HC25000019	ED LEVEL II - LIMITED	"$1,250.00"
16714-782-04	CLOBETASOL 0.05 % TOPICAL OINT	"$1,249.92"
HC25003088	LAC REPAIR INTMD S/A/T/EXT 2.6-7.5CM	"$1,249.00"
66794-160-02	MORPHINE (PF) 10 MG/ML INJ SOLN	"$1,248.96"
0641-6039-01	MORPINE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM)	"$1,248.00"
HC44200475	US OB NUCHAL MEAS EA ADL GEST+	"$1,247.00"
HC62201140	CARTRIDGE (DIALYSIS)	"$1,245.00"
HC51000560	INSERT PICC >5 YR AGE W/O IMAGING	"$1,244.00"
66220-207-30	ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN	"$1,242.00"
HC32001810	OT-ENDOSCOP EVAL SWALLOW/LARYN	"$1,236.00"
HC33000134	ST-ENDOSCOP EVAL SWALLOW/LARYN	"$1,236.00"
HC62212295	CATH RETRIEV STONE BACKSTOP GEL  AI	"$1,235.00"
HC62213012	BLADE SHAVER                      S	"$1,235.00"
HC62213319	BURR                              S	"$1,235.00"
HC62213517	REAMER                            V	"$1,235.00"
HC62214093	NEEDLE TARGETING(STREAMLINE)      Q	"$1,235.00"
HC62216239	SHEARS COAGULATING HARMONIC       P	"$1,235.00"
HC62218458	ENDO STAPLER                      S	"$1,235.00"
HC62218896	DRILL/DRILL BITS SINGLE USE       X	"$1,235.00"
HC62224472	NEEDLE BIOPSY NASHOLD             Q	"$1,235.00"
70842-120-06	MEROPENEM-VABORBACTAM 2 GRAM IV SOLR	"$1,234.00"
70842-120-01	MEROPENEM-VABORBACTAM 2 GRAM IV SOLR	"$1,234.00"
HC44001782	RIBS BILAT MIN 4VWS W/PA CHEST	"$1,233.00"
HC62214614	SYRINGE BONE MARROW ASPIRATION 20CC	"$1,232.00"
0781-3153-80	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,229.64"
0781-3153-95	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,229.64"
HC51002178	CYSTOMETROGRAM W/VOID PRSSR& URTH PRFL	"$1,229.00"
HC51060614	DESTROY MUSCLE(S) 1-4 1ST EXTREMITY	"$1,228.00"
HC51060630	DESTROY MUSCLE(S) 5/+ 1ST EXTREMITY	"$1,228.00"
HC51060655	DESTROY MUSCLE(S) TRUNK 1-5	"$1,228.00"
0173-0718-20	FLUTICASONE PROPIONATE 44 MCG/ACTUATION INHALATION HFAA	"$1,227.23"
HC25002882	DEBRIDE SKIN SUBQ; FIRST 20SQCM OR LESS	"$1,227.00"
0023-9211-05	BRIMONIDINE-TIMOLOL 0.2-0.5 % OPHT DROP	"$1,224.78"
60267-812-00	SODIUM NITRITE-SOD THIOSULFATE 300 MG/10 ML- 12.5 GRAM/50 ML IV SOLN	"$1,224.00"
0270-1316-98	IOPAMIDOL 76 % IV SOLN	"$1,221.00"
10122-325-01	NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK	"$1,220.40"
10122-325-10	NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK	"$1,220.40"
0143-9633-01	NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK	"$1,220.40"
0143-9633-10	NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK	"$1,220.40"
43066-016-10	NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK	"$1,220.40"
HC62800958	COIL EMBOLIZATION                 J	"$1,217.00"
HC43001197	MAMMO DX W/SPC VWS UNILT W/CAD LT	"$1,214.00"
HC43001205	MAMMO DX W/SPC VWS UNILT W/CAD RT	"$1,214.00"
HC47200423	RADIATION TX SUPRFCL OR/ORTH PER DAY	"$1,213.00"
0173-0449-02	SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN	"$1,212.23"
HC25000746	ASPIRATION OF ABCESS/CYST	"$1,211.00"
HC43500040	DEXA BONE DENS-AXIAL/APPEND COMB	"$1,210.00"
HC41500018	AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R	"$1,209.00"
0078-0685-15	ELTROMBOPAG 25 MG ORAL TAB	"$1,207.03"
HC44000503	CLAVICLE BILATERAL	"$1,204.00"
HC33000720	ST-EVAL LANGUAGE CMPT 180MIN	"$1,204.00"
58160-976-20	"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG"	"$1,203.27"
HC38420022	COLLECT AUTO'BLOOD ADD'L UNIT	"$1,203.00"
HC62210588	TUBING ASPIRATION NEURO	"$1,203.00"
HC74200247	BEDSIDE/OTHER SURG ADD'L 15MIN 1 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,201.00"
HC74200486	BEDSIDE/OTHER SURG ADD'L 15MIN 1 (MCAL 2ND SUBSQNT 0.5 HR)	"$1,201.00"
0548-9502-00	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$1,200.00"
43598-305-62	AZACITIDINE 100 MG INJ SOLR	"$1,200.00"
43598-610-40	DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN	"$1,200.00"
0187-0994-45	ACYCLOVIR 5 % TOPICAL CREAM	"$1,200.00"
HC81101917	GENERAL HEALTH PANEL     (CHAMPUS)	"$1,199.00"
HC62203674	KIT ANEURYSM	"$1,199.00"
59310-302-40	BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHALATION HFAB	"$1,198.35"
HC25000423	LARYNGOSCOPY FIBEROP W/FB REM	"$1,198.00"
HC62211917	DSG ABD ABTHERA OPEN	"$1,196.00"
HC25003047	LAC REPAIR SIMPLE F/E/E/N/L/M >30.0 CM	"$1,195.00"
HC44000735	FACIAL BONES COMP MIN 3 VWS	"$1,195.00"
HC25003195	LAC REPAIR INTMD F/E/E/N/L&/MM 2.5CM/<	"$1,194.00"
65250-133-09	BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP	"$1,193.04"
65250-133-10	BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP	"$1,193.04"
HC33001173	LARYNGOSC W/STROBOSCOPY	"$1,191.00"
HC31001373	PT-RE-EVAL EST POC  90MIN	"$1,191.00"
HC62206479	SHEATHS ILLUMINATOR	"$1,190.00"
HC62219340	GUIDE TIBIAL ORTHO	"$1,190.00"
HC51002640	THORACENTESIS ASP W/ IMG GUID	"$1,189.00"
HC27000959	GASTRIC INTUB ASP THER' LAVAGE	"$1,189.00"
8065183085	SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG	"$1,188.60"
HC33000860	ST-EVAL SPEECH CMPNT 120MIN	"$1,188.00"
0143-9559-01	ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN	"$1,188.00"
HC44002376	TOMOGRAM SINGLE PLANE	"$1,187.00"
HC41500026	CALORIC VESTIB BITHERM 4 IRRIG W/REC	"$1,187.00"
HC83001149	RBC'S LEUKO RED IRRAD EACH UNIT	"$1,186.00"
HC38000428	APPLY CAST RISSER JACKET BODY; ONLY	"$1,185.00"
HC47200563	RADIOELEMENT INFUSION	"$1,184.00"
24208-342-05	DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASL SPRY	"$1,182.06"
HC44200442	US OB FOLLOW UP EA ADD'L FETUS+	"$1,182.00"
47335-788-91	DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASL SPRP	"$1,182.00"
HC32001802	OT-ENDOSCOPIC EVAL LARYNGEAL	"$1,180.00"
HC33000142	ST-ENDOSCOPIC EVAL LARYNGEAL	"$1,180.00"
HC32003329	OT-EVAL MOD COMPLEXITY 30MF2F 90MIN	"$1,180.00"
HC41500729	EMG HEMIDIAPHRAGM	"$1,179.00"
HC31002074	PT-EVAL MOD COMPLEXITY 30MF2F 90MIN	"$1,177.00"
HC41500190	EMG 1 EXTREMITY	"$1,176.00"
67457-857-30	ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN	"$1,175.94"
HC25003070	LAC REPAIR INTMD S/A/T/EXT 2.5 CM/<	"$1,175.00"
HC44200434	US OB FOLLOW UP(RE-EVAL)	"$1,175.00"
HC46501615	URO-EMG	"$1,174.00"
HC12200317	IV INFUSION MONOCLONAL ABX BAMLANIVIMAB/XXXX	"$1,171.00"
HC62205398	PACK NEURO	"$1,171.00"
HC46502712	BIOPSY TANGENTIAL SKIN; SINGLE INITIAL LESION	"$1,170.00"
HC46000386	INJ FOR SIALOGRAPHY	"$1,170.00"
HC43001080	MAMMO SCREEN W/CAD BILAT	"$1,170.00"
HC62221213	KIT W/ TRACH PERCUTANEOUS         E	"$1,170.00"
HC62800081	CATH PTA ANGIOPLS BALLOON NON-LSR L	"$1,170.00"
HC62800073	CATH PTCA BALLOON NON-LASER       K	"$1,170.00"
HC62806393	CATH EP DX <20 ELECTRODES         I	"$1,170.00"
HC62220199	CATH THROMBECTOMY/EMBOLECTOMY     P	"$1,170.00"
HC62806443	PORT INDWELLING W/CATH            I	"$1,170.00"
HC62220389	CATH ANGIOG GUIDING DUAL ACCESS(ENVOY)J	"$1,170.00"
HC62227103	CATH GUIDING (GUIDEZILLA II)      P	"$1,170.00"
HC62223516	ORTHOSIS HUMERAL FRACTURE	"$1,170.00"
HC62227194	BLADE HOOK  ENDOSCOPIC	"$1,170.00"
HC62205760	PROBE BICAP WITH NEEDLE	"$1,170.00"
HC62213004	BLADE SHAVER                      R	"$1,170.00"
HC62213301	BURR                              R	"$1,170.00"
HC62213509	REAMER                            U	"$1,170.00"
HC62215793	FORCEPS BIPOLAR DISPOSABLE        P	"$1,170.00"
HC62216163	SPHINCTEROTOME CANNULATING        I	"$1,170.00"
HC62216718	PIN/WIRE FIXATION TEMPORARY       AH	"$1,170.00"
HC62217419	DEVICE LIGATOR                    K	"$1,170.00"
HC62218441	ENDO STAPLER                      R	"$1,170.00"
HC62218581	STAPLE CARTRG/ENDO RELOAD         P	"$1,170.00"
HC62218888	DRILL/DRILL BITS SINGLE USE       W	"$1,170.00"
HC62219712	KIT VITRECTOMY PROBE              I	"$1,170.00"
HC62221866	TAP SURGICAL                      P	"$1,170.00"
HC62222351	KIT PROCEDURE HYSTEROSCOPIC	"$1,170.00"
HC62222385	GUIDE DRILL                       P	"$1,170.00"
HC62222500	WAND ARTHRO                       P	"$1,170.00"
HC62223979	CANNISTER SUCTION NEURO/SPINAL	"$1,170.00"
HC62224126	CUTTER LINEAR ENDO                P	"$1,170.00"
HC62227855	CANNULA ARTHROSCOPIC              P	"$1,170.00"
55150-241-01	ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN	"$1,170.00"
55150-241-10	ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN	"$1,170.00"
HC31010168	PT-COMPUT DYNAMIC POSTURE SOT 6 CNDTNS; &MCT&ADT	"$1,168.00"
HC32010217	OT-COMPUT DYNAMIC POSTURE SOT 6 CNDTNS; &MCT&ADT	"$1,168.00"
HC42000281	ERGONOVINE PROVOCATION TEST	"$1,168.00"
HC12200119	REFILL/MAINTENANCE PORT PUMP	"$1,167.00"
HC36800761	SPIROMETRY INF PRE&POST RX ADM	"$1,166.00"
99988-000-22	NM TC-99M MERTIATIDE 1-15 MCI (TC MAG3/DOSE)	"$1,165.94"
HC21000633	WOUND VAC W/ DME >50 SQ CM PER SESSION	"$1,164.00"
HC62205174	PACK CARDIAC ACCESSORY	"$1,164.00"
66215-102-06	BOSENTAN 125 MG ORAL TAB	"$1,163.16"
66215-101-06	BOSENTAN 62.5 MG ORAL TAB	"$1,163.16"
HC43500057	DEXA BONE DENS&VERTBRL FX ASSESS	"$1,163.00"
55513-002-01	DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/ML INJ SOLN	"$1,161.00"
HC25005646	PACING TRANSCUTANEOUS TEMPORARY	"$1,160.00"
HC47200886	REMOVAL OF FIXATION DEVICE	"$1,159.00"
HC44000297	CALCANEUS (HEEL) BILAT	"$1,159.00"
HC25001330	M: ED MISC PROCEDURE	"$1,159.00"
HC25000837	ASP/INJ SMALL JOINT-BILAT	"$1,158.00"
HC74200361	OR TIME ADD'L 15MIN CASE CX 1 (MCAL 1ST SUBSQNT 0.5 HR)	"$1,158.00"
HC74200585	OR TIME ADD'L 15MIN CASE CX 1 (MCAL 2ND SUBSQNT 0.5 HR)	"$1,158.00"
HC46501946	M: MISC PROCEDURE	"$1,157.00"
HC42000836	MYOCARDIAL STRAIN QUANT ASSESS +	"$1,156.00"
HC41500711	EMG LARYNX	"$1,156.00"
HC83000612	RBC'S LR/CMV-NEG/IRRAD/UNIT	"$1,155.00"
HC81101107	FETAL FIBRONECTIN	"$1,154.00"
HC44002988	HIPS BILAT3-4VWS(W/PELVIS WHN PRFRMD)	"$1,153.00"
HC21000757	LAC REPAIR 7.6-12 5CM(MEDIUM)	"$1,151.00"
HC44002889	SPINE ENTIRE SKULL-SACRUM 2-3 VIEWS	"$1,151.00"
HC81701476	MORPH STDY ISH MNL PER SPEC INTL SNGL PROBE	"$1,150.00"
HC36800704	PLETHYSMOGRAPHY LUNG VOL	"$1,149.00"
HC25003138	LAC REPAIR INTMD N/H/F/GEN 2.5CM/<	"$1,148.00"
16714-907-01	ALBENDAZOLE 200 MG ORAL TAB	"$1,147.08"
HC62203492	SEALANT (FLOSEAL) KIT 10CC	"$1,147.00"
HC25003039	LAC REPAIR SIMPLE F/E/E/N/L/M 20.1-30.0 CM	"$1,146.00"
HC25003393	INJ(S);SGL TNDN SHEATH/LIGMNT/APONEUR-BIL	"$1,146.00"
HC44001469	KNEE 4 OR MORE VWS LT	"$1,146.00"
HC44001477	KNEE 4 OR MORE VWS RT	"$1,146.00"
HC44002772	KNEE 4 VIEWS	"$1,146.00"
99999-001-77	CHARGE-ADULT 3 IN 1 ADMIX 2000ML	"$1,146.00"
HC44001584	MANDIBLE COMPLETE MIN 4 VWS	"$1,145.00"
HC41500281	INFANT HEARING SCREEN AEP BBS AUTO INITIAL IP	"$1,144.00"
HC44002681	UROGRAPHY ANTEGRADE LTD LT	"$1,142.00"
HC44002699	UROGRAPHY ANTEGRADE LTD RT	"$1,142.00"
HC44002335	TOE (S) BILAT	"$1,141.00"
HC82200965	TISSUE EX G&M LVL 6 DIST SVC	"$1,140.00"
HC82200338	TISSUE EXAM G&M LEVEL 6	"$1,140.00"
HC82202771	TISSUE EXAM G&M LVL 6(TC ONLY)	"$1,140.00"
HC82200627	TISSUE EXAM LEVEL 6 ADD'L	"$1,140.00"
HC82200619	TISSUE EXAM LVL 6 (PQRI)	"$1,140.00"
53276-1010-09	MICROFIBRIL. COLLAGEN HEMOSTAT 70 X 35 MM TOPICAL SHEE	"$1,140.00"
53276-1010-02	MICROFIBRIL. COLLAGEN HEMOSTAT TOPICAL POWD	"$1,140.00"
HC36000651	PLETHYSMOGRAPHY LUNG VOL	"$1,139.00"
HC41500760	EEG SETUP W/VIDEO REC CONT MIN8 CHNNL	"$1,139.00"
59630-266-01	CEFIDEROCOL 1 GRAM IV SOLR	"$1,138.50"
59630-266-10	CEFIDEROCOL 1 GRAM IV SOLR	"$1,138.50"
0121-0678-16	NORTRIPTYLINE 10 MG/5 ML ORAL SOLN	"$1,138.04"
HC25003856	CLOSED TX RAD/EPHYSL SEP&ULN FX NO M-BIL	"$1,138.00"
HC46000220	INJ CONTRAST-ASSESS PV SHUNT	"$1,138.00"
HC82202466	MORPH STUDY MAN ISH QNT 9P21	"$1,138.00"
HC82202474	MORPH STUDY MAN ISH QNT CEP 3	"$1,138.00"
HC82202482	MORPH STUDY MAN ISH QNT CEP 7	"$1,138.00"
HC82202490	MORPH STUDY MAN ISH QNT CEP17	"$1,138.00"
HC82202508	MORPH STUDY MAN ISH QNT HER2	"$1,138.00"
HC62211784	GUIDEWIRE(X-PEDION ANGIO)         Q	"$1,138.00"
HC62201694	CAUTERY HOOK ASSEMBLY            AO	"$1,138.00"
HC62208749	ENDO LOOP MONO LINA GOLD	"$1,138.00"
HC62211016	CANNULA ARTERIAL PEDS             P	"$1,138.00"
HC62219977	KIT INSTRUMENTS UROLIFT	"$1,138.00"
HC62800479	CATH SWAN GANZ/THERMODILUTION     P	"$1,138.00"
HC62807714	M: ANCHOR LEAD NEUROSTIM	"$1,138.00"
HC25005745	CLOSED TX HIP FX W/MANIP LT	"$1,137.00"
HC25005752	CLOSED TX HIP FX W/MANIP RT	"$1,137.00"
60793-701-10	"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML IM SYRG"	"$1,136.24"
60793-701-02	"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML IM SYRG"	"$1,136.24"
HC44001733	PERINEOGRAM	"$1,136.00"
HC44001352	JNT SURVEY SNGL VW 2 OR>JNTS	"$1,136.00"
HC36800266	O2 UPTAKE CO2 OUTPUT @REST IND	"$1,136.00"
HC31000359	PT-EVAL HIGH COMPLEXITY 45MF2F 75MIN	"$1,135.00"
HC51062099	REMOVE CONTRACEPTIVE CAPSULE	"$1,134.00"
HC31001795	PT-APPLICATION CAST LONG LEG	"$1,132.00"
HC47201140	HDR ELECTRONIC BRACHYTHERAPY SKIN SURFACE	"$1,131.00"
0517-0375-01	INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJ SOLN	"$1,130.52"
0517-0375-05	INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJ SOLN	"$1,130.52"
HC51010908	CHEMO ADMIN PLEURAL CAV W/THORACENTESIS	"$1,130.00"
0574-0805-30	ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN	"$1,128.06"
0574-0805-00	ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN	"$1,128.06"
63323-963-30	ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN	"$1,128.06"
63323-963-21	ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN	"$1,128.06"
HC33000258	ST-SPEECH THERAPY 90 MIN/MW	"$1,128.00"
0074-4456-04	SEVOFLURANE INHALATION LIQD	"$1,128.00"
0074-4456-51	SEVOFLURANE INHALATION LIQD	"$1,128.00"
61748-024-16	ETHOSUXIMIDE 250 MG/5 ML ORAL SOLN	"$1,126.69"
HC25005422	INJ ANES/STEROID NERVE TRIGEML BRNCH EA BI	"$1,126.00"
HC27000025	ANOSCOPY DX (INCL COLLECTION)	"$1,125.00"
HC62229026	CATH ANGIO PERIPH CROSSING SET	"$1,125.00"
99999-035-64	EPIFIX SKIN GRAFT ( 14 MM )	"$1,125.00"
HC46502761	BIOPSY INCISIONAL SKIN; EACH SEP ADD'L LESION	"$1,124.00"
42023-111-01	ESTRADIOL VALERATE 20 MG/ML IM OIL	"$1,122.42"
45802-210-01	NITROGLYCERIN 400 MCG/SPRAY TL SPRY	"$1,122.38"
28595-120-49	NITROGLYCERIN 400 MCG/SPRAY TL SPRY	"$1,122.38"
HC41500919	VESTIBULR EVOKD MYOGN POTENTL-VEMP; CVEMP & OVEMP	"$1,122.00"
99999-034-92	CHARGE-ADULT TPN (LBM)	"$1,122.00"
0469-3211-10	MICAFUNGIN 100 MG IV SOLR	"$1,122.00"
63323-729-10	MICAFUNGIN 100 MG IV SOLR	"$1,122.00"
63323-729-01	MICAFUNGIN 100 MG IV SOLR	"$1,122.00"
HC44701563	ADMIN RX;MULT MSRMNTS PRE/PST+	"$1,121.00"
HC83000034	RBC'S WASHED EA UNIT	"$1,120.00"
HC83001032	RBC'S WASHED EA UNIT -SB	"$1,120.00"
HC44002970	HIPS BILAT2VWS(W/PELVIS WHN PRFRMD)	"$1,119.00"
HC62206404	SET THROMBECTOMY PUMP	"$1,117.00"
HC43500016	DEXA BONE DENS-AXIAL SKELETAL	"$1,115.00"
HC32000283	OT-EVAL HIGH COMPLEXITY 45MF2F 75MIN	"$1,114.00"
HC62207311	TRAY DIALYSIS	"$1,114.00"
HC25003708	CLOSED TX ELBOW DISLOCATION-BIL	"$1,113.00"
HC36800720	AIRWAY RESISTANCE OSCILLOMETRY	"$1,113.00"
HC36000677	AIRWAY RESISTANCE OSCILLOMETRY	"$1,113.00"
HC77400166	ANESTHESIA EPIDURAL INITIAL HR	"$1,113.00"
HC33001066	ST EVAL SOUND W/LANG COMP&EXPRESS 120MIN/M	"$1,112.00"
HC62211487	PACK CATARACT CUSTOM	"$1,112.00"
99999-039-35	GELFOAM+THROMBIN MIXTURE LBM	"$1,111.18"
HC51010320	BACLOPHEN PUMP TRIAL PROCEDURE	"$1,111.00"
HC27001296	ANORECTAL MANOMETRY DISCON'D	"$1,110.00"
0548-9501-00	ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN	"$1,110.00"
55150-166-13	SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN	"$1,110.00"
10019-938-25	CYCLOPHOSPHAMIDE 500 MG IV SOLR	"$1,110.00"
10019-938-01	CYCLOPHOSPHAMIDE 500 MG IV SOLR	"$1,110.00"
0603-1542-58	POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD	"$1,109.66"
60505-6184-6	POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD	"$1,109.66"
99999-035-91	SORAFENIB 200 MG/30 ML ORAL LIQUID	"$1,109.64"
50419-488-58	SORAFENIB 200 MG ORAL TAB	"$1,109.64"
HC62219662	KIT INSTRUMENTS ENDOBUTTON	"$1,109.00"
HC43500024	DEXA BONE DENS-BODY $	"$1,106.00"
HC62212634	CATH PTCA BALLOON NON-LASER       J	"$1,105.00"
HC62223227	INTRODUCER/SHEATH                 S	"$1,105.00"
HC62212998	BLADE SHAVER                      Q	"$1,105.00"
HC62213293	BURR                              Q	"$1,105.00"
HC62213491	REAMER                            T	"$1,105.00"
HC62214556	RETRACTOR DISPOSABLE              K	"$1,105.00"
HC62216221	SHEARS COAGULATING HARMONIC       O	"$1,105.00"
HC62217674	AWL SPINAL SINGLE PATIENT USE     N	"$1,105.00"
HC62218433	ENDO STAPLER                      Q	"$1,105.00"
HC62218870	DRILL/DRILL BITS SINGLE USE       V	"$1,105.00"
HC62227673	ELECTRODE LOOP CUTTING BIPOLAR	"$1,105.00"
HC43001171	MAMMO DX UNILAT W/CAD LT	"$1,104.00"
HC43001189	MAMMO DX UNILAT W/CAD RT	"$1,104.00"
HC51010411	EMG 4 EXTREMITY	"$1,103.00"
HC25000431	MANIPULATION MAJOR JOINT	"$1,102.00"
HC38000295	APPLY SPICA  HIP ONE LEG	"$1,101.00"
HC44000404	CHEST 4/> VIEWS	"$1,101.00"
HC41500356	NEUROMUSC REPEAT STIM EA NERVE	"$1,101.00"
16714-885-01	ACYCLOVIR 5 % TOPICAL OINT	"$1,100.16"
HC25004060	CLOSED TX THUMB DISLOC W/MANIP BIL	"$1,100.00"
HC25003500	CLOSED TX STERNOCLVCLE DISLOC W/MAN-BIL	"$1,099.00"
HC44200426	US OB 1ST TRI ADD'L GEST +	"$1,099.00"
HC62802590	WIRE INTERVENTIONAL SPECIALTY	"$1,099.00"
HC51002715	REMOVE NEPHROSTOMY TUBE	"$1,098.00"
HC51002236	ASP/INJ RENAL CYST/PELVIS	"$1,097.00"
HC38000253	APPLY BODY CAST;SHOLD/HIP/1THI	"$1,096.00"
HC44002095	SPEECH STUDY - CINE/VIDEO	"$1,096.00"
HC81700809	"HIV-1 RNA, QUANT"	"$1,096.00"
HC32000598	OT-DEBRIDE OPN WND 1ST 20SQCM OR<	"$1,095.00"
HC31000656	PT-DEBRIDE OPN WND 1ST 20SQCM OR<	"$1,095.00"
HC44001543	LUMBAR SPINE BEND ONLY;2/3 VWS	"$1,093.00"
HC51060986	"INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS LT"	"$1,092.00"
HC51060994	"INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS RT"	"$1,092.00"
HC51000107	CYSTOMETROGRAM W/VOID PRESSURE	"$1,092.00"
HC84201169	INFLUENZA A&B BY PCR (RVP PNL)	"$1,092.00"
HC62201447	CATH GASTRO TUBE	"$1,092.00"
67919-020-10	ALVIMOPAN 12 MG ORAL CAP	"$1,091.04"
HC25005588	DRAIN EXTERNAL EAR LESION SIMPLE LT	"$1,090.00"
HC25005596	DRAIN EXTERNAL EAR LESION SIMPLE RT	"$1,090.00"
HC44002012	SIALOGRAPHY	"$1,088.00"
HC42000885	ECG EXT HOLTER W/CONNECT>48HRS-7DAYS; RECORDING	"$1,088.00"
HC51002699	PARACENTESIS ABD W/O IMAGING GUIDE	"$1,085.00"
HC44200855	ART STDY SNG U/L 1-2 LVL LTD-L	"$1,085.00"
HC44200848	ART STDY SNG U/L 1-2 LVL LTD-R	"$1,085.00"
HC41000128	HOME SLEEP STUDY/T III MIN'4CH	"$1,083.00"
99999-042-18	VANCOMYCIN 250 MG / 5 ML ORAL SYRINGE	"$1,082.40"
HC51002749	ASPIRATION OF BLADDER BY NEEDLE	"$1,082.00"
HC62215769	ADAPTER INJECTION SPINAL	"$1,080.00"
44206-251-10	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	"$1,080.00"
0053-7680-92	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	"$1,080.00"
44206-251-91	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	"$1,080.00"
44206-310-50	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	"$1,080.00"
44206-310-91	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	"$1,080.00"
0053-7680-33	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	"$1,080.00"
25021-801-66	ZOLEDRONIC ACID 4 MG/5 ML IV SOLN	"$1,080.00"
25021-826-82	ZOLEDRONIC AC-MANNITOL-0.9NACL 4 MG/100 ML IV PGBK	"$1,080.00"
70069-151-01	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,079.28"
70069-151-10	CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN	"$1,079.28"
HC62211628	PAD TEMP MNGMNT SYSTEM/BOX	"$1,079.00"
HC25005356	ANOSCOPY W/REMOVE FB	"$1,078.00"
68382-384-01	DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASL SPRP	"$1,077.18"
HC51061018	REMOVE NEPHROSTOMY TUBE LT	"$1,076.00"
HC51061026	REMOVE NEPHROSTOMY TUBE RT	"$1,076.00"
HC81101974	DRUG TST DEFNTV15-21RX CLSS W/METBLTS/DAY	"$1,076.00"
HC12200002	IV INFUSION THERAPY 1ST HOUR	"$1,075.00"
HC47200621	THERAPEUTIC RAD PORT IMAGES	"$1,074.00"
HC44002939	HIP (W/PELVIS WHN PRFRMD) 2-3VWS LT	"$1,073.00"
HC44002947	HIP (W/PELVIS WHN PRFRMD) 2-3VWS RT	"$1,073.00"
HC32001273	OT-RE-EVAL EST POC  75MIN	"$1,073.00"
HC62800602	GUIDEWIRE(X-PEDION HYDROPHILIC)   P	"$1,073.00"
HC62808308	M: ADAPTER SHOULDER	"$1,073.00"
HC62215488	KNIFE BAYONET                     G	"$1,073.00"
HC62217054	WRENCH TIP SPINAL (DISP)	"$1,073.00"
HC25000464	FRACTURE TX  LONG BONE	"$1,072.00"
0068-0597-01	RIFAMPIN 600 MG IV SOLR	"$1,071.36"
0068-0599-01	RIFAMPIN 600 MG IV SOLR	"$1,071.36"
HC44001774	RIBS BILAT 3 VIEWS	"$1,071.00"
58160-976-02	"MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG"	"$1,071.00"
61314-044-75	TRIFLURIDINE 1 % OPHT DROP	"$1,070.10"
0078-0698-02	MIDOSTAURIN 25 MG ORAL CAP	"$1,069.53"
HC33000324	ST-SWALLOWING EVAL 45MIN	"$1,069.00"
HC32001844	OT-EVAL SWALLOW CINE/FLUORO 45MIN	"$1,069.00"
HC33000571	ST-EVAL SWALLOW CINE/FLUORO 45M	"$1,069.00"
HC44001691	ORBITS COMPLETE MIN 4 VWS	"$1,068.00"
HC44002210	THORACIC SPINE MIN 4 VIEWS	"$1,068.00"
HC62204573	CATH CARDIAC	"$1,066.00"
HC41500455	VASOMOTOR ADRENERGIC INNERV	"$1,065.00"
HC21000534	PAIRING BENIGN LESIONS: >4	"$1,063.00"
HC46502522	LARYNGOSCOPY DIAGNOSTIC	"$1,060.00"
HC38000311	APPLY LONG LEG CAST/WALKER	"$1,059.00"
HC32000440	OT-SWALLOWING EVAL 45MIN	"$1,059.00"
HC44002020	SINUSES COMP MIN 3 VIEWS	"$1,058.00"
HC62210265	PACK TUBING ECMO	"$1,058.00"
HC62221189	KIT TEMP MNGMNT-HEAD WRP-VEST-BLNKT	"$1,058.00"
HC51002632	THORACENTESIS ASP W/O IMG GUID	"$1,057.00"
HC44003069	ABDOMEN 3/> VIEWS	"$1,057.00"
HC44000032	ABDOMEN W/DECUB &/OR ERECT (3/>VIEWS)	"$1,057.00"
HC62225446	DEVICE RESECTION MUCOSAL ENDO(EMR)	"$1,057.00"
HC62225495	TUBE SPLINTING ENDOSCOPIC	"$1,057.00"
99999-035-63	ALTEPLASE 2 MG INTRACATH SOLR	"$1,056.00"
0254-1011-96	SUCRALFATE 100 MG/ML ORAL LIQUID (MCH)	"$1,055.88"
HC25004821	CLOSED TX TALOTARSAL JNT DISLOC; NO ANES BIL	"$1,053.00"
HC25006065	CLOSED TX TARSOMETATARSAL JNT DISLOC; NO ANES BIL	"$1,053.00"
HC25006081	CLOSED TX METATARSOPHALAN JNT DISLOC; NO ANES BIL	"$1,053.00"
HC25006107	CLOSED TX INTERPHALANGEAL JNT DISLOC; NO ANES BIL	"$1,053.00"
HC42000216	ECHO FETAL DOPPLER F/U OR REP	"$1,053.00"
HC62802269	TUBE JEJUN LOWPRO TG BUTTON	"$1,053.00"
70860-780-10	FOSAPREPITANT 150 MG IV SOLR	"$1,053.00"
70860-403-51	BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN	"$1,053.00"
70860-403-50	BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN	"$1,053.00"
HC62202874	CUTTER LINEAR ENDO                O	"$1,052.00"
16571-071-12	CEFACLOR 250 MG/5 ML ORAL SUSR (MCH)	"$1,050.30"
HC25006149	FETAL CONTRACTION STRESS TEST	"$1,050.00"
HC25006172	INSERTION CERVICAL DILATOR	"$1,050.00"
HC33000464	ST-THER SP GEN DEV W/PROG	"$1,050.00"
HC62222583	TUBING ASPIRATOR ULTRASONIC       O	"$1,050.00"
HC62228820	SCISSORS ENDOSCOPIC               Q	"$1,050.00"
HC91200133	R&B NURSERY LEVEL EOL	"$1,050.00"
25021-414-50	ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN	"$1,050.00"
43598-326-75	CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS	"$1,049.99"
99999-044-98	CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS	"$1,049.99"
HC32000523	OT-SWALLOWING THERAPY  60 MIN	"$1,049.00"
0407-2223-04	IODIXANOL 320 MG IODINE/ML IV SOLN	"$1,048.80"
HC44001741	XR PHARYNX/CERVICAL ESOPHAGUS W/CNSTRST INC SCOUT&DELAYS	"$1,048.00"
HC21000609	DEBRID OPN WOUND EA ADD 20CM/<	"$1,048.00"
HC83000588	BLOOD LR FROZ/DEGLY/WASH'D	"$1,047.00"
HC51003069	ASP/INJ HYDROCELE	"$1,045.00"
HC12200424	IV INJECTION BEBTELOVIMAB	"$1,045.00"
0078-0939-26	MOXIFLOXACIN 0.5 % OPHT DROP	"$1,044.72"
99988-000-38	NM I-123 SODIUM IODIDE DIAGNOSTIC CAPSULE (COMPOUNDED)	"$1,040.81"
HC51060598	DESTROY MUSCLE(S) LARYNX LT	"$1,040.00"
HC51060606	DESTROY MUSCLE(S) LARYNX RT	"$1,040.00"
HC62221205	KIT W/ TRACH PERCUTANEOUS         D	"$1,040.00"
HC62217237	KIT TUBE TRACH CUFFED             O	"$1,040.00"
HC62223334	CATH PTA ANGIOPLS BALLOON NON-LSR K	"$1,040.00"
HC62212626	CATH PTCA BALLOON NON-LASER       I	"$1,040.00"
HC62222575	CATH BALLOON RENAL                O	"$1,040.00"
HC62222260	CATH EP DX <20 ELECTRODES         H	"$1,040.00"
HC62223870	CATH EP DX 20+ ELECTRODES RPRSD   O	"$1,040.00"
HC62800826	CATH HEMO/PERI DIAL LONG TERM     O	"$1,040.00"
HC62220181	CATH THROMBECTOMY/EMBOLECTOMY     O	"$1,040.00"
HC62800149	CATH ANGIOGRAPHY W/BALLOON        O	"$1,040.00"
HC62223375	CATH MICROCATHETER NEUROVASC      I	"$1,040.00"
HC62221908	CATH INTRODUCER PEEL-AWAY         T	"$1,040.00"
HC62203872	KIT FECAL MANAGEMENT              O	"$1,040.00"
HC62206669	SPHINCTEROTOME                    H	"$1,040.00"
HC62212980	BLADE SHAVER                      P	"$1,040.00"
HC62213285	BURR                              P	"$1,040.00"
HC62213483	REAMER                            S	"$1,040.00"
HC62216049	PROBE HEMOSTASIS (BICAP)          H	"$1,040.00"
HC62216155	SPHINCTEROTOME CANNULATING        H	"$1,040.00"
HC62216700	PIN/WIRE FIXATION TEMPORARY       AG	"$1,040.00"
HC62217039	PROBE SPINAL DISPOSABLE           K	"$1,040.00"
HC62217435	FORCEPS BIPOLAR DISPOSABLE        O	"$1,040.00"
HC62218425	ENDO STAPLER                      P	"$1,040.00"
HC62218862	DRILL/DRILL BITS SINGLE USE       U	"$1,040.00"
HC62219852	TUBE ET NIM                       O	"$1,040.00"
HC62220033	DEVICE SUTURE ENDO                I	"$1,040.00"
HC62220744	COUNTERSINK CANNULATED            O	"$1,040.00"
HC62220900	BLANKET HYPER/HYPOTHERMIA         R	"$1,040.00"
HC62221080	KIT CELL SAVER                    O	"$1,040.00"
HC62221858	TAP SURGICAL                      O	"$1,040.00"
HC62222492	WAND ARTHRO                       O	"$1,040.00"
HC62223607	SNARE                             O	"$1,040.00"
HC62223656	STAPLE CARTRG/ENDO RELOAD         O	"$1,040.00"
HC62224308	KIT ARTHROSCOPY DISPSBLS          O	"$1,040.00"
HC62224316	RASP SPINAL DISPSBL	"$1,040.00"
HC62224480	NEEDLE BIOPSY BONE                O	"$1,040.00"
HC62225511	NEEDLE BIOPSY EUS                 O	"$1,040.00"
HC62225875	GUIDE DRILL                       O	"$1,040.00"
HC62226287	NEEDLE BONE MARROW                O	"$1,040.00"
HC62226816	TROCAR ENDO                       O	"$1,040.00"
HC62226964	CANNULA PERFUSION                 O	"$1,040.00"
HC62227392	KIT CONCENTRATOR PLATELETS        O	"$1,040.00"
HC62227897	OBTURATOR ARTHRO                  K	"$1,040.00"
HC62804208	COIL EMBOLIZATION                 I	"$1,040.00"
HC51001410	CLOSED TX BIMALLEO ANKLE FX NO MAN	"$1,039.00"
HC33000423	ST-SWALLOWING THERAPY 75 MIN	"$1,039.00"
HC51001311	CLOSED TX PELVIC RING FX W/O MANIPULATION	"$1,038.00"
HC51010056	DESTROY MUSCLE(S) FACIAL NERVE BI	"$1,038.00"
HC36800860	"TEST STRESS PULMON INCL HR,POX,O2 TIT"	"$1,037.00"
HC25001348	DEBRIDE OPN WND 1ST 20SQCM OR<	"$1,037.00"
61703-343-18	MITOXANTRONE 2 MG/ML IV CONC	"$1,035.36"
HC25000365	FB REMOVAL EYE	"$1,035.00"
HC33001132	ST EVAL BEHAVRAL QUAL VOICE 180MIN/M	"$1,034.00"
HC41500562	STUDIES NERVE CONDUCTN 1-2 STUDIES	"$1,034.00"
HC25000902	ASP/INJ LARGE JOINT-LT	"$1,031.00"
HC25000910	ASP/INJ LARGE JOINT-RT	"$1,031.00"
0597-0260-10	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	"$1,029.60"
0597-0053-01	GLUCAGON 1 MG/ML INJ SOLR	"$1,029.60"
0597-0053-45	GLUCAGON 1 MG/ML INJ SOLR	"$1,029.60"
0407-1414-94	IOHEXOL 350 MG IODINE/ML IV SOLN	"$1,029.60"
0015-3012-60	CARMUSTINE 100 MG IV SOLR	"$1,028.46"
HC51001212	CLOSED TX HUMRL CON FX MED/LAT NO M	"$1,028.00"
HC44002285	TMJ ARTHROGRAM LT	"$1,028.00"
HC44002293	TMJ ARTHROGRAM RT	"$1,028.00"
HC44001816	RIBS UNILAT MIN 3 VWS W/PA-LT	"$1,028.00"
HC44001824	RIBS UNILAT MIN 3 VWS W/PA-RT	"$1,028.00"
HC12400040	CHEMO ADMIN IVP SNGL/ADD'L INJ	"$1,028.00"
HC44002608	XR EXAM SURGICAL SPECIMEN	"$1,027.00"
HC36800738	DIFFUSING CAPACITY+	"$1,027.00"
HC11200177	DESENSITIZATION RAPID EA HR	"$1,027.00"
70408-185-34	PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP	"$1,024.52"
63323-593-03	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	"$1,023.00"
63323-596-03	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	"$1,023.00"
63323-596-13	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	"$1,023.00"
63323-596-11	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	"$1,023.00"
66658-234-01	ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRG	"$1,022.33"
66658-234-07	ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRG	"$1,022.33"
99999-045-63	NM TC-99M TILMANOCEPT 0.25 MCI (LYMPHOSEEK)	"$1,021.15"
HC36000685	DIFFUSING CAPACITY+	"$1,021.00"
HC62227111	CONTROL DOSE C02 MANUAL PAT(AEROFORM)	"$1,021.00"
HC62228515	BRONCHOSCOPE ASCOPE LRG DISP	"$1,021.00"
16729-267-65	DOCETAXEL 160 MG/8 ML (20 MG/ML) IV SOLN	"$1,020.00"
0703-4685-01	MITOXANTRONE 2 MG/ML IV CONC	"$1,020.00"
HC25006131	FETAL CONTRACT/NIPPLE STIM	"$1,019.00"
0597-0033-34	CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK	"$1,016.90"
17478-526-03	DIMERCAPROL 100 MG/ML IM SOLN	"$1,015.63"
HC44200699	US AAA SCREENING	"$1,015.00"
HC62211933	STAPLER ENDO POWERED	"$1,015.00"
HC62800024	BALLOON DILATOR BILIARY/NEPHRO	"$1,014.00"
HC62211404	KIT VENTRICULOSTOMY ACCESS	"$1,014.00"
HC62807763	M: RING ACETABULAR HIP	"$1,014.00"
HC33001058	ST EVAL SOUND W/LANG COMP&EXPRESS 90MIN/M	"$1,013.00"
HC62802624	TUBE GASTROSTOMY LOWPRFL BTTN     O	"$1,011.00"
HC46000162	INJ ARTHROGRAM WRIST-LT	"$1,009.00"
HC46000170	INJ ARTHROGRAM WRIST-RT	"$1,009.00"
HC44002301	TMJ BILAT	"$1,009.00"
HC32001760	OT-DYSPHAGIA/SWALLOW TX 75MIN/M	"$1,008.00"
HC62212758	GUIDEWIRE                         O	"$1,008.00"
HC44000776	FEMUR 2/> VIEWS LT	"$1,006.00"
HC44000784	FEMUR 2/> VIEWS RT	"$1,006.00"
0005-0100-01	"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG"	"$1,004.42"
0005-0100-05	"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG"	"$1,004.42"
HC38000246	APPLY BODY CAST;SHOLD-HIP-HEAD	"$1,004.00"
HC44001725	PELVIS COMP MIN 3 VWS	"$1,004.00"
HC62214341	PROBE PEDICLE	"$1,004.00"
HC39001037	TMS SUBSEQ DELIV MGMNT SESS	"$1,003.00"
HC77400182	ANESTHESIA SPINAL INITIAL HR	"$1,003.00"
HC25005802	CLOSED TX ANKLE FX W/MANIP LT	"$1,002.00"
HC25005810	CLOSED TX ANKLE FX W/MANIP RT	"$1,002.00"
63323-113-10	PENTAMIDINE 300 MG INJ SOLR	"$1,001.34"
63323-877-15	PENTAMIDINE 300 MG INHALATION SOLR	"$1,001.34"
HC89091359	FAM ADENOM POLYPOSIS SEQ-AU	"$1,000.00"
HC77400125	ANESTHESIA REGIONAL INITIAL HOUR	"$1,000.00"
HC62205208	PACK CELL SAVER	$998.00
HC51002426	EXCISE LESION 3.1-4CM HND-FT-SC-NCK-GN	$997.00
HC31000029	PT-APPLIC CAST SHORT LEG WALK	$997.00
HC62206305	SET LITHOTRIPTOR	$996.00
HC21000211	DEBRID SKIN EXT EA ADDL 10%BSA	$995.00
HC89019905	CYTOGENOMIC SNP MICROARRAY -AU	$995.00
55513-144-10	"EPOETIN ALFA 10,000 UNIT/ML INJ SOLN"	$994.80
55513-144-01	"EPOETIN ALFA 10,000 UNIT/ML INJ SOLN"	$994.80
16714-766-01	CEFIXIME 100 MG/5 ML ORAL SUSR	$994.80
HC44700334	INSERT ARTERIAL LINE LT	$994.00
HC44700342	INSERT ARTERIAL LINE RT	$994.00
HC44900868	CT BODY SCAN LTD ABD/CHEST/PEL	$994.00
HC51010155	DESTRUCT OTHER PERIPH NERV/BRNCH LT	$993.00
HC51010163	DESTRUCT OTHER PERIPH NERV/BRNCH RT	$993.00
HC33000712	ST-EVAL LANGUAGE CMPT 120MIN	$993.00
65162-649-78	OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP	$993.00
50383-312-84	OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP	$993.00
0781-6270-43	OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP	$993.00
HC38000055	APPLY CAST SHORT LEG WALKING	$991.00
HC62222195	BARRIER/BAG DEFECT WALL VENTRAL/ABD	$991.00
HC51000446	REPAIR CENTRAL VEN CATH W/PORT	$990.00
HC62207451	TRAY NASAL	$989.00
0703-4155-11	IDARUBICIN 1 MG/ML IV SOLN	$988.20
HC44000339	CERVICAL SPINE 2 OR 3VWS	$988.00
HC26000166	L&D EVAL LEVEL II - LIMITED	$988.00
HC62224738	SYSTEM ILLUMINATION ENDOSCOPIC	$988.00
0407-1413-66	IOHEXOL 300 MG IODINE/ML IV SOLN	$987.60
HC25005687	ASP/INJ JOINT/BURSA MAJOR W/US-LT	$986.00
HC25005695	ASP/INJ JOINT/BURSA MAJOR W/US-RT	$986.00
HC44001600	MASTOIDS MIN 3 VIEWS	$986.00
50458-305-03	RISPERIDONE 1 MG/ML ORAL SOLN	$985.50
HC31001365	PT-RE-EVAL EST POC  75MIN	$985.00
HC51001204	CLOSED TX HUMERL SUPRA/TRANS CON FX	$982.00
HC46501623	UROFLOWMETRY COMPLEX	$982.00
HC62202486	BARRIER ADHESION PELVIC(INTERCEED)	$982.00
HC62202833	ENDO BALLOON PERITONEAL SYSTEM	$982.00
0078-0508-83	CARBAMAZEPINE 100 MG/5 ML ORAL SUSP	$980.10
0409-1932-02	ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN	$980.10
HC38000147	APPLY SPLINT LONG LEG	$980.00
HC51000040	REPAIR CENTRAL VENOUS CATH	$979.00
0781-2322-06	APREPITANT 80 MG ORAL CAP	$978.15
0781-2322-68	APREPITANT 80 MG ORAL CAP	$978.05
68462-584-40	APREPITANT 80 MG ORAL CAP	$978.05
68462-584-76	APREPITANT 80 MG ORAL CAP	$978.05
HC38000063	APPLY CAST LONG LEG	$978.00
HC62211420	SENSOR PRESSURE HEMODYN (FLOTRAC)	$978.00
99999-044-50	VANCOMYCIN IN NS 750 MG/150 ML IV SOLN (MHS)	$977.40
HC51000453	REMOV IMPL VEN CATH DEVICE	$976.00
HC83000430	THERAPEUTIC PHLEBOTOMY	$976.00
99996-001-45	LINEZOLID 100 MG/5 ML ORAL SUSR	$975.84
HC12400024	CHEMO INF SEQ/NEW RX 1ST HR	$975.00
HC62227491	OVERTUBE ENDOSCOPIC               B	$975.00
HC62800156	CATH BALLOON PTA(COYOTE)          H	$975.00
HC62212618	CATH PTCA BALLOON NON-LASER       H	$975.00
HC62227012	DILATOR BALLOON ENDO PULM	$975.00
HC62212444	INTRODUCER/SHEATH                 Q	$975.00
HC62200456	BASKET RETRIEVAL                  O	$975.00
HC62202700	ELECTRODE PACER TEMPORARY	$975.00
HC62203468	HANDPIECE VESSEL SEALER DEVICE    A	$975.00
HC62210935	PACK LVAD/RVAD	$975.00
HC62212972	BLADE SHAVER                      O	$975.00
HC62213160	BLADE INCISIONAL                  O	$975.00
HC62213277	BURR                              O	$975.00
HC62213475	REAMER                            R	$975.00
HC62214374	SHEARS COAGULATING HARMONIC       N	$975.00
HC62214549	RETRACTOR DISPOSABLE              J	$975.00
HC62218417	ENDO STAPLER                      O	$975.00
HC62218854	DRILL/DRILL BITS SINGLE USE       T	$975.00
HC62219159	CANNULA TIP SOFT LONG	$975.00
HC62225230	ROD EXTRACTION CONICAL	$975.00
HC62226808	TAMP BONE KYPHOPLASTY             B	$975.00
HC62227327	WAND BREAST BIOPSY                N	$975.00
HC62228101	SYSTEM DRESSING WOUND NEG PRES    P	$975.00
HC62228309	SIZER MAMMARY                     O	$975.00
HC12800009	PHLEBOTOMY THERAPEUTIC	$974.00
HC21000617	WOUND NON-SEL DEBRID PER SESSN	$972.00
63323-594-03	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	$972.00
63323-596-06	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	$972.00
63323-596-08	GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS)	$972.00
63323-596-16	GLUCAGON HCL 1 MG/ML INJ SOLR	$972.00
HC43001130	MAMMO DX LTD/FOCUS EXM W/CAD BIL	$970.00
HC62203443	GAS INTRAOCULAR                   D	$970.00
HC51002350	EXCISION GLAND BULBOURETHRAL	$969.00
HC27001072	SIGMOIDOSCOPY DX DISCONT PROC	$968.00
HC43000975	US BREAST; COMPLETE LT	$967.00
HC43000983	US BREAST; COMPLETE RT	$967.00
HC62223003	DEVICE ELECTROSURGICAL CUT-CAUTERY N	$966.00
HC82200957	TISSUE EX G&M LVL 5  DIST SVC	$965.00
HC82200411	TISSUE EXAM G&M LEVEL 5	$965.00
HC82202581	TISSUE EXAM G&M LEVEL 5 *OP	$965.00
HC82202763	TISSUE EXAM G&M LVL 5(TC ONLY)	$965.00
HC82200684	TISSUE EXAM LEVEL 5 ADD'L	$965.00
HC82200601	TISSUE EXAM LVL 5 (PQRI)	$965.00
HC12400081	CHEMO NONHRMNL ANTINEOPL SQ/IM	$965.00
HC36800712	GAS DILUT/WASHOUT LUNG VOL	$964.00
HC36000669	GAS DILUT/WASHOUT LUNG VOL	$964.00
HC62207626	TUBE EMG REINFORCED NIM	$963.00
63459-508-30	FENTANYL CITRATE 800 MCG BUCCAL LPOP	$962.64
0023-0066-04	GENTAMICIN-PREDNISOLONE 0.3-0.6 % OPHT OINT	$962.41
0023-0106-05	GENTAMICIN-PREDNISOLONE 0.3-1 % OPHT DRPS	$962.40
11980-022-05	SULFACETAMIDE-PREDNISOLONE 10-0.2 % OPHT DRPS	$962.40
11980-174-05	PREDNISOLONE ACETATE 0.12 % OPHT DRPS	$962.40
11980-180-05	PREDNISOLONE ACETATE 1 % OPHT DRPS	$962.40
HC45400926	MR BREAST CAD+	$961.00
8065183905	CHONDROITIN SULF-SOD HYALURON 4-3 % (40-30 MG/ML) INTRAOCULAR SYRG	$960.48
HC44000487	CHOLECYSTOGRAM ORAL (GB)	$960.00
HC33000241	ST-SPEECH THERAPY 75 MIN/MW	$960.00
0517-1820-01	CHLOROTHIAZIDE SODIUM 500 MG IV SOLR	$960.00
HC44001436	KNEE 3 VIEWS LT	$959.00
HC44001444	KNEE 3 VIEWS RT	$959.00
HC62300009	RETRACTOR ATRIAL SHORT ROBOTIC	$959.00
HC32001265	OT-DBRD OPN WND EA+20SQCM OR <	$958.00
HC31001357	PT-DBRD OPN WND EA+20SQCM OR <	$958.00
HC21000922	APPLY MULTILAY COMPRS UPREX LT	$957.00
HC21000930	APPLY MULTILAY COMPRS UPREX RT	$957.00
HC33001140	ST EVAL SPEECH FLUENCY 180MIN/M	$957.00
HC33000852	ST-EVAL SPEECH CMPNT 90MIN	$957.00
HC32000416	OT-RE-EVAL EST POC  60MIN	$957.00
HC51010783	DEBRIDE MASTOIDECT CAVITY COMPLEX	$956.00
HC25002973	LAC REPAIR SIMPLE S/N/A/GEN/T/EXT >30.0CM	$955.00
HC25005281	I&D ABSCESS PERITONSILLAR BILAT	$955.00
HC31000045	PT-APPLICATION SPLINT LONG LEG	$954.00
62327-444-44	STERILE TALC 4 GRAM INTRAPLEURAL SUSR	$954.00
62327-444-04	STERILE TALC 4 GRAM INTRAPLEURAL SUSR	$954.00
0008-4990-20	TIGECYCLINE 50 MG IV SOLR	$953.15
0008-4990-19	TIGECYCLINE 50 MG IV SOLR	$953.15
HC25005307	REPOSIT NASO/ORO GASTRIC FEED TUBE THRU DUODENUM	$953.00
HC44003085	XR SMALL BOWEL F-THRU INC SERIAL+	$953.00
HC83000992	RBC'S LEUKO REDUCED EA UNIT-SB	$953.00
HC62211024	CANNULA ARTERIAL STRAIGHT         N	$953.00
42494-340-01	FLUCYTOSINE 500 MG ORAL CAP	$952.83
42494-340-03	FLUCYTOSINE 500 MG ORAL CAP	$952.83
0781-6023-46	CLARITHROMYCIN 250 MG/5 ML ORAL SUSR	$952.80
HC83000042	RBC'S LEUKOREDUCE EA UNIT	$952.00
0065-0647-05	TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS	$951.78
HC31000151	PT-COMPUT DYNAMIC POSTURE SOT 6 CONDITIONS	$950.00
HC32000051	OT-COMPUT DYNAMIC POSTURE SOT 6 CONDITIONS	$950.00
HC83000927	RBC'S LUK RED EA UNIT AUTOL~BB	$949.00
HC83000935	RBC'S LUK RED EA UNIT DIREC~BB	$949.00
42367-570-22	VASOPRESSIN 20 UNIT/ML IV SOLN	$948.29
42367-570-87	VASOPRESSIN 20 UNIT/ML IV SOLN	$948.29
43598-085-25	VASOPRESSIN 20 UNIT/ML IV SOLN	$948.29
43598-085-11	VASOPRESSIN 20 UNIT/ML IV SOLN	$948.29
0517-1020-01	VASOPRESSIN 20 UNIT/ML IV SOLN	$948.24
0517-1020-25	VASOPRESSIN 20 UNIT/ML IV SOLN	$948.24
HC41500778	EEG W/O VID UNMONITOR 2-12 HR	$948.00
HC25000449	MANIPULATION MINOR JOINT	$947.00
HC46502746	BIOPSY PUNCH SKIN; EACH SEP ADD'L LESION	$945.00
HC83001180	RBC'S LEUKO REDUCED EA UNIT	$945.00
HC62800834	CATH HEMO/PERI DIAL SHORT TRM     N	$943.00
HC62200464	BASKET RETRIEVAL                  N	$943.00
HC62205232	KIT CUSA	$943.00
HC62214952	BLADE CUP/OSTOETOME               O	$943.00
HC62300090	DISSECTOR ROBOTIC                 Z	$943.00
0037-6822-10	HYDROCORTISONE-PRAMOXINE 1-1 % RECTAL FOAM	$942.42
HC21000682	APPLY MULTILAY COMPRS BK LT	$942.00
HC21000674	APPLY MULTILAY COMPRS BK RT	$942.00
HC44000396	CHEST 2 VWS W/OBLIQUES (4VIEWS)	$942.00
HC31000011	PT-APPLICATION CAST SHORT LEG	$941.00
HC44000149	ANKLE COMP MIN 3 VWS LT	$941.00
HC44000156	ANKLE COMP MIN 3 VWS RT	$941.00
HC44002806	ANKLE MIN 3 VIEWS	$941.00
HC62201132	CARTRIDGE HIGH FREQ JET	$941.00
HC33000761	ST-EVAL NONSPEECH DEVICE RX:1ST HR	$938.00
HC32000275	OT-EVAL HIGH COMPLEXITY 45MF2F 60MIN	$938.00
HC21000625	WOUND VAC W/ DME <50 SQ CM PER SESSION	$937.00
HC62215512	RETRACTOR TUBE SPINAL ENDOSCOPIC	$937.00
HC51060622	DESTROY MUSCLE(S) 1-4 EA ADD EXTREM	$936.00
HC51060648	DESTROY MUSCLE(S) 5/+ EA ADD EXTREM	$936.00
HC51060663	DESTROY MUSCLE(S) TRUNK RT 6/+	$936.00
63323-960-10	TIGECYCLINE 50 MG IV SOLR	$936.00
HC44001998	SHOULDER COMP MIN 2VWS LT	$933.00
HC44002004	SHOULDER COMP MIN 2VWS RT	$933.00
HC12400016	CHEMO ADMIN IV ADD'L HR	$933.00
0781-7080-35	METRONIDAZOLE 1 % TOPICAL GEL	$931.68
HC38000238	APPLY BODY CAST;SHOULDER-HIPS	$930.00
61269-410-20	ETOPOSIDE PHOSPHATE 100 MG IV SOLR	$930.00
63323-272-05	FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN	$929.82
HC37000296	DAILY MNGMT BREAST MILK PROC/STORE/DIST	$929.00
HC25003021	LAC REPAIR SIMPLE F/E/E/N/L/M 12.6-20.0 CM	$928.00
HC46000311	INJ FOR DACRYCYSTOGRAPHY	$928.00
HC33000415	ST-SWALLOWING THERAPY  60 MIN	$927.00
HC62207303	TRAY CUTDOWN	$926.00
67457-445-60	RIFAMPIN 600 MG IV SOLR	$924.60
HC44001535	LUMBAR SPINE 2 OR 3 VWS	$923.00
HC42000497	SIGNAL AVERAGE ECG	$923.00
HC41000129	HOME SLEEP STUDY/T IV MIN' 3CH	$923.00
HC25005778	CLOSED TX FIBULA DISTAL FX W/MANIP LT	$922.00
HC25005786	CLOSED TX FIBULA DISTAL FX W/MANIP RT	$922.00
HC62228259	ORTH HFO W/NONTORSION JOINT(S) CUSTOM	$920.00
HC39001045	TMS REDETERMINATION THRES DELV MGNT	$919.00
HC41500539	EMG FACIAL UNILAT	$919.00
HC41500240	EMG FACIAL UNILAT LT	$919.00
HC41500257	EMG FACIAL UNILAT RT	$919.00
HC31000342	PT-EVAL HIGH COMPLEXITY 45MF2F 60MIN	$919.00
50242-041-64	ALTEPLASE 2 MG INTRACATH SOLR	$918.36
63323-351-20	RIFAMPIN 600 MG IV SOLR	$918.00
HC36800381	SPIROMETRY W/MEASUREMNTS& REC	$917.00
HC36001055	SPIROMETRY W/MEASUREMNTS& REC	$917.00
99999-041-52	NM TC-99M (DTPA) PENTETATE AEROSOL MHS	$916.76
0023-0313-04	SULFACETAMIDE-PREDNISOLONE 10-0.2 % OPHT OINT	$916.57
HC38000287	APPLY CAST SPICA SHOULDER	$916.00
HC51002160	CYSTOGRAM W/ URETH PRFL STDY	$916.00
HC32000747	OT-WOUND NON-SEL DEB 60MIN/MW	$916.00
HC31000805	PT-WOUND NON-SEL DEB 60MIN/MW	$916.00
HC46000097	INJ ARTHROGRAM ANKLE-LT	$914.00
HC46000105	INJ ARTHROGRAM ANKLE-RT	$914.00
HC38000139	APPLY SPLINT LONG ARM	$914.00
HC62209580	TRACTION KIRSCHNER WIRE UNIT	$914.00
50419-773-01	CIPROFLOXACIN 500 MG/5 ML ORAL SUMC	$913.80
HC25004219	CLOSED TX HIP DISLOC POST ARTHROPLASTY LT	$913.00
HC25004227	CLOSED TX HIP DISLOC POST ARTHROPLASTY RT	$913.00
0004-0822-05	OSELTAMIVIR 6 MG/ML ORAL SUSR	$911.16
0173-0696-04	FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE INHALATION DSDV	$910.39
0173-0695-04	FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE INHALATION DSDV	$910.39
HC44000925	FOOT COMP MIN 3 VWS LT	$910.00
HC62808415	CATH VENTRICULAR NEURO	$910.00
HC62221197	KIT W/ TRACH PERCUTANEOUS         C	$910.00
HC62219639	TUBE TRACH CUFFED                 N	$910.00
HC62226857	CATH PTA ANGIOPLS BALLOON NON-LSR J	$910.00
HC62212600	CATH PTCA BALLOON NON-LASER       G	$910.00
HC62222567	CATH BALLOON RENAL                N	$910.00
HC62222252	CATH EP DX <20 ELECTRODES         G	$910.00
HC62225297	CATH EP DX 20+ ELECTRODES RPRSD   N	$910.00
HC62803648	KIT CATH HEMO/PERI DIALYS LG TRM  N	$910.00
HC62220082	CATH THROMBECTOMY/EMBOLECTOMY     N	$910.00
HC62806120	PORT INDWELLING W/CATH            G	$910.00
HC62804588	STENT CORO BARE METAL W/DEL       A	$910.00
HC62223367	CATH MICRO NEURO(FUBUKI)          H	$910.00
HC62212436	INTRODUCER/SHEATH                 P	$910.00
HC62227178	COUNTERSINK CANNULATED            M	$910.00
HC62200241	SET AUTOTRANSFUSE                AK	$910.00
HC62204128	KIT PERCUTANEOUS CATH	$910.00
HC62205828	PROBE LASER                       N	$910.00
HC62205836	PROBE LITHOTRIPTOR                N	$910.00
HC62209416	CATH BASKET RETRIEVAL AIRWAY      Y	$910.00
HC62212964	BLADE SHAVER                      N	$910.00
HC62213152	BLADE INCISIONAL                  N	$910.00
HC62213269	BURR                              N	$910.00
HC62213467	REAMER                            Q	$910.00
HC62214564	CLIP STIMULATION NERVE            E	$910.00
HC62214945	BLADE CUP                         N	$910.00
HC62216130	STENT REMOVER                     G	$910.00
HC62216148	SPHINCTEROTOME CANNULATING        G	$910.00
HC62216213	SPHINCTEROTOME                    G	$910.00
HC62216692	PIN/WIRE FIXATION TEMPORARY       AF	$910.00
HC62217294	KIT HARVESTING BONE GRAFT         N	$910.00
HC62217666	AWL SPINAL SINGLE PATIENT USE     K	$910.00
HC62218409	ENDO STAPLER                      N	$910.00
HC62218847	DRILL/DRILL BITS SINGLE USE       S	$910.00
HC62220447	TEMPLATE ORTHO/ROD SPINAL         W	$910.00
HC62221726	SET TUBING STABILZR ENDOWRST ROBOTIC	$910.00
HC62221841	TAP SURGICAL                      N	$910.00
HC62222484	WAND ARTHRO                       N	$910.00
HC62223011	ELECTRODE RESECTOSCOPE            K	$910.00
HC62223060	APPLIER LIGA/HEMOCLIP ENDO        P	$910.00
HC62223326	KIT ACCESSORY                     K	$910.00
HC62223599	SNARE                             N	$910.00
HC62224530	TIP MIX LUERLOCK CORTOSS (CEMENT)	$910.00
HC62225305	EXTRACTOR NAIL	$910.00
HC62225339	CANNULA ARTHROSCOPIC              N	$910.00
HC62225453	FIBER OPTIC ERCP	$910.00
HC62225750	KIT DRESSING WOUND NEG PRESSURE   K	$910.00
HC62225867	GUIDE DRILL                       N	$910.00
HC62226378	PUSHER KNOT ENDO                  I	$910.00
HC62227046	KNIFE URETHROTOME	$910.00
HC62227285	FIBER LASER                       H	$910.00
HC62227509	"KIT COLON W-BTTNS,BX CAP,VALVE ENDO"	$910.00
HC62227525	FORCEPS BIPOLAR DISPOSABLE        L	$910.00
HC62228341	PROBE TURBINATE                   N	$910.00
HC62228465	PASSER SUTURE                     N	$910.00
HC62290556	GUIDE PIN ORTHO                   N	$910.00
HC62300157	SCISSORS CURVED ROBOTIC           N	$910.00
HC62300314	FORCEP ROBOTIC                    N	$910.00
HC62300504	DRIVER NEEDLE ROBOTIC             O	$910.00
HC62801543	PARTICLES EMBOLIZ (EMBOSPHERE)    M	$910.00
HC62804190	COIL EMBOLIZATION                 H	$910.00
HC62805841	HEMOSTATIC GEL/GELFOAM/PAD        N	$910.00
HC21000740	LAC REPAIR 2.6-7 5CM	$909.00
HC25002965	LAC REPAIR SIMPLE S/N/A/GEN/T/EXT 20.1-30.0CM	$909.00
HC44000065	AC JOINTS BILAT	$909.00
HC44000933	FOOT COMP MIN 3 VWS RT	$909.00
65862-057-24	NEVIRAPINE 50 MG/5 ML ORAL SUSP (MCH)	$908.64
HC25003773	CLOSED TX ULNA SHAFT FX W/MANIP LT	$908.00
HC25003781	CLOSED TX ULNA SHAFT FX W/MANIP RT	$908.00
HC33001017	ST EVAL SOUND PRODUCTION 180MIN/M	$907.00
HC62228911	SUPPORT BKA DRESSING	$907.00
HC44500684	CINERADIOGRAPHY(SEPARATE PROC)	$906.00
60793-600-02	"PENICILLIN G BENZATHIN,PROCAIN 1,200,000 UNIT/ 2 ML(600K/600K) IM SYRG"	$905.75
60793-600-10	"PENICILLIN G BENZATHIN,PROCAIN 1,200,000 UNIT/ 2 ML(600K/600K) IM SYRG"	$905.75
8065183055	SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG	$905.46
HC25004300	CLOSED TX KNEE DISLOC; NO ANESTH LT	$905.00
HC25004318	CLOSED TX KNEE DISLOC; NO ANESTH RT	$905.00
HC81101263	SWEAT COLLECT IONTOPHORESIS	$905.00
HC82202417	MORPH STDY TMR IHC CAT EGFR PER SPEC EA ADDL AB	$903.00
HC82202375	MORPH STDY TMR IHC CAT ER PER SPEC EA ADDL AB	$903.00
HC82202409	MORPH STDY TMR IHC CAT HER2 PER SPEC EA ADDL AB	$903.00
HC82202391	MORPH STDY TMR IHC CAT KI67 PER SPEC EA ADDL AB	$903.00
HC82202425	MORPH STDY TMR IHC CAT NOS PER SPEC EA ADDL AB	$903.00
HC82202433	MORPH STDY TMR IHC CAT PER SPEC EA ADDL AB	$903.00
HC82202383	MORPH STDY TMR IHC CAT PR PER SPEC EA ADDL AB	$903.00
HC33000233	ST-SPEECH THERAPY 60 MIN/MCW	$903.00
HC33000704	ST-EVAL LANGUAGE CMPNT 90MIN	$903.00
0065-0543-01	TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSP	$902.46
0006-4827-00	"VARICELLA VIRUS VACC LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSR"	$901.36
0006-4827-01	"VARICELLA VIRUS VACC LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSR"	$901.36
HC44002202	THORACIC SPINE 3 VIEWS	$901.00
HC44001832	SACRO-ILIAC JNTS 3 OR MORE VWS	$901.00
HC81101966	DRUG TST DEFNTV 8-14RX CLSS W/METBLTS/DAY	$901.00
HC33000456	ST-THER NON-SP GEN DEV W/PROG	$900.00
25021-812-30	ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN	$900.00
0187-0993-95	ACYCLOVIR 5 % TOPICAL OINT	$900.00
55150-219-10	EPTIFIBATIDE 2 MG/ML IV SOLN	$900.00
0115-1694-49	EPINEPHRINE 0.3 MG/0.3 ML INJ ATIN	$900.00
49502-101-02	EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN	$900.00
49502-102-02	EPINEPHRINE 0.3 MG/0.3 ML INJ ATIN	$900.00
49502-102-01	EPINEPHRINE 0.3 MG/0.3 ML INJ ATIN	$900.00
99999-036-35	CHARGE - REPERFUSION CARDIOPLEGIA SOLN	$900.00
49502-101-01	EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN	$900.00
0049-3190-28	VORICONAZOLE 200 MG IV SOLR	$899.64
16714-087-01	CLOBAZAM 2.5 MG/ML ORAL SUSP	$899.28
HC44001659	NASAL BONES	$898.00
HC44002707	ELBOW - COMPLETE	$898.00
HC44000669	ELBOW COMP MIN 3 VWS LT	$898.00
HC62220553	FILTER HARVESTER BONE/BONE MARROW	$898.00
0591-2312-15	ALVIMOPAN 12 MG ORAL CAP	$897.77
0591-2312-45	ALVIMOPAN 12 MG ORAL CAP	$897.77
42023-230-10	MICAFUNGIN 100 MG IV SOLR	$897.60
42023-230-01	MICAFUNGIN 100 MG IV SOLR	$897.60
HC25005661	REMOV SKIN TAGS UP TO&INCL 15 LESIONS	$897.00
HC44000677	ELBOW COMP MIN 3 VWS RT	$897.00
HC44001014	HAND COMPLETE MIN 3 VWS LT	$897.00
HC44001022	HAND COMPLETE MIN 3 VWS RT	$897.00
HC62210331	BALLOON SIZING SEPTAL DEFECT	$897.00
0143-9273-01	DIHYDROERGOTAMINE 1 MG/ML INJ SOLN	$897.00
0143-9273-10	DIHYDROERGOTAMINE 1 MG/ML INJ SOLN	$897.00
0168-0202-60	CLINDAMYCIN PHOSPHATE 1 % TOPICAL GEL	$896.04
HC44000388	CHEST 2 VWS W/APICAL LORDOTIC (3VIEWS)	$896.00
HC44003051	CHEST 3 VIEWS	$896.00
HC79200002	"MUSCLE TEST, ONE LIMB"	$896.00
HC51001378	CLOSED TX TIBIA FX	$895.00
HC43001155	MAMMO DX LTD/FOCUS EXM UNILT W/CAD LT	$895.00
HC43001163	MAMMO DX LTD/FOCUS EXM UNILT W/CAD RT	$895.00
0407-2223-19	IODIXANOL 320 MG IODINE/ML IV SOLN	$894.60
HC81701559	MULTI ORGANIZ DNA BY AMP PROBE	$894.00
HC84201623	MULTI ORGANIZ DNA BY AMP PROBE	$894.00
HC36800225	HTN ASSESSMENT W/ NITRIC OXIDE	$894.00
HC83000943	RBC'S LUK RED'IRR EAUNIT DD~BB	$894.00
HC83000596	WHOLE BLOOD LEUKO RED/IRRAD EA UNIT	$894.00
HC62211552	NEEDLE ACCESS SPINAL INSULATED	$894.00
HC62223169	CONNECTOR ASSIST PUMP VENTRICULAR	$894.00
HC62205414	PACK ORTHO MAJOR	$893.00
HC62209085	HOOK PHLEBECTOMY	$893.00
0002-8215-01	INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN	$892.20
0002-8315-01	INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSP	$892.20
0002-8715-01	INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP	$892.20
0187-3555-10	FLUCYTOSINE 500 MG ORAL CAP	$892.16
HC25000233	BURNS LOCAL TREATMENT LG 36%	$892.00
HC44002228	SPINE THORACOLUMBAR JUNCTN MIN 2 VWS	$892.00
49471-001-05	BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL SOLN	$891.60
HC44000701	EYE FOR FOREIGN BODY BILAT	$891.00
HC39000914	PSYCH TX FOR CRISIS 1ST 60MINS/COMM	$889.00
HC62228499	BRONCHOSCOPE ASCOPE SLIM DISP	$888.00
HC62228507	BRONCHOSCOPE ASCOPE REG DISP	$888.00
0173-0859-14	FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE INHALATION DSDV	$887.21
HC25003955	CLOSED TX WRIST DSLOC 1/> BONES W/MAN LT	$887.00
HC25003963	CLOSED TX WRIST DSLOC 1/> BONES W/MAN RT	$887.00
HC25003989	CLOSED TX DISTL RADIOULNAR DISLOC W/M LT	$887.00
HC25003997	CLOSED TX DISTL RADIOULNAR DISLOC W/M RT	$887.00
HC36000982	HTN ASSESSMENT W/ NITRIC OXIDE	$887.00
HC62217740	ELECTRODE NEUROMONITORING SPINAL	$887.00
HC62804679	STAPLE REINFORCEMENT(SEAMGUARD)     D	$887.00
HC12200028	IV INF HYDRATION INITIAL HR	$886.00
HC38000048	APPLY CAST SHORT LEG	$884.00
HC51061695	ECHO FETAL CARDIOVASCULAR 2D	$884.00
HC51061422	IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON)	$884.00
HC51061737	IV INFUSION MONOCLONAL ABX BAMLANIVIMAB/ETESEVIMAB	$884.00
HC25001322	BURNS 1ST DEGREE INITIAL TX	$883.00
HC38000386	REPAIR SPICA BODY CAST	$883.00
HC51002442	CHANGE CYSTOSTOMY; COMPLICATED	$883.00
HC25000415	LARYNGOSCOPY FIBEROPTIC DX	$883.00
49702-222-48	ABACAVIR 20 MG/ML ORAL SOLN	$881.28
HC12200275	SC INFUSION THERAPY EA ADDL HOUR	$881.00
HC25001389	INJ(S);TRIGGER POINT 1-2MUSCLES	$880.00
HC83500124	CHEMOSENSITIVITY ASSAY-WD	$880.00
HC62218110	CAPSULE PH (IMPLANT)              C	$880.00
HC62223128	DEVICE COUPLER ANASTAMOSIS	$880.00
0003-0527-11	DASATINIB 20 MG ORAL TAB	$879.04
HC38000345	APPLY CAST PATELR TENDN BEARNG	$879.00
HC51002723	MANOMETRIC STDY VIA NEPHRO	$879.00
HC65800054	BRACHY SEED HDR IRIDIUM 192	$878.00
HC62212741	GUIDEWIRE                         N	$878.00
HC62220835	BAG/POUCH RETRIEVAL SPECMN ENDO   M	$878.00
HC62223029	HANDPIECE ILLUMINATOR/SUCTION	$878.00
HC44001857	SACRUM & COCCYX MIN 2VWS	$877.00
HC82200544	MOLECULAR CYTO DNA PROBE	$877.00
HC83000026	WHOLE BLOOD EA UNIT	$877.00
HC44002749	WRIST - FOUR VIEWS	$876.00
HC44002582	WRIST COMP MIN 3 VWS LT	$876.00
HC44002590	WRIST COMP MIN 3 VWS RT	$876.00
HC44002731	WRIST MIN 3 VIEWS	$876.00
HC62205778	PROBE FLOW VASCULAR UTZ           N	$876.00
HC38000030	APPLY CAST LONG ARM	$875.00
HC38000378	REM/BIVALV SPICA SHOULDER/HIP	$875.00
HC29000684	TEST CHALLENGE INGEST 1ST120MIN	$875.00
HC51001196	CLOSED TX HUMERUS SHAFT FX NO MANIP	$873.00
HC25005893	INJ ANES/STEROID NERVE OCCIPITL GREAT BI	$872.00
HC44000024	ABDOMEN 2 VIEWS	$872.00
99999-041-51	NM TC-99M (DTPA) PENTETATE RENAL MHS	$871.91
HC25002957	LAC REPAIR SIMPLE S/N/A/GEN/T/EXT 12.6-20.0CM	$871.00
65649-552-04	METHYLNALTREXONE 8 MG/0.4 ML SUBCUTANEOUS SYRG	$870.84
65649-551-03	METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRG	$870.84
65649-551-02	METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLN	$870.84
65649-551-07	METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRG	$870.84
HC34000281	STENGER TEST SPEECH	$870.00
44567-223-01	NAFCILLIN 10 GRAM INJ SOLR	$870.00
70860-402-10	BIVALIRUDIN 250 MG IV SOLR	$870.00
70860-402-41	BIVALIRUDIN 250 MG IV SOLR	$870.00
67546-111-14	NITAZOXANIDE 500 MG ORAL TAB	$869.50
HC81100877	ACUTE HEPATITIS PANEL	$869.00
46287-006-01	SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML ORAL SUSP	$868.43
HC62212345	COLLAR CERV 2 PIECE W-THORA EXTN	$868.00
HC46001020	INTRO NDL/INTRACATH VEIN BI	$867.00
HC62801279	KIT CVP (PASSPORT)	$867.00
HC83000570	RBC IRRADIATED EA UNIT	$866.00
HC32001604	OT-APPLICATION CAST LONG ARM	$865.00
HC82202177	MORPHOMETRIC STUDY SKEL MUSC	$865.00
HC42000034	AMB BP MONITOR 24HR+ ANALYSIS W/RPT; SCANNING	$864.00
HC32003311	OT-EVAL MOD COMPLEXITY 30MF2F 60MIN	$864.00
71285-0108-1	CARDIOPLEGIC NO.14 (MAINT 8:1) 36 MEQ/500 ML (POTASSIUM) PERF SOLN	$864.00
99999-001-76	CHARGE-ADULT 3 IN 1 ADMIX 1500ML	$864.00
HC25000605	GASTRIC INTUB ASP THER' LAVAGE	$863.00
HC42000026	AMB BP MONITOR 24HR+ RECORD ONLY	$863.00
HC44002244	TIBIA & FIBULA (LEG) 2 VWS LT	$862.00
HC44002251	TIBIA & FIBULA (LEG) 2 VWS RT	$862.00
HC44002780	TIBIA AND FIBULA	$862.00
HC41500497	EMG EA EXTRM /PRSPNL;CMPL 5MUS+	$862.00
HC62217120	ADVANCER SYSTM ROTALINK	$862.00
HC12200127	REFILL&MAINT'N IMPLANT PUMP	$861.00
HC31002066	PT-EVAL MOD COMPLEXITY 30MF2F 60MIN	$861.00
58160-958-01	"MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR"	$860.60
58160-955-09	"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT"	$860.60
0054-3120-41	CALCITRIOL 1 MCG/ML ORAL SOLN	$859.23
55150-193-01	ADENOSINE IV INFUSION	$858.06
99999-001-80	CHARGE-NEONATAL HYPERAL	$858.00
HC51001394	CLOSED TX ANKLE FX	$856.00
HC25004987	APPLY CAST LONG LEG LT	$856.00
HC25004995	APPLY CAST LONG LEG RT	$856.00
HC51001352	CLOSED TX KNEECAP FX	$855.00
HC44002053	SKULL LTD <4 VIEWS	$855.00
HC81101750	ACTH STIMULATION PANEL	$855.00
65628-206-05	VANCOMYCIN 50 MG/ML ORAL SOLR	$853.20
HC12400073	CHEMO HORMON ANTINEOPL SQ/IM	$853.00
HC41500489	EMG 1 EXTREM W/PARASPINAL LTD+	$852.00
HC62211412	SYSTEM VENTRICULAR DRAINAGE	$852.00
50419-320-05	GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN	$851.76
63323-330-60	NAFCILLIN 10 GRAM INJ SOLR	$849.30
HC46501136	INSRT BLADDER CATH-TEMP-COMPLX	$849.00
HC51002319	LYSIS OF LABIAL ADHESIONS	$849.00
HC62208889	ADVANCER ROTALINK	$849.00
HC77400208	ANESTHESIA LOCAL INITIAL HR	$849.00
65174-288-30	KIT PREP TC 99M-PENTETIC ACID 20 MG IV SOLR	$848.94
HC62204094	KIT NEEDLE US VACUUM ASSIST	$846.00
55390-252-01	MITOMYCIN 20 MG IV SOLR	$846.00
49281-589-05	"MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN"	$845.70
49281-589-58	"MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN"	$845.70
HC62807904	M: CONNECTOR JOINT NAIL TO NAIL	$845.00
HC62800032	BALLOON ERCP	$845.00
HC62800040	BALLOON ESOPHAGEAL	$845.00
HC62227640	CATH EP DX <20 ELECTRODES RPRSD   M	$845.00
HC62802541	KIT PICC LINE                     M	$845.00
HC62212428	INTRODUCER/SHEATH                 O	$845.00
HC62202270	DISSECTOR CURVED SHORT	$845.00
HC62211503	BLADE INCISIONAL                  M	$845.00
HC62212956	BLADE SHAVER                      M	$845.00
HC62213251	BURR                              M	$845.00
HC62213459	REAMER                            P	$845.00
HC62214531	RETRACTOR DISPOSABLE              I	$845.00
HC62217658	AWL SPINAL SINGLE PATIENT USE     J	$845.00
HC62218391	ENDO STAPLER                      M	$845.00
HC62218607	PROBE SPINAL DISPOSABLE           H	$845.00
HC62218839	DRILL/DRILL BITS SINGLE USE       R	$845.00
HC62220736	COUNTERSINK CANNULATED            L	$845.00
HC62228069	MOLD/FORM CEMENT ADAPTER FEMORAL	$845.00
HC33000316	ST-SWALLOWING EVAL 30MIN	$844.00
HC21000179	"AVULSION OF NAIL, SIMPLE:1"	$843.00
HC21000732	LAC REPAIR TO 2.5 CM(SMALL)	$843.00
HC51001402	CLOSED TX LAT MALLEO ANKL FX NO MAN	$841.00
HC44200830	US EXTREMITY NON VASC LTD- LT	$840.00
HC44200822	US EXTREMITY NON VASC LTD-RT	$840.00
16729-151-31	TOPOTECAN 4 MG IV SOLR	$840.00
99999-008-41	TOPOTECAN 1 MG/ML INJ SOLN (FOR ORAL USE)(MCH)	$840.00
47335-154-40	GEMCITABINE 1 GRAM IV SOLR	$840.00
0054-0057-46	DIGOXIN 50 MCG/ML ORAL SOLN (LOADING DOSE MCH)	$839.88
HC44001790	RIBS UNILAT 2 VIEWS LT	$839.00
HC44001808	RIBS UNILAT 2 VIEWS RT	$838.00
HC32000432	OT-SWALLOWING EVAL 30MIN	$837.00
HC51002418	EXCISE LESION 2.1-3CM HND-FT-SC-NCK-GN	$836.00
HC25004862	APPLY CAST; SHOULDER TO HAND (LONG ARM) LT	$836.00
HC25004870	APPLY CAST; SHOULDER TO HAND (LONG ARM) RT	$836.00
HC38000337	APPLY CYLINDER CAST(THI-ANKLE)	$836.00
HC39001029	TMS INITIAL MAP THRES DEL MGMT SESS	$836.00
0407-1414-93	IOHEXOL 350 MG IODINE/ML IV SOLN	$835.20
0407-1414-86	IOHEXOL 350 MG IODINE/ML IV SOLN	$835.20
HC25003575	CLOSED TX SHOULDR DSLC W/MAN W/O ANES LT	$835.00
HC25003583	CLOSED TX SHOULDR DSLC W/MAN W/O ANES RT	$835.00
HC31001803	PT-APPLICATIN CAST LEG CLBFOOT	$834.00
HC44000552	DACRYOCYSTOGRAPHY	$834.00
71285-0102-1	CARDIOPLEGIC SOLUTION NO.10 108 MEQ/500 ML (POTASSIUM) PERF SOLN	$834.00
44567-820-10	ERTAPENEM 1 GRAM INJ SOLR	$832.80
44567-820-01	ERTAPENEM 1 GRAM INJ SOLR	$832.80
0409-0302-01	TOPOTECAN 4 MG/4 ML IV SOLN (MCH)	$831.31
HC43500008	DEXA BONE DENS-APPEND SKELETAL	$831.00
68982-623-03	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	$831.00
HC84201847	SARS-COV-2/FLU/RSV RNA QUAL PCR	$830.00
HC11500790	AM/PACU EVAL COMPLX-V	$829.00
76478-001-05	TIMOLOL 0.25 % OPHT DROP	$827.88
66993-962-45	METRONIDAZOLE 0.75 % TOPICAL GEL	$827.28
HC44200962	US ELASTOGRAPHY	$827.00
51672-4116-6	METRONIDAZOLE 0.75 % TOPICAL GEL	$826.47
0169-1833-11	INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN	$826.20
0169-1834-11	INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSP	$826.20
0169-1837-11	INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP	$826.20
HC51010882	PUNCTURE SPINAL TX DRAIN CSF [NOT W/FLUORO/CT]	$826.00
HC44001402	KNEE 2 VIEWS LT	$826.00
HC44001410	KNEE 2 VIEWS RT	$826.00
99999-034-76	CH - NITRIC OXIDE GAS PER HOUR/ EACH	$825.60
HC32001646	OT-APPLICATION SPLINT LONG ARM	$823.00
HC51002335	CIRCUMCISION INFANT >28D EXCISE NO DEVICE	$823.00
HC81500332	BONE MARROW SMEAR INTERP	$823.00
HC82200486	BONE MARROW SMEAR INTERP	$823.00
HC82201492	"ACID PTASE STAIN, GRP III"	$823.00
HC82201518	"ALPHA NAPBUT STAIN, GRP III"	$823.00
HC82201286	"HISTCHM ST ALK PTASE,FRZ TIS"	$823.00
HC82201294	"HISTCHM ST ATPSE PH4.3,FR TS"	$823.00
HC82201302	"HISTCHM ST ATPSE PH4.6,FR TS"	$823.00
HC82201310	"HISTCHM ST ATPSE PH9.4,FR TS"	$823.00
HC82201385	"HISTCHM ST CYTCHRM OXDS,FR TS"	$823.00
HC82201336	"HISTCHM ST MYPHSPHRYLS,FR TS"	$823.00
HC82201344	"HISTCHM ST NADH-TR,FROZ TISS"	$823.00
HC82201476	"HISTOCHEM DETERMINATIVE,GRIII"	$823.00
HC82201435	"HISTOCHM STN SDH, FRZ TIS BLK"	$823.00
HC82201500	"N-CHLORO EST STAIN, GRP III"	$823.00
HC82201484	"PEROXIDASE STAIN, GRP III"	$823.00
HC82200759	INTRAOP CNSLT CYT PREP INT'L	$823.00
HC82200734	INTRAOP CNSLT CYT PRP-DIST SRV	$823.00
0009-0005-01	"HYDROCORTISONE SOD SUCC (PF) 1,000 MG/8 ML INJ SOLR"	$821.88
HC25000456	FRACTURE TX FINGER/TOE	$821.00
HC44200921	US CHEST LTD	$820.00
HC41500307	INFANT HEARING SCREEN AEP BBS AUTO REPEAT OP	$820.00
HC31000482	PT-RE-EVAL EST POC  60MIN	$820.00
0168-0275-45	METRONIDAZOLE 0.75 % TOPICAL GEL	$819.99
HC25003443	CLOSED TX CLAVICLE FX-BIL	$819.00
HC25004540	CLOSED TX ANKLE DISLOC; NO ANES LT	$819.00
HC25004557	CLOSED TX ANKLE DISLOC; NO ANES RT	$819.00
HC33001124	ST EVAL BEHAVRAL QUAL VOICE 120MIN/M	$817.00
HC32001836	OT-EVAL SWALLOW CINE/FLUORO 30MIN	$817.00
HC33000563	ST-EVAL SWALLOW CINE/FLUORO 30M	$817.00
63304-241-59	CALCITRIOL 1 MCG/ML ORAL SOLN	$816.21
HC62208103	VALVE BIOPSY	$816.00
HC62212733	GUIDEWIRE                         M	$813.00
HC62218557	KIT ACP AUTO COND PLASMA SERIES II	$813.00
HC62225552	INJECTOR GRAFT/STENT	$813.00
HC62227889	KIT REPAIR BROVIAC/CV/HICKMAN     I	$813.00
0168-0416-30	TACROLIMUS 0.1 % TOPICAL OINT	$812.52
68462-534-35	TACROLIMUS 0.1 % TOPICAL OINT	$812.52
HC32000515	OT-SWALLOWING THERAPY  45 MIN	$812.00
HC25000399	LAC REPAIR 30.0+CM	$812.00
0407-1414-03	IOHEXOL 350 MG IODINE/ML IV SOLN	$811.80
HC25005067	ADDING WALKER HEEL PREV CAST BILAT	$811.00
HC25005380	I&D ABSCESS VULVA/PERINEUM	$811.00
HC62201785	CIRCUIT VENT HI-FREQ	$811.00
HC62212030	CANNULA PERFUSN VENOUS FEMORAL    M	$811.00
67546-111-12	NITAZOXANIDE 500 MG ORAL TAB	$807.80
HC51000438	REPAIR CENTRAL VEN CATH(TECH/HOSP)	$806.00
0703-5233-13	DAUNORUBICIN 5 MG/ML IV SOLN	$804.86
0703-5233-11	DAUNORUBICIN 5 MG/ML IV SOLN	$804.86
0143-9551-01	DAUNORUBICIN 5 MG/ML IV SOLN	$804.84
0143-9551-10	DAUNORUBICIN 5 MG/ML IV SOLN	$804.84
0143-9218-01	IDARUBICIN 1 MG/ML IV SOLN	$803.28
HC35000041	REC- EVALUATION 60MIN	$802.00
HC62220231	CUP UTERINE KOH	$802.00
HC51010890	CHEMO ADMIN CNS W/SPINAL PUNCTURE	$801.00
HC25003013	LAC REPAIR SIMPLE F/E/E/N/L/M 7.6-12.5 CM	$800.00
HC89023162	ENZYME ACTIVITY LYSOSOME-JU	$800.00
HC62228804	DEVICE CLOSURE VASCULAR           M	$800.00
HC62229158	ORTHOTIC TLSO 4 RIGID(DONJOY)	$800.00
68682-455-70	METRONIDAZOLE 0.75 % VAGINAL GEL	$799.68
HC41500299	INFANT HEARING SCREEN AEP BBS AUTO INITIAL OP	$798.00
HC44002111	STERNOCLAVICULAR MIN 3 VWS	$797.00
HC33000944	ST EVAL SPEECH FLUENCY 120MIN/M	$797.00
HC34000190	AUD-INFANT HEARING SCREEN AEP BBS AUTO INITIAL IP	$797.00
42023-110-01	ESTRADIOL VALERATE 10 MG/ML IM OIL	$796.38
HC46502720	BIOPSY TANGENTIAL SKIN; EACH SEP ADD'L LESION	$796.00
HC84201037	H.PYLORI BREATH TST UREASE	$796.00
HC44001717	PELVIS 1 OR 2 VWS	$795.00
0407-1413-65	IOHEXOL 300 MG IODINE/ML IV SOLN	$794.70
HC44000362	CHEST 2 VIEWS	$793.00
HC44001220	INFANT LOW EXTREM MIN 2VWS LT	$793.00
HC44001238	INFANT LOW EXTREM MIN 2VWS RT	$793.00
HC22000046	OST NEW PT EVAL LVL5-(60MIN)	$793.00
HC62203799	KIT COOK TRIPLE LUMEN CATH	$793.00
HC62204326	KIT TRIPLE LUMEN/IV CATH	$793.00
50419-774-01	CIPROFLOXACIN 10 G/100 ML ORAL SUMC (MCH)	$792.60
HC62205489	PACK VASCULAR	$792.00
HC62212279	KIT INTRODUCER PERC MRI VISIBLE	$792.00
0009-3169-06	ALPROSTADIL 500 MCG/ML INJ SOLN	$790.03
0009-3169-01	ALPROSTADIL 500 MCG/ML INJ SOLN	$790.03
HC32001695	OT-APP SPLINT SHORTARM;DYNAMIC	$789.00
HC36800910	PULM REHAB PER SESSION (90MIN) W POX2	$789.00
HC83001198	RBC'S EA UNIT	$789.00
HC83000018	RBC'S EA UNIT	$789.00
HC83001040	RBC'S EA UNIT (AUTOLOGOUS)-SB	$789.00
HC83000984	RBC'S EA UNIT -SB	$789.00
0574-0850-05	DIHYDROERGOTAMINE 1 MG/ML INJ SOLN	$788.10
HC44200939	US HEAD/NECK SOFT TISSUE LTD	$788.00
99999-042-03	AMNIOBAND MEMBRANE (14 MM)	$787.50
16714-403-02	CEFPODOXIME 100 MG/5 ML ORAL SUSR	$787.20
HC62201652	CATH VASCULAR	$787.00
HC62217286	PASSER SUTURE                     M	$787.00
42658-021-02	DAUNORUBICIN 5 MG/ML IV SOLN	$786.84
42658-021-01	DAUNORUBICIN 5 MG/ML IV SOLN	$786.84
0078-0494-71	TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU	$786.18
0078-0494-91	TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU	$786.18
HC25000878	ASP/INJ MED JOINT-LT	$786.00
HC25000886	ASP/INJ MED JOINT-RT	$786.00
HC32001612	OT-APPLICATION CAST SHORT ARM	$786.00
HC38000162	APPLY SPLINT SHORT LEG	$786.00
HC25004011	DRAIN ABSCESS FINGER SIMPLE	$785.00
58160-959-01	"MENINGOCOCCAL VACCINE COMPONENTS A & C,Y,W-135 SHELL"	$784.50
HC51001279	CLOSED TX FX RAD/ULN DISTAL FX NO M	$784.00
HC44002913	HIP (W/PELVIS WHN PRFRMD) 1 VIEW LT	$784.00
HC44002921	HIP (W/PELVIS WHN PRFRMD) 1 VIEW RT	$784.00
HC38000022	APPLY CAST SHORT ARM	$783.00
13533-800-12	IMMUNE GLOBUL G-GLY-IGA AVG 46 1 GRAM/10 ML (10 %) INJ SOLN	$780.72
13533-800-13	IMMUNE GLOBUL G-GLY-IGA AVG 46 1 GRAM/10 ML (10 %) INJ SOLN	$780.72
0054-3566-99	MIDAZOLAM 2 MG/ML ORAL SYRP	$780.22
HC51001329	CLOSED TX OF FEMUR FX	$780.00
HC51001337	CLOSED TX OF THIGH FX	$780.00
HC62806476	GOLD SEED MARKER FIDUCIAL EA(ALPHAOMEGA)M	$780.00
HC62801865	TUBE JEJUN STD TRANSG/SET PEG     M	$780.00
HC62227095	TUBE TRACH CUFFED                 M	$780.00
HC62223409	CATH PTA ANGIOPLS BALLOON NON-LSR I	$780.00
HC62212592	CATH PTCA BALLOON NON-LASER       F	$780.00
HC62216031	CATH BALLOON DIL NON VASCULAR     M	$780.00
HC62802533	KIT DILATORS RENAL	$780.00
HC62226980	CATH NEPHROSTOMY                  N	$780.00
HC62224605	CATH EP DX <20 ELECTRODES RPRSD   M	$780.00
HC62222070	CATH CENTRAL VENOUS               M	$780.00
HC62209739	STENT REMOVER                     F	$780.00
HC62806435	PORT INDWELLING W/CATH            F	$780.00
HC62225743	CATH GUIDING                      M	$780.00
HC62223748	SYSTEM DELIVERY LEAD              C	$780.00
HC62802418	INTRODUCER BLADDER STIM	$780.00
HC62802491	INTRODUCER/SHEATH                 N	$780.00
HC62802178	STENT PANCREATIC                  M	$780.00
HC62200217	WAND ARTHRO                       M	$780.00
HC62208566	HAND ACCESS DEVICE                B	$780.00
HC62212949	BLADE SHAVER                      L	$780.00
HC62213145	BLADE OSTEOTOME/CUP               J	$780.00
HC62213244	BURR                              L	$780.00
HC62213442	REAMER                            O	$780.00
HC62215785	FORCEPS BIPOLAR DISPOSABLE        M	$780.00
HC62216098	DEVICE SUTURE ENDO                H	$780.00
HC62216205	SPHINCTEROTOME                    F	$780.00
HC62216684	PIN/WIRE FIXATION TEMPORARY       AE	$780.00
HC62217542	KIT CONCENTRATOR PLATELETS        M	$780.00
HC62217641	AWL SPINAL SINGLE PATIENT USE     I	$780.00
HC62217856	SHIM DEVICE ACCESS SPINAL         Q	$780.00
HC62218383	ENDO STAPLER                      L	$780.00
HC62218821	DRILL/DRILL BITS SINGLE USE       Q	$780.00
HC62219035	FIBRIN SEALANT                    J	$780.00
HC62219803	SIZER MAMMARY                     L	$780.00
HC62219910	CANNULA ARTHRSCPC ROTATING/BUR    E	$780.00
HC62220009	DEVICE BIOPSY BREAST              M	$780.00
HC62221833	TAP SURGICAL                      M	$780.00
HC62222872	PAIN PUMP W/ SYSTEM               M	$780.00
HC62222922	PROBE LASER                       M	$780.00
HC62222963	CANNULA ARTERIAL                  K	$780.00
HC62223052	APPLIER LIGA/HEMOCLIP ENDO        N	$780.00
HC62223300	TEMPLATE BRACHYTHERAPY            L	$780.00
HC62223318	KIT ACCESSORY                     J	$780.00
HC62223847	SET DRILL BIT W/PIN(S)            M	$780.00
HC62224118	CUTTER LINEAR ENDO                M	$780.00
HC62224217	GUIDE DRILLL                      M	$780.00
HC62224365	CANNULA SUCTION & COAGULATION	$780.00
HC62224522	SYSTEM MIXING BONE CEMENT VACUUM	$780.00
HC62224969	PROBE LITHOTRIPTOR                M	$780.00
HC62225222	KIT DRESSING WOUND NEG PRESSURE   J	$780.00
HC62225313	GUIDE ROD                         M	$780.00
HC62225412	PUSHER KNOT ENDO                  H	$780.00
HC62225859	GUIDE DRILL                       M	$780.00
HC62226006	COUNTERSINK                       K	$780.00
HC62226279	NEEDLE BIOPSY BONE                M	$780.00
HC62226667	TEMPLATE ORTHO/ROD SPINAL         V	$780.00
HC62227277	FIBER LASER                       G	$780.00
HC62228325	STAPLE CARTRG/ENDO RELOAD         M	$780.00
HC62300140	GRASPER ROBOTIC                   F	$780.00
HC62300306	FORCEP ROBOTIC                    M	$780.00
HC62804182	COIL EMBOLIZATION                 G	$780.00
HC62805833	HEMOSTATIC GEL/GELFOAM/PAD        M	$780.00
HC62808043	SEALANT STENT ENDOPRSTH	$780.00
50419-320-01	GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN	$780.00
25021-310-02	SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN	$780.00
67457-856-20	ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN	$780.00
67457-839-02	SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN	$780.00
0054-3721-44	PREDNISONE 5 MG/ML ORAL CONC	$779.94
HC25006156	FETAL NON-STRESS TEST	$779.00
HC32000820	OT-WOUND VAC 60>50 SQ CM/M	$779.00
HC31000888	PT-WOUND VAC 60>50 SQ CM/M	$779.00
HC31001910	LOCOMOTOR TRAINING/W	$778.00
HC31001753	PT-EVAL LOCOMOTOR /W	$778.00
HC25000530	SPLINT LONG LEG	$777.00
HC51003259	COLPOSCPY CERV&ADJ VAG W/CERV BX(S)&ECC	$777.00
HC34000141	OTOACOUSTIC EVOKED EMM COMP	$777.00
HC62228192	ORTH HFO W/O JOINTS CUSTOM	$777.00
HC62228242	ORTH HO W/O JOINTS CUSTOM	$777.00
0078-0182-01	OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN	$776.87
64896-671-51	ZOLMITRIPTAN 2.5 MG ORAL TAB	$776.18
HC34000042	COMPREHENSIV AUDIOMETRY	$776.00
63323-763-52	PACLITAXEL 6 MG/ML IV CONC	$775.80
63323-763-50	PACLITAXEL 6 MG/ML IV CONC	$775.80
59762-0040-1	TRIFLURIDINE 1 % OPHT DROP	$775.44
HC44200889	ECHO VELOCIMETRY FETAL UMBILIC	$775.00
HC42000927	CTA CORONARY FFR DATA PREP&TRANSMIT	$774.00
HC25004805	CLOSED TX TALOTARSAL JNT DISLOC; NO ANES LT	$774.00
HC25004813	CLOSED TX TALOTARSAL JNT DISLOC; NO ANES RT	$774.00
HC25004839	CLOSED TX TARSOMETATARSAL JNT DISLOC; NO ANES LT	$774.00
HC25005018	APPLY CAST SHORT LEG LT	$774.00
HC25005026	APPLY CAST SHORT LEG RT	$774.00
HC25000571	BLADDER IRRIGATION SIMPLE	$774.00
HC25005497	REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD LT	$774.00
HC25005505	REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD RT	$774.00
HC44002087	SOFT PALATE CINE (OR VIDEO)	$774.00
HC33000407	ST-SWALLOWING THERAPY  45 MIN	$774.00
HC62200811	BRUSH ERCP                        M	$774.00
0781-6160-43	SEVOFLURANE INHALATION LIQD	$774.00
0781-6160-86	SEVOFLURANE INHALATION LIQD	$774.00
59762-2350-6	ETHOSUXIMIDE 250 MG/5 ML ORAL SOLN	$773.57
HC25003658	CLOSED TX ELBOW DISLOC W/O ANES LT	$773.00
HC25003666	CLOSED TX ELBOW DISLOC W/O ANES RT	$773.00
HC89500326	AUTO/DD BLD/COMP PROC/STOR-UCI	$773.00
HC36800183	FLOW VOLUME LOOP	$773.00
HC51010874	LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO ]	$772.00
HC31002090	PT-EVAL HIGH COMPLEXITY 45MF2F 45MIN	$772.00
HC32003345	OT-EVAL HIGH COMPLEXITY 45MF2F 45MIN	$772.00
0006-3843-71	ERTAPENEM 1 GRAM INJ SOLR	$771.96
63323-724-01	REMIFENTANIL 2 MG IV SOLR	$771.72
63323-724-05	REMIFENTANIL 2 MG IV SOLR	$771.72
24208-410-05	OFLOXACIN 0.3 % OTIC DROP	$771.42
0407-1413-90	IOHEXOL 300 MG IODINE/ML IV SOLN	$771.30
HC83503847	ELECTRON MICROSCOPY-CS	$771.13
HC38000105	REMV/BIVALVE FULL CAST ARM/LEG	$771.00
HC39000203	NEUROPSYCH STATUS EXAM/HR	$768.00
0703-8777-01	ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN	$765.90
17478-544-30	ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN	$765.90
HC44000743	FACIAL BONES LTD < THAN 3 VWS	$765.00
0009-0271-01	ESTRADIOL CYPIONATE 5 MG/ML IM OIL	$764.10
45802-139-70	METRONIDAZOLE 0.75 % VAGINAL GEL	$763.98
HC51001246	CLOSED TX ULNAR FX	$763.00
HC25004771	CLOSED TX TARSAL DISLOC; NO ANES LT	$763.00
HC25004789	CLOSED TX TARSAL DISLOC; NO ANES RT	$763.00
HC25005521	REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP LT	$763.00
HC25005539	REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP RT	$763.00
0054-0428-25	FLUCYTOSINE 500 MG ORAL CAP	$762.26
43386-770-01	FLUCYTOSINE 500 MG ORAL CAP	$762.24
HC44002871	SPINE ENTIRE SKULL-SACRUM 1 VIEW	$762.00
HC44001188	HUMERUS LT	$762.00
HC44001196	HUMERUS RT	$762.00
HC41500505	EMG NON-EXTREM (FACIAL) MUSC +	$762.00
HC31000037	PT-APPLIC SPLINT SHORT LEG	$761.00
HC44200970	US ELASTOGRAPHY 1ST LESION	$761.00
0395-1031-28	GLYCERIN (BULK) 100 % MISC LIQD	$760.32
HC43001106	MAMMO SCREENING W/CAD LEFT	$760.00
HC43001114	MAMMO SCREENING W/CAD RIGHT	$760.00
61958-0602-1	EMTRICITABINE 10 MG/ML ORAL SOLN	$759.90
HC33001041	ST EVAL SOUND W/LANG COMP&EXPRESS 60MIN/M	$759.00
HC51062057	IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) REPEAT	$759.00
70515-260-10	DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN	$758.15
HC25004102	CLOSED TX FINGER JNT DISLOC W/MAN SINGLE	$758.00
HC32001653	OT-APPLICATION SPLINT SHORTARM	$758.00
50419-188-83	GADOPENTETATE DIMEGLUMINE 7.5 MMOL/15 ML (469.01 MG/ML) IV SOLN	$756.00
65649-201-75	PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK	$755.28
HC38000097	APPLY CMPRSSN BOOT/WRAP(UNNA)	$755.00
HC38000204	APPLY CMPRSSN BOOT/WRAP(UNNA)L	$755.00
HC38000196	APPLY CMPRSSN BOOT/WRAP(UNNA)R	$755.00
HC89016984	HIV PHENOTYPE 1ST 1-10(PNL)-VI	$755.00
HC21000658	WOUND ULTRASOUND PER DAY	$755.00
HC25003831	CLOSED TX RAD/EPHYSL SEP&ULN FX NO M LT	$754.00
HC25003849	CLOSED TX RAD/EPHYSL SEP&ULN FX NO M RT	$754.00
HC25004128	CLOSED TX FINGER/THUMB SHAFT FX NO MANIP EA	$754.00
HC25004185	CLOSED TX HIP DISLOC TRAUMIC LT	$754.00
HC25004193	CLOSED TX HIP DISLOC TRAUMIC RT	$754.00
HC25004334	CLOSED TX PATELLAR DISLOC; NO ANESTH LT	$754.00
HC25004342	CLOSED TX PATELLAR DISLOC; NO ANESTH RT	$754.00
HC25004516	CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES LT	$754.00
HC25004524	CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES RT	$754.00
HC25004649	CLOSED TX METATARSAL FX; NO MANIPULTN EA	$754.00
HC25004896	APPLY CAST; ELBOW TO FINGER (SHORT ARM) LT	$754.00
HC25004904	APPLY CAST; ELBOW TO FINGER (SHORT ARM) RT	$754.00
HC81701518	CLOTEST FOR H. PYLORI	$754.00
31722-562-24	ABACAVIR 20 MG/ML ORAL SOLN	$753.12
HC25003005	LAC REPAIR SIMPLE F/E/E/N/L/M 5.1-7.5 CM	$753.00
HC44002194	THORACIC SPINE 2 VIEWS	$753.00
HC44001519	KNEES BILATERAL AP STANDING	$753.00
0019-1323-16	IOVERSOL 320 MG IODINE/ML IV SOLN	$751.50
67919-030-01	CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV SOLR	$751.32
16729-364-03	TIGECYCLINE 50 MG IV SOLR	$751.20
16729-364-68	TIGECYCLINE 50 MG IV SOLR	$751.20
0781-3481-70	TIGECYCLINE 50 MG IV SOLR	$751.20
0781-3481-92	TIGECYCLINE 50 MG IV SOLR	$751.20
0006-0568-40	VORINOSTAT 100 MG ORAL CAP	$750.48
67457-813-50	DAPTOMYCIN 500 MG IV SOLR	$750.06
HC89023410	TARGETED GENOME PNL SEQ 5-50 GENES PANCREASEQ-SS	$750.00
HC11501053	HOSPITAL OUTPATIENT VISIT W/PROC	$750.00
HC25004169	CLOSED TX FINGER/THUMB DISTAL FX W/MANIP EA	$749.00
HC25001140	INSRT BLADDER CATH-TEMP-COMPLX	$749.00
HC51010403	EMG 3 EXTREMITY	$749.00
HC81101958	DRUG TST DEFNTV 1-7RX CLSS W/METBLTS/DAY	$749.00
HC62223276	SYSTEM LEAD EXTRACTION	$749.00
0574-0850-10	DIHYDROERGOTAMINE 1 MG/ML INJ SOLN	$748.70
HC21000526	PAIRING BENIGN LESIONS: 2-4	$748.00
HC25000142	EXCISE NAIL FOLD INGROWN	$748.00
HC25003526	CLOSED TX STERNOCLVCLE DISLOC W/MAN RT	$748.00
HC25003518	CLOSED TX STRENOCLVCLE DISLOC W/MAN LT	$748.00
HC81500852	PLACENTAL ALPHA MICROGLOBULIN-1	$748.00
HC42000042	BIOIMPEDENCE THORACIC	$748.00
HC36000016	AEROSOL-CONTINUOUS TX FIRST HR	$748.00
HC41500737	EMG THORACIC PARASPINAL(NO T1/T12)	$748.00
HC62212725	GUIDEWIRE                         L	$748.00
HC62201322	CATH DIAGNOSTIC                   M	$748.00
HC62203666	KIT ARTHROSCOPY DISPSBLS          M	$748.00
HC62211313	KIT VENT THORACIC (URESIL)	$748.00
HC62217823	TEMPLATE STAPLE SPINAL            L	$748.00
HC62219985	BASKET RETRIEVAL                  M	$748.00
HC62227814	KIT REPAIR BROVIAC/CV/HICKMAN     H	$748.00
HC62300108	DRIVER NEEDLE ROBOTIC	$748.00
51672-1258-2	CLOBETASOL 0.05 % TOPICAL CREAM	$747.18
HC25004730	CLOSED TX PHALANX(TOE) FX; W/MANIPULTN EA	$747.00
HC25005877	CHANGE CYSTOSTOMY TUBE; SIMPLE	$747.00
HC81101115	BLOOD GAS W/MEASURED O2 SAT	$746.00
0075-2915-01	ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG	$745.34
HC44000958	FOREARM LT	$745.00
HC44000966	FOREARM RT	$745.00
HC33000936	ST EVAL SPEECH FLUENCY 90MIN/M	$743.00
0168-0370-30	CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL LOTN	$742.86
61958-0901-1	AZTREONAM LYSINE 75 MG/ML INHALATION NEBU	$742.47
HC62800438	CATH NON VASC DIL RENAL	$742.00
HC62807276	DEVICE CONTRACEPTION IUD PARAGARD	$742.00
HC25000373	I&D ABSCESS	$742.00
HC25004151	CLOSED TX FINGER/THUMB DISTAL FX NO MANIP EA	$740.00
HC32001505	OT-REMOVE/BIVAL CAST FULL LIMB	$740.00
HC31001720	PT-REMOVE/BIVAL CAST FULL LIMB	$740.00
HC44002129	STERNUM MIN 2 VIEWS	$740.00
HC44001378	KNEE 1 VIEW LT	$740.00
HC44001386	KNEE 1 VIEW RT	$740.00
HC36000131	MANIP CHEST WALL INIT DEMO/EVAL	$740.00
HC36000149	MANIP CHEST(INFANT) INIT DEMO/EVAL	$740.00
0703-9060-31	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$739.80
60505-0815-0	DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASL SPRP	$738.78
HC41500661	CALORIC VESTIB BITHERM 2 IRRIG W/REC	$738.00
HC25004698	CLOSED TX BIG TOE FX; W/MANIPULTN LT	$737.00
HC25004706	CLOSED TX BIG TOE FX; W/MANIPULTN RT	$737.00
HC51003325	CRYOCAUTERY CERVIX	$737.00
HC25005570	REMOVE FB EXTRNL EYE; CORNL W/SLITLAMP BIL	$737.00
HC25004177	CLOSED TX FINGER JNT DISLOC	$736.00
67457-198-05	REMIFENTANIL 2 MG IV SOLR	$735.49
67457-198-99	REMIFENTANIL 2 MG IV SOLR	$735.49
HC51000099	CYSTOGRAM COMPLEX	$735.00
HC62221932	KIT TRACKING JOINT ORTHO ROBOTIC	$735.00
0143-9392-10	REMIFENTANIL 2 MG IV SOLR	$735.00
0143-9392-01	REMIFENTANIL 2 MG IV SOLR	$735.00
0409-2634-50	HYDROMORPHONE (PF) 10 MG/ML INJ SOLN	$735.00
HC25002940	LAC REPAIR SIMPLE S/N/A/GEN/T/EXT 7.6-12.5CM	$734.00
HC38000154	APPLY SPLINT SHORT ARM	$734.00
HC25005851	DECLOT IVAD W/THROMBOLYTIC	$734.00
HC46501631	UROFLOWMETRY SIMPLE	$734.00
0781-7077-87	METRONIDAZOLE 0.75 % VAGINAL GEL	$733.74
0245-0860-70	METRONIDAZOLE 0.75 % VAGINAL GEL	$733.74
0597-0032-34	CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK	$733.07
47781-466-71	VORICONAZOLE 200 MG IV SOLR	$732.42
HC44002764	KNEE 1 OR 2 VIEWS	$732.00
HC82202185	MORPHOMETRIC STUDY NERVE	$732.00
HC62211131	KIT BLOWER/MISTER CLEARVIEW	$732.00
0009-0417-02	TESTOSTERONE CYPIONATE 200 MG/ML IM OIL	$731.70
HC31000755	PT-WORK HARDENING INIT 2HR/CMW	$731.00
HC32000697	OT-WORK HARDENING INIT 2HR/CMW	$731.00
50458-596-01	RISPERIDONE 1 MG/ML ORAL SOLN	$730.62
HC82200536	MORPH STDY ISH PER SPEC INTL SNGL PROBE	$730.00
HC36800175	EXHALED NITRIC OXIDE MEASRMNT	$730.00
HC41500893	VESTIBULAR EVOKD MYOGN POTENTL-VEMP;CERVICAL (CVEMP)	$729.00
HC41500901	VESTIBULR EVOKD MYOGN POTENTL-VEMP;OCULAR (OVEMP)	$729.00
HC77400075	ANESTHESIA ADD'L 15MIN	$729.00
HC44002798	ANKLE 2 VIEWS	$728.00
HC44000081	ANKLE 2 VIEWS LT	$728.00
HC44000099	ANKLE 2 VIEWS RT	$728.00
HC51003424	ANORECTAL MANOMETRY	$728.00
HC44900843	CT BODY SCAN LTD ABD/PELVIS	$728.00
HC44900850	CT BODY SCAN LTD ABD/CHEST	$728.00
HC44900918	CT BODY SCAN HRT/LUNG/SC	$728.00
HC62224548	KIT HEYMAN CATH URETHRA OBSTRUCT	$728.00
45802-144-64	HYDROCORTISONE-PRAMOXINE 1-1 % RECTAL CREAM	$727.92
HC25005232	LAC REPAIR MOUTH; 2.5 CM OR LESS	$727.00
99999-006-95	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	$726.16
0065-0656-05	CIPROFLOXACIN HCL 0.3 % OPHT DROP	$725.52
43386-405-03	NITAZOXANIDE 500 MG ORAL TAB	$725.16
HC25000241	BURNS LOCAL TREATMENT MED 18%	$725.00
HC25000522	SPLINT LONG ARM	$725.00
HC31000334	PT-EVAL MOD COMPLEXITY 30MF2F 45MIN	$725.00
HC25001355	DEBRID OPN WOUND EA ADD 20CM/<	$725.00
HC51001238	CLOSED TX RADIAL HED/NEK FX NO MANP	$724.00
HC43001007	US BREAST; LIMITED LT	$724.00
HC43001015	US BREAST; LIMITED RT	$724.00
HC33001009	ST EVAL SOUND PRODUCTION 120MIN/M	$724.00
HC44000891	FOOT 2 VIEWS LT	$723.00
HC44000909	FOOT 2 VIEWS RT	$723.00
HC51001261	CLOSED TX RADIUS&ULNA SHAFT FX NO M	$722.00
HC44002038	SINUSES LTD <  3 VWS	$722.00
HC44000321	CERVICAL SPINE 1 VIEW	$722.00
HC44001527	LUMBAR SPINE 1 VIEW	$722.00
HC44002186	THORACIC SPINE 1VIEW	$722.00
HC62800446	CATH PICC                         L	$722.00
HC62200993	CANNULA CORONARY	$722.00
HC62208251	CATHETER ENTEROCLYSIS	$722.00
HC62208525	STAPLER POWERED	$722.00
HC62214085	NEEDLE TROCAR TARGET(STREAMLINE)  M	$722.00
HC62219670	DILATOR SPINE KOROS	$722.00
HC62800495	CATH SWAN GANZ/THERMODILUTION     M	$722.00
HC44000214	BONE AGE STUDIES	$721.00
HC43500032	DEXA VERTEBRAL FX ASSESSMENT	$721.00
HC33001165	ST EVAL BEHAVRAL QUAL VOICE 90MIN/M	$721.00
99999-041-00	TOLVAPTAN 7.5 MG ORAL PARTIAL TAB	$720.78
60505-0830-1	MOMETASONE 50 MCG/ACTUATION NASL SPRY	$720.02
65162-891-29	MOMETASONE 50 MCG/ACTUATION NASL SPRY	$720.02
HC32000408	OT-RE-EVAL EST POC  45MIN	$720.00
16729-306-10	AZACITIDINE 100 MG INJ SOLR	$720.00
HC25004946	APPLY CAST HAND & LWR FOREARM (GAUNTLET) BIL	$719.00
HC62802475	INTRODUCER DIALYSIS PEEL AWAY	$719.00
HC83001271	PLASMA CONVALESCENT (COVID-AB) -SB	$719.00
HC25004847	CLOSED TX METATARSOPHALAN JNT DISLOC; NO ANES LT	$718.00
HC25000407	NASAL EPISTAXIS	$718.00
61958-2501-1	BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB	$716.76
61958-1901-1	ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG ORAL TAB	$716.76
HC51001253	CLOSED TX RADIAL SHAFT FX NO MANIP	$716.00
HC62800016	BALLOON BILIARY	$715.00
HC62210315	BALLOON BIOFEEDBACK	$715.00
HC62802368	INTRO/SHEATH EP FIXED NON-PEEL    J	$715.00
HC62212410	INTRODUCER/SHEATH                 M	$715.00
HC62300488	DISSECTOR ROBOTIC                 S	$715.00
HC62202965	ENDO STAPLER                      K	$715.00
HC62202981	ENDO STITCH/CATCH	$715.00
HC62203898	KIT HEMOFILTRATION	$715.00
HC62205034	NEEDLE TRANSSEPTAL	$715.00
HC62212931	BLADE SHAVER                      K	$715.00
HC62213137	BLADE INCISIONAL                  K	$715.00
HC62213236	BURR                              K	$715.00
HC62213434	REAMER                            N	$715.00
HC62214523	RETRACTOR DISPOSABLE              H	$715.00
HC62217021	PROBE SPINAL DISPOSABLE           F	$715.00
HC62217633	AWL SPINAL SINGLE PATIENT USE     H	$715.00
HC62218813	DRILL/DRILL BITS SINGLE USE       P	$715.00
HC62219894	BLADE SAW                        AE	$715.00
HC62224621	SUCTION IRRIGATOR ROBOTIC	$715.00
HC62228879	LARYNGOSCOPE RHINO SLIM FLEX	$715.00
70710-1021-8	ALBENDAZOLE 200 MG ORAL TAB	$714.24
HC36001097	OSCILLATE CHEST WALL MECH EA SESSION	$714.00
10223-0201-3	BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRA	$714.00
66794-015-25	SEVOFLURANE INHALATION LIQD	$714.00
63323-145-07	FLOXURIDINE 0.5 GRAM INJ SOLR	$714.00
99999-033-31	CHARGE-ADULT 3 IN 1 ADMIX 1000ML	$714.00
66689-327-02	DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLN	$713.88
5047-4508-32	SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRG	$713.76
8065183004	SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG	$713.34
HC51002400	EXCISE LESION 1.1-2CM HND-FT-SC-NCK-GN	$713.00
HC51060564	DESTROY MUSCLE(S) NECK NO LARYNX LT	$713.00
HC51060572	DESTROY MUSCLE(S) NECK NO LARYNX RT	$713.00
HC44001881	SCAPULA LT	$713.00
HC44001899	SCAPULA RT	$713.00
HC42000117	ECG ROUTINE 15 LEADS	$713.00
HC32000267	OT-EVAL MOD COMPLEXITY 30MF2F 45MIN	$713.00
0409-1219-41	NALOXONE 0.4 MG/ML INJ SOLN (MCH)	$712.44
0409-1219-01	NALOXONE 0.4 MG/ML INJ SOLN	$712.44
HC25002809	I&D ABSCESS; SIMPLE/SINGLE	$712.00
HC34000208	AUD-AUDITORY EVOKED AEP THRESHOLD EST MULT FREQ W/I&R	$712.00
HC62802830	KIT STENT BILIARY PLASTIC	$712.00
HC62206321	SET LUMBAR DRAIN	$712.00
0187-0938-01	TOLCAPONE 100 MG ORAL TAB	$711.23
HC51061133	CLOSED TX FINGER/THUMB SHAFT FX W/MANIP EA	$711.00
HC25004656	CLOSED TX METATARSAL FX; W/MANIPULTN EA	$711.00
HC62205679	PICC LINE INTRODUCER	$711.00
HC62206180	SET DIALYSIS PREWARM	$711.00
HC77400265	BEDSIDE/OTHER ANESTH' INIT'L HR CASE CX	$711.00
HC25004136	CLOSED TX FINGER/THUMB SHAFT FX W/MANIP EA	$710.00
HC25004854	CLOSED TX INTERPHALANGEAL JNT DISLOC; NO ANES LT	$710.00
HC44001931	SHOULDER 1 VIEW LT	$710.00
HC44001949	SHOULDER 1 VIEW RT	$710.00
HC47200795	RAD ONC E&M LEVEL V COMPREHNSV	$710.00
HC44001576	MANDIBLE < 4 VIEWS	$709.00
HC39000286	PSYCH TX W/PATIENT 60MIN	$709.00
HC62205786	PROBE CAUTERY	$709.00
8213100033	"PORCINE SUBMUCOSA, FENESTRATED 3 X 3.5 CM TOPICAL SHEE"	$708.78
70860-200-50	PACLITAXEL 6 MG/ML IV CONC	$708.00
0562-7805-25	"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM SYRG"	$708.00
0562-7805-00	"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM SYRG"	$708.00
0562-7805-05	"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM SYRG"	$708.00
0562-7805-01	"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM SYRG"	$708.00
HC84201813	RESP VIRUS 3-5 TARGETS	$706.00
HC38000329	APPLY LONG LEG CAST BRACE	$705.00
HC89016950	HIV PHENOTYP P'SENS GT(PNL)-VI	$705.00
HC36000172	DEMO&/OR EVAL OF INH TX	$705.00
HC32000739	OT-WOUND NON-SEL DEB 45MIN/MW	$705.00
HC31000797	PT-WOUND NON-SEL DEB 45MIN/MW	$705.00
HC25000845	ASP/INJ SMALL JOINT-LT	$704.00
HC25000852	ASP/INJ SMALL JOINT-RT	$704.00
HC25004110	CLOSED TX KNUCLE DISLOC W/MANIP EA	$704.00
HC25006057	CLOSED TX TARSOMETATARSAL JNT DISLOC; NO ANES RT	$703.00
0009-3329-01	CLINDAMYCIN PHOSPHATE 1 % TOPICAL LOTN	$702.72
0006-4943-00	PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SOLN	$702.49
0006-4943-01	PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SOLN	$702.49
0006-4837-01	PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ (MHS)	$702.49
0006-4837-03	PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ (MHS)	$702.49
42023-221-01	ERTAPENEM 1 GRAM INJ SOLR	$702.42
42023-221-10	ERTAPENEM 1 GRAM INJ SOLR	$702.42
HC25005265	I&D ABSCESS PERITONSILLAR LT	$702.00
HC25005273	I&D ABSCESS PERITONSILLAR RT	$702.00
HC44000602	ELBOW 2 VWS LT	$702.00
HC44000610	ELBOW 2 VWS RT	$702.00
HC44002723	WRIST - TWO VIEWS	$702.00
HC44002525	WRIST 2 VIEWS LT	$702.00
HC44002533	WRIST 2 VIEWS RT	$702.00
51079-550-68	ACYCLOVIR 5 % TOPICAL OINT	$701.88
51079-550-67	ACYCLOVIR 5 % TOPICAL OINT	$701.88
HC25004664	CLOSED TX BIG TOE FX; NO MANIPULTN LT	$701.00
HC25004672	CLOSED TX BIG TOE FX; NO MANIPULTN RT	$701.00
HC25004748	CLOSED TX SESAMOID FX LT	$701.00
HC25004755	CLOSED TX SESAMOID FX RT	$701.00
HC51062693	APPLY LONG LEG CAST/WALKER BILAT	$700.00
HC51001345	"CLOSED TX MIDFOOT FX, EACH"	$699.00
HC62300066	CAUTERY MONOPOLAR ROBOTIC	$699.00
HC51003267	COLPOSCPY CERV&ADJ VAG W/CERV BX(S)	$698.00
HC32001620	OT-APPLICATION CAST GAUNTLET	$697.00
HC62208475	PROSTATE BIOPSY NEEDLE	$697.00
HC62203823	CATH DIALYSIS SHORT-TERM          K	$696.00
HC51001188	CLOSED TX HUMERUS NECK FX NO MANIP	$695.00
HC89020937	SPINAL MUSCULAR ATROPHY-QN	$695.00
0944-0493-02	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$694.20
HC39000963	PSY TX W/PATIENT 60MIN W/E&M+	$694.00
HC62214606	SYRINGE BONE MARROW ASPIRATION 10CC	$694.00
HC62205885	PROBE STEREO GUIDE	$693.00
0270-1316-04	IOPAMIDOL 76 % IV SOLN	$693.00
0006-5423-02	SUGAMMADEX 100 MG/ML IV SOLN	$692.52
0006-5423-12	SUGAMMADEX 100 MG/ML IV SOLN	$692.52
0168-0203-60	CLINDAMYCIN PHOSPHATE 1 % TOPICAL LOTN	$692.28
HC25004722	CLOSED TX PHALANX(TOE) FX; NO MANIPULTN	$692.00
HC51002327	CIRCUMCISION INFANT<28D EXCISE NO DEVICE	$692.00
HC62207261	TRAY ANGIO	$692.00
HC51061166	ST-LARYNGOSC W/STROBOSCOPY	$691.00
HC44001253	INFANT UP EXTREM MIN 2VWS LT	$691.00
HC44001261	INFANT UP EXTREM MIN 2VWS RT	$691.00
HC44002715	UPPER EXTREMITY - INFANT	$691.00
HC51010916	INTRAPERITONEAL CHEMO THERAPY	$691.00
63323-324-62	PENICILLIN G POTASSIUM 20 MILLION UNIT INJ SOLR	$690.00
50242-100-39	DORNASE ALFA 1 MG/ML INHALATION SOLN	$689.52
50242-100-40	DORNASE ALFA 1 MG/ML INHALATION SOLN	$689.52
HC44000982	HAND 2 VIEWS LT	$689.00
HC44000990	HAND 2 VIEWS RT	$689.00
HC62218136	PROBE APC/ARGON PLASMA COAGULATOR	$689.00
HC34000109	AUD-INFANT HEARING SCREEN AEP BBS AUTO INITIAL OP	$688.00
HC39000260	PSYCH FAMILY TX W/PT 50MIN	$687.00
24208-539-20	ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT	$686.94
HC25004037	CLOSED TX METACARPAL FX W/MAN EA	$686.00
HC41500679	EEG ANALYSIS DIGITAL	$686.00
HC31000474	PT-RE-EVAL EST POC  45MIN	$686.00
HC62202973	ENDO STAPLER SKIN	$686.00
HC62218086	TROCAR BALLOON	$686.00
HC21000013	ABRASION; SNGL LESION	$684.00
0054-0390-63	OXYCODONE 5 MG/5 ML ORAL SOLN	$684.00
66689-403-16	OXYCODONE 5 MG/5 ML ORAL SOLN	$684.00
17478-701-02	INDOCYANINE GREEN 25 MG INJ SOLR	$683.59
17478-701-25	INDOCYANINE GREEN 25 MG INJ SOLR	$683.59
HC38000006	APPLIC CAST LEG CLUBFOOT	$683.00
HC51003226	COLPOSCOPY VAGINA W/CERVIX IF PRESENT	$683.00
HC44001840	SACROILIAC JOINTS < 3VWS	$683.00
HC62222153	GUIDEWIRE                         K	$683.00
HC62801774	OIL SILICON TAMPONADE RETINAL	$683.00
HC11200011	ASSESS-DIRECT OBSERV ADMIT	$683.00
HC62201454	CATH HYDRAGLIDE PVC ATRIUM	$683.00
HC62203922	KIT REPAIR BROVIAC/CV/HICKMAN     G	$683.00
HC62209028	CATH SEGURA BASKET                R	$683.00
HC62227541	SHIELD COLLAGEN CORNEAL	$683.00
0009-7529-05	IRINOTECAN 300 MG/15 ML IV SOLN	$682.11
HC44001592	MASTOIDS < 3 VIEWS PER SIDE	$682.00
0603-1161-58	DICYCLOMINE 10 MG/5 ML ORAL SOLN	$681.12
0054-0622-63	DICYCLOMINE 10 MG/5 ML ORAL SOLN	$681.12
HC25003450	CLOSED TX CLAVICLE FX LT	$681.00
HC25003468	CLOSED TX CLAVICLE FX RT	$681.00
HC25005885	LYSIS & STRETCHING ADHESIONS PREPUTIAL	$681.00
HC25005406	INJ ANES/STEROID NERVE TRIGEML BRNCH EA LT	$681.00
HC25005414	INJ ANES/STEROID NERVE TRIGEML BRNCH EA RT	$681.00
HC34000125	AUD-AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R	$681.00
HC36800753	SPIROMETRY INFANT-2Y/O	$681.00
99999-038-30	THROMBIN ON GELFOAM 100 MIXTURE (OCM)	$680.56
HC51062685	APPLY CAST LONG LEG BILATERAL	$680.00
HC32001497	OT-REMOVE/BIVAL CAST SHRT LIMB	$680.00
HC31001712	PT-REMOVE/BIVAL CAST SHRT LIMB	$680.00
HC62206164	SET CATH FIXATION	$680.00
0093-0264-30	FLUOCINONIDE 0.05 % TOPICAL OINT	$679.14
HC51003846	I&D HEMATOMA OR FLUID COLL	$679.00
HC44001709	ORTHOPANTOGRAM	$679.00
0998-0630-06	"NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OPHT DRPS"	$678.18
HC46000147	INJ ARTHROGRAM TMJ	$678.00
HC42000109	ECG ROUTINE 12+ LEADS	$678.00
HC24000127	HBO EA SUBSEQUNT 15MIN CMPLX/C	$678.00
HC24000135	HBO FIRST 15MIN COMPLEX/C	$678.00
HC33000696	ST-EVAL LANGUAGE CMPNT 60MIN	$677.00
HC62300116	FORCEP ROBOTIC                    L	$677.00
HC25005117	WEDGING CAST EXCEPT CLUBFOOT	$676.00
HC36800456	BLOOD GAS W/MEASURED O2 SAT	$676.00
HC33000225	ST-SPEECH THERAPY 45 MIN/MW	$676.00
HC62802442	INTRODUCER EP STEERBL NON-PEEL	$676.00
HC62203682	KIT ANGIO TOUCH HAND CONTROL	$676.00
HC62207501	TRAY PLASTIC SUTURE	$676.00
HC62211032	CANNULA AORTIC FEMORAL (CPS) EXISTS	$676.00
HC62215975	TRAY BONE MARROW                  AE	$676.00
HC51062701	APPLY CYLINDER CAST(THI-ANKLE) BIL	$675.00
0074-0576-22	VENETOCLAX 100 MG ORAL TAB	$674.45
0074-0576-11	VENETOCLAX 100 MG ORAL TAB	$674.40
HC44000511	CLAVICLE LT	$673.00
HC44000529	CLAVICLE RT	$673.00
HC62202767	ELECTRODE VAPORTRODE/VAPRTOME	$673.00
HC62220017	BLADE ENDOSCOPIC CARPAL TUNNEL	$673.00
51672-3020-2	LIDOCAINE 5 % TOPICAL OINT	$672.30
HC51001287	CLOSED TX METACARPAL FX NO MANIP	$672.00
HC51001428	CLOSED TX METATARSAL FX	$672.00
HC46501128	INSRT BLADDER CATH-TEMP FOLEY	$672.00
HC36800522	PULM REHAB PER SESSION (90MIN) W/O POX2	$672.00
HC25000761	"AVULSION OF NAIL, SIMPLE:1"	$671.00
HC82200585	TISSUE EXAM - OP	$671.00
50383-286-04	LEVOFLOXACIN 25 MG/ML ORAL LIQUID	$670.20
HC32001679	OT-APPLY SPLINT FINGER DYNAMIC	$670.00
HC51062735	APPLY CAST PATELR TENDN BEARNG BIL	$670.00
HC33000845	ST-EVAL SPEECH CMPNT 60MIN	$670.00
HC36000024	AEROSOL-CONTINUOUS TX EA AD'HR	$670.00
HC62209291	BALLOON TAMPONADE GYN (BAKRI)	$670.00
55150-124-99	NAFCILLIN 10 GRAM INJ SOLR	$669.00
50383-311-47	GABAPENTIN 250 MG/5 ML ORAL SOLN	$668.34
HC82202714	BM BIOPSY PROC & INT 2ND SITE	$667.00
HC82202706	BM BIOPSY PROCESSING & INTERP	$667.00
HC82202722	BM CELL BLOCK & INTER-2ND SITE	$667.00
HC82202367	BM CELL BLOCK & INTERP	$667.00
HC84600261	CELL BLOCK (TISSUE EX)DIST SVC	$667.00
HC84600253	CELL BLOCK (TISSUE EXAM LVL 4)	$667.00
HC82200940	TISSUE EX G&M LVL 4  DIST SVC	$667.00
HC82200403	TISSUE EXAM G&M LEVEL 4	$667.00
HC82202573	TISSUE EXAM G&M LEVEL 4 *OP	$667.00
HC82202250	TISSUE EXAM G&M LEVEL 4-REDUCE	$667.00
HC82202755	TISSUE EXAM G&M LVL 4(TC ONLY)	$667.00
HC82200718	TISSUE EXAM G&M SLIDE PREP-MHL	$667.00
HC82200668	TISSUE EXAM LEVEL 4 SKIN	$667.00
HC82200676	TISSUE EXAM LEVEL 4 SPECIAL	$667.00
HC62217997	GUIDE SHAFT DRIVER ORTHO	$667.00
65162-698-90	GABAPENTIN 250 MG/5 ML ORAL SOLN	$666.93
0781-3126-95	NAFCILLIN 10 GRAM INJ SOLR	$666.13
HC51061091	X RAY PYELOGRAM RETROGRADE	$666.00
HC51010395	EMG 2 EXTREMITY	$666.00
49702-205-48	LAMIVUDINE 10 MG/ML ORAL SOLN	$665.28
63323-885-10	LEVOTHYROXINE 20 MCG/ML IV SOLN	$665.16
HC84600287	MORPH STDY IHC QT MANUAL PER SPEC EA AB	$665.00
HC84600329	MORPH STDY IHC/ESTROG RCPTR PER SPEC EA AB	$665.00
HC84600311	MORPH STDY IHC/HER-2/NEU PER SPEC EA AB	$665.00
HC84600337	MORPH STDY IHC/PROG RCPTR PER SPEC EA AB	$665.00
HC89023840	ANALY CFTR GENE FULL SEQUENCE-AU	$663.00
HC62215736	SUTURE                            Z	$663.00
HC38000113	REMV/BIVALVE SHRT CAST ARM/LEG	$662.00
HC25005158	CHANGE TRACH TUBE PRIOR ESTAB FISTULA TRACT	$662.00
0069-1308-01	"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJ SOLN"	$661.80
0069-1308-10	"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJ SOLN"	$661.80
HC21000260	DEBRIDE OF NAILS: 6 OR >	$661.00
HC25000282	LAC REPAIR 20.1-30CM(LARGE)	$661.00
0069-6001-10	FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN	$660.12
0069-6001-21	FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN	$660.12
HC62203989	KIT INTRODUCER NEPHR/BILI/GI	$660.00
25021-141-99	NAFCILLIN 10 GRAM INJ SOLR	$660.00
65219-429-50	ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN	$660.00
24201-237-01	FLUDARABINE 50 MG IV SOLR	$660.00
59923-604-02	FLUDARABINE 50 MG/2 ML IV SOLN	$660.00
HC25005109	"REMOVE/BIVALVING; GAUNTLET,BOOT OR BODY CAST"	$659.00
HC36000735	IPV TREATMENT INITIAL	$659.00
HC28000131	CR NEW PT EVAL LVL5-(60MIN)	$657.00
60793-700-10	"PENICILLIN G BENZATHINE 600,000 UNIT/ML IM SYRG"	$656.05
60793-700-01	"PENICILLIN G BENZATHINE 600,000 UNIT/ML IM SYRG"	$656.05
HC81100273	COMP METABOLIC PANEL	$656.00
HC51062719	APPLY CAST SHORT LEG BILATERAL	$655.00
HC25005489	REMOVE FB EXTRNL EYE; CONJUNCT SUPERF BIL	$654.00
HC62206453	SHEATH ABLATION	$654.00
99999-045-48	BRILLIANT GREEN (BULK) MISC CRYS	$654.00
0955-1020-01	DOCETAXEL 20 MG/ML (1 ML) IV SOLN	$654.00
HC21000005	ABRASION; EA ADDL LESION 4OR<	$653.00
HC25006073	CLOSED TX METATARSOPHALAN JNT DISLOC; NO ANES RT	$653.00
HC62223540	DILATOR SET URETHRAL	$653.00
45963-621-51	FLUDARABINE 50 MG/2 ML RECONSTITUTED IV SOLN (MCH)	$652.50
61958-2101-1	EMTRICITAB-RILPIVIR-TENOFO ALA 200-25-25 MG ORAL TAB	$652.31
HC33000993	ST EVAL SOUND PRODUCTION 90MIN/M	$652.00
0703-1501-01	ALPROSTADIL 500 MCG/ML INJ SOLN	$650.04
0703-1501-02	ALPROSTADIL 500 MCG/ML INJ SOLN	$650.04
HC51003051	INJECT RX CORPORA CAVERNOSA	$650.00
HC51003275	COLPOSCPY CERV&ADJ VAG W/ECC	$650.00
HC51010064	DESTROY MUSCLE(S) FACIAL NERVE LT	$650.00
HC51010072	DESTROY MUSCLE(S) FACIAL NERVE RT	$650.00
HC51061703	ECHO FETAL CARDIO 2D F/U OR REPEAT	$650.00
HC62806518	KIT CATH GASTROSTOMY PEG          L	$650.00
HC62207659	TUBE GASTROSTOMY                  L	$650.00
HC62807250	TUBE GASTROSTOMY LOWPRFL BTTN OPT L	$650.00
HC62802871	TUBE JEJUN STANDRD TRANSGAS       L	$650.00
HC62227087	TUBE TRACH CUFFED                 L	$650.00
HC62224902	CATH PTA ANGIOPLS BALLOON NON-LSR H	$650.00
HC62212212	CATH PTCA BALLOON NON-LASER       E	$650.00
HC62216023	CATH BALLOON DIL NON VASCULAR     L	$650.00
HC62805015	CATH EP DX <20 ELECTRODES         E	$650.00
HC62806062	CATH HEMO/PERI DIAL LONG TERM     L	$650.00
HC62800867	CATH HICKMAN/BROVIAC              L	$650.00
HC62806542	DEVICE CLOS VASC(ANGIOSEAL/MYNX/PROGLIDE)L	$650.00
HC62222799	DEVICE CLOSURE VASCULAR           L	$650.00
HC62806427	PORT INDWELLING W/CATH            E	$650.00
HC62201470	CATH INFUS/THROMBOLYSS(CRAGG-MCNAMARA)L	$650.00
HC62204466	SYSTEM DELIVERY LEAD              B	$650.00
HC62212402	INTRODUCER/SHEATH                 L	$650.00
HC62802194	STENT NON-CORON TEMP NO DELIV SYS L	$650.00
HC62807995	STENT URETERAL                    L	$650.00
HC62807656	M: PROSTHESIS LARYNGEAL	$650.00
HC62208160	VALVE TRACH SPEAKING              L	$650.00
HC62202858	APPLIER LIGA/HEMOCLIP ENDO        L	$650.00
HC62202940	SCISSORS ENDOSCOPIC               L	$650.00
HC62203005	CLIP ENDOSCOPIC                   L	$650.00
HC62204870	NEEDLE BIOPSY BONE                L	$650.00
HC62204953	SPHINCTEROTOME NEEDLE KNIFE	$650.00
HC62210570	KIT ASPIRATION THROMBO NEURO	$650.00
HC62211529	INSERTER TIP SURGICAL             L	$650.00
HC62212923	BLADE SHAVER                      J	$650.00
HC62213129	BLADE INCISIONAL                  J	$650.00
HC62213228	BURR                              J	$650.00
HC62213426	REAMER                            M	$650.00
HC62214424	KNIFE CANNULATED RETRACT	$650.00
HC62216080	DEVICE SUTURING ENDOSCOPIC        G	$650.00
HC62216122	STENT REMOVER                     E	$650.00
HC62216197	SPHINCTEROTOME                    E	$650.00
HC62216361	NEEDLE INTRODUCER                 O	$650.00
HC62216676	PIN/WIRE FIXATION TEMPORARY       AD	$650.00
HC62217625	AWL SPINAL SINGLE PATIENT USE     G	$650.00
HC62217864	SET PIN DISTRACTORS-COUNT 2       A	$650.00
HC62218375	ENDO STAPLER                      J	$650.00
HC62218805	DRILL/DRILL BITS SINGLE USE       O	$650.00
HC62219266	DEVICE LIGATOR                    G	$650.00
HC62219563	PULLER SUTURE INCL TENSURE	$650.00
HC62220694	KIT ACCESSORY                     I	$650.00
HC62221486	TROCAR ENDO                       L	$650.00
HC62221825	TAP SURGICAL                      L	$650.00
HC62222013	GRASPER ALLIGATOR ENDO            L	$650.00
HC62222146	CASSETTE PURGE LVAD/RVAD	$650.00
HC62222344	OVERTUBE ENDOSCOPIC               A	$650.00
HC62222476	WAND ARTHRO                       L	$650.00
HC62222625	ELECTRODE ROLLER BALL             L	$650.00
HC62222914	PROBE LASER                       L	$650.00
HC62222955	CANNULA ARTERIAL                  J	$650.00
HC62223664	SYSTEM DETACHMENT COIL	$650.00
HC62224266	PROBE HEMOSTASIS (BICAP)          E	$650.00
HC62224589	DILATOR SET VASCULAR	$650.00
HC62225032	NEEDLE ASPIRAT(EUS SLIMLIN22/25GA)L	$650.00
HC62225321	CANNULA ARTHROSCOPIC              L	$650.00
HC62225404	PUSHER KNOT ENDO                  G	$650.00
HC62225842	GUIDE DRILL                       L	$650.00
HC62226360	PROTECTOR CORNEAL	$650.00
HC62226600	RETRACTOR MIS SPINAL              A	$650.00
HC62227269	FIBER LASER                       F	$650.00
HC62227558	GUIDE PIN ORTHO                   L	$650.00
HC62227699	ILLUMINATOR STRIP RETRACTOR	$650.00
HC62227905	PUNCH ARTHROSCOPIC                E	$650.00
HC62227921	SHEATH ARTHROSCOPIC               H	$650.00
HC62227939	CARTRIDGE MECHNCL WOUND NEG PRESSURE D	$650.00
HC62228333	PROBE TURBINATE                   L	$650.00
HC62228556	ELECTRODE PACING/DEFIB TEMPORARY  L	$650.00
HC62228887	DEVICE SUTURE FLOWSTASIS RETENTION	$650.00
HC62300025	CAUTERY LTD REUSE/'PERMANT' ROBOTIC	$650.00
HC62300132	GRASPER ROBOTIC                   E	$650.00
HC62300181	TIP CAUTERY HOOK ROBOTIC          Q	$650.00
HC62804174	COIL EMBOLIZATION                 F	$650.00
HC62805742	FIBRIN SEALANT                    I	$650.00
HC62805825	HEMOSTATIC GEL/GELFOAM/PAD        L	$650.00
HC51061125	CLOSED TX CARPAL SCAPHOID FX W/O MAN	$649.00
HC51062727	APPLY CAST SHORT LEG WALKING BIL	$649.00
23155-340-31	RIFAMPIN 600 MG IV SOLR	$648.00
63323-172-60	CARBOPLATIN 10 MG/ML IV SOLN	$648.00
0054-0349-25	PHENOXYBENZAMINE 10 MG ORAL CAP	$647.95
0004-0298-09	MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR	$647.87
0013-2586-91	IDARUBICIN 1 MG/ML IV SOLN	$646.68
10019-926-16	IFOSFAMIDE 3 GRAM IV SOLR	$645.24
10019-926-02	IFOSFAMIDE 3 GRAM IV SOLR	$645.24
0143-9530-01	IFOSFAMIDE 3 GRAM/60 ML IV SOLN	$645.12
HC25006099	CLOSED TX INTERPHALANGEAL JNT DISLOC; NO ANES RT	$645.00
HC11200096	OBSERVATION PER HOUR - PEDS ICU	$645.00
HC62205851	PROBE PRASS STANDARD NIM	$644.00
HC22000095	OST EST PT EVAL LVL5-(40 MIN)	$642.00
60267-705-50	SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) IV SOLN	$642.00
60267-311-10	SODIUM NITRITE 30 MG/ML IV SOLN	$642.00
17478-711-30	LIDOCAINE HCL 2 % MUCOUS MEMB JELL	$641.70
0703-4714-01	TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN	$641.28
0703-4714-71	TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN	$641.28
0548-5900-00	COSYNTROPIN 0.25 MG INJ SOLR (MCH)	$639.48
HC31002108	PT-EVAL LOW COMPLEXITY 20MF2F 45MIN	$639.00
HC83001024	CRYOPRECIP 5 UNITS POOLED -SB	$639.00
99999-035-43	LORAZEPAM 200MG IN D5W 100ML IV DRIP	$639.00
HC25003377	INJ(S);SGL TNDN SHEATH/LIGMNT/APONEUR LT	$638.00
HC25003385	INJ(S);SGL TNDN SHEATH/LIGMNT/APONEUR RT	$638.00
HC89023832	ANALY CFTR GENE DELET/DUP VARIANTS-AU	$637.00
HC33000308	ST-SPEECH THERAPY GRP120MIN/MCW	$637.00
HC32003295	OT-EVAL LOW COMPLEXITY 20MF2F 45MIN	$637.00
HC62209200	BONE TUNNELING SYSTEM	$637.00
HC62215728	SUTURE                            Y	$637.00
0703-3155-01	BLEOMYCIN 30 UNIT INJ SOLR	$636.60
16714-782-02	CLOBETASOL 0.05 % TOPICAL OINT	$636.30
0407-2223-17	IODIXANOL 320 MG IODINE/ML IV SOLN	$635.40
0407-2223-64	IODIXANOL 320 MG IODINE/ML IV SOLN	$635.40
HC36001071	ATTENDANCE AT DELIVERY	$635.00
0944-2722-03	"HYALURONIDASE, HUMAN RECOMB. 800 UNIT/5 ML SUBCUTANEOUS SOLN"	$634.50
HC25002999	LAC REPAIR SIMPLE F/E/E/N/L/M 2.6-5.0 CM	$634.00
HC62228382	WIRE PIGTAIL PROTRACK (WATCHMAN)	$634.00
HC62217211	NEEDLES 5/PACK ENDOSCOPIC         W	$634.00
HC62300165	SCISSORS POTTS ROBOTIC	$634.00
63323-735-10	PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN	$633.60
63323-649-07	LEVOTHYROXINE 100 MCG IV SOLR	$633.48
63323-649-16	LEVOTHYROXINE 100 MCG IV SOLR	$633.48
42023-201-01	LEVOTHYROXINE 100 MCG IV SOLR	$633.48
HC25003401	ASP & INJ GANGLION CYST(S)	$633.00
HC25000555	SPLINT SHORT LEG	$633.00
HC21000666	REMOV IMPACTD EAR WAX(INSTRUMENT) BI           (NO MOD50)	$633.00
HC32000788	OT-WOUND VAC 60MIN<50 SQ CM/M	$633.00
HC31000847	PT-WOUND VAC 60MIN<50 SQ CM/M	$633.00
HC62228424	ORTH FINGER NONTORSION JOINT CUSTOM	$633.00
HC35000033	REC- EVALUATION 45MIN	$632.00
HC25005398	I&D ABSCESS BARTHOLIN'S GLAND	$631.00
65162-705-88	ESCITALOPRAM OXALATE 5 MG/5 ML ORAL SOLN	$630.72
0270-1111-03	GADOTERIDOL 279.3 MG/ML IV SOLN	$630.60
HC25000134	EVACUATE SUBUNGUAL HEMATOMA	$630.00
HC25004045	CLOSED TX THUMB DISLOC W/MANIP LT	$630.00
HC25004052	CLOSED TX THUMB DISLOC W/MANIP RT	$630.00
HC51001386	CLOSED TX FIBULA FX	$630.00
HC42000414	PROGRAM/EVAL T-ICD MULTI LEAD	$630.00
HC12200184	INF CNTR-NEW PT EVAL COMPLEX	$630.00
57665-101-41	AMPHOTERICIN B LIPID COMPLEX 5 MG/ML IV SUSP	$630.00
66689-711-16	METHADONE 5 MG/5 ML ORAL SOLN	$630.00
72485-201-01	AZACITIDINE 100 MG INJ SOLR	$630.00
53276-1010-08	MICROFIBRIL. COLLAGEN HEMOSTAT 35 X 35 MM TOPICAL SHEE	$630.00
70594-035-01	TIGECYCLINE 50 MG IV SOLR	$630.00
70594-035-02	TIGECYCLINE 50 MG IV SOLR	$630.00
HC36000099	AEROSOL-PENTAMADINE	$629.00
0338-3993-01	IFOSFAMIDE 3 GRAM IV SOLR	$627.78
HC51003044	INJ CORPORA CAVERNOSOGRAM	$627.00
HC62202866	ENDO INSTRUMENT	$627.00
HC62207691	TUBE JEUJUNOSTOMY	$627.00
HC25000167	FB REMOVAL NASAL	$626.00
0168-0277-40	CLINDAMYCIN PHOSPHATE 2 % VAGINAL CREAM	$625.68
HC44500676	CINERADIOGRAPHY W/ EXAM	$625.00
HC33001157	ST EVAL SOUND W/LANG COMP&EXPRESS 45MIN/M	$625.00
HC62214390	STYLET TUNNELING DIALYSIS	$625.00
HC51062560	BRONCHOSCOPY VIA ESTAB TRACH	$624.00
HC51010940	INSERT DEVICE INTRAUTERINE IUD	$624.00
HC81101313	BLOOD GASES LTD	$624.00
HC81101768	BLOOD GASES LTD  (POS)	$624.00
HC51061653	ECHO 2D CMPLT W/O SPEC&CLR DOP	$624.00
HC11500683	WC NEW E&M ASSESS COMPREHN L:5	$624.00
HC62203740	KIT CATH CV	$624.00
HC62216668	PIN/WIRE FIXATION TEMPORARY       AC	$624.00
HC62216833	POST ANCHOR SPINAL DISPOSABLE     O	$624.00
HC62225792	TEMPLATE ORTHO/ROD SPINAL         S	$624.00
55150-228-10	TIGECYCLINE 50 MG IV SOLR	$624.00
70121-1647-1	TIGECYCLINE 50 MG IV SOLR	$624.00
70121-1647-7	TIGECYCLINE 50 MG IV SOLR	$624.00
HC44000750	FB CHILD NOSE-RECTUM EXAM	$623.00
HC25000266	I&D HEMATOMA	$623.00
HC38000402	WEDGING CAST CLUBFOOT	$622.00
HC44000412	CHEST SINGLE VIEW	$622.00
HC44000305	CALCANEUS (HEEL) LT	$622.00
HC44000313	CALCANEUS (HEEL) RT	$622.00
HC44002814	OS CALSIS	$622.00
HC36800811	BREATHING RESPONSE HYPOXIA CURVE	$622.00
HC36001113	BREATHING RESPONSE HYPOXIA CURVE	$622.00
HC12200069	IV PUSH SINGLE/INIT'L INJ	$622.00
HC11500782	AM/PACU EVAL MOD/HI-IV	$622.00
HC25000001	ED LEVEL I-BRIEF	$622.00
HC83000844	CRYOPRECIPITATE POOLED 5 UNITS	$622.00
HC78600012	PACU I 15MIN (SUBSEQUENT)	$622.00
99988-000-17	NM TC-99M LABELED RBC (PREP WITH ULTRATAG KIT)	$621.17
HC83504092	TISSUE IN-SITU HYBRI INTER-IM	$621.00
HC83000471	RBC LR/CMV NEG DIVIDED UNIT	$621.00
0703-0018-01	HYDROMORPHONE (PF) 10 MG/ML INJ SOLN	$621.00
HC41500364	NYSTAGMUS MIN 4POSITIONS W/REC	$620.00
HC81700791	HEPATITIS C QT BY DNA OR RNA	$619.00
HC11500857	PEDS ESTAB PT ASSESS COMP(40')	$619.00
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0472-0400-15	CLOBETASOL 0.05 % TOPICAL CREAM	$615.51
HC36000743	IPV TREATMENT SUBSQ SAME DAY	$615.00
HC62223714	SYSTEM MIX/DELIVR GRAFT BIOCARTLG	$615.00
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HC41500448	USE OF VERTICAL ELECTRODES	$614.00
HC42000356	INTERROGATION T-ICD	$614.00
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HC32001661	OT-APPLIC'SPLINT FINGER STATIC	$613.00
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HC62201389	CATH EXCHANGE PTCA	$612.00
17478-540-50	HYDROMORPHONE (PF) 10 MG/ML INJ SOLN	$612.00
HC81701385	HEPATITIS B DNA ULTRA QNT PCR	$611.00
HC62228291	ORTH FO W/O JOINTS CUSTOM	$611.00
HC62210992	CANNULA AORTIC EASY FLOW	$611.00
HC62215710	SUTURE                            X	$611.00
HC62216791	INFLATOR FOR BALLOON              U	$611.00
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HC39000039	PSYCH TX W/PATIENT 45MIN	$610.00
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HC25000506	REMOVAL/BIVALVE CAST ARM OR LEG	$609.00
HC36000164	MANIP CHEST (INFANT) SUBSEQ	$609.00
HC36000156	MANIP CHEST WALL SUBSEQUENT	$609.00
HC12200234	INF CNTR-ESTBL'D PT EVAL-CMPLX	$609.00
HC62807821	STAPLE REINFORCEMENT(SEAMGUARD)     C	$608.00
HC44001667	"NECK, SOFT TISSUE"	$607.00
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HC39000989	PSYCH DIAG EVAL W/ MED SERVICE	$607.00
HC83000463	RBC LEUKOREDUC/CMV NEG EA	$607.00
HC38000394	WEDGING CAST EXCEPT CLUBFOOT	$606.00
HC25001132	INSRT BLADDER CATH-TEMP FOLEY	$606.00
HC34000216	AUD-AUDITORY EVOKED AEP NEURODIAGNOSTIC W/I&R	$606.00
0469-0520-14	ISAVUCONAZONIUM SULFATE 186 MG ORAL CAP	$605.80
0407-1414-91	IOHEXOL 350 MG IODINE/ML IV SOLN	$605.40
0407-1414-84	IOHEXOL 350 MG IODINE/ML IV SOLN	$605.40
68682-201-75	PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK	$604.32
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HC44002343	TOE (S) LT	$602.00
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HC81100596	GENTAMICIN INIT	$602.00
HC82203506	IP/IHC AB BC COCKTAIL PER SPEC; EA MULTIPLEX	$602.00
47781-384-26	OSELTAMIVIR 6 MG/ML ORAL SUSR	$601.56
69238-1273-6	OSELTAMIVIR 6 MG/ML ORAL SUSR	$601.56
HC51002590	FNA ASP BX W/O GUIDE; FIRST LESION	$601.00
HC46501110	INSRT BLADDER CATH-NON INDWELL	$601.00
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HC89023857	ANSER IFX MEASUOF ABS TO INFLIXIMAB-PR	$600.00
HC89023873	ANSER VDZ MEAS OF ABS TO VEDOLIZUM-PR	$600.00
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66288-1100-1	CEFAZOLIN 100 GRAM INJ SOLR	$600.00
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67457-631-10	EPTIFIBATIDE 0.75 MG/ML IV SOLN	$600.00
70121-1002-1	EPTIFIBATIDE 2 MG/ML IV SOLN	$600.00
43598-901-58	ERTAPENEM 1 GRAM INJ SOLR	$600.00
43598-901-11	ERTAPENEM 1 GRAM INJ SOLR	$600.00
71288-115-30	AZACITIDINE 100 MG INJ SOLR	$600.00
0143-9606-01	AZACITIDINE 100 MG INJ SOLR	$600.00
67457-256-00	BIVALIRUDIN 250 MG IV SOLR	$600.00
67457-256-10	BIVALIRUDIN 250 MG IV SOLR	$600.00
72078-026-10	EPTIFIBATIDE 0.75 MG/ML IV SOLN	$600.00
0781-9317-80	OXALIPLATIN 100 MG/20 ML IV SOLN	$600.00
15584-0101-1	EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG ORAL TAB	$598.94
47335-330-40	CHLOROTHIAZIDE SODIUM 500 MG IV SOLR	$598.80
17478-419-40	CHLOROTHIAZIDE SODIUM 500 MG IV SOLR	$598.80
3932835760	"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROP"	$598.68
HC83000497	PLATELETS IRRAD EA UNIT	$598.00
HC62209705	DEVICE HEMOSTATIC CLIPPING	$598.00
HC62216650	PIN/WIRE FIXATION TEMPORARY       AB	$598.00
HC81101941	DRUG TEST PRESUMPTIVE CHEM ANALYZERS/ DOS	$597.00
63256-200-05	STERILE TALC 5 GRAM INTRAPLEURAL SUSR	$597.00
0075-2912-01	ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG	$596.26
HC36000032	AEROSOL-HHN TREATMENT INIT	$596.00
HC36000057	AEROSOL-IPPB TREATMENT INIT	$596.00
HC36000073	AEROSOL-MDI TREATMENT INIT	$596.00
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HC83000810	ALIQUOT RED CELLS	$594.00
0472-0242-60	PERMETHRIN 5 % TOPICAL CREAM	$594.00
45802-269-37	PERMETHRIN 5 % TOPICAL CREAM	$594.00
16714-897-01	PERMETHRIN 5 % TOPICAL CREAM	$594.00
68180-150-01	FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSP	$594.00
16714-244-01	FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSP	$594.00
44567-506-01	PACLITAXEL 6 MG/ML IV CONC	$594.00
70954-316-10	FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSP	$594.00
25021-158-99	VANCOMYCIN 10 GRAM IV SOLR	$593.94
HC36800365	PULSE OX NOCTURNAL STUDY DC'D	$593.00
HC25001397	I&D POSTOP WOUND	$593.00
68382-444-05	FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSP	$592.50
0574-4022-35	BACITRACIN 500 UNIT/GRAM OPHT OINT	$592.20
HC62207493	TRAY PERICARIOCENTESIS	$592.00
64980-448-01	"NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS"	$591.12
HC25005901	INJ ANES/STEROID NERVE OCCIPITL GREAT LT	$591.00
HC25005919	INJ ANES/STEROID NERVE OCCIPITL GREAT RT	$591.00
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HC84600543	CYTOPATH SELECT CELL ENHANC*OP	$591.00
HC84600055	CYTOPATH SELECT CELL ENHANCE	$590.00
0024-5924-10	INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN	$588.42
0115-1474-46	METRONIDAZOLE 0.75 % TOPICAL GEL	$588.06
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HC34000117	AUD-INFANT HEARING SCREEN AEP BBS AUTO REPEAT OP	$588.00
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0270-1316-35	IOPAMIDOL 76 % IV SOLN	$586.80
HC88600069	VENIPUNCTURE CUTDOWN <1	$585.00
HC28000016	CR REHAB CARDIAC IP SESSION PHASE I	$585.00
HC28000024	CR REHAB CARDIAC W/ ECG SESSION (II)	$585.00
HC62219621	TUBE TRACH CUFFED ADJUSTABLE      K	$585.00
HC62223268	CATH PTA ANGIOPLS BALLOON NON-LSR G	$585.00
HC62800362	CATH GUIDING                      K	$585.00
HC62220579	INTRO/SHEATH EP FIXED NON-PEEL    H	$585.00
HC62212394	INTRODUCER/SHEATH                 K	$585.00
HC62204888	NEEDLE BIOPSY BONE VERTEBROPLASTY K	$585.00
HC62205133	PACK ANGIO	$585.00
HC62208277	KIT PERICARDIOCENTESIS	$585.00
HC62212915	BLADE SHAVER                      I	$585.00
HC62213111	BLADE INCISIONAL                  I	$585.00
HC62213210	BURR                              I	$585.00
HC62213418	REAMER                            L	$585.00
HC62214515	RETRACTOR DISPOSABLE              G	$585.00
HC62215439	FORCEPS BIPOLAR DISPOSABLE        K	$585.00
HC62215504	PROBE SPINAL DISPOSABLE           D	$585.00
HC62215702	SUTURE                            W	$585.00
HC62217047	WRENCH TORQUE SHAFT SPINAL (DISP)	$585.00
HC62217799	NEEDLE BONE MARROW                K	$585.00
HC62217815	TEMPLATE STAPLE SPINAL            G	$585.00
HC62218060	BASKET RETRIEVAL                  K	$585.00
HC62218367	ENDO STAPLER                      I	$585.00
HC62218797	DRILL/DRILL BITS SINGLE USE       N	$585.00
HC62219886	ADAPTER ARTHROSCPC	$585.00
HC62221320	RESERVOIR CELL SAVER              K	$585.00
HC62221817	TAP SURGICAL                      K	$585.00
HC62222104	GUIDE PIN ORTHO                   K	$585.00
HC62222468	WAND ARTHRO                       K	$585.00
HC62222864	PAIN PUMP W/ SYSTEM               K	$585.00
HC62224175	SHEARS COAGULATING HARMONIC       K	$585.00
HC62224225	GUIDE ROD                         K	$585.00
HC62224290	KIT ARTHROSCOPY DISPSBLS          K	$585.00
HC62224399	CUTTER DISC SPINAL	$585.00
HC62225123	GUIDE DRILL                       K	$585.00
HC62225248	KIT CAUTERY LEEP (REDIKIT)	$585.00
HC62226774	COUNTERSINK CANNULATED            G	$585.00
HC62227376	KIT CONCENTRATOR PLATELETS        J	$585.00
HC62228549	ELECTRODE PACING/DEFIB TEMPORARY  K	$585.00
HC62300298	FORCEP ROBOTIC                    K	$585.00
51672-1303-2	ECONAZOLE 1 % TOPICAL CREAM	$584.28
HC25002924	LAC REPAIR SIMPLE S/N/AX/GEN/T/EXT 2.5CM OR LESS	$584.00
63323-315-10	GANCICLOVIR SODIUM 500 MG IV SOLR	$583.62
63323-315-01	GANCICLOVIR SODIUM 500 MG IV SOLR	$583.62
HC81100935	PHENYTOIN FREE	$583.00
HC32000812	OT-WOUND VAC 45MIN>50 SQ CM/M	$583.00
HC31000870	PT-WOUND VAC 45MIN>50 SQ CM/M	$583.00
HC51061109	US RETROPERITONEAL COMPLETE	$582.00
HC62203419	FORCEP BIOPSY DISP                J	$582.00
HC51002202	X RAY URETHROCYSTOGRAM VOIDING	$581.00
HC39000187	PSY PREPARE REPORT 2 HOURS	$581.00
HC83000505	PLATELETS LR IRRAD EA UNIT	$581.00
70100-424-01	INDOCYANINE GREEN 25 MG INJ SOLR	$581.00
70100-424-02	INDOCYANINE GREEN 25 MG INJ SOLR	$581.00
0591-2712-02	ALBENDAZOLE 200 MG ORAL TAB	$580.95
0093-3560-19	PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK	$580.80
0093-3560-26	PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK	$580.80
HC83505669	NRAS MUT ANALYSIS EXONS 2&3-NG	$580.00
HC62210133	TUBE TRACH PEDS/NEO CUFFED	$580.00
13533-335-04	IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH)	$578.64
13533-335-40	IMMUNE GLOB G (IGG)-GLYCINE 15-18 % RANGE IM SOLN	$578.64
HC81100588	GENTAMICIN SUBS	$577.00
HC81701773	FACTOR 2 MUTATION BY PCR	$577.00
HC33000811	ST-EVAL NONSP'CH DEV RX:ADD30MIN	$577.00
HC51010452	TESTS PERCUTANEOUS ALLERGY	$577.00
HC51010528	TEST ALLERGY PATCH	$577.00
HC51010544	TEST CHALLENGE INGEST 1ST120MIN	$577.00
HC62807615	M: CENTRALIZER HIP	$577.00
HC62219787	PUMP BLOOD CENTRIFUGAL	$577.00
HC51002293	CIRCUMCISION W/DEVICE RING/BLOCK	$576.00
HC81500951	FACTOR V LEIDEN BY PCR	$576.00
HC62211057	CANNULA VENOUS STRAIGHT           K	$576.00
61703-363-22	OXALIPLATIN 100 MG/20 ML IV SOLN	$576.00
76125-792-11	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$576.00
76125-792-10	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$576.00
99999-001-99	CHARGE-NEONATAL LVIV 4-9 ADDS	$576.00
HC89500946	RBC AG PROFILE-MOLECULAR LEVEL 4-SB	$575.00
HC25005992	NEW PT LVL5-COMPREHENSIVE	$575.00
HC12200416	INJECTIONS MONOCLONAL TIXAGEN/CILGAV	$575.00
0168-0081-30	"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOPICAL CREAM"	$574.20
HC12200051	IV INF THER SEQ/NEW RX 1ST HR	$574.00
HC25000290	LAC REPAIR 12.6-20CM	$574.00
HC51001220	CLOSED TX ELBOW DISLOCATION	$572.00
HC51003382	X-RAY ORPORA CAVERNOSGRAPHY	$572.00
HC41500380	NYSTAGMUS SPONT GAZE/FIX	$572.00
HC36800233	M V V (MAX VOL VENT)	$572.00
HC62227863	DRESSING CLOT QUICK	$572.00
HC39001110	PSYCH THERAPY ACT MUS/ART SESS45M/>	$572.00
HC62216643	PIN/WIRE FIXATION TEMPORARY       AA	$572.00
HC62220165	BLADE SAW                        AA	$572.00
0407-2222-17	IODIXANOL 270 MG IODINE/ML IV SOLN	$571.80
0998-0204-15	PILOCARPINE HCL 2 % OPHT DROP	$571.05
HC25000928	ANOSCOPY DIAGNOSTIC	$571.00
HC39000278	PSYCH FAMILY TX W/O PT 50 MIN	$571.00
0781-3465-94	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$570.36
HC25003435	CLOSED TX TMJ DISLOCATION 1ST/SBSQ	$570.00
HC27001924	GI TRACT CAPSULE PATENCY STUDY	$570.00
HC41500752	ORBICULARIS OCULI (BLINK) REFLEX	$570.00
HC21000252	DEBRIDE OF NAILS: 1-5	$569.00
HC81100265	VALPROIC ACID; TOTAL	$569.00
HC33000175	ST-EVAL RX SP GEN DEV ADD30MIN	$568.00
HC62803515	CAP END SCREW	$568.00
54295-308-25	UREA 40 % TOPICAL CREAM	$567.82
63323-172-45	CARBOPLATIN 10 MG/ML IV SOLN	$567.81
HC51010262	INJ(S);SINGLE TENDON/SHEATH BI	$567.00
HC36800415	VITAL CAPACITY	$567.00
45963-609-55	FLUDARABINE 50 MG/2 ML RECONSTITUTED IV SOLN (MCH)	$567.00
70860-451-10	LEVOTHYROXINE 100 MCG IV SOLR	$567.00
HC11500097	NEW PT LVL5-COMPREHENSIVE	$566.00
49281-752-21	TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN	$565.26
49281-752-78	TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN	$565.26
HC51002954	DILAT STRICTR URETHRL FLFRM MALE SUBSQ	$565.00
HC44001279	INTERNAL AUDITORY CANAL	$565.00
HC81100612	TOBRAMYCIN INIT	$565.00
HC33000209	SP-LARYNGEAL FUNCTION STUDIES	$565.00
HC33000779	ST-LARYNGEAL FUNCTION STUDIES	$565.00
HC39001250	PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; EA ADDL HR+	$565.00
HC31002082	PT-EVAL HIGH COMPLEXITY 45MF2F 30MIN	$565.00
HC32003337	OT-EVAL HIGH COMPLEXITY 45MF2F 30MIN	$565.00
HC81701708	MRSA BY PCR	$564.00
HC84201870	MRSA BY PCR	$564.00
0338-1130-04	PARENTERAL AMINO ACID 10% NO.7 10 % IV SOLP	$564.00
70436-026-80	EPTIFIBATIDE 2 MG/ML IV SOLN	$563.94
HC47200787	RAD ONC E&M LEVEL IV EXTENDED	$563.00
HC29000585	PREVENTATIVE MED COUNSELING 60MIN	$563.00
HC11200004	OBSERVATION PER HOUR - ICU	$563.00
17478-042-10	NALOXONE 0.4 MG/ML INJ SOLN	$562.80
HC51070407	PSY TX W/PATIENT 60MIN W/E&M+	$562.00
0078-0401-34	IMATINIB 100 MG ORAL TAB	$561.83
61703-323-22	BLEOMYCIN 30 UNIT INJ SOLR	$561.72
67457-446-10	PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN	$561.36
HC25000514	SPLINT FINGER STATIC	$561.00
0469-3250-10	MICAFUNGIN 50 MG IV SOLR	$561.00
63323-728-01	MICAFUNGIN 50 MG IV SOLR	$561.00
63323-728-10	MICAFUNGIN 50 MG IV SOLR	$561.00
25021-190-10	MICAFUNGIN 50 MG IV SOLR	$561.00
HC51002921	DILAT STRICTURE URETHRAL MALE INT'L	$560.00
HC41500745	EMG LMTD EXTRM 1 (NOT PARASP/CRANIAL/SPHINC)	$560.00
HC36000008	ADMIN SURFACTANT THRU TUBE	$559.00
HC83001131	ALIQUOT PLASMA	$559.00
HC83001289	ALIQUOT PLASMA CONVALESCENT	$559.00
HC83001123	CRYOPRECIPITATE 4 UNITS POOLED-SB	$559.00
HC62205653	PERFORATOR	$559.00
HC62215694	SUTURE                            V	$559.00
42192-608-16	GABAPENTIN 250 MG/5 ML ORAL SOLN	$558.36
0998-0203-15	PILOCARPINE HCL 1 % OPHT DROP	$558.27
HC21000187	"AVULSION OF NAIL, EA ADDL'"	$558.00
67457-299-00	NALOXONE 0.4 MG/ML INJ SOLN	$558.00
67457-299-10	NALOXONE 0.4 MG/ML INJ SOLN	$558.00
HC25000258	BURNS LOCAL TREATMENT SM 9%	$557.00
HC51010379	REFILL MAINT IMPL PMP/RESV WANAL'MD	$557.00
HC39001391	PSY-TEST COGNITIVE PERFORMANCE STDRD PER HOUR	$557.00
HC36800431	BLOOD GAS LTD	$556.00
HC36800449	BLOOD GAS LTD CORD	$556.00
HC62204045	KIT MANIFOLD SPECIALTY	$556.00
HC21000369	DESTRUCT PREMALG LESION 1ST	$555.00
HC51002228	X RAY CYSTOGRAM MIN 3 VWS	$555.00
HC51020394	SC INFUSION THERAPY INITIAL UP TO 1HR	$555.00
HC38000089	APPLICATION CAST GAUNTLET	$554.00
HC38000360	APPLY STRAPPNG KNEE(ROBRTJONES	$554.00
HC31002009	PT - STRAPPING; KNEE	$554.00
HC51070431	PSYCH FAMILY TX W/PT 50MIN	$554.00
HC41500372	NYSTAGMUS OPTOKINETIC BIDIRECT	$554.00
HC39001243	PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; 1ST HOUR	$554.00
HC39001268	NEUROPSYCH TESTING EVAL INTRG INTERP CLIN DES TX FEEDBACK; 1ST HOUR	$554.00
HC28000081	CR EST PT EVAL LVL5-(40 MIN)	$554.00
HC34000133	OTOACOUSTIC EVOKED RESP LTD	$553.00
HC62226899	GUIDEWIRE                         I	$553.00
HC62212717	GUIDEWIRE(NITREX)                 I	$553.00
HC62205125	PACK ANGIO COMBO	$553.00
HC62209002	SPLINT FOOT	$553.00
HC62209598	TRACTION PELVIC UNIT	$553.00
HC62210703	SET DECOMPRESSION COLON	$553.00
HC62212568	FORCEP BIOPSY DISP                I	$553.00
HC62225370	KIT REPAIR BROVIAC/CV/HICKMAN     E	$553.00
HC51002277	MEATOTOMY (NON-INFANT)	$552.00
HC51003150	COLPOSCOPY VULVA W/BX(S)	$552.00
68516-5216-4	"ALBUMIN, HUMAN 25 % IV SOLP (MCH)"	$552.00
68516-5216-2	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$552.00
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50268-787-12	VALGANCICLOVIR 450 MG ORAL TAB	$512.92
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HC62229166	ORTHOTIC LSO RIGID ANT POST LAT PANEL SACROCOC PREFAB	$512.00
HC77400273	ANESTHESIA ADD'L 15MIN CASE CX	$512.00
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0407-0690-17	GADODIAMIDE 7.5 MMOL/15 ML (287 MG/ML) IV SYRG	$511.29
HC62205919	PUSHER OCCLUSION COIL	$511.00
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HC81100307	PHENYTOIN TOTAL	$510.00
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16729-267-64	DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN	$510.00
76329-3399-5	PROCAINAMIDE 100 MG/ML IV SYRG	$510.00
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HC24000028	HBO FIRST 15MIN BASIC/C	$492.00
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42023-105-01	METHOHEXITAL 500 MG INJ SOLR	$490.98
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HC83500470	MOLECUL CYTO DNA PROBE FISH-GZ	$490.00
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0781-3440-71	COSYNTROPIN 0.25 MG INJ SOLR	$481.20
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HC82202078	IF STUDY DIRECT 1ST STAIN	$481.00
HC62207097	SUTURE SPECIALTY                  S	$481.00
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14789-012-02	SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN	$480.00
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55150-282-09	ERTAPENEM 1 GRAM INJ SOLR	$480.00
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0338-9557-12	DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN	$480.00
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57237-274-24	LAMIVUDINE 10 MG/ML ORAL SOLN (MCH)	$479.52
0023-7824-10	"POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OPHT DROP"	$479.22
HC34000018	PURE TONE AUDIO AIR&BONE	$479.00
HC31000466	PT-RE-EVAL EST POC  30MIN	$479.00
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HC84201607	C TRACHOMATIS BY DNA AMP PROBE	$478.00
HC84201821	SARS-COV-2 COVID-19 AMP QUAL PCR	$478.00
HC51070381	PSY TX W/PATIENT 45MIN W/E&M+	$478.00
HC42000364	INTERROGATE  IMP' CVPHYS MONITOR 1 OR MORE DATA	$477.00
HC62207113	SYRINGE KYPHOPLASTY INFLATION	$477.00
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HC25000977	INHALATION TX SUBSQ SAME DAY	$476.00
0065-0647-25	TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS	$475.08
17238-424-25	INDOCYANINE GREEN 25 MG INJ SOLR	$475.00
17238-424-06	INDOCYANINE GREEN 25 MG INJ SOLR	$475.00
HC51061539	ASP & INJ GANGLION CYST	$475.00
HC32001638	OT-APPLICATION CAST FINGER	$475.00
HC38000352	ADDING WALKER HEEL  PREV CAST	$475.00
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HC51010445	NASOPHARYNGOSCOPY	$475.00
HC62228705	IVS TUBING PUMP RAPID INFUSER	$475.00
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HC81701690	S AUREUS BY PCR	$474.00
HC33001025	ST EVAL SOUND W/LANG COMP&EXPRESS 30MIN/M	$474.00
0143-9726-01	TESTOSTERONE CYPIONATE 200 MG/ML IM OIL	$474.00
63323-617-20	MILRINONE 1 MG/ML IV SOLN	$474.00
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61314-203-15	PILOCARPINE HCL 1 % OPHT DROP	$473.13
HC21000583	TRIM NONDYSTROPHIC NAILS	$473.00
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63323-205-00	FATTY ACID6-FISH OIL-GLY-P-LIP 10 % IV EMUL	$472.80
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HC84201862	S AUREUS BY PCR	$470.00
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17478-224-12	PILOCARPINE HCL 2 % OPHT DROP	$469.35
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HC81701625	ENTEROVIRUS RNA RT PCR	$469.00
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HC82201021	ZIEHL NEELSON STN/GR I W/I&R+	$468.00
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HC12200176	INF CNTR-NEW PT EVAL HI/MOD	$467.00
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HC81500423	FACTOR XII	$464.00
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HC42000398	PROGRAM/EVAL T-ICD SNGL LEAD	$461.00
HC11500923	WM EXAM EST' PT EVAL  COMPLEX L 5	$461.00
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HC62206032	SCISSORS EYE(DISP)	$460.00
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HC32001893	OT - STRAPPING; HAND OR FINGER	$455.00
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HC25005257	DRAIN LESION DENTOALVEOLAR (GUM)	$455.00
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HC62804976	TUBE GASTROSTOMY KIT              I	$455.00
HC62212196	CATH PTA ANGIOPLS BALLOON NON-LSR E	$455.00
HC62800271	CATH DILATOR                      I	$455.00
HC62201512	CATH NEPHROSTOMY                  I	$455.00
HC62223433	CATH EP DX <20 ELECTRODES RPRSD   I	$455.00
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HC62227244	CATH IV MIDLINE                   I	$455.00
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HC62201413	CATH FOGARTY                      I	$455.00
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HC62219084	ORTHOTIC KNEE W/JNTS PRFB CUSTM   C	$455.00
HC62200555	BLADE INCISIONAL                  G	$455.00
HC62200845	BURR                              G	$455.00
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HC62203773	KIT CELL SAVER	$455.00
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HC62209374	POSITIONER FLUIDIZED MED Z-FLO	$455.00
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HC62213392	REAMER                            J	$455.00
HC62214416	DEVICE PASSING NEEDLE ARTHR	$455.00
HC62214507	RETRACTOR DISPOSABLE              F	$455.00
HC62215660	SUTURE                            R	$455.00
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HC62216338	NEEDLE INTRODUCER                 I	$455.00
HC62217393	PUSHER KNOT ENDO                  D	$455.00
HC62217609	AWL SPINAL SINGLE PATIENT USE     D	$455.00
HC62217781	NEEDLE BONE MARROW                G	$455.00
HC62217807	TEMPLATE STAPLE SPINAL            C	$455.00
HC62218342	ENDO STAPLER                      G	$455.00
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HC62220512	APPLICATOR/TIP SYRINGE ONLY       I	$455.00
HC62221395	TRAY INTUBATION RETROGRADE	$455.00
HC62221478	TROCAR ENDO                       I	$455.00
HC62221775	CLIP ENDOSCOPIC                   I	$455.00
HC62221916	PROBE SPINAL DISPOSABLE           B	$455.00
HC62222112	GUIDE PIN ORTHO                   I	$455.00
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HC62223037	APPLIER LIGA/HEMOCLIP ENDO        I	$455.00
HC62223219	CATH INTRODUCER PEEL-AWAY         N	$455.00
HC62223292	TEMPLATE BRACHYTHERAPY            I	$455.00
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HC62224134	ELECTRODE SEALING (E.G. LIGASURE)	$455.00
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HC62224944	GUIDE DRILL                       I	$455.00
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HC62300256	STAPLER ROBOTIC (ENDOWRIST)	$455.00
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HC62807698	CAP KIT LEAD PACEMAKER            I	$455.00
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HC32001885	OT - STRAPPING; ELBOW OR WRIST	$454.00
HC31001977	PT - STRAPPING; ELBOW OR WRIST	$454.00
HC83000000	PLATELETS CONCENTRATE EA UNIT	$454.00
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HC31001829	PT-THER PROC GRP 120MIN/MC	$453.00
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HC44000719	EYE FOR FOREIGN BODY LT	$452.00
HC44000727	EYE FOR FOREIGN BODY RT	$452.00
HC44001683	OPTIC FORAMINA	$452.00
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HC83001222	X-MATCH ELECTRONIC TECH EA UNIT	$452.00
HC39000013	PSYCH TX W/PATIENT 30MIN	$452.00
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HC25005042	ADDING WALKER HEEL PREV CAST LT	$451.00
HC25005059	ADDING WALKER HEEL PREV CAST RT	$451.00
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HC21001045	REMOV IMPACTD EAR WAX IRRIG/LAVG BI	$450.00
HC84201458	DNA/RNA CMV PCR(PNL)	$450.00
HC39001078	PSYCH HYPNOTHERAPY	$450.00
HC83000489	PLATELETS LEUKO RED EA UNIT	$450.00
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39822-0412-6	TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR	$450.00
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0378-8700-06	ACYCLOVIR 5 % TOPICAL OINT	$450.00
99999-038-09	GLYCERIN 100% INJ LBM	$450.00
55111-685-07	ZOLEDRONIC ACID 4 MG/5 ML IV SOLN	$450.00
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49884-161-11	CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRY	$449.22
0409-6557-01	TESTOSTERONE CYPIONATE 100 MG/ML IM OIL	$449.10
42023-229-01	MICAFUNGIN 50 MG IV SOLR	$448.80
42023-229-10	MICAFUNGIN 50 MG IV SOLR	$448.80
27808-033-01	THEOPHYLLINE 80 MG/15 ML ORAL SOLN	$448.40
54838-556-80	THEOPHYLLINE 80 MG/15 ML ORAL SOLN	$448.40
0143-9750-01	TESTOSTERONE ENANTHATE 200 MG/ML IM OIL	$448.14
HC81100281	RENAL FUNCTION PANEL	$448.00
HC81100760	CPK - MB	$448.00
5047-4508-58	SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG	$447.17
HC51001519	APPLY CAST PATELR TENDN BEARNG	$447.00
HC81500415	FACTOR XI PTA	$447.00
HC39001383	PSY-ASSESS APHASIA W/REPORT PER HOUR	$447.00
HC33000001	SP-ASSESS APHASIA/REPT EA HR/M	$447.00
HC38000014	APPLICATION CAST FINGER	$446.00
HC81500407	FACTOR X	$446.00
HC84201490	DNA/RNA S PNEUMONIAE GROUP B PCR(PNL)	$446.00
HC12200036	IV INF HYDRATION EA ADD'L HR	$446.00
HC11500667	WC NEW E&M ASSESS INTRMED LVL3	$446.00
HC62211164	SENSOR GAS CBP	$446.00
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99999-042-23	ISONIAZID 50 MG/5 ML ORAL SOLN	$444.24
HC44003093	EVAL MED PHYSICS DOSE RADIATION EXPOSE W/REPORT	$444.00
HC81100356	THEOPHYLINE	$444.00
HC32001521	OT-THER PROC GRP 90MIN/MC	$444.00
HC25005984	NEW PT LVL4-DETAILED	$444.00
HC25006040	EST PT LVL5-COMPREHENSIVE	$444.00
HC89020366	EGFR GENE COM VARIANTS-AU	$443.00
HC84200708	CULTURE ACID FAST	$443.00
HC84201557	DNA/RNA ENTEROVIRUS PCR(PNL)	$443.00
HC84201565	DNA/RNA HUMAN PARECHOVIRUS PCR(PNL)	$443.00
HC11500964	WM EXAM NEW PT EVAL  HIGH L 4	$443.00
HC28000073	CR EST PT EVAL LVL4-(25MIN)	$443.00
HC51010775	LARYNGOSCOPY DIAGNOSTIC	$442.00
HC51000081	INSRT BLADDER CATH-TEMP-COMPLX	$442.00
HC51061760	X-RAY SPINE CERVICAL; COMP 6/> VWS	$442.00
HC51061844	X-RAY SPINE ENTIRE SKULL-SACRUM 6/> VIEWS	$442.00
HC81700171	TESTOSTERONE TOTAL	$442.00
HC51061620	ECHO DOPPLER F/U OR LTD+	$442.00
HC11500717	WC ESTB E&M  INTERMEDIATE LVL3	$442.00
HC62201629	CATH URETERAL DUAL LUMEN          V	$442.00
HC62214366	SET AUTOTRANSFUSE                 S	$442.00
HC62215355	BLADE SAW                         V	$442.00
HC62216296	TEMPLATE ORTHO/ROD SPINAL         M	$442.00
HC62216593	PIN/WIRE FIXATION TEMPORARY       V	$442.00
HC82203795	IHC/IP PER SPEC EA ADD AB STAIN+ ACTH	$441.00
HC82203415	IHC/IP PER SPEC EA ADD AB STAIN+ AFP	$441.00
HC82204082	IHC/IP PER SPEC EA ADD AB STAIN+ ANTI-BCL-2	$441.00
HC82204090	IHC/IP PER SPEC EA ADD AB STAIN+ ANTI-CD3/HRP	$441.00
HC82203514	IHC/IP PER SPEC EA ADD AB STAIN+ BCL-6	$441.00
HC82203811	IHC/IP PER SPEC EA ADD AB STAIN+ CALCITON	$441.00
HC82204314	IHC/IP PER SPEC EA ADD AB STAIN+ CALRETININ	$441.00
HC82203522	IHC/IP PER SPEC EA ADD AB STAIN+ CAM5-2	$441.00
HC82204363	IHC/IP PER SPEC EA ADD AB STAIN+ CD10	$441.00
HC82204389	IHC/IP PER SPEC EA ADD AB STAIN+ CD117	$441.00
HC82203571	IHC/IP PER SPEC EA ADD AB STAIN+ CD-138	$441.00
HC82203530	IHC/IP PER SPEC EA ADD AB STAIN+ CD-1A	$441.00
HC82203548	IHC/IP PER SPEC EA ADD AB STAIN+ CD-21	$441.00
HC82203555	IHC/IP PER SPEC EA ADD AB STAIN+ CD-23	$441.00
HC82203563	IHC/IP PER SPEC EA ADD AB STAIN+ CD-31	$441.00
HC82204322	IHC/IP PER SPEC EA ADD AB STAIN+ CD4	$441.00
HC82204330	IHC/IP PER SPEC EA ADD AB STAIN+ CD5	$441.00
HC82204371	IHC/IP PER SPEC EA ADD AB STAIN+ CD56	$441.00
HC82204108	IHC/IP PER SPEC EA ADD AB STAIN+ CD-68	$441.00
HC82204348	IHC/IP PER SPEC EA ADD AB STAIN+ CD7	$441.00
HC82204454	IHC/IP PER SPEC EA ADD AB STAIN+ CD-79A	$441.00
HC82204355	IHC/IP PER SPEC EA ADD AB STAIN+ CD8	$441.00
HC82203589	IHC/IP PER SPEC EA ADD AB STAIN+ CDX-28	$441.00
HC82203365	IHC/IP PER SPEC EA ADD AB STAIN+ CEA	$441.00
HC82203597	IHC/IP PER SPEC EA ADD AB STAIN+ CEA MONOCLON	$441.00
HC82203399	IHC/IP PER SPEC EA ADD AB STAIN+ CHROMOGRAN	$441.00
HC82203613	IHC/IP PER SPEC EA ADD AB STAIN+ CK-19	$441.00
HC82203605	IHC/IP PER SPEC EA ADD AB STAIN+ CK-5/6	$441.00
HC82204397	IHC/IP PER SPEC EA ADD AB STAIN+ CMV	$441.00
HC82204603	IHC/IP PER SPEC EA ADD AB STAIN+ C-MYC	$441.00
HC82204116	IHC/IP PER SPEC EA ADD AB STAIN+ CYCLIN D1	$441.00
HC82203498	IHC/IP PER SPEC EA ADD AB STAIN+ CYTOCHM	$441.00
HC82204124	IHC/IP PER SPEC EA ADD AB STAIN+ CYTOKERATIN-20	$441.00
HC82204132	IHC/IP PER SPEC EA ADD AB STAIN+ CYTOKERATIN-7	$441.00
HC82203837	IHC/IP PER SPEC EA ADD AB STAIN+ DESMIN	$441.00
HC82203761	IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (C-TERM)	$441.00
HC82203779	IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (N-TERM)	$441.00
HC82203787	IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (ROD DOMAIN)	$441.00
HC82203621	IHC/IP PER SPEC EA ADD AB STAIN+ E-CADHERIN	$441.00
HC82204405	IHC/IP PER SPEC EA ADD AB STAIN+ EGFR	$441.00
HC82203639	IHC/IP PER SPEC EA ADD AB STAIN+ EMA (MC5)(LIVER)	$441.00
HC82203456	IHC/IP PER SPEC EA ADD AB STAIN+ EPI MEMBR	$441.00
HC82203845	IHC/IP PER SPEC EA ADD AB STAIN+ ESTR RCPT	$441.00
HC82204140	IHC/IP PER SPEC EA ADD AB STAIN+ EWINGS SARCOMA	$441.00
HC82204157	IHC/IP PER SPEC EA ADD AB STAIN+ FACTOR 13-A	$441.00
HC82203423	IHC/IP PER SPEC EA ADD AB STAIN+ FCTR 8 AG	$441.00
HC82203852	IHC/IP PER SPEC EA ADD AB STAIN+ GASTRIN	$441.00
HC82204587	IHC/IP PER SPEC EA ADD AB STAIN+ GATA-3	$441.00
HC82203431	IHC/IP PER SPEC EA ADD AB STAIN+ GFAP	$441.00
HC82203860	IHC/IP PER SPEC EA ADD AB STAIN+ GLUCAGON	$441.00
HC82204165	IHC/IP PER SPEC EA ADD AB STAIN+ GROWTH HORM	$441.00
HC82204629	IHC/IP PER SPEC EA ADD AB STAIN+ H PYLORI	$441.00
HC82203449	IHC/IP PER SPEC EA ADD AB STAIN+ HCG	$441.00
HC82203647	IHC/IP PER SPEC EA ADD AB STAIN+ HEPPAR	$441.00
HC82204298	IHC/IP PER SPEC EA ADD AB STAIN+ HER-2-NEU	$441.00
HC82203878	IHC/IP PER SPEC EA ADD AB STAIN+ HERPES POLYV	$441.00
HC82203357	IHC/IP PER SPEC EA ADD AB STAIN+ HMB-45	$441.00
HC82203829	IHC/IP PER SPEC EA ADD AB STAIN+ HPCA-1	$441.00
HC82204645	IHC/IP PER SPEC EA ADD AB STAIN+ HSV-1	$441.00
HC82204660	IHC/IP PER SPEC EA ADD AB STAIN+ HSV-2	$441.00
HC82203654	IHC/IP PER SPEC EA ADD AB STAIN+ IGD	$441.00
HC82203662	IHC/IP PER SPEC EA ADD AB STAIN+ INHIBIN	$441.00
HC82203670	IHC/IP PER SPEC EA ADD AB STAIN+ INI-1	$441.00
HC82203886	IHC/IP PER SPEC EA ADD AB STAIN+ INSULIN	$441.00
HC82203894	IHC/IP PER SPEC EA ADD AB STAIN+ KAPPA	$441.00
HC82203472	IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN	$441.00
HC82203688	IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN (AE1/AE3) LN	$441.00
HC82204173	IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN 903	$441.00
HC82203696	IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN HMWK	$441.00
HC82203902	IHC/IP PER SPEC EA ADD AB STAIN+ KI-1	$441.00
HC82204199	IHC/IP PER SPEC EA ADD AB STAIN+ KI-67	$441.00
HC82203910	IHC/IP PER SPEC EA ADD AB STAIN+ KP-1	$441.00
HC82203928	IHC/IP PER SPEC EA ADD AB STAIN+ L26 AB	$441.00
HC82203936	IHC/IP PER SPEC EA ADD AB STAIN+ LAMBDA	$441.00
HC82203381	IHC/IP PER SPEC EA ADD AB STAIN+ LCA AP	$441.00
HC82204207	IHC/IP PER SPEC EA ADD AB STAIN+ LEU M1 (CD15)	$441.00
HC82203464	IHC/IP PER SPEC EA ADD AB STAIN+ LEU-22	$441.00
HC82203944	IHC/IP PER SPEC EA ADD AB STAIN+ LN 1	$441.00
HC82203951	IHC/IP PER SPEC EA ADD AB STAIN+ LN 2	$441.00
HC82204413	IHC/IP PER SPEC EA ADD AB STAIN+ MELAN-A	$441.00
HC82203803	IHC/IP PER SPEC EA ADD AB STAIN+ MONOCLNL BREAST	$441.00
HC82204686	IHC/IP PER SPEC EA ADD AB STAIN+ MSH-2	$441.00
HC82204694	IHC/IP PER SPEC EA ADD AB STAIN+ MSH-6	$441.00
HC82203969	IHC/IP PER SPEC EA ADD AB STAIN+ MT-1	$441.00
HC82204215	IHC/IP PER SPEC EA ADD AB STAIN+ MT-1	$441.00
HC82203704	IHC/IP PER SPEC EA ADD AB STAIN+ MUM-1	$441.00
HC82203977	IHC/IP PER SPEC EA ADD AB STAIN+ MUSCLE	$441.00
HC82204223	IHC/IP PER SPEC EA ADD AB STAIN+ MYELOPEROXIDASE	$441.00
HC82203712	IHC/IP PER SPEC EA ADD AB STAIN+ MYOGENIN	$441.00
HC82203985	IHC/IP PER SPEC EA ADD AB STAIN+ MYOGLOBIN	$441.00
HC82203993	IHC/IP PER SPEC EA ADD AB STAIN+ NEURFLMNT	$441.00
HC82204009	IHC/IP PER SPEC EA ADD AB STAIN+ NSE	$441.00
HC82204421	IHC/IP PER SPEC EA ADD AB STAIN+ P16	$441.00
HC82204231	IHC/IP PER SPEC EA ADD AB STAIN+ P-53	$441.00
HC82203720	IHC/IP PER SPEC EA ADD AB STAIN+ P63	$441.00
HC82204561	IHC/IP PER SPEC EA ADD AB STAIN+ PAX8	$441.00
HC82203738	IHC/IP PER SPEC EA ADD AB STAIN+ PGP 9.5	$441.00
HC82204249	IHC/IP PER SPEC EA ADD AB STAIN+ PLAP	$441.00
HC82204702	IHC/IP PER SPEC EA ADD AB STAIN+ PMS2	$441.00
HC82204017	IHC/IP PER SPEC EA ADD AB STAIN+ PROGEST REC	$441.00
HC82204256	IHC/IP PER SPEC EA ADD AB STAIN+ PROLACTIN	$441.00
HC82204462	IHC/IP PER SPEC EA ADD AB STAIN+ PROS ACID PHOS	$441.00
HC82203373	IHC/IP PER SPEC EA ADD AB STAIN+ PSA	$441.00
HC82203340	IHC/IP PER SPEC EA ADD AB STAIN+ S100	$441.00
HC82204264	IHC/IP PER SPEC EA ADD AB STAIN+ SMMHC	$441.00
HC82204025	IHC/IP PER SPEC EA ADD AB STAIN+ SMOOTH MUSC	$441.00
HC82204033	IHC/IP PER SPEC EA ADD AB STAIN+ SOMATOSTN	$441.00
HC82204546	IHC/IP PER SPEC EA ADD AB STAIN+ SOX10	$441.00
HC82203480	IHC/IP PER SPEC EA ADD AB STAIN+ SYNAPTOP	$441.00
HC82204041	IHC/IP PER SPEC EA ADD AB STAIN+ T4	$441.00
HC82204272	IHC/IP PER SPEC EA ADD AB STAIN+ TERM DEOXZYTRANS	$441.00
HC82203746	IHC/IP PER SPEC EA ADD AB STAIN+ TH	$441.00
HC82204058	IHC/IP PER SPEC EA ADD AB STAIN+ THYROGLOBLN	$441.00
HC82204439	IHC/IP PER SPEC EA ADD AB STAIN+ TTF-1	$441.00
HC82204306	IHC/IP PER SPEC EA ADD AB STAIN+ UBIQUITIN	$441.00
HC82204066	IHC/IP PER SPEC EA ADD AB STAIN+ UCHL 1	$441.00
HC82204280	IHC/IP PER SPEC EA ADD AB STAIN+ UCHL-1	$441.00
HC82203407	IHC/IP PER SPEC EA ADD AB STAIN+ VIMENTIN	$441.00
HC82203753	IHC/IP PER SPEC EA ADD AB STAIN+ WT-1	$441.00
HC12200283	SC INFUSION THERAPY; ADD'L SET UP NEW SITE	$441.00
HC62208541	CANNULA WATERS	$441.00
25021-816-30	LEUCOVORIN CALCIUM 350 MG INJ SOLR	$441.00
HC51003242	COLPOSCOPY CERVIX&ADJACENT VAGINA	$440.00
HC51010387	EMG 1 EXTREMITY	$440.00
HC22000087	OST EST PT EVAL LVL4-(25MIN)	$440.00
63323-402-20	AZTREONAM 2 G INJ SOLR (MCH)	$439.86
63323-402-01	AZTREONAM 2 GRAM INJ SOLR	$439.86
59310-579-22	ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA	$439.82
0781-3416-94	VORICONAZOLE 200 MG IV SOLR	$439.44
63323-137-20	BLEOMYCIN 30 UNIT INJ SOLR	$439.38
0009-3116-01	CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLN	$438.12
HC51001469	APPLY CAST LONG ARM	$438.00
HC51002772	BLADDER IRRIGATION SIMPLE	$438.00
HC84200690	CULTURE CHLAMYDIA  ANY SOURCE	$438.00
51672-1386-2	FLUOCINONIDE 0.05 % TOPICAL CREAM	$437.22
0093-0262-30	FLUOCINONIDE 0.05 % TOPICAL CREAM	$437.22
HC81500365	FACTOR VII STABLE	$437.00
HC81500688	FACTOR VIII ASSAY	$437.00
HC31001811	PT-THER PROC GRP 90MIN/MC	$437.00
HC35000025	REC- EVALUATION 30MIN	$437.00
HC62224423	EXTRACTOR TISSUE SPINAL	$437.00
0409-1903-01	PROCAINAMIDE 500 MG/ML INJ SOLN	$436.57
HC46001038	INTRO NDL/INTRACATH VEIN	$436.00
HC46000576	INTRO NDL/INTRACATH VEIN LT	$436.00
HC46000584	INTRO NDL/INTRACATH VEIN RT	$436.00
HC84201417	CULT DNA/RNA AMP PCR GRAM NEG ISO	$436.00
HC84201425	CULT DNA/RNA AMP PCR GRAM POS ISO	$436.00
HC84201441	CULT DNA/RNA AMP PCR RESISTANT GENE	$436.00
HC84201433	CULT DNA/RNA AMP PCR YEAST ISO	$436.00
HC62221940	PINS BONE REFERENCE ROBOTIC(2 PK)	$436.00
0597-0031-34	CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK	$435.36
HC51001501	APPLY CYLINDER CAST(THI-ANKLE)	$435.00
HC25001520	REMOV IMPACTD EAR WAX IRRIG/LAVG BI	$435.00
HC81101446	BASIC METABOLIC PANEL/ION'D CA	$435.00
HC81700361	CD3 ABSOLUTE COUNT	$435.00
HC42000471	PROGRAM EVAL PERI-OP PACEMAKER SGL/DUAL/MULTI/LEADLESS	$435.00
HC25000308	LAC REPAIR 2.6-7 5CM	$435.00
42023-172-04	MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR	$435.00
HC34000091	CONDITIONING PLAY AUDIO	$434.00
HC32000796	OT-WOUND VAC 15MIN>50 SQ CM/M	$434.00
HC31000854	PT-WOUND VAC 15MIN>50 SQ CM/M	$434.00
HC62209713	FORCEP HOT BIOPSY                 G	$434.00
63323-103-64	CISPLATIN 1 MG/ML IV SOLN	$433.20
HC51003622	ANOSCOPY DX (INCL COLLECTION)	$433.00
HC84200302	CULTURE FUNGUS BLOOD	$433.00
HC84201581	DNA/RNA C NEOFORMANS/GATTII PCR(PNL)	$433.00
HC84201508	DNA/RNA E COLI K1 PCR(PNL)	$433.00
HC84201516	DNA/RNA INFLUENZAE H PCR(PNL)	$433.00
HC84201524	DNA/RNA L MONOCYTOGENES PCR(PNL)	$433.00
HC84201532	DNA/RNA N MENINGITIDIS PCR(PNL)	$433.00
HC84201540	DNA/RNA S AGALACTIAE PCR(PNL)	$433.00
HC84201573	DNA/RNA VARICELLA ZOSTER PCR(PNL)	$433.00
60793-215-05	"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLR"	$432.78
60793-315-01	"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLR"	$432.78
HC84201599	DNA/RNA STREP A AMP PROBE(XPERT XPRESS)	$432.00
HC82200932	TISSUE EX G&M  LVL 3  DIST SVC	$432.00
HC82200395	TISSUE EXAM G&M LEVEL 3	$432.00
HC82202565	TISSUE EXAM G&M LEVEL 3 *OP	$432.00
HC82202748	TISSUE EXAM G&M LVL 3(TC ONLY)	$432.00
HC82200650	TISSUE EXAM LEVEL 3 ADD'L	$432.00
49884-907-61	MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP	$432.00
42023-173-25	GANCICLOVIR SODIUM 500 MG IV SOLR	$432.00
42023-173-01	GANCICLOVIR SODIUM 500 MG IV SOLR	$432.00
0409-1555-54	HETASTARCH IN LACT ELECTROLYTE 6 % IV SOLN	$432.00
HC33001090	ST EVAL BEHAVRAL QUAL VOICE 45MIN/M	$431.00
HC31000185	PT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING)	$431.00
HC31000821	PT-WOUND VAC 30MIN<50 SQ CM/CM	$431.00
HC13500046	GENETIC CNSL RISK REDCTN 60MIN	$431.00
HC25000480	FRACTURE TX  NASAL	$431.00
HC89021133	NK FUNCTION ASSAY(PNL) -CN	$430.00
HC62201199	CATH ABR TRIPLE LUMEN	$430.00
51672-1290-1	HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM	$429.75
16714-730-01	CLOBETASOL 0.05 % TOPICAL CREAM	$429.03
16714-992-01	CLOBETASOL 0.05 % TOPICAL CREAM	$429.03
HC81701534	C TRACHOMATIS BY DNA AMP PROBE	$429.00
HC62210422	KIT INTRASPINAL TRIAL	$429.00
HC62215652	SUTURE                            Q	$429.00
HC62224233	PROBE ELECTROHEMOSTASIS	$429.00
0603-1508-58	PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX	$428.54
0173-0736-01	SUMATRIPTAN SUCCINATE 50 MG ORAL TAB	$428.23
0168-0323-46	METRONIDAZOLE 0.75 % TOPICAL CREAM	$428.22
HC81100083	LIPID PANEL	$428.00
HC42000372	INTERROGATE SQ CARDIAC RHYTHM MONITOR	$428.00
HC29000502	E&M PREVENTIVE NEW 18-39 Y/O	$428.00
HC29000510	E&M PREVENTIVE NEW 40-64 Y/O	$428.00
61703-342-50	PACLITAXEL 6 MG/ML IV CONC	$427.80
51672-1272-2	"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT"	$427.50
0168-0089-30	"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT"	$427.50
HC51002483	X RAY FLUORO GUIDANCE	$427.00
HC42000794	PROGRAM/EVAL S-ICD SNGL LEAD	$427.00
HC42000802	INTERROGATION S-ICD	$427.00
60758-880-05	FLUOROMETHOLONE 0.1 % OPHT DRPS	$426.30
HC83000109	X-MATCH I-SPIN TECH EA UNIT	$426.00
HC62205695	PIN PASSING	$426.00
0003-0293-28	TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP	$425.76
0143-9297-01	DANTROLENE 20 MG IV SOLR	$425.46
HC51062768	APPLY SPLINT SHORT LEG BILATERAL	$425.00
HC51062792	"COMPLEX CHRONIC CARE MGMT INITL 60MIN, PER MONTH"	$425.00
17478-716-10	APRACLONIDINE 0.5 % OPHT DROP	$424.50
16714-671-02	ONDANSETRON HCL 4 MG/5 ML ORAL SOLN	$424.20
HC51002996	DESTROY LESION(S) PENILE SIMPLE/CHEM	$424.00
HC33000290	ST-SPEECH THERAPY GRP 60MIN/MCW	$424.00
HC33000910	ST EVAL SPEECH FLUENCY 45MIN/M	$424.00
HC11500873	WM EXAM EST' PT EVAL MOD/HI IV	$424.00
HC62202783	ELECTRODES 4 CHANNEL NIM	$424.00
51672-4047-9	CARBAMAZEPINE 100 MG/5 ML ORAL SUSP	$423.90
HC25005166	LARYNGOSCOPY W/REMOVE FB	$423.00
HC62805296	CATHETER PERITONEAL               F	$423.00
HC62805569	CATH DIALYSIS SHORT-TERM          G	$423.00
HC62226881	GUIDEWIRE                         G	$423.00
HC62212014	GUIDEWIRE(E.G. HALO/SUPER STIFF)  G	$423.00
HC25000332	ANOSCOPY W/PROCEDURE	$423.00
HC62219134	CANNULA ARTHRSCPC(STICK SWITCHING)H	$423.00
HC62222369	BAG/POUCH RETRIEVAL SPECMN ENDO   F	$423.00
HC62225362	KIT REPAIR BROVIAC/CV/HICKMAN     C	$423.00
HC62225917	BASKET RETRIEVAL                  H	$423.00
HC62226873	DILATOR URETERAL	$423.00
63323-539-03	ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLN	$422.51
47335-892-72	TEMOZOLOMIDE 100 MG ORAL CAP	$422.20
47335-892-60	TEMOZOLOMIDE 100 MG ORAL CAP	$422.20
HC51003903	FNA ASP BX W/O GUIDE; EACH ADD'L LESION	$422.00
HC51010312	INJ(S);TRIGGER POINT 3/>MUSCLS	$422.00
HC89000871	ENCAINIDE-AU	$422.00
HC83000182	X-MATCH AHG TECH EA UNIT	$422.00
HC81701658	"VITAMIN D, 25-HYDROXY"	$421.00
HC32001539	OT-THER PROC GRP 120MIN/MC	$421.00
99988-000-19	NM TC-99M MACROAGGREG MAA 1-7 MCI	$420.88
59762-5050-1	GABAPENTIN 250 MG/5 ML ORAL SOLN	$420.18
68180-678-01	OSELTAMIVIR 6 MG/ML ORAL SUSR	$420.12
0054-3194-46	DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML ORAL LIQD	$420.12
HC51001576	APPLY SPLINT LONG LEG	$420.00
HC31001704	REPOSITIONING CANALITH/DAY	$420.00
27505-003-67	DANTROLENE 20 MG IV SOLR	$420.00
69315-312-28	HYDROCORTISONE 2.5 % TOPICAL CRPE	$420.00
78670-003-67	DANTROLENE 20 MG IV SOLR	$420.00
62756-016-40	TESTOSTERONE CYPIONATE 200 MG/ML IM OIL	$420.00
10631-407-01	HYDROCORTISONE 2.5 % TOPICAL CRPE	$419.98
16714-119-02	TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU	$419.58
HC89017149	"ALLERGEN SPECIFIC IGE, EACH-IB"	$419.00
HC84200146	CULTURE STOOL	$419.00
HC39001060	PSYCH THERAPY W/BIOFEEDBACK 45 MIN	$419.00
HC41500646	MONITOR NEURO INTRAOP CONT REMOTE >1 PT PER HR	$419.00
HC31001498	PT-THER PROC GRP 60MIN/MC	$419.00
68803-612-10	TRYPAN BLUE 0.06 % INTRAOCULAR SYRG	$418.80
67877-749-57	FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACK	$418.80
HC34000083	VISUAL REINFORCE AUDIO (VRA)	$418.00
HC32000762	OT-WOUND VAC 30MIN<50 SQ CM/CM	$418.00
HC62207204	TIP VITALVUE SUCTION/IRRIG	$417.00
HC62217351	SCRAPER MEMBRANE OPHTH	$417.00
66302-467-60	TADALAFIL (PULM. HYPERTENSION) 20 MG ORAL TAB	$417.00
HC81700064	CARCINOEMBRYONIC ANTIGEN (CEA)	$416.00
HC83000174	RBC ANTIBODY ELUTION	$416.00
HC51061638	ECHO DOPPLER COLOR FLOW+	$416.00
HC51070555	PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; 1ST HOUR	$416.00
HC51070571	NEUROPSYCH TESTING EVAL INTRG INTERP CLIN DES TX FEEDBACK; 1ST HOUR	$416.00
HC51020402	SC INFUSION THERAPY EA ADDL HOUR	$416.00
HC62220793	TRAY DRAIN PNEUMOPERICARDIUM	$416.00
HC62214283	CATH URETERAL                     U	$416.00
HC62200563	BLADE INDIANACTOME	$416.00
HC62215348	BLADE SAW                         U	$416.00
HC62216585	PIN/WIRE FIXATION TEMPORARY       U	$416.00
HC62216825	POST ANCHOR SPINAL DISPOSABLE     G	$416.00
68982-623-02	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	$415.50
HC51001303	"CLOSED TX FINGER DISTAL FX,EA,NO M"	$415.00
HC42000570	WCH NEW PT LVL4-DETAILED	$415.00
60432-065-00	AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR	$414.60
13517-107-16	PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX	$414.35
0121-0942-16	PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX	$414.35
HC51002152	CYSTOGRAM SIMPLE	$414.00
HC81500464	INHIB PROTEIN C ACTIVITY	$414.00
54838-523-40	FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLN	$414.00
0338-0519-14	FAT EMULSION 20 % IV EMUL	$414.00
65649-311-12	CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSP	$413.80
65862-141-50	CEFPODOXIME 100 MG/5 ML ORAL SUSR	$413.70
HC81101354	LIPID PANEL SUBSEQUENT	$413.00
HC31000086	PT-AQUATIC GRP 60MIN/M	$413.00
HC62206156	SET CARDIOPLEGIA	$413.00
0054-0517-50	MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS) 	$412.56
HC25000159	FB REMOVAL EAR	$412.00
HC82201039	ALCIAN BLUE NO DIGEST'N/GRPII+	$412.00
10702-036-45	SODIUM POLYSTYRENE SULFONATE ORAL POWD	$411.32
99999-004-26	POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP	$411.30
63459-541-04	FENTANYL CITRATE 100 MCG BUCCAL TBEF	$411.19
63459-541-28	FENTANYL CITRATE 100 MCG BUCCAL TBEF	$411.19
0049-2340-45	ELETRIPTAN 40 MG ORAL TAB	$411.19
0085-4324-02	POSACONAZOLE 100 MG ORAL TBEC	$411.18
HC83000620	PLASMA CRYO REDUCED EA UNIT-OS	$411.00
0009-0016-12	HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML INJ SOLR	$411.00
0143-9299-10	GANCICLOVIR SODIUM 500 MG IV SOLR	$410.40
0143-9299-01	GANCICLOVIR SODIUM 500 MG IV SOLR	$410.40
HC51002244	INJECT URETEROGRAGH VIA URETEROS	$410.00
HC25005554	REMOVE FB EXTRNL EYE; CORNEAL W/SLITLAMP LT	$410.00
HC25005562	REMOVE FB EXTRNL EYE; CORNEAL W/SLITLAMP RT	$410.00
HC44001675	"NECK, SOFT TISSUE (REDUCED SVC)"	$410.00
HC84200039	CULTURE FUNGUS OTHER SOURCE	$410.00
HC62205968	RETRACTOR STAYS ELASTIC	$410.00
HC62225156	RESERVOIR CSF VENTRICULAR	$410.00
HC81100299	CARBAMAZEPINE  TOTAL	$409.00
HC81101511	ALBUMIN ISCHEMIA MODIFIED	$409.00
HC81100414	AMMONIA	$409.00
HC42000430	PROGRAM EVAL CARDIAC RHYTHM MON SQ	$409.00
HC83000083	FRESH FROZEN PLASMA EA UNIT	$409.00
0281-0326-60	NITROGLYCERIN 2 % TRANSDERMAL OINT	$408.96
99999-044-38	LEVOCARNITINE 50 MG/ML IV SOLN	$408.48
0069-0206-01	"DALTEPARIN (PORCINE) 7,500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRG"	$408.35
HC81101891	BASIC METABOLIC PAN/ION'D CA (POS)	$408.00
HC81500431	ANTITHROMBIN III	$408.00
25021-454-05	OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN	$408.00
0703-3333-01	OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN	$408.00
0591-3221-26	TESTOSTERONE ENANTHATE 200 MG/ML IM OIL	$407.76
42494-416-25	PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN	$407.74
42494-416-01	PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN	$407.70
HC51003366	BX(S)/SAMPL ENDOMETRIAL(SEP PROC)	$407.00
HC62208723	CATHETER IRRIGATION SINUPLASTY	$407.00
HC62215520	RETRIEVER STENT BILI SOEHENDRA	$407.00
HC62219092	TUBE CALIBRATION GASTRIC BANDING	$407.00
HC51010353	ANAL' IMPLNTD PUMP W/PROG MD SKILL	$406.00
HC51001626	X-RAY SPINE CERVICAL; 4 OR 5VWS	$406.00
HC51010734	DESENSITIZATION RAPID EA HR	$406.00
HC65800021	CESIUM-131 NONSTRND PER SOURCE	$406.00
HC31001860	PT-AQUATIC THERAPY 30MIN/CW	$406.00
HC62201710	CEMENT INJECTOR	$406.00
HC62201728	CEMENT VERTEBROPLASTY	$406.00
HC62800560	DEVICE CLOSURE FASCIA	$406.00
01035-6101-10	WHITE PETROLATUM 41 % TOPICAL OINT	$405.11
HC51010296	INJ(S);SNGL TNDON ORIGN/INSER	$405.00
HC51000479	DECLOT IVAD W/THROMBOLYTC(TECH/HOSP)	$405.00
HC51000057	DECLOT IVAD W/THROMBOLYTIC	$405.00
HC81100968	CAFFEINE	$405.00
HC89019731	HU AUTOANTIBODY TEST-AT	$405.00
HC82201047	ALCIAN BLUE STN W/DIG/GRP II+	$405.00
HC82200007	AMYLOID (CONGO RED)/GRP II+	$405.00
HC82200148	AMYLOID (CRYST VIOLET)/GRP II+	$405.00
HC82201054	AMYLOID ST BENNHOLDS/GRP II+	$405.00
HC82201062	BONE MAR IRON STN/GRP II+	$405.00
HC84600493	COLLOIDAL IRON STAIN/GRP II+	$405.00
HC84600485	COPPER STAIN/GRP II+	$405.00
HC82200015	ELASTIC STAIN/GRP II+	$405.00
HC82201070	F-M ARGENTAFFIN STAIN/GRP II+	$405.00
HC82201088	F-M MELANIN STN BLEACH/GRPII+	$405.00
HC82201096	GIEMSA STAIN MAST CELL/GRP II+	$405.00
HC82201104	GRIMELIUS ARGYROPHL STN GRPII+	$405.00
HC82201112	HALLS BILE STAIN/GRP II+	$405.00
HC82200494	IRON STAIN/B.M. SMEARS+	$405.00
HC82200031	IRON STAIN/GRP II+	$405.00
HC82201120	JONES SILVER STAIN/GRP II+	$405.00
HC82201138	KOSSA CALCIUM STAIN/GRP II+	$405.00
HC82201146	LUXOL FAST BLUE STAIN GRP II+	$405.00
HC82201153	MASSON TRICHROME STAIN/GRP II+	$405.00
HC82201161	MAY GRUNWALD GIEMS STN GRP II+	$405.00
HC82201179	MELANIN BLEACHING/GRP II+	$405.00
HC82201187	METHYL GREEN PYRON STN/GRP II+	$405.00
HC82200064	MUCIN MUCICARMINE STN/GRP II+	$405.00
HC82201195	MYELIN STAIN GRP II+	$405.00
HC82200072	OIL RED O STAIN/GRP II+	$405.00
HC82201203	PAS STAIN W/DIGESTION GRP II+	$405.00
HC82201211	PAS STAIN/GRP II+	$405.00
HC82201229	PERLS PRUSSIAN BLU STN GRP II+	$405.00
HC82200098	PTAH STAIN/GRP II+	$405.00
HC82200122	RETICULUM STAIN/GRP II+	$405.00
HC82201237	SNOOKS RETICULIN STAIN GRP II+	$405.00
HC82200577	SPECIAL STAIN GROUP II+	$405.00
HC82202615	SPECIAL STAIN GROUP II+ *OP	$405.00
HC82201245	SUDA BLACK B STN/GRP II+	$405.00
HC82201252	TOLUID BLU MAST CL STN/GRP II+	$405.00
HC82200106	TRICHROME STAIN/GRP II+	$405.00
HC82201260	VERHOFF ELASTI TIS STN/GRP II+	$405.00
HC51003911	CHANGE GT TUBE W/REV TRACT W/O IMAGE/ENDO INCL REMVL	$404.00
HC81500340	FACTOR II PT SPECIFIC	$404.00
HC84200088	"CULTURE, BACTERIAL-OTHR SOURCE"	$404.00
50419-325-27	GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SYRG	$403.52
50419-325-22	GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SYRG	$403.52
HC84200005	CULTURE CATH TIP	$403.00
HC84200120	CULTURE CSF	$403.00
HC84200054	CULTURE DECUBITUS	$403.00
HC84200229	CULTURE NASAL	$403.00
HC84200633	CULTURE RESPIRATORY	$403.00
HC84200187	CULTURE SCREEN	$403.00
HC84200104	CULTURE THROAT	$403.00
HC84201029	CULTURE WHIRLPOOL	$403.00
HC84200575	M: CULTURE MISC	$403.00
HC12200101	IVAD IRRIGATION	$403.00
HC62204847	NEEDLE ASPIRATION                 H	$403.00
HC62206628	SOLUTION BSS PLUS 500ML	$403.00
HC62210398	GUIDE ROD                         H	$403.00
HC62215645	SUTURE                            P	$403.00
0168-0081-15	"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOPICAL CREAM"	$402.93
49702-228-13	DOLUTEGRAVIR 50 MG ORAL TAB	$402.28
HC82201328	"HISTCHM ST GOM TRICHRM,FR TS"	$402.00
HC82201450	"PAS W/DIGESTON,FROZ TIS BLK"	$402.00
HC51000115	URO-EMG	$401.00
HC84200641	CULTURE WOUND	$401.00
HC25004920	APPLY CAST HAND & LWR FOREARM (GAUNTLET) LT	$400.00
HC25004938	APPLY CAST HAND & LWR FOREARM (GAUNTLET) RT	$400.00
HC81100091	ACETAMINOPHEN/TYLENOL; 1-2	$400.00
HC81701500	PROTEIN ELECT OTHER FLUIDS	$400.00
HC32001372	OT-THER PROC GRP 60MIN/M	$400.00
HC32001315	OT-THER PROC GRP 60MIN/MC	$400.00
HC31000987	PT-THER EXER 30MIN/CW	$400.00
HC62210786	DEVICE ELECTROSURGICAL CUT-CAUTERY H	$400.00
HC81100901	AMIKACIN  SUBS	$399.00
HC81100893	AMIKACIN INIT	$399.00
HC84201649	DNA/RNA ACINETOBACTER CALCOACETICUS-BAUMANNII CMPLX(PNL)	$399.00
HC84201656	DNA/RNA ENTEROBACTER CLOACAE CMPLX (PNL)	$399.00
HC84201664	DNA/RNA KLEBSIELLA AEROGENES (PNL)	$399.00
HC84201672	DNA/RNA KLEBSIELLA OXYTOCA (PNL)	$399.00
HC84201680	DNA/RNA KLEBSIELLA PNEUMONIAE GROUP (PNL)	$399.00
HC84201698	DNA/RNA MORAXELLA CATARRHALIS (PNL)	$399.00
HC84201706	DNA/RNA PROTEUS SPP (PNL)	$399.00
HC84201714	DNA/RNA PSEUDOMONAS AERUGINOSA (PNL)	$399.00
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HC83500421	CHROMO AMNIOTIC FLD CT 17-GZ	$399.00
0270-0445-40	DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN	$398.88
49884-231-83	PRAZIQUANTEL 600 MG ORAL TAB	$398.58
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HC84200971	TRICHROME STAIN	$398.00
HC31000763	PT-WORK HARDENING ADD 1HR/CMW+	$398.00
HC32000705	OT-WORK HARDENING ADD 1HR/CMW+	$398.00
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63323-733-11	MESNA 100 MG/ML IV SOLN	$397.80
63323-733-10	MESNA 100 MG/ML IV SOLN	$397.80
63739-357-33	VALGANCICLOVIR 450 MG ORAL TAB	$397.50
0075-0622-80	ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG	$397.39
HC81101412	HAPTOGLOBIN/NEPHELOMTRY	$397.00
HC83000323	FREEZING BLOOD EA UNIT	$397.00
HC84201466	DNA/RNA HERPES SIMPLEX I PCR(PNL)	$397.00
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HC51060705	PT-EVAL HIGH COMPLEXITY 45MF2F 60MIN	$397.00
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HC22000079	OST EST PT EVAL LVL 3-(15MIN)	$397.00
HC32000911	OT-THER EXER 30MIN/CW	$397.00
HC62201744	CHEST DRAINAGE (PLEUREVAC)	$397.00
HC62204185	KIT PTCA CUSTOM NAMIC	$397.00
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HC62210968	PUMP CENTRIFUGAL	$397.00
HC62211537	SCREW EXTRACTOR BOLT	$397.00
0703-4239-01	CARBOPLATIN 10 MG/ML IV SOLN	$396.36
HC84600188	CYTP DX EVAL FNA 1ST EVAL EA SITE	$396.00
HC82200635	TISSUE FRZN SECTION REDUCED	$396.00
54288-111-01	HYOSCYAMINE SULFATE 0.5 MG/ML INJ SOLN	$396.00
54288-111-05	HYOSCYAMINE SULFATE 0.5 MG/ML INJ SOLN	$396.00
0703-3217-01	PACLITAXEL 6 MG/ML IV CONC	$396.00
HC36001089	ASPIRATION W/ CATHETER; NASOTRACHEAL	$395.00
HC81700205	TSH	$395.00
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0168-0162-30	CLOBETASOL 0.05 % TOPICAL OINT	$394.20
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HC84200591	CULTURE SPUTUM QUANT	$394.00
HC51002582	ANALYZ COMPLX NRSTM SPNL CD/PERIPH W/PROG	$394.00
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0407-2223-16	IODIXANOL 320 MG IODINE/ML IV SOLN	$393.60
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HC62208582	VASCULAR PUNCH	$393.00
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HC81701542	N-GONORRHEA BY DNA AMP PROBE	$392.00
HC84201615	N-GONORRHEA BY DNA AMP PROBE	$392.00
HC81701237	"HPV HI RISK(16,18,31,33,35,39,45,51,52,56,58,59,68)"	$392.00
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HC51002525	US GUIDE PLCMNT NEEDLE /BX	$391.00
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HC42000448	PROGRAM EVAL PACEMAKER SINGLE LEAD/LEADLESS	$391.00
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HC62202312	SET AUTOTRANSFUSE                 Q	$390.00
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HC62224753	CATH EP DX <20 ELECTRODES   RPRSD H	$390.00
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HC62227236	CATH IV MIDLINE                   H	$390.00
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HC62802426	INTRODUCER/SHEATH                 H	$390.00
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HC65800112	PALLADIUM-103 STRANDED PER SOURCE	$390.00
HC62300454	DRIVER NEEDLE ROBOTIC             I	$390.00
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HC62200613	BLADE TREPHINE                    F	$390.00
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HC62200894	BURR                              F	$390.00
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HC62212840	STYLET CARDIAC                    G	$390.00
HC62213384	REAMER                            I	$390.00
HC62215330	BLADE SAW                         T	$390.00
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HC62216106	STENT REMOVER                     C	$390.00
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HC62220777	CANNULA ARTHROSCOPIC              H	$390.00
HC62221312	RESERVOIR CELL SAVER              H	$390.00
HC62221460	TROCAR ENDO                       H	$390.00
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HC62222609	ELECTRODE ROLLER BALL             H	$390.00
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HC62224001	TUBING SUCTN/IRRIG NEURO/SPINAL	$390.00
HC62224019	SCISSORS ENDOSCOPIC               H	$390.00
HC62224373	CIRCUIT VENT SHORT WIRE HEATED	$390.00
HC62224415	DERMABOND                         H	$390.00
HC62224811	CATH BLOCKER BRONCH/TRACH	$390.00
HC62224852	NEEDLE PROBE VASCULAR SMART	$390.00
HC62225818	GUIDE DRILL                       H	$390.00
HC62225933	GUIDE VAGINAL BRACHYTHERAPY	$390.00
HC62225958	TAP SURGICAL                      H	$390.00
HC62226063	TAP SURGICAL                     H	$390.00
HC62226162	CARTRIDGE MECHNCL WOUND NEG PRESSURE	$390.00
HC62227335	GUIDE PIN ORTHO                   H	$390.00
HC62227533	SPHINCTEROTOME                    C	$390.00
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HC62300124	GRASPER ROBOTIC                   C	$390.00
HC62300231	HOOK VALVE ROBOTIC	$390.00
HC62300272	FORCEP ROBOTIC                    H	$390.00
HC62802608	WIRE PACING TEMP                  T	$390.00
HC62803606	HEMOSTATIC GEL/GELFOAM/PAD        I	$390.00
HC62805981	FIBRIN SEALANT                    G	$390.00
0143-9384-01	FOSAPREPITANT 150 MG IV SOLR	$390.00
55390-123-01	RIFAMPIN 600 MG IV SOLR	$390.00
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0703-4248-91	CARBOPLATIN 10 MG/ML IV SOLN	$389.88
59676-566-30	DARUNAVIR ETHANOLATE 800 MG ORAL TAB	$389.71
HC82200510	TISSUE EXAM - LAB REPORT - OP	$389.00
HC39000922	PSYCH TX FOR CRISIS EA ADD 30MINS+/COMM	$389.00
HC62202734	ELECTRODE RESECTOSCOPE            E	$389.00
49702-212-48	ZIDOVUDINE 10 MG/ML ORAL SYRP	$388.80
HC34000158	HEARING AID EXAM MONAURAL	$388.00
HC12400156	CHEMO ADMIN INTRA ARTERIAL INF EA ADDL HR+	$388.00
HC83001156	PLASMA FRZN COLL 8-24 HRS EA UNIT	$388.00
0270-1411-11	IOPAMIDOL 41 % INTRATHECAL SOLN	$387.72
16714-878-01	LIDOCAINE 5 % TOPICAL OINT	$387.43
HC81700148	PROGESTERONE	$387.00
HC83000190	X-MATCH INCUB TECH EA UNIT	$387.00
69238-1746-8	PILOCARPINE HCL 2 % OPHT DROP	$387.00
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0713-0655-40	TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE	$386.82
64980-320-05	TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE	$386.82
0009-0018-20	"METHYLPREDNISOLONE SOD SUC(PF) 1,000 MG/8 ML IV SOLR"	$386.46
HC84200914	"C DIFFICILE AG, EIA"	$386.00
HC11500071	NEW PT LVL3-EXPANDED	$386.00
54838-502-80	HYDROXYZINE HCL 10 MG/5 ML ORAL SOLN	$385.97
63323-723-01	REMIFENTANIL 1 MG IV SOLR	$385.86
63323-723-03	REMIFENTANIL 1 MG IV SOLR	$385.86
61314-665-05	APRACLONIDINE 0.5 % OPHT DROP	$385.50
HC31001548	PT-INDIV PROC W/COMPUT EQUIP/W	$385.00
HC62200506	DEVICE BIOPSY	$385.00
HC62200654	BODY ALIGNER	$385.00
HC62204540	LOOPS CYSTO	$385.00
0955-1016-01	ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLN	$384.89
HC25000779	"AVULSION OF NAIL, EA ADDL'"	$384.00
HC81701195	TSH SUBSEQUENT	$384.00
HC39000948	PSY TX W/PATIENT 30MIN W/E&M+	$384.00
HC51060770	OT-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR	$384.00
HC51070662	PSY-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR	$384.00
HC51060796	PT-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR	$384.00
HC62206941	SUCTION TRAP MICRODEBRIDER	$384.00
HC62210463	SUTURE ACCESSORY	$384.00
0143-9525-01	DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN	$384.00
60793-131-10	PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML IM SYRG	$383.05
HC51001634	X-RAY SPINE LUMBOSACRAL; 2 OR 3VWS	$383.00
0713-0640-15	HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM	$382.05
HC42000489	RHYTHM STRIP 1-3 LEADS	$382.00
HC14500086	PREGNANCY DIAB MGT 2HR	$382.00
HC39001102	PHP OT SKILLS PER SESSION 45 M/>	$382.00
HC11200043	OBSERVATION PER HOUR - TELEMETRY	$382.00
HC78600046	PACU II 15MIN (SUBSEQUENT)	$382.00
63323-122-50	METHOTREXATE SODIUM (PF) 1 GRAM INJ SOLR	$381.60
58160-821-01	HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP	$381.32
58160-821-11	HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP	$381.32
58160-821-52	HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG	$381.32
58160-821-43	HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG	$381.32
HC81101164	METHEMOBLOBIN QT	$381.00
HC39001011	PSYCH NARCOSYNTHESIS	$381.00
HC25006032	EST PT LVL4-DETAILED	$381.00
HC51061521	CLOSED TREATMENT TIBIAL FRACTURE PROXIMAL W/O MANIP	$380.00
HC81500241	FACTOR 8 INHIB/TITR	$380.00
HC89500532	CALL BACK FEE HRLY-SB	$380.00
HC36800589	RT RESP THER GRP 60 MIN/MW	$380.00
HC51061547	CLOSED TREATMENT ULNAR SHAFT FRACTURE W/O MANIP	$379.00
HC51001295	"CLOSED TX FINGER SHAFT FX,EA,NO MAN"	$379.00
HC11500501	LACTATION E&M COMPRHNS EST'D L:V	$379.00
HC62228861	DEVICE SUTURE CAPTURE (VALVE)	$379.00
HC81700098	ESTRADIOL	$378.00
HC81700114	IMMUNOGLOBULIN IGE	$378.00
HC51000222	IV INFUSION THERAPY 1ST HOUR	$378.00
63323-415-10	NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH)	$378.00
49452-4050-1	LIDOCAINE HCL (BULK) 100 % MISC POWD	$378.00
HC81500795	HEMOGLOBIN -HPLC	$377.00
HC62228903	COLLAR CERV SEMI-RIDG OCC/MAND	$377.00
HC62207048	SUTURE LAURUS                     O	$377.00
HC62209572	TRACTION CERVICAL UNIT	$377.00
HC51001659	X-RAY SPINE LUMBOSCARAL; BEND ONLY 2 OR 3VWS	$376.00
HC32000937	OT-NEUROMUSC RE-ED 30MIN/CW	$376.00
HC62214598	PROBE CATH V-PACING TRANSLUM	$376.00
99999-035-38	VORINOSTAT 50 MG/ML ORAL LIQUID (COMPOUND)	$375.24
HC51062636	FITTING DIAPHRAGM/CERVICAL CAP W/INSTRUCT	$375.00
HC81100984	NORPACE/DISOPYRAM	$375.00
HC84201003	SEMEN ANALYSIS COMPLETE	$375.00
HC34000224	TYMPANOMETRY & REFLEX THRESH	$375.00
6025800316	"POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN"	$374.62
5865731216	"POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN"	$374.62
57664-683-31	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$374.40
63323-424-10	FLUMAZENIL 0.1 MG/ML IV SOLN CODE NEO	$374.40
0703-9060-33	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$374.40
67684-100-14	IOXILAN (OXILAN) 350 MG/ML	$374.40
67684-100-04	IOXILAN (OXILAN) 300 MG/ML	$374.40
68462-530-35	CLOBETASOL 0.05 % TOPICAL OINT	$374.04
HC44002160	TEETH SINGLE VIEW	$374.00
HC81100380	ALCOHOL; 1-2	$374.00
HC84600535	CYTOLOGY CONC TECHNIQUE *OP	$374.00
HC84600048	CYTOLOGY CONCENTRATE TECHNIQUE	$374.00
HC34000315	COCHLEAR IMPLT DX ANALYS W/PROGRAM <7	$374.00
HC34000323	COCHLEAR IMPLT DX ANALYS W/REPROGRAM <7 SUBSEQ	$374.00
HC34000331	COCHLEAR IMPLT DX ANALYS W/PROGRAM >7	$374.00
HC34000349	COCHLEAR IMPLT DX ANALYS W/REPROGRAM >7 SUBSEQ	$374.00
HC34000356	EVAL AUD FUNC SX IMPLANT 1ST HR	$374.00
HC34000364	EVAL AUD FUNC SX IMPLANT ADD 15MIN	$374.00
HC39000252	PSY TM CONF W/PT&/FAM 60MIN	$374.00
HC62228184	ORTH HFO FLEX GLOVE W/ELSTC FNGR CNTRL PREFAB OTS	$374.00
HC62203781	KIT CHOLANGIOGRAM	$374.00
HC62210976	COIL FLOW MID-CAB SHUNTS	$374.00
99999-041-46	FLUDEOXYGLUCOSE F-18 20 MCI TO 200 MCI/ML IV SOLN	$373.75
99988-000-39	"SODIUM FLUORIDE F-18 10-200 MCI/ML 370-7,400MBQ/ML IV SOLN"	$373.75
51672-1258-1	CLOBETASOL 0.05 % TOPICAL CREAM	$373.59
27437-050-57	METHYLERGONOVINE 0.2 MG ORAL TAB	$373.50
50419-325-11	GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN	$373.50
50419-325-01	GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN	$373.50
0641-0477-25	PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN	$373.42
0641-0477-21	PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN	$373.42
27437-050-56	METHYLERGONOVINE 0.2 MG ORAL TAB	$373.28
HC81101214	PHOSPHATIDYL GLYCEROL	$373.00
HC81701468	NK CELL TOTAL COUNT	$373.00
HC84600303	CYTO CONC TECHNIQUE DIST SRV	$373.00
HC34000265	ACOUSTIC IMMITANCE TESTING	$373.00
HC12200044	IV INF THER CONCURRENT/ ENCNTR	$373.00
HC62206412	SET TUBING VGFI	$373.00
HC25005125	"CONTROL NASAL HEMORRHAGE,ANTERIOR,SIMPLE ANY TX"	$372.00
HC25005133	"CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLEX ANY TX"	$372.00
HC62212576	NEEDLE BIOPSY EBUS	$372.00
50383-961-34	OXYCODONE 5 MG/5 ML ORAL SOLN	$372.00
0378-0873-16	CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK	$371.34
0378-0873-99	CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK	$371.34
0591-3510-04	CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK	$371.34
0591-3510-54	CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK	$371.34
HC81700247	HCG QUANT	$371.00
HC81500217	"LEUKEMIA CELLS, SPINAL FL"	$371.00
HC25005976	NEW PT LVL3-EXPANDED	$371.00
HC62200936	CABLE INTRAUTERINE PRESSURE	$371.00
HC62203013	ENDOCURIE RIBBON LONG	$371.00
HC62206065	SENSOR IN-LINE	$371.00
HC81500555	HEPARIN ASSAY	$370.00
HC33000977	ST EVAL SOUND PRODUCTION 45MIN/M	$370.00
HC51001451	REFILL&MAINT'N IMPLANT PUMP	$370.00
HC28000115	CR NEW PT EVAL LVL3-(30MIN)	$370.00
HC38000170	USE OF CAST ROOM	$370.00
HC51061836	X-RAY SPINE ENTIRE SKULL-SACRUM 4-5 VIEWS	$369.00
HC83505651	KRAS MUT ANALYSIS EXON 4-NG	$369.00
HC81101818	PROCALCITONIN	$369.00
HC83000281	COMBS  INDIR TITER EA ANTISER	$369.00
HC62217377	STOPCOCK LUER LOCK ENDOSCOPE	$369.00
49502-900-01	SELEGILINE 6 MG/24 HR TRANSDERMAL PT24	$368.93
99988-000-25	NM TC-99M (DTPA) PENTETATE UP TO 25 MCI (RENAL)	$368.55
99988-001-25	NM TC-99M (DTPA) PENTETATE 26-40 MCI (AEROSOL)	$368.55
61958-0701-1	EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB	$368.45
HC89014161	LYSOSOMAL SCREEN-CA	$368.00
HC11200041	OBSERVATION PER HOUR - OB	$368.00
67457-198-00	REMIFENTANIL 1 MG IV SOLR	$367.75
67457-198-03	REMIFENTANIL 1 MG IV SOLR	$367.75
67457-912-00	REMIFENTANIL 1 MG IV SOLR	$367.75
67457-912-01	REMIFENTANIL 1 MG IV SOLR	$367.75
HC81100927	LIDOCAINE	$367.00
HC81500480	ACTIVATED PROT C RESISTANCE	$367.00
HC82200429	ANATOMIC CONSULT:SLIDE REVIEW	$367.00
HC82202623	ANATOMIC CONSULT:SLIDE REVW*OP	$367.00
HC39000724	PSY PREPARE REPORT	$367.00
HC39000179	PSY PREPARE REPORT 1 HOUR	$367.00
HC77400240	MOD CS DIFF PHYS/QHP <5 YR INIT'L 15MIN	$367.00
HC31001431	PT-TEST/MEASUREMENT 1ST30MIN/C	$367.00
59762-4537-1	MEDROXYPROGESTERONE 150 MG/ML IM SUSP	$366.96
65649-411-24	HYDROCORTISONE ACETATE 25 MG RECTAL SUPP	$366.27
39328-044-16	CYPROHEPTADINE 2 MG/5 ML ORAL SYRP	$366.10
HC81500183	PLATELET AGG EA AGENT	$366.00
HC83000919	BLOOD TYPE SERO; PER AG/ANTIGEN DONOR	$366.00
HC83000091	RBC ANTIGENS OTHER THAN ABO/RH	$366.00
HC83000331	THAWING BLOOD EA UNIT	$366.00
HC83000380	RBC PRETREAT W/ENZYMES	$366.00
HC83504050	TISSUE EXAM G&M LEVEL 5-CS	$365.00
HC13500038	GENETIC CNSL RISK REDCTN 45MIN	$365.00
HC29000601	AWV ANNUAL WELLNESS PLAN; INITIAL	$365.00
HC32001026	OT-ORTHOTIC FIT/TRNG 30MIN/CW	$365.00
HC32001380	OT-TRTMNT(ANY) INIT'L 30MIN	$365.00
0270-1111-16	GADOTERIDOL 279.3 MG/ML IV SYRG	$364.56
0013-2650-02	SOMATROPIN 0.4 MG/0.25 ML SUBCUTANEOUS SYRG	$364.34
0013-2650-01	SOMATROPIN 0.4 MG/0.25 ML SUBCUTANEOUS SYRG	$364.34
HC51010767	ENDOSCOPY NASAL DX UNI/BILAT	$364.00
HC25005463	REMOVE FB EXTRNL EYE; CONJUNCT SUPERF LT	$364.00
HC25005471	REMOVE FB EXTRNL EYE; CONJUNCT SUPERF RT	$364.00
HC51061786	X-RAY SPINE THORACIC; 3 VIEWS	$364.00
HC51061711	ECHO FETAL DOPPLER COMPLETE	$364.00
HC51070464	PSYCH HYPNOTHERAPY	$364.00
HC51061448	ECG EXT TELEM MCT>24HRS-30DAYS TECH ATTEND TIME;CONNECT&TRANS	$364.00
HC51070829	"TEST STRESS PULMON INCL HR,POX,O2 TIT (6MIN WALK)"	$364.00
HC51062594	EMG FACIAL BILATERAL	$364.00
HC22000020	OST NEW PT EVAL LVL3-(30MIN)	$364.00
HC51062495	"PRINCIPAL CARE MGMT HI RISK D; 1ST 30 MIN, PER MONTH"	$364.00
HC62214267	CATH URETERAL                     S	$364.00
HC31000920	PT-ELEC STIM/TENS ATTD30MIN/CW	$364.00
HC31001159	PT-FUNC ACTIVITY 30MIN/CW	$364.00
HC32001067	OT-FUNC ACTIVITY 30MIN/CW	$364.00
HC32001232	OT-GAIT TRAINING 30MIN/CW	$364.00
HC51060119	ST-LANGUAGE EVALUATION/C	$364.00
HC51060127	ST-SPEECH EVALUATION/C	$364.00
HC62200589	BLADE NEURO                       H	$364.00
HC62203039	ET BAG COLOSTOMY	$364.00
HC62215322	BLADE SAW                         S	$364.00
HC62216569	PIN/WIRE FIXATION TEMPORARY       S	$364.00
99999-006-94	PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN	$363.08
HC81100919	ETHOSUXIMIDE	$363.00
HC51061182	ST-ENDOSCOP EVAL SWALLOW/LARYN	$363.00
HC11500774	AM/PACU EVAL MINOR-II	$363.00
6954323460	"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROP"	$362.88
0093-9614-13	SILVER NITRATE 0.5 % TOPICAL SOLN	$362.88
HC25005075	STRAPPING; ANKLE AND/OR FOOT LT	$362.00
HC25005083	STRAPPING; ANKLE AND/OR FOOT RT	$362.00
HC39000310	PSYCH GRP TX(NOT MULTI FAMILY)90MIN	$362.00
HC13500061	GENETIC COUNSELING EA 30MIN/P	$362.00
0527-1859-43	SUMATRIPTAN 20 MG/ACTUATION NASL SPRY	$361.82
0049-3190-01	VORICONAZOLE 200 MG IV SOLR	$361.80
0078-0109-61	CYCLOSPORINE 250 MG/5 ML IV SOLN	$361.20
0078-0109-01	CYCLOSPORINE 250 MG/5 ML IV SOLN	$361.14
HC51010338	ANAL' IMPLANTED PUMP NO PROG/REFILL	$361.00
HC32001588	OT-DRIVING TRAINING 60MIN/W	$361.00
HC62214572	PROBE ELECTROSURG LAPARASCOPIC DISP	$361.00
50474-002-63	LEVETIRACETAM 500 MG/5 ML IV SOLN	$360.87
HC83505826	EGFR GENE COM VARIANTS-NG	$360.00
HC83504019	CHROM ANAL 45 CELLS-GZ	$360.00
HC51070001	PSYCH DX EVAL EXAM (NO MED SVCS)	$360.00
HC32000499	OT-SWALLOWING THERAPY  15 MIN	$360.00
HC33000381	ST-SWALLOWING THERAPY  15 MIN	$360.00
0143-9729-05	BENZTROPINE 1 MG/ML INJ SOLN	$360.00
0143-9729-01	BENZTROPINE 1 MG/ML INJ SOLN	$360.00
25021-305-20	CHLOROTHIAZIDE SODIUM 500 MG IV SOLR	$360.00
0781-3317-80	OXALIPLATIN 100 MG/20 ML IV SOLN	$360.00
65219-190-30	VORICONAZOLE 200 MG IV SOLR	$360.00
68462-746-35	ACYCLOVIR 5 % TOPICAL OINT	$360.00
65162-835-96	ACYCLOVIR 5 % TOPICAL OINT	$360.00
60432-126-16	MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP	$360.00
99999-034-84	CH - PHARMACY COMP. FEE	$360.00
25021-185-11	GANCICLOVIR SODIUM 50 MG/ML IV SOLN	$360.00
25021-185-10	GANCICLOVIR SODIUM 50 MG/ML IV SOLN	$360.00
99999-001-98	CHARGE-NEONATAL LVIV <4 ADDS	$360.00
71225-133-01	DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN	$360.00
24208-344-25	FLUNISOLIDE 25 MCG (0.025 %) NASL SPRY	$359.70
60432-129-16	CARBAMAZEPINE 100 MG/5 ML ORAL SUSP	$359.10
HC51001642	X-RAY SPINE LUMBOSACRAL; MIN 4VWS	$359.00
HC11500832	PEDS ESTAB PT ASSESS MOD(15')	$359.00
HC32001125	OT-WHEELCHAIR MGT 30MIN/C	$359.00
HC81500175	PLATELET AGG EPINEPHRINE	$358.00
HC12200168	INF CNTR-NEW PT EVAL MODERATE	$358.00
HC62806054	CATH DIALYSIS SHORT-TERM          F	$358.00
HC62212709	GUIDEWIRE                         F	$358.00
HC62802582	WIRE INTERVENTIONAL	$358.00
HC65800013	PALLADIUM-103 NONSTRND PER SOURCE	$358.00
HC62201066	CANNULA RETROPLEGIA	$358.00
HC62203401	FORCEP BIOPSY                     F	$358.00
HC62204904	NEEDLE DOPPLER	$358.00
HC62210190	FORCEP BIOPSY DISP/TRACKING       E	$358.00
HC62210919	KIT CARDIOPLEGIA CANNULA	$358.00
HC62214382	STAPLE CARTRG/RELOAD LIN CUT      N	$358.00
HC62216379	NEEDLE BONE MARROW                D	$358.00
HC62220801	SUCTION DEVICE ENDOSCOPIC BIOVAC	$358.00
HC62226527	COVER/SLEEVE PROBE	$358.00
HC62227517	"KIT COLON W-SEAL ,HYDRA, ORCA VALVE"	$358.00
HC62228598	DEVICE CLOSURE SKIN(ZIPLINE)	$358.00
HC62805791	HEMOSTATIC GEL/GELFOAM/PAD         H	$358.00
0037-9001-05	HYOSCYAMINE SULFATE 0.5 MG/ML INJ SOLN	$357.68
0703-5051-03	DESMOPRESSIN 4 MCG/ML INJ SOLN	$357.12
0703-5051-01	DESMOPRESSIN 4 MCG/ML INJ SOLN	$357.12
HC11200143	OBSERVATION PER HOUR - ED	$357.00
HC31001175	PT-ADL 30MIN/CW	$357.00
HC84200161	MIC SENSITIVITY	$356.00
99999-035-87	CHARGE-DEL NIDO CARDIOPLEGIC SOLUTION 1059 ML	$355.82
HC51003218	FIT&INSERT PESSARY/INTRAVAG SPPRT DEV	$355.00
HC62209671	CATHETER IMPEDANCE PH	$355.00
HC62211719	DRESSING HYDROGEL WND FILLER LG	$355.00
61703-339-56	CARBOPLATIN 10 MG/ML IV SOLN	$354.96
6025800216	"POT,SODIUM CITRATE-CITRIC ACID 550-500-334 MG/5 ML ORAL SOLN"	$354.75
HC51010288	INJ(S);SINGLE TENDON/SHEATH LT	$354.00
HC51010270	INJ(S);SINGLE TENDON/SHEATH RT	$354.00
HC81500100	D-DIMER QT ULTRA-SENS OR STD	$354.00
HC83000349	FREEZING & THAW BLD EA UNIT	$354.00
HC34000034	AUDIO THRESHOLD W/RECOG	$354.00
HC12200226	INF CNTR-ESTBLD PT EVAL LOWMOD	$354.00
HC62219993	FASTENERS/ANCHORS TUBE GI-SET OF 3	$354.00
HC77400083	BEDSIDE/OTHER ANESTH' ADD'L 15MIN	$354.00
0591-2927-54	LEVALBUTEROL TARTRATE 45 MCG/ACTUATION INHALATION HFAA	$353.79
99999-044-39	LORAZEPAM 100 MG/100 ML DRIP (OCM)	$353.40
HC84200724	AFB ID BY PROBE	$353.00
HC77400257	MOD CS DIFF PHYS/QHP 5/>YR INIT'L 15MIN	$353.00
HC62228960	ORTHOSIS BOOT NON-PNEUMATIC	$353.00
69918-899-10	DESMOPRESSIN 4 MCG/ML INJ SOLN	$352.76
69918-899-01	DESMOPRESSIN 4 MCG/ML INJ SOLN	$352.76
55566-5030-1	DESMOPRESSIN 4 MCG/ML INJ SOLN	$352.76
0187-1704-05	PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB	$352.56
HC83504076	IF STUDY INDIRECT 1ST STAIN-CS	$352.34
HC51002541	US ABDOMEN	$352.00
HC81700155	PROLACTIN	$352.00
HC81701450	B CELL TOTAL COUNT	$352.00
HC62202122	CURRETTE VACCUUM SUCTION	$352.00
HC62209762	COMPARTM'L PRESS' MSRMT SUPPLY	$352.00
HC81500530	KLEIHAUER-BETKE	$351.00
HC35000223	REC' THER' TX 1-30 MIN	$351.00
HC11500550	LACTATION E&M COMPRHNS NEW:V	$351.00
HC31001621	PT-WHEELCHAIR MGT 30MIN/C	$351.00
HC62208897	CABLE THRESHOLD	$351.00
HC62215637	SUTURE                            N	$351.00
67457-584-06	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$350.99
67457-584-00	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$350.99
0395-2255-94	BALSAM PERU (BULK) MISC LIQD	$350.53
HC89022685	HLA CLASS I TYPING LOW RES COMPLETE-U9	$350.00
HC89022701	HLA CLASS I TYPING HIGH RES EACH LOCUS-U9	$350.00
HC83500199	"CHROMO ANALYSIS, TISSUE -GZ"	$350.00
HC28000065	CR EST PT EVAL LVL3-(15MIN)	$350.00
HC29000700	EXAM CERVICAL OR VAGINAL SCREENING	$350.00
HC32001083	OT-DEV COGNITIVE SKLL 30MIN/CW	$350.00
99988-000-29	NM TC-99M SULFUR COLLOID (FILTERED)	$349.80
HC81101453	CORTISOL(INITIAL)	$349.00
HC81101461	CORTISOL(SUBSEQ)	$349.00
HC81701211	"CORTISOL, PREDOSE"	$349.00
HC11500048	EST PT LVL5-COMPREHENSIVE	$349.00
HC29000528	EVAL COMP PREVNTV MED NEW 18-39	$349.00
HC29000536	EVAL COMP PREVNTV MED NEW 40-64	$349.00
0270-5164-13	GADOBENATE DIMEGLUMINE 529 MG/ML (0.1MMOL/0.2ML) IV SOLN	$348.96
63323-142-10	IFOSFAMIDE 1 GRAM IV SOLR	$348.30
55150-232-10	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$348.00
55150-232-00	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$348.00
HC62801493	NEEDLE BRACHYTHERAPY TANDEM CLICK	$348.00
HC31001456	PT-PROC+MODALITY.COMBO 30MIN/C	$348.00
HC62200753	BOWL CEMENT MIXING	$348.00
0003-2570-16	AZTREONAM 2 G INJ SOLR (MCH)	$348.00
0264-4500-05	PARENTERAL AMINO ACID 15% NO.6 15 % IV SOLP	$348.00
17478-546-05	GRANISETRON HCL 1 MG/ML IV SOLN	$348.00
0009-5137-01	LINEZOLID IN DEXTROSE 5% 200 MG/100 ML IV PGBK	$347.40
0168-0163-60	CLOBETASOL 0.05 % TOPICAL CREAM	$347.04
HC51001584	APPLY SPLINT SHORT LEG	$347.00
HC84200682	CULTURE MYCOPLASMA ANY SOURCE	$347.00
HC81701997	"HIV-1 AG W/ HIV-1 & HIV-2 ABS, SINGLE RESULT"	$347.00
HC42000562	WCH NEW PT LVL3-EXPANDED	$347.00
0517-2340-10	IRON SUCROSE 100 MG IRON/5 ML IV SOLN	$346.50
0517-2340-01	IRON SUCROSE 100 MG IRON/5 ML IV SOLN	$346.50
0517-2340-25	IRON SUCROSE 100 MG IRON/5 ML IV SOLN	$346.50
62542-301-04	HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12	$346.21
HC38420048	LVAD/RVAD SERVICE/HR	$346.00
HC32001216	OT-SENSRY INTEGR TECH 30MIN/CW	$346.00
HC62209135	TRAY ARTHROGRAM(DISP)	$346.00
HC39001052	PSYCH THERAPY W/BIOFEEDBACK 30 MIN	$345.00
HC62207709	TUBE LAVAGE	$345.00
63323-474-10	HALOPERIDOL LACTATE 5 MG/ML INJ SOLN	$345.00
62756-351-44	OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN	$344.94
68982-643-01	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$344.40
99999-033-77	ALTEPLASE IN BSS (250 MCG/ML) OPHTHALMIC INJECTION	$344.38
HC51003796	EXCISE LESION <0.5CM TRNK/ARMS/LEGS	$344.00
HC33000282	ST-SPEECH THERAPY GRP 45MIN/MCW	$344.00
HC39001136	PSYCH GROUP THER (NOT FAM)45-50MIN	$344.00
HC25000274	LAC REPAIR TO 2.5 CM(SMALL)	$344.00
99999-007-88	"LYMPHOCYTE,ANTI-THYMO IMM GLOB 50000 MCG/ML INJ SOLN FOR TEST DOSE (MCH)"	$343.55
0703-3154-01	BLEOMYCIN 15 UNIT INJ SOLR	$343.20
HC82200924	TISSUE EX G&M LVL 2  DIST SVC	$343.00
HC82200387	TISSUE EXAM G&M LEVEL 2	$343.00
HC82202557	TISSUE EXAM G&M LEVEL 2 *OP	$343.00
HC82202730	TISSUE EXAM G&M LVL 2(TC ONLY)	$343.00
HC82200643	TISSUE EXAM LEVEL 2 ADD'L	$343.00
16714-696-01	FLUCONAZOLE 40 MG/ML ORAL SUSR	$342.30
0187-0730-30	BUPROPION HCL 150 MG ORAL TB24	$342.23
0173-0682-20	ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA	$342.14
HC51002533	US TRANSVAGINAL(NON OB)	$342.00
HC81100406	TROPONIN	$342.00
HC83000216	FFP THAWING EA UNIT	$342.00
HC31000730	PT-APPLY WHIRLPOOL MODALITY	$342.00
HC31000748	PT-APPLY WHIRLPOOL MODALITY	$342.00
HC32000671	OT-WHIRLPOOL-EXTREMITY/CMW	$342.00
HC11200094	OBSERVATION PER HOUR - PEDS ACUTE	$342.00
HC62225016	SPLINT NERVE RADIAL HAND-BASED	$342.00
HC62203278	SYSTEM COMPRESSION (FEMOSTOP)	$342.00
HC62217344	RFID CHANDELIER OPTHALMIC	$342.00
HC62220074	EXTRACTOR KATZ SURGICAL	$342.00
HC81700122	FSH	$341.00
HC84201151	INFLUENZA H1N1 BY PCR	$341.00
HC11500956	WM EXAM NEW PT EVAL MOD LVL3	$341.00
HC31001266	PT-ELEC STIM/TENS/MCW	$341.00
HC32001182	OT-ELEC STIM/TENS/MCW	$341.00
HC33000498	STP-ELEC STIM/TENS/MCW	$341.00
HC62225651	SET TUBING CATH COOL-TIP	$341.00
4167936513	MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL	$340.56
99999-044-32	"HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP"	$340.50
42794-010-08	FLUCYTOSINE 500 MG ORAL CAP	$340.00
HC25004953	STRAPPING; SHOULDER LT	$340.00
HC25004961	STRAPPING; SHOULDER RT	$340.00
HC83505677	NRAS MUT ANALYSIS EXON 4-NG	$340.00
HC89013924	RI ANTIBODY-AT	$340.00
HC34000059	TYMPANOMETRY IMPEDANCE	$340.00
HC83504316	PATHOLOGY CONSULT - WD	$340.00
HC31001571	PT-ELEC STIM/WOUND CARE/M	$340.00
HC32000978	OT-MANUAL THERAPY 30 MIN/CW	$340.00
HC51002962	DILATION URETHRAL FEMALE INITIAL	$339.00
HC81100950	PROCAINAMIDE	$339.00
HC81700163	PROTEIN ELECT FRACT AND QT	$339.00
HC82202276	CONSULT DURING SURG DIST SVC	$339.00
HC82200361	CONSULT DURING SURGERY	$339.00
HC82200692	CONSULT PATH SURGICAL GROSS	$339.00
HC62201355	CATH EPIDURAL	$339.00
27808-086-01	HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12	$338.79
59923-603-10	PAMIDRONATE 90 MG IV SOLR	$338.22
HC51061778	X-RAY SPINE THORACIC; 2 VIEWS	$338.00
HC51061828	X-RAY SPINE ENTIRE SKULL-SACRUM 2-3 VIEWS	$338.00
HC45201407	NM RADIOPHARM QUANTIFICATION MSRMNT SINGLE AREA+	$338.00
HC89014526	HLA DR MULT AG-U9	$338.00
HC51070399	PSYCH TX W/PATIENT 60MIN	$338.00
HC51070290	PSYCH TX FOR CRISIS 1ST 60MINS/COMM	$338.00
HC77400224	MOD CS SAME PHYS/QHP <5 YR INIT'L 15MIN	$338.00
HC62214259	CATH URETERAL                     R	$338.00
HC62228929	ORTHOSIS KNEE HINGE PREFAB	$338.00
HC62208533	BIT VERTEBROPLASTY	$338.00
HC62215314	BLADE SAW                         R	$338.00
HC62216551	PIN/WIRE FIXATION TEMPORARY       R	$338.00
HC62222427	INSERTER FUNNEL IMPLANT BREAST	$338.00
0037-0066-03	MESALAMINE WITH CLEANSING WIPE 4 GRAM/60 ML RECTAL ENKT	$337.78
0121-0670-16	ETHOSUXIMIDE 250 MG/5 ML ORAL SOLN	$337.72
HC82200726	INTRAOP CNSLT CYT PRP-DIST ADL	$337.00
HC82200742	"INTRAOP CNSLT CYTOPREP, ADL"	$337.00
HC51061174	ST-ENDOSCOPIC EVAL SWALLOW	$337.00
HC62204961	NEEDLE RETROBULBAR	$337.00
HC62207428	TRAY LUMBAR PUNCTURE	$337.00
69238-1535-2	CLOBAZAM 2.5 MG/ML ORAL SUSP	$336.24
HC51002616	CAUTERIZE W/CHEM; GRAN TISSUE	$336.00
HC51002509	US SCROTUM W/DOPPLER	$336.00
HC51002517	US TRANSRECTAL	$336.00
0409-7969-05	CARDIOPLEGIC SOLN 16 MEQ/L (= K+) PERF SOLN	$336.00
61314-126-10	KETOROLAC 0.5 % OPHT DROP	$336.00
55390-251-01	MITOMYCIN 5 MG IV SOLR	$336.00
16714-601-02	SERTRALINE 20 MG/ML ORAL CONC	$335.52
59762-0067-1	SERTRALINE 20 MG/ML ORAL CONC	$335.52
HC81100562	CREATININE CLEARANCE	$335.00
HC81101180	HOMOCYSTINE	$335.00
HC14500060	PREGNANCY DIAB MGT 1HR	$335.00
HC62202197	DEVICE CIRCULATORY ENHANCER	$335.00
HC62206834	STIMULATOR NERVE LOCATOR	$335.00
HC62222971	DILATOR/BOUGIE ESOPHAGEAL	$335.00
18657-117-02	"HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML INJ SOLN"	$334.80
18657-117-04	"HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML INJ SOLN"	$334.80
18657-117-01	"HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML INJ SOLN"	$334.80
HC62207576	VACUUM TREPHINE	$334.00
0065-0359-05	CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OPHT DROP	$333.90
50474-970-63	BRIVARACETAM 50 MG/5 ML IV SOLN	$333.90
50474-970-75	BRIVARACETAM 50 MG/5 ML IV SOLN	$333.90
16714-502-01	FLUOCINONIDE 0.05 % TOPICAL OINT	$333.45
HC51000073	INSRT BLADDER CATH-TEMP FOLEY	$333.00
HC51062602	EMG FACIAL UNILATL LT	$333.00
HC51062610	EMG FACIAL UNILATL RT	$333.00
HC39001144	PSYCH GROUP INTERACTIVE 45-50M	$333.00
0054-3556-63	METHADONE 10 MG/5 ML ORAL SOLN	$333.00
0121-1680-16	POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD	$332.05
HC89003545	ARYLSULFATASE A URINE-AU	$332.00
HC82201351	"HISTCHM ST ACID PTASE,FRO TS"	$332.00
HC82201369	"HISTCHM ST ACRIDINE OR,FR TS"	$332.00
HC82201377	"HISTCHM ST AZURE-II MB,FR TS"	$332.00
HC82201393	"HISTCHM ST MAD, FROZ TIS BLK"	$332.00
HC82201401	"HISTCHM ST MYPHSPHFRC1,FRO TS"	$332.00
HC82201419	"HISTCHM ST MYPHSPHFRC2,FRO TS"	$332.00
HC82201427	"HISTCHM ST NNSPC ESTERS,FR TS"	$332.00
HC82201278	"HISTOCHM STAIN,FROZ TIS BLK"	$332.00
HC82201443	"HISTOCHM STN OS-PPD,FROZ TIS"	$332.00
HC82201468	"OIL RED O STAIN,FROZ TIS BLK"	$332.00
HC62204193	KIT RADICAL PROSTATECTOMY	$332.00
HC62205588	HEMOSTATIC GEL/GELFOAM/PAD         G	$332.00
HC62206933	SUCTION IRRIGATOR	$332.00
55111-680-10	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$331.80
0781-3465-95	FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG	$331.80
70954-036-20	CLOTRIMAZOLE 1 % TOPICAL SOLN	$331.74
0270-0149-57	DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLN	$331.20
HC81500894	RETICULATED PLATELET ASSAY	$331.00
HC84200716	CULTURE MYCOBACTERIAL ID	$331.00
HC32001042	OT-PROSTHETIC TRNG 30MIN/CW	$331.00
0713-0664-31	FLUOCINONIDE-EMOLLIENT 0.05 % TOPICAL CREAM	$330.30
HC83000422	INJECTION IM (RHOGAM)	$330.00
HC11200131	OBSERVATION PER HOUR -PACU	$330.00
HC62209168	STAPLE STONE/TABLE	$330.00
47781-595-07	PACLITAXEL 6 MG/ML IV CONC	$330.00
60687-410-94	METHYLERGONOVINE 0.2 MG ORAL TAB	$330.00
60687-410-11	METHYLERGONOVINE 0.2 MG ORAL TAB	$330.00
63323-970-02	BENZTROPINE 1 MG/ML INJ SOLN	$330.00
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HC38000121	APPLY SPLINT FINGER STATIC	$329.00
0254-2045-02	POSACONAZOLE 100 MG ORAL TBEC	$328.94
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HC51060143	PT-EVAL MOD COMPLEXITY 30MF2F 45MIN	$328.00
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HC31001027	PT-GAIT TRAINING 30MIN/CW	$327.00
HC31001118	PT-ORTHOTIC FIT/TRNG 30MIN/CW	$327.00
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HC32000853	OT-ELEC STIM/TENS ATTD30MIN/CW	$327.00
HC32000879	OT-IONTOPHORESIS 30MIN/CW	$327.00
HC33001207	ST-DEV COGNITIVE SKILL 30MIN/CW	$327.00
61958-0501-1	ADEFOVIR 10 MG ORAL TAB	$326.05
HC81700239	T3 FREE	$326.00
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HC62802848	SET PEG 14-20 FR  CONMED          G	$325.00
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HC62806534	TUBE JEJUN STANDRD TRANSGAS       G	$325.00
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HC62211438	TUBE TRACH CUFFED ADJUSTABLE      G	$325.00
HC62226998	CATH PTA ANGIOPLS BALLOON NON-LSR C	$325.00
HC62800057	BALLOON HYSTEROSALPINGOGRAM	$325.00
HC62222559	CATH NEPHROSTOMY                  G	$325.00
HC62804562	CATH PICC PEDS                    G	$325.00
HC62213657	CATHETER PICC PEDS	$325.00
HC62806658	CATH BALLOON RETRIEVAL            D	$325.00
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HC62210539	ORTHOTIC WHFO NO JOINT RESTING    G	$325.00
HC31001001	PT-NEUROMUSC RE-ED 30MIN/CW	$325.00
HC62200522	BLADE INCISIONAL                  E	$325.00
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HC62200878	BURR                              E	$325.00
HC62201595	TROCAR ENDO                       G	$325.00
HC62201991	COOKS TRIPLE LUMEN	$325.00
HC62202544	HEMOSTATIC GEL/SURGICEL           G	$325.00
HC62202742	ELECTRODE ROLLER BALL             G	$325.00
HC62204037	KIT MANIFOLD	$325.00
HC62204383	KIT/TRAY BIOPSY                   G	$325.00
HC62206347	SET PERFUSION	$325.00
HC62206586	SNARE                             G	$325.00
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HC62209317	PROBE PH	$325.00
HC62211123	HOLDER SUTURE OCOTOBASE	$325.00
HC62212881	BLADE SHAVER ORTHO                E	$325.00
HC62213095	BLADE INCISIONAL ORTHO            E	$325.00
HC62213376	REAMER                            H	$325.00
HC62214499	RETRACTOR DISPOSABLE              E	$325.00
HC62215629	SUTURE                            M	$325.00
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HC62216981	NEEDLE TARGETING                  G	$325.00
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HC62218334	ENDO STAPLER                      E	$325.00
HC62218755	DRILL/DRILL BITS SINGLE USE       J	$325.00
HC62220686	KIT ACCESSORY                     D	$325.00
HC62220728	COUNTERSINK CANNULATED            E	$325.00
HC62221072	KIT CELL SAVER                    G	$325.00
HC62221171	KIT SUPRA PUBIC CATH              G	$325.00
HC62221304	RESERVOIR CELL SAVER              G	$325.00
HC62221510	TUBE INSUFFLATOR                  G	$325.00
HC62222039	CATHETER VENOGRAM BALLOON	$325.00
HC62222419	GUIDE ROD                         G	$325.00
HC62222898	PROBE LASER                       G	$325.00
HC62224050	VALVE ENDOSCOPIC                  G	$325.00
HC62224100	CUTTER LINEAR ENDO                G	$325.00
HC62224274	NEEDLE ENDOSCOPIC                 G	$325.00
HC62224464	KIT REPAIR LEAD PCMKR	$325.00
HC62225065	DEVICE LIGATOR                    B	$325.00
HC62225354	CATH ERCP (PUSHING)               B	$325.00
HC62225396	OVERTUBE LIGATNG HEMOSTATC ENDO	$325.00
HC62226303	NEEDLE SPINAL                     G	$325.00
HC62226337	PROBE SPINAL DISPOSABLE           A	$325.00
HC62226832	CATH CENTRAL VENOUS               G	$325.00
HC62227061	PROBE SINUS	$325.00
HC62227608	TAP SURGICAL                      G	$325.00
HC62800461	CATH SINGLE LUMEN	$325.00
HC62800537	CATH TRIPLE LUMEN	$325.00
HC62805338	CATH SWAN GANZ/THERMODILUTION     G	$325.00
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0338-0644-06	PARENTERAL AMINO ACID 10% NO.6 10 % IV SOLP	$324.00
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52565-009-50	LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN	$323.10
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HC81100430	ELECTROLYTE PANEL	$323.00
HC81700577	FERRITIN	$323.00
HC81500696	FACTOR XIII ASSAY	$323.00
HC81701799	T CELL ABSOLUTE CD4 COUNT	$323.00
HC83000224	SPLITTING BLD/BLD PROD EA UNIT	$323.00
HC84600212	CYTO PREP NON GYN S&I-DIST SVC	$323.00
HC84600162	CYTOLOGY PREP NON GYN S&I	$323.00
HC11500493	LACTATION E&M EXT'D EST'D L:IV	$323.00
HC39000617	PSYCH CASE CONF 60MIN	$323.00
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68682-170-30	PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB	$321.53
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HC51010254	ASP/INJ LARGE JOINT-RT	$321.00
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HC32001109	OT-ADL 30MIN/CW	$321.00
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59676-302-00	"EPOETIN ALFA 2,000 UNIT/ML INJ SOLN"	$320.76
64980-504-48	CYPROHEPTADINE 2 MG/5 ML ORAL SYRP	$320.69
3877926008	COMPOUND VEHICLE SUSP SF NO.18 ORAL SUSP	$320.69
HC89091342	FAM ADENOM POLYPOSIS DEL/DUP-AU	$320.00
HC31001902	LOCOMOTOR TRAINING	$320.00
HC62204995	NEEDLE SPECIALTY	$320.00
99999-001-95	LORAZEPAM 100MG IN D5W 100ML IV DRIP	$319.50
0641-6018-01	DOXAPRAM 20 MG/ML IV SOLN	$319.32
0641-6018-06	DOXAPRAM 20 MG/ML IV SOLN	$319.32
HC51000578	CHANGE GT TUBE W/O IMAGE/ENDO	$319.00
HC51061190	ST-LARYNGEAL FUNCTION STUDIES	$319.00
HC51060192	OT-EVAL MOD COMPLEXITY 30MF2F 45MIN	$319.00
HC31000946	PT-IONTOPHORESIS 30MIN/CW	$319.00
HC31001589	PT-CONTRAST BATH 30MIN/CW	$319.00
HC62208988	ROTABLATOR LUBRICANT	$319.00
HC62209648	CATH PASSER IDD THERAPY	$319.00
HC62211008	CANNULA AORTIC PEDS	$319.00
HC62221973	PIN CHECKPOINT KNEE ROBOTIC	$319.00
50383-042-24	PREDNISOLONE 15 MG/5 ML ORAL SOLN	$318.24
HC51070456	PSYCH NARCOSYNTHESIS	$318.00
13533-613-25	PLASMA PROTEIN FRACTION 5 % IV SOLP	$318.00
HC83505529	IP/IHC PER SPEC INITIAL AB STAIN -CS	$317.34
0944-2721-03	"HYALURONIDASE, HUMAN RECOMB. 400 UNIT/2.5 ML SUBCUTANEOUS SOLN"	$317.25
HC84200955	RESPIRATORY SYNCTAL VIRUS EIA	$317.00
HC84201359	RESPIRATORY SYNCTAL VIRUS EIA (POS)	$317.00
HC62228606	WOUND FILLER GEL(PLUROGEL)-1.75OZ	$317.00
HC32001430	OT-COMMTY WK/REINT ADD15MIN/CW	$317.00
43598-210-40	SILVER SULFADIAZINE 1 % TOPICAL CREAM	$316.80
24208-715-10	PREDNISOLONE SODIUM PHOSPHATE 1 % OPHT DROP	$316.26
HC89020036	TPMT GENETICS (3300)-PR	$316.00
HC12200291	APPLY ON-BODY INJECTOR FOR TIMED SQ INJ	$316.00
HC31001852	CAST ROOM USE	$316.00
HC62206594	SNARE DLP TOURNIKWIK	$316.00
0009-0746-30	MEDROXYPROGESTERONE 150 MG/ML IM SUSP	$315.78
0009-0746-35	MEDROXYPROGESTERONE 150 MG/ML IM SUSP	$315.78
HC21001029	REMOV IMPACTD EAR WAX(INSTRUMENT) LT	$315.00
HC21001037	REMOV IMPACTD EAR WAX(INSTRUMENT) RT	$315.00
HC81100869	MYOGLOBIN	$315.00
HC81500837	PLATELET AGG PLAVIX RESISTANCE	$315.00
HC84600204	CYTO SMEAR NON GYN S&I-DIS SVC	$315.00
HC84600154	CYTOLOGY SMEAR NON GYN S&I	$315.00
HC62808613	NEEDLE BRACHYTHERAPY METAL CLICK	$315.00
HC62808621	CATH/TUBE BRACHY CLICK FIT	$315.00
HC62200795	BRUSH BRONCHIAL	$315.00
HC62209382	BRUSH CYTOLOGY BRONCHIAL          G	$315.00
70860-454-41	DESMOPRESSIN 4 MCG/ML INJ SOLN	$315.00
70860-454-01	DESMOPRESSIN 4 MCG/ML INJ SOLN	$315.00
0069-4190-68	SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB	$314.90
0517-0720-01	"BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSP"	$314.46
HC51001998	REMOVE DRUG DELIVERY IMPLANT	$314.00
HC51001436	CLOSED TX BIG TOE FX	$314.00
HC81100729	SALICYLATES; 1-2	$314.00
HC89005227	HERPES VIRUS-6 DNA QUANT -FT	$314.00
HC81500001	CELL COUNT FLUID W/ DIFF	$314.00
HC25006024	EST PT LVL3-EXPANDED	$314.00
HC51060002	AHCP COORDINATE ACTIVITIES CASE	$314.00
HC51020253	NP COORDINATOR ACTIVITIES CASE	$314.00
HC51040038	RD COORDINATOR ACTIVITIES CASE	$314.00
HC51020063	RN COORDINATOR ACTIVITIES CASE	$314.00
HC51030039	SW COORDINATOR ACTIVITIES CASE	$314.00
HC51003820	I&D ABSCESS SIMPLE SNGL	$313.00
HC81700130	LH (LUTEINIZING HORMONE)	$313.00
HC83001172	CRYOPRECIPITATE EA UNIT	$313.00
HC83000075	CRYOPRECIPITATE EA UNIT	$313.00
HC83001016	CRYOPRECIPITATE EA UNIT -SB	$313.00
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HC62203831	KIT DIALYSIS	$313.00
HC62206339	SET NEEDLE INTRAOSEOUS	$313.00
HC77400117	ANESTHESIA MAC EACH ADD 15 MIN	$313.00
HC51040145	3D RENDER W/ INDEPNDNT WORKSTN	$312.00
HC51061729	ECHO FETAL DOPPLER F/U OR REPEAT	$312.00
HC81100653	LIPASE	$312.00
HC84600170	CYTOLOGY EXTENDED STUDY>5SLIDE	$312.00
HC84600550	FNA INTERPRETATION/REPORT *OP	$312.00
HC51070373	PSYCH TX W/PATIENT 45MIN	$312.00
HC51070837	TEST EXERC BRONCHOSPSM INCL SPIR & POX W/O ECG	$312.00
HC25001587	MOD CS DIFF PHYS/QHP 5/>YR INIT'L 15MIN	$312.00
HC42000638	WCH EST PT LVL5-COMPREHEN	$312.00
HC62214242	CATH URETERAL                     Q	$312.00
HC31001043	PT-MASSAGE 30MIN/CW	$312.00
HC31001068	PT-MANUAL THERAPY 30 MIN/CW	$312.00
HC32000895	OT-ULTRASOUND 30MIN/CW	$312.00
HC32000952	OT-MASSAGE 30MIN/CW	$312.00
HC62200597	BLADE OPHTHALM                    Q	$312.00
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HC62207865	TUBING IRRIGATION                 H	$312.00
HC62215306	BLADE SAW                         Q	$312.00
HC62215751	TEMPLATE ORTHO/ROD SPINAL         H	$312.00
HC62216544	PIN/WIRE FIXATION TEMPORARY       Q	$312.00
0019-1323-06	IOVERSOL 320 MG IODINE/ML IV SOLN	$312.00
0049-0530-28	PENICILLIN G POTASSIUM 20 MILLION UNIT INJ SOLR	$311.39
HC62202528	DRESSING OXYCEL	$311.00
60432-065-75	AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR	$310.50
59651-026-75	AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR	$310.50
HC51001543	APPLIC CAST LEG CLUBFOOT	$310.00
HC81500514	D-DIMER ULTRA SENSITIVE	$310.00
HC83000356	IRRADIATION EA UNIT	$310.00
HC84201102	CLOTEST FOR H. PYLORI	$310.00
HC51070365	PSY TX W/PATIENT 30MIN W/E&M+	$310.00
HC89021125	SOLUBLE IL-2R -CN	$309.00
HC39000997	PSYCH PSYCHOANALYSIS	$309.00
HC11500543	LACTATION E&M EXT'D NEW L:IV	$309.00
HC62229034	GEL VISCOUS SOL PRE-FILLED SYSTEM (ORISE)	$309.00
HC62219472	NEEDLE ACCESS FISTULA DIALYSIS	$309.00
0407-2223-01	IODIXANOL 320 MG IODINE/ML IV SOLN	$308.70
5047-4508-50	SODIUM HYALURONATE 14 MG/ML INTRAOCULAR SYRG	$308.31
HC81101032	AMINO ACIDS SNGL QUAN EA	$308.00
HC84200807	VIRAL ID (SHELL VIAL)	$308.00
HC31000318	PT-EVAL LOW COMPLEXITY <20MF2F 15MIN	$308.00
HC77400216	MOD CS GI ENDO SVCS>5YRS INIT'L 15MIN	$308.00
HC62200209	ARTERIAL LINE	$308.00
17478-215-05	ATROPINE 1 % OPHT DROP	$307.92
HC81100778	PROCAINAMIDE W/NAPA	$307.00
HC31001134	PT-PROSTHETIC TRNG 30MIN/CW	$307.00
HC62202189	DEVICE BLADDER MONITOR	$307.00
HC81101867	LIPID PANEL (DA)	$306.00
HC25001579	MOD CS DIFF PHYS/QHP <5 YR INIT'L 15MIN	$306.00
HC62205117	PACK ACL	$306.00
HC62209630	SLING PELVIC CANVAS	$306.00
0054-0391-68	METHADONE 10 MG/ML ORAL CONC	$306.00
99999-044-48	NICARDIPINE IN NS 50 MG/250 ML (0.2 MG/ML) IV SOLN (MHS)	$306.00
25021-460-01	DESMOPRESSIN 4 MCG/ML INJ SOLN	$306.00
61314-245-01	BETAXOLOL 0.5 % OPHT DROP	$305.88
0054-3177-57	DEXAMETHASONE 0.5 MG/5 ML ORAL SOLN	$305.28
HC89021182	PCA3 PROSTATE CA BIOMARKER-AU	$305.00
HC84201201	CHARCOT-LEYDEN CRYSTALS	$305.00
0065-0303-55	ATROPINE 1 % OPHT DROP	$304.56
17478-705-10	BETAXOLOL 0.5 % OPHT DROP	$304.38
HC51002301	LYSIS & STRETCHING ADHESIONS PREPUTIAL	$304.00
HC81500589	OSMOTIC FRAG INCUBATED	$304.00
HC81701963	HIV TYPE 1 ANTIGEN (RAPID)	$304.00
HC51004034	"COLLCTN SPUTM AEROSL TECH, SEP PROC"	$304.00
HC77400059	CS DIFF MD ADD'L 15 MIN	$304.00
24208-295-25	TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS	$303.42
HC81700593	IMMUNOGLOBULIN IGA	$303.00
HC81700601	IMMUNOGLOBULIN IGG	$303.00
HC81700619	IMMUNOGLOBULIN IGM.	$303.00
HC81700544	C TRACHOMATIS BY DNA PROBE	$303.00
HC83503854	ELECTRON MICROSCOPY PROF-CS	$303.00
HC39000112	PSYCH FAMILY GROUP THERAPY	$303.00
HC12200192	INF CNTR-ESTBD PT EVAL MINOR	$303.00
HC62202437	DRESSING BIOBRANE	$303.00
HC62228937	ORTHOSIS BELOW KNEE ADDON S0FT	$303.00
HC62228226	ORTH HFO METACARPAL FRACTURE PREFAB CUSTOM	$303.00
HC62228234	ORTH HO METACARPAL FRACTURE PREFAB OTS	$303.00
0407-1414-89	IOHEXOL 350 MG IODINE/ML IV SOLN	$303.00
0407-1414-08	IOHEXOL 350 MG IODINE/ML IV SOLN	$303.00
0407-1414-82	IOHEXOL 350 MG IODINE/ML IV SOLN	$303.00
61703-332-18	BLEOMYCIN 15 UNIT INJ SOLN (MCH)	$302.76
99999-046-02	IOHEXOL 350 MG IODINE/ML IV SOLN	$302.70
45802-966-94	ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL	$302.40
HC81700254	HCG QUAL	$302.00
HC32001752	OT-ASSISTV TECH ASSESS' 30MN/C	$302.00
HC62211800	CIRCUIT VENT O2 HIGH FLOW THERAPY	$302.00
68382-446-14	BOSENTAN 62.5 MG ORAL TAB	$301.16
0121-0721-04	FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLN	$300.96
99996-000-25	TRACE ELEMENTS CR-CU-MN-ZN-SE-0.36-35.6-1.8-714-3.6 MCG/ML IVN	$300.06
HC89022719	HLA CLASS II TYPING HIGH RES EACH LOCUS-U9	$300.00
HC81700106	FOLIC ACID	$300.00
HC83505339	CONSULTATION PATH; REF SLIDE REV-BR	$300.00
HC29000692	TEST CHALLENGE INGEST ADD 60MIN+	$300.00
16729-332-05	OXALIPLATIN 100 MG/20 ML IV SOLN	$300.00
25208-003-05	SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN	$300.00
55111-694-07	PALONOSETRON 0.25 MG/5 ML IV SOLN	$300.00
0781-3312-75	PALONOSETRON 0.25 MG/5 ML IV SOLN	$300.00
50383-233-10	DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP	$300.00
42571-147-26	DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP	$300.00
52536-625-10	TESTOSTERONE CYPIONATE 200 MG/ML IM OIL	$300.00
17478-420-40	LABETALOL 5 MG/ML IV SOLN	$300.00
0703-3985-01	OXALIPLATIN 5 MG/ML IV SOLN (MCH)	$300.00
25021-233-20	OXALIPLATIN 100 MG/20 ML IV SOLN	$300.00
0781-9315-70	OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN	$300.00
69639-103-01	PALONOSETRON 0.25 MG/5 ML IV SOLN	$300.00
43598-611-11	DOCETAXEL 20 MG/ML (1 ML) IV SOLN	$300.00
99999-036-33	CHARGE - COLD INDUCTION CARDIOPLEGIA SOLN	$300.00
99999-036-34	CHARGE - MAINTENANCE CARDIOPLEGIA SOLN	$300.00
24208-486-10	DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP	$299.94
25021-157-99	VANCOMYCIN 5 GRAM IV SOLR	$299.94
51672-1272-1	"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT"	$299.43
0168-0089-15	"NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT"	$299.43
16714-930-01	GEMCITABINE 1 GRAM IV SOLR	$299.34
HC81500472	INHIB PROTEIN S TOTAL	$299.00
HC62201371	CATH ESOPHAGEAL PH	$299.00
HC62207386	TRAY INCISION & DRAINAGE DISP	$299.00
HC62215611	SUTURE                            L	$299.00
55513-267-10	"EPOETIN ALFA 3,000 UNIT/ML INJ SOLN"	$298.44
55513-267-01	"EPOETIN ALFA 3,000 UNIT/ML INJ SOLN"	$298.44
63323-377-01	OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN	$298.14
0075-0621-60	ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG	$298.04
HC81701849	IGG SUBCLASS 1; EACH	$298.00
HC81701856	IGG SUBCLASS 2; EACH	$298.00
HC81701864	IGG SUBCLASS 3; EACH	$298.00
HC81701872	IGG SUBCLASS 4; EACH	$298.00
HC84200963	ROTAVIRUS ASSAY EIA/ANTIGEN	$298.00
HC51000404	IV INF HYDRATION INITIAL HR	$298.00
HC62803705	COIL EMBOLIZATION MICROCOIL       C	$298.00
HC29000619	AWV ANNUAL WELLNESS PLAN; SUBSEQUENT	$298.00
25021-235-50	GEMCITABINE 1 GRAM IV SOLR	$297.90
64980-511-10	CLINDAMYCIN PALMITATE HCL 75 MG/5 ML ORAL SOLR	$297.60
65649-303-03	RIFAXIMIN 550 MG ORAL TAB	$297.53
65649-303-02	RIFAXIMIN 550 MG ORAL TAB	$297.53
99999-036-20	RIFAXIMIN 20 MG/ML ORAL SUSPENSION (COMPOUND)	$297.50
HC81700049	AFP	$297.00
HC81101552	C-PEPTIDE	$297.00
HC81700288	COMPLEMENT TOT HEMOLYTIC CH50	$297.00
HC84200179	CLOSTRIDIUM DIFFICILE TOXIN	$297.00
HC51070563	PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; EA ADDL HR+	$297.00
HC51070514	PSY TM CONF W/PT&/FAM 60MIN	$297.00
HC14500102	DIABETIC SELF MGMT TRNG EA 30M	$297.00
HC31000961	PT-ULTRASOUND 30MIN/CW	$296.00
HC62205984	RETRIEVAL NET	$296.00
HC62221981	PIN CHECKPOINT HEX ROBOTIC	$296.00
63323-360-05	CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN	$295.80
63323-360-61	CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN (TPN-GMS)	$295.80
63323-184-10	FOLIC ACID 5 MG/ML INJ SOLN	$295.08
HC11500865	WM EXAM EST' PT EVAL LO/MODIII	$295.00
50383-966-08	CIMETIDINE HCL 300 MG/5 ML ORAL SOLN	$294.35
HC81100190	LITHIUM	$294.00
HC81100539	CPK	$294.00
HC89500698	FREEZING BLOOD EA UNIT-SB	$294.00
HC84200799	ADDITIONAL VIRUS TEST	$294.00
HC33001082	ST EVAL BEHAVRAL QUAL VOICE 30MIN/M	$294.00
HC34000000	PURE TONE AUDIO AIR ONLY	$294.00
63323-125-53	GEMCITABINE 1 GRAM IV SOLR	$294.00
16729-434-05	DAPTOMYCIN 350 MG IV SOLR	$294.00
63323-273-01	SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN	$294.00
99999-034-74	FENTANYL 2500 MCG IN NS 100 ML	$294.00
99999-035-08	FENTANYL 25 MCG/ML IN NS 100 ML OPIOID NAIVE PCA	$294.00
0409-9158-50	PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN	$293.80
0409-9158-01	PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN	$293.80
0409-9158-31	PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN	$293.80
HC81100943	PRIMIDONE	$293.00
HC81700080	VITAMIN B12	$293.00
HC81500746	LAMELLAR BODY DENSITY	$293.00
HC81101420	PREALBUMIN	$293.00
HC84200435	TRICHROME STAIN CMPLX OVA/PARA	$293.00
HC62802525	KIT CVP LINE	$293.00
HC62806047	CATH DIALYSIS SHORT-TERM          E	$293.00
HC62800594	GUIDEWIRE                         E	$293.00
HC62203757	KIT CATH RADIAL ARTERY	$293.00
HC62210273	SPLINT WRIST/ HAND RESTING	$293.00
HC31001761	PT-CASE CONF 30MIN/C	$293.00
HC62202908	BAG/POUCH RETRIEVAL SPECMN ENDO   D	$293.00
HC62203930	KIT HYSTEROSALPINGOGRAM	$293.00
HC62203948	KIT INFLATION	$293.00
HC62205802	PROBE GALACTOGRAM	$293.00
HC62206420	SET URICATH	$293.00
HC62206529	SHUNT CAROTID	$293.00
HC62208020	TUNNELER SURGICAL                 F	$293.00
HC62212105	TIP CAUTERY SINGLE USE ROBOTIC	$293.00
HC62215413	DEVICE TROCHANTER GALILEO	$293.00
HC62218748	DRILL/DRILL BITS SINGLE USE       I	$293.00
HC62224563	CABLE ELECTRODE MICRO TARGET/SCREEN	$293.00
HC62300074	DISSECTOR ROBOTIC                 F	$293.00
HC62300199	TIP CAUTERY HOOK ROBOTIC          F	$293.00
0002-7597-01	OLANZAPINE 10 MG IM SOLR	$292.80
24208-670-04	SULFACETAMIDE SODIUM 10 % OPHT DROP	$292.50
50383-740-16	ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRP	$292.31
63323-658-27	CHLOROTHIAZIDE SODIUM 500 MG IV SOLR	$292.14
HC89003271	CORTISOL FREE URINE-QD	$292.00
HC83000364	POOLING PLAT OR OTHER BLD PROD	$292.00
HC84200385	CULTURE STOOL ADDL PATH	$292.00
HC36800688	"METHGB,QUANT TRANSCUTANEUS/DAY"	$291.00
HC36000792	"METHGB,QUANT TRANSCUTANEUS/DAY"	$291.00
HC51070035	PSY PREPARE REPORT	$291.00
0054-3727-63	PROPRANOLOL 20 MG/5 ML ORAL SOLN (MCH)	$291.00
HC51003135	BX VULVA EACH ADDITIONAL+	$290.00
HC81701187	ALPHA1 ANTITRYPSIN	$290.00
HC81701880	CA 15-3	$290.00
HC81700312	CA 27-29	$290.00
HC25001561	MOD CS SAME PHYS/QHP 5/>YR INIT'L 15MIN	$290.00
HC62210802	SET PERITONEAL DIALYSIS	$290.00
0003-3622-12	ATAZANAVIR 300 MG ORAL CAP	$289.88
50383-741-20	ALBUTEROL SULFATE 5 MG/ML INHALATION NEBU	$289.80
0065-0092-65	FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN	$289.32
HC33000902	ST EVAL SPEECH FLUENCY 30MIN/M	$289.00
HC28000222	CR REHAB PAD PERIPHERAL PER SESSION	$289.00
HC51060713	OT-EVAL LOW COMPLEXITY 20MF2F 30MIN	$289.00
HC12200150	INF CNTR-NEW PT EVAL LOW/MOD	$289.00
HC31001191	PT-TEAM CONF W/PT &3D 30MINOR>	$289.00
HC32001414	OT-TEAM CONF W/PT &3D 30MINOR>	$289.00
HC33000829	ST-TEAM CONF W/PT &3D 30MINOR>	$289.00
HC11200023	OBSERVATION PER HOUR - ONCOLOGY	$289.00
HC62200704	BOOT BUCKS TRACTION UNIT	$289.00
HC62209564	TRACTION BUCKS UNIT	$289.00
HC51001444	CLOSED TX TOE FX	$288.00
HC89008809	17-KETOSTEROID FRACTIONAT'N-AU	$288.00
HC81500704	FIBRIN SPLIT PRODUCTS	$288.00
HC84200286	ANAEROBIC ID EA ISOLATE	$288.00
HC51070696	PSY-TEST COGNITIVE PERFORMANCE STDRD PER HOUR	$288.00
HC25001553	MOD CS SAME PHYS/QHP<5YR INIT'L 15MIN	$288.00
HC36800571	RT RESP THER GRP 45 MIN/MW	$288.00
76125-790-26	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	$288.00
76125-790-25	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	$288.00
67457-517-00	FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN	$288.00
67457-517-01	FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN	$288.00
61703-363-18	OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN	$288.00
0009-5140-01	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$288.00
0009-5140-04	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$288.00
0009-4992-02	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$288.00
0009-4992-01	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$288.00
0409-9158-11	PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN	$287.96
0409-9158-55	PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN	$287.96
63323-307-51	TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN	$287.10
HC51010213	ASP/INJ MED JOINT-LT	$287.00
HC51010221	ASP/INJ MED JOINT-RT	$287.00
HC32000382	OT-RE-EVAL EST POC  15MIN	$287.00
16714-358-01	LEVETIRACETAM 100 MG/ML ORAL SOLN	$286.64
0409-3024-01	SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN	$286.44
HC51062552	"CONTROL NASAL HEMORRHAGE,POST W/PCKS+/OR CAUTRY INT'L"	$286.00
HC81101362	CARBOXYHEMOGLOBIN	$286.00
HC51070357	PSYCH TX W/PATIENT 30MIN	$286.00
HC62201611	CATH URETERAL                     P	$286.00
HC62207071	SUTURE RETRIEVER	$286.00
HC62214812	BASKET RETRIEVAL                  F	$286.00
HC62215298	BLADE SAW                         P	$286.00
HC62216536	PIN/WIRE FIXATION TEMPORARY       P	$286.00
65628-070-05	OMEPRAZOLE COMPOUNDING KIT 2 MG/ML ORAL SUSR	$285.30
0003-0293-20	TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP	$285.06
HC81101933	DRUG TEST PRESUMP DIR OPT INSTRMNT ASS'T/ DOS	$285.00
HC89021216	MAG AUTOANTIBODY-AT	$285.00
HC81500134	FIBRINOGEN	$285.00
HC84200062	"URINE ISOLATE, PRESUMP ID, EA"	$285.00
HC81700551	N-GONORRHEA BY DNA PROBE	$285.00
HC32000242	OT-EVAL LOW COMPLEXITY <20MF2F 15MIN	$285.00
0641-6137-10	FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN	$285.00
16714-483-01	CLINDAMYCIN PALMITATE HCL 75 MG/5 ML ORAL SOLR	$284.40
43825-102-01	"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN"	$284.40
HC81101685	DHEA SULFATE	$284.00
HC84200609	STREP PNEUMONIAE URINE AG	$284.00
HC39000120	PSYCH GRP TX(NOT MULTI FAMILY)60MIN/COMM	$284.00
HC31000458	PT-RE-EVAL EST POC  15MIN	$284.00
HC11500030	EST PT LVL4-DETAILED	$284.00
63402-304-30	LURASIDONE 40 MG ORAL TAB	$283.74
63402-308-30	LURASIDONE 80 MG ORAL TAB	$283.74
63459-101-30	MODAFINIL 100 MG ORAL TAB	$283.66
16714-294-03	AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR	$283.20
60687-523-21	POSACONAZOLE 100 MG ORAL TBEC	$283.00
60687-523-11	POSACONAZOLE 100 MG ORAL TBEC	$283.00
HC51000065	INSRT BLADDER CATH-NON INDWELL	$283.00
HC84200864	INFLUENZA B FA ANTIGEN	$283.00
HC84200872	INFLUENZA A FA ANTIGEN	$283.00
HC51060697	PT-EVAL LOW COMPLEXITY 20MF2F 30MIN	$283.00
HC36800548	RT THER INC RESP FUNC 15MIN/MW	$283.00
HC62221361	SPLINT FOOT DROP PREFAB	$283.00
63323-278-10	VINBLASTINE 1 MG/ML IV SOLN	$282.96
61703-339-50	CARBOPLATIN 10 MG/ML IV SOLN	$282.96
HC83000125	RBC ANTIBODY SCREEN	$282.00
HC84200617	LEGIONELLA AG URINE	$282.00
HC84600097	PAP THIN LAYER PREP MAN&RE SCN	$282.00
HC62215538	ROD WORKING SPINAL	$282.00
43598-848-11	ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR	$282.00
43598-848-58	ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR	$282.00
65862-596-01	CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH)	$282.00
16729-114-08	ETOPOSIDE 20 MG/ML IV SOLN	$281.10
99999-038-54	IMATINIB 50 MG ORAL PARTIAL TAB	$280.91
0009-5091-01	EPIRUBICIN 50 MG/25 ML IV SOLN	$280.20
HC84600220	CYTP DX EVAL FNA EA ADDL SAME SITE	$280.00
HC36800696	"HGB,QUANT TRANSCUTANEOUS DAILY"	$280.00
HC36001022	"HGB,QUANT TRANSCUTANEOUS DAILY"	$280.00
HC89500300	CALL BACK FEE HRLY(2HR MIN)-AA	$280.00
HC47200761	RAD ONC E&M LEVEL II LIMITED	$280.00
HC62209655	KIT ACCESSORY IDD THERAPY	$280.00
0409-1660-55	DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN	$279.90
0409-1660-50	DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN	$279.90
HC81101289	C3 COMPLEMENT	$279.00
HC81101297	C4 COMPLEMENT	$279.00
HC32010118	OT-EVAL SWALLOW CINE/FLUORO [15MIN]	$279.00
HC33010034	ST-EVAL SWALLOW CINE/FLUORO [15MIN]	$279.00
HC51004133	ANALYZ NRSTM NO REPROGRAMMING	$279.00
HC77400158	ANESTHESIA EPIDURAL EA ADD 15MIN	$279.00
99999-046-00	IOHEXOL 350 MG IODINE/ML IV SOLN	$278.40
0407-1413-61	IOHEXOL 300 MG IODINE/ML IV SOLN	$278.10
0407-1413-08	IOHEXOL 300 MG IODINE/ML IV SOLN	$278.10
HC81101065	CALCIUM IONIZED	$278.00
HC81101800	CALCIUM IONIZED (POS)	$278.00
HC81500126	D-DIMER QUAL OR SEMI-QT	$278.00
HC84200831	CHLAMYDIA FA ANTIGEN	$278.00
HC32010159	OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN	$278.00
HC32000358	OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M	$278.00
HC31010135	PT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN	$278.00
HC31000425	PT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M	$278.00
HC77400026	MOD CS BY MD  ADD'L 15 MIN	$278.00
HC13500020	GENETIC CNSL RISK REDCTN 30MIN	$278.00
HC51001980	INSERT DRUG DELIVERY IMPLANT	$277.00
HC89013825	OLIGOCLONAL BANDS (CSF)-QD	$277.00
HC81101826	SEX HORMONE BINDING GLOB	$277.00
HC51060168	PT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING)	$277.00
HC28000107	CR NEW PT EVAL LVL2-(20MIN)	$277.00
HC62214705	ADAPTER PTCA W/GUIDEWIRE	$277.00
0781-6153-95	PENICILLIN G SODIUM 5 MILLION UNIT INJ SOLR	$276.47
0781-6153-94	PENICILLIN G SODIUM 5 MILLION UNIT INJ SOLR	$276.47
51672-1273-2	FLUOCINONIDE 0.05 % TOPICAL SOLN	$276.36
43386-026-02	FLUOCINONIDE 0.05 % TOPICAL SOLN	$276.36
0407-1412-20	IOHEXOL 240 MG IODINE/ML IV SOLN	$276.12
HC51061802	X-RAY SPINE THORACOLUMBAR JUNCTN MIN 2 VWS	$276.00
HC81100711	QUINIDINE	$276.00
HC81700585	PSA TOTAL	$276.00
HC51070548	NEUROBEHAVIORAL STATUS EXAM CLIN ASSESS INTERP & REPORT;  EA ADDL HR+	$276.00
HC11500659	WC NEW E&M ASSESS MINOR LVL 2	$276.00
HC11500709	WC ESTB E&M  MINOR LVL 2	$276.00
HC62204532	LITE PIPE	$276.00
HC62213723	GAS INTRAOCULAR                   A	$276.00
68516-5214-3	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	$276.00
68516-5214-1	"ALBUMIN, HUMAN 5 % 5 % IV SOLP"	$276.00
68516-5216-1	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$276.00
68516-5216-3	"ALBUMIN, HUMAN 25 % 25 % IV SOLP"	$276.00
71288-114-50	GEMCITABINE 1 GRAM IV SOLR	$275.58
HC51003374	BX(S)/SAMPL ENDOMETRIAL W/COLPOSCPY+	$275.00
HC81101404	FLORESCENCE POLARIZATION	$275.00
HC83001230	BB PATH; DIFFICULT CROSSMATCH IRREG AB	$275.00
HC81700338	CA 125	$275.00
HC81701112	IMMUNOELECTROPHERESIS-SRM	$275.00
HC81700353	IMMUNOFIXATION ELECTROPHORESIS	$275.00
HC89005193	INFCT AGNT ADENO DNA  PCR-FT	$275.00
HC89019236	VARICELLA ZOSTER QNT-FT	$275.00
HC89016927	ANATOMIC CONSULT; CMPLX REV-CE	$275.00
0003-1611-12	ENTECAVIR 0.5 MG ORAL TAB	$274.49
HC36800597	"CARBOXYHEMOGLOBIN,QUANT"	$274.00
HC81500621	APTT SUBS PLASMA FRACTIONS EA	$274.00
HC62201405	CATH FLUSH	$274.00
HC62201975	CONNECTOR SURGICAL	$274.00
HC81700221	T3 TOTAL	$273.00
HC81500456	INHIB PROTEIN C AG	$273.00
HC33000548	ST-SPEECH THERAPY 15 MIN/MW	$273.00
HC39000302	PSY TEAM CONF W/PT&/FAM 30MIN	$273.00
HC62209283	INFLATOR FOR BALLOON              K	$273.00
HC62215603	SUTURE                            K	$273.00
HC62215892	NEEDLE BIOPSY                     K	$273.00
HC62225594	DRESSING COLLAGEN W/ AG	$273.00
0069-0196-01	"DALTEPARIN (PORCINE) 5,000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRG"	$272.20
HC81101230	TRANSFERRIN	$272.00
HC81700817	ABSOLUTE T4/CELL MRKR ADD+	$272.00
HC81700825	CALLA/ACUTE LYMPH LEUK AG MKR+	$272.00
HC81701419	FLOW CYT MKR (TDT) TC ADD+	$272.00
HC81700858	FLOW CYT MKR TC ADD + CD38	$272.00
HC81701401	FLOW CYT MKR TC ADD+	$272.00
HC81700833	FLOW CYT MKR TC ADD+ CD23	$272.00
HC81700569	FLOW CYT MKR TC ADD+ KAPPA	$272.00
HC81700874	FLOW CYTO CELL MKR TC ADD+	$272.00
HC81700866	FLOW CYTO MKR TC ADD + CALLA	$272.00
HC81701989	FLW CYT MKR CD10/CA TC ADD+	$272.00
HC81702037	FLW CYT MKR CD103 TC ADD+	$272.00
HC81700882	FLW CYT MKR CD11 TC ADD+	$272.00
HC81702029	FLW CYT MKR CD117 TC ADD+	$272.00
HC81701062	FLW CYT MKR CD11B TC ADD+	$272.00
HC81702045	FLW CYT MKR CD11C TC ADD+	$272.00
HC81702052	FLW CYT MKR CD138 TC ADD+	$272.00
HC81700890	FLW CYT MKR CD14 TC ADD+	$272.00
HC81702060	FLW CYT MKR CD16 TC ADD+	$272.00
HC81700908	FLW CYT MKR CD19 TC ADD+	$272.00
HC81700916	FLW CYT MKR CD2 TC ADD +	$272.00
HC81700924	FLW CYT MKR CD20 TC ADD+	$272.00
HC81702086	FLW CYT MKR CD235A TC ADD+	$272.00
HC81700932	FLW CYT MKR CD24 TC ADD+	$272.00
HC81702094	FLW CYT MKR CD25 TC ADD+	$272.00
HC81700940	FLW CYT MKR CD3 (LEU-4)TC ADD+	$272.00
HC81700957	FLW CYT MKR CD30 (KI-1)TC ADD+	$272.00
HC81700965	FLW CYT MKR CD33 TC ADD+	$272.00
HC81700973	FLW CYT MKR CD34 (HPCA-1)ADD+	$272.00
HC81702102	FLW CYT MKR CD4 TC ADD+	$272.00
HC81702110	FLW CYT MKR CD41 TC ADD+	$272.00
HC81700999	FLW CYT MKR CD5 TC ADD+	$272.00
HC81701005	FLW CYT MKR CD56 TC ADD+	$272.00
HC81702128	FLW CYT MKR CD57 TC ADD+	$272.00
HC81702136	FLW CYT MKR CD61 TC ADD+	$272.00
HC81702144	FLW CYT MKR CD64 TC ADD+	$272.00
HC81701013	FLW CYT MKR CD7 TC ADD+	$272.00
HC81702151	FLW CYT MKR CD79A TC ADD+	$272.00
HC81701021	FLW CYT MKR CD8 TC ADD+	$272.00
HC81702193	FLW CYT MKR HLA-DR TC ADD+	$272.00
HC81701039	FLW CYT MKR IGA TC ADD+	$272.00
HC81701047	FLW CYT MKR IGG TC ADD+	$272.00
HC81701054	FLW CYT MKR IGM TC ADD+	$272.00
HC81701070	FLW CYT MKR LAMBDA TC ADD+	$272.00
HC81702169	FLW CYT MKR MPO TC ADD+	$272.00
HC81702177	FLW CYT MKR TCRAB TC ADD+	$272.00
HC81702185	FLW CYT MKR TCRGD TC ADD+	$272.00
HC81701088	FLW CYT MKR VS. CD13 TC ADD+	$272.00
HC81701096	"FLW CYT MKR, CDI TC ADD+"	$272.00
HC83505537	ANATOMIC CONSULT; COMPLEX REV-UX	$272.00
HC25005968	NEW PT LVL2-PROB FOCUS	$272.00
HC35000215	REC-TEAM CONF W/PT &3D 30MINOR>	$272.00
HC51020246	NP DEV PT REPORT; COMPREHENSIVE	$272.00
HC51020022	RN DEV PT REPORT;COMPREHENSIVE	$272.00
HC62205166	PACK BASIC	$272.00
0409-0181-01	GEMCITABINE 1000 MG/26.3 ML RECONSTITUTED IV SOLN (MCH)	$271.73
0004-1101-50	CAPECITABINE 500 MG ORAL TAB	$271.12
HC81101040	AMNIOTIC FLUID SCAN	$271.00
HC34000067	ACOUSTIC REFLEX TEST THRESHOLD	$271.00
HC31000128	PT CASE CONF & RPT 1-30 MIN	$271.00
HC32000036	OT-CASE CONFERENCE 30MIN	$271.00
HC33000449	ST-TEAM CONF W/PT&/FAM30MINOR>	$271.00
HC32001513	OT-INTERDISCIPLINARY TEAM W/MD	$271.00
HC31000136	PT-TEAM CONF W/MD >30MIN(NO PT)	$271.00
HC32001323	OT-TEAM CONF W/MD >30MIN(NO PT)	$271.00
HC33000837	ST-TEAM CONF W/MD>30MIN(NO PT)	$271.00
0173-0519-00	EPOPROSTENOL (GLYCINE) 1.5 MG IV SOLR	$270.84
0270-1315-30	IOPAMIDOL 61 % IV SOLN	$270.30
0496-0882-30	LIDOCAINE 4 % TOPICAL CREAM	$270.18
HC81700528	HLA B27	$270.00
HC89019889	HLA AB DETECTION-AU	$270.00
HC89023550	INFCT AGNT ADENO DNA QUAL-FT	$270.00
HC89005219	INFCT AGNT ADENO DNA(RFX QT-FT	$270.00
HC81702078	FLW CYT MKR CD22 TC ADD+	$270.00
HC83506048	MORPH STDY CAT FISH EA MULTI PROBE - NG	$270.00
HC83506063	MORPH STDY CAT FISH EA MULTI PROBE HER2-AP	$270.00
HC83505875	MORPH STDY CAT FISH EA MULTI PROBE HER2-NG	$270.00
HC51070688	PSY-ASSESS APHASIA W/REPORT PER HOUR	$270.00
HC51070589	NEUROPSYCH TEST EVAL INTRG INTERP  CLIN DES FEEDBACK; EA ADDL HR+	$270.00
55150-242-51	LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK	$270.00
0407-1413-51	IOHEXOL 300 MG IODINE/ML IV SOLN	$270.00
0548-5400-00	MEDROXYPROGESTERONE 150 MG/ML IM SUSP	$270.00
0548-5400-25	MEDROXYPROGESTERONE 150 MG/ML IM SUSP	$270.00
0703-6801-01	MEDROXYPROGESTERONE 150 MG/ML IM SUSP	$270.00
68180-405-01	CEFIXIME 100 MG/5 ML ORAL SUSR	$270.00
43598-330-11	ZOLEDRONIC ACID 4 MG/5 ML IV SOLN	$270.00
5633100615	NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA	$269.79
5633100614	NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA	$269.79
11994-127-11	XENON-133 IN CARBON DIOXIDE 370 MBQ (10 MCI) INHALATION GAS	$269.00
HC51010189	ASP/INJ SMALL JNT-SC LT	$269.00
HC51010197	ASP/INJ SMALL JNT-SC RT	$269.00
HC81500829	"HEMOGLOBIN ELECT QUANT F,S"	$269.00
HC89005235	HERPESVIRUS 6 QUAL(RFX QNT)-FT	$269.00
HC89004808	"MTB COMPLEX DNA, PCR-FT"	$269.00
HC89019251	"PARECHOVIRUS RNA, RT-PCR-FT"	$269.00
72196-0431-1	AA 3.5% NO.2 PED-D10W-HEPARIN 3.5 %-10 %- 125 UNIT/250 ML IV SOLP	$268.50
0407-1411-20	IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLN	$268.44
60687-192-11	IMATINIB 100 MG ORAL TAB	$268.00
60687-192-21	IMATINIB 100 MG ORAL TAB	$268.00
HC81500811	HEMOGLOBIN ELECTRO-CONFIRM	$268.00
HC81500712	HEMOGLOBIN ELECTROPHERESIS	$268.00
HC81700320	CA 19-9	$268.00
HC83500678	TISSUE EXAM G&M LEVEL 4-SU	$268.00
HC51070340	PSY FAMILY CONFERENCE 60MIN	$268.00
HC51060531	ST EVAL SOUND PROD W/LANG COMP&EXPRESS/C	$268.00
0378-0872-16	CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK	$267.68
0378-0872-99	CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK	$267.68
0591-3509-04	CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK	$267.68
0591-3509-54	CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK	$267.68
0002-8715-17	INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP	$267.66
0002-8215-17	INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN	$267.66
0002-8315-17	INSULIN NPH ISOPH U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSP	$267.66
HC89008718	GM1 AUTO AB-AT	$267.50
61314-701-01	SULFACETAMIDE SODIUM 10 % OPHT DROP	$267.12
HC84200484	"LACTOFERRIN/LEUK, FECAL; QUAL"	$267.00
HC81700270	CARDIOLIPIN AB EA IG CLASS	$267.00
HC83000794	COOMBS INDIRECT QUAL EA	$267.00
HC84200666	CULTURE FUNGUS HAIR/SKIN/NAIL	$267.00
HC84201789	DNA/RNA LEGIONELLA PNEUMOPHILA (PNL)	$267.00
HC84600295	CYTO FLUID/BRUSH/WASH DIST SRV	$267.00
HC84600006	CYTOLOGY FLD/BRSH/WASH-DIST SV	$267.00
HC84600014	CYTOLOGY FLUID/BRUSH/WASH	$267.00
HC84600527	CYTOLOGY FLUID/BRUSH/WASH *OP	$267.00
HC51000214	IV PUSH SINGLE/INIT'L INJ	$267.00
HC62202296	DRAIN	$267.00
HC62200761	BREAST PUMP	$267.00
HC62207022	SUTURE GENERAL MULTI PKG	$267.00
42023-119-25	TRIMETHOBENZAMIDE 100 MG/ML IM SOLN	$266.88
59148-037-13	BREXPIPRAZOLE 1 MG ORAL TAB	$266.48
99988-000-20	NM TC-99M SULFUR COLLOID (NON-FILTERED)	$266.18
HC81500068	CBC WITH AUTOMATED DIFF	$266.00
HC81500720	PROTAMINE SULFATE/PARACOAG	$266.00
HC84600568	EXM/SELEC ARCHVL TISS MOL ANAL	$266.00
HC12200093	IM OR SQ INJECTION THERAPEUTIC	$266.00
HC12200085	IVP SINGLE/REPEAT RX ADD'L INJ	$266.00
HC42000620	WCH EST PT LVL4-DETAILED	$266.00
0009-0003-02	METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML IV SOLR	$265.68
61314-637-05	PREDNISOLONE ACETATE 1 % OPHT DRPS	$265.50
16729-242-31	ZOLEDRONIC ACID 4 MG/5 ML IV SOLN	$265.32
HC51061810	X-RAY SPINE ENTIRE SKULL-SACRUM 1 VIEW	$265.00
HC89500748	"HLA TYPING A,B OR C -SB"	$265.00
HC51000156	BREATH HYDROGEN TEST	$265.00
HC29000627	IPPE EXAM INITIAL PREVENTIVE	$265.00
99999-046-03	IOHEXOL 300 MG IODINE/ML IV SOLN	$264.90
0069-1307-01	"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJ SOLN"	$264.72
0069-1307-10	"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJ SOLN"	$264.72
HC51002939	DILAT STRICTURE URETHRAL MALE SUBSQ	$264.00
HC84200948	INFLUENZA A OR B EIA EACH	$264.00
HC84201342	INFLUENZA A OR B EIA EACH (POS)	$264.00
HC62226931	DEVICE EMULSION SUBMUCOSAL INJ AMPOULE	$264.00
0338-0519-09	FAT EMULSION 20 % IV EMUL	$264.00
60758-119-05	PREDNISOLONE ACETATE 1 % OPHT DRPS	$264.00
67457-390-54	ZOLEDRONIC ACID 4 MG/5 ML IV SOLN	$264.00
67457-323-25	MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML IV PGBK	$264.00
0338-9540-06	FAT EMULSION-OLIVE-SOY-LIPID 20 % IV EMUL	$264.00
0338-9540-02	FAT EMULSION-OLIVE-SOY-LIPID 20 % IV EMUL	$264.00
0009-0698-01	"METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR"	$263.88
16729-295-12	CARBOPLATIN 10 MG/ML IV SOLN	$263.88
0143-9503-01	ACETAZOLAMIDE SODIUM 500 MG INJ SOLR	$263.76
HC51003200	IRRIG &/APPLY OINTMENT VAGINAL	$263.00
HC81101396	FOAM STABILITY	$263.00
HC81500449	ANTITHROMBIN III AG	$263.00
16714-704-01	IMATINIB 100 MG ORAL TAB	$262.85
65219-054-09	POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN	$262.80
65219-054-29	POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN	$262.80
24208-411-15	BRIMONIDINE 0.2 % OPHT DROP	$262.53
61874-115-30	CARIPRAZINE 1.5 MG ORAL CAP	$262.42
61874-115-11	CARIPRAZINE 1.5 MG ORAL CAP	$262.42
61874-115-20	CARIPRAZINE 1.5 MG ORAL CAP	$262.42
61874-130-30	CARIPRAZINE 3 MG ORAL CAP	$262.42
39822-1055-5	AMPHOTERICIN B 50 MG INJ SOLR	$262.20
HC51002608	IMPLANT PELLET(S) HORMONE SUBQ	$262.00
HC81700767	IMMUNOFIX ELECTPH URINE	$262.00
HC11500824	PEDS ESTAB PT ASSESS LTD(10')	$262.00
60505-6193-1	PALONOSETRON 0.25 MG/5 ML IV SOLN	$261.36
HC51001824	X-RAY KNEE CMPLET 4+ VWS	$261.00
HC36800654	CALCIUM IONIZED	$261.00
HC84200294	YEAST ID EA ORG	$261.00
HC31000607	PT-TEAM CONF W/NONMD>30MIN(NO PT)	$261.00
HC32001331	OT-TEAM CONF W/NONMD>30MIN(NO PT)	$261.00
99999-043-16	AMPICILLIN-SULBACTAM 30 MG/ML INJ SYRINGE (USING 3G)	$261.00
99999-045-82	NIMODIPINE 30 MG/5 ML ORAL SYRG	$260.19
24338-230-05	NIMODIPINE 30 MG/5 ML ORAL SYRG	$260.16
24338-230-12	NIMODIPINE 30 MG/5 ML ORAL SYRG	$260.16
70121-1168-1	TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP	$260.10
HC51062545	"CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLEX TX"	$260.00
HC51061752	X-RAY SPINE CERVICAL; 2 OR 3VWS