|
Alt/sgpt
|
$50.46 |
$50.46 |
$50.46 |
$49.00
|
|
Aluminum - quest
|
$375.46 |
$375.46 |
$375.46 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$86.08 |
$86.08 |
$86.08 |
$431.84
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$172.15 |
$172.15 |
$172.15 |
$44.00
|
|
Amino acid single qual
|
$119.47 |
$119.47 |
$119.47 |
$25.00
|
|
Aminolevulinic acid delta
|
$217.41 |
$217.41 |
$217.41 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$103.14 |
$103.14 |
$103.14 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$399.20 |
$399.20 |
$399.20 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$113.53 |
$113.53 |
$113.53 |
$50.85
|
|
Ammonia
|
$212.96 |
$212.96 |
$212.96 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$1,033.61 |
$1,033.61 |
$1,033.61 |
$963.79
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,084.07 |
$1,084.07 |
$1,084.07 |
$3,969.00
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$283.45 |
$283.45 |
$283.45 |
$135.63
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,578.24 |
$1,578.24 |
$1,578.24 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$63.82 |
$63.82 |
$63.82 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$39.33 |
$39.33 |
$39.33 |
$57.38
|
|
Amp metatarsal w/toe single 28810
|
$4,707.99 |
$4,707.99 |
$4,707.99 |
$3,839.54
|
|
Amp thigh through femur re-amp 27596
|
$1,114.49 |
$1,114.49 |
$1,114.49 |
$3,430.64
|
|
Amputate thigh through femur 27590
|
$1,205.75 |
$1,205.75 |
$1,205.75 |
$3,852.55
|
|
Amputation follow-up surgery
|
$894.86 |
$894.86 |
$894.86 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$1,382.35 |
$1,382.35 |
$1,382.35 |
$3,996.20
|
|
Amputation leg; tib/fib f/u 27886
|
$998.74 |
$998.74 |
$998.74 |
$3,206.40
|
|
Amputation of lower leg
|
$922.31 |
$922.31 |
$922.31 |
$2,916.80
|
|
Amputation of midtarsal 28800
|
$817.69 |
$817.69 |
$817.69 |
$2,681.60
|
|
Amputation thru metatarsal
|
$1,095.20 |
$1,095.20 |
$1,095.20 |
$3,791.82
|
|
Amputation toe interphalangeal joint
|
$5,651.08 |
$5,651.08 |
$5,651.08 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$4,760.68 |
$4,760.68 |
$4,760.68 |
$3,777.93
|
|
Amylase
|
$181.79 |
$181.79 |
$181.79 |
$93.00
|
|
Anal/urinary muscle study
|
$57.14 |
$57.14 |
$57.14 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$80.14 |
$80.14 |
$80.14 |
$340.47
|
|
Analysis gene f2 20210g>a variant
|
$194.97 |
$194.97 |
$194.97 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$217.77 |
$217.77 |
$217.77 |
$226.60
|
|
Analysis nerve
|
$1,209.46 |
$1,209.46 |
$1,209.46 |
$223.19
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$60.11 |
$60.11 |
$60.11 |
$122.20
|
|
Analysis tumor
|
$1,045.48 |
$1,045.48 |
$1,045.48 |
$240.00
|
|
Anca screen with reflex to titer -quest
|
$126.14 |
$126.14 |
$126.14 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$5,454.45 |
$5,454.45 |
$5,454.45 |
$2,426.60
|
|
An fluoro guide for cvp
|
$783.56 |
$783.56 |
$783.56 |
$509.60
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,115.88 |
$4,115.88 |
$4,115.88 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$12,174.00 |
$12,174.00 |
$12,174.00 |
$9,462.03
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$14,592.92 |
$14,592.92 |
$14,592.92 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$14,423.00 |
$14,423.00 |
$14,423.00 |
$6,513.10
|
|
Angiotensin ii
|
$213.70 |
$213.70 |
$213.70 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,340.06 |
$1,340.06 |
$1,340.06 |
$6,048.00
|
|
Angio tib/peroneal/init ves/unila 37228
|
$18,256.91 |
$18,256.91 |
$18,256.91 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$5,510.84 |
$5,510.84 |
$5,510.84 |
$5,741.00
|
|
Angio trnslmnl balloon same artery ini
|
$10,597.25 |
$10,597.25 |
$10,597.25 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$5,298.63 |
$5,298.63 |
$5,298.63 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$10,915.57 |
$10,915.57 |
$10,915.57 |
$8,745.10
|
|
Ankle arthroscopy/surgery
|
$788.01 |
$788.01 |
$788.01 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$775.39 |
$775.39 |
$775.39 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$1,463.23 |
$1,463.23 |
$1,463.23 |
$7,907.11
|
|
Ankle X-ray
|
$1,005.41 |
$1,005.41 |
$1,005.41 |
$350.85
|
|
Annual Physical, Established Patient (age 18-39)
|
$169.92 |
$169.92 |
$169.92 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$181.05 |
$181.05 |
$181.05 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$187.73 |
$187.73 |
$187.73 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$218.15 |
$218.15 |
$218.15 |
$188.15
|
|
Anodyne therapy charges pt
|
$7.42 |
$7.42 |
$7.42 |
$41.02
|
|
Anoscopy ablation lesion 46615
|
$3,898.47 |
$3,898.47 |
$3,898.47 |
$3,035.44
|
|
Anoscopy and biopsy
|
$1,670.25 |
$1,670.25 |
$1,670.25 |
$1,380.00
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$956.44 |
$956.44 |
$956.44 |
$4,934.17
|
|
Antibody
|
$112.79 |
$112.79 |
$112.79 |
$27.41
|
|
Antibody bacterium, not elsewhere specified
|
$208.66 |
$208.66 |
$208.66 |
$57.85
|
|
Antibody elution rbc reference
|
$198.12 |
$198.12 |
$198.12 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$514.21 |
$514.21 |
$514.21 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$181.79 |
$181.79 |
$181.79 |
$218.30
|
|
Antibody id rbc panel
|
$432.59 |
$432.59 |
$432.59 |
$291.75
|
|
Antibody influenza virus
|
$133.56 |
$133.56 |
$133.56 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$100.92 |
$100.92 |
$100.92 |
$53.96
|
|
Antibody screen rbc
|
$148.40 |
$148.40 |
$148.40 |
$105.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$8,388.31 |
$8,388.31 |
$8,388.31 |
$4.00
|
|
Anti mog serum - sendout
|
$430.36 |
$430.36 |
$430.36 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$35.77 |
$35.77 |
$35.77 |
$50.88
|
|
Ant instr 2-3 vert segm 22845
|
$1,113.00 |
$1,113.00 |
$1,113.00 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$1,157.52 |
$1,157.52 |
$1,157.52 |
$1,816.80
|
|
Antinuclear antibodies
|
$111.30 |
$111.30 |
$111.30 |
$91.70
|
|
Antinuclear antibodies titer
|
$186.25 |
$186.25 |
$186.25 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$165.47 |
$165.47 |
$165.47 |
$74.20
|
|
Antistreptolysin o titer
|
$26.72 |
$26.72 |
$26.72 |
$57.85
|
|
Antithrombin iii activity
|
$38.59 |
$38.59 |
$38.59 |
$106.85
|
|
Antithrombin iii injection
|
$7,774.68 |
$7,774.68 |
$7,774.68 |
$15.75
|
|
Aortic dysfunction/dilation
|
$3,327.87 |
$3,327.87 |
$3,327.87 |
$653.18
|
|
Aortic dysfunction/dilation
|
$3,327.87 |
$3,327.87 |
$3,327.87 |
$1,485.21
|
|
Aortic hemiarch graft 33866
|
$1,392.00 |
$1,392.00 |
$1,392.00 |
$2,260.80
|
|
Appendectomy
|
$928.25 |
$928.25 |
$928.25 |
$4,881.00
|
|
Appendectomy add-on 44955
|
$119.47 |
$119.47 |
$119.47 |
$206.40
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$1,265.11 |
$1,265.11 |
$1,265.11 |
$2,149.60
|
|
Appendix Removal (Laparoscopic)
|
$859.24 |
$859.24 |
$859.24 |
$6,376.26
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$5,234.81 |
$5,234.81 |
$5,234.81 |
$2,164.64
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$2,617.04 |
$2,617.04 |
$2,617.04 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$8,636.88 |
$8,636.88 |
$8,636.88 |
$3,461.40
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$4,292.47 |
$4,292.47 |
$4,292.47 |
$1,300.71
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$2,617.04 |
$2,617.04 |
$2,617.04 |
$508.18
|
|
Application finger splntstatic 29130
|
$184.02 |
$184.02 |
$184.02 |
$226.20
|
|
Application long leg splint 29505
|
$1,120.42 |
$1,120.42 |
$1,120.42 |
$370.00
|
|
Application lower leg splint 29515
|
$933.44 |
$933.44 |
$933.44 |
$365.60
|
|
Application multi layer compression below knee (both sides)
|
$883.73 |
$883.73 |
$883.73 |
$393.75
|
|
Application of forearm cast 29075
|
$123.18 |
$123.18 |
$123.18 |
$386.10
|
|
Application of long arm cast 29065
|
$135.79 |
$135.79 |
$135.79 |
$414.20
|
|
Application of long leg cast 29345
|
$192.92 |
$192.92 |
$192.92 |
$511.68
|
