|
17-hydroxypregnenolone
|
$13.14 |
$13.14 |
$13.14 |
$87.50
|
|
2nd order venous cath
|
$725.77 |
$725.77 |
$725.77 |
$1,720.80
|
|
3-d radiotherapy plan
|
$5,617.35 |
$5,617.35 |
$5,617.35 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$167.76 |
$167.76 |
$167.76 |
$425.10
|
|
5' nucleotidase - sendout
|
$5.41 |
$5.41 |
$5.41 |
$50.05
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$27.73 |
$27.73 |
$27.73 |
$3,998.03
|
|
Abd aorta w/runoff s&i
|
$4,076.47 |
$4,076.47 |
$4,076.47 |
$3,724.63
|
|
Abd/low ext cath 1st
|
$1,350.80 |
$1,350.80 |
$1,350.80 |
$2,300.20
|
|
Abd/low ext cath 2nd
|
$1,351.23 |
$1,351.23 |
$1,351.23 |
$2,401.80
|
|
Abd/low ext cath 3rd
|
$1,608.78 |
$1,608.78 |
$1,608.78 |
$2,727.40
|
|
Abd/low ext cath addl
|
$273.32 |
$273.32 |
$273.32 |
$988.80
|
|
Abdominal CT scan (with and without contrast)
|
$1,410.80 |
$1,410.80 |
$1,410.80 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$1,354.30 |
$1,354.30 |
$1,354.30 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,312.25 |
$1,312.25 |
$1,312.25 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,916.21 |
$2,916.21 |
$2,916.21 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$2,430.47 |
$2,430.47 |
$2,430.47 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$2,430.47 |
$2,430.47 |
$2,430.47 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$635.54 |
$635.54 |
$635.54 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$722.27 |
$722.27 |
$722.27 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$555.39 |
$555.39 |
$555.39 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$508.52 |
$508.52 |
$508.52 |
$1,248.00
|
|
Abl1 gene
|
$285.66 |
$285.66 |
$285.66 |
$614.25
|
|
Ablate arrhythmia add on
|
$20,936.84 |
$20,936.84 |
$20,936.84 |
$7,717.80
|
|
Ablate bone tumor(s) cryo perq 20983
|
$11,560.14 |
$11,560.14 |
$11,560.14 |
$8,096.90
|
|
Ablate bone tumor(s) perq
|
$16,477.13 |
$16,477.13 |
$16,477.13 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$9,175.23 |
$9,175.23 |
$9,175.23 |
$9,836.16
|
|
Ablate pulm tumor perq crybl
|
$4,898.16 |
$4,898.16 |
$4,898.16 |
$9,977.40
|
|
Ablate pulm tumor perq rf
|
$9,475.26 |
$9,475.26 |
$9,475.26 |
$7,911.80
|
|
Ablation cardiac vagal inputs atrium
|
$5,432.08 |
$5,432.08 |
$5,432.08 |
$2,948.40
|
|
Ablation cryo pq liver tumor(s)
|
$5,867.01 |
$5,867.01 |
$5,867.01 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$531.74 |
$531.74 |
$531.74 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$1,597.83 |
$1,597.83 |
$1,597.83 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$29.35 |
$29.35 |
$29.35 |
$89.91
|
|
Acetazolamide 500 mg solution for injection
|
$65.70 |
$65.70 |
$65.70 |
$137.80
|
|
Acetylcholine receptor modulating antibody
|
$10.08 |
$10.08 |
$10.08 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$296.53 |
$296.53 |
$296.53 |
$306.22
|
|
Acne surgery 10040
|
$332.42 |
$332.42 |
$332.42 |
$265.20
|
|
Acute hepatitis panel
|
$260.61 |
$260.61 |
$260.61 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$55.19 |
$55.19 |
$55.19 |
$64.45
|
|
#acylcarnitineprfl
|
$32.85 |
$32.85 |
$32.85 |
$87.72
|
|
Adapter b 8 channel 10cm
|
$2,797.95 |
$2,797.95 |
$2,797.95 |
$6,875.44
|
|
Adenosine 3 mg/250 ml bag for osm
|
$268.50 |
$268.50 |
$268.50 |
$217.04
|
|
Adh-sendout
|
$19.71 |
$19.71 |
$19.71 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$157.68 |
$157.68 |
$157.68 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$220.76 |
$220.76 |
$220.76 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$220.76 |
$220.76 |
$220.76 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$589.99 |
$589.99 |
$589.99 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$529.98 |
$529.98 |
$529.98 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$95.93 |
$95.93 |
$95.93 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$95.93 |
$95.93 |
$95.93 |
$267.43
|
|
Administration immunization 1 vaccine
|
$81.91 |
$81.91 |
$81.91 |
$70.00
|
|
Administration immunization each additional vaccine
|
$56.51 |
$56.51 |
$56.51 |
$46.23
|
|
Administration vaccine hepatitis b
|
$81.91 |
$81.91 |
$81.91 |
$51.11
|
|
Administration vaccine influenza virus
|
$81.91 |
$81.91 |
$81.91 |
$49.40
|
|
Administration vaccine pneumococcal
|
$81.91 |
$81.91 |
$81.91 |
$51.07
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$60.76 |
$60.76 |
$60.76 |
$14,346.62
|
|
Adrenal cortex & medulla img
|
$2,015.68 |
$2,015.68 |
$2,015.68 |
$1,818.05
|
|
Aep hearing status deter i&r
|
$305.73 |
$305.73 |
$305.73 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$305.73 |
$305.73 |
$305.73 |
$509.00
|
|
Aep thrshld est mlt freq i&r
|
$268.94 |
$268.94 |
$268.94 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$49.05 |
$49.05 |
$49.05 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$69.87 |
$69.87 |
$69.87 |
$289.60
|
|
Afo tib fx semi-rigid l2114
|
$1,654.77 |
$1,654.77 |
$1,654.77 |
$1,116.55
|
|
Airway resistance by impulse oscillometry 94728
|
$284.70 |
$284.70 |
$284.70 |
$279.73
|
|
Albumin body fluid quantitative each specimen
|
$85.41 |
$85.41 |
$85.41 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$169.51 |
$169.51 |
$169.51 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$282.51 |
$282.51 |
$282.51 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$131.40 |
$131.40 |
$131.40 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$75.34 |
$75.34 |
$75.34 |
$43.45
|
|
Aldesleukin injection
|
$6,419.33 |
$6,419.33 |
$6,419.33 |
$6,538.20
|
|
Alkaline phosphatase
|
$88.48 |
$88.48 |
$88.48 |
$46.50
|
|
Allergen egg white ige
|
$3.95 |
$3.95 |
$3.95 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$2.48 |
$2.48 |
$2.48 |
$26.95
|
|
Allograft 160mg placental salera mini membrane
|
$4,731.28 |
$4,731.28 |
$4,731.28 |
$4,906.77
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$17,578.26 |
$17,578.26 |
$17,578.26 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$7,999.20 |
$7,999.20 |
$7,999.20 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$17,578.26 |
$17,578.26 |
$17,578.26 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$6,152.59 |
$6,152.59 |
$6,152.59 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$7,999.20 |
$7,999.20 |
$7,999.20 |
$4,898.43
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,654.77 |
$1,654.77 |
$1,654.77 |
$5,381.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1,654.77 |
$1,654.77 |
$1,654.77 |
$5,538.22
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$7.71 |
$7.71 |
$7.71 |
$51.00
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$43.37 |
$43.37 |
$43.37 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$21.90 |
$21.90 |
$21.90 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$8,148.12 |
$8,148.12 |
$8,148.12 |
$9,600.63
|
|
Alt/sgpt
|
$139.29 |
$139.29 |
$139.29 |
$49.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$190.10 |
$190.10 |
$190.10 |
$431.84
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$29.35 |
$29.35 |
$29.35 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$11.39 |
$11.39 |
$11.39 |
$45.50
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$29.35 |
$29.35 |
$29.35 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$68.33 |
$68.33 |
$68.33 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$29.35 |
$29.35 |
$29.35 |
$50.85
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$30.02 |
$30.02 |
$30.02 |
$15,167.75
|
|
Ammonia
|
$222.95 |
$222.95 |
$222.95 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$360.48 |
$360.48 |
$360.48 |
$963.79
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$257.99 |
$257.99 |
$257.99 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$78.84 |
$78.84 |
$78.84 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$57.38 |
$57.38 |
$57.38 |
$57.38
|
|
Amylase
|
$194.04 |
$194.04 |
$194.04 |
$93.00
|
|
Anal pressure record
|
$418.73 |
$418.73 |
$418.73 |
$954.00
|