|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$82.44 |
$82.44 |
$82.44 |
$724.00
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$54.00 |
$54.00 |
$54.00 |
$4,677.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,327.34 |
$4,327.34 |
$4,327.34 |
$4,474.69
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,296.44 |
$2,296.44 |
$2,296.44 |
$1,406.19
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$10.31 |
$10.31 |
$10.31 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$2.17 |
$2.17 |
$2.17 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$68.58 |
$68.58 |
$68.58 |
$103.62
|
|
Alprostadil for injection
|
$29.02 |
$29.02 |
$29.02 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,880.00 |
$1,880.00 |
$1,880.00 |
$15,857.45
|
|
Alt/sgpt
|
$45.00 |
$45.00 |
$45.00 |
$48.80
|
|
Aluminum - quest
|
$3.55 |
$3.55 |
$3.55 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$131.04 |
$131.04 |
$131.04 |
$431.84
|
|
Amantadine (symmetrel)-sendout
|
$46.08 |
$46.08 |
$46.08 |
$173.16
|
|
Amifostine
|
$406.26 |
$406.26 |
$406.26 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$16.54 |
$16.54 |
$16.54 |
$40.28
|
|
Amino acids quant 2-5
|
$2.82 |
$2.82 |
$2.82 |
$104.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$10.54 |
$10.54 |
$10.54 |
$37.33
|
|
Aminolevulinic acid delta
|
$2.63 |
$2.63 |
$2.63 |
$84.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$10.68 |
$10.68 |
$10.68 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$28.22 |
$28.22 |
$28.22 |
$119.63
|
|
Amiodarone 50 mg/ml intravenous solution
|
$24.48 |
$24.48 |
$24.48 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$6.26 |
$6.26 |
$6.26 |
$89.05
|
|
Ammonia
|
$111.96 |
$111.96 |
$111.96 |
$118.83
|
|
Amniocentesisdiagnostic 59000
|
$217.62 |
$217.62 |
$217.62 |
$894.00
|
|
Amphetamine confirm urine -sendout
|
$41.22 |
$41.22 |
$41.22 |
$92.61
|
|
Amphetamines 5 or more
|
$48.24 |
$48.24 |
$48.24 |
$80.25
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$21.30 |
$21.30 |
$21.30 |
$117.75
|
|
Amphotericin b lipid complex
|
$69.49 |
$69.49 |
$69.49 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$101.74 |
$101.74 |
$101.74 |
$558.95
|
|
Ampicillin 1 gram solution for injection
|
$26.40 |
$26.40 |
$26.40 |
$54.59
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$12.35 |
$12.35 |
$12.35 |
$52.65
|
|
Amp thigh through femur re-amp 27596
|
$459.00 |
$459.00 |
$459.00 |
$3,342.87
|
|
Amputate leg at thigh
|
$433.62 |
$433.62 |
$433.62 |
$2,854.80
|
|
Amputate lower leg at knee
|
$448.92 |
$448.92 |
$448.92 |
$3,480.00
|
|
Amputate thigh through femur 27590
|
$495.36 |
$495.36 |
$495.36 |
$3,342.87
|
|
Amputation follow-up surgery
|
$285.84 |
$285.84 |
$285.84 |
$3,839.54
|
|
Amputation follow-up surgery
|
$377.64 |
$377.64 |
$377.64 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$569.70 |
$569.70 |
$569.70 |
$2,446.80
|
|
Amputation leg; tib/fib f/u 27886
|
$421.02 |
$421.02 |
$421.02 |
$1,461.89
|
|
Amputation of foot at ankle
|
$411.30 |
$411.30 |
$411.30 |
$5,886.74
|
|
Amputation of leg at hip
|
$820.80 |
$820.80 |
$820.80 |
$6,192.00
|
|
Amputation of lower leg
|
$377.46 |
$377.46 |
$377.46 |
$1,417.20
|
|
Amputation toe interphalangeal joint
|
$1,124.82 |
$1,124.82 |
$1,124.82 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$779.22 |
$779.22 |
$779.22 |
$3,821.05
|
|
Amylase
|
$82.98 |
$82.98 |
$82.98 |
$89.76
|
|
Anabolic steroid 1 or 2
|
$25.74 |
$25.74 |
$25.74 |
$80.08
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$11.16 |
$11.16 |
$11.16 |
$106.70
|
|
Analysis gene f2 20210g>a variant
|
$6.82 |
$6.82 |
$6.82 |
$221.50
|
|
Analysis gene f5 leiden variant
|
$6.84 |
$6.84 |
$6.84 |
$236.00
|
|
Analysis tumor
|
$83.88 |
$83.88 |
$83.88 |
$237.89
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$17.82 |
$17.82 |
$17.82 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$5.43 |
$5.43 |
$5.43 |
$92.40
|
|
Anastrozole 1 mg
|
$5.82 |
$5.82 |
$5.82 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$48.24 |
$48.24 |
$48.24 |
$102.70
|
|
An cholangiogram percutaneous compl
|
$1,614.24 |
$1,614.24 |
$1,614.24 |
$2,494.35
|
|
Androstanediol
|
$51.80 |
$51.80 |
$51.80 |
$115.10
|
|
An fluoro guide for cvp
|
$818.64 |
$818.64 |
$818.64 |
$509.60
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,887.20 |
$2,887.20 |
$2,887.20 |
$5,339.00
|
|
Angiotensin ii
|
$21.42 |
$21.42 |
$21.42 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,372.97 |
$1,372.97 |
$1,372.97 |
$2,797.96
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,708.02 |
$1,708.02 |
$1,708.02 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$5,267.52 |
$5,267.52 |
$5,267.52 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$270.54 |
$270.54 |
$270.54 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$4,139.10 |
$4,139.10 |
$4,139.10 |
$8,359.11
|
|
Ankle X-ray
|
$319.50 |
$319.50 |
$319.50 |
$353.60
|
|
Annual Physical, Established Patient (age 18-39)
|
$30.06 |
$30.06 |
$30.06 |
$148.20
|
|
Annual Physical, Established Patient (age 40-64)
|
$39.06 |
$39.06 |
$39.06 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$36.00 |
$36.00 |
$36.00 |
$143.25
|
|
Annual Physical, New Patient (age 40-64)
|
$42.30 |
$42.30 |
$42.30 |
$167.25
|
|
Anora (draw only)
|
$15.84 |
$15.84 |
$15.84 |
$33.83
|
|
Anoscopy and biopsy
|
$718.20 |
$718.20 |
$718.20 |
$1,395.28
|
|
Anoscopy control bleeding 46614
|
$36.54 |
$36.54 |
$36.54 |
$2,030.25
|
|
Antibody bacterium, not elsewhere specified
|
$14.76 |
$14.76 |
$14.76 |
$57.85
|
|
Antibody elution rbc reference
|
$111.96 |
$111.96 |
$111.96 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$6.21 |
$6.21 |
$6.21 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$43.56 |
$43.56 |
$43.56 |
$218.30
|
|
Antibody id rbc panel
|
$141.84 |
$141.84 |
$141.84 |
$271.70
|
|
Antibody influenza virus
|
$2.17 |
$2.17 |
$2.17 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$2.06 |
$2.06 |
$2.06 |
$48.57
|
|
Antibody screen rbc
|
$64.26 |
$64.26 |
$64.26 |
$100.00
|
|
Antidepressant not specified
|
$11.70 |
$11.70 |
$11.70 |
$67.41
|
|
Antidepressants class 6/more
|
$0.90 |
$0.90 |
$0.90 |
$29.68
|
|
Antiepileptics nos 7/more
|
$0.72 |
$0.72 |
$0.72 |
$16.24
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$0.27 |
$0.27 |
$0.27 |
$6.10
|
|
Anti mog serum - sendout
|
$31.50 |
$31.50 |
$31.50 |
$161.40
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$2.17 |
$2.17 |
$2.17 |
$38.00
|
|
Ant instr 2-3 vert segm 22845
|
$454.14 |
$454.14 |
$454.14 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$472.86 |
$472.86 |
$472.86 |
$1,430.40
|
|
Antinuclear antibodies
|
$91.44 |
$91.44 |
$91.44 |
$91.44
|
|
Antinuclear antibodies titer
|
$46.62 |
$46.62 |
$46.62 |
$74.75
|
|
Antiphosphatidylserine antibody
|
$7.56 |
$7.56 |
$7.56 |
$58.24
|
|
Antipsychotics nos 1-3
|
$30.78 |
$30.78 |
$30.78 |
$153.45
|
|
Antipsychotics nos 7/more
|
$0.72 |
$0.72 |
$0.72 |
$16.24
|
|
Antistreptolysin o titer
|
$56.70 |
$56.70 |
$56.70 |
$51.45
|
|
Antithrombin iii activity
|
$2.24 |
$2.24 |
$2.24 |
$114.00
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$293.65 |
$293.65 |
$293.65 |
$7,544.81
|
|
Aortic dysfunction/dilation
|
$114.48 |
$114.48 |
$114.48 |
$992.40
|
|
Aortic dysfunction/dilation
|
$306.72 |
$306.72 |
$306.72 |
$1,485.21
|
|
Apheresis immunoads slctv
|
$2,834.10 |
$2,834.10 |
$2,834.10 |
$5,544.24
|
|
Apheresis plasma
|
$993.06 |
$993.06 |
$993.06 |
$3,188.50
|