|
_afb id by dna probe rflx ast
|
$37.96 |
$37.96 |
$37.96 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$85.28 |
$85.28 |
$85.28 |
$35.51
|
|
Aflibercept injection
|
$3,153.84 |
$3,153.84 |
$3,153.84 |
$3,153.84
|
|
Afo tib fx semi-rigid l2114
|
$1,133.60 |
$1,133.60 |
$1,133.60 |
$817.60
|
|
Afo tibial fracture rigid
|
$322.40 |
$322.40 |
$322.40 |
$1,654.77
|
|
After cataract laser surgery
|
$1,570.40 |
$1,570.40 |
$1,570.40 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$12,701.89 |
$12,701.89 |
$12,701.89 |
$14,475.20
|
|
Air conduction bilat
|
$149.76 |
$149.76 |
$149.76 |
$133.00
|
|
Air injection into abdomen 49400
|
$681.20 |
$681.20 |
$681.20 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$365.04 |
$365.04 |
$365.04 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$17.16 |
$17.16 |
$17.16 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$195.59 |
$195.59 |
$195.59 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$234.94 |
$234.94 |
$234.94 |
$234.94
|
|
Albumin, human 5 % intravenous solution
|
$275.16 |
$275.16 |
$275.16 |
$296.32
|
|
Albumin ischemia modified
|
$263.12 |
$263.12 |
$263.12 |
$85.60
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$12.48 |
$12.48 |
$12.48 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$24.96 |
$24.96 |
$24.96 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$89.96 |
$89.96 |
$89.96 |
$93.60
|
|
Alcohols biomarkers 3/more
|
$130.00 |
$130.00 |
$130.00 |
$16.24
|
|
Alcohol/subs interv 15-30mn
|
$93.60 |
$93.60 |
$93.60 |
$51.52
|
|
Alcohol/subs interv >30 min
|
$342.16 |
$342.16 |
$342.16 |
$190.13
|
|
Aldesleukin injection
|
$9,030.11 |
$9,030.11 |
$9,030.11 |
$9,030.11
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$44,547.57 |
$44,547.57 |
$44,547.57 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$11.44 |
$11.44 |
$11.44 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$40.60 |
$40.60 |
$40.60 |
$43.72
|
|
Alginate drsg wound filler
|
$14.66 |
$14.66 |
$14.66 |
$15.79
|
|
Alkaline phosphatase
|
$46.80 |
$46.80 |
$46.80 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$38.48 |
$38.48 |
$38.48 |
$48.00
|
|
Allergen egg white ige
|
$8.32 |
$8.32 |
$8.32 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$34.84 |
$34.84 |
$34.84 |
$24.01
|
|
Allergy injections; 2 or more 95117
|
$73.84 |
$73.84 |
$73.84 |
$43.75
|
|
Allergy injection; single 95115
|
$73.84 |
$73.84 |
$73.84 |
$42.75
|
|
Allergy Skin Testing
|
$566.28 |
$566.28 |
$566.28 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$263.64 |
$263.64 |
$263.64 |
$445.00
|
|
Allgrft implnt knee w/scope
|
$6,411.60 |
$6,411.60 |
$6,411.60 |
$6,411.60
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$5,399.16 |
$5,399.16 |
$5,399.16 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$4,475.14 |
$4,475.14 |
$4,475.14 |
$2,250.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$4,841.20 |
$4,841.20 |
$4,841.20 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$10,939.50 |
$10,939.50 |
$10,939.50 |
$23,373.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$4,803.50 |
$4,803.50 |
$4,803.50 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,343.30 |
$4,343.30 |
$4,343.30 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,096.00 |
$5,096.00 |
$5,096.00 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,071.60 |
$4,071.60 |
$4,071.60 |
$4,561.83
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$4,173.00 |
$4,173.00 |
$4,173.00 |
$1,495.63
|
|
All tstg perq&iq drugs/biol
|
$116.48 |
$116.48 |
$116.48 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$73.32 |
$73.32 |
$73.32 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$3.98 |
$3.98 |
$3.98 |
$12.50
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$217.36 |
$217.36 |
$217.36 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$149.24 |
$149.24 |
$149.24 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$26.00 |
$26.00 |
$26.00 |
$106.00
|
|
Alprostadil for injection
|
$519.93 |
$519.93 |
$519.93 |
$519.93
|
|
Alprostadil urethral suppos
|
$150.04 |
$150.04 |
$150.04 |
$150.04
|
|
Alteplase 100 mg infusion from pyxis vial
|
$13,182.02 |
$13,182.02 |
$13,182.02 |
$15,857.45
|
|
Alt/sgpt
|
$21.32 |
$21.32 |
$21.32 |
$47.45
|
|
Altuviiio per factor viii iu
|
$14.21 |
$14.21 |
$14.21 |
$13.32
|
|
Aluminum - quest
|
$45.76 |
$45.76 |
$45.76 |
$83.05
|
|
Alveoloplasty each quadrant
|
$4,061.20 |
$4,061.20 |
$4,061.20 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$352.04 |
$352.04 |
$352.04 |
$434.00
|
|
Amantadine (symmetrel)-sendout
|
$48.88 |
$48.88 |
$48.88 |
$169.80
|
|
Ambl bp mntr w/sw a/r
|
$310.44 |
$310.44 |
$310.44 |
$310.44
|
|
Amifostine
|
$1,740.85 |
$1,740.85 |
$1,740.85 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$15.60 |
$15.60 |
$15.60 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$18.05 |
$18.05 |
$18.05 |
$37.14
|
|
Aminolevulinic acid hcl top
|
$640.56 |
$640.56 |
$640.56 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$45.02 |
$45.02 |
$45.02 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$89.02 |
$89.02 |
$89.02 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$115.44 |
$115.44 |
$115.44 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$260.00 |
$260.00 |
$260.00 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$6,199.36 |
$6,199.36 |
$6,199.36 |
$7,994.03
|
|
Ammonia
|
$180.96 |
$180.96 |
$180.96 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,482.00 |
$1,482.00 |
$1,482.00 |
$942.60
|
|
Amniocentesis therapeutic
|
$587.60 |
$587.60 |
$587.60 |
$785.85
|
|
Amniotic fluid scan
|
$61.88 |
$61.88 |
$61.88 |
$49.01
|
|
Amobarbital 125 mg inj
|
$1,191.90 |
$1,191.90 |
$1,191.90 |
$1,283.59
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$4,108.00 |
$4,108.00 |
$4,108.00 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$130.00 |
$130.00 |
$130.00 |
$92.61
|
|
Amphetamines 5 or more
|
$130.00 |
$130.00 |
$130.00 |
$82.96
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$96.20 |
$96.20 |
$96.20 |
$117.75
|
|
Amphotericin b lipid complex
|
$172.95 |
$172.95 |
$172.95 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$519.03 |
$519.03 |
$519.03 |
$543.85
|
|
Ampicillin 1 gram solution for injection
|
$148.31 |
$148.31 |
$148.31 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$113.75 |
$113.75 |
$113.75 |
$53.86
|
|
Amp metatarsal w/toe single 28810
|
$4,914.00 |
$4,914.00 |
$4,914.00 |
$4,271.00
|
|
Amputate metacarpal bone 26910
|
$4,914.00 |
$4,914.00 |
$4,914.00 |
$3,821.05
|
|
Amputation thru metatarsal
|
$4,914.00 |
$4,914.00 |
$4,914.00 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$4,914.00 |
$4,914.00 |
$4,914.00 |
$3,998.20
|
|
Amputation toe metatarsophalangeal joint
|
$4,914.00 |
$4,914.00 |
$4,914.00 |
$3,839.54
|
|
Amylase
|
$82.68 |
$82.68 |
$82.68 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$197.08 |
$197.08 |
$197.08 |
$80.08
|
|
Anabolic steroid 3 or more
|
$197.08 |
$197.08 |
$197.08 |
$27.20
|
|
Ana ds-dna
|
$117.00 |
$117.00 |
$117.00 |
$56.50
|
|
Analgesics non-opioid 3-5
|
$153.92 |
$153.92 |
$153.92 |
$16.24
|
|
Analgesics non-opioid 6/more
|
$153.92 |
$153.92 |
$153.92 |
$16.24
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$200.20 |
$200.20 |
$200.20 |
$117.01
|
|
Anal/urinary muscle study
|
$452.92 |
$452.92 |
$452.92 |
$407.00
|
|
Anal/urinary muscle study
|
$810.68 |
$810.68 |
$810.68 |
$576.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$352.04 |
$352.04 |
$352.04 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$279.24 |
$279.24 |
$279.24 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$281.32 |
$281.32 |
$281.32 |
$230.40
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$352.04 |
$352.04 |
$352.04 |
$122.20
|
