|
88334 ap bill cytologic exam each additional site
|
$92.82 |
$92.82 |
$92.82 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$21.96 |
$21.96 |
$21.96 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$6,557.07 |
$6,557.07 |
$6,557.07 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$5,307.57 |
$5,307.57 |
$5,307.57 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$5,051.04 |
$5,051.04 |
$5,051.04 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$5,118.87 |
$5,118.87 |
$5,118.87 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$4,656.81 |
$4,656.81 |
$4,656.81 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$4,194.24 |
$4,194.24 |
$4,194.24 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,660.05 |
$1,660.05 |
$1,660.05 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$2,803.98 |
$2,803.98 |
$2,803.98 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,818.66 |
$1,818.66 |
$1,818.66 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$1,660.05 |
$1,660.05 |
$1,660.05 |
$1,248.00
|
|
Ablate inf turbinate superf 30801
|
$2,810.61 |
$2,810.61 |
$2,810.61 |
$2,122.56
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$5,480.46 |
$5,480.46 |
$5,480.46 |
$339.18
|
|
Ablation of upper extremity nerves rf
|
$3,249.72 |
$3,249.72 |
$3,249.72 |
$825.60
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$145.35 |
$145.35 |
$145.35 |
$89.91
|
|
Acetaminophen level
|
$623.22 |
$623.22 |
$623.22 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$186.68 |
$186.68 |
$186.68 |
$137.80
|
|
Acetone qualitative
|
$143.82 |
$143.82 |
$143.82 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$22.57 |
$22.57 |
$22.57 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$363.50 |
$363.50 |
$363.50 |
$306.22
|
|
Acetylcysteine non-comp unit
|
$17.60 |
$17.60 |
$17.60 |
$29.01
|
|
Acne surgery 10040
|
$365.67 |
$365.67 |
$365.67 |
$265.20
|
|
Acute hepatitis panel
|
$436.56 |
$436.56 |
$436.56 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$145.69 |
$145.69 |
$145.69 |
$64.45
|
|
#acylcarnitineprfl
|
$87.72 |
$87.72 |
$87.72 |
$87.72
|
|
Adapter b 8 channel 10cm
|
$14,481.71 |
$14,481.71 |
$14,481.71 |
$6,875.44
|
|
Adding walker to prev cast
|
$295.29 |
$295.29 |
$295.29 |
$205.38
|
|
Adenosine 3 mg/250 ml bag for osm
|
$84.15 |
$84.15 |
$84.15 |
$217.04
|
|
Adenovirus antibody,serum - quest
|
$12.16 |
$12.16 |
$12.16 |
$60.00
|
|
Adh-sendout
|
$15.30 |
$15.30 |
$15.30 |
$109.28
|
|
Adjmt/revj ext fixj sys anes
|
$13,465.53 |
$13,465.53 |
$13,465.53 |
$7,907.11
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$3,513.90 |
$3,513.90 |
$3,513.90 |
$2,837.09
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$370.34 |
$370.34 |
$370.34 |
$158.18
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$472.26 |
$472.26 |
$472.26 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$99.45 |
$99.45 |
$99.45 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$173.91 |
$173.91 |
$173.91 |
$267.43
|
|
Administration immunization 1 vaccine
|
$105.57 |
$105.57 |
$105.57 |
$70.00
|
|
Administration immunization each additional vaccine
|
$90.78 |
$90.78 |
$90.78 |
$46.23
|
|
_afb id by dna probe rflx ast
|
$160.14 |
$160.14 |
$160.14 |
$105.00
|
|
Albumin body fluid quantitative each specimen
|
$46.41 |
$46.41 |
$46.41 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$163.95 |
$163.95 |
$163.95 |
$277.87
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$295.29 |
$295.29 |
$295.29 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$109.14 |
$109.14 |
$109.14 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$5.61 |
$5.61 |
$5.61 |
$9.93
|
|
Albuterol non-comp con
|
$12.85 |
$12.85 |
$12.85 |
$9.93
|
|
Albuterol non-comp unit
|
$5.61 |
$5.61 |
$5.61 |
$9.43
|
|
Alkaline phosphatase
|
$169.32 |
$169.32 |
$169.32 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$2.55 |
$2.55 |
$2.55 |
$56.35
|
|
Allergen egg white ige
|
$29.58 |
$29.58 |
$29.58 |
$39.78
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$8,318.96 |
$8,318.96 |
$8,318.96 |
$5,579.34
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$45,440.26 |
$45,440.26 |
$45,440.26 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$17,726.96 |
$17,726.96 |
$17,726.96 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$48,745.30 |
$48,745.30 |
$48,745.30 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$36,144.57 |
$36,144.57 |
$36,144.57 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$8,834.18 |
$8,834.18 |
$8,834.18 |
$4,898.43
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$12,135.23 |
$12,135.23 |
$12,135.23 |
$5,381.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,749.36 |
$8,749.36 |
$8,749.36 |
$5,538.22
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$10,064.32 |
$10,064.32 |
$10,064.32 |
$4,814.57
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$68.85 |
$68.85 |
$68.85 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$148.92 |
$148.92 |
$148.92 |
$103.60
|
|
Alprostadil for injection
|
$527.72 |
$527.72 |
$527.72 |
$550.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$17,531.48 |
$17,531.48 |
$17,531.48 |
$9,600.63
|
|
Alt/sgpt
|
$194.31 |
$194.31 |
$194.31 |
$49.00
|
|
Aluminum - quest
|
$6.12 |
$6.12 |
$6.12 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$84.15 |
$84.15 |
$84.15 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$84.15 |
$84.15 |
$84.15 |
$45.50
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$150.35 |
$150.35 |
$150.35 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$84.15 |
$84.15 |
$84.15 |
$50.85
|
|
Ammonia
|
$507.45 |
$507.45 |
$507.45 |
$123.48
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$6,026.16 |
$6,026.16 |
$6,026.16 |
$3,969.00
|
|
Amphetamine confirm urine -sendout
|
$30.60 |
$30.60 |
$30.60 |
$94.50
|
|
Amphetamines 5 or more
|
$5.56 |
$5.56 |
$5.56 |
$93.60
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$178.58 |
$178.58 |
$178.58 |
$135.63
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$352.88 |
$352.88 |
$352.88 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$84.15 |
$84.15 |
$84.15 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$93.72 |
$93.72 |
$93.72 |
$57.38
|
|
Amp metatarsal w/toe single 28810
|
$6,059.82 |
$6,059.82 |
$6,059.82 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$6,026.16 |
$6,026.16 |
$6,026.16 |
$3,839.54
|
|
Amylase
|
$282.03 |
$282.03 |
$282.03 |
$93.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$623.22 |
$623.22 |
$623.22 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$83.00 |
$83.00 |
$83.00 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$130.92 |
$130.92 |
$130.92 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$51.00 |
$51.00 |
$51.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$4,326.33 |
$4,326.33 |
$4,326.33 |
$2,426.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$4,550.62 |
$4,550.62 |
$4,550.62 |
$6,048.00
|
|
Ankle X-ray
|
$1,077.63 |
$1,077.63 |
$1,077.63 |
$350.85
|
|
Anogenital exam child w imag
|
$413.10 |
$413.10 |
$413.10 |
$238.06
|
|
Anora (draw only)
|
$57.12 |
$57.12 |
$57.12 |
$36.36
|
|
Anoscopy control bleeding 46614
|
$2,511.24 |
$2,511.24 |
$2,511.24 |
$1,777.86
|
|
Anoscopy remove fb 46608
|
$1,927.29 |
$1,927.29 |
$1,927.29 |
$1,313.97
|
|
Antibody bacterium, not elsewhere specified
|
$20.45 |
$20.45 |
$20.45 |
$57.85
|
|
Antibody elution rbc reference
|
$102.00 |
$102.00 |
$102.00 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$28.05 |
$28.05 |
$28.05 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$219.30 |
$219.30 |
$219.30 |
$218.30
|
|
Antibody id rbc panel
|
$567.63 |
$567.63 |
$567.63 |
$291.75
|
|
Antibody influenza virus
|
$50.62 |
$50.62 |
$50.62 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$43.76 |
$43.76 |
$43.76 |
$53.96
|
|
Antibody screen rbc
|
$120.36 |
$120.36 |
$120.36 |
$105.00
|
|
Antibody tetanus
|
$46.50 |
$46.50 |
$46.50 |
$58.50
|
