|
Administration immunization each additional vaccine
|
$10.37 |
$10.37 |
$10.37 |
$46.23
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$7.31 |
$7.31 |
$7.31 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$5.10 |
$5.10 |
$5.10 |
$30.00
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$10.54 |
$10.54 |
$10.54 |
$41.45
|
|
Administration vaccine hepatitis b
|
$10.54 |
$10.54 |
$10.54 |
$51.11
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$10.54 |
$10.54 |
$10.54 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$10,417.71 |
$10,417.71 |
$10,417.71 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$23.46 |
$23.46 |
$23.46 |
$1,780.19
|
|
Advance care planning each additional 30 min 99498
|
$29.75 |
$29.75 |
$29.75 |
$108.00
|
|
_afb id by dna probe rflx ast
|
$2.76 |
$2.76 |
$2.76 |
$95.28
|
|
_afb org id by sequencing rflx ast-sendout
|
$44.86 |
$44.86 |
$44.86 |
$293.02
|
|
Afo tib fx semi-rigid l2114
|
$370.60 |
$370.60 |
$370.60 |
$817.60
|
|
After cataract laser surgery
|
$186.66 |
$186.66 |
$186.66 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$9,181.62 |
$9,181.62 |
$9,181.62 |
$14,475.20
|
|
Air conduction bilat
|
$40.46 |
$40.46 |
$40.46 |
$122.40
|
|
Air injection into abdomen 49400
|
$288.15 |
$288.15 |
$288.15 |
$526.80
|
|
Airway resistance by impulse oscillometry 94728
|
$5.10 |
$5.10 |
$5.10 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$42.67 |
$42.67 |
$42.67 |
$45.65
|
|
Albumin (human), 25%, 50ml
|
$358.11 |
$358.11 |
$358.11 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$72.25 |
$72.25 |
$72.25 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$61.88 |
$61.88 |
$61.88 |
$41.34
|
|
Albuterol ipratrop non-comp
|
$2.72 |
$2.72 |
$2.72 |
$5.40
|
|
Albuterol non-comp con
|
$6.63 |
$6.63 |
$6.63 |
$6.07
|
|
Albuterol non-comp unit
|
$4.59 |
$4.59 |
$4.59 |
$5.61
|
|
Alginate dressing <=16 sq in
|
$4.42 |
$4.42 |
$4.42 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$9.69 |
$9.69 |
$9.69 |
$41.71
|
|
Alginate drsg wound filler
|
$3.06 |
$3.06 |
$3.06 |
$15.87
|
|
Alkaline phosphatase
|
$69.36 |
$69.36 |
$69.36 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$6.84 |
$6.84 |
$6.84 |
$48.57
|
|
Allergen egg white ige
|
$11.73 |
$11.73 |
$11.73 |
$37.20
|
|
Allergen specific ige qual multi scrn ea
|
$1.35 |
$1.35 |
$1.35 |
$23.91
|
|
Allergy injections; 2 or more 95117
|
$28.56 |
$28.56 |
$28.56 |
$40.05
|
|
Allergy injection; single 95115
|
$21.93 |
$21.93 |
$21.93 |
$42.75
|
|
Allergy Skin Testing
|
$5.78 |
$5.78 |
$5.78 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$2.55 |
$2.55 |
$2.55 |
$387.59
|
|
Allgrft implnt knee w/scope
|
$752.76 |
$752.76 |
$752.76 |
$6,411.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$199.92 |
$199.92 |
$199.92 |
$724.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$2,509.20 |
$2,509.20 |
$2,509.20 |
$4,474.69
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$185.64 |
$185.64 |
$185.64 |
$1,406.19
|
|
All tstg perq&iq drugs/biol
|
$9.18 |
$9.18 |
$9.18 |
$64.50
|
|
All tstg perq&iq w/venoms
|
$12.24 |
$12.24 |
$12.24 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$0.60 |
$0.60 |
$0.60 |
$10.65
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$9.73 |
$9.73 |
$9.73 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$2.05 |
$2.05 |
$2.05 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$2.05 |
$2.05 |
$2.05 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$13,090.00 |
$13,090.00 |
$13,090.00 |
$15,857.45
|
|
Alt/sgpt
|
$84.83 |
$84.83 |
$84.83 |
$48.80
|
|
Aluminum - quest
|
$3.35 |
$3.35 |
$3.35 |
$81.49
|
|
Alveoloplasty each quadrant
|
$150.79 |
$150.79 |
$150.79 |
$3,837.72
|
|
Alys cplx sp/pn npgt w/prgrm
|
$59.50 |
$59.50 |
$59.50 |
$431.84
|
|
Amantadine (symmetrel)-sendout
|
$54.23 |
$54.23 |
$54.23 |
$173.16
|
|
Ambl bp mntr w/software
|
$24.48 |
$24.48 |
$24.48 |
$108.55
|
|
Amino acids quant 2-5
|
$14.32 |
$14.32 |
$14.32 |
$104.00
|
|
Aminolevulinic acid delta
|
$2.49 |
$2.49 |
$2.49 |
$82.93
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$31.63 |
$31.63 |
$31.63 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$139.18 |
$139.18 |
$139.18 |
$119.63
|
|
Amiodarone 50 mg/ml intravenous solution
|
$15.30 |
$15.30 |
$15.30 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$5.91 |
$5.91 |
$5.91 |
$90.00
|
|
Ammonia
|
$195.16 |
$195.16 |
$195.16 |
$118.83
|
|
Amniocentesisdiagnostic 59000
|
$128.18 |
$128.18 |
$128.18 |
$894.00
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$414.63 |
$414.63 |
$414.63 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$38.93 |
$38.93 |
$38.93 |
$92.61
|
|
Amphetamines 5 or more
|
$82.96 |
$82.96 |
$82.96 |
$80.25
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$122.91 |
$122.91 |
$122.91 |
$117.75
|
|
Ampicillin 1 gram solution for injection
|
$32.70 |
$32.70 |
$32.70 |
$54.59
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$25.06 |
$25.06 |
$25.06 |
$52.65
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$97.41 |
$97.41 |
$97.41 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$1,307.30 |
$1,307.30 |
$1,307.30 |
$3,958.50
|
|
Amp thigh through femur re-amp 27596
|
$406.30 |
$406.30 |
$406.30 |
$3,342.87
|
|
Amputate leg at thigh
|
$384.03 |
$384.03 |
$384.03 |
$2,854.80
|
|
Amputate lower leg at knee
|
$397.46 |
$397.46 |
$397.46 |
$3,480.00
|
|
Amputate metacarpal bone 26910
|
$459.68 |
$459.68 |
$459.68 |
$3,666.29
|
|
Amputate thigh through femur 27590
|
$439.45 |
$439.45 |
$439.45 |
$3,342.87
|
|
Amputation follow-up surgery
|
$479.06 |
$479.06 |
$479.06 |
$3,766.40
|
|
Amputation follow-up surgery
|
$294.44 |
$294.44 |
$294.44 |
$3,839.54
|
|
Amputation follow-up surgery
|
$333.88 |
$333.88 |
$333.88 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$505.41 |
$505.41 |
$505.41 |
$2,446.80
|
|
Amputation leg; tib/fib f/u 27886
|
$372.30 |
$372.30 |
$372.30 |
$1,461.89
|
|
Amputation of foot at ankle
|
$364.99 |
$364.99 |
$364.99 |
$5,886.74
|
|
Amputation of foot at ankle
|
$319.60 |
$319.60 |
$319.60 |
$1,240.80
|
|
Amputation of hand
|
$516.80 |
$516.80 |
$516.80 |
$2,363.40
|
|
Amputation of lower leg
|
$334.56 |
$334.56 |
$334.56 |
$1,417.20
|
|
Amputation of lower leg
|
$472.09 |
$472.09 |
$472.09 |
$3,342.87
|
|
Amputation of midtarsal 28800
|
$312.97 |
$312.97 |
$312.97 |
$2,285.40
|
|
Amputation of upper arm
|
$456.11 |
$456.11 |
$456.11 |
$2,646.80
|
|
Amputation thru metatarsal
|
$412.59 |
$412.59 |
$412.59 |
$3,791.82
|
|
Amputation toe interphalangeal joint
|
$1,346.91 |
$1,346.91 |
$1,346.91 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$176.12 |
$176.12 |
$176.12 |
$3,821.05
|
|
Amylase
|
$89.76 |
$89.76 |
$89.76 |
$89.76
|
|
Anabolic steroid 1 or 2
|
$18.70 |
$18.70 |
$18.70 |
$80.08
|
|
Ana ds-dna
|
$7.14 |
$7.14 |
$7.14 |
$56.50
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$10.54 |
$10.54 |
$10.54 |
$106.70
|
|
Anal/urinary muscle study
|
$55.25 |
$55.25 |
$55.25 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$24.14 |
$24.14 |
$24.14 |
$292.00
|
|
Analysis gene f2 20210g>a variant
|
$61.72 |
$61.72 |
$61.72 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$34.02 |
$34.02 |
$34.02 |
$236.00
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$18.19 |
$18.19 |
$18.19 |
$113.60
|
|
Analysis tumor
|
$15.66 |
$15.66 |
$15.66 |
$237.89
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$59.50 |
$59.50 |
$59.50 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$5.13 |
$5.13 |
$5.13 |
$92.40
|
