|
Ak/bk self-aligning unit ea
|
$618.80 |
$618.80 |
$618.80 |
$618.80
|
|
Ak flex inner socket ext fra
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$1,352.40
|
|
Ak/knee disartic acrylic soc
|
$495.60 |
$495.60 |
$495.60 |
$495.60
|
|
Ak/knee disartic pelvic band
|
$120.40 |
$120.40 |
$120.40 |
$185.56
|
|
Ak/knee disartic pelvic join
|
$280.00 |
$280.00 |
$280.00 |
$280.00
|
|
Ak/knee disartic silesian ba
|
$156.80 |
$156.80 |
$156.80 |
$156.80
|
|
Ak open end sach
|
$4,928.00 |
$4,928.00 |
$4,928.00 |
$4,928.00
|
|
Ak pelvic control belt light
|
$201.60 |
$201.60 |
$201.60 |
$201.60
|
|
Ak pelvic control belt pad/l
|
$274.40 |
$274.40 |
$274.40 |
$505.78
|
|
Ak sleeve susp neoprene/equa
|
$246.40 |
$246.40 |
$246.40 |
$275.52
|
|
Ak univ multiplex sys frict
|
$1,587.60 |
$1,587.60 |
$1,587.60 |
$1,587.60
|
|
Albumin body fluid quantitative each specimen
|
$99.68 |
$99.68 |
$99.68 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$210.64 |
$210.64 |
$210.64 |
$219.30
|
|
Albumin, human 25 % intravenous solution
|
$253.01 |
$253.01 |
$253.01 |
$234.94
|
|
Albumin, human 5 % intravenous solution
|
$296.32 |
$296.32 |
$296.32 |
$296.32
|
|
Albumin ischemia modified
|
$347.20 |
$347.20 |
$347.20 |
$50.28
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$47.60 |
$47.60 |
$47.60 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$45.36 |
$45.36 |
$45.36 |
$40.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$82.32 |
$82.32 |
$82.32 |
$94.90
|
|
Alcohols biomarkers 3/more
|
$16.24 |
$16.24 |
$16.24 |
$16.24
|
|
Alcohol/sub misuse assess
|
$81.76 |
$81.76 |
$81.76 |
$31.20
|
|
Alcohol/subs interv 15-30mn
|
$238.56 |
$238.56 |
$238.56 |
$54.08
|
|
Alcohol/subs interv >30 min
|
$442.40 |
$442.40 |
$442.40 |
$189.21
|
|
Aldesleukin injection
|
$9,724.73 |
$9,724.73 |
$9,724.73 |
$9,030.11
|
|
Aldosterone suppression eval
|
$1,187.20 |
$1,187.20 |
$1,187.20 |
$315.20
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$47,974.31 |
$47,974.31 |
$47,974.31 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$11.20 |
$11.20 |
$11.20 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$43.72 |
$43.72 |
$43.72 |
$41.71
|
|
Alginate drsg wound filler
|
$15.79 |
$15.79 |
$15.79 |
$15.79
|
|
Alkaline phosphatase
|
$36.96 |
$36.96 |
$36.96 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$36.40 |
$36.40 |
$36.40 |
$48.57
|
|
Allergen egg white ige
|
$28.00 |
$28.00 |
$28.00 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$71.68 |
$71.68 |
$71.68 |
$24.60
|
|
Allergy injections; 2 or more 95117
|
$165.20 |
$165.20 |
$165.20 |
$43.75
|
|
Allergy injection; single 95115
|
$58.24 |
$58.24 |
$58.24 |
$42.75
|
|
Allergy Skin Testing
|
$627.20 |
$627.20 |
$627.20 |
$53.43
|
|
Allg patch or app # of tests 95044
|
$627.20 |
$627.20 |
$627.20 |
$289.00
|
|
Allgrft implnt knee w/scope
|
$16,861.60 |
$16,861.60 |
$16,861.60 |
$6,411.60
|
|
Allograft 160mg placental salera mini membrane
|
$34.72 |
$34.72 |
$34.72 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$5,814.48 |
$5,814.48 |
$5,814.48 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$4,819.38 |
$4,819.38 |
$4,819.38 |
$2,677.80
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$5,213.60 |
$5,213.60 |
$5,213.60 |
$5,913.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$11,781.00 |
$11,781.00 |
$11,781.00 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$5,173.00 |
$5,173.00 |
$5,173.00 |
$814.22
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,677.40 |
$4,677.40 |
$4,677.40 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,488.00 |
$5,488.00 |
$5,488.00 |
$3,604.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,384.80 |
$4,384.80 |
$4,384.80 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$4,494.00 |
$4,494.00 |
$4,494.00 |
$1,495.63
|
|
Alloskin
|
$487.20 |
$487.20 |
$487.20 |
$582.40
|
|
All tstg perq&iq drugs/biol
|
$159.60 |
$159.60 |
$159.60 |
$70.50
|
|
All tstg perq&iq w/venoms
|
$145.60 |
$145.60 |
$145.60 |
$47.45
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$4.28 |
$4.28 |
$4.28 |
$9.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$113.68 |
$113.68 |
$113.68 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$204.40 |
$204.40 |
$204.40 |
$97.80
|
|
Alpha-fetoprotein tumor marker
|
$117.04 |
$117.04 |
$117.04 |
$106.00
|
|
Alprostadil for injection
|
$559.93 |
$559.93 |
$559.93 |
$519.93
|
|
Alprostadil urethral suppos
|
$161.58 |
$161.58 |
$161.58 |
$150.04
|
|
Alteplase 100 mg infusion from pyxis vial
|
$14,196.02 |
$14,196.02 |
$14,196.02 |
$15,857.45
|
|
Alt/sgpt
|
$43.12 |
$43.12 |
$43.12 |
$47.80
|
|
Altuviiio per factor viii iu
|
$15.30 |
$15.30 |
$15.30 |
$13.32
|
|
Aluminum - quest
|
$66.64 |
$66.64 |
$66.64 |
$81.49
|
|
Alveoloplasty each quadrant
|
$3,892.00 |
$3,892.00 |
$3,892.00 |
$3,837.72
|
|
Alys cplx sp/pn npgt w/prgrm
|
$728.00 |
$728.00 |
$728.00 |
$444.50
|
|
Amantadine (symmetrel)-sendout
|
$80.08 |
$80.08 |
$80.08 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$532.00 |
$532.00 |
$532.00 |
$320.45
|
|
Amifostine
|
$1,874.76 |
$1,874.76 |
$1,874.76 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$16.80 |
$16.80 |
$16.80 |
$36.30
|
|
Amines vaginal fluid qual
|
$38.64 |
$38.64 |
$38.64 |
$12.00
|
|
Amino acid screen, urine
|
$169.12 |
$169.12 |
$169.12 |
$77.00
|
|
Amino acid single qual
|
$141.12 |
$141.12 |
$141.12 |
$36.00
|
|
Amino acids quant 2-5
|
$55.44 |
$55.44 |
$55.44 |
$138.03
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$19.44 |
$19.44 |
$19.44 |
$37.33
|
|
Aminolevulinic acid delta
|
$45.92 |
$45.92 |
$45.92 |
$74.10
|
|
Aminolevulinic acid hcl top
|
$689.84 |
$689.84 |
$689.84 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$48.48 |
$48.48 |
$48.48 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$95.87 |
$95.87 |
$95.87 |
$130.12
|
|
Amiodarone 50 mg/ml intravenous solution
|
$124.32 |
$124.32 |
$124.32 |
$58.46
|
|
Amitriptyline (elavil) -sendout
|
$84.56 |
$84.56 |
$84.56 |
$92.50
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$6,676.24 |
$6,676.24 |
$6,676.24 |
$9,084.45
|
|
Ammonia
|
$222.88 |
$222.88 |
$222.88 |
$117.00
|
|
Amnioarmor 1 sq cm
|
$16.80 |
$16.80 |
$16.80 |
$16.80
|
|
Amniocentesisdiagnostic 59000
|
$2,150.40 |
$2,150.40 |
$2,150.40 |
$943.50
|
|
Amniocentesis therapeutic
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$778.57
|
|
Amniotic fluid scan
|
$84.00 |
$84.00 |
$84.00 |
$49.01
|
|
Amobarbital 125 mg inj
|
$1,283.59 |
$1,283.59 |
$1,283.59 |
$1,283.59
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$7,845.60 |
$7,845.60 |
$7,845.60 |
$3,839.54
|
|
Amphetamine confirm urine -sendout
|
$80.08 |
$80.08 |
$80.08 |
$93.61
|
|
Amphetamines 5 or more
|
$16.24 |
$16.24 |
$16.24 |
$87.75
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$103.60 |
$103.60 |
$103.60 |
$117.75
|
|
Amphotericin b lipid complex
|
$186.26 |
$186.26 |
$186.26 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$558.95 |
$558.95 |
$558.95 |
$548.00
|
|
Ampicillin 1 gram solution for injection
|
$159.72 |
$159.72 |
$159.72 |
$62.14
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$122.50 |
$122.50 |
$122.50 |
$55.69
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$262.08 |
$262.08 |
$262.08 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$8,786.40 |
$8,786.40 |
$8,786.40 |
$4,313.40
|
|
Amputate hand at wrist
|
$5,112.80 |
$5,112.80 |
$5,112.80 |
$3,086.40
|
|
Amputate metacarpal bone 26910
|
$9,486.40 |
$9,486.40 |
$9,486.40 |
$3,839.54
|
|
Amputation follow-up surgery
|
$7,588.00 |
$7,588.00 |
$7,588.00 |
$3,839.54
|
|
Amputation follow-up surgery
|
$7,285.60 |
$7,285.60 |
$7,285.60 |
$3,839.54
|
|
Amputation follow-up surgery
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$7,807.24
|
