|
Allergen egg white ige
|
$32.11 |
$32.11 |
$32.11 |
$37.05
|
|
Allergen specific ige qual multi scrn ea
|
$1.51 |
$1.51 |
$1.51 |
$24.00
|
|
Allergy Skin Testing
|
$2.28 |
$2.28 |
$2.28 |
$47.44
|
|
Allgrft implnt knee w/scope
|
$841.32 |
$841.32 |
$841.32 |
$6,411.60
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$5,744.08 |
$5,744.08 |
$5,744.08 |
$8,800.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,474.69 |
$4,474.69 |
$4,474.69 |
$4,474.69
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,611.93 |
$2,611.93 |
$2,611.93 |
$1,616.79
|
|
All tstg perq&iq drugs/biol
|
$3.23 |
$3.23 |
$3.23 |
$64.50
|
|
All tstg perq&iq w/venoms
|
$1.71 |
$1.71 |
$1.71 |
$41.34
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$10.88 |
$10.88 |
$10.88 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$2.29 |
$2.29 |
$2.29 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$56.24 |
$56.24 |
$56.24 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$217.43 |
$217.43 |
$217.43 |
$15,857.45
|
|
Alt/sgpt
|
$47.50 |
$47.50 |
$47.50 |
$47.80
|
|
Aluminum - quest
|
$3.75 |
$3.75 |
$3.75 |
$81.49
|
|
Alveoloplasty each quadrant
|
$168.53 |
$168.53 |
$168.53 |
$3,837.72
|
|
Alys cplx sp/pn npgt w/prgrm
|
$18.24 |
$18.24 |
$18.24 |
$431.84
|
|
Amantadine (symmetrel)-sendout
|
$48.64 |
$48.64 |
$48.64 |
$174.75
|
|
Amino acids quant 2-5
|
$2.98 |
$2.98 |
$2.98 |
$113.60
|
|
Aminolevulinic acid delta
|
$2.78 |
$2.78 |
$2.78 |
$85.15
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$57.74 |
$57.74 |
$57.74 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$4.67 |
$4.67 |
$4.67 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$32.68 |
$32.68 |
$32.68 |
$89.05
|
|
Ammonia
|
$106.97 |
$106.97 |
$106.97 |
$117.00
|
|
Amniocentesisdiagnostic 59000
|
$228.00 |
$228.00 |
$228.00 |
$894.00
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$463.41 |
$463.41 |
$463.41 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$44.84 |
$44.84 |
$44.84 |
$93.61
|
|
Amphetamines 5 or more
|
$69.35 |
$69.35 |
$69.35 |
$77.44
|
|
Ampicillin 1 gram solution for injection
|
$23.24 |
$23.24 |
$23.24 |
$59.05
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$18.41 |
$18.41 |
$18.41 |
$52.65
|
|
Amp metatarsal w/toe single 28810
|
$278.35 |
$278.35 |
$278.35 |
$3,958.50
|
|
Amp thigh through femur re-amp 27596
|
$454.10 |
$454.10 |
$454.10 |
$3,342.87
|
|
Amputate leg at thigh
|
$429.21 |
$429.21 |
$429.21 |
$2,854.80
|
|
Amputate lower leg at knee
|
$444.22 |
$444.22 |
$444.22 |
$3,480.00
|
|
Amputate metacarpal bone 26910
|
$513.76 |
$513.76 |
$513.76 |
$3,666.29
|
|
Amputate thigh through femur 27590
|
$491.15 |
$491.15 |
$491.15 |
$3,370.00
|
|
Amputation follow-up surgery
|
$535.42 |
$535.42 |
$535.42 |
$3,766.40
|
|
Amputation follow-up surgery
|
$329.08 |
$329.08 |
$329.08 |
$3,839.54
|
|
Amputation follow-up surgery
|
$373.16 |
$373.16 |
$373.16 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$564.87 |
$564.87 |
$564.87 |
$2,446.80
|
|
Amputation leg; tib/fib f/u 27886
|
$416.10 |
$416.10 |
$416.10 |
$1,445.40
|
|
Amputation of foot at ankle
|
$407.93 |
$407.93 |
$407.93 |
$5,886.74
|
|
Amputation of foot at ankle
|
$357.20 |
$357.20 |
$357.20 |
$1,240.80
|
|
Amputation of hand
|
$577.60 |
$577.60 |
$577.60 |
$2,363.40
|
|
Amputation of lower leg
|
$373.92 |
$373.92 |
$373.92 |
$2,545.40
|
|
Amputation of lower leg
|
$527.63 |
$527.63 |
$527.63 |
$3,342.87
|
|
Amputation of midtarsal 28800
|
$349.79 |
$349.79 |
$349.79 |
$2,285.40
|
|
Amputation of upper arm
|
$509.77 |
$509.77 |
$509.77 |
$2,646.80
|
|
Amputation thru metatarsal
|
$461.13 |
$461.13 |
$461.13 |
$3,821.05
|
|
Amputation toe interphalangeal joint
|
$111.91 |
$111.91 |
$111.91 |
$3,969.00
|
|
Amputation toe metatarsophalangeal joint
|
$114.76 |
$114.76 |
$114.76 |
$3,821.05
|
|
Amylase
|
$81.70 |
$81.70 |
$81.70 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$83.79 |
$83.79 |
$83.79 |
$80.08
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$11.78 |
$11.78 |
$11.78 |
$106.70
|
|
Anal/urinary muscle study
|
$23.75 |
$23.75 |
$23.75 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$7.20 |
$7.20 |
$7.20 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$7.22 |
$7.22 |
$7.22 |
$236.00
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$17.86 |
$17.86 |
$17.86 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$5.73 |
$5.73 |
$5.73 |
$92.07
|
|
Anca screen with reflex to titer -quest
|
$2.54 |
$2.54 |
$2.54 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$1,687.77 |
$1,687.77 |
$1,687.77 |
$2,494.35
|
|
Androstanediol
|
$54.67 |
$54.67 |
$54.67 |
$115.10
|
|
An fluoro guide for cvp
|
$255.74 |
$255.74 |
$255.74 |
$520.20
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,487.04 |
$4,487.04 |
$4,487.04 |
$5,341.83
|
|
Angiotensin ii
|
$22.61 |
$22.61 |
$22.61 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$317.62 |
$317.62 |
$317.62 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,487.04 |
$4,487.04 |
$4,487.04 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$4,863.62 |
$4,863.62 |
$4,863.62 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,487.04 |
$4,487.04 |
$4,487.04 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$4,422.82 |
$4,422.82 |
$4,422.82 |
$8,359.11
|
|
Ankle arthroscopy/surgery
|
$450.49 |
$450.49 |
$450.49 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$337.44 |
$337.44 |
$337.44 |
$3,821.05
|
|
Ankle arthroscopy/surgery
|
$307.04 |
$307.04 |
$307.04 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$328.51 |
$328.51 |
$328.51 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$373.16 |
$373.16 |
$373.16 |
$3,839.54
|
|
Ankle X-ray
|
$197.79 |
$197.79 |
$197.79 |
$352.20
|
|
Anl sp inf pmp w/mdreprg&fil
|
$29.45 |
$29.45 |
$29.45 |
$627.94
|
|
Annual alcohol screen 15 min
|
$4.18 |
$4.18 |
$4.18 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$39.71 |
$39.71 |
$39.71 |
$148.50
|
|
Annual Physical, Established Patient (age 40-64)
|
$49.40 |
$49.40 |
$49.40 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$45.41 |
$45.41 |
$45.41 |
$151.50
|
|
Annual Physical, New Patient (age 40-64)
|
$59.28 |
$59.28 |
$59.28 |
$167.25
|
|
Anora (draw only)
|
$13.49 |
$13.49 |
$13.49 |
$33.92
|
|
Anoscopy
|
$52.25 |
$52.25 |
$52.25 |
$1,078.88
|
|
Anoscopy ablation lesion 46615
|
$58.90 |
$58.90 |
$58.90 |
$3,229.60
|
|
Anoscopy and biopsy
|
$49.21 |
$49.21 |
$49.21 |
$1,395.28
|
|
Anoscopy and dilation 46604
|
$42.94 |
$42.94 |
$42.94 |
$1,621.60
|
|
Anoscopy remove fb 46608
|
$54.15 |
$54.15 |
$54.15 |
$1,409.10
|
|
Anoscopy remove lesion 46610
|
$52.06 |
$52.06 |
$52.06 |
$3,723.75
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$60.99 |
$60.99 |
$60.99 |
$3,245.23
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$399.95 |
$399.95 |
$399.95 |
$5,394.95
|
|
Antibody bacterium, not elsewhere specified
|
$30.59 |
$30.59 |
$30.59 |
$57.85
|
|
Antibody elution rbc reference
|
$45.60 |
$45.60 |
$45.60 |
$174.93
|
|
Antibody htlv/hiv confirm test
|
$3.27 |
$3.27 |
$3.27 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$39.90 |
$39.90 |
$39.90 |
$219.30
|
|
Antibody id rbc panel
|
$69.16 |
$69.16 |
$69.16 |
$265.05
|
|
Antibody influenza virus
|
$2.29 |
$2.29 |
$2.29 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$2.17 |
$2.17 |
$2.17 |
$48.57
|
|
Antibody screen rbc
|
$40.85 |
$40.85 |
$40.85 |
$101.40
|
|
Antidepressant not specified
|
$12.35 |
$12.35 |
$12.35 |
$68.21
|
