|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$11.80 |
$11.80 |
$11.80 |
$41.45
|
|
Administration vaccine hepatitis b
|
$13.00 |
$13.00 |
$13.00 |
$51.35
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$10.20 |
$10.20 |
$10.20 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$4,596.05 |
$4,596.05 |
$4,596.05 |
$11,874.55
|
|
Adrenal cortex & medulla img
|
$27.60 |
$27.60 |
$27.60 |
$1,780.19
|
|
Advance care planning each additional 30 min 99498
|
$35.00 |
$35.00 |
$35.00 |
$108.00
|
|
_afb id by dna probe rflx ast
|
$11.80 |
$11.80 |
$11.80 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$23.48 |
$23.48 |
$23.48 |
$295.94
|
|
Afo tib fx semi-rigid l2114
|
$436.00 |
$436.00 |
$436.00 |
$817.60
|
|
After cataract laser surgery
|
$219.60 |
$219.60 |
$219.60 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$7,138.65 |
$7,138.65 |
$7,138.65 |
$14,760.37
|
|
Air conduction bilat
|
$35.20 |
$35.20 |
$35.20 |
$122.40
|
|
Air injection into abdomen 49400
|
$60.20 |
$60.20 |
$60.20 |
$531.49
|
|
Airway resistance by impulse oscillometry 94728
|
$210.00 |
$210.00 |
$210.00 |
$269.36
|
|
Albumin body fluid quantitative each specimen
|
$12.40 |
$12.40 |
$12.40 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$118.15 |
$118.15 |
$118.15 |
$222.61
|
|
Albumin (human), 5%, 250 ml
|
$95.26 |
$95.26 |
$95.26 |
$237.90
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$22.80 |
$22.80 |
$22.80 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$15.60 |
$15.60 |
$15.60 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$3.20 |
$3.20 |
$3.20 |
$5.40
|
|
Albuterol non-comp con
|
$5.40 |
$5.40 |
$5.40 |
$6.00
|
|
Albuterol non-comp unit
|
$5.40 |
$5.40 |
$5.40 |
$5.61
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$3.55 |
$3.55 |
$3.55 |
$93.60
|
|
Alginate dressing <=16 sq in
|
$5.20 |
$5.20 |
$5.20 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$11.40 |
$11.40 |
$11.40 |
$40.89
|
|
Alginate drsg wound filler
|
$3.60 |
$3.60 |
$3.60 |
$15.79
|
|
Alkaline phosphatase
|
$22.80 |
$22.80 |
$22.80 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$8.05 |
$8.05 |
$8.05 |
$48.57
|
|
Allergen egg white ige
|
$37.80 |
$37.80 |
$37.80 |
$37.05
|
|
Allergen specific ige qual multi scrn ea
|
$1.59 |
$1.59 |
$1.59 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$6.40 |
$6.40 |
$6.40 |
$40.05
|
|
Allergy injection; single 95115
|
$5.60 |
$5.60 |
$5.60 |
$42.75
|
|
Allergy Skin Testing
|
$2.40 |
$2.40 |
$2.40 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$3.00 |
$3.00 |
$3.00 |
$387.59
|
|
Allgrft implnt knee w/scope
|
$885.60 |
$885.60 |
$885.60 |
$6,411.60
|
|
Allograft amnioexcel plus 17mm disk
|
$149.40 |
$149.40 |
$149.40 |
$2,250.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$348.60 |
$348.60 |
$348.60 |
$676.69
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,551.60 |
$2,551.60 |
$2,551.60 |
$1,616.79
|
|
All tstg perq&iq drugs/biol
|
$11.00 |
$11.00 |
$11.00 |
$64.50
|
|
All tstg perq&iq w/venoms
|
$26.80 |
$26.80 |
$26.80 |
$41.34
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$11.45 |
$11.45 |
$11.45 |
$175.20
|
|
Alpha-fetoprotein tumor marker
|
$42.20 |
$42.20 |
$42.20 |
$103.60
|
|
Alprostadil for injection
|
$221.50 |
$221.50 |
$221.50 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$242.20 |
$242.20 |
$242.20 |
$15,857.45
|
|
Alt/sgpt
|
$26.60 |
$26.60 |
$26.60 |
$47.80
|
|
Aluminum - quest
|
$3.94 |
$3.94 |
$3.94 |
$81.49
|
|
Alveoloplasty each quadrant
|
$177.40 |
$177.40 |
$177.40 |
$3,837.72
|
|
Alys cplx sp/pn npgt w/prgrm
|
$39.40 |
$39.40 |
$39.40 |
$431.84
|
|
Amantadine (symmetrel)-sendout
|
$51.20 |
$51.20 |
$51.20 |
$174.75
|
|
Ambl bp mntr w/software
|
$28.80 |
$28.80 |
$28.80 |
$108.55
|
|
Amino acids quant 2-5
|
$32.11 |
$32.11 |
$32.11 |
$113.60
|
|
Aminolevulinic acid delta
|
$2.93 |
$2.93 |
$2.93 |
$85.15
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$60.36 |
$60.36 |
$60.36 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$4.63 |
$4.63 |
$4.63 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$6.95 |
$6.95 |
$6.95 |
$89.05
|
|
Ammonia
|
$77.40 |
$77.40 |
$77.40 |
$117.00
|
|
Amniocentesisdiagnostic 59000
|
$530.20 |
$530.20 |
$530.20 |
$894.00
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$487.80 |
$487.80 |
$487.80 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$45.80 |
$45.80 |
$45.80 |
$93.61
|
|
Amphetamines 5 or more
|
$114.40 |
$114.40 |
$114.40 |
$77.44
|
|
Ampicillin 1 gram solution for injection
|
$23.18 |
$23.18 |
$23.18 |
$59.05
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$12.72 |
$12.72 |
$12.72 |
$52.65
|
|
Amp metatarsal w/toe single 28810
|
$293.00 |
$293.00 |
$293.00 |
$3,958.50
|
|
Amp thigh through femur re-amp 27596
|
$478.00 |
$478.00 |
$478.00 |
$3,342.87
|
|
Amputate leg at thigh
|
$451.80 |
$451.80 |
$451.80 |
$2,854.80
|
|
Amputate lower leg at knee
|
$467.60 |
$467.60 |
$467.60 |
$3,480.00
|
|
Amputate metacarpal bone 26910
|
$540.80 |
$540.80 |
$540.80 |
$3,666.29
|
|
Amputate thigh through femur 27590
|
$517.00 |
$517.00 |
$517.00 |
$3,370.00
|
|
Amputation follow-up surgery
|
$563.60 |
$563.60 |
$563.60 |
$3,766.40
|
|
Amputation follow-up surgery
|
$346.40 |
$346.40 |
$346.40 |
$3,839.54
|
|
Amputation follow-up surgery
|
$392.80 |
$392.80 |
$392.80 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$594.60 |
$594.60 |
$594.60 |
$2,446.80
|
|
Amputation leg; tib/fib f/u 27886
|
$438.00 |
$438.00 |
$438.00 |
$1,445.40
|
|
Amputation of foot at ankle
|
$429.40 |
$429.40 |
$429.40 |
$5,886.74
|
|
Amputation of foot at ankle
|
$376.00 |
$376.00 |
$376.00 |
$1,240.80
|
|
Amputation of hand
|
$608.00 |
$608.00 |
$608.00 |
$2,363.40
|
|
Amputation of lower leg
|
$393.60 |
$393.60 |
$393.60 |
$2,545.40
|
|
Amputation of lower leg
|
$555.40 |
$555.40 |
$555.40 |
$3,342.87
|
|
Amputation of midtarsal 28800
|
$368.20 |
$368.20 |
$368.20 |
$2,285.40
|
|
Amputation of upper arm
|
$536.60 |
$536.60 |
$536.60 |
$2,646.80
|
|
Amputation thru metatarsal
|
$485.40 |
$485.40 |
$485.40 |
$3,821.05
|
|
Amputation toe interphalangeal joint
|
$2,636.40 |
$2,636.40 |
$2,636.40 |
$3,969.00
|
|
Amputation toe metatarsophalangeal joint
|
$3,442.60 |
$3,442.60 |
$3,442.60 |
$3,821.05
|
|
Amylase
|
$37.40 |
$37.40 |
$37.40 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$15.60 |
$15.60 |
$15.60 |
$80.08
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$1.20 |
$1.20 |
$1.20 |
$106.70
|
|
Anal/urinary muscle study
|
$75.60 |
$75.60 |
$75.60 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$28.40 |
$28.40 |
$28.40 |
$292.00
|
|
Analysis gene f2 20210g>a variant
|
$7.58 |
$7.58 |
$7.58 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$7.60 |
$7.60 |
$7.60 |
$236.00
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$21.40 |
$21.40 |
$21.40 |
$113.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$26.60 |
$26.60 |
$26.60 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$6.03 |
$6.03 |
$6.03 |
$92.07
|
|
Anca screen with reflex to titer -quest
|
$2.68 |
$2.68 |
$2.68 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$2,581.80 |
$2,581.80 |
$2,581.80 |
$2,494.35
|
|
An fluoro guide for cvp
|
$383.80 |
$383.80 |
$383.80 |
$520.20
|
|
Angio balloon ctrl dialysis seg add-on
|
$95.20 |
$95.20 |
$95.20 |
$5,341.83
|
|
Angiotensin ii
|
$23.80 |
$23.80 |
$23.80 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$940.13 |
$940.13 |
$940.13 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ea addl
|
$112.20 |
$112.20 |
$112.20 |
$4,683.90
|
