|
After cataract laser surgery
|
$329.40 |
$329.40 |
$329.40 |
$1,373.11
|
|
Air conduction bilat
|
$57.90 |
$57.90 |
$57.90 |
$121.00
|
|
Air injection into abdomen 49400
|
$90.30 |
$90.30 |
$90.30 |
$526.80
|
|
Airway resistance by impulse oscillometry 94728
|
$9.00 |
$9.00 |
$9.00 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$41.10 |
$41.10 |
$41.10 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$333.72 |
$333.72 |
$333.72 |
$228.15
|
|
Albumin (human), 5%, 250 ml
|
$74.30 |
$74.30 |
$74.30 |
$231.94
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$1.52 |
$1.52 |
$1.52 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$53.70 |
$53.70 |
$53.70 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$4.80 |
$4.80 |
$4.80 |
$5.19
|
|
Albuterol non-comp con
|
$8.10 |
$8.10 |
$8.10 |
$6.00
|
|
Albuterol non-comp unit
|
$8.10 |
$8.10 |
$8.10 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$5.33 |
$5.33 |
$5.33 |
$93.60
|
|
Alginate dressing <=16 sq in
|
$7.80 |
$7.80 |
$7.80 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$17.10 |
$17.10 |
$17.10 |
$40.60
|
|
Alginate drsg wound filler
|
$5.40 |
$5.40 |
$5.40 |
$15.79
|
|
Alkaline phosphatase
|
$49.50 |
$49.50 |
$49.50 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$12.08 |
$12.08 |
$12.08 |
$48.00
|
|
Allergen egg white ige
|
$31.50 |
$31.50 |
$31.50 |
$37.00
|
|
Allergen specific ige qual multi scrn ea
|
$2.39 |
$2.39 |
$2.39 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$16.50 |
$16.50 |
$16.50 |
$40.05
|
|
Allergy injection; single 95115
|
$14.10 |
$14.10 |
$14.10 |
$42.75
|
|
Allergy Skin Testing
|
$3.60 |
$3.60 |
$3.60 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$4.50 |
$4.50 |
$4.50 |
$387.59
|
|
Allgrft implnt knee w/scope
|
$1,328.40 |
$1,328.40 |
$1,328.40 |
$6,411.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$118.80 |
$118.80 |
$118.80 |
$724.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$182.10 |
$182.10 |
$182.10 |
$1,671.06
|
|
All tstg perq&iq drugs/biol
|
$16.20 |
$16.20 |
$16.20 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$6.60 |
$6.60 |
$6.60 |
$41.34
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$17.18 |
$17.18 |
$17.18 |
$175.20
|
|
Alpha-fetoprotein tumor marker
|
$65.10 |
$65.10 |
$65.10 |
$100.32
|
|
Alteplase 100 mg infusion from pyxis vial
|
$346.64 |
$346.64 |
$346.64 |
$15,857.45
|
|
Alt/sgpt
|
$52.80 |
$52.80 |
$52.80 |
$47.31
|
|
Aluminum - quest
|
$5.92 |
$5.92 |
$5.92 |
$81.49
|
|
Alveoloplasty each quadrant
|
$266.10 |
$266.10 |
$266.10 |
$3,837.72
|
|
Alys cplx sp/pn npgt w/prgrm
|
$59.10 |
$59.10 |
$59.10 |
$431.84
|
|
Amantadine (symmetrel)-sendout
|
$76.80 |
$76.80 |
$76.80 |
$169.80
|
|
Ambl bp mntr w/software
|
$43.20 |
$43.20 |
$43.20 |
$108.55
|
|
Amino acids quant 2-5
|
$48.17 |
$48.17 |
$48.17 |
$113.60
|
|
Aminolevulinic acid delta
|
$4.39 |
$4.39 |
$4.39 |
$82.50
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$87.42 |
$87.42 |
$87.42 |
$119.63
|
|
Amiodarone 50 mg/ml intravenous solution
|
$11.25 |
$11.25 |
$11.25 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$10.43 |
$10.43 |
$10.43 |
$86.10
|
|
Ammonia
|
$134.40 |
$134.40 |
$134.40 |
$117.00
|
|
Amniocentesisdiagnostic 59000
|
$79.20 |
$79.20 |
$79.20 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$731.70 |
$731.70 |
$731.70 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$68.70 |
$68.70 |
$68.70 |
$93.61
|
|
Amphetamines 5 or more
|
$4.80 |
$4.80 |
$4.80 |
$77.44
|
|
Ampicillin 1 gram solution for injection
|
$34.01 |
$34.01 |
$34.01 |
$60.48
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$30.64 |
$30.64 |
$30.64 |
$52.99
|
|
Amp metatarsal w/toe single 28810
|
$439.50 |
$439.50 |
$439.50 |
$3,958.50
|
|
Amp thigh through femur re-amp 27596
|
$717.00 |
$717.00 |
$717.00 |
$3,342.87
|
|
Amputate leg at thigh
|
$677.70 |
$677.70 |
$677.70 |
$2,854.80
|
|
Amputate lower leg at knee
|
$701.40 |
$701.40 |
$701.40 |
$3,480.00
|
|
Amputate metacarpal bone 26910
|
$811.20 |
$811.20 |
$811.20 |
$3,821.05
|
|
Amputate thigh through femur 27590
|
$775.50 |
$775.50 |
$775.50 |
$3,370.00
|
|
Amputation follow-up surgery
|
$845.40 |
$845.40 |
$845.40 |
$3,766.40
|
|
Amputation follow-up surgery
|
$519.60 |
$519.60 |
$519.60 |
$3,839.54
|
|
Amputation follow-up surgery
|
$589.20 |
$589.20 |
$589.20 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$891.90 |
$891.90 |
$891.90 |
$2,446.80
|
|
Amputation leg; tib/fib f/u 27886
|
$657.00 |
$657.00 |
$657.00 |
$1,445.40
|
|
Amputation of foot at ankle
|
$644.10 |
$644.10 |
$644.10 |
$5,886.74
|
|
Amputation of foot at ankle
|
$564.00 |
$564.00 |
$564.00 |
$1,240.80
|
|
Amputation of hand
|
$912.00 |
$912.00 |
$912.00 |
$2,363.40
|
|
Amputation of lower leg
|
$590.40 |
$590.40 |
$590.40 |
$2,545.40
|
|
Amputation of lower leg
|
$833.10 |
$833.10 |
$833.10 |
$3,342.87
|
|
Amputation of midtarsal 28800
|
$552.30 |
$552.30 |
$552.30 |
$2,285.40
|
|
Amputation of upper arm
|
$804.90 |
$804.90 |
$804.90 |
$2,646.80
|
|
Amputation thru metatarsal
|
$728.10 |
$728.10 |
$728.10 |
$3,821.05
|
|
Amputation toe interphalangeal joint
|
$304.80 |
$304.80 |
$304.80 |
$3,986.50
|
|
Amputation toe metatarsophalangeal joint
|
$310.80 |
$310.80 |
$310.80 |
$3,821.05
|
|
Amylase
|
$95.10 |
$95.10 |
$95.10 |
$88.83
|
|
Anabolic steroid 1 or 2
|
$23.40 |
$23.40 |
$23.40 |
$80.08
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$1.80 |
$1.80 |
$1.80 |
$101.20
|
|
Anal/urinary muscle study
|
$80.70 |
$80.70 |
$80.70 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$42.60 |
$42.60 |
$42.60 |
$314.00
|
|
Analysis gene f2 20210g>a variant
|
$442.95 |
$442.95 |
$442.95 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$11.40 |
$11.40 |
$11.40 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$32.10 |
$32.10 |
$32.10 |
$113.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$35.70 |
$35.70 |
$35.70 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$9.05 |
$9.05 |
$9.05 |
$92.40
|
|
An cholangiogram percutaneous compl
|
$3,366.60 |
$3,366.60 |
$3,366.60 |
$2,562.12
|
|
An fluoro guide for cvp
|
$150.00 |
$150.00 |
$150.00 |
$507.79
|
|
Angio balloon ctrl dialysis seg add-on
|
$142.80 |
$142.80 |
$142.80 |
$5,341.83
|
|
Angiotensin ii
|
$35.70 |
$35.70 |
$35.70 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$984.90 |
$984.90 |
$984.90 |
$2,987.62
|
|
Angio trnslmnl balloon same artery ea addl
|
$168.30 |
$168.30 |
$168.30 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$335.70 |
$335.70 |
$335.70 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ini
|
$289.80 |
$289.80 |
$289.80 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$711.30 |
$711.30 |
$711.30 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$532.80 |
$532.80 |
$532.80 |
$3,821.05
|
|
Ankle arthroscopy/surgery
|
$484.80 |
$484.80 |
$484.80 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$518.70 |
$518.70 |
$518.70 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$589.20 |
$589.20 |
$589.20 |
$3,839.54
|
|
Ankle X-ray
|
$412.20 |
$412.20 |
$412.20 |
$353.60
|
|
Anl sp inf pmp w/mdreprg&fil
|
$97.80 |
$97.80 |
$97.80 |
$627.94
|
|
Annual alcohol screen 15 min
|
$13.50 |
$13.50 |
$13.50 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$68.70 |
$68.70 |
$68.70 |
$148.50
|
|
Annual Physical, Established Patient (age 40-64)
|
$78.00 |
$78.00 |
$78.00 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$77.10 |
$77.10 |
$77.10 |
$151.50
|
