|
Albumin (microalbumin) 24 hour urine quantitative
|
$149.50 |
$149.50 |
$149.50 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$113.10 |
$113.10 |
$113.10 |
$43.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$376.35 |
$376.35 |
$376.35 |
$96.00
|
|
Aldesleukin injection
|
$28,544.75 |
$28,544.75 |
$28,544.75 |
$9,030.11
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$6,251.05 |
$6,251.05 |
$6,251.05 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$18.20 |
$18.20 |
$18.20 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$150.15 |
$150.15 |
$150.15 |
$43.72
|
|
Alginate drsg wound filler
|
$278.85 |
$278.85 |
$278.85 |
$15.79
|
|
Alkaline phosphatase
|
$54.60 |
$54.60 |
$54.60 |
$46.80
|
|
Allergen egg white ige
|
$15.60 |
$15.60 |
$15.60 |
$38.00
|
|
Allograft 160mg placental salera mini membrane
|
$8,247.85 |
$8,247.85 |
$8,247.85 |
$5,835.10
|
|
Allograft amnioexcel plus 17mm disk
|
$19,440.20 |
$19,440.20 |
$19,440.20 |
$497.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$43,548.70 |
$43,548.70 |
$43,548.70 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$17,189.25 |
$17,189.25 |
$17,189.25 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$67,857.40 |
$67,857.40 |
$67,857.40 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$33,216.30 |
$33,216.30 |
$33,216.30 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$30,569.50 |
$30,569.50 |
$30,569.50 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$14,605.50 |
$14,605.50 |
$14,605.50 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$13,923.65 |
$13,923.65 |
$13,923.65 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$13,185.90 |
$13,185.90 |
$13,185.90 |
$1,225.35
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$3.25 |
$3.25 |
$3.25 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$360.10 |
$360.10 |
$360.10 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$737.75 |
$737.75 |
$737.75 |
$15,857.45
|
|
Alt/sgpt
|
$54.60 |
$54.60 |
$54.60 |
$47.50
|
|
Aluminum - quest
|
$29.25 |
$29.25 |
$29.25 |
$83.05
|
|
Ambl bp mntr w/sw a/r
|
$320.45 |
$320.45 |
$320.45 |
$320.45
|
|
Amifostine
|
$6,382.35 |
$6,382.35 |
$6,382.35 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$23.40 |
$23.40 |
$23.40 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$18.20 |
$18.20 |
$18.20 |
$37.33
|
|
Aminolevulinic acid delta
|
$49.40 |
$49.40 |
$49.40 |
$87.12
|
|
Aminolevulinic acid hcl top
|
$720.85 |
$720.85 |
$720.85 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$187.20 |
$187.20 |
$187.20 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$412.10 |
$412.10 |
$412.10 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$143.65 |
$143.65 |
$143.65 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$85.15 |
$85.15 |
$85.15 |
$9,084.45
|
|
Ammonia
|
$325.00 |
$325.00 |
$325.00 |
$119.70
|
|
Amnio-maxx or lite per sq cm
|
$12,263.55 |
$12,263.55 |
$12,263.55 |
$1.00
|
|
Amphetamines 5 or more
|
$34.45 |
$34.45 |
$34.45 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$435.50 |
$435.50 |
$435.50 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$354.25 |
$354.25 |
$354.25 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$131.30 |
$131.30 |
$131.30 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$94.25 |
$94.25 |
$94.25 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$79.95 |
$79.95 |
$79.95 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$9,417.85 |
$9,417.85 |
$9,417.85 |
$3,986.00
|
|
Amputation thru metatarsal
|
$5,854.55 |
$5,854.55 |
$5,854.55 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$5,731.05 |
$5,731.05 |
$5,731.05 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$5,731.05 |
$5,731.05 |
$5,731.05 |
$3,839.54
|
|
Amylase
|
$332.15 |
$332.15 |
$332.15 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$117.65 |
$117.65 |
$117.65 |
$80.08
|
|
Analgesics non-opioid 3-5
|
$7.15 |
$7.15 |
$7.15 |
$16.24
|
|
Anal pressure record
|
$1,942.85 |
$1,942.85 |
$1,942.85 |
$954.00
|
|
Anal/urinary muscle study
|
$789.10 |
$789.10 |
$789.10 |
$407.00
|
|
Anal/urinary muscle study
|
$794.95 |
$794.95 |
$794.95 |
$602.80
|
|
Analysis gene f2 20210g>a variant
|
$156.00 |
$156.00 |
$156.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$105.30 |
$105.30 |
$105.30 |
$249.60
|
|
Analysis tumor
|
$608.40 |
$608.40 |
$608.40 |
$248.80
|
|
Anaplsma phgcytophlm amp prb
|
$70.20 |
$70.20 |
$70.20 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$129.35 |
$129.35 |
$129.35 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$6,694.35 |
$6,694.35 |
$6,694.35 |
$2,480.94
|
|
An fluoro guide for cvp
|
$612.30 |
$612.30 |
$612.30 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,413.45 |
$2,413.45 |
$2,413.45 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$26,586.95 |
$26,586.95 |
$26,586.95 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$28,113.80 |
$28,113.80 |
$28,113.80 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$14,172.60 |
$14,172.60 |
$14,172.60 |
$5,950.50
|
|
Angioscopy
|
$2,828.80 |
$2,828.80 |
$2,828.80 |
$363.20
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$21,052.20 |
$21,052.20 |
$21,052.20 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$26,586.95 |
$26,586.95 |
$26,586.95 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$10,507.25 |
$10,507.25 |
$10,507.25 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$21,039.20 |
$21,039.20 |
$21,039.20 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$10,609.30 |
$10,609.30 |
$10,609.30 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$23,143.25 |
$23,143.25 |
$23,143.25 |
$8,359.11
|
|
Ankle X-ray
|
$599.30 |
$599.30 |
$599.30 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$483.60 |
$483.60 |
$483.60 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$733.85 |
$733.85 |
$733.85 |
$630.96
|
|
Anora (draw only)
|
$37.70 |
$37.70 |
$37.70 |
$35.00
|
|
Antibody elution rbc reference
|
$217.75 |
$217.75 |
$217.75 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$185.90 |
$185.90 |
$185.90 |
$131.56
|
|
Antibody htlv-i
|
$67.60 |
$67.60 |
$67.60 |
$49.53
|
|
Antibody htlv-ii
|
$67.60 |
$67.60 |
$67.60 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$547.95 |
$547.95 |
$547.95 |
$224.00
|
|
Antibody id rbc panel
|
$250.90 |
$250.90 |
$250.90 |
$291.75
|
|
Antibody influenza virus
|
$20.80 |
$20.80 |
$20.80 |
$54.00
|
|
Antibody screen rbc
|
$130.00 |
$130.00 |
$130.00 |
$108.55
|
|
Antibody tetanus
|
$17.55 |
$17.55 |
$17.55 |
$54.15
|
|
Antidepressant not specified
|
$7.15 |
$7.15 |
$7.15 |
$72.14
|
|
Antidepressants class 3-5
|
$7.15 |
$7.15 |
$7.15 |
$72.14
|
|
Antiepileptics nos 4-6
|
$7.15 |
$7.15 |
$7.15 |
$16.24
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$8.45 |
$8.45 |
$8.45 |
$6.10
|
|
Anti-inhibitor
|
$26.00 |
$26.00 |
$26.00 |
$8.33
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$23.40 |
$23.40 |
$23.40 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$19.50 |
$19.50 |
$19.50 |
$42.00
|
|
Antinuclear antibodies
|
$460.20 |
$460.20 |
$460.20 |
$90.00
|
|
Antinuclear antibodies titer
|
$317.85 |
$317.85 |
$317.85 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$23.40 |
$23.40 |
$23.40 |
$67.43
|
|
Antipsychotics nos 1-3
|
$34.45 |
$34.45 |
$34.45 |
$136.61
|
|
Antipsychotics nos 7/more
|
$7.15 |
$7.15 |
$7.15 |
$16.24
|
|
Antistreptolysin o screen
|
$98.15 |
$98.15 |
$98.15 |
$58.56
|
|
Antistreptolysin o titer
|
$371.15 |
$371.15 |
$371.15 |
$54.00
|
|
Antithrombin iii activity
|
$513.50 |
$513.50 |
$513.50 |
$115.15
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$21,737.30 |
$21,737.30 |
$21,737.30 |
$8,214.07
|
