|
Alcohol (ethanol) any specimen except urine/breath
|
$380.93 |
$1,128.29 |
$1,128.29 |
$93.60
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$9,645.00 |
$9,645.00 |
$9,645.00 |
$8,173.80
|
|
Alkaline phosphatase
|
$240.77 |
$240.77 |
$1,254.91 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$276.75 |
$276.75 |
$276.75 |
$56.35
|
|
Allergen egg white ige
|
$80.57 |
$80.57 |
$80.57 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$4.00 |
$123.02 |
$135.16 |
$26.95
|
|
Allergy injections; 2 or more 95117
|
$492.86 |
$492.86 |
$492.86 |
$51.07
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$1,216.90 |
$1,446.10 |
$8,356.50 |
$3,104.06
|
|
Allograft amnioexcel plus 17mm disk
|
$473.24 |
$473.24 |
$2,388.50 |
$2,959.72
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$1,098.23 |
$1,098.23 |
$1,317.17 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$169.02 |
$169.02 |
$200.85 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,253.92 |
$1,253.92 |
$1,491.36 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$473.24 |
$473.24 |
$562.37 |
$2,513.00
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,528.07 |
$1,528.07 |
$1,528.07 |
$2,198.85
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1,205.09 |
$1,205.09 |
$1,205.09 |
$4,101.14
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,406.19 |
$1,406.19 |
$1,671.06 |
$3,025.07
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$994.17 |
$994.17 |
$1,480.60 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$90.03 |
$90.03 |
$262.40 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$258.85 |
$258.85 |
$258.85 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,128.27 |
$1,128.27 |
$1,243.28 |
$2,600.22
|
|
Alt/sgpt
|
$405.01 |
$405.01 |
$2,288.47 |
$49.00
|
|
Aluminum - quest
|
$20.96 |
$117.88 |
$393.29 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$966.86 |
$1,236.88 |
$1,236.88 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$211.17 |
$211.17 |
$494.00 |
$196.20
|
|
Ambl bp mntr w/sw a/r
|
$364.82 |
$364.82 |
$364.82 |
$318.96
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$142.97 |
$142.97 |
$142.97 |
$36.30
|
|
Amino acid screen, urine
|
$13.08 |
$13.08 |
$214.08 |
$64.28
|
|
Amino acid single qual
|
$16.55 |
$16.55 |
$16.55 |
$19.57
|
|
Amino acids quant 2-5
|
$302.68 |
$302.68 |
$302.68 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$60.02 |
$60.02 |
$454.49 |
$42.84
|
|
Aminolevulinic acid delta
|
$35.10 |
$253.91 |
$253.91 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$57.42 |
$61.26 |
$113.84 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$218.65 |
$546.42 |
$631.72 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$124.68 |
$124.68 |
$135.68 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$10.90 |
$17.00 |
$400.51 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$82,068.45 |
$82,068.45 |
$82,704.39 |
$15,167.75
|
|
Ammonia
|
$460.32 |
$460.32 |
$1,966.47 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$7,684.95 |
$7,684.95 |
$7,684.95 |
$942.60
|
|
Amphetamine confirm urine -sendout
|
$92.61 |
$98.10 |
$136.33 |
$94.50
|
|
Amphetamines 5 or more
|
$367.61 |
$367.61 |
$367.61 |
$101.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$2,129.18 |
$2,129.18 |
$2,129.18 |
$130.08
|
|
Amphotericin b lipid complex
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$270.17
|
|
Ampicillin 1 gram solution for injection
|
$95.29 |
$95.29 |
$104.72 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$186.50 |
$186.50 |
$206.84 |
$51.93
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$920.47 |
$920.47 |
$920.47 |
$312.00
|
|
Amputation follow-up surgery
|
$33,752.58 |
$33,752.58 |
$33,752.58 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,691.20
|
|
Amputation toe metatarsophalangeal joint
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,777.93
|
|
Amylase
|
$394.68 |
$394.68 |
$394.68 |
$93.00
|
|
Ana ds-dna
|
$19.05 |
$19.05 |
$19.05 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$237.27 |
$237.27 |
$237.27 |
$110.98
|
|
Anal/urinary muscle study
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$407.00
|
|
Anal/urinary muscle study
|
$1,824.22 |
$1,824.22 |
$1,824.22 |
$507.26
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$335.85 |
$335.85 |
$335.85 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$1,013.92 |
$1,013.92 |
$1,013.92 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$40.00 |
$1,132.47 |
$1,132.47 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$121.46 |
$121.46 |
$121.46 |
$122.20
|
|
Analysis tumor
|
$381.50 |
$381.50 |
$2,883.58 |
$240.00
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$346.04 |
$346.04 |
$346.63 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$128.96 |
$128.96 |
$211.96 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$16.10 |
$232.30 |
$232.30 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$10,758.20 |
$10,758.20 |
$10,758.20 |
$2,626.65
|
|
An fluoro guide for cvp
|
$1,582.15 |
$1,582.15 |
$1,645.64 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$8,423.32 |
$8,423.32 |
$8,423.32 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$15,256.47 |
$15,256.47 |
$15,256.47 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$12,426.74 |
$12,426.74 |
$12,965.82 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$12,977.89 |
$12,977.89 |
$12,977.89 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$5,501.23 |
$5,501.23 |
$14,669.95 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$21,373.26 |
$21,373.26 |
$23,093.66 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$17,517.69 |
$17,517.69 |
$17,517.69 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$12,426.74 |
$12,426.74 |
$12,965.82 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$9,222.26 |
$9,222.26 |
$9,222.26 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$13,690.05 |
$13,690.05 |
$13,690.05 |
$8,689.20
|
|
Ankle arthroscopy/surgery
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,839.54
|
|
Ankle X-ray
|
$1,669.55 |
$1,669.55 |
$1,669.55 |
$339.44
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,040.94 |
$1,040.94 |
$1,040.94 |
$693.75
|
|
Anodyne therapy charges pt
|
$106.94 |
$106.94 |
$106.94 |
$41.02
|
|
Anora (draw only)
|
$50.74 |
$50.74 |
$63.25 |
$36.00
|
|
Anoscopy
|
$9,248.19 |
$9,248.19 |
$9,248.19 |
$1,078.88
|
|
Anoscopy and biopsy
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$1,380.00
|
|
Anoscopy remove fb 46608
|
$9,248.19 |
$9,248.19 |
$9,248.19 |
$1,208.35
|
|
Anoscopy remove lesion 46610
|
$27,259.95 |
$27,259.95 |
$27,259.95 |
$3,245.23
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$27,259.95 |
$27,259.95 |
$27,259.95 |
$3,245.23
|
|
Antibody bacterium, not elsewhere specified
|
$39.00 |
$198.81 |
$198.81 |
$57.89
|
|
Antibody elution rbc reference
|
$498.15 |
$498.15 |
$531.02 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$298.67 |
$298.67 |
$298.67 |
$141.74
|
|
Antibody htlv-i
|
$92.38 |
$92.38 |
$92.38 |
$48.75
|
|
Antibody htlv-ii
|
$267.87 |
$267.87 |
$267.87 |
$35.22
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$283.54 |
$283.54 |
$283.54 |
$220.73
|
|
Antibody id rbc panel
|
$143.00 |
$1,017.75 |
$1,058.89 |
$291.75
|
|
Antibody influenza virus
|
$209.15 |
$209.15 |
$209.15 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$198.65 |
$198.65 |
$198.65 |
$53.96
|
|
Antibody screen rbc
|
$180.68 |
$180.68 |
$180.68 |
$105.00
|
|
Antibody tetanus
|
$9.81 |
$9.81 |
$9.81 |
$61.98
|
|
Antidepressant not specified
|
$84.70 |
$84.70 |
$84.70 |
$89.50
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$30.54 |
$30.54 |
$30.54 |
$3.12
|
|
Anti-inhibitor
|
$7.00 |
$7.00 |
$7.00 |
$3.75
|
|
Anti mog serum - sendout
|
$44.29 |
$44.29 |
$44.29 |
$140.62
|
