|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,634.00 |
$1,634.00 |
$1,634.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,184.00 |
$1,184.00 |
$1,184.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$428.00 |
$428.00 |
$428.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$797.00 |
$797.00 |
$797.00 |
$256.49
|
|
Administration immunization each additional component
|
$261.00 |
$261.00 |
$261.00 |
$29.20
|
|
Administration immunization each additional vaccine
|
$189.38 |
$189.38 |
$189.38 |
$47.40
|
|
Administration immunization first component each vaccine
|
$212.00 |
$212.00 |
$212.00 |
$46.40
|
|
Administration vaccine hepatitis b
|
$150.00 |
$150.00 |
$150.00 |
$53.00
|
|
Administration vaccine influenza virus
|
$155.00 |
$155.00 |
$155.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$150.00 |
$150.00 |
$150.00 |
$49.68
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$96.20 |
$96.20 |
$96.20 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$3,694.00 |
$3,694.00 |
$3,694.00 |
$1,987.70
|
|
Adrenalin epinephrine inject
|
$450.80 |
$450.80 |
$450.80 |
$231.47
|
|
Advance care planning each additional 30 min 99498
|
$150.00 |
$150.00 |
$150.00 |
$110.56
|
|
Aep neurodiagnostic i&r
|
$635.00 |
$635.00 |
$635.00 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$635.00 |
$635.00 |
$635.00 |
$635.00
|
|
Afamitresgene autoleucel
|
$2,995,240.00 |
$2,995,240.00 |
$2,995,240.00 |
$2,125,068.14
|
|
_afb id by dna probe rflx ast
|
$344.00 |
$344.00 |
$344.00 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$398.00 |
$398.00 |
$398.00 |
$300.00
|
|
Afluria vacc, 3 yrs & >, im
|
$83.43 |
$83.43 |
$83.43 |
$18.40
|
|
Afo rig ant tib tcf/= custom
|
$1,584.16 |
$1,584.16 |
$1,584.16 |
$1,843.53
|
|
Agalsidase beta 35 mg intravenous solution
|
$508.69 |
$508.69 |
$508.69 |
$14,475.20
|
|
Air conduction bilat
|
$390.00 |
$390.00 |
$390.00 |
$134.00
|
|
Air injection into abdomen 49400
|
$1,889.00 |
$1,889.00 |
$1,889.00 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$1,438.00 |
$1,438.00 |
$1,438.00 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$56.00 |
$56.00 |
$56.00 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$382.39 |
$382.39 |
$382.39 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$142.94 |
$142.94 |
$142.94 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$353.88 |
$353.88 |
$353.88 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$90.74 |
$90.74 |
$90.74 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$176.00 |
$176.00 |
$176.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$82.00 |
$82.00 |
$82.00 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$8.26 |
$8.26 |
$8.26 |
$5.67
|
|
Albuterol non-comp con
|
$1.86 |
$1.86 |
$1.86 |
$6.07
|
|
Albuterol non-comp unit
|
$3.84 |
$3.84 |
$3.84 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$144.00 |
$144.00 |
$144.00 |
$96.00
|
|
Alcohol/subs interv 15-30mn
|
$82.00 |
$82.00 |
$82.00 |
$56.70
|
|
Alcohol/subs interv >30 min
|
$402.00 |
$402.00 |
$402.00 |
$190.13
|
|
Aldesleukin injection
|
$1.03 |
$1.03 |
$1.03 |
$9,030.11
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$0.06 |
$0.06 |
$0.06 |
$47,974.31
|
|
Alkaline phosphatase
|
$132.00 |
$132.00 |
$132.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$94.00 |
$94.00 |
$94.00 |
$48.57
|
|
Allergen egg white ige
|
$47.00 |
$47.00 |
$47.00 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$125.00 |
$125.00 |
$125.00 |
$45.00
|
|
Allergy injection; single 95115
|
$125.00 |
$125.00 |
$125.00 |
$46.80
|
|
Allograft amnioexcel plus 17mm disk
|
$138.05 |
$138.05 |
$138.05 |
$497.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$49,280.00 |
$49,280.00 |
$49,280.00 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$217.68 |
$217.68 |
$217.68 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$740.90 |
$740.90 |
$740.90 |
$858.66
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,994.30 |
$1,994.30 |
$1,994.30 |
$5,096.00
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$13.53 |
$13.53 |
$13.53 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$222.00 |
$222.00 |
$222.00 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$378.00 |
$378.00 |
$378.00 |
$106.00
|
|
Alprostadil for injection
|
$1.58 |
$1.58 |
$1.58 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$509.75 |
$509.75 |
$509.75 |
$15,857.45
|
|
Alt/sgpt
|
$133.00 |
$133.00 |
$133.00 |
$47.50
|
|
Aluminum - quest
|
$381.00 |
$381.00 |
$381.00 |
$83.05
|
|
Alveoloplasty each quadrant
|
$7,852.00 |
$7,852.00 |
$7,852.00 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$696.00 |
$696.00 |
$696.00 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$292.00 |
$292.00 |
$292.00 |
$179.70
|
|
Ambl bp mntr w/software
|
$282.00 |
$282.00 |
$282.00 |
$178.20
|
|
Ambl bp mntr w/sw i&r
|
$110.00 |
$110.00 |
$110.00 |
$57.00
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$10.82 |
$10.82 |
$10.82 |
$39.84
|
|
Amino acid single qual
|
$585.00 |
$585.00 |
$585.00 |
$36.00
|
|
Aminolevulinic acid delta
|
$376.00 |
$376.00 |
$376.00 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$63.94 |
$63.94 |
$63.94 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$30.02 |
$30.02 |
$30.02 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$11.27 |
$11.27 |
$11.27 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$253.00 |
$253.00 |
$253.00 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$49.45 |
$49.45 |
$49.45 |
$9,084.45
|
|
Ammonia
|
$228.00 |
$228.00 |
$228.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$3,649.00 |
$3,649.00 |
$3,649.00 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$3,786.00
|
|
Amphetamine confirm urine -sendout
|
$140.00 |
$140.00 |
$140.00 |
$93.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$216.30 |
$216.30 |
$216.30 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$153.04 |
$153.04 |
$153.04 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$15.55 |
$15.55 |
$15.55 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$34.14 |
$34.14 |
$34.14 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$789.00 |
$789.00 |
$789.00 |
$262.99
|
|
Amp thigh through femur re-amp 27596
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$3,494.40
|
|
Amputate metacarpal bone 26910
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$5,989.00 |
$5,989.00 |
$5,989.00 |
$3,870.00
|
|
Amputation thru metatarsal
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$7,367.00 |
$7,367.00 |
$7,367.00 |
$3,839.54
|
|
Amylase
|
$161.00 |
$161.00 |
$161.00 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$253.00 |
$253.00 |
$253.00 |
$117.01
|
|
Anal pressure record
|
$3,420.00 |
$3,420.00 |
$3,420.00 |
$954.00
|
|
Anal/urinary muscle study
|
$1,184.00 |
$1,184.00 |
$1,184.00 |
$602.80
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$292.00 |
$292.00 |
$292.00 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$491.00 |
$491.00 |
$491.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$1,631.00 |
$1,631.00 |
$1,631.00 |
$249.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$99.00 |
$99.00 |
$99.00 |
$122.20
|
|
Analysis tumor
|
$661.00 |
$661.00 |
$661.00 |
$248.80
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$696.00 |
$696.00 |
$696.00 |
$375.00
|
|
Anca screen with reflex to titer -quest
|
$159.00 |
$159.00 |
$159.00 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$2,480.94
|
|
An fluoro guide for cvp
|
$1,542.00 |
$1,542.00 |
$1,542.00 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$6,886.00 |
$6,886.00 |
$6,886.00 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$6,886.00 |
$6,886.00 |
$6,886.00 |
$8,600.40
|
