|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$3,625.32 |
$3,625.32 |
$3,625.32 |
$5,152.95
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$193.20 |
$193.20 |
$193.20 |
$189.15
|
|
Alpha-fetoprotein amniotic
|
$144.90 |
$144.90 |
$144.90 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$175.00 |
$175.00 |
$175.00 |
$103.80
|
|
Als1-emergency
|
$2,253.30 |
$2,253.30 |
$2,253.30 |
$1,103.37
|
|
Als 2
|
$2,981.30 |
$2,981.30 |
$2,981.30 |
$1,288.56
|
|
Alteplase 100 mg infusion from pyxis vial
|
$26,546.45 |
$26,546.45 |
$26,546.45 |
$15,857.45
|
|
Alt/sgpt
|
$101.50 |
$101.50 |
$101.50 |
$47.40
|
|
Aluminum - quest
|
$107.80 |
$107.80 |
$107.80 |
$81.49
|
|
Alveoloplasty each quadrant
|
$22,132.67 |
$22,132.67 |
$22,132.67 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$211.40 |
$211.40 |
$211.40 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$328.30 |
$328.30 |
$328.30 |
$179.70
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$219.45 |
$219.45 |
$219.45 |
$40.40
|
|
Amino acids quant 2-5
|
$43.40 |
$43.40 |
$43.40 |
$113.60
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$387.27 |
$387.27 |
$387.27 |
$37.33
|
|
Aminolevulinic acid delta
|
$163.10 |
$163.10 |
$163.10 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$199.32 |
$199.32 |
$199.32 |
$46.24
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$264.07 |
$264.07 |
$264.07 |
$114.96
|
|
Amiodarone 50 mg/ml intravenous solution
|
$365.75 |
$365.75 |
$365.75 |
$55.86
|
|
Ammonia
|
$130.90 |
$130.90 |
$130.90 |
$119.70
|
|
Amniocentesis therapeutic
|
$607.60 |
$607.60 |
$607.60 |
$791.05
|
|
Amniotic fluid scan
|
$231.70 |
$231.70 |
$231.70 |
$49.01
|
|
Amphetamine confirm urine -sendout
|
$207.20 |
$207.20 |
$207.20 |
$93.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$273.52 |
$273.52 |
$273.52 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$767.02 |
$767.02 |
$767.02 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$243.07 |
$243.07 |
$243.07 |
$58.35
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$265.82 |
$265.82 |
$265.82 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$299.60 |
$299.60 |
$299.60 |
$262.99
|
|
Amputation toe interphalangeal joint
|
$7,468.30 |
$7,468.30 |
$7,468.30 |
$4,196.50
|
|
Amylase
|
$130.20 |
$130.20 |
$130.20 |
$89.04
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$108.50 |
$108.50 |
$108.50 |
$117.01
|
|
Anal/urinary muscle study
|
$617.40 |
$617.40 |
$617.40 |
$587.40
|
|
Analysis gene f2 20210g>a variant
|
$505.40 |
$505.40 |
$505.40 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$416.50 |
$416.50 |
$416.50 |
$237.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$494.90 |
$494.90 |
$494.90 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$81.20 |
$81.20 |
$81.20 |
$82.65
|
|
Anca screen with reflex to titer -quest
|
$298.90 |
$298.90 |
$298.90 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$3,404.80 |
$3,404.80 |
$3,404.80 |
$2,494.35
|
|
Androstanediol
|
$196.70 |
$196.70 |
$196.70 |
$131.04
|
|
An fluoro guide for cvp
|
$899.50 |
$899.50 |
$899.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$8,264.22 |
$8,264.22 |
$8,264.22 |
$5,500.00
|
|
Angioplasty fem/pop unilat 37224
|
$44,443.22 |
$44,443.22 |
$44,443.22 |
$8,835.00
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$7,348.60 |
$7,348.60 |
$7,348.60 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$29,477.80 |
$29,477.80 |
$29,477.80 |
$5,950.50
|
|
Angiotensin ii
|
$43.40 |
$43.40 |
$43.40 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$2,452.27 |
$2,452.27 |
$2,452.27 |
$2,792.09
|
|
Angio tib/peroneal/init ves/unila 37228
|
$40,283.42 |
$40,283.42 |
$40,283.42 |
$10,513.36
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,962.70 |
$3,962.70 |
$3,962.70 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$9,209.90 |
$9,209.90 |
$9,209.90 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$2,423.40 |
$2,423.40 |
$2,423.40 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$17,747.28 |
$17,747.28 |
$17,747.28 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$95,445.67 |
$95,445.67 |
$95,445.67 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$85,064.52 |
$85,064.52 |
$85,064.52 |
$6,193.84
|
|
Ankle arthroscopy/surgery
|
$42,380.27 |
$42,380.27 |
$42,380.27 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$58,488.70 |
$58,488.70 |
$58,488.70 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$59,073.93 |
$59,073.93 |
$59,073.93 |
$3,839.54
|
|
Ankle X-ray
|
$541.80 |
$541.80 |
$541.80 |
$352.80
|
|
Anodyne therapy charges pt
|
$25.20 |
$25.20 |
$25.20 |
$42.00
|
|
Anora (draw only)
|
$53.90 |
$53.90 |
$53.90 |
$35.00
|
|
Anoscopy ablation lesion 46615
|
$17,067.68 |
$17,067.68 |
$17,067.68 |
$3,245.23
|
|
Anoscopy and biopsy
|
$2,254.70 |
$2,254.70 |
$2,254.70 |
$1,670.25
|
|
Anoscopy and dilation 46604
|
$8,881.97 |
$8,881.97 |
$8,881.97 |
$1,621.60
|
|
Anoscopy remove fb 46608
|
$340.20 |
$340.20 |
$340.20 |
$1,374.60
|
|
Ans parasymp & symp w/tilt
|
$205.10 |
$205.10 |
$205.10 |
$368.50
|
|
Antibody bacterium, not elsewhere specified
|
$59.50 |
$59.50 |
$59.50 |
$57.81
|
|
Antibody elution rbc reference
|
$159.60 |
$159.60 |
$159.60 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$85.40 |
$85.40 |
$85.40 |
$131.28
|
|
Antibody htlv-i
|
$121.80 |
$121.80 |
$121.80 |
$49.53
|
|
Antibody htlv-ii
|
$177.10 |
$177.10 |
$177.10 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$554.40 |
$554.40 |
$554.40 |
$219.30
|
|
Antibody id rbc panel
|
$298.90 |
$298.90 |
$298.90 |
$290.21
|
|
Antibody influenza virus
|
$72.80 |
$72.80 |
$72.80 |
$53.90
|
|
Antibody lymphocytic choriomeningitis
|
$27.30 |
$27.30 |
$27.30 |
$46.20
|
|
Antibody screen rbc
|
$141.40 |
$141.40 |
$141.40 |
$106.88
|
|
Antibody tetanus
|
$43.40 |
$43.40 |
$43.40 |
$54.00
|
|
Antidepressant not specified
|
$207.20 |
$207.20 |
$207.20 |
$72.14
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$7,206.67 |
$7,206.67 |
$7,206.67 |
$6.10
|
|
Anti mog serum - sendout
|
$1,056.30 |
$1,056.30 |
$1,056.30 |
$133.50
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$210.70 |
$210.70 |
$210.70 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$68.60 |
$68.60 |
$68.60 |
$42.00
|
|
Antinuclear antibodies
|
$107.10 |
$107.10 |
$107.10 |
$90.00
|
|
Antinuclear antibodies titer
|
$118.30 |
$118.30 |
$118.30 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$100.10 |
$100.10 |
$100.10 |
$64.50
|
|
Antipsychotics nos 1-3
|
$207.20 |
$207.20 |
$207.20 |
$137.80
|
|
Antistreptolysin o titer
|
$76.30 |
$76.30 |
$76.30 |
$52.50
|
|
Antithrombin iii activity
|
$223.30 |
$223.30 |
$223.30 |
$114.00
|
|
Aortic dysfunction/dilation
|
$1,222.90 |
$1,222.90 |
$1,222.90 |
$1,088.50
|
|
Aortic dysfunction/dilation
|
$3,275.30 |
$3,275.30 |
$3,275.30 |
$1,700.16
|
|
Apc gene dup/delet variants
|
$462.00 |
$462.00 |
$462.00 |
$462.00
|
|
Apc gene full sequence
|
$1,801.80 |
$1,801.80 |
$1,801.80 |
$1,255.20
|
|
Apheresis immunoads slctv
|
$8,842.40 |
$8,842.40 |
$8,842.40 |
$5,794.21
|
|
Apheresis plasma
|
$72,516.67 |
$72,516.67 |
$72,516.67 |
$3,188.50
|
|
Apheresis rbc
|
$5,313.70 |
$5,313.70 |
$5,313.70 |
$3,290.80
|
|
Apheresis wbc
|
$4,558.40 |
$4,558.40 |
$4,558.40 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$690.90 |
$690.90 |
$690.90 |
$500.80
|
|
Appendix Removal (Laparoscopic)
|
$36,730.77 |
$36,730.77 |
$36,730.77 |
$6,904.15
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,727.60 |
$1,727.60 |
$1,727.60 |
$490.50
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,857.30 |
$4,857.30 |
$4,857.30 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,429.70 |
$2,429.70 |
$2,429.70 |
$1,132.20
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,599.50 |
$1,599.50 |
$1,599.50 |
$508.18
|
