|
Amitriptyline (elavil) -sendout
|
$26.50 |
$26.50 |
$26.50 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$675.85 |
$675.85 |
$675.85 |
$15,167.75
|
|
Ammonia
|
$40.00 |
$40.00 |
$40.00 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$250.00 |
$250.00 |
$250.00 |
$963.79
|
|
Amphetamines 5 or more
|
$35.00 |
$35.00 |
$35.00 |
$93.60
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$81.58 |
$81.58 |
$81.58 |
$135.63
|
|
Amphotericin b lipid complex
|
$24.32 |
$24.32 |
$24.32 |
$337.94
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$220.09 |
$220.09 |
$220.09 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$87.36 |
$87.36 |
$87.36 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$49.89 |
$49.89 |
$49.89 |
$57.38
|
|
Amylase
|
$31.25 |
$31.25 |
$31.25 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$50.00 |
$50.00 |
$50.00 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$41.25 |
$41.25 |
$41.25 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$37.50 |
$37.50 |
$37.50 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$37.50 |
$37.50 |
$37.50 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$2,426.60
|
|
An fluoro guide for cvp
|
$162.50 |
$162.50 |
$162.50 |
$509.60
|
|
Angio balloon ctrl dialysis seg add-on
|
$825.00 |
$825.00 |
$825.00 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$9,462.03
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$417.45 |
$417.45 |
$417.45 |
$6,048.00
|
|
Angio tib/peroneal/init ves/unila 37228
|
$3,750.00 |
$3,750.00 |
$3,750.00 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$5,741.00
|
|
Angio trnslmnl balloon same artery ini
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$8,745.10
|
|
Anidulafungin injection
|
$72.98 |
$72.98 |
$72.98 |
$209.79
|
|
Ankle X-ray
|
$137.50 |
$137.50 |
$137.50 |
$350.85
|
|
Anl sp inf pmp w/mdreprg&fil
|
$200.00 |
$200.00 |
$200.00 |
$693.75
|
|
Antibody bacterium, not elsewhere specified
|
$11.25 |
$11.25 |
$11.25 |
$57.85
|
|
Antibody elution rbc reference
|
$55.00 |
$55.00 |
$55.00 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$45.00 |
$45.00 |
$45.00 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$100.00 |
$100.00 |
$100.00 |
$218.30
|
|
Antibody id rbc panel
|
$88.75 |
$88.75 |
$88.75 |
$291.75
|
|
Antibody influenza virus
|
$11.75 |
$11.75 |
$11.75 |
$53.95
|
|
Antibody screen rbc
|
$37.50 |
$37.50 |
$37.50 |
$105.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2,169.28 |
$2,169.28 |
$2,169.28 |
$4.00
|
|
Antihemophilic viii/vwf comp
|
$1,366.03 |
$1,366.03 |
$1,366.03 |
$2.75
|
|
Anti-inhibitor
|
$6,894.55 |
$6,894.55 |
$6,894.55 |
$5.63
|
|
Anti mog serum - sendout
|
$35.00 |
$35.00 |
$35.00 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$35.00 |
$35.00 |
$35.00 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$10.50 |
$10.50 |
$10.50 |
$40.00
|
|
Antinuclear antibodies
|
$35.00 |
$35.00 |
$35.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$35.00 |
$35.00 |
$35.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$20.00 |
$20.00 |
$20.00 |
$74.20
|
|
Antistreptolysin o screen
|
$25.00 |
$25.00 |
$25.00 |
$59.40
|
|
Antistreptolysin o titer
|
$31.25 |
$31.25 |
$31.25 |
$57.85
|
|
Antithrombin iii activity
|
$35.00 |
$35.00 |
$35.00 |
$106.85
|
|
Antithrombin iii injection
|
$1,652.82 |
$1,652.82 |
$1,652.82 |
$15.75
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$611.95 |
$611.95 |
$611.95 |
$5,465.25
|
|
Antithymocyte globuln rabbit
|
$777.63 |
$777.63 |
$777.63 |
$2,291.39
|
|
Apheresis plasma
|
$800.00 |
$800.00 |
$800.00 |
$3,498.41
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$245.00 |
$245.00 |
$245.00 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$625.00 |
$625.00 |
$625.00 |
$3,461.40
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$300.00 |
$300.00 |
$300.00 |
$1,300.71
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$245.00 |
$245.00 |
$245.00 |
$508.18
|
|
Application finger splntstatic 29130
|
$43.75 |
$43.75 |
$43.75 |
$226.20
|
|
Application long leg splint 29505
|
$87.50 |
$87.50 |
$87.50 |
$370.00
|
|
Application lower leg splint 29515
|
$87.50 |
$87.50 |
$87.50 |
$365.60
|
|
Application multi layer compression below knee (both sides)
|
$87.50 |
$87.50 |
$87.50 |
$393.75
|
|
Application of forearm cast 29075
|
$143.75 |
$143.75 |
$143.75 |
$386.10
|
|
Application of long arm cast 29065
|
$143.75 |
$143.75 |
$143.75 |
$414.20
|
|
Application of paste boot 29580
|
$87.50 |
$87.50 |
$87.50 |
$336.00
|
|
Application short leg cast 29405
|
$143.75 |
$143.75 |
$143.75 |
$397.33
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$450.00 |
$450.00 |
$450.00 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$450.00 |
$450.00 |
$450.00 |
$2,164.64
|
|
Apply of finger splint 29131
|
$75.00 |
$75.00 |
$75.00 |
$177.45
|
|
Apply rigid leg cast 29445
|
$143.75 |
$143.75 |
$143.75 |
$608.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$30.30 |
$30.30 |
$30.30 |
$943.40
|
|
Aquaporin-4 antibody cba each
|
$35.00 |
$35.00 |
$35.00 |
$114.60
|
|
Aquaporin-4 antibody elisa
|
$43.75 |
$43.75 |
$43.75 |
$155.00
|
|
Argatroban nonesrd (accord)
|
$14.44 |
$14.44 |
$14.44 |
$4.20
|
|
Argatroban nonesrd (auromed)
|
$15.12 |
$15.12 |
$15.12 |
$1.49
|
|
Argatroban nonesrd use 1mg
|
$178.65 |
$178.65 |
$178.65 |
$881.10
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$592.56 |
$592.56 |
$592.56 |
$9,553.74
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$237.91 |
$237.91 |
$237.91 |
$1,301.04
|
|
Arterial blood draw/perc 36620
|
$37.50 |
$37.50 |
$37.50 |
$500.82
|
|
Artery xray each vessel 7577426
|
$425.00 |
$425.00 |
$425.00 |
$1,865.50
|
|
Artery xray of abdomen 75726-26
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$4,658.99
|
|
Artery x-rays arm/leg 75710-26
|
$1,537.50 |
$1,537.50 |
$1,537.50 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$4,029.72
|
|
Artery x-rays lung
|
$1,537.50 |
$1,537.50 |
$1,537.50 |
$3,150.00
|
|
Artery xrays of pelvis 75736 26
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$4,551.20
|
|
Artery x-rays spine
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$4,830.61
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$212.50 |
$212.50 |
$212.50 |
$588.53
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$300.00 |
$300.00 |
$300.00 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$400.00 |
$400.00 |
$400.00 |
$956.00
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$212.50 |
$212.50 |
$212.50 |
$471.34
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$250.00 |
$250.00 |
$250.00 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$375.00 |
$375.00 |
$375.00 |
$700.80
|
|
Asp & inj w/heparin pleurx cath
|
$375.00 |
$375.00 |
$375.00 |
$1,411.99
|
|
Aspirate bladder/sprapubic cath 51102
|
$1,150.00 |
$1,150.00 |
$1,150.00 |
$3,199.51
|
|
Aspirate pleura without imaging 32554
|
$325.00 |
$325.00 |
$325.00 |
$1,317.00
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$225.00 |
$225.00 |
$225.00 |
$1,306.50
|
|
Aspir/inj thyroid cyst 60300
|
$557.50 |
$557.50 |
$557.50 |
$850.78
|
|
Assay myeloperoxidase
|
$18.75 |
$18.75 |
$18.75 |
$84.19
|
|
Assay of interleukin-6 (il-6)
|
$32.50 |
$32.50 |
$32.50 |
$77.35
|
|
Assay of leflunomide
|
$40.00 |
$40.00 |
$40.00 |
$112.70
|
|
Assay of osteocalcin
|
$46.25 |
$46.25 |
$46.25 |
$93.60
|
