|
Aluminum - quest
|
$140.00 |
$140.00 |
$140.00 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$595.00 |
$595.00 |
$595.00 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$332.50 |
$332.50 |
$332.50 |
$179.70
|
|
Amino acid screen, urine
|
$25.00 |
$25.00 |
$25.00 |
$77.00
|
|
Aminolevulinic acid delta
|
$117.50 |
$117.50 |
$117.50 |
$87.12
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$9.74 |
$9.74 |
$9.74 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$11.82 |
$11.82 |
$11.82 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$347.50 |
$347.50 |
$347.50 |
$87.45
|
|
Ammonia
|
$90.00 |
$90.00 |
$90.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$500.00 |
$500.00 |
$500.00 |
$942.60
|
|
Amphetamine confirm urine -sendout
|
$265.00 |
$265.00 |
$265.00 |
$93.61
|
|
Amphetamines 5 or more
|
$240.00 |
$240.00 |
$240.00 |
$90.48
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$46.90 |
$46.90 |
$46.90 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$48.64 |
$48.64 |
$48.64 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$64.48 |
$64.48 |
$64.48 |
$54.57
|
|
Amylase
|
$52.50 |
$52.50 |
$52.50 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$550.00 |
$550.00 |
$550.00 |
$117.01
|
|
Anal/urinary muscle study
|
$167.50 |
$167.50 |
$167.50 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$285.00 |
$285.00 |
$285.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$340.00 |
$340.00 |
$340.00 |
$249.60
|
|
Analysis nerve
|
$477.50 |
$477.50 |
$477.50 |
$262.40
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$475.00 |
$475.00 |
$475.00 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$112.50 |
$112.50 |
$112.50 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$90.00 |
$90.00 |
$90.00 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$1,760.00 |
$1,760.00 |
$1,760.00 |
$2,480.94
|
|
An fluoro guide for cvp
|
$282.50 |
$282.50 |
$282.50 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$3,740.00 |
$3,740.00 |
$3,740.00 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$5,580.00 |
$5,580.00 |
$5,580.00 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$3,765.00 |
$3,765.00 |
$3,765.00 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$1,765.00 |
$1,765.00 |
$1,765.00 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$5,505.00 |
$5,505.00 |
$5,505.00 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,330.00 |
$1,330.00 |
$1,330.00 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$5,170.00 |
$5,170.00 |
$5,170.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$2,550.00 |
$2,550.00 |
$2,550.00 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$6,195.00 |
$6,195.00 |
$6,195.00 |
$8,359.11
|
|
Ankle X-ray
|
$225.00 |
$225.00 |
$225.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$175.00 |
$175.00 |
$175.00 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$497.50 |
$497.50 |
$497.50 |
$630.96
|
|
Antibody bacterium, not elsewhere specified
|
$117.50 |
$117.50 |
$117.50 |
$57.85
|
|
Antibody elution rbc reference
|
$185.00 |
$185.00 |
$185.00 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$130.00 |
$130.00 |
$130.00 |
$131.56
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$180.00 |
$180.00 |
$180.00 |
$224.00
|
|
Antibody id rbc panel
|
$250.00 |
$250.00 |
$250.00 |
$291.75
|
|
Antibody screen rbc
|
$135.00 |
$135.00 |
$135.00 |
$108.55
|
|
Antidepressant not specified
|
$50.00 |
$50.00 |
$50.00 |
$72.14
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.99 |
$2.99 |
$2.99 |
$6.10
|
|
Anti-inhibitor
|
$4.85 |
$4.85 |
$4.85 |
$8.33
|
|
Anti mog serum - sendout
|
$200.00 |
$200.00 |
$200.00 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$80.00 |
$80.00 |
$80.00 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$80.00 |
$80.00 |
$80.00 |
$42.00
|
|
Antinuclear antibodies
|
$90.00 |
$90.00 |
$90.00 |
$90.00
|
|
Antinuclear antibodies titer
|
$60.00 |
$60.00 |
$60.00 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$130.00 |
$130.00 |
$130.00 |
$67.43
|
|
Antipsychotics nos 1-3
|
$345.00 |
$345.00 |
$345.00 |
$136.61
|
|
Antistreptolysin o titer
|
$50.00 |
$50.00 |
$50.00 |
$54.00
|
|
Antithrombin iii activity
|
$82.50 |
$82.50 |
$82.50 |
$115.15
|
|
Antithymocyte globuln rabbit
|
$2,700.74 |
$2,700.74 |
$2,700.74 |
$2,111.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$375.00 |
$375.00 |
$375.00 |
$394.55
|
|
Apheresis plasma
|
$2,195.00 |
$2,195.00 |
$2,195.00 |
$3,226.34
|
|
Apheresis platelets
|
$2,195.00 |
$2,195.00 |
$2,195.00 |
$2,195.00
|
|
Apheresis rbc
|
$2,195.00 |
$2,195.00 |
$2,195.00 |
$3,290.80
|
|
Apheresis wbc
|
$2,195.00 |
$2,195.00 |
$2,195.00 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$440.00 |
$440.00 |
$440.00 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$900.00 |
$900.00 |
$900.00 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$900.00 |
$900.00 |
$900.00 |
$512.20
|
|
Application finger splntstatic 29130
|
$245.00 |
$245.00 |
$245.00 |
$208.50
|
|
Application long leg splint 29505
|
$370.00 |
$370.00 |
$370.00 |
$338.25
|
|
Application lower leg splint 29515
|
$370.00 |
$370.00 |
$370.00 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$300.00 |
$300.00 |
$300.00 |
$375.06
|
|
Application of forearm cast 29075
|
$375.00 |
$375.00 |
$375.00 |
$358.20
|
|
Application of long arm cast 29065
|
$427.50 |
$427.50 |
$427.50 |
$396.77
|
|
Application of long leg cast 29345
|
$540.00 |
$540.00 |
$540.00 |
$455.00
|
|
Application of paste boot 29580
|
$320.00 |
$320.00 |
$320.00 |
$340.11
|
|
Application short leg cast 29405
|
$635.00 |
$635.00 |
$635.00 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$65.00 |
$65.00 |
$65.00 |
$69.00
|
|
Appl multlay comprs arm/hand
|
$297.50 |
$297.50 |
$297.50 |
$289.60
|
|
Apply finger cast 29086
|
$185.00 |
$185.00 |
$185.00 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$265.00 |
$265.00 |
$265.00 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$185.00 |
$185.00 |
$185.00 |
$271.80
|
|
Apply interstit radiat compl
|
$3,970.00 |
$3,970.00 |
$3,970.00 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$3,060.00 |
$3,060.00 |
$3,060.00 |
$1,813.50
|
|
Apply intrcav radiat interm
|
$2,550.00 |
$2,550.00 |
$2,550.00 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$2,040.00 |
$2,040.00 |
$2,040.00 |
$1,269.97
|
|
Apply of finger splint 29131
|
$135.00 |
$135.00 |
$135.00 |
$177.45
|
|
Apply rigid leg cast 29445
|
$535.00 |
$535.00 |
$535.00 |
$555.00
|
|
Apply surf ldr radionuclide
|
$730.00 |
$730.00 |
$730.00 |
$282.80
|
|
Aqaprn-4 antb flo cytmtry ea
|
$635.00 |
$635.00 |
$635.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$97.50 |
$97.50 |
$97.50 |
$138.16
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$100.00 |
$100.00 |
$100.00 |
$100.75
|
|
Aquatic exercise - group charge
|
$65.00 |
$65.00 |
$65.00 |
$87.45
|
|
Argatroban nonesrd use 1mg
|
$1.48 |
$1.48 |
$1.48 |
$881.10
|
|
Arm CT Scan (with contrast, both arms)
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$980.00 |
$980.00 |
$980.00 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$510.00 |
$510.00 |
$510.00 |
$426.00
|
