|
Amifostine
|
$1,743.30 |
$1,743.30 |
$1,743.30 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$91.22 |
$91.22 |
$91.22 |
$39.84
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$83.53 |
$83.53 |
$83.53 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$250.90 |
$250.90 |
$250.90 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$94.60 |
$94.60 |
$94.60 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$73.00 |
$73.00 |
$73.00 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$9,141.88 |
$9,141.88 |
$9,141.88 |
$7,994.03
|
|
Ammonia
|
$125.00 |
$125.00 |
$125.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,125.50 |
$1,125.50 |
$1,125.50 |
$942.60
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$254.50 |
$254.50 |
$254.50 |
$117.75
|
|
Amphotericin b lipid complex
|
$270.60 |
$270.60 |
$270.60 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$266.72 |
$266.72 |
$266.72 |
$543.85
|
|
Ampicillin 1 gram solution for injection
|
$127.37 |
$127.37 |
$127.37 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$158.44 |
$158.44 |
$158.44 |
$53.86
|
|
Amylase
|
$42.00 |
$42.00 |
$42.00 |
$89.04
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$775.50 |
$775.50 |
$775.50 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$194.00 |
$194.00 |
$194.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$199.00 |
$199.00 |
$199.00 |
$230.40
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$516.50 |
$516.50 |
$516.50 |
$122.20
|
|
Anca screen with reflex to titer -quest
|
$68.00 |
$68.00 |
$68.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$926.00 |
$926.00 |
$926.00 |
$2,626.65
|
|
An fluoro guide for cvp
|
$326.50 |
$326.50 |
$326.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$10,932.50 |
$10,932.50 |
$10,932.50 |
$5,341.83
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$3,440.00 |
$3,440.00 |
$3,440.00 |
$3,080.85
|
|
Angio trnslmnl balloon same artery ini
|
$15,904.50 |
$15,904.50 |
$15,904.50 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$11,892.50 |
$11,892.50 |
$11,892.50 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$11,892.50 |
$11,892.50 |
$11,892.50 |
$8,466.00
|
|
Ankle X-ray
|
$285.00 |
$285.00 |
$285.00 |
$353.60
|
|
Anl sp inf pmp w/mdreprg&fil
|
$83.30 |
$83.30 |
$83.30 |
$627.94
|
|
Annual Physical, Established Patient (age 18-39)
|
$41.12 |
$41.12 |
$41.12 |
$141.00
|
|
Annual Physical, Established Patient (age 40-64)
|
$43.75 |
$43.75 |
$43.75 |
$158.76
|
|
Annual Physical, New Patient (age 18-39)
|
$47.08 |
$47.08 |
$47.08 |
$143.25
|
|
Annual Physical, New Patient (age 40-64)
|
$53.02 |
$53.02 |
$53.02 |
$165.10
|
|
Antibody bacterium, not elsewhere specified
|
$30.00 |
$30.00 |
$30.00 |
$57.81
|
|
Antibody elution rbc reference
|
$173.50 |
$173.50 |
$173.50 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$95.00 |
$95.00 |
$95.00 |
$218.30
|
|
Antibody id rbc panel
|
$241.00 |
$241.00 |
$241.00 |
$274.56
|
|
Antibody screen rbc
|
$103.00 |
$103.00 |
$103.00 |
$100.00
|
|
Antibody tetanus
|
$140.00 |
$140.00 |
$140.00 |
$53.95
|
|
Antigen therapy services
|
$21.00 |
$21.00 |
$21.00 |
$73.84
|
|
Antigen therapy services
|
$33.50 |
$33.50 |
$33.50 |
$83.72
|
|
Antigen therapy services
|
$37.50 |
$37.50 |
$37.50 |
$101.40
|
|
Antigen therapy services
|
$45.00 |
$45.00 |
$45.00 |
$96.72
|
|
Antigen therapy services
|
$133.00 |
$133.00 |
$133.00 |
$130.00
|
|
Antigen therapy services
|
$12.50 |
$12.50 |
$12.50 |
$70.07
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$4,240.80 |
$4,240.80 |
$4,240.80 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$3,307,904.60 |
$3,307,904.60 |
$3,307,904.60 |
$3.67
|
|
Anti-inhibitor
|
$654,255.00 |
$654,255.00 |
$654,255.00 |
$8.33
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$67.50 |
$67.50 |
$67.50 |
$37.05
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$67.50 |
$67.50 |
$67.50 |
$40.00
|
|
Antinuclear antibodies
|
$45.50 |
$45.50 |
$45.50 |
$89.40
|
|
Antinuclear antibodies titer
|
$95.50 |
$95.50 |
$95.50 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$119.00 |
$119.00 |
$119.00 |
$65.97
|
|
Antistreptolysin o titer
|
$23.50 |
$23.50 |
$23.50 |
$51.45
|
|
Antithrombin iii activity
|
$102.00 |
$102.00 |
$102.00 |
$114.00
|
|
Antithrombin iii injection
|
$3,559.48 |
$3,559.48 |
$3,559.48 |
$12.34
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$10,135.02 |
$10,135.02 |
$10,135.02 |
$7,704.70
|
|
Apheresis plasma
|
$2,882.00 |
$2,882.00 |
$2,882.00 |
$3,188.50
|
|
Apheresis platelets
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$2,042.95
|
|
Apheresis rbc
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$3,146.15
|
|
Apheresis wbc
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$2,968.80
|
|
Apl(pml-rara) quant - sendout
|
$539.00 |
$539.00 |
$539.00 |
$482.95
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$515.00 |
$515.00 |
$515.00 |
$463.65
|
|
Application finger splntstatic 29130
|
$255.00 |
$255.00 |
$255.00 |
$208.16
|
|
Application long leg splint 29505
|
$131.50 |
$131.50 |
$131.50 |
$338.25
|
|
Application lower leg splint 29515
|
$262.50 |
$262.50 |
$262.50 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$861.50 |
$861.50 |
$861.50 |
$373.20
|
|
Application of forearm cast 29075
|
$668.50 |
$668.50 |
$668.50 |
$339.30
|
|
Application of paste boot 29580
|
$818.50 |
$818.50 |
$818.50 |
$331.74
|
|
Application short leg cast 29405
|
$747.50 |
$747.50 |
$747.50 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,030.50 |
$1,030.50 |
$1,030.50 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,515.00 |
$1,515.00 |
$1,515.00 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$66.50 |
$66.50 |
$66.50 |
$66.00
|
|
Appl multlay comprs arm/hand
|
$479.50 |
$479.50 |
$479.50 |
$292.60
|
|
Apply rigid leg cast 29445
|
$1,021.50 |
$1,021.50 |
$1,021.50 |
$555.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$955.43 |
$955.43 |
$955.43 |
$955.43
|
|
Aqaprn-4 antb flo cytmtry ea
|
$197.00 |
$197.00 |
$197.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$199.00 |
$199.00 |
$199.00 |
$138.16
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$91.50 |
$91.50 |
$91.50 |
$100.00
|
|
Aquatic exercise - group charge
|
$83.00 |
$83.00 |
$83.00 |
$85.80
|
|
Argatroban nonesrd use 1mg
|
$368.67 |
$368.67 |
$368.67 |
$866.80
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$8,703.68 |
$8,703.68 |
$8,703.68 |
$6,387.85
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$258.99 |
$258.99 |
$258.99 |
$1,313.89
|
|
Arterial blood draw/perc 36620
|
$544.00 |
$544.00 |
$544.00 |
$485.69
|
|
Artery xray each vessel 7577426
|
$876.50 |
$876.50 |
$876.50 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$3,082.00 |
$3,082.00 |
$3,082.00 |
$4,446.00
|
|
Artery x-rays arm/leg 75710-26
|
$2,824.50 |
$2,824.50 |
$2,824.50 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$2,959.00 |
$2,959.00 |
$2,959.00 |
$3,729.00
|
|
Artery x-rays chest
|
$2,185.00 |
$2,185.00 |
$2,185.00 |
$2,870.00
|
|
Artery x-rays lung
|
$2,959.00 |
$2,959.00 |
$2,959.00 |
$3,279.12
|
|
Artery x-rays lung
|
$3,127.00 |
$3,127.00 |
$3,127.00 |
$2,451.75
|
|
Artery x-rays lungs
|
$3,496.00 |
$3,496.00 |
$3,496.00 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$2,573.00 |
$2,573.00 |
$2,573.00 |
$4,134.14
|
|
Artery x-rays spine
|
$2,959.00 |
$2,959.00 |
$2,959.00 |
$4,306.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$42.35 |
$42.35 |
$42.35 |
$608.40
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,963.00 |
$1,963.00 |
$1,963.00 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$37.10 |
$37.10 |
$37.10 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$383.00 |
$383.00 |
$612.50 |
$715.37
|
|
Ascenda two piece catheter
|
$33,204.50 |
$33,204.50 |
$33,204.50 |
$22,951.20
|
|
Asp & inj w/heparin pleurx cath
|
$3,856.00 |
$3,856.00 |
$3,856.00 |
$1,432.00
|