|
Aminolevulinic acid delta
|
$102.00 |
$102.00 |
$102.00 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$47.06 |
$47.06 |
$47.06 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$264.58 |
$264.58 |
$264.58 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$269.76 |
$269.76 |
$269.76 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$16.14 |
$16.14 |
$16.14 |
$9,084.45
|
|
Ammonia
|
$126.60 |
$126.60 |
$126.60 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$2,578.20 |
$2,578.20 |
$2,578.20 |
$942.60
|
|
Amniocentesis therapeutic
|
$2,557.80 |
$2,557.80 |
$2,557.80 |
$791.05
|
|
Amniotic fluid scan
|
$129.60 |
$129.60 |
$129.60 |
$49.01
|
|
Amobarbital 125 mg inj
|
$1,252.22 |
$1,252.22 |
$1,252.22 |
$1,283.59
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$54.24 |
$54.24 |
$54.24 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$178.45 |
$178.45 |
$178.45 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$154.67 |
$154.67 |
$154.67 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$66.51 |
$66.51 |
$66.51 |
$54.57
|
|
Amputation toe interphalangeal joint
|
$3,330.60 |
$3,330.60 |
$3,330.60 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$3,330.60 |
$3,330.60 |
$3,330.60 |
$3,839.54
|
|
Amylase
|
$90.00 |
$90.00 |
$90.00 |
$90.00
|
|
Ana ds-dna
|
$150.60 |
$150.60 |
$150.60 |
$55.24
|
|
Anal pressure record
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$954.00
|
|
Anal/urinary muscle study
|
$468.00 |
$468.00 |
$468.00 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$276.60 |
$276.60 |
$276.60 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$286.20 |
$286.20 |
$286.20 |
$249.60
|
|
Analysis tumor
|
$757.80 |
$757.80 |
$757.80 |
$248.80
|
|
Anca screen with reflex to titer -quest
|
$136.80 |
$136.80 |
$136.80 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$2,238.00 |
$2,238.00 |
$2,238.00 |
$2,480.94
|
|
An fluoro guide for cvp
|
$635.40 |
$635.40 |
$635.40 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$7,861.80 |
$7,861.80 |
$7,861.80 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$10,047.60 |
$10,047.60 |
$10,047.60 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$10,215.00 |
$10,215.00 |
$10,215.00 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$10,816.20 |
$10,816.20 |
$10,816.20 |
$5,950.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,444.89 |
$1,444.89 |
$1,444.89 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$15,729.00 |
$15,729.00 |
$15,729.00 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$7,002.60 |
$7,002.60 |
$7,002.60 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$10,195.80 |
$10,195.80 |
$10,195.80 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$6,329.40 |
$6,329.40 |
$6,329.40 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$10,047.60 |
$10,047.60 |
$10,047.60 |
$8,359.11
|
|
Anidulafungin injection
|
$209.79 |
$209.79 |
$209.79 |
$312.30
|
|
Ankle X-ray
|
$281.40 |
$281.40 |
$281.40 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$281.40 |
$281.40 |
$281.40 |
$282.96
|
|
Anora (draw only)
|
$49.20 |
$49.20 |
$49.20 |
$35.00
|
|
Antibody
|
$27.60 |
$27.60 |
$27.60 |
$38.40
|
|
Antibody bacterium, not elsewhere specified
|
$89.40 |
$89.40 |
$89.40 |
$57.85
|
|
Antibody elution rbc reference
|
$168.00 |
$168.00 |
$168.00 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$187.20 |
$187.20 |
$187.20 |
$131.56
|
|
Antibody htlv-i
|
$51.00 |
$51.00 |
$51.00 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$289.20 |
$289.20 |
$289.20 |
$224.00
|
|
Antibody id rbc panel
|
$234.60 |
$234.60 |
$234.60 |
$291.75
|
|
Antibody influenza virus
|
$91.20 |
$91.20 |
$91.20 |
$54.00
|
|
Antibody screen rbc
|
$107.40 |
$107.40 |
$107.40 |
$108.55
|
|
Antibody tetanus
|
$42.00 |
$42.00 |
$42.00 |
$54.15
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.12 |
$3.12 |
$3.12 |
$6.10
|
|
Anti-inhibitor
|
$3.67 |
$3.67 |
$3.67 |
$8.33
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$21.60 |
$21.60 |
$21.60 |
$42.00
|
|
Antinuclear antibodies
|
$165.60 |
$165.60 |
$165.60 |
$90.00
|
|
Antinuclear antibodies titer
|
$153.00 |
$153.00 |
$153.00 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$176.40 |
$176.40 |
$176.40 |
$67.43
|
|
Antistreptolysin o titer
|
$61.20 |
$61.20 |
$61.20 |
$54.00
|
|
Antithrombin iii activity
|
$360.00 |
$360.00 |
$360.00 |
$115.15
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$6,946.62 |
$6,946.62 |
$6,946.62 |
$8,214.07
|
|
Aortic Aneurysm Screening Ultrasound
|
$523.80 |
$523.80 |
$523.80 |
$394.55
|
|
Apheresis plasma
|
$3,291.00 |
$3,291.00 |
$3,291.00 |
$3,226.34
|
|
Apl(pml-rara) quant - sendout
|
$245.40 |
$245.40 |
$245.40 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$4,270.80 |
$4,270.80 |
$4,270.80 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$781.80 |
$781.80 |
$781.80 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$288.60 |
$288.60 |
$288.60 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$3,667.20 |
$3,667.20 |
$3,667.20 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$781.80 |
$781.80 |
$781.80 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$288.60 |
$288.60 |
$288.60 |
$512.20
|
|
Application finger splntstatic 29130
|
$191.40 |
$191.40 |
$191.40 |
$208.50
|
|
Application long leg splint 29505
|
$231.60 |
$231.60 |
$231.60 |
$338.25
|
|
Application lower leg splint 29515
|
$186.00 |
$186.00 |
$186.00 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$550.80 |
$550.80 |
$550.80 |
$375.06
|
|
Application of paste boot 29580
|
$518.40 |
$518.40 |
$518.40 |
$340.11
|
|
Application short leg cast 29405
|
$426.60 |
$426.60 |
$426.60 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,458.20 |
$2,458.20 |
$2,458.20 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,354.40 |
$2,354.40 |
$2,354.40 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$84.60 |
$84.60 |
$84.60 |
$69.00
|
|
Appl multlay comprs arm/hand
|
$309.60 |
$309.60 |
$309.60 |
$289.60
|
|
Apply forearm splintdynamic 29126
|
$234.00 |
$234.00 |
$234.00 |
$255.20
|
|
Apply interstit radiat compl
|
$3,262.80 |
$3,262.80 |
$3,262.80 |
$2,901.80
|
|
Apply of finger splint 29131
|
$117.00 |
$117.00 |
$117.00 |
$177.45
|
|
Apply rigid leg cast 29445
|
$672.00 |
$672.00 |
$672.00 |
$555.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$797.95 |
$797.95 |
$797.95 |
$955.43
|
|
#aptt mix-1:1 incubated
|
$146.40 |
$146.40 |
$146.40 |
$157.30
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$90.00 |
$90.00 |
$90.00 |
$100.75
|
|
Aquatic exercise - group charge
|
$108.60 |
$108.60 |
$108.60 |
$87.45
|
|
Arformoterol non-comp unit
|
$9.44 |
$9.44 |
$9.44 |
$24.24
|
|
Argatroban nonesrd use 1mg
|
$840.62 |
$840.62 |
$840.62 |
$881.10
|
|
Arm CT Scan (with contrast, both arms)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$885.00 |
$885.00 |
$885.00 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$523.80 |
$523.80 |
$523.80 |
$426.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$167.54 |
$167.54 |
$167.54 |
$1,303.25
|
|
Arterial blood draw/perc 36620
|
$369.00 |
$369.00 |
$369.00 |
$478.96
|
|
Artery xray each vessel 7577426
|
$2,323.80 |
$2,323.80 |
$2,323.80 |
$1,888.99
|
|
Artery xray of abdomen 75726-26
|
$3,865.20 |
$3,865.20 |
$3,865.20 |
$4,618.71
|
|
Artery x-rays arm/leg 75710-26
|
$2,450.40 |
$2,450.40 |
$2,450.40 |
$3,513.67
|
|
Artery x-rays arms/legs 75716-26
|
$4,902.00 |
$4,902.00 |
$4,902.00 |
$3,860.40
|
|
Artery x-rays chest
|
$1,562.40 |
$1,562.40 |
$1,562.40 |
$2,895.07
|
|
Artery x-rays lung
|
$1,703.40 |
$1,703.40 |
$1,703.40 |
$3,296.15
|
|
Artery x-rays lungs
|
$3,858.00 |
$3,858.00 |
$3,858.00 |
$3,660.60
|
