|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$14.00 |
$14.00 |
$14.50 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$59.76 |
$15,780.15 |
$15,780.15 |
|
|
Adrenal cortex & medulla img
|
$3,192.60 |
$3,192.60 |
$7,925.44 |
|
|
Adrenalin epinephrine inject
|
$703.95 |
$703.95 |
$703.95 |
|
|
Advance care planning each additional 30 min 99498
|
$108.00 |
$108.00 |
$108.00 |
|
|
Aep hearing status deter i&r
|
$202.20 |
$261.50 |
$795.60 |
|
|
Aep neurodiagnostic i&r
|
$466.20 |
$979.20 |
$1,630.93 |
|
|
Aep thrshld est mlt freq i&r
|
$466.20 |
$2,314.00 |
$2,430.50 |
|
|
Afamelanotide implant, 1 mg
|
$60,749.40 |
$60,749.40 |
$60,749.40 |
|
|
_afb id by dna probe rflx ast
|
$69.60 |
$216.00 |
$247.01 |
|
|
#afb mycobacteria suscep. #1
|
$18.00 |
$107.40 |
$154.20 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$438.14 |
$438.14 |
$438.14 |
|
|
Aflibercept injection
|
$3,893.02 |
$3,893.02 |
$5,101.40 |
|
|
Afo molded plas rig ant tib
|
$3,302.40 |
$3,302.40 |
$3,302.40 |
|
|
Afo sing solid stirrup calf
|
$342.85 |
$342.85 |
$342.85 |
|
|
Afo tib fx semi-rigid l2114
|
$3,638.31 |
$3,638.31 |
$3,638.31 |
|
|
After cataract laser surgery
|
$1,837.20 |
$1,837.20 |
$1,837.20 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$335.46 |
$17,255.38 |
$17,255.38 |
|
|
Air conduction bilat
|
$91.20 |
$244.50 |
$434.37 |
|
|
Air injection into abdomen 49400
|
$166.58 |
$1,395.60 |
$1,413.60 |
|
|
Airway resistance by impulse oscillometry 94728
|
$307.80 |
$307.80 |
$491.21 |
|
|
Albumin body fluid quantitative each specimen
|
$30.88 |
$67.20 |
$119.40 |
|
|
Albumin (human), 25%, 50ml
|
$470.10 |
$481.30 |
$694.43 |
|
|
Albumin (human), 5%, 250 ml
|
$262.82 |
$465.69 |
$471.44 |
|
|
Albumin, human 5 % intravenous solution
|
$470.97 |
$470.97 |
$965.34 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$28.62 |
$111.60 |
$251.40 |
|
|
Albumin serum plasma or whole blood
|
$20.00 |
$62.89 |
$99.00 |
|
|
Albuterol ipratrop non-comp
|
$9.18 |
$9.18 |
$9.18 |
|
|
Albuterol non-comp unit
|
$9.59 |
$9.59 |
$9.59 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$21.59 |
$186.00 |
$194.00 |
|
|
Aldesleukin injection
|
$2,830.85 |
$2,830.85 |
$47,400.38 |
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$0.01 |
$0.01 |
$157,560.18 |
|
|
Alglucosidase alfa injection
|
$1,281.77 |
$1,281.77 |
$10,517.33 |
|
|
Alkaline phosphatase
|
$30.50 |
$69.00 |
$109.20 |
|
|
Allergen alpha lactalbumin ige
|
$24.00 |
$61.80 |
$393.53 |
|
|
Allergen egg white ige
|
$33.38 |
$94.80 |
$235.41 |
|
|
Allergen specific ige qual multi scrn ea
|
$94.41 |
$151.20 |
$165.60 |
|
|
Allergy injections; 2 or more 95117
|
$20.00 |
$20.00 |
$20.00 |
|
|
Allergy injection; single 95115
|
$16.00 |
$16.00 |
$16.00 |
|
|
Allergy Skin Testing
|
$2.10 |
$2.10 |
$105.60 |
|
|
Allg patch or app # of tests 95044
|
$10.00 |
$10.00 |
$10.00 |
|
|
Allograft 160mg placental salera mini membrane
|
$5,481.00 |
$5,481.00 |
$5,481.00 |
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$5,796.00 |
$13,687.41 |
$13,687.50 |
|
|
Allograft amnioexcel plus 17mm disk
|
$2,677.80 |
$2,677.80 |
$14,566.20 |
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$2,130.00 |
$15,486.60 |
$68,375.58 |
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$4,291.20 |
$11,215.90 |
$12,086.40 |
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$2,550.00 |
$35,921.86 |
$127,712.34 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,484.85 |
$4,370.56 |
$11,820.00 |
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,094.40 |
$7,046.40 |
$30,711.37 |
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$2,169.60 |
$5,478.40 |
$5,478.50 |
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,744.80 |
$11,490.25 |
$11,490.25 |
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,752.20 |
$3,161.40 |
$10,199.40 |
|
|
Alloskin
|
$826.80 |
$826.80 |
$826.80 |
|
|
All tstg perq&iq drugs/biol
|
$7.52 |
$66.00 |
$115.80 |
|
|
All tstg perq&iq w/venoms
|
$3.15 |
$3.15 |
$3.15 |
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,176.00 |
$1,176.00 |
$4,774.80 |
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$218.49 |
$218.49 |
$540.60 |
|
|
Alpha-fetoprotein amniotic
|
$123.60 |
$169.80 |
$212.10 |
|
|
Alpha-fetoprotein tumor marker
|
$104.50 |
$212.10 |
$390.00 |
|
|
Alprostadil for injection
|
$122.57 |
$327.86 |
$327.86 |
|
|
Als 1
|
$1,343.40 |
$1,871.40 |
$1,905.50 |
|
|
Als1-emergency
|
$1,850.40 |
$2,150.00 |
$2,695.80 |
|
|
Als 2
|
$2,151.00 |
$2,251.50 |
$4,150.80 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$134.03 |
$2,680.50 |
$87,556.86 |
|
|
Alt/sgpt
|
$25.80 |
$66.42 |
$117.00 |
|
|
Altuviiio per factor viii iu
|
$8.21 |
$8.21 |
$8.21 |
|
|
Aluminum - quest
|
$87.00 |
$155.40 |
$320.45 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$799.20 |
$799.20 |
$1,109.72 |
|
|
Amantadine (symmetrel)-sendout
|
$889.18 |
$889.18 |
$889.18 |
|
|
Ambl bp mntr w/sw a/r
|
$385.77 |
$385.77 |
$385.77 |
|
|
Amifostine
|
$1,743.30 |
$1,743.30 |
$6,487.50 |
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$44.00 |
$83.95 |
$310.40 |
|
|
Amino acid screen, urine
|
$31.50 |
$100.20 |
$270.00 |
|
|
Amino acids quant 2-5
|
$277.80 |
$277.80 |
$379.94 |
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$19.68 |
$19.68 |
$19.68 |
|
|
Aminolevulinic acid delta
|
$52.20 |
$122.40 |
$206.25 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$39.73 |
$41.59 |
$190.89 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$48.99 |
$264.58 |
$264.58 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$41.20 |
$104.67 |
$273.46 |
|
|
Amitriptyline (elavil) -sendout
|
$69.50 |
$70.50 |
$73.00 |
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$16.14 |
$9,141.88 |
$9,141.88 |
|
|
Ammonia
|
$85.75 |
$184.80 |
$269.40 |
|
|
Amniocentesisdiagnostic 59000
|
$87.32 |
$1,072.50 |
$2,578.20 |
|
|
Amniocentesis therapeutic
|
$2,382.00 |
$2,382.00 |
$2,612.72 |
|
|
Amniotic fluid scan
|
$129.60 |
$177.60 |
$485.93 |
|
|
Amobarbital 125 mg inj
|
$1,252.22 |
$1,252.22 |
$1,252.22 |
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$54.24 |
$254.50 |
$362.48 |
|
|
Amphotericin b lipid complex
|
$270.60 |
$270.60 |
$270.60 |
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$178.45 |
$266.72 |
$266.72 |
|
|
Ampicillin 1 gram solution for injection
|
$45.53 |
$154.67 |
$266.91 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$66.51 |
$66.51 |
$575.99 |
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$1,252.03 |
$1,252.03 |
$1,252.03 |
|
|
Amputation toe interphalangeal joint
|
$3,330.60 |
$3,591.00 |
$6,066.60 |
|
|
Amputation toe metatarsophalangeal joint
|
$3,330.60 |
$3,591.00 |
$3,616.20 |
|
|
Amylase
|
$40.00 |
$125.40 |
$1,328.58 |
|
|
Ana ds-dna
|
$150.60 |
$186.00 |
$241.80 |
|
|
Anal pressure record
|
$1,074.00 |
$1,116.00 |
$1,140.00 |
|
|
Anal/urinary muscle study
|
$468.00 |
$468.00 |
$468.00 |
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$568.34 |
$743.00 |
$775.50 |
|
|
Analysis gene f2 20210g>a variant
|
$45.50 |
$217.20 |
$826.26 |
|
