|
Allergy injections; 2 or more 95117
|
$40.00 |
$40.00 |
$40.00 |
$45.00
|
|
Allergy injection; single 95115
|
$33.15 |
$33.15 |
$33.15 |
$46.80
|
|
Allergy Skin Testing
|
$85.15 |
$85.15 |
$85.15 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$289.00 |
$289.00 |
$289.00 |
$423.37
|
|
Allograft 160mg placental salera mini membrane
|
$43.26 |
$43.26 |
$43.26 |
$5,835.10
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$424.66 |
$424.66 |
$424.66 |
$5,399.16
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$3,961.09 |
$3,961.09 |
$3,961.09 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$3,663.49 |
$3,663.49 |
$3,663.49 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$159.49 |
$159.49 |
$159.49 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,097.63 |
$2,097.63 |
$2,097.63 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$238.13 |
$238.13 |
$238.13 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,609.82 |
$5,609.82 |
$5,609.82 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$232.74 |
$232.74 |
$232.74 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$815.54 |
$815.54 |
$815.54 |
$1,225.35
|
|
All tstg perq&iq drugs/biol
|
$29.90 |
$29.90 |
$29.90 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$22.75 |
$22.75 |
$22.75 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,450.00 |
$2,450.00 |
$2,450.00 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$221.65 |
$221.65 |
$221.65 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$70.85 |
$70.85 |
$70.85 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$25,477.05 |
$25,477.05 |
$25,477.05 |
$15,857.45
|
|
Alt/sgpt
|
$1,226.95 |
$1,226.95 |
$1,226.95 |
$47.50
|
|
Alys cplx sp/pn npgt w/prgrm
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$411.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$32.20 |
$32.20 |
$32.20 |
$39.84
|
|
Amino acids quant 2-5
|
$48.75 |
$48.75 |
$48.75 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$49.90 |
$49.90 |
$49.90 |
$37.33
|
|
Aminolevulinic acid delta
|
$299.00 |
$299.00 |
$299.00 |
$87.12
|
|
Aminolevulinic acid hcl top
|
$864.00 |
$864.00 |
$864.00 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$101.15 |
$101.15 |
$101.15 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$212.00 |
$212.00 |
$212.00 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$21.85 |
$21.85 |
$21.85 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$11,933.95 |
$11,933.95 |
$11,933.95 |
$9,084.45
|
|
Ammonia
|
$120.90 |
$120.90 |
$120.90 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$58.50 |
$58.50 |
$58.50 |
$93.61
|
|
Amphetamines 5 or more
|
$23.40 |
$23.40 |
$23.40 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$8.75 |
$8.75 |
$8.75 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,507.85 |
$1,507.85 |
$1,507.85 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$38.85 |
$38.85 |
$38.85 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$24.65 |
$24.65 |
$24.65 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$512.85 |
$512.85 |
$512.85 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$38,801.40 |
$38,801.40 |
$38,801.40 |
$3,986.00
|
|
Amputation thru metatarsal
|
$47,248.10 |
$47,248.10 |
$47,248.10 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$28,954.15 |
$28,954.15 |
$28,954.15 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$26,755.30 |
$26,755.30 |
$26,755.30 |
$3,839.54
|
|
Amylase
|
$81.25 |
$81.25 |
$81.25 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$150.80 |
$150.80 |
$150.80 |
$117.01
|
|
Anal/urinary muscle study
|
$107.25 |
$107.25 |
$107.25 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$299.00 |
$299.00 |
$299.00 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$176.80 |
$176.80 |
$176.80 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$159.25 |
$159.25 |
$159.25 |
$249.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$40.30 |
$40.30 |
$40.30 |
$122.20
|
|
Anaplsma phgcytophlm amp prb
|
$76.70 |
$76.70 |
$76.70 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$78.00 |
$78.00 |
$78.00 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$2,626.65 |
$2,626.65 |
$2,626.65 |
$2,480.94
|
|
Anchor suture 3.5mm pushlock
|
$2,155.00 |
$2,155.00 |
$2,155.00 |
$2,155.00
|
|
An fluoro guide for cvp
|
$19,769.33 |
$19,769.33 |
$19,769.33 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$16,387.06 |
$16,387.06 |
$16,387.06 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$65,268.66 |
$65,268.66 |
$65,268.66 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$80,481.39 |
$80,481.39 |
$80,481.39 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$43,302.40 |
$43,302.40 |
$43,302.40 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$43,302.40 |
$43,302.40 |
$43,302.40 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ini
|
$15,155.40 |
$15,155.40 |
$15,155.40 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$19,431.75 |
$19,431.75 |
$19,431.75 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$16,670.55 |
$16,670.55 |
$16,670.55 |
$8,359.11
|
|
Ankle arthroscopy/surgery
|
$60,716.68 |
$60,716.68 |
$60,716.68 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$72,278.70 |
$72,278.70 |
$72,278.70 |
$3,839.54
|
|
Ankle X-ray
|
$2,983.00 |
$2,983.00 |
$2,983.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$574.00 |
$574.00 |
$574.00 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$145.00 |
$145.00 |
$145.00 |
$630.96
|
|
Annual alcohol screen 15 min
|
$46.86 |
$46.86 |
$46.86 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$468.00 |
$468.00 |
$468.00 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$235.00 |
$235.00 |
$235.00 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$237.00 |
$237.00 |
$237.00 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$288.00 |
$288.00 |
$288.00 |
$167.25
|
|
Anora (draw only)
|
$23.40 |
$23.40 |
$23.40 |
$35.00
|
|
Anoscopy control bleeding 46614
|
$321.00 |
$321.00 |
$321.00 |
$2,140.60
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$38,733.25 |
$38,733.25 |
$38,733.25 |
$5,841.60
|
|
Antibody elution rbc reference
|
$204.75 |
$204.75 |
$204.75 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$162.50 |
$162.50 |
$162.50 |
$131.56
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$165.75 |
$165.75 |
$165.75 |
$224.00
|
|
Antibody id rbc panel
|
$128.70 |
$128.70 |
$128.70 |
$291.75
|
|
Antibody screen rbc
|
$69.55 |
$69.55 |
$69.55 |
$108.55
|
|
Anticoag mgmt pt warfarin
|
$35.00 |
$35.00 |
$35.00 |
$26.40
|
|
Antidepressant not specified
|
$48.75 |
$48.75 |
$48.75 |
$72.14
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$5,144.60 |
$5,144.60 |
$5,144.60 |
$6.10
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$46.80 |
$46.80 |
$46.80 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$84.50 |
$84.50 |
$84.50 |
$42.00
|
|
Ant instr 2-3 vert segm 22845
|
$70,421.43 |
$70,421.43 |
$70,421.43 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$91,251.78 |
$91,251.78 |
$91,251.78 |
$1,430.40
|
|
Antinuclear antibodies
|
$42.25 |
$42.25 |
$42.25 |
$90.00
|
|
Antinuclear antibodies titer
|
$219.70 |
$219.70 |
$219.70 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$131.95 |
$131.95 |
$131.95 |
$67.43
|
|
Antistreptolysin o screen
|
$48.75 |
$48.75 |
$48.75 |
$58.56
|
|
Antistreptolysin o titer
|
$42.90 |
$42.90 |
$42.90 |
$54.00
|
|
Antithrombin iii activity
|
$161.20 |
$161.20 |
$161.20 |
$115.15
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$14,664.50 |
$14,664.50 |
$14,664.50 |
$8,214.07
|
|
Aortic Aneurysm Screening Ultrasound
|
$303.55 |
$303.55 |
$303.55 |
$394.55
|
|
Apl(pml-rara) quant - sendout
|
$778.05 |
$778.05 |
$778.05 |
$513.00
|
|
Appendix Removal (Laparoscopic)
|
$51,418.66 |
$51,418.66 |
$51,418.66 |
$7,202.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,233.05 |
$1,233.05 |
$1,233.05 |
$2,114.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$635.00 |
$635.00 |
$635.00 |
$3,593.46
|