|
11-desoxycortisol - sendout
|
$66.00 |
$66.00 |
$66.00 |
$84.56
|
|
17-hydroxypregnenolone
|
$45.60 |
$45.60 |
$45.60 |
$85.15
|
|
17-ketosteroids
|
$30.60 |
$30.60 |
$30.60 |
$49.45
|
|
3d recon without postprocess indpndt
|
$1,175.40 |
$1,175.40 |
$1,175.40 |
$467.95
|
|
5' nucleotidase - sendout
|
$30.60 |
$30.60 |
$30.60 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$105.00 |
$105.00 |
$105.00 |
$94.00
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$6,696.00 |
$6,696.00 |
$6,696.00 |
$3,484.68
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$27.00 |
$27.00 |
$27.00 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$1,774.80 |
$1,774.80 |
$1,774.80 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$1,565.40 |
$1,565.40 |
$1,565.40 |
$1,655.50
|
|
Abdominal CT scan (without contrast)
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,166.80 |
$3,166.80 |
$3,166.80 |
$3,004.50
|
|
Abdominal MRI (with contrast)
|
$2,724.00 |
$2,724.00 |
$2,724.00 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$2,179.80 |
$2,179.80 |
$2,179.80 |
$1,981.20
|
|
Abdominal pad
|
$196.11 |
$196.11 |
$196.11 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$817.20 |
$817.20 |
$817.20 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$789.60 |
$789.60 |
$789.60 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$646.20 |
$646.20 |
$646.20 |
$604.80
|
|
Abd paracentesis/w/o image guide 49082
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$1,179.75
|
|
Abduct control hip semi-flex
|
$499.86 |
$499.86 |
$499.86 |
$358.29
|
|
Abduction bar jointed adjust
|
$595.67 |
$595.67 |
$595.67 |
$426.96
|
|
Abduction rotation bar shoe
|
$210.65 |
$210.65 |
$210.65 |
$150.99
|
|
Abduct rotation bar without shoe
|
$192.62 |
$192.62 |
$192.62 |
$138.07
|
|
Abl1 gene
|
$775.80 |
$775.80 |
$775.80 |
$668.85
|
|
Ablation of upper extremity nerves rf
|
$550.20 |
$550.20 |
$550.20 |
$961.20
|
|
Acetaminophen level
|
$137.40 |
$137.40 |
$137.40 |
$117.01
|
|
Acetone qualitative
|
$36.60 |
$36.60 |
$36.60 |
$46.20
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$91.80 |
$91.80 |
$91.80 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$15.30 |
$15.30 |
$15.30 |
$281.55
|
|
Acetylcysteine non-comp unit
|
$47.94 |
$47.94 |
$47.94 |
$29.01
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$68.40 |
$68.40 |
$68.40 |
$42.75
|
|
Acute hepatitis panel
|
$325.20 |
$325.20 |
$325.20 |
$278.33
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$50.76 |
$50.76 |
$50.76 |
$64.45
|
|
#acylcarnitineprfl
|
$180.60 |
$180.60 |
$180.60 |
$110.25
|
|
Adapter b 8 channel 10cm
|
$10,034.36 |
$10,034.36 |
$10,034.36 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$451.68 |
$451.68 |
$451.68 |
$323.75
|
|
Adenosine 3 mg/250 ml bag for osm
|
$24.72 |
$24.72 |
$24.72 |
$272.57
|
|
Adenovirus antibody,serum - quest
|
$89.40 |
$89.40 |
$89.40 |
$63.00
|
|
Adh-sendout
|
$158.40 |
$158.40 |
$158.40 |
$109.71
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$866.52 |
$866.52 |
$866.52 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$553.80 |
$553.80 |
$553.80 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$544.80 |
$544.80 |
$544.80 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$553.80 |
$553.80 |
$553.80 |
$690.21
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$454.20 |
$454.20 |
$454.20 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$319.20 |
$319.20 |
$319.20 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$319.20 |
$319.20 |
$319.20 |
$264.82
|
|
Administration immunization 1 vaccine
|
$49.20 |
$49.20 |
$49.20 |
$67.20
|
|
Administration immunization each additional vaccine
|
$49.20 |
$49.20 |
$49.20 |
$46.23
|
|
Administration vaccine hepatitis b
|
$105.60 |
$105.60 |
$105.60 |
$54.60
|
|
Administration vaccine influenza virus
|
$83.40 |
$83.40 |
$83.40 |
$48.00
|
|
Administration vaccine pneumococcal
|
$83.40 |
$83.40 |
$83.40 |
$49.17
|
|
_afb id by dna probe rflx ast
|
$69.60 |
$69.60 |
$69.60 |
$89.70
|
|
#afb mycobacteria suscep. #1
|
$86.40 |
$86.40 |
$86.40 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$211.80 |
$211.80 |
$211.80 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,067.98 |
$1,067.98 |
$1,067.98 |
$724.73
|
|
Afo molded plas rig ant tib
|
$2,437.93 |
$2,437.93 |
$2,437.93 |
$1,903.70
|
|
Afo molded to patient plasti
|
$1,019.72 |
$1,019.72 |
$1,019.72 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,111.34 |
$2,111.34 |
$2,111.34 |
$1,366.56
|
|
Afo sing bar clasp attach sh
|
$663.56 |
$663.56 |
$663.56 |
$475.62
|
|
Afo sing solid stirrup calf
|
$955.35 |
$955.35 |
$955.35 |
$684.77
|
|
Afo sing upright with adjust s
|
$972.01 |
$972.01 |
$972.01 |
$576.41
|
|
Afo spiral molded to pt plas
|
$1,819.66 |
$1,819.66 |
$1,819.66 |
$1,304.29
|
|
Afo sprng wir drsflx calf bd
|
$675.05 |
$675.05 |
$675.05 |
$458.09
|
|
Afo supramalleolar custom
|
$1,331.42 |
$1,331.42 |
$1,331.42 |
$954.34
|
|
Afo tib fx cast plaster mold
|
$1,864.98 |
$1,864.98 |
$1,864.98 |
$1,336.78
|
|
Afo tibial fracture rigid
|
$1,823.68 |
$1,823.68 |
$1,823.68 |
$1,541.40
|
|
Afo tibial fracture soft
|
$1,193.71 |
$1,193.71 |
$1,193.71 |
$1,052.00
|
|
Afo, walk boot type, cus fab
|
$3,754.63 |
$3,754.63 |
$3,754.63 |
$2,288.00
|
|
Afo w/ankle joint, prefab
|
$1,511.55 |
$1,511.55 |
$1,511.55 |
$567.00
|
|
Airway resistance by impulse oscillometry 94728
|
$225.00 |
$225.00 |
$225.00 |
$270.50
|
|
Ak/knee disartic pelvic band
|
$185.56 |
$185.56 |
$185.56 |
$158.05
|
|
Ak/knee disartic silesian ba
|
$230.77 |
$230.77 |
$230.77 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$418.06 |
$418.06 |
$418.06 |
$246.40
|
|
Albumin body fluid quantitative each specimen
|
$100.80 |
$100.80 |
$100.80 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$315.84 |
$315.84 |
$315.84 |
$218.40
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$36.00 |
$36.00 |
$36.00 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$21.60 |
$21.60 |
$21.60 |
$39.78
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$5.85
|
|
Albuterol non-comp unit
|
$4.02 |
$4.02 |
$4.02 |
$5.11
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$146.40 |
$146.40 |
$146.40 |
$94.90
|
|
Alkaline phosphatase
|
$34.20 |
$34.20 |
$34.20 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$51.60 |
$51.60 |
$51.60 |
$48.57
|
|
Allergen egg white ige
|
$15.00 |
$15.00 |
$15.00 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$24.60 |
$24.60 |
$24.60 |
$24.01
|
|
Allograft 160mg placental salera mini membrane
|
$6,611.20 |
$6,611.20 |
$6,611.20 |
$666.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,037.12 |
$13,037.12 |
$13,037.12 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$16,359.20 |
$16,359.20 |
$16,359.20 |
$3,380.36
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,174.10 |
$10,174.10 |
$10,174.10 |
$5,213.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,185.43 |
$46,185.43 |
$46,185.43 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$31,006.47 |
$31,006.47 |
$31,006.47 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$26,239.58 |
$26,239.58 |
$26,239.58 |
$4,732.60
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,775.26 |
$24,775.26 |
$24,775.26 |
$4,037.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,121.96 |
$8,121.96 |
$8,121.96 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$9,276.62 |
$9,276.62 |
$9,276.62 |
$1,707.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$148.80 |
$148.80 |
$148.80 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$37.20 |
$37.20 |
$37.20 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$57.00 |
$57.00 |
$57.00 |
$102.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$39,707.28 |
$39,707.28 |
$39,707.28 |
$14,503.48
|
