|
Aminolevulinic acid delta
|
$51.02 |
$51.02 |
$59.83 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$38.67 |
$38.67 |
$48.48 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$86.24 |
$86.24 |
$108.13 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$39.32 |
$39.32 |
$49.30 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$86.77 |
$86.77 |
$108.79 |
$101.17
|
|
Ammonia
|
$71.50 |
$71.50 |
$83.86 |
$124.11
|
|
Amniocentesisdiagnostic 59000
|
$126.93 |
$126.93 |
$126.93 |
$876.60
|
|
Amniocentesis therapeutic
|
$396.46 |
$396.46 |
$396.46 |
$791.05
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,015.44 |
$1,015.44 |
$1,190.90 |
$3,735.51
|
|
Amphetamine confirm urine -sendout
|
$38.57 |
$38.57 |
$48.35 |
$94.50
|
|
Amphetamines 5 or more
|
$6.03 |
$6.03 |
$7.07 |
$101.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$74.50 |
$74.50 |
$93.41 |
$130.08
|
|
Amphotericin b lipid complex
|
$35.04 |
$35.04 |
$43.93 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$156.05 |
$156.05 |
$195.65 |
$342.26
|
|
Ampicillin 1 gram solution for injection
|
$35.47 |
$35.47 |
$44.47 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$41.42 |
$41.42 |
$51.93 |
$51.93
|
|
Amylase
|
$84.36 |
$84.36 |
$98.93 |
$95.80
|
|
Ana ds-dna
|
$34.15 |
$34.15 |
$40.05 |
$69.03
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$113.28 |
$113.28 |
$142.03 |
$110.98
|
|
Anal pressure record
|
$283.59 |
$283.59 |
$332.59 |
$1,008.06
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$212.46 |
$212.46 |
$212.46 |
$340.47
|
|
Analysis gene f2 20210g>a variant
|
$68.69 |
$68.69 |
$80.56 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$77.53 |
$77.53 |
$94.18 |
$237.25
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$1,357.67 |
$1,357.67 |
$1,357.67 |
$128.82
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$448.27 |
$448.27 |
$525.73 |
$411.45
|
|
Anca screen with reflex to titer -quest
|
$46.60 |
$46.60 |
$58.42 |
$112.00
|
|
An cholangiogram percutaneous compl
|
$3,440.35 |
$3,440.35 |
$4,034.83 |
$2,478.25
|
|
An fluoro guide for cvp
|
$236.99 |
$236.99 |
$277.94 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,162.85 |
$1,162.85 |
$1,363.79 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$5,011.70 |
$5,011.70 |
$6,253.16 |
$10,344.88
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$5,628.67 |
$5,628.67 |
$6,601.29 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$6,526.01 |
$6,526.01 |
$7,653.69 |
$6,513.10
|
|
Angio tib/peroneal/init ves/unila 37228
|
$5,075.97 |
$5,075.97 |
$17,008.46 |
$12,672.89
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,810.38 |
$1,810.38 |
$1,810.38 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$1,437.20 |
$1,437.20 |
$1,872.56 |
$9,275.00
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,120.93 |
$3,120.93 |
$3,120.93 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$780.12 |
$780.12 |
$780.12 |
$8,766.15
|
|
Ankle X-ray
|
$270.73 |
$270.73 |
$339.44 |
$351.20
|
|
Anodyne therapy charges pt
|
$65.48 |
$65.48 |
$76.79 |
$41.02
|
|
Antibody bacterium, not elsewhere specified
|
$104.44 |
$104.44 |
$122.49 |
$61.10
|
|
Antibody elution rbc reference
|
$89.18 |
$89.18 |
$104.59 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$80.34 |
$80.34 |
$94.22 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$365.53 |
$365.53 |
$458.30 |
$225.75
|
|
Antibody id rbc panel
|
$118.50 |
$118.50 |
$138.97 |
$283.20
|
|
Antibody influenza virus
|
$35.75 |
$35.75 |
$41.93 |
$54.06
|
|
Antibody lymphocytic choriomeningitis
|
$55.44 |
$55.44 |
$65.01 |
$57.85
|
|
Antibody screen rbc
|
$79.54 |
$79.54 |
$99.72 |
$107.40
|
|
Antibody tetanus
|
$54.90 |
$54.90 |
$54.90 |
$61.98
|
|
Antidepressant not specified
|
$84.36 |
$84.36 |
$105.76 |
$89.50
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$126.98 |
$126.98 |
$159.21 |
$3.94
|
|
Anti mog serum - sendout
|
$7.24 |
$7.24 |
$9.07 |
$154.84
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$28.93 |
$28.93 |
$33.92 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$3.62 |
$3.62 |
$4.24 |
$48.00
|
|
Antinuclear antibodies
|
$49.81 |
$49.81 |
$58.42 |
$96.80
|
|
Antinuclear antibodies titer
|
$67.89 |
$67.89 |
$79.62 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$163.49 |
$163.49 |
$191.74 |
$79.20
|
|
Antistreptolysin o screen
|
$45.80 |
$45.80 |
$53.71 |
$60.00
|
|
Antistreptolysin o titer
|
$68.69 |
$68.69 |
$86.12 |
$58.20
|
|
Antithrombin iii activity
|
$148.62 |
$148.62 |
$186.34 |
$125.40
|
|
Antithrombin iii injection
|
$132.95 |
$132.95 |
$166.69 |
$11.85
|
|
Aortic dysfunction/dilation
|
$1,781.43 |
$1,781.43 |
$2,089.26 |
$982.80
|
|
Aortic dysfunction/dilation
|
$1,781.43 |
$1,781.43 |
$2,089.26 |
$1,485.21
|
|
Apc gene full sequence
|
$939.92 |
$939.92 |
$1,102.34 |
$1,528.20
|
|
Apheresis plasma
|
$1,454.87 |
$1,454.87 |
$1,706.27 |
$3,411.50
|
|
Apheresis rbc
|
$774.43 |
$774.43 |
$970.98 |
$3,348.50
|
|
Apheresis wbc
|
$1,101.00 |
$1,101.00 |
$1,291.24 |
$3,342.71
|
|
Apl(pml-rara) quant - sendout
|
$537.45 |
$537.45 |
$630.31 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$841.51 |
$841.51 |
$986.92 |
$2,141.08
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$561.14 |
$561.14 |
$658.11 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$210.48 |
$210.48 |
$246.85 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$841.51 |
$841.51 |
$986.92 |
$3,150.00
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$561.14 |
$561.14 |
$658.11 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$280.37 |
$280.37 |
$328.82 |
$508.18
|
|
Application finger splntstatic 29130
|
$149.03 |
$149.03 |
$186.85 |
$220.25
|
|
Application long leg splint 29505
|
$226.55 |
$226.55 |
$265.70 |
$370.00
|
|
Application lower leg splint 29515
|
$238.60 |
$238.60 |
$279.83 |
$363.10
|
|
Application multi layer compression below knee (both sides)
|
$154.65 |
$154.65 |
$308.09 |
$406.40
|
|
Application of forearm cast 29075
|
$159.47 |
$159.47 |
$187.02 |
$384.59
|
|
Application of long arm cast 29065
|
$143.80 |
$143.80 |
$168.65 |
$404.63
|
|
Application of long leg cast 29345
|
$177.14 |
$177.14 |
$207.75 |
$511.68
|
|
Application of paste boot 29580
|
$128.94 |
$128.94 |
$225.65 |
$335.78
|
|
Application short leg cast 29405
|
$155.85 |
$155.85 |
$182.79 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$561.14 |
$561.14 |
$678.36 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,753.32 |
$1,753.32 |
$2,198.30 |
$2,109.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$36.96 |
$36.96 |
$43.82 |
$69.96
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$114.08 |
$114.08 |
$133.79 |
$75.98
|
|
Apply finger cast 29086
|
$155.85 |
$155.85 |
$195.41 |
$238.15
|
|
Apply forearm splintdynamic 29126
|
$263.10 |
$263.10 |
$329.87 |
$265.00
|
|
Apply hand/wrist cast 29085
|
$155.45 |
$155.45 |
$194.91 |
$279.40
|
|
Apply interstit radiat compl
|
$2,095.38 |
$2,095.38 |
$3,573.30 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$708.04 |
$708.04 |
$1,207.44 |
$1,773.02
|
|
Apply intrcav radiat interm
|
$708.04 |
$708.04 |
$1,207.44 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$708.04 |
$708.04 |
$1,207.44 |
$1,203.12
|
|
Apply of finger splint 29131
|
$185.18 |
$185.18 |
$232.17 |
$183.20
|
|
Apply rigid leg cast 29445
|
$564.36 |
$564.36 |
$564.36 |
$646.40
|
|
Apply short leg castambul type 29425
|
$248.24 |
$248.24 |
$291.13 |
$474.88
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$623.95 |
$623.95 |
$782.31 |
$979.52
|
|
#aptt mix-1:1 incubated
|
$249.85 |
$249.85 |
$293.02 |
$162.65
|
|
Aquaporin-4 antibody cba each
|
$81.14 |
$81.14 |
$95.16 |
$121.45
|
|
Aquaporin-4 antibody elisa
|
$187.99 |
$187.99 |
$220.47 |
$151.45
|
