|
#afb mycobacteria suscep. #1
|
$10.09 |
$10.09 |
$10.09 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$159.20 |
$159.20 |
$159.20 |
$300.00
|
|
Aff2 gen aly detc abnl allel
|
$189.06 |
$189.06 |
$189.06 |
$189.06
|
|
Aff2 gen alys charac alleles
|
$379.27 |
$379.27 |
$379.27 |
$379.27
|
|
Aflibercept injection
|
$1,054.18 |
$1,054.18 |
$1,054.18 |
$2,738.00
|
|
Afo molded ankle gauntlet
|
$765.51 |
$765.51 |
$765.51 |
$765.51
|
|
Afo molded plas rig ant tib
|
$1,903.70 |
$1,903.70 |
$1,903.70 |
$2,022.34
|
|
Afo molded to patient plasti
|
$825.89 |
$825.89 |
$825.89 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$1,513.36 |
$1,513.36 |
$1,513.36 |
$1,843.53
|
|
Afo sing bar clasp attach sh
|
$475.62 |
$475.62 |
$475.62 |
$589.51
|
|
Afo sing solid stirrup calf
|
$684.77 |
$684.77 |
$684.77 |
$728.50
|
|
Afo sing upright with adjust s
|
$696.71 |
$696.71 |
$696.71 |
$740.16
|
|
Afo spiral molded to pt plas
|
$1,304.29 |
$1,304.29 |
$1,304.29 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$483.88 |
$483.88 |
$483.88 |
$599.70
|
|
Afo supramalleolar custom
|
$954.34 |
$954.34 |
$954.34 |
$1,182.83
|
|
Afo tib fx cast molded to pt
|
$1,949.73 |
$1,949.73 |
$1,949.73 |
$2,118.14
|
|
Afo tib fx cast plaster mold
|
$1,336.78 |
$1,336.78 |
$1,336.78 |
$1,656.82
|
|
Afo tib fx semi-rigid l2114
|
$1,071.69 |
$1,071.69 |
$1,071.69 |
$817.60
|
|
Afo tibial fracture rigid
|
$1,307.14 |
$1,307.14 |
$1,307.14 |
$1,489.57
|
|
Afo tibial fracture soft
|
$855.63 |
$855.63 |
$855.63 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$2,500.10 |
$2,500.10 |
$2,500.10 |
$2,859.19
|
|
Afo w/ankle joint, prefab
|
$795.02 |
$795.02 |
$795.02 |
$741.72
|
|
After cataract laser surgery
|
$756.27 |
$756.27 |
$756.27 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$317.84 |
$317.84 |
$317.84 |
$14,475.20
|
|
Air conduction bilat
|
$182.95 |
$182.95 |
$182.95 |
$134.00
|
|
Air injection into abdomen 49400
|
$114.46 |
$114.46 |
$114.46 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$176.93 |
$176.93 |
$176.93 |
$297.00
|
|
Ak 4 bar ling w/hydraul swig
|
$4,140.36 |
$4,140.36 |
$4,140.36 |
$3,673.60
|
|
Ak 4 bar link w/fric swing
|
$2,722.01 |
$2,722.01 |
$2,722.01 |
$2,228.80
|
|
Ak/bk self-aligning unit ea
|
$950.76 |
$950.76 |
$950.76 |
$618.80
|
|
Ak flex inner socket ext fra
|
$2,416.46 |
$2,416.46 |
$2,416.46 |
$1,352.40
|
|
Ak/knee disartic acrylic soc
|
$742.32 |
$742.32 |
$742.32 |
$495.60
|
|
Ak/knee disartic pelvic band
|
$158.05 |
$158.05 |
$158.05 |
$185.56
|
|
Ak/knee disartic pelvic join
|
$332.81 |
$332.81 |
$332.81 |
$280.00
|
|
Ak/knee disartic silesian ba
|
$202.75 |
$202.75 |
$202.75 |
$221.57
|
|
Ak open end sach
|
$6,070.80 |
$6,070.80 |
$6,070.80 |
$4,928.00
|
|
Ak pelvic control belt light
|
$224.48 |
$224.48 |
$224.48 |
$201.60
|
|
Ak pelvic control belt pad/l
|
$306.50 |
$306.50 |
$306.50 |
$334.90
|
|
Ak sleeve susp neoprene/equa
|
$275.52 |
$275.52 |
$275.52 |
$351.23
|
|
Ak univ multiplex sys frict
|
$2,496.50 |
$2,496.50 |
$2,496.50 |
$1,587.60
|
|
Albumin body fluid quantitative each specimen
|
$10.74 |
$10.74 |
$10.74 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$73.25 |
$73.25 |
$73.25 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$29.30 |
$29.30 |
$29.30 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$73.25 |
$73.25 |
$73.25 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$14.65 |
$14.65 |
$14.65 |
$275.16
|
|
Albumin ischemia modified
|
$46.84 |
$46.84 |
$46.84 |
$85.60
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$7.98 |
$7.98 |
$7.98 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$6.83 |
$6.83 |
$6.83 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$0.27 |
$0.27 |
$0.27 |
$5.67
|
|
Albuterol non-comp con
|
$0.36 |
$0.36 |
$0.36 |
$6.07
|
|
Albuterol non-comp unit
|
$0.10 |
$0.10 |
$0.10 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$23.83 |
$23.83 |
$23.83 |
$96.00
|
|
Alcohol/sub misuse assess
|
$39.77 |
$39.77 |
$39.77 |
$31.20
|
|
Alcohol/subs interv 15-30mn
|
$51.52 |
$51.52 |
$51.52 |
$56.70
|
|
Alcohol/subs interv >30 min
|
$244.07 |
$244.07 |
$244.07 |
$190.13
|
|
Aldesleukin injection
|
$4,607.64 |
$4,607.64 |
$4,607.64 |
$9,030.11
|
|
Aldosterone suppression eval
|
$173.19 |
$173.19 |
$173.19 |
$315.20
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$3,377.00 |
$3,377.00 |
$3,377.00 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$14.48 |
$14.48 |
$14.48 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$32.35 |
$32.35 |
$32.35 |
$43.72
|
|
Alginate drsg wound filler
|
$10.38 |
$10.38 |
$10.38 |
$15.79
|
|
Alkaline phosphatase
|
$7.15 |
$7.15 |
$7.15 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$24.74 |
$24.74 |
$24.74 |
$48.57
|
|
Allergen egg white ige
|
$7.20 |
$7.20 |
$7.20 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$11.00 |
$11.00 |
$11.00 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$64.39 |
$64.39 |
$64.39 |
$45.00
|
|
Allergy injection; single 95115
|
$64.39 |
$64.39 |
$64.39 |
$46.80
|
|
Allergy Skin Testing
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$423.37
|
|
Allgrft implnt knee w/scope
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$6,411.60
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$171.12 |
$171.12 |
$171.12 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$171.12 |
$171.12 |
$171.12 |
$497.95
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$171.12 |
$171.12 |
$171.12 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$4,677.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$1,225.35
|
|
Alloskin
|
$171.12 |
$171.12 |
$171.12 |
$582.40
|
|
Alloskin ac, 1 cm
|
$171.12 |
$171.12 |
$171.12 |
$1.00
|
|
All tstg perq&iq drugs/biol
|
$51.36 |
$51.36 |
$51.36 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$39.77 |
$39.77 |
$39.77 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$7.41 |
$7.41 |
$7.41 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$88.89 |
$88.89 |
$88.89 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$23.46 |
$23.46 |
$23.46 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$23.14 |
$23.14 |
$23.14 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$129.49 |
$129.49 |
$129.49 |
$15,857.45
|
|
Alt/sgpt
|
$7.31 |
$7.31 |
$7.31 |
$47.50
|
|
Altuviiio per factor viii iu
|
$6.36 |
$6.36 |
$6.36 |
$13.32
|
|
Aluminum - quest
|
$35.16 |
$35.16 |
$35.16 |
$83.05
|
|
Alveoloplasty each quadrant
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$130.73 |
$130.73 |
$130.73 |
$411.45
|
|
Ambl bp mntr w/software
|
$65.21 |
$65.21 |
$65.21 |
$178.20
|
|
Ambl bp mntr w/sw a/r
|
$182.95 |
$182.95 |
$182.95 |
$320.45
|
|
Ambl bp mntr w/sw i&r
|
$24.95 |
$24.95 |
$24.95 |
$57.00
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$0.86 |
$0.86 |
$0.86 |
$39.84
|
|
Amines vaginal fluid qual
|
$8.27 |
$8.27 |
$8.27 |
$12.00
|
|
Amino acid screen, urine
|
$19.14 |
$19.14 |
$19.14 |
$77.00
|
|
Amino acid single qual
|
$19.57 |
$19.57 |
$19.57 |
$36.00
|
|
Amino acids quant 2-5
|
$27.06 |
$27.06 |
$27.06 |
$112.00
|
