|
Afamelanotide implant, 1 mg
|
$4,061.92 |
$4,061.92 |
$4,061.92 |
|
|
Afamitresgene autoleucel
|
$1,063,455.60 |
$1,063,455.60 |
$1,063,455.60 |
|
|
_afb id by dna probe rflx ast
|
$27.67 |
$45.36 |
$243.20 |
|
|
#afb mycobacteria suscep. #1
|
$10.09 |
$10.09 |
$34.72 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$159.20 |
$159.20 |
$523.20 |
|
|
Aff2 gen aly detc abnl allel
|
$189.06 |
$189.06 |
$189.06 |
|
|
Aff2 gen alys charac alleles
|
$379.27 |
$379.27 |
$379.27 |
|
|
Aflibercept injection
|
$1,054.18 |
$1,054.18 |
$1,054.18 |
|
|
Afo molded ankle gauntlet
|
$765.51 |
$765.51 |
$765.51 |
|
|
Afo molded plas rig ant tib
|
$1,903.70 |
$1,903.70 |
$1,903.70 |
|
|
Afo molded to patient plasti
|
$335.16 |
$825.89 |
$825.89 |
|
|
Afo rig ant tib tcf/= custom
|
$577.92 |
$1,513.36 |
$1,513.36 |
|
|
Afo sing bar clasp attach sh
|
$475.62 |
$475.62 |
$475.62 |
|
|
Afo sing solid stirrup calf
|
$684.77 |
$684.77 |
$684.77 |
|
|
Afo sing upright with adjust s
|
$696.71 |
$696.71 |
$696.71 |
|
|
Afo spiral molded to pt plas
|
$1,304.29 |
$1,304.29 |
$1,304.29 |
|
|
Afo sprng wir drsflx calf bd
|
$483.88 |
$483.88 |
$483.88 |
|
|
Afo supramalleolar custom
|
$364.14 |
$954.34 |
$954.34 |
|
|
Afo tib fx cast molded to pt
|
$1,949.73 |
$1,949.73 |
$1,949.73 |
|
|
Afo tib fx cast plaster mold
|
$1,336.78 |
$1,336.78 |
$1,336.78 |
|
|
Afo tib fx semi-rigid l2114
|
$1,071.69 |
$1,071.69 |
$1,071.69 |
|
|
Afo tibial fracture rigid
|
$1,307.14 |
$1,307.14 |
$1,307.14 |
|
|
Afo tibial fracture soft
|
$855.63 |
$855.63 |
$855.63 |
|
|
Afo, walk boot type, cus fab
|
$998.76 |
$2,500.10 |
$2,500.10 |
|
|
Afo w/ankle joint, prefab
|
$303.66 |
$795.02 |
$795.02 |
|
|
After cataract laser surgery
|
$756.27 |
$1,518.00 |
$1,910.00 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$317.84 |
$317.84 |
$317.84 |
|
|
Air conduction bilat
|
$50.96 |
$218.00 |
$415.00 |
|
|
Air injection into abdomen 49400
|
$114.46 |
$114.46 |
$114.46 |
|
|
Airway resistance by impulse oscillometry 94728
|
$66.27 |
$176.93 |
$272.80 |
|
|
Ak 4 bar ling w/hydraul swig
|
$4,140.36 |
$4,140.36 |
$4,140.36 |
|
|
Ak 4 bar link w/fric swing
|
$2,722.01 |
$2,722.01 |
$2,722.01 |
|
|
Ak/bk self-aligning unit ea
|
$950.76 |
$950.76 |
$950.76 |
|
|
Ak flex inner socket ext fra
|
$2,416.46 |
$2,416.46 |
$2,416.46 |
|
|
Ak/knee disartic acrylic soc
|
$742.32 |
$742.32 |
$742.32 |
|
|
Ak/knee disartic pelvic band
|
$158.05 |
$158.05 |
$158.05 |
|
|
Ak/knee disartic pelvic join
|
$332.81 |
$332.81 |
$332.81 |
|
|
Ak/knee disartic silesian ba
|
$202.75 |
$202.75 |
$202.75 |
|
|
Ak open end sach
|
$6,070.80 |
$6,070.80 |
$6,070.80 |
|
|
Ak pelvic control belt light
|
$224.48 |
$224.48 |
$224.48 |
|
|
Ak pelvic control belt pad/l
|
$306.50 |
$306.50 |
$306.50 |
|
|
Ak sleeve susp neoprene/equa
|
$275.52 |
$275.52 |
$275.52 |
|
|
Ak univ multiplex sys frict
|
$2,496.50 |
$2,496.50 |
$2,496.50 |
|
|
Albumin body fluid quantitative each specimen
|
$7.52 |
$20.00 |
$225.60 |
|
|
Albumin (human), 25%, 50ml
|
$31.41 |
$73.10 |
$79.24 |
|
|
Albumin, human 25 % intravenous solution
|
$29.30 |
$29.30 |
$29.30 |
|
|
Albumin (human), 5%, 250 ml
|
$72.24 |
$73.25 |
$129.50 |
|
|
Albumin, human 5 % intravenous solution
|
$14.65 |
$14.65 |
$14.65 |
|
|
Albumin ischemia modified
|
$46.84 |
$46.84 |
$46.84 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$7.98 |
$23.00 |
$88.00 |
|
|
Albumin serum plasma or whole blood
|
$6.83 |
$20.00 |
$176.00 |
|
|
Albuterol ipratrop non-comp
|
$0.27 |
$0.27 |
$0.27 |
|
|
Albuterol non-comp con
|
$0.36 |
$0.36 |
$0.36 |
|
|
Albuterol non-comp unit
|
$0.10 |
$0.10 |
$0.10 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$23.83 |
$78.00 |
$369.60 |
|
|
Alcohol/sub misuse assess
|
$39.77 |
$39.77 |
$39.77 |
|
|
Alcohol/subs interv 15-30mn
|
$51.52 |
$51.52 |
$51.52 |
|
|
Alcohol/subs interv >30 min
|
$244.07 |
$244.07 |
$244.07 |
|
|
Aldesleukin injection
|
$4,607.64 |
$4,607.64 |
$4,607.64 |
|
|
Aldosterone suppression eval
|
$173.19 |
$173.19 |
$173.19 |
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$3,377.00 |
$3,377.00 |
$3,377.00 |
|
|
Alginate dressing <=16 sq in
|
$14.48 |
$14.48 |
$14.48 |
|
|
Alginate drsg >16 <=48 sq in
|
$32.35 |
$40.89 |
$53.76 |
|
|
Alginate drsg wound filler
|
$10.38 |
$10.38 |
$12.32 |
|
|
Alkaline phosphatase
|
$7.15 |
$19.00 |
$94.40 |
|
|
Allergen alpha lactalbumin ige
|
$12.69 |
$66.00 |
$588.00 |
|
|
Allergen egg white ige
|
$6.72 |
$37.00 |
$246.40 |
|
|
Allergen specific ige qual multi scrn ea
|
$11.00 |
$100.00 |
$100.00 |
|
|
Allergy injections; 2 or more 95117
|
$64.39 |
$99.00 |
$106.00 |
|
|
Allergy injection; single 95115
|
$64.39 |
$78.00 |
$99.00 |
|
|
Allergy Skin Testing
|
$43.00 |
$43.00 |
$1,180.80 |
|
|
Allg patch or app # of tests 95044
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
|
|
Allgrft implnt knee w/scope
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Allograft amnioexcel plus 17mm disk
|
$152.88 |
$171.12 |
$311.14 |
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$476.58 |
$1,377.04 |
$1,377.04 |
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$135.52 |
$171.12 |
$237.82 |
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$28.56 |
$126.00 |
$8,384.33 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$171.12 |
$171.12 |
$13,434.40 |
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$119.84 |
$171.12 |
$1,834.56 |
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$4,704.00 |
$4,704.00 |
$4,704.00 |
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$171.12 |
$171.12 |
$1,338.40 |
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$171.12 |
$171.12 |
$1,021.78 |
|
|
Alloskin
|
$171.12 |
$171.12 |
$171.12 |
|
|
Alloskin ac, 1 cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
All tstg perq&iq drugs/biol
|
$51.36 |
$144.00 |
$144.00 |
|
|
All tstg perq&iq w/venoms
|
$39.77 |
$39.77 |
$39.77 |
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$7.41 |
$7.41 |
$7.41 |
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$88.89 |
$88.89 |
$88.89 |
|
|
Alpha-fetoprotein amniotic
|
$18.48 |
$38.64 |
$206.40 |
|
|
Alpha-fetoprotein tumor marker
|
$23.14 |
$66.00 |
$268.00 |
|
|
Alprostadil for injection
|
$87.64 |
$87.64 |
$87.64 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$65.51 |
$129.49 |
$4,598.72 |
|
|
Alt/sgpt
|
$5.64 |
$22.00 |
$158.40 |
|
|
Altuviiio per factor viii iu
|
$6.36 |
$6.36 |
$6.36 |
|
|
Aluminum - quest
|
$13.31 |
$35.16 |
$212.00 |
|
|
Alveoloplasty each quadrant
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$125.44 |
$162.40 |
$768.00 |
|
|
Amantadine (symmetrel)-sendout
|
$162.00 |
$162.00 |
$287.00 |
|
|
Ambl bp mntr w/software
|
$65.21 |
$65.21 |
$65.21 |
|
