|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$2,674.32 |
$2,674.32 |
$2,674.32 |
$2,513.00
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$3,199.22 |
$3,199.22 |
$3,199.22 |
$2,198.85
|
|
All tstg perq&iq drugs/biol
|
$161.70 |
$161.70 |
$161.70 |
$64.80
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$138.60 |
$138.60 |
$138.60 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$126.50 |
$126.50 |
$126.50 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$76.45 |
$76.45 |
$76.45 |
$99.00
|
|
Alt/sgpt
|
$33.00 |
$33.00 |
$33.00 |
$49.00
|
|
Aluminum - quest
|
$64.35 |
$64.35 |
$64.35 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$603.90 |
$603.90 |
$603.90 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$217.80 |
$217.80 |
$217.80 |
$196.20
|
|
Amino acids quant 2-5
|
$39.05 |
$39.05 |
$39.05 |
$141.00
|
|
Aminolevulinic acid delta
|
$122.10 |
$122.10 |
$122.10 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$309.10 |
$309.10 |
$309.10 |
$101.17
|
|
Ammonia
|
$62.70 |
$62.70 |
$62.70 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$1,285.35 |
$1,285.35 |
$1,285.35 |
$942.60
|
|
Amniocentesis therapeutic
|
$1,329.90 |
$1,329.90 |
$1,329.90 |
$778.57
|
|
Amniotic fluid scan
|
$29.70 |
$29.70 |
$29.70 |
$33.15
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,031.05 |
$3,031.05 |
$3,031.05 |
$3,835.20
|
|
Amphetamine confirm urine -sendout
|
$152.90 |
$152.90 |
$152.90 |
$94.50
|
|
Amphetamines 5 or more
|
$106.70 |
$106.70 |
$106.70 |
$101.40
|
|
Amputation toe interphalangeal joint
|
$3,624.50 |
$3,624.50 |
$3,624.50 |
$3,691.20
|
|
Amylase
|
$77.55 |
$77.55 |
$77.55 |
$93.00
|
|
Ana ds-dna
|
$139.70 |
$139.70 |
$139.70 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$101.20 |
$101.20 |
$101.20 |
$110.98
|
|
Anal pressure record
|
$834.90 |
$834.90 |
$834.90 |
$955.86
|
|
Anal/urinary muscle study
|
$396.00 |
$396.00 |
$396.00 |
$407.00
|
|
Anal/urinary muscle study
|
$503.25 |
$503.25 |
$503.25 |
$507.26
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$228.80 |
$228.80 |
$228.80 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$140.25 |
$140.25 |
$140.25 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$167.75 |
$167.75 |
$167.75 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$75.35 |
$75.35 |
$75.35 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$302.50 |
$302.50 |
$302.50 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$42.35 |
$42.35 |
$42.35 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$211.75 |
$211.75 |
$211.75 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$2,664.20 |
$2,664.20 |
$2,664.20 |
$2,626.65
|
|
Androstanediol
|
$256.85 |
$256.85 |
$256.85 |
$98.58
|
|
An fluoro guide for cvp
|
$394.90 |
$394.90 |
$394.90 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$5,799.20 |
$5,799.20 |
$5,799.20 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$6,249.65 |
$6,249.65 |
$6,249.65 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$10,173.90 |
$10,173.90 |
$10,173.90 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$6,513.10 |
$6,513.10 |
$6,513.10 |
$6,513.10
|
|
Angio tib/peroneal/init ves/unila 37228
|
$8,974.90 |
$8,974.90 |
$8,974.90 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,109.40 |
$6,109.40 |
$6,109.40 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$4,963.20 |
$4,963.20 |
$4,963.20 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,935.25 |
$3,935.25 |
$3,935.25 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$5,799.20 |
$5,799.20 |
$5,799.20 |
$8,689.20
|
|
Ankle X-ray
|
$216.15 |
$216.15 |
$216.15 |
$339.44
|
|
Anl sp inf pmp w/mdreprg&fil
|
$744.15 |
$744.15 |
$744.15 |
$693.75
|
|
Annual Physical, Established Patient (age 18-39)
|
$30.80 |
$30.80 |
$30.80 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$30.80 |
$30.80 |
$30.80 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$30.80 |
$30.80 |
$30.80 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$30.80 |
$30.80 |
$30.80 |
$188.15
|
|
Anoscopy remove fb 46608
|
$807.40 |
$807.40 |
$807.40 |
$1,208.35
|
|
Antibody bacterium, not elsewhere specified
|
$116.05 |
$116.05 |
$116.05 |
$57.89
|
|
Antibody elution rbc reference
|
$110.00 |
$110.00 |
$110.00 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$167.75 |
$167.75 |
$167.75 |
$141.74
|
|
Antibody htlv-i
|
$22.00 |
$22.00 |
$22.00 |
$48.75
|
|
Antibody htlv-ii
|
$28.05 |
$28.05 |
$28.05 |
$35.22
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$263.45 |
$263.45 |
$263.45 |
$220.73
|
|
Antibody id rbc panel
|
$224.40 |
$224.40 |
$224.40 |
$291.75
|
|
Antibody influenza virus
|
$35.75 |
$35.75 |
$35.75 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$25.85 |
$25.85 |
$25.85 |
$53.96
|
|
Antibody screen rbc
|
$84.70 |
$84.70 |
$84.70 |
$105.00
|
|
Antidepressant not specified
|
$194.70 |
$194.70 |
$194.70 |
$89.50
|
|
Anti mog serum - sendout
|
$431.20 |
$431.20 |
$431.20 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$23.65 |
$23.65 |
$23.65 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$74.80 |
$74.80 |
$74.80 |
$45.82
|
|
Antinuclear antibodies
|
$60.50 |
$60.50 |
$60.50 |
$91.70
|
|
Antinuclear antibodies titer
|
$682.00 |
$682.00 |
$682.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$147.95 |
$147.95 |
$147.95 |
$74.20
|
|
Antistreptolysin o titer
|
$85.80 |
$85.80 |
$85.80 |
$57.96
|
|
Antithrombin iii activity
|
$285.45 |
$285.45 |
$285.45 |
$115.23
|
|
Apc gene known fam variants
|
$554.40 |
$554.40 |
$554.40 |
$308.00
|
|
Apheresis plasma
|
$3,076.70 |
$3,076.70 |
$3,076.70 |
$3,411.50
|
|
Apheresis platelets
|
$732.05 |
$732.05 |
$732.05 |
$2,345.00
|
|
Apheresis rbc
|
$4,040.30 |
$4,040.30 |
$4,040.30 |
$3,348.50
|
|
Apheresis wbc
|
$4,040.30 |
$4,040.30 |
$4,040.30 |
$3,342.71
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,411.75 |
$2,411.75 |
$2,411.75 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$391.60 |
$391.60 |
$391.60 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$171.05 |
$171.05 |
$171.05 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$3,977.05 |
$3,977.05 |
$3,977.05 |
$3,150.00
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,030.60 |
$2,030.60 |
$2,030.60 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$143.55 |
$143.55 |
$143.55 |
$508.18
|
|
Application finger splntstatic 29130
|
$198.55 |
$198.55 |
$198.55 |
$216.80
|
|
Application long leg splint 29505
|
$407.00 |
$407.00 |
$407.00 |
$340.80
|
|
Application lower leg splint 29515
|
$619.85 |
$619.85 |
$619.85 |
$355.85
|
|
Application multi layer compression below knee (both sides)
|
$534.60 |
$534.60 |
$534.60 |
$397.00
|
|
Application of forearm cast 29075
|
$522.50 |
$522.50 |
$522.50 |
$379.20
|
|
Application of long arm cast 29065
|
$488.40 |
$488.40 |
$488.40 |
$404.63
|
|
Application of long leg cast 29345
|
$517.55 |
$517.55 |
$517.55 |
$511.68
|
|
Application of paste boot 29580
|
$749.10 |
$749.10 |
$749.10 |
$331.74
|
|
Application short leg cast 29405
|
$849.20 |
$849.20 |
$849.20 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,275.25 |
$3,275.25 |
$3,275.25 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,754.95 |
$2,754.95 |
$2,754.95 |
$2,120.95
|
|
Applicator tag rfid localizer 12gx7cm
|
$47.68 |
$47.68 |
$47.68 |
$168.60
|
|
Appl modality 1/> areas paraffin bath 97018
|
$56.65 |
$56.65 |
$56.65 |
$69.55
|
|
Appl unipln uni ext fixj sys
|
$5,754.10 |
$5,754.10 |
$5,754.10 |
$5,754.10
|
|
Apply finger cast 29086
|
$238.15 |
$238.15 |
$238.15 |
$225.29
|
|
Apply forearm splintdynamic 29126
|
$418.00 |
$418.00 |
$418.00 |
$263.10
|
|
Apply halo w/removal cranial
|
$1,045.55 |
$1,045.55 |
$1,045.55 |
$1,608.36
|
