|
Alkaline phosphatase
|
$33.00 |
$33.00 |
$55.00 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$81.40 |
$81.40 |
$81.40 |
$56.35
|
|
Allergen egg white ige
|
$62.15 |
$62.15 |
$130.90 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$19.80 |
$19.80 |
$28.05 |
$26.95
|
|
Allergy injections; 2 or more 95117
|
$36.30 |
$36.30 |
$66.68 |
$51.07
|
|
Allergy injection; single 95115
|
$22.44 |
$22.44 |
$58.92 |
$42.75
|
|
Allergy Skin Testing
|
$5.50 |
$5.50 |
$5.94 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$12.05 |
$12.05 |
$12.05 |
$39.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$2,321.42 |
$2,321.42 |
$2,321.42 |
$6,555.62
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,594.83 |
$10,594.83 |
$10,594.83 |
$6,285.56
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$2,506.22 |
$2,506.22 |
$2,506.22 |
$2,198.85
|
|
All tstg perq&iq drugs/biol
|
$26.14 |
$26.14 |
$151.58 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$52.20 |
$52.20 |
$52.20 |
$41.34
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$164.45 |
$164.45 |
$338.80 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$167.75 |
$167.75 |
$167.75 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$82.50 |
$82.50 |
$156.75 |
$99.00
|
|
Alt/sgpt
|
$35.75 |
$35.75 |
$47.30 |
$49.00
|
|
Aluminum - quest
|
$81.40 |
$81.40 |
$201.85 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$421.85 |
$421.85 |
$421.85 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$187.55 |
$187.55 |
$574.20 |
$196.20
|
|
Amino acid screen, urine
|
$35.75 |
$35.75 |
$35.75 |
$64.28
|
|
Amino acids quant 2-5
|
$47.85 |
$47.85 |
$47.85 |
$141.00
|
|
Aminolevulinic acid delta
|
$152.35 |
$152.35 |
$193.05 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$191.95 |
$191.95 |
$242.55 |
$101.17
|
|
Ammonia
|
$77.00 |
$77.00 |
$77.55 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$1,743.88 |
$1,743.88 |
$1,743.88 |
$942.60
|
|
Amniocentesis therapeutic
|
$825.82 |
$825.82 |
$825.82 |
$778.57
|
|
Amniotic fluid scan
|
$78.65 |
$78.65 |
$78.65 |
$33.15
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$5,397.54 |
$5,397.54 |
$6,295.30 |
$3,835.20
|
|
Amphetamine confirm urine -sendout
|
$117.70 |
$117.70 |
$222.75 |
$94.50
|
|
Amphetamines 5 or more
|
$33.00 |
$33.00 |
$95.15 |
$101.40
|
|
Amputation toe interphalangeal joint
|
$3,293.95 |
$3,293.95 |
$4,721.14 |
$3,691.20
|
|
Amylase
|
$61.60 |
$61.60 |
$124.30 |
$93.00
|
|
Ana ds-dna
|
$216.15 |
$216.15 |
$216.15 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$121.00 |
$121.00 |
$151.80 |
$110.98
|
|
Anal pressure record
|
$737.00 |
$737.00 |
$1,018.16 |
$955.86
|
|
Anal/urinary muscle study
|
$384.67 |
$384.67 |
$387.75 |
$407.00
|
|
Anal/urinary muscle study
|
$732.88 |
$732.88 |
$732.88 |
$507.26
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$52.27 |
$52.27 |
$52.27 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$153.45 |
$153.45 |
$253.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$184.25 |
$184.25 |
$314.60 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$46.33 |
$46.33 |
$135.14 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$100.10 |
$100.10 |
$429.72 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$25.30 |
$25.30 |
$33.00 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$141.90 |
$141.90 |
$271.70 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$3,861.00 |
$3,861.00 |
$4,273.50 |
$2,626.65
|
|
Androstanediol
|
$213.95 |
$213.95 |
$213.95 |
$98.58
|
|
An fluoro guide for cvp
|
$645.70 |
$645.70 |
$900.90 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$5,500.00 |
$5,500.00 |
$15,362.40 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$8,250.00 |
$8,250.00 |
$11,396.19 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$8,250.00 |
$8,250.00 |
$11,503.46 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$7,150.00 |
$7,150.00 |
$7,166.31 |
$6,513.10
|
|
Angio tib/peroneal/init ves/unila 37228
|
$6,050.00 |
$6,050.00 |
$11,503.46 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$5,500.00 |
$5,500.00 |
$7,543.48 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$6,050.00 |
$6,050.00 |
$12,793.46 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$6,050.00 |
$6,050.00 |
$14,392.82 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$6,600.00 |
$6,600.00 |
$7,459.04 |
$8,689.20
|
|
Ankle X-ray
|
$285.45 |
$285.45 |
$304.70 |
$339.44
|
|
Anl sp inf pmp w/mdreprg&fil
|
$186.52 |
$186.52 |
$601.32 |
$693.75
|
|
Annual Physical, Established Patient (age 18-39)
|
$34.31 |
$34.31 |
$34.31 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$34.31 |
$34.31 |
$41.25 |
$167.25
|
|
Anora (draw only)
|
$31.35 |
$31.35 |
$31.35 |
$36.00
|
|
Anoscopy control bleeding 46614
|
$1,942.05 |
$1,942.05 |
$1,942.05 |
$1,405.05
|
|
Anoscopy remove fb 46608
|
$841.50 |
$841.50 |
$841.50 |
$1,208.35
|
|
Antibody bacterium, not elsewhere specified
|
$106.15 |
$106.15 |
$128.15 |
$57.89
|
|
Antibody elution rbc reference
|
$131.45 |
$131.45 |
$203.50 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$173.25 |
$173.25 |
$220.55 |
$141.74
|
|
Antibody htlv-i
|
$20.35 |
$20.35 |
$77.00 |
$48.75
|
|
Antibody htlv-ii
|
$30.80 |
$30.80 |
$80.85 |
$35.22
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$277.20 |
$277.20 |
$532.40 |
$220.73
|
|
Antibody id rbc panel
|
$458.15 |
$458.15 |
$491.15 |
$291.75
|
|
Antibody influenza virus
|
$30.80 |
$30.80 |
$30.80 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$34.10 |
$34.10 |
$34.10 |
$53.96
|
|
Antibody screen rbc
|
$172.15 |
$172.15 |
$181.50 |
$105.00
|
|
Antidepressant not specified
|
$163.90 |
$163.90 |
$163.90 |
$89.50
|
|
Antigen therapy services
|
$41.44 |
$41.44 |
$41.44 |
$69.43
|
|
Antigen therapy services
|
$157.97 |
$157.97 |
$157.97 |
$82.78
|
|
Antigen therapy services
|
$41.44 |
$41.44 |
$41.44 |
$99.86
|
|
Antigen therapy services
|
$61.51 |
$61.51 |
$61.51 |
$91.07
|
|
Antigen therapy services
|
$64.74 |
$64.74 |
$64.74 |
$99.00
|
|
Antigen therapy services
|
$12.60 |
$12.60 |
$47.30 |
$60.75
|
|
Anti mog serum - sendout
|
$453.75 |
$453.75 |
$453.75 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$23.65 |
$23.65 |
$23.65 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$7.15 |
$7.15 |
$78.65 |
$45.82
|
|
Antinuclear antibodies
|
$57.75 |
$57.75 |
$128.15 |
$91.70
|
|
Antinuclear antibodies titer
|
$682.00 |
$682.00 |
$682.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$36.30 |
$36.30 |
$36.30 |
$74.20
|
|
Antistreptolysin o titer
|
$67.10 |
$67.10 |
$77.55 |
$57.96
|
|
Antithrombin iii activity
|
$293.70 |
$293.70 |
$326.70 |
$115.23
|
|
Ant sgm img ir flrscn angrph
|
$110.71 |
$110.71 |
$110.71 |
$182.95
|
|
Apc gene known fam variants
|
$564.30 |
$564.30 |
$894.30 |
$308.00
|
|
Apheresis plasma
|
$3,010.15 |
$3,010.15 |
$4,174.17 |
$3,411.50
|
|
Apheresis platelets
|
$5,908.65 |
$5,908.65 |
$5,908.65 |
$2,345.00
|
|
Apheresis rbc
|
$4,462.32 |
$4,462.32 |
$4,843.30 |
$3,348.50
|
|
Apheresis wbc
|
$3,853.85 |
$3,853.85 |
$6,780.40 |
$3,342.71
|
|
Apl(pml-rara) quant - sendout
|
$1,042.80 |
$1,042.80 |
$1,042.80 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,140.28 |
$3,140.28 |
$3,140.28 |
$2,164.64
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,175.88 |
$5,175.88 |
$5,175.88 |
$3,150.00
|
|
Appl body cast sho to hips
|
$570.57 |
$570.57 |
$570.57 |
$384.59
|
|
Appl hip spica cast1&1/2
|
$1,520.09 |
$1,520.09 |
$1,520.09 |
$501.28
|
