|
Aep neurodiagnostic i&r
|
$234.65 |
$245.70 |
$904.80 |
|
|
Aep thrshld est mlt freq i&r
|
$564.20 |
$564.20 |
$865.15 |
|
|
_afb id by dna probe rflx ast
|
$84.50 |
$128.70 |
$164.45 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$347.75 |
$347.75 |
$389.35 |
|
|
After cataract laser surgery
|
$1,214.78 |
$1,214.78 |
$1,759.87 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$15,773.87 |
$15,773.87 |
$19,651.83 |
|
|
Air conduction bilat
|
$150.80 |
$150.80 |
$150.80 |
|
|
Air injection into abdomen 49400
|
$494.65 |
$494.65 |
$494.65 |
|
|
Albumin body fluid quantitative each specimen
|
$51.35 |
$53.95 |
$88.40 |
|
|
Albumin (human), 25%, 50ml
|
$141.45 |
$190.12 |
$292.50 |
|
|
Albumin (human), 5%, 250 ml
|
$141.30 |
$141.30 |
$292.50 |
|
|
Albumin, human 5 % intravenous solution
|
$497.96 |
$497.96 |
$497.96 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$20.25 |
$76.70 |
$110.50 |
|
|
Albumin serum plasma or whole blood
|
$21.75 |
$53.30 |
$84.50 |
|
|
Albuterol ipratrop non-comp
|
$2.25 |
$2.25 |
$2.25 |
|
|
Albuterol non-comp con
|
$9.00 |
$9.00 |
$9.00 |
|
|
Albuterol non-comp unit
|
$1.50 |
$1.50 |
$1.50 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$99.45 |
$110.50 |
$193.70 |
|
|
Alcohol/subs interv >30 min
|
$213.85 |
$213.85 |
$213.85 |
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$64,775.89 |
$64,775.89 |
$64,775.89 |
|
|
Alkaline phosphatase
|
$21.00 |
$65.65 |
$92.30 |
|
|
Allergen alpha lactalbumin ige
|
$40.30 |
$43.55 |
$48.75 |
|
|
Allergen egg white ige
|
$29.25 |
$54.60 |
$91.65 |
|
|
Allergen specific ige qual multi scrn ea
|
$14.30 |
$29.25 |
$46.15 |
|
|
Allergy injections; 2 or more 95117
|
$22.75 |
$22.75 |
$23.25 |
|
|
Allergy injection; single 95115
|
$18.75 |
$25.35 |
$35.10 |
|
|
Allograft amnioexcel plus 17mm disk
|
$560.95 |
$560.95 |
$715.00 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$317.85 |
$317.85 |
$414.05 |
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$373.10 |
$373.10 |
$598.00 |
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,228.50 |
$1,291.29 |
$1,608.75 |
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$99.00 |
$99.00 |
$99.00 |
|
|
Alpha-fetoprotein amniotic
|
$39.65 |
$92.95 |
$148.20 |
|
|
Alpha-fetoprotein tumor marker
|
$110.50 |
$142.35 |
$191.10 |
|
|
Alprostadil for injection
|
$511.84 |
$511.84 |
$550.37 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$17,160.70 |
$17,217.91 |
$21,450.88 |
|
|
Alt/sgpt
|
$21.75 |
$59.80 |
$100.10 |
|
|
Aluminum - quest
|
$33.15 |
$102.05 |
$148.20 |
|
|
Alveoloplasty each quadrant
|
$11,259.15 |
$11,259.15 |
$11,259.15 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$125.25 |
$778.05 |
$2,423.20 |
|
|
Amantadine (symmetrel)-sendout
|
$142.35 |
$161.85 |
$180.05 |
|
|
Ambl bp mntr w/sw a/r
|
$328.90 |
$328.90 |
$328.90 |
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$24.18 |
$25.19 |
$60.42 |
|
|
Amino acid screen, urine
|
$81.90 |
$81.90 |
$172.90 |
|
|
Amino acids quant 2-5
|
$137.80 |
$166.40 |
$365.95 |
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$29.25 |
$32.77 |
$45.80 |
|
|
Aminolevulinic acid delta
|
$30.75 |
$62.40 |
$101.40 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$13.30 |
$46.02 |
$92.91 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$139.64 |
$150.15 |
$195.19 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$7.15 |
$7.15 |
$55.81 |
|
|
Amitriptyline (elavil) -sendout
|
$42.75 |
$94.25 |
$118.95 |
|
|
Ammonia
|
$39.00 |
$107.25 |
$176.15 |
|
|
Amniocentesisdiagnostic 59000
|
$2,455.70 |
$2,455.70 |
$2,455.70 |
|
|
Amniocentesis therapeutic
|
$1,044.55 |
$1,044.55 |
$1,044.55 |
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,903.55 |
$2,903.55 |
$2,903.55 |
|
|
Amphetamine confirm urine -sendout
|
$59.25 |
$98.15 |
$132.60 |
|
|
Amphetamines 5 or more
|
$81.25 |
$92.95 |
$93.60 |
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$145.08 |
$156.00 |
$202.80 |
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$990.96 |
$1,065.54 |
$1,385.21 |
|
|
Ampicillin 1 gram solution for injection
|
$21.48 |
$23.09 |
$30.02 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$13.65 |
$29.25 |
$45.34 |
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$482.30 |
$512.20 |
$638.95 |
|
|
Amputation follow-up surgery
|
$634.50 |
$634.50 |
$634.50 |
|
|
Amputation leg thr tib/fib 27880
|
$1,582.10 |
$1,582.10 |
$1,582.10 |
|
|
Amputation leg; tib/fib f/u 27886
|
$1,321.45 |
$1,321.45 |
$1,321.45 |
|
|
Amputation toe interphalangeal joint
|
$6,927.05 |
$6,927.05 |
$6,927.05 |
|
|
Amylase
|
$29.25 |
$94.25 |
$189.80 |
|
|
Ana ds-dna
|
$89.05 |
$106.60 |
$154.70 |
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$47.25 |
$47.25 |
$47.25 |
|
|
Anal/urinary muscle study
|
$322.40 |
$322.40 |
$2,347.71 |
|
|
Anal/urinary muscle study
|
$646.75 |
$646.75 |
$3,373.73 |
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$87.10 |
$238.55 |
$254.15 |
|
|
Analysis gene f2 20210g>a variant
|
$59.25 |
$315.90 |
$528.45 |
|
|
Analysis gene f5 leiden variant
|
$53.25 |
$318.50 |
$494.65 |
|
|
Analysis nerve
|
$2,531.10 |
$2,531.10 |
$2,531.10 |
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$51.35 |
$188.50 |
$305.50 |
|
|
Analysis tumor
|
$174.85 |
$174.85 |
$174.85 |
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$629.20 |
$629.20 |
$1,188.85 |
|
|
Anaplsma phgcytophlm amp prb
|
$44.85 |
$130.00 |
$230.75 |
|
|
Anca screen with reflex to titer -quest
|
$37.70 |
$135.20 |
$223.60 |
|
|
An cholangiogram percutaneous compl
|
$1,802.19 |
$1,802.19 |
$2,060.20 |
|
|
An fluoro guide for cvp
|
$498.55 |
$627.25 |
$858.00 |
|
|
Angio balloon ctrl dialysis seg add-on
|
$9,787.94 |
$9,787.94 |
$21,415.92 |
|
|
Angioplasty fem/pop unilat 37224
|
$18,726.25 |
$18,726.25 |
$29,652.83 |
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$4.87 |
$4.87 |
$4.87 |
|
|
Angio tib/peroneal/init ves/unila 37228
|
$22,170.29 |
$22,170.29 |
$55,541.12 |
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,675.75 |
$3,675.75 |
$3,675.75 |
|
|
Angio trnslmnl balloon same artery ini
|
$14,288.77 |
$14,288.77 |
$14,288.77 |
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,622.45 |
$3,622.45 |
$3,622.45 |
|
|
Angio trnslmnl balloon same vein ini
|
$14,910.15 |
$14,910.15 |
$21,415.92 |
|
|
Anidulafungin injection
|
$288.50 |
$288.50 |
$288.50 |
|
|
Ankle arthroscopy/surgery
|
$16,551.26 |
$16,551.26 |
$16,551.26 |
|
|
Ankle arthroscopy/surgery
|
$16,609.33 |
$16,609.33 |
$16,609.33 |
|
|
Ankle arthroscopy/surgery
|
$16,806.73 |
$16,806.73 |
$21,142.80 |
|
|
Ankle X-ray
|
$65.25 |
$461.50 |
$611.00 |
|
|
Anl sp inf pmp w/mdreprg&fil
|
$379.60 |
$379.60 |
$390.65 |
|
|
Annual Physical, Established Patient (age 18-39)
|
$72.00 |
$72.00 |
$72.00 |
|
|
Annual Physical, Established Patient (age 40-64)
|
$76.50 |
$76.50 |
$76.50 |
|
|
Annual Physical, New Patient (age 18-39)
|
$96.75 |
$96.75 |
$96.75 |
|
|
Annual Physical, New Patient (age 40-64)
|
$84.75 |
$84.75 |
$84.75 |
|
|
Anodyne therapy charges pt
|
$17.55 |
$37.05 |
$50.05 |
|
