|
Allergen egg white ige
|
$336.80 |
$336.80 |
$336.80 |
$42.90
|
|
Allergy injections; 2 or more 95117
|
$18.40 |
$18.40 |
$18.40 |
$44.14
|
|
Allergy injection; single 95115
|
$16.00 |
$16.00 |
$16.00 |
$42.75
|
|
Allergy Skin Testing
|
$5.60 |
$5.60 |
$5.60 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$8.00 |
$8.00 |
$8.00 |
$39.00
|
|
All tstg perq&iq drugs/biol
|
$29.60 |
$29.60 |
$29.60 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$12.80 |
$12.80 |
$12.80 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,086.43 |
$1,086.43 |
$1,086.43 |
$14.76
|
|
Alpha-fetoprotein amniotic
|
$69.60 |
$69.60 |
$69.60 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$144.80 |
$144.80 |
$144.80 |
$106.40
|
|
Alprostadil for injection
|
$473.07 |
$473.07 |
$473.07 |
$424.09
|
|
Alteplase 100 mg infusion from pyxis vial
|
$21,626.26 |
$21,626.26 |
$21,626.26 |
$3,627.63
|
|
Alt/sgpt
|
$35.20 |
$35.20 |
$35.20 |
$49.00
|
|
Aluminum - quest
|
$118.40 |
$118.40 |
$118.40 |
$91.65
|
|
Amantadine (symmetrel)-sendout
|
$60.80 |
$60.80 |
$60.80 |
$199.58
|
|
Amino acids quant 2-5
|
$69.60 |
$69.60 |
$69.60 |
$141.00
|
|
Aminolevulinic acid delta
|
$189.60 |
$189.60 |
$189.60 |
$95.80
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$151.14 |
$151.14 |
$151.14 |
$195.19
|
|
Amiodarone 50 mg/ml intravenous solution
|
$72.36 |
$72.36 |
$72.36 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$128.00 |
$128.00 |
$128.00 |
$102.40
|
|
Ammonia
|
$188.80 |
$188.80 |
$188.80 |
$117.00
|
|
Amniocentesisdiagnostic 59000
|
$499.20 |
$499.20 |
$499.20 |
$876.60
|
|
Amniocentesis therapeutic
|
$499.20 |
$499.20 |
$499.20 |
$791.05
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,028.00 |
$1,028.00 |
$1,028.00 |
$3,735.51
|
|
Amphetamine confirm urine -sendout
|
$30.40 |
$30.40 |
$30.40 |
$94.50
|
|
Ampicillin 1 gram solution for injection
|
$74.18 |
$74.18 |
$74.18 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$98.59 |
$98.59 |
$98.59 |
$50.70
|
|
Amp metatarsal w/toe single 28810
|
$622.40 |
$622.40 |
$622.40 |
$3,594.44
|
|
Amputate thigh through femur 27590
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$3,852.55
|
|
Amputation leg thr tib/fib 27880
|
$1,325.60 |
$1,325.60 |
$1,325.60 |
$3,996.20
|
|
Amputation leg; tib/fib f/u 27886
|
$958.40 |
$958.40 |
$958.40 |
$2,605.20
|
|
Amputation thru metatarsal
|
$1,039.20 |
$1,039.20 |
$1,039.20 |
$3,622.40
|
|
Amputation toe interphalangeal joint
|
$434.40 |
$434.40 |
$434.40 |
$3,624.50
|
|
Amputation toe metatarsophalangeal joint
|
$443.20 |
$443.20 |
$443.20 |
$3,635.57
|
|
Amylase
|
$110.40 |
$110.40 |
$110.40 |
$95.80
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$140.80 |
$140.80 |
$140.80 |
$106.70
|
|
Anal/urinary muscle study
|
$94.40 |
$94.40 |
$94.40 |
$407.61
|
|
Anal/urinary muscle study
|
$587.20 |
$587.20 |
$587.20 |
$575.00
|
|
Analysis gene f2 20210g>a variant
|
$204.00 |
$204.00 |
$204.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$121.60 |
$121.60 |
$121.60 |
$253.11
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$71.20 |
$71.20 |
$71.20 |
$411.45
|
|
Anca screen with reflex to titer -quest
|
$343.20 |
$343.20 |
$343.20 |
$112.45
|
|
An cholangiogram percutaneous compl
|
$931.20 |
$931.20 |
$931.20 |
$2,478.25
|
|
An fluoro guide for cvp
|
$152.80 |
$152.80 |
$152.80 |
$482.46
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$5,038.94 |
$5,038.94 |
$5,038.94 |
$6,736.02
|
|
Ankle arthroscopy/surgery
|
$724.00 |
$724.00 |
$724.00 |
$3,786.00
|
|
Ankle X-ray
|
$238.40 |
$238.40 |
$238.40 |
$351.20
|
|
Annual alcohol screen 15 min
|
$28.00 |
$28.00 |
$28.00 |
$28.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$175.20 |
$175.20 |
$175.20 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$185.60 |
$185.60 |
$185.60 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$193.60 |
$193.60 |
$193.60 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$223.20 |
$223.20 |
$223.20 |
$188.15
|
|
Anora (draw only)
|
$32.80 |
$32.80 |
$32.80 |
$36.00
|
|
Anoscopy
|
$324.00 |
$324.00 |
$324.00 |
$1,067.25
|
|
Anoscopy and biopsy
|
$404.80 |
$404.80 |
$404.80 |
$1,364.66
|
|
Anoscopy remove lesion 46610
|
$400.00 |
$400.00 |
$400.00 |
$3,246.99
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$905.60 |
$905.60 |
$905.60 |
$4,760.24
|
|
Antibody bacterium, not elsewhere specified
|
$51.20 |
$51.20 |
$51.20 |
$61.45
|
|
Antibody htlv/hiv confirm test
|
$179.20 |
$179.20 |
$179.20 |
$141.74
|
|
Antibody htlv-i
|
$35.20 |
$35.20 |
$35.20 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$264.00 |
$264.00 |
$264.00 |
$227.00
|
|
Antibody id rbc panel
|
$283.20 |
$283.20 |
$283.20 |
$281.30
|
|
Antibody influenza virus
|
$53.60 |
$53.60 |
$53.60 |
$54.60
|
|
Antibody screen rbc
|
$144.00 |
$144.00 |
$144.00 |
$105.00
|
|
Antibody tetanus
|
$60.80 |
$60.80 |
$60.80 |
$61.98
|
|
Antigen therapy services
|
$52.80 |
$52.80 |
$52.80 |
$69.43
|
|
Antigen therapy services
|
$21.60 |
$21.60 |
$21.60 |
$64.39
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$31.20 |
$31.20 |
$31.20 |
$47.62
|
|
Antinuclear antibodies
|
$55.20 |
$55.20 |
$55.20 |
$94.25
|
|
Antinuclear antibodies titer
|
$91.20 |
$91.20 |
$91.20 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$91.20 |
$91.20 |
$91.20 |
$79.20
|
|
Antistreptolysin o titer
|
$68.00 |
$68.00 |
$68.00 |
$57.96
|
|
Antithrombin iii activity
|
$144.00 |
$144.00 |
$144.00 |
$126.25
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$1,288.00 |
$1,288.00 |
$1,288.00 |
$5,394.95
|
|
Appendectomy
|
$952.00 |
$952.00 |
$952.00 |
$3,786.00
|
|
Appendectomy add-on 44955
|
$122.40 |
$122.40 |
$122.40 |
$206.40
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$1,301.60 |
$1,301.60 |
$1,301.60 |
$2,149.60
|
|
Appendix Removal (Laparoscopic)
|
$893.60 |
$893.60 |
$893.60 |
$6,311.00
|
|
Appl cast figure-of-eight
|
$156.00 |
$156.00 |
$156.00 |
$278.22
|
|
Application clubfoot cast
|
$212.80 |
$212.80 |
$212.80 |
$370.58
|
|
Application finger splntstatic 29130
|
$60.80 |
$60.80 |
$60.80 |
$219.00
|
|
Application long leg splint 29505
|
$127.20 |
$127.20 |
$127.20 |
$370.00
|
|
Application lower leg splint 29515
|
$103.20 |
$103.20 |
$103.20 |
$363.10
|
|
Application multi layer compression below knee (both sides)
|
$221.60 |
$221.60 |
$221.60 |
$406.40
|
|
Application of cylinder cast 29365
|
$192.00 |
$192.00 |
$192.00 |
$431.08
|
|
Application of forearm cast 29075
|
$126.40 |
$126.40 |
$126.40 |
$384.59
|
|
Application of long arm cast 29065
|
$140.80 |
$140.80 |
$140.80 |
$404.63
|
|
Application of long leg cast
|
$206.40 |
$206.40 |
$206.40 |
$426.00
|
|
Application of long leg cast 29345
|
$208.80 |
$208.80 |
$208.80 |
$511.68
|
|
Application of paste boot 29580
|
$94.40 |
$94.40 |
$94.40 |
$331.74
|
|
Application short leg cast 29405
|
$116.00 |
$116.00 |
$116.00 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$236.80 |
$236.80 |
$236.80 |
$2,109.00
|
|
Appl long leg cast brace
|
$251.20 |
$251.20 |
$251.20 |
$375.00
|
|
Appl mltpln uni ext fixj sys
|
$1,708.80 |
$1,708.80 |
$1,708.80 |
$4,447.85
|
|
Appl modality 1/> areas paraffin bath 97018
|
$63.20 |
$63.20 |
$63.20 |
$69.96
|
|
Appl patllr tdn bearing cast
|
$192.00 |
$192.00 |
$192.00 |
$426.75
|
|
Appl unipln uni ext fixj sys
|
$877.60 |
$877.60 |
$877.60 |
$5,339.00
|
|
Apply forearm splintdynamic 29126
|
$121.60 |
$121.60 |
$121.60 |
$265.00
|
|
Apply hand/wrist cast 29085
|
$139.20 |
$139.20 |
$139.20 |
$279.40
|
|
Apply of finger splint 29131
|
$84.00 |
$84.00 |
$84.00 |
$177.45
|
