|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$2,293.13 |
$2,293.13 |
$2,539.23 |
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,356.08 |
$1,356.08 |
$1,501.61 |
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$93.51 |
$93.51 |
$93.51 |
|
|
Alpha-fetoprotein amniotic
|
$6.97 |
$7.72 |
$24.58 |
|
|
Alpha-fetoprotein tumor marker
|
$24.58 |
$50.23 |
$70.07 |
|
|
Als 1
|
$883.92 |
$883.92 |
$883.92 |
|
|
Als1-emergency
|
$960.04 |
$960.04 |
$960.04 |
|
|
Als 2
|
$1,304.13 |
$1,304.13 |
$1,304.13 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,797.84 |
$2,600.22 |
$3,627.63 |
|
|
Alt/sgpt
|
$28.44 |
$97.38 |
$135.85 |
|
|
Aluminum - quest
|
$17.84 |
$19.75 |
$37.11 |
|
|
Amantadine (symmetrel)-sendout
|
$156.17 |
$156.17 |
$156.17 |
|
|
Amifostine
|
$920.45 |
$920.45 |
$1,019.23 |
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$15.45 |
$15.79 |
$17.48 |
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$8.00 |
$8.00 |
$8.86 |
|
|
Aminolevulinic acid delta
|
$15.79 |
$17.48 |
$36.15 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$5.33 |
$5.33 |
$5.91 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$40.18 |
$47.97 |
$50.63 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$19.48 |
$21.57 |
$27.17 |
|
|
Amitriptyline (elavil) -sendout
|
$32.78 |
$32.78 |
$32.78 |
|
|
Ammonia
|
$55.43 |
$143.71 |
$200.49 |
|
|
Amniocentesisdiagnostic 59000
|
$229.73 |
$229.73 |
$268.09 |
|
|
Amniocentesis therapeutic
|
$205.21 |
$205.21 |
$205.21 |
|
|
Amphetamine confirm urine -sendout
|
$40.01 |
$40.01 |
$40.01 |
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$42.03 |
$42.03 |
$46.54 |
|
|
Amphotericin b lipid complex
|
$220.99 |
$220.99 |
$244.71 |
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$180.81 |
$200.22 |
$252.26 |
|
|
Ampicillin 1 gram solution for injection
|
$10.59 |
$32.19 |
$35.64 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$15.99 |
$17.71 |
$22.31 |
|
|
Amputation toe metatarsophalangeal joint
|
$903.44 |
$903.44 |
$1,000.39 |
|
|
Amylase
|
$160.31 |
$164.36 |
$223.66 |
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$74.23 |
$74.23 |
$74.23 |
|
|
Analysis gene f2 20210g>a variant
|
$40.39 |
$44.72 |
$96.23 |
|
|
Analysis gene f5 leiden variant
|
$62.32 |
$69.01 |
$107.41 |
|
|
Anaplsma phgcytophlm amp prb
|
$23.78 |
$26.34 |
$33.18 |
|
|
Anca screen with reflex to titer -quest
|
$13.94 |
$15.44 |
$31.68 |
|
|
An cholangiogram percutaneous compl
|
$211.24 |
$2,090.18 |
$2,916.06 |
|
|
An fluoro guide for cvp
|
$217.62 |
$555.14 |
$614.72 |
|
|
Angio balloon ctrl dialysis seg add-on
|
$3,697.59 |
$3,697.59 |
$4,094.40 |
|
|
Angioplasty fem/pop unilat 37224
|
$7,981.68 |
$7,981.68 |
$8,838.25 |
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$9,449.48 |
$9,449.48 |
$10,463.57 |
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$2,369.60 |
$2,369.60 |
$2,623.90 |
|
|
Angiotensin ii
|
$42.90 |
$42.90 |
$42.90 |
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,284.14 |
$1,402.00 |
$15,547.69 |
|
|
Angio tib/peroneal/init ves/unila 37228
|
$6,582.14 |
$6,582.14 |
$7,288.52 |
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,261.13 |
$4,261.13 |
$4,718.43 |
|
|
Angio trnslmnl balloon same artery ini
|
$4,261.13 |
$4,261.13 |
$4,718.43 |
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,261.13 |
$4,261.13 |
$4,718.43 |
|
|
Angio trnslmnl balloon same vein ini
|
$4,261.13 |
$4,261.13 |
$4,718.43 |
|
|
Ankle X-ray
|
$130.78 |
$543.05 |
$757.62 |
|
|
Ankle X-ray (2 views, both ankles)
|
$121.67 |
$463.51 |
$646.65 |
|
|
Anora (draw only)
|
$156.42 |
$173.21 |
$218.22 |
|
|
Anterior thoracic extension
|
$362.24 |
$401.11 |
$505.37 |
|
|
Antibody bacterium, not elsewhere specified
|
$52.28 |
$57.89 |
$88.13 |
|
|
Antibody elution rbc reference
|
$157.44 |
$174.34 |
$219.65 |
|
|
Antibody htlv/hiv confirm test
|
$18.66 |
$20.66 |
$289.73 |
|
|
Antibody htlv-i
|
$16.13 |
$16.13 |
$16.13 |
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$137.66 |
$267.53 |
$373.23 |
|
|
Antibody id rbc panel
|
$234.73 |
$259.92 |
$576.83 |
|
|
Antibody influenza virus
|
$39.17 |
$39.17 |
$39.17 |
|
|
Antibody lymphocytic choriomeningitis
|
$20.50 |
$22.70 |
$35.71 |
|
|
Antibody screen rbc
|
$86.30 |
$190.24 |
$265.41 |
|
|
Antibody tetanus
|
$36.29 |
$36.29 |
$36.29 |
|
|
Antidepressant not specified
|
$33.74 |
$33.74 |
$33.74 |
|
|
Antidepressants class 3-5
|
$46.75 |
$46.75 |
$46.75 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$11.07 |
$11.07 |
$12.26 |
|
|
Antihemophilic viii/vwf comp
|
$1.44 |
$1.44 |
$1.59 |
|
|
Anti-inhibitor
|
$185.94 |
$185.94 |
$205.89 |
|
|
Anti mog serum - sendout
|
$136.20 |
$171.60 |
$482.11 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$15.99 |
$17.71 |
$31.10 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$35.71 |
$35.71 |
$35.71 |
|
|
Antinuclear antibodies
|
$30.53 |
$37.31 |
$52.06 |
|
|
Antinuclear antibodies titer
|
$30.34 |
$33.60 |
$66.24 |
|
|
Antiphosphatidylserine antibody
|
$32.83 |
$33.62 |
$46.91 |
|
|
Antipsychotics nos 1-3
|
$25.06 |
$25.06 |
$25.06 |
|
|
Antistreptolysin o titer
|
$32.83 |
$61.71 |
$86.09 |
|
|
Antithrombin iii activity
|
$8.20 |
$9.08 |
$30.37 |
|
|
Antithrombin iii injection
|
$920.45 |
$920.45 |
$1,019.23 |
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$920.45 |
$920.45 |
$1,019.23 |
|
|
Antithymocyte globuln rabbit
|
$734.11 |
$734.11 |
$812.89 |
|
|
Aortic Aneurysm Screening Ultrasound
|
$101.48 |
$112.37 |
$240.11 |
|
|
Apc gene dup/delet variants
|
$743.33 |
$823.11 |
$1,037.04 |
|
|
Apheresis plasma
|
$1,583.42 |
$1,753.35 |
$2,209.07 |
|
|
Apheresis platelets
|
$443.42 |
$491.01 |
$618.62 |
|
|
Apheresis rbc
|
$633.45 |
$701.43 |
$883.74 |
|
|
Apheresis wbc
|
$791.71 |
$876.68 |
$1,104.54 |
|
|
Apl(pml-rara) quant - sendout
|
$141.45 |
$156.63 |
$197.34 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,656.59 |
$3,656.59 |
$3,656.59 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$934.80 |
$934.80 |
$934.80 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$398.73 |
$398.73 |
$441.52 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$3,271.80 |
$3,271.80 |
$3,271.80 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$742.31 |
$742.31 |
$742.31 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$288.64 |
$288.64 |
$319.62 |
|
|
Application multi layer compression below knee (both sides)
|
$277.57 |
$277.57 |
$307.36 |
|
|
Application of paste boot 29580
|
$142.89 |
$158.22 |
$185.44 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,567.02 |
$1,567.02 |
$1,735.19 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,374.73 |
$1,374.73 |
$1,522.27 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$26.75 |
$44.69 |
$62.35 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$50.02 |
$50.02 |
$69.79 |
|
|
Appl modality 1+lllt po pain
|
$68.70 |
$68.70 |
$68.70 |
|
