|
Albumin serum plasma or whole blood
|
$103.75 |
$103.75 |
$103.75 |
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$83,743.28 |
$83,743.28 |
$83,743.28 |
|
|
Alglucosidase alfa injection
|
$4,691.43 |
$4,691.43 |
$4,691.43 |
|
|
Alkaline phosphatase
|
$103.35 |
$103.35 |
$103.35 |
|
|
Allergen alpha lactalbumin ige
|
$109.35 |
$109.35 |
$109.35 |
|
|
Allergen egg white ige
|
$159.00 |
$159.00 |
$159.00 |
|
|
Allergen specific ige qual multi scrn ea
|
$167.70 |
$167.70 |
$167.70 |
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$13,870.50 |
$13,870.50 |
$13,870.50 |
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$3,889.00 |
$3,889.00 |
$3,889.00 |
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$16,250.25 |
$16,250.25 |
$16,250.25 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,895.00 |
$2,895.00 |
$2,895.00 |
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$2,501.00 |
$2,501.00 |
$2,501.00 |
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,295.00 |
$1,295.00 |
$1,295.00 |
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,131.50 |
$1,131.50 |
$1,131.50 |
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$4,274.92 |
$4,274.92 |
$4,274.92 |
|
|
Alpha-fetoprotein tumor marker
|
$194.65 |
$194.65 |
$194.65 |
|
|
Alprostadil for injection
|
$1,641.74 |
$1,641.74 |
$1,641.74 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$31,580.10 |
$31,580.10 |
$31,580.10 |
|
|
Alt/sgpt
|
$103.85 |
$103.85 |
$103.85 |
|
|
Aluminum - quest
|
$193.75 |
$193.75 |
$193.75 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$1,612.70 |
$1,612.70 |
$1,612.70 |
|
|
Amantadine (symmetrel)-sendout
|
$558.85 |
$558.85 |
$558.85 |
|
|
Ambl bp mntr w/sw i&r
|
$83.10 |
$83.10 |
$83.10 |
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$49.76 |
$49.76 |
$49.76 |
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$101.80 |
$101.80 |
$101.80 |
|
|
Aminolevulinic acid delta
|
$279.75 |
$279.75 |
$279.75 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$185.07 |
$185.07 |
$185.07 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$470.29 |
$470.29 |
$470.29 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$152.27 |
$152.27 |
$152.27 |
|
|
Amitriptyline (elavil) -sendout
|
$229.95 |
$229.95 |
$229.95 |
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$13,660.30 |
$13,660.30 |
$13,660.30 |
|
|
Ammonia
|
$247.40 |
$247.40 |
$247.40 |
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,517.65 |
$3,517.65 |
$3,517.65 |
|
|
Amphetamine confirm urine -sendout
|
$267.35 |
$267.35 |
$267.35 |
|
|
Amphetamines 5 or more
|
$168.90 |
$168.90 |
$168.90 |
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$488.62 |
$488.62 |
$488.62 |
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$3,240.21 |
$3,240.21 |
$3,240.21 |
|
|
Ampicillin 1 gram solution for injection
|
$168.60 |
$168.60 |
$168.60 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$96.62 |
$96.62 |
$96.62 |
|
|
Amp metatarsal w/toe single 28810
|
$967.35 |
$967.35 |
$967.35 |
|
|
Amputation of midtarsal 28800
|
$1,217.40 |
$1,217.40 |
$1,217.40 |
|
|
Amputation thru metatarsal
|
$1,641.65 |
$1,641.65 |
$1,641.65 |
|
|
Amputation toe interphalangeal joint
|
$838.25 |
$838.25 |
$838.25 |
|
|
Amputation toe metatarsophalangeal joint
|
$891.70 |
$891.70 |
$891.70 |
|
|
Amylase
|
$142.75 |
$142.75 |
$142.75 |
|
|
Anacaulase-bcdb 8.8% gel 1 g
|
$8,103.10 |
$8,103.10 |
$8,103.10 |
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$367.65 |
$367.65 |
$367.65 |
|
|
Anal/urinary muscle study
|
$505.15 |
$505.15 |
$505.15 |
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$1,612.70 |
$1,612.70 |
$1,612.70 |
|
|
Analysis gene f2 20210g>a variant
|
$1,195.10 |
$1,195.10 |
$1,195.10 |
|
|
Analysis gene f5 leiden variant
|
$713.55 |
$713.55 |
$713.55 |
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$1,612.70 |
$1,612.70 |
$1,612.70 |
|
|
Anaplsma phgcytophlm amp prb
|
$328.40 |
$328.40 |
$328.40 |
|
|
Anca screen with reflex to titer -quest
|
$216.70 |
$216.70 |
$216.70 |
|
|
An cholangiogram percutaneous compl
|
$1,730.70 |
$1,730.70 |
$1,730.70 |
|
|
An fluoro guide for cvp
|
$850.40 |
$850.40 |
$850.40 |
|
|
Angio balloon ctrl dialysis seg add-on
|
$9,225.05 |
$9,225.05 |
$9,225.05 |
|
|
Angioplasty fem/pop unilat 37224
|
$13,859.05 |
$13,859.05 |
$13,859.05 |
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$23,137.10 |
$23,137.10 |
$23,137.10 |
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$11,899.40 |
$11,899.40 |
$11,899.40 |
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$2,538.24 |
$2,538.24 |
$2,538.24 |
|
|
Angio tib/peroneal/init ves/unila 37228
|
$11,899.40 |
$11,899.40 |
$11,899.40 |
|
|
Angio trnslmnl balloon same artery ea addl
|
$11,173.10 |
$11,173.10 |
$11,173.10 |
|
|
Angio trnslmnl balloon same artery ini
|
$23,137.10 |
$23,137.10 |
$23,137.10 |
|
|
Angio trnslmnl balloon same vein ea addl
|
$11,054.40 |
$11,054.40 |
$11,054.40 |
|
|
Angio trnslmnl balloon same vein ini
|
$22,541.25 |
$22,541.25 |
$22,541.25 |
|
|
Ankle X-ray
|
$368.40 |
$368.40 |
$368.40 |
|
|
Ankle X-ray (2 views, both ankles)
|
$346.60 |
$346.60 |
$346.60 |
|
|
Anl sp inf pmp w/mdreprg&fil
|
$549.80 |
$549.80 |
$549.80 |
|
|
Annual Physical, Established Patient (age 18-39)
|
$214.35 |
$214.35 |
$214.35 |
|
|
Annual Physical, Established Patient (age 40-64)
|
$242.60 |
$242.60 |
$242.60 |
|
|
Annual Physical, New Patient (age 18-39)
|
$242.60 |
$242.60 |
$242.60 |
|
|
Annual Physical, New Patient (age 40-64)
|
$294.55 |
$294.55 |
$294.55 |
|
|
Anoscopy control bleeding 46614
|
$1,267.80 |
$1,267.80 |
$1,267.80 |
|
|
Anoscopy remove fb 46608
|
$1,928.70 |
$1,928.70 |
$1,928.70 |
|
|
Antibody bacterium, not elsewhere specified
|
$183.65 |
$183.65 |
$183.65 |
|
|
Antibody elution rbc reference
|
$285.10 |
$285.10 |
$285.10 |
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$232.15 |
$232.15 |
$232.15 |
|
|
Antibody id rbc panel
|
$310.00 |
$310.00 |
$310.00 |
|
|
Antibody screen rbc
|
$134.90 |
$134.90 |
$134.90 |
|
|
Antibody tetanus
|
$580.65 |
$580.65 |
$580.65 |
|
|
Antidepressant not specified
|
$323.65 |
$323.65 |
$323.65 |
|
|
Antidepressant tricyclic 3-5
|
$94.60 |
$94.60 |
$94.60 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$16.80 |
$16.80 |
$16.80 |
|
|
Anti-inhibitor
|
$27.49 |
$27.49 |
$27.49 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$400.90 |
$400.90 |
$400.90 |
|
|
Antinuclear antibodies
|
$212.75 |
$212.75 |
$212.75 |
|
|
Antinuclear antibodies titer
|
$128.45 |
$128.45 |
$128.45 |
|
|
Antipsychotics nos 1-3
|
$292.55 |
$292.55 |
$292.55 |
|
|
Antistreptolysin o titer
|
$106.55 |
$106.55 |
$106.55 |
|
|
Antithrombin iii activity
|
$290.80 |
$290.80 |
$290.80 |
|
|
Antithrombin iii injection
|
$5,968.38 |
$5,968.38 |
$5,968.38 |
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$8,643.12 |
$8,643.12 |
$8,643.12 |
|
|
Antithymocyte globuln rabbit
|
$4,821.65 |
$4,821.65 |
$4,821.65 |
|
|
Aortic Aneurysm Screening Ultrasound
|
$761.45 |
$761.45 |
$761.45 |
|
|
Apheresis immunoads slctv
|
$10,159.00 |
$10,159.00 |
$10,159.00 |
|
|
Apheresis plasma
|
$5,916.65 |
$5,916.65 |
$5,916.65 |
|
|
Apheresis platelets
|
$5,916.65 |
$5,916.65 |
$5,916.65 |
|
|
Apheresis rbc
|
$5,916.65 |
$5,916.65 |
$5,916.65 |
|
|
Apheresis wbc
|
$5,916.65 |
$5,916.65 |
$5,916.65 |
|