|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,082.92 |
$2,082.92 |
$2,082.92 |
$858.66
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$233.08 |
$233.08 |
$233.08 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$60.71 |
$60.71 |
$60.71 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$60.71 |
$60.71 |
$60.71 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$182.29 |
$182.29 |
$182.29 |
$15,857.45
|
|
Alt/sgpt
|
$19.18 |
$19.18 |
$19.18 |
$47.50
|
|
Aluminum - quest
|
$92.22 |
$92.22 |
$92.22 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$732.82 |
$732.82 |
$732.82 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$335.52 |
$335.52 |
$335.52 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$1.57 |
$1.57 |
$1.57 |
$39.84
|
|
Amino acids quant 2-5
|
$61.05 |
$61.05 |
$61.05 |
$112.00
|
|
Aminolevulinic acid delta
|
$59.54 |
$59.54 |
$59.54 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$85.33 |
$85.33 |
$85.33 |
$87.45
|
|
Ammonia
|
$52.74 |
$52.74 |
$52.74 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$195.00 |
$195.00 |
$195.00 |
$93.61
|
|
Amphetamines 5 or more
|
$197.35 |
$197.35 |
$197.35 |
$90.48
|
|
Ampicillin 1 gram solution for injection
|
$1.52 |
$1.52 |
$1.52 |
$56.70
|
|
Amp metatarsal w/toe single 28810
|
$6,661.44 |
$6,661.44 |
$6,661.44 |
$3,986.00
|
|
Amp thigh through femur re-amp 27596
|
$10,645.06 |
$10,645.06 |
$10,645.06 |
$3,494.40
|
|
Amputation toe interphalangeal joint
|
$6,787.76 |
$6,787.76 |
$6,787.76 |
$4,196.50
|
|
Amylase
|
$425.41 |
$425.41 |
$425.41 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$61.55 |
$61.55 |
$61.55 |
$80.08
|
|
Ana ds-dna
|
$43.81 |
$43.81 |
$43.81 |
$55.24
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$108.84 |
$108.84 |
$108.84 |
$117.01
|
|
Anal/urinary muscle study
|
$366.43 |
$366.43 |
$366.43 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$192.56 |
$192.56 |
$192.56 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$221.14 |
$221.14 |
$221.14 |
$249.60
|
|
Anaplsma phgcytophlm amp prb
|
$82.65 |
$82.65 |
$82.65 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$54.49 |
$54.49 |
$54.49 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$6,559.94 |
$6,559.94 |
$6,559.94 |
$2,480.94
|
|
Androstanediol
|
$104.36 |
$104.36 |
$104.36 |
$131.04
|
|
An fluoro guide for cvp
|
$235.88 |
$235.88 |
$235.88 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,506.91 |
$1,506.91 |
$1,506.91 |
$5,728.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$10,085.16 |
$10,085.16 |
$10,085.16 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ini
|
$9,623.59 |
$9,623.59 |
$9,623.59 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$7,714.69 |
$7,714.69 |
$7,714.69 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$9,623.59 |
$9,623.59 |
$9,623.59 |
$8,359.11
|
|
Ankle X-ray
|
$201.75 |
$201.75 |
$201.75 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$201.75 |
$201.75 |
$201.75 |
$282.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$289.65 |
$289.65 |
$289.65 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$310.26 |
$310.26 |
$310.26 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$323.18 |
$323.18 |
$323.18 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$374.22 |
$374.22 |
$374.22 |
$167.25
|
|
Anora (draw only)
|
$43.10 |
$43.10 |
$43.10 |
$35.00
|
|
Anoscopy and biopsy
|
$2,338.31 |
$2,338.31 |
$2,338.31 |
$2,288.00
|
|
Anoscopy control bleeding 46614
|
$2,598.09 |
$2,598.09 |
$2,598.09 |
$2,140.60
|
|
Anoscopy remove fb 46608
|
$1,985.22 |
$1,985.22 |
$1,985.22 |
$1,375.98
|
|
Antibody bacterium, not elsewhere specified
|
$46.60 |
$46.60 |
$46.60 |
$57.85
|
|
Antibody elution rbc reference
|
$686.56 |
$686.56 |
$686.56 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$70.06 |
$70.06 |
$70.06 |
$131.56
|
|
Antibody htlv-i
|
$27.33 |
$27.33 |
$27.33 |
$49.53
|
|
Antibody htlv-ii
|
$45.60 |
$45.60 |
$45.60 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$66.48 |
$66.48 |
$66.48 |
$224.00
|
|
Antibody id rbc panel
|
$1,183.32 |
$1,183.32 |
$1,183.32 |
$291.75
|
|
Antibody influenza virus
|
$49.04 |
$49.04 |
$49.04 |
$54.00
|
|
Antibody lymphocytic choriomeningitis
|
$46.58 |
$46.58 |
$46.58 |
$46.58
|
|
Antibody screen rbc
|
$249.07 |
$249.07 |
$249.07 |
$108.55
|
|
Antibody tetanus
|
$53.55 |
$53.55 |
$53.55 |
$54.15
|
|
Antidepressants class 3-5
|
$141.36 |
$141.36 |
$141.36 |
$72.14
|
|
Antidepressant tricyclic 3-5
|
$42.54 |
$42.54 |
$42.54 |
$23.20
|
|
Anti mog serum - sendout
|
$30.51 |
$30.51 |
$30.51 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$30.51 |
$30.51 |
$30.51 |
$38.50
|
|
Antinuclear antibodies
|
$43.74 |
$43.74 |
$43.74 |
$90.00
|
|
Antinuclear antibodies titer
|
$40.40 |
$40.40 |
$40.40 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$58.17 |
$58.17 |
$58.17 |
$67.43
|
|
Antipsychotics nos 1-3
|
$34.22 |
$34.22 |
$34.22 |
$136.61
|
|
Antistreptolysin o screen
|
$20.87 |
$20.87 |
$20.87 |
$58.56
|
|
Antistreptolysin o titer
|
$26.41 |
$26.41 |
$26.41 |
$54.00
|
|
Antithrombin iii activity
|
$42.87 |
$42.87 |
$42.87 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$323.71 |
$323.71 |
$323.71 |
$394.55
|
|
Aortic dysfunction/dilation
|
$1,477.37 |
$1,477.37 |
$1,477.37 |
$1,153.60
|
|
Apc gene dup/delet variants
|
$471.10 |
$471.10 |
$471.10 |
$462.00
|
|
Apc gene full sequence
|
$1,837.28 |
$1,837.28 |
$1,837.28 |
$1,255.20
|
|
Apc gene known fam variants
|
$620.74 |
$620.74 |
$620.74 |
$319.20
|
|
Apheresis plasma
|
$1,231.72 |
$1,231.72 |
$1,231.72 |
$3,226.34
|
|
Apheresis rbc
|
$1,231.72 |
$1,231.72 |
$1,231.72 |
$3,290.80
|
|
Apl(pml-rara) quant - sendout
|
$750.23 |
$750.23 |
$750.23 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,053.97 |
$2,053.97 |
$2,053.97 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$626.96 |
$626.96 |
$626.96 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$232.12 |
$232.12 |
$232.12 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$6,380.63 |
$6,380.63 |
$6,380.63 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$907.99 |
$907.99 |
$907.99 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$232.10 |
$232.10 |
$232.10 |
$512.20
|
|
Application finger splntstatic 29130
|
$146.22 |
$146.22 |
$146.22 |
$208.50
|
|
Application long leg splint 29505
|
$373.77 |
$373.77 |
$373.77 |
$338.25
|
|
Application lower leg splint 29515
|
$373.77 |
$373.77 |
$373.77 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$368.32 |
$368.32 |
$368.32 |
$375.06
|
|
Application of forearm cast 29075
|
$551.61 |
$551.61 |
$551.61 |
$358.20
|
|
Application of paste boot 29580
|
$368.32 |
$368.32 |
$368.32 |
$340.11
|
|
Application short leg cast 29405
|
$647.35 |
$647.35 |
$647.35 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,053.97 |
$2,053.97 |
$2,053.97 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,053.97 |
$2,053.97 |
$2,053.97 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$18.00 |
$18.00 |
$18.00 |
$69.00
|
|
Apply hand/wrist cast 29085
|
$327.04 |
$327.04 |
$327.04 |
$271.80
|
|
Apply rigid leg cast 29445
|
$647.35 |
$647.35 |
$647.35 |
$555.00
|
|
App topical fluoride varnish
|
$38.83 |
$38.83 |
$38.83 |
$27.20
|
|
#aptt mix-1:1 incubated
|
$114.30 |
$114.30 |
$114.30 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$30.51 |
$30.51 |
$30.51 |
$231.66
|
|
Aqmbf pet rest & rx stress
|
$767.54 |
$767.54 |
$767.54 |
$974.40
|
|
Aquaporin-4 antibody cba each
|
$30.51 |
$30.51 |
$30.51 |
$138.16
|
