|
Amino acid single qual
|
$203.00 |
$203.00 |
$203.00 |
$25.00
|
|
Aminolevulinic acid delta
|
$64.00 |
$64.00 |
$64.00 |
$85.15
|
|
Aminolevulinic acid hcl top
|
$0.04 |
$0.04 |
$0.04 |
$613.42
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$1.30 |
$1.30 |
$1.30 |
$48.29
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$0.62 |
$0.62 |
$0.62 |
$152.84
|
|
Amiodarone 50 mg/ml intravenous solution
|
$1.08 |
$1.08 |
$1.08 |
$58.57
|
|
Amitriptyline (elavil) -sendout
|
$348.00 |
$348.00 |
$348.00 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$1,823.17 |
$1,823.17 |
$1,823.17 |
$11,376.95
|
|
Ammonia
|
$169.00 |
$169.00 |
$169.00 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$979.00 |
$979.00 |
$979.00 |
$963.79
|
|
Amniocentesis therapeutic
|
$979.00 |
$979.00 |
$979.00 |
$791.05
|
|
Amniotic fluid scan
|
$59.00 |
$59.00 |
$59.00 |
$33.15
|
|
Amobarbital 125 mg inj
|
$2,398.90 |
$2,398.90 |
$2,398.90 |
$1,319.49
|
|
Amphetamine confirm urine -sendout
|
$386.00 |
$386.00 |
$386.00 |
$94.50
|
|
Amphetamines 5 or more
|
$300.00 |
$300.00 |
$300.00 |
$93.60
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$123.55 |
$123.55 |
$123.55 |
$130.08
|
|
Amphotericin b lipid complex
|
$17.18 |
$17.18 |
$17.18 |
$272.40
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$317.94 |
$317.94 |
$317.94 |
$434.39
|
|
Ampicillin 1 gram solution for injection
|
$6.36 |
$6.36 |
$6.36 |
$63.06
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$11.13 |
$11.13 |
$11.13 |
$56.63
|
|
Amylase
|
$105.00 |
$105.00 |
$105.00 |
$93.00
|
|
Anabolic steroid 1 or 2
|
$455.00 |
$455.00 |
$455.00 |
$74.80
|
|
Anacaulase-bcdb 8.8% gel 1 g
|
$200.46 |
$200.46 |
$200.46 |
$58.34
|
|
Analysis gene f2 20210g>a variant
|
$61.00 |
$61.00 |
$61.00 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$468.00 |
$468.00 |
$468.00 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$247.00 |
$247.00 |
$247.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$7,048.00 |
$7,048.00 |
$7,048.00 |
$2,426.60
|
|
Androstanediol
|
$225.00 |
$225.00 |
$225.00 |
$98.58
|
|
An fluoro guide for cvp
|
$1,667.00 |
$1,667.00 |
$1,667.00 |
$509.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$630.00 |
$630.00 |
$630.00 |
$5,128.65
|
|
Ankle X-ray
|
$788.00 |
$788.00 |
$788.00 |
$350.85
|
|
Annual Physical, Established Patient (age 18-39)
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$188.15
|
|
Antibody bacterium, not elsewhere specified
|
$353.00 |
$353.00 |
$353.00 |
$57.85
|
|
Antibody elution rbc reference
|
$16.00 |
$16.00 |
$16.00 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$102.00 |
$102.00 |
$102.00 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$154.00 |
$154.00 |
$154.00 |
$218.30
|
|
Antibody id rbc panel
|
$205.00 |
$205.00 |
$205.00 |
$291.75
|
|
Antibody influenza virus
|
$306.00 |
$306.00 |
$306.00 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$26.00 |
$26.00 |
$26.00 |
$53.96
|
|
Antibody screen rbc
|
$42.00 |
$42.00 |
$42.00 |
$105.00
|
|
Antibody tetanus
|
$26.00 |
$26.00 |
$26.00 |
$58.50
|
|
Antidepressant not specified
|
$150.00 |
$150.00 |
$150.00 |
$89.50
|
|
Antigen therapy services
|
$208.00 |
$208.00 |
$208.00 |
$60.75
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$4.05 |
$4.05 |
$4.05 |
$7.00
|
|
Antihemophilic viii/vwf comp
|
$3.35 |
$3.35 |
$3.35 |
$3.32
|
|
Anti-inhibitor
|
$6.73 |
$6.73 |
$6.73 |
$7.00
|
|
Anti mog serum - sendout
|
$89.00 |
$89.00 |
$89.00 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$14.00 |
$14.00 |
$14.00 |
$50.88
|
|
Antinuclear antibodies
|
$406.00 |
$406.00 |
$406.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$67.00 |
$67.00 |
$67.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$17.00 |
$17.00 |
$17.00 |
$74.20
|
|
Antipsychotics nos 1-3
|
$286.00 |
$286.00 |
$286.00 |
$161.39
|
|
Antistreptolysin o titer
|
$119.00 |
$119.00 |
$119.00 |
$57.85
|
|
Antithrombin iii activity
|
$351.00 |
$351.00 |
$351.00 |
$106.85
|
|
Antithrombin iii injection
|
$14.99 |
$14.99 |
$14.99 |
$10.74
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$2,743.35 |
$2,743.35 |
$2,743.35 |
$7,544.81
|
|
Antithymocyte globuln rabbit
|
$2,425.50 |
$2,425.50 |
$2,425.50 |
$2,245.01
|
|
Apheresis plasma
|
$7,075.00 |
$7,075.00 |
$7,075.00 |
$3,498.41
|
|
Apl(pml-rara) quant - sendout
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$5,816.00 |
$5,816.00 |
$5,816.00 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$4,190.00 |
$4,190.00 |
$4,190.00 |
$908.05
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$3,280.00 |
$3,280.00 |
$3,280.00 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$11,439.00 |
$11,439.00 |
$11,439.00 |
$3,461.40
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$4,107.00 |
$4,107.00 |
$4,107.00 |
$1,300.71
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$2,453.00 |
$2,453.00 |
$2,453.00 |
$508.18
|
|
Application finger splntstatic 29130
|
$614.00 |
$614.00 |
$614.00 |
$226.20
|
|
Application long leg splint 29505
|
$813.00 |
$813.00 |
$813.00 |
$370.00
|
|
Application lower leg splint 29515
|
$813.00 |
$813.00 |
$813.00 |
$365.60
|
|
Application multi layer compression below knee (both sides)
|
$813.00 |
$813.00 |
$813.00 |
$393.75
|
|
Application of forearm cast 29075
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$386.10
|
|
Application of long arm cast 29065
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$414.20
|
|
Application of long leg cast 29345
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$511.68
|
|
Application of paste boot 29580
|
$813.00 |
$813.00 |
$813.00 |
$336.00
|
|
Application short leg cast 29405
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$397.33
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$9,232.00 |
$9,232.00 |
$9,232.00 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$9,232.00 |
$9,232.00 |
$9,232.00 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$208.00 |
$208.00 |
$208.00 |
$68.00
|
|
Apply finger cast 29086
|
$949.00 |
$949.00 |
$949.00 |
$242.20
|
|
Apply forearm splintdynamic 29126
|
$884.00 |
$884.00 |
$884.00 |
$263.20
|
|
Apply hand/wrist cast 29085
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$275.80
|
|
Apply interstit radiat compl
|
$12,609.00 |
$12,609.00 |
$12,609.00 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$5,865.00 |
$5,865.00 |
$5,865.00 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$3,379.00 |
$3,379.00 |
$3,379.00 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,001.00
|
|
Apply of finger splint 29131
|
$506.00 |
$506.00 |
$506.00 |
$177.45
|
|
Apply rigid leg cast 29445
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$608.00
|
|
Apply short leg castambul type 29425
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$460.92
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$45.59 |
$45.59 |
$45.59 |
$1,091.17
|
|
#aptt mix-1:1 incubated
|
$78.00 |
$78.00 |
$78.00 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$220.00 |
$220.00 |
$220.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$221.00 |
$221.00 |
$221.00 |
$114.60
|
|
Aquatic exercise - group charge
|
$212.00 |
$212.00 |
$212.00 |
$91.68
|
|
Arformoterol non-comp unit
|
$7.37 |
$7.37 |
$7.37 |
$24.24
|
|
Argatroban nonesrd (accord)
|
$12.99 |
$12.99 |
$12.99 |
$4.20
|
|
Argatroban nonesrd use 1mg
|
$169.57 |
$169.57 |
$169.57 |
$881.10
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$3,161.71 |
$3,161.71 |
$3,161.71 |
$5,702.81
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$36.66 |
$36.66 |
$36.66 |
$1,642.18
|
