|
Adapter b 8 channel 10cm
|
$485.94 |
$1,718.08 |
$1,718.08 |
|
|
Adding walker to prev cast
|
$120.00 |
$187.33 |
$187.33 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$344.62 |
$1,186.20 |
$1,186.20 |
|
|
Adenovirus ag ia
|
$108.15 |
$108.15 |
$108.15 |
|
|
Adenovirus antibody,serum - quest
|
$47.00 |
$47.00 |
$47.00 |
|
|
Adhesive, liquid or equal
|
$18.63 |
$18.63 |
$18.63 |
|
|
Adh-sendout
|
$131.00 |
$240.33 |
$240.33 |
|
|
Adj gastric band via subq port
|
$511.05 |
$511.05 |
$1,245.50 |
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$3,987.43 |
$3,987.43 |
$3,987.43 |
|
|
Adjustment gastric band
|
$19.10 |
$19.10 |
$19.10 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$29.41 |
$2,721.98 |
$2,721.98 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$182.50 |
$230.35 |
$360.89 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$263.00 |
$389.98 |
$467.67 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$477.50 |
$819.65 |
$967.00 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$329.00 |
$589.90 |
$1,378.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$248.00 |
$270.20 |
$344.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$159.00 |
$267.43 |
$416.64 |
|
|
Administration immunization each additional component
|
$23.28 |
$23.28 |
$23.28 |
|
|
Administration immunization each additional vaccine
|
$46.23 |
$46.23 |
$183.00 |
|
|
Administration immunization first component each vaccine
|
$23.30 |
$23.30 |
$81.00 |
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$12.55 |
$12.55 |
$56.00 |
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$22.15 |
$22.15 |
$22.15 |
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$41.45 |
$41.45 |
$41.45 |
|
|
Administration vaccine hepatitis b
|
$48.00 |
$59.08 |
$399.00 |
|
|
Administration vaccine influenza virus
|
$58.50 |
$60.85 |
$521.68 |
|
|
Administration vaccine pneumococcal
|
$58.50 |
$59.08 |
$59.08 |
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$41.45 |
$41.45 |
$41.45 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$12,791.80 |
$12,791.80 |
$12,791.80 |
|
|
Adrenal cortex & medulla img
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
|
|
Adrenalin epinephrine inject
|
$64.03 |
$64.03 |
$102.31 |
|
|
Advance care planning each additional 30 min 99498
|
$92.63 |
$92.63 |
$93.50 |
|
|
Aep hearing status deter i&r
|
$126.43 |
$126.43 |
$126.43 |
|
|
Aep neurodiagnostic i&r
|
$776.50 |
$776.50 |
$2,192.00 |
|
|
Aep thrshld est mlt freq i&r
|
$573.65 |
$573.65 |
$776.50 |
|
|
_afb id by dna probe rflx ast
|
$67.50 |
$121.93 |
$121.93 |
|
|
#afb mycobacteria suscep. #1
|
$230.70 |
$230.70 |
$230.70 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$68.93 |
$68.93 |
$707.00 |
|
|
Aflibercept injection
|
$3,805.00 |
$3,805.00 |
$3,805.00 |
|
|
Afo molded to patient plasti
|
$436.77 |
$436.77 |
$436.77 |
|
|
Afo rig ant tib tcf/= custom
|
$706.39 |
$706.39 |
$706.39 |
|
|
Afo tib fx semi-rigid l2114
|
$385.02 |
$385.02 |
$385.02 |
|
|
Afo tibial fracture soft
|
$41.64 |
$41.64 |
$41.64 |
|
|
Afo, walk boot type, cus fab
|
$1,180.94 |
$1,180.94 |
$1,180.94 |
|
|
Afo w/ankle joint, prefab
|
$275.31 |
$275.31 |
$275.31 |
|
|
After cataract laser surgery
|
$948.50 |
$948.50 |
$948.50 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$15,667.45 |
$15,667.45 |
$15,667.45 |
|
|
Air conduction bilat
|
$61.08 |
$61.08 |
$701.00 |
|
|
Air injection into abdomen 49400
|
$601.63 |
$601.63 |
$601.63 |
|
|
Airway resistance by impulse oscillometry 94728
|
$68.40 |
$68.40 |
$68.40 |
|
|
Ak/knee disartic silesian ba
|
$88.50 |
$88.50 |
$88.50 |
|
|
Ak sleeve susp neoprene/equa
|
$157.84 |
$157.84 |
$157.84 |
|
|
Albumin body fluid quantitative each specimen
|
$23.00 |
$63.73 |
$89.36 |
|
|
Albumin (human), 25%, 50ml
|
$244.70 |
$244.70 |
$732.70 |
|
|
Albumin, human 25 % intravenous solution
|
$75.10 |
$75.10 |
$488.08 |
|
|
Albumin (human), 5%, 250 ml
|
$188.00 |
$188.00 |
$781.06 |
|
|
Albumin, human 5 % intravenous solution
|
$86.48 |
$86.48 |
$86.48 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$49.50 |
$60.45 |
$111.00 |
|
|
Albumin serum plasma or whole blood
|
$22.50 |
$64.75 |
$76.02 |
|
|
Albuterol ipratrop non-comp
|
$32.29 |
$32.29 |
$32.29 |
|
|
Albuterol non-comp unit
|
$8.65 |
$8.65 |
$8.65 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$95.50 |
$108.00 |
$108.00 |
|
|
Alcohol/sub misuse assess
|
$37.23 |
$37.23 |
$37.23 |
|
|
Alcohol/subs interv 15-30mn
|
$36.00 |
$36.00 |
$36.00 |
|
|
Aldesleukin injection
|
$10,294.10 |
$10,294.10 |
$10,294.10 |
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$30,370.93 |
$30,370.93 |
$30,370.93 |
|
|
Alginate dressing <=16 sq in
|
$15.50 |
$15.50 |
$15.50 |
|
|
Alginate drsg >16 <=48 sq in
|
$33.00 |
$33.00 |
$33.00 |
|
|
Alginate drsg wound filler
|
$11.90 |
$11.90 |
$11.90 |
|
|
Alkaline phosphatase
|
$46.00 |
$66.05 |
$125.90 |
|
|
Allergen alpha lactalbumin ige
|
$42.00 |
$56.35 |
$391.00 |
|
|
Allergen egg white ige
|
$38.00 |
$56.35 |
$391.00 |
|
|
Allergen specific ige qual multi scrn ea
|
$16.00 |
$16.00 |
$75.00 |
|
|
Allergy injections; 2 or more 95117
|
$8.75 |
$8.75 |
$314.00 |
|
|
Allergy injection; single 95115
|
$8.75 |
$8.75 |
$52.00 |
|
|
Allg patch or app # of tests 95044
|
$445.00 |
$445.00 |
$445.00 |
|
|
Allograft 160mg placental salera mini membrane
|
$666.00 |
$666.00 |
$666.00 |
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$849.50 |
$849.50 |
$849.50 |
|
|
Allograft amnioexcel plus 17mm disk
|
$287.73 |
$2,250.00 |
$2,250.00 |
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$1,375.00 |
$1,375.00 |
$1,375.00 |
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$25.80 |
$1,200.00 |
$1,200.00 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$205.45 |
$507.10 |
$507.10 |
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$934.76 |
$934.76 |
$934.76 |
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$122.13 |
$1,350.00 |
$1,350.00 |
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$173.36 |
$396.78 |
$396.78 |
|
|
Alloskin
|
$2,250.00 |
$2,250.00 |
$2,250.00 |
|
|
All tstg perq&iq drugs/biol
|
$54.93 |
$54.93 |
$54.93 |
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$22.78 |
$22.78 |
$22.78 |
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$191.00 |
$191.00 |
$700.00 |
|
|
Alpha-fetoprotein amniotic
|
$80.50 |
$174.10 |
$174.10 |
|
|
Alpha-fetoprotein tumor marker
|
$66.00 |
$132.53 |
$259.00 |
|
|
Alprostadil for injection
|
$1,307.70 |
$1,307.70 |
$1,307.70 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$346.29 |
$17,085.20 |
$17,085.20 |
|
|
Alt/sgpt
|
$33.00 |
$44.68 |
$91.00 |
|
|
Altuviiio per factor viii iu
|
$25.75 |
$25.75 |
$25.75 |
|
|
Aluminum - quest
|
$97.00 |
$121.25 |
$243.00 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$381.00 |
$386.75 |
$982.00 |
|
|
Amantadine (symmetrel)-sendout
|
$98.00 |
$169.80 |
$169.80 |
|
|
Ambl bp mntr w/sw a/r
|
$324.38 |
$324.38 |
$354.50 |
|
|
Amifostine
|
$2,003.83 |
$2,003.83 |
$2,003.83 |
|
