|
Aep thrshld est mlt freq i&r
|
$867.00 |
$867.00 |
$867.00 |
$635.00
|
|
_afb id by dna probe rflx ast
|
$108.00 |
$108.00 |
$108.00 |
$104.50
|
|
After cataract laser surgery
|
$1,459.50 |
$1,459.50 |
$1,459.50 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$28,942.08 |
$28,942.08 |
$28,942.08 |
$14,475.20
|
|
Airway resistance by impulse oscillometry 94728
|
$425.25 |
$425.25 |
$425.25 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$29.25 |
$29.25 |
$29.25 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$295.80 |
$295.80 |
$295.80 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$295.80 |
$295.80 |
$295.80 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$47.25 |
$47.25 |
$47.25 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$35.25 |
$35.25 |
$35.25 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$2.43 |
$2.43 |
$2.43 |
$5.67
|
|
Albuterol non-comp con
|
$44.56 |
$44.56 |
$44.56 |
$6.07
|
|
Albuterol non-comp unit
|
$2.43 |
$2.43 |
$2.43 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$60.75 |
$60.75 |
$60.75 |
$96.00
|
|
Aldosterone suppression eval
|
$621.00 |
$621.00 |
$621.00 |
$315.20
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$112,036.08 |
$112,036.08 |
$112,036.08 |
$47,974.31
|
|
Alginate drsg >16 <=48 sq in
|
$59.44 |
$59.44 |
$59.44 |
$43.72
|
|
Alginate drsg wound filler
|
$23.50 |
$23.50 |
$23.50 |
$15.79
|
|
Alkaline phosphatase
|
$38.25 |
$38.25 |
$38.25 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$113.25 |
$113.25 |
$113.25 |
$48.57
|
|
Allergen egg white ige
|
$82.50 |
$82.50 |
$82.50 |
$38.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,768.09 |
$13,768.09 |
$13,768.09 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$13,478.20 |
$13,478.20 |
$13,478.20 |
$497.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$911.25 |
$911.25 |
$911.25 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$9,702.00 |
$9,702.00 |
$9,702.00 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$30,615.48 |
$30,615.48 |
$30,615.48 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$10,046.28 |
$10,046.28 |
$10,046.28 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$6,367.50 |
$6,367.50 |
$6,367.50 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,887.75 |
$1,887.75 |
$1,887.75 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$6,075.00 |
$6,075.00 |
$6,075.00 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$4,038.75 |
$4,038.75 |
$4,038.75 |
$1,225.35
|
|
Alpha-fetoprotein amniotic
|
$36.00 |
$36.00 |
$36.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$138.75 |
$138.75 |
$138.75 |
$106.00
|
|
Alprostadil for injection
|
$800.48 |
$800.48 |
$800.48 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$31,563.16 |
$31,563.16 |
$31,563.16 |
$15,857.45
|
|
Alt/sgpt
|
$48.00 |
$48.00 |
$48.00 |
$47.50
|
|
Aluminum - quest
|
$150.00 |
$150.00 |
$150.00 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$932.25 |
$932.25 |
$932.25 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$174.75 |
$174.75 |
$174.75 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$199.50 |
$199.50 |
$199.50 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$79.87 |
$79.87 |
$79.87 |
$39.84
|
|
Amino acids quant 2-5
|
$239.25 |
$239.25 |
$239.25 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$35.21 |
$35.21 |
$35.21 |
$37.33
|
|
Aminolevulinic acid delta
|
$511.50 |
$511.50 |
$511.50 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$65.64 |
$65.64 |
$65.64 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$119.07 |
$119.07 |
$119.07 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$50.85 |
$50.85 |
$50.85 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$234.75 |
$234.75 |
$234.75 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$14,075.19 |
$14,075.19 |
$14,075.19 |
$9,084.45
|
|
Ammonia
|
$123.00 |
$123.00 |
$123.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$423.00 |
$423.00 |
$423.00 |
$942.60
|
|
Amniocentesis therapeutic
|
$747.75 |
$747.75 |
$747.75 |
$791.05
|
|
Amphetamine confirm urine -sendout
|
$79.50 |
$79.50 |
$79.50 |
$93.61
|
|
Amphetamines 5 or more
|
$414.75 |
$414.75 |
$414.75 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$130.08 |
$130.08 |
$130.08 |
$123.53
|
|
Amphotericin b lipid complex
|
$360.00 |
$360.00 |
$360.00 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$434.39 |
$434.39 |
$434.39 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$114.78 |
$114.78 |
$114.78 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$18.87 |
$18.87 |
$18.87 |
$54.57
|
|
Amylase
|
$120.75 |
$120.75 |
$120.75 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$70.50 |
$70.50 |
$70.50 |
$117.01
|
|
Anal/urinary muscle study
|
$1,095.75 |
$1,095.75 |
$1,095.75 |
$407.00
|
|
Anal/urinary muscle study
|
$981.00 |
$981.00 |
$981.00 |
$602.80
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$1,124.25 |
$1,124.25 |
$1,124.25 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$333.75 |
$333.75 |
$333.75 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$426.00 |
$426.00 |
$426.00 |
$249.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$1,058.25 |
$1,058.25 |
$1,058.25 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$1,263.75 |
$1,263.75 |
$1,263.75 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$105.00 |
$105.00 |
$105.00 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$202.50 |
$202.50 |
$202.50 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$5,156.25 |
$5,156.25 |
$5,156.25 |
$2,480.94
|
|
An fluoro guide for cvp
|
$808.50 |
$808.50 |
$808.50 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,703.25 |
$1,703.25 |
$1,703.25 |
$5,728.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$59,352.27 |
$59,352.27 |
$59,352.27 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,617.00 |
$1,617.00 |
$1,617.00 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$4,995.00 |
$4,995.00 |
$4,995.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,024.50 |
$4,024.50 |
$4,024.50 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$4,485.75 |
$4,485.75 |
$4,485.75 |
$8,359.11
|
|
Anidulafungin injection
|
$116.22 |
$116.22 |
$116.22 |
$312.30
|
|
Ankle X-ray
|
$236.25 |
$236.25 |
$236.25 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$213.75 |
$213.75 |
$213.75 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$429.00 |
$429.00 |
$429.00 |
$630.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$64.50 |
$64.50 |
$64.50 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$70.50 |
$70.50 |
$70.50 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$167.25 |
$167.25 |
$167.25 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$148.50 |
$148.50 |
$148.50 |
$167.25
|
|
Anoscopy ablation lesion 46615
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$3,245.23
|
|
Anoscopy control bleeding 46614
|
$1,982.25 |
$1,982.25 |
$1,982.25 |
$2,140.60
|
|
Anoscopy remove fb 46608
|
$1,611.75 |
$1,611.75 |
$1,611.75 |
$1,375.98
|
|
Anoscopy remove lesion 46610
|
$2,770.50 |
$2,770.50 |
$2,770.50 |
$3,816.64
|
|
Ans parasymp & symp w/tilt
|
$1,104.75 |
$1,104.75 |
$1,104.75 |
$368.50
|
|
Antibody bacterium, not elsewhere specified
|
$118.50 |
$118.50 |
$118.50 |
$57.85
|
|
Antibody elution rbc reference
|
$147.75 |
$147.75 |
$147.75 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$289.50 |
$289.50 |
$289.50 |
$131.56
|
|
Antibody htlv-i
|
$210.75 |
$210.75 |
$210.75 |
$49.53
|
|
Antibody htlv-ii
|
$210.75 |
$210.75 |
$210.75 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$694.50 |
$694.50 |
$694.50 |
$224.00
|
|
Antibody id rbc panel
|
$277.50 |
$277.50 |
$277.50 |
$291.75
|
|
Antibody lymphocytic choriomeningitis
|
$159.00 |
$159.00 |
$159.00 |
$46.58
|
|
Antibody screen rbc
|
$102.75 |
$102.75 |
$102.75 |
$108.55
|
