|
Administration immunization first component each vaccine
|
$45.50 |
$45.50 |
$45.50 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$139.10 |
$139.10 |
$139.10 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$123.50 |
$123.50 |
$123.50 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$102.70 |
$102.70 |
$102.70 |
$44.80
|
|
Administration vaccine hepatitis b
|
$120.25 |
$120.25 |
$120.25 |
$53.00
|
|
Administration vaccine influenza virus
|
$120.25 |
$120.25 |
$120.25 |
$51.07
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$102.70 |
$102.70 |
$102.70 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$19,916.21 |
$19,916.21 |
$19,916.21 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$712.08 |
$712.08 |
$712.08 |
$231.47
|
|
Advance care planning each additional 30 min 99498
|
$63.70 |
$63.70 |
$63.70 |
$110.56
|
|
Afamelanotide implant, 1 mg
|
$78,638.30 |
$78,638.30 |
$78,638.30 |
$78,638.30
|
|
Afamitresgene autoleucel
|
$2,268,240.00 |
$2,268,240.00 |
$2,268,240.00 |
$2,125,068.14
|
|
_afb id by dna probe rflx ast
|
$89.70 |
$89.70 |
$89.70 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$517.40 |
$517.40 |
$517.40 |
$300.00
|
|
Aflibercept injection
|
$90,901.04 |
$90,901.04 |
$90,901.04 |
$2,738.00
|
|
Afo tibial fracture rigid
|
$821.60 |
$821.60 |
$821.60 |
$1,489.57
|
|
Afo, walk boot type, cus fab
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$2,859.19
|
|
After cataract laser surgery
|
$1,640.60 |
$1,640.60 |
$1,640.60 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$25,154.35 |
$25,154.35 |
$25,154.35 |
$14,475.20
|
|
Air conduction bilat
|
$335.40 |
$335.40 |
$335.40 |
$134.00
|
|
Air injection into abdomen 49400
|
$211.25 |
$211.25 |
$211.25 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$468.00 |
$468.00 |
$468.00 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$35.10 |
$35.10 |
$35.10 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$2.71 |
$2.71 |
$2.71 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$3.26 |
$3.26 |
$3.26 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$0.84 |
$0.84 |
$0.84 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$1.54 |
$1.54 |
$1.54 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$26.00 |
$26.00 |
$26.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$22.10 |
$22.10 |
$22.10 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$3.25 |
$3.25 |
$3.25 |
$5.67
|
|
Albuterol non-comp unit
|
$1.30 |
$1.30 |
$1.30 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$77.35 |
$77.35 |
$77.35 |
$96.00
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$77,335.02 |
$77,335.02 |
$77,335.02 |
$47,974.31
|
|
Alkaline phosphatase
|
$23.40 |
$23.40 |
$23.40 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$80.60 |
$80.60 |
$80.60 |
$48.57
|
|
Allergen egg white ige
|
$23.40 |
$23.40 |
$23.40 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$35.75 |
$35.75 |
$35.75 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$128.70 |
$128.70 |
$128.70 |
$45.00
|
|
Allergy injection; single 95115
|
$89.70 |
$89.70 |
$89.70 |
$46.80
|
|
Allergy Skin Testing
|
$109.85 |
$109.85 |
$109.85 |
$47.44
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,115.40 |
$1,115.40 |
$1,115.40 |
$858.66
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,178.45 |
$1,178.45 |
$1,178.45 |
$5,096.00
|
|
Alloskin
|
$582.40 |
$582.40 |
$582.40 |
$582.40
|
|
All tstg perq&iq drugs/biol
|
$107.25 |
$107.25 |
$107.25 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$47.45 |
$47.45 |
$47.45 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1.52 |
$1.52 |
$1.52 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$288.60 |
$288.60 |
$288.60 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$75.40 |
$75.40 |
$75.40 |
$106.00
|
|
Alprostadil for injection
|
$1,639.15 |
$1,639.15 |
$1,639.15 |
$511.41
|
|
Als 1
|
$533.00 |
$533.00 |
$533.00 |
$853.44
|
|
Als1-emergency
|
$526.50 |
$526.50 |
$526.50 |
$1,103.37
|
|
Als 2
|
$561.60 |
$561.60 |
$561.60 |
$1,288.56
|
|
Alteplase 100 mg infusion from pyxis vial
|
$20,592.84 |
$20,592.84 |
$20,592.84 |
$15,857.45
|
|
Alt/sgpt
|
$24.05 |
$24.05 |
$24.05 |
$47.50
|
|
Altuviiio per factor viii iu
|
$13.32 |
$13.32 |
$13.32 |
$13.32
|
|
Aluminum - quest
|
$114.40 |
$114.40 |
$114.40 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$411.45 |
$411.45 |
$411.45 |
$411.45
|
|
Amifostine
|
$2,507.10 |
$2,507.10 |
$2,507.10 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$9.36 |
$9.36 |
$9.36 |
$39.84
|
|
Amino acid screen, urine
|
$62.40 |
$62.40 |
$62.40 |
$77.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$1.27 |
$1.27 |
$1.27 |
$37.33
|
|
Aminolevulinic acid, 10% gel
|
$297.18 |
$297.18 |
$297.18 |
$1.81
|
|
Aminolevulinic acid delta
|
$74.10 |
$74.10 |
$74.10 |
$87.12
|
|
Aminolevulinic acid hcl top
|
$613.42 |
$613.42 |
$613.42 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$5.15 |
$5.15 |
$5.15 |
$47.06
|
|
Amiodarone 50 mg/ml intravenous solution
|
$2.24 |
$2.24 |
$2.24 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$1,696.68 |
$1,696.68 |
$1,696.68 |
$9,084.45
|
|
Ammonia
|
$65.65 |
$65.65 |
$65.65 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$2,263.95 |
$2,263.95 |
$2,263.95 |
$942.60
|
|
Amniocentesis therapeutic
|
$791.05 |
$791.05 |
$791.05 |
$791.05
|
|
Amphetamines 5 or more
|
$17.55 |
$17.55 |
$17.55 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$117.00 |
$117.00 |
$117.00 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$744.84 |
$744.84 |
$744.84 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$210.15 |
$210.15 |
$210.15 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$170.37 |
$170.37 |
$170.37 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$1,179.75 |
$1,179.75 |
$1,179.75 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$9,701.25 |
$9,701.25 |
$9,701.25 |
$3,986.00
|
|
Amputation toe interphalangeal joint
|
$9,641.45 |
$9,641.45 |
$9,641.45 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$9,701.25 |
$9,701.25 |
$9,701.25 |
$3,839.54
|
|
Amylase
|
$29.25 |
$29.25 |
$29.25 |
$90.00
|
|
Analgesics non-opioid 6/more
|
$20.80 |
$20.80 |
$20.80 |
$16.24
|
|
Anal/urinary muscle study
|
$468.00 |
$468.00 |
$468.00 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$411.45 |
$411.45 |
$411.45 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$294.45 |
$294.45 |
$294.45 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$328.90 |
$328.90 |
$328.90 |
$249.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$167.05 |
$167.05 |
$167.05 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$411.45 |
$411.45 |
$411.45 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$157.30 |
$157.30 |
$157.30 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$67.60 |
$67.60 |
$67.60 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$10,552.10 |
$10,552.10 |
$10,552.10 |
$2,480.94
|
|
An fluoro guide for cvp
|
$534.95 |
$534.95 |
$534.95 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$10,547.55 |
$10,547.55 |
$10,547.55 |
$5,728.50
|
|
Angiotensin ii
|
$92.30 |
$92.30 |
$92.30 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,263.33 |
$1,263.33 |
$1,263.33 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,683.90 |
$4,683.90 |
$4,683.90 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$21,309.60 |
$21,309.60 |
$21,309.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,512.60 |
$3,512.60 |
$3,512.60 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$21,309.60 |
$21,309.60 |
$21,309.60 |
$8,359.11
|
|
Anidulafungin injection
|
$446.69 |
$446.69 |
$446.69 |
$312.30
|
|
Ankle X-ray
|
$395.20 |
$395.20 |
$395.20 |
$356.32
|
