|
Albumin, human 5 % intravenous solution
|
$1.54 |
$1.54 |
$47.45 |
$275.16
|
|
Albumin ischemia modified
|
$152.10 |
$152.10 |
$152.10 |
$85.60
|
|
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
|
$2.89 |
$3.25 |
$3.25 |
$5.67
|
|
Albuterol non-comp unit
|
$1.30 |
$1.30 |
$3.90 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$77.35 |
$77.35 |
$77.35 |
$96.00
|
|
Alcohol/subs interv 15-30mn
|
$185.90 |
$185.90 |
$185.90 |
$56.70
|
|
Alcohol/subs interv >30 min
|
$371.80 |
$371.80 |
$371.80 |
$190.13
|
|
Aldosterone suppression eval
|
$562.90 |
$562.90 |
$562.90 |
$315.20
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$3,550.79 |
$77,335.02 |
$77,335.02 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$13.09 |
$13.09 |
$13.09 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$53.95 |
$53.95 |
$53.95 |
$43.72
|
|
Alginate drsg wound filler
|
$19.04 |
$19.04 |
$19.04 |
$15.79
|
|
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
|
|
Allg patch or app # of tests 95044
|
$265.20 |
$265.20 |
$265.20 |
$423.37
|
|
Allgrft implnt knee w/scope
|
$4,781.40 |
$4,781.40 |
$4,781.40 |
$6,411.60
|
|
Allograft amnioexcel plus 17mm disk
|
$399.10 |
$399.10 |
$399.10 |
$497.95
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$15.89 |
$15.89 |
$15.89 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$409.46 |
$1,115.40 |
$1,115.40 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$167.13 |
$167.13 |
$167.13 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,178.45 |
$1,178.45 |
$1,178.45 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$83.82 |
$83.82 |
$83.82 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$133.25 |
$133.25 |
$133.25 |
$1,225.35
|
|
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 |
$10.15 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$288.60 |
$288.60 |
$288.60 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$76.05 |
$76.05 |
$76.05 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$75.40 |
$75.40 |
$75.40 |
$106.00
|
|
Alprostadil for injection
|
$321.07 |
$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
|
$63.52 |
$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
|
|
Alveoloplasty each quadrant
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$411.45 |
$411.45 |
$411.45 |
$411.45
|
|
Ambl bp mntr w/software
|
$108.55 |
$108.55 |
$108.55 |
$178.20
|
|
Ambl bp mntr w/sw a/r
|
$481.65 |
$481.65 |
$481.65 |
$320.45
|
|
Ambl bp mntr w/sw i&r
|
$108.55 |
$108.55 |
$108.55 |
$57.00
|
|
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
|
|
Amines vaginal fluid qual
|
$26.65 |
$26.65 |
$26.65 |
$12.00
|
|
Amino acid screen, urine
|
$62.40 |
$62.40 |
$62.40 |
$77.00
|
|
Amino acid single qual
|
$63.70 |
$63.70 |
$63.70 |
$36.00
|
|
Amino acids quant 2-5
|
$87.75 |
$87.75 |
$87.75 |
$112.00
|
|
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 |
$910.00 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$4.88 |
$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
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$9,701.25 |
$9,701.25 |
$9,701.25 |
$3,786.00
|
|
Amphetamine confirm urine -sendout
|
$41.60 |
$41.60 |
$41.60 |
$93.61
|
|
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
|
$6.96 |
$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
|
$1,726.40 |
$9,701.25 |
$9,701.25 |
$3,986.00
|
|
Amp thigh through femur re-amp 27596
|
$2,935.40 |
$2,935.40 |
$2,935.40 |
$3,494.40
|
|
Amputate hand at wrist
|
$2,347.80 |
$2,347.80 |
$2,347.80 |
$3,342.87
|
|
Amputate leg at thigh
|
$2,854.80 |
$2,854.80 |
$2,854.80 |
$2,854.80
|
|
Amputate lower leg at knee
|
$2,917.20 |
$2,917.20 |
$2,917.20 |
$3,342.87
|
|
Amputate metacarpal bone 26910
|
$2,025.40 |
$2,025.40 |
$2,025.40 |
$3,839.54
|
|
Amputate thigh through femur 27590
|
$3,852.55 |
$3,852.55 |
$3,852.55 |
$3,370.00
|
|
Amputation follow-up surgery
|
$1,898.00 |
$1,898.00 |
$1,898.00 |
$3,839.54
|
|
Amputation follow-up surgery
|
$2,420.60 |
$2,420.60 |
$2,420.60 |
$7,907.11
|
|
Amputation follow-up surgery
|
$2,033.20 |
$2,033.20 |
$2,033.20 |
$2,934.40
|
|
Amputation follow-up surgery
|
$2,090.40 |
$2,090.40 |
$2,090.40 |
$3,766.40
|
|
Amputation follow-up surgery
|
$1,895.40 |
$1,895.40 |
$1,895.40 |
$3,839.54
|
|
Amputation follow-up surgery
|
$2,277.60 |
$2,277.60 |
$2,277.60 |
$3,839.54
|
|
Amputation follow-up surgery
|
$2,815.80 |
$2,815.80 |
$2,815.80 |
$7,413.38
|
|
Amputation leg thr tib/fib 27880
|
$3,996.20 |
$3,996.20 |
$3,996.20 |
$3,870.00
|
|
Amputation leg; tib/fib f/u 27886
|
$2,605.20 |
$2,605.20 |
$2,605.20 |
$1,506.60
|
|
Amputation of foot at ankle
|
$2,823.60 |
$2,823.60 |
$2,823.60 |
$7,109.92
|
|
Amputation of foot at ankle
|
$2,696.20 |
$2,696.20 |
$2,696.20 |
$1,240.80
|
|
Amputation of forearm
|
$2,498.60 |
$2,498.60 |
$2,498.60 |
$7,413.38
|
|
Amputation of forearm
|
$2,493.40 |
$2,493.40 |
$2,493.40 |
$7,413.38
|
|
Amputation of hand
|
$2,363.40 |
$2,363.40 |
$2,363.40 |
$2,006.40
|
|
Amputation of leg at hip
|
$6,383.00 |
$6,383.00 |
$6,383.00 |
$4,000.80
|
|
Amputation of leg at hip
|
$5,111.60 |
$5,111.60 |
$5,111.60 |
$6,192.00
|
|
Amputation of lower leg
|
$2,545.40 |
$2,545.40 |
$2,545.40 |
$2,545.40
|
|
Amputation of lower leg
|
$3,502.20 |
$3,502.20 |
$3,502.20 |
$3,342.87
|
|
Amputation of midtarsal 28800
|
$2,285.40 |
$2,285.40 |
$2,285.40 |
$2,285.40
|
