|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$567.03 |
$567.03 |
$567.03 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$277.15 |
$277.15 |
$277.15 |
$2,513.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$227.06 |
$227.06 |
$227.06 |
$4,101.14
|
|
All tstg perq&iq drugs/biol
|
$144.30 |
$144.30 |
$144.30 |
$64.80
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$189.15 |
$189.15 |
$189.15 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$96.20 |
$96.20 |
$96.20 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$46.15 |
$46.15 |
$46.15 |
$99.00
|
|
Alprostadil for injection
|
$5.75 |
$367.90 |
$367.90 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$23,242.18 |
$23,242.18 |
$23,242.18 |
$2,600.22
|
|
Alt/sgpt
|
$6.50 |
$6.50 |
$6.50 |
$49.00
|
|
Aluminum - quest
|
$74.75 |
$74.75 |
$74.75 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$1,097.85 |
$1,097.85 |
$1,097.85 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$487.50 |
$487.50 |
$487.50 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$5.02 |
$35.07 |
$35.07 |
$36.30
|
|
Amino acids quant 2-5
|
$150.15 |
$150.15 |
$150.15 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$45.50 |
$45.50 |
$45.50 |
$42.84
|
|
Aminolevulinic acid delta
|
$133.90 |
$133.90 |
$133.90 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$58.92 |
$58.92 |
$58.92 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$79.59 |
$79.59 |
$125.09 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$23.56 |
$23.56 |
$28.40 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$119.60 |
$119.60 |
$119.60 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$10,317.19 |
$10,317.19 |
$10,317.19 |
$15,167.75
|
|
Ammonia
|
$227.50 |
$227.50 |
$227.50 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$1,672.45 |
$1,672.45 |
$1,672.45 |
$942.60
|
|
Amniocentesis therapeutic
|
$1,755.65 |
$1,755.65 |
$1,755.65 |
$778.57
|
|
Amphetamine confirm urine -sendout
|
$74.10 |
$74.10 |
$74.10 |
$94.50
|
|
Amphetamines 5 or more
|
$293.80 |
$293.80 |
$293.80 |
$101.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$141.69 |
$141.69 |
$141.69 |
$130.08
|
|
Amphotericin b lipid complex
|
$337.94 |
$337.94 |
$337.94 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$77.12 |
$268.58 |
$342.26 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$32.01 |
$34.00 |
$105.20 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$30.81 |
$47.90 |
$64.58 |
$51.93
|
|
Amputation toe interphalangeal joint
|
$3,013.40 |
$3,013.40 |
$3,013.40 |
$3,691.20
|
|
Amputation toe metatarsophalangeal joint
|
$3,122.60 |
$3,122.60 |
$3,122.60 |
$3,777.93
|
|
Amylase
|
$76.70 |
$76.70 |
$76.70 |
$93.00
|
|
Ana ds-dna
|
$304.85 |
$304.85 |
$304.85 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$58.50 |
$58.50 |
$58.50 |
$110.98
|
|
Anal pressure record
|
$1,606.80 |
$1,606.80 |
$1,606.80 |
$955.86
|
|
Analysis gene f2 20210g>a variant
|
$140.40 |
$140.40 |
$140.40 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$137.15 |
$137.15 |
$137.15 |
$226.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$365.95 |
$365.95 |
$365.95 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$33.15 |
$33.15 |
$33.15 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$135.20 |
$135.20 |
$135.20 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$6,555.90 |
$6,555.90 |
$6,555.90 |
$2,626.65
|
|
An fluoro guide for cvp
|
$436.80 |
$436.80 |
$436.80 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$7,641.40 |
$7,641.40 |
$7,641.40 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$27,470.30 |
$27,470.30 |
$27,470.30 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$27,028.30 |
$27,028.30 |
$27,028.30 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$3,294.20 |
$3,294.20 |
$3,294.20 |
$6,513.10
|
|
Angiotensin ii
|
$48.75 |
$48.75 |
$48.75 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$6,736.02 |
$6,736.02 |
$6,736.02 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$28,736.50 |
$28,736.50 |
$28,736.50 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$7,930.00 |
$7,930.00 |
$7,930.00 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$21,010.60 |
$21,010.60 |
$21,010.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$7,641.40 |
$7,641.40 |
$7,641.40 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$21,184.80 |
$21,184.80 |
$21,184.80 |
$8,689.20
|
|
Ankle X-ray
|
$482.30 |
$482.30 |
$482.30 |
$339.44
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,617.85 |
$1,617.85 |
$1,617.85 |
$693.75
|
|
Annual Physical, Established Patient (age 18-39)
|
$102.70 |
$102.70 |
$102.70 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$102.70 |
$102.70 |
$102.70 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$102.70 |
$102.70 |
$102.70 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$102.70 |
$102.70 |
$102.70 |
$188.15
|
|
Anoscopy control bleeding 46614
|
$3,718.00 |
$3,718.00 |
$3,718.00 |
$1,405.05
|
|
Antibody bacterium, not elsewhere specified
|
$140.40 |
$140.40 |
$140.40 |
$57.89
|
|
Antibody elution rbc reference
|
$860.60 |
$860.60 |
$860.60 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$227.50 |
$227.50 |
$227.50 |
$141.74
|
|
Antibody htlv-i
|
$57.20 |
$57.20 |
$57.20 |
$48.75
|
|
Antibody htlv-ii
|
$20.80 |
$20.80 |
$20.80 |
$35.22
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$469.30 |
$469.30 |
$469.30 |
$220.73
|
|
Antibody id rbc panel
|
$496.60 |
$496.60 |
$496.60 |
$291.75
|
|
Antibody influenza virus
|
$53.95 |
$53.95 |
$53.95 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$198.25 |
$198.25 |
$198.25 |
$53.96
|
|
Antibody screen rbc
|
$38.35 |
$38.35 |
$38.35 |
$105.00
|
|
Antibody tetanus
|
$94.25 |
$94.25 |
$94.25 |
$61.98
|
|
Antidepressant not specified
|
$183.30 |
$183.30 |
$183.30 |
$89.50
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.89 |
$7,689.18 |
$7,689.18 |
$3.12
|
|
Anti-inhibitor
|
$14,073.93 |
$14,073.93 |
$14,073.93 |
$3.75
|
|
Anti mog serum - sendout
|
$1,333.80 |
$1,333.80 |
$1,333.80 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$143.00 |
$143.00 |
$143.00 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$134.55 |
$134.55 |
$134.55 |
$45.82
|
|
Antinuclear antibodies
|
$122.85 |
$122.85 |
$122.85 |
$91.70
|
|
Antinuclear antibodies titer
|
$126.10 |
$126.10 |
$126.10 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$381.55 |
$381.55 |
$381.55 |
$74.20
|
|
Antistreptolysin o titer
|
$20.80 |
$20.80 |
$20.80 |
$57.96
|
|
Antithrombin iii activity
|
$363.35 |
$363.35 |
$363.35 |
$115.23
|
|
Antithrombin iii injection
|
$11.85 |
$11.85 |
$6,021.40 |
$9.32
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$12,689.90 |
$16,063.22 |
$16,063.22 |
$5,013.11
|
|
Antithymocyte globuln rabbit
|
$3,570.64 |
$3,570.64 |
$3,688.78 |
$1,679.21
|
|
Aortic dysfunction/dilation
|
$4,789.20 |
$4,789.20 |
$4,789.20 |
$653.18
|
|
Apc gene full sequence
|
$2,466.10 |
$2,466.10 |
$2,466.10 |
$1,076.40
|
|
Apc gene known fam variants
|
$827.45 |
$827.45 |
$827.45 |
$308.00
|
|
Apheresis plasma
|
$5,428.80 |
$5,428.80 |
$5,428.80 |
$3,411.50
|
|
Apheresis platelets
|
$4,909.45 |
$4,909.45 |
$4,909.45 |
$2,345.00
|
|
Apheresis rbc
|
$5,266.30 |
$5,266.30 |
$5,266.30 |
$3,348.50
|
|
Apheresis wbc
|
$2,945.80 |
$2,945.80 |
$2,945.80 |
$3,342.71
|
|
Apl(pml-rara) quant - sendout
|
$910.00 |
$910.00 |
$910.00 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,614.65 |
$3,614.65 |
$3,614.65 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$3,101.80 |
$3,101.80 |
$3,101.80 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$2,529.80 |
$2,529.80 |
$2,529.80 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,811.25 |
$2,811.25 |
$2,811.25 |
$3,150.00
|
