|
Alkaline phosphatase
|
$45.75 |
$45.75 |
$45.75 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$71.25 |
$71.25 |
$71.25 |
$48.57
|
|
Allergen egg white ige
|
$273.00 |
$273.00 |
$273.00 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$57.75 |
$57.75 |
$57.75 |
$24.00
|
|
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
|
$51.00 |
$51.00 |
$51.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$162.00 |
$162.00 |
$162.00 |
$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
|
$77.25 |
$77.25 |
$77.25 |
$47.50
|
|
Aluminum - quest
|
$193.50 |
$193.50 |
$193.50 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$1,303.50 |
$1,303.50 |
$1,303.50 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$518.25 |
$518.25 |
$518.25 |
$179.70
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$79.87 |
$79.87 |
$79.87 |
$39.84
|
|
Amino acids quant 2-5
|
$221.25 |
$221.25 |
$221.25 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$35.21 |
$35.21 |
$35.21 |
$37.33
|
|
Aminolevulinic acid delta
|
$658.50 |
$658.50 |
$658.50 |
$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
|
$289.50 |
$289.50 |
$289.50 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$14,075.19 |
$14,075.19 |
$14,075.19 |
$9,084.45
|
|
Ammonia
|
$153.00 |
$153.00 |
$153.00 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$110.25 |
$110.25 |
$110.25 |
$93.61
|
|
Amphetamines 5 or more
|
$468.00 |
$468.00 |
$468.00 |
$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
|
$197.25 |
$197.25 |
$197.25 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$92.25 |
$92.25 |
$92.25 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$515.25 |
$515.25 |
$515.25 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$654.75 |
$654.75 |
$654.75 |
$249.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$563.25 |
$563.25 |
$563.25 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$105.00 |
$105.00 |
$105.00 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$259.50 |
$259.50 |
$259.50 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$485.25 |
$485.25 |
$485.25 |
$2,480.94
|
|
An fluoro guide for cvp
|
$789.75 |
$789.75 |
$789.75 |
$525.85
|
|
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 vein ea addl
|
$6,355.50 |
$6,355.50 |
$6,355.50 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$6,389.25 |
$6,389.25 |
$6,389.25 |
$8,359.11
|
|
Anidulafungin injection
|
$116.22 |
$116.22 |
$116.22 |
$312.30
|
|
Ankle X-ray
|
$441.75 |
$441.75 |
$441.75 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$398.25 |
$398.25 |
$398.25 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$502.50 |
$502.50 |
$502.50 |
$630.96
|
|
Anodyne therapy charges pt
|
$49.50 |
$49.50 |
$49.50 |
$42.00
|
|
Anoscopy remove fb 46608
|
$1,950.00 |
$1,950.00 |
$1,950.00 |
$1,375.98
|
|
Antibody bacterium, not elsewhere specified
|
$189.75 |
$189.75 |
$189.75 |
$57.85
|
|
Antibody elution rbc reference
|
$153.00 |
$153.00 |
$153.00 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$289.50 |
$289.50 |
$289.50 |
$131.56
|
|
Antibody htlv-i
|
$195.00 |
$195.00 |
$195.00 |
$49.53
|
|
Antibody htlv-ii
|
$195.00 |
$195.00 |
$195.00 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$822.75 |
$822.75 |
$822.75 |
$224.00
|
|
Antibody id rbc panel
|
$160.50 |
$160.50 |
$160.50 |
$291.75
|
|
Antibody lymphocytic choriomeningitis
|
$205.50 |
$205.50 |
$205.50 |
$46.58
|
|
Antibody screen rbc
|
$126.00 |
$126.00 |
$126.00 |
$108.55
|
|
Antidepressant not specified
|
$318.75 |
$318.75 |
$318.75 |
$72.14
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$5,102.55 |
$5,102.55 |
$5,102.55 |
$6.10
|
|
Anti-inhibitor
|
$18,764.82 |
$18,764.82 |
$18,764.82 |
$8.33
|
|
Anti mog serum - sendout
|
$342.00 |
$342.00 |
$342.00 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$140.25 |
$140.25 |
$140.25 |
$38.50
|
|
Antinuclear antibodies
|
$124.50 |
$124.50 |
$124.50 |
$90.00
|
|
Antinuclear antibodies titer
|
$102.00 |
$102.00 |
$102.00 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$80.25 |
$80.25 |
$80.25 |
$67.43
|
|
Antipsychotics nos 1-3
|
$310.50 |
$310.50 |
$310.50 |
$136.61
|
|
Antistreptolysin o titer
|
$106.50 |
$106.50 |
$106.50 |
$54.00
|
|
Antithrombin iii activity
|
$268.50 |
$268.50 |
$268.50 |
$115.15
|
|
Antithrombin iii injection
|
$6,858.87 |
$6,858.87 |
$6,858.87 |
$11.85
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$17,349.88 |
$17,349.88 |
$17,349.88 |
$8,214.07
|
|
Antithymocyte globuln rabbit
|
$4,139.25 |
$4,139.25 |
$4,139.25 |
$2,111.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$378.75 |
$378.75 |
$378.75 |
$394.55
|
|
Apl(pml-rara) quant - sendout
|
$1,187.25 |
$1,187.25 |
$1,187.25 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,990.50 |
$1,990.50 |
$1,990.50 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,130.25 |
$1,130.25 |
$1,130.25 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$557.25 |
$557.25 |
$557.25 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,133.75 |
$2,133.75 |
$2,133.75 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,417.50 |
$1,417.50 |
$1,417.50 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$545.25 |
$545.25 |
$545.25 |
$512.20
|
|
Application finger splntstatic 29130
|
$192.75 |
$192.75 |
$192.75 |
$208.50
|
|
Application long leg splint 29505
|
$312.75 |
$312.75 |
$312.75 |
$338.25
|
|
Application lower leg splint 29515
|
$294.75 |
$294.75 |
$294.75 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$377.25 |
$377.25 |
$377.25 |
$375.06
|
|
Application of forearm cast 29075
|
$279.75 |
$279.75 |
$279.75 |
$358.20
|
|
Application of long arm cast 29065
|
$297.00 |
$297.00 |
$297.00 |
$396.77
|
|
Application of long leg cast
|
$444.00 |
$444.00 |
$444.00 |
$435.54
|
|
Application of long leg cast 29345
|
$388.50 |
$388.50 |
$388.50 |
$455.00
|
|
Application of paste boot 29580
|
$361.50 |
$361.50 |
$361.50 |
$340.11
|
|
Application short leg cast 29405
|
$332.25 |
$332.25 |
$332.25 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,682.25 |
$1,682.25 |
$1,682.25 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,441.50 |
$1,441.50 |
$1,441.50 |
$2,164.64
|
