|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$13,705.51 |
$13,705.51 |
$13,705.51 |
$5,213.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$35,734.39 |
$35,734.39 |
$35,734.39 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$23,990.19 |
$23,990.19 |
$23,990.19 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$35,347.27 |
$35,347.27 |
$35,347.27 |
$4,732.60
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$33,374.69 |
$33,374.69 |
$33,374.69 |
$4,037.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$13,437.07 |
$13,437.07 |
$13,437.07 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$12,496.51 |
$12,496.51 |
$12,496.51 |
$1,707.62
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,322.00 |
$2,322.00 |
$2,322.00 |
$9.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$243.60 |
$243.60 |
$243.60 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$45.00 |
$45.00 |
$45.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$70.20 |
$70.20 |
$70.20 |
$102.00
|
|
Alprostadil for injection
|
$1,981.38 |
$1,981.38 |
$1,981.38 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$102,964.26 |
$102,964.26 |
$102,964.26 |
$14,503.48
|
|
Alt/sgpt
|
$27.60 |
$27.60 |
$27.60 |
$44.68
|
|
Aluminum - quest
|
$66.60 |
$66.60 |
$66.60 |
$81.49
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$136.32 |
$136.32 |
$136.32 |
$38.68
|
|
Amino acid screen, urine
|
$139.20 |
$139.20 |
$139.20 |
$76.05
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$85.20 |
$85.20 |
$85.20 |
$37.32
|
|
Aminolevulinic acid delta
|
$140.40 |
$140.40 |
$140.40 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$233.94 |
$233.94 |
$233.94 |
$45.56
|
|
Amiodarone 50 mg/ml intravenous solution
|
$34.68 |
$34.68 |
$34.68 |
$61.68
|
|
Ammonia
|
$98.40 |
$98.40 |
$98.40 |
$114.40
|
|
Amniotic fluid scan
|
$115.80 |
$115.80 |
$115.80 |
$42.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$561.60 |
$561.60 |
$561.60 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,909.62 |
$1,909.62 |
$1,909.62 |
$451.51
|
|
Ampicillin 1 gram solution for injection
|
$156.78 |
$156.78 |
$156.78 |
$63.82
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$170.40 |
$170.40 |
$170.40 |
$58.36
|
|
Amputation thru metatarsal
|
$51,017.86 |
$51,017.86 |
$51,017.86 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$15,082.50 |
$15,082.50 |
$15,082.50 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$32,573.06 |
$32,573.06 |
$32,573.06 |
$3,814.50
|
|
Amylase
|
$128.40 |
$128.40 |
$128.40 |
$83.20
|
|
Ana ds-dna
|
$70.80 |
$70.80 |
$70.80 |
$58.63
|
|
Analysis gene f2 20210g>a variant
|
$898.20 |
$898.20 |
$898.20 |
$207.48
|
|
Analysis gene f5 leiden variant
|
$898.20 |
$898.20 |
$898.20 |
$219.13
|
|
Anaplsma phgcytophlm amp prb
|
$92.40 |
$92.40 |
$92.40 |
$88.00
|
|
Anca screen with reflex to titer -quest
|
$84.00 |
$84.00 |
$84.00 |
$100.32
|
|
An cholangiogram percutaneous compl
|
$6,150.60 |
$6,150.60 |
$6,150.60 |
$2,624.13
|
|
An fluoro guide for cvp
|
$891.00 |
$891.00 |
$891.00 |
$510.17
|
|
Angio balloon ctrl dialysis seg add-on
|
$8,816.40 |
$8,816.40 |
$8,816.40 |
$5,341.83
|
|
Angiotensin ii
|
$133.80 |
$133.80 |
$133.80 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$3,560.40 |
$3,560.40 |
$3,560.40 |
$5,172.70
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,712.80 |
$6,712.80 |
$6,712.80 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$10,279.80 |
$10,279.80 |
$10,279.80 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$8,816.40 |
$8,816.40 |
$8,816.40 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$8,816.40 |
$8,816.40 |
$8,816.40 |
$8,466.00
|
|
Anidulafungin injection
|
$2,233.44 |
$2,233.44 |
$2,233.44 |
$297.63
|
|
Ankle arthroscopy/surgery
|
$66,105.80 |
$66,105.80 |
$66,105.80 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$64,969.47 |
$64,969.47 |
$64,969.47 |
$3,839.54
|
|
Ankle X-ray
|
$417.60 |
$417.60 |
$417.60 |
$351.20
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$19,630.38 |
$19,630.38 |
$19,630.38 |
$5,741.00
|
|
Anterior asis pad
|
$688.97 |
$688.97 |
$688.97 |
$134.14
|
|
Anterior swing band
|
$2,448.83 |
$2,448.83 |
$2,448.83 |
$476.73
|
|
Anterior thoracic derotation
|
$821.62 |
$821.62 |
$821.62 |
$159.96
|
|
Anterior thoracic extension
|
$1,897.45 |
$1,897.45 |
$1,897.45 |
$365.76
|
|
Antibody bacterium, not elsewhere specified
|
$193.80 |
$193.80 |
$193.80 |
$57.85
|
|
Antibody elution rbc reference
|
$144.00 |
$144.00 |
$144.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$189.60 |
$189.60 |
$189.60 |
$114.40
|
|
Antibody htlv-i
|
$40.20 |
$40.20 |
$40.20 |
$48.57
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$241.20 |
$241.20 |
$241.20 |
$218.30
|
|
Antibody id rbc panel
|
$292.20 |
$292.20 |
$292.20 |
$283.80
|
|
Antibody influenza virus
|
$111.00 |
$111.00 |
$111.00 |
$53.28
|
|
Antibody screen rbc
|
$120.60 |
$120.60 |
$120.60 |
$102.05
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$15,325.20 |
$15,325.20 |
$15,325.20 |
$6.57
|
|
Anti mog serum - sendout
|
$163.20 |
$163.20 |
$163.20 |
$112.81
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$20.40 |
$20.40 |
$20.40 |
$42.35
|
|
Ant instr 2-3 vert segm 22845
|
$72,342.87 |
$72,342.87 |
$72,342.87 |
$1,748.00
|
|
Antinuclear antibodies
|
$49.80 |
$49.80 |
$49.80 |
$90.00
|
|
Antinuclear antibodies titer
|
$49.80 |
$49.80 |
$49.80 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$47.40 |
$47.40 |
$47.40 |
$67.60
|
|
Antistreptolysin o screen
|
$180.00 |
$180.00 |
$180.00 |
$58.30
|
|
Antistreptolysin o titer
|
$114.60 |
$114.60 |
$114.60 |
$55.44
|
|
Antithrombin iii activity
|
$95.40 |
$95.40 |
$95.40 |
$112.70
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$19,587.30 |
$19,587.30 |
$19,587.30 |
$7,544.81
|
|
Aortic dysfunction/dilation
|
$992.40 |
$992.40 |
$992.40 |
$992.40
|
|
Aortic dysfunction/dilation
|
$2,646.00 |
$2,646.00 |
$2,646.00 |
$1,525.60
|
|
Apc gene dup/delet variants
|
$463.20 |
$463.20 |
$463.20 |
$400.00
|
|
Apc gene full sequence
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$1,255.20
|
|
Apc gene known fam variants
|
$288.60 |
$288.60 |
$288.60 |
$308.00
|
|
Apl(pml-rara) quant - sendout
|
$503.40 |
$503.40 |
$503.40 |
$465.60
|
|
Appendix Removal (Laparoscopic)
|
$76,002.84 |
$76,002.84 |
$76,002.84 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,909.20 |
$1,909.20 |
$1,909.20 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,734.60 |
$1,734.60 |
$1,734.60 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,269.60 |
$1,269.60 |
$1,269.60 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$3,141.00 |
$3,141.00 |
$3,141.00 |
$3,619.35
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,655.40 |
$1,655.40 |
$1,655.40 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,269.60 |
$1,269.60 |
$1,269.60 |
$549.08
|
|
Application long leg splint 29505
|
$507.60 |
$507.60 |
$507.60 |
$363.00
|
|
Application lower leg splint 29515
|
$511.80 |
$511.80 |
$511.80 |
$363.10
|
|
Application multi layer compression below knee (both sides)
|
$607.80 |
$607.80 |
$607.80 |
$378.35
|
|
Application of long leg cast 29345
|
$857.40 |
$857.40 |
$857.40 |
$499.20
|
|
Application of paste boot 29580
|
$377.40 |
$377.40 |
$377.40 |
$331.74
|
|
Application short leg cast 29405
|
$606.60 |
$606.60 |
$606.60 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$8,248.06 |
$8,248.06 |
$8,248.06 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$8,440.63 |
$8,440.63 |
$8,440.63 |
$2,198.30
|
|
Applicator tag rfid localizer 12gx7cm
|
$11,193.82 |
$11,193.82 |
$11,193.82 |
$1,051.88
|
|
Apply halo w/removal cranial
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$1,367.60
|
|
Apply interstit radiat compl
|
$6,859.80 |
$6,859.80 |
$6,859.80 |
$2,901.80
|
|
Apply rigid leg cast 29445
|
$832.80 |
$832.80 |
$832.80 |
$585.31
|
|
#aptt mix-1:1 incubated
|
$40.80 |
$40.80 |
$40.80 |
$146.25
|
|
Aquaporin-4 antibody cba each
|
$314.40 |
$314.40 |
$314.40 |
$109.00
|
