|
Allograft amnioexcel plus 17mm disk
|
$18,571.63 |
$18,571.63 |
$18,571.63 |
$3,380.36
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$14,237.81 |
$14,237.81 |
$14,237.81 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$11,550.05 |
$11,550.05 |
$11,550.05 |
$5,213.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$52,431.56 |
$52,431.56 |
$52,431.56 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$35,199.79 |
$35,199.79 |
$35,199.79 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$29,788.22 |
$29,788.22 |
$29,788.22 |
$4,732.60
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$28,125.87 |
$28,125.87 |
$28,125.87 |
$4,037.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$9,220.37 |
$9,220.37 |
$9,220.37 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$10,531.19 |
$10,531.19 |
$10,531.19 |
$1,707.62
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,674.00 |
$1,674.00 |
$1,674.00 |
$9.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$170.40 |
$170.40 |
$170.40 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$45.00 |
$45.00 |
$45.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$222.60 |
$222.60 |
$222.60 |
$102.00
|
|
Alprostadil for injection
|
$690.96 |
$690.96 |
$690.96 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$35,905.50 |
$35,905.50 |
$35,905.50 |
$14,503.48
|
|
Alt/sgpt
|
$84.60 |
$84.60 |
$84.60 |
$44.68
|
|
Aluminum - quest
|
$133.20 |
$133.20 |
$133.20 |
$81.49
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$30.60 |
$30.60 |
$30.60 |
$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
|
$29.76 |
$29.76 |
$29.76 |
$37.32
|
|
Aminolevulinic acid delta
|
$39.60 |
$39.60 |
$39.60 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$16.32 |
$16.32 |
$16.32 |
$45.56
|
|
Amiodarone 50 mg/ml intravenous solution
|
$18.00 |
$18.00 |
$18.00 |
$61.68
|
|
Ammonia
|
$96.60 |
$96.60 |
$96.60 |
$114.40
|
|
Amniocentesisdiagnostic 59000
|
$744.00 |
$744.00 |
$744.00 |
$943.50
|
|
Amniotic fluid scan
|
$115.80 |
$115.80 |
$115.80 |
$42.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$195.84 |
$195.84 |
$195.84 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$665.94 |
$665.94 |
$665.94 |
$451.51
|
|
Ampicillin 1 gram solution for injection
|
$54.72 |
$54.72 |
$54.72 |
$63.82
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$37.74 |
$37.74 |
$37.74 |
$58.36
|
|
Amp metatarsal w/toe single 28810
|
$19,381.26 |
$19,381.26 |
$19,381.26 |
$4,313.40
|
|
Amputation toe interphalangeal joint
|
$29,993.50 |
$29,993.50 |
$29,993.50 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$10,032.00 |
$10,032.00 |
$10,032.00 |
$3,814.50
|
|
Amylase
|
$124.80 |
$124.80 |
$124.80 |
$83.20
|
|
Ana ds-dna
|
$82.20 |
$82.20 |
$82.20 |
$58.63
|
|
Analysis gene f2 20210g>a variant
|
$147.60 |
$147.60 |
$147.60 |
$207.48
|
|
Analysis gene f5 leiden variant
|
$293.40 |
$293.40 |
$293.40 |
$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
|
$684.00 |
$684.00 |
$684.00 |
$510.17
|
|
Angio balloon ctrl dialysis seg add-on
|
$5,988.60 |
$5,988.60 |
$5,988.60 |
$5,341.83
|
|
Angiotensin ii
|
$133.80 |
$133.80 |
$133.80 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$688.62 |
$688.62 |
$688.62 |
$5,172.70
|
|
Angio trnslmnl balloon same artery ea addl
|
$13,952.40 |
$13,952.40 |
$13,952.40 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$14,632.80 |
$14,632.80 |
$14,632.80 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$5,988.60 |
$5,988.60 |
$5,988.60 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$5,988.60 |
$5,988.60 |
$5,988.60 |
$8,466.00
|
|
Anidulafungin injection
|
$778.86 |
$778.86 |
$778.86 |
$297.63
|
|
Ankle arthroscopy/surgery
|
$30,025.40 |
$30,025.40 |
$30,025.40 |
$3,839.54
|
|
Ankle X-ray
|
$580.80 |
$580.80 |
$580.80 |
$351.20
|
|
Anl sp inf pmp w/mdreprg&fil
|
$470.40 |
$470.40 |
$470.40 |
$630.96
|
|
Anodyne therapy charges pt
|
$71.40 |
$71.40 |
$71.40 |
$41.02
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$19,928.28 |
$19,928.28 |
$19,928.28 |
$5,741.00
|
|
Anterior asis pad
|
$212.44 |
$212.44 |
$212.44 |
$134.14
|
|
Anterior swing band
|
$755.09 |
$755.09 |
$755.09 |
$476.73
|
|
Anterior thoracic derotation
|
$253.34 |
$253.34 |
$253.34 |
$159.96
|
|
Anterior thoracic extension
|
$585.07 |
$585.07 |
$585.07 |
$365.76
|
|
Antibody bacterium, not elsewhere specified
|
$135.60 |
$135.60 |
$135.60 |
$57.85
|
|
Antibody elution rbc reference
|
$271.80 |
$271.80 |
$271.80 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$102.00 |
$102.00 |
$102.00 |
$114.40
|
|
Antibody htlv-i
|
$40.20 |
$40.20 |
$40.20 |
$48.57
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$264.00 |
$264.00 |
$264.00 |
$218.30
|
|
Antibody id rbc panel
|
$669.60 |
$669.60 |
$669.60 |
$283.80
|
|
Antibody influenza virus
|
$54.00 |
$54.00 |
$54.00 |
$53.28
|
|
Antibody lymphocytic choriomeningitis
|
$21.60 |
$21.60 |
$21.60 |
$53.96
|
|
Antibody screen rbc
|
$186.00 |
$186.00 |
$186.00 |
$102.05
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$11,048.40 |
$11,048.40 |
$11,048.40 |
$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
|
$40,098.19 |
$40,098.19 |
$40,098.19 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$87,266.49 |
$87,266.49 |
$87,266.49 |
$1,816.80
|
|
Antinuclear antibodies
|
$231.60 |
$231.60 |
$231.60 |
$90.00
|
|
Antinuclear antibodies titer
|
$115.80 |
$115.80 |
$115.80 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$53.40 |
$53.40 |
$53.40 |
$67.60
|
|
Antistreptolysin o screen
|
$55.20 |
$55.20 |
$55.20 |
$58.30
|
|
Antistreptolysin o titer
|
$179.40 |
$179.40 |
$179.40 |
$55.44
|
|
Antithrombin iii activity
|
$130.80 |
$130.80 |
$130.80 |
$112.70
|
|
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
|
$319.20 |
$319.20 |
$319.20 |
$308.00
|
|
Apl(pml-rara) quant - sendout
|
$330.60 |
$330.60 |
$330.60 |
$465.60
|
|
Appendix Removal (Laparoscopic)
|
$34,913.17 |
$34,913.17 |
$34,913.17 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$58,681.24 |
$58,681.24 |
$58,681.24 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$2,990.40 |
$2,990.40 |
$2,990.40 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$2,990.40 |
$2,990.40 |
$2,990.40 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$11,095.12 |
$11,095.12 |
$11,095.12 |
$3,619.35
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$4,933.80 |
$4,933.80 |
$4,933.80 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$2,990.40 |
$2,990.40 |
$2,990.40 |
$549.08
|
|
Application multi layer compression below knee (both sides)
|
$449.40 |
$449.40 |
$449.40 |
$378.35
|
|
Application of paste boot 29580
|
$449.40 |
$449.40 |
$449.40 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$5,570.32 |
$5,570.32 |
$5,570.32 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,990.40 |
$2,990.40 |
$2,990.40 |
$2,198.30
|
|
Applicator tag rfid localizer 12gx7cm
|
$7,432.90 |
$7,432.90 |
$7,432.90 |
$1,051.88
|
|
Appl modality 1/> areas paraffin bath 97018
|
$140.40 |
$140.40 |
$140.40 |
$65.30
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$96.60 |
$96.60 |
$96.60 |
$75.98
|
|
Apply halo w/removal cranial
|
$2,955.60 |
$2,955.60 |
$2,955.60 |
$1,367.60
|
|
Apply interstit radiat compl
|
$3,532.80 |
$3,532.80 |
$3,532.80 |
$2,901.80
|
