|
Alt/sgpt
|
$6.50 |
$6.50 |
$6.50 |
$49.00
|
|
Aluminum - quest
|
$68.90 |
$68.90 |
$68.90 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$3,108.95 |
$3,108.95 |
$3,108.95 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$433.55 |
$433.55 |
$433.55 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$35.07 |
$35.07 |
$35.07 |
$36.30
|
|
Amino acids quant 2-5
|
$152.10 |
$152.10 |
$152.10 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$45.50 |
$45.50 |
$45.50 |
$42.84
|
|
Aminolevulinic acid delta
|
$134.55 |
$134.55 |
$134.55 |
$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
|
$125.09 |
$125.09 |
$125.09 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$23.56 |
$23.56 |
$23.56 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$109.20 |
$109.20 |
$109.20 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$10,317.19 |
$10,317.19 |
$10,317.19 |
$15,167.75
|
|
Ammonia
|
$229.45 |
$229.45 |
$229.45 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$682.50 |
$682.50 |
$682.50 |
$942.60
|
|
Amniocentesis therapeutic
|
$795.60 |
$795.60 |
$795.60 |
$778.57
|
|
Amphetamine confirm urine -sendout
|
$70.20 |
$70.20 |
$70.20 |
$94.50
|
|
Amphetamines 5 or more
|
$267.80 |
$267.80 |
$267.80 |
$101.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$135.78 |
$135.78 |
$135.78 |
$130.08
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$342.26 |
$342.26 |
$342.26 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$29.18 |
$29.18 |
$29.18 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$32.53 |
$32.53 |
$32.53 |
$51.93
|
|
Amputation toe interphalangeal joint
|
$629.20 |
$629.20 |
$629.20 |
$3,691.20
|
|
Amputation toe metatarsophalangeal joint
|
$629.20 |
$629.20 |
$629.20 |
$3,777.93
|
|
Amylase
|
$78.65 |
$78.65 |
$78.65 |
$93.00
|
|
Ana ds-dna
|
$364.00 |
$364.00 |
$364.00 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$67.60 |
$67.60 |
$67.60 |
$110.98
|
|
Anal pressure record
|
$2,276.95 |
$2,276.95 |
$2,276.95 |
$955.86
|
|
Analysis gene f2 20210g>a variant
|
$182.00 |
$182.00 |
$182.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$154.70 |
$154.70 |
$154.70 |
$226.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$1,036.75 |
$1,036.75 |
$1,036.75 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$40.95 |
$40.95 |
$40.95 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$168.35 |
$168.35 |
$168.35 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$2,626.65
|
|
An fluoro guide for cvp
|
$1,014.65 |
$1,014.65 |
$1,014.65 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$9,084.40 |
$9,084.40 |
$9,084.40 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$33,278.70 |
$33,278.70 |
$33,278.70 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$32,739.20 |
$32,739.20 |
$32,739.20 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$5,315.70 |
$5,315.70 |
$5,315.70 |
$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
|
$34,806.20 |
$34,806.20 |
$34,806.20 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$9,429.55 |
$9,429.55 |
$9,429.55 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$24,984.70 |
$24,984.70 |
$24,984.70 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$9,084.40 |
$9,084.40 |
$9,084.40 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$18,168.80 |
$18,168.80 |
$18,168.80 |
$8,689.20
|
|
Ankle X-ray
|
$613.60 |
$613.60 |
$613.60 |
$339.44
|
|
Anl sp inf pmp w/mdreprg&fil
|
$481.65 |
$481.65 |
$481.65 |
$693.75
|
|
Annual Physical, Established Patient (age 18-39)
|
$88.40 |
$88.40 |
$88.40 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$88.40 |
$88.40 |
$88.40 |
$167.25
|
|
Annual Physical, New Patient (age 18-39)
|
$88.40 |
$88.40 |
$88.40 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$88.40 |
$88.40 |
$88.40 |
$188.15
|
|
Anoscopy control bleeding 46614
|
$3,970.85 |
$3,970.85 |
$3,970.85 |
$1,405.05
|
|
Antibody bacterium, not elsewhere specified
|
$172.25 |
$172.25 |
$172.25 |
$57.89
|
|
Antibody elution rbc reference
|
$765.70 |
$765.70 |
$765.70 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$283.40 |
$283.40 |
$283.40 |
$141.74
|
|
Antibody htlv-i
|
$88.40 |
$88.40 |
$88.40 |
$48.75
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$517.40 |
$517.40 |
$517.40 |
$220.73
|
|
Antibody id rbc panel
|
$355.55 |
$355.55 |
$355.55 |
$291.75
|
|
Antibody influenza virus
|
$72.80 |
$72.80 |
$72.80 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$271.05 |
$271.05 |
$271.05 |
$53.96
|
|
Antibody screen rbc
|
$18.20 |
$18.20 |
$18.20 |
$105.00
|
|
Antibody tetanus
|
$116.35 |
$116.35 |
$116.35 |
$61.98
|
|
Antidepressant not specified
|
$172.90 |
$172.90 |
$172.90 |
$89.50
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$7,689.18 |
$7,689.18 |
$7,689.18 |
$3.12
|
|
Anti mog serum - sendout
|
$2,050.75 |
$2,050.75 |
$2,050.75 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$200.85 |
$200.85 |
$200.85 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$191.10 |
$191.10 |
$191.10 |
$45.82
|
|
Antinuclear antibodies
|
$136.50 |
$136.50 |
$136.50 |
$91.70
|
|
Antinuclear antibodies titer
|
$172.25 |
$172.25 |
$172.25 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$514.15 |
$514.15 |
$514.15 |
$74.20
|
|
Antistreptolysin o titer
|
$29.25 |
$29.25 |
$29.25 |
$57.96
|
|
Antithrombin iii activity
|
$321.75 |
$321.75 |
$321.75 |
$115.23
|
|
Aortic dysfunction/dilation
|
$5,038.15 |
$5,038.15 |
$5,038.15 |
$653.18
|
|
Apc gene full sequence
|
$2,335.45 |
$2,335.45 |
$2,335.45 |
$1,076.40
|
|
Apc gene known fam variants
|
$889.85 |
$889.85 |
$889.85 |
$308.00
|
|
Apheresis plasma
|
$1,876.55 |
$1,876.55 |
$1,876.55 |
$3,411.50
|
|
Apheresis platelets
|
$1,884.35 |
$1,884.35 |
$1,884.35 |
$2,345.00
|
|
Apheresis rbc
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$3,348.50
|
|
Apheresis wbc
|
$1,678.30 |
$1,678.30 |
$1,678.30 |
$3,342.71
|
|
Apl(pml-rara) quant - sendout
|
$1,036.10 |
$1,036.10 |
$1,036.10 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$438.75 |
$438.75 |
$438.75 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$369.20 |
$369.20 |
$369.20 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$310.70 |
$310.70 |
$310.70 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$334.10 |
$334.10 |
$334.10 |
$3,150.00
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$369.20 |
$369.20 |
$369.20 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$276.90 |
$276.90 |
$276.90 |
$508.18
|
|
Application finger splntstatic 29130
|
$309.40 |
$309.40 |
$309.40 |
$216.80
|
|
Application multi layer compression below knee (both sides)
|
$676.00 |
$676.00 |
$676.00 |
$397.00
|
|
Application of forearm cast 29075
|
$221.00 |
$221.00 |
$221.00 |
$379.20
|
|
Application of long arm cast 29065
|
$221.00 |
$221.00 |
$221.00 |
$404.63
|
|
Application of paste boot 29580
|
$608.40 |
$608.40 |
$608.40 |
$331.74
|
|
Application short leg cast 29405
|
$560.30 |
$560.30 |
$560.30 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$265.20 |
$265.20 |
$265.20 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$261.95 |
$261.95 |
$261.95 |
$2,120.95
|
|
Applicator tag rfid localizer 12gx7cm
|
$37.32 |
$37.32 |
$37.32 |
$168.60
|
|
Appl modality 1/> areas paraffin bath 97018
|
$98.80 |
$98.80 |
$98.80 |
$69.55
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$109.20 |
$109.20 |
$109.20 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$676.00 |
$676.00 |
$676.00 |
$339.69
|
|
Apply finger cast 29086
|
$131.30 |
$131.30 |
$131.30 |
$225.29
|
