|
11-desoxycortisol - sendout
|
$62.40 |
$62.40 |
$62.40 |
$82.50
|
|
17-hydroxypregnenolone
|
$60.00 |
$60.00 |
$60.00 |
$78.00
|
|
17-ketosteroids
|
$29.40 |
$29.40 |
$29.40 |
$42.90
|
|
2d tte w or without fol w/con,co
|
$2,996.40 |
$2,996.40 |
$2,996.40 |
$1,085.40
|
|
3d recon without postprocess indpndt
|
$523.80 |
$523.80 |
$523.80 |
$454.23
|
|
5' nucleotidase - sendout
|
$92.40 |
$92.40 |
$92.40 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$90.60 |
$90.60 |
$90.60 |
$92.82
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$94.20 |
$94.20 |
$94.20 |
$52.20
|
|
Abdominal CT scan (with and without contrast)
|
$2,298.60 |
$2,298.60 |
$2,298.60 |
$1,951.30
|
|
Abdominal CT scan (with contrast)
|
$1,840.80 |
$1,840.80 |
$1,840.80 |
$1,632.95
|
|
Abdominal CT scan (without contrast)
|
$1,788.00 |
$1,788.00 |
$1,788.00 |
$1,318.20
|
|
Abdominal MRI (with and without contrast)
|
$2,583.00 |
$2,583.00 |
$2,583.00 |
$2,929.50
|
|
Abdominal MRI (with contrast)
|
$2,367.00 |
$2,367.00 |
$2,367.00 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$2,152.20 |
$2,152.20 |
$2,152.20 |
$1,925.45
|
|
Abdominal pad
|
$222.63 |
$222.63 |
$222.63 |
$196.11
|
|
Abdominal Ultrasound (complete)
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$756.60
|
|
Abdominal Ultrasound (limited)
|
$778.20 |
$778.20 |
$778.20 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$935.40 |
$935.40 |
$935.40 |
$1,176.00
|
|
Abduct control hip semi-flex
|
$567.46 |
$567.46 |
$567.46 |
$499.86
|
|
Abduction bar jointed adjust
|
$676.23 |
$676.23 |
$676.23 |
$595.67
|
|
Abduction rotation bar shoe
|
$239.14 |
$239.14 |
$239.14 |
$210.65
|
|
Abduct rotation bar without shoe
|
$218.67 |
$218.67 |
$218.67 |
$192.62
|
|
Abl1 gene
|
$768.00 |
$768.00 |
$768.00 |
$632.80
|
|
Ablation of upper extremity nerves rf
|
$540.00 |
$540.00 |
$540.00 |
$1,055.60
|
|
Acetaminophen level
|
$129.60 |
$129.60 |
$129.60 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$128.52 |
$128.52 |
$128.52 |
$114.46
|
|
Acetone qualitative
|
$34.20 |
$34.20 |
$34.20 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.20 |
$61.20 |
$61.20 |
$61.80
|
|
Acetylcholinesterase assay
|
$91.20 |
$91.20 |
$91.20 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$13.86 |
$13.86 |
$13.86 |
$300.00
|
|
Acetylcysteine non-comp unit
|
$113.82 |
$113.82 |
$113.82 |
$29.01
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$58.80 |
$58.80 |
$58.80 |
$42.28
|
|
Acute hepatitis panel
|
$308.40 |
$308.40 |
$308.40 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$117.06 |
$117.06 |
$117.06 |
$62.16
|
|
#acylcarnitineprfl
|
$178.80 |
$178.80 |
$178.80 |
$95.94
|
|
Adapter b 8 channel 10cm
|
$11,391.41 |
$11,391.41 |
$11,391.41 |
$5,782.66
|
|
Add le poly knee custom kafo
|
$512.77 |
$512.77 |
$512.77 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$25.50 |
$25.50 |
$25.50 |
$234.26
|
|
Adenovirus antibody,serum - quest
|
$78.00 |
$78.00 |
$78.00 |
$64.35
|
|
Adh-sendout
|
$80.40 |
$80.40 |
$80.40 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$166.56 |
$166.56 |
$166.56 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$51.60 |
$51.60 |
$51.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$514.20 |
$514.20 |
$514.20 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$514.20 |
$514.20 |
$514.20 |
$644.28
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$514.20 |
$514.20 |
$514.20 |
$439.45
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$365.40 |
$365.40 |
$365.40 |
$207.94
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$365.40 |
$365.40 |
$365.40 |
$260.00
|
|
Administration immunization 1 vaccine
|
$162.60 |
$162.60 |
$162.60 |
$66.51
|
|
Administration immunization each additional vaccine
|
$162.60 |
$162.60 |
$162.60 |
$45.80
|
|
Administration vaccine hepatitis b
|
$162.60 |
$162.60 |
$162.60 |
$54.34
|
|
Administration vaccine influenza virus
|
$117.00 |
$117.00 |
$117.00 |
$46.20
|
|
Administration vaccine pneumococcal
|
$117.00 |
$117.00 |
$117.00 |
$46.80
|
|
_afb id by dna probe rflx ast
|
$78.00 |
$78.00 |
$78.00 |
$89.70
|
|
#afb mycobacteria suscep. #1
|
$81.00 |
$81.00 |
$81.00 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$403.80 |
$403.80 |
$403.80 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,212.41 |
$1,212.41 |
$1,212.41 |
$1,067.98
|
|
Afo molded plas rig ant tib
|
$2,767.63 |
$2,767.63 |
$2,767.63 |
$2,412.47
|
|
Afo molded to patient plasti
|
$1,157.63 |
$1,157.63 |
$1,157.63 |
$825.89
|
|
Afo rig ant tib tcf/= custom
|
$2,396.88 |
$2,396.88 |
$2,396.88 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$753.30 |
$753.30 |
$753.30 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,084.55 |
$1,084.55 |
$1,084.55 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,103.47 |
$1,103.47 |
$1,103.47 |
$696.71
|
|
Afo spiral molded to pt plas
|
$2,065.75 |
$2,065.75 |
$2,065.75 |
$1,819.66
|
|
Afo sprng wir drsflx calf bd
|
$766.35 |
$766.35 |
$766.35 |
$675.05
|
|
Afo supramalleolar custom
|
$1,511.48 |
$1,511.48 |
$1,511.48 |
$1,331.42
|
|
Afo tib fx cast plaster mold
|
$2,117.20 |
$2,117.20 |
$2,117.20 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$2,070.31 |
$2,070.31 |
$2,070.31 |
$1,514.10
|
|
Afo tibial fracture soft
|
$1,355.14 |
$1,355.14 |
$1,355.14 |
$855.63
|
|
Afo, walk boot type, cus fab
|
$4,262.41 |
$4,262.41 |
$4,262.41 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$1,715.98 |
$1,715.98 |
$1,715.98 |
$969.02
|
|
Ak/knee disartic pelvic band
|
$210.65 |
$210.65 |
$210.65 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$261.98 |
$261.98 |
$261.98 |
$230.77
|
|
Ak sleeve susp neoprene/equa
|
$474.61 |
$474.61 |
$474.61 |
$418.06
|
|
Albumin body fluid quantitative each specimen
|
$68.40 |
$68.40 |
$68.40 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$189.96 |
$189.96 |
$189.96 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$189.72 |
$189.72 |
$189.72 |
$251.66
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$119.40 |
$119.40 |
$119.40 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$51.00 |
$51.00 |
$51.00 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$1.98 |
$1.98 |
$1.98 |
$6.62
|
|
Albuterol non-comp con
|
$1.92 |
$1.92 |
$1.92 |
$5.61
|
|
Albuterol non-comp unit
|
$1.50 |
$1.50 |
$1.50 |
$5.11
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$138.00 |
$138.00 |
$138.00 |
$95.94
|
|
Alcohol/subs interv 15-30mn
|
$27.60 |
$27.60 |
$27.60 |
$51.52
|
|
Alcohol/subs interv >30 min
|
$249.00 |
$249.00 |
$249.00 |
$165.17
|
|
Alkaline phosphatase
|
$70.80 |
$70.80 |
$70.80 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$33.00 |
$33.00 |
$33.00 |
$50.00
|
|
Allergen egg white ige
|
$49.20 |
$49.20 |
$49.20 |
$36.82
|
|
Allergen specific ige qual multi scrn ea
|
$48.60 |
$48.60 |
$48.60 |
$24.00
|
|
Allograft 160mg placental salera mini membrane
|
$7,505.30 |
$7,505.30 |
$7,505.30 |
$5,481.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$14,800.27 |
$14,800.27 |
$14,800.27 |
$5,000.92
|
|
Allograft amnioexcel plus 17mm disk
|
$18,571.63 |
$18,571.63 |
$18,571.63 |
$2,747.07
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$11,550.05 |
$11,550.05 |
$11,550.05 |
$6,773.79
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$52,431.56 |
$52,431.56 |
$52,431.56 |
$24,912.00
|
|
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 |
$5,380.65
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$28,125.87 |
$28,125.87 |
$28,125.87 |
$3,604.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$9,220.37 |
$9,220.37 |
$9,220.37 |
$4,624.54
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$10,531.19 |
$10,531.19 |
$10,531.19 |
$1,432.84
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$207.00 |
$207.00 |
$207.00 |
$164.45
|
