|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,174.10 |
$10,174.10 |
$10,174.10 |
$5,213.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,185.43 |
$46,185.43 |
$46,185.43 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$31,006.47 |
$31,006.47 |
$31,006.47 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$26,239.58 |
$26,239.58 |
$26,239.58 |
$4,732.60
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,775.26 |
$24,775.26 |
$24,775.26 |
$4,037.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,121.96 |
$8,121.96 |
$8,121.96 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$9,276.62 |
$9,276.62 |
$9,276.62 |
$1,707.62
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$9.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$175.20 |
$175.20 |
$175.20 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$45.00 |
$45.00 |
$45.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$121.80 |
$121.80 |
$121.80 |
$102.00
|
|
Alprostadil for injection
|
$802.74 |
$802.74 |
$802.74 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$41,713.74 |
$41,713.74 |
$41,713.74 |
$14,503.48
|
|
Alt/sgpt
|
$52.20 |
$52.20 |
$52.20 |
$44.68
|
|
Altuviiio per factor viii iu
|
$65,640.00 |
$65,640.00 |
$65,640.00 |
$13.32
|
|
Aluminum - quest
|
$87.60 |
$87.60 |
$87.60 |
$81.49
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$55.26 |
$55.26 |
$55.26 |
$38.68
|
|
Amino acid screen, urine
|
$159.00 |
$159.00 |
$159.00 |
$76.05
|
|
Amino acids quant 2-5
|
$21.60 |
$21.60 |
$21.60 |
$138.03
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$34.56 |
$34.56 |
$34.56 |
$37.32
|
|
Aminolevulinic acid delta
|
$150.00 |
$150.00 |
$150.00 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$18.96 |
$18.96 |
$18.96 |
$45.56
|
|
Amiodarone 50 mg/ml intravenous solution
|
$20.88 |
$20.88 |
$20.88 |
$61.68
|
|
Ammonia
|
$148.80 |
$148.80 |
$148.80 |
$114.40
|
|
Amniocentesisdiagnostic 59000
|
$753.60 |
$753.60 |
$753.60 |
$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
|
$227.52 |
$227.52 |
$227.52 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$773.64 |
$773.64 |
$773.64 |
$451.51
|
|
Ampicillin 1 gram solution for injection
|
$35.58 |
$35.58 |
$35.58 |
$63.82
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$345.12 |
$345.12 |
$345.12 |
$58.36
|
|
Amp metatarsal w/toe single 28810
|
$10,344.78 |
$10,344.78 |
$10,344.78 |
$4,313.40
|
|
Amputation toe interphalangeal joint
|
$11,556.60 |
$11,556.60 |
$11,556.60 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$10,915.26 |
$10,915.26 |
$10,915.26 |
$3,814.50
|
|
Amylase
|
$101.40 |
$101.40 |
$101.40 |
$83.20
|
|
Ana ds-dna
|
$225.60 |
$225.60 |
$225.60 |
$58.63
|
|
Analgesics non-opioid 3-5
|
$45.00 |
$45.00 |
$45.00 |
$16.24
|
|
Analysis gene f2 20210g>a variant
|
$951.60 |
$951.60 |
$951.60 |
$207.48
|
|
Analysis gene f5 leiden variant
|
$370.80 |
$370.80 |
$370.80 |
$219.13
|
|
Anca screen with reflex to titer -quest
|
$243.60 |
$243.60 |
$243.60 |
$100.32
|
|
An cholangiogram percutaneous compl
|
$6,150.60 |
$6,150.60 |
$6,150.60 |
$2,624.13
|
|
An fluoro guide for cvp
|
$428.40 |
$428.40 |
$428.40 |
$510.17
|
|
Angio balloon ctrl dialysis seg add-on
|
$11,725.80 |
$11,725.80 |
$11,725.80 |
$5,341.83
|
|
Angiotensin ii
|
$133.80 |
$133.80 |
$133.80 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,442.46 |
$1,442.46 |
$1,442.46 |
$5,172.70
|
|
Angio trnslmnl balloon same artery ea addl
|
$11,920.20 |
$11,920.20 |
$11,920.20 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$11,920.20 |
$11,920.20 |
$11,920.20 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$11,725.80 |
$11,725.80 |
$11,725.80 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$11,725.80 |
$11,725.80 |
$11,725.80 |
$8,466.00
|
|
Ankle X-ray
|
$401.40 |
$401.40 |
$401.40 |
$351.20
|
|
Anodyne therapy charges pt
|
$86.40 |
$86.40 |
$86.40 |
$41.02
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$15,902.46 |
$15,902.46 |
$15,902.46 |
$5,741.00
|
|
Anterior asis pad
|
$187.13 |
$187.13 |
$187.13 |
$134.14
|
|
Anterior swing band
|
$665.14 |
$665.14 |
$665.14 |
$476.73
|
|
Anterior thoracic derotation
|
$223.16 |
$223.16 |
$223.16 |
$159.96
|
|
Anterior thoracic extension
|
$515.37 |
$515.37 |
$515.37 |
$365.76
|
|
Antibody bacterium, not elsewhere specified
|
$117.00 |
$117.00 |
$117.00 |
$57.85
|
|
Antibody elution rbc reference
|
$349.20 |
$349.20 |
$349.20 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$133.80 |
$133.80 |
$133.80 |
$114.40
|
|
Antibody htlv-i
|
$172.20 |
$172.20 |
$172.20 |
$48.57
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$435.60 |
$435.60 |
$435.60 |
$218.30
|
|
Antibody id rbc panel
|
$539.40 |
$539.40 |
$539.40 |
$283.80
|
|
Antibody influenza virus
|
$146.40 |
$146.40 |
$146.40 |
$53.28
|
|
Antibody screen rbc
|
$121.80 |
$121.80 |
$121.80 |
$102.05
|
|
Antibody tetanus
|
$115.20 |
$115.20 |
$115.20 |
$52.20
|
|
Anti-inhibitor
|
$25,920.00 |
$25,920.00 |
$25,920.00 |
$8.70
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$20.40 |
$20.40 |
$20.40 |
$42.35
|
|
Ant instr 2-3 vert segm 22845
|
$61,092.74 |
$61,092.74 |
$61,092.74 |
$1,748.00
|
|
Antinuclear antibodies
|
$310.20 |
$310.20 |
$310.20 |
$90.00
|
|
Antinuclear antibodies titer
|
$195.60 |
$195.60 |
$195.60 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$168.60 |
$168.60 |
$168.60 |
$67.60
|
|
Antistreptolysin o screen
|
$254.40 |
$254.40 |
$254.40 |
$58.30
|
|
Antistreptolysin o titer
|
$242.40 |
$242.40 |
$242.40 |
$55.44
|
|
Antithrombin iii activity
|
$127.80 |
$127.80 |
$127.80 |
$112.70
|
|
Antithrombin iii injection
|
$8,563.20 |
$8,563.20 |
$8,563.20 |
$12.34
|
|
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
|
$347.40 |
$347.40 |
$347.40 |
$400.00
|
|
Apc gene full sequence
|
$1,354.80 |
$1,354.80 |
$1,354.80 |
$1,255.20
|
|
Apc gene known fam variants
|
$319.20 |
$319.20 |
$319.20 |
$308.00
|
|
Apl(pml-rara) quant - sendout
|
$377.40 |
$377.40 |
$377.40 |
$465.60
|
|
Appendix Removal (Laparoscopic)
|
$32,084.96 |
$32,084.96 |
$32,084.96 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,279.40 |
$2,279.40 |
$2,279.40 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$2,279.40 |
$2,279.40 |
$2,279.40 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,059.60 |
$1,059.60 |
$1,059.60 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,279.40 |
$2,279.40 |
$2,279.40 |
$3,619.35
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,279.40 |
$2,279.40 |
$2,279.40 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,059.60 |
$1,059.60 |
$1,059.60 |
$549.08
|
|
Application multi layer compression below knee (both sides)
|
$693.00 |
$693.00 |
$693.00 |
$378.35
|
|
Application of paste boot 29580
|
$633.60 |
$633.60 |
$633.60 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,513.80 |
$1,513.80 |
$1,513.80 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,027.60 |
$3,027.60 |
$3,027.60 |
$2,198.30
|
|
Applicator tag rfid localizer 12gx7cm
|
$6,547.43 |
$6,547.43 |
$6,547.43 |
$1,051.88
|
|
Appl modality 1/> areas paraffin bath 97018
|
$162.60 |
$162.60 |
$162.60 |
$65.30
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$153.60 |
$153.60 |
$153.60 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$60.60 |
$60.60 |
$60.60 |
$49.92
|
|
Apply halo w/removal cranial
|
$1,120.80 |
$1,120.80 |
$1,120.80 |
$1,367.60
|
|
Apply interstit radiat compl
|
$3,403.20 |
$3,403.20 |
$3,403.20 |
$2,901.80
|
|
Apply intrcav radiat interm
|
$2,433.00 |
$2,433.00 |
$2,433.00 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$2,353.80 |
$2,353.80 |
$2,353.80 |
$1,269.97
|
|
Apply rigid leg cast 29445
|
$1,446.60 |
$1,446.60 |
$1,446.60 |
$585.31
|
