|
11-desoxycortisol - sendout
|
$63.00 |
$63.00 |
$63.00 |
$82.50
|
|
17-hydroxypregnenolone
|
$82.80 |
$82.80 |
$82.80 |
$85.15
|
|
17-ketosteroids
|
$65.40 |
$65.40 |
$65.40 |
$44.88
|
|
3d ech img cgen car anomal
|
$1,066.80 |
$1,066.80 |
$1,066.80 |
$463.68
|
|
3d recon without postprocess indpndt
|
$70.20 |
$70.20 |
$70.20 |
$455.83
|
|
5' nucleotidase - sendout
|
$63.00 |
$63.00 |
$63.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$171.60 |
$171.60 |
$171.60 |
$89.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$65.40 |
$65.40 |
$65.40 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$1,842.60 |
$1,842.60 |
$1,842.60 |
$1,939.00
|
|
Abdominal CT scan (with contrast)
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$1,632.95
|
|
Abdominal CT scan (without contrast)
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,330.00
|
|
Abdominal MRI (with and without contrast)
|
$3,306.60 |
$3,306.60 |
$3,306.60 |
$2,897.05
|
|
Abdominal MRI (with contrast)
|
$2,856.00 |
$2,856.00 |
$2,856.00 |
$2,169.60
|
|
Abdominal MRI (without contrast)
|
$2,605.20 |
$2,605.20 |
$2,605.20 |
$1,902.00
|
|
Abdominal pad
|
$196.11 |
$196.11 |
$196.11 |
$196.11
|
|
Abdominal paracentesis w/image guidance
|
$3,688.80 |
$3,688.80 |
$3,688.80 |
$1,661.13
|
|
Abdominal Ultrasound (complete)
|
$2,063.40 |
$2,063.40 |
$2,063.40 |
$758.43
|
|
Abdominal Ultrasound (limited)
|
$825.60 |
$825.60 |
$825.60 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$1,374.60 |
$1,374.60 |
$1,374.60 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$499.86 |
$499.86 |
$499.86 |
$499.86
|
|
Abduction bar jointed adjust
|
$595.67 |
$595.67 |
$595.67 |
$595.67
|
|
Abduction rotation bar shoe
|
$210.65 |
$210.65 |
$210.65 |
$210.65
|
|
Abduct rotation bar without shoe
|
$192.62 |
$192.62 |
$192.62 |
$192.62
|
|
Abl1 gene
|
$732.60 |
$732.60 |
$732.60 |
$668.85
|
|
Ablate pulm tumor perq rf
|
$4,102.80 |
$4,102.80 |
$4,102.80 |
$6,904.15
|
|
Ablation cryo pq liver tumor(s)
|
$4,161.00 |
$4,161.00 |
$4,161.00 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$2,077.80 |
$2,077.80 |
$2,077.80 |
$961.20
|
|
Acetaminophen level
|
$130.80 |
$130.80 |
$130.80 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$172.74 |
$172.74 |
$172.74 |
$113.40
|
|
Acetone qualitative
|
$34.80 |
$34.80 |
$34.80 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$91.80 |
$91.80 |
$91.80 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$23.22 |
$23.22 |
$23.22 |
$300.00
|
|
Acetylcysteine non-comp unit
|
$66.36 |
$66.36 |
$66.36 |
$29.01
|
|
Acne surgery 10040
|
$377.40 |
$377.40 |
$377.40 |
$260.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$110.40 |
$110.40 |
$110.40 |
$39.70
|
|
Acute hepatitis panel
|
$294.60 |
$294.60 |
$294.60 |
$281.05
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$48.96 |
$48.96 |
$48.96 |
$61.85
|
|
#acylcarnitineprfl
|
$45.60 |
$45.60 |
$45.60 |
$105.60
|
|
Adapter b 8 channel 10cm
|
$10,034.36 |
$10,034.36 |
$10,034.36 |
$4,499.69
|
|
Add le poly knee custom kafo
|
$451.68 |
$451.68 |
$451.68 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$10.92 |
$10.92 |
$10.92 |
$234.26
|
|
Adenovirus antibody,serum - quest
|
$86.40 |
$86.40 |
$86.40 |
$63.00
|
|
Adh-sendout
|
$292.80 |
$292.80 |
$292.80 |
$109.71
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$189.66 |
$189.66 |
$189.66 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$278.40 |
$278.40 |
$278.40 |
$233.11
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$229.80 |
$229.80 |
$229.80 |
$307.45
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$373.20 |
$373.20 |
$373.20 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$394.80 |
$394.80 |
$394.80 |
$439.45
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$160.20 |
$160.20 |
$160.20 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$168.00 |
$168.00 |
$168.00 |
$260.00
|
|
Administration immunization 1 vaccine
|
$48.00 |
$48.00 |
$48.00 |
$65.00
|
|
Administration immunization each additional vaccine
|
$48.00 |
$48.00 |
$48.00 |
$46.13
|
|
Administration vaccine hepatitis b
|
$91.80 |
$91.80 |
$91.80 |
$51.07
|
|
Administration vaccine influenza virus
|
$35.40 |
$35.40 |
$35.40 |
$46.80
|
|
Administration vaccine pneumococcal
|
$35.40 |
$35.40 |
$35.40 |
$46.92
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$14,841.48 |
$14,841.48 |
$14,841.48 |
$12,791.80
|
|
_afb id by dna probe rflx ast
|
$66.00 |
$66.00 |
$66.00 |
$89.70
|
|
#afb mycobacteria suscep. #1
|
$82.20 |
$82.20 |
$82.20 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$156.00 |
$156.00 |
$156.00 |
$268.63
|
|
Afo molded ankle gauntlet
|
$1,067.98 |
$1,067.98 |
$1,067.98 |
$1,067.98
|
|
Afo molded plas rig ant tib
|
$2,437.93 |
$2,437.93 |
$2,437.93 |
$2,412.47
|
|
Afo molded to patient plasti
|
$1,019.72 |
$1,019.72 |
$1,019.72 |
$757.77
|
|
Afo rig ant tib tcf/= custom
|
$2,111.34 |
$2,111.34 |
$2,111.34 |
$1,513.36
|
|
Afo sing bar clasp attach sh
|
$663.56 |
$663.56 |
$663.56 |
$663.56
|
|
Afo sing solid stirrup calf
|
$955.35 |
$955.35 |
$955.35 |
$955.35
|
|
Afo sing upright with adjust s
|
$972.01 |
$972.01 |
$972.01 |
$696.71
|
|
Afo spiral molded to pt plas
|
$1,819.66 |
$1,819.66 |
$1,819.66 |
$1,819.66
|
|
Afo sprng wir drsflx calf bd
|
$675.05 |
$675.05 |
$675.05 |
$675.05
|
|
Afo supramalleolar custom
|
$1,331.42 |
$1,331.42 |
$1,331.42 |
$1,331.42
|
|
Afo tib fx cast plaster mold
|
$1,864.98 |
$1,864.98 |
$1,864.98 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$1,823.68 |
$1,823.68 |
$1,823.68 |
$1,514.10
|
|
Afo tibial fracture soft
|
$1,193.71 |
$1,193.71 |
$1,193.71 |
$855.63
|
|
Afo, walk boot type, cus fab
|
$3,754.63 |
$3,754.63 |
$3,754.63 |
$2,500.10
|
|
Afo w/ankle joint, prefab
|
$1,511.55 |
$1,511.55 |
$1,511.55 |
$680.55
|
|
Airway resistance by impulse oscillometry 94728
|
$316.80 |
$316.80 |
$316.80 |
$269.36
|
|
Ak/knee disartic pelvic band
|
$185.56 |
$185.56 |
$185.56 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$230.77 |
$230.77 |
$230.77 |
$202.75
|
|
Ak sleeve susp neoprene/equa
|
$418.06 |
$418.06 |
$418.06 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$96.00 |
$96.00 |
$96.00 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$208.80 |
$208.80 |
$208.80 |
$235.92
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$96.00 |
$96.00 |
$96.00 |
$57.71
|
|
Albumin serum plasma or whole blood
|
$42.00 |
$42.00 |
$42.00 |
$39.60
|
|
Albuterol ipratrop non-comp
|
$1.56 |
$1.56 |
$1.56 |
$5.85
|
|
Albuterol non-comp con
|
$1.92 |
$1.92 |
$1.92 |
$5.00
|
|
Albuterol non-comp unit
|
$5.16 |
$5.16 |
$5.16 |
$5.11
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$139.20 |
$139.20 |
$139.20 |
$98.40
|
|
Alcohol/subs interv >30 min
|
$64.20 |
$64.20 |
$64.20 |
$165.17
|
|
Alkaline phosphatase
|
$46.80 |
$46.80 |
$46.80 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$33.60 |
$33.60 |
$33.60 |
$48.60
|
|
Allergen egg white ige
|
$36.60 |
$36.60 |
$36.60 |
$37.00
|
|
Allergen specific ige qual multi scrn ea
|
$23.40 |
$23.40 |
$23.40 |
$22.75
|
|
Allograft 160mg placental salera mini membrane
|
$6,611.20 |
$6,611.20 |
$6,611.20 |
$5,481.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,037.12 |
$13,037.12 |
$13,037.12 |
$4,118.96
|
|
Allograft amnioexcel plus 17mm disk
|
$16,359.20 |
$16,359.20 |
$16,359.20 |
$2,386.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$12,541.67 |
$12,541.67 |
$12,541.67 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,174.10 |
$10,174.10 |
$10,174.10 |
$6,773.79
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,185.43 |
$46,185.43 |
$46,185.43 |
$24,973.80
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$31,006.47 |
$31,006.47 |
$31,006.47 |
$724.00
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$26,239.58 |
$26,239.58 |
$26,239.58 |
$5,378.46
|
