|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,775.26 |
$24,775.26 |
$24,775.26 |
$3,668.28
|
|
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 |
$1,501.61
|
|
Alpha-fetoprotein amniotic
|
$45.00 |
$45.00 |
$45.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$135.00 |
$135.00 |
$135.00 |
$103.80
|
|
Alteplase 100 mg infusion from pyxis vial
|
$38,281.62 |
$38,281.62 |
$38,281.62 |
$15,616.81
|
|
Alt/sgpt
|
$57.60 |
$57.60 |
$57.60 |
$45.50
|
|
Aluminum - quest
|
$102.00 |
$102.00 |
$102.00 |
$81.49
|
|
Amino acid screen, urine
|
$176.40 |
$176.40 |
$176.40 |
$77.00
|
|
Amino acids quant 2-5
|
$21.60 |
$21.60 |
$21.60 |
$138.03
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$31.68 |
$31.68 |
$31.68 |
$37.32
|
|
Aminolevulinic acid delta
|
$175.20 |
$175.20 |
$175.20 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$7.50 |
$7.50 |
$7.50 |
$45.02
|
|
Amiodarone 50 mg/ml intravenous solution
|
$12.90 |
$12.90 |
$12.90 |
$61.43
|
|
Ammonia
|
$165.60 |
$165.60 |
$165.60 |
$116.64
|
|
Amniotic fluid scan
|
$115.80 |
$115.80 |
$115.80 |
$42.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$208.80 |
$208.80 |
$208.80 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$709.98 |
$709.98 |
$709.98 |
$475.75
|
|
Ampicillin 1 gram solution for injection
|
$30.90 |
$30.90 |
$30.90 |
$62.85
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$63.36 |
$63.36 |
$63.36 |
$57.38
|
|
Amputation toe interphalangeal joint
|
$8,464.20 |
$8,464.20 |
$8,464.20 |
$3,981.06
|
|
Amylase
|
$112.80 |
$112.80 |
$112.80 |
$84.36
|
|
Ana ds-dna
|
$358.20 |
$358.20 |
$358.20 |
$58.63
|
|
Analgesics non-opioid 3-5
|
$46.80 |
$46.80 |
$46.80 |
$16.24
|
|
Analysis gene f2 20210g>a variant
|
$951.60 |
$951.60 |
$951.60 |
$212.65
|
|
Analysis gene f5 leiden variant
|
$353.40 |
$353.40 |
$353.40 |
$219.13
|
|
Anca screen with reflex to titer -quest
|
$159.60 |
$159.60 |
$159.60 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$5,857.80 |
$5,857.80 |
$5,857.80 |
$2,494.35
|
|
An fluoro guide for cvp
|
$315.60 |
$315.60 |
$315.60 |
$520.20
|
|
Angiotensin ii
|
$133.80 |
$133.80 |
$133.80 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$652.50 |
$652.50 |
$652.50 |
$5,172.70
|
|
Anidulafungin injection
|
$830.40 |
$830.40 |
$830.40 |
$312.30
|
|
Ankle X-ray
|
$808.80 |
$808.80 |
$808.80 |
$352.20
|
|
Anodyne therapy charges pt
|
$90.60 |
$90.60 |
$90.60 |
$41.02
|
|
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
|
$111.60 |
$111.60 |
$111.60 |
$57.85
|
|
Antibody elution rbc reference
|
$214.20 |
$214.20 |
$214.20 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$93.00 |
$93.00 |
$93.00 |
$121.80
|
|
Antibody htlv-i
|
$112.80 |
$112.80 |
$112.80 |
$48.57
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$285.60 |
$285.60 |
$285.60 |
$219.30
|
|
Antibody id rbc panel
|
$536.40 |
$536.40 |
$536.40 |
$281.30
|
|
Antibody influenza virus
|
$101.40 |
$101.40 |
$101.40 |
$53.90
|
|
Antibody screen rbc
|
$75.60 |
$75.60 |
$75.60 |
$102.75
|
|
Antibody tetanus
|
$78.60 |
$78.60 |
$78.60 |
$52.20
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$20.40 |
$20.40 |
$20.40 |
$43.32
|
|
Antinuclear antibodies
|
$205.80 |
$205.80 |
$205.80 |
$90.00
|
|
Antinuclear antibodies titer
|
$127.20 |
$127.20 |
$127.20 |
$78.26
|
|
Antiphosphatidylserine antibody
|
$110.40 |
$110.40 |
$110.40 |
$67.43
|
|
Antistreptolysin o screen
|
$167.40 |
$167.40 |
$167.40 |
$58.30
|
|
Antistreptolysin o titer
|
$167.40 |
$167.40 |
$167.40 |
$54.16
|
|
Antithrombin iii activity
|
$143.40 |
$143.40 |
$143.40 |
$113.85
|
|
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
|
$330.60 |
$330.60 |
$330.60 |
$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
|
|
Apheresis plasma
|
$3,806.40 |
$3,806.40 |
$3,806.40 |
$3,291.00
|
|
Apl(pml-rara) quant - sendout
|
$377.40 |
$377.40 |
$377.40 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,836.60 |
$1,836.60 |
$1,836.60 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,836.60 |
$1,836.60 |
$1,836.60 |
$934.80
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$852.60 |
$852.60 |
$852.60 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,380.20 |
$5,380.20 |
$5,380.20 |
$3,667.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,836.60 |
$1,836.60 |
$1,836.60 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$852.60 |
$852.60 |
$852.60 |
$549.08
|
|
Application finger splntstatic 29130
|
$82.20 |
$82.20 |
$82.20 |
$219.00
|
|
Application long leg splint 29505
|
$199.80 |
$199.80 |
$199.80 |
$356.85
|
|
Application lower leg splint 29515
|
$199.80 |
$199.80 |
$199.80 |
$362.70
|
|
Application multi layer compression below knee (both sides)
|
$507.00 |
$507.00 |
$507.00 |
$377.65
|
|
Application of paste boot 29580
|
$507.00 |
$507.00 |
$507.00 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,854.80 |
$2,854.80 |
$2,854.80 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,854.80 |
$2,854.80 |
$2,854.80 |
$2,189.70
|
|
Applicator tag rfid localizer 12gx7cm
|
$6,547.43 |
$6,547.43 |
$6,547.43 |
$938.52
|
|
Appl modality 1/> areas paraffin bath 97018
|
$167.40 |
$167.40 |
$167.40 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$160.20 |
$160.20 |
$160.20 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$60.60 |
$60.60 |
$60.60 |
$49.92
|
|
Apply forearm splintdynamic 29126
|
$163.80 |
$163.80 |
$163.80 |
$258.65
|
|
Apply halo w/removal cranial
|
$929.40 |
$929.40 |
$929.40 |
$1,367.60
|
|
Apply of finger splint 29131
|
$101.40 |
$101.40 |
$101.40 |
$171.00
|
|
Apply rigid leg cast 29445
|
$1,059.60 |
$1,059.60 |
$1,059.60 |
$585.31
|
|
#aptt mix-1:1 incubated
|
$39.00 |
$39.00 |
$39.00 |
$146.25
|
|
Aquaporin-4 antibody cba each
|
$184.80 |
$184.80 |
$184.80 |
$114.60
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$194.40 |
$194.40 |
$194.40 |
$100.00
|
|
Aquatic exercise - group charge
|
$147.60 |
$147.60 |
$147.60 |
$87.15
|
|
Arch supp att to shoe long/m
|
$96.31 |
$96.31 |
$96.31 |
$69.03
|
|
Arch supp att to shoe metata
|
$75.23 |
$75.23 |
$75.23 |
$75.23
|
|
Arch suprt att to sho longit
|
$75.23 |
$75.23 |
$75.23 |
$53.93
|
|
Argatroban esrd dialysis 1mg
|
$861.30 |
$861.30 |
$861.30 |
$934.80
|
|
Argatroban nonesrd (accord)
|
$848.28 |
$848.28 |
$848.28 |
$14.44
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$0.06 |
$0.06 |
$0.06 |
$6,286.51
|
|
Arterial blood draw/perc 36620
|
$1,188.60 |
$1,188.60 |
$1,188.60 |
$495.60
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$524.40 |
$524.40 |
$524.40 |
$588.53
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$550.80 |
$550.80 |
$550.80 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$550.80 |
$550.80 |
$550.80 |
$956.00
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$499.80 |
$499.80 |
$499.80 |
$474.60
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$550.80 |
$550.80 |
$550.80 |
$715.37
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$14,247.72 |
$14,247.72 |
$14,247.72 |
$4,240.08
|
|
Arthrp ntrcrpl/crp/mtcrp ssp
|
$20,006.90 |
$20,006.90 |
$20,006.90 |
$3,839.54
|
