|
11-desoxycortisol - sendout
|
$477.00 |
$477.00 |
$477.00 |
$84.56
|
|
17-hydroxypregnenolone
|
$370.80 |
$370.80 |
$370.80 |
$85.15
|
|
17-ketosteroids
|
$155.40 |
$155.40 |
$155.40 |
$46.20
|
|
24 hr ambulatory b/p monitor
|
$222.60 |
$222.60 |
$222.60 |
$313.04
|
|
2d tte w or without fol w/con,co
|
$2,323.80 |
$2,323.80 |
$2,323.80 |
$1,150.99
|
|
3d recon without postprocess indpndt
|
$616.80 |
$616.80 |
$616.80 |
$480.00
|
|
5' nucleotidase - sendout
|
$55.80 |
$55.80 |
$55.80 |
$46.53
|
|
88334 ap bill cytologic exam each additional site
|
$141.00 |
$141.00 |
$141.00 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$115.80 |
$115.80 |
$115.80 |
$53.68
|
|
Abdominal CT scan (with and without contrast)
|
$2,679.60 |
$2,679.60 |
$2,679.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,284.20 |
$2,284.20 |
$2,284.20 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$1,708.80 |
$1,708.80 |
$1,708.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$6,450.00 |
$6,450.00 |
$6,450.00 |
$3,045.84
|
|
Abdominal MRI (with contrast)
|
$5,608.80 |
$5,608.80 |
$5,608.80 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$4,876.80 |
$4,876.80 |
$4,876.80 |
$2,047.72
|
|
Abdominal pad
|
$350.40 |
$350.40 |
$350.40 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$843.60 |
$843.60 |
$843.60 |
$600.00
|
|
Abd paracentesis/w/o image guide 49082
|
$863.40 |
$863.40 |
$863.40 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$762.04 |
$762.04 |
$762.04 |
$499.86
|
|
Abduction bar jointed adjust
|
$834.59 |
$834.59 |
$834.59 |
$595.67
|
|
Abduction rotation bar shoe
|
$376.37 |
$376.37 |
$376.37 |
$150.99
|
|
Abduct rotation bar without shoe
|
$344.17 |
$344.17 |
$344.17 |
$192.62
|
|
Abl1 gene
|
$795.00 |
$795.00 |
$795.00 |
$668.85
|
|
Ablation of upper extremity nerves rf
|
$550.20 |
$550.20 |
$550.20 |
$832.50
|
|
Acetaminophen level
|
$137.40 |
$137.40 |
$137.40 |
$116.80
|
|
Acetone qualitative
|
$57.60 |
$57.60 |
$57.60 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$223.20 |
$223.20 |
$223.20 |
$112.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$12.72 |
$12.72 |
$12.72 |
$244.95
|
|
Acetylcysteine non-comp unit
|
$119.16 |
$119.16 |
$119.16 |
$31.21
|
|
Acne surgery 10040
|
$396.00 |
$396.00 |
$396.00 |
$265.20
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$45.00 |
$45.00 |
$45.00 |
$40.20
|
|
Acute hepatitis panel
|
$431.40 |
$431.40 |
$431.40 |
$281.09
|
|
#acylcarnitineprfl
|
$349.80 |
$349.80 |
$349.80 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$10,111.68 |
$10,111.68 |
$10,111.68 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$688.58 |
$688.58 |
$688.58 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$23.46 |
$23.46 |
$23.46 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$90.00 |
$90.00 |
$90.00 |
$60.00
|
|
Adh-sendout
|
$240.00 |
$240.00 |
$240.00 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$179.40 |
$179.40 |
$179.40 |
$171.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$132.60 |
$132.60 |
$132.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$163.80 |
$163.80 |
$163.80 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$307.80 |
$307.80 |
$307.80 |
$646.80
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$222.60 |
$222.60 |
$222.60 |
$439.55
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$287.40 |
$287.40 |
$287.40 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$252.60 |
$252.60 |
$252.60 |
$264.70
|
|
Administration immunization 1 vaccine
|
$55.20 |
$55.20 |
$55.20 |
$66.51
|
|
Administration immunization each additional vaccine
|
$49.20 |
$49.20 |
$49.20 |
$46.23
|
|
Administration vaccine hepatitis b
|
$55.20 |
$55.20 |
$55.20 |
$54.60
|
|
Administration vaccine influenza virus
|
$37.80 |
$37.80 |
$37.80 |
$48.35
|
|
Administration vaccine pneumococcal
|
$37.20 |
$37.20 |
$37.20 |
$49.50
|
|
_afb id by dna probe rflx ast
|
$154.80 |
$154.80 |
$154.80 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$45.00 |
$45.00 |
$45.00 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$150.60 |
$150.60 |
$150.60 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,076.21 |
$1,076.21 |
$1,076.21 |
$765.51
|
|
Afo molded plas rig ant tib
|
$2,456.71 |
$2,456.71 |
$2,456.71 |
$2,011.42
|
|
Afo molded to patient plasti
|
$1,158.65 |
$1,158.65 |
$1,158.65 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,127.61 |
$2,127.61 |
$2,127.61 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$837.58 |
$837.58 |
$837.58 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,085.51 |
$1,085.51 |
$1,085.51 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,104.44 |
$1,104.44 |
$1,104.44 |
$696.71
|
|
Afo spiral molded to pt plas
|
$1,833.68 |
$1,833.68 |
$1,833.68 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$852.08 |
$852.08 |
$852.08 |
$483.88
|
|
Afo supramalleolar custom
|
$1,341.68 |
$1,341.68 |
$1,341.68 |
$1,162.69
|
|
Afo tib fx cast plaster mold
|
$1,879.35 |
$1,879.35 |
$1,879.35 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$1,837.73 |
$1,837.73 |
$1,837.73 |
$1,464.20
|
|
Afo tibial fracture soft
|
$1,202.90 |
$1,202.90 |
$1,202.90 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$3,783.56 |
$3,783.56 |
$3,783.56 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$1,523.20 |
$1,523.20 |
$1,523.20 |
$567.00
|
|
Ak/knee disartic pelvic band
|
$331.55 |
$331.55 |
$331.55 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$412.34 |
$412.34 |
$412.34 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$637.34 |
$637.34 |
$637.34 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$32.40 |
$32.40 |
$32.40 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$216.96 |
$216.96 |
$216.96 |
$219.08
|
|
Albumin (human), 5%, 250 ml
|
$174.42 |
$174.42 |
$174.42 |
$225.47
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$58.20 |
$58.20 |
$58.20 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$64.20 |
$64.20 |
$64.20 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$5.28
|
|
Albuterol non-comp con
|
$16.80 |
$16.80 |
$16.80 |
$5.61
|
|
Albuterol non-comp unit
|
$3.00 |
$3.00 |
$3.00 |
$5.13
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$146.40 |
$146.40 |
$146.40 |
$94.90
|
|
Alcohol/subs interv 15-30mn
|
$27.60 |
$27.60 |
$27.60 |
$54.08
|
|
Alcohol/subs interv >30 min
|
$67.20 |
$67.20 |
$67.20 |
$189.21
|
|
Alkaline phosphatase
|
$85.20 |
$85.20 |
$85.20 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$55.20 |
$55.20 |
$55.20 |
$46.80
|
|
Allergen egg white ige
|
$24.60 |
$24.60 |
$24.60 |
$33.66
|
|
Allergen specific ige qual multi scrn ea
|
$43.20 |
$43.20 |
$43.20 |
$24.00
|
|
Allergy injection; single 95115
|
$38.40 |
$38.40 |
$38.40 |
$42.75
|
|
Allograft 160mg placental salera mini membrane
|
$6,662.14 |
$6,662.14 |
$6,662.14 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,137.58 |
$13,137.58 |
$13,137.58 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$16,485.25 |
$16,485.25 |
$16,485.25 |
$2,677.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$12,638.31 |
$12,638.31 |
$12,638.31 |
$11,121.17
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,252.49 |
$10,252.49 |
$10,252.49 |
$5,913.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,541.30 |
$46,541.30 |
$46,541.30 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$31,245.38 |
$31,245.38 |
$31,245.38 |
$715.20
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$26,441.75 |
$26,441.75 |
$26,441.75 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,966.16 |
$24,966.16 |
$24,966.16 |
$3,604.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,184.54 |
$8,184.54 |
$8,184.54 |
$4,384.80
|
