|
Aluminum - quest
|
$90.35 |
$102.70 |
$158.00 |
|
|
Alveoloplasty each quadrant
|
$6,290.44 |
$6,290.44 |
$6,290.44 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$507.00 |
$507.00 |
$507.00 |
|
|
Amantadine (symmetrel)-sendout
|
$175.50 |
$175.50 |
$208.00 |
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$50.97 |
$62.56 |
$69.71 |
|
|
Amino acid screen, urine
|
$76.05 |
$111.80 |
$198.90 |
|
|
Amino acids quant 2-5
|
$90.35 |
$91.65 |
$347.10 |
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$44.97 |
$44.97 |
$52.84 |
|
|
Aminolevulinic acid delta
|
$110.50 |
$111.80 |
$172.00 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$96.20 |
$107.20 |
$107.20 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$202.10 |
$202.10 |
$346.50 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.76 |
$9.76 |
$75.12 |
|
|
Amitriptyline (elavil) -sendout
|
$59.80 |
$59.80 |
$119.60 |
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$43,630.44 |
$43,630.44 |
$43,630.44 |
|
|
Ammonia
|
$85.80 |
$100.10 |
$164.00 |
|
|
Amniocentesisdiagnostic 59000
|
$755.95 |
$755.95 |
$1,425.45 |
|
|
Amniocentesis therapeutic
|
$1,218.10 |
$1,218.10 |
$1,218.10 |
|
|
Amphetamine confirm urine -sendout
|
$84.50 |
$84.50 |
$117.00 |
|
|
Amphetamines 5 or more
|
$76.05 |
$76.05 |
$76.05 |
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$209.98 |
$234.00 |
$234.00 |
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,114.41 |
$1,114.41 |
$1,598.32 |
|
|
Ampicillin 1 gram solution for injection
|
$31.08 |
$34.64 |
$3,315.29 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$17.50 |
$30.62 |
$218.72 |
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$495.95 |
$503.75 |
$706.00 |
|
|
Amputation toe metatarsophalangeal joint
|
$6,460.35 |
$6,460.35 |
$6,460.35 |
|
|
Amylase
|
$65.65 |
$83.20 |
$208.00 |
|
|
Ana ds-dna
|
$75.40 |
$81.25 |
$230.10 |
|
|
Anal/urinary muscle study
|
$275.60 |
$353.60 |
$435.50 |
|
|
Anal/urinary muscle study
|
$1,175.85 |
$1,175.85 |
$1,175.85 |
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$141.05 |
$141.05 |
$141.05 |
|
|
Analysis gene f2 20210g>a variant
|
$271.70 |
$304.20 |
$483.60 |
|
|
Analysis gene f5 leiden variant
|
$263.90 |
$280.80 |
$481.65 |
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$124.15 |
$124.15 |
$124.15 |
|
|
Analysis tumor
|
$159.00 |
$167.05 |
$357.50 |
|
|
Anaplsma phgcytophlm amp prb
|
$133.90 |
$154.05 |
$449.80 |
|
|
Anca screen with reflex to titer -quest
|
$90.35 |
$98.15 |
$158.00 |
|
|
An cholangiogram percutaneous compl
|
$1,581.90 |
$1,581.90 |
$2,046.85 |
|
|
An fluoro guide for cvp
|
$319.15 |
$464.10 |
$714.00 |
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,053.65 |
$1,053.65 |
$9,550.62 |
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,874.40 |
$6,874.40 |
$7,670.65 |
|
|
Angio trnslmnl balloon same artery ini
|
$6,443.45 |
$6,443.45 |
$12,207.65 |
|
|
Angio trnslmnl balloon same vein ini
|
$7,638.15 |
$7,638.15 |
$11,241.94 |
|
|
Ankle arthroscopy/surgery
|
$14,893.39 |
$14,893.39 |
$14,893.39 |
|
|
Ankle arthroscopy/surgery
|
$13,609.05 |
$13,609.05 |
$13,609.05 |
|
|
Ankle arthroscopy/surgery
|
$20,844.25 |
$20,844.25 |
$20,844.25 |
|
|
Ankle arthroscopy/surgery
|
$11,619.06 |
$11,619.06 |
$11,619.06 |
|
|
Ankle X-ray
|
$221.00 |
$468.00 |
$652.60 |
|
|
Anora (draw only)
|
$9.75 |
$12.35 |
$16.90 |
|
|
Anoscopy control bleeding 46614
|
$4,721.94 |
$4,721.94 |
$4,721.94 |
|
|
Anoscopy remove fb 46608
|
$550.00 |
$550.00 |
$550.00 |
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$6,293.22 |
$6,293.22 |
$6,293.22 |
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$8,217.92 |
$8,217.92 |
$12,002.82 |
|
|
Antibody bacterium, not elsewhere specified
|
$48.10 |
$49.40 |
$94.25 |
|
|
Antibody elution rbc reference
|
$61.75 |
$187.20 |
$336.00 |
|
|
Antibody htlv/hiv confirm test
|
$137.80 |
$141.70 |
$218.00 |
|
|
Antibody htlv-i
|
$61.75 |
$65.00 |
$100.00 |
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$224.90 |
$305.50 |
$480.00 |
|
|
Antibody id rbc panel
|
$198.25 |
$212.55 |
$493.35 |
|
|
Antibody influenza virus
|
$72.15 |
$76.70 |
$144.95 |
|
|
Antibody lymphocytic choriomeningitis
|
$65.00 |
$68.90 |
$88.40 |
|
|
Antibody screen rbc
|
$102.70 |
$109.85 |
$313.95 |
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$32.50 |
$32.50 |
$5,468.58 |
|
|
Antihemophilic viii/vwf comp
|
$8,307.00 |
$8,307.00 |
$9,248.46 |
|
|
Anti-inhibitor
|
$32.50 |
$32.50 |
$32.50 |
|
|
Anti mog serum - sendout
|
$404.95 |
$446.55 |
$1,040.65 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$66.00 |
$85.80 |
$92.30 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$89.70 |
$104.00 |
$226.20 |
|
|
Antinuclear antibodies
|
$83.20 |
$91.65 |
$180.05 |
|
|
Antinuclear antibodies titer
|
$46.00 |
$66.30 |
$128.05 |
|
|
Antiphosphatidylserine antibody
|
$82.55 |
$83.85 |
$129.00 |
|
|
Antistreptolysin o screen
|
$53.95 |
$53.95 |
$55.25 |
|
|
Antistreptolysin o titer
|
$46.15 |
$63.05 |
$102.00 |
|
|
Antithrombin iii activity
|
$93.60 |
$136.50 |
$151.45 |
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$17,306.26 |
$17,306.26 |
$17,306.26 |
|
|
Apheresis plasma
|
$2,574.00 |
$3,615.30 |
$5,802.09 |
|
|
Apheresis platelets
|
$1,740.70 |
$2,037.10 |
$10,037.57 |
|
|
Apheresis rbc
|
$2,657.20 |
$3,128.45 |
$4,741.07 |
|
|
Apheresis wbc
|
$2,657.20 |
$2,728.70 |
$4,088.00 |
|
|
Apl(pml-rara) quant - sendout
|
$324.35 |
$330.20 |
$534.00 |
|
|
Appendix Removal (Laparoscopic)
|
$9,610.77 |
$9,610.77 |
$11,662.65 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$113.10 |
$401.70 |
$1,842.75 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,808.00 |
$2,808.00 |
$7,710.30 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,399.80 |
$2,574.00 |
$3,723.20 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$75.40 |
$335.40 |
$620.10 |
|
|
Application finger splntstatic 29130
|
$104.65 |
$120.25 |
$371.00 |
|
|
Application long leg splint 29505
|
$189.80 |
$236.60 |
$291.00 |
|
|
Application lower leg splint 29515
|
$165.10 |
$165.10 |
$255.00 |
|
|
Application multi layer compression below knee (both sides)
|
$190.45 |
$377.65 |
$599.95 |
|
|
Application of forearm cast 29075
|
$218.40 |
$218.40 |
$1,116.05 |
|
|
Application of long arm cast 29065
|
$206.05 |
$206.05 |
$366.60 |
|
|
Application of paste boot 29580
|
$248.30 |
$248.30 |
$709.15 |
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$223.60 |
$348.40 |
$1,160.25 |
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$118.95 |
$118.95 |
$1,160.25 |
|
|
Appl modality 1/> areas paraffin bath 97018
|
$44.20 |
$68.00 |
$156.00 |
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$71.50 |
$71.50 |
$217.10 |
|
|
Appl multlay comprs arm/hand
|
$214.50 |
$214.50 |
$214.50 |
|
|
Apply finger cast 29086
|
$309.40 |
$309.40 |
$309.40 |
|
|
Apply forearm splintdynamic 29126
|
$126.75 |
$126.75 |
$126.75 |
|
|
Apply hand/wrist cast 29085
|
$289.25 |
$289.25 |
$315.00 |
|
|
Apply interstit radiat compl
|
$1,386.45 |
$5,769.40 |
$6,247.80 |
|
