|
Allergy injections; 2 or more 95117
|
$19.20 |
$19.20 |
$19.20 |
$42.00
|
|
Allergy injection; single 95115
|
$29.00 |
$29.00 |
$29.00 |
$42.75
|
|
Allergy Skin Testing
|
$5.76 |
$5.76 |
$5.76 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$7.68 |
$7.68 |
$7.68 |
$289.00
|
|
Allgrft implnt knee w/scope
|
$1,965.12 |
$1,965.12 |
$1,965.12 |
$6,411.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$232.80 |
$232.80 |
$232.80 |
$724.00
|
|
Alpha-fetoprotein tumor marker
|
$75.81 |
$75.81 |
$75.81 |
$103.60
|
|
Alprostadil for injection
|
$404.11 |
$404.11 |
$404.11 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$19,479.20 |
$19,479.20 |
$19,479.20 |
$15,815.36
|
|
Alt/sgpt
|
$23.91 |
$23.91 |
$23.91 |
$47.45
|
|
Aluminum - quest
|
$62.58 |
$62.58 |
$62.58 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$86.88 |
$86.88 |
$86.88 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$17.81 |
$17.81 |
$17.81 |
$178.10
|
|
Aminolevulinic acid delta
|
$82.93 |
$82.93 |
$82.93 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$88.14 |
$88.14 |
$88.14 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$92.88 |
$92.88 |
$92.88 |
$123.03
|
|
Amiodarone 50 mg/ml intravenous solution
|
$81.03 |
$81.03 |
$81.03 |
$56.70
|
|
Amitriptyline (elavil) -sendout
|
$91.08 |
$91.08 |
$91.08 |
$91.08
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$7,356.82 |
$7,356.82 |
$7,356.82 |
$9,084.45
|
|
Ammonia
|
$83.44 |
$83.44 |
$83.44 |
$117.00
|
|
Amniocentesisdiagnostic 59000
|
$181.92 |
$181.92 |
$181.92 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,058.88 |
$1,058.88 |
$1,058.88 |
$3,835.20
|
|
Amphetamine confirm urine -sendout
|
$39.18 |
$39.18 |
$39.18 |
$93.61
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$750.83 |
$750.83 |
$750.83 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$77.59 |
$77.59 |
$77.59 |
$61.93
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$83.22 |
$83.22 |
$83.22 |
$54.60
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$334.56 |
$334.56 |
$334.56 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$648.48 |
$648.48 |
$648.48 |
$3,986.00
|
|
Amputate metacarpal bone 26910
|
$1,177.92 |
$1,177.92 |
$1,177.92 |
$3,839.54
|
|
Amputation leg thr tib/fib 27880
|
$1,366.08 |
$1,366.08 |
$1,366.08 |
$3,870.00
|
|
Amputation leg; tib/fib f/u 27886
|
$990.72 |
$990.72 |
$990.72 |
$2,193.00
|
|
Amputation of foot at ankle
|
$871.20 |
$871.20 |
$871.20 |
$1,240.80
|
|
Amputation of lower leg
|
$900.96 |
$900.96 |
$900.96 |
$2,545.40
|
|
Amputation of midtarsal 28800
|
$808.32 |
$808.32 |
$808.32 |
$2,285.40
|
|
Amputation thru metatarsal
|
$1,077.60 |
$1,077.60 |
$1,077.60 |
$3,821.05
|
|
Amputation toe interphalangeal joint
|
$445.44 |
$445.44 |
$445.44 |
$3,958.50
|
|
Amputation toe metatarsophalangeal joint
|
$452.64 |
$452.64 |
$452.64 |
$3,814.50
|
|
Amylase
|
$37.65 |
$37.65 |
$37.65 |
$85.65
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$134.32 |
$134.32 |
$134.32 |
$113.28
|
|
Anal/urinary muscle study
|
$98.40 |
$98.40 |
$98.40 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$222.35 |
$222.35 |
$222.35 |
$219.00
|
|
Analysis gene f5 leiden variant
|
$169.43 |
$169.43 |
$169.43 |
$223.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$73.44 |
$73.44 |
$73.44 |
$411.45
|
|
Anastrozole 1 mg
|
$6.20 |
$6.20 |
$6.20 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$141.45 |
$141.45 |
$141.45 |
$102.70
|
|
An cholangiogram percutaneous compl
|
$5,950.56 |
$5,950.56 |
$5,950.56 |
$2,494.35
|
|
An fluoro guide for cvp
|
$98.20 |
$98.20 |
$98.20 |
$507.79
|
|
Ankle arthroscopy/surgery
|
$1,040.16 |
$1,040.16 |
$1,040.16 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$987.84 |
$987.84 |
$987.84 |
$6,193.84
|
|
Ankle arthroscopy/surgery
|
$778.56 |
$778.56 |
$778.56 |
$3,821.05
|
|
Ankle arthroscopy/surgery
|
$714.24 |
$714.24 |
$714.24 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$764.64 |
$764.64 |
$764.64 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$863.04 |
$863.04 |
$863.04 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$1,542.72 |
$1,542.72 |
$1,542.72 |
$8,334.74
|
|
Ankle X-ray
|
$167.90 |
$167.90 |
$167.90 |
$353.60
|
|
Annual alcohol screen 15 min
|
$24.48 |
$24.48 |
$24.48 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$149.28 |
$149.28 |
$149.28 |
$152.00
|
|
Annual Physical, Established Patient (age 40-64)
|
$158.88 |
$158.88 |
$158.88 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$165.60 |
$165.60 |
$165.60 |
$154.80
|
|
Annual Physical, New Patient (age 40-64)
|
$190.56 |
$190.56 |
$190.56 |
$167.25
|
|
Anodyne therapy charges pt
|
$15.26 |
$15.26 |
$15.26 |
$41.02
|
|
Anora (draw only)
|
$33.58 |
$33.58 |
$33.58 |
$35.00
|
|
Anoscopy
|
$340.80 |
$340.80 |
$340.80 |
$1,169.60
|
|
Anoscopy ablation lesion 46615
|
$270.72 |
$270.72 |
$270.72 |
$3,229.60
|
|
Anoscopy and biopsy
|
$2,038.08 |
$2,038.08 |
$2,038.08 |
$1,395.28
|
|
Anoscopy and dilation 46604
|
$977.76 |
$977.76 |
$977.76 |
$1,621.60
|
|
Anoscopy control bleeding 46614
|
$257.28 |
$257.28 |
$257.28 |
$2,030.25
|
|
Anoscopy remove fb 46608
|
$442.56 |
$442.56 |
$442.56 |
$1,457.76
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$942.24 |
$942.24 |
$942.24 |
$5,463.96
|
|
Antibody bacterium, not elsewhere specified
|
$25.44 |
$25.44 |
$25.44 |
$57.85
|
|
Antibody elution rbc reference
|
$197.92 |
$197.92 |
$197.92 |
$179.62
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$81.41 |
$81.41 |
$81.41 |
$219.30
|
|
Antibody id rbc panel
|
$211.15 |
$211.15 |
$211.15 |
$267.00
|
|
Antibody influenza virus
|
$25.86 |
$25.86 |
$25.86 |
$53.90
|
|
Antibody lymphocytic choriomeningitis
|
$25.29 |
$25.29 |
$25.29 |
$48.57
|
|
Antibody screen rbc
|
$49.86 |
$49.86 |
$49.86 |
$102.75
|
|
Antibody tetanus
|
$32.56 |
$32.56 |
$32.56 |
$52.20
|
|
Antigen therapy services
|
$99.36 |
$99.36 |
$99.36 |
$101.40
|
|
Antigen therapy services
|
$22.56 |
$22.56 |
$22.56 |
$70.07
|
|
Anti mog serum - sendout
|
$22.99 |
$22.99 |
$22.99 |
$110.80
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$22.99 |
$22.99 |
$22.99 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$22.99 |
$22.99 |
$22.99 |
$36.37
|
|
Antinuclear antibodies
|
$44.77 |
$44.77 |
$44.77 |
$91.70
|
|
Antinuclear antibodies titer
|
$47.32 |
$47.32 |
$47.32 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$55.46 |
$55.46 |
$55.46 |
$58.24
|
|
Antistreptolysin o titer
|
$47.83 |
$47.83 |
$47.83 |
$52.50
|
|
Antithrombin iii activity
|
$56.48 |
$56.48 |
$56.48 |
$114.00
|
|
Apl(pml-rara) quant - sendout
|
$407.52 |
$407.52 |
$407.52 |
$465.60
|
|
Appendectomy
|
$983.04 |
$983.04 |
$983.04 |
$5,681.93
|
|
Appendectomy add-on 44955
|
$126.24 |
$126.24 |
$126.24 |
$206.40
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$1,341.12 |
$1,341.12 |
$1,341.12 |
$1,644.60
|
|
Appendix Removal (Laparoscopic)
|
$925.44 |
$925.44 |
$925.44 |
$6,463.42
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,189.12 |
$3,189.12 |
$3,189.12 |
$2,154.21
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,594.08 |
$1,594.08 |
$1,594.08 |
$873.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,594.08 |
$1,594.08 |
$1,594.08 |
$512.20
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,850.72 |
$5,850.72 |
$5,850.72 |
$3,721.90
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,925.12 |
$2,925.12 |
$2,925.12 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,594.08 |
$1,594.08 |
$1,594.08 |
$508.18
|
|
Appl cast shoulder spica
|
$353.28 |
$353.28 |
$353.28 |
$468.00
|
|
Application finger splntstatic 29130
|
$122.62 |
$122.62 |
$122.62 |
$208.50
|
