|
Amifostine
|
$642.60 |
$642.60 |
$642.60 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$3.60 |
$3.60 |
$3.60 |
$39.84
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$7.80 |
$7.80 |
$7.80 |
$47.06
|
|
Amiodarone 50 mg/ml intravenous solution
|
$0.60 |
$0.60 |
$0.60 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$63.00 |
$63.00 |
$63.00 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$298.20 |
$298.20 |
$298.20 |
$9,084.45
|
|
Ammonia
|
$74.40 |
$74.40 |
$74.40 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,511.40 |
$1,511.40 |
$1,511.40 |
$942.60
|
|
Amniocentesis therapeutic
|
$1,034.40 |
$1,034.40 |
$1,034.40 |
$791.05
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$4,150.20 |
$4,150.20 |
$4,150.20 |
$3,786.00
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$28.80 |
$28.80 |
$28.80 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$185.40 |
$185.40 |
$185.40 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$16.20 |
$16.20 |
$16.20 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$43.20 |
$43.20 |
$43.20 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$502.20 |
$502.20 |
$502.20 |
$262.99
|
|
Amputation toe metatarsophalangeal joint
|
$6,501.60 |
$6,501.60 |
$6,501.60 |
$3,839.54
|
|
Amylase
|
$32.40 |
$32.40 |
$32.40 |
$90.00
|
|
Ana ds-dna
|
$44.40 |
$44.40 |
$44.40 |
$55.24
|
|
Anal pressure record
|
$954.00 |
$954.00 |
$954.00 |
$954.00
|
|
Anal/urinary muscle study
|
$587.40 |
$587.40 |
$587.40 |
$602.80
|
|
Analysis gene f2 20210g>a variant
|
$380.40 |
$380.40 |
$380.40 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$424.80 |
$424.80 |
$424.80 |
$249.60
|
|
Analysis tumor
|
$337.20 |
$337.20 |
$337.20 |
$248.80
|
|
Anaplsma phgcytophlm amp prb
|
$70.80 |
$70.80 |
$70.80 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$83.40 |
$83.40 |
$83.40 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$7,069.80 |
$7,069.80 |
$7,069.80 |
$2,480.94
|
|
Androstanediol
|
$103.80 |
$103.80 |
$103.80 |
$131.04
|
|
An fluoro guide for cvp
|
$450.00 |
$450.00 |
$450.00 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$3,240.60 |
$3,240.60 |
$3,240.60 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$17,281.80 |
$17,281.80 |
$17,281.80 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$16,320.60 |
$16,320.60 |
$16,320.60 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$8,640.60 |
$8,640.60 |
$8,640.60 |
$5,950.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$0.60 |
$0.60 |
$0.60 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$17,281.80 |
$17,281.80 |
$17,281.80 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$2,162.40 |
$2,162.40 |
$2,162.40 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$12,116.40 |
$12,116.40 |
$12,116.40 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,862.40 |
$1,862.40 |
$1,862.40 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$12,394.80 |
$12,394.80 |
$12,394.80 |
$8,359.11
|
|
Anidulafungin injection
|
$114.00 |
$114.00 |
$114.00 |
$312.30
|
|
Ankle X-ray
|
$188.40 |
$188.40 |
$188.40 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$188.40 |
$188.40 |
$188.40 |
$282.96
|
|
Anora (draw only)
|
$136.80 |
$136.80 |
$136.80 |
$35.00
|
|
Anoscopy control bleeding 46614
|
$3,812.40 |
$3,812.40 |
$3,812.40 |
$2,140.60
|
|
Anoscopy remove fb 46608
|
$2,551.20 |
$2,551.20 |
$2,551.20 |
$1,375.98
|
|
Anterior thoracic extension
|
$496.80 |
$496.80 |
$496.80 |
$454.00
|
|
Antibody bacterium, not elsewhere specified
|
$72.00 |
$72.00 |
$72.00 |
$57.85
|
|
Antibody elution rbc reference
|
$203.40 |
$203.40 |
$203.40 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$107.40 |
$107.40 |
$107.40 |
$131.56
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$102.60 |
$102.60 |
$102.60 |
$224.00
|
|
Antibody id rbc panel
|
$403.20 |
$403.20 |
$403.20 |
$291.75
|
|
Antibody influenza virus
|
$75.60 |
$75.60 |
$75.60 |
$54.00
|
|
Antibody lymphocytic choriomeningitis
|
$46.20 |
$46.20 |
$46.20 |
$46.58
|
|
Antibody screen rbc
|
$70.20 |
$70.20 |
$70.20 |
$108.55
|
|
Antibody tetanus
|
$82.20 |
$82.20 |
$82.20 |
$54.15
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$6.10
|
|
Anti-inhibitor
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$8.33
|
|
Antinuclear antibodies
|
$67.80 |
$67.80 |
$67.80 |
$90.00
|
|
Antinuclear antibodies titer
|
$63.00 |
$63.00 |
$63.00 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$89.40 |
$89.40 |
$89.40 |
$67.43
|
|
Antistreptolysin o titer
|
$41.40 |
$41.40 |
$41.40 |
$54.00
|
|
Antithrombin iii activity
|
$60.00 |
$60.00 |
$60.00 |
$115.15
|
|
Antithymocyte globuln rabbit
|
$639.60 |
$639.60 |
$639.60 |
$2,111.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$394.20 |
$394.20 |
$394.20 |
$394.55
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,895.60 |
$2,895.60 |
$2,895.60 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$2,895.60 |
$2,895.60 |
$2,895.60 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$288.00 |
$288.00 |
$288.00 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,513.80 |
$4,513.80 |
$4,513.80 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,772.40 |
$1,772.40 |
$1,772.40 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$372.00 |
$372.00 |
$372.00 |
$512.20
|
|
Appl cast figure-of-eight
|
$613.80 |
$613.80 |
$613.80 |
$314.28
|
|
Application finger splntstatic 29130
|
$226.20 |
$226.20 |
$226.20 |
$208.50
|
|
Application long leg splint 29505
|
$789.00 |
$789.00 |
$789.00 |
$338.25
|
|
Application lower leg splint 29515
|
$520.80 |
$520.80 |
$520.80 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$570.60 |
$570.60 |
$570.60 |
$375.06
|
|
Application of forearm cast 29075
|
$370.80 |
$370.80 |
$370.80 |
$358.20
|
|
Application of long arm cast 29065
|
$440.40 |
$440.40 |
$440.40 |
$396.77
|
|
Application of long leg cast 29345
|
$520.80 |
$520.80 |
$520.80 |
$455.00
|
|
Application of paste boot 29580
|
$496.20 |
$496.20 |
$496.20 |
$340.11
|
|
Application short leg cast 29405
|
$520.80 |
$520.80 |
$520.80 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,460.00 |
$2,460.00 |
$2,460.00 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,460.00 |
$2,460.00 |
$2,460.00 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$168.60 |
$168.60 |
$168.60 |
$981.75
|
|
Appl modality 1/> areas paraffin bath 97018
|
$24.60 |
$24.60 |
$24.60 |
$69.00
|
|
Apply forearm splintdynamic 29126
|
$239.40 |
$239.40 |
$239.40 |
$255.20
|
|
Apply hand/wrist cast 29085
|
$520.80 |
$520.80 |
$520.80 |
$271.80
|
|
Apply interstit radiat compl
|
$2,441.40 |
$2,441.40 |
$2,441.40 |
$2,901.80
|
|
Apply intrcav radiat compl
|
$1,959.60 |
$1,959.60 |
$1,959.60 |
$1,813.50
|
|
Apply of finger splint 29131
|
$370.80 |
$370.80 |
$370.80 |
$177.45
|
|
Apply rigid leg cast 29445
|
$961.80 |
$961.80 |
$961.80 |
$555.00
|
|
Apply short leg castambul type 29425
|
$520.80 |
$520.80 |
$520.80 |
$404.74
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$13.80 |
$13.80 |
$13.80 |
$955.43
|
|
Aqmbf pet rest & rx stress
|
$105.60 |
$105.60 |
$105.60 |
$974.40
|
|
Aquaporin-4 antibody cba each
|
$66.60 |
$66.60 |
$66.60 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$58.80 |
$58.80 |
$58.80 |
$150.00
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$48.00 |
$48.00 |
$48.00 |
$100.75
|
|
Aquatic exercise - group charge
|
$171.60 |
$171.60 |
$171.60 |
$87.45
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$579.60 |
$579.60 |
$579.60 |
$6,387.85
|
|
Arm CT Scan (with contrast, both arms)
|
$1,424.40 |
$1,424.40 |
$1,424.40 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$876.00 |
$876.00 |
$876.00 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$394.20 |
$394.20 |
$394.20 |
$426.00
|
