|
Administration vaccine hepatitis b
|
$12.00 |
$12.00 |
$12.00 |
$53.00
|
|
Administration vaccine influenza virus
|
$12.00 |
$12.00 |
$12.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$12.00 |
$12.00 |
$12.00 |
$49.68
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$102.60 |
$106.80 |
$12,076.20 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$8,015.40 |
$8,015.40 |
$8,015.40 |
$1,987.70
|
|
Adrenalin epinephrine inject
|
$91.20 |
$108.60 |
$736.20 |
$231.47
|
|
Advance care planning each additional 30 min 99498
|
$464.40 |
$464.40 |
$572.40 |
$110.56
|
|
Aep hearing status deter i&r
|
$282.60 |
$336.60 |
$1,386.60 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$407.40 |
$831.60 |
$1,635.60 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$519.60 |
$831.60 |
$1,635.60 |
$635.00
|
|
Afamelanotide implant, 1 mg
|
$6,529.20 |
$140,689.80 |
$140,689.80 |
$78,638.30
|
|
_afb id by dna probe rflx ast
|
$139.20 |
$198.00 |
$1,349.40 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$218.40 |
$218.40 |
$218.40 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$574.80 |
$1,180.80 |
$1,327.80 |
$300.00
|
|
Aff2 gen aly detc abnl allel
|
$1,539.00 |
$1,539.00 |
$1,539.00 |
$189.06
|
|
Aflibercept injection
|
$6,024.00 |
$6,024.00 |
$6,024.00 |
$2,738.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$955.20 |
$4,783.20 |
$20,627.40 |
$14,475.20
|
|
Air conduction bilat
|
$72.00 |
$72.00 |
$122.40 |
$134.00
|
|
Air injection into abdomen 49400
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$16.80 |
$37.20 |
$93.60 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$376.00 |
$1,577.40 |
$1,577.40 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$406.80 |
$406.80 |
$406.80 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$466.40 |
$609.00 |
$810.00 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$292.80 |
$292.80 |
$292.80 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$38.40 |
$76.80 |
$606.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$34.20 |
$76.20 |
$165.00 |
$43.00
|
|
Albuterol comp unit
|
$1.20 |
$1.20 |
$1.20 |
$0.80
|
|
Albuterol ipratrop non-comp
|
$5.85 |
$7.80 |
$25.00 |
$5.67
|
|
Albuterol non-comp con
|
$0.80 |
$5.00 |
$370.80 |
$6.07
|
|
Albuterol non-comp unit
|
$6.80 |
$7.20 |
$18.00 |
$5.40
|
|
Aldesleukin injection
|
$8,184.00 |
$8,184.00 |
$8,184.00 |
$9,030.11
|
|
Alefacept
|
$214.20 |
$214.20 |
$214.20 |
$37.63
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$55.50 |
$55.50 |
$16,540.80 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$78.60 |
$78.60 |
$105.00 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$133.20 |
$141.00 |
$189.00 |
$43.72
|
|
Alginate drsg wound filler
|
$81.00 |
$156.00 |
$210.00 |
$15.79
|
|
Alkaline phosphatase
|
$43.80 |
$88.20 |
$259.20 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$42.00 |
$57.60 |
$498.00 |
$48.57
|
|
Allergen egg white ige
|
$42.00 |
$66.60 |
$499.20 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$24.00 |
$24.00 |
$52.20 |
$45.00
|
|
Allergy injection; single 95115
|
$22.80 |
$22.80 |
$52.20 |
$46.80
|
|
Allergy Skin Testing
|
$16.20 |
$16.20 |
$122.40 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$32.40 |
$32.40 |
$55.20 |
$423.37
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$4,444.20 |
$6,838.20 |
$33,312.60 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$9,274.20 |
$12,411.00 |
$16,546.20 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$28,764.00 |
$38,351.40 |
$67,982.40 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$8,304.60 |
$8,304.60 |
$8,304.60 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$5,527.20 |
$5,527.20 |
$5,527.20 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$825.00 |
$2,715.00 |
$9,430.20 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$8,445.00 |
$8,445.00 |
$8,445.00 |
$1,225.35
|
|
All tstg perq&iq drugs/biol
|
$102.60 |
$102.60 |
$146.40 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$42.00 |
$42.00 |
$146.40 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$40.40 |
$59.40 |
$59.40 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$441.00 |
$957.60 |
$1,975.20 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$100.20 |
$138.60 |
$180.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$108.00 |
$222.00 |
$966.60 |
$106.00
|
|
Alprostadil for injection
|
$12.00 |
$12.00 |
$282.00 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$285.00 |
$540.80 |
$39,117.00 |
$15,857.45
|
|
Alt/sgpt
|
$44.40 |
$86.40 |
$235.20 |
$47.50
|
|
Altuviiio per factor viii iu
|
$13.80 |
$13.80 |
$13.80 |
$13.32
|
|
Aluminum - quest
|
$110.40 |
$178.20 |
$189.60 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$999.00 |
$1,074.00 |
$1,378.20 |
$411.45
|
|
Ambl bp mntr w/sw a/r
|
$91.20 |
$91.20 |
$544.20 |
$320.45
|
|
Amifostine
|
$7,365.60 |
$7,365.60 |
$7,365.60 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$27.00 |
$44.55 |
$186.00 |
$39.84
|
|
Amino acids quant 2-5
|
$156.00 |
$170.40 |
$1,419.00 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$8.20 |
$9.15 |
$10.20 |
$37.33
|
|
Aminolevulinic acid, 10% gel
|
$3.00 |
$3.00 |
$3.00 |
$1.81
|
|
Aminolevulinic acid delta
|
$117.00 |
$124.20 |
$1,502.40 |
$87.12
|
|
Aminolevulinic acid hcl top
|
$725.40 |
$725.40 |
$725.40 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$11.40 |
$11.40 |
$92.80 |
$47.06
|
|
Amiodarone 50 mg/ml intravenous solution
|
$71.60 |
$102.60 |
$1,201.80 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$348.60 |
$348.60 |
$348.60 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$32.40 |
$32.40 |
$49.80 |
$9,084.45
|
|
Ammonia
|
$88.20 |
$159.00 |
$235.20 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$2,431.80 |
$2,431.80 |
$2,431.80 |
$942.60
|
|
Amniocentesis therapeutic
|
$2,431.80 |
$2,431.80 |
$2,431.80 |
$791.05
|
|
Amniotic fluid scan
|
$251.40 |
$251.40 |
$251.40 |
$49.01
|
|
Amobarbital 125 mg inj
|
$75.60 |
$75.60 |
$75.60 |
$1,283.59
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$5,537.40 |
$5,537.40 |
$5,537.40 |
$3,786.00
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$108.00 |
$175.20 |
$175.20 |
$123.53
|
|
Amphotericin b lipid complex
|
$87.60 |
$272.40 |
$1,085.40 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$592.80 |
$621.00 |
$2,961.60 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$60.40 |
$110.40 |
$319.20 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$48.00 |
$246.60 |
$811.20 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$213.00 |
$243.00 |
$447.60 |
$262.99
|
|
Amputate metacarpal bone 26910
|
$10,948.80 |
$10,948.80 |
$10,948.80 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$3,045.00 |
$3,607.80 |
$5,593.20 |
$4,196.50
|
|
Amylase
|
$45.00 |
$163.80 |
$316.20 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$253.20 |
$253.20 |
$253.20 |
$80.08
|
|
Ana ds-dna
|
$240.00 |
$240.00 |
$277.80 |
$55.24
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$384.60 |
$384.60 |
$384.60 |
$117.01
|
|
Anal pressure record
|
$633.00 |
$633.00 |
$2,451.00 |
$954.00
|
|
Anal/urinary muscle study
|
$580.20 |
$580.20 |
$580.20 |
$407.00
|
|
Anal/urinary muscle study
|
$1,722.00 |
$2,410.80 |
$3,063.60 |
$602.80
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$197.40 |
$197.40 |
$197.40 |
$320.40
|
|
Analysis gene f2 20210g>a variant
|
$1,601.40 |
$2,503.20 |
$2,503.20 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$1,191.60 |
$1,251.60 |
$1,788.00 |
$249.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$148.20 |
$148.20 |
$148.20 |
$122.20
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$558.60 |
$573.00 |
$769.20 |
$375.00
|
