|
Allergen egg white ige
|
$216.80 |
$216.80 |
$216.80 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$6.80 |
$6.80 |
$6.80 |
$45.00
|
|
Allergy injection; single 95115
|
$10.20 |
$10.20 |
$10.20 |
$46.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$2,929.80 |
$2,929.80 |
$2,929.80 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$5,792.80 |
$5,792.80 |
$5,792.80 |
$6,285.56
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,781.60 |
$4,781.60 |
$4,781.60 |
$4,677.40
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$29.80 |
$29.80 |
$29.80 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$177.60 |
$177.60 |
$177.60 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$160.20 |
$160.20 |
$160.20 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$168.00 |
$168.00 |
$168.00 |
$106.00
|
|
Alprostadil for injection
|
$550.20 |
$550.20 |
$550.20 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$40,758.00 |
$40,758.00 |
$40,758.00 |
$15,857.45
|
|
Alt/sgpt
|
$161.60 |
$161.60 |
$161.60 |
$47.50
|
|
Aluminum - quest
|
$386.40 |
$386.40 |
$386.40 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$1,680.80 |
$1,680.80 |
$1,680.80 |
$411.45
|
|
Ambl bp mntr w/sw a/r
|
$207.20 |
$207.20 |
$207.20 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$26.80 |
$26.80 |
$26.80 |
$39.84
|
|
Amino acids quant 2-5
|
$266.40 |
$266.40 |
$266.40 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$8.00 |
$8.00 |
$8.00 |
$37.33
|
|
Aminolevulinic acid delta
|
$216.00 |
$216.00 |
$216.00 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$70.20 |
$70.20 |
$70.20 |
$47.06
|
|
Amiodarone 50 mg/ml intravenous solution
|
$224.40 |
$224.40 |
$224.40 |
$55.86
|
|
Ammonia
|
$152.00 |
$152.00 |
$152.00 |
$119.70
|
|
Amniotic fluid scan
|
$245.60 |
$245.60 |
$245.60 |
$49.01
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$176.40 |
$176.40 |
$176.40 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$77.40 |
$77.40 |
$77.40 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$67.20 |
$67.20 |
$67.20 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$280.20 |
$280.20 |
$280.20 |
$262.99
|
|
Amputation toe interphalangeal joint
|
$3,304.80 |
$3,304.80 |
$3,304.80 |
$4,196.50
|
|
Amylase
|
$136.80 |
$136.80 |
$136.80 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$222.40 |
$222.40 |
$222.40 |
$80.08
|
|
Ana ds-dna
|
$216.00 |
$216.00 |
$216.00 |
$55.24
|
|
Anal pressure record
|
$2,128.00 |
$2,128.00 |
$2,128.00 |
$954.00
|
|
Analysis gene f2 20210g>a variant
|
$2,361.60 |
$2,361.60 |
$2,361.60 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$1,764.00 |
$1,764.00 |
$1,764.00 |
$249.60
|
|
Anaplsma phgcytophlm amp prb
|
$290.40 |
$290.40 |
$290.40 |
$85.80
|
|
Anastrozole 1 mg
|
$13.00 |
$13.00 |
$13.00 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$188.80 |
$188.80 |
$188.80 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$840.00 |
$840.00 |
$840.00 |
$2,480.94
|
|
An fluoro guide for cvp
|
$1,542.40 |
$1,542.40 |
$1,542.40 |
$525.85
|
|
Angiotensin ii
|
$334.40 |
$334.40 |
$334.40 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,796.80 |
$1,796.80 |
$1,796.80 |
$2,979.43
|
|
Anidulafungin injection
|
$417.00 |
$417.00 |
$417.00 |
$312.30
|
|
Ankle X-ray
|
$372.00 |
$372.00 |
$372.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$697.60 |
$697.60 |
$697.60 |
$282.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$156.60 |
$156.60 |
$156.60 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$170.40 |
$170.40 |
$170.40 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$171.60 |
$171.60 |
$171.60 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$208.80 |
$208.80 |
$208.80 |
$167.25
|
|
Antibody bacterium, not elsewhere specified
|
$44.20 |
$44.20 |
$44.20 |
$57.85
|
|
Antibody elution rbc reference
|
$82.40 |
$82.40 |
$82.40 |
$177.29
|
|
Antibody htlv-i
|
$96.00 |
$96.00 |
$96.00 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$720.80 |
$720.80 |
$720.80 |
$224.00
|
|
Antibody id rbc panel
|
$248.80 |
$248.80 |
$248.80 |
$291.75
|
|
Antibody influenza virus
|
$111.20 |
$111.20 |
$111.20 |
$54.00
|
|
Antibody lymphocytic choriomeningitis
|
$111.20 |
$111.20 |
$111.20 |
$46.58
|
|
Antibody screen rbc
|
$136.80 |
$136.80 |
$136.80 |
$108.55
|
|
Antibody tetanus
|
$402.40 |
$402.40 |
$402.40 |
$54.15
|
|
Anticoag mgmt pt warfarin
|
$39.00 |
$39.00 |
$39.00 |
$26.40
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$11.40 |
$11.40 |
$11.40 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$10.20 |
$10.20 |
$10.20 |
$3.67
|
|
Anti mog serum - sendout
|
$115.80 |
$115.80 |
$115.80 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$188.80 |
$188.80 |
$188.80 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$188.80 |
$188.80 |
$188.80 |
$42.00
|
|
Antinuclear antibodies
|
$206.40 |
$206.40 |
$206.40 |
$90.00
|
|
Antinuclear antibodies titer
|
$110.40 |
$110.40 |
$110.40 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$476.80 |
$476.80 |
$476.80 |
$67.43
|
|
Antistreptolysin o screen
|
$68.40 |
$68.40 |
$68.40 |
$58.56
|
|
Antistreptolysin o titer
|
$141.60 |
$141.60 |
$141.60 |
$54.00
|
|
Antithrombin iii activity
|
$190.40 |
$190.40 |
$190.40 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$331.20 |
$331.20 |
$331.20 |
$394.55
|
|
Aortic dysfunction/dilation
|
$8,320.00 |
$8,320.00 |
$8,320.00 |
$1,153.60
|
|
Apc gene dup/delet variants
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$462.00
|
|
Apc gene full sequence
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,255.20
|
|
Apheresis plasma
|
$1,532.00 |
$1,532.00 |
$1,532.00 |
$3,226.34
|
|
Apl(pml-rara) quant - sendout
|
$503.20 |
$503.20 |
$503.20 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,148.00 |
$2,148.00 |
$2,148.00 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,830.40 |
$1,830.40 |
$1,830.40 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$315.20 |
$315.20 |
$315.20 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$6,088.00 |
$6,088.00 |
$6,088.00 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,156.00 |
$2,156.00 |
$2,156.00 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$315.20 |
$315.20 |
$315.20 |
$512.20
|
|
Application finger splntstatic 29130
|
$569.60 |
$569.60 |
$569.60 |
$208.50
|
|
Application long leg splint 29505
|
$569.60 |
$569.60 |
$569.60 |
$338.25
|
|
Application lower leg splint 29515
|
$471.00 |
$471.00 |
$471.00 |
$340.20
|
|
Application of cylinder cast 29365
|
$801.60 |
$801.60 |
$801.60 |
$431.08
|
|
Application of forearm cast 29075
|
$998.40 |
$998.40 |
$998.40 |
$358.20
|
|
Application of long leg cast 29345
|
$176.40 |
$176.40 |
$176.40 |
$455.00
|
|
Application of paste boot 29580
|
$569.60 |
$569.60 |
$569.60 |
$340.11
|
|
Application short leg cast 29405
|
$103.20 |
$103.20 |
$103.20 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$170.40 |
$170.40 |
$170.40 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,502.40 |
$1,502.40 |
$1,502.40 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$92.80 |
$92.80 |
$92.80 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$92.80 |
$92.80 |
$92.80 |
$75.98
|
|
Apply forearm splintdynamic 29126
|
$569.60 |
$569.60 |
$569.60 |
$255.20
|
|
Apply of finger splint 29131
|
$664.80 |
$664.80 |
$664.80 |
$177.45
|
|
Apply short leg castambul type 29425
|
$100.00 |
$100.00 |
$100.00 |
$404.74
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$4.20 |
$4.20 |
$4.20 |
$955.43
|
|
#aptt mix-1:1 incubated
|
$252.00 |
$252.00 |
$252.00 |
$157.30
|
