|
Alginate dressing <=16 sq in
|
$73.80 |
$73.80 |
$73.80 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$139.80 |
$139.80 |
$139.80 |
$43.72
|
|
Alkaline phosphatase
|
$114.00 |
$114.00 |
$114.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$25.80 |
$25.80 |
$25.80 |
$48.57
|
|
Allergen egg white ige
|
$25.80 |
$25.80 |
$25.80 |
$38.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$2,982.60 |
$2,982.60 |
$2,982.60 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$9,287.40 |
$9,287.40 |
$9,287.40 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$4,721.40 |
$4,721.40 |
$4,721.40 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$3,954.00 |
$3,954.00 |
$3,954.00 |
$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
|
$147.00 |
$147.00 |
$147.00 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$160.20 |
$160.20 |
$160.20 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$139.20 |
$139.20 |
$139.20 |
$106.00
|
|
Alprostadil for injection
|
$550.20 |
$550.20 |
$550.20 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$543.20 |
$543.20 |
$543.20 |
$15,857.45
|
|
Alt/sgpt
|
$133.80 |
$133.80 |
$133.80 |
$47.50
|
|
Aluminum - quest
|
$319.20 |
$319.20 |
$319.20 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$1,389.60 |
$1,389.60 |
$1,389.60 |
$411.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$26.80 |
$26.80 |
$26.80 |
$39.84
|
|
Amino acids quant 2-5
|
$220.80 |
$220.80 |
$220.80 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$8.00 |
$8.00 |
$8.00 |
$37.33
|
|
Aminolevulinic acid delta
|
$178.80 |
$178.80 |
$178.80 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$70.20 |
$70.20 |
$70.20 |
$47.06
|
|
Amiodarone 50 mg/ml intravenous solution
|
$42.80 |
$42.80 |
$42.80 |
$55.86
|
|
Ammonia
|
$126.00 |
$126.00 |
$126.00 |
$119.70
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$136.80 |
$136.80 |
$136.80 |
$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
|
$27.40 |
$27.40 |
$27.40 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$45.20 |
$45.20 |
$45.20 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$280.20 |
$280.20 |
$280.20 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$4,707.00 |
$4,707.00 |
$4,707.00 |
$3,986.00
|
|
Amputation toe interphalangeal joint
|
$2,733.00 |
$2,733.00 |
$2,733.00 |
$4,196.50
|
|
Amylase
|
$113.40 |
$113.40 |
$113.40 |
$90.00
|
|
Ana ds-dna
|
$178.80 |
$178.80 |
$178.80 |
$55.24
|
|
Anal/urinary muscle study
|
$1,258.20 |
$1,258.20 |
$1,258.20 |
$602.80
|
|
Analysis gene f2 20210g>a variant
|
$2,479.80 |
$2,479.80 |
$2,479.80 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$1,217.40 |
$1,217.40 |
$1,217.40 |
$249.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$744.60 |
$744.60 |
$744.60 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$290.40 |
$290.40 |
$290.40 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$103.20 |
$103.20 |
$103.20 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$2,636.40 |
$2,636.40 |
$2,636.40 |
$2,480.94
|
|
An fluoro guide for cvp
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,525.40 |
$2,525.40 |
$2,525.40 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$4,394.40 |
$4,394.40 |
$4,394.40 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$3,734.40 |
$3,734.40 |
$3,734.40 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$4,394.40 |
$4,394.40 |
$4,394.40 |
$5,950.50
|
|
Angiotensin ii
|
$276.60 |
$276.60 |
$276.60 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$21,829.80 |
$21,829.80 |
$21,829.80 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$4,394.40 |
$4,394.40 |
$4,394.40 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,126.80 |
$4,126.80 |
$4,126.80 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$4,416.60 |
$4,416.60 |
$4,416.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,126.80 |
$4,126.80 |
$4,126.80 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$4,416.60 |
$4,416.60 |
$4,416.60 |
$8,359.11
|
|
Anidulafungin injection
|
$8.40 |
$8.40 |
$8.40 |
$312.30
|
|
Ankle X-ray
|
$307.20 |
$307.20 |
$307.20 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$577.20 |
$577.20 |
$577.20 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,135.80 |
$1,135.80 |
$1,135.80 |
$630.96
|
|
Annual Physical, Established Patient (age 18-39)
|
$97.20 |
$97.20 |
$97.20 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$96.60 |
$96.60 |
$96.60 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$115.20 |
$115.20 |
$115.20 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$121.20 |
$121.20 |
$121.20 |
$167.25
|
|
Anoscopy control bleeding 46614
|
$991.20 |
$991.20 |
$991.20 |
$2,140.60
|
|
Antibody bacterium, not elsewhere specified
|
$36.60 |
$36.60 |
$36.60 |
$57.85
|
|
Antibody htlv/hiv confirm test
|
$246.60 |
$246.60 |
$246.60 |
$131.56
|
|
Antibody htlv-i
|
$79.20 |
$79.20 |
$79.20 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$527.40 |
$527.40 |
$527.40 |
$224.00
|
|
Antibody id rbc panel
|
$205.80 |
$205.80 |
$205.80 |
$291.75
|
|
Antibody lymphocytic choriomeningitis
|
$91.80 |
$91.80 |
$91.80 |
$46.58
|
|
Antibody screen rbc
|
$113.40 |
$113.40 |
$113.40 |
$108.55
|
|
Antibody tetanus
|
$332.40 |
$332.40 |
$332.40 |
$54.15
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$11.40 |
$11.40 |
$11.40 |
$6.10
|
|
Anti mog serum - sendout
|
$132.60 |
$132.60 |
$132.60 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$103.20 |
$103.20 |
$103.20 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$156.00 |
$156.00 |
$156.00 |
$42.00
|
|
Antinuclear antibodies
|
$71.40 |
$71.40 |
$71.40 |
$90.00
|
|
Antinuclear antibodies titer
|
$91.20 |
$91.20 |
$91.20 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$394.20 |
$394.20 |
$394.20 |
$67.43
|
|
Antistreptolysin o screen
|
$56.40 |
$56.40 |
$56.40 |
$58.56
|
|
Antithrombin iii activity
|
$157.80 |
$157.80 |
$157.80 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$248.40 |
$248.40 |
$248.40 |
$394.55
|
|
Aortic dysfunction/dilation
|
$7,223.40 |
$7,223.40 |
$7,223.40 |
$1,153.60
|
|
Apl(pml-rara) quant - sendout
|
$741.00 |
$741.00 |
$741.00 |
$513.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,034.60 |
$5,034.60 |
$5,034.60 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$3,682.80 |
$3,682.80 |
$3,682.80 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$261.00 |
$261.00 |
$261.00 |
$512.20
|
|
Application finger splntstatic 29130
|
$471.00 |
$471.00 |
$471.00 |
$208.50
|
|
Application long leg splint 29505
|
$471.00 |
$471.00 |
$471.00 |
$338.25
|
|
Application lower leg splint 29515
|
$471.00 |
$471.00 |
$471.00 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$274.20 |
$274.20 |
$274.20 |
$375.06
|
|
Application of forearm cast 29075
|
$825.60 |
$825.60 |
$825.60 |
$358.20
|
|
Application of long arm cast 29065
|
$1,258.80 |
$1,258.80 |
$1,258.80 |
$396.77
|
|
Application of long leg cast 29345
|
$73.20 |
$73.20 |
$73.20 |
$455.00
|
|
Application of paste boot 29580
|
$307.20 |
$307.20 |
$307.20 |
$340.11
|
|
Application short leg cast 29405
|
$62.40 |
$62.40 |
$62.40 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,242.60 |
$1,242.60 |
$1,242.60 |
$2,123.50
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,242.60 |
$1,242.60 |
$1,242.60 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$843.00 |
$843.00 |
$843.00 |
$981.75
|
|
Appl mltpln uni ext fixj sys
|
$6,347.40 |
$6,347.40 |
$6,347.40 |
$5,855.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$76.80 |
$76.80 |
$76.80 |
$69.00
|
|
Appl multlay comprs arm/hand
|
$508.20 |
$508.20 |
$508.20 |
$289.60
|
