|
Allergen alpha lactalbumin ige
|
$187.00 |
$187.00 |
$187.00 |
$48.57
|
|
Allergen egg white ige
|
$81.50 |
$81.50 |
$81.50 |
$37.20
|
|
Allergy injections; 2 or more 95117
|
$34.50 |
$34.50 |
$34.50 |
$43.75
|
|
Allergy injection; single 95115
|
$34.50 |
$34.50 |
$34.50 |
$45.00
|
|
Allergy Skin Testing
|
$602.50 |
$602.50 |
$602.50 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$5.50 |
$5.50 |
$5.50 |
$423.37
|
|
Allograft 160mg placental salera mini membrane
|
$31.50 |
$31.50 |
$31.50 |
$6,022.57
|
|
Allograft amnioexcel plus 17mm disk
|
$341.50 |
$341.50 |
$341.50 |
$507.30
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,095.00 |
$7,095.00 |
$7,095.00 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$422.00 |
$422.00 |
$422.00 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$226.00 |
$226.00 |
$226.00 |
$21,790.11
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$571.50 |
$571.50 |
$571.50 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$885.50 |
$885.50 |
$885.50 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$8,300.00 |
$8,300.00 |
$8,300.00 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$451.50 |
$451.50 |
$451.50 |
$1,777.39
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$230.00 |
$230.00 |
$230.00 |
$189.15
|
|
Alpha-fetoprotein amniotic
|
$58.00 |
$58.00 |
$58.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$96.00 |
$96.00 |
$96.00 |
$103.80
|
|
Alt/sgpt
|
$26.00 |
$26.00 |
$26.00 |
$47.40
|
|
Aluminum - quest
|
$52.00 |
$52.00 |
$52.00 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$171.00 |
$171.00 |
$171.00 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$553.00 |
$553.00 |
$553.00 |
$179.70
|
|
Aminolevulinic acid delta
|
$116.50 |
$116.50 |
$116.50 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$87.50 |
$87.50 |
$87.50 |
$84.56
|
|
Ammonia
|
$102.50 |
$102.50 |
$102.50 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$520.00 |
$520.00 |
$520.00 |
$923.50
|
|
Amniocentesis therapeutic
|
$572.50 |
$572.50 |
$572.50 |
$791.05
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,078.50 |
$3,078.50 |
$3,078.50 |
$3,735.51
|
|
Amphetamine confirm urine -sendout
|
$149.50 |
$149.50 |
$149.50 |
$93.61
|
|
Amphetamines 5 or more
|
$87.00 |
$87.00 |
$87.00 |
$90.48
|
|
Amp metatarsal w/toe single 28810
|
$3,743.00 |
$3,743.00 |
$3,743.00 |
$3,986.00
|
|
Amputate metacarpal bone 26910
|
$4,878.50 |
$4,878.50 |
$4,878.50 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$3,965.50 |
$3,965.50 |
$3,965.50 |
$3,839.54
|
|
Amylase
|
$63.50 |
$63.50 |
$63.50 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$194.00 |
$194.00 |
$194.00 |
$80.08
|
|
Anal pressure record
|
$972.50 |
$972.50 |
$972.50 |
$946.24
|
|
Anal/urinary muscle study
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$407.00
|
|
Anal/urinary muscle study
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$587.40
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$143.50 |
$143.50 |
$143.50 |
$335.85
|
|
Analysis gene f2 20210g>a variant
|
$581.50 |
$581.50 |
$581.50 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$581.50 |
$581.50 |
$581.50 |
$237.60
|
|
Analysis nerve
|
$148.00 |
$148.00 |
$148.00 |
$262.40
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$45.50 |
$45.50 |
$45.50 |
$123.84
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$171.00 |
$171.00 |
$171.00 |
$375.00
|
|
Anca screen with reflex to titer -quest
|
$288.50 |
$288.50 |
$288.50 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$2,328.50 |
$2,328.50 |
$2,328.50 |
$2,494.35
|
|
An fluoro guide for cvp
|
$676.00 |
$676.00 |
$676.00 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$5,728.50 |
$5,728.50 |
$5,728.50 |
$5,500.00
|
|
Angioplasty fem/pop unilat 37224
|
$6,703.50 |
$6,703.50 |
$6,703.50 |
$8,835.00
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$6,895.00 |
$6,895.00 |
$6,895.00 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$6,707.00 |
$6,707.00 |
$6,707.00 |
$5,950.50
|
|
Angio tib/peroneal/init ves/unila 37228
|
$7,547.50 |
$7,547.50 |
$7,547.50 |
$10,513.36
|
|
Angio trnslmnl balloon same artery ea addl
|
$5,728.50 |
$5,728.50 |
$5,728.50 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$8,155.00 |
$8,155.00 |
$8,155.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$5,728.50 |
$5,728.50 |
$5,728.50 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$8,155.00 |
$8,155.00 |
$8,155.00 |
$8,466.00
|
|
Ankle X-ray
|
$163.00 |
$163.00 |
$163.00 |
$352.80
|
|
Anl sp inf pmp w/mdreprg&fil
|
$380.00 |
$380.00 |
$380.00 |
$627.94
|
|
Anogenital exam child w imag
|
$84.50 |
$84.50 |
$84.50 |
$277.99
|
|
Anora (draw only)
|
$15.00 |
$15.00 |
$15.00 |
$35.00
|
|
Ans parasymp & symp w/tilt
|
$125.00 |
$125.00 |
$125.00 |
$368.50
|
|
Anterior thoracic extension
|
$454.00 |
$454.00 |
$454.00 |
$496.80
|
|
Antibody elution rbc reference
|
$211.00 |
$211.00 |
$211.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$147.00 |
$147.00 |
$147.00 |
$131.28
|
|
Antibody htlv-i
|
$67.50 |
$67.50 |
$67.50 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$452.00 |
$452.00 |
$452.00 |
$219.30
|
|
Antibody id rbc panel
|
$232.00 |
$232.00 |
$232.00 |
$290.21
|
|
Antibody influenza virus
|
$84.50 |
$84.50 |
$84.50 |
$53.90
|
|
Antibody screen rbc
|
$92.00 |
$92.00 |
$92.00 |
$106.88
|
|
Antidepressant not specified
|
$163.00 |
$163.00 |
$163.00 |
$72.14
|
|
Antigen therapy services
|
$41.50 |
$41.50 |
$41.50 |
$73.84
|
|
Antigen therapy services
|
$59.50 |
$59.50 |
$59.50 |
$83.72
|
|
Antigen therapy services
|
$47.50 |
$47.50 |
$47.50 |
$70.07
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$299.50 |
$299.50 |
$299.50 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$37.50 |
$37.50 |
$37.50 |
$42.00
|
|
Antinuclear antibodies
|
$95.00 |
$95.00 |
$95.00 |
$90.00
|
|
Antinuclear antibodies titer
|
$84.00 |
$84.00 |
$84.00 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$76.50 |
$76.50 |
$76.50 |
$64.50
|
|
Antipsychotics nos 1-3
|
$169.50 |
$169.50 |
$169.50 |
$137.80
|
|
Antistreptolysin o titer
|
$43.00 |
$43.00 |
$43.00 |
$52.50
|
|
Antithrombin iii activity
|
$162.50 |
$162.50 |
$162.50 |
$114.00
|
|
Ant sgm img i&r speclr mic
|
$185.00 |
$185.00 |
$185.00 |
$286.00
|
|
Aphakia prosth service temp
|
$108.50 |
$108.50 |
$108.50 |
$81.12
|
|
Apheresis immunoads slctv
|
$4,348.00 |
$4,348.00 |
$4,348.00 |
$5,794.21
|
|
Apheresis plasma
|
$2,962.50 |
$2,962.50 |
$2,962.50 |
$3,188.50
|
|
Apheresis platelets
|
$3,550.50 |
$3,550.50 |
$3,550.50 |
$2,195.00
|
|
Apheresis rbc
|
$2,202.00 |
$2,202.00 |
$2,202.00 |
$3,290.80
|
|
Apl(pml-rara) quant - sendout
|
$760.00 |
$760.00 |
$760.00 |
$500.80
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,123.50 |
$2,123.50 |
$2,123.50 |
$2,112.66
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,486.50 |
$1,486.50 |
$1,486.50 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,486.50 |
$1,486.50 |
$1,486.50 |
$490.50
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,366.00 |
$4,366.00 |
$4,366.00 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$3,056.00 |
$3,056.00 |
$3,056.00 |
$1,132.20
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,486.50 |
$1,486.50 |
$1,486.50 |
$508.18
|
|
Appl hip spica cast1&1/2
|
$422.00 |
$422.00 |
$422.00 |
$501.28
|
|
Application clubfoot cast
|
$293.50 |
$293.50 |
$293.50 |
$303.00
|
|
Application finger splntstatic 29130
|
$262.50 |
$262.50 |
$262.50 |
$208.50
|
|
Application long leg splint 29505
|
$202.00 |
$202.00 |
$202.00 |
$338.25
|
|
Application lower leg splint 29515
|
$191.00 |
$191.00 |
$191.00 |
$334.20
|
|
Application multi layer compression below knee (both sides)
|
$205.50 |
$205.50 |
$205.50 |
$370.92
|
