|
Allograft membrn amnio 1x2cm hu ambriodry
|
$59,195.07 |
$59,195.07 |
$59,195.07 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$19,405.65 |
$19,405.65 |
$19,405.65 |
$4,561.83
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$22,164.45 |
$22,164.45 |
$22,164.45 |
$1,495.63
|
|
Alpha-fetoprotein amniotic
|
$87.00 |
$87.00 |
$87.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$151.80 |
$151.80 |
$151.80 |
$106.00
|
|
Alprostadil for injection
|
$1,407.22 |
$1,407.22 |
$1,574.86 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$73,130.99 |
$73,130.99 |
$81,843.35 |
$15,857.45
|
|
Alt/sgpt
|
$80.40 |
$80.40 |
$80.40 |
$47.45
|
|
Aluminum - quest
|
$94.80 |
$94.80 |
$94.80 |
$83.05
|
|
Alveoloplasty each quadrant
|
$9,037.33 |
$9,037.33 |
$9,037.33 |
$3,892.00
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$96.82 |
$96.82 |
$108.35 |
$39.84
|
|
Amino acids quant 2-5
|
$74.40 |
$74.40 |
$74.40 |
$104.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$60.50 |
$60.50 |
$67.70 |
$37.14
|
|
Aminolevulinic acid delta
|
$114.60 |
$114.60 |
$114.60 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$45.00 |
$45.00 |
$45.00 |
$45.02
|
|
Amiodarone 50 mg/ml intravenous solution
|
$45.00 |
$45.00 |
$45.00 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$54.00 |
$54.00 |
$54.00 |
$87.45
|
|
Ammonia
|
$118.80 |
$118.80 |
$118.80 |
$119.70
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$7,289.40 |
$7,289.40 |
$7,289.40 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$71.40 |
$71.40 |
$71.40 |
$92.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$398.88 |
$398.88 |
$446.40 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$797.40 |
$797.40 |
$892.39 |
$543.85
|
|
Ampicillin 1 gram solution for injection
|
$573.19 |
$573.19 |
$641.47 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$76.76 |
$76.76 |
$85.91 |
$53.86
|
|
Amp metatarsal w/toe single 28810
|
$12,726.90 |
$12,726.90 |
$12,726.90 |
$4,271.00
|
|
Amputation follow-up surgery
|
$10,050.51 |
$10,050.51 |
$10,050.51 |
$3,839.54
|
|
Amputation leg; tib/fib f/u 27886
|
$10,252.70 |
$10,252.70 |
$10,252.70 |
$1,461.89
|
|
Amputation thru metatarsal
|
$15,865.65 |
$15,865.65 |
$15,865.65 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$13,839.17 |
$13,839.17 |
$14,059.26 |
$3,998.20
|
|
Amputation toe metatarsophalangeal joint
|
$9,693.60 |
$9,693.60 |
$9,693.60 |
$3,839.54
|
|
Amylase
|
$261.60 |
$261.60 |
$261.60 |
$89.04
|
|
Anca screen with reflex to titer -quest
|
$435.00 |
$435.00 |
$435.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$8,500.80 |
$8,500.80 |
$8,500.80 |
$2,626.65
|
|
An fluoro guide for cvp
|
$743.40 |
$743.40 |
$743.40 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$30,965.89 |
$30,965.89 |
$30,965.89 |
$5,341.83
|
|
Angioplasty fem/pop unilat 37224
|
$89,498.43 |
$89,498.43 |
$89,498.43 |
$8,772.38
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$255.12 |
$255.12 |
$285.51 |
$3,080.85
|
|
Angio tib/peroneal/init ves/unila 37228
|
$63,563.21 |
$63,563.21 |
$63,563.21 |
$10,522.96
|
|
Angio trnslmnl balloon same artery ea addl
|
$9,520.20 |
$9,520.20 |
$9,520.20 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$13,416.60 |
$13,416.60 |
$13,416.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$13,877.40 |
$13,877.40 |
$13,877.40 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$108,704.86 |
$108,704.86 |
$108,704.86 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$35,808.43 |
$35,808.43 |
$35,808.43 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$40,692.73 |
$40,692.73 |
$40,692.73 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$37,445.08 |
$37,445.08 |
$37,445.08 |
$3,839.54
|
|
Ankle X-ray
|
$487.20 |
$487.20 |
$487.20 |
$353.60
|
|
Anodyne therapy charges pt
|
$60.00 |
$60.00 |
$60.00 |
$42.00
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$26,739.40 |
$26,739.40 |
$42,989.65 |
$5,463.96
|
|
Anterior asis pad
|
$447.11 |
$447.11 |
$447.11 |
$187.13
|
|
Anterior swing band
|
$1,589.20 |
$1,589.20 |
$1,589.20 |
$665.14
|
|
Anterior thoracic derotation
|
$533.20 |
$533.20 |
$533.20 |
$223.16
|
|
Anterior thoracic extension
|
$1,231.37 |
$1,231.37 |
$1,231.37 |
$496.80
|
|
Antibody elution rbc reference
|
$169.20 |
$169.20 |
$169.20 |
$175.50
|
|
Antibody htlv-i
|
$72.00 |
$72.00 |
$72.00 |
$49.53
|
|
Antibody htlv-ii
|
$66.60 |
$66.60 |
$66.60 |
$42.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$270.00 |
$270.00 |
$270.00 |
$218.30
|
|
Antibody id rbc panel
|
$220.80 |
$220.80 |
$220.80 |
$274.56
|
|
Antibody influenza virus
|
$97.80 |
$97.80 |
$97.80 |
$53.95
|
|
Antibody screen rbc
|
$109.80 |
$109.80 |
$109.80 |
$100.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$8,316.00 |
$8,316.00 |
$9,504.00 |
$6.10
|
|
Anti-inhibitor
|
$11,340.00 |
$11,340.00 |
$12,960.00 |
$8.33
|
|
Anti mog serum - sendout
|
$495.00 |
$495.00 |
$495.00 |
$159.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$36.60 |
$36.60 |
$36.60 |
$37.05
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$36.60 |
$36.60 |
$36.60 |
$40.00
|
|
Ant instr 2-3 vert segm 22845
|
$47,489.02 |
$47,489.02 |
$47,489.02 |
$1,748.00
|
|
Antiphosphatidylserine antibody
|
$189.60 |
$189.60 |
$189.60 |
$65.97
|
|
Antistreptolysin o titer
|
$114.60 |
$114.60 |
$114.60 |
$51.45
|
|
Antithrombin iii activity
|
$229.80 |
$229.80 |
$229.80 |
$114.00
|
|
Antithrombin iii injection
|
$9,366.00 |
$9,366.00 |
$10,704.00 |
$12.34
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$21,257.50 |
$21,257.50 |
$24,294.29 |
$7,704.70
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$37,170.19 |
$37,170.19 |
$37,170.19 |
$4,155.20
|
|
Aortic dysfunction/dilation
|
$2,316.60 |
$2,316.60 |
$2,316.60 |
$1,008.00
|
|
Apl(pml-rara) quant - sendout
|
$414.00 |
$414.00 |
$414.00 |
$482.95
|
|
Appendix Removal (Laparoscopic)
|
$38,575.04 |
$38,575.04 |
$42,596.98 |
$6,870.89
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,809.00 |
$4,809.00 |
$4,809.00 |
$3,345.60
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$405.60 |
$405.60 |
$405.60 |
$498.81
|
|
Application finger splntstatic 29130
|
$187.20 |
$187.20 |
$187.20 |
$208.16
|
|
Application long leg splint 29505
|
$187.20 |
$187.20 |
$187.20 |
$338.25
|
|
Application lower leg splint 29515
|
$187.20 |
$187.20 |
$187.20 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$252.00 |
$252.00 |
$252.00 |
$373.20
|
|
Application of forearm cast 29075
|
$248.40 |
$248.40 |
$248.40 |
$339.30
|
|
Application of long arm cast 29065
|
$248.40 |
$248.40 |
$248.40 |
$395.00
|
|
Application of long leg cast 29345
|
$248.40 |
$248.40 |
$248.40 |
$455.00
|
|
Application of paste boot 29580
|
$289.80 |
$289.80 |
$289.80 |
$331.74
|
|
Application short leg cast 29405
|
$248.40 |
$248.40 |
$248.40 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,977.60 |
$1,977.60 |
$28,601.43 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,537.20 |
$1,537.20 |
$1,537.20 |
$2,164.64
|
|
Applicator tag rfid localizer 12gx7cm
|
$15,643.65 |
$15,643.65 |
$15,643.65 |
$744.90
|
|
Appl modality 1/> areas paraffin bath 97018
|
$85.20 |
$85.20 |
$85.20 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$98.40 |
$98.40 |
$98.40 |
$75.60
|
|
Apply forearm splintdynamic 29126
|
$187.20 |
$187.20 |
$187.20 |
$246.18
|
|
Apply interstit radiat compl
|
$2,577.60 |
$2,577.60 |
$2,577.60 |
$2,910.05
|
|
Apply of finger splint 29131
|
$187.20 |
$187.20 |
$187.20 |
$168.00
|
|
Apply rigid leg cast 29445
|
$592.80 |
$592.80 |
$592.80 |
$555.00
|
|
Apply short leg castambul type 29425
|
$248.40 |
$248.40 |
$248.40 |
$381.00
|
|
#aptt mix-1:1 incubated
|
$241.80 |
$241.80 |
$241.80 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$495.00 |
$495.00 |
$495.00 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$526.80 |
$526.80 |
$526.80 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$361.20 |
$361.20 |
$361.20 |
$148.80
|
|
Aquatic exercise - group charge
|
$91.20 |
$91.20 |
$91.20 |
$85.80
|
