|
2nd order venous cath
|
$191.36 |
$191.36 |
$191.36 |
$1,543.85
|
|
3-d radiotherapy plan
|
$1,039.36 |
$1,039.36 |
$1,039.36 |
$5,002.69
|
|
88334 ap bill cytologic exam each additional site
|
$18.24 |
$18.24 |
$18.24 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,690.37 |
$1,690.37 |
$1,690.37 |
$3,128.29
|
|
Abd aorta w/runoff s&i
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$153.60 |
$153.60 |
$153.60 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$156.80 |
$156.80 |
$156.80 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$159.04 |
$159.04 |
$159.04 |
$2,486.97
|
|
Abd/low ext cath addl
|
$162.56 |
$162.56 |
$162.56 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$633.28 |
$633.28 |
$633.28 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$422.40 |
$422.40 |
$422.40 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$422.40 |
$422.40 |
$422.40 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$808.32 |
$808.32 |
$808.32 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$568.64 |
$568.64 |
$568.64 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$568.64 |
$568.64 |
$568.64 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$568.96 |
$568.96 |
$568.96 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$286.08 |
$286.08 |
$286.08 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$155.84 |
$155.84 |
$155.84 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$449.92 |
$449.92 |
$449.92 |
$1,145.40
|
|
Ablation cardiac vagal inputs atrium
|
$1,345.92 |
$1,345.92 |
$1,345.92 |
$1,960.80
|
|
Ablation cryo abd perit om
|
$449.92 |
$449.92 |
$449.92 |
$2,312.80
|
|
Abobotulinumtoxina
|
$960.24 |
$960.24 |
$960.24 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$798.08 |
$798.08 |
$798.08 |
$2,957.17
|
|
Acetaminophen level
|
$63.68 |
$63.68 |
$63.68 |
$107.62
|
|
Acetone qualitative
|
$14.40 |
$14.40 |
$14.40 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$44.48 |
$44.48 |
$44.48 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$119.42 |
$119.42 |
$119.42 |
$216.00
|
|
Acute hepatitis panel
|
$144.00 |
$144.00 |
$144.00 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$56.06 |
$56.06 |
$56.06 |
$63.48
|
|
Adapter b 8 channel 10cm
|
$622.57 |
$622.57 |
$622.57 |
$5,695.04
|
|
Adenosine 3 mg/250 ml bag for osm
|
$400.86 |
$400.86 |
$400.86 |
$255.41
|
|
Administration chemotherapy IV infusion each additional hour
|
$35.20 |
$35.20 |
$35.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$40.64 |
$40.64 |
$40.64 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$161.92 |
$161.92 |
$161.92 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$161.92 |
$161.92 |
$161.92 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$46.72 |
$46.72 |
$46.72 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$46.72 |
$46.72 |
$46.72 |
$257.40
|
|
Administration immunization 1 vaccine
|
$35.20 |
$35.20 |
$35.20 |
$69.21
|
|
Administration immunization each additional vaccine
|
$32.96 |
$32.96 |
$32.96 |
$47.40
|
|
Administration vaccine hepatitis b
|
$32.96 |
$32.96 |
$32.96 |
$54.40
|
|
Administration vaccine influenza virus
|
$32.96 |
$32.96 |
$32.96 |
$50.43
|
|
Administration vaccine pneumococcal
|
$32.96 |
$32.96 |
$32.96 |
$50.43
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$6,961.48 |
$6,961.48 |
$6,961.48 |
$11,350.31
|
|
_afb org id by sequencing rflx ast-sendout
|
$112.00 |
$112.00 |
$112.00 |
$315.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$8,536.33 |
$8,536.33 |
$8,536.33 |
$14,475.20
|
|
Air injection into abdomen 49400
|
$116.16 |
$116.16 |
$116.16 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$31.68 |
$31.68 |
$31.68 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$313.96 |
$313.96 |
$313.96 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$245.11 |
$245.11 |
$245.11 |
$243.59
|
|
Albumin, human 5 % intravenous solution
|
$73.54 |
$73.54 |
$73.54 |
$296.32
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$7.68 |
$7.68 |
$7.68 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$15.36 |
$15.36 |
$15.36 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$38.72 |
$38.72 |
$38.72 |
$93.60
|
|
Alkaline phosphatase
|
$16.00 |
$16.00 |
$16.00 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$44.16 |
$44.16 |
$44.16 |
$48.00
|
|
Allergen egg white ige
|
$53.76 |
$53.76 |
$53.76 |
$38.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$5,680.00 |
$5,680.00 |
$5,680.00 |
$6,414.50
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$2,206.40 |
$2,206.40 |
$2,206.40 |
$874.65
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$0.67 |
$0.67 |
$0.67 |
$12.50
|
|
Alpha-fetoprotein tumor marker
|
$37.44 |
$37.44 |
$37.44 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$9,597.32 |
$9,597.32 |
$9,597.32 |
$15,857.45
|
|
Alt/sgpt
|
$16.00 |
$16.00 |
$16.00 |
$47.45
|
|
Aluminum - quest
|
$21.44 |
$21.44 |
$21.44 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$54.97 |
$54.97 |
$54.97 |
$39.84
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$44.84 |
$44.84 |
$44.84 |
$45.02
|
|
Amiodarone 50 mg/ml intravenous solution
|
$457.18 |
$457.18 |
$457.18 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$3,976.56 |
$3,976.56 |
$3,976.56 |
$7,994.03
|
|
Ammonia
|
$47.04 |
$47.04 |
$47.04 |
$119.70
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$92.93 |
$92.93 |
$92.93 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$347.13 |
$347.13 |
$347.13 |
$543.85
|
|
Ampicillin 1 gram solution for injection
|
$20.44 |
$20.44 |
$20.44 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$18.88 |
$18.88 |
$18.88 |
$53.86
|
|
Amylase
|
$20.80 |
$20.80 |
$20.80 |
$89.04
|
|
Analysis gene f2 20210g>a variant
|
$53.76 |
$53.76 |
$53.76 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$48.00 |
$48.00 |
$48.00 |
$230.40
|
|
Analysis nerve
|
$114.56 |
$114.56 |
$114.56 |
$274.49
|
|
An cholangiogram percutaneous compl
|
$1,755.84 |
$1,755.84 |
$1,755.84 |
$2,626.65
|
|
An fluoro guide for cvp
|
$65.60 |
$65.60 |
$65.60 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,789.12 |
$1,789.12 |
$1,789.12 |
$5,341.83
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,365.76 |
$1,365.76 |
$1,365.76 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$1,365.76 |
$1,365.76 |
$1,365.76 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,789.12 |
$1,789.12 |
$1,789.12 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$1,789.12 |
$1,789.12 |
$1,789.12 |
$8,466.00
|
|
Anidulafungin injection
|
$208.18 |
$208.18 |
$208.18 |
$312.30
|
|
Ankle X-ray
|
$139.84 |
$139.84 |
$139.84 |
$353.60
|
|
Antibody elution rbc reference
|
$194.24 |
$194.24 |
$194.24 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$56.00 |
$56.00 |
$56.00 |
$218.30
|
|
Antibody id rbc panel
|
$577.60 |
$577.60 |
$577.60 |
$274.56
|
|
Antibody screen rbc
|
$24.00 |
$24.00 |
$24.00 |
$100.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.70 |
$3.70 |
$3.70 |
$6.10
|
|
Anti-inhibitor
|
$6.05 |
$6.05 |
$6.05 |
$8.33
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$7.68 |
$7.68 |
$7.68 |
$37.05
|
|
Antinuclear antibodies
|
$11.20 |
$11.20 |
$11.20 |
$89.40
|
|
Antinuclear antibodies titer
|
$10.24 |
$10.24 |
$10.24 |
$77.00
|
|
Antistreptolysin o titer
|
$18.88 |
$18.88 |
$18.88 |
$51.45
|
|
Antithrombin iii activity
|
$52.48 |
$52.48 |
$52.48 |
$114.00
|
|
Antithrombin iii injection
|
$10.30 |
$10.30 |
$10.30 |
$12.34
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$5,519.66 |
$5,519.66 |
$5,519.66 |
$7,704.70
|
|
Antithymocyte globuln rabbit
|
$1,220.85 |
$1,220.85 |
$1,220.85 |
$2,111.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$449.60 |
$449.60 |
$449.60 |
$463.65
|