|
Alt/sgpt
|
$9.30 |
$9.30 |
$9.30 |
$46.75
|
|
Aluminum - quest
|
$42.30 |
$42.30 |
$42.30 |
$81.49
|
|
Amantadine (symmetrel)-sendout
|
$7.05 |
$7.05 |
$7.05 |
$179.70
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$59.94 |
$59.94 |
$59.94 |
$36.30
|
|
Aminolevulinic acid delta
|
$28.80 |
$28.80 |
$28.80 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$33.63 |
$33.63 |
$33.63 |
$45.02
|
|
Amiodarone 50 mg/ml intravenous solution
|
$84.86 |
$84.86 |
$84.86 |
$61.29
|
|
Amitriptyline (elavil) -sendout
|
$13.20 |
$13.20 |
$13.20 |
$92.50
|
|
Ammonia
|
$25.50 |
$25.50 |
$25.50 |
$117.00
|
|
Amniocentesisdiagnostic 59000
|
$202.20 |
$202.20 |
$202.20 |
$943.50
|
|
Amniocentesis therapeutic
|
$143.10 |
$143.10 |
$143.10 |
$770.00
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,518.15 |
$1,518.15 |
$1,518.15 |
$3,839.54
|
|
Amphetamine confirm urine -sendout
|
$11.70 |
$11.70 |
$11.70 |
$93.61
|
|
Amphetamines 5 or more
|
$25.80 |
$25.80 |
$25.80 |
$87.75
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$92.22 |
$92.22 |
$92.22 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$408.23 |
$408.23 |
$408.23 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$62.14 |
$62.14 |
$62.14 |
$62.14
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$35.61 |
$35.61 |
$39.00 |
$55.69
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$75.15 |
$75.15 |
$75.15 |
$262.99
|
|
Amputation toe interphalangeal joint
|
$835.35 |
$835.35 |
$835.35 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$1,343.25 |
$1,343.25 |
$1,343.25 |
$3,814.50
|
|
Amylase
|
$11.40 |
$11.40 |
$11.40 |
$85.65
|
|
Ana ds-dna
|
$21.15 |
$21.15 |
$21.15 |
$58.63
|
|
Analgesics non-opioid 6/more
|
$33.60 |
$33.60 |
$33.60 |
$20.80
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$14.70 |
$14.70 |
$14.70 |
$117.01
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$61.80 |
$61.80 |
$61.80 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$86.10 |
$86.10 |
$86.10 |
$217.27
|
|
Analysis gene f5 leiden variant
|
$106.95 |
$106.95 |
$106.95 |
$221.13
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$59.85 |
$59.85 |
$59.85 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$61.50 |
$61.50 |
$61.50 |
$91.80
|
|
Anca screen with reflex to titer -quest
|
$25.35 |
$25.35 |
$25.35 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$1,027.20 |
$1,027.20 |
$1,027.20 |
$2,494.35
|
|
An fluoro guide for cvp
|
$69.30 |
$69.30 |
$69.30 |
$528.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,618.55 |
$2,618.55 |
$2,618.55 |
$5,341.83
|
|
Angioplasty fem/pop unilat 37224
|
$2,483.55 |
$2,483.55 |
$2,483.55 |
$9,074.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$2,483.55 |
$2,483.55 |
$2,483.55 |
$10,215.00
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$2,004.00 |
$2,004.00 |
$2,004.00 |
$5,950.50
|
|
Angiotensin ii
|
$22.05 |
$22.05 |
$22.05 |
$55.00
|
|
Angio tib/peroneal/init ves/unila 37228
|
$2,483.55 |
$2,483.55 |
$2,483.55 |
$10,933.65
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,059.15 |
$1,059.15 |
$1,059.15 |
$4,976.22
|
|
Angio trnslmnl balloon same artery ini
|
$2,648.25 |
$2,648.25 |
$2,648.25 |
$9,120.80
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,059.15 |
$1,059.15 |
$1,059.15 |
$4,560.40
|
|
Angio trnslmnl balloon same vein ini
|
$2,648.25 |
$2,648.25 |
$2,648.25 |
$8,689.20
|
|
Ankle X-ray
|
$76.35 |
$76.35 |
$76.35 |
$353.60
|
|
Anodyne therapy charges pt
|
$17.70 |
$17.70 |
$17.70 |
$41.02
|
|
Anora (draw only)
|
$2.10 |
$2.10 |
$2.10 |
$35.00
|
|
Antibody bacterium, not elsewhere specified
|
$22.50 |
$22.50 |
$22.50 |
$57.85
|
|
Antibody elution rbc reference
|
$47.40 |
$47.40 |
$47.40 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$33.90 |
$33.90 |
$33.90 |
$126.67
|
|
Antibody htlv-i
|
$14.70 |
$14.70 |
$14.70 |
$48.57
|
|
Antibody htlv-ii
|
$15.60 |
$15.60 |
$15.60 |
$36.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$31.05 |
$31.05 |
$31.05 |
$219.30
|
|
Antibody id rbc panel
|
$93.75 |
$93.75 |
$93.75 |
$277.53
|
|
Antibody influenza virus
|
$23.70 |
$23.70 |
$23.70 |
$53.95
|
|
Antibody screen rbc
|
$19.80 |
$19.80 |
$19.80 |
$105.00
|
|
Antibody tetanus
|
$25.95 |
$25.95 |
$25.95 |
$52.20
|
|
Antidepressant not specified
|
$13.20 |
$13.20 |
$13.20 |
$84.36
|
|
Antidepressants class 6/more
|
$29.70 |
$29.70 |
$29.70 |
$29.68
|
|
Antiepileptics nos 7/more
|
$11.10 |
$11.10 |
$11.10 |
$18.85
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$1,724.74 |
$1,724.74 |
$1,724.74 |
$6.10
|
|
Anti-inhibitor
|
$10,171.61 |
$10,171.61 |
$10,171.61 |
$8.33
|
|
Anti mog serum - sendout
|
$28.95 |
$28.95 |
$28.95 |
$115.80
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$28.20 |
$28.20 |
$28.20 |
$44.31
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$29.70 |
$29.70 |
$29.70 |
$36.60
|
|
Antinuclear antibodies
|
$21.15 |
$21.15 |
$21.15 |
$91.70
|
|
Antinuclear antibodies titer
|
$19.50 |
$19.50 |
$19.50 |
$79.95
|
|
Antiphosphatidylserine antibody
|
$27.15 |
$27.15 |
$27.15 |
$65.97
|
|
Antipsychotics nos 1-3
|
$11.10 |
$11.10 |
$11.10 |
$153.75
|
|
Antipsychotics nos 7/more
|
$25.80 |
$25.80 |
$25.80 |
$18.85
|
|
Antistreptolysin o screen
|
$10.05 |
$10.05 |
$10.05 |
$58.30
|
|
Antistreptolysin o titer
|
$12.75 |
$12.75 |
$12.75 |
$52.50
|
|
Antithrombin iii activity
|
$20.70 |
$20.70 |
$20.70 |
$114.00
|
|
Antithrombin iii injection
|
$9.78 |
$9.78 |
$9.78 |
$12.34
|
|
Antithymocyte globuln rabbit
|
$1,076.29 |
$1,076.29 |
$1,076.29 |
$2,111.00
|
|
Apc gene dup/delet variants
|
$96.75 |
$96.75 |
$96.75 |
$400.00
|
|
Apc gene full sequence
|
$96.75 |
$96.75 |
$96.75 |
$1,255.02
|
|
Apheresis plasma
|
$638.85 |
$638.85 |
$638.85 |
$3,291.00
|
|
Apl(pml-rara) quant - sendout
|
$363.00 |
$363.00 |
$363.00 |
$466.44
|
|
Appendix Removal (Laparoscopic)
|
$2,401.65 |
$2,401.65 |
$2,401.65 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$272.10 |
$272.10 |
$272.10 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$137.55 |
$137.55 |
$137.55 |
$908.05
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$26.25 |
$26.25 |
$26.25 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$860.70 |
$860.70 |
$860.70 |
$3,767.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$137.55 |
$137.55 |
$137.55 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$26.25 |
$26.25 |
$26.25 |
$545.25
|
|
Application finger splntstatic 29130
|
$51.60 |
$51.60 |
$51.60 |
$216.80
|
|
Application long leg splint 29505
|
$77.85 |
$77.85 |
$77.85 |
$356.85
|
|
Application lower leg splint 29515
|
$64.65 |
$64.65 |
$64.65 |
$354.00
|
|
Application multi layer compression below knee (both sides)
|
$110.40 |
$110.40 |
$110.40 |
$377.25
|
|
Application of forearm cast 29075
|
$130.20 |
$130.20 |
$130.20 |
$365.30
|
|
Application of long leg cast 29345
|
$93.75 |
$93.75 |
$93.75 |
$481.25
|
|
Application of paste boot 29580
|
$60.30 |
$60.30 |
$60.30 |
$331.74
|
|
Application short leg cast 29405
|
$99.60 |
$99.60 |
$99.60 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$373.50 |
$373.50 |
$373.50 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$373.50 |
$373.50 |
$373.50 |
$2,189.70
|
|
Appl mltpln uni ext fixj sys
|
$5,668.20 |
$5,668.20 |
$5,668.20 |
$6,411.60
|
|
Appl modality 1/> areas paraffin bath 97018
|
$18.75 |
$18.75 |
$18.75 |
$66.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$25.20 |
$25.20 |
$25.20 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$65.85 |
$65.85 |
$65.85 |
$297.50
|
|
Apply finger cast 29086
|
$43.95 |
$43.95 |
$43.95 |
$242.20
|