|
Administration immunization intranasal/oral route 1 vaccine
|
$48.00 |
$48.00 |
$48.00 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$33.60 |
$33.60 |
$33.60 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$27.46 |
$27.46 |
$27.46 |
$44.80
|
|
Administration vaccine hepatitis b
|
$66.97 |
$66.97 |
$66.97 |
$53.00
|
|
Administration vaccine influenza virus
|
$15.00 |
$15.00 |
$15.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$42.50 |
$42.50 |
$42.50 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$24.68 |
$24.68 |
$24.68 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$7,705.67 |
$7,705.67 |
$11,350.31 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,987.70
|
|
Adrenalin epinephrine inject
|
$541.25 |
$541.25 |
$541.25 |
$231.47
|
|
Aep hearing status deter i&r
|
$293.72 |
$293.72 |
$293.72 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$517.35 |
$517.35 |
$710.53 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$517.35 |
$517.35 |
$710.53 |
$635.00
|
|
Afamitresgene autoleucel
|
$2,125,068.14 |
$2,125,068.14 |
$2,125,068.14 |
$2,125,068.14
|
|
_afb id by dna probe rflx ast
|
$133.35 |
$133.35 |
$307.03 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$353.10 |
$353.10 |
$473.33 |
$300.00
|
|
Afo molded to patient plasti
|
$113.98 |
$113.98 |
$617.81 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$1,883.09 |
$1,883.09 |
$1,883.09 |
$1,843.53
|
|
Afo spiral molded to pt plas
|
$1,450.86 |
$1,450.86 |
$1,450.86 |
$1,450.86
|
|
Afo tib fx cast molded to pt
|
$2,175.63 |
$2,175.63 |
$2,175.63 |
$2,118.14
|
|
Afo tib fx semi-rigid l2114
|
$121.64 |
$121.64 |
$1,227.08 |
$817.60
|
|
Afo tibial fracture rigid
|
$1,464.20 |
$1,464.20 |
$1,464.20 |
$1,489.57
|
|
Afo tibial fracture soft
|
$1,060.02 |
$1,060.02 |
$1,060.02 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$2,903.60 |
$2,903.60 |
$2,903.60 |
$2,859.19
|
|
After cataract laser surgery
|
$1,373.11 |
$1,373.11 |
$1,373.11 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$13,418.51 |
$13,418.51 |
$14,760.37 |
$14,475.20
|
|
Ag detect nos ia single
|
$74.79 |
$74.79 |
$74.79 |
$74.79
|
|
Air injection into abdomen 49400
|
$531.49 |
$531.49 |
$531.49 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$436.14 |
$436.14 |
$436.14 |
$297.00
|
|
Ak pelvic control belt pad/l
|
$505.78 |
$505.78 |
$505.78 |
$334.90
|
|
Albumin body fluid quantitative each specimen
|
$61.52 |
$61.52 |
$105.90 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$327.39 |
$327.39 |
$327.39 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$174.30 |
$174.30 |
$174.30 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$258.00 |
$258.00 |
$258.00 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$413.18 |
$413.18 |
$413.18 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$92.09 |
$92.09 |
$159.75 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$53.23 |
$53.23 |
$92.85 |
$43.00
|
|
Albuterol non-comp unit
|
$0.96 |
$0.96 |
$0.96 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$214.18 |
$214.18 |
$214.18 |
$96.00
|
|
Aldesleukin injection
|
$8,460.48 |
$8,460.48 |
$28,179.27 |
$9,030.11
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$57,020.40 |
$57,020.40 |
$57,020.40 |
$47,974.31
|
|
Alginate dressing <=16 sq in
|
$21.50 |
$21.50 |
$21.50 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$94.71 |
$94.71 |
$94.71 |
$43.72
|
|
Alginate drsg wound filler
|
$27.60 |
$27.60 |
$27.60 |
$15.79
|
|
Alkaline phosphatase
|
$60.94 |
$60.94 |
$189.60 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$100.50 |
$100.50 |
$100.50 |
$48.57
|
|
Allergen egg white ige
|
$91.71 |
$91.71 |
$260.57 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$53.82 |
$53.82 |
$53.82 |
$24.00
|
|
Allergy Skin Testing
|
$47.44 |
$47.44 |
$47.44 |
$47.44
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$617.65 |
$617.65 |
$617.65 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$507.30 |
$507.30 |
$507.30 |
$497.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$23,308.05 |
$23,308.05 |
$23,308.05 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$1,002.56 |
$1,002.56 |
$1,002.56 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$276.75 |
$276.75 |
$17,608.49 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$615.32 |
$615.32 |
$13,249.84 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1,085.80 |
$1,085.80 |
$5,705.88 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,463.70 |
$1,463.70 |
$1,463.70 |
$5,096.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$424.19 |
$424.19 |
$1,067.03 |
$1,225.35
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$18.72 |
$18.72 |
$6,365.31 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$295.46 |
$295.46 |
$369.00 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$102.49 |
$102.49 |
$102.49 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$159.75 |
$159.75 |
$252.87 |
$106.00
|
|
Alprostadil for injection
|
$460.40 |
$460.40 |
$460.40 |
$511.41
|
|
Als1-emergency
|
$457.49 |
$457.49 |
$457.49 |
$1,103.37
|
|
Alteplase 100 mg infusion from pyxis vial
|
$15,857.45 |
$15,857.45 |
$17,424.72 |
$15,857.45
|
|
Alt/sgpt
|
$65.01 |
$65.01 |
$148.65 |
$47.50
|
|
Aluminum - quest
|
$123.83 |
$123.83 |
$123.83 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$268.20 |
$268.20 |
$784.35 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$357.28 |
$357.28 |
$357.28 |
$320.45
|
|
Amifostine
|
$2,121.39 |
$2,121.39 |
$2,121.39 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$33.53 |
$33.53 |
$58.80 |
$39.84
|
|
Amino acid screen, urine
|
$159.39 |
$159.39 |
$218.55 |
$77.00
|
|
Amino acids quant 2-5
|
$164.23 |
$164.23 |
$164.23 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$43.01 |
$43.01 |
$43.01 |
$37.33
|
|
Aminolevulinic acid delta
|
$95.80 |
$95.80 |
$183.90 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$43.07 |
$43.07 |
$59.47 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$108.03 |
$108.03 |
$108.03 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$55.86 |
$55.86 |
$166.32 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$44.64 |
$44.64 |
$44.64 |
$87.45
|
|
Ammonia
|
$145.94 |
$145.94 |
$165.90 |
$119.70
|
|
Amnioarmor 1 sq cm
|
$8,466.60 |
$8,466.60 |
$8,466.60 |
$1.00
|
|
Amniocentesisdiagnostic 59000
|
$876.60 |
$876.60 |
$943.50 |
$942.60
|
|
Amniocentesis therapeutic
|
$672.92 |
$672.92 |
$672.92 |
$791.05
|
|
Amniotic fluid scan
|
$49.01 |
$49.01 |
$49.01 |
$49.01
|
|
Amobarbital 125 mg inj
|
$87.09 |
$87.09 |
$1,319.49 |
$1,283.59
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,924.65 |
$1,924.65 |
$4,448.69 |
$3,786.00
|
|
Amphetamine confirm urine -sendout
|
$93.61 |
$93.61 |
$93.61 |
$93.61
|
|
Amphetamines 5 or more
|
$198.47 |
$198.47 |
$198.47 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$117.00 |
$117.00 |
$175.80 |
$123.53
|
|
Amphotericin b lipid complex
|
$226.80 |
$226.80 |
$226.80 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$667.53 |
$667.53 |
$837.41 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$38.20 |
$38.20 |
$54.59 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$19.92 |
$19.92 |
$30.76 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$171.14 |
$171.14 |
$171.14 |
$262.99
|
|
Amputate metacarpal bone 26910
|
$5,248.75 |
$5,248.75 |
$5,248.75 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$3,088.91 |
$3,088.91 |
$3,088.91 |
$4,196.50
|
|
Amputation toe metatarsophalangeal joint
|
$2,914.52 |
$2,914.52 |
$2,914.52 |
$3,839.54
|
|
Amylase
|
$275.25 |
$275.25 |
$373.12 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$49.18 |
$49.18 |
$49.18 |
$80.08
|
|
Ana ds-dna
|
$58.63 |
$58.63 |
$58.63 |
$55.24
|
