|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$1,396.50 |
$1,396.50 |
$1,396.50 |
$6,555.62
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$877.10 |
$877.10 |
$877.10 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1,650.00 |
$1,650.00 |
$7,149.00 |
$2,513.00
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$4,037.03 |
$6,229.13 |
$6,229.13 |
$2,198.85
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,098.94 |
$1,098.94 |
$1,098.94 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$1,932.00 |
$1,932.00 |
$1,932.00 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$1,400.55 |
$1,400.55 |
$1,400.55 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$106.40 |
$106.40 |
$106.40 |
$99.00
|
|
Alprostadil for injection
|
$207.04 |
$207.04 |
$1,988.03 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$21,753.62 |
$21,753.62 |
$21,753.62 |
$2,600.22
|
|
Alt/sgpt
|
$49.00 |
$49.00 |
$772.00 |
$49.00
|
|
Aluminum - quest
|
$30.10 |
$30.10 |
$416.00 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$347.22 |
$347.22 |
$347.22 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$35.42 |
$35.42 |
$191.00 |
$36.30
|
|
Amino acid screen, urine
|
$206.00 |
$206.00 |
$206.00 |
$64.28
|
|
Amino acid single qual
|
$635.66 |
$635.66 |
$2,034.00 |
$19.57
|
|
Amino acids quant 2-5
|
$3,331.27 |
$3,331.27 |
$3,331.27 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$49.79 |
$49.79 |
$51.00 |
$42.84
|
|
Aminolevulinic acid delta
|
$36.40 |
$36.40 |
$677.86 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$39.45 |
$39.45 |
$39.45 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$81.31 |
$81.31 |
$81.31 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$37.55 |
$37.55 |
$37.55 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$1,008.74 |
$1,008.74 |
$1,008.74 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$9,084.45 |
$9,084.45 |
$9,084.45 |
$15,167.75
|
|
Ammonia
|
$129.50 |
$129.50 |
$955.00 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$206.15 |
$206.15 |
$206.15 |
$942.60
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$13.70 |
$70.28 |
$369.40 |
$130.08
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$158.46 |
$158.46 |
$158.46 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$29.91 |
$29.91 |
$29.91 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$40.62 |
$40.62 |
$40.62 |
$51.93
|
|
Amylase
|
$154.70 |
$154.70 |
$154.70 |
$93.00
|
|
Ana ds-dna
|
$145.17 |
$145.17 |
$1,056.00 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$896.78 |
$896.78 |
$896.78 |
$110.98
|
|
Anal/urinary muscle study
|
$313.60 |
$313.60 |
$313.60 |
$407.00
|
|
Anal/urinary muscle study
|
$496.30 |
$496.30 |
$496.30 |
$507.26
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$420.16 |
$2,439.50 |
$2,439.50 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$811.65 |
$811.65 |
$1,959.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$901.60 |
$901.60 |
$1,959.00 |
$226.60
|
|
Analysis tumor
|
$1,815.00 |
$1,815.00 |
$1,815.00 |
$240.00
|
|
Anca screen with reflex to titer -quest
|
$130.90 |
$130.90 |
$130.90 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$2,823.00 |
$3,525.90 |
$12,001.96 |
$2,626.65
|
|
An fluoro guide for cvp
|
$2,285.15 |
$2,285.15 |
$13,429.55 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,359.25 |
$4,359.25 |
$4,359.25 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$11,956.35 |
$11,956.35 |
$11,956.35 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$8,301.65 |
$8,301.65 |
$8,301.65 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$2,044.70 |
$2,044.70 |
$2,044.70 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$464.04 |
$464.04 |
$464.04 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$5,525.80 |
$5,525.80 |
$5,525.80 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$2,733.50 |
$2,733.50 |
$2,733.50 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$5,514.25 |
$5,514.25 |
$20,640.51 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$2,309.30 |
$2,309.30 |
$2,309.30 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$4,712.75 |
$4,712.75 |
$31,226.02 |
$8,689.20
|
|
Anidulafungin injection
|
$775.42 |
$775.42 |
$775.42 |
$209.79
|
|
Ankle X-ray
|
$542.85 |
$542.85 |
$542.85 |
$339.44
|
|
Anoscopy and biopsy
|
$981.05 |
$981.05 |
$981.05 |
$1,380.00
|
|
Anoscopy remove fb 46608
|
$647.15 |
$647.15 |
$647.15 |
$1,208.35
|
|
Antibody bacterium, not elsewhere specified
|
$662.00 |
$662.00 |
$662.00 |
$57.89
|
|
Antibody elution rbc reference
|
$249.55 |
$249.55 |
$430.00 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$52.15 |
$52.15 |
$2,408.12 |
$141.74
|
|
Antibody htlv-i
|
$862.09 |
$862.09 |
$1,000.96 |
$48.75
|
|
Antibody htlv-ii
|
$29.40 |
$29.40 |
$1,000.96 |
$35.22
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$228.20 |
$228.20 |
$228.20 |
$220.73
|
|
Antibody id rbc panel
|
$246.00 |
$576.45 |
$576.45 |
$291.75
|
|
Antibody screen rbc
|
$127.75 |
$127.75 |
$584.00 |
$105.00
|
|
Antibody tetanus
|
$1,289.78 |
$1,289.78 |
$1,289.78 |
$61.98
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$126.08 |
$126.08 |
$126.08 |
$3.12
|
|
Antihemophilic viii/vwf comp
|
$36.88 |
$2,811.64 |
$2,811.64 |
$2.75
|
|
Anti-inhibitor
|
$129.20 |
$129.20 |
$129.20 |
$3.75
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$657.00 |
$657.00 |
$657.00 |
$50.88
|
|
Antinuclear antibodies
|
$91.70 |
$91.70 |
$294.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$92.75 |
$92.75 |
$294.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$74.20 |
$74.20 |
$74.20 |
$74.20
|
|
Antistreptolysin o screen
|
$592.14 |
$592.14 |
$592.14 |
$59.40
|
|
Antistreptolysin o titer
|
$51.45 |
$51.45 |
$827.00 |
$57.96
|
|
Antithrombin iii activity
|
$267.75 |
$267.75 |
$663.00 |
$115.23
|
|
Antithrombin iii injection
|
$132.25 |
$132.25 |
$51,379.00 |
$9.32
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$5,465.25 |
$5,465.25 |
$5,465.25 |
$5,013.11
|
|
Antithymocyte globuln rabbit
|
$2,305.89 |
$2,305.89 |
$2,305.89 |
$1,679.21
|
|
Apheresis plasma
|
$3,293.15 |
$3,293.15 |
$3,293.15 |
$3,411.50
|
|
Apheresis platelets
|
$3,754.45 |
$3,754.45 |
$3,754.45 |
$2,345.00
|
|
Apheresis rbc
|
$3,754.45 |
$3,754.45 |
$3,754.45 |
$3,348.50
|
|
Apheresis wbc
|
$3,951.85 |
$3,951.85 |
$3,951.85 |
$3,342.71
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$408.45 |
$408.45 |
$408.45 |
$549.08
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$73.50 |
$73.50 |
$73.50 |
$508.18
|
|
Appl cast shoulder spica
|
$102.55 |
$102.55 |
$102.55 |
$384.59
|
|
Application finger splntstatic 29130
|
$246.05 |
$246.05 |
$246.05 |
$216.80
|
|
Application long leg splint 29505
|
$177.10 |
$177.10 |
$177.10 |
$340.80
|
|
Application lower leg splint 29515
|
$274.05 |
$274.05 |
$274.05 |
$355.85
|
|
Application multi layer compression below knee (both sides)
|
$359.10 |
$359.10 |
$359.10 |
$397.00
|
|
Application of paste boot 29580
|
$223.30 |
$223.30 |
$223.30 |
$331.74
|
|
Application short leg cast 29405
|
$204.05 |
$204.05 |
$204.05 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$643.30 |
$643.30 |
$643.30 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$643.30 |
$643.30 |
$643.30 |
$2,120.95
|
|
Applicator tag rfid localizer 12gx7cm
|
$6,441.05 |
$6,441.05 |
$6,441.05 |
$168.60
|
|
Appl modality 1/> areas paraffin bath 97018
|
$37.10 |
$37.10 |
$699.00 |
$69.55
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$334.37 |
$334.37 |
$334.37 |
$75.98
|
|
Appl modality 1+lllt po pain
|
$231.12 |
$231.12 |
$231.12 |
$49.92
|
|
Apply forearm splintdynamic 29126
|
$351.05 |
$351.05 |
$351.05 |
$263.10
|
|
Apply hand/wrist cast 29085
|
$84.35 |
$84.35 |
$84.35 |
$272.46
|
|
Apply interstit radiat compl
|
$673.40 |
$673.40 |
$673.40 |
$2,877.50
|
