|
1pc ost pch drain hgh output
|
$2.97 |
$2.97 |
$2.97 |
$8.40
|
|
1 pc ost pouch w filter
|
$16.37 |
$16.37 |
$16.37 |
$9.19
|
|
1 pc ost pou w built-in conv
|
$10.75 |
$10.75 |
$10.75 |
$11.05
|
|
3d recon without postprocess indpndt
|
$1,067.10 |
$1,067.10 |
$1,067.10 |
$485.00
|
|
88334 ap bill cytologic exam each additional site
|
$143.55 |
$143.55 |
$143.55 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,827.84 |
$2,827.84 |
$2,827.84 |
$3,232.57
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$118.50 |
$118.50 |
$118.50 |
$53.50
|
|
Abdominal CT scan (with and without contrast)
|
$3,264.90 |
$3,264.90 |
$3,264.90 |
$2,002.00
|
|
Abdominal CT scan (with contrast)
|
$2,612.85 |
$2,612.85 |
$2,612.85 |
$1,678.00
|
|
Abdominal CT scan (without contrast)
|
$2,394.15 |
$2,394.15 |
$2,394.15 |
$1,363.35
|
|
Abdominal MRI (with and without contrast)
|
$3,264.90 |
$3,264.90 |
$3,264.90 |
$3,054.10
|
|
Abdominal MRI (with contrast)
|
$2,482.20 |
$2,482.20 |
$2,482.20 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$2,394.15 |
$2,394.15 |
$2,394.15 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,178.85 |
$1,178.85 |
$1,178.85 |
$1,660.05
|
|
Abdominal Ultrasound (complete)
|
$785.55 |
$785.55 |
$785.55 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$545.55 |
$545.55 |
$545.55 |
$603.33
|
|
Ablation cardiac vagal inputs atrium
|
$2,538.75 |
$2,538.75 |
$2,538.75 |
$2,260.30
|
|
Ablation of upper extremity nerves rf
|
$832.50 |
$832.50 |
$832.50 |
$832.50
|
|
Absorpt drg >16<=48 in w/bdr
|
$115.62 |
$115.62 |
$115.62 |
$5.70
|
|
Absorpt drg >16 <=48 without bdr
|
$260.76 |
$260.76 |
$260.76 |
$6.40
|
|
Absorpt drg <=16 sq in w/bdr
|
$22.77 |
$22.77 |
$22.77 |
$5.18
|
|
Absorpt drg <=16 sq in without b
|
$171.02 |
$171.02 |
$171.02 |
$5.00
|
|
Absorpt drg > 48 sq in without b
|
$528.90 |
$528.90 |
$528.90 |
$7.76
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$110.76 |
$110.76 |
$110.76 |
$81.07
|
|
Acetazolamide 500 mg solution for injection
|
$39.69 |
$39.69 |
$39.69 |
$114.08
|
|
Acetone qualitative
|
$31.80 |
$31.80 |
$31.80 |
$43.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$216.00 |
$216.00 |
$216.00 |
$244.95
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$37.35 |
$37.35 |
$37.35 |
$41.67
|
|
Acute hepatitis panel
|
$401.10 |
$401.10 |
$401.10 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$88.20 |
$88.20 |
$88.20 |
$64.45
|
|
Adalimumab injection
|
$6,853.40 |
$6,853.40 |
$6,853.40 |
$6,853.40
|
|
Adapter b 8 channel 10cm
|
$8,400.00 |
$8,400.00 |
$8,400.00 |
$6,196.27
|
|
Adenosine 3 mg/250 ml bag for osm
|
$275.73 |
$275.73 |
$275.73 |
$272.57
|
|
Adhesive, liquid or equal
|
$27.60 |
$27.60 |
$27.60 |
$18.63
|
|
Administration immunization 1 vaccine
|
$113.70 |
$113.70 |
$113.70 |
$67.60
|
|
Administration vaccine hepatitis b
|
$113.70 |
$113.70 |
$113.70 |
$54.60
|
|
Administration vaccine influenza virus
|
$113.70 |
$113.70 |
$113.70 |
$48.35
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$7,705.67 |
$7,705.67 |
$7,705.67 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$541.25 |
$541.25 |
$541.25 |
$231.47
|
|
Aep neurodiagnostic i&r
|
$517.35 |
$517.35 |
$517.35 |
$570.16
|
|
Aep thrshld est mlt freq i&r
|
$517.35 |
$517.35 |
$517.35 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$133.35 |
$133.35 |
$133.35 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$353.10 |
$353.10 |
$353.10 |
$289.60
|
|
Afo molded to patient plasti
|
$617.81 |
$617.81 |
$617.81 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$1,883.09 |
$1,883.09 |
$1,883.09 |
$1,535.95
|
|
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
|
$1,227.08 |
$1,227.08 |
$1,227.08 |
$817.60
|
|
Afo tibial fracture rigid
|
$1,464.20 |
$1,464.20 |
$1,464.20 |
$1,464.20
|
|
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 |
$2,903.60
|
|
Agalsidase beta 35 mg intravenous solution
|
$14,760.37 |
$14,760.37 |
$14,760.37 |
$14,760.37
|
|
Ak pelvic control belt pad/l
|
$505.78 |
$505.78 |
$505.78 |
$505.78
|
|
Albumin body fluid quantitative each specimen
|
$105.90 |
$105.90 |
$105.90 |
$47.50
|
|
Albumin, human 25 % intravenous solution
|
$174.30 |
$174.30 |
$174.30 |
$234.94
|
|
Albumin, human 5 % intravenous solution
|
$413.18 |
$413.18 |
$413.18 |
$296.32
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$159.75 |
$159.75 |
$159.75 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$92.85 |
$92.85 |
$92.85 |
$40.45
|
|
Aldesleukin injection
|
$28,179.27 |
$28,179.27 |
$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 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$94.71 |
$94.71 |
$94.71 |
$40.89
|
|
Alginate drsg wound filler
|
$27.60 |
$27.60 |
$27.60 |
$15.79
|
|
Alkaline phosphatase
|
$189.60 |
$189.60 |
$189.60 |
$46.80
|
|
Allograft amnioexcel plus 17mm disk
|
$507.30 |
$507.30 |
$507.30 |
$2,677.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$23,308.05 |
$23,308.05 |
$23,308.05 |
$12,402.00
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$276.75 |
$276.75 |
$276.75 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$615.32 |
$615.32 |
$615.32 |
$724.00
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1,085.80 |
$1,085.80 |
$1,085.80 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,463.70 |
$1,463.70 |
$1,463.70 |
$3,604.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,067.03 |
$1,067.03 |
$1,067.03 |
$1,406.19
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$6,365.31 |
$6,365.31 |
$6,365.31 |
$9.62
|
|
Alpha-fetoprotein tumor marker
|
$159.75 |
$159.75 |
$159.75 |
$103.62
|
|
Alteplase 100 mg infusion from pyxis vial
|
$17,424.72 |
$17,424.72 |
$17,424.72 |
$15,857.45
|
|
Alt/sgpt
|
$148.65 |
$148.65 |
$148.65 |
$47.88
|
|
Amantadine (symmetrel)-sendout
|
$342.00 |
$342.00 |
$342.00 |
$179.70
|
|
Amifostine
|
$2,121.39 |
$2,121.39 |
$2,121.39 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$33.53 |
$33.53 |
$33.53 |
$36.30
|
|
Aminolevulinic acid delta
|
$183.90 |
$183.90 |
$183.90 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$43.07 |
$43.07 |
$43.07 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$108.03 |
$108.03 |
$108.03 |
$125.09
|
|
Amiodarone 50 mg/ml intravenous solution
|
$55.86 |
$55.86 |
$55.86 |
$57.60
|
|
Ammonia
|
$165.90 |
$165.90 |
$165.90 |
$117.00
|
|
Amnioarmor 1 sq cm
|
$8,466.60 |
$8,466.60 |
$8,466.60 |
$16.80
|
|
Amobarbital 125 mg inj
|
$87.09 |
$87.09 |
$87.09 |
$1,283.59
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$117.00 |
$117.00 |
$117.00 |
$117.75
|
|
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 |
$667.53 |
$521.86
|
|
Ampicillin 1 gram solution for injection
|
$38.20 |
$38.20 |
$38.20 |
$62.03
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$19.92 |
$19.92 |
$19.92 |
$54.69
|
|
Amylase
|
$275.25 |
$275.25 |
$275.25 |
$85.65
|
|
Anal pressure record
|
$474.60 |
$474.60 |
$474.60 |
$871.21
|
|
Anal/urinary muscle study
|
$508.20 |
$508.20 |
$508.20 |
$575.00
|
|
Analysis gene f5 leiden variant
|
$288.00 |
$288.00 |
$288.00 |
$219.13
|
|
Anca screen with reflex to titer -quest
|
$210.00 |
$210.00 |
$210.00 |
$102.70
|
|
An fluoro guide for cvp
|
$537.90 |
$537.90 |
$537.90 |
$510.17
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$76,729.48 |
$76,729.48 |
$76,729.48 |
$5,038.94
|
|
Anidulafungin injection
|
$412.32 |
$412.32 |
$412.32 |
$312.30
|
|
Ankle X-ray
|
$404.40 |
$404.40 |
$404.40 |
$356.32
|
|
Antibody bacterium, not elsewhere specified
|
$166.80 |
$166.80 |
$166.80 |
$57.85
|
