|
Albuterol non-comp con
|
$1.09 |
$1.09 |
$1.09 |
$5.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$22.20 |
$22.20 |
$22.20 |
$94.90
|
|
Alcohols biomarkers 3/more
|
$8.10 |
$8.10 |
$8.10 |
$16.24
|
|
Alkaline phosphatase
|
$9.15 |
$9.15 |
$9.15 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$28.50 |
$28.50 |
$28.50 |
$48.57
|
|
Allergen egg white ige
|
$9.15 |
$9.15 |
$9.15 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$13.80 |
$13.80 |
$13.80 |
$24.01
|
|
Allergy injections; 2 or more 95117
|
$12.90 |
$12.90 |
$12.90 |
$44.25
|
|
Allergy injection; single 95115
|
$6.00 |
$6.00 |
$6.00 |
$42.75
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$25,702.08 |
$25,702.08 |
$25,702.08 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$304.95 |
$304.95 |
$304.95 |
$989.09
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$186.21 |
$186.21 |
$186.21 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$346.95 |
$346.95 |
$346.95 |
$1,671.06
|
|
Alloskin
|
$1,843.45 |
$1,843.45 |
$1,843.45 |
$582.40
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$112.80 |
$112.80 |
$112.80 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$29.40 |
$29.40 |
$29.40 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$29.40 |
$29.40 |
$29.40 |
$103.60
|
|
Alprostadil for injection
|
$189.90 |
$189.90 |
$189.90 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$9,743.32 |
$9,743.32 |
$9,743.32 |
$14,700.00
|
|
Alt/sgpt
|
$9.30 |
$9.30 |
$9.30 |
$44.68
|
|
Aluminum - quest
|
$42.30 |
$42.30 |
$42.30 |
$81.49
|
|
Amantadine (symmetrel)-sendout
|
$7.05 |
$7.05 |
$7.05 |
$178.10
|
|
Ambl bp mntr w/software
|
$57.15 |
$57.15 |
$57.15 |
$178.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$59.94 |
$59.94 |
$59.94 |
$37.78
|
|
Amino acid screen, urine
|
$24.30 |
$24.30 |
$24.30 |
$76.05
|
|
Amino acid single qual
|
$24.30 |
$24.30 |
$24.30 |
$36.00
|
|
Aminolevulinic acid delta
|
$28.80 |
$28.80 |
$28.80 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$33.63 |
$33.63 |
$33.63 |
$45.56
|
|
Amiodarone 50 mg/ml intravenous solution
|
$84.86 |
$84.86 |
$84.86 |
$61.67
|
|
Amitriptyline (elavil) -sendout
|
$13.20 |
$13.20 |
$13.20 |
$92.50
|
|
Ammonia
|
$25.50 |
$25.50 |
$25.50 |
$115.80
|
|
Amniocentesisdiagnostic 59000
|
$202.20 |
$202.20 |
$202.20 |
$943.50
|
|
Amniocentesis therapeutic
|
$143.10 |
$143.10 |
$143.10 |
$778.57
|
|
Amniotic fluid scan
|
$12.15 |
$12.15 |
$12.15 |
$42.40
|
|
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 |
$121.25
|
|
Ampicillin 1 gram solution for injection
|
$32.77 |
$32.77 |
$32.77 |
$63.28
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$35.61 |
$35.61 |
$35.61 |
$58.29
|
|
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 |
$83.20
|
|
Anabolic steroid 1 or 2
|
$19.05 |
$19.05 |
$19.05 |
$80.08
|
|
Anabolic steroid 3 or more
|
$19.05 |
$19.05 |
$19.05 |
$27.20
|
|
Ana ds-dna
|
$21.15 |
$21.15 |
$21.15 |
$58.63
|
|
Analgesics non-opioid 3-5
|
$14.70 |
$14.70 |
$14.70 |
$16.24
|
|
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
|
|
Anal/urinary muscle study
|
$30.45 |
$30.45 |
$30.45 |
$411.48
|
|
Anal/urinary muscle study
|
$118.20 |
$118.20 |
$118.20 |
$575.00
|
|
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 |
$210.26
|
|
Analysis gene f5 leiden variant
|
$106.95 |
$106.95 |
$106.95 |
$219.13
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$19.35 |
$19.35 |
$19.35 |
$123.84
|
|
Analysis tumor
|
$47.40 |
$47.40 |
$47.40 |
$248.80
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$59.85 |
$59.85 |
$59.85 |
$411.45
|
|
Anaplsma phgcytophlm amp prb
|
$61.50 |
$61.50 |
$61.50 |
$88.00
|
|
Anca screen with reflex to titer -quest
|
$25.35 |
$25.35 |
$25.35 |
$100.89
|
|
An cholangiogram percutaneous compl
|
$1,027.20 |
$1,027.20 |
$1,027.20 |
$2,547.00
|
|
Androstanediol
|
$50.40 |
$50.40 |
$50.40 |
$103.80
|
|
An fluoro guide for cvp
|
$69.30 |
$69.30 |
$69.30 |
$510.17
|
|
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 |
$8,838.25
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$2,483.55 |
$2,483.55 |
$2,483.55 |
$10,173.90
|
|
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 |
$11,285.00
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,059.15 |
$1,059.15 |
$1,059.15 |
$4,683.90
|
|
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 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$2,648.25 |
$2,648.25 |
$2,648.25 |
$8,466.00
|
|
Ankle X-ray
|
$76.35 |
$76.35 |
$76.35 |
$351.20
|
|
Annual Physical, Established Patient (age 18-39)
|
$61.80 |
$61.80 |
$61.80 |
$167.25
|
|
Annual Physical, Established Patient (age 40-64)
|
$64.95 |
$64.95 |
$64.95 |
$166.20
|
|
Annual Physical, New Patient (age 18-39)
|
$70.35 |
$70.35 |
$70.35 |
$167.25
|
|
Annual Physical, New Patient (age 40-64)
|
$73.20 |
$73.20 |
$73.20 |
$188.15
|
|
Anodyne therapy charges pt
|
$17.70 |
$17.70 |
$17.70 |
$41.02
|
|
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 |
$118.30
|
|
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 |
$218.30
|
|
Antibody id rbc panel
|
$93.75 |
$93.75 |
$93.75 |
$283.80
|
|
Antibody influenza virus
|
$23.70 |
$23.70 |
$23.70 |
$53.28
|
|
Antibody lymphocytic choriomeningitis
|
$22.50 |
$22.50 |
$22.50 |
$48.57
|
|
Antibody screen rbc
|
$19.80 |
$19.80 |
$19.80 |
$102.60
|
|
Antibody tetanus
|
$25.95 |
$25.95 |
$25.95 |
$52.20
|
|
Antidepressant not specified
|
$13.20 |
$13.20 |
$13.20 |
$72.14
|
|
Antidepressants class 3-5
|
$12.75 |
$12.75 |
$12.75 |
$72.14
|
|
Antidepressants class 6/more
|
$29.70 |
$29.70 |
$29.70 |
$29.68
|
|
Antidepressant tricyclic 3-5
|
$13.20 |
$13.20 |
$13.20 |
$23.20
|
|
Antiepileptics nos 4-6
|
$11.10 |
$11.10 |
$11.10 |
$12.80
|
|
Antiepileptics nos 7/more
|
$11.10 |
$11.10 |
$11.10 |
$18.85
|
|
Anti-inhibitor
|
$10,171.61 |
$10,171.61 |
$10,171.61 |
$8.33
|
|
Anti mog serum - sendout
|
$28.95 |
$28.95 |
$28.95 |
$113.83
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$28.20 |
$28.20 |
$28.20 |
$42.35
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$29.70 |
$29.70 |
$29.70 |
$36.60
|
