|
Afo w/ankle joint, prefab
|
$275.31 |
$275.31 |
$275.31 |
$567.00
|
|
After cataract laser surgery
|
$897.00 |
$897.00 |
$897.00 |
$1,411.20
|
|
Air conduction bilat
|
$55.50 |
$55.50 |
$55.50 |
$138.00
|
|
Ak/knee disartic silesian ba
|
$88.50 |
$88.50 |
$88.50 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$157.84 |
$157.84 |
$157.84 |
$246.40
|
|
Albumin body fluid quantitative each specimen
|
$24.50 |
$24.50 |
$24.50 |
$47.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$28.00 |
$28.00 |
$28.00 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$23.00 |
$23.00 |
$23.00 |
$40.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$132.00 |
$132.00 |
$132.00 |
$94.90
|
|
Alcohol/subs interv 15-30mn
|
$36.00 |
$36.00 |
$36.00 |
$55.77
|
|
Alginate dressing <=16 sq in
|
$20.18 |
$20.18 |
$20.18 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$73.83 |
$73.83 |
$73.83 |
$40.60
|
|
Alginate drsg wound filler
|
$38.82 |
$38.82 |
$38.82 |
$15.79
|
|
Alkaline phosphatase
|
$24.50 |
$24.50 |
$24.50 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$42.00 |
$42.00 |
$42.00 |
$48.57
|
|
Allergen egg white ige
|
$38.00 |
$38.00 |
$38.00 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$16.00 |
$16.00 |
$16.00 |
$24.01
|
|
Allergy injections; 2 or more 95117
|
$20.50 |
$20.50 |
$20.50 |
$44.25
|
|
Allergy injection; single 95115
|
$20.50 |
$20.50 |
$20.50 |
$42.75
|
|
Allg patch or app # of tests 95044
|
$445.00 |
$445.00 |
$445.00 |
$289.00
|
|
Allograft amnioexcel plus 17mm disk
|
$287.73 |
$287.73 |
$287.73 |
$2,959.72
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$1,008.15 |
$1,008.15 |
$1,008.15 |
$9,434.12
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$205.45 |
$205.45 |
$205.45 |
$922.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$739.70 |
$739.70 |
$739.70 |
$3,833.74
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$173.36 |
$173.36 |
$173.36 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$173.36 |
$173.36 |
$173.36 |
$1,616.79
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$265.00 |
$265.00 |
$265.00 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$77.00 |
$77.00 |
$77.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$77.00 |
$77.00 |
$77.00 |
$103.60
|
|
Alt/sgpt
|
$24.50 |
$24.50 |
$24.50 |
$44.68
|
|
Aluminum - quest
|
$114.50 |
$114.50 |
$114.50 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$444.50 |
$444.50 |
$444.50 |
$444.50
|
|
Ambl bp mntr w/sw a/r
|
$73.50 |
$73.50 |
$73.50 |
$320.45
|
|
Aminolevulinic acid delta
|
$68.50 |
$68.50 |
$68.50 |
$74.10
|
|
Ammonia
|
$63.50 |
$63.50 |
$63.50 |
$116.40
|
|
Amniocentesisdiagnostic 59000
|
$1,715.50 |
$1,715.50 |
$1,715.50 |
$943.50
|
|
Amniocentesis therapeutic
|
$1,974.00 |
$1,974.00 |
$1,974.00 |
$778.57
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,563.00 |
$2,563.00 |
$2,563.00 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$3,922.00 |
$3,922.00 |
$3,922.00 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$3,922.00 |
$3,922.00 |
$3,922.00 |
$3,814.50
|
|
Amylase
|
$31.50 |
$31.50 |
$31.50 |
$83.20
|
|
Ana ds-dna
|
$54.00 |
$54.00 |
$54.00 |
$58.63
|
|
Anal pressure record
|
$317.50 |
$317.50 |
$317.50 |
$871.21
|
|
Anal/urinary muscle study
|
$494.00 |
$494.00 |
$494.00 |
$575.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$200.00 |
$200.00 |
$200.00 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$145.00 |
$145.00 |
$145.00 |
$212.40
|
|
Analysis gene f5 leiden variant
|
$167.00 |
$167.00 |
$167.00 |
$219.13
|
|
Analysis nerve
|
$159.50 |
$159.50 |
$159.50 |
$274.49
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$64.50 |
$64.50 |
$64.50 |
$123.84
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$232.50 |
$232.50 |
$232.50 |
$411.45
|
|
Anca screen with reflex to titer -quest
|
$65.00 |
$65.00 |
$65.00 |
$100.89
|
|
An cholangiogram percutaneous compl
|
$4,865.00 |
$4,865.00 |
$4,865.00 |
$2,547.00
|
|
An fluoro guide for cvp
|
$251.50 |
$251.50 |
$251.50 |
$515.34
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,604.00 |
$4,604.00 |
$4,604.00 |
$5,341.83
|
|
Angioplasty fem/pop unilat 37224
|
$7,596.00 |
$7,596.00 |
$7,596.00 |
$8,838.25
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$7,596.00 |
$7,596.00 |
$7,596.00 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$1,628.50 |
$1,628.50 |
$1,628.50 |
$5,950.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$3.62 |
$3.62 |
$3.62 |
$5,315.64
|
|
Angio tib/peroneal/init ves/unila 37228
|
$7,596.00 |
$7,596.00 |
$7,596.00 |
$11,285.00
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,604.00 |
$4,604.00 |
$4,604.00 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$4,604.00 |
$4,604.00 |
$4,604.00 |
$9,120.80
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,604.00 |
$4,604.00 |
$4,604.00 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$4,604.00 |
$4,604.00 |
$4,604.00 |
$8,466.00
|
|
Ankle X-ray
|
$213.00 |
$213.00 |
$213.00 |
$351.45
|
|
Anl sp inf pmp w/mdreprg&fil
|
$445.50 |
$445.50 |
$445.50 |
$630.96
|
|
Annual alcohol screen 15 min
|
$52.50 |
$52.50 |
$52.50 |
$40.00
|
|
Anodyne therapy charges pt
|
$12.00 |
$12.00 |
$12.00 |
$41.02
|
|
Anora (draw only)
|
$34.50 |
$34.50 |
$34.50 |
$35.00
|
|
Anoscopy ablation lesion 46615
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$3,245.23
|
|
Anoscopy and biopsy
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$1,409.10
|
|
Anoscopy control bleeding 46614
|
$516.00 |
$516.00 |
$516.00 |
$2,111.46
|
|
Anoscopy remove fb 46608
|
$1,304.50 |
$1,304.50 |
$1,304.50 |
$1,435.00
|
|
Ans parasymp & symp w/tilt
|
$142.50 |
$142.50 |
$142.50 |
$368.50
|
|
Anterior thoracic extension
|
$184.23 |
$184.23 |
$184.23 |
$365.76
|
|
Antibody bacterium, not elsewhere specified
|
$46.50 |
$46.50 |
$46.50 |
$57.85
|
|
Antibody elution rbc reference
|
$112.00 |
$112.00 |
$112.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$82.00 |
$82.00 |
$82.00 |
$121.50
|
|
Antibody htlv-i
|
$38.00 |
$38.00 |
$38.00 |
$48.57
|
|
Antibody htlv-ii
|
$62.50 |
$62.50 |
$62.50 |
$36.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$339.00 |
$339.00 |
$339.00 |
$218.30
|
|
Antibody id rbc panel
|
$187.50 |
$187.50 |
$187.50 |
$283.80
|
|
Antibody influenza virus
|
$61.50 |
$61.50 |
$61.50 |
$53.28
|
|
Antibody lymphocytic choriomeningitis
|
$58.00 |
$58.00 |
$58.00 |
$48.57
|
|
Antibody screen rbc
|
$58.00 |
$58.00 |
$58.00 |
$102.68
|
|
Antibody tetanus
|
$16.00 |
$16.00 |
$16.00 |
$52.20
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$23.00 |
$23.00 |
$23.00 |
$42.35
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$37.50 |
$37.50 |
$37.50 |
$36.60
|
|
Antinuclear antibodies
|
$52.50 |
$52.50 |
$52.50 |
$90.00
|
|
Antinuclear antibodies titer
|
$50.50 |
$50.50 |
$50.50 |
$78.00
|
|
Antiphosphatidylserine antibody
|
$69.00 |
$69.00 |
$69.00 |
$67.60
|
|
Antistreptolysin o titer
|
$32.00 |
$32.00 |
$32.00 |
$54.40
|
|
Antithrombin iii activity
|
$56.00 |
$56.00 |
$56.00 |
$113.80
|
|
Apheresis plasma
|
$2,929.50 |
$2,929.50 |
$2,929.50 |
$3,292.80
|
|
Apheresis platelets
|
$2,929.50 |
$2,929.50 |
$2,929.50 |
$2,195.00
|
|
Apheresis rbc
|
$2,929.50 |
$2,929.50 |
$2,929.50 |
$3,348.50
|
|
Apheresis wbc
|
$2,929.50 |
$2,929.50 |
$2,929.50 |
$3,139.20
|
|
Apl(pml-rara) quant - sendout
|
$406.00 |
$406.00 |
$406.00 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,210.00 |
$3,210.00 |
$3,210.00 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$3,210.00 |
$3,210.00 |
$3,210.00 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$3,210.00 |
$3,210.00 |
$3,210.00 |
$549.08
|
