|
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
|
$37.50 |
$37.50 |
$37.50 |
$47.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$82.00 |
$82.00 |
$82.00 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$36.00 |
$36.00 |
$36.00 |
$40.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$259.00 |
$259.00 |
$259.00 |
$94.90
|
|
Alcohol/subs interv 15-30mn
|
$37.50 |
$37.50 |
$37.50 |
$55.77
|
|
Alginate dressing <=16 sq in
|
$20.18 |
$20.18 |
$20.18 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$36.22 |
$36.22 |
$36.22 |
$40.60
|
|
Alginate drsg wound filler
|
$38.82 |
$38.82 |
$38.82 |
$15.79
|
|
Alkaline phosphatase
|
$82.00 |
$82.00 |
$82.00 |
$46.50
|
|
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
|
$18.50 |
$18.50 |
$18.50 |
$24.01
|
|
Allergy injections; 2 or more 95117
|
$35.00 |
$35.00 |
$35.00 |
$44.25
|
|
Allergy injection; single 95115
|
$24.50 |
$24.50 |
$24.50 |
$42.75
|
|
Allg patch or app # of tests 95044
|
$589.00 |
$589.00 |
$589.00 |
$289.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$230.75 |
$230.75 |
$230.75 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$287.73 |
$287.73 |
$287.73 |
$2,959.72
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$2,641.00 |
$2,641.00 |
$2,641.00 |
$10,179.63
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$28.64 |
$28.64 |
$28.64 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$205.45 |
$205.45 |
$205.45 |
$879.80
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$940.50 |
$940.50 |
$973.42 |
$3,668.28
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$122.13 |
$122.13 |
$122.13 |
$4,384.80
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$307.00 |
$307.00 |
$307.00 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$129.00 |
$129.00 |
$129.00 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$106.00 |
$106.00 |
$106.00 |
$103.80
|
|
Alt/sgpt
|
$36.00 |
$36.00 |
$36.00 |
$45.50
|
|
Aluminum - quest
|
$156.50 |
$156.50 |
$156.50 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$614.00 |
$614.00 |
$614.00 |
$444.50
|
|
Ambl bp mntr w/sw a/r
|
$572.00 |
$572.00 |
$572.00 |
$320.45
|
|
Aminolevulinic acid delta
|
$123.50 |
$123.50 |
$123.50 |
$74.10
|
|
Ammonia
|
$63.00 |
$63.00 |
$63.00 |
$116.64
|
|
Amniocentesisdiagnostic 59000
|
$2,039.50 |
$2,039.50 |
$2,039.50 |
$943.50
|
|
Amniocentesis therapeutic
|
$4,579.50 |
$4,579.50 |
$4,579.50 |
$778.57
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,045.00 |
$3,045.00 |
$3,045.00 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$4,196.50 |
$4,196.50 |
$4,196.50 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$4,196.50 |
$4,196.50 |
$4,196.50 |
$3,814.50
|
|
Amylase
|
$115.50 |
$115.50 |
$115.50 |
$84.36
|
|
Ana ds-dna
|
$65.00 |
$65.00 |
$65.00 |
$58.63
|
|
Anal pressure record
|
$420.00 |
$420.00 |
$420.00 |
$871.21
|
|
Anal/urinary muscle study
|
$552.00 |
$552.00 |
$552.00 |
$575.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$264.50 |
$264.50 |
$264.50 |
$338.40
|
|
Analysis gene f2 20210g>a variant
|
$356.50 |
$356.50 |
$356.50 |
$212.65
|
|
Analysis gene f5 leiden variant
|
$391.00 |
$391.00 |
$391.00 |
$219.13
|
|
Analysis nerve
|
$159.50 |
$159.50 |
$159.50 |
$274.49
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$85.00 |
$85.00 |
$85.00 |
$123.84
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$433.50 |
$433.50 |
$433.50 |
$411.45
|
|
Anca screen with reflex to titer -quest
|
$83.50 |
$83.50 |
$83.50 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$5,205.50 |
$5,205.50 |
$5,205.50 |
$2,494.35
|
|
An fluoro guide for cvp
|
$774.00 |
$774.00 |
$774.00 |
$520.20
|
|
Angio balloon ctrl dialysis seg add-on
|
$3,164.00 |
$3,164.00 |
$3,164.00 |
$5,341.83
|
|
Angioplasty fem/pop unilat 37224
|
$11,206.50 |
$11,206.50 |
$11,206.50 |
$9,048.90
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$9,197.00 |
$9,197.00 |
$9,197.00 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$5,950.50 |
$5,950.50 |
$5,950.50 |
$5,950.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$3.62 |
$3.62 |
$3.62 |
$5,172.70
|
|
Angio tib/peroneal/init ves/unila 37228
|
$8,384.00 |
$8,384.00 |
$8,384.00 |
$11,285.00
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,374.50 |
$3,374.50 |
$3,374.50 |
$4,718.43
|
|
Angio trnslmnl balloon same artery ini
|
$3,374.50 |
$3,374.50 |
$3,374.50 |
$9,120.80
|
|
Angio trnslmnl balloon same vein ea addl
|
$3,374.50 |
$3,374.50 |
$3,374.50 |
$4,479.30
|
|
Angio trnslmnl balloon same vein ini
|
$3,374.50 |
$3,374.50 |
$3,374.50 |
$8,466.00
|
|
Ankle X-ray
|
$315.50 |
$315.50 |
$315.50 |
$352.20
|
|
Anl sp inf pmp w/mdreprg&fil
|
$430.00 |
$430.00 |
$430.00 |
$630.96
|
|
Annual alcohol screen 15 min
|
$42.50 |
$42.50 |
$42.50 |
$40.00
|
|
Anodyne therapy charges pt
|
$14.00 |
$14.00 |
$14.00 |
$41.02
|
|
Anora (draw only)
|
$101.00 |
$101.00 |
$101.00 |
$35.00
|
|
Anoscopy ablation lesion 46615
|
$2,928.50 |
$2,928.50 |
$2,928.50 |
$3,245.23
|
|
Anoscopy and biopsy
|
$2,928.50 |
$2,928.50 |
$2,928.50 |
$1,395.28
|
|
Anoscopy control bleeding 46614
|
$1,073.00 |
$1,073.00 |
$1,073.00 |
$2,111.46
|
|
Anoscopy remove fb 46608
|
$1,519.50 |
$1,519.50 |
$1,519.50 |
$1,457.76
|
|
Ans parasymp & symp w/tilt
|
$188.50 |
$188.50 |
$188.50 |
$368.50
|
|
Anterior thoracic extension
|
$184.23 |
$184.23 |
$184.23 |
$365.76
|
|
Antibody bacterium, not elsewhere specified
|
$60.50 |
$60.50 |
$60.50 |
$57.85
|
|
Antibody elution rbc reference
|
$191.00 |
$191.00 |
$191.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$102.00 |
$102.00 |
$102.00 |
$121.80
|
|
Antibody htlv-i
|
$102.00 |
$102.00 |
$102.00 |
$48.57
|
|
Antibody htlv-ii
|
$102.00 |
$102.00 |
$102.00 |
$36.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$339.00 |
$339.00 |
$339.00 |
$219.30
|
|
Antibody id rbc panel
|
$190.00 |
$190.00 |
$190.00 |
$281.30
|
|
Antibody influenza virus
|
$45.50 |
$45.50 |
$45.50 |
$53.90
|
|
Antibody lymphocytic choriomeningitis
|
$80.00 |
$80.00 |
$80.00 |
$48.57
|
|
Antibody screen rbc
|
$123.00 |
$123.00 |
$123.00 |
$102.75
|
|
Antibody tetanus
|
$16.00 |
$16.00 |
$16.00 |
$52.20
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$23.00 |
$23.00 |
$23.00 |
$43.32
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$37.50 |
$37.50 |
$37.50 |
$36.60
|
|
Antinuclear antibodies
|
$137.50 |
$137.50 |
$137.50 |
$90.00
|
|
Antinuclear antibodies titer
|
$122.00 |
$122.00 |
$122.00 |
$78.26
|
|
Antiphosphatidylserine antibody
|
$54.50 |
$54.50 |
$54.50 |
$67.43
|
|
Antistreptolysin o titer
|
$52.50 |
$52.50 |
$52.50 |
$54.16
|
|
Antithrombin iii activity
|
$154.00 |
$154.00 |
$154.00 |
$113.85
|
|
Apheresis plasma
|
$2,790.50 |
$2,790.50 |
$2,790.50 |
$3,291.00
|
|
Apheresis platelets
|
$3,715.50 |
$3,715.50 |
$3,715.50 |
$2,195.00
|
|
Apheresis rbc
|
$2,790.50 |
$2,790.50 |
$2,790.50 |
$3,250.39
|
|
Apheresis wbc
|
$2,790.50 |
$2,790.50 |
$2,790.50 |
$3,113.60
|
|
Apl(pml-rara) quant - sendout
|
$605.50 |
$605.50 |
$605.50 |
$465.60
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,101.50 |
$3,101.50 |
$3,101.50 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$3,101.50 |
$3,101.50 |
$3,101.50 |
$934.80
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$3,101.50 |
$3,101.50 |
$3,101.50 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$5,351.50 |
$5,351.50 |
$5,351.50 |
$3,667.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$5,351.50 |
$5,351.50 |
$5,351.50 |
$1,148.00
|
