|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$5,063.02 |
$5,063.02 |
$5,063.02 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$2,393.10 |
$2,393.10 |
$2,393.10 |
$21,790.11
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$21,223.97 |
$21,223.97 |
$21,223.97 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$3,959.17 |
$3,959.17 |
$3,959.17 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$4,951.51 |
$4,951.51 |
$4,951.51 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$5,524.41 |
$5,524.41 |
$5,524.41 |
$5,152.95
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$6,567.92 |
$6,567.92 |
$6,567.92 |
$1,777.39
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$6,174.12 |
$6,174.12 |
$6,174.12 |
$12.50
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$206.18 |
$206.18 |
$206.18 |
$189.15
|
|
Alpha-fetoprotein amniotic
|
$68.19 |
$68.19 |
$68.19 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$76.62 |
$76.62 |
$76.62 |
$103.80
|
|
Alprostadil for injection
|
$144.01 |
$144.01 |
$144.01 |
$511.84
|
|
Alteplase 100 mg infusion from pyxis vial
|
$11,838.49 |
$11,838.49 |
$11,838.49 |
$15,857.45
|
|
Alt/sgpt
|
$34.12 |
$34.12 |
$34.12 |
$47.40
|
|
Aluminum - quest
|
$104.31 |
$104.31 |
$104.31 |
$81.49
|
|
Amifostine
|
$1,424.82 |
$1,424.82 |
$1,424.82 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$165.97 |
$165.97 |
$165.97 |
$40.40
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$42.03 |
$42.03 |
$42.03 |
$37.33
|
|
Aminolevulinic acid delta
|
$125.42 |
$125.42 |
$125.42 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$1,905.48 |
$1,905.48 |
$1,905.48 |
$46.24
|
|
Amiodarone 50 mg/ml intravenous solution
|
$192.75 |
$192.75 |
$192.75 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$5,660.19 |
$5,660.19 |
$5,660.19 |
$8,941.39
|
|
Ammonia
|
$63.42 |
$63.42 |
$63.42 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$320.18 |
$320.18 |
$320.18 |
$923.50
|
|
Amniocentesis therapeutic
|
$500.73 |
$500.73 |
$500.73 |
$791.05
|
|
Amniotic fluid scan
|
$54.39 |
$54.39 |
$54.39 |
$49.01
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$125,416.93 |
$125,416.93 |
$125,416.93 |
$117.75
|
|
Amphotericin b lipid complex
|
$3,156.50 |
$3,156.50 |
$3,156.50 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$3,162.53 |
$3,162.53 |
$3,162.53 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$491.20 |
$491.20 |
$491.20 |
$58.35
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$529.01 |
$529.01 |
$529.01 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$157.96 |
$157.96 |
$157.96 |
$262.99
|
|
Amylase
|
$45.15 |
$45.15 |
$45.15 |
$89.04
|
|
Ana ds-dna
|
$90.68 |
$90.68 |
$90.68 |
$55.25
|
|
Analysis gene f2 20210g>a variant
|
$174.67 |
$174.67 |
$174.67 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$164.19 |
$164.19 |
$164.19 |
$237.60
|
|
Anca screen with reflex to titer -quest
|
$69.41 |
$69.41 |
$69.41 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$1,431.91 |
$1,431.91 |
$1,431.91 |
$2,494.35
|
|
Androstanediol
|
$207.81 |
$207.81 |
$207.81 |
$131.04
|
|
An fluoro guide for cvp
|
$387.05 |
$387.05 |
$387.05 |
$515.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$238.64 |
$238.64 |
$238.64 |
$2,792.09
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,920.43 |
$3,920.43 |
$3,920.43 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$6,080.67 |
$6,080.67 |
$6,080.67 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,000.44 |
$4,000.44 |
$4,000.44 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$4,000.44 |
$4,000.44 |
$4,000.44 |
$8,466.00
|
|
Anl sp inf pmp w/mdreprg&fil
|
$304.76 |
$304.76 |
$304.76 |
$627.94
|
|
Annual Physical, Established Patient (age 18-39)
|
$163.16 |
$163.16 |
$163.16 |
$148.50
|
|
Annual Physical, Established Patient (age 40-64)
|
$190.35 |
$190.35 |
$190.35 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$163.16 |
$163.16 |
$163.16 |
$151.50
|
|
Annual Physical, New Patient (age 40-64)
|
$190.35 |
$190.35 |
$190.35 |
$167.25
|
|
Anora (draw only)
|
$76.95 |
$76.95 |
$76.95 |
$35.00
|
|
Anoscopy control bleeding 46614
|
$1,566.72 |
$1,566.72 |
$1,566.72 |
$2,140.60
|
|
Anoscopy remove fb 46608
|
$361.68 |
$361.68 |
$361.68 |
$1,374.60
|
|
Antibody bacterium, not elsewhere specified
|
$30.19 |
$30.19 |
$30.19 |
$57.81
|
|
Antibody elution rbc reference
|
$97.74 |
$97.74 |
$97.74 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$90.20 |
$90.20 |
$90.20 |
$131.28
|
|
Antibody htlv-i
|
$28.60 |
$28.60 |
$28.60 |
$49.53
|
|
Antibody htlv-ii
|
$42.44 |
$42.44 |
$42.44 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$167.20 |
$167.20 |
$167.20 |
$219.30
|
|
Antibody id rbc panel
|
$167.72 |
$167.72 |
$167.72 |
$290.21
|
|
Antibody influenza virus
|
$47.09 |
$47.09 |
$47.09 |
$53.90
|
|
Antibody screen rbc
|
$47.76 |
$47.76 |
$47.76 |
$106.88
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$257.12 |
$257.12 |
$257.12 |
$6.10
|
|
Antihemophilic viii/vwf comp
|
$3.22 |
$3.22 |
$3.22 |
$3.67
|
|
Anti-inhibitor
|
$30,870.60 |
$30,870.60 |
$30,870.60 |
$8.33
|
|
Anti mog serum - sendout
|
$36.32 |
$36.32 |
$36.32 |
$133.50
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$38.07 |
$38.07 |
$38.07 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$11.47 |
$11.47 |
$11.47 |
$42.00
|
|
Antinuclear antibodies
|
$37.96 |
$37.96 |
$37.96 |
$90.00
|
|
Antinuclear antibodies titer
|
$29.23 |
$29.23 |
$29.23 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$46.27 |
$46.27 |
$46.27 |
$64.50
|
|
Antistreptolysin o screen
|
$17.19 |
$17.19 |
$17.19 |
$59.40
|
|
Antistreptolysin o titer
|
$68.19 |
$68.19 |
$68.19 |
$52.50
|
|
Antithrombin iii activity
|
$104.43 |
$104.43 |
$104.43 |
$114.00
|
|
Antithrombin iii injection
|
$2,500.49 |
$2,500.49 |
$2,500.49 |
$12.34
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$64,691.61 |
$64,691.61 |
$64,691.61 |
$7,704.70
|
|
Antithymocyte globuln rabbit
|
$1,046.51 |
$1,046.51 |
$1,046.51 |
$1,958.74
|
|
Apheresis plasma
|
$1,425.45 |
$1,425.45 |
$1,425.45 |
$3,188.50
|
|
Apheresis rbc
|
$1,439.70 |
$1,439.70 |
$1,439.70 |
$3,290.80
|
|
Apl(pml-rara) quant - sendout
|
$246.66 |
$246.66 |
$246.66 |
$500.80
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,661.55 |
$2,661.55 |
$2,661.55 |
$2,112.66
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$2,661.55 |
$2,661.55 |
$2,661.55 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$557.07 |
$557.07 |
$557.07 |
$490.50
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,661.55 |
$2,661.55 |
$2,661.55 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,661.55 |
$2,661.55 |
$2,661.55 |
$1,132.20
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$557.07 |
$557.07 |
$557.07 |
$508.18
|
|
Application finger splntstatic 29130
|
$183.29 |
$183.29 |
$183.29 |
$208.50
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,114.14 |
$1,114.14 |
$1,114.14 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,031.61 |
$1,031.61 |
$1,031.61 |
$2,123.50
|
|
Applicator tag rfid localizer 12gx7cm
|
$42.97 |
$42.97 |
$42.97 |
$895.00
|
|
Apply interstit radiat compl
|
$2,223.90 |
$2,223.90 |
$2,223.90 |
$2,877.50
|
|
Apply of finger splint 29131
|
$82.48 |
$82.48 |
$82.48 |
$177.45
|
|
Apply rigid leg cast 29445
|
$256.13 |
$256.13 |
$256.13 |
$555.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$493.40 |
$493.40 |
$493.40 |
$943.40
|
|
#aptt mix-1:1 incubated
|
$127.04 |
$127.04 |
$127.04 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$13.07 |
$13.07 |
$13.07 |
$244.50
|
|
Aquaporin-4 antibody cba each
|
$34.60 |
$34.60 |
$34.60 |
$140.84
|
|
Aquaporin-4 antibody elisa
|
$9.98 |
$9.98 |
$9.98 |
$150.00
|
|
Argatroban nonesrd use 1mg
|
$4,015.32 |
$4,015.32 |
$4,015.32 |
$881.10
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$5,752.20 |
$5,752.20 |
$5,752.20 |
$6,387.85
|
