|
Alkaline phosphatase
|
$22.80 |
$22.80 |
$22.80 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$12.40 |
$12.40 |
$12.40 |
$48.57
|
|
Allergen egg white ige
|
$22.80 |
$22.80 |
$22.80 |
$37.05
|
|
Allograft 160mg placental salera mini membrane
|
$5,128.00 |
$5,128.00 |
$5,128.00 |
$5,481.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$9,065.60 |
$9,065.60 |
$9,065.60 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$13,082.80 |
$13,082.80 |
$13,082.80 |
$19,637.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,708.40 |
$1,708.40 |
$1,708.40 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$6,262.00 |
$6,262.00 |
$6,262.00 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$7,488.00 |
$7,488.00 |
$7,488.00 |
$5,096.00
|
|
Alpha-fetoprotein amniotic
|
$74.00 |
$74.00 |
$74.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$74.00 |
$74.00 |
$74.00 |
$103.80
|
|
Alteplase 100 mg infusion from pyxis vial
|
$192.73 |
$192.73 |
$192.73 |
$15,857.45
|
|
Alt/sgpt
|
$23.20 |
$23.20 |
$23.20 |
$47.40
|
|
Aluminum - quest
|
$112.40 |
$112.40 |
$112.40 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$306.40 |
$306.40 |
$306.40 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$110.00 |
$110.00 |
$110.00 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$214.00 |
$214.00 |
$214.00 |
$320.45
|
|
Aminolevulinic acid delta
|
$72.40 |
$72.40 |
$72.40 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$70.62 |
$70.62 |
$70.62 |
$46.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$22.92 |
$22.92 |
$22.92 |
$114.61
|
|
Amiodarone 50 mg/ml intravenous solution
|
$10.92 |
$10.92 |
$10.92 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$49.20 |
$49.20 |
$49.20 |
$84.56
|
|
Ammonia
|
$64.80 |
$64.80 |
$64.80 |
$119.00
|
|
Amniocentesisdiagnostic 59000
|
$820.40 |
$820.40 |
$820.40 |
$923.50
|
|
Amniocentesis therapeutic
|
$390.00 |
$390.00 |
$390.00 |
$791.05
|
|
Amniotic fluid scan
|
$33.60 |
$33.60 |
$33.60 |
$49.01
|
|
Amphetamine confirm urine -sendout
|
$41.20 |
$41.20 |
$41.20 |
$93.61
|
|
Amphetamines 5 or more
|
$37.60 |
$37.60 |
$37.60 |
$90.48
|
|
Ampicillin 1 gram solution for injection
|
$48.52 |
$48.52 |
$48.52 |
$58.35
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$102.42 |
$102.42 |
$102.42 |
$54.57
|
|
Amputation toe interphalangeal joint
|
$3,818.40 |
$3,818.40 |
$3,818.40 |
$4,196.50
|
|
Amylase
|
$28.80 |
$28.80 |
$28.80 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$86.40 |
$86.40 |
$86.40 |
$80.08
|
|
Ana ds-dna
|
$30.40 |
$30.40 |
$30.40 |
$55.25
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$49.60 |
$49.60 |
$49.60 |
$113.28
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$274.00 |
$274.00 |
$274.00 |
$335.85
|
|
Analysis gene f2 20210g>a variant
|
$234.80 |
$234.80 |
$234.80 |
$221.52
|
|
Analysis gene f5 leiden variant
|
$269.60 |
$269.60 |
$269.60 |
$237.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$228.40 |
$228.40 |
$228.40 |
$123.84
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$183.20 |
$183.20 |
$183.20 |
$375.00
|
|
Anca screen with reflex to titer -quest
|
$67.20 |
$67.20 |
$67.20 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$2,765.20 |
$2,765.20 |
$2,765.20 |
$2,494.35
|
|
An fluoro guide for cvp
|
$478.00 |
$478.00 |
$478.00 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,415.60 |
$4,415.60 |
$4,415.60 |
$5,500.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$28.32 |
$28.32 |
$28.32 |
$2,792.09
|
|
Angio trnslmnl balloon same artery ea addl
|
$2,098.00 |
$2,098.00 |
$2,098.00 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$11,219.60 |
$11,219.60 |
$11,219.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$6,219.60 |
$6,219.60 |
$6,219.60 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$11,219.60 |
$11,219.60 |
$11,219.60 |
$8,466.00
|
|
Ankle X-ray
|
$222.00 |
$222.00 |
$222.00 |
$352.80
|
|
Ank symes mold sckt sach ft
|
$1,682.40 |
$1,682.40 |
$1,682.40 |
$2,996.00
|
|
Anterior swing band
|
$142.40 |
$142.40 |
$142.40 |
$506.45
|
|
Anterior thoracic extension
|
$158.80 |
$158.80 |
$158.80 |
$496.80
|
|
Antibody bacterium, not elsewhere specified
|
$56.80 |
$56.80 |
$56.80 |
$57.81
|
|
Antibody elution rbc reference
|
$261.60 |
$261.60 |
$261.60 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$86.00 |
$86.00 |
$86.00 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$81.60 |
$81.60 |
$81.60 |
$219.30
|
|
Antibody id rbc panel
|
$481.60 |
$481.60 |
$481.60 |
$290.21
|
|
Antibody influenza virus
|
$59.60 |
$59.60 |
$59.60 |
$53.90
|
|
Antibody screen rbc
|
$160.00 |
$160.00 |
$160.00 |
$106.00
|
|
Antibody tetanus
|
$66.00 |
$66.00 |
$66.00 |
$54.00
|
|
Antidepressant not specified
|
$66.40 |
$66.40 |
$66.40 |
$72.14
|
|
Antidepressant tricyclic 3-5
|
$97.60 |
$97.60 |
$97.60 |
$23.20
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.20 |
$2.20 |
$2.20 |
$6.10
|
|
Anti mog serum - sendout
|
$18.00 |
$18.00 |
$18.00 |
$133.50
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$10.40 |
$10.40 |
$10.40 |
$37.58
|
|
Antinuclear antibodies
|
$53.20 |
$53.20 |
$53.20 |
$90.00
|
|
Antinuclear antibodies titer
|
$49.20 |
$49.20 |
$49.20 |
$79.86
|
|
Antiphosphatidylserine antibody
|
$70.40 |
$70.40 |
$70.40 |
$64.50
|
|
Antipsychotics nos 1-3
|
$479.60 |
$479.60 |
$479.60 |
$137.80
|
|
Antistreptolysin o screen
|
$14.40 |
$14.40 |
$14.40 |
$59.40
|
|
Antistreptolysin o titer
|
$32.00 |
$32.00 |
$32.00 |
$52.50
|
|
Antithrombin iii activity
|
$52.40 |
$52.40 |
$52.40 |
$114.00
|
|
Apheresis plasma
|
$2,436.40 |
$2,436.40 |
$2,436.40 |
$3,188.50
|
|
Apheresis platelets
|
$855.60 |
$855.60 |
$855.60 |
$2,195.00
|
|
Apheresis rbc
|
$2,320.40 |
$2,320.40 |
$2,320.40 |
$3,290.80
|
|
Apheresis wbc
|
$2,436.40 |
$2,436.40 |
$2,436.40 |
$3,342.71
|
|
Apl(pml-rara) quant - sendout
|
$915.20 |
$915.20 |
$915.20 |
$500.80
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$215.20 |
$215.20 |
$215.20 |
$508.18
|
|
Application finger splntstatic 29130
|
$108.80 |
$108.80 |
$108.80 |
$208.50
|
|
Application long leg splint 29505
|
$245.60 |
$245.60 |
$245.60 |
$338.25
|
|
Application lower leg splint 29515
|
$245.60 |
$245.60 |
$245.60 |
$334.20
|
|
Application multi layer compression below knee (both sides)
|
$196.80 |
$196.80 |
$196.80 |
$370.92
|
|
Application of long leg cast 29345
|
$429.20 |
$429.20 |
$429.20 |
$455.00
|
|
Application of paste boot 29580
|
$258.40 |
$258.40 |
$258.40 |
$336.00
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$2,234.40 |
$2,234.40 |
$2,234.40 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$2,234.40 |
$2,234.40 |
$2,234.40 |
$2,123.50
|
|
Applicator tag rfid localizer 12gx7cm
|
$1,018.80 |
$1,018.80 |
$1,018.80 |
$895.00
|
|
Apply interstit radiat compl
|
$2,555.60 |
$2,555.60 |
$2,555.60 |
$2,877.50
|
|
Apply of finger splint 29131
|
$106.80 |
$106.80 |
$106.80 |
$177.45
|
|
Apply rigid leg cast 29445
|
$334.80 |
$334.80 |
$334.80 |
$555.00
|
|
Apply surf ldr radionuclide
|
$237.20 |
$237.20 |
$237.20 |
$282.80
|
|
#aptt mix-1:1 incubated
|
$21.60 |
$21.60 |
$21.60 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$12.40 |
$12.40 |
$12.40 |
$244.50
|
|
Aquaporin-4 antibody cba each
|
$21.20 |
$21.20 |
$21.20 |
$140.84
|
|
Aquatic exercise - group charge
|
$29.60 |
$29.60 |
$29.60 |
$87.15
|
|
Arterial blood draw/perc 36620
|
$285.60 |
$285.60 |
$285.60 |
$479.05
|
|
Artery xray each vessel 7577426
|
$2,449.60 |
$2,449.60 |
$2,449.60 |
$1,865.50
|
|
Artery xray of abdomen 75726-26
|
$12,086.00 |
$12,086.00 |
$12,086.00 |
$4,515.50
|
|
Artery x-rays adrenal gland
|
$3,874.40 |
$3,874.40 |
$3,874.40 |
$3,320.35
|