|
Antibody identification platelet antibodies heparin-pf4 igg
|
$492.00 |
$492.00 |
$492.00 |
$218.30
|
|
Antibody id rbc panel
|
$200.40 |
$200.40 |
$200.40 |
$274.56
|
|
Antibody screen rbc
|
$90.60 |
$90.60 |
$90.60 |
$100.00
|
|
Antidepressant not specified
|
$31.80 |
$31.80 |
$31.80 |
$61.80
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.60 |
$3.60 |
$3.60 |
$6.10
|
|
Antinuclear antibodies
|
$304.80 |
$304.80 |
$304.80 |
$89.40
|
|
Antistreptolysin o titer
|
$28.20 |
$28.20 |
$28.20 |
$51.45
|
|
Antithrombin iii activity
|
$219.60 |
$219.60 |
$219.60 |
$114.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$973.20 |
$973.20 |
$973.20 |
$463.65
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$45.60 |
$45.60 |
$45.60 |
$498.81
|
|
Application finger splntstatic 29130
|
$203.40 |
$203.40 |
$203.40 |
$208.16
|
|
Application long leg splint 29505
|
$203.40 |
$203.40 |
$203.40 |
$338.25
|
|
Application lower leg splint 29515
|
$203.40 |
$203.40 |
$203.40 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$200.40 |
$200.40 |
$200.40 |
$373.20
|
|
Application of forearm cast 29075
|
$64.20 |
$64.20 |
$64.20 |
$339.30
|
|
Application of paste boot 29580
|
$196.20 |
$196.20 |
$196.20 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,358.40 |
$1,358.40 |
$1,358.40 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,426.20 |
$1,426.20 |
$1,426.20 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$140.40 |
$140.40 |
$140.40 |
$66.00
|
|
Art bypass aortobifemoral 35646
|
$3,394.20 |
$3,394.20 |
$3,394.20 |
$3,443.40
|
|
Art bypass carotid-subclavian 35606
|
$2,380.20 |
$2,380.20 |
$2,380.20 |
$5,724.80
|
|
Art bypass common ipsi carotid 35601
|
$2,634.00 |
$2,634.00 |
$2,634.00 |
$1,958.50
|
|
Art bypass femoral-femoral 35661
|
$2,605.80 |
$2,605.80 |
$2,605.80 |
$5,291.20
|
|
Art bypass femoral-popliteal 35656
|
$3,049.80 |
$3,049.80 |
$3,049.80 |
$4,717.50
|
|
Art byp pop-tibl-prl-other 35571
|
$2,956.20 |
$2,956.20 |
$2,956.20 |
$2,674.20
|
|
Arterial blood draw/perc 36620
|
$218.40 |
$218.40 |
$218.40 |
$485.69
|
|
Artery-vein nonautograft
|
$1,871.40 |
$1,871.40 |
$1,871.40 |
$6,396.89
|
|
Artery xray each vessel 7577426
|
$1,659.00 |
$1,659.00 |
$1,659.00 |
$1,844.46
|
|
Artery x-rays arm/leg 75710-26
|
$3,111.60 |
$3,111.60 |
$3,111.60 |
$3,480.00
|
|
Artery x-rays arms/legs 75716-26
|
$4,980.00 |
$4,980.00 |
$4,980.00 |
$3,729.00
|
|
Artery xrays of pelvis 75736 26
|
$2,410.80 |
$2,410.80 |
$2,410.80 |
$4,134.14
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$109.80 |
$109.80 |
$109.80 |
$608.40
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$580.80 |
$580.80 |
$580.80 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$109.80 |
$109.80 |
$109.80 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$947.40 |
$947.40 |
$947.40 |
$715.37
|
|
Arthrotomy hip w/drainage
|
$1,644.60 |
$1,644.60 |
$1,644.60 |
$3,549.00
|
|
Aspirate/inj ganglion cyst 20612
|
$144.00 |
$144.00 |
$144.00 |
$433.07
|
|
Aspirate pleura without imaging 32554
|
$1,974.00 |
$1,974.00 |
$1,974.00 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$933.00 |
$933.00 |
$933.00 |
$1,226.87
|
|
Assay of interleukin-6 (il-6)
|
$687.00 |
$687.00 |
$687.00 |
$79.97
|
|
Assay of lrh hormone
|
$810.60 |
$810.60 |
$810.60 |
$189.50
|
|
Assay toxin or antitoxin
|
$529.20 |
$529.20 |
$529.20 |
$75.90
|
|
Ast/sgot
|
$122.40 |
$122.40 |
$122.40 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$29,607.60 |
$29,607.60 |
$29,607.60 |
$23,166.53
|
|
Atropine 0.1 mg/ml injection syringe
|
$30.60 |
$30.60 |
$30.60 |
$51.28
|
|
Autoimmune rheumatoid arthr anl 12 mrk ia
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$925.10
|
|
Av fistula revision
|
$1,591.80 |
$1,591.80 |
$1,591.80 |
$7,014.75
|
|
Av fuse uppr arm basilic
|
$1,464.00 |
$1,464.00 |
$1,464.00 |
$7,651.38
|
|
Av fusion direct any site
|
$1,365.60 |
$1,365.60 |
$1,365.60 |
$4,804.00
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$279.60 |
$279.60 |
$279.60 |
$318.75
|
|
Azacitidine injection
|
$1,333.80 |
$1,333.80 |
$1,333.80 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$3.60 |
$3.60 |
$3.60 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$25.20 |
$25.20 |
$25.20 |
$35.06
|
|
Aztreonam 1 gram solution for injection
|
$295.20 |
$295.20 |
$295.20 |
$157.30
|
|
Baclofen eval charges
|
$70.80 |
$70.80 |
$70.80 |
$85.00
|
|
Bacterial meningitis antigen
|
$116.40 |
$116.40 |
$116.40 |
$66.30
|
|
Bacterial vaginosis pcr
|
$120.00 |
$120.00 |
$120.00 |
$278.40
|
|
Basic vestibular evaluation
|
$240.00 |
$240.00 |
$240.00 |
$328.00
|
|
Belatacept 250 mg intravenous solution
|
$3,474.60 |
$3,474.60 |
$3,474.60 |
$2,036.75
|
|
Bendamustine 25 mg/ml intravenous solution (belrapzo)
|
$10,440.60 |
$10,440.60 |
$10,440.60 |
$4,107.38
|
|
Benign lesion paring 2-4
|
$54.00 |
$54.00 |
$54.00 |
$257.50
|
|
Benztropine 1 mg/ml injection solution
|
$217.80 |
$217.80 |
$217.80 |
$103.20
|
|
Beta 2 glycoprotein 1 antibody iga
|
$42.60 |
$42.60 |
$42.60 |
$78.50
|
|
Beta-2 microglobulin
|
$171.00 |
$171.00 |
$171.00 |
$85.94
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$6.60 |
$6.60 |
$6.60 |
$64.15
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$10,628.40 |
$10,628.40 |
$10,628.40 |
$5,705.92
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$9,482.40 |
$9,482.40 |
$9,482.40 |
$3,291.73
|
|
Bevacizumab-bvzr 25 mg/ml intravenous solution
|
$9,008.40 |
$9,008.40 |
$9,008.40 |
$2,508.56
|
|
Bilirubin direct
|
$88.20 |
$88.20 |
$88.20 |
$50.00
|
|
Bilirubin total
|
$133.80 |
$133.80 |
$133.80 |
$52.57
|
|
Biopsy abdominal mass
|
$2,041.80 |
$2,041.80 |
$2,041.80 |
$1,718.60
|
|
Biopsy cervixsingle/multiple 57500
|
$211.80 |
$211.80 |
$211.80 |
$1,266.48
|
|
Biopsy external ear 69100
|
$136.80 |
$136.80 |
$136.80 |
$416.52
|
|
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides)
|
$3,292.20 |
$3,292.20 |
$3,292.20 |
$2,716.95
|
|
Biopsy needle liver percutaneous
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$1,892.80
|
|
Biopsy needle lymph node superficial
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$1,878.14
|
|
Biopsy roof of mouth
|
$172.20 |
$172.20 |
$172.20 |
$1,752.89
|
|
Biopsy skin incisional single lesion
|
$179.40 |
$179.40 |
$179.40 |
$657.66
|
|
Biopsy tongue anterior two-thirds
|
$414.00 |
$414.00 |
$414.00 |
$1,148.15
|
|
Biopsy vestibule of mouth 40808
|
$112.20 |
$112.20 |
$112.20 |
$629.50
|
|
Bivalirudin
|
$1,834.20 |
$1,834.20 |
$1,834.20 |
$1,033.55
|
|
Bladder irrigate/lavage/instill 51700
|
$398.40 |
$398.40 |
$398.40 |
$408.00
|
|
Blepharoplasty upper 15822
|
$750.00 |
$750.00 |
$750.00 |
$2,265.51
|
|
Bln 1.2 mono emrg 15x1.2
|
$8,290.80 |
$8,290.80 |
$8,290.80 |
$8,530.55
|
|
Bln 30frx10mmx12cm renal nephromax
|
$535.28 |
$535.28 |
$535.28 |
$5,169.58
|
|
Bln dil 900ml preperitnl
|
$385.36 |
$385.36 |
$385.36 |
$1,427.17
|
|
Bln inpact admiral 4x150x130cm
|
$3,439.80 |
$3,439.80 |
$3,439.80 |
$4,816.50
|
|
Blood Clotting (PT/INR) Test
|
$132.60 |
$132.60 |
$132.60 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$293.40 |
$293.40 |
$293.40 |
$73.44
|
|
Blood Count (CBC) Test
|
$108.60 |
$108.60 |
$108.60 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Blood Culture Test
|
$203.40 |
$203.40 |
$203.40 |
$145.80
|
|
Blood gases ph venous
|
$166.20 |
$166.20 |
$166.20 |
$64.60
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$261.00 |
$261.00 |
$261.00 |
$57.42
|
|
Blood occult peroxidase activity qualitative gastric
|
$141.60 |
$141.60 |
$141.60 |
$34.00
|
|
Blood smear microscopic w manual differential wbc count
|
$88.20 |
$88.20 |
$88.20 |
$38.61
|
|
Blood typing abo
|
$55.80 |
$55.80 |
$55.80 |
$83.03
|
|
Blood typing rbc ag non abo/rh ea
|
$88.80 |
$88.80 |
$88.80 |
$199.50
|
|
Blood typing rh (d)
|
$60.00 |
$60.00 |
$60.00 |
$57.14
|
|
Bone biopsy open superficial
|
$351.00 |
$351.00 |
$351.00 |
$3,786.00
|
