|
Afo sing bar clasp attach sh
|
$188.50 |
$188.50 |
$188.50 |
$663.56
|
|
Afo sing solid stirrup calf
|
$728.50 |
$728.50 |
$728.50 |
$955.35
|
|
Afo, walk boot type, cus fab
|
$244.00 |
$244.00 |
$244.00 |
$2,903.60
|
|
After cataract laser surgery
|
$632.00 |
$632.00 |
$632.00 |
$1,373.11
|
|
Air conduction bilat
|
$41.00 |
$41.00 |
$41.00 |
$133.00
|
|
Air injection into abdomen 49400
|
$68.50 |
$68.50 |
$68.50 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$28.00 |
$28.00 |
$28.00 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$79.00 |
$79.00 |
$79.00 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$40.00 |
$40.00 |
$40.00 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$34.50 |
$34.50 |
$34.50 |
$40.80
|
|
Albuterol ipratrop non-comp
|
$1.00 |
$1.00 |
$1.00 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$46.00 |
$46.00 |
$46.00 |
$93.60
|
|
Alcohol/subs interv 15-30mn
|
$43.50 |
$43.50 |
$43.50 |
$51.52
|
|
Alginate dressing <=16 sq in
|
$76.00 |
$76.00 |
$76.00 |
$18.20
|
|
Alkaline phosphatase
|
$34.50 |
$34.50 |
$34.50 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$53.00 |
$53.00 |
$53.00 |
$48.00
|
|
Allergen egg white ige
|
$138.00 |
$138.00 |
$138.00 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$29.50 |
$29.50 |
$29.50 |
$43.75
|
|
Allergy injection; single 95115
|
$29.50 |
$29.50 |
$29.50 |
$42.75
|
|
Allergy Skin Testing
|
$24.50 |
$24.50 |
$24.50 |
$47.44
|
|
Allograft amnioexcel plus 17mm disk
|
$143.50 |
$143.50 |
$143.50 |
$2,250.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$0.01 |
$0.01 |
$0.01 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$123.50 |
$123.50 |
$123.50 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$44.00 |
$44.00 |
$44.00 |
$23,373.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$219.00 |
$219.00 |
$219.00 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$145.00 |
$145.00 |
$145.00 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$650.50 |
$650.50 |
$650.50 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$261.00 |
$261.00 |
$261.00 |
$4,561.83
|
|
All tstg perq&iq drugs/biol
|
$52.50 |
$52.50 |
$52.50 |
$64.80
|
|
Alpha-fetoprotein amniotic
|
$28.50 |
$28.50 |
$28.50 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$93.00 |
$93.00 |
$93.00 |
$106.00
|
|
Alprostadil for injection
|
$14.00 |
$14.00 |
$14.00 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$191.50 |
$191.50 |
$191.50 |
$15,857.45
|
|
Alt/sgpt
|
$36.00 |
$36.00 |
$36.00 |
$47.45
|
|
Aluminum - quest
|
$25.00 |
$25.00 |
$25.00 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$455.50 |
$455.50 |
$455.50 |
$434.00
|
|
Amantadine (symmetrel)-sendout
|
$142.00 |
$142.00 |
$142.00 |
$169.80
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$1.50 |
$1.50 |
$1.50 |
$39.84
|
|
Amino acids quant 2-5
|
$104.00 |
$104.00 |
$104.00 |
$104.00
|
|
Aminolevulinic acid delta
|
$88.50 |
$88.50 |
$88.50 |
$85.15
|
|
Aminolevulinic acid hcl top
|
$885.00 |
$885.00 |
$885.00 |
$640.56
|
|
Amitriptyline (elavil) -sendout
|
$62.00 |
$62.00 |
$62.00 |
$87.45
|
|
Ammonia
|
$100.00 |
$100.00 |
$100.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,059.00 |
$1,059.00 |
$1,059.00 |
$942.60
|
|
Amniocentesis therapeutic
|
$434.00 |
$434.00 |
$434.00 |
$785.85
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,761.00 |
$3,761.00 |
$3,761.00 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$32.00 |
$32.00 |
$32.00 |
$92.61
|
|
Amphetamines 5 or more
|
$28.00 |
$28.00 |
$28.00 |
$82.96
|
|
Ampicillin 1 gram solution for injection
|
$1.50 |
$1.50 |
$1.50 |
$56.70
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$425.00 |
$425.00 |
$425.00 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$3,799.50 |
$3,799.50 |
$3,799.50 |
$4,271.00
|
|
Amputation toe interphalangeal joint
|
$3,761.00 |
$3,761.00 |
$3,761.00 |
$3,998.20
|
|
Amputation toe metatarsophalangeal joint
|
$4,084.50 |
$4,084.50 |
$4,084.50 |
$3,839.54
|
|
Amylase
|
$237.00 |
$237.00 |
$237.00 |
$89.04
|
|
Ana ds-dna
|
$62.50 |
$62.50 |
$62.50 |
$56.50
|
|
Analgesics non-opioid 3-5
|
$5.00 |
$5.00 |
$5.00 |
$16.24
|
|
Analgesics non-opioid 6/more
|
$5.00 |
$5.00 |
$5.00 |
$16.24
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$45.00 |
$45.00 |
$45.00 |
$117.01
|
|
Anal/urinary muscle study
|
$149.50 |
$149.50 |
$149.50 |
$407.00
|
|
Anal/urinary muscle study
|
$381.00 |
$381.00 |
$381.00 |
$576.00
|
|
Analysis gene f2 20210g>a variant
|
$74.00 |
$74.00 |
$74.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$74.00 |
$74.00 |
$74.00 |
$230.40
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$174.00 |
$174.00 |
$174.00 |
$396.48
|
|
Anaplsma phgcytophlm amp prb
|
$110.00 |
$110.00 |
$110.00 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$99.00 |
$99.00 |
$99.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$3,426.50 |
$3,426.50 |
$3,426.50 |
$2,626.65
|
|
An fluoro guide for cvp
|
$219.50 |
$219.50 |
$219.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,629.00 |
$4,629.00 |
$4,629.00 |
$5,341.83
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$186.00 |
$186.00 |
$186.00 |
$3,080.85
|
|
Angio trnslmnl balloon same artery ini
|
$4,377.00 |
$4,377.00 |
$4,377.00 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$6,721.50 |
$6,721.50 |
$6,721.50 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$4,377.00 |
$4,377.00 |
$4,377.00 |
$8,466.00
|
|
Ankle X-ray
|
$168.50 |
$168.50 |
$168.50 |
$353.60
|
|
Annual alcohol screen 15 min
|
$43.50 |
$43.50 |
$43.50 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$78.00 |
$78.00 |
$78.00 |
$141.00
|
|
Annual Physical, Established Patient (age 40-64)
|
$78.00 |
$78.00 |
$78.00 |
$158.76
|
|
Annual Physical, New Patient (age 18-39)
|
$9.50 |
$9.50 |
$9.50 |
$143.25
|
|
Annual Physical, New Patient (age 40-64)
|
$9.50 |
$9.50 |
$9.50 |
$165.10
|
|
Anterior thoracic extension
|
$503.00 |
$503.00 |
$503.00 |
$496.80
|
|
Antibody bacterium, not elsewhere specified
|
$52.50 |
$52.50 |
$52.50 |
$57.81
|
|
Antibody elution rbc reference
|
$94.00 |
$94.00 |
$94.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$72.00 |
$72.00 |
$72.00 |
$130.00
|
|
Antibody htlv-i
|
$121.00 |
$121.00 |
$121.00 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$455.00 |
$455.00 |
$455.00 |
$218.30
|
|
Antibody id rbc panel
|
$60.50 |
$60.50 |
$60.50 |
$274.56
|
|
Antibody influenza virus
|
$82.50 |
$82.50 |
$82.50 |
$53.95
|
|
Antibody lymphocytic choriomeningitis
|
$25.50 |
$25.50 |
$25.50 |
$48.57
|
|
Antibody screen rbc
|
$54.50 |
$54.50 |
$54.50 |
$100.00
|
|
Antibody tetanus
|
$15.00 |
$15.00 |
$15.00 |
$53.95
|
|
Anticoag mgmt pt warfarin
|
$13.00 |
$13.00 |
$13.00 |
$26.40
|
|
Antidepressant not specified
|
$5.00 |
$5.00 |
$5.00 |
$61.80
|
|
Antidepressants class 3-5
|
$5.00 |
$5.00 |
$5.00 |
$59.46
|
|
Antidepressants class 6/more
|
$5.00 |
$5.00 |
$5.00 |
$29.21
|
|
Antiepileptics nos 4-6
|
$5.00 |
$5.00 |
$5.00 |
$16.24
|
|
Antiepileptics nos 7/more
|
$5.00 |
$5.00 |
$5.00 |
$16.24
|
|
Antigen therapy services
|
$54.00 |
$54.00 |
$54.00 |
$73.84
|
|
Antigen therapy services
|
$54.00 |
$54.00 |
$54.00 |
$83.72
|
|
Antigen therapy services
|
$83.00 |
$83.00 |
$83.00 |
$101.40
|
|
Antigen therapy services
|
$83.00 |
$83.00 |
$83.00 |
$96.72
|
|
Antigen therapy services
|
$83.00 |
$83.00 |
$83.00 |
$130.00
|
