|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$587.52 |
$587.52 |
$587.52 |
$181.12
|
|
Admin ecg contrast agent
|
$56.00 |
$56.00 |
$56.00 |
$119.00
|
|
Administration chemotherapy IV infusion each additional hour
|
$1,060.50 |
$1,060.50 |
$1,060.50 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$657.00 |
$657.00 |
$657.00 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$657.00 |
$657.00 |
$657.00 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$240.50 |
$240.50 |
$240.50 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$178.00 |
$178.00 |
$178.00 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$178.00 |
$178.00 |
$178.00 |
$257.40
|
|
Administration immunization 1 vaccine
|
$54.00 |
$54.00 |
$54.00 |
$69.21
|
|
Administration immunization each additional component
|
$78.00 |
$78.00 |
$78.00 |
$27.95
|
|
Administration immunization each additional vaccine
|
$43.00 |
$43.00 |
$43.00 |
$47.40
|
|
Administration immunization first component each vaccine
|
$52.00 |
$52.00 |
$52.00 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$42.00 |
$42.00 |
$42.00 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$15.00 |
$15.00 |
$15.00 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$178.00 |
$178.00 |
$178.00 |
$41.45
|
|
Administration vaccine hepatitis b
|
$32.00 |
$32.00 |
$32.00 |
$54.40
|
|
Administration vaccine influenza virus
|
$31.00 |
$31.00 |
$31.00 |
$50.43
|
|
Administration vaccine pneumococcal
|
$31.00 |
$31.00 |
$31.00 |
$50.43
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$178.00 |
$178.00 |
$178.00 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$39,306.70 |
$39,306.70 |
$39,306.70 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$1,156.50 |
$1,156.50 |
$1,156.50 |
$1,818.05
|
|
Adrenalin epinephrine inject
|
$245.97 |
$245.97 |
$245.97 |
$229.69
|
|
Advance care planning each additional 30 min 99498
|
$124.00 |
$124.00 |
$124.00 |
$108.00
|
|
Aep hearing status deter i&r
|
$284.50 |
$284.50 |
$284.50 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$582.50 |
$582.50 |
$582.50 |
$576.80
|
|
Aep thrshld est mlt freq i&r
|
$898.67 |
$898.67 |
$898.67 |
$605.15
|
|
_afb id by dna probe rflx ast
|
$159.50 |
$159.50 |
$159.50 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$24.00 |
$24.00 |
$24.00 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$472.00 |
$472.00 |
$472.00 |
$315.00
|
|
Aflibercept injection
|
$8,742.00 |
$8,742.00 |
$8,742.00 |
$3,153.84
|
|
Afo molded to patient plasti
|
$971.00 |
$971.00 |
$971.00 |
$710.45
|
|
Afo sing bar clasp attach sh
|
$199.50 |
$199.50 |
$199.50 |
$663.56
|
|
Afo sing solid stirrup calf
|
$725.50 |
$725.50 |
$725.50 |
$955.35
|
|
Afo tibial fracture rigid
|
$38.50 |
$38.50 |
$38.50 |
$1,654.77
|
|
After cataract laser surgery
|
$1,250.00 |
$1,250.00 |
$1,250.00 |
$1,373.11
|
|
Agalsidase beta 35 mg intravenous solution
|
$46,964.82 |
$46,964.82 |
$46,964.82 |
$14,475.20
|
|
Air conduction bilat
|
$106.50 |
$106.50 |
$106.50 |
$133.00
|
|
Air injection into abdomen 49400
|
$91.50 |
$91.50 |
$91.50 |
$525.60
|
|
Airway resistance by impulse oscillometry 94728
|
$226.50 |
$226.50 |
$226.50 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$113.50 |
$113.50 |
$113.50 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$432.00 |
$432.00 |
$432.00 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$1,845.00 |
$1,845.00 |
$1,845.00 |
$243.59
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$38.00 |
$38.00 |
$38.00 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$27.50 |
$27.50 |
$27.50 |
$40.80
|
|
Albuterol ipratrop non-comp
|
$1.00 |
$1.00 |
$1.00 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$55.50 |
$55.50 |
$55.50 |
$93.60
|
|
Alcohol/subs interv 15-30mn
|
$48.00 |
$48.00 |
$48.00 |
$51.52
|
|
Alcohol/subs interv >30 min
|
$201.00 |
$201.00 |
$201.00 |
$190.13
|
|
Alginate dressing <=16 sq in
|
$76.00 |
$76.00 |
$76.00 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$93.50 |
$93.50 |
$93.50 |
$43.72
|
|
Alkaline phosphatase
|
$28.50 |
$28.50 |
$28.50 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$153.00 |
$153.00 |
$153.00 |
$48.00
|
|
Allergen egg white ige
|
$210.00 |
$210.00 |
$210.00 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$13.61 |
$13.61 |
$13.61 |
$24.01
|
|
Allergy injections; 2 or more 95117
|
$55.00 |
$55.00 |
$55.00 |
$43.75
|
|
Allergy injection; single 95115
|
$46.00 |
$46.00 |
$46.00 |
$42.75
|
|
Allergy Skin Testing
|
$940.00 |
$940.00 |
$940.00 |
$47.44
|
|
Allg patch or app # of tests 95044
|
$1,890.00 |
$1,890.00 |
$1,890.00 |
$445.00
|
|
Allograft amnioexcel plus 17mm disk
|
$1,904.00 |
$1,904.00 |
$1,904.00 |
$2,250.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$1,371.05 |
$1,371.05 |
$1,371.05 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$4,200.99 |
$4,200.99 |
$4,200.99 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$8,240.97 |
$8,240.97 |
$8,240.97 |
$23,373.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$266.50 |
$266.50 |
$266.50 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$2,921.81 |
$2,921.81 |
$2,921.81 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$2,555.25 |
$2,555.25 |
$2,555.25 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$318.00 |
$318.00 |
$318.00 |
$4,561.83
|
|
All tstg perq&iq drugs/biol
|
$272.50 |
$272.50 |
$272.50 |
$64.80
|
|
All tstg perq&iq w/venoms
|
$177.50 |
$177.50 |
$177.50 |
$41.34
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$964.97 |
$964.97 |
$964.97 |
$12.50
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$116.50 |
$116.50 |
$116.50 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$174.50 |
$174.50 |
$174.50 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$158.00 |
$158.00 |
$158.00 |
$106.00
|
|
Alprostadil for injection
|
$328.46 |
$328.46 |
$328.46 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$18,191.03 |
$18,191.03 |
$18,191.03 |
$15,857.45
|
|
Alt/sgpt
|
$29.00 |
$29.00 |
$29.00 |
$47.45
|
|
Aluminum - quest
|
$92.00 |
$92.00 |
$92.00 |
$83.05
|
|
Alveoloplasty each quadrant
|
$3,636.63 |
$3,636.63 |
$3,636.63 |
$3,892.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$4,353.67 |
$4,353.67 |
$4,353.67 |
$434.00
|
|
Amantadine (symmetrel)-sendout
|
$143.50 |
$143.50 |
$143.50 |
$169.80
|
|
Ambl bp mntr w/sw a/r
|
$228.00 |
$228.00 |
$228.00 |
$310.44
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$53.02 |
$53.02 |
$53.02 |
$39.84
|
|
Amino acids quant 2-5
|
$196.50 |
$196.50 |
$196.50 |
$104.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$9.23 |
$9.23 |
$9.23 |
$37.14
|
|
Aminolevulinic acid delta
|
$214.50 |
$214.50 |
$214.50 |
$85.15
|
|
Aminolevulinic acid hcl top
|
$885.00 |
$885.00 |
$885.00 |
$640.56
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$15.59 |
$15.59 |
$15.59 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$120.00 |
$120.00 |
$120.00 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$14.41 |
$14.41 |
$14.41 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$256.00 |
$256.00 |
$256.00 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$29,170.80 |
$29,170.80 |
$29,170.80 |
$7,994.03
|
|
Ammonia
|
$88.00 |
$88.00 |
$88.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,229.00 |
$1,229.00 |
$1,229.00 |
$942.60
|
|
Amniocentesis therapeutic
|
$538.50 |
$538.50 |
$538.50 |
$785.85
|
|
Amniotic fluid scan
|
$152.50 |
$152.50 |
$152.50 |
$49.01
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$10,030.00 |
$10,030.00 |
$10,030.00 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$204.50 |
$204.50 |
$204.50 |
$92.61
|
|
Amphetamines 5 or more
|
$53.00 |
$53.00 |
$53.00 |
$82.96
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$0.75 |
$0.75 |
$0.75 |
$117.75
|
|
Ampicillin 1 gram solution for injection
|
$8.88 |
$8.88 |
$8.88 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$17.99 |
$17.99 |
$17.99 |
$53.86
|
