|
Administration vaccine pneumococcal
|
$57.50 |
$57.50 |
$57.50 |
$50.43
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$78.50 |
$78.50 |
$78.50 |
$41.00
|
|
Adrenalin epinephrine inject
|
$64.13 |
$64.13 |
$64.13 |
$229.69
|
|
Aep hearing status deter i&r
|
$308.50 |
$308.50 |
$308.50 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$461.00 |
$461.00 |
$461.00 |
$576.80
|
|
Aep thrshld est mlt freq i&r
|
$461.00 |
$461.00 |
$461.00 |
$605.15
|
|
_afb id by dna probe rflx ast
|
$75.50 |
$75.50 |
$75.50 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$24.00 |
$24.00 |
$24.00 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$495.50 |
$495.50 |
$495.50 |
$315.00
|
|
Aflibercept injection
|
$2,185.50 |
$2,185.50 |
$2,185.50 |
$3,153.84
|
|
Afo molded to patient plasti
|
$974.50 |
$974.50 |
$974.50 |
$710.45
|
|
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
|
$88.00 |
$88.00 |
$88.00 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$28.00 |
$28.00 |
$28.00 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$922.50 |
$922.50 |
$922.50 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$216.00 |
$216.00 |
$216.00 |
$243.59
|
|
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
|
$110.00 |
$110.00 |
$110.00 |
$48.00
|
|
Allergen egg white ige
|
$249.50 |
$249.50 |
$249.50 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$29.50 |
$29.50 |
$29.50 |
$43.75
|
|
Allergy injection; single 95115
|
$54.50 |
$54.50 |
$54.50 |
$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
|
$758.14 |
$758.14 |
$758.14 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$3,777.26 |
$3,777.26 |
$3,777.26 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$3,812.63 |
$3,812.63 |
$3,812.63 |
$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
|
$3,457.75 |
$3,457.75 |
$3,457.75 |
$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-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$3,179.34 |
$3,179.34 |
$3,179.34 |
$12.50
|
|
Alpha-fetoprotein amniotic
|
$28.50 |
$28.50 |
$28.50 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$96.00 |
$96.00 |
$96.00 |
$106.00
|
|
Alprostadil for injection
|
$14.00 |
$14.00 |
$14.00 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$16,169.78 |
$16,169.78 |
$16,169.78 |
$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
|
$1,720.33 |
$1,720.33 |
$1,720.33 |
$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
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$4.07 |
$4.07 |
$4.07 |
$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
|
$4.66 |
$4.66 |
$4.66 |
$55.86
|
|
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
|
$53.00 |
$53.00 |
$53.00 |
$82.96
|
|
Ampicillin 1 gram solution for injection
|
$8.15 |
$8.15 |
$8.15 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$6.13 |
$6.13 |
$6.13 |
$53.86
|
|
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
|
$6,840.00 |
$6,840.00 |
$6,840.00 |
$4,271.00
|
|
Amputation toe interphalangeal joint
|
$3,761.00 |
$3,761.00 |
$3,761.00 |
$3,998.20
|
|
Amputation toe metatarsophalangeal joint
|
$4,501.00 |
$4,501.00 |
$4,501.00 |
$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
|
$123.50 |
$123.50 |
$123.50 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$121.00 |
$121.00 |
$121.00 |
$230.40
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$174.00 |
$174.00 |
$174.00 |
$396.48
|
|
Anaplsma phgcytophlm amp prb
|
$167.50 |
$167.50 |
$167.50 |
$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
|
$303.50 |
$303.50 |
$303.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,629.00 |
$4,629.00 |
$4,629.00 |
$5,341.83
|
|
Angioplasty fem/pop unilat 37224
|
$7,289.00 |
$7,289.00 |
$7,289.00 |
$8,772.38
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$5,009.00 |
$5,009.00 |
$5,009.00 |
$10,173.90
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$293.56 |
$293.56 |
$293.56 |
$3,080.85
|
|
Angio tib/peroneal/init ves/unila 37228
|
$7,644.00 |
$7,644.00 |
$7,644.00 |
$10,522.96
|
|
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
|
$4,758.00 |
$4,758.00 |
$4,758.00 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$2,875.25 |
$2,875.25 |
$2,875.25 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$888.46 |
$888.46 |
$888.46 |
$6,193.84
|
|
Ankle arthroscopy/surgery
|
$5,750.67 |
$5,750.67 |
$5,750.67 |
$3,797.90
|
|
Ankle arthroscopy/surgery
|
$7,558.50 |
$7,558.50 |
$7,558.50 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$2,031.42 |
$2,031.42 |
$2,031.42 |
$3,839.54
|
|
Ankle X-ray
|
$368.00 |
$368.00 |
$368.00 |
$353.60
|
|
Anl sp inf pmp w/mdreprg&fil
|
$584.00 |
$584.00 |
$584.00 |
$627.94
|
|
Annual alcohol screen 15 min
|
$43.50 |
$43.50 |
$43.50 |
$40.00
|
