|
11-desoxycortisol - sendout
|
$39.00 |
$39.00 |
$39.00 |
|
|
17-hydroxypregnenolone
|
$39.00 |
$39.00 |
$39.00 |
|
|
5' nucleotidase - sendout
|
$18.72 |
$18.72 |
$18.72 |
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$67.86 |
$67.86 |
$67.86 |
|
|
Abdominal CT scan (with and without contrast)
|
$3,403.14 |
$3,403.14 |
$3,403.14 |
|
|
Abdominal CT scan (with contrast)
|
$3,059.16 |
$3,059.16 |
$3,059.16 |
|
|
Abdominal CT scan (without contrast)
|
$2,457.78 |
$2,457.78 |
$2,457.78 |
|
|
Abdominal paracentesis w/image guidance
|
$2,229.24 |
$2,229.24 |
$2,229.24 |
|
|
Abdominal Ultrasound (complete)
|
$1,101.36 |
$1,101.36 |
$1,101.36 |
|
|
Abdominal Ultrasound (limited)
|
$630.24 |
$630.24 |
$630.24 |
|
|
Abd paracentesis/w/o image guide 49082
|
$1,517.10 |
$1,517.10 |
$1,517.10 |
|
|
Ablate inf turbinate superf 30801
|
$2,706.60 |
$2,706.60 |
$2,706.60 |
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$404.04 |
$404.04 |
$404.04 |
|
|
Ablation of upper extremity nerves rf
|
$609.96 |
$609.96 |
$609.96 |
|
|
Abscess drain retroperitoneal surg code
|
$4,994.34 |
$4,994.34 |
$4,994.34 |
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$50.70 |
$50.70 |
$50.70 |
|
|
Acetaminophen level
|
$82.68 |
$82.68 |
$82.68 |
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$226.44 |
$226.44 |
$226.44 |
|
|
Acetylcysteine non-comp unit
|
$31.47 |
$31.47 |
$31.47 |
|
|
Acne surgery 10040
|
$351.78 |
$351.78 |
$351.78 |
|
|
Acute hepatitis panel
|
$400.92 |
$400.92 |
$400.92 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$50.70 |
$50.70 |
$50.70 |
|
|
#acylcarnitineprfl
|
$46.80 |
$46.80 |
$46.80 |
|
|
Adding walker to prev cast
|
$283.92 |
$283.92 |
$283.92 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$217.04 |
$217.04 |
$217.04 |
|
|
Adjmt/revj ext fixj sys anes
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$3,870.36 |
$3,870.36 |
$3,870.36 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$245.49 |
$245.49 |
$245.49 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$279.24 |
$279.24 |
$279.24 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,410.24 |
$1,410.24 |
$1,410.24 |
|
|
Administration immunization 1 vaccine
|
$270.66 |
$270.66 |
$270.66 |
|
|
Administration immunization each additional vaccine
|
$29.64 |
$29.64 |
$29.64 |
|
|
_afb id by dna probe rflx ast
|
$90.48 |
$90.48 |
$90.48 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$206.70 |
$206.70 |
$206.70 |
|
|
Albumin body fluid quantitative each specimen
|
$28.86 |
$28.86 |
$28.86 |
|
|
Albumin (human), 25%, 50ml
|
$222.00 |
$222.00 |
$222.00 |
|
|
Albumin (human), 5%, 250 ml
|
$239.70 |
$239.70 |
$239.70 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$132.60 |
$132.60 |
$132.60 |
|
|
Albumin serum plasma or whole blood
|
$61.62 |
$61.62 |
$61.62 |
|
|
Albuterol ipratrop non-comp
|
$24.96 |
$24.96 |
$24.96 |
|
|
Albuterol non-comp unit
|
$24.96 |
$24.96 |
$24.96 |
|
|
Alkaline phosphatase
|
$13.26 |
$13.26 |
$13.26 |
|
|
Allergen alpha lactalbumin ige
|
$54.60 |
$54.60 |
$54.60 |
|
|
Allergen egg white ige
|
$54.60 |
$54.60 |
$54.60 |
|
|
Allergen specific ige qual multi scrn ea
|
$47.58 |
$47.58 |
$47.58 |
|
|
Alpha-fetoprotein tumor marker
|
$174.72 |
$174.72 |
$174.72 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$960.10 |
$960.10 |
$960.10 |
|
|
Alt/sgpt
|
$60.06 |
$60.06 |
$60.06 |
|
|
Aluminum - quest
|
$22.62 |
$22.62 |
$22.62 |
|
|
Amantadine (symmetrel)-sendout
|
$165.36 |
$165.36 |
$165.36 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$169.73 |
$169.73 |
$169.73 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$50.70 |
$50.70 |
$50.70 |
|
|
Amitriptyline (elavil) -sendout
|
$91.26 |
$91.26 |
$91.26 |
|
|
Ammonia
|
$156.00 |
$156.00 |
$156.00 |
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$6,133.92 |
$6,133.92 |
$6,133.92 |
|
|
Amphetamine confirm urine -sendout
|
$94.38 |
$94.38 |
$94.38 |
|
|
Amphetamines 5 or more
|
$85.80 |
$85.80 |
$85.80 |
|
|
Ampicillin 1 gram solution for injection
|
$79.62 |
$79.62 |
$79.62 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$50.70 |
$50.70 |
$50.70 |
|
|
Amp metatarsal w/toe single 28810
|
$6,675.24 |
$6,675.24 |
$6,675.24 |
|
|
Amputation toe interphalangeal joint
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
|
|
Amylase
|
$101.40 |
$101.40 |
$101.40 |
|
|
Analysis gene f2 20210g>a variant
|
$72.54 |
$72.54 |
$72.54 |
|
|
Analysis gene f5 leiden variant
|
$145.86 |
$145.86 |
$145.86 |
|
|
Angiotensin ii
|
$123.24 |
$123.24 |
$123.24 |
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$180.84 |
$180.84 |
$180.84 |
|
|
Ankle X-ray
|
$647.40 |
$647.40 |
$647.40 |
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,481.22 |
$1,481.22 |
$1,481.22 |
|
|
Anogenital exam child w imag
|
$347.10 |
$347.10 |
$347.10 |
|
|
Anoscopy control bleeding 46614
|
$2,111.46 |
$2,111.46 |
$2,111.46 |
|
|
Anoscopy remove fb 46608
|
$1,620.84 |
$1,620.84 |
$1,620.84 |
|
|
Antibody bacterium, not elsewhere specified
|
$12.48 |
$12.48 |
$12.48 |
|
|
Antibody htlv-i
|
$125.58 |
$125.58 |
$125.58 |
|
|
Antibody htlv-ii
|
$125.58 |
$125.58 |
$125.58 |
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$108.42 |
$108.42 |
$108.42 |
|
|
Antibody id rbc panel
|
$76.44 |
$76.44 |
$76.44 |
|
|
Antibody influenza virus
|
$38.22 |
$38.22 |
$38.22 |
|
|
Antibody screen rbc
|
$75.66 |
$75.66 |
$75.66 |
|
|
Anti mog serum - sendout
|
$567.84 |
$567.84 |
$567.84 |
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$74.10 |
$74.10 |
$74.10 |
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$21.84 |
$21.84 |
$21.84 |
|
|
Antinuclear antibodies
|
$177.06 |
$177.06 |
$177.06 |
|
|
Antinuclear antibodies titer
|
$63.96 |
$63.96 |
$63.96 |
|
|
Antiphosphatidylserine antibody
|
$37.44 |
$37.44 |
$37.44 |
|
|
Antithrombin iii activity
|
$68.64 |
$68.64 |
$68.64 |
|
|
Apl(pml-rara) quant - sendout
|
$330.72 |
$330.72 |
$330.72 |
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,388.32 |
$3,388.32 |
$3,388.32 |
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$6,665.88 |
$6,665.88 |
$6,665.88 |
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$3,870.36 |
$3,870.36 |
$3,870.36 |
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
|
|
Appl body cast sho to hips
|
$468.00 |
$468.00 |
$468.00 |
|
|
Appl cast figure-of-eight
|
$468.00 |
$468.00 |
$468.00 |
|
|
Appl cast plaster velpeau
|
$468.00 |
$468.00 |
$468.00 |
|
|
Appl cast shoulder spica
|
$468.00 |
$468.00 |
$468.00 |
|
|
Appl hip spica cast1&1/2
|
$468.00 |
$468.00 |
$468.00 |
|
|
Appl hip spica cast 1 leg
|
$468.00 |
$468.00 |
$468.00 |
|
|
Application clubfoot cast
|
$283.92 |
$283.92 |
$283.92 |
|
|
Application finger splntstatic 29130
|
$300.30 |
$300.30 |
$300.30 |
|