|
11-desoxycortisol - sendout
|
$9.94 |
$9.94 |
$9.94 |
$91.85
|
|
17-hydroxypregnenolone
|
$7.80 |
$7.80 |
$7.80 |
$92.65
|
|
17-ketosteroids
|
$9.04 |
$9.04 |
$9.04 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$551.41 |
$551.41 |
$551.41 |
$1,724.25
|
|
2d tte w or without fol w/con,co
|
$304.48 |
$304.48 |
$304.48 |
$1,284.00
|
|
2nd order venous cath
|
$445.97 |
$445.97 |
$445.97 |
$1,532.04
|
|
3d recon without postprocess indpndt
|
$65.56 |
$65.56 |
$65.56 |
$508.13
|
|
5' nucleotidase - sendout
|
$11.19 |
$11.19 |
$11.19 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$25.20 |
$25.20 |
$25.20 |
$100.10
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$12.07 |
$12.07 |
$12.07 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$1,216.32 |
$1,216.32 |
$1,216.32 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$705.80 |
$705.80 |
$705.80 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$862.30 |
$862.30 |
$862.30 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$1,085.29 |
$1,085.29 |
$1,085.29 |
$2,475.45
|
|
Abd/low ext cath addl
|
$558.43 |
$558.43 |
$558.43 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$366.13 |
$366.13 |
$366.13 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$233.90 |
$233.90 |
$233.90 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$440.55 |
$440.55 |
$440.55 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$367.12 |
$367.12 |
$367.12 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$293.70 |
$293.70 |
$293.70 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$626.67 |
$626.67 |
$626.67 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$522.32 |
$522.32 |
$522.32 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$417.78 |
$417.78 |
$417.78 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,230.53 |
$1,230.53 |
$1,230.53 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$237.24 |
$237.24 |
$237.24 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$179.63 |
$179.63 |
$179.63 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$115.89 |
$115.89 |
$115.89 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$154.58 |
$154.58 |
$154.58 |
$418.63
|
|
Abdominal X-ray (single view)
|
$95.03 |
$95.03 |
$95.03 |
$260.00
|
|
Abl1 gene
|
$228.47 |
$228.47 |
$228.47 |
$683.20
|
|
Ablate bone tumor(s) perq
|
$2,801.58 |
$2,801.58 |
$2,801.58 |
$9,511.44
|
|
Ablation cardiac vagal inputs atrium
|
$1,221.34 |
$1,221.34 |
$1,221.34 |
$2,260.30
|
|
Abscess drain retroperitoneal surg code
|
$644.03 |
$644.03 |
$644.03 |
$3,050.40
|
|
Acetazolamide 500 mg solution for injection
|
$0.32 |
$0.32 |
$0.32 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$13.26 |
$13.26 |
$13.26 |
$67.50
|
|
Acute hepatitis panel
|
$51.19 |
$51.19 |
$51.19 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$24.54 |
$24.54 |
$24.54 |
$54.77
|
|
#acylcarnitineprfl
|
$13.00 |
$13.00 |
$13.00 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$1,077.26 |
$1,077.26 |
$1,077.26 |
$5,109.58
|
|
Adenovirus antibody,serum - quest
|
$10.37 |
$10.37 |
$10.37 |
$58.00
|
|
Adh-sendout
|
$11.53 |
$11.53 |
$11.53 |
$118.79
|
|
Administration chemotherapy IV infusion each additional hour
|
$29.05 |
$29.05 |
$29.05 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$59.67 |
$59.67 |
$59.67 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$126.87 |
$126.87 |
$126.87 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$147.19 |
$147.19 |
$147.19 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$82.65 |
$82.65 |
$82.65 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$178.35 |
$178.35 |
$178.35 |
$256.49
|
|
Administration immunization each additional vaccine
|
$4.39 |
$4.39 |
$4.39 |
$47.40
|
|
Administration vaccine hepatitis b
|
$9.07 |
$9.07 |
$9.07 |
$53.00
|
|
Administration vaccine influenza virus
|
$9.07 |
$9.07 |
$9.07 |
$51.07
|
|
Administration vaccine pneumococcal
|
$9.07 |
$9.07 |
$9.07 |
$49.68
|
|
Adrenal cortex & medulla img
|
$486.59 |
$486.59 |
$486.59 |
$1,987.70
|
|
_afb id by dna probe rflx ast
|
$15.11 |
$15.11 |
$15.11 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$13.04 |
$13.04 |
$13.04 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$99.59 |
$99.59 |
$99.59 |
$300.00
|
|
Air injection into abdomen 49400
|
$113.85 |
$113.85 |
$113.85 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$6.55 |
$6.55 |
$6.55 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$7.68 |
$7.68 |
$7.68 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$14.24 |
$14.24 |
$14.24 |
$43.00
|
|
Alkaline phosphatase
|
$15.71 |
$15.71 |
$15.71 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$13.60 |
$13.60 |
$13.60 |
$48.57
|
|
Allergen egg white ige
|
$9.52 |
$9.52 |
$9.52 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$10.03 |
$10.03 |
$10.03 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$206.04 |
$206.04 |
$206.04 |
$9,900.02
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$212.54 |
$212.54 |
$212.54 |
$858.66
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$21.92 |
$21.92 |
$21.92 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$5.76 |
$5.76 |
$5.76 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$5.76 |
$5.76 |
$5.76 |
$106.00
|
|
Alt/sgpt
|
$14.69 |
$14.69 |
$14.69 |
$47.50
|
|
Aluminum - quest
|
$8.70 |
$8.70 |
$8.70 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$21.13 |
$21.13 |
$21.13 |
$179.70
|
|
Aminolevulinic acid delta
|
$8.47 |
$8.47 |
$8.47 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$7.68 |
$7.68 |
$7.68 |
$87.45
|
|
Ammonia
|
$24.07 |
$24.07 |
$24.07 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$330.74 |
$330.74 |
$330.74 |
$942.60
|
|
Amniocentesis therapeutic
|
$785.85 |
$785.85 |
$785.85 |
$791.05
|
|
Amphetamine confirm urine -sendout
|
$17.63 |
$17.63 |
$17.63 |
$93.61
|
|
Amylase
|
$38.53 |
$38.53 |
$38.53 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$50.40 |
$50.40 |
$50.40 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$50.09 |
$50.09 |
$50.09 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$55.93 |
$55.93 |
$55.93 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$9.35 |
$9.35 |
$9.35 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$397.50 |
$397.50 |
$397.50 |
$2,480.94
|
|
An fluoro guide for cvp
|
$100.19 |
$100.19 |
$100.19 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$2,589.12 |
$2,589.12 |
$2,589.12 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$5,042.51 |
$5,042.51 |
$5,042.51 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$6,030.57 |
$6,030.57 |
$6,030.57 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$2,643.13 |
$2,643.13 |
$2,643.13 |
$5,950.50
|
|
Angiotensin ii
|
$10.06 |
$10.06 |
$10.06 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,292.70 |
$1,292.70 |
$1,292.70 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$5,536.12 |
$5,536.12 |
$5,536.12 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,021.52 |
$3,021.52 |
$3,021.52 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$6,043.59 |
$6,043.59 |
$6,043.59 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,948.42 |
$1,948.42 |
$1,948.42 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$5,300.95 |
$5,300.95 |
$5,300.95 |
$8,359.11
|
|
Ankle X-ray
|
$80.19 |
$80.19 |
$80.19 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$72.89 |
$72.89 |
$72.89 |
$282.96
|
|
Anl sp inf pmp w/mdreprg&fil
|
$132.96 |
$132.96 |
$132.96 |
$630.96
|
|
Antibody bacterium, not elsewhere specified
|
$26.01 |
$26.01 |
$26.01 |
$57.85
|
|
Antibody elution rbc reference
|
$62.05 |
$62.05 |
$62.05 |
$177.29
|
