|
11-desoxycortisol - sendout
|
$15.22 |
$15.22 |
$15.22 |
$91.85
|
|
17-hydroxypregnenolone
|
$11.94 |
$11.94 |
$11.94 |
$92.65
|
|
17-ketosteroids
|
$13.84 |
$13.84 |
$13.84 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$852.18 |
$852.18 |
$852.18 |
$1,724.25
|
|
2d tte w or without fol w/con,co
|
$470.56 |
$470.56 |
$470.56 |
$1,284.00
|
|
3d recon without postprocess indpndt
|
$184.80 |
$184.80 |
$184.80 |
$508.13
|
|
5' nucleotidase - sendout
|
$17.13 |
$17.13 |
$17.13 |
$50.05
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$14.77 |
$14.77 |
$14.77 |
$53.95
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$323.27 |
$323.27 |
$323.27 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$206.52 |
$206.52 |
$206.52 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$483.27 |
$483.27 |
$483.27 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$402.72 |
$402.72 |
$402.72 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$322.18 |
$322.18 |
$322.18 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$585.52 |
$585.52 |
$585.52 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$488.03 |
$488.03 |
$488.03 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$390.35 |
$390.35 |
$390.35 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$660.06 |
$660.06 |
$660.06 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$364.98 |
$364.98 |
$364.98 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$276.36 |
$276.36 |
$276.36 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$126.66 |
$126.66 |
$126.66 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$168.96 |
$168.96 |
$168.96 |
$418.63
|
|
Abdominal X-ray (single view)
|
$103.87 |
$103.87 |
$103.87 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$506.05 |
$506.05 |
$506.05 |
$1,148.40
|
|
Abl1 gene
|
$354.27 |
$354.27 |
$354.27 |
$683.20
|
|
Ablate pulm tumor perq rf
|
$4,585.29 |
$4,585.29 |
$4,585.29 |
$7,243.60
|
|
Abscess drain retroperitoneal surg code
|
$897.45 |
$897.45 |
$897.45 |
$3,050.40
|
|
Acetylcholine receptor modulating antibody
|
$16.22 |
$16.22 |
$16.22 |
$67.50
|
|
Acute hepatitis panel
|
$78.37 |
$78.37 |
$78.37 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$0.15 |
$0.15 |
$0.15 |
$54.77
|
|
#acylcarnitineprfl
|
$19.90 |
$19.90 |
$19.90 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$5,935.98 |
$5,935.98 |
$5,935.98 |
$5,109.58
|
|
Adenovirus antibody,serum - quest
|
$12.69 |
$12.69 |
$12.69 |
$58.00
|
|
Adh-sendout
|
$17.65 |
$17.65 |
$17.65 |
$118.79
|
|
Administration chemotherapy IV infusion each additional hour
|
$24.07 |
$24.07 |
$24.07 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$49.44 |
$49.44 |
$49.44 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$105.12 |
$105.12 |
$105.12 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$201.81 |
$201.81 |
$201.81 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$113.33 |
$113.33 |
$113.33 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$244.54 |
$244.54 |
$244.54 |
$256.49
|
|
Administration immunization each additional vaccine
|
$5.25 |
$5.25 |
$5.25 |
$47.40
|
|
Administration vaccine hepatitis b
|
$10.84 |
$10.84 |
$10.84 |
$53.00
|
|
Administration vaccine influenza virus
|
$10.84 |
$10.84 |
$10.84 |
$51.07
|
|
Administration vaccine pneumococcal
|
$10.84 |
$10.84 |
$10.84 |
$49.68
|
|
Aep hearing status deter i&r
|
$345.75 |
$345.75 |
$345.75 |
$303.00
|
|
_afb id by dna probe rflx ast
|
$19.56 |
$19.56 |
$19.56 |
$104.50
|
|
#afb mycobacteria suscep. #1
|
$16.88 |
$16.88 |
$16.88 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$93.00 |
$93.00 |
$93.00 |
$300.00
|
|
Albumin body fluid quantitative each specimen
|
$10.03 |
$10.03 |
$10.03 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$9.69 |
$9.69 |
$9.69 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$21.80 |
$21.80 |
$21.80 |
$43.00
|
|
Alkaline phosphatase
|
$24.05 |
$24.05 |
$24.05 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$16.64 |
$16.64 |
$16.64 |
$48.57
|
|
Allergen egg white ige
|
$11.65 |
$11.65 |
$11.65 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$12.27 |
$12.27 |
$12.27 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$3,882.35 |
$3,882.35 |
$3,882.35 |
$9,900.02
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$4,749.00 |
$4,749.00 |
$4,749.00 |
$5,096.00
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$33.56 |
$33.56 |
$33.56 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$8.82 |
$8.82 |
$8.82 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$8.82 |
$8.82 |
$8.82 |
$106.00
|
|
Alt/sgpt
|
$22.49 |
$22.49 |
$22.49 |
$47.50
|
|
Aluminum - quest
|
$13.32 |
$13.32 |
$13.32 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$32.35 |
$32.35 |
$32.35 |
$179.70
|
|
Aminolevulinic acid delta
|
$12.97 |
$12.97 |
$12.97 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$11.76 |
$11.76 |
$11.76 |
$87.45
|
|
Ammonia
|
$36.85 |
$36.85 |
$36.85 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$460.88 |
$460.88 |
$460.88 |
$942.60
|
|
Amniocentesis therapeutic
|
$1,095.08 |
$1,095.08 |
$1,095.08 |
$791.05
|
|
Amphetamine confirm urine -sendout
|
$26.99 |
$26.99 |
$26.99 |
$93.61
|
|
Amylase
|
$58.99 |
$58.99 |
$58.99 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$77.16 |
$77.16 |
$77.16 |
$117.01
|
|
Anal pressure record
|
$435.07 |
$435.07 |
$435.07 |
$954.00
|
|
Analysis gene f2 20210g>a variant
|
$77.66 |
$77.66 |
$77.66 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$86.73 |
$86.73 |
$86.73 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$11.44 |
$11.44 |
$11.44 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$553.91 |
$553.91 |
$553.91 |
$2,480.94
|
|
An fluoro guide for cvp
|
$109.51 |
$109.51 |
$109.51 |
$525.85
|
|
Angiotensin ii
|
$15.40 |
$15.40 |
$15.40 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,593.43 |
$1,593.43 |
$1,593.43 |
$2,979.43
|
|
Angio trnslmnl balloon same vein ini
|
$4,924.59 |
$4,924.59 |
$4,924.59 |
$8,359.11
|
|
Ankle X-ray
|
$87.66 |
$87.66 |
$87.66 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$79.66 |
$79.66 |
$79.66 |
$282.96
|
|
Antibody bacterium, not elsewhere specified
|
$31.82 |
$31.82 |
$31.82 |
$57.85
|
|
Antibody elution rbc reference
|
$75.92 |
$75.92 |
$75.92 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$104.62 |
$104.62 |
$104.62 |
$131.56
|
|
Antibody htlv-i
|
$5.82 |
$5.82 |
$5.82 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$49.71 |
$49.71 |
$49.71 |
$224.00
|
|
Antibody id rbc panel
|
$182.88 |
$182.88 |
$182.88 |
$291.75
|
|
Antibody influenza virus
|
$14.14 |
$14.14 |
$14.14 |
$54.00
|
|
Antibody lymphocytic choriomeningitis
|
$12.90 |
$12.90 |
$12.90 |
$46.58
|
|
Antibody screen rbc
|
$41.76 |
$41.76 |
$41.76 |
$108.55
|
|
Antibody tetanus
|
$13.10 |
$13.10 |
$13.10 |
$54.15
|
|
Antidepressant not specified
|
$12.11 |
$12.11 |
$12.11 |
$72.14
|
|
Anti mog serum - sendout
|
$174.10 |
$174.10 |
$174.10 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$11.86 |
$11.86 |
$11.86 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$12.90 |
$12.90 |
$12.90 |
$42.00
|
|
Antinuclear antibodies
|
$11.02 |
$11.02 |
$11.02 |
$90.00
|
|
Antinuclear antibodies titer
|
$23.92 |
$23.92 |
$23.92 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$11.86 |
$11.86 |
$11.86 |
$67.43
|
|
Antistreptolysin o titer
|
$11.86 |
$11.86 |
$11.86 |
$54.00
|
|
Antithrombin iii activity
|
$14.24 |
$14.24 |
$14.24 |
$115.15
|
