|
11-desoxycortisol - sendout
|
$103.35 |
$103.35 |
$103.35 |
$92.04
|
|
17-hydroxypregnenolone
|
$76.05 |
$76.05 |
$76.05 |
$98.40
|
|
1st hosp/birthing center care per day nml nb 99460
|
$135.20 |
$135.20 |
$135.20 |
$172.80
|
|
3d recon without postprocess indpndt
|
$504.40 |
$504.40 |
$504.40 |
$455.83
|
|
88334 ap bill cytologic exam each additional site
|
$85.80 |
$85.80 |
$85.80 |
$98.15
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,138.72 |
$3,138.72 |
$3,138.72 |
$3,649.67
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$53.95 |
$53.95 |
$53.95 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,193.75 |
$2,193.75 |
$2,193.75 |
$1,997.40
|
|
Abdominal CT scan (with contrast)
|
$1,804.40 |
$1,804.40 |
$1,804.40 |
$1,678.00
|
|
Abdominal CT scan (without contrast)
|
$1,389.05 |
$1,389.05 |
$1,389.05 |
$1,290.90
|
|
Abdominal MRI (with and without contrast)
|
$2,670.85 |
$2,670.85 |
$2,670.85 |
$2,713.80
|
|
Abdominal MRI (with contrast)
|
$2,195.70 |
$2,195.70 |
$2,195.70 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$1,602.90 |
$1,602.90 |
$1,602.90 |
$1,883.70
|
|
Abdominal paracentesis w/image guidance
|
$533.00 |
$533.00 |
$533.00 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$745.55 |
$745.55 |
$745.55 |
$733.85
|
|
Abdominal Ultrasound (limited)
|
$457.60 |
$457.60 |
$457.60 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$438.75 |
$438.75 |
$438.75 |
$1,145.00
|
|
Ablation of upper extremity nerves rf
|
$267.15 |
$267.15 |
$267.15 |
$1,408.20
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$32.64 |
$32.64 |
$32.64 |
$47.25
|
|
Acetaminophen level
|
$141.70 |
$141.70 |
$141.70 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$120.90 |
$120.90 |
$120.90 |
$97.26
|
|
Acetone qualitative
|
$45.50 |
$45.50 |
$45.50 |
$48.75
|
|
Acetylcholine receptor modulating antibody
|
$188.50 |
$188.50 |
$188.50 |
$93.60
|
|
Acetylcholinesterase assay
|
$193.70 |
$193.70 |
$193.70 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$160.95 |
$160.95 |
$160.95 |
$406.77
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$32.50 |
$32.50 |
$32.50 |
$44.80
|
|
Acute hepatitis panel
|
$363.35 |
$363.35 |
$363.35 |
$310.20
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$34.01 |
$34.01 |
$34.01 |
$63.47
|
|
#acylcarnitineprfl
|
$95.55 |
$95.55 |
$95.55 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$16.55 |
$16.55 |
$16.55 |
$97.58
|
|
Adh-sendout
|
$158.60 |
$158.60 |
$158.60 |
$152.10
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$84.01 |
$84.01 |
$84.01 |
$163.25
|
|
Administration chemotherapy IV infusion each additional hour
|
$334.10 |
$334.10 |
$334.10 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$295.75 |
$295.75 |
$295.75 |
$319.15
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$334.10 |
$334.10 |
$334.10 |
$735.00
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$210.60 |
$210.60 |
$210.60 |
$464.40
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$172.25 |
$172.25 |
$172.25 |
$224.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$172.25 |
$172.25 |
$172.25 |
$267.43
|
|
Administration immunization 1 vaccine
|
$35.75 |
$35.75 |
$35.75 |
$66.51
|
|
Administration immunization each additional component
|
$0.65 |
$0.65 |
$0.65 |
$27.20
|
|
Administration immunization each additional vaccine
|
$0.65 |
$0.65 |
$0.65 |
$46.23
|
|
Administration immunization first component each vaccine
|
$20.15 |
$20.15 |
$20.15 |
$46.00
|
|
Administration vaccine influenza virus
|
$46.80 |
$46.80 |
$46.80 |
$37.05
|
|
Administration vaccine pneumococcal
|
$46.80 |
$46.80 |
$46.80 |
$38.25
|
|
Albumin body fluid quantitative each specimen
|
$37.70 |
$37.70 |
$37.70 |
$42.90
|
|
Albumin (human), 25%, 50ml
|
$272.02 |
$272.02 |
$272.02 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$70.20 |
$70.20 |
$70.20 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$53.30 |
$53.30 |
$53.30 |
$41.90
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$103.35 |
$103.35 |
$103.35 |
$78.00
|
|
Alkaline phosphatase
|
$65.65 |
$65.65 |
$65.65 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$42.25 |
$42.25 |
$42.25 |
$56.35
|
|
Allergen egg white ige
|
$57.20 |
$57.20 |
$57.20 |
$41.38
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$264.55 |
$264.55 |
$264.55 |
$3,035.85
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$600.60 |
$600.60 |
$600.60 |
$4,038.75
|
|
Alpha-fetoprotein amniotic
|
$120.25 |
$120.25 |
$120.25 |
$102.49
|
|
Alpha-fetoprotein tumor marker
|
$143.65 |
$143.65 |
$143.65 |
$124.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$17,217.91 |
$17,217.91 |
$17,217.91 |
$285.00
|
|
Alt/sgpt
|
$57.85 |
$57.85 |
$57.85 |
$44.68
|
|
Aluminum - quest
|
$108.55 |
$108.55 |
$108.55 |
$121.25
|
|
Amantadine (symmetrel)-sendout
|
$167.05 |
$167.05 |
$167.05 |
$169.80
|
|
Amino acids quant 2-5
|
$148.20 |
$148.20 |
$148.20 |
$148.20
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$32.77 |
$32.77 |
$32.77 |
$32.77
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$66.47 |
$66.47 |
$66.47 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$139.64 |
$139.64 |
$139.64 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$13.31 |
$13.31 |
$13.31 |
$42.92
|
|
Amitriptyline (elavil) -sendout
|
$100.10 |
$100.10 |
$100.10 |
$96.35
|
|
Ammonia
|
$110.50 |
$110.50 |
$110.50 |
$96.53
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,361.45 |
$2,361.45 |
$2,361.45 |
$3,743.15
|
|
Amphetamine confirm urine -sendout
|
$87.75 |
$87.75 |
$87.75 |
$93.61
|
|
Amphetamines 5 or more
|
$87.75 |
$87.75 |
$87.75 |
$85.15
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$145.08 |
$145.08 |
$145.08 |
$130.08
|
|
Ampicillin 1 gram solution for injection
|
$21.48 |
$21.48 |
$21.48 |
$77.40
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$27.20 |
$27.20 |
$27.20 |
$45.34
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$616.20 |
$616.20 |
$616.20 |
$362.93
|
|
Amylase
|
$96.85 |
$96.85 |
$96.85 |
$83.20
|
|
Ana ds-dna
|
$91.65 |
$91.65 |
$91.65 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$246.35 |
$246.35 |
$246.35 |
$249.03
|
|
Analysis gene f5 leiden variant
|
$282.75 |
$282.75 |
$282.75 |
$263.90
|
|
Anaplsma phgcytophlm amp prb
|
$142.35 |
$142.35 |
$142.35 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$139.10 |
$139.10 |
$139.10 |
$112.45
|
|
An fluoro guide for cvp
|
$412.10 |
$412.10 |
$412.10 |
$510.17
|
|
Ankle X-ray
|
$512.20 |
$512.20 |
$512.20 |
$327.20
|
|
Anodyne therapy charges pt
|
$34.45 |
$34.45 |
$34.45 |
$41.02
|
|
Anora (draw only)
|
$20.15 |
$20.15 |
$20.15 |
$36.00
|
|
Antibody bacterium, not elsewhere specified
|
$55.25 |
$55.25 |
$55.25 |
$61.45
|
|
Antibody htlv/hiv confirm test
|
$112.45 |
$112.45 |
$112.45 |
$154.85
|
|
Antibody htlv-i
|
$48.75 |
$48.75 |
$48.75 |
$50.70
|
|
Antibody htlv-ii
|
$31.85 |
$31.85 |
$31.85 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$281.45 |
$281.45 |
$281.45 |
$227.00
|
|
Antibody id rbc panel
|
$205.40 |
$205.40 |
$205.40 |
$265.05
|
|
Antibody influenza virus
|
$63.70 |
$63.70 |
$63.70 |
$65.79
|
|
Antibody screen rbc
|
$77.35 |
$77.35 |
$77.35 |
$101.09
|
|
Anti mog serum - sendout
|
$453.05 |
$453.05 |
$453.05 |
$154.84
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$87.75 |
$87.75 |
$87.75 |
$59.15
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$174.20 |
$174.20 |
$174.20 |
$48.57
|
|
Antinuclear antibodies
|
$113.10 |
$113.10 |
$113.10 |
$98.25
|
|
Antinuclear antibodies titer
|
$87.10 |
$87.10 |
$87.10 |
$79.95
|
|
Antistreptolysin o screen
|
$53.95 |
$53.95 |
$53.95 |
$57.20
|
|
Antistreptolysin o titer
|
$65.65 |
$65.65 |
$65.65 |
$60.00
|
|
Antithrombin iii activity
|
$169.65 |
$169.65 |
$169.65 |
$135.20
|
