|
11-desoxycortisol - sendout
|
$74.10 |
$74.10 |
$74.10 |
$92.04
|
|
17-hydroxypregnenolone
|
$103.35 |
$103.35 |
$103.35 |
$98.40
|
|
5' nucleotidase - sendout
|
$34.45 |
$34.45 |
$34.45 |
$64.80
|
|
88334 ap bill cytologic exam each additional site
|
$71.50 |
$71.50 |
$71.50 |
$98.15
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$59.80 |
$59.80 |
$59.80 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,215.85 |
$2,215.85 |
$2,215.85 |
$1,997.40
|
|
Abdominal CT scan (with contrast)
|
$1,762.15 |
$1,762.15 |
$1,762.15 |
$1,678.00
|
|
Abdominal CT scan (without contrast)
|
$1,238.25 |
$1,238.25 |
$1,238.25 |
$1,290.90
|
|
Abdominal paracentesis w/image guidance
|
$387.40 |
$387.40 |
$387.40 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$554.45 |
$554.45 |
$554.45 |
$733.85
|
|
Abdominal Ultrasound (limited)
|
$412.10 |
$412.10 |
$412.10 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$440.05 |
$440.05 |
$440.05 |
$1,145.00
|
|
Acetaminophen level
|
$146.90 |
$146.90 |
$146.90 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$97.26 |
$97.26 |
$97.26 |
$97.26
|
|
Acetone qualitative
|
$27.95 |
$27.95 |
$27.95 |
$48.75
|
|
Acetylcholine receptor modulating antibody
|
$203.45 |
$203.45 |
$203.45 |
$93.60
|
|
Acetylcholinesterase assay
|
$185.25 |
$185.25 |
$185.25 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$339.66 |
$339.66 |
$339.66 |
$406.77
|
|
Acne surgery 10040
|
$161.85 |
$161.85 |
$161.85 |
$234.00
|
|
Acute hepatitis panel
|
$212.55 |
$212.55 |
$212.55 |
$310.20
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$34.74 |
$34.74 |
$34.74 |
$63.47
|
|
#acylcarnitineprfl
|
$126.10 |
$126.10 |
$126.10 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$9.26 |
$9.26 |
$9.26 |
$97.58
|
|
Adh-sendout
|
$93.60 |
$93.60 |
$93.60 |
$152.10
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$86.12 |
$86.12 |
$86.12 |
$163.25
|
|
Administration chemotherapy IV infusion each additional hour
|
$252.20 |
$252.20 |
$252.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$252.20 |
$252.20 |
$252.20 |
$319.15
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$252.20 |
$252.20 |
$252.20 |
$735.00
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$256.75 |
$256.75 |
$256.75 |
$464.40
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$154.05 |
$154.05 |
$154.05 |
$224.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$195.00 |
$195.00 |
$195.00 |
$267.43
|
|
Administration immunization 1 vaccine
|
$20.15 |
$20.15 |
$20.15 |
$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
|
$11.05 |
$11.05 |
$11.05 |
$37.05
|
|
Administration vaccine pneumococcal
|
$11.05 |
$11.05 |
$11.05 |
$38.25
|
|
_afb id by dna probe rflx ast
|
$123.50 |
$123.50 |
$123.50 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$365.95 |
$365.95 |
$365.95 |
$330.00
|
|
Albumin body fluid quantitative each specimen
|
$73.45 |
$73.45 |
$73.45 |
$42.90
|
|
Albumin (human), 25%, 50ml
|
$277.87 |
$277.87 |
$277.87 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$83.85 |
$83.85 |
$83.85 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$45.50 |
$45.50 |
$45.50 |
$41.90
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$93.60 |
$93.60 |
$93.60 |
$78.00
|
|
Alkaline phosphatase
|
$66.30 |
$66.30 |
$66.30 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$46.15 |
$46.15 |
$46.15 |
$56.35
|
|
Allergen egg white ige
|
$52.00 |
$52.00 |
$52.00 |
$41.38
|
|
Allergen specific ige qual multi scrn ea
|
$49.40 |
$49.40 |
$49.40 |
$39.00
|
|
Allergy injection; single 95115
|
$19.50 |
$19.50 |
$19.50 |
$46.80
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$358.15 |
$358.15 |
$358.15 |
$3,035.85
|
|
Alpha-fetoprotein amniotic
|
$102.70 |
$102.70 |
$102.70 |
$102.49
|
|
Alpha-fetoprotein tumor marker
|
$131.30 |
$131.30 |
$131.30 |
$124.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$17,732.73 |
$17,732.73 |
$17,732.73 |
$285.00
|
|
Alt/sgpt
|
$26.65 |
$26.65 |
$26.65 |
$44.68
|
|
Aluminum - quest
|
$91.65 |
$91.65 |
$91.65 |
$121.25
|
|
Amantadine (symmetrel)-sendout
|
$178.10 |
$178.10 |
$178.10 |
$169.80
|
|
Amino acid screen, urine
|
$112.45 |
$112.45 |
$112.45 |
$76.05
|
|
Amino acids quant 2-5
|
$148.20 |
$148.20 |
$148.20 |
$148.20
|
|
Aminolevulinic acid delta
|
$85.15 |
$85.15 |
$85.15 |
$95.80
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$142.64 |
$142.64 |
$142.64 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$7.15 |
$7.15 |
$7.15 |
$42.92
|
|
Amitriptyline (elavil) -sendout
|
$81.25 |
$81.25 |
$81.25 |
$96.35
|
|
Ammonia
|
$104.65 |
$104.65 |
$104.65 |
$96.53
|
|
Amphetamine confirm urine -sendout
|
$104.00 |
$104.00 |
$104.00 |
$93.61
|
|
Amphetamines 5 or more
|
$101.40 |
$101.40 |
$101.40 |
$85.15
|
|
Ampicillin 1 gram solution for injection
|
$14.96 |
$14.96 |
$14.96 |
$77.40
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$16.54 |
$16.54 |
$16.54 |
$45.34
|
|
Amp metatarsal w/toe single 28810
|
$873.60 |
$873.60 |
$873.60 |
$3,545.97
|
|
Amputate thigh through femur 27590
|
$1,698.45 |
$1,698.45 |
$1,698.45 |
$3,880.00
|
|
Amputation leg thr tib/fib 27880
|
$1,486.55 |
$1,486.55 |
$1,486.55 |
$3,996.20
|
|
Amputation toe metatarsophalangeal joint
|
$932.75 |
$932.75 |
$932.75 |
$3,743.15
|
|
Amylase
|
$70.20 |
$70.20 |
$70.20 |
$83.20
|
|
Ana ds-dna
|
$46.15 |
$46.15 |
$46.15 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$275.60 |
$275.60 |
$275.60 |
$249.03
|
|
Analysis gene f5 leiden variant
|
$300.95 |
$300.95 |
$300.95 |
$263.90
|
|
Analysis tumor
|
$187.85 |
$187.85 |
$187.85 |
$248.80
|
|
Anaplsma phgcytophlm amp prb
|
$157.95 |
$157.95 |
$157.95 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$112.45 |
$112.45 |
$112.45 |
$112.45
|
|
Ankle X-ray
|
$563.55 |
$563.55 |
$563.55 |
$327.20
|
|
Anodyne therapy charges pt
|
$44.20 |
$44.20 |
$44.20 |
$41.02
|
|
Anora (draw only)
|
$16.25 |
$16.25 |
$16.25 |
$36.00
|
|
Antibody
|
$39.65 |
$39.65 |
$39.65 |
$29.40
|
|
Antibody bacterium, not elsewhere specified
|
$55.25 |
$55.25 |
$55.25 |
$61.45
|
|
Antibody elution rbc reference
|
$94.90 |
$94.90 |
$94.90 |
$168.00
|
|
Antibody htlv/hiv confirm test
|
$114.40 |
$114.40 |
$114.40 |
$154.85
|
|
Antibody htlv-i
|
$50.70 |
$50.70 |
$50.70 |
$50.70
|
|
Antibody htlv-ii
|
$37.70 |
$37.70 |
$37.70 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$331.50 |
$331.50 |
$331.50 |
$227.00
|
|
Antibody id rbc panel
|
$204.10 |
$204.10 |
$204.10 |
$265.05
|
|
Antibody influenza virus
|
$82.55 |
$82.55 |
$82.55 |
$65.79
|
|
Antibody lymphocytic choriomeningitis
|
$59.15 |
$59.15 |
$59.15 |
$57.85
|
|
Antibody screen rbc
|
$84.50 |
$84.50 |
$84.50 |
$101.09
|
|
Anti mog serum - sendout
|
$409.50 |
$409.50 |
$409.50 |
$154.84
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$55.25 |
$55.25 |
$55.25 |
$59.15
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$167.05 |
$167.05 |
$167.05 |
$48.57
|
|
Antinuclear antibodies
|
$65.00 |
$65.00 |
$65.00 |
$98.25
|
|
Antinuclear antibodies titer
|
$70.85 |
$70.85 |
$70.85 |
$79.95
|
|
Antiphosphatidylserine antibody
|
$67.60 |
$67.60 |
$67.60 |
$82.55
|
|
Antistreptolysin o screen
|
$53.30 |
$53.30 |
$53.30 |
$57.20
|
|
Antistreptolysin o titer
|
$58.50 |
$58.50 |
$58.50 |
$60.00
|
