|
11-desoxycortisol - sendout
|
$5.20 |
$5.20 |
$5.20 |
$84.56
|
|
17-hydroxypregnenolone
|
$4.06 |
$4.06 |
$4.06 |
$85.15
|
|
17-ketosteroids
|
$5.95 |
$5.95 |
$5.95 |
$46.20
|
|
2nd order venous cath
|
$1,046.80 |
$1,046.80 |
$1,046.80 |
$1,635.60
|
|
3d recon without postprocess indpndt
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$480.00
|
|
5% dextrose and 0.45% saline
|
$13.93 |
$13.93 |
$13.93 |
$48.00
|
|
5' nucleotidase - sendout
|
$1.98 |
$1.98 |
$1.98 |
$46.53
|
|
88334 ap bill cytologic exam each additional site
|
$4.40 |
$4.40 |
$4.40 |
$97.65
|
|
99381 initial comp preventive med less than 1 year new
|
$39.60 |
$39.60 |
$39.60 |
$135.00
|
|
99382 initial comp preventive med 1 to 4 years new
|
$41.80 |
$41.80 |
$41.80 |
$135.00
|
|
99383 initial comp preventive med 5 to 11 years new
|
$44.20 |
$44.20 |
$44.20 |
$116.00
|
|
99391 periodic comp preventive med less than 1 year est
|
$26.40 |
$26.40 |
$26.40 |
$113.52
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$28.20 |
$28.20 |
$28.20 |
$133.92
|
|
99393 periodic comp preventive med 5 to 11 years est
|
$30.80 |
$30.80 |
$30.80 |
$120.25
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$33.20 |
$33.20 |
$33.20 |
$137.15
|
|
99397 periodic comp preventive med 65+ years est
|
$23.80 |
$23.80 |
$23.80 |
$164.73
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$2.13 |
$2.13 |
$2.13 |
$53.68
|
|
Abd aorta w/runoff s&i
|
$1,631.60 |
$1,631.60 |
$1,631.60 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$1,301.80 |
$1,301.80 |
$1,301.80 |
$2,121.00
|
|
Abd/low ext cath 2nd
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$2,158.00
|
|
Abd/low ext cath 3rd
|
$1,765.00 |
$1,765.00 |
$1,765.00 |
$2,639.65
|
|
Abd/low ext cath addl
|
$773.80 |
$773.80 |
$773.80 |
$965.25
|
|
Abdominal CT scan (with and without contrast)
|
$2,210.80 |
$2,210.80 |
$2,210.80 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,963.80 |
$1,963.80 |
$1,963.80 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$1,817.80 |
$1,817.80 |
$1,817.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$3,045.84
|
|
Abdominal MRI (with contrast)
|
$2,512.20 |
$2,512.20 |
$2,512.20 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$2,502.40 |
$2,502.40 |
$2,502.40 |
$2,047.72
|
|
Abdominal paracentesis w/image guidance
|
$297.80 |
$297.80 |
$297.80 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$826.80 |
$826.80 |
$826.80 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$572.40 |
$572.40 |
$572.40 |
$600.00
|
|
Abl1 gene
|
$148.23 |
$148.23 |
$148.23 |
$668.85
|
|
Abrasion lesions add-on
|
$95.60 |
$95.60 |
$95.60 |
$100.00
|
|
Abrasion lesion single
|
$95.60 |
$95.60 |
$95.60 |
$340.86
|
|
Abscess drain retroperitoneal surg code
|
$450.60 |
$450.60 |
$450.60 |
$2,903.45
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$11.36 |
$11.36 |
$11.36 |
$80.14
|
|
Acetaminophen 120 mg rectal suppository
|
$1.80 |
$1.80 |
$1.80 |
$107.02
|
|
Acetaminophen level
|
$66.80 |
$66.80 |
$66.80 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$39.95 |
$39.95 |
$39.95 |
$113.40
|
|
Acetone qualitative
|
$88.60 |
$88.60 |
$88.60 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$1.72 |
$1.72 |
$1.72 |
$61.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$105.54 |
$105.54 |
$105.54 |
$244.95
|
|
Acute hepatitis panel
|
$132.20 |
$132.20 |
$132.20 |
$281.09
|
|
Acute venous thrombus image
|
$365.40 |
$365.40 |
$365.40 |
$1,113.43
|
|
Acyclovir 400 mg tablet
|
$15.17 |
$15.17 |
$15.17 |
$51.36
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$16.30 |
$16.30 |
$16.30 |
$64.45
|
|
#acylcarnitineprfl
|
$3.00 |
$3.00 |
$3.00 |
$121.55
|
|
Adenosine 3 mg/250 ml bag for osm
|
$7.58 |
$7.58 |
$7.58 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$15.80 |
$15.80 |
$15.80 |
$60.00
|
|
Adh-sendout
|
$9.00 |
$9.00 |
$9.00 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$4.68 |
$4.68 |
$4.68 |
$171.07
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$94.20 |
$94.20 |
$94.20 |
$439.55
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$48.00 |
$48.00 |
$48.00 |
$220.00
|
|
Administration immunization 1 vaccine
|
$27.00 |
$27.00 |
$27.00 |
$66.51
|
|
Administration immunization each additional vaccine
|
$11.60 |
$11.60 |
$11.60 |
$46.23
|
|
Aep hearing status deter i&r
|
$80.80 |
$80.80 |
$80.80 |
$303.05
|
|
_afb id by dna probe rflx ast
|
$50.00 |
$50.00 |
$50.00 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$20.51 |
$20.51 |
$20.51 |
$289.60
|
|
Air conduction bilat
|
$41.00 |
$41.00 |
$41.00 |
$122.40
|
|
Albumin body fluid quantitative each specimen
|
$116.40 |
$116.40 |
$116.40 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$126.74 |
$126.74 |
$126.74 |
$219.08
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$79.60 |
$79.60 |
$79.60 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$117.20 |
$117.20 |
$117.20 |
$40.00
|
|
Alkaline phosphatase
|
$123.80 |
$123.80 |
$123.80 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$8.05 |
$8.05 |
$8.05 |
$46.80
|
|
Allergen egg white ige
|
$6.81 |
$6.81 |
$6.81 |
$33.66
|
|
Allergen specific ige qual multi scrn ea
|
$1.59 |
$1.59 |
$1.59 |
$24.00
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$450.80 |
$450.80 |
$450.80 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$90.07 |
$90.07 |
$90.07 |
$715.20
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$135.40 |
$135.40 |
$135.40 |
$1,495.63
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$11.45 |
$11.45 |
$11.45 |
$158.40
|
|
Alpha-fetoprotein amniotic
|
$2.41 |
$2.41 |
$2.41 |
$97.80
|
|
Alpha-fetoprotein tumor marker
|
$55.40 |
$55.40 |
$55.40 |
$102.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$127.11 |
$127.11 |
$127.11 |
$15,815.36
|
|
Alt/sgpt
|
$130.40 |
$130.40 |
$130.40 |
$47.45
|
|
Aluminum - quest
|
$3.94 |
$3.94 |
$3.94 |
$81.49
|
|
Amantadine (symmetrel)-sendout
|
$51.20 |
$51.20 |
$51.20 |
$178.10
|
|
Amino acids quant 2-5
|
$20.70 |
$20.70 |
$20.70 |
$137.80
|
|
Aminolevulinic acid delta
|
$2.93 |
$2.93 |
$2.93 |
$74.10
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$38.20 |
$38.20 |
$38.20 |
$123.03
|
|
Amitriptyline (elavil) -sendout
|
$7.80 |
$7.80 |
$7.80 |
$89.05
|
|
Ammonia
|
$183.20 |
$183.20 |
$183.20 |
$117.00
|
|
Amphetamine confirm urine -sendout
|
$47.20 |
$47.20 |
$47.20 |
$93.61
|
|
Amphetamines 5 or more
|
$48.80 |
$48.80 |
$48.80 |
$85.15
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$144.73 |
$144.73 |
$144.73 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$13.57 |
$13.57 |
$13.57 |
$61.93
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$7.34 |
$7.34 |
$7.34 |
$54.60
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$287.00 |
$287.00 |
$287.00 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$899.80 |
$899.80 |
$899.80 |
$3,986.00
|
|
Amputation toe interphalangeal joint
|
$899.80 |
$899.80 |
$899.80 |
$3,958.50
|
|
Amputation toe metatarsophalangeal joint
|
$899.80 |
$899.80 |
$899.80 |
$3,814.50
|
|
Amylase
|
$165.60 |
$165.60 |
$165.60 |
$84.50
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$15.20 |
$15.20 |
$15.20 |
$110.98
|
|
Analysis gene f2 20210g>a variant
|
$7.58 |
$7.58 |
$7.58 |
$217.80
|
|
Analysis gene f5 leiden variant
|
$15.20 |
$15.20 |
$15.20 |
$222.30
|
|
Analysis tumor
|
$54.40 |
$54.40 |
$54.40 |
$248.80
|
|
Anaplsma phgcytophlm amp prb
|
$6.03 |
$6.03 |
$6.03 |
$76.70
|
|
Anca screen with reflex to titer -quest
|
$2.68 |
$2.68 |
$2.68 |
$102.70
|
|
An cholangiogram percutaneous compl
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$2,494.35
|
|
Androstanediol
|
$57.55 |
$57.55 |
$57.55 |
$103.80
|
