|
11-desoxycortisol - sendout
|
$16.06 |
$16.06 |
$16.06 |
$84.56
|
|
17-hydroxypregnenolone
|
$28.16 |
$28.16 |
$28.16 |
$85.15
|
|
17-ketosteroids
|
$16.28 |
$16.28 |
$16.28 |
$46.20
|
|
2nd order venous cath
|
$1,357.18 |
$1,357.18 |
$1,357.18 |
$1,635.60
|
|
3d ech img cgen car anomal
|
$824.34 |
$824.34 |
$824.34 |
$532.35
|
|
3-d radiotherapy plan
|
$4,235.88 |
$4,235.88 |
$4,235.88 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$1,509.20 |
$1,509.20 |
$1,509.20 |
$480.00
|
|
5% dextrose and 0.45% saline
|
$16.82 |
$16.82 |
$16.82 |
$48.00
|
|
5' nucleotidase - sendout
|
$23.54 |
$23.54 |
$23.54 |
$46.53
|
|
88334 ap bill cytologic exam each additional site
|
$12.76 |
$12.76 |
$12.76 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$777.35 |
$777.35 |
$777.35 |
$3,128.29
|
|
Abd aorta w/runoff s&i
|
$2,763.42 |
$2,763.42 |
$2,763.42 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$1,666.72 |
$1,666.72 |
$1,666.72 |
$2,121.00
|
|
Abd/low ext cath 2nd
|
$1,562.00 |
$1,562.00 |
$1,562.00 |
$2,158.00
|
|
Abd/low ext cath 3rd
|
$1,941.50 |
$1,941.50 |
$1,941.50 |
$2,639.65
|
|
Abd/low ext cath addl
|
$1,199.66 |
$1,199.66 |
$1,199.66 |
$965.25
|
|
Abdominal CT scan (with and without contrast)
|
$2,431.88 |
$2,431.88 |
$2,431.88 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,160.18 |
$2,160.18 |
$2,160.18 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$1,999.58 |
$1,999.58 |
$1,999.58 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,798.40 |
$2,798.40 |
$2,798.40 |
$3,045.84
|
|
Abdominal MRI (with contrast)
|
$2,763.42 |
$2,763.42 |
$2,763.42 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$2,752.64 |
$2,752.64 |
$2,752.64 |
$2,047.72
|
|
Abdominal paracentesis w/image guidance
|
$683.76 |
$683.76 |
$683.76 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$909.48 |
$909.48 |
$909.48 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$629.64 |
$629.64 |
$629.64 |
$600.00
|
|
Abd paracentesis/w/o image guide 49082
|
$607.64 |
$607.64 |
$607.64 |
$1,145.00
|
|
Abl1 gene
|
$92.40 |
$92.40 |
$92.40 |
$668.85
|
|
Ablate arrhythmia add on
|
$2,801.04 |
$2,801.04 |
$2,801.04 |
$6,913.20
|
|
Ablate heart dysrhythm focus
|
$9,398.62 |
$9,398.62 |
$9,398.62 |
$9,522.05
|
|
Ablation cardiac vagal inputs atrium
|
$4,185.28 |
$4,185.28 |
$4,185.28 |
$2,260.30
|
|
Abscess drain retroperitoneal surg code
|
$1,356.96 |
$1,356.96 |
$1,356.96 |
$2,903.45
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$18.66 |
$18.66 |
$18.66 |
$80.14
|
|
Acetaminophen level
|
$95.26 |
$95.26 |
$95.26 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$60.09 |
$60.09 |
$60.09 |
$113.40
|
|
Acetone qualitative
|
$97.46 |
$97.46 |
$97.46 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$1.89 |
$1.89 |
$1.89 |
$61.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$106.82 |
$106.82 |
$106.82 |
$244.95
|
|
Aco ccm; at least 20 min 99490aco
|
$20.90 |
$20.90 |
$20.90 |
$102.38
|
|
Aco ccm; ea addl 20 min 99439aco
|
$23.32 |
$23.32 |
$23.32 |
$70.00
|
|
Acute hepatitis panel
|
$202.62 |
$202.62 |
$202.62 |
$281.09
|
|
Acyclovir 400 mg tablet
|
$36.09 |
$36.09 |
$36.09 |
$51.36
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$37.27 |
$37.27 |
$37.27 |
$64.45
|
|
#acylcarnitineprfl
|
$37.84 |
$37.84 |
$37.84 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$2,750.44 |
$2,750.44 |
$2,750.44 |
$6,142.50
|
|
Adenosine 3 mg/250 ml bag for osm
|
$168.78 |
$168.78 |
$168.78 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$17.38 |
$17.38 |
$17.38 |
$60.00
|
|
Adh-sendout
|
$24.20 |
$24.20 |
$24.20 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$8.96 |
$8.96 |
$8.96 |
$171.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$113.52 |
$113.52 |
$113.52 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$194.26 |
$194.26 |
$194.26 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$385.44 |
$385.44 |
$385.44 |
$646.80
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$204.60 |
$204.60 |
$204.60 |
$439.55
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$124.96 |
$124.96 |
$124.96 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$153.12 |
$153.12 |
$153.12 |
$264.70
|
|
Administration immunization 1 vaccine
|
$38.28 |
$38.28 |
$38.28 |
$66.51
|
|
Administration immunization each additional vaccine
|
$38.28 |
$38.28 |
$38.28 |
$46.23
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$3,049.43 |
$3,049.43 |
$3,049.43 |
$11,350.31
|
|
Aep hearing status deter i&r
|
$88.88 |
$88.88 |
$88.88 |
$303.05
|
|
_afb id by dna probe rflx ast
|
$55.00 |
$55.00 |
$55.00 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$12.98 |
$12.98 |
$12.98 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$22.56 |
$22.56 |
$22.56 |
$289.60
|
|
Airway resistance by impulse oscillometry 94728
|
$156.64 |
$156.64 |
$156.64 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$128.04 |
$128.04 |
$128.04 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$178.75 |
$178.75 |
$178.75 |
$219.08
|
|
Albumin (human), 5%, 250 ml
|
$172.55 |
$172.55 |
$172.55 |
$225.47
|
|
Albumin, human 5 % intravenous solution
|
$12.43 |
$12.43 |
$12.43 |
$296.32
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$87.56 |
$87.56 |
$87.56 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$128.92 |
$128.92 |
$128.92 |
$40.00
|
|
Alkaline phosphatase
|
$136.18 |
$136.18 |
$136.18 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$8.86 |
$8.86 |
$8.86 |
$46.80
|
|
Allergen egg white ige
|
$34.10 |
$34.10 |
$34.10 |
$33.66
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$4,884.00 |
$4,884.00 |
$4,884.00 |
$11,121.17
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$1,113.64 |
$1,113.64 |
$1,113.64 |
$22,984.85
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$4,384.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$0.25 |
$0.25 |
$0.25 |
$9.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$12.60 |
$12.60 |
$12.60 |
$158.40
|
|
Alpha-fetoprotein tumor marker
|
$71.28 |
$71.28 |
$71.28 |
$102.00
|
|
Alprostadil for injection
|
$148.68 |
$148.68 |
$148.68 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$2,773.16 |
$2,773.16 |
$2,773.16 |
$15,815.36
|
|
Alt/sgpt
|
$143.44 |
$143.44 |
$143.44 |
$47.45
|
|
Amantadine (symmetrel)-sendout
|
$56.32 |
$56.32 |
$56.32 |
$178.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$24.36 |
$24.36 |
$24.36 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$91.36 |
$91.36 |
$91.36 |
$123.03
|
|
Amiodarone 50 mg/ml intravenous solution
|
$9.88 |
$9.88 |
$9.88 |
$56.70
|
|
Amitriptyline (elavil) -sendout
|
$25.96 |
$25.96 |
$25.96 |
$89.05
|
|
Ammonia
|
$201.52 |
$201.52 |
$201.52 |
$117.00
|
|
Amphetamine confirm urine -sendout
|
$1.89 |
$1.89 |
$1.89 |
$93.61
|
|
Amphetamines 5 or more
|
$77.44 |
$77.44 |
$77.44 |
$85.15
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$162.41 |
$162.41 |
$162.41 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$20.72 |
$20.72 |
$20.72 |
$61.93
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$20.09 |
$20.09 |
$20.09 |
$54.60
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$315.70 |
$315.70 |
$315.70 |
$262.99
|
|
Amylase
|
$182.16 |
$182.16 |
$182.16 |
$84.50
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$1.32 |
$1.32 |
$1.32 |
$110.98
|
|
Analysis gene f2 20210g>a variant
|
$8.34 |
$8.34 |
$8.34 |
$217.80
|
|
Analysis gene f5 leiden variant
|
$8.36 |
$8.36 |
$8.36 |
$222.30
|
|
Anaplsma phgcytophlm amp prb
|
$6.63 |
$6.63 |
$6.63 |
$76.70
|
|
Anastrozole 1 mg
|
$11.11 |
$11.11 |
$11.11 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$172.70 |
$172.70 |
$172.70 |
$102.70
|
|
An cholangiogram percutaneous compl
|
$2,029.28 |
$2,029.28 |
$2,029.28 |
$2,494.35
|
