|
11-desoxycortisol - sendout
|
$88.89 |
$88.89 |
$88.89 |
$87.50
|
|
17-hydroxypregnenolone
|
$88.89 |
$88.89 |
$88.89 |
$87.50
|
|
17-ketosteroids
|
$15.28 |
$15.28 |
$15.28 |
$44.88
|
|
2d tee w or without fol w/con,in
|
$1,051.79 |
$1,051.79 |
$1,051.79 |
$1,525.28
|
|
2d tte w or without fol w/con,co
|
$757.45 |
$757.45 |
$757.45 |
$1,108.76
|
|
3d ech img cgen car anomal
|
$1,366.56 |
$1,366.56 |
$1,366.56 |
$632.45
|
|
3d recon without postprocess indpndt
|
$154.76 |
$154.76 |
$154.76 |
$425.10
|
|
5' nucleotidase - sendout
|
$7.22 |
$7.22 |
$7.22 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$59.57 |
$59.57 |
$59.57 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$3,998.03
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$7.01 |
$7.01 |
$7.01 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$3,993.40 |
$3,993.40 |
$3,993.40 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,675.89 |
$2,675.89 |
$2,675.89 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,318.09 |
$1,318.09 |
$1,318.09 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,873.87 |
$2,873.87 |
$2,873.87 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$1,839.60 |
$1,839.60 |
$1,839.60 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$1,925.45 |
$1,925.45 |
$1,925.45 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$793.08 |
$793.08 |
$793.08 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$1,308.75 |
$1,308.75 |
$1,308.75 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,909.10 |
$1,909.10 |
$1,909.10 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$547.21 |
$547.21 |
$547.21 |
$1,248.00
|
|
Abl1 gene
|
$380.88 |
$380.88 |
$380.88 |
$614.25
|
|
Ablate bone tumor(s) cryo perq 20983
|
$6,255.23 |
$6,255.23 |
$6,255.23 |
$8,096.90
|
|
Ablation of upper extremity nerves rf
|
$418.73 |
$418.73 |
$418.73 |
$825.60
|
|
Abscess drain retroperitoneal surg code
|
$5,815.48 |
$5,815.48 |
$5,815.48 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$151.26 |
$151.26 |
$151.26 |
$89.91
|
|
Acetazolamide 500 mg solution for injection
|
$167.61 |
$167.61 |
$167.61 |
$137.80
|
|
Acetone qualitative
|
$91.11 |
$91.11 |
$91.11 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$13.44 |
$13.44 |
$13.44 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,175.60 |
$1,175.60 |
$1,175.60 |
$306.22
|
|
Acute hepatitis panel
|
$19.28 |
$19.28 |
$19.28 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$181.63 |
$181.63 |
$181.63 |
$64.45
|
|
#acylcarnitineprfl
|
$43.80 |
$43.80 |
$43.80 |
$87.72
|
|
Adapter b 8 channel 10cm
|
$3,773.23 |
$3,773.23 |
$3,773.23 |
$6,875.44
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,316.34 |
$1,316.34 |
$1,316.34 |
$217.04
|
|
Adh-sendout
|
$26.28 |
$26.28 |
$26.28 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$941.41 |
$941.41 |
$941.41 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$544.88 |
$544.88 |
$544.88 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$1,701.20 |
$1,701.20 |
$1,701.20 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,701.20 |
$1,701.20 |
$1,701.20 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$948.42 |
$948.42 |
$948.42 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$452.02 |
$452.02 |
$452.02 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$542.54 |
$542.54 |
$542.54 |
$267.43
|
|
Administration immunization 1 vaccine
|
$352.74 |
$352.74 |
$352.74 |
$70.00
|
|
Administration immunization each additional vaccine
|
$77.68 |
$77.68 |
$77.68 |
$46.23
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$5,025.91 |
$5,025.91 |
$5,025.91 |
$14,346.62
|
|
Aep hearing status deter i&r
|
$366.76 |
$366.76 |
$366.76 |
$305.73
|
|
_afb id by dna probe rflx ast
|
$192.14 |
$192.14 |
$192.14 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$87.50 |
$87.50 |
$87.50 |
$289.60
|
|
Airway resistance by impulse oscillometry 94728
|
$420.48 |
$420.48 |
$420.48 |
$279.73
|
|
Albumin body fluid quantitative each specimen
|
$66.00 |
$66.00 |
$66.00 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$277.87
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$113.30 |
$113.30 |
$113.30 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$33.29 |
$33.29 |
$33.29 |
$43.45
|
|
Alkaline phosphatase
|
$87.02 |
$87.02 |
$87.02 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$21.61 |
$21.61 |
$21.61 |
$56.35
|
|
Allergen egg white ige
|
$33.29 |
$33.29 |
$33.29 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$4.66 |
$4.66 |
$4.66 |
$26.95
|
|
Allograft 160mg placental salera mini membrane
|
$4,906.77 |
$4,906.77 |
$4,906.77 |
$4,906.77
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$8,295.72 |
$8,295.72 |
$8,295.72 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$8,295.72 |
$8,295.72 |
$8,295.72 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$14,021.84 |
$14,021.84 |
$14,021.84 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$18,229.56 |
$18,229.56 |
$18,229.56 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,906.77 |
$4,906.77 |
$4,906.77 |
$4,898.43
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$2,901.32 |
$2,901.32 |
$2,901.32 |
$5,381.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$2,230.88 |
$2,230.88 |
$2,230.88 |
$5,538.22
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,901.32 |
$2,901.32 |
$2,901.32 |
$4,814.57
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$57.82 |
$57.82 |
$57.82 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$4.68 |
$4.68 |
$4.68 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$8,165.49 |
$8,165.49 |
$8,165.49 |
$9,600.63
|
|
Alt/sgpt
|
$119.14 |
$119.14 |
$119.14 |
$49.00
|
|
Aluminum - quest
|
$7.05 |
$7.05 |
$7.05 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$227.18 |
$227.18 |
$227.18 |
$431.84
|
|
Ambl bp mntr w/sw a/r
|
$109.80 |
$109.80 |
$109.80 |
$318.96
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$47.31 |
$47.31 |
$47.31 |
$44.00
|
|
Amino acids quant 2-5
|
$127.93 |
$127.93 |
$127.93 |
$141.00
|
|
Aminolevulinic acid delta
|
$25.77 |
$25.77 |
$25.77 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$43.22 |
$43.22 |
$43.22 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$176.37 |
$176.37 |
$176.37 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$52.56 |
$52.56 |
$52.56 |
$50.85
|
|
Ammonia
|
$192.72 |
$192.72 |
$192.72 |
$123.48
|
|
Amniocentesis therapeutic
|
$705.48 |
$705.48 |
$705.48 |
$791.05
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,026.68 |
$1,026.68 |
$1,026.68 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$125.56 |
$125.56 |
$125.56 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$125.56 |
$125.56 |
$125.56 |
$57.38
|
|
Amputation toe interphalangeal joint
|
$5,904.24 |
$5,904.24 |
$5,904.24 |
$3,839.54
|
|
Amputation toe metatarsophalangeal joint
|
$6,200.33 |
$6,200.33 |
$6,200.33 |
$3,777.93
|
|
Amylase
|
$143.08 |
$143.08 |
$143.08 |
$93.00
|
|
Anal/urinary muscle study
|
$506.33 |
$506.33 |
$506.33 |
$575.00
|
|
Analysis gene f2 20210g>a variant
|
$23.36 |
$23.36 |
$23.36 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$62.60 |
$62.60 |
$62.60 |
$226.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$183.38 |
$183.38 |
$183.38 |
$396.48
|
|
Anaplsma phgcytophlm amp prb
|
$23.36 |
$23.36 |
$23.36 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$36.72 |
$36.72 |
$36.72 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$1,667.91 |
$1,667.91 |
$1,667.91 |
$2,426.60
|
|
Androstanediol
|
$56.65 |
$56.65 |
$56.65 |
$98.58
|
|
Angiotensin ii
|
$63.33 |
$63.33 |
$63.33 |
$55.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$15,908.16 |
$15,908.16 |
$15,908.16 |
$6,048.00
|
|
Anora (draw only)
|
$25.70 |
$25.70 |
$25.70 |
$36.36
|
|
Antibody elution rbc reference
|
$223.68 |
$223.68 |
$223.68 |
$179.62
|