|
11-desoxycortisol - sendout
|
$10.18 |
$10.18 |
$10.18 |
$87.50
|
|
3-d radiotherapy plan
|
$4,722.54 |
$4,722.54 |
$4,722.54 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$427.34 |
$427.34 |
$427.34 |
$425.10
|
|
5' nucleotidase - sendout
|
$4.50 |
$4.50 |
$4.50 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$16.38 |
$16.38 |
$16.38 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$3,998.03
|
|
Abdominal CT scan (with and without contrast)
|
$2,947.31 |
$2,947.31 |
$2,947.31 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,711.44 |
$2,711.44 |
$2,711.44 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,564.02 |
$2,564.02 |
$2,564.02 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$5,274.73 |
$5,274.73 |
$5,274.73 |
$2,933.60
|
|
Abdominal MRI (without contrast)
|
$4,395.67 |
$4,395.67 |
$4,395.67 |
$1,975.74
|
|
Abdominal Ultrasound (complete)
|
$1,178.27 |
$1,178.27 |
$1,178.27 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$624.63 |
$624.63 |
$624.63 |
$604.43
|
|
Abl1 gene
|
$237.40 |
$237.40 |
$237.40 |
$614.25
|
|
Ablate arrhythmia add on
|
$13,611.42 |
$13,611.42 |
$13,611.42 |
$7,717.80
|
|
Ablate heart dysrhythm focus
|
$14,997.53 |
$14,997.53 |
$14,997.53 |
$9,836.16
|
|
Ablation cardiac vagal inputs atrium
|
$6,805.35 |
$6,805.35 |
$6,805.35 |
$2,948.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$33.49 |
$33.49 |
$33.49 |
$89.91
|
|
Acetaminophen level
|
$26.58 |
$26.58 |
$26.58 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$145.24 |
$145.24 |
$145.24 |
$137.80
|
|
Acetylcholine receptor modulating antibody
|
$8.38 |
$8.38 |
$8.38 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$657.02 |
$657.02 |
$657.02 |
$306.22
|
|
Acute hepatitis panel
|
$575.12 |
$575.12 |
$575.12 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$122.31 |
$122.31 |
$122.31 |
$64.45
|
|
Adapter b 8 channel 10cm
|
$2,738.74 |
$2,738.74 |
$2,738.74 |
$6,875.44
|
|
Adenosine 3 mg/250 ml bag for osm
|
$594.42 |
$594.42 |
$594.42 |
$217.04
|
|
Adh-sendout
|
$16.38 |
$16.38 |
$16.38 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$282.47 |
$282.47 |
$282.47 |
$158.18
|
|
Administration chemotherapy IV infusion each additional hour
|
$386.94 |
$386.94 |
$386.94 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$577.67 |
$577.67 |
$577.67 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$577.67 |
$577.67 |
$577.67 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$577.67 |
$577.67 |
$577.67 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$426.61 |
$426.61 |
$426.61 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$426.61 |
$426.61 |
$426.61 |
$267.43
|
|
Administration immunization 1 vaccine
|
$65.16 |
$65.16 |
$65.16 |
$70.00
|
|
Administration immunization each additional vaccine
|
$65.16 |
$65.16 |
$65.16 |
$46.23
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$70.62 |
$70.62 |
$70.62 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$70.62 |
$70.62 |
$70.62 |
$33.60
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$14,346.62
|
|
_afb id by dna probe rflx ast
|
$18.93 |
$18.93 |
$18.93 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$58.06 |
$58.06 |
$58.06 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$223.86 |
$223.86 |
$223.86 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$262.08 |
$262.08 |
$262.08 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$160.89 |
$160.89 |
$160.89 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$265.36 |
$265.36 |
$265.36 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$208.21 |
$208.21 |
$208.21 |
$43.45
|
|
Alkaline phosphatase
|
$232.96 |
$232.96 |
$232.96 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$4.59 |
$4.59 |
$4.59 |
$56.35
|
|
Allergen egg white ige
|
$8.75 |
$8.75 |
$8.75 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$2.68 |
$2.68 |
$2.68 |
$26.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$10,179.63 |
$10,179.63 |
$10,179.63 |
$15,083.48
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$7,830.01 |
$7,830.01 |
$7,830.01 |
$8,295.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$29,900.78 |
$29,900.78 |
$29,900.78 |
$25,508.83
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$6,022.02 |
$6,022.02 |
$6,022.02 |
$3,621.72
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$6,022.02 |
$6,022.02 |
$6,022.02 |
$4,898.43
|
|
Alpha-fetoprotein tumor marker
|
$2.92 |
$2.92 |
$2.92 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$4,616.98 |
$4,616.98 |
$4,616.98 |
$9,600.63
|
|
Alt/sgpt
|
$255.17 |
$255.17 |
$255.17 |
$49.00
|
|
Aluminum - quest
|
$4.39 |
$4.39 |
$4.39 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$54.24 |
$54.24 |
$54.24 |
$44.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$37.86 |
$37.86 |
$37.86 |
$45.50
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$10.20 |
$10.20 |
$10.20 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$151.43 |
$151.43 |
$151.43 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$32.76 |
$32.76 |
$32.76 |
$50.85
|
|
Ammonia
|
$361.46 |
$361.46 |
$361.46 |
$123.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$132.86 |
$132.86 |
$132.86 |
$135.63
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$571.48 |
$571.48 |
$571.48 |
$382.55
|
|
Ampicillin 1 gram solution for injection
|
$68.44 |
$68.44 |
$68.44 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$50.24 |
$50.24 |
$50.24 |
$57.38
|
|
Amylase
|
$273.37 |
$273.37 |
$273.37 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$62.98 |
$62.98 |
$62.98 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$62.98 |
$62.98 |
$62.98 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$14.56 |
$14.56 |
$14.56 |
$95.45
|
|
An fluoro guide for cvp
|
$1,077.08 |
$1,077.08 |
$1,077.08 |
$509.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$2,502.87 |
$2,502.87 |
$2,502.87 |
$6,048.00
|
|
Anora (draw only)
|
$24.76 |
$24.76 |
$24.76 |
$36.36
|
|
Antibody elution rbc reference
|
$31.67 |
$31.67 |
$31.67 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$25.45 |
$25.45 |
$25.45 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$100.47 |
$100.47 |
$100.47 |
$218.30
|
|
Antibody id rbc panel
|
$201.66 |
$201.66 |
$201.66 |
$291.75
|
|
Antibody screen rbc
|
$91.73 |
$91.73 |
$91.73 |
$105.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$5.46 |
$5.46 |
$5.46 |
$4.00
|
|
Anti mog serum - sendout
|
$52.78 |
$52.78 |
$52.78 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$3.95 |
$3.95 |
$3.95 |
$50.88
|
|
Antinuclear antibodies
|
$1.46 |
$1.46 |
$1.46 |
$91.70
|
|
Antinuclear antibodies titer
|
$9.10 |
$9.10 |
$9.10 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$14.56 |
$14.56 |
$14.56 |
$74.20
|
|
Antithrombin iii activity
|
$5.76 |
$5.76 |
$5.76 |
$106.85
|
|
Antithrombin iii injection
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$15.75
|
|
Aortic dysfunction/dilation
|
$408.14 |
$408.14 |
$408.14 |
$653.18
|
|
Aortic dysfunction/dilation
|
$408.14 |
$408.14 |
$408.14 |
$1,485.21
|
|
Apheresis plasma
|
$2,180.36 |
$2,180.36 |
$2,180.36 |
$3,498.41
|
|
Apheresis platelets
|
$2,427.52 |
$2,427.52 |
$2,427.52 |
$2,302.65
|
|
Apheresis rbc
|
$2,416.24 |
$2,416.24 |
$2,416.24 |
$3,497.90
|
|
Apheresis wbc
|
$2,416.24 |
$2,416.24 |
$2,416.24 |
$3,342.71
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1,031.22 |
$1,031.22 |
$1,031.22 |
$943.40
|
|
Aquaporin-4 antibody cba each
|
$36.40 |
$36.40 |
$36.40 |
$114.60
|
|
Argatroban nonesrd use 1mg
|
$1,747.20 |
$1,747.20 |
$1,747.20 |
$881.10
|
|
Arterial blood draw/perc 36620
|
$601.70 |
$601.70 |
$601.70 |
$500.82
|
|
Artery xray each vessel 7577426
|
$2,927.66 |
$2,927.66 |
$2,927.66 |
$1,865.50
|