|
11-desoxycortisol - sendout
|
$29.04 |
$29.04 |
$29.04 |
$91.85
|
|
17-hydroxypregnenolone
|
$22.77 |
$22.77 |
$22.77 |
$92.65
|
|
2d tte w or without fol w/con,co
|
$497.12 |
$497.12 |
$497.12 |
$1,284.00
|
|
3-d radiotherapy plan
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$213.84 |
$213.84 |
$213.84 |
$508.13
|
|
5' nucleotidase - sendout
|
$32.67 |
$32.67 |
$32.67 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$29.12 |
$29.12 |
$29.12 |
$100.10
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$28.90 |
$28.90 |
$28.90 |
$53.95
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$509.92 |
$509.92 |
$509.92 |
$988.00
|
|
Abdominal CT scan (with and without contrast)
|
$552.15 |
$552.15 |
$552.15 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$460.08 |
$460.08 |
$460.08 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$368.01 |
$368.01 |
$368.01 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$2,201.74 |
$2,201.74 |
$2,201.74 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$1,834.78 |
$1,834.78 |
$1,834.78 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$1,467.82 |
$1,467.82 |
$1,467.82 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$528.67 |
$528.67 |
$528.67 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$678.76 |
$678.76 |
$678.76 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$506.09 |
$506.09 |
$506.09 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$183.15 |
$183.15 |
$183.15 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$221.85 |
$221.85 |
$221.85 |
$418.63
|
|
Abdominal X-ray (single view)
|
$101.25 |
$101.25 |
$101.25 |
$260.00
|
|
Abl1 gene
|
$277.20 |
$277.20 |
$277.20 |
$683.20
|
|
Abscess drain retroperitoneal surg code
|
$1,751.29 |
$1,751.29 |
$1,751.29 |
$3,050.40
|
|
Acetylcholine receptor modulating antibody
|
$31.75 |
$31.75 |
$31.75 |
$67.50
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$20.00 |
$20.00 |
$20.00 |
$38.50
|
|
Acute hepatitis panel
|
$82.83 |
$82.83 |
$82.83 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$1.06 |
$1.06 |
$1.06 |
$54.77
|
|
#acylcarnitineprfl
|
$37.95 |
$37.95 |
$37.95 |
$121.55
|
|
Acylcarnitines qual
|
$16.50 |
$16.50 |
$16.50 |
$45.60
|
|
Adapter b 8 channel 10cm
|
$3,454.46 |
$3,454.46 |
$3,454.46 |
$5,109.58
|
|
Adenovirus antibody,serum - quest
|
$24.83 |
$24.83 |
$24.83 |
$58.00
|
|
Adh-sendout
|
$33.66 |
$33.66 |
$33.66 |
$118.79
|
|
Administration chemotherapy IV infusion each additional hour
|
$30.54 |
$30.54 |
$30.54 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$69.40 |
$69.40 |
$69.40 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$141.23 |
$141.23 |
$141.23 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$209.18 |
$209.18 |
$209.18 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$98.98 |
$98.98 |
$98.98 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$264.82 |
$264.82 |
$264.82 |
$256.49
|
|
Administration immunization each additional vaccine
|
$17.88 |
$17.88 |
$17.88 |
$47.40
|
|
Administration vaccine hepatitis b
|
$32.18 |
$32.18 |
$32.18 |
$53.00
|
|
Administration vaccine influenza virus
|
$32.18 |
$32.18 |
$32.18 |
$51.07
|
|
Administration vaccine pneumococcal
|
$32.18 |
$32.18 |
$32.18 |
$49.68
|
|
Adrenal cortex & medulla img
|
$920.97 |
$920.97 |
$920.97 |
$1,987.70
|
|
Aep hearing status deter i&r
|
$180.01 |
$180.01 |
$180.01 |
$303.00
|
|
_afb id by dna probe rflx ast
|
$31.39 |
$31.39 |
$31.39 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$183.22 |
$183.22 |
$183.22 |
$300.00
|
|
Airway resistance by impulse oscillometry 94728
|
$101.95 |
$101.95 |
$101.95 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$19.14 |
$19.14 |
$19.14 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$22.44 |
$22.44 |
$22.44 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$20.79 |
$20.79 |
$20.79 |
$43.00
|
|
Alkaline phosphatase
|
$18.81 |
$18.81 |
$18.81 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$32.56 |
$32.56 |
$32.56 |
$48.57
|
|
Allergen egg white ige
|
$22.79 |
$22.79 |
$22.79 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$24.01 |
$24.01 |
$24.01 |
$24.00
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$94.37 |
$94.37 |
$94.37 |
$20,311.34
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,795.50 |
$1,795.50 |
$1,795.50 |
$5,096.00
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$64.02 |
$64.02 |
$64.02 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$16.83 |
$16.83 |
$16.83 |
$106.00
|
|
Alt/sgpt
|
$19.47 |
$19.47 |
$19.47 |
$47.50
|
|
Aluminum - quest
|
$25.41 |
$25.41 |
$25.41 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$106.92 |
$106.92 |
$106.92 |
$179.70
|
|
Aminolevulinic acid delta
|
$24.75 |
$24.75 |
$24.75 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$22.44 |
$22.44 |
$22.44 |
$87.45
|
|
Ammonia
|
$37.95 |
$37.95 |
$37.95 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$454.97 |
$454.97 |
$454.97 |
$942.60
|
|
Amphetamine confirm urine -sendout
|
$27.39 |
$27.39 |
$27.39 |
$93.61
|
|
Amylase
|
$112.53 |
$112.53 |
$112.53 |
$90.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$50.82 |
$50.82 |
$50.82 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$60.98 |
$60.98 |
$60.98 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$68.07 |
$68.07 |
$68.07 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$22.38 |
$22.38 |
$22.38 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$477.97 |
$477.97 |
$477.97 |
$2,480.94
|
|
An fluoro guide for cvp
|
$299.25 |
$299.25 |
$299.25 |
$525.85
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$2,696.77 |
$2,696.77 |
$2,696.77 |
$2,979.43
|
|
Ankle X-ray
|
$211.95 |
$211.95 |
$211.95 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$119.25 |
$119.25 |
$119.25 |
$282.96
|
|
Anodyne therapy charges pt
|
$30.18 |
$30.18 |
$30.18 |
$42.00
|
|
Antibody bacterium, not elsewhere specified
|
$62.27 |
$62.27 |
$62.27 |
$57.85
|
|
Antibody elution rbc reference
|
$140.01 |
$140.01 |
$140.01 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$204.72 |
$204.72 |
$204.72 |
$131.56
|
|
Antibody htlv-i
|
$11.40 |
$11.40 |
$11.40 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$97.27 |
$97.27 |
$97.27 |
$224.00
|
|
Antibody id rbc panel
|
$379.10 |
$379.10 |
$379.10 |
$291.75
|
|
Antibody influenza virus
|
$27.68 |
$27.68 |
$27.68 |
$54.00
|
|
Antibody lymphocytic choriomeningitis
|
$25.23 |
$25.23 |
$25.23 |
$46.58
|
|
Antibody screen rbc
|
$61.78 |
$61.78 |
$61.78 |
$108.55
|
|
Antibody tetanus
|
$25.64 |
$25.64 |
$25.64 |
$54.15
|
|
Anti mog serum - sendout
|
$340.66 |
$340.66 |
$340.66 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$21.98 |
$21.98 |
$21.98 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$25.23 |
$25.23 |
$25.23 |
$42.00
|
|
Antinuclear antibodies
|
$21.57 |
$21.57 |
$21.57 |
$90.00
|
|
Antinuclear antibodies titer
|
$46.80 |
$46.80 |
$46.80 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$23.20 |
$23.20 |
$23.20 |
$67.43
|
|
Antistreptolysin o titer
|
$23.20 |
$23.20 |
$23.20 |
$54.00
|
|
Antithrombin iii activity
|
$21.10 |
$21.10 |
$21.10 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$218.11 |
$218.11 |
$218.11 |
$394.55
|
|
Apheresis plasma
|
$1,988.16 |
$1,988.16 |
$1,988.16 |
$3,226.34
|
|
Apl(pml-rara) quant - sendout
|
$191.58 |
$191.58 |
$191.58 |
$513.00
|
|
Application multi layer compression below knee (both sides)
|
$158.51 |
$158.51 |
$158.51 |
$375.06
|
|
Application of paste boot 29580
|
$156.73 |
$156.73 |
$156.73 |
$340.11
|
