|
17-hydroxypregnenolone
|
$41.00 |
$41.00 |
$41.00 |
$85.15
|
|
17-ketosteroids
|
$16.33 |
$16.33 |
$16.33 |
$44.00
|
|
3-d radiotherapy plan
|
$2,695.00 |
$2,695.00 |
$2,695.00 |
$4,886.50
|
|
5' nucleotidase - sendout
|
$9.37 |
$9.37 |
$9.37 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$708.62 |
$708.62 |
$708.62 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$5,460.25 |
$5,460.25 |
$5,460.25 |
$3,634.61
|
|
Abciximab injection
|
$6,627.75 |
$6,627.75 |
$6,627.75 |
$3,012.98
|
|
Abdominal CT scan (with and without contrast)
|
$21,710.05 |
$21,710.05 |
$21,710.05 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$20,007.91 |
$20,007.91 |
$20,007.91 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$17,357.98 |
$17,357.98 |
$17,357.98 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$7,085.84 |
$7,085.84 |
$7,085.84 |
$2,916.21
|
|
Abdominal MRI (without contrast)
|
$7,085.84 |
$7,085.84 |
$7,085.84 |
$1,972.66
|
|
Abdominal Ultrasound (complete)
|
$8,422.96 |
$8,422.96 |
$8,422.96 |
$759.57
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$188.00 |
$188.00 |
$188.00 |
$125.63
|
|
Acetaminophen level
|
$1,841.84 |
$1,841.84 |
$1,841.84 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$189.00 |
$189.00 |
$189.00 |
$133.60
|
|
Acetone qualitative
|
$674.95 |
$674.95 |
$674.95 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$718.90 |
$718.90 |
$718.90 |
$323.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$67.50 |
$67.50 |
$67.50 |
$50.70
|
|
Adenovirus antibody,serum - quest
|
$69.00 |
$69.00 |
$69.00 |
$63.00
|
|
Adh-sendout
|
$30.00 |
$30.00 |
$30.00 |
$109.28
|
|
Administration chemotherapy IV infusion each additional hour
|
$208.00 |
$208.00 |
$208.00 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$891.00 |
$891.00 |
$891.00 |
$672.03
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$125.00 |
$125.00 |
$125.00 |
$264.00
|
|
Administration vaccine hepatitis b
|
$137.09 |
$137.09 |
$137.09 |
$51.35
|
|
Administration vaccine influenza virus
|
$137.09 |
$137.09 |
$137.09 |
$49.50
|
|
Administration vaccine pneumococcal
|
$137.09 |
$137.09 |
$137.09 |
$51.11
|
|
_afb org id by sequencing rflx ast-sendout
|
$268.63 |
$268.63 |
$268.63 |
$289.60
|
|
Air conduction bilat
|
$129.90 |
$129.90 |
$129.90 |
$106.50
|
|
Alkaline phosphatase
|
$1,105.40 |
$1,105.40 |
$1,105.40 |
$46.20
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$13,784.08 |
$13,784.08 |
$13,784.08 |
$18,384.03
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$49.75 |
$49.75 |
$49.75 |
$13.14
|
|
Alprostadil for injection
|
$2,805.00 |
$2,805.00 |
$2,805.00 |
$533.06
|
|
Alt/sgpt
|
$1,245.95 |
$1,245.95 |
$1,245.95 |
$49.00
|
|
Aluminum - quest
|
$19.23 |
$19.23 |
$19.23 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$100.00 |
$100.00 |
$100.00 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$79.75 |
$79.75 |
$79.75 |
$36.30
|
|
Amino acid screen, urine
|
$15.18 |
$15.18 |
$15.18 |
$64.28
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$43.68 |
$43.68 |
$43.68 |
$42.84
|
|
Aminolevulinic acid delta
|
$32.20 |
$32.20 |
$32.20 |
$87.12
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$276.84 |
$276.84 |
$276.84 |
$202.10
|
|
Amitriptyline (elavil) -sendout
|
$14.66 |
$14.66 |
$14.66 |
$101.17
|
|
Ammonia
|
$1,105.40 |
$1,105.40 |
$1,105.40 |
$120.90
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$390.00 |
$390.00 |
$390.00 |
$130.08
|
|
Amphotericin b lipid complex
|
$971.00 |
$971.00 |
$971.00 |
$270.17
|
|
Ana ds-dna
|
$12.00 |
$12.00 |
$12.00 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$1,245.95 |
$1,245.95 |
$1,245.95 |
$110.98
|
|
Anal pressure record
|
$2,924.00 |
$2,924.00 |
$2,924.00 |
$955.86
|
|
Analysis tumor
|
$240.00 |
$240.00 |
$240.00 |
$240.00
|
|
Anidulafungin injection
|
$1,187.25 |
$1,187.25 |
$1,187.25 |
$209.79
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$3.20 |
$3.20 |
$3.20 |
$3.12
|
|
Anti-inhibitor
|
$26.50 |
$26.50 |
$26.50 |
$3.75
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$34.11 |
$34.11 |
$34.11 |
$45.82
|
|
Antinuclear antibodies
|
$3.00 |
$3.00 |
$3.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$92.24 |
$92.24 |
$92.24 |
$80.25
|
|
Antistreptolysin o titer
|
$4.50 |
$4.50 |
$4.50 |
$57.96
|
|
Antithrombin iii injection
|
$7.90 |
$7.90 |
$7.90 |
$9.32
|
|
Apheresis plasma
|
$10,415.60 |
$10,415.60 |
$10,415.60 |
$3,411.50
|
|
Apheresis rbc
|
$10,415.60 |
$10,415.60 |
$10,415.60 |
$3,348.50
|
|
Apheresis wbc
|
$10,415.60 |
$10,415.60 |
$10,415.60 |
$3,342.71
|
|
Aqaprn-4 antb flo cytmtry ea
|
$300.00 |
$300.00 |
$300.00 |
$231.66
|
|
Artery x-rays chest
|
$13,935.31 |
$13,935.31 |
$13,935.31 |
$2,587.20
|
|
Artery x-rays lung
|
$14,491.66 |
$14,491.66 |
$14,491.66 |
$2,332.57
|
|
Artery x-rays spine
|
$2,023.38 |
$2,023.38 |
$2,023.38 |
$4,306.40
|
|
Assay blood catecholamines
|
$25.00 |
$25.00 |
$25.00 |
$72.00
|
|
Assay of breath ethanol
|
$50.00 |
$50.00 |
$50.00 |
$45.76
|
|
Assay of interleukin-6 (il-6)
|
$138.00 |
$138.00 |
$138.00 |
$77.35
|
|
Assay of procainamide w/metab
|
$102.49 |
$102.49 |
$102.49 |
$61.20
|
|
Assay of PSA complexed
|
$148.00 |
$148.00 |
$148.00 |
$64.28
|
|
Assay of thiocyanate
|
$57.00 |
$57.00 |
$57.00 |
$57.00
|
|
Assay of urine urobilinogen
|
$11.04 |
$11.04 |
$11.04 |
$10.51
|
|
Assay phosphatidylglycerol
|
$132.00 |
$132.00 |
$132.00 |
$87.20
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$2,333.77 |
$2,333.77 |
$2,333.77 |
$312.00
|
|
Ast/sgot
|
$1,245.95 |
$1,245.95 |
$1,245.95 |
$45.65
|
|
Autologous blood process
|
$604.62 |
$604.62 |
$604.62 |
$234.27
|
|
Azacitidine injection
|
$17.25 |
$17.25 |
$17.25 |
$912.29
|
|
Azathioprine 50 mg tablet
|
$63.25 |
$63.25 |
$63.25 |
$6.76
|
|
Azathioprine parenteral
|
$1,511.75 |
$1,511.75 |
$1,511.75 |
$441.40
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$1,334.50 |
$1,334.50 |
$1,334.50 |
$191.55
|
|
Bacterial meningitis antigen
|
$878.46 |
$878.46 |
$878.46 |
$68.40
|
|
Barrier film 28ml spray no stng cavilon
|
$45.89 |
$45.89 |
$45.89 |
$21.33
|
|
Barrier skin flextend 2.25in floating flang new image
|
$4.77 |
$4.77 |
$4.77 |
$2.40
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$112.00 |
$112.00 |
$112.00 |
$6,720.38
|
|
Benztropine 1 mg/ml injection solution
|
$1,047.00 |
$1,047.00 |
$1,047.00 |
$121.88
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$323.00 |
$323.00 |
$323.00 |
$75.12
|
|
Bile acids cholylglycine
|
$11.88 |
$11.88 |
$11.88 |
$53.60
|
|
Bilirubin direct
|
$612.00 |
$612.00 |
$612.00 |
$49.29
|
|
Bleomycin 15 unit solution for injection
|
$568.25 |
$568.25 |
$568.25 |
$245.75
|
|
Blood Count (CBC) Test (without differential)
|
$963.38 |
$963.38 |
$963.38 |
$62.28
|
|
Blood Culture Test
|
$2,040.95 |
$2,040.95 |
$2,040.95 |
$144.65
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$591.49 |
$591.49 |
$591.49 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$591.49 |
$591.49 |
$591.49 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$300.15 |
$300.15 |
$300.15 |
$37.44
|
|
Blood typing abo
|
$472.90 |
$472.90 |
$472.90 |
$83.82
|
|
Blood typing patient serum
|
$323.57 |
$323.57 |
$323.57 |
$70.29
|
|
Blood typing rh phenotype complete reference
|
$22.00 |
$22.00 |
$22.00 |
$77.25
|
|
Bone/joint imaging ltd area
|
$5,979.92 |
$5,979.92 |
$5,979.92 |
$1,151.16
|
|
Bone marrow imaging ltd
|
$5,979.92 |
$5,979.92 |
$5,979.92 |
$723.00
|
|
Boot mlti podous univ xlg
|
$1,191.94 |
$1,191.94 |
$1,191.94 |
$318.36
|
|
(both sides) smear without diff wbc count
|
$210.83 |
$210.83 |
$210.83 |
$33.57
|
