|
11-desoxycortisol - sendout
|
$238.00 |
$238.00 |
$238.00 |
$87.50
|
|
17-hydroxypregnenolone
|
$47.25 |
$47.25 |
$47.25 |
$85.15
|
|
17-ketosteroids
|
$149.60 |
$149.60 |
$149.60 |
$44.00
|
|
5' nucleotidase - sendout
|
$6.95 |
$6.95 |
$6.95 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$83.30 |
$83.30 |
$83.30 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,293.75 |
$2,293.75 |
$2,293.75 |
$3,634.61
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$30.00 |
$30.00 |
$30.00 |
$52.25
|
|
Abciximab injection
|
$2,681.25 |
$2,681.25 |
$2,681.25 |
$3,012.98
|
|
Abd aorta w/runoff s&i
|
$21,648.90 |
$21,648.90 |
$21,648.90 |
$3,667.71
|
|
Abdominal MRI (with and without contrast)
|
$25,837.00 |
$25,837.00 |
$25,837.00 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$21,682.20 |
$21,682.20 |
$21,682.20 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$16,775.50 |
$16,775.50 |
$16,775.50 |
$1,972.66
|
|
Ablate heart dysrhythm focus
|
$50,527.10 |
$50,527.10 |
$50,527.10 |
$10,008.58
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$73.25 |
$73.25 |
$73.25 |
$125.63
|
|
Acetaminophen level
|
$2,431.50 |
$2,431.50 |
$2,431.50 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$155.00 |
$155.00 |
$155.00 |
$133.60
|
|
Acetone qualitative
|
$605.70 |
$605.70 |
$605.70 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$868.25 |
$868.25 |
$868.25 |
$323.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$5.75 |
$5.75 |
$5.75 |
$50.70
|
|
#acylcarnitineprfl
|
$172.80 |
$172.80 |
$172.80 |
$105.60
|
|
Adenovirus ag ia
|
$17.25 |
$17.25 |
$17.25 |
$31.20
|
|
Adenovirus antibody,serum - quest
|
$13.85 |
$13.85 |
$13.85 |
$63.00
|
|
Adh-sendout
|
$41.45 |
$41.45 |
$41.45 |
$109.28
|
|
Administration chemotherapy IV infusion each additional hour
|
$136.85 |
$136.85 |
$136.85 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,414.35 |
$1,414.35 |
$1,414.35 |
$672.03
|
|
Administration immunization each additional vaccine
|
$233.70 |
$233.70 |
$233.70 |
$46.23
|
|
_afb id by dna probe rflx ast
|
$84.85 |
$84.85 |
$84.85 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$141.45 |
$141.45 |
$141.45 |
$38.58
|
|
Air conduction bilat
|
$60.35 |
$60.35 |
$60.35 |
$106.50
|
|
Alkaline phosphatase
|
$965.00 |
$965.00 |
$965.00 |
$46.20
|
|
Allergen egg white ige
|
$5.45 |
$5.45 |
$5.45 |
$41.00
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$7,392.45 |
$7,392.45 |
$7,392.45 |
$2,513.00
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,359.50 |
$1,359.50 |
$1,359.50 |
$13.14
|
|
Alpha-fetoprotein amniotic
|
$17.25 |
$17.25 |
$17.25 |
$79.30
|
|
Alt/sgpt
|
$1,505.80 |
$1,505.80 |
$1,505.80 |
$49.00
|
|
Aluminum - quest
|
$22.15 |
$22.15 |
$22.15 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$48.40 |
$48.40 |
$48.40 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$592.00 |
$592.00 |
$592.00 |
$36.30
|
|
Aminolevulinic acid delta
|
$54.00 |
$54.00 |
$54.00 |
$87.12
|
|
Ammonia
|
$1,364.90 |
$1,364.90 |
$1,364.90 |
$120.90
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$352.25 |
$352.25 |
$352.25 |
$130.08
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$385.00 |
$385.00 |
$385.00 |
$331.80
|
|
Ana ds-dna
|
$20.15 |
$20.15 |
$20.15 |
$65.52
|
|
Analysis gene f2 20210g>a variant
|
$38.90 |
$38.90 |
$38.90 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$48.50 |
$48.50 |
$48.50 |
$226.60
|
|
Analysis tumor
|
$1,200.80 |
$1,200.80 |
$1,200.80 |
$240.00
|
|
Anidulafungin injection
|
$606.50 |
$606.50 |
$606.50 |
$209.79
|
|
Antibody bacterium, not elsewhere specified
|
$415.85 |
$415.85 |
$415.85 |
$57.89
|
|
Antibody htlv-i
|
$19.60 |
$19.60 |
$19.60 |
$48.75
|
|
Antihemophilic viii/vwf comp
|
$10.00 |
$10.00 |
$10.00 |
$2.75
|
|
Antinuclear antibodies titer
|
$4.20 |
$4.20 |
$4.20 |
$80.25
|
|
Antistreptolysin o titer
|
$804.25 |
$804.25 |
$804.25 |
$57.96
|
|
Antithymocyte globuln rabbit
|
$2,202.50 |
$2,202.50 |
$2,202.50 |
$1,679.21
|
|
Apheresis platelets
|
$1,438.50 |
$1,438.50 |
$1,438.50 |
$2,345.00
|
|
Apheresis wbc
|
$1,438.50 |
$1,438.50 |
$1,438.50 |
$3,342.71
|
|
#aptt mix-1:1 incubated
|
$282.85 |
$282.85 |
$282.85 |
$157.30
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$1,677.50 |
$1,677.50 |
$1,677.50 |
$1,303.25
|
|
Artery xray each vessel 7577426
|
$6,343.45 |
$6,343.45 |
$6,343.45 |
$1,752.53
|
|
Artery x-rays arms/legs 75716-26
|
$16,757.35 |
$16,757.35 |
$16,757.35 |
$3,844.10
|
|
Artery x-rays lungs
|
$12,831.35 |
$12,831.35 |
$12,831.35 |
$3,686.58
|
|
Artery xrays of pelvis 75736 26
|
$2,999.05 |
$2,999.05 |
$2,999.05 |
$4,086.49
|
|
Assay myeloperoxidase
|
$22.80 |
$22.80 |
$22.80 |
$84.19
|
|
Assay of adp & amp
|
$40.30 |
$40.30 |
$40.30 |
$127.40
|
|
Assay of breath ethanol
|
$118.10 |
$118.10 |
$118.10 |
$45.76
|
|
Assay of lap enzyme
|
$31.30 |
$31.30 |
$31.30 |
$56.25
|
|
Assay of thiocyanate
|
$56.55 |
$56.55 |
$56.55 |
$57.00
|
|
Assay phosphatidylglycerol
|
$65.20 |
$65.20 |
$65.20 |
$87.20
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$1,800.95 |
$1,800.95 |
$1,800.95 |
$312.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$664.50 |
$664.50 |
$664.50 |
$49.80
|
|
Azathioprine 50 mg tablet
|
$11.25 |
$11.25 |
$11.25 |
$6.76
|
|
Azathioprine parenteral
|
$163.75 |
$163.75 |
$163.75 |
$441.40
|
|
Aztreonam 1 gram solution for injection
|
$480.45 |
$480.45 |
$480.45 |
$157.30
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$490.50 |
$490.50 |
$490.50 |
$191.55
|
|
Barrier skn ft cx ff red 2.25 ctf new image w/tape
|
$36.74 |
$36.74 |
$36.74 |
$30.00
|
|
Bendamustine 100 mg intravenous powder for solution
|
$1,940.75 |
$1,940.75 |
$1,940.75 |
$3,101.94
|
|
#_benzodiazconfur
|
$16.80 |
$16.80 |
$16.80 |
$99.72
|
|
Benztropine 1 mg/ml injection solution
|
$116.25 |
$116.25 |
$116.25 |
$121.88
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$296.75 |
$296.75 |
$296.75 |
$75.12
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$2,569.25 |
$2,569.25 |
$2,569.25 |
$4,905.00
|
|
Bilicheck
|
$179.50 |
$179.50 |
$179.50 |
$25.20
|
|
Bilirubin direct
|
$1,166.65 |
$1,166.65 |
$1,166.65 |
$49.29
|
|
Biofeedback, pt
|
$915.85 |
$915.85 |
$915.85 |
$148.66
|
|
Biotinidase - quest
|
$72.55 |
$72.55 |
$72.55 |
$72.80
|
|
Bivalirudin
|
$2,201.00 |
$2,201.00 |
$2,201.00 |
$1,246.70
|
|
Bleomycin 15 unit solution for injection
|
$248.50 |
$248.50 |
$248.50 |
$245.75
|
|
Blood Culture Test
|
$2,152.00 |
$2,152.00 |
$2,152.00 |
$144.65
|
|
Blood draw capillary 36416
|
$133.65 |
$133.65 |
$133.65 |
$22.32
|
|
Blood gases ph venous
|
$605.70 |
$605.70 |
$605.70 |
$63.70
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$383.05 |
$383.05 |
$383.05 |
$33.57
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$1,141.90 |
$1,141.90 |
$1,141.90 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$403.30 |
$403.30 |
$403.30 |
$37.44
|
|
Blood typing ag donor ea ag
|
$366.30 |
$366.30 |
$366.30 |
$166.80
|
|
Blood typing patient serum
|
$214.65 |
$214.65 |
$214.65 |
$70.29
|
|
Bone/joint imaging ltd area
|
$8,210.35 |
$8,210.35 |
$8,210.35 |
$1,151.16
|
|
Bowel imaging
|
$8,844.50 |
$8,844.50 |
$8,844.50 |
$1,186.25
|
|
Braf gene
|
$318.50 |
$318.50 |
$318.50 |
$421.20
|
|
Brain flow imaging only
|
$8,940.10 |
$8,940.10 |
$8,940.10 |
$636.97
|
|
Brain image w/flow < 4 views
|
$7,192.10 |
$7,192.10 |
$7,192.10 |
$828.39
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$19,107.55 |
$19,107.55 |
$19,107.55 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$19,281.85 |
$19,281.85 |
$19,281.85 |
$1,998.00
|
