|
Assay of semen fructose
|
$306.00 |
$306.00 |
$306.00 |
$53.00
|
|
Assay of sialic acid
|
$184.00 |
$184.00 |
$184.00 |
$60.45
|
|
Assay of thiocyanate
|
$114.00 |
$114.00 |
$114.00 |
$57.00
|
|
Assay phosphatidylglycerol
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$87.20
|
|
Assay phosphohexose enzymes
|
$555.00 |
$555.00 |
$555.00 |
$73.60
|
|
Assay toxin or antitoxin
|
$1,701.00 |
$1,701.00 |
$1,701.00 |
$72.75
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$316.00 |
$316.00 |
$316.00 |
$49.80
|
|
Ast/sgot
|
$1,244.00 |
$1,244.00 |
$1,244.00 |
$45.65
|
|
Autologous blood process
|
$430.00 |
$430.00 |
$430.00 |
$234.27
|
|
Azacitidine injection
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
$912.29
|
|
Azathioprine 50 mg tablet
|
$41.00 |
$41.00 |
$41.00 |
$6.76
|
|
Azathioprine parenteral
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$441.40
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$1,190.00 |
$1,190.00 |
$1,190.00 |
$191.55
|
|
Bacterial meningitis antigen
|
$406.00 |
$406.00 |
$406.00 |
$68.40
|
|
Bactericidal level serum
|
$4,061.00 |
$4,061.00 |
$4,061.00 |
$82.50
|
|
Barrier skin flextend 2.25in floating flang new image
|
$35.00 |
$35.00 |
$35.00 |
$2.40
|
|
Barrier skn ft cx ff red 2.25 ctf new image w/tape
|
$67.00 |
$67.00 |
$67.00 |
$30.00
|
|
Belt ostomy lg 34-65in
|
$25.00 |
$25.00 |
$25.00 |
$5.20
|
|
Benztropine 1 mg/ml injection solution
|
$224.00 |
$224.00 |
$224.00 |
$121.88
|
|
Beta-2 microglobulin
|
$1,632.00 |
$1,632.00 |
$1,632.00 |
$84.66
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$50.00 |
$50.00 |
$50.00 |
$75.12
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$9,057.00 |
$9,057.00 |
$9,057.00 |
$4,905.00
|
|
B-hexosaminidase ea assay
|
$228.00 |
$228.00 |
$228.00 |
$104.25
|
|
Bilicheck
|
$328.00 |
$328.00 |
$328.00 |
$25.20
|
|
Bilirubin direct
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$49.29
|
|
Biotinidase - quest
|
$39.00 |
$39.00 |
$39.00 |
$72.80
|
|
Bivalirudin
|
$9,760.00 |
$9,760.00 |
$9,760.00 |
$1,246.70
|
|
Bleomycin 15 unit solution for injection
|
$6,974.00 |
$6,974.00 |
$6,974.00 |
$245.75
|
|
Blood Culture Test
|
$1,978.00 |
$1,978.00 |
$1,978.00 |
$144.65
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$260.00 |
$260.00 |
$260.00 |
$33.57
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$14.00 |
$14.00 |
$14.00 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$10.00 |
$10.00 |
$10.00 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$1,466.00 |
$1,466.00 |
$1,466.00 |
$37.44
|
|
Blood typing abo
|
$551.00 |
$551.00 |
$551.00 |
$83.82
|
|
Blood typing rbc ag non abo/rh ea
|
$298.00 |
$298.00 |
$298.00 |
$181.74
|
|
Blood typing rh (d)
|
$499.00 |
$499.00 |
$499.00 |
$56.24
|
|
Blood typing rh phenotype complete reference
|
$885.00 |
$885.00 |
$885.00 |
$77.25
|
|
Bone imaging multiple areas
|
$3,442.00 |
$3,442.00 |
$3,442.00 |
$1,147.57
|
|
Bone/joint imaging ltd area
|
$12,938.00 |
$12,938.00 |
$12,938.00 |
$1,151.16
|
|
Bone survey-lead poisoning
|
$4,763.00 |
$4,763.00 |
$4,763.00 |
$346.28
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$620.00 |
$620.00 |
$620.00 |
$98.57
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$21,393.00 |
$21,393.00 |
$21,393.00 |
$1,683.04
|
|
(both sides) smear without diff wbc count
|
$186.00 |
$186.00 |
$186.00 |
$33.57
|
|
Bowel imaging
|
$6,357.00 |
$6,357.00 |
$6,357.00 |
$1,186.25
|
|
Brain image < 4 views
|
$4,637.00 |
$4,637.00 |
$4,637.00 |
$475.51
|
|
Brain image w/flow 4 + views
|
$3,209.00 |
$3,209.00 |
$3,209.00 |
$1,308.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$8,246.00 |
$8,246.00 |
$8,246.00 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$5,497.00 |
$5,497.00 |
$5,497.00 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$5,152.00 |
$5,152.00 |
$5,152.00 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$19,041.00 |
$19,041.00 |
$19,041.00 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$7,850.00 |
$7,850.00 |
$7,850.00 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$7,545.00 |
$7,545.00 |
$7,545.00 |
$1,927.04
|
|
Bundle his recording
|
$22,686.00 |
$22,686.00 |
$22,686.00 |
$5,157.39
|
|
Buprenorphine hydrochloride
|
$85.00 |
$85.00 |
$85.00 |
$42.14
|
|
C1 esterase inhibitor func - sendout
|
$7,602.00 |
$7,602.00 |
$7,602.00 |
$106.60
|
|
Cabergoline, oral 0.25mg
|
$468.00 |
$468.00 |
$468.00 |
$126.69
|
|
Caffeine citrate 20 mg/ml inj for po
|
$166.00 |
$166.00 |
$166.00 |
$43.81
|
|
Calcium 24 hour urine
|
$944.00 |
$944.00 |
$944.00 |
$52.00
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$80.70 |
$80.70 |
$80.70 |
$59.40
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$72.60 |
$72.60 |
$72.60 |
$92.91
|
|
Calcium ionized
|
$418.00 |
$418.00 |
$418.00 |
$86.35
|
|
Calcium total
|
$584.00 |
$584.00 |
$584.00 |
$48.75
|
|
Calculi urinary-sendout
|
$55.00 |
$55.00 |
$55.00 |
$68.05
|
|
Calprotectin fecal
|
$813.00 |
$813.00 |
$813.00 |
$170.00
|
|
Carbamazepine total therapeutic drug level
|
$1,872.00 |
$1,872.00 |
$1,872.00 |
$113.25
|
|
Carbon dioxide
|
$458.00 |
$458.00 |
$458.00 |
$44.82
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$243.39 |
$243.39 |
$243.39 |
$432.25
|
|
Carcinoembryonic ag (cea)
|
$771.00 |
$771.00 |
$771.00 |
$146.90
|
|
Cardiac drug stress test
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$543.20
|
|
Cardiac perf planar sgl/ef/wm
|
$8,016.00 |
$8,016.00 |
$8,016.00 |
$1,911.62
|
|
Carmustine 100 mg intravenous powder for solution
|
$1,986.00 |
$1,986.00 |
$1,986.00 |
$1,582.20
|
|
Carotene
|
$254.00 |
$254.00 |
$254.00 |
$46.80
|
|
Carotid Artery Ultrasound (Duplex)
|
$2,827.00 |
$2,827.00 |
$2,827.00 |
$1,067.40
|
|
Catecholamines,fractionated, urine
|
$466.00 |
$466.00 |
$466.00 |
$55.20
|
|
Cath stripping venous s&i
|
$1,707.00 |
$1,707.00 |
$1,707.00 |
$602.40
|
|
Cefotaxime sodium injection
|
$343.00 |
$343.00 |
$343.00 |
$40.63
|
|
Cell count w differential body fluid
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$95.55
|
|
Cell marker study
|
$6,443.00 |
$6,443.00 |
$6,443.00 |
$239.85
|
|
Cerebrospinal fld flw imag
|
$2,043.00 |
$2,043.00 |
$2,043.00 |
$884.00
|
|
#cf-97variants
|
$1,381.00 |
$1,381.00 |
$1,381.00 |
$612.26
|
|
Chest 2 vws w oblique
|
$2,650.00 |
$2,650.00 |
$2,650.00 |
$373.20
|
|
Chest apical lordotic proj
|
$2,650.00 |
$2,650.00 |
$2,650.00 |
$288.81
|
|
Chest CT scan (with and without contrast)
|
$15,400.00 |
$15,400.00 |
$15,400.00 |
$2,021.80
|
|
Chest CT scan (with contrast)
|
$12,658.00 |
$12,658.00 |
$12,658.00 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$11,450.00 |
$11,450.00 |
$11,450.00 |
$1,350.03
|
|
Chest X-ray
|
$1,922.00 |
$1,922.00 |
$1,922.00 |
$294.06
|
|
Chest X-ray (single view)
|
$922.00 |
$922.00 |
$922.00 |
$229.08
|
|
Chlamydia culture
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$94.90
|
|
Chloramphenicol sodium injec
|
$117.00 |
$117.00 |
$117.00 |
$122.59
|
|
Chloride
|
$342.00 |
$342.00 |
$342.00 |
$38.50
|
|
Chloride 24 hour urine
|
$456.00 |
$456.00 |
$456.00 |
$46.13
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$114.00 |
$114.00 |
$114.00 |
$333.01
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$4,154.00 |
$4,154.00 |
$4,154.00 |
$625.60
|
|
Cholesterol
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$46.15
|
|
Cholesterol (Lipid) Test
|
$2,308.00 |
$2,308.00 |
$2,308.00 |
$115.70
|
|
Cholinesterase
|
$458.00 |
$458.00 |
$458.00 |
$38.69
|
|
Chrom analysis
|
$1,103.00 |
$1,103.00 |
$1,103.00 |
$127.86
|
|
Chromatography
|
$67.00 |
$67.00 |
$67.00 |
$80.60
|
|
Chromo high res and frag x - sendout
|
$288.00 |
$288.00 |
$288.00 |
$264.25
|
|
Chromosome analys amniotic
|
$1,801.00 |
$1,801.00 |
$1,801.00 |
$436.00
|
