|
#a/b/c/c/h pnl-candida albicans ab
|
$30.00 |
$30.00 |
$30.00 |
$53.95
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$6,091.00 |
$6,091.00 |
$6,091.00 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$3,214.00 |
$3,214.00 |
$3,214.00 |
$662.40
|
|
Abdominal MRI (with and without contrast)
|
$5,030.00 |
$5,030.00 |
$5,030.00 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$4,024.00 |
$4,024.00 |
$4,024.00 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$4,024.00 |
$4,024.00 |
$4,024.00 |
$2,048.36
|
|
Abdominal Ultrasound (complete)
|
$8,669.00 |
$8,669.00 |
$8,669.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$5,502.00 |
$5,502.00 |
$5,502.00 |
$586.43
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$137.00 |
$137.00 |
$137.00 |
$72.74
|
|
Acetaminophen level
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$316.00 |
$316.00 |
$316.00 |
$122.55
|
|
Acetone qualitative
|
$460.00 |
$460.00 |
$460.00 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$124.43 |
$124.43 |
$124.43 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,441.00 |
$1,441.00 |
$1,441.00 |
$218.79
|
|
Acute hepatitis panel
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$93.00 |
$93.00 |
$93.00 |
$64.45
|
|
Adh-sendout
|
$28.00 |
$28.00 |
$28.00 |
$118.79
|
|
Administration chemotherapy IV infusion each additional hour
|
$589.00 |
$589.00 |
$589.00 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,838.00 |
$1,838.00 |
$1,838.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$439.20
|
|
#afb mycobacteria suscep. #1
|
$123.00 |
$123.00 |
$123.00 |
$34.72
|
|
_afb org id by sequencing rflx ast-sendout
|
$404.00 |
$404.00 |
$404.00 |
$300.00
|
|
Albumin body fluid quantitative each specimen
|
$31.00 |
$31.00 |
$31.00 |
$47.45
|
|
Albumin (human), 5%, 250 ml
|
$2,310.00 |
$2,310.00 |
$2,310.00 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$11.41 |
$11.41 |
$11.41 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$361.00 |
$361.00 |
$361.00 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$95.00 |
$95.00 |
$95.00 |
$5.67
|
|
Albuterol non-comp con
|
$45.00 |
$45.00 |
$45.00 |
$6.07
|
|
Albuterol non-comp unit
|
$45.00 |
$45.00 |
$45.00 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$1,189.00 |
$1,189.00 |
$1,189.00 |
$96.00
|
|
Alginate drsg >16 <=48 sq in
|
$234.00 |
$234.00 |
$234.00 |
$43.72
|
|
Alkaline phosphatase
|
$878.00 |
$878.00 |
$878.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$11.41 |
$11.41 |
$11.41 |
$48.57
|
|
Allergen egg white ige
|
$12.00 |
$12.00 |
$12.00 |
$38.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$1.00 |
$1.00 |
$1.00 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$1.00 |
$1.00 |
$1.00 |
$497.95
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$20,311.34
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$4,677.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$5,278.73
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1,225.35
|
|
Alloskin
|
$1.00 |
$1.00 |
$1.00 |
$582.40
|
|
Alloskin ac, 1 cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$262.50 |
$262.50 |
$262.50 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$247.00 |
$247.00 |
$247.00 |
$106.00
|
|
Aluminum - quest
|
$46.62 |
$46.62 |
$46.62 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$175.00 |
$175.00 |
$175.00 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$346.00 |
$346.00 |
$346.00 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$71.00 |
$71.00 |
$71.00 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$1,012.00 |
$1,012.00 |
$1,012.00 |
$108.13
|
|
Ammonia
|
$690.00 |
$690.00 |
$690.00 |
$119.70
|
|
Amnioarmor 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Amniocore per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Amnio-maxx or lite per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Amniowrap2 per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Amphetamine confirm urine -sendout
|
$51.45 |
$51.45 |
$51.45 |
$93.61
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$806.00 |
$806.00 |
$806.00 |
$519.03
|
|
Analysis gene f2 20210g>a variant
|
$96.29 |
$96.29 |
$96.29 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$922.25 |
$922.25 |
$922.25 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$175.00 |
$175.00 |
$175.00 |
$101.50
|
|
An fluoro guide for cvp
|
$8,023.00 |
$8,023.00 |
$8,023.00 |
$525.85
|
|
Antibody bacterium, not elsewhere specified
|
$38.64 |
$38.64 |
$38.64 |
$57.85
|
|
Antibody elution rbc reference
|
$86.00 |
$86.00 |
$86.00 |
$177.29
|
|
Antibody id rbc panel
|
$166.00 |
$166.00 |
$166.00 |
$291.75
|
|
Antibody screen rbc
|
$361.00 |
$361.00 |
$361.00 |
$108.55
|
|
Anti mog serum - sendout
|
$1,925.00 |
$1,925.00 |
$1,925.00 |
$132.60
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$56.16 |
$56.16 |
$56.16 |
$42.00
|
|
Antinuclear antibodies
|
$9.87 |
$9.87 |
$9.87 |
$90.00
|
|
Antistreptolysin o titer
|
$701.00 |
$701.00 |
$701.00 |
$54.00
|
|
Antithrombin iii activity
|
$606.38 |
$606.38 |
$606.38 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$3,294.00 |
$3,294.00 |
$3,294.00 |
$394.55
|
|
Aquaporin-4 antibody cba each
|
$2,048.20 |
$2,048.20 |
$2,048.20 |
$138.16
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$495.00 |
$495.00 |
$495.00 |
$100.75
|
|
Architect ecm px fx 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$171.12
|
|
Arformoterol non-comp unit
|
$49.00 |
$49.00 |
$49.00 |
$24.24
|
|
Argatroban dialysis, auromed
|
$4,684.00 |
$4,684.00 |
$4,684.00 |
$374.54
|
|
Arm or Leg Ultrasound (limited, left side)
|
$3,243.00 |
$3,243.00 |
$3,243.00 |
$426.00
|
|
Artacent ac 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Artacent wound, per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Assay acid phosphatase
|
$106.00 |
$106.00 |
$106.00 |
$38.22
|
|
Assay myeloperoxidase
|
$54.25 |
$54.25 |
$54.25 |
$97.41
|
|
Assay of prostaglandin
|
$930.00 |
$930.00 |
$930.00 |
$230.00
|
|
Assay of salicylate
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$96.50
|
|
Assay of somatostatin
|
$203.00 |
$203.00 |
$203.00 |
$170.50
|
|
Assay of urine sulfate
|
$29.53 |
$29.53 |
$29.53 |
$28.20
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$537.00 |
$537.00 |
$537.00 |
$46.80
|
|
Azathioprine 50 mg tablet
|
$55.00 |
$55.00 |
$55.00 |
$3.44
|
|
Azithromycin 500 mg intravenous solution
|
$243.00 |
$243.00 |
$243.00 |
$37.53
|
|
Baclofen eval charges
|
$136.00 |
$136.00 |
$136.00 |
$87.50
|
|
Barium Enema (Colon X-ray, barium and air)
|
$9,638.00 |
$9,638.00 |
$9,638.00 |
$820.15
|
|
Barium Enema (Colon X-ray, barium only)
|
$7,161.00 |
$7,161.00 |
$7,161.00 |
$666.90
|
|
Barium Swallow (Esophagus X-ray)
|
$5,003.00 |
$5,003.00 |
$5,003.00 |
$484.80
|
|
Barrier film 28ml spray no stng cavilon
|
$16.00 |
$16.00 |
$16.00 |
$19.50
|
|
B cells total count
|
$122.00 |
$122.00 |
$122.00 |
$132.48
|
|
Benztropine 1 mg/ml injection solution
|
$336.00 |
$336.00 |
$336.00 |
$108.90
|
|
Beta-2 microglobulin
|
$240.00 |
$240.00 |
$240.00 |
$85.20
|
|
Beta-amyloid 1-40
|
$280.00 |
$280.00 |
$280.00 |
$312.00
|
|
Beta-amyloid 1-42
|
$280.00 |
$280.00 |
$280.00 |
$333.00
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$243.00 |
$243.00 |
$243.00 |
$65.00
|
|
Bilirubin direct
|
$980.00 |
$980.00 |
$980.00 |
$51.35
|
