|
17-hydroxypregnenolone
|
$33.39 |
$33.39 |
$33.39 |
$85.15
|
|
3-d radiotherapy plan
|
$2,045.01 |
$2,045.01 |
$2,045.01 |
$4,886.50
|
|
5' nucleotidase - sendout
|
$4.89 |
$4.89 |
$4.89 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$1,604.26 |
$1,604.26 |
$1,604.26 |
$97.65
|
|
Abdominal CT scan (with and without contrast)
|
$20,600.86 |
$20,600.86 |
$20,600.86 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$18,330.36 |
$18,330.36 |
$18,330.36 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$17,058.98 |
$17,058.98 |
$17,058.98 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$21,255.92 |
$21,255.92 |
$21,255.92 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$15,462.69 |
$15,462.69 |
$15,462.69 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$14,939.12 |
$14,939.12 |
$14,939.12 |
$1,972.66
|
|
Abdominal Ultrasound (complete)
|
$7,134.74 |
$7,134.74 |
$7,134.74 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$4,100.29 |
$4,100.29 |
$4,100.29 |
$603.33
|
|
Ablate arrhythmia add on
|
$51,659.71 |
$51,659.71 |
$51,659.71 |
$7,417.15
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$170.65 |
$170.65 |
$170.65 |
$125.63
|
|
Acetaminophen level
|
$2,079.14 |
$2,079.14 |
$2,079.14 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$363.26 |
$363.26 |
$363.26 |
$133.60
|
|
Acetone qualitative
|
$253.85 |
$253.85 |
$253.85 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$71.68 |
$71.68 |
$71.68 |
$65.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,206.72 |
$1,206.72 |
$1,206.72 |
$323.77
|
|
Adenovirus antibody,serum - quest
|
$9.77 |
$9.77 |
$9.77 |
$63.00
|
|
Adh-sendout
|
$29.32 |
$29.32 |
$29.32 |
$109.28
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,357.10 |
$1,357.10 |
$1,357.10 |
$672.03
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$558.96 |
$558.96 |
$558.96 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$558.96 |
$558.96 |
$558.96 |
$264.00
|
|
Administration vaccine influenza virus
|
$196.05 |
$196.05 |
$196.05 |
$49.50
|
|
Adrenal cortex & medulla img
|
$10,535.07 |
$10,535.07 |
$10,535.07 |
$1,780.19
|
|
_afb id by dna probe rflx ast
|
$141.00 |
$141.00 |
$141.00 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$65.00 |
$65.00 |
$65.00 |
$289.60
|
|
Air conduction bilat
|
$35.00 |
$35.00 |
$35.00 |
$106.50
|
|
Aldesleukin injection
|
$6,686.36 |
$6,686.36 |
$6,686.36 |
$6,446.09
|
|
Alkaline phosphatase
|
$1,053.11 |
$1,053.11 |
$1,053.11 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$3.26 |
$3.26 |
$3.26 |
$56.35
|
|
Allergen egg white ige
|
$3.95 |
$3.95 |
$3.95 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$97.74 |
$97.74 |
$97.74 |
$26.95
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$3,298.17 |
$3,298.17 |
$3,298.17 |
$3,025.07
|
|
Aluminum - quest
|
$13.32 |
$13.32 |
$13.32 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$116.75 |
$116.75 |
$116.75 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$73.65 |
$73.65 |
$73.65 |
$36.30
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$37.33 |
$37.33 |
$37.33 |
$42.84
|
|
Aminolevulinic acid delta
|
$13.11 |
$13.11 |
$13.11 |
$87.12
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$216.00 |
$216.00 |
$216.00 |
$202.10
|
|
Amitriptyline (elavil) -sendout
|
$14.66 |
$14.66 |
$14.66 |
$101.17
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$158.26 |
$158.26 |
$158.26 |
$130.08
|
|
Ana ds-dna
|
$14.24 |
$14.24 |
$14.24 |
$65.52
|
|
Anal pressure record
|
$5,301.26 |
$5,301.26 |
$5,301.26 |
$955.86
|
|
Analysis gene f2 20210g>a variant
|
$27.51 |
$27.51 |
$27.51 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$34.28 |
$34.28 |
$34.28 |
$226.60
|
|
An fluoro guide for cvp
|
$6,736.20 |
$6,736.20 |
$6,736.20 |
$484.45
|
|
Antibody bacterium, not elsewhere specified
|
$21.55 |
$21.55 |
$21.55 |
$57.89
|
|
Antibody elution rbc reference
|
$106.00 |
$106.00 |
$106.00 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$157.58 |
$157.58 |
$157.58 |
$141.74
|
|
Antibody htlv-i
|
$20.36 |
$20.36 |
$20.36 |
$48.75
|
|
Antibody htlv-ii
|
$20.37 |
$20.37 |
$20.37 |
$35.22
|
|
Antibody tetanus
|
$7.33 |
$7.33 |
$7.33 |
$61.98
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$10,080.00 |
$10,080.00 |
$10,080.00 |
$3.12
|
|
Anti mog serum - sendout
|
$605.00 |
$605.00 |
$605.00 |
$140.62
|
|
Antinuclear antibodies titer
|
$90.86 |
$90.86 |
$90.86 |
$80.25
|
|
Antistreptolysin o screen
|
$43.51 |
$43.51 |
$43.51 |
$59.40
|
|
Antithrombin iii activity
|
$43.81 |
$43.81 |
$43.81 |
$115.23
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$3,969.70 |
$3,969.70 |
$3,969.70 |
$5,013.11
|
|
Apheresis platelets
|
$3,040.93 |
$3,040.93 |
$3,040.93 |
$2,345.00
|
|
Apheresis rbc
|
$3,040.93 |
$3,040.93 |
$3,040.93 |
$3,348.50
|
|
Application finger splntstatic 29130
|
$385.70 |
$385.70 |
$385.70 |
$216.80
|
|
Application long leg splint 29505
|
$2,086.61 |
$2,086.61 |
$2,086.61 |
$340.80
|
|
Apply forearm splintdynamic 29126
|
$385.70 |
$385.70 |
$385.70 |
$263.10
|
|
Apply of finger splint 29131
|
$385.70 |
$385.70 |
$385.70 |
$177.45
|
|
Aquaporin-4 antibody cba each
|
$483.18 |
$483.18 |
$483.18 |
$114.20
|
|
Argatroban nonesrd (auromed)
|
$1,096.87 |
$1,096.87 |
$1,096.87 |
$1.49
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$3,104.27 |
$3,104.27 |
$3,104.27 |
$1,303.25
|
|
Artery x-rays adrenals
|
$48,328.94 |
$48,328.94 |
$48,328.94 |
$3,706.68
|
|
Artery x-rays chest
|
$37,767.15 |
$37,767.15 |
$37,767.15 |
$2,587.20
|
|
Artery x-rays lung
|
$40,412.41 |
$40,412.41 |
$40,412.41 |
$2,332.57
|
|
Artery xrays of pelvis 75736 26
|
$40,412.41 |
$40,412.41 |
$40,412.41 |
$4,086.49
|
|
Artery x-rays spine
|
$37,767.15 |
$37,767.15 |
$37,767.15 |
$4,306.40
|
|
Assay acid phosphatase
|
$55.66 |
$55.66 |
$55.66 |
$38.22
|
|
Assay of adp & amp
|
$24.31 |
$24.31 |
$24.31 |
$127.40
|
|
Assay of breath ethanol
|
$50.00 |
$50.00 |
$50.00 |
$45.76
|
|
Assay of interleukin-6 (il-6)
|
$54.00 |
$54.00 |
$54.00 |
$77.35
|
|
Assay of lrh hormone
|
$196.29 |
$196.29 |
$196.29 |
$210.60
|
|
Assay of procainamide w/metab
|
$12.04 |
$12.04 |
$12.04 |
$61.20
|
|
Assay of sialic acid
|
$14.99 |
$14.99 |
$14.99 |
$60.45
|
|
Assay of somatostatin
|
$221.66 |
$221.66 |
$221.66 |
$165.75
|
|
Assay of urine sulfate
|
$10.49 |
$10.49 |
$10.49 |
$31.35
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$788.40 |
$788.40 |
$788.40 |
$49.80
|
|
Ast/sgot
|
$772.29 |
$772.29 |
$772.29 |
$45.65
|
|
Autologous blood process
|
$568.89 |
$568.89 |
$568.89 |
$234.27
|
|
Azacitidine injection
|
$3,987.77 |
$3,987.77 |
$3,987.77 |
$912.29
|
|
Azathioprine 50 mg tablet
|
$29.67 |
$29.67 |
$29.67 |
$6.76
|
|
Azathioprine parenteral
|
$888.00 |
$888.00 |
$888.00 |
$441.40
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$542.47 |
$542.47 |
$542.47 |
$191.55
|
|
Bactericidal level serum
|
$166.29 |
$166.29 |
$166.29 |
$82.50
|
|
Barrier skn ft cx ff red 2.25 ctf new image w/tape
|
$57.21 |
$57.21 |
$57.21 |
$30.00
|
|
Bcg live 50 mg intravesical suspension
|
$640.47 |
$640.47 |
$640.47 |
$517.26
|
|
Belatacept 250 mg intravenous solution
|
$4,125.00 |
$4,125.00 |
$4,125.00 |
$2,843.40
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$105.67 |
$105.67 |
$105.67 |
$6,720.38
|
|
#_benzodiazconfur
|
$13.32 |
$13.32 |
$13.32 |
$99.72
|
|
Benztropine 1 mg/ml injection solution
|
$322.86 |
$322.86 |
$322.86 |
$121.88
|
|
Beta-2 microglobulin
|
$131.71 |
$131.71 |
$131.71 |
$84.66
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$258.78 |
$258.78 |
$258.78 |
$75.12
|
|
Bilirubin direct
|
$1,117.89 |
$1,117.89 |
$1,117.89 |
$49.29
|
