|
17-hydroxypregnenolone
|
$455.41 |
$455.41 |
$455.41 |
$85.15
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$46.24 |
$46.24 |
$46.24 |
$52.25
|
|
Abd/low ext cath addl
|
$1,058.15 |
$1,058.15 |
$1,058.15 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$2,710.26 |
$2,710.26 |
$2,710.26 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,710.26 |
$2,710.26 |
$2,710.26 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,213.93 |
$2,213.93 |
$2,213.93 |
$1,358.76
|
|
Abdominal paracentesis w/image guidance
|
$2,798.84 |
$2,798.84 |
$2,798.84 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$6,504.43 |
$6,504.43 |
$6,504.43 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$2,213.93 |
$2,213.93 |
$2,213.93 |
$603.33
|
|
Abscess drain retroperitoneal surg code
|
$27,071.34 |
$27,071.34 |
$27,071.34 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$164.99 |
$164.99 |
$164.99 |
$125.63
|
|
Acetazolamide 500 mg solution for injection
|
$487.43 |
$487.43 |
$487.43 |
$133.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$211.43 |
$211.43 |
$211.43 |
$323.77
|
|
Acute hepatitis panel
|
$632.43 |
$632.43 |
$632.43 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$101.94 |
$101.94 |
$101.94 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,533.03 |
$1,533.03 |
$1,533.03 |
$219.86
|
|
Adh-sendout
|
$677.61 |
$677.61 |
$677.61 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$83.62 |
$83.62 |
$83.62 |
$124.70
|
|
Administration immunization 1 vaccine
|
$208.13 |
$208.13 |
$208.13 |
$70.52
|
|
Administration vaccine influenza virus
|
$1,134.99 |
$1,134.99 |
$1,134.99 |
$49.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$2,303.16 |
$2,303.16 |
$2,303.16 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$100.74 |
$100.74 |
$100.74 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$2,294.20 |
$2,294.20 |
$2,294.20 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$1,432.49 |
$1,432.49 |
$1,432.49 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$2,305.12 |
$2,305.12 |
$2,305.12 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$115.40 |
$115.40 |
$115.40 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$131.24 |
$131.24 |
$131.24 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$56.61 |
$56.61 |
$56.61 |
$22.45
|
|
Albuterol non-comp unit
|
$13.92 |
$13.92 |
$13.92 |
$9.59
|
|
Alkaline phosphatase
|
$152.28 |
$152.28 |
$152.28 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$357.98 |
$357.98 |
$357.98 |
$56.35
|
|
Allergen egg white ige
|
$104.21 |
$104.21 |
$104.21 |
$41.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,616.79 |
$1,616.79 |
$1,616.79 |
$3,025.07
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$1,285.96 |
$1,285.96 |
$1,285.96 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$334.82 |
$334.82 |
$334.82 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,540.71 |
$1,540.71 |
$1,540.71 |
$2,600.22
|
|
Alt/sgpt
|
$105.82 |
$105.82 |
$105.82 |
$49.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$76.12 |
$76.12 |
$76.12 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$614.47 |
$614.47 |
$614.47 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$167.97 |
$167.97 |
$167.97 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$400.51 |
$400.51 |
$400.51 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$93,415.65 |
$93,415.65 |
$93,415.65 |
$15,167.75
|
|
Ammonia
|
$307.01 |
$307.01 |
$307.01 |
$120.90
|
|
Ampicillin 1 gram solution for injection
|
$112.14 |
$112.14 |
$112.14 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$212.57 |
$212.57 |
$212.57 |
$51.93
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$920.47 |
$920.47 |
$920.47 |
$312.00
|
|
Amylase
|
$249.41 |
$249.41 |
$249.41 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$1,311.51 |
$1,311.51 |
$1,311.51 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$1,464.84 |
$1,464.84 |
$1,464.84 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$300.48 |
$300.48 |
$300.48 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$12,397.54 |
$12,397.54 |
$12,397.54 |
$2,626.65
|
|
An fluoro guide for cvp
|
$1,873.66 |
$1,873.66 |
$1,873.66 |
$484.45
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$16,030.08 |
$16,030.08 |
$16,030.08 |
$6,736.02
|
|
Ankle X-ray
|
$1,726.89 |
$1,726.89 |
$1,726.89 |
$339.44
|
|
Antibody elution rbc reference
|
$547.97 |
$547.97 |
$547.97 |
$176.54
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$636.77 |
$636.77 |
$636.77 |
$220.73
|
|
Antibody id rbc panel
|
$1,119.53 |
$1,119.53 |
$1,119.53 |
$291.75
|
|
Antibody screen rbc
|
$196.55 |
$196.55 |
$196.55 |
$105.00
|
|
Anti mog serum - sendout
|
$51.04 |
$51.04 |
$51.04 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$240.58 |
$240.58 |
$240.58 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$240.58 |
$240.58 |
$240.58 |
$45.82
|
|
Antinuclear antibodies
|
$202.27 |
$202.27 |
$202.27 |
$91.70
|
|
Antinuclear antibodies titer
|
$222.81 |
$222.81 |
$222.81 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$320.85 |
$320.85 |
$320.85 |
$74.20
|
|
Antistreptolysin o screen
|
$115.20 |
$115.20 |
$115.20 |
$59.40
|
|
Antistreptolysin o titer
|
$145.75 |
$145.75 |
$145.75 |
$57.96
|
|
Antithrombin iii activity
|
$236.59 |
$236.59 |
$236.59 |
$115.23
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,514.62 |
$1,514.62 |
$1,514.62 |
$549.08
|
|
Application finger splntstatic 29130
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$216.80
|
|
Application of long arm cast 29065
|
$4,899.81 |
$4,899.81 |
$4,899.81 |
$404.63
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$320.50 |
$320.50 |
$320.50 |
$75.98
|
|
Apply finger cast 29086
|
$2,867.78 |
$2,867.78 |
$2,867.78 |
$225.29
|
|
Apply short leg castambul type 29425
|
$4,899.81 |
$4,899.81 |
$4,899.81 |
$408.75
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$2,749.87 |
$2,749.87 |
$2,749.87 |
$943.40
|
|
Aquaporin-4 antibody cba each
|
$240.58 |
$240.58 |
$240.58 |
$114.20
|
|
Aquaporin-4 antibody elisa
|
$230.21 |
$230.21 |
$230.21 |
$139.59
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$228.77 |
$228.77 |
$228.77 |
$98.90
|
|
Aquatic exercise - group charge
|
$196.53 |
$196.53 |
$196.53 |
$87.60
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$2,192.46 |
$2,192.46 |
$2,192.46 |
$1,303.25
|
|
Arterial blood draw/perc 36620
|
$571.88 |
$571.88 |
$571.88 |
$505.60
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$2,237.08 |
$2,237.08 |
$2,237.08 |
$567.78
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$2,237.08 |
$2,237.08 |
$2,237.08 |
$910.79
|
|
Assay of interleukin-6 (il-6)
|
$176.09 |
$176.09 |
$176.09 |
$77.35
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$793.77 |
$793.77 |
$793.77 |
$312.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$137.05 |
$137.05 |
$137.05 |
$49.80
|
|
Ast/sgot
|
$103.42 |
$103.42 |
$103.42 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$91,594.88 |
$91,594.88 |
$91,594.88 |
$31,208.35
|
|
Atropine 0.1 mg/ml injection syringe
|
$173.41 |
$173.41 |
$173.41 |
$43.01
|
|
Azacitidine injection
|
$1,175.70 |
$1,175.70 |
$1,175.70 |
$912.29
|
|
Azithromycin 500 mg intravenous solution
|
$124.93 |
$124.93 |
$124.93 |
$52.69
|
|
Bacterial meningitis antigen
|
$230.40 |
$230.40 |
$230.40 |
$68.40
|
|
Bacterial vaginosis pcr
|
$1,401.54 |
$1,401.54 |
$1,401.54 |
$298.04
|
|
#bac vag cand-c. albicans naa
|
$157.06 |
$157.06 |
$157.06 |
$112.80
|
|
Bartonella dna pcr-sendout
|
$700.58 |
$700.58 |
$700.58 |
$196.20
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$25,786.88 |
$25,786.88 |
$25,786.88 |
$6,720.38
|
|
Benign lesion paring 2-4
|
$3,506.66 |
$3,506.66 |
$3,506.66 |
$275.49
|
|
#_benzodiazconfur
|
$104.05 |
$104.05 |
$104.05 |
$99.72
|
|
Benztropine 1 mg/ml injection solution
|
$192.75 |
$192.75 |
$192.75 |
$121.88
|
|
Beta 2 glycoprotein 1 antibody iga
|
$508.11 |
$508.11 |
$508.11 |
$97.21
|
|
Beta-2 microglobulin
|
$323.04 |
$323.04 |
$323.04 |
$84.66
|