|
17-ketosteroids
|
$41.50 |
$41.50 |
$41.50 |
$44.00
|
|
3-d radiotherapy plan
|
$1,619.29 |
$1,619.29 |
$1,619.29 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$983.51 |
$983.51 |
$983.51 |
$427.34
|
|
5' nucleotidase - sendout
|
$6.00 |
$6.00 |
$6.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$908.53 |
$908.53 |
$908.53 |
$97.65
|
|
Abciximab injection
|
$5,520.66 |
$5,520.66 |
$5,520.66 |
$3,012.98
|
|
Abd aorta w/runoff s&i
|
$1,840.96 |
$1,840.96 |
$1,840.96 |
$3,667.71
|
|
Abdominal CT scan (with and without contrast)
|
$13,534.14 |
$13,534.14 |
$13,534.14 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$10,883.16 |
$10,883.16 |
$10,883.16 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$10,009.59 |
$10,009.59 |
$10,009.59 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$22,864.20 |
$22,864.20 |
$22,864.20 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$20,069.10 |
$20,069.10 |
$20,069.10 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$18,023.51 |
$18,023.51 |
$18,023.51 |
$1,972.66
|
|
Abdominal Ultrasound (complete)
|
$12,921.84 |
$12,921.84 |
$12,921.84 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$4,440.13 |
$4,440.13 |
$4,440.13 |
$603.33
|
|
Ablate arrhythmia add on
|
$90,494.97 |
$90,494.97 |
$90,494.97 |
$7,417.15
|
|
Ablate heart dysrhythm focus
|
$94,240.59 |
$94,240.59 |
$94,240.59 |
$10,008.58
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$173.81 |
$173.81 |
$173.81 |
$125.63
|
|
Acetaminophen level
|
$1,686.69 |
$1,686.69 |
$1,686.69 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$950.17 |
$950.17 |
$950.17 |
$133.60
|
|
Acetone qualitative
|
$576.88 |
$576.88 |
$576.88 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$2,981.12 |
$2,981.12 |
$2,981.12 |
$323.77
|
|
Acoustic refl threshold tst
|
$72.19 |
$72.19 |
$72.19 |
$83.79
|
|
Acute venous thrombus image
|
$7,049.68 |
$7,049.68 |
$7,049.68 |
$873.75
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$99.11 |
$99.11 |
$99.11 |
$50.70
|
|
Adenovirus antibody,serum - quest
|
$69.00 |
$69.00 |
$69.00 |
$63.00
|
|
Adh-sendout
|
$30.00 |
$30.00 |
$30.00 |
$109.28
|
|
Administration chemotherapy IV infusion each additional hour
|
$409.62 |
$409.62 |
$409.62 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$2,181.31 |
$2,181.31 |
$2,181.31 |
$672.03
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$2,181.31 |
$2,181.31 |
$2,181.31 |
$264.00
|
|
Administration immunization each additional vaccine
|
$57.61 |
$57.61 |
$57.61 |
$46.23
|
|
_afb id by dna probe rflx ast
|
$430.50 |
$430.50 |
$430.50 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$74.70 |
$74.70 |
$74.70 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$268.63 |
$268.63 |
$268.63 |
$289.60
|
|
Afo tib fx semi-rigid l2114
|
$1,708.85 |
$1,708.85 |
$1,708.85 |
$1,116.55
|
|
Air conduction bilat
|
$35.00 |
$35.00 |
$35.00 |
$106.50
|
|
Aldesleukin injection
|
$1,959.76 |
$1,959.76 |
$1,959.76 |
$6,446.09
|
|
Allergen specific ige qual multi scrn ea
|
$28.51 |
$28.51 |
$28.51 |
$26.95
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$39,477.49 |
$39,477.49 |
$39,477.49 |
$18,384.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$4,170.10 |
$4,170.10 |
$4,170.10 |
$4,101.14
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2.65 |
$2.65 |
$2.65 |
$13.14
|
|
Alpha-fetoprotein amniotic
|
$39.00 |
$39.00 |
$39.00 |
$79.30
|
|
Alprostadil for injection
|
$1,480.31 |
$1,480.31 |
$1,480.31 |
$533.06
|
|
Aluminum - quest
|
$19.23 |
$19.23 |
$19.23 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$96.00 |
$96.00 |
$96.00 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$52.13 |
$52.13 |
$52.13 |
$36.30
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$28.88 |
$28.88 |
$28.88 |
$42.84
|
|
Aminolevulinic acid delta
|
$40.25 |
$40.25 |
$40.25 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$13.77 |
$13.77 |
$13.77 |
$41.59
|
|
Ammonia
|
$1,637.21 |
$1,637.21 |
$1,637.21 |
$120.90
|
|
Amphetamine confirm urine -sendout
|
$17.23 |
$17.23 |
$17.23 |
$94.50
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$413.87 |
$413.87 |
$413.87 |
$130.08
|
|
Amphotericin b lipid complex
|
$110.96 |
$110.96 |
$110.96 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$3,182.47 |
$3,182.47 |
$3,182.47 |
$331.80
|
|
Ana ds-dna
|
$17.48 |
$17.48 |
$17.48 |
$65.52
|
|
Analysis nerve
|
$37.84 |
$37.84 |
$37.84 |
$223.19
|
|
Analysis tumor
|
$15.30 |
$15.30 |
$15.30 |
$240.00
|
|
Anca screen with reflex to titer -quest
|
$16.10 |
$16.10 |
$16.10 |
$109.20
|
|
Anidulafungin injection
|
$1,161.46 |
$1,161.46 |
$1,161.46 |
$209.79
|
|
Antibody bacterium, not elsewhere specified
|
$47.95 |
$47.95 |
$47.95 |
$57.89
|
|
Antibody elution rbc reference
|
$82.87 |
$82.87 |
$82.87 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$39.00 |
$39.00 |
$39.00 |
$141.74
|
|
Antibody htlv-i
|
$40.73 |
$40.73 |
$40.73 |
$48.75
|
|
Antibody id rbc panel
|
$466.74 |
$466.74 |
$466.74 |
$291.75
|
|
Antibody screen rbc
|
$609.00 |
$609.00 |
$609.00 |
$105.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.72 |
$2.72 |
$2.72 |
$3.12
|
|
Antistreptolysin o screen
|
$176.07 |
$176.07 |
$176.07 |
$59.40
|
|
Antistreptolysin o titer
|
$4.50 |
$4.50 |
$4.50 |
$57.96
|
|
Antithrombin iii activity
|
$177.12 |
$177.12 |
$177.12 |
$115.23
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$2,829.69 |
$2,829.69 |
$2,829.69 |
$5,013.11
|
|
Antithymocyte globuln rabbit
|
$3,472.50 |
$3,472.50 |
$3,472.50 |
$1,679.21
|
|
Apheresis plasma
|
$3,080.36 |
$3,080.36 |
$3,080.36 |
$3,411.50
|
|
Apheresis platelets
|
$2,520.88 |
$2,520.88 |
$2,520.88 |
$2,345.00
|
|
Apheresis rbc
|
$3,250.39 |
$3,250.39 |
$3,250.39 |
$3,348.50
|
|
Apheresis wbc
|
$3,250.39 |
$3,250.39 |
$3,250.39 |
$3,342.71
|
|
Artery xray each vessel 7577426
|
$2,137.20 |
$2,137.20 |
$2,137.20 |
$1,752.53
|
|
Artery xray of abdomen 75726-26
|
$2,137.20 |
$2,137.20 |
$2,137.20 |
$4,337.45
|
|
Artery x-rays adrenals
|
$7,700.42 |
$7,700.42 |
$7,700.42 |
$3,706.68
|
|
Artery x-rays arms/legs 75716-26
|
$2,137.20 |
$2,137.20 |
$2,137.20 |
$3,844.10
|
|
Artery x-rays lung
|
$2,137.20 |
$2,137.20 |
$2,137.20 |
$2,332.57
|
|
Artery x-rays lungs
|
$2,635.78 |
$2,635.78 |
$2,635.78 |
$3,686.58
|
|
Artery xrays of pelvis 75736 26
|
$11,029.19 |
$11,029.19 |
$11,029.19 |
$4,086.49
|
|
Artery x-rays spine
|
$11,029.19 |
$11,029.19 |
$11,029.19 |
$4,306.40
|
|
Assay acid phosphatase
|
$225.10 |
$225.10 |
$225.10 |
$38.22
|
|
Assay free hydroxyproline
|
$24.40 |
$24.40 |
$24.40 |
$46.15
|
|
Assay of feces porphyrins
|
$50.42 |
$50.42 |
$50.42 |
$168.62
|
|
Assay of lap enzyme
|
$4.26 |
$4.26 |
$4.26 |
$56.25
|
|
Assay of salicylate
|
$112.77 |
$112.77 |
$112.77 |
$105.95
|
|
Assay of somatostatin
|
$149.40 |
$149.40 |
$149.40 |
$165.75
|
|
Assay of thiocyanate
|
$57.00 |
$57.00 |
$57.00 |
$57.00
|
|
Assay of urine urobilinogen
|
$4.26 |
$4.26 |
$4.26 |
$10.51
|
|
Assay phosphatidylglycerol
|
$9.02 |
$9.02 |
$9.02 |
$87.20
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$1,254.30 |
$1,254.30 |
$1,254.30 |
$312.00
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$40,965.33 |
$40,965.33 |
$40,965.33 |
$31,208.35
|
|
Atropine 0.1 mg/ml injection syringe
|
$16.19 |
$16.19 |
$16.19 |
$43.01
|
|
Audiometry air + bone
|
$189.29 |
$189.29 |
$189.29 |
$176.93
|
|
Azacitidine injection
|
$1,056.08 |
$1,056.08 |
$1,056.08 |
$912.29
|
|
Azathioprine 50 mg tablet
|
$67.76 |
$67.76 |
$67.76 |
$6.76
|
|
Azathioprine parenteral
|
$1,435.85 |
$1,435.85 |
$1,435.85 |
$441.40
|
|
Azithromycin 500 mg intravenous solution
|
$505.73 |
$505.73 |
$505.73 |
$52.69
|
