|
17-hydroxypregnenolone
|
$72.75 |
$72.75 |
$72.75 |
$85.15
|
|
5' nucleotidase - sendout
|
$9.37 |
$9.37 |
$9.37 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$594.18 |
$594.18 |
$594.18 |
$97.65
|
|
Abdominal CT scan (with contrast)
|
$11,944.83 |
$11,944.83 |
$11,944.83 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$10,750.86 |
$10,750.86 |
$10,750.86 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$10,439.28 |
$10,439.28 |
$10,439.28 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$6,110.71 |
$6,110.71 |
$6,110.71 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$3,515.46 |
$3,515.46 |
$3,515.46 |
$1,972.66
|
|
Abdominal Ultrasound (complete)
|
$5,763.52 |
$5,763.52 |
$5,763.52 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$4,919.49 |
$4,919.49 |
$4,919.49 |
$603.33
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$87.88 |
$87.88 |
$87.88 |
$125.63
|
|
Acetazolamide 500 mg solution for injection
|
$80.73 |
$80.73 |
$80.73 |
$133.60
|
|
Acetone qualitative
|
$547.21 |
$547.21 |
$547.21 |
$47.45
|
|
Acetylcysteine non-comp unit
|
$33.41 |
$33.41 |
$33.41 |
$29.01
|
|
Acute hepatitis panel
|
$415.23 |
$415.23 |
$415.23 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$14.04 |
$14.04 |
$14.04 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$13.16 |
$13.16 |
$13.16 |
$219.86
|
|
Adh-sendout
|
$14.66 |
$14.66 |
$14.66 |
$109.28
|
|
_afb id by dna probe rflx ast
|
$245.61 |
$245.61 |
$245.61 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$274.70 |
$274.70 |
$274.70 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$65.00 |
$65.00 |
$65.00 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$34.91 |
$34.91 |
$34.91 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$210.60 |
$210.60 |
$210.60 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$765.42 |
$765.42 |
$765.42 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$34.91 |
$34.91 |
$34.91 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$476.76 |
$476.76 |
$476.76 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$3.75 |
$3.75 |
$3.75 |
$22.45
|
|
Albuterol non-comp con
|
$3.75 |
$3.75 |
$3.75 |
$15.00
|
|
Albuterol non-comp unit
|
$0.35 |
$0.35 |
$0.35 |
$9.59
|
|
Alkaline phosphatase
|
$899.39 |
$899.39 |
$899.39 |
$46.20
|
|
Allergen egg white ige
|
$6.90 |
$6.90 |
$6.90 |
$41.00
|
|
Alpha-fetoprotein tumor marker
|
$68.50 |
$68.50 |
$68.50 |
$99.00
|
|
Aluminum - quest
|
$19.23 |
$19.23 |
$19.23 |
$87.00
|
|
Amino acid screen, urine
|
$12.55 |
$12.55 |
$12.55 |
$64.28
|
|
Aminolevulinic acid delta
|
$141.30 |
$141.30 |
$141.30 |
$87.12
|
|
Ammonia
|
$1,338.24 |
$1,338.24 |
$1,338.24 |
$120.90
|
|
Amylase
|
$1,587.50 |
$1,587.50 |
$1,587.50 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$28.51 |
$28.51 |
$28.51 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$26.06 |
$26.06 |
$26.06 |
$226.60
|
|
Analysis tumor
|
$1,047.10 |
$1,047.10 |
$1,047.10 |
$240.00
|
|
Antibody bacterium, not elsewhere specified
|
$80.50 |
$80.50 |
$80.50 |
$57.89
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$31.53 |
$31.53 |
$31.53 |
$220.73
|
|
Antibody tetanus
|
$22.47 |
$22.47 |
$22.47 |
$61.98
|
|
Antinuclear antibodies
|
$3.00 |
$3.00 |
$3.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$6.68 |
$6.68 |
$6.68 |
$80.25
|
|
Antistreptolysin o screen
|
$68.13 |
$68.13 |
$68.13 |
$59.40
|
|
Antithrombin iii activity
|
$68.50 |
$68.50 |
$68.50 |
$115.23
|
|
Assay acid phosphatase
|
$81.53 |
$81.53 |
$81.53 |
$38.22
|
|
Assay of adp & amp
|
$18.59 |
$18.59 |
$18.59 |
$127.40
|
|
Assay of corticosterone
|
$78.48 |
$78.48 |
$78.48 |
$47.10
|
|
Assay of interleukin-6 (il-6)
|
$2,272.90 |
$2,272.90 |
$2,272.90 |
$77.35
|
|
Assay of procainamide w/metab
|
$14.78 |
$14.78 |
$14.78 |
$61.20
|
|
Assay of sialic acid
|
$11.33 |
$11.33 |
$11.33 |
$60.45
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$747.69 |
$747.69 |
$747.69 |
$49.80
|
|
Ast/sgot
|
$533.69 |
$533.69 |
$533.69 |
$45.65
|
|
Azathioprine 50 mg tablet
|
$14.18 |
$14.18 |
$14.18 |
$6.76
|
|
Baclofen eval charges
|
$1,974.21 |
$1,974.21 |
$1,974.21 |
$86.14
|
|
Bacterial meningitis antigen
|
$69.83 |
$69.83 |
$69.83 |
$68.40
|
|
Benztropine 1 mg/ml injection solution
|
$122.43 |
$122.43 |
$122.43 |
$121.88
|
|
Beta-2 microglobulin
|
$154.44 |
$154.44 |
$154.44 |
$84.66
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$229.97 |
$229.97 |
$229.97 |
$75.12
|
|
Bilirubin direct
|
$953.58 |
$953.58 |
$953.58 |
$49.29
|
|
Bilirubin total
|
$967.12 |
$967.12 |
$967.12 |
$51.39
|
|
Blood Clotting (PT/INR) Test
|
$2,058.86 |
$2,058.86 |
$2,058.86 |
$51.35
|
|
Blood Clotting (PTT) Test
|
$2,210.55 |
$2,210.55 |
$2,210.55 |
$72.15
|
|
Blood Count (CBC) Test (without differential)
|
$674.55 |
$674.55 |
$674.55 |
$62.28
|
|
Blood draw capillary 36416
|
$1,435.79 |
$1,435.79 |
$1,435.79 |
$22.32
|
|
Blood gases ph venous
|
$357.60 |
$357.60 |
$357.60 |
$63.70
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$240.63 |
$240.63 |
$240.63 |
$33.57
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$577.01 |
$577.01 |
$577.01 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$214.27 |
$214.27 |
$214.27 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$577.01 |
$577.01 |
$577.01 |
$37.44
|
|
Blood typing ag donor ea ag
|
$1,435.79 |
$1,435.79 |
$1,435.79 |
$166.80
|
|
Blood typing rh phenotype complete reference
|
$13.33 |
$13.33 |
$13.33 |
$77.25
|
|
Bone/joint imaging ltd area
|
$8,941.27 |
$8,941.27 |
$8,941.27 |
$1,151.16
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$161.50 |
$161.50 |
$161.50 |
$98.57
|
|
(both sides) smear without diff wbc count
|
$186.91 |
$186.91 |
$186.91 |
$33.57
|
|
Bowel imaging
|
$4,410.54 |
$4,410.54 |
$4,410.54 |
$1,186.25
|
|
Brain image w/flow 4 + views
|
$7,785.10 |
$7,785.10 |
$7,785.10 |
$1,308.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$9,017.72 |
$9,017.72 |
$9,017.72 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$8,322.17 |
$8,322.17 |
$8,322.17 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$7,483.48 |
$7,483.48 |
$7,483.48 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$9,308.81 |
$9,308.81 |
$9,308.81 |
$2,854.80
|
|
Brain MRI (without contrast)
|
$7,665.63 |
$7,665.63 |
$7,665.63 |
$1,927.04
|
|
Budesonide non-comp unit
|
$21.97 |
$21.97 |
$21.97 |
$32.78
|
|
Bundled special stain group 1 microorganisms
|
$3,250.82 |
$3,250.82 |
$3,250.82 |
$164.89
|
|
Calcium 24 hour urine
|
$70.26 |
$70.26 |
$70.26 |
$52.00
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$59.40 |
$59.40 |
$59.40 |
$59.40
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$45.56 |
$45.56 |
$45.56 |
$45.30
|
|
Calcium ionized
|
$133.67 |
$133.67 |
$133.67 |
$86.35
|
|
Calculi urinary-sendout
|
$10.00 |
$10.00 |
$10.00 |
$68.05
|
|
Calprotectin fecal
|
$100.00 |
$100.00 |
$100.00 |
$170.00
|
|
Carbamazepine total therapeutic drug level
|
$1,489.96 |
$1,489.96 |
$1,489.96 |
$113.25
|
|
Carbon dioxide
|
$476.76 |
$476.76 |
$476.76 |
$44.82
|
|
Carboxyhemoglobin quantitative
|
$357.60 |
$357.60 |
$357.60 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$177.55 |
$177.55 |
$177.55 |
$146.90
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$8,438.60 |
$8,438.60 |
$8,438.60 |
$2,792.00
|
|
Carotene
|
$7.20 |
$7.20 |
$7.20 |
$46.80
|
|
Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr
|
$21.80 |
$21.80 |
$21.80 |
$29.03
|
|
Cell count body fluid
|
$1,471.02 |
$1,471.02 |
$1,471.02 |
$63.52
|
