|
17-hydroxypregnenolone
|
$9.34 |
$9.34 |
$9.34 |
$85.15
|
|
3-d radiotherapy plan
|
$5,044.68 |
$5,044.68 |
$5,044.68 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$892.81 |
$892.81 |
$892.81 |
$427.34
|
|
5' nucleotidase - sendout
|
$4.44 |
$4.44 |
$4.44 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$14.34 |
$14.34 |
$180.58 |
$97.65
|
|
Abciximab injection
|
$7,309.44 |
$7,309.44 |
$7,309.44 |
$3,012.98
|
|
Abd aorta w/runoff s&i
|
$1,235.43 |
$1,235.43 |
$1,235.43 |
$3,667.71
|
|
Abdominal CT scan (with and without contrast)
|
$693.10 |
$693.10 |
$693.10 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$647.32 |
$647.32 |
$647.32 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$601.44 |
$601.44 |
$601.44 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$622.25 |
$622.25 |
$622.25 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$590.15 |
$590.15 |
$590.15 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$558.05 |
$558.05 |
$558.05 |
$1,972.66
|
|
Abdominal Ultrasound (complete)
|
$897.07 |
$897.07 |
$897.07 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$875.70 |
$875.70 |
$875.70 |
$603.33
|
|
Ablate arrhythmia add on
|
$111,983.04 |
$111,983.04 |
$111,983.04 |
$7,417.15
|
|
Ablate heart dysrhythm focus
|
$36,409.65 |
$36,409.65 |
$36,409.65 |
$10,008.58
|
|
Acetaminophen level
|
$117.11 |
$117.11 |
$117.11 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$48.29 |
$48.29 |
$567.00 |
$133.60
|
|
Acetone qualitative
|
$57.02 |
$57.02 |
$57.02 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$5.49 |
$5.49 |
$1,173.96 |
$323.77
|
|
Acoustic immitance testing
|
$293.93 |
$293.93 |
$293.93 |
$158.50
|
|
Acoustic refl threshold tst
|
$384.91 |
$384.91 |
$384.91 |
$83.79
|
|
Acute hepatitis panel
|
$163.91 |
$163.91 |
$844.67 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$48.29 |
$48.29 |
$567.00 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$57.11 |
$57.11 |
$57.11 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$29.23 |
$29.23 |
$96.23 |
$63.00
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$50.14 |
$50.14 |
$50.14 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$676.51 |
$676.51 |
$676.51 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,343.69 |
$1,343.69 |
$1,343.69 |
$672.03
|
|
Administration immunization 1 vaccine
|
$53.37 |
$53.37 |
$53.37 |
$70.52
|
|
Administration immunization each additional component
|
$25.62 |
$25.62 |
$25.62 |
$27.20
|
|
Administration immunization each additional vaccine
|
$52.63 |
$52.63 |
$52.63 |
$46.23
|
|
Administration immunization first component each vaccine
|
$51.80 |
$51.80 |
$51.80 |
$45.50
|
|
Administration vaccine hepatitis b
|
$211.12 |
$211.12 |
$211.12 |
$51.35
|
|
_afb id by dna probe rflx ast
|
$53.28 |
$53.28 |
$127.12 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$5.46 |
$5.46 |
$57.02 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$45.88 |
$45.88 |
$92.66 |
$289.60
|
|
Air conduction bilat
|
$346.42 |
$346.42 |
$346.42 |
$106.50
|
|
Airway resistance by impulse oscillometry 94728
|
$332.54 |
$332.54 |
$332.54 |
$276.66
|
|
Albumin body fluid quantitative each specimen
|
$76.04 |
$76.04 |
$76.04 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$65.89 |
$65.89 |
$65.89 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$252.12 |
$252.12 |
$252.12 |
$295.80
|
|
Albumin, human 5 % intravenous solution
|
$1,645.92 |
$1,645.92 |
$1,645.92 |
$248.88
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$4.75 |
$4.75 |
$29.88 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$19.61 |
$19.61 |
$19.61 |
$43.50
|
|
Albuterol non-comp con
|
$23.76 |
$23.76 |
$23.76 |
$15.00
|
|
Albuterol non-comp unit
|
$23.76 |
$23.76 |
$23.76 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$62.16 |
$62.16 |
$62.16 |
$93.60
|
|
Aldesleukin injection
|
$7,770.60 |
$7,770.60 |
$7,770.60 |
$6,446.09
|
|
Alkaline phosphatase
|
$7.77 |
$7.77 |
$7.77 |
$46.20
|
|
Allergen egg white ige
|
$4.75 |
$4.75 |
$44.03 |
$41.00
|
|
Allograft amnioexcel plus 17mm disk
|
$237.00 |
$237.00 |
$2,959.72 |
$2,959.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$131.00 |
$131.00 |
$35,164.80 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$3,035.85 |
$3,035.85 |
$3,035.85 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$11,539.93 |
$11,539.93 |
$11,539.93 |
$2,513.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$7,255.61 |
$7,255.61 |
$7,255.61 |
$4,101.14
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$5,849.05 |
$5,849.05 |
$5,849.05 |
$3,025.07
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$32.40 |
$32.40 |
$32.40 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$27.20 |
$27.20 |
$318.38 |
$99.00
|
|
Alprostadil for injection
|
$2,376.00 |
$2,376.00 |
$2,376.00 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$192.51 |
$192.51 |
$192.51 |
$2,600.22
|
|
Alt/sgpt
|
$21.09 |
$21.09 |
$21.09 |
$49.00
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$50.00 |
$50.00 |
$50.00 |
$36.30
|
|
Amino acids quant 2-5
|
$40.15 |
$40.15 |
$40.15 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$36.00 |
$36.00 |
$36.00 |
$42.84
|
|
Aminolevulinic acid delta
|
$15.73 |
$15.73 |
$15.73 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$47.95 |
$47.95 |
$47.95 |
$41.59
|
|
Amiodarone 50 mg/ml intravenous solution
|
$15.32 |
$15.32 |
$15.32 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$20.20 |
$20.20 |
$20.20 |
$101.17
|
|
Ammonia
|
$75.02 |
$75.02 |
$75.02 |
$120.90
|
|
Amphetamine confirm urine -sendout
|
$42.37 |
$42.37 |
$42.37 |
$94.50
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$107.44 |
$107.44 |
$314.28 |
$130.08
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$47.33 |
$47.33 |
$2,032.56 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$159.84 |
$159.84 |
$159.84 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$79.34 |
$79.34 |
$79.34 |
$51.93
|
|
Amylase
|
$58.09 |
$58.09 |
$58.09 |
$93.00
|
|
Ana ds-dna
|
$5.92 |
$5.92 |
$5.92 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$117.11 |
$117.11 |
$117.11 |
$110.98
|
|
Analysis gene f2 20210g>a variant
|
$39.20 |
$39.20 |
$39.20 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$36.83 |
$36.83 |
$36.83 |
$226.60
|
|
Analysis nerve
|
$679.54 |
$679.54 |
$679.54 |
$223.19
|
|
Analysis tumor
|
$57.72 |
$57.72 |
$57.72 |
$240.00
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$514.86 |
$514.86 |
$514.86 |
$411.45
|
|
Anca screen with reflex to titer -quest
|
$19.89 |
$19.89 |
$19.89 |
$109.20
|
|
An fluoro guide for cvp
|
$419.67 |
$419.67 |
$419.67 |
$484.45
|
|
Anidulafungin injection
|
$1.59 |
$1.59 |
$1.59 |
$209.79
|
|
Ankle X-ray
|
$206.83 |
$206.83 |
$206.83 |
$339.44
|
|
Ans parasymp & symp w/tilt
|
$158.82 |
$158.82 |
$158.82 |
$366.72
|
|
Antibody bacterium, not elsewhere specified
|
$19.06 |
$19.06 |
$29.70 |
$57.89
|
|
Antibody elution rbc reference
|
$77.52 |
$77.52 |
$77.52 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$24.42 |
$24.42 |
$24.42 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$122.10 |
$122.10 |
$122.10 |
$220.73
|
|
Antibody id rbc panel
|
$87.32 |
$87.32 |
$87.32 |
$291.75
|
|
Antibody screen rbc
|
$32.75 |
$32.75 |
$32.75 |
$105.00
|
|
Antidepressant not specified
|
$12.95 |
$12.95 |
$12.95 |
$89.50
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$190.18 |
$190.18 |
$190.18 |
$3.12
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$17.83 |
$17.83 |
$17.83 |
$45.82
|
|
Antinuclear antibodies
|
$116.09 |
$116.09 |
$116.09 |
$91.70
|
|
Antinuclear antibodies titer
|
$15.82 |
$15.82 |
$209.09 |
$80.25
|
