|
17-hydroxypregnenolone
|
$59.41 |
$59.41 |
$59.41 |
$85.15
|
|
2nd order venous cath
|
$1,173.95 |
$1,173.95 |
$1,173.95 |
$1,809.60
|
|
3-d radiotherapy plan
|
$8,244.55 |
$8,244.55 |
$8,244.55 |
$4,886.50
|
|
5' nucleotidase - sendout
|
$29.04 |
$29.04 |
$29.04 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$160.40 |
$160.40 |
$160.40 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$16.56 |
$16.56 |
$16.56 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$5,632.73 |
$5,632.73 |
$5,632.73 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$1,517.14 |
$1,517.14 |
$1,517.14 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$1,556.40 |
$1,556.40 |
$1,556.40 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$1,690.63 |
$1,690.63 |
$1,690.63 |
$3,050.58
|
|
Abd/low ext cath addl
|
$511.61 |
$511.61 |
$511.61 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$4,584.28 |
$4,584.28 |
$4,584.28 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$3,804.32 |
$3,804.32 |
$3,804.32 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$3,200.73 |
$3,200.73 |
$3,200.73 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$6,482.38 |
$6,482.38 |
$6,482.38 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$4,872.85 |
$4,872.85 |
$4,872.85 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$3,503.34 |
$3,503.34 |
$3,503.34 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$1,807.48 |
$1,807.48 |
$1,807.48 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$1,957.99 |
$1,957.99 |
$1,957.99 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$1,126.70 |
$1,126.70 |
$1,126.70 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$1,783.06 |
$1,783.06 |
$1,783.06 |
$1,170.28
|
|
Abl1 gene
|
$1,852.83 |
$1,852.83 |
$1,852.83 |
$609.93
|
|
Ablate bone tumor(s) perq
|
$18,836.38 |
$18,836.38 |
$18,836.38 |
$9,812.40
|
|
Abscess drain retroperitoneal surg code
|
$4,759.83 |
$4,759.83 |
$4,759.83 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$107.87 |
$107.87 |
$107.87 |
$125.63
|
|
Acetaminophen level
|
$70.91 |
$70.91 |
$70.91 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$204.09 |
$204.09 |
$204.09 |
$133.60
|
|
Acetylcholine receptor modulating antibody
|
$107.25 |
$107.25 |
$107.25 |
$65.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$88.25 |
$88.25 |
$88.25 |
$323.77
|
|
Acute hepatitis panel
|
$265.08 |
$265.08 |
$265.08 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$42.09 |
$42.09 |
$42.09 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$642.92 |
$642.92 |
$642.92 |
$219.86
|
|
Adh-sendout
|
$133.57 |
$133.57 |
$133.57 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$34.45 |
$34.45 |
$34.45 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$338.19 |
$338.19 |
$338.19 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$338.19 |
$338.19 |
$338.19 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$995.19 |
$995.19 |
$995.19 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$446.60 |
$446.60 |
$446.60 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$388.37 |
$388.37 |
$388.37 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$347.91 |
$347.91 |
$347.91 |
$264.00
|
|
Administration immunization 1 vaccine
|
$139.17 |
$139.17 |
$139.17 |
$70.52
|
|
Administration immunization each additional vaccine
|
$51.20 |
$51.20 |
$51.20 |
$46.23
|
|
Administration vaccine influenza virus
|
$475.87 |
$475.87 |
$475.87 |
$49.50
|
|
_afb id by dna probe rflx ast
|
$73.53 |
$73.53 |
$73.53 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$295.94 |
$295.94 |
$295.94 |
$289.60
|
|
Air injection into abdomen 49400
|
$1,311.33 |
$1,311.33 |
$1,311.33 |
$531.49
|
|
Albumin body fluid quantitative each specimen
|
$20.26 |
$20.26 |
$20.26 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$862.91 |
$862.91 |
$862.91 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$514.56 |
$514.56 |
$514.56 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$823.85 |
$823.85 |
$823.85 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$88.03 |
$88.03 |
$88.03 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$81.05 |
$81.05 |
$81.05 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$29.91 |
$29.91 |
$29.91 |
$22.45
|
|
Albuterol non-comp unit
|
$8.09 |
$8.09 |
$8.09 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$291.28 |
$291.28 |
$291.28 |
$93.60
|
|
Alkaline phosphatase
|
$48.14 |
$48.14 |
$48.14 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$89.44 |
$89.44 |
$89.44 |
$56.35
|
|
Allergen egg white ige
|
$72.74 |
$72.74 |
$72.74 |
$41.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$596.64 |
$596.64 |
$596.64 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$102.13 |
$102.13 |
$102.13 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$814.22 |
$814.22 |
$814.22 |
$905.18
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$891.72 |
$891.72 |
$891.72 |
$4,101.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$263.53 |
$263.53 |
$263.53 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$155.23 |
$155.23 |
$155.23 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$646.15 |
$646.15 |
$646.15 |
$2,600.22
|
|
Alt/sgpt
|
$98.06 |
$98.06 |
$98.06 |
$49.00
|
|
Aluminum - quest
|
$112.23 |
$112.23 |
$112.23 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$293.71 |
$293.71 |
$293.71 |
$196.20
|
|
Aminolevulinic acid delta
|
$53.60 |
$53.60 |
$53.60 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$31.33 |
$31.33 |
$31.33 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$408.08 |
$408.08 |
$408.08 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$66.77 |
$66.77 |
$66.77 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$57.36 |
$57.36 |
$57.36 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$55,569.33 |
$55,569.33 |
$55,569.33 |
$15,167.75
|
|
Ammonia
|
$257.36 |
$257.36 |
$257.36 |
$120.90
|
|
Ampicillin 1 gram solution for injection
|
$78.99 |
$78.99 |
$78.99 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$152.40 |
$152.40 |
$152.40 |
$51.93
|
|
Amylase
|
$277.41 |
$277.41 |
$277.41 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$217.27 |
$217.27 |
$217.27 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$242.68 |
$242.68 |
$242.68 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$114.80 |
$114.80 |
$114.80 |
$95.45
|
|
An cholangiogram percutaneous compl
|
$1,084.04 |
$1,084.04 |
$1,084.04 |
$2,626.65
|
|
An fluoro guide for cvp
|
$476.15 |
$476.15 |
$476.15 |
$484.45
|
|
Angioplasty fem/pop unilat 37224
|
$14,520.43 |
$14,520.43 |
$14,520.43 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$14,520.43 |
$14,520.43 |
$14,520.43 |
$11,524.11
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$5,501.23 |
$5,501.23 |
$5,501.23 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$13,961.95 |
$13,961.95 |
$13,961.95 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ini
|
$14,070.86 |
$14,070.86 |
$14,070.86 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$14,305.01 |
$14,305.01 |
$14,305.01 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$14,070.86 |
$14,070.86 |
$14,070.86 |
$8,689.20
|
|
Ankle X-ray
|
$679.63 |
$679.63 |
$679.63 |
$339.44
|
|
Antibody elution rbc reference
|
$177.29 |
$177.29 |
$177.29 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$56.16 |
$56.16 |
$56.16 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$406.82 |
$406.82 |
$406.82 |
$220.73
|
|
Antibody id rbc panel
|
$630.08 |
$630.08 |
$630.08 |
$291.75
|
|
Antibody screen rbc
|
$101.31 |
$101.31 |
$101.31 |
$105.00
|
|
Antidepressant not specified
|
$95.43 |
$95.43 |
$95.43 |
$89.50
|
|
Anti mog serum - sendout
|
$362.50 |
$362.50 |
$362.50 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$33.22 |
$33.22 |
$33.22 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$33.22 |
$33.22 |
$33.22 |
$45.82
|