|
11-desoxycortisol - sendout
|
$84.74 |
$84.74 |
$84.74 |
$87.50
|
|
17-ketosteroids
|
$30.40 |
$30.40 |
$30.40 |
$44.00
|
|
2nd order venous cath
|
$1,444.91 |
$1,444.91 |
$1,444.91 |
$1,809.60
|
|
3-d radiotherapy plan
|
$6,556.53 |
$6,556.53 |
$6,556.53 |
$4,886.50
|
|
5' nucleotidase - sendout
|
$21.72 |
$21.72 |
$21.72 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$226.50 |
$226.50 |
$226.50 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$28.37 |
$28.37 |
$28.37 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$11,911.49 |
$11,911.49 |
$11,911.49 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$2,303.64 |
$2,303.64 |
$2,303.64 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$2,303.64 |
$2,303.64 |
$2,303.64 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$2,303.64 |
$2,303.64 |
$2,303.64 |
$3,050.58
|
|
Abd/low ext cath addl
|
$963.08 |
$963.08 |
$963.08 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$5,726.68 |
$5,726.68 |
$5,726.68 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$4,886.85 |
$4,886.85 |
$4,886.85 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$4,602.68 |
$4,602.68 |
$4,602.68 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$6,035.46 |
$6,035.46 |
$6,035.46 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$6,281.01 |
$6,281.01 |
$6,281.01 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$5,029.17 |
$5,029.17 |
$5,029.17 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$1,949.28 |
$1,949.28 |
$1,949.28 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$2,232.63 |
$2,232.63 |
$2,232.63 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$1,647.89 |
$1,647.89 |
$1,647.89 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$1,170.28
|
|
Ablate bone tumor(s) cryo perq 20983
|
$7,231.58 |
$7,231.58 |
$7,231.58 |
$7,896.23
|
|
Abscess drain retroperitoneal surg code
|
$6,376.15 |
$6,376.15 |
$6,376.15 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$84.69 |
$84.69 |
$84.69 |
$125.63
|
|
Acetaminophen level
|
$1,367.70 |
$1,367.70 |
$1,367.70 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$124.38 |
$124.38 |
$124.38 |
$133.60
|
|
Acetone qualitative
|
$116.46 |
$116.46 |
$116.46 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$129.08 |
$129.08 |
$129.08 |
$65.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$60.15 |
$60.15 |
$60.15 |
$323.77
|
|
Acute hepatitis panel
|
$278.33 |
$278.33 |
$278.33 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$34.46 |
$34.46 |
$34.46 |
$50.70
|
|
#acylcarnitineprfl
|
$434.13 |
$434.13 |
$434.13 |
$105.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$367.70 |
$367.70 |
$367.70 |
$219.86
|
|
Adh-sendout
|
$34.77 |
$34.77 |
$34.77 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$30.24 |
$30.24 |
$30.24 |
$124.70
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$353.91 |
$353.91 |
$353.91 |
$264.00
|
|
Administration immunization 1 vaccine
|
$180.21 |
$180.21 |
$180.21 |
$70.52
|
|
Administration immunization each additional vaccine
|
$178.11 |
$178.11 |
$178.11 |
$46.23
|
|
Administration vaccine influenza virus
|
$275.07 |
$275.07 |
$275.07 |
$49.50
|
|
Albumin body fluid quantitative each specimen
|
$434.13 |
$434.13 |
$434.13 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$1,196.81 |
$1,196.81 |
$1,196.81 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$751.97 |
$751.97 |
$751.97 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$1,207.49 |
$1,207.49 |
$1,207.49 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$434.13 |
$434.13 |
$434.13 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$434.13 |
$434.13 |
$434.13 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$24.69 |
$24.69 |
$24.69 |
$22.45
|
|
Albuterol non-comp unit
|
$7.02 |
$7.02 |
$7.02 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$339.82 |
$339.82 |
$339.82 |
$93.60
|
|
Alkaline phosphatase
|
$146.62 |
$146.62 |
$146.62 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$107.15 |
$107.15 |
$107.15 |
$56.35
|
|
Allergen egg white ige
|
$54.61 |
$54.61 |
$54.61 |
$41.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$6,839.54 |
$6,839.54 |
$6,839.54 |
$905.18
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,319.51 |
$1,319.51 |
$1,319.51 |
$3,025.07
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$434.13 |
$434.13 |
$434.13 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$181.10 |
$181.10 |
$181.10 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$369.49 |
$369.49 |
$369.49 |
$2,600.22
|
|
Alt/sgpt
|
$131.13 |
$131.13 |
$131.13 |
$49.00
|
|
Aluminum - quest
|
$434.13 |
$434.13 |
$434.13 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$306.00 |
$306.00 |
$306.00 |
$196.20
|
|
Aminolevulinic acid delta
|
$154.61 |
$154.61 |
$154.61 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$29.67 |
$29.67 |
$29.67 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$291.12 |
$291.12 |
$291.12 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$50.01 |
$50.01 |
$50.01 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$293.78 |
$293.78 |
$293.78 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$24,090.57 |
$24,090.57 |
$24,090.57 |
$15,167.75
|
|
Ammonia
|
$300.26 |
$300.26 |
$300.26 |
$120.90
|
|
Amphetamines 5 or more
|
$201.94 |
$201.94 |
$201.94 |
$101.40
|
|
Ampicillin 1 gram solution for injection
|
$63.06 |
$63.06 |
$63.06 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$118.04 |
$118.04 |
$118.04 |
$51.93
|
|
Amylase
|
$323.64 |
$323.64 |
$323.64 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$228.13 |
$228.13 |
$228.13 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$254.81 |
$254.81 |
$254.81 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$123.34 |
$123.34 |
$123.34 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$161.76 |
$161.76 |
$161.76 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$8,459.19 |
$8,459.19 |
$8,459.19 |
$2,626.65
|
|
An fluoro guide for cvp
|
$1,015.10 |
$1,015.10 |
$1,015.10 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$9,961.02 |
$9,961.02 |
$9,961.02 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$20,548.48 |
$20,548.48 |
$20,548.48 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$21,117.66 |
$21,117.66 |
$21,117.66 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$44,790.43 |
$44,790.43 |
$44,790.43 |
$6,513.10
|
|
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
|
$42,693.72 |
$42,693.72 |
$42,693.72 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ini
|
$21,117.23 |
$21,117.23 |
$21,117.23 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$19,042.78 |
$19,042.78 |
$19,042.78 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$21,117.23 |
$21,117.23 |
$21,117.23 |
$8,689.20
|
|
Ankle X-ray
|
$805.86 |
$805.86 |
$805.86 |
$339.44
|
|
Antibody elution rbc reference
|
$218.59 |
$218.59 |
$218.59 |
$176.54
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$427.16 |
$427.16 |
$427.16 |
$220.73
|
|
Antibody id rbc panel
|
$735.09 |
$735.09 |
$735.09 |
$291.75
|
|
Antibody screen rbc
|
$155.37 |
$155.37 |
$155.37 |
$105.00
|
|
Antidepressant not specified
|
$402.26 |
$402.26 |
$402.26 |
$89.50
|
|
Anti mog serum - sendout
|
$380.63 |
$380.63 |
$380.63 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$34.88 |
$34.88 |
$34.88 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$34.88 |
$34.88 |
$34.88 |
$45.82
|
|
Antinuclear antibodies
|
$199.30 |
$199.30 |
$199.30 |
$91.70
|
|
Antinuclear antibodies titer
|
$38.20 |
$38.20 |
$38.20 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$32.95 |
$32.95 |
$32.95 |
$74.20
|
|
Antistreptolysin o screen
|
$10.74 |
$10.74 |
$10.74 |
$59.40
|
|
Antistreptolysin o titer
|
$22.19 |
$22.19 |
$22.19 |
$57.96
|
