|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$169.56 |
$169.56 |
$169.56 |
$43.65
|
|
Dextrose 5 % IV bolus
|
$171.72 |
$171.72 |
$171.72 |
$68.25
|
|
Diab manage trn ind/group
|
$327.89 |
$327.89 |
$327.89 |
$49.50
|
|
Diagnostic Mammogram (both breasts)
|
$1,144.04 |
$1,144.04 |
$1,144.04 |
$403.32
|
|
Dialysis one evaluation
|
$1,041.88 |
$1,041.88 |
$1,041.88 |
$827.97
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$54.00 |
$54.00 |
$54.00 |
$67.89
|
|
Dicyclomine injection
|
$227.88 |
$227.88 |
$227.88 |
$210.00
|
|
Diffusing capacity
|
$1,091.79 |
$1,091.79 |
$1,091.79 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$21.60 |
$21.60 |
$21.60 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$9,155.16 |
$9,155.16 |
$9,155.16 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$142.42 |
$142.42 |
$142.42 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$385.56 |
$385.56 |
$385.56 |
$308.90
|
|
Dimenhydrinate injection
|
$38.88 |
$38.88 |
$38.88 |
$24.68
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$8.64 |
$8.64 |
$8.64 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$237.60 |
$237.60 |
$237.60 |
$100.80
|
|
Disability dlco
|
$940.58 |
$940.58 |
$940.58 |
$302.40
|
|
Disaccharidases
|
$200.09 |
$200.09 |
$200.09 |
$224.58
|
|
Dna probe chlamydia
|
$3.83 |
$3.83 |
$3.83 |
$82.20
|
|
Dna probe gc
|
$3.83 |
$3.83 |
$3.83 |
$88.67
|
|
Dna trichomonas
|
$108.94 |
$108.94 |
$108.94 |
$68.50
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$3,663.36 |
$3,663.36 |
$3,663.36 |
$712.02
|
|
Doppler echo complete
|
$2,436.74 |
$2,436.74 |
$2,436.74 |
$644.00
|
|
Dornase alfa non-comp unit
|
$615.16 |
$615.16 |
$615.16 |
$500.29
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$119.88 |
$119.88 |
$119.88 |
$232.80
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$116.14 |
$116.14 |
$116.14 |
$89.34
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$374.63 |
$374.63 |
$374.63 |
$2,458.05
|
|
Droperidol 2.5 mg/ml injection solution
|
$10.80 |
$10.80 |
$10.80 |
$33.99
|
|
Drug assay voriconazole
|
$75.33 |
$75.33 |
$75.33 |
$96.75
|
|
Drug of abuse screen urine
|
$550.00 |
$550.00 |
$550.00 |
$63.75
|
|
Drug test def 22+ classes
|
$1,027.52 |
$1,027.52 |
$1,027.52 |
$246.92
|
|
Drug test def 8-14 classes
|
$653.24 |
$653.24 |
$653.24 |
$172.25
|
|
Ecg external < 48 hours recording
|
$5,675.44 |
$5,675.44 |
$5,675.44 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$4,331.49 |
$4,331.49 |
$4,331.49 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$10,088.45 |
$10,088.45 |
$10,088.45 |
$2,049.45
|
|
Echocardiography transthoracic 2d followup/limited
|
$5,187.43 |
$5,187.43 |
$5,187.43 |
$773.30
|
|
Echograp trans r pros study
|
$4,279.18 |
$4,279.18 |
$4,279.18 |
$445.25
|
|
Echo guide for amniocentesis
|
$1,715.47 |
$1,715.47 |
$1,715.47 |
$377.11
|
|
Echo guide for artery repair
|
$5,120.28 |
$5,120.28 |
$5,120.28 |
$676.80
|
|
Echo stress
|
$6,963.21 |
$6,963.21 |
$6,963.21 |
$1,607.45
|
|
Eeg 41-60 minutes 95812-26
|
$1,373.70 |
$1,373.70 |
$1,373.70 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$8,405.21 |
$8,405.21 |
$8,405.21 |
$1,048.30
|
|
Eeg during surgery
|
$5,446.31 |
$5,446.31 |
$5,446.31 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$5,440.80 |
$5,440.80 |
$5,440.80 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$2,726.46 |
$2,726.46 |
$2,726.46 |
$1,100.40
|
|
Eeg recording awake and asleep
|
$7,951.35 |
$7,951.35 |
$7,951.35 |
$1,030.27
|
|
Electrolyte panel
|
$238.93 |
$238.93 |
$238.93 |
$86.33
|
|
Electrophysiologic study
|
$9,579.51 |
$9,579.51 |
$9,579.51 |
$6,758.40
|
|
Electrophysiology evaluation
|
$37,689.04 |
$37,689.04 |
$37,689.04 |
$8,979.45
|
|
Electrophysiology evaluation
|
$37,505.07 |
$37,505.07 |
$37,505.07 |
$11,542.01
|
|
Electrophysiology evaluation
|
$11,727.63 |
$11,727.63 |
$11,727.63 |
$8,393.40
|
|
Electrophysiology evaluation
|
$33,365.26 |
$33,365.26 |
$33,365.26 |
$6,516.00
|
|
Electrophysiology evaluation
|
$5,159.89 |
$5,159.89 |
$5,159.89 |
$2,845.10
|
|
Electrophysiology evaluation
|
$3,656.21 |
$3,656.21 |
$3,656.21 |
$2,630.40
|
|
Electrophys map 3d add-on
|
$30,838.19 |
$30,838.19 |
$30,838.19 |
$6,534.00
|
|
Embolization s&i
|
$10,409.10 |
$10,409.10 |
$10,409.10 |
$2,745.08
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$2,183.37 |
$2,183.37 |
$2,183.37 |
$436.64
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$2,604.18 |
$2,604.18 |
$2,604.18 |
$512.85
|
|
Emg needle test 1-extremity
|
$1,719.60 |
$1,719.60 |
$1,719.60 |
$340.80
|
|
Emg needle test 4-extremities
|
$3,406.15 |
$3,406.15 |
$3,406.15 |
$547.00
|
|
Endo cath bile duct s&i
|
$4,463.52 |
$4,463.52 |
$4,463.52 |
$545.37
|
|
Entamoeba histolytica ag eia - sendout
|
$48.53 |
$48.53 |
$48.53 |
$66.60
|
|
Ep & ablate supravent arrhyt
|
$99,585.74 |
$99,585.74 |
$99,585.74 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$99,585.74 |
$99,585.74 |
$99,585.74 |
$30,975.00
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$45.12 |
$45.12 |
$45.12 |
$59.36
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$4.50 |
$4.50 |
$4.50 |
$441.60
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$39.48 |
$39.48 |
$39.48 |
$46.16
|
|
Epoetin alfa, 100 units esrd
|
$15.12 |
$15.12 |
$15.12 |
$41.32
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$595.08 |
$595.08 |
$595.08 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$178.20 |
$178.20 |
$178.20 |
$232.84
|
|
Esophageal dilat s&i
|
$1,839.06 |
$1,839.06 |
$1,839.06 |
$525.00
|
|
Esophagus motility study
|
$5,653.12 |
$5,653.12 |
$5,653.12 |
$1,274.00
|
|
Estrogens total-sendout
|
$25.78 |
$25.78 |
$25.78 |
$89.25
|
|
Ethanolamine oleate 100 mg
|
$1,399.68 |
$1,399.68 |
$1,399.68 |
$933.59
|
|
Ethylene glycol -sendout
|
$17.86 |
$17.86 |
$17.86 |
$78.00
|
|
Euglobulin lysis
|
$66.74 |
$66.74 |
$66.74 |
$37.70
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$489.63 |
$489.63 |
$489.63 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$157.53 |
$157.53 |
$157.53 |
$347.75
|
|
Evoked potentials upper limbs
|
$4,493.43 |
$4,493.43 |
$4,493.43 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$5,708.49 |
$5,708.49 |
$5,708.49 |
$844.00
|
|
Exercise tst brncspsm w/ecg
|
$665.97 |
$665.97 |
$665.97 |
$306.08
|
|
F-18 fdg pet diag
|
$2,275.91 |
$2,275.91 |
$2,275.91 |
$609.85
|
|
Facial bones <3
|
$1,986.96 |
$1,986.96 |
$1,986.96 |
$241.75
|
|
Factor ix complex
|
$3.24 |
$3.24 |
$3.24 |
$3.23
|
|
Factor viii
|
$4.32 |
$4.32 |
$4.32 |
$1.60
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$3.00 |
$3.00 |
$3.00 |
$22.20
|
|
Feeding tube reposition
|
$9,139.20 |
$9,139.20 |
$9,139.20 |
$438.70
|
|
Felbamate (felbatol(r)) - sendout
|
$21.78 |
$21.78 |
$21.78 |
$66.43
|
|
Fetal biophys profile w/nst 76818
|
$3,047.22 |
$3,047.22 |
$3,047.22 |
$541.74
|
|
Fetal fibronectin
|
$1,036.94 |
$1,036.94 |
$1,036.94 |
$342.47
|
|
Fetal hemoglobin (kleihauer betke)
|
$48.26 |
$48.26 |
$48.26 |
$85.00
|
|
Fetal hemoglobin rosette
|
$142.42 |
$142.42 |
$142.42 |
$74.25
|
|
Fetal non stress test
|
$1,201.85 |
$1,201.85 |
$1,201.85 |
$500.57
|
|
Fibrin degradation d dimer quantitative
|
$177.73 |
$177.73 |
$177.73 |
$111.55
|
|
Fibrin degradation products
|
$177.73 |
$177.73 |
$177.73 |
$63.90
|
|
Fibrin degrade semiquant
|
$177.73 |
$177.73 |
$177.73 |
$90.35
|
|
Fibrinolytic antiplasmin
|
$58.85 |
$58.85 |
$58.85 |
$56.00
|
|
Fibrinolytic plasminogen
|
$29.43 |
$29.43 |
$29.43 |
$112.02
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$64.97 |
$64.97 |
$64.97 |
$59.89
|
|
Flecainide (tambocor)-sendout
|
$15.68 |
$15.68 |
$15.68 |
$66.43
|
|
Flow cytometry marker each additional
|
$30.05 |
$30.05 |
$30.05 |
$102.00
|
