|
Autologous blood process
|
$80.75 |
$80.75 |
$80.75 |
$234.27
|
|
Automated diff wbc count
|
$201.25 |
$201.25 |
$201.25 |
$34.39
|
|
Azathioprine 50 mg tablet
|
$13.00 |
$13.00 |
$13.00 |
$6.76
|
|
Azithromycin 500 mg intravenous solution
|
$95.00 |
$95.00 |
$95.00 |
$52.69
|
|
Bactericidal level serum
|
$483.25 |
$483.25 |
$483.25 |
$82.50
|
|
Bartonella dna pcr-sendout
|
$162.00 |
$162.00 |
$162.00 |
$196.20
|
|
Benztropine 1 mg/ml injection solution
|
$169.00 |
$169.00 |
$169.00 |
$121.88
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$58.00 |
$58.00 |
$58.00 |
$75.12
|
|
B-hexosaminidase ea assay
|
$490.25 |
$490.25 |
$490.25 |
$104.25
|
|
Bile acids cholylglycine
|
$525.25 |
$525.25 |
$525.25 |
$53.60
|
|
Bilicheck
|
$146.75 |
$146.75 |
$146.75 |
$25.20
|
|
Biotinidase - quest
|
$513.00 |
$513.00 |
$513.00 |
$72.80
|
|
Bivalirudin
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$1,246.70
|
|
Blood Clotting (PT/INR) Test
|
$124.75 |
$124.75 |
$124.75 |
$51.35
|
|
Blood Count (CBC) Test (without differential)
|
$610.00 |
$610.00 |
$610.00 |
$62.28
|
|
Blood count spun microhematocrit
|
$78.75 |
$78.75 |
$78.75 |
$20.40
|
|
Blood Culture Test
|
$1,058.25 |
$1,058.25 |
$1,058.25 |
$144.65
|
|
Blood draw capillary 36416
|
$143.00 |
$143.00 |
$143.00 |
$22.32
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$236.25 |
$236.25 |
$236.25 |
$33.57
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$20.00 |
$20.00 |
$20.00 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$362.25 |
$362.25 |
$362.25 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$818.25 |
$818.25 |
$818.25 |
$37.44
|
|
Blood typing patient serum
|
$151.00 |
$151.00 |
$151.00 |
$70.29
|
|
Bone Density Scan (DEXA)
|
$1,940.50 |
$1,940.50 |
$1,940.50 |
$395.00
|
|
Bone marrow imaging ltd
|
$1,839.25 |
$1,839.25 |
$1,839.25 |
$723.00
|
|
Bone marrow interpretation
|
$179.25 |
$179.25 |
$179.25 |
$439.78
|
|
Borrelia antibody
|
$406.25 |
$406.25 |
$406.25 |
$35.83
|
|
Braf gene
|
$809.25 |
$809.25 |
$809.25 |
$421.20
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$9,244.25 |
$9,244.25 |
$9,244.25 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$9,244.25 |
$9,244.25 |
$9,244.25 |
$1,998.00
|
|
Brain MRI (with contrast)
|
$10,076.25 |
$10,076.25 |
$10,076.25 |
$2,224.96
|
|
Buprenorphine and metabolite - sendout
|
$47.00 |
$47.00 |
$47.00 |
$99.72
|
|
Butorphanol tartrate 1 mg
|
$37.50 |
$37.50 |
$37.50 |
$39.89
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$91.00 |
$91.00 |
$91.00 |
$59.40
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$91.00 |
$91.00 |
$91.00 |
$45.30
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$123.00 |
$123.00 |
$123.00 |
$92.91
|
|
Calculi urinary-sendout
|
$12.75 |
$12.75 |
$12.75 |
$68.05
|
|
Campylobacter antibody
|
$395.25 |
$395.25 |
$395.25 |
$66.61
|
|
Candida dna
|
$386.50 |
$386.50 |
$386.50 |
$66.05
|
|
Candida skin test
|
$129.75 |
$129.75 |
$129.75 |
$39.77
|
|
Carbamazepine free
|
$406.25 |
$406.25 |
$406.25 |
$66.43
|
|
Carbamazepine total therapeutic drug level
|
$393.75 |
$393.75 |
$393.75 |
$113.25
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$706.00 |
$706.00 |
$706.00 |
$432.25
|
|
Carcinoembryonic ag (cea)
|
$232.50 |
$232.50 |
$232.50 |
$146.90
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$573.50 |
$573.50 |
$573.50 |
$254.80
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$2,504.75 |
$2,504.75 |
$2,504.75 |
$1,504.08
|
|
Catecholamines,fractionated, urine
|
$520.00 |
$520.00 |
$520.00 |
$55.20
|
|
Catheterization collection of specimen single patient all places of service
|
$20.00 |
$20.00 |
$20.00 |
$48.75
|
|
Ceftazidime and avibactam
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$935.40
|
|
#celiac hla-dq2
|
$437.00 |
$437.00 |
$437.00 |
$226.28
|
|
Cell marker study
|
$103.75 |
$103.75 |
$103.75 |
$239.85
|
|
Chest CT scan (with and without contrast)
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$2,021.80
|
|
Chest CT scan (with contrast)
|
$10,453.00 |
$10,453.00 |
$10,453.00 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$9,792.00 |
$9,792.00 |
$9,792.00 |
$1,350.03
|
|
Chest X-ray
|
$354.00 |
$354.00 |
$354.00 |
$294.06
|
|
Chest X-ray (single view)
|
$354.00 |
$354.00 |
$354.00 |
$229.08
|
|
Chlamydia culture
|
$513.00 |
$513.00 |
$513.00 |
$94.90
|
|
Chlamydia trachomatis ag if
|
$362.25 |
$362.25 |
$362.25 |
$30.40
|
|
Chlamydia type
|
$176.00 |
$176.00 |
$176.00 |
$34.75
|
|
Chloride
|
$249.00 |
$249.00 |
$249.00 |
$38.50
|
|
Chloride 24 hour urine
|
$47.50 |
$47.50 |
$47.50 |
$46.13
|
|
Chloroprocaine hcl injection
|
$91.00 |
$91.00 |
$91.00 |
$78.26
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$108.00 |
$108.00 |
$108.00 |
$89.81
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$4,128.50 |
$4,128.50 |
$4,128.50 |
$625.60
|
|
Cholesterol
|
$217.75 |
$217.75 |
$217.75 |
$46.15
|
|
Chromatogram assay sugars
|
$268.75 |
$268.75 |
$268.75 |
$53.82
|
|
Chromo high res and frag x - sendout
|
$263.25 |
$263.25 |
$263.25 |
$264.25
|
|
Chromosome analys amniotic
|
$1,103.25 |
$1,103.25 |
$1,103.25 |
$436.00
|
|
Chromosome analysis 100
|
$1,400.25 |
$1,400.25 |
$1,400.25 |
$321.44
|
|
Chromosome analysis 20-25
|
$4,056.75 |
$4,056.75 |
$4,056.75 |
$277.09
|
|
Chromosome analysis 45
|
$1,103.25 |
$1,103.25 |
$1,103.25 |
$367.29
|
|
Chromosome analysis 5
|
$1,429.25 |
$1,429.25 |
$1,429.25 |
$644.80
|
|
Chromosome analysis 50-100
|
$1,400.25 |
$1,400.25 |
$1,400.25 |
$301.50
|
|
Chromosome analys placenta
|
$1,453.00 |
$1,453.00 |
$1,453.00 |
$642.00
|
|
Chromosome count additional
|
$154.00 |
$154.00 |
$154.00 |
$110.00
|
|
Clostridium toxin a w/optic
|
$362.25 |
$362.25 |
$362.25 |
$17.60
|
|
Clot factor fletcher fact
|
$168.00 |
$168.00 |
$168.00 |
$88.20
|
|
Clot factor viii reltd antgn
|
$623.75 |
$623.75 |
$623.75 |
$95.72
|
|
Clot factor wght kininogen
|
$168.00 |
$168.00 |
$168.00 |
$134.81
|
|
Clot factor xii hageman
|
$578.50 |
$578.50 |
$578.50 |
$125.00
|
|
Clot factor xiii fibrin scrn
|
$268.75 |
$268.75 |
$268.75 |
$47.30
|
|
Clot factor xiii fibrin stab
|
$492.00 |
$492.00 |
$492.00 |
$84.27
|
|
#cms hgb-carboxyhemoglobin
|
$179.25 |
$179.25 |
$179.25 |
$19.42
|
|
#cms hgb-sulfhemoglobin
|
$179.25 |
$179.25 |
$179.25 |
$53.30
|
|
Cmv pcr-sendout
|
$896.50 |
$896.50 |
$896.50 |
$172.25
|
|
Colistimethate sodium inj
|
$217.00 |
$217.00 |
$217.00 |
$84.22
|
|
Collection of venous blood by venipuncture
|
$20.00 |
$20.00 |
$20.00 |
$21.66
|
|
Compatibility test each unit electronic
|
$164.50 |
$164.50 |
$164.50 |
$167.17
|
|
Compatibility test incubate
|
$289.25 |
$289.25 |
$289.25 |
$143.64
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,212.00 |
$1,212.00 |
$1,212.00 |
$792.24
|
|
Consultation pathology during surgery
|
$256.50 |
$256.50 |
$256.50 |
$112.45
|
|
Consultation pathology during surgery cytological exam initial site
|
$265.50 |
$265.50 |
$265.50 |
$402.05
|
|
Consult comp w/report rfrd material
|
$218.00 |
$218.00 |
$218.00 |
$345.71
|
|
Contrast exam abdominl aorta 75625-26
|
$8,980.50 |
$8,980.50 |
$8,980.50 |
$3,389.09
|
|
Contrast x-ray of hip
|
$2,567.00 |
$2,567.00 |
$2,567.00 |
$770.88
|
|
Cortisol acth stimulation test - sendout
|
$979.25 |
$979.25 |
$979.25 |
$120.13
|
|
Cosyntropin 0.25 mg solution for injection
|
$475.00 |
$475.00 |
$475.00 |
$258.83
|
|
Counseling smoke cess interm >10mins
|
$225.50 |
$225.50 |
$225.50 |
$57.60
|
|
C-peptide
|
$216.25 |
$216.25 |
$216.25 |
$100.26
|
|
C-reactive protein
|
$60.50 |
$60.50 |
$60.50 |
$61.10
|
