|
11-desoxycortisol - sendout
|
$45.56 |
$45.56 |
$45.56 |
$87.50
|
|
17-hydroxypregnenolone
|
$42.60 |
$42.60 |
$42.60 |
$85.15
|
|
17-ketosteroids
|
$13.28 |
$13.28 |
$13.28 |
$44.00
|
|
3d ech img cgen car anomal
|
$1,827.60 |
$1,827.60 |
$1,827.60 |
$669.00
|
|
3-d radiotherapy plan
|
$5,602.00 |
$5,602.00 |
$5,602.00 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$670.00 |
$670.00 |
$670.00 |
$427.34
|
|
5' nucleotidase - sendout
|
$11.00 |
$11.00 |
$11.00 |
$50.05
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$51.60 |
$51.60 |
$51.60 |
$3,634.61
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$70.52 |
$70.52 |
$70.52 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$2,813.20 |
$2,813.20 |
$2,813.20 |
$3,667.71
|
|
Abdominal CT scan (with and without contrast)
|
$1,679.60 |
$1,679.60 |
$1,679.60 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$1,678.00 |
$1,678.00 |
$1,678.00 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,181.60 |
$1,181.60 |
$1,181.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$1,484.40 |
$1,484.40 |
$1,484.40 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$1,488.40 |
$1,488.40 |
$1,488.40 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$1,488.40 |
$1,488.40 |
$1,488.40 |
$1,972.66
|
|
Abdominal Ultrasound (complete)
|
$1,738.00 |
$1,738.00 |
$1,738.00 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$929.60 |
$929.60 |
$929.60 |
$603.33
|
|
Abl1 gene
|
$166.80 |
$166.80 |
$166.80 |
$609.93
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$0.16 |
$0.16 |
$0.16 |
$125.63
|
|
Acetazolamide 500 mg solution for injection
|
$40.16 |
$40.16 |
$40.16 |
$133.60
|
|
Acetone qualitative
|
$18.92 |
$18.92 |
$18.92 |
$47.45
|
|
Acetylcholinesterase assay
|
$45.80 |
$45.80 |
$45.80 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$4.36 |
$4.36 |
$4.36 |
$323.77
|
|
Acute hepatitis panel
|
$210.12 |
$210.12 |
$210.12 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$1.16 |
$1.16 |
$1.16 |
$50.70
|
|
#acylcarnitineprfl
|
$28.14 |
$28.14 |
$28.14 |
$105.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$2.80 |
$2.80 |
$2.80 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$31.60 |
$31.60 |
$31.60 |
$63.00
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$6.40 |
$6.40 |
$6.40 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$36.40 |
$36.40 |
$36.40 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$77.60 |
$77.60 |
$77.60 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$167.20 |
$167.20 |
$167.20 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$137.20 |
$137.20 |
$137.20 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$158.00 |
$158.00 |
$158.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$108.80 |
$108.80 |
$108.80 |
$264.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$28.68 |
$28.68 |
$28.68 |
$11,874.55
|
|
_afb id by dna probe rflx ast
|
$29.24 |
$29.24 |
$29.24 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$28.36 |
$28.36 |
$28.36 |
$38.58
|
|
Agalsidase beta 35 mg intravenous solution
|
$205.02 |
$205.02 |
$205.02 |
$13,696.68
|
|
Albumin body fluid quantitative each specimen
|
$9.36 |
$9.36 |
$9.36 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$288.40 |
$288.40 |
$288.40 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$45.32 |
$45.32 |
$45.32 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$108.03 |
$108.03 |
$108.03 |
$295.80
|
|
Albumin, human 5 % intravenous solution
|
$48.00 |
$48.00 |
$48.00 |
$248.88
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$24.76 |
$24.76 |
$24.76 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$20.80 |
$20.80 |
$20.80 |
$43.50
|
|
Albuterol non-comp con
|
$0.32 |
$0.32 |
$0.32 |
$15.00
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$2,158.84 |
$2,158.84 |
$2,158.84 |
$8,173.80
|
|
Alkaline phosphatase
|
$17.80 |
$17.80 |
$17.80 |
$46.20
|
|
Allergen egg white ige
|
$18.00 |
$18.00 |
$18.00 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$10.91 |
$10.91 |
$10.91 |
$26.95
|
|
Allograft amnioexcel plus 17mm disk
|
$9,044.72 |
$9,044.72 |
$9,044.72 |
$2,959.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$28,008.00 |
$28,008.00 |
$28,008.00 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$4,871.52 |
$4,871.52 |
$4,871.52 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$2,513.00 |
$2,513.00 |
$2,513.00 |
$2,513.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$5,779.00 |
$5,779.00 |
$5,779.00 |
$4,101.14
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$882.24 |
$882.24 |
$882.24 |
$3,025.07
|
|
Alloskin
|
$4,094.96 |
$4,094.96 |
$4,094.96 |
$759.00
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$9.36 |
$9.36 |
$9.36 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$28.61 |
$28.61 |
$28.61 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$194.16 |
$194.16 |
$194.16 |
$99.00
|
|
Alprostadil for injection
|
$1.20 |
$1.20 |
$1.20 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$80.24 |
$80.24 |
$80.24 |
$2,600.22
|
|
Alt/sgpt
|
$20.20 |
$20.20 |
$20.20 |
$49.00
|
|
Amantadine (symmetrel)-sendout
|
$98.40 |
$98.40 |
$98.40 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$40.28 |
$40.28 |
$40.28 |
$36.30
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$1.96 |
$1.96 |
$1.96 |
$42.84
|
|
Aminolevulinic acid delta
|
$16.93 |
$16.93 |
$16.93 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$11.16 |
$11.16 |
$11.16 |
$41.59
|
|
Amiodarone 50 mg/ml intravenous solution
|
$16.68 |
$16.68 |
$16.68 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$102.40 |
$102.40 |
$102.40 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$21.46 |
$21.46 |
$21.46 |
$15,167.75
|
|
Ammonia
|
$31.92 |
$31.92 |
$31.92 |
$120.90
|
|
Amniotic fluid scan
|
$9.67 |
$9.67 |
$9.67 |
$33.15
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$82.52 |
$82.52 |
$82.52 |
$130.08
|
|
Amphotericin b lipid complex
|
$26.00 |
$26.00 |
$26.00 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$50.44 |
$50.44 |
$50.44 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$18.96 |
$18.96 |
$18.96 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$33.32 |
$33.32 |
$33.32 |
$51.93
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$166.40 |
$166.40 |
$166.40 |
$312.00
|
|
Amylase
|
$29.40 |
$29.40 |
$29.40 |
$93.00
|
|
Ana ds-dna
|
$6.44 |
$6.44 |
$6.44 |
$65.52
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$42.40 |
$42.40 |
$42.40 |
$110.98
|
|
Analysis gene f2 20210g>a variant
|
$59.20 |
$59.20 |
$59.20 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$58.00 |
$58.00 |
$58.00 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$21.49 |
$21.49 |
$21.49 |
$109.20
|
|
Androstanediol
|
$115.10 |
$115.10 |
$115.10 |
$98.58
|
|
An fluoro guide for cvp
|
$329.20 |
$329.20 |
$329.20 |
$484.45
|
|
Anidulafungin injection
|
$1.76 |
$1.76 |
$1.76 |
$209.79
|
|
Ankle X-ray
|
$844.00 |
$844.00 |
$844.00 |
$339.44
|
|
Anodyne therapy charges pt
|
$12.40 |
$12.40 |
$12.40 |
$41.02
|
|
Anora (draw only)
|
$17.68 |
$17.68 |
$17.68 |
$36.00
|
|
Antibody bacterium, not elsewhere specified
|
$93.36 |
$93.36 |
$93.36 |
$57.89
|
|
Antibody elution rbc reference
|
$189.68 |
$189.68 |
$189.68 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$65.52 |
$65.52 |
$65.52 |
$141.74
|
|
Antibody htlv-i
|
$22.40 |
$22.40 |
$22.40 |
$48.75
|
|
Antibody htlv-ii
|
$50.40 |
$50.40 |
$50.40 |
$35.22
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$1,207.04 |
$1,207.04 |
$1,207.04 |
$220.73
|
|
Antibody id rbc panel
|
$200.04 |
$200.04 |
$200.04 |
$291.75
|
