|
Blink reflex test
|
$826.00 |
$826.00 |
$826.00 |
$225.60
|
|
Blood smear microscopic w manual differential wbc count
|
$400.00 |
$400.00 |
$400.00 |
$37.44
|
|
Blood typing rh phenotype complete reference
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$77.25
|
|
Bone Density Scan (DEXA)
|
$1,501.00 |
$1,501.00 |
$1,501.00 |
$395.00
|
|
Bone/joint imaging ltd area
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$1,151.16
|
|
Bone survey-lead poisoning
|
$2,455.00 |
$2,455.00 |
$2,455.00 |
$346.28
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$23,659.00 |
$23,659.00 |
$23,659.00 |
$1,683.04
|
|
(both sides) smear without diff wbc count
|
$171.00 |
$171.00 |
$171.00 |
$33.57
|
|
Bowel imaging
|
$5,512.00 |
$5,512.00 |
$5,512.00 |
$1,186.25
|
|
Brain image w/flow 4 + views
|
$6,830.00 |
$6,830.00 |
$6,830.00 |
$1,308.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$10,526.00 |
$10,526.00 |
$10,526.00 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$7,170.00 |
$7,170.00 |
$7,170.00 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$6,538.00 |
$6,538.00 |
$6,538.00 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$9,384.00 |
$9,384.00 |
$9,384.00 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$7,737.00 |
$7,737.00 |
$7,737.00 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$11,785.00 |
$11,785.00 |
$11,785.00 |
$1,927.04
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$85,062.00 |
$85,062.00 |
$85,062.00 |
$24,679.59
|
|
Bronchial challenge
|
$9,702.00 |
$9,702.00 |
$9,702.00 |
$835.20
|
|
C1 esterase inhibitor func - sendout
|
$606.00 |
$606.00 |
$606.00 |
$106.60
|
|
Caffeine citrate 20 mg/ml inj for po
|
$197.00 |
$197.00 |
$197.00 |
$43.81
|
|
Calcium 24 hour urine
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$52.00
|
|
Calprotectin fecal
|
$234.00 |
$234.00 |
$234.00 |
$170.00
|
|
Candida dna
|
$290.00 |
$290.00 |
$290.00 |
$66.05
|
|
Carbohydrate deficient transf - sendout
|
$20.90 |
$20.90 |
$20.90 |
$113.36
|
|
Carbon dioxide
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$44.82
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$3,638.00 |
$3,638.00 |
$3,638.00 |
$432.25
|
|
Carboxyhemoglobin quantitative
|
$55.00 |
$55.00 |
$55.00 |
$84.73
|
|
Cardiac MRI w/stress img
|
$3,204.00 |
$3,204.00 |
$3,204.00 |
$1,392.95
|
|
Carfilzomib 10 mg intravenous solution
|
$26,199.00 |
$26,199.00 |
$26,199.00 |
$3,574.20
|
|
Carmustine 100 mg intravenous powder for solution
|
$911.00 |
$911.00 |
$911.00 |
$1,582.20
|
|
Catheterization collection of specimen single patient all places of service
|
$121.00 |
$121.00 |
$121.00 |
$48.75
|
|
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr
|
$40.00 |
$40.00 |
$40.00 |
$51.66
|
|
Ceftazidime and avibactam
|
$2,276.00 |
$2,276.00 |
$2,276.00 |
$935.40
|
|
Cetuximab 100 mg/50 ml intravenous solution
|
$5,013.00 |
$5,013.00 |
$5,013.00 |
$3,358.00
|
|
#cf-97variants
|
$922.00 |
$922.00 |
$922.00 |
$612.26
|
|
Chemo ia push tecnique
|
$331.69 |
$331.69 |
$331.69 |
$500.20
|
|
Chlnggrphy intraop addl s&i
|
$1,942.00 |
$1,942.00 |
$1,942.00 |
$280.00
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$54.00 |
$54.00 |
$54.00 |
$333.01
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$274.00 |
$274.00 |
$274.00 |
$89.81
|
|
Cholinesterase
|
$39.60 |
$39.60 |
$39.60 |
$38.69
|
|
Cholinesterase challenge
|
$950.00 |
$950.00 |
$950.00 |
$298.60
|
|
Chromatography
|
$93.00 |
$93.00 |
$93.00 |
$80.60
|
|
Chromosome analysis 100
|
$6,001.00 |
$6,001.00 |
$6,001.00 |
$321.44
|
|
Chromosome analysis 20-25
|
$10,813.00 |
$10,813.00 |
$10,813.00 |
$277.09
|
|
Chromosome analysis 50-100
|
$7,039.00 |
$7,039.00 |
$7,039.00 |
$301.50
|
|
Chromosome analys placenta
|
$2,276.00 |
$2,276.00 |
$2,276.00 |
$642.00
|
|
Chromosome count additional
|
$89.00 |
$89.00 |
$89.00 |
$110.00
|
|
Chromosome karyotype study
|
$115.00 |
$115.00 |
$115.00 |
$102.72
|
|
Chylomicron screen, bf - sendout
|
$156.00 |
$156.00 |
$156.00 |
$123.20
|
|
Cine/video x-rays
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$242.24
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$2,602.00 |
$2,602.00 |
$2,602.00 |
$576.60
|
|
Clofarabine 1 mg/ml intravenous solution
|
$9,393.00 |
$9,393.00 |
$9,393.00 |
$604.88
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$163.00 |
$163.00 |
$163.00 |
$81.02
|
|
Clot factor viii reltd antgn
|
$717.00 |
$717.00 |
$717.00 |
$95.72
|
|
Clot factor xii hageman
|
$842.00 |
$842.00 |
$842.00 |
$125.00
|
|
Clot factor xiii fibrin stab
|
$127.00 |
$127.00 |
$127.00 |
$84.27
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$24,244.00 |
$24,244.00 |
$24,244.00 |
$4.22
|
|
Codeine 15 mg/ml inj 2 ml
|
$179.00 |
$179.00 |
$179.00 |
$43.17
|
|
Colistimethate sodium inj
|
$975.00 |
$975.00 |
$975.00 |
$84.22
|
|
Compatibility test each unit electronic
|
$2,051.00 |
$2,051.00 |
$2,051.00 |
$167.17
|
|
Compatibility test each unit immediate spin technique
|
$681.00 |
$681.00 |
$681.00 |
$159.95
|
|
Compatibility test incubate
|
$356.00 |
$356.00 |
$356.00 |
$143.64
|
|
Conjugated estrogens 25 mg solution for injection
|
$371.00 |
$371.00 |
$371.00 |
$792.24
|
|
Consultation pathology during surgery frozen section each additional block
|
$474.00 |
$474.00 |
$474.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,816.00 |
$1,816.00 |
$1,816.00 |
$210.80
|
|
Consultation/report referred material w/preparation of slides
|
$1,888.00 |
$1,888.00 |
$1,888.00 |
$235.95
|
|
Consultation/report referred slides prepared elsewhere
|
$1,888.00 |
$1,888.00 |
$1,888.00 |
$176.15
|
|
Consult comp w/report rfrd material
|
$520.00 |
$520.00 |
$520.00 |
$345.71
|
|
Contrast baths charges
|
$560.00 |
$560.00 |
$560.00 |
$77.98
|
|
Contrast exam thoracic aorta 75605-26
|
$10,981.00 |
$10,981.00 |
$10,981.00 |
$3,780.00
|
|
Contrast x-ray gallbladder
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
$276.65
|
|
Coombs indirect titer reference
|
$131.00 |
$131.00 |
$131.00 |
$143.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$312.00 |
$312.00 |
$312.00 |
$258.83
|
|
Counseling smoke cess interm >10mins
|
$105.00 |
$105.00 |
$105.00 |
$57.60
|
|
Covid-19 lab test non-cdc
|
$50.00 |
$50.00 |
$50.00 |
$56.44
|
|
C-peptide
|
$258.00 |
$258.00 |
$258.00 |
$100.26
|
|
Crbrospnl fld flw imag cistern
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$1,409.85
|
|
Creatine kinase isoenzymes
|
$1,859.00 |
$1,859.00 |
$1,859.00 |
$49.40
|
|
Creatine - sendout
|
$187.00 |
$187.00 |
$187.00 |
$40.59
|
|
Crotalidae poly immune fab
|
$28,266.00 |
$28,266.00 |
$28,266.00 |
$6,208.33
|
|
Cryofibrinogen qualitative - sendout
|
$299.00 |
$299.00 |
$299.00 |
$50.88
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$15,798.00 |
$15,798.00 |
$15,798.00 |
$1,058.40
|
|
CT guid parench tis ablat
|
$5,175.00 |
$5,175.00 |
$5,175.00 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$404.00 |
$404.00 |
$404.00 |
$192.00
|
|
CT hrt w/3d image
|
$11,357.00 |
$11,357.00 |
$11,357.00 |
$1,477.35
|
|
CT limited or localized follow-up study
|
$6,259.00 |
$6,259.00 |
$6,259.00 |
$630.50
|
|
CT thorax low dose for lung screening without contrast
|
$852.00 |
$852.00 |
$852.00 |
$420.60
|
|
Culture mycobacteria definitive id each isolate
|
$468.00 |
$468.00 |
$468.00 |
$88.14
|
|
Culture mycoplasma any source
|
$192.00 |
$192.00 |
$192.00 |
$90.37
|
|
Culture typing immunologic
|
$246.00 |
$246.00 |
$246.00 |
$41.19
|
|
Cyanocobalamin unsat binding capacity
|
$48.40 |
$48.40 |
$48.40 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$29.00 |
$29.00 |
$29.00 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$85.03
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$421.00 |
$421.00 |
$421.00 |
$150.79
|
|
Cyclosporine modified 25 mg capsule
|
$15.00 |
$15.00 |
$15.00 |
$9.79
|
|
Cystatin c
|
$111.00 |
$111.00 |
$111.00 |
$82.50
|
|
Cystine urine quantitative
|
$1,280.00 |
$1,280.00 |
$1,280.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$2,624.00 |
$2,624.00 |
$2,624.00 |
$527.50
|
|
Cytomegalovirus (cmv) antibody igg
|
$1,022.00 |
$1,022.00 |
$1,022.00 |
$101.25
|
|
Cytomegalovirus dfa
|
$321.00 |
$321.00 |
$321.00 |
$51.20
|
