|
11-desoxycortisol - sendout
|
$102.48 |
$102.48 |
$102.48 |
$87.50
|
|
17-hydroxypregnenolone
|
$152.48 |
$152.48 |
$152.48 |
$85.15
|
|
24 hr ambulatory b/p monitor
|
$430.33 |
$430.33 |
$430.33 |
$319.15
|
|
2nd order venous cath
|
$2,853.84 |
$2,853.84 |
$2,853.84 |
$1,809.60
|
|
3-d radiotherapy plan
|
$5,619.54 |
$5,619.54 |
$5,619.54 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$830.55 |
$830.55 |
$830.55 |
$427.34
|
|
5' nucleotidase - sendout
|
$39.03 |
$39.03 |
$39.03 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$498.62 |
$498.62 |
$498.62 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$80.14 |
$80.14 |
$80.14 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$17,345.71 |
$17,345.71 |
$17,345.71 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$7,417.65 |
$7,417.65 |
$7,417.65 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$6,264.78 |
$6,264.78 |
$6,264.78 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$8,374.21 |
$8,374.21 |
$8,374.21 |
$3,050.58
|
|
Abd/low ext cath addl
|
$2,317.93 |
$2,317.93 |
$2,317.93 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$10,534.71 |
$10,534.71 |
$10,534.71 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$10,089.10 |
$10,089.10 |
$10,089.10 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$7,696.08 |
$7,696.08 |
$7,696.08 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$11,736.14 |
$11,736.14 |
$11,736.14 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$3,169.82 |
$3,169.82 |
$3,169.82 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$8,131.84 |
$8,131.84 |
$8,131.84 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$3,531.68 |
$3,531.68 |
$3,531.68 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$2,309.32 |
$2,309.32 |
$2,309.32 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$2,490.27 |
$2,490.27 |
$2,490.27 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$1,170.28
|
|
Abl1 gene
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$609.93
|
|
Ablate arrhythmia add on
|
$12,245.87 |
$12,245.87 |
$12,245.87 |
$7,417.15
|
|
Ablate bone tumor(s) cryo perq 20983
|
$14,879.70 |
$14,879.70 |
$14,879.70 |
$7,896.23
|
|
Ablate bone tumor(s) perq
|
$15,090.26 |
$15,090.26 |
$15,090.26 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$20,103.05 |
$20,103.05 |
$20,103.05 |
$10,008.58
|
|
Ablation cardiac vagal inputs atrium
|
$1,963.96 |
$1,963.96 |
$1,963.96 |
$3,587.65
|
|
Abscess drain retroperitoneal surg code
|
$9,867.86 |
$9,867.86 |
$9,867.86 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$479.40 |
$479.40 |
$479.40 |
$125.63
|
|
Acetaminophen level
|
$137.87 |
$137.87 |
$137.87 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$578.26 |
$578.26 |
$578.26 |
$133.60
|
|
Acetone qualitative
|
$30.05 |
$30.05 |
$30.05 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$135.41 |
$135.41 |
$135.41 |
$65.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$572.02 |
$572.02 |
$572.02 |
$323.77
|
|
Acute hepatitis panel
|
$352.06 |
$352.06 |
$352.06 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$386.56 |
$386.56 |
$386.56 |
$50.70
|
|
#acylcarnitineprfl
|
$504.80 |
$504.80 |
$504.80 |
$105.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,996.45 |
$1,996.45 |
$1,996.45 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$85.70 |
$85.70 |
$85.70 |
$63.00
|
|
Adh-sendout
|
$227.05 |
$227.05 |
$227.05 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$363.95 |
$363.95 |
$363.95 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$276.02 |
$276.02 |
$276.02 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$477.48 |
$477.48 |
$477.48 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,537.05 |
$1,537.05 |
$1,537.05 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$905.98 |
$905.98 |
$905.98 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$446.31 |
$446.31 |
$446.31 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$446.31 |
$446.31 |
$446.31 |
$264.00
|
|
Administration immunization 1 vaccine
|
$403.84 |
$403.84 |
$403.84 |
$70.52
|
|
Administration immunization each additional component
|
$365.14 |
$365.14 |
$365.14 |
$27.20
|
|
Administration immunization each additional vaccine
|
$296.98 |
$296.98 |
$296.98 |
$46.23
|
|
Administration immunization first component each vaccine
|
$365.14 |
$365.14 |
$365.14 |
$45.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$278.63 |
$278.63 |
$278.63 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$278.63 |
$278.63 |
$278.63 |
$33.60
|
|
Aep hearing status deter i&r
|
$544.10 |
$544.10 |
$544.10 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$1,916.59 |
$1,916.59 |
$1,916.59 |
$509.00
|
|
Aep thrshld est mlt freq i&r
|
$1,916.59 |
$1,916.59 |
$1,916.59 |
$537.95
|
|
_afb id by dna probe rflx ast
|
$147.72 |
$147.72 |
$147.72 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$48.97 |
$48.97 |
$48.97 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$770.20 |
$770.20 |
$770.20 |
$289.60
|
|
Air injection into abdomen 49400
|
$3,399.90 |
$3,399.90 |
$3,399.90 |
$531.49
|
|
Albumin body fluid quantitative each specimen
|
$57.85 |
$57.85 |
$57.85 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$726.00 |
$726.00 |
$726.00 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$522.40 |
$522.40 |
$522.40 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$316.00 |
$316.00 |
$316.00 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$43.09 |
$43.09 |
$43.09 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$36.93 |
$36.93 |
$36.93 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$49.73 |
$49.73 |
$49.73 |
$22.45
|
|
Albuterol non-comp unit
|
$29.61 |
$29.61 |
$29.61 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$128.02 |
$128.02 |
$128.02 |
$93.60
|
|
Alkaline phosphatase
|
$38.16 |
$38.16 |
$38.16 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$120.20 |
$120.20 |
$120.20 |
$56.35
|
|
Allergen egg white ige
|
$38.16 |
$38.16 |
$38.16 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$53.42 |
$53.42 |
$53.42 |
$26.95
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,939.65 |
$1,939.65 |
$1,939.65 |
$905.18
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$189.00 |
$189.00 |
$189.00 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$124.33 |
$124.33 |
$124.33 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,882.36 |
$1,882.36 |
$1,882.36 |
$2,600.22
|
|
Alt/sgpt
|
$39.40 |
$39.40 |
$39.40 |
$49.00
|
|
Aluminum - quest
|
$170.29 |
$170.29 |
$170.29 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$452.63 |
$452.63 |
$452.63 |
$437.50
|
|
Amantadine (symmetrel)-sendout
|
$124.66 |
$124.66 |
$124.66 |
$196.20
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$205.84 |
$205.84 |
$205.84 |
$42.84
|
|
Aminolevulinic acid delta
|
$64.64 |
$64.64 |
$64.64 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$360.69 |
$360.69 |
$360.69 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$202.40 |
$202.40 |
$202.40 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$409.08 |
$409.08 |
$409.08 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$83.48 |
$83.48 |
$83.48 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$7,792.53 |
$7,792.53 |
$7,792.53 |
$15,167.75
|
|
Ammonia
|
$107.09 |
$107.09 |
$107.09 |
$120.90
|
|
Amphetamine confirm urine -sendout
|
$83.48 |
$83.48 |
$83.48 |
$94.50
|
|
Amphetamines 5 or more
|
$83.48 |
$83.48 |
$83.48 |
$101.40
|
|
Ampicillin 1 gram solution for injection
|
$440.90 |
$440.90 |
$440.90 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$457.30 |
$457.30 |
$457.30 |
$51.93
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$920.47 |
$920.47 |
$920.47 |
$312.00
|
|
Amputation toe interphalangeal joint
|
$6,154.89 |
$6,154.89 |
$6,154.89 |
$3,691.20
|
|
Amputation toe metatarsophalangeal joint
|
$6,154.89 |
$6,154.89 |
$6,154.89 |
$3,777.93
|
|
Amylase
|
$48.01 |
$48.01 |
$48.01 |
$93.00
|
