|
3-d radiotherapy plan
|
$4,953.00 |
$4,953.00 |
$4,953.00 |
$4,886.50
|
|
88334 ap bill cytologic exam each additional site
|
$44.85 |
$44.85 |
$44.85 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,026.00 |
$3,026.00 |
$3,026.00 |
$3,634.61
|
|
Abciximab injection
|
$4,898.00 |
$4,898.00 |
$4,898.00 |
$3,012.98
|
|
Abd aorta w/runoff s&i
|
$16,038.50 |
$16,038.50 |
$16,038.50 |
$3,667.71
|
|
Abdominal MRI (with and without contrast)
|
$5,273.65 |
$5,273.65 |
$5,273.65 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$3,902.35 |
$3,902.35 |
$3,902.35 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$3,637.30 |
$3,637.30 |
$3,637.30 |
$1,972.66
|
|
Ablate arrhythmia add on
|
$64,058.95 |
$64,058.95 |
$64,058.95 |
$7,417.15
|
|
Ablate heart dysrhythm focus
|
$37,537.50 |
$37,537.50 |
$37,537.50 |
$10,008.58
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$142.00 |
$142.00 |
$142.00 |
$125.63
|
|
Acetaminophen level
|
$1,957.35 |
$1,957.35 |
$1,957.35 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$321.00 |
$321.00 |
$321.00 |
$133.60
|
|
Acetone qualitative
|
$354.25 |
$354.25 |
$354.25 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,622.00 |
$1,622.00 |
$1,622.00 |
$323.77
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$90.05 |
$90.05 |
$90.05 |
$42.28
|
|
Adh-sendout
|
$31.10 |
$31.10 |
$31.10 |
$109.28
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$447.10 |
$447.10 |
$447.10 |
$308.10
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$415.35 |
$415.35 |
$415.35 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$415.35 |
$415.35 |
$415.35 |
$264.00
|
|
Administration vaccine hepatitis b
|
$259.70 |
$259.70 |
$259.70 |
$51.35
|
|
Administration vaccine influenza virus
|
$79.70 |
$79.70 |
$79.70 |
$49.50
|
|
Administration vaccine pneumococcal
|
$79.70 |
$79.70 |
$79.70 |
$51.11
|
|
Aep thrshld est mlt freq i&r
|
$489.30 |
$489.30 |
$489.30 |
$537.95
|
|
_afb id by dna probe rflx ast
|
$23.55 |
$23.55 |
$23.55 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$10.50 |
$10.50 |
$10.50 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$82.60 |
$82.60 |
$82.60 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$7.00 |
$7.00 |
$7.00 |
$48.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$7.00 |
$7.00 |
$7.00 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$359.50 |
$359.50 |
$359.50 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$11.95 |
$11.95 |
$11.95 |
$22.45
|
|
Albuterol non-comp con
|
$15.00 |
$15.00 |
$15.00 |
$15.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$1,316.80 |
$1,316.80 |
$1,316.80 |
$93.60
|
|
Alkaline phosphatase
|
$239.05 |
$239.05 |
$239.05 |
$46.20
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$347.80 |
$347.80 |
$347.80 |
$189.00
|
|
Alt/sgpt
|
$719.40 |
$719.40 |
$719.40 |
$49.00
|
|
Amantadine (symmetrel)-sendout
|
$127.10 |
$127.10 |
$127.10 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$1,530.00 |
$1,530.00 |
$1,530.00 |
$36.30
|
|
Amitriptyline (elavil) -sendout
|
$17.35 |
$17.35 |
$17.35 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$15,167.75 |
$15,167.75 |
$15,167.75 |
$15,167.75
|
|
Ammonia
|
$834.25 |
$834.25 |
$834.25 |
$120.90
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$101.00 |
$101.00 |
$101.00 |
$130.08
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$3,039.00 |
$3,039.00 |
$3,039.00 |
$331.80
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$1,957.35 |
$1,957.35 |
$1,957.35 |
$110.98
|
|
Analysis gene f2 20210g>a variant
|
$32.10 |
$32.10 |
$32.10 |
$219.60
|
|
Analysis nerve
|
$390.30 |
$390.30 |
$390.30 |
$223.19
|
|
Analysis tumor
|
$798.40 |
$798.40 |
$798.40 |
$240.00
|
|
Anaplsma phgcytophlm amp prb
|
$175.45 |
$175.45 |
$175.45 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$81.25 |
$81.25 |
$81.25 |
$109.20
|
|
Antibody bacterium, not elsewhere specified
|
$31.80 |
$31.80 |
$31.80 |
$57.89
|
|
Antibody elution rbc reference
|
$158.25 |
$158.25 |
$158.25 |
$176.54
|
|
Antibody id rbc panel
|
$320.20 |
$320.20 |
$320.20 |
$291.75
|
|
Antibody screen rbc
|
$82.65 |
$82.65 |
$82.65 |
$105.00
|
|
Anti-inhibitor
|
$4.00 |
$4.00 |
$4.00 |
$3.75
|
|
Anti mog serum - sendout
|
$594.00 |
$594.00 |
$594.00 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$82.30 |
$82.30 |
$82.30 |
$50.88
|
|
Antinuclear antibodies titer
|
$7.30 |
$7.30 |
$7.30 |
$80.25
|
|
Antistreptolysin o titer
|
$4.65 |
$4.65 |
$4.65 |
$57.96
|
|
Antithrombin iii activity
|
$15.65 |
$15.65 |
$15.65 |
$115.23
|
|
Apheresis plasma
|
$3,280.55 |
$3,280.55 |
$3,280.55 |
$3,411.50
|
|
Application finger splntstatic 29130
|
$246.90 |
$246.90 |
$246.90 |
$216.80
|
|
Application long leg splint 29505
|
$472.05 |
$472.05 |
$472.05 |
$340.80
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$79.70 |
$79.70 |
$79.70 |
$75.98
|
|
Apply forearm splintdynamic 29126
|
$470.60 |
$470.60 |
$470.60 |
$263.10
|
|
Apply hand/wrist cast 29085
|
$594.70 |
$594.70 |
$594.70 |
$272.46
|
|
Apply of finger splint 29131
|
$246.90 |
$246.90 |
$246.90 |
$177.45
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1,190.75 |
$1,190.75 |
$1,190.75 |
$943.40
|
|
#aptt mix-1:1 incubated
|
$146.25 |
$146.25 |
$146.25 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$381.40 |
$381.40 |
$381.40 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$297.00 |
$297.00 |
$297.00 |
$114.20
|
|
Artery x-rays arms/legs 75716-26
|
$6,127.00 |
$6,127.00 |
$6,127.00 |
$3,844.10
|
|
Artery x-rays chest
|
$2,586.80 |
$2,586.80 |
$2,586.80 |
$2,587.20
|
|
Artery x-rays lung
|
$2,586.80 |
$2,586.80 |
$2,586.80 |
$2,332.57
|
|
Artery xrays of pelvis 75736 26
|
$6,429.50 |
$6,429.50 |
$6,429.50 |
$4,086.49
|
|
Artery x-rays spine
|
$25,290.30 |
$25,290.30 |
$25,290.30 |
$4,306.40
|
|
Assay acid phosphatase
|
$8.25 |
$8.25 |
$8.25 |
$38.22
|
|
Assay myeloperoxidase
|
$44.35 |
$44.35 |
$44.35 |
$84.19
|
|
Assay of interleukin-6 (il-6)
|
$96.95 |
$96.95 |
$96.95 |
$77.35
|
|
Assay of procainamide w/metab
|
$15.30 |
$15.30 |
$15.30 |
$61.20
|
|
Assay of salicylate
|
$1,957.35 |
$1,957.35 |
$1,957.35 |
$105.95
|
|
Assay of somatostatin
|
$235.05 |
$235.05 |
$235.05 |
$165.75
|
|
Assay of thiocyanate
|
$72.45 |
$72.45 |
$72.45 |
$57.00
|
|
Assay of tyrosine
|
$9.95 |
$9.95 |
$9.95 |
$56.10
|
|
Ast/sgot
|
$393.95 |
$393.95 |
$393.95 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$31,082.00 |
$31,082.00 |
$31,082.00 |
$31,208.35
|
|
Autologous blood process
|
$590.65 |
$590.65 |
$590.65 |
$234.27
|
|
Azacitidine injection
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$912.29
|
|
Azathioprine 50 mg tablet
|
$58.00 |
$58.00 |
$58.00 |
$6.76
|
|
Baclofen eval charges
|
$238.80 |
$238.80 |
$238.80 |
$86.14
|
|
Bacterial meningitis antigen
|
$10.75 |
$10.75 |
$10.75 |
$68.40
|
|
Barrier skn ft cx ff red 2.25 ctf new image w/tape
|
$10.00 |
$10.00 |
$10.00 |
$30.00
|
|
Bartonella dna pcr-sendout
|
$311.30 |
$311.30 |
$311.30 |
$196.20
|
|
B cells total count
|
$203.75 |
$203.75 |
$203.75 |
$125.28
|
|
Belt ostomy lg 34-65in
|
$10.00 |
$10.00 |
$10.00 |
$5.20
|
|
Bendamustine 100 mg intravenous powder for solution
|
$10,220.00 |
$10,220.00 |
$10,220.00 |
$3,101.94
|
|
#_benzodiazconfur
|
$18.05 |
$18.05 |
$18.05 |
$99.72
|
|
Benztropine 1 mg/ml injection solution
|
$141.00 |
$141.00 |
$141.00 |
$121.88
|
|
Beta-2 microglobulin
|
$12.35 |
$12.35 |
$12.35 |
$84.66
|
|
Bilirubin direct
|
$688.75 |
$688.75 |
$688.75 |
$49.29
|
|
Bld prd mix
|
$59.50 |
$59.50 |
$59.50 |
$139.21
|
