|
Assay of somatostatin
|
$50.00 |
$50.00 |
$50.00 |
$165.75
|
|
Assay of thiocyanate
|
$63.00 |
$63.00 |
$63.00 |
$57.00
|
|
Assay phosphatidylglycerol
|
$323.00 |
$323.00 |
$323.00 |
$87.20
|
|
Assay toxin or antitoxin
|
$2,198.81 |
$2,198.81 |
$2,198.81 |
$72.75
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$2,044.42 |
$2,044.42 |
$2,044.42 |
$312.00
|
|
Ast/sgot
|
$838.53 |
$838.53 |
$838.53 |
$45.65
|
|
Autologous blood process
|
$597.33 |
$597.33 |
$597.33 |
$234.27
|
|
Azathioprine 50 mg tablet
|
$56.00 |
$56.00 |
$56.00 |
$6.76
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$7,713.00 |
$7,713.00 |
$7,713.00 |
$920.45
|
|
Barrier film 28ml spray no stng cavilon
|
$41.90 |
$41.90 |
$41.90 |
$21.33
|
|
Barrier skin flextend 2.25in floating flang new image
|
$8.27 |
$8.27 |
$8.27 |
$2.40
|
|
Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft
|
$3.81 |
$3.81 |
$3.81 |
$3.00
|
|
Bartonella dna pcr-sendout
|
$220.00 |
$220.00 |
$220.00 |
$196.20
|
|
Belt ostomy lg 34-65in
|
$7.40 |
$7.40 |
$7.40 |
$5.20
|
|
#_benzodiazconfur
|
$13.32 |
$13.32 |
$13.32 |
$99.72
|
|
Benztropine 1 mg/ml injection solution
|
$380.00 |
$380.00 |
$380.00 |
$121.88
|
|
Beta-2 microglobulin
|
$247.00 |
$247.00 |
$247.00 |
$84.66
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$312.00 |
$312.00 |
$312.00 |
$75.12
|
|
Bilirubin direct
|
$937.02 |
$937.02 |
$937.02 |
$49.29
|
|
Bivalirudin
|
$2,342.00 |
$2,342.00 |
$2,342.00 |
$1,246.70
|
|
Bld prd mix
|
$435.24 |
$435.24 |
$435.24 |
$139.21
|
|
Blood Culture Test
|
$1,706.34 |
$1,706.34 |
$1,706.34 |
$144.65
|
|
Blood gases o2 saturation direct measurement
|
$724.06 |
$724.06 |
$724.06 |
$220.35
|
|
Blood gases ph venous
|
$363.36 |
$363.36 |
$363.36 |
$63.70
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$35.00 |
$35.00 |
$35.00 |
$57.60
|
|
Blood occult peroxidase activity qualitative gastric
|
$479.16 |
$479.16 |
$479.16 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$573.66 |
$573.66 |
$573.66 |
$37.44
|
|
Blood typing rbc ag non abo/rh ea
|
$456.35 |
$456.35 |
$456.35 |
$181.74
|
|
Blood typing rh phenotype complete reference
|
$573.66 |
$573.66 |
$573.66 |
$77.25
|
|
Bone Density Scan (DEXA)
|
$1,362.94 |
$1,362.94 |
$1,362.94 |
$395.00
|
|
Bone imaging multiple areas
|
$8,639.52 |
$8,639.52 |
$8,639.52 |
$1,147.57
|
|
Bone/joint imaging ltd area
|
$3,569.74 |
$3,569.74 |
$3,569.74 |
$1,151.16
|
|
Bone survey-lead poisoning
|
$1,452.12 |
$1,452.12 |
$1,452.12 |
$346.28
|
|
Boot mlti podous univ xlg
|
$1,088.43 |
$1,088.43 |
$1,088.43 |
$318.36
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$9,058.00 |
$9,058.00 |
$9,058.00 |
$1,683.04
|
|
(both sides) smear without diff wbc count
|
$436.57 |
$436.57 |
$436.57 |
$33.57
|
|
Bowel imaging
|
$7,709.15 |
$7,709.15 |
$7,709.15 |
$1,186.25
|
|
Brace halo bremer l2830
|
$656.09 |
$656.09 |
$656.09 |
$291.75
|
|
Brace kafo dbl upright cust
|
$5,202.42 |
$5,202.42 |
$5,202.42 |
$3,966.59
|
|
Brace m arm board
|
$1,088.43 |
$1,088.43 |
$1,088.43 |
$153.81
|
|
Brachytx isodose complex
|
$4,635.00 |
$4,635.00 |
$4,635.00 |
$1,631.00
|
|
Brachytx isodose intermed
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$1,207.50
|
|
Brachytx isodose plan simple
|
$1,556.00 |
$1,556.00 |
$1,556.00 |
$817.20
|
|
Brain image w/flow 4 + views
|
$8,284.14 |
$8,284.14 |
$8,284.14 |
$1,308.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$12,725.57 |
$12,725.57 |
$12,725.57 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$11,044.88 |
$11,044.88 |
$11,044.88 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$10,193.04 |
$10,193.04 |
$10,193.04 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$12,725.57 |
$12,725.57 |
$12,725.57 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$11,044.88 |
$11,044.88 |
$11,044.88 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$10,193.04 |
$10,193.04 |
$10,193.04 |
$1,927.04
|
|
Brcassure comprehensive panel-sendout
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$2,287.20
|
|
Breath test analysis c-14
|
$271.52 |
$271.52 |
$271.52 |
$197.34
|
|
Bundle his recording
|
$6,816.01 |
$6,816.01 |
$6,816.01 |
$5,157.39
|
|
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet
|
$42.00 |
$42.00 |
$42.00 |
$12.78
|
|
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet
|
$76.00 |
$76.00 |
$76.00 |
$17.13
|
|
Butorphanol tartrate 1 mg
|
$158.00 |
$158.00 |
$158.00 |
$39.89
|
|
Calcium 24 hour urine
|
$988.93 |
$988.93 |
$988.93 |
$52.00
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$87.05 |
$87.05 |
$87.05 |
$59.40
|
|
Calcium total
|
$697.44 |
$697.44 |
$697.44 |
$48.75
|
|
Calprotectin fecal
|
$221.00 |
$221.00 |
$221.00 |
$170.00
|
|
Campylobacter antibody
|
$93.00 |
$93.00 |
$93.00 |
$66.61
|
|
Carbamazepine total therapeutic drug level
|
$588.30 |
$588.30 |
$588.30 |
$113.25
|
|
Carbon dioxide
|
$866.48 |
$866.48 |
$866.48 |
$44.82
|
|
Carboplatin 10 mg/ml desensitization
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$141.98
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$165.87 |
$165.87 |
$165.87 |
$432.25
|
|
Carboxyhemoglobin quantitative
|
$456.53 |
$456.53 |
$456.53 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$247.00 |
$247.00 |
$247.00 |
$146.90
|
|
Cardiac drug stress test
|
$5,566.45 |
$5,566.45 |
$5,566.45 |
$543.20
|
|
Cardiac perf planar mult/ef/wm
|
$21,309.31 |
$21,309.31 |
$21,309.31 |
$2,544.75
|
|
Cardiac perf planar sgl/ef/wm
|
$15,786.99 |
$15,786.99 |
$15,786.99 |
$1,911.62
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$20,253.83 |
$20,253.83 |
$20,253.83 |
$2,792.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$998.25 |
$998.25 |
$998.25 |
$254.80
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$77.20 |
$77.20 |
$77.20 |
$195.00
|
|
Cardiac shunt imaging
|
$8,168.35 |
$8,168.35 |
$8,168.35 |
$860.63
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$3,636.93 |
$3,636.93 |
$3,636.93 |
$1,504.08
|
|
Carotene
|
$21.00 |
$21.00 |
$21.00 |
$46.80
|
|
Carotid Artery Ultrasound (Duplex)
|
$7,634.62 |
$7,634.62 |
$7,634.62 |
$1,067.40
|
|
Catecholamines,fractionated, urine
|
$27.00 |
$27.00 |
$27.00 |
$55.20
|
|
Catheterization collection of specimen single patient all places of service
|
$431.24 |
$431.24 |
$431.24 |
$48.75
|
|
Cath stripping venous s&i
|
$5,578.22 |
$5,578.22 |
$5,578.22 |
$602.40
|
|
Ceftaroline fosamil 600 mg intravenous solution
|
$820.00 |
$820.00 |
$820.00 |
$634.46
|
|
Ceftazidime and avibactam
|
$1,455.00 |
$1,455.00 |
$1,455.00 |
$935.40
|
|
#celiac hla-dq8
|
$112.40 |
$112.40 |
$112.40 |
$246.88
|
|
Cell count w differential body fluid
|
$866.48 |
$866.48 |
$866.48 |
$95.55
|
|
Cell marker study
|
$163.00 |
$163.00 |
$163.00 |
$239.85
|
|
Cerebrospinal fld flw imag
|
$14,652.98 |
$14,652.98 |
$14,652.98 |
$884.00
|
|
#cf-97variants
|
$62.00 |
$62.00 |
$62.00 |
$612.26
|
|
Chemo adm cns w/lmbr punct
|
$3,909.00 |
$3,909.00 |
$3,909.00 |
$722.70
|
|
Chest 2 vws w oblique
|
$3,178.43 |
$3,178.43 |
$3,178.43 |
$373.20
|
|
Chest apical lordotic proj
|
$3,179.76 |
$3,179.76 |
$3,179.76 |
$288.81
|
|
Chest CT scan (with and without contrast)
|
$22,067.08 |
$22,067.08 |
$22,067.08 |
$2,021.80
|
|
Chest CT scan (with contrast)
|
$19,203.44 |
$19,203.44 |
$19,203.44 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$19,203.44 |
$19,203.44 |
$19,203.44 |
$1,350.03
|
|
Chest X-ray
|
$3,046.66 |
$3,046.66 |
$3,046.66 |
$294.06
|
|
Chest X-ray (single view)
|
$2,783.12 |
$2,783.12 |
$2,783.12 |
$229.08
|
|
Chg pr pul rehab for copd patients
|
$55.90 |
$55.90 |
$55.90 |
$150.00
|
|
Chg radiologic exam esophagus double contrast
|
$2,507.60 |
$2,507.60 |
$2,507.60 |
$520.80
|
|
Chlamydia culture
|
$21.00 |
$21.00 |
$21.00 |
$94.90
|
|
Chlnggrphy intraop addl s&i
|
$1,561.26 |
$1,561.26 |
$1,561.26 |
$280.00
|
|
Chloride
|
$694.78 |
$694.78 |
$694.78 |
$38.50
|
