|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$103.50 |
$103.50 |
$103.50 |
$47.66
|
|
Dextrose 5 % IV bolus
|
$386.35 |
$386.35 |
$386.35 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$77.20 |
$77.20 |
$77.20 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$178.78 |
$178.78 |
$178.78 |
$79.30
|
|
Diatrizoate meglumine 18 % urethral solution
|
$510.98 |
$510.98 |
$510.98 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$142.86 |
$142.86 |
$142.86 |
$70.99
|
|
Dicyclomine injection
|
$584.84 |
$584.84 |
$584.84 |
$210.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$64.31 |
$64.31 |
$64.31 |
$56.30
|
|
Digoxin total therapeutic drug level
|
$182.64 |
$182.64 |
$182.64 |
$99.35
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$48.91 |
$48.91 |
$48.91 |
$23.22
|
|
Disaccharidases
|
$282.30 |
$282.30 |
$282.30 |
$224.58
|
|
Dna antibody native/double stranded
|
$47.71 |
$47.71 |
$47.71 |
$101.40
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$1,278.51 |
$1,278.51 |
$1,278.51 |
$99.10
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$665.64 |
$665.64 |
$665.64 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$495.24 |
$495.24 |
$495.24 |
$65.37
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,445.26 |
$2,445.26 |
$2,445.26 |
$686.60
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$40,007.10 |
$40,007.10 |
$40,007.10 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$203.32 |
$203.32 |
$203.32 |
$244.00
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$7,534.05 |
$7,534.05 |
$7,534.05 |
$2,469.31
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$2,069.56 |
$2,069.56 |
$2,069.56 |
$820.50
|
|
Drainage external ear simple 69000
|
$1,835.55 |
$1,835.55 |
$1,835.55 |
$818.40
|
|
Drainage of arm bursa 23931
|
$23,545.05 |
$23,545.05 |
$23,545.05 |
$2,271.01
|
|
Drainage of nose lesion int 30000
|
$3,656.59 |
$3,656.59 |
$3,656.59 |
$548.00
|
|
Drain blood from under nail 11740
|
$333.94 |
$333.94 |
$333.94 |
$190.10
|
|
Drain finger abscess;simple 26010
|
$3,049.88 |
$3,049.88 |
$3,049.88 |
$492.81
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$3,049.88 |
$3,049.88 |
$3,049.88 |
$359.45
|
|
Drng of finger abscess comp 26011
|
$23,545.05 |
$23,545.05 |
$23,545.05 |
$1,917.33
|
|
Drng of scrotum abscess 55100
|
$23,545.05 |
$23,545.05 |
$23,545.05 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$76.35 |
$76.35 |
$76.35 |
$35.62
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$791.29 |
$791.29 |
$791.29 |
$280.11
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$4,056.83 |
$4,056.83 |
$4,056.83 |
$886.60
|
|
Durvalumab 50 mg/ml intravenous solution
|
$43,925.32 |
$43,925.32 |
$43,925.32 |
$7,876.43
|
|
Ear irrigation 69209
|
$959.73 |
$959.73 |
$959.73 |
$155.20
|
|
Ecg 12 lead tracing only
|
$494.54 |
$494.54 |
$494.54 |
$245.30
|
|
Ecg external > 48 hours up to 7 days recording
|
$959.73 |
$959.73 |
$959.73 |
$146.90
|
|
Echocardiogram (Heart Ultrasound)
|
$8,488.40 |
$8,488.40 |
$8,488.40 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$649.89 |
$649.89 |
$649.89 |
$463.45
|
|
Echocardiography transthoracic 2d followup/limited
|
$4,056.83 |
$4,056.83 |
$4,056.83 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$706.46 |
$706.46 |
$706.46 |
$356.40
|
|
Electrical stimulation/unattended 97014
|
$352.99 |
$352.99 |
$352.99 |
$82.55
|
|
Electrolyte panel
|
$259.40 |
$259.40 |
$259.40 |
$88.20
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$523.68 |
$523.68 |
$523.68 |
$112.79
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,610.62 |
$1,610.62 |
$1,610.62 |
$840.97
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$3,525.75 |
$3,525.75 |
$3,525.75 |
$781.71
|
|
Epstein barr early antigen antibody
|
$70.61 |
$70.61 |
$70.61 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$76.41 |
$76.41 |
$76.41 |
$81.81
|
|
Epstein barr viral capsid antigen antibody igm
|
$231.00 |
$231.00 |
$231.00 |
$93.60
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$875.96 |
$875.96 |
$875.96 |
$363.57
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$20,559.58 |
$20,559.58 |
$20,559.58 |
$6,313.52
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$6,619.51 |
$6,619.51 |
$6,619.51 |
$2,528.17
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$544.72 |
$544.72 |
$544.72 |
$323.00
|
|
ER Visit (level 1, minor)
|
$629.93 |
$629.93 |
$629.93 |
$276.25
|
|
ER Visit (level 2)
|
$951.17 |
$951.17 |
$951.17 |
$482.40
|
|
ER Visit (level 3)
|
$1,432.54 |
$1,432.54 |
$1,432.54 |
$850.50
|
|
ER Visit (level 4)
|
$2,343.25 |
$2,343.25 |
$2,343.25 |
$1,351.35
|
|
ER Visit (level 5, high severity)
|
$3,851.88 |
$3,851.88 |
$3,851.88 |
$1,957.38
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$680.16 |
$680.16 |
$680.16 |
$240.87
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$2,018.63 |
$2,018.63 |
$2,018.63 |
$1,138.94
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$1,467.09 |
$1,467.09 |
$1,467.09 |
$562.34
|
|
Estradiol total
|
$355.79 |
$355.79 |
$355.79 |
$153.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$311.91 |
$311.91 |
$311.91 |
$213.17
|
|
Euflexxa inj per dose
|
$1,848.30 |
$1,848.30 |
$1,848.30 |
$727.80
|
|
Exp w remove/deep fb/forearm/wrist 25248
|
$23,406.48 |
$23,406.48 |
$23,406.48 |
$3,623.43
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$228.31 |
$228.31 |
$228.31 |
$102.50
|
|
Facial bones <3
|
$1,134.89 |
$1,134.89 |
$1,134.89 |
$241.75
|
|
Factor viii
|
$64.65 |
$64.65 |
$64.65 |
$148.34
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$50.66 |
$50.66 |
$50.66 |
$22.23
|
|
Fat/lipids feces qualitative
|
$22.98 |
$22.98 |
$22.98 |
$37.40
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$282.64 |
$282.64 |
$282.64 |
$104.57
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$653.53 |
$653.53 |
$653.53 |
$1,548.30
|
|
Ferritin
|
$217.14 |
$217.14 |
$217.14 |
$103.95
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$6,264.01 |
$6,264.01 |
$6,264.01 |
$2,175.15
|
|
Fetal chrom aneuploidy gsa panel
|
$2,636.09 |
$2,636.09 |
$2,636.09 |
$1,231.20
|
|
Fetal hemoglobin rosette
|
$119.20 |
$119.20 |
$119.20 |
$78.30
|
|
Fibrin degradation d dimer quantitative
|
$129.63 |
$129.63 |
$129.63 |
$111.68
|
|
Fibrinogen activity
|
$440.32 |
$440.32 |
$440.32 |
$82.38
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$197.12 |
$197.12 |
$197.12 |
$66.00
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$5,635.05 |
$5,635.05 |
$5,635.05 |
$1,309.01
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$2,363.44 |
$2,363.44 |
$2,363.44 |
$998.68
|
|
Flow cytometry marker each additional
|
$34.13 |
$34.13 |
$34.13 |
$102.00
|
|
Flow cytometry one marker technical component
|
$4,709.40 |
$4,709.40 |
$4,709.40 |
$288.60
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$301.23 |
$301.23 |
$301.23 |
$82.94
|
|
Fluidotherapy charges pt
|
$159.44 |
$159.44 |
$159.44 |
$101.40
|
|
Fluorescent antibody titer dna
|
$153.45 |
$153.45 |
$153.45 |
$125.64
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$964.98 |
$964.98 |
$964.98 |
$97.74
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$136.55 |
$136.55 |
$136.55 |
$168.00
|
|
Folic acid
|
$185.67 |
$185.67 |
$185.67 |
$87.50
|
|
Folic acid 5 mg/ml injection solution
|
$44.68 |
$44.68 |
$44.68 |
$50.70
|
|
Fomepizole 1 gram/ml intravenous solution
|
$4,024.66 |
$4,024.66 |
$4,024.66 |
$2,993.41
|
|
Fondaparinux sodium
|
$194.86 |
$194.86 |
$194.86 |
$157.59
|
|
Foot X-ray
|
$1,493.47 |
$1,493.47 |
$1,493.47 |
$365.30
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$348.56 |
$348.56 |
$348.56 |
$94.85
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$1,261.34 |
$1,261.34 |
$1,261.34 |
$183.15
|
|
Fructosamine glycated protein
|
$58.20 |
$58.20 |
$58.20 |
$63.05
|
|
Ftl cgen abnor four anal
|
$1,954.66 |
$1,954.66 |
$1,954.66 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$166.21 |
$166.21 |
$166.21 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$233.48 |
$233.48 |
$233.48 |
$177.43
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$386.61 |
$386.61 |
$386.61 |
$144.98
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$551.33 |
$551.33 |
$551.33 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$705.38 |
$705.38 |
$705.38 |
$210.50
|