|
17-hydroxypregnenolone
|
$352.08 |
$352.08 |
$352.08 |
$85.15
|
|
2nd order venous cath
|
$3,004.04 |
$3,004.04 |
$3,004.04 |
$1,809.60
|
|
3d recon without postprocess indpndt
|
$669.42 |
$669.42 |
$669.42 |
$427.34
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$185.38 |
$185.38 |
$185.38 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$8,023.82 |
$8,023.82 |
$8,023.82 |
$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
|
|
Abdominal CT scan (with and without contrast)
|
$7,925.34 |
$7,925.34 |
$7,925.34 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$6,848.12 |
$6,848.12 |
$6,848.12 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$6,844.73 |
$6,844.73 |
$6,844.73 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$8,070.45 |
$8,070.45 |
$8,070.45 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$6,371.24 |
$6,371.24 |
$6,371.24 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$5,638.72 |
$5,638.72 |
$5,638.72 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$2,599.58 |
$2,599.58 |
$2,599.58 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$5,248.15 |
$5,248.15 |
$5,248.15 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$2,532.21 |
$2,532.21 |
$2,532.21 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$8,887.79 |
$8,887.79 |
$8,887.79 |
$1,170.28
|
|
Ablate arrhythmia add on
|
$12,890.39 |
$12,890.39 |
$12,890.39 |
$7,417.15
|
|
Abscess drain retroperitoneal surg code
|
$7,621.45 |
$7,621.45 |
$7,621.45 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$224.49 |
$224.49 |
$224.49 |
$125.63
|
|
Acetaminophen level
|
$287.71 |
$287.71 |
$287.71 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$766.24 |
$766.24 |
$766.24 |
$133.60
|
|
Acetone qualitative
|
$116.46 |
$116.46 |
$116.46 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$42.18 |
$42.18 |
$42.18 |
$65.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$323.77 |
$323.77 |
$323.77 |
$323.77
|
|
Acute hepatitis panel
|
$387.70 |
$387.70 |
$387.70 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$150.97 |
$150.97 |
$150.97 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$2,442.52 |
$2,442.52 |
$2,442.52 |
$219.86
|
|
Adh-sendout
|
$118.79 |
$118.79 |
$118.79 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$120.99 |
$120.99 |
$120.99 |
$124.70
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$709.08 |
$709.08 |
$709.08 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$256.49 |
$256.49 |
$256.49 |
$264.00
|
|
Administration immunization 1 vaccine
|
$146.03 |
$146.03 |
$146.03 |
$70.52
|
|
Administration immunization each additional vaccine
|
$172.78 |
$172.78 |
$172.78 |
$46.23
|
|
Administration vaccine hepatitis b
|
$492.86 |
$492.86 |
$492.86 |
$51.35
|
|
Administration vaccine influenza virus
|
$1,804.39 |
$1,804.39 |
$1,804.39 |
$49.50
|
|
Aep thrshld est mlt freq i&r
|
$3,212.94 |
$3,212.94 |
$3,212.94 |
$537.95
|
|
_afb id by dna probe rflx ast
|
$309.48 |
$309.48 |
$309.48 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$423.95 |
$423.95 |
$423.95 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$83.43 |
$83.43 |
$83.43 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$1,371.73 |
$1,371.73 |
$1,371.73 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$717.58 |
$717.58 |
$717.58 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$1,151.53 |
$1,151.53 |
$1,151.53 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$173.96 |
$173.96 |
$173.96 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$142.20 |
$142.20 |
$142.20 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$43.09 |
$43.09 |
$43.09 |
$22.45
|
|
Albuterol non-comp unit
|
$10.81 |
$10.81 |
$10.81 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$1,128.29 |
$1,128.29 |
$1,128.29 |
$93.60
|
|
Alkaline phosphatase
|
$240.77 |
$240.77 |
$240.77 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$276.75 |
$276.75 |
$276.75 |
$56.35
|
|
Allergen egg white ige
|
$80.57 |
$80.57 |
$80.57 |
$41.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$958.51 |
$958.51 |
$958.51 |
$3,104.06
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$1,317.16 |
$1,317.16 |
$1,317.16 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$785.40 |
$785.40 |
$785.40 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$989.09 |
$989.09 |
$989.09 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1,190.22 |
$1,190.22 |
$1,190.22 |
$2,513.00
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,107.61 |
$1,107.61 |
$1,107.61 |
$3,025.07
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$994.17 |
$994.17 |
$994.17 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$258.85 |
$258.85 |
$258.85 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$2,454.83 |
$2,454.83 |
$2,454.83 |
$2,600.22
|
|
Alt/sgpt
|
$405.01 |
$405.01 |
$405.01 |
$49.00
|
|
Amantadine (symmetrel)-sendout
|
$211.17 |
$211.17 |
$211.17 |
$196.20
|
|
Aminolevulinic acid delta
|
$253.91 |
$253.91 |
$253.91 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$107.35 |
$107.35 |
$107.35 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$695.27 |
$695.27 |
$695.27 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$259.22 |
$259.22 |
$259.22 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$103.39 |
$103.39 |
$103.39 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$44,124.06 |
$44,124.06 |
$44,124.06 |
$15,167.75
|
|
Ammonia
|
$460.32 |
$460.32 |
$460.32 |
$120.90
|
|
Amphetamines 5 or more
|
$367.61 |
$367.61 |
$367.61 |
$101.40
|
|
Ampicillin 1 gram solution for injection
|
$159.37 |
$159.37 |
$159.37 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$324.87 |
$324.87 |
$324.87 |
$51.93
|
|
Amylase
|
$394.68 |
$394.68 |
$394.68 |
$93.00
|
|
Anal/urinary muscle study
|
$1,824.22 |
$1,824.22 |
$1,824.22 |
$507.26
|
|
Analysis gene f2 20210g>a variant
|
$1,013.92 |
$1,013.92 |
$1,013.92 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$1,132.47 |
$1,132.47 |
$1,132.47 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$128.96 |
$128.96 |
$128.96 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$232.30 |
$232.30 |
$232.30 |
$109.20
|
|
An cholangiogram percutaneous compl
|
$10,758.20 |
$10,758.20 |
$10,758.20 |
$2,626.65
|
|
An fluoro guide for cvp
|
$1,582.15 |
$1,582.15 |
$1,582.15 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$8,423.32 |
$8,423.32 |
$8,423.32 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$15,256.47 |
$15,256.47 |
$15,256.47 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$12,426.74 |
$12,426.74 |
$12,426.74 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$12,977.89 |
$12,977.89 |
$12,977.89 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$14,669.95 |
$14,669.95 |
$14,669.95 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$21,373.26 |
$21,373.26 |
$21,373.26 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$17,517.69 |
$17,517.69 |
$17,517.69 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$12,426.74 |
$12,426.74 |
$12,426.74 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ini
|
$13,690.05 |
$13,690.05 |
$13,690.05 |
$8,689.20
|
|
Ankle X-ray
|
$1,669.55 |
$1,669.55 |
$1,669.55 |
$339.44
|
|
Anodyne therapy charges pt
|
$106.94 |
$106.94 |
$106.94 |
$41.02
|
|
Antibody bacterium, not elsewhere specified
|
$198.81 |
$198.81 |
$198.81 |
$57.89
|
|
Antibody elution rbc reference
|
$498.15 |
$498.15 |
$498.15 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$298.67 |
$298.67 |
$298.67 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$283.54 |
$283.54 |
$283.54 |
$220.73
|
|
Antibody id rbc panel
|
$1,017.75 |
$1,017.75 |
$1,017.75 |
$291.75
|
|
Antibody screen rbc
|
$180.68 |
$180.68 |
$180.68 |
$105.00
|
|
Anti mog serum - sendout
|
$44.29 |
$44.29 |
$44.29 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$46.50 |
$46.50 |
$46.50 |
$50.88
|