|
11-desoxycortisol - sendout
|
$135.00 |
$135.00 |
$135.00 |
$91.85
|
|
24 hr ambulatory b/p monitor
|
$635.00 |
$635.00 |
$635.00 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$3,543.00 |
$3,543.00 |
$3,543.00 |
$1,724.25
|
|
3d ech img cgen car anomal
|
$2,407.00 |
$2,407.00 |
$2,407.00 |
$511.60
|
|
3d recon without postprocess indpndt
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$508.13
|
|
5' nucleotidase - sendout
|
$52.00 |
$52.00 |
$52.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$117.00 |
$117.00 |
$117.00 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$5,295.77 |
$5,295.77 |
$5,295.77 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$55.00 |
$55.00 |
$55.00 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$10,857.00 |
$10,857.00 |
$10,857.00 |
$3,629.42
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,288.00 |
$1,288.00 |
$1,288.00 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$610.00 |
$610.00 |
$610.00 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$2,122.00 |
$2,122.00 |
$2,122.00 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$2,122.00 |
$2,122.00 |
$2,122.00 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$3,341.00 |
$3,341.00 |
$3,341.00 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$606.00 |
$606.00 |
$606.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$606.00 |
$606.00 |
$606.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$572.00 |
$572.00 |
$572.00 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$572.00 |
$572.00 |
$572.00 |
$418.63
|
|
Abdominal X-ray (single view)
|
$445.00 |
$445.00 |
$445.00 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$3,341.00 |
$3,341.00 |
$3,341.00 |
$1,148.40
|
|
Ablate arrhythmia add on
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$18,403.00 |
$18,403.00 |
$18,403.00 |
$9,332.05
|
|
Ablation cardiac vagal inputs atrium
|
$530.00 |
$530.00 |
$530.00 |
$2,260.30
|
|
Ablation of upper extremity nerves rf
|
$1,142.00 |
$1,142.00 |
$1,142.00 |
$832.50
|
|
Abobotulinumtoxina
|
$2,113.20 |
$2,113.20 |
$2,113.20 |
$1,541.21
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$198.80 |
$198.80 |
$198.80 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$184.63 |
$184.63 |
$184.63 |
$122.55
|
|
Acetone qualitative
|
$21.00 |
$21.00 |
$21.00 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$55.00 |
$55.00 |
$55.00 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,081.50 |
$1,081.50 |
$1,081.50 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$124.53 |
$124.53 |
$124.53 |
$31.21
|
|
Acute hepatitis panel
|
$219.00 |
$219.00 |
$219.00 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$31.50 |
$31.50 |
$31.50 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$147.00 |
$147.00 |
$147.00 |
$64.45
|
|
#acylcarnitineprfl
|
$78.00 |
$78.00 |
$78.00 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,440.81 |
$1,440.81 |
$1,440.81 |
$271.98
|
|
Adh-sendout
|
$156.00 |
$156.00 |
$156.00 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1,190.95 |
$1,190.95 |
$1,190.95 |
$193.40
|
|
Admin ecg contrast agent
|
$355.00 |
$355.00 |
$355.00 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$277.00 |
$277.00 |
$277.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$277.00 |
$277.00 |
$277.00 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$847.00 |
$847.00 |
$847.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$468.00 |
$468.00 |
$468.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$468.00 |
$468.00 |
$468.00 |
$256.49
|
|
Administration immunization each additional vaccine
|
$112.00 |
$112.00 |
$112.00 |
$47.40
|
|
Administration vaccine influenza virus
|
$139.00 |
$139.00 |
$139.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$139.00 |
$139.00 |
$139.00 |
$49.68
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$15,320.16 |
$15,320.16 |
$15,320.16 |
$11,350.31
|
|
#afb mycobacteria suscep. #1
|
$34.00 |
$34.00 |
$34.00 |
$34.72
|
|
Airway resistance by impulse oscillometry 94728
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$36.00 |
$36.00 |
$36.00 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$756.00 |
$756.00 |
$756.00 |
$244.70
|
|
Albumin, human 25 % intravenous solution
|
$378.00 |
$378.00 |
$378.00 |
$234.94
|
|
Albumin (human), 5%, 250 ml
|
$378.00 |
$378.00 |
$378.00 |
$252.77
|
|
Albumin, human 5 % intravenous solution
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$275.16
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$29.00 |
$29.00 |
$29.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$24.00 |
$24.00 |
$24.00 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$8.03 |
$8.03 |
$8.03 |
$5.67
|
|
Albuterol non-comp con
|
$202.86 |
$202.86 |
$202.86 |
$6.07
|
|
Albuterol non-comp unit
|
$4.89 |
$4.89 |
$4.89 |
$5.40
|
|
Aldesleukin injection
|
$1,156.91 |
$1,156.91 |
$1,156.91 |
$9,030.11
|
|
Alkaline phosphatase
|
$25.00 |
$25.00 |
$25.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$83.00 |
$83.00 |
$83.00 |
$48.57
|
|
Allergen egg white ige
|
$83.00 |
$83.00 |
$83.00 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$174.00 |
$174.00 |
$174.00 |
$45.00
|
|
Allergy injection; single 95115
|
$174.00 |
$174.00 |
$174.00 |
$46.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$10,612.09 |
$10,612.09 |
$10,612.09 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$5,291.40 |
$5,291.40 |
$5,291.40 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$953.19 |
$953.19 |
$953.19 |
$858.66
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,280.00 |
$1,280.00 |
$1,280.00 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$297.00 |
$297.00 |
$297.00 |
$198.60
|
|
Alpha-fetoprotein tumor marker
|
$77.00 |
$77.00 |
$77.00 |
$106.00
|
|
Alprostadil for injection
|
$711.24 |
$711.24 |
$711.24 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$43,507.20 |
$43,507.20 |
$43,507.20 |
$15,857.45
|
|
Alt/sgpt
|
$26.00 |
$26.00 |
$26.00 |
$47.50
|
|
Aluminum - quest
|
$117.00 |
$117.00 |
$117.00 |
$83.05
|
|
Ambl bp mntr w/sw a/r
|
$635.00 |
$635.00 |
$635.00 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$102.94 |
$102.94 |
$102.94 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$33.37 |
$33.37 |
$33.37 |
$37.33
|
|
Aminolevulinic acid delta
|
$76.00 |
$76.00 |
$76.00 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$83.97 |
$83.97 |
$83.97 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$171.08 |
$171.08 |
$171.08 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$57.14 |
$57.14 |
$57.14 |
$55.86
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$14,115.18 |
$14,115.18 |
$14,115.18 |
$9,084.45
|
|
Ammonia
|
$67.00 |
$67.00 |
$67.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$2,120.00 |
$2,120.00 |
$2,120.00 |
$942.60
|
|
Amniocore per sq cm
|
$1,286.21 |
$1,286.21 |
$1,286.21 |
$1.00
|
|
Amobarbital 125 mg inj
|
$1,759.32 |
$1,759.32 |
$1,759.32 |
$1,283.59
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$210.00 |
$210.00 |
$210.00 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,336.90 |
$1,336.90 |
$1,336.90 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$377.21 |
$377.21 |
$377.21 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$235.20 |
$235.20 |
$235.20 |
$54.57
|
|
Amylase
|
$32.00 |
$32.00 |
$32.00 |
$90.00
|
