|
3-d radiotherapy plan
|
$10,325.45 |
$10,325.45 |
$10,325.45 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$734.19 |
$734.19 |
$734.19 |
$425.10
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$335.97 |
$335.97 |
$335.97 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$3,438.28 |
$3,438.28 |
$3,438.28 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,951.45 |
$2,951.45 |
$2,951.45 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,840.89 |
$1,840.89 |
$1,840.89 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$5,734.46 |
$5,734.46 |
$5,734.46 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$4,478.52 |
$4,478.52 |
$4,478.52 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$4,289.83 |
$4,289.83 |
$4,289.83 |
$1,975.74
|
|
Abdominal Ultrasound (complete)
|
$944.78 |
$944.78 |
$944.78 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$979.40 |
$979.40 |
$979.40 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$5,774.94 |
$5,774.94 |
$5,774.94 |
$1,248.00
|
|
Ablation of upper extremity nerves rf
|
$1,454.14 |
$1,454.14 |
$1,454.14 |
$825.60
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$264.66 |
$264.66 |
$264.66 |
$89.91
|
|
Acetaminophen level
|
$307.88 |
$307.88 |
$307.88 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$730.21 |
$730.21 |
$730.21 |
$137.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$309.26 |
$309.26 |
$309.26 |
$306.22
|
|
Acute hepatitis panel
|
$142.91 |
$142.91 |
$142.91 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$139.18 |
$139.18 |
$139.18 |
$64.45
|
|
Adenosine 3 mg/250 ml bag for osm
|
$2,324.97 |
$2,324.97 |
$2,324.97 |
$217.04
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$111.93 |
$111.93 |
$111.93 |
$158.18
|
|
Administration immunization 1 vaccine
|
$137.62 |
$137.62 |
$137.62 |
$70.00
|
|
Administration immunization each additional vaccine
|
$137.10 |
$137.10 |
$137.10 |
$46.23
|
|
Administration vaccine influenza virus
|
$1,717.88 |
$1,717.88 |
$1,717.88 |
$49.40
|
|
_afb org id by sequencing rflx ast-sendout
|
$389.50 |
$389.50 |
$389.50 |
$289.60
|
|
Albumin (human), 25%, 50ml
|
$4,398.18 |
$4,398.18 |
$4,398.18 |
$277.87
|
|
Albumin, human 25 % intravenous solution
|
$2,710.31 |
$2,710.31 |
$2,710.31 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$4,371.42 |
$4,371.42 |
$4,371.42 |
$292.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$127.24 |
$127.24 |
$127.24 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$96.64 |
$96.64 |
$96.64 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$61.36 |
$61.36 |
$61.36 |
$9.93
|
|
Albuterol non-comp unit
|
$14.54 |
$14.54 |
$14.54 |
$9.43
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$316.46 |
$316.46 |
$316.46 |
$94.90
|
|
Alkaline phosphatase
|
$123.28 |
$123.28 |
$123.28 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$231.68 |
$231.68 |
$231.68 |
$56.35
|
|
Allergen egg white ige
|
$180.59 |
$180.59 |
$180.59 |
$39.78
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$524.73 |
$524.73 |
$524.73 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$276.99 |
$276.99 |
$276.99 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$2,336.68 |
$2,336.68 |
$2,336.68 |
$9,600.63
|
|
Alt/sgpt
|
$97.45 |
$97.45 |
$97.45 |
$49.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$99.87 |
$99.87 |
$99.87 |
$43.72
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$1,137.68 |
$1,137.68 |
$1,137.68 |
$174.72
|
|
Amiodarone 50 mg/ml intravenous solution
|
$242.54 |
$242.54 |
$242.54 |
$50.85
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$33,738.02 |
$33,738.02 |
$33,738.02 |
$15,167.75
|
|
Ammonia
|
$311.48 |
$311.48 |
$311.48 |
$123.48
|
|
Ampicillin 1 gram solution for injection
|
$178.05 |
$178.05 |
$178.05 |
$68.44
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$364.64 |
$364.64 |
$364.64 |
$57.38
|
|
Amylase
|
$232.85 |
$232.85 |
$232.85 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$821.13 |
$821.13 |
$821.13 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$1,569.79 |
$1,569.79 |
$1,569.79 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$110.40 |
$110.40 |
$110.40 |
$95.45
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$14,937.12 |
$14,937.12 |
$14,937.12 |
$6,048.00
|
|
Ankle X-ray
|
$280.78 |
$280.78 |
$280.78 |
$350.85
|
|
Antibody htlv/hiv confirm test
|
$230.48 |
$230.48 |
$230.48 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$714.22 |
$714.22 |
$714.22 |
$218.30
|
|
Antibody id rbc panel
|
$480.03 |
$480.03 |
$480.03 |
$291.75
|
|
Antibody screen rbc
|
$544.86 |
$544.86 |
$544.86 |
$105.00
|
|
Antidepressant not specified
|
$186.71 |
$186.71 |
$186.71 |
$89.50
|
|
Anti mog serum - sendout
|
$427.68 |
$427.68 |
$427.68 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$116.30 |
$116.30 |
$116.30 |
$50.88
|
|
Antinuclear antibodies
|
$234.65 |
$234.65 |
$234.65 |
$91.70
|
|
Antinuclear antibodies titer
|
$363.33 |
$363.33 |
$363.33 |
$80.25
|
|
Antistreptolysin o titer
|
$399.24 |
$399.24 |
$399.24 |
$57.85
|
|
Antithrombin iii activity
|
$533.13 |
$533.13 |
$533.13 |
$106.85
|
|
Application finger splntstatic 29130
|
$749.57 |
$749.57 |
$749.57 |
$226.20
|
|
Application long leg splint 29505
|
$1,832.84 |
$1,832.84 |
$1,832.84 |
$370.00
|
|
Application lower leg splint 29515
|
$1,085.16 |
$1,085.16 |
$1,085.16 |
$365.60
|
|
Application multi layer compression below knee (both sides)
|
$1,171.32 |
$1,171.32 |
$1,171.32 |
$393.75
|
|
Application of forearm cast 29075
|
$1,608.74 |
$1,608.74 |
$1,608.74 |
$386.10
|
|
Application of paste boot 29580
|
$1,083.19 |
$1,083.19 |
$1,083.19 |
$336.00
|
|
Application short leg cast 29405
|
$924.50 |
$924.50 |
$924.50 |
$397.33
|
|
Apply finger cast 29086
|
$941.91 |
$941.91 |
$941.91 |
$242.20
|
|
Apply intrcav radiat compl
|
$9,394.74 |
$9,394.74 |
$9,394.74 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$7,147.27 |
$7,147.27 |
$7,147.27 |
$1,521.98
|
|
Apply intrcav radiat simple
|
$7,147.27 |
$7,147.27 |
$7,147.27 |
$1,001.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$3,153.78 |
$3,153.78 |
$3,153.78 |
$943.40
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$224.34 |
$224.34 |
$224.34 |
$100.00
|
|
Aquatic exercise - group charge
|
$180.07 |
$180.07 |
$180.07 |
$91.68
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$810.50 |
$810.50 |
$810.50 |
$1,301.04
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$2,468.16 |
$2,468.16 |
$2,468.16 |
$588.53
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$2,365.59 |
$2,365.59 |
$2,365.59 |
$715.37
|
|
Aspirate/inj ganglion cyst 20612
|
$1,016.42 |
$1,016.42 |
$1,016.42 |
$440.00
|
|
Assay dir meas fr estradiol
|
$87.90 |
$87.90 |
$87.90 |
$75.11
|
|
Assay of salicylate
|
$244.61 |
$244.61 |
$244.61 |
$104.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$165.84 |
$165.84 |
$165.84 |
$47.25
|
|
Ast/sgot
|
$102.25 |
$102.25 |
$102.25 |
$46.20
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$33,080.81 |
$33,080.81 |
$33,080.81 |
$31,198.64
|
|
Atropine 0.1 mg/ml injection syringe
|
$244.84 |
$244.84 |
$244.84 |
$43.85
|
|
Avul nail plate addl
|
$859.10 |
$859.10 |
$859.10 |
$232.80
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$666.29 |
$666.29 |
$666.29 |
$356.00
|
|
Azacitidine injection
|
$451.62 |
$451.62 |
$451.62 |
$1,042.91
|
|
Azithromycin 500 mg intravenous solution
|
$196.33 |
$196.33 |
$196.33 |
$55.63
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$9,162.37 |
$9,162.37 |
$9,162.37 |
$6,471.19
|
|
Benztropine 1 mg/ml injection solution
|
$280.76 |
$280.76 |
$280.76 |
$116.84
|
|
Beta 2 glycoprotein 1 antibody iga
|
$235.44 |
$235.44 |
$235.44 |
$92.82
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$296.55 |
$296.55 |
$296.55 |
$70.37
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$10,069.21 |
$10,069.21 |
$10,069.21 |
$5,250.00
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$2,143.22 |
$2,143.22 |
$2,143.22 |
$4,868.42
|
|
Bevacizumab injection
|
$1,786.58 |
$1,786.58 |
$1,786.58 |
$697.32
|
|
Bilateral n block inj occipital 64405
|
$1,483.37 |
$1,483.37 |
$1,483.37 |
$825.60
|