|
2nd order venous cath
|
$4,783.50 |
$4,783.50 |
$4,783.50 |
$1,809.60
|
|
3d recon without postprocess indpndt
|
$3,762.77 |
$3,762.77 |
$3,762.77 |
$431.75
|
|
5' nucleotidase - sendout
|
$504.28 |
$504.28 |
$504.28 |
$50.05
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$643.69 |
$643.69 |
$643.69 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$9,782.45 |
$9,782.45 |
$9,782.45 |
$3,683.78
|
|
Abdominal CT scan (with and without contrast)
|
$15,161.93 |
$15,161.93 |
$15,161.93 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$6,844.22 |
$6,844.22 |
$6,844.22 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$11,740.70 |
$11,740.70 |
$11,740.70 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$7,504.82 |
$7,504.82 |
$7,504.82 |
$2,929.50
|
|
Abdominal MRI (with contrast)
|
$4,221.62 |
$4,221.62 |
$4,221.62 |
$2,199.24
|
|
Abdominal MRI (without contrast)
|
$7,985.04 |
$7,985.04 |
$7,985.04 |
$1,979.51
|
|
Abdominal paracentesis w/image guidance
|
$6,452.07 |
$6,452.07 |
$6,452.07 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$4,555.62 |
$4,555.62 |
$4,555.62 |
$780.00
|
|
Abdominal Ultrasound (limited)
|
$3,504.76 |
$3,504.76 |
$3,504.76 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$9,634.22 |
$9,634.22 |
$9,634.22 |
$1,176.00
|
|
Ablate arrhythmia add on
|
$23,450.45 |
$23,450.45 |
$23,450.45 |
$7,417.15
|
|
Ablate heart dysrhythm focus
|
$39,486.47 |
$39,486.47 |
$39,486.47 |
$10,008.58
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$343.03 |
$343.03 |
$343.03 |
$122.86
|
|
Acetaminophen level
|
$999.03 |
$999.03 |
$999.03 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$722.81 |
$722.81 |
$722.81 |
$136.50
|
|
Acetone qualitative
|
$467.92 |
$467.92 |
$467.92 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$617.96 |
$617.96 |
$617.96 |
$65.16
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$306.22 |
$306.22 |
$306.22 |
$323.77
|
|
Acute hepatitis panel
|
$2,547.52 |
$2,547.52 |
$2,547.52 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$139.48 |
$139.48 |
$139.48 |
$50.85
|
|
Adenosine 3 mg/250 ml bag for osm
|
$2,301.02 |
$2,301.02 |
$2,301.02 |
$217.04
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$112.16 |
$112.16 |
$112.16 |
$136.99
|
|
Administration chemotherapy IV infusion each additional hour
|
$770.25 |
$770.25 |
$770.25 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$770.25 |
$770.25 |
$770.25 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,775.97 |
$1,775.97 |
$1,775.97 |
$677.05
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$564.97 |
$564.97 |
$564.97 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$302.28 |
$302.28 |
$302.28 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$302.28 |
$302.28 |
$302.28 |
$264.00
|
|
Administration immunization 1 vaccine
|
$162.31 |
$162.31 |
$162.31 |
$72.80
|
|
Administration immunization each additional vaccine
|
$141.74 |
$141.74 |
$141.74 |
$48.02
|
|
Administration vaccine influenza virus
|
$1,700.22 |
$1,700.22 |
$1,700.22 |
$49.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$6,182.80 |
$6,182.80 |
$6,182.80 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$150.34 |
$150.34 |
$150.34 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$4,379.28 |
$4,379.28 |
$4,379.28 |
$292.50
|
|
Albumin, human 25 % intravenous solution
|
$2,685.55 |
$2,685.55 |
$2,685.55 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$4,331.40 |
$4,331.40 |
$4,331.40 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$309.79 |
$309.79 |
$309.79 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$211.43 |
$211.43 |
$211.43 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$63.32 |
$63.32 |
$63.32 |
$21.68
|
|
Albuterol non-comp unit
|
$14.49 |
$14.49 |
$14.49 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$925.60 |
$925.60 |
$925.60 |
$93.60
|
|
Alkaline phosphatase
|
$232.65 |
$232.65 |
$232.65 |
$46.40
|
|
Allergen egg white ige
|
$279.77 |
$279.77 |
$279.77 |
$41.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$381.12 |
$381.12 |
$381.12 |
$6,788.78
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$905.18 |
$905.18 |
$905.18 |
$1,028.25
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$3,452.10 |
$3,452.10 |
$3,452.10 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$898.81 |
$898.81 |
$898.81 |
$99.71
|
|
Alteplase 100 mg infusion from pyxis vial
|
$2,312.61 |
$2,312.61 |
$2,312.61 |
$2,680.50
|
|
Alt/sgpt
|
$590.95 |
$590.95 |
$590.95 |
$49.00
|
|
Aluminum - quest
|
$1,365.62 |
$1,365.62 |
$1,365.62 |
$86.45
|
|
Amantadine (symmetrel)-sendout
|
$232.78 |
$232.78 |
$232.78 |
$196.20
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$99.57 |
$99.57 |
$99.57 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$1,101.40 |
$1,101.40 |
$1,101.40 |
$195.19
|
|
Amiodarone 50 mg/ml intravenous solution
|
$238.88 |
$238.88 |
$238.88 |
$49.49
|
|
Amitriptyline (elavil) -sendout
|
$160.06 |
$160.06 |
$160.06 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$38,189.57 |
$38,189.57 |
$38,189.57 |
$15,167.75
|
|
Ammonia
|
$731.30 |
$731.30 |
$731.30 |
$123.48
|
|
Amphetamine confirm urine -sendout
|
$102.08 |
$102.08 |
$102.08 |
$94.50
|
|
Ampicillin 1 gram solution for injection
|
$240.97 |
$240.97 |
$240.97 |
$60.40
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$500.34 |
$500.34 |
$500.34 |
$52.65
|
|
Amylase
|
$961.81 |
$961.81 |
$961.81 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$3,520.69 |
$3,520.69 |
$3,520.69 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$3,932.32 |
$3,932.32 |
$3,932.32 |
$221.13
|
|
Anaplsma phgcytophlm amp prb
|
$110.40 |
$110.40 |
$110.40 |
$95.45
|
|
An cholangiogram percutaneous compl
|
$37,788.55 |
$37,788.55 |
$37,788.55 |
$2,664.20
|
|
An fluoro guide for cvp
|
$1,840.87 |
$1,840.87 |
$1,840.87 |
$489.47
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$14,937.12 |
$14,937.12 |
$14,937.12 |
$6,736.02
|
|
Angio trnslmnl balloon same artery ini
|
$35,623.89 |
$35,623.89 |
$35,623.89 |
$9,074.63
|
|
Ankle X-ray
|
$1,237.24 |
$1,237.24 |
$1,237.24 |
$351.20
|
|
Anodyne therapy charges pt
|
$433.15 |
$433.15 |
$433.15 |
$41.02
|
|
Antibody elution rbc reference
|
$1,963.89 |
$1,963.89 |
$1,963.89 |
$176.54
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$1,717.40 |
$1,717.40 |
$1,717.40 |
$219.30
|
|
Antibody id rbc panel
|
$639.49 |
$639.49 |
$639.49 |
$291.75
|
|
Antibody screen rbc
|
$403.78 |
$403.78 |
$403.78 |
$106.88
|
|
Anti mog serum - sendout
|
$37.91 |
$37.91 |
$37.91 |
$150.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$645.84 |
$645.84 |
$645.84 |
$51.00
|
|
Antinuclear antibodies
|
$724.39 |
$724.39 |
$724.39 |
$91.70
|
|
Antinuclear antibodies titer
|
$598.13 |
$598.13 |
$598.13 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$232.65 |
$232.65 |
$232.65 |
$72.15
|
|
Antistreptolysin o titer
|
$516.44 |
$516.44 |
$516.44 |
$57.96
|
|
Antithrombin iii activity
|
$1,071.00 |
$1,071.00 |
$1,071.00 |
$113.80
|
|
Application finger splntstatic 29130
|
$1,475.52 |
$1,475.52 |
$1,475.52 |
$222.28
|
|
Application long leg splint 29505
|
$2,052.93 |
$2,052.93 |
$2,052.93 |
$370.00
|
|
Application lower leg splint 29515
|
$2,052.93 |
$2,052.93 |
$2,052.93 |
$362.72
|
|
Application multi layer compression below knee (both sides)
|
$952.76 |
$952.76 |
$952.76 |
$393.75
|
|
Application of forearm cast 29075
|
$3,507.58 |
$3,507.58 |
$3,507.58 |
$384.59
|
|
Application of long arm cast 29065
|
$3,507.58 |
$3,507.58 |
$3,507.58 |
$404.63
|
|
Application of long leg cast 29345
|
$3,507.58 |
$3,507.58 |
$3,507.58 |
$511.68
|
|
Application short leg cast 29405
|
$3,507.58 |
$3,507.58 |
$3,507.58 |
$396.77
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$12,600.28 |
$12,600.28 |
$12,600.28 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$12,600.28 |
$12,600.28 |
$12,600.28 |
$2,154.21
|
|
Appl modality 1/> areas paraffin bath 97018
|
$546.14 |
$546.14 |
$546.14 |
$69.96
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$421.85 |
$421.85 |
$421.85 |
$75.98
|
|
Apply intrcav radiat compl
|
$10,346.41 |
$10,346.41 |
$10,346.41 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$7,871.27 |
$7,871.27 |
$7,871.27 |
$1,338.48
|
