|
11-desoxycortisol - sendout
|
$225.00 |
$225.00 |
$225.00 |
$84.56
|
|
17-hydroxypregnenolone
|
$174.00 |
$174.00 |
$174.00 |
$85.15
|
|
17-ketosteroids
|
$151.20 |
$151.20 |
$151.20 |
$49.45
|
|
1st hosp/birthing center care per day nml nb 99460
|
$126.00 |
$126.00 |
$126.00 |
$172.80
|
|
1st inpatient critical care pr day age 28 days/less than 99468
|
$1,696.80 |
$1,696.80 |
$1,696.80 |
$1,656.80
|
|
2nd order venous cath
|
$1,635.60 |
$1,635.60 |
$1,635.60 |
$1,809.60
|
|
3-d radiotherapy plan
|
$12,312.00 |
$12,312.00 |
$12,312.00 |
$4,953.00
|
|
3d recon without postprocess indpndt
|
$4,113.60 |
$4,113.60 |
$4,113.60 |
$469.20
|
|
5' nucleotidase - sendout
|
$163.20 |
$163.20 |
$163.20 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$197.40 |
$197.40 |
$197.40 |
$96.39
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$133.80 |
$133.80 |
$133.80 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$2,957.40 |
$2,957.40 |
$2,957.40 |
$3,683.78
|
|
Abd/low ext cath 1st
|
$2,563.20 |
$2,563.20 |
$2,563.20 |
$2,383.31
|
|
Abd/low ext cath 2nd
|
$2,540.40 |
$2,540.40 |
$2,540.40 |
$2,261.83
|
|
Abd/low ext cath 3rd
|
$2,638.80 |
$2,638.80 |
$2,638.80 |
$2,662.40
|
|
Abd/low ext cath addl
|
$401.40 |
$401.40 |
$401.40 |
$965.25
|
|
Abdominal CT scan (with and without contrast)
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,992.00
|
|
Abdominal CT scan (with contrast)
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,920.60 |
$4,920.60 |
$4,920.60 |
$3,039.92
|
|
Abdominal MRI (with contrast)
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$1,993.50
|
|
Abdominal paracentesis w/image guidance
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$1,594.20 |
$1,594.20 |
$1,594.20 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$687.00 |
$687.00 |
$687.00 |
$1,176.00
|
|
Abl1 gene
|
$1,123.80 |
$1,123.80 |
$1,123.80 |
$668.85
|
|
Ablate arrhythmia add on
|
$8,131.80 |
$8,131.80 |
$8,131.80 |
$6,913.20
|
|
Ablate heart dysrhythm focus
|
$11,858.40 |
$11,858.40 |
$11,858.40 |
$9,556.83
|
|
Ablation cardiac vagal inputs atrium
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$2,126.95
|
|
Ablation of upper extremity nerves rf
|
$1,947.00 |
$1,947.00 |
$1,947.00 |
$921.06
|
|
Abscess drain retroperitoneal surg code
|
$4,194.00 |
$4,194.00 |
$4,194.00 |
$3,053.18
|
|
Acetaminophen level
|
$142.20 |
$142.20 |
$142.20 |
$117.01
|
|
Acetone qualitative
|
$39.60 |
$39.60 |
$39.60 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$157.80 |
$157.80 |
$157.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$251.40 |
$251.40 |
$251.40 |
$106.70
|
|
Acute hepatitis panel
|
$696.00 |
$696.00 |
$696.00 |
$281.09
|
|
#acylcarnitineprfl
|
$501.00 |
$501.00 |
$501.00 |
$110.25
|
|
Adenovirus ag ia
|
$241.20 |
$241.20 |
$241.20 |
$40.70
|
|
Adenovirus antibody,serum - quest
|
$54.60 |
$54.60 |
$54.60 |
$63.00
|
|
Adh-sendout
|
$330.60 |
$330.60 |
$330.60 |
$109.41
|
|
Administration chemotherapy IV infusion each additional hour
|
$591.60 |
$591.60 |
$591.60 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$520.80 |
$520.80 |
$520.80 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,336.80 |
$1,336.80 |
$1,336.80 |
$688.88
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$478.80 |
$478.80 |
$478.80 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$163.20 |
$163.20 |
$163.20 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$163.20 |
$163.20 |
$163.20 |
$265.50
|
|
Administration immunization 1 vaccine
|
$75.60 |
$75.60 |
$75.60 |
$67.60
|
|
Administration immunization each additional vaccine
|
$27.60 |
$27.60 |
$27.60 |
$46.23
|
|
Administration vaccine hepatitis b
|
$45.00 |
$45.00 |
$45.00 |
$54.60
|
|
Administration vaccine influenza virus
|
$52.80 |
$52.80 |
$52.80 |
$48.35
|
|
Administration vaccine pneumococcal
|
$58.20 |
$58.20 |
$58.20 |
$49.17
|
|
Aep hearing status deter i&r
|
$459.00 |
$459.00 |
$459.00 |
$303.05
|
|
Aep neurodiagnostic i&r
|
$475.20 |
$475.20 |
$475.20 |
$576.80
|
|
Aep thrshld est mlt freq i&r
|
$475.20 |
$475.20 |
$475.20 |
$590.25
|
|
_afb id by dna probe rflx ast
|
$223.80 |
$223.80 |
$223.80 |
$89.70
|
|
_afb org id by sequencing rflx ast-sendout
|
$414.60 |
$414.60 |
$414.60 |
$289.60
|
|
Afo molded ankle gauntlet
|
$169.20 |
$169.20 |
$169.20 |
$724.73
|
|
Afo rig ant tib tcf/= custom
|
$3,423.00 |
$3,423.00 |
$3,423.00 |
$1,421.28
|
|
Air injection into abdomen 49400
|
$2,313.60 |
$2,313.60 |
$2,313.60 |
$531.49
|
|
Airway resistance by impulse oscillometry 94728
|
$318.00 |
$318.00 |
$318.00 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$89.40 |
$89.40 |
$89.40 |
$47.50
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$63.00 |
$63.00 |
$63.00 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$91.20 |
$91.20 |
$91.20 |
$40.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$301.20 |
$301.20 |
$301.20 |
$94.90
|
|
Alkaline phosphatase
|
$120.60 |
$120.60 |
$120.60 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$465.00 |
$465.00 |
$465.00 |
$48.57
|
|
Allergen egg white ige
|
$194.40 |
$194.40 |
$194.40 |
$36.60
|
|
Allergy Skin Testing
|
$46.20 |
$46.20 |
$46.20 |
$53.43
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$715.20 |
$715.20 |
$715.20 |
$922.40
|
|
Alpha-fetoprotein amniotic
|
$159.60 |
$159.60 |
$159.60 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$253.20 |
$253.20 |
$253.20 |
$103.60
|
|
Alt/sgpt
|
$148.80 |
$148.80 |
$148.80 |
$44.68
|
|
Aluminum - quest
|
$198.60 |
$198.60 |
$198.60 |
$81.49
|
|
Amino acid screen, urine
|
$540.00 |
$540.00 |
$540.00 |
$76.05
|
|
Amino acids quant 2-5
|
$406.80 |
$406.80 |
$406.80 |
$138.03
|
|
Aminolevulinic acid delta
|
$244.20 |
$244.20 |
$244.20 |
$74.10
|
|
Amitriptyline (elavil) -sendout
|
$135.60 |
$135.60 |
$135.60 |
$92.50
|
|
Ammonia
|
$159.60 |
$159.60 |
$159.60 |
$116.40
|
|
Amniocentesisdiagnostic 59000
|
$549.00 |
$549.00 |
$549.00 |
$943.50
|
|
Amniotic fluid scan
|
$164.40 |
$164.40 |
$164.40 |
$42.40
|
|
Amphetamine confirm urine -sendout
|
$274.20 |
$274.20 |
$274.20 |
$93.61
|
|
Amphetamines 5 or more
|
$247.20 |
$247.20 |
$247.20 |
$87.75
|
|
Amylase
|
$214.20 |
$214.20 |
$214.20 |
$83.20
|
|
Anabolic steroid 1 or 2
|
$162.00 |
$162.00 |
$162.00 |
$80.08
|
|
Ana ds-dna
|
$192.00 |
$192.00 |
$192.00 |
$58.63
|
|
Anal/urinary muscle study
|
$481.20 |
$481.20 |
$481.20 |
$575.00
|
|
Analysis gene f2 20210g>a variant
|
$613.20 |
$613.20 |
$613.20 |
$212.40
|
|
Analysis gene f5 leiden variant
|
$613.20 |
$613.20 |
$613.20 |
$219.13
|
|
Anaplsma phgcytophlm amp prb
|
$37.80 |
$37.80 |
$37.80 |
$88.00
|
|
Anca screen with reflex to titer -quest
|
$324.00 |
$324.00 |
$324.00 |
$100.89
|
|
An cholangiogram percutaneous compl
|
$2,641.20 |
$2,641.20 |
$2,641.20 |
$2,547.00
|
|
Androstanediol
|
$97.80 |
$97.80 |
$97.80 |
$103.80
|
|
An fluoro guide for cvp
|
$676.20 |
$676.20 |
$676.20 |
$515.34
|
|
Angio balloon ctrl dialysis seg add-on
|
$27,252.00 |
$27,252.00 |
$27,252.00 |
$5,341.83
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,161.60 |
$4,161.60 |
$4,161.60 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$8,322.00 |
$8,322.00 |
$8,322.00 |
$9,120.80
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,161.60 |
$4,161.60 |
$4,161.60 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$8,322.00 |
$8,322.00 |
$8,322.00 |
$8,466.00
|
|
Ankle X-ray
|
$679.80 |
$679.80 |
$679.80 |
$351.45
|
