|
11-desoxycortisol - sendout
|
$87.50 |
$87.50 |
$87.50 |
$91.85
|
|
17-hydroxypregnenolone
|
$87.50 |
$87.50 |
$87.50 |
$92.65
|
|
17-ketosteroids
|
$95.00 |
$95.00 |
$95.00 |
$55.00
|
|
2nd order venous cath
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,532.04
|
|
3d ech img cgen car anomal
|
$810.00 |
$810.00 |
$810.00 |
$511.60
|
|
3d recon without postprocess indpndt
|
$395.00 |
$395.00 |
$395.00 |
$508.13
|
|
5' nucleotidase - sendout
|
$102.50 |
$102.50 |
$102.50 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$142.50 |
$142.50 |
$142.50 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$135.62 |
$135.62 |
$135.62 |
$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
|
$3,850.00 |
$3,850.00 |
$3,850.00 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$1,620.00 |
$1,620.00 |
$1,620.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,745.00 |
$1,745.00 |
$1,745.00 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$1,865.00 |
$1,865.00 |
$1,865.00 |
$2,475.45
|
|
Abd/low ext cath addl
|
$695.00 |
$695.00 |
$695.00 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$670.00 |
$670.00 |
$670.00 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,225.00 |
$1,225.00 |
$1,225.00 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$2,575.00 |
$2,575.00 |
$2,575.00 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$810.00 |
$810.00 |
$810.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$610.00 |
$610.00 |
$610.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$245.00 |
$245.00 |
$245.00 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$295.00 |
$295.00 |
$295.00 |
$418.63
|
|
Abdominal X-ray (single view)
|
$195.00 |
$195.00 |
$195.00 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$1,148.40
|
|
Abl1 gene
|
$805.00 |
$805.00 |
$805.00 |
$683.20
|
|
Ablat 1/+thyr ndul addl prq rf
|
$1,775.00 |
$1,775.00 |
$1,775.00 |
$1,155.50
|
|
Ablate arrhythmia add on
|
$3,010.00 |
$3,010.00 |
$3,010.00 |
$6,828.51
|
|
Ablate bone tumor(s) perq
|
$7,220.00 |
$7,220.00 |
$7,220.00 |
$9,511.44
|
|
Ablate heart dysrhythm focus
|
$5,305.00 |
$5,305.00 |
$5,305.00 |
$9,332.05
|
|
Ablate pulm tumor perq crybl
|
$4,365.00 |
$4,365.00 |
$4,365.00 |
$9,970.50
|
|
Ablation cardiac vagal inputs atrium
|
$620.00 |
$620.00 |
$620.00 |
$2,260.30
|
|
Ablation of upper extremity nerves rf
|
$452.50 |
$452.50 |
$452.50 |
$832.50
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$3,550.00 |
$3,550.00 |
$3,550.00 |
$3,055.20
|
|
Abscess drain retroperitoneal surg code
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$3,050.40
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$315.00 |
$315.00 |
$315.00 |
$2,314.00
|
|
Acetaminophen level
|
$320.00 |
$320.00 |
$320.00 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$83.66 |
$83.66 |
$83.66 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$67.50 |
$67.50 |
$67.50 |
$67.50
|
|
Acetylcholinesterase assay
|
$92.50 |
$92.50 |
$92.50 |
$107.63
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$425.00 |
$425.00 |
$425.00 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$20.00 |
$20.00 |
$20.00 |
$38.50
|
|
Acute hepatitis panel
|
$242.50 |
$242.50 |
$242.50 |
$284.95
|
|
#acylcarnitineprfl
|
$125.00 |
$125.00 |
$125.00 |
$121.55
|
|
Acylcarnitines qual
|
$25.00 |
$25.00 |
$25.00 |
$45.60
|
|
Adenovirus antibody,serum - quest
|
$77.50 |
$77.50 |
$77.50 |
$58.00
|
|
Adh-sendout
|
$150.00 |
$150.00 |
$150.00 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$7.97 |
$7.97 |
$7.97 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$307.50 |
$307.50 |
$307.50 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$307.50 |
$307.50 |
$307.50 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$615.00 |
$615.00 |
$615.00 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$392.50 |
$392.50 |
$392.50 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$220.00 |
$220.00 |
$220.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$260.00 |
$260.00 |
$260.00 |
$256.49
|
|
Administration immunization each additional vaccine
|
$25.00 |
$25.00 |
$25.00 |
$47.40
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$85.43 |
$85.43 |
$85.43 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$2,040.00 |
$2,040.00 |
$2,040.00 |
$1,987.70
|
|
Adrenalin epinephrine inject
|
$11.02 |
$11.02 |
$11.02 |
$231.47
|
|
Aep neurodiagnostic i&r
|
$402.50 |
$402.50 |
$402.50 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$460.00 |
$460.00 |
$460.00 |
$635.00
|
|
_afb id by dna probe rflx ast
|
$105.00 |
$105.00 |
$105.00 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$330.00 |
$330.00 |
$330.00 |
$300.00
|
|
Aflibercept injection
|
$2,288.95 |
$2,288.95 |
$2,288.95 |
$2,738.00
|
|
After cataract laser surgery
|
$915.00 |
$915.00 |
$915.00 |
$1,373.11
|
|
Air injection into abdomen 49400
|
$525.00 |
$525.00 |
$525.00 |
$525.60
|
|
Albumin body fluid quantitative each specimen
|
$40.00 |
$40.00 |
$40.00 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$120.85 |
$120.85 |
$120.85 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$147.71 |
$147.71 |
$147.71 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$47.50 |
$47.50 |
$47.50 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$40.00 |
$40.00 |
$40.00 |
$43.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$357.50 |
$357.50 |
$357.50 |
$96.00
|
|
Alkaline phosphatase
|
$50.00 |
$50.00 |
$50.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$50.00 |
$50.00 |
$50.00 |
$48.57
|
|
Allergen egg white ige
|
$27.50 |
$27.50 |
$27.50 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$12.50 |
$12.50 |
$12.50 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$1,842.66 |
$1,842.66 |
$1,842.66 |
$9,900.02
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,429.65 |
$1,429.65 |
$1,429.65 |
$5,096.00
|
|
Alpha-fetoprotein amniotic
|
$140.00 |
$140.00 |
$140.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$90.00 |
$90.00 |
$90.00 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$270.68 |
$270.68 |
$270.68 |
$15,857.45
|
|
Alt/sgpt
|
$52.50 |
$52.50 |
$52.50 |
$47.50
|
|
Aluminum - quest
|
$140.00 |
$140.00 |
$140.00 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$595.00 |
$595.00 |
$595.00 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$332.50 |
$332.50 |
$332.50 |
$179.70
|
|
Amino acid screen, urine
|
$25.00 |
$25.00 |
$25.00 |
$77.00
|
|
Aminolevulinic acid delta
|
$117.50 |
$117.50 |
$117.50 |
$87.12
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$9.75 |
$9.75 |
$9.75 |
$108.13
|
|
Amitriptyline (elavil) -sendout
|
$347.50 |
$347.50 |
$347.50 |
$87.45
|
|
Ammonia
|
$90.00 |
$90.00 |
$90.00 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$500.00 |
$500.00 |
$500.00 |
$942.60
|
|
Amphetamine confirm urine -sendout
|
$265.00 |
$265.00 |
$265.00 |
$93.61
|
|
Amphetamines 5 or more
|
$240.00 |
$240.00 |
$240.00 |
$90.48
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$50.64 |
$50.64 |
$50.64 |
$519.03
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$31.20 |
$31.20 |
$31.20 |
$54.57
|
|
Amylase
|
$52.50 |
$52.50 |
$52.50 |
$90.00
|
