|
11-desoxycortisol - sendout
|
$55.44 |
$55.44 |
$55.44 |
$87.50
|
|
17-hydroxypregnenolone
|
$133.20 |
$133.20 |
$133.20 |
$89.25
|
|
2d tee w or without fol w/con,in
|
$3,693.60 |
$3,693.60 |
$3,693.60 |
$1,624.70
|
|
2nd order venous cath
|
$1,959.84 |
$1,959.84 |
$1,959.84 |
$1,543.85
|
|
3-d radiotherapy plan
|
$7,891.92 |
$7,891.92 |
$7,891.92 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$570.96 |
$570.96 |
$570.96 |
$485.00
|
|
5' nucleotidase - sendout
|
$156.96 |
$156.96 |
$156.96 |
$50.40
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3.60 |
$3.60 |
$3.60 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$87.12 |
$87.12 |
$87.12 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$6,798.24 |
$6,798.24 |
$6,798.24 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$3,896.64 |
$3,896.64 |
$3,896.64 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$3,283.92 |
$3,283.92 |
$3,283.92 |
$2,015.85
|
|
Abd/low ext cath 3rd
|
$3,283.92 |
$3,283.92 |
$3,283.92 |
$2,486.97
|
|
Abd/low ext cath addl
|
$2,953.44 |
$2,953.44 |
$2,953.44 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$3,655.44 |
$3,655.44 |
$3,655.44 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$3,390.48 |
$3,390.48 |
$3,390.48 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,744.64 |
$2,744.64 |
$2,744.64 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$5,265.36 |
$5,265.36 |
$5,265.36 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$4,188.96 |
$4,188.96 |
$4,188.96 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$4,068.72 |
$4,068.72 |
$4,068.72 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$2,041.20 |
$2,041.20 |
$2,041.20 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$1,295.28 |
$1,295.28 |
$1,295.28 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$1,147.68 |
$1,147.68 |
$1,147.68 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,241.36 |
$2,241.36 |
$2,241.36 |
$1,145.40
|
|
Abl1 gene
|
$925.20 |
$925.20 |
$925.20 |
$682.50
|
|
Ablate arrhythmia add on
|
$13,082.40 |
$13,082.40 |
$13,082.40 |
$6,898.92
|
|
Ablate bone tumor(s) cryo perq 20983
|
$21,828.24 |
$21,828.24 |
$21,828.24 |
$8,453.60
|
|
Ablate bone tumor(s) perq
|
$27,792.00 |
$27,792.00 |
$27,792.00 |
$9,350.33
|
|
Ablate heart dysrhythm focus
|
$15,705.36 |
$15,705.36 |
$15,705.36 |
$9,522.05
|
|
Ablation cardiac vagal inputs atrium
|
$13,925.52 |
$13,925.52 |
$13,925.52 |
$1,960.80
|
|
Ablation cryo abd perit om
|
$3,443.76 |
$3,443.76 |
$3,443.76 |
$2,312.80
|
|
Ablation cryo pq liver tumor(s)
|
$22,488.48 |
$22,488.48 |
$22,488.48 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$1,779.12 |
$1,779.12 |
$1,779.12 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$4,961.52 |
$4,961.52 |
$4,961.52 |
$2,957.17
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$729.36 |
$729.36 |
$729.36 |
$2,314.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$10.80 |
$10.80 |
$10.80 |
$74.96
|
|
Acetazolamide 500 mg solution for injection
|
$172.80 |
$172.80 |
$172.80 |
$122.55
|
|
Acetone qualitative
|
$93.60 |
$93.60 |
$93.60 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$197.28 |
$197.28 |
$197.28 |
$64.50
|
|
Acetylcholinesterase assay
|
$93.60 |
$93.60 |
$93.60 |
$113.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$21.00 |
$21.00 |
$21.00 |
$216.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$100.80 |
$100.80 |
$100.80 |
$41.67
|
|
Actigraphy testing
|
$421.92 |
$421.92 |
$421.92 |
$218.05
|
|
Acute hepatitis panel
|
$440.64 |
$440.64 |
$440.64 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$3.60 |
$3.60 |
$3.60 |
$63.48
|
|
#acylcarnitineprfl
|
$224.64 |
$224.64 |
$224.64 |
$125.40
|
|
Adapter b 8 channel 10cm
|
$9,288.00 |
$9,288.00 |
$9,288.00 |
$5,695.04
|
|
Adenosine 3 mg/250 ml bag for osm
|
$8.64 |
$8.64 |
$8.64 |
$255.41
|
|
Adenovirus ag ia
|
$205.20 |
$205.20 |
$205.20 |
$53.95
|
|
Adenovirus antibody,serum - quest
|
$109.44 |
$109.44 |
$109.44 |
$63.00
|
|
Adh-sendout
|
$210.24 |
$210.24 |
$210.24 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$43.20 |
$43.20 |
$43.20 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$272.16 |
$272.16 |
$272.16 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$272.16 |
$272.16 |
$272.16 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$622.80 |
$622.80 |
$622.80 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$698.40 |
$698.40 |
$698.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$210.96 |
$210.96 |
$210.96 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$213.84 |
$213.84 |
$213.84 |
$257.40
|
|
Administration immunization 1 vaccine
|
$133.92 |
$133.92 |
$133.92 |
$69.21
|
|
Administration immunization each additional vaccine
|
$110.88 |
$110.88 |
$110.88 |
$47.40
|
|
Administration vaccine hepatitis b
|
$110.88 |
$110.88 |
$110.88 |
$54.40
|
|
Administration vaccine influenza virus
|
$116.64 |
$116.64 |
$116.64 |
$50.43
|
|
Administration vaccine pneumococcal
|
$116.64 |
$116.64 |
$116.64 |
$50.43
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$103.41 |
$103.41 |
$103.41 |
$11,350.31
|
|
Aep thrshld est mlt freq i&r
|
$672.48 |
$672.48 |
$672.48 |
$605.15
|
|
_afb id by dna probe rflx ast
|
$151.20 |
$151.20 |
$151.20 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$30.96 |
$30.96 |
$30.96 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$696.96 |
$696.96 |
$696.96 |
$315.00
|
|
Afo molded plas rig ant tib
|
$2,265.84 |
$2,265.84 |
$2,265.84 |
$2,412.47
|
|
Afo rig ant tib tcf/= custom
|
$1,400.40 |
$1,400.40 |
$1,400.40 |
$1,877.15
|
|
Afo w/ankle joint, prefab
|
$109.44 |
$109.44 |
$109.44 |
$795.02
|
|
Airway resistance by impulse oscillometry 94728
|
$337.68 |
$337.68 |
$337.68 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$30.96 |
$30.96 |
$30.96 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$250.02 |
$250.02 |
$250.02 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$388.80 |
$388.80 |
$388.80 |
$243.59
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$64.08 |
$64.08 |
$64.08 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$26.64 |
$26.64 |
$26.64 |
$40.80
|
|
Alginate dressing <=16 sq in
|
$15.84 |
$15.84 |
$15.84 |
$18.20
|
|
Alginate drsg >16 <=48 sq in
|
$23.04 |
$23.04 |
$23.04 |
$43.72
|
|
Alginate drsg wound filler
|
$58.32 |
$58.32 |
$58.32 |
$15.79
|
|
Alkaline phosphatase
|
$42.48 |
$42.48 |
$42.48 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$19.44 |
$19.44 |
$19.44 |
$48.00
|
|
Allergen egg white ige
|
$91.44 |
$91.44 |
$91.44 |
$38.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$7,992.00 |
$7,992.00 |
$7,992.00 |
$9,018.12
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$11,880.00 |
$11,880.00 |
$11,880.00 |
$874.65
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$4,725.00
|
|
Alloskin
|
$3,240.00 |
$3,240.00 |
$3,240.00 |
$582.40
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$347.04 |
$347.04 |
$347.04 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$94.32 |
$94.32 |
$94.32 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$149.76 |
$149.76 |
$149.76 |
$106.00
|
|
Alprostadil for injection
|
$731.59 |
$731.59 |
$731.59 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$399.96 |
$399.96 |
$399.96 |
$15,857.45
|
|
Alt/sgpt
|
$38.88 |
$38.88 |
$38.88 |
$47.45
|
|
Aluminum - quest
|
$82.80 |
$82.80 |
$82.80 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$167.76 |
$167.76 |
$167.76 |
$169.80
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$8.64 |
$8.64 |
$8.64 |
$39.84
|
|
Amino acid single qual
|
$99.36 |
$99.36 |
$99.36 |
$36.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$8.87 |
$8.87 |
$8.87 |
$37.14
|
|
Aminolevulinic acid delta
|
$61.20 |
$61.20 |
$61.20 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$86.36 |
$86.36 |
$86.36 |
$45.02
|
