|
11-desoxycortisol - sendout
|
$48.24 |
$48.24 |
$48.24 |
$87.50
|
|
17-hydroxypregnenolone
|
$165.60 |
$165.60 |
$165.60 |
$89.25
|
|
17-ketosteroids
|
$38.88 |
$38.88 |
$38.88 |
$55.00
|
|
3d recon without postprocess indpndt
|
$1,019.52 |
$1,019.52 |
$1,019.52 |
$485.00
|
|
5' nucleotidase - sendout
|
$54.72 |
$54.72 |
$54.72 |
$50.40
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$214.27 |
$214.27 |
$214.27 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$84.24 |
$84.24 |
$84.24 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,930.40 |
$2,930.40 |
$2,930.40 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,635.92 |
$2,635.92 |
$2,635.92 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,062.80 |
$2,062.80 |
$2,062.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,759.84 |
$3,759.84 |
$3,759.84 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$3,337.20 |
$3,337.20 |
$3,337.20 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$3,098.16 |
$3,098.16 |
$3,098.16 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,761.12 |
$1,761.12 |
$1,761.12 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$1,254.24 |
$1,254.24 |
$1,254.24 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$1,131.84 |
$1,131.84 |
$1,131.84 |
$590.00
|
|
Ablation of upper extremity nerves rf
|
$637.92 |
$637.92 |
$637.92 |
$808.50
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$1.28 |
$1.28 |
$1.28 |
$74.96
|
|
Acetylcholine receptor modulating antibody
|
$131.76 |
$131.76 |
$131.76 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$6.34 |
$6.34 |
$6.34 |
$216.00
|
|
Acute hepatitis panel
|
$194.40 |
$194.40 |
$194.40 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.46 |
$0.46 |
$0.46 |
$63.48
|
|
#acylcarnitineprfl
|
$127.44 |
$127.44 |
$127.44 |
$125.40
|
|
Adenosine 3 mg/250 ml bag for osm
|
$6.31 |
$6.31 |
$6.31 |
$255.41
|
|
Adenovirus antibody,serum - quest
|
$43.92 |
$43.92 |
$43.92 |
$63.00
|
|
Adh-sendout
|
$118.08 |
$118.08 |
$118.08 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$12.96 |
$12.96 |
$12.96 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$344.16 |
$344.16 |
$344.16 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$344.16 |
$344.16 |
$344.16 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$716.40 |
$716.40 |
$716.40 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$716.40 |
$716.40 |
$716.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$269.28 |
$269.28 |
$269.28 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$260.64 |
$260.64 |
$260.64 |
$257.40
|
|
Administration immunization 1 vaccine
|
$133.92 |
$133.92 |
$133.92 |
$69.21
|
|
Administration immunization each additional vaccine
|
$36.72 |
$36.72 |
$36.72 |
$47.40
|
|
Administration vaccine hepatitis b
|
$99.36 |
$99.36 |
$99.36 |
$54.40
|
|
Administration vaccine influenza virus
|
$90.72 |
$90.72 |
$90.72 |
$50.43
|
|
Administration vaccine pneumococcal
|
$99.36 |
$99.36 |
$99.36 |
$50.43
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$69.07 |
$69.07 |
$69.07 |
$11,350.31
|
|
_afb id by dna probe rflx ast
|
$342.72 |
$342.72 |
$342.72 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$122.40 |
$122.40 |
$122.40 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$499.68 |
$499.68 |
$499.68 |
$315.00
|
|
After cataract laser surgery
|
$1,606.32 |
$1,606.32 |
$1,606.32 |
$1,373.11
|
|
Albumin body fluid quantitative each specimen
|
$76.32 |
$76.32 |
$76.32 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$198.43 |
$198.43 |
$198.43 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$112.32 |
$112.32 |
$112.32 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$99.36 |
$99.36 |
$99.36 |
$40.80
|
|
Alginate drsg wound filler
|
$46.80 |
$46.80 |
$46.80 |
$15.79
|
|
Alkaline phosphatase
|
$69.84 |
$69.84 |
$69.84 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$84.96 |
$84.96 |
$84.96 |
$48.00
|
|
Allergen egg white ige
|
$33.84 |
$33.84 |
$33.84 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$99.36 |
$99.36 |
$99.36 |
$43.75
|
|
Allergy injection; single 95115
|
$99.36 |
$99.36 |
$99.36 |
$42.75
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$424.80 |
$424.80 |
$424.80 |
$874.65
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$424.80 |
$424.80 |
$424.80 |
$1,495.63
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$20.71 |
$20.71 |
$20.71 |
$12.50
|
|
Alpha-fetoprotein tumor marker
|
$89.28 |
$89.28 |
$89.28 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$319.97 |
$319.97 |
$319.97 |
$15,857.45
|
|
Alt/sgpt
|
$81.36 |
$81.36 |
$81.36 |
$47.45
|
|
Aluminum - quest
|
$42.48 |
$42.48 |
$42.48 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$238.32 |
$238.32 |
$238.32 |
$169.80
|
|
Amino acids quant 2-5
|
$238.32 |
$238.32 |
$238.32 |
$104.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$69.12 |
$69.12 |
$69.12 |
$45.02
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$13.30 |
$13.30 |
$13.30 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$3.05 |
$3.05 |
$3.05 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$42.48 |
$42.48 |
$42.48 |
$87.45
|
|
Ammonia
|
$174.24 |
$174.24 |
$174.24 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$44.64 |
$44.64 |
$44.64 |
$92.61
|
|
Ampicillin 1 gram solution for injection
|
$12.96 |
$12.96 |
$12.96 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$27.58 |
$27.58 |
$27.58 |
$53.86
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$378.72 |
$378.72 |
$378.72 |
$262.99
|
|
Amylase
|
$123.84 |
$123.84 |
$123.84 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$42.48 |
$42.48 |
$42.48 |
$80.08
|
|
Analysis gene f2 20210g>a variant
|
$509.04 |
$509.04 |
$509.04 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$509.04 |
$509.04 |
$509.04 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$235.44 |
$235.44 |
$235.44 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$87.84 |
$87.84 |
$87.84 |
$103.20
|
|
An fluoro guide for cvp
|
$463.68 |
$463.68 |
$463.68 |
$515.00
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$32.40 |
$32.40 |
$32.40 |
$3,080.85
|
|
Ankle X-ray
|
$446.40 |
$446.40 |
$446.40 |
$353.60
|
|
Anora (draw only)
|
$42.48 |
$42.48 |
$42.48 |
$33.58
|
|
Antibody bacterium, not elsewhere specified
|
$95.04 |
$95.04 |
$95.04 |
$57.81
|
|
Antibody elution rbc reference
|
$216.00 |
$216.00 |
$216.00 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$60.48 |
$60.48 |
$60.48 |
$218.30
|
|
Antibody id rbc panel
|
$393.84 |
$393.84 |
$393.84 |
$274.56
|
|
Antibody influenza virus
|
$40.32 |
$40.32 |
$40.32 |
$53.95
|
|
Antibody screen rbc
|
$82.80 |
$82.80 |
$82.80 |
$100.00
|
|
Antibody tetanus
|
$43.92 |
$43.92 |
$43.92 |
$53.95
|
|
Antiepileptics nos 4-6
|
$79.92 |
$79.92 |
$79.92 |
$16.24
|
|
Anti mog serum - sendout
|
$900.00 |
$900.00 |
$900.00 |
$159.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$92.16 |
$92.16 |
$92.16 |
$37.05
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$92.16 |
$92.16 |
$92.16 |
$40.00
|
|
Antinuclear antibodies
|
$181.44 |
$181.44 |
$181.44 |
$89.40
|
|
Antinuclear antibodies titer
|
$57.60 |
$57.60 |
$57.60 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$54.72 |
$54.72 |
$54.72 |
$65.97
|
|
Antipsychotics nos 1-3
|
$167.76 |
$167.76 |
$167.76 |
$142.42
|
|
Antistreptolysin o titer
|
$144.72 |
$144.72 |
$144.72 |
$51.45
|
|
Antithrombin iii activity
|
$60.48 |
$60.48 |
$60.48 |
$114.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,951.36 |
$3,951.36 |
$3,951.36 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$767.52 |
$767.52 |
$767.52 |
$851.85
|