|
11-desoxycortisol - sendout
|
$198.60 |
$198.60 |
$198.60 |
$87.50
|
|
17-hydroxypregnenolone
|
$155.40 |
$155.40 |
$155.40 |
$89.25
|
|
1st hosp/birthing center care per day nml nb 99460
|
$126.00 |
$126.00 |
$126.00 |
$161.60
|
|
24 hr ambulatory b/p monitor
|
$421.20 |
$421.20 |
$421.20 |
$313.04
|
|
2nd order venous cath
|
$1,323.00 |
$1,323.00 |
$1,323.00 |
$1,543.85
|
|
3-d radiotherapy plan
|
$6,102.60 |
$6,102.60 |
$6,102.60 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$1,648.20 |
$1,648.20 |
$1,648.20 |
$485.00
|
|
5' nucleotidase - sendout
|
$163.20 |
$163.20 |
$163.20 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$99.60 |
$99.60 |
$99.60 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$5,272.80 |
$5,272.80 |
$5,272.80 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$2,375.40 |
$2,375.40 |
$2,375.40 |
$2,015.85
|
|
Abdominal CT scan (with and without contrast)
|
$3,060.00 |
$3,060.00 |
$3,060.00 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,606.40 |
$2,606.40 |
$2,606.40 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,139.00 |
$2,139.00 |
$2,139.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,239.00 |
$4,239.00 |
$4,239.00 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$3,446.40 |
$3,446.40 |
$3,446.40 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,784.60 |
$2,784.60 |
$2,784.60 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,701.00 |
$1,701.00 |
$1,701.00 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$765.00 |
$765.00 |
$765.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$890.40 |
$890.40 |
$890.40 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$687.00 |
$687.00 |
$687.00 |
$1,145.40
|
|
Abl1 gene
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$682.50
|
|
Ablation of upper extremity nerves rf
|
$232.80 |
$232.80 |
$232.80 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$2,957.17
|
|
Acetaminophen level
|
$290.40 |
$290.40 |
$290.40 |
$107.62
|
|
Acetone qualitative
|
$30.60 |
$30.60 |
$30.60 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$157.80 |
$157.80 |
$157.80 |
$64.50
|
|
Acetylcholinesterase assay
|
$295.20 |
$295.20 |
$295.20 |
$113.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$18.60 |
$18.60 |
$18.60 |
$41.67
|
|
Acute hepatitis panel
|
$392.40 |
$392.40 |
$392.40 |
$292.00
|
|
#acylcarnitineprfl
|
$244.20 |
$244.20 |
$244.20 |
$125.40
|
|
Adenovirus antibody,serum - quest
|
$43.80 |
$43.80 |
$43.80 |
$63.00
|
|
Adh-sendout
|
$297.00 |
$297.00 |
$297.00 |
$109.28
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$1,790.40 |
$1,790.40 |
$1,790.40 |
$3,146.85
|
|
Administration chemotherapy IV infusion each additional hour
|
$285.60 |
$285.60 |
$285.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$285.60 |
$285.60 |
$285.60 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$850.20 |
$850.20 |
$850.20 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$478.80 |
$478.80 |
$478.80 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$165.60 |
$165.60 |
$165.60 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$165.60 |
$165.60 |
$165.60 |
$257.40
|
|
Administration immunization 1 vaccine
|
$49.20 |
$49.20 |
$49.20 |
$69.21
|
|
Administration immunization each additional vaccine
|
$27.60 |
$27.60 |
$27.60 |
$47.40
|
|
Administration vaccine hepatitis b
|
$45.00 |
$45.00 |
$45.00 |
$54.40
|
|
Administration vaccine influenza virus
|
$52.80 |
$52.80 |
$52.80 |
$50.43
|
|
Administration vaccine pneumococcal
|
$59.40 |
$59.40 |
$59.40 |
$50.43
|
|
Aep hearing status deter i&r
|
$459.00 |
$459.00 |
$459.00 |
$305.73
|
|
Aep neurodiagnostic i&r
|
$481.20 |
$481.20 |
$481.20 |
$576.80
|
|
Aep thrshld est mlt freq i&r
|
$481.20 |
$481.20 |
$481.20 |
$605.15
|
|
_afb org id by sequencing rflx ast-sendout
|
$348.60 |
$348.60 |
$348.60 |
$315.00
|
|
Afo molded ankle gauntlet
|
$169.20 |
$169.20 |
$169.20 |
$765.51
|
|
Afo rig ant tib tcf/= custom
|
$3,423.00 |
$3,423.00 |
$3,423.00 |
$1,877.15
|
|
After cataract laser surgery
|
$1,305.00 |
$1,305.00 |
$1,305.00 |
$1,373.11
|
|
Albumin body fluid quantitative each specimen
|
$165.00 |
$165.00 |
$165.00 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$61.80 |
$61.80 |
$61.80 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$117.00 |
$117.00 |
$117.00 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$223.20 |
$223.20 |
$223.20 |
$93.60
|
|
Alkaline phosphatase
|
$110.40 |
$110.40 |
$110.40 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$424.20 |
$424.20 |
$424.20 |
$48.00
|
|
Allergen egg white ige
|
$166.20 |
$166.20 |
$166.20 |
$38.00
|
|
Allergy Skin Testing
|
$46.80 |
$46.80 |
$46.80 |
$47.44
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$691.80 |
$691.80 |
$691.80 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$444.60 |
$444.60 |
$444.60 |
$4,677.40
|
|
Alpha-fetoprotein amniotic
|
$165.60 |
$165.60 |
$165.60 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$245.40 |
$245.40 |
$245.40 |
$106.00
|
|
Alt/sgpt
|
$151.20 |
$151.20 |
$151.20 |
$47.45
|
|
Aluminum - quest
|
$241.80 |
$241.80 |
$241.80 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$361.80 |
$361.80 |
$361.80 |
$434.00
|
|
Amino acid screen, urine
|
$501.60 |
$501.60 |
$501.60 |
$102.00
|
|
Amino acids quant 2-5
|
$336.00 |
$336.00 |
$336.00 |
$104.00
|
|
Aminolevulinic acid delta
|
$216.00 |
$216.00 |
$216.00 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$96.60 |
$96.60 |
$96.60 |
$87.45
|
|
Ammonia
|
$190.80 |
$190.80 |
$190.80 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$548.40 |
$548.40 |
$548.40 |
$942.60
|
|
Amniotic fluid scan
|
$159.00 |
$159.00 |
$159.00 |
$49.01
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,044.20 |
$2,044.20 |
$2,044.20 |
$3,730.53
|
|
Amphetamine confirm urine -sendout
|
$261.00 |
$261.00 |
$261.00 |
$92.61
|
|
Amphetamines 5 or more
|
$225.60 |
$225.60 |
$225.60 |
$82.96
|
|
Amylase
|
$210.60 |
$210.60 |
$210.60 |
$89.04
|
|
Anabolic steroid 1 or 2
|
$145.20 |
$145.20 |
$145.20 |
$80.08
|
|
Anal/urinary muscle study
|
$487.80 |
$487.80 |
$487.80 |
$576.00
|
|
Analysis gene f2 20210g>a variant
|
$604.20 |
$604.20 |
$604.20 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$604.20 |
$604.20 |
$604.20 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$37.20 |
$37.20 |
$37.20 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$258.60 |
$258.60 |
$258.60 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,242.80 |
$2,242.80 |
$2,242.80 |
$2,626.65
|
|
An fluoro guide for cvp
|
$685.20 |
$685.20 |
$685.20 |
$515.00
|
|
Angio trnslmnl balloon same artery ea addl
|
$4,153.20 |
$4,153.20 |
$4,153.20 |
$4,604.00
|
|
Angio trnslmnl balloon same artery ini
|
$8,305.80 |
$8,305.80 |
$8,305.80 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$4,153.20 |
$4,153.20 |
$4,153.20 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$8,305.80 |
$8,305.80 |
$8,305.80 |
$8,466.00
|
|
Ankle X-ray
|
$484.80 |
$484.80 |
$484.80 |
$353.60
|
|
Anora (draw only)
|
$55.80 |
$55.80 |
$55.80 |
$33.58
|
|
Anoscopy remove fb 46608
|
$872.40 |
$872.40 |
$872.40 |
$1,435.00
|
|
Antibody bacterium, not elsewhere specified
|
$289.20 |
$289.20 |
$289.20 |
$57.81
|
|
Antibody elution rbc reference
|
$117.60 |
$117.60 |
$117.60 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$436.80 |
$436.80 |
$436.80 |
$130.00
|
|
Antibody htlv-i
|
$181.80 |
$181.80 |
$181.80 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$1,086.60 |
$1,086.60 |
$1,086.60 |
$218.30
|
|
Antibody id rbc panel
|
$226.80 |
$226.80 |
$226.80 |
$274.56
|
|
Antibody influenza virus
|
$240.60 |
$240.60 |
$240.60 |
$53.95
|
