|
11-desoxycortisol - sendout
|
$259.20 |
$259.20 |
$259.20 |
$87.50
|
|
17-hydroxypregnenolone
|
$200.80 |
$200.80 |
$200.80 |
$89.25
|
|
3d recon without postprocess indpndt
|
$625.60 |
$625.60 |
$625.60 |
$485.00
|
|
5' nucleotidase - sendout
|
$217.60 |
$217.60 |
$217.60 |
$50.40
|
|
Abdominal CT scan (with and without contrast)
|
$3,652.80 |
$3,652.80 |
$3,652.80 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$3,048.00 |
$3,048.00 |
$3,048.00 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,852.00 |
$2,852.00 |
$2,852.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,656.00 |
$4,656.00 |
$4,656.00 |
$3,015.94
|
|
Abdominal MRI (without contrast)
|
$2,898.40 |
$2,898.40 |
$2,898.40 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,255.20 |
$1,255.20 |
$1,255.20 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$730.40 |
$730.40 |
$730.40 |
$590.00
|
|
Acetaminophen level
|
$271.20 |
$271.20 |
$271.20 |
$107.62
|
|
Acetone qualitative
|
$99.20 |
$99.20 |
$99.20 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$210.40 |
$210.40 |
$210.40 |
$64.50
|
|
Acetylcholinesterase assay
|
$230.40 |
$230.40 |
$230.40 |
$113.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$68.80 |
$68.80 |
$68.80 |
$41.67
|
|
Acute hepatitis panel
|
$323.20 |
$323.20 |
$323.20 |
$292.00
|
|
#acylcarnitineprfl
|
$112.00 |
$112.00 |
$112.00 |
$125.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$237.60 |
$237.60 |
$237.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$390.40 |
$390.40 |
$390.40 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$633.60 |
$633.60 |
$633.60 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$437.60 |
$437.60 |
$437.60 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$225.60 |
$225.60 |
$225.60 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$114.40 |
$114.40 |
$114.40 |
$257.40
|
|
Administration immunization 1 vaccine
|
$74.40 |
$74.40 |
$74.40 |
$69.21
|
|
Administration immunization each additional vaccine
|
$51.20 |
$51.20 |
$51.20 |
$47.40
|
|
Administration vaccine influenza virus
|
$38.40 |
$38.40 |
$38.40 |
$50.43
|
|
Administration vaccine pneumococcal
|
$68.00 |
$68.00 |
$68.00 |
$50.43
|
|
Albumin body fluid quantitative each specimen
|
$104.00 |
$104.00 |
$104.00 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$70.40 |
$70.40 |
$70.40 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$75.20 |
$75.20 |
$75.20 |
$40.80
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$194.40 |
$194.40 |
$194.40 |
$93.60
|
|
Alkaline phosphatase
|
$88.00 |
$88.00 |
$88.00 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$564.80 |
$564.80 |
$564.80 |
$48.00
|
|
Allergen egg white ige
|
$128.80 |
$128.80 |
$128.80 |
$38.00
|
|
Allergy Skin Testing
|
$52.80 |
$52.80 |
$52.80 |
$47.44
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$922.40 |
$922.40 |
$922.40 |
$874.65
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$378.40 |
$378.40 |
$378.40 |
$175.20
|
|
Alpha-fetoprotein tumor marker
|
$194.40 |
$194.40 |
$194.40 |
$106.00
|
|
Alt/sgpt
|
$91.20 |
$91.20 |
$91.20 |
$47.45
|
|
Amino acid screen, urine
|
$615.20 |
$615.20 |
$615.20 |
$102.00
|
|
Aminolevulinic acid delta
|
$168.00 |
$168.00 |
$168.00 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$264.00 |
$264.00 |
$264.00 |
$87.45
|
|
Ammonia
|
$178.40 |
$178.40 |
$178.40 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$731.20 |
$731.20 |
$731.20 |
$942.60
|
|
Amphetamines 5 or more
|
$37.60 |
$37.60 |
$37.60 |
$82.96
|
|
Amylase
|
$154.40 |
$154.40 |
$154.40 |
$89.04
|
|
Analysis gene f2 20210g>a variant
|
$288.00 |
$288.00 |
$288.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$211.20 |
$211.20 |
$211.20 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$49.60 |
$49.60 |
$49.60 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$201.60 |
$201.60 |
$201.60 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$2,930.40 |
$2,930.40 |
$2,930.40 |
$2,626.65
|
|
An fluoro guide for cvp
|
$674.40 |
$674.40 |
$674.40 |
$515.00
|
|
Ankle X-ray
|
$639.20 |
$639.20 |
$639.20 |
$353.60
|
|
Antibody elution rbc reference
|
$347.20 |
$347.20 |
$347.20 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$151.20 |
$151.20 |
$151.20 |
$218.30
|
|
Antibody id rbc panel
|
$302.40 |
$302.40 |
$302.40 |
$274.56
|
|
Antibody screen rbc
|
$170.40 |
$170.40 |
$170.40 |
$100.00
|
|
Antibody tetanus
|
$81.60 |
$81.60 |
$81.60 |
$53.95
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$34.40 |
$34.40 |
$34.40 |
$37.05
|
|
Antinuclear antibodies
|
$84.00 |
$84.00 |
$84.00 |
$89.40
|
|
Antinuclear antibodies titer
|
$96.80 |
$96.80 |
$96.80 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$182.40 |
$182.40 |
$182.40 |
$65.97
|
|
Antistreptolysin o titer
|
$201.60 |
$201.60 |
$201.60 |
$51.45
|
|
Antithrombin iii activity
|
$128.80 |
$128.80 |
$128.80 |
$114.00
|
|
Aortic dysfunction/dilation
|
$5,369.60 |
$5,369.60 |
$5,369.60 |
$1,008.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$3,748.80 |
$3,748.80 |
$3,748.80 |
$2,114.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$3,603.20 |
$3,603.20 |
$3,603.20 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$6,692.80 |
$6,692.80 |
$6,692.80 |
$3,345.60
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$4,686.40 |
$4,686.40 |
$4,686.40 |
$1,091.30
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$2,623.20 |
$2,623.20 |
$2,623.20 |
$498.81
|
|
Application finger splntstatic 29130
|
$268.00 |
$268.00 |
$268.00 |
$208.16
|
|
Application long leg splint 29505
|
$280.80 |
$280.80 |
$280.80 |
$338.25
|
|
Application lower leg splint 29515
|
$280.80 |
$280.80 |
$280.80 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$343.20 |
$343.20 |
$343.20 |
$373.20
|
|
Application of forearm cast 29075
|
$347.20 |
$347.20 |
$347.20 |
$339.30
|
|
Application of long arm cast 29065
|
$347.20 |
$347.20 |
$347.20 |
$395.00
|
|
Application of long leg cast
|
$538.40 |
$538.40 |
$538.40 |
$426.00
|
|
Application of long leg cast 29345
|
$410.40 |
$410.40 |
$410.40 |
$455.00
|
|
Application of paste boot 29580
|
$444.80 |
$444.80 |
$444.80 |
$331.74
|
|
Application short leg cast 29405
|
$396.00 |
$396.00 |
$396.00 |
$388.80
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$3,748.80 |
$3,748.80 |
$3,748.80 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,748.80 |
$3,748.80 |
$3,748.80 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$70.40 |
$70.40 |
$70.40 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$70.40 |
$70.40 |
$70.40 |
$75.60
|
|
Appl multlay comprs arm/hand
|
$343.20 |
$343.20 |
$343.20 |
$292.60
|
|
Apply hand/wrist cast 29085
|
$246.40 |
$246.40 |
$246.40 |
$259.20
|
|
Apply rigid leg cast 29445
|
$409.60 |
$409.60 |
$409.60 |
$555.00
|
|
Aqaprn-4 antb flo cytmtry ea
|
$933.60 |
$933.60 |
$933.60 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$144.00 |
$144.00 |
$144.00 |
$100.00
|
|
Aquatic exercise - group charge
|
$106.40 |
$106.40 |
$106.40 |
$85.80
|
|
Artery x-rays lungs
|
$2,644.00 |
$2,644.00 |
$2,644.00 |
$3,535.57
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$608.40
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$1,005.42
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$726.40 |
$726.40 |
$726.40 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$715.37
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$699.00
|
|
Aspirate pleura without imaging 32554
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$1,196.52
|
