|
5' nucleotidase - sendout
|
$92.16 |
$92.16 |
$92.16 |
$50.40
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$92.88 |
$92.88 |
$92.88 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,904.48 |
$2,904.48 |
$2,904.48 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$2,024.64 |
$2,024.64 |
$2,024.64 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,745.44 |
$3,745.44 |
$3,745.44 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$3,620.16 |
$3,620.16 |
$3,620.16 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,881.44 |
$2,881.44 |
$2,881.44 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$2,025.36 |
$2,025.36 |
$2,025.36 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$921.60 |
$921.60 |
$921.60 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$732.24 |
$732.24 |
$732.24 |
$590.00
|
|
Ablate inf turbinate superf 30801
|
$3,199.68 |
$3,199.68 |
$3,199.68 |
$1,944.80
|
|
Acetone qualitative
|
$1,662.48 |
$1,662.48 |
$1,662.48 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$197.28 |
$197.28 |
$197.28 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$3.17 |
$3.17 |
$3.17 |
$216.00
|
|
Acute hepatitis panel
|
$145.44 |
$145.44 |
$145.44 |
$292.00
|
|
#acylcarnitineprfl
|
$249.12 |
$249.12 |
$249.12 |
$125.40
|
|
Adenosine 3 mg/250 ml bag for osm
|
$25.20 |
$25.20 |
$25.20 |
$255.41
|
|
Adenovirus antibody,serum - quest
|
$192.24 |
$192.24 |
$192.24 |
$63.00
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$3,957.84 |
$3,957.84 |
$3,957.84 |
$3,146.85
|
|
Administration chemotherapy IV infusion each additional hour
|
$154.08 |
$154.08 |
$154.08 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$692.64 |
$692.64 |
$692.64 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$716.40 |
$716.40 |
$716.40 |
$439.20
|
|
Administration immunization 1 vaccine
|
$138.96 |
$138.96 |
$138.96 |
$69.21
|
|
Administration vaccine hepatitis b
|
$99.36 |
$99.36 |
$99.36 |
$54.40
|
|
Administration vaccine influenza virus
|
$86.40 |
$86.40 |
$86.40 |
$50.43
|
|
Administration vaccine pneumococcal
|
$99.36 |
$99.36 |
$99.36 |
$50.43
|
|
_afb id by dna probe rflx ast
|
$159.84 |
$159.84 |
$159.84 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$105.84 |
$105.84 |
$105.84 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$396.72 |
$396.72 |
$396.72 |
$315.00
|
|
Albumin body fluid quantitative each specimen
|
$127.44 |
$127.44 |
$127.44 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$99.36 |
$99.36 |
$99.36 |
$244.70
|
|
Albumin ischemia modified
|
$40.32 |
$40.32 |
$40.32 |
$85.60
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$23.04 |
$23.04 |
$23.04 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$1,321.92 |
$1,321.92 |
$1,321.92 |
$40.80
|
|
Alkaline phosphatase
|
$104.40 |
$104.40 |
$104.40 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$66.96 |
$66.96 |
$66.96 |
$48.00
|
|
Allergen egg white ige
|
$48.96 |
$48.96 |
$48.96 |
$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
|
|
Alpha-fetoprotein tumor marker
|
$228.96 |
$228.96 |
$228.96 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$160.02 |
$160.02 |
$160.02 |
$15,857.45
|
|
Alt/sgpt
|
$98.64 |
$98.64 |
$98.64 |
$47.45
|
|
Aluminum - quest
|
$170.64 |
$170.64 |
$170.64 |
$83.05
|
|
Aminolevulinic acid delta
|
$123.84 |
$123.84 |
$123.84 |
$85.15
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$108.00 |
$108.00 |
$108.00 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$25.20 |
$25.20 |
$25.20 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$174.24 |
$174.24 |
$174.24 |
$87.45
|
|
Ammonia
|
$525.60 |
$525.60 |
$525.60 |
$119.70
|
|
Amphetamines 5 or more
|
$112.32 |
$112.32 |
$112.32 |
$82.96
|
|
Ampicillin 1 gram solution for injection
|
$25.20 |
$25.20 |
$25.20 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$13.86 |
$13.86 |
$13.86 |
$53.86
|
|
Amylase
|
$150.48 |
$150.48 |
$150.48 |
$89.04
|
|
Ana ds-dna
|
$105.12 |
$105.12 |
$105.12 |
$56.50
|
|
Analysis gene f2 20210g>a variant
|
$110.88 |
$110.88 |
$110.88 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$416.16 |
$416.16 |
$416.16 |
$230.40
|
|
Anca screen with reflex to titer -quest
|
$230.40 |
$230.40 |
$230.40 |
$103.20
|
|
Ankle X-ray
|
$334.80 |
$334.80 |
$334.80 |
$353.60
|
|
Antibody bacterium, not elsewhere specified
|
$311.04 |
$311.04 |
$311.04 |
$57.81
|
|
Antibody elution rbc reference
|
$216.00 |
$216.00 |
$216.00 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$307.44 |
$307.44 |
$307.44 |
$218.30
|
|
Antibody id rbc panel
|
$393.84 |
$393.84 |
$393.84 |
$274.56
|
|
Antibody influenza virus
|
$365.76 |
$365.76 |
$365.76 |
$53.95
|
|
Antibody screen rbc
|
$77.04 |
$77.04 |
$77.04 |
$100.00
|
|
Antibody tetanus
|
$319.68 |
$319.68 |
$319.68 |
$53.95
|
|
Anti mog serum - sendout
|
$900.00 |
$900.00 |
$900.00 |
$159.00
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$174.96 |
$174.96 |
$174.96 |
$37.05
|
|
Antinuclear antibodies
|
$92.88 |
$92.88 |
$92.88 |
$89.40
|
|
Antinuclear antibodies titer
|
$154.08 |
$154.08 |
$154.08 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$26.64 |
$26.64 |
$26.64 |
$65.97
|
|
Antistreptolysin o titer
|
$126.72 |
$126.72 |
$126.72 |
$51.45
|
|
Antithrombin iii activity
|
$245.52 |
$245.52 |
$245.52 |
$114.00
|
|
Application finger splntstatic 29130
|
$347.04 |
$347.04 |
$347.04 |
$208.16
|
|
Application long leg splint 29505
|
$424.08 |
$424.08 |
$424.08 |
$338.25
|
|
Application lower leg splint 29515
|
$296.64 |
$296.64 |
$296.64 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$366.48 |
$366.48 |
$366.48 |
$373.20
|
|
Application of forearm cast 29075
|
$573.84 |
$573.84 |
$573.84 |
$339.30
|
|
Application of long arm cast 29065
|
$573.84 |
$573.84 |
$573.84 |
$395.00
|
|
Application short leg cast 29405
|
$573.84 |
$573.84 |
$573.84 |
$388.80
|
|
Appl modality 1/> areas paraffin bath 97018
|
$156.96 |
$156.96 |
$156.96 |
$66.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$131.76 |
$131.76 |
$131.76 |
$75.60
|
|
Apply forearm splintdynamic 29126
|
$368.64 |
$368.64 |
$368.64 |
$246.18
|
|
Aquaporin-4 antibody cba each
|
$400.32 |
$400.32 |
$400.32 |
$138.16
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$799.20 |
$799.20 |
$799.20 |
$608.40
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$708.48 |
$708.48 |
$708.48 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$1,620.00 |
$1,620.00 |
$1,620.00 |
$715.37
|
|
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah)
|
$7,008.48 |
$7,008.48 |
$7,008.48 |
$4,240.08
|
|
Assay of procainamide w/metab
|
$195.84 |
$195.84 |
$195.84 |
$70.50
|
|
Assay of somatostatin
|
$318.24 |
$318.24 |
$318.24 |
$165.00
|
|
Assay of urine sulfate
|
$46.08 |
$46.08 |
$46.08 |
$29.04
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$6.48 |
$6.48 |
$6.48 |
$49.80
|
|
Ast/sgot
|
$102.96 |
$102.96 |
$102.96 |
$45.65
|
|
Atropine 0.1 mg/ml injection syringe
|
$25.20 |
$25.20 |
$25.20 |
$51.28
|
|
Avul nail plate addl
|
$192.24 |
$192.24 |
$192.24 |
$194.22
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$596.00 |
$596.00 |
$596.00 |
$318.75
|
|
Azithromycin 500 mg intravenous solution
|
$25.20 |
$25.20 |
$25.20 |
$35.06
|
|
Baclofen eval charges
|
$133.20 |
$133.20 |
$133.20 |
$85.00
|
|
Bacterial meningitis antigen
|
$161.28 |
$161.28 |
$161.28 |
$66.30
|
|
Bacterial vaginosis pcr
|
$483.84 |
$483.84 |
$483.84 |
$278.40
|
|
#bac vag cand-c. albicans naa
|
$153.36 |
$153.36 |
$153.36 |
$105.00
|
