|
#a/b/c/c/h pnl-candida albicans ab
|
$31.80 |
$31.80 |
$31.80 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$1,494.60 |
$1,494.60 |
$1,494.60 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$996.00 |
$996.00 |
$996.00 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$2,774.40 |
$2,774.40 |
$2,774.40 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$2,311.20 |
$2,311.20 |
$2,311.20 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$1,849.20 |
$1,849.20 |
$1,849.20 |
$1,789.65
|
|
Abdominal paracentesis w/image guidance
|
$2,271.00 |
$2,271.00 |
$2,271.00 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$780.00 |
$780.00 |
$780.00 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$549.60 |
$549.60 |
$549.60 |
$574.53
|
|
Abrasion lesion single
|
$374.40 |
$374.40 |
$374.40 |
$340.86
|
|
Acetaminophen level
|
$36.00 |
$36.00 |
$36.00 |
$117.01
|
|
Acetone qualitative
|
$80.40 |
$80.40 |
$80.40 |
$43.80
|
|
Acetylcysteine non-comp unit
|
$29.01 |
$29.01 |
$29.01 |
$29.01
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$56.40 |
$56.40 |
$56.40 |
$45.60
|
|
Acoustic immitance testing
|
$224.40 |
$224.40 |
$224.40 |
$157.30
|
|
Acoustic refl threshold tst
|
$91.20 |
$91.20 |
$91.20 |
$90.13
|
|
Acute hepatitis panel
|
$576.60 |
$576.60 |
$576.60 |
$294.45
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$64.45 |
$64.45 |
$64.45 |
$48.72
|
|
#acylcarnitineprfl
|
$291.00 |
$291.00 |
$291.00 |
$110.25
|
|
Acylcarnitines qual
|
$55.20 |
$55.20 |
$55.20 |
$45.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$45.39 |
$45.39 |
$45.39 |
$97.50
|
|
Adenovirus ag ia
|
$145.20 |
$145.20 |
$145.20 |
$31.20
|
|
Adenovirus antibody,serum - quest
|
$145.20 |
$145.20 |
$145.20 |
$63.00
|
|
Adh-sendout
|
$160.80 |
$160.80 |
$160.80 |
$152.10
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$437.94 |
$437.94 |
$437.94 |
$163.25
|
|
Administration chemotherapy IV infusion each additional hour
|
$408.00 |
$408.00 |
$408.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$273.00 |
$273.00 |
$273.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,018.20 |
$1,018.20 |
$1,018.20 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$531.00 |
$531.00 |
$531.00 |
$454.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$369.60 |
$369.60 |
$369.60 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$369.60 |
$369.60 |
$369.60 |
$267.43
|
|
Administration immunization 1 vaccine
|
$110.40 |
$110.40 |
$110.40 |
$65.00
|
|
Administration immunization each additional vaccine
|
$110.40 |
$110.40 |
$110.40 |
$45.50
|
|
Adrenal cortex & medulla img
|
$3,492.60 |
$3,492.60 |
$3,492.60 |
$1,642.08
|
|
Aep hearing status deter i&r
|
$202.20 |
$202.20 |
$202.20 |
$308.40
|
|
Aep neurodiagnostic i&r
|
$466.20 |
$466.20 |
$466.20 |
$570.16
|
|
Aep thrshld est mlt freq i&r
|
$466.20 |
$466.20 |
$466.20 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$135.00 |
$135.00 |
$135.00 |
$105.00
|
|
Air conduction bilat
|
$91.20 |
$91.20 |
$91.20 |
$140.87
|
|
Albumin body fluid quantitative each specimen
|
$90.00 |
$90.00 |
$90.00 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$481.30 |
$481.30 |
$481.30 |
$277.87
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$130.80 |
$130.80 |
$130.80 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$46.20 |
$46.20 |
$46.20 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$9.18 |
$9.18 |
$9.18 |
$9.18
|
|
Alkaline phosphatase
|
$69.00 |
$69.00 |
$69.00 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$64.80 |
$64.80 |
$64.80 |
$56.35
|
|
Allergen egg white ige
|
$78.60 |
$78.60 |
$78.60 |
$41.00
|
|
Alpha-fetoprotein tumor marker
|
$147.00 |
$147.00 |
$147.00 |
$110.40
|
|
Alteplase 100 mg infusion from pyxis vial
|
$134.03 |
$134.03 |
$134.03 |
$189.60
|
|
Alt/sgpt
|
$52.80 |
$52.80 |
$52.80 |
$43.55
|
|
Amino acid screen, urine
|
$142.80 |
$142.80 |
$142.80 |
$64.28
|
|
Aminolevulinic acid delta
|
$79.20 |
$79.20 |
$79.20 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$39.73 |
$39.73 |
$39.73 |
$40.47
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$264.58 |
$264.58 |
$264.58 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$269.76 |
$269.76 |
$269.76 |
$15.32
|
|
Ammonia
|
$184.80 |
$184.80 |
$184.80 |
$96.53
|
|
Ampicillin 1 gram solution for injection
|
$154.67 |
$154.67 |
$154.67 |
$30.28
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$66.51 |
$66.51 |
$66.51 |
$37.60
|
|
Amylase
|
$100.80 |
$100.80 |
$100.80 |
$83.20
|
|
Ana ds-dna
|
$152.40 |
$152.40 |
$152.40 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$189.60 |
$189.60 |
$189.60 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$300.60 |
$300.60 |
$300.60 |
$253.11
|
|
Anca screen with reflex to titer -quest
|
$289.20 |
$289.20 |
$289.20 |
$111.20
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$39.61 |
$39.61 |
$39.61 |
$44,765.71
|
|
Ankle X-ray
|
$513.60 |
$513.60 |
$513.60 |
$311.92
|
|
Anodyne therapy charges pt
|
$51.60 |
$51.60 |
$51.60 |
$41.02
|
|
Anora (draw only)
|
$27.00 |
$27.00 |
$27.00 |
$36.00
|
|
Antibody
|
$18.00 |
$18.00 |
$18.00 |
$29.40
|
|
Antibody bacterium, not elsewhere specified
|
$184.80 |
$184.80 |
$184.80 |
$57.85
|
|
Antibody elution rbc reference
|
$264.00 |
$264.00 |
$264.00 |
$156.24
|
|
Antibody htlv/hiv confirm test
|
$161.40 |
$161.40 |
$161.40 |
$154.85
|
|
Antibody htlv-i
|
$163.20 |
$163.20 |
$163.20 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$344.40 |
$344.40 |
$344.40 |
$216.24
|
|
Antibody id rbc panel
|
$137.40 |
$137.40 |
$137.40 |
$250.90
|
|
Antibody screen rbc
|
$102.60 |
$102.60 |
$102.60 |
$99.99
|
|
Antibody tetanus
|
$170.40 |
$170.40 |
$170.40 |
$74.53
|
|
Antinuclear antibodies
|
$160.80 |
$160.80 |
$160.80 |
$97.50
|
|
Antinuclear antibodies titer
|
$110.40 |
$110.40 |
$110.40 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$136.20 |
$136.20 |
$136.20 |
$72.15
|
|
Antistreptolysin o screen
|
$35.40 |
$35.40 |
$35.40 |
$57.20
|
|
Antistreptolysin o titer
|
$120.60 |
$120.60 |
$120.60 |
$58.50
|
|
Antithrombin iii activity
|
$381.00 |
$381.00 |
$381.00 |
$135.20
|
|
Application finger splntstatic 29130
|
$243.60 |
$243.60 |
$243.60 |
$208.16
|
|
Application multi layer compression below knee (both sides)
|
$968.40 |
$968.40 |
$968.40 |
$384.80
|
|
Application of paste boot 29580
|
$402.00 |
$402.00 |
$402.00 |
$331.74
|
|
Appl modality 1/> areas paraffin bath 97018
|
$84.00 |
$84.00 |
$84.00 |
$69.44
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$111.60 |
$111.60 |
$111.60 |
$71.50
|
|
#aptt mix-1:1 incubated
|
$337.80 |
$337.80 |
$337.80 |
$157.30
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$73.80 |
$73.80 |
$73.80 |
$90.52
|
|
Aquatic exercise - group charge
|
$68.40 |
$68.40 |
$68.40 |
$86.90
|
|
Arterial blood draw/perc 36620
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$529.19
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,909.80 |
$1,909.80 |
$1,909.80 |
$1,219.50
|
|
Assay acid phosphatase
|
$59.40 |
$59.40 |
$59.40 |
$38.81
|
|
Assay of estrogen
|
$406.80 |
$406.80 |
$406.80 |
$185.60
|
|
Assay of fluoride
|
$142.80 |
$142.80 |
$142.80 |
$115.83
|
|
Assay of galactose
|
$103.80 |
$103.80 |
$103.80 |
$49.21
|
|
Assay of lap enzyme
|
$117.00 |
$117.00 |
$117.00 |
$82.20
|
|
Assay of neonatal thyroxine
|
$25.20 |
$25.20 |
$25.20 |
$13.33
|
|
Assay of osteocalcin
|
$114.00 |
$114.00 |
$114.00 |
$126.75
|
