|
17-hydroxypregnenolone
|
$232.20 |
$232.20 |
$232.20 |
$102.05
|
|
17-ketosteroids
|
$196.20 |
$196.20 |
$196.20 |
$57.20
|
|
3d recon without postprocess indpndt
|
$510.00 |
$510.00 |
$510.00 |
$443.20
|
|
5' nucleotidase - sendout
|
$206.40 |
$206.40 |
$206.40 |
$64.80
|
|
88334 ap bill cytologic exam each additional site
|
$117.00 |
$117.00 |
$117.00 |
$93.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$39.00 |
$39.00 |
$39.00 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,145.00 |
$2,145.00 |
$2,145.00 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$1,787.40 |
$1,787.40 |
$1,787.40 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$1,430.40 |
$1,430.40 |
$1,430.40 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$3,420.00 |
$3,420.00 |
$3,420.00 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$2,850.60 |
$2,850.60 |
$2,850.60 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$2,280.60 |
$2,280.60 |
$2,280.60 |
$1,789.65
|
|
Abdominal paracentesis w/image guidance
|
$3,851.40 |
$3,851.40 |
$3,851.40 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$765.00 |
$765.00 |
$765.00 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$554.40 |
$554.40 |
$554.40 |
$574.53
|
|
Abd paracentesis/w/o image guide 49082
|
$1,649.40 |
$1,649.40 |
$1,649.40 |
$1,144.26
|
|
Abrasion lesion single
|
$297.00 |
$297.00 |
$297.00 |
$340.86
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$41.82 |
$41.82 |
$41.82 |
$45.63
|
|
Acetaminophen level
|
$36.00 |
$36.00 |
$36.00 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$55.49 |
$55.49 |
$55.49 |
$94.47
|
|
Acetone qualitative
|
$102.00 |
$102.00 |
$102.00 |
$43.80
|
|
Acetylcysteine non-comp unit
|
$29.01 |
$29.01 |
$29.01 |
$29.01
|
|
Acoustic immitance testing
|
$101.40 |
$101.40 |
$101.40 |
$157.30
|
|
Acoustic refl threshold tst
|
$78.60 |
$78.60 |
$78.60 |
$90.13
|
|
Acute hepatitis panel
|
$757.20 |
$757.20 |
$757.20 |
$294.45
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$48.72 |
$48.72 |
$48.72 |
$48.72
|
|
#acylcarnitineprfl
|
$370.20 |
$370.20 |
$370.20 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$199.72 |
$199.72 |
$199.72 |
$97.50
|
|
Adh-sendout
|
$277.20 |
$277.20 |
$277.20 |
$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
|
$475.80 |
$475.80 |
$475.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$523.80 |
$523.80 |
$523.80 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$954.60 |
$954.60 |
$954.60 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$585.60 |
$585.60 |
$585.60 |
$454.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$396.00 |
$396.00 |
$396.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$390.60 |
$390.60 |
$390.60 |
$267.43
|
|
Administration immunization 1 vaccine
|
$124.80 |
$124.80 |
$124.80 |
$65.00
|
|
Administration immunization each additional vaccine
|
$56.40 |
$56.40 |
$56.40 |
$45.50
|
|
Adrenal cortex & medulla img
|
$3,267.60 |
$3,267.60 |
$3,267.60 |
$1,642.08
|
|
_afb id by dna probe rflx ast
|
$241.80 |
$241.80 |
$241.80 |
$105.00
|
|
Air conduction bilat
|
$93.00 |
$93.00 |
$93.00 |
$140.87
|
|
Air injection into abdomen 49400
|
$1,306.20 |
$1,306.20 |
$1,306.20 |
$525.00
|
|
Albumin body fluid quantitative each specimen
|
$104.40 |
$104.40 |
$104.40 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$481.30 |
$481.30 |
$481.30 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$465.69 |
$465.69 |
$465.69 |
$253.48
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$189.60 |
$189.60 |
$189.60 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$88.20 |
$88.20 |
$88.20 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$9.18 |
$9.18 |
$9.18 |
$9.18
|
|
Alkaline phosphatase
|
$94.80 |
$94.80 |
$94.80 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$63.00 |
$63.00 |
$63.00 |
$56.35
|
|
Allergen egg white ige
|
$109.20 |
$109.20 |
$109.20 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$165.60 |
$165.60 |
$165.60 |
$39.00
|
|
Alpha-fetoprotein tumor marker
|
$297.00 |
$297.00 |
$297.00 |
$110.40
|
|
Alteplase 100 mg infusion from pyxis vial
|
$134.03 |
$134.03 |
$134.03 |
$189.60
|
|
Alt/sgpt
|
$106.80 |
$106.80 |
$106.80 |
$43.55
|
|
Aluminum - quest
|
$196.20 |
$196.20 |
$196.20 |
$114.40
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$44.00 |
$44.00 |
$44.00 |
$36.30
|
|
Amino acid screen, urine
|
$251.40 |
$251.40 |
$251.40 |
$64.28
|
|
Aminolevulinic acid delta
|
$187.80 |
$187.80 |
$187.80 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$41.59 |
$41.59 |
$41.59 |
$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
|
$41.20 |
$41.20 |
$41.20 |
$15.32
|
|
Ammonia
|
$225.60 |
$225.60 |
$225.60 |
$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
|
$175.80 |
$175.80 |
$175.80 |
$83.20
|
|
Ana ds-dna
|
$182.40 |
$182.40 |
$182.40 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$219.00 |
$219.00 |
$219.00 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$438.00 |
$438.00 |
$438.00 |
$253.11
|
|
Analysis tumor
|
$809.40 |
$809.40 |
$809.40 |
$248.80
|
|
Anca screen with reflex to titer -quest
|
$472.80 |
$472.80 |
$472.80 |
$111.20
|
|
An fluoro guide for cvp
|
$466.20 |
$466.20 |
$466.20 |
$469.17
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,444.89 |
$1,444.89 |
$1,444.89 |
$44,765.71
|
|
Anidulafungin injection
|
$209.79 |
$209.79 |
$209.79 |
$209.79
|
|
Ankle X-ray
|
$516.00 |
$516.00 |
$516.00 |
$311.92
|
|
Anodyne therapy charges pt
|
$51.60 |
$51.60 |
$51.60 |
$41.02
|
|
Anora (draw only)
|
$34.80 |
$34.80 |
$34.80 |
$36.00
|
|
Antibody
|
$29.40 |
$29.40 |
$29.40 |
$29.40
|
|
Antibody bacterium, not elsewhere specified
|
$120.00 |
$120.00 |
$120.00 |
$57.85
|
|
Antibody elution rbc reference
|
$410.40 |
$410.40 |
$410.40 |
$156.24
|
|
Antibody htlv/hiv confirm test
|
$231.60 |
$231.60 |
$231.60 |
$154.85
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$537.00 |
$537.00 |
$537.00 |
$216.24
|
|
Antibody id rbc panel
|
$316.20 |
$316.20 |
$316.20 |
$250.90
|
|
Antibody influenza virus
|
$160.20 |
$160.20 |
$160.20 |
$63.33
|
|
Antibody screen rbc
|
$151.80 |
$151.80 |
$151.80 |
$99.99
|
|
Antibody tetanus
|
$196.80 |
$196.80 |
$196.80 |
$74.53
|
|
Antinuclear antibodies
|
$237.00 |
$237.00 |
$237.00 |
$97.50
|
|
Antinuclear antibodies titer
|
$200.40 |
$200.40 |
$200.40 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$214.80 |
$214.80 |
$214.80 |
$72.15
|
|
Antistreptolysin o titer
|
$194.40 |
$194.40 |
$194.40 |
$58.50
|
|
Antithrombin iii activity
|
$449.40 |
$449.40 |
$449.40 |
$135.20
|
|
Application finger splntstatic 29130
|
$238.80 |
$238.80 |
$238.80 |
$208.16
|
|
Application long leg splint 29505
|
$255.00 |
$255.00 |
$255.00 |
$325.60
|
|
Application lower leg splint 29515
|
$255.00 |
$255.00 |
$255.00 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$889.20 |
$889.20 |
$889.20 |
$384.80
|
|
Application of paste boot 29580
|
$566.40 |
$566.40 |
$566.40 |
$331.74
|
|
Appl modality 1/> areas paraffin bath 97018
|
$85.80 |
$85.80 |
$85.80 |
$69.44
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$110.40 |
$110.40 |
$110.40 |
$71.50
|
|
Appl multlay comprs arm/hand
|
$352.20 |
$352.20 |
$352.20 |
$237.60
|
|
Apply forearm splintdynamic 29126
|
$268.80 |
$268.80 |
$268.80 |
$245.40
|
