|
17-ketosteroids
|
$177.60 |
$177.60 |
$177.60 |
$57.20
|
|
3d ech img cgen car anomal
|
$669.00 |
$669.00 |
$669.00 |
$695.69
|
|
3d recon without postprocess indpndt
|
$469.20 |
$469.20 |
$469.20 |
$443.20
|
|
5' nucleotidase - sendout
|
$217.20 |
$217.20 |
$217.20 |
$64.80
|
|
88334 ap bill cytologic exam each additional site
|
$111.60 |
$111.60 |
$111.60 |
$93.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$52.20 |
$52.20 |
$52.20 |
$53.95
|
|
Abciximab injection
|
$2,432.72 |
$2,432.72 |
$2,432.72 |
$1,084.06
|
|
Abdominal CT scan (with and without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$1,789.65
|
|
Abdominal paracentesis w/image guidance
|
$2,205.60 |
$2,205.60 |
$2,205.60 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$520.20 |
$520.20 |
$520.20 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$329.40 |
$329.40 |
$329.40 |
$574.53
|
|
Abscess drain retroperitoneal surg code
|
$3,617.40 |
$3,617.40 |
$3,617.40 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$125.63 |
$125.63 |
$125.63 |
$45.63
|
|
Acetaminophen level
|
$36.00 |
$36.00 |
$36.00 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$60.38 |
$60.38 |
$60.38 |
$94.47
|
|
Acetone qualitative
|
$129.00 |
$129.00 |
$129.00 |
$43.80
|
|
Acetylcholinesterase assay
|
$175.20 |
$175.20 |
$175.20 |
$104.40
|
|
Acetylcysteine non-comp unit
|
$29.01 |
$29.01 |
$29.01 |
$29.01
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$53.40 |
$53.40 |
$53.40 |
$45.60
|
|
Acoustic immitance testing
|
$108.00 |
$108.00 |
$108.00 |
$157.30
|
|
Acoustic refl threshold tst
|
$150.60 |
$150.60 |
$150.60 |
$90.13
|
|
Acute hepatitis panel
|
$982.80 |
$982.80 |
$982.80 |
$294.45
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$64.45 |
$64.45 |
$64.45 |
$48.72
|
|
#acylcarnitineprfl
|
$339.00 |
$339.00 |
$339.00 |
$110.25
|
|
Acylcarnitines qual
|
$52.80 |
$52.80 |
$52.80 |
$45.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$199.72 |
$199.72 |
$199.72 |
$97.50
|
|
Adenovirus ag ia
|
$140.40 |
$140.40 |
$140.40 |
$31.20
|
|
Adenovirus antibody,serum - quest
|
$140.40 |
$140.40 |
$140.40 |
$63.00
|
|
Adh-sendout
|
$283.20 |
$283.20 |
$283.20 |
$152.10
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$639.08 |
$639.08 |
$639.08 |
$163.25
|
|
Administration chemotherapy IV infusion each additional hour
|
$304.20 |
$304.20 |
$304.20 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$607.80 |
$607.80 |
$607.80 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,210.20 |
$1,210.20 |
$1,210.20 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$543.00 |
$543.00 |
$543.00 |
$454.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$497.40 |
$497.40 |
$497.40 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$497.40 |
$497.40 |
$497.40 |
$267.43
|
|
Administration immunization 1 vaccine
|
$99.00 |
$99.00 |
$99.00 |
$65.00
|
|
Administration immunization each additional vaccine
|
$116.40 |
$116.40 |
$116.40 |
$45.50
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$59.76 |
$59.76 |
$59.76 |
$59.76
|
|
Adrenal cortex & medulla img
|
$3,192.60 |
$3,192.60 |
$3,192.60 |
$1,642.08
|
|
Aep hearing status deter i&r
|
$636.60 |
$636.60 |
$636.60 |
$308.40
|
|
Aep neurodiagnostic i&r
|
$979.20 |
$979.20 |
$979.20 |
$570.16
|
|
Aep thrshld est mlt freq i&r
|
$979.20 |
$979.20 |
$979.20 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$216.00 |
$216.00 |
$216.00 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$107.40 |
$107.40 |
$107.40 |
$38.58
|
|
Aflibercept injection
|
$3,893.02 |
$3,893.02 |
$3,893.02 |
$2,738.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$335.46 |
$335.46 |
$335.46 |
$19,651.83
|
|
Air conduction bilat
|
$169.80 |
$169.80 |
$169.80 |
$140.87
|
|
Albumin body fluid quantitative each specimen
|
$105.60 |
$105.60 |
$105.60 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$481.30 |
$481.30 |
$481.30 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$471.44 |
$471.44 |
$471.44 |
$253.48
|
|
Albumin, human 5 % intravenous solution
|
$470.97 |
$470.97 |
$470.97 |
$196.74
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$226.20 |
$226.20 |
$226.20 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$87.60 |
$87.60 |
$87.60 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$9.18 |
$9.18 |
$9.18 |
$9.18
|
|
Albuterol non-comp unit
|
$9.59 |
$9.59 |
$9.59 |
$7.20
|
|
Aldesleukin injection
|
$6,446.09 |
$6,446.09 |
$6,446.09 |
$5,301.26
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$1,513.25 |
$1,513.25 |
$1,513.25 |
$27,257.23
|
|
Alkaline phosphatase
|
$96.00 |
$96.00 |
$96.00 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$61.80 |
$61.80 |
$61.80 |
$56.35
|
|
Allergen egg white ige
|
$135.00 |
$135.00 |
$135.00 |
$41.00
|
|
Allergy Skin Testing
|
$82.80 |
$82.80 |
$82.80 |
$47.44
|
|
Allograft amnioexcel plus 17mm disk
|
$6,637.80 |
$6,637.80 |
$6,637.80 |
$2,959.72
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$2,550.00 |
$2,550.00 |
$2,550.00 |
$30,615.48
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$4,094.40 |
$4,094.40 |
$4,094.40 |
$4,304.40
|
|
Alpha-fetoprotein amniotic
|
$169.80 |
$169.80 |
$169.80 |
$94.25
|
|
Alpha-fetoprotein tumor marker
|
$352.80 |
$352.80 |
$352.80 |
$110.40
|
|
Alprostadil for injection
|
$228.18 |
$228.18 |
$228.18 |
$522.85
|
|
Alteplase 100 mg infusion from pyxis vial
|
$2,680.50 |
$2,680.50 |
$2,680.50 |
$189.60
|
|
Alt/sgpt
|
$105.00 |
$105.00 |
$105.00 |
$43.55
|
|
Aluminum - quest
|
$177.00 |
$177.00 |
$177.00 |
$114.40
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$47.58 |
$47.58 |
$47.58 |
$36.30
|
|
Amino acid screen, urine
|
$52.80 |
$52.80 |
$52.80 |
$64.28
|
|
Aminolevulinic acid delta
|
$61.20 |
$61.20 |
$61.20 |
$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
|
$273.46 |
$273.46 |
$273.46 |
$15.32
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$16.14 |
$16.14 |
$16.14 |
$22.21
|
|
Ammonia
|
$244.80 |
$244.80 |
$244.80 |
$96.53
|
|
Amniocentesisdiagnostic 59000
|
$319.20 |
$319.20 |
$319.20 |
$876.60
|
|
Amniocentesis therapeutic
|
$2,382.00 |
$2,382.00 |
$2,382.00 |
$747.75
|
|
Amniotic fluid scan
|
$177.60 |
$177.60 |
$177.60 |
$33.15
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$54.24 |
$54.24 |
$54.24 |
$107.46
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$178.45 |
$178.45 |
$178.45 |
$94.57
|
|
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
|
$184.80 |
$184.80 |
$184.80 |
$83.20
|
|
Ana ds-dna
|
$186.00 |
$186.00 |
$186.00 |
$69.03
|
|
Anal pressure record
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$1,077.44
|
|
Analysis gene f2 20210g>a variant
|
$219.60 |
$219.60 |
$219.60 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$435.60 |
$435.60 |
$435.60 |
$253.11
|
|
Analysis tumor
|
$909.00 |
$909.00 |
$909.00 |
$248.80
|
|
Anca screen with reflex to titer -quest
|
$563.40 |
$563.40 |
$563.40 |
$111.20
|
|
An cholangiogram percutaneous compl
|
$2,238.00 |
$2,238.00 |
$2,238.00 |
$2,417.63
|
|
An fluoro guide for cvp
|
$276.00 |
$276.00 |
$276.00 |
$469.17
|
