|
17-ketosteroids
|
$154.80 |
$154.80 |
$154.80 |
$57.20
|
|
5' nucleotidase - sendout
|
$127.20 |
$127.20 |
$127.20 |
$64.80
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$36.00 |
$36.00 |
$36.00 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$1,908.60 |
$1,908.60 |
$1,908.60 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$1,634.40 |
$1,634.40 |
$1,634.40 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$1,143.60 |
$1,143.60 |
$1,143.60 |
$1,213.74
|
|
Abdominal MRI (with and without contrast)
|
$2,485.20 |
$2,485.20 |
$2,485.20 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$2,222.40 |
$2,222.40 |
$2,222.40 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$2,123.40 |
$2,123.40 |
$2,123.40 |
$1,789.65
|
|
Abdominal paracentesis w/image guidance
|
$2,456.40 |
$2,456.40 |
$2,456.40 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$742.80 |
$742.80 |
$742.80 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$516.00 |
$516.00 |
$516.00 |
$574.53
|
|
Abd paracentesis/w/o image guide 49082
|
$2,056.80 |
$2,056.80 |
$2,056.80 |
$1,144.26
|
|
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
|
$54.60 |
$54.60 |
$54.60 |
$43.80
|
|
Acetylcysteine non-comp unit
|
$29.01 |
$29.01 |
$29.01 |
$29.01
|
|
Acute hepatitis panel
|
$711.60 |
$711.60 |
$711.60 |
$294.45
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$48.72 |
$48.72 |
$48.72 |
$48.72
|
|
#acylcarnitineprfl
|
$374.40 |
$374.40 |
$374.40 |
$110.25
|
|
Acylcarnitines qual
|
$59.40 |
$59.40 |
$59.40 |
$45.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$199.72 |
$199.72 |
$199.72 |
$97.50
|
|
Adenovirus ag ia
|
$143.40 |
$143.40 |
$143.40 |
$31.20
|
|
Adh-sendout
|
$290.40 |
$290.40 |
$290.40 |
$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
|
$318.00 |
$318.00 |
$318.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$534.00 |
$534.00 |
$534.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$582.60 |
$582.60 |
$582.60 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$282.00 |
$282.00 |
$282.00 |
$454.00
|
|
Administration immunization 1 vaccine
|
$79.80 |
$79.80 |
$79.80 |
$65.00
|
|
Administration immunization each additional vaccine
|
$108.60 |
$108.60 |
$108.60 |
$45.50
|
|
_afb id by dna probe rflx ast
|
$69.60 |
$69.60 |
$69.60 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$18.00 |
$18.00 |
$18.00 |
$38.58
|
|
Albumin body fluid quantitative each specimen
|
$109.20 |
$109.20 |
$109.20 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$470.10 |
$470.10 |
$470.10 |
$277.87
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$152.40 |
$152.40 |
$152.40 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$75.00 |
$75.00 |
$75.00 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$9.18 |
$9.18 |
$9.18 |
$9.18
|
|
Alkaline phosphatase
|
$83.40 |
$83.40 |
$83.40 |
$43.80
|
|
Allergen alpha lactalbumin ige
|
$64.80 |
$64.80 |
$64.80 |
$56.35
|
|
Allergen egg white ige
|
$73.80 |
$73.80 |
$73.80 |
$41.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$11,820.00 |
$11,820.00 |
$11,820.00 |
$3,035.85
|
|
Alpha-fetoprotein amniotic
|
$192.00 |
$192.00 |
$192.00 |
$94.25
|
|
Alpha-fetoprotein tumor marker
|
$152.40 |
$152.40 |
$152.40 |
$110.40
|
|
Alteplase 100 mg infusion from pyxis vial
|
$134.03 |
$134.03 |
$134.03 |
$189.60
|
|
Alt/sgpt
|
$83.40 |
$83.40 |
$83.40 |
$43.55
|
|
Aluminum - quest
|
$204.60 |
$204.60 |
$204.60 |
$114.40
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$44.00 |
$44.00 |
$44.00 |
$36.30
|
|
Amino acid screen, urine
|
$59.40 |
$59.40 |
$59.40 |
$64.28
|
|
Aminolevulinic acid delta
|
$165.60 |
$165.60 |
$165.60 |
$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
|
$269.76 |
$269.76 |
$269.76 |
$15.32
|
|
Ammonia
|
$204.00 |
$204.00 |
$204.00 |
$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
|
$125.40 |
$125.40 |
$125.40 |
$83.20
|
|
Ana ds-dna
|
$200.40 |
$200.40 |
$200.40 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$217.20 |
$217.20 |
$217.20 |
$246.35
|
|
Analysis gene f5 leiden variant
|
$436.80 |
$436.80 |
$436.80 |
$253.11
|
|
Anca screen with reflex to titer -quest
|
$456.00 |
$456.00 |
$456.00 |
$111.20
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$39.61 |
$39.61 |
$39.61 |
$44,765.71
|
|
Ankle X-ray
|
$602.40 |
$602.40 |
$602.40 |
$311.92
|
|
Anora (draw only)
|
$33.00 |
$33.00 |
$33.00 |
$36.00
|
|
Antibody
|
$20.40 |
$20.40 |
$20.40 |
$29.40
|
|
Antibody bacterium, not elsewhere specified
|
$36.00 |
$36.00 |
$36.00 |
$57.85
|
|
Antibody elution rbc reference
|
$236.40 |
$236.40 |
$236.40 |
$156.24
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$424.20 |
$424.20 |
$424.20 |
$216.24
|
|
Antibody id rbc panel
|
$279.00 |
$279.00 |
$279.00 |
$250.90
|
|
Antibody influenza virus
|
$47.40 |
$47.40 |
$47.40 |
$63.33
|
|
Antibody screen rbc
|
$118.20 |
$118.20 |
$118.20 |
$99.99
|
|
Antibody tetanus
|
$188.40 |
$188.40 |
$188.40 |
$74.53
|
|
Antinuclear antibodies
|
$186.00 |
$186.00 |
$186.00 |
$97.50
|
|
Antinuclear antibodies titer
|
$147.00 |
$147.00 |
$147.00 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$55.20 |
$55.20 |
$55.20 |
$72.15
|
|
Antistreptolysin o titer
|
$140.40 |
$140.40 |
$140.40 |
$58.50
|
|
Antithrombin iii activity
|
$186.00 |
$186.00 |
$186.00 |
$135.20
|
|
Application finger splntstatic 29130
|
$148.20 |
$148.20 |
$148.20 |
$208.16
|
|
Application long leg splint 29505
|
$148.20 |
$148.20 |
$148.20 |
$325.60
|
|
Application lower leg splint 29515
|
$140.40 |
$140.40 |
$140.40 |
$345.60
|
|
Application of paste boot 29580
|
$285.00 |
$285.00 |
$285.00 |
$331.74
|
|
Appl modality 1/> areas paraffin bath 97018
|
$46.80 |
$46.80 |
$46.80 |
$69.44
|
|
Apply forearm splintdynamic 29126
|
$219.60 |
$219.60 |
$219.60 |
$245.40
|
|
Apply of finger splint 29131
|
$175.20 |
$175.20 |
$175.20 |
$177.45
|
|
Arterial blood draw/perc 36620
|
$684.60 |
$684.60 |
$684.60 |
$529.19
|
|
Aspirate pleura without imaging 32554
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$1,196.52
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$1,482.60 |
$1,482.60 |
$1,482.60 |
$1,219.50
|
|
Assay of chloramphenicol
|
$73.80 |
$73.80 |
$73.80 |
$78.00
|
|
Assay of galactose
|
$47.40 |
$47.40 |
$47.40 |
$49.21
|
|
Assay of neonatal thyroxine
|
$26.40 |
$26.40 |
$26.40 |
$13.33
|
|
Assay of salicylate
|
$36.00 |
$36.00 |
$36.00 |
$83.85
|
|
Assay phosphatidylglycerol
|
$57.00 |
$57.00 |
$57.00 |
$133.56
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$67.80 |
$67.80 |
$67.80 |
$43.55
|
|
Ast/sgot
|
$84.60 |
$84.60 |
$84.60 |
$43.40
|
|
Atropine 0.1 mg/ml injection syringe
|
$101.04 |
$101.04 |
$101.04 |
$25.04
|
|
Automated diff wbc count
|
$20.40 |
$20.40 |
$20.40 |
$33.80
|
|
Azathioprine 50 mg tablet
|
$2.18 |
$2.18 |
$2.18 |
$2.18
|
|
Azithromycin 500 mg intravenous solution
|
$65.10 |
$65.10 |
$65.10 |
$22.94
|
|
Aztreonam 1 gram solution for injection
|
$158.89 |
$158.89 |
$158.89 |
$157.83
|
|
Baclofen eval charges
|
$61.20 |
$61.20 |
$61.20 |
$84.35
|
