|
17-hydroxypregnenolone
|
$69.60 |
$69.60 |
$69.60 |
$92.65
|
|
24 hr ambulatory b/p monitor
|
$349.60 |
$349.60 |
$349.60 |
$313.04
|
|
3d recon without postprocess indpndt
|
$891.20 |
$891.20 |
$891.20 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$118.40 |
$118.40 |
$118.40 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,091.11 |
$2,091.11 |
$2,091.11 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,216.80 |
$1,216.80 |
$1,216.80 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$850.40 |
$850.40 |
$850.40 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,880.80 |
$2,880.80 |
$2,880.80 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,761.60 |
$2,761.60 |
$2,761.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,223.20 |
$2,223.20 |
$2,223.20 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,155.20 |
$4,155.20 |
$4,155.20 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,222.40 |
$3,222.40 |
$3,222.40 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,896.80 |
$2,896.80 |
$2,896.80 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,884.00 |
$1,884.00 |
$1,884.00 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$983.20 |
$983.20 |
$983.20 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$756.00 |
$756.00 |
$756.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$376.80 |
$376.80 |
$376.80 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$520.80 |
$520.80 |
$520.80 |
$418.63
|
|
Abdominal X-ray (single view)
|
$313.60 |
$313.60 |
$313.60 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$1,148.40
|
|
Ablation cryo thigh/knee
|
$4,309.60 |
$4,309.60 |
$4,309.60 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$526.40 |
$526.40 |
$526.40 |
$832.50
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$137.75 |
$137.75 |
$137.75 |
$72.74
|
|
Acetaminophen level
|
$62.40 |
$62.40 |
$62.40 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$78.58 |
$78.58 |
$78.58 |
$122.55
|
|
Acetone qualitative
|
$39.20 |
$39.20 |
$39.20 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$368.16 |
$368.16 |
$368.16 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$24.16 |
$24.16 |
$24.16 |
$31.21
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$451.20 |
$451.20 |
$451.20 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$53.60 |
$53.60 |
$53.60 |
$38.50
|
|
Acute hepatitis panel
|
$382.40 |
$382.40 |
$382.40 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$417.63 |
$417.63 |
$417.63 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$63.05 |
$63.05 |
$63.05 |
$64.45
|
|
#acylcarnitineprfl
|
$51.20 |
$51.20 |
$51.20 |
$121.55
|
|
Adenosine 3 mg/250 ml bag for osm
|
$64.61 |
$64.61 |
$64.61 |
$271.98
|
|
Adh-sendout
|
$174.40 |
$174.40 |
$174.40 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$91.80 |
$91.80 |
$91.80 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$328.80 |
$328.80 |
$328.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$362.40 |
$362.40 |
$362.40 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$858.40 |
$858.40 |
$858.40 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$550.40 |
$550.40 |
$550.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$254.40 |
$254.40 |
$254.40 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$298.40 |
$298.40 |
$298.40 |
$256.49
|
|
Administration immunization each additional vaccine
|
$86.40 |
$86.40 |
$86.40 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$58.40 |
$58.40 |
$58.40 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$54.40 |
$54.40 |
$54.40 |
$30.24
|
|
_afb id by dna probe rflx ast
|
$109.60 |
$109.60 |
$109.60 |
$104.50
|
|
Airway resistance by impulse oscillometry 94728
|
$458.40 |
$458.40 |
$458.40 |
$297.00
|
|
Albumin body fluid quantitative each specimen
|
$42.40 |
$42.40 |
$42.40 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$146.20 |
$146.20 |
$146.20 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$67.20 |
$67.20 |
$67.20 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$28.80 |
$28.80 |
$28.80 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$5.62 |
$5.62 |
$5.62 |
$5.67
|
|
Albuterol non-comp con
|
$4.80 |
$4.80 |
$4.80 |
$6.07
|
|
Albuterol non-comp unit
|
$4.80 |
$4.80 |
$4.80 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$100.80 |
$100.80 |
$100.80 |
$96.00
|
|
Alkaline phosphatase
|
$29.60 |
$29.60 |
$29.60 |
$46.80
|
|
Allergen egg white ige
|
$36.00 |
$36.00 |
$36.00 |
$38.00
|
|
Alpha-fetoprotein tumor marker
|
$136.00 |
$136.00 |
$136.00 |
$106.00
|
|
Alprostadil for injection
|
$90.76 |
$90.76 |
$90.76 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$12,850.08 |
$12,850.08 |
$12,850.08 |
$15,857.45
|
|
Alt/sgpt
|
$39.20 |
$39.20 |
$39.20 |
$47.50
|
|
Ambl bp mntr w/sw a/r
|
$376.00 |
$376.00 |
$376.00 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$63.37 |
$63.37 |
$63.37 |
$39.84
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$60.35 |
$60.35 |
$60.35 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$123.03 |
$123.03 |
$123.03 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$60.83 |
$60.83 |
$60.83 |
$55.86
|
|
Ammonia
|
$116.80 |
$116.80 |
$116.80 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$1,204.80 |
$1,204.80 |
$1,204.80 |
$942.60
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$398.40 |
$398.40 |
$398.40 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$74.12 |
$74.12 |
$74.12 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$67.06 |
$67.06 |
$67.06 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$496.00 |
$496.00 |
$496.00 |
$262.99
|
|
Amylase
|
$79.20 |
$79.20 |
$79.20 |
$90.00
|
|
Ana ds-dna
|
$128.00 |
$128.00 |
$128.00 |
$55.24
|
|
Analysis gene f2 20210g>a variant
|
$345.60 |
$345.60 |
$345.60 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$331.20 |
$331.20 |
$331.20 |
$249.60
|
|
Anastrozole 1 mg
|
$4.44 |
$4.44 |
$4.44 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$176.00 |
$176.00 |
$176.00 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$2,060.00 |
$2,060.00 |
$2,060.00 |
$2,480.94
|
|
An fluoro guide for cvp
|
$716.00 |
$716.00 |
$716.00 |
$525.85
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$202.21 |
$202.21 |
$202.21 |
$2,979.43
|
|
Ankle X-ray
|
$353.60 |
$353.60 |
$353.60 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$302.40 |
$302.40 |
$302.40 |
$282.96
|
|
Anora (draw only)
|
$43.20 |
$43.20 |
$43.20 |
$35.00
|
|
Anoscopy remove fb 46608
|
$1,424.80 |
$1,424.80 |
$1,424.80 |
$1,375.98
|
|
Antibody bacterium, not elsewhere specified
|
$31.20 |
$31.20 |
$31.20 |
$57.85
|
|
Antibody elution rbc reference
|
$164.80 |
$164.80 |
$164.80 |
$177.29
|
|
Antibody id rbc panel
|
$341.60 |
$341.60 |
$341.60 |
$291.75
|
|
Antibody screen rbc
|
$86.40 |
$86.40 |
$86.40 |
$108.55
|
|
Antibody tetanus
|
$134.40 |
$134.40 |
$134.40 |
$54.15
|
|
Antinuclear antibodies
|
$96.80 |
$96.80 |
$96.80 |
$90.00
|
|
Antinuclear antibodies titer
|
$86.40 |
$86.40 |
$86.40 |
$80.04
|
|
Antistreptolysin o titer
|
$67.20 |
$67.20 |
$67.20 |
$54.00
|
|
Antithrombin iii activity
|
$187.20 |
$187.20 |
$187.20 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$482.40 |
$482.40 |
$482.40 |
$394.55
|
|
Application finger splntstatic 29130
|
$214.40 |
$214.40 |
$214.40 |
$208.50
|
|
Application long leg splint 29505
|
$301.60 |
$301.60 |
$301.60 |
$338.25
|
|
Application lower leg splint 29515
|
$277.60 |
$277.60 |
$277.60 |
$340.20
|
