|
17-hydroxypregnenolone
|
$96.00 |
$96.00 |
$96.00 |
|
|
17-ketosteroids
|
$76.40 |
$76.40 |
$76.40 |
|
|
24 hr ambulatory b/p monitor
|
$75.20 |
$75.20 |
$75.20 |
|
|
2d tee w or without fol w/con,in
|
$1,063.40 |
$1,063.40 |
$1,063.40 |
|
|
3-d radiotherapy plan
|
$778.00 |
$778.00 |
$7,381.40 |
|
|
3d recon without postprocess indpndt
|
$198.00 |
$198.00 |
$425.75 |
|
|
5' nucleotidase - sendout
|
$56.00 |
$56.00 |
$56.00 |
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,649.67 |
$3,649.67 |
$3,649.67 |
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$44.80 |
$44.80 |
$44.80 |
|
|
Abd aorta w/runoff s&i
|
$2,639.00 |
$2,639.00 |
$3,256.80 |
|
|
Abd/low ext cath 1st
|
$17,868.36 |
$17,868.36 |
$17,868.36 |
|
|
Abd/low ext cath 3rd
|
$8,367.25 |
$8,367.25 |
$8,367.25 |
|
|
Abdominal CT scan (with and without contrast)
|
$1,330.00 |
$1,490.80 |
$2,223.00 |
|
|
Abdominal CT scan (with contrast)
|
$1,203.60 |
$1,400.80 |
$1,931.80 |
|
|
Abdominal CT scan (without contrast)
|
$982.80 |
$1,014.40 |
$1,714.70 |
|
|
Abdominal MRI (with and without contrast)
|
$1,762.00 |
$2,420.60 |
$2,475.20 |
|
|
Abdominal MRI (with contrast)
|
$1,376.00 |
$1,382.00 |
$1,676.35 |
|
|
Abdominal MRI (without contrast)
|
$1,386.40 |
$1,402.00 |
$2,122.25 |
|
|
Abdominal paracentesis w/image guidance
|
$461.20 |
$461.20 |
$1,688.70 |
|
|
Abdominal Ultrasound (complete)
|
$554.40 |
$713.20 |
$753.35 |
|
|
Abdominal Ultrasound (limited)
|
$452.80 |
$471.90 |
$519.20 |
|
|
Abd paracentesis/w/o image guide 49082
|
$957.47 |
$957.47 |
$957.47 |
|
|
Ablate arrhythmia add on
|
$19,434.35 |
$19,434.35 |
$19,434.35 |
|
|
Ablate inf turbinate submuc 30802
|
$16,470.48 |
$16,470.48 |
$16,470.48 |
|
|
Ablation cardiac vagal inputs atrium
|
$4,050.15 |
$4,050.15 |
$4,050.15 |
|
|
Ablation of upper extremity nerves rf
|
$22,776.94 |
$22,776.94 |
$22,776.94 |
|
|
Abscess drain retroperitoneal surg code
|
$2,181.60 |
$2,181.60 |
$2,181.60 |
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$45.63 |
$45.63 |
$45.63 |
|
|
Acetaminophen level
|
$196.30 |
$196.30 |
$196.30 |
|
|
Acetazolamide 500 mg solution for injection
|
$185.73 |
$185.73 |
$185.73 |
|
|
Acetone qualitative
|
$32.00 |
$32.00 |
$38.00 |
|
|
Acetylcholine receptor modulating antibody
|
$70.40 |
$70.40 |
$245.70 |
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$224.98 |
$224.98 |
$224.98 |
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$110.00 |
$110.00 |
$110.00 |
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$24.80 |
$24.80 |
$63.05 |
|
|
Actinotherapy uv light
|
$96.20 |
$96.20 |
$194.00 |
|
|
Acute hepatitis panel
|
$134.40 |
$220.40 |
$378.30 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$47.53 |
$47.53 |
$47.53 |
|
|
#acylcarnitineprfl
|
$92.00 |
$92.00 |
$140.00 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$276.02 |
$276.02 |
$276.02 |
|
|
Adenovirus antibody,serum - quest
|
$79.20 |
$79.20 |
$79.20 |
|
|
Adh-sendout
|
$92.40 |
$92.40 |
$96.80 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$93.96 |
$93.96 |
$93.96 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$88.40 |
$102.80 |
$399.10 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$111.60 |
$111.60 |
$299.00 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$238.00 |
$307.45 |
$385.60 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$174.80 |
$174.80 |
$286.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$58.00 |
$58.00 |
$121.55 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$54.00 |
$54.00 |
$135.85 |
|
|
Administration immunization 1 vaccine
|
$43.20 |
$48.80 |
$59.80 |
|
|
Administration immunization each additional component
|
$52.00 |
$52.00 |
$52.00 |
|
|
Administration immunization each additional vaccine
|
$19.20 |
$35.10 |
$43.20 |
|
|
Administration immunization first component each vaccine
|
$48.00 |
$48.00 |
$52.00 |
|
|
Administration vaccine hepatitis b
|
$16.25 |
$16.25 |
$16.25 |
|
|
Administration vaccine influenza virus
|
$52.00 |
$52.00 |
$52.00 |
|
|
Administration vaccine pneumococcal
|
$52.00 |
$52.00 |
$52.00 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$11,874.55 |
$11,874.55 |
$11,874.55 |
|
|
Adrenal cortex & medulla img
|
$1,044.40 |
$1,044.40 |
$1,044.40 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$176.80 |
$176.80 |
$176.80 |
|
|
After cataract laser surgery
|
$1,531.10 |
$1,531.10 |
$1,531.10 |
|
|
Agalsidase beta 35 mg intravenous solution
|
$18,341.71 |
$18,341.71 |
$18,341.71 |
|
|
Air conduction bilat
|
$29.60 |
$29.60 |
$67.20 |
|
|
Albumin body fluid quantitative each specimen
|
$28.80 |
$42.25 |
$66.40 |
|
|
Albumin (human), 25%, 50ml
|
$380.25 |
$380.25 |
$380.25 |
|
|
Albumin (human), 5%, 250 ml
|
$292.58 |
$292.58 |
$292.58 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$58.00 |
$72.80 |
$115.60 |
|
|
Albumin serum plasma or whole blood
|
$33.15 |
$47.60 |
$56.40 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$171.60 |
$171.60 |
$171.60 |
|
|
Alkaline phosphatase
|
$18.00 |
$32.40 |
$40.95 |
|
|
Allergen alpha lactalbumin ige
|
$30.00 |
$30.00 |
$72.80 |
|
|
Allergen egg white ige
|
$35.60 |
$46.15 |
$57.60 |
|
|
Allergen specific ige qual multi scrn ea
|
$40.80 |
$40.80 |
$40.80 |
|
|
Alpha-fetoprotein tumor marker
|
$66.80 |
$117.20 |
$126.10 |
|
|
Alprostadil for injection
|
$715.48 |
$715.48 |
$715.48 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$442.33 |
$442.33 |
$442.33 |
|
|
Alt/sgpt
|
$47.45 |
$58.00 |
$65.60 |
|
|
Aluminum - quest
|
$39.60 |
$39.60 |
$39.60 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$235.20 |
$235.20 |
$235.20 |
|
|
Ambl bp mntr w/sw a/r
|
$164.80 |
$164.80 |
$164.80 |
|
|
Amino acids quant 2-5
|
$159.60 |
$159.60 |
$159.60 |
|
|
Aminolevulinic acid delta
|
$60.00 |
$60.00 |
$60.00 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$92.91 |
$92.91 |
$92.91 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$195.19 |
$195.19 |
$195.19 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$37.57 |
$37.57 |
$37.57 |
|
|
Amitriptyline (elavil) -sendout
|
$87.60 |
$87.60 |
$152.75 |
|
|
Ammonia
|
$57.20 |
$93.60 |
$112.45 |
|
|
Amphetamine confirm urine -sendout
|
$100.10 |
$100.10 |
$100.10 |
|
|
Amphetamines 5 or more
|
$58.00 |
$58.00 |
$58.00 |
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,385.21 |
$1,385.21 |
$1,385.21 |
|
|
Ampicillin 1 gram solution for injection
|
$30.02 |
$30.02 |
$30.02 |
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$29.57 |
$29.57 |
$29.57 |
|
|
Amylase
|
$45.20 |
$80.80 |
$91.00 |
|
|
Ana ds-dna
|
$47.60 |
$47.60 |
$62.40 |
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$119.20 |
$119.20 |
$161.60 |
|
|
Analysis gene f2 20210g>a variant
|
$91.20 |
$91.20 |
$415.35 |
|
|
Analysis gene f5 leiden variant
|
$84.00 |
$84.80 |
$447.20 |
|
|
Anaplsma phgcytophlm amp prb
|
$88.00 |
$88.00 |
$147.55 |
|
|
Anca screen with reflex to titer -quest
|
$48.80 |
$80.80 |
$182.00 |
|
|
An fluoro guide for cvp
|
$579.60 |
$579.60 |
$579.60 |
|
|
Anidulafungin injection
|
$806.51 |
$806.51 |
$806.51 |
|
