|
17-hydroxypregnenolone
|
$1,484.18 |
$1,484.18 |
$1,484.18 |
$90.90
|
|
17-ketosteroids
|
$690.23 |
$690.23 |
$690.23 |
$55.00
|
|
1 pc ost pouch w filter
|
$3.00 |
$3.00 |
$3.00 |
$6.72
|
|
2d tee w or without fol w/con,in
|
$5,427.97 |
$5,427.97 |
$5,427.97 |
$1,665.35
|
|
2d tte w or without fol w/con,co
|
$4,155.30 |
$4,155.30 |
$4,155.30 |
$1,278.75
|
|
3d recon without postprocess indpndt
|
$4,385.99 |
$4,385.99 |
$4,385.99 |
$505.05
|
|
88334 ap bill cytologic exam each additional site
|
$53.53 |
$53.53 |
$53.53 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,976.77 |
$3,976.77 |
$3,976.77 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$175.05 |
$175.05 |
$175.05 |
$53.90
|
|
Abdominal MRI (with and without contrast)
|
$15,426.55 |
$15,426.55 |
$15,426.55 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$14,140.83 |
$14,140.83 |
$14,140.83 |
$2,226.96
|
|
Abdominal MRI (without contrast)
|
$12,852.37 |
$12,852.37 |
$12,852.37 |
$2,048.36
|
|
Ablate arrhythmia add on
|
$67,783.94 |
$67,783.94 |
$67,783.94 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$43,235.51 |
$43,235.51 |
$43,235.51 |
$9,476.33
|
|
Acetaminophen level
|
$769.42 |
$769.42 |
$769.42 |
$111.00
|
|
Acetylcholine receptor modulating antibody
|
$1,044.85 |
$1,044.85 |
$1,044.85 |
$66.28
|
|
Adh-sendout
|
$617.58 |
$617.58 |
$617.58 |
$114.50
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$327.29 |
$327.29 |
$327.29 |
$298.35
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$382.01 |
$382.01 |
$382.01 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$382.01 |
$382.01 |
$382.01 |
$254.40
|
|
_afb id by dna probe rflx ast
|
$911.01 |
$911.01 |
$911.01 |
$104.50
|
|
Aflibercept injection
|
$6,475.00 |
$6,475.00 |
$6,475.00 |
$2,738.00
|
|
Airway resistance by impulse oscillometry 94728
|
$558.73 |
$558.73 |
$558.73 |
$289.20
|
|
Albumin (human), 5%, 250 ml
|
$205.00 |
$205.00 |
$205.00 |
$246.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$548.63 |
$548.63 |
$548.63 |
$94.90
|
|
Amantadine (symmetrel)-sendout
|
$868.66 |
$868.66 |
$868.66 |
$179.70
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$325.70 |
$325.70 |
$325.70 |
$37.33
|
|
Aminolevulinic acid delta
|
$895.41 |
$895.41 |
$895.41 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$89.07 |
$89.07 |
$89.07 |
$46.24
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$119.71 |
$119.71 |
$119.71 |
$114.96
|
|
Amitriptyline (elavil) -sendout
|
$489.51 |
$489.51 |
$489.51 |
$84.56
|
|
Amphetamine confirm urine -sendout
|
$354.62 |
$354.62 |
$354.62 |
$93.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$154.50 |
$154.50 |
$154.50 |
$117.75
|
|
Amphotericin b lipid complex
|
$840.00 |
$840.00 |
$840.00 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$686.88 |
$686.88 |
$686.88 |
$519.03
|
|
Anabolic steroid 1 or 2
|
$528.55 |
$528.55 |
$528.55 |
$80.08
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$467.23 |
$467.23 |
$467.23 |
$117.01
|
|
Analysis tumor
|
$537.48 |
$537.48 |
$537.48 |
$248.80
|
|
Antibody elution rbc reference
|
$311.10 |
$311.10 |
$311.10 |
$175.50
|
|
Antibody lymphocytic choriomeningitis
|
$1,979.29 |
$1,979.29 |
$1,979.29 |
$46.20
|
|
Antibody screen rbc
|
$438.24 |
$438.24 |
$438.24 |
$106.88
|
|
Antihemophilic viii/vwf comp
|
$4.17 |
$4.17 |
$4.17 |
$3.67
|
|
Anti-inhibitor
|
$8.37 |
$8.37 |
$8.37 |
$8.33
|
|
Apl(pml-rara) quant - sendout
|
$1,509.84 |
$1,509.84 |
$1,509.84 |
$500.80
|
|
Apply of finger splint 29131
|
$1,127.03 |
$1,127.03 |
$1,127.03 |
$177.45
|
|
#aptt mix-1:1 incubated
|
$94.08 |
$94.08 |
$94.08 |
$157.30
|
|
Aqmbf pet rest & rx stress
|
$218.00 |
$218.00 |
$218.00 |
$974.40
|
|
Aquaporin-4 antibody elisa
|
$1,341.65 |
$1,341.65 |
$1,341.65 |
$150.00
|
|
Arformoterol non-comp unit
|
$9.50 |
$9.50 |
$9.50 |
$24.24
|
|
Aripiprazole injection
|
$145.76 |
$145.76 |
$145.76 |
$118.52
|
|
Arterial blood draw/perc 36620
|
$3,421.74 |
$3,421.74 |
$3,421.74 |
$485.69
|
|
Artery x-rays adrenals
|
$26,626.47 |
$26,626.47 |
$26,626.47 |
$3,764.59
|
|
Artery xrays of pelvis 75736 26
|
$15,055.64 |
$15,055.64 |
$15,055.64 |
$4,306.40
|
|
Artery x-rays spine
|
$19,862.47 |
$19,862.47 |
$19,862.47 |
$4,500.95
|
|
Assay acid phosphatase
|
$221.89 |
$221.89 |
$221.89 |
$38.22
|
|
Assay of corticosterone
|
$297.74 |
$297.74 |
$297.74 |
$55.20
|
|
Assay of feces porphyrins
|
$919.72 |
$919.72 |
$919.72 |
$136.50
|
|
Assay of procainamide
|
$1,339.22 |
$1,339.22 |
$1,339.22 |
$114.91
|
|
Assay of procainamide w/metab
|
$773.88 |
$773.88 |
$773.88 |
$70.50
|
|
Assay of sialic acid
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$92.50
|
|
Assay of thiocyanate
|
$650.11 |
$650.11 |
$650.11 |
$72.60
|
|
Assay phosphatidylglycerol
|
$1,484.18 |
$1,484.18 |
$1,484.18 |
$134.16
|
|
Assay toxin or antitoxin
|
$537.48 |
$537.48 |
$537.48 |
$76.76
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$581.47 |
$581.47 |
$581.47 |
$300.00
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$36,215.31 |
$36,215.31 |
$36,215.31 |
$22,528.65
|
|
Autologous blood process
|
$1,203.42 |
$1,203.42 |
$1,203.42 |
$266.75
|
|
Autonomic nrv adrenrg inervj
|
$560.74 |
$560.74 |
$560.74 |
$310.45
|
|
Autonomic nrv parasym inervj
|
$699.00 |
$699.00 |
$699.00 |
$299.72
|
|
Avelumab 20 mg/ml intravenous solution
|
$5,959.03 |
$5,959.03 |
$5,959.03 |
$3,721.71
|
|
Azithromycin dihydrate, oral
|
$49.50 |
$49.50 |
$49.50 |
$41.92
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$257.04 |
$257.04 |
$257.04 |
$161.17
|
|
Bacterial vaginosis pcr
|
$851.84 |
$851.84 |
$851.84 |
$287.04
|
|
#_benzodiazconfur
|
$690.23 |
$690.23 |
$690.23 |
$117.15
|
|
Benztropine 1 mg/ml injection solution
|
$700.71 |
$700.71 |
$700.71 |
$106.46
|
|
Bilicheck
|
$72.48 |
$72.48 |
$72.48 |
$27.00
|
|
Bld prd mix
|
$226.22 |
$226.22 |
$226.22 |
$140.25
|
|
Blood count spun microhematocrit
|
$221.89 |
$221.89 |
$221.89 |
$25.00
|
|
Blood gases o2 saturation direct measurement
|
$2,520.09 |
$2,520.09 |
$2,520.09 |
$226.20
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$32.33 |
$32.33 |
$32.33 |
$33.15
|
|
Blood occult peroxidase activity qualitative gastric
|
$137.18 |
$137.18 |
$137.18 |
$34.65
|
|
Blood typing abo
|
$234.16 |
$234.16 |
$234.16 |
$84.75
|
|
Blood typing ag donor ea ag
|
$915.48 |
$915.48 |
$915.48 |
$204.84
|
|
Blood typing patient serum
|
$368.61 |
$368.61 |
$368.61 |
$70.07
|
|
Blood typing rbc ag non abo/rh ea
|
$915.48 |
$915.48 |
$915.48 |
$206.33
|
|
Blood typing rh phenotype complete reference
|
$368.61 |
$368.61 |
$368.61 |
$86.33
|
|
Bone imaging multiple areas
|
$8,179.53 |
$8,179.53 |
$8,179.53 |
$1,194.00
|
|
Bone/joint imaging ltd area
|
$6,167.71 |
$6,167.71 |
$6,167.71 |
$1,035.16
|
|
Bone marrow imaging ltd
|
$5,207.25 |
$5,207.25 |
$5,207.25 |
$811.00
|
|
Boot mlti podous univ xlg
|
$1,565.00 |
$1,565.00 |
$1,565.00 |
$246.13
|
|
(both sides) smear without diff wbc count
|
$601.04 |
$601.04 |
$601.04 |
$30.68
|
|
Bowel imaging
|
$6,994.18 |
$6,994.18 |
$6,994.18 |
$1,065.53
|
|
Brace ank aftr bioskn med lg
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$194.42
|
|
Brace halo bremer l2830
|
$1,567.00 |
$1,567.00 |
$1,567.00 |
$195.59
|
|
Brace kafo dbl upright cust
|
$8,692.00 |
$8,692.00 |
$8,692.00 |
$3,609.22
|
|
Brace oths wrist hnd fngr without
|
$3,437.00 |
$3,437.00 |
$3,437.00 |
$250.88
|
|
Braf gene
|
$2,359.59 |
$2,359.59 |
$2,359.59 |
$436.47
|
|
Brain image 4+ views
|
$8,208.72 |
$8,208.72 |
$8,208.72 |
$847.80
|
|
Brain image w/flow < 4 views
|
$3,626.08 |
$3,626.08 |
$3,626.08 |
$907.20
|
|
Brain image w/flow 4 + views
|
$3,624.96 |
$3,624.96 |
$3,624.96 |
$1,330.00
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$14,041.77 |
$14,041.77 |
$14,041.77 |
$2,761.59
|
