|
17-hydroxypregnenolone
|
$96.00 |
$96.00 |
$96.00 |
$102.05
|
|
17-ketosteroids
|
$76.40 |
$76.40 |
$76.40 |
$57.20
|
|
5' nucleotidase - sendout
|
$56.00 |
$56.00 |
$56.00 |
$65.84
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$44.80 |
$44.80 |
$44.80 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$1,330.00 |
$1,330.00 |
$1,330.00 |
$1,951.30
|
|
Abdominal CT scan (with contrast)
|
$1,203.60 |
$1,203.60 |
$1,203.60 |
$1,610.00
|
|
Abdominal CT scan (without contrast)
|
$982.80 |
$982.80 |
$982.80 |
$1,237.60
|
|
Abdominal MRI (with and without contrast)
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$2,629.50
|
|
Abdominal MRI (with contrast)
|
$1,382.00 |
$1,382.00 |
$1,382.00 |
$2,042.68
|
|
Abdominal MRI (without contrast)
|
$1,402.00 |
$1,402.00 |
$1,402.00 |
$1,830.00
|
|
Abdominal paracentesis w/image guidance
|
$461.20 |
$461.20 |
$461.20 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$554.40 |
$554.40 |
$554.40 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$452.80 |
$452.80 |
$452.80 |
$586.43
|
|
Acetone qualitative
|
$32.00 |
$32.00 |
$32.00 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$70.40 |
$70.40 |
$70.40 |
$94.20
|
|
Acute hepatitis panel
|
$220.40 |
$220.40 |
$220.40 |
$306.00
|
|
#acylcarnitineprfl
|
$92.00 |
$92.00 |
$92.00 |
$110.25
|
|
Adh-sendout
|
$96.80 |
$96.80 |
$96.80 |
$152.10
|
|
Administration chemotherapy IV infusion each additional hour
|
$88.40 |
$88.40 |
$88.40 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$385.60 |
$385.60 |
$385.60 |
$695.37
|
|
Administration immunization 1 vaccine
|
$48.80 |
$48.80 |
$48.80 |
$65.00
|
|
Administration immunization each additional vaccine
|
$19.20 |
$19.20 |
$19.20 |
$46.23
|
|
Administration immunization first component each vaccine
|
$48.00 |
$48.00 |
$48.00 |
$46.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$176.80 |
$176.80 |
$176.80 |
$330.00
|
|
Air conduction bilat
|
$67.20 |
$67.20 |
$67.20 |
$140.87
|
|
Albumin body fluid quantitative each specimen
|
$28.80 |
$28.80 |
$28.80 |
$42.81
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$58.00 |
$58.00 |
$58.00 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$47.60 |
$47.60 |
$47.60 |
$40.00
|
|
Alkaline phosphatase
|
$18.00 |
$18.00 |
$18.00 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$30.00 |
$30.00 |
$30.00 |
$56.35
|
|
Allergen egg white ige
|
$57.60 |
$57.60 |
$57.60 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$40.80 |
$40.80 |
$40.80 |
$39.00
|
|
Alpha-fetoprotein tumor marker
|
$117.20 |
$117.20 |
$117.20 |
$115.70
|
|
Alt/sgpt
|
$58.00 |
$58.00 |
$58.00 |
$44.68
|
|
Aluminum - quest
|
$39.60 |
$39.60 |
$39.60 |
$114.40
|
|
Amino acids quant 2-5
|
$159.60 |
$159.60 |
$159.60 |
$148.20
|
|
Amitriptyline (elavil) -sendout
|
$87.60 |
$87.60 |
$87.60 |
$96.35
|
|
Ammonia
|
$93.60 |
$93.60 |
$93.60 |
$96.53
|
|
Amphetamines 5 or more
|
$58.00 |
$58.00 |
$58.00 |
$81.25
|
|
Amylase
|
$45.20 |
$45.20 |
$45.20 |
$85.65
|
|
Ana ds-dna
|
$47.60 |
$47.60 |
$47.60 |
$69.03
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$119.20 |
$119.20 |
$119.20 |
$98.87
|
|
Analysis gene f2 20210g>a variant
|
$91.20 |
$91.20 |
$91.20 |
$244.00
|
|
Analysis gene f5 leiden variant
|
$84.80 |
$84.80 |
$84.80 |
$253.11
|
|
Anaplsma phgcytophlm amp prb
|
$88.00 |
$88.00 |
$88.00 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$48.80 |
$48.80 |
$48.80 |
$112.45
|
|
Ankle X-ray
|
$165.20 |
$165.20 |
$165.20 |
$325.59
|
|
Anora (draw only)
|
$38.80 |
$38.80 |
$38.80 |
$36.36
|
|
Antibody bacterium, not elsewhere specified
|
$39.60 |
$39.60 |
$39.60 |
$57.85
|
|
Antibody elution rbc reference
|
$98.40 |
$98.40 |
$98.40 |
$164.80
|
|
Antibody htlv/hiv confirm test
|
$62.00 |
$62.00 |
$62.00 |
$154.85
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$161.60 |
$161.60 |
$161.60 |
$218.30
|
|
Antibody id rbc panel
|
$207.60 |
$207.60 |
$207.60 |
$265.05
|
|
Antibody influenza virus
|
$52.40 |
$52.40 |
$52.40 |
$63.33
|
|
Antibody screen rbc
|
$58.40 |
$58.40 |
$58.40 |
$102.60
|
|
Antibody tetanus
|
$48.80 |
$48.80 |
$48.80 |
$82.20
|
|
Antidepressant not specified
|
$67.60 |
$67.60 |
$67.60 |
$85.14
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$36.80 |
$36.80 |
$36.80 |
$58.80
|
|
Antinuclear antibodies
|
$122.00 |
$122.00 |
$122.00 |
$98.25
|
|
Antinuclear antibodies titer
|
$99.60 |
$99.60 |
$99.60 |
$79.95
|
|
Antiphosphatidylserine antibody
|
$70.80 |
$70.80 |
$70.80 |
$79.20
|
|
Antistreptolysin o titer
|
$48.80 |
$48.80 |
$48.80 |
$58.50
|
|
Antithrombin iii activity
|
$80.00 |
$80.00 |
$80.00 |
$135.20
|
|
Application finger splntstatic 29130
|
$114.40 |
$114.40 |
$114.40 |
$208.50
|
|
Application long leg splint 29505
|
$110.80 |
$110.80 |
$110.80 |
$338.25
|
|
Application lower leg splint 29515
|
$114.40 |
$114.40 |
$114.40 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$114.00 |
$114.00 |
$114.00 |
$384.80
|
|
Application of long leg cast 29345
|
$218.80 |
$218.80 |
$218.80 |
$464.51
|
|
Application of paste boot 29580
|
$138.40 |
$138.40 |
$138.40 |
$331.74
|
|
Application short leg cast 29405
|
$135.60 |
$135.60 |
$135.60 |
$388.80
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,240.00 |
$1,240.00 |
$1,240.00 |
$2,087.50
|
|
Appl modality 1/> areas paraffin bath 97018
|
$75.20 |
$75.20 |
$75.20 |
$70.65
|
|
#aptt mix-1:1 incubated
|
$33.20 |
$33.20 |
$33.20 |
$157.30
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$32.80 |
$32.80 |
$32.80 |
$90.52
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$274.00 |
$274.00 |
$274.00 |
$567.78
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$274.00 |
$274.00 |
$274.00 |
$451.48
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$287.60 |
$287.60 |
$287.60 |
$696.00
|
|
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion
|
$933.60 |
$933.60 |
$933.60 |
$1,219.50
|
|
Assay alkaline phosphatase
|
$26.40 |
$26.40 |
$26.40 |
$42.60
|
|
Assay of feces porphyrins
|
$120.00 |
$120.00 |
$120.00 |
$175.50
|
|
Assay of lrh hormone
|
$290.00 |
$290.00 |
$290.00 |
$210.60
|
|
Assay of prostaglandin
|
$53.20 |
$53.20 |
$53.20 |
$183.60
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$17.20 |
$17.20 |
$17.20 |
$44.00
|
|
Ast/sgot
|
$58.00 |
$58.00 |
$58.00 |
$43.40
|
|
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic
|
$4,499.20 |
$4,499.20 |
$4,499.20 |
$11,566.33
|
|
Automated diff wbc count
|
$26.00 |
$26.00 |
$26.00 |
$35.10
|
|
Avul nail plate addl
|
$98.00 |
$98.00 |
$98.00 |
$244.70
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$122.40 |
$122.40 |
$122.40 |
$356.00
|
|
Baclofen eval charges
|
$63.60 |
$63.60 |
$63.60 |
$85.00
|
|
Bacterial meningitis antigen
|
$56.40 |
$56.40 |
$56.40 |
$66.30
|
|
Bacterial vaginosis pcr
|
$86.00 |
$86.00 |
$86.00 |
$314.60
|
|
B cells total count
|
$167.20 |
$167.20 |
$167.20 |
$131.30
|
|
#_benzodiazconfur
|
$86.00 |
$86.00 |
$86.00 |
$99.45
|
|
Beta 2 glycoprotein 1 antibody iga
|
$36.00 |
$36.00 |
$36.00 |
$111.15
|
|
Beta-2 microglobulin
|
$32.00 |
$32.00 |
$32.00 |
$84.00
|
|
Bilateral n block inj occipital 64405
|
$274.00 |
$274.00 |
$274.00 |
$834.15
|
|
Bilirubin direct
|
$60.00 |
$60.00 |
$60.00 |
$43.20
|
|
Bilirubin total
|
$54.40 |
$54.40 |
$54.40 |
$49.77
|
|
Biopsy needle lymph node superficial
|
$245.20 |
$245.20 |
$245.20 |
$1,794.93
|
|
Biopsy of salivary gland 42400
|
$432.00 |
$432.00 |
$432.00 |
$1,145.90
|
