|
17-hydroxypregnenolone
|
$240.60 |
$240.60 |
$240.60 |
$89.25
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,489.00 |
$3,489.00 |
$3,489.00 |
$3,128.29
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$78.60 |
$78.60 |
$78.60 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,256.60 |
$2,256.60 |
$2,256.60 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$1,892.40 |
$1,892.40 |
$1,892.40 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,667.00 |
$2,667.00 |
$2,667.00 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$2,667.00 |
$2,667.00 |
$2,667.00 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,539.80 |
$2,539.80 |
$2,539.80 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$1,651.20
|
|
Abl1 gene
|
$1,226.40 |
$1,226.40 |
$1,226.40 |
$682.50
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$49.20 |
$49.20 |
$49.20 |
$74.96
|
|
Acetaminophen level
|
$34.20 |
$34.20 |
$34.20 |
$107.62
|
|
Acetazolamide 500 mg solution for injection
|
$138.60 |
$138.60 |
$138.60 |
$122.55
|
|
Acetone qualitative
|
$70.80 |
$70.80 |
$70.80 |
$45.65
|
|
Acute hepatitis panel
|
$251.40 |
$251.40 |
$251.40 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$70.80 |
$70.80 |
$70.80 |
$63.48
|
|
Adh-sendout
|
$116.40 |
$116.40 |
$116.40 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1.20 |
$1.20 |
$1.20 |
$181.12
|
|
Albumin body fluid quantitative each specimen
|
$5.40 |
$5.40 |
$5.40 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$257.40 |
$257.40 |
$257.40 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$76.80 |
$76.80 |
$76.80 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$70.80 |
$70.80 |
$70.80 |
$40.80
|
|
Alkaline phosphatase
|
$61.20 |
$61.20 |
$61.20 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$112.80 |
$112.80 |
$112.80 |
$48.00
|
|
Allergen egg white ige
|
$39.60 |
$39.60 |
$39.60 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$19.20 |
$19.20 |
$19.20 |
$24.01
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,313.47 |
$1,313.47 |
$1,313.47 |
$874.65
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$284.00 |
$284.00 |
$284.00 |
$4,677.40
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$380.73 |
$380.73 |
$380.73 |
$1,495.63
|
|
Alpha-fetoprotein tumor marker
|
$130.80 |
$130.80 |
$130.80 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$32,310.00 |
$32,310.00 |
$32,310.00 |
$15,857.45
|
|
Alt/sgpt
|
$96.00 |
$96.00 |
$96.00 |
$47.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$39.60 |
$39.60 |
$39.60 |
$39.84
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$154.80 |
$154.80 |
$154.80 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$7.80 |
$7.80 |
$7.80 |
$55.86
|
|
Ammonia
|
$154.80 |
$154.80 |
$154.80 |
$119.70
|
|
Ampicillin 1 gram solution for injection
|
$49.20 |
$49.20 |
$49.20 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$55.20 |
$55.20 |
$55.20 |
$53.86
|
|
Amylase
|
$309.00 |
$309.00 |
$309.00 |
$89.04
|
|
Analysis gene f2 20210g>a variant
|
$262.20 |
$262.20 |
$262.20 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$218.40 |
$218.40 |
$218.40 |
$230.40
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$51.00 |
$51.00 |
$51.00 |
$3,080.85
|
|
Antibody bacterium, not elsewhere specified
|
$22.80 |
$22.80 |
$22.80 |
$57.81
|
|
Antibody screen rbc
|
$75.00 |
$75.00 |
$75.00 |
$100.00
|
|
Antinuclear antibodies
|
$220.80 |
$220.80 |
$220.80 |
$89.40
|
|
Antistreptolysin o titer
|
$18.00 |
$18.00 |
$18.00 |
$51.45
|
|
Antithrombin iii activity
|
$159.00 |
$159.00 |
$159.00 |
$114.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$70.20 |
$70.20 |
$70.20 |
$66.00
|
|
Assay of interleukin-6 (il-6)
|
$549.60 |
$549.60 |
$549.60 |
$79.97
|
|
Assay of osteocalcin
|
$152.40 |
$152.40 |
$152.40 |
$92.50
|
|
Assay toxin or antitoxin
|
$383.40 |
$383.40 |
$383.40 |
$75.90
|
|
Ast/sgot
|
$97.80 |
$97.80 |
$97.80 |
$45.65
|
|
Atropine 0.1 mg/ml injection syringe
|
$30.60 |
$30.60 |
$30.60 |
$51.28
|
|
Autoimmune rheumatoid arthr anl 12 mrk ia
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$925.10
|
|
Azathioprine 50 mg tablet
|
$3.60 |
$3.60 |
$3.60 |
$3.46
|
|
Azithromycin 500 mg intravenous solution
|
$25.20 |
$25.20 |
$25.20 |
$35.06
|
|
Aztreonam 1 gram solution for injection
|
$145.80 |
$145.80 |
$145.80 |
$157.30
|
|
Bacterial meningitis antigen
|
$84.60 |
$84.60 |
$84.60 |
$66.30
|
|
Beta 2 glycoprotein 1 antibody iga
|
$42.60 |
$42.60 |
$42.60 |
$78.50
|
|
Beta-2 microglobulin
|
$126.60 |
$126.60 |
$126.60 |
$85.94
|
|
Bilirubin direct
|
$63.60 |
$63.60 |
$63.60 |
$50.00
|
|
Bilirubin total
|
$96.00 |
$96.00 |
$96.00 |
$52.57
|
|
Blood Clotting (PT/INR) Test
|
$93.60 |
$93.60 |
$93.60 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$213.60 |
$213.60 |
$213.60 |
$73.44
|
|
Blood Count (CBC) Test
|
$57.60 |
$57.60 |
$57.60 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$45.60 |
$45.60 |
$45.60 |
$61.80
|
|
Blood Culture Test
|
$149.40 |
$149.40 |
$149.40 |
$145.80
|
|
Blood gases ph venous
|
$120.60 |
$120.60 |
$120.60 |
$64.60
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$234.00 |
$234.00 |
$234.00 |
$57.42
|
|
Blood occult peroxidase activity qualitative gastric
|
$103.20 |
$103.20 |
$103.20 |
$34.00
|
|
Blood smear microscopic w manual differential wbc count
|
$77.40 |
$77.40 |
$77.40 |
$38.61
|
|
Blood typing abo
|
$51.60 |
$51.60 |
$51.60 |
$83.03
|
|
Blood typing rbc ag non abo/rh ea
|
$12.60 |
$12.60 |
$12.60 |
$199.50
|
|
Blood typing rh (d)
|
$46.80 |
$46.80 |
$46.80 |
$57.14
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$24.60 |
$24.60 |
$24.60 |
$94.80
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$2,779.20 |
$2,779.20 |
$2,779.20 |
$2,785.50
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,646.60 |
$2,646.60 |
$2,646.60 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$4,602.60 |
$4,602.60 |
$4,602.60 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$3,603.00 |
$3,603.00 |
$3,603.00 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$3,205.20 |
$3,205.20 |
$3,205.20 |
$1,977.27
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$13.80 |
$13.80 |
$13.80 |
$23.92
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$16.20 |
$16.20 |
$16.20 |
$32.88
|
|
Calcium 24 hour urine
|
$120.00 |
$120.00 |
$120.00 |
$53.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$41.40 |
$41.40 |
$41.40 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$153.00 |
$153.00 |
$153.00 |
$91.60
|
|
Calcium ionized
|
$154.80 |
$154.80 |
$154.80 |
$90.00
|
|
Calcium total
|
$61.20 |
$61.20 |
$61.20 |
$50.00
|
|
Calculi urinary-sendout
|
$150.00 |
$150.00 |
$150.00 |
$68.05
|
|
Calprotectin fecal
|
$469.80 |
$469.80 |
$469.80 |
$169.95
|
|
Candida dna
|
$37.20 |
$37.20 |
$37.20 |
$62.50
|
|
Capsaicin 8% patch
|
$14,219.40 |
$14,219.40 |
$14,219.40 |
$4,719.65
|
|
Carbamazepine free
|
$61.20 |
$61.20 |
$61.20 |
$59.15
|
|
Carbamazepine free -sendout
|
$154.80 |
$154.80 |
$154.80 |
$47.94
|
|
Carbon dioxide
|
$172.80 |
$172.80 |
$172.80 |
$44.00
|
|
Carboxyhemoglobin quantitative
|
$261.00 |
$261.00 |
$261.00 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$401.40 |
$401.40 |
$401.40 |
$144.00
|
|
Cardiolipin antibody iga
|
$82.80 |
$82.80 |
$82.80 |
$105.00
|
|
#cbg+cort-cbg
|
$34.20 |
$34.20 |
$34.20 |
$73.10
|
|
Cdna analysis for variants
|
$463.20 |
$463.20 |
$463.20 |
$525.00
|
