|
11-desoxycortisol - sendout
|
$87.74 |
$87.74 |
$87.74 |
$87.74
|
|
17-hydroxypregnenolone
|
$48.21 |
$48.21 |
$48.21 |
$87.50
|
|
17-ketosteroids
|
$124.86 |
$124.86 |
$124.86 |
$46.20
|
|
2d tte w or without fol w/con,co
|
$978.58 |
$978.58 |
$978.58 |
$1,165.05
|
|
3d ech img cgen car anomal
|
$300.32 |
$300.32 |
$300.32 |
$669.00
|
|
3-d radiotherapy plan
|
$2,157.68 |
$2,157.68 |
$2,157.68 |
$4,953.00
|
|
5' nucleotidase - sendout
|
$68.94 |
$68.94 |
$68.94 |
$51.03
|
|
88334 ap bill cytologic exam each additional site
|
$102.20 |
$102.20 |
$102.20 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,078.10 |
$4,078.10 |
$4,078.10 |
$3,634.61
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$82.44 |
$82.44 |
$82.44 |
$52.47
|
|
Abd/low ext cath 1st
|
$107.99 |
$107.99 |
$107.99 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$101.72 |
$101.72 |
$101.72 |
$2,517.20
|
|
Abdominal CT scan (with and without contrast)
|
$654.15 |
$654.15 |
$654.15 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$595.34 |
$595.34 |
$595.34 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$386.13 |
$386.13 |
$386.13 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$1,607.66 |
$1,607.66 |
$1,607.66 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$1,527.63 |
$1,527.63 |
$1,527.63 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$1,045.10 |
$1,045.10 |
$1,045.10 |
$1,993.50
|
|
Abdominal paracentesis w/image guidance
|
$301.29 |
$301.29 |
$301.29 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$592.93 |
$592.93 |
$592.93 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$554.37 |
$554.37 |
$554.37 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$352.87 |
$352.87 |
$352.87 |
$1,176.00
|
|
Ablation cardiac vagal inputs atrium
|
$177.88 |
$177.88 |
$177.88 |
$3,812.17
|
|
Ablation of upper extremity nerves rf
|
$344.19 |
$344.19 |
$344.19 |
$1,164.00
|
|
Abscess drain retroperitoneal surg code
|
$499.90 |
$499.90 |
$499.90 |
$3,053.18
|
|
Acetaminophen level
|
$79.06 |
$79.06 |
$79.06 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$99.03 |
$99.03 |
$99.03 |
$133.60
|
|
Acetone qualitative
|
$31.34 |
$31.34 |
$31.34 |
$48.75
|
|
Acetylcholine receptor modulating antibody
|
$14.47 |
$14.47 |
$14.47 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$96.61 |
$96.61 |
$96.61 |
$323.77
|
|
Acetylcysteine non-comp unit
|
$4.14 |
$4.14 |
$4.14 |
$29.01
|
|
Acne surgery 10040
|
$177.88 |
$177.88 |
$177.88 |
$260.00
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$184.15 |
$184.15 |
$184.15 |
$370.55
|
|
Acute hepatitis panel
|
$224.64 |
$224.64 |
$224.64 |
$287.10
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$32.24 |
$32.24 |
$32.24 |
$50.70
|
|
#acylcarnitineprfl
|
$36.64 |
$36.64 |
$36.64 |
$105.60
|
|
Adapter b 8 channel 10cm
|
$241.03 |
$241.03 |
$241.03 |
$1,638.00
|
|
Adenosine 3 mg/250 ml bag for osm
|
$512.78 |
$512.78 |
$512.78 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$46.28 |
$46.28 |
$46.28 |
$63.00
|
|
Adh-sendout
|
$267.55 |
$267.55 |
$267.55 |
$109.71
|
|
Adj gastric band via subq port
|
$1,045.58 |
$1,045.58 |
$1,045.58 |
$2,057.40
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$58.42 |
$58.42 |
$58.42 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$263.69 |
$263.69 |
$263.69 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$195.72 |
$195.72 |
$195.72 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$393.36 |
$393.36 |
$393.36 |
$688.88
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$202.47 |
$202.47 |
$202.47 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$84.85 |
$84.85 |
$84.85 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$84.85 |
$84.85 |
$84.85 |
$267.43
|
|
Administration immunization 1 vaccine
|
$56.41 |
$56.41 |
$56.41 |
$69.21
|
|
Administration immunization each additional vaccine
|
$44.35 |
$44.35 |
$44.35 |
$46.23
|
|
Administration vaccine influenza virus
|
$56.41 |
$56.41 |
$56.41 |
$46.80
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$21.70 |
$21.70 |
$21.70 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$17,985.73 |
$17,985.73 |
$17,985.73 |
$11,874.55
|
|
_afb id by dna probe rflx ast
|
$77.13 |
$77.13 |
$77.13 |
$105.00
|
|
After cataract laser surgery
|
$701.88 |
$701.88 |
$701.88 |
$1,499.25
|
|
Agalsidase beta 35 mg intravenous solution
|
$16,437.53 |
$16,437.53 |
$16,437.53 |
$13,696.68
|
|
Airway resistance by impulse oscillometry 94728
|
$110.40 |
$110.40 |
$110.40 |
$320.43
|
|
Albumin body fluid quantitative each specimen
|
$28.45 |
$28.45 |
$28.45 |
$48.95
|
|
Albumin (human), 25%, 50ml
|
$179.50 |
$179.50 |
$179.50 |
$295.80
|
|
Albumin, human 5 % intravenous solution
|
$157.82 |
$157.82 |
$157.82 |
$248.88
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$65.56 |
$65.56 |
$65.56 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$27.96 |
$27.96 |
$27.96 |
$43.50
|
|
Alkaline phosphatase
|
$19.29 |
$19.29 |
$19.29 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$99.79 |
$99.79 |
$99.79 |
$59.00
|
|
Allergen egg white ige
|
$115.22 |
$115.22 |
$115.22 |
$41.60
|
|
Allergen specific ige qual multi scrn ea
|
$109.43 |
$109.43 |
$109.43 |
$26.95
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$42.91 |
$42.91 |
$42.91 |
$6,555.62
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$114.07 |
$114.07 |
$114.07 |
$2,674.32
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$151.02 |
$151.02 |
$151.02 |
$14.76
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$161.98 |
$161.98 |
$161.98 |
$189.15
|
|
Alpha-fetoprotein tumor marker
|
$91.60 |
$91.60 |
$91.60 |
$106.40
|
|
Alprostadil for injection
|
$210.91 |
$210.91 |
$210.91 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$25,204.05 |
$25,204.05 |
$25,204.05 |
$3,627.63
|
|
Alt/sgpt
|
$28.45 |
$28.45 |
$28.45 |
$49.00
|
|
Aluminum - quest
|
$46.76 |
$46.76 |
$46.76 |
$91.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$524.96 |
$524.96 |
$524.96 |
$442.04
|
|
Amantadine (symmetrel)-sendout
|
$384.20 |
$384.20 |
$384.20 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$69.16 |
$69.16 |
$69.16 |
$36.30
|
|
Amino acid screen, urine
|
$108.47 |
$108.47 |
$108.47 |
$64.28
|
|
Aminolevulinic acid delta
|
$80.03 |
$80.03 |
$80.03 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$46.41 |
$46.41 |
$46.41 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$103.50 |
$103.50 |
$103.50 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$47.19 |
$47.19 |
$47.19 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$109.43 |
$109.43 |
$109.43 |
$101.17
|
|
Ammonia
|
$113.77 |
$113.77 |
$113.77 |
$124.11
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,030.64 |
$1,030.64 |
$1,030.64 |
$3,735.51
|
|
Amphetamine confirm urine -sendout
|
$39.53 |
$39.53 |
$39.53 |
$94.50
|
|
Amphetamines 5 or more
|
$5.79 |
$5.79 |
$5.79 |
$101.40
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$89.41 |
$89.41 |
$89.41 |
$130.08
|
|
Amphotericin b lipid complex
|
$42.05 |
$42.05 |
$42.05 |
$270.17
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$187.27 |
$187.27 |
$187.27 |
$342.26
|
|
Ampicillin 1 gram solution for injection
|
$42.57 |
$42.57 |
$42.57 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$49.71 |
$49.71 |
$49.71 |
$51.93
|
|
Amylase
|
$63.15 |
$63.15 |
$63.15 |
$95.80
|
|
Ana ds-dna
|
$102.20 |
$102.20 |
$102.20 |
$69.03
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$92.56 |
$92.56 |
$92.56 |
$110.98
|
|
Anal pressure record
|
$343.71 |
$343.71 |
$343.71 |
$1,008.06
|
|
Analysis gene f2 20210g>a variant
|
$87.74 |
$87.74 |
$87.74 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$103.65 |
$103.65 |
$103.65 |
$237.25
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$542.80 |
$542.80 |
$542.80 |
$411.45
|