|
24 hr ambulatory b/p monitor
|
$136.80 |
$136.80 |
$136.80 |
$313.04
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,489.00 |
$3,489.00 |
$3,489.00 |
$3,128.29
|
|
Abdominal CT scan (with and without contrast)
|
$2,650.80 |
$2,650.80 |
$2,650.80 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$2,220.60 |
$2,220.60 |
$2,220.60 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$1,801.80 |
$1,801.80 |
$1,801.80 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$3,015.94
|
|
Abdominal MRI (without contrast)
|
$2,929.80 |
$2,929.80 |
$2,929.80 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,124.40 |
$1,124.40 |
$1,124.40 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$616.20 |
$616.20 |
$616.20 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,101.60 |
$1,101.60 |
$1,101.60 |
$1,145.40
|
|
Abl1 gene
|
$1,226.40 |
$1,226.40 |
$1,226.40 |
$682.50
|
|
Absorpt drg >16 <=48 without bdr
|
$21.23 |
$21.23 |
$21.23 |
$6.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$49.20 |
$49.20 |
$49.20 |
$74.96
|
|
Acetaminophen 120 mg rectal suppository
|
$1,417.80 |
$1,417.80 |
$1,417.80 |
$75.09
|
|
Acetaminophen level
|
$34.20 |
$34.20 |
$34.20 |
$107.62
|
|
Acetazolamide 500 mg solution for injection
|
$150.00 |
$150.00 |
$150.00 |
$122.55
|
|
Acetone qualitative
|
$91.80 |
$91.80 |
$91.80 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$1,092.60 |
$1,092.60 |
$1,092.60 |
$64.50
|
|
Acute hepatitis panel
|
$331.80 |
$331.80 |
$331.80 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$70.80 |
$70.80 |
$70.80 |
$63.48
|
|
Adh-sendout
|
$139.20 |
$139.20 |
$139.20 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1.20 |
$1.20 |
$1.20 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$141.60 |
$141.60 |
$141.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$136.20 |
$136.20 |
$136.20 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$477.00 |
$477.00 |
$477.00 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$223.20 |
$223.20 |
$223.20 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$54.00 |
$54.00 |
$54.00 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$135.00 |
$135.00 |
$135.00 |
$257.40
|
|
Administration immunization 1 vaccine
|
$86.40 |
$86.40 |
$86.40 |
$69.21
|
|
Administration immunization each additional vaccine
|
$33.60 |
$33.60 |
$33.60 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$86.40 |
$86.40 |
$86.40 |
$48.00
|
|
Administration vaccine hepatitis b
|
$49.20 |
$49.20 |
$49.20 |
$54.40
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$9,962.40 |
$9,962.40 |
$9,962.40 |
$11,350.31
|
|
_afb org id by sequencing rflx ast-sendout
|
$282.60 |
$282.60 |
$282.60 |
$315.00
|
|
Albumin body fluid quantitative each specimen
|
$5.40 |
$5.40 |
$5.40 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$294.00 |
$294.00 |
$294.00 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$80.40 |
$80.40 |
$80.40 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$91.80 |
$91.80 |
$91.80 |
$40.80
|
|
Alkaline phosphatase
|
$82.80 |
$82.80 |
$82.80 |
$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 allowrap 4x4cm dry 16sqcm
|
$635.04 |
$635.04 |
$635.04 |
$5,401.92
|
|
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-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$3.60 |
$3.60 |
$3.60 |
$12.50
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$325.20 |
$325.20 |
$325.20 |
$175.20
|
|
Alpha-fetoprotein tumor marker
|
$172.80 |
$172.80 |
$172.80 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$32,310.00 |
$32,310.00 |
$32,310.00 |
$15,857.45
|
|
Alt/sgpt
|
$118.80 |
$118.80 |
$118.80 |
$47.45
|
|
Aluminum - quest
|
$238.80 |
$238.80 |
$238.80 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$112.20 |
$112.20 |
$112.20 |
$169.80
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$39.60 |
$39.60 |
$39.60 |
$39.84
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$24.00 |
$24.00 |
$24.00 |
$45.02
|
|
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
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$12,139.80 |
$12,139.80 |
$12,139.80 |
$7,994.03
|
|
Ammonia
|
$204.00 |
$204.00 |
$204.00 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$55.80 |
$55.80 |
$55.80 |
$92.61
|
|
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
|
$365.40 |
$365.40 |
$365.40 |
$89.04
|
|
Analysis gene f2 20210g>a variant
|
$309.00 |
$309.00 |
$309.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$258.60 |
$258.60 |
$258.60 |
$230.40
|
|
An cholangiogram percutaneous compl
|
$4,467.00 |
$4,467.00 |
$4,467.00 |
$2,626.65
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$853.20 |
$853.20 |
$853.20 |
$3,080.85
|
|
Ankle X-ray
|
$642.00 |
$642.00 |
$642.00 |
$353.60
|
|
Anora (draw only)
|
$19.20 |
$19.20 |
$19.20 |
$33.58
|
|
Antibody bacterium, not elsewhere specified
|
$22.80 |
$22.80 |
$22.80 |
$57.81
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$463.80 |
$463.80 |
$463.80 |
$218.30
|
|
Antibody id rbc panel
|
$195.60 |
$195.60 |
$195.60 |
$274.56
|
|
Antibody screen rbc
|
$88.20 |
$88.20 |
$88.20 |
$100.00
|
|
Antinuclear antibodies
|
$265.20 |
$265.20 |
$265.20 |
$89.40
|
|
Antiphosphatidylserine antibody
|
$347.40 |
$347.40 |
$347.40 |
$65.97
|
|
Antistreptolysin o titer
|
$25.80 |
$25.80 |
$25.80 |
$51.45
|
|
Antithrombin iii activity
|
$193.20 |
$193.20 |
$193.20 |
$114.00
|
|
Application finger splntstatic 29130
|
$203.40 |
$203.40 |
$203.40 |
$208.16
|
|
Application long leg splint 29505
|
$203.40 |
$203.40 |
$203.40 |
$338.25
|
|
Application lower leg splint 29515
|
$203.40 |
$203.40 |
$203.40 |
$330.48
|
|
Application multi layer compression below knee (both sides)
|
$382.20 |
$382.20 |
$382.20 |
$373.20
|
|
Application of paste boot 29580
|
$391.80 |
$391.80 |
$391.80 |
$331.74
|
|
Application short leg cast 29405
|
$463.20 |
$463.20 |
$463.20 |
$388.80
|
|
Appl modality 1/> areas paraffin bath 97018
|
$122.40 |
$122.40 |
$122.40 |
$66.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$1,620.00 |
$1,620.00 |
$1,620.00 |
$955.43
|
|
Argatroban nonesrd use 1mg
|
$2,065.20 |
$2,065.20 |
$2,065.20 |
$866.80
|
|
Aripiprazole 441 mg/1.6 ml inj
|
$8,145.60 |
$8,145.60 |
$8,145.60 |
$6,387.85
|
|
Arterial blood draw/perc 36620
|
$127.20 |
$127.20 |
$127.20 |
$485.69
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$394.80 |
$394.80 |
$394.80 |
$608.40
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$512.40 |
$512.40 |
$512.40 |
$889.20
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$373.20 |
$373.20 |
$373.20 |
$465.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$318.60 |
$318.60 |
$318.60 |
$715.37
|
|
Artiss fibrin sealant
|
$1,940.40 |
$1,940.40 |
$1,940.40 |
$1,583.11
|
|
Asp core fat pad
|
$249.60 |
$249.60 |
$249.60 |
$939.95
|
|
Aspirate pleura without imaging 32554
|
$1,504.20 |
$1,504.20 |
$1,504.20 |
$1,196.52
|
|
Assay of feces for trypsin
|
$105.00 |
$105.00 |
$105.00 |
$22.40
|
|
Assay of interleukin-6 (il-6)
|
$647.40 |
$647.40 |
$647.40 |
$79.97
|
|
Assay of osteocalcin
|
$183.60 |
$183.60 |
$183.60 |
$92.50
|
|
Assay toxin or antitoxin
|
$462.00 |
$462.00 |
$462.00 |
$75.90
|
