|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$65.40 |
$65.40 |
$65.40 |
$65.40
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$96.60 |
$96.60 |
$96.60 |
$84.80
|
|
Drug test def 15-21 classes
|
$146.40 |
$146.40 |
$146.40 |
$263.25
|
|
Drug test def 1-7 classes
|
$203.40 |
$203.40 |
$203.40 |
$250.52
|
|
Drug test def 8-14 classes
|
$156.60 |
$156.60 |
$156.60 |
$282.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$574.20 |
$574.20 |
$574.20 |
$541.20
|
|
Electrical stimulation/unattended 97014
|
$197.40 |
$197.40 |
$197.40 |
$79.20
|
|
Electrolyte panel
|
$117.00 |
$117.00 |
$117.00 |
$84.24
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$249.00 |
$249.00 |
$249.00 |
$109.71
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$54.90 |
$54.90 |
$54.90 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$897.90 |
$897.90 |
$897.90 |
$393.15
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$45.00 |
$45.00 |
$45.00 |
$34.13
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$429.60 |
$429.60 |
$429.60 |
$222.98
|
|
ER Visit (level 1, minor)
|
$61.20 |
$61.20 |
$61.20 |
$246.24
|
|
ER Visit (level 2)
|
$143.40 |
$143.40 |
$143.40 |
$452.20
|
|
ER Visit (level 3)
|
$277.80 |
$277.80 |
$277.80 |
$770.04
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$1,298.40 |
$1,298.40 |
$1,298.40 |
$553.88
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$4.20 |
$4.20 |
$4.20 |
$22.20
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$8.40 |
$8.40 |
$8.40 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$3,310.20 |
$3,310.20 |
$3,310.20 |
$2,590.25
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$21.00 |
$21.00 |
$21.00 |
$64.22
|
|
Fluidotherapy charges pt
|
$63.60 |
$63.60 |
$63.60 |
$91.00
|
|
Fructosamine glycated protein
|
$171.60 |
$171.60 |
$171.60 |
$60.75
|
|
Furosemide 10 mg/ml injection solution
|
$11.40 |
$11.40 |
$11.40 |
$19.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$336.00 |
$336.00 |
$336.00 |
$177.52
|
|
Gamma glutamyltransferase
|
$111.00 |
$111.00 |
$111.00 |
$57.54
|
|
Glucagon 1 mg solution for injection
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$601.79
|
|
Glucose 1 hr post dose
|
$127.80 |
$127.80 |
$127.80 |
$47.20
|
|
Glucose blood quantitative
|
$67.80 |
$67.80 |
$67.80 |
$40.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$208.20 |
$208.20 |
$208.20 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$135.00 |
$135.00 |
$135.00 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$316.20 |
$316.20 |
$316.20 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$316.20 |
$316.20 |
$316.20 |
$129.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$5,087.40 |
$5,087.40 |
$5,087.40 |
$672.50
|
|
Graft axiofill 1000mg
|
$133.20 |
$133.20 |
$133.20 |
$5,125.68
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$70.67 |
$70.67 |
$70.67 |
$24,469.57
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$94.08 |
$94.08 |
$94.08 |
$1,455.76
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$22,192.80 |
$22,192.80 |
$22,192.80 |
$1,181.41
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$10,595.70 |
$10,595.70 |
$10,595.70 |
$1,132.47
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$526.26 |
$526.26 |
$526.26 |
$373.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$517.44 |
$517.44 |
$517.44 |
$1,132.47
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$4.80 |
$4.80 |
$4.80 |
$23.06
|
|
Hcg qualitative
|
$120.00 |
$120.00 |
$120.00 |
$89.70
|
|
Head CT scan (with and without contrast)
|
$2,133.60 |
$2,133.60 |
$2,133.60 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$1,502.40 |
$1,502.40 |
$1,502.40 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$1,372.20 |
$1,372.20 |
$1,372.20 |
$1,268.90
|
|
Hematocrit
|
$61.20 |
$61.20 |
$61.20 |
$33.57
|
|
Hemoglobin
|
$60.60 |
$60.60 |
$60.60 |
$31.80
|
|
Heparin bolus from bag
|
$32.40 |
$32.40 |
$32.40 |
$66.47
|
|
Hepatitis c antibody
|
$45.00 |
$45.00 |
$45.00 |
$108.00
|
|
Heterophile antibodies screening
|
$89.40 |
$89.40 |
$89.40 |
$74.00
|
|
Hydralazine 20 mg/ml injection solution
|
$42.60 |
$42.60 |
$42.60 |
$46.74
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$48.60 |
$48.60 |
$48.60 |
$154.78
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$17.40 |
$17.40 |
$17.40 |
$131.47
|
|
I-123 sod iodide diag per 100 uci
|
$154.20 |
$154.20 |
$154.20 |
$139.20
|
|
Ihc/icc per specimen each additional single antibody stain
|
$292.80 |
$292.80 |
$292.80 |
$191.52
|
|
Infect ag ia optc obs influenza
|
$36.00 |
$36.00 |
$36.00 |
$72.93
|
|
Infect ag na influenza r/amp 1st 2 types
|
$202.80 |
$202.80 |
$202.80 |
$219.70
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$208.80 |
$208.80 |
$208.80 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$286.20 |
$286.20 |
$286.20 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$216.60 |
$216.60 |
$216.60 |
$127.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$146.40 |
$146.40 |
$146.40 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$85.20 |
$85.20 |
$85.20 |
$94.53
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$262.80 |
$262.80 |
$262.80 |
$303.59
|
|
Inj, lidocaine w epinephrine
|
$19.80 |
$19.80 |
$19.80 |
$44.96
|
|
Inj vancomycin (xellia) 10mg
|
$114.60 |
$114.60 |
$114.60 |
$79.21
|
|
Iodine i-123 sod iodide mil
|
$1,972.80 |
$1,972.80 |
$1,972.80 |
$350.74
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$368.40 |
$368.40 |
$368.40 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$409.20 |
$409.20 |
$409.20 |
$279.10
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$321.00 |
$321.00 |
$321.00 |
$187.06
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$277.80 |
$277.80 |
$277.80 |
$60.20
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$18.00 |
$18.00 |
$18.00 |
$23.50
|
|
Knee MRI (without contrast)
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$2,169.60
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$33.60 |
$33.60 |
$33.60 |
$32.34
|
|
Lactated ringers intravenous solution
|
$21.00 |
$21.00 |
$21.00 |
$45.56
|
|
Lactic acid
|
$135.00 |
$135.00 |
$135.00 |
$107.00
|
|
Lead capillary
|
$50.40 |
$50.40 |
$50.40 |
$57.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$27.00 |
$27.00 |
$27.00 |
$95.68
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$39.00 |
$39.00 |
$39.00 |
$55.60
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$135.60 |
$135.60 |
$135.60 |
$125.66
|
|
Lipoprotein direct measurement ldl
|
$132.60 |
$132.60 |
$132.60 |
$61.60
|
|
Lithium therapeutic drug level
|
$133.20 |
$133.20 |
$133.20 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$145.80 |
$145.80 |
$145.80 |
$340.00
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$4.20 |
$4.20 |
$4.20 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,344.80 |
$2,344.80 |
$2,344.80 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,576.00 |
$3,576.00 |
$3,576.00 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,908.20 |
$2,908.20 |
$2,908.20 |
$2,096.84
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$28.20 |
$28.20 |
$28.20 |
$58.70
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$1,147.80 |
$1,147.80 |
$1,147.80 |
$172.90
|
|
Mayo covid-19 antibody nucleocapsid total
|
$96.00 |
$96.00 |
$96.00 |
$70.20
|
|
Mayo estrone
|
$598.80 |
$598.80 |
$598.80 |
$84.60
|
|
Mayo hvdip HIV 1 antibody
|
$260.40 |
$260.40 |
$260.40 |
$67.24
|
|
Mayo infectious agent antigen immunoassay direct optical observation cryptococcus
|
$31.80 |
$31.80 |
$31.80 |
$81.04
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$25.80 |
$25.80 |
$25.80 |
$65.00
|
|
Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm
|
$5,087.40 |
$5,087.40 |
$5,087.40 |
$1,660.50
|
|
Meropenem 1 gram intravenous solution
|
$119.70 |
$119.70 |
$119.70 |
$59.84
|
|
Metabolic Blood Panel (Basic)
|
$141.00 |
$141.00 |
$141.00 |
$117.50
|
|
Metabolic Blood Panel (Comprehensive)
|
$172.80 |
$172.80 |
$172.80 |
$157.50
|
|
Metabolic panel ionized ca
|
$151.20 |
$151.20 |
$151.20 |
$144.95
|