|
24 hr ambulatory b/p monitor
|
$135.00 |
$135.00 |
$135.00 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$2,213.30 |
$2,213.30 |
$2,213.30 |
$1,724.25
|
|
2nd order venous cath
|
$1,077.10 |
$1,077.10 |
$1,077.10 |
$1,532.04
|
|
3d ech img cgen car anomal
|
$744.15 |
$744.15 |
$744.15 |
$511.60
|
|
3d recon without postprocess indpndt
|
$361.30 |
$361.30 |
$361.30 |
$508.13
|
|
5' nucleotidase - sendout
|
$31.00 |
$31.00 |
$31.00 |
$50.05
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$33.35 |
$33.35 |
$33.35 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$2,987.65 |
$2,987.65 |
$2,987.65 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$1,513.00 |
$1,513.00 |
$1,513.00 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$2,000.40 |
$2,000.40 |
$2,000.40 |
$2,475.45
|
|
Abd/low ext cath addl
|
$333.50 |
$333.50 |
$333.50 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,465.45 |
$1,465.45 |
$1,465.45 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$409.75 |
$409.75 |
$409.75 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$1,509.20 |
$1,509.20 |
$1,509.20 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,325.95 |
$1,325.95 |
$1,325.95 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$861.85 |
$861.85 |
$861.85 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$2,456.90 |
$2,456.90 |
$2,456.90 |
$2,967.00
|
|
Abdominal MRI (without contrast)
|
$1,624.80 |
$1,624.80 |
$1,624.80 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,826.80 |
$1,826.80 |
$1,826.80 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$924.60 |
$924.60 |
$924.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$844.10 |
$844.10 |
$844.10 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$459.75 |
$459.75 |
$459.75 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$621.35 |
$621.35 |
$621.35 |
$418.63
|
|
Abdominal X-ray (single view)
|
$459.75 |
$459.75 |
$459.75 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,405.45 |
$2,405.45 |
$2,405.45 |
$1,148.40
|
|
Ablation of upper extremity nerves rf
|
$2,528.95 |
$2,528.95 |
$2,528.95 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$5,288.30 |
$5,288.30 |
$5,288.30 |
$3,050.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$60.45 |
$60.45 |
$60.45 |
$72.74
|
|
Acetaminophen level
|
$502.25 |
$502.25 |
$502.25 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$221.44 |
$221.44 |
$221.44 |
$122.55
|
|
Acetone qualitative
|
$13.40 |
$13.40 |
$13.40 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$31.35 |
$31.35 |
$31.35 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$342.12 |
$342.12 |
$342.12 |
$218.79
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$54.25 |
$54.25 |
$54.25 |
$38.50
|
|
Actinotherapy uv light
|
$103.85 |
$103.85 |
$103.85 |
$105.60
|
|
Acute hepatitis panel
|
$776.15 |
$776.15 |
$776.15 |
$284.95
|
|
#acylcarnitineprfl
|
$81.75 |
$81.75 |
$81.75 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$361.00 |
$361.00 |
$361.00 |
$5,109.58
|
|
Adh-sendout
|
$297.15 |
$297.15 |
$297.15 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$337.53 |
$337.53 |
$337.53 |
$193.40
|
|
Admin ecg contrast agent
|
$290.60 |
$290.60 |
$290.60 |
$120.78
|
|
Administration immunization each additional vaccine
|
$134.25 |
$134.25 |
$134.25 |
$47.40
|
|
Administration vaccine hepatitis b
|
$134.25 |
$134.25 |
$134.25 |
$53.00
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$134.25 |
$134.25 |
$134.25 |
$41.45
|
|
Adrenalin epinephrine inject
|
$513.23 |
$513.23 |
$513.23 |
$231.47
|
|
_afb id by dna probe rflx ast
|
$59.60 |
$59.60 |
$59.60 |
$104.50
|
|
Albumin body fluid quantitative each specimen
|
$96.75 |
$96.75 |
$96.75 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$395.87 |
$395.87 |
$395.87 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$62.85 |
$62.85 |
$62.85 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$50.90 |
$50.90 |
$50.90 |
$43.00
|
|
Alkaline phosphatase
|
$36.75 |
$36.75 |
$36.75 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$46.65 |
$46.65 |
$46.65 |
$48.57
|
|
Allergen egg white ige
|
$23.65 |
$23.65 |
$23.65 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$23.70 |
$23.70 |
$23.70 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$2,266.31 |
$2,266.31 |
$2,266.31 |
$9,900.02
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$3,947.00 |
$3,947.00 |
$3,947.00 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$858.66
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$1,212.00 |
$1,212.00 |
$1,212.00 |
$4,677.40
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,018.69 |
$2,018.69 |
$2,018.69 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$71.05 |
$71.05 |
$71.05 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$10,872.85 |
$10,872.85 |
$10,872.85 |
$15,857.45
|
|
Alt/sgpt
|
$126.85 |
$126.85 |
$126.85 |
$47.50
|
|
Aluminum - quest
|
$70.75 |
$70.75 |
$70.75 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$150.85 |
$150.85 |
$150.85 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$135.00 |
$135.00 |
$135.00 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$37.78 |
$37.78 |
$37.78 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$45.34 |
$45.34 |
$45.34 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$91.58 |
$91.58 |
$91.58 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$232.72 |
$232.72 |
$232.72 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$75.35 |
$75.35 |
$75.35 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$35.65 |
$35.65 |
$35.65 |
$87.45
|
|
Ammonia
|
$427.95 |
$427.95 |
$427.95 |
$119.70
|
|
Amniotic fluid scan
|
$46.00 |
$46.00 |
$46.00 |
$49.01
|
|
Amphetamine confirm urine -sendout
|
$108.00 |
$108.00 |
$108.00 |
$93.61
|
|
Amphetamines 5 or more
|
$53.45 |
$53.45 |
$53.45 |
$90.48
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,089.10 |
$1,089.10 |
$1,089.10 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$35.78 |
$35.78 |
$35.78 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$53.40 |
$53.40 |
$53.40 |
$54.57
|
|
Amylase
|
$116.30 |
$116.30 |
$116.30 |
$90.00
|
|
Analysis gene f2 20210g>a variant
|
$242.90 |
$242.90 |
$242.90 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$163.00 |
$163.00 |
$163.00 |
$249.60
|
|
Anaplsma phgcytophlm amp prb
|
$378.85 |
$378.85 |
$378.85 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$125.95 |
$125.95 |
$125.95 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$1,157.10 |
$1,157.10 |
$1,157.10 |
$2,480.94
|
|
An fluoro guide for cvp
|
$784.25 |
$784.25 |
$784.25 |
$525.85
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$14,727.65 |
$14,727.65 |
$14,727.65 |
$9,765.79
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$465.80 |
$465.80 |
$465.80 |
$2,979.43
|
|
Angio trnslmnl balloon same artery ea addl
|
$6,026.25 |
$6,026.25 |
$6,026.25 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$6,026.25 |
$6,026.25 |
$6,026.25 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ini
|
$6,026.25 |
$6,026.25 |
$6,026.25 |
$8,359.11
|
|
Ankle X-ray
|
$237.45 |
$237.45 |
$237.45 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$207.05 |
$207.05 |
$207.05 |
$282.96
|
|
Antibody bacterium, not elsewhere specified
|
$146.40 |
$146.40 |
$146.40 |
$57.85
|
|
Antibody elution rbc reference
|
$154.85 |
$154.85 |
$154.85 |
$177.29
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$103.30 |
$103.30 |
$103.30 |
$224.00
|
|
Antibody id rbc panel
|
$64.80 |
$64.80 |
$64.80 |
$291.75
|
|
Antibody screen rbc
|
$67.55 |
$67.55 |
$67.55 |
$108.55
|
|
Antibody tetanus
|
$37.00 |
$37.00 |
$37.00 |
$54.15
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$58.00 |
$58.00 |
$58.00 |
$38.50
|
