|
17-hydroxypregnenolone
|
$180.70 |
$180.70 |
$180.70 |
$92.65
|
|
24 hr ambulatory b/p monitor
|
$348.10 |
$348.10 |
$348.10 |
$313.04
|
|
3d recon without postprocess indpndt
|
$510.95 |
$510.95 |
$510.95 |
$508.13
|
|
5' nucleotidase - sendout
|
$110.50 |
$110.50 |
$110.50 |
$50.05
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$117.70 |
$117.70 |
$117.70 |
$53.95
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$895.10 |
$895.10 |
$895.10 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,503.35 |
$2,503.35 |
$2,503.35 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,190.55 |
$2,190.55 |
$2,190.55 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,430.20 |
$1,430.20 |
$1,430.20 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,956.45 |
$3,956.45 |
$3,956.45 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,136.80 |
$3,136.80 |
$3,136.80 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,554.55 |
$2,554.55 |
$2,554.55 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,804.95 |
$1,804.95 |
$1,804.95 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$699.65 |
$699.65 |
$699.65 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$537.95 |
$537.95 |
$537.95 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$318.20 |
$318.20 |
$318.20 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$389.60 |
$389.60 |
$389.60 |
$418.63
|
|
Abdominal X-ray (single view)
|
$199.50 |
$199.50 |
$199.50 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,858.80 |
$2,858.80 |
$2,858.80 |
$1,148.40
|
|
Ablation cryo abd perit om
|
$1,832.00 |
$1,832.00 |
$1,832.00 |
$2,312.80
|
|
Ablation cryo thigh/knee
|
$1,121.15 |
$1,121.15 |
$1,121.15 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$1,437.00 |
$1,437.00 |
$1,437.00 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$6,730.65 |
$6,730.65 |
$6,730.65 |
$3,050.40
|
|
Acetaminophen level
|
$221.10 |
$221.10 |
$221.10 |
$116.80
|
|
Acetone qualitative
|
$52.55 |
$52.55 |
$52.55 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$234.90 |
$234.90 |
$234.90 |
$67.50
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$26.95 |
$26.95 |
$26.95 |
$38.50
|
|
Acute hepatitis panel
|
$483.95 |
$483.95 |
$483.95 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$62.73 |
$62.73 |
$62.73 |
$64.45
|
|
#acylcarnitineprfl
|
$154.30 |
$154.30 |
$154.30 |
$121.55
|
|
Adh-sendout
|
$374.35 |
$374.35 |
$374.35 |
$118.79
|
|
Adj gastric band via subq port
|
$2,726.00 |
$2,726.00 |
$2,726.00 |
$1,666.86
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$226.13 |
$226.13 |
$226.13 |
$193.40
|
|
Admin ecg contrast agent
|
$263.65 |
$263.65 |
$263.65 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$541.85 |
$541.85 |
$541.85 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$541.85 |
$541.85 |
$541.85 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$541.85 |
$541.85 |
$541.85 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$412.50 |
$412.50 |
$412.50 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$186.00 |
$186.00 |
$186.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$157.70 |
$157.70 |
$157.70 |
$256.49
|
|
Administration immunization each additional vaccine
|
$28.30 |
$28.30 |
$28.30 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$64.70 |
$64.70 |
$64.70 |
$48.00
|
|
Administration vaccine hepatitis b
|
$41.75 |
$41.75 |
$41.75 |
$53.00
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$41.75 |
$41.75 |
$41.75 |
$41.45
|
|
Adrenalin epinephrine inject
|
$684.32 |
$684.32 |
$684.32 |
$231.47
|
|
_afb id by dna probe rflx ast
|
$180.25 |
$180.25 |
$180.25 |
$104.50
|
|
Albumin body fluid quantitative each specimen
|
$57.95 |
$57.95 |
$57.95 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$293.25 |
$293.25 |
$293.25 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$62.00 |
$62.00 |
$62.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$33.75 |
$33.75 |
$33.75 |
$43.00
|
|
Alkaline phosphatase
|
$80.80 |
$80.80 |
$80.80 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$107.60 |
$107.60 |
$107.60 |
$48.57
|
|
Allergen egg white ige
|
$57.10 |
$57.10 |
$57.10 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$56.85 |
$56.85 |
$56.85 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$91.60 |
$91.60 |
$91.60 |
$45.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$1,704.75 |
$1,704.75 |
$1,704.75 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$858.66
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,794.43 |
$1,794.43 |
$1,794.43 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$98.90 |
$98.90 |
$98.90 |
$106.00
|
|
Alprostadil for injection
|
$735.78 |
$735.78 |
$735.78 |
$511.41
|
|
Als 1
|
$1,183.55 |
$1,183.55 |
$1,183.55 |
$853.44
|
|
Als1-emergency
|
$1,774.05 |
$1,774.05 |
$1,774.05 |
$1,103.37
|
|
Als 2
|
$2,539.70 |
$2,539.70 |
$2,539.70 |
$1,288.56
|
|
Alteplase 100 mg infusion from pyxis vial
|
$26,765.42 |
$26,765.42 |
$26,765.42 |
$15,857.45
|
|
Alt/sgpt
|
$61.55 |
$61.55 |
$61.55 |
$47.50
|
|
Aluminum - quest
|
$169.85 |
$169.85 |
$169.85 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$306.30 |
$306.30 |
$306.30 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$114.10 |
$114.10 |
$114.10 |
$179.70
|
|
Ambl bp mntr w/sw a/r
|
$348.10 |
$348.10 |
$348.10 |
$320.45
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$44.29 |
$44.29 |
$44.29 |
$37.33
|
|
Aminolevulinic acid delta
|
$159.30 |
$159.30 |
$159.30 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$65.24 |
$65.24 |
$65.24 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$234.19 |
$234.19 |
$234.19 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$83.41 |
$83.41 |
$83.41 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$166.40 |
$166.40 |
$166.40 |
$87.45
|
|
Ammonia
|
$159.05 |
$159.05 |
$159.05 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$630.85 |
$630.85 |
$630.85 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$3,099.15 |
$3,099.15 |
$3,099.15 |
$3,786.00
|
|
Amphetamine confirm urine -sendout
|
$284.10 |
$284.10 |
$284.10 |
$93.61
|
|
Amphetamines 5 or more
|
$150.95 |
$150.95 |
$150.95 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$243.32 |
$243.32 |
$243.32 |
$123.53
|
|
Ampicillin 1 gram solution for injection
|
$141.69 |
$141.69 |
$141.69 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$46.36 |
$46.36 |
$46.36 |
$54.57
|
|
Amylase
|
$71.50 |
$71.50 |
$71.50 |
$90.00
|
|
Analysis gene f2 20210g>a variant
|
$264.15 |
$264.15 |
$264.15 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$264.15 |
$264.15 |
$264.15 |
$249.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$306.30 |
$306.30 |
$306.30 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$285.80 |
$285.80 |
$285.80 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$227.40 |
$227.40 |
$227.40 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$12,266.95 |
$12,266.95 |
$12,266.95 |
$2,480.94
|
|
An fluoro guide for cvp
|
$461.00 |
$461.00 |
$461.00 |
$525.85
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$621.09 |
$621.09 |
$621.09 |
$2,979.43
|
|
Ankle X-ray
|
$262.90 |
$262.90 |
$262.90 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$226.50 |
$226.50 |
$226.50 |
$282.96
|
|
Antibody bacterium, not elsewhere specified
|
$145.05 |
$145.05 |
$145.05 |
$57.85
|
|
Antibody elution rbc reference
|
$361.50 |
$361.50 |
$361.50 |
$177.29
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$157.45 |
$157.45 |
$157.45 |
$224.00
|
|
Antibody id rbc panel
|
$136.10 |
$136.10 |
$136.10 |
$291.75
|
|
Antibody screen rbc
|
$115.95 |
$115.95 |
$115.95 |
$108.55
|
|
Antibody tetanus
|
$90.30 |
$90.30 |
$90.30 |
$54.15
|
