|
11-desoxycortisol - sendout
|
$40.20 |
$40.20 |
$40.20 |
$91.85
|
|
17-hydroxypregnenolone
|
$40.20 |
$40.20 |
$40.20 |
$92.65
|
|
17-ketosteroids
|
$97.20 |
$97.20 |
$97.20 |
$55.00
|
|
24 hr ambulatory b/p monitor
|
$66.00 |
$66.00 |
$66.00 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$405.00 |
$405.00 |
$405.00 |
$1,724.25
|
|
2nd order venous cath
|
$0.60 |
$0.60 |
$0.60 |
$1,532.04
|
|
3d ech img cgen car anomal
|
$66.00 |
$66.00 |
$66.00 |
$511.60
|
|
3-d radiotherapy plan
|
$445.80 |
$445.80 |
$445.80 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$259.20 |
$259.20 |
$259.20 |
$508.13
|
|
5' nucleotidase - sendout
|
$24.00 |
$24.00 |
$24.00 |
$50.05
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$1,429.80 |
$1,429.80 |
$1,429.80 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$53.40 |
$53.40 |
$53.40 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$0.60 |
$0.60 |
$0.60 |
$3,629.42
|
|
Abd/low ext cath 1st
|
$0.60 |
$0.60 |
$0.60 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$0.60 |
$0.60 |
$0.60 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$0.60 |
$0.60 |
$0.60 |
$2,475.45
|
|
Abd/low ext cath addl
|
$0.60 |
$0.60 |
$0.60 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,126.20 |
$1,126.20 |
$1,126.20 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$625.80 |
$625.80 |
$625.80 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$160.80 |
$160.80 |
$160.80 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$140.40 |
$140.40 |
$140.40 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$74.40 |
$74.40 |
$74.40 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$654.00 |
$654.00 |
$654.00 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$607.20 |
$607.20 |
$607.20 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$430.20 |
$430.20 |
$430.20 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$0.60 |
$0.60 |
$0.60 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$411.00 |
$411.00 |
$411.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$321.60 |
$321.60 |
$321.60 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$124.80 |
$124.80 |
$124.80 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$142.80 |
$142.80 |
$142.80 |
$418.63
|
|
Abdominal X-ray (single view)
|
$71.40 |
$71.40 |
$71.40 |
$260.00
|
|
Ablate arrhythmia add on
|
$0.60 |
$0.60 |
$0.60 |
$6,828.51
|
|
Ablate heart dysrhythm focus
|
$0.60 |
$0.60 |
$0.60 |
$9,332.05
|
|
Ablate pulm tumor perq rf
|
$0.60 |
$0.60 |
$0.60 |
$7,243.60
|
|
Abscess drain retroperitoneal surg code
|
$0.60 |
$0.60 |
$0.60 |
$3,050.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$8.40 |
$8.40 |
$8.40 |
$72.74
|
|
Acute hepatitis panel
|
$145.80 |
$145.80 |
$145.80 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$67.80 |
$67.80 |
$67.80 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$6.00 |
$6.00 |
$6.00 |
$64.45
|
|
#acylcarnitineprfl
|
$210.60 |
$210.60 |
$210.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$471.00 |
$471.00 |
$471.00 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$55.20 |
$55.20 |
$55.20 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$53.40 |
$53.40 |
$53.40 |
$58.00
|
|
Adh-sendout
|
$40.20 |
$40.20 |
$40.20 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$124.20 |
$124.20 |
$124.20 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$937.80 |
$937.80 |
$937.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$28.80 |
$28.80 |
$28.80 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$527.40 |
$527.40 |
$527.40 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$292.80 |
$292.80 |
$292.80 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$204.60 |
$204.60 |
$204.60 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$204.60 |
$204.60 |
$204.60 |
$256.49
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$6,328.80 |
$6,328.80 |
$6,328.80 |
$11,350.31
|
|
_afb id by dna probe rflx ast
|
$40.20 |
$40.20 |
$40.20 |
$104.50
|
|
Albumin body fluid quantitative each specimen
|
$16.20 |
$16.20 |
$16.20 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$24.00 |
$24.00 |
$24.00 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$3.00 |
$3.00 |
$3.00 |
$43.00
|
|
Aldesleukin injection
|
$3,847.80 |
$3,847.80 |
$3,847.80 |
$9,030.11
|
|
Alkaline phosphatase
|
$3.00 |
$3.00 |
$3.00 |
$46.80
|
|
Allergen egg white ige
|
$24.00 |
$24.00 |
$24.00 |
$38.00
|
|
Allergen specific ige qual multi scrn ea
|
$40.20 |
$40.20 |
$40.20 |
$24.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$3,161.40 |
$3,161.40 |
$3,161.40 |
$9,900.02
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$3,402.60 |
$3,402.60 |
$3,402.60 |
$4,677.40
|
|
Alloskin
|
$759.00 |
$759.00 |
$759.00 |
$582.40
|
|
Alpha-fetoprotein tumor marker
|
$24.00 |
$24.00 |
$24.00 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$9,848.40 |
$9,848.40 |
$9,848.40 |
$15,857.45
|
|
Alt/sgpt
|
$3.00 |
$3.00 |
$3.00 |
$47.50
|
|
Aluminum - quest
|
$64.80 |
$64.80 |
$64.80 |
$83.05
|
|
Ambl bp mntr w/sw a/r
|
$199.20 |
$199.20 |
$199.20 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$12.00 |
$12.00 |
$12.00 |
$39.84
|
|
Amino acids quant 2-5
|
$194.40 |
$194.40 |
$194.40 |
$112.00
|
|
Aminolevulinic acid delta
|
$42.00 |
$42.00 |
$42.00 |
$87.12
|
|
Amiodarone 50 mg/ml intravenous solution
|
$2.40 |
$2.40 |
$2.40 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$48.60 |
$48.60 |
$48.60 |
$87.45
|
|
Ammonia
|
$32.40 |
$32.40 |
$32.40 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$64.80 |
$64.80 |
$64.80 |
$93.61
|
|
Amphotericin b lipid complex
|
$96.00 |
$96.00 |
$96.00 |
$226.80
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$109.80 |
$109.80 |
$109.80 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$0.60 |
$0.60 |
$0.60 |
$56.70
|
|
Amylase
|
$9.60 |
$9.60 |
$9.60 |
$90.00
|
|
Ana ds-dna
|
$49.80 |
$49.80 |
$49.80 |
$55.24
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$48.60 |
$48.60 |
$48.60 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$259.80 |
$259.80 |
$259.80 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$154.20 |
$154.20 |
$154.20 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$64.80 |
$64.80 |
$64.80 |
$101.50
|
|
An cholangiogram percutaneous compl
|
$0.60 |
$0.60 |
$0.60 |
$2,480.94
|
|
An fluoro guide for cvp
|
$0.60 |
$0.60 |
$0.60 |
$525.85
|
|
Angio balloon ctrl dialysis seg add-on
|
$0.60 |
$0.60 |
$0.60 |
$5,728.50
|
|
Angioplasty fem/pop unilat 37224
|
$0.60 |
$0.60 |
$0.60 |
$8,600.40
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$0.60 |
$0.60 |
$0.60 |
$9,765.79
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$0.60 |
$0.60 |
$0.60 |
$5,950.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$1,346.40 |
$1,346.40 |
$1,346.40 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$0.60 |
$0.60 |
$0.60 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$0.60 |
$0.60 |
$0.60 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$0.60 |
$0.60 |
$0.60 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$0.60 |
$0.60 |
$0.60 |
$4,350.00
|
|
Angio trnslmnl balloon same vein ini
|
$0.60 |
$0.60 |
$0.60 |
$8,359.11
|
|
Ankle X-ray
|
$106.80 |
$106.80 |
$106.80 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$106.80 |
$106.80 |
$106.80 |
$282.96
|
|
Antibody bacterium, not elsewhere specified
|
$53.40 |
$53.40 |
$53.40 |
$57.85
|
|
Antibody elution rbc reference
|
$32.40 |
$32.40 |
$32.40 |
$177.29
|
