|
17-ketosteroids
|
$38.12 |
$38.12 |
$38.12 |
$57.20
|
|
5' nucleotidase - sendout
|
$6.30 |
$6.30 |
$6.30 |
$64.80
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$45.94 |
$45.94 |
$45.94 |
$66.33
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$7.45 |
$7.45 |
$7.45 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$2,308.74 |
$2,308.74 |
$2,308.74 |
$3,483.84
|
|
Abdominal CT scan (with and without contrast)
|
$997.50 |
$997.50 |
$997.50 |
$1,906.80
|
|
Abdominal CT scan (with contrast)
|
$906.36 |
$906.36 |
$906.36 |
$1,608.98
|
|
Abdominal CT scan (without contrast)
|
$736.68 |
$736.68 |
$736.68 |
$1,213.74
|
|
Abdominal Ultrasound (complete)
|
$265.86 |
$265.86 |
$265.86 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$245.28 |
$245.28 |
$245.28 |
$574.53
|
|
Acetaminophen level
|
$39.90 |
$39.90 |
$39.90 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$29.99 |
$29.99 |
$29.99 |
$94.47
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.66 |
$0.66 |
$0.66 |
$48.72
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1.13 |
$1.13 |
$1.13 |
$97.50
|
|
Adenovirus antibody,serum - quest
|
$15.69 |
$15.69 |
$15.69 |
$63.00
|
|
Adh-sendout
|
$10.15 |
$10.15 |
$10.15 |
$152.10
|
|
Administration immunization 1 vaccine
|
$44.52 |
$44.52 |
$44.52 |
$65.00
|
|
Administration immunization each additional vaccine
|
$50.40 |
$50.40 |
$50.40 |
$45.50
|
|
Adrenal cortex & medulla img
|
$794.22 |
$794.22 |
$794.22 |
$1,642.08
|
|
Albumin body fluid quantitative each specimen
|
$11.34 |
$11.34 |
$11.34 |
$42.40
|
|
Albumin (human), 25%, 50ml
|
$79.24 |
$79.24 |
$79.24 |
$277.87
|
|
Albumin (human), 5%, 250 ml
|
$72.24 |
$72.24 |
$72.24 |
$253.48
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$12.60 |
$12.60 |
$12.60 |
$60.45
|
|
Allergen egg white ige
|
$58.59 |
$58.59 |
$58.59 |
$41.00
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$974.40 |
$974.40 |
$974.40 |
$1,377.04
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$434.70 |
$434.70 |
$434.70 |
$3,035.85
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$133.56 |
$133.56 |
$133.56 |
$4,304.40
|
|
Alpha-fetoprotein amniotic
|
$18.48 |
$18.48 |
$18.48 |
$94.25
|
|
Alpha-fetoprotein tumor marker
|
$36.54 |
$36.54 |
$36.54 |
$110.40
|
|
Alteplase 100 mg infusion from pyxis vial
|
$104.32 |
$104.32 |
$104.32 |
$189.60
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$3.48 |
$3.48 |
$3.48 |
$36.30
|
|
Amino acid single qual
|
$31.50 |
$31.50 |
$31.50 |
$36.00
|
|
Aminolevulinic acid delta
|
$30.24 |
$30.24 |
$30.24 |
$95.80
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$21.90 |
$21.90 |
$21.90 |
$40.47
|
|
Amiodarone 50 mg/ml intravenous solution
|
$0.58 |
$0.58 |
$0.58 |
$15.32
|
|
Ammonia
|
$31.08 |
$31.08 |
$31.08 |
$96.53
|
|
Amniotic fluid scan
|
$10.16 |
$10.16 |
$10.16 |
$33.15
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$54.45 |
$54.45 |
$54.45 |
$107.46
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$20.83 |
$20.83 |
$20.83 |
$94.57
|
|
Ampicillin 1 gram solution for injection
|
$12.53 |
$12.53 |
$12.53 |
$30.28
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$11.09 |
$11.09 |
$11.09 |
$37.60
|
|
Amp metatarsal w/toe single 28810
|
$2,250.36 |
$2,250.36 |
$2,250.36 |
$3,591.33
|
|
Amputation toe interphalangeal joint
|
$2,250.36 |
$2,250.36 |
$2,250.36 |
$3,591.33
|
|
Amputation toe metatarsophalangeal joint
|
$2,250.36 |
$2,250.36 |
$2,250.36 |
$3,743.15
|
|
Amylase
|
$14.28 |
$14.28 |
$14.28 |
$83.20
|
|
Ana ds-dna
|
$6.76 |
$6.76 |
$6.76 |
$69.03
|
|
Analysis nerve
|
$111.72 |
$111.72 |
$111.72 |
$274.49
|
|
Anca screen with reflex to titer -quest
|
$164.64 |
$164.64 |
$164.64 |
$111.20
|
|
Ankle X-ray
|
$128.10 |
$128.10 |
$128.10 |
$311.92
|
|
Antibody elution rbc reference
|
$68.88 |
$68.88 |
$68.88 |
$156.24
|
|
Antibody htlv/hiv confirm test
|
$21.74 |
$21.74 |
$21.74 |
$154.85
|
|
Antibody htlv-i
|
$3.61 |
$3.61 |
$3.61 |
$49.53
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$63.00 |
$63.00 |
$63.00 |
$216.24
|
|
Antibody id rbc panel
|
$52.08 |
$52.08 |
$52.08 |
$250.90
|
|
Antibody influenza virus
|
$27.72 |
$27.72 |
$27.72 |
$63.33
|
|
Antibody lymphocytic choriomeningitis
|
$23.84 |
$23.84 |
$23.84 |
$57.85
|
|
Antibody screen rbc
|
$27.30 |
$27.30 |
$27.30 |
$99.99
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$1.09 |
$1.09 |
$1.09 |
$2.69
|
|
Anti-inhibitor
|
$57.57 |
$57.57 |
$57.57 |
$3.44
|
|
Antinuclear antibodies
|
$30.03 |
$30.03 |
$30.03 |
$97.50
|
|
Antinuclear antibodies titer
|
$24.36 |
$24.36 |
$24.36 |
$78.65
|
|
Antiphosphatidylserine antibody
|
$6.83 |
$6.83 |
$6.83 |
$72.15
|
|
Antistreptolysin o titer
|
$8.69 |
$8.69 |
$8.69 |
$58.50
|
|
Antithrombin iii activity
|
$8.93 |
$8.93 |
$8.93 |
$135.20
|
|
Antithrombin iii injection
|
$4.08 |
$4.08 |
$4.08 |
$6.36
|
|
Antithymocyte globuln rabbit
|
$761.49 |
$761.49 |
$761.49 |
$996.39
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,394.82 |
$1,394.82 |
$1,394.82 |
$2,078.20
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$377.16 |
$377.16 |
$377.16 |
$552.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$2,227.26 |
$2,227.26 |
$2,227.26 |
$2,978.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$377.16 |
$377.16 |
$377.16 |
$549.08
|
|
Application lower leg splint 29515
|
$456.54 |
$456.54 |
$456.54 |
$345.60
|
|
Application multi layer compression below knee (both sides)
|
$888.30 |
$888.30 |
$888.30 |
$384.80
|
|
Application of paste boot 29580
|
$612.36 |
$612.36 |
$612.36 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,394.82 |
$1,394.82 |
$1,394.82 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,394.82 |
$1,394.82 |
$1,394.82 |
$2,087.50
|
|
Apply rigid leg cast 29445
|
$625.38 |
$625.38 |
$625.38 |
$593.57
|
|
Artery xray each vessel 7577426
|
$1,288.98 |
$1,288.98 |
$1,288.98 |
$1,749.69
|
|
Artery xray of abdomen 75726-26
|
$2,268.00 |
$2,268.00 |
$2,268.00 |
$4,252.60
|
|
Artery x-rays arm/leg 75710-26
|
$1,372.56 |
$1,372.56 |
$1,372.56 |
$3,341.00
|
|
Artery x-rays arms/legs 75716-26
|
$1,377.60 |
$1,377.60 |
$1,377.60 |
$3,860.40
|
|
Artery x-rays lung
|
$1,916.88 |
$1,916.88 |
$1,916.88 |
$2,921.88
|
|
Artery x-rays lungs
|
$1,320.06 |
$1,320.06 |
$1,320.06 |
$3,535.57
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$415.38 |
$415.38 |
$415.38 |
$451.48
|
|
Assay acid phosphatase
|
$26.88 |
$26.88 |
$26.88 |
$38.81
|
|
Assay of adp & amp
|
$19.66 |
$19.66 |
$19.66 |
$169.65
|
|
Assay of chloramphenicol
|
$31.51 |
$31.51 |
$31.51 |
$78.00
|
|
Assay of corticosterone
|
$15.65 |
$15.65 |
$15.65 |
$49.20
|
|
Assay of idh enzyme
|
$38.12 |
$38.12 |
$38.12 |
$13.12
|
|
Assay of lap enzyme
|
$14.90 |
$14.90 |
$14.90 |
$82.20
|
|
Assay of methemalbumin
|
$42.84 |
$42.84 |
$42.84 |
$27.20
|
|
Assay of pregnanediol
|
$47.15 |
$47.15 |
$47.15 |
$51.94
|
|
Assay of procainamide w/metab
|
$36.54 |
$36.54 |
$36.54 |
$63.07
|
|
Assay of prostaglandin
|
$56.49 |
$56.49 |
$56.49 |
$186.20
|
|
Assay of salicylate
|
$144.06 |
$144.06 |
$144.06 |
$83.85
|
|
Assay of sialic acid
|
$34.86 |
$34.86 |
$34.86 |
$60.45
|
|
Assay of somatostatin
|
$68.88 |
$68.88 |
$68.88 |
$118.20
|
|
Assay of thiocyanate
|
$54.71 |
$54.71 |
$54.71 |
$55.25
|
|
Assay of urine urobilinogen
|
$15.44 |
$15.44 |
$15.44 |
$12.10
|
|
Assay phosphatidylglycerol
|
$36.12 |
$36.12 |
$36.12 |
$133.56
|
|
Atropine 0.1 mg/ml injection syringe
|
$0.47 |
$0.47 |
$0.47 |
$25.04
|
