|
Autologous blood op salvage
|
$1,095.78 |
$1,095.78 |
$1,095.78 |
$910.70
|
|
Autologous blood process
|
$80.64 |
$80.64 |
$80.64 |
$262.50
|
|
Automated diff wbc count
|
$10.08 |
$10.08 |
$10.08 |
$33.80
|
|
Avul nail plate addl
|
$154.98 |
$154.98 |
$154.98 |
$239.85
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$268.80 |
$268.80 |
$268.80 |
$356.00
|
|
Azathioprine 50 mg tablet
|
$1.10 |
$1.10 |
$1.10 |
$2.18
|
|
Azithromycin 500 mg intravenous solution
|
$21.56 |
$21.56 |
$21.56 |
$22.94
|
|
Bacterial meningitis antigen
|
$15.54 |
$15.54 |
$15.54 |
$66.30
|
|
Bactericidal level serum
|
$38.12 |
$38.12 |
$38.12 |
$67.60
|
|
Bendamustine 100 mg intravenous powder for solution
|
$21.81 |
$21.81 |
$21.81 |
$66.40
|
|
Benign lesion paring 2-4
|
$197.82 |
$197.82 |
$197.82 |
$275.88
|
|
Benign lesion paring 4+
|
$326.34 |
$326.34 |
$326.34 |
$276.75
|
|
Benztropine 1 mg/ml injection solution
|
$33.35 |
$33.35 |
$33.35 |
$92.62
|
|
Beta 2 glycoprotein 1 antibody iga
|
$7.56 |
$7.56 |
$7.56 |
$108.55
|
|
Beta-2 microglobulin
|
$5.21 |
$5.21 |
$5.21 |
$84.00
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$19.70 |
$19.70 |
$19.70 |
$50.56
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$122.98 |
$122.98 |
$122.98 |
$2,946.69
|
|
B-hexosaminidase ea assay
|
$92.60 |
$92.60 |
$92.60 |
$104.25
|
|
Bilirubin direct
|
$21.42 |
$21.42 |
$21.42 |
$42.90
|
|
Bilirubin total
|
$15.54 |
$15.54 |
$15.54 |
$48.00
|
|
Binder abdominal lg 12 x 62-74
|
$18.48 |
$18.48 |
$18.48 |
$74.73
|
|
Biopsy, bone open deep
|
$2,320.92 |
$2,320.92 |
$2,320.92 |
$3,370.52
|
|
Bivalirudin
|
$4.14 |
$4.14 |
$4.14 |
$634.79
|
|
Bld prd mix
|
$68.88 |
$68.88 |
$68.88 |
$139.21
|
|
Bleomycin 15 unit solution for injection
|
$58.65 |
$58.65 |
$58.65 |
$176.86
|
|
Bln ureth 5ml 28f 2wy ltx st
|
$7.98 |
$7.98 |
$7.98 |
$34.40
|
|
Blood Clotting (PT/INR) Test
|
$8.40 |
$8.40 |
$8.40 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$13.02 |
$13.02 |
$13.02 |
$67.35
|
|
Blood Count (CBC) Test
|
$16.38 |
$16.38 |
$16.38 |
$66.30
|
|
Blood Culture Test
|
$12.18 |
$12.18 |
$12.18 |
$112.20
|
|
Blood draw capillary 36416
|
$3.36 |
$3.36 |
$3.36 |
$20.80
|
|
Blood gases o2 saturation direct measurement
|
$129.78 |
$129.78 |
$129.78 |
$210.35
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$5.46 |
$5.46 |
$5.46 |
$32.50
|
|
Blood occult peroxidase activity qualitative gastric
|
$5.88 |
$5.88 |
$5.88 |
$31.20
|
|
Blood smear microscopic w manual differential wbc count
|
$6.30 |
$6.30 |
$6.30 |
$34.40
|
|
Blood typing abo
|
$14.70 |
$14.70 |
$14.70 |
$71.40
|
|
Blood typing ag donor ea ag
|
$27.30 |
$27.30 |
$27.30 |
$134.40
|
|
Blood typing rbc ag non abo/rh ea
|
$27.30 |
$27.30 |
$27.30 |
$156.21
|
|
Blood typing rh (d)
|
$34.86 |
$34.86 |
$34.86 |
$52.73
|
|
Blood volume
|
$503.16 |
$503.16 |
$503.16 |
$704.60
|
|
Bone biopsy open superficial
|
$2,320.92 |
$2,320.92 |
$2,320.92 |
$3,965.54
|
|
Bone imaging multiple areas
|
$646.38 |
$646.38 |
$646.38 |
$966.40
|
|
Bone/joint imaging ltd area
|
$631.26 |
$631.26 |
$631.26 |
$935.00
|
|
Bone marrow imaging body
|
$518.70 |
$518.70 |
$518.70 |
$973.73
|
|
Bone marrow imaging ltd
|
$390.18 |
$390.18 |
$390.18 |
$702.26
|
|
Bone marrow imaging mult
|
$571.20 |
$571.20 |
$571.20 |
$759.27
|
|
Bone marrow interpretation
|
$63.84 |
$63.84 |
$63.84 |
$542.03
|
|
Boot cast sandal rocker med
|
$10.92 |
$10.92 |
$10.92 |
$10.92
|
|
Boot j walker l
|
$102.48 |
$102.48 |
$102.48 |
$301.60
|
|
Boot mlti podous univ xlg
|
$108.36 |
$108.36 |
$108.36 |
$256.95
|
|
Boot walker genesis full shell 3-strap s
|
$187.74 |
$187.74 |
$187.74 |
$179.82
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$47.66 |
$47.66 |
$47.66 |
$103.66
|
|
(both sides) smear without diff wbc count
|
$6.30 |
$6.30 |
$6.30 |
$38.22
|
|
Bowel imaging
|
$614.04 |
$614.04 |
$614.04 |
$1,077.60
|
|
Brace afo dbl upright cust
|
$301.98 |
$301.98 |
$301.98 |
$301.98
|
|
Brace afo lg left 6607
|
$160.44 |
$160.44 |
$160.44 |
$70.65
|
|
Brace afopos solid ankle cust
|
$375.48 |
$375.48 |
$375.48 |
$685.08
|
|
Brace ank aftr bioskn med lg
|
$81.48 |
$81.48 |
$81.48 |
$67.77
|
|
Brace ank air stirrup univ
|
$60.48 |
$60.48 |
$60.48 |
$67.28
|
|
Brace ankle joint dflxn assist
|
$45.36 |
$45.36 |
$45.36 |
$76.05
|
|
Brace ankle stablizing lg
|
$54.18 |
$54.18 |
$54.18 |
$158.60
|
|
Brace back pinnacle lo 627 lumbar
|
$266.28 |
$266.28 |
$266.28 |
$673.20
|
|
Brace back pinnacle tlso 464
|
$962.64 |
$962.64 |
$962.64 |
$962.64
|
|
Brace back t-lso custom
|
$1,277.64 |
$1,277.64 |
$1,277.64 |
$1,981.20
|
|
Brace cust back lso
|
$664.86 |
$664.86 |
$664.86 |
$417.67
|
|
Brace fx hum ovr shldr sm
|
$204.96 |
$204.96 |
$204.96 |
$364.00
|
|
Brace halo bremer l2830
|
$63.84 |
$63.84 |
$63.84 |
$254.62
|
|
Brace kafo dbl upright cust
|
$1,257.48 |
$1,257.48 |
$1,257.48 |
$1,257.48
|
|
Brace knee extender plus 22-30in
|
$412.02 |
$412.02 |
$412.02 |
$351.60
|
|
Brace knee hing pat open med
|
$87.78 |
$87.78 |
$87.78 |
$433.29
|
|
Brace knee support neoprene padded open patella med
|
$66.78 |
$66.78 |
$66.78 |
$91.20
|
|
Brace ortho exos 28-50in sm
|
$759.78 |
$759.78 |
$759.78 |
$1,272.70
|
|
Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr
|
$643.86 |
$643.86 |
$643.86 |
$1,975.62
|
|
Brace oths wrist hnd fngr without
|
$147.42 |
$147.42 |
$147.42 |
$122.31
|
|
Brace tlso flex cust
|
$76.02 |
$76.02 |
$76.02 |
$346.45
|
|
Brace wrist classic lft sm
|
$39.90 |
$39.90 |
$39.90 |
$92.25
|
|
Brain flow imaging only
|
$387.66 |
$387.66 |
$387.66 |
$559.44
|
|
Brain image w/flow 4 + views
|
$651.42 |
$651.42 |
$651.42 |
$1,186.77
|
|
Bronchial challenge
|
$519.54 |
$519.54 |
$519.54 |
$777.60
|
|
Bundled special stain group 1 microorganisms
|
$39.06 |
$39.06 |
$39.06 |
$161.46
|
|
Bundled special stain group 2
|
$39.06 |
$39.06 |
$39.06 |
$169.60
|
|
C1 esterase inhibitor func - sendout
|
$21.74 |
$21.74 |
$21.74 |
$123.49
|
|
Caffeine citrate 20 mg/ml inj for po
|
$4.56 |
$4.56 |
$4.56 |
$47.78
|
|
Calcium 24 hour urine
|
$11.76 |
$11.76 |
$11.76 |
$51.63
|
|
Calcium ionized
|
$29.82 |
$29.82 |
$29.82 |
$80.80
|
|
Calcium total
|
$10.50 |
$10.50 |
$10.50 |
$43.20
|
|
Calculus analysis qual
|
$22.37 |
$22.37 |
$22.37 |
$88.80
|
|
Candida skin test
|
$29.72 |
$29.72 |
$29.72 |
$37.68
|
|
Carbamazepine free
|
$6.77 |
$6.77 |
$6.77 |
$66.43
|
|
Carbamazepine total therapeutic drug level
|
$31.50 |
$31.50 |
$31.50 |
$108.81
|
|
Carbon dioxide
|
$10.92 |
$10.92 |
$10.92 |
$42.00
|
|
Carboplatin 10 mg/ml desensitization
|
$7.19 |
$7.19 |
$7.19 |
$59.36
|
|
Carboxyhemoglobin quantitative
|
$39.06 |
$39.06 |
$39.06 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$39.90 |
$39.90 |
$39.90 |
$125.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$154.56 |
$154.56 |
$154.56 |
$258.10
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$113.82 |
$113.82 |
$113.82 |
$208.00
|
|
Cardiolipin antibody iga
|
$6.30 |
$6.30 |
$6.30 |
$126.14
|
|
Catheterization collection of specimen single patient all places of service
|
$110.46 |
$110.46 |
$110.46 |
$58.50
|
|
Cath pezzer 34fr drain bardex propor head mushrm ltx
|
$14.70 |
$14.70 |
$14.70 |
$53.07
|
|
Cath/saline/contrast/sis/hysteosal 58340
|
$636.72 |
$636.72 |
$636.72 |
$505.90
|
