|
11-desoxycortisol - sendout
|
$70.40 |
$70.40 |
$70.40 |
$91.85
|
|
3d recon without postprocess indpndt
|
$876.00 |
$876.00 |
$876.00 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$86.40 |
$86.40 |
$86.40 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$55.20 |
$55.20 |
$55.20 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,341.48 |
$2,341.48 |
$2,341.48 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,552.80 |
$1,552.80 |
$1,552.80 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$952.00 |
$952.00 |
$952.00 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,701.60 |
$2,701.60 |
$2,701.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,637.60 |
$2,637.60 |
$2,637.60 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,130.40 |
$2,130.40 |
$2,130.40 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,098.40 |
$4,098.40 |
$4,098.40 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,392.00 |
$3,392.00 |
$3,392.00 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$3,083.20 |
$3,083.20 |
$3,083.20 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,934.40 |
$1,934.40 |
$1,934.40 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$772.00 |
$772.00 |
$772.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$404.80 |
$404.80 |
$404.80 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$531.20 |
$531.20 |
$531.20 |
$418.63
|
|
Abdominal X-ray (single view)
|
$329.60 |
$329.60 |
$329.60 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,487.20 |
$1,487.20 |
$1,487.20 |
$1,148.40
|
|
Ablation cryo pq chest wall tumor(s) w/guid
|
$4,517.60 |
$4,517.60 |
$4,517.60 |
$441.09
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$194.01 |
$194.01 |
$194.01 |
$72.74
|
|
Acetaminophen level
|
$73.60 |
$73.60 |
$73.60 |
$116.80
|
|
Acetone qualitative
|
$59.20 |
$59.20 |
$59.20 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$374.36 |
$374.36 |
$374.36 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$16.83 |
$16.83 |
$16.83 |
$31.21
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$427.20 |
$427.20 |
$427.20 |
$341.00
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$26.40 |
$26.40 |
$26.40 |
$38.50
|
|
Acute hepatitis panel
|
$342.40 |
$342.40 |
$342.40 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$6.97 |
$6.97 |
$6.97 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$62.48 |
$62.48 |
$62.48 |
$64.45
|
|
Adenosine 3 mg/250 ml bag for osm
|
$69.86 |
$69.86 |
$69.86 |
$271.98
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$20.00 |
$20.00 |
$20.00 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$280.80 |
$280.80 |
$280.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$308.00 |
$308.00 |
$308.00 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$799.20 |
$799.20 |
$799.20 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$685.60 |
$685.60 |
$685.60 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$508.00 |
$508.00 |
$508.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$508.00 |
$508.00 |
$508.00 |
$256.49
|
|
Administration immunization each additional vaccine
|
$40.00 |
$40.00 |
$40.00 |
$47.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$32.80 |
$32.80 |
$32.80 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$37.60 |
$37.60 |
$37.60 |
$30.24
|
|
Administration vaccine influenza virus
|
$40.00 |
$40.00 |
$40.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$70.40 |
$70.40 |
$70.40 |
$49.68
|
|
_afb id by dna probe rflx ast
|
$80.00 |
$80.00 |
$80.00 |
$104.50
|
|
Albumin body fluid quantitative each specimen
|
$36.80 |
$36.80 |
$36.80 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$232.17 |
$232.17 |
$232.17 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$67.20 |
$67.20 |
$67.20 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$47.20 |
$47.20 |
$47.20 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$3.89 |
$3.89 |
$3.89 |
$5.67
|
|
Albuterol non-comp con
|
$18.37 |
$18.37 |
$18.37 |
$6.07
|
|
Albuterol non-comp unit
|
$3.89 |
$3.89 |
$3.89 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$140.00 |
$140.00 |
$140.00 |
$96.00
|
|
Alkaline phosphatase
|
$50.40 |
$50.40 |
$50.40 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$66.40 |
$66.40 |
$66.40 |
$48.57
|
|
Allergen egg white ige
|
$54.40 |
$54.40 |
$54.40 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$47.20 |
$47.20 |
$47.20 |
$45.00
|
|
Allergy injection; single 95115
|
$42.40 |
$42.40 |
$42.40 |
$46.80
|
|
Alpha-fetoprotein tumor marker
|
$155.20 |
$155.20 |
$155.20 |
$106.00
|
|
Als1-emergency
|
$1,666.40 |
$1,666.40 |
$1,666.40 |
$1,103.37
|
|
Alteplase 100 mg infusion from pyxis vial
|
$255.80 |
$255.80 |
$255.80 |
$15,857.45
|
|
Alt/sgpt
|
$74.40 |
$74.40 |
$74.40 |
$47.50
|
|
Aluminum - quest
|
$176.00 |
$176.00 |
$176.00 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$61.82 |
$61.82 |
$61.82 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$75.68 |
$75.68 |
$75.68 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$69.26 |
$69.26 |
$69.26 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$192.09 |
$192.09 |
$192.09 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$65.24 |
$65.24 |
$65.24 |
$55.86
|
|
Ammonia
|
$251.20 |
$251.20 |
$251.20 |
$119.70
|
|
Amphetamines 5 or more
|
$58.40 |
$58.40 |
$58.40 |
$90.48
|
|
Ampicillin 1 gram solution for injection
|
$73.75 |
$73.75 |
$73.75 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$66.07 |
$66.07 |
$66.07 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$496.00 |
$496.00 |
$496.00 |
$262.99
|
|
Amylase
|
$67.20 |
$67.20 |
$67.20 |
$90.00
|
|
Analysis gene f5 leiden variant
|
$192.00 |
$192.00 |
$192.00 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$114.40 |
$114.40 |
$114.40 |
$101.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$306.85 |
$306.85 |
$306.85 |
$2,979.43
|
|
Ankle X-ray
|
$368.80 |
$368.80 |
$368.80 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$313.60 |
$313.60 |
$313.60 |
$282.96
|
|
Anodyne therapy charges pt
|
$54.40 |
$54.40 |
$54.40 |
$42.00
|
|
Anora (draw only)
|
$46.40 |
$46.40 |
$46.40 |
$35.00
|
|
Antibody bacterium, not elsewhere specified
|
$32.00 |
$32.00 |
$32.00 |
$57.85
|
|
Antibody id rbc panel
|
$325.60 |
$325.60 |
$325.60 |
$291.75
|
|
Antibody screen rbc
|
$115.20 |
$115.20 |
$115.20 |
$108.55
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$94.40 |
$94.40 |
$94.40 |
$38.50
|
|
Antinuclear antibodies
|
$121.60 |
$121.60 |
$121.60 |
$90.00
|
|
Antinuclear antibodies titer
|
$66.40 |
$66.40 |
$66.40 |
$80.04
|
|
Antistreptolysin o titer
|
$68.00 |
$68.00 |
$68.00 |
$54.00
|
|
Antithrombin iii activity
|
$204.00 |
$204.00 |
$204.00 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$627.20 |
$627.20 |
$627.20 |
$394.55
|
|
Application finger splntstatic 29130
|
$288.80 |
$288.80 |
$288.80 |
$208.50
|
|
Application long leg splint 29505
|
$389.60 |
$389.60 |
$389.60 |
$338.25
|
|
Application lower leg splint 29515
|
$365.60 |
$365.60 |
$365.60 |
$340.20
|
|
Application of paste boot 29580
|
$744.00 |
$744.00 |
$744.00 |
$340.11
|
|
Appl modality 1/> areas paraffin bath 97018
|
$94.40 |
$94.40 |
$94.40 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$113.60 |
$113.60 |
$113.60 |
$75.98
|
|
Apply hand/wrist cast 29085
|
$340.80 |
$340.80 |
$340.80 |
$271.80
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$146.40 |
$146.40 |
$146.40 |
$100.75
|
|
Arm CT Scan (with contrast, both arms)
|
$2,221.60 |
$2,221.60 |
$2,221.60 |
$1,687.88
|
|
Arm CT Scan (without contrast, both arms)
|
$1,944.80 |
$1,944.80 |
$1,944.80 |
$1,380.00
|
