|
3d recon without postprocess indpndt
|
$640.00 |
$640.00 |
$640.00 |
$508.13
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,981.96 |
$2,981.96 |
$2,981.96 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$56.80 |
$56.80 |
$56.80 |
$53.95
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$732.80 |
$732.80 |
$732.80 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,724.00 |
$2,724.00 |
$2,724.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,375.20 |
$2,375.20 |
$2,375.20 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,888.80 |
$1,888.80 |
$1,888.80 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,297.60 |
$4,297.60 |
$4,297.60 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,252.00 |
$3,252.00 |
$3,252.00 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$3,114.40 |
$3,114.40 |
$3,114.40 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,989.60 |
$1,989.60 |
$1,989.60 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$912.80 |
$912.80 |
$912.80 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$664.80 |
$664.80 |
$664.80 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$387.20 |
$387.20 |
$387.20 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$524.00 |
$524.00 |
$524.00 |
$418.63
|
|
Abdominal X-ray (single view)
|
$313.60 |
$313.60 |
$313.60 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$1,148.40
|
|
Ablation of upper extremity nerves rf
|
$824.00 |
$824.00 |
$824.00 |
$832.50
|
|
Abscess drain retroperitoneal surg code
|
$3,050.40 |
$3,050.40 |
$3,050.40 |
$3,050.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$74.96 |
$74.96 |
$74.96 |
$72.74
|
|
Acetaminophen level
|
$116.80 |
$116.80 |
$116.80 |
$116.80
|
|
Acetone qualitative
|
$74.40 |
$74.40 |
$74.40 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$82.68 |
$82.68 |
$82.68 |
$218.79
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$418.40 |
$418.40 |
$418.40 |
$341.00
|
|
Acoustic refl threshold tst
|
$51.20 |
$51.20 |
$51.20 |
$102.05
|
|
Acute hepatitis panel
|
$390.40 |
$390.40 |
$390.40 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$8.06 |
$8.06 |
$8.06 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$37.62 |
$37.62 |
$37.62 |
$64.45
|
|
#acylcarnitineprfl
|
$49.60 |
$49.60 |
$49.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$560.00 |
$560.00 |
$560.00 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$467.05 |
$467.05 |
$467.05 |
$271.98
|
|
Adh-sendout
|
$157.60 |
$157.60 |
$157.60 |
$118.79
|
|
Admin ecg contrast agent
|
$295.20 |
$295.20 |
$295.20 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$101.60 |
$101.60 |
$101.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$288.80 |
$288.80 |
$288.80 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$596.80 |
$596.80 |
$596.80 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$388.00 |
$388.00 |
$388.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$155.20 |
$155.20 |
$155.20 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$219.20 |
$219.20 |
$219.20 |
$256.49
|
|
Administration immunization each additional vaccine
|
$51.20 |
$51.20 |
$51.20 |
$47.40
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$7,010.12 |
$7,010.12 |
$7,010.12 |
$11,350.31
|
|
Aep hearing status deter i&r
|
$300.80 |
$300.80 |
$300.80 |
$303.00
|
|
_afb id by dna probe rflx ast
|
$67.20 |
$67.20 |
$67.20 |
$104.50
|
|
After cataract laser surgery
|
$1,464.80 |
$1,464.80 |
$1,464.80 |
$1,373.11
|
|
Albumin body fluid quantitative each specimen
|
$50.40 |
$50.40 |
$50.40 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$79.91 |
$79.91 |
$79.91 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$121.71 |
$121.71 |
$121.71 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$83.20 |
$83.20 |
$83.20 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$45.60 |
$45.60 |
$45.60 |
$43.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$144.80 |
$144.80 |
$144.80 |
$96.00
|
|
Alkaline phosphatase
|
$46.40 |
$46.40 |
$46.40 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$59.20 |
$59.20 |
$59.20 |
$48.57
|
|
Allergen egg white ige
|
$61.60 |
$61.60 |
$61.60 |
$38.00
|
|
Allograft amnioexcel plus 17mm disk
|
$421.60 |
$421.60 |
$421.60 |
$497.95
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$233.60 |
$233.60 |
$233.60 |
$6,285.56
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$352.00 |
$352.00 |
$352.00 |
$858.66
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,625.77 |
$2,625.77 |
$2,625.77 |
$13.14
|
|
Alpha-fetoprotein tumor marker
|
$138.40 |
$138.40 |
$138.40 |
$106.00
|
|
Alprostadil for injection
|
$76.64 |
$76.64 |
$76.64 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$11,385.60 |
$11,385.60 |
$11,385.60 |
$15,857.45
|
|
Alt/sgpt
|
$43.20 |
$43.20 |
$43.20 |
$47.50
|
|
Aluminum - quest
|
$196.80 |
$196.80 |
$196.80 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$120.00 |
$120.00 |
$120.00 |
$179.70
|
|
Amino acids quant 2-5
|
$266.40 |
$266.40 |
$266.40 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$40.50 |
$40.50 |
$40.50 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$36.33 |
$36.33 |
$36.33 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$102.40 |
$102.40 |
$102.40 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$36.04 |
$36.04 |
$36.04 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$120.00 |
$120.00 |
$120.00 |
$87.45
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$6,056.60 |
$6,056.60 |
$6,056.60 |
$9,084.45
|
|
Ammonia
|
$70.40 |
$70.40 |
$70.40 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$864.00 |
$864.00 |
$864.00 |
$942.60
|
|
Amphetamine confirm urine -sendout
|
$68.00 |
$68.00 |
$68.00 |
$93.61
|
|
Amphetamines 5 or more
|
$58.40 |
$58.40 |
$58.40 |
$90.48
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$80.24 |
$80.24 |
$80.24 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$144.25 |
$144.25 |
$144.25 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$40.45 |
$40.45 |
$40.45 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$75.10 |
$75.10 |
$75.10 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$496.00 |
$496.00 |
$496.00 |
$262.99
|
|
Amylase
|
$105.60 |
$105.60 |
$105.60 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$220.80 |
$220.80 |
$220.80 |
$80.08
|
|
Analysis gene f2 20210g>a variant
|
$192.00 |
$192.00 |
$192.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$192.00 |
$192.00 |
$192.00 |
$249.60
|
|
Analysis nerve
|
$292.00 |
$292.00 |
$292.00 |
$262.40
|
|
Anca screen with reflex to titer -quest
|
$228.80 |
$228.80 |
$228.80 |
$101.50
|
|
An fluoro guide for cvp
|
$705.60 |
$705.60 |
$705.60 |
$525.85
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$251.24 |
$251.24 |
$251.24 |
$2,979.43
|
|
Ankle X-ray
|
$351.20 |
$351.20 |
$351.20 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$220.00 |
$220.00 |
$220.00 |
$282.96
|
|
Anora (draw only)
|
$48.00 |
$48.00 |
$48.00 |
$35.00
|
|
Antibody bacterium, not elsewhere specified
|
$32.00 |
$32.00 |
$32.00 |
$57.85
|
|
Antibody elution rbc reference
|
$144.00 |
$144.00 |
$144.00 |
$177.29
|
|
Antibody htlv-i
|
$66.40 |
$66.40 |
$66.40 |
$49.53
|
|
Antibody htlv-ii
|
$66.40 |
$66.40 |
$66.40 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$347.20 |
$347.20 |
$347.20 |
$224.00
|
|
Antibody id rbc panel
|
$212.80 |
$212.80 |
$212.80 |
$291.75
|
|
Antibody screen rbc
|
$117.60 |
$117.60 |
$117.60 |
$108.55
|
|
Antihemophilic viii/vwf comp
|
$62.36 |
$62.36 |
$62.36 |
$3.67
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$55.20 |
$55.20 |
$55.20 |
$38.50
|