|
Autoimmune rheumatoid arthr anl 12 mrk ia
|
$1,418.56 |
$1,418.56 |
$1,418.56 |
$925.10
|
|
Autologous blood process
|
$511.68 |
$511.68 |
$511.68 |
$262.50
|
|
Automated diff wbc count
|
$15.08 |
$15.08 |
$15.08 |
$38.28
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$106.60 |
$106.60 |
$106.60 |
$318.75
|
|
Azathioprine parenteral
|
$811.79 |
$811.79 |
$811.79 |
$442.98
|
|
Aztreonam 1 gram solution for injection
|
$198.00 |
$198.00 |
$198.00 |
$157.30
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$1,204.16 |
$1,204.16 |
$1,204.16 |
$1,800.33
|
|
Baclofen eval charges
|
$85.28 |
$85.28 |
$85.28 |
$85.00
|
|
Bacterial meningitis antigen
|
$46.80 |
$46.80 |
$46.80 |
$66.30
|
|
Bacterial vaginosis pcr
|
$39.00 |
$39.00 |
$39.00 |
$278.40
|
|
Bebtelovimab injection
|
$789.36 |
$789.36 |
$789.36 |
$450.48
|
|
Bendamustine 100 mg intravenous powder for solution
|
$2,309.05 |
$2,309.05 |
$2,309.05 |
$4,844.85
|
|
Bendamustine 25 mg/ml intravenous solution (belrapzo)
|
$3,186.99 |
$3,186.99 |
$3,186.99 |
$4,107.38
|
|
Benign lesion paring 2-4
|
$276.12 |
$276.12 |
$276.12 |
$257.50
|
|
#_benzodiazconfur
|
$113.36 |
$113.36 |
$113.36 |
$114.40
|
|
Beta 2 glycoprotein 1 antibody iga
|
$43.68 |
$43.68 |
$43.68 |
$78.50
|
|
Beta-2 microglobulin
|
$36.40 |
$36.40 |
$36.40 |
$85.94
|
|
Bilateral n block inj occipital 64405
|
$419.12 |
$419.12 |
$419.12 |
$768.60
|
|
Bilateral n block inj trigeminal 64400
|
$197.08 |
$197.08 |
$197.08 |
$556.40
|
|
Bilirubin direct
|
$34.84 |
$34.84 |
$34.84 |
$50.00
|
|
Bilirubin total
|
$34.84 |
$34.84 |
$34.84 |
$52.57
|
|
Biopsy cervixsingle/multiple 57500
|
$1,131.00 |
$1,131.00 |
$1,131.00 |
$1,266.48
|
|
Bladder irrigate/lavage/instill 51700
|
$157.04 |
$157.04 |
$157.04 |
$408.00
|
|
Bld prd mix
|
$33.28 |
$33.28 |
$33.28 |
$139.21
|
|
Blood Clotting (PT/INR) Test
|
$24.96 |
$24.96 |
$24.96 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$24.96 |
$24.96 |
$24.96 |
$73.44
|
|
Blood component/product noc
|
$131.56 |
$131.56 |
$131.56 |
$54.21
|
|
Blood Count (CBC) Test
|
$39.00 |
$39.00 |
$39.00 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$39.00 |
$39.00 |
$39.00 |
$61.80
|
|
Blood Culture Test
|
$46.28 |
$46.28 |
$46.28 |
$145.80
|
|
Blood gases o2 saturation direct measurement
|
$121.16 |
$121.16 |
$121.16 |
$220.35
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$14.56 |
$14.56 |
$14.56 |
$33.15
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$14.56 |
$14.56 |
$14.56 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$14.56 |
$14.56 |
$14.56 |
$34.00
|
|
Blood smear microscopic w manual differential wbc count
|
$19.76 |
$19.76 |
$19.76 |
$38.61
|
|
Blood typing abo
|
$11.96 |
$11.96 |
$11.96 |
$83.03
|
|
Blood typing ag donor ea ag
|
$32.24 |
$32.24 |
$32.24 |
$190.80
|
|
Blood typing patient serum
|
$32.24 |
$32.24 |
$32.24 |
$68.40
|
|
Blood typing rbc ag non abo/rh ea
|
$248.56 |
$248.56 |
$248.56 |
$199.50
|
|
Blood typing rh (d)
|
$11.96 |
$11.96 |
$11.96 |
$57.14
|
|
Bls-emergency
|
$298.48 |
$298.48 |
$298.48 |
$892.32
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$92.56 |
$92.56 |
$92.56 |
$94.80
|
|
Borrelia miyamotoi amp prb
|
$58.76 |
$58.76 |
$58.76 |
$68.88
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$432.95 |
$432.95 |
$432.95 |
$2,825.96
|
|
(both sides) smear without diff wbc count
|
$14.04 |
$14.04 |
$14.04 |
$30.68
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$1,070.68 |
$1,070.68 |
$1,070.68 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$1,420.12 |
$1,420.12 |
$1,420.12 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$1,070.16 |
$1,070.16 |
$1,070.16 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$993.20 |
$993.20 |
$993.20 |
$1,977.27
|
|
Bronchoscopy w/fb removal 31635
|
$2,377.44 |
$2,377.44 |
$2,377.44 |
$2,445.96
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$19.50 |
$19.50 |
$19.50 |
$23.92
|
|
Bundled special stain group 1 microorganisms
|
$31.72 |
$31.72 |
$31.72 |
$160.80
|
|
Buprenorphine oral 1mg
|
$21.05 |
$21.05 |
$21.05 |
$10.50
|
|
Busulfan injection
|
$721.58 |
$721.58 |
$721.58 |
$783.10
|
|
Cabergoline, oral 0.25mg
|
$3.52 |
$3.52 |
$3.52 |
$65.85
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$2,164.73 |
$2,164.73 |
$2,164.73 |
$2,111.64
|
|
Calcium 24 hour urine
|
$49.92 |
$49.92 |
$49.92 |
$53.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$138.84 |
$138.84 |
$138.84 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$65.13 |
$65.13 |
$65.13 |
$91.60
|
|
Calcium ionized
|
$31.20 |
$31.20 |
$31.20 |
$90.00
|
|
Calcium total
|
$34.84 |
$34.84 |
$34.84 |
$50.00
|
|
Calprotectin fecal
|
$178.88 |
$178.88 |
$178.88 |
$169.95
|
|
Canthotomy 67715
|
$3,430.44 |
$3,430.44 |
$3,430.44 |
$2,956.50
|
|
Capecitabine, oral, 50 mg
|
$21.12 |
$21.12 |
$21.12 |
$59.42
|
|
Carbamazepine free -sendout
|
$40.04 |
$40.04 |
$40.04 |
$47.94
|
|
Carbamazepine total therapeutic drug level
|
$40.56 |
$40.56 |
$40.56 |
$120.25
|
|
Carboxyhemoglobin quantitative
|
$73.32 |
$73.32 |
$73.32 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$160.16 |
$160.16 |
$160.16 |
$144.00
|
|
Cardiolipin antibody iga
|
$174.20 |
$174.20 |
$174.20 |
$105.00
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$663.52 |
$663.52 |
$663.52 |
$1,396.00
|
|
Caregiver training strategies&tq 1st 30 minutes
|
$81.12 |
$81.12 |
$81.12 |
$99.60
|
|
Caregiver training strategies&tq ea addl 15 min
|
$40.56 |
$40.56 |
$40.56 |
$51.50
|
|
Carmustine 100 mg intravenous powder for solution
|
$1,082.37 |
$1,082.37 |
$1,082.37 |
$1,731.00
|
|
Carotene
|
$22.88 |
$22.88 |
$22.88 |
$45.24
|
|
Carotid Artery Ultrasound (Duplex)
|
$256.36 |
$256.36 |
$256.36 |
$1,018.68
|
|
Casiri and imdev repeat
|
$821.08 |
$821.08 |
$821.08 |
$540.00
|
|
Cell count body fluid
|
$23.92 |
$23.92 |
$23.92 |
$63.63
|
|
Cell count w differential body fluid
|
$23.92 |
$23.92 |
$23.92 |
$93.23
|
|
Cftr gene dup/delet variants
|
$762.84 |
$762.84 |
$762.84 |
$779.35
|
|
Change cystostomy tube simple
|
$117.52 |
$117.52 |
$117.52 |
$451.00
|
|
Change g-tube to g-j perc
|
$1,488.24 |
$1,488.24 |
$1,488.24 |
$2,198.40
|
|
Chest 2 vws w oblique
|
$267.28 |
$267.28 |
$267.28 |
$377.06
|
|
Chest CT scan (with and without contrast)
|
$1,003.08 |
$1,003.08 |
$1,003.08 |
$1,975.00
|
|
Chest CT scan (with contrast)
|
$982.28 |
$982.28 |
$982.28 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$960.44 |
$960.44 |
$960.44 |
$1,350.03
|
|
Chest X-ray
|
$177.84 |
$177.84 |
$177.84 |
$294.06
|
|
Chest X-ray (single view)
|
$123.76 |
$123.76 |
$123.76 |
$239.04
|
|
Chloride
|
$34.84 |
$34.84 |
$34.84 |
$40.95
|
|
Chloride 24 hour urine
|
$49.92 |
$49.92 |
$49.92 |
$49.50
|
|
Chloroprocaine hcl injection
|
$72.70 |
$72.70 |
$72.70 |
$61.51
|
|
Cholesterol
|
$17.16 |
$17.16 |
$17.16 |
$45.76
|
|
Cholesterol body fluid
|
$97.24 |
$97.24 |
$97.24 |
$77.55
|
|
Cholesterol (Lipid) Test
|
$267.28 |
$267.28 |
$267.28 |
$115.80
|
|
Cholinesterase
|
$37.96 |
$37.96 |
$37.96 |
$38.69
|
|
Chrom analysis
|
$62.92 |
$62.92 |
$62.92 |
$156.00
|
|
Cidofovir injection
|
$1,057.26 |
$1,057.26 |
$1,057.26 |
$1,295.73
|
|
Cinacalcet 30 mg tablet
|
$41.25 |
$41.25 |
$41.25 |
$41.25
|
|
Ciprofloxacin otic susp 6 mg
|
$4.93 |
$4.93 |
$4.93 |
$63.31
|
|
Circumcision (newborn)
|
$1,366.04 |
$1,366.04 |
$1,366.04 |
$1,395.20
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$505.11 |
$505.11 |
$505.11 |
$569.55
|
