|
17-hydroxypregnenolone
|
$90.90 |
$90.90 |
$90.90 |
$85.15
|
|
2019-ncov diagnostic p
|
$58.95 |
$58.95 |
$58.95 |
$49.57
|
|
5' nucleotidase - sendout
|
$22.50 |
$22.50 |
$22.50 |
$50.05
|
|
Abdominal CT scan (with and without contrast)
|
$1,124.55 |
$1,124.55 |
$1,124.55 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$947.70 |
$947.70 |
$947.70 |
$1,655.50
|
|
Abdominal CT scan (without contrast)
|
$829.35 |
$829.35 |
$829.35 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,131.65 |
$2,131.65 |
$2,131.65 |
$3,004.50
|
|
Abdominal MRI (with contrast)
|
$1,223.55 |
$1,223.55 |
$1,223.55 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$1,981.20
|
|
Abdominal paracentesis w/image guidance
|
$379.80 |
$379.80 |
$379.80 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$369.90 |
$369.90 |
$369.90 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$401.85 |
$401.85 |
$401.85 |
$604.80
|
|
Abd paracentesis/w/o image guide 49082
|
$845.10 |
$845.10 |
$845.10 |
$1,179.75
|
|
Ablation cryo abd perit om
|
$1,568.25 |
$1,568.25 |
$1,568.25 |
$2,566.58
|
|
Ablation of upper extremity nerves rf
|
$354.60 |
$354.60 |
$354.60 |
$961.20
|
|
Acetaminophen level
|
$34.65 |
$34.65 |
$34.65 |
$117.01
|
|
Acetone qualitative
|
$50.85 |
$50.85 |
$50.85 |
$46.20
|
|
Acetylcholine receptor modulating antibody
|
$16.65 |
$16.65 |
$16.65 |
$61.80
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$19.80 |
$19.80 |
$19.80 |
$42.75
|
|
Acute hepatitis panel
|
$146.70 |
$146.70 |
$146.70 |
$278.33
|
|
#acylcarnitineprfl
|
$157.50 |
$157.50 |
$157.50 |
$110.25
|
|
Adh-sendout
|
$60.75 |
$60.75 |
$60.75 |
$109.71
|
|
Administration chemotherapy IV infusion each additional hour
|
$106.20 |
$106.20 |
$106.20 |
$235.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$831.60 |
$831.60 |
$831.60 |
$690.21
|
|
Administration immunization 1 vaccine
|
$45.00 |
$45.00 |
$45.00 |
$67.20
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$28.80 |
$28.80 |
$28.80 |
$41.15
|
|
Administration vaccine hepatitis b
|
$35.10 |
$35.10 |
$35.10 |
$54.60
|
|
Administration vaccine influenza virus
|
$10.35 |
$10.35 |
$10.35 |
$48.00
|
|
Administration vaccine pneumococcal
|
$10.35 |
$10.35 |
$10.35 |
$49.17
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$24.75 |
$24.75 |
$24.75 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$8,617.59 |
$8,617.59 |
$8,617.59 |
$11,350.31
|
|
After cataract laser surgery
|
$697.50 |
$697.50 |
$697.50 |
$1,411.20
|
|
Albumin body fluid quantitative each specimen
|
$27.00 |
$27.00 |
$27.00 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$99.63 |
$99.63 |
$99.63 |
$218.40
|
|
Albumin (human), 5%, 250 ml
|
$99.90 |
$99.90 |
$99.90 |
$242.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$88.65 |
$88.65 |
$88.65 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$31.05 |
$31.05 |
$31.05 |
$39.78
|
|
Alkaline phosphatase
|
$32.85 |
$32.85 |
$32.85 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$26.10 |
$26.10 |
$26.10 |
$48.57
|
|
Allergen egg white ige
|
$16.20 |
$16.20 |
$16.20 |
$36.60
|
|
Alpha-fetoprotein tumor marker
|
$55.35 |
$55.35 |
$55.35 |
$102.00
|
|
Alprostadil for injection
|
$479.57 |
$479.57 |
$479.57 |
$519.93
|
|
Alt/sgpt
|
$25.65 |
$25.65 |
$25.65 |
$44.68
|
|
Aluminum - quest
|
$66.15 |
$66.15 |
$66.15 |
$81.49
|
|
Aminolevulinic acid delta
|
$93.60 |
$93.60 |
$93.60 |
$74.10
|
|
Amitriptyline (elavil) -sendout
|
$150.75 |
$150.75 |
$150.75 |
$92.50
|
|
Ammonia
|
$70.20 |
$70.20 |
$70.20 |
$114.40
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$3,839.54
|
|
Amphetamine confirm urine -sendout
|
$17.10 |
$17.10 |
$17.10 |
$93.61
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$633.82 |
$633.82 |
$633.82 |
$451.51
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$207.00 |
$207.00 |
$207.00 |
$262.99
|
|
Amylase
|
$53.10 |
$53.10 |
$53.10 |
$83.20
|
|
Anabolic steroid 1 or 2
|
$159.30 |
$159.30 |
$159.30 |
$80.08
|
|
Ana ds-dna
|
$40.50 |
$40.50 |
$40.50 |
$58.63
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$94.50 |
$94.50 |
$94.50 |
$117.01
|
|
Analysis gene f2 20210g>a variant
|
$90.00 |
$90.00 |
$90.00 |
$207.48
|
|
Analysis gene f5 leiden variant
|
$90.00 |
$90.00 |
$90.00 |
$219.13
|
|
Anaplsma phgcytophlm amp prb
|
$50.85 |
$50.85 |
$50.85 |
$88.00
|
|
Ankle X-ray
|
$118.35 |
$118.35 |
$118.35 |
$351.20
|
|
Anora (draw only)
|
$17.10 |
$17.10 |
$17.10 |
$35.00
|
|
Anoscopy remove fb 46608
|
$1,128.15 |
$1,128.15 |
$1,128.15 |
$1,432.59
|
|
Antibody elution rbc reference
|
$80.10 |
$80.10 |
$80.10 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$113.85 |
$113.85 |
$113.85 |
$114.40
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$421.65 |
$421.65 |
$421.65 |
$218.30
|
|
Antibody id rbc panel
|
$247.05 |
$247.05 |
$247.05 |
$283.80
|
|
Antibody screen rbc
|
$68.40 |
$68.40 |
$68.40 |
$102.05
|
|
Antibody tetanus
|
$20.70 |
$20.70 |
$20.70 |
$52.20
|
|
Antidepressant tricyclic 3-5
|
$73.80 |
$73.80 |
$73.80 |
$23.20
|
|
Anti mog serum - sendout
|
$18.00 |
$18.00 |
$18.00 |
$112.81
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$18.00 |
$18.00 |
$18.00 |
$42.35
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$18.00 |
$18.00 |
$18.00 |
$36.60
|
|
Antinuclear antibodies
|
$76.50 |
$76.50 |
$76.50 |
$90.00
|
|
Antinuclear antibodies titer
|
$54.00 |
$54.00 |
$54.00 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$62.55 |
$62.55 |
$62.55 |
$67.60
|
|
Antipsychotics nos 1-3
|
$93.60 |
$93.60 |
$93.60 |
$153.45
|
|
Antistreptolysin o titer
|
$80.10 |
$80.10 |
$80.10 |
$55.44
|
|
Antithrombin iii activity
|
$13.05 |
$13.05 |
$13.05 |
$112.70
|
|
Apheresis plasma
|
$1,333.35 |
$1,333.35 |
$1,333.35 |
$3,292.80
|
|
Apomorphine hydrochloride
|
$542.00 |
$542.00 |
$542.00 |
$174.99
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$1,290.60 |
$1,290.60 |
$1,290.60 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$129.15 |
$129.15 |
$129.15 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,290.60 |
$1,290.60 |
$1,290.60 |
$549.08
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$832.05 |
$832.05 |
$832.05 |
$3,619.35
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$1,290.60 |
$1,290.60 |
$1,290.60 |
$1,148.00
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$583.65 |
$583.65 |
$583.65 |
$549.08
|
|
Application finger splntstatic 29130
|
$14.40 |
$14.40 |
$14.40 |
$225.29
|
|
Application long leg splint 29505
|
$94.50 |
$94.50 |
$94.50 |
$363.00
|
|
Application lower leg splint 29515
|
$71.10 |
$71.10 |
$71.10 |
$363.10
|
|
Application multi layer compression below knee (both sides)
|
$38.70 |
$38.70 |
$38.70 |
$378.35
|
|
Application of cylinder cast 29365
|
$153.00 |
$153.00 |
$153.00 |
$468.00
|
|
Application of forearm cast 29075
|
$141.75 |
$141.75 |
$141.75 |
$370.80
|
|
Application of long arm cast 29065
|
$180.00 |
$180.00 |
$180.00 |
$404.63
|
|
Application of long leg cast 29345
|
$148.05 |
$148.05 |
$148.05 |
$499.20
|
|
Application of paste boot 29580
|
$640.35 |
$640.35 |
$640.35 |
$331.74
|
|
Application short leg cast 29405
|
$130.50 |
$130.50 |
$130.50 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$1,290.60 |
$1,290.60 |
$1,290.60 |
$2,164.64
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$1,290.60 |
$1,290.60 |
$1,290.60 |
$2,198.30
|
|
Appl modality 1/> areas paraffin bath 97018
|
$39.60 |
$39.60 |
$39.60 |
$65.30
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$18.00 |
$18.00 |
$18.00 |
$75.98
|
|
Apply forearm splintdynamic 29126
|
$65.25 |
$65.25 |
$65.25 |
$250.20
|