|
3d recon without postprocess indpndt
|
$215.15 |
$215.15 |
$215.15 |
$455.83
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$3,128.29 |
$3,128.29 |
$3,128.29 |
$3,649.67
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$82.55 |
$82.55 |
$82.55 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,148.25 |
$2,148.25 |
$2,148.25 |
$1,997.40
|
|
Abdominal CT scan (with contrast)
|
$1,329.90 |
$1,329.90 |
$1,329.90 |
$1,678.00
|
|
Abdominal CT scan (without contrast)
|
$1,075.10 |
$1,075.10 |
$1,075.10 |
$1,290.90
|
|
Abdominal MRI (with and without contrast)
|
$1,561.95 |
$1,561.95 |
$1,561.95 |
$2,713.80
|
|
Abdominal MRI (with contrast)
|
$1,450.15 |
$1,450.15 |
$1,450.15 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$1,337.70 |
$1,337.70 |
$1,337.70 |
$1,883.70
|
|
Abdominal Ultrasound (complete)
|
$583.70 |
$583.70 |
$583.70 |
$733.85
|
|
Abdominal Ultrasound (limited)
|
$474.50 |
$474.50 |
$474.50 |
$603.33
|
|
Acetaminophen level
|
$158.60 |
$158.60 |
$158.60 |
$117.01
|
|
Acetone qualitative
|
$66.95 |
$66.95 |
$66.95 |
$48.75
|
|
Acetylcholine receptor modulating antibody
|
$39.65 |
$39.65 |
$39.65 |
$93.60
|
|
Acute hepatitis panel
|
$285.35 |
$285.35 |
$285.35 |
$310.20
|
|
Administration chemotherapy IV infusion each additional hour
|
$16.90 |
$16.90 |
$16.90 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$65.65 |
$65.65 |
$65.65 |
$319.15
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$728.00 |
$728.00 |
$728.00 |
$735.00
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$343.20 |
$343.20 |
$343.20 |
$464.40
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$105.95 |
$105.95 |
$105.95 |
$224.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$132.60 |
$132.60 |
$132.60 |
$267.43
|
|
Administration immunization 1 vaccine
|
$76.05 |
$76.05 |
$76.05 |
$66.51
|
|
Administration immunization each additional component
|
$25.35 |
$25.35 |
$25.35 |
$27.20
|
|
Administration immunization each additional vaccine
|
$63.70 |
$63.70 |
$63.70 |
$46.23
|
|
Administration immunization first component each vaccine
|
$36.40 |
$36.40 |
$36.40 |
$46.00
|
|
Administration vaccine hepatitis b
|
$59.80 |
$59.80 |
$59.80 |
$38.25
|
|
Administration vaccine influenza virus
|
$76.05 |
$76.05 |
$76.05 |
$37.05
|
|
Administration vaccine pneumococcal
|
$61.75 |
$61.75 |
$61.75 |
$38.25
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$10,121.53 |
$10,121.53 |
$10,121.53 |
$59.76
|
|
Albumin body fluid quantitative each specimen
|
$53.95 |
$53.95 |
$53.95 |
$42.90
|
|
Albumin (human), 25%, 50ml
|
$190.12 |
$190.12 |
$190.12 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$110.50 |
$110.50 |
$110.50 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$53.30 |
$53.30 |
$53.30 |
$41.90
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$193.70 |
$193.70 |
$193.70 |
$78.00
|
|
Alkaline phosphatase
|
$48.75 |
$48.75 |
$48.75 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$48.75 |
$48.75 |
$48.75 |
$56.35
|
|
Allergen egg white ige
|
$42.90 |
$42.90 |
$42.90 |
$41.38
|
|
Alpha-fetoprotein tumor marker
|
$156.65 |
$156.65 |
$156.65 |
$124.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$17,160.70 |
$17,160.70 |
$17,160.70 |
$285.00
|
|
Alt/sgpt
|
$51.35 |
$51.35 |
$51.35 |
$44.68
|
|
Ammonia
|
$97.50 |
$97.50 |
$97.50 |
$96.53
|
|
Amylase
|
$73.45 |
$73.45 |
$73.45 |
$83.20
|
|
Analysis gene f2 20210g>a variant
|
$204.10 |
$204.10 |
$204.10 |
$249.03
|
|
Analysis gene f5 leiden variant
|
$252.85 |
$252.85 |
$252.85 |
$263.90
|
|
Anaplsma phgcytophlm amp prb
|
$44.85 |
$44.85 |
$44.85 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$37.70 |
$37.70 |
$37.70 |
$112.45
|
|
Ankle X-ray
|
$299.65 |
$299.65 |
$299.65 |
$327.20
|
|
Anodyne therapy charges pt
|
$17.55 |
$17.55 |
$17.55 |
$41.02
|
|
Antibody bacterium, not elsewhere specified
|
$35.10 |
$35.10 |
$35.10 |
$61.45
|
|
Antibody elution rbc reference
|
$83.20 |
$83.20 |
$83.20 |
$168.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$93.60 |
$93.60 |
$93.60 |
$227.00
|
|
Antibody id rbc panel
|
$153.40 |
$153.40 |
$153.40 |
$265.05
|
|
Antibody screen rbc
|
$82.55 |
$82.55 |
$82.55 |
$101.09
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$39.00 |
$39.00 |
$39.00 |
$59.15
|
|
Antinuclear antibodies
|
$128.05 |
$128.05 |
$128.05 |
$98.25
|
|
Antinuclear antibodies titer
|
$80.60 |
$80.60 |
$80.60 |
$79.95
|
|
Antiphosphatidylserine antibody
|
$249.60 |
$249.60 |
$249.60 |
$82.55
|
|
Antistreptolysin o titer
|
$91.00 |
$91.00 |
$91.00 |
$60.00
|
|
Antithrombin iii activity
|
$413.40 |
$413.40 |
$413.40 |
$135.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$35.75 |
$35.75 |
$35.75 |
$71.50
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$979.52 |
$979.52 |
$979.52 |
$4.20
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$93.60 |
$93.60 |
$93.60 |
$94.25
|
|
Assay of osteocalcin
|
$167.70 |
$167.70 |
$167.70 |
$133.90
|
|
Assay of salicylate
|
$107.25 |
$107.25 |
$107.25 |
$93.60
|
|
Assay of tyrosine
|
$34.45 |
$34.45 |
$34.45 |
$56.00
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$210.60 |
$210.60 |
$210.60 |
$308.40
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$63.05 |
$63.05 |
$63.05 |
$44.20
|
|
Ast/sgot
|
$45.50 |
$45.50 |
$45.50 |
$43.40
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$29,104.33 |
$29,104.33 |
$29,104.33 |
$24,447.63
|
|
Bacterial vaginosis pcr
|
$40.95 |
$40.95 |
$40.95 |
$314.60
|
|
B cells total count
|
$217.10 |
$217.10 |
$217.10 |
$131.30
|
|
Belimumab 120 mg intravenous solution
|
$5,373.15 |
$5,373.15 |
$5,373.15 |
$7,881.60
|
|
Bendamustine 100 mg intravenous powder for solution
|
$860.92 |
$860.92 |
$860.92 |
$66.40
|
|
Beta 2 glycoprotein 1 antibody iga
|
$113.75 |
$113.75 |
$113.75 |
$113.75
|
|
Beta-2 microglobulin
|
$91.00 |
$91.00 |
$91.00 |
$84.00
|
|
Beta-amyloid 1-40
|
$378.95 |
$378.95 |
$378.95 |
$312.00
|
|
Beta-amyloid 1-42
|
$378.95 |
$378.95 |
$378.95 |
$312.00
|
|
Bevacizumab-awwb 25 mg/ml intravenous solution
|
$1,708.52 |
$1,708.52 |
$1,708.52 |
$6,055.20
|
|
Bilirubin direct
|
$50.05 |
$50.05 |
$50.05 |
$42.90
|
|
Bilirubin total
|
$70.20 |
$70.20 |
$70.20 |
$48.00
|
|
Biotinidase - quest
|
$31.20 |
$31.20 |
$31.20 |
$88.00
|
|
Bladder irrigate/lavage/instill 51700
|
$533.65 |
$533.65 |
$533.65 |
$422.51
|
|
Bld push tfuj 2 yr/<
|
$1,790.10 |
$1,790.10 |
$1,790.10 |
$838.78
|
|
Blood Clotting (PT/INR) Test
|
$45.50 |
$45.50 |
$45.50 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$59.15 |
$59.15 |
$59.15 |
$69.00
|
|
Blood Count (CBC) Test
|
$92.95 |
$92.95 |
$92.95 |
$67.07
|
|
Blood Count (CBC) Test (without differential)
|
$27.95 |
$27.95 |
$27.95 |
$56.55
|
|
Blood Culture Test
|
$96.85 |
$96.85 |
$96.85 |
$115.00
|
|
Blood draw capillary 36416
|
$130.65 |
$130.65 |
$130.65 |
$22.40
|
|
Blood gases ph venous
|
$21.45 |
$21.45 |
$21.45 |
$60.00
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$57.20 |
$57.20 |
$57.20 |
$57.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$32.50 |
$32.50 |
$32.50 |
$32.50
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$47.45 |
$47.45 |
$47.45 |
$32.50
|
|
Blood occult peroxidase activity qualitative gastric
|
$36.40 |
$36.40 |
$36.40 |
$30.68
|
|
Blood typing abo
|
$37.70 |
$37.70 |
$37.70 |
$75.60
|
|
Blood typing ag donor ea ag
|
$284.05 |
$284.05 |
$284.05 |
$134.87
|
|
Blood typing patient serum
|
$57.85 |
$57.85 |
$57.85 |
$73.45
|
|
Blood typing rbc ag non abo/rh ea
|
$51.35 |
$51.35 |
$51.35 |
$159.26
|
|
Blood typing rh (d)
|
$39.00 |
$39.00 |
$39.00 |
$52.73
|
|
Blood typing rh phenotype complete reference
|
$85.15 |
$85.15 |
$85.15 |
$78.80
|
