|
11-desoxycortisol - sendout
|
$41.00 |
$41.00 |
$41.00 |
$87.50
|
|
17-hydroxypregnenolone
|
$41.00 |
$41.00 |
$41.00 |
$87.50
|
|
17-ketosteroids
|
$38.00 |
$38.00 |
$38.00 |
$44.88
|
|
3d ech img cgen car anomal
|
$718.00 |
$718.00 |
$718.00 |
$632.45
|
|
3-d radiotherapy plan
|
$7,140.00 |
$7,140.00 |
$7,140.00 |
$5,002.69
|
|
5' nucleotidase - sendout
|
$18.00 |
$18.00 |
$18.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$132.00 |
$132.00 |
$132.00 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,990.72 |
$4,990.72 |
$4,990.72 |
$3,627.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$26.00 |
$26.00 |
$26.00 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$4,601.00 |
$4,601.00 |
$4,601.00 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$3,835.00 |
$3,835.00 |
$3,835.00 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$3,337.00 |
$3,337.00 |
$3,337.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$10,547.00 |
$10,547.00 |
$10,547.00 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$7,597.00 |
$7,597.00 |
$7,597.00 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$6,747.00 |
$6,747.00 |
$6,747.00 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$6,776.22 |
$6,776.22 |
$6,776.22 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$6,198.00 |
$6,198.00 |
$6,198.00 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$3,827.00 |
$3,827.00 |
$3,827.00 |
$604.43
|
|
Abdominoplasty 15830
|
$10,267.72 |
$10,267.72 |
$10,267.72 |
$5,741.00
|
|
Abl1 gene
|
$951.00 |
$951.00 |
$951.00 |
$614.25
|
|
Abobotulinumtoxina
|
$1,804.25 |
$1,804.25 |
$1,804.25 |
$1,773.50
|
|
Abortion (mpr)
|
$2,182.00 |
$2,182.00 |
$2,182.00 |
$571.80
|
|
Abscess drain retroperitoneal surg code
|
$5,366.00 |
$5,366.00 |
$5,366.00 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$0.14 |
$0.14 |
$0.14 |
$74.96
|
|
Acetazolamide 500 mg solution for injection
|
$92.86 |
$92.86 |
$92.86 |
$120.90
|
|
Acetone qualitative
|
$54.00 |
$54.00 |
$54.00 |
$48.00
|
|
Acetylcholinesterase assay
|
$113.00 |
$113.00 |
$113.00 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$2.51 |
$2.51 |
$2.51 |
$306.72
|
|
Acetylcysteine non-comp unit
|
$12.68 |
$12.68 |
$12.68 |
$29.01
|
|
Acute hepatitis panel
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$10.14 |
$10.14 |
$10.14 |
$41.63
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.95 |
$0.95 |
$0.95 |
$62.48
|
|
#acylcarnitineprfl
|
$554.00 |
$554.00 |
$554.00 |
$87.72
|
|
Adenosine 3 mg/250 ml bag for osm
|
$17.88 |
$17.88 |
$17.88 |
$268.50
|
|
Adenovirus ag ia
|
$225.00 |
$225.00 |
$225.00 |
$31.20
|
|
Adenovirus antibody,serum - quest
|
$117.00 |
$117.00 |
$117.00 |
$60.00
|
|
Adh-sendout
|
$38.00 |
$38.00 |
$38.00 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$310.05 |
$310.05 |
$310.05 |
$172.86
|
|
Administration chemotherapy IV infusion each additional hour
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$460.00 |
$460.00 |
$460.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$4,373.00 |
$4,373.00 |
$4,373.00 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,086.00 |
$1,086.00 |
$1,086.00 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$298.00 |
$298.00 |
$298.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$302.00 |
$302.00 |
$302.00 |
$267.43
|
|
Administration immunization 1 vaccine
|
$305.00 |
$305.00 |
$305.00 |
$70.00
|
|
Administration immunization first component each vaccine
|
$78.00 |
$78.00 |
$78.00 |
$45.50
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$117.00 |
$117.00 |
$117.00 |
$41.15
|
|
Administration vaccine hepatitis b
|
$305.00 |
$305.00 |
$305.00 |
$54.60
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$117.00 |
$117.00 |
$117.00 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$22,011.71 |
$22,011.71 |
$22,011.71 |
$12,791.80
|
|
Adrenal cortex & medulla img
|
$2,265.00 |
$2,265.00 |
$2,265.00 |
$1,818.05
|
|
Adrenalin epinephrine inject
|
$2.84 |
$2.84 |
$2.84 |
$108.60
|
|
_afb id by dna probe rflx ast
|
$163.00 |
$163.00 |
$163.00 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$193.00 |
$193.00 |
$193.00 |
$289.60
|
|
Aflibercept injection
|
$129,500.00 |
$129,500.00 |
$129,500.00 |
$1,263.12
|
|
Agalsidase beta 35 mg intravenous solution
|
$26,091.56 |
$26,091.56 |
$26,091.56 |
$15,667.45
|
|
Airway resistance by impulse oscillometry 94728
|
$123.00 |
$123.00 |
$123.00 |
$279.73
|
|
Albumin body fluid quantitative each specimen
|
$87.00 |
$87.00 |
$87.00 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$2.39 |
$2.39 |
$2.39 |
$256.84
|
|
Albumin, human 25 % intravenous solution
|
$3.83 |
$3.83 |
$3.83 |
$117.82
|
|
Albumin (human), 5%, 250 ml
|
$0.48 |
$0.48 |
$0.48 |
$258.00
|
|
Albumin, human 5 % intravenous solution
|
$1.81 |
$1.81 |
$1.81 |
$125.99
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$260.00 |
$260.00 |
$260.00 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$62.00 |
$62.00 |
$62.00 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$0.33 |
$0.33 |
$0.33 |
$7.43
|
|
Albuterol non-comp con
|
$27.27 |
$27.27 |
$27.27 |
$9.25
|
|
Albuterol non-comp unit
|
$0.32 |
$0.32 |
$0.32 |
$5.28
|
|
Aldesleukin injection
|
$19,430.15 |
$19,430.15 |
$19,430.15 |
$8,460.48
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$81,959.19 |
$81,959.19 |
$81,959.19 |
$30,370.93
|
|
Alkaline phosphatase
|
$90.00 |
$90.00 |
$90.00 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$6.00 |
$6.00 |
$6.00 |
$56.35
|
|
Allergen egg white ige
|
$6.00 |
$6.00 |
$6.00 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$10.00 |
$10.00 |
$10.00 |
$26.95
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,598.07 |
$1,598.07 |
$1,598.07 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$135.00 |
$135.00 |
$135.00 |
$187.20
|
|
Alpha-fetoprotein amniotic
|
$392.00 |
$392.00 |
$392.00 |
$90.03
|
|
Alpha-fetoprotein tumor marker
|
$392.00 |
$392.00 |
$392.00 |
$103.60
|
|
Alprostadil for injection
|
$424.09 |
$424.09 |
$424.09 |
$522.85
|
|
Alteplase 100 mg infusion from pyxis vial
|
$28,799.19 |
$28,799.19 |
$28,799.19 |
$15,857.45
|
|
Alt/sgpt
|
$57.00 |
$57.00 |
$57.00 |
$49.00
|
|
Aluminum - quest
|
$18.00 |
$18.00 |
$18.00 |
$83.05
|
|
Amantadine (symmetrel)-sendout
|
$455.00 |
$455.00 |
$455.00 |
$188.65
|
|
Amifostine
|
$3,508.81 |
$3,508.81 |
$3,508.81 |
$2,507.10
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$3.68 |
$3.68 |
$3.68 |
$44.00
|
|
Amino acid single qual
|
$203.00 |
$203.00 |
$203.00 |
$25.00
|
|
Aminolevulinic acid delta
|
$64.00 |
$64.00 |
$64.00 |
$85.15
|
|
Aminolevulinic acid hcl top
|
$0.04 |
$0.04 |
$0.04 |
$613.42
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$1.30 |
$1.30 |
$1.30 |
$48.29
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$0.62 |
$0.62 |
$0.62 |
$152.84
|
|
Amiodarone 50 mg/ml intravenous solution
|
$1.08 |
$1.08 |
$1.08 |
$58.57
|
|
Amitriptyline (elavil) -sendout
|
$368.00 |
$368.00 |
$368.00 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$1,823.17 |
$1,823.17 |
$1,823.17 |
$11,376.95
|
|
Ammonia
|
$170.00 |
$170.00 |
$170.00 |
$123.48
|
|
Amniocentesisdiagnostic 59000
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$963.79
|
|
Amniocentesis therapeutic
|
$1,271.00 |
$1,271.00 |
$1,271.00 |
$791.05
|
|
Amniotic fluid scan
|
$59.00 |
$59.00 |
$59.00 |
$33.15
|
|
Amobarbital 125 mg inj
|
$2,398.90 |
$2,398.90 |
$2,398.90 |
$1,319.49
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$10,317.00 |
$10,317.00 |
$10,317.00 |
$3,969.00
|
|
Amphetamine confirm urine -sendout
|
$386.00 |
$386.00 |
$386.00 |
$94.50
|
|
Amphetamines 5 or more
|
$300.00 |
$300.00 |
$300.00 |
$93.60
|
