|
17-ketosteroids
|
$123.00 |
$123.00 |
$123.00 |
$44.88
|
|
3d recon without postprocess indpndt
|
$686.00 |
$686.00 |
$686.00 |
$425.10
|
|
5' nucleotidase - sendout
|
$65.00 |
$65.00 |
$65.00 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$197.00 |
$197.00 |
$197.00 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$77.00 |
$77.00 |
$77.00 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$5,301.00 |
$5,301.00 |
$5,301.00 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$4,598.00 |
$4,598.00 |
$4,598.00 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$7,320.00 |
$7,320.00 |
$7,320.00 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$5,821.00 |
$5,821.00 |
$5,821.00 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$4,109.00 |
$4,109.00 |
$4,109.00 |
$1,975.74
|
|
Abdominal paracentesis w/image guidance
|
$1,278.00 |
$1,278.00 |
$1,278.00 |
$1,688.29
|
|
Abdominal Ultrasound (complete)
|
$1,319.00 |
$1,319.00 |
$1,319.00 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$1,088.00 |
$1,088.00 |
$1,088.00 |
$604.43
|
|
Abl1 gene
|
$2,003.00 |
$2,003.00 |
$2,003.00 |
$614.25
|
|
Abscess drain retroperitoneal surg code
|
$5,597.00 |
$5,597.00 |
$5,597.00 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$66.29 |
$66.29 |
$66.29 |
$74.96
|
|
Acetaminophen level
|
$129.00 |
$129.00 |
$129.00 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$117.24 |
$117.24 |
$117.24 |
$120.90
|
|
Acetone qualitative
|
$37.00 |
$37.00 |
$37.00 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$142.00 |
$142.00 |
$142.00 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$57.22 |
$57.22 |
$57.22 |
$306.72
|
|
Acoustic immitance testing
|
$129.00 |
$129.00 |
$129.00 |
$173.18
|
|
Acute hepatitis panel
|
$242.00 |
$242.00 |
$242.00 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$34.91 |
$34.91 |
$34.91 |
$62.48
|
|
Adenosine 3 mg/250 ml bag for osm
|
$344.62 |
$344.62 |
$344.62 |
$268.50
|
|
Adh-sendout
|
$164.00 |
$164.00 |
$164.00 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$30.59 |
$30.59 |
$30.59 |
$172.86
|
|
Administration chemotherapy IV infusion each additional hour
|
$343.00 |
$343.00 |
$343.00 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$294.00 |
$294.00 |
$294.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$967.00 |
$967.00 |
$967.00 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$344.00 |
$344.00 |
$344.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$344.00 |
$344.00 |
$344.00 |
$267.43
|
|
Administration immunization 1 vaccine
|
$183.00 |
$183.00 |
$183.00 |
$70.00
|
|
Administration immunization each additional vaccine
|
$183.00 |
$183.00 |
$183.00 |
$46.23
|
|
Administration immunization first component each vaccine
|
$81.00 |
$81.00 |
$81.00 |
$45.50
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$56.00 |
$56.00 |
$56.00 |
$48.00
|
|
Administration vaccine hepatitis b
|
$399.00 |
$399.00 |
$399.00 |
$54.60
|
|
Administration vaccine influenza virus
|
$258.06 |
$258.06 |
$258.06 |
$48.35
|
|
Adrenalin epinephrine inject
|
$64.03 |
$64.03 |
$64.03 |
$108.60
|
|
Aep neurodiagnostic i&r
|
$2,192.00 |
$2,192.00 |
$2,192.00 |
$509.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$707.00 |
$707.00 |
$707.00 |
$289.60
|
|
Air conduction bilat
|
$701.00 |
$701.00 |
$701.00 |
$116.22
|
|
Albumin body fluid quantitative each specimen
|
$49.00 |
$49.00 |
$49.00 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$732.70 |
$732.70 |
$732.70 |
$256.84
|
|
Albumin, human 25 % intravenous solution
|
$488.08 |
$488.08 |
$488.08 |
$117.82
|
|
Albumin (human), 5%, 250 ml
|
$781.06 |
$781.06 |
$781.06 |
$258.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$111.00 |
$111.00 |
$111.00 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$63.00 |
$63.00 |
$63.00 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$32.29 |
$32.29 |
$32.29 |
$7.43
|
|
Albuterol non-comp unit
|
$8.65 |
$8.65 |
$8.65 |
$5.28
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$108.00 |
$108.00 |
$108.00 |
$94.90
|
|
Alkaline phosphatase
|
$46.00 |
$46.00 |
$46.00 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$217.00 |
$217.00 |
$217.00 |
$56.35
|
|
Allergen egg white ige
|
$75.00 |
$75.00 |
$75.00 |
$39.78
|
|
Allergen specific ige qual multi scrn ea
|
$75.00 |
$75.00 |
$75.00 |
$26.95
|
|
Allergy injections; 2 or more 95117
|
$314.00 |
$314.00 |
$314.00 |
$47.20
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$934.76 |
$934.76 |
$934.76 |
$4,906.77
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$700.00 |
$700.00 |
$700.00 |
$187.20
|
|
Alpha-fetoprotein tumor marker
|
$259.00 |
$259.00 |
$259.00 |
$103.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$346.29 |
$346.29 |
$346.29 |
$15,857.45
|
|
Alt/sgpt
|
$91.00 |
$91.00 |
$91.00 |
$49.00
|
|
Aluminum - quest
|
$243.00 |
$243.00 |
$243.00 |
$83.05
|
|
Alys cplx sp/pn npgt w/prgrm
|
$982.00 |
$982.00 |
$982.00 |
$431.84
|
|
Amantadine (symmetrel)-sendout
|
$98.00 |
$98.00 |
$98.00 |
$188.65
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$28.28 |
$28.28 |
$28.28 |
$48.29
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$219.32 |
$219.32 |
$219.32 |
$152.84
|
|
Amiodarone 50 mg/ml intravenous solution
|
$49.49 |
$49.49 |
$49.49 |
$58.57
|
|
Amitriptyline (elavil) -sendout
|
$49.00 |
$49.00 |
$49.00 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$53,555.52 |
$53,555.52 |
$53,555.52 |
$11,376.95
|
|
Ammonia
|
$107.00 |
$107.00 |
$107.00 |
$123.48
|
|
Amphetamine confirm urine -sendout
|
$49.00 |
$49.00 |
$49.00 |
$94.50
|
|
Amphetamines 5 or more
|
$165.00 |
$165.00 |
$165.00 |
$93.60
|
|
Ampicillin 1 gram solution for injection
|
$47.83 |
$47.83 |
$47.83 |
$63.06
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$77.98 |
$77.98 |
$77.98 |
$56.63
|
|
Amputation toe interphalangeal joint
|
$21,238.00 |
$21,238.00 |
$21,238.00 |
$3,839.54
|
|
Amylase
|
$218.00 |
$218.00 |
$218.00 |
$93.00
|
|
Anal/urinary muscle study
|
$985.00 |
$985.00 |
$985.00 |
$407.00
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$291.00 |
$291.00 |
$291.00 |
$340.47
|
|
Analysis gene f2 20210g>a variant
|
$767.00 |
$767.00 |
$767.00 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$857.00 |
$857.00 |
$857.00 |
$226.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$102.00 |
$102.00 |
$102.00 |
$122.20
|
|
Anaplsma phgcytophlm amp prb
|
$119.00 |
$119.00 |
$119.00 |
$95.45
|
|
Anca screen with reflex to titer -quest
|
$163.00 |
$163.00 |
$163.00 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$2,426.60
|
|
An fluoro guide for cvp
|
$568.00 |
$568.00 |
$568.00 |
$509.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$14,390.64 |
$14,390.64 |
$14,390.64 |
$5,128.65
|
|
Ankle X-ray
|
$491.00 |
$491.00 |
$491.00 |
$350.85
|
|
Antibody elution rbc reference
|
$480.00 |
$480.00 |
$480.00 |
$179.62
|
|
Antibody htlv/hiv confirm test
|
$215.00 |
$215.00 |
$215.00 |
$141.26
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$495.00 |
$495.00 |
$495.00 |
$218.30
|
|
Antibody id rbc panel
|
$312.00 |
$312.00 |
$312.00 |
$291.75
|
|
Antibody screen rbc
|
$123.00 |
$123.00 |
$123.00 |
$105.00
|
|
Antidepressant not specified
|
$45.00 |
$45.00 |
$45.00 |
$89.50
|
|
Anti mog serum - sendout
|
$425.00 |
$425.00 |
$425.00 |
$142.29
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$38.00 |
$38.00 |
$38.00 |
$50.88
|
|
Antinuclear antibodies
|
$138.00 |
$138.00 |
$138.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$138.00 |
$138.00 |
$138.00 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$175.00 |
$175.00 |
$175.00 |
$74.20
|
