|
11-desoxycortisol - sendout
|
$99.45 |
$99.45 |
$99.45 |
$87.50
|
|
17-hydroxypregnenolone
|
$187.20 |
$187.20 |
$187.20 |
$85.15
|
|
17-ketosteroids
|
$282.10 |
$282.10 |
$282.10 |
$44.00
|
|
24 hr ambulatory b/p monitor
|
$379.60 |
$379.60 |
$379.60 |
$319.15
|
|
2d tee w or without fol w/con,in
|
$2,700.75 |
$2,700.75 |
$2,700.75 |
$1,570.80
|
|
2d tte w or without fol w/con,co
|
$2,180.10 |
$2,180.10 |
$2,180.10 |
$1,088.36
|
|
3d ech img cgen car anomal
|
$532.35 |
$532.35 |
$532.35 |
$669.00
|
|
3d recon without postprocess indpndt
|
$492.70 |
$492.70 |
$492.70 |
$427.34
|
|
5' nucleotidase - sendout
|
$3,963.70 |
$3,963.70 |
$3,963.70 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$167.70 |
$167.70 |
$167.70 |
$97.65
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$185.90 |
$185.90 |
$185.90 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$185.90 |
$185.90 |
$185.90 |
$176.03
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,934.18 |
$4,934.18 |
$4,934.18 |
$3,634.61
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$145.60 |
$145.60 |
$145.60 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$1,931.80 |
$1,931.80 |
$1,931.80 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$1,755.65 |
$1,755.65 |
$1,755.65 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,597.05 |
$1,597.05 |
$1,597.05 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,437.50 |
$2,437.50 |
$2,437.50 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$2,057.90 |
$2,057.90 |
$2,057.90 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$1,981.20 |
$1,981.20 |
$1,981.20 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$1,830.40 |
$1,830.40 |
$1,830.40 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$848.90 |
$848.90 |
$848.90 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$564.85 |
$564.85 |
$564.85 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$1,537.90 |
$1,537.90 |
$1,537.90 |
$1,170.28
|
|
Abl1 gene
|
$772.20 |
$772.20 |
$772.20 |
$609.93
|
|
Ablate bone tumor(s) cryo perq 20983
|
$4,863.30 |
$4,863.30 |
$4,863.30 |
$7,896.23
|
|
Ablate bone tumor(s) perq
|
$8,977.80 |
$8,977.80 |
$8,977.80 |
$9,812.40
|
|
Ablate pulm tumor perq rf
|
$9,890.40 |
$9,890.40 |
$9,890.40 |
$6,904.15
|
|
Ablation cryo abd perit om
|
$2,335.45 |
$2,335.45 |
$2,335.45 |
$2,555.80
|
|
Ablation cryo adrenal tumor
|
$1,397.50 |
$1,397.50 |
$1,397.50 |
$6,904.15
|
|
Ablation cryo retro lymph node
|
$228.15 |
$228.15 |
$228.15 |
$859.50
|
|
Ablation cryo thigh/knee
|
$3,058.90 |
$3,058.90 |
$3,058.90 |
$386.10
|
|
Ablation of upper extremity nerves rf
|
$1,827.15 |
$1,827.15 |
$1,827.15 |
$987.60
|
|
Abltj mal prst8 tiss hifu
|
$4,944.55 |
$4,944.55 |
$4,944.55 |
$5,077.94
|
|
Abscess drain retroperitoneal surg code
|
$4,609.80 |
$4,609.80 |
$4,609.80 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$5,943.60 |
$5,943.60 |
$5,943.60 |
$3,263.74
|
|
Acetaminophen level
|
$108.55 |
$108.55 |
$108.55 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$101.30 |
$101.30 |
$101.30 |
$133.60
|
|
Acetone qualitative
|
$49.40 |
$49.40 |
$49.40 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$164.45 |
$164.45 |
$164.45 |
$65.60
|
|
Acetylcholinesterase assay
|
$401.70 |
$401.70 |
$401.70 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$27.66 |
$27.66 |
$27.66 |
$323.77
|
|
Acute hepatitis panel
|
$345.80 |
$345.80 |
$345.80 |
$284.70
|
|
#acylcarnitineprfl
|
$196.30 |
$196.30 |
$196.30 |
$105.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$24.21 |
$24.21 |
$24.21 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$110.50 |
$110.50 |
$110.50 |
$63.00
|
|
Adh-sendout
|
$283.40 |
$283.40 |
$283.40 |
$109.28
|
|
Adj gastric band via subq port
|
$2,884.05 |
$2,884.05 |
$2,884.05 |
$1,874.60
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$202.28 |
$202.28 |
$202.28 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$511.55 |
$511.55 |
$511.55 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$354.25 |
$354.25 |
$354.25 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$701.35 |
$701.35 |
$701.35 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$514.80 |
$514.80 |
$514.80 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$195.00 |
$195.00 |
$195.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$308.75 |
$308.75 |
$308.75 |
$264.00
|
|
Administration immunization 1 vaccine
|
$31.20 |
$31.20 |
$31.20 |
$70.52
|
|
Administration immunization each additional vaccine
|
$31.20 |
$31.20 |
$31.20 |
$46.23
|
|
Administration vaccine hepatitis b
|
$31.20 |
$31.20 |
$31.20 |
$51.35
|
|
Administration vaccine influenza virus
|
$31.20 |
$31.20 |
$31.20 |
$49.50
|
|
Administration vaccine pneumococcal
|
$31.20 |
$31.20 |
$31.20 |
$51.11
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$22.75 |
$22.75 |
$22.75 |
$41.00
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$17,264.68 |
$17,264.68 |
$17,264.68 |
$11,874.55
|
|
_afb id by dna probe rflx ast
|
$130.00 |
$130.00 |
$130.00 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$230.10 |
$230.10 |
$230.10 |
$289.60
|
|
Air conduction bilat
|
$70.85 |
$70.85 |
$70.85 |
$106.50
|
|
Air injection into abdomen 49400
|
$2,660.45 |
$2,660.45 |
$2,660.45 |
$531.49
|
|
Albumin body fluid quantitative each specimen
|
$62.40 |
$62.40 |
$62.40 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$155.45 |
$155.45 |
$155.45 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$89.05 |
$89.05 |
$89.05 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$11.70 |
$11.70 |
$11.70 |
$43.50
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$215.15 |
$215.15 |
$215.15 |
$93.60
|
|
Alkaline phosphatase
|
$11.70 |
$11.70 |
$11.70 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$274.30 |
$274.30 |
$274.30 |
$56.35
|
|
Allergen egg white ige
|
$121.55 |
$121.55 |
$121.55 |
$41.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$567.03 |
$567.03 |
$567.03 |
$905.18
|
|
All tstg perq&iq drugs/biol
|
$136.50 |
$136.50 |
$136.50 |
$64.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,659.38 |
$1,659.38 |
$1,659.38 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$362.70 |
$362.70 |
$362.70 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$135.85 |
$135.85 |
$135.85 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$74.75 |
$74.75 |
$74.75 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$23,242.18 |
$23,242.18 |
$23,242.18 |
$2,600.22
|
|
Alt/sgpt
|
$11.70 |
$11.70 |
$11.70 |
$49.00
|
|
Aluminum - quest
|
$118.30 |
$118.30 |
$118.30 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$422.50 |
$422.50 |
$422.50 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$28.63 |
$28.63 |
$28.63 |
$36.30
|
|
Amino acids quant 2-5
|
$193.70 |
$193.70 |
$193.70 |
$141.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$45.50 |
$45.50 |
$45.50 |
$42.84
|
|
Aminolevulinic acid delta
|
$171.60 |
$171.60 |
$171.60 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$58.92 |
$58.92 |
$58.92 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$125.09 |
$125.09 |
$125.09 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$27.40 |
$27.40 |
$27.40 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$105.30 |
$105.30 |
$105.30 |
$101.17
|
|
Ammonia
|
$266.50 |
$266.50 |
$266.50 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$942.60
|
|
Amniocentesis therapeutic
|
$1,219.40 |
$1,219.40 |
$1,219.40 |
$778.57
|
|
Amphetamine confirm urine -sendout
|
$68.25 |
$68.25 |
$68.25 |
$94.50
|
|
Amphetamines 5 or more
|
$261.30 |
$261.30 |
$261.30 |
$101.40
|
|
Ampicillin 1 gram solution for injection
|
$32.01 |
$32.01 |
$32.01 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$32.53 |
$32.53 |
$32.53 |
$51.93
|
|
Amputation toe interphalangeal joint
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$3,691.20
|
