|
11-desoxycortisol - sendout
|
$81.90 |
$81.90 |
$81.90 |
$87.50
|
|
17-hydroxypregnenolone
|
$111.80 |
$111.80 |
$111.80 |
$85.15
|
|
17-ketosteroids
|
$112.45 |
$112.45 |
$112.45 |
$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
|
$969.15 |
$969.15 |
$969.15 |
$1,570.80
|
|
2d tte w or without fol w/con,co
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,088.36
|
|
3d ech img cgen car anomal
|
$391.30 |
$391.30 |
$391.30 |
$669.00
|
|
3d recon without postprocess indpndt
|
$260.00 |
$260.00 |
$260.00 |
$427.34
|
|
5' nucleotidase - sendout
|
$39.65 |
$39.65 |
$39.65 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$102.70 |
$102.70 |
$102.70 |
$97.65
|
|
99394 periodic comp preventive med 12 to 17 years est
|
$157.30 |
$157.30 |
$157.30 |
$147.92
|
|
99397 periodic comp preventive med 65+ years est
|
$157.30 |
$157.30 |
$157.30 |
$176.03
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$133.25 |
$133.25 |
$133.25 |
$52.25
|
|
Abdominal CT scan (with and without contrast)
|
$976.95 |
$976.95 |
$976.95 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$845.65 |
$845.65 |
$845.65 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$714.35 |
$714.35 |
$714.35 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,106.65 |
$2,106.65 |
$2,106.65 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$1,892.15 |
$1,892.15 |
$1,892.15 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$1,678.30 |
$1,678.30 |
$1,678.30 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$733.85 |
$733.85 |
$733.85 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$536.25 |
$536.25 |
$536.25 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$1,480.70 |
$1,480.70 |
$1,480.70 |
$1,170.28
|
|
Abl1 gene
|
$750.75 |
$750.75 |
$750.75 |
$609.93
|
|
Ablate bone tumor(s) cryo perq 20983
|
$3,458.00 |
$3,458.00 |
$3,458.00 |
$7,896.23
|
|
Ablate bone tumor(s) perq
|
$6,384.30 |
$6,384.30 |
$6,384.30 |
$9,812.40
|
|
Ablate pulm tumor perq rf
|
$7,911.80 |
$7,911.80 |
$7,911.80 |
$6,904.15
|
|
Ablation cryo abd perit om
|
$1,868.75 |
$1,868.75 |
$1,868.75 |
$2,555.80
|
|
Ablation cryo adrenal tumor
|
$1,118.00 |
$1,118.00 |
$1,118.00 |
$6,904.15
|
|
Ablation cryo retro lymph node
|
$182.65 |
$182.65 |
$182.65 |
$859.50
|
|
Ablation cryo thigh/knee
|
$2,447.90 |
$2,447.90 |
$2,447.90 |
$386.10
|
|
Ablation of upper extremity nerves rf
|
$487.50 |
$487.50 |
$487.50 |
$987.60
|
|
Abltj mal prst8 tiss hifu
|
$3,955.90 |
$3,955.90 |
$3,955.90 |
$5,077.94
|
|
Abscess drain retroperitoneal surg code
|
$2,684.50 |
$2,684.50 |
$2,684.50 |
$3,053.18
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$6,604.65 |
$6,604.65 |
$6,604.65 |
$3,263.74
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$48.42 |
$48.42 |
$48.42 |
$125.63
|
|
Acetaminophen 120 mg rectal suppository
|
$6.66 |
$6.66 |
$6.66 |
$146.76
|
|
Acetaminophen level
|
$109.85 |
$109.85 |
$109.85 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$100.06 |
$100.06 |
$100.06 |
$133.60
|
|
Acetone qualitative
|
$11.05 |
$11.05 |
$11.05 |
$47.45
|
|
Acetylcholine receptor modulating antibody
|
$182.65 |
$182.65 |
$182.65 |
$65.60
|
|
Acetylcholinesterase assay
|
$331.50 |
$331.50 |
$331.50 |
$106.70
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$27.66 |
$27.66 |
$27.66 |
$323.77
|
|
Acup 1/> wo estim 1st 15 min
|
$26.00 |
$26.00 |
$26.00 |
$42.90
|
|
Acute hepatitis panel
|
$117.00 |
$117.00 |
$117.00 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$30.22 |
$30.22 |
$30.22 |
$50.70
|
|
#acylcarnitineprfl
|
$182.65 |
$182.65 |
$182.65 |
$105.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$74.07 |
$74.07 |
$74.07 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$137.15 |
$137.15 |
$137.15 |
$63.00
|
|
Adh-sendout
|
$122.85 |
$122.85 |
$122.85 |
$109.28
|
|
Adj gastric band via subq port
|
$2,307.50 |
$2,307.50 |
$2,307.50 |
$1,874.60
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$239.49 |
$239.49 |
$239.49 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$149.50 |
$149.50 |
$149.50 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$494.00 |
$494.00 |
$494.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$763.10 |
$763.10 |
$763.10 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$650.00 |
$650.00 |
$650.00 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$149.50 |
$149.50 |
$149.50 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$149.50 |
$149.50 |
$149.50 |
$264.00
|
|
Administration immunization 1 vaccine
|
$65.00 |
$65.00 |
$65.00 |
$70.52
|
|
Administration immunization each additional vaccine
|
$39.00 |
$39.00 |
$39.00 |
$46.23
|
|
Administration vaccine hepatitis b
|
$65.00 |
$65.00 |
$65.00 |
$51.35
|
|
Administration vaccine influenza virus
|
$65.00 |
$65.00 |
$65.00 |
$49.50
|
|
Administration vaccine pneumococcal
|
$65.00 |
$65.00 |
$65.00 |
$51.11
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$20.80 |
$20.80 |
$20.80 |
$41.00
|
|
_afb id by dna probe rflx ast
|
$175.50 |
$175.50 |
$175.50 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$247.65 |
$247.65 |
$247.65 |
$289.60
|
|
Air conduction bilat
|
$79.30 |
$79.30 |
$79.30 |
$106.50
|
|
Air injection into abdomen 49400
|
$1,892.15 |
$1,892.15 |
$1,892.15 |
$531.49
|
|
Albumin body fluid quantitative each specimen
|
$58.50 |
$58.50 |
$58.50 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$136.28 |
$136.28 |
$136.28 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$148.26 |
$148.26 |
$148.26 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$16.25 |
$16.25 |
$16.25 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$12.35 |
$12.35 |
$12.35 |
$43.50
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$177.45 |
$177.45 |
$177.45 |
$93.60
|
|
Alkaline phosphatase
|
$12.35 |
$12.35 |
$12.35 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$304.85 |
$304.85 |
$304.85 |
$56.35
|
|
Allergen egg white ige
|
$23.40 |
$23.40 |
$23.40 |
$41.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$567.03 |
$567.03 |
$567.03 |
$905.18
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$2,021.90 |
$2,021.90 |
$2,021.90 |
$4,101.14
|
|
All tstg perq&iq drugs/biol
|
$152.10 |
$152.10 |
$152.10 |
$64.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,925.27 |
$1,925.27 |
$1,925.27 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$299.65 |
$299.65 |
$299.65 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$112.45 |
$112.45 |
$112.45 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$41.60 |
$41.60 |
$41.60 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$541.29 |
$541.29 |
$541.29 |
$2,600.22
|
|
Alt/sgpt
|
$14.95 |
$14.95 |
$14.95 |
$49.00
|
|
Aluminum - quest
|
$92.30 |
$92.30 |
$92.30 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$425.75 |
$425.75 |
$425.75 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$35.07 |
$35.07 |
$35.07 |
$36.30
|
|
Amino acids quant 2-5
|
$159.90 |
$159.90 |
$159.90 |
$141.00
|
|
Aminolevulinic acid delta
|
$54.60 |
$54.60 |
$54.60 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$45.56 |
$45.56 |
$45.56 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$79.59 |
$79.59 |
$79.59 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$23.56 |
$23.56 |
$23.56 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$106.60 |
$106.60 |
$106.60 |
$101.17
|
|
Ammonia
|
$35.75 |
$35.75 |
$35.75 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$867.10 |
$867.10 |
$867.10 |
$942.60
|
|
Amniocentesis therapeutic
|
$1,146.60 |
$1,146.60 |
$1,146.60 |
$778.57
|
|
Amphetamine confirm urine -sendout
|
$68.90 |
$68.90 |
$68.90 |
$94.50
|
|
Amphetamines 5 or more
|
$263.25 |
$263.25 |
$263.25 |
$101.40
|
