|
11-desoxycortisol - sendout
|
$96.20 |
$97.50 |
$150.00 |
|
|
17-hydroxypregnenolone
|
$92.30 |
$108.55 |
$125.00 |
|
|
2d tee w or without fol w/con,in
|
$2,969.20 |
$2,969.20 |
$3,208.40 |
|
|
2d tte w or without fol w/con,co
|
$996.45 |
$996.45 |
$996.45 |
|
|
2nd order venous cath
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
|
|
3-d radiotherapy plan
|
$3,913.00 |
$3,913.00 |
$34,757.45 |
|
|
3d recon without postprocess indpndt
|
$541.45 |
$722.80 |
$833.00 |
|
|
5' nucleotidase - sendout
|
$65.65 |
$71.50 |
$71.50 |
|
|
88334 ap bill cytologic exam each additional site
|
$38.00 |
$65.65 |
$101.40 |
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,275.33 |
$4,275.33 |
$4,275.33 |
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$60.45 |
$61.75 |
$110.00 |
|
|
Abd aorta w/runoff s&i
|
$3,086.85 |
$4,012.45 |
$4,749.00 |
|
|
Abd/low ext cath 1st
|
$9,954.83 |
$9,954.83 |
$9,954.83 |
|
|
Abd/low ext cath 2nd
|
$11,396.41 |
$11,396.41 |
$11,396.41 |
|
|
Abd/low ext cath 3rd
|
$8,911.57 |
$8,911.57 |
$8,911.57 |
|
|
Abd/low ext cath addl
|
$3,339.05 |
$3,339.05 |
$3,339.05 |
|
|
Abdominal CT scan (with and without contrast)
|
$2,158.00 |
$2,495.35 |
$3,839.00 |
|
|
Abdominal CT scan (with contrast)
|
$1,906.45 |
$2,128.75 |
$3,275.00 |
|
|
Abdominal CT scan (without contrast)
|
$1,652.95 |
$1,763.45 |
$2,713.00 |
|
|
Abdominal MRI (with and without contrast)
|
$2,694.25 |
$3,443.70 |
$4,856.00 |
|
|
Abdominal MRI (with contrast)
|
$2,644.85 |
$2,644.85 |
$2,644.85 |
|
|
Abdominal MRI (without contrast)
|
$2,225.60 |
$2,451.80 |
$3,546.40 |
|
|
Abdominal paracentesis w/image guidance
|
$444.60 |
$444.60 |
$4,798.30 |
|
|
Abdominal Ultrasound (complete)
|
$726.05 |
$800.80 |
$1,199.25 |
|
|
Abdominal Ultrasound (limited)
|
$507.00 |
$512.20 |
$947.05 |
|
|
Abd paracentesis/w/o image guide 49082
|
$360.10 |
$360.10 |
$360.10 |
|
|
Ablation cardiac vagal inputs atrium
|
$5,248.75 |
$5,248.75 |
$5,248.75 |
|
|
Ablation cryo adrenal tumor
|
$3,569.15 |
$3,569.15 |
$3,569.15 |
|
|
Ablation of upper extremity nerves rf
|
$505.70 |
$505.70 |
$1,695.20 |
|
|
Abscess drain retroperitoneal surg code
|
$1,281.80 |
$1,281.80 |
$1,281.80 |
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$47.25 |
$47.25 |
$47.25 |
|
|
Acetaminophen level
|
$99.00 |
$146.90 |
$260.65 |
|
|
Acetazolamide 500 mg solution for injection
|
$153.56 |
$153.56 |
$153.56 |
|
|
Acetone qualitative
|
$31.85 |
$32.50 |
$87.00 |
|
|
Acetylcholine receptor modulating antibody
|
$88.40 |
$96.85 |
$169.00 |
|
|
Acetylcholinesterase assay
|
$161.85 |
$168.35 |
$249.00 |
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$232.95 |
$481.24 |
$536.30 |
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$29.90 |
$29.90 |
$55.25 |
|
|
Actinotherapy uv light
|
$89.05 |
$111.15 |
$171.00 |
|
|
Acute hepatitis panel
|
$196.00 |
$273.00 |
$294.45 |
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$49.22 |
$49.22 |
$102.37 |
|
|
#acylcarnitineprfl
|
$16.90 |
$69.00 |
$124.15 |
|
|
Adapter b 8 channel 10cm
|
$1,638.00 |
$1,638.00 |
$1,638.00 |
|
|
Adenosine 3 mg/250 ml bag for osm
|
$13.12 |
$14.62 |
$234.00 |
|
|
Adh-sendout
|
$118.30 |
$144.95 |
$230.00 |
|
|
Adj gastric band via subq port
|
$2,971.42 |
$2,971.42 |
$2,971.42 |
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$136.99 |
$163.25 |
$242.87 |
|
|
Administration chemotherapy IV infusion each additional hour
|
$300.95 |
$338.00 |
$638.00 |
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$300.95 |
$338.00 |
$638.00 |
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$338.00 |
$361.40 |
$638.00 |
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$253.50 |
$286.00 |
$440.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$110.50 |
$166.40 |
$259.00 |
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$166.40 |
$177.45 |
$273.00 |
|
|
Administration immunization 1 vaccine
|
$67.60 |
$85.80 |
$104.00 |
|
|
Administration immunization each additional component
|
$13.00 |
$13.00 |
$13.00 |
|
|
Administration immunization each additional vaccine
|
$40.30 |
$52.65 |
$81.00 |
|
|
Administration immunization first component each vaccine
|
$34.45 |
$35.10 |
$53.00 |
|
|
Administration vaccine hepatitis b
|
$60.45 |
$70.20 |
$93.00 |
|
|
Administration vaccine influenza virus
|
$25.35 |
$49.40 |
$80.00 |
|
|
Administration vaccine pneumococcal
|
$25.35 |
$52.00 |
$80.00 |
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$19,424.81 |
$19,424.81 |
$19,424.81 |
|
|
Advance care planning each additional 30 min 99498
|
$144.30 |
$144.30 |
$222.00 |
|
|
Aep hearing status deter i&r
|
$261.30 |
$402.00 |
$760.50 |
|
|
Aep neurodiagnostic i&r
|
$261.30 |
$402.00 |
$941.20 |
|
|
Aep thrshld est mlt freq i&r
|
$605.15 |
$929.50 |
$931.00 |
|
|
_afb id by dna probe rflx ast
|
$88.40 |
$101.40 |
$105.00 |
|
|
_afb org id by sequencing rflx ast-sendout
|
$314.60 |
$314.60 |
$391.95 |
|
|
Albumin body fluid quantitative each specimen
|
$15.60 |
$40.95 |
$66.00 |
|
|
Albumin (human), 25%, 50ml
|
$228.15 |
$393.70 |
$438.75 |
|
|
Albumin (human), 5%, 250 ml
|
$227.91 |
$227.91 |
$227.91 |
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$54.60 |
$68.25 |
$105.00 |
|
|
Albumin serum plasma or whole blood
|
$17.55 |
$31.85 |
$63.00 |
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$59.00 |
$113.10 |
$120.90 |
|
|
Alkaline phosphatase
|
$33.15 |
$37.05 |
$57.00 |
|
|
Allergen alpha lactalbumin ige
|
$44.85 |
$45.50 |
$70.00 |
|
|
Allergen egg white ige
|
$55.25 |
$55.90 |
$102.70 |
|
|
Allergen specific ige qual multi scrn ea
|
$22.75 |
$22.75 |
$22.75 |
|
|
Allograft amnioexcel plus 17mm disk
|
$418.60 |
$418.60 |
$418.60 |
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$338.65 |
$388.70 |
$423.15 |
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,652.30 |
$1,652.30 |
$1,652.30 |
|
|
Alpha-fetoprotein amniotic
|
$72.15 |
$79.30 |
$122.00 |
|
|
Alpha-fetoprotein tumor marker
|
$70.20 |
$77.35 |
$92.00 |
|
|
Alprostadil for injection
|
$825.55 |
$825.55 |
$825.55 |
|
|
Alteplase 100 mg infusion from pyxis vial
|
$518.16 |
$25,741.05 |
$36,081.48 |
|
|
Alt/sgpt
|
$22.00 |
$33.15 |
$41.60 |
|
|
Aluminum - quest
|
$90.35 |
$102.70 |
$158.00 |
|
|
Alveoloplasty each quadrant
|
$6,290.44 |
$6,290.44 |
$6,290.44 |
|
|
Alys cplx sp/pn npgt w/prgrm
|
$507.00 |
$507.00 |
$507.00 |
|
|
Amantadine (symmetrel)-sendout
|
$208.00 |
$208.00 |
$208.00 |
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$50.97 |
$50.97 |
$69.71 |
|
|
Amino acid screen, urine
|
$76.05 |
$94.90 |
$146.00 |
|
|
Amino acids quant 2-5
|
$90.35 |
$90.35 |
$91.65 |
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$52.84 |
$52.84 |
$52.84 |
|
|
Aminolevulinic acid delta
|
$110.50 |
$111.80 |
$172.00 |
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$107.20 |
$107.20 |
$107.20 |
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$202.10 |
$225.22 |
$346.50 |
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.76 |
$9.76 |
$15.01 |
|
|
Amitriptyline (elavil) -sendout
|
$59.80 |
$59.80 |
$59.80 |
|
|
Ammonia
|
$85.80 |
$100.10 |
$164.00 |
|
|
Amniocentesisdiagnostic 59000
|
$1,425.45 |
$1,425.45 |
$1,425.45 |
|
