|
11-desoxycortisol - sendout
|
$96.20 |
$96.20 |
$96.20 |
$92.04
|
|
5' nucleotidase - sendout
|
$71.50 |
$71.50 |
$71.50 |
$64.28
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$61.75 |
$61.75 |
$61.75 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,187.90 |
$2,187.90 |
$2,187.90 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$1,933.10 |
$1,933.10 |
$1,933.10 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,675.70 |
$1,675.70 |
$1,675.70 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,443.70 |
$3,443.70 |
$3,443.70 |
$2,713.80
|
|
Abdominal MRI (with contrast)
|
$2,644.85 |
$2,644.85 |
$2,644.85 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$2,451.80 |
$2,451.80 |
$2,451.80 |
$1,883.70
|
|
Abdominal paracentesis w/image guidance
|
$444.60 |
$444.60 |
$444.60 |
$1,637.98
|
|
Abdominal Ultrasound (complete)
|
$800.80 |
$800.80 |
$800.80 |
$740.00
|
|
Abdominal Ultrasound (limited)
|
$510.90 |
$510.90 |
$510.90 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$360.10 |
$360.10 |
$360.10 |
$1,144.26
|
|
Ablation of upper extremity nerves rf
|
$505.70 |
$505.70 |
$505.70 |
$1,364.52
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$47.25 |
$47.25 |
$47.25 |
$47.25
|
|
Acetaminophen level
|
$146.90 |
$146.90 |
$146.90 |
$117.01
|
|
Acetone qualitative
|
$31.85 |
$31.85 |
$31.85 |
$48.10
|
|
Acetylcholine receptor modulating antibody
|
$96.85 |
$96.85 |
$96.85 |
$93.60
|
|
Acetylcholinesterase assay
|
$168.35 |
$168.35 |
$168.35 |
$92.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$232.95 |
$232.95 |
$232.95 |
$406.77
|
|
Acute hepatitis panel
|
$272.35 |
$272.35 |
$272.35 |
$306.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$49.22 |
$49.22 |
$49.22 |
$63.47
|
|
#acylcarnitineprfl
|
$124.15 |
$124.15 |
$124.15 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$13.12 |
$13.12 |
$13.12 |
$116.84
|
|
Adh-sendout
|
$144.95 |
$144.95 |
$144.95 |
$152.10
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$163.25 |
$163.25 |
$163.25 |
$146.59
|
|
Administration chemotherapy IV infusion each additional hour
|
$338.00 |
$338.00 |
$338.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$338.00 |
$338.00 |
$338.00 |
$319.15
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$338.00 |
$338.00 |
$338.00 |
$728.00
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$253.50 |
$253.50 |
$253.50 |
$455.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$166.40 |
$166.40 |
$166.40 |
$223.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$166.40 |
$166.40 |
$166.40 |
$267.43
|
|
Administration immunization 1 vaccine
|
$85.80 |
$85.80 |
$85.80 |
$66.51
|
|
Administration immunization each additional vaccine
|
$53.95 |
$53.95 |
$53.95 |
$46.23
|
|
Administration immunization first component each vaccine
|
$35.10 |
$35.10 |
$35.10 |
$46.00
|
|
Administration vaccine influenza virus
|
$49.40 |
$49.40 |
$49.40 |
$38.25
|
|
Administration vaccine pneumococcal
|
$49.40 |
$49.40 |
$49.40 |
$38.25
|
|
Advance care planning each additional 30 min 99498
|
$144.30 |
$144.30 |
$144.30 |
$134.40
|
|
Albumin body fluid quantitative each specimen
|
$40.95 |
$40.95 |
$40.95 |
$42.25
|
|
Albumin (human), 25%, 50ml
|
$393.70 |
$393.70 |
$393.70 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$59.80 |
$59.80 |
$59.80 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$31.85 |
$31.85 |
$31.85 |
$40.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$113.10 |
$113.10 |
$113.10 |
$78.00
|
|
Alkaline phosphatase
|
$33.15 |
$33.15 |
$33.15 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$44.85 |
$44.85 |
$44.85 |
$56.35
|
|
Allergen egg white ige
|
$55.90 |
$55.90 |
$55.90 |
$41.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$423.15 |
$423.15 |
$423.15 |
$4,343.78
|
|
Alpha-fetoprotein amniotic
|
$72.15 |
$72.15 |
$72.15 |
$102.49
|
|
Alpha-fetoprotein tumor marker
|
$76.70 |
$76.70 |
$76.70 |
$116.35
|
|
Alteplase 100 mg infusion from pyxis vial
|
$25,741.05 |
$25,741.05 |
$25,741.05 |
$630.01
|
|
Alt/sgpt
|
$32.50 |
$32.50 |
$32.50 |
$44.40
|
|
Aluminum - quest
|
$90.35 |
$90.35 |
$90.35 |
$121.25
|
|
Alys cplx sp/pn npgt w/prgrm
|
$507.00 |
$507.00 |
$507.00 |
$431.84
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$50.97 |
$50.97 |
$50.97 |
$44.00
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$202.10 |
$202.10 |
$202.10 |
$195.19
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.76 |
$8.76 |
$8.76 |
$42.80
|
|
Ammonia
|
$99.45 |
$99.45 |
$99.45 |
$96.53
|
|
Ampicillin 1 gram solution for injection
|
$31.08 |
$31.08 |
$31.08 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$30.62 |
$30.62 |
$30.62 |
$37.60
|
|
Amylase
|
$76.70 |
$76.70 |
$76.70 |
$83.20
|
|
Ana ds-dna
|
$75.40 |
$75.40 |
$75.40 |
$69.03
|
|
Anal/urinary muscle study
|
$353.60 |
$353.60 |
$353.60 |
$407.00
|
|
Analysis gene f2 20210g>a variant
|
$271.70 |
$271.70 |
$271.70 |
$253.50
|
|
Analysis gene f5 leiden variant
|
$263.90 |
$263.90 |
$263.90 |
$253.24
|
|
Anaplsma phgcytophlm amp prb
|
$133.90 |
$133.90 |
$133.90 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$90.35 |
$90.35 |
$90.35 |
$103.20
|
|
Ankle X-ray
|
$468.00 |
$468.00 |
$468.00 |
$325.59
|
|
Anora (draw only)
|
$12.35 |
$12.35 |
$12.35 |
$36.00
|
|
Antibody bacterium, not elsewhere specified
|
$48.10 |
$48.10 |
$48.10 |
$61.45
|
|
Antibody elution rbc reference
|
$187.20 |
$187.20 |
$187.20 |
$164.80
|
|
Antibody htlv/hiv confirm test
|
$137.80 |
$137.80 |
$137.80 |
$154.85
|
|
Antibody htlv-i
|
$61.75 |
$61.75 |
$61.75 |
$50.70
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$305.50 |
$305.50 |
$305.50 |
$220.73
|
|
Antibody id rbc panel
|
$198.25 |
$198.25 |
$198.25 |
$265.05
|
|
Antibody influenza virus
|
$76.70 |
$76.70 |
$76.70 |
$63.33
|
|
Antibody screen rbc
|
$109.20 |
$109.20 |
$109.20 |
$99.99
|
|
Anti mog serum - sendout
|
$446.55 |
$446.55 |
$446.55 |
$154.84
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$85.80 |
$85.80 |
$85.80 |
$60.00
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$108.55 |
$108.55 |
$108.55 |
$48.57
|
|
Antinuclear antibodies
|
$91.65 |
$91.65 |
$91.65 |
$98.25
|
|
Antinuclear antibodies titer
|
$53.95 |
$53.95 |
$53.95 |
$76.70
|
|
Antiphosphatidylserine antibody
|
$82.55 |
$82.55 |
$82.55 |
$80.25
|
|
Antistreptolysin o titer
|
$66.95 |
$66.95 |
$66.95 |
$58.50
|
|
Antithrombin iii activity
|
$136.50 |
$136.50 |
$136.50 |
$135.20
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,574.00 |
$2,574.00 |
$2,574.00 |
$1,051.25
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$75.40 |
$75.40 |
$75.40 |
$549.08
|
|
Application finger splntstatic 29130
|
$104.65 |
$104.65 |
$104.65 |
$208.50
|
|
Application long leg splint 29505
|
$236.60 |
$236.60 |
$236.60 |
$338.25
|
|
Application lower leg splint 29515
|
$165.10 |
$165.10 |
$165.10 |
$354.00
|
|
Application multi layer compression below knee (both sides)
|
$377.65 |
$377.65 |
$377.65 |
$393.75
|
|
Application of paste boot 29580
|
$248.30 |
$248.30 |
$248.30 |
$331.74
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$223.60 |
$223.60 |
$223.60 |
$2,109.00
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$118.95 |
$118.95 |
$118.95 |
$2,108.87
|
|
Appl modality 1/> areas paraffin bath 97018
|
$71.50 |
$71.50 |
$71.50 |
$71.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$71.50 |
$71.50 |
$71.50 |
$75.92
|
|
Appl multlay comprs arm/hand
|
$214.50 |
$214.50 |
$214.50 |
$289.60
|
|
#aptt mix-1:1 incubated
|
$125.45 |
$125.45 |
$125.45 |
$157.30
|
|
Aqaprn-4 antb flo cytmtry ea
|
$258.05 |
$258.05 |
$258.05 |
$231.66
|
|
Aquaporin-4 antibody cba each
|
$261.30 |
$261.30 |
$261.30 |
$128.10
|
|
Aquaporin-4 antibody elisa
|
$135.20 |
$135.20 |
$135.20 |
$151.45
|
