|
11-desoxycortisol - sendout
|
$176.55 |
$176.55 |
$176.55 |
$87.50
|
|
17-hydroxypregnenolone
|
$166.65 |
$166.65 |
$166.65 |
$87.50
|
|
2d tee w or without fol w/con,in
|
$1,171.50 |
$1,171.50 |
$1,171.50 |
$1,771.25
|
|
2nd order venous cath
|
$716.65 |
$716.65 |
$716.65 |
$1,809.60
|
|
3-d radiotherapy plan
|
$1,975.60 |
$1,975.60 |
$1,975.60 |
$4,953.00
|
|
3d recon without postprocess indpndt
|
$260.70 |
$260.70 |
$260.70 |
$431.75
|
|
5' nucleotidase - sendout
|
$68.20 |
$68.20 |
$68.20 |
$51.19
|
|
88334 ap bill cytologic exam each additional site
|
$59.40 |
$59.40 |
$59.40 |
$97.65
|
|
99392 periodic comp preventive med 1 to 4 years est
|
$106.13 |
$106.13 |
$106.13 |
$139.32
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$26.40 |
$26.40 |
$26.40 |
$52.47
|
|
Abd aorta w/runoff s&i
|
$2,428.25 |
$2,428.25 |
$2,428.25 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$1,006.50 |
$1,006.50 |
$1,006.50 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$798.60 |
$798.60 |
$798.60 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$1,006.50 |
$1,006.50 |
$1,006.50 |
$3,050.58
|
|
Abd/low ext cath addl
|
$135.85 |
$135.85 |
$135.85 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$1,783.10 |
$1,783.10 |
$1,783.10 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$1,647.25 |
$1,647.25 |
$1,647.25 |
$1,704.75
|
|
Abdominal CT scan (without contrast)
|
$1,234.20 |
$1,234.20 |
$1,234.20 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,861.10 |
$2,861.10 |
$2,861.10 |
$2,923.05
|
|
Abdominal MRI (without contrast)
|
$1,574.10 |
$1,574.10 |
$1,574.10 |
$1,979.51
|
|
Abdominal paracentesis w/image guidance
|
$797.50 |
$797.50 |
$797.50 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$629.20 |
$629.20 |
$629.20 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$504.35 |
$504.35 |
$504.35 |
$604.43
|
|
Abd paracentesis/w/o image guide 49082
|
$761.75 |
$761.75 |
$761.75 |
$1,176.00
|
|
Ablation cardiac vagal inputs atrium
|
$1,735.25 |
$1,735.25 |
$1,735.25 |
$3,812.17
|
|
Ablation cryo thigh/knee
|
$828.85 |
$828.85 |
$828.85 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$495.55 |
$495.55 |
$495.55 |
$1,164.00
|
|
Abscess drain retroperitoneal surg code
|
$2,265.45 |
$2,265.45 |
$2,265.45 |
$3,053.18
|
|
Acetylcholine receptor modulating antibody
|
$7.15 |
$7.15 |
$7.15 |
$67.50
|
|
Acute hepatitis panel
|
$250.25 |
$250.25 |
$250.25 |
$286.05
|
|
Adenovirus antibody,serum - quest
|
$86.90 |
$86.90 |
$86.90 |
$63.00
|
|
Adh-sendout
|
$42.35 |
$42.35 |
$42.35 |
$109.71
|
|
Administration chemotherapy IV infusion each additional hour
|
$214.50 |
$214.50 |
$214.50 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$178.75 |
$178.75 |
$178.75 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$344.85 |
$344.85 |
$344.85 |
$677.05
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$398.75 |
$398.75 |
$398.75 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$83.05 |
$83.05 |
$83.05 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$84.15 |
$84.15 |
$84.15 |
$267.43
|
|
Administration immunization 1 vaccine
|
$117.15 |
$117.15 |
$117.15 |
$69.21
|
|
Administration immunization each additional vaccine
|
$70.40 |
$70.40 |
$70.40 |
$46.23
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$34.32 |
$34.32 |
$34.32 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$17.82 |
$17.82 |
$17.82 |
$33.60
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$19.25 |
$19.25 |
$19.25 |
$41.15
|
|
Administration vaccine hepatitis b
|
$55.00 |
$55.00 |
$55.00 |
$45.60
|
|
Administration vaccine influenza virus
|
$30.25 |
$30.25 |
$30.25 |
$46.80
|
|
Administration vaccine pneumococcal
|
$30.25 |
$30.25 |
$30.25 |
$49.40
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$11.55 |
$11.55 |
$11.55 |
$41.00
|
|
_afb id by dna probe rflx ast
|
$330.00 |
$330.00 |
$330.00 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$609.81 |
$609.81 |
$609.81 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$48.95 |
$48.95 |
$48.95 |
$49.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$63.80 |
$63.80 |
$63.80 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$55.55 |
$55.55 |
$55.55 |
$43.50
|
|
Alkaline phosphatase
|
$53.35 |
$53.35 |
$53.35 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$141.02 |
$141.02 |
$141.02 |
$59.12
|
|
Allergen egg white ige
|
$20.35 |
$20.35 |
$20.35 |
$41.60
|
|
Allergen specific ige qual multi scrn ea
|
$4.40 |
$4.40 |
$4.40 |
$28.05
|
|
Allergy injections; 2 or more 95117
|
$13.86 |
$13.86 |
$13.86 |
$44.14
|
|
Allergy injection; single 95115
|
$12.54 |
$12.54 |
$12.54 |
$42.75
|
|
Alpha-fetoprotein amniotic
|
$20.90 |
$20.90 |
$20.90 |
$90.03
|
|
Alpha-fetoprotein tumor marker
|
$140.25 |
$140.25 |
$140.25 |
$106.40
|
|
Alt/sgpt
|
$53.35 |
$53.35 |
$53.35 |
$50.05
|
|
Aluminum - quest
|
$141.90 |
$141.90 |
$141.90 |
$91.00
|
|
Amantadine (symmetrel)-sendout
|
$515.35 |
$515.35 |
$515.35 |
$198.61
|
|
Aminolevulinic acid delta
|
$105.60 |
$105.60 |
$105.60 |
$95.80
|
|
Amitriptyline (elavil) -sendout
|
$228.25 |
$228.25 |
$228.25 |
$101.17
|
|
Ammonia
|
$59.40 |
$59.40 |
$59.40 |
$124.79
|
|
Amphetamine confirm urine -sendout
|
$144.65 |
$144.65 |
$144.65 |
$94.50
|
|
Amphetamines 5 or more
|
$113.30 |
$113.30 |
$113.30 |
$101.40
|
|
Amylase
|
$226.05 |
$226.05 |
$226.05 |
$96.60
|
|
Ana ds-dna
|
$37.40 |
$37.40 |
$37.40 |
$69.03
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$129.80 |
$129.80 |
$129.80 |
$113.28
|
|
Analysis gene f2 20210g>a variant
|
$202.40 |
$202.40 |
$202.40 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$111.10 |
$111.10 |
$111.10 |
$241.20
|
|
Analysis tumor
|
$228.80 |
$228.80 |
$228.80 |
$248.80
|
|
Anca screen with reflex to titer -quest
|
$180.40 |
$180.40 |
$180.40 |
$112.45
|
|
An fluoro guide for cvp
|
$203.50 |
$203.50 |
$203.50 |
$484.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$4,737.70 |
$4,737.70 |
$4,737.70 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$5,415.30 |
$5,415.30 |
$5,415.30 |
$10,344.88
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$4,003.45 |
$4,003.45 |
$4,003.45 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$4,984.10 |
$4,984.10 |
$4,984.10 |
$6,513.10
|
|
Angio tib/peroneal/init ves/unila 37228
|
$9,303.25 |
$9,303.25 |
$9,303.25 |
$12,672.89
|
|
Angio trnslmnl balloon same artery ea addl
|
$5,130.95 |
$5,130.95 |
$5,130.95 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$7,104.90 |
$7,104.90 |
$7,104.90 |
$9,275.00
|
|
Angio trnslmnl balloon same vein ea addl
|
$5,130.95 |
$5,130.95 |
$5,130.95 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$7,104.90 |
$7,104.90 |
$7,104.90 |
$8,766.15
|
|
Ankle X-ray
|
$338.25 |
$338.25 |
$338.25 |
$351.20
|
|
Annual Physical, Established Patient (age 40-64)
|
$127.51 |
$127.51 |
$127.51 |
$167.25
|
|
Antibody elution rbc reference
|
$95.15 |
$95.15 |
$95.15 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$85.25 |
$85.25 |
$85.25 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$287.65 |
$287.65 |
$287.65 |
$225.75
|
|
Antibody id rbc panel
|
$176.55 |
$176.55 |
$176.55 |
$283.80
|
|
Antibody influenza virus
|
$53.90 |
$53.90 |
$53.90 |
$54.06
|
|
Antibody lymphocytic choriomeningitis
|
$14.85 |
$14.85 |
$14.85 |
$57.85
|
|
Antibody screen rbc
|
$110.00 |
$110.00 |
$110.00 |
$107.40
|
|
Antidepressant not specified
|
$166.10 |
$166.10 |
$166.10 |
$89.50
|
|
Antigen therapy services
|
$19.93 |
$19.93 |
$19.93 |
$64.39
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$100.65 |
$100.65 |
$100.65 |
$50.88
|
|
Antinuclear antibodies
|
$31.90 |
$31.90 |
$31.90 |
$96.20
|
|
Antinuclear antibodies titer
|
$31.90 |
$31.90 |
$31.90 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$14.85 |
$14.85 |
$14.85 |
$79.20
|
