|
11-desoxycortisol - sendout
|
$96.20 |
$96.20 |
$96.20 |
$92.04
|
|
17-hydroxypregnenolone
|
$92.30 |
$92.30 |
$92.30 |
$96.25
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$61.75 |
$61.75 |
$61.75 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,154.10 |
$2,154.10 |
$2,154.10 |
$2,010.00
|
|
Abdominal CT scan (with contrast)
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$982.80 |
$982.80 |
$982.80 |
$1,331.40
|
|
Abdominal MRI (with and without contrast)
|
$2,694.25 |
$2,694.25 |
$2,694.25 |
$2,713.80
|
|
Abdominal MRI (with contrast)
|
$1,558.05 |
$1,558.05 |
$1,558.05 |
$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 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$493.35 |
$493.35 |
$493.35 |
$740.00
|
|
Abdominal Ultrasound (limited)
|
$381.55 |
$381.55 |
$381.55 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$360.10 |
$360.10 |
$360.10 |
$1,144.26
|
|
Ablation of upper extremity nerves rf
|
$343.85 |
$343.85 |
$343.85 |
$1,408.20
|
|
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
|
$32.50 |
$32.50 |
$32.50 |
$50.05
|
|
Acetylcholine receptor modulating antibody
|
$100.75 |
$100.75 |
$100.75 |
$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 |
$399.38
|
|
Acute hepatitis panel
|
$269.10 |
$269.10 |
$269.10 |
$310.20
|
|
#acylcarnitineprfl
|
$124.15 |
$124.15 |
$124.15 |
$110.25
|
|
Adenosine 3 mg/250 ml bag for osm
|
$13.12 |
$13.12 |
$13.12 |
$97.58
|
|
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 |
$163.25
|
|
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 |
$740.00
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$253.50 |
$253.50 |
$253.50 |
$464.40
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$166.40 |
$166.40 |
$166.40 |
$225.60
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$166.40 |
$166.40 |
$166.40 |
$267.43
|
|
Administration immunization 1 vaccine
|
$80.60 |
$80.60 |
$80.60 |
$67.60
|
|
Administration immunization each additional vaccine
|
$51.35 |
$51.35 |
$51.35 |
$46.23
|
|
Administration immunization first component each vaccine
|
$35.10 |
$35.10 |
$35.10 |
$46.00
|
|
Administration vaccine influenza virus
|
$25.35 |
$25.35 |
$25.35 |
$38.25
|
|
Administration vaccine pneumococcal
|
$52.00 |
$52.00 |
$52.00 |
$38.25
|
|
Advance care planning each additional 30 min 99498
|
$144.30 |
$144.30 |
$144.30 |
$134.40
|
|
Albumin body fluid quantitative each specimen
|
$42.25 |
$42.25 |
$42.25 |
$42.90
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$62.40 |
$62.40 |
$62.40 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$31.85 |
$31.85 |
$31.85 |
$40.95
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$117.65 |
$117.65 |
$117.65 |
$78.00
|
|
Alkaline phosphatase
|
$34.45 |
$34.45 |
$34.45 |
$47.40
|
|
Allergen alpha lactalbumin ige
|
$44.85 |
$44.85 |
$44.85 |
$56.35
|
|
Allergen egg white ige
|
$55.25 |
$55.25 |
$55.25 |
$41.00
|
|
Alpha-fetoprotein amniotic
|
$72.15 |
$72.15 |
$72.15 |
$102.49
|
|
Alpha-fetoprotein tumor marker
|
$79.95 |
$79.95 |
$79.95 |
$124.20
|
|
Alteplase 100 mg infusion from pyxis vial
|
$25,741.05 |
$25,741.05 |
$25,741.05 |
$630.01
|
|
Alt/sgpt
|
$34.45 |
$34.45 |
$34.45 |
$44.68
|
|
Aluminum - quest
|
$91.00 |
$91.00 |
$91.00 |
$121.25
|
|
Amino acids quant 2-5
|
$94.90 |
$94.90 |
$94.90 |
$148.20
|
|
Aminolevulinic acid delta
|
$110.50 |
$110.50 |
$110.50 |
$95.80
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$202.10 |
$202.10 |
$202.10 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.76 |
$8.76 |
$8.76 |
$50.85
|
|
Ammonia
|
$94.25 |
$94.25 |
$94.25 |
$96.53
|
|
Ampicillin 1 gram solution for injection
|
$31.08 |
$31.08 |
$31.08 |
$77.40
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$17.50 |
$17.50 |
$17.50 |
$45.20
|
|
Amylase
|
$65.65 |
$65.65 |
$65.65 |
$87.20
|
|
Ana ds-dna
|
$75.40 |
$75.40 |
$75.40 |
$69.03
|
|
Analysis gene f2 20210g>a variant
|
$271.70 |
$271.70 |
$271.70 |
$253.24
|
|
Analysis gene f5 leiden variant
|
$263.90 |
$263.90 |
$263.90 |
$263.90
|
|
Anaplsma phgcytophlm amp prb
|
$153.40 |
$153.40 |
$153.40 |
$105.00
|
|
Anca screen with reflex to titer -quest
|
$90.35 |
$90.35 |
$90.35 |
$112.45
|
|
Ankle X-ray
|
$221.00 |
$221.00 |
$221.00 |
$330.00
|
|
Anora (draw only)
|
$12.35 |
$12.35 |
$12.35 |
$36.00
|
|
Antibody bacterium, not elsewhere specified
|
$49.40 |
$49.40 |
$49.40 |
$61.45
|
|
Antibody elution rbc reference
|
$187.20 |
$187.20 |
$187.20 |
$169.20
|
|
Antibody htlv/hiv confirm test
|
$137.80 |
$137.80 |
$137.80 |
$161.40
|
|
Antibody htlv-i
|
$61.75 |
$61.75 |
$61.75 |
$50.70
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$305.50 |
$305.50 |
$305.50 |
$227.00
|
|
Antibody id rbc panel
|
$205.40 |
$205.40 |
$205.40 |
$265.05
|
|
Antibody influenza virus
|
$72.15 |
$72.15 |
$72.15 |
$63.70
|
|
Antibody lymphocytic choriomeningitis
|
$68.90 |
$68.90 |
$68.90 |
$57.85
|
|
Antibody screen rbc
|
$102.70 |
$102.70 |
$102.70 |
$102.60
|
|
Anti mog serum - sendout
|
$446.55 |
$446.55 |
$446.55 |
$154.84
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$89.70 |
$89.70 |
$89.70 |
$60.00
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$104.00 |
$104.00 |
$104.00 |
$48.57
|
|
Antinuclear antibodies
|
$83.20 |
$83.20 |
$83.20 |
$98.25
|
|
Antinuclear antibodies titer
|
$66.30 |
$66.30 |
$66.30 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$82.55 |
$82.55 |
$82.55 |
$82.55
|
|
Antistreptolysin o screen
|
$53.95 |
$53.95 |
$53.95 |
$57.20
|
|
Antistreptolysin o titer
|
$63.05 |
$63.05 |
$63.05 |
$60.00
|
|
Antithrombin iii activity
|
$136.50 |
$136.50 |
$136.50 |
$135.20
|
|
Apl(pml-rara) quant - sendout
|
$324.35 |
$324.35 |
$324.35 |
$500.80
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,574.00 |
$2,574.00 |
$2,574.00 |
$1,051.25
|
|
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)
|
$345.15 |
$345.15 |
$345.15 |
$393.75
|
|
Application of paste boot 29580
|
$248.30 |
$248.30 |
$248.30 |
$331.74
|
|
Appl modality 1/> areas paraffin bath 97018
|
$65.00 |
$65.00 |
$65.00 |
$71.50
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$71.50 |
$71.50 |
$71.50 |
$75.98
|
|
Appl multlay comprs arm/hand
|
$214.50 |
$214.50 |
$214.50 |
$289.60
|
|
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
|
$115.05 |
$115.05 |
$115.05 |
$151.45
|
|
Aquatic exercise - group charge
|
$68.25 |
$68.25 |
$68.25 |
$91.87
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$235.30 |
$235.30 |
$235.30 |
$567.78
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$343.85 |
$343.85 |
$343.85 |
$970.61
|
|
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides)
|
$401.05 |
$401.05 |
$401.05 |
$882.70
|
|
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance
|
$229.45 |
$229.45 |
$229.45 |
$453.60
|
