|
17-hydroxypregnenolone
|
$95.20 |
$95.20 |
$95.20 |
$90.90
|
|
3-d radiotherapy plan
|
$8,770.40 |
$8,770.40 |
$8,770.40 |
$4,965.20
|
|
3d recon without postprocess indpndt
|
$332.80 |
$332.80 |
$332.80 |
$505.05
|
|
5% dextrose and 0.45% saline
|
$75.60 |
$75.60 |
$75.60 |
$48.00
|
|
5' nucleotidase - sendout
|
$46.40 |
$46.40 |
$46.40 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$145.60 |
$145.60 |
$145.60 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$49.60 |
$49.60 |
$49.60 |
$53.90
|
|
Abdominal CT scan (with and without contrast)
|
$560.00 |
$560.00 |
$560.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$468.50 |
$468.50 |
$468.50 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$273.50 |
$273.50 |
$273.50 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$706.00 |
$706.00 |
$706.00 |
$2,967.00
|
|
Abdominal MRI (without contrast)
|
$457.00 |
$457.00 |
$457.00 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,440.80 |
$1,440.80 |
$1,440.80 |
$1,636.80
|
|
Abdominal Ultrasound (complete)
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$785.25
|
|
Abdominal Ultrasound (limited)
|
$910.40 |
$910.40 |
$910.40 |
$581.10
|
|
Abd paracentesis/w/o image guide 49082
|
$852.80 |
$852.80 |
$852.80 |
$1,145.00
|
|
Ablation cardiac vagal inputs atrium
|
$14,256.80 |
$14,256.80 |
$14,256.80 |
$2,260.30
|
|
Abscess drain retroperitoneal surg code
|
$2,611.20 |
$2,611.20 |
$2,611.20 |
$2,999.34
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$62.00 |
$62.00 |
$62.00 |
$73.44
|
|
Acetaminophen 120 mg rectal suppository
|
$183.60 |
$183.60 |
$183.60 |
$75.09
|
|
Acetazolamide 500 mg solution for injection
|
$280.60 |
$280.60 |
$280.60 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$49.60 |
$49.60 |
$49.60 |
$66.28
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$200.00 |
$200.00 |
$200.00 |
$224.98
|
|
Actinotherapy uv light
|
$390.40 |
$390.40 |
$390.40 |
$105.60
|
|
Acute hepatitis panel
|
$198.40 |
$198.40 |
$198.40 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$36.00 |
$36.00 |
$36.00 |
$64.15
|
|
#acylcarnitineprfl
|
$68.80 |
$68.80 |
$68.80 |
$118.85
|
|
Adenosine 3 mg/250 ml bag for osm
|
$61.00 |
$61.00 |
$61.00 |
$272.57
|
|
Adenovirus antibody,serum - quest
|
$53.60 |
$53.60 |
$53.60 |
$58.00
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$1,877.60 |
$1,877.60 |
$1,877.60 |
$197.05
|
|
Administration chemotherapy IV infusion each additional hour
|
$268.80 |
$268.80 |
$268.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$268.80 |
$268.80 |
$268.80 |
$298.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$292.00 |
$292.00 |
$292.00 |
$647.50
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$173.60 |
$173.60 |
$173.60 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$120.80 |
$120.80 |
$120.80 |
$210.96
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$120.80 |
$120.80 |
$120.80 |
$254.40
|
|
Administration immunization 1 vaccine
|
$25.60 |
$25.60 |
$25.60 |
$67.60
|
|
Administration immunization each additional vaccine
|
$25.60 |
$25.60 |
$25.60 |
$46.89
|
|
Administration vaccine hepatitis b
|
$23.20 |
$23.20 |
$23.20 |
$51.80
|
|
Administration vaccine influenza virus
|
$17.60 |
$17.60 |
$17.60 |
$48.73
|
|
Administration vaccine pneumococcal
|
$17.60 |
$17.60 |
$17.60 |
$48.73
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$113.60 |
$113.60 |
$113.60 |
$41.45
|
|
_afb org id by sequencing rflx ast-sendout
|
$480.00 |
$480.00 |
$480.00 |
$293.02
|
|
Albumin body fluid quantitative each specimen
|
$32.80 |
$32.80 |
$32.80 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$217.40 |
$217.40 |
$217.40 |
$235.92
|
|
Albumin (human), 5%, 250 ml
|
$163.20 |
$163.20 |
$163.20 |
$246.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$24.00 |
$24.00 |
$24.00 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$20.80 |
$20.80 |
$20.80 |
$42.40
|
|
Alkaline phosphatase
|
$21.60 |
$21.60 |
$21.60 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$75.20 |
$75.20 |
$75.20 |
$48.57
|
|
Allergen egg white ige
|
$21.60 |
$21.60 |
$21.60 |
$37.20
|
|
Alpha-fetoprotein tumor marker
|
$69.60 |
$69.60 |
$69.60 |
$103.80
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,077.00 |
$1,077.00 |
$1,077.00 |
$15,857.45
|
|
Alt/sgpt
|
$22.40 |
$22.40 |
$22.40 |
$47.40
|
|
Aluminum - quest
|
$104.00 |
$104.00 |
$104.00 |
$81.49
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$59.00 |
$59.00 |
$59.00 |
$40.40
|
|
Amino acid screen, urine
|
$56.00 |
$56.00 |
$56.00 |
$77.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$147.00 |
$147.00 |
$147.00 |
$37.33
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$114.80 |
$114.80 |
$114.80 |
$46.24
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$270.80 |
$270.80 |
$270.80 |
$114.96
|
|
Amiodarone 50 mg/ml intravenous solution
|
$55.00 |
$55.00 |
$55.00 |
$55.86
|
|
Ammonia
|
$60.80 |
$60.80 |
$60.80 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$892.00 |
$892.00 |
$892.00 |
$923.50
|
|
Ampicillin 1 gram solution for injection
|
$66.60 |
$66.60 |
$66.60 |
$58.35
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$135.40 |
$135.40 |
$135.40 |
$54.57
|
|
Amylase
|
$26.40 |
$26.40 |
$26.40 |
$89.04
|
|
Analysis gene f2 20210g>a variant
|
$268.00 |
$268.00 |
$268.00 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$299.20 |
$299.20 |
$299.20 |
$237.60
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$75.20 |
$75.20 |
$75.20 |
$123.84
|
|
Anaplsma phgcytophlm amp prb
|
$162.40 |
$162.40 |
$162.40 |
$82.65
|
|
Anca screen with reflex to titer -quest
|
$62.40 |
$62.40 |
$62.40 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$1,526.40 |
$1,526.40 |
$1,526.40 |
$2,494.35
|
|
An fluoro guide for cvp
|
$824.80 |
$824.80 |
$824.80 |
$515.00
|
|
Ankle X-ray
|
$291.20 |
$291.20 |
$291.20 |
$352.80
|
|
Anodyne therapy charges pt
|
$164.80 |
$164.80 |
$164.80 |
$42.00
|
|
Antibody bacterium, not elsewhere specified
|
$53.60 |
$53.60 |
$53.60 |
$57.81
|
|
Antibody elution rbc reference
|
$141.60 |
$141.60 |
$141.60 |
$175.50
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$120.00 |
$120.00 |
$120.00 |
$219.30
|
|
Antibody id rbc panel
|
$1,403.20 |
$1,403.20 |
$1,403.20 |
$290.21
|
|
Antibody screen rbc
|
$208.80 |
$208.80 |
$208.80 |
$106.88
|
|
Antibody tetanus
|
$61.60 |
$61.60 |
$61.60 |
$54.00
|
|
Anti mog serum - sendout
|
$49.60 |
$49.60 |
$49.60 |
$133.50
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$49.60 |
$49.60 |
$49.60 |
$37.58
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$49.60 |
$49.60 |
$49.60 |
$42.00
|
|
Antinuclear antibodies
|
$49.60 |
$49.60 |
$49.60 |
$90.00
|
|
Antinuclear antibodies titer
|
$46.40 |
$46.40 |
$46.40 |
$79.86
|
|
Antistreptolysin o titer
|
$30.40 |
$30.40 |
$30.40 |
$52.50
|
|
Antithrombin iii activity
|
$54.40 |
$54.40 |
$54.40 |
$114.00
|
|
Apl(pml-rara) quant - sendout
|
$862.40 |
$862.40 |
$862.40 |
$500.80
|
|
Application finger splntstatic 29130
|
$415.20 |
$415.20 |
$415.20 |
$208.50
|
|
Application long leg splint 29505
|
$375.20 |
$375.20 |
$375.20 |
$338.25
|
|
Application lower leg splint 29515
|
$375.20 |
$375.20 |
$375.20 |
$334.20
|
|
Application of paste boot 29580
|
$175.20 |
$175.20 |
$175.20 |
$336.00
|
|
Appl modality 1/> areas paraffin bath 97018
|
$103.20 |
$103.20 |
$103.20 |
$68.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$189.60 |
$189.60 |
$189.60 |
$76.80
|
|
Aquaporin-4 antibody cba each
|
$52.80 |
$52.80 |
$52.80 |
$140.84
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$118.40 |
$118.40 |
$118.40 |
$100.00
|
|
Argatroban nonesrd use 1mg
|
$694.60 |
$694.60 |
$694.60 |
$881.10
|
|
Arterial blood draw/perc 36620
|
$1,788.00 |
$1,788.00 |
$1,788.00 |
$485.69
|
|
Artery x-rays arm/leg 75710-26
|
$6,960.00 |
$6,960.00 |
$6,960.00 |
$3,483.84
|
