|
17-hydroxypregnenolone
|
$508.20 |
$508.20 |
$508.20 |
$92.65
|
|
24 hr ambulatory b/p monitor
|
$150.60 |
$150.60 |
$150.60 |
$313.04
|
|
2d tee w or without fol w/con,in
|
$2,431.20 |
$2,431.20 |
$2,431.20 |
$1,724.25
|
|
2d tte w or without fol w/con,co
|
$2,434.80 |
$2,434.80 |
$2,434.80 |
$1,284.00
|
|
2nd order venous cath
|
$8,284.80 |
$8,284.80 |
$8,284.80 |
$1,532.04
|
|
3-d radiotherapy plan
|
$6,364.20 |
$6,364.20 |
$6,364.20 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$148.80 |
$148.80 |
$148.80 |
$48.00
|
|
5% dextrose with potassium
|
$204.00 |
$204.00 |
$204.00 |
$85.20
|
|
5' nucleotidase - sendout
|
$166.20 |
$166.20 |
$166.20 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$175.80 |
$175.80 |
$175.80 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$228.00 |
$228.00 |
$228.00 |
$3,138.72
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$260.40 |
$260.40 |
$260.40 |
$53.95
|
|
Abd/low ext cath 1st
|
$3,504.60 |
$3,504.60 |
$3,504.60 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$4,642.20 |
$4,642.20 |
$4,642.20 |
$2,016.00
|
|
Abd/low ext cath 3rd
|
$5,161.80 |
$5,161.80 |
$5,161.80 |
$2,475.45
|
|
Abd/low ext cath addl
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$913.75
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,066.80 |
$1,066.80 |
$1,066.80 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$712.20 |
$712.20 |
$712.20 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$3,242.40 |
$3,242.40 |
$3,242.40 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,917.20 |
$2,917.20 |
$2,917.20 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,863.00 |
$1,863.00 |
$1,863.00 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$6,218.40 |
$6,218.40 |
$6,218.40 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$4,742.40 |
$4,742.40 |
$4,742.40 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$3,940.80 |
$3,940.80 |
$3,940.80 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$2,540.40 |
$2,540.40 |
$2,540.40 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$897.00 |
$897.00 |
$897.00 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$436.20 |
$436.20 |
$436.20 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$732.60 |
$732.60 |
$732.60 |
$418.63
|
|
Abdominal X-ray (single view)
|
$436.20 |
$436.20 |
$436.20 |
$260.00
|
|
Abd paracentesis/w/o image guide 49082
|
$2,243.40 |
$2,243.40 |
$2,243.40 |
$1,148.40
|
|
Abl1 gene
|
$3,340.80 |
$3,340.80 |
$3,340.80 |
$683.20
|
|
Ablate bone tumor(s) cryo perq 20983
|
$25,249.80 |
$25,249.80 |
$25,249.80 |
$9,290.70
|
|
Ablate bone tumor(s) perq
|
$39,336.00 |
$39,336.00 |
$39,336.00 |
$9,511.44
|
|
Ablation of upper extremity nerves rf
|
$987.60 |
$987.60 |
$987.60 |
$832.50
|
|
Abobotulinumtoxina
|
$64.60 |
$64.60 |
$64.60 |
$1,541.21
|
|
Abscess drain retroperitoneal surg code
|
$7,281.60 |
$7,281.60 |
$7,281.60 |
$3,050.40
|
|
Absorpt drg >16<=48 in w/bdr
|
$1.80 |
$1.80 |
$1.80 |
$5.99
|
|
Absorpt drg <=16 sq in w/bdr
|
$16.80 |
$16.80 |
$16.80 |
$13.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$0.80 |
$0.80 |
$0.80 |
$72.74
|
|
Acetazolamide 500 mg solution for injection
|
$301.60 |
$301.60 |
$301.60 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$284.40 |
$284.40 |
$284.40 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$108.00 |
$108.00 |
$108.00 |
$31.21
|
|
Acute hepatitis panel
|
$976.80 |
$976.80 |
$976.80 |
$284.95
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$627.00 |
$627.00 |
$627.00 |
$64.45
|
|
#acylcarnitineprfl
|
$180.60 |
$180.60 |
$180.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$6,523.80 |
$6,523.80 |
$6,523.80 |
$5,109.58
|
|
Adenosine 3 mg/250 ml bag for osm
|
$240.00 |
$240.00 |
$240.00 |
$271.98
|
|
Adenovirus antibody,serum - quest
|
$192.00 |
$192.00 |
$192.00 |
$58.00
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$400.00 |
$400.00 |
$400.00 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$371.40 |
$371.40 |
$371.40 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$799.20 |
$799.20 |
$799.20 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,632.60 |
$1,632.60 |
$1,632.60 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,159.80 |
$1,159.80 |
$1,159.80 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$505.20 |
$505.20 |
$505.20 |
$256.49
|
|
Administration immunization each additional vaccine
|
$12.00 |
$12.00 |
$12.00 |
$47.40
|
|
Administration vaccine hepatitis b
|
$12.00 |
$12.00 |
$12.00 |
$53.00
|
|
Administration vaccine influenza virus
|
$12.00 |
$12.00 |
$12.00 |
$51.07
|
|
Administration vaccine pneumococcal
|
$12.00 |
$12.00 |
$12.00 |
$49.68
|
|
Adrenalin epinephrine inject
|
$89.40 |
$89.40 |
$89.40 |
$231.47
|
|
_afb id by dna probe rflx ast
|
$201.00 |
$201.00 |
$201.00 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$1,253.40 |
$1,253.40 |
$1,253.40 |
$300.00
|
|
Agalsidase beta 35 mg intravenous solution
|
$2,305.60 |
$2,305.60 |
$2,305.60 |
$14,475.20
|
|
Albumin body fluid quantitative each specimen
|
$34.20 |
$34.20 |
$34.20 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$1,898.40 |
$1,898.40 |
$1,898.40 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$922.40 |
$922.40 |
$922.40 |
$252.77
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$85.80 |
$85.80 |
$85.80 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$74.40 |
$74.40 |
$74.40 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$8.60 |
$8.60 |
$8.60 |
$5.67
|
|
Albuterol non-comp con
|
$0.80 |
$0.80 |
$0.80 |
$6.07
|
|
Albuterol non-comp unit
|
$34.00 |
$34.00 |
$34.00 |
$5.40
|
|
Alcohol/subs interv 15-30mn
|
$382.20 |
$382.20 |
$382.20 |
$56.70
|
|
Alginate dressing <=16 sq in
|
$78.60 |
$78.60 |
$78.60 |
$16.56
|
|
Alginate drsg >16 <=48 sq in
|
$118.20 |
$118.20 |
$118.20 |
$43.72
|
|
Alkaline phosphatase
|
$76.20 |
$76.20 |
$76.20 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$110.40 |
$110.40 |
$110.40 |
$48.57
|
|
Allergen egg white ige
|
$110.40 |
$110.40 |
$110.40 |
$38.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$12,411.00 |
$12,411.00 |
$12,411.00 |
$6,285.56
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$38.40 |
$38.40 |
$38.40 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$1,293.00 |
$1,293.00 |
$1,293.00 |
$198.60
|
|
Alpha-fetoprotein amniotic
|
$141.00 |
$141.00 |
$141.00 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$250.80 |
$250.80 |
$250.80 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$288.80 |
$288.80 |
$288.80 |
$15,857.45
|
|
Alt/sgpt
|
$78.60 |
$78.60 |
$78.60 |
$47.50
|
|
Aluminum - quest
|
$380.40 |
$380.40 |
$380.40 |
$83.05
|
|
Ambl bp mntr w/sw a/r
|
$85.20 |
$85.20 |
$85.20 |
$320.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$14.00 |
$14.00 |
$14.00 |
$39.84
|
|
Amino acids quant 2-5
|
$171.00 |
$171.00 |
$171.00 |
$112.00
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$10.20 |
$10.20 |
$10.20 |
$37.33
|
|
Aminolevulinic acid delta
|
$173.40 |
$173.40 |
$173.40 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$12.20 |
$12.20 |
$12.20 |
$47.06
|
|
Amiodarone 50 mg/ml intravenous solution
|
$145.60 |
$145.60 |
$145.60 |
$55.86
|
|
Ammonia
|
$216.00 |
$216.00 |
$216.00 |
$119.70
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,407.00 |
$1,407.00 |
$1,407.00 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$153.60 |
$153.60 |
$153.60 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$91.20 |
$91.20 |
$91.20 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$247.20 |
$247.20 |
$247.20 |
$262.99
|
|
Amylase
|
$96.60 |
$96.60 |
$96.60 |
$90.00
|
