|
11-desoxycortisol - sendout
|
$80.60 |
$80.60 |
$80.60 |
$91.85
|
|
Abd/low ext cath 1st
|
$1,388.40 |
$1,388.40 |
$1,388.40 |
$2,015.85
|
|
Abd/low ext cath 2nd
|
$728.65 |
$728.65 |
$728.65 |
$2,016.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$777.40 |
$777.40 |
$777.40 |
$662.40
|
|
Ablate arrhythmia add on
|
$18,569.20 |
$18,569.20 |
$18,569.20 |
$6,828.51
|
|
Ablation cryo retro lymph node
|
$672.10 |
$672.10 |
$672.10 |
$857.60
|
|
Ablation of upper extremity nerves rf
|
$1,147.25 |
$1,147.25 |
$1,147.25 |
$832.50
|
|
Acetazolamide 500 mg solution for injection
|
$178.16 |
$178.16 |
$178.16 |
$122.55
|
|
Adj gastric band via subq port
|
$2,611.70 |
$2,611.70 |
$2,611.70 |
$1,666.86
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$49.27 |
$49.27 |
$49.27 |
$193.40
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$36.40 |
$36.40 |
$36.40 |
$44.80
|
|
Aep hearing status deter i&r
|
$451.10 |
$451.10 |
$451.10 |
$303.00
|
|
Albumin (human), 25%, 50ml
|
$676.26 |
$676.26 |
$676.26 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$338.39 |
$338.39 |
$338.39 |
$252.77
|
|
Alteplase 100 mg infusion from pyxis vial
|
$239.39 |
$239.39 |
$239.39 |
$15,857.45
|
|
Altuviiio per factor viii iu
|
$28,501.59 |
$28,501.59 |
$28,501.59 |
$13.32
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$39.58 |
$39.58 |
$39.58 |
$37.33
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$269.75 |
$269.75 |
$269.75 |
$108.13
|
|
Amphetamine confirm urine -sendout
|
$50.70 |
$50.70 |
$50.70 |
$93.61
|
|
Ampicillin 1 gram solution for injection
|
$75.85 |
$75.85 |
$75.85 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$29.90 |
$29.90 |
$29.90 |
$54.57
|
|
Amputation of midtarsal 28800
|
$6,182.80 |
$6,182.80 |
$6,182.80 |
$2,285.40
|
|
Analgesics non-opioid 6/more
|
$9.75 |
$9.75 |
$9.75 |
$16.24
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$8,298.55 |
$8,298.55 |
$8,298.55 |
$2,979.43
|
|
Angio tib/peroneal/init ves/unila 37228
|
$14,331.85 |
$14,331.85 |
$14,331.85 |
$10,413.45
|
|
Ankle X-ray (2 views, both ankles)
|
$284.70 |
$284.70 |
$284.70 |
$282.96
|
|
Annual Physical, New Patient (age 18-39)
|
$115.70 |
$115.70 |
$115.70 |
$154.00
|
|
Anodyne therapy charges pt
|
$66.95 |
$66.95 |
$66.95 |
$42.00
|
|
Antibody bacterium, not elsewhere specified
|
$75.40 |
$75.40 |
$75.40 |
$57.85
|
|
Antibody lymphocytic choriomeningitis
|
$72.15 |
$72.15 |
$72.15 |
$46.58
|
|
Aortic dysfunction/dilation
|
$982.80 |
$982.80 |
$982.80 |
$1,153.60
|
|
Apheresis wbc
|
$3,502.20 |
$3,502.20 |
$3,502.20 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$344.50 |
$344.50 |
$344.50 |
$513.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$4,931.55 |
$4,931.55 |
$4,931.55 |
$2,114.00
|
|
Application long leg splint 29505
|
$308.10 |
$308.10 |
$308.10 |
$338.25
|
|
Application multi layer compression below knee (both sides)
|
$295.75 |
$295.75 |
$295.75 |
$375.06
|
|
Aqaprn-4 antb flo cytmtry ea
|
$193.70 |
$193.70 |
$193.70 |
$231.66
|
|
Ar gene charac alleles
|
$398.45 |
$398.45 |
$398.45 |
$287.70
|
|
Asp core fat pad
|
$4,771.65 |
$4,771.65 |
$4,771.65 |
$1,123.50
|
|
Assay of interleukin-6 (il-6)
|
$177.45 |
$177.45 |
$177.45 |
$79.00
|
|
Assay of somatostatin
|
$165.75 |
$165.75 |
$165.75 |
$170.50
|
|
Azithromycin 500 mg intravenous solution
|
$40.36 |
$40.36 |
$40.36 |
$37.53
|
|
Bacterial meningitis antigen
|
$143.00 |
$143.00 |
$143.00 |
$66.30
|
|
Bartonella dna pcr-sendout
|
$401.70 |
$401.70 |
$401.70 |
$195.25
|
|
B cells total count
|
$211.90 |
$211.90 |
$211.90 |
$132.48
|
|
Benztropine 1 mg/ml injection solution
|
$265.78 |
$265.78 |
$265.78 |
$108.90
|
|
Beta-amyloid 1-42
|
$569.40 |
$569.40 |
$569.40 |
$333.00
|
|
Biopsy of rectum wall anal approach 45100
|
$3,524.95 |
$3,524.95 |
$3,524.95 |
$3,467.55
|
|
Biopsy thigh soft tissues
|
$4,080.05 |
$4,080.05 |
$4,080.05 |
$3,854.40
|
|
Bln 30frx10mmx12cm renal nephromax
|
$250.25 |
$250.25 |
$250.25 |
$5,330.60
|
|
Bln dil 900ml preperitnl
|
$1,717.25 |
$1,717.25 |
$1,717.25 |
$1,320.21
|
|
Blood Clotting (PT/INR) Test
|
$61.10 |
$61.10 |
$61.10 |
$53.30
|
|
Blood Transfusion
|
$1,530.75 |
$1,530.75 |
$1,530.75 |
$989.60
|
|
Boot j walker l
|
$165.10 |
$165.10 |
$165.10 |
$234.00
|
|
Boot walker genesis mid-calf full shell s
|
$109.85 |
$109.85 |
$109.85 |
$175.89
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$177.45 |
$177.45 |
$177.45 |
$93.60
|
|
Brace back pinnacle lo 627 lumbar
|
$278.85 |
$278.85 |
$278.85 |
$863.91
|
|
Brain MRI (with contrast)
|
$2,826.20 |
$2,826.20 |
$2,826.20 |
$2,267.23
|
|
Breast punct aspir cyst, bil
|
$1,154.40 |
$1,154.40 |
$1,154.40 |
$871.80
|
|
Bronchial valve remov addl
|
$2,816.45 |
$2,816.45 |
$2,816.45 |
$2,611.20
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$105.10 |
$105.10 |
$105.10 |
$23.92
|
|
Bundle his recording
|
$2,960.75 |
$2,960.75 |
$2,960.75 |
$4,781.70
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$44.52 |
$44.52 |
$44.52 |
$32.47
|
|
Buprenorphine oral 1mg
|
$19.17 |
$19.17 |
$19.17 |
$10.70
|
|
Burr hole for vent puncture 61120
|
$1,154.40 |
$1,154.40 |
$1,154.40 |
$2,496.00
|
|
Bx/curett of cervix w/scope 57454
|
$613.60 |
$613.60 |
$613.60 |
$515.50
|
|
C1 esterase inhibitor func - sendout
|
$188.50 |
$188.50 |
$188.50 |
$96.72
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$131.88 |
$131.88 |
$131.88 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$107.25 |
$107.25 |
$107.25 |
$91.60
|
|
Cannula ercp contour 5-4-3 tip
|
$0.01 |
$0.01 |
$0.01 |
$44,000.00
|
|
Capecitabine, oral, 50 mg
|
$190.71 |
$190.71 |
$190.71 |
$59.42
|
|
Carbohydrate deficient transf - sendout
|
$349.05 |
$349.05 |
$349.05 |
$116.40
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$1,731.79 |
$1,731.79 |
$1,731.79 |
$455.11
|
|
Carcinoembryonic ag (cea)
|
$163.80 |
$163.80 |
$163.80 |
$145.20
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$252.85 |
$252.85 |
$252.85 |
$204.54
|
|
Car seat/bed test additional 30 minutes
|
$41.60 |
$41.60 |
$41.60 |
$65.00
|
|
Car-t therapy prepj bld-drv t lymphcyt f/trns
|
$2,340.00 |
$2,340.00 |
$2,340.00 |
$1,296.10
|
|
Cath 2lum 14.5frx43cm maxid kt mahurkar
|
$780.00 |
$780.00 |
$780.00 |
$830.58
|
|
Cath access del ds spyscop 2.0
|
$625.95 |
$625.95 |
$625.95 |
$5,212.99
|
|
Cath acunav ge 10frx90cm
|
$4,641.65 |
$4,641.65 |
$4,641.65 |
$6,475.07
|
|
Cath cv dl inj 7fx16cm
|
$872.95 |
$872.95 |
$872.95 |
$4,488.99
|
|
Cathj umbilical vein dx/ther nb
|
$252.85 |
$252.85 |
$252.85 |
$246.00
|
|
Cath lt/rt pulm art
|
$380.25 |
$380.25 |
$380.25 |
$1,273.15
|
|
Cath malecot 28fr 4-wing ltx
|
$334.10 |
$334.10 |
$334.10 |
$2,549.50
|
|
Cath w/drainage 2-way latex
|
$65.00 |
$65.00 |
$65.00 |
$71.20
|
|
Cefoxitin 1 gram intravenous solution
|
$53.75 |
$53.75 |
$53.75 |
$74.82
|
|
Ceftazidime and avibactam
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$904.66
|
|
Ceftriaxone 1 gram solution for injection
|
$27.82 |
$27.82 |
$27.82 |
$83.39
|
|
#celiac hla-dq2
|
$128.05 |
$128.05 |
$128.05 |
$225.12
|
|
Cftr gene intron poly t
|
$208.65 |
$208.65 |
$208.65 |
$301.65
|
|
Change of ureter tube/stent
|
$3,978.65 |
$3,978.65 |
$3,978.65 |
$2,424.12
|
|
Change of windpipe airway 31502
|
$433.55 |
$433.55 |
$433.55 |
$401.50
|
|
Chemodenervation/face muscl/unilat 64612
|
$565.50 |
$565.50 |
$565.50 |
$600.00
|
|
Chest apical lordotic proj
|
$376.35 |
$376.35 |
$376.35 |
$310.80
|
|
Chest CT scan (without contrast)
|
$1,513.20 |
$1,513.20 |
$1,513.20 |
$1,303.15
|
|
Cholangiogram percutaneous compl
|
$2,611.05 |
$2,611.05 |
$2,611.05 |
$3,427.55
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$674.05 |
$674.05 |
$674.05 |
$602.40
|
|
Cholinesterase
|
$68.25 |
$68.25 |
$68.25 |
$39.48
|
|
Chromogenic substrate assay
|
$120.90 |
$120.90 |
$120.90 |
$159.00
|
|
Ciltacabtagene car-pos t
|
$1,804,758.80 |
$1,804,758.80 |
$1,804,758.80 |
$1,573,072.37
|
