|
5% dextrose and 0.45% saline
|
$86.40 |
$86.40 |
$86.40 |
$48.00
|
|
88334 ap bill cytologic exam each additional site
|
$60.00 |
$60.00 |
$60.00 |
$100.10
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,341.48 |
$2,341.48 |
$2,341.48 |
$3,138.72
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,353.60 |
$1,353.60 |
$1,353.60 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$984.00 |
$984.00 |
$984.00 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,666.40 |
$2,666.40 |
$2,666.40 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$2,214.40 |
$2,214.40 |
$2,214.40 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$4,211.20 |
$4,211.20 |
$4,211.20 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,372.80 |
$3,372.80 |
$3,372.80 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,994.40 |
$2,994.40 |
$2,994.40 |
$2,048.36
|
|
Abdominal paracentesis w/image guidance
|
$1,892.80 |
$1,892.80 |
$1,892.80 |
$1,632.96
|
|
Abdominal Ultrasound (complete)
|
$1,109.60 |
$1,109.60 |
$1,109.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$764.80 |
$764.80 |
$764.80 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$387.20 |
$387.20 |
$387.20 |
$318.20
|
|
Abdominal X-ray (single view)
|
$307.20 |
$307.20 |
$307.20 |
$260.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$109.70 |
$109.70 |
$109.70 |
$72.74
|
|
Acetaminophen level
|
$53.60 |
$53.60 |
$53.60 |
$116.80
|
|
Acetone qualitative
|
$48.00 |
$48.00 |
$48.00 |
$46.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$218.60 |
$218.60 |
$218.60 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$43.42 |
$43.42 |
$43.42 |
$31.21
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$50.40 |
$50.40 |
$50.40 |
$38.50
|
|
Acute hepatitis panel
|
$316.00 |
$316.00 |
$316.00 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$16.40 |
$16.40 |
$16.40 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$63.21 |
$63.21 |
$63.21 |
$64.45
|
|
Adenosine 3 mg/250 ml bag for osm
|
$62.10 |
$62.10 |
$62.10 |
$271.98
|
|
Adh-sendout
|
$240.80 |
$240.80 |
$240.80 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$26.08 |
$26.08 |
$26.08 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$281.60 |
$281.60 |
$281.60 |
$230.35
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$828.80 |
$828.80 |
$828.80 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$370.40 |
$370.40 |
$370.40 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$239.20 |
$239.20 |
$239.20 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$312.00 |
$312.00 |
$312.00 |
$256.49
|
|
_afb id by dna probe rflx ast
|
$80.00 |
$80.00 |
$80.00 |
$104.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$308.00 |
$308.00 |
$308.00 |
$300.00
|
|
Albumin (human), 25%, 50ml
|
$175.03 |
$175.03 |
$175.03 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$109.60 |
$109.60 |
$109.60 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$40.00 |
$40.00 |
$40.00 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$4.82 |
$4.82 |
$4.82 |
$5.67
|
|
Albuterol non-comp con
|
$18.37 |
$18.37 |
$18.37 |
$6.07
|
|
Albuterol non-comp unit
|
$4.16 |
$4.16 |
$4.16 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$104.80 |
$104.80 |
$104.80 |
$96.00
|
|
Alkaline phosphatase
|
$62.40 |
$62.40 |
$62.40 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$52.00 |
$52.00 |
$52.00 |
$48.57
|
|
Allergen egg white ige
|
$54.40 |
$54.40 |
$54.40 |
$38.00
|
|
Alpha-fetoprotein tumor marker
|
$133.60 |
$133.60 |
$133.60 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$12,473.57 |
$12,473.57 |
$12,473.57 |
$15,857.45
|
|
Alt/sgpt
|
$41.60 |
$41.60 |
$41.60 |
$47.50
|
|
Aminolevulinic acid delta
|
$104.00 |
$104.00 |
$104.00 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$69.26 |
$69.26 |
$69.26 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$150.55 |
$150.55 |
$150.55 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$61.30 |
$61.30 |
$61.30 |
$55.86
|
|
Ammonia
|
$168.80 |
$168.80 |
$168.80 |
$119.70
|
|
Ampicillin 1 gram solution for injection
|
$62.03 |
$62.03 |
$62.03 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$63.96 |
$63.96 |
$63.96 |
$54.57
|
|
Amylase
|
$83.20 |
$83.20 |
$83.20 |
$90.00
|
|
Ana ds-dna
|
$204.80 |
$204.80 |
$204.80 |
$55.24
|
|
Analysis gene f2 20210g>a variant
|
$400.80 |
$400.80 |
$400.80 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$265.60 |
$265.60 |
$265.60 |
$249.60
|
|
Anca screen with reflex to titer -quest
|
$163.20 |
$163.20 |
$163.20 |
$101.50
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$86.40 |
$86.40 |
$86.40 |
$2,979.43
|
|
Ankle X-ray
|
$376.80 |
$376.80 |
$376.80 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$308.00 |
$308.00 |
$308.00 |
$282.96
|
|
Anodyne therapy charges pt
|
$53.60 |
$53.60 |
$53.60 |
$42.00
|
|
Anora (draw only)
|
$50.40 |
$50.40 |
$50.40 |
$35.00
|
|
Antibody bacterium, not elsewhere specified
|
$32.00 |
$32.00 |
$32.00 |
$57.85
|
|
Antibody elution rbc reference
|
$129.60 |
$129.60 |
$129.60 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$224.80 |
$224.80 |
$224.80 |
$131.56
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$224.00 |
$224.00 |
$224.00 |
$224.00
|
|
Antibody id rbc panel
|
$258.40 |
$258.40 |
$258.40 |
$291.75
|
|
Antibody screen rbc
|
$116.00 |
$116.00 |
$116.00 |
$108.55
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$56.00 |
$56.00 |
$56.00 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$66.40 |
$66.40 |
$66.40 |
$42.00
|
|
Antinuclear antibodies
|
$89.60 |
$89.60 |
$89.60 |
$90.00
|
|
Antinuclear antibodies titer
|
$58.40 |
$58.40 |
$58.40 |
$80.04
|
|
Antistreptolysin o titer
|
$86.40 |
$86.40 |
$86.40 |
$54.00
|
|
Antithrombin iii activity
|
$214.40 |
$214.40 |
$214.40 |
$115.15
|
|
Aortic Aneurysm Screening Ultrasound
|
$565.60 |
$565.60 |
$565.60 |
$394.55
|
|
Application lower leg splint 29515
|
$365.60 |
$365.60 |
$365.60 |
$340.20
|
|
Appl modality 1/> areas paraffin bath 97018
|
$94.40 |
$94.40 |
$94.40 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$80.80 |
$80.80 |
$80.80 |
$75.98
|
|
Aqaprn-4 antb flo cytmtry ea
|
$190.40 |
$190.40 |
$190.40 |
$231.66
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$128.00 |
$128.00 |
$128.00 |
$100.75
|
|
Arm CT Scan (without contrast, both arms)
|
$2,022.40 |
$2,022.40 |
$2,022.40 |
$1,380.00
|
|
Arm or Leg Ultrasound (limited, left side)
|
$601.60 |
$601.60 |
$601.60 |
$426.00
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$591.20 |
$591.20 |
$591.20 |
$609.00
|
|
Aspirate/inj ganglion cyst 20612
|
$365.60 |
$365.60 |
$365.60 |
$441.30
|
|
Assay of salicylate
|
$93.60 |
$93.60 |
$93.60 |
$96.50
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$391.20 |
$391.20 |
$391.20 |
$300.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$54.40 |
$54.40 |
$54.40 |
$46.80
|
|
Ast/sgot
|
$53.60 |
$53.60 |
$53.60 |
$45.90
|
|
Atropine 0.1 mg/ml injection syringe
|
$60.71 |
$60.71 |
$60.71 |
$53.24
|
|
Automated diff wbc count
|
$36.80 |
$36.80 |
$36.80 |
$36.30
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$428.00 |
$428.00 |
$428.00 |
$326.27
|
|
Azithromycin 500 mg intravenous solution
|
$64.72 |
$64.72 |
$64.72 |
$37.53
|
|
Azithromycin dihydrate, oral
|
$58.52 |
$58.52 |
$58.52 |
$46.31
|
|
Baclofen eval charges
|
$86.40 |
$86.40 |
$86.40 |
$87.50
|
|
Bacterial meningitis antigen
|
$121.60 |
$121.60 |
$121.60 |
$66.30
|
|
Balance and Coordination Retraining (each 15 minutes)
|
$127.20 |
$127.20 |
$127.20 |
$102.20
|
|
B cells total count
|
$124.80 |
$124.80 |
$124.80 |
$132.48
|
