|
Benign lesion paring 2-4
|
$252.00 |
$252.00 |
$252.00 |
$264.60
|
|
Beta 2 glycoprotein 1 antibody iga
|
$102.40 |
$102.40 |
$102.40 |
$82.55
|
|
Beta-2 microglobulin
|
$142.40 |
$142.40 |
$142.40 |
$85.20
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$65.93 |
$65.93 |
$65.93 |
$65.00
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$3,398.40 |
$3,398.40 |
$3,398.40 |
$5,737.97
|
|
Bilirubin direct
|
$54.40 |
$54.40 |
$54.40 |
$51.35
|
|
Bilirubin total
|
$40.00 |
$40.00 |
$40.00 |
$54.60
|
|
Bladder Catheter Insertion (simple)
|
$273.60 |
$273.60 |
$273.60 |
$232.30
|
|
Bln 30frx10mmx12cm renal nephromax
|
$382.40 |
$382.40 |
$382.40 |
$5,330.60
|
|
Blood Clotting (PT/INR) Test
|
$52.80 |
$52.80 |
$52.80 |
$53.30
|
|
Blood Clotting (PTT) Test
|
$65.60 |
$65.60 |
$65.60 |
$74.00
|
|
Blood Count (CBC) Test
|
$67.20 |
$67.20 |
$67.20 |
$74.75
|
|
Blood Count (CBC) Test (without differential)
|
$74.40 |
$74.40 |
$74.40 |
$62.28
|
|
Blood Culture Test
|
$98.40 |
$98.40 |
$98.40 |
$146.16
|
|
Blood draw capillary 36416
|
$22.40 |
$22.40 |
$22.40 |
$20.00
|
|
Blood Draw (Venipuncture)
|
$22.40 |
$22.40 |
$22.40 |
$21.66
|
|
Blood gases ph venous
|
$68.80 |
$68.80 |
$68.80 |
$64.60
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$57.60 |
$57.60 |
$57.60 |
$57.60
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$25.60 |
$25.60 |
$25.60 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$38.40 |
$38.40 |
$38.40 |
$34.98
|
|
Blood smear microscopic w manual differential wbc count
|
$52.80 |
$52.80 |
$52.80 |
$38.35
|
|
Blood Transfusion
|
$1,021.60 |
$1,021.60 |
$1,021.60 |
$989.60
|
|
Blood typing abo
|
$31.20 |
$31.20 |
$31.20 |
$86.45
|
|
Blood typing ag donor ea ag
|
$146.40 |
$146.40 |
$146.40 |
$207.60
|
|
Blood typing rbc ag non abo/rh ea
|
$75.20 |
$75.20 |
$75.20 |
$211.90
|
|
Blood typing rh (d)
|
$42.40 |
$42.40 |
$42.40 |
$57.60
|
|
Bone Density Scan (DEXA)
|
$591.20 |
$591.20 |
$591.20 |
$407.94
|
|
Bone survey-lead poisoning
|
$612.00 |
$612.00 |
$612.00 |
$387.00
|
|
Boot j walker l
|
$75.20 |
$75.20 |
$75.20 |
$234.00
|
|
Boot softgait shrt m
|
$94.40 |
$94.40 |
$94.40 |
$139.20
|
|
Boot walker genesis full shell 3-strap s
|
$92.00 |
$92.00 |
$92.00 |
$439.09
|
|
Boot walker genesis mid-calf full shell s
|
$119.20 |
$119.20 |
$119.20 |
$175.89
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$169.60 |
$169.60 |
$169.60 |
$93.60
|
|
Brace ank air stirrup univ
|
$52.00 |
$52.00 |
$52.00 |
$108.67
|
|
Brace ankle stablizing lg
|
$64.80 |
$64.80 |
$64.80 |
$122.82
|
|
Brace m arm board
|
$113.60 |
$113.60 |
$113.60 |
$162.50
|
|
Brace or Splint Fitting and Training (each 15 minutes)
|
$133.60 |
$133.60 |
$133.60 |
$105.30
|
|
Brace oths wrist hnd fngr without
|
$42.40 |
$42.40 |
$42.40 |
$257.45
|
|
Brace wrist classic lft sm
|
$81.60 |
$81.60 |
$81.60 |
$89.04
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,832.80 |
$3,832.80 |
$3,832.80 |
$2,772.11
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,071.20 |
$3,071.20 |
$3,071.20 |
$2,136.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,849.60 |
$2,849.60 |
$2,849.60 |
$1,897.53
|
|
Brain MRI (with and without contrast)
|
$4,516.00 |
$4,516.00 |
$4,516.00 |
$2,854.80
|
|
Brain MRI (without contrast)
|
$3,093.60 |
$3,093.60 |
$3,093.60 |
$1,948.00
|
|
Breastbone (Sternum) X-ray
|
$396.00 |
$396.00 |
$396.00 |
$274.65
|
|
Bronchial challenge
|
$1,071.20 |
$1,071.20 |
$1,071.20 |
$820.05
|
|
Budesonide non-comp unit
|
$13.85 |
$13.85 |
$13.85 |
$20.52
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$60.29 |
$60.29 |
$60.29 |
$23.92
|
|
Bundled special stain group 1 microorganisms
|
$223.20 |
$223.20 |
$223.20 |
$159.00
|
|
Bundled special stain group 2
|
$178.40 |
$178.40 |
$178.40 |
$173.40
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$61.17 |
$61.17 |
$61.17 |
$32.47
|
|
Caffeine citrate 20 mg/ml inj for po
|
$63.35 |
$63.35 |
$63.35 |
$46.09
|
|
Calcium 24 hour urine
|
$34.40 |
$34.40 |
$34.40 |
$53.00
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$67.18 |
$67.18 |
$67.18 |
$48.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$66.74 |
$66.74 |
$66.74 |
$64.49
|
|
Calcium ionized
|
$109.60 |
$109.60 |
$109.60 |
$90.00
|
|
Calcium total
|
$40.00 |
$40.00 |
$40.00 |
$50.00
|
|
Calprotectin fecal
|
$237.60 |
$237.60 |
$237.60 |
$170.00
|
|
Carbamazepine total therapeutic drug level
|
$110.40 |
$110.40 |
$110.40 |
$122.85
|
|
Carbon dioxide
|
$52.80 |
$52.80 |
$52.80 |
$44.00
|
|
Carboxyhemoglobin quantitative
|
$103.20 |
$103.20 |
$103.20 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$100.00 |
$100.00 |
$100.00 |
$145.20
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$3,508.00 |
$3,508.00 |
$3,508.00 |
$2,917.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$282.40 |
$282.40 |
$282.40 |
$249.60
|
|
Cardiolipin antibody iga
|
$96.80 |
$96.80 |
$96.80 |
$107.25
|
|
Cardioversion (Scheduled Heart Rhythm Shock)
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$1,431.36
|
|
Caregiver training strategies&tq 1st 30 minutes
|
$123.20 |
$123.20 |
$123.20 |
$97.01
|
|
Caregiver training strategies&tq ea addl 15 min
|
$61.60 |
$61.60 |
$61.60 |
$51.52
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$1,024.32
|
|
Caspofungin acetate
|
$585.06 |
$585.06 |
$585.06 |
$633.91
|
|
Cath cv dl inj 7fx16cm
|
$756.00 |
$756.00 |
$756.00 |
$4,488.99
|
|
Cath malecot 28fr 4-wing ltx
|
$583.20 |
$583.20 |
$583.20 |
$2,549.50
|
|
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr
|
$111.26 |
$111.26 |
$111.26 |
$39.52
|
|
Cefepime 1 gram solution for injection
|
$63.58 |
$63.58 |
$63.58 |
$45.47
|
|
Ceftaroline fosamil 600 mg intravenous solution
|
$289.44 |
$289.44 |
$289.44 |
$602.45
|
|
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr
|
$64.36 |
$64.36 |
$64.36 |
$58.89
|
|
Ceftriaxone 1 gram solution for injection
|
$136.60 |
$136.60 |
$136.60 |
$83.39
|
|
Cell count w differential body fluid
|
$40.00 |
$40.00 |
$40.00 |
$92.56
|
|
Chest 2 vws w oblique
|
$502.40 |
$502.40 |
$502.40 |
$375.60
|
|
Chest apical lordotic proj
|
$385.60 |
$385.60 |
$385.60 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$3,286.40 |
$3,286.40 |
$3,286.40 |
$1,947.00
|
|
Chest CT scan (with contrast)
|
$2,666.40 |
$2,666.40 |
$2,666.40 |
$1,658.80
|
|
Chest CT scan (without contrast)
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
$1,303.15
|
|
Chest Physiotherapy (first session)
|
$212.80 |
$212.80 |
$212.80 |
$160.80
|
|
Chest Physiotherapy (follow-up session)
|
$160.00 |
$160.00 |
$160.00 |
$134.50
|
|
Chest X-ray
|
$352.80 |
$352.80 |
$352.80 |
$294.06
|
|
Chest X-ray (single view)
|
$309.60 |
$309.60 |
$309.60 |
$236.60
|
|
Chlamydia culture
|
$149.60 |
$149.60 |
$149.60 |
$91.00
|
|
Chloride
|
$51.20 |
$51.20 |
$51.20 |
$42.63
|
|
Chloride 24 hour urine
|
$65.60 |
$65.60 |
$65.60 |
$50.88
|
|
Cholesterol
|
$46.40 |
$46.40 |
$46.40 |
$45.76
|
|
Cholesterol (Lipid) Test
|
$80.80 |
$80.80 |
$80.80 |
$115.80
|
|
Chrom analysis
|
$84.80 |
$84.80 |
$84.80 |
$156.00
|
|
Chromo high res and frag x - sendout
|
$139.20 |
$139.20 |
$139.20 |
$250.00
|
|
Chromosome analysis 15-20 cell count
|
$306.40 |
$306.40 |
$306.40 |
$517.11
|
|
Chromosome analysis 45
|
$366.40 |
$366.40 |
$366.40 |
$382.85
|
|
Chromosome analysis 5
|
$644.80 |
$644.80 |
$644.80 |
$644.80
|
|
Chronic urticaria - sendout
|
$160.00 |
$160.00 |
$160.00 |
$75.71
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$85.97 |
$85.97 |
$85.97 |
$35.65
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$62.03 |
$62.03 |
$62.03 |
$55.20
|
