|
11-desoxycortisol - sendout
|
$70.40 |
$70.40 |
$70.40 |
$91.85
|
|
17-hydroxypregnenolone
|
$69.60 |
$69.60 |
$69.60 |
$92.65
|
|
3d recon without postprocess indpndt
|
$795.20 |
$795.20 |
$795.20 |
$508.13
|
|
5% dextrose and 0.45% saline
|
$148.40 |
$148.40 |
$148.40 |
$48.00
|
|
5' nucleotidase - sendout
|
$96.80 |
$96.80 |
$96.80 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$63.20 |
$63.20 |
$63.20 |
$100.10
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$56.80 |
$56.80 |
$56.80 |
$53.95
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (complete)
|
$1,183.20 |
$1,183.20 |
$1,183.20 |
$988.00
|
|
Abdominal and Pelvic Blood Vessel Ultrasound (limited)
|
$847.20 |
$847.20 |
$847.20 |
$662.40
|
|
Abdominal CT scan (with and without contrast)
|
$2,489.60 |
$2,489.60 |
$2,489.60 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$2,431.20 |
$2,431.20 |
$2,431.20 |
$1,667.60
|
|
Abdominal CT scan (without contrast)
|
$1,976.00 |
$1,976.00 |
$1,976.00 |
$1,353.32
|
|
Abdominal MRI (with and without contrast)
|
$3,806.40 |
$3,806.40 |
$3,806.40 |
$2,967.00
|
|
Abdominal MRI (with contrast)
|
$3,154.40 |
$3,154.40 |
$3,154.40 |
$2,240.00
|
|
Abdominal MRI (without contrast)
|
$2,978.40 |
$2,978.40 |
$2,978.40 |
$2,048.36
|
|
Abdominal Ultrasound (complete)
|
$877.60 |
$877.60 |
$877.60 |
$783.00
|
|
Abdominal Ultrasound (limited)
|
$748.80 |
$748.80 |
$748.80 |
$586.43
|
|
Abdominal X-ray (2 views)
|
$308.00 |
$308.00 |
$308.00 |
$318.20
|
|
Abdominal X-ray Series (acute, with chest view)
|
$358.40 |
$358.40 |
$358.40 |
$418.63
|
|
Abdominal X-ray (single view)
|
$255.20 |
$255.20 |
$255.20 |
$260.00
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$181.43 |
$181.43 |
$181.43 |
$72.74
|
|
Acetaminophen level
|
$43.20 |
$43.20 |
$43.20 |
$116.80
|
|
Acetone qualitative
|
$34.40 |
$34.40 |
$34.40 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$65.60 |
$65.60 |
$65.60 |
$67.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$90.84 |
$90.84 |
$90.84 |
$218.79
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$44.80 |
$44.80 |
$44.80 |
$38.50
|
|
Acute hepatitis panel
|
$231.20 |
$231.20 |
$231.20 |
$284.95
|
|
Acyclovir 400 mg tablet
|
$212.11 |
$212.11 |
$212.11 |
$54.77
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$62.48 |
$62.48 |
$62.48 |
$64.45
|
|
Adenosine 3 mg/250 ml bag for osm
|
$61.59 |
$61.59 |
$61.59 |
$271.98
|
|
Adh-sendout
|
$164.00 |
$164.00 |
$164.00 |
$118.79
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$32.31 |
$32.31 |
$32.31 |
$193.40
|
|
Administration chemotherapy IV infusion each additional hour
|
$285.60 |
$285.60 |
$285.60 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$386.40 |
$386.40 |
$386.40 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$695.20 |
$695.20 |
$695.20 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$588.00 |
$588.00 |
$588.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$256.00 |
$256.00 |
$256.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$320.00 |
$320.00 |
$320.00 |
$256.49
|
|
Administration immunization each additional component
|
$29.60 |
$29.60 |
$29.60 |
$29.20
|
|
Administration immunization each additional vaccine
|
$82.40 |
$82.40 |
$82.40 |
$47.40
|
|
Administration immunization first component each vaccine
|
$47.20 |
$47.20 |
$47.20 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$60.80 |
$60.80 |
$60.80 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$45.60 |
$45.60 |
$45.60 |
$30.24
|
|
Aep thrshld est mlt freq i&r
|
$417.60 |
$417.60 |
$417.60 |
$635.00
|
|
Albumin body fluid quantitative each specimen
|
$25.60 |
$25.60 |
$25.60 |
$47.45
|
|
Albumin (human), 25%, 50ml
|
$262.06 |
$262.06 |
$262.06 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$43.20 |
$43.20 |
$43.20 |
$58.17
|
|
Albumin serum plasma or whole blood
|
$31.20 |
$31.20 |
$31.20 |
$43.00
|
|
Albuterol ipratrop non-comp
|
$4.00 |
$4.00 |
$4.00 |
$5.67
|
|
Albuterol non-comp con
|
$22.00 |
$22.00 |
$22.00 |
$6.07
|
|
Albuterol non-comp unit
|
$3.90 |
$3.90 |
$3.90 |
$5.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$84.00 |
$84.00 |
$84.00 |
$96.00
|
|
Alkaline phosphatase
|
$32.00 |
$32.00 |
$32.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$52.00 |
$52.00 |
$52.00 |
$48.57
|
|
Allergen egg white ige
|
$24.80 |
$24.80 |
$24.80 |
$38.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$298.40 |
$298.40 |
$298.40 |
$858.66
|
|
Alpha-fetoprotein tumor marker
|
$76.00 |
$76.00 |
$76.00 |
$106.00
|
|
Alprostadil for injection
|
$89.99 |
$89.99 |
$89.99 |
$511.41
|
|
Alteplase 100 mg infusion from pyxis vial
|
$12,473.57 |
$12,473.57 |
$12,473.57 |
$15,857.45
|
|
Alt/sgpt
|
$34.40 |
$34.40 |
$34.40 |
$47.50
|
|
Aminolevulinic acid delta
|
$108.80 |
$108.80 |
$108.80 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$65.88 |
$65.88 |
$65.88 |
$47.06
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$239.98 |
$239.98 |
$239.98 |
$108.13
|
|
Amiodarone 50 mg/ml intravenous solution
|
$62.84 |
$62.84 |
$62.84 |
$55.86
|
|
Ammonia
|
$82.40 |
$82.40 |
$82.40 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$57.60 |
$57.60 |
$57.60 |
$93.61
|
|
Ampicillin 1 gram solution for injection
|
$61.96 |
$61.96 |
$61.96 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$63.92 |
$63.92 |
$63.92 |
$54.57
|
|
Amylase
|
$64.00 |
$64.00 |
$64.00 |
$90.00
|
|
Anabolic steroid 1 or 2
|
$136.00 |
$136.00 |
$136.00 |
$80.08
|
|
Analysis gene f2 20210g>a variant
|
$192.00 |
$192.00 |
$192.00 |
$226.85
|
|
Analysis gene f5 leiden variant
|
$192.00 |
$192.00 |
$192.00 |
$249.60
|
|
Anastrozole 1 mg
|
$3.76 |
$3.76 |
$3.76 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$120.80 |
$120.80 |
$120.80 |
$101.50
|
|
An fluoro guide for cvp
|
$722.40 |
$722.40 |
$722.40 |
$525.85
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$202.45 |
$202.45 |
$202.45 |
$2,979.43
|
|
Ankle X-ray
|
$284.00 |
$284.00 |
$284.00 |
$356.32
|
|
Ankle X-ray (2 views, both ankles)
|
$271.20 |
$271.20 |
$271.20 |
$282.96
|
|
Anodyne therapy charges pt
|
$72.80 |
$72.80 |
$72.80 |
$42.00
|
|
Antibody bacterium, not elsewhere specified
|
$32.00 |
$32.00 |
$32.00 |
$57.85
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$187.20 |
$187.20 |
$187.20 |
$224.00
|
|
Antibody id rbc panel
|
$341.60 |
$341.60 |
$341.60 |
$291.75
|
|
Antibody screen rbc
|
$68.80 |
$68.80 |
$68.80 |
$108.55
|
|
Antibody tetanus
|
$92.80 |
$92.80 |
$92.80 |
$54.15
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$56.00 |
$56.00 |
$56.00 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$56.00 |
$56.00 |
$56.00 |
$42.00
|
|
Antinuclear antibodies
|
$60.00 |
$60.00 |
$60.00 |
$90.00
|
|
Antinuclear antibodies titer
|
$68.00 |
$68.00 |
$68.00 |
$80.04
|
|
Antistreptolysin o screen
|
$80.00 |
$80.00 |
$80.00 |
$58.56
|
|
Antistreptolysin o titer
|
$54.40 |
$54.40 |
$54.40 |
$54.00
|
|
Antithrombin iii activity
|
$95.20 |
$95.20 |
$95.20 |
$115.15
|
|
Application finger splntstatic 29130
|
$262.40 |
$262.40 |
$262.40 |
$208.50
|
|
Application long leg splint 29505
|
$303.20 |
$303.20 |
$303.20 |
$338.25
|
|
Application lower leg splint 29515
|
$396.00 |
$396.00 |
$396.00 |
$340.20
|
|
Application multi layer compression below knee (both sides)
|
$384.80 |
$384.80 |
$384.80 |
$375.06
|
|
Application of paste boot 29580
|
$304.00 |
$304.00 |
$304.00 |
$340.11
|
|
Application short leg cast 29405
|
$316.00 |
$316.00 |
$316.00 |
$393.98
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$3,042.40 |
$3,042.40 |
$3,042.40 |
$2,164.64
|
|
Appl modality 1/> areas paraffin bath 97018
|
$81.60 |
$81.60 |
$81.60 |
$69.00
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$99.20 |
$99.20 |
$99.20 |
$75.98
|
