|
Glucose tolerance test (gtt) 3 specimens
|
$1,172.73 |
$1,172.73 |
$1,172.73 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$296.60 |
$296.60 |
$296.60 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$1,944.48 |
$1,944.48 |
$1,944.48 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$1,568.22 |
$1,568.22 |
$1,568.22 |
$129.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$217.89 |
$217.89 |
$217.89 |
$23.06
|
|
Hcg qualitative
|
$785.48 |
$785.48 |
$785.48 |
$89.70
|
|
Head CT scan (with and without contrast)
|
$12,310.28 |
$12,310.28 |
$12,310.28 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$9,175.71 |
$9,175.71 |
$9,175.71 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$8,633.13 |
$8,633.13 |
$8,633.13 |
$1,268.90
|
|
Hematocrit
|
$447.66 |
$447.66 |
$447.66 |
$33.57
|
|
Hemoglobin
|
$447.66 |
$447.66 |
$447.66 |
$31.80
|
|
Hemoglobin methemoglobin quantitative
|
$1,241.37 |
$1,241.37 |
$1,241.37 |
$53.60
|
|
Hepatitis a antibody igm
|
$1,101.32 |
$1,101.32 |
$1,101.32 |
$87.75
|
|
Hepatitis b core antibody igm
|
$1,581.92 |
$1,581.92 |
$1,581.92 |
$87.98
|
|
Hepatitis b core antibody total
|
$1,101.32 |
$1,101.32 |
$1,101.32 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$4,362.82 |
$4,362.82 |
$4,362.82 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$1,658.84 |
$1,658.84 |
$1,658.84 |
$82.05
|
|
Hepatitis c antibody
|
$1,518.75 |
$1,518.75 |
$1,518.75 |
$108.00
|
|
Herpes simplex type 1 antibody igg
|
$129.07 |
$129.07 |
$129.07 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$513.56 |
$513.56 |
$513.56 |
$87.10
|
|
Herpes simplex virus isolation
|
$150.00 |
$150.00 |
$150.00 |
$104.10
|
|
Heterophile antibodies screening
|
$678.35 |
$678.35 |
$678.35 |
$74.00
|
|
Hla i low res one antigen equiv ea
|
$900.00 |
$900.00 |
$900.00 |
$161.70
|
|
Hocm 350-399mg/ml iodine,1ml
|
$241.65 |
$241.65 |
$241.65 |
$79.78
|
|
Homocysteine
|
$1,601.16 |
$1,601.16 |
$1,601.16 |
$121.92
|
|
Homogenization tissue
|
$49.12 |
$49.12 |
$49.12 |
$39.20
|
|
H pylori (c-13) breath
|
$797.62 |
$797.62 |
$797.62 |
$213.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$13,042.68 |
$13,042.68 |
$13,042.68 |
$5,836.20
|
|
Hydralazine 20 mg/ml injection solution
|
$204.89 |
$204.89 |
$204.89 |
$46.74
|
|
Hydration IV infusion each additional hour
|
$304.34 |
$304.34 |
$304.34 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$1,335.56 |
$1,335.56 |
$1,335.56 |
$383.00
|
|
Hydroxyurea 500 mg
|
$20.33 |
$20.33 |
$20.33 |
$14.00
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$347.24 |
$347.24 |
$347.24 |
$72.65
|
|
Iadna legionella pneumophila amplified probe tq
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$109.80
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$3,090.28 |
$3,090.28 |
$3,090.28 |
$980.94
|
|
Ifosfamide 1 gram intravenous solution
|
$824.63 |
$824.63 |
$824.63 |
$243.78
|
|
Ihc/icc per specimen each additional single antibody stain
|
$557.49 |
$557.49 |
$557.49 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$557.49 |
$557.49 |
$557.49 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$557.49 |
$557.49 |
$557.49 |
$274.86
|
|
Immunoassay tumor antigen quantitative ca 125
|
$1,241.37 |
$1,241.37 |
$1,241.37 |
$130.00
|
|
Immunofixation electrophoresis serum
|
$2,721.73 |
$2,721.73 |
$2,721.73 |
$138.60
|
|
Infect ag if legionella pneumophila
|
$75.00 |
$75.00 |
$75.00 |
$73.46
|
|
Infect ag if pneumocystis carinii
|
$75.00 |
$75.00 |
$75.00 |
$67.46
|
|
Infect ag na orthopoxvirus amp prb each
|
$102.46 |
$102.46 |
$102.46 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$8,412.43 |
$8,412.43 |
$8,412.43 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$131.59 |
$131.59 |
$131.59 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$161.99 |
$161.99 |
$161.99 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$161.99 |
$161.99 |
$161.99 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$1,263.33 |
$1,263.33 |
$1,263.33 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$983.21 |
$983.21 |
$983.21 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$1,129.00 |
$1,129.00 |
$1,129.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$161.99 |
$161.99 |
$161.99 |
$55.31
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$354.00 |
$354.00 |
$354.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$500.00 |
$500.00 |
$500.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$1,147.98 |
$1,147.98 |
$1,147.98 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$200.00 |
$200.00 |
$200.00 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$785.67 |
$785.67 |
$785.67 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$354.00 |
$354.00 |
$354.00 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$42.00 |
$42.00 |
$42.00 |
$100.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$212.62 |
$212.62 |
$212.62 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$250.00 |
$250.00 |
$250.00 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,261.02 |
$1,261.02 |
$1,261.02 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$2,144.97 |
$2,144.97 |
$2,144.97 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$2,342.72 |
$2,342.72 |
$2,342.72 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$3,051.28 |
$3,051.28 |
$3,051.28 |
$374.50
|
|
Inj, biorphen, 20 micrograms
|
$67.65 |
$67.65 |
$67.65 |
$17.12
|
|
Inj cefazolin sodium, hikma
|
$68.00 |
$68.00 |
$68.00 |
$29.10
|
|
Inj crotalidae im f(ab')2 eq
|
$8,991.87 |
$8,991.87 |
$8,991.87 |
$2,613.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$625.24 |
$625.24 |
$625.24 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$439.37 |
$439.37 |
$439.37 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$1,063.12 |
$1,063.12 |
$1,063.12 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$381.26 |
$381.26 |
$381.26 |
$135.20
|
|
Inj hydroxocobalamin IV 25mg
|
$9,188.92 |
$9,188.92 |
$9,188.92 |
$2,452.32
|
|
Inj meropenem (wg crit care)
|
$312.00 |
$312.00 |
$312.00 |
$77.97
|
|
Insitu hybridization auto
|
$322.11 |
$322.11 |
$322.11 |
$371.00
|
|
Insitu hybridization manual
|
$369.26 |
$369.26 |
$369.26 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$418.38 |
$418.38 |
$418.38 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$881.61 |
$881.61 |
$881.61 |
$326.04
|
|
Insulin total
|
$326.78 |
$326.78 |
$326.78 |
$66.64
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$678.94 |
$678.94 |
$678.94 |
$172.98
|
|
Ipratropium bromide non-comp
|
$32.69 |
$32.69 |
$32.69 |
$3.75
|
|
Iron
|
$422.93 |
$422.93 |
$422.93 |
$74.40
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1,322.90 |
$1,322.90 |
$1,322.90 |
$187.06
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$304.34 |
$304.34 |
$304.34 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$591.06 |
$591.06 |
$591.06 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$696.68 |
$696.68 |
$696.68 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$2,105.22 |
$2,105.22 |
$2,105.22 |
$439.56
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$216.92 |
$216.92 |
$216.92 |
$60.20
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$3,756.01 |
$3,756.01 |
$3,756.01 |
$666.00
|
|
Kras gene variants exon 2
|
$1,708.36 |
$1,708.36 |
$1,708.36 |
$486.45
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$1,411.67 |
$1,411.67 |
$1,411.67 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$626.15 |
$626.15 |
$626.15 |
$55.50
|
|
Lactic acid
|
$829.39 |
$829.39 |
$829.39 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$225.00 |
$225.00 |
$225.00 |
$80.40
|
|
Lead capillary
|
$1,348.51 |
$1,348.51 |
$1,348.51 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$3,390.22 |
$3,390.22 |
$3,390.22 |
$1,088.26
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$229.63 |
$229.63 |
$229.63 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$1,010.65 |
$1,010.65 |
$1,010.65 |
$88.92
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$2,453.78 |
$2,453.78 |
$2,453.78 |
$385.62
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$171.10 |
$171.10 |
$171.10 |
$39.37
|