|
Prolactin
|
$1,450.10 |
$1,450.10 |
$1,450.10 |
$123.50
|
|
Protamine 10 mg/ml intravenous solution
|
$305.95 |
$305.95 |
$305.95 |
$59.61
|
|
Protein electrophoretic fractionation & quantitation serum
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$84.00
|
|
Protein total 24 hour urine
|
$768.99 |
$768.99 |
$768.99 |
$52.47
|
|
Protein total serum plasma whole blood
|
$447.66 |
$447.66 |
$447.66 |
$42.81
|
|
Prothrombin complex kcentra
|
$10,445.11 |
$10,445.11 |
$10,445.11 |
$7.55
|
|
PSA (Prostate) Test
|
$2,362.00 |
$2,362.00 |
$2,362.00 |
$107.50
|
|
Pyridoxine hcl 100 mg
|
$217.21 |
$217.21 |
$217.21 |
$48.70
|
|
Rapid Strep Test
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$74.25
|
|
Red blood cells leukocytes reduced each unit
|
$584.10 |
$584.10 |
$584.10 |
$422.84
|
|
Remdesivir 100 mg intravenous powder for solution
|
$3,811.74 |
$3,811.74 |
$3,811.74 |
$1,524.70
|
|
Renal function panel
|
$983.21 |
$983.21 |
$983.21 |
$113.52
|
|
Reticulocyte automated
|
$530.01 |
$530.01 |
$530.01 |
$53.00
|
|
Rheumatoid factor quantitative
|
$652.00 |
$652.00 |
$652.00 |
$56.55
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$3,956.23 |
$3,956.23 |
$3,956.23 |
$247.55
|
|
Ring ostmy barr adapt 48mm
|
$14.50 |
$14.50 |
$14.50 |
$9.40
|
|
Rsv assay w/optic
|
$953.02 |
$953.02 |
$953.02 |
$82.68
|
|
Rubeola antibody igg
|
$683.84 |
$683.84 |
$683.84 |
$80.00
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,827.36 |
$1,827.36 |
$1,827.36 |
$653.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,827.36 |
$1,827.36 |
$1,827.36 |
$744.47
|
|
Scan duplex lower extremity arteries complete bilateral
|
$5,211.98 |
$5,211.98 |
$5,211.98 |
$985.20
|
|
Screening prostate cancer PSA
|
$2,037.87 |
$2,037.87 |
$2,037.87 |
$98.28
|
|
Sickling rbc
|
$422.93 |
$422.93 |
$422.93 |
$54.00
|
|
Sinus CT scan (with and without contrast)
|
$806.40 |
$806.40 |
$806.40 |
$1,800.90
|
|
Sinus CT scan (with contrast)
|
$9,909.77 |
$9,909.77 |
$9,909.77 |
$1,562.50
|
|
Sinus CT scan (without contrast)
|
$9,728.92 |
$9,728.92 |
$9,728.92 |
$1,281.80
|
|
Smear gram stain
|
$678.35 |
$678.35 |
$678.35 |
$55.35
|
|
Smear special stain inclusion bodies/parasites
|
$480.60 |
$480.60 |
$480.60 |
$68.85
|
|
Sodium 24 hour urine
|
$376.24 |
$376.24 |
$376.24 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$130.77 |
$130.77 |
$130.77 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$130.77 |
$130.77 |
$130.77 |
$44.34
|
|
Sodium chloride 3 % ivpb
|
$136.49 |
$136.49 |
$136.49 |
$42.25
|
|
Sodium serum/plasma/whole blood
|
$444.90 |
$444.90 |
$444.90 |
$45.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$359.60 |
$359.60 |
$359.60 |
$50.22
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$263.55 |
$263.55 |
$263.55 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,949.63 |
$1,949.63 |
$1,949.63 |
$123.58
|
|
Surgical pathology level 1 gross examination only
|
$175.74 |
$175.74 |
$175.74 |
$80.60
|
|
Surgical pathology level 2 gross & microscopic examination
|
$260.88 |
$260.88 |
$260.88 |
$146.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$560.26 |
$560.26 |
$560.26 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$560.26 |
$560.26 |
$560.26 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$881.61 |
$881.61 |
$881.61 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$881.61 |
$881.61 |
$881.61 |
$730.20
|
|
Susceptibility enzyme detection per enzyme
|
$25.00 |
$25.00 |
$25.00 |
$35.10
|
|
Suscept studies macrobroth dilution ea
|
$546.44 |
$546.44 |
$546.44 |
$59.28
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$552.00 |
$552.00 |
$552.00 |
$40.11
|
|
T3 (triiodothyronine) free
|
$788.23 |
$788.23 |
$788.23 |
$99.20
|
|
T3 (triiodothyronine) total
|
$944.74 |
$944.74 |
$944.74 |
$93.52
|
|
T4 (thyroxine) free
|
$1,128.75 |
$1,128.75 |
$1,128.75 |
$85.20
|
|
T4 (thyroxine) total
|
$612.45 |
$612.45 |
$612.45 |
$67.80
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$138.28 |
$138.28 |
$138.28 |
$10.03
|
|
Tacrolimus therapeutic drug level
|
$719.54 |
$719.54 |
$719.54 |
$120.60
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$20.33 |
$20.33 |
$20.33 |
$14.62
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$108.05 |
$108.05 |
$108.05 |
$175.00
|
|
T cells absolute cd4/cd8 including ratio
|
$756.97 |
$756.97 |
$756.97 |
$175.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$42,960.43 |
$42,960.43 |
$42,960.43 |
$15,600.75
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$128.01 |
$128.01 |
$128.01 |
$39.18
|
|
Tetanus immune globulin inj
|
$4,574.98 |
$4,574.98 |
$4,574.98 |
$1,228.80
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$160.15 |
$160.15 |
$160.15 |
$25.54
|
|
Thyroglobulin antibody
|
$678.35 |
$678.35 |
$678.35 |
$81.90
|
|
Thyroid (TSH) Test
|
$1,746.72 |
$1,746.72 |
$1,746.72 |
$112.00
|
|
Thyroid Ultrasound
|
$2,315.56 |
$2,315.56 |
$2,315.56 |
$589.96
|
|
Tissue exam koh skin/hair/nails
|
$90.00 |
$90.00 |
$90.00 |
$47.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$468.72 |
$468.72 |
$468.72 |
$152.80
|
|
Transferrin
|
$980.47 |
$980.47 |
$980.47 |
$81.60
|
|
Treponema pallidum antibody
|
$204.71 |
$204.71 |
$204.71 |
$70.85
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$209.93 |
$209.93 |
$209.93 |
$43.80
|
|
Triglycerides
|
$719.54 |
$719.54 |
$719.54 |
$57.85
|
|
Troponin quantitative
|
$747.03 |
$747.03 |
$747.03 |
$128.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$2,458.96 |
$2,458.96 |
$2,458.96 |
$394.20
|
|
Ultrasound chest
|
$1,590.12 |
$1,590.12 |
$1,590.12 |
$451.52
|
|
Ultrasound joint complete left
|
$1,966.33 |
$1,966.33 |
$1,966.33 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,409.29 |
$1,409.29 |
$1,409.29 |
$418.80
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$548.77 |
$548.77 |
$548.77 |
$323.40
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,881.13 |
$1,881.13 |
$1,881.13 |
$442.80
|
|
Ultrasound pregnant uterus transvaginal
|
$2,521.31 |
$2,521.31 |
$2,521.31 |
$484.52
|
|
Ultrasound retroperitoneal limited
|
$2,458.96 |
$2,458.96 |
$2,458.96 |
$477.10
|
|
Ultrasound scrotum and contents
|
$2,835.21 |
$2,835.21 |
$2,835.21 |
$606.60
|
|
Ultrasound transvaginal non obstetric
|
$3,034.74 |
$3,034.74 |
$3,034.74 |
$549.75
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$19,751.80 |
$19,751.80 |
$19,751.80 |
$3,039.60
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$11,471.75 |
$11,471.75 |
$11,471.75 |
$2,034.41
|
|
Urea nitrogen
|
$508.05 |
$508.05 |
$508.05 |
$39.90
|
|
Urea nitrogen 24 hour urine
|
$530.01 |
$530.01 |
$530.01 |
$52.00
|
|
Uric acid blood
|
$546.54 |
$546.54 |
$546.54 |
$49.32
|
|
Uric acid urine
|
$530.01 |
$530.01 |
$530.01 |
$44.14
|
|
Urinalysis (with microscopy)
|
$606.94 |
$606.94 |
$606.94 |
$55.00
|
|
Urinalysis (without microscopy)
|
$606.94 |
$606.94 |
$606.94 |
$35.91
|
|
Urine Culture Test
|
$1,186.46 |
$1,186.46 |
$1,186.46 |
$84.00
|
|
Urine pregnancy test
|
$856.89 |
$856.89 |
$856.89 |
$69.48
|
|
Vaccine dtap < 7 years im
|
$527.33 |
$527.33 |
$527.33 |
$73.01
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$636.68 |
$636.68 |
$636.68 |
$154.78
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$698.00 |
$698.00 |
$698.00 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$207.00 |
$207.00 |
$207.00 |
$47.88
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,634.80 |
$1,634.80 |
$1,634.80 |
$252.90
|
|
Vaccine rabies im
|
$3,914.15 |
$3,914.15 |
$3,914.15 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$819.14 |
$819.14 |
$819.14 |
$136.80
|
|
Vaccine td preservative free >= 7 years im
|
$475.58 |
$475.58 |
$475.58 |
$112.10
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$134.98 |
$134.98 |
$134.98 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$3,117.23 |
$3,117.23 |
$3,117.23 |
$115.00
|
|
Varicella zoster antibody igg
|
$1,625.89 |
$1,625.89 |
$1,625.89 |
$85.05
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,872.08 |
$1,872.08 |
$1,872.08 |
$342.98
|
