|
3-d radiotherapy plan
|
$12,459.44 |
$12,459.44 |
$12,459.44 |
$5,002.69
|
|
5% dextrose and 0.45% saline
|
$92.29 |
$92.29 |
$92.29 |
$48.00
|
|
5' nucleotidase - sendout
|
$323.18 |
$323.18 |
$323.18 |
$50.40
|
|
Abd aorta w/runoff s&i
|
$12,464.16 |
$12,464.16 |
$12,464.16 |
$3,569.56
|
|
Abdominal MRI (with and without contrast)
|
$12,897.95 |
$12,897.95 |
$12,897.95 |
$3,015.94
|
|
Abdominal MRI (without contrast)
|
$10,094.98 |
$10,094.98 |
$10,094.98 |
$2,050.14
|
|
Acetazolamide 500 mg solution for injection
|
$78.76 |
$78.76 |
$78.76 |
$122.55
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,029.61 |
$1,029.61 |
$1,029.61 |
$216.00
|
|
Acute hepatitis panel
|
$1,949.71 |
$1,949.71 |
$1,949.71 |
$291.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$968.40 |
$968.40 |
$968.40 |
$657.12
|
|
Administration vaccine influenza virus
|
$263.61 |
$263.61 |
$263.61 |
$50.43
|
|
#afb mycobacteria suscep. #1
|
$367.00 |
$367.00 |
$367.00 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$215.97 |
$215.97 |
$215.97 |
$315.00
|
|
Albumin body fluid quantitative each specimen
|
$270.00 |
$270.00 |
$270.00 |
$46.20
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$342.38 |
$342.38 |
$342.38 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$249.46 |
$249.46 |
$249.46 |
$40.45
|
|
Albuterol ipratrop non-comp
|
$20.40 |
$20.40 |
$20.40 |
$5.40
|
|
Alkaline phosphatase
|
$229.05 |
$229.05 |
$229.05 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$70.61 |
$70.61 |
$70.61 |
$48.00
|
|
Allergen egg white ige
|
$104.00 |
$104.00 |
$104.00 |
$38.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$2,454.00 |
$2,454.00 |
$2,454.00 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$176.00 |
$176.00 |
$176.00 |
$2,250.00
|
|
Alprostadil for injection
|
$2,569.32 |
$2,569.32 |
$2,569.32 |
$519.93
|
|
Alt/sgpt
|
$148.00 |
$148.00 |
$148.00 |
$47.45
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$828.67 |
$828.67 |
$828.67 |
$40.28
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$152.32 |
$152.32 |
$152.32 |
$37.14
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$61.07 |
$61.07 |
$61.07 |
$45.02
|
|
Amitriptyline (elavil) -sendout
|
$848.85 |
$848.85 |
$848.85 |
$87.45
|
|
Amphetamine confirm urine -sendout
|
$220.07 |
$220.07 |
$220.07 |
$92.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$955.13 |
$955.13 |
$955.13 |
$117.75
|
|
Analysis gene f2 20210g>a variant
|
$1,050.08 |
$1,050.08 |
$1,050.08 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$962.77 |
$962.77 |
$962.77 |
$230.40
|
|
Anastrozole 1 mg
|
$95.45 |
$95.45 |
$95.45 |
$22.40
|
|
An fluoro guide for cvp
|
$1,645.50 |
$1,645.50 |
$1,645.50 |
$510.17
|
|
Antibody elution rbc reference
|
$135.21 |
$135.21 |
$135.21 |
$175.50
|
|
Antibody id rbc panel
|
$375.82 |
$375.82 |
$375.82 |
$274.83
|
|
Antibody screen rbc
|
$906.45 |
$906.45 |
$906.45 |
$100.00
|
|
Anti mog serum - sendout
|
$913.75 |
$913.75 |
$913.75 |
$159.00
|
|
Antinuclear antibodies
|
$1,554.98 |
$1,554.98 |
$1,554.98 |
$89.40
|
|
Antinuclear antibodies titer
|
$510.76 |
$510.76 |
$510.76 |
$76.70
|
|
Antistreptolysin o titer
|
$338.02 |
$338.02 |
$338.02 |
$51.45
|
|
Antithrombin iii activity
|
$1,523.00 |
$1,523.00 |
$1,523.00 |
$114.00
|
|
#aptt mix-1:1 incubated
|
$30.83 |
$30.83 |
$30.83 |
$157.30
|
|
Aquaporin-4 antibody cba each
|
$981.48 |
$981.48 |
$981.48 |
$138.16
|
|
Aquaporin-4 antibody elisa
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$148.80
|
|
Argatroban nonesrd use 1mg
|
$3,488.00 |
$3,488.00 |
$3,488.00 |
$866.80
|
|
Artery xray each vessel 7577426
|
$2,855.18 |
$2,855.18 |
$2,855.18 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$15,776.39 |
$15,776.39 |
$15,776.39 |
$4,446.00
|
|
Artery x-rays arms/legs 75716-26
|
$11,756.06 |
$11,756.06 |
$11,756.06 |
$3,729.00
|
|
Assay acid phosphatase
|
$280.41 |
$280.41 |
$280.41 |
$38.22
|
|
Assay of glutathione
|
$212.44 |
$212.44 |
$212.44 |
$76.14
|
|
Assay of interleukin-6 (il-6)
|
$275.21 |
$275.21 |
$275.21 |
$79.97
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$346.71 |
$346.71 |
$346.71 |
$49.80
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$1,425.45 |
$1,425.45 |
$1,425.45 |
$186.60
|
|
Azathioprine 50 mg tablet
|
$34.27 |
$34.27 |
$34.27 |
$3.46
|
|
B cells total count
|
$77.63 |
$77.63 |
$77.63 |
$131.30
|
|
#_benzodiazconfur
|
$497.21 |
$497.21 |
$497.21 |
$114.40
|
|
Benztropine 1 mg/ml injection solution
|
$164.55 |
$164.55 |
$164.55 |
$103.20
|
|
Beta-2 microglobulin
|
$804.23 |
$804.23 |
$804.23 |
$85.94
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$276.18 |
$276.18 |
$276.18 |
$64.15
|
|
Bilirubin total
|
$397.00 |
$397.00 |
$397.00 |
$52.57
|
|
Bivalirudin
|
$4,814.87 |
$4,814.87 |
$4,814.87 |
$1,019.23
|
|
Blood Culture Test
|
$529.34 |
$529.34 |
$529.34 |
$145.60
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$129.38 |
$129.38 |
$129.38 |
$33.57
|
|
Blood typing abo
|
$271.76 |
$271.76 |
$271.76 |
$83.03
|
|
Blood typing ag donor ea ag
|
$28.56 |
$28.56 |
$28.56 |
$190.80
|
|
Blood typing rbc ag non abo/rh ea
|
$46.00 |
$46.00 |
$46.00 |
$199.50
|
|
Blood typing rh (d)
|
$271.76 |
$271.76 |
$271.76 |
$57.14
|
|
Blood typing rh phenotype complete reference
|
$342.38 |
$342.38 |
$342.38 |
$82.80
|
|
Bone Density Scan (DEXA)
|
$526.14 |
$526.14 |
$526.14 |
$397.28
|
|
Bone imaging multiple areas
|
$7,121.70 |
$7,121.70 |
$7,121.70 |
$1,194.00
|
|
Bone/joint imaging ltd area
|
$4,939.88 |
$4,939.88 |
$4,939.88 |
$1,013.50
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$1,151.62 |
$1,151.62 |
$1,151.62 |
$94.80
|
|
Braf gene
|
$174.69 |
$174.69 |
$174.69 |
$427.50
|
|
Brain image w/flow 4 + views
|
$1,506.73 |
$1,506.73 |
$1,506.73 |
$1,332.80
|
|
Brain MRI (with contrast)
|
$14,517.67 |
$14,517.67 |
$14,517.67 |
$2,267.23
|
|
Budesonide non-comp unit
|
$90.96 |
$90.96 |
$90.96 |
$20.57
|
|
Bundled special stain group 1 microorganisms
|
$225.00 |
$225.00 |
$225.00 |
$160.00
|
|
Bundled special stain group 2
|
$158.00 |
$158.00 |
$158.00 |
$173.40
|
|
Buprenorphine and metabolite - sendout
|
$40.31 |
$40.31 |
$40.31 |
$82.82
|
|
C-1 esterase, berinert
|
$257.44 |
$257.44 |
$257.44 |
$7,466.16
|
|
C1 esterase inhibitor func - sendout
|
$51.06 |
$51.06 |
$51.06 |
$96.72
|
|
Caffeine citrate 20 mg/ml inj for po
|
$454.14 |
$454.14 |
$454.14 |
$47.78
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$9,802.97 |
$9,802.97 |
$9,802.97 |
$2,111.64
|
|
Calcium 24 hour urine
|
$176.43 |
$176.43 |
$176.43 |
$53.00
|
|
Calcium ionized
|
$529.34 |
$529.34 |
$529.34 |
$89.88
|
|
Calprotectin fecal
|
$419.96 |
$419.96 |
$419.96 |
$169.95
|
|
Carbamazepine total therapeutic drug level
|
$556.00 |
$556.00 |
$556.00 |
$120.25
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$493.93 |
$493.93 |
$493.93 |
$513.08
|
|
Carboxyhemoglobin quantitative
|
$445.14 |
$445.14 |
$445.14 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$848.85 |
$848.85 |
$848.85 |
$144.00
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$5,612.91 |
$5,612.91 |
$5,612.91 |
$2,626.88
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$531.23 |
$531.23 |
$531.23 |
$244.00
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$35.00 |
$35.00 |
$35.00 |
$196.50
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$2,645.95 |
$2,645.95 |
$2,645.95 |
$1,396.00
|
|
Cath ext adhere actv m 28mm
|
$21.00 |
$21.00 |
$21.00 |
$1.81
|
|
Cath stripping venous s&i
|
$14,924.90 |
$14,924.90 |
$14,924.90 |
$682.34
|
|
Chest apical lordotic proj
|
$1,815.56 |
$1,815.56 |
$1,815.56 |
$310.80
|
|
Chlamydia culture
|
$966.48 |
$966.48 |
$966.48 |
$93.90
|
|
Chlamydia type
|
$63.00 |
$63.00 |
$63.00 |
$34.20
|
