|
3-d radiotherapy plan
|
$14,372.65 |
$14,372.65 |
$14,372.65 |
$5,002.69
|
|
88334 ap bill cytologic exam each additional site
|
$71.38 |
$71.38 |
$71.38 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$751.00 |
$751.00 |
$751.00 |
$53.95
|
|
Abd aorta w/runoff s&i
|
$13,388.87 |
$13,388.87 |
$13,388.87 |
$3,569.56
|
|
Abdominal MRI (with and without contrast)
|
$19,972.64 |
$19,972.64 |
$19,972.64 |
$3,015.94
|
|
Abdominal MRI (without contrast)
|
$12,786.29 |
$12,786.29 |
$12,786.29 |
$2,050.14
|
|
Ablate arrhythmia add on
|
$29,997.87 |
$29,997.87 |
$29,997.87 |
$6,898.92
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$64.67 |
$64.67 |
$64.67 |
$74.96
|
|
Acetazolamide 500 mg solution for injection
|
$1,231.02 |
$1,231.02 |
$1,231.02 |
$122.55
|
|
Acetylcholine receptor modulating antibody
|
$139.97 |
$139.97 |
$139.97 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,914.25 |
$1,914.25 |
$1,914.25 |
$216.00
|
|
Acetylcysteine non-comp unit
|
$88.44 |
$88.44 |
$88.44 |
$31.21
|
|
Acute hepatitis panel
|
$780.00 |
$780.00 |
$780.00 |
$292.00
|
|
Adh-sendout
|
$648.00 |
$648.00 |
$648.00 |
$109.28
|
|
Administration vaccine influenza virus
|
$319.96 |
$319.96 |
$319.96 |
$50.43
|
|
#afb mycobacteria suscep. #1
|
$92.88 |
$92.88 |
$92.88 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$1,034.97 |
$1,034.97 |
$1,034.97 |
$315.00
|
|
Albumin body fluid quantitative each specimen
|
$75.00 |
$75.00 |
$75.00 |
$46.23
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$634.00 |
$634.00 |
$634.00 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$295.00 |
$295.00 |
$295.00 |
$40.80
|
|
Albuterol ipratrop non-comp
|
$107.54 |
$107.54 |
$107.54 |
$5.40
|
|
Albuterol non-comp con
|
$47.81 |
$47.81 |
$47.81 |
$6.07
|
|
Allergen alpha lactalbumin ige
|
$62.08 |
$62.08 |
$62.08 |
$48.00
|
|
Allergen egg white ige
|
$46.00 |
$46.00 |
$46.00 |
$38.00
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$514.00 |
$514.00 |
$514.00 |
$175.20
|
|
Aluminum - quest
|
$250.00 |
$250.00 |
$250.00 |
$83.05
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$126.53 |
$126.53 |
$126.53 |
$37.14
|
|
Amitriptyline (elavil) -sendout
|
$173.00 |
$173.00 |
$173.00 |
$87.45
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$404.90 |
$404.90 |
$404.90 |
$117.75
|
|
Analysis gene f2 20210g>a variant
|
$210.00 |
$210.00 |
$210.00 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$271.53 |
$271.53 |
$271.53 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$522.72 |
$522.72 |
$522.72 |
$85.80
|
|
Anastrozole 1 mg
|
$245.00 |
$245.00 |
$245.00 |
$22.40
|
|
An fluoro guide for cvp
|
$1,785.61 |
$1,785.61 |
$1,785.61 |
$515.00
|
|
Antibody bacterium, not elsewhere specified
|
$119.62 |
$119.62 |
$119.62 |
$57.81
|
|
Antibody elution rbc reference
|
$339.00 |
$339.00 |
$339.00 |
$175.50
|
|
Antibody id rbc panel
|
$837.00 |
$837.00 |
$837.00 |
$274.56
|
|
Antibody screen rbc
|
$700.00 |
$700.00 |
$700.00 |
$100.00
|
|
Antidepressants class 3-5
|
$138.60 |
$138.60 |
$138.60 |
$59.46
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$4,499.63 |
$4,499.63 |
$4,499.63 |
$6.10
|
|
Anti-inhibitor
|
$44,513.47 |
$44,513.47 |
$44,513.47 |
$8.33
|
|
Anti mog serum - sendout
|
$1,435.94 |
$1,435.94 |
$1,435.94 |
$159.00
|
|
Antinuclear antibodies
|
$86.00 |
$86.00 |
$86.00 |
$89.40
|
|
Antistreptolysin o titer
|
$443.00 |
$443.00 |
$443.00 |
$51.45
|
|
Antithrombin iii activity
|
$210.00 |
$210.00 |
$210.00 |
$114.00
|
|
Application finger splntstatic 29130
|
$566.61 |
$566.61 |
$566.61 |
$208.16
|
|
Aquaporin-4 antibody elisa
|
$972.00 |
$972.00 |
$972.00 |
$148.80
|
|
Artery xray each vessel 7577426
|
$4,516.33 |
$4,516.33 |
$4,516.33 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$9,514.38 |
$9,514.38 |
$9,514.38 |
$4,446.00
|
|
Artery x-rays arms/legs 75716-26
|
$10,091.66 |
$10,091.66 |
$10,091.66 |
$3,729.00
|
|
Artery x-rays lungs
|
$8,445.24 |
$8,445.24 |
$8,445.24 |
$3,535.57
|
|
Artery xrays of pelvis 75736 26
|
$8,939.37 |
$8,939.37 |
$8,939.37 |
$4,134.14
|
|
Artery x-rays spine
|
$6,734.06 |
$6,734.06 |
$6,734.06 |
$4,306.40
|
|
Assay of glutathione
|
$209.00 |
$209.00 |
$209.00 |
$76.14
|
|
Assay of interleukin-6 (il-6)
|
$168.21 |
$168.21 |
$168.21 |
$79.97
|
|
Assay of osteocalcin
|
$149.00 |
$149.00 |
$149.00 |
$92.50
|
|
Assay of procainamide w/metab
|
$732.64 |
$732.64 |
$732.64 |
$70.50
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$852.99 |
$852.99 |
$852.99 |
$292.50
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$384.17 |
$384.17 |
$384.17 |
$49.80
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$3,688.49 |
$3,688.49 |
$3,688.49 |
$186.60
|
|
Azathioprine 50 mg tablet
|
$59.75 |
$59.75 |
$59.75 |
$3.46
|
|
Bacterial vaginosis pcr
|
$188.51 |
$188.51 |
$188.51 |
$278.40
|
|
B cells total count
|
$288.00 |
$288.00 |
$288.00 |
$131.30
|
|
Bendamustine 100 mg intravenous powder for solution
|
$227.79 |
$227.79 |
$227.79 |
$4,844.85
|
|
Benztropine 1 mg/ml injection solution
|
$174.44 |
$174.44 |
$174.44 |
$103.20
|
|
Beta-2 microglobulin
|
$365.00 |
$365.00 |
$365.00 |
$85.94
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$65.42 |
$65.42 |
$65.42 |
$64.15
|
|
Bivalirudin
|
$7,978.56 |
$7,978.56 |
$7,978.56 |
$1,033.55
|
|
Blood Culture Test
|
$971.00 |
$971.00 |
$971.00 |
$145.80
|
|
Blood gases o2 saturation direct measurement
|
$1,179.00 |
$1,179.00 |
$1,179.00 |
$220.35
|
|
Blood smear microscopic w manual differential wbc count
|
$303.00 |
$303.00 |
$303.00 |
$38.61
|
|
Blood typing abo
|
$282.00 |
$282.00 |
$282.00 |
$83.03
|
|
Blood typing ag donor ea ag
|
$275.00 |
$275.00 |
$275.00 |
$190.80
|
|
Blood typing rbc ag non abo/rh ea
|
$207.00 |
$207.00 |
$207.00 |
$199.50
|
|
Blood typing rh (d)
|
$273.00 |
$273.00 |
$273.00 |
$57.14
|
|
Blood typing rh phenotype complete reference
|
$441.00 |
$441.00 |
$441.00 |
$82.80
|
|
Bone survey-lead poisoning
|
$1,113.00 |
$1,113.00 |
$1,113.00 |
$390.00
|
|
Boot mlti podous univ xlg
|
$3,081.00 |
$3,081.00 |
$3,081.00 |
$235.98
|
|
Boot walker genesis mid-calf full shell s
|
$1,747.00 |
$1,747.00 |
$1,747.00 |
$173.88
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$602.00 |
$602.00 |
$602.00 |
$94.80
|
|
Braf gene
|
$1,355.00 |
$1,355.00 |
$1,355.00 |
$427.50
|
|
Brain flow imaging only
|
$4,867.41 |
$4,867.41 |
$4,867.41 |
$636.97
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$7,787.06 |
$7,787.06 |
$7,787.06 |
$2,136.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$8,847.21 |
$8,847.21 |
$8,847.21 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$19,492.76 |
$19,492.76 |
$19,492.76 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$13,715.74 |
$13,715.74 |
$13,715.74 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$10,643.20 |
$10,643.20 |
$10,643.20 |
$1,977.27
|
|
Bronchial challenge
|
$3,447.87 |
$3,447.87 |
$3,447.87 |
$777.60
|
|
Bundled special stain group 1 microorganisms
|
$197.00 |
$197.00 |
$197.00 |
$160.80
|
|
Bundled special stain group 2
|
$168.00 |
$168.00 |
$168.00 |
$173.46
|
|
C-1 esterase, berinert
|
$19,511.07 |
$19,511.07 |
$19,511.07 |
$7,466.16
|
|
C1 esterase inhibitor func - sendout
|
$325.37 |
$325.37 |
$325.37 |
$96.72
|
|
Cabergoline, oral 0.25mg
|
$449.82 |
$449.82 |
$449.82 |
$65.85
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$20,955.37 |
$20,955.37 |
$20,955.37 |
$2,111.64
|
|
Calcium 24 hour urine
|
$350.59 |
$350.59 |
$350.59 |
$53.00
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$114.94 |
$114.94 |
$114.94 |
$91.60
|
|
Calcium ionized
|
$537.00 |
$537.00 |
$537.00 |
$90.00
|
|
Calprotectin fecal
|
$703.00 |
$703.00 |
$703.00 |
$169.95
|
|
Capecitabine, oral, 50 mg
|
$199.20 |
$199.20 |
$199.20 |
$59.42
|
|
Carbamazepine total therapeutic drug level
|
$833.00 |
$833.00 |
$833.00 |
$120.25
|
