|
3-d radiotherapy plan
|
$10,915.53 |
$10,915.53 |
$10,915.53 |
$5,002.69
|
|
3d recon without postprocess indpndt
|
$500.88 |
$500.88 |
$500.88 |
$485.00
|
|
Abd aorta w/runoff s&i
|
$6,594.71 |
$6,594.71 |
$6,594.71 |
$3,569.56
|
|
Abdominal CT scan (with and without contrast)
|
$4,419.07 |
$4,419.07 |
$4,419.07 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$3,895.85 |
$3,895.85 |
$3,895.85 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$3,250.31 |
$3,250.31 |
$3,250.31 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$6,224.13 |
$6,224.13 |
$6,224.13 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$5,106.42 |
$5,106.42 |
$5,106.42 |
$2,268.20
|
|
Abdominal Ultrasound (complete)
|
$1,502.60 |
$1,502.60 |
$1,502.60 |
$785.55
|
|
Acetazolamide 500 mg solution for injection
|
$1,258.20 |
$1,258.20 |
$1,258.20 |
$122.55
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$3,874.18 |
$3,874.18 |
$3,874.18 |
$216.00
|
|
Acute hepatitis panel
|
$968.52 |
$968.52 |
$968.52 |
$292.00
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$238.41 |
$238.41 |
$238.41 |
$63.48
|
|
Adenovirus antibody,serum - quest
|
$729.17 |
$729.17 |
$729.17 |
$63.00
|
|
Adh-sendout
|
$1,588.91 |
$1,588.91 |
$1,588.91 |
$109.28
|
|
Administration immunization each additional vaccine
|
$499.08 |
$499.08 |
$499.08 |
$47.40
|
|
Administration immunization first component each vaccine
|
$308.44 |
$308.44 |
$308.44 |
$46.40
|
|
Administration vaccine influenza virus
|
$168.72 |
$168.72 |
$168.72 |
$50.43
|
|
#afb mycobacteria suscep. #1
|
$339.68 |
$339.68 |
$339.68 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$461.44 |
$461.44 |
$461.44 |
$315.00
|
|
Albuterol ipratrop non-comp
|
$41.96 |
$41.96 |
$41.96 |
$5.40
|
|
Albuterol non-comp con
|
$39.84 |
$39.84 |
$39.84 |
$6.07
|
|
Albuterol non-comp unit
|
$39.84 |
$39.84 |
$39.84 |
$5.61
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$929.92 |
$929.92 |
$929.92 |
$93.60
|
|
Alkaline phosphatase
|
$629.81 |
$629.81 |
$629.81 |
$46.40
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$5,401.92
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$743.00 |
$743.00 |
$743.00 |
$4,677.40
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$791.00 |
$791.00 |
$791.00 |
$4,561.83
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$705.00 |
$705.00 |
$705.00 |
$1,495.63
|
|
Alprostadil for injection
|
$2,387.13 |
$2,387.13 |
$2,387.13 |
$519.93
|
|
Alt/sgpt
|
$664.53 |
$664.53 |
$664.53 |
$47.45
|
|
Aluminum - quest
|
$818.57 |
$818.57 |
$818.57 |
$83.05
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$150.15 |
$150.15 |
$150.15 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$63.18 |
$63.18 |
$63.18 |
$37.14
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$98.70 |
$98.70 |
$98.70 |
$45.02
|
|
Amitriptyline (elavil) -sendout
|
$206.87 |
$206.87 |
$206.87 |
$87.45
|
|
Ammonia
|
$346.37 |
$346.37 |
$346.37 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$627.40 |
$627.40 |
$627.40 |
$92.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$548.32 |
$548.32 |
$548.32 |
$117.75
|
|
Ana ds-dna
|
$995.02 |
$995.02 |
$995.02 |
$56.50
|
|
Analysis gene f2 20210g>a variant
|
$412.80 |
$412.80 |
$412.80 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$377.55 |
$377.55 |
$377.55 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$1,730.67 |
$1,730.67 |
$1,730.67 |
$85.80
|
|
Anastrozole 1 mg
|
$246.54 |
$246.54 |
$246.54 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$92.32 |
$92.32 |
$92.32 |
$103.20
|
|
An fluoro guide for cvp
|
$1,655.94 |
$1,655.94 |
$1,655.94 |
$515.00
|
|
Antibody bacterium, not elsewhere specified
|
$90.16 |
$90.16 |
$90.16 |
$57.81
|
|
Antibody elution rbc reference
|
$979.69 |
$979.69 |
$979.69 |
$175.50
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$4,207.50 |
$4,207.50 |
$4,207.50 |
$6.10
|
|
Antinuclear antibodies
|
$995.02 |
$995.02 |
$995.02 |
$89.40
|
|
Antistreptolysin o titer
|
$646.87 |
$646.87 |
$646.87 |
$51.45
|
|
#aptt mix-1:1 incubated
|
$144.20 |
$144.20 |
$144.20 |
$157.30
|
|
Aquatic exercise - group charge
|
$308.03 |
$308.03 |
$308.03 |
$85.80
|
|
Artery xray each vessel 7577426
|
$3,961.65 |
$3,961.65 |
$3,961.65 |
$1,844.46
|
|
Artery xray of abdomen 75726-26
|
$5,837.69 |
$5,837.69 |
$5,837.69 |
$4,446.00
|
|
Artery x-rays chest
|
$14,374.93 |
$14,374.93 |
$14,374.93 |
$2,870.00
|
|
Artery xrays of pelvis 75736 26
|
$5,837.69 |
$5,837.69 |
$5,837.69 |
$4,134.14
|
|
Assay of galactose
|
$72.93 |
$72.93 |
$72.93 |
$49.21
|
|
Assay of interleukin-6 (il-6)
|
$511.36 |
$511.36 |
$511.36 |
$79.97
|
|
Assay of salicylate
|
$664.53 |
$664.53 |
$664.53 |
$95.00
|
|
Assay of thiocyanate
|
$746.63 |
$746.63 |
$746.63 |
$65.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$422.21 |
$422.21 |
$422.21 |
$49.80
|
|
Ast/sgot
|
$598.65 |
$598.65 |
$598.65 |
$45.65
|
|
Attn at delivery+ 1 stabilization of newborn 99464
|
$1,552.66 |
$1,552.66 |
$1,552.66 |
$186.60
|
|
Azathioprine 50 mg tablet
|
$38.75 |
$38.75 |
$38.75 |
$3.46
|
|
Azathioprine parenteral
|
$3,073.20 |
$3,073.20 |
$3,073.20 |
$442.98
|
|
Azithromycin 500 mg intravenous solution
|
$802.45 |
$802.45 |
$802.45 |
$35.06
|
|
Baclofen eval charges
|
$489.76 |
$489.76 |
$489.76 |
$85.00
|
|
B cells total count
|
$288.00 |
$288.00 |
$288.00 |
$131.30
|
|
Benztropine 1 mg/ml injection solution
|
$2,206.19 |
$2,206.19 |
$2,206.19 |
$103.20
|
|
Beta-2 microglobulin
|
$1,118.49 |
$1,118.49 |
$1,118.49 |
$85.94
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$880.73 |
$880.73 |
$880.73 |
$64.15
|
|
Bilirubin direct
|
$557.47 |
$557.47 |
$557.47 |
$50.00
|
|
Biofeedback, pt
|
$758.39 |
$758.39 |
$758.39 |
$118.25
|
|
Biotinidase - quest
|
$72.93 |
$72.93 |
$72.93 |
$71.02
|
|
Blood Clotting (PT/INR) Test
|
$538.07 |
$538.07 |
$538.07 |
$53.00
|
|
Blood Clotting (PTT) Test
|
$565.12 |
$565.12 |
$565.12 |
$73.44
|
|
Blood Count (CBC) Test (without differential)
|
$588.06 |
$588.06 |
$588.06 |
$61.80
|
|
Blood Culture Test
|
$622.17 |
$622.17 |
$622.17 |
$145.80
|
|
Blood gases ph venous
|
$625.12 |
$625.12 |
$625.12 |
$64.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$29.61 |
$29.61 |
$29.61 |
$33.15
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$107.06 |
$107.06 |
$107.06 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$98.22 |
$98.22 |
$98.22 |
$34.00
|
|
Blood typing ag donor ea ag
|
$606.28 |
$606.28 |
$606.28 |
$190.80
|
|
Blood typing rh phenotype complete reference
|
$676.89 |
$676.89 |
$676.89 |
$82.80
|
|
Bone/joint imaging ltd area
|
$3,203.74 |
$3,203.74 |
$3,203.74 |
$1,013.50
|
|
Boot mlti podous univ xlg
|
$1,106.00 |
$1,106.00 |
$1,106.00 |
$235.98
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$1,069.09 |
$1,069.09 |
$1,069.09 |
$94.80
|
|
Bowel imaging
|
$3,378.69 |
$3,378.69 |
$3,378.69 |
$1,065.00
|
|
Brace back pinnacle tlso 464
|
$4,615.00 |
$4,615.00 |
$4,615.00 |
$2,283.03
|
|
Braf gene
|
$730.76 |
$730.76 |
$730.76 |
$427.50
|
|
Brain flow imaging only
|
$3,203.74 |
$3,203.74 |
$3,203.74 |
$636.97
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$4,373.64 |
$4,373.64 |
$4,373.64 |
$2,785.50
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,469.64 |
$3,469.64 |
$3,469.64 |
$2,136.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$4,036.92 |
$4,036.92 |
$4,036.92 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$6,219.16 |
$6,219.16 |
$6,219.16 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$5,106.42 |
$5,106.42 |
$5,106.42 |
$2,267.23
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$28.29 |
$28.29 |
$28.29 |
$23.92
|
|
Bundled special stain group 1 microorganisms
|
$404.58 |
$404.58 |
$404.58 |
$160.80
|
|
Bundled special stain group 2
|
$188.18 |
$188.18 |
$188.18 |
$173.46
|
