|
Dextrose 5 % and lactated ringers intravenous solution
|
$137.64 |
$137.64 |
$137.64 |
$45.40
|
|
Dhea-s (dehydroepiand sulfate)
|
$471.96 |
$471.96 |
$471.96 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$243.91 |
$243.91 |
$243.91 |
$79.20
|
|
Diagnostic Mammogram (both breasts)
|
$843.88 |
$843.88 |
$843.88 |
$399.30
|
|
Diatrizoate meglumine 18 % urethral solution
|
$177.88 |
$177.88 |
$177.88 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$241.11 |
$241.11 |
$241.11 |
$74.76
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$122.63 |
$122.63 |
$122.63 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$29,825.25 |
$29,825.25 |
$29,825.25 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$283.58 |
$283.58 |
$283.58 |
$102.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$56.12 |
$56.12 |
$56.12 |
$17.75
|
|
Dna antibody native/double stranded
|
$297.45 |
$297.45 |
$297.45 |
$97.50
|
|
Dna gardnerella
|
$305.39 |
$305.39 |
$305.39 |
$62.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$258.66 |
$258.66 |
$258.66 |
$98.43
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$562.43 |
$562.43 |
$562.43 |
$65.40
|
|
Doppler echo complete
|
$3,000.60 |
$3,000.60 |
$3,000.60 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,153.36 |
$2,153.36 |
$2,153.36 |
$662.35
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$243.18 |
$243.18 |
$243.18 |
$84.80
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$320.00 |
$320.00 |
$320.00 |
$127.14
|
|
Drug assay posaconazole
|
$188.40 |
$188.40 |
$188.40 |
$96.75
|
|
Drug test def 1-7 classes
|
$610.77 |
$610.77 |
$610.77 |
$250.52
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$515.59 |
$515.59 |
$515.59 |
$278.85
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,384.40 |
$1,384.40 |
$1,384.40 |
$887.25
|
|
Ecg 12 lead tracing only
|
$647.75 |
$647.75 |
$647.75 |
$226.50
|
|
Ecg external < 48 hours recording
|
$1,549.27 |
$1,549.27 |
$1,549.27 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$723.00 |
$723.00 |
$723.00 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$5,142.59 |
$5,142.59 |
$5,142.59 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$3,000.60 |
$3,000.60 |
$3,000.60 |
$469.95
|
|
Echo stress
|
$2,882.86 |
$2,882.86 |
$2,882.86 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$5,399.17 |
$5,399.17 |
$5,399.17 |
$1,849.50
|
|
Egfr gene com variants
|
$3,149.84 |
$3,149.84 |
$3,149.84 |
$657.00
|
|
Ehrlicha chaffeensis amp prb
|
$1,139.28 |
$1,139.28 |
$1,139.28 |
$93.00
|
|
Electrolyte panel
|
$140.80 |
$140.80 |
$140.80 |
$84.24
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$122.63 |
$122.63 |
$122.63 |
$809.08
|
|
Epstein barr nuclear antigen antibody
|
$750.87 |
$750.87 |
$750.87 |
$78.65
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$696.31 |
$696.31 |
$696.31 |
$222.98
|
|
Estradiol total
|
$591.00 |
$591.00 |
$591.00 |
$146.50
|
|
Estrogens total-sendout
|
$464.03 |
$464.03 |
$464.03 |
$96.20
|
|
Ethylene glycol -sendout
|
$317.29 |
$317.29 |
$317.29 |
$89.40
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$879.14 |
$879.14 |
$879.14 |
$219.60
|
|
External chromosome analysis 20-25 cells
|
$1,089.70 |
$1,089.70 |
$1,089.70 |
$384.15
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$79.92 |
$79.92 |
$79.92 |
$61.10
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$2,984.28 |
$2,984.28 |
$2,984.28 |
$454.20
|
|
F-18 fdg pet diag
|
$1,110.42 |
$1,110.42 |
$1,110.42 |
$551.72
|
|
F-18 florbetapir less than or equal to 10 mci
|
$8,779.00 |
$8,779.00 |
$8,779.00 |
$4,960.80
|
|
Facial bones <3
|
$501.36 |
$501.36 |
$501.36 |
$252.60
|
|
Factor viii
|
$390.68 |
$390.68 |
$390.68 |
$133.81
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$29.11 |
$29.11 |
$29.11 |
$22.20
|
|
Fat/lipids feces qualitative
|
$111.06 |
$111.06 |
$111.06 |
$38.35
|
|
Ferritin
|
$289.54 |
$289.54 |
$289.54 |
$100.94
|
|
Fetal biophys profile w/nst 76818
|
$2,371.61 |
$2,371.61 |
$2,371.61 |
$535.37
|
|
Fetal fibronectin
|
$916.19 |
$916.19 |
$916.19 |
$373.41
|
|
Fetal hemoglobin (kleihauer betke)
|
$355.00 |
$355.00 |
$355.00 |
$105.12
|
|
Fetal hemoglobin rosette
|
$820.16 |
$820.16 |
$820.16 |
$67.20
|
|
#_fet/norfentcnfrmur
|
$334.55 |
$334.55 |
$334.55 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$581.03 |
$581.03 |
$581.03 |
$117.70
|
|
Fibrin degradation products
|
$144.76 |
$144.76 |
$144.76 |
$62.64
|
|
Fibrinogen activity
|
$178.47 |
$178.47 |
$178.47 |
$83.50
|
|
Fibrinolytic antiplasmin
|
$2,191.03 |
$2,191.03 |
$2,191.03 |
$72.80
|
|
Finasteride, 5 mg
|
$51.96 |
$51.96 |
$51.96 |
$7.71
|
|
Flow cytometry marker each additional
|
$166.57 |
$166.57 |
$166.57 |
$97.50
|
|
Flow cytometry one marker technical component
|
$1,421.86 |
$1,421.86 |
$1,421.86 |
$284.40
|
|
Fluoroscopy up to 1 hour
|
$903.26 |
$903.26 |
$903.26 |
$492.00
|
|
Folic acid
|
$313.32 |
$313.32 |
$313.32 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$10.58 |
$10.58 |
$10.58 |
$54.75
|
|
Fomepizole 1 gram/ml intravenous solution
|
$12,679.02 |
$12,679.02 |
$12,679.02 |
$2,581.14
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$864.00 |
$864.00 |
$864.00 |
$156.60
|
|
Fructosamine glycated protein
|
$321.26 |
$321.26 |
$321.26 |
$60.75
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$1,854.04 |
$1,854.04 |
$1,854.04 |
$250.83
|
|
Gammaglobulin ige
|
$341.09 |
$341.09 |
$341.09 |
$83.85
|
|
Gamma glutamyltransferase
|
$154.68 |
$154.68 |
$154.68 |
$57.54
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$346.55 |
$346.55 |
$346.55 |
$132.00
|
|
Ghs histoplasma antigen
|
$735.72 |
$735.72 |
$735.72 |
$141.00
|
|
Ghs ot sensory integrative tech/15min
|
$450.78 |
$450.78 |
$450.78 |
$94.80
|
|
Ghs phenylketonurid
|
$402.56 |
$402.56 |
$402.56 |
$53.76
|
|
Ghs pr without cont pulse ox
|
$463.22 |
$463.22 |
$463.22 |
$146.86
|
|
Ghs rsv eia (respir synctial vrs)
|
$350.40 |
$350.40 |
$350.40 |
$96.60
|
|
Ghs sensitivity (per antimicro)
|
$39.26 |
$39.26 |
$39.26 |
$57.60
|
|
Gi inhouse confirmation
|
$414.46 |
$414.46 |
$414.46 |
$83.70
|
|
Glucagon 1 mg solution for injection
|
$1,910.16 |
$1,910.16 |
$1,910.16 |
$601.79
|
|
Glucose 1 hr post dose
|
$109.07 |
$109.07 |
$109.07 |
$47.20
|
|
Glucose blood quantitative
|
$136.83 |
$136.83 |
$136.83 |
$40.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$1,431.78 |
$1,431.78 |
$1,431.78 |
$100.16
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$220.13 |
$220.13 |
$220.13 |
$35.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$400.59 |
$400.59 |
$400.59 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$400.59 |
$400.59 |
$400.59 |
$129.00
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$2,052.00 |
$2,052.00 |
$2,052.00 |
$584.99
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$3,335.00 |
$3,335.00 |
$3,335.00 |
$1,181.41
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$176.68 |
$176.68 |
$176.68 |
$23.06
|
|
Haptoglobin quantitative
|
$271.68 |
$271.68 |
$271.68 |
$91.14
|
|
Hbot, full body chamber, 30m
|
$2,683.37 |
$2,683.37 |
$2,683.37 |
$526.90
|
|
Hcg qualitative
|
$567.16 |
$567.16 |
$567.16 |
$89.70
|
|
Head CT scan (with and without contrast)
|
$4,615.61 |
$4,615.61 |
$4,615.61 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,545.60
|
|
Head CT scan (without contrast)
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,268.90
|
|
Hematocrit
|
$118.98 |
$118.98 |
$118.98 |
$33.57
|
|
Hemoglobin
|
$43.63 |
$43.63 |
$43.63 |
$31.80
|
|
Hemoglobin methemoglobin quantitative
|
$43.63 |
$43.63 |
$43.63 |
$53.60
|
|
Hemolysins/agglutinins auto
|
$762.48 |
$762.48 |
$762.48 |
$57.14
|
|
Hemolysins and agglutinins incubated
|
$177.12 |
$177.12 |
$177.12 |
$57.14
|
|
Hepatitis a antibody igm
|
$243.91 |
$243.91 |
$243.91 |
$87.75
|
