|
Hepatitis b core antibody igm
|
$249.87 |
$249.87 |
$249.87 |
$87.98
|
|
Hepatitis b core antibody total
|
$257.80 |
$257.80 |
$257.80 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$349.11 |
$349.11 |
$349.11 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$233.99 |
$233.99 |
$233.99 |
$82.05
|
|
Hepatitis c antibody
|
$303.40 |
$303.40 |
$303.40 |
$108.00
|
|
Hepatobiliary system imaging
|
$2,307.86 |
$2,307.86 |
$2,307.86 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$283.58 |
$283.58 |
$283.58 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$414.46 |
$414.46 |
$414.46 |
$87.10
|
|
Herpes simplex virus isolation
|
$557.25 |
$557.25 |
$557.25 |
$104.10
|
|
Heterophile antibodies screening
|
$438.26 |
$438.26 |
$438.26 |
$74.00
|
|
Hla i low res one antigen equiv ea
|
$285.56 |
$285.56 |
$285.56 |
$161.70
|
|
Homogenization tissue
|
$49.68 |
$49.68 |
$49.68 |
$39.20
|
|
H pylori (c-13) breath
|
$858.65 |
$858.65 |
$858.65 |
$213.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$6,631.12 |
$6,631.12 |
$6,631.12 |
$5,836.20
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$621.49 |
$621.49 |
$621.49 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$207.86 |
$207.86 |
$207.86 |
$46.74
|
|
Hydroxyurea 500 mg
|
$18.71 |
$18.71 |
$18.71 |
$14.00
|
|
Hysterosalpingography s&i
|
$2,229.14 |
$2,229.14 |
$2,229.14 |
$651.85
|
|
I-123 sod iodide diag per 100 uci
|
$383.95 |
$383.95 |
$383.95 |
$139.20
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$5,034.18 |
$5,034.18 |
$5,034.18 |
$980.94
|
|
Ihc/icc per specimen each additional single antibody stain
|
$626.65 |
$626.65 |
$626.65 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$773.95 |
$773.95 |
$773.95 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$773.00 |
$773.00 |
$773.00 |
$274.86
|
|
Immunoassay tumor antigen quantitative ca 125
|
$442.22 |
$442.22 |
$442.22 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$1,351.58 |
$1,351.58 |
$1,351.58 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$471.96 |
$471.96 |
$471.96 |
$138.60
|
|
In-111 autol wbc diag per dose
|
$4,513.28 |
$4,513.28 |
$4,513.28 |
$3,567.60
|
|
Infect ag ia direct hiv-1 antgn
|
$370.44 |
$370.44 |
$370.44 |
$95.55
|
|
Infect ag if legionella pneumophila
|
$2,225.66 |
$2,225.66 |
$2,225.66 |
$73.46
|
|
Infect ag if pneumocystis carinii
|
$985.75 |
$985.75 |
$985.75 |
$67.46
|
|
Infect ag na resp virus 12-25 targets
|
$4,771.27 |
$4,771.27 |
$4,771.27 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$658.41 |
$658.41 |
$658.41 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$1,551.77 |
$1,551.77 |
$1,551.77 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$186.40 |
$186.40 |
$186.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$220.13 |
$220.13 |
$220.13 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$501.71 |
$501.71 |
$501.71 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$374.80 |
$374.80 |
$374.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$269.44 |
$269.44 |
$269.44 |
$55.31
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$577.08 |
$577.08 |
$577.08 |
$137.67
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$588.98 |
$588.98 |
$588.98 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$408.52 |
$408.52 |
$408.52 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$143.64 |
$143.64 |
$143.64 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$543.16 |
$543.16 |
$543.16 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$553.27 |
$553.27 |
$553.27 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$428.35 |
$428.35 |
$428.35 |
$100.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$416.00 |
$416.00 |
$416.00 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$207.36 |
$207.36 |
$207.36 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,963.44 |
$1,963.44 |
$1,963.44 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$543.36 |
$543.36 |
$543.36 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$910.22 |
$910.22 |
$910.22 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,814.51 |
$1,814.51 |
$1,814.51 |
$374.50
|
|
Initiation & management bipap/cpap initial day
|
$1,536.03 |
$1,536.03 |
$1,536.03 |
$576.00
|
|
Inj, biorphen, 20 micrograms
|
$52.35 |
$52.35 |
$52.35 |
$17.12
|
|
Inj cefazolin sodium, hikma
|
$15.37 |
$15.37 |
$15.37 |
$29.10
|
|
Inj crotalidae im f(ab')2 eq
|
$8,580.16 |
$8,580.16 |
$8,580.16 |
$2,613.60
|
|
Inj hydroxocobalamin IV 25mg
|
$3,647.41 |
$3,647.41 |
$3,647.41 |
$2,452.32
|
|
Inj ivig privigen 500 mg
|
$873.26 |
$873.26 |
$873.26 |
$6,967.29
|
|
Inj meropenem (wg crit care)
|
$49.35 |
$49.35 |
$49.35 |
$77.97
|
|
Insitu hybridization auto
|
$2,291.12 |
$2,291.12 |
$2,291.12 |
$371.00
|
|
Insitu hybridization manual
|
$1,752.04 |
$1,752.04 |
$1,752.04 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$221.92 |
$221.92 |
$221.92 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$418.44 |
$418.44 |
$418.44 |
$326.04
|
|
Insulin total
|
$247.88 |
$247.88 |
$247.88 |
$66.64
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$125.59 |
$125.59 |
$125.59 |
$172.98
|
|
Ipratropium bromide non-comp
|
$18.71 |
$18.71 |
$18.71 |
$3.75
|
|
Iron
|
$136.83 |
$136.83 |
$136.83 |
$74.40
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$300.23 |
$300.23 |
$300.23 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$593.15 |
$593.15 |
$593.15 |
$119.83
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$347.04 |
$347.04 |
$347.04 |
$60.20
|
|
Kidney img w/bldflw sgl without rx
|
$2,339.12 |
$2,339.12 |
$2,339.12 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,059.33 |
$1,059.33 |
$1,059.33 |
$666.00
|
|
Kras gene variants exon 2
|
$2,518.34 |
$2,518.34 |
$2,518.34 |
$486.45
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$80.45 |
$80.45 |
$80.45 |
$32.34
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$140.54 |
$140.54 |
$140.54 |
$175.92
|
|
Lactic acid
|
$230.04 |
$230.04 |
$230.04 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$69.00 |
$69.00 |
$69.00 |
$80.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,384.40 |
$1,384.40 |
$1,384.40 |
$1,088.26
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$8.32 |
$8.32 |
$8.32 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$91.23 |
$91.23 |
$91.23 |
$88.92
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$1,091.22 |
$1,091.22 |
$1,091.22 |
$385.62
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$49.29 |
$49.29 |
$49.29 |
$39.37
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$241.11 |
$241.11 |
$241.11 |
$125.66
|
|
Lipase
|
$178.47 |
$178.47 |
$178.47 |
$93.58
|
|
Lithium therapeutic drug level
|
$349.00 |
$349.00 |
$349.00 |
$69.42
|
|
Liver Function Test
|
$146.74 |
$146.74 |
$146.74 |
$115.44
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$18.71 |
$18.71 |
$18.71 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$9,547.50 |
$9,547.50 |
$9,547.50 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$6,365.58 |
$6,365.58 |
$6,365.58 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$7,825.33 |
$7,825.33 |
$7,825.33 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$6,273.48 |
$6,273.48 |
$6,273.48 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$6,500.85 |
$6,500.85 |
$6,500.85 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$4,317.01 |
$4,317.01 |
$4,317.01 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$1,012.37 |
$1,012.37 |
$1,012.37 |
$352.32
|
|
Lung perfusion imaging
|
$1,876.34 |
$1,876.34 |
$1,876.34 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$2,730.50 |
$2,730.50 |
$2,730.50 |
$1,448.00
|
|
Macroscopic exam parasite
|
$44.28 |
$44.28 |
$44.28 |
$36.40
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$637.84 |
$637.84 |
$637.84 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$1,536.03 |
$1,536.03 |
$1,536.03 |
$152.54
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$81.31 |
$81.31 |
$81.31 |
$66.36
|
|
Mayo activated protein c resistance assay
|
$259.78 |
$259.78 |
$259.78 |
$97.50
|