|
11-desoxycortisol - sendout
|
$1,035.40 |
$1,035.40 |
$1,035.40 |
$84.56
|
|
17-ketosteroids
|
$1,526.81 |
$1,526.81 |
$1,526.81 |
$49.54
|
|
3-d radiotherapy plan
|
$4,825.40 |
$4,825.40 |
$4,825.40 |
$5,002.69
|
|
5% dextrose and 0.45% saline
|
$112.88 |
$112.88 |
$112.88 |
$48.00
|
|
5' nucleotidase - sendout
|
$407.62 |
$407.62 |
$407.62 |
$48.60
|
|
88334 ap bill cytologic exam each additional site
|
$980.00 |
$980.00 |
$980.00 |
$94.50
|
|
99391 periodic comp preventive med less than 1 year est
|
$158.59 |
$158.59 |
$158.59 |
$113.40
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$159.04 |
$159.04 |
$159.04 |
$3,390.19
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$1,255.53 |
$1,255.53 |
$1,255.53 |
$53.95
|
|
Abciximab injection
|
$24,399.65 |
$24,399.65 |
$24,399.65 |
$2,443.52
|
|
Abdominal CT scan (with and without contrast)
|
$11,521.90 |
$11,521.90 |
$11,521.90 |
$1,960.95
|
|
Abdominal CT scan (with contrast)
|
$9,733.08 |
$9,733.08 |
$9,733.08 |
$1,642.50
|
|
Abdominal CT scan (without contrast)
|
$8,670.47 |
$8,670.47 |
$8,670.47 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$13,445.32 |
$13,445.32 |
$13,445.32 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$12,615.99 |
$12,615.99 |
$12,615.99 |
$2,210.00
|
|
Abdominal MRI (without contrast)
|
$11,807.65 |
$11,807.65 |
$11,807.65 |
$1,993.50
|
|
Abdominal Ultrasound (complete)
|
$3,250.91 |
$3,250.91 |
$3,250.91 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$2,449.76 |
$2,449.76 |
$2,449.76 |
$592.15
|
|
Ablate arrhythmia add on
|
$47,719.24 |
$47,719.24 |
$47,719.24 |
$6,913.20
|
|
Ablate heart dysrhythm focus
|
$43,860.95 |
$43,860.95 |
$43,860.95 |
$9,522.05
|
|
Ablation cardiac vagal inputs atrium
|
$12,095.62 |
$12,095.62 |
$12,095.62 |
$2,126.95
|
|
Abscess drain retroperitoneal surg code
|
$7,248.25 |
$7,248.25 |
$7,248.25 |
$2,903.45
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$72.74 |
$72.74 |
$72.74 |
$81.07
|
|
Acetaminophen level
|
$414.67 |
$414.67 |
$414.67 |
$111.00
|
|
Acetazolamide 500 mg solution for injection
|
$627.75 |
$627.75 |
$627.75 |
$113.40
|
|
Acetone qualitative
|
$335.19 |
$335.19 |
$335.19 |
$43.80
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$2,939.65 |
$2,939.65 |
$2,939.65 |
$243.01
|
|
Acetylcysteine non-comp unit
|
$266.24 |
$266.24 |
$266.24 |
$31.21
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$232.80 |
$232.80 |
$232.80 |
$39.70
|
|
Actinotherapy uv light
|
$96.21 |
$96.21 |
$96.21 |
$104.65
|
|
Acute hepatitis panel
|
$4,405.74 |
$4,405.74 |
$4,405.74 |
$284.70
|
|
#acylcarnitineprfl
|
$1,384.79 |
$1,384.79 |
$1,384.79 |
$110.25
|
|
Acylcarnitines qual
|
$1,502.67 |
$1,502.67 |
$1,502.67 |
$45.60
|
|
Adalimumab injection
|
$4,373.35 |
$4,373.35 |
$4,373.35 |
$6,853.40
|
|
Adenovirus antibody,serum - quest
|
$2,636.05 |
$2,636.05 |
$2,636.05 |
$63.00
|
|
Adh-sendout
|
$2,532.37 |
$2,532.37 |
$2,532.37 |
$109.28
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$370.43 |
$370.43 |
$370.43 |
$298.11
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$661.35 |
$661.35 |
$661.35 |
$437.19
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$122.47 |
$122.47 |
$122.47 |
$211.09
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$132.97 |
$132.97 |
$132.97 |
$259.20
|
|
Administration vaccine hepatitis b
|
$193.57 |
$193.57 |
$193.57 |
$51.35
|
|
Administration vaccine pneumococcal
|
$193.57 |
$193.57 |
$193.57 |
$48.00
|
|
Adrenal cortex & medulla img
|
$6,242.88 |
$6,242.88 |
$6,242.88 |
$1,780.19
|
|
_afb id by dna probe rflx ast
|
$945.91 |
$945.91 |
$945.91 |
$93.52
|
|
_afb org id by sequencing rflx ast-sendout
|
$576.80 |
$576.80 |
$576.80 |
$295.94
|
|
Afo molded to patient plasti
|
$1,871.00 |
$1,871.00 |
$1,871.00 |
$757.77
|
|
Afo rig ant tib tcf/= custom
|
$3,545.00 |
$3,545.00 |
$3,545.00 |
$1,843.53
|
|
Afo, walk boot type, cus fab
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$2,903.60
|
|
Albumin body fluid quantitative each specimen
|
$1,542.43 |
$1,542.43 |
$1,542.43 |
$47.45
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$593.69 |
$593.69 |
$593.69 |
$57.20
|
|
Albumin serum plasma or whole blood
|
$434.60 |
$434.60 |
$434.60 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$4.29 |
$4.29 |
$4.29 |
$5.40
|
|
Albuterol non-comp con
|
$16.47 |
$16.47 |
$16.47 |
$6.00
|
|
Albuterol non-comp unit
|
$34.31 |
$34.31 |
$34.31 |
$5.61
|
|
Alginate drsg >16 <=48 sq in
|
$366.00 |
$366.00 |
$366.00 |
$40.89
|
|
Alkaline phosphatase
|
$515.56 |
$515.56 |
$515.56 |
$46.65
|
|
Allergen egg white ige
|
$181.80 |
$181.80 |
$181.80 |
$37.05
|
|
Allergen specific ige qual multi scrn ea
|
$211.63 |
$211.63 |
$211.63 |
$24.00
|
|
Allograft 160mg placental salera mini membrane
|
$456.00 |
$456.00 |
$456.00 |
$6,611.20
|
|
Alpha-fetoprotein amniotic
|
$1,183.10 |
$1,183.10 |
$1,183.10 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$823.76 |
$823.76 |
$823.76 |
$103.60
|
|
Alprostadil for injection
|
$1,494.54 |
$1,494.54 |
$1,494.54 |
$519.93
|
|
Alt/sgpt
|
$515.56 |
$515.56 |
$515.56 |
$47.80
|
|
Aluminum - quest
|
$1,184.52 |
$1,184.52 |
$1,184.52 |
$81.49
|
|
Amifostine
|
$12,952.58 |
$12,952.58 |
$12,952.58 |
$2,121.39
|
|
Amino acid screen, urine
|
$1,414.61 |
$1,414.61 |
$1,414.61 |
$81.90
|
|
Amino acids quant 2-5
|
$4,086.18 |
$4,086.18 |
$4,086.18 |
$113.60
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$2,324.82 |
$2,324.82 |
$2,324.82 |
$37.33
|
|
Aminolevulinic acid delta
|
$1,759.74 |
$1,759.74 |
$1,759.74 |
$85.15
|
|
Amitriptyline (elavil) -sendout
|
$2,121.92 |
$2,121.92 |
$2,121.92 |
$89.05
|
|
Ammonia
|
$711.57 |
$711.57 |
$711.57 |
$117.00
|
|
Amphetamine confirm urine -sendout
|
$311.59 |
$311.59 |
$311.59 |
$93.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$1,285.92 |
$1,285.92 |
$1,285.92 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,512.37 |
$1,512.37 |
$1,512.37 |
$558.95
|
|
Ana ds-dna
|
$1,228.55 |
$1,228.55 |
$1,228.55 |
$56.50
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$897.62 |
$897.62 |
$897.62 |
$106.70
|
|
Analysis complx cranial nerve pulse gen prgrmg 95977
|
$495.67 |
$495.67 |
$495.67 |
$292.00
|
|
Analysis gene f2 20210g>a variant
|
$3,309.27 |
$3,309.27 |
$3,309.27 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$2,262.52 |
$2,262.52 |
$2,262.52 |
$236.00
|
|
Analysis; simple cranial nerv pulse gen prgrmg 95976
|
$102.06 |
$102.06 |
$102.06 |
$113.60
|
|
Analysis tumor
|
$1,207.25 |
$1,207.25 |
$1,207.25 |
$237.89
|
|
Anastrozole 1 mg
|
$205.86 |
$205.86 |
$205.86 |
$22.40
|
|
Anca screen with reflex to titer -quest
|
$974.32 |
$974.32 |
$974.32 |
$101.50
|
|
Angio balloon ctrl dialysis seg add-on
|
$1,658.21 |
$1,658.21 |
$1,658.21 |
$5,341.83
|
|
Angio tib/peroneal/init ves/unila 37228
|
$47,147.18 |
$47,147.18 |
$47,147.18 |
$10,413.45
|
|
Angio trnslmnl balloon same artery ea addl
|
$1,658.21 |
$1,658.21 |
$1,658.21 |
$4,683.90
|
|
Angio trnslmnl balloon same vein ea addl
|
$1,868.21 |
$1,868.21 |
$1,868.21 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$6,538.01 |
$6,538.01 |
$6,538.01 |
$8,359.11
|
|
Anterior thoracic extension
|
$1,182.00 |
$1,182.00 |
$1,182.00 |
$503.00
|
|
Antibody elution rbc reference
|
$1,350.70 |
$1,350.70 |
$1,350.70 |
$174.93
|
|
Antibody htlv/hiv confirm test
|
$2,245.47 |
$2,245.47 |
$2,245.47 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$4,073.39 |
$4,073.39 |
$4,073.39 |
$219.30
|
|
Antibody id rbc panel
|
$1,607.76 |
$1,607.76 |
$1,607.76 |
$265.05
|
|
Antibody screen rbc
|
$940.24 |
$940.24 |
$940.24 |
$101.40
|
|
Antidepressant tricyclic 3-5
|
$1,053.85 |
$1,053.85 |
$1,053.85 |
$23.20
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$9,863.54 |
$9,863.54 |
$9,863.54 |
$6.57
|
|
Anti mog serum - sendout
|
$35.69 |
$35.69 |
$35.69 |
$153.17
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$1,576.52 |
$1,576.52 |
$1,576.52 |
$38.50
|
|
Antinuclear antibodies
|
$1,467.16 |
$1,467.16 |
$1,467.16 |
$91.44
|
|
Antinuclear antibodies titer
|
$1,495.57 |
$1,495.57 |
$1,495.57 |
$75.60
|
