|
Assay of somatostatin
|
$2,288.97 |
$2,288.97 |
$2,288.97 |
$165.00
|
|
Assay of thiocyanate
|
$497.06 |
$497.06 |
$497.06 |
$65.00
|
|
Assay of urine urobilinogen
|
$517.01 |
$517.01 |
$517.01 |
$13.18
|
|
Assay toxin or antitoxin
|
$1,073.91 |
$1,073.91 |
$1,073.91 |
$75.90
|
|
Azacitidine injection
|
$4,283.23 |
$4,283.23 |
$4,283.23 |
$1,042.91
|
|
Azathioprine 50 mg tablet
|
$66.97 |
$66.97 |
$66.97 |
$3.46
|
|
Azithromycin dihydrate, oral
|
$5.27 |
$5.27 |
$5.27 |
$47.16
|
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
$1,156.83 |
$1,156.83 |
$1,156.83 |
$161.17
|
|
Baclofen eval charges
|
$214.44 |
$214.44 |
$214.44 |
$85.00
|
|
Bacterial meningitis antigen
|
$274.61 |
$274.61 |
$274.61 |
$66.30
|
|
Bacterial vaginosis pcr
|
$471.00 |
$471.00 |
$471.00 |
$278.40
|
|
Bactericidal level serum
|
$573.76 |
$573.76 |
$573.76 |
$121.80
|
|
Barrier film 28ml spray no stng cavilon
|
$381.00 |
$381.00 |
$381.00 |
$19.50
|
|
Barrier skin flextend 2.25in floating flang new image
|
$25.00 |
$25.00 |
$25.00 |
$4.80
|
|
Bartonella dna pcr-sendout
|
$351.32 |
$351.32 |
$351.32 |
$195.66
|
|
Basiliximab
|
$30,338.29 |
$30,338.29 |
$30,338.29 |
$8,045.59
|
|
Battery elec/combo vad, rep
|
$16,678.00 |
$16,678.00 |
$16,678.00 |
$1,489.00
|
|
B cells total count
|
$282.28 |
$282.28 |
$282.28 |
$131.30
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$7,669.53 |
$7,669.53 |
$7,669.53 |
$4,702.68
|
|
Benztropine 1 mg/ml injection solution
|
$1,536.02 |
$1,536.02 |
$1,536.02 |
$103.20
|
|
Beta-2 microglobulin
|
$943.52 |
$943.52 |
$943.52 |
$85.94
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$11,578.14 |
$11,578.14 |
$11,578.14 |
$5,705.92
|
|
Bivalirudin
|
$11,412.36 |
$11,412.36 |
$11,412.36 |
$1,033.55
|
|
Bk waist belt webbing
|
$874.00 |
$874.00 |
$874.00 |
$136.13
|
|
Bleomycin 15 unit solution for injection
|
$3,402.47 |
$3,402.47 |
$3,402.47 |
$215.36
|
|
Blood count spun microhematocrit
|
$188.70 |
$188.70 |
$188.70 |
$22.36
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$273.09 |
$273.09 |
$273.09 |
$33.15
|
|
Blood occult peroxidase activity qualitative gastric
|
$217.86 |
$217.86 |
$217.86 |
$34.00
|
|
Blood split unit
|
$416.44 |
$416.44 |
$416.44 |
$250.00
|
|
Blood typing rh phenotype complete reference
|
$365.14 |
$365.14 |
$365.14 |
$82.80
|
|
Bone imaging multiple areas
|
$2,360.54 |
$2,360.54 |
$2,360.54 |
$1,194.00
|
|
Bone/joint imaging ltd area
|
$1,806.69 |
$1,806.69 |
$1,806.69 |
$1,013.50
|
|
Bone marrow imaging mult
|
$3,565.43 |
$3,565.43 |
$3,565.43 |
$923.00
|
|
Bone marrow interpretation
|
$100.46 |
$100.46 |
$100.46 |
$542.03
|
|
Bone tendon board add on
|
$26,334.00 |
$26,334.00 |
$26,334.00 |
$7,448.27
|
|
Boot softgait shrt m
|
$589.00 |
$589.00 |
$589.00 |
$139.20
|
|
Boot walker genesis full shell 3-strap s
|
$2,428.00 |
$2,428.00 |
$2,428.00 |
$453.47
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$20,285.53 |
$20,285.53 |
$20,285.53 |
$2,825.96
|
|
(both sides) smear without diff wbc count
|
$164.16 |
$164.16 |
$164.16 |
$30.68
|
|
Brace adj motion lerman type
|
$849.00 |
$849.00 |
$849.00 |
$281.75
|
|
Brace afo lg left 6607
|
$2,845.00 |
$2,845.00 |
$2,845.00 |
$461.76
|
|
Brace afopos solid ankle cust
|
$4,096.00 |
$4,096.00 |
$4,096.00 |
$1,087.89
|
|
Brace afo spiral prefab
|
$6,944.00 |
$6,944.00 |
$6,944.00 |
$1,652.50
|
|
Brace back pinnacle lo 627 lumbar
|
$3,092.00 |
$3,092.00 |
$3,092.00 |
$857.43
|
|
Brace halo bremer l2830
|
$777.00 |
$777.00 |
$777.00 |
$195.59
|
|
Brace kafo dbl upright cust
|
$8,319.00 |
$8,319.00 |
$8,319.00 |
$3,609.22
|
|
Brace knee hing pat open med
|
$811.00 |
$811.00 |
$811.00 |
$216.00
|
|
Brachy source iodine-125 nonstranded
|
$456.00 |
$456.00 |
$456.00 |
$66.76
|
|
Brachy source yttrium-90
|
$380,383.00 |
$380,383.00 |
$380,383.00 |
$29,856.80
|
|
Braf gene
|
$94.64 |
$94.64 |
$94.64 |
$427.50
|
|
Brain image 4+ views
|
$2,838.50 |
$2,838.50 |
$2,838.50 |
$952.80
|
|
Brain image w/flow 4 + views
|
$3,420.31 |
$3,420.31 |
$3,420.31 |
$1,330.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$5,245.12 |
$5,245.12 |
$5,245.12 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$9,521.42 |
$9,521.42 |
$9,521.42 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$7,890.02 |
$7,890.02 |
$7,890.02 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$7,277.73 |
$7,277.73 |
$7,277.73 |
$1,977.27
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$56,042.77 |
$56,042.77 |
$56,042.77 |
$22,383.57
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$83.47 |
$83.47 |
$83.47 |
$23.92
|
|
Bupren/nal 3.1 to 6mg bupren
|
$26.90 |
$26.90 |
$26.90 |
$23.32
|
|
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet
|
$31.41 |
$31.41 |
$31.41 |
$11.72
|
|
Butorphanol tartrate 1 mg
|
$433.82 |
$433.82 |
$433.82 |
$39.09
|
|
C-1 esterase, berinert
|
$35,374.41 |
$35,374.41 |
$35,374.41 |
$7,466.16
|
|
C1 esterase inhibitor func - sendout
|
$546.16 |
$546.16 |
$546.16 |
$96.72
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$23,107.65 |
$23,107.65 |
$23,107.65 |
$2,111.64
|
|
Calcium 24 hour urine
|
$555.36 |
$555.36 |
$555.36 |
$53.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$79.01 |
$79.01 |
$79.01 |
$64.49
|
|
Calculi urinary-sendout
|
$1,353.13 |
$1,353.13 |
$1,353.13 |
$68.05
|
|
Calprotectin fecal
|
$254.68 |
$254.68 |
$254.68 |
$169.95
|
|
Campylobacter antibody
|
$406.56 |
$406.56 |
$406.56 |
$77.83
|
|
Candida skin test
|
$480.20 |
$480.20 |
$480.20 |
$58.76
|
|
Carbamazepine free
|
$602.93 |
$602.93 |
$602.93 |
$59.15
|
|
Carboplatin 10 mg/ml desensitization
|
$493.39 |
$493.39 |
$493.39 |
$186.10
|
|
Carboxyhemoglobin quantitative
|
$619.79 |
$619.79 |
$619.79 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$1,049.36 |
$1,049.36 |
$1,049.36 |
$144.00
|
|
Cardiac MRI w/stress img
|
$7,234.50 |
$7,234.50 |
$7,234.50 |
$1,474.98
|
|
Cardiac perf planar mult/ef/wm
|
$8,653.96 |
$8,653.96 |
$8,653.96 |
$2,768.80
|
|
Cardiac perf planar sgl/ef/wm
|
$6,923.18 |
$6,923.18 |
$6,923.18 |
$2,063.70
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$6,923.18 |
$6,923.18 |
$6,923.18 |
$2,626.88
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$6,050.44 |
$6,050.44 |
$6,050.44 |
$1,396.00
|
|
Card MRI veloc flow mapping
|
$2,782.50 |
$2,782.50 |
$2,782.50 |
$600.50
|
|
Carfilzomib 10 mg intravenous solution
|
$2,588.78 |
$2,588.78 |
$2,588.78 |
$6,877.19
|
|
Carotene
|
$688.86 |
$688.86 |
$688.86 |
$45.24
|
|
Catecholamines,fractionated, urine
|
$1,297.89 |
$1,297.89 |
$1,297.89 |
$117.14
|
|
Cath access del ds spyscop 2.0
|
$97,189.00 |
$97,189.00 |
$97,189.00 |
$5,212.99
|
|
Cath stripping venous s&i
|
$3,376.05 |
$3,376.05 |
$3,376.05 |
$682.34
|
|
Cebpa gene full sequence
|
$807.53 |
$807.53 |
$807.53 |
$484.90
|
|
Ceftazidime and avibactam
|
$2,217.02 |
$2,217.02 |
$2,217.02 |
$904.66
|
|
Cell count body fluid
|
$408.09 |
$408.09 |
$408.09 |
$63.63
|
|
Cell function assay w/stim
|
$443.37 |
$443.37 |
$443.37 |
$314.25
|
|
Cell marker study
|
$1,851.74 |
$1,851.74 |
$1,851.74 |
$247.20
|
|
Cerebrospinal fld flw imag
|
$2,838.50 |
$2,838.50 |
$2,838.50 |
$938.50
|
|
Cer post col occ/man sup adj
|
$84.00 |
$84.00 |
$84.00 |
$802.30
|
|
Cetuximab 100 mg/50 ml intravenous solution
|
$11,987.52 |
$11,987.52 |
$11,987.52 |
$3,028.20
|
|
#cf-97variants
|
$532.36 |
$532.36 |
$532.36 |
$622.20
|
|
Chemo adm cns w/lmbr punct
|
$1,338.41 |
$1,338.41 |
$1,338.41 |
$665.40
|
|
Chlamydia culture
|
$822.32 |
$822.32 |
$822.32 |
$93.90
|
|
Chlamydia type
|
$147.28 |
$147.28 |
$147.28 |
$34.20
|
|
Chloride 24 hour urine
|
$469.45 |
$469.45 |
$469.45 |
$49.50
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$3,934.14 |
$3,934.14 |
$3,934.14 |
$377.85
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,025.90 |
$2,025.90 |
$2,025.90 |
$602.40
|
