|
17-ketosteroids
|
$20.79 |
$20.79 |
$20.79 |
$44.00
|
|
2019-ncov diagnostic p
|
$12.95 |
$12.95 |
$12.95 |
$39.51
|
|
2nd order venous cath
|
$394.07 |
$394.07 |
$394.07 |
$1,809.60
|
|
3-d radiotherapy plan
|
$7,729.75 |
$7,729.75 |
$7,729.75 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$337.75 |
$337.75 |
$337.75 |
$427.34
|
|
88334 ap bill cytologic exam each additional site
|
$35.00 |
$35.00 |
$35.00 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$3,305.05 |
$3,305.05 |
$3,305.05 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$1,094.63 |
$1,094.63 |
$1,094.63 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$524.65 |
$524.65 |
$524.65 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$629.65 |
$629.65 |
$629.65 |
$3,050.58
|
|
Abdominal CT scan (with and without contrast)
|
$4,648.00 |
$4,648.00 |
$4,648.00 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$4,113.09 |
$4,113.09 |
$4,113.09 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,385.60 |
$2,385.60 |
$2,385.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$5,034.60 |
$5,034.60 |
$5,034.60 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$4,531.45 |
$4,531.45 |
$4,531.45 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$2,920.40 |
$2,920.40 |
$2,920.40 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$1,321.43 |
$1,321.43 |
$1,321.43 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$1,649.55 |
$1,649.55 |
$1,649.55 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$923.65 |
$923.65 |
$923.65 |
$603.33
|
|
Abscess drain retroperitoneal surg code
|
$1,678.01 |
$1,678.01 |
$1,678.01 |
$3,053.18
|
|
Acetaminophen level
|
$8.75 |
$8.75 |
$8.75 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$58.44 |
$58.44 |
$58.44 |
$133.60
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$244.39 |
$244.39 |
$244.39 |
$323.77
|
|
Acetylcysteine non-comp unit
|
$29.04 |
$29.04 |
$29.04 |
$29.01
|
|
Acute hepatitis panel
|
$236.60 |
$236.60 |
$236.60 |
$284.70
|
|
Acyclovir 400 mg tablet
|
$467.94 |
$467.94 |
$467.94 |
$654.96
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$35.65 |
$35.65 |
$35.65 |
$50.70
|
|
#acylcarnitineprfl
|
$39.38 |
$39.38 |
$39.38 |
$105.60
|
|
Adapter b 8 channel 10cm
|
$1,837.50 |
$1,837.50 |
$1,837.50 |
$1,638.00
|
|
Adenosine 3 mg/250 ml bag for osm
|
$32.64 |
$32.64 |
$32.64 |
$219.86
|
|
Adh-sendout
|
$62.65 |
$62.65 |
$62.65 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$45.72 |
$45.72 |
$45.72 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$256.15 |
$256.15 |
$256.15 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$256.20 |
$256.20 |
$256.20 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$508.99 |
$508.99 |
$508.99 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$509.25 |
$509.25 |
$509.25 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$323.05 |
$323.05 |
$323.05 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$321.57 |
$321.57 |
$321.57 |
$264.00
|
|
Administration immunization 1 vaccine
|
$74.90 |
$74.90 |
$74.90 |
$70.52
|
|
Administration immunization each additional vaccine
|
$38.15 |
$38.15 |
$38.15 |
$46.23
|
|
Administration vaccine hepatitis b
|
$35.35 |
$35.35 |
$35.35 |
$51.35
|
|
Administration vaccine influenza virus
|
$38.15 |
$38.15 |
$38.15 |
$49.50
|
|
Administration vaccine pneumococcal
|
$38.15 |
$38.15 |
$38.15 |
$51.11
|
|
_afb id by dna probe rflx ast
|
$43.47 |
$43.47 |
$43.47 |
$105.00
|
|
_afb org id by sequencing rflx ast-sendout
|
$135.77 |
$135.77 |
$135.77 |
$289.60
|
|
Air injection into abdomen 49400
|
$151.83 |
$151.83 |
$151.83 |
$531.49
|
|
Albumin body fluid quantitative each specimen
|
$21.00 |
$21.00 |
$21.00 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$123.87 |
$123.87 |
$123.87 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$97.92 |
$97.92 |
$97.92 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$36.75 |
$36.75 |
$36.75 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$33.81 |
$33.81 |
$33.81 |
$43.50
|
|
Albuterol non-comp unit
|
$3.31 |
$3.31 |
$3.31 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$14.00 |
$14.00 |
$14.00 |
$93.60
|
|
Alkaline phosphatase
|
$28.35 |
$28.35 |
$28.35 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$25.48 |
$25.48 |
$25.48 |
$56.35
|
|
Allergen egg white ige
|
$9.10 |
$9.10 |
$9.10 |
$41.00
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$2,854.39 |
$2,854.39 |
$2,854.39 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$3,621.72 |
$3,621.72 |
$3,621.72 |
$905.18
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$657.15 |
$657.15 |
$657.15 |
$2,198.85
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$33.25 |
$33.25 |
$33.25 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$74.03 |
$74.03 |
$74.03 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$7,917.98 |
$7,917.98 |
$7,917.98 |
$2,600.22
|
|
Alt/sgpt
|
$29.40 |
$29.40 |
$29.40 |
$49.00
|
|
Amantadine (symmetrel)-sendout
|
$45.99 |
$45.99 |
$45.99 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$23.16 |
$23.16 |
$23.16 |
$36.30
|
|
Amino acid screen, urine
|
$38.75 |
$38.75 |
$38.75 |
$64.28
|
|
Amiodarone 50 mg/ml intravenous solution
|
$61.68 |
$61.68 |
$61.68 |
$47.44
|
|
Ammonia
|
$133.41 |
$133.41 |
$133.41 |
$120.90
|
|
Amniotic fluid scan
|
$3.15 |
$3.15 |
$3.15 |
$33.15
|
|
Amphetamines 5 or more
|
$0.63 |
$0.63 |
$0.63 |
$101.40
|
|
Ampicillin 1 gram solution for injection
|
$31.98 |
$31.98 |
$31.98 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$55.45 |
$55.45 |
$55.45 |
$51.93
|
|
Amylase
|
$93.45 |
$93.45 |
$93.45 |
$93.00
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$96.39 |
$96.39 |
$96.39 |
$110.98
|
|
Analysis gene f2 20210g>a variant
|
$103.60 |
$103.60 |
$103.60 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$116.55 |
$116.55 |
$116.55 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$100.32 |
$100.32 |
$100.32 |
$109.20
|
|
An fluoro guide for cvp
|
$193.55 |
$193.55 |
$193.55 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$3,864.42 |
$3,864.42 |
$3,864.42 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$4,770.15 |
$4,770.15 |
$4,770.15 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$3,291.44 |
$3,291.44 |
$3,291.44 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$3,384.85 |
$3,384.85 |
$3,384.85 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$147.37 |
$147.37 |
$147.37 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$9,181.20 |
$9,181.20 |
$9,181.20 |
$13,351.25
|
|
Angio trnslmnl balloon same artery ea addl
|
$2,454.80 |
$2,454.80 |
$2,454.80 |
$5,576.45
|
|
Angio trnslmnl balloon same artery ini
|
$4,770.15 |
$4,770.15 |
$4,770.15 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$2,862.41 |
$2,862.41 |
$2,862.41 |
$4,865.57
|
|
Angio trnslmnl balloon same vein ini
|
$4,770.15 |
$4,770.15 |
$4,770.15 |
$8,689.20
|
|
Ankle X-ray
|
$582.45 |
$582.45 |
$582.45 |
$339.44
|
|
Anodyne therapy charges pt
|
$8.05 |
$8.05 |
$8.05 |
$41.02
|
|
Anora (draw only)
|
$20.00 |
$20.00 |
$20.00 |
$36.00
|
|
Antibody elution rbc reference
|
$126.63 |
$126.63 |
$126.63 |
$176.54
|
|
Antibody htlv/hiv confirm test
|
$30.87 |
$30.87 |
$30.87 |
$141.74
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$133.88 |
$133.88 |
$133.88 |
$220.73
|
|
Antibody id rbc panel
|
$423.15 |
$423.15 |
$423.15 |
$291.75
|
|
Antibody screen rbc
|
$78.75 |
$78.75 |
$78.75 |
$105.00
|
|
Antibody tetanus
|
$12.53 |
$12.53 |
$12.53 |
$61.98
|
|
Antidepressant not specified
|
$0.63 |
$0.63 |
$0.63 |
$89.50
|
|
Anti mog serum - sendout
|
$275.36 |
$275.36 |
$275.36 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$17.98 |
$17.98 |
$17.98 |
$50.88
|
