|
3d ech img cgen car anomal
|
$3,512.00 |
$3,512.00 |
$3,512.00 |
$669.00
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$486.68 |
$486.68 |
$486.68 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$26,876.20 |
$26,876.20 |
$26,876.20 |
$3,667.71
|
|
Abdominal MRI (with and without contrast)
|
$18,152.95 |
$18,152.95 |
$18,152.95 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$13,106.54 |
$13,106.54 |
$13,106.54 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$13,106.54 |
$13,106.54 |
$13,106.54 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$9,185.09 |
$9,185.09 |
$9,185.09 |
$1,666.30
|
|
Ablate arrhythmia add on
|
$52,415.64 |
$52,415.64 |
$52,415.64 |
$7,417.15
|
|
Ablation cardiac vagal inputs atrium
|
$3,300.97 |
$3,300.97 |
$3,300.97 |
$3,587.65
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$297.58 |
$297.58 |
$297.58 |
$125.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,306.71 |
$1,306.71 |
$1,306.71 |
$323.77
|
|
Acute hepatitis panel
|
$3,185.82 |
$3,185.82 |
$3,185.82 |
$284.70
|
|
Administration vaccine pneumococcal
|
$85.13 |
$85.13 |
$85.13 |
$51.11
|
|
Albumin body fluid quantitative each specimen
|
$853.09 |
$853.09 |
$853.09 |
$48.00
|
|
Albumin (human), 5%, 250 ml
|
$2,269.56 |
$2,269.56 |
$2,269.56 |
$295.80
|
|
Albumin, human 5 % intravenous solution
|
$1,970.65 |
$1,970.65 |
$1,970.65 |
$248.88
|
|
Albuterol ipratrop non-comp
|
$103.16 |
$103.16 |
$103.16 |
$22.45
|
|
Albuterol non-comp con
|
$13.23 |
$13.23 |
$13.23 |
$15.00
|
|
Albuterol non-comp unit
|
$13.23 |
$13.23 |
$13.23 |
$9.59
|
|
Alkaline phosphatase
|
$1,110.42 |
$1,110.42 |
$1,110.42 |
$46.20
|
|
Allergen egg white ige
|
$152.44 |
$152.44 |
$152.44 |
$41.00
|
|
Alpha-fetoprotein tumor marker
|
$1,390.12 |
$1,390.12 |
$1,390.12 |
$99.00
|
|
Alt/sgpt
|
$1,011.13 |
$1,011.13 |
$1,011.13 |
$49.00
|
|
Aluminum - quest
|
$709.04 |
$709.04 |
$709.04 |
$87.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$36.81 |
$36.81 |
$36.81 |
$41.59
|
|
Ammonia
|
$1,268.45 |
$1,268.45 |
$1,268.45 |
$120.90
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$2,990.36 |
$2,990.36 |
$2,990.36 |
$130.08
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,054.10 |
$1,054.10 |
$1,054.10 |
$331.80
|
|
Amylase
|
$1,110.42 |
$1,110.42 |
$1,110.42 |
$93.00
|
|
An cholangiogram percutaneous compl
|
$1,766.90 |
$1,766.90 |
$1,766.90 |
$2,626.65
|
|
Angio trnslmnl balloon same artery ini
|
$31,414.69 |
$31,414.69 |
$31,414.69 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ini
|
$31,414.69 |
$31,414.69 |
$31,414.69 |
$8,689.20
|
|
Antibody elution rbc reference
|
$1,461.46 |
$1,461.46 |
$1,461.46 |
$176.54
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$2,033.45 |
$2,033.45 |
$2,033.45 |
$220.73
|
|
Antibody id rbc panel
|
$1,285.23 |
$1,285.23 |
$1,285.23 |
$291.75
|
|
Antibody screen rbc
|
$783.17 |
$783.17 |
$783.17 |
$105.00
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$6,709.51 |
$6,709.51 |
$6,709.51 |
$3.12
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$997.14 |
$997.14 |
$997.14 |
$50.88
|
|
Antinuclear antibodies titer
|
$1,339.77 |
$1,339.77 |
$1,339.77 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$647.51 |
$647.51 |
$647.51 |
$74.20
|
|
Antithrombin iii activity
|
$1,797.10 |
$1,797.10 |
$1,797.10 |
$115.23
|
|
Artery xray each vessel 7577426
|
$7,769.37 |
$7,769.37 |
$7,769.37 |
$1,752.53
|
|
Artery xray of abdomen 75726-26
|
$15,200.84 |
$15,200.84 |
$15,200.84 |
$4,337.45
|
|
Artery x-rays adrenals
|
$20,232.68 |
$20,232.68 |
$20,232.68 |
$3,706.68
|
|
Artery x-rays arms/legs 75716-26
|
$21,665.60 |
$21,665.60 |
$21,665.60 |
$3,844.10
|
|
Artery x-rays chest
|
$9,624.31 |
$9,624.31 |
$9,624.31 |
$2,587.20
|
|
Artery x-rays lung
|
$8,800.00 |
$8,800.00 |
$8,800.00 |
$2,921.88
|
|
Artery x-rays lung
|
$9,042.34 |
$9,042.34 |
$9,042.34 |
$2,332.57
|
|
Artery x-rays lungs
|
$2,118.88 |
$2,118.88 |
$2,118.88 |
$3,686.58
|
|
Aspirate bladder/sprapubic cath 51102
|
$10,712.23 |
$10,712.23 |
$10,712.23 |
$3,162.90
|
|
Assay toxin or antitoxin
|
$934.20 |
$934.20 |
$934.20 |
$72.75
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$369.21 |
$369.21 |
$369.21 |
$49.80
|
|
Ast/sgot
|
$999.94 |
$999.94 |
$999.94 |
$45.65
|
|
Azithromycin 500 mg intravenous solution
|
$976.06 |
$976.06 |
$976.06 |
$52.69
|
|
Aztreonam 1 gram solution for injection
|
$18.49 |
$18.49 |
$18.49 |
$157.30
|
|
Barrier film 28ml spray no stng cavilon
|
$391.00 |
$391.00 |
$391.00 |
$21.33
|
|
Beta-2 microglobulin
|
$1,201.33 |
$1,201.33 |
$1,201.33 |
$84.66
|
|
Biliary endoscopy thru skin
|
$24,268.13 |
$24,268.13 |
$24,268.13 |
$4,292.73
|
|
Bilirubin direct
|
$879.66 |
$879.66 |
$879.66 |
$49.29
|
|
Bilirubin total
|
$879.66 |
$879.66 |
$879.66 |
$51.39
|
|
Blood Clotting (PT/INR) Test
|
$620.95 |
$620.95 |
$620.95 |
$51.35
|
|
Blood Clotting (PTT) Test
|
$868.48 |
$868.48 |
$868.48 |
$72.15
|
|
Blood Count (CBC) Test (without differential)
|
$706.26 |
$706.26 |
$706.26 |
$62.28
|
|
Blood Culture Test
|
$1,166.37 |
$1,166.37 |
$1,166.37 |
$144.65
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$496.48 |
$496.48 |
$496.48 |
$33.57
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$496.48 |
$496.48 |
$496.48 |
$33.57
|
|
Blood typing abo
|
$223.77 |
$223.77 |
$223.77 |
$83.82
|
|
Blood typing patient serum
|
$421.64 |
$421.64 |
$421.64 |
$70.29
|
|
Blood typing rbc ag non abo/rh ea
|
$486.68 |
$486.68 |
$486.68 |
$181.74
|
|
Blood typing rh (d)
|
$288.09 |
$288.09 |
$288.09 |
$56.24
|
|
Bone Density Scan (DEXA)
|
$2,164.61 |
$2,164.61 |
$2,164.61 |
$395.00
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$879.66 |
$879.66 |
$879.66 |
$98.57
|
|
Bowel imaging
|
$2,834.00 |
$2,834.00 |
$2,834.00 |
$1,186.25
|
|
Brain flow imaging only
|
$5,025.70 |
$5,025.70 |
$5,025.70 |
$636.97
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$15,278.96 |
$15,278.96 |
$15,278.96 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$13,106.54 |
$13,106.54 |
$13,106.54 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$13,106.54 |
$13,106.54 |
$13,106.54 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$18,152.95 |
$18,152.95 |
$18,152.95 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$13,106.54 |
$13,106.54 |
$13,106.54 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$13,110.77 |
$13,110.77 |
$13,110.77 |
$1,927.04
|
|
Bundled special stain group 1 microorganisms
|
$721.62 |
$721.62 |
$721.62 |
$164.89
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$179.87 |
$179.87 |
$179.87 |
$30.97
|
|
Buprenorphine oral 1mg
|
$2.97 |
$2.97 |
$2.97 |
$11.95
|
|
Bx bone trocar/ndl deep
|
$14,009.05 |
$14,009.05 |
$14,009.05 |
$2,264.77
|
|
Bypass temp external fem-fem
|
$1,938.60 |
$1,938.60 |
$1,938.60 |
$2,428.80
|
|
Caffeine citrate 20 mg/ml inj for po
|
$110.87 |
$110.87 |
$110.87 |
$43.81
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$11,703.55 |
$11,703.55 |
$11,703.55 |
$2,910.00
|
|
Calcium 24 hour urine
|
$861.48 |
$861.48 |
$861.48 |
$52.00
|
|
Calcium acetate(phosphate binders) 667 mg tablet
|
$6.61 |
$6.61 |
$6.61 |
$2.47
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$390.79 |
$390.79 |
$390.79 |
$59.40
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$65.34 |
$65.34 |
$65.34 |
$92.91
|
|
Calcium ionized
|
$1,243.27 |
$1,243.27 |
$1,243.27 |
$86.35
|
|
Calcium total
|
$790.17 |
$790.17 |
$790.17 |
$48.75
|
|
Calculi urinary-sendout
|
$1,139.80 |
$1,139.80 |
$1,139.80 |
$68.05
|
|
Candida skin test
|
$763.58 |
$763.58 |
$763.58 |
$39.77
|
|
Carbamazepine total therapeutic drug level
|
$791.55 |
$791.55 |
$791.55 |
$113.25
|
|
Carbon dioxide
|
$639.12 |
$639.12 |
$639.12 |
$44.82
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$93.16 |
$93.16 |
$93.16 |
$432.25
|
|
Carboxyhemoglobin quantitative
|
$2,479.57 |
$2,479.57 |
$2,479.57 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$1,027.91 |
$1,027.91 |
$1,027.91 |
$146.90
|
