|
17-hydroxypregnenolone
|
$18.75 |
$18.75 |
$18.75 |
$85.15
|
|
17-ketosteroids
|
$43.20 |
$43.20 |
$43.20 |
$44.00
|
|
2d tee w or without fol w/con,in
|
$1,057.95 |
$1,057.95 |
$1,057.95 |
$1,570.80
|
|
2nd order venous cath
|
$673.05 |
$673.05 |
$673.05 |
$1,809.60
|
|
3-d radiotherapy plan
|
$1,514.40 |
$1,514.40 |
$1,514.40 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$220.35 |
$220.35 |
$220.35 |
$427.34
|
|
5' nucleotidase - sendout
|
$32.01 |
$32.01 |
$32.01 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$26.85 |
$26.85 |
$26.85 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$4,676.57 |
$4,676.57 |
$4,676.57 |
$3,634.61
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$24.60 |
$24.60 |
$24.60 |
$52.25
|
|
Abd aorta w/runoff s&i
|
$1,494.90 |
$1,494.90 |
$1,494.90 |
$3,667.71
|
|
Abd/low ext cath 1st
|
$261.00 |
$261.00 |
$261.00 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$191.10 |
$191.10 |
$191.10 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$227.40 |
$227.40 |
$227.40 |
$3,050.58
|
|
Abd/low ext cath addl
|
$134.25 |
$134.25 |
$134.25 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$1,638.15 |
$1,638.15 |
$1,638.15 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$1,449.75 |
$1,449.75 |
$1,449.75 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$840.90 |
$840.90 |
$840.90 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$1,533.90 |
$1,533.90 |
$1,533.90 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$1,380.60 |
$1,380.60 |
$1,380.60 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$889.80 |
$889.80 |
$889.80 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$498.15 |
$498.15 |
$498.15 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$520.50 |
$520.50 |
$520.50 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$391.35 |
$391.35 |
$391.35 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$478.35 |
$478.35 |
$478.35 |
$1,170.28
|
|
Ablate arrhythmia add on
|
$2,214.45 |
$2,214.45 |
$2,214.45 |
$7,417.15
|
|
Ablate bone tumor(s) perq
|
$2,798.85 |
$2,798.85 |
$2,798.85 |
$9,812.40
|
|
Ablate heart dysrhythm focus
|
$5,456.85 |
$5,456.85 |
$5,456.85 |
$10,008.58
|
|
Abscess drain retroperitoneal surg code
|
$1,186.95 |
$1,186.95 |
$1,186.95 |
$3,053.18
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$122.86 |
$122.86 |
$122.86 |
$125.63
|
|
Acetaminophen level
|
$53.25 |
$53.25 |
$53.25 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$152.56 |
$152.56 |
$152.56 |
$133.60
|
|
Acetone qualitative
|
$25.05 |
$25.05 |
$25.05 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$323.77
|
|
Acetylcysteine non-comp unit
|
$2.52 |
$2.52 |
$2.52 |
$29.01
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$9.30 |
$9.30 |
$9.30 |
$42.28
|
|
Acute hepatitis panel
|
$191.85 |
$191.85 |
$191.85 |
$284.70
|
|
Acute venous thrombus image
|
$308.85 |
$308.85 |
$308.85 |
$873.75
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$120.90 |
$120.90 |
$120.90 |
$50.70
|
|
#acylcarnitineprfl
|
$50.85 |
$50.85 |
$50.85 |
$105.60
|
|
Adapter b 8 channel 10cm
|
$28,253.61 |
$28,253.61 |
$28,253.61 |
$1,638.00
|
|
Adenosine 3 mg/250 ml bag for osm
|
$234.26 |
$234.26 |
$234.26 |
$219.86
|
|
Adenovirus antibody,serum - quest
|
$46.53 |
$46.53 |
$46.53 |
$63.00
|
|
Adh-sendout
|
$33.15 |
$33.15 |
$33.15 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$93.49 |
$93.49 |
$93.49 |
$124.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$84.45 |
$84.45 |
$84.45 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$70.05 |
$70.05 |
$70.05 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$148.95 |
$148.95 |
$148.95 |
$672.03
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$121.20 |
$121.20 |
$121.20 |
$440.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$57.00 |
$57.00 |
$57.00 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$87.45 |
$87.45 |
$87.45 |
$264.00
|
|
Administration immunization 1 vaccine
|
$46.65 |
$46.65 |
$46.65 |
$70.52
|
|
Administration immunization each additional vaccine
|
$22.35 |
$22.35 |
$22.35 |
$46.23
|
|
Administration vaccine influenza virus
|
$33.00 |
$33.00 |
$33.00 |
$49.50
|
|
Administration vaccine pneumococcal
|
$31.50 |
$31.50 |
$31.50 |
$51.11
|
|
_afb id by dna probe rflx ast
|
$31.65 |
$31.65 |
$31.65 |
$105.00
|
|
Albumin body fluid quantitative each specimen
|
$25.20 |
$25.20 |
$25.20 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$763.44 |
$763.44 |
$763.44 |
$295.80
|
|
Albumin (human), 5%, 250 ml
|
$8.79 |
$8.79 |
$8.79 |
$295.80
|
|
Albumin, human 5 % intravenous solution
|
$5.85 |
$5.85 |
$5.85 |
$248.88
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$41.85 |
$41.85 |
$41.85 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$35.10 |
$35.10 |
$35.10 |
$43.50
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$75.60 |
$75.60 |
$75.60 |
$93.60
|
|
Alkaline phosphatase
|
$46.65 |
$46.65 |
$46.65 |
$46.20
|
|
Allergen egg white ige
|
$20.40 |
$20.40 |
$20.40 |
$41.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$7,581.58 |
$7,581.58 |
$7,581.58 |
$6,285.56
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$12,951.86 |
$12,951.86 |
$12,951.86 |
$18,384.03
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,028.25 |
$1,028.25 |
$1,028.25 |
$905.18
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$2,167.02 |
$2,167.02 |
$2,167.02 |
$2,513.00
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$8,447.99 |
$8,447.99 |
$8,447.99 |
$2,198.85
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$103.50 |
$103.50 |
$103.50 |
$4,101.14
|
|
All tstg perq&iq drugs/biol
|
$19.35 |
$19.35 |
$19.35 |
$64.80
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$1,590.60 |
$1,590.60 |
$1,590.60 |
$13.14
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$28.65 |
$28.65 |
$28.65 |
$189.00
|
|
Alpha-fetoprotein amniotic
|
$58.95 |
$58.95 |
$58.95 |
$79.30
|
|
Alpha-fetoprotein tumor marker
|
$44.25 |
$44.25 |
$44.25 |
$99.00
|
|
Alprostadil for injection
|
$533.06 |
$533.06 |
$533.06 |
$533.06
|
|
Alteplase 100 mg infusion from pyxis vial
|
$30,540.77 |
$30,540.77 |
$30,540.77 |
$2,600.22
|
|
Alt/sgpt
|
$60.30 |
$60.30 |
$60.30 |
$49.00
|
|
Aluminum - quest
|
$31.80 |
$31.80 |
$31.80 |
$87.00
|
|
Amantadine (symmetrel)-sendout
|
$43.05 |
$43.05 |
$43.05 |
$196.20
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$116.26 |
$116.26 |
$116.26 |
$36.30
|
|
Amino acid screen, urine
|
$38.25 |
$38.25 |
$38.25 |
$64.28
|
|
Aminolevulinic acid delta
|
$42.75 |
$42.75 |
$42.75 |
$87.12
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$47.73 |
$47.73 |
$47.73 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$151.08 |
$151.08 |
$151.08 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$28.52 |
$28.52 |
$28.52 |
$47.44
|
|
Ammonia
|
$38.41 |
$38.41 |
$38.41 |
$120.90
|
|
Amniocentesisdiagnostic 59000
|
$942.60 |
$942.60 |
$942.60 |
$942.60
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$1,301.53 |
$1,301.53 |
$1,301.53 |
$3,835.20
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$927.61 |
$927.61 |
$927.61 |
$331.80
|
|
Ampicillin 1 gram solution for injection
|
$506.10 |
$506.10 |
$506.10 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$275.90 |
$275.90 |
$275.90 |
$51.93
|
|
Amputation toe metatarsophalangeal joint
|
$893.10 |
$893.10 |
$893.10 |
$3,777.93
|
|
Amylase
|
$77.85 |
$77.85 |
$77.85 |
$93.00
|
|
Ana ds-dna
|
$55.24 |
$55.24 |
$55.24 |
$65.52
|
|
Anal/urinary muscle study
|
$104.55 |
$104.55 |
$104.55 |
$507.26
|
|
Analysis gene f2 20210g>a variant
|
$84.30 |
$84.30 |
$84.30 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$94.65 |
$94.65 |
$94.65 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$34.97 |
$34.97 |
$34.97 |
$109.20
|
