|
Azathioprine 50 mg tablet
|
$11.72 |
$11.72 |
$11.72 |
$3.46
|
|
Azithromycin dihydrate, oral
|
$0.93 |
$0.93 |
$0.93 |
$47.16
|
|
Baclofen eval charges
|
$246.11 |
$246.11 |
$246.11 |
$85.00
|
|
Barrier film 28ml spray no stng cavilon
|
$169.00 |
$169.00 |
$169.00 |
$19.50
|
|
Bartonella dna pcr-sendout
|
$1,811.16 |
$1,811.16 |
$1,811.16 |
$195.66
|
|
Battery elec/combo vad, rep
|
$32,400.00 |
$32,400.00 |
$32,400.00 |
$1,489.00
|
|
Benztropine 1 mg/ml injection solution
|
$1,457.09 |
$1,457.09 |
$1,457.09 |
$103.20
|
|
Beta-2 microglobulin
|
$777.58 |
$777.58 |
$777.58 |
$85.94
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$274.77 |
$274.77 |
$274.77 |
$64.15
|
|
Bilirubin direct
|
$544.87 |
$544.87 |
$544.87 |
$50.00
|
|
Biotinidase - quest
|
$657.98 |
$657.98 |
$657.98 |
$71.02
|
|
Bivalirudin
|
$12,712.33 |
$12,712.33 |
$12,712.33 |
$1,033.55
|
|
Blood Count (CBC) Test (without differential)
|
$659.51 |
$659.51 |
$659.51 |
$61.80
|
|
Blood Culture Test
|
$792.48 |
$792.48 |
$792.48 |
$145.80
|
|
Blood gases ph venous
|
$582.33 |
$582.33 |
$582.33 |
$64.60
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$260.98 |
$260.98 |
$260.98 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$260.98 |
$260.98 |
$260.98 |
$34.00
|
|
Blood typing ag donor ea ag
|
$497.11 |
$497.11 |
$497.11 |
$190.80
|
|
Bone Density Scan (DEXA)
|
$802.25 |
$802.25 |
$802.25 |
$397.28
|
|
Bone/joint imaging ltd area
|
$3,128.99 |
$3,128.99 |
$3,128.99 |
$1,013.50
|
|
Bone marrow imaging ltd
|
$3,128.99 |
$3,128.99 |
$3,128.99 |
$811.00
|
|
Bone marrow interpretation
|
$746.63 |
$746.63 |
$746.63 |
$542.03
|
|
Bone tendon board add on
|
$756.00 |
$756.00 |
$756.00 |
$7,448.27
|
|
Boot mlti podous univ xlg
|
$2,605.00 |
$2,605.00 |
$2,605.00 |
$235.98
|
|
Bowel imaging
|
$4,883.53 |
$4,883.53 |
$4,883.53 |
$1,065.00
|
|
Brace adj motion lerman type
|
$1,249.00 |
$1,249.00 |
$1,249.00 |
$281.75
|
|
Brace ank aftr bioskn med lg
|
$391.00 |
$391.00 |
$391.00 |
$194.42
|
|
Brace ankle joint dflxn assist
|
$972.00 |
$972.00 |
$972.00 |
$141.89
|
|
Brace fx hum ovr shldr sm
|
$2,987.00 |
$2,987.00 |
$2,987.00 |
$597.11
|
|
Brace halo bremer l2830
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$195.59
|
|
Brace kafo dbl upright cust
|
$16,162.00 |
$16,162.00 |
$16,162.00 |
$3,609.22
|
|
Brace knee hing pat open med
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$216.00
|
|
Brace oths wrist hnd fngr without
|
$2,116.00 |
$2,116.00 |
$2,116.00 |
$245.00
|
|
Brachy source iodine-125 nonstranded
|
$395.00 |
$395.00 |
$395.00 |
$66.76
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$7,338.14 |
$7,338.14 |
$7,338.14 |
$1,902.00
|
|
Brain MRI (with and without contrast)
|
$9,817.05 |
$9,817.05 |
$9,817.05 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$9,695.60 |
$9,695.60 |
$9,695.60 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$9,537.01 |
$9,537.01 |
$9,537.01 |
$1,977.27
|
|
Bronchial challenge
|
$2,165.78 |
$2,165.78 |
$2,165.78 |
$777.60
|
|
Bundled special stain group 2
|
$603.72 |
$603.72 |
$603.72 |
$173.46
|
|
Buprenorphine oral 1mg
|
$1.91 |
$1.91 |
$1.91 |
$10.50
|
|
Butorphanol tartrate, nasal
|
$2,064.20 |
$2,064.20 |
$2,064.20 |
$248.82
|
|
C1 esterase inhibitor func - sendout
|
$323.22 |
$323.22 |
$323.22 |
$96.72
|
|
Caffeine citrate 20 mg/ml inj for po
|
$236.78 |
$236.78 |
$236.78 |
$47.78
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$20,506.31 |
$20,506.31 |
$20,506.31 |
$2,111.64
|
|
Calcium 24 hour urine
|
$534.93 |
$534.93 |
$534.93 |
$53.00
|
|
Calcium acetate(phosphate binders) 667 mg tablet
|
$0.66 |
$0.66 |
$0.66 |
$2.70
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$205.14 |
$205.14 |
$205.14 |
$45.49
|
|
Calcium ionized
|
$633.53 |
$633.53 |
$633.53 |
$90.00
|
|
Calcium total
|
$562.84 |
$562.84 |
$562.84 |
$50.00
|
|
Calculi urinary-sendout
|
$946.85 |
$946.85 |
$946.85 |
$68.05
|
|
Calprotectin fecal
|
$966.35 |
$966.35 |
$966.35 |
$169.95
|
|
Campylobacter antibody
|
$802.42 |
$802.42 |
$802.42 |
$77.83
|
|
Carbohydrate urine - sendout
|
$342.76 |
$342.76 |
$342.76 |
$66.64
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$1,722.51 |
$1,722.51 |
$1,722.51 |
$513.08
|
|
Carboxyhemoglobin quantitative
|
$748.15 |
$748.15 |
$748.15 |
$85.00
|
|
Carcinoembryonic ag (cea)
|
$830.32 |
$830.32 |
$830.32 |
$144.00
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$12,458.84 |
$12,458.84 |
$12,458.84 |
$2,626.88
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$531.27 |
$531.27 |
$531.27 |
$196.50
|
|
Carotene
|
$818.85 |
$818.85 |
$818.85 |
$45.24
|
|
Carotid Artery Ultrasound (Duplex)
|
$3,602.58 |
$3,602.58 |
$3,602.58 |
$1,018.68
|
|
Catecholamines,fractionated, urine
|
$1,271.63 |
$1,271.63 |
$1,271.63 |
$117.14
|
|
#cbg+cort-cbg
|
$269.01 |
$269.01 |
$269.01 |
$73.10
|
|
Cdna analysis for variants
|
$278.17 |
$278.17 |
$278.17 |
$525.00
|
|
Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr
|
$490.70 |
$490.70 |
$490.70 |
$29.45
|
|
#celiac hla-dq2
|
$1,152.04 |
$1,152.04 |
$1,152.04 |
$225.12
|
|
#celiac hla-dq8
|
$1,187.95 |
$1,187.95 |
$1,187.95 |
$246.88
|
|
Cell function assay w/stim
|
$1,251.76 |
$1,251.76 |
$1,251.76 |
$314.25
|
|
#cf-97variants
|
$1,936.49 |
$1,936.49 |
$1,936.49 |
$622.20
|
|
Cftr gene dup/delet variants
|
$10,929.65 |
$10,929.65 |
$10,929.65 |
$779.35
|
|
Chest 2 vws w oblique
|
$1,260.89 |
$1,260.89 |
$1,260.89 |
$377.06
|
|
Chest apical lordotic proj
|
$976.92 |
$976.92 |
$976.92 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$6,392.00 |
$6,392.00 |
$6,392.00 |
$1,975.00
|
|
Chest CT scan (with contrast)
|
$5,006.32 |
$5,006.32 |
$5,006.32 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$4,486.86 |
$4,486.86 |
$4,486.86 |
$1,350.03
|
|
Chest X-ray
|
$976.92 |
$976.92 |
$976.92 |
$294.06
|
|
Chest X-ray (single view)
|
$843.70 |
$843.70 |
$843.70 |
$239.04
|
|
Chg pr pul rehab for copd patients
|
$476.17 |
$476.17 |
$476.17 |
$147.95
|
|
Chlamydia culture
|
$1,278.13 |
$1,278.13 |
$1,278.13 |
$93.90
|
|
Chlamydia type
|
$137.83 |
$137.83 |
$137.83 |
$34.20
|
|
Chlnggrphy intraop addl s&i
|
$10.73 |
$10.73 |
$10.73 |
$301.40
|
|
Chloride
|
$300.34 |
$300.34 |
$300.34 |
$40.95
|
|
Chloride 24 hour urine
|
$328.22 |
$328.22 |
$328.22 |
$49.50
|
|
Chloroprocaine hcl injection
|
$102.51 |
$102.51 |
$102.51 |
$61.51
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$5,042.65 |
$5,042.65 |
$5,042.65 |
$377.85
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$456.78 |
$456.78 |
$456.78 |
$78.43
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,650.36 |
$2,650.36 |
$2,650.36 |
$602.40
|
|
Cholesterol
|
$489.10 |
$489.10 |
$489.10 |
$45.76
|
|
Cholesterol (Lipid) Test
|
$836.80 |
$836.80 |
$836.80 |
$115.80
|
|
Cholinesterase
|
$582.33 |
$582.33 |
$582.33 |
$38.69
|
|
Chromatography
|
$531.50 |
$531.50 |
$531.50 |
$81.25
|
|
Chromogenic substrate assay
|
$848.27 |
$848.27 |
$848.27 |
$148.68
|
|
Chromo high res and frag x - sendout
|
$2,138.24 |
$2,138.24 |
$2,138.24 |
$247.59
|
|
Chromosome analys amniotic
|
$4,090.02 |
$4,090.02 |
$4,090.02 |
$450.00
|
|
Chromosome analysis 45
|
$2,740.45 |
$2,740.45 |
$2,740.45 |
$429.28
|
|
Chromosome count additional
|
$718.74 |
$718.74 |
$718.74 |
$92.45
|
|
Chronic urticaria - sendout
|
$131.27 |
$131.27 |
$131.27 |
$75.00
|
|
Chylomicron screen, bf - sendout
|
$901.00 |
$901.00 |
$901.00 |
$124.15
|
|
Cilastatin sodium injection
|
$53.84 |
$53.84 |
$53.84 |
$77.40
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$556.89 |
$556.89 |
$556.89 |
$81.90
|
