|
17-hydroxypregnenolone
|
$719.28 |
$719.28 |
$719.28 |
$87.50
|
|
1 pc ost pou w built-in conv
|
$11.00 |
$11.00 |
$11.00 |
$18.00
|
|
88334 ap bill cytologic exam each additional site
|
$372.60 |
$372.60 |
$372.60 |
$97.65
|
|
Abd aorta w/runoff s&i
|
$11,121.76 |
$11,121.76 |
$11,121.76 |
$3,724.63
|
|
Abdominal CT scan (with and without contrast)
|
$5,626.40 |
$5,626.40 |
$5,626.40 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$5,241.60 |
$5,241.60 |
$5,241.60 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$3,693.04 |
$3,693.04 |
$3,693.04 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$11,849.39 |
$11,849.39 |
$11,849.39 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$10,374.62 |
$10,374.62 |
$10,374.62 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$10,812.80 |
$10,812.80 |
$10,812.80 |
$1,975.74
|
|
Abdominal Ultrasound (complete)
|
$2,920.32 |
$2,920.32 |
$2,920.32 |
$785.25
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$545.40 |
$545.40 |
$545.40 |
$74.96
|
|
Acetaminophen level
|
$608.04 |
$608.04 |
$608.04 |
$117.01
|
|
Acetone qualitative
|
$222.00 |
$222.00 |
$222.00 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$150.12 |
$150.12 |
$150.12 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$294.52 |
$294.52 |
$294.52 |
$306.72
|
|
Acute hepatitis panel
|
$605.88 |
$605.88 |
$605.88 |
$284.70
|
|
#acylcarnitineprfl
|
$1,481.76 |
$1,481.76 |
$1,481.76 |
$87.72
|
|
Adh-sendout
|
$1,699.92 |
$1,699.92 |
$1,699.92 |
$109.28
|
|
_afb id by dna probe rflx ast
|
$279.72 |
$279.72 |
$279.72 |
$105.00
|
|
#afb mycobacteria suscep. #1
|
$156.60 |
$156.60 |
$156.60 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$2,193.48 |
$2,193.48 |
$2,193.48 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$72.36 |
$72.36 |
$72.36 |
$48.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$627.48 |
$627.48 |
$627.48 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$374.76 |
$374.76 |
$374.76 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$9.72 |
$9.72 |
$9.72 |
$7.43
|
|
Albuterol non-comp con
|
$9.72 |
$9.72 |
$9.72 |
$9.25
|
|
Albuterol non-comp unit
|
$15.12 |
$15.12 |
$15.12 |
$5.28
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$565.92 |
$565.92 |
$565.92 |
$94.90
|
|
Alkaline phosphatase
|
$488.16 |
$488.16 |
$488.16 |
$46.50
|
|
Allergen alpha lactalbumin ige
|
$136.08 |
$136.08 |
$136.08 |
$56.35
|
|
Allergen egg white ige
|
$451.44 |
$451.44 |
$451.44 |
$39.78
|
|
Alt/sgpt
|
$185.76 |
$185.76 |
$185.76 |
$49.00
|
|
Aminolevulinic acid delta
|
$419.04 |
$419.04 |
$419.04 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$42.12 |
$42.12 |
$42.12 |
$48.29
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$548.64 |
$548.64 |
$548.64 |
$152.84
|
|
Ammonia
|
$504.36 |
$504.36 |
$504.36 |
$123.48
|
|
Analysis gene f2 20210g>a variant
|
$765.72 |
$765.72 |
$765.72 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$765.72 |
$765.72 |
$765.72 |
$226.60
|
|
Anastrozole 1 mg
|
$47.52 |
$47.52 |
$47.52 |
$5.16
|
|
Antibody bacterium, not elsewhere specified
|
$483.84 |
$483.84 |
$483.84 |
$57.85
|
|
Antibody elution rbc reference
|
$1,082.16 |
$1,082.16 |
$1,082.16 |
$179.62
|
|
Antibody id rbc panel
|
$1,306.80 |
$1,306.80 |
$1,306.80 |
$291.75
|
|
Antibody lymphocytic choriomeningitis
|
$483.84 |
$483.84 |
$483.84 |
$53.96
|
|
Antibody screen rbc
|
$349.92 |
$349.92 |
$349.92 |
$105.00
|
|
Antinuclear antibodies
|
$171.72 |
$171.72 |
$171.72 |
$91.70
|
|
Antistreptolysin o titer
|
$409.32 |
$409.32 |
$409.32 |
$57.85
|
|
Antithrombin iii activity
|
$1,069.20 |
$1,069.20 |
$1,069.20 |
$106.85
|
|
Apl(pml-rara) quant - sendout
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$465.60
|
|
#aptt mix-1:1 incubated
|
$2,111.40 |
$2,111.40 |
$2,111.40 |
$157.30
|
|
Aquaporin-4 antibody elisa
|
$3,192.48 |
$3,192.48 |
$3,192.48 |
$155.00
|
|
Argatroban nonesrd use 1mg
|
$2,487.24 |
$2,487.24 |
$2,487.24 |
$881.10
|
|
Artery x-rays lung
|
$15,063.36 |
$15,063.36 |
$15,063.36 |
$3,150.00
|
|
Artery x-rays lungs
|
$11,580.40 |
$11,580.40 |
$11,580.40 |
$3,724.63
|
|
Artery xrays of pelvis 75736 26
|
$8,530.08 |
$8,530.08 |
$8,530.08 |
$4,551.20
|
|
Assay of procainamide w/metab
|
$659.88 |
$659.88 |
$659.88 |
$63.07
|
|
Assay of salicylate
|
$608.04 |
$608.04 |
$608.04 |
$104.00
|
|
Assay toxin or antitoxin
|
$967.68 |
$967.68 |
$967.68 |
$77.55
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$352.08 |
$352.08 |
$352.08 |
$47.25
|
|
Ast/sgot
|
$403.92 |
$403.92 |
$403.92 |
$46.20
|
|
Autoimmune rheumatoid arthr anl 12 mrk ia
|
$4,539.24 |
$4,539.24 |
$4,539.24 |
$924.72
|
|
Azathioprine 50 mg tablet
|
$35.64 |
$35.64 |
$35.64 |
$4.00
|
|
Baclofen eval charges
|
$191.16 |
$191.16 |
$191.16 |
$85.00
|
|
Barrier skn ft cx ff red 2.25 ctf new image w/tape
|
$8.00 |
$8.00 |
$8.00 |
$30.00
|
|
Bartonella dna pcr-sendout
|
$962.28 |
$962.28 |
$962.28 |
$196.20
|
|
B cells total count
|
$374.76 |
$374.76 |
$374.76 |
$128.13
|
|
Benztropine 1 mg/ml injection solution
|
$596.16 |
$596.16 |
$596.16 |
$118.00
|
|
Beta-2 microglobulin
|
$659.88 |
$659.88 |
$659.88 |
$86.40
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$44.28 |
$44.28 |
$44.28 |
$70.37
|
|
Bilicheck
|
$141.48 |
$141.48 |
$141.48 |
$22.75
|
|
Bilirubin direct
|
$198.72 |
$198.72 |
$198.72 |
$49.31
|
|
Biofeedback, pt
|
$240.84 |
$240.84 |
$240.84 |
$148.66
|
|
Bivalirudin
|
$7,567.56 |
$7,567.56 |
$7,567.56 |
$1,310.40
|
|
Blood Culture Test
|
$622.08 |
$622.08 |
$622.08 |
$145.60
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$158.76 |
$158.76 |
$158.76 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$72.36 |
$72.36 |
$72.36 |
$37.05
|
|
Blood typing abo
|
$145.80 |
$145.80 |
$145.80 |
$83.03
|
|
Blood typing ag donor ea ag
|
$365.04 |
$365.04 |
$365.04 |
$166.80
|
|
Blood typing rbc ag non abo/rh ea
|
$178.20 |
$178.20 |
$178.20 |
$181.74
|
|
Blood typing rh (d)
|
$180.36 |
$180.36 |
$180.36 |
$57.10
|
|
Blood typing rh phenotype complete reference
|
$401.76 |
$401.76 |
$401.76 |
$77.25
|
|
Bone marrow imaging ltd
|
$3,713.04 |
$3,713.04 |
$3,713.04 |
$728.85
|
|
Bone marrow imaging mult
|
$4,417.20 |
$4,417.20 |
$4,417.20 |
$790.92
|
|
Bone survey-lead poisoning
|
$1,203.28 |
$1,203.28 |
$1,203.28 |
$370.18
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$747.36 |
$747.36 |
$747.36 |
$96.72
|
|
Bowel imaging
|
$3,218.40 |
$3,218.40 |
$3,218.40 |
$1,200.00
|
|
Braf gene
|
$765.72 |
$765.72 |
$765.72 |
$421.00
|
|
Brain flow imaging only
|
$1,076.76 |
$1,076.76 |
$1,076.76 |
$636.97
|
|
Brain image w/flow 4 + views
|
$1,989.36 |
$1,989.36 |
$1,989.36 |
$1,365.72
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$10,575.18 |
$10,575.18 |
$10,575.18 |
$2,623.74
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$6,162.86 |
$6,162.86 |
$6,162.86 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$7,782.60 |
$7,782.60 |
$7,782.60 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$7,782.60 |
$7,782.60 |
$7,782.60 |
$2,267.23
|
|
Brain MRI (without contrast)
|
$7,782.60 |
$7,782.60 |
$7,782.60 |
$1,949.38
|
|
Bundled special stain group 1 microorganisms
|
$408.24 |
$408.24 |
$408.24 |
$165.10
|
|
Bundled special stain group 2
|
$581.04 |
$581.04 |
$581.04 |
$169.00
|
|
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet
|
$57.24 |
$57.24 |
$57.24 |
$9.56
|
|
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet
|
$101.52 |
$101.52 |
$101.52 |
$14.01
|
|
Butorphanol tartrate 1 mg
|
$48.60 |
$48.60 |
$48.60 |
$46.00
|
|
Caffeine citrate 20 mg/ml inj for po
|
$84.60 |
$84.60 |
$84.60 |
$47.78
|
