|
Cystogram >= 3 views supervision & interpretation
|
$2,113.28 |
$2,113.28 |
$2,113.28 |
$539.55
|
|
Cytomegalovirus (cmv) antibody igg
|
$466.56 |
$466.56 |
$466.56 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$694.44 |
$694.44 |
$694.44 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$608.04 |
$608.04 |
$608.04 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$579.96 |
$579.96 |
$579.96 |
$142.94
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$405.00 |
$405.00 |
$405.00 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$516.24 |
$516.24 |
$516.24 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$516.24 |
$516.24 |
$516.24 |
$205.00
|
|
Cytopath smear other source
|
$271.08 |
$271.08 |
$271.08 |
$85.80
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$324.00 |
$324.00 |
$324.00 |
$362.16
|
|
Decalcification
|
$275.40 |
$275.40 |
$275.40 |
$73.60
|
|
Deferoxamine 500 mg solution for injection
|
$164.16 |
$164.16 |
$164.16 |
$96.41
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,071.36 |
$1,071.36 |
$1,071.36 |
$116.22
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$3,659.04 |
$3,659.04 |
$3,659.04 |
$641.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$200.88 |
$200.88 |
$200.88 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$709.56 |
$709.56 |
$709.56 |
$61.49
|
|
Dextrose 5 % IV bolus
|
$227.88 |
$227.88 |
$227.88 |
$48.58
|
|
Dhea-s (dehydroepiand sulfate)
|
$282.96 |
$282.96 |
$282.96 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$437.40 |
$437.40 |
$437.40 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$684.32 |
$684.32 |
$684.32 |
$424.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$679.32 |
$679.32 |
$679.32 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$118.80 |
$118.80 |
$118.80 |
$73.22
|
|
Dicyclomine injection
|
$450.36 |
$450.36 |
$450.36 |
$202.91
|
|
Digoxin immune fab 40 mg intravenous solution
|
$17,983.08 |
$17,983.08 |
$17,983.08 |
$10,388.97
|
|
Digoxin total therapeutic drug level
|
$325.08 |
$325.08 |
$325.08 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$143.64 |
$143.64 |
$143.64 |
$309.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$118.80 |
$118.80 |
$118.80 |
$24.70
|
|
Dipyridamole injection
|
$19.44 |
$19.44 |
$19.44 |
$46.97
|
|
Dna antibody native/double stranded
|
$447.12 |
$447.12 |
$447.12 |
$102.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,257.20 |
$2,257.20 |
$2,257.20 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,177.20 |
$1,177.20 |
$1,177.20 |
$482.03
|
|
Dornase alfa non-comp unit
|
$234.36 |
$234.36 |
$234.36 |
$350.67
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$182.52 |
$182.52 |
$182.52 |
$88.05
|
|
Droperidol 2.5 mg/ml injection solution
|
$133.92 |
$133.92 |
$133.92 |
$34.85
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$240.00 |
$240.00 |
$240.00 |
$6,228.55
|
|
Drug assay voriconazole
|
$625.32 |
$625.32 |
$625.32 |
$96.75
|
|
Drug test def 1-7 classes
|
$1,618.92 |
$1,618.92 |
$1,618.92 |
$268.00
|
|
Drug test def 8-14 classes
|
$2,491.56 |
$2,491.56 |
$2,491.56 |
$282.00
|
|
Dup scan/hemodialysis access 93990
|
$760.32 |
$760.32 |
$760.32 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,692.36 |
$1,692.36 |
$1,692.36 |
$903.00
|
|
Echo exam of fetal heart
|
$2,931.82 |
$2,931.82 |
$2,931.82 |
$855.38
|
|
Echo exam of fetal heart
|
$1,144.52 |
$1,144.52 |
$1,144.52 |
$503.80
|
|
Echo exam of fetal heart
|
$1,518.40 |
$1,518.40 |
$1,518.40 |
$431.41
|
|
Edetate calcium disodium inj
|
$1,139.40 |
$1,139.40 |
$1,139.40 |
$6,086.32
|
|
Egfr gene com variants
|
$765.72 |
$765.72 |
$765.72 |
$619.04
|
|
Electrolyte panel
|
$636.12 |
$636.12 |
$636.12 |
$86.33
|
|
Electron microscopy diagnostic
|
$1,508.76 |
$1,508.76 |
$1,508.76 |
$966.69
|
|
Embolization s&i
|
$13,005.20 |
$13,005.20 |
$13,005.20 |
$3,060.05
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$203.74 |
$203.74 |
$203.74 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$249.48 |
$249.48 |
$249.48 |
$50.40
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$165.28 |
$165.28 |
$165.28 |
$42.00
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$536.76 |
$536.76 |
$536.76 |
$136.00
|
|
Epstein barr early antigen antibody
|
$168.48 |
$168.48 |
$168.48 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$581.04 |
$581.04 |
$581.04 |
$81.81
|
|
Ercp biliary & pancreas
|
$1,489.28 |
$1,489.28 |
$1,489.28 |
$943.50
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$649.08 |
$649.08 |
$649.08 |
$265.40
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$157.68 |
$157.68 |
$157.68 |
$248.39
|
|
Estradiol total
|
$867.24 |
$867.24 |
$867.24 |
$153.00
|
|
Estrogens total-sendout
|
$841.32 |
$841.32 |
$841.32 |
$89.25
|
|
Ethanolamine oleate 100 mg
|
$3,265.92 |
$3,265.92 |
$3,265.92 |
$1,046.87
|
|
Ethylene glycol -sendout
|
$193.32 |
$193.32 |
$193.32 |
$75.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$962.28 |
$962.28 |
$962.28 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$1,343.52 |
$1,343.52 |
$1,343.52 |
$347.75
|
|
External chromosome analysis 20-25 cells
|
$1,431.00 |
$1,431.00 |
$1,431.00 |
$389.35
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$131.76 |
$131.76 |
$131.76 |
$61.32
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$6,868.80 |
$6,868.80 |
$6,868.80 |
$458.73
|
|
F-18 sodium fluoride
|
$2,380.32 |
$2,380.32 |
$2,380.32 |
$564.20
|
|
Facial bones <3
|
$698.88 |
$698.88 |
$698.88 |
$248.60
|
|
Factor ix
|
$545.40 |
$545.40 |
$545.40 |
$131.30
|
|
Factor viii
|
$545.40 |
$545.40 |
$545.40 |
$144.30
|
|
Factor viii recombinant nos
|
$19.44 |
$19.44 |
$19.44 |
$6.55
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$11.88 |
$11.88 |
$11.88 |
$24.21
|
|
Fat/lipids feces qualitative
|
$357.48 |
$357.48 |
$357.48 |
$34.56
|
|
Fees w/laryngeal sense test
|
$655.56 |
$655.56 |
$655.56 |
$433.50
|
|
Ferritin
|
$168.48 |
$168.48 |
$168.48 |
$103.68
|
|
Fetal chrom aneuploidy gsa panel
|
$1,902.96 |
$1,902.96 |
$1,902.96 |
$1,217.45
|
|
Fetal fibronectin
|
$1,557.36 |
$1,557.36 |
$1,557.36 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$635.04 |
$635.04 |
$635.04 |
$88.80
|
|
Fetal hemoglobin rosette
|
$180.36 |
$180.36 |
$180.36 |
$76.70
|
|
Fetal non stress test
|
$716.10 |
$716.10 |
$716.10 |
$507.90
|
|
Fibrin degradation products
|
$483.84 |
$483.84 |
$483.84 |
$62.40
|
|
Fibrinogen activity
|
$498.96 |
$498.96 |
$498.96 |
$82.38
|
|
Fibrinolytic antiplasmin
|
$581.04 |
$581.04 |
$581.04 |
$56.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$235.44 |
$235.44 |
$235.44 |
$59.89
|
|
Finasteride, 5 mg
|
$23.76 |
$23.76 |
$23.76 |
$4.87
|
|
Flow cytometry marker each additional
|
$461.16 |
$461.16 |
$461.16 |
$103.00
|
|
Flow cytometry one marker technical component
|
$461.16 |
$461.16 |
$461.16 |
$270.75
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$414.72 |
$414.72 |
$414.72 |
$79.52
|
|
Folic acid
|
$564.84 |
$564.84 |
$564.84 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$784.46 |
$784.46 |
$784.46 |
$56.70
|
|
Formoterol fumarate, inh
|
$311.04 |
$311.04 |
$311.04 |
$59.40
|
|
Ga-67 gallium 0.1 mci
|
$401.76 |
$401.76 |
$401.76 |
$163.80
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$1,812.24 |
$1,812.24 |
$1,812.24 |
$210.50
|
|
Gammaglobulin ige
|
$488.16 |
$488.16 |
$488.16 |
$85.00
|
|
Gamma glutamyltransferase
|
$193.32 |
$193.32 |
$193.32 |
$55.28
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$638.28 |
$638.28 |
$638.28 |
$197.40
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$962.28 |
$962.28 |
$962.28 |
$134.55
|
|
Ghs community re-entry 15 minutes
|
$172.80 |
$172.80 |
$172.80 |
$89.28
|
|
Ghs histoplasma antigen
|
$911.52 |
$911.52 |
$911.52 |
$137.80
|
|
Ghs ot sensory integrative tech/15min
|
$264.60 |
$264.60 |
$264.60 |
$101.05
|
