|
11-desoxycortisol - sendout
|
$108.60 |
$108.60 |
$108.60 |
$84.56
|
|
17-hydroxypregnenolone
|
$84.60 |
$84.60 |
$84.60 |
$88.20
|
|
2d tte w or without fol w/con,co
|
$1,540.20 |
$1,540.20 |
$1,540.20 |
$1,155.75
|
|
5' nucleotidase - sendout
|
$42.00 |
$42.00 |
$42.00 |
$50.05
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$2,511.00 |
$2,511.00 |
$2,511.00 |
$3,128.29
|
|
Abdominal CT scan (with and without contrast)
|
$1,033.20 |
$1,033.20 |
$1,033.20 |
$1,992.00
|
|
Abdominal CT scan (with contrast)
|
$834.00 |
$834.00 |
$834.00 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$690.00 |
$690.00 |
$690.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,855.40 |
$2,855.40 |
$2,855.40 |
$2,999.67
|
|
Abdominal MRI (without contrast)
|
$1,353.00 |
$1,353.00 |
$1,353.00 |
$2,048.36
|
|
Abdominal pad
|
$295.78 |
$295.78 |
$295.78 |
$151.32
|
|
Abdominal paracentesis w/image guidance
|
$1,011.60 |
$1,011.60 |
$1,011.60 |
$1,655.36
|
|
Abdominal Ultrasound (complete)
|
$241.80 |
$241.80 |
$241.80 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$342.00 |
$342.00 |
$342.00 |
$581.94
|
|
Abd paracentesis/w/o image guide 49082
|
$703.80 |
$703.80 |
$703.80 |
$1,145.00
|
|
Abduct control hip semi-flex
|
$753.90 |
$753.90 |
$753.90 |
$499.86
|
|
Abduction bar jointed adjust
|
$898.40 |
$898.40 |
$898.40 |
$595.67
|
|
Abduction rotation bar shoe
|
$317.70 |
$317.70 |
$317.70 |
$210.65
|
|
Abduct rotation bar without shoe
|
$290.51 |
$290.51 |
$290.51 |
$192.62
|
|
Abl1 gene
|
$900.00 |
$900.00 |
$900.00 |
$668.85
|
|
Ablation of upper extremity nerves rf
|
$549.60 |
$549.60 |
$549.60 |
$808.50
|
|
Acetaminophen level
|
$59.40 |
$59.40 |
$59.40 |
$103.75
|
|
Acetazolamide 500 mg solution for injection
|
$163.20 |
$163.20 |
$163.20 |
$122.55
|
|
Acetone qualitative
|
$18.60 |
$18.60 |
$18.60 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$208.20 |
$208.20 |
$208.20 |
$62.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$13.84 |
$13.84 |
$13.84 |
$216.00
|
|
Acetylcysteine non-comp unit
|
$36.44 |
$36.44 |
$36.44 |
$31.21
|
|
Acne surgery 10040
|
$527.40 |
$527.40 |
$527.40 |
$260.49
|
|
Acute hepatitis panel
|
$185.40 |
$185.40 |
$185.40 |
$286.05
|
|
#acylcarnitineprfl
|
$62.40 |
$62.40 |
$62.40 |
$125.00
|
|
Adapter b 8 channel 10cm
|
$15,134.02 |
$15,134.02 |
$15,134.02 |
$5,695.04
|
|
Add le poly knee custom kafo
|
$681.23 |
$681.23 |
$681.23 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$22.34 |
$22.34 |
$22.34 |
$235.74
|
|
Adh-sendout
|
$127.20 |
$127.20 |
$127.20 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$307.48 |
$307.48 |
$307.48 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$159.00 |
$159.00 |
$159.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$342.60 |
$342.60 |
$342.60 |
$298.11
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$910.80 |
$910.80 |
$910.80 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$582.00 |
$582.00 |
$582.00 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$169.80 |
$169.80 |
$169.80 |
$207.94
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$246.00 |
$246.00 |
$246.00 |
$257.40
|
|
Administration immunization 1 vaccine
|
$46.20 |
$46.20 |
$46.20 |
$69.00
|
|
Administration immunization each additional vaccine
|
$18.60 |
$18.60 |
$18.60 |
$46.80
|
|
Administration vaccine influenza virus
|
$22.80 |
$22.80 |
$22.80 |
$49.50
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$11,490.12 |
$11,490.12 |
$11,490.12 |
$11,350.31
|
|
_afb id by dna probe rflx ast
|
$74.40 |
$74.40 |
$74.40 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$22.20 |
$22.20 |
$22.20 |
$35.51
|
|
_afb org id by sequencing rflx ast-sendout
|
$445.80 |
$445.80 |
$445.80 |
$300.22
|
|
Afo molded ankle gauntlet
|
$1,610.75 |
$1,610.75 |
$1,610.75 |
$1,067.98
|
|
Afo molded plas rig ant tib
|
$3,676.93 |
$3,676.93 |
$3,676.93 |
$2,412.47
|
|
Afo molded to patient plasti
|
$1,537.96 |
$1,537.96 |
$1,537.96 |
$710.45
|
|
Afo rig ant tib tcf/= custom
|
$3,184.37 |
$3,184.37 |
$3,184.37 |
$1,654.77
|
|
Afo sing bar clasp attach sh
|
$1,000.79 |
$1,000.79 |
$1,000.79 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,440.88 |
$1,440.88 |
$1,440.88 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,466.00 |
$1,466.00 |
$1,466.00 |
$696.71
|
|
Afo spiral molded to pt plas
|
$2,744.45 |
$2,744.45 |
$2,744.45 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$1,018.13 |
$1,018.13 |
$1,018.13 |
$675.05
|
|
Afo supramalleolar custom
|
$2,008.08 |
$2,008.08 |
$2,008.08 |
$1,331.42
|
|
Afo tib fx cast plaster mold
|
$2,812.80 |
$2,812.80 |
$2,812.80 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$2,750.50 |
$2,750.50 |
$2,750.50 |
$1,654.77
|
|
Afo tibial fracture soft
|
$1,800.37 |
$1,800.37 |
$1,800.37 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$5,662.81 |
$5,662.81 |
$5,662.81 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$2,279.75 |
$2,279.75 |
$2,279.75 |
$795.02
|
|
Agalsidase beta 35 mg intravenous solution
|
$12,680.50 |
$12,680.50 |
$12,680.50 |
$14,475.20
|
|
Ak/knee disartic pelvic band
|
$279.86 |
$279.86 |
$279.86 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$348.06 |
$348.06 |
$348.06 |
$202.75
|
|
Ak sleeve susp neoprene/equa
|
$630.53 |
$630.53 |
$630.53 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$26.40 |
$26.40 |
$26.40 |
$45.18
|
|
Albumin (human), 25%, 50ml
|
$189.92 |
$189.92 |
$189.92 |
$244.70
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$22.80 |
$22.80 |
$22.80 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$19.80 |
$19.80 |
$19.80 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$4.80 |
$4.80 |
$4.80 |
$5.40
|
|
Albuterol non-comp con
|
$4.80 |
$4.80 |
$4.80 |
$6.07
|
|
Albuterol non-comp unit
|
$4.80 |
$4.80 |
$4.80 |
$5.61
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$55.20 |
$55.20 |
$55.20 |
$91.00
|
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
$48,185.67 |
$48,185.67 |
$48,185.67 |
$47,974.31
|
|
Alkaline phosphatase
|
$21.00 |
$21.00 |
$21.00 |
$45.75
|
|
Allergen alpha lactalbumin ige
|
$66.60 |
$66.60 |
$66.60 |
$47.65
|
|
Allergen egg white ige
|
$42.60 |
$42.60 |
$42.60 |
$37.05
|
|
Allograft 160mg placental salera mini membrane
|
$9,971.14 |
$9,971.14 |
$9,971.14 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$19,662.85 |
$19,662.85 |
$19,662.85 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$24,673.27 |
$24,673.27 |
$24,673.27 |
$2,386.00
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$15,344.78 |
$15,344.78 |
$15,344.78 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$69,657.77 |
$69,657.77 |
$69,657.77 |
$23,373.60
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$46,764.57 |
$46,764.57 |
$46,764.57 |
$989.09
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$39,575.04 |
$39,575.04 |
$39,575.04 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$37,366.54 |
$37,366.54 |
$37,366.54 |
$4,725.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$12,249.70 |
$12,249.70 |
$12,249.70 |
$4,561.83
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$13,991.18 |
$13,991.18 |
$13,991.18 |
$1,495.63
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$972.00 |
$972.00 |
$972.00 |
$12.50
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$215.40 |
$215.40 |
$215.40 |
$175.20
|
|
Alpha-fetoprotein tumor marker
|
$165.00 |
$165.00 |
$165.00 |
$103.74
|
|
Alteplase 100 mg infusion from pyxis vial
|
$35,905.47 |
$35,905.47 |
$35,905.47 |
$15,857.45
|
|
Alt/sgpt
|
$21.00 |
$21.00 |
$21.00 |
$46.75
|
|
Aluminum - quest
|
$94.80 |
$94.80 |
$94.80 |
$81.49
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$47.53 |
$47.53 |
$47.53 |
$39.84
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$29.71 |
$29.71 |
$29.71 |
$37.14
|
|
Aminolevulinic acid delta
|
$61.20 |
$61.20 |
$61.20 |
$82.50
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$16.31 |
$16.31 |
$16.31 |
$45.02
|
|
Amiodarone 50 mg/ml intravenous solution
|
$17.96 |
$17.96 |
$17.96 |
$55.86
|
