|
Culture mycobacteria definitive id each isolate
|
$597.00 |
$597.00 |
$597.00 |
$84.75
|
|
Culture mycoplasma any source
|
$863.00 |
$863.00 |
$863.00 |
$90.37
|
|
Culture quantitative aerobic other source
|
$645.00 |
$645.00 |
$645.00 |
$87.02
|
|
Culture typing immunologic
|
$222.00 |
$222.00 |
$222.00 |
$41.60
|
|
Culture urine each isolate
|
$574.00 |
$574.00 |
$574.00 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$299.00 |
$299.00 |
$299.00 |
$28.00
|
|
Cyclic citrullinated peptide antibody
|
$432.00 |
$432.00 |
$432.00 |
$80.05
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$2,425.00 |
$2,425.00 |
$2,425.00 |
$140.78
|
|
Cyclosporine 2 hour
|
$901.00 |
$901.00 |
$901.00 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$120.00 |
$120.00 |
$120.00 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$104.00 |
$104.00 |
$104.00 |
$34.00
|
|
Cystatin c
|
$443.00 |
$443.00 |
$443.00 |
$82.26
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,839.00 |
$1,839.00 |
$1,839.00 |
$539.55
|
|
Cytomegalovirus (cmv) antibody igg
|
$549.00 |
$549.00 |
$549.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$610.00 |
$610.00 |
$610.00 |
$96.80
|
|
Cytomegalovirus imm IV /vial
|
$17,223.00 |
$17,223.00 |
$17,223.00 |
$3,058.32
|
|
Cytopathology cellular enhancement technique non-gyn
|
$597.00 |
$597.00 |
$597.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$321.00 |
$321.00 |
$321.00 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$348.00 |
$348.00 |
$348.00 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$576.00 |
$576.00 |
$576.00 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$509.00 |
$509.00 |
$509.00 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$377.00 |
$377.00 |
$377.00 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$377.00 |
$377.00 |
$377.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$479.00 |
$479.00 |
$479.00 |
$205.00
|
|
Dacarbazine 100 mg intravenous solution
|
$567.00 |
$567.00 |
$567.00 |
$73.20
|
|
Dactinomycin 0.5 mg intravenous solution
|
$10,361.00 |
$10,361.00 |
$10,361.00 |
$3,019.83
|
|
Dalteparin sodium
|
$933.00 |
$933.00 |
$933.00 |
$75.17
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$55,168.00 |
$55,168.00 |
$55,168.00 |
$23,789.22
|
|
Decalcification
|
$154.00 |
$154.00 |
$154.00 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$14,435.00 |
$14,435.00 |
$14,435.00 |
$1,350.27
|
|
Deferoxamine 500 mg solution for injection
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$96.41
|
|
Dermagraft
|
$1,173.00 |
$1,173.00 |
$1,173.00 |
$252.49
|
|
Device intraute mirena
|
$7,841.00 |
$7,841.00 |
$7,841.00 |
$2,211.85
|
|
Dextroamphetamine
|
$104.00 |
$104.00 |
$104.00 |
$143.40
|
|
Dextrose 5 % IV bolus
|
$1,495.00 |
$1,495.00 |
$1,495.00 |
$48.58
|
|
Dhea-s (dehydroepiand sulfate)
|
$713.00 |
$713.00 |
$713.00 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$438.00 |
$438.00 |
$438.00 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$750.00 |
$750.00 |
$750.00 |
$424.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$1,039.00 |
$1,039.00 |
$1,039.00 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$285.00 |
$285.00 |
$285.00 |
$73.22
|
|
Dicyclomine injection
|
$509.00 |
$509.00 |
$509.00 |
$202.91
|
|
Digoxin immune fab 40 mg intravenous solution
|
$17,276.00 |
$17,276.00 |
$17,276.00 |
$10,388.97
|
|
Digoxin total therapeutic drug level
|
$574.00 |
$574.00 |
$574.00 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,696.00 |
$1,696.00 |
$1,696.00 |
$309.20
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,391.00 |
$2,391.00 |
$2,391.00 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$367.00 |
$367.00 |
$367.00 |
$24.70
|
|
Dipyridamole injection
|
$1,743.00 |
$1,743.00 |
$1,743.00 |
$45.09
|
|
Disaccharidases
|
$288.00 |
$288.00 |
$288.00 |
$223.80
|
|
Dna antibody native/double stranded
|
$516.00 |
$516.00 |
$516.00 |
$102.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,826.00 |
$1,826.00 |
$1,826.00 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$955.00 |
$955.00 |
$955.00 |
$482.03
|
|
Dornase alfa non-comp unit
|
$1,573.00 |
$1,573.00 |
$1,573.00 |
$350.67
|
|
Dornhoffer fixed part w/window
|
$138,568.00 |
$138,568.00 |
$138,568.00 |
$36,072.59
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$75,909.00 |
$75,909.00 |
$75,909.00 |
$25,883.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$411.00 |
$411.00 |
$411.00 |
$171.12
|
|
Drug assay voriconazole
|
$597.00 |
$597.00 |
$597.00 |
$96.75
|
|
Drug test def 1-7 classes
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$268.00
|
|
Drvvt confirm - quest
|
$834.00 |
$834.00 |
$834.00 |
$101.66
|
|
Dup scan/hemodialysis access 93990
|
$619.00 |
$619.00 |
$619.00 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$2,025.00 |
$2,025.00 |
$2,025.00 |
$757.57
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,374.00 |
$1,374.00 |
$1,374.00 |
$903.00
|
|
Duragen 1x1 5ea/bx
|
$1,471.00 |
$1,471.00 |
$1,471.00 |
$13,812.34
|
|
Echo exam of fetal heart
|
$2,625.00 |
$2,625.00 |
$2,625.00 |
$855.38
|
|
Echo exam of fetal heart
|
$1,928.00 |
$1,928.00 |
$1,928.00 |
$503.80
|
|
Echo exam of fetal heart
|
$2,557.00 |
$2,557.00 |
$2,557.00 |
$431.41
|
|
Echo exam of fetal heart
|
$2,557.00 |
$2,557.00 |
$2,557.00 |
$323.40
|
|
Echo guide for amniocentesis
|
$971.00 |
$971.00 |
$971.00 |
$384.65
|
|
Echo guide for artery repair
|
$737.00 |
$737.00 |
$737.00 |
$680.28
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$30,508.00 |
$30,508.00 |
$30,508.00 |
$17,051.72
|
|
Edetate calcium disodium inj
|
$1,924.00 |
$1,924.00 |
$1,924.00 |
$6,086.32
|
|
Egfr gene com variants
|
$732.00 |
$732.00 |
$732.00 |
$619.04
|
|
Ehrlicha chaffeensis amp prb
|
$953.00 |
$953.00 |
$953.00 |
$105.00
|
|
Electrolyte panel
|
$347.00 |
$347.00 |
$347.00 |
$86.33
|
|
Electron microscopy diagnostic
|
$1,483.00 |
$1,483.00 |
$1,483.00 |
$966.69
|
|
Embolization s&i
|
$10,573.00 |
$10,573.00 |
$10,573.00 |
$3,060.05
|
|
Endo cath bile duct s&i
|
$967.00 |
$967.00 |
$967.00 |
$612.37
|
|
Endo cath panc duct s&i
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$645.00
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$204.00 |
$204.00 |
$204.00 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$388.00 |
$388.00 |
$388.00 |
$50.40
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$2,108.00 |
$2,108.00 |
$2,108.00 |
$136.00
|
|
Epstein barr early antigen antibody
|
$574.00 |
$574.00 |
$574.00 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$574.00 |
$574.00 |
$574.00 |
$81.81
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$10,359.00 |
$10,359.00 |
$10,359.00 |
$4,539.76
|
|
Ercp biliary & pancreas
|
$3,131.00 |
$3,131.00 |
$3,131.00 |
$943.50
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,836.00 |
$1,836.00 |
$1,836.00 |
$265.40
|
|
Esophageal dilat s&i
|
$4,950.00 |
$4,950.00 |
$4,950.00 |
$525.00
|
|
Estradiol total
|
$708.00 |
$708.00 |
$708.00 |
$153.00
|
|
Estrogens total-sendout
|
$713.00 |
$713.00 |
$713.00 |
$89.25
|
|
Ethanolamine oleate 100 mg
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$1,046.87
|
|
Ethylene glycol -sendout
|
$597.00 |
$597.00 |
$597.00 |
$75.00
|
|
Etonogestrel implant system
|
$7,095.00 |
$7,095.00 |
$7,095.00 |
$2,081.30
|
|
Etoposide 50 mg cap
|
$448.00 |
$448.00 |
$448.00 |
$135.02
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$881.00 |
$881.00 |
$881.00 |
$219.60
|
|
Exemestane, 25 mg
|
$157.00 |
$157.00 |
$157.00 |
$60.60
|
|
External chromosome analysis 20-25 cells
|
$1,409.00 |
$1,409.00 |
$1,409.00 |
$389.35
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$132.00 |
$132.00 |
$132.00 |
$61.32
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$1,757.00 |
$1,757.00 |
$1,757.00 |
$458.73
|
|
F-18 fdg pet diag
|
$2,222.00 |
$2,222.00 |
$2,222.00 |
$602.25
|
|
F-18 florbetapir less than or equal to 10 mci
|
$3,514.00 |
$3,514.00 |
$3,514.00 |
$4,960.80
|
|
Factor ix
|
$848.00 |
$848.00 |
$848.00 |
$131.30
|
