|
1 pc ost pou w built-in conv
|
$58.00 |
$58.00 |
$58.00 |
$18.00
|
|
3-d radiotherapy plan
|
$13,037.96 |
$13,037.96 |
$13,037.96 |
$5,002.69
|
|
5' nucleotidase - sendout
|
$440.07 |
$440.07 |
$440.07 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$150.23 |
$150.23 |
$150.23 |
$97.65
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$7,380.55 |
$7,380.55 |
$7,380.55 |
$3,627.00
|
|
Abd aorta w/runoff s&i
|
$10,323.50 |
$10,323.50 |
$10,323.50 |
$3,724.63
|
|
Abdominal MRI (with and without contrast)
|
$11,120.51 |
$11,120.51 |
$11,120.51 |
$2,933.60
|
|
Abdominal MRI (with contrast)
|
$11,438.24 |
$11,438.24 |
$11,438.24 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$10,439.49 |
$10,439.49 |
$10,439.49 |
$1,975.74
|
|
Abl1 gene
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$614.25
|
|
Ablate arrhythmia add on
|
$4,150.64 |
$4,150.64 |
$4,150.64 |
$7,717.80
|
|
Ablate heart dysrhythm focus
|
$10,665.50 |
$10,665.50 |
$10,665.50 |
$9,836.16
|
|
Ablation cardiac vagal inputs atrium
|
$3,527.70 |
$3,527.70 |
$3,527.70 |
$2,948.40
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$560.84 |
$560.84 |
$560.84 |
$74.96
|
|
Acetaminophen level
|
$385.83 |
$385.83 |
$385.83 |
$117.01
|
|
Acetone qualitative
|
$841.42 |
$841.42 |
$841.42 |
$48.00
|
|
Acetylcholine receptor modulating antibody
|
$267.50 |
$267.50 |
$267.50 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$4,787.42 |
$4,787.42 |
$4,787.42 |
$306.72
|
|
Acute hepatitis panel
|
$724.97 |
$724.97 |
$724.97 |
$284.70
|
|
Administration chemotherapy IV infusion each additional hour
|
$1,748.47 |
$1,748.47 |
$1,748.47 |
$233.56
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$1,748.47 |
$1,748.47 |
$1,748.47 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$2,367.51 |
$2,367.51 |
$2,367.51 |
$695.37
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$3,592.24 |
$3,592.24 |
$3,592.24 |
$444.49
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$3,592.24 |
$3,592.24 |
$3,592.24 |
$267.43
|
|
#afb mycobacteria suscep. #1
|
$95.40 |
$95.40 |
$95.40 |
$38.58
|
|
Albumin body fluid quantitative each specimen
|
$95.40 |
$95.40 |
$95.40 |
$48.00
|
|
Albumin, human 5 % intravenous solution
|
$248.88 |
$248.88 |
$248.88 |
$125.99
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$775.81 |
$775.81 |
$775.81 |
$58.00
|
|
Albumin serum plasma or whole blood
|
$472.91 |
$472.91 |
$472.91 |
$43.45
|
|
Albuterol ipratrop non-comp
|
$35.02 |
$35.02 |
$35.02 |
$7.43
|
|
Albuterol non-comp con
|
$23.19 |
$23.19 |
$23.19 |
$9.25
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$876.45 |
$876.45 |
$876.45 |
$94.90
|
|
Alkaline phosphatase
|
$603.16 |
$603.16 |
$603.16 |
$46.50
|
|
Allergen egg white ige
|
$202.76 |
$202.76 |
$202.76 |
$39.78
|
|
Alpha-fetoprotein tumor marker
|
$1,034.24 |
$1,034.24 |
$1,034.24 |
$103.60
|
|
Alt/sgpt
|
$237.58 |
$237.58 |
$237.58 |
$49.00
|
|
Amifostine
|
$3,602.17 |
$3,602.17 |
$3,602.17 |
$2,507.10
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$198.29 |
$198.29 |
$198.29 |
$39.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$112.99 |
$112.99 |
$112.99 |
$48.29
|
|
Amitriptyline (elavil) -sendout
|
$775.81 |
$775.81 |
$775.81 |
$101.17
|
|
Ammonia
|
$625.57 |
$625.57 |
$625.57 |
$123.48
|
|
Analysis gene f2 20210g>a variant
|
$1,008.28 |
$1,008.28 |
$1,008.28 |
$219.13
|
|
Analysis gene f5 leiden variant
|
$1,090.22 |
$1,090.22 |
$1,090.22 |
$226.60
|
|
Anaplsma phgcytophlm amp prb
|
$1,182.27 |
$1,182.27 |
$1,182.27 |
$95.45
|
|
Anastrozole 1 mg
|
$94.28 |
$94.28 |
$94.28 |
$5.16
|
|
Antibody bacterium, not elsewhere specified
|
$194.55 |
$194.55 |
$194.55 |
$57.85
|
|
Antibody elution rbc reference
|
$384.23 |
$384.23 |
$384.23 |
$179.62
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$1,807.27 |
$1,807.27 |
$1,807.27 |
$218.30
|
|
Antibody id rbc panel
|
$1,407.59 |
$1,407.59 |
$1,407.59 |
$291.75
|
|
Antibody screen rbc
|
$391.94 |
$391.94 |
$391.94 |
$105.00
|
|
Antinuclear antibodies
|
$214.11 |
$214.11 |
$214.11 |
$91.70
|
|
Antistreptolysin o titer
|
$510.59 |
$510.59 |
$510.59 |
$57.85
|
|
Antithrombin iii activity
|
$792.72 |
$792.72 |
$792.72 |
$106.85
|
|
#aptt mix-1:1 incubated
|
$2,607.33 |
$2,607.33 |
$2,607.33 |
$157.30
|
|
Aquaporin-4 antibody elisa
|
$2,914.92 |
$2,914.92 |
$2,914.92 |
$155.00
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$426.15 |
$426.15 |
$426.15 |
$1,642.18
|
|
Artery xray each vessel 7577426
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$1,865.50
|
|
Artery xray of abdomen 75726-26
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$4,658.99
|
|
Artery x-rays adrenals
|
$7,648.56 |
$7,648.56 |
$7,648.56 |
$3,724.63
|
|
Artery x-rays arms/legs 75716-26
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$4,029.72
|
|
Artery x-rays lung
|
$6,798.60 |
$6,798.60 |
$6,798.60 |
$2,483.00
|
|
Artery x-rays lungs
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$3,724.63
|
|
Artery xrays of pelvis 75736 26
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$4,551.20
|
|
Artery x-rays spine
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$4,830.61
|
|
Assay of digoxin free
|
$162.72 |
$162.72 |
$162.72 |
$24.52
|
|
Assay of interleukin-6 (il-6)
|
$1,180.60 |
$1,180.60 |
$1,180.60 |
$77.35
|
|
Assay of prostaglandin
|
$1,786.70 |
$1,786.70 |
$1,786.70 |
$220.00
|
|
Assay of salicylate
|
$385.83 |
$385.83 |
$385.83 |
$104.00
|
|
Ast/sgot
|
$484.26 |
$484.26 |
$484.26 |
$46.20
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$40,495.94 |
$40,495.94 |
$40,495.94 |
$25,944.32
|
|
Azacitidine injection
|
$4,714.47 |
$4,714.47 |
$4,714.47 |
$1,083.43
|
|
Azathioprine 50 mg tablet
|
$56.51 |
$56.51 |
$56.51 |
$4.00
|
|
Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft
|
$50.00 |
$50.00 |
$50.00 |
$3.00
|
|
Barrier skn ft cx ff red 2.25 ctf new image w/tape
|
$43.00 |
$43.00 |
$43.00 |
$30.00
|
|
B cells total count
|
$837.00 |
$837.00 |
$837.00 |
$128.13
|
|
Belt ostomy lg 34-65in
|
$106.00 |
$106.00 |
$106.00 |
$5.20
|
|
Benztropine 1 mg/ml injection solution
|
$948.48 |
$948.48 |
$948.48 |
$118.00
|
|
Beta-2 microglobulin
|
$183.20 |
$183.20 |
$183.20 |
$86.40
|
|
Beta-amyloid 1-40
|
$623.70 |
$623.70 |
$623.70 |
$312.00
|
|
Beta-amyloid 1-42
|
$623.70 |
$623.70 |
$623.70 |
$312.00
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$178.46 |
$178.46 |
$178.46 |
$70.37
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$6,948.42 |
$6,948.42 |
$6,948.42 |
$4,773.00
|
|
Bilicheck
|
$170.87 |
$170.87 |
$170.87 |
$22.75
|
|
Bilirubin direct
|
$249.92 |
$249.92 |
$249.92 |
$49.31
|
|
Biovance 1 square cm
|
$927.00 |
$927.00 |
$927.00 |
$1,448.56
|
|
Bivalirudin
|
$9,486.58 |
$9,486.58 |
$9,486.58 |
$1,310.40
|
|
Bleomycin 15 unit solution for injection
|
$3,003.42 |
$3,003.42 |
$3,003.42 |
$250.00
|
|
Blood Culture Test
|
$771.03 |
$771.03 |
$771.03 |
$145.60
|
|
Blood draw capillary 36416
|
$94.63 |
$94.63 |
$94.63 |
$22.40
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$195.78 |
$195.78 |
$195.78 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$95.52 |
$95.52 |
$95.52 |
$37.05
|
|
Blood typing abo
|
$165.30 |
$165.30 |
$165.30 |
$83.03
|
|
Blood typing ag donor ea ag
|
$40.41 |
$40.41 |
$40.41 |
$166.80
|
|
Blood typing rbc ag non abo/rh ea
|
$202.77 |
$202.77 |
$202.77 |
$181.74
|
|
Blood typing rh (d)
|
$203.50 |
$203.50 |
$203.50 |
$57.10
|
|
Bone Density Scan (DEXA)
|
$1,587.99 |
$1,587.99 |
$1,587.99 |
$395.00
|
|
Bone marrow interpretation
|
$174.84 |
$174.84 |
$174.84 |
$436.00
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$923.10 |
$923.10 |
$923.10 |
$96.72
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$16,408.42 |
$16,408.42 |
$16,408.42 |
$2,880.64
|
|
Bowel imaging
|
$2,955.42 |
$2,955.42 |
$2,955.42 |
$1,200.00
|
