|
Abdominal CT scan (with and without contrast)
|
$847.35 |
$847.35 |
$847.35 |
$1,951.30
|
|
Abdominal CT scan (without contrast)
|
$830.34 |
$830.34 |
$830.34 |
$1,213.74
|
|
Abdominal MRI (without contrast)
|
$955.08 |
$955.08 |
$955.08 |
$1,806.35
|
|
Abdominal Ultrasound (complete)
|
$706.23 |
$706.23 |
$706.23 |
$732.03
|
|
Abdominal Ultrasound (limited)
|
$592.20 |
$592.20 |
$592.20 |
$574.53
|
|
Acetaminophen level
|
$295.44 |
$295.44 |
$295.44 |
$117.01
|
|
Acetone qualitative
|
$119.70 |
$119.70 |
$119.70 |
$46.20
|
|
Acetylcysteine non-comp unit
|
$26.24 |
$26.24 |
$26.24 |
$29.01
|
|
Acute hepatitis panel
|
$382.41 |
$382.41 |
$382.41 |
$310.20
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$193.99 |
$193.99 |
$193.99 |
$49.22
|
|
Adenosine 3 mg/250 ml bag for osm
|
$70.66 |
$70.66 |
$70.66 |
$119.26
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$679.27 |
$679.27 |
$679.27 |
$186.07
|
|
Administration immunization 1 vaccine
|
$103.60 |
$103.60 |
$103.60 |
$65.00
|
|
Albumin body fluid quantitative each specimen
|
$44.10 |
$44.10 |
$44.10 |
$42.90
|
|
Albumin (human), 25%, 50ml
|
$383.99 |
$383.99 |
$383.99 |
$290.52
|
|
Albumin (human), 5%, 250 ml
|
$350.60 |
$350.60 |
$350.60 |
$253.48
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$181.44 |
$181.44 |
$181.44 |
$60.45
|
|
Albumin serum plasma or whole blood
|
$70.56 |
$70.56 |
$70.56 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$8.11 |
$8.11 |
$8.11 |
$9.18
|
|
Albuterol non-comp unit
|
$7.26 |
$7.26 |
$7.26 |
$8.00
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$279.72 |
$279.72 |
$279.72 |
$78.00
|
|
Alkaline phosphatase
|
$34.65 |
$34.65 |
$34.65 |
$43.80
|
|
Alpha-fetoprotein tumor marker
|
$223.65 |
$223.65 |
$223.65 |
$93.60
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,536.68 |
$1,536.68 |
$1,536.68 |
$518.16
|
|
Alt/sgpt
|
$34.65 |
$34.65 |
$34.65 |
$44.68
|
|
Amiodarone 50 mg/ml intravenous solution
|
$70.66 |
$70.66 |
$70.66 |
$42.92
|
|
Ammonia
|
$88.20 |
$88.20 |
$88.20 |
$97.50
|
|
Ampicillin 1 gram solution for injection
|
$314.20 |
$314.20 |
$314.20 |
$35.64
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$536.57 |
$536.57 |
$536.57 |
$45.20
|
|
Amylase
|
$211.40 |
$211.40 |
$211.40 |
$85.65
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$70.66 |
$70.66 |
$70.66 |
$9,226.46
|
|
Ankle X-ray
|
$145.53 |
$145.53 |
$145.53 |
$325.59
|
|
Antibody elution rbc reference
|
$344.61 |
$344.61 |
$344.61 |
$163.80
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$147.32 |
$147.32 |
$147.32 |
$185.76
|
|
Antibody id rbc panel
|
$224.28 |
$224.28 |
$224.28 |
$256.79
|
|
Antibody screen rbc
|
$87.57 |
$87.57 |
$87.57 |
$103.08
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$28.98 |
$28.98 |
$28.98 |
$40.00
|
|
Antinuclear antibodies
|
$161.81 |
$161.81 |
$161.81 |
$90.00
|
|
Antithrombin iii activity
|
$167.58 |
$167.58 |
$167.58 |
$126.67
|
|
Apheresis plasma
|
$2,496.06 |
$2,496.06 |
$2,496.06 |
$3,486.60
|
|
Application multi layer compression below knee (both sides)
|
$275.31 |
$275.31 |
$275.31 |
$381.60
|
|
Appl modality 1/> areas paraffin bath 97018
|
$66.00 |
$66.00 |
$66.00 |
$68.90
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$66.00 |
$66.00 |
$66.00 |
$71.50
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$121.72 |
$121.72 |
$121.72 |
$90.52
|
|
Aquatic exercise - group charge
|
$147.39 |
$147.39 |
$147.39 |
$86.90
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides)
|
$1,499.40 |
$1,499.40 |
$1,499.40 |
$959.00
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$592.20 |
$592.20 |
$592.20 |
$687.20
|
|
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604
|
$592.20 |
$592.20 |
$592.20 |
$650.37
|
|
Assay of salicylate
|
$295.44 |
$295.44 |
$295.44 |
$83.85
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$328.44 |
$328.44 |
$328.44 |
$302.50
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$77.49 |
$77.49 |
$77.49 |
$44.20
|
|
Ast/sgot
|
$34.65 |
$34.65 |
$34.65 |
$43.40
|
|
Atropine 0.1 mg/ml injection syringe
|
$70.66 |
$70.66 |
$70.66 |
$36.52
|
|
Azathioprine 50 mg tablet
|
$7.58 |
$7.58 |
$7.58 |
$3.86
|
|
Azithromycin 500 mg intravenous solution
|
$70.66 |
$70.66 |
$70.66 |
$34.11
|
|
Aztreonam 1 gram solution for injection
|
$459.79 |
$459.79 |
$459.79 |
$158.89
|
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
$2,699.32 |
$2,699.32 |
$2,699.32 |
$1,062.64
|
|
Baclofen eval charges
|
$57.20 |
$57.20 |
$57.20 |
$84.35
|
|
Bacterial meningitis antigen
|
$281.75 |
$281.75 |
$281.75 |
$66.30
|
|
B cells total count
|
$229.43 |
$229.43 |
$229.43 |
$121.86
|
|
Bfb train 1st 15min cntct 90912
|
$412.16 |
$412.16 |
$412.16 |
$176.00
|
|
Bfb train ea addl 15 min 90913
|
$181.13 |
$181.13 |
$181.13 |
$107.50
|
|
Bilirubin direct
|
$34.65 |
$34.65 |
$34.65 |
$46.33
|
|
Bilirubin total
|
$34.65 |
$34.65 |
$34.65 |
$49.60
|
|
Biofeedback, pt
|
$409.89 |
$409.89 |
$409.89 |
$144.98
|
|
Bld prd mix
|
$197.82 |
$197.82 |
$197.82 |
$139.21
|
|
Blood Clotting (PT/INR) Test
|
$71.19 |
$71.19 |
$71.19 |
$46.15
|
|
Blood Clotting (PTT) Test
|
$109.62 |
$109.62 |
$109.62 |
$69.85
|
|
Blood Count (CBC) Test
|
$78.75 |
$78.75 |
$78.75 |
$66.40
|
|
Blood Count (CBC) Test (without differential)
|
$89.46 |
$89.46 |
$89.46 |
$57.20
|
|
Blood count spun microhematocrit
|
$44.10 |
$44.10 |
$44.10 |
$20.15
|
|
Blood Culture Test
|
$122.22 |
$122.22 |
$122.22 |
$119.20
|
|
Blood draw capillary 36416
|
$23.31 |
$23.31 |
$23.31 |
$22.00
|
|
Blood gases o2 saturation direct measurement
|
$155.61 |
$155.61 |
$155.61 |
$213.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$35.28 |
$35.28 |
$35.28 |
$32.50
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$146.79 |
$146.79 |
$146.79 |
$33.15
|
|
Blood smear interpretation
|
$40.60 |
$40.60 |
$40.60 |
$86.58
|
|
Blood smear microscopic w manual differential wbc count
|
$85.68 |
$85.68 |
$85.68 |
$36.00
|
|
Blood split unit
|
$314.30 |
$314.30 |
$314.30 |
$247.80
|
|
Blood typing abo
|
$45.36 |
$45.36 |
$45.36 |
$75.60
|
|
Blood typing ag donor ea ag
|
$160.65 |
$160.65 |
$160.65 |
$134.40
|
|
Blood typing rbc ag non abo/rh ea
|
$208.53 |
$208.53 |
$208.53 |
$170.31
|
|
Blood typing rh (d)
|
$45.36 |
$45.36 |
$45.36 |
$54.60
|
|
Blood typing rh phenotype complete reference
|
$148.68 |
$148.68 |
$148.68 |
$66.60
|
|
(both sides) smear without diff wbc count
|
$18.90 |
$18.90 |
$18.90 |
$33.57
|
|
Brain MRI (with and without contrast)
|
$1,678.32 |
$1,678.32 |
$1,678.32 |
$2,659.03
|
|
Brain MRI (with contrast)
|
$1,401.12 |
$1,401.12 |
$1,401.12 |
$2,163.67
|
|
Brain MRI (without contrast)
|
$1,304.10 |
$1,304.10 |
$1,304.10 |
$1,815.00
|
|
Budesonide non-comp unit
|
$17.72 |
$17.72 |
$17.72 |
$32.78
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$70.66 |
$70.66 |
$70.66 |
$9.00
|
|
Bundled special stain group 2
|
$185.85 |
$185.85 |
$185.85 |
$167.50
|
|
Buprenorphine oral 1mg
|
$12.67 |
$12.67 |
$12.67 |
$11.24
|
|
Calcium 24 hour urine
|
$34.65 |
$34.65 |
$34.65 |
$51.63
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$70.66 |
$70.66 |
$70.66 |
$42.83
|
|
Calcium ionized
|
$224.28 |
$224.28 |
$224.28 |
$80.40
|
|
Calcium total
|
$83.16 |
$83.16 |
$83.16 |
$44.00
|
|
Carbamazepine total therapeutic drug level
|
$115.29 |
$115.29 |
$115.29 |
$113.25
|
|
Carbon dioxide
|
$41.58 |
$41.58 |
$41.58 |
$41.34
|
|
Carcinoembryonic ag (cea)
|
$101.43 |
$101.43 |
$101.43 |
$125.15
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$354.20 |
$354.20 |
$354.20 |
$255.00
|
