|
11-desoxycortisol - sendout
|
$40.92 |
$40.92 |
$40.92 |
$87.50
|
|
17-hydroxypregnenolone
|
$106.26 |
$106.26 |
$106.26 |
$89.25
|
|
17-ketosteroids
|
$73.92 |
$73.92 |
$73.92 |
$55.00
|
|
2d tee w or without fol w/con,in
|
$1,657.26 |
$1,657.26 |
$1,657.26 |
$1,624.70
|
|
3d recon without postprocess indpndt
|
$641.52 |
$641.52 |
$641.52 |
$485.00
|
|
5' nucleotidase - sendout
|
$117.48 |
$117.48 |
$117.48 |
$50.40
|
|
88334 ap bill cytologic exam each additional site
|
$154.44 |
$154.44 |
$154.44 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$36.30 |
$36.30 |
$36.30 |
$53.95
|
|
Abdominal CT scan (with and without contrast)
|
$2,091.54 |
$2,091.54 |
$2,091.54 |
$2,009.80
|
|
Abdominal CT scan (with contrast)
|
$1,750.32 |
$1,750.32 |
$1,750.32 |
$1,680.60
|
|
Abdominal CT scan (without contrast)
|
$1,259.28 |
$1,259.28 |
$1,259.28 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,375.24 |
$3,375.24 |
$3,375.24 |
$3,015.94
|
|
Abdominal MRI (with contrast)
|
$2,789.16 |
$2,789.16 |
$2,789.16 |
$2,268.20
|
|
Abdominal MRI (without contrast)
|
$2,656.50 |
$2,656.50 |
$2,656.50 |
$2,050.14
|
|
Abdominal paracentesis w/image guidance
|
$1,721.94 |
$1,721.94 |
$1,721.94 |
$1,651.20
|
|
Abdominal Ultrasound (complete)
|
$769.56 |
$769.56 |
$769.56 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$578.16 |
$578.16 |
$578.16 |
$590.00
|
|
Abd paracentesis/w/o image guide 49082
|
$1,083.06 |
$1,083.06 |
$1,083.06 |
$1,145.40
|
|
Abl1 gene
|
$415.14 |
$415.14 |
$415.14 |
$682.50
|
|
Ablation of upper extremity nerves rf
|
$351.12 |
$351.12 |
$351.12 |
$808.50
|
|
Abscess drain retroperitoneal surg code
|
$1,627.56 |
$1,627.56 |
$1,627.56 |
$2,957.17
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$1.80 |
$1.80 |
$1.80 |
$74.96
|
|
Acetazolamide 500 mg solution for injection
|
$159.85 |
$159.85 |
$159.85 |
$122.55
|
|
Acetone qualitative
|
$46.86 |
$46.86 |
$46.86 |
$45.65
|
|
Acetylcholine receptor modulating antibody
|
$89.10 |
$89.10 |
$89.10 |
$64.50
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$8.93 |
$8.93 |
$8.93 |
$216.00
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$177.54 |
$177.54 |
$177.54 |
$243.00
|
|
Acute hepatitis panel
|
$316.80 |
$316.80 |
$316.80 |
$292.00
|
|
#acylcarnitineprfl
|
$387.42 |
$387.42 |
$387.42 |
$125.40
|
|
Adenosine 3 mg/250 ml bag for osm
|
$8.90 |
$8.90 |
$8.90 |
$255.41
|
|
Adh-sendout
|
$207.24 |
$207.24 |
$207.24 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$32.34 |
$32.34 |
$32.34 |
$181.12
|
|
Administration chemotherapy IV infusion each additional hour
|
$203.28 |
$203.28 |
$203.28 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$279.18 |
$279.18 |
$279.18 |
$294.00
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$772.20 |
$772.20 |
$772.20 |
$657.12
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$502.26 |
$502.26 |
$502.26 |
$439.20
|
|
Administration immunization 1 vaccine
|
$120.12 |
$120.12 |
$120.12 |
$69.21
|
|
Administration immunization each additional vaccine
|
$42.90 |
$42.90 |
$42.90 |
$47.40
|
|
Administration vaccine hepatitis b
|
$62.70 |
$62.70 |
$62.70 |
$54.40
|
|
Administration vaccine influenza virus
|
$53.46 |
$53.46 |
$53.46 |
$50.43
|
|
Administration vaccine pneumococcal
|
$53.46 |
$53.46 |
$53.46 |
$50.43
|
|
_afb org id by sequencing rflx ast-sendout
|
$594.66 |
$594.66 |
$594.66 |
$315.00
|
|
Airway resistance by impulse oscillometry 94728
|
$209.22 |
$209.22 |
$209.22 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$54.12 |
$54.12 |
$54.12 |
$46.23
|
|
Albumin (human), 25%, 50ml
|
$279.68 |
$279.68 |
$279.68 |
$244.70
|
|
Albumin (human), 5%, 250 ml
|
$337.92 |
$337.92 |
$337.92 |
$243.59
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$144.54 |
$144.54 |
$144.54 |
$57.00
|
|
Albumin serum plasma or whole blood
|
$31.02 |
$31.02 |
$31.02 |
$40.80
|
|
Alkaline phosphatase
|
$25.74 |
$25.74 |
$25.74 |
$46.40
|
|
Allergen alpha lactalbumin ige
|
$33.66 |
$33.66 |
$33.66 |
$48.00
|
|
Allergen egg white ige
|
$9.24 |
$9.24 |
$9.24 |
$38.00
|
|
Allergy injections; 2 or more 95117
|
$52.80 |
$52.80 |
$52.80 |
$43.75
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$629.64 |
$629.64 |
$629.64 |
$874.65
|
|
Alpha-fetoprotein tumor marker
|
$99.00 |
$99.00 |
$99.00 |
$106.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$304.31 |
$304.31 |
$304.31 |
$15,857.45
|
|
Alt/sgpt
|
$60.06 |
$60.06 |
$60.06 |
$47.45
|
|
Aluminum - quest
|
$126.06 |
$126.06 |
$126.06 |
$83.05
|
|
Aminolevulinic acid delta
|
$137.28 |
$137.28 |
$137.28 |
$85.15
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$37.85 |
$37.85 |
$37.85 |
$119.07
|
|
Amiodarone 50 mg/ml intravenous solution
|
$3.23 |
$3.23 |
$3.23 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$62.70 |
$62.70 |
$62.70 |
$87.45
|
|
Ammonia
|
$89.76 |
$89.76 |
$89.76 |
$119.70
|
|
Amphetamine confirm urine -sendout
|
$62.70 |
$62.70 |
$62.70 |
$92.61
|
|
Ampicillin 1 gram solution for injection
|
$16.16 |
$16.16 |
$16.16 |
$56.70
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$38.86 |
$38.86 |
$38.86 |
$53.86
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$347.16 |
$347.16 |
$347.16 |
$262.99
|
|
Amp metatarsal w/toe single 28810
|
$3,747.48 |
$3,747.48 |
$3,747.48 |
$4,271.00
|
|
Amylase
|
$70.62 |
$70.62 |
$70.62 |
$89.04
|
|
Ana ds-dna
|
$101.64 |
$101.64 |
$101.64 |
$56.50
|
|
Analysis gene f2 20210g>a variant
|
$237.60 |
$237.60 |
$237.60 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$237.60 |
$237.60 |
$237.60 |
$230.40
|
|
Anaplsma phgcytophlm amp prb
|
$237.60 |
$237.60 |
$237.60 |
$85.80
|
|
Anca screen with reflex to titer -quest
|
$108.90 |
$108.90 |
$108.90 |
$103.20
|
|
An cholangiogram percutaneous compl
|
$3,544.20 |
$3,544.20 |
$3,544.20 |
$2,626.65
|
|
An fluoro guide for cvp
|
$465.96 |
$465.96 |
$465.96 |
$515.00
|
|
Ankle X-ray
|
$315.48 |
$315.48 |
$315.48 |
$353.60
|
|
Antibody
|
$36.30 |
$36.30 |
$36.30 |
$36.60
|
|
Antibody bacterium, not elsewhere specified
|
$31.02 |
$31.02 |
$31.02 |
$57.81
|
|
Antibody elution rbc reference
|
$198.00 |
$198.00 |
$198.00 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$312.18 |
$312.18 |
$312.18 |
$130.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$178.86 |
$178.86 |
$178.86 |
$218.30
|
|
Antibody id rbc panel
|
$415.80 |
$415.80 |
$415.80 |
$274.56
|
|
Antibody screen rbc
|
$75.24 |
$75.24 |
$75.24 |
$100.00
|
|
Antibody tetanus
|
$99.00 |
$99.00 |
$99.00 |
$53.95
|
|
Antidepressant not specified
|
$42.24 |
$42.24 |
$42.24 |
$61.80
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$2.92 |
$2.92 |
$2.92 |
$6.10
|
|
Antinuclear antibodies
|
$116.82 |
$116.82 |
$116.82 |
$89.40
|
|
Antinuclear antibodies titer
|
$79.86 |
$79.86 |
$79.86 |
$77.00
|
|
Antipsychotics nos 7/more
|
$95.04 |
$95.04 |
$95.04 |
$16.24
|
|
Antistreptolysin o screen
|
$93.06 |
$93.06 |
$93.06 |
$62.00
|
|
Antistreptolysin o titer
|
$108.90 |
$108.90 |
$108.90 |
$51.45
|
|
Antithrombin iii activity
|
$129.36 |
$129.36 |
$129.36 |
$114.00
|
|
Aortic dysfunction/dilation
|
$2,284.26 |
$2,284.26 |
$2,284.26 |
$1,008.00
|
|
Apc gene dup/delet variants
|
$905.52 |
$905.52 |
$905.52 |
$400.00
|
|
Apc gene full sequence
|
$905.52 |
$905.52 |
$905.52 |
$1,255.02
|
|
Apl(pml-rara) quant - sendout
|
$861.96 |
$861.96 |
$861.96 |
$482.95
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,112.66 |
$2,112.66 |
$2,112.66 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$786.06 |
$786.06 |
$786.06 |
$851.85
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$323.40 |
$323.40 |
$323.40 |
$463.65
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$4,228.62 |
$4,228.62 |
$4,228.62 |
$3,345.60
|
