|
11-desoxycortisol - sendout
|
$82.50 |
$82.50 |
$82.50 |
$84.56
|
|
17-hydroxypregnenolone
|
$97.50 |
$97.50 |
$97.50 |
$85.15
|
|
2nd order venous cath
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$1,809.60
|
|
3d ech img cgen car anomal
|
$460.00 |
$460.00 |
$460.00 |
$460.00
|
|
3-d radiotherapy plan
|
$5,635.00 |
$5,635.00 |
$5,635.00 |
$4,953.00
|
|
3d recon without postprocess indpndt
|
$492.50 |
$492.50 |
$492.50 |
$467.95
|
|
5' nucleotidase - sendout
|
$62.50 |
$62.50 |
$62.50 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$57.50 |
$57.50 |
$57.50 |
$94.00
|
|
Abatacept (with maltose) 250 mg intravenous solution
|
$123.28 |
$123.28 |
$123.28 |
$3,484.68
|
|
Abd aorta w/runoff s&i
|
$2,515.00 |
$2,515.00 |
$2,515.00 |
$3,683.78
|
|
Abd/low ext cath 1st
|
$1,395.00 |
$1,395.00 |
$1,395.00 |
$2,412.00
|
|
Abd/low ext cath 2nd
|
$1,395.00 |
$1,395.00 |
$1,395.00 |
$2,271.00
|
|
Abd/low ext cath 3rd
|
$1,395.00 |
$1,395.00 |
$1,395.00 |
$2,662.40
|
|
Abd/low ext cath addl
|
$700.00 |
$700.00 |
$700.00 |
$964.70
|
|
Abdominal CT scan (with and without contrast)
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,976.00
|
|
Abdominal CT scan (with contrast)
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,655.50
|
|
Abdominal CT scan (without contrast)
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,265.00 |
$3,265.00 |
$3,265.00 |
$3,004.50
|
|
Abdominal MRI (with contrast)
|
$2,210.00 |
$2,210.00 |
$2,210.00 |
$2,200.55
|
|
Abdominal MRI (without contrast)
|
$2,110.00 |
$2,110.00 |
$2,110.00 |
$1,981.20
|
|
Abdominal paracentesis w/image guidance
|
$910.00 |
$910.00 |
$910.00 |
$1,668.08
|
|
Abdominal Ultrasound (complete)
|
$685.00 |
$685.00 |
$685.00 |
$785.55
|
|
Abdominal Ultrasound (limited)
|
$515.00 |
$515.00 |
$515.00 |
$604.80
|
|
Abd paracentesis/w/o image guide 49082
|
$725.00 |
$725.00 |
$725.00 |
$1,179.75
|
|
Abl1 gene
|
$805.00 |
$805.00 |
$805.00 |
$668.85
|
|
Ablat 1/+thyr ndul addl prq rf
|
$1,775.00 |
$1,775.00 |
$1,775.00 |
$1,155.50
|
|
Ablate bone tumor(s) cryo perq 20983
|
$5,285.00 |
$5,285.00 |
$5,285.00 |
$8,512.80
|
|
Ablate bone tumor(s) perq
|
$4,540.00 |
$4,540.00 |
$4,540.00 |
$9,773.01
|
|
Ablate pulm tumor perq crybl
|
$5,540.00 |
$5,540.00 |
$5,540.00 |
$9,970.50
|
|
Ablate pulm tumor perq rf
|
$5,540.00 |
$5,540.00 |
$5,540.00 |
$7,243.60
|
|
Ablation cardiac vagal inputs atrium
|
$610.00 |
$610.00 |
$610.00 |
$1,996.95
|
|
Ablation cryo abd perit om
|
$9,015.00 |
$9,015.00 |
$9,015.00 |
$2,566.58
|
|
Ablation cryo adrenal tumor
|
$3,680.00 |
$3,680.00 |
$3,680.00 |
$6,904.15
|
|
Ablation cryo pq liver tumor(s)
|
$4,615.00 |
$4,615.00 |
$4,615.00 |
$8,581.80
|
|
Ablation of upper extremity nerves rf
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$961.20
|
|
Abltj 1/+thyr ndul 1lobe prq
|
$3,550.00 |
$3,550.00 |
$3,550.00 |
$2,964.48
|
|
Abscess drain retroperitoneal surg code
|
$2,890.00 |
$2,890.00 |
$2,890.00 |
$3,053.18
|
|
Absorpt drg >16 <=48 without bdr
|
$3.70 |
$3.70 |
$3.70 |
$5.70
|
|
Absorpt drg <=16 sq in without b
|
$5.00 |
$5.00 |
$5.00 |
$5.00
|
|
Absorpt drg > 48 sq in without b
|
$7.50 |
$7.50 |
$7.50 |
$7.76
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$1,850.00 |
$1,850.00 |
$1,850.00 |
$2,670.25
|
|
Acetaminophen level
|
$157.50 |
$157.50 |
$157.50 |
$117.01
|
|
Acetylcholine receptor modulating antibody
|
$62.50 |
$62.50 |
$62.50 |
$61.80
|
|
Acetylcholinesterase assay
|
$157.50 |
$157.50 |
$157.50 |
$106.70
|
|
Acup 1/> w/estim 1st 15 min
|
$28.50 |
$28.50 |
$28.50 |
$56.16
|
|
Acup 1/> w/estim ea addl 15
|
$23.00 |
$23.00 |
$23.00 |
$70.56
|
|
Acup 1/> without estim ea add 15
|
$20.50 |
$20.50 |
$20.50 |
$56.16
|
|
Acup 1/> wo estim 1st 15 min
|
$26.00 |
$26.00 |
$26.00 |
$49.40
|
|
Acute hepatitis panel
|
$322.50 |
$322.50 |
$322.50 |
$278.33
|
|
#acylcarnitineprfl
|
$225.00 |
$225.00 |
$225.00 |
$110.25
|
|
Adapter b 8 channel 10cm
|
$388.28 |
$388.28 |
$388.28 |
$6,142.50
|
|
Adh-sendout
|
$170.00 |
$170.00 |
$170.00 |
$109.71
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$28.31 |
$28.31 |
$28.31 |
$183.76
|
|
Administration chemotherapy IV infusion each additional hour
|
$235.00 |
$235.00 |
$235.00 |
$235.00
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$235.00 |
$235.00 |
$235.00 |
$308.10
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$470.00 |
$470.00 |
$470.00 |
$690.21
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$272.50 |
$272.50 |
$272.50 |
$448.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$122.50 |
$122.50 |
$122.50 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$147.50 |
$147.50 |
$147.50 |
$264.82
|
|
Administration immunization 1 vaccine
|
$32.50 |
$32.50 |
$32.50 |
$67.20
|
|
Administration immunization each additional vaccine
|
$15.00 |
$15.00 |
$15.00 |
$46.23
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$88.09 |
$88.09 |
$88.09 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$6.71 |
$6.71 |
$6.71 |
$92.03
|
|
Aep hearing status deter i&r
|
$147.50 |
$147.50 |
$147.50 |
$303.05
|
|
_afb id by dna probe rflx ast
|
$80.00 |
$80.00 |
$80.00 |
$89.70
|
|
_afb org id by sequencing rflx ast-sendout
|
$785.00 |
$785.00 |
$785.00 |
$289.60
|
|
Air injection into abdomen 49400
|
$520.00 |
$520.00 |
$520.00 |
$531.49
|
|
Airway resistance by impulse oscillometry 94728
|
$240.00 |
$240.00 |
$240.00 |
$270.50
|
|
Albumin body fluid quantitative each specimen
|
$47.50 |
$47.50 |
$47.50 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$109.83 |
$109.83 |
$109.83 |
$218.40
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$62.50 |
$62.50 |
$62.50 |
$55.90
|
|
Albumin serum plasma or whole blood
|
$37.50 |
$37.50 |
$37.50 |
$39.78
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$112.50 |
$112.50 |
$112.50 |
$94.90
|
|
Alginate dressing <=16 sq in
|
$12.70 |
$12.70 |
$12.70 |
$18.03
|
|
Alginate drsg >16 <=48 sq in
|
$20.00 |
$20.00 |
$20.00 |
$40.60
|
|
Alginate drsg wound filler
|
$7.50 |
$7.50 |
$7.50 |
$15.42
|
|
Alkaline phosphatase
|
$65.00 |
$65.00 |
$65.00 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$15.00 |
$15.00 |
$15.00 |
$48.57
|
|
Allergen egg white ige
|
$25.00 |
$25.00 |
$25.00 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$12.50 |
$12.50 |
$12.50 |
$24.01
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$71.56 |
$71.56 |
$71.56 |
$9,018.12
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$405.29 |
$405.29 |
$405.29 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$210.00 |
$210.00 |
$210.00 |
$4,732.60
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$721.91 |
$721.91 |
$721.91 |
$1,707.62
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$11.36 |
$11.36 |
$11.36 |
$9.62
|
|
Alpha-fetoprotein tumor marker
|
$110.00 |
$110.00 |
$110.00 |
$102.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$204.50 |
$204.50 |
$204.50 |
$14,503.48
|
|
Alt/sgpt
|
$62.50 |
$62.50 |
$62.50 |
$44.68
|
|
Aluminum - quest
|
$97.50 |
$97.50 |
$97.50 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$885.00 |
$885.00 |
$885.00 |
$444.50
|
|
Amantadine (symmetrel)-sendout
|
$312.50 |
$312.50 |
$312.50 |
$178.10
|
|
Aminolevulinic acid delta
|
$70.00 |
$70.00 |
$70.00 |
$74.10
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$9.77 |
$9.77 |
$9.77 |
$150.15
|
|
Amitriptyline (elavil) -sendout
|
$92.50 |
$92.50 |
$92.50 |
$92.50
|
|
Ammonia
|
$85.00 |
$85.00 |
$85.00 |
$114.40
|
|
Amphetamine confirm urine -sendout
|
$95.00 |
$95.00 |
$95.00 |
$93.61
|
|
Amphetamines 5 or more
|
$92.50 |
$92.50 |
$92.50 |
$87.75
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$23.98 |
$23.98 |
$23.98 |
$58.36
|
|
Amylase
|
$70.00 |
$70.00 |
$70.00 |
$83.20
|
|
Ana ds-dna
|
$37.50 |
$37.50 |
$37.50 |
$58.63
|
