Inventory Description Inventory Price *LIDEX(FLUOCIN)0.05%60ML(DO NOT USE) $ 100.00 CHLAMYDIA CULTURE 3015581 $ 100.00 Culture Blood $ 100.00 I V START $ 100.00 MS ALBUMIN Charge Only $ 100.00 MS Charge Only $ 100.00 MS Charge Only $ 100.00 MS IgG #1 Charge Only $ 100.00 MS IgG #2 Charge Only $ 100.00 PERSONAL HYGIENE TOOL $ 100.00 PROF US ABDOMEN/LIVER LTD $ 100.00 PULSE OX READING $ 100.00 CHLORPROMAZINE (THORAZINE) 50MG/2ML AMP $ 100.32 *ADENOCARD(ADENO)6MG/2MLSYR(DO NOT USE) $ 101.00 CANDIDA SKIN TEST $ 101.00 PROINSULIN CHARGE FOR 3015221 $ 101.00 IBD EXP CPT 86255 $ 101.25 CPT 88365-TC $ 102.00 Culture Urine $ 102.00 EOSINOPHIL COUNT NASAL 008581 $ 102.00 Lithium (Eskalith), Serum $ 102.00 Lower Resp. Clt., Other than Expectorant $ 102.00 MONITOR CO2 $ 102.00 MONONUCLEOSIS TEST $ 102.00 NEUROMUSCULAR RE-EDUCATION $ 102.00 NEUTOMUSCULAR RE-EDUCAITON $ 102.00 OSMOLALITY SERUM $ 102.00 Osmolality, Urine Random or 24 Hour $ 102.00 PH, BODY FLUID $ 102.00 PT STERILE WHIRLPOOL $ 102.00 PT WHIRLPOOL $ 102.00 SIDE PLATE 5 HOLE SEMI TUBE $ 102.00 STOOL pH $ 102.00 AIRCAST ANKLE LG LEFT $ 103.00 AIRCAST ANKLE LG RIGHT $ 103.00 AIRCAST ANKLE MED LEFT $ 103.00 AIRCAST ANKLE MED RIGHT $ 103.00 AIRCAST ANKLE SM LEFT $ 103.00 AIRCAST ANKLE SM RIGHT $ 103.00 ASPERGILLUS AB QUANT CHG $ 103.00 CSF PROTEIN $ 103.00 Culture Genital $ 103.00 MORPHINE PCA 60MG (1MG/ML) $ 103.00 SOLU-CORTEF (HYDRCORTISONE) 250MG VIAL $ 103.51 ADULT LUMBAR PUNCTURE $ 104.00 PED LUMBAR PUNCTURE TRAY $ 104.00 PEDIATRIC LUMBAR PUNCTURE $ 104.00 NYSTOP (NYSTATIN) POWDER 15GM $ 104.34 ROBINUL (GLYCOPYRROLATE) 0.4MG/2ML VL $ 104.88 50-g GLUCOSE LOAD TOLERANCE 1 HOUR TEST $ 105.00 BONE DENSITY VERTEBRAL FRACTURE $ 105.00 COGNITIVE TRAINING $ 105.00 CONGNITIVE SKILLS DEVELOPMENT $ 105.00 HGB A1C $ 105.00 LEVEL 2 EXAM $ 105.00 VARI-STIM 111 NERVE LOCATOR $ 105.00 PRED FORTE 1% OPTH SOL : 1ML $ 105.48 PROF US NON VAS UE/LE $ 106.00 ABBOTT EPIDURAL TRAY $ 107.00 CORTICAL SCREW NON S.T.40MM $ 107.00 CORTICAL SCREW NON S.T.42MM $ 107.00 CSF-CELL COUNT $ 107.00 Ethanol, Blood (Chain of Custody) $ 107.00 SET STENT INTRODUCTION $ 107.00 *CECLOR(CEFA)250MG/5MLSUSP(DO NOT USE) $ 108.00 C-Reactive Protein (CRP), Quant. 006627 $ 108.00 EKG MONITOR $ 108.00 GASTRIC pH 082214 $ 108.00 INCISION OF THROMBOSED HEMORRHOID EXTER $ 108.00 OCCULT BLOODD, GASTRIC FLUID (LABCORP) $ 108.00 PROF US SCROTUM & CONTENTS $ 108.00 WOUND VAC DAILY RENTAL $ 108.00 FLUZONE (HIGH DOSE) 0.5ML VACCINE $ 108.63 CORTICAL SCREW SELF TAP 34MM $ 109.00 CORTICAL SCREW SELF TAP 36MM $ 109.00 PROF CT SOFT TISSUE NECK W/WO IV CONTRA $ 109.00 INFED (IRON DEXTRAN) 100MG/2ML 2ML VIAL $ 109.69 D-DIMER LABCORP $ 110.00 F. B RETRIEVAL BASKET (MED.) $ 110.00 FB RETRIEVAL BASKET MED. $ 110.00 INJ; SINGLE TENDON/LIGA, APONEUROSIS $ 110.00 DOXYCYCLINE 100MG VIAL $ 110.16 *ISOPTOHYOSCINE(SCOPOLAMINE)(DO NOT USE) $ 111.00 16MM CORTICAL SCREWS $ 111.00 22MM CORTICAL SCREWS $ 111.00 G6PD LCM 001917 $ 111.00 GLUCOSE BODY FLUID $ 111.00 PERFORMATRAK MASK LARGE $ 111.00 PERFORMATRAK MASK MED $ 111.00 PERFORMATRAK MASK SMALL $ 111.00 ASPIRATION ABSCESS $ 112.00 CHANGE GASTRO TUBE $ 112.00 EXCISION BENIGN LESION SCALPHANDFEET $ 112.00 INJECTER NEEDLE TIPS DISP. $ 112.00 PERCUTANEOUS SHEATH IN $ 112.00 Rubella Antibodies, IgG $ 112.00 CYCLOGYL (CYCLOPENTOLATE) 2% 2ML OPHTH $ 112.13 C-Reactive Protien (CRP), High Card. $ 113.00 FECAL REDUCING SUBSTANCES (NOT AVAILABLE $ 113.00 I&D OF PERIANAL ABSCESS $ 113.00 I/D PERIANAL ABSCESS SUPERFICIAL $ 113.00 Lead, Blood (Adult)ROYAL BLUE EDTA $ 113.00 Lead, Blood (Pediatric)ROYAL BLUE EDTA $ 113.00 NF-LANTUS INS(GLARGINE) 100UNITS (1ML) $ 113.31 Hepatitis A Virus (HAV) Antibody, Total $ 113.75 MEGACE ES (MEGESTROL) 625MG/5ML 5ML SUSP $ 113.81 DIAZEPAM (VALIUM) 10MG/2ML 2ML SYRINGE $ 113.92 *EPOGEN (EPOETIN 2,000UN/ML(DO NOT USE) $ 114.00 ARTHROCENTESIS A/I MAJOR JOINT $ 114.00 ARTHROCENTESIS A/I MAJOR JOINT $ 114.00 BASIC METABOLIC PANEL $ 114.00 DIGOXIN $ 114.00 DILANTIN $ 114.00 E&M 15 MIN $ 114.00 ENDOCLOSE $ 114.00 LEPTOSPIROSIS $ 114.00 MONITOR ULTRASOUND $ 114.00 PRIMAXIN (IMIPENEM/CILASTATIN) 500MG VL $ 114.00 PROF US ARM UNILAT VENOUS $ 114.00 SOFT TISSUE BIOPSY TRAY $ 114.00 Toxoplasma gondii Ab, IgG, Qn $ 114.00 Vitamin C (chilled tube and LP) $ 114.00 DAILY VISIT BRIEF $ 115.00 DRAIN BLAKE 15FR ROUND $ 115.00 SLEEVE FOOT SCD LARGE $ 115.00 SLEEVE FOOT SCD REG. $ 115.00 PRED FORTE (PREDNISOLO) 1% 1ML OPHTH SOL $ 115.52 PROCALAMINE 3% 1000ML IV SOLN $ 115.97 *ISOPTO5%(HOMATROP)OP5ML (DO NOT USE) $ 116.00 CENTRALIV AGE2UNDER $ 116.00 CERULOPLASMIN LCM 001560 $ 116.00 INCISION OF SKINABSC $ 116.00 PROF US PELVIC COMPLETE $ 116.00 Low-density Lipoprotien Chol. Direct $ 116.25 MRSA Screening Culture $ 116.25 LOTRISONE (CLOTRIMA/BETAMET) 15GM CREAM $ 116.73 *NULYTELY 4000ML(DO NOT USE) $ 117.00 BLADE DERMATONE DISP $ 117.00 CORTISPORIN(NEO/POLY B/HC)10ML OTIC SOLN $ 117.00 Helicobacter pylori Ab, IgA $ 117.00 Helicobacter pylori Ab, IgG $ 117.00 Helicobacter pylori Ab, IgM $ 117.00 SUTURE 8.0 ETHILON 1716G $ 117.00 VAGINAL / RECTAL STREP GROUP B CULTURE $ 117.50 *BLEPH-10(SULFA)10%5MLOP (DO NOT USE) $ 117.57 *PRENATAL1PLUSTAB27/1MG(DO NOT USE) $ 118.00 ALDOLASE 002030 $ 118.00 ALDOLASE 002030 $ 118.00 Hepatitis B Surface Antigen $ 118.00 PCA MAINT DAILY $ 118.00 PCA MAINT DAILY $ 118.00 *HALDOLDEC(HALOPERID)50MG/ML(DO NOT USE) $ 118.02 ADMINISTRATION INJECTION $ 119.00 Creatinine Clearance 24H Urine & Ser Cre $ 119.00 FOLEY TIP PUNCH $ 119.00 Insulin $ 119.00 SALICYLATE $ 119.00 LEVSIN (HYOSCYAMINE) 0.125MG/ML 15ML $ 119.97 Brucella Antibody IgG, EIA $ 120.00 Brucella Antibody IgM, EIA $ 120.00 DRUG SCREEN-GASTRIC $ 120.00 INJE-TAK FLEXABLE NEEDLE 4.8 FR $ 120.00 PLEURX DRAINAGE KIT $ 120.00 SPINAL ORTHOSIS MED TLSO $ 120.00 SEBSEQUENT OBSERVATION VISIT LOW $ 121.00 *PILOCAR (PILOCARPINE) 2%(DO NOT USE) $ 121.00 GASTRIN LEVEL $ 121.00 Giardia lamblia, Direct Detection 182204 $ 121.00 LEUKOCYTE ALKALINE PHOSPHATASE $ 121.00 LEVEL 3 EXAM $ 121.00 PT VASOPNEUMATIC DEVICE $ 121.00 TRACHEOSTOMY TUBE SIZE 4 $ 121.00 Hepatitis B Core Ab, IgM $ 121.25 ARIPIPRAZOLE (ABILIFY) 15MG TAB $ 121.26 CMV IgM CHARGE ONLY (TORCH) $ 122.00 DISP LMA MASK SZ. 4 $ 122.00 Hepatitis Be Ag $ 122.00 Hepatitis Be Antibody $ 122.00 HSV CHARGE ONLY (TORCH) $ 122.00 HSV CHARGE ONLY (TORCH) $ 122.00 PROF US BILAT BREAST $ 122.00 REUSEABLE LMA MASK $ 122.00 RUBELLA CHARGE ONLY (TORCH) $ 122.00 TOXOPLASMA CHARGE ONLY (TORCH) $ 122.00 ARIPIPRAZOLE (ABILIFY) 5MG TAB $ 122.02 INTRALIPID 20%(FAT EMULSIONS) 100ML $ 122.68 SENSIPAR(CINACALCET)30MGTAB $ 122.75 Prostatic Acid Phosphatase (PAP), Serum $ 123.00 Urine Culture, Comprehensive $ 123.75 INFECTIONS AG ANTIGEN DET NOT SPECIFIED $ 124.00 INFECTIONS AGENT ANTIGEN DET STREP GRP B $ 124.00 IV MANNITOL 20% 500M $ 124.00 MANNITOL 20% INJ $ 124.00 BRIMONIDINE (ALPHAGAN) 0.2% 5ML OPHTH $ 124.07 *ZITHROMAX(AZITHRO)100MG/5ML(DO NOT USE) $ 125.00 AMP PROBE CHG $ 125.00 Antinuclear Antibodies, IFA LCM 164947 $ 125.00 ENDOSTITCH SURGIDAC 2.0 $ 125.00 Gold, Serum or Plasma $ 125.00 Mycoplasma genitalium charge $ 125.00 Mycoplasma hominis charge $ 125.00 Mycoplasma ureaplasma charge $ 125.00 PHENOBARBITAL $ 125.00 THEOPHYLLINE $ 125.00 GENTAMICIN 0.1% OINT 15GM $ 125.09 NOVOLOG (INSULIN ASPART) 100UNITS (1ML) $ 125.66 CATAPRES TTS-1 (CLONIDINE) 0.1MG PATCH $ 125.86 AQUINOX HUMIDIFIER $ 126.00 Ferritin, Serum $ 126.00 NMR LipoProfile w/IR Markers $ 126.00 URINE SULFATE $ 126.00 CLOSED TREATMENT OF FRACTURE GREAT TOE $ 127.00 Ova and Parasite Examination $ 127.00 SIDE PLATE NARROW 4 HOLE $ 127.00 35W SKIN STAPLER $ 128.00 CAST LEG LONG $ 128.00 CRYSTAL,SYNOVIAL/JOINT FLUID $ 128.00 Microalbumin, Quantitative Urine 24 Hr $ 128.00 Urine Microalbumin,Quantitative RANDOM $ 128.00 ADM PNEUMO VACCINE $ 129.00 ADM PNEUMO VACCINE $ 129.00 ADM SINGLE VACCINE $ 129.00 ADM SINGLE VACCINE $ 129.00 DAILY VISIT BRIEF $ 129.00 DIPRIVAN(PROPOFOL)10MG/ML 100ML BOTTLE $ 129.96 EXCISION LESION SCALPNECKTRUNK .5CM OR $ 130.00 MAX-CORE BIOPSY INSTRUMENT 16G $ 130.00 PERC/VIBRATION SUB TREATMENT $ 130.00 PROF MAMMO BILAT-SCREEN W/CAD $ 130.00 TROCAR 11MM ENDOPATH $ 130.00 TROCAR 12MM ENDOPATH $ 130.00 TROCAR 5MM ENDOPATH $ 130.00 WALKER $ 130.00 NOVOLOG MIX 70/30 100UNITS (1ML) $ 130.34 *CLINIMIX(AMINO/D5W)5/151000ML(DONOTUSE) $ 131.00 Aerobic Bacterial Culture, General $ 131.00 Culture, Upper Respiratory $ 131.00 GENTAMICIN PEAK $ 131.00 GENTAMICIN RANDOM $ 131.00 GENTAMICIN TROUGH $ 131.00 ORTHOTIC FITTING 15 MIN $ 131.00 ORTHOTIC FITTING, 15 MIN $ 131.00 ORTHOTIC-PROSTHETIC MANAGEMENT $ 131.00 PROF US EXTREMITY BILAT ARTERIAL $ 131.00 VANCOMYCIN PEAK $ 131.00 VANCOMYCIN RANDOM $ 131.00 VANCOMYCIN TROUGH $ 131.00 Volatiles, Urine LCM716001 $ 131.25 PHENOBARBITAL 130MG/ML 1ML VIAL $ 131.32 ADMINISTRATION INJ ANTIBIOTIC $ 132.00 ADMINISTRATION PPD $ 132.00 I AND D COLLECTION $ 132.00 INCISION AND DRAINAGE OF PILONIDAL CYST $ 132.00 INCISION/REMOVAL FB SIMPLE $ 132.00 ONESTEP SUPRAPUBIC INTRODUCER $ 132.00 REMOVAL FB DENTOALVEOLAR STRUCTURE;ST $ 132.00 SEQ COMPRE SLEEVES MED $ 132.00 SEQ COMPRE SLEEVES SM $ 132.00 SLEEVE KNEE LTH. SCD LARGE $ 132.00 SLEEVE KNEE LTH. SCD MED. $ 132.00 THYROID PEROXIDASE (TPO) ANTIBODIES $ 132.00 MULTI-VIT/FLUO (POLY-VIT/FLU)0.25MG 50ML $ 132.24 AZITHROMYCIN 200MG/5ML SUSP $ 132.54 VERAPAMIL (10MG/4ML 4ML VIAL) $ 132.74 TOTAL IRON BINDING CAPACITY $ 133.00 TRANSFERRIN $ 133.00 VITAMIN B-12 (NON-ORDABLE) $ 133.00 AUGMENTIN (AMOXICIL/CLAV) 400MG/5ML 50ML $ 133.57 CONTROL NASAL HEMORRHAGE $ 134.00 PROF US ABDOMEN COMPLETE $ 134.00 ANCA CHARGE $ 135.00 CPT 88184 FLOW CYTOMETRY $ 135.00 IV TRAVASOL3.5%1000M $ 135.00 WOUND-VAC DRESSING MED. $ 135.00 WOUND-VAC DRESSING SMALL $ 135.00 LOVENOX (ENOXAPARIN) 40MG/0.4ML SOD SYRI $ 135.59 PERCUTANEOUS INTRO NEEDLE $ 136.00 CPT 88185-TC FLOWCYTOMETRY/ADD-ON $ 137.00 HEMOGLOBIN SOL WITH REFLEX LCM 005330 $ 137.00 HEMOGLOBIN SOLUBILITY LCM005223 $ 137.00 PADDED FEMORAL LEG SPLINT $ 137.00 PADDED FEMORAL LEG SPLINT 79-72295 $ 137.00 PADDED FEMORAL LEG SPLINT 79-72297 $ 137.00 POSTERIOR TIB/FIB SPLINT 79-72283 $ 137.00 POSTERIOR TIB/FIB SPLINT 79-72285 $ 137.00 POSTERIOR TIB/FIB SPLINT 79-72287 $ 137.00 PUMP ESOPHAGEAL BALLON $ 137.00 DONNATAL(BELLADONNA/PHENOBARB) 10ML ELIX $ 137.12 BB LBC COURIER 21-60M $ 138.00 FLU A $ 138.00 FLU B $ 138.00 Hepatitis B Surface Antibody 006530 $ 138.00 INSERTION URINARY CATHETER $ 138.00 Testosterone, Free + Weakly Bound $ 139.25 ALPHA-1-ANTITRYPSIN 001982 $ 140.00 Complement C1q, Quantitative $ 140.00 Complement C3, Serum $ 140.00 Complement C4, Serum $ 140.00 COOK CUTTING LOOP 24 FR. $ 140.00 COOK ROLLER BALL ELECTRODE $ 140.00 DRVVT CHARGE $ 140.00 ENDOSHEER BLADE REFILL $ 140.00 FETOGRAM 1 VIEW $ 140.00 Folate (Folic Acid), Serum $ 140.00 GIVMOHR SLING $ 140.00 HEPATIC FUNCTION PANEL $ 140.00 HSV Type 1-Specific Ab, IgG 164897 $ 140.00 HSV Type 2-Specific Ab, IgG 163033 $ 140.00 LIPID PANEL $ 140.00 MAX-CORE BIOPSY INSTRUMENT 18G $ 140.00 Mumps Antibodies, IgG $ 140.00 Mumps Antibodies, IgM $ 140.00 OXALATE 24H URINE $ 140.00 PT RE-EVALUATION $ 140.00 PT DEBRIDEMENT $ 140.00 SURGINEEDLE 120mm $ 140.00 Varicella-Zoster V Ab, IgG $ 140.00 VERSAPORT 10-15 MM $ 140.00 ACETAMINOPHEN $ 141.00 CARBAMAZEPINE $ 141.00 CMV IgG CHARGE ONLY (TORCH) $ 141.00 DRAINAGE ABSCESS EXTERNAL EAR $ 141.00 HSV CHARGE ONLY (TORCH) $ 141.00 LACTATE, GRAY (NO FIST/TOURN) $ 141.00 PROF US AORTA $ 141.00 PROF US THYROID/NECK NON VASCULAR $ 141.00 REDUCTION FRACTURE FINGER W/O MANIPULATI $ 141.00 RUBELLA CHARGE ONLY (TORCH) $ 141.00 TOXOPLASMA CHARGE ONLY (TORCH) $ 141.00 VALPROIC ACID $ 141.00 Human T-Cell Lymph. Virus 1,2(HTLV)Conf. $ 141.25 Sex Hormone-binding Globulin, Serum $ 141.25 Fungus Culture W/Rflx Rapid ID LCM 18857 $ 142.00 Growth Hormone, Serum LCM 004275 $ 142.00 TRACH SHILEY 10 FENESTRATED $ 142.00 TRACHEOSTOMY TUBE SIZE 10 $ 142.00 MYDRIACYL(TROPICAMIDE) 1% 15ML OPHT SOLN $ 142.50 GIA 60 3.8 RELOAD $ 143.00 GIA 60 4.8 RELOAD $ 143.00 REMOVAL FB INTRANASAL $ 143.00 GEL-FOAM SPONGE 3/1/8X5 $ 144.00 MOL ISOLATION OF HIGH PUR NUCLEIC ACID $ 144.00 MOTION HYBRID WIRE GUIDE $ 144.00 SEPARATION BY GEL ELECTROPHORESIS CHG $ 144.00 CHEST TUBE $ 145.00 Cold Agglutinin Titer, Quant $ 145.00 DIGOXIN; TOTAL $ 145.00 DILANTIN $ 145.00 DRUG BLOOD TOX CHARGE ONLY $ 145.00 E&M 20-30 MIN $ 145.00 FERRLECIT (SOD FER GLUC) 62.5MG/5ML AMP $ 145.00 MULIFIRE TA 60 LOADING UNITS $ 145.00 PROF US OB $ 145.00 Zinc, Plasma (metal free transport tube) $ 145.00 *PROVENTI HFA(ALBUTEROL)18GM(DO NOT USE) $ 146.00 CYCLOGYL (CYCLOPENTOLATE) 1% 15ML OPHTH $ 146.00 EXCISION OTHER BENIGN LESION FACE NOSE $ 146.00 IBUPROFEN 808462 $ 146.00 INTUBATION ENDOTRACHEAL $ 146.00 MONIT. CARDIAC OUTPU $ 146.00 MULTIFIRE TA90 RELOAD $ 146.00 Calculi Urinary LCM 120790 $ 147.00 Copper Plasma(metal free transport tube) $ 147.00 Herpes DELETED ITEM SEE 3015258 - JC $ 147.00 LAPARASCOPIC SCISSOR TIP $ 147.00 PICC INTRODUCER SET 5FR. $ 147.00 PICC INTRODUCER SET 6FR $ 147.00 SIDE PLATE 7 HOLE SEMI TUBE $ 147.00 THORACENTESIS WITH INSERTION OF TUBE $ 147.00 VMA 24 HR URINE $ 147.00 BENZENE STANDARD PROFILE $ 147.50 EXTRACTABLE NUCLEAR AG CHARGE ONLY $ 147.50 Mycoplasma pneumoniae Antibodies IgG $ 147.50 Mycoplasma pneumoniae Antibodies, IgM $ 147.50 DURAGESIC (FENTANYL) 50MCG/HR PATCH $ 147.75 ANTI-SS-A CHARGE ONLY $ 148.00 ANTI-SS-B CHARGE ONLY $ 148.00 DOUBLE STRANDED DNA $ 148.00 I/D ABSCESS PERITONSILLAR $ 148.00 Leptin, Serum $ 148.00 Lysozyme, Serum LCM 080713 $ 148.00 *CEFZIL(CEFPROZIL)250MG/5ML(DO NOT USE) $ 149.00 GASTRIC LAVAGE KIT 34F $ 149.00 URETERAL STENT SOFT $ 149.00 URETERAL STENT SOFT $ 149.00 URETERAL STENT SOFT $ 149.00 URETERAL STENT SOFT $ 149.00 VERSAPORT 12 MM $ 149.00 a-Fetoprotein (AFP), Serum, Tumor Marker $ 150.00 AMMONIA $ 150.00 B pertussis, NP Culture 180224 $ 150.00 Candida dna amp probe charge $ 150.00 GENERAL OR PACKS $ 150.00 LIPOPROTEIN (a) $ 150.00 OCCUPATIONAL THERAPY RE-EVALUAT $ 150.00 Rubeola Antibodies, IgG 096560 $ 150.00 SUSCEPTIBILITY AEROBIC AND FAC ANAEROBIC $ 150.00 TROCAR 12MM ENDOPATH LONG $ 150.00 TROCAR 5MM ENDOPATH LONG $ 150.00 TSH (3rd IS) $ 150.00 TSH w reflex FT4 & TPO $ 150.00 Hepatitis A Antibody IgM $ 151.00 SALICYLATE $ 151.00 STOOL OCCULT BLOOD $ 151.00 WOUND-VAC DRESSING LARGE $ 151.00 *GTT 1ST 3 SPECIMENS $ 152.00 ANTI-JO-1 $ 152.00 Calcium, Ionized, Serum $ 152.00 COOK PEEL AWAY INTRODUCER $ 152.00 Deamidated gliadin IgA $ 152.00 FIBRINOGEN DEGRADATION PRODUCTS $ 152.00 HSV TYPES 1/2, IgM, EIA LCM 164806 $ 152.00 I&D OF BARTHOLIN'S GLAND ABSCESS $ 152.00 MONITOR INVASIVE SI $ 152.00 MULT BOOT 6962 $ 152.00 MULT BOOT LINER 6963 $ 152.00 REPAIR LAC <2.5; MOUTH/ANT TONGUE $ 152.00 SIDE PLATE BROAD 5 HOLE $ 152.00 Tissue Transglutaminase IgA $ 152.00 TRACH SHILEY 8 FEN $ 152.00 TRACHEOSTOMY TUBE 6 FEN $ 152.00 TRACHEOSTOMY TUBE FEN 4 $ 152.00 TRACHEOSTOMY TUBE SIZE 6 $ 152.00 TRACHEOSTOMY TUBE SIZE 8 NF $ 152.00 DRESSING/DEBRIDEMENT P-T BURN 5-10% $ 153.00 MIOSTAT (CARBACHOL) 0.01% 1.5ML OPHTH $ 153.58 ACE 010116 $ 154.00 HEPATITIS B CORE AB TOTAL IgG $ 154.00 INTUBATION ENDOTRACHEAL $ 154.00 SUTURE SURGIPRO 5.0 $ 154.00 NEO-SYNEPHRINE(PHENYLEPHRINE) 2.5% 2ML $ 154.39 PROF BARIUM ENEMA THERAPEUTIC $ 155.00 CLINIMIX 5/15 TPN MIX $ 156.00 CLINIMIX 5/25 TPN MIX $ 156.00 Cortisol $ 156.00 Cortisol, AM $ 156.00 Cortisol, PM $ 156.00 GLASSMAN VISCERA RETAINER FISH $ 156.00 PROF MAMMO NEEDLE LOC (PER LESION) $ 156.00 T pallidum Ab (FTA-Ab) $ 156.00 THERAPEUTIC IV PUSH INITIAL $ 156.00 THERAPEUTIC IV PUSH-INITIAL $ 156.00 TURKEL PARACENTESIS TRAY $ 156.00 VERSAPORT 10MM $ 156.00 Fecal Fat, Qualitative $ 157.00 INSULIN ANTIBODY $ 157.00 Pre-Albumin $ 157.00 HYDRATION INITAL 31 MIN UP TO 1 HOUR $ 158.00 HYDRATION INITIAL, 31 MIN UP TO 1 HOUR $ 158.00 NEXTERONE (AMIODARON) 150MG/100ML PREMIX $ 158.19 CYCLIC CITRULLINATED PEPTIDE ANTI 164914 $ 159.00 Immunoglobulin E (IgE), Qn Serum $ 159.00 OCUFLOX (OFLOXACIN) 0.3% 5ML OPHTH DROP $ 159.00 PHENOBARBITAL $ 159.00 QUINIDINE 007831 $ 159.00 REPAIR CX EA ADD 5CM FACE HAND FEET GEN $ 159.00 THEOPHYLLINE $ 159.00 ETHICON BABCOCK 5MM $ 160.00 GASTROSTOMY TUBE 20 FR. $ 160.00 GASTROSTOMY TUBE 22 FR. $ 160.00 GASTROSTOMY TUBE 24 FR. $ 160.00 GASTROSTOMY TUBE 26 FR. $ 160.00 GASTROSTOMY TUBE 28 FR. $ 160.00 LOW PRO G-TUBE $ 160.00 PROF MAMMO BILAT-DIAG W/CAD $ 160.00 SEQ SLEEVES LARGE $ 160.00 T4 FREE $ 160.00 TIMOLOL MALEATE 0.25% 15ML OPHTH DROP $ 160.00 VISION 0.06%(TRYPAN BLUE) 2.25ML OPHTH $ 160.00 PROTAMINE SULFATE 250MG/25ML VL $ 160.05 BORRELIA BURGDORFERI ANTIBODY CHG $ 161.00 PROF US ARM BILAT VENOUS $ 161.00 DISP. UTERINE MONIPULATER $ 162.00 DISP. UTERINE MONIPULATER $ 162.00 DISP. UTERINE MONIPULATER $ 162.00 DISP. UTERINE MONIPULATER $ 162.00 GIRDLE ABOVE KNEE POST-OP $ 162.00 MANIPULATOR TIP 10MM $ 162.00 MANIPULATOR TIP 6MM $ 162.00 MANIPULATOR TIP 8MM $ 162.00 PBG,QU,RANDOM URINE 003053 $ 162.00 BACTROBAN (MUPIROCIN) 2% 22GM OINT $ 162.45 CHLAMYDIA-TRACHOMATIS AMP PROBE CHG $ 162.50 PERICARDIOCENTESIS; INITIAL $ 163.00 Thyroxin-binding Globlin (TBG), Serum $ 163.00 Toxoplasma gondii Ab, IgM, Qn $ 163.00 *TERAZOL(TERCON)0.4%VAGCR(DO NOT USE) $ 163.40 SIDE PLATE 2HOLE SEMI-TUBE $ 164.00 Thyroglobulin Ab 006685 $ 164.00 *DEMSER(METYROSINE) 250MG (DO NOT USE) $ 165.00 CONTOUR STAPLER RELOAD $ 165.00 CONTRACT EMPLOYMENT PHYSICAL $ 165.00 CRITI CARE ADD 30MIN $ 165.00 ELECTRODE ADULT MULTI FUNCTION $ 165.00 ELECTRODE PACING $ 165.00 ELECTRODE PEDIATRIC $ 165.00 EXCISION OF NAIL MATRIX PERM REMOVAL $ 165.00 PROF US OB > 14 WEEKS $ 165.00 REMOVAL OF NAIL BED $ 165.00 REPAIR SIMPLE 0-2.5 SCALP NECK EXTREM $ 165.00 Carbon Monoxide, Blood $ 166.00 Chromium, Plasma (metal free transfer tu $ 166.00 DRUG DEF 1 CLASSES ACTM,SAL,ETOH,ECT $ 166.00 ETHANOL $ 166.00 GENTAMICIN PEAK $ 166.00 GENTAMICIN RANDOM $ 166.00 GENTAMICIN TROUGH $ 166.00 PREGNANCY TEST SERUM QUALITATIVE $ 166.00 PREGNANCY TEST URINE $ 166.00 THORACENTESIS KIT $ 166.00 TRACH SHILEY 6 LPC $ 166.00 VANCOMYCIN PEAK $ 166.00 VANCOMYCIN RANDOM $ 166.00 VANCOMYCIN TROUGH $ 166.00 PROPARACAINE (ALCAINE) 0.5% 15ML OPHTH $ 166.70 DILATOR INFLATOR SYRINGE WITH GUAGE $ 167.00 EBV Early Antibody IgG 096248 $ 167.00 ER LEVEL 1 $ 167.00 PROF CT C-SPINE WO IV CONTRAST $ 167.00 SIDE PLATE 3HOLE SEMI-TUBE $ 167.00 MAXITROL (NEO/POLY B/DEX) 5ML OPHTH SUSP $ 167.20 MAXITROL(NEO/POLY/DEXA) 3.5GM OPHTH OINT $ 167.20 Opiates Confirmation Charge 737846 $ 168.00 ANTIBODY SCREEN $ 169.00 BB Antigen Testing Grp I LBC $ 169.00 BB Antigen Testing Grp II LBC $ 169.00 BB Antigen Testing Grp III LBC $ 169.00 BB Antigen Testing Grp IV $ 169.00 BB BLOOD TYPING, SEROLOGIC; ABO $ 169.00 BB BLOOD TYPING, SEROLOGIC; Rh (D) $ 169.00 BB RH PHENOTYPE LBC $ 169.00 BB SELECT CELL SCREEN LBC $ 169.00 Phencycline Confirmation Charge 712588 $ 169.00 Vitamin B12 Level $ 169.00 *DELESTROGEN(ESTRAD)40MG/ML(DO NOT USE) $ 169.79 *BIAXIN(CLARITHRO)250MG/5ML(DO NOT USE) $ 170.00 *PILOCAR(PILOCARPINE)1%15ML(DO NOT USE) $ 170.00 Anticardiolipin Antibodies IGG 161810 $ 170.00 Anticardiolipin Antibodies IGM 161828 $ 170.00 Anticardiolipin Antibodies IGA 161836 $ 170.00 Follicle,stimulating Hormone (FSH), Seru $ 170.00 Helper T-Lymphocyte Marker CD4 $ 170.00 Hepatitis C Virus (HCV) Antibody $ 170.00 Lyme, IgM, Early Test/Reflex LCM 160333 $ 170.00 PSA ANNUAL SCREENING $ 170.00 PSA TOTAL DIAGNOSTIC $ 170.00 PT EVAL MODERATE COMPLEXITY $ 170.00 TETANUS/DIPHTHERIA CHARGE $ 170.00 INTRALIPID 20% 250ML $ 170.01 INTRALIPID 20%(FAT EMULSIONS) 250ML $ 170.02 BLUNT SPACEMAKER TROCAR $ 171.00 COMPLEMENT C2 $ 171.00 Haptoglobin $ 171.00 Anti-DNase B (Streptococcal) Antibodies $ 173.00 Bodly Fluid Culture, Sterile $ 173.00 GM1 Ab IgG Charge Only $ 173.00 GM1 Ab IgG Charge Only $ 173.00 PTT LA LCM 117002 $ 173.00 SURGICEL ABSORBABLE HEMOSTAT $ 173.00 Trichomonas vaginalis, NAA 188052 $ 173.00 DOXEPIN (SINEQUAN) $ 174.00 *RONDEC(CARDEC)30MLDROP(DO NOT USE) $ 175.00 BB CHEMICAL MODIFICATION LBC $ 175.00 BB RHOGAM $ 175.00 *PRILOSEC(OMEPRA)2MG/ML90ML(DO NOT USE) $ 175.94 Amphetamines Confirmation Charge Only $ 176.00 Barbiturates Confirmation Charge 071290 $ 176.00 Benzodiazepines Confirmation Charge Only $ 176.00 Cocaine Confirmation Charge 071324 $ 176.00 E&M 25 MIN $ 176.00 Methadone Confirmation Charge 700070 $ 176.00 ORGANISM ID YEAST 182212 $ 176.00 Propoxyphene Confirmation Charge 074567 $ 176.00 REPAIR SIMPLE 0-2.5CM FACE EARS $ 176.00 THC (Marijuan Confirmation Charge 071316 $ 176.00 Vitamin A, SERUM (LIGHT PROTECT) $ 176.00 VYGON MASK LARGE $ 176.00 VYGON MASK MED $ 176.00 SOLU-MEDROL (METHYLPRED) 1000MG VIAL $ 176.89 *NASALIDE(FLUNI)0.025%25MLNS(DO NOT USE) $ 177.00 PROF US BIOPHYSICAL PROFILE NON STRESS $ 177.00 AMIKACIN PEAK, LCM 007204 $ 178.00 AMIKACIN TROUGH, LCM 007205 $ 178.00 BLUNT PORT PLUS 5m TO 12m $ 178.00 Cytomegalovirus (CMV) Ab, IgM LCM 096727 $ 178.00 LUTEINIZING HORMONE $ 178.00 PARVOVIRUS B19 HUMAN IGG $ 178.00 PARVOVIRUS B19 HUMAN IGM $ 178.00 SPINAL PUNCTURE LUMBAR DIAGNOSTIC $ 178.00 ZOSTAVAX (ZOSTER VACCINE) 19400 UNIT $ 178.00 *AUGMENTINE(AMOX/POT)600MG(DO NOT USE) $ 178.03 ACETAMINOPHEN $ 179.00 CARBAMAZEPINE $ 179.00 ETHOSUXIMIDE LCM 007443 $ 179.00 IV PERITON DYS TRAY $ 179.00 PARASITE EXAMINATION BLOOD LCM 008185 $ 179.00 PROF CTA AORTA W/RUNOFFS WITH IV WO ORAL $ 179.00 TOTAL T3 (NON-ORDABLE) $ 179.00 Triiodothyronine (T3) $ 179.00 Valproic Acid (Depakote) ; Total $ 179.00 Varicella-Zoster Ab, IgM $ 179.00 Fentanyl Confirmation Charge 764220 $ 180.00 HAND-THUMB ORTHOSIS $ 180.00 Meperidine Confirmation Charge 761050 $ 180.00 PREMIUM SURGICLIP M-11.5 $ 180.00 Tramadol Confirmation Charge 761050 $ 180.00 *SANDOSTATIN(OCTRE)200MCG/ML(DO NOT USE) $ 181.00 Antiparietal Cell Antibodies 006486 $ 181.00 CENTRALIV AGE2 OVER $ 181.00 C-PEPTIDE LCM 010108 $ 181.00 Hemoglobin Fract. w/o Solubility $ 181.00 Legionella Titer $ 181.00 MITOCHONDRIAL (M2) ANTIBODY LCM 006650 $ 181.00 SPEECH EVAL SOUND PROD $ 181.00 Vitamin B1 EDTA WB LIGHT PROTECT $ 181.00 *GC/CHLAMYDIA DNA PROBE LCM 096479 $ 182.00 *GELFOAM(ABSORGELATIN)100MM (DO NOT USE) $ 182.00 NUCLEIC ACID AMP CHG $ 182.00 HTLV I CHARGE CPT 86687 LCM 164133 $ 182.50 HTLV II CHARGE CPT 86688 LCM 164133 $ 182.50 *AREDIA(PAMIDRON)30MG/10ML(DO NOT USE) $ 183.00 Protein Electrophoresis Random Urine $ 183.00 Protein Electrophoresis, 24-Hour Urine $ 183.00 CENTRAL VENOUS CATHETER $ 184.00 Free Kappa Light Chains $ 184.00 Free Lambda Light Chains $ 184.00 INDIVIDUAL MEDICAL $ 184.00 URINE AMMONIA $ 184.00 Benzodiazepine Confirmation, Quant Serum $ 185.00 DFS 20W FASIA STAPLER $ 185.00 MULTIFIRE TA 30 3.5 RELOAD $ 185.00 PROF US CAROTID ARTERY $ 185.00 CLOSED TX OF FX PHALANX OR PHALANGES MA $ 186.00 DERMA GRAFT $ 186.00 DESIPRAMINE $ 186.00 IV DEXTRAN 40 500ML $ 186.00 LEVEL 4 EXAM $ 187.00 REPAIR SIMPLE 2.6-7.5 SCALP NECK EXTREM $ 187.00 GENTAMICIN 0.1% 15GM CREAM $ 187.64 *TIMOPTICXE(TIMOLOLGFS)0.25%(DO NOT USE) $ 188.00 Anti SCL-70 018705 $ 188.00 ANTICENTROMERE B ANTIBODIES LCM 164814 $ 188.00 Anti-dsDNA (Double-stranded) Antibodies $ 188.00 Antihistone Antibodies LCM 012518 $ 188.00 ENDO HERNIA RELOAD 4.8 $ 188.00 PROF CT HEAD WO IV CONTRAST $ 188.00 Rubella Antibodies, IgM $ 188.00 VERSAPORT 5MM $ 188.00 Zika Virus MAC-ELISA (EUA) 163049 $ 188.00 Fecal Fat, 72 Hr Quantitative collection $ 188.75 Deamidated gliadin IgG $ 189.00 E K G $ 189.00 EKG $ 189.00 EKG BY RADIOLOGY $ 189.00 Lipid-associated Sialic Acid LCM 100313 $ 189.00 Tissue Transglutaminase IgG $ 189.00 CLINIMIX E (AMIN/D5W/CAL) 4.25/10 1000ML $ 189.41 SOLU-CORTEF (HYDROCORTISONE) 500MG VIAL $ 189.92 AMMONIA $ 190.00 ANA With Reflex if Positive 164863 $ 190.00 ANA, Direct(QUALITATIVE) LCM 164855 $ 190.00 ARTERIAL BLOOD GAS TEST $ 190.00 COMPRES SCREW OMAGA 32.5 MM $ 190.00 F. B RETRIEVAL BASKET (SM) $ 190.00 Human Chorionic Gonadotropin,B-Subunit,Q $ 190.00 Imm IgG SUBCLASS 2(CHARGE ONLY) $ 190.00 Imm IgG SUBCLASS 3(CHARGE ONLY) $ 190.00 Imm IgG SUBCLASS 4(CHARGE ONLY) $ 190.00 Imm IgG, Subclass 1 $ 190.00 MALE SURGICAL VEST $ 190.00 MONITOR FETAL W/SE $ 190.00 NEO-SYNEPHRINE (PHENYLEPHRINE)10% 5ML OP $ 190.00 Respiratory Syncytial Virus (RSV), Adult $ 190.00 VENOUS BLOOD GAS $ 190.00 CYCLOGYL (CYCLOPENTOLATE) 2% 5ML OPHTH $ 191.00 IV INFUSION-THERAPEUTIC-INITIAL HOUR $ 191.00 IV INFUSTION-THERAPEUTIC-INITIAL HOUR $ 191.00 MAHURKAR DIALYSIS CATH KT.16CM $ 191.00 *MIOCHOL-E(ACETYLCHO)1% 2ML(DO NOT USE) $ 192.00 RBC Folate LCM 266015 $ 192.00 Selenium, Serum or Plasma $ 192.00 *TAMIFLU(OSELTA)12MG/ML 25ML(DO NOT USE) $ 193.00 BETA-HYDROXYBUTYRIC ACID 845260 $ 193.00 INCISION/DRAINAGE ABComplicated or Multi $ 193.00 THORACENTESIS PUNCTURE OF PLEURAL CAVIT $ 193.00 Activated Protein C Resistance (APCR) $ 193.75 Actin (Smooth Muscle) Antibody (ASMA) $ 194.00 ENDOMYSIAL AB, IGA LCM 164996 $ 194.00 Flecainide ( Tambocor(TM)),S $ 194.00 SYNTHROID (LEVOTHYROXINE) 200MCG VIAL $ 194.00 CLINIMIX E 4.25/25 1000ML $ 194.29 ANTICHROMATIN ANTIBODIES LCM 012580 $ 195.00 CMP+TBILI+DBILI+IBILI $ 195.00 COMPREHENSIVE METABOLIC PANEL $ 195.00 Cryptosporidium EIA $ 195.00 MAHURKAR DIALYSIS CATH KT.19.5CM $ 196.00 MAHURKAR DIALYSIS CATH KT.24CM $ 196.00 Anti-Jo-1 LCM 161455 $ 197.00 Antiribosomal P Antibodies 012700 $ 197.00 COMPLEMENT TOTAL LCM 001941 $ 197.00 Susceptibility, Anaerobic $ 197.00 OMNIPAQUE (IOHEXAL) 300MG/ML 50ML VIAL $ 197.61 ACTONEL (RISEDRONATE) 35MG TAB $ 197.77 BB LBC COURIER >60M $ 198.00 IGF-1 $ 198.00 OLYMPUS INJECTER NEEDLE TIPS $ 198.00 REPAIR SIMPLE 2.6-5.0CM FACE EARS $ 198.00 NIZORAL (KETOCONAZOLE) 2% 30GM CREAM $ 198.01 *ACULAR(TROMETH)0.5%3MLOP(DO NOT USE) $ 199.00 AFB CULTURE CHARGE ONLY $ 199.00 DAILY VISIT LIMITED $ 199.00 BB FFP EACH UNIT $ 200.00 BETA-2 MICROGLOBULIN LCM 010181 $ 200.00 Bordetella pertussis Antibodies IgG $ 200.00 Bordetella pertussis Antibodies IgM $ 200.00 ESTRIOL SERUM 004614 $ 200.00 ORGANISM ID MOLD 008474 $ 200.00 ADACEL VACC (TET/DIPH/PERTUSS) 0.5ML SDV $ 200.03 VITAMIN K1 10MG/ML 1ML $ 201.00 CART CRASH $ 203.00 Clostridium difficle Tox (ASS CHARGE) $ 203.00 DO NOT USE!! USE CODE 2704532 $ 203.00 REPAIR ITM 7.6-12.5CM NECK HAND FEET GEN $ 203.00 SET-UP COLONOSCOPE $ 203.00 SET-UP CYSTOSCOPE $ 203.00 SETUP SIGMOLSCOPE $ 203.00 ANTI-DNA (SS) LCM 161422 $ 204.00 ENDO CLINCH $ 204.00 H. PYLORI (ADULT ONLY) $ 204.00 HYDROYINDOLEACETIC ACID 24 HR URINE $ 204.00 NT-proBNP $ 205.00 PROTEIN S FREE CHG $ 205.50 BB Cell Separation $ 206.00 DRESS/DEBRIDE BURN >10% $ 206.00 NEISSERIA GONORRHOEAE AMP PROBE CHG $ 206.00 REMOVE FB EXT EYE $ 206.00 ZIPRASIDONE (GEODON) 20MG/ML VIAL $ 206.99 Anti Mag $ 207.00 REMOVAL OF FOREIGN BODY FROM PHARYNX $ 207.00 REMOVAL OF FOREIGN BODY UPPER ARM SUBCUT $ 207.00 REPAIR ITM 0-2.5CM NECK HAND FEET GENIT $ 207.00 *ARIXTRA(FOND)2.5MG/0.5MLSYR(DO NOT USE) $ 207.67 *VASOLEX(TRY/BAL/CASOIL)60GM(DO NOT USE) $ 208.00 ENDOBABCOCK $ 208.00 Myoglobin, Quanititative, Random Urine $ 208.00 Myoglobin, Serum $ 208.00 PHENYTOIN FREE AND TOTAL LCM 070706 $ 208.00 DICLOFENAC (VOLTAREN) 1% 100GM GEL $ 208.31 PROGESTERONE $ 209.00 Prolactin LCM 004465 $ 209.00 PSA, Ultrasensitive W/O Serial 140731 $ 209.00 REPAIR ITM 0-2.5CM SCALP TRUNK EXTREM $ 209.00 SIGNAL AVERAGE ECG $ 209.00 ZONEGRAN $ 209.00 *NEOSP(NEO/BAC/POLY)3.5GMOPO(DO NOT USE) $ 209.95 DAILY VISIT LIMITED $ 210.00 DISCHARGE LESS 30 MIN $ 210.00 ERYTHROPOEITIN $ 210.00 Manganese, Blood (Adult)ROYAL BLUE EDTA $ 210.00 Min Inhibitory Conc (1 Drug) $ 210.00 PRED FORTE (PREDNISOLON) 1% 5ML OPTH SOL $ 210.21 CHLAMYDIA ANTIBODIES IgG 096180 $ 211.00 PROF CT C-SPINE WITH IV CONTRAST $ 211.00 CATAPRES TTS-2 (CLONIDINE) 0.2MG PATCH $ 211.90 DISCHARGE LESS 30 MIN $ 212.00 Antipancreatic Islet Cells 160721 $ 213.00 Clonazepam (Klonopin), Serum 071712 $ 213.00 COCAINE CONFIRMATORY $ 214.00 MERCURY BLOOD LCM 085324 $ 214.00 OPIATES CONFIRMATORY 713644 $ 214.00 THC CONFIRMATORY $ 214.00 *H1N1 AMP PROBE CHG $ 214.50 EPHEDRINE 50MG AMP $ 215.64 Carcinoembryonic Antigen(CEA)(Serial M.) $ 216.00 ROTAVIRUS DIRECT DETECTION $ 216.00 Renin Activity EDTA Plasm Frozen $ 217.00 T-Spot TB (Order 009985) $ 217.50 EMERGENCY PNEUMOTHORAX SET $ 218.00 CORTISPORIN(NEO/POLY B/HC)10ML OTIC SUSP $ 218.88 INTRINSIC FACTOR BLOCKING AB, SERUM $ 219.00 ROCKY MTN SPOTTED FEV IgG LCM 016592 $ 219.00 ROCKY MTN SPOTTED FEV IgM LCM 016667 $ 219.00 GROUP 60 MIN $ 220.00 EZ IO LARGE ADULT $ 220.00 EZ IO NEEDLES PED. $ 220.00 EZ IO NEEDLES ADULT $ 220.00 LEVEL 5 EXAM $ 220.00 PT EVAL HIGH COMPLEXITY $ 220.00 PT EVAL LOW COMPLEXITY $ 220.00 PT EVAL LOW COMPLEXITY $ 220.00 PT EVAL MODERATECOMPLEXITY $ 220.00 REPAIR SIMPLE 7.6-12.5 SCALP NECK EXTREM $ 220.00 SEBSEQUENT OBSERVATION VISIT MODERATE $ 221.00 GEL MARK BREAST BIOPSY MARKER $ 221.00 OBSERVATION DISCHARGE $ 221.00 ATROPINE SULF 1% 5ML OPHTH $ 221.84 CAST BODY CHILD $ 222.00 FIBRINOGEN ANTIGEN 117052 $ 222.00 HIV 1/0/2 (FOURTH GENERATION) $ 222.00 QUICKCLIP 2 230CM $ 222.00 QUICKCLIP 2 L230CM $ 222.00 Insulin Antibodies 141598 $ 223.00 REMOVAL FB EYE; CORNEAL WITH SLIT LAMP $ 223.00 PSA, Complexed LCM 140674 $ 224.00 PT EVAL HIGH COMPLEXITY 60 MIN $ 224.00 REPAIR ITM 2.6-7.5CM SCALP TRUNK EXTREM $ 224.00 ALBUMIN 25% (PLASBUMIN) 12.5GM/50ML VL $ 224.84 C-Telopeptide, Serum 500089 $ 226.00 Estrogens, Total $ 226.00 PROF CT FACIAL WO IV CONTRAST $ 226.00 REPAIR SIMPLE 5.1-7.5CM FACE EARS $ 226.00 MOXIFLOXACIN (VIGAMOX) OPHTH SOL : 1ML $ 226.48 SANDOSTATIN (OCTRE) 500MCG/ML 1ML VL $ 226.58 *EPOGEN (EPOETIN 4,000UN/ML(DO NOT USE) $ 228.00 COLPO OCCULDER $ 228.00 IRON SUCROSE (VENOFER) 100MG/5ML 5ML VL $ 228.00 MRI PORT INTRODUCER SET $ 228.00 PTHrP (PTH Related Hormone) 503380 $ 228.00 VAPOTHERM ADULT CIRCUT $ 228.00 VAPOTHERM LOW-FLOW CIRCUT $ 228.00 Anabolic Steroids Panel, Urine $ 229.00 REPAIR ITM 0-2.5CM FACE EARS $ 229.00 *DOMEBORO (DO NOT USE) $ 230.00 FLEXOR URETERAL ACCESS SHEATH $ 230.00 FLEXOR URETERAL ACCESS SHEATH $ 230.00 FLEXOR URETERAL ACCESS SHEATH $ 230.00 *DURICEF(CEFADRO)250MG/5ML(DO NOT USE) $ 231.00 ENDO DISSECTOR $ 231.00 NUCLEIC ACID SEP AND ID CHG $ 231.00 PURSESTRING 65 $ 231.00 REMOVAL FB FOOT; SUBCU $ 231.00 SPEECH HEARING THERAPY $ 231.00 17-a-HYDROXYPROGESTERONE $ 232.00 Amitriptyline, Serum LCM 007476 $ 232.00 Arsenic, Blood 007245 $ 232.00 HSV Culture and Typing 008250 $ 232.00 Protein Electrophoresis, Serum 001487 $ 232.00 HSV 1 NAA (CHARGE ONLY) $ 232.50 HSV 2 NAA CHARGE ONLY $ 232.50 REMOVE FOREIGN BODY COMPLICATED $ 233.00 CORTISPORIN (NEO/BAC/POLY/HC) 3.5GM OPHT $ 234.38 HALDOL DECANOATE (HALOPERIDOL) 100MG/ML $ 234.76 Oxcarbazepine (Trileptal), Serum $ 235.00 *NEOSPORIN(NEO/POLY/GRA)OP(DO NOT USE) $ 235.37 CLEOCIN(CLINDAMYCIN) 75MG/5ML 100ML SUSP $ 236.00 SPEECH THERAPY EVALUATION $ 237.00 TUBE THORACOSTOMY WITH/WITHOUT WATER SEA $ 237.00 BB LIFESHARE STAT FEE $ 238.00 EPISTAT II KIT $ 238.00 CL TX INTERPHALANGEAL JOINT DISLO SINGLE $ 239.00 *CEFTIN(CEFUROXIME)250MG/5ML(DO NOT USE) $ 240.00 *FRAGMIN(DALTEPARIN)10,000(DO NOT USE) $ 240.00 BB FFP THAWING FEE $ 240.00 Lyme Western Blot IgG Reflex Charge Only $ 240.00 Lyme Western Blot IgM Reflex Charge Only $ 240.00 CYSTOGRAFIN (DIATRIZOATE) 30% 300ML BT $ 240.03 Bordetella Pertussis Ab, IgA LCM 164384 $ 241.00 GQ1b Antibody IgG LCM 808602 $ 241.00 MASK LMA FASTRACH SZ-3 $ 241.00 POLYPECTOMY SNARE WIRES $ 241.00 TESTOSTERONE, TOTAL $ 241.00 TROPONIN $ 241.00 TOBRAMYCIN RANDOM $ 241.50 SILVADENE (SILVER SULFA) 1% 400GM CREAM $ 241.64 ANAEROBIC CULTURE $ 242.00 GIA 60 3.8 STAPLER $ 242.00 GIA 60 4.8 STAPLER $ 242.00 OCCUPATIONAL THERAPY EVAL HIGH $ 242.00 OCCUPATIONAL THERAPY EVAL LOW $ 242.00 OCCUPATIONAL THERAPY EVAL MODERATE $ 242.00 PLEUR-EVAC CHEST DRAIN $ 242.00 BB PHLEBOTOMY $ 243.00 BIPOLAR PACING CATH. $ 243.00 CPT 88189 FLOW CYTOMETRY $ 243.00 E&M 75-80 MIN $ 243.00 ENDORETRACTOR $ 243.00 LOW PRO WALKER (LARGE) $ 245.00 LOW PRO WALKER (MED) $ 245.00 LOW PRO WALKER (SM) $ 245.00 REPAIR ITM 2.6-7.5CM NECK HAND FEET GEN $ 245.00 ENGERIX B(HEPATITIS B ADULT)20MCG/ML $ 245.91 *AUGMENTIN(AMOX/POT)250MG (DO NOT USE) $ 246.00 Cell Count, Serous Fluid(EDTA OR HEPARIN $ 246.00 TOPIRAMATE 716285 $ 246.00 CADMIUM BLOOD LCM 085340 $ 247.00 CART ISOLATION $ 247.00 ENDO GRASPER $ 247.00 CK-MB $ 248.00 Galectin-3 $ 248.00 REPAIR ITM 2.6-5.0CM FACE EARS $ 248.00 TOBRAMYCIN 0.3% / DEX 0.1% OP SUSP 2.5ML $ 248.17 E&M 40 MIN $ 249.00 CENTRAL VENOUS CATHETER KIT $ 250.00 CENTRAL VENOUS KIT LARGE BORE $ 250.00 Chronic Urticaria $ 250.00 DEVICE PORT SITE CLOSURE $ 250.00 PERITONEAL LAVAGE $ 250.00 SACCHAROMYCES CEREVISIAE CHG $ 250.00 SWALLOWING THERAPY $ 250.00 CPR $ 251.00 *BETOPTIC(BETAXOLOL)0.5% (DO NOT USE) $ 252.00 Clonazepam (as Metabolite), Urine $ 252.00 HIV 1/2 SCREEN QUALITATIVE $ 252.00 ADENOID IRRIGATOR SET $ 253.00 DEFIBRILLATOR $ 253.00 Lamotrigine,Serum LCM 716944 $ 253.00 MONITOR INVESIVE MU $ 253.00 ROOM CIRCUMCISION $ 253.00 ROOM SPECIAL PROCED $ 253.00 VENTILATOR $ 253.00 *VANCOCIN(VANCOMYCIN)250MG(DO NOT USE) $ 254.00 PROF CT L-SPINE WO IV CONTRAST $ 254.00 PROF CT T-SPINE WO IV CONTRAST $ 254.00 ACULAR LS(KETOROLAC)0.4% 5ML OPHTH $ 254.14 Viral Culture, Rapid, Respiratory $ 254.50 HLA-B 27 ANTIGEN- DELETED ITEM $ 255.00 HLA-B27 Disease Association $ 255.00 Murine Typhus Antibodies, IgG $ 255.00 Parathyroid Hormone Intact (EDTA Plasma) $ 255.00 REMOVAL FB EYE; CORNEAL W/O SLIT LAMP $ 255.00 REP SIMPLE >30CM SCALP NECK EXTREM $ 255.00 Typhus Fever Group IgM $ 255.00 *MITOMYCIN 5MG VIAL (DO NOT USE) $ 256.00 CYSTOGRAM INJECTION CODE $ 256.00 INDIVIDUAL 45-60 MIN $ 256.00 INDIVIDUAL 45-60 MIN $ 256.00 INITIAL VISIT $ 256.00 TRUSOPT (DORZOLAMIDE) 2% 10ML OPHTH SOLN $ 256.46 Aldosterone Serum LCM 004374 $ 257.00 CHARGE ONLY HSV Types 1/2 DNA PCR $ 257.00 Cyclic AMP, Urine $ 257.00 Cyclosporine, Blood $ 257.00 REP SIMPLE12.6-20.0 SCALP NECK EXTREM $ 257.00 Anaerobe Identification Only 182345 $ 259.00 Carbohydrate Ag 19-9 $ 259.00 CAST BODY-ADULT $ 260.00 LAPARASOPIC CHOLANGIO $ 260.00 PROTEIN S ANTIGEN LCM 164517 $ 260.00 REPAIR ITM 7.6-12.5CM SCALP TRUNK EXTREM $ 260.00 URINE TOXICOLOGY SCREEN (RMC) $ 260.00 MAHURKAR DIALYSIS CATHETER KIT 16CM $ 261.00 URETHEAL DILATOR SET S-CURVE $ 261.00 DAILY VISIT EXTENDED $ 262.00 CLINIMIX E (AMIN/D5W/CAL) 4.25/10 2000ML $ 262.44 Vitamin B2, WH BL LV FZN LIGHT PROTECT $ 263.00 *BACTROBAN(MUPIROCIN)2%CR(DO NOT USE) $ 263.15 AMIODARONE LCM 706705 $ 264.00 *AZACTAM(AZTREONAM)2GMVL(DO NOT USE) $ 265.00 25-Hydroxyvitamin D LCMS D2 + D3 $ 265.00 Cancer Ag 125, Serum 480061 $ 265.00 Cancer Ag 27.29 (Serial Monito $ 265.00 INITIAL INHALATION TREATMENT $ 265.00 FUNCTIONAL RESIDUAL CAPACITY $ 266.00 GIA 50 PREMIUM $ 266.00 TOBRAMYCIN PEAK $ 266.00 TOBRAMYCIN TROUGH $ 266.00 Estradiol $ 267.00 HALOPERIDOL LCM 070482 $ 267.00 SINUS WATERS VIEW $ 267.00 STONE EXTRACTOR TIPLESS $ 268.00 ENDO CATCH 10mm $ 269.00 GAD-65 Autoantibody 143008 $ 269.00 CARBON MONOXIDE DIFFUSING CAPACITY $ 270.00 INPATIENT BRIEF ADMIT $ 270.00 THAL-QUICK CHEST TUBE TRAY $ 270.00 WAYNE PNEUMOTHORAX TRAY $ 270.00 *MINOCIN(MINOCYCLINE)100MGVL(DO NOT USE) $ 271.00 Drug Abuse Profile ,Urine 9 CLASSES $ 271.00 ENDO CATCH 15mm $ 272.00 Thyrotropin Receptor Antbody, Serum $ 272.00 REPAIR ITM 5.1-7.5CM FACE EARS $ 273.00 PRILOSEC (OMEPRAZOLE) 2MG/ML 150ML SUSP $ 274.32 BB Adsorption LBC $ 275.00 Culture CSF(NOT ORDERABLE) $ 275.00 FAMILY 45- 60 MIN $ 275.00 MASK LMA FASTRACH SZ 5 $ 275.00 MASK LMA FASTRACH SZ-4 $ 275.00 ENDOCLIP II $ 276.00 ENDOCLIP III 5MM $ 276.00 Antithrombin Antigen 015057 $ 278.00 BB CROSSMATCH $ 278.00 BB DAT LBC $ 278.00 BB ELUTION PREP LBC $ 278.00 Direct Coombs LabCorp $ 278.00 ENDOVINE INTERNAL BOLSTER KIT $ 278.00 PROF CT FACIAL WITH IV CONTRAST $ 278.00 PROF CT HEAD WITH IV CONTRAST $ 278.00 Zolpidem (Ambien) Level, $ 278.00 D-DIMER RMC $ 279.00 PROTEIN C ANTIGEN LCM 080465 $ 279.00 RETROGRADE INTUBATION SET $ 279.00 Sirolimus, Blood $ 279.00 Cortisol, Urinary Free $ 280.00 ENDO AVITENE $ 280.00 PROF CT ABDOMEN WO IV WITH ORAL CONTRAST $ 280.00 *FLOXIN(OFLOXA)0.3%5MLOTIC(DO NOT USE) $ 281.00 Cystine, 24-Hour Urine $ 281.00 Organophosphate Pesticide $ 281.00 REPAIR ITM 20.1-30CM SCALP TRUNK EXTREM $ 281.00 REPAIR SIMPLE 7.6-12.5 CM FACE EARS $ 281.00 SHOULDER LT 1V $ 282.00 SHOULDER RT 1V $ 282.00 CATECHOLAMINES URINE 24 HR LCM 004176 $ 283.00 ABDOMEN SUPINE 1VIEW $ 284.00 ABDOMEN UPRIGHT 1VIEW $ 284.00 *COGENTIN(BENZTROPIN)2MG/2ML(DO NOT USE) $ 285.00 Alpha 1 Antitrypsin, Random Stool 818333 $ 285.00 Levetiracetam (Keppra), Serum $ 285.00 SET-UP CATARACT $ 285.00 SWAN GANZ 7FR CATH $ 285.00 GLUCAGON, PLASMA 004622 $ 286.00 Homocysteine $ 286.00 DEBRIDMENT SKIN MUSCLE BONE $ 288.00 EXCISION OF EXTERNAL TAGS/PAP; ANUS $ 288.00 REPAIR LAC >2.6CM MOUTH/TONGUE $ 288.00 GASTROGRAFIN (DIATRME/DIATRIZ)120ML SOLN $ 288.88 CLAVICLE LT 1 VIEW $ 289.00 CLAVICLE RT 1 VIEW $ 289.00 OBSERVATION HOURLY $ 289.00 OBSERVATION HOURLY DIRECT ADMIT $ 289.00 OBSERVATION VISIT LOW $ 289.00 PROF CT LOWER EXTREMITY WO IV CONTRAST $ 289.00 PROF CT UPPER EXTREMITY WO IV CONTRAST $ 289.00 PROF CT CHEST WO IV CONTRAST $ 289.00 PROF CT ORB/SELLA/IAC WO IV CONTRAST $ 289.00 PROF CT PELVIC WO IV WITH ORAL CONTRAST $ 289.00 PROF CT SOFT TISSUE NECK WO IV CONTRAST $ 289.00 SIDE PLATE NARROW 2 HOLE $ 289.00 SIDE PLATE NARROW 3 HOLE $ 289.00 West Nile Virus (WNV) Antibody, Serum $ 289.00 CT GUIDANCE NEEDLE PLACEMENT $ 290.00 REPAIR ITM 12.6-20 CM SCALP TRUNK EXTREM $ 290.00 vW FACTIVTY 164509 $ 290.00 Acylcarnitine Profile, Quantitative $ 291.00 Aldosterone, 24-Hour Urine $ 291.00 Campylobacter Jejuni Antibody LCM 878728 $ 291.00 RENAL FUNCTION PANEL $ 291.00 Triiodothyronine (T3), Free $ 291.00 HIP LT 1V $ 292.00 HIP RT 1V $ 292.00 MULTIFIRE TA90 STAPLER $ 292.00 MVV (PFT) $ 292.00 Vitamin B6 EDTA PLASMA LIGHT PROTECT $ 293.00 CATAPRES TTS-3 (CLONIDINE) 0.3MG PATCH $ 293.96 REPAIR COMPLEX 1.1-2.5CM SCALP ARM LEG $ 294.00 HYDROXYPROLINE TOTAL $ 295.00 URETHEAL DILATOR SET STRAIGHT $ 296.00 FOOT LT 2V $ 297.00 FOOT RT 2V $ 297.00 FOREARM LT 2V $ 297.00 FOREARM RT 2V $ 297.00 HAND LT 2V $ 297.00 HAND RT 2V $ 297.00 INPATIENT BRIEF VISIT $ 297.00 STERNUM 2V $ 297.00 SURGICAL PATH LEVEL IV $ 298.00 ELBOW LT 2V $ 299.00 ELBOW RT 2V $ 299.00 INFANT LT LOWER EXT $ 299.00 INFANT LT UPPER EXT $ 299.00 INFANT RT LOWER EXT $ 299.00 INFANT RT UPPER EXT $ 299.00 STONE EXTRACTOR NITINOL $ 299.00 CLINIMIX(AMIN/D5W)5/25 2000ML $ 299.41 CENTRAL LINE IV $ 300.00 CLOSED TX SHOULDER DISLOCATION W/O ANES $ 300.00 ENDOSHEER DISP INSTRUMENT $ 300.00 HOLTER MONIT HOOKUP $ 300.00 MYCOBACTERIA TUB AMP PROBE TECHNIQUE $ 300.00 PROF CT ABDOMEN WITH IV WITH ORAL CONTRA $ 300.00 PROF CT L-SPINE WITH IV CONTRAST $ 300.00 PROF CT T-SPINE WITH IV CONTRAST $ 300.00 WRIST LT 2V $ 301.00 WRIST RT 2V $ 301.00 ANKLE LT 2V $ 302.00 ANKLE RT 2V $ 302.00 OCCULT BLOODB TWO SAMPLES $ 302.00 Testosterone, Free (Direct), Serum $ 302.00 DAILY VISIT EXTENDED $ 303.00 ER LEVEL 2 $ 303.00 SWALLOWING EVALUATION $ 303.00 Tacrolimus (Prograf) Level $ 303.00 MULTIFIRE GIA 60-3.8 STAPLER $ 307.00 PROF CT LOWER EXTREM WITH IV CONTRAST $ 307.00 PROF CT UPPER EXTREM WITH IV CONTRAST $ 307.00 PROF CT CHEST WITH IV CONTRAST $ 307.00 PROF CT ORB/SELLA/IAC WITH IV CONTRAST $ 307.00 PROF CT PELVIC WITH IV WITH ORAL CONTRA $ 307.00 PROF CT SOFT TISSUE NECK WITH IV CONTRA $ 307.00 SIDE PLATE NARROW 5 HOLE $ 307.00 HIP LT PEDIATRIC $ 308.00 HIP RT PEDIATRIC $ 308.00 VERSATRAK STAPLER 4.8MM $ 308.00 ANDROSTENEDIONE 004705 $ 309.00 URINE CITRATE $ 309.00 DISCHARGE MORE 30 MIN $ 310.00 HEPATITIS PROFILE $ 310.00 IMMUNOFIXATION URINE LCM 123034 $ 310.00 MIACALCIN(CALCITONIN-SALMON)200IU/ML 2ML $ 310.00 PROF CT ABDOMEN W/WO IV WITH ORAL CONTRA $ 310.00 REPAIR ITM 7.6-12.5CM FACE EARS $ 311.00 ERYTHROCIN(ERYTH)500MG/10ML VIAL $ 311.26 Adrenocorticotropic Hormone(ACTH),Plasma $ 312.00 BONE DENSITY AXIAL $ 312.00 CHEST 1V $ 312.00 CHEST PRE-OP $ 312.00 Organic Acid Analysis, Urine LCM 71620 $ 312.00 *EDEX(ALPROSTADIL)20MCG (DO NOT USE) $ 312.17 MULTIFIRE ENDO TA 30 2.5 REFILL $ 315.00 ENDO GIA UNIVERSAL 12MM $ 316.00 BICILLIN LA (PENICILLIN G) 600,000UN 1ML $ 316.09 SEBSEQUENT OBSERVATION VISIT HIGH $ 317.00 ANESTH MACHINE $ 317.00 FOREIGN BODY CHILD 1V NOSE TO RECTUM $ 317.00 IABP DAILY RENTAL $ 317.00 MACHINE LIPOSUCTION $ 317.00 SET-UP DENTAL $ 317.00 SET-UP RUMI-KOH $ 317.00 CALCITONIN SERUM LCM 004895 $ 318.00 MESH PRE-SHAPED W KEYHOLE $ 318.67 REMOVAL FB IN MUSCLE SIMPLE $ 319.00 DDAVP INJECTION 4MCG/ML $ 319.28 PROF CT ORB/SELLA/IAC W/WO IV CONTRAST $ 320.00 FLONASE (FLUTICASONE) 50MCG NS 16GM $ 320.41 CHROMOSOME ANALYSIS 15-20 CELLS CHG $ 321.00 CHROMOSOME ANALYSIS INTERP & REPORT CHG $ 321.00 CL TX INTERPHALANGEAL JOINT DISLOC W ANE $ 321.00 REPAIR ITM 12.6-20CM NECK HAND FEET GEN $ 321.00 ROTICULATOR ENDO GIA 30-3.5 $ 321.00 TISSUE CULTURE NEOPLASTIC DISORDERS $ 321.00 ROTICULATOR ENDO GIA 30-2.5 $ 322.00 6-THIOGUANINE $ 323.00 METHYLMERCAPTOPURINE $ 323.00 SUMATRIPTAN (IMITREX) 6MG/0.5ML 0.5ML VL $ 323.00 CLINIMIX(AMIN/DEX) 5/20 2000ML $ 324.72 PELVIS 1-2V $ 325.00 Reverse T3, Serum $ 325.00 CHEST LAT DECUB BILAT $ 326.00 REPAIR CX 1.1-2.5 CM FACE HAND FEET GEN $ 326.00 PROF CT CHEST W/WO IV CONTRAST $ 327.00 CHEST APICAL LORD $ 328.00 CRITICAL CARE ADDITIONAL MINUTES $ 328.00 *ENTEREG(ALVIMOPAN)12MGCAP(DO NOT USE) $ 329.00 CARPAL TUNNEL KIT $ 329.00 Dehydroepiandrosterone (DHEA LCM 004100 $ 329.00 SWAN GANZ 7.5FR CATH $ 329.00 IOPIDINE (APRACLONIDINE) 0.5% 5ML OPHTH $ 329.72 Calprotectin, Fecal $ 330.00 CRITICAL CARE 1ST HR $ 330.00 DRUG DEF 2 CLASSES ACTM,SAL,ETOH $ 330.00 KNEE AP STANDING BILAT $ 330.00 HYDROCORTISONE (ANUSOL HC) 2.5% 30GM CRM $ 331.85 HYSTERO INJECTION CODE $ 332.00 BNP $ 333.00 EMERGENCY CRICOTHYROTOMY SET $ 333.00 Helicobacter pylor Stool Antigen $ 333.00 PELVIMETRY $ 333.00 Serotonin, Serum $ 333.00 LOTRISONE(CLOTRIMA/BETAMET) 45GM CREAM $ 333.52 CL TX PATELLA DISLOCATION WO ANESTH $ 334.00 ENDOSCOPIC GASTROSTOMY KIT 14FR $ 334.00 ENDOSCOPIC GASTROSTOMY KIT 24FR $ 334.00 REP SIMPLE 20.1-30CM SCALP NECK EXTREM $ 336.00 ROTICULATOR ENDO GIA 45-2.5 $ 336.00 ROTICULATOR ENDO GIA 45-3.5 $ 336.00 CPT 81264-TC $ 337.00 METANEPHRINES TOTAL 24 HR URINE $ 337.00 SPEEDBAND MULTI-BAND LIGATOR $ 337.00 PROF US ECHOCARDIOGRAPHY $ 339.00 SHOULDER LT MIN 2 VW $ 341.00 SHOULDER RT MIN 2 VW $ 341.00 SPINE SINGLE VIEW (C T OR L) $ 341.00 CLINIMIX E 5/15 1000ML $ 341.20 SCAPULA LT 2 VIEW $ 342.00 SCAPULA RT 2 VIEW $ 342.00 CPT 81342-TC $ 343.00 KNEE LT 2V $ 343.00 KNEE RT 2V $ 343.00 REPAIR SIMPLE 12.6-20CM FACE EARS $ 343.00 Catecholamines, Fractionated, Plasma $ 345.00 MANDIBLE LT 3V $ 346.00 MANDIBLE RT 3V $ 346.00 NASAL BONES 3V $ 346.00 ALBUMIN 25% 25GM/100ML VL $ 347.70 FACTOR VIII ANTIGEN 500196 $ 348.00 RSV FOR <18 Y/O $ 348.00 US DOPPLER COLOR FLOW $ 348.00 25(OH) VITAMIN D TOTAL $ 350.00 ADH LCM 010447 $ 350.00 TELEMETRY MONITOR $ 350.00 VIitamin K1 (draw in chilled tube LP) $ 350.00 SKULL 1-2-3V $ 351.00 SINUS 3V $ 353.00 DIGNISHIELD FECAL MANAGEMENT KIT $ 355.00 EXAM CHOLODUCOSCOPE $ 355.00 CPT 81340-TC $ 356.00 AChR AB BINDING $ 357.00 AChR AB BLOCKING $ 357.00 MASTOIDS LT 3V $ 357.00 MASTOIDS RT 3V $ 357.00 SIMPLE SPIROMETRY (PFT) $ 358.00 Viral Culture, General $ 358.75 TIOTROPIUM BROMIDE 18MCG INHALER $ 359.13 QuantiFERON-TB Gold Plus(time sensitive) $ 360.00 BB EMERENCY TRANS $ 361.00 REPAIR COMPLEX 2.6-7.5CM SCALP ARM LEG $ 363.00 SIDE PLATE BROAD 7 HOLE $ 363.00 LINEZOLID (ZYVOX) 600MG/300ML PREMIX $ 364.80 MDI TREATMENT $ 365.00 2ND FREQ SUB INHALATION $ 365.00 2ND FREQ SUB IPPB TX $ 365.00 2ND FREQ SUB MDI TX $ 365.00 3RD FREQ SUB INHALATION $ 365.00 3RD FREQ SUB IPPB TX $ 365.00 3RD FREQ SUB MDI TX $ 365.00 CPAP PER DAY $ 365.00 DEMONTSTRATION OF RT EQUIPMENT $ 365.00 ENDOSTITCH $ 365.00 INITIAL 2ND FREQUENCY NEB TREATMENT $ 365.00 METHYLMALONIC ACID 706961 $ 365.00 PERC/VIBRATION INITIAL $ 365.00 SUB INHALATION TREATMENT $ 365.00 SUB IPPB TREATMENT $ 365.00 SUB MDI TREATMENT $ 365.00 TRACHEAL SUCTIONING $ 365.00 RIFADIN (RIFAMPIN) 600MG VIAL $ 365.99 CL TX OF CARPOMETACARPAL DISLOCA THUMB $ 366.00 ENDO UNIVERSAL STAPLER $ 368.00 Pancreatic Elastase, Fecal LCM 123234 $ 368.00 PROF CT HEAD W/WO IV CONTRAST $ 368.00 PROF CT PELVIC W/WO IV WITH ORAL CONTRA $ 368.00 CD4:CD8 Ratio Profile LCM 505271 $ 369.00 SURGIPRO MESH 9X14 $ 369.00 AC JOINT $ 370.00 *REPLIVA (PRUVATE)21/7 TAB(DO NOT USE) $ 371.00 HIV-Western Blot Confirmation Charge onl $ 373.00 THROMBOLYSIS BY INTRAVENOUS FUSION $ 374.00 BB RH CONFIRMATION BY GENOTYPING $ 375.00 HOLTER MONIT REPORT $ 376.00 MULTIFIRE ENDO GIA 30 3.5 $ 377.00 TMJ BILAT $ 377.00 CEFDINIR 250MG/5ML 60ML SUSP $ 377.91 BIPAP SUB DAYS $ 380.00 EXAM BROCHOSCOPIC $ 380.00 EXAM CHOLEDOCHOSCOPE $ 380.00 EXAM CYSTOSCOPE $ 380.00 EXAM GASTROSCOPE $ 380.00 EXAM PROCTO $ 380.00 EXAM SIGMOIDOSCOPY $ 380.00 ROOM TREATMENT $ 380.00 Vitamin B7 Serum 0070097 $ 380.00 *BACTROBAN(MUPIROCIN)2%30GM(DO NOT USE) $ 381.00 Acetylcholine Receptor -modulating Ab $ 383.00 CT 3D RENDERING $ 383.00 KUB $ 384.00 von Willebrand Factor (vWF) Ag $ 384.00 ADMINISTRATION IV AND MED $ 385.00 INPATIENT LIMITED ADMIT $ 385.00 OMNIPAQUE (IOHEXAL) 300MG/ML 100ML VIAL $ 387.23 CLOSED TX SHOULDER DISLOCATION W/O ANEST $ 389.00 PROF CTA ABDOMEN WITH IV CONTRAST WO OR $ 389.00 PROF CTA HEAD WITH IV CONTRAST $ 389.00 PROF CTA NECK WITH IV WO ORAL CONTRAST $ 389.00 PROF CTA THORACIC(AORTA) WITH IV WO ORAL $ 389.00 NECK SOFT TISSUE 1V $ 390.00 MULTIFIRE TA 60 3.5 $ 391.00 PERITONEAL TAP $ 393.00 A/D OB/IP SAME DAY LOW $ 394.00 CONT PULSE OX $ 394.00 FACTOR IX ACTIVITY 086298 $ 394.00 FACTOR VII ACTIVITY 800599 $ 394.00 FACTOR VIII ACTIVITY 086264 $ 394.00 FACTOR XI ACTIVITY 086314 $ 394.00 OVERNIGHT PULSE OX STUDY $ 394.00 HERNIA PLUG (MED) $ 395.00 NON-ROUTIN LAB FEE $ 395.00 OBSERVATION VISIT MODERATE $ 395.00 PROTOPAM (PRALIDOXIME) 1GM VIAL $ 395.00 HEEL LT 3V $ 398.00 HEEL RT 3V $ 398.00 TX CLOSED ELBOW DISLOCATION W/O ANEST $ 398.00 REPAIR ITM 20.1-30CM SCALP TRUNK EXTREM $ 399.00 TOE LT 2ND MIN 2V $ 399.00 TOE LT 3RD MIN 2V $ 399.00 TOE LT 4TH MIN 2V $ 399.00 TOE LT 5TH MIN 2V $ 399.00 TOE LT GREAT MIN 2V $ 399.00 TOE RT 2ND MIN 2V $ 399.00 TOE RT 3RD MIN 2V $ 399.00 TOE RT 4TH MIN 2V $ 399.00 TOE RT 5TH MIN 2V $ 399.00 TOE RT GREAT MIN 2V $ 399.00 *RHINOCORT(BUDESON)INH:8.6GM(DO NOT USE) $ 400.00 CHEST 2V $ 400.00 COCCYX 2V $ 400.00 SACRUM 2V $ 400.00 FOOT LT 3V $ 401.00 FOOT RT 3V $ 401.00 MULTIFIRE TA 30 3.5 $ 402.00 HAND LT 3V $ 403.00 HAND RT 3V $ 403.00 INPATIENT LIMITED VISIT $ 403.00 PNEUMOVAX(PNEUMOCOCCAL) 25CG/0.5ML VIAL $ 403.03 HYPERHEP (HEPATITIS B) 0.5ML SYRINGE $ 403.33 ANKLE LT 3V $ 404.00 ANKLE RT 3V $ 404.00 DANTRIUM (DANTROLENE) 20MG VIAL $ 404.00 ELBOW LT 3V $ 404.00 ELBOW RT 3V $ 404.00 FINGER LT INDEX MIN 2V $ 404.00 FINGER LT LITTLE MIN 2V $ 404.00 FINGER LT MIDDLE MIN 2V $ 404.00 FINGER LT RING MIN 2V $ 404.00 FINGER LT THUMB MIN 2V $ 404.00 FINGER RT INDEX MIN 2V $ 404.00 FINGER RT LITTLE MIN 2V $ 404.00 FINGER RT MIDDLE MIN 2V $ 404.00 FINGER RT RING MIN 2V $ 404.00 FINGER RT THUMB MIN 2V $ 404.00 Helicobacter pylori Urea Breath Test $ 405.00 REPAIR ITM 12.6-20CM FACE EARS $ 405.00 CPT 81261-TC $ 406.00 BB AB ID Std Com Panel LBC $ 407.00 BB SELECT CELL PANEL LBC $ 407.00 CPT 88368-TC $ 407.00 RIBS LT 2V $ 407.00 RIBS RT 2V $ 407.00 SPUTUM COLLECTION $ 407.00 HIP LT (AP PELVIS AND LT LAT HIP) $ 408.00 HIP RT (AP PELVIS AND RT LAT HIP) $ 408.00 ZYGOMATIC ARCH LT $ 408.00 ZYGOMATIC ARCH RT $ 408.00 INTUBATION $ 409.00 WRIST LT MIN 3V $ 410.00 WRIST RT MIN 3V $ 410.00 KCP MICROSCOPE RENT $ 412.00 Factor V Leiden Mutation Analysis $ 412.50 MAMMO LT CONE/MAG-W/CAD $ 413.00 MAMMO LT UNILAT DIAG W/CAD $ 413.00 MAMMO LT UNILAT SCREEN W/CAD $ 413.00 MAMMO RT CONE/MAG-W/CAD $ 413.00 MAMMO RT UNILAT DIAG W/CAD $ 413.00 MAMMO RT UNILAT SCREEN W/CAD $ 413.00 CPT 88307-TC $ 413.85 CPT 88342 $ 413.85 CPT 88360 $ 413.85 CPT 88361-TC $ 413.85 CPT 88377-TC $ 413.85 IHC,PER SPECIMEN, MULTIPLEX CPT 88344-T $ 413.85 Blood Drugs of Abuse 8+Alc, WB $ 414.00 STAT BIOPSY 10-20 $ 414.03 PACEMAKER $ 417.00 FACTOR XII 086322 $ 418.00 COOK HELICAL STONE EXTRACT $ 420.00 TIBIA/FIBULA LT 2V $ 420.00 TIBIA/FIBULA RT 2V $ 420.00 HUMERUS LT 2V $ 421.00 HUMERUS RT 2V $ 421.00 SHADOW SPINAL SYSTEM 3X $ 422.00 TUMOR NECROSIS FACTOR-ALPHA LCM 140673 $ 424.00 MYCOLOG (NYSTATIN/TRIAMCINOLNE) 15GM OIN $ 425.37 MYCOLOG(NYSTATIN/TRIAMCINOLONE) 15GM CRM $ 425.37 FEMUR LT 2V $ 426.00 FEMUR RT 2V $ 426.00 GATOR GRASPER $ 426.00 PAMIDRONATE 90MG/10ML 10ML VIAL $ 426.62 MAMMO BILAT-SCREEN W/CAD $ 427.00 MULTIFIRE ENDO GIA 30 $ 427.00 *COMBIGAN(BRIM/TIM)0.2%/0.5%(DO NOT USE) $ 427.54 INFLUENZA A, H1N1 LCM 186205 $ 427.75 Acetylcholine Receptor-binding Ab $ 429.00 Acetylcholine Receptor-blocking Ab $ 429.00 TETANUS/DIPHTHERIA (PEDIACTRIC) 0.5ML VL $ 429.68 CL TX ANKLE DISLOCATION WO ANESTH $ 431.00 *BETOPTICS(BETAXOLOL)0.25%(DO NOT USE) $ 433.00 BRIDION (SUGAMMADEX) 200MG/2ML 2ML VIAL $ 433.20 ALPHAGAN-P (BRIMONIDINE) 0.15% 5ML OPHTH $ 434.64 *FLOVENT(FLUTICASONE)44MCG (DO NOT USE) $ 435.00 *TYGACIL(TIGECYCLINE)50MGVL (DO NOT USE) $ 435.92 REPAIR CX 2.6-7.5CM EYELID NOSE EAR LIP $ 436.00 PROINSULIN 140533 $ 437.00 *ASTELIN(AZELASTIN)137MCG(DO NOT USE) $ 441.00 CPT UNKNOWN ITEM 86255 CHARGE $ 441.00 *NASACORTAQ(TRIAMCINOLONE (DO NOT USE) $ 443.00 BIPAP FIRST DAY $ 443.00 DIALATOR ESOPAGEAL BALLOON $ 443.00 DIALATOR BALLOON ESOPAGEAL $ 443.00 INHIBIN B LCM 146795 $ 443.00 RECOVERY ROOM $ 443.00 ROOM ENDOSCOPY $ 443.00 YAG LASER RENTAL $ 443.00 REPAIR SIMPLE 20.1-30CM FACE EARS $ 444.00 Calcitriol (1,25 di-OH Vit.D) 081091 $ 445.00 IMMULITE 2000 immunoassay (IA) TSI $ 446.00 SACROILIAC 3V $ 446.00 KNEE LT 3V $ 449.00 REPAIR ITM >30 CM SCALP TRUNK EXTREM $ 449.00 CONTOUR STAPLER $ 450.00 ESTABLISHED PATIENT VISIT LEVEL 1 $ 450.00 ESTABLISHED PATIENT VISIT LEVEL 2 $ 450.00 KNEE RT 3V $ 450.00 NEW PATIENT VISIT LEVEL 1 $ 450.00 NEW PATIENT VISIT LEVEL 2 $ 450.00 PATELLA LT 3V $ 450.00 PATELLA RT 3V $ 450.00 SC JOINT LT 3V $ 450.00 SC JOINT RT 3V $ 450.00 US TRANSRECTAL $ 450.00 US TRANSVAGINAL - OB $ 450.00 US TRANSVAGINAL-NON OB $ 450.00 MIACALCIN NASAL SPRAY 3.7ML $ 450.45 PERMETHRIN (ACTICIN) 5% 60GM CREAM $ 451.11 ABDOMEN 2V $ 453.00 MANDIBLE BILAT 5V $ 453.00 OCCULT BLOODC THREE SAMPLES $ 453.00 MRA BRAIN $ 455.00 FACIAL BONES LT 4V $ 458.00 FACIAL BONES RT 4V $ 458.00 MULTIFIRE ENDO GIA 30 2.5 $ 459.00 ORBITS LT 4V $ 459.00 ORBITS RT 4V $ 459.00 Drugs of Abuse 10 (Whole Blood $ 465.00 LIGASURE DOLPHIN TIP 20CM $ 465.00 SKULL 4V $ 465.00 Vitamin B3 (Niacin+Metabolite)PL RED $ 465.00 TIMOLOL 0.5% / DORZOLAMIDE 2% 10ML OPHTH $ 465.88 HCV RNA (Abbott) Quantitative 551300 $ 475.00 HCV RNA NAA Qualitative 550713 $ 475.00 Hla ii type 1 ag equiv 1r $ 475.00 Hla ii typing allele hr $ 475.00 INTUBATION ENDOTRACHEAL $ 479.00 SYNTHROID (LEVOTHYROXINE) 100MCG VIAL $ 481.46 GROSHONG CV CATH KT. $ 485.00 CORTROSYN (COSYNTROPIN) 0.25MG VIAL $ 486.00 REPAIR CX 2.6-7.5 FACE HAND FEET GEN $ 486.00 vWF MULTIMERS 500148 $ 486.00 C SPINE 3V $ 487.00 MTHFR $ 487.00 US GUIDED NEEDLE PLACEMENT $ 487.00 BB PHENOTYPE LBC $ 488.00 INPATIENT EXTENDED ADMIT $ 488.00 T-SPINE 2V $ 488.00 *ARIXTRA(FONDAP)5MG/0.4MLSYR(DO NOT USE) $ 489.00 Apo E Genotyping: Cardio Risk 503935 $ 489.00 L-SPINE 3V $ 489.00 A/D OB/IP SAME DAY MODERATE $ 493.00 Heparin Anti-Xa $ 494.00 SCOLIOSIS STDY(STAND AP/LAT/T/LSPINE) $ 494.00 BB FFP EACH UNIT $ 495.00 DRUG DEF 3 CLASSES ACTM,SAL,ETOH $ 496.00 US GUIDED AMNIOCENTESIS $ 498.00 *PONTOCAINE(TETRACAINE)1%(DO NOT USE) $ 500.00 ER LEVEL 3 $ 500.00 GALLBLADDER DOUBLE DOSE OR REPEAT $ 500.00 CPT 88184-TC FLOWCYTOMETRY/MARKER 1 $ 502.00 US ABI (ANKLE/BRACHIAL INDICES) $ 503.00 COLONSCOPE W/POLYPEC $ 506.00 COLONSCOPE W/POLYPEC $ 506.00 EXAM COLONOSCOPE $ 506.00 HEMORRHOIDAL BANDING $ 506.00 MAMMO BILAT-CONE/MAG W/CAD $ 508.00 MAMMO BILAT-DIAG W/CAD $ 508.00 *PREMARIN(ESTRO)0.625MGVAGCR(DO NOT USE) $ 510.00 *DEPOPROVERA(MEDR)150MG/ML(DO NOT USE) $ 510.03 JC Virus DNA, PCR (Whole Blood) $ 515.00 ESTABLISHED PATIENT VISIT LEVEL 3 $ 517.00 NEW PATIENT VISIT LEVEL 3 $ 517.00 ROTICULATOR ENDO GIA 60-3.5 $ 517.00 Thiopurine Methyltransferase(TPMT),Enzym $ 518.75 HIP BILAT MIN (2V EACH HIP) $ 519.00 *TIMOPTICXE(TIMOGFS)0.5%5ML(DO NOT USE) $ 519.80 BB RARE UNIT FEE LBC $ 523.00 CLOSED TX OF CARPAL FRACT WITH MANIPULAT $ 525.00 JAK2 V617F MUTATION ANALYSIS,QUAL 489200 $ 525.00 LIFEPORT VASCULAR ACCESS PORT $ 525.00 MRI PORT 8 FRENCH $ 525.00 OMNIPAQUE (IOHEXAL) 350MG/ML 125ML VIAL $ 526.67 VASOPRESSIN 20UN/ML 1ML VL $ 526.68 HERNIA PLUG LARGE $ 529.00 HERNIA PLUG MEDIUM $ 529.00 HERNIA PLUG SMALL $ 529.00 DIALYSIS CATHETER 28CM $ 530.00 BRONCHOSPASM EVALUATION $ 532.00 MULTI FIRE GIA 30 STAPLER $ 532.00 MULTIFIRE ENDO TA 30 2.5 $ 532.00 *CORT(NEO/POLYB/HC)7.5MLOPSUS(DONOTUSE) $ 535.49 CLOSED TX OF DISTAL RADIAL FRACTURE W MA $ 537.00 DISCHARGE GREATER 30 MIN $ 541.00 OBSERVATION VISIT HIGH $ 541.00 Metanephrines, Fractionated, Plasma Free $ 542.00 *DDAVP(DESMOPRES).01%5MLNS(DO NOT USE) $ 544.00 ECHOENCEPHALOGRAN EE $ 545.00 ELECTROENCEPHALOGRAM $ 545.00 EPINEPHRINE 1MG/ML 30ML MDV $ 545.83 *TAMIFLU (OSELTAMIVIR) 6MG/ML 60ML SUSP $ 549.93 CHEST 4V $ 550.00 CMV, Quant DNA PCR (Plasma) 139149 $ 551.00 CRE BALLOON DILATOR 15-18 MM $ 551.00 Hepatitis Panel, Acute $ 551.00 PICC LINE KIT 5FR. $ 551.00 US LT BREAST $ 551.00 US RT BREAST $ 551.00 RIBS LT 3V $ 552.00 RIBS RT 3V $ 552.00 BB NONROUTINE LAB FEE $ 555.00 Drug Screen and Confirm.(13 Drugs)Blood $ 555.00 POWERED LDS 15W $ 556.00 PROF CT ABD/PELV WO IV WITH ORAL CONTRAS $ 558.00 *TALWIN(PENTAZ)30MG/ML1ML(DO NOT USE) $ 563.75 HERNIA PLUG/PATCH KIT LG $ 565.00 HERNIA PLUG/PATCH KIT SM $ 565.00 US CHEST INCLUDES MEDIASTINUM $ 565.00 US LT NON VAS LE LIMITED $ 565.00 US LT NON VASC UE LIMITED $ 565.00 US RT NON VAS LE LIMITED $ 565.00 US RT NON VAS UE LIMITED $ 565.00 CHEST FLUORO $ 566.00 FLUORO GENERAL $ 566.00 EPOGEN (EPOETIN) 10,000UN/1ML VIAL $ 570.00 WHEELCHAIR $ 570.00 HIP LT OPERATIVE $ 572.00 HIP RT OPERATIVE $ 572.00 BICILLIN CR (BENZA/PROCAINE) 1.2MU 2ML $ 572.01 ROTICULATOR 55 POLY $ 576.00 TEFLARO(CEFTAROLINE)600MGVL(DO NOT USE) $ 576.13 TUBE JEJUNOSTOMY 22F KIT $ 585.00 ADVAIR DISKUS (FLUTICASONE) 100/50MCG IN $ 587.74 RIBA (HCV Confirmation) $ 588.00 INVANZ (ERTAPENEM) 1GM VIAL $ 590.00 INPATIENT EXTENDED VISIT $ 593.00 GALLBLADDER ORAL CONTRAST $ 598.00 US SCROTUM AND CONTENTS $ 598.00 UROMAX ULTRA BALLOON DILATOR $ 600.00 US BILAT BREAST $ 601.00 Cytomegalovirus (CMV), Qualitative, PCR $ 606.00 KNEE RT MIN 4V $ 606.00 PICC LINE KIT 6FR $ 610.00 *AZMACORT(TRIAMCINOLONE)INH (DO NOT USE) $ 612.00 COAPTITE INJECTABLE IMPLANT $ 612.00 KNEE LT MIN 4V $ 612.00 US LT ARM UNILAT ARTERIAL $ 614.00 US RT ARM UNILAT ARTERIAL $ 614.00 PROF CT ABD/PELV WITH IV WITH ORAL CONT $ 619.00 US PELVIC COMPLETE $ 620.00 *LUMIGAN(BIMATO)0.01%OPSOLN(DO NOT USE) $ 622.47 METHYLENE BLUE 1% 100MG/10ML 10ML VIAL $ 622.88 US LT LEG UNILAT ARTERIAL $ 624.00 US RT LEG UNILAT ARTERIAL $ 624.00 JAGWIRE GUIDEWIRE $ 625.00 BK Quant PCR (Plasma/Serum) LCM 138962 $ 627.00 US OB $ 627.00 TRAVOPROST 0.004% 2.5ML OPHTH DROP $ 627.22 MINOR 1/2 HOUR $ 633.00 RECOVERY RM OVERNIGH $ 633.00 Adalimumab + Ab (Serial Monitor) 503890 $ 634.00 TUBE BLAKEMORE 20FR. $ 634.00 ADVAIR DISKUS (FLUTICASONE) 250/50MCG IN $ 634.75 MOXIFLOXACIN (VIGAMOX) 0.5% 3ML OPHTH $ 635.93 LOTRISONE(CLOTRIMA/BETAMET) 30ML LOTION $ 636.72 A/D OB/IP SAME DAY HIGH $ 637.00 INFANT SPINE ENTIRE AP AND LAT $ 637.00 US SPINAL CANAL AND CONTENTS $ 642.00 HF LOOP LARGE 30 DEGREE $ 643.00 Alpha-Thalassemia LCM 511172 $ 644.00 *AVITENE(MICROCOLLAGE)1GMJAR(DO NOT USE) $ 646.00 PROF CT ABD/PELV W/WO IV WITH ORAL CONT $ 649.00 CPT 88309-TC $ 652.00 CRITICAL CARE (30-74) MINUTES $ 655.00 BICILLIN LA (PENICILLIN G) 1.2MU 2ML SYR $ 655.69 DRUG DEF 4 CLASSES ACTM,SAL,ETOH $ 660.00 US THYROID/HEAD/NECK NON VASCULAR $ 663.00 ELECTRODE HF RESECTION PLASMA BUTTON $ 665.00 MOSS PEG TRAY $ 665.00 US HEAD/CRANIAL INFANTS $ 666.00 ABDOMEN SERIES $ 668.00 RUSH NAIL 3/16 $ 670.00 CARDIO-PUL.RESUSCITA $ 676.00 PREMIUM PLUS CEEA 25mm $ 676.00 PREMIUM PLUS CEEA 28mm $ 676.00 PREMIUM PLUS CEEA 31mm $ 676.00 US BIOPHYSICAL PROFILE NON STRESS $ 677.00 *FAMVIR(FAMCICLOVIR)500MGTAB(DO NOT USE) $ 680.00 PATADAY (OLOPATADINE) 0.2% 2.5ML OPHTH $ 680.58 C SPINE 5V $ 684.00 REGITINE (PHENTOLAMINE) 5MG VIAL $ 684.00 BB PRBC LEUKO REDUCED EACH UNIT $ 688.00 L-SPINE 5V $ 689.00 LINEZOLID 600MG TAB $ 697.91 ALOMIDE (IODOXAMIDE) 0.1% 10ML OP SOLN $ 700.87 *FLOVENT(FLUTICA)110MCGINH(DO NOT USE) $ 703.00 ESOPHOGRAM $ 703.00 VENTRALEX HERNIA PATCH SMALL $ 715.00 RIBS BILAT 4V W/PA CHEST $ 718.00 LAG SCREW STANDARD 100MM $ 722.00 LAG SCREW STANDARD 105MM $ 722.00 LAG SCREW STANDARD 110MM $ 722.00 LAG SCREW STANDARD 115MM $ 722.00 LAG SCREW STANDARD 120MM $ 722.00 LAG SCREW STANDARD 130MM $ 722.00 LAG SCREW STANDARD 60MM $ 722.00 LAG SCREW STANDARD 70MM $ 722.00 LAG SCREW STANDARD 80MM $ 722.00 LAG SCREW STANDARD 85MM $ 722.00 LAG SCREW STANDARD 90MM $ 722.00 LAG SCREW STANDARD 95MM $ 722.00 AVITENE (MICROFIB COLLAGEN) SHEET $ 724.77 CO2 ANALYZER WITH VENT $ 732.00 LUNG VOLUMES (PFT) $ 732.00 CARDIAC MONITOR $ 733.00 EVALUATION STRESS $ 733.00 TREADMILL W/S ECHO $ 733.00 HCV, Quantitative, Real-Time PCR(w/refle $ 734.00 LAG SCREW STANDARD 55MM $ 734.00 LAG SCREW STANDARD 75MM $ 734.00 SMALL BOWEL FOLLOW THROUGH $ 734.00 SORBAFIX FIXATION SYSTEM $ 735.00 EXCISION OF TOENAIL $ 738.00 INCISION-DRAINAGE ABSCESS (SIMPLE) $ 738.00 PUNCH BIOPSY (SKINSUBCUTANEOUS)SINGLE $ 738.00 *TOBRADEX 0.3%(TOBRA/DEXAM) 3.5MLOPOINT $ 748.75 CHOLANGIOGRAM INTRA OP $ 749.00 ESTABLISHED PATIENT VISIT LEVEL 4 $ 751.00 ESTABLISHED PATIENT VISIT LEVEL5 $ 751.00 NEW PATIENT VISIT LEVEL 4 $ 751.00 NEW PATIENT VISIT LEVEL 5 $ 751.00 SET UP LAPROSCOPE $ 759.00 VALLEYLAB GENERATOR $ 759.00 Human Immunodeficiency Virus 1,Qualitati $ 766.00 MAMMO LT NEEDLE LOC (PER LESION) $ 766.00 MAMMO RT NEEDLE LOC (PER LESION) $ 766.00 RNA, Real Time PCR (Graph) HIV-1 RNA $ 766.00 *PRANDIN(REPAGLINIDE)1MGTAB(DO NOT USE) $ 768.00 PREVNAR 13 INTRAMUSCULAR SUSPENSION $ 770.52 HCV RNA PCR QUANT 550100 (>600IU/mL) $ 777.00 US ABDOMEN LIMITED-ANY SINGLE ORGAN/QUAD $ 779.00 US GALLBLADDER $ 779.00 US GALLBLADDER WITH EF $ 779.00 US LIVER $ 779.00 TESTOSTERONE 12.5MG GEL 88G BOTTLE $ 784.60 EXAM EGD W/ PEG TUBE PLACEMEMT $ 787.00 EPSTEIN-BARR DNA, QUANT,PCR LCM 138230 $ 792.00 NASONEX (MOMETASONE) 50MCG 17GM NS $ 793.44 *ADVAIR(FLUTICA)500/50MCG (DO NOT USE) $ 812.21 SET UP -DIALYSIS $ 823.00 DRUG DEF 5 CLASSES ACTM,SAL,ETOH $ 825.00 CYSTOGRAM $ 827.00 STAPLER ENDO HERNIA 4.8 $ 832.00 CHEMICAL CAUTERIZATION OF GRANULATION TI $ 834.00 DEBRIDE SKIN FULL $ 834.00 DEBRIDE SKIN, PARTIAL $ 834.00 Amino Acid Profile, Quantitative, Plasma $ 842.00 EPSTEIN-BARR VIRUS, QUAL PCR 138289 $ 849.00 PROVAYBLUE (METHYLENE BLUE) 50MG/10ML $ 850.15 MYCAMINE (MICAFUNGIN) 100MG VIAL $ 852.72 BARD DULEX MESH $ 854.00 INTEGRILIN (EPTIFIBATIDE) 2MG/ML 10ML VL $ 855.00 VENTRALEX HERNIA PATCH MED. $ 855.00 BB BLOOD COMP ADMIN FEE $ 856.00 BLOOD PK. RED BLOOD CELL #2 $ 856.00 AMP_B ABELCET IV SUSP 5MG/1ML $ 857.28 US AORTA $ 860.00 US RENAL $ 860.00 MYCOLOG (NYSTATIN/TRIAMCINO) 60GM CREAM $ 863.74 *WELCHOL(COLESEVELAM)625MG(DO NOT USE) $ 880.00 *DDAVP(DESMO)40MCG/10ML (DO NOT USE) $ 880.08 ER LEVEL 4 $ 882.00 UPPER GI $ 882.00 MRI CHOLANGIOPANCREYOGRAPHY $ 885.00 CYSTOGRAM VOIDING $ 886.00 MAJOR 1/2 HOUR $ 886.00 MINOR 1 1/2 HOURS $ 886.00 MINOR 1 HOUR $ 886.00 LIGASURE ATLAS 20CM $ 890.00 LIGASURE V-SEALER $ 890.00 VACORA BIOPSY PROBE $ 911.00 VACORA BIOPSY PROBE 14G $ 911.00 LIGASURE ATLAS 37CM $ 921.00 BARD KUGEL PATCH (OVAL) $ 926.00 IVP $ 926.00 Hepatitis C Virus Genotyping 550475 $ 942.00 PYELOGRAM RETROGRADE $ 943.00 UROGRAPHY RETROGRADE $ 943.00 *CARDENE(NICARDIPINE)25MG(DO NOT USE) $ 950.00 BARIUM ENEMA $ 953.00 ADVAIR DISKUS (FLUTICASONE/SALM) 500/50 $ 957.90 US LT ARM UNILAT VENOUS $ 966.00 US LT LEG UNILAT VENOUS $ 966.00 US RT ARM UNILAT VENOUS $ 966.00 US RT LEG UNILAT VENOUS $ 966.00 NATROBA (SPINOSAD) 0.9% TOPICAL SUSP $ 970.40 Hepatitis C Virus(HCV), QuantaSURE $ 972.50 PATANOL (OLOPATADINE) 0.1% 5ML OPHTH $ 974.70 M R I $ 975.00 MRI HEAD $ 975.00 MRI LOWER EXTREMITY $ 975.00 MRI T-SPINE $ 975.00 MRI UPPER EXT JOINT $ 975.00 MRI UPPER EXTREMITY $ 975.00 MAMMO LT SPECIMEN $ 978.00 MAMMO RT SPECIMEN $ 978.00 F. B RETRIEVAL BASKET (LARGE) $ 983.00 US VASCULAR ABDOMEN/PELVIC/SCROTUM $ 989.00 DRUG DEF 6 CLASSES ACTM,SAL,ETOH $ 990.00 *ISUPREL(ISOPROT)0.2MG/ML5ML(DO NOT USE) $ 995.42 US DOPPLER $ 997.00 BARD KUGEL PATCH (CIRCLE) $ 1,006.00 BARIUM ENEMA W/AIR $ 1,025.00 PROF BARIUM ENEMA W/AIR $ 1,025.00 SANTYL(CLOSTRIDIUM) 250UN/G 30GM OINT $ 1,029.42 FISTULOGRAM $ 1,033.00 HBV RT PCR QUANT 551620 $ 1,033.00 VENTRALEX HERNIA PATCH LARGE $ 1,040.00 BARIUM ENEMA THERAPEUTIC $ 1,047.00 VENTILATOR SUB DAYS $ 1,048.00 HYSTEROSALPINGOGRAPHY $ 1,058.00 VOLUME VENT FIRST DAY $ 1,058.00 NITROLINGUAL (NITROGLYCERIN) SPRAY 4.9G $ 1,090.82 Beta Thalassemia: HBB Full Gene Sequence $ 1,102.00 LIGASURE 5MM SEALER $ 1,117.00 RUSH NAIL $ 1,117.00 RUSH NAIL 1/8 X 10 $ 1,117.00 RUSH NAIL 1/8 X 4'' $ 1,117.00 RUSH NAIL 1/8 X 4.5 $ 1,117.00 RUSH NAIL 1/8 X 5 $ 1,117.00 RUSH NAIL 1/8 X 5.5 $ 1,117.00 RUSH NAIL 1/8 X 6' $ 1,117.00 RUSH NAIL 1/8 X 6.5 $ 1,117.00 RUSH NAIL 1/8 X 7 $ 1,117.00 RUSH NAIL 1/8 X 7.5 $ 1,117.00 RUSH NAIL 1/8 X 8 $ 1,117.00 RUSH NAIL 1/8 X 8.5 $ 1,117.00 RUSH NAIL 1/8 X 9 $ 1,117.00 RUSH NAIL 1/8 X 9.5 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 RUSH NAIL 3/16 $ 1,117.00 PROCRIT (EPOETIN) 10,000UN/ML 1ML VIAL $ 1,118.11 APPLICATION OF UNNABOOT $ 1,133.00 DREBRIDE DEVITALIZED TISSUE 1ST 20CM $ 1,133.00 DREBRIDE DEVITALIZED TISSUE EACN 20CM $ 1,133.00 PROSTHESIS BREAST $ 1,139.00 GRANIX SUBCUTANEOUS SOLUTION 300MCG/.5ML $ 1,139.35 AZOPT(BRINZOLAMIDE) 1% 10ML OPHTH DROP $ 1,140.00 DAPTOMYCIN 500MG VIAL $ 1,157.00 US ABDOMEN COMPLETE $ 1,159.00 US ARM BILAT ARTERIAL $ 1,168.00 PARACENTESIS W IMAGING $ 1,173.00 PARACENTESIS W/O IMAGING $ 1,173.00 THORACENTESIS W IMAGING $ 1,173.00 THORACENTESIS W/O IMAGING $ 1,173.00 SIDE PLATE OMEGA 135 X 4 $ 1,186.00 GLUCOGEN (GLUGACON) 1MG KIT $ 1,190.23 US TREADMILL STRESS ECHO $ 1,200.00 HLA TYPING AB&C $ 1,228.00 HCV QUANTASURE 140639 $ 1,231.00 US LEG BILAT ARTERIAL $ 1,237.00 GI AND SBFT $ 1,238.00 NITHIODOTE ANTIDOTE KIT $ 1,253.00 MRI C-S W $ 1,260.00 MRI HEAD W $ 1,260.00 MRI L-S W $ 1,260.00 MRI T-S W $ 1,260.00 MINOR 2 HOURS $ 1,265.00 SURGIMESH SILICONE BARRIER $ 1,275.00 ACTIVE WOUND MGNT (NON-SEL DEBRIDEMENT) $ 1,279.00 DEBRIDE MUSCLE/FASCIA 1ST 20CM $ 1,279.00 DEBRIDE MUSCLE/FASCIA EACH 20CM $ 1,279.00 DEBRIDE, PARTIAL BURN<5% $ 1,279.00 DEBRIDE, SUBQ TISSUE 1ST 20CM $ 1,279.00 DEBRIDE, SUBQ TISSUE EACH 20CM $ 1,279.00 US CAROTID ARTERY $ 1,281.00 FLOVENT (FLUTICASONE) 220MCG INH 120GM $ 1,288.12 US ARM BILAT VENOUS $ 1,301.00 US LEG BILAT VENOUS $ 1,301.00 SIDEPLATE 130 DEGREE 5 HOLE $ 1,306.00 PREMARIN (ESTROGENS) 25MG 5ML VIAL $ 1,314.00 *ETHAMOLIN(ETHANOL)5%2ML AMP(DO NOT USE) $ 1,315.00 SIDEPLATE 135 3 HOLE $ 1,317.00 SIDEPLATE 135 4 HOLE $ 1,317.00 SIDEPLATE 135 5 HOLE $ 1,317.00 SIDEPLATE 135 6 HOLE $ 1,317.00 SIDEPLATE 135 8 HOLE $ 1,317.00 SIDEPLATE 140 4 HOLE $ 1,317.00 SIDEPLATE 140 5 HOLE $ 1,317.00 SIDEPLATE 140 6 HOLE $ 1,317.00 SIDEPLATE 145 4 HOLE $ 1,317.00 SIDEPLATE 145 5 HOLE $ 1,317.00 SIDEPLATE 150 4 HOLE $ 1,317.00 SIDEPLATE 150 5 HOLE $ 1,317.00 MP3 LASER RENTAL $ 1,350.00 MuSK Antibodies, Serum $ 1,350.00 ER LEVEL 5 $ 1,368.00 NITROPRESS (NITROPRUSSIDE) 50MG/2ML VL $ 1,368.00 MRI C-S WWO $ 1,370.00 MRI T-S W/WO $ 1,370.00 CHOLANGIOGRAM T TUBE $ 1,388.00 MRA HEAD W $ 1,390.00 MINOR 2 1/2 HOURS $ 1,392.00 NEUPOGEN (FILGRASTIM) 300MCG/0.5ML SYRIN $ 1,478.80 CHEMOSITE $ 1,493.00 BB PLATELETS, PHERESIS $ 1,501.00 ACYCLOVIR (ZOVIRAX) 5% 15GM OINT $ 1,515.44 MAJOR 1 HOUR $ 1,518.00 MINOR 3 HOURS $ 1,518.00 CANCIDAS (CASPOFUNGIN ACE) 50MG 10ML VL $ 1,539.95 IMOVAX RABIES (RABIES VACCINE) 1ML VIAL $ 1,547.58 COMBIVENT INHALER 14.7GM $ 1,565.50 GAMUNEX(IMMUNE GLOBULIN) 10% 5GM 50ML $ 1,590.30 PRIVIGEN INTRAVENOUS SOLUTION 10% 5GM $ 1,590.30 BARD DULEX MESH 15X19 $ 1,635.00 MRI L-SPINE $ 1,641.00 GORE FISTULA PLUG $ 1,645.00 MRI C-SPINE $ 1,674.00 MRI LOWER EXT JOINT $ 1,674.00 MOOR HIP PROSTHESIS 43MM $ 1,708.00 MINOR 4 1/2 HOURS $ 1,771.00 GRANIX(TBO-FILGRASTIM) 480MCG/0.8ML INJ $ 1,823.51 SUNT EXPRESS $ 1,889.00 SLEEP STUDY SCREEN $ 1,893.00 MAJOR 1 1/2 HOUR $ 1,898.00 MOOR HIP PROSTHESIS 38MM $ 1,898.00 MOOR HIP PROSTHESIS 40MM $ 1,898.00 MOOR HIP PROSTHESIS 41MM $ 1,898.00 MOOR HIP PROSTHESIS 42MM $ 1,898.00 MOOR HIP PROSTHESIS 44MM $ 1,898.00 MOOR HIP PROSTHESIS 45MM $ 1,898.00 MOOR HIP PROSTHESIS 46MM $ 1,898.00 MOOR HIP PROSTHESIS 47MM $ 1,898.00 MOOR HIP PROSTHESIS 48MM $ 1,898.00 MOOR HIP PROSTHESIS 49MM $ 1,898.00 MOOR HIP PROSTHESIS 50MM $ 1,898.00 MOOR HIP PROSTHESIS 51MM $ 1,898.00 MOOR HIP PROSTHESIS 52MM $ 1,898.00 MOOR HIP PROSTHESIS 53MM $ 1,898.00 MOOR HIP PROSTHESIS 54MM $ 1,898.00 MOOR HIP PROSTHESIS 55MM $ 1,898.00 MOOR HIP PROSTHESIS 57MM $ 1,898.00 MOOR HIP PROSTHESIS 60MM $ 1,898.00 SLEEP STUDY CPAP $ 1,900.00 CRITICAL CARE $ 1,905.00 *ZOVIRAX(ACYCLOVIR)5%30GM(DO NOT USE) $ 1,911.00 US ECHO 2D COMPLETE $ 2,000.00 EXAM LAPROSCOPE $ 2,024.00 LAP CHOLESCYST INST $ 2,024.00 *ZYVOX(LINEZ)100MG/5ML150ML(DO NOT USE) $ 2,036.00 *CIMZIA(CERTOLIZUMA)200MG/ML(DO NOT USE) $ 2,038.00 CORVERT (IBUTILIDE) 1MG/10ML 10ML VIAL $ 2,062.33 DEVICE ENDOMETRIAL ABLATION $ 2,119.50 GYNECARE TVT KIT $ 2,132.10 MRI HEAD W/WO $ 2,197.00 Paraneoplastic Autoanti. Evaluation $ 2,239.00 CT HEAD WO IV CONTRAST $ 2,263.00 CT STROKE PROTOCOL WO IV CONTRAST $ 2,263.00 *FERAHEME(FERUMOX)510MG/17ML(DO NOT USE) $ 2,268.06 MAJOR 2 HOUR $ 2,277.00 CT FACIAL WO IV CONTRAST $ 2,294.00 CT SINUS WO IV CONTRAST $ 2,294.00 CT PELVIC WO IV WITH ORAL CONTRAST $ 2,306.00 CT PELVIC WO IV WO ORAL CONTRAST $ 2,306.00 CATARACT SETUP W/O IMPLANT $ 2,309.00 CT ABDOMEN WO IV WITH ORAL CONTRAST $ 2,311.00 CT ABDOMEN WO IV WO ORAL CONTRAST $ 2,311.00 CT RENAL WO IV WITH ORAL CONTRAST $ 2,311.00 CT RENAL WO IV WO ORAL CONTRAST $ 2,311.00 CT L-SPINE WO IV CONTRAST $ 2,326.00 CT T-SPINE WO IV CONTRAST $ 2,326.00 CT CHEST WO IV CONTRAST $ 2,331.00 CT C-SPINE WO IV CONTRAST $ 2,331.00 CT ORB/SELLA/IAC WO IV CONTRAST $ 2,347.00 CT SOFT TISSUE NECK WO IV CONTRAST $ 2,347.00 I STENT RIGHT EYE $ 2,363.00 NEUPOGEN(FILGR)480MCG/0.8ML $ 2,423.33 BARD DULEX MESH LG. $ 2,443.00 MRI L-S W/WO $ 2,485.00 VENTRALIGHT ECHO MESH 6X8 $ 2,500.00 CT PELVIS BONY WO IV WO ORAL CONTRAST $ 2,586.00 CATARACT SETUP $ 2,594.00 CT LT LOWER EXTREMITY WO IV CONTRAST $ 2,606.00 CT LT UPPER EXTREMITY WO IV CONTRAST $ 2,606.00 CT RT LOWER EXTREMITY WO IV CONTRAST $ 2,606.00 CT RT UPPER EXTREMITY WO IV CONTRAST $ 2,606.00 BOTOX THERAPEUTIC (ONABOTUL) 100 UNITS $ 2,640.24 VENOGRAM LT LOWER EXT $ 2,643.00 VENOGRAM LT UPPER EXT $ 2,643.00 VENOGRAM RT LOWER EXT $ 2,643.00 VENOGRAM RT UPPER EXT $ 2,643.00 MAJOR 2 1/2 HOURS $ 2,657.00 INTEGRILIN (EPTIFIBATIDE) 75MG/100ML VL $ 2,679.00 LYMPHAZURIN 1% (ISOSULFAN BLUE)50MG/5ML $ 2,710.00 *ORENCIA(ABATACEPT)250MGVIAL(DO NOT USE) $ 2,714.00 NUCLEAR MED HIDA $ 2,766.00 APLY SKIN SUBST FT EA ADD 100 SQ CM $ 2,772.00 APPLI OASIS WOUND MATRIX 1ST 100CM2 $ 2,772.00 APPLI OASIS WOUND MATRIX ADD1 100CM2 $ 2,772.00 MAJOR 3 HOURS $ 2,783.00 CT FACIAL WITH IV CONTRAST $ 2,834.00 CT SINUS WITH IV CONTRAST $ 2,834.00 CT HEAD WITH IV CONTRAST $ 2,867.00 *PROCRIT (EPOETI)40,000UN/ML(DO NOT USE) $ 2,875.00 MAJOR 3 1/2 HOURS $ 2,910.00 CT PELVIC WITH IV WITH ORAL CONTRAST $ 2,914.00 CT PELVIC WITH IV WO ORAL CONTRAST $ 2,914.00 CT CHEST WITH IV CONTRAST $ 2,917.00 CT C-SPINE WITH IV CONTRAST $ 2,917.00 CT L-SPINE WITH IV CONTRAST $ 2,917.00 CT T-SPINE WITH IV CONTRAST $ 2,919.00 CT ABDOMEN WITH IV WITH ORAL CONTRAST $ 2,921.00 CT ABDOMEN WITH IV WO ORAL CONTRAST $ 2,921.00 CT RENAL WITH IV WITH ORAL CONTRAST $ 2,921.00 CT RENAL WITH IV WO ORAL CONTRAST $ 2,921.00 CT SOFT TISSUE NECK WITH IV CONTRAST $ 2,928.00 CT ORB/SELLA/IAC WITH IV CONTRAST $ 2,982.00 VENOGRAM INJECTION $ 2,990.00 VENTRIO ST X-LARGE OVAL 8X10 MESH $ 3,000.00 HYPERRAB (RABIES IMMUNE) 150IU/ML 2ML VL $ 3,010.55 I&D OF HEMATOMA SEROMA OR FLUID COLLECT $ 3,040.00 CT ABD/PELV WO IV WITH ORAL CONTRAST $ 3,084.00 CT ABD/PELV WO IV WO ORAL CONTRAST $ 3,084.00 CT STONE WO IV WO ORAL CONTRAST $ 3,084.00 SNP Microarray Pediatric (Reveal) 510002 $ 3,150.00 PRIVIGEN INTRAVENOUS SOLUTION 10% 10GM $ 3,180.60 CT LT UPPER EXTREMITY WITH IV CONTRAST $ 3,189.00 CT RT UPPER EXTREMITY WITH IV CONTRAST $ 3,189.00 CT LT LOWER EXTREMITY WITH IV CONTRAST $ 3,194.00 CT RT LOWER EXTREMITY WITH IV CONTRAST $ 3,194.00 CTA NECK WITH IV WO ORAL CONTRAST $ 3,208.00 CTA HEAD WITH IV CONTRAST $ 3,209.00 CTA PE CHEST WITH IV WO ORAL $ 3,218.00 CTA THORACIC(AORTA) WITH IV WO ORAL $ 3,218.00 CTA ABDOMEN WITH IV CONTRAST WO ORAL $ 3,228.00 CT HEAD W/WO IV CONTRAST $ 3,268.00 CT FACIAL W/WO IV CONTRAST $ 3,285.00 CT SINUS W/WO IV CONTRAST $ 3,285.00 MAJOR 4 HOURS $ 3,289.00 CTA AORTA W/RUNOFFS WITH IV WO ORAL $ 3,333.00 CT PELVIC W/WO IV WITH ORAL CONTRAST $ 3,360.00 CT PELVIC W/WO IV WO ORAL CONTRAST $ 3,360.00 CT ABDOMEN W/WO IV WITH ORAL CONTRAST $ 3,364.00 CT ABDOMEN W/WO IV WO ORAL CONTRAST $ 3,364.00 CT RENAL W/WO IV WITH ORAL CONTRAST $ 3,364.00 CT RENAL W/WO IV WO ORAL CONTRAST $ 3,364.00 CT C-SPINE W/WO IV CONTRAST $ 3,373.00 CT L-SPINE W/WO IV CONTRAST $ 3,373.00 CT T-SPINE W/WO IV CONTRAST $ 3,375.00 CT CHEST W/WO IV CONTRAST $ 3,381.00 CT SOFT TISSUE NECK W/WO IV CONTRAST $ 3,385.00 CT ORB/SELLA/IAC W/WO IV CONTRAST $ 3,416.00 CT ABD/PELV WITH IV WITH ORAL CONTRAST $ 3,433.00 CT ABD/PELV WITH IV WO ORAL CONTRAST $ 3,433.00 DEBRIDE BONE 1ST 20CM $ 3,435.00 DEBRIDE BONE EACH 20CM $ 3,435.00 CT LT LOWER EXTREMITY W/WO IV CONTRAST $ 3,658.00 CT RT LOWER EXTREMITY W/WO IV CONTRAST $ 3,658.00 CT LT UPPER EXTREMITY W/WO IV CONTRAST $ 3,663.00 CT RT UPPER EXTREMITY W/WO IV CONTRAST $ 3,663.00 MAJOR 4 1/2 HOURS $ 3,669.00 CT ABD W/WO IV PELV W IV WO ORAL $ 3,691.00 CT ABD W/WO IV PELV WITH IV WITH ORAL $ 3,691.00 CT ABD/PELV W/WO IV WITH ORAL CONTRAST $ 3,691.00 CT ABD/PELV W/WO IV WO ORAL CONTRAST $ 3,691.00 CT RENAL W/WO IV PELV WITH IV WITH ORAL $ 3,691.00 CT RENAL W/WO IV PELV WITH IV WO ORAL $ 3,691.00 CT STONE WO IV/ORAL ABD/PEL W IV WO ORAL $ 3,691.00 CT STONE WO IV/ORAL ABD/PEL W IV/ORAL $ 3,691.00 VENTRIO ST X-LARGE OVAL 10X13 MESH $ 3,700.00 RECLAST (ZOLEDR/MANNIT/H20) 5MG/100ML VL $ 3,816.79 PICC INSERTION; 5 yrs and older $ 3,922.00 VENTRALIGHT ST MESH 8X10 $ 3,975.00 MAJOR 5 HOURS $ 4,048.00 APLY SKIN SUBS FT 1ST 100 SQ CM $ 4,114.57 MAJOR 5 1/2 HOURS $ 4,428.00 REMOVAL FB FOOT; DEEP $ 4,476.00 GAMUNEX (IMMUNE GLOBULIN) 10% 10GM 100ML $ 4,635.24 INJECTAFER 750MG/15ML VIAL $ 4,715.50 WALLFLEX ESOPHAGEAL STENT $ 5,081.00 *FLEBOGAMMA5%(IMMGLOB)20GM(DO NOT USE) $ 5,276.00 REMICADE (INFLIXIMAB) 100MG/20ML 20ML VL $ 5,325.24 PROLIA (DENOSUMAB) 60MG/ML 1ML SYRINGE $ 5,396.99 DECELLULARIZED DERMIS $ 5,547.36 RADIAL ARTERY CAT 22 $ 6,072.00 ALLOMAX SURGICAL GRAFT 3.9 X 5.9 $ 6,361.00 *HUMIRA(ADALIMUB)40MG/0.8ML(DO NOT USE) $ 6,892.00 LASER ENUCLEATION PROSTATE $ 8,000.00 LASER VAPORIZATION PROSTATE $ 8,000.00 LITHOTRIPSY $ 8,000.00 GAMUNEX (IMMUNE GLOBULIN) 10% 20GM 200ML $ 8,166.35 ELIGARD SUBQ PWDFORSUSP, 4 MONTH 30MG $ 8,238.81 LITHOTRIPSY/EXTRACORPORE $ 9,488.00 *HYPERRAB(RABI)150IU/ML10ML(DO NOT USE) $ 9,820.00 DIGIFAB (DIGOXIN IMMUNE FAB) 40MG VIAL $ 11,600.64 PRIVIGEN INTRAVENOUS SOLUTION 10% 40GM $ 12,541.82 CROFAB VACCINE (ANTIVENIN) 1GM VIAL $ 14,582.89 *NEULASTA(PEGFILG) 6MG/0.6ML(DO NOT USE) $ 14,872.00 *SANDOSTATIN LAR (OCTRE)30MG(DO NOT USE) $ 15,118.00 XENMATRIX SURGICAL GRAFT $ 15,500.00 *AVONEX(INTERFERON BETA-1A)(DO NOT USE) $ 16,122.00 GAMUNEX-C INJECTION SOLUTION 100MG/ML $ 17,176.00 TNKASE (TENECTEPLASE) 50MG/10ML VIAL $ 24,523.03 E R C P $ 25,738.00 ACTIVASE RECOMB (ALTEPLASE) 100MG VIAL $ 38,960.83