PRICE Description 1330.84 ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION [85656] 433.50 Abdominal ultrasound of pregnant uterus 183.00 Abdominal ultrasound of pregnant uterus 435.00 Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus 433.50 Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) 663.00 Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus 663.00 Abdominal ultrasound of pregnant uterus single or first fetus 1086.00 ACCESSORY KIT 504.00 ACCESSORY KIT 961.75 ACCESSORY KIT 1.18 ACEBUTOLOL 200 MG CAPSULE [6512] 1.57 ACEBUTOLOL 400 MG CAPSULE [6513] 41.25 ACETAMINOPHEN 1000MG INJ,VIAL 41.25 ACETAMINOPHEN 1000MG IV SOL 2599.00 2d tte w or w/o fol w/con,co 964.75 2d tte w or w/o fol w/con,fu 413.75 3D radiographic procedure with computerized image postprocessing 0.80 ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY [6427] 0.20 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION [114834] 0.36 ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET [39227] 0.14 ACETAMINOPHEN 300 MG-CODEINE 30 MG/12.5 ML (12.5 ML) ORAL SOLUTION [134214] 0.80 ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY [6725] 0.03 ACETAMINOPHEN 325 MG TABLET [2671] 0.01 ACETAMINOPHEN 500 MG TABLET [2672] 0.43 ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY [6312] 0.12 ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION [114839] 7.00 ACETAMINOPHEN,650 MG TAB 2.88 ACETAZOLAMIDE 250 MG TABLET [7412] 4.29 ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE [44772] 118.68 ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT [47973] 0.40 ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION [2549] 8.63 ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION [55511] 0.41 ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION [2550] 0.14 ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION [56187] 138.50 Activated protein resistance assay 2245.25 Acute digestive tract blood loss imaging 617.75 Acute hepatitis panel 0.97 ACYCLOVIR 200 MG CAPSULE [5086] 2.26 ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION [26614] 3.75 ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION [42660] 253.75 ADH (antidiuretic hormone) level 53.00 Admin hepatitis b vaccine 46.00 Admin influenza virus vac 61.74 Admin pneumococcal vaccine 134.75 Administration of 1 vaccine 93.00 Administration of 1 vaccine 53.00 Administration of 1 vaccine 30.00 Administration of first vaccine or toxoid component through 18 years of age with counseling 93.00 Administration of vaccine 30.00 Administration of vaccine 30.00 Administration of vaccine or toxoid component through 18 years of age with counseling 3675.13 ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION [135742] 417.00 Adrenocorticotropic hormone (ACTH) level 160.00 Advance care planning by the physician or other qualified health care professional 1980.00 Aflibercept injection 66702.75 Aicd, dual chamber 106896.00 Aicd, other than sing/dual 55586.25 Aicd, single chamber 162.00 Air and bone conduction assessment of hearing loss and speech recognition 120.75 Air tone conduction hearing assessment screening 76.75 Albumin (protein) level 1.39 ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION [17292] 0.27 ALBUTEROL 2.5 MG/3 ML (0.083 %) (PEDIATRIC ASTHMA) [613116] 66.43 ALBUTEROL 90MCG(VENTOLIN HFA) 10.00 ALBUTEROL INHLTN SOL PER 1MG 7.05 ALBUTEROL SULFATE 2 MG TABLET [647] 2.23 ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER (PED) [613117] 217.50 Aldolase (enzyme) level 458.50 Aldosterone hormone level 20.46 ALENDRONATE 70 MG TABLET [45120] 8.25 ALFUZOSIN 10MG TAB 106.00 Allergy testing with drugs or biologicals into or within the skin, immediate type reaction, including test interpretation and report 38.00 Allergy testing with venoms into or within skin, immediate type reaction, including test interpretation and report 0.27 ALLOPURINOL 100 MG TABLET [6395] 0.74 ALLOPURINOL 300 MG TABLET [6396] 207.25 Alpha-1-antitrypsin (protein) blood test 47.25 Alpha-1-antitrypsin (protein) blood test PRICE Description 38.25 Alpha-1-antitrypsin (protein) blood test 0.61 ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION [160173] 293.50 Alpha-fetoprotein (AFP) level, amniotic fluid 105.00 Alpha-fetoprotein (AFP) level, serum 0.70 ALPRAZOLAM 0.25 MG TABLET [668] 0.06 ALPRAZOLAM 0.5 MG TABLET [669] 10560.43 ALTEPLASE 100 MG INTRAVENOUS SOLUTION [46614] 183.67 ALTEPLASE 2 MG INTRA-CATHETER SOLUTION [49213] 247.50 Aluminum level 0.12 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [35974] 0.12 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP [42579] 7.00 AMANTADINE PER 100MG, 100MG CA 253.50 Ambulatory continuous glucose (sugar) monitoring for a minimum of 72 hours 0.04 AMI ACID 4.25% D5W SOL,1000ML 0.04 AMI ACID 4.25% D5W SOL,2000ML 308.25 Amikacin (antibiotic) level 293.50 Amikacin (antibiotic) level 1.66 AMIKACIN 500 MG/2 ML INJECTION SOLUTION [117935] 0.27 AMILORIDE 5 MG TABLET [6466] 0.04 AMINO ACID 5 % IN 15 % DEXTROSE INTRAVENOUS SOLUTION [49112] 0.05 AMINO ACID 5 % IN 15 % DEXTROSE INTRAVENOUS SOLUTION [49112] 382.75 Amino acid level, multiple amino acids 0.39 AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION [3803] 207.25 Aminolevulinic acid (protein) level 0.42 AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION [3954] 0.36 AMIODARONE 200 MG TABLET [5218] 0.28 AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV [123486] 0.58 AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION [38735] 1.45 AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION [38735] 0.32 AMITRIPTYLINE 10 MG TABLET [6289] 0.64 AMITRIPTYLINE 25 MG TABLET [6290] 0.57 AMLODIPINE 10 MG TABLET [47061] 0.40 AMLODIPINE 2.5 MG TABLET [45715] 3.48 AMLODIPINE 5 MG TABLET [45846] 0.52 AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION [7948] 177.25 Ammonia level 0.03 AMMONIUM LACTATE 12 % LOTION [20296] 0.12 AMOXICILLIN 250 MG CAPSULE [2352] 0.07 AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION [2366] 5.92 AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET [45621] 0.21 AMOXICILLIN 500 MG CAPSULE [2353] 3.67 AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET [38056] 0.92 AMOXICILLIN 875 MG TABLET [28148] 4.90 AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET [38057] 204.50 AMOXICILLIN-CLAVULANATE 250MG- 6.00 AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION [46854] 7.08 AMPICILLIN 1 GRAM SOLUTION FOR INJECTION [1478] 9.53 AMPICILLIN 2 GRAM SOLUTION FOR INJECTION [1481] 2.95 AMPICILLIN 500 MG SOLUTION FOR INJECTION [1475] 4.67 AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION [41966] 9.25 AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION [41967] 5450.00 AMPUTATION OF FINGER/THUMB 3000.00 Amputation of foot 154.00 Amylase (enzyme) level 206.00 Analysis for antibody (IgM) to Cytomegalovirus (CMV) 59.25 Analysis for antibody (IgM) to Cytomegalovirus (CMV) 230.50 Analysis for antibody (IgM) to Toxoplasma (parasite) 134.50 Analysis for antibody (IgM) to West Nile virus 384.50 Analysis for antibody bacteria 35.75 Analysis for antibody bacteria 52.00 Analysis for antibody bordetella (respiratory bacteria) 56.50 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) 330.75 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) 103.25 Analysis for antibody to aspergillus (fungus) 54.00 Analysis for antibody to Bartonella (bacteria) 93.25 Analysis for antibody to blastomyces (fungus) 103.25 Analysis for antibody to blastomyces (fungus) 33.25 Analysis for antibody to Brucella (bacteria) 103.25 Analysis for antibody to Coccidioides (bacteria) 225.00 Analysis for antibody to Cytomegalovirus (CMV) 59.25 Analysis for antibody to Cytomegalovirus (CMV) 225.00 Analysis for antibody to Diphtheria (bacteria) 259.00 Analysis for antibody to Enterovirus (gastrointestinal virus) 185.25 Analysis for antibody to Enterovirus (gastrointestinal virus) 61.25 Analysis for antibody to Enterovirus (gastrointestinal virus) 166.25 Analysis for antibody to Epstein-Barr virus (mononucleosis virus) 123.25 Analysis for antibody to Epstein-Barr virus (mononucleosis virus) PRICE Description 131.75 Analysis for antibody to Epstein-Barr virus (mononucleosis virus) 172.00 Analysis for antibody to Epstein-Barr virus (mononucleosis virus) 155.75 Analysis for antibody to Giardia lamblia (intestinal parasite) 51.00 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) 190.50 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) 59.00 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) 50.50 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) 210.00 Analysis for antibody to helminth (intestinal worm) 230.50 Analysis for antibody to Hepatitis D virus 116.25 Analysis for antibody to Herpes simplex virus 87.25 Analysis for antibody to Herpes simplex virus, type 1 59.25 Analysis for antibody to Herpes simplex virus, type 1 53.75 Analysis for antibody to Herpes simplex virus, type 2 93.25 Analysis for antibody to histoplasma (fungus) 103.25 Analysis for antibody to histoplasma (fungus) 22.00 Analysis for antibody to HIV -1 virus 105.75 Analysis for antibody to HIV -1 virus 263.25 Analysis for antibody to Influenza virus 206.25 Analysis for antibody to Leptospira 118.75 Analysis for antibody to mumps virus 217.50 Analysis for antibody to Mycoplasma (bacteria) 127.25 Analysis for antibody to Mycoplasma (bacteria) 66.25 Analysis for antibody to parvovirus 71.25 Analysis for antibody to Rickettsia (bacteria) 118.75 Analysis for antibody to Rubella (German measles virus) 118.75 Analysis for antibody to Rubeola (measles virus) 48.25 Analysis for antibody to Salmonella (intestinal bacteria) 243.00 Analysis for antibody to tetanus bacteria (Clostridium tetanus) 274.25 Analysis for antibody to Toxoplasma (parasite) 53.75 Analysis for antibody to Toxoplasma (parasite) 108.25 Analysis for antibody to Toxoplasma (parasite) 46.00 Analysis for antibody to varicella-zoster virus (chicken pox) 110.25 Analysis for antibody to varicella-zoster virus (chicken pox) 104.25 Analysis for antibody to varicella-zoster virus (chicken pox) 207.25 Analysis for antibody to virus 179.00 Analysis for antibody to virus 134.50 Analysis for antibody to West Nile virus 180.25 Analysis for antibody, Treponema pallidum 228.00 Analysis for antibody, Treponema pallidum 52.00 Analysis for antibody, Treponema pallidum 207.25 Analysis for detection of tumor marker 246.00 Analysis for detection of tumor marker 326.00 Analysis of substance using immunoassay technique 98.75 Analysis of substance using immunoassay technique 259.00 Analysis of substance using immunoassay technique 261.75 Analysis of substance using immunoassay technique 133.25 Analysis of substance using immunoassay technique 204.00 Analysis of substance using immunoassay technique 53.50 Analysis using chemiluminescent technique (light and chemical )reaction 56.25 Analysis using chemiluminescent technique (light and chemical )reaction 4.04 ANASTROZOLE 1 MG TABLET [44145] 881.00 Anchor/screw bn/bn,tis/bn 192.50 Anchor/screw bn/bn,tis/bn 1660.00 Anchor/screw bn/bn,tis/bn 71.50 Anchor/screw bn/bn,tis/bn 636.00 Anchor/screw bn/bn,tis/bn 474.50 Anchor/screw bn/bn,tis/bn 3612.25 Anchor/screw bn/bn,tis/bn 1632.75 Anchor/screw bn/bn,tis/bn 340.00 Anchor/screw bn/bn,tis/bn 695.25 Anchor/screw bn/bn,tis/bn 745.00 Anchor/screw bn/bn,tis/bn 869.75 Anchor/screw bn/bn,tis/bn 395.75 Anchor/screw bn/bn,tis/bn 405.00 Anchor/screw bn/bn,tis/bn 428.25 Anchor/screw bn/bn,tis/bn 441.50 Anchor/screw bn/bn,tis/bn 730.25 Anchor/screw bn/bn,tis/bn 45.25 Anchor/screw bn/bn,tis/bn 286.50 Anchor/screw bn/bn,tis/bn 2994.50 Anchor/screw bn/bn,tis/bn 54.50 Anchor/screw bn/bn,tis/bn 620.50 Anchor/screw bn/bn,tis/bn 317.50 Anchor/screw bn/bn,tis/bn 1403.25 Anchor/screw bn/bn,tis/bn 1211.50 Anchor/screw bn/bn,tis/bn 158.00 Anchor/screw bn/bn,tis/bn PRICE Description 842.50 Anchor/screw bn/bn,tis/bn 1181.50 Anchor/screw bn/bn,tis/bn 1004.75 Anchor/screw bn/bn,tis/bn 113.75 Androstenedione (hormone) level 566.00 ANES-BIER BLOCK 15 MIN 566.00 ANES-GENERAL 15 MIN 335.75 ANES-MAC 15MIN 335.75 ANES-PARAVERT BLOCK 15 MIN 335.75 ANES-REGIONAL BLOCK 15 MIN 335.75 ANES-SPINAL 15MIN 566.00 ANESTH GENERAL 1ST 15 MIN 566.00 ANESTH GENRAL ADD 15 MIN 335.75 ANES-WPIDURAL 15MIN 266.50 Angiotensin l - converting enzyme (ACE) level 73.25 Angiotensin l - converting enzyme (ACE) level 3.75 ANSEF 2GM PREMIX BAG PER 500MG 498.75 Antibody evaluation 316.50 Antibody evaluation 319.50 Antibody evaluation 56.25 Antibody evaluation 440.50 Antibody identification test for platelet antibodies 296.25 Antibody identification test for platelet antibodies 141.50 Antibody identification test for platelet antibodies 194.25 Antibody identification test for platelet antibodies 361.50 Antibody identification test for white blood cell antibodies 2.70 ANTI-INHIBITOR COAGULANT COMPLEX 350 UNIT-650 UNIT INTRAVENOUS SOLN [166957] 226.25 Antimicrobial study, mycobacteria (TB organism family) 211.75 Antithrombin III antigen (clotting inhibitor) activity 206.00 Antithrombin III antigen (clotting inhibitor) level 9.42 APIXABAN 2.5 MG TAB, EACH 8.88 APIXABAN 5 MG TABLET [135092] 120.50 Apligraf 222.25 Apolipoprotein level 92.50 Application of blood vessel compression or decompression device to 1 or more areas 260.00 Application of cast to hand and lower forearm 260.00 Application of cast, elbow to finger (short arm) 260.00 Application of cast, shoulder to hand (long arm) 215.00 Application of chemical agent to excessive wound tissue 391.50 Application of chemical agent to excessive wound tissue 480.00 Application of cylinder cast (thigh to ankle) 92.50 Application of electrical stimulation to 1 or more areas, each 15 minutes 92.50 Application of hot or cold packs to 1 or more areas 88.25 Application of hot or cold packs to 1 or more areas 92.50 Application of hot wax bath to 1 or more areas 267.00 Application of long arm splint (shoulder to hand) 149.00 Application of long arm splint (shoulder to hand) 275.00 Application of long leg cast (thigh to toes) 404.00 Application of long leg splint (thigh to ankle or toes) 92.50 Application of mechanical traction to 1 or more areas 103.75 Application of medication through skin using electrical current, each 15 minutes 103.00 Application of medication through skin using electrical current, each 15 minutes 252.50 Application of moveable, hinged finger splint 388.25 Application of moveable, hinged short arm splint (forearm to hand) 267.00 Application of non-moveable, hinged finger splint 267.00 Application of non-moveable, short arm splint (forearm to hand) 125.00 Application of non-moveable, short arm splint (forearm to hand) 295.75 Application of non-moveable, short arm splint (forearm to hand) 84.00 Application of on-body injector for injection under skin 300.00 Application of rigid total contact leg cast 516.50 Application of rigid total contact leg cast 260.00 Application of short leg cast (below knee to toes) 266.75 Application of short leg splint (calf to foot) 149.00 Application of short leg splint (calf to foot) 759.25 Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes 2479.50 Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less) 888.25 Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs 2479.50 Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) 92.50 Application of ultrasound to 1 or more areas, each 15 minutes 266.00 Application of vein wound compression system lower leg below knee including ankle and foot 33.27 APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE [49077] 109.94 APREPITANT 40 MG CAPSULE [87882] 10.30 ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION [90429] 630.48 ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION [28081] 1997.50 ARGON FOCAL LASER 32.08 ARIPIPRAZOLE 10 MG TABLET [52490] 32.00 ARIPIPRAZOLE 15 MG TABLET [52491] 35.68 ARIPIPRAZOLE 2 MG TABLET [85655] PRICE Description 50.45 ARIPIPRAZOLE 30 MG TABLET [52493] 32.00 ARIPIPRAZOLE 5 MG TABLET [53505] 5.00 ARIPIPRAZOLE ER 400 MG SUSPENSION, EXTENDED REL.INTRAMUSCULAR SYRINGE [145939] 5.00 ARIPIPRAZOLE LAUROXIL ER 1,064 MG/3.9 ML SUSPENSION,EXT.REL IM SYRINGE [157829] 5.00 ARIPIPRAZOLE LAUROXIL ER 882 MG/3.2 ML SUSPENSION, EXT.REL. IM SYRINGE [149385] 120.25 ARMSTRONG BEVELED VENT 140242 314.00 Arsenic level 82.75 Arsenic level 60.25 Arsenic level 119.25 Arterial puncture withdrawal of blood for diagnosis 0.66 ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE [144775] 0.04 ASCORBIC ACID (VITAMIN C) 500 MG TABLET [5289] 6.00 ASCORBIC ACID 250 MG TAB EACH 24.02 ASENAPINE 5 MG SUBLINGUAL TABLET [113444] 1399.50 ASP/INJ RENAL CYST/PELVIS 1440.50 Aspiration and/or injection of cysts 280.00 Aspiration and/or injection of cysts 720.00 Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance 612.00 Aspiration and/or injection of large joint or joint capsule 336.00 Aspiration and/or injection of large joint or joint capsule 450.00 Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance 389.00 Aspiration and/or injection of medium joint or joint capsule 336.00 Aspiration and/or injection of medium joint or joint capsule 546.75 Aspiration and/or injection of small joint or joint capsule 280.00 Aspiration and/or injection of small joint or joint capsule 450.00 Aspiration and/or injection of small joint or joint capsule with recording and reporting using ultrasound guidance 936.50 Aspiration and/or injection of thyroid cyst 656.25 Aspiration of abscess, blood accumulation, blister, or cyst 375.00 Aspiration of abscess, blood accumulation, blister, or cyst 5025.00 Aspiration of bladder with insertion of bladder tube to skin surface 11.28 ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULE,EXT.RELEASE 12 HR MULTIPHASE [44176] 1.46 ASPIRIN 300 MG RECTAL SUPPOSITORY [10039] 0.06 ASPIRIN 325 MG TABLET [5278] 0.01 ASPIRIN 325 MG TABLET,DELAYED RELEASE [5455] 0.02 ASPIRIN 81 MG CHEWABLE TABLET [31359] 0.01 ASPIRIN 81 MG TABLET,DELAYED RELEASE [30082] 0.03 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET [49371] 440.00 Assessment and recording of balance system during hot and cold irrigation of both ears 162.00 Assessment of eardrum and muscle function 38.00 Assessment of hearing loss and speech recognition 38.00 Assessment of hearing loss with placement of probe in ear to assess ear bone contraction 38.00 Assessment of speech hearing loss 0.80 ATENOLOL 25 MG TABLET [656] 0.89 ATENOLOL 50 MG TABLET [657] 540.83 ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION [154304] 17.18 ATOMOXETINE 40 MG CAPSULE [52510] 17.18 ATOMOXETINE 60 MG CAPSULE [52511] 0.30 ATORVASTATIN 10 MG TABLET [44642] 0.36 ATORVASTATIN 20 MG TABLET [44341] 0.38 ATORVASTATIN 40 MG TABLET [44070] 0.52 ATORVASTATIN 80 MG TABLET [44182] 33.25 ATRACURIUM 10 MG/ML INJ 5ML 1.11 ATROPINE 0.1 MG/ML INJECTION SYRINGE [31590] 1.99 ATROPINE 0.1 MG/ML INJECTION SYRINGE [31590] 8.40 ATROPINE 0.4 MG/ML INJECTION SOLUTION [9618] 22.30 ATROPINE 1 % EYE DROPS [2911] 13.20 ATROPINE 1 MG/ML INJECTION SOLUTION [9622] 673.00 Attempt to restart heart and lungs 25.00 Automated urinalysis test 40.25 Automated urinalysis test 79.00 Automated white blood cell count 14.50 Automated white blood cell count 617.62 AZACITIDINE 100 MG SOLUTION FOR INJECTION [55919] 2.35 AZATHIOPRINE 50 MG TABLET [2614] 332.25 AZELASTINE 137MCG/ACT NASAL SP 29.13 AZITHROMYCIN 1 GRAM ORAL PACKET [49573] 2.33 AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION [48236] 2.33 AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [48737] 7.39 AZITHROMYCIN 250 MG TABLET [44705] 8.92 AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION [47813] 15.57 AZITHROMYCIN 500 MG TABLET [52022] 77.50 AZITHROMYCIN 500MG/250ML IVPB 39.54 AZTREONAM 1 GRAM SOLUTION FOR INJECTION [48634] 80.34 AZTREONAM 2 GRAM SOLUTION FOR INJECTION [47326] 13.31 BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION [1180] 0.18 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT [5858] 0.11 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL PACKET [53345] PRICE Description 7.34 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT [8855] 0.47 BACLOFEN 10 MG TABLET [5192] 6.00 BACLOFEN 20MG TAB 255.50 Bacterial blood culture 131.75 Bacterial colony count, urine 197.25 Bacterial culture 255.50 Bacterial culture 91.50 Bacterial culture for aerobic isolates 152.50 Bacterial culture for anaerobic isolates 185.75 Bacterial urine culture 9.25 BAG LEG DISP LARGE 9.25 BAG LEG DISP SM 0.55 BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION [55404] 0.73 BALANCED SALT SOLUTION NON-SURGICAL NO.3 EYE WASH [55538] 14659.75 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure 8442.75 Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure 12487.00 Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure 14661.00 Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure 13740.50 Balloon dilation of groin artery, endovascular, open, or percutaneous approach 0.63 BALSAM PERU-CASTOR OIL TOPICAL OINTMENT [163944] 1152.75 BANDING HEMORRHOID 0.05 B-COMPLEX WITH VITAMIN C TABLET [38958] 27.20 BECLOMETHASONE DIPROP 80 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL [159341] 237.50 Behavioral and qualitative analysis of voice and resonance 33.45 BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY [49308] 0.95 BENAZEPRIL 10 MG TABLET [41881] 7.00 BENAZEPRIL 5MG TAB 742.14 BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION [151748] 0.79 BENZOCAINE 20 % MUCOSAL GEL [20266] 0.10 BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL [44713] 0.09 BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE [97758] 0.28 BENZONATATE 100 MG CAPSULE [2339] 6.00 BENZTROPINE 0.5 MG TAB EACH 0.59 BENZTROPINE 1 MG TABLET [6435] 33.00 BENZTROPINE 2 MG/2 ML INJECTION SOLUTION [48165] 174.50 Beta-2 microglobulin (protein) level 11.87 BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION [46447] 7.00 BETHANECHOL 10MG TAB 6.00 BETHANECHOL 25MG TAB 239.08 BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION [54932] 25.00 Bevacizumab injection 203.22 BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION [165084] 56.25 BICALUTAMIDE 50MG TAB 51.00 BICARBONATE 75.00 Bilirubin level 23.25 Bilirubin level 91.50 Bilirubin level 162.00 BIOFEEDBACK TRAINING 634.25 BIOFIX 121560 1.5X 60 314.00 Biopsy and scraping of the cervix using an endoscope 1271.00 BIOPSY CERVIX SINGLE/MULT EXC 2147.50 Biopsy of breast accessed through the skin with stereotactic guidance 2862.75 Biopsy of breast accessed through the skin with ultrasound guidance 670.00 Biopsy of cervix or excision of local growths 2835.00 Biopsy of cervix using an endoscope 675.00 Biopsy of external female genitals 20.00 Biopsy of external female genitals 326.00 Biopsy of eyelid 1980.00 Biopsy of mouth 4221.75 Biopsy of one lobe of lung using an endoscope 1883.00 Biopsy of prostate gland 2855.75 Biopsy of prostate gland 2080.00 Biopsy of roof of mouth 550.00 Biopsy of tongue 176.00 Biopsy of uterine lining 1490.00 Biopsy or removal of nasal polyp or tissue using an endoscope 0.08 BISACODYL 10 MG RECTAL SUPPOSITORY [26910] 0.03 BISACODYL 5 MG TABLET,DELAYED RELEASE [5759] 0.01 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION [47305] 2.25 BISOPROLOL FUMARATE 5 MG TABLET [28177] 7.00 BISOPROLOL-HYDROCHLOROTHIAZIDE 1053.00 Bladder instillation of cancer preventive, inhibiting, or suppressive agent 557.25 Bladder irrigation and/or instillation 553.75 Bladder irrigation and/or instillation 258.00 Bladder irrigation and/or instillation 87.88 BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION [1354] 100.00 Blood chloride level PRICE Description 83.00 Blood creatinine level 288.50 Blood gases measurement 282.25 Blood gases measurement 326.00 Blood gases measurement 68.50 Blood glucose (sugar) level 93.25 Blood glucose (sugar) level after receiving dose of glucose 64.25 Blood glucose (sugar) level after receiving dose of glucose 62.25 Blood glucose (sugar) measurement using reagent strip 14.50 Blood glucose (sugar) test performed by hand-held instrument 15.00 Blood glucose (sugar) test performed by hand-held instrument 199.00 Blood glucose (sugar) tolerance test 131.25 Blood group typing (ABO) 116.25 Blood osmolality (concentration) measurement 79.00 Blood pH level 79.00 Blood potassium level 68.50 Blood sodium level 142.75 Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) 166.25 Blood test, basic group of blood chemicals 15.00 Blood test, clotting time 30.00 Blood test, clotting time 51.50 Blood test, clotting time 15.25 Blood test, clotting time 241.50 Blood test, comprehensive group of blood chemicals 195.50 Blood test, lipids (cholesterol and triglycerides) 93.25 Blood test, lipids (cholesterol and triglycerides) 142.75 Blood test, thyroid stimulating hormone (TSH) 40.25 Blood test, thyroid stimulating hormone (TSH) 319.50 Blood typing for red blood cell antigens 51.50 Blood typing for Rh (D) antigen 157.50 Blood unit compatibility test 183.75 Blood unit compatibility test 93.25 Blood viscosity measurement 145.75 Body fluid cell count with cell identification 25.50 Body fluid pH level 2727.25 Bone and/or joint imaging, 3 phase study 2209.75 Bone and/or joint imaging, whole body 490.00 Bone density measurement using dedicated X-ray machine 148.25 Bone density measurement using dedicated X-ray machine 2147.50 Bone marrow biopsy 2877.00 Bone marrow biopsy and aspiration 4615.00 BONE MARROW BX & ASPIRATION 1923.60 BORTEZOMIB 3.5 MG SOLUTION FOR INJECTION [53024] 739.00 BRAVO PH CAPSULE 9552.00 BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION [124163] 46.60 BREXPIPRAZOLE 0.5 MG TABLET [147953] 46.60 BREXPIPRAZOLE 1 MG TABLET [147954] 46.60 BREXPIPRAZOLE 4 MG TABLET [147957] 38.39 BRIMONIDINE 0.1 % EYE DROPS [86277] 40.93 BRIMONIDINE 0.15 % EYE DROPS [49362] 3.63 BRIMONIDINE 0.2 % EYE DROPS [40132] 392.00 BRINZOLAMIDE 1% OPHTH DPS, 10M 7.00 BROMOCRIPTINE 2.5MG TAB 4221.75 BRONCHOSCOPY DIAGNOSTIC 4221.75 BRONCHOSCOPY FLEX W/BIOPSY 4221.75 BRONCHOSCOPY FLEX W/BRUSHING 4221.75 BRONCHOSCOPY W/NEEDLE ASP/BX 4.71 BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION [48023] 5.54 BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION [48076] 2.67 BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE [48662] 0.30 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION [3333] 0.68 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION [3333] 0.81 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION [3333] 0.41 BUMETANIDE 1 MG TABLET [5999] 0.07 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION [3287] 0.19 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION [3287] 0.07 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION [3290] 0.23 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION [3290] 1.39 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [3707] 0.25 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION [3292] 0.04 BUPIVACAINE 0.0625%-FENTANYL 2 MCG/ML-EPINEPHRINE 1.25 MCG/ML EPIDURAL INTERMITTENT DOSING IN NS 150 ML PYXIS (AC) [614835] 0.04 BUPIVACAINE 0.1%-FENTANYL 2 MCG/ML EPIDURAL CLINICIAN DOSE [616277] 0.06 BUPIVACAINE 0.5 % (5 MG/ML) INJECTION SOLUTION [3289] 0.11 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION [53067] 0.64 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION [53067] 0.28 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION [53065] 0.23 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION [4265] 0.31 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION [4267] PRICE Description 5.73 BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM [118317] 18.20 BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION [82400] 4.14 BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET [52705] 1.96 BUPROPION HCL 100 MG TABLET [5119] 1.55 BUPROPION HCL 75 MG TABLET [5118] 1.69 BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE [41898] 1.81 BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE [41899] 4.66 BUPROPION XL 150 MG TAB [53708] 6.00 BUPROPION XL 300MG TAB EACH 1.36 BUSPIRONE 10 MG TABLET [28850] 0.78 BUSPIRONE 5 MG TABLET [28849] 1.69 BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET [5165] 1.70 BUTALBITAL-ASPIRIN-CAFFEINE 50 MG-325 MG-40 MG CAPSULE [41145] 4.45 BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY [45401] 8780.21 CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION [117628] 11.49 CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN [9080] 342.50 Calcitonin (hormone) level 1621.84 CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION [49705] 1.28 CALCITRIOL 0.25 MCG CAPSULE [29853] 0.17 CALCIUM ACETATE 667 MG TABLET [45815] 7.00 CALCIUM ACETATE 667MG TAB 0.07 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) CHEWABLE TABLET [9859] 0.05 CALCIUM CARBONATE 500 MG (1,250 MG)-VITAMIN D3 200 UNIT TABLET [82334] 0.04 CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) TABLET [32875] 0.81 CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE [3903] 7.00 CALCIUM CITRATE-VITAMIN D 315M 1.10 CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION [9081] 1.75 CALCIUM GLUCONATE PER 10ML, 10 116.25 Calcium level 187.25 Calcium level 0.13 CALCIUM POLYCARBOPHIL 625 MG TABLET [47666] 79.25 CAPECITABINE 500MG TAB 715.50 CAPSULAR TENSION RING 1.22 CAPTOPRIL 12.5 MG TABLET [5092] 2.03 CAPTOPRIL 50 MG TABLET [5094] 23.57 CARBACHOL 0.01 % INTRAOCULAR SOLUTION [47535] 0.66 CARBAMAZEPINE 100 MG CHEWABLE TABLET [5152] 7.00 CARBAMAZEPINE 100MG XR TAB 1.60 CARBAMAZEPINE 200 MG TABLET [5099] 7.00 CARBAMAZEPINE 200MG ER CAP 270.00 Carbamazepine level 102.75 Carbamazepine level 0.09 CARBAMIDE PEROXIDE 6.5 % EAR DROPS [23259] 0.31 CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET [5120] 0.80 CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET [42527] 1.62 CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET [5122] 0.84 CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE [42932] 503.00 Carbohydrate deficient transferrin (protein) level 97.75 Carbon dioxide (bicarbonate) level 1.68 CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION [42654] 425.32 CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION [49618] 178.50 Carboxyhemoglobin (protein) level 40.75 Carboxyhemoglobin (protein) level 0.63 CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE LIQUID GEL DROPS [49604] 250.75 Carcinoembryonic antigen (CEA) protein level 244.00 Cardiac output measurements 263.25 Cardiolipin antibody (tissue antibody) measurement 2785.99 CARFILZOMIB 60 MG INTRAVENOUS SOLUTION [132199] 48.71 CARFILZOMIB(KYPROLIS) PER 1MG 48.03 CARIPRAZINE 1.5 MG CAPSULE [152796] 0.23 CARISOPRODOL 350 MG TABLET [7375] 70.25 Carnitine level 67.75 Carnitine level 2.13 CARVEDILOL 12.5 MG TABLET [44354] 2.13 CARVEDILOL 25 MG TABLET [44195] 2.13 CARVEDILOL 3.125 MG TABLET [46124] 2.13 CARVEDILOL 6.25 MG TABLET [44249] 25.00 Cast sup long arm ped fbrgls 45.00 Cast sup shrt leg ped fbrgls 30.00 Cast sup sht arm adult fbrgl 367.50 Catecholamines (organic nitrogen) level 16.00 CATH FOLEY SIL 2 WAY 14 FR 5CC 490.00 CATH KIT MAN 10 FR. 19.5 868.00 Cath, drainage 1634.75 Cath, ep, 19 or few elect 649.75 Cath, hemodialysis,long-term 759.75 Cath, inf, per/cent/midline PRICE Description 409.00 Cath, inf, per/cent/midline 4062.25 Cath, thrombectomy/embolect 7035.25 Cath, trans atherectomy, dir 1069.50 Cath, translumin non-laser 6199.25 Cath, translumin, drug-coat 241.50 Cath,hemodialysis,short-term 23.25 CATHETER 12 FR 128.00 Catheter, guiding 2501.50 Catheter, intraspinal 1.26 CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [1470] 10.20 CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION [1472] 2.00 CEFAZOLIN 2G IV SYR,PER 500MG 2.40 CEFAZOLIN 500 MG SOLUTION FOR INJECTION [1469] 1.66 CEFDINIR 250 MG/5 ML ORAL SUSPENSION [56375] 5.11 CEFDINIR 300 MG CAPSULE [49074] 20.33 CEFEPIME 1 GRAM SOLUTION FOR INJECTION [44445] 40.36 CEFEPIME 2 GRAM SOLUTION FOR INJECTION [45061] 2.64 CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION [30667] 54.75 CEFOTAXIME PER 1GM, 1GM IN 5% 11.23 CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION [28465] 90.75 CEFPODOXIME 100MG TAB 181.75 CEFPODOXIME 100MG/5ML SUSP, 50 230.55 CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [119582] 230.55 CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [119584] 10.46 CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION [48701] 13.20 CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION [45152] 430.57 CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION [146872] 150.00 CEFTOLOZANE/TAZOBACTAM 1500MG 46.00 CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION [46535] 91.41 CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION [49591] 1.44 CEFTRIAXONE 250 MG SOLUTION FOR INJECTION [45128] 26.88 CEFTRIAXONE 500 MG SOLUTION FOR INJECTION [48379] 44.00 CEFTRIAXONE PER 250MG, 1GM IN 27.00 Ceftriaxone sodium injection 4.40 CEFUROXIME AXETIL 250 MG TABLET [30665] 15.19 CELECOXIB 200 MG CAPSULE [40379] 225.00 Cell examination of body fluid 211.75 Cell examination of specimen 187.75 Cell examination of specimen 2891.00 CELLSAVER REPROFUSION PROCEDUR 1.00 CEPACOL (MENTHOL)3MG LOZENGE 0.70 CEPHALEXIN 250 MG CAPSULE [209] 0.29 CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION [384] 1.38 CEPHALEXIN 500 MG CAPSULE [227] 154.00 Cerebrospinal fluid, or amniotic fluid albumin (protein) level 119.25 Ceruloplasmin (protein) level 213.00 Cervicovaginal secretion of placenta protein 2865.00 Cesarean delivery 15.30 CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION [110228] 47.75 CFSCRN NUC ACID PROBE(12) 2725.00 CHANGE NEPHROSTOMY TUBE 260.00 Change of breathing tube of windpipe in neck 47.50 CH-CARBOPLATIN/50MG,0MG/ML INJ 187.25 Chemical analysis using chromatography technique 229.75 Chemical analysis using chromatography technique 228.00 Chemical analysis using chromatography technique 138.75 Chemical analysis using chromatography technique 242.25 Chemical analysis using chromatography technique 213.75 Chemical analysis using spectrophotometry (light) 178.00 Chemical analysis using spectrophotometry (light) 685.00 Chemical receptor analysis 70.25 Chemical test for genetic disorder 603.75 CHEMO PUMP INITIAL HOOK UP 997.25 Chest ultrasound examination of heart 26.23 CH-GEMCITABINE/200MG,1GM INJ 411.75 CH-GEMCITABINE/200MG,200MG INJ 75.00 CHLAMYDIA PNEUMONIAE,AMP PROBE 0.43 CHLORDIAZEPOXIDE 25 MG CAPSULE [9168] 0.35 CHLORDIAZEPOXIDE 5 MG CAPSULE [9167] 5.14 CHLORDIAZEPOXIDE-CLIDINIUM 5 MG-2.5 MG CAPSULE [6756] 0.03 CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH [84608] 0.03 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID [8511] 70.75 Chloride level 9.56 CHLORPROMAZINE 25 MG TABLET [7440] 2.30 CHLORTHALIDONE 25 MG TABLET [5966] 1.08 CHLORZOXAZONE 500 MG TABLET [30935] 0.28 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET [49223] PRICE Description 0.33 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) TABLET [112436] 0.05 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET [88837] 128.25 Cholesterol level 3.35 CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL POWDER FOR SUSP IN A PACKET [53595] 177.25 Cholinesterase (enzyme) level 199.76 CHONDROITIN-SOD HYALURON 3 %-4 %(0.5 ML)1 %(0.55 ML)INTRAOCULAR SYRING [44754] 290.25 Chromium level to test for poisoning or deficiency 926.25 Chromosome analysis for genetic defects 31.75 CH-SODIUM CHLORIDE 0.9%IV SOL 31.75 CH-SODIUM CHLORIDE/0.9% IV SOL 1.83 CILOSTAZOL 100 MG TABLET [43441] 30.66 CINACALCET 30 MG TABLET [55310] 10.01 CIPROFLOXACIN 0.3 % EYE DROPS [42747] 37.78 CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION [53566] 0.15 CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [49732] 5.46 CIPROFLOXACIN 250 MG TABLET [39995] 0.02 CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [45200] 3.18 CIPROFLOXACIN 500 MG TABLET [39996] 3.76 CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION [47334] 0.48 CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION [32805] 6.00 CITALOPRAM 10 MG TAB EACH 2.55 CITALOPRAM 20 MG TABLET [43432] 6.00 CITALOPRAM 40MG TAB, EACH 426.25 Citrate level 279.25 Citrate level 108.00 CLADRIBINE PER 1MG, 10MG SDV 6.02 CLARITHROMYCIN 500 MG TABLET [44878] 0.87 CLINDAMYCIN 150 MG/ML INJECTION SOLUTION [3755] 0.30 CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [30476] 0.36 CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [30477] 0.63 CLINDAMYCIN HCL 150 MG CAPSULE [5201] 8.55 CLOBETASOL 0.05 % TOPICAL CREAM [5904] 10.36 CLOBETASOL 0.05 % TOPICAL OINTMENT [5903] 18.75 CLOMIPRAMINE 25MG CAP 0.75 CLONAZEPAM 0.5 MG TABLET [5159] 0.91 CLONAZEPAM 1 MG TABLET [5160] 33.16 CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH [44448] 55.83 CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH [44707] 77.45 CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH [48421] 0.06 CLONIDINE HCL 0.1 MG TABLET [653] 0.08 CLONIDINE HCL 0.2 MG TABLET [654] 27.84 CLOPIDOGREL 300 MG TABLET [102007] 7.74 CLOPIDOGREL 75 MG TABLET [45777] 1313.00 Closed treatment of ankle dislocation 460.00 Closed treatment of broke forearm bone at elbow 270.00 Closed treatment of broken ankle 297.00 Closed treatment of broken ankle 300.00 Closed treatment of broken ankle joint bone 2745.75 Closed treatment of broken ankle with manipulation 764.25 Closed treatment of broken ankle with manipulation 1786.75 Closed treatment of broken ankle with manipulation 1512.25 Closed treatment of broken ankle with manipulation 401.00 Closed treatment of broken finger or thumb 270.00 Closed treatment of broken finger or thumb 415.75 Closed treatment of broken finger or thumb with manipulation 297.00 Closed treatment of broken finger or thumb with manipulation 393.25 Closed treatment of broken finger or thumb with manipulation 270.00 Closed treatment of broken foot bone 270.00 Closed treatment of broken forearm bone 270.00 Closed treatment of broken forearm bone at elbow 2113.75 Closed treatment of broken forearm bone at elbow with manipulation 270.00 Closed treatment of broken forearm bones 297.00 Closed treatment of broken forearm bones 1513.00 Closed treatment of broken forearm bones with manipulation 1371.00 Closed treatment of broken forearm bones with manipulation 270.00 Closed treatment of broken great toe 460.00 Closed treatment of broken great toe with manipulation 2730.00 Closed treatment of broken hand or finger with manipulation 297.00 Closed treatment of broken heel bone 1512.25 Closed treatment of broken of upper arm bone at shoulder with manipulation 1513.00 Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation 297.00 Closed treatment of broken shin bone 2976.75 Closed treatment of broken shin bone with manipulation 430.00 Closed treatment of broken spine bones with casting or bracing 450.00 Closed treatment of broken thigh bone 345.00 Closed treatment of broken toe 764.25 Closed treatment of broken toe with manipulation PRICE Description 297.00 Closed treatment of broken toe with manipulation 5038.50 Closed treatment of broken upper arm bone at shoulder joint with manipulation 5038.50 Closed treatment of broken upper arm bone with manipulation 270.00 Closed treatment of broken wrist bone 2976.75 Closed treatment of collar bone broken with manipulation 265.00 Closed treatment of collar bone fracture 470.50 Closed treatment of dislocated finger joint with manipulation 393.50 Closed treatment of dislocated finger joint with manipulation 4187.75 Closed treatment of dislocated finger joint with manipulation under anesthesia 393.50 Closed treatment of dislocated foot joint 1250.25 Closed treatment of dislocated forearm bone of elbow, child 393.25 Closed treatment of dislocated hand joint with manipulation 2113.75 Closed treatment of dislocated hand joint with manipulation under anesthesia 577.50 Closed treatment of dislocated hip prosthesis 2745.75 Closed treatment of dislocated hip prosthesis under anesthesia 441.00 Closed treatment of dislocation of joint between collar and chest bones with manipulation 764.25 Closed treatment of dislocation of knee cap 400.00 Closed treatment of fracture and/or dislocation of pelvis and/or sacrum 2700.00 Closed treatment of fracture below neck of upper thigh bone 270.00 Closed treatment of fracture hand bone 1250.25 Closed treatment of fracture of bone of hand with manipulation 297.00 Closed treatment of fracture of bone of hand with manipulation 270.00 Closed treatment of fracture of shin bone 297.00 Closed treatment of fracture of upper arm bone at shoulder joint 297.00 Closed treatment of growth plate or broken upper arm bone at elbow 2745.75 Closed treatment of hip dislocation under anesthesia 300.00 Closed treatment of hip socket fractures 764.25 Closed treatment of jaw temporomandibular joint (TMJ) dislocation 2954.75 Closed treatment of knee cap dislocation under anesthesia 270.00 Closed treatment of knee cap fracture 1512.00 Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation 1512.25 Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation 764.25 Closed treatment of shoulder dislocation with manipulation 3828.25 Closed treatment of shoulder dislocation with manipulation under anesthesia 426.75 Closed treatment of thumb dislocation with manipulation 270.00 Closed treatment of upper arm fracture 460.00 Closed treatment of upper arm fracture 855.50 Closure dev, vasc 392.00 Closure of tear duct opening using plug 0.57 CLOTRIMAZOLE 1 % TOPICAL CREAM [6666] 3.22 CLOTRIMAZOLE 10 MG TROCHE [43061] 3.22 CLOTRIMAZOLE 10MG ORAL TROCHE 1.35 CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM [41550] 249.25 Clotting factor II prothrombin, measurement 249.25 Clotting factor inhibitor test 197.25 Clotting factor IX (PTC or Christmas) measurement 457.00 Clotting factor V (AcG or proaccelerin) measurement 502.00 Clotting factor VIII (AHG) measurement 316.25 Clotting factor VIII (von Willebrand factor) measurement 457.00 Clotting factor VIII (VW factor) antigen 621.25 Clotting factor VIII (VW factor) measurement 152.50 Clotting factor X (Stuart-Prower) measurement 294.50 Clotting factor X assessment test 189.00 Clotting factor XI (PTA) measurement 187.25 Clotting factor XII (Hageman) measurement 148.50 Clotting factor XIII (fibrin stabilizing) measurement 3.43 CLOZAPINE 100 MG TABLET [6014] 1.32 CLOZAPINE 25 MG TABLET [6013] 340.75 Clozapine level 460.00 CLSD FX FEMORAL SHAFT FRACTURE 110.25 Coagulation assessment blood test 24.00 Coagulation assessment blood test 166.25 Coagulation assessment blood test 26.75 Coagulation assessment blood test 187.25 Coagulation function measurement 21.00 Coagulation function screening test with interpretation and report 15.25 Coagulation time measurement 55.78 COCAINE 4 % TOPICAL SOLUTION [2556] 294.00 COCAINE 4% NASAL PER EACH 4ML 0.13 CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID [39878] 1.03 CODEINE SULFATE 30 MG TABLET [2165] 6.74 COLCHICINE 0.6 MG TABLET [3725] 3.96 COLESEVELAM 625 MG TABLET [47047] 33.59 COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION [19591] 212.00 Collagen cross links test, (urine test to evaluate bone health) 488.50 Collagen cross links test, (urine test to evaluate bone health) 200.75 Collection of blood specimen from a completely implantable venous access device PRICE Description 248.00 Collection of blood specimen from central or peripheral venous catheter 1886.50 COLONOSCOPY 2640.00 COLONOSCOPY CONTROL BLEED APC 2266.50 COLONOSCOPY W/ BIOPSY 139.00 Community or work reintegration training, each 15 minutes 40.25 Complete blood cell count (red cells, white blood cell, platelets), automated test 83.00 Complete blood cell count (red cells, white blood cell, platelets), automated test 611.50 Complete X-ray study of abdomen with single X-ray of chest 764.25 Complex control of nose bleed 194.00 Complex control of nose bleed 70.00 Computerized mapping of corneal curvature 110.25 Concentration of specimen for infectious agents 156.25 Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria) 147.50 Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria) 342.50 Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV 356.16 CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION [49576] 5429.50 Conn tiss, human(inc fascia) 126.75 Continuous monitoring of glucose in tissue fluid using sensor under skin 1490.00 Control of nasal bleeding using an endoscope 764.25 Control of nose bleed and insertion of packing 37182.50 Conversion to two chamber pacemaker system 209.25 Copper level 50.75 Copper level 100.00 CORONAVIRUS 170.00 Cortisol (hormone) measurement 323.75 Cortisol (hormone) measurement 309.25 Cortisol (hormone) measurement 127.90 COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION [45671] 100.00 COVID 19 100.00 COVID 19 EMPLOYEE SCREEN 284.75 C-peptide (protein) level 142.75 Creatine kinase (cardiac enzyme) level 174.50 Creatine kinase (cardiac enzyme) level 152.50 Creatine kinase (cardiac enzyme) level 166.25 Creatinine clearance measurement to test for kidney function 100.00 Creatinine level to test for kidney function or muscle injury 755.25 Critical care delivery critically ill or injured patient 1964.00 Critical care delivery critically ill or injured patient, first 30-74 minutes 1870.50 Critical care delivery critically ill or injured patient, first 30-74 minutes 325.00 CROMOLYN 5.2MG/ACT NASAL SPRAY 125.50 Cryoglobulin (protein) measurement 103.75 Crystal identification from tissue or body fluid 1993.25 CT scan abdomen 3087.25 CT scan abdomen before and after contrast 2469.50 CT scan abdomen with contrast 1110.00 CT scan abdomen with contrast 1989.50 CT scan chest 2521.50 CT scan chest with contrast 2038.25 CT scan head or brain 1157.50 CT scan head or brain before and after contrast 2553.00 CT scan head or brain with contrast 1970.25 CT scan leg 2309.75 CT scan leg with contrast injection 752.25 CT scan of abdomen and pelvis 1296.75 CT scan of abdomen and pelvis before and after contrast 2144.25 CT scan of abdomen and pelvis before and after contrast 2144.00 CT scan of abdomen and pelvis with contrast 1163.25 CT scan of abdomen and pelvis with contrast 1715.25 CT scan of abdominal and pelvic blood vessels with contrast 5218.50 CT scan of abdominal aorta and both leg arteries with contrast 607.75 CT scan of abdominal aorta and both leg arteries with contrast 3241.25 CT scan of abdominal blood vessels with contrast 1927.25 CT scan of arm 2563.50 CT scan of arm blood vessels with contrast 2118.75 CT scan of arm with contrast 1157.50 CT scan of blood vessel of head with contrast 2752.75 CT scan of blood vessels in chest with contrast 721.25 CT scan of blood vessels in chest with contrast 1877.75 CT scan of cranial cavity 2199.75 CT scan of cranial cavity before and after contrast 2064.00 CT scan of cranial cavity with contrast 638.25 CT scan of cranial cavity with contrast 758.25 CT scan of face 1806.75 CT scan of face 796.50 CT scan of face 325.75 CT scan of face 2803.75 CT scan of face before and after contrast PRICE Description 2243.50 CT scan of face with contrast 1482.00 CT scan of heart blood vessels and grafts with contrast dye 3609.75 CT scan of lower leg blood vessels with contrast 2771.50 CT scan of lower spine 3353.25 CT scan of lower spine before and after contrast 3046.75 CT scan of lower spine with contrast 2091.25 CT scan of middle spine 2298.75 CT scan of middle spine with contrast 2257.25 CT scan of neck 2755.75 CT scan of neck before and after contrast 1157.50 CT scan of neck blood vessels with contrast 2506.50 CT scan of neck with contrast 3022.75 CT scan of pelvic blood vessels with contrast 2747.75 CT scan of pelvis before and after contrast 2097.25 CT scan of upper spine 2623.25 CT scan of upper spine with contrast 612.75 CT scan of upper spine with contrast 1950.00 CT scan pelvis 2340.75 CT scan pelvis with contrast 1877.75 CT TEMP BONES WO CONTRAST 250.75 Culture for acid-fast bacilli 154.75 Culture for acid-fast bacilli 2.35 CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION [44283] 0.04 CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET [26173] 8.39 CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION [8608] 0.02 CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET [5291] 194.25 Cyanocobalamin (vitamin B-12) level 6.00 CYANOCOBALAMIN 500 MCG TAB EA 0.97 CYCLOBENZAPRINE 10 MG TABLET [6480] 6.00 CYCLOBENZAPRINE 5MG TAB EA 5.40 CYCLOPENTOLATE 2 % EYE DROPS [47437] 9.76 CYCLOPENTOLATE 2 % EYE DROPS [47437] 14.76 CYCLOPENTOLATE 2 % EYE DROPS [47437] 824.06 CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS SOLUTION [42451] 1648.13 CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS SOLUTION [42452] 439.50 CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS SOLUTION [42450] 11.15 CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE [52797] 303.00 Cyclosporine level 7.00 CYCLOSPORINE PER 25MG, 25MG CA 1.07 CYPROHEPTADINE 4 MG TABLET [5816] 300.00 CYTOLOGY BRUSH 8.01 DABIGATRAN ETEXILATE 150 MG CAPSULE [119046] 8.01 DABIGATRAN ETEXILATE 75 MG CAPSULE [119358] 14.40 DACARBAZINE 200 MG INTRAVENOUS SOLUTION [10520] 1841.64 DALBAVANCIN 500 MG INTRAVENOUS SOLUTION [142890] 1.94 DANTROLENE 25 MG CAPSULE [44539] 534.59 DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION [54582] 127.13 DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION [149877] 1857.60 DARBEPOETIN ALFA 100 MCG/0.5 ML IN POLYSORBATE INJECTION SYRINGE [88219] 4644.00 DARBEPOETIN ALFA 150 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE [88351] 4644.00 DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE [88214] 4644.00 DARBEPOETIN ALFA 300 MCG/0.6 ML IN POLYSORBATE INJECTION SYRINGE [88217] 928.80 DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE [88215] 4644.00 DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE [87339] 1857.60 DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE [88218] 3769.75 DBX MIX 10CC 2406.00 DBX MIX 5CC 1077.25 DBX PUTTY 2.5CC 1965.75 DBX PUTTY 5CC 1140.00 DECITABINE 50 MG INTRAVENOUS SOLUTION [87152] 910.25 Declotting infusion of implanted central venous access device or catheter 11.29 DEFEROXAMINE 500 MG SOLUTION FOR INJECTION [39169] 914.51 DEGARELIX 120 MG SUBCUTANEOUS SOLUTION [111040] 586.14 DEGARELIX 80 MG SUBCUTANEOUS SOLUTION [111032] 213.75 Dehydroepiandrosterone (DHEA) hormone level 217.50 Dehydroepiandrosterone (DHEA-S) hormone level 263.25 Demonstration and/or evaluation of manual maneuvers to chest wall to assist movement of lung secretions 187.00 Demonstration and/or evaluation of patient use of aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device 1612.05 DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION [119545] 1462.87 DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE [116929] 870.75 DEPUY 1 GENTAMICIN BN CMNT 40G 7.62 DESMOPRESSIN 0.2 MG TABLET [45242] 70.55 DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION [10519] 380.00 Destruction of 15 or more skin growths 215.00 Destruction of 15 or more skin growths 35.00 Destruction of 2-14 skin growths 2672.00 Destruction of extensive growths of external female genitals PRICE Description 1764.00 Destruction of external female genital growths 1028.00 Destruction of peripheral nerve or branch 206.00 Destruction of skin growth 708.75 Destruction of skin growth (less than 10 sq centimeters) 215.00 Destruction of up to 14 skin growths 11.95 DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [102745] 241.25 Detection of infectious agent antibody 194.25 Detection of infectious agent antibody 70.25 Detection test for candida species (yeast) 170.00 Detection test for chlamydia 136.00 Detection test for chlamydia 135.00 Detection test for chlamydia 136.00 Detection test for clostridium difficile 131.75 Detection test for cryptosporidium (parasite) 369.75 Detection test for Cytomegalovirus (CMV) 374.25 Detection test for cytomegalovirus, quantification 62.25 Detection test for entamoeba histolytica group (parasite) 587.00 Detection test for enterovirus (intestinal virus) 70.25 Detection test for gardnerella vaginalis (bacteria) 25.25 Detection test for Hepatitis B surface antigen 55.75 Detection test for Hepatitis B surface antigen 793.00 Detection test for Hepatitis B virus 180.25 Detection test for Hepatitis Be surface antigen 467.50 Detection test for Hepatitis C virus 729.25 Detection test for Hepatitis C virus 481.50 Detection test for Hepatitis C virus 842.50 Detection test for herpes simplex virus 247.00 Detection test for herpes simplex virus 253.50 Detection test for histoplasma capsulatum (parasite) 105.75 Detection test for HIV-1 and HIV-2 564.75 Detection test for HIV-1 virus 669.25 Detection test for HIV-1 virus 44.25 Detection test for identification of organism 76.75 Detection test for influenza A virus 76.75 Detection test for influenza B virus 270.25 Detection test for multiple types influenza virus 1527.50 Detection test for multiple types of respiratory virus 136.00 Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria) 135.00 Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria) 520.75 Detection test for organism 530.75 Detection test for organism 190.75 Detection test for respiratory syncytial virus 419.50 Detection test for Rotavirus 160.50 Detection test for Strep (Streptococcus, group A) 119.25 Detection test for Streptococcus, group B (bacteria) 70.25 Detection test for Trichomonas vaginalis (genital parasite) 170.00 Detection test for Trichomonas vaginalis (genital parasite) 429.75 Determination of lung volumes using gas dilution or washout 403.00 Determination of lung volumes using plethysmography 0.21 DEXAMETHASONE 0.5 MG TABLET [2619] 1.21 DEXAMETHASONE 4 MG TABLET [2624] 3.00 Dexamethasone sodium phos 12.94 DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS [8828] 1.56 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION [8803] 2.88 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION [8806] 1.78 DEXAMETHASONE(PF) PER 1MG, 1.01 DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV [136578] 56.00 DEXMEDETOMIDINE PER 2ML,200MCG 0.15 DEXTRAN 70-HYPROMELLOSE 0.1 %-0.3 % EYE DROPS [122778] 1.71 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET [30497] 0.50 DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP [5559] 0.57 DEXTROMETHORPHAN-GUAIFENESIN 30 MG-600 MG TABLET EXTENDED RELEASE12 HR [6297] 0.02 DEXTROSE 1.5% PERITONEAL SOLN, 0.01 DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION [3922] 1.00 DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE - FOR ED USE [617604] 0.11 DEXTROSE 40 % ORAL GEL [45232] 0.01 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4204] 0.01 DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4206] 0.01 DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4213] 0.01 DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION [4209] 0.12 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK [85043] 0.01 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION [3347] 0.02 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION [3347] 0.05 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION [3347] 15.55 DEXTROSE 5 100ML 0.01 DEXTROSE 5% AND 0.3 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4205] 25.50 DEXTROSE 5% IN WATER IV SOLN PRICE Description 0.07 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION [31153] 0.20 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE [31255] 0.02 DEXTRSE 2.5% PERIT SOLN,2500ML 0.02 DEXTRSE 4.25% PERITSOLN,2500ML 76.50 Diab manage trn per indiv 78.75 Diab manage trn ind/group 27.00 Diagnostic examination of ear and nose 247.00 Diagnostic examination of nasal passages using an endoscope 625.00 Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope 247.00 Diagnostic examination of voice box using flexible endoscope 145.42 Diagnostic imaging of eyes 70.00 Diagnostic imaging of optic nerve of eye 70.00 Diagnostic imaging of retina 3951.75 Diagnostic test for sleep disorder 2901.75 Diagnostic test for sleep disorder 275.00 Diagnostic testing in a pulmonary function lab 382.75 Diagnostic testing in a pulmonary function lab 0.43 DIAZEPAM 10 MG TABLET [652] 0.24 DIAZEPAM 2 MG TABLET [650] 281.59 DIAZEPAM 2.5 MG RECTAL KIT [48418] 0.32 DIAZEPAM 5 MG TABLET [651] 16.41 DIAZEPAM 5 MG/ML INJECTION SYRINGE [3319] 334.04 DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT [84557] 0.55 DICLOFENAC 1 % TOPICAL GEL [102842] 1.47 DICLOFENAC SODIUM 50 MG TABLET,DELAYED RELEASE [2631] 1.77 DICLOFENAC SODIUM 75 MG TABLET,DELAYED RELEASE [2632] 0.60 DICYCLOMINE 10 MG CAPSULE [5721] 50.44 DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION [40923] 0.60 DICYCLOMINE 20 MG TABLET [5702] 2.07 DIFLUNISAL 500 MG TABLET [5145] 14.91 DIGOXIN 125 MCG (0.125 MG) TABLET [10285] 3.30 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION [10328] 216.25 Digoxin level 157.62 DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION [40728] 332.25 Dihydroxyvitamin D, 1, 25 level 420.00 Dilation of tear-drainage opening 0.45 DILTIAZEM 30 MG TABLET [479] 0.32 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION [3294] 0.38 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION [3294] 0.43 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION [3294] 7.00 DILTIAZEM 60MG TAB 3.97 DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR [5082] 1.20 DILTIAZEM SR 120 MG 24 HR CAP [42210] 0.51 DILTIAZEM SR 180 MG 24 HR CAP [28893] 2.05 DILTIAZEM SR 240 MG 24 HR CAP [5207] 492.71 DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE [47783] 0.03 DIPHENHYDRAMINE - MYLANTA DS - LIDOCAINE VISCOUS [612717] 0.18 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR [47470] 0.01 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID [5549] 0.08 DIPHENHYDRAMINE 25 MG CAPSULE [5722] 0.14 DIPHENHYDRAMINE 50 MG CAPSULE [6758] 1.28 DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [7394] 5.00 Diphenhydramine hcl injectio 0.70 DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET [40864] 1.40 DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID [2566] 1.06 DIPYRIDAMOLE 25 MG TABLET [686] 848.75 Direct Admit for Observation Care per hour 1745.00 DISCISSION 2ND CATARACT 22.00 DISPOSABLE CATHETER NEEDLE 1.42 DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE [49173] 7.00 DIVALPROEX 125MG EC TAB 1.76 DIVALPROEX 250 MG TABLET,DELAYED RELEASE [44568] 3.23 DIVALPROEX 500 MG TABLET,DELAYED RELEASE [45891] 2.45 DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR [52500] 3.83 DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR [47489] 290.25 DNA testing for genetic defects 0.12 DOBUTAMINE 1,000 MG/250 ML(4,000 MCG/ML) IN 5 % DEXTROSE IV [83] 365.15 DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION [119179] 365.15 DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION [119180] 9.28 DOCOSANOL 10 % TOPICAL CREAM [44106] 0.04 DOCUSATE SODIUM 100 MG CAPSULE [6249] 0.07 DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID [5553] 8.56 DOFETILIDE 125 MCG CAPSULE [45509] 8.56 DOFETILIDE 250 MCG CAPSULE [45380] 8.56 DOFETILIDE 500 MCG CAPSULE [49237] 7.79 DONEPEZIL 10 MG TABLET [45035] 7.79 DONEPEZIL 5 MG TABLET [44390] PRICE Description 0.08 DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN [110218] 458.50 Doppler ultrasound study of color-directed heart blood flow, rate, and valve function 458.50 Doppler ultrasound study of heart blood flow, valves, and chambers 4.59 DORZOLAMIDE 2 % EYE DROPS [49581] 12.26 DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS [48286] 0.92 DOXAZOSIN 2 MG TABLET [28152] 3.95 DOXAZOSIN 4 MG TABLET [28153] 0.64 DOXEPIN 10 MG CAPSULE [8474] 2.00 DOXEPIN 100 MG CAPSULE [7433] 0.84 DOXEPIN 25 MG CAPSULE [7479] 3.96 DOXERCALCIFEROL 2 MCG/ML INTRAVENOUS SOLUTION [47475] 28.00 DOXERCLCIFEROL 2MCG/ML INJ,2ML 2.16 DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION [109594] 2.66 DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION [109593] 116.28 DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION [44101] 1.44 DOXYCYCLINE HYCLATE 100 MG CAPSULE [2354] 14.52 DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION [26741] 348.50 Drainage of abscess 177.00 Drainage of abscess 363.50 Drainage of abscess 764.25 Drainage of abscess, cyst, or blood accumulation of dental bone 3179.25 Drainage of blood or fluid accumulation 1500.00 Drainage of blood or fluid accumulation 5313.50 Drainage of breast abscess 347.50 Drainage of finger abscess 1543.50 Drainage of fluid from abdominal cavity using imaging guidance 880.00 Drainage of fluid from abdominal cavity using imaging guidance 1620.75 Drainage of fluid from abdominal cavity using imaging guidance 2207.50 Drainage of fluid-filled sac (bursa) of upper arm or elbow 5500.00 Drainage of heart sac 348.50 Drainage of multiple abscess 375.00 Drainage of multiple abscess 364.50 Drainage of multiple abscess 5701.00 Drainage of rectal abscess 3003.75 Drainage of rectal abscess 936.50 Drainage of tailbone cyst 640.00 Drainage of tailbone cyst 3097.25 Drainage of tailbone cyst 395.75 Drainage of tonsil abscess 372.75 Dressing change and/or removal of burn tissue (5% to 10% total body surface) 372.75 Dressing change and/or removal of burn tissue (less than 5% total body surface) 391.50 Dressing change and/or removal of burn tissue (less than 5% total body surface) 5.30 DRONABINOL 2.5 MG CAPSULE [46345] 170.00 Drug test def 1-7 classes 62.75 Drug test def 1-7 classes 162.00 Drug test def 1-7 classes 91.25 Drug test def 1-7 classes 8.89 DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [56270] 1.72 DULOXETINE 30 MG CAPSULE,DELAYED RELEASE [56271] 1.72 DULOXETINE 60 MG CAPSULE,DELAYED RELEASE [56272] 10.00 DUO NEB 433.30 DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION [157325] 6.05 DUTASTERIDE 0.5 MG CAPSULE [52424] 46.00 Eardrum testing using ear probe 206.50 ED AMOXICILLIN-CLAV 400MG-57MG 21.25 Education 86.00 Education 84.50 Education 1325.00 EGD 2504.25 EGD LESION ABLATION 1807.00 EGD W/ BIOPSY 1511.75 EGD W/DILATATION 3693.75 EGD W/POLYPECTOMY/SNARE TECHNQ 2673.50 EGD WITH BANDING LIGATION 21.00 Ekg tracing for initial prev 157.50 Elastography ultrasound of additional lesion 341.25 Elastography ultrasound of first lesion 363.75 Elastography ultrasound of organ tissue 92.50 Elec stim other than wound 240.00 Electronic analysis of implanted brain, spinal cord or peripheral stimulation device with complex cranial nerve stimulator programming 133.00 Electronic analysis of implanted brain, spinal cord or peripheral stimulation device with complex spinal cord or peripheral nerve stimulator programming 80.00 Electronic analysis of implanted brain, spinal cord or peripheral stimulation device with simple cranial nerve stimulator programming 162.00 Electronic assessment of bladder emptying 2131.20 ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION [151710] 2841.60 ELOTUZUMAB 400 MG INTRAVENOUS SOLUTION [151711] 367.50 Emergency department visit, low to moderately severe problem 630.00 Emergency department visit, moderately severe problem PRICE Description 787.50 Emergency department visit, problem of high severity 1522.50 Emergency department visit, problem with significant threat to life or function 210.75 Emergency department visit, self limited or minor problem 1007.00 EMERGENCY HEMODIALYSIS 594.50 Emergent insertion of breathing tube into windpipe cartilage using an endoscope 1440.75 Emergent insertion of breathing tube into windpipe cartilage using an endoscope 1852.50 Emergent surgical opening of windpipe for insertion of breathing tube 19.71 EMPAGLIFLOZIN 10 MG TABLET [143841] 19.71 EMPAGLIFLOZIN 25 MG TABLET [143840] 4.56 EMPTY CONTAINER, PLASTIC BAG 250 ML [4216] 70.32 EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET [56267] 1.94 ENALAPRIL MALEATE 10 MG TABLET [28143] 1.85 ENALAPRIL MALEATE 5 MG TABLET [28142] 4.29 ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION [28112] 4.80 ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION [28112] 2164.50 ENDO SM INTESTINE,DIAG,NO SPEC 100.50 ENDOVIVE REPLACEMENT PEG TUBE 216.25 ENDURANCE 40MG BONE CEMENT 99.34 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE [50530] 149.07 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE [48296] 99.23 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE [50527] 99.23 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE [50531] 99.35 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE [50528] 99.35 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE [50529] 149.07 ENOXAPARIN SODIUM 120 MG/0.8 ML SUBQ SYRG [52014] 3.96 ENTACAPONE 200 MG TABLET [46529] 200.75 Enzyme activity measurement 7.00 EPHEDRINE 50MG/ML INJ, 1ML 56.75 EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION [154292] 0.55 EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE [3898] 247.01 EPINEPHRINE 0.15 MG/0.15 ML AUTO-INJECTOR (FOR 33 TO 66 LB PATIENTS) [114943] 365.17 EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR [48675] 17.95 EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION [122648] 10.02 EPINEPHRINE 1 MG/ML INJECTION SOLUTION [4112] 2625.00 Episiotomy or vaginal repair 4.10 EPLERENONE 25 MG TABLET [52307] 320.69 EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION [49156] 641.40 EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION [46658] 1282.80 EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION [46965] 132.36 EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION [161614] 529.44 EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION [161864] 2019.25 ERCP 6842.50 ERCP DUCT STENT PLACEMENT 4359.50 ERCP EA DUCT/AMPULLA DILATE 4359.50 ERCP REMOVE FOREIGN BODY DUCT 6205.25 ERCP W/SPHINCTEROTOMY 1.97 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE [48547] 154.39 ERTAPENEM 1 GRAM SOLUTION FOR INJECTION [49738] 7.00 ERYTHROMYCIN 250MG BASE TAB 5.33 ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [5890] 10.22 ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [5890] 89.28 ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION [31242] 250.75 Erythropoietin (protein) level 4.32 ESCITALOPRAM 10 MG TABLET [52180] 4.51 ESCITALOPRAM 20 MG TABLET [52181] 6.00 ESCITALOPRAM 5MG TAB EACH 0.62 ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION [40010] 2.25 ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV [45178] 842.50 ESOPHAGEAL PH ELECTRODE PLACEM 120.25 Established patient office or other outpatient visit, typically 5 minutes 70.00 Established patient periodic preventive medicine examination age 18-39 years 250.00 Established patient periodic preventive medicine examination infant younger than 1 year 70.00 Established patient periodic preventive medicine examination, age 1 through 4 years 70.00 Established patient periodic preventive medicine examination, age 12 through 17 years 70.00 Established patient periodic preventive medicine examination, age 5 through 11 years 222.25 Estradiol (hormone) level 9.74 ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM [48776] 0.68 ESTRADIOL 1 MG TABLET [6528] 105.00 Estriol (hormone) level 194.25 Estriol (hormone) level 572.00 Estrogen analysis 401.50 Estrogen analysis 187.00 Estrone (hormone) level 230.50 Ethosuximide level 8.64 ETIDRONATE DISODIUM 400 MG TABLET [48254] 0.75 ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION [24641] 1121.78 ETONOGESTREL 68 MG SUBDERMAL IMPLANT [88213] PRICE Description 2.99 ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION [3344] 300.00 Euflexxa inj per dose 111.00 Evaluation and prescription of speech-generating and alternative communication device 122.25 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 139.00 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 319.50 Evaluation of fine needle aspirate 305.50 Evaluation of occupational therapy established plan of care, typically 60 minutes 282.50 Evaluation of occupational therapy, typically 30 minutes 294.00 Evaluation of occupational therapy, typically 45 minutes 433.50 Evaluation of patient with prescription of speech-generating and alternative communication device 213.00 Evaluation of physical therapy, typically 20 minutes 224.00 Evaluation of physical therapy, typically 30 minutes 235.00 Evaluation of physical therapy, typically 45 minutes 2137.75 Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement 283.50 Evaluation of single or dual chamber pacing cardioverter-defibrillator at time of implantation or replacement 2066.50 Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming 279.75 Evaluation of speech fluency 209.25 Evaluation of speech sound production 472.50 Evaluation of speech sound production with evaluation of language comprehension and expression 433.50 Evaluation of swallowing function 14537.75 Event recorder, cardiac 1.00 EVIDENCE COLLECTION 114.00 Examination of cornea and iris using lens device and slit lamp 176.00 Examination of the vagina and cervix using an endoscope 2193.75 Exchange of abdominal cavity drainage catheter using imaging guidance 1465.25 Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring 222.50 Exercise test for spasm of lung airways 100.00 EXPEDITED COVID 3307.50 Exploration of penetrating wound of abdomen, flank, or back 3928.50 Exploration of penetrating wound of arm or leg 2195.75 External shock to heart to regulate heart beat 128.00 Eye and medical examination for diagnosis and treatment, established patient 128.00 Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits 128.00 Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits 11.30 EZETIMIBE 10 MG TABLET [52412] 1040.00 F18 fdg 330.75 Family psychotherapy including patient, 50 minutes 0.54 FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION [101199] 0.54 FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION [28904] 1.74 FAMOTIDINE 20 MG TABLET [28881] 0.20 FAT EMULSION 20% IV SOLN, 250M 2045.25 FB REMOVE MUSCLE/TENDON 20520 13.20 FEBUXOSTAT 40 MG TABLET [110835] 2.38 FENOFIBRATE 160 MG TABLET [82238] 0.79 FENOFIBRATE 54 MG TABLET [108488] 0.38 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [4270] 0.45 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [4270] 4.97 FENTANYL 100 MCG/2ML VIAL 78.71 FENTANYL 100 MCG/HR TRANSDERMAL PATCH [46753] 20.30 FENTANYL 12 MCG/HR TRANSDERMAL PATCH [82230] 21.27 FENTANYL 25 MCG/HR TRANSDERMAL PATCH [48755] 26.36 FENTANYL 50 MCG/HR TRANSDERMAL PATCH [44096] 59.31 FENTANYL 75 MCG/HR TRANSDERMAL PATCH [49029] 0.09 FENTANYL IV INFUSION 2000 MCG IN NS 100 ML PYXIS [614476] 1.75 FENTANYL PER 0.1MG, 0.05MG/ML 7.00 FENTANYL PER 0.1MG, 0.05MG/ML 5.30 FENTANYL, PER 100MCG,50MCG 85.94 FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION [137807] 166.25 Ferritin (blood protein) level 0.06 FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET [89134] 0.03 FERROUS SULFATE 325 MG (65 MG IRON) TABLET [6239] 637.75 Fetal contraction stress test 168.75 Fetal hemoglobin level 57.25 Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation 59.00 Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation 72.25 Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation 252.50 Fetal monitoring during labor by consulting physician 393.50 Fetal non-stress test 176.00 Fetal non-stress test 138.00 Fibrinogen (factor 1) activity measurement 35.00 Fibrinogen (factor 1) antigen detection 231.95 FIDAXOMICIN 200 MG TABLET [122738] 377.80 FILGRASTIM 300 MCG/ML INJECTION SOLUTION [45742] 376.00 FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION [52755] 658.46 FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE [148731] 140.50 FILSHIE CLIP 1.08 FINASTERIDE 5 MG TABLET [49340] PRICE Description 1.00 Fine needle aspiration of additional lesion using CT guidance 26.25 Fine needle aspiration of additional lesion using fluoroscopice guidance 26.25 Fine needle aspiration of additional lesion using ultrasound guidance 1.00 Fine needle aspiration of additional lesion using ultrasound guidance 375.00 Fine needle aspiration of first lesion 1218.00 Fine needle aspiration of first lesion using CT guidance 1218.00 Fine needle aspiration of first lesion using fluoroscopice guidance 1218.00 Fine needle aspiration of first lesion using ultrasound guidance 203.50 First degree burn treatment 385.75 First degree burn treatment 176.00 Fitting and insertion of vaginal support device 20.00 Fitting of contact lens for treatment of ocular surface disease 3.58 FLECAINIDE 100 MG TABLET [30587] 6.00 FLECAINIDE 50 MG TAB, EACH 1906.00 FLEX SIGMOID W/BIOPSY 238.87 FLOSEAL HEMOSTATIC MATRIX 5 ML KIT [613283] 319.50 Flow cytometry technique for DNA or cell analysis 103.75 Flow cytometry technique for DNA or cell analysis 168.50 Flow cytometry technique for DNA or cell analysis 172.00 Flow cytometry technique for DNA or cell analysis 52.00 FLU VACCINE ADMIN 8.75 FLUCONAZOLE 100 MG TABLET [43062] 14.01 FLUCONAZOLE 150 MG TABLET [43064] 0.22 FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK [43068] 0.08 FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK [43067] 113.40 FLUDARABINE 50 MG INTRAVENOUS SOLUTION [41160] 0.75 FLUDROCORTISONE 0.1 MG TABLET [30479] 936.50 Fluid collection drainage by catheter using imaging guidance, accessed through the skin 1943.00 Fluid collection drainage by catheter using imaging guidance, accessed through the skin 1.63 FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION [43498] 2.34 FLUOCINOLONE 0.025 % TOPICAL CREAM [5886] 2.25 FLUOCINOLONE 0.025 % TOPICAL OINTMENT [5887] 0.15 FLUORESCEIN 0.6 MG EYE STRIPS [46801] 0.23 FLUORESCEIN 1 MG EYE STRIPS [46173] 9.13 FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION [45406] 521.75 Fluoroscopic and video recorded motion evaluation of swallowing function 682.25 Fluoroscopic guidance for injection into spine or muscle next to spine 828.25 Fluoroscopic guidance for insertion of needle 242.00 Fluoroscopic guidance for insertion, replacement or removal of central venous access device 0.36 FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION [106097] 0.31 FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION [106098] 0.28 FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION [106099] 0.33 FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [106096] 0.10 FLUOXETINE 10 MG CAPSULE [29111] 0.11 FLUOXETINE 20 MG CAPSULE [29095] 0.58 FLUPHENAZINE 1 MG TABLET [6354] 0.69 FLUPHENAZINE 2.5 MG TABLET [6355] 3.49 FLURBIPROFEN 0.03 % EYE DROPS [18439] 5.80 FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER [137895] 5.80 FLUTICASONE FUROATE 200 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER [147454] 63.75 FLUTICASONE HFA 44MCG/PUFF INH 31.87 FLUTICASONE PROPIONATE 115 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER [88375] 47.27 FLUTICASONE PROPIONATE 230 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER [88376] 5.27 FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION [49145] 0.19 FOLIC ACID 1 MG TABLET [5703] 5.41 FOLIC ACID 5 MG/ML INJECTION SOLUTION [24635] 180.25 Folic acid level 257.50 Folic acid level 880.00 Follow-up or limited ultrasound examination of heart 34.75 FONDAPARINUX PER 0.5MG, 2.5MG 384.26 FOSAPREPITANT 150 MG INTRAVENOUS SOLUTION [119459] 2.88 FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION [102472] 0.79 FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION [102473] 2617.00 FREEZE DRIED CRUSHED BONE 232.69 FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE [50473] 219.75 Fungal blood culture (mold or yeast) 200.75 Fungal culture (mold or yeast) 225.00 Fungal culture (mold or yeast) of skin, hair, or nail 147.25 Fungal culture, yeast 0.69 FUROSEMIDE 10 MG/ML INJ [3967] 0.87 FUROSEMIDE 10 MG/ML INJ [3967] 1.32 FUROSEMIDE 10 MG/ML INJ [3967] 0.15 FUROSEMIDE 20 MG TABLET [684] 0.06 FUROSEMIDE 40 MG TABLET [685] 0.45 FUROSEMIDE 80 MG TABLET [649] 2013.00 FX CLSD METACRPL MANIP 230.50 G6PD (enzyme) level PRICE Description 88.75 Ga67 gallium 0.58 GABAPENTIN 100 MG CAPSULE [43401] 1.38 GABAPENTIN 300 MG CAPSULE [43402] 1.22 GABAPENTIN 400 MG CAPSULE [43403] 187.25 Gabapentin level 15.00 Gad-base mr contrast nos,1ml 4.22 GALANTAMINE 4 MG TABLET [45391] 3090.25 GALLIUM SPECT 185.75 Gammaglobulin (immune system protein) measurement 35.75 Gammaglobulin (immune system protein) measurement 316.50 Gammaglobulin (immune system protein) measurement 47.25 Gammaglobulin (immune system protein) measurement 225.00 Gastrin (GI tract hormone) level 196.75 GASTROVIEW CONTRAST AGENT 146.00 GASTROVIEW MO 40.25 GB CHEM PROFILE 105.00 GB HCG 0.21 GEL DRESSING TOPICAL [50553] 49.99 GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE [45780] 10.31 GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE [48556] 33.44 GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 50 TOPICAL SPONGE [48059] 8.00 Gelsyn-3 injection 0.1 mg 2.04 GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION [125678] 2.32 GEMFIBROZIL 600 MG TABLET [2340] 210.75 Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants 2110.75 Gene analysis (adenomatous polyposis coli), full gene sequence 196.75 Gene analysis (coagulation factor V) Leiden variant 1155.50 Gene analysis (cystic fibrosis transmembrane conductance regular) common variants 281.50 Gene analysis (hemochromatosis) common variants 562.75 Gene analysis (Janus kinase 2) variant 196.75 Gene analysis (prothrombin, coagulation factor II) A variant 206.75 Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants 37991.50 Generator neuro rechg bat sy 45764.25 Generator, neuro non-recharg 308.25 Gentamicin (antibiotic) level 3.29 GENTAMICIN 0.1 % TOPICAL CREAM [5891] 0.24 GENTAMICIN 0.1 % TOPICAL OINTMENT [5892] 8.57 GENTAMICIN 0.3 % EYE DROPS [6434] 1.39 GENTAMICIN 40 MG/ML INJECTION SOLUTION [3308] 1.94 GENTAMICIN 40 MG/ML INJECTION SOLUTION [3308] 2.36 GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION [100028] 66.25 GLENBEIGH THYROID PANEL 0.40 GLIMEPIRIDE 1 MG TABLET [46189] 1.23 GLIMEPIRIDE 2 MG TABLET [46122] 1.23 GLIMEPIRIDE 4 MG TABLET [47454] 7.00 GLIPIZIDE 2.5MG XL TAB 0.38 GLIPIZIDE 5 MG TABLET [2345] 7.00 GLIPIZIDE 5MG XL TAB 336.96 GLUCAGON (HUMAN RECOMBINANT) 1 MG SOLUTION FOR INJECTION [47961] 205.92 GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML SOLUTION FOR INJECTION [118031] 39.25 Glucose (sugar) level on body fluid 66.25 Glucose (sugar) level on body fluid 103.75 Glutamyltransferase (liver enzyme) level 7.00 GLYBURIDE 2.5MG TAB 7.00 GLYBURIDE 3MG TAB 7.00 GLYBURIDE 5MG TAB 82.75 Glycated protein level 0.11 GLYCERIN (ADULT) RECTAL SUPPOSITORY [6248] 0.13 GLYCERIN (CHILD) RECTAL SUPPOSITORY [6247] 0.06 GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS [83775] 8.40 GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION [1962] 1.06 GLYCOPYRROLATE 1 MG TABLET [40412] 545.55 GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION [137948] 119.25 Gonadotropin (reproductive hormone) analysis 105.00 Gonadotropin, chorionic (reproductive hormone) level 238.50 Gonadotropin, follicle stimulating (reproductive hormone) level 237.00 Gonadotropin, luteinizing (reproductive hormone) level 1483.00 GORETEX PATCH 762.30 GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT [44653] 694.50 Grafix stravix prime pl sqcm 7129.25 Graft, vascular 4639.25 Graft, vascular 3224.00 Graft, vascular 1152.75 Graftjacket 268.75 Group psychotherapy 147.25 Group treatment of speech, language, voice, communication, and/or hearing processing disorder 0.06 GUAIFENESIN 100 MG/5 ML ORAL LIQUID [46030] PRICE Description 7.00 GUAIFENESIN 600MG SR TAB 423.50 Guide wire 34.00 Guide wire 39.25 Guide wire 164.00 Guide wire 92.75 Guide wire 320.00 Guide wire 129.50 HALCINONIDE 0.1% OINT, 30GM 0.46 HALOPERIDOL 1 MG TABLET [6336] 0.78 HALOPERIDOL 5 MG TABLET [6338] 31.07 HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION [5726] 0.45 HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE [5233] 7.19 HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION [24330] 166.25 Haptoglobin (serum protein) level 401.25 Hbot, full body chamber, 30m 249.00 HDL cholesterol level 162.00 Hearing test for children 485.00 Heart rhythm analysis, interpretation and report of 48-hour EKG 458.50 Heart rhythm tracing of 48-hour EKG 134.50 Heavy metal level 1446.25 HELICAL BLADE 80MM-120MM 154.00 Hemoglobin A1C level 52.00 Hemoglobin A1C level 180.25 Hemoglobin analysis and measurement 361.50 Hemoglobin analysis and measurement 53.75 Hemoglobin measurement 59.50 HEM-O-LOK CLIP-LARGE 91.50 Hemosiderin (hemoglobin breakdown product) analysis 1448.50 HEMOSPLIT 5744420 0.32 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION [44427] 2.88 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION [44427] 6.16 HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION [48865] 0.04 HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN [86562] 2.40 HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION [49187] 163.25 Heparin assay 52.00 Heparin assay 0.74 HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE [86551] 247.50 Hepatitis B core antibody (IgM) measurement 60.75 Hepatitis B core antibody measurement 183.69 Hepatitis B immune globulin for injection into muscle 108.25 Hepatitis B surface antibody measurement 89.00 Hepatitis Be antibody measurement 43.75 Hepatitis C antibody measurement 32.50 Hepatitis C antibody measurement 71.75 Hepatitis C antibody measurement 0.04 HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4113] 289.25 HI FLOW OXYGEN 597.75 HLA class I typing, low resolution one antigen equivalent 147.50 HLA class II typing high resolution one allele or allele group 244.00 HLA class II typing high resolution one locus 341.75 HLA class II typing high resolution one locus 295.50 HLA class II typing low resolution one antigen equivalent 34.00 Hocm <=149 mg/ml iodine, 1ml 970.50 HOLTER MONITOR 48 HRS 241.50 Homocysteine (amino acid) level 0.39 HONEY 80 % TOPICAL GEL [135106] 145.00 Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle 70.00 Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle 308.25 Hosp grade elec breast pump 55.50 Hospital observation care, typically 30 minutes 154.00 Hospital outpt clinic visit 250.00 Hospital outpt clinic visit 2.90 HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION [142610] 230.00 Hyalgan supartz visco-3 dose 66.96 HYALURONIDASE 150 UNIT/ML INJECTION EXTRAVASATION ANTIDOTE [613321] 0.42 HYDRALAZINE 10 MG TABLET [5823] 6.00 HYDRALAZINE 12.5MG SPLIT TAB 15.70 HYDRALAZINE 20 MG/ML INJECTION SOLUTION [9621] 0.51 HYDRALAZINE 25 MG TABLET [682] 0.56 HYDRALAZINE 50 MG TABLET [683] 166.00 Hydration infusion into a vein 294.50 Hydration infusion into a vein 31 minutes to 1 hour 514.50 Hydration infusion into a vein 31 minutes to 1 hour 0.43 HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE [8563] 0.15 HYDROCHLOROTHIAZIDE 25 MG TABLET [687] 1.57 HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [7513] 0.63 HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET [39038] PRICE Description 0.89 HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET [39037] 0.19 HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SYRUP [10205] 0.17 HYDROCORTISONE 1 % TOPICAL OINTMENT [5865] 0.42 HYDROCORTISONE 2.5 % TOPICAL CREAM [5894] 3.08 HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR [11288] 0.14 HYDROCORTISONE 2.5 % TOPICAL OINTMENT [5900] 0.34 HYDROCORTISONE 5 MG TABLET [40397] 14.43 HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY [6736] 16.12 HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION [116381] 0.06 HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM [41932] 6.48 HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE [137438] 4.32 HYDROMORPHONE 1 MG/ML INJECTION SYRINGE [1037] 0.71 HYDROMORPHONE 2 MG TABLET [2635] 3.29 HYDROMORPHONE 2 MG/ML INJECTION SYRINGE [1021] 0.72 HYDROMORPHONE 4 MG TABLET [2636] 0.17 HYDROMORPHONE PCA 0.5 MG/ML IN NS 100 ML PYXIS [600633] 4.39 HYDROXYCHLOROQUINE 200 MG TABLET [5245] 3.00 HYDROXYCHLOROQUINE, PER 1ML 263.25 Hydroxycorticosteroids, 17 (adrenal gland hormone) level 245.25 Hydroxyindolacetic acid (product of metabolism) level 394.75 Hydroxyprogesterone, 17-D (synthetic hormone) level 1.10 HYDROXYUREA 500 MG CAPSULE [2534] 0.28 HYDROXYZINE HCL 10 MG TABLET [6397] 0.40 HYDROXYZINE HCL 25 MG TABLET [6398] 25.63 HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION [9637] 0.30 HYDROXYZINE PAMOATE 25 MG CAPSULE [5962] 0.32 HYDROXYZINE PAMOATE 50 MG CAPSULE [5961] 0.85 HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET [47479] 7.00 HYOSCYAMINE 0.125 SL TAB 1.10 HYPROMELLOSE 2.5 % EYE DROPS [42330] 210.96 IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE [86283] 0.17 IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [8877] 0.08 IBUPROFEN 200 MG TABLET [5479] 0.08 IBUPROFEN 400 MG TABLET [5985] 0.10 IBUPROFEN 600 MG TABLET [5976] 0.09 IBUPROFEN 800 MG TABLET [5977] 44.52 IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION [614571] 276.25 Identification of mycobacteria (TB or TB like organism) 48.50 Identification of organisms by genetic analysis 326.00 Identification of red blood cell antibodies 200.75 IgE (immune system protein) level 110.25 Iliac art angio,cardiac cath 35.50 ILOPERIDONE 2MG TAB 35.50 ILOPERIDONE 6MG TAB 35.50 ILOPERIDONE 8MG TAB 854.75 Imaging for abscess or abnormal drainage tract procedure 244.00 Imaging for bone age assessment 443.50 Imaging for bone length assessment 734.25 Imaging for evaluation of swallowing function 467.00 Imaging from nose to rectum, single view, child 577.50 Imaging guidance for procedure, up to 1 hour 435.50 Imaging guidance for procedure, up to 1 hour 367.00 Imaging of 2 or more joints, single view 461.50 Imaging of blood vessels in back of eye using fluorescein dye 1071.75 Imaging of bone marrow limited area 618.50 Imaging of bone marrow multiple areas 772.00 Imaging of bone marrow whole body 270.00 Imaging of colon using enema 1155.00 Imaging of digestive tract done from the inside of the digestive tract 772.00 Imaging of liver and bile duct system 2949.75 Imaging of liver and bile duct system with use of drugs 1276.00 Imaging of liver and spleen 747.75 Imaging of lymphatic tissue and lymph node 1615.25 Imaging of parathyroid 772.00 Imaging of parathyroid with nuclear medicine study 854.75 Imaging of surgical specimen 788.75 Imaging of surgical specimen 1832.25 Imaging of urinary tract 907.75 Imaging of urinary tract with injection of contrast into a vein 11.65 IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION [44933] 7.00 IMIPRAMINE 25MG TAB 7.00 IMIPRAMINE 50MG TAB 14.31 IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN [119839] 16.63 IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION [147460] 119.25 Immunologic analysis for autoimmune disease 182.25 Immunologic analysis for detection of organism 259.00 Immunologic analysis for detection of organism PRICE Description 154.00 Immunologic analysis for detection of tumor antigen 285.75 Immunologic analysis for detection of tumor antigen 386.75 Immunologic analysis for detection of tumor antigen 336.00 Immunologic analysis technique on body fluid 336.00 Immunologic analysis technique on serum 280.00 Implantation of lower leg neurostimulator electrode, accessed through the skin 2043.00 Incision and drainage of abscess in scrotal sac of testicle 1130.75 Incision and drainage of ear canal abscess 936.50 Incision and drainage of external ear abscess or blood accumulation 1100.00 Incision and drainage of external ear abscess or blood accumulation 868.75 Incision and drainage of eyelid abscess 326.00 Incision and drainage of eyelid abscess 382.00 Incision and drainage of female genital gland abscess 176.00 Incision and drainage of female genital gland abscess 1250.25 Incision and drainage of female genitals abscess 314.00 Incision and drainage of female genitals abscess 1250.25 Incision and drainage of roof of mouth or its soft tissue projection 936.50 Incision of abscess, cyst, or blood accumulation in mouth 630.00 Incision of eardrum with insertion of eardrum tube under local or topical anesthesia 5834.25 Incision of elbow with exploration, drainage, or removal of foreign body 764.25 Incision of engorged external hemorrhoid 434.00 Incision of engorged external hemorrhoid 4020.25 Incision of penile foreskin 1535.00 Incision of tissue connecting tongue and floor of mouth 391.00 Incision, aspiration, and/or inflation of eardrum 1.00 Incisional biopsy of additional skin lesion 630.00 Incisional biopsy of single skin lesion 656.25 Incisional biopsy of single skin lesion 1.42 INDAPAMIDE 1.25 MG TABLET [3141] 26.25 Indium in-111 auto wbc 1358.00 Indium in-111 pentetreotide 335.75 INDOCYANINE 25MG INJ KIT 0.38 INDOMETHACIN 25 MG CAPSULE [5986] 204.00 INDOMETHACIN 50 MG RECTAL SUPPOSITORY [30358] 1401.38 INFLIXIMAB 100 MG INTRAVENOUS SOLUTION [47461] 130.00 Infliximab not biosimil 10mg 904.07 INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION [158533] 222.25 Infrared analysis of stone 145.00 Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour 268.75 Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour 103.00 Infusion into a vein for therapy, prevention, or diagnosis 178.50 Infusion into a vein for therapy, prevention, or diagnosis 555.75 Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour 504.00 Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour 145.00 Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion 268.75 Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion 145.00 Infusion of chemotherapy into a vein 362.25 Infusion of chemotherapy into a vein up to 1 hour 350.00 Infusion of chemotherapy into a vein up to 1 hour 499.50 Infusion of chemotherapy into a vein using push technique 294.50 Infusion of different chemotherapy drug or substance into a vein 294.50 Infusion of different chemotherapy drug or substance into a vein up to 1 hour 603.50 Infusion of drug into vein to dissolve coronary blood clot 40335.00 Infusion pump, programmable 30730.75 Infusion pump, programmable 496.00 Ingestion of test items for allergies, 120 minutes 105.00 Inhibin A (reproductive organ hormone) measurement 798.75 INIATE INFUSION PUMP 70.00 Initial new patient preventive medicine evaluation age 18-39 years 70.00 Initial new patient preventive medicine evaluation infant younger than 1 year 70.00 Initial new patient preventive medicine evaluation, age 1 through 4 years 70.00 Initial new patient preventive medicine evaluation, age 12 through 17 years 70.00 Initial new patient preventive medicine evaluation, age 5 through 11 years 642.75 Initiation and management of continued pressured respiratory assistance by mask or breathing tube 613.50 Initiation and management of continued pressured respiratory assistance by mask or breathing tube 1327.00 Initiation and management of continued pressured respiratory assistance by mask or breathing tube 0.25 Inj gadoterate meglumi 0.1ml 80.00 Inj., cosyntropin, 0.25 mg 102.75 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 106.50 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 155.75 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 93.00 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 127.00 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 360.00 INJECTION INTRALESIONAL 70.00 Injection of allergenic extracts into skin for immediate reaction analysis 38.00 Injection of allergenic extracts into skin with delayed reaction analysis 30.00 Injection of allergenic extracts into skin, accessed through the skin PRICE Description 1128.75 Injection of anesthetic agent and/or steroid into femoral nerve of thigh 897.75 Injection of anesthetic agent and/or steroid into other peripheral nerve or branch 546.75 Injection of anesthetic agent and/or steroid into trigeminal nerve of face 4971.00 Injection of bile duct for X-ray imaging procedure accessed through the skin using imaging guidance including radiological supervision and interpretation 897.75 Injection of blood or blood clot into spinal canal 336.00 Injection of carpal tunnel 450.00 Injection of chemical for destruction of facial and neck nerve muscles on both sides of face 1170.00 Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles 1170.00 Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles 280.00 Injection of chemical for destruction of nerve muscles on one side of face 450.00 Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin 720.00 Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles 450.00 Injection of chemical for destruction of salivary glands on both sides of the mouth 145.00 Injection of different drug or substance into a vein for therapy, diagnosis, or prevention 764.25 Injection of drug into erectile tissue at sides and back of penis 516.50 Injection of drug into erectile tissue at sides and back of penis 350.00 Injection of drug into eye 230.50 Injection of drug or substance into a vein for therapy, diagnosis, or prevention 175.00 Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility 166.75 Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility 1269.50 Injection of dye for X-ray imaging and/or CT of lower spinal canal 546.75 Injection of dye for X-ray imaging of elbow joint 2168.75 Injection of dye for X-ray imaging of hip joint 384.25 Injection of dye for X-ray imaging of hip joint 546.75 Injection of dye for X-ray imaging of shoulder joint 1250.25 Injection of dye for X-ray imaging of wrist joint 127.00 Injection of incremental dosages of allergen 39.00 Injection of incremental dosages of allergen, 2 or more injections 570.00 Injection of medication or substance into membrane covering eyeball 360.00 Injection of more than 7 skin growths 548.25 Injection procedure for X-ray imaging of the bladder or during voiding 10.00 Injection,onabotulinumtoxina 280.00 Injections of anesthetic and/or steroid drug into nerve of foot 280.00 Injections of tendon attachment to bone 336.00 Injections of tendon sheath, ligament, or muscle membrane 543.75 Injections of trigger points in 1 or 2 muscles 280.00 Injections of trigger points in 1 or 2 muscles 534.75 Injections of trigger points in 3 or more muscles 280.00 Injections of trigger points in 3 or more muscles 51601.25 INSERT INTRATHECAL PUMP PROGRA 651.75 Insertion dilator device into cervix 1352.50 Insertion of arterial catheter for blood sampling or infusion, accessed through the skin 127.50 Insertion of assistive heart blood flow device into aorta, accessed through the skin 10580.00 Insertion of catheter for diagnostic evaluation of right heart structures 764.25 Insertion of catheter for suction of secretions 10580.00 Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart 4919.75 Insertion of catheter in right heart for imaging of blood vessels or grafts 2280.25 Insertion of catheter into abdominal pelvic or leg artery 1352.50 Insertion of catheter into abdominal pelvic or leg artery 1352.50 Insertion of catheter into aorta 6813.75 Insertion of catheter into artery for drug infusion for blood clot including radiological supervision and interpretation 10580.00 Insertion of catheter into right and left heart for diagnosis 4119.00 Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes 1715.50 Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes 4099.25 Insertion of catheter into vein for drug infusion for blood clot including radiological supervision and interpretation 864.25 Insertion of catheter into vein of navel, newborn 1690.75 Insertion of central venous catheter for infusion, patient 5 years or older 2875.50 Insertion of central venous catheter for infusion, patient 5 years or older 3812.75 Insertion of central venous catheter for infusion, patient 5 years or older 2721.50 Insertion of central venous catheter for infusion, patient 5 years or older 1586.00 Insertion of central venous catheter for infusion, patient 5 years or older 4007.75 Insertion of central venous catheter for infusion, patient 5 years or older 2792.00 Insertion of central venous catheter for infusion, patient 5 years or older 2096.50 Insertion of central venous catheter for infusion, patient 5 years or older 2721.25 Insertion of central venous catheter for infusion, patient younger than 5 years 315.00 Insertion of device into the abdomen with measurement of pressure and urine flow rate 114.00 Insertion of drug delivery implant into tissue 11025.00 Insertion of electrode for permanent pacemaker or pacing defibrillator device 13036.50 Insertion of electrodes for permanent pacemaker or pacing defibrillator device 656.00 Insertion of electronic device into bladder with voiding pressure studies 2472.75 Insertion of feeding tube (accessed beneath the skin) into small bowel using an endoscope 18799.75 Insertion of heart rhythm monitor under skin 173.50 Insertion of indwelling bladder catheter 251.00 Insertion of indwelling bladder catheter 764.25 Insertion of indwelling bladder catheter 190.00 Insertion of indwelling bladder catheter 23822.25 Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation PRICE Description 55894.50 Insertion of left heart electrode for pacing defibrillator device 577.50 Insertion of nasal or oral stomach tube using fluoroscopic guidance 11171.00 Insertion of needle and/or catheter into dialysis circuit and balloon dilation of dialysis segment, with imaging including radiological supervision and interpretation 22573.75 Insertion of needle and/or catheter into dialysis circuit and insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation 1586.00 Insertion of needle and/or catheter into dialysis circuit, with imaging including radiological supervision and interpretation 393.75 Insertion of needle for infusion into bone 134.75 Insertion of needle into scalp vein, patient younger than 3 years 35.50 Insertion of needle into vein for collection of blood sample 8.00 Insertion of needle into vein for collection of blood sample 16.00 Insertion of needle into vein, patient 3 years or older 2040.25 Insertion of needle or catheter into an artery of arm or leg 37182.50 Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes 13301.50 Insertion of pacemaker pulse generator with existing dual leads 26801.75 Insertion of pacemaker pulse generator with existing multiple leads 60304.50 Insertion of pacing defibrillator pulse generator with existing dual leads 46903.00 Insertion of pacing defibrillator pulse generator with existing multiple leads 82636.75 Insertion of pacing defibrillator pulse generator with existing single lead 6598.50 Insertion of permanent catheter for drainage of lung fluid 1625.75 Insertion of probe in esophagus for heart ultrasound examination including interpretation and report 3500.00 Insertion of stent in urinary duct (ureter) using an endoscope 23934.75 Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure 31125.50 Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 371.25 Insertion of stomach tube and aspirations of gastric contents 403.00 Insertion of stomach tube and aspirations of gastric contents 173.50 Insertion of temporary bladder catheter 268.00 Insertion of temporary bladder catheter 251.00 Insertion of temporary bladder catheter 12663.75 Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation 30405.00 Insertion or replacement of permanent pacemaker and lower chamber electrodes 42117.00 Insertion or replacement of single or dual chamber pacing defibrillator leads 21.00 INSTA-CHAR CHERRY 25GM 98.75 Insulin antibody measurement 44.71 INSULIN ASPAR PROT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS PEN [52213] 36.01 INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN [52753] 44.71 INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN [52754] 34.72 INSULIN ASPART U-100 100 UNIT/ML SUBCUTANEOUS SOLUTION [47133] 36.98 INSULIN DETEMIR (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN [86331] 36.98 INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION [86276] 16.52 INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP [45486] 145.75 Insulin measurement 16.52 INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION [38178] 17.84 INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION (SLIDING SCALE) [613484] 17.84 INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION [38177] 220.50 INT SCALP ELECTRODE 684.00 Intestine imaging 380.25 INTRATHECAL CATHETER PASSER 2904.00 INTRATHECAL PATIENT PROGRAMMER 259.25 INTRAUTERINE PRESSURE CATH 187.25 Intrinsic factor (stomach protein) antibody measurement 568.00 Intro/sheath, fixed,non-peel 33.75 Intro/sheath, non-laser 92.75 Intro/sheath, non-laser 598.00 Intro/sheath, non-laser 324.25 Intro/sheath,fixed,peel-away 187.75 Intro/sheath,strble,non-peel 264.25 Introduction of saline or X-ray contrast material for X-ray imaging of the uterus and tubes 11199.00 Iodine i-123 iobenguane 140.00 Iodine i-123 sod iodide mic 2.14 IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION [44322] 886.86 IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION [121467] 886.87 IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [121465] 0.74 IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN [44387] 0.53 IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION [2683] 1.52 IPRATROPIUM BROMIDE 0.03 % NASAL SPRAY [39164] 6.38 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY [39165] 511.74 IPRATROPIUM-ALBUTEROL20-100MCG 3.07 IRBESARTAN 150 MG TABLET [48608] 2037.50 IRIDECTOMY FOR GLAUCOMA 4.77 IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION [102292] 7.40 IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION [102293] 152.50 Iron binding capacity 16.69 IRON DEXTRAN 50 MG/ML INJECTION SOLUTION [161237] 108.25 Iron level 11.52 IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION [47580] 101.50 Irradiation of blood product, each unit 170.25 Irrigation of implanted venous access drug delivery device 183.00 Islet cell (pancreas) antibody measurement PRICE Description 0.28 ISOFLURANE 99.9 % INHALATION LIQUID [129667] 1.08 ISOSORBIDE DINITRATE 10 MG TABLET [5715] 2.49 ISOSORBIDE DINITRATE 20 MG TABLET [5716] 1.31 ISOSORBIDE DINITRATE 30 MG TABLET [8380] 6.00 ISOSORBIDE DINITRATE 5MGTAB EA 0.41 ISOSORBIDE MONONITRATE 20 MG TABLET [5088] 0.52 ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR [7312] 0.54 ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR [7311] 17.25 JELCO ALL SIZES 20 22 24 14.50 JELCO NEXIVA 20X 1 14.50 JELCO NEXIVA 22 X 1 2659.50 Joint device (implantable) 1625.50 Joint device (implantable) 257.00 Joint device (implantable) 4136.75 Joint device (implantable) 3841.50 Joint device (implantable) 3545.75 Joint device (implantable) 886.50 Joint device (implantable) 2068.25 Joint device (implantable) 2363.75 Joint device (implantable) 9.25 KERLIX ROLL ST 1.97 KETAMINE 100 MG/ML INJECTION SOLUTION [3541] 0.79 KETAMINE 50 MG/ML INJECTION SOLUTION [3542] 80.75 Ketone bodies analysis 93.25 Ketone bodies analysis 16.24 KETOROLAC 0.5 % EYE DROPS [46278] 21.26 KETOROLAC 0.5 % EYE DROPS [46278] 214.00 KETOROLAC 0.5%OPTH, 10ML 2.16 KETOROLAC 10 MG TABLET [5127] 0.95 KETOROLAC 15 MG/ML INJECTION SOLUTION [3726] 1.04 KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [3728] 0.62 KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION [3729] 20.00 Ketorolac tromethamine inj 461.50 Ketosteroids, 17 (hormone) measurement 241.50 Kidney function blood test panel 111.75 KIT CATH TRIPLE LUMEN 16CM 23.25 KIT DRESSING CHG 9.25 KIT IV START DISP 9.25 KIT STAPLER SK REM 0.10 L.ACIDOPHIL,SALIVARI-BIFIDO BIFIDUM-STREP THERMOPH 175 MG CAPSULE [103278] 0.55 LABETALOL 100 MG TABLET [5096] 0.68 LABETALOL 200 MG TABLET [5097] 0.20 LABETALOL 5 MG/ML INTRAVENOUS SOLUTION [3551] 113.50 LABOR ROOM PER HOUR 17.29 LACOSAMIDE 100 MG TABLET [111128] 4.54 LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION [111885] 119.25 Lactate dehydrogenase (enzyme) level 0.01 LACTATED RINGERS INTRAVENOUS SOLUTION [4220] 98.00 Lactic acid level 0.86 LACTOBACILLUS ACIDOPHILUS, BULGARICUS 100 MILLION CELL GRANULES PACKET [53589] 0.25 LACTOBACILLUS ACIDOPHILUS100MG 0.03 LACTULOSE 20 GRAM/30 ML ORAL SOLUTION [126158] 0.23 LAMOTRIGINE 100 MG TABLET [49320] 0.22 LAMOTRIGINE 25 MG TABLET [46191] 340.75 Lamotrigine level 11916.00 Laser vaporization of prostate including control of bleeding using an endoscope 38.00 LATANOPROST 0.005 % EYE DROPS [40543] 134.75 Lead level 84.25 Lead level 49.00 Lead level 8576.75 Lead, aicd, endo dual coil 15392.75 Lead, aicd, endo single coil 4020.25 Lead, coronary venous 6321.75 Lead, neurostim test kit 6321.75 Lead, neurostimulator 12255.00 Lead, neurostimulator 5347.00 Lead, neurostimulator 1139.00 Lead, pmkr, other than trans 1834.00 Lead, pmkr, transvenous vdd 16.42 LEFLUNOMIDE 10 MG TABLET [45618] 1414.50 Lens, intraocular (new tech) 524.50 Lens, intraocular (new tech) 63.75 LET INJ 3CC 18.05 LETROZOLE 2.5 MG TABLET [48801] 36.25 LEUCOVORIN 25MG TAB 22.74 LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION [10521] 2.80 LEUCOVORIN CALCIUM 5 MG TABLET [2638] PRICE Description 11157.24 LEUPROLIDE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT [123205] 5578.54 LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT [47291] 1859.52 LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT [123868] 400.00 Leuprolide acetate suspnsion 5.00 LEVALBUTEROL PER 0.5MG, 1.25MG 154.00 LEVEL 1 VISIT ONCOLOGY NURSE 0.65 LEVETIRACETAM 100 MG/ML ORAL SOLUTION [53723] 0.60 LEVETIRACETAM 250 MG TABLET [46871] 0.72 LEVETIRACETAM 500 MG TABLET [44833] 1.49 LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION [88386] 241.25 Levetiracetam level 16.49 LEVOFLOXACIN 250 MG TABLET [45823] 0.26 LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [53060] 18.90 LEVOFLOXACIN 500 MG TABLET [48762] 0.13 LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [53058] 35.40 LEVOFLOXACIN 750 MG TABLET [48799] 0.09 LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [53059] 58.25 LEVONORGESTREL 0.75MG TAB 126.70 LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION [125998] 0.61 LEVOTHYROXINE 100 MCG TABLET [7400] 0.71 LEVOTHYROXINE 112 MCG TABLET [28229] 0.72 LEVOTHYROXINE 125 MCG TABLET [7403] 0.74 LEVOTHYROXINE 150 MCG TABLET [7401] 0.48 LEVOTHYROXINE 25 MCG TABLET [6405] 0.54 LEVOTHYROXINE 50 MCG TABLET [6402] 0.60 LEVOTHYROXINE 75 MCG TABLET [7399] 0.61 LEVOTHYROXINE 88 MCG TABLET [28232] 0.41 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [87063] 0.81 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [87063] 0.96 LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE [87068] 0.72 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [87064] 1.53 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [87064] 0.66 LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION [87067] 26.56 LIDOCAINE (PF) 3.5 % EYE GEL [109597] 1.04 LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION [87061] 0.09 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION [87066] 0.04 LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION [87074] 0.09 LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3657] 0.13 LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3657] 3.00 LIDOCAINE 1%,PER10MG,2ML SDV 0.07 LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION [3791] 0.09 LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION [3791] 1.56 LIDOCAINE 2 % MUCOSAL JELLY [7460] 3.06 LIDOCAINE 2 % MUCOSAL JELLY [7460] 0.69 LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR [108584] 0.13 LIDOCAINE 2 % MUCOSAL SOLUTION [48036] 0.09 LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION [3544] 0.13 LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION [3544] 0.36 LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION [3544] 0.11 LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3661] 0.18 LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3661] 1.29 LIDOCAINE 4 % (40 MG/ML) MUCOSAL SOLUTION [2577] 1.20 LIDOCAINE 4 % TOPICAL CREAM [45297] 1.68 LIDOCAINE 4 % TOPICAL PATCH [44492] 22.75 LIDOCAINE 5% PATCH 13.12 LIDOCAINE HCL GEL 4% TOP, 75ML 7.00 LIDOCAINE VISCOUS 100MG/5ML LI 0.43 LIDOCAINE W/EPINEPHRINE DENTAL CARTRIDGE 1.7 ML [600866] 300.00 LILETTA IUD 52 MG 433.50 LINDANE 1% TOP SHAM, 60ML 204.08 LINEZOLID 600 MG TABLET [46868] 0.19 LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK [51789] 1.05 LIOTHYRONINE 25 MCG TABLET [44830] 0.80 LIOTHYRONINE 5 MCG TABLET [45974] 174.50 Lipase (fat enzyme) level 3.73 LIPASE-PROTEASE-AMYLASE 12,000-38,000-60,000 UNIT CAPSULE,DELAYED REL [112665] 11.23 LIPASE-PROTEASE-AMYLASE 36,000-114,000-180,000 UNIT CAPSULE,DELAY REL [136638] 10.24 LIPONAVIR-RITONAVIR,PER EACH 48.25 Lipoprotein (A) level 193.75 Lipoprotein level 249.00 Lipoprotein measurement 0.42 LISINOPRIL 10 MG TABLET [38031] 6.00 LISINOPRIL 2.5MG TAB EACH 0.40 LISINOPRIL 20 MG TABLET [38032] 0.87 LISINOPRIL 5 MG TABLET [38030] 0.14 LITHIUM CARBONATE 150 MG CAPSULE [2535] 0.21 LITHIUM CARBONATE 300 MG CAPSULE [2536] PRICE Description 0.47 LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE [39730] 0.54 LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE [40708] 139.00 Lithium level 3858.75 LITHOTRIPSY 62.25 Liver enzyme (SGOT), level 68.50 Liver enzyme (SGPT), level 241.50 Liver function blood test panel 2540.25 LIVER-SPECT 6.75 Locm 300-399mg/ml iodine,1ml 39.25 Locm 300-399mg/ml iodine,1ml 65.00 Locm 300-399mg/ml iodine,1ml 0.05 LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID [83576] 0.88 LOPERAMIDE 2 MG CAPSULE [5126] 0.86 LORATADINE 10 MG TABLET [39351] 0.71 LORATADINE 5 MG-PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE,12HR [47707] 0.70 LORAZEPAM 0.5 MG TABLET [6461] 0.91 LORAZEPAM 1 MG TABLET [6462] 0.90 LORAZEPAM 2 MG/ML INJECTION SOLUTION [3520] 2.02 LORAZEPAM 2 MG/ML INJECTION SOLUTION [3520] 3.20 LORAZEPAM 2 MG/ML INJECTION SYRINGE [3521] 1.60 LORAZEPAM 2 MG/ML ORAL CONCENTRATE [49260] 1.68 LOSARTAN 25 MG TABLET [47616] 2.26 LOSARTAN 50 MG TABLET [40349] 154.00 Low Level Evaluation and Management Visit 7.42 LUBIPROSTONE 24 MCG CAPSULE [86287] 48.94 LURASIDONE 40 MG TABLET [119959] 28.00 Macroscopic examination (visual inspection) of parasite 0.01 MAGNESIUM CITRATE ORAL SOLUTION [40288] 0.08 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION [46732] 64.75 Magnesium level 114.50 Magnesium level 0.03 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET [11204] 0.09 MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK [101989] 0.40 MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK [101604] 0.01 MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION [101990] 0.67 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION [3546] 984.25 MAJOR SUTURE CHARGE 371.50 Mammography of both breasts 298.75 Mammography of both breasts 291.75 Mammography of one breast 147.25 Manganese (heavy metal) level 93.75 MANNITOL 20% (200MG/ML) IV SOL 0.05 MANNITOL 25 % INTRAVENOUS SOLUTION [3751] 134.75 Manual (physical) therapy techniques to 1 or more regions, each 15 minutes 225.75 Manual maneuvers to chest wall to assist movement of lung secretions 397.00 Mass spectrometry (laboratory testing method) 952.25 Maternity care and delivery procedure 275.00 Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration 792.00 Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration 162.00 Measurement and graphic recording of total and timed exhaled air capacity 332.50 Measurement and graphic recording of total and timed exhaled air capacity 616.25 Measurement and recording of brain wave (EEG) activity, awake and drowsy 26.25 Measurement C-reactive protein for detection of infection or inflammation 196.75 Measurement C-reactive protein for detection of infection or inflammation 180.25 Measurement C-reactive protein for detection of infection or inflammation 152.50 Measurement for Strep antibody (strep throat) 83.00 Measurement of antibody (IgE) to allergic substance 72.00 Measurement of antibody (IgE) to allergic substance 55.50 Measurement of antibody (IgE) to allergic substance 166.25 Measurement of antibody for assessment of autoimmune disorder 245.00 Measurement of antibody for assessment of autoimmune disorder 210.25 Measurement of antibody for assessment of autoimmune disorder 79.00 Measurement of antibody for assessment of autoimmune disorder 120.25 Measurement of antibody for assessment of autoimmune disorder 103.75 Measurement of antibody for assessment of autoimmune disorder 222.50 Measurement of antibody for assessment of autoimmune disorder 189.25 Measurement of antibody for assessment of autoimmune disorder 167.75 Measurement of antibody for rheumatoid arthritis assessment 62.50 Measurement of antibody to noninfectious agent 36.75 Measurement of bilirubin 152.50 Measurement of cold agglutinin (protein) to detect infection or disease 190.50 Measurement of complement (immune system proteins) 282.25 Measurement of complement (immune system proteins) 187.25 Measurement of complement function (immune system proteins) 114.00 Measurement of corneal curvature and depth of eye 384.50 Measurement of DNA antibody 561.75 Measurement of DNA antibody PRICE Description 114.00 Measurement of eye muscles to detect deviation of eyeball 80.00 Measurement of field of vision during daylight conditions 114.00 Measurement of field of vision during daylight conditions 141.25 Measurement of Hepatitis A antibody 44.00 Measurement of Hepatitis A antibody (IgM) 162.00 Measurement of hydrogen in breath to test for GI symptoms 219.75 Measurement of immune substance (oligoclonal bands) 288.50 Measurement of largest amount of air breathed in an out of lungs over one minute 393.50 Measurement of lung diffusing capacity 255.75 Measurement of oxygen saturation in blood using ear or finger device 182.25 Measurement of oxygen saturation in blood using ear or finger device 342.50 Measurement of substance using immunoassay technique 1156.50 Measurement of substance using immunoassay technique 260.50 Measurement of substance using immunoassay technique 328.50 Measurement of substance using immunoassay technique 128.50 Measurement of substance using immunoassay technique 72.25 Measurement of substance using immunoassay technique 167.75 Measurement of substance using immunoassay technique 430.50 Measurement of substance using immunoassay technique 249.25 Measurement of substance using immunoassay technique 222.25 Measurement of substance using immunoassay technique 511.50 Measurement of substance using immunoassay technique 105.50 Measurement of substance using immunoassay technique 52.00 Measurement of substance using immunoassay technique 267.25 Measurement of substance using immunoassay technique 194.25 Measurement of white blood cell function 375.00 Mechanical chest wall manipulation for improvement in lung function 0.71 MECLIZINE 12.5 MG TABLET [5810] 0.40 MECLIZINE 25 MG TABLET [5804] 1.44 MECOBALAMIN-LEVOMEFOLATE CALCIUM-PYRIDOXAL PHOS 3 MG-35 MG-2 MG TABLET [115659] 25.75 MECONIUM ASPIRATOR 112.25 Medical nutrition therapy performed in a group setting, each 30 minutes 112.25 Medical nutrition therapy re-assessment and intervention, each 15 minutes 110.75 Medical nutrition therapy, assessment and intervention, each 15 minutes 54.00 MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION [43500] 0.47 MEDROXYPROGESTERONE 5 MG TABLET [7434] 0.60 Medroxyprogesterone acetate 0.28 MEGESTROL 40 MG TABLET [2650] 0.42 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION [133949] 0.03 MELATONIN 1 MG TABLET [18150] 0.27 MELATONIN 3 MG TABLET [9851] 6.00 MELOXICAM 15MG TAB, EACH 3.13 MELOXICAM 7.5 MG TABLET [46391] 8.89 MEMANTINE 10 MG TABLET [54725] 8.89 MEMANTINE 5 MG TABLET [54728] 0.09 MENTHOL 0.44 %-ZINC OXIDE 20.6 % TOPICAL OINTMENT [114617] 0.59 MENTHOL 3.3 MG LOZENGES [122655] 6.91 MEPERIDINE (PF) 100 MG/ML INJECTION SYRINGE [84593] 7.14 MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE [84588] 2.89 MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION [84582] 7.38 MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE [84589] 0.21 MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [104162] 0.30 MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [104161] 0.71 MEPIVACAINE 30 MG/ML (3 %) INJECTION DENTAL CARTRIDGE [154208] 3545.68 MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION [149811] 247.50 Mercury level 82.75 Mercury level 127.25 Mercury level 64.75 Mercury level 13.99 MEROPENEM 1 GRAM INTRAVENOUS SOLUTION [47447] 7.20 MEROPENEM 500 MG INTRAVENOUS SOLUTION [47317] 5.10 MESALAMINE ER 0.375 GRAM CAPSULE,EXTENDED RELEASE 24 HR [110454] 1076.25 Mesh (implantable) 316.75 Mesh (implantable) 3150.00 Mesh (implantable) 2955.50 Mesh (implantable) 950.75 Mesh (implantable) 591.00 Mesh (implantable) 192.25 Mesh (implantable) 170.50 Mesh (implantable) 160.00 Mesh (implantable) 463.75 Metanephrines level 227.50 Metanephrines level 67.75 Metanephrines level 4.89 METAXALONE 800 MG TABLET [52328] 1.44 METFORMIN 1,000 MG TABLET [30145] 6.00 METFORMIN 1000MG TAB, EACH PRICE Description 0.70 METFORMIN 500 MG TABLET [30139] 1.21 METFORMIN 850 MG TABLET [30140] 0.11 METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR [41543] 90.00 METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION [45008] 0.44 METHADONE 10 MG TABLET [2645] 0.39 METHADONE 5 MG TABLET [2644] 0.77 METHIMAZOLE 10 MG TABLET [21513] 0.44 METHIMAZOLE 5 MG TABLET [21512] 7.00 METHOCARBAMOL 500MG TAB 0.59 METHOCARBAMOL 750 MG TABLET [681] 6.24 METHOTREXATE SODIUM 2.5 MG TABLET [710] 16.75 METHOTREXATE SODIUM 50 MG 0.06 METHYL SALICYLATE-MENTHOL 30 %-10 % TOPICAL CREAM [88548] 0.06 METHYL SALICYLATE-MENTHOL TOPICAL OINTMENT [48520] 0.37 METHYLDOPA 250 MG TABLET [694] 0.67 METHYLDOPA 500 MG TABLET [695] 24.79 METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) INTRAVENOUS SOLUTION [152051] 29.64 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION [46428] 92.00 METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION [103876] 1.04 METHYLPHENIDATE 10 MG TABLET [5731] 1.43 METHYLPREDNISOLONE 4 MG TABLET [6299] 1.65 METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [48819] 25.00 Methylprednisolone 40 mg inj 50.00 Methylprednisolone 80 mg inj 12.69 METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [47215] 40.00 METHYLPREDNISOLONE ACETATE PER 10.00 Methylprednisolone injection 11.63 METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION [115224] 7.22 METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION [138648] 50.27 METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [43951] 27.74 METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10345] 0.30 METOCLOPRAMIDE 10 MG TABLET [5187] 0.40 METOCLOPRAMIDE 5 MG TABLET [5188] 0.68 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION [2586] 0.67 METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION [3696] 3.29 METOLAZONE 2.5 MG TABLET [40990] 1.68 METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR [45229] 1.12 METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR [48536] 1.12 METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [44824] 6.00 METOPROLOL TART 12.5MG SPLIT 0.07 METOPROLOL TARTRATE 25 MG TABLET [41907] 0.25 METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION [3554] 0.06 METOPROLOL TARTRATE 50 MG TABLET [5142] 0.48 METRONIDAZOLE 250 MG TABLET [5163] 66.25 METRONIDAZOLE 250MG/5ML SUSP, 0.92 METRONIDAZOLE 500 MG TABLET [5164] 0.02 METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK [4177] 2.54 MEXILETINE 150 MG CAPSULE [2541] 224.40 MICAFUNGIN 100 MG INTRAVENOUS SOLUTION [89112] 10.25 MICONAZOLE 2% POWDER, 43G 0.11 MICONAZOLE NITRATE 2 % TOPICAL OINTMENT [47001] 0.06 MICONAZOLE NITRATE 2 % TOPICAL POWDER [45370] 0.26 MICONAZOLE NITRATE 2 % VAGINAL CREAM [5490] 228.00 MICROFIBRILLAR COLLAGEN HEMOSTAT 70 MM X 35 MM SHEETS [112671] 112.80 MICROFIBRILLAR COLLAGEN HEMOSTAT TOPICAL POWDER IN PACKET [130476] 157.50 Microsomal antibodies (autoantibody) measurement 0.23 MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION [139415] 0.33 MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION [139415] 1.25 MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION [139414] 0.33 MIDAZOLAM 1 MG/ML INJECTION SOLUTION [28026] 0.39 MIDAZOLAM 1 MG/ML INJECTION SOLUTION [28026] 0.81 MIDAZOLAM 5 MG/ML INJECTION SOLUTION [28027] 4.98 MIDODRINE 10 MG TABLET [41133] 0.90 MIDODRINE 5 MG TABLET [41132] 7.64 MILNACIPRAN 25 MG TABLET [111755] 3.72 MILRINONE 1 MG/ML INTRAVENOUS SOLUTION [30707] 80.75 MILRINONE PER 5MG, 20MG IN 5% 1.67 MINERAL OIL [31523] 0.02 MINERAL OIL ENEMA [29934] 0.03 MINERAL OIL ORAL [185] 0.59 MINOXIDIL 2.5 MG TABLET [8481] 2.60 MIRTAZAPINE 15 MG DISINTEGRATING TABLET [41555] 2.72 MIRTAZAPINE 15 MG TABLET [39181] 1.29 MIRTAZAPINE 30 MG TABLET [39182] 6.00 MIRTAZAPINE 7.5MG TAB, EACH 4.54 MISOPROSTOL 100 MCG TABLET [38037] 1676.25 MITEK QUICK ANCHOR PRICE Description 169.20 MITOMYCIN 20 MG INTRAVENOUS SOLUTION [24632] 1415.64 MITOMYCIN 40 MG INTRAVENOUS SOLUTION [24633] 26.38 MODAFINIL 100 MG TABLET [49666] 150.25 Moderate sedation services by physician also performing a procedure, additional 15 minutes 195.25 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes 57.75 Moderate sedation services by physician also performing a procedure, patient younger than 5 years of age, first 15 minutes 0.34 MODIFIED LANOLIN 100 % TOPICAL CREAM [165405] 206.75 Molecular pathology procedure 1438.50 Molecular pathology procedure 1266.25 Molecular pathology procedure level 1 520.75 Molecular pathology procedure level 2 591.00 Molecular pathology procedure level 2 2110.75 Molecular pathology procedure level 6 88.75 MOMETASONE 220 MCG/ACTUATION(14 DOSES) BREATH ACTIVATED POWDER INHALER [83460] 229.86 MOMETASONE 220MCG(ASMANEX) 5.66 MONTELUKAST 10 MG TABLET [48315] 5.66 MONTELUKAST 5 MG CHEWABLE TABLET [44062] 2.18 MORPHINE (PF) 1 MG/ML INJECTION SOLUTION [3538] 0.17 MORPHINE 10 MG/5 ML ORAL SOLUTION [2607] 2.53 MORPHINE 10 MG/ML INTRAVENOUS SOLUTION [3983] 0.91 MORPHINE 15 MG IMMEDIATE RELEASE TABLET [25285] 3.44 MORPHINE 2 MG/ML INJECTION SYRINGE [1062] 2.26 MORPHINE 2 MG/ML INTRAVENOUS SYRINGE [141641] 1.54 MORPHINE 30 MG IMMEDIATE RELEASE TABLET [2647] 3.44 MORPHINE 4 MG/ML INJECTION SYRINGE [1063] 2.48 MORPHINE 4 MG/ML INTRAVENOUS SOLUTION [149352] 2.26 MORPHINE 4 MG/ML INTRAVENOUS SYRINGE [141642] 0.84 MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION [6879] 7.64 MORPHINE ER 100 MG TABLET,EXTENDED RELEASE [26214] 1.87 MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [26202] 3.38 MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [26203] 0.01 MORPHINE IV INFUSION 1 MG/ML IN 0.9% NACL [612808] 69.65 MOXIFLOXACIN 0.5 % EYE DROPS [52985] 2649.35 MRA ABDOMEN W/WO CONTRAST 3523.75 MRA scan of head blood vessels 3961.75 MRA scan of head blood vessels before and after contrast 3523.75 MRA scan of neck blood vessels 3961.75 MRA scan of neck blood vessels before and after contrast 1964.00 Mra w/cont, abd 4673.00 Mra w/o cont, abd 1155.00 Mra w/o fol w/cont, abd 1155.00 Mra w/o fol w/cont, pelvis 483.00 MRI of one breast 3095.75 MRI scan bones of the eye, face, and/or neck 4704.75 MRI scan bones of the eye, face, and/or neck before and after contrast 3714.75 MRI scan brain 3411.75 MRI scan of abdomen 4249.25 MRI scan of abdomen before and after contrast 2775.00 MRI scan of arm 4010.00 MRI scan of arm before and after contrast 4211.75 MRI scan of arm joint 5438.75 MRI scan of arm joint before and after contrast 4421.75 MRI scan of arm joint with contrast 3646.00 MRI scan of arm with contrast 5955.75 MRI scan of brain before and after contrast 1238.25 MRI scan of brain before and after contrast 4082.75 MRI scan of brain with contrast 2997.75 MRI scan of chest 3353.25 MRI scan of chest before and after contrast 3297.50 MRI scan of jaw joints 2775.00 MRI scan of leg 4624.00 MRI scan of leg before and after contrast 4250.50 MRI scan of leg joint 4685.25 MRI scan of leg joint before and after contrast 4465.50 MRI scan of leg joint with contrast 3016.50 MRI scan of leg with contrast 4409.25 MRI scan of lower spinal canal 5947.75 MRI scan of lower spinal canal before and after contrast 4849.75 MRI scan of lower spinal canal with contrast 3615.75 MRI scan of middle spinal canal 5091.50 MRI scan of middle spinal canal before and after contrast 3434.25 MRI scan of pelvis 4525.50 MRI scan of pelvis before and after contrast 3791.75 MRI scan of pelvis with contrast 1250.25 MRI scan of upper spinal canal 5324.50 MRI scan of upper spinal canal before and after contrast 4839.50 MRI scan of upper spinal canal with contrast PRICE Description 1746.50 Mri w/o fol w/cont, breast, 2068.25 Multiple measurements and graphic recordings of the amount and speed of breathed air, before and following medication administration 50.00 Multiple measurements of eye fluid pressure over an extended time period, same day 341.00 Multiple measurements of oxygen saturation in blood using ear or finger device 232.25 Multiple measurements of oxygen saturation in blood using ear or finger device 227.50 Multiple measurements of oxygen saturation in blood using ear or finger device 7.00 MULTIVITAMIN WITH MINERALS TAB 8.33 MUPIROCIN 2 % TOPICAL CREAM [47938] 1.94 MUPIROCIN 2 % TOPICAL OINTMENT [41535] 4.86 MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION [133542] 212.00 Mycophenolate (mycophenolic acid) level 3.96 MYCOPHENOLATE MOFETIL 250 MG CAPSULE [44926] 7.93 MYCOPHENOLATE MOFETIL 500 MG TABLET [46296] 75.00 MYCOPLASMA PNEUMONIAE, AMP PRO 167.75 Myelin basic protein (nerve protein) level, spinal fluid 216.25 Myoglobin (muscle protein) level 1.30 NABUMETONE 500 MG TABLET [29026] 1.63 NABUMETONE 750 MG TABLET [29855] 7.23 NADOLOL 40 MG TABLET [6002] 14.60 NAFCILLIN 1 GRAM SOLUTION FOR INJECTION [1467] 4293.25 NAIL TROCHANTERIC 340-400MM LH 4.35 NALBUPHINE 10 MG/ML INJECTION SOLUTION [3336] 7.47 NALBUPHINE 20 MG/ML INJECTION SOLUTION [3338] 4.25 NALBUPHINE 20MG/ML 19.00 NALOXONE 0.4 MG/ML INJECTION SOLUTION [3314] 19.80 NALOXONE 1 MG/ML INJECTION SYRINGE [9885] 4.28 NALTREXONE 50 MG TABLET [8908] 1570.80 NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE [87219] 0.78 NAPROXEN 250 MG TABLET [665] 1.30 NAPROXEN 500 MG TABLET [667] 688.75 Nasal procedure 52.50 Nasal smear for eosinophils (allergy related white blood cells) 529.61 NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION [56595] 1.73 NATEGLINIDE 120 MG TABLET [40628] 180.25 Natriuretic peptide (heart and blood vessel protein) level 5.73 NEBIVOLOL 10 MG TABLET [101886] 5.73 NEBIVOLOL 2.5 MG TABLET [101885] 3159.75 Needle biopsy of abdominal cavity growth, accessed through the skin 1545.00 Needle biopsy of kidney, accessed through the skin 2606.25 Needle biopsy of liver, accessed through the skin 2008.50 Needle biopsy of lung or chest tissue, accessed through the skin 936.50 Needle biopsy of thyroid, accessed through the skin 29.25 NEEDLE HUBER 20G 1 1/2 RA 29.25 NEEDLE HUBER 22G 1 1/2 RA 29.75 NEEDLE HUBER SAFETY 20X1 420.00 Needle measurement and recording of electrical activity of cranial nerve-supplied muscles on one side of body 70.00 Needle measurement and recording of electrical activity of head or trunk muscles 162.00 Needle measurement and recording of electrical activity of middle spine muscles 275.00 Needle measurement and recording of electrical activity of muscles in arms or legs 70.00 Needle measurement and recording of electrical activity of muscles of arm or leg complete study 95.00 Needle measurement and recording of electrical activity of muscles of arm or leg limited study 114.00 Needle measurement and recording of electrical activity of muscles of arms or legs 38.00 NEEDLE, HUBER 185.75 NEEDLE,BIOPSY TYPE 1 62.25 NEEDLE,BIOPSY TYPE 2 508.25 Negative pressure wound therapy, surface area greater than 50 square centimeters, per session 213.75 Negative pressure wound therapy, surface area less than or equal to 50 square centimeters, per session 12.57 NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT [5917] 16.27 NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT [6411] 0.39 NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT [44328] 3.97 NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS [6731] 10.07 NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP [8818] 7.00 NEOSPORIN OINT, 1GM 2.28 NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION [137918] 2.20 NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION [137919] 1.25 NEOSTIGMINE PER 0.5MG, 0.5MG/M 176.50 Nephelometry, test method using light 162.25 Nephelometry, test method using light 164.50 Nephelometry, test method using light 496.00 Nerve transmission studies, 11-12 studies 275.00 Nerve transmission studies, 3-4 studies 275.00 Nerve transmission studies, 5-6 studies 275.00 Nerve transmission studies, 7-8 studies 496.00 Nerve transmission studies, 9-10 studies 640.50 Nervous system procedure 396.25 Neurobehavioral status examination by qualified health care professional with interpretation and report, first 60 minutes 0.05 NIACIN 250 MG TABLET [6619] PRICE Description 6.20 NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR [31585] 25.29 NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION [45909] 0.28 NICOTINE (POLACRILEX) 2 MG GUM [9770] 2.06 NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH [8499] 2.52 NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH [8500] 2.06 NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH [8498] 3.30 NIFEDIPINE 10 MG CAPSULE [6408] 1.33 NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR [5176] 2.29 NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR [8578] 7.00 NIFEREX-150 FORTE CAP 194.25 Nitroblue tetrazolium dye test to measure white blood cell function 3.53 NITROFURANTOIN MONOHYDRATE & MACROCRYSTAL 100 MG ORAL CAP [41908] 1.86 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH [8585] 1.90 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH [8586] 1.50 NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET [24864] 2.17 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH [8493] 0.69 NITROGLYCERIN 0.6 MG SUBLINGUAL TABLET [24865] 2.40 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH [8587] 2.76 NITROGLYCERIN 2 % TRANSDERMAL OINTMENT [23994] 0.08 NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS [110223] 1.56 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [111991] 0.09 NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS [3341] 324.16 NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION [145690] 324.16 NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION [160167] 324.16 NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION [145689] 2532.00 NM SPECT MULT AREA MULT DAYS 2532.00 NM SPECT MULT AREA, SINGLE DAY 2532.00 NM SPECT SINGLE AREA, MULT DAY 22.00 Non-heu tc-99m add-on/dose 145.00 Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle 200.00 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 1007.00 NON-ROUTINE HEMODIALYSIS 6.07 NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION [39256] 0.74 NORTRIPTYLINE 10 MG CAPSULE [5155] 1.47 NORTRIPTYLINE 25 MG CAPSULE [5156] 1594.50 Nuclear medicine imaging for thyroid uptake measurements 4574.00 Nuclear medicine imaging from skull base to mid-thigh 3912.50 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, 2 or more days imaging 3637.25 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, 2 or more days imaging 1737.50 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, single day imaging 2639.50 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, single day imaging 1259.25 Nuclear medicine study of blood circulation in the lungs 1625.75 Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study 1838.00 Nuclear medicine study of kidney with assessment of blood flow and function 1929.25 Nuclear medicine study of kidney with assessment of blood flow and function 1179.25 Nuclear medicine study of lung ventilation 1789.50 Nuclear medicine study of lung ventilation and blood circulation in the lungs 2886.50 Nuclear medicine study of vessels of heart using drugs or exercise multiple studies 2886.50 Nuclear medicine study of vessels of heart using drugs or exercise single study 6187.00 Nuclear medicine study with CT imaging skull base to mid-thigh 6187.00 Nuclear medicine study with CT imaging whole body 3618.00 Nuclear medicine study with CT imaging whole body 2314.25 Nuclear medicine study with measurement of blood circulation in the lungs 1.17 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM [5881] 0.33 NYSTATIN ORAL LIQUID 500,000 UNIT/5 ML ADS [600992] 50.75 NYSTATIN SUSPENSION 7.46 NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM [42135] 196.53 OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION [139519] 62.25 Observation care per hour 88.00 Observation care per hour 293.50 Observation care per hour 398.50 Observation care per hour 60.25 Observation care per hour 147.00 Observation care per hour 65.25 Observation care per hour 66.50 Observation care per hour 848.75 Observation care per hour 483.75 Observation care per hour 207.25 Observation care per hour 91.75 Observation care per hour 52.75 Observation care per hour 272.25 Observation care per hour 276.00 Observation care per hour 244.00 Observation care per hour 394.00 Observation care per hour 275.00 Observation, testing, and recording of abnormal eye movement 110.25 Occlusive device in vein art PRICE Description 12.00 OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION [40470] 11.92 OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION [45267] 24.48 OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION [40522] 4242.59 OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE [146855] 7663.37 OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE [146856] 50.00 OHS PHYSICAL ABILITY TEST 53.64 OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION [55352] 14.27 OLANZAPINE 5 MG DISINTEGRATING TABLET [49664] 13.22 OLANZAPINE 5 MG TABLET [45302] 16.08 OLANZAPINE 7.5 MG TABLET [45957] 7.00 OLMESARTAN 20MG TAB 1327.63 OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION [53280] 1327.63 OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE [163865] 1327.63 OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRINGE [163863] 90.00 Omalizumab injection 0.08 OMEGA-3 FATTY ACIDS 1,000 MG CAPSULE [28284] 7.00 OMEGA-3 FISH OIL 1 G CAP 3.70 OMEPRAZOLE 10 MG CAPSULE,DELAYED RELEASE [40725] 3.90 OMEPRAZOLE 20 MG CAPSULE,DELAYED RELEASE [38954] 6.00 OMEPRAZOLE 40MGCAP, EA 721.20 ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION [44871] 1.28 ONDANSETRON 4 MG DISINTEGRATING TABLET [49063] 0.36 ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [89684] 0.47 ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [45003] 24.78 ONDANSETRON HCL 4 MG TABLET [45094] 12.75 One-way allow prorated trip 3524.75 Open treatment of broken finger or thumb 5834.25 Open treatment of broken hand or finger 2169.50 OR MAJOR 1ST 1/2 HOUR 725.50 Organic acids level 1160.00 ORITAVANCIN 400 MG INTRAVENOUS SOLUTION [144401] 11.10 ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION [40245] 14.18 OSELTAMIVIR 30 MG CAPSULE [100574] 14.18 OSELTAMIVIR 45 MG CAPSULE [100575] 15.46 OSELTAMIVIR 75 MG CAPSULE [47232] 364.75 OSELTAMIVIR PER 75 MG/ML SUSP 195.50 Osteocalcin (bone protein) level 50.00 Osteopathic manipulative treatment to 1-2 body regions 50.00 Osteopathic manipulative treatment to 3-4 body regions 50.00 Osteopathic manipulative treatment to 5-6 body regions 50.00 Osteopathic manipulative treatment to 7-8 body regions 50.00 Osteopathic manipulative treatment to 9-10 body regions 1768.25 OSTEOSET MINI BEAD KIT 719.25 OSTEOTOMY BLADE 42.00 OT QUAL NONMD EST PT 11-20M 70.00 OT QUAL NONMD EST PT 21+M 24.00 OT QUAL NONMD EST PT 5-10 MIN 259.75 Oth resp proc, group 469.75 Overnight measurement of oxygen saturation in blood using ear or finger device 142.75 Oxalate level 1650.00 OXALIPLATIN 100 MG INTRAVENOUS SOLUTION [52195] 6.00 OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [82295] 1.51 OXCARBAZEPINE 150 MG TABLET [44190] 2.76 OXCARBAZEPINE 300 MG TABLET [45738] 340.75 Oxcarbazepine level 0.72 OXYBUTYNIN CHLORIDE 5 MG TABLET [6340] 7.00 OXYCODONE 10MG CR TAB 6.00 OXYCODONE 10MG TAB, EACH 1.87 OXYCODONE 15 MG TABLET [42173] 11.75 OXYCODONE 20MG CR TAB 3.56 OXYCODONE 30 MG TABLET [42174] 0.54 OXYCODONE 5 MG TABLET [5526] 1.73 OXYCODONE 5 MG/5 ML ORAL SOLUTION [30157] 15.81 OXYCODONE ER 40 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR [145888] 1.37 OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET [6388] 187.25 OXYGEN SUPPLY/DAY 0.06 OXYMETAZOLINE 0.05 % NASAL SPRAY [8816] 0.09 OXYMETAZOLINE 0.05 % NASAL SPRAY [8816] 1.79 OXYTOCIN 10 UNIT/ML INJECTION SOLUTION [24027] 3.10 PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS [29507] 4.10 PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS [29507] 1653.61 PACLITAXEL-PROTEIN BOUND 100 MG INTRAVENOUS SUSPENSION [56991] 47.14 PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR [89881] 47.14 PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR [89882] 2139.50 PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE [113160] 2139.45 PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE [113161] 12.00 PALONSETRON PER25MCG,25MCG/5ML PRICE Description 153.75 PAMIDRONATE /30MG,9MG/MLINJ,10 48.00 PAMIDRONATE 30 MG INTRAVENOUS SOLUTION [30368] 1.66 PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION [30648] 7.00 PANCRELIPASE DR(27K-5K-17K)UNI 293.53 PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION [108983] 5.27 PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE [46266] 15.73 PANTOPRAZOLE 40 MG GRANULES FOR ORAL SUSP, DELAYED RELEASE [102486] 6.00 PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION [45454] 0.46 PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE [47191] 20.60 PAPAVERINE 30 MG/ML INJECTION SOLUTION [9632] 567.50 Parathormone (parathyroid hormone) level 2.81 PAROXETINE 10 MG TABLET [40192] 2.79 PAROXETINE 20 MG TABLET [40193] 138.75 Partial ultrasound of joint or other non-blood vessel structure of arm or leg 132.25 Partial ultrasound of joint or other non-blood vessel structure of arm or leg 287.25 Pathology examination of specimen during surgery 583.75 Pathology examination of tissue during surgery 228.00 Pathology examination of tissue using a microscope 769.75 Pathology examination of tissue using a microscope, high complexity 349.00 Pathology examination of tissue using a microscope, intermediate complexity 138.00 Pathology examination of tissue using a microscope, limited examination 572.00 Pathology examination of tissue using a microscope, moderately high complexity 276.25 Pathology examination of tissue using a microscope, moderately low complexity 5041.75 Patient progr, neurostim 0.72 PEG 400-PROPYLENE GLYCOL 0.4 %-0.3 % EYE DROPS [53045] 1034.75 PEG TUBES 0.01 PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION [45950] 75.25 PEG-ELECTROLYTES PWD, 4000 ML 12462.12 PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR [145974] 12462.12 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE [49713] 8350.00 PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE [164277] 27122.40 PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION [119747] 1437.06 PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION [146005] 849.12 PEMETREXED 100 MG INTRAVENOUS SOLUTION [102009] 4245.60 PEMETREXED 500 MG INTRAVENOUS SOLUTION [54889] 9.25 PEN SURG MARKING 94.42 PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE [52015] 96.74 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE [23960] 109.03 PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE [23953] 15.19 PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION [36069] 1.19 PENICILLIN V POTASSIUM 250 MG TABLET [2348] 0.78 PENICILLIN V POTASSIUM 500 MG TABLET [5182] 200.27 PENTAMIDINE 300 MG SOLUTION FOR INHALATION [46516] 1.50 PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE [5205] 1593.00 Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast 56.16 PERFLUTREN PROTEIN-TYPE A MICROSPHERES 0.22 MG/ML INTRAVENOUS SUSP [109557] 0.17 PERMETHRIN 1 % TOPICAL LIQUID [28216] 1.98 PERMETHRIN 5 % TOPICAL CREAM [9387] 1.97 PERPHENAZINE 2 MG TABLET [5978] 2.69 PERPHENAZINE 4 MG TABLET [5979] 3.26 PERPHENAZINE 8 MG TABLET [5980] 468.00 PERQ REPLACEMENT G TUBE 440.39 PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION [131738] 75.00 Pessary, non rubber,any type 7.25 PHASE 1 RECOVERY PER MIN 2.70 PHENAZOPYRIDINE 100 MG TABLET [5760] 4.00 PHENAZOPYRIDINE 200 MG TABLET [5761] 180.25 Phenobarbital level 26.18 PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION [10316] 1.25 PHENOBARBITOL 32.4 MG TABLET 0.02 PHENOL 1.4 % MUCOSAL AEROSOL SPRAY [49548] 535.00 PHENTOLAMINE 5 MG INJECTION EXTRAVASATION ANTIDOTE [612844] 131.75 Phenylalanine, PKU (amino acid) level 0.43 PHENYLEPHRINE 1 % NASAL SPRAY [47141] 139.50 PHENYLEPHRINE 1 %-KETOROLAC 0.3 % INTRAOCULAR CONCENTRATE FOR IRRIG [146865] 9.60 PHENYLEPHRINE 10 % EYE DROPS [42331] 2.98 PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION [9615] 7.20 PHENYLEPHRINE 2.5 % EYE DROPS [7373] 7.00 PHENYLEPHRINE-BROMPHENIRAMINE 2.16 PHENYTOIN 100 MG/4 ML ORAL SUSPENSION [103820] 0.78 PHENYTOIN 50 MG CHEWABLE TABLET [45771] 187.25 Phenytoin level 177.25 Phenytoin level 0.44 PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION [3327] 0.68 PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE [8567] 1.34 PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE [49318] 152.50 Phosphatase (enzyme) level PRICE Description 304.75 Phosphatase (enzyme) level 194.25 Phosphatase (enzyme) measurement 108.25 Phosphate level 171.75 Phospholipid antibody (autoimmune antibody) measurement 114.00 Photography of content of eyes 114.00 Photography of the retina 279.25 Photography of the retina 274.75 Phototherapy light w/ photom 152.50 Physical performance test or measurement with report, each 15 minutes 165.00 Physician services for outpatient heart cardiac rehabilitation per session 229.50 Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session 54.00 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE [9882] 57.89 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION [44598] 12.33 PHYTONADIONE (VITAMIN K1) 5 MG TABLET [49647] 5.79 PHYTONADIONE 1 MG/ML ORAL LIQUID (CCF) [614329] 7.61 PILOCARPINE 2 % EYE DROPS [2914] 1.81 PILOCARPINE 5 MG TABLET [43501] 79.00 PIN STEINMAN AND GUIDEWIRE 131.75 Pinworm test 5.68 PIOGLITAZONE 15 MG TABLET [44066] 8.68 PIOGLITAZONE 30 MG TABLET [48922] 30.00 PIPERACILLIN/TAZOBACTAM PER 1G 8.24 PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION [49017] 18.46 PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION [47006] 16.48 PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION [47178] 23.75 PIPERACILLIN-TAZOBACTAM 4.5GM 30.00 PIPERACILLIN-TAZOBACTAM PER 1G 252.50 Placement of breast localization devices accessed through the skin with mammographic guidance 1168.00 Placement of breast localization devices accessed through the skin with stereotactic guidance 1250.25 Placement of breast localization devices accessed through the skin with ultrasound guidance 252.50 Placement of breast localization devices accessed through the skin with ultrasound guidance 1142.75 Placement of catheter of gallbladder and pancreas under imaging using an endoscope 1088.25 Placement of catheter of gallbladder and pancreas under imaging using an endoscope 3676.75 Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation 3646.50 Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation 275.00 Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report 275.00 Placement of ear probe for computerized measurement of sound with interpretation and report 100.00 Placement of intra-uterine device (IUD) for pregnancy prevention 9554.50 Placement of temporary pacemaker leads 16591.50 Placement of temporary pacemaker leads 523.00 Plasma 1 donor frz w/in 8 hr 100.00 Platelet count, automated test 154.50 Platelet function test 42.25 Platelet function test 56.25 Platelet function test 120.75 Platelet function test 119.25 Platelet function test 2257.25 Platelets, pheresis 17787.50 Pmkr, dual, rate-resp 14039.00 Pmkr, other than sing/dual 13682.50 Pmkr, single, rate-resp 300.00 Pneumococcal vaccine for injection into muscle 1.87 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET [44609] 13.50 POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION [24627] 0.13 POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE [10442] 0.34 POLYVINYL ALCOHOL-POVIDONE (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE [52439] 341.91 PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION [85155] 1135.00 PORT A CATH LOW PROFILE 100.00 Post-delivery care 0.20 POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [3680] 0.50 POTASSIUM BICARBONATE AND CHLORIDE 25 MEQ EFFERVESCENT TABLET [44058] 0.25 POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET [6400] 0.04 POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK [4087] 0.08 POTASSIUM CHLORIDE 10 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK [4088] 0.01 POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4228] 0.25 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION [3349] 0.36 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION [3349] 0.04 POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK [4089] 0.81 POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID [2596] 0.01 POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION [4197] 0.01 POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS [4096] 0.01 POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV [4191] 0.01 POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4193] 16.00 POTASSIUM CHLORIDE 20MEQ IN DE 0.01 POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4195] 0.01 POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS [4097] 0.01 POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4196] PRICE Description 0.65 POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE [4170] 0.68 POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST) [30045] 2.76 POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE [47066] 40.25 POTASSIUM IODIDE 1000MG/ML CON 0.69 POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION [4114] 0.65 POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET [101488] 0.06 POVIDONE-IODINE 10 % TOPICAL OINTMENT [6747] 0.56 POVIDONE-IODINE 5 % EYE SOLUTION [47507] 1124.00 POWER PORT 6.00 PRAMIPEXOLE 0.125MG TAB, EACH 2.95 PRAMIPEXOLE 0.25 MG TABLET [47991] 3.34 PRAMIPEXOLE 1 MG TABLET [40492] 18.36 PRASUGREL 10 MG TABLET [112844] 0.47 PRAVASTATIN 10 MG TABLET [46693] 3.27 PRAVASTATIN 20 MG TABLET [48414] 15.75 PRAVASTATIN 40MG TAB 1.81 PRAZOSIN 1 MG CAPSULE [671] 6.00 PRAZOSIN 2MG CAP 166.25 Prealbumin (protein) level 200.00 Predelivery care 4-6 visits 11.06 PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [23260] 7.00 PREDNISOLONE SODIUM PHOSPHATE 0.31 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION [38180] 0.28 PREDNISONE 1 MG TABLET [2659] 0.27 PREDNISONE 10 MG TABLET [2657] 0.29 PREDNISONE 20 MG TABLET [2656] 0.25 PREDNISONE 5 MG TABLET [2655] 0.74 PREDNISONE 5 MG/5 ML ORAL SOLUTION [2599] 6.00 PREGABALIN 100MG CAP, EACH 6.00 PREGABALIN 150MG CAP, EACH 9.36 PREGABALIN 25 MG CAPSULE [83700] 1.62 PREGABALIN 50 MG CAPSULE [83701] 1.62 PREGABALIN 75 MG CAPSULE [83702] 172.00 Pregnenolone (reproductive hormone) level 0.05 PRENATAL VITS NO.126-FERROUS FUM 28 MG IRON-FOLIC ACID 800 MCG TABLET [152091] 39.00 Preparation and provision of single or multiple antigens for allergen immunotherapy 222.25 Preparation of tissue for examination by removing any calcium present 195.50 Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement 319.50 Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement 225.00 Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement 115.50 Pretreatment of serum for use in red blood cell antibody analysis and measurement 119.25 Pretreatment of serum for use in red blood cell antibody analysis and measurement 0.50 PRIMIDONE 50 MG TABLET [29089] 211.75 Primidone level 1.15 PROBENECID 500 MG TABLET [5953] 279.50 Procalcitonin (hormone) level 12.58 PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY [10542] 11.10 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION [125626] 247.00 PROCHLORPERAZINE EDYSLATE PER 0.97 PROCHLORPERAZINE MALEATE 10 MG TABLET [5240] 2012.00 PROCTOSCOPY WITH BIOPSY 66.25 Progesterone (reproductive hormone) level 243.00 Progesterone (reproductive hormone) level 80.00 Programming device evaluation of heart monitoring system with adjustment of programmed values with analysis, review and report 361.50 Prolactin (milk producing hormone) level 798.75 Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours 812.25 Prolonged iv inf, req pump 40.00 Prolonged office or other outpatient service first hour 17.71 PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY [39731] 17.71 PROMETHAZINE 25 MG RECTAL SUPPOSITORY [38990] 0.14 PROMETHAZINE 25 MG TABLET [5513] 0.18 PROMETHAZINE 6.25 MG-CODEINE 10 MG/5 ML SYRUP [38455] 8.00 Promethazine hcl injection 7.00 PROMETHAZINE PER 50MG, 25MG/ML 2.93 PROPARACAINE 0.5 % EYE DROPS [8851] 0.14 PROPOFOL 10 MG/ML [613035] 0.38 PROPOFOL 10 MG/ML [613035] 0.20 PROPRANOLOL 10 MG TABLET [6447] 0.51 PROPRANOLOL 20 MG TABLET [6448] 1.30 PROPRANOLOL 40 MG TABLET [6449] 2.18 PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE [24304] 2.39 PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE [23235] 3.36 PROPYLTHIOURACIL 50 MG TABLET [714] 2.95 PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION [11] 494.75 Protein C, (clotting inhibitor) activity 304.75 Protein measurement 98.75 Protein measurement PRICE Description 200.75 Protein measurement, body fluid 200.75 Protein measurement, serum 366.00 Protein S (clotting inhibitor) measurement 249.25 Protein S (clotting inhibitor) measurement 469.75 PSA (prostate specific antigen) measurement 228.00 Psa screening 0.05 PSEUDOEPHEDRINE 30 MG TABLET [2661] 422.25 Psychiatric diagnostic evaluation 275.50 Psychotherapy, 30 minutes 286.75 Psychotherapy, 45 minutes 297.75 Psychotherapy, 60 minutes 0.51 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET [142080] 130.00 PT NEEDLE INSERTION 3+ MUSC 110.00 PT NEEDLE INSERTION, 1-2 MUSC 42.00 PT QUAL NONMD ESP PT 11-20M 70.00 PT QUAL NONMD EST PT 21+M 24.00 PT QUAL NONMD EST PT 5-10 M 55.00 PT WORK CONDITION PER 15 MIN 157.50 Pulmonary rehab w exer 1.00 Punch biopsy of additional skin lesion 360.00 Punch biopsy of single skin lesion 367.50 Punch biopsy of single skin lesion 236.25 Puraply 1 sq cm 262.50 Puraply am 1 sq cm 114.00 Pure tone air conduction threshold hearing assessment 1.48 PYRIDOSTIGMINE BROMIDE 60 MG TABLET [39241] 18.24 PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION [8594] 0.03 PYRIDOXINE (VITAMIN B6) 50 MG TABLET [7391] 6.00 PYRIDOXINE 100MG TAB, EACH 249.25 Pyruvate kinase (enzyme) level 199.00 Qualitative or semiquantitative detection test for helicobacter pylori in stool, multiple-step method 340.75 Quantitation of therapeutic drug 255.50 Quantitation of therapeutic drug 187.00 Quantitation of therapeutic drug 42.25 Quantitation of therapeutic drug 8.00 QUETIAPINE 100 MG TABLET [46007] 12.22 QUETIAPINE 200 MG TABLET [45276] 3.78 QUETIAPINE 25 MG TABLET [40359] 19.79 QUETIAPINE 300 MG TABLET [44464] 15.93 QUETIAPINE ER 150 MG TABLET,EXTENDED RELEASE 24 HR [110511] 8.87 QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [110510] 1.22 QUINAPRIL 20 MG TABLET [48402] 1.22 QUINAPRIL 5 MG TABLET [47912] 804.53 Rabies immune globulin for injection beneath the skin and/or into muscle 1154.25 Rabies immune globulin for injection beneath the skin and/or into muscle 1.80 RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION [56042] 2068.25 Radiological supervision and interpretation of CT guidance for needle insertion 6332.00 Radiological supervision and interpretation of imaging of arteries of both arms or legs 7639.50 Radiological supervision and interpretation of imaging of artery of one arm or leg 244.00 Radiological supervision and interpretation of imaging of previous placed shunt 2169.75 Radiological supervision and interpretation of imaging of vein of one arm or leg 2787.75 Radiological supervision and interpretation of imaging of vein system of head 133.00 Radiological supervision and interpretation of placement of catheter with drainage (accessed through the skin) procedure 7639.50 Radiological supervision and interpretation X-ray of abdominal aorta 7639.50 Radiological supervision and interpretation X-ray of abdominal aorta and both leg arteries 854.50 Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery 521.75 Radiological supervision and interpretation X-ray of elbow 656.75 Radiological supervision and interpretation X-ray of hip joint 710.50 Radiological supervision and interpretation X-ray of knee joint 1716.50 Radiological supervision and interpretation X-ray of lower spinal canal 1347.25 Radiological supervision and interpretation X-ray of middle spinal canal 788.75 Radiological supervision and interpretation X-ray of shoulder joint 1934.50 Radiological supervision and interpretation X-ray of spinal canal, 2 or more spinal regions 1324.00 Radiological supervision and interpretation X-ray of upper spinal canal 467.00 Radiological supervision and interpretation X-ray of urinary bladder and urethra 854.75 Radiological supervision and interpretation X-ray of urinary bladder and urethra 527.00 Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views 581.00 Radiological supervision and interpretation X-ray of urinary tract 569.25 Radiological supervision and interpretation X-ray of uterine tubes and ovaries 521.75 Radiological supervision and interpretation X-ray of wrist joint 7.92 RALOXIFENE 60 MG TABLET [48127] 31.49 RALTEGRAVIR 400 MG TABLET [100667] 1.90 RAMIPRIL 1.25 MG CAPSULE [49346] 138.60 RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION [142239] 7.00 RANITIDINE 150MG TAB 6.42 RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR [86285] 649.00 Rbc leukocytes reduced PRICE Description 7.25 RECOVERY L/D PER MINUTE 7.25 RECOVERY ROOM/ MINUTE 59.50 RECOVERY-ENDO 760.00 RECTUM WO W CON 131.75 Red blood cell antibody detection test 180.50 Red blood cell antibody detection test 174.50 Red blood cell antibody level 41.25 Red blood cell concentration measurement 60.00 Red blood cell sedimentation rate, to detect inflammation 84.75 Red blood cell sickling measurement 649.00 Red blood cells unit 34.75 Red blood count automated, with additional calculations 170.00 Re-evaluation of occupational therapy established plan of care, typically 30 minutes 162.00 Re-evaluation of physical therapy, typically 20 minutes 499.50 Refilling and maintenance of portable pump 58.31 REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE [103954] 2153.25 Relocation of mouth tissue to gum surface 4125.00 Relocation of pacemaker generator skin pocket 3000.00 Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe 2850.00 Removal (over 4.0 centimeters) growth of the face, ears, eyelids, nose, lips, or mouth 50253.50 Removal and replacement of defibrillator pulse generator 42883.00 Removal and replacement of defibrillator pulse generator 22513.50 Removal and replacement of dual lead permanent pacemaker pulse generator 22513.50 Removal and replacement of multiple lead permanent pacemaker pulse generator 19565.25 Removal and replacement of single lead permanent pacemaker pulse generator 189.00 Removal of antibodies from surface of red blood cell 252.50 Removal of blood accumulation between nail and nail bed 175.00 Removal of blood accumulation between nail and nail bed 8295.75 Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance 8295.75 Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin 2047.50 Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin 679.00 Removal of central venous catheter for infusion 6598.50 Removal of central venous catheter for infusion 2630.00 Removal of deep foreign body in muscle or tendon 3360.00 Removal of defibrillator pulse generator 420.00 Removal of drug delivery implant from tissue 5998.50 Removal of electrode from right heart 114.00 Removal of eyelashes by forceps 326.00 Removal of eyelid growth 1618.00 Removal of eyelid growth 1312.25 Removal of fluid from between lung and chest cavity, open procedure 1306.75 Removal of fluid from chest cavity with imaging guidance 2180.75 Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin 3098.00 Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin 173.50 Removal of foreign body from ear canal 114.00 Removal of foreign body from ear canal 4116.50 Removal of foreign body from inside the eye or lens 670.75 Removal of foreign body from tissue, accessed beneath the skin 380.00 Removal of foreign body from tissue, accessed beneath the skin 3990.50 Removal of foreign body from tissue, accessed beneath the skin 230.00 Removal of foreign body in external eye, conjunctiva 114.00 Removal of foreign body in external eye, conjunctiva 420.00 Removal of foreign body in external eye, conjunctiva or sclera 173.50 Removal of foreign body in nose 2031.00 Removal of foreign body of foot tissue, accessed beneath the skin 897.75 Removal of foreign body, external eye, cornea 540.00 Removal of foreign body, external eye, cornea 230.00 Removal of foreign body, external eye, cornea with slit lamp examination 114.00 Removal of foreign body, external eye, cornea with slit lamp examination 5413.25 Removal of foreskin of using clamp or device 1883.00 Removal of foreskin of using clamp or device 601.00 Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth 1773.25 Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals 1655.00 Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals 1360.25 Removal of growth (0.5 centimeters or less) of the trunk, arms or legs 601.00 Removal of growth (0.5 centimeters or less) of the trunk, arms or legs 601.00 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth 1177.00 Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals 601.00 Removal of growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs 1177.00 Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth 1655.00 Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals 601.00 Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs 1655.00 Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals 1177.00 Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs 1413.00 Removal of growth (3.1 to 4.0 centimeters) of the trunk, arms, or legs 1768.00 Removal of growth (4.0 centimeters) of the trunk, arms, or legs 3000.00 Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals PRICE Description 4470.00 Removal of growth of mouth 2132.50 Removal of heart rhythm monitor from under skin 252.50 Removal of impact ear wax, one ear 70.00 Removal of impact ear wax, one ear 252.50 Removal of impacted ear wax by washing 110.00 Removal of impacted ear wax by washing 3529.25 Removal of impacted stool or foreign body under anesthesia 314.00 Removal of intra-uterine device (IUD) for pregnancy prevention 1160.00 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips 1177.00 Removal of malignant growth (0.5 centimeters or less) of the trunk, arms, or legs 601.00 Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips 601.00 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs 601.00 Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips 1177.00 Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals 601.00 Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs 1550.00 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips 1550.00 Removal of malignant growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals 1177.00 Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs 645.00 Removal of malignant growth (3.1 to 4 centimeters) of the trunk, arms, or legs 1768.00 Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs 350.00 Removal of more than 4 thickened skin growths 326.00 Removal of multiple growths of different eyelids 900.00 Removal of multiple growths of same eyelid 399.00 Removal of nail 1393.00 Removal of outer layer of cornea 7980.00 Removal of permanent pacemaker pulse generator 26923.25 Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 23920.50 Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure 216.75 Removal of single thickened skin growth 215.00 Removal of single thickened skin growth 213.75 Removal of single thickened skin growth 1865.50 Removal of skin and bone first 20 sq cm or less 230.00 Removal of skin and tissue 736.75 Removal of skin and tissue 1250.25 Removal of skin and tissue first 20 sq cm or less 375.00 Removal of skin and tissue first 20 sq cm or less 736.75 Removal of skin and/or muscle 536.00 Removal of skin and/or muscle first 20 sq cm or less 704.25 Removal of skin and/or muscle first 20 sq cm or less 215.00 Removal of skin debris and drainage of mastoid cavity 508.25 Removal of skin of finger or toe nail 380.00 Removal of skin of finger or toe nail 518.50 Removal of skin suture with change of bladder tube 461.50 Removal of skin suture with change of bladder tube 460.00 Removal of skin suture with change of bladder tube 80.00 Removal of skin tags 3403.25 Removal of tailbone cyst 114.00 Removal of tissue from 1 to 5 finger or toe nails 127.25 Removal of tissue from 1 to 5 finger or toe nails 98.00 Removal of tissue from 6 or more finger or toe nails 127.25 Removal of tissue from 6 or more finger or toe nails 282.00 Removal of tissue from wounds per session 391.50 Removal of tissue from wounds per session 20.00 Removal of tissue from wounds per session 245.25 Removal of tissue from wounds per session 215.00 Removal of up to and including 15 skin tags 263.25 Renin (kidney enzyme) level 10080.00 Reopening of arteries in thigh and behind knee with placement of stent via catheter using imaging guidance 3958.25 Rep dev, urinary, w/sling 7.51 REPAGLINIDE 2 MG TABLET [44293] 1250.25 Repair of (2.5 centimeter or less) laceration to floor of mouth and/or tongue 2116.00 Repair of (over 2.6 laceration) to floor of mouth or tongue 5628.25 Repair of blood vessel of arm 2246.25 Repair of blood vessel of leg 847.25 Repair of finger or toe nail bed 1008.00 Repair of separation of wound closure 1740.00 Repair of toe tendon, accessed through the skin 846.75 Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs 1250.25 Repair of wound (12.6 to 20.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 1250.25 Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 1250.25 Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 323.50 Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth 323.50 Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes 215.00 Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes 323.50 Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs 206.00 Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs 508.25 Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs PRICE Description 400.00 Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs 661.50 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 323.50 Repair of wound (2.6 to 5.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 2153.25 Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 656.25 Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals 2153.25 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs 323.50 Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 200.00 Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 846.50 Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 2153.25 Repair of wound (2.6 to 7.5 centimeters) of trunk 1250.25 Repair of wound (20.1 to 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 323.50 Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 1250.25 Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals 323.50 Repair of wound (7.6 to 12.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 323.50 Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 1250.25 Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 1250.25 Repair of wound (over 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 370.75 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 1250.25 Repair of wound of scalp, arms, and/or legs 2205.00 Replacement of catheter in peripheral vein accessed through same vein 2205.00 Replacement of kidney drainage catheter accessed through the skin with imaging and radiological supervision and interpretation 1593.00 Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 1266.25 Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin 484.00 Replacement of stomach stoma tube accessed through skin 470.00 Replacement of stomach stoma tube accessed through skin 470.00 Replacement of stomach stoma tube accessed through skin with revision of stoma opening 162.50 Repositioning maneuvers for treatment of vertigo, per day 5714.25 Repositioning of implanted pacemaker or defibrillator device 389.00 RESOLUTION CLIPS 231.50 Respiratory inhaled aerosol treatment to relieve airway obstruction 231.50 Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour 187.00 Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen 404.25 Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen 101.00 Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen 929.75 Reviving newborn at delivery 145.75 Rheumatoid factor level 113.75 Rhophylac injection 9.93 RIBAVIRIN, PER EA, 200MG CAP 1.33 RIFAMPIN 300 MG CAPSULE [6769] 445.25 RIFAMPIN PER EACH, 600MG INJ, 47.37 RIFAXIMIN 550 MG TABLET [116444] 4.27 RISPERIDONE 0.5 MG TABLET [49430] 4.54 RISPERIDONE 1 MG TABLET [49198] 3.93 RISPERIDONE 2 MG TABLET [46376] 674.52 RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN [158015] 673.08 RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN [158077] 112.74 RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS [49197] 17.92 RIVAROXABAN 10 MG TABLET [123504] 17.92 RIVAROXABAN 15 MG TABLET [125739] 17.92 RIVAROXABAN 20 MG TABLET [125740] 4.24 RIVASTIGMINE 1.5 MG CAPSULE [40539] 40.75 RIVASTIGMINE 13.3MG/24HR PATCH 27.44 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH [99231] 27.44 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH [99232] 43.88 RIZATRIPTAN 10 MG DISINTEGRATING TABLET [47090] 36.37 RIZATRIPTAN 5 MG DISINTEGRATING TABLET [48921] 0.88 ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION [45675] 14.44 ROFLUMILAST 500 MCG TABLET [122215] 3088.00 Room and Board Intensive Care Unit General 2159.00 Room and Board Intermediate Intensive Care Unit 1054.00 Room and Board Nursery 1445.00 Room and Board Private Medical/Surgical/GYN 1445.00 Room and Board Semiprivate Hospice 1445.00 Room and Board Semiprivate Medical/Surgical/GYN 1971.00 Room and Board Semiprivate Psychiatric 1445.00 Room and Board Semiprivate Skilled Nursing 2.51 ROPINIROLE 0.25 MG TABLET [46912] 6.00 ROPINIROLE 0.5MG TAB 2.51 ROPINIROLE 1 MG TABLET [44378] 2.50 ROPINIROLE 4 MG TABLET [49629] 0.21 ROPIVACAINE, PER 1MG,0.5% 30ML 0.10 ROPIVACAINE,PER 1MG, 0.2% 20ML 0.29 ROPIVACAINE,PER 1MG,0.2% 10ML 1.44 ROSUVASTATIN 10 MG TABLET [53606] 1.44 ROSUVASTATIN 20 MG TABLET [53607] 8.94 ROSUVASTATIN 40MG TAB, EACH 140.00 Routine electrocardiogram (EKG) with tracing using at least 12 leads PRICE Description 324.25 Routine electrocardiogram (EKG) with tracing using at least 12 leads 1007.00 ROUTINE HEMODIALYSIS 0.48 SACCHAROMYCES BOULARDII 250 MG CAPSULE [54687] 10.18 SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET [147927] 10.18 SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET [147928] 6.00 SALIVA SUB(BIOTENE) 59ML 0.02 SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH [142575] 9.81 SALMETEROL 50 MCG/DOSE BLISTER POWDER FOR INHALATION [47762] 19.26 SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH [48815] 94.75 Screening digital tomography of both breasts 177.25 Screening examination of specimen cells 170.00 Screening test for antibody to noninfectious agent 33.00 Screening test for antibody to noninfectious agent 199.00 Screening test for autoimmune disorder 319.50 Screening test for compatible blood unit 91.50 Screening test for mononucleosis (mono) 110.25 Screening test for pathogenic organisms 44.50 Screening test for pathogenic organisms 230.50 Screening test for presence of antibody 147.25 Screening test for red blood cell antibodies 45.25 SCRW 4.0CNCLS PTL THRD 10-50MM 429.75 SCRW 5.0 LCKG/IM NAIL 26-100MM 467.50 SCRW 5.0MM CNLTD LCKNG 25-95MM 310.25 SCS ACCESSORY KIT 3550-29 310.25 SCS ANTENNA 37092 145.75 Selenium (vitamin) level 152.50 Self-care or home management training, each 15 minutes 162.00 Semen analysis for sperm presence 243.00 Semen evaluation volume, sperm count, motility and analysis 0.04 SENNOSIDES 8.6 MG TABLET [24585] 0.04 SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET [43603] 97.75 Sensory technique to enhance processing and adaptation to environmental demands, each 15 minutes 203.50 Separation of nail plate from nail bed 215.00 Separation of nail plate from nail bed 546.75 Serotonin (hormone) level 0.40 SERTRALINE 100 MG TABLET [45246] 0.40 SERTRALINE 25 MG TABLET [48021] 3.36 SERTRALINE 50 MG TABLET [49170] 14.50 SET BUTTERFLY 24 X 3/4 21.25 SET EXT W/TCONNECTOR 35.75 SET FILTER & AXALL FIONCO 9.91 SEVELAMER CARBONATE 800 MG TABLET [101881] 18.00 SEVELAMER HCL 800 MG TABLET 153.00 Sex hormone binding globulin (protein) level 282.00 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth 215.00 Shaving of 0.5 centimeters or less skin growth of scalp, neck, hands, feet, or genitals 215.00 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs 282.00 Shaving of 0.6 centimeters to 1.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth 215.00 Shaving of 0.6 centimeters to 1.0 centimeters skin growth of scalp, neck, hands, feet, or genitals 215.00 Shaving of 0.6 centimeters to 1.0 centimeters skin growth of the trunk, arms, or legs 380.00 Shaving of 1.1 to 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth 355.00 Shaving of 1.1 to 2.0 centimeters skin growth of the trunk, arms, or legs 380.00 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth 630.00 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs 20.75 SHEEHY COLLR EAR TUBE 23-40300 2412.25 SIGMOID FLEX W/CONTROL BLEEDIN 1474.25 SIGMOID FLEX W/SUBMUCOSAL INJ 1684.00 SIGMOIDOSCOPY 2349.25 SIGMOIDOSCOPY W/POLYP REM 62.50 SILDENAFIL CITRATE 20 MG TAB 29.50 SILICONE I/A TIP 0.69 SILVER ER TOPICAL GEL,EXTENDED RELEASE [56063] 0.73 SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK [90041] 0.30 SILVER SULFADIAZINE 1 % TOPICAL CREAM [8861] 0.18 SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION [5365] 0.09 SIMETHICONE 80 MG CHEWABLE TABLET [6749] 248.75 Simple control of nose bleed 220.00 Simple control of nose bleed 16.00 SIMVASTATIN 20MG TAB 127.48 SINCALIDE 5 MCG SOLUTION FOR INJECTION [46081] 224.75 Sincalide injection 279.00 Sirolimus level 18.05 SITAGLIPTIN 100 MG TABLET [88990] 18.05 SITAGLIPTIN 25 MG TABLET [88987] 30.00 Skin barrier, wipe or swab 20.00 Skin test for tuberculosis 404.00 Skin, mucus membrane and beneath the skin procedure PRICE Description 4735.25 Sleep monitoring of patient (6 years or older) in sleep lab 3685.25 Sleep monitoring of patient (6 years or older) in sleep lab 5124.75 Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube 1608.25 Sleep monitoring of patient (younger than 6 years) in sleep lab 3265.00 SM BOWEL ENTEROS W/CTRL BLEED 2112.50 SM BOWEL ENTEROSCOPY W/BX 25.00 Smear for infectious agents 12.50 Smear for infectious agents 105.75 Smear for infectious agents 34.00 Smoking and tobacco use intensive counseling, greater than 10 minutes 34.00 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes 3790.50 Snip incision of tear duct opening 7.75 SOD CHL 0.9% PF LUSH INJ 10 ML 0.19 SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [3684] 0.23 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION [4053] 1.69 SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE [132536] 0.07 SODIUM BICARBONATE 650 MG TABLET [16] 0.01 SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION [4104] 0.01 SODIUM CHLORIDE 0.45 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP [53083] 0.02 SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL [24003] 0.05 SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE [1028] 0.85 SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE [1028] 0.04 SODIUM CHLORIDE 0.9 % FOR NEBULIZATION [2688] 0.08 SODIUM CHLORIDE 0.9 % INJECTION SOLUTION [1827] 0.11 SODIUM CHLORIDE 0.9 % INJECTION SOLUTION [1827] 0.06 SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK [85042] 0.12 SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK [85042] 0.01 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346] 0.02 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346] 0.03 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346] 0.05 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346] 0.01 SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION [3972] 0.01 SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP [4100] 0.01 SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP [4101] 0.10 SODIUM CHLORIDE 1 GRAM TABLET [15] 1.15 SODIUM CHLORIDE 2 % EYE DROPS [49623] 0.10 SODIUM CHLORIDE 3 % FOR NEBULIZATION [21221] 0.01 SODIUM CHLORIDE 3 % INTRAVENOUS INJECTION SOLUTION [7658] 0.18 SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION [3279] 0.81 SODIUM CHLORIDE 5 % EYE DROPS [6732] 3.57 SODIUM CHLORIDE 5 % EYE OINTMENT [6657] 0.07 SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION [5555] 0.51 SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [48260] 7.63 SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS [48780] 114.00 SODIUM HYALURONATE (HYALGAN) 10 MG/ML INTRA-ARTICULAR SYRINGE [613563] 219.68 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE [47065] 203.96 SODIUM HYALURONATE 10 MG/ML(MW 2.4-3.6 MILLION)INTRA-ARTICULAR SYRINGE [155545] 27.00 SODIUM HYPOCHLORITE 0.125% 23.25 SODIUM HYPOCHLORITE 0.25% TOP 72.25 Sodium level 35.75 Sodium level 28.65 SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION [10511] 1.17 SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION [31251] 0.01 SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA [47846] 0.02 SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA [90717] 0.37 SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP [152071] 2.14 SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION [9084] 5.50 SOL SOD CHOL 0.9% IRR 14.65 SOLIFENACIN 5 MG TABLET [56684] 310.50 Somatomedin (growth factor) level 0.11 SORBITOL 70 % SOLUTION [5564] 15.00 SORBSAN DRESS, 4X4 3.13 SOTALOL 120 MG TABLET [5178] 2.35 SOTALOL 80 MG TABLET [5179] 42.00 SP QUAL NONMD EST PT 11-20 MIN 70.00 SP QUAL NONMD EST PT 21+MIN 24.00 SP QUAL NONMD EST PT 5-10 MIN 70.75 Special stain for microorganism 76.75 Special stain for microorganism 42.00 Special stain for microorganism 108.75 Special stained specimen slides to examine tissue 182.25 Special stained specimen slides to examine tissue including interpretation and report 163.75 Special stained specimen slides to identify organisms including interpretation and report 43.25 Specimen analysis for blood 50.00 SPECIMEN COLL FOR COVID 19 2083.25 SPECT nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in single area, 1 day of imaging 21.25 Speical Charge General Admission - IV Board PRICE Description 656.25 Spinal tap for diagnosis 897.75 Spinal tap for diagnosis 1422.25 Spinal tap for diagnosis 0.43 SPIRONOLACTONE 25 MG TABLET [8568] 0.88 SPIRONOLACTONE 50 MG TABLET [7309] 9.25 SPONGE 4X4 ST RAYTEC 421.50 Standardized thought processing testing, interpretation, and report per hour 374.75 Stent, non-coa/non-cov w/del 3848.00 Stent, non-coa/non-cov w/del 605.25 Stent, non-cor, tem w/o del 1721.50 Stomach emptying study 25.00 Stool analysis for blood 62.25 Stool analysis for blood 19.25 Stool analysis for blood to screen for colon tumors 72.25 Stool calprotectin (protein) level 228.00 Stool culture 490.50 Stool porphyrins (metabolism substance) level 295.75 Strapping of ankle and/or foot 295.75 Strapping of knee 295.75 Strapping of shoulder 268.00 Strapping, Unna boot 280.00 Strapping, Unna boot 35.00 Strep test (Streptococcus, group A) 615.25 Study of sleep patterns 2.30 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION [2486] 0.38 SUCRALFATE 1 GRAM TABLET [5189] 1.13 SUCRALFATE 100 MG/ML ORAL SUSPENSION [44976] 0.07 SUCROSE IN WATER 24% CUP [600870] 3.71 SULFACETAMIDE SODIUM 10 % EYE DROPS [5916] 0.78 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET [5089] 1.51 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION [10348] 0.22 SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET [5090] 7.00 SULFAMETHOXAZOLE TMP200MG40MG/ 0.24 SULFASALAZINE 500 MG TABLET [6287] 2.13 SUMATRIPTAN 100 MG TABLET [44895] 1.58 SUMATRIPTAN 25 MG TABLET [45070] 25.14 SUMATRIPTAN 50 MG TABLET [45483] 62.40 SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION [46568] 70.00 SUMATRIPTAN SUCCINATE 6MG 1676.25 SUPER QUICK ANCHOR 1859.75 SURG LEVEL 1 EA ADD 30 MIN 2451.00 SURG LEVEL 2 EA ADD 30 MIN 2859.00 SURG LEVEL 3 EA ADD 30 MIN 3196.00 SURG LEVEL 4 EA ADD 30 MIN 3603.75 SURG LEVEL 5 EA ADD 30 MIN 2520.25 SURGERY LEVEL 1 1ST 30 MIN 3113.00 SURGERY LEVEL 2 1ST 30 MIN 3518.75 SURGERY LEVEL 3 1ST 30 MIN 3854.50 SURGERY LEVEL 4 1ST 30 MIN 4263.75 SURGERY LEVEL 5 1ST 30 MIN 243.11 SURGIFLO HEMOSTATIC MATRIX 12 ML KIT [613282] 101.00 SURGIFOAM HEMORRHOIDECTOMY SPG 3648.75 SUTURLYSIS FOR SUTURE REMOVAL 187.25 Sweat collection 11.25 SYNTH CIRC WIRE W/EYE 200.00 Synvisc or synvisc-one 40.25 Syphilis detection test 16.00 Syphilis detection test 97.75 Syphilis test 598.00 T cell count and ratio 155.75 T cell count and ratio 238.50 T cell count and ratio 380.25 T cells count, total 103.75 T cells count, total 155.75 T cells count, total 189.75 T cells count, total 2.23 TACROLIMUS 0.5 MG CAPSULE [49612] 4.46 TACROLIMUS 1 MG CAPSULE [49232] 279.00 Tacrolimus level 2.37 TAMOXIFEN 10 MG TABLET [9935] 4.21 TAMSULOSIN 0.4 MG CAPSULE [46859] 1.00 Tangential biopsy of additional skin lesion 360.00 Tangential biopsy of single skin lesion 367.50 Tangential biopsy of single skin lesion 7.00 TAPENTADOL 50 MG TAB 393.75 Tc99m labeled rbc 87.50 Tc99m maa PRICE Description 192.25 Tc99m mebrofenin 122.00 Tc99m medronate 818.00 Tc99m mertiatide 189.50 Tc99m pentetate 2.50 Tc99m pertechnetate 140.50 Tc99m pyrophosphate 1146.00 Tc99m sestamibi 91.75 Tc99m sulfur colloid 321.00 Tc99m tetrofosmin 109.00 Technetium tc-99m aerosol 358.52 TEDIZOLID 200 MG INTRAVENOUS SOLUTION [142991] 570.13 TELAVANCIN 750 MG INTRAVENOUS SOLUTION [114114] 8.63 TELMISARTAN 80 MG TABLET [47538] 0.71 TEMAZEPAM 15 MG CAPSULE [7304] 0.83 TEMAZEPAM 30 MG CAPSULE [7305] 9.94 TEMAZEPAM 7.5 MG CAPSULE [10673] 93.00 TENCKHOFF CATHETER 1.61 TERAZOSIN 1 MG CAPSULE [5148] 1.61 TERAZOSIN 2 MG CAPSULE [5149] 47.25 TERBINAFINE 250MG TAB 4.80 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION [42549] 2156.50 TESIO CATHETER 220.00 Test for exercise-induced lung stress 131.25 Test for exercise-induced lung stress 153.00 Testing for presence of drug 515.75 Testing for presence of drug 150.75 Testing for presence of drug 162.00 Testing with stimulation for assessment of function at muscle-nerve junction 311.00 Testosterone (hormone) level 280.25 Testosterone (hormone) level 24.00 TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL [24332] 9.96 TETRACAINE 0.5 % HYPERVISCOUS EYE DROPS IN A DROPPERETTE [116200] 9.96 TETRACAINE 0.5 % VISCOUS EYE DROPS IN A DROPPERETTE [114968] 3.07 TETRACAINE HCL (PF) 0.5 % EYE DROPS [120375] 3.30 THEOPHYLLINE ER 300 MG CAPSULE,EXTENDED RELEASE 24 HR [49016] 4.30 THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR [6365] 1.36 THEOPHYLLINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR [44813] 1.96 THEOPHYLLINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR [47402] 185.75 Theophylline level 148.75 Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes 139.00 Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 141.75 Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 0.05 THERAPEUTIC MULTIVITAMIN TABLET [7355] 152.50 Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 87.75 Therapeutic procedures in a group setting 245.25 Therapeutic removal of whole blood to correct blood level imbalance 6.00 THIAMINE 100 MG TABLET 0.02 THIAMINE HCL (VITAMIN B1) 100 MG TABLET [33349] 5.97 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION [9088] 207.25 Thiocyanate (organic sulfur substance) level 7.00 THIOTHIXENE 2MG CAP 7.00 THIOTHIXENE 5MG CAP 63.00 THORACENTESIS TRAY 356.64 THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY SYRINGE [131920] 86.12 THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION [100271] 103.20 THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION [102124] 95.75 Thrombin time, fibrinogen screening test 18.25 Thrombin time, fibrinogen screening test 95.75 Thyroglobulin (thyroid protein) antibody measurement 185.75 Thyroglobulin (thyroid protein) antibody measurement 188.00 Thyroglobulin (thyroid related hormone) level 0.91 THYROID (PORK) 30 MG TABLET [113861] 1.01 THYROID (PORK) 60 MG TABLET [113862] 126.75 Thyroid hormone evaluation 274.25 Thyroid hormone, T3 measurement 311.00 Thyroid hormone, T3 measurement 290.25 Thyroid hormone, T3 measurement 384.50 Thyroid stimulating immune globulins (thyroid related protein) level 155.75 Thyroxine (thyroid chemical) measurement 279.25 Thyroxine (thyroid chemical) measurement 7.48 TICAGRELOR 90 MG TABLET [123691] 187.20 TIGECYCLINE 50 MG INTRAVENOUS SOLUTION [82440] 3.49 TIMOLOL MALEATE 0.25 % EYE DROPS [5907] 3.40 TIMOLOL MALEATE 0.5 % EYE DROPS [5908] 44.50 TIOTROPIUM BROMIDE 18MCG CAP F 55.67 TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION [144777] 2.49 TIROFIBAN 12.5 MG/250 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS [111767] PRICE Description 1120.50 Tissue culture for tumor disorders of bone marrow and blood cells 339.75 Tissue culture for virus isolation 1575.25 Tissue culture to identify white blood cell disorders 25.00 Tissue fungi or parasites 89.00 Tissue fungi or parasites 677.00 Tissue or cell analysis by immunologic technique 1.48 TIZANIDINE 4 MG TABLET [37867] 249.00 Tobramycin (antibiotic) level 2.91 TOBRAMYCIN 0.3 % EYE DROPS [6738] 73.50 TOBRAMYCIN 0.3 % EYE OINTMENT [48028] 29.02 TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION [49657] 1.46 TOBRAMYCIN 40 MG/ML INJECTION SOLUTION [79] 78.24 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT [45613] 134.32 TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION [115220] 134.32 TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION [115219] 3.31 TOLTERODINE 1 MG TABLET [44973] 3.40 TOLTERODINE 2 MG TABLET [46652] 540.96 TOLVAPTAN 15 MG TABLET [112266] 214.69 TOLVAPTAN 7.5 MG PRE-SPLIT TABLET [612577] 94.75 Tomosynthesis, mammo 6.20 TOPIRAMATE 100 MG TABLET [49087] 6.00 TOPIRAMATE 200MG TAB, EACH 2.10 TOPIRAMATE 25 MG TABLET [45657] 6.00 TOPIRAMATE 50MG TAB, EACH 155.75 Topiramate level 3.04 TORSEMIDE 100 MG TABLET [37863] 0.82 TORSEMIDE 20 MG TABLET [37862] 192.25 Total cell count for B cells (white blood cells) 189.75 Total cell count for natural killer cells (white blood cell) 100.00 Total protein level, blood 37.50 Total protein level, body fluid 100.00 Total protein level, body fluid 100.00 Total protein level, urine 4509.00 TRABECULOPASTY 65855 14.70 TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN [40547] 309.25 TRACH TUBE XLT PROX 7MM 103.75 Tracing of electrical activity of the heart using 1-3 leads 249.00 Tracing of electrical activity of the heart using 1-3 leads 155.75 Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes 141.75 Training in use of prosthesis for arms and/or legs, per 15 minutes 0.80 TRAMADOL 50 MG TABLET [37859] 8.68 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION [125934] 5.22 TRANEXAMIC ACID 650 MG TABLET [116660] 141.25 Transferrin (iron binding protein) level 997.25 Transfusion of blood or blood products 907.50 Transfusion of blood or blood products 824.75 Transfusion of blood or blood products 128.00 Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge 128.00 Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge 633.00 Translocation analysis (BCR/ABL1) minor breakpoint 1870.10 TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION [157693] 4436.71 TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION [165400] 393.25 TRAVOPROST 0.004% OPHTH DPS, 2 91.25 TRAY LUMBAR DISP 25.75 TRAY SCRUB SKIN DISP 0.22 TRAZODONE 100 MG TABLET [5135] 2.79 TRAZODONE 150 MG TABLET [6341] 0.16 TRAZODONE 50 MG TABLET [5134] 297.00 Treatment of broken foot bone 2745.75 Treatment of dislocated elbow under anesthesia 764.25 Treatment of elbow dislocation 764.25 Treatment of hip dislocation 311.00 Treatment of speech, language, voice, communication, and/or hearing processing disorder 398.50 Treatment of swallowing and/or oral feeding function 10.00 Triamcinolone acet inj nos 180.49 TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION [103159] 16.12 TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE [6646] 0.17 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM [5852] 0.26 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM [5852] 0.74 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM [5850] 11.23 TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION [8798] 7.00 TRIAMETERENE-HYDROCHLOROTHIAZI 0.39 TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET [6478] 2.55 TRIFLUOPERAZINE 5 MG TABLET [8571] 93.25 Triglycerides level 0.27 TRIHEXYPHENIDYL 2 MG TABLET [5711] 0.67 TRIHEXYPHENIDYL 5 MG TABLET [5710] PRICE Description 15.75 TROLAMINE 10% CRM, 90GM 1.78 TROPICAMIDE 0.5 % EYE DROPS [18451] 3.17 TROPICAMIDE 1 % EYE DROPS [18450] 4.67 TROPICAMIDE 1 % EYE DROPS [18450] 5.00 TROPICAMIDE 1 % EYE DROPS [18450] 214.50 Troponin (protein) analysis 152.16 TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE [85027] 102.54 TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [44141] 235.75 Tuberculosis test 7.25 TUBING IV 20" EXT 21.25 TUBING IV PRIM PUMP 2719.50 Turning of fetus from breech to presenting position 250.75 Tying or incision of fallopian tubes at time of cesarean delivery or other abdominal surgery 1058.25 UGI W SM BOWEL 60.00 Ultrasonic guidance imaging supervision and interpretation for insertion of needle 1114.00 Ultrasonic guidance imaging supervision and interpretation for insertion of needle 682.25 Ultrasound and monitoring of heart of fetus 578.75 Ultrasound behind abdominal cavity 551.25 Ultrasound behind abdominal cavity 752.25 Ultrasound behind abdominal cavity, limited 716.50 Ultrasound behind abdominal cavity, limited 162.00 Ultrasound evaluation of abdominal aorta to detect bulging (aneurysm) 997.25 Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function 870.00 Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report 114.00 Ultrasound measurement of bladder capacity after voiding 1262.00 Ultrasound of abdomen 729.50 Ultrasound of abdomen 446.50 Ultrasound of brain 709.00 Ultrasound of chest 260.50 Ultrasound of chest 675.25 Ultrasound of chest 38.00 Ultrasound of corneal structure and measurement 435.00 Ultrasound of dialysis access 115.00 Ultrasound of eye disease, growth, or structure 115.00 Ultrasound of eye for determination of lens power 233.25 Ultrasound of fetal umbilical artery flow rate 270.00 Ultrasound of fetus 696.25 Ultrasound of head and neck 663.00 Ultrasound of head and neck 892.00 Ultrasound of hips with manipulation, infant 138.75 Ultrasound of hips, infant 166.00 Ultrasound of one breast 128.50 Ultrasound of one breast 862.50 Ultrasound of pelvis 821.50 Ultrasound of pelvis 115.00 Ultrasound of pelvis 564.75 Ultrasound of pelvis 537.75 Ultrasound of pelvis 635.75 Ultrasound of pregnant uterus, 1 or more fetus(es) 321.00 Ultrasound of pregnant uterus, 1 or more fetus(es) 192.00 Ultrasound of rectum 987.25 Ultrasound of rectum 640.75 Ultrasound of scrotum 610.25 Ultrasound of scrotum 377.50 Ultrasound of spinal canal 591.00 Ultrasound of uterus 192.00 Ultrasound pelvis through vagina 734.25 Ultrasound pelvis through vagina 699.25 Ultrasound pelvis through vagina 699.50 Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow 387.75 Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow 666.25 Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow 699.50 Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers 435.00 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers 435.00 Ultrasound scan of vena cava or groin graft or vessel blood flow 847.00 Ultrasound scanning of blood flow (outside of brain) on one side of head and neck or limited 699.50 Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck 907.75 Ultrasound study of arteries and arterial grafts of both arms 699.50 Ultrasound study of arteries and arterial grafts of both legs 435.00 Ultrasound study of arteries and arterial grafts of one arm or limited 435.00 Ultrasound study of arteries and arterial grafts of one leg or limited 437.75 Ultrasound study of arteries of both arms and legs 12.13 UMECLIDINIUM 62.5 MCG/ACTUATION BLISTER POWDER FOR INHALATION [145547] 8.44 UMECLIDINIUM 62.5 MCG-VILANTEROL 25 MCG/ACTUATION POWDR FOR INHALATION [141476] 29.50 UNASYN/1.5GM,3GM-1GM CMPDIVSOL 615.25 Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort 1255.00 UNL PROC VASCULAR SURGERY PRICE Description 89.00 Urea nitrogen level to assess kidney function 103.75 Urea nitrogen level to assess kidney function 101.50 Uric acid level 70.75 Uric acid level, blood 15.00 Urinalysis, manual test 60.00 Urinalysis, manual test 101.50 Urine calcium level 48.50 Urine chloride level 174.50 Urine microalbumin (protein) level 105.75 Urine osmolality (concentration) measurement 41.25 Urine osmolality (concentration) measurement 101.50 Urine phosphate level 294.50 Urine porphyrins (metabolism substance) measurement 76.75 Urine potassium level 35.75 Urine potassium level 25.00 Urine pregnancy test 108.25 Urine pregnancy test 72.25 Urine sodium level 206.00 Urine vanillylmandelic acid 19.25 Urine volume measurement 7.35 URSODIOL 300 MG CAPSULE [5230] 73.85 USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION [154997] 11.00 Vaccine for diphtheria, tetanus toxoids, acellular pertussis (whooping cough), and polio for injection into muscle, patient 4 through 6 years of age 170.00 Vaccine for diphtheria, tetanus toxoids, acellular pertussis (whooping cough), haemophilus influenza type B, and polio for injection into muscle 11.00 Vaccine for diphtheria, tetanus toxoids, acellular pertussis (whooping cough), Hepatitis B, and polio for injection into muscle 25.00 Vaccine for diphtheria, tetanus, and acellular pertussis (whooping cough) injection into muscle, child younger than 7 years 55.00 Vaccine for Hemophilus influenza B (4 dose schedule) injection into muscle 120.00 Vaccine for Hepatitis A (2 dose schedule) injection into muscle, pediatric or adolescent dosage 120.00 Vaccine for Hepatitis A injection into muscle, adult dosage 170.00 Vaccine for Hepatitis B (2 dose schedule) for injection into muscle, adolescent patient 85.75 Vaccine for Hepatitis B (3 dose schedule) for injection into muscle, pediatric and adolescent patients 65.00 Vaccine for Hepatitis B (3 dose schedule) for injection into muscle, pediatric and adolescent patients 73.85 Vaccine for Hepatitis B adult dosage (3 dose schedule) injection into muscle 110.00 Vaccine for Hepatitis B adult dosage (3 dose schedule) injection into muscle 85.00 Vaccine for Hepatitis B and Hemophilus influenza B for injection into muscle 400.00 Vaccine for human papilloma virus (3 dose schedule) injection into muscle 330.00 Vaccine for human papilloma virus (3 dose schedule) injection into muscle 59.40 Vaccine for influenza for administration into muscle, 0.25 ml dosage 25.00 Vaccine for influenza for administration into muscle, 0.25 ml dosage 50.00 Vaccine for influenza for administration into muscle, 0.25 ml dosage 17.32 Vaccine for influenza for administration into muscle, 0.5 ml dosage 18.66 Vaccine for influenza for administration into muscle, 0.5 ml dosage 55.40 Vaccine for influenza for administration into muscle, 0.5 ml dosage 20.00 Vaccine for influenza for administration into muscle, 0.5 ml dosage 50.00 Vaccine for influenza for administration into muscle, 0.5 ml dosage 54.00 Vaccine for influenza for injection into muscle 145.50 Vaccine for influenza for injection into muscle 60.00 Vaccine for influenza for injection into muscle 40.00 Vaccine for influenza for nasal administration 50.00 Vaccine for influenza for nasal administration 91.71 Vaccine for measles, mumps, and rubella (German measles) injection beneath skin 120.00 Vaccine for measles, mumps, and rubella (German measles) injection beneath skin 350.00 Vaccine for measles, mumps, rubella (German measles), and varicella (chicken pox) injection beneath skin 306.32 Vaccine for meningococcus for administration into muscle 200.00 Vaccine for meningococcus for administration into muscle 153.00 Vaccine for meningococcus for injection into muscle 188.00 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 252.47 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 165.00 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 404.40 Vaccine for rabies injection into muscle 449.00 Vaccine for rabies injection into muscle 190.00 Vaccine for Rotavirus (2 dose schedule) for oral administration 11.00 Vaccine for Rotavirus (3 dose schedule) for oral administration 62.10 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older 79.92 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older 93.46 Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older 106.92 Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older 120.00 Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older 150.00 Vaccine for typhoid for injection into muscle 200.00 Vaccine for varicella (chicken pox) injection beneath skin 76.75 VACUUM EXTRACTOR 21.25 VAD DRESSING KIT 2719.50 Vaginal delivery 2719.50 Vaginal delivery after prior cesarean delivery 192.00 Vaginal ultrasound of pregnant uterus 734.25 Vaginal ultrasound of pregnant uterus 7.22 VALACYCLOVIR 500 MG TABLET [45916] PRICE Description 0.86 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION [39763] 0.11 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION [126161] 1.01 VALPROIC ACID 250 MG CAPSULE [6446] 197.25 Valproic acid level 104.25 Valproic acid level 5.00 VALSARTAN 160 MG TABLET [49674] 7.88 VALSARTAN 40 MG TABLET [52185] 4.65 VALSARTAN 80 MG TABLET [45577] 304.75 Vancomycin (antibiotic) level 0.16 VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK [56505] 19.25 VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION [4040] 256.81 VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION [26749] 0.64 VANCOMYCIN 25 MG/ML ORAL LIQUID (CCF) [612850] 9.65 VANCOMYCIN 500 MG INTRAVENOUS SOLUTION [3800] 11.63 VANCOMYCIN 750 MG INTRAVENOUS SOLUTION [112530] 79.33 VANCOMYCIN1500MG/250MLIVBP/500 4100.00 VASCULAR GRAFT ARTEGRAFT 3357.00 VASCULAR GRAFT RRT06030040L 1001.75 VASCULART GRAFT V4604DKL 215.75 VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION [145182] 10.20 VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION [3389] 7762.68 VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION [142636] 223.00 VEIN MAPPING, DIALYSIS ACC,UNI 463.00 VEIN MAPPING,DIALYSIS ACC BIL 2137.75 Vena cava filter 1.94 VENLAFAXINE 25 MG TABLET [45062] 2.00 VENLAFAXINE 37.5 MG TABLET [47199] 5.08 VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR [45480] 4.16 VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR [44220] 4.67 VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR [44254] 1327.00 Ventilation assistance and management, hospital inpatient or observation 789.75 Ventilation assistance and management, hospital inpatient or observation 8.73 VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION [3284] 0.53 VERAPAMIL 80 MG TABLET [6343] 1.44 VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [6010] 2.54 VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE [6008] 10.89 VILAZODONE 10 MG TABLET [122286] 10.89 VILAZODONE 20 MG TABLET [122288] 10.89 VILAZODONE 40 MG TABLET [122289] 5.17 VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION [26748] 6.90 VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION [10516] 6.41 VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION [108485] 59.50 VISITEC MICRO J CANNULA 585003 0.14 VIT A 1,000 UNIT-C 200 MG-E 60 UNIT-LUTEIN 2 MG AND MINERALS TABLET [87871] 0.02 VITAMIN A 10,000 UNIT CAPSULE [10610] 115.00 Vitamin A level 0.94 VITAMIN B COMPLEX AND VITAMIN C NO.20-FOLIC ACID 1 MG CAPSULE [48691] 77.75 Vitamin B-1 (thiamine) level 10.00 Vitamin b12 injection 241.25 Vitamin B-6 level 279.75 Vitamin D-3 level 138.75 Vitamin D-3 level 0.08 VITAMIN E 400 UNIT CAPSULE [10601] 53.50 Vitamin E level 396.25 Vitamin K level 152.50 Volatile chemical measurement 179.03 VORICONAZOLE 200 MG INTRAVENOUS SOLUTION [50726] 26.00 VORTIOXETINE 10 MG 14.00 VORTIOXETINE TAB 20 MG 125.50 Walking training to 1 or more areas, each 15 minutes 6.00 WARFARIN 0.5MG SPLIT TAB, EACH 2.47 WARFARIN 1 MG TABLET [6534] 3.84 WARFARIN 10 MG TABLET [6542] 2.58 WARFARIN 2 MG TABLET [6535] 2.66 WARFARIN 2.5 MG TABLET [6536] 2.67 WARFARIN 3 MG TABLET [6537] 2.68 WARFARIN 4 MG TABLET [6538] 2.78 WARFARIN 5 MG TABLET [6539] 3.58 WARFARIN 6 MG TABLET [6540] 3.70 WARFARIN 7.5 MG TABLET [6541] 238.50 WARMING BLANKET 61.25 WASHER 7MM-10MM-13MM 0.07 WATER FOR INJECTION, STERILE INJECTION SOLUTION [3750] 0.10 WATER FOR INJECTION, STERILE INJECTION SOLUTION [3750] 0.01 WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION [3375] 162.50 Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes 99.25 Wheelchair management, each 15 minutes PRICE Description 111.00 White blood cell enzyme activity measurement 180.75 White blood cell function measurement 70.75 White blood cell measure, stool specimen 0.05 WHITE PETROLATUM TOPICAL OINTMENT IN PACKET [132620] 1.11 WHITE PETROLATUM-MINERAL OIL 83 %-15 % EYE OINTMENT [101074] 44.00 WIRE,KIRSCHNER .045X4 35.75 WIRE,KIRSCHNER .062X4 250.00 XENOSURE BIOLOGICAL GRAFT 363.00 XR ESOPHAGRAM W DBL CONTRAST 160.00 XR FOOT 4V AP/LAT/OBL/OTHER LT 160.00 XR FOOT 4V AP/LAT/OBL/OTHER RT 1.00 XR GI SMALL BOWEL FOLLOW THRU 369.50 XR STERNOCLAVI JNTS MIN 3 VIEW 369.50 XR STERNOCLOVACIC JNTS MIN 3VI 611.50 X-ray lower and sacral spine including bending views minimum 6 views 369.50 X-ray of abdomen, 1 view 443.50 X-ray of abdomen, 2 views 221.00 X-ray of ankle, 2 views 369.50 X-ray of ankle, minimum of 3 views 244.00 X-ray of bones 148.25 X-ray of bones of face, less than 3 views 244.00 X-ray of bones of face, minimum of 3 views 148.25 X-ray of bones of nose, minimum of 3 views 148.25 X-ray of both collar bones 244.00 X-ray of both hips with pelvis, 2 views 244.00 X-ray of both hips with pelvis, 3-4 views 486.25 X-ray of both hips with pelvis, minimum of 5 views 148.25 X-ray of both knees, standing, front to back view 244.00 X-ray of both sides of the ribs including the chest, minimum of 4 views 148.25 X-ray of breast bone, minimum of 2 views 369.50 X-ray of chest, 1 view 443.50 X-ray of chest, 2 views 148.25 X-ray of chest, 3 views 148.25 X-ray of chest, minimum of 4 views 221.00 X-ray of collar bone 221.00 X-ray of elbow, 2 views 369.50 X-ray of elbow, minimum of 3 views 385.75 X-ray of esophagus with single contrast 148.25 X-ray of eye 244.00 X-ray of eye bones, minimum of 4 views 148.25 X-ray of femur, 1 view 443.50 X-ray of femur, minimum 2 views 369.50 X-ray of fingers, minimum of 2 views 221.00 X-ray of foot, 2 views 369.50 X-ray of foot, minimum of 3 views 295.50 X-ray of forearm, 2 views 244.00 X-ray of hand, 2 views 369.50 X-ray of hand, minimum of 3 views 221.00 X-ray of heel, minimum of 2 views 148.25 X-ray of hip with pelvis, 1 view 443.50 X-ray of hip with pelvis, 2-3 views 148.25 X-ray of jaw joints on both sides of the face 369.50 X-ray of junction of breast and collar bones, minimum of 2 views 352.00 X-ray of junction of breast and collar bones, minimum of 2 views 369.50 X-ray of knee, 1 or 2 views 443.50 X-ray of knee, 3 views 315.00 X-ray of knee, 4 or more views 490.00 X-ray of knee, 4 or more views 700.00 X-ray of large bowel with double contrast 385.75 X-ray of large bowel with single contrast 490.00 X-ray of lower and sacral spine, 2 or 3 views 611.50 X-ray of lower and sacral spine, minimum of 4 views 369.50 X-ray of lower leg, 2 views 148.25 X-ray of mandible, less than 4 views 244.00 X-ray of mandible, minimum of 4 views 244.00 X-ray of mastoid, minimum of 3 views per side 148.25 X-ray of middle and lower spine, 2 views 244.00 X-ray of middle spine, 3 views 490.00 X-ray of middle spine, 3 views 244.00 X-ray of middle spine, minimum of 4 views 148.25 X-ray of paranasal sinus, complete, minimum of 3 views 148.25 X-ray of paranasal sinus, less than 3 views 367.00 X-ray of pelvis, 1 or 2 views 221.00 X-ray of pelvis, minimum of 2 views 244.00 X-ray of pelvis, minimum of 3 views 148.25 X-ray of ribs of one side of body, 2 views 490.00 X-ray of ribs on one side of body including the chest, minimum of 3 views PRICE Description 260.50 X-ray of sacroiliac joints, 3 or more views 244.00 X-ray of sacroiliac joints, less than 3 views 148.25 X-ray of shoulder blade 148.25 X-ray of shoulder, 1 view 443.50 X-ray of shoulder, minimum of 2 views 244.00 X-ray of skull, complete, minimum of 4 views 367.00 X-ray of skull, less than 4 views 369.50 X-ray of soft tissue of neck 367.00 X-ray of spine of neck, 2 or 3 views 148.25 X-ray of spine, 1 view 244.00 X-ray of spine, 2 or 3 views 486.25 X-ray of spine, 4 or 5 views 221.00 X-ray of toes, minimum of 2 views 148.25 X-ray of upper arm, minimum of 2 views 385.75 X-ray of upper digestive tract with double contrast 367.00 X-ray of upper digestive tract with single contrast 244.00 X-ray of upper digestive tract with single contrast and multiple serial films 611.50 X-ray of upper spine, 4 or 5 views 367.00 X-ray of upper spine, 6 or more views 367.00 X-ray of voice box and/or esophagus in neck with contrast 369.50 X-ray of wrist, 2 views 369.50 X-ray of wrist, minimum of 3 views 244.00 X-ray survey of bones, infant 244.00 X-ray survey of forearm or wrist bone density 4509.00 YAG LASER SECONDARY 2.99 ZAFIRLUKAST 20 MG TABLET [47881] 12.50 ZALEPLON 10MG CAP 12.25 ZALEPLON 5MG CAP 64.75 Zinc level 12.22 ZINC OXIDE 3" X 10 YARD BANDAGE [53184] 0.03 ZINC SULFATE 220 MG (50 MG) CAPSULE [88464] 23.08 ZIPRASIDONE 20 MG CAPSULE [46617] 59.62 ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION [51739] 23.08 ZIPRASIDONE 40 MG CAPSULE [48497] 28.01 ZIPRASIDONE 60 MG CAPSULE [49045] 28.01 ZIPRASIDONE 80 MG CAPSULE [40466] 167.66 ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION [52932] 9.94 ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK [97351] 0.11 ZOLPIDEM 10 MG TABLET [48810] 0.10 ZOLPIDEM 5 MG TABLET [48479] 13.00 ZOLPIDEM 6.25MG CR TAB 1.98 ZONISAMIDE 100 MG CAPSULE [46358]