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Pricing

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Financial Counselor

NEW! COVID-19 Transparency Pricing

Beginning January 1, 2019, the Centers for Medicare & Medicaid Services requires hospitals to publicly post hospital charges on the internet. This price transparency is the ability for you, the healthcare consumer, to access provider-specific information on the price of healthcare services – including out-of-pocket costs − regardless of the setting in which they are delivered.

Listed below this copy you will find three tables. The tables are also downloadable by clicking on the file (files are in a CSV format).

  1. Hospital Charges for Services
  2. Inpatient Hospitalization Charges  (2019 estimated/average charge per stay)
  3. Pharmacy-Medication-Charges (based on 2018 average charge per unit)

We strongly encourage patients to learn about Memorial’s estimated charges. You may contact a Financial Counselor at (989) 729-4160 for specific and individualized information regarding charges associated with an anticipated hospitalization or outpatient procedure.

Hospital Charges For Services

Description Fee
ASSAY DIPROPYLACETIC ACD TOT 92.75
ASSAY OF BREATH ETHANOL 62.5
ASSAY OF DIGOXIN TOTAL 142.5
ASSAY OF FECES PORPHYRINS 185.5
ASSAY OF VOLATILES 123.5
BLD TYPING SEROLOGIC RH PHNT 119.5
BLOOD TYPING RBC ANTIGENS 247
BLOOD TYPING SEROLOGIC ABO 119.5
BLOOD TYPING SEROLOGIC RH(D) 119.5
BREAST TOMOSYNTHESIS BI 59
CONTRAST X-RAY GALLBLADDER 570
DRAIN/INJ MAJOR JOINT/BURSA W/O US 648.75
DRAIN/INJ MAJOR JOINT/BURSA W/O US 973.25
DRUG SCREEN QUANT GABAPENTIN 58.25
DXA BONE DENSITY STUDY 622.5
FETAL CHRMOML ANEUPLOIDY 1,082.25
FLT3 GENE 235
FLT3 GENE ANALYSIS 117.75
FRACTURE ASSESSMENT VIA DXA 132
HPV HIGH-RISK TYPES 357
HPV TYPES 16 & 18 ONLY 85.5
IADNA-DNA/RNA PROBE TQ 12-25 706.75
IMMUNOHISTO ANTIBODY ADDL SLIDE 88.25
IMMUNOHISTO ANTIBODY SLIDE 287.25
INSITU HYBRIDIZATION (FISH) 317
INSITU HYBRIDIZATION AUTO 263.25
INSITU HYBRIDIZATION MANUAL 301
MYELOGRAPHY LUMBAR INJECTION 4,808.75
NEG PRESS WOUND TX <=50 CM 168
NEG PRESS WOUND TX <=50 CM 205.5
NEG PRESS WOUND TX >50 CM 320
NEG PRESS WOUND TX >50 CM 392.5
QUANTITATIVE ASSAY DRUG 91.25
TUMOR IMMUNOHISTOCHEM/COMPUT 287.25
TUMOR IMMUNOHISTOCHEM/MANUAL 247
ULTRASOUND BREAST COMPLETE 947
ULTRASOUND BREAST COMPLETE 1,894.75
ULTRASOUND BREAST LIMITED 985
ULTRASOUND BREAST LIMITED 1,970.75
UNLISTED PX SMALL INTESTINE 3,347.00
014104 LASER FIBERGUIDE 270 1,723.25
1′ REPR/SUTR LEG FLEXOR TENDON 3,270.00
12 LEAD EKG; TRACING ONLY 219.25
17-HYDROXYPREGNENOLONE 95
2 PC DRAINABLE OST POUCH 8
2 PC DRAINABLE OST POUCH 18.5
2 PC DRAINABLE OST POUCH 22
3 HR GLUCOSE TOLERANCE GEST-E 275
3 HR GLUCOSE TOLERANCE-E 370.25
3D RENDER W/INTRP POSTPROCES 58.25
3D RENDER W/INTRP POSTPROCES 1,189.50
4 HR GLUCOSE TOLERANCE-E 465.5
5 HIAA, RANDOM URINE-E 69.25
5 HR GLUCOSE TOLERANCE-E 560.75
5% DEXTROSE/NORMAL SALINE 500 ML=1 UNIT 65.75
5% DEXTROSE/WATER (500 ML = 1 UNIT) 65.75
5-HIAA 48.75
AB ID RBC EA PANEL EA TECHN 285.75
AB ID; LEUKOCYTE AB 87
AB ID; PLATELET AB 66
AB ID; PLATELET IG ASSAY 28.75
AB: HBCAB – IGM AB 61.5
AB: HBSAB 142
AB: THYROGLOBULIN 82.25
AB; ACTINOMYCES 72.25
AB; ADENOVIRUS 52.25
AB; ASPERGILLUS 71.5
AB; BACTERIUM NES 348.25
AB; BARTONELLA 52.75
AB; BLASTOMYCES 55
AB; BORDETELLA 67.25
AB; BRUCELLA 107.75
AB; CANDIDA 238.5
AB; CHLAMYDIA 50.75
AB; CHLAMYDIA IGM 52.75
AB; CMV 50.75
AB; CMV IGM 49.25
AB; COCCIDIOIDES 50
AB; COXIELLA BRUNETII 61.5
AB; COXIELLA BRUNETII 273
AB; CRYPTOCOCCUS 55.75
AB; EB EARLY AG VIRUS 102.75
AB; EB VCA 65.75
AB; EBNA 65.75
AB; ENCEPHALITIS CALIF 53
AB; ENCEPHALITIS E EQUINE 53
AB; ENCEPHALITIS ST. LOUIS 53
AB; ENCEPHALITIS W EQUINE 53
AB; ENTEROVIRUS 179
AB; ENTEROVIRUS 476.75
AB; ERLICHIA 85.75
AB; ERLICHIA 172.75
AB; FRANCISELLA TULARENSIS 42.5
AB; FRANCISELLA TULARENSIS 84.5
AB; FUNGUS NES 52.5
AB; HBCAB – TOTAL 125.5
AB; HBEAB 80
AB; HELICOBACTER PYLORI 70.75
AB; HELMINTH NES 59.25
AB; HEMOPHILUS INFLUENZA 72
AB; HISTOPLASMA 82
AB; HIV-1 30.5
AB; HIV-2 57
AB; HSV 1 69.25
AB; HSV NON-SPECIFIC 61.75
AB; HSV TYPE 2 154.5
AB; INFLUENZA VIRUS 57
AB; LEGIONELLA 238.5
AB; LEPTOSPIRA 99
AB; LISTERIA MONOCYTOGENES 117.5
AB; LYME’S (WB) CONFIRM 161.5
AB; LYME’S DISEASE 82
AB; MUMPS 67.25
AB; MYCOPLASMA 57
AB; PARVOVIRUS 117.75
AB; PROTOZOA NES 42.5
AB; RICKETTSIA 48
AB; RUBELLA 184
AB; RUBEOLA 101.75
AB; TETANUS 65
AB; TOXOPLASMA 134.5
AB; TOXOPLASMA IGM 196.5
AB; TRICHINELLA 67.75
AB; VARICELLA-ZOSTER 196.25
AB; VIRUS NES 55
AB; YERSINIA 49
ABD PARACENTESIS 694.75
ABD PARACENTESIS W/IMAGING 694.75
ABL1 GENE 426.25
ABO/RH-E 238.75
ABSC LOCALIZ; WB 2,114.25
ABSCESS FISTULA/SINUS TRACT STUDY 1,210.25
ABSCLOCALIZ; SPECT 2,114.25
ABSORBATACK 5MM FIXATION 3,126.75
ABSORBATACK SHORT DEVICE 1,976.75
ACETONE ASSAY 70
ACJ BILATERAL W/WO WEIGHTS 699
ACTH 163.75
ACTH 1,307.50
ACTIVATED PROTEIN C RESISTANCE 154.5
ACUTE GI BLEED STUDY 1,069.50
ACUTE HEPATITIS PANEL 766
ACYLCARNITINES; QUAN 201.25
ADALIMUMAB AB-E 128.25
ADAPTER <Y CONNECTER LG 1/4X1 36
ADAPTER PORTEX BRONCHIAL 33.25
ADMIN FLU VIRUS VACCINE 133.5
ADMIN PNEUMONIA VACCINE 133.5
ADRENAL ANDROGEN PROFILE-E 485
AEROB BACTERIA CULTURE STOOL 162.5
AEROB BACTERIAL BLOOD CULTURE 159
AEROBIC STOOL CULTR ADDTL PATHOG EA PLATE 87.75
AEROCHAMBER INHALER 49.25
AEROSOL MASK 184
AEROSOL PENTAMIDEN FOR P. CARINII 484.75
AEROSOL SPUTUM COLLECT 164
AFP TETRA SEND OUT-E 381.25
AG DETECT NOS IA MULT 51.5
AGENT NOS ASSAY W/OPTIC 99.25
AIRWAY INHALATION TREATMENT 245.75
ALDOLASE 204.25
ALDOSTERONE 364.5
ALDOSTERONE/RENIN-E 479
ALEXIS RETRACTOR (ORTHO) C8303 352.5
ALEXIS WOUND RETRACTOR MEDIUM 99.75
ALEXIS WOUND RETRACTOR SMALL 99.75
ALKALINE PHOS ISOE SEND OUT-E 140.5
ALKALINE PHOSPHATASE 91.25
ALKALINE PHOSPHATASE ISOENZYM 49.25
ALLERG SP IGG QUAN OR SEMIQUAN 21
ALLG SPEC IGE RECOMB EA 41.5
ALPHA-1-ANTITRYPS PHENO SEND-E 308
ALPHA-1-ANTITRYPSIN; PHENOTYPE 137.25
ALPHA-1-ANTITRYPSIN; TOTAL 170.75
ALPHA-FETOPROTEIN L3 149.5
ALPHA-FETOPROTEIN SERUM 147.25
ALYS NPGT W/O PRGRMG 281
ALYS SMPL SP/PN NPGT W/PRGRM 307
AMIKACIN 152.75
AMINO ACIDS 6/> QUAN EA 264
AMINO ACIDS; SGL QUAN EA 71.75
AMMONIA 148.75
AMNIOFILL ALLOGRAFT AF1000 5,055.75
AMNIOFIX MEMBRANE ALLOGRAFT 4,750.50
AMNIOFIX MEMBRANE GRAFT 3,134.75
AMPLIF NA PROBE NOS AGENT 91.25
AMPLIF NA PROBE NOS AGENT 182
AMYLASE 96.25
AMYLASE 191.75
ANAEROB BACT CULTURE W ID 194.25
ANALYZE SP INF PUMP W/REPROG 709.5
ANCHOR SWIVELOCK SP AR2324BSLM 2,500.25
ANCHOR/SCREW BN/BN TIS/BN 50
ANCHOR/SCREW BN/BN TIS/BN 53
ANCHOR/SCREW BN/BN TIS/BN 53.5
ANCHOR/SCREW BN/BN TIS/BN 56
ANCHOR/SCREW BN/BN TIS/BN 58.25
ANCHOR/SCREW BN/BN TIS/BN 64.75
ANCHOR/SCREW BN/BN TIS/BN 68.75
ANCHOR/SCREW BN/BN TIS/BN 82.25
ANCHOR/SCREW BN/BN TIS/BN 89.75
ANCHOR/SCREW BN/BN TIS/BN 101.5
ANCHOR/SCREW BN/BN TIS/BN 110.75
ANCHOR/SCREW BN/BN TIS/BN 113.75
ANCHOR/SCREW BN/BN TIS/BN 115.25
ANCHOR/SCREW BN/BN TIS/BN 147.75
ANCHOR/SCREW BN/BN TIS/BN 156.25
ANCHOR/SCREW BN/BN TIS/BN 185.75
ANCHOR/SCREW BN/BN TIS/BN 197.75
ANCHOR/SCREW BN/BN TIS/BN 199.75
ANCHOR/SCREW BN/BN TIS/BN 206.75
ANCHOR/SCREW BN/BN TIS/BN 285.5
ANCHOR/SCREW BN/BN TIS/BN 285.75
ANCHOR/SCREW BN/BN TIS/BN 311.5
ANCHOR/SCREW BN/BN TIS/BN 315.75
ANCHOR/SCREW BN/BN TIS/BN 318
ANCHOR/SCREW BN/BN TIS/BN 365
ANCHOR/SCREW BN/BN TIS/BN 369.5
ANCHOR/SCREW BN/BN TIS/BN 375
ANCHOR/SCREW BN/BN TIS/BN 393
ANCHOR/SCREW BN/BN TIS/BN 442.25
ANCHOR/SCREW BN/BN TIS/BN 462
ANCHOR/SCREW BN/BN TIS/BN 472
ANCHOR/SCREW BN/BN TIS/BN 497.75
ANCHOR/SCREW BN/BN TIS/BN 587.25
ANCHOR/SCREW BN/BN TIS/BN 587.5
ANCHOR/SCREW BN/BN TIS/BN 595.25
ANCHOR/SCREW BN/BN TIS/BN 614.5
ANCHOR/SCREW BN/BN TIS/BN 628.75
ANCHOR/SCREW BN/BN TIS/BN 654.25
ANCHOR/SCREW BN/BN TIS/BN 674.5
ANCHOR/SCREW BN/BN TIS/BN 683.75
ANCHOR/SCREW BN/BN TIS/BN 704.5
ANCHOR/SCREW BN/BN TIS/BN 721.25
ANCHOR/SCREW BN/BN TIS/BN 725.5
ANCHOR/SCREW BN/BN TIS/BN 735.25
ANCHOR/SCREW BN/BN TIS/BN 742.75
ANCHOR/SCREW BN/BN TIS/BN 743
ANCHOR/SCREW BN/BN TIS/BN 815.5
ANCHOR/SCREW BN/BN TIS/BN 1,328.25
ANCHOR/SCREW BN/BN TIS/BN 1,368.75
ANCHOR/SCREW BN/BN TIS/BN 1,394.75
ANCHOR/SCREW BN/BN TIS/BN 1,416.75
ANCHOR/SCREW BN/BN TIS/BN 1,674.25
ANCHOR/SCREW BN/BN TIS/BN 1,900.25
ANCHOR/SCREW BN/BN TIS/BN 2,008.75
ANCHOR/SCREW BN/BN TIS/BN 2,061.75
ANCHOR/SCREW BN/BN TIS/BN 2,239.75
ANCHOR/SCREW BN/BN TIS/BN 3,796.25
ANCHOR/SCREW BN/BN TIS/BN 5,180.50
ANCHOR/SCREW BN/BN TIS/BN 5,977.50
ANDROSTENEDIONE 95
ANES SUPPLIES ADD’L 15 MINS 113
ANES SUPPLIES-0-30 MINS 333.5
ANES.GEN SUPP-MAJOR 0-30MIN 259
ANES.GEN SUPP-MAJOR 31-60MIN 227.75
ANES.GEN SUPP-MAJOR 61-90 MIN 247
ANES.GEN SUPP-MAJOR 91-120 MI 259
ANES.GEN SUPP-MAJOR ADD’1/2HR 66.5
ANESTH CAT OR MRI SCAN 236
ANGIOTENSIN I – CONVERTING ENZYME 198.5
ANKLE ARTHROGRAM 935
ANKLE ARTHROGRAPHY INJ 593.75
ANKLE CONTROL ORTHO PRE OTS 139.25
ANL SP INF PMP W/MDREPRG&FIL 709.5
ANTI ENA ANTIBODIES SEND OUT-E 119.5
ANTI-CARDIOLIPIN IGG/M SENDO-E 141.25
ANTINEUTRO CYTO PANEL SEND-E 154.5
ANTINEUTROPHIL CYTOPL AB PAN-E 266.25
ANTINUCLEAR AB (ANA); 162.75
ANTINUCLEAR AB (ANA); TITER 147.25
ANTI-PHOSPHATIDYLSERINE AB 204.75
ANTIPHOSPHOLIPID SYNDROME-E 632
ANTITHROMBIN III ACTIVITY ASSAY 100.25
ANTITHROMBIN III ANTIGEN ASSAY 271.75
ANTITRYPSIN PROFILE-E 311.25
APC GENE FULL SEQUENCE 876.5
APHASIA ASSESMENT PER HR 511
APOLIPOPROTEIN EACH 100.25
APOLIPOPROTEIN EACH 200.25
APPLY FINGER SPLINT; STATIC 339.75
APPLY INTERSTIT RADIAT COMPL 8,812.00
APPLY LONG ARM SPLINT 595.5
APPLY LONG LEG CAST 446.75
APPLY LONG LEG SPLINT 693
APPLY MULTLAY COMPRS LWR LEG 149
APPLY MULTLAY COMPRS LWR LEG 298
APPLY SH LEG CAST 333.75
APPLY SHORT ARM SPLINT; STATIC 558.75
APPLY SHORT LEG SPLINT 577.5
AQUATIC THERAPY/EXERCISES EA 15 MINS 195.75
ARISTA FLEXTIP 54.25
ARISTA HEMOSTAT 419.5
ARSENIC 98.5
ARSENIC EXPOSURE-E 119
ARTERIAL CATH – SAMPLE/MONITOR/TRANSFUSE 194.75
ARTERIAL LINE INSERT-ICU 251.25
ARTERIAL LINE INSERTION 282.5
ARTERIAL PUNCTURE BLOOD FOR DX 194.75
ARTHRITIS PANEL-E 477.25
ARTHROGRAM -LEFT SHOULDER-E 2,400.25
ARTHROGRAM-RIGHT SHOULDER-E 2,400.25
ARTHROSCOPE,SHOULDER ABDUCT SY 63.75
ASCORBIC ACID BLOOD 109.25
ASO ; TITER 79.25
ASO; SCREEN 50.75
ASPERGILLUS AB PANEL SEND OU-E 214.5
ASPERGILLUS AG IA 51.5
ASPIR/INJ THYROID CYST 634.75
ASPIRATE PLEURA W/ IMAGING 1,082.50
ASPIRATE/INJ GANGLION CYST 648.75
ASSAY CARBOXYHB QUANT 87
ASSAY FOR CALPROTECTIN FECAL 48.75
ASSAY IGA/IGD/IGG/IGM EACH 40
ASSAY LIPOPROTEIN PLA2 90.75
ASSAY NONENDOCRINE RECEPTOR 229
ASSAY OF BLOOD LIPOPROTEIN LDL 67.25
ASSAY OF BLOOD LIPOPROTEIN VLDL 33
ASSAY OF HOMOCYSTINE 215
ASSAY OF IGE 223.75
ASSAY OF LIPOPROTEIN(A) 117.75
ASSAY OF PROTEIN SERUM 58.25
ASSAY OF RIBOFLAVIN (VITAMIN B-2) 348.25
ASSAY OF SERUM ALBUMIN 54.5
ASSAY OF SERUM POTASSIUM 49.25
ASSAY OF SERUM SODIUM 58.25
ASSAY OF SIROLIMUS 256.5
ASSAY OF THIAMINE (VITAMIN B-1) 138.75
ASSAY PH BODY FLUID NOS 54.5
AST OR SGOT 74.5
ATC STRENGTH & CONDIT COACHING 11,056.25
ATHLETIC TRAINER COVERAGE 1 HR 40.25
ATHLETIC TRAINING BASIC 12,668.50
ATHLETIC TRAINING TOURN COVE-M 291.5
ATL SCRN CYTOPATH W RVW BY TECH 149
AUTOIMMUNE RHEUMATOID ARTHR 796.5
AUTOM URINALYSIS WO MICRO 38
AUTOM URINE DIP W MICRO 72.5
AUTOMATED RBC COUNT 21.25
AUTOPSY GROSS & MICRO W BR 1,093.25
B PERTUSSIS IGG/M/A AB SENDO-E 201.5
BABESIA MICROTI ABS-E 84.75
BACT CULTURE – URINE; QUAN COUNT 120.25
BACTERIA FILTER 37.25
BACTERIAL ANTIGEN PANEL SEND-E 397
BACTERIAL CULTURE – OTHR SOURCE 94
BAG LEG DISP LG 58.25
BAG LEG DISP MED 31.5
BAG OSTOMY 2 1/4 (UROSTOMY) 18.5
BAG URI METER DRAINAGE 63.75
BAG URINARY DRAINAGE 31.5
BAG URINE COLLECTOR PED STER 22
BALLOON DILATOR 10-11-12 1,118.75
BALLOON KIT 5 X 10,15F 887510 1,296.50
BALLOON KIT 6 X 10,18F 887610 1,296.50
BANDAGE ACE 6IN DL 70.75
BANDAGE ACE N/S 2 IN 9.5
BANDAGE ACE N/S 3 IN 22
BANDAGE ACE N/S 4 IN 22
BANDAGE ACE N/S 4 IN-WC 19
BANDAGE ACE N/S 6 IN 29.5
BANDAGE ACE N/S 6 IN-WC 25
BANDAGE ACE STERILE 4 IN 48.5
BANDAGE ACE STERILE 6 IN 54.5
BANDAGE COBAN 1 IN 10.5
BANDAGE COBAN 2 IN 16.5
BANDAGE COBAN 3 IN 18.5
BANDAGE COBAN 4 IN 22
BANDAGE COBAN 6 IN 28
BANDAGE COBAN ELASTIC 4 IN-WC 19
BARTONELLA AB PANEL SEND OUT-E 211
BC – AEROBIC – ADDTL ID 99.25
BC – ANAEROBE – ADDTL ID 109.75
B-CELL CD20-E 349.75
BCR ABL CML/ALL-E 683.5
BCR/ABL1 GENE MAJOR BP 362.75
BCR/ABL1 GENE MINOR BP 320.75
BE COLON W AIR & BARIUM 1,603.50
BED HOLD-ER 2N 2,416.75
BED HOLD-ER 2S STRESS 1,800.50
BED HOLD-ER 3S 2,416.75
BED HOLD-ER INTENSIVE CARE 4,945.25
BED HOLD-ER PROGRESSIVE CARE 3,759.00
BEHAV CHNG SMOKING 3-10 MIN 36.5
BEHAVRAL QUALIT ANALYS VOICE 7.25
BEHAVRAL QUALIT ANALYS VOICE 421.25
BETA 2 GLYCOPROTEIN I AB EA 88.75
BETA-2 MICROGLOBULIN 190
BETA-2-GLYCOPROTEIN I SEND O-E 265.75
BF PERINEAL MUSCLES OR SPINCTER 169.25
BILAT SELCTV RENAL VENOGRAM 3,973.50
BILE ACIDS; TOTAL 117
BILIRUBIN PROFILE-E 135.25
BINDER,BREAST LARGE 101.25
BINDER,BREAST MEDIUM 101.25
BINDER,BREAST SMALL 101.25
BINDER,BREAST X-LRG 101.25
BINDER,BREAST XX-LARGE 101.25
BIOFEEDBACK ANY MODALITY 83.75
BIOPATCH 4152 26.75
BIOPSY THYROID PERC CORE NEEDLE 1,872.25
BIO-PUSHLOCK 3.5MM ANCHOR 3,067.25
BIOTINIDASE EA SPECIMEN 70.25
BIOVAC SUCTION DEVICE 396.75
BIPOLAR PENCIL DISP 23G 159.25
BIRTHING CLASS 26.75
BIRTHING CLASS 36.25
BITBLOCKS 1.63 DISPOSABLE BB-2 15
BITE BLOCK HP M1828A 16.5
BL SMEAR W/DIFF WBC COUNT 49.5
BLADE (3M) L124 29X85 127.75
BLADE (Z) LG 32.0 63.5 372.75
BLADE (Z) SAG MICRO 09.5 25.5 56
BLADE 11.5 X 5.5 2296-3-410 169.5
BLADE 18.5 X 9.0 2296-3-105 169.5
BLADE 25.0 X 5.5 2296-3-414 169.75
BLADE 25.0 X 9.0 2296-3-111 169.5
BLADE 4.5 FULL RADIUS 188.75
BLADE 5.5 RAZORCUT 129.5
BLADE ALCON 15 DEG 41.5
BLADE ALCON SLIT KNIFE 76.75
BLADE ARTHROTOME ACROM 4.0 336
BLADE ARTHROTOME ACROM 5.5 278
BLADE ARTHROTOME INCISOR 4.5 192
BLADE ARTHROTOME INCISOR 4.5CR 472
BLADE ARTHROTOME RAZORCUT 4.5 342
BLADE ARTHROTOME SYNOVATOR 4.5 336
BLADE BEAVE 67 9
BLADE DERMATOME 156.25
BLADE EYE SHARP ALL AROUND ST 46.5
BLADE KNIFE MICRO ENT SPEAR ED 135
BLADE OSC CURVED MICRO 13.5X2 311.5
BLADE OSC LG BRAZ/RIB 19.5X.09 187.25
BLADE OSCILLATING 142.75
BLADE RECIP 9.4 54.5 5052-259 139
BLADE RECIP MAXI 12.5 X 73.5 26
BLADE RECIPROCATING 277-96-277 349.5
BLADE SAG MICRO 9.5 X 25.5 148
BLADE SAGITTEL SAW 4118-127-90 278
BLADE SAW GIGLE 35
BLADE SINUS 40 CRVD 18-84006 637
BLADE SINUS TRICUT 18-84004 786.5
BLADE SLIT KNIFE 4.5 86
BLADE TRICUT 2.9MM 621.5
BLAST/COCI/CRY/HISTO AB SEND-E 242.25
BLEEDING TIME 44
BLEPHAROTOMY DRAIN ABSC EYELID 565.25
BLOOD CLOT FACTOR VIII TEST 145.25
BLOOD GAS MIXED WO O2 SAT 49.5
BLOOD GAS PH ONLY 144
BLOOD GASES W/02 SATURATION 232.75
BLOOD OSMOLALITY 109.25
BM IMAGING; LIMITED 525.25
BM SMR INTERP 609.5
BONE BX TR/NDL; SUPERF 1,520.50
BONE IMAGING 3 PHASE 2,853.75
BONE SCAN MULTI AND BONE SPE-E 6,132.75
BONE SCAN SINGL AND BONE SPE-E 6,227.25
BONE SCAN TOTAL AND BONE SPE-E 5,275.25
BONE/JOINT; LIMITED 2,948.25
BONE/JOINT; MULTI AREAS 2,853.75
BONE/JOINT; SPECT (3D) 3,279.25
BONE/JOINT; WB 1,996.25
BOWL CEMENT MIXER 323.25
BRAF GENE 291.25
BRAIN IMAGE W/FLOW 4 + VIEWS 1,903.00
BRAIN IMAGING (3D) 1,636.75
BRAIN PET; METABOLIC EVAL 6,826.75
BRAIN VASCULAR FLOW ONLY 1,105.00
BRCA1&2 GEN FULL SEQ DUP/DEL 3,375.25
BRCA2 GENE KNOWN FAMIL VRNT 211
BRIDGE LOOP OSTOMY 10.5
BRONCHOSCOPY 2,081.00
BRONCHOSCOPY AT BEDSIDE-ICU 2,140.50
BRONCHOSCOPY W FLOUROSCOPY 2,739.75
BRONCHOSCOPY W/ BIOPSY 2,081.00
BRONCHOSCOPY W/ BIOPSY-MAB 2,081.00
BRONCHOSPASM – PRE & POST BD 536.75
BRUSH CYSTOLOGY/BRONCH 60
BRUSH URO BX 3FR 115CM 228
BRUSHINGS-BRONCH 1,522.00
BUR 4.0MM OVAL 287.25
BUR CRVD SEPTO 3.2 18833121HS 961.5
BX BREAST 1ST LESION MR IMAG 1,368.25
BX BREAST 1ST LESION STRTCTC 1,567.25
BX BREAST 1ST LESION US IMAG 1,568.25
BX BREAST ADD LESION MR IMAG 116.25
BX BREAST ADD LESION STRTCTC 108.25
BX BREAST ADD LESION US IMAG 109
BX PANCREAS PERC NEEDLE 2,314.50
C DIFF AMPLIFIED PROBE 91.25
C REP S/A/L; EA ADD 5 CM/< 1,195.50
C TRACH/N GONOR CONFIRM-E 297.5
C TX PATELLAR DISLOCATION; WO ANESTH 232.5
C0 DIFFUSE CAPACITY 501
CABLE CERCLAGE 1.8MM X 25IN 1,590.25
CAD BREAST MRI 274
CADMIUM 50.75
CAH PROFILE-E 858
CALCITONIN 328
CALCIUM; IONIZED 134.5
CALCIUM; TOTAL 70.75
CALCIUM; URINE QUAN TIMED 83.25
CALR GENE COM VARIANTS 373
CANALITH REPOSITIONING PROC 213.25
CANCELLED PROC MED/IV GIV-AC 110.75
CANCELLED PROC MED/IV GIV-MAB 110.75
CANDIDA ANTIGEN AB PANEL-E 576
CANDIDA NA AMPLIFIED PROBE 108
CANDIDA NA DIRECT PROBE 62.5
CANNULA 7MM X 7CM WORKING 225.5
CANNULA 8.25MM X 7CM TWIST IN 212.5
CAPNOGRAPHY EQUIP-MAB 170.5
CAPNOGRAPHY EQUIP-PC 170.5
CAPNOGRAPHY EQUIP-SDC 170.5
CAPSULE POLISHER TERRY SQUEEGE 15
CARB DEFICIENT TRANSRERRIN 56
CARBAMAZEPINE; FREE 231.5
CARBAMAZEPINE; TOTAL 286
CARBON DIOXIDE (CO2) 50.75
CARD PET PERFUS; MULTIPLE 4,364.75
CARD PET PERFUS; SINGLE 4,364.75
CARDIAC ENZYMES-E 153.5
CARDIAC PET METABOL EVAL 5,595.25
CARDIAC REHAB 160
CARDIAC REHAB PHASE I 181.25
CARDIAC REHAB/MONITOR 273
CARDIOLIPIN AB EA IG CLASS 70.75
CARDIOVERSION ELECTRIC EXT 3,437.25
CARNITINE QUAN EA 320.25
CAROTENE 134.25
CAROTID DUPLEX SCAN; BILAT 1,101.75
CAROTID DUPLEX SCAN; UNIL/LIMIT 689
CARPAL TUNNEL TX INJ 648.75
CARTER THOMASON DEVICE #CTXL 835
CAST PLASTER – LONG ARM 398.25
CAST PLASTER – SHORT ARM 201.5
CAST PLASTER – SHORT LEG 219.5
CAST PLASTER APPLICATION 115.75
CAST SCOTCHCAST – 2 IN ROLL 60.25
CAST SCOTCHCAST – 3 IN ROLL 67.5
CAST SCOTCHCAST – 4 IN ROLL 127.75
CAST SCOTCHCAST – 5 IN ROLL 68
CAST SCOTCHCAST APPLICATION 412.25
CATECHOLAMINES FRACTIONATED 78.25
CATECHOLOMINES FREE,RANDOM-E 98.5
CATH ASH SPLIT 11.5F X 8 443.25
CATH BI-POLAR PACE FR 5.0 676.75
CATH CAUDE SIZE 14 FR 56
CATH CAUDE SIZE 16 FR 80
CATH CAUDE SIZE 18 FR 71
CATH CAUDE SIZE 20 FR 71
CATH DELEE SUCTION 39.25
CATH DIALYSIS CATH 14 FRX24CM 625
CATH DRAIN PLUG 8
CATH FEMALE CATH KIT 54.5
CATH FOLEY WIPE,SURE TEMP 4.5
CATH FOR SPECIMEN COLLECT SGL PT 37.25
CATH FORTE ACCESS SHEATH B7016 456
CATH HEMODIALYSIS LONG-TERM 1,548.00
CATH HEMODIALYSIS LONG-TERM 1,952.25
CATH HEMODIALYSIS LONG-TERM 2,002.75
CATH INDW FOLEY 2 WAY SILICONE 12.75
CATH INDW FOLEY 2 WAY SILICONE 14
CATH INDW FOLEY 2 WAY SILICONE 15.25
CATH INDW FOLEY 2 WAY SILICONE 69.75
CATH INDW FOLEY 2 WAY SILICONE 94
CATH INDW FOLEY 2 WAY SILICONE 109
CATH INDW FOLEY 2 WAY SILICONE 110.5
CATH INDW FOLEY 2 WAY SILICONE 116.25
CATH INDW FOLEY 2 WAY SILICONE 131.75
CATH INDW FOLEY 2 WAY SILICONE 140.5
CATH INDW FOLEY 2 WAY SILICONE 164.75
CATH INDW FOLEY 3 WAY 48.5
CATH INDW FOLEY 3 WAY 63.75
CATH INDW FOLEY 3 WAY 67.5
CATH INDW FOLEY 3 WAY 74.25
CATH INDW FOLEY 3 WAY 75.75
CATH INDW FOLEY 3 WAY 90.5
CATH INDW FOLEY 3 WAY 98.75
CATH INDW FOLEY 3 WAY 103.5
CATH INDW FOLEY 3 WAY 113.5
CATH INFANT KIT SFR 15
CATH INTER UTERINE PRES (IUPC) 223.25
CATH MELKER ER CRIC TUBE 614.5
CATH PHILLIPS FOLLOWER 8 FR 274
CATH PHILLIPS FOLLOWER 18 FR 231.75
CATH PHILLIPS FOLLOWER 20 FR 231.75
CATH PHILLIPS FOLLOWER 22 FR 231.75
CATH PHILLPS FOLLOWER 16 FR 231.75
CATH SILICONE 30 CC 20 FR 157.5
CATH SINUS IRRIGATION LC7065 696
CATH THORACIC #28 32.75
CATH THORACIC #32 60
CATH THORACIC #40 67
CATH URET FIL SPIRAL TIP 3 FR 144.75
CATH URET FIL SPIRAL TIP 4 FR 126
CATH URET FIL SPIRAL TIP 5 FR 126
CATH URET FILIFORM STRA TIP 4 144.75
CATH URET FILIFORM STRA TIP 5 144.75
CATHETER URETERAL 10.5
CATHETER URETERAL 16.5
CATHETER URETERAL 18.5
CATHETER URETERAL 33.5
CATHETER URETERAL 120
CATHETER URETERAL 177
CAUTERY BOVIE 86.25
CAUTERY BOVIE CLEANER 10
CAUTERY BOVIE TIP BALL 6 IN 28.25
CAUTERY BOVIE TIP-BALL 14.75
CAUTERY BOVIE TIP-EXT. BLADE 62.5
CAUTERY BOVIE TIP-NEEDLE 22
CAUTERY CORD TUR 14.25
CAUTERY CORD TUR 14.5
CAUTERY CUTTING LOOP 26 OR/3 287.75
CAUTERY DAC CIRON 95
CAUTERY ELECTROVAC 58.25
CAUTERY OF CERVIX; ELECTRO/THERMAL 2,748.00
CBC W AUTO DIFF & W MAN DIFF-E 109.25
CBC WITH MANUAL DIFF-E 109.25
CCP ANTIBODY 184
CD4/CD8 SEND OUT-E 359
CEA 222.25
CEBPA GENE FULL SEQUENCE 426.25
CELIAC DISEASE AB SEND OUT-E 268.75
CELIAC DISEASE COMPREHENSIVE-E 375.25
CELIAC HLA PANEL-E 758.25
CELL ENUMERATION & ID 922.5
CELL FUNCTION ASSAY W/STIM 288.5
CELL FUNCTION ASSAY W/STIM 416.25
CEMENT BONE PALACOS 478.5
CENTRAL LINE TRIPLE W/POW PORT 538
CEREBR SEIZURE 8-CH; EA 24 HRS 1,440.50
CERULOPLASMIN 142
CERV COL SR FOAM 2PC PRE OTS 202.25
CERV SR 2PC THOR EXT PRE OTS 396.75
CERVICAL DILATION BALLOON 170.25
CFTR GENE COM VARIANTS 679.5
CHANGE OF CYSTOSTOMY TUBE; SIMPLE 392
CHANGE TUBE/CATH NEPHRO PR-E 3,145.75
CHEM CAUT OF GRANLTJ TISSUE 170
CHEM CAUT OF GRANLTJ TISSUE 243.25
CHEMILUMINESCENT ASSAY 37
CHEMILUMINESCENT ASSAY 110
CHEMO ANTI-NEOPL SQ/IM 387
CHEMO CNS (INTRATHECAL) W LP 740.75
CHEMO HORMON ANTINEOPL SQ/IM 362.5
CHEMO INTRALESIONAL UP TO 7 343.5
CHEMO IV INFUS EACH ADDL SEQ =<1 HR 417.75
CHEMO IV INFUSION 1 HR 702.75
CHEMO IV INFUSION ADDL HR 569.25
CHEMO IV PUSH ADDL DRUG 470.75
CHEMO IV PUSH SNGL DRUG 472.75
CHEMO PROLONG 8+ HRS INFUSE W/PUMP 1,150.00
CHEMODENERV MUSC MIGRAINE 600
CHEST PT; INIT OR EVAL 245.75
CHEST PT; SUBSEQUENT 159
CHILDBIRTH CLASS-NO SHOW 36.25
CHLAMYDIA AB PANEL SEND OUT-E 310
CHLAMYDIA ANTIBODY PANEL-E 461.5
CHLAMYDIA CULTURE 482.75
CHLAMYDIA PNEU IGG/A/M SENDO-E 154
CHLAMYDIA T AMPLIF NA PROBE 148.75
CHLAMYDIA/GC SEND OUT-E 297.5
CHLORAPREP HI LITE ORANGE 41.25
CHLORAPREP ONE STEP 20.5
CHLORIDE; BLOOD 45
CHLORIDE; OTHER 34.75
CHLORIDE; URINE 69.25
CHOLANGIOGRAM ADDTL INTRAOP 614.5
CHOLANGIOGRAM INTRAOP 1,113.50
CHOLESTEROL COUNSELING 30 MIN 25.75
CHOLINESTERASE; RBC 25.25
CHOLINESTERASE; SERUM 25.25
CHROM ANALY; 15-20 CELLS 278.25
CHROM ANALY; 20-25 CELLS 299.5
CHROM ANALY; 5 CELLS 419.75
CHROM ANALY; ADDTL KARYOT EA STUDY 62
CHROM ANALY; AF/CV 15 CELLS 551.25
CHROMIUM 189.75
CHROMIUM & COBALT-E 412.5
CHROMOSOME ANALYSIS SEND OUT-E 538
CHROMOSOME,LEUKEMIA/LYMPH-E 705
CHRONIC LEUKEMIA PANEL SENDO-E 661.5
CINE OR VIDEO SPEECH EVAL 268
CIRCULAR HEM STAPLER 1,862.75
CIRCUMCISION 518.5
CIRCUMCISON PROC AND SET-E 609
CITRATE 117.75
CK TOTAL ISOENZYMES SEND OUT-E 146.5
CL TX “NURSEMAID ELBOW” W MANIP 888.25
CL TX ANKLE DISLOCATION; WO ANESTH 883.75
CL TX ARTFX MCP/IP JNT; W MANIP 2,634.75
CL TX C HUMERUS FX W MANIP 1,633.00
CL TX CMC DISL W M EA 1,797.50
CL TX CMC DISLOC THUMB W MANIP 527
CL TX CMC FX DISLOC THUMB W MANIP 1,633.00
CL TX DISTL FIB FX W MANIP 2,415.00
CL TX EC HUMERUS FX W MANIP 3,120.00
CL TX FX GT PHALANX(S); W MANIP 813
CL TX FX PHALANX/PHALANG; W MANIP 822.5
CL TX HUMERUS FX W MANIP 1,633.00
CL TX IP JNT D W MANIP ; WO ANESTH 1,889.50
CL TX IP JOINT DISL; WO ANESTH 1,010.75
CL TX IP JT D W MANIP; W ANESTH 2,298.25
CL TX KNEE DISL; W ANESTHESIA 2,937.50
CL TX KNEE DISL; WO ANESTH 318.75
CL TX MC FX SGL; W MANIP 1,756.75
CL TX MCP DISLOC SGL W MANIP 1,933.50
CL TX MTP JNT DISLOC; WO ANESTH 1,010.75
CL TX PATELLAR DISLOCATION; W ANESTH 1,800.25
CL TX PHALANG SHFT FX; W MANIP 1,914.00
CL TX POST HIP DISLOC WO ANESTH 318.75
CL TX POSTOP HIP DISLOC W ANESTH 1,800.25
CL TX PROX FIB/SHAFT FX W MANIP 2,462.25
CL TX PROX TIB-FIB JNT DISL; WO ANESTH 2,559.25
CL TX PROX TIBIAL FX W SK TRACTION 3,270.00
CL TX RADIAL HD/NECK FX; W MANIP 2,082.00
CL TX RADIAL SHFT FX W MANIP 2,790.75
CL TX SC/TC FEMUR FX W MANIP 1,657.00
CL TX SCAPULAR FX; W MANIP 3,309.25
CL TX SHDR DISLOC W NK FX W MANIP 3,065.50
CL TX SHLDR DISL W MANI; WO ANESTH 629.25
CL TX SHLDR DISL W MANIP; W ANESTH 2,868.00
CL TX SHLDR DISLOC & FX GT; W MAN 1,981.00
CL TX TARSAL BONE DISLO; WO ANESTH 225.25
CL TX TIB SHFT FX W MANIP 3,338.00
CL TX TMJ DISLOCATION; INITIAL 1,712.00
CL TX TMT JNT DISL; WO ANESTHESIA 1,254.00
CL TX TRIMALL ANKLE FX; W MANIP 3,548.50
CL TX WB DSTL TIB FX W MANIP 3,866.00
CLAVICLE COMPLETE 654.5
CLIP FIXING DEVICE DISP HX-200 225.25
CLIP LIGATION 154.75
CLIP RESOLUTION 360 235CM 763.5
CLL PROFILE,FISH SEND OUT-E 524.5
CLOTH CHLORHEXADINE GLUC 13.5
CLOTTING INHIBITOR PROTEIN S FREE 154.5
CLOTTING INHIBITOR; PROTEIN C ACTIVITY 123.25
CLOTTING INHIBITOR; PROTEIN C AG 116.25
CLOTTING INHIBITOR; PROTEIN S TOTAL 195.75
CLOTTING: FACTOR VIII VW FACTOR AG 122
CLOTTING; FACTOR II PROTHROMBIN SPECIF 122
CLOTTING; FACTOR IX 215
CLOTTING; FACTOR V 121.25
CLOTTING; FACTOR VII 105.5
CLOTTING; FACTOR VIII RISTOCETIN COFACT 154.5
CLOTTING; FACTOR X 109.75
CLOTTING; FACTOR XI 134.5
CLOTTING; FACTOR XII 61.75
CLOTTING; FACTOR XIII SCREEN SOLUBLE 253.5
CLTX BIMALLEOLAR ANKLE FRACT W MNP 3,411.25
CLTX BIMALLEOLAR ANKLE FRACT WO MNP 761
CLTX DSTL RDL FX/EPIPHYSL SEP W MNP 1,859.00
CLTX MED ANKLE FX W/MNPJ 2,803.00
CML PROFILE,FISH REFL SEND O-E 278.25
CML PROFILE,FISH SEND OUT-E 640.25
CMV IGG&IBM,CSF-E 100
CNTRL POST EPISTAX INIT 1,586.50
CO EXPIRED GAS BY IR 376.25
COAGULATION PROFILE-E 235.5
COGNITIVE SKILLS DEVELOPMENT 10.75
COGNITIVE SKILLS DEVELOPMENT 159.25
COL CHROMOTOGRAPHY QUAL/QUAN 67.5
COLD AGGLUTININ; SCREEN 44
COLD AGGLUTININ; TITER 192.5
COLLAGEN BASED WOUND FILLER 21
COLLAGEN BINDING ASSAY-E 178
COLLAGEN CROSS LINKS 79.5
COLLAGEN DRESSING <=16 SQ IN 21
COLLECTION FEE DOT 41.75
COLLECTION FEE SENDOUT 41.75
COLLECTION FEE, HAIR 41.75
COLLECTION FEE,AMBRY-MAB 15
COLLECTION FEE,MYRIAD 15
COLLECTION FEE,MYRIAD-MAB 15
COLON W POLYPECTOMY 4,640.00
COLON W POLYPECTOMY-MAB 4,640.00
COLONIC DISP BALLOON 15MM CRE 1,189.25
COLONIC DISP BALLOON 5847 866.5
COLONIC DISP BALLOON 8MM 5846 1,189.25
COLONOS W ABLATION SPLENIC 1,857.25
COLONOS W ABLATION SPLENIC-MAB 1,857.25
COLONOS W BL CONT 1,857.25
COLONOS W BL CONT SPLENIC 1,857.25
COLONOS W BL CONT SPLENIC-MAB 1,857.25
COLONOS W BL CONT-MAB 1,857.25
COLONOSCOPY DIL W BALLOON 1,857.25
COLONOSCOPY DIL W BALLOON-MAB 1,857.25
COLONOSCOPY REMOVAL FB 1,857.25
COLONOSCOPY REMOVAL FB-MAB 1,857.25
COLONOSCOPY SCREEN/DIAG 3,577.50
COLONOSCOPY SCREEN/DIAG-MAB 3,577.50
COLONOSCOPY SUBMUCOUS INJ-AMB 1,203.50
COLONOSCOPY SUBMUCOUS INJ-MAB 1,203.50
COLONOSCOPY W BIOPSY 4,640.00
COLONOSCOPY W BIOPSY-MAB 4,640.00
COLPOPERINEORRHAPHY 3,890.75
COLPORRHAPHY 3,890.75
COLPOTOMY; W DR OF PELVIC ABSCESS 2,796.75
COMMUNITY/WORK REINTEGRATION 10.75
COMMUNITY/WORK REINTEGRATION 159.25
COMPATIBILITY TEST ANTIGLOB 312.75
COMPATIBILITY TEST SPIN 312.75
COMPL ACUTE ABDOMEN 620.75
COMPL AUTOM CBC W PLT 59.75
COMPL CBC W PLT W AUTOM DIFF 97.75
COMPL RPLCMT PICC RS&I 1,593.25
COMPLEMENT; AG EA 158.75
COMPLEMENT; FCN ACTIVITY EA 123.5
COMPLEMENT; TOT HEMOLYTIC (CH50) 282.25
COMPREHEN METABOLIC PANEL 268
CONCENTRATION FOR INFECT AGNT 63.25
CONN TISS HUMAN (INC FASCIA) 1,502.25
CONN TISS HUMAN (INC FASCIA) 4,732.50
CONT POSTIVE AIRWAY PRESSURE 35.75
CONTINUOUS AEROSOL SET UP 184
CONTINUOUS PULSE OX 540.25
CONTRAST BATH THERAPY EA 15 MINS 7
CONTRAST BATH THERAPY EA 15 MINS 102.5
CONTRAST X-RAY BLADDER 3+ VIEWS 896.5
CONTRAST X-RAY EXAM OF COLON 1,004.50
CONTRAST X-RAY SPINE 2+ REGIONS 5,463.75
CONTROL NASAL HEMORRH ANT COMPLEX 193.75
CONTROL NASAL HEMORRH ANT SIMPLE 790.5
CONTROL OROPHARYNGEAL HEMORRH; SIMPLE 1,114.50
CONTRST X-RAY UPPR GI TRACT 1,205.00
CONTRST X-RAY URINARY TRACT 720.5
COOMBS TEST INDIRECT QUAL 164
COOMBS TEST INDIRECT TITER 164
COOMBS; DIRECT 195.75
COPPER 53
COPPER,URINE PANEL SEND OUT-E 73.5
CORD BLOOD GAS PANEL-E 99
CORNEAL LIGHT SHIELD 5.25
CORTISOL FREE, 2 TEST PANEL-E 114.25
CORTISOL; FREE 198.5
CORTISOL; TOTAL 69.75
CORTISOL; TOTAL 208.75
COVID-19 DIAGNOSTIC TEST PCR METHODOLOGY; TOTAL 119.25
COVID-19 SPECIMEN COLLECTION, SKILLED NURSING FACILITY 28.25
CP CERV/VAG; ATL; MANUAL SCRN 140.5
CP SMR OTHR; SCRN & INT 91
C-PEPTIDE 345.75
CPK: ISOENZYMES 65.75
CPK: MB FRACTION ONLY 162.75
CPK; TOTAL 81
CPR 739
CRASH CART ADULT 439.5
CRASH CART INFANT 361
CRE 12-15MM ESOPH BLAS 1,309.75
CRE BALLOON 12-13.5-15 5848 1,110.25
CRE ESOPH BLAS 15-18MM 1,300.25
CRE ESOPH BLAS 18-20MM 1,110.25
C-REACTIVE PROTEIN 13
C-REACTIVE PROTEIN HS 396.25
CREATINE 51.5
CREATININE; BLOOD 54.5
CREATININE; CLEARANCE 131.5
CREATININE; NOT BLOOD 20.5
CREP E/N/E/L; 1.1-2.5CM 1,541.75
CREP E/N/E/L; 2.6-7.5CM 1,618.50
CREP E/N/E/L; EA ADDTL 5 CM/< 1,280.00
CREP F/G/H/F; 1-2.5CM 941.25
CREP F/G/H/F; 2.6-7.5CM 1,468.25
CREP H/A/G/EXTR; EA ADD 5 CM/< 1,244.25
CREP S/A/L; 2.6-7.5CM 2,451.50
CREUTZSELDT-JAKOB, CSF-E 112.75
CRITICAL CARE 1ST HOUR 3,410.75
CRITICAL CARE ADDL 30 MIN 1,610.75
CRYOGLOBULIN – QUAL/SEMI QUAN 63.25
CRYOPRECIPITATE EA UNIT 1,298.75
CRYPTOSPOR AG BY IFA 132.5
CRYPTOSPORIDIUM AG IA 71
CRYPTOSPORIDIUM/ISO SMEAR-E 84
CSF FLOW; CISTEROGRAM 2,829.00
CSF IGG INDEX PANEL SEND OUT-E 199.75
CSF PROTEIN ELECTROPHORESIS-E 130.75
CT – HEAD/BRAIN W & WO CONTRAST 3,087.00
CT – HEAD/BRAIN W CONTRAST 2,595.50
CT – HEAD/BRAIN WO CONTRAST 2,375.00
CT – LIMITED OR FOLLOW-UP STUDY 1,660.75
CT – MF W CONTR 2,380.25
CT – MF W&WO CONTR 2,499.50
CT – MF WO CONTR 2,267.00
CT – ORBIT SELLA MID/INNER EAR W & WO 2,499.50
CT – ORBIT SELLA MID/INNER EAR W CONTR 2,380.25
CT – ORBIT SELLA MID/INNER EAR WO CONT 2,267.00
CT – ST NECK W CONTR 2,649.50
CT – ST NECK W&WO CONTR 2,499.50
CT – ST NECK WO CONTR 2,267.00
CT ABD & PELV 1/> REGNS 6,497.00
CT ABD & PELV W/CONTRAST 5,217.25
CT ABD & PELVIS 4,555.50
CT ABD W AND WO CONTRAST 3,382.50
CT ABD W CONTRAST 2,745.50
CT ABD WO CONTRAST 2,400.50
CT ANGIO ABD&PELV W/O&W/DYE 5,457.25
CT ANGIO ABDOM W/O & W/DYE 3,949.25
CT ANGIO ABDOMINAL ARTERIES 4,931.25
CT ANGIO CHEST/ABD/PELV-E 9,433.75
CT ANGIO LWR EXTR W/O&W/DYE 3,017.50
CT ANGIO UPR EXTRM W/O&W/DYE 2,834.75
CT ANGIOGRAPH PELV W/O&W/DYE 3,564.75
CT ANGIOGRAPHY CHEST 3,976.50
CT ANGIOGRAPHY HEAD 3,923.50
CT ANGIOGRAPHY NECK 2,955.25
CT BRAIN PERFUSION STUDY-E 3,087.00
CT CERV SPINE W & WO CONTR 2,902.00
CT CERV SPINE W CONTR 2,763.75
CT CERV SPINE WO CONTR 2,631.75
CT CHEST & ABD W/WO CONTR-E 6,073.00
CT CHEST W CONTR/ ABD W/WO-E 5,861.75
CT CHEST/ABD W CONTRACT-E 5,225.00
CT CHEST/ABD W/O CONTRAST-E 4,594.25
CT CHEST/ABD/PELVIS W CONT-E 7,696.75
CT CHEST/ABD/PELVIS W/O CONT-E 6,749.25
CT C-SPINE & T-SPINE W/O CON-E 5,263.50
CT C-SPINE &T-SPINE W CONT-E 5,527.50
CT GUIDED NDL BC RENAL RT PR-E 3,982.75
CT GUIDED NDL BX ABD PROFILE-E 3,984.50
CT GUIDED NDL BX BONE PROFIL-E 3,970.50
CT GUIDED NDL BX LIVER PROFI-E 3,924.50
CT GUIDED NDL BX LUNG LT PRO-E 3,982.75
CT GUIDED NDL BX LUNG RT PRO-E 3,982.75
CT GUIDED NDL BX PANCREAS PR-E 4,764.75
CT GUIDED NDL BX PELVIS PROF-E 3,970.50
CT GUIDED NDL BX RENAL LT PR-E 3,982.75
CT GUIDED NDL BX S TIS NECK-E 4,330.75
CT HEAD/FAC BONES W/O C AX O-E 4,641.75
CT L EXTR W AND WO CONTRAST 2,547.75
CT L EXTR W CONTRAST 2,426.25
CT L EXTR WO CONTRAST 2,311.00
CT LS W & WO CONTRAST 2,902.00
CT LS W CONTRAST 2,763.75
CT LS WO CONTRAST 2,631.75
CT PELVIS; W & WO CONTR 2,436.25
CT PELVIS; W CONTR 2,733.50
CT PELVIS; WO CONTR 2,383.50
CT SCAN FOR NEEDLE BIOPSY 2,450.25
CT SCAN FOR THERAPY GUIDE 2,914.25
CT THORACIC SPINE W & WO CONTR 2,902.00
CT THORACIC SPINE W CONTR 2,763.75
CT THORACIC SPINE WO CONTR 2,631.75
CT THORAX; W & WO CONTRAST 2,690.75
CT THORAX; W CONTRAST 2,479.50
CT THORAX; WO CONTRAST 2,193.75
CT T-SPINE, L-SPINE W CONT-E 5,527.50
CT T-SPINE,L-SPINE W/O CONT-E 5,263.50
CT: U EXTR W AND WO CONTRAST 2,499.50
CT; U EXTR W CONTRAST 2,380.25
CT; U EXTR WO CONTRAST 2,267.00
CTRL POST EPISTAX SQ 345
CULT FUNGUS W P ID; SKIN HR NL 29.5
CULTURE P PATHOG – SCREEN 28.25
CULTURE TYPE IMMUNOLOGIC 78.5
CULTURE,STOOL PROFILE 4 TEST-E 460.25
CUSHION CHAIR SOFTCARE CC476CE 84.5
CVSLR STRESS TEST; TRACING 1,217.75
CYANIDE 37
CYCLOSPORINE 61.75
CYSTATIN C 29.25
CYSTO PACK CS/5 119.5
CYSTOGRAM PROFILE-E 2,018.75
CYTOGEN M ARRAY COPY NO&SNP 1,489.50
CYTOMEGALOV AMPLIF NA PROBE 75
CYTOMEGALOVIRUS IGG&IGM SEND-E 100
CYTOMEGALOVIRUS NA QUAN 446.75
CYTOPATH C/V AUTO FLUID REDO 106
CYTOPATH CELL ENHANCE TECH 217.75
CYTP DX EVAL FNA 1ST EA SITE 235.25
CYTP URINE 3-5 PROBES CMPTR 580
DAVINCI CANNULA SEAL 8MM 50.5
DAVINCI OBTURATOR 8MM 83.25
DAVINCI VESSEL SEALER 2,075.50
D-DIMER- QUAL/SEMIQUAN 76.25
DEB SUBQ TISSUE 20 SQ CM/< 762.25
DEBRIDE NAIL 1-5 61
DECALCIFICATION 142.5
DECANTER BAG POUR SPOUT 30.5
DECLOT VASCULAR DEVICE 658.25
DECOMPRESS; UNSPECIFIED NERVE(S) 4,389.75
DEEP BONE BX TRCR/NDL 1,575.00
DEEP I&D THIGH/KNEE 2,420.75
DELTA ALA 91.5
DEOXYCORTISOL 11 99.25
DEOXYPYRIDINOLINE-E 100
DESOXYCORTICOSTERONE 11 99.25
DESTR W NEUROLYTIC; INTERCOSTAL NRV 1,794.00
DESTR W NEUROLYT TRIGEM NRV; INF ALV BR 1,794.00
DESTR W NEUROLYTIC; CELIAC PLEXUS 1,794.00
DESTR W NEUROLYTIC; OTHER PERIPH NRV 1,794.00
DESTR W NEUROLYTIC; PUDENDA NRV 1,794.00
DESTROY C/TH FACET JNT ADDL 961.25
DESTROY C/TH FACET JNT ADDL 1,442.00
DESTROY CERV/THOR FACET JNT 4,389.75
DESTROY CERV/THOR FACET JNT 6,584.75
DESTROY L/S FACET JNT ADDL 961.25
DESTROY L/S FACET JNT ADDL 1,442.00
DESTROY LUMB/SAC FACET JNT 4,389.75
DESTROY LUMB/SAC FACET JNT 6,584.75
DHEA 107.75
DHEA-S 280.5
DIALYSIS CATH INSERT-2N 251.25
DIALYSIS CATH INSERT-3S 251.25
DIALYSIS CATH INSERT-ICU 251.25
DIALYSIS CATH INSERT-PCU 251.25
DIALYSIS ONE EVALUATION 969.5
DIFF CELL COUNT NOT BLOOD 101.75
DIGITAL ANALYSIS OF EEG 991.25
DIL URETHR STRICT FILIF/FOLLOW; MALE 1ST 2,525.50
DILATE FOR STRICTURE/OBSTR 334
DIRECT BILIRUBIN 99
DIRECT IMMUNOFLUO PANEL-E 448
DIRECT REFER HOSPITAL OBSERV 1,590.75
DM OP SMT GRP PER 30 MIN 64.25
DM OP SMT INDIV PER 30 MIN 117.25
DNA AB 65.75
DNA AB; NATIVE OR DS 104.75
DNA AB; SS 246.25
DNA/RNA; MULTI ORG – AMP PR 251.25
DONOR PUNCH 8.0MM 472.25
DONOR PUNCH SET 8.5MM 472.25
DOPPLER COLOR FLOW 666.75
DOPPLER ECHO; COMPLETE 726.5
DR ABSC CYST HEMAT-MOUTH; SIMPLE 723.25
DR ABSC CYST HEMATOM – DENTOALVEOLAR 347
DR EXT EAR ABSCESS/HEMATOMA; SIMPLE 723.25
DRAIN CEREBRO SPINAL FLUID 1,424.25
DRAIN ENT SILASTIC 2X3 142.75
DRAIN EXTERNAL AUDITORY CANAL ABSCESS 723.25
DRAIN FINGER ABSC; COMPLICATED 1,707.00
DRAIN FINGER ABSC; SIMPLE 673.5
DRAIN HEYER SCHULTE 10FR FLAT 71
DRAIN HEYER SCHULTE RES 400 221.25
DRAIN J-VAC RESEVOIR SM 150CC 145.25
DRAIN J-VAC TUBING #10 FLAT 104
DRAIN J-VAC TUBING #15 80
DRAIN J-VAC TUBING #19 129.75
DRAIN ORTHOSILASTIC 2X3 143
DRAIN/INJ INTER JOINT/BURSA W/O US 648.75
DRAIN/INJ INTER JOINT/BURSA W/O US 973.25
DRAIN/INJ MAJOR JOINT/BURSA W/US 648.75
DRAIN/INJ SMALL JOINT/BURSA W/O US 648.75
DRAIN/INJ SMALL JOINT/BURSA W/O US 973.25
DRAINAGE OF ABSCESS OF PALATE UVULA 442
DRAINAGE OF SCROTAL WALL ABSCESS 2,245.50
DRAPE ARTHROSCOPE KNEE 73.75
DRAPE STERI 1060 EYE/INCISE 14.75
DRAW BLOOD OFF VENOUS DEVICE 170.5
DRAWING FEE PATERNITY TESTING 88.75
DRESS/DEBRID P-THICK BURN M 168
DRESS/DEBRID P-THICK BURN M 597.25
DRESS/DEBRID P-THICK BURN S 170
DRESS/DEBRID P-THICK BURN S 568
DRILL (DVR) 2.0MM FDB20 474.5
DRILL (HIP) 30MM 305.25
DRILL (S/H) 1.5MM STRYKER J 248.75
DRILL (S/H) 2.0MM STRYKER J 194.5
DRILL BIT 2.5MM X 100MM 09023 266.25
DRILL BIT 2.5MM X 110MM 326.75
DRILL BIT 2.7MM X 100MM 221.25
DRILL BIT 3.5MM X 110MM 206.75
DRILL(S/H) 1.5MM MINI QUICK 280.5
DRSG 2 X 2 SPLIT EA 8.75
DRSG 4 X 4 SPLIT EA 9.5
DRSG 4 X 4 STERILE EA 9.75
DRSG 4 X 4 STER-WOUND CENTER 9
DRSG 4 X 4 X 12 PLY STER 3.5
DRSG 4 X 4 X 12 PLY STER-WC 2
DRSG 4X12 PICO WOUND SYSTEM 759
DRSG 4X4 AQUACELL AG HYDRAFIB 44
DRSG 4X4 AQUACELL AG HYDRAFIBE 54.5
DRSG 4X8X12 RAYTEC 15
DRSG 6X6 PICO WOUND SYSTEM 759
DRSG 6X8 PICO WOUND SYSTEM 759
DRSG ABD 8 X 7 1/2 STER EA 9.5
DRSG ABD STER 8 X 7 1/2-WOUND 9
DRSG ACTACOAT 7 89
DRSG ADAPTIC 3 X 16 EA 24
DRSG ADAPTIC 3 X 3 EA 9.5
DRSG ADAPTIC 3 X 3 STER 9
DRSG ADAPTIC 3 X 8 EA 29.5
DRSG ADAPTIC 3 X 8 STER 25
DRSG AQUACEL 28.75
DRSG AQUACEL 9CM X 15CM 8.25
DRSG AQUACEL AG 9X30CM 122.25
DRSG AQUACEL FOAM 10X10-WOUND 19.75
DRSG AQUACEL FOAM 15X20-WOUND 35.25
DRSG AQUACEL FOAM 8X8-WOUND 12
DRSG COBAN 20.25
DRSG COBAN 4IN 2084S 10.5
DRSG COBAN 6IN STERILE 1586S 20.5
DRSG COMPRESSION-PROFORE 64
DRSG CURAGEL HYDOGEL 2X3 16.5
DRSG DERMABOND TOPICAL SKIN GL 142
DRSG DERMABOND TOPICAL SKIN GL 170.5
DRSG DUODERM 2 X 4 EX THIN 37.25
DRSG DUODERM 4 X 4 22
DRSG DUODERM 4 X 4 EXTRA THI 22
DRSG DUODERM 5 X 5 SIGNADRESS 28.75
DRSG DUODERM CGF 4X4 187660 WC 13
DRSG DUODERM SIGNAL 4 X 4 18.5
DRSG DUODERM THIN 4X4 9
DRSG DUODERM THIN 4X4 10.75
DRSG EXTRA SUTURES 80
DRSG GAUZE PLAIN 1 IN 55
DRSG GAUZE PLAIN 1 IN 67.5
DRSG GAUZE PLAIN 1/2 IN 80
DRSG GAUZE PLAIN 1/2 IN-WOUND 67
DRSG GRANUFOAM MD BLACK 207.5
DRSG HEAVY DRAINAGE EA 28
DRSG IODAFORM GAUZE 1 IN 90.5
DRSG IODAFORM GAUZE 1/2 IN 58.25
DRSG IODAFORM GAUZE 2 IN 48.5
DRSG IODOFORM 5% 1/4 IN-WC 5
DRSG IODOFORM GAUZE 5% 1 IN 89
DRSG IODOFORM GAUZE 5% 1/2 IN 48
DRSG KERLIX FLUFFS 31.5
DRSG KERLIX ROLL 28
DRSG KERLIX ROLL-WC 28
DRSG LYOFOAM 4 X 4 WOUND CENTE 9
DRSG MEPILEX AG 4X4 28710 33
DRSG MEPILEX BORDER 10X10CM 14
DRSG MEPILEX BORDER 10X10CM 15.75
DRSG MEPILEX BORDER 3X3 295200 11
DRSG MEPILEX BORDER 3X3 295200 11.25
DRSG MEPITEL SILICONE 59
DRSG NASAL RAPID RHINO 245.75
DRSG OWENS 3X8 62.5
DRSG PRISMA MATRIX 4.34 SQ 49
DRSG RHINO NASAL PAC 5.5CM 104.5
DRSG RHINO NASAL PAC 7.5CM 110.25
DRSG ROPE AQUACELL HYDRAFIBER 64
DRSG SILVERCEL 4 X 4 WC 40
DRSG SPANDAGE 10 X 24 58.25
DRSG SPANDAGE 9 X 24 28
DRSG TEGADERM TRANSPARENT XLG 15
DRSG TELFA EA 3 X 4 9.5
DRSG TELFA EA 3 X 8 9.5
DRSG TRANSP TEGADERM 4 X 5 1/2 5
DRSG TRANSPARENT 2 X 3 9.5
DRSG UNA BOOT 48.75
DRSG VAG PACKING 95.5
DRSG VASELINE GAUZE 1/2 X 72 22
DRSG VASELINE GAUZE 3 X 9 18.5
DRSG XERO FORM 1 X 8 13.5
DRSG XERO FORM 5 X 9 18.5
DRUG SCR 10 PANEL-MHC 59.25
DRUG SCR COURT 10 171.25
DRUG SCR DOT SEND OUT 59.25
DRUG SCR NON DOT SEND OUT 59.25
DRUG SCR,URINE 7 PANEL CORP 59.25
DRUG SCREEN QUAN LAMOTRIGINE 47
DRUG SCREEN QUANT CLOZAPINE 49
DRUG SCREEN QUANT EVEROLIMUS 82.5
DRUG SCREEN QUANT ZONISAMIDE 47.25
DRUG SCRN QUAN LEVETIRACETAM 47
DRUG SCRN QUAN MYCOPHENOLATE 47
DRUG SCRN QUANT OXCARBAZEPIN 63.75
DRUG TEST DEF 1-7 CLASSES 147.75
DRUG TEST DEF 8-14 CLASSES 147.75
DRUG TEST PRSMV CHEM ANLYZR 147.75
DRUG TEST PRSMV CHEM ANLYZR 413.25
DRUG TEST PRSMV CHEM ANLYZR 472
DRUG TEST PRSMV CHEM ANLYZR 531
DRUG TEST PRSMV CHEM ANLYZR 619.75
DRUG TEST PRSMV CHEM ANLYZR 678.5
DRUG TEST PRSMV DIR OPT OBS 53.5
DT VACCINE UNDER 7 YRS IM 143.75
DUCTOGRAM MAM SINGLE DUCT PR-E 1,391.75
DUCTOGRAM MAMM MULTIDUCT PRO-E 2,160.25
DUPLEX A IVC IL/BPG; COMPL 726.75
DUPLEX EXT VEINS; BILAT 956
DUPLEX EXT VEINS; UNIL/LIMIT 753.75
DUPLEX LE ART/BPG; BILAT 1,050.50
DUPLEX LE ART/BPG; UNIL/LIMIT 619
DUPLEX UE ART/BPG; BILAT 807.5
DUPLEX UE ART/BPG; UNIL/LIMIT 502.25
DX BONE MARROW ASPIRATIONS 1,658.50
DX BONE MARROW BIOPSIES 1,658.50
DX MAMMO INCL CAD BI 519.75
DX MAMMO INCL CAD BI 638.75
DX MAMMO INCL CAD UNI 519.75
DX PAP SMR; AUTOM SCRN 43
DXA BONE DENSITY AXIAL 1+ SITES 622.5
DXA BONE DENSITY/PERIPHERAL 1+ SITES 132
EBUS-BRONCH W/ ENDOBRONCH US 6,414.75
EBVCA IGG IGM EVALUATR SEND-E 196.75
ECG UP TO 48 HRS RECORDING 859.25
ECG UP TO 48 HRS SCANNING ANALYSIS REPORT 842.25
ECHELON STAPLER / CUTTER EC60A 1,120.00
ECHO EXAM OF ABDOMEN 1,256.25
ECHO EXAM OF HEAD 1,358.00
ECHO TRANSESOPHAGEAL COMPLETE 977.25
EEG 41-60 MINUTES 1,371.75
EEG AWAKE & ASLEEP 1,678.00
EEG AWAKE & DROWSY 1,434.75
EEG COMA OR SLEEP ONLY 1,486.00
EEG OVER 1 HOUR 1,555.25
EGD DIAGNOSTIC BRUSH WASH 2,304.25
EGD DILATATION W BALLON 2,453.75
EGD DILATATION W BALLON-MAB 2,453.75
EGD GAST 1,785.50
EGD GAST-MAB 1,785.50
EGD PLUS DIL ACH 2,300.25
EGD PLUS DIL ESO STRICTURE 2,531.00
EGD REMOVAL FB 2,453.75
EGD REMOVAL FB-MAB 2,453.75
EGD W BANDING 2,453.75
EGD W BANDING-MAB 2,453.75
EGD W BIOPSY 3,027.00
EGD W BIOPSY-MAB 3,027.00
EGD W BLEED CONTROL 2,453.75
EGD W BLEED CONTROL-MAB 2,453.75
EGD W DILATORS 2,453.75
EGD W DILATORS-MAB 2,453.75
EGD W FEEDING TUBE 1,481.25
EGD W FEEDING TUBE-MAB 1,481.25
EGD W POLYPECTOMY 3,027.00
EGD W POLYPECTOMY-MAB 3,027.00
EGD W STENT PLACEMENT 5,284.25
EGFR GENE COM VARIANTS 511
ELBOW ARTHROGRAM 935
ELBOW ARTHROGRAM INJ 580
ELECTRIC CURRENT THERAPY EA 15 MINS 12.75
ELECTRIC CURRENT THERAPY EA 15 MINS 187
ELECTRICAL STIMULATION EA 15 MINS 14
ELECTRICAL STIMULATION EA 15 MINS 205
ELECTRODE ADULT SPLIT ARTHREX 74.5
ELECTRODE CLEARVAC 60-6829-005 89.75
ELECTRODE RESECTOSCOPE ROLLER 614
ELECTROLYTE PANEL 149
ELECTROLYTES STOOL(NA,K,CL)-E 123.75
ELECTROPHORESIS NES 106
EMERG DIALYSIS ESRD PT 1,084.50
EMERGENCY DEPT VISIT 312.25
EMERGENCY DEPT VISIT 557
EMERGENCY DEPT VISIT 1,013.50
EMERGENCY DEPT VISIT 1,614.50
EMERGENCY DEPT VISIT 2,433.75
EMPLOYEE PUNCTURE PROFILE-E 466.25
EMPLOYEE PUNCTURE-E 1,040.00
ENA ANY METHOD 59.75
ENA ANY METHOD 415.25
ENDO CATH – BIL & PANCR D 1,613.50
ENDO CLIP APPLIER 5MM EL5ML 855.5
ENDO CUTTER 60MM LONG 2,005.25
ENDO DR FOG PREVENTION KIT 17
ENDO LINEAR CUTTER 45 MM ATS45 1,255.25
ENDO LOOP O-VICRYL 66.25
ENDO RELOAD 45MM 386.75
ENDO RELOAD 45MM BLUE 386.75
ENDO RELOAD 45MM BLUE TR45B 1,210.75
ENDO RELOAD 45MM WHITE TR45W 1,210.00
ENDO RETRIEVAL POUCH 5MM 199.25
ENDO TRUMPET TUBING 135.5
ENDO W ABLATION DUODENUM 2,453.75
ENDO W ABLATION DUODENUM-MAB 2,453.75
ENDO W BLEED CONT DUODENUM 2,453.75
ENDO W BLEED CONT DUODENUM-MAB 2,453.75
ENDO W BLEED CONT ILEUM 2,453.75
ENDO W BLEED CONT ILEUM-MAB 2,453.75
ENDO W BLEED CONT UPPER GI 2,453.75
ENDO W BLEED CONT UPPER GI-MAB 2,453.75
ENDO W THERMAL TX UPPER GI 3,186.50
ENDO W THERMAL TX UPPER GI-MAB 3,186.50
ENDO-CATCH SPECIMEN POUCH 1,366.25
ENDOSCOPY-EXT. OBSERVATION. 238.75
ENDOSCRUB2 SHEATH 30D.19-1201 248
ENDOSCRUB2 SHEATH O D.19-12000 279.5
ENDO-STAPLE CLIP 321.75
ENDOSTITCH 2-0 POLYSORB 170053 277.5
ENTEROSCOPY 2,147.00
ENTEROSCOPY-MAB 2,147.00
ENTEROVIRUS PROBE&REVRS TRNS 96.25
ENZYME ACTIVITY BC; NOT RA 67.5
ENZYME ACTIVITY BC; NOT RA 206.75
ENZYME HISTOCHEMISTRY 609.5
EP INTRACARD FIX-CURVE GUIDNG INTROD/SHEATH 109.5
EPIDISC TM PERF PATCH KIT 560
EPIFIX 1 SQ CM 559
EPIFIX 1 SQ CM 1,117.00
EPIFIX 1 SQ CM 1,675.00
EPIFIX 1 SQ CM 2,233.00
EPIFIX 1 SQ CM 3,419.00
EPIFIX 1 SQ CM 4,465.00
EPIFIX 1 SQ CM 5,023.00
EQUIP GAYMER THERMIA UNIT-ER 264.25
EQUIP K-PAD WITH MOTOR SETUP 234.5
EQUIP SCD SLEEVE SET UP 272.5
EQUIP-BLOOD WARMER-ER 223.25
EQUIP-HARMONIC SCALPEL 392.25
EQUIP-I/A CAVITRON 254.25
ER PARACENTESIS 694.75
ERYTHROPOIETIN 195.5
ESOPHAGOGAS-JEJUNOSC W DIL-MAB 2,147.00
ESOPHAGOGASTRO-JEJUNOSCO W DIL 2,147.00
ESOPHAGOGASTRO-JEJUNOSCOPY 2,147.00
ESOPHAGOGASTRO-JEJUNOSCOPY-MAB 2,147.00
ESOPHAGOSCOPY W ABLATION 2,147.00
ESOPHAGOSCOPY W ABLATION-MAB 2,147.00
ESOPHAGOSCOPY W BLEED CONT 2,147.00
ESOPHAGOSCOPY W BLEED CONT-MAB 2,147.00
ESOPHAGUS-PH 1,174.00
ESOPHAGUS-PH PROLONGED 1,629.00
ESOPHOGRAM 581.75
ESOPHOSCOPY DIAG 1,562.25
ESOPHOSCOPY DIAG-MAB 1,562.25
ESTRADIOL 136.5
ESTRADIOL,FREE-E 195.25
ESTRIOL UNCONJUGATED 123.75
ESTROGENS FRACTION, SEND OUT-E 289.25
ESTROGENS; TOTAL 87.5
ESTRONE 152.75
ETHOSUXIMIDE 59.5
ETHYLENE GLYCOL 58
EVAC SU HEMATOMA 270.75
EVAL AMNIOTIC FLUID PROTEIN 133.5
EVAL OF FNA; INT & REP 249.75
EVALUATE SPEECH PRODUCTION 7.25
EVALUATE SPEECH PRODUCTION 421.25
EVALUATE SWALLOWING FUNCTION 9.5
EVALUATE SWALLOWING FUNCTION 421.25
EVALUATION OF SPEECH FLUENCY 7.25
EVALUATION OF SPEECH FLUENCY 421.25
EVALUATION OF WHEEZING 750.25
EVICEL APPLICATOR 45CM 3909 153.25
EXAM SYNOVIAL FLUID CRYSTALS 105.5
EXC FACE-MM B9+MARG 1.1-2 CM 1,329.75
EXCHANGE NEPHROSTOMY CATH 2,009.75
EXHALED NITRIC OXIDE MEAS 78.25
EXPL KNEE W DRAIN/REM FB 3,355.00
EXPL P WND; EXTREM 3,033.25
EXPL/REM FB IPH JOINT EA 1,770.50
EXTENSOR TENDON REPAIR EACH 3,237.25
EXTERNAL PACEMAKER-ICU 148.5
EXTERNAL PACEMAKER-PCU 148.5
F18 FDG =< 45 MCI 194.5
F2 GENE 185.25
F5 GENE 172
FACTOR 8 VWF MULTIMRIC 124.25
FACTOR INHIBITOR TEST 52
FANCC GENE 47.25
FAT/LIPIDS FECES; QUAL 60.5
FAT/LIPIDS FECES; QUAN 98.5
FATTY ACIDS NONESTERIFIED 128.75
FBP W NON-STRESS TEST 2,196.00
FBP WO NON-STRESS 1,664.50
FECAL LEUKO CNT QUAL/SEMIQUAN 52.25
FEM 60/ROD 3.2 416.5
FEM GD/ROD 2.4 SMOOTH 187.25
FEMORAL N BLOCK SGL 1,424.25
FEMORAL N BLOCK SGL 2,136.50
FERRITIN 175.5
FETAL CONTRACTION STRESS TEST 964.75
FETAL FIBRONECTIN CV SEMIQUAN 415
FETAL HGB SCREENING TEST 24
FETAL NON-STRESS TEST 772.25
FFP THAWING EA UNIT 247
FIBERSTICK #2 AR-7209 267.5
FIBERWIRE #2 1BLUE/1WHITE 118.25
FIBERWIRE #2 W/BLUE TAPERED 118.25
FIBRIN SEALANT EVICEL #3907 1,519.00
FIBRINOGEN EVAL PROFILE-E 333.75
FIBRINOGEN PANEL-E 90.5
FIBRINOGEN; ACTIVITY 36.5
FIBRINOGEN; ANTIGEN 54.25
FILSHIE CLIP 338.5
FIRST RESPONDER EXPOSURE-E 201.25
FISH CHARCKOT-E 481.25
FISH MICRODELETION-E 216.75
FISH NO CULTURE-E 896.25
FISTULAGRAM PROFILE-E 1,722.00
FLEXI-SEAL FECAL MANAGEMENT KI 2,458.25
FLOSEAL HEMOSTATIC SEALANT 738.25
FLOW CYTOMETRY EA ADDTL MARKER 62.5
FLOW CYTOMETRY EA ADDTL MARKER 374
FLOW CYTOMETRY EA ADDTL MARKER 498.75
FLOW CYTOMETRY PNH PANEL-E 1,216.00
FLOW CYTOMETRY TC 1ST MARKER 287.5
FLT3 PANEL-E 352.75
FLUORESCENT AB; SCRN EA AB 67.25
FLUORESCENT AB; SCRN EA AB 201.25
FLUORESCENT AB; TITER EA AB 51.75
FLUORESCENT AB; TITER EA AB 154.5
FLUOROGUIDE FOR SPINE INJECT 186.25
FLUOROGUIDE FOR VEIN DEVICE 1,075.50
FLUOROSCOPE EXAM EXTENSIVE 859.25
FLUOROSCOPY <1 HR PHYS/QHP 486.25
FMR1 GENE DETECTION 273.5
FNA BX W/O IMG GDN 1ST LES 423
FNA W/IMAGE 1,872.25
FOLATE, RBC SEND OUT-E 81
FOLEY TRAY SURE TEMP 95.25
FOLIC ACID; RBC 59.75
FOLIC ACID; SERUM 212
FOOT COVER LG AV IMPULSE 5075 417
FOOT COVER MD AV IMPULSE 5065 417
FORCE TRIVERSE DEVICE 167.5
FORCEPS COLD 000569 58.25
FORCEPS RADIAL JAW 1524 167.5
FORESKIN MANIPULATION 318.75
FREE INSULIN 100.25
FREE K+L LT CHAINS SEND OUT-E 492.25
FREE L/HIP GUIDE PIN THREADED 43.75
FREE THYROXINE 149.75
FREE THYROXINE INDEX-E 57.25
FRESH FROZEN PLASMA THAW-PAN-E 488
FUNGAL AB BY CF-E 339.75
FUNGUS CULTURE BLOOD 29.5
FUNGUS CULTURE DEF I.D YEAST 80.75
FUNGUS CULTURE DEF ID MOLD 98.75
FUNGUS CULTURE NOT BLOOD 29.5
FUNNEL KELLER KS-001 486.5
G-6-PD AND RBC PANEL SEND OU-E 180.75
G6PD; QUAN 159.5
GAD-BASE MR CONTRAST NOS PER 1 ML 24.25
GAIT TRAINING THERAPY EA 15 MINS 140
GALACTOSE 102.75
GARDNERELLA DIR NA PROBE 62.5
GASTRIC EMPTYING IMAG STUDY 1,437.75
GASTRIC REFLUX SCAN 1,607.00
GASTRIN 213.25
GAUZE <=16 IN NO W/SAL W/O B 30
GELPORT ACCESS DEVICE C8XX2 1,892.75
GENET VIRUS ISOLATE HSV 75.5
GENOTYPE DNA HEPATITIS B 476.5
GENTAMICIN 142
G-ESOPH REFLUX W MUCOSAL PH 1,856.50
GI TRACT CAPSULE ENDOSCOPY 3,912.25
GIARDIA & CONCENTRATION-E 132.5
GIARDIA AG BY IF 69.5
GLIADIN ANTIBODIES SEND OUT-E 134.5
GLIDE SHEET FOR IOL 5
GLOBULIN PROFILE-E 112.5
GLUCAGON 55.25
GLUCOSE BODY FLUID NOT BLOOD 61.75
GLUCOSE TOLERANCE 2 HR-E 275
GLUCOSE TOLERANCE TEST (GTT) 3 SPECM 180
GLUCOSE; BLD BY MONITOR DEVICE 54.5
GLUCOSE; POST GLUCOSE DOSE 164
GLUCOSE; QUAN BLOOD 44.75
GLUTAMYLTRANSFERASE GAMMA 70.75
GLUTATHIONE 73.25
GLYCATED PROTEIN 83.25
GLYCOSYLATED HEMOGLOBIN TEST 114
GOLF EVALUATION (1)-M52 151.75
GONADOTROPIN; FSH 289.75
GONADOTROPIN; LUTEINIZING HORMONE 344.75
GOWN XX-LG MICROCOOL 92056 47.5
GRAFT ALLOMATRIX C PUTTY 2,882.75
GRAFT ALLOMATRIX INJ PUTTY 3,417.00
GROWTH HORMONE HUMAN 232.75
GRP NUTRITION THERAPY; EA 30M 22.5
GTT-ADDED SAMPLES 95.25
GUIDE CATHET FLUID DRAINAGE 1,219.25
GUIDE WIRE 106.25
GUIDE WIRE 108.25
GUIDE WIRE 131
GUIDE WIRE 162.5
GUIDE WIRE 165.5
GUIDE WIRE 165.75
GUIDE WIRE 303.25
GUIDE WIRE 315.5
GUIDE WIRE 440
GYN/SCOPE PACK CS/5 117.75
H PYLORI (C-13) BREATH TEST 164.75
H PYLORI DRUG ADMIN 24.5
H PYLORI IGG IGM IGA SEND OU-E 212
HAMS; AUTO SCRN EA 93.25
HANDLING FEE-QUEST 8.75
HANDPIECE,ECHELON FLEX 1,035.25
HAPTOGLOBIN; QUAN 127.5
HARMONIC SHEARS & 7 DEVICE 2,349.25
HARMONIC SHEARS ACE36E 2,573.00
HBA1/HBA2 GENE 321.75
HBG; METHEMOGLOBIN QUAN 158.5
HBV CORE AB IGG/IGM-E 186.75
HCG; QUAL 128.5
HCG; QUAN 29.75
HCV FIBROSURE-E 654.75
HCV GENOSURE-E 1,033.50
HCV NSSA RESISTANCE-E 1,033.50
HEAVY METAL PANEL 5 TESTS-E 304.75
HEAVY METAL PROFILE SENDOUT-E 284.5
HEAVY METAL PROFILE UA-E 254.25
HEAVY METAL QUANT EACH NES 223
HEEL BOOT MED HCB204ML 187.75
HELICOBACTER PYLORI CULTURE-E 80.25
HEMATOCRIT 21.25
HEMODIALYSIS ONE EVALUATION 968
HEMOLYSINS/AGGLUTININS 93.25
HEMORROIDECTOMY 2,512.50
HEMORROIDECTOMY-MAB 2,512.50
HEPARIN ASSAY 135.5
HEPATIC FUNCTION PANEL 162.75
HEPATITIS A ANTIBODY 175
HEPATITIS A IGM ANTIBODY 105.5
HEPATITIS B SCREEN-MH-E 411.5
HEPATITIS B SURFACE AG IA 144.25
HEPATITIS BE AG IA 46.5
HEPATITIS BE ANTIGEN/AB-E 126.5
HEPATITIS C – DNA OR RNA 697.75
HEPATITIS C AB 123.5
HEPATITIS C CONFIRMATION 66
HEPATITIS C PROBE&RVRS TRNSC 78.25
HEPATITIS C REVRS TRNSCRPJ 308
HEPATOBIL SYST IMAGE W/DRUG 2,384.00
HEPATOBILIARY SYSTEM IMAGING 2,384.00
HEP-B AMPLIF NA PROBE 83.25
HEP-B NA QUAN 284.75
HERPES S AMPLIF NA PROBE 91
HERPES S AMPLIF NA PROBE 181.75
HERPES SIMPLEX VIRUS I,II-E 285
HEXA GENE 167.75
HEXAGNAL PHOSPH PLTLT NEUTRL 23.5
HFE GENE 502.25
HGB CHROMATOGRAPHY 98.75
HGB FRAC PROFILE SEND OUT-E 171.25
HGB; PLASMA 45
HGH AB 63.5
HIP (D) FEM HEAD 28MM 01.5 GR 2,772.25
HIP (D) FEM HEAD 28MM 05.0 BR 2,771.00
HIP (D) FEM HEAD 28MM 08.5 BL 2,771.00
HIP (D) SUMMIT STEM STD SIZE 5 16,728.75
HIP (Z) KIENCTIV NECK K 3,334.00
HIP (Z) KINECTIV FEM STEM 13.5 11,421.50
HIP (Z) KINECTIV NECK B 3,334.00
HIP (Z) KINECTIV NECK G2 3,334.00
HIP (Z) KINECTIV STEM SIZE 5 11,764.00
HIP (Z) VERSYS FEM HEAD +0 32 2,258.25
HIP (Z/MOD M) BIPOL SHELL 42MM 2,428.00
HIP (Z/MOD M) BIPOL SHELL 43M 2,357.50
HIP (Z/MOD M) BIPOL SHELL 44 2,241.75
HIP (Z/MOD M) LINER 42/43 1,495.75
HIP (Z/MOD M) LINER 44/45/46 1,495.00
HIP (Z/MOD M) LINER 47/48/49 1,495.00
HIP (Z/MOD M) LINER 50/51/52 1,495.00
HIP (Z/MOD M) LINER 53/54/55 1,451.00
HIP ARTHROGRAM 1,287.00
HIP ARTHROGRAPHY INJ WO ANESTH 672.5
HIP LONGEVITY LINER STND 32 56 3,993.00
HIP SHELL TRAB POR CLUSTER 50 4,135.75
HIP SHELL TRAB POR CLUSTER 52 4,259.75
HIP SHELL TRAB POR CLUSTER 56 7,780.25
HIP SHELL TRAB POR CLUSTER 58 4,259.75
HIP SHELL TRABECUALR METAL 60 4,135.75
HIP SHELL TRABECULAR METAL 54 4,259.75
HIP TRIL LINER 10 DEG 32MM 2,841.50
HIP TRILOGY 32MM STND 50/52/5 3,196.50
HISTAMINE 91
HISTOCHEMICAL STAINS ADD-ON 77.5
HISTOPLASMA AB 3 TEST PANEL-E 245.75
HISTOPLASMA CAPSUL AG IA 142.5
HIV CONFIRMATION 1 & 2-E 87.5
HIV-1 AG W/HIV-1 & HIV-2 AB 117.75
HIV-1 QUANT&REVRSE TRNSCRPJ 999.75
HIV-1/HIV-2 SINGLE RESULT 57
HLA I TYPING 1 ANTIGEN LR 209.25
HLA II TYPE 1 AG EQUIV LR 387
HLA II TYPING 1 ALLELE HR 400
HLA II TYPING 1 LOC HR 436.25
HLA II TYPING AG EQUIV LR 473.25
HOCM <=149 MG/ML IODINE. 1ML 9.25
HOME SLEEP TEST/TYPE 3 PORTA 743.5
HOMOGENIZ TISS FOR CULTURE 71
HOSPITAL OBSERVATION PER HR 169.25
HOSPITAL OUTPT CLINIC VISIT 115
HOT OR COLD PACKS THERAPY 1+ AREAS 109.25
HPYLORI STOOL IA 182.5
HSV 1 & 2 AB IGG-E 223.5
HSV 1/2 PCR SEND OUT-E 182
HSV AND VZV PCR PANEL-E 273
HT MUSCLE IMAGE SPECT MULT 6,095.75
HT MUSCLE IMAGE SPECT SING 2,526.75
HTA UTERINE ABLATION SYSTEM 3,692.00
HUMAN EPIDIDYMIS PROTEIN 4 88.5
HYDRATE IV INFUSION ADD-ON 293.5
HYDRATION IV INFUSION INIT 31-60 MINS 513.5
HYDROGEL DRSG GEL FILLER 107.75
HYDROXYPROGESTERONE 17-D 95
HYPERSENSITIVITY PNEUMO-E 307.5
HYPOXIA RESPONSE CURVE 316
HYSTEROGR/SIS CONTR/SALINE INJ 511.75
HYSTEROSALPINGOGRAM 1,505.25
HYSTEROSALPINGOGRAM PROFILE-E 2,017.00
I & D EPIDIDYMIS TESTIS/SCROTAL SP 2,911.75
I & D OF BARTHOLIN’S GLAND ABSCESS 1,072.75
I & D OF VULVA OR PERINEAL ABSCESS 537.5
I&D ABSC; COMPL OR MULTI 1,046.50
I&D ABSC; SMPL OR SGL 187
I&D ABSC; SMPL OR SGL 996.5
I&D ABSCESS; PERITONSILLAR 1,235.75
I&D CPLX POSTOP WND INF 2,882.00
I&D HEMATOMA/FLUID 1,353.00
I&D HEMATOMA/FLUID 2,933.75
I&D OF SUBMUCOSAL ABSCESS; RECTUM 2,164.75
I&D PILONID CYS; SMPL 1,552.75
I&D; PERIANAL ABSCESS 1,433.75
I&D; PERIRECTAL OR ISCHIAL ABSCESS 2,965.75
I131 IODIDE CAP RX PER 1 MCI 56
IA INFECTIOUS AGENT AB QUAN 65
IA INFECTIOUS AGENT AB QUAN 908.5
IA INFECTIOUS AGENT AB QUAN 1,492.50
IA INFECTIOUS AGENT SGL STEP 122
IA QUANT; CA 125 88.5
IA QUANT; CA 15-3 (27.29) 88.5
IA QUANT; CA 19-9 88.5
IA; OTHER TUMOR AG QUAN EA 136.5
ID; GEL QUAL; EA AB/AG 111.5
IGG 1 2 3 OR 4 EACH 72.5
IGG SUBCLASSES 1-4 SEND OUT-E 330
IGH GENE REARRANGE AMP METH 366.5
IGK REARRANGEABN CLONAL POP 275.5
ILESOSCOPY 1,087.25
ILESOSCOPY-MAB 1,087.25
IMAGE CATH FLUID COLXN VISC 1,566.75
IMAGE CATH FLUID PERI/RETRO 1,566.75
IMMOB ARM SHOULDER UNIV 72.5
IMMUNE COMPLEX ASSAY; 47.5
IMMUNE COMPLEX ASSAY; 94.5
IMMUNFIX E-PHORSIS/URINE/CSF 123.5
IMMUNIZATION ADM; EA ADDTL VACCINE 54.5
IMMUNIZATION ADMIN 1 VACCINE 133
IMMUNIZATION ADMIN 1 VACCINE 133.5
IMMUNOASSAY NONANTIBODY 67.25
IMMUNOASSAY NONANTIBODY 134.25
IMMUNOASSAY NONANTIBODY 268.25
IMMUNOASSAY QUANT NOS NONAB 56
IMMUNOASSAY QUANT NOS NONAB 167.75
IMMUNOASSAY QUANT NOS NONAB 279
IMMUNOASSAY QUANT NOS NONAB 446.25
IMMUNOFLUOR ANTB 1ST STAIN 287.5
IMMUNOFLUOR ANTB ADDL STAIN 40.25
IMMUNOFLUOR ANTB ADDL STAIN 160.5
IMMUNOGLOBULINS (G,A,M)-E 119.75
IMMUNOHISTO ANTB 1ST STAIN 456.5
IMPACT TOOTH REMOV SOFT TISS 2,177.25
IMPL INDWELLING PORT 847.25
IMPL INDWELLING PORT 2,426.50
IMPL INDWELLING PORT 3,270.50
IMPL INDWELLING PORT 3,346.75
IMPL NEUROSTIM LEAD TEST KIT 2,229.75
IMPLANTABLE TISSUE MARKER 2,948.00
IN111 CAPROMAB =< 10 MCI 4,622.50
INC & REM FB SQ; SMPL 358.75
INC/REPL SPINE NSTIM PG/RCVR 75,936.75
INCISE THROMBOSED HEMORRHOID EXT 433.25
INDWELLING CATHETER FOLEY TYPE 33.25
INDWELLING CATHETER FOLEY TYPE 41
INDWELLING CATHETER FOLEY TYPE 45.5
INDWELLING CATHETER FOLEY TYPE 52.25
INDWELLING CATHETER FOLEY TYPE 61.75
INDWELLING CATHETER FOLEY TYPE 101.75
INF BURSA I&D – UA/ELBOW 2,136.50
INFLAM BOWEL DIS PANEL SEND-E 155
INFLIXIMAB/ANTIINFLIXIMAB AB-E 128.25
INFLU A/H1N1 SEND OUT-E 359
INFLUENZA A/B AB-E 114
INFLUENZA DNA AMP PROBE 304.75
INFLUENZA IA W DO 214.5
INFLUENZA VIRUS A AN B PCR-E 609.5
INFRARED THERAPY 1+ AREAS 29.75
INHIBIN A 81
INIT NUTRITION THERAPY; EACH 15M 68.5
INIT TX 1ST DEGR BURN 205.5
INJ ANESTH ; GREATER OCCIPITAL NERVE 648.75
INJ ANESTH ; GREATER OCCIPITAL NERVE 1,297.25
INJ ANESTH; FACIAL NERVE 740.25
INJ ANESTH ; TRIGEMINAL NERVE 648.75
INJ ANESTH ; VAGUS NERVE 648.75
INJ ANESTH; AXILLARY NERVE 1,794.00
INJ ANESTH; AXILLARY NERVE 2,690.75
INJ ANESTH; CELIAC PLEXUS 1,794.00
INJ ANESTH; CERVICAL PLEXUS 1,424.25
INJ ANESTH; INTERCOST NRV MULTI/REGION 1,794.00
INJ ANESTH; INTERCOSTAL NERVE SGL 1,424.25
INJ ANESTH; LUMB/THOR (SYMPATHETIC) 1,794.00
INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH 1,424.25
INJ ANESTH; PHRENIC NERVE 1,794.00
INJ ANESTH; PUDENDAL NERVE 1,794.00
INJ ANESTH; SPHENOPALATINE GANGLION 648.75
INJ ANESTH; STELLATE GANGLION 1,794.00
INJ ANESTH; STELLATE GANGLION 2,371.50
INJ ANESTH; SUPRASCAPULAR NERVE 1,424.25
INJ ANESTH; SUPRASCAPULAR NERVE 2,136.50
INJ EPIDURAL BLOOD OR CLOT PATCH 1,424.25
INJ FOR CYSTOGRAM 1,122.25
INJ FOR SIALOGRAPHY 494
INJ FORAMEN EPIDURAL ADD-ON 844
INJ FORAMEN EPIDURAL ADD-ON 844.25
INJ FORAMEN EPIDURAL ADD-ON 1,266.50
INJ FORAMEN EPIDURAL C/T 1,794.00
INJ FORAMEN EPIDURAL C/T 2,371.50
INJ FORAMEN EPIDURAL L/S 1,794.00
INJ FORAMEN EPIDURAL L/S 2,690.75
INJ NEUROLYTIC; EPIDURAL CERV/THORACIC 1,794.25
INJ NEUROLYTIC; EPIDURAL LUMB/CAUDAL 1,794.25
INJ NEUROLYTIC; SUBARACHNOID 1,794.25
INJ PARAVERT F JNT C/T 1 LEV 1,794.00
INJ PARAVERT F JNT C/T 1 LEV 2,371.50
INJ PARAVERT F JNT C/T 2 LEV 915.25
INJ PARAVERT F JNT C/T 2 LEV 1,829.50
INJ PARAVERT F JNT C/T 3 LEV 915.25
INJ PARAVERT F JNT C/T 3 LEV 1,829.50
INJ PARAVERT F JNT L/S 1 LEV 1,794.00
INJ PARAVERT F JNT L/S 1 LEV 2,690.75
INJ PARAVERT F JNT L/S 2 LEV 915.25
INJ PARAVERT F JNT L/S 2 LEV 1,829.50
INJ PARAVERT F JNT L/S 3 LEV 915.25
INJ PARAVERT F JNT L/S 3 LEV 1,829.50
INJ SGL TENDON SHTH OR LIGAMENT 648.75
INJ TENDON ORIGIN/INSERT 648.75
INJ TRIGGER POINT 1/2 MUSCL 648.75
INJECT TRIGGER POINTS 3/> 648.75
INJECTION FOR CHOLANGIOGRAM 3,839.00
INJECTION FOR KNEE X-RAY 561
INJECTION INTO SKIN LESIONS =<7 427.75
INS NON-TUNNEL CV CATH 5 YRS/> 2,512.00
INS PACK FOR NON-OB VAG HEMORRHAGE 264.25
INS TEMP BLADDER CATH 473.25
INSERT CERVICAL DILATOR 605
INSERT BLADDER CATHETER 212.25
INSERT CATH PLEURA W/ IMAGE 918
INSERT CATH PLEURA W/O IMAGE 1,790.25
INSERT ELECTRD/PM CATH SNGL 9,739.00
INSERT O2 THERMO CATH-ICU 1,215.00
INSERTER-DILAMEZINSERT 141.75
INSERTION OF CHEST TUBE 1,953.75
INSITU HYBRIDIZATION (FISH) 142.25
INSJ PICC <5 YR W/O IMAGING 1,311.25
INSJ PICC 5 YR+ W/O IMAGING 2,441.75
INSTRUMENT-SINGLE 54.5
INSULIN AB 86.5
INSULIN,FREE AND TOTAL-E 158.25
INSULIN; TOTAL 58.25
INSULIN; TOTAL 173.75
INTEGRATED INFUSION SYSTEM 506 186.25
INTEGRATED SCREEN 2 SEND OUT-E 381.25
INTEGUSEAL MICROBIAL SEALANT 185.5
INTERCEED GAUZE 3X4 888.5
INTERROG EVL PM/LDLS PM IP 84.5
INTMD WND REPAIR FACE/MM =< 2.5 CM 417
INTMD WND REPAIR FACE/MM 2.6-5.0 CM 418.25
INTMD WND REPAIR FACE/MM 7.6-12.5 CM 2,664.50
INTMD WND REPAIR N-HF/GENIT 608.25
INTMD WND REPAIR N-HF/GENIT 1,737.50
INTMD WND REPAIR N-HF/GENIT =< 2.5 CM 1,433.75
INTMD WND REPAIR S/A/T/EXT 376
INTMD WND REPAIR S/A/T/EXT 774.25
INTMD WND REPAIR S/A/T/EXT 853.25
INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM 813
INTRINSIC FACTOR AB 92.75
INTRO NDL ICATH UPR/LXTR ART 2,638.75
INTRO/SHEATH NON-LASER 117.5
INTRO/SHEATH NON-LASER 357.5
INTROD LONG GI TUBE 852
INTRODUCER SUPRAPUBIC CATH16FR 80
INTUBATION ET EMERGENT 1,270.25
IO MAP OF SENT LYMPH NODE 468.75
IODINE I-123 SOD IODIDE PER 100 UCI TO 999 UCI 338.25
IOL ALCON 441.25
IRIS FLEXIBLE RET. GRIESHABER 489.75
IRON 55.75
IRON BINDING CAPACITY 86
IRON/TIBC-E 141.75
IRRIG DRUG DELIVERY DEVICE 418
IRRIGATE CORPORA CAVERNOSA FOR PRIAPISM 1,808.00
ISLET CELL AB 114.25
IV 1.5 DIALYSIS 2500 CC 65.75
IV 1.5 DIALYSIS 3 LITER 57.75
IV 2.5 DIALYSIS 2500 CC 35.5
IV 2.5 DIALYSIS 3 LITERS 65.75
IV 2B7116 ST H20 2000 ML 47
IV 4.25 DIALYSIS 2500 CC 40
IV LOW CALCIUM 1.5 DIANEAL 145
IV LOW CALCIUM 2.5 DIANEAL 149.75
IV SOLUTION-OR (ANES) 21.5
IVP W/WO TOMO/KUB 1,397.50
JAK2 GENE 311.25
JOHN CUNNINGHAM ANTIBODY 47
JOINT DEVICE (IMPLANTABLE) 1,215.75
JOINT DEVICE (IMPLANTABLE) 1,460.75
JOINT DEVICE (IMPLANTABLE) 1,910.00
JOINT DEVICE (IMPLANTABLE) 1,992.50
JOINT DEVICE (IMPLANTABLE) 2,092.00
JOINT DEVICE (IMPLANTABLE) 2,176.00
JOINT DEVICE (IMPLANTABLE) 2,176.25
JOINT DEVICE (IMPLANTABLE) 2,192.50
JOINT DEVICE (IMPLANTABLE) 2,215.50
JOINT DEVICE (IMPLANTABLE) 2,241.50
JOINT DEVICE (IMPLANTABLE) 2,241.75
JOINT DEVICE (IMPLANTABLE) 2,284.75
JOINT DEVICE (IMPLANTABLE) 2,357.50
JOINT DEVICE (IMPLANTABLE) 2,362.50
JOINT DEVICE (IMPLANTABLE) 2,433.50
JOINT DEVICE (IMPLANTABLE) 2,637.75
JOINT DEVICE (IMPLANTABLE) 2,696.50
JOINT DEVICE (IMPLANTABLE) 2,757.25
JOINT DEVICE (IMPLANTABLE) 2,840.25
JOINT DEVICE (IMPLANTABLE) 2,856.00
JOINT DEVICE (IMPLANTABLE) 2,921.25
JOINT DEVICE (IMPLANTABLE) 2,941.50
JOINT DEVICE (IMPLANTABLE) 3,196.50
JOINT DEVICE (IMPLANTABLE) 3,306.00
JOINT DEVICE (IMPLANTABLE) 3,334.00
JOINT DEVICE (IMPLANTABLE) 3,408.00
JOINT DEVICE (IMPLANTABLE) 3,807.75
JOINT DEVICE (IMPLANTABLE) 4,230.25
JOINT DEVICE (IMPLANTABLE) 4,235.25
JOINT DEVICE (IMPLANTABLE) 4,259.75
JOINT DEVICE (IMPLANTABLE) 4,270.75
JOINT DEVICE (IMPLANTABLE) 4,323.25
JOINT DEVICE (IMPLANTABLE) 4,639.00
JOINT DEVICE (IMPLANTABLE) 4,663.50
JOINT DEVICE (IMPLANTABLE) 4,663.75
JOINT DEVICE (IMPLANTABLE) 4,668.75
JOINT DEVICE (IMPLANTABLE) 4,706.00
JOINT DEVICE (IMPLANTABLE) 4,721.00
JOINT DEVICE (IMPLANTABLE) 4,935.50
JOINT DEVICE (IMPLANTABLE) 5,106.00
JOINT DEVICE (IMPLANTABLE) 5,252.25
JOINT DEVICE (IMPLANTABLE) 5,613.25
JOINT DEVICE (IMPLANTABLE) 5,617.50
JOINT DEVICE (IMPLANTABLE) 5,735.25
JOINT DEVICE (IMPLANTABLE) 6,059.00
JOINT DEVICE (IMPLANTABLE) 6,458.75
JOINT DEVICE (IMPLANTABLE) 6,617.00
JOINT DEVICE (IMPLANTABLE) 6,815.25
JOINT DEVICE (IMPLANTABLE) 7,008.00
JOINT DEVICE (IMPLANTABLE) 7,081.75
JOINT DEVICE (IMPLANTABLE) 7,089.50
JOINT DEVICE (IMPLANTABLE) 7,099.50
JOINT DEVICE (IMPLANTABLE) 8,270.75
JOINT DEVICE (IMPLANTABLE) 8,519.25
JOINT DEVICE (IMPLANTABLE) 9,137.50
JOINT DEVICE (IMPLANTABLE) 9,543.00
JOINT DEVICE (IMPLANTABLE) 9,925.25
JOINT DEVICE (IMPLANTABLE) 14,101.50
JOINT DEVICE (IMPLANTABLE) 14,103.75
JOINT DEVICE (IMPLANTABLE) 16,728.75
K FLOW/FUNCT IMAGE MULTIPLE 1,102.50
K FLOW/FUNCT IMAGE W/DRUG 1,917.00
K FLOW/FUNCT IMAGE W/O DRUG 1,917.00
K-B STAIN FOR FETAL HGB 75
KETOSTEROIDS 17; TOTAL 54.75
KIDNEY IMAGING (3D) 1,521.00
KIDNEY IMAGING MORPHOL 1,385.25
KIDNEY IMAGING WITH FLOW 926.25
KIDNEY STONE SATURATION 24HR-E 398.25
KIT GENE TARGETED SEQ ANALYS 426.25
KNEE (NEX) CR ART YLW 14MM 2,856.00
KNEE (Z/NEX) CR ART GRN 10MM 2,941.50
KNEE (Z/NEX) CR ART GRN 12MM 4,804.00
KNEE (Z/NEX) CR ART YLW 10MM 2,941.50
KNEE (Z/NEX) PATELLA 32MM 2,433.50
KNEE (Z/NEX) PATELLA 35MM 1,765.25
KNEE AC ART SURFACE 10 YEL 3/ 4,235.75
KNEE AC ART SURFACE 12 GRN 5/6 2,941.50
KNEE AC ART SURFACE 12 YEL 3/4 2,941.50
KNEE AC ART SURFACE 14 GRN 5/ 2,856.00
KNEE ARTHROGRAM 1,045.00
KNEE PROLONG ART BLUE 10MM C/ 5,106.00
KNEE; BOTH KNEES STANDING AP 329.25
KO IMMOB CANVAS LONG PRE OTS 119.75
KOH FOR FUNGI/PARASITES/MITES 103.5
KRAS GENE VARIANTS EXON 2 358.5
K-WIRE (S) CANN 1.25 150 32
K-WIRE 1.6MM X 150MM 181.75
KWIRES (DVR) 0.062 STAINLESS 86
LABOR & DELIVERY CHARGE 6,724.25
LACTATE 215
LACTATE DEHYDROGENASE 72.5
LACTOFERRIN FECAL (QUAL) 61.75
LACTOFERRIN FECAL (QUANT) 64.25
LACTOSE TOLERANCE PROFILE-E 134.25
LAP CHOLE PACK CS/5 406
LAPROSCOPIC PROCEDURE 1,304.00
LARYNGOSCOPY TELESCOPIC 486.5
LASER FIBERGUIDE 400 DUR400DBX 1,723.25
LASER FIBERGUIDE 600 DUR600DB 1,673.50
LASER FIBERS 1,194.75
LASER FIBERS 1,520.50
LASER FIBERS 1,629.25
LDCT FOR LUNG CA SCREEN 359.25
LDH ISOENZYMES PANEL SENDOUT-E 145
LDH; ISOENZYMES 72.5
LEAD 63.25
LENS ALCON 15.0 SN60WF 182.25
LENS ALCON 22.0 SN60WF 182.25
LENS ALCON 22.5 SN60WF 182.25
LENS ALCON 23.5 SN60WF 182.25
LENS ALCON MA60AC 30.0 687.75
LENS ALCON SN60AT 12.5 751
LENS ALCON SN60AT 20.0 751
LENS ALCON SN60AT 21.0 751
LENS ALCON SN60AT 24.0 197.5
LENS ALCON SN60AT 24.5 751
LENS ALLERGAN AR40E 10.0 626.25
LENS ALLERGAN AR40E 10.5 626.25
LENS ALLERGAN AR40E 11.5 626.25
LENS ALLERGAN AR40E 14.0 626.25
LENS ALLERGAN AR40E 17.5 626.25
LENS ALLERGAN AR40E 18.0 626.5
LENS ALLERGAN AR40E 18.5 626.5
LENS INTRAOCULAR 10.0 ZCBOO 203.5
LENS INTRAOCULAR 10.5 ZCBOO 203.5
LENS INTRAOCULAR 23.0 ZCBOO 203.5
LENS-IOL MODEL AUOOTO 434.5
LEUKEMIA PHEN TRIAGE SEND-E 661.5
LEUKOCYTE ALK PHOS W COUNT 204.25
LEUKOCYTE POOR BLOOD EA UNIT 1,179.75
LHR TEST 73.75
LIGASURE MARYLAND SEALER 2,137.00
LIGASURE SMALL JAW 1,852.25
LIMITED TUMOR LOCALIZ/RP DISTRIB 966.5
LINEAR STAPLER RELOAD XR60B 538.25
LIPASE 142.5
LIPID PANEL 175.5
LIPID PROFILE PANEL-E 242.75
LIPOPROTEIN BLD HR FRACTION 238.5
LIPOPROTEIN BLD QUAN PART 87.5
LIPOPROTEIN; HDL 109.25
LITHIUM 125.5
LITHOVUE URETEROSCOPE 3,370.50
LIVER – SPECT (3D) 1,973.75
LIVER & SPLEEN; STATIC ONLY 1,374.25
LOCALIZ INFLAMM; LIMITED AREA 1,423.50
LOCM 200-299MG/ML IODINE 1ML 10
LOCM 300-399MG/ML IODINE 1ML 9.75
LOCM 300-399MG/ML IODINE 1ML 10
LOW COST SKIN SUBSTITUTE APP 179
LOW COST SKIN SUBSTITUTE APP 179
LOW COST SKIN SUBSTITUTE APP 536
LUNG PERFUSION IMAGING 1,206.50
LUNG VENTILAT&PERFUS IMAGING 3,388.00
LUPUS ANTICOAGULANT COMP PAN-E 196.25
LUPUS PROFILE-E 644.25
LUTEINIZING RELEASING FACTOR 69.5
LYME WESTERN BLOT CSF SENDO-E 322.75
LYME WESTERN BLOT SEND OUT-E 322.75
LYMES AMPLIFIED NA PROBE 108
LYMPH OR LN NM SCAN 1,705.25
LYSIS OF ADH MULTI 1 DAY 2,425.00
M PNEUM AB IGG&IGM SEND OUT-E 114
M/PHMTRC ALYS ISHQUANT/SEMIQ 164
M/PHMTRC ALYS ISHQUANT/SEMIQ 399.5
MACROSCOPIC EXAM ARTHROPOD 45.75
MACROSCOPIC EXAM PARASITE 48.25
MAG DUAL ANTIBODY SEND OUT-E 112
MAGNESIUM 83.25
MAGNETIC IMAGE BONE MARROW 3,069.25
MAJOR SUR & REC 0-30 MIN(OB)-E 4,800.50
MAJOR SUR & REC 31-60MIN(OB)-E 7,653.25
MAJOR SUR & REC 61-90MIN(OB)-E 10,556.25
MAJOR SUR & REC91-120MIN(OB)-E 13,453.00
MAJOR SURG 61- 90 MIN (OB) 9,098.00
MAJOR SURG ADDITIONAL PROC 4,114.25
MAJOR SURG EA ADD’L 1/2 HR (OB 2,886.25
MAJOR SURG&REC ADD 1/2HR(OB)-E 2,952.50
MAJOR SURG(OB) EACH ADD’L 15 M 1,444.25
MAJOR SURGER 31- 60 MIN (OB) 6,214.50
MAJOR SURGERY 91-120 MIN (OB) 11,982.75
MAJOR SURGERY 0- 30 MIN (OB) 3,330.25
MAMM BIL DIAG 3D-MDC-E 578.75
MAMM BIL DIAG 3D-MH-E 578.75
MAMM BIL SCR W BIL DIAG-MDC-E 1,113.00
MAMM BIL SCR W BIL DIAG-MH-E 1,113.00
MAMM BIL SCR W LT DIAG-MDC-E 1,113.00
MAMM BIL SCR W LT DIAG-MH-E 1,113.00
MAMM BIL SCR W RT DIAG-MDC-E 1,113.00
MAMM BIL SCR W RT DIAG-MH-E 1,113.00
MAMM BIL SCR/BIL DIAG 3D-MDC-E 1,230.50
MAMM BIL SCR/BIL DIAG 3D-MH-E 1,230.50
MAMM BIL SCR/LT DIAG 3D-MDC-E 1,230.50
MAMM BIL SCR/LT DIAG 3D-MH-E 1,230.50
MAMM BIL SCR/RT DIAG 3D-MDC-E 1,230.50
MAMM BIL SCR/RT DIAG 3D-MH-E 1,230.50
MAMM BIL SCREEN 3D-MH-E 652
MAMM BIL SCREEN3D-MDC-E 652
MAMM UNI DIAG LT 3D-MDC-E 578.75
MAMM UNI DIAG LT 3D-MH-E 578.75
MAMM UNI DIAG RT 3D-MDC-E 578.75
MAMM UNI DIAG RT 3D-MH-E 578.75
MAMM UNI SCREEN LT 3D-MDC-E 652
MAMM UNI SCREEN LT 3D-MH-E 652
MAMM UNI SCREEN RT 3D-MDC-E 652
MAMM UNI SCREEN RT 3D-MH-E 652
MAMMARY DUCT INJ 622.25
MANGANESE 99
MANGANESE,URINE-E 119.5
MANIPULATOR UTERINE VCARE LG 363
MANIPULATOR UTERINE VCARE STND 363.5
MANUAL RETICULOCYTE COUNT 77.75
MANUAL THERAPY EA 15 MINS 12
MANUAL THERAPY EA 15 MINS 173
MASS SPECTROMETRY QUAL/QUAN 86.75
MASSAGE THERAPY EA 15 MINS 11
MASSAGE THERAPY EA 15 MINS 162.25
MASTISOL LIQUID ADHESIVE VIAL 9.5
MASTOTOMY W EXPL DEEP 2,393.25
MATERNAL SCREEN 1ST TRI SEND-E 126.75
MCG; DNA PROBE EA 61.75
MCG; DNA PROBE EA 123.25
MCG; DNA PROBE EA 246.25
MCG; DNA PROBE EA 369.25
MCG; DNA PROBE EA 430.75
MCG; DNA PROBE EA 615.25
MCG; IP SITU 100-300 CELLS 155.25
MCG; IP SITU 100-300 CELLS 465.5
MCG; IP SITU 100-300 CELLS 775.75
MCG; IP SITU 25-99 CELLS 80
MCG; SITU HYBRID 10-30 CELLS 80
MDC-PLAIN FILM POSTURAL STUD-E 998.75
MDS PROFILE,FISH SEND OUT-E 401.25
MEASLES/MUMPS/RUBELLA IMMUNE-E 352.75
MECHANICAL CHEST WALL OSCILL 457
MECHANICAL TRACTION THERAPY 1+ AREAS 187
MECKELS DIVERT EXAM 1,230.50
MECONIUM DRUG SCREEN WARDE-E 138.5
MEPITEL SILICONE DRESSING-SPD 69.75
MERCURY QUAN 72.25
MERCURY,RANDOM UA-E 92.75
MESH (IMPLANTABLE) 342.5
MESH (IMPLANTABLE) 479.25
MESH (IMPLANTABLE) 621.25
MESH (IMPLANTABLE) 1,314.00
MESH (IMPLANTABLE) 1,464.75
MESH (IMPLANTABLE) 1,618.75
MESH (IMPLANTABLE) 1,893.25
MESH (IMPLANTABLE) 1,911.25
MESH (IMPLANTABLE) 2,035.00
MESH (IMPLANTABLE) 2,140.75
MESH (IMPLANTABLE) 2,266.00
MESH (IMPLANTABLE) 2,316.50
MESH (IMPLANTABLE) 2,320.25
MESH (IMPLANTABLE) 2,435.00
MESH (IMPLANTABLE) 2,766.25
MESH (IMPLANTABLE) 3,074.75
MESH (IMPLANTABLE) 4,411.00
MESH COMPOSIX LRG 13.8 X 17.8 5,795.75
MESH COMPOSIX SMALL 8CM X 12C 2,571.25
MESH PERFIX PLUG LG 805.25
MESH PERFIX PLUG MED 805.25
MESH PERFIX PLUG SMALL 805.25
MESH PERFIX PLUG X-L 803
METABOLIC PANEL TOTAL CA 208.5
METABOLIC SYNDROME PROFILE-E 252.25
METANEPHRINES 72.25
MIC CYSTOLOGY BRUSHES 60317 48.5
MIC GASTROSTOMY FOG TUBE 0100- 464
MIC PEG KIT 20FR 0160-20 464
MICRO EZ 4.5 FR 197.75
MICROBE SUSCEPTIBLE MIC 148.75
MICROEZ 6FR 7CM 197.75
MICROLINE METZENBAUM TIPS 3142 234.5
MICROSOMAL AB EACH 75.75
MIDLINE INFUSION CATH 372
MINERVA ABLATION SYSTEM 2,606.75
MINOR NURSING PROCEDURE-AC 398.75
MINOR NURSING PROCEDURE-MAB 398.75
MINOR PROC LEVEL I-AC 2,613.00
MINOR PROC LEVEL II-AC 2,961.25
MINOR SURG PROC LEVEL II-RAD 2,961.25
MINOR SURG PROC LEVEL I-RAD 2,613.00
MLH1 GENE DUP/DELETE VARIANT 259
MLH1 GENE FULL SEQ 867.25
MM PROFILE,FISH SEND OUT-E 1,206.50
MNT EA 15 M AFTER 2ND REFRL 39
MOD SED SAME PHYS/QHP <5 YRS 207
MOD SED SAME PHYS/QHP 5/>YRS 207
MOPATH PROCEDURE LEVEL 1 299.5
MOPATH PROCEDURE LEVEL 2 419
MOPATH PROCEDURE LEVEL 3 310
MOPATH PROCEDURE LEVEL 4 238
MOPATH PROCEDURE LEVEL 5 588
MOPATH PROCEDURE LEVEL 6 716.25
MOPATH PROCEDURE LEVEL 6 2,148.50
MOPATH PROCEDURE LEVEL 7 1,551.50
MOPATH PROCEDURE LEVEL 8 1,087.00
MOPATH PROCEDURE LEVEL 9 3,794.50
MOPATH PROCEDURE LEVEL 9 7,589.00
MOTION FLUORO SWALLOW FCN 9.5
MOTION FLUORO SWALLOW FCN 421.25
MRA ABD W CONTRAST 4,090.50
MRA ABD W/WO CONTRAST 4,383.00
MRA ABD WO CONTRAST 3,224.50
MRA CHEST W/WO CONTR 2,318.00
MRA W/DYE UPPER EXTREMITY 4,090.50
MRA W/O DYE UPPER EXTR 3,224.50
MRA W/O&W/DYE UPPER EXTR 4,383.00
MRA; HEAD W & WO CONTRAST 4,383.00
MRA; HEAD W CONTRAST 3,541.25
MRA; HEAD; WO CONTRAST 3,224.50
MRA; NECK W & WO CONTRAST 4,383.00
MRA; NECK W CONTRAST 4,090.50
MRA; NECK WO CONTRAST 3,546.75
MRI – LE JNT WO CONTR 3,372.00
MRI – LE JNT WO CONTR 4,836.50
MRI – LEXTREM W CONTR 4,090.50
MRI – LEXTREM WO CONTR 3,224.50
MRI ABD & PELVIS W/WO CONT-E 8,766.00
MRI ABDOMEN W & WO CONTRAST 4,383.00
MRI ABDOMEN W CONTRAST 3,718.50
MRI ABDOMEN WO CONTRAST 3,224.50
MRI BRAIN & CERVIAL W/WO CON-E 8,869.75
MRI BRAIN & OBRITS W/WO CONT-E 9,307.75
MRI BRAIN W & WO CONTRAST 4,486.75
MRI BRAIN W CONTRAST 4,090.50
MRI BRAIN W/WO & SPINAL SURV-E 17,731.75
MRI BRAIN WO CONTRAST 3,546.75
MRI BREAST BIL W CONT W CAD-E 3,285.50
MRI BREAST BIL W/WO CONTR W-E 3,594.75
MRI BREAST BILAT W CONTR 3,011.50
MRI BREAST BILAT W/WO CONTR 3,320.75
MRI BREAST C- BILATERAL 3,162.25
MRI BREAST C- UNILATERAL 2,817.50
MRI BREAST LT W CONT W CA-E 2,957.25
MRI BREAST LT W/WO CONT W CA-E 3,232.50
MRI BREAST RT W CONT W CA-E 2,957.25
MRI BREAST RT W/WO CONT W CA-E 3,232.50
MRI BREAST UNIL W CONTRAST 2,683.25
MRI BREAST UNIL W/WO CONTR 2,958.50
MRI CERV SPINE W & WO CONTR 4,383.00
MRI CERV/THOR/LUMB W/O C-E 9,673.25
MRI CERVIAL & LUMBAR W/WO CO-E 8,862.25
MRI CERVICAL & THORACIC W/WO-E 8,766.00
MRI CERVICAL/THORA/LUMB W/WO-E 13,245.25
MRI CHEST W & WO CONTRAST 4,383.00
MRI CHEST W CONTRAST 4,090.50
MRI CHEST WO CONTRAST 3,224.50
MRI GUIDANCE NDL PLMT RS&I 1,144.00
MRI LE JNT W CONTR 3,386.00
MRI LE JNT W CONTR 5,078.50
MRI LE JNT W&WO CONTR 3,555.25
MRI LE JNT W&WO CONTR 5,332.75
MRI LEXTREM W&WO CONTR 4,383.00
MRI LUMB SPINE W & WO CONTR 4,479.25
MRI OF TMJ(S) 2,790.00
MRI ORBIT/FACE/NECK W/O DYE 3,546.75
MRI ORBT/FAC/NCK W/O & W/DYE 4,821.00
MRI PELVIS W & WO CONTRAST 4,383.00
MRI PELVIS W CONTRAST 4,090.50
MRI PELVIS WO CONTRAST 3,224.50
MRI SPINE CERV; WO CONTR 3,224.50
MRI SPINE CERVICAL W CONTR 3,718.50
MRI SPINE LUMBAR W CONTR 3,718.50
MRI SPINE LUMBAR WO CONTR 3,224.50
MRI SPINE THORACIC W CONTR 3,718.50
MRI SPINE THORACIC WO CONTR 3,224.50
MRI THORAC SPINE W & WO CONTR 4,383.00
MRI THORACIC & LUMB W/WO CO-E 8,862.25
MRI U EXT NOT JOINT W CONTRAST 4,090.50
MRI U EXT NOT JOINT WO CONTRAST 3,224.50
MRI U EXTR; ANY JOINT W CONTRAST 4,089.50
MRI U EXTR; ANY JOINT WO CONTRAST 3,224.50
MRI U EXTR; NOT JOINT W&WO CONTR 4,383.00
MRI UE ANY JOINT W & WO CONTRAST 4,383.00
MR-STAPH DNA AMP PROBE 65.5
MSH2 GENE DUP/DELETE VARIANT 274
MSH2 GENE FULL SEQ 490.5
MSH6 GENE DUP/DELETE VARIANT 305.75
MSH6 GENE FULL SEQ 824.25
MSLT/MWT; GLOBAL 5,959.75
MTHFR GENE 374.25
MUCIN SYNORVIAL FLUID 46.5
MUGA; SGL W WM & EF 2,213.75
MUMPS VIRUS ANITBODIES-SENDO-E 134.5
MURAMIDASE 175
MUSCLE BX; PERC NDL 1,567.25
MUSCLE TEST; EXTREM OR TRUNK 71
MYASTHENIA GRAVIS 2 TEST PAN-E 125
MYCOPLASMA AMPLIF NA PROBE 543.5
MYELIN BASIC PROTEIN CSF 237.25
MYELOGRAM CERVICAL 4,749.25
MYELOGRAM LUMBAR PROFILE-E 9,029.25
MYELOGRAM LUMBOSACRAL 4,220.75
MYELOGRAM THORACIC 3,488.50
MYELOGRAPHY LUMBAR INJECTION 4,808.75
MYELOGRAPHY LUMBAR INJECTION 4,808.75
MYOCARDIAL STRAIN IMAGING 741
MYOGLOBIN 123.5
N BLOCK INJ COMMON DIGIT 649
N BLOCK SGL SCIATIC NRV 1,424.25
N BLOCK SGL SCIATIC NRV 2,136.50
N EOSINOPHIL SMEAR 39.5
NA QUAN NOS AGENT 282.75
NASAL CANNULA 35.75
NASOPHARYNGOSCOPY W ENDOSCOPE 385.25
NATRIURETIC PEPTIDE 318.25
N-AUTOM URINALYS WO MICRO 38
NB INJ HYPOGAS PLXS 1,794.00
NEEDLE ANTERIOR CHAMBER-EYE 66.25
NEEDLE ASPIRATION NA-411D-132 256.75
NEEDLE BIOPSY CHEST LINING 1,532.75
NEEDLE BX LIVER; PERCUTANEOUS 1,474.25
NEEDLE BX TRU-CUT DISP 126.5
NEEDLE BX TRU-CUT LONG 61
NEEDLE COAPTITE 14.6IN 21G 177.75
NEEDLE GRIPPER SAFETY 20G 1 (H 22.25
NEEDLE GRIPPER SAFETY 20G 3/4 22.25
NEEDLE GRIPPER SAFETY 22G 5/8 20
NEEDLE INSUFFLATION 120 C2201 172.5
NEEDLE INSUFFLATION 150 02202 166
NEEDLE JAFFEE-EYE 42
NEEDLE JAMSHIDI 8 GA X 4 170.5
NEEDLE LOCALIZATION BY XRAY 186.25
NEEDLE RETROBULBULAR 23GA 1.5 38
NEEDLE SAFETY PAC 20 G 3/4 (P 35.75
NEEDLE SCORPION AR-13990N 1,027.75
NEISSERIA AMPLIF NA PROBE 148.75
NEPHELOMETRY EA ANALYTE NES 246.25
NERVE BLOCK ILIOING/ILIOHYPOGASTRIC 1,424.25
NERVE BLOCK SET 18GX2 CNB200T 137.5
NEUROMUSCULAR REEDUCATION EA 15 MINS 15
NEUROMUSCULAR REEDUCATION EA 15 MINS 224
NEUROPATHY PROFILE II SENDO-E 537.25
NICKEL 38.75
NJX CHEMONUCLEOLYSIS LMBR 4,389.75
NJX INTERLAMINAR CRV/THRC 1,424.25
NJX INTERLAMINAR CRV/THRC 1,424.25
NJX INTERLAMINAR LMBR/SAC 1,424.25
NJX INTERLAMINAR LMBR/SAC 1,424.25
NJX PX NFROSGRM &/URTRGRM 740.5
NJX PX NFROSGRM &/URTRGRM 740.5
NK CELLS TOTAL COUNT 128.75
NMR LIPO PROFILE SEND OUT-E 263
NON WND ELECT STIM 5.75
NON WND ELECT STIM 166.75
NONAUTO ERYTHROCYTE SED RATE 64.25
NON-ELECTRONIC SPIROMETER 223.75
NON-OB TRANSVAG US 1,131.75
NONSELECT CATH – CAROTID/VERTEBRAL ART 1,707.25
NON-VASC BALLOON DILATN CATH 2,360.50
NORMAL SALINE SOLUTION INFUS 250 CC 65.75
NOSE TO RECTUM FOR FB CHILD 335.25
NPM1 GENE 319.25
NRAS GENE VARIANTS EXON 2&3 382.75
NRML SALINE INFUSION 1000 CC 65.75
NTX TELEOPETIDE-E 100
NUCLEUS HYDRODISECTOR 38
O2 UPTAKE DIRECT SIMPLE 622.75
OB LIMITED AND TRANS VAG-MDC-E 2,357.25
OB US < 14 WKS ADDL FETUS 201.5
OB US < 14 WKS SINGLE FETUS 1,507.75
OB US >= 14 WKS ADDL FETUS 298.5
OB US >= 14 WKS SNGL FETUS 1,658.25
OB US LIMITED 1+ FETUS(S) 1,279.50
OB US NUCHAL MEAS 1 GEST 595.5
OB US NUCHAL MEAS ADD-ON 595.5
OBSTETRIC PANEL 857.75
OBSTETRIC PANEL MCR-E 857.75
OCCULT BLD FECES 1-3 TESTS 77.75
OCCULT BLD IA SCRN 77.75
OCCULT BLOOD FECES 77.75
OCCULT BLOOD OTHER SOURCES 49.25
OCTREOSCAN-E 3,760.75
OFFICE/OUTPATIENT VISIT EST 227.25
OFFICE/OUTPATIENT VISIT EST 239.5
OFFICE/OUTPATIENT VISIT EST 249.75
OFFICE/OUTPATIENT VISIT EST 260.5
OFFICE/OUTPATIENT VISIT EST 289.75
OFFICE/OUTPATIENT VISIT EST 800.25
OFFICE/OUTPATIENT VISIT EST 874.75
OFFICE/OUTPATIENT VISIT EST 955
OFFICE/OUTPATIENT VISIT EST 1,043.25
OFFICE/OUTPATIENT VISIT EST 1,149.25
OFFICE/OUTPATIENT VISIT NEW 115
OFFICE/OUTPATIENT VISIT NEW 184
OFFICE/OUTPATIENT VISIT NEW 227.25
OFFICE/OUTPATIENT VISIT NEW 239.5
OFFICE/OUTPATIENT VISIT NEW 249.75
OFFICE/OUTPATIENT VISIT NEW 260.5
OFFICE/OUTPATIENT VISIT NEW 289.75
OFFICE/OUTPATIENT VISIT NEW 800.25
OFFICE/OUTPATIENT VISIT NEW 874.75
OFFICE/OUTPATIENT VISIT NEW 955
OFFICE/OUTPATIENT VISIT NEW 1,043.25
OFFICE/OUTPATIENT VISIT NEW 1,149.25
OLIGOCLONAL BANDS 94.25
ONCO (OVAR) FIVE PROTEINS 906.75
ONCO (OVAR) TWO PROTEINS 461.5
ONCOLOGY BREAST MRNA 4,558.75
ONCOLOGY TUM UNKNOWN ORIGIN 3,937.50
ONE-WAY ALLOW PRORATED TRIP 22
OPEN TX RADIAL & ULNAR SHAFT FX FIXJ RADIUS/ULNA 7,685.50
OR USAGE CHARGE 240.5
ORAL RADIOPHARM RX 2,136.75
ORGAN/TISSUE PROCURE OPER ROOM 602.75
ORGANIC ACID SINGLE QUANT 342.75
ORTHOTIC MGMT&TRAINJ 1ST ENC 10.25
ORTHOTIC MGMT&TRAINJ 1ST ENC 151.75
OSMOLALITY; URINE 77.75
OSTEOCALCIN 66.75
OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS 55
OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS 86.75
OT EVAL HIGH COMPLEX 60 MIN 8.25
OT EVAL HIGH COMPLEX 60 MIN 471.5
OT EVAL LOW COMPLEX 30 MIN 8.25
OT EVAL LOW COMPLEX 30 MIN 471.5
OT EVAL MOD COMPLEX 45 MIN 8.25
OT EVAL MOD COMPLEX 45 MIN 471.5
OT RE-EVAL EST PLAN CARE 3.75
OT RE-EVAL EST PLAN CARE 224
OTHER SOURCE ALBUMIN QUAN EA 65.75
OVA & PARASITES DIR SMR W ID 269.25
OXALATE 184.5
OXYGEN CHARGE DAILY 154.25
OXYGEN SETUP-ER 184
OXYGEN UPTAKE REST INDIRECT 226.75
OXYGEN-NASAL AND MASK SET UP 154.25
OXYGEN-PORTABLE 41.25
PACK BASIC GEN 193.5
PACK CAT CUSTOM R/L 1,290.25
PACK C-SECTION 456.75
PACK CUSTOM TOTAL KNEE 410
PACK SHOULDER ARTHOSCOPY/KIM 369
PACK UNIVERSAL DRAPES / GOWN 63
PACU ADD’L 15 MIN 338.5
PACU CHARGE 01-30 MINS 924.5
PAD DISPERSIVE CAUTERY ADULT S 35.75
PAD MAGNETIC INSTR-MAG OR 81.5
PAIN CLINIC PACK 24
PANCREATIC ELASTASE FECAL 284
PANORAMIC X-RAY OF JAWS 424.75
PAP IG LABCORP-E 373
PAP W/ CHLAMYDIA&GONOCOCCUS-E 438
PAP W/ HIGH RISK HPV-E 794.75
PAP,HIGH RISK HPV REFLUX-E 505.75
PAPPA SERUM 97
PARACENTESIS-2N 694.75
PARACENTESIS-AC 694.75
PARACENTESIS-ICU 694.75
PARACENTESIS-LTC 694.75
PARAFFIN BATH THERAPY 1+ AREAS 8.75
PARAFFIN BATH THERAPY 1+ AREAS 166.5
PARANEOPLASTIC AB EVAL SENDO-E 809.5
PARANEOPLASTIC AUTOANTIBODY-E 155
PARATHORMONE 301
PARATHYRD PLANAR W/SPECT&CT 1,044.75
PARATHYRD PLANAR W/WO SUBTRJ 1,044.75
PARATHYROID PLANAR IMAGING 903
PARVOVIRUS B19 IGG,IGM SENDO-E 235.5
PASSPORT BUTTON CANULA 8MM 3C 106.75
PASSPORT BUTTON CANULA 8MM 4C 145
PATH CONSULT DURING SURGERY 215.25
PATH CONSULT INTRAOP ADDL 133.75
PDGFRA GENE 426.25
PEG TUBE CHANGE 1,018.75
PEG TUBE CHANGE-MAB 1,018.75
PEG TUBE INSERT 1,975.00
PEG TUBE INSERT-MAB 1,975.00
PEG TUBE REM BY INCIS (IP ONLY 5,412.00
PEG TUBE REMOVAL BY GASTROSCOP 1,561.50
PEG TUBE REMOVAL-GASTROSCO-MAB 1,561.50
PEG TUBE REPLACEMENT BY ENDOSC 1,976.00
PEG TUBE REPLACEMENT-MAB 1,976.00
PELVIMETRY W/WO PLACENTAL LOCALIZATION 599.5
PERC ASP OR INJ OF RENAL CYST/PELVIS 1,532.75
PERC ASP OR INJ OF RENAL CYST/PELVIS 1,592.25
PERC BX OR EXC LN; SUPERFICIAL 1,566.75
PERC IMPL NS ELECTRODE ARRAY; EPIDURAL 12,904.25
PERC N BX ABD OR RETROPERITONEAL MASS 1,534.25
PERCUT BX LUNG/MEDIASTINUM 1,532.75
PERCUT/NEEDLE INSERT PROS 1,862.75
PERCUTANEOUS CHOLECYSTOSTOMY 3,839.00
PERCUTANEOUS DISKECTOMY 11,657.00
PERICARDIOCENTESIS; INITIAL 903.75
PERITON-VENOUS SHUNT PATENCY 1,236.75
PERQ DEV BREAST 1ST MR GUIDE 663
PERQ DEV BREAST 1ST US IMAG 723.25
PERQ DEV BREAST ADD MR GUIDE 68.25
PERQ DEV BREAST ADD US IMAG 78.5
PERQ DEVICE BREAST 1ST IMAG 723.25
PERQ DEVICE BREAST EA IMAG 78.5
PERQ LAMOT/LAM LUMBAR 7,110.75
PET IMAGE W/CT FULL BODY 7,184.25
PET IMAGE W/CT SKULL-THIGH 6,937.00
PHENOBARBITAL 60
PHENOTYPE INFECT AGENT DRUG 335.75
PHENYLALANINE BLOOD 374.5
PHENYTOIN FREE & TOTAL SENDO-E 758.25
PHENYTOIN; FREE 579.75
PHENYTOIN; TOTAL 178.5
PHILADELPHIA PROFILE-E 683.5
PHLEBOTOMY THERAPEUTIC 468.5
PHOSPHATE 40
PHYSICAL PERFORM EA 15M 62
PIN (Z) 1.6 X 6 SMOOTH GUIDE 81.5
PIN (Z) 1.6 X 6IN P/THD GUIDE 68.75
PIN GUARD WHITE 0.45 15.25
PIN GUARDS BLUE 18.25
PIN GUARDS GREEN 22.5
PIN KIRSCH/UNTHR .062 X 9 IN 57
PIN K-WIRE 4IN .035 87.25
PIN K-WIRE 4IN .045 87.25
PIN K-WIRE 4IN .054 71
PIN K-WIRE 4IN .062 87.25
PINWORM EXAM 41.5
PLACE NEEDLE INTRAOSSEOUS INFUSION 3,043.75
PLACE DEVICE/MARKER NON PRO 1,477.25
PLAIN FILM POSTURAL STUDY-E 998.75
PLASMA 1 DONOR FRZ W/IN 8 HR 241.25
PLASMINOGEN ACTIVATOR 88.5
PLASMINOGEN ANTIGEN LEVEL 15.75
PLATELET AB 3TEST PANEL SEND-E 197.5
PLATELETS PHERESIS LR EA UNIT 1,557.75
PLATELETS PHERESIS LR IRRAD EA UNIT 1,419.25
PLMT NEPHROSTOMY CATHETER 2,083.75
PLMT NEPHROSTOMY CATHETER 2,164.75
PML/RARALPHA COM BREAKPOINTS 365.5
POLAR PAD MULTIUSE C04740 188
POLAR PAD SHOULDER X-LG C04905 233.75
POLYSOM 6/> YRS 4/> PARAM 6,095.75
POLYSOM 6/>YRS CPAP 4/> PARM 6,709.50
PORPHOBILINOGEN URINE; QUAN 36.5
PORPHYRINS QUANT UA SEND OUT-E 89.25
POS AIRWAY PRESSURE CPAP 797
POSITIVE EXP PRESSURE DEVICE 88.75
POST OP SDC > 2HRS 2N 2,280.25
POST OP SDC > 2HRS 3N 2,280.25
POST OP SDC > 2HRS 3S 2,280.25
POST OP SDC > 2HRS PED 2,280.25
POST OP SDC > 2HRS-ICU 2,280.25
POST OP/PACU2 0-2 HRS-AC 1,336.25
POST OP/PACU2 OVER 2HRS-AC 881
POUCHOSCOPY 1,562.25
POUCHOSCOPY W BX 2,648.75
POUCHOSCOPY W BX-MAB 2,648.75
POUCHOSCOPY-MAB 1,562.25
PRE DIABETES COUNSELING 30 MIN 25.75
PRE EMPLOYMENT LIFT TEST 118
PRE EMPLOYMENT SCREEN – OT 77.75
PRE EMPLOYMENT SCREEN DETAILED 237.75
PRE EMPLOYMENT SCREEN G L RR 110.5
PRE OP ASSESSMENT-AC 110.75
PRE OP PREP & ASSESSMENT-AC 574.5
PREALBUMIN 138.75
PREGNENOLONE 200.5
PRETREAT RBC; CHEM OR DRUGS 84.5
PRETREAT RBC; DGS 164
PRETREAT RBC; ENZYMES 247
PRIMIDONE 76
PRIMIDONE/MYSOLIN PANEL SEND-E 136
PROBE ABLATION NS2000 NOASURE 3,375.50
PROBE COVER W/NEEDLE GUIDE 95
PROBE GOLD 7FR 6007 824.75
PROBE STIMULATOR 82-25103 463.25
PROBE-APC CIRCULAR 804
PROBE-APC STRAIGHT 804
PROCALCITONIN (PCT) 171.75
PROCTOSCOPY 1,221.50
PROCTOSIGMOIDOSC W ABLATIO-MAB 2,613.00
PROCTOSIGMOIDOSC W ABLATION 2,613.00
PROCTOSIGMOIDOSC W BL CONT-MAB 1,446.25
PROCTOSIGMOIDOSC W BX-MAB 1,446.25
PROCTOSIGMOIDOSCOPY-MAB 1,221.50
PROFILE, FISH SEND OUT-E 770.5
PROGESTERONE ASSAY 87.75
PROINSULIN 368.75
PROLACTIN ASSAY 304.5
PROMETHEUS CELIAC SEROLOGY-E 383.25
PROMETHEUS CHROHN PANEL-E 1,025.50
PROMETHEUS IBCAUSE-E 920
PROMETHEUS IBD DIAG PANEL-E 1,518.00
PROMETHEUS THIOPURINE-E 274
PROMETHEUS TPMT-E 274
PROMETHIUS CELIAC PLUS-E 931
PROSTAGLANDIN EACH 104
PROSTATE BIOPSY, ANY MTHD 732.5
PROSTH IMPL NOS 5,169.25
PROSTHETIC TRAINJ 1ST ENC 10.25
PROSTHETIC TRAINJ 1ST ENC 151.5
PROTEIN ELECTROPHO,U PANEL-E 252
PROTEIN ELECTROPHORESIS-E 125.25
PROTEIN E-PHORESIS/URINE/CSF 70.75
PROTEIN S PROFILE SEND OUT-E 350
PROTEIN WB; IM ID FOR BANDS 47.75
PROTEIN WESTERN BLOT 162.75
PROTEIN; EP FRACT & QUAN 67.25
PROTHROMBIN TIME; 64
PROTOPORPHYRIN RBC; QUAN 32.5
PSA FREE PANEL-SEND OUT-E 182
PSA SCREENING 160.5
PSA; FREE 104
PSA; TOTAL 78.25
PT EVAL HIGH COMPLEX 45 MIN 471.5
PT EVAL LOW COMPLEX 20 MIN 471.5
PT EVAL MOD COMPLEX 30 MIN 471.5
PT MIXING STUDY-E 160
PT RE-EVAL EST PLAN CARE 224
PT; SUBSTITUTION PLASMA FRACTIONS EA 96.25
PTEN GENE DUP/DELET VARIANT 385.25
PTEN GENE FULL SEQUENCE 775.75
PTT; PLASMA OR WHOLE BLOOD 91.25
PTT; SUBSTITUTION PLASMA FRACTIONS EA 30.5
PULM FUNCT TEST OSCILLOMETRY 320.25
PULM FUNCT TST PLETHYSMOGRAP 661.5
PULM FUNCTION TEST BY GAS 733.25
PULMONARY REHAB W EXER 114.5
PULMONARY STRESS TESTING 197.5
PULSAVAC IRRIGATOR 00515047500 274
PULSE OX SGL 196.5
PUNCT ASP – ABSC HEMAT CYST 392.5
PUNCT ASP BRST CYST – INITIAL 634.75
PUNCTURE SHUNT OR RSVR FOR ASP OR INJ 1,424.25
PYRUVATE 181
QUAL HETEROPHILE AB 190.75
QUAL ORGANIC ACIDS EA SPECIM 99
QUAN RHEUM FACTOR 190.75
QUAN URINE PORPHYRINS 52.75
RA TRACER ID OF SENTINL NODE 643
RABIES IG INJECTION IM/SQ 323
RADIOPH RX BY IV ADMIN 1,050.00
RAPID FIRE MULTI BAND LIGATOR 1,410.75
RBC AB ELUTION EA 164
RBC AB SCRN EA TECHIQ 174.75
RBC LR IRRADIATED EACH UNIT 1,297.75
RE-ASSESS NUTRITION THER; EA 15M 39
REBREATHER MASKS 154.25
RECOVERY ROOM OB 0- 30 MIN 601
RECOVERY ROOM OB 31- 60 MIN 1,211.25
RECOVERY ROOM OB 61- 90 MIN 1,397.50
RECOVERY ROOM OB 91-120 MIN 1,444.50
REF CONSULT PREP ELSEWHERE 140
REF CONSULT W SLIDE PREP 287.25
REFILL/MAINT PORTABLE PUMP 639.25
RELIEVA INFLATION DEVICE BID30 314.5
RELOAD 60MM GREEN ECHELON SUTU 748.75
RELOADS CONTOUR BLUE 1,183.00
REM DEEP FB OF FOOT 2,105.50
REM DEEP FB THIGH OR KNEE 2,524.25
REM FB CONEAL W SLIT LAMP 526.25
REM FB CONJUNCTIVA; EMBEDDED 353.75
REM FB CONJUNCTIVA; SUPERFICIAL 131.25
REM FB EXT AUDITORY CANAL; WO ANESTH 902.25
REM FB EXT EYE; CORNEAL WO SLIT LAMP 394
REM FB FOOT; SQ 1,564.50
REM FB IN; BY LAT RHINECTOMY 1,393.00
REM FB INTRANASAL; OFFICE 197.5
REM FB MUSCLE; SMPL 1,394.50
REM GAUNTLET BOOT OR BODY CAST 430.25
REM I-NASAL LES INT APPR 2,915.00
REM IO FB ANTCHAMB/LENS 3,678.50
REM SKIN TAGS; <=15 LESIONS 168
REM SKIN TAGS; <=15 LESIONS 205.5
REM TUNNELED CVAD W PORT/PUMP 2,119.50
REMOTE PT 30 DAY ECG REV/REPORT 769.25
REMOVAL DUCT GLBLDR CALCULI 2,904.25
REMOVAL OF NAIL BED 837.25
REMOVAL OF SUPPORT IMPLANT 1,710.00
REMOVE DRUG IMPLANT 353.75
REMOVE EMBEDDED FB EYELID 425
REMOVE FECAL IMPACTION OR FB 2,007.25
REMOVE FOREIGN BODY IN SCROTUM 2,911.75
REMOVE FOREIGN BODY PHARYNX 321
REMOVE FULL ARM OR LEG CAST 333.75
REMOVE IMPACTED EAR WAX UNI 79.5
REMOVE IMPACTED EAR WAX UNI 214
REMOVE IUD 337.75
REMOVE RENAL TUBE W/FLUORO 1,084.75
REMOVE SPINE ELTRD PERQ ARAY 4,389.75
RENAL BIOPSY PERQ 1,532.75
RENAL FUNCTION PANEL 240.25
RENIN 114.5
RENIN VEIN SAMPLING 5,262.50
REP DEV URINARY W/SLING 2,212.50
REP DEV URINARY W/SLING 2,615.75
REP DEV URINARY W/SLING 4,612.25
REP DEV URINARY W/SLING 5,706.25
REP ET HAND; WO FG EA TENDON 3,249.50
REP FLXR TENDON NOT ZONE 2 WO GRFT EA 5,351.00
REP LAC; CORNEA NONPERFOR W/WO REM FB 3,721.25
REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3 1,358.75
REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX 1,098.00
REPAIR BLOOD VESSEL DIRECT; UPR EXTREM 4,390.25
REPAIR LIP FT; VERMILION ONLY 1,073.50
REPAIR NAIL BED 1,123.50
REPLACE G/C TUBE PERC 938.75
REPTILASE TEST 149.75
RESP FCN/STRENGH 2/> INDIV 128
RESP MS THERAPY/15 MIN 118
RETROBULBAR INJECTION; MEDICATION 754.25
RETROGRADE PYELOGRAM 1,462.00
REV OR REM IMPL SPINAL NS PG OR RECEIVER 7,554.00
REVISE SPINE ELTRD PERQ ARAY 16,130.00
RHO D IMMUNE GLOBULIN INJ 300 MICROGRAMS (1500 IU) 583.5
RIA NONANTIBODY 58
RINGERS LACTATE INFUSION TO 1000 CC 65.75
ROOM,BORDER BABY-NURSERY 2,416.75
ROOM,ISOLATION-2N 2,416.75
ROOM,MED NEC PRIVATE-3S 2,416.75
ROOM,PRIVATE-2N 2,416.75
ROOM,PRIVATE-3S 2,416.75
ROOM,PRIVATE-LTC4 635.25
ROOM,PRIVATE-LTC5 635.25
ROOM,PRIVATE-PEDS 2,416.75
ROOM,PRIVATE-SKILLED 2,601.25
ROOM,PT REQUEST PRIVATE-3S 2,558.50
ROOM,SEMI PRIV-2N 2,416.75
ROOM,SEMI PRIV-2S STRESS 1,800.50
ROOM,SEMI PRIV-3N OB 2,416.75
ROOM,SEMI PRIV-3S 2,416.75
ROOM,SEMI PRIV-LTC4 635.25
ROOM,SEMI PRIV-LTC5 635.25
ROOM,SEMI PRIV-OB OVERFLOW 2,416.75
ROOM,SEMI PRIV-PEDS 2,416.75
ROOM,SEMI PRIV-SKILLED 2,601.25
ROOM,SPECIAL-ICU 2,416.75
ROOM-INTENSIVE CARE 4,945.25
ROOM-NURSERY 2,416.75
ROOM-PROGRESSIVE CARE UNIT 3,759.00
ROTAVIRUS AG IA 310
ROTH RETRIEVAL NET 00711050 414
ROTH RETRIEVAL NET 00715050 485
ROTH RETRIEVAL NET PED 472
ROUTINE VENIPUNCTURE 22.25
RSV IA W DIR OBSERV 279
RUBEOLA AB IGG, IGM SEND OUT-E 203.5
RUMI OCCLUDER BALLOON # CP0-6 225.5
RUMI UTERINE BLUE TIP UMB678 231.5
RUMI UTERINE GREEN TIP UMG670 231.5
RUMI UTERINE PURPLE TIP UML516 277.5
RUMI UTERINE WHITE TIP UMW676 184
RUSSELL VIPER VENOM TIME; DILUTED 41.5
RX CL ELBOW DISLOC WO ANESTH 327.5
SALIVARY GLAND FUNCTION 458.5
SC THER INFUSION RESET PUMP 306.25
SCALPEL #10 22
SCALPEL #11 22
SCALPEL #15 22
SCALPEL #20 18.5
SCAPULA COMPLETE 656
SCISSOR 5MM DIRECT DRIV CB030 281.25
SCOPE WARMER CLEARIFY 136.5
SCR MAMMO BI INCL CAD 504
SCR MAMMO BI INCL CAD 593.25
SCS,LEAD CABLE,BOSTON SC-PC 513.5
SCS,MULT LEAD CABLE,ST JUDE-PC 790.5
SCS,MULTI LEAD CABLE,MED TR-PC 684.5
SCS,PATIENT KIT,BOSTON SC-PC 394
SEECLEAR MAX SMOKE EVACUATION 100.5
SELENIUM 149.75
SELF CARE MNGMENT TRAINING 12.25
SELF CARE MNGMENT TRAINING 179.25
SEMEN ANAL SPERM DETECTION 245
SENSITIVITY – AGAR DILUTION/AGENT 40.25
SENSITIVITY – DISK PER PLATE 138.75
SENSOR A-2000 BIS ASPECT MED 159
SENSORY INTEGRATION 38
SENSTITIVITY – ENZYME DETECT 77
SEROTONIN 379.25
SERPINA1 GENE 140.5
SERUM IMMUNOFIXATION ELECTROPHORES 117.75
SERUM PRETX; DILUTION 44
SERUM PRETX; DRUG INCUBATE 164
SERUM PRETX; INHIBITOR INCUBATE 164
SERUM PRETX; RC ABSORPT 77.25
SERUM/WB TOT CHOLEST 82
SEX HORMONE BINDING GLOBULIN 220.5
SFT TISS BX – NECK/THORAX 1,880.75
SGL NBI BRACHIAL PLEXUS 1,794.00
SGL NBI BRACHIAL PLEXUS 2,690.75
SGL QUAN EXPIRED GAS 561.5
SGL VW SPINE XR 498.75
SHIA REG EDUC SPEECH 1/2 HR 42.75
SHIA REG EDUC SPEECH PER HOUR 83.5
SHIGA-LIKE TOXIN AG IA 51.5
SHOULDER ARTHROGRAM 1,733.00
SHOULDER ARTHROGRAM INJ 667.25
SHUNT SERIES-E 1,719.50
SIALAGRAM PROFILE LT-E 1,340.50
SIALAGRAM PROFILE RT-E 1,340.50
SIALOGRAM 846.75
SICKLING OF RBC REDUCTION 72.5
SIGMOID FLEX 1,242.50
SIGMOID FLEX W BIOPSY 1,881.00
SIGMOID FLEX W BIOPSY-MAB 1,881.00
SIGMOID FLEX W BLEED CONT 1,221.50
SIGMOID FLEX W BLEED CONT-MAB 1,221.50
SIGMOID FLEX W DILATATION 1,373.50
SIGMOID FLEX W DILATION-MAB 1,373.50
SIGMOID FLEX W FB REMOVAL 1,373.50
SIGMOID FLEX W FB REMOVAL-MAB 1,373.50
SIGMOID FLEX W POLYPECTOMY 1,881.00
SIGMOID FLEX W POLYPECTOMY-MAB 1,881.00
SIGMOID FLEX-MAB 1,242.50
SIGMOIDOSCOPY W ABLATION 1,221.50
SIGMOIDOSCOPY W ABLATION-MAB 1,221.50
SIGMOIDOSCOPY W BLEED CONT 1,221.50
SIGMOIDOSCOPY W BLEED CONT-MAB 1,221.50
SIJ ANESTH/STEROID INJ 1,577.00
SIJ ANESTH/STEROID INJ 2,371.50
SILASTIC NAIL 436
SILVADENE -WOUND CENTER 34
SIMPLE BLADDER IRRIGATE LAVAGE/INSTILL 410
SINUS TRACT INJ; DX 511.75
SJOGREN ANIT SEND OUT-E 119.5
SKIN BARRIER WITH FLANGE 22
SKIN BARRIER WITH FLANGE 28
SKIN BARRIER WITH FLANGE 37.25
SKIN GRAFT CARRIER 93.5
SKIN SUB GRAFT F/N/HF/G ADDL 31
SKIN SUB GRAFT FACE/NK/HF/G 1,622.00
SKIN SUB GRAFT T/A/L ADD-ON 21
SKIN SUB GRAFT TRNK/ARM/LEG 1,622.00
SKIN TEST; TB ID 91.25
SLCTV WND DEBRIDEM ADDL 20 CM/< 3.25
SLCTV WND DEBRIDEM ADDL 20 CM/< 14
SLCTV WND DEBRIDEM ADDL 20 CM/< 183.75
SLCTV WND DEBRIDEM 20 CM OR < 5.25
SLCTV WND DEBRIDEM 20 CM OR < 248
SLCTV WND DEBRIDEM 20 CM OR < 293
SLEEVE EXPRESS KNEE LG 9789 210.5
SLEEVE EXPRESS KNEE MD 9529 156.25
SLEEVE FOOT REGULAR 5897 61.75
SLEEVE SCD FOOT LARGE 5898 137
SLEEVE SCD FOOT REGULAR 5897 130.5
SLIT PREPUCE DORSAL OR LAT; NOT NEWBORN 2,938.50
SMEAR – GRAM OR GIEMSA 52.25
SMEAR – INFECTIOUS WET MOUNT 61
SMEAR SPECIAL STAIN 98
SMEAR; FLUORESCENT OR AFB STAIN 21
SNARE POLYPECTOMY DSII 60415 82.75
SNARE POLYPECTOMY ROTATOR 144
SODIUM OTHER SOURCE 40
SODIUM; URINE 40
SOLUTION-2B7126 SOD CHL 2000IR 39.25
SOLUTION-2B7357 SORBITAL 3% 47
SOLUTION-IV SOL STER H20 1500 38
SOLUTION-STER SALINE 28
SOMATOMEDIN 412
SP CONSULT; 1ST TB W FS SGL SP 258.5
SP-BILITRAC RETRIEVAL BOOLON 674.25
SPECIAL STAINS GROUP 1 164
SPECIAL STAINS GROUP 2 198.5
SPECTROPHOTOMETRY ANALYTE NES 16.25
SPEECH SOUND LANG COMPREHEN 7.25
SPEECH SOUND LANG COMPREHEN 421.25
SPEECH THERAPY 1/4 HR-OVID HEA 37.25
SPEECH THERAPY CONSULT SERV-30 67
SPEECH/HEARING THERAPY GROUP 113.25
SPEECH/HEARING THERAPY INDIV 10.25
SPEECH/HEARING THERAPY INDIV 446.5
SP-ELECTRODE TEN/EMS-M52 139.5
SPIN/BRAIN PUMP REFIL & MAIN 509.75
SPINAL INJ OCCLUDED AV MALFORM 1,794.25
SPINAL PUNCTURE LUMBAR DIAGNOSTIC 1,465.00
SPINAL/EPIDURAL ANES 199.5
SPIROMETRY 463.25
SPL AVULSE NP; SGL 228
SPLINT DENVER LG 267.5
SPLINT DENVER SM 267.5
SPLINT INTRANASAL AIRWAY DOYLE 199.5
SPLINT-PLASTER ARM 323.5
SPLINT-PLASTER LEG 323.5
SPONGE INST WIPE 10.75
SPONGE NEURO 0.5 X 3 23.25
SPONGE WECK CELLS 17
SPONGE-TONSIL STERILE 9.5
SP-THERABAND O.T. 45
SREP F/E/N/L/MM; 12.6-20.0CM 702
SREP F/E/N/L/MM; 2.5CM/< 577.5
SREP F/E/N/L/MM; 2.6-5.0CM 606.5
SREP F/E/N/L/MM; 20.1-30.0CM 736.5
SREP F/E/N/L/MM; 5.1-7.5CM 637
SREP F/E/N/L/MM; 7.6-12.5CM 668.5
SREP S/N/A/G/TR/E; 12.6-20.0CM 668.5
SREP S/N/A/G/TR/E; 2.5CM/< 577.5
SREP S/N/A/G/TR/E; 20.1-30.0CM 702
SREP S/N/A/G/TR/E; 7.6-12.5CM 637
SREPS/N/A/G/TR/E; 2.6-7.5CM 624
ST BX BACK/FLANK; SUPERF 1,520.50
ST BX; HIP/PELVIS; SUPERFICIAL 1,520.50
STAPLE CEEA CURVED 28 1,063.00
STAPLE CEEA CURVED PREM 25 1,224.75
STAPLE ENDOCLIP LG 1,718.75
STAPLE GIA MF 60 X 3.8 421
STAPLE GIA MF 80 X 3.8 553.75
STAPLE GIA MF RE 60X3.8 228
STAPLE GIA MF RE 80X3.8 421.75
STAPLE PURSTRING 65 709.5
STAPLE RELOAD 60MM BLUE ECHEL 748.75
STAPLE RELOAD 60MM WHITE ECHE 424.5
STAPLE SURGICLIP LG 227.5
STAPLE SURGICLIP MED 513
STAPLE SURGICLIP SM 220.5
STAPLE TA DISP LONG 90 X 4.8 459.5
STAPLE TA MF RELOAD UNIT55X3. 451.75
STAPLER CONTOUR BLUE 2,286.25
STAPLER SKIN ROYAL 35 SPD 31.5
STELLANT SYRINGE KIT-DUAL 42.25
STENT 4.7 X 24 778424 826
STENT 4.7 X 26 778426 826
STENT COATED/COV W/DEL SYS 5,853.00
STENT NON-COR TEM W/O DEL 328.25
STENT UR 6FR X 24CM 778624 344.5
STENT UR 6FR X 26 CM 77826 745.75
STENT UR 6FR X 28CM 778628 1,677.50
STERILE EYE PAD 9.5
STERILE SALINE SOLN 500 ML=1 UNIT 65.75
STOCKING-TEDS 3071 107.75
STOCKING-TEDS 3130 107.75
STOCKING-TEDS 3222 26.75
STOCKING-TEDS 3310 98.75
STOCKING-TEDS 3416 239.75
STOCKING-TEDS 3549 164.75
STOCKING-TEDS 3634 135
STOCKING-TEDS 3728 139
STOCKING-TEDS 3856 174.75
STOCKING-TEDS 3922 313.75
STOCKING-TEDS 7071 45.5
STOCKING-TEDS 7115 45.5
STOCKING-TEDS 7203 67.5
STOCKING-TEDS 7480 73
STOCKING-TEDS 7594 61.75
STOCKING-TEDS 7604 45.5
STOCKING-TEDS 7802 78.75
STONE BASKET 584
STONE EXTR FLAT WIRE 039815 1,466.75
STONE EXTR HELICAL 040490 598
STONE EXTRACTOR 744.75
STONE EXTRACTOR 753.25
STONE/EXTR FORCEPS 3.5FR 65CM 754
STONE/EXTR HELICAL 3WIRE 115CM 1,302.25
STONE/EXTR HELICAL 4WIRE 65CM 1,089.00
STONE; QUAN CHEMICAL 324.25
STRAP ANKLE OR FOOT 149
STRAP ANKLE OR FOOT 298
STRAPPING; ELBOW OR WRIST 214
STRAPPING; HAND OR FINGER 214
STRAPPING; SHOULDER 453.25
STREP A AMPLIF NA PROBE 125.75
STREP A ASSAY W/OPTIC 127.75
STREP B DNA AMP PROBE 91.25
STREP B IA W DO 99.25
STRESS TTE COMPLETE 917
SUCTION CANNISTER 1200 (OR) 46.5
SUCTION SYSTEM 24HR 6904 98.25
SUCTION TIP POOL 37.25
SUGARS; SINGLE QUAL EA SPECIMEN 21.5
SUPERV HNDL LOAD – RAD SOURCE 2,734.25
SURG MINUTES-EA ADD’L 15 1,714.75
SURG PATH LEVEL-I GROSS ONLY 83.75
SURG PATH LVL 2 345.75
SURGERY MINUTES-0-30 MINS 3,955.00
SURGICEL FIBRILLAR 4 X 4 491.75
SURGICEL SNOW ABSORBABLE HEMO 381
SURGICEL-WC 94.5
SURGIFISH RETRACTOR 70.75
SUTURE 2-0 VICRYL J317H 10.25
SUTURE 3-0 SILK C017T 64.75
SUTURE 9-0 VICRYL V402G 118.25
SUTURE CAPIO PROLENE 148.25
SUTURE CHROMIC 0 812H 15.25
SUTURE CHROMIC 2-0 CG883 18.25
SUTURE CHROMIC 2-0 G123H 18.75
SUTURE CHROMIC 2-0 L113G 17
SUTURE CHROMIC 3-0 G122H 18.25
SUTURE CHROMIC 3-0 L112G 18.25
SUTURE ENDO AUTO STITCH 206.75
SUTURE ETHIBOND 0 CX21D 80.25
SUTURE ETHILON 10-0 7756G 84.5
SUTURE ETHILON 2-0 664H 13.75
SUTURE ETHILON 3-0 1669H 11
SUTURE ETHILON 3-0 663H 13.75
SUTURE ETHILON 5-0 1668H 30
SUTURE FIBERLINK 2 AR-7235 330
SUTURE FIBERTAPE 2MM AR-7237-7 304.25
SUTURE MONOCRYL 3-0 Y497G 24
SUTURE MONOCRYL 4-0 Y4966 24
SUTURE PDS 0 LOOP Z990G 31.25
SUTURE PLAIN 3-0 G322H 15.25
SUTURE PLAIN 3-0 L102G 17
SUTURE PROLENE 0 8690H 15.25
SUTURE PROLENE 4-0 13
SUTURE QUILL 2 PDO # RA 1058Q 118.25
SUTURE QUILL 3-0 #YA1016Q 94.5
SUTURE QUILL O PDO #RA 1030Q 213.75
SUTURE RAPIDE 5-O VICRYL VR844 29.25
SUTURE S/O 1 PDS Z880G 31.75
SUTURE S/O 2-0 PROLENE C-822G 89.75
SUTURE S/O PDS (Z-341 H) 35.25
SUTURE S/O PDS (Z-497 G) 52
SUTURE S/O TEVDEK 7-588W 42.5
SUTURE S/O VICRYL J-489 G 28.5
SUTURE S/O/E MILD CH (363-23) 78.25
SUTURE S/O/EY PLAIN (770) 80.25
SUTURE S/O/EY SILK (1732 G) 57
SUTURE S/O/EY SILK 780 G 5.25
SUTURE S/O/EY VICRYL (J-566G) 42
SUTURE SILK 3-0 CR C013D 59.25
SUTURE SURGIGUT 4-0 1643G 27.75
SUTURE SURGIGUT 4-0 GG121 10.75
SUTURE SURGIPRO VP-522 32
SUTURE SURGIPRO VP-581 36.25
SUTURE SURGIPROV VP-977 36.25
SUTURE TIGERTAPE 2 AR-7237-7T 304.25
SUTURE TIGERTAPE LOOP 116.5
SUTURE VICRYL 0 13.75
SUTURE VICRYL 0 J334H 17
SUTURE VICRYL 2-0 J333H 13.75
SUTURE VICRYL 2-0 J339H 13.75
SUTURE VICRYL 3-0 J332H 17
SUTURE VICRYL 3-0 J344H 17
SUTURE VICRYL 3-0 REEL J205G 18.75
SUTURE VICRYL 4-0 J304H 15.25
SUTURE VICRYL 4-0 J682H 32
SUTURE VICRYL 6-0 J578G 86
SUTURE VICRYL CT-1 1 J347H 17
SUTURE VICRYL UNDYED 2-0 J269H 13.75
SUTURE VICRYL UNDYED 2-O J259H 13.75
SUTURE VLOC 68.75
SUTURE V-LOC 120.75
SUTURE VLOC 90 2-0 68.75
SWALLOWING FCN W CINE/VIDEO 953
SWAN GANZ (PA CATH) INSERT-ICU 1,105.75
SYNTHETIC IMPLNT URINARY 1ML 1,403.50
SYPHILIS TEST NON-TREP QUAL 18.75
T & B LYMPHOCYTE/NAT KILLER-E 487.75
T CELLS; ABSOL CD4 AND CD8 199.25
T CELLS; ABSOL CD4 COUNT 82.25
T CELLS; TOTAL COUNT 160
T3 OR T4 OR THBR 28
T3; FREE 133
T3; REVERSE 136.5
T3; TOTAL 128.5
TACROLIMUS 64.5
TARGETED GENOMIC SEQ ANALYS 3,749.25
TB TEST CELL IMMUN MEASURE 262.5
TC99M EXAMETAZIME =< 25 MCI 2,393.00
TC99M LABELED RBC =< 30 MCI 3,286.50
TC99M MAA =< 10 MCI 426.5
TC99M MEBROFENIN =< 15 MCI 914.5
TC99M MEDRONATE =< 30 MCI 354.5
TC99M MERTIATIDE =< 15 MCI 6,574.00
TC99M PERTECHNETATE PER 1 MCI 10
TC99M SESTAMIBI 619
TC99M SULFUR COLLOID =< 20 MCI 4,289.00
TECHNETIUM TC99M AEROSOL =< 75 MCI 2,656.50
TEE CONGENITAL; GLOBAL 2,223.75
TEETH; PARTIAL EXAM < FULL MOUTH 603.25
TEMP TRANS PACER INSERT-ICU 1,428.25
TEMP TRANS PACER INSERT-PCU 1,428.25
TEMP TRANS PACER INSERT-TWO NO 1,428.25
TEMP TRANSCUTAN PACING 701.5
TENOTOMY SQ TOE; SINGLE 2,008.00
TESTICULAR IMAGING W/FLOW 3,335.00
TESTOSTERONE BIO PANEL SENDO-E 218.25
TESTOSTERONE,FREE/TOTAL SEND-E 217.75
TESTOSTERONE; FREE 108.5
TESTOSTERONE; TOTAL 109.75
THEOPHYLLINE 109.25
THER/DIAG CONCURRENT INF 225.25
THER/PROPH/DIAG INJ IV PUSH 362.5
THER/PROPH/DIAG INJ SC/IM 139.5
THER/PROPH/DIAG IV INF ADDON 286.25
THER/PROPH/DIAG IV INF INIT =<1 HR 569.75
THERAPEUTIC ACTIVITIES 11.5
THERAPEUTIC ACTIVITIES 171.25
THERAPEUTIC CONSULT –
THERAPEUTIC EXERCISES EA 15 MINS 12.25
THERAPEUTIC EXERCISES EA 15 MINS 180.75
THERAPEUTIC REHAB GROUP 126.75
THERMIA BAIR HUGGER-FL BDY CO 27.25
THIN PREP PAP HPV-LABCORP-E 521.75
THORA SEAL 458.25
THORACENTESIS KIT 204.75
THROMBIN TIME; PLASMA 93.75
THROMBOPLASTIN INHIBITION TISSUE 30.5
THROMBOTIC PANEL-E 731.5
THYROGLOBULIN 63.25
THYROGLOBULIN QN PANEL SENDO-E 145.25
THYROID IMAGING W/BLOOD FLOW 795
THYROID IMAGING W/BLOOD FLOW 1,349.00
THYROID METS; LIMITED 795
THYROID METS; WHOLE BODY 795.75
THYROID STIMULATING HORMONE 204
THYROID STIMULATING IMMUNOGLOBULINS 552.5
THYROID UPTAKE MEASUREMENT 668.25
THYROXINE BINDING GLOBULIN 190.5
THYROXINE; TOTAL 29.5
TISSUE CULTURE; BM BLD CELLS 282
TISSUE CULTURE; LYMPHOCYTE 259.75
TISSUE EXAM BY PATHOLOGIST LVL 3 362.5
TISSUE EXAM BY PATHOLOGIST LVL 4 364.5
TISSUE EXAM BY PATHOLOGIST LVL 5 397.75
TISSUE EXAM BY PATHOLOGIST LVL 6 609.5
TL PAP W AUTO SCRN & MANUAL RSCR 224.25
TL201 THALLIUM PER 1 MCI 462.25
TMJ JOINT – BILATERAL 635.5
TOBRAMYCIN 117.75
TOCOPHEROL ALPHA (VIT E) 72.5
TOMOGRAM 800.75
TOMOSYNTHESIS, MAMMO 59
TOPIRAMATE 100.25
TOTAL BILIRUBIN 36.25
TOTAL PROTEIN OTHER SPECIMEN 60
TOTAL VITAL CAPACITY 240.5
TPMT GENE COM VARIANTS 434.25
TRANSCORTIN 44.75
TRANSDUCER-PATIENT MOUNT 312
TRANSDUCER-POLE MOUNT 257
TRANSFERASE; ALANINE AMINO 74.5
TRANSFERRIN 140
TRANSFUSION BLOOD OR BLOOD COMPONENTS 1,788.00
TRANSGLUTAMINASE IGA/G SENDO-E 134.5
TRANSRECTAL US 1,436.25
TRANSVAGINAL OB US 1,078.00
TRAY CHOL/KARLAN BALLOON CTH 4 356
TRAY COOK RADIAL 85.75
TRAY LAP CHOLE ROBART/SCHULZ 982
TRAY LAP/CHOL AZMEH/VACH 595.75
TRAY LOWER GYN 300.25
TRAY MEDIZIV (EDUIDURAL) 232.75
TRAY PICC DUAL LUMEN 5 FR 1,009.75
TRAY PICC POWER 5FR 954.75
TRAY PICC TRIPLE LUMEN POWE 6F 1,173.50
TRAY TROCAR OB/GYN 428.75
TRAY WITHOUT CATH 37.25
TRAY-ARROW ART LINE KIT 193.25
TRAY-ARROW MULTI LUMEN 469.5
TRAY-ARROW PERCUTANEOUS 8.5 270.25
TRAY-ARROW RADIAL ARTERY 80
TRAY-CHEST TUBE ASSERTION 294.75
TRAY-CLOSED SYSTEM 16 FR 131.75
TRAY-ENT TRAY 191
TRAY-EPIDURAL W/GLASS LOR 121.75
TRAY-INSTRUMENT CIRC SET 90.5
TRAY-INSTRUMENT EPISIOTOMY S 117.5
TRAY-INTRODUCER SET 12 FR 224.25
TRAY-IRRIGATION W/PISTON 18.5
TRAY-LUMBAR (SPINAL) ADULT 236.75
TRAY-LUMBAR (SPINAL) INFANT 164.75
TRAY-NOSE 31.5
TRAY-SPINAL ANESTHESIA 206.75
TRAY-SUTURE SET (AMB CARE) 148.5
TRAY-SUTURE SET (ER) 180.75
TRAY-SUTURE SET FINE FACIAL LA 196.75
TRAY-SUTURE SET-HAND 191
TRAY-THORACENTESIS W CATH 156
TRAY-TRACHEOSTOMY TRAY 264
TRAY-URETHRAL CATH 14 FR 37.25
TRAY-UROLOGY 29.5
TRAY-VAGINAL EXAM 191
TRB@ GENE REARRANGE AMPLIFY 403.5
TREAT CLAVICLE FRACTURE 7,110.75
TREAT SWALLOWING DYSFUNCTION 10.25
TREAT SWALLOWING DYSFUNCTION 446.5
TREATMENT OF BLADDER LESION 393.25
TREPHINE X-HAIR 8MM 432.75
TREPONEMA PALLIDUM 41.25
TRG GENE REARRANGEMENT ANAL 427.75
TRICHOMONAS VAGIN DIR PROBE 62.5
TRICHOMONAS VAGINALIS AMPLIF 86.5
TRIGLYCERIDES 98.5
TRIPOD RETRIEVAL FORCEP FG-45U 2,235.50
TROCAR 11 X 100 OPTICAL CFR33 172.75
TROCAR 11MM CANNULA SEAL CFS12 79
TROCAR 11MM FIRST ENTRY CFF33 191
TROCAR 11MM X-CEL 267.5
TROCAR 12 X 100 OPTICAL CFR73 79
TROCAR 12MM EXCEL B12LT 410.25
TROCAR 12MM FIRST ENTRY CFF73 191
TROCAR 12X150MM 566
TROCAR 5 100 FIRST ENTRY 110.75
TROCAR 5 X 100MM OPTICAL CFR03 133.5
TROCAR 5MM CANNULA SEAL CFS02 34.25
TROCAR 5MM FIRST ENTRY CFF03 191
TROCAR 5MM SLEEVE BSLT 202.5
TROCAR 5MM X 100MM CB5LT-R 64.75
TROCAR BALLOON SPACEMAKER KIT 2,279.50
TROCAR BLADED 12 X 100 CTB73 113
TROCAR BLADED 5 X 100 CTB03 87.5
TROCAR BLADED 8MM X 100 C0676 455.75
TROCAR EXCEL 12MM X 150 B12X1 443.25
TROCAR EXCEL 5MM X 150MM B5XT 334.75
TROCAR X-CEL BLUNT TIP H12LP 421.75
TROPONIN QUAN 159.25
TTE F-UP OR LMTD 582.75
TTE W/DOPPLER COMPLETE 2,515.00
TTE W/O DOPPLER COMPLETE 1,125.00
TUBE BAKER INTESTIONAL 16 FR 367.25
TUBE BOUGEE 15FR 70CM CAUDE 35
TUBE CANNULA DISP 10 31.5
TUBE CANNULA DISP 4 24
TUBE CANNULA DISP 8 31.5
TUBE FEEDING 5FR X 16IN 9.5
TUBE FEEDING 8FR X 16 IN 9.5
TUBE GASTROSTOMY 291.5
TUBE GASTROSTOMY 12 FR 121.75
TUBE GASTROSTOMY 14 FR 111.5
TUBE GASTROSTOMY 16 FR 175
TUBE GASTROSTOMY 18 FR 169.75
TUBE GASTROTUBE 212.25
TUBE JEJUNOSTOMY-VIVINEX 111.75
TUBE LUKI 48.5
TUBE ORAL RAE 4.5 CUFFED MURPH 33.25
TUBE PHEUMOTHORIAX SET 644
TUBE SALEM SUMP 10FR 29.5
TUBE SALEM SUMP 12FR 28
TUBE SALEM SUMP 14 FR W/VAVE 28
TUBE SALEM SUMP W/REFLEX 16F 61.75
TUBE SALEM SUMP W/REFLEX 18F 80
TUBE SUCTION ATTACHMENT DEVI 48.5
TUBE TRACH 5.0 LO PRO MURPHY 9.5
TUBE TRACH CUFF XLT 6.0 196.75
TUBE TRACH CUFF XLT 8.0 274.75
TUBE TRACH CUFF/LO/MAGI 6.5 26.5
TUBE TRACH CUFF/LO/MAGI 7.5 29.25
TUBE TRACH CUFF/LO/MURPHY 8.0 29.25
TUBE TRACH CUFF/LO/MURPHY 8.5 26.5
TUBE TRACH CUFF/REA 6.0 76.75
TUBE TRACH RAE CUFFED 4.0 29.5
TUBE TRACH UNCUFF/MAGIL 2.5 15
TUBE TRACH UNCUFF/RAE 7.0 22.25
TUBE TRACHEAL 2.0 20.25
TUBE TRACHEAL 3.5 UNCUFF/RAE 20.25
TUBE TRACHEAL 5.0 CUFF/RAE 41.25
TUBE TRACHEAL 5.0 UNCUFF/RAE 41.25
TUBE TRACHEAL 5.5 CUFF/RAE 41.25
TUBE TRACHEAL 5.5 UNCUFF/RAE 41.25
TUBE TRACHEAL 6.0 CUFF/LO MAGI 41.25
TUBE TRACHEAL 6.5 CUFF/RAE 41.25
TUBE TRACHEAL 6.5 UNCUFF/RAE 40
TUBE TRACHEAL 7.0 CUFF/LO.MAGI 46.5
TUBE TRACHEAL 7.0 CUFF/RAE 41.25
TUBE TRACHEAL 7.0 CUFF/RAE/NAS 41.25
TUBE TRACHEAL 7.5 CUFF/RAE 41.25
TUBE TRACHEAL 7.5 CUFF/RAE/NAS 31.5
TUBE TRACHEAL 8.0 CUFF/RAE 41.25
TUBE TRACHEAL 8.0 CUFF/RAE/NA 28.25
TUBE TRACHEAL UNCUT 5.5 26.5
TUBE TRACHEAL UNCUT 7.0 46.75
TUBE TRACHEAL UNCUT 8.5 161.25
TUBE TROCAR 10 FR 66.25
TUBE TROCAR 20 FR 69.75
TUBE TROCAR 24 FR 285.75
TUBE TROCAR 28 71.75
TUBE-TRACH ADULT CUFFED 10 136
TUBE-TRACH ADULT CUFFED 6 360.75
TUBE-TRACH ADULT CUFFED 8 296.75
TUBE-TRACH ADULT CUFFLESS 6 206.25
TUBE-TRACH ADULT CUFFLESS 8 126.75
TUBE-TRACHEAL 3.0 76.75
TUBING ADAPTER Y 96
TUBING PATIENT REDEUCE 143.25
TUBING REDUECE PUMP 212
TUMOR IMAGING WHOLE BODY 2+ DAYS 1,880.50
TUMOR LOCALIZ; MULTI AREAS 1,081.00
TUMOR LOCALIZ; SPECT (3D) 1,880.50
TX CL ELBOW DISLOC W ANESTH 3,060.50
TX GASTRO INTUB W/ASP 766.5
TX S WND DEHIS; W PACK 1,092.75
TX S WND DEHISC; SMPL 658.75
TX/PRO/DX INJ NEW DRUG ADDON 292
TX/PRO/DX INJ SAME DRUG ADDON 235
TX/PROPH/DG ADDL SEQ IV INF 353.25
TYPE & SCREEN, PRENATAL-E 413.5
TYPE AND SCREEN-E 413.5
UGI W AIR & BARIUM W SB 2,307.25
ULTRACISION HDH05 DISS HOOK 728
ULTRASOUND ABD/PELIVS-E 2,952.50
ULTRASOUND ABD/PELVIS/TRAS V-E 4,084.00
ULTRASOUND ABDOMEN/RENAL-E 2,640.50
ULTRASOUND EARLY OB W TR-MDC-E 2,585.50
ULTRASOUND EARLY OB W TV-H-E 2,585.50
ULTRASOUND EARLY OB WITH TV-E 2,585.50
ULTRASOUND PELVIS/TRANS VAG-E 2,698.50
ULTRASOUND THERAPY EA 15 MINS 12
ULTRASOUND THERAPY EA 15 MINS 176.5
UNIL SELCTV RENAL VENOGRAM 3,973.50
UNLISTED ABDOMEN MUSCULOSKEL OP 553
UNLISTED CHEMISTRY TEST 58.75
UNLISTED CHEMOTHERAPY PROCEDURE 96.75
UNLISTED DX GASTROENTEROLOGY PROC 565
UNLISTED FLUORO 164.25
UNLISTED MOLECULAR PATHOLOGY 148
UNLISTED MOLECULAR PATHOLOGY 621.5
UNLISTED MOLECULAR PATHOLOGY 932
UNLISTED PROC SKIN MM & SQ TISS 3,347.00
UNLISTED PROCEDURE ANUS 895.75
UNLISTED PROCEDURE CASTING OR STRAPPING 144
UNLISTED PROCEDURE CASTING OR STRAPPING 207.5
UNLISTED PROCEDURE ENDOCRINE SYSTEM 5,466.25
UNLISTED PROCEDURE EXTERNAL EAR 2,832.50
UNLISTED PROCEDURE HANDS OR FINGERS 1,419.50
UNLISTED PROCEDURE HUMERUS OR ELBOW 252
UNLISTED PROCEDURE LEG OR ANKLE 524.75
UNLISTED PROCEDURE MATERNITY CARE & DEL 385.75
UNLISTED PROCEDURE NERVOUS SYSTEM 648.75
UNLISTED PROCEDURE PALATE UVULA 238
UNLISTED PROCEDURE PHARYNX ADENOIDS 238
UNLISTED PROCEDURE RECTUM 1,808.25
UNLISTED PROCEDURE STOMACH 1,052.50
UNLISTED PROCEDURE URINARY SYSTEM 2,884.00
UNLISTED PULMONARY SERVICE 422.5
UNLISTED VASC PROCEDURE 1,925.50
UNNA BOOT STRAPPING 149
UNNA BOOT STRAPPING 298
UNNA-FLEX PLUS WOUND CENTER 41
UPPR GI ENDOSCOPY W/STENT-MAB 3,483.50
UPR/L XTREMITY ART 2 LEVELS 484
UPR/LXTR ART STDY 3+ LVLS 557.75
UR ALBUMIN QUANTITATIVE 83.25
UREA NITROGEN URINE 49.5
UREA NITROGEN; QUAN 49.5
URETER REFLUX STUDY 787.75
URETHROGRAM RETROGRADE 1,218.50
URIC ACID; BLOOD 59.75
URIC ACID; NOT BLOOD 20.5
URINE BACTERIA CULTURE 138.75
URINE PHOSPHATE 109.25
URINE POTASSIUM 85.75
URINE PREGNANCY VISUAL COLOR 121
URINE SULFATE 13.5
URINE TOTAL PROTEIN 58.25
URINE+PROTEIN ELECTR SEND OU-E 252
UROLOGY DRAINAGE BA (OEC)U2068 75.25
US ABD/PELIVS-MDC-E 2,952.50
US ABD/PELVIS/TRAS VAG-MDC-E 4,084.00
US ABDL AORTA SCREEN AAA 1,255.00
US ABDOMEN& RENAL-MDC-E 2,640.50
US COMPL JOINT R-T W/IMG 1,127.75
US EARLY OB TWINS HD-E 1,709.25
US EARLY OB TWINS W TV-E 2,787.00
US EARLY OB TWINS W TV-MDC-E 2,787.00
US EARLY OB TWINS-E 1,709.25
US EARLY OB TWINS-MDC-E 1,709.25
US EARLY OB W TRANS VAG-MDC-E 2,639.25
US EXAM ABDO BACK WALL COMP 1,255.00
US EXAM ABDO BACK WALL LIM 1,255.00
US EXAM ABDOM COMPLETE 1,385.75
US EXAM CHEST 1,254.00
US EXAM INFANT HIPS STATIC 485
US EXAM OF HEAD AND NECK 1,572.00
US EXAM PELVIC COMPLETE 1,566.75
US EXAM PELVIC LIMITED 1,296.50
US FOLLOW-UP STUDY 314.25
US GUIDE INTRAOP 428.75
US GUIDE VASCULAR ACCESS 1,100.25
US GUIDED AMNIOCENTESIS 647.75
US GUIDED NEEDLE PLACEMENT 1,371.50
US INTERSTITIAL RE APPLIC 1,795.50
US LATE OB TWINS >14 WKS-MDC-E 1,956.50
US LATE OB TWINS AND BIOPHYS-E 5,285.50
US LATE OB TWINS HD-E 1,956.50
US LATE OB TWINS-E 1,956.50
US LMTD JT/NONVASC XTR STRUX 1,116.75
US OB LIMITED & BIOPHYS MAB-E 2,944.00
US OB LIMITED AND ABD-E 2,665.25
US OB LIMITED AND BIOPHYSICA-E 2,944.00
US OB LIMITED AND RENAL-E 2,534.50
US OB LIMITED AND TV-E 2,357.25
US PELVIS/TRANS VAG-MDC-E 2,698.50
US PROSTATE VOLUME FOR BT 440.75
US SCROTUM AND CONTENTS 1,918.75
US SPINE 1,101.00
UTERINE MANIPULATOR KRONNER 141.75
V.A.C KCI FOAM BLACK 277
V.A.C. KCI CANNISTER W/GEL 548.75
VAGINITIS/VAGINOSIS DNA-E 187
VALPROIC ACID,FREE/TOT SEND-E 185.25
VANCOMYCIN 154.5
VARICELLA ZOSTER CULTURE-E 106
VASOPRESSIN 190.25
VENIPUNCTURE CUTDOWN; AGE 1 OR OVER 353.75
VENT MGMT INPAT INIT DAY 988.25
VENT MGMT INPAT SUBQ DAY 1,342.00
VENT REUTER-BOBBINS 10-56162 59.25
VENT TUBE TOUMA 104
VENTILATOR – NOSE 15
VERY LONG FATTY ACID CHAINS 49.5
VESSEL LOOPS MAXI/RED 84.5
VIDEOFLUORSCOPY DYSPHAGIA-OT 116.25
VIP – VASOACTIVE INTESTINAL PEPTIDE 142.75
VIRAL NEUTRALIZATION 39
VIRUS ISOL SHELL VIAL TECHN 44.25
VIRUS ISOLATE; TISSUE CULT INOC 62
VISCOSITY 104
VIT B-12; UNSATURATED BC 229
VIT D 1 25-DIHYDROXY 445.25
VITAMIN A 131.5
VITAMIN B-12 LEVEL 181
VITAMIN B6 269.5
VITAMIN D 25 HYDROXY 73.25
VITAMIN K 58.5
VITAMIN NOS 123.75
VMA ACID RANDON UA-E 57
VMA URINE 36.75
VOIDING CYSTO PROFILE-E 2,208.25
VOIDING URETHROCYSTOGRAM 1,086.25
VON WILLEBRAND PROFILE SEND-E 421.75
WAND ENT EVAC 70 EIC5870-01 1,004.75
WAND ENT REFLEX ULTRA 45 1,284.50
WAND OPES ASPIRATING ABLATOR 1,284.50
WASHERS (Z) 3.5/4.0 CANN. SET 224
WASHERS (Z) 6.5 CANNULATED 161.75
WAX BONE 22.5
WB SGL DAY TUMOR IMAGING 1,730.25
WEDGE EXC NAIL FOLD 392.5
WEST NILE VIRUS AB CSF-E 123.75
WEST NILE VIRUS AB IGM 62
WEST NILE VIRUS ANTIBODY 62
WEST NILE VIRUS,SERUM SENDO-E 123.75
WHEELCHAIR MNGMENT TRAINING EA 15 MINS 9.5
WHEELCHAIR MNGMENT TRAINING EA 15 MINS 140
WHIRLPOOL THERAPY 1+ AREAS 178
WHO COCK-UP NONMOLDE PRE OTS 96.25
WIRE STEEL 18GA 39.75
WIRE STEEL 25GA 40.5
WORK HARDENING EA ADDTL HR 64.25
WORK HARDENING INIT 2 HRS 188.5
WOUND(S) CARE NON-SELECTIVE 3.5
WOUND(S) CARE NON-SELECTIVE 170
WOUND(S) CARE NON-SELECTIVE 205.5
WRIST ARTHROGRAM 1,167.25
WRIST ARTHROGRAPHY INJ 586.25
XPRESS MULTI SINUS TOOL 3,763.00
XR FB IN EYE 457.25
XR NECK SOFT TISSUE 431.75
XR OPTIC FORAMINA 173.5
X-RAY C/T SPINE DISK 4,389.75
XRAY CONTROL CATHETER CHANGE 1,136.00
X-RAY EXAM ABDOMEN 1 VIEW 328
X-RAY EXAM ABDOMEN 2 VIEWS 504.75
X-RAY EXAM ABDOMEN 3+ VIEWS 504.75
X-RAY EXAM CHEST 1 VIEW 339.5
X-RAY EXAM CHEST 2 VIEWS 410
X-RAY EXAM CHEST 3 VIEWS 567.5
X-RAY EXAM CHEST 4+ VIEWS 594.75
X-RAY EXAM ENTIRE SPI 2/3 VW 890.25
X-RAY EXAM ENTIRE SPI 4/5 VW 1,410.75
X-RAY EXAM HIP UNI 1 VIEW 434.25
X-RAY EXAM HIPS BI 2 VIEWS 614.75
X-RAY EXAM KNEE 4 OR MORE 687.5
X-RAY EXAM NECK SPINE 2-3 VW 590.75
X-RAY EXAM NECK SPINE 4/5VWS 716.75
X-RAY EXAM NECK SPINE 6/>VWS 837.75
X-RAY EXAM OF ANKLE 2 VIEWS 394.75
X-RAY EXAM OF ANKLE 3+ VIEWS 511.25
X-RAY EXAM OF ARM INFANT 2+ VIEWS 290.25
X-RAY EXAM OF BREASTBONE 2+ VIEWS 417.25
X-RAY EXAM OF BREASTBONE 3+ VIEWS 205.5
X-RAY EXAM OF ELBOW 2 VIEWS 352
X-RAY EXAM OF ELBOW 3+ VIEWS 446.25
X-RAY EXAM OF EYE SOCKETS 4+ VIEWS 641.5
X-RAY EXAM OF FACIAL BONES <3 VIEWS 321.5
X-RAY EXAM OF FACIAL BONES 3+ VIEWS 699
X-RAY EXAM OF FEMUR 2/> 614.75
X-RAY EXAM OF FINGER(S) 2+ VIEWS 447
X-RAY EXAM OF FOOT; 2 VIEWS 394.75
X-RAY EXAM OF FOOT; 3+ VIEWS 456.25
X-RAY EXAM OF FOREARM 2 VIEWS 500
X-RAY EXAM OF HAND 2 VIEWS 373
X-RAY EXAM OF HAND 3+ VIEWS 515.5
X-RAY EXAM OF HEEL 2+ VIEWS 610.75
X-RAY EXAM OF HUMERUS 2+ VIEWS 500
X-RAY EXAM OF JAW <4 VIEWS 286.25
X-RAY EXAM OF JAW 4+ VIEWS 649
X-RAY EXAM OF KNEE 1 OR 2 417.25
X-RAY EXAM OF LEG INFANT 2 VIEWS 290.25
X-RAY EXAM OF LOWER LEG 2 VIEWS 511.25
X-RAY EXAM OF LOWER SPINE 974
X-RAY EXAM OF LOWER SPINE 1,168.50
X-RAY EXAM OF LOWER SPINE 2-3 VIEWS 504.25
X-RAY EXAM OF LOWER SPINE 4+ VIEWS 722
X-RAY EXAM OF MASTOIDS 3+ VIEWS 658.75
X-RAY EXAM OF NASAL BONES 3+ VIEWS 436.5
X-RAY EXAM OF PELVIS 1-2 VIEWS 500
X-RAY EXAM OF RIBS 2 VIEWS UNILAT 406.5
X-RAY EXAM OF RIBS 3 VIEWS BILAT 617.75
X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT 683.25
X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT 1,194.00
X-RAY EXAM OF SHOULDER 1 VIEW 261.25
X-RAY EXAM OF SHOULDER 2+ VIEWS 547
X-RAY EXAM OF SINUSES <3 VIEWS 424.75
X-RAY EXAM OF SINUSES 3+ VIEWS 692.75
X-RAY EXAM OF SKULL <4 VIEWS 550
X-RAY EXAM OF SKULL 4+ VIEWS 768.5
X-RAY EXAM OF SMALL BOWEL 651.5
X-RAY EXAM OF SMALL BOWEL 1,842.50
X-RAY EXAM OF TAILBONE 2+ VIEWS 569.25
X-RAY EXAM OF THORACIC SPINE 2 VIEWS 635.75
X-RAY EXAM OF THORACIC SPINE 3 VIEWS 827
X-RAY EXAM OF TOE(S) 2+ VIEWS 394.75
X-RAY EXAM OF WRIST 2 VIEWS 394.75
X-RAY EXAM OF WRIST 3+ VIEWS 500
X-RAY EXAM SACROILIAC JOINTS 3+ VIEWS 485
X-RAY EXAM SURGICAL SPECIMEN 751
X-RAY OF LOWER SPINE DISK 4,389.75
X-RAY OF MAMMARY DUCT 769.5
X-RAY OF MAMMARY DUCTS 1,538.00
X-RAY UPPER GI DELAY W/KUB 1,082.75
X-RAY UPPER GI&SMALL INTEST 2,128.00
X-RAYS BONE LENGTH STUDIES 648
X-RAYS BONE SURVEY COMPLETE 1,825.00
X-RAYS BONE SURVEY INFANT 1,179.25
X-RAYS FOR BONE AGE 648
YAG LASER AFTER CATERACT-AC 1,384.50
ZIKA VIRUS DNA/RNA AMP PROBE 157.5
ZINC 124.25

Inpatient Hospitalization Charges

DRG Description Average fee
100 SEIZURES W MCC 35,400.76
101 SEIZURES W/O MCC 29,526.26
102 HEADACHES W MCC 68,355.57
103 HEADACHES W/O MCC 18,618.49
125 OTHER DISORDERS OF T 40,153.10
146 EAR, NOSE, MOUTH & T 25,679.76
149 DYSEQUILIBRIUM 25,985.86
158 DENTAL & ORAL DISEAS 15,424.76
159 DENTAL & ORAL DISEAS 16,365.36
175 PULMONARY EMBOLISM W 40,553.48
176 PULMONARY EMBOLISM W 26,461.88
177 RESPIRATORY INFECTIO 72,507.08
178 RESPIRATORY INFECTIO 44,173.06
179 RESPIRATORY INFECTIO 12,032.27
180 RESPIRATORY NEOPLASM 45,535.10
181 RESPIRATORY NEOPLASM 36,615.50
182 RESPIRATORY NEOPLASM 1,655.60
183 MAJOR CHEST TRAUMA W 44,027.87
184 MAJOR CHEST TRAUMA W 32,748.44
185 MAJOR CHEST TRAUMA W 19,560.79
186 PLEURAL EFFUSION W M 61,259.02
187 PLEURAL EFFUSION W C 74,531.49
189 PULMONARY EDEMA & RE 46,218.93
190 CHRONIC OBSTRUCTIVE 46,495.48
191 CHRONIC OBSTRUCTIVE 36,781.30
192 CHRONIC OBSTRUCTIVE 24,789.06
193 SIMPLE PNEUMONIA & P 45,534.02
194 SIMPLE PNEUMONIA & P 29,372.91
195 SIMPLE PNEUMONIA & P 21,581.75
196 INTERSTITIAL LUNG DI 56,261.94
198 INTERSTITIAL LUNG DI 144,243.42
199 PNEUMOTHORAX W MCC 26,803.34
200 PNEUMOTHORAX W CC 34,099.14
201 PNEUMOTHORAX W/O CC/ 16,562.35
202 BRONCHITIS & ASTHMA 31,183.28
203 BRONCHITIS & ASTHMA 18,073.39
204 RESPIRATORY SIGNS & 22,417.11
205 OTHER RESPIRATORY SY 31,368.16
206 OTHER RESPIRATORY SY 28,480.96
207 RESPIRATORY SYSTEM D 158,862.05
208 RESPIRATORY SYSTEM D 78,135.87
252 OTHER VASCULAR PROCE 58,097.34
264 OTHER CIRCULATORY SY 49,315.43
270 OTHER MAJOR CARDIOVA 47,266.77
280 ACUTE MYOCARDIAL INF 46,614.29
281 ACUTE MYOCARDIAL INF 19,804.07
282 ACUTE MYOCARDIAL INF 19,035.31
283 ACUTE MYOCARDIAL INF 13,120.93
288 ACUTE & SUBACUTE END 98,274.06
291 HEART FAILURE & SHOC 44,911.86
292 HEART FAILURE & SHOC 37,842.48
293 HEART FAILURE & SHOC 25,643.85
299 PERIPHERAL VASCULAR 33,008.20
3 ECMO OR TRACH W MV >96 338,907.60
300 PERIPHERAL VASCULAR 21,564.09
301 PERIPHERAL VASCULAR 15,580.37
302 ATHEROSCLEROSIS W MC 40,044.33
304 HYPERTENSION W MCC 25,867.65
305 HYPERTENSION W/O MCC 19,505.34
308 CARDIAC ARRHYTHMIA & 42,294.89
309 CARDIAC ARRHYTHMIA & 27,440.71
310 CARDIAC ARRHYTHMIA & 18,663.68
312 SYNCOPE & COLLAPSE 25,687.07
313 CHEST PAIN 39,455.66
314 OTHER CIRCULATORY SY 34,856.69
315 OTHER CIRCULATORY SY 29,617.20
327 STOMACH, ESOPHAGEAL 62,005.83
329 MAJOR SMALL & LARGE 70,106.57
330 MAJOR SMALL & LARGE 76,133.95
331 MAJOR SMALL & LARGE 48,823.15
335 PERITONEAL ADHESIOLY 111,890.81
336 PERITONEAL ADHESIOLY 53,384.60
337 PERITONEAL ADHESIOLY 51,449.63
340 APPENDECTOMY W COMPL 48,340.76
343 APPENDECTOMY W/O COM 34,001.56
345 MINOR SMALL & LARGE 70,759.37
348 ANAL & STOMAL PROCED 59,889.98
349 ANAL & STOMAL PROCED 41,732.88
351 INGUINAL & FEMORAL H 36,290.15
352 INGUINAL & FEMORAL H 49,541.34
371 MAJOR GASTROINTESTIN 41,739.05
372 MAJOR GASTROINTESTIN 26,669.40
373 MAJOR GASTROINTESTIN 13,440.26
374 DIGESTIVE MALIGNANCY 37,242.72
375 DIGESTIVE MALIGNANCY 22,179.84
376 DIGESTIVE MALIGNANCY 12,628.00
377 G.I. HEMORRHAGE W MC 50,514.73
378 G.I. HEMORRHAGE W CC 29,253.62
379 G.I. HEMORRHAGE W/O 24,805.47
381 COMPLICATED PEPTIC U 31,927.38
383 UNCOMPLICATED PEPTIC 34,032.53
386 INFLAMMATORY BOWEL D 27,568.61
388 G.I. OBSTRUCTION W M 29,860.56
389 G.I. OBSTRUCTION W C 27,183.58
390 G.I. OBSTRUCTION W/O 21,158.05
391 ESOPHAGITIS, GASTROE 40,308.87
392 ESOPHAGITIS, GASTROE 23,411.41
393 OTHER DIGESTIVE SYST 49,550.49
394 OTHER DIGESTIVE SYST 26,124.30
395 OTHER DIGESTIVE SYST 9,735.03
4 TRACH W MV >96 HRS OR 126,469.51
41 PERIPH/CRANIAL NERVE 31,700.02
412 CHOLECYSTECTOMY W C. 70,025.34
414 CHOLECYSTECTOMY EXCE 48,400.72
415 CHOLECYSTECTOMY EXCE 59,763.95
416 CHOLECYSTECTOMY EXCE 66,414.06
417 LAPAROSCOPIC CHOLECY 112,401.09
418 LAPAROSCOPIC CHOLECY 56,200.81
419 LAPAROSCOPIC CHOLECY 47,956.73
432 CIRRHOSIS & ALCOHOLI 43,805.34
433 CIRRHOSIS & ALCOHOLI 22,114.52
435 MALIGNANCY OF HEPATO 47,415.88
436 MALIGNANCY OF HEPATO 82,779.84
438 DISORDERS OF PANCREA 50,177.55
439 DISORDERS OF PANCREA 32,917.21
440 DISORDERS OF PANCREA 22,540.25
442 DISORDERS OF LIVER E 20,720.38
443 DISORDERS OF LIVER E 26,487.43
444 DISORDERS OF THE BIL 32,595.33
445 DISORDERS OF THE BIL 47,471.17
462 BILATERAL OR MULTIPL 86,780.75
465 WND DEBRID & SKN GRF 41,115.70
467 REVISION OF HIP OR K 83,864.23
468 REVISION OF HIP OR K 68,238.22
469 MAJOR HIP AND KNEE J 88,923.48
470 MAJOR HIP AND KNEE J 56,184.42
477 BIOPSIES OF MUSCULOS 61,867.26
480 HIP & FEMUR PROCEDUR 72,959.26
481 HIP & FEMUR PROCEDUR 52,530.88
482 HIP & FEMUR PROCEDUR 48,432.06
483 MAJOR JOINT/LIMB REA 55,148.23
486 KNEE PROCEDURES W PD 99,206.61
487 KNEE PROCEDURES W PD 32,411.34
488 KNEE PROCEDURES W/O 31,045.42
489 KNEE PROCEDURES W/O 34,464.13
493 LOWER EXTREM & HUMER 63,949.05
494 LOWER EXTREM & HUMER 58,004.38
499 LOCAL EXCISION & REM 35,014.56
501 SOFT TISSUE PROCEDUR 29,440.42
502 SOFT TISSUE PROCEDUR 32,925.73
511 SHOULDER,ELBOW OR FO 41,017.07
517 OTHER MUSCULOSKELET 41,487.29
533 FRACTURES OF FEMUR W 25,563.98
534 FRACTURES OF FEMUR W 14,210.75
535 FRACTURES OF HIP & P 39,936.94
536 FRACTURES OF HIP & P 23,296.30
54 NERVOUS SYSTEM NEOPLA 33,606.83
540 OSTEOMYELITIS W CC 29,273.40
543 PATHOLOGICAL FRACTUR 60,626.27
545 CONNECTIVE TISSUE DI 26,480.31
546 CONNECTIVE TISSUE DI 43,874.88
55 NERVOUS SYSTEM NEOPLA 73,000.06
551 MEDICAL BACK PROBLEM 45,763.49
552 MEDICAL BACK PROBLEM 26,775.04
553 BONE DISEASES & ARTH 42,936.22
554 BONE DISEASES & ARTH 22,201.99
556 SIGNS & SYMPTOMS OF 44,391.29
557 TENDONITIS, MYOSITIS 52,750.65
558 TENDONITIS, MYOSITIS 13,820.61
559 AFTERCARE, MUSCULOSK 61,635.13
56 DEGENERATIVE NERVOUS 73,476.03
560 AFTERCARE, MUSCULOSK 63,422.74
561 AFTERCARE, MUSCULOSK 57,176.27
562 FX, SPRN, STRN & DIS 43,760.02
563 FX, SPRN, STRN & DIS 28,306.35
564 OTHER MUSCULOSKELETA 33,173.09
565 OTHER MUSCULOSKELETA 30,279.71
566 OTHER MUSCULOSKELETA 21,663.75
57 DEGENERATIVE NERVOUS 71,324.35
571 SKIN DEBRIDEMENT W C 59,104.12
572 SKIN DEBRIDEMENT W/O 35,478.49
580 OTHER SKIN, SUBCUT T 57,129.03
581 OTHER SKIN, SUBCUT T 43,820.67
59 MULTIPLE SCLEROSIS & 23,941.36
592 SKIN ULCERS W MCC 14,771.67
593 SKIN ULCERS W CC 31,170.23
596 MAJOR SKIN DISORDERS 27,571.46
597 MALIGNANT BREAST DIS 18,560.66
600 NON-MALIGNANT BREAST 23,082.43
601 NON-MALIGNANT BREAST 27,932.35
602 CELLULITIS W MCC 86,303.05
603 CELLULITIS W/O MCC 21,266.06
604 TRAUMA TO THE SKIN, 31,050.19
605 TRAUMA TO THE SKIN, 28,151.61
607 MINOR SKIN DISORDERS 8,575.41
617 AMPUTAT OF LOWER LIM 35,185.72
624 SKIN GRAFTS & WOUND 19,780.74
637 DIABETES W MCC 28,006.68
638 DIABETES W CC 22,011.59
639 DIABETES W/O CC/MCC 18,537.75
64 INTRACRANIAL HEMORRHA 53,545.82
640 MISC DISORDERS OF NU 32,632.26
641 MISC DISORDERS OF NU 22,986.21
642 INBORN AND OTHER DIS 27,475.33
643 ENDOCRINE DISORDERS 29,528.52
644 ENDOCRINE DISORDERS 22,079.93
645 ENDOCRINE DISORDERS 31,350.70
65 INTRACRANIAL HEMORRHA 31,969.98
653 MAJOR BLADDER PROCED 152,024.29
659 KIDNEY & URETER PROC 24,312.29
66 INTRACRANIAL HEMORRHA 28,706.99
660 KIDNEY & URETER PROC 34,612.00
661 KIDNEY & URETER PROC 24,863.59
663 MINOR BLADDER PROCED 191,856.50
666 PROSTATECTOMY W CC 79,586.71
669 TRANSURETHRAL PROCED 35,760.10
670 TRANSURETHRAL PROCED 31,280.84
673 OTHER KIDNEY & URINA 100,868.42
674 OTHER KIDNEY & URINA 47,999.25
675 OTHER KIDNEY & URINA 31,033.04
682 RENAL FAILURE W MCC 45,409.74
683 RENAL FAILURE W CC 28,239.30
684 RENAL FAILURE W/O CC 26,287.69
686 KIDNEY & URINARY TRA 153,644.52
689 KIDNEY & URINARY TRA 37,384.88
69 TRANSIENT ISCHEMIA W/ 27,370.47
690 KIDNEY & URINARY TRA 25,540.69
693 URINARY STONES W/O E 40,075.32
694 URINARY STONES W/O E 25,262.32
695 KIDNEY & URINARY TRA 10,542.38
696 KIDNEY & URINARY TRA 22,879.40
698 OTHER KIDNEY & URINA 21,951.26
699 OTHER KIDNEY & URINA 69,607.27
71 NONSPECIFIC CEREBROVA 22,875.01
714 TRANSURETHRAL PROSTA 32,642.64
717 OTHER MALE REPRODUCT 79,332.36
72 NONSPECIFIC CEREBROVA 13,229.60
722 MALIGNANCY, MALE REP 86,771.40
726 BENIGN PROSTATIC HYP 31,188.99
742 UTERINE & ADNEXA PRO 26,931.91
743 UTERINE & ADNEXA PRO 40,619.28
744 D&C, CONIZATION, LAP 32,937.15
747 VAGINA, CERVIX & VUL 61,113.92
755 MALIGNANCY, FEMALE R 25,784.43
76 VIRAL MENINGITIS W/O 15,631.79
765 CESAREAN SECTION W C 21,309.35
766 CESAREAN SECTION W/O 21,113.92
767 VAGINAL DELIVERY W S 25,240.49
768 VAGINAL DELIVERY W O 36,393.59
769 POSTPARTUM & POST AB 29,430.54
774 VAGINAL DELIVERY W C 17,423.64
775 VAGINAL DELIVERY W/O 15,298.36
776 POSTPARTUM & POST AB 31,095.52
779 ABORTION W/O D&C 16,929.44
781 OTHER ANTEPARTUM DIA 14,906.58
784 CESAREAN SECTION W S 20,097.89
785 CESAREAN SECTION W S 19,883.23
786 CESAREAN SECTION W/O 23,841.24
787 CESAREAN SECTION W/O 19,717.07
788 CESAREAN SECTION W/O 20,273.24
789 NEONATES, DIED OR TR 4,895.48
792 PREMATURITY W/O MAJO 7,017.52
793 FULL TERM NEONATE W 11,081.26
794 NEONATE W OTHER SIGN 7,112.32
795 NORMAL NEWBORN 6,510.92
798 VAGINAL DELIVERY W S 24,899.28
80 NONTRAUMATIC STUPOR & 77,146.06
805 VAGINAL DELIVERY W/O 15,357.18
806 VAGINAL DELIVERY W/O 15,727.94
807 VAGINAL DELIVERY W/O 14,656.75
808 MAJOR HEMATOL/IMMUN 46,330.94
809 MAJOR HEMATOL/IMMUN 48,684.40
810 MAJOR HEMATOL/IMMUN 18,282.07
811 RED BLOOD CELL DISOR 41,869.93
812 RED BLOOD CELL DISOR 29,858.89
813 COAGULATION DISORDER 25,873.42
816 RETICULOENDOTHELIAL 26,908.00
821 LYMPHOMA & LEUKEMIA 146,030.42
822 LYMPHOMA & LEUKEMIA 64,299.85
825 LYMPHOMA & NON-ACUTE 32,971.61
832 OTHER ANTEPARTUM DIA 8,256.66
840 LYMPHOMA & NON-ACUTE 36,262.57
841 LYMPHOMA & NON-ACUTE 31,302.03
842 LYMPHOMA & NON-ACUTE 45,347.70
853 INFECTIOUS & PARASIT 81,495.40
854 INFECTIOUS & PARASIT 40,349.56
856 POSTOPERATIVE OR POS 41,389.89
857 POSTOPERATIVE OR POS 72,983.14
858 POSTOPERATIVE OR POS 61,165.99
862 POSTOPERATIVE & POST 42,576.71
863 POSTOPERATIVE & POST 16,484.22
864 FEVER AND INFLAMMATO 38,607.63
865 VIRAL ILLNESS W MCC 58,977.49
866 VIRAL ILLNESS W/O MC 14,929.27
867 OTHER INFECTIOUS & P 183,102.98
87 TRAUMATIC STUPOR & CO 14,634.95
870 SEPTICEMIA OR SEVERE 158,906.97
871 SEPTICEMIA OR SEVERE 50,390.36
872 SEPTICEMIA OR SEVERE 31,755.30
876 O.R. PROCEDURE W PRI 13,993.68
880 ACUTE ADJUSTMENT REA 9,513.21
881 DEPRESSIVE NEUROSES 12,144.12
882 NEUROSES EXCEPT DEPR 9,784.41
884 ORGANIC DISTURBANCES 64,781.68
885 PSYCHOSES 15,217.61
894 ALCOHOL/DRUG ABUSE O 23,283.58
896 ALCOHOL/DRUG ABUSE O 49,831.17
897 ALCOHOL/DRUG ABUSE O 25,653.02
90 CONCUSSION W/O CC/MCC 22,949.69
908 OTHER O.R. PROCEDURE 25,941.07
91 OTHER DISORDERS OF NE 40,637.25
915 ALLERGIC REACTIONS W 48,429.54
916 ALLERGIC REACTIONS W 13,212.92
917 POISONING & TOXIC EF 35,544.22
918 POISONING & TOXIC EF 20,058.80
92 OTHER DISORDERS OF NE 28,463.73
920 COMPLICATIONS OF TRE 11,555.03
921 COMPLICATIONS OF TRE 35,646.06
922 OTHER INJURY, POISON 38,420.92
93 OTHER DISORDERS OF NE 26,506.46
939 O.R. PROC W DIAGNOSE 69,542.57
947 SIGNS & SYMPTOMS W M 56,032.63
948 SIGNS & SYMPTOMS W/O 50,364.55
949 AFTERCARE W CC/MCC 103,339.97
956 LIMB REATTACHMENT, H 50,926.07
96 BACTERIAL & TUBERCULO 115,691.05
964 OTHER MULTIPLE SIGNI 29,943.73
981 EXTENSIVE O.R. PROCE 67,051.63
983 EXTENSIVE O.R. PROCE 35,186.23
988 NON-EXTENSIVE O.R. P 35,137.62

Pharmacy (Medication) Charges

Pharmacy Description Average fee per unit
ABATACEPT 10MG INJECTION 276.95
ABSORBASE OINTMENT 18.91
ACETA/OXYCODONE HYD 10MG/325 T 4.21
ACETAMI/OXYCOD HYD 7.5/325MG T 4.97
ACETAMINOPHEN 120 MG SUPP 3.1
ACETAMINOPHEN 320 MG/10.15 ML 5.92
ACETAMINOPHEN 325 MG SUPP 3.09
ACETAMINOPHEN 325 MG TAB 2.94
ACETAMINOPHEN 500MG TAB 2.96
ACETAMINOPHEN 600 MG SUPP 3
ACETAMINOPHEN/CODEINE #3 TAB 2.42
ACETAMINOPHEN/CODEINE 120MG 5.54
ACETAZOLAMIDE 250 MG TAB 32.5
ACETAZOLAMIDE 500 MG CAP 18.47
ACETAZOLAMIDE 500 MG/5 ML VIAL 99.46
ACETYLCHOLINE CHLORIDE 2 ML VI 262.21
ACETYLCYSTEIN 20% 200MG/30ML 31.51
ACETYLCYSTEINE 100MG INJ 364.25
ACETYLCYSTEINE NON-COMP UNIT/G 30.11
ACTIVATED CHARCOAL 50GM BOTTLE 114.05
ACTIVATED CHARCOAL W SORBITOL 130.29
ACYCLOVIR 200 MG CAP 2.96
ACYCLOVIR 5MG INJECTION 0.17
ADENOSINE 1MG INJECTION 14.17
ADO-TRASTUZUMAB EMT 1MG INJ 212.35
ADO-TRASTUZUMAB EMT 1MG-WASTE 210.79
ADRENALIN EPINEPHRINE .1MG INJ 2.4
ADRENALIN EPINEPHRINE .1MG INJ 35.08
ADRENALINE EPINEPHRINE 0.1MG 63.61
ALBUMIN(HUMAN)25%50ML INFUSION 391.12
ALBUT UpTo2.5MG IPRATR UpTo.5M 2.92
ALBUTEROL INHALER 85.9
ALBUTEROL NON-COMP UNIT 1MG 3.24
ALENDRONATE 70MG 3.74
ALLOPURINOL 100 MG TAB 3.02
ALLOPURINOL 300 MG TAB 3
ALOE VERA/GLYCERIN 1 BOT BOT 17.26
ALPRAZOLAM 0.25 MG TAB 2.89
ALPRAZOLAM 0.5 MG TAB 2.95
ALTEPLASE 1MG INJ 648.42
ALUM. MAGNES. HYDROX SIMET TAB 2.97
ALVIMOPAN 12 MG CAP 765.87
AMANTADINE HCL 100 MG CAP 6.85
AMIKACIN SULFATE 100MG INJ 30.19
AMINOCAPROIC ACID 250 MG/ML 10.38
AMINOPHYLLINE 250 MG/10ML VIAL 61.86
AMIODARONE (NEXTERONE) 360MG 286.75
AMIODARONE 150MG VIAL (CORDARO 5.7
AMITIZA 8MCG CAP(LUBIPROSTONE) 32.96
AMITRIPTYLINE 10 MG TAB 2.63
AMITRIPTYLINE 25 MG TAB 3.08
AMLODIPINE 2.5 MG TAB 2.99
AMLODIPINE 5 MG TAB 2.95
AMMONIUM LACTATE 12 OZ BOTTLE 18.11
AMOX/POT. CLAVUL 250MG/5ML SUS 214.79
AMOXICILLIN 125 MG/5 ML SUSPEN 18.74
AMOXICILLIN 250 MG CAP 3
AMOXICILLIN 250 MG/5 ML SUSPEN 12.32
AMOXICILLIN 500 MG CAP 2.93
AMOXICILLIN CHEW 250 MG TAB 4.25
AMOXICILLIN/CLAV.POTAS.250MG T 27.5
AMOXICILLIN/CLAV.POTAS.500MG T 6.46
AMOXICILLIN/POT.CLAV 875MG UD 5.14
AMPHET ASP/AMPHET 5 MG TAB 4.86
AMPICILLIN 1000 MG/5 ML VIAL 6.91
AMPICILLIN 250 MG VIAL 9.26
AMPICILLIN 500 MG CAP 3
AMPICILLIN 500 MG VIAL PAR 9.33
AMPICILLIN SODIUM 500MG INJ 11.72
AMPICILLIN SULBACTAM 1.5 GM VI 17.79
AMPICILLIN SULBACTAM 3 GM BOT 16.59
ANALGESIC BALM-BEN GAY 5.02
APRACLONIDINE HCL 0.5 ML DP 238.13
AQUA MEPHYTON MDV 10 MG/ML 257.73
ARIPIPRAZOLE 10MG 7.5
ARIPIPRAZOLE 15 MG TAB 24.85
ARIPIPRAZOLE 2 MG TAB 6.75
ARIPIPRAZOLE 5MG TAB 7.58
ARIPIPRAZOLE EXT 1MG INJ 3,250.92
ARTIFICIAL TEARS 15 ML BOTTLE 7.67
ARTIFICIAL TEARS 3.5 GM TUBE 15.67
ASACOL HD 800MG DR TAB 21.56
ASPIRIN 300 MG SUPP 6.75
ASPIRIN 325 MG TAB 2.97
ASPIRIN 81 MG TAB 2.94
ASPIRIN EC 325 MG TAB 3
ASPIRIN ENTERIC COATED 81MG 2.89
ASTRINGYN FERRIC SUBSULFATE 74.91
ATENOLOL 25 MG TAB 2.92
ATENOLOL 50 MG TAB 2.83
ATORVASTATIN (LIPITOR)10MG TAB 2.97
ATROPINE SULFATE .01MG INJ 43.93
ATROPINE SULFATE 0.4 MG/ML VIA 27.02
ATROPINE SULFATE EYE DROPS 312.34
ATROVASTATIN CALCIUM 40 MG TA 3.04
ATROVENT 0.06 NASAL SPRAY 129.86
AVAPRO 150MG CAPSULES 3.16
AVITENE NON-WOVEN 70X35 121.76
AZATHIOPRINE 50 MG TAB 3
AZELASTINE 130.68
AZITHROMYCIN 1 GM POWDER 138.53
AZITHROMYCIN INJ 500 ML 16.93
AZTREONAM 1 GM 126.41
AZTREONAM 2GM INJ 212.98
B O SUPPOSITORY 16.2/30MG 119.97
BACITRACIN TUBE OINT 8.2
BACLOFEN 10 MG TAB 2.95
BACLOFEN 10MG INJ 1,164.36
BACTRIM UDC 11.44
BALANCED SALT SOLUTION 500 ML 39.25
BASIC OINTMENT 454 GM JAR 16.29
BENAZEPRIL 10 MG 3
BENDAMUSTINE 1MG INJ 191
BENDAMUSTINE 1MG INJ WASTE 138.13
BENDAMUSTINE 1MG INJECTION 201.72
BENLYSTA (BELIMUMAB) WASTE 306.9
BENLYSTA (BELIMUMAB)400MG VIAL 209.94
BENZOCAINE 2 OZ CAN SPRAY 25.99
BENZOCAINE SPRAY 20% 55.66
BENZOCAINE/MENTHOL 1 SPR SPRA 0.1
BENZONATATE 100 MG CAP 2.69
BENZTROPINE 1 MG TAB 2.96
BENZTROPINE MESYLATE /1MG INJ 481.96
BETAMET. 15 GM CR (DIPROSONE) 169.03
BETAMETHASONE ACET & SOD PHOSP 36.15
BETHANECHOL 25 MG TAB 3
BEVACIZUMAB 10 MG/0.4 ML WASTE 396.02
BEVACIZUMAB 10MG INJ 389.26
BEVACIZUMAB 10MG INJ WASTE 356.65
BEVACIZUMAB 10MG INJECTION 366.27
BICITRA 30CC 6.84
BIMATOPROST(LUMIGAN).01% 2.5ML 762.96
BIOTENE ORAL BALANCE GEL 31.66
BISACODYL 10 MG SUPP 2.98
BISACODYL 5 MG TAB 2.99
BISOPROLOL/HCTZ 5/625MG TAB 3
BLEOMYCIN SULFATE 15UNIT INJ 138.99
BORTEZOMIB(VELCADE).1MG WASTE 327.39
BORTEZOMIB(VELCASE).1MG 330.38
BREO ELLIPTA INHALATION POWDER 336.83
BREXPIPRAZOLE 1MG 210.85
BRIMONIDINE TARTRATE 5ML DROP 12.99
BRINZOLAMIDE 5ML 1,329.96
BSS PLUS 236.63
BUDESONIDE 0.5MG/2ML 31.01
BUMETANIDE 7.74
BUMETANIDE 1 MG TAB 3.28
BUMETANIDE INJ 11.38
BUPIVACAINE 0.25% 10ML HCL 9.6
BUPIVACAINE 0.5% M VIAL 11.35
BUPIVACAINE 0.75% 2ML 18.56
BUPIVACAINE 30 ML VIAL 1% 9.96
BUPIVACAINE HCL 0.5% PER 1ML 11.24
BUPIVACAINE/EPI 0.5% VIAL 12.72
BUPRENORPHINE/NALOXO 8MG/2MG 18.62
BUPRENORPHINE/NALOXONE <=3MG 18.13
BUPROPION HCL 100 MG TAB 7.13
BUPROPION HCL 100 MG TABLET 3.53
BUPROPION HCL 150 MG TABLET 3.62
BUPROPION HCL 75MG TAB 5.27
BUSPIRONE 5 MG TAB 2.97
BUSPIRONE HCL 15 MG TAB 2.97
BUTORPHANOL TART 2 MG/ML VIAL 26.32
BUTORPHANOL TARTRATE 1MG INJ 22.38
C1 ESTERASE INHIBITOR,HUMAN 50 19,802.74
CAFFEINE 200MG CAPLET 3
CALAMINE LOTION 7.29
CALC. CHLORIDE 13.6 MEQ/10 ML 43.85
CALCITON SALMON 400 UNIT/2 ML 12,410.06
CALCITONIN 2 ML NASAL SPRAY 269.14
CALCITRIOL 0.25 MCG TAB 2.98
CALCIUM 667 TAB 4.08
CALCIUM CARB. 500 MG TAB-TUMS 2.92
CALCIUM CARBONATE/VIT D2 1 TAB 3.05
CALCIUM CHLORIDE 100 MG/ML SYR 44.82
CALCIUM GLUCONATE 10 ML VIAL 34.13
CAPTOPRIL 25 MG TAB 9.45
CARBACHOL 1.5 ML BOTTLE 73.67
CARBAMAZEPINE 200 MG TAB 3
CARBAMIDE PEROX. 30 ML BOTTLE 3.59
CARBIDOPA/LEVODOPA 10/100 TAB 3
CARBIDOPA/LEVODOPA SR 50/200 3
CARBOPLATIN 50MG INJ 21.9
CARBOPR. TROMETHAM. 250 MCG/ML 1,786.39
CARFILZOMIB INJ 1MG 78.35
CARFILZOMIB INJ 1MG WASTE 189.36
CARVEDILOL 12.5 MG TAB 3
CARVEDILOL 25 MG TAB 2.97
CARVEDILOL 3.125 MG TAB 2.94
CARVEDILOL 6.25 MG TAB 3
CEFAZOLIN 1000 MG/3 ML VIAL 5.45
CEFAZOLIN SODIUM 500MG INJ 40.41
CEFAZOLIN SODIUM 500MG INJ 43.06
CEFDINIR 125 MG/5 ML ML 39.05
CEFDINIR 300 MG CAP 8.56
CEFEPIME 500MG INJ 15.37
CEFEPIME 500MG INJECTION 30.28
CEFOTAXIME 1 GM 35
CEFOXITIN 1 GM 2.84
CEFTAZIDIME PER 500MG INJ 12.83
CEFTAZIDIME PER 500MG INJ 41.47
CEFTAZIDIME PER 500MG INJ 53.77
CEFTAZIDIME PER 500MG INJ 75.38
CEFTRIAXONE PER 250MG INJ 48.35
CEFTRIAXONE PER 250MG INJ 87.17
CEFTRIAXONE SOD PER 20MG INJ 6.14
CEFTRIAXONE SOD PER 250MG INJ 7.36
CEFTRIAXONE SODIUM 250 MG VIAL 8.79
CELECOXIB 100MG CAPS 6.08
CELECOXIB 200MG CAPS 9.15
CELEXA (CITALOPRAM) 20 MG TAB 2.95
CEPACOL SUGAR FREE(BENZOCAINE) 6.41
CEPHALEXIN 250 MG CAP 2.79
CEPHALEXIN 250 MG/5 ML BOTTLE 29.58
CEPHALEXIN 500 MG CAP 2.71
CETAPHIL CREAM 16 oz 35.57
CETIRIZINE HYDROCHLOR 10 MG TA 2.78
CETUXIMAB 10MG INJ 214.72
CETUXIMAB 10MG INJ WASTE 256.05
CETUXIMAB 10MG INJECTION 80.04
CETUXIMAB 10MG/5ML VIAL WASTE 138.62
CHLORDIAZEPOXIDE 10 MG CAP 3.06
CHLORDIAZEPOXIDE 25 MG CAP 2.75
CHLORDIAZEPOXIDE 5 MG CAP 2.66
CHLORHEXIDINE GLUCONATE 0.12% 3.51
CHLORHEXIDINE GLUCONATE 0.12% 27.57
CHLORPROMAZINE HCL 25 MG TAB 6
CHLORPROMAZINE HCL 50 MG AMPUL 131.71
CHOLECALCIFEROL VIT D3 1000MG 3.04
CHOLESTYRAMINE 4 GM PACKET PWD 10.37
CHONDROITIN SULFATE/HYALURON 1 285.04
CILOSTAZOL 100MG 3.64
CILOSTAZOL 50MG TAB 3
CIMETIDINE 300 MG TAB 3
CINACALCET 30MG TAB 157.38
CIPRODEX OTIC 0.3% 948.33
CIPROFLOXACIN 0.3% OPH SOL 15.79
CIPROFLOXACIN 250MG TAB 2.98
CIPROFLOXACIN 500 MG TAB 2.96
CIPROFLOXACIN HCL 10 ML DROP 1,268.29
CIPROFLOXACIN IV 200MG 42.15
CISATRACURIUM 20MG/10ML 116.78
CISPLATIN 10MG INJECTION 11.85
CITALOPRAM HYDROBROMI 10MG TAB 2.96
CLINDAMYCIN 150 MG CAP 2.95
CLINDAMYCIN 300MG INJ 16.83
CLINDAMYCIN 600MH/50ML D5W PRE 43.53
CLINDAMYCIN 75MG/5ML 2
CLINDAMYCIN 900MG/50ML D5W PRE 50.27
CLINIMIX 4.25/25 165.97
CLINIMIX 4.25/5 325.48
CLINIMIX E 4.25/5 308.15
CLOBETASOL PROPIONATE 15GM CR 163.16
CLONAZEPAM 0.5 MG ODT 3.27
CLONAZEPAM 0.5 TAB 2.99
CLONAZEPAM 1 MG TAB 3.01
CLONIDINE HCL 0.1 MG TAB 3.03
CLONIDINE-TTS 0.1 MG PATCH 97.55
CLONIDINE-TTS 0.2 MG PATCH 232.55
CLONIDINE-TTS 0.3 MG PATCH 229.41
CLOTRIMAZOLE 10 MG TAB 3.39
CLOTRIMAZOLE 15 GM TUBE CR 5
CLOZAPINE 100 MG TAB 4.38
CODEINE/APAP/CAFFEIN/BUTALB 30 5.59
COLCHICINE 0.6 MG TAB 36.39
COLESTIPOL 1GM 6.92
COLLAGEN HEMOSTAT 1 POW 167.2
COLLAGENASE 751.55
CORDARONE 200 MG TAB 3.01
CORTISPORIN OPTH OINTMENT 281.54
CORTISPORIN OTIC SUSPENSION 250.61
COSYNTROPIN 0.25 MG VIAL 164.06
CO-TRIMOXAZOLE 1 TAB (SULFAM) 2.85
CO-TRIMOXAZOLE 10 ML VIAL 55.41
CULTURELLE CAPSULE 4.03
CYANOCOBALAMIN 500 MCG TAB 3.02
CYCLOBENZAPRINE 10 MG TAB 2.76
CYCLOPENTOLATE 1% EYE DROPS 12.32
CYCLOPENTOLATE HCL 2% 73.59
CYCLOPHOSPHAMIDE 100MG 268.38
CYCLOPHOSPHAMIDE 100MG 277.18
CYCLOPHOSPHAMIDE 100MG WASTE 284.1
CYCLOPHOSPHAMIDE 100MG WASTE 293.48
DABIGATRAN 150MG CAP(PRADAXA) 32.51
DABIGATRAN 75MG CAP(PRADAXA) 31.91
DACRIOSE 150 U BOTTLE 16.85
DANTROLENE 25 MG CAP 7.04
DAPTOMYCIN 1MG INJ 1,366.65
DARATUMUMAB 10MG INJ 244.64
DARATUMUMAB 10MG INJ 250.57
DARATUMUMAB 10MG INJ-WASTE 238.83
DARBEPOETIN ALFA 100MCG ESRD 2,142.18
DARBEPOETIN ALFA 100MCG NONESR 2,056.91
DARBEPOETIN ALFA 200MCG NONESR 3,874.80
DARBEPOETIN ALFA 300MCG NONESR 9,114.04
DARBEPOETIN ALFA 40MCG ESRD 829.24
DARBEPOETIN ALFA 40MCG NONESRD 829.24
DARBEPOETIN ALFA 500MCG NONESR 12,662.88
DARBEPOETIN ALFA 60MCG ESRD 1,326.76
DARBEPOETIN ALFA 60MCG NONESRD 1,211.93
DEFEROXAMINE 500MG INJECTION 88
DENOSUMAB 1MG INJ 134.99
DEPO MEDROL 80 MG/ML VIAL 92.26
DESMOPRESSIN ACETATE /1MCG INJ 241.34
DEXAMETH SOD TO 1MG INJ 0.5
DEXAMETHASONE 0.5 MG TAB 4.59
DEXAMETHASONE 1MG/1 ML 4.92
DEXAMETHASONE 4 MG TAB 5.39
DEXAMETHASONE SOD PHOS 10MG/1M 10.04
DEXAMETHASONE SOD PHOS 1MG,INJ 10.12
DEXMEDETOMIDE 200MCG/2ML VIAL 93.08
DEXMEDETOMIDINE HCL 60.76
DEXTROSE 10% IN WATER 1000 ML 43.12
DEXTROSE 10% IN WATER 500 ML 38.39
DEXTROSE 5 % IN WATER 1000 ML 41.39
DEXTROSE 5% 100 ML 39.83
DEXTROSE 5% 50 ML 41.42
DEXTROSE 5% 500ML EXCEL BAG 21.56
DEXTROSE 5% IN LACTATED RINGE 43.12
DEXTROSE 5% IN WATER 250 ML 37.78
DEXTROSE 5% IN WATER 500ML 38.81
DEXTROSE 5% SALINE 0.2% 1000ML 43.12
DEXTROSE 5% SALINE 0.2% 500ML 43.12
DEXTROSE 5% SALINE 0.33% 500ML 43.12
DEXTROSE 5% SALINE 0.45% 1000 40.91
DEXTROSE 5% SALINE 0.45% 500ML 37.92
DEXTROSE 5% SALINE 0.9% 1000ML 43.12
DEXTROSE 50 ML SYRINGE 51.34
DEXTROSE 50% IN WATER 57.28
DIAZEPAM 10 MG TAB 2.96
DIAZEPAM 10 MG/2 ML SYRINGE 148.81
DIAZEPAM 2 MG TAB 3
DIAZEPAM 5 MG TAB 2.72
DIAZEPAM TO 5MG INJ 183.28
DIBUCAINE 1 OZ TUBE OINT 34.46
DICLOFENAC SODIUM 1 APPLIC GEL 210.84
DICYCLOMINE 10 MG TAB 2.81
DICYCLOMINE 20MG TAB 3
DICYCLOMINE HCI UP TO 20MG INJ 371.16
DICYCLOMINE HYDROCHLORIDE 10MG 1.35
DIFLUCAN 400MG IV 43.12
DIGOXIN 0.125 MG TAB 6.05
DIGOXIN 0.5 MG/2 ML AMPULE 23.81
DILIAZEM 120 MG 2.94
DILTIAZEM 100MG INJ 34.33
DILTIAZEM 125MG PREMIX 86.15
DILTIAZEM 180 CAP 2.9
DILTIAZEM 240 MG CAP 3.48
DILTIAZEM 25MG 5ML 12.64
DILTIAZEM 30 MG TAB 2.91
DILTIAZEM 300 MG CAP 6.47
DILTIAZEM 60 MG TAB 2.99
DILTIAZEM HYDROCHLORIDE 14.56
DIPHENHYDRAMINE 12.5MG/5ML BOT 5.87
DIPHENHYDRAMINE 50 MG CAP 2.86
DIPHENHYDRAMINE 50 MG/ML VIAL 9.81
DIPHENHYDRAMINE HCL 15 GM CR 7.1
DIPHENHYDRAMINE HYDROCHLO 25MG 2.87
DIPHENOXYLATE/ATROPINE 1 TAB 2.96
DIVALPROEX SODIUM 125 MG 3.55
DIVALPROEX SODIUM 125 MG CAP 4.2
DIVALPROEX SODIUM 250 MG TAB 3
DIVALPROEX SODIUM 250MG TAB 7.46
DIVALPROEX SODIUM 500 MG TAB 7.61
DIVALPROEX SODIUM 500MG 2.99
DOBUTAMINE 250 MG VIAL 34.44
DOBUTAMINE 250 MG/250ML 26.48
DOCETAXEL (TAXOTER) 160MG/16ML 10.89
DOCUSATE SODIUM 100 MG CAP 2.71
DONEPEZIL 5MG UD (ARICEPT) 3.03
DOPAMINE 400MG IN DEXTROSE 250 44.64
DORZOLAMIDE HYDROCHLORIDE 1 DR 48.68
DOXAZOSIN 1 MG CAP 3.96
DOXAZOSIN 4 MG TAB 6.58
DOXEPIN 25 MG CAP 3.13
DOXEPIN 50 MG CAP 4.23
DOXORUBICIN HCL 10MG INJ 21.83
DOXORUBICIN HCL LIPOS 10MG 1,971.80
DOXYCYCLINE 100 MG CAP 2.87
DOXYCYCLINE 100 MG VIAL 84.72
DRONEDARONE 400 MG TABLET 54.68
DULOXETINE HYDROCHLORIDE 20MG 6.87
DULOXETINE HYDROCHLORIDE 30MG 6.31
DULOXETINE HYDROCHLORIDE 60MG 4.94
DUOVISC -CHON1KIT 263.69
DURVALUMAB 10MG ING 53.63
DURVALUMAB 10MG INJ 53.71
DURVALUMAB 10MG INJ WASTE 53.7
EDARAVONE 1MG INJ 2,658.79
ELECTROLYTE CONE VIAL 28.67
ELIQUIS (APIXABAN) 2.5MG TAB 11.29
ELIQUIS (APIXABAN) 5MG TAB 10.19
EMLA 5 GM 38.87
ENALAPRIL 10 MG TAB 2.96
ENALAPRIL 5 MG TAB 3
ENALAPRILAT 1.25MG/1 ML VIAL 10
ENOXAPARIN 30MG/0.3 ML 21.24
ENOXAPARIN 80 MG INJ 55.94
ENOXAPARIN SODIUM 100MG 63.66
ENOXAPARIN SODIUM 10MG INJ 104.06
ENOXAPARIN SODIUM 120 MG 78.84
ENOXAPARIN SODIUM 60MG/0.6 ML 37.52
EPHEDRINE 50MG/5ML SYR 53.7
EPHEDRINE SULFATE 50 MG/ML AMP 177.35
EPINEPHRINE HCL 30 ML BOTTLE 707.01
EPINEPHRINE HCL 30 ML VIAL 9.45
EPINEPHRINE LIDOCAINE HCL INJ 16.74
EPINEPHRINE PEN 671.87
ERGOCALCIFEROL 50000 IU SGL 3.68
ERTAPENEM SODIUM 1 GM VIAL 563.7
ERYTHROMYCIN 5 MG/GM OINT 10.34
ERYTHROMYCIN BASE 250 MG TAB 27.53
ESCITALOPRAM OXALATE 10MG TAB 2.95
ESMOLOL 100 MG/10 ML VIAL 16.35
ESMOLOL 2500MG/250ML BAG 1,192.49
ESTRADIOL 1 MG TAB 2.96
ESTROGEN. SUBS CONJUGAT 5ML 1,398.94
ESTROGENS CONJUGATED 42.5 TUBE 1,668.14
ETHYL ALC(DEHYDR ALC)5ML AMP 486.66
ETOMIDATE 2 MG/ML ML 9.9
ETOPOSIDE 10MG INJECTION 9.69
EXPAREL 1.3% 20ML 266MG 1,584.00
EZETIMIBE 10 MG TAB 37.41
FACTOR VIII FUSION RECOMB INJ 9.64
FAMOTIDINE 20 MG TAB 2.88
FAMOTIDINE 20MG/2ML 9.69
FAMOTIDINE 20MG/50ML BAG 36.48
FAMOTIDINE 40 MG TAB 2.92
FELODIPINE 5 MG TAB 5
FENOFIBRATE 160MG 12.28
FENOFIBRATE 54MG TAB 3.87
FENTANYL 100 MCG 54.21
FENTANYL 25 MCG 28.77
FENTANYL 50 MG 60.46
FENTANYL 75 MG 38.93
FENTANYL CITRATE 0.1MG INJ 10.03
FENTANYL CITRATE 0.1MG INJ 13.27
FENTANYL CITRATE,SODIUM CHL 131.36
FENTANYL CITRATE0 0.1MG INJ 4.63
FENTANYL PATCH 12MCG 41.38
FENTANYL/BUPIV EPI 2MCG .125% 102.11
FERRIC CARBOXYMALTOSE 1MG INJ 3,717.21
FERRLECIT 12.5MG INJECTION 33.08
FERROUS SULFATE 325 MG TAB 3.13
FERROUS SULFATE 325 MG/5ML LIQ 3
FERUMOXYTOL 1MG/0.03MI ESRD 3.73
FERUMOZYTOL 1MG/0.03ML NONESRD 3.74
FIBER TAB 2.67
FILGRASTIM 300 MCG INJ p1mcg 1,358.34
FILGRASTIN 1.6ML 480 MCGp1mcg 2,324.63
FINASTERIDE 5MG TAB 3.63
FIORICET TAB 8.25
FLECAINIDE 50MG TAB 4.65
FLOMAX 2.99
FLONASE NASAL SPRAY 30.74
FLUCONAZOLE 100 MG TAB 6.27
FLUCONAZOLE 150 MG TAB 10.92
FLUCONAZOLE 200 MG/100 ML BOT 42.89
FLUDROCORTISONE 0.1 MG TAB 3
FLUMAZENIL (ROMAZICON).5MG/5ML 46.84
FLUORESCEIN SODIUM STRIP 9 MG 3
FLUOROURACIL 500MG INJ 8.37
FLUOROURACIL 500MG INJ 10.3
FLUOROURACIL 5FU 500MG 12.25
FLUOXETINE 10MG (PROZAC) 2.86
FLUOXETINE 20 MG CAP 2.97
FLUOXETINE LIQUID 1.92
FLUPHENAZINE HCL 5 MG TAB 27.56
FLUTICASONE (FLOVENT 110MCG) 1,069.98
FLUTICASONE (FLOVENT 220MCG) 1,662.07
FLUVOXAMINE 50 MG TAB 3.13
FOLIC ACID 1 MG TAB 2.83
FOLIC ACID 5 MG/ML 10.58
FONDAPARINAX 2.5MG/0.5ML 67.97
FONDAPARINUX SODIUM 10 MG/0.8 221.51
FONDAPARINUX SODIUM7.5MG/0.6ML 170.56
FORMULATION R OINT 10.49
FOSAPREPITANT 1MG INJ 9.26
FOSFOMYCIN 3GM ORAL PKT 374.16
FOSINOPRIL 10MG TAB 3
FOSPHENYTOIN 50MG INJ PHENYTOI 23.21
FULVESTRANT 25MG INJ 645.96
FUROSEMIDE 10 MG/ML SOLUTION 1.5
FUROSEMIDE 20 MG TAB 2.95
FUROSEMIDE 20 MG/ML VIAL – 2ML 10.1
FUROSEMIDE 40 MG TAB 2.99
FUROSEMIDE 80 MG TAB 3
GABAPENTIN 100 MG CAPS 2.95
GABAPENTIN 250 MG/5 ML SOL 3
GABAPENTIN 400MG CAP 2.93
GABAPENTIN 800MG 3.01
GAUIFENESIN AC 10ML 3.26
GELFOAM LG 100 107.84
GELFOAM SM 12X7 21.94
GEMCITABINE 200MG INJECTION 47.41
GEMCITABINE HCL 200MG INJ 40.01
GEMFIBROZIL 600 MG TAB 3
GENTAMICIN 15 GM TUBE CREAM 193.87
GENTAMICIN 5 ML BOTTLE DROPS 8.47
GENTAMICIN 80 MG/2 ML VIAL 9.32
GENTAMICIN UP TO 80MG INJ 7.45
GENTAMICIN/NS 80 MG BAG 41.45
GLIMEPIRIDE 2GM (AMARYL) 3.03
GLIPIZIDE (GLUCOTROL)XL 2.5MG 4.03
GLIPIZIDE 5 MG TAB 2.98
GLIPIZIDE XL 5 MG TAB 3.02
GLUCAGON 1 MG VIAL 496.49
GLUCOSE GEL 25.03
GLUCOSE TABLETS 3
GLYBURIDE 2.5 MG TAB 3
GLYBURIDE 5 MG TAB 3
GLYCERIN 1 SUPPOSITORY 3.76
GLYCERIN 1 SUPPOSITORY INFANT 3
GLYCOPYRROLATE .4MG/2ML INJ 80.57
GLYCOPYRROLATE 1 MG TAB 4.8
GLYCOPYRROLATE 1MG/5ML SYR INJ 56.93
GNRC DACARBAZINE 100MG INJ 16.25
GOLYTELY POWDER FOR SOLUTION 33.15
GUAIFENESIN 10 ML CONTAINER 3.06
GUAIFENESIN DM 10ML 3.62
GUAIFENESIN TAB 3.79
GUAIFENESIN/DEXTROMETHROPHAN T 3.09
HALOBETASOL PROPIONATE 172.67
HALOPERIDAL DECANOATE 100 ML 212.18
HALOPERIDOL 1 MG TAB 3.29
HALOPERIDOL 2 MG/ML BOTTLE 1.82
HALOPERIDOL 5 MG TAB 3
HALOPERIDOL 5 MG TAB 4
HALOPERIDOL 5 MG/ML AMPULE 9.97
HALOPERIDOL DECAN. 50 MG/1 ML 129.32
HEMORRHOIDAL HC 1 SUPP 34.77
HEMORRHOIDAL OINTMENT TUBE 11.41
HEMORRHOIDAL/HC 30 GM TUBE 116.33
HEP LOCK FLUSH INJ PER 10 UNIT 9.59
HEPARIN PER 1000 UNIT INJ 12.73
HEPARIN SOD /1000 UNITS INJ 2.1
HEPARIN SODIUM,PORCINE 5000 UN 9.82
HEPARIN SODIUM/1000 UNITS INJ 2.44
HEPARIN SODIUM/1000U INJ 84.96
HEPATITIS A VACCINE ADULT IM 278.25
HEPATITIS B VACC (RECOMBINANT) 10.53
HETASTAR. 6% /NACL 0.9% 500 ML 92.21
HEXAMINOLEVULINATE 100MG INJ 5,166.51
HUMAN TETANUS IG INJ TO 250UNI 2,027.94
HYALURANATE SODIUM 4,284.43
HYDRALAZINE 10 MG TAB 3
HYDRALAZINE 20 MG/ML AMPULE 15.38
HYDRALAZINE 25 MG TAB 3.06
HYDROCHLOROTHIAZIDE 25 MG 2.96
HYDROCODONE 7.5-325 SOL 15ML 8.74
HYDROCODONE BIT/ACETAMIN TAB 2.86
HYDROCODONE/BITARTRA/APAP5/325 2.5
HYDROCODONE/BITARTRATE/APAP 7. 2.81
HYDROCORT 30 GM TUBE HYTONE1% 8.91
HYDROCORT 30 GM TUBE OINT 1% 6.25
HYDROCORT SOD SUCC 100MG 75
HYDROCORT SOD.SUCC. 250MG/2ML 141.13
HYDROCORT/POLYMYXIN/NEOMY 10ML 401.61
HYDROCORTISONE 10MG TAB 3.92
HYDROCORTISONE CM 2.5% 11.44
HYDROMORPHONE 2 MG TAB 2.73
HYDROMORPHONE HCL 10 MG/ML 10
HYDROMORPHONE UP TO 4MG INJ 18.44
HYDROMORPHONE UPto 4MG 185.56
HYDROXYCHLOROQUINE 200 MG TAB 7.86
HYDROXYUREA 500 MG CAP 3.85
HYDROXYZINE 100MG/2ML INJ 12.52
HYDROXYZINE HCL 10 MG TAB 3
HYDROXYZINE HCL 25 MG TAB 2.94
HYDROXYZINE PAMOATE 25 MG CAP 2.97
HYOSCYAMINE 0.125 MG 2.76
IBANDRONATE SODIUM INJ 1MG 396.86
IBUPROFEN 100MG/5ML SUSP 3.41
IBUPROFEN 200 MG TAB 2.82
IBUPROFEN 400 MG TAB 2.86
IBUPROFEN 600 MG TAB 2.73
IMIPRAMINE HCL 25 MG TAB 3
IMITREX 6 MG SYR 64.31
IMMUNE GLOBUL NONLYO 500mg INJ 158.59
IMMUNE GLOBUL NONLYOP 500mgINJ 186.38
IMMUNE GLOBUL NONLYOP 500mgINJ 187.4
IMMUNE GLOBULIN NONLYO 500 INJ 208.87
IMMUNE GLOBULIN NON-LYPH INJ 197.82
IMMUNE GLOBULIN NONLYPHOLIZED 220.24
IMMUNE GLOBULIN NONLYPHOLYZED 231.8
INCRUSE ELLIPTA INHALER 214.12
INDAPAMIDE 2.5 MG TAB 3
INDOCYANINE GREEN 25MG KIT 341.79
INDOMETHACIN 25 MG CAP 3
INDOMETHACIN 50 MG CAP 3
INFLIXIMAB (INFLECTRA)10MG INJ 213.64
INFLIXIMAB (REMICAD)10MG WASTE 505.4
INFLIXIMAB (REMICADE) 10MG INJ 480.71
INFLUENZA VIRUS VAC IIV4,0.5ML 96.24
INSULIN PER 5 UNITS INJ 27.34
INSULIN PER 5 UNITS INJ 88.31
INSULIN PER 5 UNITS INJ 131.74
INSULIN PER 5 UNITS INJ 168.49
INSULIN PER 5 UNITS INJ 1,343.08
INTRALIPID 20% 250 ML 79.71
IODINE 480 ML 1.09
IPILIMUMAB (YERVOY) 1MG 697.55
IPILIMUMAB (YERVOY) 1MG INJ 698.86
IPILIMUMAB(YERVOY)1MG INJ WAST 691.59
IPRATROPIUM 0.03% NASAL SPRAY 114.51
IPRATROPIUM BROMIDE 14 GM INH 1,659.83
IPRATROPIUMM (ATROVENT) 2.5ML 2.97
IRINOTECAN 20MG INJ 55.1
IRINOTECAN 20MG INJ WASTE 53.99
IRINOTECAN 20MG INJECTION 19.03
IRON DEXTRAN 50 MG/ML AMPULE 94.46
IRON SUCROSE 1MG 1.47
ISOSORBIDE 5 MG TAB 5.55
ISOSORBIDE MONONITRATE 20MG TA 3
ISOSORBIDE MONONITRATE 30MG TA 2.95
ISOSORBIDE MONONITRATE 60MG TA 3
ISOSULFAN BLUE(LYMPHAZUIN)1% 3,937.25
IVIG PRIVIGEN 500MG INJ 184.75
IVIG PRIVIGEN 500MG INJ 192.45
KCENTRA PER 1IU 8.8
KCENTRA PER 1IU-WASTE 8.39
KCENTRA PER IU 9.76
KCENTRA PER IU-WASTE 8.49
KENALOG 0.1% 15 GM CREAM 26.69
KETAMINE HCI 50 MG/ML VIAL 18.79
KETAMINE HYDROCHLORIDE INJ 32.3
KETOCONAZOLE 2% 49.96
KETOCONAZOLE 30 GM TUBE 118.54
KETOROLAC 10 MG TAB 5.09
KETOROLAC TROMETHAMINE 30 MG 9.77
KETOROLAC TROMETHAMINE 60 MG 11.62
KETOROLAC TROMETHAMPINE EYE DR 134.88
LABETALOL 100 MG TAB 2.82
LABETALOL 100 MG/20 ML VIAL 20.97
LACOSAMIDE 200MG TAB 86.69
LACOSAMIDE 50MG TAB 49.61
LACTATED RINGERS 1000 ML BAG 36.22
LACTOBACILLUS ACIDOPHILUS 1 BO 8.2
LACTULOSE 20 GM/30 ML UDC LIQ 3
LAMOTRIGINE 100MG TAB 2.92
LAMOTRIGINE 25 MG TAB 2.83
LANREOTIDE 1MG INJ 36,922.78
LANSINOH LANOLIN CREAM 7GM 7.66
LANSOPRAZOLE 15MG 81.36
LATANOPROST 2.5 ML BOTTLE 51.09
LEMTRADA(ALEMTUZUMAB) 1MG INJ 84,639.54
LET GEL 37.92
LETROZOLE (FEMARA) 2.5 MG TAB 3.53
LEUCOVORIN CALCIUM /50MG INJ 22.91
LEUCOVORIN CALCIUM PER 50MG 18.7
LEUPROLIDE 7.5 MG INJ 620.85
LEUPROLIDE ACETATE 22.5MG 2,228.35
LEUPROLIDE ACETATE 7.5MG 3,791.78
LEUPROLIDE ACETATE 7.5MG(45MG) 4,471.89
LEVALBUTEROL HAFA INHALER 247.8
LEVALBUTEROL NON-COMP 0.5MG 8.98
LEVAQUIN 250 MG TAB 2.75
LEVARTERENOL BITARTRATE 4 ML 21.78
LEVETIRACETAM 10 MG INJ 4.47
LEVETIRACETAM ORAL SOLUTION 9.49
LEVETRACETAM 500 MG TAB 2.84
LEVOFLOXACIN 250MG INJ 40.13
LEVOFLOXACIN 500 MG IVPB 42.42
LEVOFLOXACIN 500MG PO UD 2.93
LEVOFLOXACIN 750MG TAB 3.04
LEVOFLOXACIN/D5%W 5MG/1ML BAG 43.12
LEVONORGESTREL 1.5 MG TAB 85.59
LEVOTHYOXINE INJ 100MCG VIAL 470.16
LEVOTHYROXINE 112MCG TAB 3.07
LEVOTHYROXINE SOD 100MCG TAB 2.91
LEVOTHYROXINE SOD 125MCG TAB 2.91
LEVOTHYROXINE SOD 150MCG TAB 3.25
LEVOTHYROXINE SOD 25MCG TAB 2.98
LEVOTHYROXINE SOD 75MCG TAB 2.98
LEVOTHYROXINE SOD 88MCG TAB 2.97
LEVOTHYROXINE SODIUM 50MCG TAB 3.02
LIDOCAINE 0.5% 50 ML VIAL 13.57
LIDOCAINE 1% 10 MG/ML 10.84
LIDOCAINE 1% 30ML 15.63
LIDOCAINE 1% 5ML AMP 10.13
LIDOCAINE 1% W/EPI 20 ML VIAL 15.66
LIDOCAINE 2% 10 ML AMPULE 16.34
LIDOCAINE 2% 20 ML VIAL 9.97
LIDOCAINE 2% 20 ML VIAL 13.35
LIDOCAINE 2% 5ML PF SYR 35.07
LIDOCAINE 2% GEL 5ML TUBE 12.43
LIDOCAINE 2% STERILE JELLY 10M 36.67
LIDOCAINE 30 GM TUBE GEL 43.17
LIDOCAINE 5% PATCH 24.88
LIDOCAINE 50 ML BOTTLE 204.32
LIDOCAINE HCL 5ML AMP 59.66
LIDOCAINE HCL INJ 9.99
LIDOCAINE HYDROCHLORIDE 4 ML 106.22
LIDOCAINE UDL 4.37
LIDOCAINEfor10MG IV(100MG/5ML) 14.88
LINEZOLID 600MG/300 ML BAG 207.19
LIOTHYRONINE 5MCG TAB 3.49
LISINOPRIL 2.5MG TAB 3.01
LISINOPRIL 10MG TAB 2.93
LISINOPRIL 40MG 2.96
LITHIUM 450 MG 3
LITHIUM CARBONATE 150 MG CAP 3
LITHIUM CARBONATE 300 MG CAP 1.77
LOPERAMIDE 2 MG CAP 3.13
LORATADINE 10MG TAB 2.95
LORATADINE 5MG/ 5 ML SY 0.77
LORATADINE/PSEUDEOPHEDRINE TAB 3.8
LORATADINE/PSEUDOEPHEDRINE D24 3.74
LORAZEPAM 0.5 MG TAB 2.74
LORAZEPAM 1 MG TAB 2.87
LORAZEPAM 2 MG SYRINGE 9.27
LORAZEPAM ORAL SOLUTION 7.36
LORTREL 5/20 2.77
LOSARTAN POTASSIUM 25 MG TAB 3
LOTRISONE 15 GM TUBE CREAM 88.53
LOVASTATIN 50MG UD (COZAAR) 3.02
LOVENOX (ENOXAPARIN) 300MG/3ML 50.98
LOVENOX 10MG INJ 26.76
LUBIPOSTONE 24MCG 34.18
LURASIDONE (LATUDA) 20MG TAB 149.42
LURASIDONE (LATUDA) 40MG TAB 218.49
LURASIDONE (LATUDA) 80MG TAB 218.85
MAGNESIUM CITRATE 10 OZ BOTTLE 53.99
MAGNESIUM OXIDE 400 MG TAB 2.9
MAGNESIUM SULFATE /500MG INJ 11.15
MAGNESIUM SULFATE 40 MEQ/10 ML 5.61
MAGNESIUM SULFATE 40GM/ML BAG 37.16
MAGNESIUM SULFATE 50% 1GM/2ML 3.4
MAGNESIUM SULFATE 500MG INJ 37.72
MAGNESIUM SULFATE PER 500MG 78
MANNITOL 12.5 GM/50 ML VIAL 12.63
MARINOL CAPSULES 15.37
MAXITROL 3.5% OPHTH OINT 96.61
MAXITROL SUSP 5 ML BOTTLE 92.48
MEASLES MUMPS RUBELLA VACCINE 273.2
MECLIZINE 12.5MG TAB 2.87
MECLIZINE 25 MG TAB 2.78
MEDROXYPROGESTERONE 150MG/ML 313.29
MEDROXYPROGESTERONE 25 MG TAB 3
MEGESTROL ACETATE 40 MG TAB 3
MELOXICAM 7.5 MG TAB 3.01
MEMANTINE HYDROCHLORIDE 10MG 2.99
MENTHOL/ZINC OXIDE 113 GM TUBE 17.18
MEPERIDINE HYDROCHLORIDE 25MG 26.76
MEROPENEM 100MG INJECTION 4.23
METAMUCIL UD PACKET 3
METFORMIN 3
METFORMIN 850MG (GLUCOPHAGE) 2.96
METFORMIN HCL 500 MG TAB 3
METHACHOLINE 1MG 2.72
METHADONE 10 MG TB 3.17
METHADONE HCL 5 MG TAB 2.14
METHERGINE 0.2 MG TAB 236.99
METHERGINE 0.2 MG/ML AMPULE 80.39
METHIMAZOLE 10 MG 1.75
METHOL/ZINC OXIDE 3.5 GM PACK 2.98
METHOTRAXATE 2.5 MG TAB 12.33
METHOTREXATE 50 MG/2 ML VIAL 63
METHOTREXATE SODIUM 50MG 110.44
METHYLDOPA 250 MG TAB 3.09
METHYLNALTREXONE BROMIDE 12MG 444.45
METHYLPHENIDATE 10 MG TAB 6.65
METHYLPHENIDATE 5 MG TAB 3.02
METHYLPREDNISOLONE 4 MG TAB 2.14
METHYLPREDNISOLONE 40MG INJ 44.98
METHYLPREDNISOLONE INJto125MG 94.49
METHYLPREDNOSOLONE 125MG INJ 111.22
METOCLOPRAMIDE 10 MG TAB 2.83
METOLAZONE 2.5 MG TAB 12.53
METOLAZONE 5 MG TAB 7.09
METOPROLOL 100 MG TAB 6.39
METOPROLOL 5 MG/5 ML AMPULE 9.67
METOPROLOL 50 MG TAB 2.99
METOPROLOL 50MG TAB 4.09
METOPROLOL SUCCINATE 25 MG TAB 4.26
METOPROLOL TARTRATE 25 MG TAB 2.97
METRONIDAZOLE 250 MG TAB 2.97
METRONIDAZOLE 500 MG/100 ML 39.93
MICAFUNGIN (MYCAMINE) 100MG VI 341.47
MICONAZOKE 2% POWDER 31.78
MICONAZOLE TUBE VAGINAL CREAM 13.89
MIDAZOLAM 2MG/2ML VL PF 9.99
MIDAZOLAM 5 MG/5 ML VIAL 15.03
MIDAZOLAM HCL 1MG INJ 121.34
MIDAZOLAM PER 1MG INJ 9.23
MIDODRINE 10MG TAB 6.46
MIDODRINE 2.5MG TAB 2.92
MILK OF MAGNESIA 30 ML 6.82
MINERAL OIL 30 ML CONTAINER 3.84
MIRTAZAPINE 15 MG TAB 6.84
MISC PHARM NON FORMULARY INJ 156.2
MISC PHARM ORAL DRUGS 7.32
MISC PHARMACY NON FORMULARY 1.07
MISOPROSTOL 100 MCG TAB 4.1
MISOPROSTOL 200 MCG TAB 4.57
MISOPROSTOL 25MCG CUT TAB 3.06
MITOMYCIN PER 5MG(40MG VIAL) 573.12
MITOMYCIN TOPICAL EYE IRR 680.35
MODAFINIL 200 MG TAB 54.76
MOMETASONE FUROATE 1 APPLIC CR 32.64
MONTELUKAST SODIUM 10 MG TAB 2.98
MORPHINE 100 MG TABS 17.94
MORPHINE 10MG PRESERV FREE INJ 11.89
MORPHINE 15 TAB 3.42
MORPHINE 20MG ER CAPSULE 19.32
MORPHINE SULFATE 10MG/5ML SOLN 6.57
MORPHINE SULFATE 15 MG TAB 3.4
MORPHINE SULFATE 30 MG TAB 6.6
MORPHINE SULFATE 30MG 30MLVIAL 46.48
MORPHINE SULFATE INJ 4MG/ML 10.32
MORPHINE SULFATE ORAL SOLUTION 10.62
MORPHINE SULFATE TO 10MG INJ 9.56
MOXIFLOXACIN HCL 0.5 ML DP 177.24
MULTIVITAMIN (MVI-12) 10 ML 52.68
MULTIVITAMIN AND IRON15 1 TAB 2.36
MUPIROCIN 15 GM TUBE OINT 33.85
MYCOPHENOLATE CELLC 250MG CAP 3
MYCOPHENOLATE MOFETIL 500 MG T 4.54
MYLANTA LIQUID 30 ML 7.27
NA POLYSTYRENE SULFONATE 1GM 49.1
NABUMETONE 500 MG TAB 3.13
NAFCILLIN 2 GM VIAL 136.53
NALBUPHINE HCL PER 10MG INJ 39.12
NALOXONE 0.4 MG/ML VIAL 53.8
NALOXONE 2 MG/2 ML AMPULE 187.43
NALTREXONE 50 MG TAB 9
NAMENDA 5MG 10.28
NAPROXEN 500 MG TAB 2.96
NATALIZUMAB 1MG INJECTION 127.95
NEOMYCIN 500 MG TAB 5.36
NEOSPORIN 7.32
NEOSTIGMINE METHYL UP TO 0.5MG 216.08
NEOSYNEPHRINE OPHTH 10% GTTS 205.75
NEOSYNEPHRINE SPRAY 4.98
NEO-SYNEPHRINE TO 1ML INJ 21.72
NEPHROCAPS 1 TAB CAP 3.7
NEURONTIN 300MG CAPS (GABAPENT 2.84
NEUTRAPHOS 1.25 GM CAP 3.07
NIACIN 500 MG TAB 20.5
NICARDIPINE HCL 25MG/10ML INJ 60.83
NICOTINE POLACRILEX 2 MG GUM 2.92
NICOTINE TRANSDERMAL 14MGPATCH 6.95
NICOTINE TRANSDERMAL 21MGPATCH 7.11
NICOTINE TRANSDERMAL 7MG PATCH 6.93
NIFEDIPINE 10 MG CAP 2.74
NIFEDIPINE 30 MG TAB 3.56
NIFEDIPINE 60 MG TAB 5.32
NITRO DRIP PREMIX 250ML 25MG 49.3
NITROFURANTOIN 50 MG CAP 11.42
NITROFURANTOIN MONO/MACROCRYST 15.19
NITROGLYCERIN 0.1 MG PATCH 3.19
NITROGLYCERIN 0.2 MG PATCH 3
NITROGLYCERIN 0.4 MG PATCH 3
NITROGLYCERIN 0.4 MG/TAB 25 108.86
NITROGLYCERIN 1 GM TUBE 9.4
NOREPINEPHRINE DRIP 503B COMP 260.21
NORMAL SALINE INFUSION 250CC 41.46
NORMAL SALINE SOL INFUS 250CC 43.12
NORTRIPTYLINE 25 MG CAP 2.83
NORTRIPTYLINE 75 MG CAP 3
NUSINERSEN(SPINRAZA)0.1MG INJ 426,622.01
NYSTATIN 15 GM TUBE CREAM 22.69
NYSTATIN 500000 UNITS/5ML ML 4.61
NYSTATIN POWDER 15 GM 21.68
OCREVUS (OCRELIZUMAB) 1MG INJ 228.22
OCTREOTIDE ACETATE 30MG 27,928.91
OCTREOTIDE NOT DEPOT 25MCG INJ 14.04
OCTREOTIDE NOT DEPOT 25MCG INJ 25.37
ODANSETRON (ZOFRAN) 1MG 11.12
OFIRMEV IV ACETAMINOPHEN 1000 2.54
OFLOXACIN OTIC 0.3% DROPS 606.83
OLANZAPINE 10 GM TAB 2.88
OLANZAPINE 10 MG VIAL-5MG DOSE 163.32
OLANZAPINE 5 MG TAB 6.38
OLANZAPINE ZYDIS 10 MG TAB 12.82
OLANZIPINE 5 MG TAB 3
OLARATUMAB 10MG INJ 237.6
OLARATUMAB 10MG INJ-WASTE 347.33
OLPATADINE HCL 0.1% 5ML PATANO 231.46
OMALIZUMAB 5MG INJECTION 75.48
OMEGA-3-ACID ETHYL ESTERS 18.63
OMEPRAZOLE 20 MG PO 2.93
ONABOTULINUMTOXINA 1UNIT INJ 30.29
ONABOTULINUMTOXINA 1UNIT-WASTE 30.29
ONDANSETRON 4 MG ORAL 2.95
ONDANSETRON 4MG TAB-NON CHEMO 2.02
ONDANSETRON 8 MG TAB-NON CHEMO 3
ONDANSETRON PER 1MG INJ 9.8
OPDIVO (NIVOLUMAB) 1MG INJ 158.64
OPDIVO (NIVOLUMAB) 1MG INJ 164.26
OPDIVO (NIVOLUMAB) 1MG WASTE 184.02
OPDIVO (NIVOLUMAB)1MG INJ 175.66
OPDIVO (NIVOLUMAB)1MG INJ-WAST 186.35
OPHTH DILATING SOLN 0.5ML 66.44
ORAJEL (BENZOCAINE 10%) 7GM TU 19.95
ORAL DRUG,CHEMOTHERAPY NOS 14.44
ORPHENADRINE CITR UP TO 60MG 84.6
OSELTAMIVIR 30MG CAP 59.71
OSELTAMIVIR ORAL SUSPENSION 77.47
OSELTAMIVIR PHOSPHATE 75MG CAP 50.46
OSMITROL 10% 500 ML BAG 112.31
OXALIPLATIN .5MG INJ WASTE 7.35
OXALIPLATIN 0.5MG INJ 7.45
OXALIPLATIN 0.5MG WASTE 0.09
OXALIPLATIN 0.5MG/0.1ML 7.22
OXCARBAZEPINE 150MG(TRILEPTAL) 3.17
OXCARBAZEPINE 300MG 3
OXYBUTYNIN 5 MG TAB 2.99
OXYBUTYNIN XL 5MG TAB 8.45
OXYCINTIN 20MG (OXYCODONE) 28.63
OXYCODONE 10 MG TABLETS 18.14
OXYCODONE 40MG 38.52
OXYCODONE IR 5MG TAB 2.11
OXYCODONE/APAP 5/325MG 1 TAB 2.83
OXYMETAZOLINE HCL NASAL SPRAY 3.72
OXYTOCIN 10 UNIT/ML AMPULE 9.89
OXYTOCIN TO 10 UNITS INJ 54.69
PACLITAXEL 1MG INJECTION 8.31
PACLITAXEL PROTEIN-BOUND 1MG 86.62
PACLITAXEL PROTEIN-BOUND WASTE 87.16
PALIPERIDONE 3 MG TAB 127.28
PALIPERIDONE 6MG TAB 113.57
PALONOSETRON HCI 25MCG INJ 1,217.46
PANCRELIPASE TAB 6.27
PANTOPRAZOLE SODIUM 40 MG/VIAL 19.36
PARICALCITOL 1 MG CAP 30.27
PARICALCITOL 2 MCG/ML VIAL 27.21
PAROXETINE 20 MG TAB 2.93
PAROXETINE HYDROCHLOR 10MG TAB 3.07
PCV13 (PNEUM) VACCINE 801.58
PEGFILGRASTIM 6 MG/0.6 ML DISP 22,857.13
PEGFILGRASTIM 6MG DEL KIT INJ 18,740.17
PEMBROLIZUMAB 1MG INJ 259.46
PEMBROLIZUMAB 1MG INJ-WASTE 167.31
PEMETREXED 10MG INJ 236.7
PEMETREXED 10MG INJ 284.75
PEMETREXED 10MG INJ WASTE 126.7
PEMETREXED 500 MG/20 ML WASTE 308.89
PEN.VK SUSP-BIOCRAFT 25OMG/5ML 3.55
PENICILLIN G BENZ 100000UN INJ 600.1
PENICILLIN G POT UP TO 600000U 3.03
PENTASA 250 MG CAP 17.35
PENTOXIFYLLINE 400 MG TAB 3
PERMETHRIN LOTION 1% 60ML BTL 30.5
PERPHENAZINE 4 MG TAB 5.71
PERTUZUMAB 1MG INJ 81.45
PETROLATUM OINTMENT 5.55
PETROLATUM,WHITE 5GM FOILPAC 2.94
PHENAPHTHAZINE 100 MG TAB 4.84
PHENOBARBITAL 130 MG/ML VIAL 279.31
PHENOBARBITAL 32.4MG TAB 3.04
PHENYLEPHRINE 10 MG/ML VIAL 24.78
PHENYLEPHRINE HCL INJ UPto 1ML 40.2
PHENYLEPHRINE HCL OPH 10%0.5ML 20.82
PHENYTOIN 100 MG CAP 2.73
PHENYTOIN 100 MG/ML UDC 5.85
PHENYTOIN 30MG (DILANTIN) 5.87
PHYSOSTIGMINE 2 MG/2 ML AMPULE 262.1
PHYTONADIONE (VIT K)/1MG INJ 102.32
PHYTONADIONE 5 MG 290.96
PILOCARPINE 2 15 ML 353.14
PIOGLITAZONE 15MG 4.11
PIPERACILL/TAZOBACTAM 4/0.5GM 21.8
PIPERACILLIN/TAZOBACTAM 23.93
PIPERACILLIN/TAZOBACTAM 2.25 15.61
PLAVIX 75mg ORAL TABLET 3.03
PNU-IMMUNE SYRINGE 0.5 ML 398.12
POLYETHYLENE GLYCOL 14OZ 67.94
POLYETHYLENE GLYCOL 3350 1 EAC 6.56
POLYMIXIN B/TM EYE GTTS 10ML 48.37
POTASSIUM ACETATE 2 MEQ/MLVIAL 14.17
POTASSIUM CHLORIDE /2MEQ 2.31
POTASSIUM CHLORIDE /2MEQ 40.14
POTASSIUM CHLORIDE /2MEQ 42.81
POTASSIUM CHLORIDE /2MEQ INJ 11.37
POTASSIUM CHLORIDE /2MEQ INJ 28.75
POTASSIUM CHLORIDE /2MEQ INJ 30.2
POTASSIUM CHLORIDE 10 MEQ TAB 3.08
POTASSIUM CHLORIDE 2 MEQ INJ 11.35
POTASSIUM CHLORIDE 20 MEQ TAB 2.93
POTASSIUM CHLORIDE 20MEG/100ML 39.07
POTASSIUM CHLORIDE 20MEQ/15 ML 58.23
POTASSIUM PHOSPHATE 3MM/ML 5ML 27.69
POTASSIUM-CITRATE/BICAR 25 MEQ 2.92
PRAMIPEXOLE DI-HCL 0.25 MG TAB 2.86
PRAMIPEXOLE DI-HCL 1 MG TAB 3.74
PRAMOXINE & HYDROCORTISONE 447.56
PREDNISOLONE 15 MG/5 ML UDC 10.03
PREDNISONE 1 MG TAB 3
PREDNISONE 1 MG/1 ML 3.44
PREDNISONE 10 MG TAB 3.07
PREDNISONE 20 MG UD TAB 2.91
PREDNISONE 5 MG TAB UD 3.01
PREGABALIN 46.57
PREGABALIN 150 MG CAP 45.16
PREGABALIN 75MG CAP 48.63
PREMETHRIN CREAM 5% 60GM TUBE 303.38
PRIMIDONE 250 MG TAB 3.66
PRIMIDONE 50 MG TAB 3.09
PROBENECID 500 MG TAB 3
PROCHLORPERAZINE 10 MG TAB 3
PROCHLORPERAZINE 25 MG SUPP 31.08
PROCHLORPERAZINE 5 MG TAB 3
PROMETHAZINE 12.5 MG SUPP 43.11
PROMETHAZINE 25 MG TAB 2.93
PROMETHAZINE 50 MG/ML AMPULE 9.09
PROMETHAZINE 6.25 MG/5 ML 2.81
PROMETHAZINE HCL 25MG/SUP RECT 35.98
PROPAFENONE 150 MG TAB 3
PROPANOLOL 20 MG TAB 2.98
PROPARACAINE 15 ML BOTTLE 124.76
PROPOFOL 10MG INJ 42.33
PROPOFOL 10MG INJ 42.86
PROPOFOL 10MG INJ 75.33
PROPRANOLOL 1 MG/ML AMPULE 13.48
PROPRANOLOL 10 MG TAB 2.96
PROPRANOLOL 120 MG CAP 8.76
PROPRANOLOL 40 MG TAB 3.91
PROPRANOLOL 60 MG CAP 11.18
PROPRANOLOL 80 MG CAP 11.29
PROPRANOLOL 80MG TAB 3
PROSTIGMIN TO 0.5MG INJ 89.35
PSEUDOEPHEDRINE 30 MG TAB 3
PYRIDOXINE 50 MG TAB 3.03
PYRIDOXINE HCL 100MG INJ 55.48
QUETAPINE FURMATE 50 MG TAB 3.49
QUETIAPINE 200MG TAB (SERQUEL) 4.44
QUETIAPINE 50MG TAB (SEROQUEL) 2.98
QUETIAPINE FUMARATE 100MG 2.92
QUETIAPINE FUMARATE 200 MG TAB 38.83
QUETIAPINE FUMARATE 25 MG TAB 2.99
QUETIAPINE FUMRATE 150 MG TAB 10.28
QUINAPRIL 10 MG TAB 3
RABIES IG INJ IM/SQ 150U/ML 3,922.11
RABIES VACCINE IM 1ML 1,262.25
RALOXIFENE HCL 60MG TAB 26.69
RAMIPRIL 2.5MG UD 3
RAMIPRIL 5MG UD (ALTACE) 3
RANOLAZINE ER 500MG TAB 32.66
RASBURICASE .5MG INJ 3,719.49
RASBURICASE .5MG INJ WASTE 3,765.25
RASBURICASE 0.5 MG 1,244.88
RASBURICASE 0.5MG 7.5MG WASTE 1,288.93
RECOMBIVAX HB PED-ADOLESCENT 6.77
REGADENOSAN(LEXISCAN)/.10mg 1,039.56
REGLAN 5 MG/ML VIAL 14.6
RENVELA (SEVELAMER) 800MG TAB 34.32
REQUIP 0.5MG 3.03
RESLIZUMAB 1MG INJ 62.69
RESLIZUMAB 1MG INJ-WASTE 62.69
RIFAMPIN 300 MG 3.6
RINGERS LACTATE INFUS,TO 1000C 38.39
RISPERDONE CONSTA 50MG 4,154.36
RISPERIDONE 0.25 MG TAB 3
RISPERIDONE 0.5 MG TAB 3.97
RISPERIDONE 1 MG 2.74
RISPERIDONE 1 MG TAB 3.76
RISPERIDONE 2 MG TAB 3.02
RISPERIDONE 2 MG TAB 7.58
RISPERIDONE MICROPHER 25MG/2ML 2,132.94
RITUXAN HYALURONIDASE 10MG INJ 33,497.81
RITUXIMAB 100MG INJ 4,348.45
RITUXIMAB 100MG/10 ML 4,097.10
RIVAROXABAN (XARELTO) 10MG TAB 50.32
RIVASTIGMINE 4.6MG PATCH 45.22
RIVASTIGMINE TARTRATE 1.5MG C 3.33
RIVASTIGMINE TARTRATE 3 MG CAP 3.8
RIVASTIGMINE(EXELON) 9.5MG PAT 47.54
ROCEPHIN 500MG INJ 7.2
ROCURONIUM SYR 50MG/5ML 60.69
ROFLUMILAST 500MCG TAB 52.14
ROMIPLOSTIN INJ 10MCG 264.49
ROMIPLOSTIN INJ 10MCG WASTE 311.54
ROPINIROLE HCL 3
ROPINIROLE HCL 2MG 2.45
ROPIVACAINE 10MG/ML 15.77
ROPIVACAINE HCL 1MG INJ 21
ROPIVACAINE HCL 1MG INJ 30.67
SALINE NOSE SPRAY 45 ML 3.25
SENNA CONCENTRATE 1 TAB UD 3.38
SENNA CONCENTRATE/DOCUS TAB 2.9
SENNA SYRUP UDC 8.67
SENSORCAINE MPF W EPI 14.88
SERTRALINE 50 MG TAB 2.88
SILVER NITRATE STICKS 3
SILVER SULFADIAZINE 50 JAR 43.92
SIMETHICONE 40 MG/0.6 ML BOT 14.29
SINCALIDE INJ 5 MCG 457.82
SINEMET 25-100 UD TAB 3.16
SINEMET 25-250 UD TAB 3
SITAGLIPTIN PHOSPHATE 50MG 79.8
SODIUM BICAR TAB 650MG 6.05
SODIUM BICARBONATE 10 MEQ/10 57.47
SODIUM BICARBONATE 50 MEQ SYR 41.8
SODIUM BICARBONATE 50 MEQ/50ML 39.26
SODIUM CHL 0.9% 2000ML IRR BAG 45.67
SODIUM CHLORIDE 0.45% 1000 ML 10.32
SODIUM CHLORIDE 0.9% 100ML BAG 39.93
SODIUM CHLORIDE 0.9% 50 ML BAG 40.42
SODIUM CHLORIDE 0.9%50ML BAG 33.36
SODIUM CHLORIDE 10 ML SOL 8.37
SODIUM CHLORIDE 10 ML SYR 9.54
SODIUM CHLORIDE 10 ML VIAL 9.98
SODIUM CHLORIDE 1000 ML BAG 37.82
SODIUM CHLORIDE 100ML 29.91
SODIUM CHLORIDE 15 ML BOTTLE 16.47
SODIUM CHLORIDE 2% MURO 128 86.32
SODIUM CHLORIDE 25ML BAG 21.72
SODIUM CHLORIDE 3% 500ML 9.58
SODIUM CHLORIDE 30 ML VIAL 10
SODIUM CHLORIDE 3L IRRIGATION 45.66
SODIUM CHLORIDE 50 MEQ/20 ML 10.27
SODIUM CHLORIDE 500 ML BAG 22.12
SODIUM PHOSPHATE 3 MM/ML MM 62
SODIUM SULFACETAMIDE 15 ML BOT 170.7
SODIUM THIOS 12.5GM/50ML INJ 439.17
SOLU-MEDROL 125 MG/2ML VIAL 48.02
SOLU-MEDROL 40 MG/1ML VIAL 31.32
SOTALOL 80 MG CAP 4.81
SPIRONOLACTONE 25 MG TAB 2.99
STERILE H20 FOR INJ 10OOML 13.62
STERILE H2O FOR INJECTION 10ML 10
SUCCINYLCHOLINE 200 MG/10 ML 108.1
SUCCINYLCHOLINE CHL 200MG INJ 101.77
SUCRALFATE 1 GM LIQU 44.19
SUCRALFATE 1 GM TAB 2.9
SUGGAMADEX 500MG INJ 542.06
SULF HEXA LIPID MICROSPH INJ 669.77
SULFAMETHOXAZOLE 1 MG TAB 3
SULFASALAZINE E.C. 500 MG TAB 3.03
SUMATRIPTAN 100MG 3.36
SUMATRIPTAN 25MG 3.48
SUPARTZ/VISCO-3 INTRA-ART INJ 332.13
SYNVISC 1MG INJ 1,002.05
TACROLIMUS (PROGRAF) 0.5MG CAP 6.57
TAMOXIFEN CITRATE 10 MG TAB 3
TD VACCINE NO PRSRV >=7YRS IM 170.46
TDAP VACCINE >=7 YRS 0.5ML IM 204.51
TEMAZEPAM 15 MG CAP 2.92
TEMAZEPAM 30 MG CAP 2.96
TEMAZEPAM 7.5 CAP 16.86
TENECTEPLASE 50MG (TNKase) 27,144.40
TERAZOSIN 1 MG TAB 3
TERAZOSIN 2 MG TAB 2.94
TERAZOSIN 5MG CAP 2.89
TERBINAFINE HYDROCHLORIDE 1 AP 28.98
TERBUTALINE 1 MG/ML AMPULE 8.4
TESTOSTERONE CYPIONATE 1MG INJ 108.98
THEOPHYLINE 100MG CAP ER 24HR 10.88
THEOPHYLLINE 300 MG CAP 13.64
THEOPHYLLINE 400 MG TAB 5.48
THIAMINE (VIT B1) 200MG/2ML 15.55
THIAMINE 100MG TAB 2.69
THROMBINAR 10000 UNIT POWDER 316.12
THYROID 30 MG TAB 3
THYROID 60 MG TAB 2.52
TICE BCG 50MG VACCINE 694
TIMOLOL 0.25% 5 ML BOTTLE 18
TIMOLOL 0.5% BOTTLE 33.34
TIMOLOL MALEATE/DORZOLAM HCL 5 675.32
TIZANIDINE HCL 2 MG TAB 3.37
TIZANIDINE HCL 4 MG TAB 3.03
TOBRAMYCIN 3.5 GM TUBE OINT 973.38
TOBRAMYCIN 5 ML BOTTLE 19.23
TOBRAMYCIN UP TO 80MG INJ 3.33
TOBRAMYCIN/DEXAMETHASONE 2.5ML 224.99
TOCILIZUMAB 1MG INJ 32.12
TOCILIZUMAB 1MG INJ 34.35
TOCILIZUMAB 1MG INJ WASTE 24.59
TOPIRAMATE 100MG TAB 3
TOPIRAMATE 25 MG TAB 3.03
TOPOTECAN .1MG INJ 10
TOPOTECAN .1MG INJ WASTE 10
TORSEMIDE 10 MG (TAB ) 3.28
TORSEMIDE 20 MG (TAB) 3.03
TPA (ALTEPLASE) 1MG INJ 431.11
TPA 1MG INJ WASTE 429.01
TRACE ELEMENT 10 ML 58.35
TRAMADOL – 50 MG TAB 2.78
TRANEXMIC ACID 1000MG/10ML 46.19
TRANSDERM SCOP 1 PATCH 99.41
TRASTUZUMAB 10MG INJ 450.48
TRASTUZUMAB 10MG INJ WASTE 461.55
TRAVOPROST 0.004% 779.68
TRAZODONE 100 MG TAB 3.01
TRAZODONE 50 MG TAB 2.85
TRIAMCINALONE OINT 15 GM 16.04
TRIAMCINOLONE 40 MG/ML VIAL 62.52
TRIAMCINOLONE CREAM 0.025% 13.48
TRIAMCINOLONE CREAM 0.5% 31.6
TRIAMCINOLONE LOTION 0.1% 97.22
TRIAMTERENE + HCTZ 1 CAP 3
TRIAMTERENE/HCTZ 1 TAB 3.1
TRIHEXYPHENIDYL 2 MG TAB 3.04
TRIMETHOBENZAMIDE 100 MG/ML 164.44
TRIPLE ANTIBIOTIC OINTMENT 2.9
TROPICAMIDE EYE DROPS 23.74
TRYPAN BLUE 276.72
TUBERCULIN (PPD) 1 ML 0.1ML 30.05
URSODIOL 300MG CAP 21.97
USTEKINUMAB 1MG INJ 7,980.00
VALACYCLOVIR HC1 500MG 13.26
VALPROATE SODIUM 100 MG/ML VIA 10.82
VALSARTAN 160 MG CAP 4.26
VALSARTAN 80MG tab 9.19
VANCOMYCIN 125 MG CAP 31.41
VANCOMYCIN HCL 500MG INJ 15.69
VARENICLINE 1 MG TAB 35.85
VARICELLA VACCINE 0.5ML 475.64
VECURONIUM BR 10 MG VIAL 30.65
VEDOLIZUMAB 1MG INJ 132.2
VEETIDS 250 MG UD TAB 3.04
VENLAFAXINE 37.5 TAB 3.06
VENLAFAXINE 50 TAB 4.82
VENLAFAXINE HYDROCHL 150MG CA 2.99
VENLAFAXINE HYDROCHLORIDE 75MG 2.97
VERAPAMIL 120 MG TAB 3
VERAPAMIL 240 MG TAB 3.07
VERAPAMIL 80 MG TAB 3
VERAPAMIL SR 180 MG TAB 6.66
VERSED LIQUID 10MG/5ML UDC 29.42
VIIBRYD 10MG TAB (VILAZODONE) 38.92
VIIBRYD 20MG TAB (VILAZODONE) 23.94
VIIBRYD 40MG TAB (VILAZODONE) 43.3
VINBLASTINE SULFATE 1MG INJ 17.97
VINCRISTINE SULF 1MG 33.95
VISUALIZATION ADJUNCT 1MG INJ 761.77
VITAMIN A AND D 2 OZ TUBE OINT 10.8
VITAMIN B COMPLEX WITH C 1 CAP 2.98
VITAMIN B12 1000 MG 1 ML VIAL 20.6
VITAMIN C 500 MG TAB 2.99
VITAMINS MULTI THERAPUTIC 1TAB 2.99
VITAMINS MULTI W/MINERALS CAP 2.96
VITAMINS PRENATAL 1 TAB 2.49
VORTIOXETINE 10MG TAB 66.91
WARFARIN SODIUM 1 MG TAB 3.01
WARFARIN SODIUM 2 MG TAB 3.01
WARFARIN SODIUM 2.5 MG TAB 2.97
WARFARIN SODIUM 3MG TAB 3.02
WARFARIN SODIUM 5MG TAB 2.89
WITCH HAZEL 1 PAD CONTAINER 10.94
XARELTO (RIVAROXABAN) 15MG TAB 60.66
XARELTO (RIVAROXABAN) 20MG TAB 55.29
XGEVA(DENOSUMAB) 120MG/1.7ML V 10,340.90
ZEMURON (ROCURONIUM BROMIDE) 21.91
ZINC OXIDE 2 OZ TUBE OINT 6.22
ZIPRASIDONE HCI 40 MG 3.04
ZIPRASIDONE HYDROCHLO 80 MG CA 3.26
ZIPRASIDONE MESYLATE 20MG/ML I 118.66
ZITHROMAX 100MG/5ML 70.05
ZITHROMAX 200MG/5ML 70.02
ZITHROMAX 250 CAPS (AZITHROYCI 9.49
ZOFRAN INJ PER 4MG/2ML VIAL 2.5
ZOLEDRONIC ACID 1MG INJ 214.8
ZOLPIDEM 5 MG TAB 3
ZOPRASIDONE HC1 20MG CAPS 3
ZYPREXA 2 .5MG (OLANZAPINE) 3
ZYVOX 600MG 23.38

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