neshob general chargemaster 12/31/2018 description … · 2019-03-27 · neshob general...
TRANSCRIPT
NESHOB GENERAL CHARGEMASTER
12/31/2018
DESCRIPTION PRICE
GERO-PSYCHIATRY ROOM 620.00
PRIVATE ROOM 330.00
SWING BED ROOM RATE 165.00
KLING GAUZE 6 IN 035 17.00
CHEST DRAINAGE SY DO 189.00
SPINAL NEEDLE-DIS035 16.00
SUCTION TRAP DEE 035 25.00
IV EXTENSION TUBE 12.50
URINE COLLECTOR P035 9.00
VIT D 400 3.50
SUCTION CATHETER 035 9.00
PLATELETS CONCENTRATE 976.58
PROTEIN ELECTROPHORESIS S 75.00
LITHIUM 029 32.00
FUNGUS CULTURE SPUTUM 51.00
ALDACTONE TABS 5.50
T3 UPTAKE 16.00
T4 FREE 57.00
PHLEBOTOMY 029 460.00
CEA 029 61.00
VITAMIN B-12 029 86.00
FOLATE 029 43.00
VMA 029 54.00
CATECHOLAMINES URINE 54.00
FSH 029 43.00
AMOXIL 500MG CAPS 6.50
C REACTIVE PROTEI029 56.00
ABDOMINAL BINDER 035 50.00
AIR STRIP DRESSIN035 6.00
CATHETER FRENCH 035 26.00
SPINE ONE 143.00
IV INJECTION CAP 035 4.50
TRIGLYCERIDES 029 41.00
SPLINT FINGER MET035 16.00
TELFA STRIP SMALL035 9.00
SALEM SUMP TUBE 035 15.00
SHOULDER IMMOBILI035 188.19
STERILE WATER 100035 23.00
STERILE SALINE 31.00
SUCTION BTL/TUBE 20.00
MECLIZINE ANTIVERT TABLET 4.50
APRESOLINE TABLET 5.50
CREATININE CLEARANCE 96.00
TIBC 23.00
BONE AGE 143.00
ASPIRIN BABY CHEW 81MG 1.50
IV NSS 100CC 17.50
IV D5W 50 CC 8.00
PRIMARY ADD SET 2035 24.00
IV SECONDARY SET 18.00
ASPIRIN 5GR 325MG 1.50
BACTRIM DS TABS 6.50
BENADRYL 25MG CAPS 1.00
BENTYL 10MG CAPS 4.50
BENTYL 20MG TABS 4.50
INCENT. SPIRO. SUPPLIES 15.00
BEROCCA TABS 5.50
CT NECK W/WO CONT 1,210.00
US SCAN CHEST 249.00
CALAN TABS 5.50
CALAN 120MG TABS 7.00
CARAFATE 1GM TABLETS 6.50
CARDIZEM 30MG TABS 6.00
CARDIZEM 60MG TABS 7.00
CATAPRES 0.1MG TABS 5.00
CATAPRES 0.2MG TABS 5.50
CATAPRES TTS-1 53.50
CENTRUM TABLETS 4.50
EEG W/O 038 324.00
THEOPHYLLINE 029 52.00
GGTP 029 42.00
TSH 029 67.00
TESTOSTERONE FREE 69.30
PHENOBARITOL 029 52.00
DILANTIN TOTAL 54.00
LEAD LEVEL 029 41.00
IV D 51/2 5 250 C035 25.50
IV D 51/4 5 500 C035 31.50
IV D 51/4 5 250 C035 25.50
COGENTIN 0.5MG TABS 5.00
COGENTIN 1MG TABS 4.50
COLACE 100MG CAPS 4.50
COLCHICINE 0.6MG TAB 12.00
MAMMOGRAM DIAGNOSTIC BIL 210.70
STERNUM-2V 33.22
COMPAZINE 10MG TABS 5.50
CORGARD 40MG TABS 6.50
IV DIAL A FLOA 035 17.50
BETADINE SOL-DOUC035 10.00
IV D5W PIGGYBACK 21.00
IV OP SITE DRESSI035 4.50
ABD PAD 8 BY 7 1/035 5.00
AIR WAYS ALL SIZE035 9.00
ASEPTO SYRINGE-DI035 12.00
EXTERNAL CATH 6.00
CATHETER FOLEY 035 23.00
CATH FOLEY FULL KIT TRAY 57.00
CATHETER FRENCH TRAY 38.00
CATHETER SUCTION 035 9.00
OSTOMY BAGS BND R035 15.00
SUCT CONNECTING T035 11.00
DRESSING-ADHES6X4035 9.00
ENEMA FLEETS 035 13.00
ENEMA OIL 035 11.00
EYE PAD 9.00
GAUZE 4X4 STERILE 1.00
HIBRCLENS SOL 4 035 22.00
INDOFORM GAUZE 1"035 50.00
KLING GAUZE 2 IN 035 8.00
KLING GAUZE 3 IN 035 9.00
KLING GAUZE 4 IN 035 9.00
RIB BELT 035 110.00
T E D HOSE 88.00
SUTURE REMOVAL SE035 23.00
URINARY LEG BAG 035 24.00
URINE-CLEAN CTCH 035 17.00
URINE STRAINER 035 12.00
VASELINE GAUZE 3X9 11.00
VASELINE GUAZE 1X8 8.00
EKG HOLTER MONITOR SCANNI 362.00
KLING GAUZE 1 IN 035 9.00
BONE SCAN WHOLE BODY 673.00
DECADRON 0.75MG TABS 6.00
DELTASONE 10MG TABS 6.00
DELTASONE 20MG TABS 6.00
DEPAKOTE 250MG TABS 5.00
DESYREL 50MG TABS 5.50
HEPATOBILIARY 1,245.00
DIAMOX 250MG TABS 5.50
DILANTIN 100MG CAPS 4.50
DITROSPAN 5MG TABS 5.00
DULCOLAX TABS 6.00
DYAZIDE CAPS 5.00
ESKALITH 300MG CAPS 5.00
FERGON TABS 5.50
FERROUS SULFATE TABS 4.50
FLORINEF 0.1MG TABS 5.00
GLUCOTROL 5MG TABS 5.00
GLUCOTROL 10MG TABS 8.50
HALDOL .5MG TABS 5.50
HALDOL 1MG TABS 5.50
HALDOL 5MG TABS 6.50
HIPREX TABS 6.50
HYDREA 500MG CAPS 7.00
IMODIUM CAPS 6.50
INDERAL 10MG TABS 4.50
INDERAL 40MG TABS 5.50
INDOCIN 25MG CAPS 5.50
ISOSORBIDE TABLET 4.50
KEFLEX 500MG CAPS 8.50
K-LYTE 25MEQ 7.50
K-LOR 20MEQ 5.50
LANOXIN 0.125MG TABS 4.50
LASIX 20MG TABS 4.00
LASIX 40MG TABS 4.50
LOPRESSOR 50MG TABS 5.00
LOPRESSOR 100MG TABS 7.00
LEVSIN TABS 4.50
LIBRAX CAPS 7.50
INDAPAMIDE 1.25MG TAB 4.50
MACRODANTIN 50MG TAB 6.50
MACRODANTIN 100MG 6.50
MEGACE 40MG TABS 6.50
MEPHYTON 5MG TABS 5.50
MICRO-K EXTENCAPS 4.50
MOTRIN 400MG TABS 6.50
MYLICON-80 TABS 5.00
MICRO K 10 POTASSIUM 10 4.50
NAPROSYN 250MG TABS 7.00
NEPTAZANE 50MG TABS 5.50
NITROSTAT TABS 4.50
NOLVADEX 10MG TABS 7.00
OS-CAL 250MG TABS 4.50
OS-CAL 500MG TABS 4.50
PAMELOR 25MG CAPS 5.50
IV D 5 W 1000CC 8.00
IV D 5 W 500 CC 035 8.00
NORMAL SALINE SOLUTON INF 1.00
IV D 5/S 1000 CC 035 58.50
IV D 5/S 500 CC 035 31.50
NORM SALINE 1000ML IV 3.00
IV NORM SALINE 50035 31.50
IV NORM SALINE 25035 23.00
IV D 5 1/2 S 1000035 58.50
IV D5 1/2S 500 CC035 31.50
IV D 5 1/4 S 1000035 42.00
IV LAC RINGERS 1000ML 4.00
IV LAC RINGERS 50035 2.00
IV D5W 1000CC 8.00
IV D5LR 500ML 44.00
IV 1/2 N 5 1000 C035 42.00
IV VENTED SET 035 32.50
IV SMALL VEINSET23GA 11.50
IV ANGIO-CATH #14 21.00
IV ANGIO-CATH #16 21.00
IV ANGIO-CATH #18 20 21.00
IV ANGIO-CATH #22 24 15.00
PERIACTIN 4MG TABS 6.50
PERI-COLACE CAPS 5.00
PEN-VEE-K 500MG TABS 5.50
PRONESTYL 500MG CAPS 7.00
PROPADRINE 50MG TABS 5.00
PROPYLTHIOURICIL TAB 5.00
PROSTAPHLIN 250MG 7.00
PYRIDIUM 100MG TABS 5.00
PYRIDIUM 200MG TABS 5.00
PHAZYME 125 TABS 5.00
REGLAN 10MG TABS 5.50
SYNTHROID TABLET 5.00
TEGRETOL 200MG TABS 6.50
TENORMIN TABLETS 7.00
TESSALON PERLES 5.00
URECHOLINE 10MG TABS 6.00
TRANDATE 200MG TABS 6.00
TRENTAL 400MG TABS 5.50
VIBRAMYCIN TABLET 7.00
VITAMIN B-6 50MG TAB 5.00
ZYLOPRIM 100MG TABS 6.00
ZYLOPRIM 300MG TABS 5.50
VENTOLIN TABLET 5.50
VITAMIN D TABLET 4.50
HYDROXYZINE 25MG CAP 4.50
HYDROXYZINE 50MG CAP 5.00
ADRENALIN 1:1000 INJ 26.00
AMINOPHYLLINE INJ. 26.00
APRESOLINE 20MG INJ 25.50
AQUA-MEPHYTON 10MG 20.50
ARISTOCORT FORTE INJ 35.00
ATROPINE .4MG 20ML 26.00
ATROPINE.4MGINGSYRIN 33.50
BENADRYL 50MG INJ. 6.00
THIAMINE 100MG INJ 26.00
BENTYL 10MG INJ 65.50
CAL GLUCONATE INJ 18.50
CELESTONE SOLU 5CC 28.00
CYANOCOBALAMIN INJ 18.50
COGENTIN 2MG/2ML INJ 295.00
DECADRON INJECTION 26.00
PHENERGAN 25MG TABS 5.00
CHILDREN'S CHEWABLE VITAM 5.00
GLUCOSE SERUM 29.00
BUN 029 27.00
CREATININE 029 40.00
BILIRUBIN TOTAL 28.00
BILIRUBIN DIRECT 029 42.00
AMYLASE 029 58.00
CHOLESTEROL 029 40.00
CALCIUM 029 40.00
PHOSPHORUS 029 58.00
URIC ACID 029 58.00
SODIUM SERUM 029 26.00
POTASSIUM SERUM 26.00
CHLORIDE 029 30.00
BICARDONATE CO2 029 28.00
SGOT 41.00
ALKALINEPHOSPHATASE 32.00
SGPT 029 57.00
CPK 029 67.00
LDH 029 42.00
DIGOXIN 029 73.00
PROTEIN TOTAL SERUM 42.00
ALBUMIN--SERUM 42.00
PROTHROMBIN TIME 029 27.00
MONO TEST 42.00
CKMB 67.00
PTT 029 42.00
RIMACTANE 300MG CAPS 8.50
ROBAXIN 750MG TABS 5.00
ROBAXIN 500MG TABS 6.50
SENOKOT S TABS 5.00
SEPTRA TABS 5.50
SINEQUAN 50MG CAPS 6.00
SINEMET 10/100 TABS 6.00
SINEMET 25/100 TABS 6.50
SINEMET 25/250 TABS 7.00
SODIUM BICARB TABS 5.00
THEO 24 CAPSULES 5.50
THEODUR TABLET 5.00
THERMOTABS 5.00
TOFRANIL 25MG TABS 5.50
TRINSICON CAPSULES 5.00
VITAMIN B-12 TABS 5.00
VITAMIN E 400IU CAPS 4.50
ZANTAC 150MG TAB 4.00
ZAROXOLYN TABLET 6.50
ZOVIRAX 200MG CAPS 6.50
AMITRIPTYLINE TABLET 4.50
CHLORTHALIDONE 25MG 5.00
HCTZ 25MG TABS 4.50
HYDROXYZINE 10MG TAB 5.00
ASPIRIN TABLET E C 4.50
DEPO-MEDROL 40MG INJ 35.00
BRETHINE 1MG/ML INJ 82.00
COMPAZINE 5MG/ML10CC 20.50
DILANTIN 100MG INJ 31.00
EPHEDRINE SULFATE IM 20.50
FOLVITE 5MG/ML INJ 26.00
GLUCAGON INJ 177.50
HEPARIN SOD.1000U/ML 18.50
HEP-LOCK 100U 13.50
HALDOL 5MG/ML INJ 25.50
LANOXIN AMPS 18.50
LASIX INJECTION 20MG 18.50
DILANTIN 250MG INJ 31.00
KENOLOG-40MG INJ. 31.00
KETALAR 100MG INJ. 71.00
LASIX INJECTION 100MG 31.00
LEVOPHED 4MG/4ML INJ 61.00
SENSORCAINE INJ 26.00
NARCAN 0.4MG/ML 31.00
NEO-SYNEPHRINE INJ 28.00
NORFLEX 2CC INJ 35.00
NUBAIN INJ 26.00
PHENERGAN INJ 30.00
POTASSIUM CHLOR20MEQ 18.50
POTASSIUM CHLOR40MEQ 18.50
REGLAN INJECTION 25.50
ROBAXIN INJ 10CC 95.00
ROBINUL 1CC INJ 26.00
SOLU-CORTEF 100MG IM 25.50
SOLU MEDROL INJ 41MG-12 71.50
ATARAX 10MG/5ML PER DOSE 10.00
BENADRYL ELIXER 25MG/10 P 4.00
DECADRON ELIXER PER DOSE 10.00
ROBITUSSIN DM PER DOSE 4.00
CORTISPORIN OPTH SUSP 198.00
EYE-STREAM 18.50
FML LIQUIFILM 5ML 31.00
GARAMYCIN OPTH. OINT 35.50
GARAMYCIN OPTH. SUSP 35.50
LACRI-LUBE SOP 20.50
MAXITROL OPTH. SUSP. 34.50
MYDRIACYL 1% OPTH. 59.50
PILOCAR 4% OPTH SOL 37.00
CORTISPORIN OTIC SUS 33.50
DEBROX OTIC 19.00
RPR 27.00
SOLU MEDROL INJ 1MG-40M 25.50
RA TEST 029 35.00
ANA 79.00
LOPRESSOR 5MG/ML INJ 26.00
CHLORPROMAZINE 50MG/ML 26.00
HYDROXYZINE INJ 26.00
VITAMIN B-12 CYNOCOBLMN 1 60.00
XYLOCAINE W/EPI INJECTION 26.00
XYLOCAINE MPF 1 OR 2% VIA 21.00
TRANDATE 100MG INJ 88.50
NTG-50MG PREMIX 90.00
FERROUS SULFATE LIQ PER D 10.00
HYCODAN SYRUP PER DOSE 4.00
KAOPECTATE 4OZ. 21.00
LEVSIN DROPS 24.00
IMODIUM ORAL SOL 2MG/10ML 4.00
MAGNESIUM CITR OS 9.00
LIDOCAINE VISCOUS 2% PER 10.00
DIMETAPP LIQ PER DOSE 20M 4.00
DECADRON .1% OPTH. 38.00
ILOTYCIN 5MG OPT OIN 20.50
AFRIN NASAL SPRAY 15.50
MUCOMYST 20% 60.50
NEO-SYNEP 1/2% SPRAY 19.50
GENTEAL LUBRI EYEDROPS 35.00
TIMOPTIC 0.5% 10ML 49.50
TIMOPTIC 0.25% 5ML 47.00
DESITIN OINT. 16.00
ARISTOCORT 1% CR. 36.50
BACITRACIN OINT 15GM 22.50
URINALYSIS W/MICRO 35.00
HCG URINE 52.00
CREATININE URINE 56.00
BLOOD OCCULT, STOOL DIAGN 20.00
OVA CYSTS PARASIT029 42.00
NEOSPORIN OINT. 30GM 18.50
NEOSPORIN PKTS. 3.00
NYSTATIN OINT 16.00
POLYSPORIN OINT. 1OZ 18.00
AMOXIL 125MG SUSP 28.00
NYSTATIN SUSP 60ML 59.00
NYSTATIN ORAL SUSP PER DO 10.00
BETADINE PINT (OWC) 3.00
MYCOSTATIN POWDER 113.00
BICILLIN LA 600000 120.00
BICILLIN LA 1.2MU 120.00
BICILLIN CR 600000 120.00
BICILLIN CR 1.2MU 120.00
ASA 5GR SUPP 6.50
ANECTINE INJ. 26.00
TD FOR OVER 7 YRS OLD 124.00
FLUARIX QUAD 2017-2018 50.00
LIDOCAINE INJECTION 25.50
LIDOCAINE 2% 100MG BOLUS 35.00
ACTIV CHARCOAL 50GMS 40.50
AMPICILLIN INJ 33.50
CLEOCIN INJ 150MG/ML 58.00
GENTAMICIN INJECTION 20.50
LINCOCIN INJECTION 35.00
ANCEF INJECTION CEFAZ 39.00
MEFOXIN 1GM INJ 54.00
NAFCIL 1GM INJ 28.00
XYLOCAINE 2% JELLY 33.50
ZINC OXIDE OINT. 16.00
CROSSMATCH IMMEDIATE SPIN 129.60
ANTIBODY SCREEN 76.07
DIRECT COOMBS 187.68
BLOOD TYPING ABO 114.11
MILK OF MAGNESIA30ML 6.00
METAMUCIL ORAL PACKET PER 4.00
DULCOLAX SUPP. 6.00
MAALOX ALAMAG 19.50
SILVADENE CR. 400GMS 165.50
SILVADENE CR. 50GMS 35.00
TRANSDERM SCOP PATCH 13.50
ACETAMINOPHEN SUPPOSITORY 6.00
ANUSOL HC SUPP 6.00
MVI 12 20.00
GLYCERIN ADULT SUPP 6.00
GLYCERIN INFANT SUPP 6.00
PHENERGAN 25MG SUPP. 6.00
PREVNAR PNEUMONIA VAC 23 142.01
T.B. SKIN TEST 126.65
BACID 6.00
DEXTROSE 50% INJ 25.50
SOD BICARB 50ML INJ 25.50
CALCIUM CHLOR 10%INJ 35.00
EPINEPHINE 1MG INJ 35.00
VIBRAMYCIN 100MG INJ 64.50
IV NS PIGGYBACK 28.50
FLAGYL 500MG IV IP 61.00
ROCEPHIN INJECTION 551M 99.50
ROCEPHIN INJECTION 251-5 52.50
ROCEPHIN INJECTION 0-250 20.00
VANCOCIN INJECTION 91.00
ATIVAN 1MG TAB 5.50
CBC W/DIFF 52.00
HEMOGLOBIN 029 19.00
HEMATOCRIT 029 19.00
WBC 029 19.00
RETIC, AUTOMATAD 32.00
SEDIMENTATION RAT029 28.00
SICKLE CELL PREP 029 39.00
LOMOTIL 2.5MG TAB 5.00
ATIVAN 0.5MG TAB 5.00
PHENOBARB 30MG TABS 6.00
RESTORIL 15MG CAPS 5.00
RESTORIL 30MG CAPS 5.00
TRANXENE 3.75MG TABLET 5.50
TRANXENE 7.5MG TABLET 7.50
TYLENOL #3 TABS 6.50
VALIUM 5MG TABS 5.00
RITALIN 5MG TABS 5.00
SUBLIMAZE 2ML INJ. 35.00
NEB/MDI TREATMENT 273.42
HANDHELD NEB EQUIP 18.00
PULM FUNCT BRONC INTERP P 25.34
AMMONIA 029 61.00
STOOL FOR WBC 28.00
C PEPTIDE 029 158.00
C4 ANTIGEN 78.00
CLOSTRIDUM TOXIN 029 73.00
CORTISOL TOTAL 56.00
EBV EBNA IGG 67.00
ESTRADIOL 029 79.00
FERRITIN 029 43.00
IRON 029 42.00
INSULIN 029 69.00
KETONES SERUM QUALITATIVE 27.00
LH 029 54.00
LIPASE 029 55.00
MAGNESIUM 029 58.00
OSMOLARITY URINE 40.00
PTH - INTACT 120.00
PROGESTERONE LEVE029 50.00
PROLACTIN 029 61.00
ROTAVIRUS 029 54.00
RSV 49.00
TEGRETOL LEVEL 029 52.00
VALPROICACIDDEPAK029 62.00
VIRAL CULTURE 029 125.00
WET MOUNT 33.00
ROCEPHIN INJECTION 1.1G 183.00
INSULIN 25.50
INDUSTRIAL DRUG SCREEN (C 35.00
1-2 NERVE COND STUDIES 238.29
3-4 NERVE COND STUDIES 277.22
RITUXIMAB C INJ 100 MG (O 3,845.00
FEEDING TUBE ADAPTER 14.00
THYROID UPTAKE SINGLE OR 418.50
IOBAN DRAPE 18.00
5MM X 23MM HARMONIC SHEAR 1,035.00
EZ IO 45MM NEEDLE 172.50
THYROID IMAGING INCL VASC 423.00
THYROID IMAGING INCL VASC 418.50
PEG 24 PULL 442.50
EZ STABILIZED 16.00
INDIVIDUAL PSYCHOTHERAPY 209.74
INDIVIDUAL PSYCHOTHERAPY 118.56
GROUP PSYCHOTHERAPY 118.56
FAMILY THERAPY WITH PATIE 209.74
FAMILY THERAPY WITHOUT PA 209.74
IV PUSH SEQUENTIAL SAME D 35.49
PCSD PT THERAPY (CONTRACT 75.00
PCSD PT EVALUATION 125.00
SIGMOIDSCOPY W/POLYPECTOM 1,755.20
CONTINUOUS NEB 1ST HOUR 197.63
EZ IO NEEDLE SET 150.00
K-WIRE 7.90
VALIUM 10MG INJ. 35.00
EKG COMPUTER 117.71
XANAX 0.25MG TABS 5.00
XANAX 0.5MG TABS 7.50
DEMEROL INJ 26.00
DILAUDID 2MG TAB 5.50
DILAUDID INJECTION 18.50
MORPHINE INJECTION 26.00
PERCOCET-5 TABS 5.00
MORPHINE 30MG TABS 5.50
COGN LING TRTM PER DAY 39.00
STAPLES/SKIN 000 11.00
STAPLE EXTRACTOR 035 23.00
NORCURON INJ 80.50
TRANSPARENT DRESS035 8.00
SKULL AP/LAT 148.00
FLAGYL 500MG TABS 7.00
SOMA TABLETS 6.50
VERSED INJ. 43.50
MOTRIN 800MG TABS 7.50
GENTAMYCIN 55.00
HGB A1C 73.00
DELTASONE 5MG TABS 4.50
DIABETA 5MG TABS 5.50
FLAGYL 250MG TABS 9.50
FLEXERIL 10MG TABS 6.50
FOLIC ACID 1MG TABS 6.00
AUGMENTIN 500MG TABS 9.50
MAG SULFATE INJ 18.50
LASIX 80MG TABS 5.00
CAPOTEN 12.5MG TABS 5.50
XANAX 1MG TABS 8.50
VENTIL CIRCUIT DISP 33.00
DEPO-MEDROL 80MG INJ 31.00
LOTRISONE CR. 15GM 63.00
HIV 73.00
PEPCID 20MG TABS 8.00
MYOGLOBIN 79.00
LIDOCAINE 1GM/250CBG 34.50
J P DRAIN 72.00
SILVER NITRATE STICK 3.00
ALDOSTERONE 215.00
AFP TUMOR MARKER 61.00
CARBON MONOXIDE 77.00
DHEA SULFATE 67.00
GTT-1ST 3 SPEC 101.00
GAMMAGLOBULIN IGA 20.51
GAMMAGLOBULIN IGG 20.51
GAMMAGLOBULIN IGM 20.51
METANEPHRINES TOTAL 54.00
VITAMIN D 25-HYDROXY 83.00
KAYEXALATE 120ML 31.50
ABDOMEN 2 VIEWS XR 238.00
ABDOMEN 1 VIEW XR 148.00
ANKLE LT-MIN 3V 134.00
FOREARM LT-2V 134.00
CHEST 2 VIEWS XR 137.00
CLAVICLE LEFT 131.00
COCCYX/SACRUM MIN 2V 180.00
ELBOW LT 2V 134.00
WRIST LT-2V 126.00
FOOT LEFT-2V 126.00
UPPER GI SERIES 294.00
UGI W/SMALL BOWEL 319.00
BARIUM ENEMA 030 XR 301.00
BARIUM SWALLOW XR 249.00
HIP W/PELVIS LT 2-3 V 153.00
KNEE LT 1/2 V 148.00
TIB/FIB LT-2V 148.00
FEMUR LT-2V 134.00
PELVIS 1/2 V 148.00
IVP 832.00
RIBS LT-2V 153.00
SHOULDER LT-MIN 2V 134.00
SINUSES MINIMUN 3 VIEWS 152.00
SKULL SERIES COMP-MIN 4V 283.00
CERVICAL SP COMP >/= 4 V 245.00
LUMBOSACRAL SP/COMP-MIN 4 245.00
FLUOROSCOPY 171.00
FACIAL >/= 3V 211.00
RENNIN 029 67.00
INDERAL LA 60MG CAPS 5.50
CLAFORAN 1GM INJ 68.00
FCMA BMP 140.00
FCMA CBC 52.00
FCMA INFLUENZA A 49.00
FCMA RSV 49.00
FCMA RAPID STREP 43.00
FCMA URINALYSIS W/MICROSC 35.00
CT ABDOMEN ANGIOGRAPHY 1,954.00
CT PELVIS ANGIOGRAPY 1,954.00
DXA BONE DENSITY STUDY 270.00
FACTOR V, GEL SEPARATION 125.00
RIBS BIL 3V 180.00
LMA 105.00
CHEST 1 VIEW XR 104.00
UROSTOMY POUCH 2 1/4 6.98
AQUATIC THERAPY W/THERAPE 59.22
ECHO W/DOPPLER AND COLOR 824.00
OUTPATIENT/FU ER VISIT 180.00
INTUBATION W/WO GLIDESCOP 213.16
OUTPATIENT VISIT 180.00
STANDARDIZED COGN PERFORM 168.00
2.7 LOCKING SCREW 125.00
DRILL BIT 220.00
SCOLIOSIS STUDY 556.00
SOFT TISSUE NECK 167.00
HOGNOSE SUCTION DEVICE 40.00
IV INF SEQ DIAG/THER/PROP 300.00
INDUSTRIAL BREATH ALCOHOL 25.00
FCMA PT/INR 27.00
DEBRIDE SUBCUT TISSUE 20 1,375.00
DEBRIDE BONE 1ST 20 SQ CM 4,710.00
VENTRIO MESH 1,131.00
PLATE MED MPJ 208.00
CORTISOL; FREE 32.61
CT ORBIT W/WO 1,294.00
AQUATIC THERAPY W/THERAPE 59.22
ANTISCLERODERMA 70 ANTIBO 44.00
ANIT SS A 44.00
ANTI SS B 44.00
CT CHEST ANGIOGRAPHY 2,150.00
NASAL BONE-MIN 3V 188.00
TRACH CARE KIT 10.00
DEBRIDE BONE EA ADD 20 SQ 10.00
DEBRIDE WATER JET WO SUCT 1,130.00
MASSAGE 15 MIN 036 93.00
ULTRASOUND 15MIN 93.00
THERAPEUTIC EXERCISE 15MI 84.00
NEURO MUSCULAR RE ED - EA 83.00
ELECTRICAL STIMUL036 75.00
GAIT TRAINING 15MIN 68.00
CULTURE, GROUP A STREP 15.00
EPISTAXIS CATH 133.00
SUFENTA INJ. 43.50
INDERAL LA 80MG CAPS 7.00
ESTRACE 2MG TABS 5.00
HCG SERUM 52.00
VASOTEC TABLET 7.00
ELECT PEN HT DISP 17.00
THROMBOSTAT KIT 264.00
SALINE NOSE DROPS 9.50
CALAN 240MG SR TABS 6.50
TOBRADEX 0/5 2.5ML 105.00
ATROPINE 1% OPT SOL 25.00
LASIX INJECTION 40MG 25.50
BUSPAR 5MG TABS 5.50
CATAPRES 0.3MG TABS 6.50
ZANTAC 300MG TABS 9.00
SOFT WICK DRAIN SPON 7.00
AZACTAM INJ 121.50
OXYGEN SUPPLIES 28.00
OXYGEN PER HOUR 038 14.00
BLOOD GAS ANALYSIS 123.00
PULM FUNCT SINGLE 241.92
PULM FUNCT BRONC 391.86
ALBUTEROL 0.083%/3ML 13.00
AEROSOL MASK 038 16.00
TRACH MASK 038 14.00
NASAL CANNULA 14.00
VENTI MASK 038 17.00
AQUA PAK 038 22.00
FCMA INFLUENZA B 49.00
NUCC INFLUENZA B 49.00
NIMA INFLUENZA B 49.00
NUCC BMP 140.00
NIMA BMP 140.00
NUCC CBC 52.00
NIMA CBC 52.00
NUCC H.PYLORI QUALITATIVE 61.00
CYTOTAC 200 MCG TAB 6.50
STOCKINETTE 14.00
NIMA H.PYLORI QUALITATIVE 61.00
NUCC HCG SERUM 52.00
NUCC INFLUENZA A 49.00
NIMA INFLUENZA A 49.00
NUCC PT/INR 27.00
NIMA PT/INR 27.00
NUCC RAPID STREP 43.00
NIMA RAPID STREP 43.00
NUCC RSV 49.00
NIMA RSV 49.00
NUCC URINALYSIS W/MICROSC 35.00
SKILLED AND SB PT THERAPY 75.00
SKILLED AND SB OT THERAPY 75.00
SKILLED AND SB SPEECH THE 75.00
NIMA URINALYSIS W/MICROSC 35.00
NUCC WET PREP 33.00
ANTI STREPTOLYSIN 0 30.00
NIMA WET PREP 33.00
DEBRIDEMENT OPEN WOUND (O 1,130.00
TISSUE EXAM BY PATHOLOGIS 84.00
TISSUE EXAM BY PATHOLOGIS 106.00
DECALCIFY TISSUE 40.00
SPECIAL STAINS GROUP 2 123.00
CHEM CAUTERIZATION GRAN T 766.00
APPLICATION UNNA BOOT (OW 700.00
LACERATION TRAY DISP 37.00
INF AGENT DET NUCLEIC ACI 71.70
ENDOMYSIAL AB, IGA 54.71
POLYSOM INITIAL 6YRS> W 4 1,458.32
W/MED/SURG SUPPLIES GENER -
POLYSOM CPAP 6YRS> W4> 1,458.32
ARM SLING 10.00
JURGAN PIN BALL 1.26
LUMBAR PUNCTURE TRAY 25.00
CINCINNATI STITCH CUTTER 12.00
THORACENTESIS TRAY 65.00
AMBU BAG 15.00
SURGICEL FIBRILLAR 1X2 105.00
SURGICEL ORIGINAL.5X2 90.00
SURGIFOAM 95.00
CT ABD AND PELVIS W/O CON 1,625.00
CT ABD AND PELVIS W CONTR 2,014.00
CT ABD AND PELVIS W W/O C 2,534.00
SKILLED NURSING HOME ROOM 165.00
LEVETIRACETAM (KEPPRA) 50.00
TUBERCULOSIS TEST; QUANTI 126.65
IV PUSH SEQUENTIAL SAME D 35.49
MWT/MSLT 1,458.32
ATROPINE 1 CC 034 24.00
ANESTHESIA CIRCUI034 55.00
ENDO TUBES 034 42.00
INFLIXIMAB/REMICADE INJ 1 410.00
IRRIGATION IMPLANT VENOUS 280.00
CHEMO ADM IV INF TECH EA 215.00
BASIC METABOLIC PANEL (OI 140.00
VENIPUNCTURE (OIT) 15.00
RECOVERY ROOM FIRST 30 MI 250.00
FIBERCON TABS 2.50
SLEEP STUDY UNATT REC HEA 217.64
INJ FACET JOINT CER/THOR 2,016.18
INJ FACET JOINT CER/THOR 2,016.18
REM DEVITALIZED TISSUE FR 590.00
EVAL OF SPEECH SOUND PROD 195.00
EVAL SPEECH SOUND W/EVAL 273.98
CYCLIC CITRULLINATED PEPT 26.43
INJECT ANESTHETIC AGAENT 490.79
INJ PARAVERTEBRAL FACET J 517.14
ANESTHESIA FIRST HOUR 1,295.00
ANESTHESIA EACH ADD 15 MI 323.75
INJECT ANESTHETIC AGENT F 490.80
IV INFUSION HYDRATION EA 155.00
DEXAMUTHASONE INJ 1 MG (O 24.00
CEFEPIME INJ 500 MG (OIT) 18.00
HEPARIN LOCK FLUSH PER 10 2.00
LEVOFLOXACIN INJ 250 MG ( 48.00
BENDAMUSTINE HCI (BENDEKA 117.00
CURETTE (OWC) 50.00
BACTROBAN (OIT) 13.00
DEST BY NEUR AG PARAV FAC 2,285.26
DEST BY NEUR AG PARA FAC 4,570.50
DEST BY NEUR AG PARAV FAC 2,285.26
IV CUBICIN 1 MG (OIT) 4.00
IV INFUSION INIT 1ST HR ( 870.00
DEST BY NEUR AG PARAV FAC 4,570.50
DBX PUTTY .5ML 286.00
OCTAGAM INJ 500 MG (OIT) 212.00
IV PUSH INITIAL/SINGLE (O 304.00
TUOHY EPIDURAL NEEDLE 18G 30.00
W/MEDICAL SURGICAL SUPPLI -
W/MINOR SURGERY OPERATING -
W/DRUGS REQUIRING IDENTIF -
W/TREATMENT ROOM -
INJ PARAV FACET JT LUM/SA 2,049.60
INJ PARAV FACET JT LUM/SA 1,024.80
INJ PARAV FACET JT LUM/SA 1,024.80
OP HOSPITAL VISIT (OWC) 515.00
VANCOMYCIN INJ 500 MG (OI 17.00
OP LEVEL II NEW PATIENT P 103.00
OP LEVEL III NEW PATIENT 150.00
OP LEVEL IV NEW PATIENT P 230.00
OP LEVEL I EST PATIENT PH 30.00
OP LEVEL II EST PATIENT P 60.00
OP LEVEL III EST PATIENT 125.00
OP LEVEL IV EST PATIENT P 150.00
CHEM CAUTERIZATION GRAN T 766.00
DEBRIDE BONE 1ST 20 SQ CM 574.00
DEBRID MUSC/FASCIA 1ST 20 314.00
DEBRIDE MUSC/FASCUA EA AD 102.00
DEBRIDE SUBCUT TISS 20 SQ 117.18
DEBRID SUBCUT TISS EA ADD 57.00
DEBRID WATER JT WO SUCT O 1,130.00
DEBRIDE WATER JET EA ADD 35.00
SLEEP STUDY DIAG INCOMPLE 1,458.32
GAUZE IMPREG W/OTHER 46-4 150.00
MOBILITY CURRENT STATUS 0.01
MOBILITY CURRENT STATUS 0.01
MOBILITY GOAL STATUS 0.01
MOBILITY GOAL STATUS 0.01
MOBILITY D/C STATUS 0.01
MOBILITY D/C STATUS 0.01
BODY POS CURRENT STATUS 0.01
BODY POS CURRENT STATUS 0.01
BODY POS GOAL STATUS 0.01
BODY POS GOAL STATUS 0.01
BODY POS D/C STATUS 0.01
BODY POS D/C STATUS 0.01
CARRY CURRENT STATUS 0.01
CARRY CURRENT STATUS 0.01
CARRY GOAL STATUS 0.01
CARRY GOAL STATUS 0.01
CARRY D/C STATUS 0.01
CARRY D/C STATUS 0.01
SELF CARE CURRENT STATUS 0.01
SELF CARE CURRENT STATUS 0.01
SELF CARE GOAL STATUS 0.01
SELF CARE GOAL STATUS 0.01
SELF CARE D/C STATUS 0.01
OTHER PT/OT CURRENT STATU 0.01
OTHER PT/OT GOAL STATUS 0.01
OTHER PT/OT D/C STATUS 0.01
SUB PT/OT CURRENT STATUS 0.01
SUB PT/OT CURRENT STATUS 0.01
SUB PT/OT GOAL STATUS 0.01
SUB PT/OT GOAL STATUS 0.01
SUB PT/OT D/C STATUS 0.01
SUB PT/OT DC/ STATUS 0.01
SWALLOW CURRENT STUDY 0.01
SWALLOW GOAL STATUS 0.01
SWALLOW D/C STATUS 0.01
MOTOR SPECH CURRENT STATU 0.01
MOTOR SPEECH GOAL STATUS 0.01
MOTOR SPEECH D/C STATUS 0.01
PFT INTERP SINGLE 20.00
ALPHA 1-PROTEINASE INHIB 23.00
IND DRUG SCREEN NATL (CON 25.00
SILVER ANTIMICROBIAL WOUN 46.00
SPLASH CAP WOUND IRRIGATO 12.00
INTRODUCER BOUGIE 30.00
DOT BLOOD GAS ANALYSIS (C 32.00
DOT ARTERIAL PUNCTURE 10.00
IV D5W 500 CC (OIT) 30.00
HYDOGEL DRESS WOUND FIL G 30.00
CEFAZOLIN SODIUM INJ 500M 132.00
IV PRIMARY SET INFUSION S 3.00
NATALIZUMAB INJ 1MG (OIT) 90.00
MEPOLIZUMAB INJ 1MG (OIT) 120.00
ALGINATE/FIB GEL DRESS WO 162.00
PALONOSETRON HCL 25 MG ( 46.00
CARBOPLATIN 50MG (OIT) 111.00
PEMETREXED 10MG (OIT) 118.00
TERAHONEY 23.00
BORTEZOMIB INJ O.1 MG (OI 234.00
EXUDERM HYDROC DRSG 16 SQ 28.00
IV INFUSION INITIAL 1ST H 304.00
IV INFUSION THER/DIAG/PRO 200.00
IV INF SEQ DIAG/THER/PROP 300.00
OBS IV INFUSION CONCURREN 145.25
IV PUSH EA SEQUENTIAL NEW 215.00
ACHR, BINDING ANTIBODY 67.00
ACHR, BLOCKING ANTIBODY 67.00
STRIATIONAL ANTIBODIES 54.71
CL TREATMENT RADIAL SHAFT 337.22
ERP CL TREAT RAD SHAFT FR 457.30
RADIUS PLATE VA-LCP 2.4MM 3,386.00
LOCKING SCREW VA 2.4MM 432.00
TAPPING SCREW CORTEX SLF 122.00
DRILL BIT 2.0MM 252.00
DRILL BIT DEPTHMARK 1.8MM 484.00
BIOMET INDIANA TOME 432.00
TRIMAL ANKLE FR CL W MAN 2,054.42
ERP TRIM ANK FR CL W MAN 798.28
BOVIE PAD DISP 035 38.00
LAP SPONGES 035 38.00
PENROSE DRAIN 035 11.00
SUTURES PKG 035 23.00
SUCTION ORAL TIP 035 9.00
PATHOLOGY REVIEW SLIDE 32.00
VITAMIN C TABLET 4.50
IBUPROFEN 200MG TABLET 5.00
REGLAN 5MG TABS 5.00
SLOW-MAG TABS 4.50
HYTRIN TERAZOSIN CAPSUL 6.50
PROCTOCREAM HC 1OZ 52.50
LOTENSIN TAB 20MG 5.00
ANES COMPLICATED BY EMERG 53.62
INJ FACET JOINT CERV/THOR 512.40
INJ FACET JOINT CERV/THOR 1,024.80
SWITCH DRAPE 88.00
INDIVIDUAL PSYCHOTHERAPY 209.74
THERAPY DIAGNOSTIC EVAL 209.74
THERAPY FOR CRISIS FIRST 209.74
CERVICAL EPIDURAL W/IMAGI 1,004.85
OTO-RHINO FOREIGN BODY RE 175.00
COUMADIN TABLETS 6.50
DEST BY NEURO AGE PARAVER 2,285.25
DEST BY NEURO AGE PARAVER 2,285.25
DEST BY NEURO AGENT PERIP 1,024.80
IV INFUSION INIT 1ST HR 304.00
LUMBAR EPIDURAL W/IMAGING 1,004.85
ELECTROLYTE PANEL (OIT) 66.00
MEROPENUM/MERREM 100MG (O 120.00
ZOFRAN PER 4MG INJ (OIT) 5.00
INJ ANES OTHER PERIPHERAL 559.14
INJ ANES OTHER PERIPHERAL 838.71
INJ ANES OTHER PERIPHERAL 559.14
INJ ANES OTHER PERIPHERAL 838.71
LOW COMPLEXITY EVAL 150.66
MOD COMPLEXITY EVAL 150.66
HIGH COMPLEXITY EVAL 150.66
LOW COMPLEXITY EVAL 146.30
MOD COMPLEXITY EVAL 146.30
HIGH COMPLEXITY EVAL 146.30
CPK (OIT) 67.00
NORMAL SALINE 250 CC (OIT 30.00
PEGFILGRASTIM/NEULASTA 6M 14,605.00
CHEMO IV PUSH INITIAL/SIN 870.00
ENTYVIO PER 1MG (OIT) 85.00
LEUPROLIDE ACETATE INJ 3. 5,122.80
ADM PNEUMONIA VACCINE 80.31
INJ TRIGGER POINT ONE OR 303.30
INJ SMALL JOINT 303.30
INJ MAJOR JOINT 345.00
PERCUT KYPHOPLASTY THOR 11,849.56
CRANIAL 350.00
CERVICAL EPIDURAL 1,004.85
INJ INTERMEDIATE JOINT 303.30
LUMBAR EPIDURAL 1,004.85
LANG EXPRESS CURRENT STAT 0.01
LANG EXPRESS GOAL STATUS 0.01
LANG EXPRESS D/C STATUS 0.01
MEMORY CURRENT STATUS 0.01
MEMORY GOAL STATUS 0.01
MEMORY D/C STATUS 0.01
IMPLANT NEUROSTIMULATOR/E 7,997.25
ATIVAN INJ. 31.00
UNASYN INJECTION 3MG 71.50
UNASYN INJECTION 1.5MG 35.50
REMOVE SPINE ELECTRODE PL 3,193.22
INJ ANESTHETIC LUMBAR/SAC 981.58
INJ ANES FACET JOINT/NERV 1,034.27
INJ ANES FACET JOINT/NERV 1,034.27
HYDROMORPHONE INJ 40MG (O 24.00
RANITIDINE INJ 25MG (OIT) 5.00
DOCETAXEL INJ 1MG (OIT) 13.00
CYCLOPHOSPHAMIDE INJ 100M 88.00
CH 50 55.36
FLUCONAZOLE 200MG (OIT) 30.00
GAMUNEX-C/GAMMAKED 500MG 209.00
MBS ANTIGEN TYPING 10.50
MBS DIRECT COOMBS TEST 14.78
MBS ANTIBODY SCREENING 21.25
MBS CELL PANEL FOR ANTIBO 30.00
COMPATIBILITY SCREENING 26.25
IMMUNOASSAY TUMOR ANTIGEN 42.82
GAS SAMPLING TUBING 9.36
GAUZE NON IMPREG NON STER 1.00
IV INF THER/DIAG/PROPH AD 200.00
IV INF SEQ DIAG/THER/PROP 300.00
REM DEVITAL TISS WOUND (O 590.00
COLLAGEN DRESSING < 16 SQ 25.00
ALGINATE DRESSING (OWC) 25.00
CALMOSEPTINE/SKIN SEAL,MO 10.00
ABSORB DRESS 16 SQ < WITH 35.00
WOUND FILLER GEL/PASTE FL 50.00
PAD BAND >3 <5 YRDS (OWC) 10.41
CONFORM BAND N/S >3 <5 YD 1.26
CORBAN SELF ADH BAND <3 Y 6.00
ZINC PASTE BAND W >3 <5 Y 335.00
BENADRYL 25 MG TAB (OIT) 3.00
DENOSUMAB INJ 1 MG (OIT) 77.00
BENADRYL UP TO 50 MG 30.00
INVANZ 500 MG IV (OIT) 360.00
IRON DEXTRAN INJ 50 MG (O 61.00
FUROSEMIDE INJ 20 MG < (O 30.00
XOLAIR 5 MG (OIT) 150.00
SOLUMEDROL 40 MG (OIT) 36.00
K-CHLORID INJ PER 2 MEQ ( 18.00
LIDOCAINE 2% TOPICAL JELL 13.00
NORMAL SALINE SOLUTION 10 7.00
BLOOD PROCESSING & STORAG 953.00
IV PUSH EA SEQUENTIAL NEW 215.00
GAUZE NON IMPREG STERILE 3.00
DALBAVANCIN(DALVANCE)INJ 73.00
ZOLEDRONIC ACID/RECLAST I 530.00
GAUZE INPREG STERILE 3.00
BONE CEMENT 2,400.00
STRYKER IVAS KIT 2,553.34
HANK DRILL 10G 200.00
CEMENT CANULA 145.42
STYLET GLIDERITES 12.00
DRESSING 16 SQ IN < (OIT) 25.00
METHYLP SOD INJ 125MG (OI 72.00
CHEMO ADM IV INF TECH (OI 1,405.00
GEMCITABINE HCL 200 MG (O 1,004.00
STERILE WATER,SAL,DEXT FL 6.00
MAGNESIUM SULFATE INJ 500 5.00
PACLITAXEL PROTEIN BOUND 52.25
CHEMO INJ IM/SQ (OIT) 465.00
FOAM DRESS STERILE 16-48 25.00
IV INFUSION CONCURRENT (O 107.00
GARAMYCIN,GENTAMICIN INJ 24.00
ENOXAPARIN SODIUM INJ 10M 144.00
LORAZEPAM INJ 2MG (OIT) 120.00
IMMUNE GLOBULIN(PRIVIGEN) 191.00
OCTREOTIDE INJ 1MG (OIT) 794.00
COLLAGEN DRESS >16-48 SQ 69.00
US BREAST LIMITED RIGHT 195.00
IV INFUSION CHEMO W PUMP 632.00
LEVOLEUCOVORIN CALCIUM IN 355.00
BEVACIZUMAB INJ 10MG (OIT 368.00
FLUOROURACIL 500 MG (OIT) 15.00
OXALIPLATIN/ELOXATIN .5 M 1.35
BACTROBAN OINTMENT (OWC) 23.00
DAKINS SOLUTION (OWC) 22.00
LANOLIN (OWC) 5.34
NYSTATIN POWDER (OWC) 53.82
SEALANTS MOISTURIZERS OIN 10.00
SILVADENE CREAM (OWC) 30.00
TIBIAL NAIL 4,580.00
LOCKING SCREW 28MM 556.00
LOCKING SCREWS 34MM 556.00
LOCKING SCREW 556.00
GUIDE WIRE 400MM 314.00
DRILL BIT 402MM 772.00
DRILL BIT NEEDLE POINT 4. 550.00
REAMING ROD WITH BALL 2.5 374.00
CLARITIN 10 MG TAB (OIT) 0.50
IRINOTECAN LIPOSOME INJ 1 198.00
VINCRISTINE SULFATE 1 MG 500.00
BETADINE WIPES (OIT) 5.00
PEPIC 20MG (OIT) 5.00
LASIX TAB 20 MG (OIT) 1.00
TYLENOL 625 MG TAB 1.00
CIPROFLOXACIN IV INFUSION 60.00
FLAGYL 500 MG PER UNIT (O 2.00
PALIPERIDONE PALMITATE (O 22.95
CPR METER ADHESIVE PADS 6.68
TIBIAL NAIL TI CANNULTED 4,580.00
LOCKING SCREW TI 5.0MM 556.00
GUIDE WIRE 3.2 MM 314.00
DRILL BIT 4.2 MM 330/100 772.00
DRILL BIT 4.2 MM NIDDLE P 550.00
REAMING ROD 2.5MM/950MM 374.00
SCREW TI CANNULATED 4.0 M 774.00
WIRE GUIDE THREADED 1.25 104.00
DRILL BIT CANNULATED 2.7M 1,542.00
BONE SCREW CANCELLO 4.4MM 70.00
PLATE 5 HOLE 1/3 TUBULAR 326.00
TIBIA PLATE 3.5MM PROX VA 5,310.00
LOCKING SCREW 3.5MM VARIA 256.00
CHRONOS GRANULES LARGE 1,218.00
IV INFUSION EA ADD SEQ DR 327.00
ATROPINE SULFATE .01 MG ( 0.20
IRINOTECAN 20 MG (OIT) 16.25
LEUCOVORIN CALCIUM 50 MG 14.10
PERJETA 1 MG (OIT) 57.15
MORPHINE SULFATE >10 MG 24.00
CIPLATIN POWDER OR SOLUTI 8.00
MANNITOL 25% 45.00
KETOROLAC TROMETHAMIND PE 12.00
CONTACT LAYER DRESS 16SQ 6.25
BCR/ABL 1 MAJOR BREAKPOIN 404.84
BCR/ABL 1 MINOR BREAKPOIN 357.62
SUCTION CANISTER J 60.00
CATH THORACIC TRO035 53.00
URETHRAL CATH TRA035 46.00
BANDAGE ELASTIC 2035 11.00
BANDAGE ELASTIC 3035 11.00
BANDAGE ELASTIC 4035 15.00
BANDAGE ELASTIC 6035 26.00
SCAPEL-DISP 035 12.00
MUCUS BULBS DISP 9.00
STERI-STRIP 1 PK 035 17.00
TELFA 3X8 035 11.00
CLAVICLE STRAP 135.02
C COLLAR SOFT 64.00
SPLINTS-FOREARM V035 111.00
BUSPAR 10MG TABS 7.00
CIPRO 250MG TABS 9.00
BACTROBAN 2% CREAM 15GM 86.50
KAYEXALATE DOSE 30.00
CAROTID DOP 350.00
ANTACID LAXATIVE DOSE 5.50
THIAMINE 100MG TABS 4.50
LEVEL I NEW PATIENT PIT 60.00
LEVEL II NEW PATIENT(PIT) 103.00
LEVEL III NEW PATIENT(PIT 150.00
LEVEL IV NEW PATIENT(PIT) 230.00
LEVEL V NEW PATIENT (PIT) 289.00
LEVEL 1 EST PATIENT(PIT) 30.00
LEVEL II EST PATIENT(PIT) 60.00
LEVEL III EST PATIENT(PIT 125.00
LEVEL IV EST PATIENT(PIT) 150.00
LEVEL V EST PATIENT(PIT) 203.00
INJ VEDOLIZUMAB/ENTYVIO 1 85.00
TYLENOL 650 MG 1.00
OCRELIZUMAB INJ 1MG 270.85
AZACITIDINE INJ 1 MG (OIT 21.00
TRIMETHAPHAN CAMSYLATE .2 5.69
PHLEBOTOMY (OIT) 460.00
CHEMO ADM IV OFFICE TO CO 632.00
TRANSPRT FILM 16 SQ IN OR 2.00
PHENERGAN 25 MG (OIT) 30.00
MAJOR SURGERY BILATERAL 7,500.00
MINOR SURGERY BILATERAL 2,600.00
INJ ARIPIPRAZOLE EXT RELE 22.95
FILGRASTIM INJ (G-CSF) 1 5.00
DEBRIDE BONE EA ADD 20 SQ 10.00
ELECTROLYTE PANEL 66.00
IV PUSH EA SEQUENTIAL NEW 215.00
IV INFUSION HYDRAT INIT 3 202.00
IV INFUSION THER/DIAG/PRO 200.00
PROTEIN ELECTROPHORETIC O 40.00
GI PANEL STOOL PCR 1,135.50
JAK2 V617F MATATION DETEC 249.74
CL DISLOCATION THUMB W/MA 337.22
ERP CL DISLOCATION THUMB 627.16
PATH LEV IV GROSS MICROSC 60.80
DOXORUBICIN HCL 10 MG (OI 9.65
OXY-EARS 9.00
BLITT CVP TRAY DISP 94.00
BLOOD PROCESSING & STORAG 953.00
SUCTION CANISTER JUMBO 60.00
TRASTUZUMAB/HERCEPTIN INJ 459.00
ECULIZUMAB/SOLIRIS INJ 10 1,035.00
CIPRO 500MG TABS 9.00
CYTOMEL TABS 5.00
PREVACID 15MG 9.50
INPATIENT ZOFRAM INJECTIO 135.50
CALPROTECIN, FECAL 53.48
MRA NECK W/C 1,674.00
MRI LOW EXT NO JNT LT W/W 1,670.00
SKELETAL SURVEY CHILD 168.90
DARBEPOETIN ALFA INJ 1MCG 21.00
IV ANESTHESIA SET 10.00
NON-REBREATHING MASK 17.00
MEVACOR TABLETS 8.50
K-DUR 20MEQ TABS 5.00
PSA - DIAGNOSTIC 55.00
KLONOPIN CLONAZEPAM TAB 6.00
DESYREL 150MG TABS 10.50
PROZAC CAPS 8.00
INJ ANES FACET JOINT/NERV 187.68
DEST BY NEURO AGE PARAVER 1,142.63
RADIOFREQUENCY RF CANNULA 45.00
RADIOFREQUENCY RF ELECTRO 150.00
RADIOFREQUENCY RF GROUNDI 25.00
INJ PARAVERTEBRAL FACET J 517.14
ROTH NET RETRIEVAL 165.00
DES BY NEUR AG PAR FAC JT 1,142.63
CIPRO 400MG IV BAG 139.00
CMV DNA DETECTION 258.00
MRI FACE ORBITS OR NECK W 888.00
MRI LOW EXT JNT RT WO 1,295.00
MRI LOW EXT JNT LT WO 1,295.00
MRI LOW EXT JNT RT W/WO 1,690.00
MRI LOW EXT JNT LT W/WO 1,690.00
MRI LOW EXT JNT BIL WO 1,639.00
MRI LOW EXT NO JNT RT WO 1,295.00
MRI LOW EXT NO JNT LT WO 1,295.00
MRI UPPER EXT JNT RT WO 1,323.00
MRI UPPER EXT JNT LT WO 1,323.00
MRI UPPER EXT JNT RT W/C 254.00
MRI UPPER EXT JNT RT W/WO 1,510.00
MRI UPPER EXT JNT LT W/WO 1,510.00
MRI UPPER EXT JNT BIL WO 1,751.00
MRI UPPER EXT NO JNT RT W 1,323.00
MRI UPPER EXT NO JNT LT W 1,323.00
HIP BIL-2V/SIDE W/AP PELV 305.00
DEST SUP MED GEN PERIP NE 1,537.20
HEP B/ENGERIX-ADULT OFF S 70.00
IMMUNIZATION ADM OFF SITE 60.00
HEP B SURFACE AB OFF SITE 20.00
VENIFPUNCTURE OFF SITE 5.00
KNEE IMMOBOLIZER 100.00
HYDROCORTISONE CREAM 15.00
CLEOCIN 150MG CAPS 8.50
GRIFULVIN SUSP PER DOSE 5 10.00
QUESTRAN PKTS. 7.00
LISINOPRIL TABLET 6.50
CONNECTING TUBE 13.00
MYSOLINE 50MG TABS 5.00
PROCARDIA XL 60 MG 9.00
LYMES AB IGG 129.00
NICOBID 500MG 6.50
HUMULIN N DOSE 22.50
HUMALIN R DOSE 22.50
PRESSURE TRANSDUCER KIT 33.56
RADIAL ARTERY CATHETERIZA 50.00
VASOPRESSIN INJ 22.60
LOVAZA 6.00
KEPPRA ORAL SOL 10ML 10.00
TRILIPIX 135MG CAP 18.00
RESTASIS 0.5% BOX OF 30 499.70
ULORIC 40MG TAB 17.00
LACTULOSE 20GM/30ML DOSE 2.50
MULTAQ 400MG 18.00
ONGLYZA TAB 5MG 24.00
TOVIAZ TAB 4MG 20.00
TRAVATAN Z 5ML 482.00
TRILIPIX 45MG DR 4.80
PRADAXA CAP 150MG 17.00
MANNITOL INJ 20% 87.00
AZOPT SUS 1%OP 320.00
DEXILANT 60MG CAP 20.00
PRESER VISION TAB 5.00
VIMPAT TAB 50MG 16.00
NEXTERONE 150MG/100ML 144.00
NEXTERONE 360MG/200ML 192.00
XOPENEX 1.25MG/3ML 22.50
ZOSYN 3.375GM 60.00
XOPENEX 0.63MG/3ML 20.50
XOPENEX 0.31MG/3ML 20.50
SOD CHLORIDE INH SOL 0.9% 8.00
S-Z RACEMIE E 2.25% 13.00
ALBUTEROL 0.042% 1.25MG/3 13.00
DUONEBS 3ML 13.00
IPRATROPIUM 0.02% .5MG/2. 13.00
D5W 1000 W/KCL 20MEG 58.50
DONNATAL ELIXER 5ML 5.80
NITROBID OINT 1GM 4.00
VICTOZA 18MG/3ML 530.00
DULERA 200/5 15.00
SYMBICORT 160/4.5 PER DOS 10.00
TRUVADA 90.00
HEPATITIS B-ENGERIX 228.00
TRADJENTA 5MG 28.00
ED-A-HIST TAB 3.85
VIT D 1000 IV 3.50
RT MDI/MUCOMYST 10.00
APLISOL 5TU/0.1ML 17.00
D5 1/20 KCL 500ML 47.50
XARELTO 20MG TAB 31.50
VIMPAT 200MG/20ML INJ 186.00
SIMBRINZA OPH SUSP 275.00
ELIQUIS 2.5 MG 15.75
KEPPRA 500MG/5ML INJ 187.00
FLOVENT HFA 110MCG PER DO 15.00
FLOVENT HFA 220MCG PER DO 15.00
QVARINH PER DOSE 10.00
NIASPAN 1000MG 19.00
ZOMETA 4MG/100ML INJ 2,270.00
PREDNISOLONE 15MG/5ML PER 5.00
PREDNISOLNE 5MG/5ML PER D 5.00
ALBUTEROL HFA PER DOSE 10.00
ZITHROMAX SUSP 200MG/5ML 25.00
ZITHROMAX SUSP 100MG/5ML 25.00
CARAFATE SUSP U/D 1GM/10M 25.00
PLAN B ONE STEP 102.50
ONGLYZA 2.5MG TAB 24.00
NAMENDA XR 28 27.00
MUCOMYST PER DOSE 400MG/2 10.00
JALYN CAP 17.30
CARDENE 20MG/200ML IV 359.00
PHOS-NAK PKTS 4.00
ATROVENT .02% INH SOL 13.00
CETACAINE SPRAY PER APPPL 20.00
VIIBRYD 20MG TABS 20.75
ESTRACE 0.5 MG TAB 4.50
XARELTO 15MG 31.00
ESTRATEST 1.25/2.5 MG TAB 12.50
AMITIZA 8 MCG 18.00
DEXAMETHASONE 10MG INJ 4.00
LEVETIRACETAM 1000MG 18.00
OMNIPAQUE 180MG/ML/10ML 165.00
BICTRA PER 30ML 3.50
FLUZONE HIGH DOSE 2017-20 80.00
BRILINTA 90MG TABLET 17.50
FOLBEE TAB 4.50
ELIQUIS 5MG TAB 16.00
GENTAMYCIN 80MG PB IN 100 19.50
DIPRIVAN 1% 20ML 24.00
ACCUPRIL 5MG TAB 5.00
STERILE WARTER IV 52.50
MAXZIDE 25MG TABS 5.00
ADM INFLUENZA VIRUS 40.00
INSUFFLATION NEEDLE 32.00
DEST OTHER PERIPHERAL NER 512.40
DEST OTHER PERIPHERSL NER 1,024.80
SACROILIAC JOINT INJ 1,008.09
SACROILIAC JOINT INJ BILA 1,512.14
TROCARS AND DRILL T34A 1,600.00
CEMENT STICK F06A 180.00
BALLOON K15B 1,900.00
CEMENT AND MIXER C01B 300.00
INFLATION SYRINGE A08A 180.00
INFECT AGENT BY NECLEIC A 95.60
DRUG SCREEN 9 PANEL HAIR 150.00
PULSAVAC PLUS FAN KIT 92.00
DRUG TEST PRESUMP OPTICAL 29.72
DRUG TEST PRESUMP NOT OPT 258.50
DRUG TEST DEF 8-14 CLASSE 245.98
DRUG TEST DEF 22+ CLASSSE 430.46
CO2 DRYLINE WATER TRAP 34.66
CO2 DRYLINE AIRWAY ADAPTE 6.90
CO2 SAMPLING LINE (ADULT) 13.86
I & D ABCESS 180.30
INJ CERV/THOR NJX ANES/ST 981.58
INJ CERV/THOR NJX ANES/ST 490.79
DYONICS 25 DISP TUBE SET 137.32
STAY FIX DRESSING 22.78
EPIDURAL TRAY KIMBERLY-CL 115.10
POLAR CARE SYSTEM SHOULDE 260.90
POLAR CARE SYSTEM KNEE 247.02
FIRSTPASS STR PASSR SELF 350.00
AMBIENT SUPER TURBOVAC 90 530.00
DYONICS 5.5MM STONECUTTER 168.98
BOXED INCISOR PLUS BL BX6 125.16
COUDE BLUNT NEEDLE 31.78
SMITH & NEPHEW DISP FACE 58.00
CORTEX SCREWS 84.00
PAP NAP SLEEP STUDY 665.14
CRYPTOSPORIDIUM EIA 32.66
INFECT AGENT DET NUC ACID 54.60
SCREW CANNULAT 4.5MM 668.00
GUIDEWIRE 1.6MM/150MM 111.00
DRILL BIT 3.2MM/QC170MM 1,414.00
VASOPNEUMATIC DEVICE 26.00
MAXORB EXTRA AG 35.00
VASOPNEUMATIC DEVICE 26.00
GLIDESCOPE BLADE COVERS 36.00
PREVNAR PHEUMONIA VAC 13 130.00
CHRONULAC SYRUP 4OZ 18.50
PERCUT KYPHOPLASTY LUMBAR 11,849.56
BRINTELLIX 10MG TAB 28.80
PROTONIX 40MG SUSPENSION 34.50
EARACHE DROPS 15.00
MYREBETRIC 25 MG ER TAB 7.00
THEO 24 100 MG CAPSULE 3.34
ZYLOCAIN MPF .5% VIAL 30.00
TRINTELLIX 5 MG TABS 25.46
NS 3000 ML FOR IRRIGATION 15.82
PHILLIPS MOM TAB 500MG 0.30
REQUIP 2MG TAB 2.50
INFED 100MG/2ML INJ 57.80
OCTAGAM 5%-200ML 3,194.40
QVAR INH 40 MCG PER DOSE 20.00
SENSORCAINE MPF 0.75% 10M 11.40
OMNIPAQUE 240MG/ML-50ML 87.92
INCRUSE ELLIPTA 62.5 INH 356.76
TRANXENE 15MG 9.40
TRESIBA 100UNIT/ML 212.00
DOPAMINE 200MG/5ML VIAL 5.82
TAMIFLU 6MG/ML (30MG)PERD 21.00
ISENTRESS 400MG TAB 28.00
BYDUREON 2MG/VIAL 372.00
JARDIANCE 10MG TAB 37.20
MYDRIACYL 1% OPTH SOL 73.40
RESPIRATORY VIRAL PANEL 851.63
INJ ANESTHETIC LUMBAR/THO 1,344.12
SJM TEST LEAD KIT 700.00
PRIV PAY ROOM ADJ -
ROUTINE N/H CAID -
PHARMACY N/H -
PHARMACY NH PVT -
ROOM\BOARD-N/H -
HAIR CARE 9.50
PHARMACY OTHER -
ROOM/BOARD N/H HOSPICE -
DIFLUCAN SUSP 10MGML 80.50
IGLOO WOUND IRRIGATION SY 8.00
MS CONTIN SR 30 MG 6.50
VANCONYCIN 75.00
LOTRIMIN CREAM 45GM 62.00
OBS-DIRECT ADMIT 623.15
HUBER NEEDLE 21.00
PEPCID 20MG PREMIX 35.00
BENA-MAA-XYLO-3OZ. 15.50
COLYTE-4 LITER 46.00
ACTIGALL CUPS 9.50
CARDIZEM 90MG TABS 6.50
PLAQUENIL 200 MG 8.00
PRILOSEC 20MG 9.50
LOPID 600MG 7.50
DIFLUCAN 100MG 35.00
P T EVAL 184.00
VANCOMYCIN INJECTION 17.00
ACTIVASE PER 1MG 111.99
CLEOCIN 300 MG CAP 8.50
XEROFOAM GAUZE 11.00
TORADOL INJ 52.00
HEPA/EJFR 1,245.00
BASIC METABOLIC PANE 140.00
BIOPSY FORCEPS 75.00
WELLBUTRIN 5.50
RPR QUANT 27.00
RELAFEN 500MG TAB 5.00
ZESTORETIC 20.12.5 6.50
VAGINAL SPECULA 8.00
BUFFALO FILTER TUBING 25.00
ROCEPHIN 250 MG (OIT) 20.00
RYTHMOL 150MG 6.00
ZESTORETIC 20/25 6.50
INDUSTRIAL WHOLE BLOOD AL 25.00
BACTROBAN OINT 22 GM 87.50
ORTHO/PROST MNG/TRAIN SUB 59.00
ADM INFLUENZA VIRUS OFF S 40.00
DUO DERM DRES. 4X4 17.00
ENDO TRACHEAL TUBE 14.00
PREPARATION H OINT 11.50
DIFLUCAN IV 125.00
MS CONTIN SR 15MG 6.50
MUCINEX 600MG 6.00
ERP TUBE THORACOSTMY 450.00
ERP INTUBA/ENDOTRACH 213.16
ERP CARDIOP RESUSCIT 330.00
ERP CV CATH PER > 5YR 176.58
ERP CV CATH CD > 5YR 176.39
ERP LUMBAR PUNCTURE 197.00
ERP NASAL HEMOR AN S 197.00
ERP I&R FB SUB TIS S 197.00
ERP I&D ABCESS 180.30
ERP I&D ABCESS 293.00
ERP REM NAIL WEDGE 156.00
ERP I&D HEMATOM NAIL 103.00
ERP I&D BARTH GL ABS 260.00
ERP INJ/AR/AS MAJ JO 147.00
ERP BURN 1ST DEG/LOC 134.00
ERP DL CL IPHAL WO/A 352.43
ERP LS SCALP 02.5 CM 210.00
ERP LS SCALP 07.5 CM 251.00
ERP LS SCALP 12.5 CM 281.00
ERP LS SCALP 20.0 CM 407.00
ERP LS SCALP 30.0CM+ 648.00
ERP LS FACE 02.5 CM 239.00
ERP LS FACE 05.0 CM 260.00
ERP LS FACE 07.5 CM 344.00
ERP LS FACE 12.5 CM 470.00
ERP LI SCALP 07.5 CM 354.60
MAMMOGRAM SCREENING BIL R 71.52
TOBRADEX OPTH SOL5ML 131.00
GI COCKTAIL 10.00
HCV RT PCR QUANT 550080 87.44
VENIPUNCTURE 15.00
DIFLUCAN 200 MG TAB 36.50
SKINBARRIERHOLLIHES 31.00
TRIAMCINOLONE 0.1%CR 28.50
ERP LEVEL 1 111.00
ERP LEVEL 2 155.00
ERP LEVEL 3 228.00
ERP LEVEL 4 315.00
ERP LEVEL 5 417.00
CA-125 42.82
ZITHROMAX 250MG TABLET 35.50
HCG - QUANT 66.00
NICOTINE PATCH 18.50
ABDOMINAL AORTA LIMITED 199.00
BONESCAN 3-PH 710.00
BREAST US UNIL LEFT 243.00
FETAL STUDY EA ADD GEST 421.00
ECHO 2 D 634.13
FETAL STUDY SINGLE FIRST 284.43
FETAL STUDY LIMITED 202.28
UPPER EXT ART LT 249.00
PELVIC 276.00
RLQ APPENDIX 276.00
THYROID 282.00
TRANSVAGINAL 276.00
ABDOMEN UPPER 331.00
VENOUS DUPLEX BIL 528.00
VENOUS DUPLEX LT 238.00
SINGLE ORGAN 276.00
RAPID STREP 43.00
GASTRIC OCCULT BLOOD 14.00
MODIFIED BARIUM 321.00
HEPATITIS C 52.00
PRAVACHOL 20MG TAB 6.50
NIZOREL CR. 91.00
THERAPEUTIC EXERCISE 15MI 84.00
ZOCOR 10MG 8.00
CL TREATMENT DISTAL RADIA 337.22
ERP CL TREATMENT DISTAL R 256.00
INFLUENZA A 49.00
BIAXIN 500MG 8.50
INFLUENZA B 49.00
DEBRIDEMENT NAILS 1-5 111.92
CHEST TUBE KIT 140.00
BAXTER PRIMARY SET 20.00
NORVASC 10MG TABLET 11.50
SHIGA-LIKE TOXIN 27.17
PROSIGHT 4.00
ORTHO/PROST MNG/TRAIN SUB 59.00
CARDIZEM 25MG(5MG/ML 40.00
E STIM SUPERVISION 75.00
IMITREX 6MG INJ 290.79
P T RE EVAL 113.00
LOWER EXT ART BIL 354.00
US EXT NON VASC COMPLETE 202.28
PULSE OXI CONTINUOUS 169.07
PULSE OXI SINGLE 16.00
LARYNGOSCOPY W/BIOPSY 4,862.46
SIGMOIDSCOPY W/BIOPSY 1,335.34
IV NORM SAL 1/2 5OOM 17.50
MINOXIDIL P.O. 4.50
DURAGESIC PATCH 25MG 55.50
NORVASC TABLET 8.50
CARDIZEM CD 8.50
NASOTRACHEAL SUCTION 246.95
CHEST PHYSIO THERAPY INIT 246.95
CT ABDOMEN WO/W CONT 1,240.00
CT ABDOMEN W/O CONT 818.00
CT ABDOMEN W CONT 980.00
CT C SPINE W/O CONT 1,007.00
CT CHEST WO/W CONT 1,713.00
CT CHEST W/O CONT 669.00
CT CHEST W CONT 1,137.00
CT HD/BRN WO/W CONT 1,627.00
CT HD/BRN W CONT 1,368.00
CT HD/BRN W/O CONT 914.00
CT LUMBAR WO/C 1,034.00
CT NECK WO/C 807.00
CT PELVIS/WO-W/C 1,294.00
CT PELVIS/ W/CONT 1,034.00
CT PELVIS/WO/C 807.00
CT SINUSES WO/C 806.00
ZOLOFT TAB 7.00
TESTICULAR 276.00
KNEE SUPPORT 58.00
CARDENE SR 45MG CAP 6.00
WRIST SPLINT COCKUP 45.00
TEARGEN OPTH DROPS 19.00
ADENOCARD 6MG/2ML 90.50
SPECIAL STAIN O&P 36.69
PROSCAR 5MG 7.50
BACLOFEN TABLETS 5.00
PAXIL TABS 6.00
ACCUPRIL TABLET 5.50
CARDURA TABLET 5.50
CARDIOPUL RESUSCIT 394.00
DURAGESIC PATCH 75MG 118.50
GASTROGRAFIN 120 ML 97.00
ERP DL CL MECAPOPH W 500.00
ERP DL CL SHOULDE WO 750.00
ENDO TUBE HOLDER 23.00
SINEMET CR 6.00
ALTACE CAPSULE 6.50
CALAN SR 180 7.00
HUMERUS LT-MIN 2V 134.00
SCAPULA LT 134.00
DEPAKOTE 500 MG TABS 6.00
KAOCHLOR SF 10% 16OZ 26.00
RELAFEN 750MG TAB 5.00
AMBIEN 10MG 17.00
EEG INTERP 324.00
EKG PRO FEE 34.50
HOLTERMONITOR PROFEE 227.50
OPTH STAIN 9.50
CLARITEN TABS 17.00
EMERGENCY ROOM-1 120.00
EMERGENCY ROOM-2 190.00
EMERGENCY ROOM-3 340.00
EMERGENCY ROOM-4 560.00
EMERGENCY ROOM-5 825.00
DURAGESIC PATCH 100M 172.50
SIMPLE MASK 13.00
OXYGEN ED 20.00
SEXUAL ASSAULT KIT 87.00
VASOTEC 1.25MG IV 30.50
IV ENTERNALFEED TUBE 54.50
CT UPPER EXT LT WO 833.00
TOPROL XL TABLETS 7.00
TRANSPARENT DSG 9.00
ZIAC 10/6.25 TAB 6.00
DEPAKENE LIQ PER DOSE 10M 10.00
CATAFLAM 50 MG TAB 6.50
MAMMOGRAM SCREENING W/CAD 173.98
FLONASE NASAL SPRAY 132.50
DIPRIVAN INJ 72.50
ULTRAM 50MG 6.50
VARICELLA ZOSTER 26.30
DURAGESIC PATCH 50MG 85.50
LOVENOX 30MG 0.3ML 99.50
EPOETIN ALFA 1000 NON ESR 62.00
NEURONTIN 300MG 7.50
SPECIMEN TRAPS 40CC 11.00
PREVACID 30MG CAP 9.00
COZAAR 50MG TAB 7.00
DIFLUCAN 150MG TAB 36.50
GLUCOPHAGE 500MG TAB 5.50
CT ORBIT WO 807.00
CORDURONE 200MG TAB 7.50
KINEVAC 5MCG INJ 200.20
MAG-OX 400 5.50
TREADMILL-BASIC 352.00
HYZAAR 50/12.5 5.50
ROBITUSSIN DAC PER DOSE 4.00
ANKLE/ARM/INDEX LT UNIL 1 217.00
POST OP SHOE 50.00
ZOCAR 20MG 9.00
BRONCHOSCOPY 2,539.58
BRONCHOSCOPY W/BIOPSY 2,539.58
COLONOSCOPY 1,335.34
COLONSCOPY W/BIOPSY 1,755.20
COLONSCOPY W/POLYPECTOMY 1,755.20
GASTROSCOPE 1,399.58
GASTROSCOPEW/BIOPSY 1,399.58
GASTROSCOPEW/POLYPEC 2,669.66
SIGMOIDSCOPYE 1,335.34
GASTROSCOPY W/DILATION 2,669.66
AUGMENTIN 875 MG TAB 12.50
LOWER EXT ART LT 237.00
HEPARIN PREMIX 500CC 31.50
RISPERDAL TABS 9.50
METHOTREXATE 2.5MGTB 9.50
DEFIB/PACER PADS 40.00
RETRO PERITONEAL 214.00
LAMISIL 250MG TAB 21.00
FLOVENT INHALER 193.50
EFFEXOR TAB 6.50
ZYRTEC 10MG TAB 7.50
IV D51/2 NS 20MEQ KCL 58.50
IB D5 1/2 NS 40 MEQ KCL 42.00
IV NS 20MEG KCL 58.50
DOPAMINE 400MGPREMIX 44.50
NASAREL NASAL SPRAY 103.50
ZANTAC SYRUP PER DOSE 10M 10.00
ARICEPT TABLET 9.50
CULTURE URINE COLONY COUN 33.00
CULTURE BLOOD 66.00
CULTURE EAR NOSE & THROAT 66.00
CULTURE SPUTUM 66.00
CULTURE OTHER SOURCE 66.00
GTT EACH ADDL SPEC 16.00
BLOOD TYPING RH 114.11
PYLORIC BALLOON DILATATIO 4,862.46
SAVORY-GILLARD DILATATION 4,862.46
LIPITOR TABLET 21.00
IMDUR TAB 7.50
LEVAQUIN 500MG IVPB 168.00
GLUCOPHAGE 850MG 6.00
M S CONTIN 100MG 9.00
ADL TRAINING 15MIN 59.00
MOD BAR SWAL FUN STU 364.00
MANUAL THERAPY 15MIN 123.00
MANUAL THERAPY 15MIN 123.00
LIPID PANEL 68.00
HEPATITISPANEL A B C 211.00
HEPATIC FUNCTION PANEL 147.00
COMP. METABOLIC PANE 169.00
THERAPEUTIC ACT 15MI 84.00
CASODEX TABS 27.00
CT MASTOIDS W/O CONT 807.00
BLADDER LIMITED 276.00
NECK 282.00
AMARYL TABLET 6.50
FLOMAX 0.4MG CAP 6.50
OCCUP THER EVAL 184.00
IONTOPHORESIS 15 MIN 93.00
MASSAGE 15 MIN 68.00
NEUROMUSCU RE-ED 15M 83.00
ORTHOTIC FITTING/TRAINING 83.00
PARAFFIN BATH 43.00
THERAPEUTIC ACT 15MI 84.00
ULTRASOUND 15 MIN 93.00
WHEELCHAIR MGT TRAIN 15MI 68.00
PREALBUMIN 57.00
DILATATION ESOPHAGUS W/BO 1,399.58
EMPLOYEE HEP. ABC PANAL -
IV INFUSION HYDRATION EA 155.00
N. GONORRHOEAE BY N.A.AMP 82.00
CHLAMYDIA BY N.A. AMP 82.00
D-DIMER QUANTITATIVE 93.00
OBS-PRIVATE-PER HR 18.00
OBS-PRIVATE W/TEL PER HR 18.00
POLYPECTOMYSNARE-DIS 55.00
AMONIA INHALANTS 2.50
REMERON TABLET 7.50
TROPONIN 35.00
H. PYLORI AG, SERUM 61.00
SODIUM URINE * 26.00
LEVAQUIN 500 MG TAB 20.00
CERBYX 50MG 2.50
BUSPAR 15MG 7.00
ZYPREXA 5MG TAB 28.00
LAMICTAL TABS 7.00
GASTRIC EMPTYING 798.00
SMALL BOWEL 345.00
MAMMOGRAM DIAGNOSTIC UNIL 164.64
CT THORACIC WO/C 1,294.00
CT LOWER EXT LT W/O CONT 669.00
CT FACIAL W/O CONT 806.00
CPAP SUPPLIES 72.00
MRI BRAIN WO 1,782.00
MRI BRAIN WC 1,970.00
MRI BRAIN W/WO 2,120.00
MRI CERVICAL SPINE WO 1,313.00
MRI CERVICAL SPINE W/WO 2,120.00
MRI LUMBAR SPINE WO 1,760.00
MRI LUMBAR W 1,930.00
MRI LUMBAR SPINE W/WO 2,119.00
MRI THORACIC SPINE WO 1,890.00
MRI THORACIC W/WO 2,119.00
MRI ABDOMEN W/O 1,914.00
MAGNAVIST 226.00
XALATAN OPTH SOL 142.50
CT LOWER EXT RT W/O CONT 669.00
CT UPPER EXT RT WO 833.00
ANKLE/ARM/INDEX RT UNIL 1 217.00
ANKLE/ARM/INDEX BIL-UNIL 217.00
US BREAST LIMITED LEFT 195.00
LOWER EXT ART RT 237.00
UPPER EXT ART RT 249.00
VENOUS DUPLEX RT 238.00
DERMA BOND 69.00
FOOT RIGHT-2V 126.00
FOOT BIL-2V 250.00
FOREARM RT-2V 134.00
FOREARM BIL-2V/SIDE 213.00
HIP W/PELVIS RT 2-3 V 153.00
KNEE RT 1/2 V 148.00
TIB/FIB RT-2V 148.00
TIB/FIB BIL-2V/SIDE 295.00
MANDIBLE MIN 4V 336.00
CULTURE STOOL INITIAL 33.00
RIBS BIL W/PA CXR-MIN 4V 289.00
SCAPULA RT 134.00
SHOULDER RT-MIN 2V 134.00
SHOULDER BIL-MIN 2V/SIDE 213.00
SPINE AP/LAT C/S 185.00
SPINE AP/LAT T/S 185.00
SPINE AP/LAT L/S 185.00
FINGER RT-MIN 2V 117.00
FINGERS BIL-MIN 2V/SIDE 199.00
TOE LT-MIN 2V 117.00
TOES RT MIN 2V 117.00
TOES BIL-MIN 2V/SIDE 234.00
CARDIAC SPECT 2,908.00
GLUCOSE - WHOLE BLOOD 16.00
DIOVAN CAP 8.00
ZITHROMAX 500MG IV 132.50
MRA NECK W/WO 1,819.00
RECOVERY ROOM ADDI 30MIN 125.00
GASTROSCOPY REMOVAL FB 1,399.58
BARD MESH PERFIX PLUG (ME 451.00
METACARPAL FX CLOSED 525.00
NASAL FX W/O MANIP 235.00
NURSEMAID'S ELBOW DISLOCA 320.75
SHOULDER DISLOCATION 320.75
TEMPOROMANDIBULAR DISLOCA 198.00
TOE DISLOCATION 253.00
ARTHROCENTESIS MAJOR JOIN 345.00
GASTRIC TUBE CHANGE 221.00
EXCISION OF NAIL FOLD(ING 158.00
ABSCESS SIMPLE/SINGLE 198.00
ABSCESS COMPLICATED/MULTI 198.00
PILONIDAL CYST SIMPLE 198.00
SUBUNGUAL HEMATOMA 81.00
BARTHOLIN'S GLAND ABSCESS 277.00
REMOVE FB NOSE 197.63
ANT HEMORRHAGE W/CAUTERIZ 197.63
ANT HEMORRHAGE W/CAUT & P 158.00
CPR 394.00
CENTRAL VENOUS LINE > 5YR 1,505.00
BLOOD ADMINISTRATION 1,746.00
SUTURE REPAIR 2.6 TO 7.5 198.00
SUTURE REPAIR 7.6 TO 12.5 206.00
SUTURE REPAIR 12.6 TO 20. 310.00
SUTURE REPAIR OVER 30.0 C 229.00
SUTURE REPAIR SIMPLE FACE 210.00
SUTURE REPAIR SIMPLE 2.6 230.00
SUTURE REPAIR FACE 5.1 TO 206.00
SUTURE REPAIR FACE 7.6 TO 214.00
SUTURE REPAIR SCALP 2.6 T 621.60
YUTURE REPAIR INT FACE 2. 283.76
ZOSYN 2.25GM INJ 40.00
WELLBUTRIN SR TABS 6.00
OXY-CONTIN TAB 7.50
OCUFLOX 0.3% OPTH SO 69.00
ALPHAGAN OPTH 0.2% 195.00
HUMALOG DOSE 50.00
MELATONIN 1MG TAB 4.50
SEROQUEL 25MG TAB 10.00
SEROQUEL 100MG TAB 18.00
ZINC SUL 220MG TAB 4.50
MORPHINE LIQ 20MG/5M 5.50
AVAPRO TAB 5.00
SINGULAIR TABLET 7.50
DEMADEX 20MG 4.50
PLAVIX 75MG TAB 8.00
DETROL 2MG TABS 5.50
SANTYL OINT 30G 445.00
LOVENOX 40MG 0.4ML 127.50
LANTISEPTIC 4.5OZ 10.50
FLEET ENEMA ADULT 13.50
ZANAFLEX 4MG 7.50
IOPIDINE 110.50
CELEXA TABLET 7.00
MEGACE ORAL SUSP 400MG/10 17.00
REQUIP 0.25MG TAB 7.00
COREG TABLET 8.00
CREON CAPSULE 5.00
ZESTORETIC 10/12.5 6.50
MICROZIDE 12.5MG CAP 4.50
EVISTA 60MG TAB 7.00
BETAPACE 80 MG 7.50
CELEBREX 200 MG CAP 7.50
EFFEXOR XR CAP 7.50
ICAR-C PLUS 5.00
ACTOS TABLET 13.00
MICARDIS 40MG 6.00
XYRTEC ORAL SOLUTION PER 4.00
PRILOSEC 40MG CAP 18.00
SEROQUEL 200MG TAB 25.00
MOTRIN LIQUID DOSE 3.00
TAMIFLU 75 MG CAP 32.00
CLARITIN SYRUP PER DOSE 4.00
CALMOSEPTINE OINT 17.00
DITROPAN XL TAB 7.00
NS/40KCL/1000ML 58.50
MAGNESIUM SULF 2GM/50CC H 32.00
PROAMATINE 5MG 6.50
POLYTRIM OPTH SOL 40.50
MIRALAX 17 G DOSE 7.00
CRANBERRY SOFTGELS 5.00
TOPAMAX 25MG 6.00
LUPRON DEPOT 7.5MG 10,245.50
PLETAL TABS 6.00
PATONOL O/S 0.1% 160.50
CATARACT OPTH DIALATION M 52.50
DIAMOX 500MG SEQUEL 6.00
AGGRENOX CAP 6.50
OMNICEF 300MG CAP 15.00
AMOXIL 875MG TAB 7.00
TAPAZOLE 5MG 5.00
EXELON CAPS 7.00
ARIMIDEX TAB 22.50
OMNICEF 125MG/5ML 60ML 107.50
MIRAPEX 0.25MG 6.00
PROTONIX 40MG TABLET 9.50
MOBIC 7.5 MG TAB 7.00
GLUCOVANCE TAB 7.50
LOVENOX 60 MG 0.6ML 193.50
LEVAQUIN 750 MG IV 205.50
ZYPREXA ZYDIS TAB 31.00
COSOPT OCUMETER 5ML 125.50
FOSAMAX 70MG TABLET 38.00
NORCO 10 MG TAB 5.50
DETROL LA CAPSULE 9.50
TRICOR TABS 17.00
GLUCOPHAGE XR 500MG 5.50
TUSSIONEX SUSP DOSE 5.50
PERIDEX 0.12% LIQ 16OZ 28.50
NEXIUM 40MG CAP 9.50
DOBUTAMINE 250MG PREMIX 102.50
LOVENOX 100MG 1ML 314.50
ADVAIR DISKUS 100/50 326.50
ADVAIR DISKUS 250/50 287.50
ADVAIR DISKUS 500/50 359.50
LEVAQUIN 250MG TAB 20.00
ZEMURON INJ 5ML 87.50
LANTUS DOSE 60.00
PAVULON INJ 26.00
TRILEPTAL TABLET 6.00
IV SPINAL ANESTHESIA TRAY 110.50
REMERON SOL TAB 15MG 7.50
NEOSTIGMIN INJ 26.00
ANESTHESIA GASES 217.50
PULMICORT RESP 14.00
HUMALOG MIS 75/25 DOSE 50.00
D5NS 40KCL 1000CC 55.50
ZYPREXA 10MG TAB 41.00
ULTRACET TABLETS 7.50
PRAVACHOL 40MG 12.50
TOPAMAX 100MG TAB 19.00
PROTONIX 40MG IV 121.50
CILOXAN OPTH DOSE 10.00
XYLOCAINE MPF POLYAMP 31.50
TETRACAINE OPTH SOL 18.00
TRAVATAN 0.004% OPTH 2.5M 138.50
ZOCOR 40MG TAB 20.00
CARDIZEM 125MG INJ 121.50
ZOFRAN 4MG TAB 52.00
CYCLOGYL OPTH 21.00
CENTRUM LIQ PER DOSE 15ML 4.00
GEODON 20MG CAP 17.50
LIDODERM 28.00
LOVENOX 150MG 1ML 408.00
COMTAN 200MG TAB 8.00
LEXAPRO 20MG 11.50
LEXAPRO 10MG TABS 9.50
VALTREX 1GM CAPLET 22.50
LUMIGAN OPTH SOL 0.03% 233.00
EMLA TOPICAL APPLICATION 20.50
ZETIA 10MG TABS 10.00
TOBRAMYCIN O/S 0.3% 15ML 30.00
TAMIFLU SUSP 12MG/ML 25CC 96.50
MIRAPEX 0.12MG TAB 5.00
FROVA 2.5MG TAB 45.50
GEODON 20MG/ML INJ 178.00
BENICAR 40MG 6.00
NOVOLOG DOSE 50.00
TRILEPTAL ORAL SUSP PER D 17.00
DIOVAN 320MG TAB 10.00
METFORMIN 1000MG 7.00
AMIDATE INJ 103.50
MINOXIDIL 2.5 TAB 4.00
ABILIFY TABLET 33.50
DEPAKOTE ER 500MG TAB 9.00
BOUDREAUX'S BUTT PASTE 4O 24.00
PLETAL 50MG TAB 7.00
LEVAQUIN 750MG TAB 27.50
1/2 NS W/20KCL 1000ML 58.50
WELLBUTRIN XL 150MG TABLE 14.00
MAXIPIME 2GM INJ 146.00
MICARDIS HCT 40MG/12.5MG 6.00
HYZAR 100-25 TABS 10.00
HUMULIN 70/30 10ML 52.50
NEURONTIN 800MG TABS 16.00
NEURONTIN 600MG TABS 14.00
NEURONTIN 400MG CAPS 8.50
NEURONTIN 100MG CAP 5.50
NAMENDA TAB 11.50
NORCO 7.5MG 5.50
MAXIPIME 1GM 87.50
MIDAZOLAM 50MG/10ML 110.50
SPIRIVA HANDIHALER 95.50
MERREM 1GM INJ 241.50
NOVOLOG MIX 70/30 DOSE 50.00
LOTREL CAPSULES 14.00
LEVAQUIN 250MG IV 130.50
METOPROLOL 25MG TAB 4.50
CYMBALTA 60MG CAP 17.00
ERP AVULSION OF NAIL, PLA 88.00
PROTEIN S FUNCTIONAL 85.00
PROTEIN C FUNCTIONAL 85.00
TC99M MEDRONATE UP TO 30M 64.53
TC99M SUFLER COLLOID UP T 157.83
TC99M MEBROFENIN UP TO 15 74.78
TC99M ALBUMIN AGGREGATED 232.37
TC99M PENTETATE AEROSOL U 156.59
SODIUM IODIDE 123 PER 100 276.27
TC99M SESTAMIBI PER DOSE 257.64
IMMUNIZATION ADMINISTRATI 80.31
MRI ABDOMEN W/WO 2,001.00
HAND LT-MIN3V 133.00
HAND RT-MIN 3V 133.00
HAND BIL-MIN 3V/SIDE 266.00
OB TRANSVAGINAL 331.00
CT LOWER EXT RT WC 823.00
CT LOWER EXT LT W CONT 823.00
CT LOWER EXT RT W/WO CONT 1,164.00
CT LOWER EXT LT W/WO CONT 1,164.00
CT UPPER EXT RT WC 1,034.00
CT UPPER EXT RT W/WO 1,294.00
MRI FACE ORBITS OR NECK W 2,130.00
MRI FACE ORBITS OR NECK W 1,790.00
DEPAKOTE ER 250MG TAB 6.00
LOVENOX 80 MG 0.8ML 254.00
CRESTOR TABLETS 14.00
ZYRTEC 5MG CHEW TAB 10.00
SANDOSTATIN 50MCG/MI INJ 44.00
CYMBALTA 30MG 17.00
KEPPRA 500MG TAB 14.00
TEGRETOL XR 200MG 7.00
BENICAR HCT TABLET 9.00
ZYPREXA INJ 99.50
PERCOCET 10/325 TAB 8.50
CALCITRIOL 0.25 MCG 6.00
CIPRODEX OTIC SUSPENSION 298.00
INTEGRILIN 20MG INJ X4 158.00
INTEGRILIN 75 MG INJ X15 158.00
FLUORESCEIN OPTH STRIPS 4.50
REQUIP 0.5MG 9.00
HEPARIN 5000UNITS/0.5ML 22.00
ZYPREXA 2.5MG TAB 24.00
FERROUS GLUCONATE 225MG 4.50
AMBIEN 5MG 15.50
SINGULAIR 4MG GRANULES 17.00
VESICARE 5MG 17.00
MIRAPEX 1MG TABS 13.00
WELCHOL 625MG TABS 5.50
UROXATRAL 10MG TABS 9.50
SPIRIVA 30 CAPS 292.50
ZYPREXA 15MG 51.00
BIDEX 400 TAB 4.50
FEMERA 2.5MG TAB 320.00
INVANT 1GM INJ 239.50
SEROQUEL 50MG TABLET 17.00
SEROQUEL 300MG TAB 33.50
FOLIC ACID 400MCG TAB 4.50
LUNESTA TABS 19.00
SYSTANE OPTH DROPS 42.00
LOVENOX 120MG 0.8ML 381.00
AVODART 0.5MG CAP 16.00
SYNTHROID 137MCG 5.00
LYRICA CAPSULES 10.50
ASMANEX 220MG 338.00
DIOVAN HCT TABLET 10.00
LEVEMIR FLEX PEN 131.50
LEVEMIR DOSE 50.00
PROTONIX 20MG TABLET 10.00
ZITHROMAX 500MG TABLET 22.50
BREVIBLOC 10MG/ML 89.50
CRESTOR 40MG TAB 15.00
CUBICIN INJ 1MG 4.00
VIT D 50000 UNITS CAPS 4.00
SOLUMEDROL INJ 126MG-99 143.00
JANUVIA 100MG TABLET 21.00
OMEGA 1000MG 4.00
BYETTA 10MCG INJ PEN 754.00
ZEBETA TAB 5MG 5.50
ZOSYN INJ 4.5GM/ 70.00
BIOTIN 300MG TAB 1.50
TDAP INJ 7 YRS & OLDER 178.50
AMITIZA 24MCG CAP 16.00
MOBIC 15MG TAB 21.00
KEPPRA 250MG TABLET 12.00
KCL 20MEQ/100CC STERILE H 25.00
CARDENE INJECTION 305.00
JANUMET 50/1000 13.00
EXELON PATCH 30.00
VYTORIN TAB 14.00
DIOVAN HCT 320/12.5MG 9.50
SYMBICORT 80/4.5 PER DOSE 10.00
MERREM 500MG INJECTION 142.00
ZOFRAN INJ 1MG/UNIT 3.00
BYSTOLIC 2.5MG TAB 8.00
COMBIGAN OPTH SOLUTION 5M 190.00
MAGNESIUM SULF 1GM/100CCH 32.00
CLEOCIN 300MG IN D5W 50CC 40.00
CLEOCIN 600MG IN D5W 50CC 60.00
DESOWEN OINT 0.05% 20.00
CLEOCIN 900MG IN D5W 50CC 80.00
VOLTERAN GEL 1% 77.00
PRISTIQ TAB 50MG 17.90
ZYVOX 600MG/300ML BAG 345.00
LOMOTIL LIQUID PER DOSE 4.00
POTASSIUM 15CC (20MEQ) LI 4.00
DIFLUCAN 400MG IV 200.00
CHLORHEXIDINE ANTISEPT (O 27.00
AFB CULTURE 38.00
GRAM STAIN 28.00
CT NECK W/CONTRAST 1,034.00
MRA BRAIN WO 1,474.00
MRA PELVIS WO 1,639.00
MRA ABDOMEN W/WO 1,774.00
BLOOD ADM TRANSFUSION (OI 1,746.00
CROSSMATCH INCUBATION PHA 129.60
CROSSMATCH ANTIGLOBULIN P 172.80
CSF GLUCOSE 29.00
PROTEIN TOTAL OTHER SOURC 44.00
CSF CELL COUNT 49.00
CT FACIAL W CONT 923.00
CT FACIAL W/WO CONT 1,230.00
CT LUMBAR W/WO 1,294.00
SKULL ONE VIEW 143.00
SINUSES LESS THAN 3 VIEWS 104.00
ORTHOTIC FITTING/TRAINING 83.00
ANTI RE-FLUX SALEM SUMP 38.00
E STIM CON - EA 15 MIN 90.00
E STIM CON - EA 15 MIN 90.00
CATARACT EXTRACTION W/LEN 3,648.70
MRI TEMP MAND JNT BIL 1,719.00
ANKLE RT-MIN 3V 134.00
ANKLE BIL-MIN 3V/SIDE 267.00
HUMERUS RT-MIN 2V 134.00
HUMERUS BIL-MIN 2V/SIDE 213.00
CLAVICLE RIGHT 131.00
CLAVICLE BIL 206.00
ELBOW RT 2V 134.00
ELBOW BIL 2V/SIDE 213.00
FEMUR RT-2V 134.00
FEMUR BIL-2V 213.00
FINGER LT-MIN 2V 117.00
RIBS RT-2V 153.00
RENAL PANEL 103.00
CALCANEOUS RT-MIN 2V 126.00
CALCANEOUS LT-MIN 2V 126.00
CALCANEOUS BIL-MIN 2V/SID 250.00
WRIST BIL 2V/SIDE 250.00
WRIST RT-2V 126.00
KNEE BIL 1 OR 2V/SIDE 236.00
KNEE/PATELLA RT-3V 142.53
KNEE/PATELLA BIL 3V/SIDE 285.00
CT LOWER EXT BIL W/O CONT 1,406.00
CT LUMBAR W/C 1,149.00
ARTERIAL PUNCTURE IN ER/O 197.63
CLTE/PATELLA LT-3V 142.53
TC99 PENTATE UP TO 25 57.00
TMJ BILATERAL 336.00
GASTROSCOPY W/TUBE PLACEM 2,669.66
YAG CAPSULOTOMY 1,324.00
HOLTER HOOKUP RECORD & DI 133.00
T3 TOTAL 81.00
TESTOSTERONE TOTAL 55.00
PSA CANCER SCREEN 55.00
EVALUATION DYSPHAGIA ORAL 284.00
SPEECH EVAL 175.00
SPEECH TRMT 175.00
DYSPHAGIA TRMT 15 MIN 121.88
DYSPHAGIA TRMT 190.00
ISOVUE 53.00
CT IAC W/O CONT 807.00
CT IAC W CONT 1,086.00
CT IAC W/WO 1,294.00
GASTROSTOMY TUBE REMOVAL 1,339.58
BLOOD ADM ONE PER VISIT O 1,746.00
IV INFUSION HYDRATION INI 202.00
INJ IM DIAG/THER/PROP 90.00
IV PUSH,INITIAL/SINGLE 304.00
BURN 1ST DEGREE 148.25
FINGER DISLOCATION 253.00
FINGER FX CLOSED 253.00
LUMBAR PUNCTURE 472.00
REMOVAL OF FOREIGN BODY W 377.00
INTUBATION IN ER 216.88
SUTURE REPAIR SCALP UP TO 329.90
SUTURE REPAIR UP TO 2.5 C 191.00
REMOVE FB EAR 114.71
AVULSION OF NAIL PLATE PA 148.25
CHEST TUBE INSERTION 748.00
CT SINUSES W/CONTRAST 923.00
DEBRIDEMENT - NON SELECTI 590.00
SENSORY INTEGRATION EA 15 90.00
ER ROOM - CC 30-74 MIN 991.00
ENDOTROL TRACHEAL TUBES 42.00
CO2 DETECTORS 45.00
AIRCAST ANKLE SPLINT 109.00
PROGRAF (TACROLIMUS) 141.00
AFB CONCENTRATION 19.00
AFB STAIN 23.00
CULTURE STOOL ADD PATH 33.00
BARTH GLAND CATH 72.00
11MM DISP TROCAR 154.00
C & S ID 20.00
C & S SENS 10 AB 17.66
C & S ID ADD ORGANISM 20.00
C & S SENS 10AB ADD ORG 17.66
PEAK FLOW/FVC/FEV1 241.92
MAJOR SURGERY 1ST SURGERY 3,750.00
MAJOR SURGERY 2ND SURGERY 3,750.00
MINOR SURGERY 1ST SURGERY 1,300.00
MINOR SURGERY 2ND SURGERY 1,300.00
STRYKER FLO/IRRIG SET 211.00
LENS FOG REDUCTION 29.00
L/S COMPLETE WITH BENDING 212.00
TEMP STRIP 15.00
BRAUN EPIDURAL TRAY 60.20
ANES FACE MASK 9.00
ESOPHAGEAL SETH/TEMP 26.00
ERP REMOVE FB NOSE 335.00
ERP FX METATARSAL 476.00
ERP FX METACARPAL 400.49
ERP FX NASAL 89.00
ERP DISLOCATION ELBOW 280.00
ERP DISLOCATION TEMPOROMA 93.00
ERP DISLOCATION TOE 310.00
ERP GASTRIC TUBE CHANGE 653.61
VOLUME MEASUREMENT 14.00
INTRA OC LENS 274.00
INFLUENZA A/B 118.88
INJ IM DIAG/THER/PROP 90.00
IV PUSH INITIAL/SINGLE 304.00
INJ IM DIAG/THER/PROP (OI 215.00
HERPES SIMPLEX TYPE I 27.00
HERPES SIMPLEX TYPE II 39.56
CELL COUNT(MISC BODY FLUI 62.00
BAIR HUGGER BLANKET 33.00
REPEAT EKG SAME DAY/DIFF 117.71
REPEAT EKG SAME DAY/SAME 117.71
REPEAT ABG ANALYSIS SAME 123.00
ARTERIAL PUNCTURE - NON E 197.63
NEB/MDI SUBSEQ TREATMENT 273.42
CHEST PHYSIO THERAPY SUBS 141.89
DNA AB NATIVE/DOUBLE 46.00
OSMOLARITY BLOOD 35.00
MICROALBUMIN URINE QUANTI 27.00
URINALYSIS DIP STICK ONLY 16.00
NERVE COND STUDY W/F-WAVE 146.00
10/12 TROCAR DIL TIP 134.00
5MM TROCAR DIL. TIP 112.00
35MM ENDO GIA 802.00
ENDO GIA RELOADS 208.00
SKIN STAPLER ROT. HEAD 64.00
LIGACLIP 195.00
ULNA NERVE PROTECTOR 20.00
BENZOIN SWAB STICK 3.00
INSUFFLATION TUBING 42.00
SPUTUM COLL W/AEROSOL TRE 275.54
CPAP INIT MANAGEMANT OR S 246.95
H PYLORI QUANT IGG 29.66
H PYLORI QUANT IGA 29.66
H PYLORI QUANT IGM 29.66
TRANSFERRIN 42.00
LDL DIRECT 26.36
MRI PELVIS WO 1,739.00
MRI PELVIS W/WO 2,119.00
EKG INTERP REPEAT 34.50
GAIT TRAINING 15MIN SAME 68.00
DEMO AND/OR EVAL OF NEBOR 246.95
IV INFUSION HYDRATION INI 202.00
DRUG SCREEN COLLECTION FE 10.00
RESUSCITATOR BAG DISP 49.00
TELEMETRY PRIVATE 720.00
WEST NILE AB IGM 91.00
WEST NILE AB IGG 91.00
ALLERGEN TESTING PER ALLE 29.00
LACTIC ACID 51.00
HEP BE AB 43.00
HEP B SURFACE AB 43.00
HEP BE AG 43.00
HEP B SURFACE AG 43.00
ENDO RETRIEVER 172.00
TUBE ATTACHMENT DEVICE 13.00
LAPAROSCOPIC DISSECTOR 175.00
PROTEIN TATAL URINE 42.00
GIARDIA ENZYME IMMUNOASSA 30.00
LAMICTAL 50.00
ROCKY MOUNTAIN SPOTTED FE 67.00
BNP LEVEL 87.00
FINGER PROBE DISP 42.00
H. PYLORI AG STOOL 38.00
APTT FRACTION 53.00
RUSSELL VIPER VENOM DILUT 53.00
CARDIOLIPIN IGG 53.00
CARDIOLIPIN IGA 53.00
CARDIOLIPIN IGM 53.00
TRI-IODOTHYRONINE FREE 36.41
POX SENSOR STAT DISP 32.00
SODIUM NA+ 26.00
POTASSIUM K+ STAT 26.00
IONIZED CALCIUM CA+ STAT 41.00
CHLORIDE C1- STAT 30.00
CARBXYHEMOGLOBIN STAT 77.00
IV INFUSION HYDRATION EA 155.00
MINUTES & UNITS ANESTHESI 50.00
LUNG SCAN (VENT & PERF) 660.51
T4 TOTAL 62.00
EBV EARLY AG 30.00
PULSE OX WALK 34.00
HEAT-MOSITURE EXCHANGER 15.00
EBV VCA-IGG 50.00
EBV VCA-IGM 50.00
INTUBATION, ENDOTRACHEAL 439.00
CENTRAL LINE PLACEMENT UN 1,836.00
CENTRAL LINE PLACEMENT OV 1,336.00
INSERTION PICC LINE < 5 Y 144.44
INSERTION PICC LINE > 5 Y 134.25
IVP 66.00
CARDIOPULMONARY RESUSCITA 559.00
OBS LEVEL 1 DAILY ROUND 43.00
OBS LEVEL 2 DAILY ROUND 61.00
OBS LEVEL 3 DAILY ROUND 72.53
OBS LEVEL 4 DAILY ROUND 113.00
OBSERVATION DISCHARGE 117.00
OBSERVATION H&P LEVEL 1 146.00
OBSERVATION H&P LEVEL 2 195.00
OBSERVATION H&P LEVEL 3 249.00
ACUTE H&P LEVEL 1 163.00
ACUTE H&P LEVEL 2 219.00
ACUTE H&P LEVEL 3 269.00
SUB OBS CARE PROB FOCUSED 76.00
SUB OBS CARE EXP PROB FOC 140.00
SUB OBS DETAILED 35 MIN 200.00
ACUTE LEVEL 1 DAILY ROUND 86.00
ACUTE LEVEL 2 DAILY ROUND 117.00
ACUTE LEVEL 3 DAILY ROUND 172.00
ADMIT & DISCHARGE SAME DA 161.00
ADMIT & DISCHARGE SAME DA 218.00
ADMIT & DISCHARGE SAME DA 275.00
ACUTE DISCHARGE SUMMARY 110.00
D/C MORE THAN 30 MIN 127.00
INTIAL IP CONSULT 2 180.00
INTIAL IP CONSULT 3 221.00
CONSULT, INITIAL INPT 348.00
INITIAL NH LEVEL 1 111.00
INITIAL NH LEVEL 2 155.00
NH ROUND LEVEL 1 66.00
NH ROUND LEVEL II 84.00
NH ROUND LEVEL III 122.00
NH ROUND LEVEL IV 167.00
N/H DISCHARGE 120.00
SWING/BED NURSING HOME DI 100.00
NSF FEE 30.00
REMOVE PICC LINE 72.53
ACNE SURGERY
195.00
DRAINAGE OF SKIN ABSCESS
215.00
DRAINAGE OF SKIN ABSCESS
325.00
DRAINAGE OF PILONIDAL CYST
80.00
DRAINAGE OF PILONIDAL CYST
473.00
REMOVE FOREIGN BODY
165.00
REMOVE FOREIGN BODY
378.00
DRAINAGE OF HEMATOMA/FLUID
260.00
PUNCTURE DRAINAGE OF LESION
237.60
DEBRIDE INFECTED SKIN
102.00
DEBRIDE INFECTED SKIN ADD-ON
350.00
DEB SUBQ TISSUE 20 SQ CM/<
208.00
DEB MUSC/FASCIA 20 SQ CM/<
422.00
DEB BONE 20 SQ CM/<
640.00
DEB SUBQ TISSUE ADD-ON
59.00
DEB MUSC/FASCIA ADD-ON
103.00
TRIM SKIN LESION
70.00
TRIM SKIN LESIONS 2 TO 4
90.00
TRIM SKIN LESIONS OVER 4
110.00
BIOPSY SKIN LESION
117.00
REMOVAL OF SKIN TAGS <W/15
155.00
REMOVE SKIN TAGS ADD-ON
104.00
SHAVE SKIN LESION 0.5 CM/<
123.00
SHAVE SKIN LESION 0.6-1.0 CM
218.20
SHAVE SKIN LESION 1.1-2.0 CM
189.00
SHAVE SKIN LESION >2.0 CM
275.26
EXC TR-EXT B9+MARG 0.5 CM<
230.00
EXC TR-EXT B9+MARG 0.6-1 CM
250.00
EXC TR-EXT B9+MARG 1.1-2 CM
300.00
EXC TR-EXT B9+MARG 2.1-3CM/<
364.00
EXC TR-EXT B9+MARG 3.1-4 CM
499.00
EXC TR-EXT B9+MARG >4.0 CM
734.00
EXC H-F-NK-SP B9+MARG 0.5/<
221.00
EXC H-F-NK-SP B9+MARG 0.6-1
250.00
EXC H-F-NK-SP B9+MARG 1.1-2
304.00
EXC H-F-NK-SP B9+MARG 2.1-3
430.00
EXC H-F-NK-SP B9+MARG 3.1-4
550.00
EXC H-F-NK-SP B9+MARG >4 CM
757.00
EXC FACE-MM B9+MARG 0.5 CM/<
240.00
EXC FACE-MM B9+MARG 0.6-1 CM
290.00
EXC FACE-MM B9+MARG 1.1-2 CM
692.00
EXC FACE-MM B9+MARG 2.1-3 CM
482.00
EXC FACE-MM B9+MARG 3.1-4 CM
619.00
EXC FACE-MM B9+MARG >4 CM
886.00
REMOVAL SWEAT GLAND LESION
683.22
REMOVAL SWEAT GLAND LESION
516.74
EXC TR-EXT MAL+MARG 0.5 CM/<
300.00
EXC TR-EXT MAL+MARG 0.6-1 CM
351.00
EXC TR-EXT MAL+MARG 1.1-2 CM
410.00
EXC TR-EXT MAL+MARG 2.1-3 CM
424.00
EXC TR-EXT MAL+MARG 3.1-4 CM
657.00
EXC TR-EXT MAL+MARG >4 CM
960.00
EXC H-F-NK-SP MAL+MARG 0.5/<
391.00
EXC S/N/H/F/G MAL+MRG 0.6-1
492.00
EXC S/N/H/F/G MAL+MRG 1.1-2
550.00
EXC S/N/H/F/G MAL+MRG 2.1-3
692.00
EXC S/N/H/F/G MAL+MRG 3.1-4
852.00
EXC S/N/H/F/G MAL+MRG >4 CM
1,065.00
EXC F/E/E/N/L MAL+MRG 0.5CM<
323.00
EXC F/E/E/N/L MAL+MRG 0.6-1
564.00
EXC F/E/E/N/L MAL+MRG 1.1-2
601.00
EXC F/E/E/N/L MAL+MRG 2.1-3
585.00
EXC F/E/E/N/L MAL+MRG 3.1-4
729.00
EXC F/E/E/N/L MAL+MRG >4 CM
969.00
TRIM NAIL(S) ANY NUMBER
40.00
DEBRIDE NAIL 1-5
58.00
DEBRIDE NAIL 6 OR MORE
90.00
REMOVAL OF NAIL PLATE
155.00
REMOVE NAIL PLATE ADD-ON
84.00
DRAIN BLOOD FROM UNDER NAIL
87.00
REMOVAL OF NAIL BED
300.00
REPAIR OF NAIL BED
519.00
EXCISION OF NAIL FOLD TOE
283.00
REMOVE PILONIDAL CYST EXTEN
1,036.16
REMOVE PILONIDAL CYST COMPL
1,047.42
REMOVE CONTRACEPTIVE CAPSULE
260.92
REMOVE DRUG IMPLANT DEVICE
338.00
RPR S/N/AX/GEN/TRNK 2.5CM/<
280.00
RPR S/N/AX/GEN/TRNK2.6-7.5CM
275.00
RPR F/E/E/N/L/M 2.5 CM/<
275.00
RPR F/E/E/N/L/M 2.6-5.0 CM
323.00
INTMD RPR S/A/T/EXT 2.5 CM/<
293.00
INTMD RPR S/A/T/EXT 2.6-7.5
378.00
INTMD RPR S/TR/EXT 7.6-12.5
451.00
INTMD RPR S/A/T/EXT 20.1-30
746.00
INTMD RPR N-HF/GENIT 2.5CM/<
350.00
INTMD RPR N-HF/GENIT2.6-7.5
378.00
INTMD RPR FACE/MM 2.5 CM/<
425.00
INTMD RPR FACE/MM 2.6-5.0 CM
472.00
INTMD RPR FACE/MM 5.1-7.5 CM
425.00
INTMD RPR FACE/MM 7.6-12.5CM
861.00
RPR S/N/AX/GEN/TRNK 2.5CM/<
280.00
CMPLX RPR F/C/C/M/N/AX/G/H/F
1,316.00
DRESS/DEBRID P-THICK BURN S
160.00
DESTRUCT PREMALG LESION
127.00
DESTRUCT PREMALG LES 2-14
31.00
DESTRUCT B9 LESION 1-14
182.00
DESTRUCT LESION 15 OR MORE
158.70
CHEMICAL CAUTERY TISSUE
130.00
DESTRUCTION OF SKIN LESIONS
368.00
DRAINAGE OF BREAST LESION
227.00
DRAIN BREAST LESION ADD-ON
110.00
INCISION OF BREAST LESION
564.44
BX BREAST PERCUT W/O IMAGE
271.96
REMOVAL OF BREAST LESION
1,016.00
EXCISION BREAST LESION
841.62
MAST SIMPLE COMPLETE
1,860.94
I&D ABSCESS SUBFASCIAL
571.44
EXPLORE WOUND NECK
1,131.42
EXPLORE WOUND EXTREMITY
650.12
DEEP MUSCLE BIOPSY
518.00
REMOVAL OF FOREIGN BODY
272.88
REMOVAL OF FOREIGN BODY
465.16
INJ TENDON SHEATH/LIGAMENT
153.00
INJ TENDON ORIGIN/INSERTION
121.00
INJ TRIGGER POINT 1/2 MUSCL
129.00
INJECT TRIGGER POINTS 3/>
129.00
DRAIN/INJ JOINT/BURSA W/O US
114.00
DRAIN/INJ JOINT/BURSA W/O US
145.00
DRAIN/INJ JOINT/BURSA W/O US
180.00
ASPIRATE/INJ GANGLION CYST
98.00
REMOVAL OF SUPPORT IMPLANT
273.50
REMOVAL OF SUPPORT IMPLANT
793.28
REMOVAL OF FASCIA FOR GRAFT
740.44
REMOVAL OF FASCIA FOR GRAFT
931.66
REMOVAL OF TENDON FOR GRAFT
941.74
EXC FACE LES SBQ 2 CM/>
630.22
EXC FACE TUM DEEP 2 CM/>
966.00
CLOSED TX NOSE FX W/O MANJ
276.00
CLOSED TX NOSE FX W/O STABLJ
500.00
RESET DISLOCATED JAW
322.00
EXC NECK LES SC 3 CM/>
1,216.00
EXC NECK TUM DEEP 5 CM/>
1,354.74
TREATMENT OF RIB FRACTURE
325.00
TREAT STERNUM FRACTURE
273.00
EXC BACK LES SC < 3 CM
846.28
EXC BACK LES SC 3 CM/>
877.56
EXC BACK TUM DEEP 5 CM/>
2,051.00
EXC ABD LES SC 3 CM/>
808.38
DRAIN SHOULDER LESION
476.40
DRAIN SHOULDER BURSA
407.24
DRAIN SHOULDER BONE LESION
1,259.42
EXPLORATORY SHOULDER SURGERY
1,338.58
EXPLORATORY SHOULDER SURGERY
1,056.48
EXC SHOULDER LES SC 3 CM/>
1,145.00
SHOULDER JOINT SURGERY
841.10
REMOVE SHOULDER JOINT LINING
1,294.86
INCISION OF COLLARBONE JOINT
910.04
EXPLORE TREAT SHOULDER JOINT
1,226.04
PARTIAL REMOVAL COLLAR BONE
1,082.66
REMOVAL OF COLLAR BONE
1,319.02
REMOVE SHOULDER BONE PART
1,130.44
REPAIR ROTATOR CUFF ACUTE
1,532.10
REPAIR ROTATOR CUFF CHRONIC
1,590.20
RELEASE OF SHOULDER LIGAMENT
1,293.94
REPAIR OF SHOULDER
1,807.64
REPAIR BICEPS TENDON
1,389.32
REMOVE/TRANSPLANT TENDON
1,405.24
REPAIR SHOULDER CAPSULE
1,766.16
REPAIR SHOULDER CAPSULE
1,870.84
RPR S/N/AX/GEN/TRNK 2.5CM/<
280.00
REPAIR SHOULDER CAPSULE
2,038.18
REPAIR SHOULDER CAPSULE
1,985.38
REPAIR SHOULDER CAPSULE
2,082.30
REPAIR SHOULDER CAPSULE
2,090.56
REVISION OF COLLAR BONE
1,785.16
TREAT CLAVICLE FRACTURE
399.34
TREAT CLAVICLE FRACTURE
647.20
TREAT CLAVICLE DISLOCATION
409.74
TREAT CLAVICLE DISLOCATION
636.36
TREAT CLAVICLE DISLOCATION
1,025.12
TREAT CLAVICLE DISLOCATION
1,153.20
TREAT CLAVICLE DISLOCATION
411.14
TREAT CLAVICLE DISLOCATION
568.16
TREAT CLAVICLE DISLOCATION
1,045.62
TREAT CLAVICLE DISLOCATION
1,218.14
TREAT SHOULDER BLADE FX
1,649.46
TREAT SHOULDER DISLOCATION
739.46
TREAT SHOULDER DISLOCATION
1,079.80
EX ARM/ELBOW TUM DEEP < 5 CM
1,000.72
REMOVAL OF ELBOW BURSA
643.70
REPAIR OF RUPTURED TENDON
1,446.66
REPAIR ELBOW W/DEB OPEN
961.80
TREAT HUMERUS FRACTURE
883.75
TREAT HUMERUS FRACTURE
1,502.50
TREAT ELBOW DISLOCATION
1,156.00
TREAT ELBOW DISLOCATION
350.00
INCISION OF TENDON SHEATH
617.54
EXC FOREARM LES SC 3 CM/>
784.22
EXC FOREARM TUM DEEP 3 CM/>
983.84
EXC FOREARM LES SC < 3 CM
693.00
REMOVE WRIST TENDON LESION
588.08
REPAIR RADIUS OR ULNA
1,486.74
TREAT FRACTURE OF RADIUS
1,458.58
TREAT FRACTURE OF ULNA
661.00
TREAT FRACTURE RADIUS & ULNA
705.00
TREAT FRACTURE RADIUS & ULNA
1,453.00
TREAT FRACTURE RADIUS/ULNA
765.00
TREAT FRACTURE RADIUS/ULNA
1,497.00
TREAT FX RADIAL 3+ FRAG
1,949.80
DRAINAGE OF FINGER ABSCESS
341.92
INCISE FINGER TENDON SHEATH
567.24
REMOVE TENDON SHEATH LESION
871.00
TREAT METACARPAL FRACTURE
650.00
TREAT METACARPAL FRACTURE
946.00
TREAT METACARPAL FRACTURE
944.00
TREAT METACARPAL FRACTURE
1,065.00
TREAT FINGER FRACTURE EACH
501.00
TREAT FINGER FRACTURE EACH
913.00
TREAT FINGER FRACTURE EACH
1,369.64
TREAT FINGER FRACTURE EACH
541.00
TREAT FINGER FRACTURE EACH
864.00
TREAT FINGER FRACTURE EACH
923.46
EXC HIP PELVIS LES SC 3 CM/>
877.20
EXC HIP/PELV TUM DEEP 5 CM/>
1,401.82
TREAT TAIL BONE FRACTURE
350.00
EXC THIGH/KNEE LES SC 3 CM/>
1,149.00
REMOVAL OF KNEE CYST
881.52
SURGERY TO STOP LEG GROWTH
1,919.00
TREATMENT OF THIGH FRACTURE
1,031.00
TREAT KNEECAP FRACTURE
881.00
TREAT KNEE FRACTURE
1,035.00
EXC LEG/ANKLE TUM < 3 CM
278.00
REMOVE LOWER LEG BONE LESION
1,096.76
REPAIR OF ANKLE LIGAMENT
892.96
TREATMENT OF TIBIA FRACTURE
945.00
TREATMENT OF TIBIA FRACTURE
1,502.00
CLTX MEDIAL ANKLE FX
899.00
CLTX MED ANKLE FX W/MNPJ
894.00
OPTX MEDIAL ANKLE FX
1,134.80
CLTX POST ANKLE FX W/MNPJ
810.92
TREATMENT OF FIBULA FRACTURE
838.00
TREATMENT OF FIBULA FRACTURE
1,319.66
TREATMENT OF ANKLE FRACTURE
879.00
TREATMENT OF ANKLE FRACTURE
1,188.00
TREATMENT OF ANKLE FRACTURE
1,216.14
TREATMENT OF ANKLE FRACTURE
976.00
TREATMENT OF ANKLE FRACTURE
1,440.34
TREAT LOWER LEG JOINT
1,271.24
REMOVAL OF FOOT LESION
973.92
REMOVAL OF FOOT LESION
877.04
REMOVAL OF HEEL BONE
782.04
REMOVAL OF HEEL SPUR
983.40
REMOVAL OF FOOT FOREIGN BODY
534.00
REMOVAL OF FOOT FOREIGN BODY
909.00
REMOVAL OF FOOT FOREIGN BODY
704.12
REPAIR OF FOOT TENDON
881.86
REPAIR/GRAFT OF FOOT TENDON
1,075.06
REPAIR OF METATARSALS
1,091.62
TREATMENT OF HEEL FRACTURE
805.00
TREAT MIDFOOT FRACTURE EACH
720.00
TREAT METATARSAL FRACTURE
666.00
TREAT METATARSAL FRACTURE
1,014.84
TREAT BIG TOE FRACTURE
325.00
TREAT BIG TOE FRACTURE
330.00
TREATMENT OF TOE FRACTURE
325.00
TREATMENT OF TOE FRACTURE
438.00
AMPUTATION THRU METATARSAL
1,387.20
AMPUTATION TOE & METATARSAL
1,080.00
APPLICATION OF LONG ARM CAST
175.74
APPLY HAND/WRIST CAST
143.00
APPLY LONG ARM SPLINT
161.42
STRAPPING OF KNEE
54.00
STRAPPING OF ANKLE AND/OR FT
315.00
APPLICATION OF PASTE BOOT
125.00
SHOULDER ARTHROSCOPY/SURGERY
529.65
SHOULDER ARTHROSCOPY/SURGERY
333.52
ARTHROSCOP ROTATOR CUFF REPR
1,986.56
KNEE ARTHROSCOPY/SURGERY
960.98
KNEE ARTHROSCOPY/SURGERY
1,226.10
KNEE ARTHROSCOPY/SURGERY
1,223.94
KNEE ARTHROSCOPY/SURGERY
1,008.04
DRAINAGE OF NOSE LESION
418.00
REMOVE NASAL FOREIGN BODY
75.00
REMOVE FOREIGN BODY LARYNX
247.92
INSERTION OF CHEST TUBE
299.06
ASPIRATE PLEURA W/O IMAGING
183.57
NON-ROUTINE BL DRAW 3/> YRS
55.00
ROUTINE VENIPUNCTURE
20.00
CAPILLARY BLOOD DRAW
18.00
INSERT NON-TUNNEL CV CATH
419.00
REMOVAL TUNNELED CV CATH
389.60
TEMPORAL ARTERY PROCEDURE
391.46
BIOPSY/REMOVAL LYMPH NODES
901.00
NEEDLE BIOPSY LYMPH NODES
331.00
ESOPHAGOSCOPY FLEXIBLE BRUSH
618.00
EGD DIAGNOSTIC BRUSH WASH
618.00
EGD BIOPSY SINGLE/MULTIPLE
717.00
EGD PLACE GASTROSTOMY TUBE
486.00
EGD REMOVE FOREIGN BODY
843.00
EGD GUIDE WIRE INSERTION
745.00
EGD REMOVE LESION SNARE
928.00
DILATE ESOPHAGUS 1/MULT PASS
220.00
CHANGE GASTROSTOMY TUBE
541.00
FREEING OF BOWEL ADHESION
2,065.98
APPENDECTOMY
1,648.58
LAPAROSCOPY APPENDECTOMY
2,058.00
EXC RECT TUM TRANSANAL PART
1,125.18
PROCTOSIGMOIDOSCOPY DX
101.84
DIAGNOSTIC SIGMOIDOSCOPY
238.00
SIGMOIDOSCOPY AND BIOPSY
346.00
SIGMOIDOSCOPY W/TUMR REMOVE
749.00
DIAGNOSTIC COLONOSCOPY
872.00
COLONOSCOPY AND BIOPSY
959.00
COLONOSCOPY W/LESION REMOVAL
1,236.00
SURG DX EXAM ANORECTAL
199.50
INCISION OF RECTAL ABSCESS
649.00
INCISION OF RECTAL ABSCESS
882.40
INCISE EXTERNAL HEMORRHOID
506.00
REMOVE IN/EX HEM GROUPS 2+
1,587.00
REMOVE ANAL FIST SUBQ
952.00
REMOVAL OF HEMORRHOID CLOT
206.72
DIAGNOSTIC ANOSCOPY SPX
76.26
ANOSCOPY AND BIOPSY
406.84
DESTRUCTION ANAL LESION(S)
256.50
DESTRUCTION ANAL LESION(S)
796.00
LAPAROSCOPIC CHOLECYSTECTOMY
2,862.00
REMOVAL OF GALLBLADDER
1,979.98
REOPENING OF ABDOMEN
1,975.78
DIAG LAPARO SEPARATE PROC
601.00
PRP I/HERN INIT REDUC >5 YR
1,340.00
PRP I/HERN INIT BLOCK >5 YR
1,097.96
REREPAIR ING HERNIA BLOCKED
1,759.00
RPR FEM HERNIA INIT BLOCKED
1,152.76
RPR VENTRAL HERN INIT REDUC
1,858.00
RPR VENTRAL HERN INIT BLOCK
2,136.00
REREPAIR VENTRL HERN REDUCE
1,424.14
HERNIA REPAIR W/MESH
495.00
RPR UMBIL HERN REDUC > 5 YR
1,393.00
RPR UMBIL HERN BLOCK > 5 YR
890.08
PREPUTIAL STRETCHING
170.00
SPINAL FLUID TAP DIAGNOSTIC
278.00
CARPAL TUNNEL SURGERY
791.68
REMOVE FOREIGN BODY FROM EYE
130.00
CLEAR OUTER EAR CANAL
195.00
REMOVE IMPACTED EAR WAX UNI
22.10
REMOVE IMPACTED EAR WAX UNI
115.00
X-RAY EXAM OF JAW <4VIEWS
40.66
X-RAY EXAM OF JAW 4/> VIEWS
75.00
X-RAY EXAM OF MASTOIDS
65.00
X-RAY EXAM OF FACIAL BONES
80.00
X-RAY EXAM OF NASAL BONES
55.00
X-RAY EXAM OF EYE SOCKETS
100.00
X-RAY EXAM OF SINUSES
68.00
X-RAY EXAM OF SINUSES
86.00
X-RAY EXAM OF SKULL
57.00
X-RAY EXAM OF SKULL
102.00
X-RAY EXAM OF JAW JOINT
72.00
X-RAY EXAM OF JAW JOINTS
106.00
X-RAY EXAM OF NECK
58.00
CHEST X-RAY 1 VIEW FRONTAL
59.00
CHEST X-RAY 2VW FRONTAL&LATL
72.00
Chest 1 View
18.44
Chest 2 Views
34.10
X-RAY EXAM RIBS UNI 2 VIEWS
70.00
X-RAY EXAM UNILAT RIBS/CHEST
42.86
X-RAY EXAM RIBS BIL 3 VIEWS
85.00
X-RAY EXAM RIBS/CHEST4/> VWS
102.00
X-RAY EXAM BREASTBONE 2/>VWS
62.00
X-RAY EXAM OF SPINE 1 VIEW
47.00
X-RAY EXAM NECK SPINE 2-3 VW
67.00
X-RAY EXAM NECK SPINE 4/5VWS
100.00
X-RAY EXAM NECK SPINE 6/>VWS
101.00
X-RAY EXAM THORAC SPINE 2VWS
74.00
X-RAY EXAM THORAC SPINE 3VWS
61.80
X-RAY EXAM THORAC SPINE4/>VW
48.90
X-RAY EXAM ENTIRE SPI 1 VW
47.80
X-RAY EXAM ENTIRE SPI 2/3 VW
87.00
X-RAY EXAM ENTIRE SPI 6/> VW
64.04
X-RAY EXAM L-S SPINE 2/3 VWS
61.00
X-RAY EXAM L-2 SPINE 4/>VWS
101.00
X-RAY EXAM L-S SPINE BENDING
113.00
X-RAY EXAM OF PELVIS
75.00
X-RAY EXAM OF PELVIS
67.88
X-RAY EXAM SACRUM TAILBONE
81.00
X-RAY EXAM OF COLLAR BONE
64.00
X-RAY EXAM OF SHOULDER BLADE
67.00
X-RAY EXAM OF SHOULDER
71.00
X-RAY EXAM OF HUMERUS
65.00
X-RAY EXAM OF ELBOW
63.00
X-RAY EXAM OF FOREARM
60.00
X-RAY EXAM OF WRIST
47.00
X-RAY EXAM OF WRIST
62.00
X-RAY EXAM OF HAND
48.00
X-RAY EXAM OF HAND
62.00
X-RAY EXAM OF FINGER(S)
51.00
X-RAY EXAM HIP UNI 1 VIEW
37.66
X-RAY EXAM HIP UNI 2-3 VIEWS
73.56
X-RAY EXAM OF HIP
114.00
X-RAY EXAM OF HIPS
79.00
X-RAY EXAM HIPS BI 3-4 VIEWS
87.04
X-RAY EXAM OF THIGH
65.00
X-RAY EXAM OF FEMUR 2/>
39.42
X-RAY EXAM OF KNEE 1 OR 2
62.00
X-RAY EXAM OF KNEE 3
63.00
X-RAY EXAM KNEE 4 OR MORE
48.08
X-RAY EXAM OF KNEES
47.24
X-RAY EXAM OF LOWER LEG
61.00
X-RAY EXAM OF ANKLE
36.94
X-RAY EXAM OF ANKLE
62.00
X-RAY EXAM OF FOOT
54.00
X-RAY EXAM OF FOOT
62.00
X-RAY EXAM OF HEEL
57.00
X-RAY EXAM OF TOE(S)
51.00
X-RAY EXAM OF ABDOMEN
61.00
Abdomen 1 View
31.58
Abdomen 2 Views
37.84
X-RAY EXAM OF ABDOMEN
84.00
X-RAY EXAM ABDOMEN 3+ VIEWS
44.12
X-RAYS FOR BONE AGE
23.38
METABOLIC PANEL IONIZED CA
65.00
METABOLIC PANEL TOTAL CA
50.00
GENERAL HEALTH PANEL
180.00
ELECTROLYTE PANEL
30.00
COMPREHEN METABOLIC PANEL
70.00
LIPID PANEL
60.00
RENAL FUNCTION PANEL
22.00
ACUTE HEPATITIS PANEL
110.00
HEPATIC FUNCTION PANEL
55.00
DRUG SCREEN QUALITATE/MULTI
70.00
Wellness Works DOT E Screen NonDOTa
35.00
DRUG SCREEN SINGLE
65.00
DRUG CONFIRMATION
65.00
ASSAY CARBAMAZEPINE TOTAL
60.00
ASSAY OF DIGOXIN TOTAL
60.00
ASSAY DIPROPYLACETIC ACD TOT
65.00
DRUG SCREEN QUAN LAMOTRIGINE
32.72
DRUG SCRN QUAN LEVETIRACETAM
32.72
ASSAY OF LITHIUM
35.00
DRUG SCRN QUANT OXCARBAZEPIN
36.36
ASSAY OF PHENOBARBITAL
60.00
ASSAY OF PHENYTOIN TOTAL
55.00
ASSAY OF TACROLIMUS
141.00
ASSAY OF THEOPHYLLINE
60.00 DRUG SCREEN, ANY NUMBER OF DRUG CLASSES
35.00
DRUG TEST PRSMV DIR OPT OBS
29.92
ALKALOIDS NOS
20.00
URINALYSIS NONAUTO W/SCOPE
15.00
URINALYSIS AUTO W/SCOPE
20.00
URINALYSIS AUTO W/O SCOPE
15.00
URINE PREGNANCY TEST
20.00
BRCA1&2 SEQ & FULL DUP/DEL
5,006.52
BRCA1&2 SEQ & COM DUP/DEL
4,390.96
BRCA1&2 UNCOM DUP/DEL VAR
1,171.82
F2 GENE
134.06
F5 GENE
80.00
JAK2 GENE
249.74
HLA I TYPING 1 ANTIGEN LR
179.62
ASSAY OF ACETAMINOPHEN
60.00
TEST FOR ACETONE/KETONES
12.40
ASSAY OF ACTH
160.00
ASSAY OF SERUM ALBUMIN
25.00
MICROALBUMIN QUANTITATIVE
30.00
MICROALBUMIN SEMIQUANT
30.00
ASSAY OF ETHANOL
50.00
ASSAY OF BREATH ETHANOL
58.50
ASSAY OF ALDOLASE
30.85
ASSAY OF ALDOSTERONE
165.00
ALPHA-1-ANTITRYPSIN TOTAL
29.02
ALPHA-FETOPROTEIN SERUM
60.00
ASSAY OF AMMONIA
60.00
ASSAY OF AMYLASE
30.00
ASSAY OF ANDROSTENEDIONE
135.00
ANGIOTENSIN I ENZYME TEST
99.00
ASSAY OF ARSENIC
80.00
BILIRUBIN TOTAL
28.00
BILIRUBIN DIRECT
42.00
OCCULT BLOOD FECES
20.00
OCCULT BLD FECES 1-3 TESTS
15.00
ASSAY OF CADMIUM
90.00
VITAMIN D 25 HYDROXY
120.00
ASSAY OF CALCITONIN
66.16
ASSAY OF CALCIUM
25.00
ASSAY OF CALCIUM
55.00
ASSAY OF CALCIUM IN URINE
30.00
CALCULUS ASSAY QUANT
55.00
ASSAY BLOOD CARBON DIOXIDE
20.00
CARCINOEMBRYONIC ANTIGEN
80.00
ASSAY THREE CATECHOLAMINES
120.00
ASSAY OF CERULOPLASMIN
40.00
CHEMILUMINESCENT ASSAY
54.00
ASSAY OF URINE CHLORIDE
13.80
ASSAY BLD/SERUM CHOLESTEROL
25.00
CHROMOTOGRAPHY QUANT SING
97.00
CORTISOL FREE
75.00
TOTAL CORTISOL
70.00
COL CHROMOTOGRAPHY QUAL/QUAN
60.00
ASSAY OF CK (CPK)
30.00
CREATINE MB FRACTION
40.00
ASSAY OF CREATININE
25.00
ASSAY OF URINE CREATININE
25.00
CREATININE CLEARANCE TEST
35.00
VITAMIN B-12
56.00
DEHYDROEPIANDROSTERONE
35.00
DEHYDROEPIANDROSTERONE
100.00
VIT D 1 25-DIHYDROXY
155.00
ASSAY OF ERYTHROPOIETIN
80.00
ASSAY OF ESTRADIOL
105.00
ASSAY OF ESTROGEN
85.00
ASSAY OF ESTRONE
110.00
FATS/LIPIDS FECES QUAL
12.58
ASSAY OF FERRITIN
65.00
ASSAY OF FOLIC ACID SERUM
60.00
ASSAY IGA/IGD/IGG/IGM EACH
45.00
ASSAY OF IGE
75.00
GLUCOSE OTHER FLUID
15.00
ASSAY GLUCOSE BLOOD QUANT
20.00
GLUCOSE TOLERANCE TEST (GTT)
60.00
GTT-ADDED SAMPLES
20.00
ASSAY OF G6PD ENZYME
29.00
GLUCOSE BLOOD TEST
15.00
ASSAY OF GGT
32.00
ASSAY OF GONADOTROPIN (FSH)
80.00
ASSAY OF GONADOTROPIN (LH)
80.00
ASSAY GROWTH HORMONE (HGH)
75.00
H PYLORI (C-13) BREATH
184.00
HEMOGLOBIN CHROMOTOGRAPHY
49.54
GLYCOSYLATED HEMOGLOBIN TEST
45.00
BLOOD METHEMOGLOBIN ASSAY
30.00
ASSAY OF HOMOCYSTINE
65.00
ASSAY OF CORTICOSTEROIDS 17
85.00
ASSAY OF 5-HIAA
65.00
IMMUNOASSAY NONANTIBODY
50.00
RIA NONANTIBODY
51.00
IMMUNOASSAY QUANT NOS NONAB
52.00
ASSAY OF INSULIN
69.00
ASSAY OF IRON
30.00
IRON BINDING TEST
45.00
ASSAY 17- KETOSTEROIDS
62.00
ASSAY OF LACTIC ACID
15.96
LACTATE (LD) (LDH) ENZYME
25.00
ASSAY OF LEAD
50.00
ASSAY OF LIPASE
35.00
ASSAY OF LIPOPROTEIN(A)
35.52
LIPOPROTEIN BLD QUAN PART
68.00
ASSAY OF MAGNESIUM
25.00
ASSAY OF MERCURY
75.00
ASSAY OF METANEPHRINES
70.00
ASSAY OF MYOGLOBIN
60.00
ASSAY OF NATRIURETIC PEPTIDE
100.00
ASSAY NEPHELOMETRY NOT SPEC
42.50
MOLECULE ISOLATE
50.00
MOLECULE GEL ELECTROPHOR
25.00
MOLECULAR DIAGNOSTICS
30.00
MOLECULE NUCLEIC AMPLI EACH
50.00
MOLECULE NUCLEIC AMPLI ADDON
50.00
GENETIC EXAMINATION
60.00
ORGANIC ACID SINGLE QUANT
60.00
ASSAY OF BLOOD OSMOLALITY
30.00
ASSAY OF URINE OSMOLALITY
35.00
ASSAY OF PARATHORMONE
170.00
ASSAY FOR CALPROTECTIN FECAL
53.86
ASSAY ALKALINE PHOSPHATASE
25.00
ASSAY ALKALINE PHOSPHATASES
54.00
ASSAY OF PHOSPHORUS
58.00
ASSAY OF PORPHOBILINOGEN
10.00
ASSAY OF SERUM POTASSIUM
25.00
ASSAY OF URINE POTASSIUM
28.00
ASSAY OF PREALBUMIN
43.00
ASSAY OF PROGESTERONE
75.00
ASSAY OF PROLACTIN
90.00
ASSAY OF PSA TOTAL
55.00
ASSAY OF PROTEIN SERUM
25.00
ASSAY OF PROTEIN URINE
25.00
PROTEIN E-PHORESIS SERUM
60.00
PROTEIN E-PHORESIS/URINE/CSF
60.00
ASSAY RBC PROTOPORPHYRIN
61.00
ASSAY OF RENIN
85.00
ASSAY OF SELENIUM
63.04
ASSAY OF SEROTONIN
110.00
ASSAY OF SEX HORMONE GLOBUL
65.00
ASSAY OF SIALIC ACID
60.00
ASSAY OF SERUM SODIUM
26.00
ASSAY OF URINE SODIUM
22.00
ASSAY OF SOMATOMEDIN
100.00
ASSAY OF FREE TESTOSTERONE
100.00
ASSAY OF TOTAL TESTOSTERONE
100.00
ASSAY OF VITAMIN B-1
70.00
ASSAY OF THYROGLOBULIN
13.80
ASSAY OF TOTAL THYROXINE
35.00
ASSAY OF FREE THYROXINE
50.00
ASSAY THYROID STIM HORMONE
70.00
ASSAY OF TSI GLOBULIN
125.56
ASSAY OF VITAMIN E
38.90
TRANSFERASE (AST) (SGOT)
25.00
ALANINE AMINO (ALT) (SGPT)
25.00
ASSAY OF TRANSFERRIN
15.96
ASSAY OF TRIGLYCERIDES
25.00
ASSAY OF THYROID (T3 OR T4)
35.00
ASSAY TRIIODOTHYRONINE (T3)
60.00
FREE ASSAY (FT-3)
80.00
T3 REVERSE
43.28
ASSAY OF TROPONIN QUANT
45.00
ASSAY OF TROPONIN QUAL
20.98
ASSAY OF UREA NITROGEN
25.00
ASSAY OF BLOOD/URIC ACID
25.00
ASSAY OF URINE VMA
70.00
ASSAY OF VASOPRESSIN
93.12
ASSAY OF VITAMIN A
31.84
ASSAY OF VITAMIN K
33.88
ASSAY OF ZINC
37.50
ASSAY OF C-PEPTIDE
70.00
CHORIONIC GONADOTROPIN TEST
57.00
CHORIONIC GONADOTROPIN ASSAY
35.00
HEMATOCRIT
20.00
HEMOGLOBIN
20.00
COMPLETE CBC W/AUTO DIFF WBC
40.00
COMPLETE CBC AUTOMATED
35.00
AUTOMATED RBC COUNT
20.00
MANUAL RETICULOCYTE COUNT
32.00
AUTOMATED RETICULOCYTE COUNT
25.00
AUTOMATED LEUKOCYTE COUNT
20.00
AUTOMATED PLATELET COUNT
13.52
BLOOD SMEAR INTERPRETATION
65.00
CLOT FACTOR II PROTHROM SPEC
21.00
BLOOC CLOT FACTOR V TEST
65.00
CLOT FACTOR VII PROCONVERTIN
61.00
CLOT FACTOR VIII RELTD ANTGN
159.50
ANTITHROMBIN III ACTIVITY
75.00
ANTITHROMBIN III ANTIGEN
60.00
CLOT INHIBIT PROT C ANTIGEN
95.00
CLOT INHIBIT PROT C ACTIVITY
100.00
CLOT INHIBIT PROT S TOTAL
43.00
CLOT INHIBIT PROT S FREE
44.00
ASSAY ACTIVATED PROTEIN C
50.00
FIBRIN DEGRADE SEMIQUANT
35.00
FIBRIN DEGRADATION QUANT
45.00
FIBRINOGEN ACTIVITY
23.30
FIBRINOGEN ANTIGEN
47.00
HEXAGNAL PHOSPH PLTLT NEUTRL
15.88
PROTHROMBIN TIME
25.00
RUSSELL VIPER VENOM DILUTED
45.00
RBC SED RATE NONAUTOMATED
25.00
RBC SICKLE CELL TEST
39.00
THROMBIN TIME PLASMA
79.00
THROMBOPLASTIN INHIBITION
11.53
THROMBOPLASTIN TIME PARTIAL
30.00
THROMBOPLASTIN TIME PARTIAL
53.00
AGGLUTININS FEBRILE ANTIGEN
25.00
ALLERGEN SPECIFIC IGE
45.00
ANTINUCLEAR ANTIBODIES
50.00
ANTISTREPTOLYSIN O TITER
40.00
C-REACTIVE PROTEIN
35.00
C-REACTIVE PROTEIN HS
40.50
BETA-2 GLYCOPROTEIN ANTIBODY
64.00
CARDIOLIPIN ANTIBODY EA IG
53.00
COMPLEMENT ANTIGEN
48.00
COMPLEMENT TOTAL (CH50)
81.00
CCP ANTIBODY
35.00
DEOXYRIBONUCLEASE ANTIBODY
36.34
DNA ANTIBODY NATIVE
70.00
DNA ANTIBODY SINGLE STRAND
58.50
NUCLEAR ANTIGEN ANTIBODY
75.00
FLUORESCENT ANTIBODY SCREEN
60.00
IMMUNOASSAY TUMOR CA 15-3
43.12
IMMUNOASSAY TUMOR CA 19-9
43.12
IMMUNOASSAY TUMOR CA 125
75.00
HETEROPHILE ANTIBODY SCREEN
25.00
IMMUNOASSAY INFECTIOUS AGENT
85.00
IMMUNOASSAY INFECTIOUS AGENT
85.00
IMMUNOFIX E-PHORESIS SERUM
60.88
IMMUNFIX E-PHORSIS/URINE/CSF
35.62
ISLET CELL ANTIBODY
60.00
MICROSOMAL ANTIBODY EACH
60.00
PARTICLE AGGLUT ANTBDY SCRN
35.00
RHEUMATOID FACTOR TEST QUAL
35.00
RHEUMATOID FACTOR QUANT
35.00
TB TEST CELL IMMUN MEASURE
153.04
TB INTRADERMAL TEST
30.00
SYPHILIS TEST NON-TREP QUAL
25.00
ADENOVIRUS ANTIBODY
31.78
ASPERGILLUS ANTIBODY
65.00
BARTONELLA ANTIBODY
112.24
BORDETELLA ANTIBODY
58.00
LYME DISEASE ANTIBODY
130.00
CAMPYLOBACTER ANTIBODY
35.74
CHLAMYDIA ANTIBODY
29.20
COCCIDIOIDES ANTIBODY
31.26
Q FEVER ANTIBODY
54.00
CMV ANTIBODY
39.48
CMV ANTIBODY IGM
75.00
ENTEROVIRUS ANTIBODY
35.74
EPSTEIN-BARR ANTIBODY
70.00
EPSTEIN-BARR NUCLEAR ANTIGEN
69.00
EPSTEIN-BARR CAPSID VCA
75.00
EHRLICHIA ANTIBODY
33.00
HELICOBACTER PYLORI ANTIBODY
85.00
HEMOPHILUS INFLUENZA ANTIBDY
63.00
HERPES SIMPLEX NES ANTBDY
70.00
HERPES SIMPLEX TYPE 1 TEST
65.00
HERPES SIMPLEX TYPE 2 TEST
70.00
HIV-1ANTIBODY
55.00
HIV-1/HIV-2 1 RESULT ANTBDY
70.00
HEP B CORE ANTIBODY TOTAL
55.00
HEP B CORE ANTIBODY IGM
55.00
HEP B SURFACE ANTIBODY
55.00
HEPATITIS BE ANTIBODY
60.00
HEPATITIS A ANTIBODY
60.00
HEPATITIS A IGM ANTIBODY
50.00
LEGIONELLA ANTIBODY
31.23
MUMPS ANTIBODY
60.00
MYCOPLASMA ANTIBODY
32.68
PARVOVIRUS ANTIBODY
66.00
RESPIRATORY VIRUS ANTIBODY
49.00
RICKETTSIA ANTIBODY
70.00
RUBELLA ANTIBODY
45.00
RUBEOLA ANTIBODY
70.00
TREPONEMA PALLIDUM
36.32
VARICELLA-ZOSTER ANTIBODY
65.00
WEST NILE VIRUS AB IGM
65.00
WEST NILE VIRUS ANTIBODY
62.00
VIRUS ANTIBODY NOS
65.00
THYROGLOBULIN ANTIBODY
75.00
HEPATITIS C AB TEST
65.00
RBC ANTIBODY SCREEN
25.50
COOMBS TEST DIRECT
12.74
BLOOD TYPING SEROLOGIC ABO
14.00
BLOOD TYPING SEROLOGIC RH(D)
14.00
BLOOD CULTURE FOR BACTERIA
66.00
FECES CULTURE AEROBIC BACT
45.00
STOOL CULTR AEROBIC BACT EA
30.00
CULTURE OTHR SPECIMN AEROBIC
40.00
CULTR BACTERIA EXCEPT BLOOD
26.00
CULTURE SCREEN ONLY
30.00
URINE CULTURE/COLONY COUNT
40.00
SKIN FUNGI CULTURE
40.00
CHLAMYDIA CULTURE
48.38
CULTURE TYPE IMMUNOFLUORESC
13.76
MACROSCOPIC EXAM PARASITE
17.62
OVA AND PARASITES SMEARS
45.00
MICROBE SUSCEPTIBLE DISK
35.00
MICROBE SUSCEPTIBLE MIC
35.00
SMEAR GRAM STAIN
25.00
SMEAR FLUORESCENT/ACID STAI
31.50
SMEAR COMPLEX STAIN
50.00
SMEAR WET MOUNT SALINE/INK
25.00
VIRUS INOCULATION TISSUE
80.00
VIRUS INOCULATION SHELL VIA
65.00
GENET VIRUS ISOLATE HSV
100.00
CLOSTRIDIUM AG IA
49.50
CRYPTOSPORIDIUM AG IA
32.66
GIARDIA AG IA
30.00
HPYLORI STOOL IA
38.00
HEPATITIS B SURFACE AG IA
50.00
HEPATITIS BE AG IA
55.00
INFLUENZA A/B AG IA
40.00
SHIGA-LIKE TOXIN AG IA
45.00
CHYLMD TRACH DNA DIR PROBE
78.00
CHYLMD TRACH DNA AMP PROBE
125.00
CYTOMEG DNA QUANT
144.72
HEPATITIS B DNA AMP PROBE
120.00
HEPATITIS B DNA QUANT
20.00
HEPATITIS C PROBE&RVRS TRNSC
125.00
HEPATITIS C REVRS TRNSCRPJ
100.00
HSV DNA AMP PROBE
125.00
N.GONORRHOEAE DNA AMP PROB
125.00
HPV HIGH-RISK TYPES
85.00
RESP VIRUS 12-25 TARGETS
1,143.44
DETECT AGENT NOS DNA AMP
108.00
DETECT AGENT NOS DNA QUANT
66.00
DETECT AGNT MULT DNA DIREC
97.00
DETECT AGNT MULT DNA AMPLI
170.00
INFLUENZA ASSAY W/OPTIC
32.88
RSV ASSAY W/OPTIC
32.66
STREP A ASSAY W/OPTIC
50.00
CYTOPATH CELL ENHANCE TECH
300.00
CYTOPATH C/V INTERPRET
80.00
CYTOPATH C/V THIN LAYER
65.00
CYTOPATH TBS C/V MANUAL
45.00
TISSUE CULTURE LYMPHOCYTE
220.00
CHROMOSOME ANALYSIS 15-20
469.00
CHROMOSOME STUDY ADDITIONAL
101.00
CYTO/MOLECULAR REPORT
70.00
TISSUE EXAM BY PATHOLOGIST
120.00
TISSUE EXAM BY PATHOLOGIST
230.00
SPECIAL STAINS GROUP 1
190.00
MICROSLIDE CONSULTATION
190.00
BODY FLUID CELL COUNT
40.00
LEUKOCYTE ASSESSMENT FECAL
25.00
EXAM SYNOVIAL FLUID CRYSTALS
60.00
IM ADMIN 1ST/ONLY COMPONENT
10.00
IM ADMIN EACH ADDL COMPONENT
10.00
IMMUNIZATION ADMIN
40.00
IMMUNIZATION ADMIN EACH ADD
40.00
IMMUNE ADMIN ORAL/NASAL
25.00
IMMUNE ADMIN ORAL/NASAL ADDL
20.00
MENB RLP VACCINE IM
80.00
HEPA VACCINE ADULT IM
105.00
HEPA VACC PED/ADOL 2 DOSE IM
47.00
HIB PRP-OMP VACC 3 DOSE IM
42.00
HIB PRP-T VACCINE 4 DOSE IM
42.00
4VHPV VACCINE 3 DOSE IM
160.00
IIV3 VACCINE SPLT 0.25 ML IM
20.00
IIV3 VACCINE SPLT 0.5 ML IM
20.00
IIV NO PRSV INCREASED AG IM
35.00
PNEUMOCOCCAL VACC 7 VAL IM
120.00
LAIV4 VACCINE INTRANASAL
36.00
RV5 VACC 3 DOSE LIVE ORAL
110.00
IIV4 VACC NO PRSV 0.25 ML IM
34.00
IIV4 VACC NO PRSV 0.5 ML IM
27.00
DTAP-IPV VACCINE 4-6 YRS IM
75.00
DTAP-IPV/HIB VACCINE IM
80.00
DTAP VACCINE < 7 YRS IM
50.00
DTP VACCINE IM
60.00
DT VACCINE UNDER 7 YRS IM
40.00
TETANUS VACCINE IM
35.00
MMR VACCINE SC
70.00
MMRV VACCINE SC
170.00
ORAL POLIOVIRUS VACCINE
35.00
POLIOVIRUS IPV SC/IM
44.00
TDAP VACCINE 7 YRS/> IM
65.00
VAR VACCINE LIVE SUBQ
115.00
DTAP/HIB VACCINE IM
75.00
DTAP-HEP B-IPV VACCINE IM
90.00
PPSV23 VACC 2 YRS+ SUBQ/IM
50.00
MCV4 MENACWY VACCINE IM
16.00
HZV VACCINE LIVE SUBQ
220.00
HEPB VACC 3 DOSE PED/ADOL IM
50.00
HEPB VACCINE 3 DOSE ADULT IM
90.00
HIB-HEPB VACCINE IM
80.00
PSYTX COMPLEX INTERACTIVE
27.16
PSYCH DIAGNOSTIC EVALUATION
254.68
PSYCH DIAG EVAL W/MED SRVCS
284.00
PSYTX W PT 30 MINUTES
62.18
PSYTX W PT 45 MINUTES
165.32
PSYTX W PT 60 MINUTES
247.84
PSYTX CRISIS INITIAL 60 MIN
259.04
PSYTX CRISIS EA ADDL 30 MIN
123.74
PSYCHOANALYSIS
88.60
FAMILY PSYTX W/O PT 50 MIN
199.72
FAMILY PSYTX W/PT 50 MIN
207.52
PURE TONE HEARING TEST AIR
30.00
PURE TONE AUDIOMETRY AIR
37.00
TYMPANOMETRY
35.00
ELECTROCARDIOGRAM COMPLETE
83.00
ELECTROCARDIOGRAM TRACING
50.00
AIRWAY INHALATION TREATMENT
40.00
MEASURE BLOOD OXYGEN LEVEL
20.00
MEASURE BLOOD OXYGEN LEVEL
46.00
IMMUNOTHERAPY ONE INJECTION
25.00
IMMUNOTHERAPY INJECTIONS
30.00
HYDRATION IV INFUSION INIT
80.00
HYDRATE IV INFUSION ADD-ON
30.00
THER/PROPH/DIAG IV INF INIT
140.00
THER/PROPH/DIAG IV INF ADDON
50.00
THER/PROPH/DIAG INJ SC/IM
48.00
THER/PROPH/DIAG INJ IV PUSH
85.00
RMVL DEVITAL TIS 20 CM/<
67.89
VISUAL ACUITY SCREEN
20.00
APP TOPICAL FLUORIDE VARNISH
50.10
OFFICE/OUTPATIENT VISIT NEW
50.00
OFFICE/OUTPATIENT VISIT NEW
90.00
OFFICE/OUTPATIENT VISIT NEW
132.00
OFFICE/OUTPATIENT VISIT NEW
205.00
OFFICE/OUTPATIENT VISIT NEW
245.00
OFFICE/OUTPATIENT VISIT EST
40.00
OFFICE/OUTPATIENT VISIT EST
70.00
OFFICE/OUTPATIENT VISIT EST
80.00
OFFICE/OUTPATIENT VISIT EST
115.00
OFFICE/OUTPATIENT VISIT EST
175.00
OBSERVATION CARE DISCHARGE
115.00
INITIAL OBSERVATION CARE
143.00
INITIAL OBSERVATION CARE
195.00
INITIAL OBSERVATION CARE
245.00
INITIAL HOSPITAL CARE
160.00
INITIAL HOSPITAL CARE
215.00
INITIAL HOSPITAL CARE
264.00
SUBSEQUENT HOSPITAL CARE
84.00
SUBSEQUENT HOSPITAL CARE
115.00
SUBSEQUENT HOSPITAL CARE
169.00
OBSERV/HOSP SAME DATE
194.00
OBSERV/HOSP SAME DATE
214.00
OBSERV/HOSP SAME DATE
270.00
HOSPITAL DISCHARGE DAY
99.00
HOSPITAL DISCHARGE DAY
124.00
OFFICE CONSULTATION
114.00
OFFICE CONSULTATION
145.00
OFFICE CONSULTATION
180.00
OFFICE CONSULTATION
245.00
OFFICE CONSULTATION
305.00
INPATIENT CONSULTATION
333.00
NURSING FACILITY CARE INIT
111.00
NURSING FACILITY CARE INIT
155.00
NURSING FACILITY CARE INIT
189.00
NURSING FAC CARE SUBSEQ
66.00
NURSING FAC CARE SUBSEQ
84.00
NURSING FAC CARE SUBSEQ
122.00
NURSING FAC CARE SUBSEQ
167.00
NURSING FAC DISCHARGE DAY
120.00
NURSING FAC DISCHARGE DAY
155.00
ANNUAL NURSING FAC ASSESSMNT
175.00
HOME VISIT NEW PATIENT
117.00
HOME VISIT NEW PATIENT
152.00
HOME VISIT NEW PATIENT
216.00
HOME VISIT NEW PATIENT
292.00
HOME VISIT EST PATIENT
73.00
HOME VISIT EST PATIENT
94.00
HOME VISIT EST PATIENT
136.00
HOME VISIT EST PATIENT
217.00
INIT PM E/M NEW PAT INFANT
145.00
INIT PM E/M NEW PAT 1-4 YRS
156.00
PREV VISIT NEW AGE 5-11
150.00
PREV VISIT NEW AGE 12-17
165.00
PREV VISIT NEW AGE 18-39
175.00
PREV VISIT NEW AGE 18-39
55.00
PREV VISIT NEW AGE 40-64
183.00
PREV VISIT NEW AGE 40-64
55.00
INIT PM E/M NEW PAT 65+ YRS
206.00
INIT PM E/M NEW PAT 65+ YRS
55.00
PER PM REEVAL EST PAT INFANT
110.00
PREV VISIT EST AGE 1-4
125.00
PREV VISIT EST AGE 5-11
125.00
PREV VISIT EST AGE 12-17
135.00
PREV VISIT EST AGE 18-39
147.00
PREV VISIT EST AGE 18-39
55.00
PREV VISIT EST AGE 40-64
154.00
PREV VISIT EST AGE 40-64
55.00
PER PM REEVAL EST PAT 65+ YR
190.00
PER PM REEVAL EST PAT 65+ YR
55.00
PREVENTIVE COUNSELING INDIV
55.00
PREVENTIVE COUNSELING INDIV
150.00
BEHAV CHNG SMOKING 3-10 MIN
36.00
BEHAV CHNG SMOKING > 10 MIN
75.00
CARE MGMT SVC BHVL HLTH COND
87.12
CMPLX CHRON CARE W/O PT VSIT
170.36
CMPLX CHRON CARE ADDL 30 MIN
85.48
CHRON CARE MGMT SRVC 20 MIN
78.80
1ST PSYC COLLAB CARE MGMT
287.80
SBSQ PSYC COLLAB CARE MGMT
230.74
TRANS CARE MGMT 14 DAY DISCH
304.06
TRANS CARE MGMT 7 DAY DISCH
429.06
ADVNCD CARE PLAN 30 MIN
161.30
ADVNCD CARE PLAN ADDL 30 MIN
141.14
Botox
10.00
Oral Eval Pt <3yrs
75.74
Topical Fluoride Varnish
50.10
Admin influenza virus vac
40.00
Admin pneumococcal vaccine
40.00
PSA screening
55.00
CA screen;flexi sigmoidscope
238.00
Colorectal scrn; hi risk ind
872.00
Diab manage trn per indiv
100.06
Colon ca scrn not hi rsk ind
872.00
MD service required for PMD
16.94
Alcohol/subs interv 15-30mn
68.10
Initial preventive exam
310.52
Drug screen multi drug class
25.00
Tobacco-use counsel 3-10 min
58.00
Tobacco-use counsel>10min
120.00
PPPS, initial visit
320.36
PPPS, subseq visit
215.12
Annual alcohol screen 15 min
33.18
Brief alcohol misuse counsel
48.92
Depression screen annual
33.12
Behavior counsel obesity 15m
49.00
Group Behave Coun 2-10
24.32
Drug Test Nicotine Screening
5.00
Ccm/ Bhi By Rhc/fqhc 20 Min Mo
170.36
Cocm By Rhc/fqhc 60 Min Mo
287.80
Dexamethasone sodium phos
6.00
Adrenalin epinephrin inject
15.00
Ampicillin 500 MG inj
25.00
Azithromycin
20.00
Atropine sulfate injection
20.00
Atropine sulfate injection
15.00
PenG benzathine/procaine inj
4.00
Penicillin g benzathine inj
5.00
Cefazolin sodium injection
18.00
Ceftriaxone sodium injection
17.00
Cefotaxime sodium injection
20.00
Betamethasone acet&sod phosp
20.00
Estradiol valerate injection
50.00
Depo-estradiol cypionate inj
40.20
Methylprednisolone 40 MG inj
20.00
Methylprednisolone 80 MG inj
35.00
Medroxyprogesterone acetate
0.50
Medrxyprogester acetate inj
20.00
Testosterone cypionat 100 MG
25.00
Depotestosterone 1mg
0.25
Inj dexamethasone acetate
35.00
Dexamethasone sodium phos
6.00
Diphenhydramine hcl injectio
10.00
Dimenhydrinate injection
25.00
Estradiol valerate 10 MG inj
25.00
Garamycin gentamicin inj
15.00
Inj heparin sodium per 10 u
4.00
Inj enoxaparin sodium
10.00
Tetanus immune globulin inj
35.00
Ketorolac tromethamine inj
15.00
Furosemide injection
18.00
Lincomycin injection
23.00
Lorazepam injection
20.00
Meperidine hydrochl /100 MG
20.00
Inj nalbuphine hydrochloride
30.00
Inj naloxone hydrochloride
15.00
Orphenadrine injection
30.00
Ondansetron hcl injection
33.00
Promethazine hcl injection
22.00
Methocarbamol injection
35.00
Trimethobenzamide hcl inj
25.00
Triamcinolone acet inj NOS
17.00
Triamcinolone diacetate inj
15.00
Diazepam injection
25.00
Hydroxyzine hcl injection
15.00
Thiamine hcl 100 mg
25.00
Vitamin b12 injection
18.00
Vitamin k phytonadione inj
25.00
Synvisc or Synvisc-One
22.00
Gel-one
1,143.92
Injection, clindamycin phosp
3.50
Bumetanide 0.5 mg
30.00