PRICE Description 1330.84 ABATACEPT (WITH MALTOSE ......259.00 Analysis of substance using immunoassay technique 261.75 Analysis of substance using immunoassay technique 133.25 Analysis

PRICE Description1330.84 ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION [85656]433.50 Abdominal ultrasound of pregnant uterus183.00 Abdominal ultrasound of pregnant uterus435.00 Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus433.50 Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days)663.00 Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus663.00 Abdominal ultrasound of pregnant uterus single or first fetus

1086.00 ACCESSORY KIT504.00 ACCESSORY KIT961.75 ACCESSORY KIT

1.18 ACEBUTOLOL 200 MG CAPSULE [6512]1.57 ACEBUTOLOL 400 MG CAPSULE [6513]

41.25 ACETAMINOPHEN 1000MG INJ,VIAL41.25 ACETAMINOPHEN 1000MG IV SOL

2599.00 2d tte w or w/o fol w/con,co964.75 2d tte w or w/o fol w/con,fu413.75 3D radiographic procedure with computerized image postprocessing

0.80 ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY [6427]0.20 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION [114834]0.36 ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET [39227]0.14 ACETAMINOPHEN 300 MG-CODEINE 30 MG/12.5 ML (12.5 ML) ORAL SOLUTION [134214]0.80 ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY [6725]0.03 ACETAMINOPHEN 325 MG TABLET [2671]0.01 ACETAMINOPHEN 500 MG TABLET [2672]0.43 ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY [6312]0.12 ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION [114839]7.00 ACETAMINOPHEN,650 MG TAB2.88 ACETAZOLAMIDE 250 MG TABLET [7412]4.29 ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE [44772]

118.68 ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT [47973]0.40 ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION [2549]8.63 ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION [55511]0.41 ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION [2550]0.14 ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION [56187]

138.50 Activated protein resistance assay2245.25 Acute digestive tract blood loss imaging617.75 Acute hepatitis panel

0.97 ACYCLOVIR 200 MG CAPSULE [5086]2.26 ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION [26614]3.75 ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION [42660]

253.75 ADH (antidiuretic hormone) level53.00 Admin hepatitis b vaccine46.00 Admin influenza virus vac61.74 Admin pneumococcal vaccine

134.75 Administration of 1 vaccine93.00 Administration of 1 vaccine53.00 Administration of 1 vaccine30.00 Administration of first vaccine or toxoid component through 18 years of age with counseling93.00 Administration of vaccine30.00 Administration of vaccine30.00 Administration of vaccine or toxoid component through 18 years of age with counseling

3675.13 ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION [135742]417.00 Adrenocorticotropic hormone (ACTH) level160.00 Advance care planning by the physician or other qualified health care professional

1980.00 Aflibercept injection66702.75 Aicd, dual chamber

106896.00 Aicd, other than sing/dual55586.25 Aicd, single chamber

162.00 Air and bone conduction assessment of hearing loss and speech recognition120.75 Air tone conduction hearing assessment screening76.75 Albumin (protein) level1.39 ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION [17292]0.27 ALBUTEROL 2.5 MG/3 ML (0.083 %) (PEDIATRIC ASTHMA) [613116]

66.43 ALBUTEROL 90MCG(VENTOLIN HFA)10.00 ALBUTEROL INHLTN SOL PER 1MG7.05 ALBUTEROL SULFATE 2 MG TABLET [647]2.23 ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER (PED) [613117]

217.50 Aldolase (enzyme) level458.50 Aldosterone hormone level20.46 ALENDRONATE 70 MG TABLET [45120]8.25 ALFUZOSIN 10MG TAB

106.00 Allergy testing with drugs or biologicals into or within the skin, immediate type reaction, including test interpretation and report38.00 Allergy testing with venoms into or within skin, immediate type reaction, including test interpretation and report0.27 ALLOPURINOL 100 MG TABLET [6395]0.74 ALLOPURINOL 300 MG TABLET [6396]

207.25 Alpha-1-antitrypsin (protein) blood test47.25 Alpha-1-antitrypsin (protein) blood test

PRICE Description38.25 Alpha-1-antitrypsin (protein) blood test0.61 ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION [160173]

293.50 Alpha-fetoprotein (AFP) level, amniotic fluid105.00 Alpha-fetoprotein (AFP) level, serum

0.70 ALPRAZOLAM 0.25 MG TABLET [668]0.06 ALPRAZOLAM 0.5 MG TABLET [669]

10560.43 ALTEPLASE 100 MG INTRAVENOUS SOLUTION [46614]183.67 ALTEPLASE 2 MG INTRA-CATHETER SOLUTION [49213]247.50 Aluminum level

0.12 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [35974]0.12 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP [42579]7.00 AMANTADINE PER 100MG, 100MG CA

253.50 Ambulatory continuous glucose (sugar) monitoring for a minimum of 72 hours0.04 AMI ACID 4.25% D5W SOL,1000ML0.04 AMI ACID 4.25% D5W SOL,2000ML

308.25 Amikacin (antibiotic) level293.50 Amikacin (antibiotic) level

1.66 AMIKACIN 500 MG/2 ML INJECTION SOLUTION [117935]0.27 AMILORIDE 5 MG TABLET [6466]0.04 AMINO ACID 5 % IN 15 % DEXTROSE INTRAVENOUS SOLUTION [49112]0.05 AMINO ACID 5 % IN 15 % DEXTROSE INTRAVENOUS SOLUTION [49112]

382.75 Amino acid level, multiple amino acids0.39 AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION [3803]

207.25 Aminolevulinic acid (protein) level0.42 AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION [3954]0.36 AMIODARONE 200 MG TABLET [5218]0.28 AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV [123486]0.58 AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION [38735]1.45 AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION [38735]0.32 AMITRIPTYLINE 10 MG TABLET [6289]0.64 AMITRIPTYLINE 25 MG TABLET [6290]0.57 AMLODIPINE 10 MG TABLET [47061]0.40 AMLODIPINE 2.5 MG TABLET [45715]3.48 AMLODIPINE 5 MG TABLET [45846]0.52 AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION [7948]

177.25 Ammonia level0.03 AMMONIUM LACTATE 12 % LOTION [20296]0.12 AMOXICILLIN 250 MG CAPSULE [2352]0.07 AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION [2366]5.92 AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET [45621]0.21 AMOXICILLIN 500 MG CAPSULE [2353]3.67 AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET [38056]0.92 AMOXICILLIN 875 MG TABLET [28148]4.90 AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET [38057]

204.50 AMOXICILLIN-CLAVULANATE 250MG-6.00 AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION [46854]7.08 AMPICILLIN 1 GRAM SOLUTION FOR INJECTION [1478]9.53 AMPICILLIN 2 GRAM SOLUTION FOR INJECTION [1481]2.95 AMPICILLIN 500 MG SOLUTION FOR INJECTION [1475]4.67 AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION [41966]9.25 AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION [41967]

5450.00 AMPUTATION OF FINGER/THUMB3000.00 Amputation of foot154.00 Amylase (enzyme) level206.00 Analysis for antibody (IgM) to Cytomegalovirus (CMV)59.25 Analysis for antibody (IgM) to Cytomegalovirus (CMV)

230.50 Analysis for antibody (IgM) to Toxoplasma (parasite)134.50 Analysis for antibody (IgM) to West Nile virus384.50 Analysis for antibody bacteria35.75 Analysis for antibody bacteria52.00 Analysis for antibody bordetella (respiratory bacteria)56.50 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)

330.75 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)103.25 Analysis for antibody to aspergillus (fungus)54.00 Analysis for antibody to Bartonella (bacteria)93.25 Analysis for antibody to blastomyces (fungus)

103.25 Analysis for antibody to blastomyces (fungus)33.25 Analysis for antibody to Brucella (bacteria)

103.25 Analysis for antibody to Coccidioides (bacteria)225.00 Analysis for antibody to Cytomegalovirus (CMV)59.25 Analysis for antibody to Cytomegalovirus (CMV)

225.00 Analysis for antibody to Diphtheria (bacteria)259.00 Analysis for antibody to Enterovirus (gastrointestinal virus)185.25 Analysis for antibody to Enterovirus (gastrointestinal virus)61.25 Analysis for antibody to Enterovirus (gastrointestinal virus)

166.25 Analysis for antibody to Epstein-Barr virus (mononucleosis virus)123.25 Analysis for antibody to Epstein-Barr virus (mononucleosis virus)

PRICE Description131.75 Analysis for antibody to Epstein-Barr virus (mononucleosis virus)172.00 Analysis for antibody to Epstein-Barr virus (mononucleosis virus)155.75 Analysis for antibody to Giardia lamblia (intestinal parasite)51.00 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)

190.50 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)59.00 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)50.50 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)

210.00 Analysis for antibody to helminth (intestinal worm)230.50 Analysis for antibody to Hepatitis D virus116.25 Analysis for antibody to Herpes simplex virus87.25 Analysis for antibody to Herpes simplex virus, type 159.25 Analysis for antibody to Herpes simplex virus, type 153.75 Analysis for antibody to Herpes simplex virus, type 293.25 Analysis for antibody to histoplasma (fungus)

103.25 Analysis for antibody to histoplasma (fungus)22.00 Analysis for antibody to HIV -1 virus

105.75 Analysis for antibody to HIV -1 virus263.25 Analysis for antibody to Influenza virus206.25 Analysis for antibody to Leptospira118.75 Analysis for antibody to mumps virus217.50 Analysis for antibody to Mycoplasma (bacteria)127.25 Analysis for antibody to Mycoplasma (bacteria)66.25 Analysis for antibody to parvovirus71.25 Analysis for antibody to Rickettsia (bacteria)

118.75 Analysis for antibody to Rubella (German measles virus)118.75 Analysis for antibody to Rubeola (measles virus)48.25 Analysis for antibody to Salmonella (intestinal bacteria)

243.00 Analysis for antibody to tetanus bacteria (Clostridium tetanus)274.25 Analysis for antibody to Toxoplasma (parasite)53.75 Analysis for antibody to Toxoplasma (parasite)

108.25 Analysis for antibody to Toxoplasma (parasite)46.00 Analysis for antibody to varicella-zoster virus (chicken pox)

110.25 Analysis for antibody to varicella-zoster virus (chicken pox)104.25 Analysis for antibody to varicella-zoster virus (chicken pox)207.25 Analysis for antibody to virus179.00 Analysis for antibody to virus134.50 Analysis for antibody to West Nile virus180.25 Analysis for antibody, Treponema pallidum228.00 Analysis for antibody, Treponema pallidum52.00 Analysis for antibody, Treponema pallidum

207.25 Analysis for detection of tumor marker246.00 Analysis for detection of tumor marker326.00 Analysis of substance using immunoassay technique98.75 Analysis of substance using immunoassay technique

259.00 Analysis of substance using immunoassay technique261.75 Analysis of substance using immunoassay technique133.25 Analysis of substance using immunoassay technique204.00 Analysis of substance using immunoassay technique53.50 Analysis using chemiluminescent technique (light and chemical )reaction56.25 Analysis using chemiluminescent technique (light and chemical )reaction4.04 ANASTROZOLE 1 MG TABLET [44145]

881.00 Anchor/screw bn/bn,tis/bn192.50 Anchor/screw bn/bn,tis/bn



3612.25 Anchor/screw bn/bn,tis/bn1632.75 Anchor/screw bn/bn,tis/bn340.00 Anchor/screw bn/bn,tis/bn695.25 Anchor/screw bn/bn,tis/bn745.00 Anchor/screw bn/bn,tis/bn869.75 Anchor/screw bn/bn,tis/bn395.75 Anchor/screw bn/bn,tis/bn405.00 Anchor/screw bn/bn,tis/bn428.25 Anchor/screw bn/bn,tis/bn441.50 Anchor/screw bn/bn,tis/bn730.25 Anchor/screw bn/bn,tis/bn45.25 Anchor/screw bn/bn,tis/bn


54.50 Anchor/screw bn/bn,tis/bn620.50 Anchor/screw bn/bn,tis/bn317.50 Anchor/screw bn/bn,tis/bn

1403.25 Anchor/screw bn/bn,tis/bn1211.50 Anchor/screw bn/bn,tis/bn158.00 Anchor/screw bn/bn,tis/bn

PRICE Description842.50 Anchor/screw bn/bn,tis/bn

1181.50 Anchor/screw bn/bn,tis/bn1004.75 Anchor/screw bn/bn,tis/bn113.75 Androstenedione (hormone) level566.00 ANES-BIER BLOCK 15 MIN566.00 ANES-GENERAL 15 MIN335.75 ANES-MAC 15MIN335.75 ANES-PARAVERT BLOCK 15 MIN335.75 ANES-REGIONAL BLOCK 15 MIN335.75 ANES-SPINAL 15MIN566.00 ANESTH GENERAL 1ST 15 MIN566.00 ANESTH GENRAL ADD 15 MIN335.75 ANES-WPIDURAL 15MIN266.50 Angiotensin l - converting enzyme (ACE) level73.25 Angiotensin l - converting enzyme (ACE) level3.75 ANSEF 2GM PREMIX BAG PER 500MG

498.75 Antibody evaluation316.50 Antibody evaluation319.50 Antibody evaluation56.25 Antibody evaluation

440.50 Antibody identification test for platelet antibodies296.25 Antibody identification test for platelet antibodies141.50 Antibody identification test for platelet antibodies194.25 Antibody identification test for platelet antibodies361.50 Antibody identification test for white blood cell antibodies

2.70 ANTI-INHIBITOR COAGULANT COMPLEX 350 UNIT-650 UNIT INTRAVENOUS SOLN [166957]226.25 Antimicrobial study, mycobacteria (TB organism family)211.75 Antithrombin III antigen (clotting inhibitor) activity206.00 Antithrombin III antigen (clotting inhibitor) level

9.42 APIXABAN 2.5 MG TAB, EACH8.88 APIXABAN 5 MG TABLET [135092]

120.50 Apligraf222.25 Apolipoprotein level92.50 Application of blood vessel compression or decompression device to 1 or more areas

260.00 Application of cast to hand and lower forearm260.00 Application of cast, elbow to finger (short arm)260.00 Application of cast, shoulder to hand (long arm)215.00 Application of chemical agent to excessive wound tissue391.50 Application of chemical agent to excessive wound tissue480.00 Application of cylinder cast (thigh to ankle)92.50 Application of electrical stimulation to 1 or more areas, each 15 minutes92.50 Application of hot or cold packs to 1 or more areas88.25 Application of hot or cold packs to 1 or more areas92.50 Application of hot wax bath to 1 or more areas

267.00 Application of long arm splint (shoulder to hand)149.00 Application of long arm splint (shoulder to hand)275.00 Application of long leg cast (thigh to toes)404.00 Application of long leg splint (thigh to ankle or toes)92.50 Application of mechanical traction to 1 or more areas

103.75 Application of medication through skin using electrical current, each 15 minutes103.00 Application of medication through skin using electrical current, each 15 minutes252.50 Application of moveable, hinged finger splint388.25 Application of moveable, hinged short arm splint (forearm to hand)267.00 Application of non-moveable, hinged finger splint267.00 Application of non-moveable, short arm splint (forearm to hand)125.00 Application of non-moveable, short arm splint (forearm to hand)295.75 Application of non-moveable, short arm splint (forearm to hand)84.00 Application of on-body injector for injection under skin

300.00 Application of rigid total contact leg cast516.50 Application of rigid total contact leg cast260.00 Application of short leg cast (below knee to toes)266.75 Application of short leg splint (calf to foot)149.00 Application of short leg splint (calf to foot)759.25 Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes

2479.50 Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less)888.25 Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs

2479.50 Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less)92.50 Application of ultrasound to 1 or more areas, each 15 minutes

266.00 Application of vein wound compression system lower leg below knee including ankle and foot33.27 APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE [49077]

109.94 APREPITANT 40 MG CAPSULE [87882]10.30 ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION [90429]

630.48 ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION [28081]1997.50 ARGON FOCAL LASER

32.08 ARIPIPRAZOLE 10 MG TABLET [52490]32.00 ARIPIPRAZOLE 15 MG TABLET [52491]35.68 ARIPIPRAZOLE 2 MG TABLET [85655]

PRICE Description50.45 ARIPIPRAZOLE 30 MG TABLET [52493]32.00 ARIPIPRAZOLE 5 MG TABLET [53505]5.00 ARIPIPRAZOLE ER 400 MG SUSPENSION, EXTENDED REL.INTRAMUSCULAR SYRINGE [145939]5.00 ARIPIPRAZOLE LAUROXIL ER 1,064 MG/3.9 ML SUSPENSION,EXT.REL IM SYRINGE [157829]5.00 ARIPIPRAZOLE LAUROXIL ER 882 MG/3.2 ML SUSPENSION, EXT.REL. IM SYRINGE [149385]

120.25 ARMSTRONG BEVELED VENT 140242314.00 Arsenic level82.75 Arsenic level60.25 Arsenic level

119.25 Arterial puncture withdrawal of blood for diagnosis0.66 ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE [144775]0.04 ASCORBIC ACID (VITAMIN C) 500 MG TABLET [5289]6.00 ASCORBIC ACID 250 MG TAB EACH

24.02 ASENAPINE 5 MG SUBLINGUAL TABLET [113444]1399.50 ASP/INJ RENAL CYST/PELVIS1440.50 Aspiration and/or injection of cysts280.00 Aspiration and/or injection of cysts720.00 Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance612.00 Aspiration and/or injection of large joint or joint capsule336.00 Aspiration and/or injection of large joint or joint capsule450.00 Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance389.00 Aspiration and/or injection of medium joint or joint capsule336.00 Aspiration and/or injection of medium joint or joint capsule546.75 Aspiration and/or injection of small joint or joint capsule280.00 Aspiration and/or injection of small joint or joint capsule450.00 Aspiration and/or injection of small joint or joint capsule with recording and reporting using ultrasound guidance936.50 Aspiration and/or injection of thyroid cyst656.25 Aspiration of abscess, blood accumulation, blister, or cyst375.00 Aspiration of abscess, blood accumulation, blister, or cyst

5025.00 Aspiration of bladder with insertion of bladder tube to skin surface11.28 ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULE,EXT.RELEASE 12 HR MULTIPHASE [44176]1.46 ASPIRIN 300 MG RECTAL SUPPOSITORY [10039]0.06 ASPIRIN 325 MG TABLET [5278]0.01 ASPIRIN 325 MG TABLET,DELAYED RELEASE [5455]0.02 ASPIRIN 81 MG CHEWABLE TABLET [31359]0.01 ASPIRIN 81 MG TABLET,DELAYED RELEASE [30082]0.03 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET [49371]

440.00 Assessment and recording of balance system during hot and cold irrigation of both ears162.00 Assessment of eardrum and muscle function38.00 Assessment of hearing loss and speech recognition38.00 Assessment of hearing loss with placement of probe in ear to assess ear bone contraction38.00 Assessment of speech hearing loss0.80 ATENOLOL 25 MG TABLET [656]0.89 ATENOLOL 50 MG TABLET [657]

540.83 ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION [154304]17.18 ATOMOXETINE 40 MG CAPSULE [52510]17.18 ATOMOXETINE 60 MG CAPSULE [52511]0.30 ATORVASTATIN 10 MG TABLET [44642]0.36 ATORVASTATIN 20 MG TABLET [44341]0.38 ATORVASTATIN 40 MG TABLET [44070]0.52 ATORVASTATIN 80 MG TABLET [44182]

33.25 ATRACURIUM 10 MG/ML INJ 5ML1.11 ATROPINE 0.1 MG/ML INJECTION SYRINGE [31590]1.99 ATROPINE 0.1 MG/ML INJECTION SYRINGE [31590]8.40 ATROPINE 0.4 MG/ML INJECTION SOLUTION [9618]

22.30 ATROPINE 1 % EYE DROPS [2911]13.20 ATROPINE 1 MG/ML INJECTION SOLUTION [9622]

673.00 Attempt to restart heart and lungs25.00 Automated urinalysis test40.25 Automated urinalysis test79.00 Automated white blood cell count14.50 Automated white blood cell count

617.62 AZACITIDINE 100 MG SOLUTION FOR INJECTION [55919]2.35 AZATHIOPRINE 50 MG TABLET [2614]

332.25 AZELASTINE 137MCG/ACT NASAL SP29.13 AZITHROMYCIN 1 GRAM ORAL PACKET [49573]2.33 AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION [48236]2.33 AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [48737]7.39 AZITHROMYCIN 250 MG TABLET [44705]8.92 AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION [47813]

15.57 AZITHROMYCIN 500 MG TABLET [52022]77.50 AZITHROMYCIN 500MG/250ML IVPB39.54 AZTREONAM 1 GRAM SOLUTION FOR INJECTION [48634]80.34 AZTREONAM 2 GRAM SOLUTION FOR INJECTION [47326]13.31 BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION [1180]0.18 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT [5858]0.11 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL PACKET [53345]

PRICE Description7.34 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT [8855]0.47 BACLOFEN 10 MG TABLET [5192]6.00 BACLOFEN 20MG TAB

255.50 Bacterial blood culture131.75 Bacterial colony count, urine197.25 Bacterial culture255.50 Bacterial culture91.50 Bacterial culture for aerobic isolates

152.50 Bacterial culture for anaerobic isolates185.75 Bacterial urine culture

9.25 BAG LEG DISP LARGE9.25 BAG LEG DISP SM0.55 BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION [55404]0.73 BALANCED SALT SOLUTION NON-SURGICAL NO.3 EYE WASH [55538]

14659.75 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure8442.75 Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure

12487.00 Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure14661.00 Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure13740.50 Balloon dilation of groin artery, endovascular, open, or percutaneous approach

0.63 BALSAM PERU-CASTOR OIL TOPICAL OINTMENT [163944]1152.75 BANDING HEMORRHOID

0.05 B-COMPLEX WITH VITAMIN C TABLET [38958]27.20 BECLOMETHASONE DIPROP 80 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL [159341]

237.50 Behavioral and qualitative analysis of voice and resonance33.45 BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY [49308]0.95 BENAZEPRIL 10 MG TABLET [41881]7.00 BENAZEPRIL 5MG TAB

742.14 BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION [151748]0.79 BENZOCAINE 20 % MUCOSAL GEL [20266]0.10 BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL [44713]0.09 BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE [97758]0.28 BENZONATATE 100 MG CAPSULE [2339]6.00 BENZTROPINE 0.5 MG TAB EACH0.59 BENZTROPINE 1 MG TABLET [6435]

33.00 BENZTROPINE 2 MG/2 ML INJECTION SOLUTION [48165]174.50 Beta-2 microglobulin (protein) level11.87 BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION [46447]7.00 BETHANECHOL 10MG TAB6.00 BETHANECHOL 25MG TAB

239.08 BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION [54932]25.00 Bevacizumab injection

203.22 BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION [165084]56.25 BICALUTAMIDE 50MG TAB51.00 BICARBONATE75.00 Bilirubin level23.25 Bilirubin level91.50 Bilirubin level

162.00 BIOFEEDBACK TRAINING634.25 BIOFIX 121560 1.5X 60314.00 Biopsy and scraping of the cervix using an endoscope

1271.00 BIOPSY CERVIX SINGLE/MULT EXC2147.50 Biopsy of breast accessed through the skin with stereotactic guidance2862.75 Biopsy of breast accessed through the skin with ultrasound guidance670.00 Biopsy of cervix or excision of local growths

2835.00 Biopsy of cervix using an endoscope675.00 Biopsy of external female genitals20.00 Biopsy of external female genitals

326.00 Biopsy of eyelid1980.00 Biopsy of mouth4221.75 Biopsy of one lobe of lung using an endoscope1883.00 Biopsy of prostate gland2855.75 Biopsy of prostate gland2080.00 Biopsy of roof of mouth550.00 Biopsy of tongue176.00 Biopsy of uterine lining

1490.00 Biopsy or removal of nasal polyp or tissue using an endoscope0.08 BISACODYL 10 MG RECTAL SUPPOSITORY [26910]0.03 BISACODYL 5 MG TABLET,DELAYED RELEASE [5759]0.01 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION [47305]2.25 BISOPROLOL FUMARATE 5 MG TABLET [28177]7.00 BISOPROLOL-HYDROCHLOROTHIAZIDE

1053.00 Bladder instillation of cancer preventive, inhibiting, or suppressive agent557.25 Bladder irrigation and/or instillation553.75 Bladder irrigation and/or instillation258.00 Bladder irrigation and/or instillation87.88 BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION [1354]

100.00 Blood chloride level

PRICE Description83.00 Blood creatinine level

288.50 Blood gases measurement282.25 Blood gases measurement326.00 Blood gases measurement68.50 Blood glucose (sugar) level93.25 Blood glucose (sugar) level after receiving dose of glucose64.25 Blood glucose (sugar) level after receiving dose of glucose62.25 Blood glucose (sugar) measurement using reagent strip14.50 Blood glucose (sugar) test performed by hand-held instrument15.00 Blood glucose (sugar) test performed by hand-held instrument

199.00 Blood glucose (sugar) tolerance test131.25 Blood group typing (ABO)116.25 Blood osmolality (concentration) measurement79.00 Blood pH level79.00 Blood potassium level68.50 Blood sodium level

142.75 Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)166.25 Blood test, basic group of blood chemicals15.00 Blood test, clotting time30.00 Blood test, clotting time51.50 Blood test, clotting time15.25 Blood test, clotting time

241.50 Blood test, comprehensive group of blood chemicals195.50 Blood test, lipids (cholesterol and triglycerides)93.25 Blood test, lipids (cholesterol and triglycerides)

142.75 Blood test, thyroid stimulating hormone (TSH)40.25 Blood test, thyroid stimulating hormone (TSH)

319.50 Blood typing for red blood cell antigens51.50 Blood typing for Rh (D) antigen

157.50 Blood unit compatibility test183.75 Blood unit compatibility test93.25 Blood viscosity measurement

145.75 Body fluid cell count with cell identification25.50 Body fluid pH level

2727.25 Bone and/or joint imaging, 3 phase study2209.75 Bone and/or joint imaging, whole body490.00 Bone density measurement using dedicated X-ray machine148.25 Bone density measurement using dedicated X-ray machine

2147.50 Bone marrow biopsy2877.00 Bone marrow biopsy and aspiration4615.00 BONE MARROW BX & ASPIRATION1923.60 BORTEZOMIB 3.5 MG SOLUTION FOR INJECTION [53024]739.00 BRAVO PH CAPSULE

9552.00 BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION [124163]46.60 BREXPIPRAZOLE 0.5 MG TABLET [147953]46.60 BREXPIPRAZOLE 1 MG TABLET [147954]46.60 BREXPIPRAZOLE 4 MG TABLET [147957]38.39 BRIMONIDINE 0.1 % EYE DROPS [86277]40.93 BRIMONIDINE 0.15 % EYE DROPS [49362]3.63 BRIMONIDINE 0.2 % EYE DROPS [40132]

392.00 BRINZOLAMIDE 1% OPHTH DPS, 10M7.00 BROMOCRIPTINE 2.5MG TAB

4221.75 BRONCHOSCOPY DIAGNOSTIC4221.75 BRONCHOSCOPY FLEX W/BIOPSY4221.75 BRONCHOSCOPY FLEX W/BRUSHING4221.75 BRONCHOSCOPY W/NEEDLE ASP/BX

4.71 BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION [48023]5.54 BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION [48076]2.67 BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE [48662]0.30 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION [3333]0.68 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION [3333]0.81 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION [3333]0.41 BUMETANIDE 1 MG TABLET [5999]0.07 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION [3287]0.19 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION [3287]0.07 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION [3290]0.23 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION [3290]1.39 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [3707]0.25 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION [3292]0.04 BUPIVACAINE 0.0625%-FENTANYL 2 MCG/ML-EPINEPHRINE 1.25 MCG/ML EPIDURAL INTERMITTENT DOSING IN NS 150 ML PYXIS (AC) [614835]0.04 BUPIVACAINE 0.1%-FENTANYL 2 MCG/ML EPIDURAL CLINICIAN DOSE [616277]0.06 BUPIVACAINE 0.5 % (5 MG/ML) INJECTION SOLUTION [3289]0.11 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION [53067]0.64 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION [53067]0.28 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION [53065]0.23 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION [4265]0.31 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION [4267]

PRICE Description5.73 BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM [118317]

18.20 BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION [82400]4.14 BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET [52705]1.96 BUPROPION HCL 100 MG TABLET [5119]1.55 BUPROPION HCL 75 MG TABLET [5118]1.69 BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE [41898]1.81 BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE [41899]4.66 BUPROPION XL 150 MG TAB [53708]6.00 BUPROPION XL 300MG TAB EACH1.36 BUSPIRONE 10 MG TABLET [28850]0.78 BUSPIRONE 5 MG TABLET [28849]1.69 BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET [5165]1.70 BUTALBITAL-ASPIRIN-CAFFEINE 50 MG-325 MG-40 MG CAPSULE [41145]4.45 BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY [45401]

8780.21 CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION [117628]11.49 CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN [9080]

342.50 Calcitonin (hormone) level1621.84 CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION [49705]

1.28 CALCITRIOL 0.25 MCG CAPSULE [29853]0.17 CALCIUM ACETATE 667 MG TABLET [45815]7.00 CALCIUM ACETATE 667MG TAB0.07 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) CHEWABLE TABLET [9859]0.05 CALCIUM CARBONATE 500 MG (1,250 MG)-VITAMIN D3 200 UNIT TABLET [82334]0.04 CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) TABLET [32875]0.81 CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE [3903]7.00 CALCIUM CITRATE-VITAMIN D 315M1.10 CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION [9081]1.75 CALCIUM GLUCONATE PER 10ML, 10

116.25 Calcium level187.25 Calcium level

0.13 CALCIUM POLYCARBOPHIL 625 MG TABLET [47666]79.25 CAPECITABINE 500MG TAB

715.50 CAPSULAR TENSION RING1.22 CAPTOPRIL 12.5 MG TABLET [5092]2.03 CAPTOPRIL 50 MG TABLET [5094]

23.57 CARBACHOL 0.01 % INTRAOCULAR SOLUTION [47535]0.66 CARBAMAZEPINE 100 MG CHEWABLE TABLET [5152]7.00 CARBAMAZEPINE 100MG XR TAB1.60 CARBAMAZEPINE 200 MG TABLET [5099]7.00 CARBAMAZEPINE 200MG ER CAP

270.00 Carbamazepine level102.75 Carbamazepine level

0.09 CARBAMIDE PEROXIDE 6.5 % EAR DROPS [23259]0.31 CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET [5120]0.80 CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET [42527]1.62 CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET [5122]0.84 CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE [42932]

503.00 Carbohydrate deficient transferrin (protein) level97.75 Carbon dioxide (bicarbonate) level1.68 CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION [42654]

425.32 CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION [49618]178.50 Carboxyhemoglobin (protein) level40.75 Carboxyhemoglobin (protein) level0.63 CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE LIQUID GEL DROPS [49604]

250.75 Carcinoembryonic antigen (CEA) protein level244.00 Cardiac output measurements263.25 Cardiolipin antibody (tissue antibody) measurement

2785.99 CARFILZOMIB 60 MG INTRAVENOUS SOLUTION [132199]48.71 CARFILZOMIB(KYPROLIS) PER 1MG48.03 CARIPRAZINE 1.5 MG CAPSULE [152796]0.23 CARISOPRODOL 350 MG TABLET [7375]

70.25 Carnitine level67.75 Carnitine level2.13 CARVEDILOL 12.5 MG TABLET [44354]2.13 CARVEDILOL 25 MG TABLET [44195]2.13 CARVEDILOL 3.125 MG TABLET [46124]2.13 CARVEDILOL 6.25 MG TABLET [44249]

25.00 Cast sup long arm ped fbrgls45.00 Cast sup shrt leg ped fbrgls30.00 Cast sup sht arm adult fbrgl

367.50 Catecholamines (organic nitrogen) level16.00 CATH FOLEY SIL 2 WAY 14 FR 5CC

490.00 CATH KIT MAN 10 FR. 19.5868.00 Cath, drainage

1634.75 Cath, ep, 19 or few elect649.75 Cath, hemodialysis,long-term759.75 Cath, inf, per/cent/midline

PRICE Description409.00 Cath, inf, per/cent/midline

4062.25 Cath, thrombectomy/embolect7035.25 Cath, trans atherectomy, dir1069.50 Cath, translumin non-laser6199.25 Cath, translumin, drug-coat241.50 Cath,hemodialysis,short-term23.25 CATHETER 12 FR

128.00 Catheter, guiding2501.50 Catheter, intraspinal

1.26 CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [1470]10.20 CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION [1472]2.00 CEFAZOLIN 2G IV SYR,PER 500MG2.40 CEFAZOLIN 500 MG SOLUTION FOR INJECTION [1469]1.66 CEFDINIR 250 MG/5 ML ORAL SUSPENSION [56375]5.11 CEFDINIR 300 MG CAPSULE [49074]

20.33 CEFEPIME 1 GRAM SOLUTION FOR INJECTION [44445]40.36 CEFEPIME 2 GRAM SOLUTION FOR INJECTION [45061]2.64 CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION [30667]

54.75 CEFOTAXIME PER 1GM, 1GM IN 5%11.23 CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION [28465]90.75 CEFPODOXIME 100MG TAB

181.75 CEFPODOXIME 100MG/5ML SUSP, 50230.55 CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [119582]230.55 CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [119584]10.46 CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION [48701]13.20 CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION [45152]

430.57 CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION [146872]150.00 CEFTOLOZANE/TAZOBACTAM 1500MG46.00 CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION [46535]91.41 CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION [49591]1.44 CEFTRIAXONE 250 MG SOLUTION FOR INJECTION [45128]

26.88 CEFTRIAXONE 500 MG SOLUTION FOR INJECTION [48379]44.00 CEFTRIAXONE PER 250MG, 1GM IN27.00 Ceftriaxone sodium injection4.40 CEFUROXIME AXETIL 250 MG TABLET [30665]

15.19 CELECOXIB 200 MG CAPSULE [40379]225.00 Cell examination of body fluid211.75 Cell examination of specimen187.75 Cell examination of specimen

2891.00 CELLSAVER REPROFUSION PROCEDUR1.00 CEPACOL (MENTHOL)3MG LOZENGE0.70 CEPHALEXIN 250 MG CAPSULE [209]0.29 CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION [384]1.38 CEPHALEXIN 500 MG CAPSULE [227]

154.00 Cerebrospinal fluid, or amniotic fluid albumin (protein) level119.25 Ceruloplasmin (protein) level213.00 Cervicovaginal secretion of placenta protein

2865.00 Cesarean delivery15.30 CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION [110228]47.75 CFSCRN NUC ACID PROBE(12)

2725.00 CHANGE NEPHROSTOMY TUBE260.00 Change of breathing tube of windpipe in neck47.50 CH-CARBOPLATIN/50MG,0MG/ML INJ

187.25 Chemical analysis using chromatography technique229.75 Chemical analysis using chromatography technique228.00 Chemical analysis using chromatography technique138.75 Chemical analysis using chromatography technique242.25 Chemical analysis using chromatography technique213.75 Chemical analysis using spectrophotometry (light)178.00 Chemical analysis using spectrophotometry (light)685.00 Chemical receptor analysis70.25 Chemical test for genetic disorder

603.75 CHEMO PUMP INITIAL HOOK UP997.25 Chest ultrasound examination of heart26.23 CH-GEMCITABINE/200MG,1GM INJ

411.75 CH-GEMCITABINE/200MG,200MG INJ75.00 CHLAMYDIA PNEUMONIAE,AMP PROBE0.43 CHLORDIAZEPOXIDE 25 MG CAPSULE [9168]0.35 CHLORDIAZEPOXIDE 5 MG CAPSULE [9167]5.14 CHLORDIAZEPOXIDE-CLIDINIUM 5 MG-2.5 MG CAPSULE [6756]0.03 CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH [84608]0.03 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID [8511]

70.75 Chloride level9.56 CHLORPROMAZINE 25 MG TABLET [7440]2.30 CHLORTHALIDONE 25 MG TABLET [5966]1.08 CHLORZOXAZONE 500 MG TABLET [30935]0.28 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET [49223]

PRICE Description0.33 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) TABLET [112436]0.05 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET [88837]

128.25 Cholesterol level3.35 CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL POWDER FOR SUSP IN A PACKET [53595]

177.25 Cholinesterase (enzyme) level199.76 CHONDROITIN-SOD HYALURON 3 %-4 %(0.5 ML)1 %(0.55 ML)INTRAOCULAR SYRING [44754]290.25 Chromium level to test for poisoning or deficiency926.25 Chromosome analysis for genetic defects31.75 CH-SODIUM CHLORIDE 0.9%IV SOL31.75 CH-SODIUM CHLORIDE/0.9% IV SOL1.83 CILOSTAZOL 100 MG TABLET [43441]

30.66 CINACALCET 30 MG TABLET [55310]10.01 CIPROFLOXACIN 0.3 % EYE DROPS [42747]37.78 CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION [53566]0.15 CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [49732]5.46 CIPROFLOXACIN 250 MG TABLET [39995]0.02 CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [45200]3.18 CIPROFLOXACIN 500 MG TABLET [39996]3.76 CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION [47334]0.48 CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION [32805]6.00 CITALOPRAM 10 MG TAB EACH2.55 CITALOPRAM 20 MG TABLET [43432]6.00 CITALOPRAM 40MG TAB, EACH

426.25 Citrate level279.25 Citrate level108.00 CLADRIBINE PER 1MG, 10MG SDV

6.02 CLARITHROMYCIN 500 MG TABLET [44878]0.87 CLINDAMYCIN 150 MG/ML INJECTION SOLUTION [3755]0.30 CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [30476]0.36 CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [30477]0.63 CLINDAMYCIN HCL 150 MG CAPSULE [5201]8.55 CLOBETASOL 0.05 % TOPICAL CREAM [5904]

10.36 CLOBETASOL 0.05 % TOPICAL OINTMENT [5903]18.75 CLOMIPRAMINE 25MG CAP0.75 CLONAZEPAM 0.5 MG TABLET [5159]0.91 CLONAZEPAM 1 MG TABLET [5160]

33.16 CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH [44448]55.83 CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH [44707]77.45 CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH [48421]0.06 CLONIDINE HCL 0.1 MG TABLET [653]0.08 CLONIDINE HCL 0.2 MG TABLET [654]

27.84 CLOPIDOGREL 300 MG TABLET [102007]7.74 CLOPIDOGREL 75 MG TABLET [45777]

1313.00 Closed treatment of ankle dislocation460.00 Closed treatment of broke forearm bone at elbow270.00 Closed treatment of broken ankle297.00 Closed treatment of broken ankle300.00 Closed treatment of broken ankle joint bone

2745.75 Closed treatment of broken ankle with manipulation764.25 Closed treatment of broken ankle with manipulation

1786.75 Closed treatment of broken ankle with manipulation1512.25 Closed treatment of broken ankle with manipulation401.00 Closed treatment of broken finger or thumb270.00 Closed treatment of broken finger or thumb415.75 Closed treatment of broken finger or thumb with manipulation297.00 Closed treatment of broken finger or thumb with manipulation393.25 Closed treatment of broken finger or thumb with manipulation270.00 Closed treatment of broken foot bone270.00 Closed treatment of broken forearm bone270.00 Closed treatment of broken forearm bone at elbow

2113.75 Closed treatment of broken forearm bone at elbow with manipulation270.00 Closed treatment of broken forearm bones297.00 Closed treatment of broken forearm bones

1513.00 Closed treatment of broken forearm bones with manipulation1371.00 Closed treatment of broken forearm bones with manipulation270.00 Closed treatment of broken great toe460.00 Closed treatment of broken great toe with manipulation

2730.00 Closed treatment of broken hand or finger with manipulation297.00 Closed treatment of broken heel bone

1512.25 Closed treatment of broken of upper arm bone at shoulder with manipulation1513.00 Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation297.00 Closed treatment of broken shin bone

2976.75 Closed treatment of broken shin bone with manipulation430.00 Closed treatment of broken spine bones with casting or bracing450.00 Closed treatment of broken thigh bone345.00 Closed treatment of broken toe764.25 Closed treatment of broken toe with manipulation

PRICE Description297.00 Closed treatment of broken toe with manipulation

5038.50 Closed treatment of broken upper arm bone at shoulder joint with manipulation5038.50 Closed treatment of broken upper arm bone with manipulation270.00 Closed treatment of broken wrist bone

2976.75 Closed treatment of collar bone broken with manipulation265.00 Closed treatment of collar bone fracture470.50 Closed treatment of dislocated finger joint with manipulation393.50 Closed treatment of dislocated finger joint with manipulation

4187.75 Closed treatment of dislocated finger joint with manipulation under anesthesia393.50 Closed treatment of dislocated foot joint

1250.25 Closed treatment of dislocated forearm bone of elbow, child393.25 Closed treatment of dislocated hand joint with manipulation

2113.75 Closed treatment of dislocated hand joint with manipulation under anesthesia577.50 Closed treatment of dislocated hip prosthesis

2745.75 Closed treatment of dislocated hip prosthesis under anesthesia441.00 Closed treatment of dislocation of joint between collar and chest bones with manipulation764.25 Closed treatment of dislocation of knee cap400.00 Closed treatment of fracture and/or dislocation of pelvis and/or sacrum

2700.00 Closed treatment of fracture below neck of upper thigh bone270.00 Closed treatment of fracture hand bone

1250.25 Closed treatment of fracture of bone of hand with manipulation297.00 Closed treatment of fracture of bone of hand with manipulation270.00 Closed treatment of fracture of shin bone297.00 Closed treatment of fracture of upper arm bone at shoulder joint297.00 Closed treatment of growth plate or broken upper arm bone at elbow

2745.75 Closed treatment of hip dislocation under anesthesia300.00 Closed treatment of hip socket fractures764.25 Closed treatment of jaw temporomandibular joint (TMJ) dislocation

2954.75 Closed treatment of knee cap dislocation under anesthesia270.00 Closed treatment of knee cap fracture

1512.00 Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation1512.25 Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation764.25 Closed treatment of shoulder dislocation with manipulation

3828.25 Closed treatment of shoulder dislocation with manipulation under anesthesia426.75 Closed treatment of thumb dislocation with manipulation270.00 Closed treatment of upper arm fracture460.00 Closed treatment of upper arm fracture855.50 Closure dev, vasc392.00 Closure of tear duct opening using plug

0.57 CLOTRIMAZOLE 1 % TOPICAL CREAM [6666]3.22 CLOTRIMAZOLE 10 MG TROCHE [43061]3.22 CLOTRIMAZOLE 10MG ORAL TROCHE1.35 CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM [41550]

249.25 Clotting factor II prothrombin, measurement249.25 Clotting factor inhibitor test197.25 Clotting factor IX (PTC or Christmas) measurement457.00 Clotting factor V (AcG or proaccelerin) measurement502.00 Clotting factor VIII (AHG) measurement316.25 Clotting factor VIII (von Willebrand factor) measurement457.00 Clotting factor VIII (VW factor) antigen621.25 Clotting factor VIII (VW factor) measurement152.50 Clotting factor X (Stuart-Prower) measurement294.50 Clotting factor X assessment test189.00 Clotting factor XI (PTA) measurement187.25 Clotting factor XII (Hageman) measurement148.50 Clotting factor XIII (fibrin stabilizing) measurement

3.43 CLOZAPINE 100 MG TABLET [6014]1.32 CLOZAPINE 25 MG TABLET [6013]

340.75 Clozapine level460.00 CLSD FX FEMORAL SHAFT FRACTURE110.25 Coagulation assessment blood test24.00 Coagulation assessment blood test

166.25 Coagulation assessment blood test26.75 Coagulation assessment blood test

187.25 Coagulation function measurement21.00 Coagulation function screening test with interpretation and report15.25 Coagulation time measurement55.78 COCAINE 4 % TOPICAL SOLUTION [2556]

294.00 COCAINE 4% NASAL PER EACH 4ML0.13 CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID [39878]1.03 CODEINE SULFATE 30 MG TABLET [2165]6.74 COLCHICINE 0.6 MG TABLET [3725]3.96 COLESEVELAM 625 MG TABLET [47047]

33.59 COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION [19591]212.00 Collagen cross links test, (urine test to evaluate bone health)488.50 Collagen cross links test, (urine test to evaluate bone health)200.75 Collection of blood specimen from a completely implantable venous access device

PRICE Description248.00 Collection of blood specimen from central or peripheral venous catheter

1886.50 COLONOSCOPY2640.00 COLONOSCOPY CONTROL BLEED APC2266.50 COLONOSCOPY W/ BIOPSY139.00 Community or work reintegration training, each 15 minutes40.25 Complete blood cell count (red cells, white blood cell, platelets), automated test83.00 Complete blood cell count (red cells, white blood cell, platelets), automated test

611.50 Complete X-ray study of abdomen with single X-ray of chest764.25 Complex control of nose bleed194.00 Complex control of nose bleed70.00 Computerized mapping of corneal curvature

110.25 Concentration of specimen for infectious agents156.25 Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria)147.50 Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria)342.50 Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV356.16 CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION [49576]

5429.50 Conn tiss, human(inc fascia)126.75 Continuous monitoring of glucose in tissue fluid using sensor under skin

1490.00 Control of nasal bleeding using an endoscope764.25 Control of nose bleed and insertion of packing

37182.50 Conversion to two chamber pacemaker system209.25 Copper level50.75 Copper level

100.00 CORONAVIRUS170.00 Cortisol (hormone) measurement323.75 Cortisol (hormone) measurement309.25 Cortisol (hormone) measurement127.90 COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION [45671]100.00 COVID 19100.00 COVID 19 EMPLOYEE SCREEN284.75 C-peptide (protein) level142.75 Creatine kinase (cardiac enzyme) level174.50 Creatine kinase (cardiac enzyme) level152.50 Creatine kinase (cardiac enzyme) level166.25 Creatinine clearance measurement to test for kidney function100.00 Creatinine level to test for kidney function or muscle injury755.25 Critical care delivery critically ill or injured patient

1964.00 Critical care delivery critically ill or injured patient, first 30-74 minutes1870.50 Critical care delivery critically ill or injured patient, first 30-74 minutes325.00 CROMOLYN 5.2MG/ACT NASAL SPRAY125.50 Cryoglobulin (protein) measurement103.75 Crystal identification from tissue or body fluid

1993.25 CT scan abdomen3087.25 CT scan abdomen before and after contrast2469.50 CT scan abdomen with contrast1110.00 CT scan abdomen with contrast1989.50 CT scan chest2521.50 CT scan chest with contrast2038.25 CT scan head or brain1157.50 CT scan head or brain before and after contrast2553.00 CT scan head or brain with contrast1970.25 CT scan leg2309.75 CT scan leg with contrast injection752.25 CT scan of abdomen and pelvis

1296.75 CT scan of abdomen and pelvis before and after contrast2144.25 CT scan of abdomen and pelvis before and after contrast2144.00 CT scan of abdomen and pelvis with contrast1163.25 CT scan of abdomen and pelvis with contrast1715.25 CT scan of abdominal and pelvic blood vessels with contrast5218.50 CT scan of abdominal aorta and both leg arteries with contrast607.75 CT scan of abdominal aorta and both leg arteries with contrast

3241.25 CT scan of abdominal blood vessels with contrast1927.25 CT scan of arm2563.50 CT scan of arm blood vessels with contrast2118.75 CT scan of arm with contrast1157.50 CT scan of blood vessel of head with contrast2752.75 CT scan of blood vessels in chest with contrast721.25 CT scan of blood vessels in chest with contrast

1877.75 CT scan of cranial cavity2199.75 CT scan of cranial cavity before and after contrast2064.00 CT scan of cranial cavity with contrast638.25 CT scan of cranial cavity with contrast758.25 CT scan of face

1806.75 CT scan of face796.50 CT scan of face325.75 CT scan of face

2803.75 CT scan of face before and after contrast

PRICE Description2243.50 CT scan of face with contrast1482.00 CT scan of heart blood vessels and grafts with contrast dye3609.75 CT scan of lower leg blood vessels with contrast2771.50 CT scan of lower spine3353.25 CT scan of lower spine before and after contrast3046.75 CT scan of lower spine with contrast2091.25 CT scan of middle spine2298.75 CT scan of middle spine with contrast2257.25 CT scan of neck2755.75 CT scan of neck before and after contrast1157.50 CT scan of neck blood vessels with contrast2506.50 CT scan of neck with contrast3022.75 CT scan of pelvic blood vessels with contrast2747.75 CT scan of pelvis before and after contrast2097.25 CT scan of upper spine2623.25 CT scan of upper spine with contrast612.75 CT scan of upper spine with contrast

1950.00 CT scan pelvis2340.75 CT scan pelvis with contrast1877.75 CT TEMP BONES WO CONTRAST250.75 Culture for acid-fast bacilli154.75 Culture for acid-fast bacilli

2.35 CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION [44283]0.04 CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET [26173]8.39 CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION [8608]0.02 CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET [5291]

194.25 Cyanocobalamin (vitamin B-12) level6.00 CYANOCOBALAMIN 500 MCG TAB EA0.97 CYCLOBENZAPRINE 10 MG TABLET [6480]6.00 CYCLOBENZAPRINE 5MG TAB EA5.40 CYCLOPENTOLATE 2 % EYE DROPS [47437]9.76 CYCLOPENTOLATE 2 % EYE DROPS [47437]

14.76 CYCLOPENTOLATE 2 % EYE DROPS [47437]824.06 CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS SOLUTION [42451]

1648.13 CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS SOLUTION [42452]439.50 CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS SOLUTION [42450]11.15 CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE [52797]

303.00 Cyclosporine level7.00 CYCLOSPORINE PER 25MG, 25MG CA1.07 CYPROHEPTADINE 4 MG TABLET [5816]

300.00 CYTOLOGY BRUSH8.01 DABIGATRAN ETEXILATE 150 MG CAPSULE [119046]8.01 DABIGATRAN ETEXILATE 75 MG CAPSULE [119358]

14.40 DACARBAZINE 200 MG INTRAVENOUS SOLUTION [10520]1841.64 DALBAVANCIN 500 MG INTRAVENOUS SOLUTION [142890]

1.94 DANTROLENE 25 MG CAPSULE [44539]534.59 DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION [54582]127.13 DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION [149877]

1857.60 DARBEPOETIN ALFA 100 MCG/0.5 ML IN POLYSORBATE INJECTION SYRINGE [88219]4644.00 DARBEPOETIN ALFA 150 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE [88351]4644.00 DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE [88214]4644.00 DARBEPOETIN ALFA 300 MCG/0.6 ML IN POLYSORBATE INJECTION SYRINGE [88217]928.80 DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE [88215]

4644.00 DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE [87339]1857.60 DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE [88218]3769.75 DBX MIX 10CC2406.00 DBX MIX 5CC1077.25 DBX PUTTY 2.5CC1965.75 DBX PUTTY 5CC1140.00 DECITABINE 50 MG INTRAVENOUS SOLUTION [87152]910.25 Declotting infusion of implanted central venous access device or catheter11.29 DEFEROXAMINE 500 MG SOLUTION FOR INJECTION [39169]

914.51 DEGARELIX 120 MG SUBCUTANEOUS SOLUTION [111040]586.14 DEGARELIX 80 MG SUBCUTANEOUS SOLUTION [111032]213.75 Dehydroepiandrosterone (DHEA) hormone level217.50 Dehydroepiandrosterone (DHEA-S) hormone level263.25 Demonstration and/or evaluation of manual maneuvers to chest wall to assist movement of lung secretions187.00 Demonstration and/or evaluation of patient use of aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device

1612.05 DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION [119545]1462.87 DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE [116929]870.75 DEPUY 1 GENTAMICIN BN CMNT 40G

7.62 DESMOPRESSIN 0.2 MG TABLET [45242]70.55 DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION [10519]

380.00 Destruction of 15 or more skin growths215.00 Destruction of 15 or more skin growths35.00 Destruction of 2-14 skin growths

2672.00 Destruction of extensive growths of external female genitals

PRICE Description1764.00 Destruction of external female genital growths1028.00 Destruction of peripheral nerve or branch206.00 Destruction of skin growth708.75 Destruction of skin growth (less than 10 sq centimeters)215.00 Destruction of up to 14 skin growths11.95 DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [102745]

241.25 Detection of infectious agent antibody194.25 Detection of infectious agent antibody70.25 Detection test for candida species (yeast)

170.00 Detection test for chlamydia136.00 Detection test for chlamydia135.00 Detection test for chlamydia136.00 Detection test for clostridium difficile131.75 Detection test for cryptosporidium (parasite)369.75 Detection test for Cytomegalovirus (CMV)374.25 Detection test for cytomegalovirus, quantification62.25 Detection test for entamoeba histolytica group (parasite)

587.00 Detection test for enterovirus (intestinal virus)70.25 Detection test for gardnerella vaginalis (bacteria)25.25 Detection test for Hepatitis B surface antigen55.75 Detection test for Hepatitis B surface antigen

793.00 Detection test for Hepatitis B virus180.25 Detection test for Hepatitis Be surface antigen467.50 Detection test for Hepatitis C virus729.25 Detection test for Hepatitis C virus481.50 Detection test for Hepatitis C virus842.50 Detection test for herpes simplex virus247.00 Detection test for herpes simplex virus253.50 Detection test for histoplasma capsulatum (parasite)105.75 Detection test for HIV-1 and HIV-2564.75 Detection test for HIV-1 virus669.25 Detection test for HIV-1 virus44.25 Detection test for identification of organism76.75 Detection test for influenza A virus76.75 Detection test for influenza B virus

270.25 Detection test for multiple types influenza virus1527.50 Detection test for multiple types of respiratory virus136.00 Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria)135.00 Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria)520.75 Detection test for organism530.75 Detection test for organism190.75 Detection test for respiratory syncytial virus419.50 Detection test for Rotavirus160.50 Detection test for Strep (Streptococcus, group A)119.25 Detection test for Streptococcus, group B (bacteria)70.25 Detection test for Trichomonas vaginalis (genital parasite)

170.00 Detection test for Trichomonas vaginalis (genital parasite)429.75 Determination of lung volumes using gas dilution or washout403.00 Determination of lung volumes using plethysmography

0.21 DEXAMETHASONE 0.5 MG TABLET [2619]1.21 DEXAMETHASONE 4 MG TABLET [2624]3.00 Dexamethasone sodium phos

12.94 DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS [8828]1.56 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION [8803]2.88 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION [8806]1.78 DEXAMETHASONE(PF) PER 1MG,1.01 DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV [136578]

56.00 DEXMEDETOMIDINE PER 2ML,200MCG0.15 DEXTRAN 70-HYPROMELLOSE 0.1 %-0.3 % EYE DROPS [122778]1.71 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET [30497]0.50 DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP [5559]0.57 DEXTROMETHORPHAN-GUAIFENESIN 30 MG-600 MG TABLET EXTENDED RELEASE12 HR [6297]0.02 DEXTROSE 1.5% PERITONEAL SOLN,0.01 DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION [3922]1.00 DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE - FOR ED USE [617604]0.11 DEXTROSE 40 % ORAL GEL [45232]0.01 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4204]0.01 DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4206]0.01 DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4213]0.01 DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION [4209]0.12 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK [85043]0.01 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION [3347]0.02 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION [3347]0.05 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION [3347]

15.55 DEXTROSE 5 100ML0.01 DEXTROSE 5% AND 0.3 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4205]

25.50 DEXTROSE 5% IN WATER IV SOLN

PRICE Description0.07 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION [31153]0.20 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE [31255]0.02 DEXTRSE 2.5% PERIT SOLN,2500ML0.02 DEXTRSE 4.25% PERITSOLN,2500ML

76.50 Diab manage trn per indiv78.75 Diab manage trn ind/group27.00 Diagnostic examination of ear and nose

247.00 Diagnostic examination of nasal passages using an endoscope625.00 Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope247.00 Diagnostic examination of voice box using flexible endoscope145.42 Diagnostic imaging of eyes70.00 Diagnostic imaging of optic nerve of eye70.00 Diagnostic imaging of retina

3951.75 Diagnostic test for sleep disorder2901.75 Diagnostic test for sleep disorder275.00 Diagnostic testing in a pulmonary function lab382.75 Diagnostic testing in a pulmonary function lab

0.43 DIAZEPAM 10 MG TABLET [652]0.24 DIAZEPAM 2 MG TABLET [650]

281.59 DIAZEPAM 2.5 MG RECTAL KIT [48418]0.32 DIAZEPAM 5 MG TABLET [651]

16.41 DIAZEPAM 5 MG/ML INJECTION SYRINGE [3319]334.04 DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT [84557]

0.55 DICLOFENAC 1 % TOPICAL GEL [102842]1.47 DICLOFENAC SODIUM 50 MG TABLET,DELAYED RELEASE [2631]1.77 DICLOFENAC SODIUM 75 MG TABLET,DELAYED RELEASE [2632]0.60 DICYCLOMINE 10 MG CAPSULE [5721]

50.44 DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION [40923]0.60 DICYCLOMINE 20 MG TABLET [5702]2.07 DIFLUNISAL 500 MG TABLET [5145]

14.91 DIGOXIN 125 MCG (0.125 MG) TABLET [10285]3.30 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION [10328]

216.25 Digoxin level157.62 DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION [40728]332.25 Dihydroxyvitamin D, 1, 25 level420.00 Dilation of tear-drainage opening

0.45 DILTIAZEM 30 MG TABLET [479]0.32 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION [3294]0.38 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION [3294]0.43 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION [3294]7.00 DILTIAZEM 60MG TAB3.97 DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR [5082]1.20 DILTIAZEM SR 120 MG 24 HR CAP [42210]0.51 DILTIAZEM SR 180 MG 24 HR CAP [28893]2.05 DILTIAZEM SR 240 MG 24 HR CAP [5207]

492.71 DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE [47783]0.03 DIPHENHYDRAMINE - MYLANTA DS - LIDOCAINE VISCOUS [612717]0.18 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR [47470]0.01 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID [5549]0.08 DIPHENHYDRAMINE 25 MG CAPSULE [5722]0.14 DIPHENHYDRAMINE 50 MG CAPSULE [6758]1.28 DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [7394]5.00 Diphenhydramine hcl injectio0.70 DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET [40864]1.40 DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID [2566]1.06 DIPYRIDAMOLE 25 MG TABLET [686]

848.75 Direct Admit for Observation Care per hour1745.00 DISCISSION 2ND CATARACT

22.00 DISPOSABLE CATHETER NEEDLE1.42 DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE [49173]7.00 DIVALPROEX 125MG EC TAB1.76 DIVALPROEX 250 MG TABLET,DELAYED RELEASE [44568]3.23 DIVALPROEX 500 MG TABLET,DELAYED RELEASE [45891]2.45 DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR [52500]3.83 DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR [47489]

290.25 DNA testing for genetic defects0.12 DOBUTAMINE 1,000 MG/250 ML(4,000 MCG/ML) IN 5 % DEXTROSE IV [83]

365.15 DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION [119179]365.15 DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION [119180]

9.28 DOCOSANOL 10 % TOPICAL CREAM [44106]0.04 DOCUSATE SODIUM 100 MG CAPSULE [6249]0.07 DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID [5553]8.56 DOFETILIDE 125 MCG CAPSULE [45509]8.56 DOFETILIDE 250 MCG CAPSULE [45380]8.56 DOFETILIDE 500 MCG CAPSULE [49237]7.79 DONEPEZIL 10 MG TABLET [45035]7.79 DONEPEZIL 5 MG TABLET [44390]

PRICE Description0.08 DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN [110218]

458.50 Doppler ultrasound study of color-directed heart blood flow, rate, and valve function458.50 Doppler ultrasound study of heart blood flow, valves, and chambers

4.59 DORZOLAMIDE 2 % EYE DROPS [49581]12.26 DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS [48286]0.92 DOXAZOSIN 2 MG TABLET [28152]3.95 DOXAZOSIN 4 MG TABLET [28153]0.64 DOXEPIN 10 MG CAPSULE [8474]2.00 DOXEPIN 100 MG CAPSULE [7433]0.84 DOXEPIN 25 MG CAPSULE [7479]3.96 DOXERCALCIFEROL 2 MCG/ML INTRAVENOUS SOLUTION [47475]

28.00 DOXERCLCIFEROL 2MCG/ML INJ,2ML2.16 DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION [109594]2.66 DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION [109593]

116.28 DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION [44101]1.44 DOXYCYCLINE HYCLATE 100 MG CAPSULE [2354]

14.52 DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION [26741]348.50 Drainage of abscess177.00 Drainage of abscess363.50 Drainage of abscess764.25 Drainage of abscess, cyst, or blood accumulation of dental bone

3179.25 Drainage of blood or fluid accumulation1500.00 Drainage of blood or fluid accumulation5313.50 Drainage of breast abscess347.50 Drainage of finger abscess

1543.50 Drainage of fluid from abdominal cavity using imaging guidance880.00 Drainage of fluid from abdominal cavity using imaging guidance

1620.75 Drainage of fluid from abdominal cavity using imaging guidance2207.50 Drainage of fluid-filled sac (bursa) of upper arm or elbow5500.00 Drainage of heart sac348.50 Drainage of multiple abscess375.00 Drainage of multiple abscess364.50 Drainage of multiple abscess

5701.00 Drainage of rectal abscess3003.75 Drainage of rectal abscess936.50 Drainage of tailbone cyst640.00 Drainage of tailbone cyst

3097.25 Drainage of tailbone cyst395.75 Drainage of tonsil abscess372.75 Dressing change and/or removal of burn tissue (5% to 10% total body surface)372.75 Dressing change and/or removal of burn tissue (less than 5% total body surface)391.50 Dressing change and/or removal of burn tissue (less than 5% total body surface)

5.30 DRONABINOL 2.5 MG CAPSULE [46345]170.00 Drug test def 1-7 classes62.75 Drug test def 1-7 classes

162.00 Drug test def 1-7 classes91.25 Drug test def 1-7 classes8.89 DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [56270]1.72 DULOXETINE 30 MG CAPSULE,DELAYED RELEASE [56271]1.72 DULOXETINE 60 MG CAPSULE,DELAYED RELEASE [56272]

10.00 DUO NEB433.30 DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION [157325]

6.05 DUTASTERIDE 0.5 MG CAPSULE [52424]46.00 Eardrum testing using ear probe

206.50 ED AMOXICILLIN-CLAV 400MG-57MG21.25 Education86.00 Education84.50 Education

1325.00 EGD2504.25 EGD LESION ABLATION1807.00 EGD W/ BIOPSY1511.75 EGD W/DILATATION3693.75 EGD W/POLYPECTOMY/SNARE TECHNQ2673.50 EGD WITH BANDING LIGATION

21.00 Ekg tracing for initial prev157.50 Elastography ultrasound of additional lesion341.25 Elastography ultrasound of first lesion363.75 Elastography ultrasound of organ tissue92.50 Elec stim other than wound

240.00 Electronic analysis of implanted brain, spinal cord or peripheral stimulation device with complex cranial nerve stimulator programming133.00 Electronic analysis of implanted brain, spinal cord or peripheral stimulation device with complex spinal cord or peripheral nerve stimulator programming80.00 Electronic analysis of implanted brain, spinal cord or peripheral stimulation device with simple cranial nerve stimulator programming

162.00 Electronic assessment of bladder emptying2131.20 ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION [151710]2841.60 ELOTUZUMAB 400 MG INTRAVENOUS SOLUTION [151711]367.50 Emergency department visit, low to moderately severe problem630.00 Emergency department visit, moderately severe problem

PRICE Description787.50 Emergency department visit, problem of high severity

1522.50 Emergency department visit, problem with significant threat to life or function210.75 Emergency department visit, self limited or minor problem

1007.00 EMERGENCY HEMODIALYSIS594.50 Emergent insertion of breathing tube into windpipe cartilage using an endoscope

1440.75 Emergent insertion of breathing tube into windpipe cartilage using an endoscope1852.50 Emergent surgical opening of windpipe for insertion of breathing tube

19.71 EMPAGLIFLOZIN 10 MG TABLET [143841]19.71 EMPAGLIFLOZIN 25 MG TABLET [143840]4.56 EMPTY CONTAINER, PLASTIC BAG 250 ML [4216]

70.32 EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET [56267]1.94 ENALAPRIL MALEATE 10 MG TABLET [28143]1.85 ENALAPRIL MALEATE 5 MG TABLET [28142]4.29 ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION [28112]4.80 ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION [28112]

2164.50 ENDO SM INTESTINE,DIAG,NO SPEC100.50 ENDOVIVE REPLACEMENT PEG TUBE216.25 ENDURANCE 40MG BONE CEMENT99.34 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE [50530]

149.07 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE [48296]99.23 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE [50527]99.23 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE [50531]99.35 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE [50528]99.35 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE [50529]

149.07 ENOXAPARIN SODIUM 120 MG/0.8 ML SUBQ SYRG [52014]3.96 ENTACAPONE 200 MG TABLET [46529]

200.75 Enzyme activity measurement7.00 EPHEDRINE 50MG/ML INJ, 1ML

56.75 EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION [154292]0.55 EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE [3898]

247.01 EPINEPHRINE 0.15 MG/0.15 ML AUTO-INJECTOR (FOR 33 TO 66 LB PATIENTS) [114943]365.17 EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR [48675]17.95 EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION [122648]10.02 EPINEPHRINE 1 MG/ML INJECTION SOLUTION [4112]

2625.00 Episiotomy or vaginal repair4.10 EPLERENONE 25 MG TABLET [52307]

320.69 EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION [49156]641.40 EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION [46658]

1282.80 EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION [46965]132.36 EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION [161614]529.44 EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION [161864]

2019.25 ERCP6842.50 ERCP DUCT STENT PLACEMENT4359.50 ERCP EA DUCT/AMPULLA DILATE4359.50 ERCP REMOVE FOREIGN BODY DUCT6205.25 ERCP W/SPHINCTEROTOMY

1.97 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE [48547]154.39 ERTAPENEM 1 GRAM SOLUTION FOR INJECTION [49738]

7.00 ERYTHROMYCIN 250MG BASE TAB5.33 ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [5890]

10.22 ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [5890]89.28 ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION [31242]

250.75 Erythropoietin (protein) level4.32 ESCITALOPRAM 10 MG TABLET [52180]4.51 ESCITALOPRAM 20 MG TABLET [52181]6.00 ESCITALOPRAM 5MG TAB EACH0.62 ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION [40010]2.25 ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV [45178]

842.50 ESOPHAGEAL PH ELECTRODE PLACEM120.25 Established patient office or other outpatient visit, typically 5 minutes70.00 Established patient periodic preventive medicine examination age 18-39 years

250.00 Established patient periodic preventive medicine examination infant younger than 1 year70.00 Established patient periodic preventive medicine examination, age 1 through 4 years70.00 Established patient periodic preventive medicine examination, age 12 through 17 years70.00 Established patient periodic preventive medicine examination, age 5 through 11 years

222.25 Estradiol (hormone) level9.74 ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM [48776]0.68 ESTRADIOL 1 MG TABLET [6528]

105.00 Estriol (hormone) level194.25 Estriol (hormone) level572.00 Estrogen analysis401.50 Estrogen analysis187.00 Estrone (hormone) level230.50 Ethosuximide level

8.64 ETIDRONATE DISODIUM 400 MG TABLET [48254]0.75 ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION [24641]

1121.78 ETONOGESTREL 68 MG SUBDERMAL IMPLANT [88213]

PRICE Description2.99 ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION [3344]

300.00 Euflexxa inj per dose111.00 Evaluation and prescription of speech-generating and alternative communication device122.25 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)139.00 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)319.50 Evaluation of fine needle aspirate305.50 Evaluation of occupational therapy established plan of care, typically 60 minutes282.50 Evaluation of occupational therapy, typically 30 minutes294.00 Evaluation of occupational therapy, typically 45 minutes433.50 Evaluation of patient with prescription of speech-generating and alternative communication device213.00 Evaluation of physical therapy, typically 20 minutes224.00 Evaluation of physical therapy, typically 30 minutes235.00 Evaluation of physical therapy, typically 45 minutes

2137.75 Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement283.50 Evaluation of single or dual chamber pacing cardioverter-defibrillator at time of implantation or replacement

2066.50 Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming279.75 Evaluation of speech fluency209.25 Evaluation of speech sound production472.50 Evaluation of speech sound production with evaluation of language comprehension and expression433.50 Evaluation of swallowing function

14537.75 Event recorder, cardiac1.00 EVIDENCE COLLECTION

114.00 Examination of cornea and iris using lens device and slit lamp176.00 Examination of the vagina and cervix using an endoscope

2193.75 Exchange of abdominal cavity drainage catheter using imaging guidance1465.25 Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring222.50 Exercise test for spasm of lung airways100.00 EXPEDITED COVID

3307.50 Exploration of penetrating wound of abdomen, flank, or back3928.50 Exploration of penetrating wound of arm or leg2195.75 External shock to heart to regulate heart beat128.00 Eye and medical examination for diagnosis and treatment, established patient128.00 Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits128.00 Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits11.30 EZETIMIBE 10 MG TABLET [52412]

1040.00 F18 fdg330.75 Family psychotherapy including patient, 50 minutes

0.54 FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION [101199]0.54 FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION [28904]1.74 FAMOTIDINE 20 MG TABLET [28881]0.20 FAT EMULSION 20% IV SOLN, 250M

2045.25 FB REMOVE MUSCLE/TENDON 2052013.20 FEBUXOSTAT 40 MG TABLET [110835]2.38 FENOFIBRATE 160 MG TABLET [82238]0.79 FENOFIBRATE 54 MG TABLET [108488]0.38 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [4270]0.45 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION [4270]4.97 FENTANYL 100 MCG/2ML VIAL

78.71 FENTANYL 100 MCG/HR TRANSDERMAL PATCH [46753]20.30 FENTANYL 12 MCG/HR TRANSDERMAL PATCH [82230]21.27 FENTANYL 25 MCG/HR TRANSDERMAL PATCH [48755]26.36 FENTANYL 50 MCG/HR TRANSDERMAL PATCH [44096]59.31 FENTANYL 75 MCG/HR TRANSDERMAL PATCH [49029]0.09 FENTANYL IV INFUSION 2000 MCG IN NS 100 ML PYXIS [614476]1.75 FENTANYL PER 0.1MG, 0.05MG/ML7.00 FENTANYL PER 0.1MG, 0.05MG/ML5.30 FENTANYL, PER 100MCG,50MCG

85.94 FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION [137807]166.25 Ferritin (blood protein) level

0.06 FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET [89134]0.03 FERROUS SULFATE 325 MG (65 MG IRON) TABLET [6239]

637.75 Fetal contraction stress test168.75 Fetal hemoglobin level57.25 Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation59.00 Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation72.25 Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation

252.50 Fetal monitoring during labor by consulting physician393.50 Fetal non-stress test176.00 Fetal non-stress test138.00 Fibrinogen (factor 1) activity measurement35.00 Fibrinogen (factor 1) antigen detection

231.95 FIDAXOMICIN 200 MG TABLET [122738]377.80 FILGRASTIM 300 MCG/ML INJECTION SOLUTION [45742]376.00 FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION [52755]658.46 FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE [148731]140.50 FILSHIE CLIP

1.08 FINASTERIDE 5 MG TABLET [49340]

PRICE Description1.00 Fine needle aspiration of additional lesion using CT guidance

26.25 Fine needle aspiration of additional lesion using fluoroscopice guidance26.25 Fine needle aspiration of additional lesion using ultrasound guidance1.00 Fine needle aspiration of additional lesion using ultrasound guidance

375.00 Fine needle aspiration of first lesion1218.00 Fine needle aspiration of first lesion using CT guidance1218.00 Fine needle aspiration of first lesion using fluoroscopice guidance1218.00 Fine needle aspiration of first lesion using ultrasound guidance203.50 First degree burn treatment385.75 First degree burn treatment176.00 Fitting and insertion of vaginal support device20.00 Fitting of contact lens for treatment of ocular surface disease3.58 FLECAINIDE 100 MG TABLET [30587]6.00 FLECAINIDE 50 MG TAB, EACH

1906.00 FLEX SIGMOID W/BIOPSY238.87 FLOSEAL HEMOSTATIC MATRIX 5 ML KIT [613283]319.50 Flow cytometry technique for DNA or cell analysis103.75 Flow cytometry technique for DNA or cell analysis168.50 Flow cytometry technique for DNA or cell analysis172.00 Flow cytometry technique for DNA or cell analysis52.00 FLU VACCINE ADMIN8.75 FLUCONAZOLE 100 MG TABLET [43062]

14.01 FLUCONAZOLE 150 MG TABLET [43064]0.22 FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK [43068]0.08 FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK [43067]

113.40 FLUDARABINE 50 MG INTRAVENOUS SOLUTION [41160]0.75 FLUDROCORTISONE 0.1 MG TABLET [30479]

936.50 Fluid collection drainage by catheter using imaging guidance, accessed through the skin1943.00 Fluid collection drainage by catheter using imaging guidance, accessed through the skin

1.63 FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION [43498]2.34 FLUOCINOLONE 0.025 % TOPICAL CREAM [5886]2.25 FLUOCINOLONE 0.025 % TOPICAL OINTMENT [5887]0.15 FLUORESCEIN 0.6 MG EYE STRIPS [46801]0.23 FLUORESCEIN 1 MG EYE STRIPS [46173]9.13 FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION [45406]

521.75 Fluoroscopic and video recorded motion evaluation of swallowing function682.25 Fluoroscopic guidance for injection into spine or muscle next to spine828.25 Fluoroscopic guidance for insertion of needle242.00 Fluoroscopic guidance for insertion, replacement or removal of central venous access device

0.36 FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION [106097]0.31 FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION [106098]0.28 FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION [106099]0.33 FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [106096]0.10 FLUOXETINE 10 MG CAPSULE [29111]0.11 FLUOXETINE 20 MG CAPSULE [29095]0.58 FLUPHENAZINE 1 MG TABLET [6354]0.69 FLUPHENAZINE 2.5 MG TABLET [6355]3.49 FLURBIPROFEN 0.03 % EYE DROPS [18439]5.80 FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER [137895]5.80 FLUTICASONE FUROATE 200 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER [147454]

63.75 FLUTICASONE HFA 44MCG/PUFF INH31.87 FLUTICASONE PROPIONATE 115 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER [88375]47.27 FLUTICASONE PROPIONATE 230 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER [88376]5.27 FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION [49145]0.19 FOLIC ACID 1 MG TABLET [5703]5.41 FOLIC ACID 5 MG/ML INJECTION SOLUTION [24635]

180.25 Folic acid level257.50 Folic acid level880.00 Follow-up or limited ultrasound examination of heart34.75 FONDAPARINUX PER 0.5MG, 2.5MG

384.26 FOSAPREPITANT 150 MG INTRAVENOUS SOLUTION [119459]2.88 FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION [102472]0.79 FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION [102473]

2617.00 FREEZE DRIED CRUSHED BONE232.69 FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE [50473]219.75 Fungal blood culture (mold or yeast)200.75 Fungal culture (mold or yeast)225.00 Fungal culture (mold or yeast) of skin, hair, or nail147.25 Fungal culture, yeast

0.69 FUROSEMIDE 10 MG/ML INJ [3967]0.87 FUROSEMIDE 10 MG/ML INJ [3967]1.32 FUROSEMIDE 10 MG/ML INJ [3967]0.15 FUROSEMIDE 20 MG TABLET [684]0.06 FUROSEMIDE 40 MG TABLET [685]0.45 FUROSEMIDE 80 MG TABLET [649]

2013.00 FX CLSD METACRPL MANIP230.50 G6PD (enzyme) level

PRICE Description88.75 Ga67 gallium0.58 GABAPENTIN 100 MG CAPSULE [43401]1.38 GABAPENTIN 300 MG CAPSULE [43402]1.22 GABAPENTIN 400 MG CAPSULE [43403]

187.25 Gabapentin level15.00 Gad-base mr contrast nos,1ml4.22 GALANTAMINE 4 MG TABLET [45391]

3090.25 GALLIUM SPECT185.75 Gammaglobulin (immune system protein) measurement35.75 Gammaglobulin (immune system protein) measurement

316.50 Gammaglobulin (immune system protein) measurement47.25 Gammaglobulin (immune system protein) measurement

225.00 Gastrin (GI tract hormone) level196.75 GASTROVIEW CONTRAST AGENT146.00 GASTROVIEW MO40.25 GB CHEM PROFILE

105.00 GB HCG0.21 GEL DRESSING TOPICAL [50553]

49.99 GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE [45780]10.31 GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE [48556]33.44 GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 50 TOPICAL SPONGE [48059]8.00 Gelsyn-3 injection 0.1 mg2.04 GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION [125678]2.32 GEMFIBROZIL 600 MG TABLET [2340]

210.75 Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants2110.75 Gene analysis (adenomatous polyposis coli), full gene sequence196.75 Gene analysis (coagulation factor V) Leiden variant

1155.50 Gene analysis (cystic fibrosis transmembrane conductance regular) common variants281.50 Gene analysis (hemochromatosis) common variants562.75 Gene analysis (Janus kinase 2) variant196.75 Gene analysis (prothrombin, coagulation factor II) A variant206.75 Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants

37991.50 Generator neuro rechg bat sy45764.25 Generator, neuro non-recharg

308.25 Gentamicin (antibiotic) level3.29 GENTAMICIN 0.1 % TOPICAL CREAM [5891]0.24 GENTAMICIN 0.1 % TOPICAL OINTMENT [5892]8.57 GENTAMICIN 0.3 % EYE DROPS [6434]1.39 GENTAMICIN 40 MG/ML INJECTION SOLUTION [3308]1.94 GENTAMICIN 40 MG/ML INJECTION SOLUTION [3308]2.36 GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION [100028]

66.25 GLENBEIGH THYROID PANEL0.40 GLIMEPIRIDE 1 MG TABLET [46189]1.23 GLIMEPIRIDE 2 MG TABLET [46122]1.23 GLIMEPIRIDE 4 MG TABLET [47454]7.00 GLIPIZIDE 2.5MG XL TAB0.38 GLIPIZIDE 5 MG TABLET [2345]7.00 GLIPIZIDE 5MG XL TAB

336.96 GLUCAGON (HUMAN RECOMBINANT) 1 MG SOLUTION FOR INJECTION [47961]205.92 GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML SOLUTION FOR INJECTION [118031]39.25 Glucose (sugar) level on body fluid66.25 Glucose (sugar) level on body fluid

103.75 Glutamyltransferase (liver enzyme) level7.00 GLYBURIDE 2.5MG TAB7.00 GLYBURIDE 3MG TAB7.00 GLYBURIDE 5MG TAB

82.75 Glycated protein level0.11 GLYCERIN (ADULT) RECTAL SUPPOSITORY [6248]0.13 GLYCERIN (CHILD) RECTAL SUPPOSITORY [6247]0.06 GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS [83775]8.40 GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION [1962]1.06 GLYCOPYRROLATE 1 MG TABLET [40412]

545.55 GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION [137948]119.25 Gonadotropin (reproductive hormone) analysis105.00 Gonadotropin, chorionic (reproductive hormone) level238.50 Gonadotropin, follicle stimulating (reproductive hormone) level237.00 Gonadotropin, luteinizing (reproductive hormone) level

1483.00 GORETEX PATCH762.30 GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT [44653]694.50 Grafix stravix prime pl sqcm

7129.25 Graft, vascular4639.25 Graft, vascular3224.00 Graft, vascular1152.75 Graftjacket268.75 Group psychotherapy147.25 Group treatment of speech, language, voice, communication, and/or hearing processing disorder

0.06 GUAIFENESIN 100 MG/5 ML ORAL LIQUID [46030]

PRICE Description7.00 GUAIFENESIN 600MG SR TAB

423.50 Guide wire34.00 Guide wire39.25 Guide wire

164.00 Guide wire92.75 Guide wire

320.00 Guide wire129.50 HALCINONIDE 0.1% OINT, 30GM

0.46 HALOPERIDOL 1 MG TABLET [6336]0.78 HALOPERIDOL 5 MG TABLET [6338]

31.07 HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION [5726]0.45 HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE [5233]7.19 HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION [24330]

166.25 Haptoglobin (serum protein) level401.25 Hbot, full body chamber, 30m249.00 HDL cholesterol level162.00 Hearing test for children485.00 Heart rhythm analysis, interpretation and report of 48-hour EKG458.50 Heart rhythm tracing of 48-hour EKG134.50 Heavy metal level

1446.25 HELICAL BLADE 80MM-120MM154.00 Hemoglobin A1C level52.00 Hemoglobin A1C level

180.25 Hemoglobin analysis and measurement361.50 Hemoglobin analysis and measurement53.75 Hemoglobin measurement59.50 HEM-O-LOK CLIP-LARGE91.50 Hemosiderin (hemoglobin breakdown product) analysis

1448.50 HEMOSPLIT 57444200.32 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION [44427]2.88 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION [44427]6.16 HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION [48865]0.04 HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN [86562]2.40 HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION [49187]

163.25 Heparin assay52.00 Heparin assay0.74 HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE [86551]

247.50 Hepatitis B core antibody (IgM) measurement60.75 Hepatitis B core antibody measurement

183.69 Hepatitis B immune globulin for injection into muscle108.25 Hepatitis B surface antibody measurement89.00 Hepatitis Be antibody measurement43.75 Hepatitis C antibody measurement32.50 Hepatitis C antibody measurement71.75 Hepatitis C antibody measurement0.04 HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [4113]

289.25 HI FLOW OXYGEN597.75 HLA class I typing, low resolution one antigen equivalent147.50 HLA class II typing high resolution one allele or allele group244.00 HLA class II typing high resolution one locus341.75 HLA class II typing high resolution one locus295.50 HLA class II typing low resolution one antigen equivalent34.00 Hocm <=149 mg/ml iodine, 1ml

970.50 HOLTER MONITOR 48 HRS241.50 Homocysteine (amino acid) level

0.39 HONEY 80 % TOPICAL GEL [135106]145.00 Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle70.00 Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle

308.25 Hosp grade elec breast pump55.50 Hospital observation care, typically 30 minutes

154.00 Hospital outpt clinic visit250.00 Hospital outpt clinic visit

2.90 HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION [142610]230.00 Hyalgan supartz visco-3 dose66.96 HYALURONIDASE 150 UNIT/ML INJECTION EXTRAVASATION ANTIDOTE [613321]0.42 HYDRALAZINE 10 MG TABLET [5823]6.00 HYDRALAZINE 12.5MG SPLIT TAB

15.70 HYDRALAZINE 20 MG/ML INJECTION SOLUTION [9621]0.51 HYDRALAZINE 25 MG TABLET [682]0.56 HYDRALAZINE 50 MG TABLET [683]

166.00 Hydration infusion into a vein294.50 Hydration infusion into a vein 31 minutes to 1 hour514.50 Hydration infusion into a vein 31 minutes to 1 hour

0.43 HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE [8563]0.15 HYDROCHLOROTHIAZIDE 25 MG TABLET [687]1.57 HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [7513]0.63 HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET [39038]

PRICE Description0.89 HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET [39037]0.19 HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SYRUP [10205]0.17 HYDROCORTISONE 1 % TOPICAL OINTMENT [5865]0.42 HYDROCORTISONE 2.5 % TOPICAL CREAM [5894]3.08 HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR [11288]0.14 HYDROCORTISONE 2.5 % TOPICAL OINTMENT [5900]0.34 HYDROCORTISONE 5 MG TABLET [40397]

14.43 HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY [6736]16.12 HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION [116381]0.06 HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM [41932]6.48 HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE [137438]4.32 HYDROMORPHONE 1 MG/ML INJECTION SYRINGE [1037]0.71 HYDROMORPHONE 2 MG TABLET [2635]3.29 HYDROMORPHONE 2 MG/ML INJECTION SYRINGE [1021]0.72 HYDROMORPHONE 4 MG TABLET [2636]0.17 HYDROMORPHONE PCA 0.5 MG/ML IN NS 100 ML PYXIS [600633]4.39 HYDROXYCHLOROQUINE 200 MG TABLET [5245]3.00 HYDROXYCHLOROQUINE, PER 1ML

263.25 Hydroxycorticosteroids, 17 (adrenal gland hormone) level245.25 Hydroxyindolacetic acid (product of metabolism) level394.75 Hydroxyprogesterone, 17-D (synthetic hormone) level

1.10 HYDROXYUREA 500 MG CAPSULE [2534]0.28 HYDROXYZINE HCL 10 MG TABLET [6397]0.40 HYDROXYZINE HCL 25 MG TABLET [6398]

25.63 HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION [9637]0.30 HYDROXYZINE PAMOATE 25 MG CAPSULE [5962]0.32 HYDROXYZINE PAMOATE 50 MG CAPSULE [5961]0.85 HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET [47479]7.00 HYOSCYAMINE 0.125 SL TAB1.10 HYPROMELLOSE 2.5 % EYE DROPS [42330]

210.96 IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE [86283]0.17 IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [8877]0.08 IBUPROFEN 200 MG TABLET [5479]0.08 IBUPROFEN 400 MG TABLET [5985]0.10 IBUPROFEN 600 MG TABLET [5976]0.09 IBUPROFEN 800 MG TABLET [5977]

44.52 IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION [614571]276.25 Identification of mycobacteria (TB or TB like organism)48.50 Identification of organisms by genetic analysis

326.00 Identification of red blood cell antibodies200.75 IgE (immune system protein) level110.25 Iliac art angio,cardiac cath35.50 ILOPERIDONE 2MG TAB35.50 ILOPERIDONE 6MG TAB35.50 ILOPERIDONE 8MG TAB

854.75 Imaging for abscess or abnormal drainage tract procedure244.00 Imaging for bone age assessment443.50 Imaging for bone length assessment734.25 Imaging for evaluation of swallowing function467.00 Imaging from nose to rectum, single view, child577.50 Imaging guidance for procedure, up to 1 hour435.50 Imaging guidance for procedure, up to 1 hour367.00 Imaging of 2 or more joints, single view461.50 Imaging of blood vessels in back of eye using fluorescein dye

1071.75 Imaging of bone marrow limited area618.50 Imaging of bone marrow multiple areas772.00 Imaging of bone marrow whole body270.00 Imaging of colon using enema

1155.00 Imaging of digestive tract done from the inside of the digestive tract772.00 Imaging of liver and bile duct system

2949.75 Imaging of liver and bile duct system with use of drugs1276.00 Imaging of liver and spleen747.75 Imaging of lymphatic tissue and lymph node

1615.25 Imaging of parathyroid772.00 Imaging of parathyroid with nuclear medicine study854.75 Imaging of surgical specimen788.75 Imaging of surgical specimen

1832.25 Imaging of urinary tract907.75 Imaging of urinary tract with injection of contrast into a vein11.65 IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION [44933]7.00 IMIPRAMINE 25MG TAB7.00 IMIPRAMINE 50MG TAB

14.31 IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN [119839]16.63 IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION [147460]

119.25 Immunologic analysis for autoimmune disease182.25 Immunologic analysis for detection of organism259.00 Immunologic analysis for detection of organism

PRICE Description154.00 Immunologic analysis for detection of tumor antigen285.75 Immunologic analysis for detection of tumor antigen386.75 Immunologic analysis for detection of tumor antigen336.00 Immunologic analysis technique on body fluid336.00 Immunologic analysis technique on serum280.00 Implantation of lower leg neurostimulator electrode, accessed through the skin

2043.00 Incision and drainage of abscess in scrotal sac of testicle1130.75 Incision and drainage of ear canal abscess936.50 Incision and drainage of external ear abscess or blood accumulation

1100.00 Incision and drainage of external ear abscess or blood accumulation868.75 Incision and drainage of eyelid abscess326.00 Incision and drainage of eyelid abscess382.00 Incision and drainage of female genital gland abscess176.00 Incision and drainage of female genital gland abscess

1250.25 Incision and drainage of female genitals abscess314.00 Incision and drainage of female genitals abscess

1250.25 Incision and drainage of roof of mouth or its soft tissue projection936.50 Incision of abscess, cyst, or blood accumulation in mouth630.00 Incision of eardrum with insertion of eardrum tube under local or topical anesthesia

5834.25 Incision of elbow with exploration, drainage, or removal of foreign body764.25 Incision of engorged external hemorrhoid434.00 Incision of engorged external hemorrhoid

4020.25 Incision of penile foreskin1535.00 Incision of tissue connecting tongue and floor of mouth391.00 Incision, aspiration, and/or inflation of eardrum

1.00 Incisional biopsy of additional skin lesion630.00 Incisional biopsy of single skin lesion656.25 Incisional biopsy of single skin lesion

1.42 INDAPAMIDE 1.25 MG TABLET [3141]26.25 Indium in-111 auto wbc

1358.00 Indium in-111 pentetreotide335.75 INDOCYANINE 25MG INJ KIT

0.38 INDOMETHACIN 25 MG CAPSULE [5986]204.00 INDOMETHACIN 50 MG RECTAL SUPPOSITORY [30358]

1401.38 INFLIXIMAB 100 MG INTRAVENOUS SOLUTION [47461]130.00 Infliximab not biosimil 10mg904.07 INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION [158533]222.25 Infrared analysis of stone145.00 Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour268.75 Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour103.00 Infusion into a vein for therapy, prevention, or diagnosis178.50 Infusion into a vein for therapy, prevention, or diagnosis555.75 Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour504.00 Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour145.00 Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion268.75 Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion145.00 Infusion of chemotherapy into a vein362.25 Infusion of chemotherapy into a vein up to 1 hour350.00 Infusion of chemotherapy into a vein up to 1 hour499.50 Infusion of chemotherapy into a vein using push technique294.50 Infusion of different chemotherapy drug or substance into a vein294.50 Infusion of different chemotherapy drug or substance into a vein up to 1 hour603.50 Infusion of drug into vein to dissolve coronary blood clot

40335.00 Infusion pump, programmable30730.75 Infusion pump, programmable

496.00 Ingestion of test items for allergies, 120 minutes105.00 Inhibin A (reproductive organ hormone) measurement798.75 INIATE INFUSION PUMP70.00 Initial new patient preventive medicine evaluation age 18-39 years70.00 Initial new patient preventive medicine evaluation infant younger than 1 year70.00 Initial new patient preventive medicine evaluation, age 1 through 4 years70.00 Initial new patient preventive medicine evaluation, age 12 through 17 years70.00 Initial new patient preventive medicine evaluation, age 5 through 11 years

642.75 Initiation and management of continued pressured respiratory assistance by mask or breathing tube613.50 Initiation and management of continued pressured respiratory assistance by mask or breathing tube

1327.00 Initiation and management of continued pressured respiratory assistance by mask or breathing tube0.25 Inj gadoterate meglumi 0.1ml

80.00 Inj., cosyntropin, 0.25 mg102.75 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention106.50 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention155.75 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention93.00 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention

127.00 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention360.00 INJECTION INTRALESIONAL70.00 Injection of allergenic extracts into skin for immediate reaction analysis38.00 Injection of allergenic extracts into skin with delayed reaction analysis30.00 Injection of allergenic extracts into skin, accessed through the skin

PRICE Description1128.75 Injection of anesthetic agent and/or steroid into femoral nerve of thigh897.75 Injection of anesthetic agent and/or steroid into other peripheral nerve or branch546.75 Injection of anesthetic agent and/or steroid into trigeminal nerve of face

4971.00 Injection of bile duct for X-ray imaging procedure accessed through the skin using imaging guidance including radiological supervision and interpretation897.75 Injection of blood or blood clot into spinal canal336.00 Injection of carpal tunnel450.00 Injection of chemical for destruction of facial and neck nerve muscles on both sides of face

1170.00 Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles1170.00 Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles280.00 Injection of chemical for destruction of nerve muscles on one side of face450.00 Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin720.00 Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles450.00 Injection of chemical for destruction of salivary glands on both sides of the mouth145.00 Injection of different drug or substance into a vein for therapy, diagnosis, or prevention764.25 Injection of drug into erectile tissue at sides and back of penis516.50 Injection of drug into erectile tissue at sides and back of penis350.00 Injection of drug into eye230.50 Injection of drug or substance into a vein for therapy, diagnosis, or prevention175.00 Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility166.75 Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility

1269.50 Injection of dye for X-ray imaging and/or CT of lower spinal canal546.75 Injection of dye for X-ray imaging of elbow joint

2168.75 Injection of dye for X-ray imaging of hip joint384.25 Injection of dye for X-ray imaging of hip joint546.75 Injection of dye for X-ray imaging of shoulder joint

1250.25 Injection of dye for X-ray imaging of wrist joint127.00 Injection of incremental dosages of allergen39.00 Injection of incremental dosages of allergen, 2 or more injections

570.00 Injection of medication or substance into membrane covering eyeball360.00 Injection of more than 7 skin growths548.25 Injection procedure for X-ray imaging of the bladder or during voiding10.00 Injection,onabotulinumtoxina

280.00 Injections of anesthetic and/or steroid drug into nerve of foot280.00 Injections of tendon attachment to bone336.00 Injections of tendon sheath, ligament, or muscle membrane543.75 Injections of trigger points in 1 or 2 muscles280.00 Injections of trigger points in 1 or 2 muscles534.75 Injections of trigger points in 3 or more muscles280.00 Injections of trigger points in 3 or more muscles

51601.25 INSERT INTRATHECAL PUMP PROGRA651.75 Insertion dilator device into cervix

1352.50 Insertion of arterial catheter for blood sampling or infusion, accessed through the skin127.50 Insertion of assistive heart blood flow device into aorta, accessed through the skin

10580.00 Insertion of catheter for diagnostic evaluation of right heart structures764.25 Insertion of catheter for suction of secretions

10580.00 Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart4919.75 Insertion of catheter in right heart for imaging of blood vessels or grafts2280.25 Insertion of catheter into abdominal pelvic or leg artery1352.50 Insertion of catheter into abdominal pelvic or leg artery1352.50 Insertion of catheter into aorta6813.75 Insertion of catheter into artery for drug infusion for blood clot including radiological supervision and interpretation

10580.00 Insertion of catheter into right and left heart for diagnosis4119.00 Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes1715.50 Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes4099.25 Insertion of catheter into vein for drug infusion for blood clot including radiological supervision and interpretation864.25 Insertion of catheter into vein of navel, newborn

1690.75 Insertion of central venous catheter for infusion, patient 5 years or older2875.50 Insertion of central venous catheter for infusion, patient 5 years or older3812.75 Insertion of central venous catheter for infusion, patient 5 years or older2721.50 Insertion of central venous catheter for infusion, patient 5 years or older1586.00 Insertion of central venous catheter for infusion, patient 5 years or older4007.75 Insertion of central venous catheter for infusion, patient 5 years or older2792.00 Insertion of central venous catheter for infusion, patient 5 years or older2096.50 Insertion of central venous catheter for infusion, patient 5 years or older2721.25 Insertion of central venous catheter for infusion, patient younger than 5 years315.00 Insertion of device into the abdomen with measurement of pressure and urine flow rate114.00 Insertion of drug delivery implant into tissue

11025.00 Insertion of electrode for permanent pacemaker or pacing defibrillator device13036.50 Insertion of electrodes for permanent pacemaker or pacing defibrillator device

656.00 Insertion of electronic device into bladder with voiding pressure studies2472.75 Insertion of feeding tube (accessed beneath the skin) into small bowel using an endoscope

18799.75 Insertion of heart rhythm monitor under skin173.50 Insertion of indwelling bladder catheter251.00 Insertion of indwelling bladder catheter764.25 Insertion of indwelling bladder catheter190.00 Insertion of indwelling bladder catheter

23822.25 Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation

PRICE Description55894.50 Insertion of left heart electrode for pacing defibrillator device

577.50 Insertion of nasal or oral stomach tube using fluoroscopic guidance11171.00 Insertion of needle and/or catheter into dialysis circuit and balloon dilation of dialysis segment, with imaging including radiological supervision and interpretation22573.75 Insertion of needle and/or catheter into dialysis circuit and insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation1586.00 Insertion of needle and/or catheter into dialysis circuit, with imaging including radiological supervision and interpretation393.75 Insertion of needle for infusion into bone134.75 Insertion of needle into scalp vein, patient younger than 3 years35.50 Insertion of needle into vein for collection of blood sample8.00 Insertion of needle into vein for collection of blood sample

16.00 Insertion of needle into vein, patient 3 years or older2040.25 Insertion of needle or catheter into an artery of arm or leg

37182.50 Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes13301.50 Insertion of pacemaker pulse generator with existing dual leads26801.75 Insertion of pacemaker pulse generator with existing multiple leads60304.50 Insertion of pacing defibrillator pulse generator with existing dual leads46903.00 Insertion of pacing defibrillator pulse generator with existing multiple leads82636.75 Insertion of pacing defibrillator pulse generator with existing single lead6598.50 Insertion of permanent catheter for drainage of lung fluid1625.75 Insertion of probe in esophagus for heart ultrasound examination including interpretation and report3500.00 Insertion of stent in urinary duct (ureter) using an endoscope

23934.75 Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure31125.50 Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure

371.25 Insertion of stomach tube and aspirations of gastric contents403.00 Insertion of stomach tube and aspirations of gastric contents173.50 Insertion of temporary bladder catheter268.00 Insertion of temporary bladder catheter251.00 Insertion of temporary bladder catheter

12663.75 Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation30405.00 Insertion or replacement of permanent pacemaker and lower chamber electrodes42117.00 Insertion or replacement of single or dual chamber pacing defibrillator leads

21.00 INSTA-CHAR CHERRY 25GM98.75 Insulin antibody measurement44.71 INSULIN ASPAR PROT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS PEN [52213]36.01 INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN [52753]44.71 INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN [52754]34.72 INSULIN ASPART U-100 100 UNIT/ML SUBCUTANEOUS SOLUTION [47133]36.98 INSULIN DETEMIR (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN [86331]36.98 INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION [86276]16.52 INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP [45486]

145.75 Insulin measurement16.52 INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION [38178]17.84 INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION (SLIDING SCALE) [613484]17.84 INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION [38177]

220.50 INT SCALP ELECTRODE684.00 Intestine imaging380.25 INTRATHECAL CATHETER PASSER

2904.00 INTRATHECAL PATIENT PROGRAMMER259.25 INTRAUTERINE PRESSURE CATH187.25 Intrinsic factor (stomach protein) antibody measurement568.00 Intro/sheath, fixed,non-peel33.75 Intro/sheath, non-laser92.75 Intro/sheath, non-laser

598.00 Intro/sheath, non-laser324.25 Intro/sheath,fixed,peel-away187.75 Intro/sheath,strble,non-peel264.25 Introduction of saline or X-ray contrast material for X-ray imaging of the uterus and tubes

11199.00 Iodine i-123 iobenguane140.00 Iodine i-123 sod iodide mic

2.14 IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION [44322]886.86 IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION [121467]886.87 IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [121465]

0.74 IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN [44387]0.53 IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION [2683]1.52 IPRATROPIUM BROMIDE 0.03 % NASAL SPRAY [39164]6.38 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY [39165]

511.74 IPRATROPIUM-ALBUTEROL20-100MCG3.07 IRBESARTAN 150 MG TABLET [48608]

2037.50 IRIDECTOMY FOR GLAUCOMA4.77 IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION [102292]7.40 IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION [102293]

152.50 Iron binding capacity16.69 IRON DEXTRAN 50 MG/ML INJECTION SOLUTION [161237]

108.25 Iron level11.52 IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION [47580]

101.50 Irradiation of blood product, each unit170.25 Irrigation of implanted venous access drug delivery device183.00 Islet cell (pancreas) antibody measurement

PRICE Description0.28 ISOFLURANE 99.9 % INHALATION LIQUID [129667]1.08 ISOSORBIDE DINITRATE 10 MG TABLET [5715]2.49 ISOSORBIDE DINITRATE 20 MG TABLET [5716]1.31 ISOSORBIDE DINITRATE 30 MG TABLET [8380]6.00 ISOSORBIDE DINITRATE 5MGTAB EA0.41 ISOSORBIDE MONONITRATE 20 MG TABLET [5088]0.52 ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR [7312]0.54 ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR [7311]

17.25 JELCO ALL SIZES 20 22 2414.50 JELCO NEXIVA 20X 114.50 JELCO NEXIVA 22 X 1

2659.50 Joint device (implantable)1625.50 Joint device (implantable)257.00 Joint device (implantable)

4136.75 Joint device (implantable)3841.50 Joint device (implantable)3545.75 Joint device (implantable)886.50 Joint device (implantable)

2068.25 Joint device (implantable)2363.75 Joint device (implantable)

9.25 KERLIX ROLL ST1.97 KETAMINE 100 MG/ML INJECTION SOLUTION [3541]0.79 KETAMINE 50 MG/ML INJECTION SOLUTION [3542]

80.75 Ketone bodies analysis93.25 Ketone bodies analysis16.24 KETOROLAC 0.5 % EYE DROPS [46278]21.26 KETOROLAC 0.5 % EYE DROPS [46278]

214.00 KETOROLAC 0.5%OPTH, 10ML2.16 KETOROLAC 10 MG TABLET [5127]0.95 KETOROLAC 15 MG/ML INJECTION SOLUTION [3726]1.04 KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [3728]0.62 KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION [3729]

20.00 Ketorolac tromethamine inj461.50 Ketosteroids, 17 (hormone) measurement241.50 Kidney function blood test panel111.75 KIT CATH TRIPLE LUMEN 16CM23.25 KIT DRESSING CHG9.25 KIT IV START DISP9.25 KIT STAPLER SK REM0.10 L.ACIDOPHIL,SALIVARI-BIFIDO BIFIDUM-STREP THERMOPH 175 MG CAPSULE [103278]0.55 LABETALOL 100 MG TABLET [5096]0.68 LABETALOL 200 MG TABLET [5097]0.20 LABETALOL 5 MG/ML INTRAVENOUS SOLUTION [3551]

113.50 LABOR ROOM PER HOUR17.29 LACOSAMIDE 100 MG TABLET [111128]4.54 LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION [111885]

119.25 Lactate dehydrogenase (enzyme) level0.01 LACTATED RINGERS INTRAVENOUS SOLUTION [4220]

98.00 Lactic acid level0.86 LACTOBACILLUS ACIDOPHILUS, BULGARICUS 100 MILLION CELL GRANULES PACKET [53589]0.25 LACTOBACILLUS ACIDOPHILUS100MG0.03 LACTULOSE 20 GRAM/30 ML ORAL SOLUTION [126158]0.23 LAMOTRIGINE 100 MG TABLET [49320]0.22 LAMOTRIGINE 25 MG TABLET [46191]

340.75 Lamotrigine level11916.00 Laser vaporization of prostate including control of bleeding using an endoscope

38.00 LATANOPROST 0.005 % EYE DROPS [40543]134.75 Lead level84.25 Lead level49.00 Lead level

8576.75 Lead, aicd, endo dual coil15392.75 Lead, aicd, endo single coil4020.25 Lead, coronary venous6321.75 Lead, neurostim test kit6321.75 Lead, neurostimulator

12255.00 Lead, neurostimulator5347.00 Lead, neurostimulator1139.00 Lead, pmkr, other than trans1834.00 Lead, pmkr, transvenous vdd

16.42 LEFLUNOMIDE 10 MG TABLET [45618]1414.50 Lens, intraocular (new tech)524.50 Lens, intraocular (new tech)63.75 LET INJ 3CC18.05 LETROZOLE 2.5 MG TABLET [48801]36.25 LEUCOVORIN 25MG TAB22.74 LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION [10521]2.80 LEUCOVORIN CALCIUM 5 MG TABLET [2638]

PRICE Description11157.24 LEUPROLIDE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT [123205]5578.54 LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT [47291]1859.52 LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT [123868]400.00 Leuprolide acetate suspnsion

5.00 LEVALBUTEROL PER 0.5MG, 1.25MG154.00 LEVEL 1 VISIT ONCOLOGY NURSE

0.65 LEVETIRACETAM 100 MG/ML ORAL SOLUTION [53723]0.60 LEVETIRACETAM 250 MG TABLET [46871]0.72 LEVETIRACETAM 500 MG TABLET [44833]1.49 LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION [88386]

241.25 Levetiracetam level16.49 LEVOFLOXACIN 250 MG TABLET [45823]0.26 LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [53060]

18.90 LEVOFLOXACIN 500 MG TABLET [48762]0.13 LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [53058]

35.40 LEVOFLOXACIN 750 MG TABLET [48799]0.09 LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK [53059]

58.25 LEVONORGESTREL 0.75MG TAB126.70 LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION [125998]

0.61 LEVOTHYROXINE 100 MCG TABLET [7400]0.71 LEVOTHYROXINE 112 MCG TABLET [28229]0.72 LEVOTHYROXINE 125 MCG TABLET [7403]0.74 LEVOTHYROXINE 150 MCG TABLET [7401]0.48 LEVOTHYROXINE 25 MCG TABLET [6405]0.54 LEVOTHYROXINE 50 MCG TABLET [6402]0.60 LEVOTHYROXINE 75 MCG TABLET [7399]0.61 LEVOTHYROXINE 88 MCG TABLET [28232]0.41 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [87063]0.81 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [87063]0.96 LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE [87068]0.72 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [87064]1.53 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [87064]0.66 LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION [87067]

26.56 LIDOCAINE (PF) 3.5 % EYE GEL [109597]1.04 LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION [87061]0.09 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION [87066]0.04 LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION [87074]0.09 LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3657]0.13 LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3657]3.00 LIDOCAINE 1%,PER10MG,2ML SDV0.07 LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION [3791]0.09 LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION [3791]1.56 LIDOCAINE 2 % MUCOSAL JELLY [7460]3.06 LIDOCAINE 2 % MUCOSAL JELLY [7460]0.69 LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR [108584]0.13 LIDOCAINE 2 % MUCOSAL SOLUTION [48036]0.09 LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION [3544]0.13 LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION [3544]0.36 LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION [3544]0.11 LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3661]0.18 LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION [3661]1.29 LIDOCAINE 4 % (40 MG/ML) MUCOSAL SOLUTION [2577]1.20 LIDOCAINE 4 % TOPICAL CREAM [45297]1.68 LIDOCAINE 4 % TOPICAL PATCH [44492]

22.75 LIDOCAINE 5% PATCH13.12 LIDOCAINE HCL GEL 4% TOP, 75ML7.00 LIDOCAINE VISCOUS 100MG/5ML LI0.43 LIDOCAINE W/EPINEPHRINE DENTAL CARTRIDGE 1.7 ML [600866]

300.00 LILETTA IUD 52 MG433.50 LINDANE 1% TOP SHAM, 60ML204.08 LINEZOLID 600 MG TABLET [46868]

0.19 LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK [51789]1.05 LIOTHYRONINE 25 MCG TABLET [44830]0.80 LIOTHYRONINE 5 MCG TABLET [45974]

174.50 Lipase (fat enzyme) level3.73 LIPASE-PROTEASE-AMYLASE 12,000-38,000-60,000 UNIT CAPSULE,DELAYED REL [112665]

11.23 LIPASE-PROTEASE-AMYLASE 36,000-114,000-180,000 UNIT CAPSULE,DELAY REL [136638]10.24 LIPONAVIR-RITONAVIR,PER EACH48.25 Lipoprotein (A) level

193.75 Lipoprotein level249.00 Lipoprotein measurement

0.42 LISINOPRIL 10 MG TABLET [38031]6.00 LISINOPRIL 2.5MG TAB EACH0.40 LISINOPRIL 20 MG TABLET [38032]0.87 LISINOPRIL 5 MG TABLET [38030]0.14 LITHIUM CARBONATE 150 MG CAPSULE [2535]0.21 LITHIUM CARBONATE 300 MG CAPSULE [2536]

PRICE Description0.47 LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE [39730]0.54 LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE [40708]

139.00 Lithium level3858.75 LITHOTRIPSY

62.25 Liver enzyme (SGOT), level68.50 Liver enzyme (SGPT), level

241.50 Liver function blood test panel2540.25 LIVER-SPECT

6.75 Locm 300-399mg/ml iodine,1ml39.25 Locm 300-399mg/ml iodine,1ml65.00 Locm 300-399mg/ml iodine,1ml0.05 LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID [83576]0.88 LOPERAMIDE 2 MG CAPSULE [5126]0.86 LORATADINE 10 MG TABLET [39351]0.71 LORATADINE 5 MG-PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE,12HR [47707]0.70 LORAZEPAM 0.5 MG TABLET [6461]0.91 LORAZEPAM 1 MG TABLET [6462]0.90 LORAZEPAM 2 MG/ML INJECTION SOLUTION [3520]2.02 LORAZEPAM 2 MG/ML INJECTION SOLUTION [3520]3.20 LORAZEPAM 2 MG/ML INJECTION SYRINGE [3521]1.60 LORAZEPAM 2 MG/ML ORAL CONCENTRATE [49260]1.68 LOSARTAN 25 MG TABLET [47616]2.26 LOSARTAN 50 MG TABLET [40349]

154.00 Low Level Evaluation and Management Visit7.42 LUBIPROSTONE 24 MCG CAPSULE [86287]

48.94 LURASIDONE 40 MG TABLET [119959]28.00 Macroscopic examination (visual inspection) of parasite0.01 MAGNESIUM CITRATE ORAL SOLUTION [40288]0.08 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION [46732]

64.75 Magnesium level114.50 Magnesium level

0.03 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET [11204]0.09 MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK [101989]0.40 MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK [101604]0.01 MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION [101990]0.67 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION [3546]

984.25 MAJOR SUTURE CHARGE371.50 Mammography of both breasts298.75 Mammography of both breasts291.75 Mammography of one breast147.25 Manganese (heavy metal) level93.75 MANNITOL 20% (200MG/ML) IV SOL0.05 MANNITOL 25 % INTRAVENOUS SOLUTION [3751]

134.75 Manual (physical) therapy techniques to 1 or more regions, each 15 minutes225.75 Manual maneuvers to chest wall to assist movement of lung secretions397.00 Mass spectrometry (laboratory testing method)952.25 Maternity care and delivery procedure275.00 Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration792.00 Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration162.00 Measurement and graphic recording of total and timed exhaled air capacity332.50 Measurement and graphic recording of total and timed exhaled air capacity616.25 Measurement and recording of brain wave (EEG) activity, awake and drowsy26.25 Measurement C-reactive protein for detection of infection or inflammation

196.75 Measurement C-reactive protein for detection of infection or inflammation180.25 Measurement C-reactive protein for detection of infection or inflammation152.50 Measurement for Strep antibody (strep throat)83.00 Measurement of antibody (IgE) to allergic substance72.00 Measurement of antibody (IgE) to allergic substance55.50 Measurement of antibody (IgE) to allergic substance

166.25 Measurement of antibody for assessment of autoimmune disorder245.00 Measurement of antibody for assessment of autoimmune disorder210.25 Measurement of antibody for assessment of autoimmune disorder79.00 Measurement of antibody for assessment of autoimmune disorder

120.25 Measurement of antibody for assessment of autoimmune disorder103.75 Measurement of antibody for assessment of autoimmune disorder222.50 Measurement of antibody for assessment of autoimmune disorder189.25 Measurement of antibody for assessment of autoimmune disorder167.75 Measurement of antibody for rheumatoid arthritis assessment62.50 Measurement of antibody to noninfectious agent36.75 Measurement of bilirubin

152.50 Measurement of cold agglutinin (protein) to detect infection or disease190.50 Measurement of complement (immune system proteins)282.25 Measurement of complement (immune system proteins)187.25 Measurement of complement function (immune system proteins)114.00 Measurement of corneal curvature and depth of eye384.50 Measurement of DNA antibody561.75 Measurement of DNA antibody

PRICE Description114.00 Measurement of eye muscles to detect deviation of eyeball80.00 Measurement of field of vision during daylight conditions

114.00 Measurement of field of vision during daylight conditions141.25 Measurement of Hepatitis A antibody44.00 Measurement of Hepatitis A antibody (IgM)

162.00 Measurement of hydrogen in breath to test for GI symptoms219.75 Measurement of immune substance (oligoclonal bands)288.50 Measurement of largest amount of air breathed in an out of lungs over one minute393.50 Measurement of lung diffusing capacity255.75 Measurement of oxygen saturation in blood using ear or finger device182.25 Measurement of oxygen saturation in blood using ear or finger device342.50 Measurement of substance using immunoassay technique

1156.50 Measurement of substance using immunoassay technique260.50 Measurement of substance using immunoassay technique328.50 Measurement of substance using immunoassay technique128.50 Measurement of substance using immunoassay technique72.25 Measurement of substance using immunoassay technique

167.75 Measurement of substance using immunoassay technique430.50 Measurement of substance using immunoassay technique249.25 Measurement of substance using immunoassay technique222.25 Measurement of substance using immunoassay technique511.50 Measurement of substance using immunoassay technique105.50 Measurement of substance using immunoassay technique52.00 Measurement of substance using immunoassay technique

267.25 Measurement of substance using immunoassay technique194.25 Measurement of white blood cell function375.00 Mechanical chest wall manipulation for improvement in lung function

0.71 MECLIZINE 12.5 MG TABLET [5810]0.40 MECLIZINE 25 MG TABLET [5804]1.44 MECOBALAMIN-LEVOMEFOLATE CALCIUM-PYRIDOXAL PHOS 3 MG-35 MG-2 MG TABLET [115659]

25.75 MECONIUM ASPIRATOR112.25 Medical nutrition therapy performed in a group setting, each 30 minutes112.25 Medical nutrition therapy re-assessment and intervention, each 15 minutes110.75 Medical nutrition therapy, assessment and intervention, each 15 minutes54.00 MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION [43500]0.47 MEDROXYPROGESTERONE 5 MG TABLET [7434]0.60 Medroxyprogesterone acetate0.28 MEGESTROL 40 MG TABLET [2650]0.42 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION [133949]0.03 MELATONIN 1 MG TABLET [18150]0.27 MELATONIN 3 MG TABLET [9851]6.00 MELOXICAM 15MG TAB, EACH3.13 MELOXICAM 7.5 MG TABLET [46391]8.89 MEMANTINE 10 MG TABLET [54725]8.89 MEMANTINE 5 MG TABLET [54728]0.09 MENTHOL 0.44 %-ZINC OXIDE 20.6 % TOPICAL OINTMENT [114617]0.59 MENTHOL 3.3 MG LOZENGES [122655]6.91 MEPERIDINE (PF) 100 MG/ML INJECTION SYRINGE [84593]7.14 MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE [84588]2.89 MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION [84582]7.38 MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE [84589]0.21 MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [104162]0.30 MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [104161]0.71 MEPIVACAINE 30 MG/ML (3 %) INJECTION DENTAL CARTRIDGE [154208]

3545.68 MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION [149811]247.50 Mercury level82.75 Mercury level

127.25 Mercury level64.75 Mercury level13.99 MEROPENEM 1 GRAM INTRAVENOUS SOLUTION [47447]7.20 MEROPENEM 500 MG INTRAVENOUS SOLUTION [47317]5.10 MESALAMINE ER 0.375 GRAM CAPSULE,EXTENDED RELEASE 24 HR [110454]

1076.25 Mesh (implantable)316.75 Mesh (implantable)

3150.00 Mesh (implantable)2955.50 Mesh (implantable)950.75 Mesh (implantable)591.00 Mesh (implantable)192.25 Mesh (implantable)170.50 Mesh (implantable)160.00 Mesh (implantable)463.75 Metanephrines level227.50 Metanephrines level67.75 Metanephrines level4.89 METAXALONE 800 MG TABLET [52328]1.44 METFORMIN 1,000 MG TABLET [30145]6.00 METFORMIN 1000MG TAB, EACH

PRICE Description0.70 METFORMIN 500 MG TABLET [30139]1.21 METFORMIN 850 MG TABLET [30140]0.11 METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR [41543]

90.00 METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION [45008]0.44 METHADONE 10 MG TABLET [2645]0.39 METHADONE 5 MG TABLET [2644]0.77 METHIMAZOLE 10 MG TABLET [21513]0.44 METHIMAZOLE 5 MG TABLET [21512]7.00 METHOCARBAMOL 500MG TAB0.59 METHOCARBAMOL 750 MG TABLET [681]6.24 METHOTREXATE SODIUM 2.5 MG TABLET [710]

16.75 METHOTREXATE SODIUM 50 MG0.06 METHYL SALICYLATE-MENTHOL 30 %-10 % TOPICAL CREAM [88548]0.06 METHYL SALICYLATE-MENTHOL TOPICAL OINTMENT [48520]0.37 METHYLDOPA 250 MG TABLET [694]0.67 METHYLDOPA 500 MG TABLET [695]

24.79 METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) INTRAVENOUS SOLUTION [152051]29.64 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION [46428]92.00 METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION [103876]1.04 METHYLPHENIDATE 10 MG TABLET [5731]1.43 METHYLPREDNISOLONE 4 MG TABLET [6299]1.65 METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [48819]

25.00 Methylprednisolone 40 mg inj50.00 Methylprednisolone 80 mg inj12.69 METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [47215]40.00 METHYLPREDNISOLONE ACETATE PER10.00 Methylprednisolone injection11.63 METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION [115224]7.22 METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION [138648]

50.27 METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [43951]27.74 METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10345]0.30 METOCLOPRAMIDE 10 MG TABLET [5187]0.40 METOCLOPRAMIDE 5 MG TABLET [5188]0.68 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION [2586]0.67 METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION [3696]3.29 METOLAZONE 2.5 MG TABLET [40990]1.68 METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR [45229]1.12 METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR [48536]1.12 METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [44824]6.00 METOPROLOL TART 12.5MG SPLIT0.07 METOPROLOL TARTRATE 25 MG TABLET [41907]0.25 METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION [3554]0.06 METOPROLOL TARTRATE 50 MG TABLET [5142]0.48 METRONIDAZOLE 250 MG TABLET [5163]

66.25 METRONIDAZOLE 250MG/5ML SUSP,0.92 METRONIDAZOLE 500 MG TABLET [5164]0.02 METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK [4177]2.54 MEXILETINE 150 MG CAPSULE [2541]

224.40 MICAFUNGIN 100 MG INTRAVENOUS SOLUTION [89112]10.25 MICONAZOLE 2% POWDER, 43G0.11 MICONAZOLE NITRATE 2 % TOPICAL OINTMENT [47001]0.06 MICONAZOLE NITRATE 2 % TOPICAL POWDER [45370]0.26 MICONAZOLE NITRATE 2 % VAGINAL CREAM [5490]

228.00 MICROFIBRILLAR COLLAGEN HEMOSTAT 70 MM X 35 MM SHEETS [112671]112.80 MICROFIBRILLAR COLLAGEN HEMOSTAT TOPICAL POWDER IN PACKET [130476]157.50 Microsomal antibodies (autoantibody) measurement

0.23 MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION [139415]0.33 MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION [139415]1.25 MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION [139414]0.33 MIDAZOLAM 1 MG/ML INJECTION SOLUTION [28026]0.39 MIDAZOLAM 1 MG/ML INJECTION SOLUTION [28026]0.81 MIDAZOLAM 5 MG/ML INJECTION SOLUTION [28027]4.98 MIDODRINE 10 MG TABLET [41133]0.90 MIDODRINE 5 MG TABLET [41132]7.64 MILNACIPRAN 25 MG TABLET [111755]3.72 MILRINONE 1 MG/ML INTRAVENOUS SOLUTION [30707]

80.75 MILRINONE PER 5MG, 20MG IN 5%1.67 MINERAL OIL [31523]0.02 MINERAL OIL ENEMA [29934]0.03 MINERAL OIL ORAL [185]0.59 MINOXIDIL 2.5 MG TABLET [8481]2.60 MIRTAZAPINE 15 MG DISINTEGRATING TABLET [41555]2.72 MIRTAZAPINE 15 MG TABLET [39181]1.29 MIRTAZAPINE 30 MG TABLET [39182]6.00 MIRTAZAPINE 7.5MG TAB, EACH4.54 MISOPROSTOL 100 MCG TABLET [38037]

1676.25 MITEK QUICK ANCHOR

PRICE Description169.20 MITOMYCIN 20 MG INTRAVENOUS SOLUTION [24632]

1415.64 MITOMYCIN 40 MG INTRAVENOUS SOLUTION [24633]26.38 MODAFINIL 100 MG TABLET [49666]

150.25 Moderate sedation services by physician also performing a procedure, additional 15 minutes195.25 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes57.75 Moderate sedation services by physician also performing a procedure, patient younger than 5 years of age, first 15 minutes0.34 MODIFIED LANOLIN 100 % TOPICAL CREAM [165405]

206.75 Molecular pathology procedure1438.50 Molecular pathology procedure1266.25 Molecular pathology procedure level 1520.75 Molecular pathology procedure level 2591.00 Molecular pathology procedure level 2

2110.75 Molecular pathology procedure level 688.75 MOMETASONE 220 MCG/ACTUATION(14 DOSES) BREATH ACTIVATED POWDER INHALER [83460]

229.86 MOMETASONE 220MCG(ASMANEX)5.66 MONTELUKAST 10 MG TABLET [48315]5.66 MONTELUKAST 5 MG CHEWABLE TABLET [44062]2.18 MORPHINE (PF) 1 MG/ML INJECTION SOLUTION [3538]0.17 MORPHINE 10 MG/5 ML ORAL SOLUTION [2607]2.53 MORPHINE 10 MG/ML INTRAVENOUS SOLUTION [3983]0.91 MORPHINE 15 MG IMMEDIATE RELEASE TABLET [25285]3.44 MORPHINE 2 MG/ML INJECTION SYRINGE [1062]2.26 MORPHINE 2 MG/ML INTRAVENOUS SYRINGE [141641]1.54 MORPHINE 30 MG IMMEDIATE RELEASE TABLET [2647]3.44 MORPHINE 4 MG/ML INJECTION SYRINGE [1063]2.48 MORPHINE 4 MG/ML INTRAVENOUS SOLUTION [149352]2.26 MORPHINE 4 MG/ML INTRAVENOUS SYRINGE [141642]0.84 MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION [6879]7.64 MORPHINE ER 100 MG TABLET,EXTENDED RELEASE [26214]1.87 MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [26202]3.38 MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [26203]0.01 MORPHINE IV INFUSION 1 MG/ML IN 0.9% NACL [612808]

69.65 MOXIFLOXACIN 0.5 % EYE DROPS [52985]2649.35 MRA ABDOMEN W/WO CONTRAST3523.75 MRA scan of head blood vessels3961.75 MRA scan of head blood vessels before and after contrast3523.75 MRA scan of neck blood vessels3961.75 MRA scan of neck blood vessels before and after contrast1964.00 Mra w/cont, abd4673.00 Mra w/o cont, abd1155.00 Mra w/o fol w/cont, abd1155.00 Mra w/o fol w/cont, pelvis483.00 MRI of one breast

3095.75 MRI scan bones of the eye, face, and/or neck4704.75 MRI scan bones of the eye, face, and/or neck before and after contrast3714.75 MRI scan brain3411.75 MRI scan of abdomen4249.25 MRI scan of abdomen before and after contrast2775.00 MRI scan of arm4010.00 MRI scan of arm before and after contrast4211.75 MRI scan of arm joint5438.75 MRI scan of arm joint before and after contrast4421.75 MRI scan of arm joint with contrast3646.00 MRI scan of arm with contrast5955.75 MRI scan of brain before and after contrast1238.25 MRI scan of brain before and after contrast4082.75 MRI scan of brain with contrast2997.75 MRI scan of chest3353.25 MRI scan of chest before and after contrast3297.50 MRI scan of jaw joints2775.00 MRI scan of leg4624.00 MRI scan of leg before and after contrast4250.50 MRI scan of leg joint4685.25 MRI scan of leg joint before and after contrast4465.50 MRI scan of leg joint with contrast3016.50 MRI scan of leg with contrast4409.25 MRI scan of lower spinal canal5947.75 MRI scan of lower spinal canal before and after contrast4849.75 MRI scan of lower spinal canal with contrast3615.75 MRI scan of middle spinal canal5091.50 MRI scan of middle spinal canal before and after contrast3434.25 MRI scan of pelvis4525.50 MRI scan of pelvis before and after contrast3791.75 MRI scan of pelvis with contrast1250.25 MRI scan of upper spinal canal5324.50 MRI scan of upper spinal canal before and after contrast4839.50 MRI scan of upper spinal canal with contrast

PRICE Description1746.50 Mri w/o fol w/cont, breast,2068.25 Multiple measurements and graphic recordings of the amount and speed of breathed air, before and following medication administration

50.00 Multiple measurements of eye fluid pressure over an extended time period, same day341.00 Multiple measurements of oxygen saturation in blood using ear or finger device232.25 Multiple measurements of oxygen saturation in blood using ear or finger device227.50 Multiple measurements of oxygen saturation in blood using ear or finger device

7.00 MULTIVITAMIN WITH MINERALS TAB8.33 MUPIROCIN 2 % TOPICAL CREAM [47938]1.94 MUPIROCIN 2 % TOPICAL OINTMENT [41535]4.86 MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION [133542]

212.00 Mycophenolate (mycophenolic acid) level3.96 MYCOPHENOLATE MOFETIL 250 MG CAPSULE [44926]7.93 MYCOPHENOLATE MOFETIL 500 MG TABLET [46296]

75.00 MYCOPLASMA PNEUMONIAE, AMP PRO167.75 Myelin basic protein (nerve protein) level, spinal fluid216.25 Myoglobin (muscle protein) level

1.30 NABUMETONE 500 MG TABLET [29026]1.63 NABUMETONE 750 MG TABLET [29855]7.23 NADOLOL 40 MG TABLET [6002]

14.60 NAFCILLIN 1 GRAM SOLUTION FOR INJECTION [1467]4293.25 NAIL TROCHANTERIC 340-400MM LH

4.35 NALBUPHINE 10 MG/ML INJECTION SOLUTION [3336]7.47 NALBUPHINE 20 MG/ML INJECTION SOLUTION [3338]4.25 NALBUPHINE 20MG/ML

19.00 NALOXONE 0.4 MG/ML INJECTION SOLUTION [3314]19.80 NALOXONE 1 MG/ML INJECTION SYRINGE [9885]4.28 NALTREXONE 50 MG TABLET [8908]

1570.80 NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE [87219]0.78 NAPROXEN 250 MG TABLET [665]1.30 NAPROXEN 500 MG TABLET [667]

688.75 Nasal procedure52.50 Nasal smear for eosinophils (allergy related white blood cells)

529.61 NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION [56595]1.73 NATEGLINIDE 120 MG TABLET [40628]

180.25 Natriuretic peptide (heart and blood vessel protein) level5.73 NEBIVOLOL 10 MG TABLET [101886]5.73 NEBIVOLOL 2.5 MG TABLET [101885]

3159.75 Needle biopsy of abdominal cavity growth, accessed through the skin1545.00 Needle biopsy of kidney, accessed through the skin2606.25 Needle biopsy of liver, accessed through the skin2008.50 Needle biopsy of lung or chest tissue, accessed through the skin936.50 Needle biopsy of thyroid, accessed through the skin29.25 NEEDLE HUBER 20G 1 1/2 RA29.25 NEEDLE HUBER 22G 1 1/2 RA29.75 NEEDLE HUBER SAFETY 20X1

420.00 Needle measurement and recording of electrical activity of cranial nerve-supplied muscles on one side of body70.00 Needle measurement and recording of electrical activity of head or trunk muscles

162.00 Needle measurement and recording of electrical activity of middle spine muscles275.00 Needle measurement and recording of electrical activity of muscles in arms or legs70.00 Needle measurement and recording of electrical activity of muscles of arm or leg complete study95.00 Needle measurement and recording of electrical activity of muscles of arm or leg limited study

114.00 Needle measurement and recording of electrical activity of muscles of arms or legs38.00 NEEDLE, HUBER

185.75 NEEDLE,BIOPSY TYPE 162.25 NEEDLE,BIOPSY TYPE 2

508.25 Negative pressure wound therapy, surface area greater than 50 square centimeters, per session213.75 Negative pressure wound therapy, surface area less than or equal to 50 square centimeters, per session12.57 NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT [5917]16.27 NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT [6411]0.39 NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT [44328]3.97 NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS [6731]

10.07 NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP [8818]7.00 NEOSPORIN OINT, 1GM2.28 NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION [137918]2.20 NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION [137919]1.25 NEOSTIGMINE PER 0.5MG, 0.5MG/M

176.50 Nephelometry, test method using light162.25 Nephelometry, test method using light164.50 Nephelometry, test method using light496.00 Nerve transmission studies, 11-12 studies275.00 Nerve transmission studies, 3-4 studies275.00 Nerve transmission studies, 5-6 studies275.00 Nerve transmission studies, 7-8 studies496.00 Nerve transmission studies, 9-10 studies640.50 Nervous system procedure396.25 Neurobehavioral status examination by qualified health care professional with interpretation and report, first 60 minutes

0.05 NIACIN 250 MG TABLET [6619]

PRICE Description6.20 NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR [31585]

25.29 NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION [45909]0.28 NICOTINE (POLACRILEX) 2 MG GUM [9770]2.06 NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH [8499]2.52 NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH [8500]2.06 NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH [8498]3.30 NIFEDIPINE 10 MG CAPSULE [6408]1.33 NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR [5176]2.29 NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR [8578]7.00 NIFEREX-150 FORTE CAP

194.25 Nitroblue tetrazolium dye test to measure white blood cell function3.53 NITROFURANTOIN MONOHYDRATE & MACROCRYSTAL 100 MG ORAL CAP [41908]1.86 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH [8585]1.90 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH [8586]1.50 NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET [24864]2.17 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH [8493]0.69 NITROGLYCERIN 0.6 MG SUBLINGUAL TABLET [24865]2.40 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH [8587]2.76 NITROGLYCERIN 2 % TRANSDERMAL OINTMENT [23994]0.08 NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS [110223]1.56 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [111991]0.09 NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS [3341]

324.16 NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION [145690]324.16 NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION [160167]324.16 NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION [145689]

2532.00 NM SPECT MULT AREA MULT DAYS2532.00 NM SPECT MULT AREA, SINGLE DAY2532.00 NM SPECT SINGLE AREA, MULT DAY

22.00 Non-heu tc-99m add-on/dose145.00 Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle200.00 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings

1007.00 NON-ROUTINE HEMODIALYSIS6.07 NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION [39256]0.74 NORTRIPTYLINE 10 MG CAPSULE [5155]1.47 NORTRIPTYLINE 25 MG CAPSULE [5156]

1594.50 Nuclear medicine imaging for thyroid uptake measurements4574.00 Nuclear medicine imaging from skull base to mid-thigh3912.50 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, 2 or more days imaging3637.25 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, 2 or more days imaging1737.50 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, single day imaging2639.50 Nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in whole body, single day imaging1259.25 Nuclear medicine study of blood circulation in the lungs1625.75 Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study1838.00 Nuclear medicine study of kidney with assessment of blood flow and function1929.25 Nuclear medicine study of kidney with assessment of blood flow and function1179.25 Nuclear medicine study of lung ventilation1789.50 Nuclear medicine study of lung ventilation and blood circulation in the lungs2886.50 Nuclear medicine study of vessels of heart using drugs or exercise multiple studies2886.50 Nuclear medicine study of vessels of heart using drugs or exercise single study6187.00 Nuclear medicine study with CT imaging skull base to mid-thigh6187.00 Nuclear medicine study with CT imaging whole body3618.00 Nuclear medicine study with CT imaging whole body2314.25 Nuclear medicine study with measurement of blood circulation in the lungs

1.17 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM [5881]0.33 NYSTATIN ORAL LIQUID 500,000 UNIT/5 ML ADS [600992]

50.75 NYSTATIN SUSPENSION7.46 NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM [42135]

196.53 OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION [139519]62.25 Observation care per hour88.00 Observation care per hour

293.50 Observation care per hour398.50 Observation care per hour60.25 Observation care per hour

147.00 Observation care per hour65.25 Observation care per hour66.50 Observation care per hour

848.75 Observation care per hour483.75 Observation care per hour207.25 Observation care per hour91.75 Observation care per hour52.75 Observation care per hour

272.25 Observation care per hour276.00 Observation care per hour244.00 Observation care per hour394.00 Observation care per hour275.00 Observation, testing, and recording of abnormal eye movement110.25 Occlusive device in vein art

PRICE Description12.00 OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION [40470]11.92 OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION [45267]24.48 OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION [40522]

4242.59 OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE [146855]7663.37 OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE [146856]

50.00 OHS PHYSICAL ABILITY TEST53.64 OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION [55352]14.27 OLANZAPINE 5 MG DISINTEGRATING TABLET [49664]13.22 OLANZAPINE 5 MG TABLET [45302]16.08 OLANZAPINE 7.5 MG TABLET [45957]7.00 OLMESARTAN 20MG TAB

1327.63 OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION [53280]1327.63 OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE [163865]1327.63 OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRINGE [163863]

90.00 Omalizumab injection0.08 OMEGA-3 FATTY ACIDS 1,000 MG CAPSULE [28284]7.00 OMEGA-3 FISH OIL 1 G CAP3.70 OMEPRAZOLE 10 MG CAPSULE,DELAYED RELEASE [40725]3.90 OMEPRAZOLE 20 MG CAPSULE,DELAYED RELEASE [38954]6.00 OMEPRAZOLE 40MGCAP, EA

721.20 ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION [44871]1.28 ONDANSETRON 4 MG DISINTEGRATING TABLET [49063]0.36 ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION [89684]0.47 ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [45003]

24.78 ONDANSETRON HCL 4 MG TABLET [45094]12.75 One-way allow prorated trip

3524.75 Open treatment of broken finger or thumb5834.25 Open treatment of broken hand or finger2169.50 OR MAJOR 1ST 1/2 HOUR725.50 Organic acids level

1160.00 ORITAVANCIN 400 MG INTRAVENOUS SOLUTION [144401]11.10 ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION [40245]14.18 OSELTAMIVIR 30 MG CAPSULE [100574]14.18 OSELTAMIVIR 45 MG CAPSULE [100575]15.46 OSELTAMIVIR 75 MG CAPSULE [47232]

364.75 OSELTAMIVIR PER 75 MG/ML SUSP195.50 Osteocalcin (bone protein) level50.00 Osteopathic manipulative treatment to 1-2 body regions50.00 Osteopathic manipulative treatment to 3-4 body regions50.00 Osteopathic manipulative treatment to 5-6 body regions50.00 Osteopathic manipulative treatment to 7-8 body regions50.00 Osteopathic manipulative treatment to 9-10 body regions

1768.25 OSTEOSET MINI BEAD KIT719.25 OSTEOTOMY BLADE42.00 OT QUAL NONMD EST PT 11-20M70.00 OT QUAL NONMD EST PT 21+M24.00 OT QUAL NONMD EST PT 5-10 MIN

259.75 Oth resp proc, group469.75 Overnight measurement of oxygen saturation in blood using ear or finger device142.75 Oxalate level

1650.00 OXALIPLATIN 100 MG INTRAVENOUS SOLUTION [52195]6.00 OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [82295]1.51 OXCARBAZEPINE 150 MG TABLET [44190]2.76 OXCARBAZEPINE 300 MG TABLET [45738]

340.75 Oxcarbazepine level0.72 OXYBUTYNIN CHLORIDE 5 MG TABLET [6340]7.00 OXYCODONE 10MG CR TAB6.00 OXYCODONE 10MG TAB, EACH1.87 OXYCODONE 15 MG TABLET [42173]

11.75 OXYCODONE 20MG CR TAB3.56 OXYCODONE 30 MG TABLET [42174]0.54 OXYCODONE 5 MG TABLET [5526]1.73 OXYCODONE 5 MG/5 ML ORAL SOLUTION [30157]

15.81 OXYCODONE ER 40 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR [145888]1.37 OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET [6388]

187.25 OXYGEN SUPPLY/DAY0.06 OXYMETAZOLINE 0.05 % NASAL SPRAY [8816]0.09 OXYMETAZOLINE 0.05 % NASAL SPRAY [8816]1.79 OXYTOCIN 10 UNIT/ML INJECTION SOLUTION [24027]3.10 PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS [29507]4.10 PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS [29507]

1653.61 PACLITAXEL-PROTEIN BOUND 100 MG INTRAVENOUS SUSPENSION [56991]47.14 PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR [89881]47.14 PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR [89882]

2139.50 PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE [113160]2139.45 PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE [113161]

12.00 PALONSETRON PER25MCG,25MCG/5ML

PRICE Description153.75 PAMIDRONATE /30MG,9MG/MLINJ,1048.00 PAMIDRONATE 30 MG INTRAVENOUS SOLUTION [30368]1.66 PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION [30648]7.00 PANCRELIPASE DR(27K-5K-17K)UNI

293.53 PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION [108983]5.27 PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE [46266]

15.73 PANTOPRAZOLE 40 MG GRANULES FOR ORAL SUSP, DELAYED RELEASE [102486]6.00 PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION [45454]0.46 PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE [47191]

20.60 PAPAVERINE 30 MG/ML INJECTION SOLUTION [9632]567.50 Parathormone (parathyroid hormone) level

2.81 PAROXETINE 10 MG TABLET [40192]2.79 PAROXETINE 20 MG TABLET [40193]

138.75 Partial ultrasound of joint or other non-blood vessel structure of arm or leg132.25 Partial ultrasound of joint or other non-blood vessel structure of arm or leg287.25 Pathology examination of specimen during surgery583.75 Pathology examination of tissue during surgery228.00 Pathology examination of tissue using a microscope769.75 Pathology examination of tissue using a microscope, high complexity349.00 Pathology examination of tissue using a microscope, intermediate complexity138.00 Pathology examination of tissue using a microscope, limited examination572.00 Pathology examination of tissue using a microscope, moderately high complexity276.25 Pathology examination of tissue using a microscope, moderately low complexity

5041.75 Patient progr, neurostim0.72 PEG 400-PROPYLENE GLYCOL 0.4 %-0.3 % EYE DROPS [53045]

1034.75 PEG TUBES0.01 PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION [45950]

75.25 PEG-ELECTROLYTES PWD, 4000 ML12462.12 PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR [145974]12462.12 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE [49713]8350.00 PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE [164277]

27122.40 PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION [119747]1437.06 PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION [146005]849.12 PEMETREXED 100 MG INTRAVENOUS SOLUTION [102009]

4245.60 PEMETREXED 500 MG INTRAVENOUS SOLUTION [54889]9.25 PEN SURG MARKING

94.42 PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE [52015]96.74 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE [23960]

109.03 PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE [23953]15.19 PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION [36069]1.19 PENICILLIN V POTASSIUM 250 MG TABLET [2348]0.78 PENICILLIN V POTASSIUM 500 MG TABLET [5182]

200.27 PENTAMIDINE 300 MG SOLUTION FOR INHALATION [46516]1.50 PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE [5205]

1593.00 Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast56.16 PERFLUTREN PROTEIN-TYPE A MICROSPHERES 0.22 MG/ML INTRAVENOUS SUSP [109557]0.17 PERMETHRIN 1 % TOPICAL LIQUID [28216]1.98 PERMETHRIN 5 % TOPICAL CREAM [9387]1.97 PERPHENAZINE 2 MG TABLET [5978]2.69 PERPHENAZINE 4 MG TABLET [5979]3.26 PERPHENAZINE 8 MG TABLET [5980]

468.00 PERQ REPLACEMENT G TUBE440.39 PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION [131738]75.00 Pessary, non rubber,any type7.25 PHASE 1 RECOVERY PER MIN2.70 PHENAZOPYRIDINE 100 MG TABLET [5760]4.00 PHENAZOPYRIDINE 200 MG TABLET [5761]

180.25 Phenobarbital level26.18 PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION [10316]1.25 PHENOBARBITOL 32.4 MG TABLET0.02 PHENOL 1.4 % MUCOSAL AEROSOL SPRAY [49548]

535.00 PHENTOLAMINE 5 MG INJECTION EXTRAVASATION ANTIDOTE [612844]131.75 Phenylalanine, PKU (amino acid) level

0.43 PHENYLEPHRINE 1 % NASAL SPRAY [47141]139.50 PHENYLEPHRINE 1 %-KETOROLAC 0.3 % INTRAOCULAR CONCENTRATE FOR IRRIG [146865]

9.60 PHENYLEPHRINE 10 % EYE DROPS [42331]2.98 PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION [9615]7.20 PHENYLEPHRINE 2.5 % EYE DROPS [7373]7.00 PHENYLEPHRINE-BROMPHENIRAMINE2.16 PHENYTOIN 100 MG/4 ML ORAL SUSPENSION [103820]0.78 PHENYTOIN 50 MG CHEWABLE TABLET [45771]

187.25 Phenytoin level177.25 Phenytoin level

0.44 PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION [3327]0.68 PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE [8567]1.34 PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE [49318]

152.50 Phosphatase (enzyme) level

PRICE Description304.75 Phosphatase (enzyme) level194.25 Phosphatase (enzyme) measurement108.25 Phosphate level171.75 Phospholipid antibody (autoimmune antibody) measurement114.00 Photography of content of eyes114.00 Photography of the retina279.25 Photography of the retina274.75 Phototherapy light w/ photom152.50 Physical performance test or measurement with report, each 15 minutes165.00 Physician services for outpatient heart cardiac rehabilitation per session229.50 Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session54.00 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE [9882]57.89 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION [44598]12.33 PHYTONADIONE (VITAMIN K1) 5 MG TABLET [49647]5.79 PHYTONADIONE 1 MG/ML ORAL LIQUID (CCF) [614329]7.61 PILOCARPINE 2 % EYE DROPS [2914]1.81 PILOCARPINE 5 MG TABLET [43501]

79.00 PIN STEINMAN AND GUIDEWIRE131.75 Pinworm test

5.68 PIOGLITAZONE 15 MG TABLET [44066]8.68 PIOGLITAZONE 30 MG TABLET [48922]

30.00 PIPERACILLIN/TAZOBACTAM PER 1G8.24 PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION [49017]

18.46 PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION [47006]16.48 PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION [47178]23.75 PIPERACILLIN-TAZOBACTAM 4.5GM30.00 PIPERACILLIN-TAZOBACTAM PER 1G

252.50 Placement of breast localization devices accessed through the skin with mammographic guidance1168.00 Placement of breast localization devices accessed through the skin with stereotactic guidance1250.25 Placement of breast localization devices accessed through the skin with ultrasound guidance252.50 Placement of breast localization devices accessed through the skin with ultrasound guidance

1142.75 Placement of catheter of gallbladder and pancreas under imaging using an endoscope1088.25 Placement of catheter of gallbladder and pancreas under imaging using an endoscope3676.75 Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation3646.50 Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation275.00 Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report275.00 Placement of ear probe for computerized measurement of sound with interpretation and report100.00 Placement of intra-uterine device (IUD) for pregnancy prevention

9554.50 Placement of temporary pacemaker leads16591.50 Placement of temporary pacemaker leads

523.00 Plasma 1 donor frz w/in 8 hr100.00 Platelet count, automated test154.50 Platelet function test42.25 Platelet function test56.25 Platelet function test

120.75 Platelet function test119.25 Platelet function test

2257.25 Platelets, pheresis17787.50 Pmkr, dual, rate-resp14039.00 Pmkr, other than sing/dual13682.50 Pmkr, single, rate-resp

300.00 Pneumococcal vaccine for injection into muscle1.87 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET [44609]

13.50 POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION [24627]0.13 POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE [10442]0.34 POLYVINYL ALCOHOL-POVIDONE (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE [52439]

341.91 PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION [85155]1135.00 PORT A CATH LOW PROFILE100.00 Post-delivery care

0.20 POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [3680]0.50 POTASSIUM BICARBONATE AND CHLORIDE 25 MEQ EFFERVESCENT TABLET [44058]0.25 POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET [6400]0.04 POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK [4087]0.08 POTASSIUM CHLORIDE 10 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK [4088]0.01 POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4228]0.25 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION [3349]0.36 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION [3349]0.04 POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK [4089]0.81 POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID [2596]0.01 POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION [4197]0.01 POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS [4096]0.01 POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV [4191]0.01 POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4193]

16.00 POTASSIUM CHLORIDE 20MEQ IN DE0.01 POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4195]0.01 POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS [4097]0.01 POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV [4196]

PRICE Description0.65 POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE [4170]0.68 POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST) [30045]2.76 POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE [47066]

40.25 POTASSIUM IODIDE 1000MG/ML CON0.69 POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION [4114]0.65 POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET [101488]0.06 POVIDONE-IODINE 10 % TOPICAL OINTMENT [6747]0.56 POVIDONE-IODINE 5 % EYE SOLUTION [47507]

1124.00 POWER PORT6.00 PRAMIPEXOLE 0.125MG TAB, EACH2.95 PRAMIPEXOLE 0.25 MG TABLET [47991]3.34 PRAMIPEXOLE 1 MG TABLET [40492]

18.36 PRASUGREL 10 MG TABLET [112844]0.47 PRAVASTATIN 10 MG TABLET [46693]3.27 PRAVASTATIN 20 MG TABLET [48414]

15.75 PRAVASTATIN 40MG TAB1.81 PRAZOSIN 1 MG CAPSULE [671]6.00 PRAZOSIN 2MG CAP

166.25 Prealbumin (protein) level200.00 Predelivery care 4-6 visits11.06 PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [23260]7.00 PREDNISOLONE SODIUM PHOSPHATE0.31 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION [38180]0.28 PREDNISONE 1 MG TABLET [2659]0.27 PREDNISONE 10 MG TABLET [2657]0.29 PREDNISONE 20 MG TABLET [2656]0.25 PREDNISONE 5 MG TABLET [2655]0.74 PREDNISONE 5 MG/5 ML ORAL SOLUTION [2599]6.00 PREGABALIN 100MG CAP, EACH6.00 PREGABALIN 150MG CAP, EACH9.36 PREGABALIN 25 MG CAPSULE [83700]1.62 PREGABALIN 50 MG CAPSULE [83701]1.62 PREGABALIN 75 MG CAPSULE [83702]

172.00 Pregnenolone (reproductive hormone) level0.05 PRENATAL VITS NO.126-FERROUS FUM 28 MG IRON-FOLIC ACID 800 MCG TABLET [152091]

39.00 Preparation and provision of single or multiple antigens for allergen immunotherapy222.25 Preparation of tissue for examination by removing any calcium present195.50 Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement319.50 Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement225.00 Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement115.50 Pretreatment of serum for use in red blood cell antibody analysis and measurement119.25 Pretreatment of serum for use in red blood cell antibody analysis and measurement

0.50 PRIMIDONE 50 MG TABLET [29089]211.75 Primidone level

1.15 PROBENECID 500 MG TABLET [5953]279.50 Procalcitonin (hormone) level12.58 PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY [10542]11.10 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION [125626]

247.00 PROCHLORPERAZINE EDYSLATE PER0.97 PROCHLORPERAZINE MALEATE 10 MG TABLET [5240]

2012.00 PROCTOSCOPY WITH BIOPSY66.25 Progesterone (reproductive hormone) level

243.00 Progesterone (reproductive hormone) level80.00 Programming device evaluation of heart monitoring system with adjustment of programmed values with analysis, review and report

361.50 Prolactin (milk producing hormone) level798.75 Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours812.25 Prolonged iv inf, req pump40.00 Prolonged office or other outpatient service first hour17.71 PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY [39731]17.71 PROMETHAZINE 25 MG RECTAL SUPPOSITORY [38990]0.14 PROMETHAZINE 25 MG TABLET [5513]0.18 PROMETHAZINE 6.25 MG-CODEINE 10 MG/5 ML SYRUP [38455]8.00 Promethazine hcl injection7.00 PROMETHAZINE PER 50MG, 25MG/ML2.93 PROPARACAINE 0.5 % EYE DROPS [8851]0.14 PROPOFOL 10 MG/ML [613035]0.38 PROPOFOL 10 MG/ML [613035]0.20 PROPRANOLOL 10 MG TABLET [6447]0.51 PROPRANOLOL 20 MG TABLET [6448]1.30 PROPRANOLOL 40 MG TABLET [6449]2.18 PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE [24304]2.39 PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE [23235]3.36 PROPYLTHIOURACIL 50 MG TABLET [714]2.95 PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION [11]

494.75 Protein C, (clotting inhibitor) activity304.75 Protein measurement98.75 Protein measurement

PRICE Description200.75 Protein measurement, body fluid200.75 Protein measurement, serum366.00 Protein S (clotting inhibitor) measurement249.25 Protein S (clotting inhibitor) measurement469.75 PSA (prostate specific antigen) measurement228.00 Psa screening

0.05 PSEUDOEPHEDRINE 30 MG TABLET [2661]422.25 Psychiatric diagnostic evaluation275.50 Psychotherapy, 30 minutes286.75 Psychotherapy, 45 minutes297.75 Psychotherapy, 60 minutes

0.51 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET [142080]130.00 PT NEEDLE INSERTION 3+ MUSC110.00 PT NEEDLE INSERTION, 1-2 MUSC42.00 PT QUAL NONMD ESP PT 11-20M70.00 PT QUAL NONMD EST PT 21+M24.00 PT QUAL NONMD EST PT 5-10 M55.00 PT WORK CONDITION PER 15 MIN

157.50 Pulmonary rehab w exer1.00 Punch biopsy of additional skin lesion

360.00 Punch biopsy of single skin lesion367.50 Punch biopsy of single skin lesion236.25 Puraply 1 sq cm262.50 Puraply am 1 sq cm114.00 Pure tone air conduction threshold hearing assessment

1.48 PYRIDOSTIGMINE BROMIDE 60 MG TABLET [39241]18.24 PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION [8594]0.03 PYRIDOXINE (VITAMIN B6) 50 MG TABLET [7391]6.00 PYRIDOXINE 100MG TAB, EACH

249.25 Pyruvate kinase (enzyme) level199.00 Qualitative or semiquantitative detection test for helicobacter pylori in stool, multiple-step method340.75 Quantitation of therapeutic drug255.50 Quantitation of therapeutic drug187.00 Quantitation of therapeutic drug42.25 Quantitation of therapeutic drug8.00 QUETIAPINE 100 MG TABLET [46007]

12.22 QUETIAPINE 200 MG TABLET [45276]3.78 QUETIAPINE 25 MG TABLET [40359]

19.79 QUETIAPINE 300 MG TABLET [44464]15.93 QUETIAPINE ER 150 MG TABLET,EXTENDED RELEASE 24 HR [110511]8.87 QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [110510]1.22 QUINAPRIL 20 MG TABLET [48402]1.22 QUINAPRIL 5 MG TABLET [47912]

804.53 Rabies immune globulin for injection beneath the skin and/or into muscle1154.25 Rabies immune globulin for injection beneath the skin and/or into muscle

1.80 RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION [56042]2068.25 Radiological supervision and interpretation of CT guidance for needle insertion6332.00 Radiological supervision and interpretation of imaging of arteries of both arms or legs7639.50 Radiological supervision and interpretation of imaging of artery of one arm or leg244.00 Radiological supervision and interpretation of imaging of previous placed shunt

2169.75 Radiological supervision and interpretation of imaging of vein of one arm or leg2787.75 Radiological supervision and interpretation of imaging of vein system of head133.00 Radiological supervision and interpretation of placement of catheter with drainage (accessed through the skin) procedure

7639.50 Radiological supervision and interpretation X-ray of abdominal aorta7639.50 Radiological supervision and interpretation X-ray of abdominal aorta and both leg arteries854.50 Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery521.75 Radiological supervision and interpretation X-ray of elbow656.75 Radiological supervision and interpretation X-ray of hip joint710.50 Radiological supervision and interpretation X-ray of knee joint

1716.50 Radiological supervision and interpretation X-ray of lower spinal canal1347.25 Radiological supervision and interpretation X-ray of middle spinal canal788.75 Radiological supervision and interpretation X-ray of shoulder joint

1934.50 Radiological supervision and interpretation X-ray of spinal canal, 2 or more spinal regions1324.00 Radiological supervision and interpretation X-ray of upper spinal canal467.00 Radiological supervision and interpretation X-ray of urinary bladder and urethra854.75 Radiological supervision and interpretation X-ray of urinary bladder and urethra527.00 Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views581.00 Radiological supervision and interpretation X-ray of urinary tract569.25 Radiological supervision and interpretation X-ray of uterine tubes and ovaries521.75 Radiological supervision and interpretation X-ray of wrist joint

7.92 RALOXIFENE 60 MG TABLET [48127]31.49 RALTEGRAVIR 400 MG TABLET [100667]1.90 RAMIPRIL 1.25 MG CAPSULE [49346]

138.60 RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION [142239]7.00 RANITIDINE 150MG TAB6.42 RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR [86285]

649.00 Rbc leukocytes reduced

PRICE Description7.25 RECOVERY L/D PER MINUTE7.25 RECOVERY ROOM/ MINUTE

59.50 RECOVERY-ENDO760.00 RECTUM WO W CON131.75 Red blood cell antibody detection test180.50 Red blood cell antibody detection test174.50 Red blood cell antibody level41.25 Red blood cell concentration measurement60.00 Red blood cell sedimentation rate, to detect inflammation84.75 Red blood cell sickling measurement

649.00 Red blood cells unit34.75 Red blood count automated, with additional calculations

170.00 Re-evaluation of occupational therapy established plan of care, typically 30 minutes162.00 Re-evaluation of physical therapy, typically 20 minutes499.50 Refilling and maintenance of portable pump58.31 REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE [103954]

2153.25 Relocation of mouth tissue to gum surface4125.00 Relocation of pacemaker generator skin pocket3000.00 Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe2850.00 Removal (over 4.0 centimeters) growth of the face, ears, eyelids, nose, lips, or mouth

50253.50 Removal and replacement of defibrillator pulse generator42883.00 Removal and replacement of defibrillator pulse generator22513.50 Removal and replacement of dual lead permanent pacemaker pulse generator22513.50 Removal and replacement of multiple lead permanent pacemaker pulse generator19565.25 Removal and replacement of single lead permanent pacemaker pulse generator

189.00 Removal of antibodies from surface of red blood cell252.50 Removal of blood accumulation between nail and nail bed175.00 Removal of blood accumulation between nail and nail bed

8295.75 Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance8295.75 Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin2047.50 Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin679.00 Removal of central venous catheter for infusion

6598.50 Removal of central venous catheter for infusion2630.00 Removal of deep foreign body in muscle or tendon3360.00 Removal of defibrillator pulse generator420.00 Removal of drug delivery implant from tissue

5998.50 Removal of electrode from right heart114.00 Removal of eyelashes by forceps326.00 Removal of eyelid growth

1618.00 Removal of eyelid growth1312.25 Removal of fluid from between lung and chest cavity, open procedure1306.75 Removal of fluid from chest cavity with imaging guidance2180.75 Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin3098.00 Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin173.50 Removal of foreign body from ear canal114.00 Removal of foreign body from ear canal

4116.50 Removal of foreign body from inside the eye or lens670.75 Removal of foreign body from tissue, accessed beneath the skin380.00 Removal of foreign body from tissue, accessed beneath the skin

3990.50 Removal of foreign body from tissue, accessed beneath the skin230.00 Removal of foreign body in external eye, conjunctiva114.00 Removal of foreign body in external eye, conjunctiva420.00 Removal of foreign body in external eye, conjunctiva or sclera173.50 Removal of foreign body in nose

2031.00 Removal of foreign body of foot tissue, accessed beneath the skin897.75 Removal of foreign body, external eye, cornea540.00 Removal of foreign body, external eye, cornea230.00 Removal of foreign body, external eye, cornea with slit lamp examination114.00 Removal of foreign body, external eye, cornea with slit lamp examination

5413.25 Removal of foreskin of using clamp or device1883.00 Removal of foreskin of using clamp or device601.00 Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth

1773.25 Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals1655.00 Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals1360.25 Removal of growth (0.5 centimeters or less) of the trunk, arms or legs601.00 Removal of growth (0.5 centimeters or less) of the trunk, arms or legs601.00 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth

1177.00 Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals601.00 Removal of growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs

1177.00 Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth1655.00 Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals601.00 Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

1655.00 Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals1177.00 Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs1413.00 Removal of growth (3.1 to 4.0 centimeters) of the trunk, arms, or legs1768.00 Removal of growth (4.0 centimeters) of the trunk, arms, or legs3000.00 Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals

PRICE Description4470.00 Removal of growth of mouth2132.50 Removal of heart rhythm monitor from under skin252.50 Removal of impact ear wax, one ear70.00 Removal of impact ear wax, one ear

252.50 Removal of impacted ear wax by washing110.00 Removal of impacted ear wax by washing

3529.25 Removal of impacted stool or foreign body under anesthesia314.00 Removal of intra-uterine device (IUD) for pregnancy prevention

1160.00 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips1177.00 Removal of malignant growth (0.5 centimeters or less) of the trunk, arms, or legs601.00 Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips601.00 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs601.00 Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips

1177.00 Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals601.00 Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

1550.00 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips1550.00 Removal of malignant growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals1177.00 Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs645.00 Removal of malignant growth (3.1 to 4 centimeters) of the trunk, arms, or legs

1768.00 Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs350.00 Removal of more than 4 thickened skin growths326.00 Removal of multiple growths of different eyelids900.00 Removal of multiple growths of same eyelid399.00 Removal of nail

1393.00 Removal of outer layer of cornea7980.00 Removal of permanent pacemaker pulse generator

26923.25 Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure23920.50 Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure

216.75 Removal of single thickened skin growth215.00 Removal of single thickened skin growth213.75 Removal of single thickened skin growth

1865.50 Removal of skin and bone first 20 sq cm or less230.00 Removal of skin and tissue736.75 Removal of skin and tissue

1250.25 Removal of skin and tissue first 20 sq cm or less375.00 Removal of skin and tissue first 20 sq cm or less736.75 Removal of skin and/or muscle536.00 Removal of skin and/or muscle first 20 sq cm or less704.25 Removal of skin and/or muscle first 20 sq cm or less215.00 Removal of skin debris and drainage of mastoid cavity508.25 Removal of skin of finger or toe nail380.00 Removal of skin of finger or toe nail518.50 Removal of skin suture with change of bladder tube461.50 Removal of skin suture with change of bladder tube460.00 Removal of skin suture with change of bladder tube80.00 Removal of skin tags

3403.25 Removal of tailbone cyst114.00 Removal of tissue from 1 to 5 finger or toe nails127.25 Removal of tissue from 1 to 5 finger or toe nails98.00 Removal of tissue from 6 or more finger or toe nails

127.25 Removal of tissue from 6 or more finger or toe nails282.00 Removal of tissue from wounds per session391.50 Removal of tissue from wounds per session20.00 Removal of tissue from wounds per session

245.25 Removal of tissue from wounds per session215.00 Removal of up to and including 15 skin tags263.25 Renin (kidney enzyme) level

10080.00 Reopening of arteries in thigh and behind knee with placement of stent via catheter using imaging guidance3958.25 Rep dev, urinary, w/sling

7.51 REPAGLINIDE 2 MG TABLET [44293]1250.25 Repair of (2.5 centimeter or less) laceration to floor of mouth and/or tongue2116.00 Repair of (over 2.6 laceration) to floor of mouth or tongue5628.25 Repair of blood vessel of arm2246.25 Repair of blood vessel of leg847.25 Repair of finger or toe nail bed

1008.00 Repair of separation of wound closure1740.00 Repair of toe tendon, accessed through the skin846.75 Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs

1250.25 Repair of wound (12.6 to 20.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes1250.25 Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs1250.25 Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs323.50 Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth323.50 Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes215.00 Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes323.50 Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs206.00 Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs508.25 Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs

PRICE Description400.00 Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs661.50 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth323.50 Repair of wound (2.6 to 5.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes

2153.25 Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet656.25 Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals

2153.25 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs323.50 Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs200.00 Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs846.50 Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

2153.25 Repair of wound (2.6 to 7.5 centimeters) of trunk1250.25 Repair of wound (20.1 to 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs323.50 Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes

1250.25 Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals323.50 Repair of wound (7.6 to 12.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes323.50 Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs

1250.25 Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs1250.25 Repair of wound (over 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs370.75 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet

1250.25 Repair of wound of scalp, arms, and/or legs2205.00 Replacement of catheter in peripheral vein accessed through same vein2205.00 Replacement of kidney drainage catheter accessed through the skin with imaging and radiological supervision and interpretation1593.00 Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin1266.25 Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin484.00 Replacement of stomach stoma tube accessed through skin470.00 Replacement of stomach stoma tube accessed through skin470.00 Replacement of stomach stoma tube accessed through skin with revision of stoma opening162.50 Repositioning maneuvers for treatment of vertigo, per day

5714.25 Repositioning of implanted pacemaker or defibrillator device389.00 RESOLUTION CLIPS231.50 Respiratory inhaled aerosol treatment to relieve airway obstruction231.50 Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour187.00 Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen404.25 Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen101.00 Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen929.75 Reviving newborn at delivery145.75 Rheumatoid factor level113.75 Rhophylac injection

9.93 RIBAVIRIN, PER EA, 200MG CAP1.33 RIFAMPIN 300 MG CAPSULE [6769]

445.25 RIFAMPIN PER EACH, 600MG INJ,47.37 RIFAXIMIN 550 MG TABLET [116444]4.27 RISPERIDONE 0.5 MG TABLET [49430]4.54 RISPERIDONE 1 MG TABLET [49198]3.93 RISPERIDONE 2 MG TABLET [46376]

674.52 RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN [158015]673.08 RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN [158077]112.74 RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS [49197]17.92 RIVAROXABAN 10 MG TABLET [123504]17.92 RIVAROXABAN 15 MG TABLET [125739]17.92 RIVAROXABAN 20 MG TABLET [125740]4.24 RIVASTIGMINE 1.5 MG CAPSULE [40539]

40.75 RIVASTIGMINE 13.3MG/24HR PATCH27.44 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH [99231]27.44 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH [99232]43.88 RIZATRIPTAN 10 MG DISINTEGRATING TABLET [47090]36.37 RIZATRIPTAN 5 MG DISINTEGRATING TABLET [48921]0.88 ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION [45675]

14.44 ROFLUMILAST 500 MCG TABLET [122215]3088.00 Room and Board Intensive Care Unit General2159.00 Room and Board Intermediate Intensive Care Unit 1054.00 Room and Board Nursery1445.00 Room and Board Private Medical/Surgical/GYN1445.00 Room and Board Semiprivate Hospice1445.00 Room and Board Semiprivate Medical/Surgical/GYN1971.00 Room and Board Semiprivate Psychiatric1445.00 Room and Board Semiprivate Skilled Nursing

2.51 ROPINIROLE 0.25 MG TABLET [46912]6.00 ROPINIROLE 0.5MG TAB2.51 ROPINIROLE 1 MG TABLET [44378]2.50 ROPINIROLE 4 MG TABLET [49629]0.21 ROPIVACAINE, PER 1MG,0.5% 30ML0.10 ROPIVACAINE,PER 1MG, 0.2% 20ML0.29 ROPIVACAINE,PER 1MG,0.2% 10ML1.44 ROSUVASTATIN 10 MG TABLET [53606]1.44 ROSUVASTATIN 20 MG TABLET [53607]8.94 ROSUVASTATIN 40MG TAB, EACH

140.00 Routine electrocardiogram (EKG) with tracing using at least 12 leads

PRICE Description324.25 Routine electrocardiogram (EKG) with tracing using at least 12 leads

1007.00 ROUTINE HEMODIALYSIS0.48 SACCHAROMYCES BOULARDII 250 MG CAPSULE [54687]

10.18 SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET [147927]10.18 SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET [147928]6.00 SALIVA SUB(BIOTENE) 59ML0.02 SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH [142575]9.81 SALMETEROL 50 MCG/DOSE BLISTER POWDER FOR INHALATION [47762]

19.26 SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH [48815]94.75 Screening digital tomography of both breasts

177.25 Screening examination of specimen cells170.00 Screening test for antibody to noninfectious agent33.00 Screening test for antibody to noninfectious agent

199.00 Screening test for autoimmune disorder319.50 Screening test for compatible blood unit91.50 Screening test for mononucleosis (mono)

110.25 Screening test for pathogenic organisms44.50 Screening test for pathogenic organisms

230.50 Screening test for presence of antibody147.25 Screening test for red blood cell antibodies45.25 SCRW 4.0CNCLS PTL THRD 10-50MM

429.75 SCRW 5.0 LCKG/IM NAIL 26-100MM467.50 SCRW 5.0MM CNLTD LCKNG 25-95MM310.25 SCS ACCESSORY KIT 3550-29310.25 SCS ANTENNA 37092145.75 Selenium (vitamin) level152.50 Self-care or home management training, each 15 minutes162.00 Semen analysis for sperm presence243.00 Semen evaluation volume, sperm count, motility and analysis

0.04 SENNOSIDES 8.6 MG TABLET [24585]0.04 SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET [43603]

97.75 Sensory technique to enhance processing and adaptation to environmental demands, each 15 minutes203.50 Separation of nail plate from nail bed215.00 Separation of nail plate from nail bed546.75 Serotonin (hormone) level

0.40 SERTRALINE 100 MG TABLET [45246]0.40 SERTRALINE 25 MG TABLET [48021]3.36 SERTRALINE 50 MG TABLET [49170]

14.50 SET BUTTERFLY 24 X 3/421.25 SET EXT W/TCONNECTOR35.75 SET FILTER & AXALL FIONCO9.91 SEVELAMER CARBONATE 800 MG TABLET [101881]

18.00 SEVELAMER HCL 800 MG TABLET153.00 Sex hormone binding globulin (protein) level282.00 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth215.00 Shaving of 0.5 centimeters or less skin growth of scalp, neck, hands, feet, or genitals215.00 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs282.00 Shaving of 0.6 centimeters to 1.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth215.00 Shaving of 0.6 centimeters to 1.0 centimeters skin growth of scalp, neck, hands, feet, or genitals215.00 Shaving of 0.6 centimeters to 1.0 centimeters skin growth of the trunk, arms, or legs380.00 Shaving of 1.1 to 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth355.00 Shaving of 1.1 to 2.0 centimeters skin growth of the trunk, arms, or legs380.00 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth630.00 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs20.75 SHEEHY COLLR EAR TUBE 23-40300

2412.25 SIGMOID FLEX W/CONTROL BLEEDIN1474.25 SIGMOID FLEX W/SUBMUCOSAL INJ1684.00 SIGMOIDOSCOPY2349.25 SIGMOIDOSCOPY W/POLYP REM

62.50 SILDENAFIL CITRATE 20 MG TAB29.50 SILICONE I/A TIP0.69 SILVER ER TOPICAL GEL,EXTENDED RELEASE [56063]0.73 SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK [90041]0.30 SILVER SULFADIAZINE 1 % TOPICAL CREAM [8861]0.18 SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION [5365]0.09 SIMETHICONE 80 MG CHEWABLE TABLET [6749]

248.75 Simple control of nose bleed220.00 Simple control of nose bleed16.00 SIMVASTATIN 20MG TAB

127.48 SINCALIDE 5 MCG SOLUTION FOR INJECTION [46081]224.75 Sincalide injection279.00 Sirolimus level18.05 SITAGLIPTIN 100 MG TABLET [88990]18.05 SITAGLIPTIN 25 MG TABLET [88987]30.00 Skin barrier, wipe or swab20.00 Skin test for tuberculosis

404.00 Skin, mucus membrane and beneath the skin procedure

PRICE Description4735.25 Sleep monitoring of patient (6 years or older) in sleep lab3685.25 Sleep monitoring of patient (6 years or older) in sleep lab5124.75 Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube1608.25 Sleep monitoring of patient (younger than 6 years) in sleep lab3265.00 SM BOWEL ENTEROS W/CTRL BLEED2112.50 SM BOWEL ENTEROSCOPY W/BX

25.00 Smear for infectious agents12.50 Smear for infectious agents

105.75 Smear for infectious agents34.00 Smoking and tobacco use intensive counseling, greater than 10 minutes34.00 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes

3790.50 Snip incision of tear duct opening7.75 SOD CHL 0.9% PF LUSH INJ 10 ML0.19 SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [3684]0.23 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION [4053]1.69 SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE [132536]0.07 SODIUM BICARBONATE 650 MG TABLET [16]0.01 SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION [4104]0.01 SODIUM CHLORIDE 0.45 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP [53083]0.02 SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL [24003]0.05 SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE [1028]0.85 SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE [1028]0.04 SODIUM CHLORIDE 0.9 % FOR NEBULIZATION [2688]0.08 SODIUM CHLORIDE 0.9 % INJECTION SOLUTION [1827]0.11 SODIUM CHLORIDE 0.9 % INJECTION SOLUTION [1827]0.06 SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK [85042]0.12 SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK [85042]0.01 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346]0.02 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346]0.03 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346]0.05 SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION [3346]0.01 SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION [3972]0.01 SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP [4100]0.01 SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP [4101]0.10 SODIUM CHLORIDE 1 GRAM TABLET [15]1.15 SODIUM CHLORIDE 2 % EYE DROPS [49623]0.10 SODIUM CHLORIDE 3 % FOR NEBULIZATION [21221]0.01 SODIUM CHLORIDE 3 % INTRAVENOUS INJECTION SOLUTION [7658]0.18 SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION [3279]0.81 SODIUM CHLORIDE 5 % EYE DROPS [6732]3.57 SODIUM CHLORIDE 5 % EYE OINTMENT [6657]0.07 SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION [5555]0.51 SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [48260]7.63 SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS [48780]

114.00 SODIUM HYALURONATE (HYALGAN) 10 MG/ML INTRA-ARTICULAR SYRINGE [613563]219.68 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE [47065]203.96 SODIUM HYALURONATE 10 MG/ML(MW 2.4-3.6 MILLION)INTRA-ARTICULAR SYRINGE [155545]27.00 SODIUM HYPOCHLORITE 0.125%23.25 SODIUM HYPOCHLORITE 0.25% TOP72.25 Sodium level35.75 Sodium level28.65 SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION [10511]1.17 SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION [31251]0.01 SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA [47846]0.02 SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA [90717]0.37 SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP [152071]2.14 SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION [9084]5.50 SOL SOD CHOL 0.9% IRR

14.65 SOLIFENACIN 5 MG TABLET [56684]310.50 Somatomedin (growth factor) level

0.11 SORBITOL 70 % SOLUTION [5564]15.00 SORBSAN DRESS, 4X43.13 SOTALOL 120 MG TABLET [5178]2.35 SOTALOL 80 MG TABLET [5179]

42.00 SP QUAL NONMD EST PT 11-20 MIN70.00 SP QUAL NONMD EST PT 21+MIN24.00 SP QUAL NONMD EST PT 5-10 MIN70.75 Special stain for microorganism76.75 Special stain for microorganism42.00 Special stain for microorganism

108.75 Special stained specimen slides to examine tissue182.25 Special stained specimen slides to examine tissue including interpretation and report163.75 Special stained specimen slides to identify organisms including interpretation and report43.25 Specimen analysis for blood50.00 SPECIMEN COLL FOR COVID 19

2083.25 SPECT nuclear medicine localization of tumor or inflammation or study of distribution of radioactive tracer in single area, 1 day of imaging21.25 Speical Charge General Admission - IV Board

PRICE Description656.25 Spinal tap for diagnosis897.75 Spinal tap for diagnosis

1422.25 Spinal tap for diagnosis0.43 SPIRONOLACTONE 25 MG TABLET [8568]0.88 SPIRONOLACTONE 50 MG TABLET [7309]9.25 SPONGE 4X4 ST RAYTEC

421.50 Standardized thought processing testing, interpretation, and report per hour374.75 Stent, non-coa/non-cov w/del

3848.00 Stent, non-coa/non-cov w/del605.25 Stent, non-cor, tem w/o del

1721.50 Stomach emptying study25.00 Stool analysis for blood62.25 Stool analysis for blood19.25 Stool analysis for blood to screen for colon tumors72.25 Stool calprotectin (protein) level

228.00 Stool culture490.50 Stool porphyrins (metabolism substance) level295.75 Strapping of ankle and/or foot295.75 Strapping of knee295.75 Strapping of shoulder268.00 Strapping, Unna boot280.00 Strapping, Unna boot35.00 Strep test (Streptococcus, group A)

615.25 Study of sleep patterns2.30 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION [2486]0.38 SUCRALFATE 1 GRAM TABLET [5189]1.13 SUCRALFATE 100 MG/ML ORAL SUSPENSION [44976]0.07 SUCROSE IN WATER 24% CUP [600870]3.71 SULFACETAMIDE SODIUM 10 % EYE DROPS [5916]0.78 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET [5089]1.51 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION [10348]0.22 SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET [5090]7.00 SULFAMETHOXAZOLE TMP200MG40MG/0.24 SULFASALAZINE 500 MG TABLET [6287]2.13 SUMATRIPTAN 100 MG TABLET [44895]1.58 SUMATRIPTAN 25 MG TABLET [45070]

25.14 SUMATRIPTAN 50 MG TABLET [45483]62.40 SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION [46568]70.00 SUMATRIPTAN SUCCINATE 6MG

1676.25 SUPER QUICK ANCHOR1859.75 SURG LEVEL 1 EA ADD 30 MIN2451.00 SURG LEVEL 2 EA ADD 30 MIN2859.00 SURG LEVEL 3 EA ADD 30 MIN3196.00 SURG LEVEL 4 EA ADD 30 MIN3603.75 SURG LEVEL 5 EA ADD 30 MIN2520.25 SURGERY LEVEL 1 1ST 30 MIN3113.00 SURGERY LEVEL 2 1ST 30 MIN3518.75 SURGERY LEVEL 3 1ST 30 MIN3854.50 SURGERY LEVEL 4 1ST 30 MIN4263.75 SURGERY LEVEL 5 1ST 30 MIN243.11 SURGIFLO HEMOSTATIC MATRIX 12 ML KIT [613282]101.00 SURGIFOAM HEMORRHOIDECTOMY SPG

3648.75 SUTURLYSIS FOR SUTURE REMOVAL187.25 Sweat collection11.25 SYNTH CIRC WIRE W/EYE

200.00 Synvisc or synvisc-one40.25 Syphilis detection test16.00 Syphilis detection test97.75 Syphilis test

598.00 T cell count and ratio155.75 T cell count and ratio238.50 T cell count and ratio380.25 T cells count, total103.75 T cells count, total155.75 T cells count, total189.75 T cells count, total

2.23 TACROLIMUS 0.5 MG CAPSULE [49612]4.46 TACROLIMUS 1 MG CAPSULE [49232]

279.00 Tacrolimus level2.37 TAMOXIFEN 10 MG TABLET [9935]4.21 TAMSULOSIN 0.4 MG CAPSULE [46859]1.00 Tangential biopsy of additional skin lesion

360.00 Tangential biopsy of single skin lesion367.50 Tangential biopsy of single skin lesion

7.00 TAPENTADOL 50 MG TAB393.75 Tc99m labeled rbc87.50 Tc99m maa

PRICE Description192.25 Tc99m mebrofenin122.00 Tc99m medronate818.00 Tc99m mertiatide189.50 Tc99m pentetate

2.50 Tc99m pertechnetate140.50 Tc99m pyrophosphate

1146.00 Tc99m sestamibi91.75 Tc99m sulfur colloid

321.00 Tc99m tetrofosmin109.00 Technetium tc-99m aerosol358.52 TEDIZOLID 200 MG INTRAVENOUS SOLUTION [142991]570.13 TELAVANCIN 750 MG INTRAVENOUS SOLUTION [114114]

8.63 TELMISARTAN 80 MG TABLET [47538]0.71 TEMAZEPAM 15 MG CAPSULE [7304]0.83 TEMAZEPAM 30 MG CAPSULE [7305]9.94 TEMAZEPAM 7.5 MG CAPSULE [10673]

93.00 TENCKHOFF CATHETER1.61 TERAZOSIN 1 MG CAPSULE [5148]1.61 TERAZOSIN 2 MG CAPSULE [5149]

47.25 TERBINAFINE 250MG TAB4.80 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION [42549]

2156.50 TESIO CATHETER220.00 Test for exercise-induced lung stress131.25 Test for exercise-induced lung stress153.00 Testing for presence of drug515.75 Testing for presence of drug150.75 Testing for presence of drug162.00 Testing with stimulation for assessment of function at muscle-nerve junction311.00 Testosterone (hormone) level280.25 Testosterone (hormone) level24.00 TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL [24332]9.96 TETRACAINE 0.5 % HYPERVISCOUS EYE DROPS IN A DROPPERETTE [116200]9.96 TETRACAINE 0.5 % VISCOUS EYE DROPS IN A DROPPERETTE [114968]3.07 TETRACAINE HCL (PF) 0.5 % EYE DROPS [120375]3.30 THEOPHYLLINE ER 300 MG CAPSULE,EXTENDED RELEASE 24 HR [49016]4.30 THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR [6365]1.36 THEOPHYLLINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR [44813]1.96 THEOPHYLLINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR [47402]

185.75 Theophylline level148.75 Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes139.00 Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes141.75 Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes

0.05 THERAPEUTIC MULTIVITAMIN TABLET [7355]152.50 Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes87.75 Therapeutic procedures in a group setting

245.25 Therapeutic removal of whole blood to correct blood level imbalance6.00 THIAMINE 100 MG TABLET0.02 THIAMINE HCL (VITAMIN B1) 100 MG TABLET [33349]5.97 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION [9088]

207.25 Thiocyanate (organic sulfur substance) level7.00 THIOTHIXENE 2MG CAP7.00 THIOTHIXENE 5MG CAP

63.00 THORACENTESIS TRAY356.64 THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY SYRINGE [131920]86.12 THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION [100271]

103.20 THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION [102124]95.75 Thrombin time, fibrinogen screening test18.25 Thrombin time, fibrinogen screening test95.75 Thyroglobulin (thyroid protein) antibody measurement

185.75 Thyroglobulin (thyroid protein) antibody measurement188.00 Thyroglobulin (thyroid related hormone) level

0.91 THYROID (PORK) 30 MG TABLET [113861]1.01 THYROID (PORK) 60 MG TABLET [113862]

126.75 Thyroid hormone evaluation274.25 Thyroid hormone, T3 measurement311.00 Thyroid hormone, T3 measurement290.25 Thyroid hormone, T3 measurement384.50 Thyroid stimulating immune globulins (thyroid related protein) level155.75 Thyroxine (thyroid chemical) measurement279.25 Thyroxine (thyroid chemical) measurement

7.48 TICAGRELOR 90 MG TABLET [123691]187.20 TIGECYCLINE 50 MG INTRAVENOUS SOLUTION [82440]

3.49 TIMOLOL MALEATE 0.25 % EYE DROPS [5907]3.40 TIMOLOL MALEATE 0.5 % EYE DROPS [5908]

44.50 TIOTROPIUM BROMIDE 18MCG CAP F55.67 TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION [144777]2.49 TIROFIBAN 12.5 MG/250 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS [111767]

PRICE Description1120.50 Tissue culture for tumor disorders of bone marrow and blood cells339.75 Tissue culture for virus isolation

1575.25 Tissue culture to identify white blood cell disorders25.00 Tissue fungi or parasites89.00 Tissue fungi or parasites

677.00 Tissue or cell analysis by immunologic technique1.48 TIZANIDINE 4 MG TABLET [37867]

249.00 Tobramycin (antibiotic) level2.91 TOBRAMYCIN 0.3 % EYE DROPS [6738]

73.50 TOBRAMYCIN 0.3 % EYE OINTMENT [48028]29.02 TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION [49657]1.46 TOBRAMYCIN 40 MG/ML INJECTION SOLUTION [79]

78.24 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT [45613]134.32 TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION [115220]134.32 TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION [115219]

3.31 TOLTERODINE 1 MG TABLET [44973]3.40 TOLTERODINE 2 MG TABLET [46652]

540.96 TOLVAPTAN 15 MG TABLET [112266]214.69 TOLVAPTAN 7.5 MG PRE-SPLIT TABLET [612577]94.75 Tomosynthesis, mammo 6.20 TOPIRAMATE 100 MG TABLET [49087]6.00 TOPIRAMATE 200MG TAB, EACH2.10 TOPIRAMATE 25 MG TABLET [45657]6.00 TOPIRAMATE 50MG TAB, EACH

155.75 Topiramate level3.04 TORSEMIDE 100 MG TABLET [37863]0.82 TORSEMIDE 20 MG TABLET [37862]

192.25 Total cell count for B cells (white blood cells)189.75 Total cell count for natural killer cells (white blood cell)100.00 Total protein level, blood37.50 Total protein level, body fluid

100.00 Total protein level, body fluid100.00 Total protein level, urine

4509.00 TRABECULOPASTY 6585514.70 TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN [40547]

309.25 TRACH TUBE XLT PROX 7MM103.75 Tracing of electrical activity of the heart using 1-3 leads249.00 Tracing of electrical activity of the heart using 1-3 leads155.75 Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes141.75 Training in use of prosthesis for arms and/or legs, per 15 minutes

0.80 TRAMADOL 50 MG TABLET [37859]8.68 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION [125934]5.22 TRANEXAMIC ACID 650 MG TABLET [116660]

141.25 Transferrin (iron binding protein) level997.25 Transfusion of blood or blood products907.50 Transfusion of blood or blood products824.75 Transfusion of blood or blood products128.00 Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge128.00 Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge633.00 Translocation analysis (BCR/ABL1) minor breakpoint

1870.10 TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION [157693]4436.71 TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION [165400]393.25 TRAVOPROST 0.004% OPHTH DPS, 291.25 TRAY LUMBAR DISP25.75 TRAY SCRUB SKIN DISP0.22 TRAZODONE 100 MG TABLET [5135]2.79 TRAZODONE 150 MG TABLET [6341]0.16 TRAZODONE 50 MG TABLET [5134]

297.00 Treatment of broken foot bone2745.75 Treatment of dislocated elbow under anesthesia764.25 Treatment of elbow dislocation764.25 Treatment of hip dislocation311.00 Treatment of speech, language, voice, communication, and/or hearing processing disorder398.50 Treatment of swallowing and/or oral feeding function10.00 Triamcinolone acet inj nos

180.49 TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION [103159]16.12 TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE [6646]0.17 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM [5852]0.26 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM [5852]0.74 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM [5850]

11.23 TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION [8798]7.00 TRIAMETERENE-HYDROCHLOROTHIAZI0.39 TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET [6478]2.55 TRIFLUOPERAZINE 5 MG TABLET [8571]

93.25 Triglycerides level0.27 TRIHEXYPHENIDYL 2 MG TABLET [5711]0.67 TRIHEXYPHENIDYL 5 MG TABLET [5710]

PRICE Description15.75 TROLAMINE 10% CRM, 90GM1.78 TROPICAMIDE 0.5 % EYE DROPS [18451]3.17 TROPICAMIDE 1 % EYE DROPS [18450]4.67 TROPICAMIDE 1 % EYE DROPS [18450]5.00 TROPICAMIDE 1 % EYE DROPS [18450]

214.50 Troponin (protein) analysis152.16 TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE [85027]102.54 TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [44141]235.75 Tuberculosis test

7.25 TUBING IV 20" EXT21.25 TUBING IV PRIM PUMP

2719.50 Turning of fetus from breech to presenting position250.75 Tying or incision of fallopian tubes at time of cesarean delivery or other abdominal surgery

1058.25 UGI W SM BOWEL60.00 Ultrasonic guidance imaging supervision and interpretation for insertion of needle

1114.00 Ultrasonic guidance imaging supervision and interpretation for insertion of needle682.25 Ultrasound and monitoring of heart of fetus578.75 Ultrasound behind abdominal cavity551.25 Ultrasound behind abdominal cavity752.25 Ultrasound behind abdominal cavity, limited716.50 Ultrasound behind abdominal cavity, limited162.00 Ultrasound evaluation of abdominal aorta to detect bulging (aneurysm)997.25 Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function870.00 Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report114.00 Ultrasound measurement of bladder capacity after voiding

1262.00 Ultrasound of abdomen729.50 Ultrasound of abdomen446.50 Ultrasound of brain709.00 Ultrasound of chest260.50 Ultrasound of chest675.25 Ultrasound of chest38.00 Ultrasound of corneal structure and measurement

435.00 Ultrasound of dialysis access115.00 Ultrasound of eye disease, growth, or structure115.00 Ultrasound of eye for determination of lens power233.25 Ultrasound of fetal umbilical artery flow rate270.00 Ultrasound of fetus696.25 Ultrasound of head and neck663.00 Ultrasound of head and neck892.00 Ultrasound of hips with manipulation, infant138.75 Ultrasound of hips, infant166.00 Ultrasound of one breast128.50 Ultrasound of one breast862.50 Ultrasound of pelvis821.50 Ultrasound of pelvis115.00 Ultrasound of pelvis564.75 Ultrasound of pelvis537.75 Ultrasound of pelvis635.75 Ultrasound of pregnant uterus, 1 or more fetus(es)321.00 Ultrasound of pregnant uterus, 1 or more fetus(es)192.00 Ultrasound of rectum987.25 Ultrasound of rectum640.75 Ultrasound of scrotum610.25 Ultrasound of scrotum377.50 Ultrasound of spinal canal591.00 Ultrasound of uterus192.00 Ultrasound pelvis through vagina734.25 Ultrasound pelvis through vagina699.25 Ultrasound pelvis through vagina699.50 Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow387.75 Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow666.25 Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow699.50 Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers435.00 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers435.00 Ultrasound scan of vena cava or groin graft or vessel blood flow847.00 Ultrasound scanning of blood flow (outside of brain) on one side of head and neck or limited699.50 Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck907.75 Ultrasound study of arteries and arterial grafts of both arms699.50 Ultrasound study of arteries and arterial grafts of both legs435.00 Ultrasound study of arteries and arterial grafts of one arm or limited435.00 Ultrasound study of arteries and arterial grafts of one leg or limited437.75 Ultrasound study of arteries of both arms and legs12.13 UMECLIDINIUM 62.5 MCG/ACTUATION BLISTER POWDER FOR INHALATION [145547]8.44 UMECLIDINIUM 62.5 MCG-VILANTEROL 25 MCG/ACTUATION POWDR FOR INHALATION [141476]

29.50 UNASYN/1.5GM,3GM-1GM CMPDIVSOL615.25 Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort

1255.00 UNL PROC VASCULAR SURGERY

PRICE Description89.00 Urea nitrogen level to assess kidney function

103.75 Urea nitrogen level to assess kidney function101.50 Uric acid level70.75 Uric acid level, blood15.00 Urinalysis, manual test60.00 Urinalysis, manual test

101.50 Urine calcium level48.50 Urine chloride level

174.50 Urine microalbumin (protein) level105.75 Urine osmolality (concentration) measurement41.25 Urine osmolality (concentration) measurement

101.50 Urine phosphate level294.50 Urine porphyrins (metabolism substance) measurement76.75 Urine potassium level35.75 Urine potassium level25.00 Urine pregnancy test

108.25 Urine pregnancy test72.25 Urine sodium level

206.00 Urine vanillylmandelic acid19.25 Urine volume measurement7.35 URSODIOL 300 MG CAPSULE [5230]

73.85 USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION [154997]11.00 Vaccine for diphtheria, tetanus toxoids, acellular pertussis (whooping cough), and polio for injection into muscle, patient 4 through 6 years of age

170.00 Vaccine for diphtheria, tetanus toxoids, acellular pertussis (whooping cough), haemophilus influenza type B, and polio for injection into muscle11.00 Vaccine for diphtheria, tetanus toxoids, acellular pertussis (whooping cough), Hepatitis B, and polio for injection into muscle25.00 Vaccine for diphtheria, tetanus, and acellular pertussis (whooping cough) injection into muscle, child younger than 7 years55.00 Vaccine for Hemophilus influenza B (4 dose schedule) injection into muscle

120.00 Vaccine for Hepatitis A (2 dose schedule) injection into muscle, pediatric or adolescent dosage120.00 Vaccine for Hepatitis A injection into muscle, adult dosage170.00 Vaccine for Hepatitis B (2 dose schedule) for injection into muscle, adolescent patient85.75 Vaccine for Hepatitis B (3 dose schedule) for injection into muscle, pediatric and adolescent patients65.00 Vaccine for Hepatitis B (3 dose schedule) for injection into muscle, pediatric and adolescent patients73.85 Vaccine for Hepatitis B adult dosage (3 dose schedule) injection into muscle

110.00 Vaccine for Hepatitis B adult dosage (3 dose schedule) injection into muscle85.00 Vaccine for Hepatitis B and Hemophilus influenza B for injection into muscle

400.00 Vaccine for human papilloma virus (3 dose schedule) injection into muscle330.00 Vaccine for human papilloma virus (3 dose schedule) injection into muscle59.40 Vaccine for influenza for administration into muscle, 0.25 ml dosage25.00 Vaccine for influenza for administration into muscle, 0.25 ml dosage50.00 Vaccine for influenza for administration into muscle, 0.25 ml dosage17.32 Vaccine for influenza for administration into muscle, 0.5 ml dosage18.66 Vaccine for influenza for administration into muscle, 0.5 ml dosage55.40 Vaccine for influenza for administration into muscle, 0.5 ml dosage20.00 Vaccine for influenza for administration into muscle, 0.5 ml dosage50.00 Vaccine for influenza for administration into muscle, 0.5 ml dosage54.00 Vaccine for influenza for injection into muscle

145.50 Vaccine for influenza for injection into muscle60.00 Vaccine for influenza for injection into muscle40.00 Vaccine for influenza for nasal administration50.00 Vaccine for influenza for nasal administration91.71 Vaccine for measles, mumps, and rubella (German measles) injection beneath skin

120.00 Vaccine for measles, mumps, and rubella (German measles) injection beneath skin350.00 Vaccine for measles, mumps, rubella (German measles), and varicella (chicken pox) injection beneath skin306.32 Vaccine for meningococcus for administration into muscle200.00 Vaccine for meningococcus for administration into muscle153.00 Vaccine for meningococcus for injection into muscle188.00 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older252.47 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older165.00 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older404.40 Vaccine for rabies injection into muscle449.00 Vaccine for rabies injection into muscle190.00 Vaccine for Rotavirus (2 dose schedule) for oral administration11.00 Vaccine for Rotavirus (3 dose schedule) for oral administration62.10 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older79.92 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older93.46 Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older

106.92 Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older120.00 Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older150.00 Vaccine for typhoid for injection into muscle200.00 Vaccine for varicella (chicken pox) injection beneath skin76.75 VACUUM EXTRACTOR21.25 VAD DRESSING KIT

2719.50 Vaginal delivery2719.50 Vaginal delivery after prior cesarean delivery192.00 Vaginal ultrasound of pregnant uterus734.25 Vaginal ultrasound of pregnant uterus

7.22 VALACYCLOVIR 500 MG TABLET [45916]

PRICE Description0.86 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION [39763]0.11 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION [126161]1.01 VALPROIC ACID 250 MG CAPSULE [6446]

197.25 Valproic acid level104.25 Valproic acid level

5.00 VALSARTAN 160 MG TABLET [49674]7.88 VALSARTAN 40 MG TABLET [52185]4.65 VALSARTAN 80 MG TABLET [45577]

304.75 Vancomycin (antibiotic) level0.16 VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK [56505]

19.25 VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION [4040]256.81 VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION [26749]

0.64 VANCOMYCIN 25 MG/ML ORAL LIQUID (CCF) [612850]9.65 VANCOMYCIN 500 MG INTRAVENOUS SOLUTION [3800]

11.63 VANCOMYCIN 750 MG INTRAVENOUS SOLUTION [112530]79.33 VANCOMYCIN1500MG/250MLIVBP/500

4100.00 VASCULAR GRAFT ARTEGRAFT3357.00 VASCULAR GRAFT RRT06030040L1001.75 VASCULART GRAFT V4604DKL215.75 VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION [145182]10.20 VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION [3389]

7762.68 VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION [142636]223.00 VEIN MAPPING, DIALYSIS ACC,UNI463.00 VEIN MAPPING,DIALYSIS ACC BIL

2137.75 Vena cava filter1.94 VENLAFAXINE 25 MG TABLET [45062]2.00 VENLAFAXINE 37.5 MG TABLET [47199]5.08 VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR [45480]4.16 VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR [44220]4.67 VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR [44254]

1327.00 Ventilation assistance and management, hospital inpatient or observation789.75 Ventilation assistance and management, hospital inpatient or observation

8.73 VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION [3284]0.53 VERAPAMIL 80 MG TABLET [6343]1.44 VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [6010]2.54 VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE [6008]

10.89 VILAZODONE 10 MG TABLET [122286]10.89 VILAZODONE 20 MG TABLET [122288]10.89 VILAZODONE 40 MG TABLET [122289]5.17 VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION [26748]6.90 VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION [10516]6.41 VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION [108485]

59.50 VISITEC MICRO J CANNULA 5850030.14 VIT A 1,000 UNIT-C 200 MG-E 60 UNIT-LUTEIN 2 MG AND MINERALS TABLET [87871]0.02 VITAMIN A 10,000 UNIT CAPSULE [10610]

115.00 Vitamin A level0.94 VITAMIN B COMPLEX AND VITAMIN C NO.20-FOLIC ACID 1 MG CAPSULE [48691]

77.75 Vitamin B-1 (thiamine) level10.00 Vitamin b12 injection

241.25 Vitamin B-6 level279.75 Vitamin D-3 level138.75 Vitamin D-3 level

0.08 VITAMIN E 400 UNIT CAPSULE [10601]53.50 Vitamin E level

396.25 Vitamin K level152.50 Volatile chemical measurement179.03 VORICONAZOLE 200 MG INTRAVENOUS SOLUTION [50726]26.00 VORTIOXETINE 10 MG14.00 VORTIOXETINE TAB 20 MG

125.50 Walking training to 1 or more areas, each 15 minutes6.00 WARFARIN 0.5MG SPLIT TAB, EACH2.47 WARFARIN 1 MG TABLET [6534]3.84 WARFARIN 10 MG TABLET [6542]2.58 WARFARIN 2 MG TABLET [6535]2.66 WARFARIN 2.5 MG TABLET [6536]2.67 WARFARIN 3 MG TABLET [6537]2.68 WARFARIN 4 MG TABLET [6538]2.78 WARFARIN 5 MG TABLET [6539]3.58 WARFARIN 6 MG TABLET [6540]3.70 WARFARIN 7.5 MG TABLET [6541]

238.50 WARMING BLANKET61.25 WASHER 7MM-10MM-13MM0.07 WATER FOR INJECTION, STERILE INJECTION SOLUTION [3750]0.10 WATER FOR INJECTION, STERILE INJECTION SOLUTION [3750]0.01 WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION [3375]

162.50 Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes99.25 Wheelchair management, each 15 minutes

PRICE Description111.00 White blood cell enzyme activity measurement180.75 White blood cell function measurement70.75 White blood cell measure, stool specimen0.05 WHITE PETROLATUM TOPICAL OINTMENT IN PACKET [132620]1.11 WHITE PETROLATUM-MINERAL OIL 83 %-15 % EYE OINTMENT [101074]

44.00 WIRE,KIRSCHNER .045X435.75 WIRE,KIRSCHNER .062X4

250.00 XENOSURE BIOLOGICAL GRAFT363.00 XR ESOPHAGRAM W DBL CONTRAST160.00 XR FOOT 4V AP/LAT/OBL/OTHER LT160.00 XR FOOT 4V AP/LAT/OBL/OTHER RT

1.00 XR GI SMALL BOWEL FOLLOW THRU369.50 XR STERNOCLAVI JNTS MIN 3 VIEW369.50 XR STERNOCLOVACIC JNTS MIN 3VI611.50 X-ray lower and sacral spine including bending views minimum 6 views369.50 X-ray of abdomen, 1 view443.50 X-ray of abdomen, 2 views221.00 X-ray of ankle, 2 views369.50 X-ray of ankle, minimum of 3 views244.00 X-ray of bones148.25 X-ray of bones of face, less than 3 views244.00 X-ray of bones of face, minimum of 3 views148.25 X-ray of bones of nose, minimum of 3 views148.25 X-ray of both collar bones244.00 X-ray of both hips with pelvis, 2 views244.00 X-ray of both hips with pelvis, 3-4 views486.25 X-ray of both hips with pelvis, minimum of 5 views148.25 X-ray of both knees, standing, front to back view244.00 X-ray of both sides of the ribs including the chest, minimum of 4 views148.25 X-ray of breast bone, minimum of 2 views369.50 X-ray of chest, 1 view443.50 X-ray of chest, 2 views148.25 X-ray of chest, 3 views148.25 X-ray of chest, minimum of 4 views221.00 X-ray of collar bone221.00 X-ray of elbow, 2 views369.50 X-ray of elbow, minimum of 3 views385.75 X-ray of esophagus with single contrast148.25 X-ray of eye244.00 X-ray of eye bones, minimum of 4 views148.25 X-ray of femur, 1 view443.50 X-ray of femur, minimum 2 views369.50 X-ray of fingers, minimum of 2 views221.00 X-ray of foot, 2 views369.50 X-ray of foot, minimum of 3 views295.50 X-ray of forearm, 2 views244.00 X-ray of hand, 2 views369.50 X-ray of hand, minimum of 3 views221.00 X-ray of heel, minimum of 2 views148.25 X-ray of hip with pelvis, 1 view443.50 X-ray of hip with pelvis, 2-3 views148.25 X-ray of jaw joints on both sides of the face369.50 X-ray of junction of breast and collar bones, minimum of 2 views352.00 X-ray of junction of breast and collar bones, minimum of 2 views369.50 X-ray of knee, 1 or 2 views443.50 X-ray of knee, 3 views315.00 X-ray of knee, 4 or more views490.00 X-ray of knee, 4 or more views700.00 X-ray of large bowel with double contrast385.75 X-ray of large bowel with single contrast490.00 X-ray of lower and sacral spine, 2 or 3 views611.50 X-ray of lower and sacral spine, minimum of 4 views369.50 X-ray of lower leg, 2 views148.25 X-ray of mandible, less than 4 views244.00 X-ray of mandible, minimum of 4 views244.00 X-ray of mastoid, minimum of 3 views per side148.25 X-ray of middle and lower spine, 2 views244.00 X-ray of middle spine, 3 views490.00 X-ray of middle spine, 3 views244.00 X-ray of middle spine, minimum of 4 views148.25 X-ray of paranasal sinus, complete, minimum of 3 views148.25 X-ray of paranasal sinus, less than 3 views367.00 X-ray of pelvis, 1 or 2 views221.00 X-ray of pelvis, minimum of 2 views244.00 X-ray of pelvis, minimum of 3 views148.25 X-ray of ribs of one side of body, 2 views490.00 X-ray of ribs on one side of body including the chest, minimum of 3 views

PRICE Description260.50 X-ray of sacroiliac joints, 3 or more views244.00 X-ray of sacroiliac joints, less than 3 views148.25 X-ray of shoulder blade148.25 X-ray of shoulder, 1 view443.50 X-ray of shoulder, minimum of 2 views244.00 X-ray of skull, complete, minimum of 4 views367.00 X-ray of skull, less than 4 views369.50 X-ray of soft tissue of neck367.00 X-ray of spine of neck, 2 or 3 views148.25 X-ray of spine, 1 view244.00 X-ray of spine, 2 or 3 views486.25 X-ray of spine, 4 or 5 views221.00 X-ray of toes, minimum of 2 views148.25 X-ray of upper arm, minimum of 2 views385.75 X-ray of upper digestive tract with double contrast367.00 X-ray of upper digestive tract with single contrast244.00 X-ray of upper digestive tract with single contrast and multiple serial films611.50 X-ray of upper spine, 4 or 5 views367.00 X-ray of upper spine, 6 or more views367.00 X-ray of voice box and/or esophagus in neck with contrast369.50 X-ray of wrist, 2 views369.50 X-ray of wrist, minimum of 3 views244.00 X-ray survey of bones, infant244.00 X-ray survey of forearm or wrist bone density

4509.00 YAG LASER SECONDARY2.99 ZAFIRLUKAST 20 MG TABLET [47881]

12.50 ZALEPLON 10MG CAP12.25 ZALEPLON 5MG CAP64.75 Zinc level12.22 ZINC OXIDE 3" X 10 YARD BANDAGE [53184]0.03 ZINC SULFATE 220 MG (50 MG) CAPSULE [88464]

23.08 ZIPRASIDONE 20 MG CAPSULE [46617]59.62 ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION [51739]23.08 ZIPRASIDONE 40 MG CAPSULE [48497]28.01 ZIPRASIDONE 60 MG CAPSULE [49045]28.01 ZIPRASIDONE 80 MG CAPSULE [40466]

167.66 ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION [52932]9.94 ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK [97351]0.11 ZOLPIDEM 10 MG TABLET [48810]0.10 ZOLPIDEM 5 MG TABLET [48479]

13.00 ZOLPIDEM 6.25MG CR TAB1.98 ZONISAMIDE 100 MG CAPSULE [46358]

Documents

PRICE Description 1330.84 ABATACEPT (WITH MALTOSE ......259.00 Analysis of substance using immunoassay technique 261.75 Analysis of substance using immunoassay technique 133.25 Analysis