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Standard charges listing

Jerold Phelps Community Hospital Standard Charges Listing - December 2018  
INVESTIGATION OF TRANSFSION REACTION /SOBB322.95
RH FACTORBB115.85
ABO BLOOD TYPEBB75.30
ANTIBODY DETECTION /SOBB24.40
ANTIGEN SCREENING OF PATIENT BLOOD, ABOBB93.35
ANTIGEN SCREENING OF DONOR BLOOD, RH (D)BB93.35
RED BLOOD CELLS LEUKOREDUCEDBB531.30
PLATELETS PHERESISBB934.85
Rbc leukoreduced irradiatedBB827.85
CT LOWER EXT W/CONTRASTCT1,800.00
CT MAXILLOFACIAL W W/O CONTRASTCT1,800.00
CT HEAD W/O CONTRASTCT810.00
CT HEAD W/CONTRASTCT1,800.00
CT HEAD W W/O CONTRASTCT1,800.00
CT EYE/EAR/FOSSA W/O CONTRASTCT810.00
CT EYE/EAR/FOSSA W/CONTRASTCT1,800.00
CT EYE/EAR/FOSSA W W/O CONTRASTCT1,800.00
CT MAXILLOFACIAL W/O CONTRASTCT810.00
CT MAXILLOFACIAL W/CONTRASTCT1,800.00
CT MAXILLOFACIAL W&W/O CONTCT1,800.00
CT SOFT TISS NECK W/O CONTRASTCT810.00
CT SOFT TISS NECK W/CONTRASTCT1,800.00
CT SOFT TISS NECK W W/O CONTRASTCT1,800.00
CT ANGIO HEADCT1,800.00
CT ANGIO NECKCT1,800.00
CT THORAX W/CONTRASTCT1,800.00
CT THORAX W W/O CONTRASTCT1,800.00
CT ANGIO CHESTCT1,800.00
CT C-SPINE W/O CONTRASTCT810.00
CT C-SPINE W/CONTRASTCT1,880.00
CT C-SPINE W W/O CONTRASTCT2,880.00
CT T-SPINE W/O CONTRASTCT810.00
CT T-SPINE W/CONTRASTCT1,800.00
CT T-SPINE W W/O CONTRASTCT1,800.00
CT L-SPINE W/O CONTRASTCT810.00
CT L-SPINE W/CONTRASTCT1,800.00
CT L-SPINE W W/O CONTRASTCT2,880.00
CT PELVIS W/O CONTRASTCT810.00
CT PELVIS W/CONTRASTCT1,800.00
CT PELVIS W W/O CONTRASTCT1,800.00
CT UPPER EXT W/O CONTRASTCT810.00
CT UPPER EXT W/CONTRASTCT1,800.00
CT UPPER EXT W W/O CONTRASTCT1,800.00
CT LOWER EXT W/O CONTRASTCT810.00
CT LOWER EXTREM W/CONTCT1,800.00
CT LOWER EXT W W/O CONTRASTCT1,800.00
CT ABDOMEN W/O CONTRASTCT810.00
CT ABDOMEN W/CONTRASTCT1,800.00
CT ABDOMEN W W/O CONTRASTCT1,800.00
CT ANGIO ABD/PELV W W/O CONTRASTCT1,800.00
CT ABD PELV W/O CONTRASTCT1,800.00
CT ABD PELV W/CONTRASTCT1,800.00
CT ABD &/OR PELV W W/O CONTRASTCT2,880.00
CT HEART W/O CONTRAST W/CA TESTCT450.00
CT ANGIO ABD ARTERIESCT1,800.00
CT LTD F/U HEAD/NECKCT450.00
CT LTD F/U OTHR THAN HEAD/NECKCT450.00
CT BONE DENSITY PERIPHERALCT450.00
CT LOW DOSE CANCER SCREENCT450.00
CT THORAX W/O CONTRASTCT810.00
CT HEAD W/O CONTRAST PRO FEECTMD292.50
CT HEAD W/CONTRAST PRO FEECTMD411.00
CT HEAD W W/O CONTRAST PRO FEECTMD487.50
CT EYE/EAR/FOSSA W/O CONTRAST PRO FEECTMD590.00
CT EYE/EAR/FOSSA W/CONTRAST PRO FEECTMD697.50
CT EYE/EAR/FOSSA W W/O CONTRAST PRO FEECTMD760.00
CT MAXILLOFACIAL W/O CONTRAST PRO FEECTMD352.50
CT MAXILLOFACIAL W/CONTRAST PRO FEECTMD425.00
CT MAXILLOFACIAL W W/O CONTRAST PRO FEECTMD517.50
CT SOFT TISS NECK W/O CONTRAST PRO FEECTMD490.00
CT SOFT TISS NECK W/CONTRAST PRO FEECTMD597.50
CT SOFT TISS NECK W W/O CONTRAST PRO FEECTMD702.50
CT ANGIO HEAD PRO FEECTMD742.50
CT ANGIO NECK PRO FEECTMD740.00
CT THORAX W/CONTRAST PRO FEECTMD582.50
CT THORAX W W/O CONTRAST PRO FEECTMD697.50
CT ANGIO CHEST PRO FEECTMD760.00
CT C-SPINE W/O CONTRAST PRO FEECTMD467.50
CT C-SPINE W/CONTRAST PRO FEECTMD577.60
CT C-SPINE W W/O CONTRAST PRO FEECTMD682.50
CT T-SPINE W/O CONTRAST PRO FEECTMD457.50
CT T-SPINE W/CONTRAST PRO FEECTMD582.50
CT T-SPINE W W/O CONTRAST PRO FEECTMD687.50
CT L-SPINE W/O CONTRAST PRO FEECTMD455.00
CT L-SPINE W/CONTRAST PRO FEECTMD577.50
CT L-SPINE W W/O CONTRAST PRO FEECTMD682.50
CT PELVIS W/O CONTRAST PRO FEECTMD370.00
CT PELVIS W/CONTRAST PRO FEECTMD572.50
CT PELVIS W W/O CONTRAST PRO FEECTMD657.50
CT UPPER EXT W/O CONTRAST PRO FEECTMD455.00
CT UPPER EXT W/CONTRAST PRO FEECTMD562.50
CT UPPER EXT W W/O CONTRAST PRO FEECTMD702.50
CT LOWER EXT W/O CONTRAST PRO FEECTMD458.00
CT LOWER EXT W/CONTRAST PRO FEECTMD572.50
CT LOWER EXT W W/O CONTRAST PRO FEECTMD692.50
CT ABDOMEN W/O CONTRAST PRO FEECTMD380.00
CT ABDOMEN W/CONTRAST PRO FEECTMD585.00
CT ABDOMEN W W/O CONTRAST PRO FEECTMD665.00
CT ANGIO ABD/PELV W W/O CONTRAST PRO FEECTMD985.00
CT ABD PELV W/O CONTRAST PRO FEECTMD510.00
CT ABD PELV W/CONTRAST PRO FEECTMD787.50
CT ABD &/OR PELV W W/O CONTRAST PRO FEECTMD895.00
CT HEART W/O CONTRAST W/CA TEST PRO FEECTMD255.00
CT ANGIO ABD ARTERIES PRO FEECTMD967.50
CT HEAD/NECK 3D ADDL PRO FEECTMD60.00
CT LTD F/U HEAD/NECK PRO FEECTMD370.00
CT LTD F/U OTHR THAN HEAD/NECK PRO FEECTMD370.00
CT GUIDE NEEDLE PLACE PRO FEECTMD315.00
CT BONE DENSITY PERIPHERAL PRO FEECTMD287.50
CT LOW DOSE CANCER SCREEN PRO FEECTMD640.00
CT THORAX W/O CONTRAST PRO FEECTMD457.50
ECG-12 LEADS TRACING ONLYED656.15
ECG-1-3 LEAD TRACING ONLYED92.20
PEAK FLOW MEASUREED107.95
POS AIRWAY PRESSURE CPAPED465.00
SVN INITIAL TREATMENTED327.00
VENIPUNCTURE, EDED38.25
IMMUN ADMIN ADDL EA COMBOED60.70
IV PLC OF NDL W/CAP ONLYED197.85
INFUSION HYDRATION > 1 HRED652.80
INFUSION HYDRATION < 1 HRED1,267.45
IV PUSH ADDL-SAME DRUGED194.50
GLUCOSE BY REAGENT STRIPED24.80
IV PUSH ADDL-NEW DRUGED211.30
IV PUSH SINGLE-INIT DRUGED272.05
INJ THER-PROP-DX SQ-IMED219.15
INFUSION CONCURRENT LINE >1 HRED237.95
INFUSION 2ND LINE <1 HRED137.15
INFUSION THER/DX <1 HOURED585.40
INFUSION THER/DX 1-8HR EAED430.40
I&D PILONIDAL CYST SIMPLEED682.25
I&D ABSCESS SIMPLE/SINGLEED366.35
I&D ABSCESS/CYST COMPLEXED459.60
DRIANAGE OF GLAND ABCESSED393.25
INC/REM FB SUBCUT SIMPLEED476.40
INC/REM FB SUBCUT COMPLEXED1,724.65
NG TUBE INSERTIONED1,121.30
CD TRT FX PHLNG SHFT W/MED976.40
REPAIR LAC TONGUE FLOOR MOUTH >2.6CMED1,808.10
REP LAC SCP/NK/TNK <2.5CMED829.20
REP LAC SCP/NK/TNK2.5-7.5ED919.10
REPAIR FINGER TENDONED2,696.40
REP LAC SCP/NK 7.6-12.5CMED500.05
REPAIR TONGUE LACERATION <2.5CMED239.40
REP LAC SIMPLE 12.6-20 CMED842.65
REP LAC FAC/MUC <2.5CMED593.35
REPAIR SIMPLE F/E/E/N/L 2.6-5CMED337.15
REP LAC FAC/MUC 5.1-7.5CMED328.15
REP LAC FAC/MUC 7.6-12.5CED500.05
REMOVAL OF NAIL BEDED640.40
LAY CLS TK/EXT <2.5 CMED588.75
LAY CLS TK/EXT 2.6-7.5 CMED588.75
LAY CLS TK/EXT 7.6-12.5CMED587.70
LAY CLS TK/EXT 12.6-20 CMED550.20
LAY CLS NK/HND/FT<2.5CMED500.05
LAY CLS FC/MUC5.1-7.5 CMED603.85
LAY CLS NK/HND/FT2.6-7.5CMED577.20
LAY CLS FC/MUC<2.5CMED500.05
LAY CLS FC/MUC2.6-5.0CMED500.05
INJ TRIG PNT 1 OR 2 MUSCLED629.20
REMOVE FOREARM FBED3,038.00
CD TRT DSL SHLDR W/M WO/AED976.40
DRAINAGE OF ARM BURSAED3,370.00
REM FB INTRANASALED262.60
CONTROL OF NOSEBLEEDED258.41
CONTROL OF NOSEBLEEDED363.00
INTUBATE ET EMERGENTED2,103.35
DX LARYNGOSCOPY EXCL NBED2,540.00
ANOSCOPY W/REMVL FOREIGN BODYED1,575.00
SPINAL PUNCT LUMBAR DXED1,236.90
REM FB CORNEAL WO/SLITLMPED537.10
INCS THROMBOSED HEMOR EXTED540.85
REMOV FB EYE CORNEA W SLIT LAMPED692.05
ABD PARACENTESIS W/IMAGINGED1,486.00
REM FB EAR CABAK WO/ANESTED212.10
REM IMPACT CERUMEN UN/BILED112.45
EXC BEN LES INC MAR HEAD/FT/GENIT <.5CMED840.00
EXC TR EXT B9+MARG 1.1-2 CMED1,078.00
REMOVE IMPACTED EAR WAX UNIED153.95
REMOVAL OF SKIN TAGS ED308.70
AVUL NAIL PRTL/COMPLT SINGED309.85
DRESS/DEBRID PT-THICK BURN LGED621.00
DRS/DBD BURN W/O ANS SMLED330.35
DRESS/DEBRID BURN W/O ANESTHED230.35
DESTRUCTION B9 LESION UP TO 14ED401.95
AMPUTATION OF FINGER/THUMBED2,025.55
DEBR ECZEM/INFCT SKN 10%ED460.65
CD TRT FX DIS RAD/EP WO/MED549.50
CLSD TX TIBIAL FX W/MANIPED416.35
I&D HEMAT/SEROMA/FLDED1,468.45
CD TRT FX RADIUS/ULNAED505.60
CLSD TX FX ULNAR STYLOIDED524.60
OPN TRT FX DIST PHLNG EAED3,351.50
TREAT LOWER LEG FRACTUREED2,878.15
TREAT WRIST BONE FXED2,434.00
TREAT WRIST BONE FXED2,434.00
CLOSED TX ANKLE FX W/MANIPED2,434.00
CLOSED TX ANKLE DISLOC W/O ANESED537.25
TX CLOSED HEEL FXED537.25
CENTRAL LINE PLACEMENT>5ED2,512.25
CD TRT FX TRIMALLEOARED416.35
I&D ABCESS PERITONSILLARED421.40
REM OF FOREIGN BODY FR PHARYNXED825.05
ARTHR/ASP/INJ INT JNT/BRSED587.05
ARTHROCENTESIS ASPIR/INJ MAJOR JT/BURSAED592.10
DRAIN/INJ JOINT/BURSA W ULTRASOUND GUIDEED625.80
CLSD TX TOE DISLOC WO ANESED598.50
REP CMLX FC/HND/GN1.1-2.5ED621.00
REP CMLX FC/HND/GN2.6-7.5ED565.00
REPAIR COMPLEX TRUNK 2.6-7.5 CMED1,220.50
REPAIR COMPX SCALP/ARM/LEG 2.6-7.5CMED879.80
LAY CLS FC/MUC 736-12.5 CMED385.55
LAY CLS FC/MUC20.1-30 CMED500.05
REP LAC SIMPLE 20.1-30 CMED756.00
APPL SPLINT LONG LEGED556.20
CLSD TX CLAVICLE FX W/MANIPED628.00
CD TRT FX METACP W/M EAED603.85
CD TRT FX NAS BN W/O STBNED2,062.85
CD TRT SUBLX RAD HEAD W/MED646.10
REPAIR NAIL BED EAED1,125.60
TX FX RADIUS & ULNAED1,392.00
CONTROL THROAT BLEEDING SIMPLEED447.20
REM FB EYE EXT CNJT SUPERED262.60
SHV EP/DM LS/TR/AR/LG<0.5ED306.60
APPL SPLINT SHT LEGED366.35
APPL SPLINT SHT ARM STATIED366.35
APPL SPLINT LONG ARMED274.25
CATH INSRT BLADDR NONINDWED252.85
CATH INSERT FOLEY SIMPLEED523.65
CATH INSRT FOLEY COMPLEXED179.80
CHANGE OF BLADDER TUBEED420.00
VAGINAL DELIVERY ONLYED932.40
DRAIN BLADDER BY NEEDLEED1,414.00
CARDIOVERSION ELECTIVE EXED752.75
CARDIOPULMONARY RESUSED814.60
THOROCOSTOMY TUBE PLACEDED908.35
THORACENTESISED1,589.81
THORACENTESIS W/IMAGING GUIDANCEED1,225.00
APPL SPLINT FNGR STATICED179.80
CL TX FINGER FX W MANIPED415.80
CD TRT DSL IPJNT W/M WO/AED640.40
CLSD TX PST HIP DISCLOC W/O ANESED525.00
CD TRT DSL SHLDR W/M W/AED2,602.15
EVAC SUBUNGUAL HEMATOMAED163.00
CD TRT FX TOE DISLOC W/O ANESTHED597.80
CD TRT FX PHLNX/NG W/MED640.40
TX BIG TOE FRACTUREED2,439.00
DEBR SKN & SUBQ TISSUEED760.65
DEBR/REM FB SKIN/SQ/MUS/BONEED2,344.85
BX SKIN SUBQ MUC MEMB 1 LESIONED592.10
EXPL PENETRATING WOUND ABD/BACKED3,747.55
EXPLOR PENETRATING WOUND EXTREMITYED1,131.90
CD TRT FX HUM CONDYL W/MANIPED597.80
CLTX SHLDR DISLOC W MANIPED2,434.80
INSERT PICC CATHED1,965.00
CD TRT FX SHOULDER DISL W/MANIPED2,878.15
INSERT TUNNELED CV CATHED6,196.15
INTRAOSSEOUS NEEDLE PLACEED941.55
DRAINAGE OF GUM LESIONED588.75
RMVL DEVITAL TIS 20CM<ED973.05
DRAINAGE ABCESS FINGER SIMPLEED727.75
INCISION ANAL ABCESSED905.65
DRAIINAGE OF MOUTH LESION, SIMPLEED640.40
CLOSD MOUTH LAC RPR >2.5CMED1,160.35
I&D PILONIDAL CYST SIMPLEED682.25
CD TRT FX LAT MAL W/MED537.25
UA DIP WO/MICROED27.00
I&D VULVA/PERINEAL ABSCESSED395.95
REPAIR OF VAGINAED4,544.00
O2 SAT MEAS SNGL READED54.00
REP CMLX FC/HND/GN AD<5CMED565.00
RPR WOUND, LESION EA ADDL <5CMED863.10
TRANSFUSE BLOOD/BLD PRODED2,030.20
DRAIN EXTERNAL EAR LESIONED599.65
DRAIN OUTER EAR CANAL LESIONED599.65
OCCULT BLOOD FECESED78.65
PREGNANCY TESTED75.30
RAPID STREP SCREENED104.60
ED VISIT LEVEL 1ED351.85
ED VISIT LEVEL 2ED1,105.55
ED VISIT LEVEL 3ED2,067.25
ED VISIT LEVEL 4ED3,008.80
ED VISIT LEVEL 5ED5,447.95
ED VISIT LEVEL 6 CC SVCSED9,436.45
ED VISIT CC SVCS ADL 30MNED812.40
ED NURSE ONLY - NO CHGED0.00
INJECT TRIGGER POINTS 3+ MUSCLESED584.95
MOD SED SAME PHYS >5 YRS 1st 30MED210.00
MOD SED SAME PHYS>5 YRS EA ADDL 15MED105.00
PUNCT/ASP ABCS/HEM/BUL/CYED180.95
NERVE BLOCK INJ TRIGEMINALED592.10
INJ/ANES OTHR PERIPHERALED584.95
ECG-12 LEAD INTP REPORT ONLYEDMD63.00
I&D ABSCESS SIMPLE/SINGLEEDMD257.45
I&D ABSCESS/CYST COMPLEXEDMD515.80
DRAINAGE OF GLAND ABCESSEDMD260.75
INC/REM FB SUBCUT SIMPLEEDMD363.00
INC/REM FB SUBCUT COMPLEXEDMD786.55
NG TUBE INSERTIONEDMD330.35
CD TRT FX PHLNG SHFT W/MEDMD952.80
RPR LAC TONGUE FLOOR MOUTH >2.6CM PRO FEEDMD861.00
REP LAC SCP/NK/TNK <2.5CMEDMD389.90
REP LAC SCP/NK/TNK2.5-7.5EDMD470.85
REPAIR FINGER TENDONEDMD1,348.20
REP LAC SCP/NK 7.6-12.5CMEDMD583.20
REPAIR TONGUE LACERATION <2.5CM PRO FEEEDMD876.35
REP LAC SIMPLE 12.6-20 CMEDMD615.75
REP LAC FAC/MUC <2.5CMEDMD470.85
REP LAC FAC/MUC 2.6-5.0CMEDMD551.70
REP LAC FAC/MUC 5.1-7.5CMEDMD512.40
REP LAC FAC/MUC 7.6-12.5C PRO FEEEDMD713.50
REMOVAL OF NAIL BED PRO FEEEDMD449.40
LAY CLS TK/EXT <2.5 CMEDMD425.90
LAY CLS TK/EXT 2.6-7.5 CMEDMD548.35
LAY CLS TK/EXT 7.6-12.5CMEDMD617.95
LAY CLS TK/EXT 12.6-20 CM PRO FEEEDMD782.35
LAY CLS NK/HND/FT<2.5 CMEDMD471.90
LAY CLS NK/HND/FT2.6-7.5CEDMD560.70
LAY CLS NK/HND/FT7.6-12.5EDMD624.85
LAY CLS FC/MUC<2.5 CMEDMD560.70
LAY CLS FC/MUC2.6-5.0 CMEDMD525.85
LAY CLS FC/MUC5.1-7.5 CM PRO FEEEDMD619.10
INJ TRIG PNT 1 OR 2 MUSCLEDMD250.65
INJ TEND SHTH/LIG/APNEUROEDMD250.65
REMOVE FOREARM FB PRO FEEEDMD1,058.00
CD TRT DSL SHLDR W/M WO/AEDMD716.85
DRAINAGE OF ARM BURSA PRO FEEEDMD413.00
REM FB INTRANASAL PRO FEEEDMD350.60
CTL HEMORRAGE NASAL ANTEREDMD258.41
CTL HEMORRHAGIC NASAL POSTERIOREDMD375.30
INTUBATE ET EMERGENTEDMD402.35
DX LARYNGOSCOPY EXCL NB PRO FEEEDMD516.50
LAV PERITON/ABD PARA INTLEDMD387.70
ANOSCOPY W/REMVL FOREIGN BODY PRO FEEEDMD220.50
SPINAL PUNCT LUMBAR DX PRO FEEEDMD751.70
REM FB CORNEAL WO/SLITLMPEDMD270.80
INCS THROMBOSED HEMOR EXT PRO FEEEDMD286.75
REMOV FB EYE CORNEA W SLIT LAMP PRO FEEEDMD155.40
ABD PARACENTESIS W/IMAGING PRO FEEEDMD282.00
REM FB EAR CABAK WO/ANEST PRO FEEEDMD311.25
REM IMPACT CERUMEN UN/BIL PRO FEEEDMD122.55
EXC BEN LES HEAD/FT/GENIT <.5CM PRO FEEEDMD214.20
EXC TR EXT B9+MARG 1.1-2 CM PRO FEEEDMD422.00
REMOVE IMPACTED EAR WAX UNIEDMD37.20
REMOVAL OF SKIN TAGS EDMD196.45
ARTERIAL CATH PERCUTANEOUEDMD147.25
AVUL NAIL PRTL/CMPLT SINGEDMD176.40
BX SKN/SQ/MUC MEMB SINGLEEDMD215.80
DRESS/DEBRID PT-THICK BURN LG PRO FEEEDMD420.00
DRS/DED BURN W/O ANS SMLEDMD240.55
DRESS/DEBRID BURN W/O ANESTHEDMD455.10
INTL TRMT 1DEG BURN/LOCALEDMD179.80
DESTRUCTION B9 LESION UP TO 14 PRO FEEEDMD295.85
AMPUTATION OF FINGER/THUMB PRO FEEEDMD1,733.40
DEBR ECZEM/INFCT SKN 10%EDMD104.60
CD TRT FX DIS RAD/EP WO/MEDMD806.75
CLSD TX TIBIAL FX W/MANIP PRO FEEEDMD1,721.05
I&D HEMAT/SEROMA/FLDEDMD424.75
CD TRT FX TIB SHFT WO/MEDMD901.15
CD TRT FX RADIUS/ULNAEDMD1,471.80
CLSD TX FX ULNAR STYLOID PRO FEEEDMD802.20
OPN TRT FX DIST PHLNG EAEDMD1,082.05
TREAT LOWER LEG FRACTUREEDMD1,330.45
CD TRT DSL ELBOW WO/AEDMD1,035.95
TREAT WRIST BONE FX PRO FEEEDMD1,217.50
CLOSED TX ANKLE FX W/MANIP PRO FEEEDMD660.50
CLOSED TX ANKLE DISLOC W/O ANES PRO FEEEDMD955.80
TX CLOSED HEEL FRACTURE PRO FEEEDMD914.40
CD TRT FX TRIMALLEOAR W/M PRO FEEEDMD1,659.45
CD TRT FX HUM/PROX W/MANEDMD1,297.70
I&D ABCESS PERITONSILLAREDMD489.95
REM OF FOREIGN BODY FR PHARYNX PRO FEEEDMD314.10
ARTHR/ASP/INJ SM JNT/BRSEDMD186.60
ARTHR/ASP/INJ INT JNT/BRSEDMD212.45
ARTHR/ASP/INJ MJR JNT/BRSEDMD195.55
DRAIN/INJ JOINT/BURSA W ULTRASOUND GUIDEEDMD176.40
CLSD TX TOE DISLOC WO ANES PRO FEEEDMD343.45
CD TRT FX DIST PHLNG WO/MEDMD879.80
REP CMLX FC/HND/GN1.1-2.5 PRO FEEEDMD656.15
REP CMLX FC/HND/GN2.6-7.5 PRO FEEEDMD1,018.00
REPAIR COMPLEX TRUNK 2.6-7.5 CM PRO FEEEDMD657.00
REP CMLX LD/N/E/L1.1-2.5EDMD825.85
REP CMLX SCLP/LIMB2.6-7.5EDMD861.75
LEG SURGERY PROCEDURE PRO FEEEDMD350.00
LAY CLS FC/MUC 7.6-12.5 CMEDMD987.65
REP LAC SIMPLE 20.1-30 CM PRO FEEEDMD642.60
APPL SPLINT LONG LEGEDMD243.85
CLSD TX CLAVICLE FX W/MANIP PRO FEEEDMD1,081.00
CD TRT FX METACP W/M EA PRO FEEEDMD952.80
CD TRT FX NAS BN W/O STBNEDMD532.60
CD TRT SUBLX RAD HEAD W/MEDMD333.70
CD TRT DSL PATELLAR WO/AEDMD903.35
CD TRT FX RAD SHFT WO/MEDMD1,357.25
REPAIR NAIL BED EAEDMD327.00
TX FX RADIUS & ULNA PRO FEEEDMD1,056.00
REM FB EYE EXT CONJ EMBEDEDMD251.70
CONTROL THROAT BLEEDING SIMPLEEDMD713.50
REM FB EYE EXT CNJT SUPEREDMD232.60
SHV EP/DM LS/TR/AR/LG<0.5 PRO FEEEDMD94.50
APPL SPLINT SHT LEGEDMD158.45
APPL SPLINT SHT ARM STATIEDMD163.00
APPL CAST SHT LEGEDMD211.30
APPL SPLINT LONG ARMEDMD191.00
CHANGE OF BLADDER TUBE PRO FEEEDMD139.75
VAGINAL DELIVERY ONLYEDMD3,698.65
DRAIN BLADDER BY NEEDLE PRO FEEEDMD100.80
CARDIOVERSION ELECTIVE EXEDMD449.40
CARDIOPULMONARY RESUSEDMD589.90
CD TRT FX MED MALLOS WO/MEDMD808.95
ED MD EMS DIRECTED ALSEDMD437.15
THOROCOSTOMY TUBE PLACED PRO FEEEDMD630.35
THORACENTESIS W/O IMAGING GUIDANCEEDMD669.70
THORACENTESIS W/IMAGING GUIDANCE PRO FEEEDMD290.00
APPL SPLINT FNGR STATICEDMD107.95
CD TRT FX PHL SHFT WOM EAEDMD429.25
CL TX FINGER FX W MANIP PRO FEEEDMD1,222.20
CD TRT DSL IPJNT W/M WO/AEDMD687.65
CLSD TX PST HIP DISCLOC W/O ANES PRO FEEEDMD1,072.15
CD TRT DSL SHLDR W/M W/AEDMD1,159.55
EVAC SUBUNGUAL HEMATOMAEDMD81.05
CD TRT FX TOE DISLOC W/O ANESTHEDMD314.60
CD TRT FX PHLNX/NG W/MEDMD388.85
TX BIG TOE FRACTURE PRO FEEEDMD1,034.00
PARTIAL AMPUTATION OF TOEEDMD1,632.55
DEBR SKN & SUBQ TISSUEEDMD209.15
DEBR/REM FB SKIN/SQ/MUS/BONEEDMD1,419.10
EXPL PENETRATING WOUND ABD/BACK PRO FEEEDMD1,304.80
EXPLOR PENETRATING WOUND EXTRMTY PRO FEEEDMD944.05
CD TRT FX HUM SHFT WO/MEDMD807.90
CD TRT FX HUM CONDYLAR W/MANIPEDMD1,455.00
CLTX SHLDR DISLOC W MANIP PRO FEEEDMD1,013.00
INSERT PICC CATH PRO FEEEDMD221.40
CD TRT FX SHOULDER DISL W/MANIP PRO FEEEDMD1,330.45
INSERT TUNNELED CV CATH PRO FEEEDMD719.35
INTRAOSSEOUS NEEDLE PLACEEDMD419.20
DRAINAGE OF GUM LESIONEDMD501.20
RMVL DEVITAL TIS 20CM<EDMD124.75
DRAINAGE ABCESS FINGER SIMPLE PRO FEEEDMD383.15
INCISION ANAL ABCESS PRO FEEEDMD470.80
DRAIINAGE OF MOUTH LESION, SIMPLEEDMD387.70
CLOSD MOUTH LAC RPR >2.5CM PRO FEEEDMD619.50
MOD SED SAME PHYS <5 YRSEDMD173.05
I&D PILONIDAL CYST SIMPLE PRO FEEEDMD393.60
CD TRT FX LAT MAL W/M PRO FEEEDMD1,406.70
INJECTION THERAPEUTICEDMD132.65
I&D VULVA/PERINEAL ABSCESS PRO FEEEDMD353.95
REPAIR OF VAGINAEDMD822.00
APPL SPLINT SHT ARM DYNAMEDMD237.10
REP CMLX FC/HND/GN AD<5CM PRO FEEEDMD332.65
RPR WOUND, LESION EA ADDL <5CM PRO FEEEDMD383.15
DRAIN EXTERNAL EAR LESIONEDMD535.95
DRAIN OUTER EAR CANAL LESION PRO FEEEDMD590.00
CENTRAL LINE PLCMT > 5 YREDMD674.10
ED VISIT PROBLEM FOCUSEDEDMD155.10
ED VISIT EXPANDEDEDMD210.11
ED VISIT EXPANDED/MODEREDMD314.60
ED VISIT DETAILEDEDMD470.85
ED VISIT COMPREHENSIVEEDMD701.10
ED CC SVCS 30-74 MINEDMD698.90
ED CC SVCS ADDL 30 MIN ++EDMD349.45
MEDICAL SCREENING EXAMEDMD67.45
INJECT TRIGGER POINTS 3+ MUSCLES PRO FEEEDMD170.10
MOD SED SAME PHYS >5 YRS 1st 30M PRO FEEEDMD143.95
MOD SED SAME PHYS>5 YR EA AD 15M PRO FEEDMD72.55
OBSERV DISCH DIFF DAYEDMD152.90
OBSRV H&P LOW CMPLXEDMD191.00
OBSRV H&P MOD CMPLXEDMD259.60
OBSRV H&P HIGH CMPLXEDMD324.80
HSP CARE INITIAL LOWEDMD237.10
HSP CARE INITIAL / MODERATEEDMD319.10
HSP CARE INITIAL / HIGHEDMD392.20
OBSERVATION SUBS LOWEDMD104.60
OBSERVATION SUBS MODERATEEDMD159.60
OBSERVATION SUBS HIGHEDMD235.95
HSP CARE SUBQ/FOCUSED/LOWEDMD119.20
HSP CARE SUBQ/EXPNDED/MODEDMD169.70
HSP CARE SUBQ / HIGHEDMD230.40
OBS/ HSP ADM/DIS SAME DAY LOWEDMD334.85
OBS/ HSP ADM/DIS SAME DAY MODEDMD455.10
OBS/ HSP ADM/DIS SAME DAY HIGHEDMD510.10
HSP DISCHARG MGMT/MD/<30EDMD201.20
HSP DISCHARG MGMT/MD/>31EDMD251.70
PUNCT/ASP ABCS/HEM/BUL/CYEDMD311.25
NERVE BLOCK INJ TRIGEMINALEDMD205.70
NERVE BLOCK INJECTION FACIALEDMD521.35
NERVE BLOCK INJ OCCIPITALEDMD182.10
INJ/ANES OTHR PERIPHERAL PRO FEEEDMD277.55
LIPASE /SOLAB127.15
DOT Drug Testing - DATCOLAB90.00
ORGANISM ID AEROBIC EACH /SOLAB29.10
SENSITIVITY/SUSCEPTIBILTY ON CULTURE /SOLAB31.15
LEUKOCYTE ALK PHOS /SOLAB26.55
CULTURE TYPE IMMUN NOT FLUORES /SOLAB18.65
ORGANISM ID ANAEROBIC EACH /SOLAB29.10
LIPID PANELLAB232.60
PSA TOTALLAB219.15
TSHLAB309.05
CADMIUM ASSAY /SOLAB71.45
DRUG SCREEN QUAN LAMOTRIGINE /SOLAB40.85
HGB A1CLAB176.40
ALCOHOL BLOODLAB197.85
LIPASELAB127.15
MAGNESIUMLAB121.40
TROPONIN QUANTITATIVELAB350.60
RENAL PANELLAB214.65
OB PANELLAB358.50
T4, FREELAB176.40
LDL DIRECTLAB170.85
HS-CRP /SOLAB238.25
NUCLEAR ANTIGEN ANTIBODY /SOLAB55.35
CYTOLOGY URINE /SOLAB79.50
PROTEIN/CREAT RATIO /SOLAB11.30
LDH /SOLAB22.50
LEISHMANIA AB /SOLAB43.80
MICROBE SUSCEPTIBLE ENZYME /SOLAB17.10
URINE BACTERIA CULTURE /SOLAB29.15
METHYLMALONIC ACID /SOLAB52.85
ALK PHOS ISOENZYMES /SOLAB79.80
GLIADIN AB IgG IgA 2nd test /SOLAB35.60
GRAM STAIN /SOLAB13.15
WBC SMEAR STOOL / QLAB13.15
GLIADIN AB IgG IgA /SOLAB69.20
HAPTOGLOBIN /SOLAB38.80
FUNGI IDENT MOLD /SOLAB31.85
CELIAC DIAGNOSTIC PNL /SOLAB35.60
ALDOLASE /SOLAB29.95
ALKALOIDS NOS /SOLAB29.20
FOLATES RBC /SOLAB143.25
COMPLEMENT C3C /SOLAB37.00
COMPLEMENT CH50 /SOLAB62.70
COMPLEMENT C4 /SOLAB53.45
CA19-9 /SOLAB64.25
SHBG /SOLAB67.05
SODIUM 24 URINE /SOLAB15.00
PTH BIOINTACT /SOLAB127.40
ANTI-DNA /SOLAB42.40
COL CHROMOTOGRAPHY QUAL/QUAN /SOLAB64.60
TOTAL/DIRECT BILI FXNTD /SOLAB84.35
H PLORI IGA AAB /SOLAB44.75
AMH /SOLAB43.15
TISSUE TRANSGLUTAM ABS /SOLAB35.60
MERCURY /SOLAB50.15
ALPHA 1 ANTITRUPSIN /SOLAB41.14
CORTISOL 24 URINE /SOLAB51.55
M. TUBERCULO DNAAMP PROBE /SOLAB108.30
ANTITHROMBIN III PAN /SOLAB36.55
LUPUS ANTICOAG EVAL /SOLAB29.55
CARDIOLIPIN AB SCREEN /SOLAB78.55
ZONISAMIDE(ZONEGRAN) /SOLAB40.90
ERYTHROPOIETIN /SOLAB58.00
RENIN /SOLAB67.85
POTASSIUM 24 URINE /SOLAB13.30
HSV I IGG /SOLAB40.70
HSV II IGG /SOLAB59.75
VAP IM CHOLESTEROL /SOLAB84.65
VITAMIN A /SOLAB35.80
VITAMIN B6 /SOLAB86.70
VITAMIN D 1 25-DIHYDROXY /SOLAB118.80
HERPES SIMPLEX NES ANTBDY /SOLAB44.40
VIT B1 THIAMINE /SOLAB65.50
URIC ACID 24 URINE /SOLAB14.65
CHROMOGRANIN A /SOLAB64.25
ASSAY OF URINE, UREA NIT /SOLAB14.65
FIBRIROGEN /SOLAB36.15
APOLIPOPROTEIN A-1 /SOLAB52.70
CHLAMYDIA PENUMONIAE /SOLAB108.30
MYCOPLASMA PNEUMONIAE /SOLAB40.85
DRUG ASSAY EVEROLIMUS /SOLAB42.40
ZINC /SOLAB35.15
CLOTTING FACTOR VIII VW MEASURE /SOLAB70.80
CYSTIC FIBROSIS SCREEN /SOLAB112.45
IGA /SOLAB28.70
IGG /SOLAB28.70
IGM /SOLAB28.70
ANTIEPILEPTIC LEVEL ETHOSUXIMIDE /SOLAB12.40
CULTURE BACT ANAEROBIC EXCEPT BLOOD /SOLAB29.20
ARSENIC /SOLAB58.55
MOLECULAR PATH 2 HUNTINGTON'S /SOLAB342.00
H. PYLORI ANTIGEN /SOLAB44.40
CP AB /SOLAB39.95
A1C /SOLAB176.40
GENTAMICIN ASSAY PEAK /SOLAB50.55
GENTAMICIN ASSAY TROUGH /SOLAB50.55
MAGNESIUM RBC /SOLAB121.40
ACTH /SOLAB119.20
B-2 MICROGLOBULIN /SOLAB49.90
UA MICRO ONLYLAB42.75
ASSAY OF LIPOPROTEIN (A) /SOLAB39.95
CERULOPLASMIN /SOLAB33.15
FECAL FAT /SOLAB15.70
GASTRIN /SOLAB54.42
T3 REVERSE / QLAB48.65
FOLIC ACID RBCLAB143.25
HEP B GENOTYPE DNA /SOLAB794.60
5 HIAA URINE /SOLAB39.80
COPPER SERUM /SOLAB38.30
MUMPS /SOLAB40.30
ALPHA 1 ANTITRYPSIN PHENOTYPE /SOLAB44.65
IGFBP3 /SOLAB46.00
IGF1 /SOLAB65.60
SUGARS SINGLE QUAL /SOLAB17.00
FLOW CYTOMETRY TC 1 MARKER /SOLAB35.95
FLOW CYTOMETRY EA ADDL MARKER /SOLAB9.35
CATECHOLAMINES /SOLAB77.95
KAPPA LAMBDA LIT CHN /SOLAB41.95
ESTRONE /SOLAB77.00
B-2 GLYCOPROTEIN /SOLAB78.55
PHOSPHOLIPID ANTIBODY /SOLAB49.60
T4 FREE BY DIALYSIS /SOLAB176.40
TRANSFERRIN /SOLAB39.40
TRICHOMMONAS AMP PROBE /SOLAB102.10
CULTURE TYPING GLC/HPLC /SOLAB38.65
MICROBE SUSCEPTIBLE DIFFUSE /SOLAB14.65
MICROBE SUSCEPTIBLE DISK /SOLAB21.25
MRSA SCREEN RT PCR /SOLAB108.30
CALCULUS INFRARED SPECTROSCOPY /SOLAB39.80
SMR PRIM SRC FLUORESC&/AFS BCT FNGI /SOLAB16.60
MICOBACTERIA CULTURE ACID FAST /SOLAB33.35
SKIN FUNGI CULT MOLD, YEAST /SOLAB23.75
CANDIDA DNA DIR PROBE /SOLAB61.90
GARDNER VAG DNA DIR PROBE /SOLAB61.90
TRICHOMONAS VAGIN DIR PROBE /SOLAB61.90
TOXIN/ANTITOXIN ASSAY TISSUE /SOLAB60.90
AB EPSTEIN BARR NUCLEAR AG /SOLAB47.20
AB EPSTEIN-BARR VIRAL CAPSID /SOLAB56.00
SMEAR COMPLX STAIN OVA PARASIT /SOLAB55.45
AB CYTOMEGALOVIRUS /SOLAB44.40
AB CYTOMEGALOVIRUS IGM /SOLAB52.00
AB HEP DELTA AGENT /SOLAB52.95
HEPATITIS BE ANTIBODY /SOLAB35.70
CHLAMYDIA CULTURE ANY SOURCE /SOLAB60.45
CULT TYPE IMMUNOFLUORESC EA ANTISERM /SOLAB17.20
HEATITIS B IADNA QUANT /SOLAB132.20
HPV IADNA HIGH RISK TYPES /SOLAB108.30
HPV TYPES 16 & 18 ONLY /SOLAB108.30
HUMAN EPIDIDYMIS PROTEIN 4 HE4 /SOLAB64.25
ONCO OVARIAN BIOCHEM ASSAY 2 PROTEIN /SOLAB651.25
STOOL CULTR AEROBIC BACT EACH /SOLAB29.15
SHIGA LIKE TOXIN IAAD EIA /SOLAB37.00
DRUG SCREEN QUANT MYCOPHENOLATE /SOLAB55.70
CYTOPATH CELL ENHANCE TECHNIQ SLCTV /SOLAB70.25
ELASTASE PANCREATIC FECAL QUAL /SOLAB35.60
H PYLORI BREATH ANAL UREASE /SOLAB207.90
HLA I LOW RES ONE ANTIGEN EQUIV EACH /SOLAB224.50
CALCIUM URINE QUANT TIMED SPECIMEN /SOLAB18.60
CLOSTRIDIUM DIFF AMPLIFIED PROBE /SOLAB108.30
ASSAY OF CALPROTECTIN FECAL /SOLAB60.10
ASSAY OF PREGNENOLONE /SOLAB63.80
AB VIRUS NOT ELSEWHERE CLASSIFIED /SOLAB39.75
ASSAY OF CRYOFIBRINOGEN /SOLAB35.35
ASSAY OF CRYOGLOBULIN SEMI QUANT /SOLAB19.95
IADNA AMP PROBE TQ EACH NOT SPECIFD /SOLAB108.30
ISLET CELL ANTIBODY /SOLAB61.05
HEP DELTA AGENT ANTIBODY /SOLAB52.95
CRYOGLOBULIN QUAL SEMI-QUANT /SOLAB19.95
CHLAMYDIA ANTIBODY /SOLAB36.50
CHLAMYDIA IGM ANTIBODY /SOLAB19.15
GLUCOSE TOLERANCE EA ADDL AFTER 3 SPECIMLAB17.45
BILE ACID /SOLAB52.85
POTASSIUM,URINE /SOLAB13.30
TISSUE EXAM BY PATHOLOGIST LVL 1 /SOLAB43.65
TISSUE EXAM BY PATHOLOGIST LVL II /SOLAB79.50
TISSUE EXAM BY PATHOLOGIST LVL III /SOLAB111.75
TISSUE EXAM BY PATHOLOGIST LVL IV /SOLAB111.75
TISSUE EXAM BY PATHOLOGIST LVL V /SOLAB538.55
TISSUE EXAM BY PATHOLOGIST LVL VI /SOLAB1,352.40
CHLORIDE,URINE /SOLAB15.50
CARBON DIOXIDE BLOOD ASSAY /SOLAB15.05
CHLORIDE, BLOOD /SOLAB14.20
CHEMILUMINESCENT ASSAY /SOLAB43.60
QUANTITATION OF TX DRUG NES /SOLAB46.60
BETA 2 MICROGLOBULIN /SOLAB49.90
HSV CULTURE,SOFP /SOLAB104.50
THYROGLOBULIN W/O TGAB /SOLAB49.55
INFLUENZA A&B AG,EIA /SOLAB37.00
NT-PRO BNPLAB623.60
ASSAY OF CALCITONIN /SOLAB82.70
CULTURE SCREEN /SOLAB20.45
SODIUM SERUMLAB83.20
EHRLICHIA ABS /SOLAB31.40
LIPO PROFILE TEST /SOLAB52.70
COLLAGEN CROSSLINKS NTX /SOLAB57.65
MCARE SCREENING PSALAB219.15
HSV 1/2 IGG /SOLAB40.70
CA 15-3 /SOLAB64.25
PREALBUMIN /SOLAB45.00
AMINO ACID ANALYSIS /SOLAB52.05
SIROLIMUS/RAPAMYCIN /SOLAB42.40
CYTOMEGALOVIRUS DNA /SOLAB132.20
CHROMIUM,PLASMA /SOLAB62.60
COBALT,BLOOD /SOLAB87.80
TSH /SOLAB309.05
UA DIP W/O MICROSCOPICLAB27.00
CMP /SOLAB213.50
VITAMIN B12 /SOLAB46.50
TOTAL PSA /SOLAB219.15
PHOSPHORUS/PHOSPHATE /SOLAB88.85
THYROID STIMUL IMM /SOLAB156.95
OB PANEL /SOLAB231.05
ASSAY OF VIT E TOCOPHEROL ALPHA /SOLAB43.80
ANCA SCREEN /SOLAB46.45
TOXICOLOGY DRUG SCREEN, MULT CLASSES, /SLAB617.30
DRUG SCREEN PRESUMPTIVE OPT INSTLAB76.45
C-REACTIVE PROTEIN HS /SOLAB238.25
ASSAY LIPOPROTEIN PLA2 /SOLAB116.40
HEP B CORE TOTAL/HBC IG /SOLAB37.20
KIT DRAW FROM PATIENTLAB56.00
BRCA1&2 SEQ & FULL DUP/DEL /SOLAB5,632.00
BARTONELLA HENSELEA /SOLAB31.40
GENE ANALYSIS HEMOCHROMATOSIS /SOLAB201.70
HLA II TYPING 1 LOC HR /SOLAB381.70
VIRUS TISSUE INOCULATION /SOLAB80.45
VIRUS INOCULATION SHELL STAIN /SOLAB60.35
VANCOMYCIN /SOLAB41.80
LYME WEST BLOT /SOLAB216.65
RUBEOLOA TITER /SOLAB39.75
ASSAY OF PROTEIN SERUM INHOUSELAB14.10
C-REACTIVE PROTEIN INHOUSELAB19.85
ASSAY OF VASOPRESSIN /SOLAB104.75
ALLERGEN IGE, EA ALLERGEN /SOLAB16.10
DHEA /SOLAB78.00
PORPHOBILINOGEN ASSAY, RANDOM /SOLAB26.05
ANGIOTENSION CONV ENZY/SOLAB45.05
HEPATITIS A, TOTAL /SOLAB38.20
HEPATITIS Be AG EIA /SOLAB35.55
URINE PORPHYRINS, FRACT, /SOLAB45.40
HIV-1 RNA QUANT BDNA /SOLAB262.65
THYROXINE FREE /SOLAB176.40
KETONES PANEL /SOLAB13.55
ALDOSTERONE ASSAY /SOLAB125.75
PROTEIN,SYNOVIAL FLUID /SOLAB11.30
GLUCOSE,SYNOVIAL FLUID /SOLAB12.15
SJOGREN'S ANTIBODY-SS-A /SOLAB55.35
SM ANTIBODY NUCLEAR ANTIGEN /SOLAB55.35
HSV 1/2 DNA PCR /SOLAB108.30
ASSAY OF ANDROSTENEDIONE /SOLAB100.40
CARBOXYHEMOGLOBIN /SOLAB38.00
LACTIC ACID/LACTATELAB196.70
TBII /SOLAB48.00
RETICULOCYTE COUNTLAB184.30
CRP-HSLAB238.25
INFLUENZALAB89.90
ANIBODY FUNGUS /SOLAB37.80
D DIMERLAB306.85
VISCOSITY,SERUM /SOLAB36.05
IGE /SOLAB50.80
ASSAY OF G6PD ENZYME /SOLAB29.85
ASSAY OF GLYCATED PROTEIN /SOLAB46.52
HEMOGLOBIN CHROMOTOGRAPHY /SOLAB55.75
OXALATE URINE /SOLAB11.25
ASSAY PH BODY FLUID NOS /SOLAB11.05
MAGNESIUM URINELAB11.25
ASSAY OF HISTAMINE /SOLAB92.00
CITRATE URINE /SOLAB11.25
INTRINSIC FACTOR /SOLAB46.50
COXSACKIE AB /SOLAB40.20
QUANTIFERON GOLD /SOLAB191.30
CARDIO IQ (TM) LIPO, ION /SOLAB97.35
CARDIO IQ (TM) HDL CHOL /SOLAB25.30
MASS SPECTROMETRY QUAL/QUAN /SOLAB60.25
MUCIN SYNOVIA FLUID ROPES TEST /SOLAB18.10
PHOSPHORUS URINE /SOLAB15.98
17-HYDROXYPREGNENOLONE LEVEL /SOLAB70.40
ASSAY OF PROSTAGLNDIN EACH /SOLAB105.00
WESTERN BLOT TEST /SOLAB52.60
ASSAY OF SELENIUM /SOLAB78.80
SULFATE URINE /SOLAB14.65
ASSAY OF VITAMIN NOS /SOLAB42.65
VITAMIN K LEVEL /SOLAB42.35
CALCIUM IONIZED /SOLAB42.20
VIT D 25-HYDROXY /SOLAB91.35
GIARDIA AG STOOL /SOLAB37.00
CRYPTOSPORIDIUM OR INFECTIOUS AGENT /SOLAB20.60
CRYPTOSPORIDIUM AG IF /SOLAB37.00
ENTAMOEB HIST GRP AG IA /SOLAB37.00
CLOTTING FACTOR VIII AHG 1 STAGE /SOLAB55.25
CLOTTING FACTOR VIII VW FACTOR ANTGN /SOLAB70.80
CLOTTING FACTR VIII VW MULTIMETRIC /SOLAB70.80
BLOOD CLOTTING FACTOR X /SOLAB66.25
FIBRIN DEGRADATION PRODUCTS /SOLAB22.00
RBC SICKLE CELL TEST /SOLAB17.00
ALLERGEN SPEC IGG QUAN/SEMIQUAN EA /SOLAB19.55
FLUORESCENT ANTIBODY SCREEN /SOLAB37.20
IMMUNOFIXATION ELECTROPHORESIS SERUM /SOLAB69.00
NK CELLS TOTAL CT /SOLAB116.45
NEUTRALIZATION TEST VIRAL /SOLAB52.20
AB CANDIDA /SOLAB37.05
AB COXIELLA BURNET II Q FEVER /SOLAB38.00
GIARDIA LAMBLIA AB /SOLAB45.40
IgG ANTIBODY NOS /SOLAB38.20
RICKETTSIA ANTIBODY /SOLAB60.00
TOXOPLASMA ANTIBODY /SOLAB44.40
TOXOPLASMA ANTIBODY IGM /SOLAB44.45
MACROSCOPIC EXAM PARASITE /SOLAB13.15
PINWORM EXAM /SOLAB13.15
VARICELLA ZOSTER AG IF /SOLAB37.00
ANTIBODY DETECTION NOS IF /SOLAB40.30
IADNA BARTONELLA AMP PROBE TECHNIQ /SOLAB108.30
HCV RNA QUAL /SOLAB108.30
DRUG SCREEN V /SOLAB262.95
CELL COUNT (BODY FLUID) /SOLAB17.00
HEP B CORE ANTI IGM /SOLAB36.35
HEP B SURFACE ANTIB /SOLAB33.15
HEPATITIS C ANTIBODY /SOLAB44.00
CALCIUM /SOLAB65.21
LEVETIRACETAM DRUG SCREEN /SOLAB47.41
C. DIFF TOXIN, EIA/SOLAB37.00
PCR AG DETECT NOS IIA MULT /SOLAB37.00
BLOOD SMEAR INTERPRETATION /SOLAB63.90
CBC W/AUTO DIFFLAB163.00
CYTOPATH C/V THIN LAYER /SOLAB62.50
UA AUTO WO/MICROLAB114.70
CYTOPATH C/V THIN LAYER RESCREEN /SOLAB81.75
CRYSTALS- SYNOVIAL FLUI /SOLAB22.05
CBC W/MANUAL DIFFLAB115.85
ESRLAB73.10
HEMATOCRITLAB66.40
HEMOGLOBINLAB75.30
CBC W/O DIFFERENTIALLAB129.35
P.T.TLAB195.55
PLATELET CT SEPARATE PROCLAB195.55
PREGNANCY TEST URINELAB94.40
PROTIME W/INR /SOLAB172.00
PROTHROMBIN TIMELAB172.00
IMMUNODIFFUSION NES /SOLAB43.35
IMMUNFIX ELEC SERUM /SOLAB74.80
IMMUNOFIXATN ELEC URIN /SOLAB90.55
URINE, DIP STICK W/MICRO, NON-AUTOLAB61.85
RETICULOCYTE/SOLAB184.30
SEMEN ANALYSIS POST /SOLAB66.40
CYSTIC FIBROSIS SCREEN /SOLAB1,391.50
UA W/ MICROSCOPICLAB133.80
HEPATITIS C BY RIBA /SOLAB47.80
STREPTOCOCCUS PNEUMONIAE IgG AB /SOLAB46.25
CULTURE, BLOOD /SOLAB31.85
ESTRADIOL (E2) /SOLAB86.20
CHLAMYDIA DNA,SDA /SOLAB108.30
CULTURE-FUNGUS /SOLAB25.95
DNA ANTIBODY SINGLE STRAND /SOLAB37.35
GC DNA,SDA /SOLAB108.30
PROTEIN C INHIBIT /SOLAB42.70
HERPES CULTURE /SOLAB46.55
TISSUE KOH FOR FUNGI /SOLAB42.75
KOH PREP WET MOUNT FUNGUSLAB42.75
PROTHROMBIN GENE /SOLAB164.20
CYSTATIN C /SOLAB46.30
ASSAY OF LDH ENZYMES /SOLAB39.50
JAK2 GENE /SOLAB288.85
FACTOR V LEIDEN /SOLAB188.60
BLOOD OCCULT FECAL HGB IA QUAL 1-3 /S0LAB56.90
ANTITHROMBIN III ANTIGEN /SOLAB33.35
OCCULT BLOOD FECESLAB37.20
PROTEIN S CLOT INHIBIT /SOLAB21.35
OVA & PARASITES /SOLAB27.45
BLOOD OCCULT FECAL HGB IA QUAL 1-3LAB56.90
RAPID STREP SCREENLAB165.20
MTHFR GENE ANALYSIS /SOLAB163.35
SKIN TEST TUBERCULOSISLAB49.55
CULTURE URINE /SOLAB24.90
WET MOUNTLAB51.80
ACETOMINOPHENLAB371.95
ALBUMINLAB85.50
AMMONIA- BLOODLAB204.55
AMYLASE /SOLAB177.65
AMYLASELAB177.65
VITAMIN B12 /SOLAB46.70
BILIRUBIN TOTALLAB84.35
BILIRUBIN- DIRECTLAB86.55
CALCIUM- BLOODLAB65.21
CA 27.29 (BR27.29) /SOLAB64.25
CEA /SOLAB7.15
CHOLESTEROL- TOTALLAB44.95
CORTISOL TOTAL /SOLAB50.30
CPK ISOENZYMES /SOLAB153.95
CPK ISOENZYMESLAB153.95
CPK /SOLAB143.95
CPKLAB143.95
CKMB - CREATINE KINASE MB FRACTION /SOLAB35.65
CREATININELAB94.40
CREATININE/ URINE /SOLAB17.75
CREATININE URINELAB17.75
DIGOXINLAB243.85
DRUG ASSAY CYCLOSPORINE /SOLAB55.70
ANA LYZER /SOLAB37.30
ELECTROLYTE PANELLAB127.15
ESTROGEN TOT /SOLAB66.95
FERRITIN /SOLAB42.05
FOLIC ACID /SOLAB45.35
FSH /SOLAB57.35
T3 FREE /SOLAB52.30
GLUCOSE QUANTLAB61.85
GLUCOSE TOL 3 SPECIMENSLAB235.95
RAY'S MARKET DRUG SCREENLAB43.90
HCG, QUANTITATIVELAB52.00
IRON TOTAL /SOLAB20.00
IRON TOTAL/IRON BIND /SOLAB27.00
INSULIN /SOLAB35.25
C PEPTIDE /SOLAB64.25
T3 BY RIA /SOLAB43.75
VARICELLA ZOSTER IGG /SOLAB39.75
TETANUS ANTITOXID /SOLAB46.40
LITHIUM /SOLAB20.40
HEPATIC PANELLAB151.75
LUTEINIZING HORMONE(LH) /SOLAB57.15
OSMOLALITY(SERUM) /SOLAB20.40
OSMOLALITY (URINE) /SOLAB21.05
PHOSPHATASE ALKALINELAB79.80
PHOSPHATE INORGANICLAB88.85
POTASSIUMLAB88.85
PROGESTERONE /SOLAB64.40
PROCALCITONIN (PCT) /SOLAB82.70
PROLACTIN /SOLAB59.80
PROTEIN TOTAL/ SERUM /SOLAB14.10
PROTEIN ELECTRO SERUM /SOLAB33.15
SALYCILATESLAB224.70
SGOTLAB38.25
SGPTLAB42.75
STONE ANALYSIS /SOLAB35.70
T4 /SOLAB21.20
TEGRETOL- CARBAMAZEPHN /SOLAB44.95
C REACTIVE PROTEIN /SOLAB19.85
TESTOSTERONE TOTAL ADULT MALE /SOLAB79.65
TESTOSTERONE TOTAL LC/MS/MS /SOLAB79.65
PROTEIN TOTAL 24HR URIN /SOLAB11.30
TRIGLYCERIDESLAB59.65
UREA NITROGEN (BUN) QUANTLAB79.80
DHEA SULFATE /SOLAB68.60
HEPATITIS A ANTIB IGM /SOLAB34.75
VMA /SOLAB47.80
VALPROIC ACID /SOLAB41.80
CA 125 /SOLAB64.25
MICRO ALBUMIN /SOLAB17.85
DRUG SCRN QUANT OXCARBAZEPIN /SOLAB40.90
MICROALBUMIN URINE /SOLAB17.85
ANTINUCLEAR ANTIBODY/SOLAB37.30
ANA TITER /SOLAB34.45
CROSS MATCH EACH UNITLAB483.11
DETECT DNA /SOLAB132.20
HEPATITIS B SURF AG /SOLAB31.85
DRUG SCREEN/MULTI DRG CLSLAB262.95
HEPATITIS PANEL/SOLAB146.25
HIV 1\2 AB SCREEN /SOLAB42.30
HLA B27 /SOLAB79.65
HIV-1&2, AG & ANTIBODY /SOLAB74.30
LYME DISEASE ANTIBODY /SOLAB52.55
LYME DISEAS ANTIBDY IGM /SOLAB47.80
LEAD BLOOD /SOLAB37.35
MONONUCLEOSIS TESTLAB95.65
PTH /SOLAB127.40
PREGNANCY TEST SERUM QUALLAB138.30
H. PYLORI AB /SOLAB46.55
GIARDIA ANTIGEN /SOLAB37.00
RUBELLA /SOLAB44.40
RHEUMATOID FACTOR /SOLAB17.50
RPR /SOLAB13.15
MYELIN BASIC PROTEIN CSF ANALYSIS /SOLAB53.10
OLIGOCLONAL IMMUNE BANDS /SOLAB68.45
PROTEIN E-PHORESIS/URINE/CSF /SOLAB55.00
HEP C RNA QUANT /SOLAB132.20
THYROGLOBULIN AB /SOLAB49.10
AFP /SOLAB51.75
DIRECT ANTIGLOBULIN TEST /SOLAB16.60
PSA FREE RATIO /SOLAB56.75
HEP C GENOTYPE LIPA /SOLAB794.60
EHRLICA CANIS AB /SOLAB37.20
MALARIA SMEAR /SOLAB18.50
HOMOCYSTINE TOTAL /SOLAB52.10
FLOW CYTOMETRY INTERP 16/> MARKERS /SOLAB222.30
GASES-PH PCO2 PO2 & SATLAB657.30
METANEPHRINES TOTAL /SOLAB52.30
COMPREHENSIVE METAB PANELLAB213.50
BASIC METABOLIC PANELLAB179.80
DILANTIN (PHENYTOIN)LAB243.85
PHENOBARBITAL /SOLAB38.25
ASO TITER /SOLAB22.50
ARTERIAL PUNC/BLOOD WTHDRLAB84.35
VENIPUNCTURELAB38.25
CHP BLOOD DRAWLAB35.00
CENTRAL LINE BLOOD DRAWLAB36.05
GLUCOSE POST GLUCOSE DOSELAB65.21
T LYMPHOCYTE CD4 /SOLAB82.65
GGT /SOLAB22.20
URIC ACID /SOLAB13.95
CREATININE CLEARANCE 24 /SOLAB29.15
THYROID PEROXIDASE AB /SOLAB44.90
CULTURE AEROBIC /SOLAB26.60
AMMONIA /SOLAB204.55
TESTOSTERONE FREE /SOLAB78.60
HCV RNA QUANT R-T PCR /SOLAB132.20
TACROLIMUS /SOLAB42.40
CULTURE STOOL /SOLAB29.15
CULTURE THROAT /SOLAB26.60
DRUG TEST DEF 1-7 CLASSES /SOLAB286.05
T3 UPTAKE /SOLAB19.95
HEPATIC PANEL /SOLAB151.75
MAMM DX UNILATERALMAMM330.00
MAMMOGRAPHY SCREENING BILAT W/CADMAMM333.20
IMMUN ADMIN 1ST EA COMBOMM111.30
BANDG- ACE ELASTIC 4"MM32.75
BANDG- ACE ELASTIC 3"MM23.65
BANDG- ACE ELASTIC 2"MM23.65
BANDG- ACE ELASTIC 6"MM23.65
SOL- IV, D5, 500MLMM30.00
SOL- IV, D5, 100MLMM30.00
SOL- IV, 9% NACL, 1000MLMM40.00
SOL- IV, 9% NACL, 500MLMM50.00
SOL- IV, 9% NACL, 100MLMM30.00
SOL-IV, 45% NACL, 1000MLMM40.00
SOL- IV, 9% NACL, 250MLMM30.00
SOL-IV, D5,.45NACL 1000MLMM24.80
SOL-IV,D5/.9NACL EA 1LMM24.80
SOL-IV, LR, 1000MLMM41.50
SOL-IV, D5, LR, 1000MLMM74.25
SALINE SOL 10CC FOR MDIMM12.40
CATH-FOLEY, 18FR, 05CCMM73.10
CATH-FOLEY, 16FR, 05CCMM73.10
CATH FOLEY 14F 05CCMM73.10
CATH-FOLEY, 8FR, 03CCMM73.10
CATH-FOLEY, 12FR, 05CCMM73.10
TRAY- THORENCENT PARACENTMM383.15
TRAY- LUMBAR PUNCTURE ADUMM130.45
PLEUR- EVACMM730.30
CRUTCH- ADULT TALL ADJMM178.75
CRUTCH- ADULT ADJMM178.75
CRUTCH- YOUTH ADJMM178.75
SANDAL-CAST, LGMM96.71
SANDAL- CAST MEDMM96.71
CAST- SANDAL, SMMM96.71
CAST- FIBERGLASS 4"MM60.70
BANDG-TUBULAR GZ SZ2 /YDMM4.55
BANDG-TUBULAR GZ SZ 1/YDMM10.20
BAG- FOLEY 2000MLMM33.71
CATH- FEMALE KITMM33.71
BAG-LEG URINARYMM54.00
TRAY-URETHRAL CATHMM32.75
STRAP-CATH LEGMM88.85
TRAY- URINE METER FOLEYMM104.60
SPLINT-CRDBD/FOAM 12"MM12.40
CLAVICAL SMMM28.00
CLAVICLE SPLINT LGMM28.00
CLAVICAL SPLINT XLMM28.00
SPLINT-COLLES LG LMM50.65
SPLNT-COLLES,LARGE,RMM89.90
SPLNT-COLLES,SMALL,LMM89.90
SPLNT-COLLES,SMALL,RMM89.90
SPLNT-COLLES,MEDIUM,RMM89.90
SPLNT-COLLES,MEDIUM,LMM89.90
RIB BELT UNIVERSALMM24.00
SPLINT-WRIST,UNIV,RMM98.95
SPLINT-WRIST UNIVERSALMM98.95
SPLINT-FNGR PLN END 4.25MM10.20
BANDG-ROLL GAUZE 4" STLMM20.30
BANDG-ROLL GAUZE 2" STLMM7.90
BANDG-CONFORM 4" PER YARDMM10.20
BANDG-CONFORM 3" PER YARDMM10.20
BANDG-CONFORM 2" PER YARDMM10.20
SPONGE-GAUZE 4X4 TRAYMM10.00
DRESS- TELFA 3"X8"MM7.90
DRESS-TELFA 3X4MM20.30
DRESS- TELFA 2"X3"MM7.90
DRESS- XSPAN SIZE 4/YDMM7.90
DRESS- XEROFORM 1"X8"MM9.05
DRESS- XEROFORM 5"X9"MM14.70
DRESS-TRANSPARENT 2X3MM20.30
DRESS-NONADHERING 3"X16"MM10.20
DRESS-NONADHERING 3"X3"MM7.90
DRESS-NONADHEARING 3"X8"MM12.40
DRESS-TRANS 10CMX14CMMM14.70
PACKING- IODOFORM 1/4"MM48.41
PACKING- PLAIN 1/2"MM23.65
CATH- MALE EXTERNALMM7.90
TRAY-CV CATH MULTI LUMENMM316.90
SPLINT-ANKLE SUPPORT STRPMM194.50
BANDG-TUBULAR GZ SZ3/YDMM12.40
STOCKINETTEMM12.40
PLASTER SPLINTMM25.95
PACKINGMM48.41
DRESSING-XPANDMM7.90
DRESSING-TELFAMM20.30
SPLINT-FINGERMM18.10
PADDING-CASTMM18.10
BANGAGE-TUBULAR GZMM12.40
DRESSING-NONADHEARINGMM20.30
BELT-RIBMM64.15
SANDAL-CASTMM96.71
SPLINT-WRISTMM89.90
IMMOBILIZER-SHOULDER MESHMM66.40
SLING-ARM UNIVERSALMM60.70
RIB BELT FEMALE XLMM28.00
SOL-IRRIGATION H2O STL 1LMM12.40
SOL-IRRIGATION STL NACL1LMM12.40
OCULAR IRRIG LENS MORGANMM176.40
DRESS-DUODERM CGF 4X4MM58.50
DRESS-DUODERM CGF 2.5X2.5MM36.05
TRAY-CATH 'ADD A FOLEY'MM104.60
DRESSING-ALLEVYN SAC 5X5MM35.00
NACL FLUSH 10MLMM6.00
ADHESIVE-SKINMM89.90
UNIVERSAL STIRRUP ANKLE BRACEMM45.80
ELECTRODE- ZOLL ONE STEPMM225.00
TRAY-CENTRAL LINE DRESSMM30.35
BIOPATCH DISKMM46.10
cv plus catheter stablilization deviceMM74.00
SOL-IV D10W 250MLMM7.90
BLANKET-BAIR HUGGERMM35.00
QUICK TRACH 4.0MM195.00
QUICK TRACH PEDS 2.0MM195.00
CAST ARM SHRT FBRGL >11YOMM84.35
CAST LEG SHRT FBRGL >10YOMM142.70
CAST LEG SHRT PLSTR >11YOMM73.10
SPLINT ARM LONG FBRGL <11MM64.15
SPLINT ARM LONG FBRGL >11MM170.85
SPLINT ARM SHRT FBRGL <11MM94.40
SPLINT ARM SHRT FBRGL >11MM88.85
SPLINT LEG LONG FBRGL >11MM104.60
SPLINT LEG SHRT FBRGL <11MM114.70
SPLINT LEG SHRT FBRGL >11MM130.45
SPLINT LEG SHRT PLSTR >11MM37.20
TRAY-CV CATH,PED 22GMM280.00
ARM SLING LGMM20.56
ARM SLING MDMM19.25
SOL-IRRIGATION NACL 500MLMM23.00
TEGADERM DRESSINGMM16.05
WALKING BOOT LGMM125.00
WALKING BOOT SMMM125.00
WALKING BOOT MEDMM125.00
DUODERM CGF BORDER 2.5 X 2.5MM19.00
PARACENTESIS KITMM100.00
U SHAPED CALLUS CUSHIONMM12.50
SEMI PVT BED ACUITY LVL 1NUR3,093.10
SEMI PVT BED ACUITY LVL 2NUR4,639.65
OBS BED CHARGE PER HOUROBS195.55
RABIES IMM GLOB (Rig=HT)PHAR1,104.00
RABIES VACC POST EXPOSUREPHAR482.60
CALCIUM 500 MG TABPHAR4.30
AMIODARONE HCL 200MG TABPHAR5.40
GUAIFENESIN DM 5ML SUSPHAR5.00
LABETALOL HCL 5MG INJPHAR25.00
XYLOCAINE VISC BOTTLEPHAR32.10
CALCIUM GLUC PER 10ML INJPHAR21.50
MAGNESIUM 300MG TABPHAR4.30
NEUPOGEN 300MCGPHAR891.40
ACETAMINOPHEM 120MG SUPPPHAR4.30
ERYTHROMYCIN SULF 2-600MGPHAR83.50
METOPROLOL <5MG IVPHAR13.00
WARFARIN 5MGPHAR5.25
NEULASTA 6MG INJPHAR4,983.00
LEVAQUIN PER 250MG IVPHAR148.00
XOPENEX UD INHLPHAR18.20
PROTONIX 40MG IVPHAR29.00
ZOSYN 1G/0.125G 1.125 IVPHAR167.00
FLUCONAZOLEPHAR6.00
PEN G 5 MILLIONPHAR27.00
ONDANSETRON HCL IV PER MGPHAR13.00
ONDANSETRON HCL TAB 4MGPHAR6.00
IRON SUCROSE 200MGPHAR33.00
RECLAST EA 5MG INJPHAR185.00
AMIODARONE HCL 30MG INJPHAR4.30
ACETAMINOPHEN 300MG SUPPPHAR7.50
PSEUDOEPHEDRN HCL/ACTF TBPHAR4.30
EPINEPHRINE 1ML INJ 1:1KPHAR21.00
ALBUTEROL INHALERPHAR85.00
ALCAINE O/S 4 DROPSPHAR6.50
SPIRONOLCTN/ADLACTONE TBPHAR4.30
AMOXICILLIN 250MG CAPPHAR4.30
AMOXICILIN 125MG/5CC SUSPHAR18.00
AMOXICILLIN 250MG/5CC SUSPHAR16.00
AMOXICILLIN 500MG CAPPHAR4.30
AMPICILLIN SOD 1 GM INJPHAR30.00
SUCCINYLCHNE 20MG INJPHAR22.50
CEPHALEXIN 250MG/100ML POPHAR18.00
CEPHALEXIN 250MG/5ML POPHAR3.30
ASA SUPPOSITOR 600 MGPHAR9.70
ASCORBIC ACIDPHAR4.30
ASA 325MG TABPHAR4.30
LORAXEPAM/ATIVAN 1MG TABPHAR4.30
ATROPINE 0.1MG INJPHAR28.00
DIPHENHYDRMN HCL 25MG CAPPHAR4.30
DIPHENHYDRAMIN 50MGPHAR6.00
DIPHENHYDRAMINE 50MG ELIXPHAR6.00
PEN G BENZ/LA 100,000 unitsPHAR53.50
CALCIUM CHLR 10%<10ML INJPHAR20.40
CAPTOPRIL 25MG TABPHAR23.00
DILTIAZEM 5MG INJPHAR39.60
DILTIAZEM HCL/CARD 60MG TPHAR4.30
CLONIDINE HCL/CAP .1MG TBPHAR5.00
CLINDAMYCIN 300MG INJPHAR42.80
CLINDAMYCN 600MG INJPHAR65.30
DILAUDID 2MG TABPHAR4.30
BENZTROPINE 1 MG TABPHAR5.00
DOCUSATE SOD/COL 100MG TBPHAR5.00
PROCHLORPERAZINE 10MG TABPHAR4.00
PROCHLORPRZN/COMPZ SUP 25PHAR16.10
PROCHLORPERAZINE <=10MG IPHAR45.00
CORTISPORIN 1 SQUIRTPHAR6.50
DEXAMETH/DECRON 4 MG TABPHAR4.30
DEXAMTH <4MG/ML INJPHAR14.00
DEXAMETHASONE PER 1MG INJPHAR4.30
DEXAMETHASONE 10MG INJPHAR9.00
VALPROIC ACID/DEPKN 250MGPHAR4.30
DEPO MEDROL 40MG INJPHAR42.00
DEPO MEDROL 20MG INJPHAR7.50
DEPO MEDROL 80MG INJPHAR43.00
MEDROXYPROGSTRNE 1 MGPHAR190.00
TRAZODONE HCL 50MGPHAR6.00
DEXTROSE 50% <25GM INJPHAR42.00
DIGOXIN .125MG TABPHAR6.50
DIGOXIN .25MG TABPHAR4.30
DIGOXIN .5MG TABPHAR4.30
DIGOXIN <.5MG INJPHAR37.50
FOSPHENYTOIN SOD 100MG INJPHAR24.00
PHENYTOIN SODIUM 100MG TBPHAR6.00
HYDROMORPHONE HCL <4MGINJPHAR52.50
DONNATAL ELIXIR 5CCPHAR32.00
DOPAMINE 400MG INJPHAR37.00
DOXAZOSIN 4MG TABPHAR6.50
BISACODYL 10MG SUPPPHAR8.00
AMITRIPYLINE HCIPHAR4.30
EPINEPHRINE 1-10000MINIJTPHAR97.00
ERYTHROMYCIN OPTH OINT 4GPHAR21.40
ERYTHROMYCIN 250MG TABPHAR4.30
FERROUS SULFT/FE SUF 325MPHAR5.00
METRONIDAZOLE 500 MGPHAR66.40
FLU VACCINE INJ MEDICAREPHAR0.00
FLU VACCINE HI DOSE INJ MDCRPHAR0.00
FLU VACCINE INJPHAR25.00
FOLIC ACID 1MG TABPHAR3.00
GENTAMICIN SULF <80MG INJPHAR12.90
GENTAMICIN SULF OPTH <5MLPHAR19.30
GLUCAGON 1MG INJPHAR176.00
GLUCOTROL 10 MGPHAR4.30
HALOPERIDOL LACTAT<5MGINJPHAR27.00
HALDOL 2MG TABPHAR4.30
HEPARIN SOD PER 1000U INJPHAR14.00
HEPATITUS B ADULT INJPHAR238.70
HCTZ 50MG TABPHAR4.30
INDERAL 10MG TABPHAR9.00
INDOCIN 25MG CAPPHAR4.30
INSULIN N PER 5 UNITSPHAR16.10
INSULIN R PER 5 UNITSPHAR15.00
SODIUM POLY SULF 15GM SUSPHAR26.80
KEFLEX 250MG/5CC 100CC LQPHAR37.50
KEFLEX 500MG TABPHAR6.00
CEFAZOLIN 1 GMPHAR15.00
TRIAMCINOLONE /10MG INJPHAR12.50
LACTULOSE 30CC LIQUIDPHAR7.50
LASIX 40MG TABPHAR5.00
FUROSEMIDE <20MG INJPHAR31.10
LIDOCAINE 50CC INJPHAR24.70
LOMOTIL 2.5MG TABPHAR4.30
METOPROLOL TARTRATE TABPHAR4.00
MAALOX 30CC LIQUIDPHAR5.00
MAGNESIUM SULF 500MG INJPHAR15.00
MAG CITRATE 10 OZ LIQUIDPHAR11.80
BUPIVICAINE .5% 1CC INJPHAR25.00
MILK OF MAGNESA 30ML LQUDPHAR4.30
EPINEPHRINE .4 UD INH SOLPHAR7.50
MORPHINE SULF 4MG INJPHAR52.50
MMR VACCINEPHAR104.90
IBUPROFEN 400MG TABPHAR4.50
IBUPROFEN 600MG TABPHAR5.00
MULTIVITAMIN CONCRTE INJPHAR256.80
MYLANTA <30CCPHAR4.30
NAPROSYN 250MG TABPHAR5.00
NARCAN /1MG INJPHAR128.00
NEOSPORIN 1/32 OZ TOPICALPHAR4.30
NEOSPORIN OPTH SOLPHAR147.00
NITROGLYCERIN 50MG INJPHAR49.30
NITROGLYCERIN TABPHAR4.30
NITROGLYCERIN 2% OINTMENTPHAR19.00
ORPHENADRINE CIT<=60MG INPHAR40.00
OPTHAINE OPTHAMALIC 15MLPHAR97.00
PEN VK 250MG/5CC 100MLPHAR18.50
PEN VK 500MG TABPHAR4.30
PEN VK 250MGPHAR5.00
PERCOCET -5 TABPHAR4.30
PERMETHRIN 5% CREAMPHAR108.10
PHENERGAN 25MG SUPPOSITORPHAR12.90
PHENERGAN 25MG TABPHAR4.30
POTASSIUM CL 10MEQ TABPHAR5.00
POTASSIUM CL EA 2 MEQ INJPHAR17.20
PREDNISONE 20MG TABPHAR4.00
PREDNISONE 10MG TABPHAR4.30
PREDNISONE 5MG TABPHAR4.00
INFLUENZA (HIGH DOSE)PHAR140.00
LIDOCAINE 2% (SYRING)PHAR28.00
GENTAMICIN 0.3% OPTH OINNTPHAR118.00
ISOSORBIDE 10MGPHAR31.00
XYLOCAINE/EPI 2%PHAR28.00
VERAPAMIL 80MGPHAR10.00
PROTAMINE SULFATE 250MG/25MLPHAR110.00
CEFTAZIDIME 1GRPHAR37.00
KENALOG 0.1% CREAMPHAR18.00
PROCARDIA 30MG TABPHAR12.00
LEVOTHYROXINE 100MGPHAR13.00
SUDOGESTPHAR3.00
PROPRANOLOL 10MGPHAR19.50
PROMETHAZINE TAB 25 MGPHAR3.15
PREDNISOLONE 1%PHAR153.00
PROMETHAZINE HCL<50MG INJPHAR15.00
PILOCARPINE 1%PHAR188.50
VECURONIUM BROMIDE IVPHAR56.80
NORVASC 5MG TABPHAR6.00
PHYSOSTGMINEPHAR125.00
ALBUTERAL/IPRATROPIUM INHPHAR5.00
SODIUM BICARBONATE 84PHAR55.00
PENICILLIN VK 250MGPHAR6.75
AFRINPHAR10.00
DOXYCYCLINE 100MGPHAR101.00
LITHIUM 300MGPHAR15.00
BENAZEPRIL 5MGPHAR3.50
METFROMIN 500MGPHAR5.00
METOCLOPRAMIDE 10MGPHAR12.00
PYRIDIUM 100MG TABPHAR4.30
PYRIDIUM 200MG TABPHAR5.00
HYDROcodone/Apap 10/325PHAR22.00
ALBUTEROL UD / MG INH SOLPHAR5.00
OFLOXAXINPHAR167.50
NYSTATIN CREAMPHAR19.50
NICOTINE PATCH 21MGPHAR5.00
NAFCILIINPHAR28.50
MANNITOLPHAR26.00
MAGNESIUM CITRATEPHAR5.00
REGLAN 10MG TABPHAR4.30
HEPARIN 5,000PHAR25.00
METOCLOPRAMIDE <=10MG INJPHAR16.00
POTASSIUM CL 20 MEQPHAR15.00
LIDOCAINE W/D5WPHAR22.50
PITOCINPHAR20.75
POTASSIUM CHLORIDE ORAL SOLUTION 20MEQPHAR15.00
RESTORIL 15MG TABPHAR4.30
PEN VK SUSP 125MGPHAR15.00
PERMETHRIN CREAMPHAR115.00
ETOMIDATE 2MG >10MLPHAR53.50
PROMTHAZINE SUPP 25MGPHAR37.15
SODIUM BICARB 8.4PHAR53.00
GUAIFENESIN AC 5ML SUSPHAR4.30
GUAIFENESIN AC 30ML SUSPHAR9.70
SULF/TRIM 400/80MG TABPHAR5.00
SULF/TRIM 200/40MG/5MLSUSPHAR4.30
SILVADENE 1%<50GM TOPICALPHAR21.40
SODIUM BICARBONATE 7.5%PHAR20.40
SOLU-CORTEF100 MG INJPHAR48.00
SOLU-MEDROL <=40MG INJPHAR69.60
SOLU-MEDROL <=125MG INJPHAR43.00
DOXYCYCLINE 100MG TABPHAR18.00
CIMETIDINE 300MG INJPHAR28.90
TEGRETOL 200MG TABPHAR4.30
ATENOLOL 50MG TABPHAR5.00
TD VACC PRSV FREE 7 YRS & OLDERPHAR96.30
DIPTHERIA & TETNS TXD INJ >7 PRESERV FREPHAR96.30
TDAP VACCINEPHAR152.00
MULTI VIT TABPHAR4.30
CHLORPROMAZINE 50 MGPHAR88.90
THYROID 60MG TABPHAR4.30
CLINDAMYCIN 150MG POPHAR5.00
TYLENOL 325MG TABPHAR5.00
TYLENOL 650MG TABPHAR4.30
TYLENOL 5CC LIQUIDPHAR4.30
TYLENOL W/CODEINE 30MG TBPHAR4.30
VALIUM 10MG TABPHAR4.30
VALIUM 5MG TABPHAR5.40
CEFTRIAXONE SOD 250MGPHAR23.00
VITAMIN K PER MG INJPHAR129.00
DIAZEPAM <=5MG INJPHAR71.70
VANCOMYCIN 1GMPHAR154.10
MIDAZOLAM PER 5 MG INJPHAR58.90
VICODIN POPHAR4.30
THIAMINE 100MG INJPHAR37.00
XYLOCAINE 1% 1CC INJPHAR22.00
XYLOCAINE 1% W/EPIPHAR18.00
NITROGLYCERINPHAR5.00
XYLOCAINE 2% 1CC INJPHAR23.00
XYLOCAINE 2% W/EPI 1CC INPHAR22.00
XYLOCAINE VISCPHAR39.60
XYLOCAINE JELLY 30GMPHAR20.40
XYLOCAINE JELLY 1GMPHAR4.30
CHARCOAL ACIVT 50GM 8OZPHAR27.90
CORTISPORIN OINTMENT 15GMPHAR55.70
CIPROFLOXACIN 500MG TABPHAR11.80
BACITRACIN TOPICALPHAR12.00
IMODIUM 2MG TABPHAR6.00
KETOROLAC TROMTH 15MG INJPHAR51.40
AUGMENTIN 500MG TABPHAR7.00
OTIC SOL/AURALGAN GTTSPHAR4.30
AUGMENTIN 200MG SUSPPHAR850.00
MECLIZINE HCL 25MG TABPHAR4.30
PREDNISONE 5CC ELIXPHAR24.00
PREDNISONE 30 CC ELIXPHAR5.40
RANITIDINE HCL 50MG INJPHAR48.20
LOTENSION 10MG TABPHAR9.00
Naproxen 500mgPHAR6.50
METRONIDAZOLE 500MG TABPHAR5.00
PRILOSEC 20MG TABPHAR11.80
ADENOSINE 6MG INJPHAR16.00
AZITHROMYCIN 250MG TABPHAR8.00
HEP A VACCINEPHAR185.00
LORAZEPAM 1MGPHAR51.40
IBUPROFEN 100MG/ML 5MLPHAR6.00
SUMATRIPTAN SUCC 6MG INJPHAR37.00
IPRATROPIUM BROMIDE UDPHAR9.70
NYSTATIN CREAM 1MPHAR24.70
PEPCID 20MG TABPHAR6.00
BACLOFEN 10MG TABPHAR6.00
GLUCOPHAGE 500MG TABPHAR5.40
MACROBID 100MG TABPHAR140.00
NEURONTIN 300MGPHAR3.00
ASA 81MG TABPHAR6.00
ACYCLOVIR 200MG CAPPHAR18.00
KETAMINE 50MG INJPHAR30.00
XOLAIR 225MG SQPHAR2,925.40
PROPOFOL 10 ML INJPHAR45.00
PNEUMOCOCCAL VAC INJPHAR274.47
PNEUMO 23 VACCINE INJ MEDICAREPHAR0.00
FENTANYL CIT <100MCG INJPHAR42.80
PNEUMO 13 VACC INJ MEDICAREPHAR0.00
AZITHROMYCIN 500MG IVPHAR112.00
VANCOMYCIN 1.5 GMPHAR185.20
LISINOPRIL 5MG TABPHAR4.50
LISINOPRIL 10MG TABPHAR4.30
GEODON 20MGPHAR100.00
HEPATITUS B CHILD INJPHAR238.70
PROLIA 60 MG INJPHAR1,372.90
MEROPENEM 100 MG IVPHAR41.00
PULMICORT/BUDESONIDE NEBPHAR312.50
SPIRIVAPHAR376.70
INFED 50MGPHAR68.50
AMOXICILLIN 875 MGPHAR4.30
CEPHALEXIN 250 MGPHAR15.00
DIVALPROEX SODIUMPHAR4.30
ENALAPRILPHAR5.00
FLUOXETINEPHAR5.00
LEVOFLOXACIN 500 MGPHAR357.40
AMPICILLIN/SULBACTAM 1.5 GMPHAR36.00
AMPICILLIN/SULBACTAM 3 GMPHAR72.00
BUMETANIDE 2.5 MGPHAR20.00
CEFTRIAXONE 1 GMPHAR20.00
CEFTRIAXONE 2 GMPHAR25.00
DOBUTAMINE 250 MGPHAR40.70
FLUMAZENIL .5 MGPHAR13.50
ENALAPRILAT 1.25 MGPHAR25.70
FUROSEMIDE 40 MGPHAR18.00
HEAPRIN FLUSHPHAR26.80
SOLU-CORTEF 250 MGPHAR74.90
SOLU-MEDROL 1 GRAMPHAR30.00
SOLU-MEDROL 500 MGPHAR25.00
PROMETHAZINE 25MGPHAR15.00
ACETAMINOPHEN SUPP 650 MGPHAR7.50
AMOXICILLIN POT CLAV 400 MGPHAR22.50
NASAL SPRAYPHAR8.60
FENTANYL CITRATE 50 MCGPHAR42.80
KETORLAC 30 MG/MLPHAR16.00
EMLA 2.5% CREAMPHAR16.10
ENEMAPHAR11.80
ENEMA MINERAL OILPHAR11.80
ESTROGEN/PREMARINPHAR116.70
eye washPHAR15.00
FENTANYL 250 MCGPHAR42.80
HPV VACCINEPHAR246.10
DTAPPHAR100.00
KETORLAC 60MGPHAR30.00
NOREPINEPHRINE 4 MGPHAR100.00
DICLOXACILLIN 250MGPHAR4.00
ENOXAPARIN 10MG INJPHAR88.00
LUPRON 7.5 MG INJPHAR3,045.30
CLOPIDOGRE/PLAIV 75MG TABPHAR5.00
BENZOCAINE SPRAYPHAR83.00
HYDROXYZIN HCL CAP 25MGPHAR4.10
LANSOPRAZOL/PREVACD 30MGPHAR10.00
HYDROXYZINE 50MG/MLPHAR63.00
AUGMENTIN 875MG TABPHAR9.00
AZITHROMYCIN 250MG Z-PACPHAR31.00
CYANOBALAMIN <=1000 MCG IPHAR29.00
TENECTEPLASE (TNK) 50MGIVPHAR8,173.00
LIDOCAINE LOCAL 1-2CC INJPHAR29.89
TH CLINDAMYCIN 6 PKPHAR12.90
NORCOPHAR5.00
Daptomycin 750 MGPHAR1,040.00
VARICELLA VACC-PT > 19Y/OPHAR210.80
VFC- VARICELLAPHAR0.00
AZITHROMICIN 750MG IVPHAR409.90
VANCOMYCIN INJ 750 MGPHAR308.20
CATHFLO ACTIVASEPHAR280.40
DTAP-IPVPHAR165.00
TRUVADAPHAR101.70
ROCURONIUM 10 MGPHAR6.50
POTASIUM CHLORIDE 10MEG/100MLPHAR36.40
CELESTONE INJ PER 3MGPHAR68.00
POTASIUM CHLORIDE 10MEQ/50MLPHAR36.40
FERRLECIT 12.5 MGPHAR22.00
CEFTAZIDIME 500MGPHAR41.00
HPV-GARDASILPHAR292.00
BEXSEROPHAR350.00
DIHYDROERGOTAMINE 1 MG INJPHAR304.00
PRIMAXIN 500MGPHAR51.00
NITROGLYCERIN SPRAYPHAR16.00
ONDANSETRON ODT 8MGPHAR6.00
Acetylcysteine INJ 6g/30mlPHAR240.00
WARFARIN 5MGPHAR4.00
SILVADENE CREAMPHAR102.50
OMEPRAZOLE 20MG CAPPHAR5.00
MULTI-VITPHAR3.50
RANITIDINE 150MG TABPHAR4.00
ACETAMINOPHEN 500MG TABPHAR4.30
ACETYLCYSTEINE INH SOLPHAR31.95
CALMOSEPTINE OINTMENTPHAR27.60
DOCUSATE SODIUM 250MGPHAR4.00
PROCAINAMIDE 100MG/ML INJPHAR113.00
SODIUM BICARBINATE 8.4%PHAR96.30
VERAPAMIL 2.5MG INJPHAR122.00
GENTAMYCIN 0.3% OINTPHAR38.00
HCTZ 25MGPHAR6.00
HYDROMORPHONE 2MG TABPHAR5.00
HEPARIN 5000U INJPHAR17.00
HEPATITIS A PED/ADOLESCENTPHAR101.00
MENINGOCOCCAL MPSV4PHAR230.00
IPOL Polio VaccinePHAR130.00
Neo/Poly/HC SuspensionPHAR128.00
Neo/Poly/Bac OintmentPHAR49.00
PITOCIN 10UN/MLPHAR20.00
PREVNAR 13PHAR373.00
INSULIN LANTUS PER 5 UNITSPHAR50.00
FLUCONAZOLE 150MGPHAR19.00
TRANEXAMIC ACIDPHAR100.00
FLUORESCEIN SODIUM STRIPPHAR5.00
ARISTADA 1064MGPHAR4,194.33
Paroxetine 20mgPHAR5.00
Oseltamivir 75mgPHAR80.00
PHENYTOIN SUSP 125MGPHAR75.00
AMIODARONE 150MG/3MLPHAR26.00
NALOXONE 0.4MGPHAR80.00
NALOXONE 0.4MLPHAR40.00
Ceftaroline 600mg vialPHAR270.00
LEVOFLOXACIN 500MG TABPHAR5.00
POTASSIUM 20MEQ/15MLPHAR70.00
STERILE WATERPHAR66.00
LILETTA IUD 52MGPHAR1,030.00
CYCLOPENTOLATE HCL OPTH SOL 2%PHAR65.00
Ertapenem 1GMPHAR249.12
NIFEDIPINE CAP 30MGPHAR28.00
DECAVAC INJPHAR125.00
EPINEPHRINE 1MG/MLPHAR33.00
Prednisilone 15mg/5mlPHAR5.00
BACLOFENPHAR4.50
AZITROMYCIN SUS 200MG/5MLPHAR147.70
LOPERAMIDE 2MGPHAR9.00
SKILLED NURSING BED CHGSNF371.54
SNF BED HOLD / LOASNF371.54
SWING BED CHARGESWB674.10
SWB BED HOLD / LOASWB674.10
RIBS UNILAT 2V MIN LXR155.30
RIBS UNILAT 2V+ RXR155.30
RIBS BILAT MIN 3VXR296.85
ABD COMP W/PA CHESTXR296.85
ABDOMEN 1 VWXR155.30
ABDOMEN 2 VWXR296.90
ABDOMEN 3 OR MORE VWXR296.90
ACROMIOCLAVICULAR JTS/BILXR155.30
ELBOW COMP 3V BILATXR310.60
CHEST 1 VWXR155.30
CHEST 2 VWXR155.30
CHEST 3 VWXR155.30
CHEST 4 OR MORE VWXR296.90
ANKLE COMP 3V+ RXR155.30
ANKLE COMP 3V+ LXR155.30
ANKLE LTD 2V LXR155.30
ANKLE LTD 2V RXR155.30
ANKLE LTD 2V BILATXR310.60
BONE AGE STUDIESXR296.85
BONE SURVEY COMP W/LNG BOXR296.85
CLAVICLE COMP LXR155.30
CLAVICLE COMP RXR155.30
ELBOW COMP 3V+ LXR155.30
ELBOW COMP 3V+ RXR155.30
ELBOW LTD 2V LXR155.30
ELBOW LTD 2V RXR155.30
SHOULDERS 2V+ BILATXR310.60
ANKLE COMP 3V+ BILATXR310.60
ELBOW 2VW BILATERALXR310.60
FACIAL BONES COMPL/3V MINXR296.85
FACIAL BONES 1 OR 2 VIEWSXR155.30
ORBITS/4V MINXR296.85
FINGERS 2V+ LXR155.30
FINGERS 2V+ RXR155.30
FEMUR MIN 2 V RTXR155.30
FEMUR MIN 2 V LTXR155.30
FOOT 2V BILATERALXR310.60
FOOT COMP 3V+ RXR155.30
FOOT COMP 3V+ LXR155.30
FOOT 3V BILATERALXR310.60
FOOT 2V RXR155.30
FOOT 2V LXR155.30
UPPER EXTREMITY INFANT RXR296.85
FOREARM 2V RXR155.30
FOREARM 2V LXR155.30
FOREIGN BODY CHILD 1 VXR155.30
FOREARM 2V BILATXR310.60
HAND 3V+ LXR155.30
HAND 3V+ RXR155.30
HAND 3V+ BILATERALXR310.60
HAND 2V LXR296.85
HAND 2V RXR296.85
HAND 2V BILATERALXR593.70
HIPS BILAT W PELVIS 2 VXR296.85
HIPS BILAT W PELVIS 3-4 VXR296.85
HIP UNILAT 2-3 V LTXR155.30
HIP UNILAT 2-3 V RTXR155.30
HUMERUS 2V+ LXR155.30
HUMERUS 2V+ RXR155.30
HIP & PELVIS UNILAT 1 VW LXR155.30
HIP & PELVIS UNILAT 1 VW RXR155.30
KNEE 3V RXR155.30
KNEE 3V LXR155.30
KNEE 3V BILATERALXR310.60
KNEE 1-2V LXR155.30
KNEE 1-2V RXR155.30
KNEE 1-2V BILATERALXR310.60
KNEE/PATELLA 1-2V LXR155.30
MANDIBLE PRTL/1-3V LXR155.30
MANDIBLE PRTL 1-3V RXR155.30
MANDIBLE PRTL 1-3V BILATXR310.60
NASAL BONES/3V MINXR155.30
NECK/SOFT TISSUEXR155.30
CALCANEUS 2V+ LXR155.30
CALCANEUS 2V+ RXR155.30
CALCANEUS 2V BILATXR310.60
SINUSES/PARANASAL 3V MINXR155.30
SINUSES/PARANASAL 1 OR 2VXR155.30
PELVIS AP 1-2VXR296.85
RIBS BILAT W/PA CHEST 4VXR296.85
RIBS UNILAT W/PA CXR 3V LXR296.85
RIBS UNILAT W/PA CXR 3V RXR296.85
SACROILIAC JNTS MIN 3VXR296.85
SI JOINTS LESS THAN 3 VWSXR296.85
SACRUM/COCCYX MIN 2VXR155.30
SCAPULA COMP LXR296.85
SCAPULA COMP RXR296.85
SHOULDER COMP 2V+ LXR155.30
SHOULDER COMP 2V+ RXR155.30
SHOULDER LTD 1V LXR155.30
SHOULDER LTD 1V RXR155.30
SKULL COMP 4VXR296.85
SKULL LTD/1-3VXR296.85
SPINE CERVICAL AP/LATXR155.30
SPINE SINGLE VIEWXR155.30
C-SPINE FLEXION / EXTENSION ONLYXR155.30
SPINE CERVICAL COMP 4V+XR296.85
SPINE CERVICAL W/FLEX EXTXR296.85
SPINE LUMBOSACRAL AP/LATXR296.85
SPINE LUMBOSACRAL BEND ONLYXR286.15
SPINE LUMBOSACRAL W/OBLXR296.85
SPINE, ENTIRE, 1VWXR155.30
SPINE THORACIC AP/LATXR296.85
SPINE THORACIC W/SWIMMERXR296.85
STERNUM MIN 2VXR155.30
TMJ JOINTS BILATERALXR155.30
SPINE THORACOLUMBAR 2VXR155.30
TIBIA/FIBULA 2V RXR155.30
TIBIA/FIBULA 2V LXR155.30
LOWER EXTREM-INFANT LXR155.30
LOWER EXTREM-INFANT RXR155.30
TOES 2V+ LXR155.30
TOES 2V+ RXR155.30
TIBIA/FIBULA 2V BILATXR310.60
TOE 2V BIG DIGIT LXR155.30
TOE 2V BIG DIGIT RXR155.30
TOES 2V+ BILATXR310.60
WRIST COMP 3V+ RXR155.30
WRIST COMP 3V+ LXR155.30
WRIST LTD 2V BILATXR310.60
WRIST LTD 2V RXR155.30
WRIST LTD 2V LXR155.30
WRIST COMP 3V+ BILATERALXR310.60
KNEE COMP 4V LXR296.85
KNEE COMP 4V RXR296.85
KNEE COMP 4V BILATERALXR593.60
KNEE BILAT STANDING APXR155.30
UPPER EXTREMITY INFANT LXR296.85
FINGER 2ND DIGIT LXR155.30
FINGER 3RD DIGIT LXR155.30
FINGER 4TH DIGIT LXR155.30
FINGER 5TH DIGIT LXR155.30
FINGER THUMB LXR155.30
FINGER 2ND DIGIT RXR155.30
FINGER 3RD DIGIT RXR155.30
FINGER 4TH DIGIT RXR155.30
FINGER 5TH DIGIT RXR155.30
FINGER THUMB RXR155.30
RIBS UNILATERAL 2V MIN LT PRO FEEXRMD30.00
RIBS UNILAT 2V MIN RT PRO FEEXRMD30.00
RIBS BILAT MIN 3V PROXRMD37.80
ABD COMP W/PA CHEST PRO FEEXRMD41.40
ABDOMEN 1 VW PRO FEEXRMD30.00
ABDOMEN 2 VW PRO FEEXRMD30.00
ABDOMEN 3 OR MORE VW PRO FEEXRMD35.11
ACROMIOCLAVICULAR JTS/BIL PRO FEEXRMD30.00
ELBOW COMP 3V BILAT PRO FEEXRMD45.00
CHEST 1 VW PRO FEEXRMD30.00
CHEST 2 VW PRO FEEXRMD30.00
CHEST 3 VW PRO FEEXRMD36.00
CHEST 4 OR MORE VW PRO FEEXRMD41.40
ANKLE COMP 3V+ RT PRO FEEXRMD30.00
ANKLE COMP 3V LT PRO FEEXRMD30.00
ANKLE LTD 2V LT PRO FEEXRMD30.00
ANKLE LTD 2V RT PRO FEEXRMD30.00
ANKLE LTD 2V BILAT PRO FEEXRMD60.00
BONE AGE STUDIES PROXRMD30.00
BONE SURVEY SOMP W/LNG BO PRO FEEXRMD69.30
RADIOLOGIST FEE 71010XRMD37.50
POST PROCEDURE PLACEMENT XRAY PRO FEEXRMD0.00
RADIOLOGIST FEE 71020XRMD45.00
CLAVICLE COMP LT PRO FEEXRMD30.00
CLAVICLE COMP RT PRO FEEXRMD30.00
ELBOW COMP 3V+ LT PRO FEEXRMD30.00
ELBOW COMP 3V+ RT PRO FEEXRMD30.00
ELBOW LTD 2V LT PRO FEEXRMD30.00
ELBOW LTD 2V RT PRO FEEXRMD30.00
SHOULDERS 2V+ BILAT PRO FEEXRMD48.60
ANKLE COMP 3V+ BILAT PRO FEEXRMD90.00
ELBOW 2VW BILATERAL PRO FEEXRMD41.40
FACIAL BONES COMPL/3V MIN PRO FEEXRMD34.20
FACIAL BONES 1 OR 2 VIEWS PRO FEEXRMD30.00
ORBITS 4V MIN PROXRMD36.90
FINGERS 2V+ L PRO FEEXRMD30.00
FINGERS 2V+ R PRO FEEXRMD30.00
FEMUR MIN 2 V RT PRO FEEXRMD30.00
FEMUR MIN 2 V LT PRO FEEXRMD30.00
FOOT 2V BILATERAL PRO FEEXRMD79.20
FOOT COMP 3V+ R PRO FEEXRMD30.00
FOOT COMP 3V+ L PRO FEEXRMD30.00
FOOT 3V BILATERAL PRO FEEXRMD86.40
FOOT 2V RT PRO FEEXRMD30.00
FOOT 2V LT PRO FEEXRMD30.00
UPPER EXTREM INFANT R PROXRMD30.00
FOREARM 2V RT PRO FEEXRMD30.00
FOREARM 2V LT PRO FEEXRMD30.00
FOREIGN BODY CHILD 1V PROXRMD30.00
FOREARM 2V BILAT PRO FEEXRMD43.20
HAND 3V+ LT PRO FEEXRMD30.00
HAND 3V+ RT PRO FEEXRMD30.00
HAND 3V+ BILATERAL PRO FEEXRMD45.00
HAND 2V LT PRO FEEXRMD30.00
HAND 2V R PROXRMD30.00
HAND 2V BILATERAL PRO FEEXRMD43.20
HIPS BILAT W PELVIS 2 V PRO FEEXRMD60.00
HIPS BILAT W PELVIS 3-4 V PRO FEEXRMD38.70
HIP UNILAT 2-3 V LT PRO FEEXRMD30.00
HIP UNILAT 2-3 V RT PRO FEEXRMD30.00
HUMERUS 2V+ LT PRO FEEXRMD30.00
HUMERUS 2V+ RT PRO FEEXRMD30.00
HIP & PELVIS UNILAT 1 VW LT PRO FEEXRMD30.00
HIP & PELVIS UNILAT 1 VW RT PRO FEEXRMD30.00
KNEE 3V RT PRO FEEXRMD30.00
KNEE 3V LT PRO FEEXRMD30.00
KNEE 3V BILATERAL PRO FEEXRMD97.20
KNEE/PATELLA 1-2v LTXRMD30.00
KNEE/PATELLA 1-2V RTXRMD30.00
KNEE 1-2V BILATERAL PRO FEEXRMD86.40
KNEE 1-2V L PROXRMD30.00
KNEE/PATELLA 1-2V R PROXRMD30.00
MAMM DX UNILATERAL PRO FEEXRMD110.00
MAMMOGRAPHY SCREEN BILAT W/CAD PRO FEEXRMD116.80
MANDIBLE PRTL 1-3V L PRO FEEXRMD30.00
MANDIBLE PRTL 1-3V R PRO FEEXRMD30.00
MANDIBLE PRTL 1-3V BILAT PRO FEEXRMD46.80
NASAL BONES/3V MIN PRO FEEXRMD30.00
NECK/SOFT TISSUE PRO FEEXRMD30.00
CALCANEUS 2V+ LT PRO FEEXRMD30.00
CALCANEUS 2V+ RT PRO FEEXRMD30.00
CALCANEUS 2V BILAT PRO FEEXRMD82.80
SINUSES/PARANASAL 3V MIN PRO FEEXRMD32.40
SINUSES/PARANASAL 1 OR 2V PRO FEEXRMD30.00
PELVIS AP 1-2V PRO FEEXRMD30.00
RIBS BILAT W/PA CHEST 4VN PRO FEEXRMD42.30
RIBS UNILAT W/PA CXR 3V LT PRO FEEXRMD35.01
RIBS UNILAT W/PA CXR 3V RT PRO FEEXRMD35.01
SACROILIAC JNTS MIN 3V PRO FEEXRMD30.00
SI JOINTS LESS THAN 3 VWS PRO FEEXRMD30.00
SACRUM/COCCYX MIN 2V PRO FEEXRMD30.00
SCAPULA COMP LT PRO FEEXRMD53.50
SCAPULA COMP R PROXRMD30.00
SHOULDERS 2V+ LT PRO FEEXRMD30.00
SHOULDERS 2V+ RT PRO FEEXRMD30.00
SHOULDER LTD 1V LT PRO FEEXRMD30.00
SHOULDER LTD 1V RT PRO FEEXRMD30.00
SKULL COMP 4V PROXRMD45.00
SKULL LTD/1-3V PRO FEEXRMD32.40
SPINE CERVICAL AP/LAT PRO FEEXRMD30.00
SPINE SINGLE VIEW PRO FEEXRMD30.00
C-SPINE FLEXION / EXTENSION ONLY PRO FEEXRMD30.00
SPINE CERVICAL COMP 4V+ PRO FEEXRMD40.50
SPINE CERVICAL W/FLEX EXT PROXRMD46.80
SPINE LUMBOSACRAL AP/LAT PRO FEEXRMD30.00
SPINE LUMBOSACRAL BEND ONLY PRO FEEXRMD103.50
SPINE LUMBOSACRAL W/OBL PRO FEEXRMD40.50
SPINE, ENTIRE, 1VW PRO FEEXRMD34.20
SPINE THORACIC AP/LAT PRO FEEXRMD30.00
SPINE THORACIC W/SWIMMER PRO FEEXRMD30.00
STERNUM MIN 2V PRO FEEXRMD30.00
TMJ JOINTS BILATERAL PRO FEEXRMD31.50
SPINE THORACOLUMBAR 2V PRO FEEXRMD30.00
TIBIA/FIBULA 2V RT PRO FEEXRMD30.00
TIBIA/FIBULA 2V LT PRO FEEXRMD30.00
LOWER EXTREM-INFANT L PRO FEEXRMD30.00
LOWER EXTREM-INFANT R PRO FEEXRMD30.00
TOES 2V+ L PRO FEEXRMD30.00
TOES 2V+ R PRO FEEXRMD30.00
TIBIA/FIBULA 2 V BILAT PRO FEEXRMD86.40
TOE 2V BIG DIGIT L PRO FEEXRMD30.00
TOE 2V BIG DIGIT R PRO FEEXRMD30.00
TOES 2V+ BILAT PRO FEEXRMD60.00
WRIST COMP 3V+ RT PRO FEEXRMD30.00
WRIST COMP 3V+ LT PRO FEEXRMD30.00
WRIST LTD 2V BILAT PRO FEEXRMD45.00
WRIST LTD 2V R PROXRMD30.00
WRIST LTD 2V L PRO FEEXRMD30.00
WRIST COMP 3V+ BILAT PRO FEEXRMD45.00
KNEE COMP 4V LT PRO FEEXRMD30.00
KNEE COMP 4V RT PRO FEEXRMD30.00
KNEE COMP 4V BILATERAL PRO FEEXRMD60.00
KNEE BILAT STANDING AP PRO FEEXRMD60.00
UPPER EXTREM INFANT L PROXRMD30.00
FINGER 2ND DIGIT L PRO FEEXRMD30.00
FINGER 3RD DIGIT L PRO FEEXRMD30.00
FINGER 4TH DIGIT L PRO FEEXRMD30.00
FINGER 5TH DIGIT L PRO FEEXRMD30.00
FINGER THUMB L PRO FEEXRMD30.00
FINGER 2ND DIGIT R PRO FEEXRMD30.00
FINGER 3RD DIGIT R PRO FEEXRMD30.00
FINGER 4TH DIGIT R PRO FEEXRMD30.00
FINGER 5TH DIGIT R PRO FEEXRMD30.00
FINGER THUMB R PRO FEEXRMD30.00