PMC PRICING AS OF 3-27-2020.csv - Prowers Medical Center

DESCRIPTION PRICE WIGGLE PADS M, L, XL PADS REPL OPTIFLO $36.00 WIGGLE PADS XS, S REPLACEMENTOPTIFLOW $36.00 XCEL BLDLS TROCAR 100MM $165.00#3 GLIDESCOPE DISPOSAL BLADE $96.00#4 GLIDESCOPE DISPOSAL BLADE $167.00...JOINT INJ/ASP W/FLUORO GUIDANCE $722.00..TEST HERPES CULTURE & TYPING 008250 $116.00.82397 CHARGE $273.00.ALLERGEN BASIC FOOD $14.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.ASH FIBROSURE $81.00.AUTO IMMUNE PROFILE $31.00.AUTO IMMUNE PROFILE $31.00.BB FFP THAWING FEE $35.00.BB IRRADIATION FEE $186.00.BB POOLING FEE $75.00.BETA-2 TRANSFERRIN $311.00.BLOOD SMEAR REVIEW $60.00.CA 125 $150.00.CALCIUM /CREAT RATIO $40.00.CANCER ANTIGEN 15-3 $150.00.CBC W/AUTO DIFF $130.00.CBC W/MAN DIF $151.00.CHARGE $82.00.CHLAMYDIA CHARGE $178.00.CHLAMYDIA CHARGE $178.00.CHLAMYDIA CHARGE 2 $178.00.CLL PROFILE FISH $333.00.CLL PROFILE FISH $333.00.CLL PROFILE FISH $333.00.COOMBS, DIRECT NB $72.00.CRP $102.00.CULTURE ACID FAST $109.00.CYTOLOGY BODY FLUID $279.00.DIFF $60.00.FSH & LH $118.00.HANTA VIRUS ANTIBODIES $474.00.HCV FIBROSURE $50.00.HCV FIBROSURE $50.00

.HCV FIBROSURE $50.00



.HCV QUANTASURE $929.00

.HEP C VIRUS FIBROSURE $52.00






.HEP CHARGE $39.00

.HEP CHARGE $37.00

.HEP CHARGE $30.00

.HEP CHARGE $30.00

.HEP CHARGE $30.00

.HEP CHARGE $30.00

.HEPATITIS B e ANTIGEN $103.00

.HEPATITIS B VIRUS DNA REAL TIME $681.00

.HEPATITIS PROFILE VIII $30.00





.HERPES SIMPLEX VIRUS 1/2 IGG $219.00

.HERPES SIMPLEX VIRUS 2 IGM $186.00

.HERPES SIMPLEX VIRUS TYPES 1/2 DNA PCR $158.00

.HF A1C 2017 $14.00

.HF CHEM, CBC, A1C 2019 $25.00

.HF FEMALE $20.00

.HF MALE $20.00

.HF TSH $15.00

.HUMAN IMMUNODEFICIENCY VIRUS $94.00

.IBD PROFILE $54.00

.IBD PROFILE $54.00

.INHERITEST CARRIER SCREEN $161.00

.INHERITEST CARRIER SCREEN $161.00

.KIDNEY STONE RISK ANALYSIS $18.00














.KIDNEY STONE TEST $20.00













.LUPUS ANTICOAGULANT/CARDIOLIPIN $104.00






.LUPUS ANTICOAGULAT/CARDIOLIPIN $104.00

.MACROPROLACTIN $121.00

.MATERNIT GENOME $75.00

.MATERNIT GENOME $1,385.00

.MUTATION $420.00

.MUTATION ANALYSIS $420.00

.MYCOPLASMA CHARGE $50.00

.NASH FIBROSURE $82.00








.OCCULT BLOOD STOOL X3 DIAGNOSTIC $71.00

.OCCULT BLOOD STOOL X3 SCREENING $71.00

.PAP & HPV REFLEX 16 TO 18 $132.00

.PAP W/CT/NG/HR/HPV REFLEX 16 & 18 $69.00



.PAP W/CT/NG/TV/HSV/HR/HPV REFLEX16 & 18 $324.00





.PAP W/HPV $125.00

.PATH-BONE MARROW PATH EXAM $272.00

.PNEUMONITIS PROFILE $67.00

.PNEUMONITIS PROFILE $67.00

.PNEUMONITIS PROFILE 3 $67.00

.PRE EMPLOYMENT SENDOUT $23.00



.PROGESTERONE $161.00

.PROTEIN ELEC SERUM $33.00

.PROTEIN ELECTROPHORESIS $35.00

.PROTEIN ELECTROPHORESIS SERUM $39.00

.PROTEIN ELECTROPHORESIS INTERPRETATION $39.00

.PTH-DO NOT USE $62.00

.REPRODUCTIVE HEALTH THROMBOPHILIA PROFI $231.00














.RH-NB $87.00

.RSV $87.00

.STREP A RAPID SCREEN $81.00

.SYNTHETIC DRUG PROFILE $245.00

.T3-TOTAL $75.00

.THYROGLOBULIN $61.00

.THYROGLOBULIN COMP $84.00

.THYROID PEROXIDASE ANTIBODY $95.00

.THYROID PROFILE W/ TSH $28.00

.THYROID PROFILE W/ TSH $28.00

.TORCH ANTIBODIES $28.00




.TOTAL PROTEIN $73.00

.TOTAL T4 $75.00???EPIDURAL NEEDLE 18GA 31/2 $37.000.45% SODIUM CHLORIDE 1000ML $19.00

0.9% HOSPIRA SODIUM CHLORIDE: 500ML $38.000.9% HOSPIRA SODIUM CHLORIDE: 250ML $38.000.9% SODIUM CHLORIDE 100ML $20.000.9% SODIUM CHLORIDE AVIVA- 500ML $32.000.9% SODIUM CHLORIDE PLUS BAG 100ML $25.000.9% SODIUM CHLORIDE: 1000ML $18.000.9% SODIUM CHLORIDE: 250ML $17.000.9% SODIUM CHLORIDE: 500ML $12.001.1 K WIRE $180.001.7 CANNULATED DRILL BIT $837.001/3 TUBULAR - PLATE 7 HOLE 81MM $496.001/3 TUBULAR - PLATE 8 HOLE 93MM $459.001/3 TUBULAR - PLATE SIX HOLE 69MM $513.0010 MM INZII RETRIEVAL BAG PK/10 $413.0011-DEOXYCORTISOL $142.0011mm.TROCARS(ETHICON)B11LT $278.0012mm.BLUNT TIP TROCAR(ETHICON)H12LP BX/6 $323.0012mm.ENDOPATH XCEL TROCAR BLADELESS $260.0017-ALPHA HYDROXYPROGESTERONE $297.0017-HYDROXYCORTICOSTEROIDS, URINE $78.0017-KETOGENIC STEROIDS; 24 HOUR URINE $116.0017-KETOSTEROIDS; 24 HOUR URINE $159.0017-OH PROGESTERONE SERUM $303.002.4 NEUTRAL ASSEMBLY IFS IMPLANT $1,995.002.5 GUIDE WIRE $180.002.8MM GUIDE WIRE, 350MM $252.0020 SUPER KNEE SPLINT LG $53.0020 SUPER KNEE SPLINT MED $53.0020 SUPER KNEE SPLINT SM $118.0020 SUPER KNEE SPLINT XL $53.0020550 CL INJECT; SINGLE TENDON SHEATH $128.0020551 CL INJECT SINGLE TENDON ORIGIN/INS $95.0020552 CL INJ SINGLE/MULTIPLE TRIGG 1-2 $450.0020553 CL INJ SINGLE/ MULTI TRIG 3 OR MOR $116.0020600 CL ARTHROCENTESIS SMALL JOINT BURS $130.0020605 CL ARTHROCENTESIS INTERM JOINT BUR $108.0020610 CL INJECTION MAJOR JOINT $63.0020615 CL ASPIRATION/INJ TRMNT BONE CYST $403.0020670 CL REMOVAL OF IMPLANT SUPERFICIAL $943.0020680 CL REMOVAL OF IMPLANT DEEP $613.0024FR REPL G-TUBE, STRAIGHT $275.003% SODIUM CHLORIDE FOR INHALATION 4ML $1.003.5 CORTEX SELF-TAPPING SCREW 22MM $143.003.5 MM CORTEX SCREW, SELF TAPPING $143.003.5 MM CORTEX SCREW,14MM SELF TAPING $143.003.5 MM CORTEX SCREW,20MM SELF TAPING $135.003.5 RESECTOR FULL RADIUS BX/6 $247.00

3.5LOCKING SCREW/W STARDRIVE RECESS 45MM $451.003.5MM CORTEX SCREW 18MM SELF TAPING $144.003.5MM CORTEX SCREW, SELF TAPPING $79.003.5MM CORTEX SCREW, SELF TAPPING 20MM $143.003/4 DISP.45cm CURVED SCISSORS $410.003/4 DISP.45cm CURVED SCISSORS BX/10 $405.003D RENDER W/O POSTPROCESS $364.004.0 CANCELLOUS SCREW 14MM $119.004.0 CANCELLOUS SCREW FT 10MM $119.004.0 CANCELLOUS SCREW FT 12MM $119.004.0 CANCELLOUS SCREW PT 12MM $77.004.0 CANCELLOUS SCREW PT 35MM $77.004.2 RESECTOR FULL RADIUS BX/6 $247.005 FR KRATON H/S CATH SET $175.005 X 30MM LOCK SCREW $513.005% DEXTROSE INJECTION 500ML $19.005%DEXTROSE- EXEL CONTAINER $15.415.5cm BILATERAL/ W/ AIRWAY (RAPID RHINO) $374.005.5cm RAPID -PAC (RAPID RHINO ANTERIOR) $171.005.5cm RAPID RHINO ANTERIOR $206.255.5cm.RAPID RHINO ANTERIOR BILATERAL $253.0050-S RF PROBE 3.5mm $462.0059430 ROUTINE POSTPARTUM FOLLOWUP $307.005-HIAA 24 HOUR URINE $113.005MM X 100MM TROCAR (PROGRESSIVE) $164.005MM X 70MM PALM BLUNT TROCAR $129.005mm.TROCAR(ETHICON)B5LT BX/6 $200.005mm.x150 ENDOPATH XCEL TROCAR $205.006.5MM CANNULATED SCREW 75MM $666.006.5mm CANNULATED SCREW 85MM $666.006.5mm CANNULATED SCREW 90MM $666.007 STANDARD FIELD STEREOSCOPIC PHOTOS WIT $1.007.5cm ANT/ POSTERIOR (RAPID RHINO) $186.007.5cm ANT/POSTERIOR BILATERAL (RAPID RHI $374.007.5cm RAPID RHINO ANTERIOR /POSTERIOR $253.007MM WASHER $168.0090460 CL VACCINE ADMIN FEE 1ST 0-18 $23.0090461 CL VACCINE ADMIN FEE ADDTL 0-18YRS $23.0090471 CL VACCINE ADMIN 1ST 19YRS+ $21.6890472 CL VACCINE ADMIN FEE ADDTL 19YRS+ $21.6890473 CL IMMUNE ADMIN ORAL/NASAL $12.0090474 CL IMMUN ADMIN ORAL/NASAL ADDL $12.0094760 CL NONINVASIVE EAR OR PULSE OX $79.0095115 CL ALLERGY ONE INJECTION $28.0095117 CL ALLERGY 2 OR MORE INJECTION $46.0095972 CL ELEC ANYS IMPLT NPGT W PRGRM $300.0096372 CL THER PROPH DIAG INJ SC IM $23.00

97597 CL RMVL DEVITAL TIS 20 CM/< $145.0098925 CL OSTEOPATH MANJ 1-2 REGIONS $61.0098926 CL OSTEOPATH MANJ 3-4 REGIONS $92.0098927 CL OSTEOPATH MANJ 5-6 REGIONS $121.0098928 CL OSTEOPATH MANJ 7-8 REGIONS $151.0098929 CL OSTEOPATH MANJ 9-10 REGIONS $182.0098940 CL CHIROPRACT MANJ 1-2 REGIONS $58.0098941 CL CHIROPRACT MANJ 3-4 REGIONS $89.0098942 CL CHIROPRACT MANJ 5 REGIONS $119.0099201 CL NEW PT OFC/OUTPT PROB/PROB/STFW $137.0099202 CL NET PT OFC/OUTPT EXP/EXP/STFWD $162.0099203 CL NEW PT OFC/OUTPT DET/DET/LOW $220.0099204 CL NEW PT OFC/OUTPT COMP/COMP/MOD $268.0099205 CL NEW PT OFC/OUTPT COMP/COMP/HIGH $300.0099211 CL OFFICE OR OTHER OUTPATIENT VISI $53.0099212 CL ESTAB OFC.OUTPT PROB/PROB/STFWD $105.0099213 CL ESTAB IFC/OUTPT EXP/EXP/LOW $131.0099214 CL ESTAB OFC/OUTPT DET/DET/MOD $188.0099215 CL OFC/OUTPT COMP/COMP/HIGH $237.0099241 CL OFFICE CONSULT PROB/PROB/STFWD $143.0099242 CL OFFICE CONSULT EXP/EXP/STFWD $170.0099243 CL OFFICE CONSULT DET/DET/LOW $229.0099244 CL OFFICE CONSULT COMP/COMP/HIGH $280.0099245 CL OFFICE CONSULT COMP/COMP/HIGH $480.0099347 CL HOME VISIT PROB/PROB/STFWD $217.0099348 CL HOME VISIT EXP/EXP/LOW $268.0099349 CL HOME VISIT DET/DET/MOD $331.0099350 CL HOME VISIT COMP/COMP/MOD-HIGH $431.0099381 CL NEW PT COMP/PREV VISIT <1YR $141.0099382 CL NEW PT COMP/PREV VISIT 1-4YR $141.0099383 CL NEW PT COMP/PREV VISIT 5-11YR $129.0099384 CL NEW PT COMP/PREV VISIT 12-17YR $170.0099385 CL NEW PT COMP/PREV VISIT 18-39YR $226.0099386 CL NEW PT INITIA COMP/PREV 40-64YR $242.0099387 CL NEW PT COMP/PREV VISIT 65+YR $284.0099391 CL ESTAB COMP/PREV <1YR $115.0099392 CL ESTAB COMP/PREV 1-4YR $115.0099393 CL ESTAB COMP/PREV 5-11YR $129.0099394 CL ESTAB COMP/PREV 12-17YR $157.0099395 CL ESTAB COMP/PREV 18-39YR $170.0099396 CL ESTAB COMP/PREV 40-64YR $242.0099397 CL ESTAB COMP/PREV 65+YR $222.0099455 CL WORK RELATED OR MEDICAL DISABIL $216.0099456 CL WORK RELATED OR MEDICAL DISABIL $216.00ABBOCATH 14 GA $18.00ABBOCATH 18 X 1 1/4 $21.00ABBOCATH 20 $18.00

ABBOCATH 22 GA 1 $12.00ABBPCATJ 16 X 1 14 $18.00ABD HYSTERECTOMY W/COLPO $2,079.00ABD HYSTERECTOMY W/COLPO $2,079.00ABDOMEN W/MULTIPLE VIEWS $401.00ABDOMINAL PARACENTESIS (DIAGNOSTIC OR TH $445.00ABDOMINAL PARACENTESIS (DIAGNOSTIC OR TH $557.00ABDOMINAL PARACENTESIS W/IMAGING GUIDANC $557.00ABDOMINAL PARACENTESIS W/IMAGING GUIDANC $557.00ABDOMINAL PARACENTESIS W/OUT IMAGING $445.00ABDOMINAL PARACENTESIS W/OUT IMAGING $445.00ABLASION WAND- STRYKER $490.00ABRAXANE 100MG VIAL (PACLITAXEL) $2,695.00ABSORBATACK 5MM BX/6 $940.00ACADVL-VLCAD SEQUENCING $2,006.00ACAPELLA VIBRARTORY PEP SYSTEM CHOICE $218.00ACCESS PORT NEEDLE 20GX51mm(2 ) $21.00ACCESSORY KIT- INTERSTIM $625.00ACCOLATE (ZAFIRLUKAST) TABLET 20MG $6.00ACCUNEB (ALBUTEROL) 0.21 MG-3ML UD $10.00ACCUNEB (ALBUTEROL) 0.42/3 ML UD $10.00ACCUPASS DIR CRESCENT XL-ORTHO $1,330.00ACE 4 WRAP ELAST BANDAGE STERILE CS/20 $6.00ACE 6 WRAP ELAST BANDAGE STERILE CS/20 $34.00ACE WRAP 2 $9.00ACE WRAP 3 $7.00ACE WRAP 4 $6.00ACE WRAP 6 $8.00ACEBUTOLOL 200 MG CAPSULE (SECTRAL) $11.00ACEON (PERINDORPRIL ERIMUNE) 4MG TABLET $7.00ACETABULAR LINER 36MM-ORTHO $3,280.00ACETABULAR LINER-ORTHO $3,032.00ACETADOTE IV 6G/30ML (ACETYLCYSTEINE) $834.00ACETAMINOPHEN / SALICYLATES $139.00ACETAMINOPHEN 120 MG RECT SUPP (TYLENOL) $6.00ACETAMINOPHEN 325 MG RECT SUPP (TYLENOL) $7.00ACETAMINOPHEN 325 MG TAB (TYLENOL) $1.00ACETAMINOPHEN 500 MG TABLET $1.00ACETAMINOPHEN 500 MG/15ML (TYLENOL) $1.00ACETAMINOPHEN 650 MG RECT SUPP (TYLENOL) $7.00ACETAMINOPHEN 80 MG TABLET (TYLENOL JR) $4.00ACETAMINOPHEN ELIX 160MG/5ML (TYLENOL) $1.00ACETAMINOPHEN WITH CODEINE 300/30MG TAB $11.00ACETAMINOPHEN/CODEINE ELIX 120/12MG/5ML $12.00ACETAZOLAMIDE 250 MG TABLET (DIAMOX) $9.00ACETAZOLAMIDE 500 MG VIAL (DIAMOX) $168.00ACETIC ACID (GLACIAL ACETIC ACID) 99% SO $10.00

ACETIC ACID IRR SOLN 0.25% 1,000 ML $72.00ACETIC ACID OTIC SOLN 2% 15 ML $20.00ACETONE (ACETONE CP) 4 OZ. BOTTLE $17.00ACETONE SERUM $108.00ACETONE URINE $90.00ACETYLCHOLINE RECEPTOR BLOCKING AB $172.00ACETYLCHOLINE RECEPTOR MODULATING AB $172.00ACETYLCYSTEINE 20% 200MG/ML 10ML $70.00ACETYLCYSTEINE 20% 200MG/ML 4ML $18.00ACID FAST SMEAR & CULTURE W/REFLEX $210.00ACID PHOSPHATASE $60.00ACIPHEX (RABEPRAZOLE) 20MG TABLET $21.00ACP PLATE BOARD 219MM $428.00ACP PLATE BOARD 255MM $541.00ACRYSOF IOL MA60AC POSTERIOR INTRAOCULAR $355.00ACRYSOF IQ TORIC IOL (ASTIGMATISM)SN6AT3 $481.00ACRYSOF TORIC IOL (ASTIGMATISM)SN60T3 $481.00ACTH $159.00ACTH (CORTICOTROPIN) 40 UNITS $119.00ACTHIB $42.74ACTHIB $42.74ACTHIB (HAEMOPH B POLYSAC CONJ-TET)10MCG $45.00ACTHREL 100MCG (CORTICORELIN OVINE) $2,558.00ACTIQ (FENTANYL) 200MCG LOLLIPOP $81.00ACTIVASE (ALTEPLASE) 100MG INJ $16,125.00ACTIVASE (ALTEPLASE) 2MG/2ML CATH FLUSH $478.00ACTIVASE 50MG INJ 10ML/10MG SYRINGE $2,373.00ACTIVATED PROT.C RESISTANCE $192.00ACTONEL (RISEDRONATE) 35MG WEEKLY TABLET $87.00ACUTE BURN TRAY $80.00ACUTRAK 2 BONE SCREW 34.0MM $1,428.00ACUTRAK 2 DRILL $915.00ACUTRAK 2 DRILL LONG $1,016.00ACYCLOVIR 200 MG CAPSULE (ZOVIRAX) $7.00ACYCLOVIR 500 MG VIAL (ZOVIRAX) $51.00ACYCLOVIR SUSP 200MG/5ML 2 OZ (ZOVIRAX) $63.00ACYLCARNITINE PROFILE QUANT - PLASMA $385.00ADACEL $53.15ADACEL $59.00ADACEL $59.00ADACEL (DIPHT/PERTUSS(ACELL)/TET) VACCIN $55.00ADALIMUMAB AND ANTI-ADALIMUMAB $459.00ADAPT BARRIER RINGS $12.00ADAPTER NEBULIZER $26.00ADAPTER WITH HOSE NEBULIZER $57.00ADDITIONAL MARKER EACH BY FLOW $85.00ADENOSINE 6MG/2ML VIAL (ADENOCARD) $41.00

ADENOVIRUS $102.00ADENOVIRUS DIRECT DETECTION $92.00ADHESIVE SPRAY $69.00ADMIN FLU VACCINE $17.00ADMIN PNEUMONIA VACCINE $17.00ADMINISTRATION OF HEPATITIS B VACCINE $14.00ADMIXTURE FEE * C H E M O T H E R A P Y* $21.00ADMIXTURE FEE * COMPOUNDED L V P * $24.00ADMIXTURE FEE * L V P NONCOMPOUNDED*** $24.00ADMIXTURE FEE * T P N * *T P N * $44.00ADSON SM $16.00ADULT CANNULA HIGH FLOW GREEN $13.00ADULT CANNULA HIGH FLOW TUBING $22.00ADULT CIRCUIT SINGLE LIMB $127.00ADULT MULTIVENT MASK $8.00ADULT TRACK MASK $12.00ADVAIR(FLUTICASONE/SALMETROL) 100/50 DIS $159.00ADVAIR(FLUTICASONE/SALMETROL) 250/50 DIS $159.00ADVAIR(FLUTICASONE/SALMETROL) 500/50 DIS $256.00AEM 3/4 DISP.CRVD 35cm SHORT SCISSORS $404.00AERO CHAMBER PED MASK $85.00AERO ECLIPSE $38.00AEROCHAMBER (DRUG DELIVERY SYSTEM) INH $94.00AEROCHAMBER (SPACE DELIV. SYSTEM) KIT $94.00AEROCHAMBER W/FLOW SIGNAL $37.00AEROCHAMBER WITH FLOW SIGNAL $61.00AEROCHAMBER WITH FLOW SIGNAL $61.00AEROSEL EFFUSION BAG $9.00AEROSOL CONT. 1ST HOUR $159.00AEROSOL CONT. ADDL. HOUR $76.00AEROSOL TREATMENT $73.00AEROSOL TREATMENT INITIAL (NMT) $73.00AFB ID BY DNA PROBE $241.00AFP CHARGE $145.00AFP SERUM SPINA BIFIDA $112.00AFP TETRA $114.00AFP TUMOR MARKER $114.00AFP WITH AFP-L3% $397.00AGGRASTAT (TIROFIF HCL/NACL 0.9-500 ML $1,653.00AGGRENOX (DIPYRIDAMOLE/ASPIRIN) 200/25 $38.00AHTO SUCT IRR TUBE SET $229.00AIR ANKLE SPLINT ADULT $134.00AIR GEL SPLINT $55.00AIRLOCK DRILL BIT 2.0 $506.00AIRWAY LMA #1 $46.00AIRWAY LMA #2 $46.00AIRWAY LMA #3 $55.00

AIRWAY LMA #4 $76.00AIRWAY LMA #5 $75.00AIRWAY NASOPHARYGEAL 14FR. $13.00AIRWAY NASOPHARYGEAL 18FR. $13.00AK-SPORE-HC OPTH OINT(POLY/NEO/HC)O.O. $22.00ALBUMIN $88.00ALBUMIN 25% (HUMAN ALBUMIN) IV 50 ML $605.00ALBUMIN 5% (HUMAN ALBUMIN) IV 50 ML $366.00ALBUMIN BODY FLUID $94.00ALBUTEROL E.R. 4 MG TABLET (PROVENTIL) $6.00ALBUTEROL 0.083% 2.5MG/3ML INH SOLN 3ML $6.00ALBUTEROL 0.5% INH SOLN (VENTOLIN) $83.00ALBUTEROL CONC 0.5% 5MG/ML BOTTLE 20ML $32.00ALBUTEROL CONCENTRATED 0.5% 2.5MG/0.5ML $7.00ALBUTEROL INHALER 17 GM (PROVENTIL) $85.00ALBUTEROL SYRUP 2MG/5ML 2 OZ $5.00ALBUTEROL/IPRATROPIUM 2.5/0.5MG (DUONEB) $8.00ALCOHOL $123.00ALCOHOL DEHYDRATED (ETHYL ALCOLHOL) 98% $44.00ALCOHOL ISOPROPYL 1 PT $6.00ALCOHOL ISOPROPYL(ISOPROPYLALC) 1 GAL $40.00ALCON SHORT CUT $156.00ALCON TORIC $481.00ALCON TORIC (ASTIGMATISM) $481.00ALCON TORIC (PRESBYOPIA) $481.00ALDOLASE $104.00ALDOSTERONE $113.00ALDOSTERONE 24 HOUR URINE $113.00ALENDRONATE WEEKLY 35MG TABLET (FOSAMAX) $33.00ALEXIS C SECTION- LG $514.00ALEXIS C SECTION- LG $402.00ALEXIS O WOUND PROTECTOR-MD $370.00ALEXIS O WOUND PROTECTOR-MD $286.00ALEXIS O WOUND PROTECTOR-SM $370.00ALEXIS O WOUND PROTECTOR-SM $286.00ALEXIS PROTECTOR-BARNEY-ORTHO $530.00ALFUZOSIN ER 10MG (UROXATROL) TABLET $31.00ALIMTA 100MG VIAL (PEMETREXED) $1,300.00ALIMTA 500MG VIAL (PEMETREXED) $5,642.00ALKA SELTZER (ASPIRIN/SODIUM BICAR) TAB $4.00ALKALINE PHOSPHATASE ISOENYMES $86.00ALL ALCON ACRYLIC IOL'S $61.00ALLERGEN BASIC FOOD $14.00ALLERGEN PANEL FOOD-BERRY $63.00ALLERGEN PANEL FOOD-FRUIT $65.00ALLERGEN PROFILE PERENNIAL ALLERGEN $223.00ALLERGEN PROFILE PERENNIAL ALLERGEN $12.00

ALLERGEN PROFILE ZONE 11 $12.00ALLERGEN PROFILE ZONE 11 - INTERFACED $12.00ALLERGEN PROFILE ZONE II $12.00ALLERGENS ZONE II $63.00ALLOPURINOL 100 MG TABLET (ZYLOPRIM) $6.00ALMOTRIPTAN 12.5MG TABLET (AXERT) $92.00ALP $86.00ALP BONE SPECIFIC $86.00ALPHA 1 ANTITRYPSIN $91.00ALPHA 2 ANTIPLASMIN $179.00ALPHA 2 MACROGOBULIN QUANT $99.00ALPHA PGH $205.00ALPHA SUBUNIT FREE $176.00ALPRAZolam 0.25MG TABLET (XANAX) $11.00ALPRAZOLAM 1MG TABLET (XANAX) $11.00ALPRAZOLAM 1MG/1ML INTENSOL ORAL SOLN $138.00ALT $81.00ALT REV HUMERAL STEM- ORTHO $10,171.00ALUMINUM $75.00ALUMINUM HYDROXIDE 4 OZ BOT (AMPHOGEL) $10.00AM ACP PLATE 5 HOLE 48MM $243.00AMANTADINE 100 MG CAPSULE (SYMMETREL) $7.00AMANTADINE 50MG/5ML SYRUP (SYMMETREL) $8.00AMBIENT SUPER TURBOVAC-ORTHO $815.00AMERGE (NAPATRIPTAN) 2.5 MG TABLET $66.00AMIDATE 2MG/ML 10ML VIAL (ETOMIDATE) $82.00AMIKACIN PEAK $76.00AMIKACIN TROUGH $76.00AMILORIDE HCL 5 MG TABLET (MIDAMOR) $13.00AMINO ACID PROFILE QUANT PLASMA 700068 $388.00AMINO ACID SCREEN RANDOM URINE $380.00AMINOCAPROLIC ACID 5 GM VIAL $57.00AMINOPHYLLIN 500MG $17.00AMINOSYN 7% 500 ML $116.00AMINOSYN 7.0 500 ML PLAIN $60.00AMINOSYN 7.0% KIT $34.00AMIODARONE 150MG VIAL (CORDARONE) $31.00AMIODARONE 200 MG TABLET (CORDARONE) $6.00AMITIZA (LUBIPROSTONE) 24MCG CAPSULE $15.00AMITRIPTYLINE $99.00AMITRIPTYLINE 10MG TABLET (ELAVIL) $6.00AMITRIPTYLINE 25 MG TABLET (ELAVIL) $6.00AMLODI/BENAZP 5/10MG CAPSULE (LOTREL) $10.00AMLODI/BENAZP 5/20 MG CAPSULE (LOTREL) $10.00AMLODIPINE BESYLATE 5MG TABLET (NORVASC) $6.00AMLODIPINE/BENAZP 10/20 CAPSULE (LOTREL) $15.00AMMONIA $113.00

AMMONIA INHALANT $6.00AMNICOT $22.00AMNIHOOK $13.00AMNIOCENTESIS $327.00AMNIOCENTESIS DIAGNOSTIC $311.00AMNIOCENTESIS DIAGNOSTIC $311.00AMNIOCENTESIS; DIAGNOSTIC $327.00AMNIOTIC MEMBRANNE $801.00AMNISURE $225.00AMNISURE ROM TEST $225.00AMO TECNIS ZA9003 IOL $61.00AMO TECNIS ZCB00 IOL $61.00AMOX/CLAV 600/42.9MG/5ML (AUGMENTIN ES) $25.00AMOXAPINE 50 MG TABLET $8.00AMOXIC/POT CLAV 400 MG/5ML (AUGMENTIN) $112.00AMOXICILLIN 250 MG CAPSULE $4.00AMOXICILLIN 250MG CHEWABLE TABLET $5.00AMOXICILLIN 400MG/5ML ORAL SUSPENSION $39.00AMOXICILLIN 400MG/5ML SUSPENSION $11.00AMOXICILLIN 500 MG CAPSULE $6.00AMOXICILLIN 500MG/CLAVULANATE 125MG $6.00AMOXICILLIN SUSP 250MG/5ML $10.00AMOXICILLIN/CLAVULAN 250MG (AUGMENTIN) $11.00AMOXICILLIN/CLAVULAN 250MG/5ML (AUGMENT) $121.00AMOXICILLIN/CLAVULAN 875 MG(AUGMENTIN) $9.00AMPHOTERICIN B CONVENTIONAL 50MG V $116.00AMPICILLIN 1 GM VIAL $46.00AMPICILLIN 125 MG/5ML SUSPENSION $16.00AMPICILLIN 2 GM VIAL (OMNIPEN) $45.00AMPICILLIN 250MG VIAL $34.00AMPICILLIN 250MG/5ML SUSPENSION $21.00AMPICILLIN 500 MG CAPSULE $4.00AMPICILLIN 500MG VIAL $31.00AMPICILLIN/SULBACTAM 1.5GM (UNASYN) $52.00AMPICILLIN/SULBACTAM 3 GM VIAL (UNASYN) $79.00AMPUTATION $1,048.00AMPUTATION ABOVE THE KNEE $2,032.00AMPUTATION LEG;TIBIA/ FIBULA $1,377.00AMPUTATION LEG;TIBIA/FIBU $1,377.00AMPUTATION OF THE TOE $797.00AMPUTATION OF TOE $847.00AMPUTATION THRU METATARSAL $1,158.00AMPUTATION, FINGER OR THUMB, PRIMARY OR $1,454.00AMPUTATION, LEG, THROUGH TIBIA AND FIBUL $1,446.00AMPUTATION, METATARSAL, WITH TOE, SINGLE $1,048.00AMPUTATION, TOE; INTERPHALANGEAL JOINT $944.00AMPUTE FNG/THUMB W/DIRECT CLOSURE $1,454.00

AMPUTE FNG/THUMB W/DIRECT CLOSURE $1,454.00AMPUTE THIGH W/SECONDARY CLOSURE $1,304.00AMPUTE THIGH W/SECONDARY CLOSURE $1,304.00AMPUTE THIGH;REAMPUTATION $1,886.00AMPUTE THIGH;REAMPUTATION $1,886.00AMPUTE THIGH;SECOND CLOSE;SCAR REVISION $1,515.00AMPUTE THIGH;SECOND CLOSE;SCAR REVISION $1,515.00AMVISC PLUS 0.5CC $342.00AMYLASE $94.00ANA $123.00ANA BY IFA, REFLEX 11-BIOMARKER $256.00ANA COMP. PLUS $105.00ANA WITH REFLEX $89.00ANAEROBIC ID 182345 $159.00ANAL DILATION EXAM UNDER ANESTHESIA $570.00ANAL DILATION EXAM UNDER ANESTHESIA $425.00ANAL FISSURE TREATMENT $367.00ANAL FISTULOTOMY $1,195.00ANAL/URINARY MUSCLE STUDY $175.00ANAL/URINARY MUSCLE STUDY $175.00ANALYZE NEUROSTIM COMPLEX $300.00ANALYZE NEUROSTIM COMPLEX $300.00ANALYZE NEUROSTIM COMPLEX $300.00ANAYZE 20-25 CELLS $304.00ANCA $25.00ANCA $25.00ANCA ANTIBODIES $28.00ANCHOR 4.5 INSITE FT TI $665.00ANCHOR PITON (EXPLANT) 3.5 $895.00ANCHORING DEVICE PIC $33.00ANCHOR-SUTURE- MORPHIX $1,675.00ANDROSTENEDIONE $164.00ANECTINE FLO PACK $9.00ANESTHESIA ADM 01/15 MIN $456.00ANESTHESIA ADM 106 TO 120 MI $1,593.00ANESTHESIA ADM 121 TO 135 MIN $1,755.00ANESTHESIA ADM 136 TO 150 MIN $1,918.00ANESTHESIA ADM 151 TO 165 MIN $2,081.00ANESTHESIA ADM 16 TO 30 $623.00ANESTHESIA ADM 166 TO 180 MIN $2,239.00ANESTHESIA ADM 181 TO 195 MIN $2,394.00ANESTHESIA ADM 196 TO 210 MIN $2,561.00ANESTHESIA ADM 211 TO 225 MIN $2,729.00ANESTHESIA ADM 226 TO 240 MIN $2,887.00ANESTHESIA ADM 241 TO 255 MIN $3,051.00ANESTHESIA ADM 256 TO 270 MIN $3,217.00ANESTHESIA ADM 271 TO 285 MIN $3,373.00

ANESTHESIA ADM 286 TO 300 MIN $3,538.00ANESTHESIA ADM 31 TO 45 MIN $783.00ANESTHESIA ADM 46 TO 60 MIN $942.00ANESTHESIA ADM 61 TO 75 MIN $1,108.00ANESTHESIA ADM 76 TO 90 MIN $1,270.00ANESTHESIA ADM 91 TO 105 MIN $1,430.00ANESTHESIA AGENT /ANY $123.00ANESTHESIA EXTENSION SET $17.00ANESTHESIA EXTENSION SET $19.00ANESTHESIA TECHNICAL $687.00ANESTHETIC/ANECTINE/CC $9.00ANESTHETIC\FLOUTHANE/CC $9.00ANGICATH 16 $21.00ANGIOTENSIN CONVERTING ENZYME $66.00ANGIOTENSIN CONVERTING ENZYME (ACE) INHI $1.00ANGLED AGG PLUS SHAVER $67.00ANKLE ARTHROGRAPHY LT $250.00ANKLE ARTHROGRAPHY RT $250.00ANKLE ARTHROSCOPY/SURGERY $1,210.00ANKLE LT 2V $244.00ANKLE LT ROUTINE MIN 3V $341.00ANKLE RT 2V $244.00ANKLE RT ROUTINE MIN 3V $341.00ANKLE STRAPING $157.00ANORECTAL EXAM, SURGICAL, REQUIRING ANES $264.00ANOSCOPE DISP.(SANISCOPE) $6.00ANOSCOPY AND DILATION $1,917.00ANOSCOPY FOR REMOVAL OF F B $362.00ANOSCOPY INITIAL $149.00ANOSCOPY/DX/W OR W/O $141.00ANOSCOPY/DX/W OR W/O $141.00ANOSCOPY/DX/W OR W/O $149.00ANOSCOPY; DIAGNOSTIC, INCLUDING COLLECTI $149.00ANOSCOPY; WITH DILATION (EG, BALLOON, GU $1,917.00ANTABUSE 250MG TABLET (DISULFIRAM) $15.00ANTENNA- INTERSTIM $405.00ANTEPARTUM CARE ONLY 4-6 VISITS $666.00ANTEPARTUM CARE ONLY 4-6 VISITS $666.00ANTEPARTUM CARE ONLY 7+ VISITS $1,166.00ANTEPARTUM CARE ONLY 7+ VISITS $1,166.00ANTEPARTUM CARE ONLY; 4-6 VISITS $700.00ANTEPARTUM CARE ONLY; 7 OR MORE VISITS $1,225.00ANTERIOR COLPORRHAPHY, REPAIR OF CYSTOCE $752.00ANTERIOR VESICOURETHROPEX Y, OR URETHROP $1,267.00ANTERIOR VITRECTOMY PACK $370.00ANTI CARDIOLIPIN IGA,IGG,IGM $159.00ANTI CARDIOLIPIN IGG $159.00

ANTI CARDIOLIPIN IGM $159.00ANTI DNA SINGLE STRANDED IGG $69.00ANTI MULLERIAN HORMONE $206.00ANTI SMITH $75.00ANTI SSA $94.00ANTI SSB $103.00ANTIADRENAL ANTIBODIES, QUANT $120.00ANTICENTROMERE B ANTIBODIES $103.00ANTICENTROMERE B ANTIBODY $159.00ANTICHROMATIN ANTIBODY $103.00ANTIDIURETIC HORMONE $139.00ANTI-EXTRACTABLE NUCLEAR AG $83.00ANTIFOG AGENT $37.00ANTIGLOMERULAR BASEMENT MEMBRANE ABS $195.00ANTI-HU ANTIBODIES $218.00ANTI-JO-1 $205.00ANTIMULLERIAN HORMONE $199.00ANTIPANCREATIC ISLET CELLS $137.00ANTIPHOSPHOLIIPID SYNDORME PANEL (D) $145.00ANTIPHOSPHOLIPID SYNDROME COMPREHENSIVE $104.00ANTIPOSPHTIDYLERINE IGG $145.00ANTIPOSPHTIDYLERINE IGM $145.00ANTIPYRINE & BENZOCAINE OTIC SOLN 10 ML $17.00ANTIRIBOSOMAL P ANTIBODIES $105.00ANTISCLERODERMA 70 ANTIBODY $103.00ANTI-SPASTICITY BALL SPLINT LEFT $164.00ANTI-SPASTICITY BALL SPLINT RIGHT $164.00ANTITHROMBIN III, ACTIVITY $265.00ANTITHROMBIN III, ANTIGEN $160.00ANTI-THYROID $78.00ANTIVENIN (ANTIVENT.CROTALIDAE POLY)VIAL $693.00ANTIVENIN BLACK WIDOW (LACTRODECTUS MAC) $232.00ANTI-YO ANTIBODIES $98.00ANTIZOL (FOMEPIZOLE) 1G/ML 1.5ML VIAL $4,454.00ANTPARIETAL CELL ANTIBODIES $199.00ANZEMET 100MG TAB(DOLASETRON MESYLATE) $382.00ANZEMET 12.5MG/0.5ML (DOLASETRON MESYL) $130.00ANZEMET 50MG TAB (DOLASETRON MESYLATE) $145.00API CHEM PANEL $261.00APIRATION/INJ FOR TRMNT BONE CYST $403.00APIRATION/INJ FOR TRMNT BONE CYST $403.00APOE $480.00APOLIPOPROTEIN A 1 $72.00APOLIPOPROTEIN B $72.00APPENDECTOMY $1,236.00APPENDECTOMY $1,282.00APPENDECTOMY $1,236.00

APPENDECTOMY RUPTURE W/ABC/ GEN PERITONI $1,282.00APPENDECTOMY; $1,298.00APPENDECTOMY; FOR RUPTURED APPENDIX WITH $1,347.00APPENDECTOMY; WHEN DONE FOR INDICATED PU $159.00APPENDECTOMY;DONE @ TIME OF OTHER PROC $151.00APPLICATION CAST/SHOULDER $192.00APPLICATION LONG LEG CAST $238.00APPLICATION LONG LEG SPLINT $52.00APPLICATION OF FINGER SPLINT; STATIC $90.00APPLICATION OF FOREARM CAST $169.00APPLICATION OF LONG LEG CAST (THIGH TO T $238.00APPLICATION OF LONG LEG CAST (THIGH TO T $344.00APPLICATION OF SHORT ARM SPLINT (FOREARM $137.00APPLICATION OF SHORT LEG CAST (BELOW KNE $180.00APPLICATION OF SHORT LEG CAST (BELOW KNE $187.00APPLICATION OF SHORT LEG SPLINT (CALF TO $130.00APPLICATION OF SKIN SUBSTITUTE GRAFT TO $353.00APPLICATION SHORT ARM SPLINT $137.00APPLICATION SHORT ARM SPLINT $130.00APPLICATION SHORT ARM SPLINT $130.00APPLICATION SPLINT $130.00APPLICATION SPLINT/SHOULDER $52.00APPLICATION, CAST; ELBOW TO FINGER (SHOR $178.00APPLICATION, CAST; SHOULDER TO HAND (LON $192.00APPLICATON SPLINT/FINGER $85.00APPLICATON SPLINT/FINGER $90.00APPLICTION OF FOREARM CAST $169.00APPLY STRAPPING UNNA BOOT $118.00APPLY UNIPLANE EXTERNAL FIXATION SYSTEM $1,510.00APPY DONE AT TIME OF ANOTHER PROCEDURE $151.00APTT 1:1 NP MIXING STUDING $241.00APTT 1:1 SALINE MIXING STUDING $241.00APTT-LUPUS ANTICOAGULANT $184.00AQUILEX INFLOW TUBING $411.00AQUILEX KIT CANN TUBING SOCK $51.00AQUILEX Y OUTFLOW TUBING $96.00AQUINOX HIGH FLOW HUMID SYSTEM $141.00AR SM SOCKET INSERT $1,342.00AR SM SOCKET INSERT 32MM- ORTHO $1,342.00ARAMINE (METARAMINOL) 1% VIAL $87.00ARANESP (DARBEPOETIN) 100MCG SDV $2,851.00ARANESP (DARBEPOETIN) 100MCG SDV $2,851.00ARANESP (DARBEPOETIN) 150MCG PFS $2,264.00ARANESP (DARBEPOETIN) 150MCG PFS $2,264.00ARANESP (DARBEPOETIN) 200MCG PFS $3,002.00ARANESP (DARBEPOETIN) 200MCG PFS $3,002.00ARANESP (DARBEPOETIN) 300MCG PFS $3,670.00

ARANESP (DARBEPOETIN) 300MCG PFS $3,670.00ARANESP (DARBEPOETIN) 40MCG VIAL $1,123.00ARANESP (DARBEPOETIN) 40MCG VIAL $1,123.00ARANESP (DARBEPOETIN) 500MCG PFS: NON C $7,441.00ARANESP (DARBEPOETIN) 500MCG PFS:CHEMO $7,441.00ARANESP (DARBEPOETIN) 60MCG SYRINGE $1,498.00ARANESP (DARBEPOETIN) 60MCG SYRINGE $1,498.00ARANESP 25MCG PFS (DARBEPOETIN) $720.00ARANESP 60 MCG $1,375.00ARIMIDEX (ANASTROZOLE) 1MG TABLET $93.00ARIPIPRAZOLE 5MG TABLET $35.00ARM SLING UNIVERSAL $61.00ARM SLING CLINIC EX LG $13.00ARM SLING CLINIC LARGE $13.00ARM SLING CLINIC MEDIUM $13.00ARM SLING CLINIC SMALL $13.00ARM SLING CLINIC X-SMALL $13.00ARM SLING CLINIC XX-SMALL $13.00ARM SLING UNIVERSAL $49.00ARSENIC BLOOD $98.00ARSENIC URINE $89.00ARTERIAL BLOOD GAS $319.00ARTERIAL LINE PLACEMENT $891.00ARTERIAL PUNCTURE $50.00ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD F $50.00ARTERIAL PUNCTUR-RT $50.00ARTERY; ABDOMEN $3,137.00ARTH SHAVER BLADE 6 FLUTE BARREL BUR $300.00ARTH SHAVER BLADE ANGLED CUTTER $253.00ARTH SHAVER BLADE DUAL EDGE CUTTER $412.00ARTH SHAVER BLADE RESECTOR CUTTER $253.00ARTHOR BIOINDCTIVE 1 MED- ORTHO $5,712.00ARTHROCENTESIS INTERM JOINT BURSA $108.00ARTHROCENTESIS INTERM JOINT OR BURSA $108.00ARTHROCENTESIS INTERM JOINT OR BURSA $108.00ARTHROCENTESIS MAJOR JOINT OR BURSA $722.00ARTHROCENTESIS MAJOR JOINT OR BURSA $722.00ARTHROCENTESIS MAJOR JOINT OR BURSA $722.00ARTHROCENTESIS MAJOR JOINT OR BURSA $722.00ARTHROCENTESIS SMALL JOINT $130.00ARTHROCENTESIS SMALL JOINT $130.00ARTHROCENTESIS SMALL JOINT OR BURSA $130.00ARTHROGRAPHY HIP RT OR LT $734.00ARTHROGRAPHY SHOULDER $266.00ARTHROGRAPHY SHOULDER INJECTION $152.00ARTHROGRAPHY WRIST LT $255.00ARTHROGRAPHY WRIST RT $255.00

ARTHROSCOPIC SHAVER BLADES 3.5MM $385.00ARTHROSCOPIC SHAVER BLADES 3.5MM SMALL J $205.00ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT $3,147.00ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT $3,147.00ARTHROSCOPY PACK $248.00ARTHROSCOPY SHOULDER BICEPS TENODESIS $2,226.00ARTHROSCOPY SHOULDER BICEPS TENODESIS $2,226.00ARTHROSCOPY SHOULDER DISTAL CLAVICULECTO $1,633.00ARTHROSCOPY SHOULDER DISTAL CLAVICULECTO $1,633.00ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR $2,586.00ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR $2,586.00ARTHROSCOPY SHOULDER SURG DEBRIDEMNT EXT $1,515.00ARTHROSCOPY SHOULDER SURG DEBRIDEMNT EXT $1,515.00ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT $411.00ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT $411.00ARTHROSCOPY TUBING SET $242.00ARTHROSCOPY W/SYNOVECTOMY MAJOR 2/MORE $1,837.00ARTHROSCOPY W/SYNOVECTOMY MAJOR 2/MORE $1,837.00ARTHROSCOPY-ABRASION $1,077.00ARTHROSCOPY-ABRASION $1,077.00ARTHROSCOPY-SYNVECTOMY $907.00ARTHROSCOPY-SYNVECTOMY $907.00ARTHROTEC 50 (DICLOFENAC/MISOPROSTOL) $10.00ARTHROTEC 75 (DICLOFENAC/MISOPROSTOL) $10.00ARTHROTOMY METATARSOPHALANGEAL JOINT $824.00ARTHROTOMY METATARSOPHALANGEAL JOINT $824.00ARTHROTOMY, KNEE, W/ESPLORATION, DRAIN $1,696.00ARTHROTOMY;DRAIN/REMOVE FB $700.00ARTHRS KNE SURG W/MENISCECTOMY MED/LAT/W $1,075.00ARTHRS KNE SURG W/MENISCECTOMY MED/LAT/W $1,075.00ARTHRS KNEE W/MENISCECTOMY MED&LATW/SHAV $1,129.00ARTHRS KNEEW/MENISCECTOMY MED&LATW/SHAVI $1,129.00ARTIFICIAL TEARS OPHTH DROPS $9.00AS 11MM TROCAR $465.00AS 12MM TROCAR $463.00ASCORBIC ACID (VITAMIN C) 500MG TABLET $6.00ASH FIBROSURE $81.00ASMANEX 220MCG INHALER (MOMETASONE) $209.00ASPERGILLUS FLAVUS ANTIBOY $34.00ASPERGILLUS FUMIGATUS ANTIBOY $39.00ASPERGILLUS NIGER ANTIBOY $38.00ASPIRA PLEURAL DRAINAGE-KIT $254.00ASPIRA PLEURAL DRAINAGE-STARTER $1,085.00ASPIRA PLEURAL DRESSING KIT $119.00ASPIRA PLEURAL VALVE REPAIR KIT $183.00ASPIRATE ADDTL BREAST CYST $52.00ASPIRATE ADDTL BREAST CYST $52.00

ASPIRATE EACH ADDITIONAL BREAST CYST $55.00ASPIRATION BREAST CYST $962.00ASPIRATION BREAST CYST $962.00ASPIRATION NEEDLE 16 GA $108.00ASPIRATION OF BLADDER BY NEEDLE $188.00ASPIRATION OF BLADDER BY NEEDLE $188.00ASPIRATION OF BLADDER BY NEEDLE $198.00ASPIRATION OF BLADDER; BY NEEDLE $198.00ASPIRATION/BL $631.00ASPIRATION/BLADDER/CAT $387.00ASPIRATION/BLADDER/INS $631.00ASPIRATOR NASAL TIP $13.00ASPIRIN (ASA) 300 MG RECTAL SUPP $11.00ASPIRIN (ASA) 81 MG CHEWABLE TABLET $1.00ASPIRIN (ASA) 81 MG ENTERIC COATED TABS $1.00ASPIRIN 120 MG RECTAL SUPP $4.00ASPIRIN 600 MG RECTAL SUPP $4.00ASPIRIN BUFFERED 325 MG TABLET $4.00ASPIRIN ENTERIC COATED 325 MG TABLET $1.00ASPIRIN OR CLOPIDOGREL PRESCRIBED OR CUR $1.00ASPIRIN/BUFFERS 325 MG TABLET $4.00ASPIRIN/CAFFEINE 400 MG TABLET (ANACIN) $4.00ASSAY OF ETHYLENE GLYCOL $99.00AST $80.00ASTHMA ACTION PLAN $40.00ATACAND (CANDESARTAN CILEXETIL) 16 MG $14.00ATACAND 4MG (CANDESARTAN CILEXETIL) TAB $8.00ATENOLOL 25 MG TABLET (TENORMIN) $6.00ATENOLOL 50 MG TABLET (TENORMIN) $6.00ATENOLOL 5MG IV AMP (TENORMIN) $42.00ATIVAN (LORAZEPAM) 2MG TUBEX $103.00ATORVASTATIN CAL 10 MG TAB (LIPITOR) $7.00ATORVASTATIN CAL 40 MG TAB (LIPITOR) $7.00ATRACURIUM 100 MG VIAL (TRACRIUM) $299.00ATROPHINE-TX $17.00ATROPINE 0.5% ABBOJ. SYRINGE $78.00ATROPINE 1MG ABBOJ. SYRINGE $25.00ATROPINE 1MG VIAL $27.00ATROPINE SULFATE 1% OPHT SOLN $33.00ATROVENT HFA(IPRATROPIUM) 200 DOSE INHAL $314.00ATS CANISTER W/GEL $247.00ATTACH BLADDER/URETHRA $1,267.00ATTACHMENT PADS $3.00ATTAPULGITE 2 OZ BOTTLE (DONNAGEL) $9.00AUGMENTIN XR (AMOX/CLAV) 1000/62.5MG $14.00AUTO COMP WIDEBONE PLATE $395.00AUTO COMPBONE PLTE 4MMX15 $393.00

AUTO IMMUNE PROFILE $31.00AUTOCOMP BONE PLTE 4MMX13 $306.00AUXILLARY LYMPH ADENECTOMY; COMPLETE $1,925.00AV FUSE, UPPER ARM, BASILIC $1,916.00AV FUSE, UPPER ARM, BASILIC $1,916.00AVALIDE (IRBESARTAN/HCTZ)300/12.5 TAB $12.00AVANDIA (ROSIGLITAZONE MAL) 4 MG TABLET $24.00AVELOX 400MG TABLET (MOXIFLOXACIN) $49.00AVULSION NAIL,PART/COMP;SING $199.00AVULSION NAIL,PART/COMP;SING $189.00AVULSION NAIL,PART/COMP;SING $199.00AVULSION NAIL;EA ADDTL $181.00AVULSION NAIL;EA ADDTL $181.00AVULSION OF NAIL PLATE, PARTIAL OR COMPL $199.00AVULSION OF NAIL PLATE, PARTIAL OR COMPL $191.00AWL TAPERED 3.8MM- ORTHO $80.00AYR (SOD CHL) NASAL MIST 50ML $12.00AYR NASAL GEL WITH ALOE VERA 0.5 OZ $13.00AZACITIDINE 100MG VIAL (VIDAZA) $470.00AZATHIOPRINE 50 MG TAB (IMURAN) $6.00AZELASTINE NASAL SPRAY (ASTELIN) $120.00AZITHROMYCIN 100 MG/5ML 15ML (ZITHROMAX) $35.00AZITHROMYCIN 200 MG/5ML 30ML (ZITHROMAX) $31.00AZITHROMYCIN 250 MG TABLET (ZITHROMAX) $8.00AZITHROMYCIN 500 MG VIAL $41.00AZITHROMYCIN IVPB 500 MG/NS 250ML $128.00AZOPT OPTH SUSP 1% 10ML (BRINZOLAMIDE) $190.00AZTREONAM 1 GM VIAL (AZACTAM) $171.00AZTREONAM 2GM VIAL $310.00B&L AKREOS AO60 & M160 IOL'S $61.00B&L L 161 - AOR IOL $39.00B.A.T.H WRIST SPLINT LT MEDIUM $47.00B.A.T.H WRIST SPLINT LT EX LG $47.00B.A.T.H WRIST SPLINT LT LARGE $47.00B.A.T.H WRIST SPLINT LT SMALL $47.00B.A.T.H WRIST SPLINT RT EX LG $47.00B.A.T.H WRIST SPLINT RT LARGE $47.00B.A.T.H WRIST SPLINT RT MEDIUM $47.00B.A.T.H WRIST SPLINT RT SMALL $47.00B.A.T.H WRIST SPLINT RT X SM $47.00BACITRACIN (BACITRACIN ZINC) U/D OINT $6.00BACITRACIN 50000U VIAL $44.00BACITRACIN 500UGM OINT $10.00BACITRACIN/POLYMYCIN PWD (POLYSPORIN) $41.00BACK BELT- LARGE $99.00BACK BELT- MEDIUM $104.00BACK SUPPORT- XXXLARGE $36.00

BACLOFEN 10 MG TABLET (LIORESAL) $6.00BACTERIA FILTER $8.00BACTERIA FILTER $17.00BAG CLAMP $18.00BAG COLOSTOMY BELT $44.00BAG DECANTER $8.00BAG PUC COLLECTOR STERILE $10.00BAG STOMA DRAIN 1 IN $17.00BAKRI POSTPARTUM BALLOON $568.00BALLARD TRACH CARE 14FR CATHETER $42.00BALOON VALVE $15.00BANDAGE 2 CONFORM $6.00BANDAGE 3 CONFORM $7.00BANDAGE 4 CONFORM $7.00BANDAGE GAUZE 2 SUPRA FORM STERILE $3.00BANDAGE GAUZE 3 SUPRA FORM STERILE $6.00BANDAGE HIGH COMPRESSION SUREPRESS $54.00BANDAGE PLASTER 2 INCH $31.00BANDAGE PLASTER 3 INCH $31.00BANDAGE PLASTER 4 INCH $51.00BANDAGE PLASTER 6 INCH $61.00BAR STRAIGHT SM MINI PENNING $718.00BARD BUTTON TUBE 1.7CM 24 FR $421.00BARIUM ENEMA ROUTINE W/AIR CONTRAST $551.00BARIUM ENEMA SINGLE CONTRAST $456.00BARTHOLINS GLAND ABCESS I & D $366.00BARTONELLA ANTIBODY $119.00BASEPLATE FINNED SIZE9 $3,468.00BASEPLATE FINNED SZ4-ORTHO $3,304.00BASEPLATE FINNED SZ5-ORTHO $3,302.00BASIC SOLUTION SET $25.00BASIC SOLUTION SET W/1 LUER VALVE $23.00BATH BENCH $110.00BATH BENCH W/ BACK $55.00BAYCOL (CERIVASTATIN SOD) 0.3 MG TAB $10.00BAYCOL (CERVISTATIN SOD) 0.4 MG TAB $10.00BAYGAM NR (IMMUN GLOBULIN GAMMA (1 GG)T $545.00BB ABO $114.00BB ABO-NB $87.00BB ABSORPTION $480.00BB ADDITIONAL PANELS $216.00BB ANTIBODY IDENTIFICATION $615.00BB ANTIBODY SCREEN $143.00BB ANTIBODY TITER $324.00BB ANTIGEN SCREEN $369.00BB ANTIGEN TYPE, PATIENT $147.00BB COOMBS, DIRECT $79.00

BB CROSSMATCH IMMED SPIN $105.00BB CROSSMATCH MAJOR OR MINOR $173.00BB CRYOPRECIPITATE $890.00BB DEGLYCERIZED LP RBC $575.00BB DEGLYC-FROZ RBC $2,355.00BB ELUTION (RBC ANTIBODY) $338.00BB ELUTION (RBC ANTIBODY) $153.00BB FETAL SCREEN $70.00BB FFP $293.00BB GLYCINE ACID TREATMENT $492.00BB NEUTRALIZATION $216.00BB PLATELETS (PLA) LEUKOREDUCED $1,280.00BB PLATELETS (PLP) LEUKOREDUCED SPLIT PK $1,061.00BB PLT FILTER (PX8) $352.00BB PRETREATMENT $404.00BB RBC - PRE-FILTERED $511.00BB RBC - PRE-FILTERED IRRADIATED $596.00BB RBC PEDI UNIT $276.00BB RBC REJUVENATION $146.00BB RH $114.00BB RH PHENOTYPE $206.00BB RHD SEQUENCING $874.00BB TRANSFER PAK $85.00BBTAK- ARTHREX $396.00BCR ABL1 CML/ALL by PCR QUANTITATIVE $222.00BCR ABL1 MINOR BREAK POINT QUALITATIVE $222.00BCR-ABL $304.00BCR-ABL1 KINASE DOMAIN MUTATION ANALYSIS $874.00BEACH CHAIR DRAPE $78.00BEAVER BLADES $9.00BECLOMETHASONE INHALER 17 GM (VANCERIL) $164.00BECONASE AQ NASAL (BECLOMETHASONE).042% $199.00BELMONT 3 SPIKE BAG SET $509.00BELT CONT PELVIC 5M S SRP $76.00BELT CONT PELVIC MED S SR $56.00BELT PELVIC D STRAP 30 34 $85.00BELT PELVIC D STRAP 34 38 $85.00BELT PELVIC S STRAP 34 38 $58.00BELT PELVIC TRAC 24 X 16 $53.00BELT RIB ELAS MEN LARGE $31.00BELT RIB ELAS MEN MED $31.00BELT RIB ELAS WOMEN LARGE $31.00BELT RIB ELAS WOMEN MED $31.00BELT RIB ELASTIC 48 54 $31.00BENADRYL (DIPHENHYD) 50 MG VIAL $38.00BENAZEPRIL 10 MG TABLET (LOTENSIN) $6.00BENEFIBER CHEWABLE TABLET $4.00

BENEFIBER POWDER $5.00BENICAR (OLMESARTAN) 20MG TABLET $12.00BENLYSTA (BELIMUMAB) 120MG VIAL $2,044.00BENLYSTA (BELIMUMAB) 400MG VIAL $3,578.00BENZOIN (BENZOIN TR) 2 OZ $16.00BENZOIN CMPD TINCT 2 OZ $12.00BENZONATATE 100 MG CAPSULE (TESSALON) $7.00BENZTROPINE 1 MG TABLET (COGENTIN) $6.00BETA 2 TRANSFERRIN $388.00BETA HCG QUANTITATIVE $159.00BETA HYDROXY BUTYRATE $244.00BETA HYDROXYBUTYRATE $105.00BETA-2 GLYCOPROTEIN 1 IGA $159.00BETA-2 GLYCOPROTEIN 1 IGG $159.00BETA-2 GLYCOPROTEIN 1 IGM $159.00BETA-2 MICROGLOBULIN SERUM $82.00BETA-BLOCKER THERAPY PRESCRIBED OR CURRE $1.00BETADINE OPHTH SOLN 5% (POVIDONE IODINE) $20.00BETAGAN 0.5% (LEVOBUNOLOL) OPTH SOLN 2ML $48.00BETAMETHASONE SOD PHOS&ACETATE 30MG/5ML $44.00BETAXOLOL .5% 5 ML OPHT SOLN (BETOPTIC) $101.00BETAXOLOL 10 MG TABLET (KERLONE) $6.00BETHANECHOL 10 MG TABLET (URECHOLINE) $6.00BETHANECHOL 25 MG TABLET (URECHOLINE) $5.00BETHANECHOL 5 MG TABLET (URECHOLINE) $5.00BETHANECHOL 5 MG VIAL (URECHOLINE) $51.00BETHESDA FACE MASK $25.00BETOPTIC(BETAXOLOL) 0.25% 2.5ML OP SOLN $52.00BEVACIZUMAB 100MG VIAL (AVASTIN) $2,786.00BEVACIZUMAB 400MG VIAL (AVASTIN) $5,522.00BICALUTAMIDE 50MG TABLET (CASODEX) $540.00BICARB $75.00BICILLIN CR (PEN G/PROC G BEN) 1,200,000 $79.00BICILLIN CR (PENIC G PROC/PEN G BEN)600 $52.00BICILLIN LA (BENZATHINE) 1.0 MIL U $93.00BICILLIN LA (PENIC G BENZ) 600,000 TBX $226.00BICILLIN LA 1.2MU SYR (PENICIL G BEN) $473.00BIFURCATED ARTGRAFT 19-9 $607.00BILAT OOPHRORECTOMY $1,292.00BILE ACIDS $198.00BILI-MASK $32.00BILIRUBIN DIRECT $92.00BILIRUBIN INDIRECT $76.00BILIRUBIN NEONATAL $76.00BILIRUBIN TOTAL $76.00BILIRUBIN TOTAL TRANSCUT $12.00BIMALLEOLAR ANKLE FRACTURE W/MAN $1,034.00

BIMALLEOLAR ANKLE FX W/MANIPULATION $1,011.00BIMALLEOLAR ANKLE TX $1,149.00BINDER ABDOMINAL 12 L $81.00BINDER ABDOMINAL 12 M $81.00BINDER ABDOMINAL 12 S $81.00BINDER ABDOMINAL 12 XL $71.00BINDER ABDOMINAL 12 XXL $86.00BINDER ABDOMINAL 14 L $75.00BINDER ABDOMINAL 14 M $74.00BINDER ABDOMINAL 14 S $86.00BINDER ABDOMINAL 14 XL $73.00BIO PELVIS/HIP TISSUE;DEEP $1,743.00BIO VULVA PERINEIUM $187.00BIO VULVA PERINEIUM $187.00BIOBAG 200 (LARVAE) $750.00BIOBAG 50 (LARVAE) $730.00BIOINDUCTIVE IMPLANT W/ARTH DEL-ORTHO $5,580.00BIOPATCH $45.00BIOPSY NEEDLE 14 GAX15CM $163.00BIOPSY NEEDLE 14GA 3 $118.00BIOPSY NEEDLE COAXLE 13G x 5 1/2 $115.00BIOPSY OF ANORECTAL WALL ANAL APPROACH $755.00BIOPSY OF BOWEL $281.00BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE C $237.00BIOPSY OF CERVIX, SINGLE OR MULTIPLE, OR $306.00BIOPSY OF LIVER NEEDLE PERCUTANEOUS $232.00BIOPSY OF LIVER, WEDGE $2,112.00BIOPSY OF VAGINAL MUCOSA; EXTENSIVE, REQ $357.00BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARA $181.00BIOPSY OF VULVA OR PERINEUM (SEPARATE PR $197.00BIOPSY OF VULVA OR PERINEUM (SEPARATE PR $93.00BIOPSY OR EXCISION OF LYMPH NODE(S); OPE $580.00BIOPSY OR EXCISION OF LYMPH NODE(S); OPE $1,251.00BIOPSY OR EXCISION OF LYMPH NODE(S); OPE $776.00BIOPSY SOFT TISSUE BACK/FLANK SUPERFICI $406.00BIOPSY SOFT TISSUE OF NECK OR THORAX $389.00BIOPSY, MUSCLE; DEEP $511.00BIOPSY, SOFT TISSUE OF BACK OR FLANK; SU $406.00BIOPSY, SOFT TISSUE OF NECK OR THORAX $389.00BIOPSY, SOFT TISSUE OF THIGH OR KNEE ARE $987.00BIOPSY/BREAST/OPEN INC $546.00BIOPSY/BREAST/OPEN INC $546.00BIOPSY/BREAST/OPEN INC $186.00BIOPSY/SING OR MULP $306.00BIOPSY/VAGINAL MUCOSA $172.00BIOPSY/VAGINAL MUCOSA $172.00BIOTINIDASE $323.00

BIPAP/CPAP $144.00BIPOLAR SEALER 6.0-ORTHO $773.00BIPOLARPACING CATH KIT SF $147.00BIRTHING ROOM PACK $102.00BISACODYL 10MG RECTAL SUPP (DULCOLAX) $6.00BISACODYL 5 MG TABLET (DULCOLAX) $6.00BISOPROLOL FUM/HCTZ 2.5MG TABLET (ZIAC) $7.00BISOPROLOL FUM/HCTZ 5.0 MG TABLET (ZIAC) $7.00BISOPROLOL/HCTZ 10MG TABET (ZIAC) $9.00BITE BLOCK $12.00BK VIRUS BY PCR SERUM $831.00BK VIRUS BY PCR URINE $831.00BLADDER CATH INSERT $185.00BLADDER CATH INSERT $195.00BLADDER IRRIGATION, SIMPLE, LAVAGE AND/O $254.00BLADE 3.5 BONE CUTTER-ORTHO $287.00BLADE 3.5 CURVED CONCAVE FULL RADI-ORTHO $288.00BLADE 715 $67.00BLADE 762 B $179.00BLADE MICRO S $46.00BLADE SAW 31 X 9 MM $153.00BLADE SAW THIN OFFSET 13.3X0.38X42.0MM $153.00BLADE SURGICAL 3.2 $84.00BLADE SURGICAL 5.1 $84.00BLADE, SAGITTAL 9 1/2 X 25 1/2 $110.00BLADE,MICRO 9.5X25.5X.4 $165.00BLADE,OSCILLATOR 19.5X95X1.27 $137.00BLADES 6900 $57.00BLADES KERATOME $197.00BLANKET- FULL BODY- MISTRAL AIR $43.00BLANKET- PEDIATRIC UNDERBODY MISTRAL AIR $85.00BLANKET THERAPEUTIC 64 X25 WARMING $62.00BLANKET- UPPER BODY- MISTRAL AIR $43.00BLASTOMYCOSIS AB $217.00BLDDER IRRIG,SIMPL,LAVAGE &/INSTILLATION $254.00BLDDER IRRIG,SIMPL,LAVAGE&/INSTILLATION $254.00BLDDER IRRIG,SIMPL,LAVAGE&/INSTILLATION $254.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/ NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/NORMAL PTT/PT $320.00BLEEDING DIATHESIS W/NORMAL PTT/PT $320.00

BLEEDING DIATHESIS W/NORMAL PTT/PT $320.00BLEEDING TIME $95.00BLEOMYCIN SULF 30 UNITS $303.00BLOOD ADMIN SECONDARY SET $8.00BLOOD GAS CAPILLARY $180.00BLOOD SET 78 $18.00BLOOD SET COLLECTION $13.00BLOOD SET Y TYPE $43.00BLOOD WARMER SET $83.00BLOOD WARMING SET $94.00BLOOD Y TYPE SET $37.00BLUE CARTRIDGE 45MM RELOAD $462.00BMP $141.00BNP, PRO $290.00BODY FLUID $64.00BODY FLUID AMYLASE $94.00BODY FLUID BILIRUBIN $107.00BODY FLUID CEA $87.00BODY FLUID CELL COUNT (W/DIFF IF INDIC) $104.00BODY FLUID CHOLESTEROL $107.00BODY FLUID CRYSTALS $76.00BODY FLUID GLUCOSE $87.00BODY FLUID PROTEIN $103.00BODY FLUID TRIGLYCERIDES $65.00BODY SECTION RADIOGRAPHY $352.00BONE AGE STUDIES X RAY $173.00BONE ANCHOR 3- ORTHO $2,856.00BONE CEMENT PMMA-ORTHO $397.00BONE CEMENT W/ANTBI COBALT-ORTHO $490.00BONE CLEANING TIP ORTHO $55.00BONE GRAFT TIB/FIB $1,422.00BONE GRAFT TIB/FIB $1,422.00BONE LENGTH STUDIES $188.00BONE MARROW $786.00BONE MARROW ASPIRATE ONLY $146.00BONE PINS- 1/8 -ORTHO $193.00BONE PLATE SELF COMP 32MM $225.00BONE PLATE SELF COMP 40MM $229.00BONE SCREW 18MM ACUTRAK 2 $1,428.00BONE SCREW 18MM ACUTRAK 2-MINI $1,428.00BONE SCREW 22MM ACUTRAK 2 $1,428.00BONE SCREW-ACUTRAK2 $1,428.00BONE SCREWS STEEL $94.00BONE SCREWS TITANIUM $203.00BONIVA (IBANDRONATE SOD) 3MG/3ML KIT340B $313.01BOOSTRIX (DIPHTH/PERTUSS(ACELL)TET) $63.00BOOT DECUBITUS ULCER $130.00

BORDETELLA PARAPERTUSIS PCR $165.00BOUGIE INTRODUCER $41.00BOVIE HAND CONTROL SWITCH $35.00BOVIE NEEDLE ELECTRODE $270.00BOVIE NEEDLE ELECTRODE $270.00BOWEL DISORDER CASCADE $492.00BP CUFF DISP- ADULT $35.00BP CUFF DISP- ADULT LG $40.00BP CUFF DISP- ADULT LG LONG $46.00BP CUFF DISP- ADULT SMALL $35.00BP CUFF DISP- CHILD $31.00BRACE KNEE MD HINGED $219.00BRAF MUTATION $268.00BRASSELER LARGE BONE BLADE $288.00BREAST PAD $13.00BREAST PUMP KIT $176.00BREAST SHIELD 16MM $36.00BREAST SHIELD 20MM $36.00BREAST SHIELD 24MM $36.00BREAST TISSUE (005T)MARKER 14G $417.00BREAST TISSUE COIL MARKER 14G $390.00BREAST TISSUE S MARKER 14G $385.00BREAST TISSUE V MARKER 14G $385.00BREATHING CIRCUIT ADULT ANESTHESIA $68.00BREATHING CIRCUIT PEDS $48.00BRETYLLIUM 500 MG / 250 D5W (2MG/ML) $68.00BREYTOL (BRETYLIUM) : 500MG/10ML VIAL $112.00BRIMONIDINE TARTRATE OPTH SOLUTION 0.15% $298.00BROMOCRIPTINE 2.5MG TABLET (PARLODEL) $10.00BROMOCRIPTINE 5 MG TABLET (PARLODEL) $14.00BRONCHODILATION;PRE&POST $112.00BRONCHOSCOPY $707.00BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDI $681.00BROVANA 15MCG/2ML INH (ARFORMOTEROL) $20.00BRUCELLA ABORTUS IGG $94.00BRUCELLA ABORTUS IGM $94.00BRUSH CYTOLOGY W/SHEATH $82.00BSS HT SOLN 15ML $32.00BSS PLUS IRRIG SOLN $85.00BUCKWAY CURETTE SIZE 0 $65.00BUMETANIDE 0.25MG/ML 10ML VIAL $19.00BUMETANIDE 0.25MG/ML 2ML VIAL (BUMEX) $20.00BUMETANIDE 1 MG TABLET (BUMEX) $6.00BUMEX (BUTETANIDE) : 0.5 MG DO NOT USE $33.00BUN $75.00BUNNY BOOT PAD $75.00BUNNY FRAME $91.00

BUNNY LINER $91.00BUPIVACAINE 0.25% VIAL (MARCAINE) 10ML $18.00BUPIVACAINE 0.25% VIAL (MARCAINE) 30ML $26.00BUPIVACAINE 0.25% W/ EPI VIAL 30ML $27.00BUPIVACAINE 0.5% 30 ML VIAL (MARCAINE) $20.00BUPIVACAINE 0.5% 50ML VIAL (SENSORCAINE) $23.00BUPIVACAINE 0.5% PF 550ML IN ON-Q PUMP $522.00BUPIVACAINE 0.5% VIAL 10ML (MARCAINE) $17.00BUPIVACAINE 0.5% VIAL 30ML (MARCAINE) $23.00BUPIVACAINE 0.5% W/ EPI VIAL 30ML $34.00BUPIVACAINE 0.75% 10ML VIAL (MARCAINE) $23.00BUPIVACAINE MPF 0.25% (MARCAINE) 30ML $21.00BUPIVACAINE/DEXTR AMP(MARCAINE SPINAL) $22.00BUPIVACAINE/EPI 0.25% 10ML(MARCAINE/EPI) $85.00BUPIVACAINE/EPI 0.5% 10ML (MARCAINE/EPI) $29.00BUPRENORPHINE $164.00BUPRENORPHINE 0.3 MG AMP $20.00BUPROPION $204.00BUPROPION 75 MG TABLET (WELLBUTRIN) $8.00BUPROPION HCL SR 150MG TABLET (12H TAB) $7.00BUPROPION XL 150MG TAB (WELLBUTRIN XL) $9.00BUR ROUND DIAMOND 4.0MM $120.00BURETROL W/BALL VALVE DRIP $45.00BURN DEBRIDE/DRESSING LG $605.00BURN INITIAL TREATMENT $110.00BURR BARREL 6 FLUTE $65.00BURR ROUND 2.0MM $310.00BURR ROUND 6 FLUTE $65.00BURR ROUND SMALL 1.5MM $310.00BUSPIRONE 5 MG TABLET (BUSPAR) $6.00BUTALBITAL/CAFF/ACET TAB (FIORICET) $6.00BUTALBITAL/CAFF/ACET TABLET (ESGIC PLUS) $7.00BUTORPHANOL (STADOL) 2 MG VIAL $33.00BUTORPHANOL 1 MG VIAL (STADOL) $18.00BUTORPHANOL NASAL SPRAY (STADOL) 10MG/ML $211.00BUTTERFLY 16 ST $8.00BUTTERFLY 19 $10.00BUTTERFLY 19 SHORT TUBE $19.00BUTTERFLY 19GA. $8.00BUTTERFLY 25 $19.00BUTTON SWITCH PENCIL $71.00BX LIVER NDLE/DONE W/OTHER MAJ PROC $176.00BX LIVER NDLE/DONE W/OTHER MAJ PROC $176.00BX OF LIVER WEDGE $2,112.00BX OF LIVER WEDGE $2,112.00BX OF SUBMANDIBULAR GLAND $538.00BX/EXC LYMPH NODE OPEN INGUINOFEMORAL $1,074.00

BX/EXC LYMPH NODE(S);DEEP $1,251.00BX/EXC LYMPH NODE(S);DEEP $1,251.00BX/EXC LYMPH NODE(S);SUPERFICIA $311.00BX/EXC LYMPH NODE(S);SUPERFICIA $311.00BX/EXC LYMPH NODE;CERV W/EXC FAT $771.00BX/EXC LYMPH NODE;CERV W/EXC FAT $771.00BXB SAMPLE LINE $15.00BYETTA 250MCG/ML 2.4ML (EXENATIDE) PEN $504.00BYSTOLIC 10MG TABLET (NEBIVOLOL) $22.00BYSTOLIC 2.5MG TABLET (NEBIVOLOL) $22.00BYSTOLIC 5MG TABLET (NEBIVOLOL) $10.00C ARM DRAPE- FULL- ORTHO $20.00C SECTION PACK $495.00C1 ESTERASE INHIBITOR ASSAY $189.00C1 ESTERASE INHIBITOR FUNC. $112.00C1Q COMPLEMENT $186.00C3 $92.00CADD PAIN PUMP ADMIN SET $60.00CADMIUM BLOOD $186.00CAFFEINE $277.00CAFFEINE 200MG TABLETS $6.00CAFFEINE/SOD BENZ SDPF 250/ML $56.00CALADRYL (CALAMINE/PRAMOXINE) 6 0Z $19.00CALAMINE LOTION 6OZ $7.00CALCANEAL FX $1,194.00CALCIFEROL (VITAMIN D) 8 MU /DROPPER $16.00CALCIFEROL 50 MCG CAPSULE $11.00CALCITONIN $82.00CALCITONIN 400 IU/2ML VIAL (MIACALCIN) $531.00CALCITRIOL $82.00CALCITRIOL 0.25 MCG CAP (ROCALTROL) $6.00CALCIUM $74.00CALCIUM /CREAT RATIO $40.00CALCIUM 600MG WITH D TAB (CALTRATE W/ D) $1.00CALCIUM ACETATE (PHOSLO) 667 MG CAPSULE $8.00CALCIUM CARBONATE 500MG TABLET (TUMS) $6.00CALCIUM CARBONATE 600MG TABLET(CALTRATE) $6.00CALCIUM CARBONATE E.X. 750 MG TAB (TUMS) $4.00CALCIUM CHLORIDE 10% SYRINGE $40.00CALCIUM GLUCONATE 10% 1 GM VIAL $16.00CALCIUM GLUCONATE 1GM/NS 50ML PREMIX $31.00CALCIUM IONIZED $104.00CALCIUM URINE 24 $54.00CALF GARMENT UP TO 17 $81.00CALF GARMENT UP TO 23 LG $120.00CALIBRATED GUIDE PIN $31.00CALMOSEPTINE OINTMENT UD PACKET $1.00

CALMOSEPTINE TUBE(THYM/MENTHOL/GLY/CALA) $13.00CALPROTECTIN $456.00CALRETICULIN MUTATION ANALYSIS $1,144.00CAMPHO-PHENIQUE (CAMPHOR/PHENOL) GEL $19.00CANCER ANTIGEN 125 $150.00CANCER ANTIGEN 15-3 $150.00CANCER ANTIGEN 19-9 $124.00CANCER ANTIGEN 27.29 $150.00CANCIDAS 50MG VIAL (CASPOFUNGIN ACETATE) $1,698.00CANDIDA ANTIBODY, QUALITATIVE $285.00CANDIDA ANTIGEN $166.00CANE ORTHO $191.00CANE TIPS $17.00CANISTER 3000CC LINER $14.00CANISTER LINER 1200CC $12.00CANNABINOID CONFIRMATION URINE $277.00CANNISTER LINER W/FILTER $13.00CANNULA 8.5MMX72MMCLEAR TRAC-ORTHO $276.00CANNULA ADULT $7.00CANNULA ADULT $9.00CANNULA BIOPSY ENDOMETRIAL(FIRM FLEX) $25.00CANNULA CLEAR TRAC8.5X 90MM-ORTHO $276.00CANNULA CRYSTAL PART THREAD-ORTHO $198.00CANNULA DIVIDED ADULT O2/CO2 $12.00CANNULA INFANT $16.00CANNULA PASSPORT BUTTON-ORTHO $253.00CANNULA PED $14.00CANNULA PED $27.00CANNULA SET 6X 25 LONGTERM $533.00CANNULATED DRILL BIT 2.7 $1,463.00CANNULATED DRILL BIT 3.2MM $825.00CANNULATED SCREW 4.0 26MM $544.00CANNULATED SCREW 4.0 28MM $544.00CANNULATED SCREW 4.0 32MM $544.00CANNULATED SCREW 4.0 40MM $560.00CANNULATED SCREW 4.0 42MM $544.00CANNULATED SCREW 4.0 44MM $560.00CANNULATED SCREW 4.5MM $560.00CANNULATED SHORT SCREW 3.2 X18 MM $635.00CANNULATED SHORT SCREW 3.2 X 16 MM $635.00CANOPY LG $65.00CANOPY SM $40.00CAPILLARY DRAW $27.00CAPIO SYSTEM STANDARD 12MM X 32C $664.00CAPSAICIN CREAM 0.025% 60GM $15.00CAPSULAR CONTRACTURE RELEASE $458.00CAPTOPRIL 12.5 MG TABLET $6.00

CAPTOPRIL 25MG TABLET (CAPOTEN) $5.00CARBAMAZEPINE 100 MG TABLET (TEGRETOL) $6.00CARBAMAZEPINE 200MG TABLET (TEGRETOL) $6.00CARBAMAZEPINE SUSP 100MG/5ML (TEGRETOL) $2.00CARBAMAZEPINE XR 200MG TABLET (TEGRETOL) $7.00CARBAMIDE PEROXIDE 15ML $25.00CARBAMIDE PEROXIDE EAR DROPS (DEBROX) $8.00CARBIDOPA/LEVOD 10/100MG TABLET(SINEMET) $6.00CARBIDOPA/LEVOD 25/250MG TABLET(SINEMET) $7.00CARBIDOPA/LEVOD CR25/100 TABLET(SINEMET) $10.00CARBIDOPA/LEVODOPA 25/100MG TAB(SINEMET) $6.00CARBIDOPA/LEVODOPA/ENTACAP 25/100/200MG $20.00CARBOPLATIN 150 MG VIAL (PARAPLATIN) $121.00CARBOPLATIN 450 MG VIAL $448.00CARBOPLATIN 50 MG VIAL $96.00CARBOPLATIN 600 MG VIAL $309.00CARBOXYHEMOGLOBIN $312.00CARD VAS STR W/PHY SUPERVISION $62.00CARDIAC REHAB WITH MONITORING $37.00CARDIOPULMONARY RESUS 15 MIN $704.00CARDIOPULMONARY RESUSC PER HOUR $952.00CARDIOVAS STRESS TEST $62.00CARDIOVAS STRESS TEST $62.00CARDIOVASCULAR STRESS TEST $62.00CARDIOVASCULAR STRESS TEST W/ SUP AND IN $498.00CARDIOVASCULAR STRESS TEST W/ SUP AND IN $498.00CARDIOVERSION $924.00CARDIOVERSION $398.00CARDURA (DOXAZOSIN : 4 MG DO NOT USE $7.00CARIMUNE NF 12G (IMMUNE GLOBULIN) $1,747.00CARIMUNE NF 6GM (IMMUNE GLOBULIN) $1,076.00CARIOPULMONARY RESUSCITATION (CODE BLUE) $920.00CARISOPRODOL 350 MG TAB (SOMA) $6.00C-ARM /FLUORO UP TO 1 HR PHY QHP TIME $231.00C-ARM FLUOROGUIDE FOR VEIN DEVICE $309.00CARMEX (ALUM/SAL ACID/MENTH/CAMPH) OINT $15.00CARNITINE TOTAL & FREE $121.00CARNITOR 200MG/ML 5ML (LEVOCARNITINE) $1,095.00CAROTENE $70.00CARPAL FX $1,078.00CARSEAT/BED TESTING 60 MIN $132.00CARSEAT/BED TESTING ADDL 30 MIN $132.00CARTEOLOL HCL 1% OPTH SOLN 5ML (OCUPRES) $19.00CARVEDILOL 3.125 MG TABLET $6.00CARVEDILOL TABLET 12.5MG (COREG) $6.00CASCARA SAGRADA AROMATIC $5.00CAST PADDING SPEC 4 YAKEL $9.50

CAST RM METAL ARM SPLINT $33.00CAST RM METAL HAND SPLINT $28.00CAST RM METAL LEG SPLINT $33.00CAST RM METAL TOE SPLINT $24.00CAST RM WALKING HEEL $43.00CAST SUPPLY FIB $106.00CAST SUPPLY LONG $106.00CAST SUPPLY LONG ARM $101.00CAST SUPPLY LONG ARM $106.00CAST SUPPLY SHORT ARM $106.00CAST SUPPLY SHORT ARM $106.00CAST SUPPLY SHORT LEG $106.00CAST SUPPLY SHORT LEG $106.00CAST SUPPLY SHORT LEG $106.00CASTOR OIL 2 OZ $8.00CATAPRES (CLONIDINE) TTS 0.3MG/DAY PATCH $102.00CATARACT RECOVERY ROOM $491.00CATARACT SURG ROOM $2,294.00CATECHOLAMINE FRACTIONATED 24 HR URINE $86.00CATECHOLAMINE FRACTIONATED RANDOM URINE $86.00CATECHOLAMINE FRACTIONATED, PLASMA $86.00CATH & INTRO SALINE/CONTRACT SIS/HSG $321.00CATH & INTRO SALINE/CONTRACT SIS/HSG $321.00CATH 18X1 1/4 IV $17.00CATH 20X1 IV $16.00CATH 22 IV $18.00CATH 22G IV ANGIOCATH $32.00CATH 24G IV ANGIOCATH $32.00CATH ALL PURPOSE 12FR $7.00CATH ALL PURPOSE 14FR $7.00CATH ALL PURPOSE 16FR $7.00CATH ALL PURPOSE 8FR $7.00CATH ANGIOCATH 16G $28.00CATH DIALYSIS PERITONEAL $326.00CATH FOL 2 WAY 22FR 30CC $31.00CATH FOLEY 12 FR 5CC $38.00CATH FOLEY SILASTIC 20FRX5CC $40.00CATH IRRIGATION TRAY $14.00CATH IV 20GA.X1 BD INSYTE AUTOGUARD $14.00CATH KIT INFANT & PEDIATRIC $14.00CATH N GLOVE 14 FR $6.00CATH N GLOVE 18 FR LATEX FREE $11.00CATH OLIVE TIP 4FR $234.00CATH OLIVE TIP 5FR $224.00CATH OXYGEN 14 FR $53.00CATH PLUG $5.00CATH SUCTION 10 FR $8.00

CATH SUCTION 14 FR $8.00CATH SUCTION 8 FR $8.00CATH SUCTION INFANT 5/6FR $8.00CATH TRAY 14FR. $14.00CATH TRAY ADD A FOLEY $28.00CATH TRAY ADD A FOLEY $83.00CATH UMB ARTE $132.00CATH UMBIL VE $343.00CATH WHISTLE TIP 4FR $234.00CATH WHISTLE TIP 8FR $234.00CATH/NEEDLE INSYTE 24GA. 0.56 $16.00CATHERTER TWIN-CATH 18/20 $68.00CATHETER $8.00CATHETER 2.5X3.25 NEEDLE $233.00CATHETER 28FR THORACIC $35.00CATHETER 36FR THORACIC $39.00CATHETER 5 X 6 NEEDLE $233.00CATHETER 7.5 x 8 NEEDLE $444.00CATHETER ADAPTER $7.00CATHETER BIPOLAR 4 FR $315.00CATHETER CARE KIT $8.00CATHETER COUDE FOLEY 14FR 5CC 2WAY $66.00CATHETER COUDE FOLEY 20FR 5CC 2WAY $93.00CATHETER COUDE FOLEY 22FR 5CC 2WAY $102.00CATHETER COUDE TIP 18FR.5cc. $54.00CATHETER DRAW $44.00CATHETER EXTENSION SET 0.6 $21.00CATHETER FOLEY 12FR.5CC 2/WAY latex free $29.00CATHETER FOLEY 16FR 30CC 2WAY LF $55.00CATHETER FOLEY 16FR.5CC LATEX FREE $28.00CATHETER FOLEY 18FR 5CC 2WAY $53.00CATHETER FOLEY 18FR.30CC 3WAY $53.00CATHETER FOLEY 5CC 14FR LATEX FREE $24.00CATHETER FOLEY 6FR LATEX $24.00CATHETER FOLEY 8FR 3CC LATEX FREE $24.00CATHETER FOLEY PEDS 10 FR 3CC LATEX FREE $21.00CATHETER FOLEY PEDS 8FR 3CC $77.00CATHETER GROSHONG 8 FR X 19 $566.00CATHETER IV ANGIOCATH 14GA 1.75 $10.00CATHETER LEG STRAP $10.00CATHETER MALE EXTERNAL LARGE $10.00CATHETER MALE EXTERNAL MEDIUM $23.00CATHETER MULTI LUMEN $168.00CATHETER MULTI LUMEN-20CM $200.00CATHETER NASAL $130.00CATHETER PEZZER 24FR. $99.00CATHETER PEZZER 32FR. $68.00

CATHETER SIMPLE (FOLEY) $250.00CATHETER STABILIZATION DEVICE $28.00CATHETER STABILIZATION DEVICE $65.00CATHETER STRAIGHT $195.00CATHETER STRAIGHT $195.00CATHETER SUBCLAVIAN $61.00CATHETER THORACIC 32 FR TROCAR $66.00CATHETER THORACIC 36 FR $53.00CATHETER TROCAR 16 FR $93.00CATHETER TROCAR 24 FR $163.00CATHETER TROCAR 28 FR THRORACIC $47.00CATHETER TWIN-CATH 20/22 $68.00CATHETER ULTRA SEAL SONOHYSTEROGRAPHY $88.00CATHETER UTERINE BALLOON $1,526.00CATHETER WORD BARTHOLIN 10F $52.00CATHETERIZATION AND INTRODUCTION OF SALI $338.00CATHETERIZATION OF UMBILICAL VEIN FOR DI $361.00CATHETERIZATION, UMBILICAL ARTERY, NEWBO $139.00CATHFLO ACTIVASE (ALTEPLASE) 2 MG $515.00CATH-SECURE $16.00CAUTERY HOTSY TOTSY $82.00CAUTERY OF CERVIX ELECT OR THERMAL $293.00CAUTERY OF CERVIX ELECT. OR THERMAL $293.00CAUTERY OF CERVIX; CRYOCAUTERY, INITIAL $293.00CD20 $301.00CD8 $85.00CEA $151.00CEDAX (CEFTIBUTEN) 90MG/5ML 60ML $157.00CEFACLOR 125MG/5ML SUSP (CECLOR) $50.00CEFACLOR 250 MG CAPSULE (CECLOR) $13.00CEFACLOR 250MG/5ML SUSP (CECLOR) $82.00CEFACLOR CD 500 MG TAB (CECLOR) $16.00CEFADROXIL (VELSOSEF) 500 MG CAPS $15.00CEFADROXIL 500 MG CAPSULE (DURICEF) $20.00CEFAZOLIN 1GM/DEXTROSE 5% 50ML *DUPLEX $20.00CEFAZOLIN 2GM/DEXTROSE 5% 50ML *DUPLEX* $35.00CEFAZOLIN 500 MG VIAL (KEFZOL) $38.00CEFAZOLIN 500 MG VIAL (KEFZOL) $33.00CEFAZOLIN INJ 1 GM VIAL (KEFZOL,ANCEF) $28.00CEFDINIR 125MG/5ML SUSPENSION 60ML $36.00CEFDINIR 300MG CAPSULE (OMNICEF) $12.00CEFEPIME 1GM VIAL (MAXIPIME) $49.00CEFEPIME 2 GM VIAL (MAXIPIME) $73.00CEFIXIME 400 MG TABLET (SUPRAX) $40.00CEFOBID IVPB 1GM/NS+ 100ML ** $110.00CEFOPERAZONE 1 GM VIAL (CEFOBID) $110.00CEFOPERAZONE 2 GM VIAL (CEFOBID) $197.00

CEFOTAXIME 2 GM VIAL (CLAFORAN) $135.00CEFOTAXIME IVPB 1GM/NS+ 100ML ** $139.00CEFOTAXIME IVPB 2GM/NS+ 100ML ** $139.00CEFOTAXIME PER GM $48.00CEFOTETAN 1GM VIAL $86.00CEFOTETAN 1GM/NS 100ML $86.00CEFOTETAN 2 GM VIAL $146.00CEFOTETAN 2GM/50ML DEXTROSE *DUPLEX $123.00CEFOTETAN DISOD 1 GM VIAL (CEFOTAN) $63.00CeFOXitin :1 GM VIAL (MEFOXIN) $92.00CEFOXITIN 1GM/50ML D5W DUPLEX $72.00CeFOXitin 2 GM VIAL (MEFOXIN) $113.00CEFOXITIN 2GM/D5W 50ML DUPLEX $117.00CeFOXitin 2GM/NS+100ML IVPB (MEFOXIN) $152.00CEFPODOXIME 100 MG/5ML SUSP (VANTIN) $304.00CEFPODOXIME PROXETIL 100 MG TAB (VANTIN) $4.00CEFPODOXIME PROXETIL 200 MG TAB (VANTIN) $6.00CEFPROZIL 250MG/5ML SUSPENSION (CEFZIL) $209.00CEFPROZIL 500MG TABLET (CEFZIL) $46.00CEFTAZIDIME 1 GM VIAL (FORTAZ) $55.00CEFTAZIDIME 2 GM VIAL (FORTAZ) $64.00CEFTIBUTEN 400 MG CAPSULE (CEDAX) $9.00CefTRIAXone 1GM/D5% 50ML *DUPLEX $39.00CefTRIAXone 250 MG VIAL (ROCEPHIN) $29.00CefTRIAXone 500 MG VIAL (ROCEPHIN) $30.00CefTRIAXone: 1 GM VIAL (ROCEPHIN) $32.00CefTRIAXone: 2 GM VIAL (ROCEPHIN) $42.00CEFUROXIME 1.5 GM VIAL (ZINACEF) $95.00CEFUROXIME 1.5GM/NS+ 100ML (ZINACEF) $100.00CEFUROXIME 125 MG/5ML SUSPENSION(CEFTIN) $79.00CEFUROXIME 250 MG TABLET (CEFTIN) $7.00CEFUROXIME 250 MG/5ML SUSPENSION(CEFTIN) $115.00CEFUROXIME 750MG VIAL (ZINACEF) $60.00CEFUROXIME 750MG/NS+ 100ML (ZINACEF) $70.00CeleBREX (CELECOXIB) 100 MG CAPSULE $20.00CELESTONE (BETAMETHASONE) 3MG/ML 5ML $107.00CELESTONE 6MG/ML 5ML $50.00CELL CULTURE FOR CHROSOME ANALYSIS $97.00CENTRAL CATH < 5 $75.00CENTRAL CATH >5 YRSA $239.00CENTRAL CATH >5 YRSA $227.00CENTRAL CATH >5 YRSA $227.00CENTRUM (MULTIVITAMIN/MULTMINERAL)TABLET $4.00CEPACOL (CETYLPYRIDINIUM) LOZENGES $1.00CEPHALEXIN 125MG/5ML SUSP 100ML (KEFLEX) $21.00CEPHALEXIN 250 MG CAPSULE (KEFLEX) $6.00CEPHALEXIN 250MG/5ML SUSP 100ML (KEFLEX) $21.00

CEPHALEXIN 500 MG CAPSULE (KEFLEX) $6.00CERCLAGE OF CERVIX $702.00CERCLAGE OF CERVIX $558.00CERCLAGE OF CERVIX $558.00CERCLAGE OF CERVIX, DURING PREGNANCY; VA $586.00CERTA VITE (VITAMINS&MINERAL) 2OZ $15.00CERULOPLASMIN $65.00CERVICAL COLLAR $154.00CERVICAL PUDENDAL INJ SET $18.00CERVICAL SUPPORT 4 1/4 $219.00CERVICAL SUPPORT LG 3 1/4 $225.00CERVICAL SUPPORT LG 4 1/4 $169.00CERVICAL SUPPORT MED 3 1/4 $169.00CERVICAL SUPPORT MED 4 1/4 $169.00CERVICAL SUPPORT SMALL 3 1/4 $105.00CERVIDIL (DINOPROSTONE) 10 MG VAG SUPP $636.00CERVIX BIO;SING/MULT $291.00CERVIX BIO;SING/MULT $291.00CESAREAN DELIVERY ONLY, FOLLOWING ATTEMP $2,304.00CESAREAN DELIVERY ONLY, FOLLOWING ATTEMP $3,161.00CESAREAN DELIVERY ONLY; $1,817.00CESAREAN DELIVERY ONLY; INCLUDING POSTPA $2,153.00CETIRIZINE 10MG TABLET (ZYRTEC) $6.00CETIRIZINE HCL 5MG/5ML SYRUP (ZYRTEC) $10.00CETIRIZINE HCL 5MG/5ML SYRUP (ZYRTEC) $5.00CHAIR CUSHION SOFCARE $67.00CHANGE OF CYSTOSTOMY TUBE SIMPLE $227.00CHANGE OF CYSTOSTOMY TUBE; SIMPLE $114.00CHANGE OF CYSTOSTOMY TUBE; SIMPLE $114.00CHANGE OF WINDPIPE AIRWAY $87.00CHANGE OF WINDPIPE AIRWAY $87.00CHANGE OF WINDPIPE AIRWAY $5.00CHANNEL DRAIN $80.00CHARCOAL IN AQUEOUS BASE 50GM/240ML $29.00CHARCOAL LIQ (CHARCOAL/SORBITOL) 25 GM $30.00CHARCOAL LIQ AQUEOUS BASE 25 GM $58.00CHEMICAL CAUT GRANULATION TISSUE $119.00CHEMICAL CAUT GRANULATION TISSUE $119.00CHEMICAL CAUT GRANULATION TISSUE $67.00CHEMO EXTEND IV INFUSION W/PUMP $688.00CHEMO INFUSION 1ST HR $566.00CHEMO INFUSION EA ADDL HR $128.00CHEMO IV INFUSION EA SEQUENTIAL $245.00CHEMO IV PUSH EA ADDL INJECTION $160.00CHEMO IV PUSH,INITIAL DRUG $355.00CHEMO PROLONG INFUSE W/PUMP $732.00CHEMO, ANTI-NEOPL, SQ/IM $160.00

CHEMO,HORMON ANTINEOPL SQ/IM $93.00CHEMOTHERAPY UNSPECIFIED $87.00CHERATUSSIN AC SYR 10MG-100MG/5ML BTL $11.00CHEST MULT VIEWS-MIN 4V $292.00CHEST PA/LAT - 2V $317.00CHEST SINGLE VIEW $170.00CHEST3V W/APICAL LORDOTIC $154.00CHIROPRACT MANIPULAT TX 1-2 SPINAL REGIO $58.00CHIROPRACT MANIPULAT TX 3-4 SPINAL REGIO $89.00CHIROPRACT MANIPULAT TX 5 SPINAL REGIONS $119.00CHIROPRACT MANJ TX EXTRA SPINAL 1/>REGIO $60.00CHLAMYDIA PCR $132.00CHLAMYDIA AMPLIFICATION $121.00CHLAMYDIA PNEUMONIAE IgG, IgM, IgA $178.00CHLAMYDIA PSITTACI ANTIBODY IGG $197.00CHLAMYDIA PSITTACI ANTIBODY IGM $113.00CHLAMYDIA TRACHOMATIS IGM $113.00CHLORAL HYDRATE 324 MG RS $48.00CHLORAL HYDRATE 500MG $5.00CHLORAL HYDRATE 648 MG RS $17.00CHLORAMPHENICOL 1GM VIAL $22.00CHLORASEPTIC (PHENOL/NAPHENOLATE) LOZENG $4.00CHLORASEPTIC (PHENOL/NAPHENOLATE) SPRAY $5.00CHLORDIAZEPOXIDE 10 MG CAPSULE (LIBRIUM) $4.00CHLORDIAZEPOXIDE 25 MG CAPSULE (LIBRIUM) $6.00CHLORHEXIDINE GLUC SOLN 4OZ (HIBICLENS) $20.00CHLORIDE $71.00CHLORIDE URINE $62.00CHLORIDE,BODY FLUID $69.00CHLOROPROCAINE 3 % SOLN (NESACAINE-MDF) $123.00CHLOROTHIAZIDE 500 MG IV (DIURIL) $55.00CHLOROTHIAZIDE 500 MG TABLET (DIURIL) $4.00CHLOROXAZONE 500 MG TAB (PARAFON FORTE) $4.00CHLORPH/PSEUDO 8/120MG (DECONAMINE SR) $5.00CHLORPHENIRAMIN 4MG TAB (CHLOR-TRIMETON) $4.00CHLORPHENIRAMINE 8MG TAB(CHLOR-TRIMETON) $11.00CHLORPROMAZINE 100MG TABLET $20.00ChlorproMAZINE 25 MG AMP (THORAZINE) $135.00ChlorproMAZINE 25 MG TABLET (THORAZINE) $4.00ChlorPROPAMIDE 250 MG TABLET (DIABINESE) $4.00CHLOR-TRIMETON (CHLORPHENIRAMINE) 2 OZ $14.00CHLORZINE 80 GRAMS $21.00CHOLANGIOGRAM CATH $133.00CHOLANGIOGRAPH CATH 4FR $61.00CHOLECT LAPARSCPY W/EXPLO COMMON DUCT $2,151.00CHOLECT LAPARSCPY W/EXPLO COMMON DUCT $2,151.00CHOLECYSTECT W/CHOLANGIOGRAPH $1,458.00

CHOLECYSTECT W/CHOLANGIOGRAPH $1,458.00CHOLECYSTECTOMY $2,239.00CHOLECYSTECTOMY $2,239.00CHOLECYSTECTOMY WITH EXPLORATION OF COMM $2,412.00CHOLECYSTECTOMY; $1,784.00CHOLESTEROL $75.00CHOLESTYRAMINE POWDER (QUESTRAN) PCKT $12.00CHOLINESTERASE $92.00CHOMOSOME ANALYSIS EACH KARYOTYPE $105.00CHORIONIC GONADOTROPIN BETA SUB UNIT $272.00CHROMIUM PLASMA $81.00CHROMOGRANIN A $480.00CHROMOTUBATION OF OVIDUCT, INCLUDING MAT $219.00CHROMOTUBATION OVIDUCT W/MATERIALS $219.00CHROMOTUBATION OVIDUCT W/MATERIALS $219.00CHRONIC LYMPHOCYTIC LEUKEMIA (FISH) $333.00CICLOPIROX OLAMINE 1% CREAM 15G (LOPROX) $57.00CILOSTAZOL 100MG TABLETS (PLETAL) $9.00CILOSTAZOL 50MG TABLET $7.00CIMETIDINE 300 MG TABLET (TAGAMET) $4.00CIMETIDINE 400 MG TABLET (TAGAMET) $6.00CIMETIDINE SYRUP 300 MG/5ML (TAGAMET) $59.00CIMZIA 2X200MG SYRINGES (CERTOLIZUMAB) $3,735.00CIPRO (CIPROFLOX) 400MG/D5W 200ML PREMIX $204.00CIPRO (CIPROFLOXACIN) 250MG/5ML ORAL SUS $221.00CIPRODEX OTIC SUSP 0.3%-0.1% $310.00CIPROFLOXACIN 0.3% OPTH SOLN $44.00CIPROFLOXACIN 200MG/100ML D5W PREMIX $33.00CIPROFLOXACIN 400MG VIAL (CIPRO) $36.00CIPROFLOXACIN 400MG/200ML D5W PREMIX $21.00CIPROFLOXACIN HCL 250 MG TAB (CIPRO) $6.00CIPROFLOXIN OTIC SOLN 10ML (CIPRO HC) $160.00CIRCUMCISION PROCEDURE $245.00CIRCUMCISION SET $24.00CIRCUMCISION WITH SET $195.00CIRCUMCISION, SURGICAL EXCISION OTHER TH $368.00CIRCUMCISION, SURGICAL EXCISION OTHER TH $346.00CIRCUMCISION, USING CLAMP OR OTHER DEVIC $611.00CIRCUMCISION/SURGICAL $329.00CIRCUMCISION/SURGICAL $329.00CIRCUMCISION/UNDER 28 DAYS $581.00CISPLANTIN 100MG VIAL $1,121.00CISPLATIN 200MG VIAL $163.00CISPLATIN AQ 100MG VIAL $13.50CISPLATIN AQ 50MG VIAL $205.00CITALOPRAM 20 MG TABLET (CeleXA) $6.00CITRIC ACID, 24 HOUR URINE $104.00

CK $72.00CK $132.00CK TOTAL $45.00CK-MB $99.00CL 17110DESTRUCTION B9 LESION 1-14 $187.00CL ADJUSTMENT OF GASTRIC BAND DIAMETER V $176.00CL ADVANCE CARE PLANNING INCLUDING THE E $205.00CL ADVANCE CARE PLANNING INCLUDING THE E $180.00CL ATTENDANCE AT DELIVERY (WHEN REQUESTE $181.00CL CHRONIC CARE MANAGEMENT SERVICES, AT $100.00CL COLPOSCOPY OF VULVA W/BIOPSY $375.00CL CRITICAL CARE FACE-TO-FACE SERVICES, $287.00CL CURRENT SMOKELESS TOBACCO USE $1.00CL CURRENT TOBACCO NONUSE CAD, CAP, COPD $1.00CL CURRENT TOBACCO SMOKE CAD, CAP, COPD, $1.00CL DEBRIDEMENT SUBCUTANEOUS TISSUE $217.00CL DEBRIDEMENT, BONE (INCLUDES EPIDERMIS $578.00CL DEBRIDEMENT, MUSCLE AND/OR FASCIA $692.00CL DEBRIDEMENT, SUBCUTANEOUS TISSUE $101.00CL DELIVERY/BIRTHING ROOM RESUSCITATION $352.00CL DEST LESION 15 OR MORE $186.00CL DISCHARGE MEDICATIONS RECONCILED $1.00CL DOMICILIARY OR REST HOME VISIT FOR TH $146.00CL DOMICILIARY OR REST HOME VISIT FOR TH $195.00CL DOMICILIARY OR REST HOME VISIT FOR TH $334.00CL DOMICILIARY OR REST HOME VISIT FOR TH $449.00CL DOMICILIARY OR REST HOME VISIT FOR TH $528.00CL DOMICILIARY OR REST HOME VISIT FOR TH $145.00CL DOMICILIARY OR REST HOME VISIT FOR TH $454.00CL DOMICILIARY OR REST HOME VISIT FOR TH $495.00CL DOMICILIARY OR REST HOME VISIT FOR TH $467.00CL DRAINAGE OF MULTI ABSCESS $373.00CL DRAINAGE OF SINGLE ABSCESS $235.00CL ELEVATED BLOOD PRESSURE PLAN CARE DOC $1.00CL EXCISION, BENIGN LESION INCLUD MARGIN $238.00CL EXCISION, BENIGN LESION INCLUD MARGIN $273.00CL EXCISION, BENIGN LESION INCLUD MARGIN $428.00CL FINE NEEDLE ASPIRATION; WITHOUT IMAGI $250.00CL HEMOGLOBIN A1C $84.00CL HOME VISIT FOR THE EVALUATION AND MAN $133.00CL HOSPITAL DISCHARGE DAY MANAGEMENT; 30 $176.00CL HOSPITAL DISCHARGE DAY MANAGEMENT; MO $214.00CL INCISION AND DRAIN, COMPLEX, POSTOPER $536.00CL INCISION AND DRAINAGE HEMATOMA, SEROM $248.00CL INCISION AND DRAINAGE PILONIDAL CYST; $418.00CL INCISION AND DRAINAGE PILONIDAL CYST; $740.00CL INCISION AND REMOVAL FOREIGN BODY, SU $299.00

CL INCISION BIOPSY SKIN EA SEP ADDL LESI $174.00CL INCISIONAL BIOPSY SKIN SINGLE LESION $363.00CL INITIAL HOSPITAL CARE, PER DAY, FOR T $244.00CL INITIAL HOSPITAL CARE, PER DAY, FOR T $251.00CL INITIAL HOSPITAL CARE, PER DAY, FOR T $486.00CL INITIAL HOSPITAL OR BIRTHING CENTER C $231.00CL INITIAL HOSPITAL OR BIRTHING CENTER C $267.00CL INITIAL INPATIENT NEONATAL CRITICAL C $2,214.00CL INITIAL NURSING FACILITY CARE, PER DA $309.00CL INITIAL NURSING FACILITY CARE, PER DA $395.00CL INITIAL OBSERVATION CARE, PER DAY, FO $177.00CL INITIAL OBSERVATION CARE, PER DAY, FO $367.00CL INITIAL OBSERVATION CARE, PER DAY, FO $340.00CL INJECTION, BUPIVICAINE HYDROCHLORID30 $36.00CL INPATIENT CONSULTATION FOR A NEW OR E $83.00CL INPATIENT CONSULTATION FOR A NEW OR E $179.00CL INPATIENT CONSULTATION FOR A NEW OR E $278.00CL INT NURSING FAC CARE 99304 $212.00CL INT NURSING FAC CARE 99305 $309.00CL INT NURSING FAC CARE 99306 $395.00CL LEVEL II ACCREDITED AUTHORIZED TREATI $373.00CL NURSING FAC DISCHARGE DAY 99315 $188.00CL NURSING FAC DISCHARGE DAY 99316 $237.00CL OBSERVATION CARE DISCHARGE DAY MANAGE $139.00CL OBSERVATION OR INPATIENT HOSPITAL CAR $320.00CL OBSERVATION OR INPATIENT HOSPITAL CAR $412.00CL OBSERVATION OR INPATIENT HOSPITAL CAR $498.00CL PARING CUTTING OF BENIGN HYPERKERATOT $58.00CL PARING CUTTING OF BENIGN HYPERKERATOT $93.00CL PATIENT SCREENED FUTURE FALL RISK $1.00CL PATIENT SCREENED FUTURE FALL RISK $1.00CL PERIODIC COMPREHENSIVE PREVENTIVE MED $185.00CL PHYSICIAN STANDBY SERVICE, REQ PRO $168.00CL PROLONGED EVALUATION AND MGMNT SERV $420.00CL PROLONGED EVALUATION AND MGMNT SRVC $474.00CL PROLONGED PHYSICIAN SERVICE INPAT $223.00CL PROLONGED PHYSICIAN SERVICE INPATIENT $222.00CL PUNCH BIOPSY SKIN (INCLUDING SIMPLE C $300.00CL PUNCH BIOPSY SKIN EA SEP ADDL LESION $147.00CL PUNCTURE ASPIRATION ABSCESS, HEMATOMA $229.00CL REFERRAL, LEVEL II ACCREDITED AUTHORI $604.00CL REMOVAL PROSTHETIC MATERIAL OR MESH $648.00CL REMOVAL SKIN TAGS <W/15 $172.00CL REMOVE SKIN TAGS ADD ON $40.00CL RITICAL CARE FACE-TO-FACE SERVICES, $623.00CL SHAVING EPIDERMAL OR DERMAL LESION, S $81.00CL SHAVING EPIDERMAL OR DERMAL LESION, S $363.00

CL SHAVING EPIDERMAL OR DERMAL LESION, S $329.00CL SKIN SUB GRFT FACE/NK/HF/G $372.00CL SMOKING AND TOBACCO USE CESSATION COU $27.00CL SMOKING AND TOBACCO USE CESSATION COU $37.00CL SUB NURSING FAC CARE 99307 $110.00CL SUB NURSING FAC CARE 99308 $168.00CL SUB NURSING FAC CARE 99309 $222.00CL SUB NURSING FAC CARE 99310 $286.00CL SUBSEQUENT HOSPITAL CARE, PER DAY, FO $80.00CL SUBSEQUENT HOSPITAL CARE, PER DAY, FO $175.00CL SUBSEQUENT HOSPITAL CARE, PER DAY, FO $307.00CL SUBSEQUENT HOSPITAL CARE, PER DAY, FO $101.00CL SUBSEQUENT NURSING FACILITY CARE, PER $110.00CL SUBSEQUENT NURSING FACILITY CARE, PER $168.00CL SUBSEQUENT NURSING FACILITY CARE, PER $222.00CL SUBSEQUENT OBSERVATION CARE, PER DAY $99.00CL SUBSEQUENT OBSERVATION CARE, PER DAY, $181.00CL TANGENTIAL BIOPSY SKIN E SEP ADDL LES $129.00CL TANGENTIAL BIOPSY SKIN LESION $239.00CL TELEPHONIC MEETING BY PHYSICIAN WITH $69.00CL TRANSITIONAL CARE MANAGEMENT SERVICES $394.00CL TRANSITIONAL CARE MANAGEMENT SERVICES $556.00CL TX POST HIP ARTHRP DISLC REQ ANEST $1,426.00CL UNLISTED EVALUATION AND MANAGEMENT SE $172.00CL WORKERS COMP $158.00CL-ACTHIB VACCINE $45.00CL-ADACEL VACCINE FOR 7 YEARS AND ABOVE $55.00CL-ALBUTEROL 0.083% 2.5MG/3ML INH3ML $6.00CL-ALBUTEROL/IPRATROPIUM 2.5/0.5MG $8.00CLARINEX (DESLORATIDINE) 5MG TABLET $11.00CLARITHROMYCIN (BIAXIN) 500 MG TABLET $30.00CLARITHROMYCIN 125MG/5ML SUSP $106.00CLARITHROMYCIN 250 MG TABLET (BIAXIN) $19.00CLARITHROMYCIN 250 MG/5ML SUSPENSION $153.00CLARITHROMYCIN ER 500 MG TAB (BIAXIN XL) $24.00CLARITIN D (LORATADINE/PSEUDOPHED) 12HR $10.00CLARITIN D (LORATADINE/PSEUDOPHED) 24HR $14.00CLAVICLE BRACE INFANT $47.00CLAVICLE BRACE LARGE $61.00CLAVICLE BRACE MED $42.00CLAVICLE BRACE SMALL $48.00CLAVICLE SPLINT EX LARGE $35.00CLAVICLE SPLINT EX SMALL $35.00CLAVICULAR FX $370.00CLAVICULECTOMY;PARTIAL $983.00CLAVICULECTOMY;PARTIAL $983.00CL-AZITHROMYCIN DIHYDRATE, ORAL, CAPSULE $9.00

CL-BICILLIN LA (PENIC G BENZ) 600,000U $226.00CL-BICILLIN LA 1.2MU SYR (PENICIL G BEN) $473.00CL-BOOSTRIX VACCINE $55.00CL-BUPIVACAINE 0.5% VIAL $17.00CL-CefTRIAXone 1G VIAL $32.00CL-CefTRIAXone 250MG VIAL $8.00CL-CefTRIAXone 500MG VIAL $16.00CL-CELESTONE 6MG/ML 5ML $53.00CL-CYANOCOBALAMIN 1000MCG/1ML $18.00CL-DIPHENHYDRAMINE 50MG VIAL $15.00CLEANING ENEMA SET $11.00CLEANSING DOUCHE $8.00CLEAR UNIVERSAL EYE SHIELD $8.00CLEARVIEW UTERINE MANIPULATOR $402.00CL-ENGERIX-B 10MCG/0.5ML $18.00CL-ENGERIX-B 20MCG/1ML $18.00CLEOCIN (CLINDAMYCIN) 600MG/NS+100ML $112.00CLEOCIN (CLINDAMYCIN) 75 MG/5ML SUSP $88.00CL-GARDASIL VACCINE 9 $222.00CL-HAVRIX PEDIATRIC 720EL U/0.5ML $92.00CL-HUMALOG 100 UNITS/ML: 3ML VIAL $14.00CL-HYALGAN 10MG/ML 2ML VIAL $253.00CLINDAMYCIN 150MG CAPSULE (CLEOCIN) $7.00CLINDAMYCIN 600 MG VIAL (CLEOCIN) $51.00CLINDAMYCIN 600MG/50ML NS PREMIX BAG $34.00CLINDAMYCIN 900 MG VIAL (CLEOCIN) $24.00CLINDAMYCIN 900MG/50ML NS PREMIX BAG $40.00CLINDAMYCIN PHOSPHATE 300MG (CLEOCIN) $112.00CL-INFANRIX VACCINE FOR 6 AND UNDER $36.00CL-INFLUENZA VACCINE $25.00CL-INFLUENZA VACCINE HIGH DOSE $45.00CLINIMIX E 4.25/10 (AMINO ACID/ELEC/DEX) $667.00CLINIMIX E 4.25/5 (AMINO ACID/ELEC/DEX) $293.00CLINIMIX E 5/20 (AMINO ACID/ELEC/DEX) $288.00CL-IPOL VACCINE $47.00CL-IPRATROPIUM INHALANT 0.02%(ATROVENT) $6.00CL-KENALOG INJ 40MG/ML 10ML $15.00CL-KETOROLAC 30 MG VIAL $50.00CL-KETOROLAC 60MG VIAL $50.00CL-KINRIX VACCINE $80.00CL-KYLEENA 19.5MG IUD $1,414.00CL-MEDROXYPROGESTERONE 150MG $66.00CL-MENVEO VACCINE SDV $192.00CL-MEPHYTON (PHYTONADIONE) 5MG TABLET $74.00CL-METHYLPREDNISOLONE 80MG/1ML VIAL $31.00CL-MIRENA 52MG IUD $1,055.00CL-MMR VACCINE $91.00

CL-NEXPLANON 68MG IUD $825.00CLOBAZAM $237.00CLOBETASOL PROPIONATE OINT 0.05% 30GM $45.00CLONAZEPAM 0.5 MG TABLET (KLONIPIN) $6.00CLONAZEPAM 2MG TABLET $6.00CLONIDINE 0.1MG/DAY TTS PATCH (CATAPRES) $27.00CLONIDINE 0.2MG/DAY TTS PATCH (CATAPRES) $42.00CLONIDINE HCL 0.1 MG TAB (CATAPRES) $4.00CLONIDINE HCL 0.1 MG TAB (CATAPRES) $6.00CLOPIDOGREL BISULFATE 75 MG (PLAVIX) $6.00CLORAZEPATE 7.5 MG TABLET (TRANXENE) $10.00CL-ORTHOVISC 30MG/2ML INJECTION $1,140.00CLOS TX FEM FX DIST END W/O MANIP $883.00CLOS TX FEM FX DIST END W/O MANIP $883.00CLOS TX FEM FX DIST END W/O MANIP $74.00CLOS TX MED MALLEOUS X W/MANIP $827.00CLOS TX MED MALLEOUS X W/MANIP $827.00CLOS TX MED MALLEOUS X W/MANIP $68.00CLOS TX RADIAL & ULNA FX; NO MANIP $410.00CLOS TX RADIAL & ULNA FX; NO MANIP $410.00CLOS TX RADIAL & ULNA FX; NO MANIP $81.00CLOS TX RADIAL & ULNA FX;W/MANIP $965.00CLOS TX RADIAL & ULNA FX;W/MANIP $883.00CLOS TX RADIAL & ULNA FX;W/MANIP $883.00CLOS TX RADIAL HEAD SUBLUX CHILD $214.00CLOS TX RADIAL HEAD SUBLUX CHILD $214.00CLOS TX RADIAL HEAD SUBLUX CHILD $79.00CLOS TX TIBAL FX PROX W/O MANIP $648.00CLOS TX TIBAL FX PROX W/O MANIP $648.00CLOS TX TIBAL FX PROX W/O MANIP $68.00CLOS TX ULNAR STYLOID FX $522.00CLOS TX ULNAR STYLOID FX $522.00CLOSED SUPRACONDYLAR FX W/O MANIP $544.00CLOSED TREATEMENT ANKLE DISLC ANESTHESIA $1,255.00CLOSED TREATMENT DISLOCATION TOE ANESTH $332.00CLOSED TREATMENT OF METACARPAL FRACTURE, $1,210.00CLOSED TX ARTICULAR FX;W/O MANIP $487.00CLOSED TX ARTICULAR FX;W/O MANIP $487.00CLOSED TX BIMALLEOLAR ANKLE $1,184.00CLOSED TX BIMALLEOLAR ANKLE $1,184.00CLOSED TX CARPAL BN FX W/MANIP EA BN $924.00CLOSED TX CARPAL BN FX W/MANIP EA BN $924.00CLOSED TX CARPAL BN FX W/MANIP EA BN $192.00CLOSED TX CARPAL BN FX W/O MANIP EA BN $705.00CLOSED TX CARPAL BN FX W/O MANIP EA BN $705.00CLOSED TX CARPAL SCAPHOID NO MANIPULATIO $100.00CLOSED TX CARPAL SCAPHOID W/O MANIP $561.00

CLOSED TX CARPAL SCAPHOID W/O MANIP $561.00CLOSED TX CLAVICULAR FX W/O MANIP $338.00CLOSED TX CLAVICULAR FX W/O MANIP $338.00CLOSED TX DIST FIBR FX NO MANIPULATION $81.00CLOSED TX DIST FIBR FX W/MANIP $1,226.00CLOSED TX DIST FIBR FX W/MANIP $1,226.00CLOSED TX DIST FIBR FX W/O MANIP $601.00CLOSED TX DIST FIBR FX W/O MANIP $601.00CLOSED TX DISTAL PHALANGEAL FX/MANIP $785.00CLOSED TX DISTAL PHALANGEAL FX/MANIP $785.00CLOSED TX DISTAL PHALANGEAL FX/NO MANIP $340.00CLOSED TX DISTAL PHALANGEAL FX/NO MANIP $340.00CLOSED TX DISTAL PHALANGEAL FX/NO MANIP $35.00CLOSED TX DISTAL RADIAL FX NO MANIPULATO $81.00CLOSED TX DISTAL RADIAL FX W/MANIP $1,518.00CLOSED TX DISTAL RADIAL FX W/MANIP $1,095.00CLOSED TX DISTAL RADIAL FX W/MANIP $1,095.00CLOSED TX DISTAL RADIAL FX W/O MANIP $555.00CLOSED TX DISTAL RADIAL FX W/O MANIP $555.00CLOSED TX ELBOW DISLOCAT;ANESTH $849.00CLOSED TX ELBOW DISLOCAT;ANESTH $776.00CLOSED TX ELBOW DISLOCAT;ANESTH $776.00CLOSED TX FEMUR FX W/MANIP $1,925.00CLOSED TX FEMUR FX W/MANIP $2,030.00CLOSED TX FX ARTIC DIST TIB W/O ANESTH $494.00CLOSED TX FX ARTIC DIST TIB W/O ANESTH $494.00CLOSED TX FX ARTIC DIST TIB W/SKELETAL $1,178.00CLOSED TX FX ARTIC DIST TIB W/SKELETAL T $1,197.00CLOSED TX FX ARTIC DIST TIB W/SKELETAL T $1,357.00CLOSED TX FX ARTIC DIST TIB W/SKELETAL T $1,357.00CLOSED TX FX GT TOE PHALANX W/O MANIP $218.00CLOSED TX FX GT TOE PHALANX W/O MANIP $218.00CLOSED TX FX PHLNX EX GT TOE/NO MANIP $47.00CLOSED TX HUM CONDYLAR FX/NO MANIP $539.00CLOSED TX HUM CONDYLAR FX/NO MANIP $539.00CLOSED TX HUM CONDYLAR FX/NO MANIPULATIO $79.00CLOSED TX HUM EPICOND FX W/MANIP $872.00CLOSED TX HUM EPICOND FX W/MANIP $872.00CLOSED TX HUM EPICOND FX W/MANIP $50.00CLOSED TX HUM EPICOND FX W/O MANIP $490.00CLOSED TX HUM EPICOND FX W/O MANIP $490.00CLOSED TX HUM EPICOND FX W/O MANIP $96.00CLOSED TX HUMERAL FX W/MANIP $1,167.00CLOSED TX HUMERAL FX W/O MANIP $511.00CLOSED TX HUMERAL FX W/O MANIP $511.00CLOSED TX HUMERAL SHAFT FX;W/O MANIP $770.00CLOSED TX HUMERAL SHAFT FX;W/O MANIP $770.00

CLOSED TX KNEE DISLOCATION W/ ANESTHESIA $1,587.00CLOSED TX MC FX 1/WITHOUT MANIP EA BN $70.00CLOSED TX MED MALLEOUS FX W/O MANIP $928.00CLOSED TX MED MALLEOUS FX W/O MANIP $928.00CLOSED TX MED MALLEOUS X W/MANIP $1,037.00CLOSED TX MT FX W/O MANIP $420.00CLOSED TX MT FX W/O MANIP $420.00CLOSED TX MT FX WITHOUT MANIP EACH $21.00CLOSED TX OF KNEE DISLOCATION W/O ANEST $1,186.00CLOSED TX OF RADIAL HEAD/NECK FX NO MANI $75.00CLOSED TX PATELLAR FX W/O MANIP $437.00CLOSED TX PATELLAR FX W/O MANIP $437.00CLOSED TX PATELLAR FX WITHOUT MANIP $80.00CLOSED TX PHALANGEAL FX W/MANIP $853.00CLOSED TX PHALANGEAL FX W/MANIP $853.00CLOSED TX PHALANGEAL FX W/MANIP EACH $130.00CLOSED TX PHALANGEAL FX W/O MANIP $299.00CLOSED TX PHALANGEAL FX W/O MANIP $299.00CLOSED TX PHALANGEAL FX/NO MANIP EACH $53.00CLOSED TX PROX FIB/SHAFT FX NO MANIP $490.00CLOSED TX PROX FIB/SHAFT FX NO MANIP $490.00CLOSED TX PROX FIB/SHAFT FX NO MANIP $71.00CLOSED TX RADIAL HD/NCK FX W/O MANI $424.00CLOSED TX RADIAL HD/NCK FX W/O MANI $424.00CLOSED TX RADIAL SHAFT FX NO MANIP $408.00CLOSED TX RADIAL SHAFT FX NO MANIP $408.00CLOSED TX SHOULDER DISC/W MANIP W ANEST $686.00CLOSED TX SHOULDER DISC/W MANIP W ANEST $686.00CLOSED TX SHOULDER DISC/W MANIP W ANEST $627.00CLOSED TX SHOULDER DISC/W MANIP W ANEST $627.00CLOSED TX SHOULDER DISLOCATION W/MANIP $504.00CLOSED TX SHOULDER DISLOCATION W/MANIP $504.00CLOSED TX SUPERCOND HUM FX NO MANIP $588.00CLOSED TX SUPERCOND HUM FX NO MANIP $588.00CLOSED TX SUPERCOND HUM FX NO MANIPULATI $81.00CLOSED TX TIBIAL SHAFT FX W W/O MANIP $762.00CLOSED TX TIBIAL SHAFT FX W W/O MANIP $762.00CLOSED TX TMJ DISLOCATION 1ST/SBSQ $1,443.00CLOSED TX ULNAR FX PROX END NO MANIP $475.00CLOSED TX ULNAR FX PROX END NO MANIP $475.00CLOSED TX ULNAR FX PROX END NO MANIPULAT $75.00CLOSED TX ULNAR SHAFT FX NO MANIP $430.00CLOSED TX ULNAR SHAFT FX NO MANIP $430.00CLOSED TX ULNAR SHAFT FX NO MANIPULATION $97.00CLOSTRIDIA DIFFICILE $166.00CLOSURE ENTEROSTOMY, LG/SM INTESTINE $1,861.00CLOSURE ENTEROSTOMY, LG/SM INTESTINE $1,861.00

CLOSURE LACERATION MOUTH OVER 2.5 $615.00CLOSURE LACERATION MOUTH UNDER 2 $362.00CLOSURE OF ENTEROSTOMY, LARGE OR SMALL I $1,861.00CLOTRIMAZOLE 1% CREAM 30G (LOTRIMIN) $8.00CLOTRIMAZOLE 1% VAG CREA (GYNE-LOTRIMIN) $71.00CLOTRIMAZOLE 1% VAGINAL CREAM $15.00CLOTRIMAZOLE 500 MG VAG INS (MYCELEX-G) $71.00CLOTRIMAZOLE TROCHE 10 MG (MYCELEX) $9.00CLOTRIMAZOLE VAG INSERTS (GYNE-LOTRIMIN) $73.00CLOTRIMAZOLE/BETAMETH 45G CR (LOTRISONE) $263.00CL-PARAGARD T380A IUD $684.00CL-PEDIARIX VACCINE $118.00CL-PELLET PLACEMENT/MENS $691.00CL-PELLET PLACEMENT/WOMENS $344.00CL-PENTACEL VACCINE $135.00CL-PNEUMOVAX 23 VACCINE $111.00CL-PREVNAR- 13 VACCINE $226.00CL-PROMETHAZINE 25 MG VIAL $18.00CL-PROQUAD VACCINE $219.00CL-ROTATEQ VACCINE $116.00CLSD TX PELVIC RING FX W/O MANIP W/ANEST $765.00CLSD TX PELVIC RING FX W/O MANIPULATION $306.00CL-SYNVISC 16MG/2ML $715.00CL-TETANUS/ DIPHTHERIA TOX ADULT $33.00CLTX ART FX INVG METAC/INTERPH JT W/MANJ $905.00CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA $785.00CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TR $1,249.00CL-VAQTA 25U/0.5ML SYRINGE $39.00CL-VARICELLA VIRUS LIVE VACCINE $153.00CMBND ANTEROPOST COLPORRHAPHY W/ ENTEROC $1,355.00CMBND ANTEROPOST COLPORRHAPHY W/ ENTEROC $1,355.00CMP $261.00CMPLX REP EYE, NOSE, EAR, LIP, 2.6-7.5CM $983.00CMPLX REP EYE, NOSE, EAR, LIP, 2.6-7.5CM $983.00CMV DNA, QUAL PCR $577.00CMV IGM AB 096727 $76.00CMV QUANT - PCR $233.00CNTRL NASL HEMOR PACKS&/CAUT;INIT $381.00CNTRL NASL HEMOR PACKS&/CAUT;INIT $381.00CNTRL NASL HEMOR PACKS&/CAUT;INIT $204.00CNTRL NASL HEMORR ANT SMPL ANY METH $171.00CNTRL NASL HEMORR ANT SMPL ANY METH $171.00CNTRL NASL HEMORR ANT SMPL ANY METH $78.00CO 2 DECTECTOR ADULT $86.00CO 2 DECTECTOR PEDIATRIC $55.00CO2 $75.00COAGULATOR HANDSWITCHING 10FR/CH-6 $54.00

COBAN STERILE 3 $35.00COBLATION WAND 90-ORTHO $1,218.00COBLATION WAND-ORTHO $1,085.00COCAINE TOP SOLN 4% $130.00COCCIDIDIOIDES $108.00COCCIDIODES ANTIBODY CF $96.00COCCYGEAL FX; CLOSED TX $272.00CODEINE SULFATE 30MG TABLET $5.00COFLEX AFD STERILE 4 LF $17.00COGNITIVE IMPAIRMENT OR DYSFUNCTION ASSE $1.00COLCHICINE 0.6 MG TAB $6.00COLCRYS 0.6MG TABLET (COLCHICINE) $33.00COLD AGGLUTININS $61.00COLECTOMY PRTL W/ RMVL SMALL & LARGE BOW $3,066.00COLECTOMY W/ILEOSTOMY $4,444.00COLECTOMY, PARTIAL, HARTMANN PROCEDURE $4,106.00COLECTOMY, PARTIAL; WITH ANASTOMOSIS $3,081.00COLECTOMY/PAR $2,934.00COLLAGEN BINDING ASSAY $214.00COLLAR CER FM XLG $44.00COLLAR CERVICAL UNIVERSAL $27.00COLLAR CLAVICLE INFANT $31.00COLLAR JOBST VERTEBRACE RG $107.00COLLAR MED 5 1/4 $174.00COLLAR PHIL LGE 5 1/4 $185.00COLLAR THOM MD $33.00COLLECTION 6ft TUBING SET $39.00COLLECTION CANISTER SYSTEM SAFE TOUCH $96.00COLONOSCOPY FLX W/ABLATION OF POLYP(S) $1,942.00COLONOSCOPY STOMA W/ RMVL TUM POLYP SNAR $1,520.00COLONOSCOPY THROUGH STOMA, W/BIOPSY SING $1,391.00COLONOSCOPY THROUGH STOMA, WITH REMOVAL $1,447.00COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, I $1,461.00COLONOSCOPY THRU STOMA; W/BX 1 MX $675.00COLONOSCOPY THRU STOMA; W/BX 1 MX $675.00COLONOSCOPY, FLEX, PROXIMAL $1,391.00COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $452.00COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $1,651.00COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $1,461.00COLONOSCOPY, FLEXIBLE; WITH ABLATION OF $1,942.00COLONOSCOPY, FLEXIBLE; WITH BAND LIGATIO $1,777.00COLONOSCOPY, FLEXIBLE; WITH CONTROL OF B $1,750.00COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF T $591.00COLONOSCOPY, WITH BIOPSY, SINGLE OR MULT $1,572.00COLONOSCOPY, WITH REMOVAL OF TUMOR $1,391.00COLONOSCOPY,THROUGH STOMA, W/W-O COLLECT $1,391.00COLONOSCOPY/EGD KIT $47.00

COLONOSCOPY/REM TUMOR $562.00COLONOSCOPY/REM TUMOR $562.00COLONOSCOPY/REM TUMOR BY HOT FORCEPS $591.00COLONOSCOPY/STOMA/DX/W $1,391.00COLONOSCOPY/STOMA/DX/W $1,391.00COLONOSCOPY;BIO;SINGLE $1,572.00COLONOSCOPY;BIO;SINGLE $1,572.00COLONOSCOPY;DX/W OR W/O $430.00COLONOSCOPY;DX/W OR W/O $430.00COLONOSCOPY;REMOVAL TUMOR $1,391.00COLONOSCOPY;REMOVAL TUMOR $1,391.00COLORECTAL CANCER SCREENING RESULTS DOCU $1.00COLORECTAL SCRN;HIGH RISK $557.00COLOSTOMY IIOSTOMY POST OP 1 3/4 $135.00COLOSTOMY OR SKIN LEVEL CECOSTOMY; $2,648.00COLOSTOMY REVISION $1,570.00COLOSTOMY SKIN LEVEL CECOSTOMY $2,648.00COLOSTOMY SKIN LEVEL CECOSTOMY $2,648.00COLPOPEXY ABDOMINAL APPROACH $2,370.00COLPOPEXY VAGINAL EXTRAPERITONEAL APPRO $1,250.00COLPOPEXY VAGINAL INTRAPERITONEAL APPROA $1,725.00COLPOPEXY VAGINAL INTRAPERITONEAL APPROA $1,725.00COLPOPEXY, ABDOMINAL APPROACH $2,370.00COLPOPEXY, VAGINAL; EXTRA-PERITONEAL APP $1,250.00COLPOPEXY, VAGINAL; INTRA-PERITONEAL APP $1,725.00COLPORRHAPHY $772.00COLPORRHAPHY $772.00COLPORRHAPHY/ANTERIOR $716.00COLPORRHAPHY/ANTERIOR $716.00COLPORRHAPHY/COMBINED $963.00COLPORRHAPHY/COMBINED $963.00COLPORRHAPHY/POSTERIOR $667.00COLPORRHAPHY/POSTERIOR $667.00COLPOSCOPY CERVIX $254.00COLPOSCOPY CERVIX VAG ELTRD CONIZATION $4,538.00COLPOSCOPY CERVIX VAG ELTRD CONIZATION $4,538.00COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERI $4,538.00COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERI $4,538.00COLPOSCOPY CERVIX;UPPER/ADJACENT $241.00COLPOSCOPY CERVIX;UPPER/ADJACENT $241.00COLPOSCOPY OF CERVIX INC UPPER/ADJ VAG $254.00COLPOSCOPY OF VAGINA WITH CERVIX $294.00COLPOSCOPY VAGINA;W/BIO VAGINA/CERVIX $325.00COLPOSCOPY VAGINA;W/BIO VAGINA/CERVIX $325.00COLPOSCOPY W/BIO $349.00COLPOSCOPY W/BIO $349.00COLPOSCOPY W/BIOPSY OF CERVIX & EC $367.00

COLPOSCOPY W/BIOPSY OF VAGINA $325.00COLPOSCOPY W/LOOP ELECTRODE BIOPSY $4,538.00COLPOSCOPY W/LOOP ELECTRODE CONIZATION $4,538.00COLPOSCOPY/WITH BIOPSY $367.00COMBIGAN OPTH SOLN 0.2%-0.5% (BRIM/TIMI) $138.00COMBINED ANTEROPOSTERIOR COLPORRHAPHY; $1,012.00COMBINED ANTEROPOSTERIOR COLPORRHAPHY; W $1,355.00COMBIVENT (IPATROPIUM/ALBUTEROL)RESPIMAT $517.00COMFOT FORM WRIST RT SMALL $47.00COMMODES $171.00COMP HIM SCREW 2 150 $561.00COMP HIP SCREW 3 135 $630.00COMP HIP SCREW 3 140 $662.00COMP HIP SCREW 4 140 $662.00COMP HIP SCREW 4 145 $644.00COMP HIP SCREW 4 150 $559.00COMP HIP SCREW 5 145 $644.00COMP HIP SCREW 5 150 $607.00COMP PLAT 135 4 $644.00COMP PLATE 135 5 $630.00COMP PLATE 150 6 $559.00COMP SCREW 135 INCH $653.00COMP SCREW 19MM $130.00COMP SCREW 28.5 $139.00COMPARTMENT PRESSURE $229.00COMPARTMENT PRESSURE $237.00COMPAZINE 10 MG $26.00COMPLEMENT C2 $186.00COMPLEMENT C3 $189.00COMPLEMENT C4 $189.00COMPLEMENT TOTAL (CH50) $117.00COMPLES REPAIR, EA ADD 5CM $391.00COMPLETE NATAL DHA (PRENATAL VITAMIN) $7.00COMPLEX CYSTOMETROGRAM (IE, CALIBRATED E $790.00COMPLEX CYSTOMETROGRAM (IE, CALIBRATED E $854.00COMPLEX III 1 $372.00COMPLEX III 1.1 CM TO 2.5 CM $1,518.00COMPLEX III 1.1 CM TO 2.5 CM $228.00COMPLEX III 1.1 CM TO 2.5 CM $208.00COMPLEX REPAI $1,923.00COMPLEX REPAIR I 1.1 CM TO 2.5 CM $660.00COMPLEX REPAIR I 2.6 CM TO 7.5 CM $1,518.00COMPLEX REPAIR I 2.6 CM TO 7.5 CM $1,518.00COMPLEX REPAIR II 1.1 CM TO 2.5 CM $1,266.00COMPLEX REPAIR II 2.6 CM TO 7.5 CM $2,020.00COMPLEX REPAIR II 2.6 CM TO 7.5 CM $1,923.00COMPLEX REPAIR III 2.6 CM TO 7.5 CM $2,522.00

COMPLEX REPAIR IV 1.1 CM TO 2.5 CM $2,020.00COMPLEX REPAIR IV 2.6 CM TO 7.5 CM $3,029.00COMPLEX REPAIR OF FOREHEAD/CHEEK/CHIN/NE $638.00COMPLEX REPAIR, EA ADD 5 CM $660.00COMPLEX REPAIR, EA ADD 5CM $342.00COMPLEX REPAIR, TO 2.6 - 7.5 CM $1,518.00COMPOSITE FINGER LOOP $156.00COMPR FT SCRW 2.5 $850.00COMPR FT SCRW 2.5 12MM $875.00COMPR FT SCRW 2.5 13MM $875.00COMPR SCRW 2.5 MICRO $875.00COMPR SCRW 2.5 MICRO $875.00COMPR SCRW 2.5 MICRO 14MM $875.00COMPR SCRW 2.5 MICRO 16MM $875.00COMPR SCRW 2.5 MICRO 20MM $875.00COMPR SCRW 3.5 MICRO 12MM $875.00COMPRESS BONE PLATE 4.5MM $437.00COMPRESS BONE PLATE 4MM $367.00COMPRESS BONE PLTE 4.5X16 $553.00COMPRESS COLD FLEX $24.00COMPRESSION HIP SCREW 3 $560.00COMPRESSION HIP SCREW 4 $560.00COMPRESSION PLATE 6 HOLE $395.00COMPRESSION PLATE -ZIMMER $517.00COMPRESSION SCREW $49.00COMVAX (HAEMOPHILUS B CONJUGATE) $233.00CONE HAND POLYFORM $59.00CONE TUBE IRRIG SET $226.00CONFERENCE CLINICS PER HR $33.00CONIVAPTAN 20MG/D5% 100ML (VAPRISOL) $2,721.00CONIZATION CERVIX;LOOP $606.00CONIZATION CERVIX;LOOP $606.00CONIZATION OF CERVIX, WITH OR WITHOUT FU $637.00CONIZATION/CERVIX/COL $574.00CONIZATION/CERVIX/COL $574.00CONNECTORS HYPERTHERMIA $133.00CONRAY 43 $59.00CONSTRUCTION AV FISTULA $935.00CONSULT LEVEL 1 OV $143.00CONSULT LEVEL 1 OV $143.00CONSULT LEVEL 2 OV $170.00CONSULT LEVEL 2 OV $170.00CONSULT LEVEL 3 OV $229.00CONSULT LEVEL 3 OV $229.00CONT POST NASAL HEMORR PACKS SUBS $1,011.00CONTAINER EMPTY 1000 $18.00CONTAINER EVACUATED 1000ML $47.00

CONTAINER EVACUATED 500ML $21.00CONTIGIN IMPLANT TRMT SYR KIT $940.00CONTINGEN IMPLANT SKIN TEST KIT $243.00CONTINUOUS EPIDURAL ANEST. TRAY $108.00CONTINUOUS POSITIVE AIRWAY PRESSURE VENT $152.00CONTOUR MOLDED BACK SUPPO $135.00CONTROL ANTERIOR NASAL HEMORR COMPL $313.00CONTROL ANTERIOR NASAL HEMORR SIMP $187.00CONTROL OROPHARYNG HEMORAGE SIMPLE $302.00CONTROL OROPHARYNG HEMORAGE SIMPLE $302.00CONTROL POSTERIOR NASAL HEMORR PACK $659.00COPPER $75.00COPPER-SERUM/PLASMA $76.00CORACOACROMIAL LIGAME $1,308.00CORACOACROMIAL LIGAME $1,308.00CORD TRACTION $31.00CORDIS INTRODUCER KIT $325.00CORDIS VASC ACCESS KIT $308.00COREG (CARVEDILOL) 25MG TAB $10.00CORLOPAM (FENOLDOPAM) 10MG AMP $678.00CORNEA&/SCLERA PERFORATING NO UVEAL TISS $1,414.00CORNEA&/SCLERA PERFORATING NO UVEAL TISS $1,414.00CORRA TUBING $12.00CORTISOL $101.00CORTISOL FREE SERUM WITH CBG $101.00CORTISOL FREE URINE $60.00CORTISOL LC/MS $101.00CORTISOL SALIVARY THREE $101.00CORTISONE ACET 25MG TABLET $4.00CORTISONE URINE $93.00CORTROSYN .25 MG IM $59.00CORVERT (IBUTILIDE) 1MG/10ML VIAL $672.00COSTOMY BAGS TO 1 3/4IN BARRIER AND 2 1/ $11.00COSYNTROPIN 0.25 MG VIAL (CORTROSYN) $504.00COTININE $72.00COUMADIN (WARFARIN) 10MG TABLET $6.00COUMADIN (WARFARIN) 1MG TABLET $6.00COUMADIN (WARFARIN) 2.5MG TABLET $6.00COUMADIN (WARFARIN) 2MG TABLET $6.00COUMADIN (WARFARIN) 5MG TABLET $6.00COUMADIN (WARFRIN) 5MG VIAL $82.00COUNT 10 - 15 CELLS FOR CHROMOSOMES $142.00COUNT 5 CELLS FOR CHROMOSOMES $2,103.00COUNTERSINK 2.0 HEADLESS $530.00COUNTERSINK 2.5X2.7 HEADED $550.00COUNTERSINK 3.2 $565.00COUNTERSINK-2.5HCS $565.00

COVER, PERINEAL POST $42.00COVERS ARM X-RAY $102.00COVID-19 - LABCORP $100.00CP SLORR ANT W/CORACOI PRC TRNSF $1,900.00CP SLORR ANT W/CORACOI PRC TRNSF $1,900.00CPAP CANNULAS $65.00C-PEPTIDE SERUM $77.00CPK ISOENZYMES $145.00CPPB DEVICE $27.00CPT (ADD'L) $61.00CPT INITIAL $94.00CRAINI/CRANIOT W/EXC FB FROM BRAIN $2,892.00CRASH CART FEE *********** $85.00CRAWFORD LACRIMAL INTUBATION SET $404.00CRE WIRE GUIDED BALLOON 10-12 $624.00CRE WIRE GUIDED BALLOON 18-19-20 $624.00CRE WIRE GUIDED BALLOON 8-10 $624.00CREAM BARRIER CARRINGTON ZINC TUBE $15.00CREATINE & GAA $347.00CREATININE $71.00CREATININE 24HR URINE $104.00CREATININE CLEARANCE $65.00CREATININE FOR REFERENCE LAB $77.00CREATININE URINE $104.00CREON 24000U DELAYED RELEASE CAPSULE $30.00CRICOTHYROIDOTOMY KIT $458.00CRICOTHYROTOMY $1,363.00CRITICAL CARE E&M 1ST 30-74 MINUTES $791.00CRITICAL CARE E&M EA ADD 30 MINUTES $439.00CRITICAL CARE E&M EACH ADD 30 MINUTES $461.00CRITICAL CARE FIRST HOUR $831.00CRITICAL CARE, E&M 1ST 30-74 MINUTES $798.00CRITICAL CARE, EA ADDL 30 MIN $461.00CRNA SERVICES $1,971.00CROFAB 1G (ANTIVENIN CROTALIDAIE) VIAL $4,442.00CROSS FLOW INFLOW CASSETTE TUBING $264.00CROSSFLOW INFLOW CASSETTE $84.00CROUP TENT ADDITIONAL DAY $62.00CROUP TENT INITIAL SETUP $184.00CRP - INFLAMMATION $100.00CRP CAL $127.00CRP, HIGH SENS (CARDIAC) $91.00CRUTCHES ADULT MEDIUM 5'1-5'9 DME $62.00CRUTCHES ADULT XL TALL 5'10-6'6 $25.00CRUTCHES YOUTH 4'6-5'2 $25.00CRYOCAUTERY/INITIAL $279.00CRYOCAUTERY/INITIAL $279.00

CRYOCAUTERY/INITIAL $279.00CRYOGLOBULINS QUALITATIVE $105.00CRYOSURGERY PENIS LESION(S) $273.00CRYOTHERAPY FOR ACNE $81.00CRYOTHERAPY FOR ACNE $81.00CRYOTHERAPY FOR ACNE $2.00CRYPTOCOCCUS ANTIGEN $119.00CRYPTOCOCCUS ANTIGEN CSF $81.00CRYPTOSPORIDIUM DIRECT DETECTION $75.00CRYSTALENS AO $983.00CRYSTALENS HD 500 $1,174.00CRYSTALS SYNOVIAL FLUID $75.00CSF CELL CT W/DIFF $96.00CSF CHLORIDE $69.00CSF GLUCOSE $89.00CSF IgG INDEX $88.00CSF PROTEIN $73.00CT ABD/PELVIS W & WO CONTRAST $3,542.00CT ABD/PELVIS W/CONTRAST $3,461.00CT ABD/PELVIS W/O CONTRAST $3,043.00CT ABDOMEN W & W/O CONTRAST $2,321.00CT ABDOMEN W/O CONTRAST $1,590.00CT ABDOMEN WITH CONTRAST $2,150.00CT CERVICAL SPINE W & W/O CONTRAST $1,827.00CT CERVICAL SPINE W/O CONTRAST $1,668.00CT CERVICAL SPINE WITH CONTRAST $1,750.00CT CHEST W & W/O CONTRAST $2,154.00CT CHEST W/O CONTRAST $1,311.00CT CHEST WITH CONTRAST $1,941.00CT CHEST/ABD/PELVIS W & W/O CONTRAST $1,941.00CT CHEST/ABD/PELVIS W & WO CONTRAST $3,542.00CT CHEST/ABD/PELVIS W/CONTRAST $3,461.00CT CHEST/ABD/PELVIS W/O CONTRAST $3,043.00CT CHEST/ADB/PELVIS W/ CONTRAST $1,311.00CT CHEST/ADB/PELVIS W/O CONTRAST $1,311.00CT EXT LOWER W & W/O CONTRAST $1,941.00CT EXT LOWER W/CONTRAST $1,901.00CT EXT LOWER W/O CONTRAST $1,603.00CT EXTREMITY UPPER W & W/O CONTRAST $1,901.00CT EXTREMITY UPPER W/O CONTRAST $1,687.00CT EXTREMITY UPPER WITH CONTRAST $1,687.00CT GUIDED NEEDLE BIOPSY $1,227.00CT HEAD W & W/O CONTRAST $2,321.00CT HEAD W/O CONTRAST $1,743.00CT HEAD WITH CONTRAST $2,019.00CT LIMITED/LOCALIZED STUDY $562.00CT LUMBAR SPINE W & W/O CONTRAST $1,901.00

CT LUMBAR SPINE W/O CONTRAST $1,603.00CT LUMBAR SPINE WITH CONTRAST $1,687.00CT MAXILLO FACIAL AREA W & W/O CONTRAST $2,019.00CT MAXILLO FACIAL AREA W/O CONTRAST $1,901.00CT MAXILLO FACIAL AREA WITH CONTRAST $1,941.00CT ORBIT/IAC/SELL/PF WITH CONTRAST $1,687.00CT ORBIT/IAC/SELLA/PF W & W/O CONTRAST $1,941.00CT ORBIT/IAC/SELLA/PF W/O CONTRAST $1,381.00CT PELVIC WITH CONTRAST $1,901.00CT PELVIS W & W/O CONTRAST $1,941.00CT PELVIS W/O CONTRAST $1,901.00CT SOFT TISSUE NECK W & W/O CONTRAST $1,941.00CT SOFT TISSUE NECK W/O CONTRAST $1,381.00CT SOFT TISSUE NECK WITH CONTRAST $1,687.00CT THORACIC SPINE W & W/O CONTRAST $1,687.00CT THORACIC SPINE W/O CONTRAST $1,569.00CT THORACIC SPINE WITH CONTRAST $1,687.00CTA ABD/PELVIS $855.00CTA ABDOMEN/AORTA $1,490.00CTA AORTA AND BLT ILIOFEMORAL(LE RUNOFF) $1,465.00CTA CHEST $2,321.00CTA HEAD & NECK $1,687.00CTA HEAD W & W/O $1,687.00CTA LOWER EXT $1,687.00CTA NECK $2,000.00CTA NECK/CAROTIDS $1,646.00CTA UPPER EXTRM $1,003.00C-TELOPEPTIDE SERUM $270.00CU WRIST BRACE LG LT $81.00CU WRIST BRACE LG RT $81.00CU WRIST BRACE MED LT $81.00CU WRIST BRACE MED RT $81.00CU WRIST BRACE SM LT $81.00CU WRIST BRACE SM RT $81.00CU WRIST BRACE XLG LT $81.00CU WRIST BRACE XLG RT $81.00CUFF&COLLAR SMALL SLING $51.00CUFFLESS TRACH TUBE $305.00CUFFLESS TRACH TUBE 8 CFN $305.00CULDOCENTESIS $198.00CULTURE AEROBIC $141.00CULTURE ANAEROBIC 008904 $70.00CULTURE BLOOD $153.00CULTURE BODY FLUID $144.00CULTURE CSF $144.00CULTURE DIPHTHERIA $104.00CULTURE EYE $131.00

CULTURE FUNGUS - OTHER $66.00CULTURE FUNGUS 008482 $73.00CULTURE FUNGUS BLOOD $56.00CULTURE GC 008128 $115.00CULTURE GENITAL 008334 $144.00CULTURE MRSA $131.00CULTURE MYCOPLASMA/UREAPLASMA $207.00CULTURE NASOPHARYNGEAL $128.00CULTURE SPUTUM $144.00CULTURE STOOL $102.00CULTURE STOOL COMPREHENSIVE 008144 $76.00CULTURE STOOL FOR CAMPYLOBACTER $34.00CULTURE STOOL VIBRIO 182311 $113.00CULTURE STOOL YERSINIA 182410 $113.00CULTURE STOOL-E. COLI ANTIGEN $34.00CULTURE STOOL-E. COLI ANTIGEN $36.00CULTURE STOOL-SALMONELLA & SHEGELA $34.00CULTURE STREP SCREEN - THROAT $115.00CULTURE THROAT $144.00CULTURE URINE $92.00CULTURE VIRAL 008573 $100.00CULTURE WOUND $137.00CULTURE-INFECTION CONTROL $141.00CURETTAGE POSTPARTUM $456.00CURETTAGE POSTPARTUM $456.00CURETTAGE, POSTPARTUM $479.00CURETTE 2mm.DERMAL DISP(MILTEX) $11.00CURETTE 4mm.DERMAL DISP(MILTEX) $10.82CURVED ELECTRODE $203.00CUT DOWN TRAY $67.00CUT DOWN TRAY $47.00CUTDOWN, < 1YR $248.00CUTDOWN, >1 YR $184.00CUTTER LINEAR TITANIUM 75MM $437.00CV/GROSHONG CATH REPAIR $470.00CYANOCOBALAMIN 1000MCG TABLET (VIT B-12) $6.00CYANOCOBALAMIN 1000MCG/1ML (VIT B-12) $30.00CYANOKIT 5GM (HYDROXOCOBALAMIN) $4,300.00CYCLIC CITRULLINATED PEPTIDE AB $324.00CYCLOBENZAPRINE 10 MG TAB (FLEXERIL) $6.00CYCLOGYL (CYCLOPENTOLATE) 1% OPHT SOLN $70.00CYCLOGYL OPTH SOLN 1% (CYCLOPENTOLATE) $10.00CYCLOPHOSHAMIDE TABLET 50 MG (CYTOXAN) $26.00CYCLOPHOSPHAMIDE 1GM (CYTOXAN) $3,174.00CYCLOPHOSPHAMIDE 2GM (CYTOXAN LYPH) $3,174.00CYCLOPHOSPHAMIDE 500 MG (CYTOXAN) $1,612.00CYCLOSPORINE $89.00

CYCLOSPORINE 25MG CAPSULE $7.00CYPROHEPTADINE 4MG TABLET (PERIACTIN) $15.00CYRAMZA 100MG/10ML (RAMUCIRUMAB) VIAL $2,345.00CYRAMZA 500MG/50ML (RAMUCIRUMAB) VIAL $8,975.00CYSTATIN C $157.00CYSTECTOMY/OVARY $1,265.00CYSTIC FIBROSIS GENE $336.00CYSTINE URINE 24 $198.00CYSTO PACK $162.00CYSTOGRAM X RAY $256.00CYSTOMETROGRAM/UPP/VOIDING $854.00CYSTOMETROGRAM/VOIDING $790.00CYSTOMETROGRAM/VOIDING $790.00CYSTORRHAPY;SIMP $1,965.00CYSTORRHAPY;SIMP $1,965.00CYSTOSCOPY $317.00CYSTOSTOMY, CYSTOTMY W/ DRAINAGE $759.00CYSTOURESTHROSCOPY/MALE $673.00CYSTOURESTHROSCOPY/MALE $673.00CYSTOURETHROSCOP Y (SEPARATE PROCEDURE) $553.00CYSTOURETHROSCOPY $553.00CYSTOURETHROSCOPY $553.00CYTARABINE 100 MG VIAL $179.00CYTARABINE 1000 MG VIAL (CYTOSAR-U) $112.00CYTARABINE 500 MG VIAL $299.00CYTOCHROME P450 2 C19 GENOTYPE $152.00CYTOLOGY BRUSH DISPOSABLE $386.00CYTOMEGALOVIRUS IGG $112.00CYTOMEGALOVIRUS IGM $112.00CYTOPATHOLOGY-CELLULAR ENHANCE $324.00D&C;DIAG/THERAPEUTIC $467.00D&C;DIAG/THERAPEUTIC $467.00D. RAMP SERVICES $45.00D10% WATER 1000ML $19.00D10% WATER 250ML BAG $37.00D5 NS WITH 20 MEQ KCL 1000ML $38.00D5% INJECTION 500 $21.00D5% LACTATED RINGERS : 1000ML $16.00D5% NORMAL SALINE : 1000ML $19.00D5% WATER : 250ML ADD-V $15.00D5% WATER 100 $34.00D5% WATER 100 ML $9.00D5% WATER 1000 $57.00D5% WATER 250ML $16.00D5% WATER 50 $32.00D5% WATER 50ML $20.00D5%/0.45% SODIUM CHLORIDE: 1000ML $13.00

D5%+0.2% SODIUM CHLORIDE 1000ML $19.00DACARBAZINE 200MG/20ML VIAL $101.00DACOGEN 50MG (DECITABINE) VIAL $3,511.00DACRIOSE (SODIUM/POT/SOD CL) OPHT SOLN $21.00DALIRESP (ROFLUMILAST) 500MCG TABLET $51.00DANTROLENE 20MG VIAL (DANTRIUM) $1,579.00DANTROLENE 25 MG CAPSULE (DANTRIUM) $11.00DAPSONE 100MG TABLET $12.00DAPTOMYCIN 350MG VIAL (CUBICIN) $386.00DARAPRIM (PYRIMETHAMINE) 25 MG TAB $6.00DAUNORUBICIN 5MG/ML 4ML VIAL $1,247.00DAYPRO (OXAPROZIN) 600 MG TABLET $9.00DBX PUTTY 1CC $605.00D-DIMER $225.00D-DIMER $225.00DEBRIDE SKIN;SUBCUT $692.00DEBRIDE SKIN;SUBCUT $692.00DEBRIDEMENT FOR OVER 10% EACH $36.00DEBRIDEMENT INFECTED SKIN $676.00DEBRIDEMENT NAIL ANY METHOD 1-5 $57.00DEBRIDEMENT NAIL ANY METHOD 1-5 $54.00DEBRIDEMENT NAIL ANY METHOD 1-5 $54.00DEBRIDEMENT NAIL ANY METHOD 6/> $100.00DEBRIDEMENT NAIL ANY METHOD ONE TO FIVE $57.00DEBRIDEMENT NAIL;6 OR MORE $100.00DEBRIDEMENT NAIL;6 OR MORE $100.00DEBRIDEMENT OF BONE 20 SQ CM/< $578.00DEBRIDEMENT OF BONE 20 SQ CM/< $578.00DEBRIDEMENT OF SKIN UP TO 10% $147.00DEBRIDEMENT OPEN WOUND 20 SQ CM/< $62.00DEBRIDEMENT OPEN WOUND 20 SQ CM/< $92.00DEBRIDEMENT PARTIAL $374.00DEBRIDEMENT PARTIAL $374.00DEBRIDEMENT SKIN BONE AT FX SITE $1,071.00DEBRIDEMENT SKIN PARTIAL THICKNESS $206.00DEBRIDEMENT SKIN PARTIAL THICKNESS $206.00DEBRIDEMENT SKIN PARTIAL THICKNESS $217.00DEBRIDEMENT SKIN SUBCUTANEOUS $217.00DEBRIDEMENT SKIN, INFECTED SKIN $75.00DEBRIDEMENT SKIN, SUBQ NECRO INFECTION $1,729.00DEBRIDEMENT SKIN, SUBQ NECRO INFECTION $1,729.00DEBRIDEMENT SKIN/SUBCU $206.00DEBRIDEMENT SKIN/SUBCU $206.00DECADRON (DEXAMETHASONE) : 4 MG DONT USE $59.00DECELLULARIZED DERMIS- MESH $1,242.00DECLOTTING OF VAD BY THROMBOLYTIC AGENT $131.00DECOMPRESSION UNSPECIFIED NERVE $913.00

DEEP MUSCLE BIOPSY $511.00DEFEROXAMINE 500MG VIAL $79.00DEFIB PAD ADULT $385.00DEFIB PAD PEDS $304.00DELAY FLAP SECTION FLAP F/C/C/N/AX/G/F $1,066.00DELAY FLAP SECTION FLAP F/C/C/N/AX/G/F $1,066.00DELESTROGEN (ESTRADIOL VAL) 10 MG/ML $299.00DELESTROGEN (ESTRADIOL VAL) 20 MG/ML $268.00DELIVERY C SECTION/;/POSTPARTUM $2,050.00DELIVERY C SECTION;DELIVERY ONLY $1,730.00DELIVERY C SECTION;DELIVERY ONLY $1,730.00DELIVERY C SECTION;GLOBAL $3,970.00DELIVERY C SECTION;GLOBAL $3,970.00DELIVERY C SECTION;W/POST PARTUM $2,050.00DELIVERY OF PLACENTA $453.00DELIVERY OF PLACENTA $453.00DELIVERY OF PLACENTA (SEPARATE PROCEDURE $453.00DELIVERY VAG ONLY W/WO FORCEPS $1,602.00DELIVERY VAGI $1,525.00DELIVERY VAGINAL GLOBAL $3,502.00DEMADEX (TORSEMIDE) 20 MG AMPULE $44.00DEMECLOCYCLINE 150MG TABLET (DECLOMYCIN) $22.00DEMECLOCYCLINE 300MG TABLET $50.00DEMECLOCYCLINE 300MG TABLET (DECLOMYCIN) $39.00DEMECLOCYCLINE TABLET 150MG $16.00DEMEROL (MEPERIDINE) 25MG TUBEX $20.00DEMEROL (MEPERIDINE) 50MG TUBEX $21.00DEMEROL (MEPERIDINE) 75MG TUBEX $18.00DEMEROL (MEPERIDINE)100MG TUBEX $20.00DEMO&/EVAL PAT $31.00DEOXYCORTICOSTERONE $206.00DEPAKENE $72.00DEPAKOTE ER (DIVALPROEX SOD) 500 MG TAB $13.00DEPO ESTRADIOL $110.00DEPO-PROVERA (MEDOXYPROG) DO NOT USE $110.00DEPO-PROVERA (MEDROXYPROGESTER) 400 MG $527.00DEPO-TESTOSTERONE (TESTOSTERONE) 200MG $57.00DERM AUTOGRAFT, FACE/NECK/HF/G $1,747.00DERM AUTOGRAFT, FACE/NECK/HF/G $1,747.00DERMA BOND ETHICON $120.00DERMABOND WOUND ADHESION $168.00DERMACARRIERS II SKIN GRAFT(1.5 to 1) $380.00DERMACARRIERS II SKIN GRAFT(3 to1) $126.00DERMATAPE $65.00DERMATONE BLADE STERILE $171.00DERMATONE/MESHER $94.00DERMOPLAST (BENZOCAI/BENZETHON) SPRAY $20.00

DES Y CARBOXY PROTHROMBIN (DCP) $146.00DESIPRAMINE 25 MG TABLET (NORPRAMIN) $6.00DESMOPRESSIN 40MCG IV (DDAVP) $622.00DESMOPRESSIN ACETATE NASAL SPRAY (DDAVP) $197.00DESONIDE 0.05% CREAM 15G $29.00DESONIDE 0.05% LOTION 118ML $249.00DESOXIMETASONE 0.05% GEL (TOPICORT) $79.00DESOXIMETASONE 0.25% CREAM (TOPICORT) $92.00DESOXIMETASONE LP CREAM (TOPICORT) $68.00DEST BEN LES/FI $129.00DEST BEN LES/FI $129.00DEST BEN LES;2-14 EA $25.00DEST BEN LES;2-14 EA $23.00DEST BEN LES;2-14 EA $23.00DEST BEN LES;2-14 EA $25.00DEST BEN LES;2-14 EA $25.00DEST BENIGN LESIONS $187.00DEST EYELID LESION $330.00DEST EYELID LESION $330.00DEST LESIONS;VULVA;SMPL $349.00DEST LESIONS;VULVA;SMPL $349.00DEST MAL LES FACE EARS .6-1.0 CM $61.00DEST MAL LES FACE EARS LESS THAN .5 CM $60.00DEST MAL LES FACE/EARS/EYE/NOSE .5CM $182.00DEST MAL LES FACE/EARS/EYE/NOSE 1.1-2CM $353.00DEST MAL LES FACE/EARS/EYE/NOSE 1.1-2CM $353.00DEST MAL/LES FACE/EARS/EYE/NOSE .5CM $182.00DEST MAL/LES FACE/EARS/EYE/NOSE .6-1CM $249.00DEST MAL/LES FACE/EARS/EYE/NOSE .6-1CM $249.00DEST MAL/LES SCLP/HND/FT/GNT .5CM $208.00DEST MAL/LES SCLP/HND/FT/GNT .5CM $208.00DEST MAL/LES SCLP/HND/FT/GNT .6 -1CM $279.00DEST MAL/LES SCLP/HND/FT/GNT .6-1CM $279.00DEST MAL/LES TRUNK/ARMS/LEGS .5CM $151.00DEST MAL/LES TRUNK/ARMS/LEGS .5CM $151.00DEST MALG LES TRUNK LESS THAN .5 CM $47.00DEST MALIG LES SCALP NECK ECT .5 CM OR L $63.00DEST WARTS;15/MORE $177.00DEST WARTS;15/MORE $177.00DEST WARTS;ANY OR LESIONS $178.00DEST WARTS;ANY OR LESIONS $178.00DEST WARTS;ANY OR LESIONS $187.00DESTRUCT B9 LESION 1-14 $187.00DESTRUCTION (EG, LASER SURGERY, ELECTROS $136.00DESTRUCTION (EG, LASER SURGERY, ELECTROS $25.00DESTRUCTION BEN LES/2- $25.00DESTRUCTION BEN LES/FI $136.00

DESTRUCTION BENIGN LESIONS UP TO 14 $187.00DESTRUCTION OF LESION(S), ANUS (EG, COND $629.00DESTRUCTION OF LESION(S), ANUS (EG, COND $509.00DESTRUCTION OF LESION(S), VULVA; SIMPLE $349.00DESTRUCTION OF LOCALIZED LESION OF RETIN $1,254.00DESTRUCTION OF VAGINAL LESION(S); SIMPLE $273.00DESTRUCTION PREMALIGNANT LESION: 1ST LES $136.00DESTRUCTION VAG LESION(S);SIMP $273.00DESTRUCTION VAG LESION(S);SIMP $273.00DESTRUCTION WARTS/ANY $187.00DESTRUCTION WARTS/ANY $65.00DETROL (TOLTERODINE TARTRATE) LA 4 MG $10.00DEXA SCAN $339.00DEXAMET/NEOMY/POLY OPTH OINT (MAXITROL) $9.00DEXAMETH/NEO/POLY OPTH SUSP (DEXACIDIN) $27.00DEXAMETHASONE $660.00DEXAMETHASONE 0.05% OPHT OINT (DECADRON) $33.00DEXAMETHASONE 0.1% OPHT SOLN (DECADRON) $83.00DEXAMETHASONE 0.5MG/5ML ELIX (DECADRON) $8.00DEXAMETHASONE 0.75MG TABLET (DECADRON) $6.00DEXAMETHASONE 10MG VIAL*CHEMO (DECADRON) $32.00DEXAMETHASONE 10MG/ML VIAL (DECADRON) $32.00DEXAMETHASONE 1MG TABLET (DECADRON) $7.00DEXAMETHASONE 4 MG/ML 5ML MDV (DECADRON) $30.00DEXAMETHASONE 4MG SDV (DECADRON) $45.00DEXAMETHASONE 4MG SDV (DECADRON)*CHEMO $14.00DEXAMETHASONE 4MG TABLET (DECADRON) $6.00DEXAMETHASONE 4MG/ML 1 ML SDV (DECADRON) $14.00DEXON II VICRYL $180.00DEXPANTHENOL 250 MG VIAL (ILOPAN) $46.00DEXT WATER 5% ADY Q 100 $32.00DEXT.5%IN.SSTB SALINE1000 $32.00DEXTRAIN 6% VD 5W 500CC $103.00DEXTRAN 40% (DEXTRAN40%/NACL) 10% IV SOL $576.00DEXTRAN 500 $128.00DEXTRAN 70% (DEXTRAN70/NACL) 6% IV SOLN $258.00DEXTROMETHOPHAN 30MG GELCAP (DEXALONE) $5.00DEXTROSE 10% 500ML FILL IN 1000ML $11.00DEXTROSE 5% 100ML MIN BAG $23.00DEXTROSE 5% WATER 1000ML $16.00DEXTROSE 50% (DEXTROSE) 500 ML FILL LITE $227.00DEXTROSE 50% SYRINGE 25G/50ML $49.00DHEA $108.00DHEA-S $71.00DHS/DCS ONE STEP LAG SCREW 130MM $607.00DIABETIC TRAINING PER 30 MIN $62.00DIAL A FLO $38.00

DIASORB (ATTAPULGITE) 2 OZ BOTTLE $17.00DIATX (FOLIC ACID/VIT B COMPLEX)TABLET $4.00DIATX ZN (FOLIC ACID/VIT B COMP/ZN) TAB $4.00DIAZEPAM 10 MG SYRINGE (VALIUM) $89.00DIAZEPAM 5 MG TABLET (VALIUM) $6.00DIAZEPAM 5MG/ML 10ML (VALIUM) $145.00DIAZEPAM RECTAL KIT 10MG $499.00DIBUCAINE 30 GM OINT $10.00DICLOFENAC 100 XR TABLET (VOLTAREN) $16.00DICLOFENAC 25 MG TABLET (VOLTAREN) $4.00DICLOFENAC 50 MG TABLET (CATAFLAM) $10.00DICLOFENAC 75MG DR TABLET (VOLTAREN) $7.00DICLOFENAC OPHT SOL 0.1% 2.5ML (VOTAREN) $49.00DICLOFENAC SODIUM 1% GEL $96.00DICLOFENAC SODIUM OPTH SOLN 0.1% $9.00DICLOXACILLIN 250 MG CAPSULE (PATHOCIL) $4.00DICYCLOMINE 10 MG CAPSULE (BENTYL) $6.00DICYCLOMINE 10MG/ML 2ML AMP (BENTYL) $167.00DICYCLOMINE 20 MG TABLET (BENTYL) $4.00DICYCLOMINE SYRUP 10MG/5ML 2OZ $20.00DIDANOSINE 200 MG TABLET (VIDEX) $25.00DIFFUSING CAPACITY CO $432.00DIFUNISAL 500 MG TABLET (DOLOBID) $7.00DIGOXIN $114.00DIGOXIN 0.05MG/ML ELIXIR 60 ML (LANOXIN) $69.00DIGOXIN 0.125 MG TABLET (LANOXIN) $21.00DIGOXIN 0.25MG TABLET (LANOXIN) $4.00DIGOXIN IMMUNE FAB 40 MG (DIGIBIND) $7,147.00DIGOXIN INJ 0.5 MG AMPULE (LANOXIN) $37.00DIHYDROERGOTAMINE 1 MG AMP (D.H.E. 45) $65.00DIHYDROTESTOSTERONE $102.00DILANTIN $130.00DILANTIN, FREE $187.00DILATION AND CURETTAGE, DIAGNOSTIC AND/O $491.00DILATION OF ANAL SPHINCTER (SEPARATE PRO $425.00DILATION OF CERVICAL CANAL $115.00DILATION OF CERVICAL CANAL, INSTRUMENTAL $115.00DILTIAZEM 100MG/D5 100ML PREMIX BAG $83.00DILTIAZEM 25 MG VIAL (CARDIZEM) $24.00DILTIAZEM 50 MG VIAL (CARDIZEM) $52.00DILTIAZEM CD HCL 120MG CAP (CARDIZEM CD) $10.00DILTIAZEM CD HCL 300MG CAP (CARDIZEM CD) $9.00DILTIAZEM DRIP 125MG/NS 125ML $388.00DILTIAZEM HCL 120MG CAPSULE(CARDIZEM SR) $10.00DILTIAZEM HCL 30 MG TABLET (CARDIZEM) $4.00DILTIAZEM HCL 60 MG TABLET (CARDIZEM) $6.00DILTIAZEM HCL 90MG CAPSULE (CARDIZEM SR) $8.00

DILTIAZEM HCL CD 180MG CAP (CARDIZEM CD) $11.00DILTIAZEM HCL CD 240MG CAP (CARDIZEM CD) $4.00DILUTE PROTHROMBIN TIME $84.00DILUTE RUSSELS VIPER VENOM RATIO $202.00DILUTE RUSSELS VIPER VENOM TIME $198.00DIMENHYDRINATE 50 MG TAB $5.00DIMETAPP (BROMPH/PPA) 12/75MG TAB $4.00DIMETAPP (PHENYLPROP/BPM) 2 OZ $14.00DIMETHYL SULFOXIDE 50% 50ML SDV $802.00DIMETHYLACETAMIDE EXP PANEL $104.00DINACLICK- ADULT 2T $12.00DINACLICK- ADULT 2T LG $13.00DINACLICK- ADULT 2T LONG $13.00DINACLICK- ADULT FOREARM $13.00DIOPTER LENS 30.0 $887.00DIOVAN HCTZ (VALSARTAN/HCTZ) 160/12.5MG $10.00DIOVAN HCTZ (VALSARTAN/HCTZ) 80/12.5 MG $10.00DIPHENHYDRAMINE 12.5MG/5ML ELIXIR $8.00DIPHENHYDRAMINE 25 MG CAPSULE (BENADRYL) $6.00DIPHENHYDRAMINE 50 MG VIAL *CHEMO* $15.00DIPHENHYDRAMINE 50MG VIAL (BENADRYL) $15.00DIPHENHYDRAMINE CREAM 2% $8.00DIPHENOXY/ATROP 2.5/0.025MG TAB(LOMOTIL) $11.00DIPHENOXYLATE/ATROPINE 2 OZ (LOMOTIL) $68.00DIPHENYDRAMINE 50 MG CAPSULE (BENADRYL) $4.00DIPHTHERIA ANTIBODY $44.00DIPYRIDAMOLE 25 MG TAB (PERSANTINE) $6.00DIPYRIDAMOLE 50 MG TABLET (PERSANTINE) $4.00DIPYRIDAMOLE 50 MG VIAL (PERSANATINE) $554.00DIPYRIDAMOLE 75 MG TABLET (PERSANTINE) $6.00DISCHARGE NUR $188.00DISCHARGE NURSING FACILITY $188.00DISCREPENCY PAD MED $90.00DISCREPENCY PAD SM $90.00DISOPYRAMIDE 100 MG CAPSULE (NORPACE) $4.00DISOPYRAMIDE 150 MG CAPSULE (NORPACE) $10.00DISP BUCK WAX CURRENT 1 $65.00DISP INJECTION NEEDLE $133.00DISP INSTRS KIT $437.00DISP IPPB SYSTEM $28.00DISP VOLUME RESP SYSTEM $69.00DISPOSABLE AEM CORD $74.00DISPOSABLE LIGHT HANDLE COVER $37.00DISPOSABLE SHEATH 45CM $94.00DISPOSA-FILTER $47.00DISULFIRAM 250MG TABLET (ANTABUSE) $8.00DIVALPROEX SOD (DEPAKOTE DR) 250MG TAB $6.00

DIVALPROEX SOD (DEPAKOTE ER) 250 MG TAB $7.00DIVALPROEX SODIUM 125 MG SPRI (DEPAKOTE) $9.00DJO EMPOWR KNEE FIN MINUS-ORTHO $3,302.00DNA ANTIBODY DOUBLE STRANDED $66.00DNA FLOW CYTOM-TISSUE $147.00DoBUTAMine 250 MG VIAL (DOBUTREX) $52.00DOBUTAMINE 250MG/250 D5W (1,000 MCG/ML) $144.00DOCETAXEL 160MG/8ML $1,225.00DOCETAXEL 20MG/2ML SDV $652.00DOCETAXEL 80MG/4ML $1,747.00DOCTOR DIRECTED EMS ADV LIFE SUPP $375.00DOCUSATE 100MG/10ML SYRUP UD (COLACE) $8.00DOCUSATE CAL 240MG CAPSULE (SURFAK) $4.00DOCUSATE SOD 100MG CAPSULES (COLACE) $6.00DOMEBORO (ALUM.SULF/CAL.ACET) PACKETS $5.00DOMED TRIPEG PAT SZ32-ORTHO $1,579.00DONEPEZIL HCL 5 MG TABLET (ARICEPT) $20.00DONEPEZIL HCL 10 MG TABLET (ARICEPT) $6.00DONNATAL (PHEN/HYOSCY/SCOP) EXTENTAB $8.00DONNATAL (PHEN/HYOSCY/SCOP) TAB $4.00DOPAmine 400 MG VIAL $121.00DOPAMINE 400 MG/250 ML D5W (1,600MCG/ML) $122.00DOPAmine 400MG/250ML D5W RTU $47.00DOPRAM (DOXAPRAM) 400MG/20ML (20MG/ML) $325.00DORZOLAMIDE HCL OPHTH SOLN 2% 10ML $42.00DORZOLAMIDE/TIMOLOL OPHTH SOLN $207.00DOT PHYSICAL (INCLUDES COST OF UA) $179.00DOUBLE STRANDED DNA ANTIBODY $67.00DOVONEX (CALCIPROTRIENE) CRM 0.005% 60GM $356.00DOXAZOSIN 2 MG TABLET (CARDURA) $9.00DOXAZOSIN 4 MG TABLET (CARDURA) $5.00DOXEPIN 10 MG CAP (SINEQUAN) $6.00DOXEPIN 100MG CAPSULE (SINEQUAN) $8.00DOXEPIN 25 MG CAPSULE (SINEQUAN) $6.00DOXIDAN (PHENOLPHTA/DOCUS.CALC) TAB $4.00DOXIL 2MG/ML 10ML VIAL (DOXORUBICIN LIP) $2,548.00DOXIL 2MG/ML 25ML VIAL (DOXORUBICIN LIP) $5,601.00DOXORUBICIN 10 MG VIAL (ADRIAMYCIN) $259.00DOXORUBICIN 150MG MDV (ADRIAMYCIN) $17.00DOXORUBICIN 20 MG VIAL (ADRIAMYCIN) $108.00DOXORUBICIN 200 MG (ADRIAMYCIN) $278.00DOXORUBICIN 50 MG (ADRIAMYCIN) $285.00DOXYCYCLINE 100 MG VIAL (VIBRAMYCIN) $117.00DOXYCYCLINE 25 MG/5ML SUSP 60ML $145.00DOXYCYCLINE MONOHYDRATE 100 MG TABLET $6.00DOXYLAMINE SUCCINATE 25MG TABLET $2.00DPD 5-FLUOROURACIL $541.00

DR/ER PLASTIC SET $24.00DR/ER/SUTURE/6 INSTR PAKS $21.00DRAIN 19 ROUND JP $130.00DRAIN ABDOMINAL ABSCESS $1,987.00DRAIN ABDOMINAL ABSCESS $3,534.00DRAIN ABDOMINAL ABSCESS $1,987.00DRAIN APP ABSCESS, OPEN $1,338.00DRAIN APP ABSCESS, OPEN $1,338.00DRAIN BAG FOLEY 14FR.TRAY LF $35.00DRAIN BAG FOLEY 16FR.TRAY LF $35.00DRAIN BAG FOLEY 18FR.TRAY LF $35.00DRAIN EXT EAR ABSCESS OR HEMATOMA SIMPLE $475.00DRAIN EXT EAR ABSCESS;SMPL $475.00DRAIN EXT EAR ABSCESS;SMPL $490.00DRAIN EXT EAR ABSCESS;SMPL $490.00DRAIN FALLOPIAN TUBE CYST $1,971.00DRAIN FINGER ABSCESS;COMPLICATED $979.00DRAIN FINGER ABSCESS;COMPLICATED $979.00DRAIN FINGER ABSCESS;COMPLICATED $979.00DRAIN FINGER ABSCESS;SIMPLE $811.00DRAIN FINGER ABSCESS;SIMPLE $836.00DRAIN FINGER ABSCESS;SIMPLE $836.00DRAIN RETROPERITONEAL ABSCESS;OPEN $2,450.00DRAIN RETROPERITONEAL ABSCESS;OPEN $2,450.00DRAIN SPONGE 4x4 $3.00DRAIN WOUND ROUND 19FR 1/4 $44.00DRAIN/INJECT JOINT/BURSA $201.00DRAINABLE OVAL POUCH $62.00DRAINABLE POUCH 1 PIECE $8.00DRAINABLE POUCH 2 W/FILTER & WAFER $18.00DRAINABLE POUCH CLAMP $17.00DRAINABLE POUCH W/FILTER & WAFER $7.00DRAINAGE PERIRENAL/RENAL ABSCESS OPEN $2,606.00DRAINAGE BAG(CLOSED) $41.00DRAINAGE MOUTH ROOF LESION $521.00DRAINAGE MOUTH ROOF LESION $521.00DRAINAGE MOUTH ROOF LESION $521.00DRAINAGE OF SCROTUM ABSCESS $539.00DRAINAGE OF SCROTUM ABSCESS $414.00DRAINAGE OF SKIN ABSCESS $373.00DRAPE - STERI $14.00DRAPE ABDOMINAL W/POUCHES $40.00DRAPE C-ARM $102.00DRAPE EXTREMITY $40.00DRAPE INCISE 23X33- IOBAN $117.00DRAPE INCISE 24X14 IOBAN $36.00DRAPE INCISE 35X35- IOBAN $191.40

DRAPE LAP CHOLE $40.00DRAPE LAPAROTOMY $35.00DRAPE LARGE IOBAN-ORTHO $137.00DRAPE LAVH TIBURON CS/8 $75.00DRAPE LEGGINGS SURGICAL 48X31IN $225.00DRAPE MICROBAN ADHESIVE 36 X 2 $93.00DRAPE TRANSVERSE LAPAROTOMY $34.00DRESS/DEBRID SMALL $209.00DRESS/DEBRIDEMENT LARGE W/O ANESTH $475.00DRESS/DEBRIDEMENT MEDIUM W/O ANESTH $239.00DRESSING 5X9 NON ADHERING $10.00DRESSING ADAPTIC 3X3 NON ADHERING $12.00DRESSING ADAPTIC 3X8 NON ADHERING $7.00DRESSING ADAPTIC 5X9 NON ADHERING $12.00DRESSING DERMAGRAN 4X4 HYDROPHILIC $32.00DRESSING FOAM ADHESIVE- ORTHO $61.00DRESSING GAUZE EPISTAXIS 10.0X1.5X2.5 $36.00DRESSING KALTOSTAT 10X20 $41.00DRESSING POLYMEM MEMBRANE 5X5 $38.00DRESSING TRAY $11.00DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL- $209.00DRILL 2.3 $565.00DRILL BIT 1/8 $88.00DRILL BIT 2.0MM $458.00DRILL BIT 2.0MM CMP CAL $520.00DRILL BIT 2.4 SOLID $550.00DRILL BIT 2.5MM $458.00DRILL BIT 2.5MM CALIBRATED $150.00DRILL BIT 4.0 MM $450.00DRILL BIT 4.0MM $158.00DRILL BIT- CANNULATED- 2.0MM $565.00DRILL BIT, QUICK COUPLING 2.5MM $406.00DRILL FLEX 1.8MM QFIX-ORTHO $811.00DRILL PROFILE $475.00DRILL- SINGLE USE- MORPHIX $1,075.00DRILL, CANNULATED, 1.7X110 $530.00DROPERIDOL 2.5 MG AMPULE (INAPSINE) $47.00DRUG SCREEN URINE $219.00DRUGS OF ABUSE 10 DRUG WHOLE BLOOD $217.00DRUGS OF ABUSE 11 DRUGS SERUM $141.00DRUGS SCREEN 16 DRUGS $240.00DRYTEX ROCKET SOCK LG LEFT $57.00DRYTEX ROCKET SOCK LG RIGHT $57.00DRYTEX ROCKET SOCK MED LEFT $57.00DRYTEX ROCKET SOCK SM LEFT $57.00DSG &/DEBRID INIT/SUBSQT;W/O ANES SM $199.00DSG &/DEBRID INIT/SUBSQT;W/O ANES SM $199.00

DSG &/DEBRID INIT/SUBSQT;W/O ANES SM $209.00DTP <7YRS $20.00DTP <7YRS $20.00DUAL EDGE SHAVER BLAD 3.5MM $122.00DUAL EDGE SHAVER BLADE $131.00DULOXETINE DR 30MG CAPSULE (CYMBALTA) $53.00DUO DERM 8X12 CGF $74.20DUO DERM CGF 4 X 4 $14.00DUO DERM CGF 6 X 6 $35.00DUO DERM THIN 4 X 4 $10.00DUO DERM X THIN 6 X 6 $21.00DUO THERM HEATING K PAD 18X24 $27.00DUO THERM HEATING K PAD 25 X64 $66.00DUONEB(ALBUTEROL/IPRATROPIUM) 0.5-3MG UD $11.00DUOVISC (CHONDROITIN/SOD HYALURONA) KIT $658.00DURAPREP ORTHO $28.00DUTASTERIDE (AVODART) 0.5MG CAPSULE $33.00DVLPMNTL SCREENING W/INTERPRETATION REPO $27.00DVLPMNTL SCREENING W/INTERPRETATION REPO $32.00DVRAN NARROW RIGHT $1,122.00DX BC SUTURE TAK #2 $813.00DX LARYNGOSCOPY EXCL NB $644.00DX LARYNGOSCOPY EXCL NB $644.00DYNACIRC (ISRADIPINE) 2.5 MG CAP $5.00DYNACIRC CR (ISRADIPINE) 5 MG TABLET $11.00DYONICS 4MM BURR- ORTHO $204.00E Z PRN SET 219A $12.00E Z PRN SET 239A $12.00E. HISTOLYTICA $176.00E2 SET PRN G 21 $8.00EACH ADDL RESECTION ANASTOMOSIS $576.00EAR COUPLERS $61.00EAR IRRIGATION $130.00EAR SPECULA 6 MM $50.00EAR SPECULA ADULT 7 MM $36.00EAR SPECULA CHILD 2.5 MM $36.00EAR SPECULA CHILD 4 MM $50.00EAR SPECULUM DISP. CHILD 3MM $37.00EAR SPEULUM DISP ADULT 5MM $51.00EAR SUCTION NEEDLE 14 GA $62.00EAR SUCTION NEEDLE 16 GA $62.00EAR SUCTION NEEDLE 18 GA $62.00EAR VENT TUBE, PAPARELLA 1.14 MM $188.00EBV ACUTE PROFILE $201.00EBV ANTIBODY PROFILE $50.00EBV QUANT PCR $386.00ECG;I&R ONLY CMPNT INIT PREV PE $25.00

ECHELON FLEX 45 ENDOSCOPIC LINEAR CUTTER $583.43ECHINOCOCCUS ANTIBODY $390.00ECONAZOLE NITRATE OINT 1% (SPECTAZOLE) $50.00EDECRIN (ETHACRYNIC ACID) 25 MG TAB $4.00EFFEXOR (VENLAFAXINE) 75 MG XR CAPS $10.00EGD W/DIALATION OF ESOPHAGUS $410.00EGG BUR 4.0MM $260.00EKG $150.00EKG INTERP. AND REPORT ONLY $21.00EKG MONITORING VEST $56.00EKG READ ONLY $20.00EKG READ ONLY $20.00EKG VEST $30.00ELBOW ARTHROGRAPHY LT $462.00ELBOW ARTHROGRAPHY RT $462.00ELBOW LT 2V $261.00ELBOW RT 2V $261.00ELECTRO CAUTERY OF CERVIX $93.00ELECTRO UROFLOWMETRY FIRST $40.00ELECTRO UROFLOWMETRY FIRST $40.00ELECTROCARDIOGRA M, ROUTINE ECG WITH AT $150.00ELECTROCARDIOGRA M, ROUTINE ECG WITH AT $21.00ELECTRODE $28.00ELECTRODES 10 MM LOOP LEEP $112.00ELECTRODES 15 MM LOOP LEEP $102.00ELECTRODES 20 MM LOOP LEEP $112.00ELECTRODES 5 MM BALL LEEP $112.00ELECTRODES INFANT REM POLYHESIVE II $36.57ELECTRODES NEEDLE POINT TIP $12.00ELECTROLYTES $133.00ELECTROMYOGRAPH Y STUDIES (EMG) OF ANAL $175.00ELEVIEW SUBMUCOSAL 10ML $406.00ELIGARD 30MG KIT (LEUPROLIDE) $2,463.00ELIQUIS 2.5MG TABLET (APIXABAN) $34.00ELIXOPHYLLIN (THEOPHYLLIN ANHYD) 2 OZ $46.00ELLENCE (EPIRUBICIN) 50MG/25ML VIAL $228.00EMERG SRVC OUT OF OFFICE;DISRUPTS SCHD $67.00EMERGENCY RM LEVEL 2 $222.00EMERGENCY RM LEVEL 3 $406.00EMERGENCY RM LEVEL 4 $448.00EMERGENCY RM LEVEL 5 $668.00EMPOWER INSERT SZ5 11MM-ORTHO $3,386.00EMPOWER PS INSERT SIZE 8-ORTHO $3,288.00EMPOWER PS INSERT SZ5-ORTHO $3,077.00EMPOWER PS KNEE 5R-ORTHO $3,386.00EMPOWER PS KNEE 6R-ORTHO $6,298.00EMPOWR 3D KNEE 6 12MM-ORTHO $3,385.00

EMPOWR 3D KNEE FEMUR 6-ORTHO $6,299.00EMPOWR 3D KNEE FEMUR 7L 12MM- ORTHO $3,386.00EMPOWR 3D KNEE FEMUR 7L- ORTHO $6,298.00EMPOWR 3D KNEE FEMUR 8R-ORTHO $6,298.00EMPOWR 3D KNEE FIN BP- ORTHO $3,302.00EMPOWR 3D KNEE INS 8R-ORTHO $3,385.00EMPOWR 3D KNEE MINUS 8R-ORTHO $3,302.00EMPOWR 3D KNEETM FEMUR 4-ORTHO $6,299.00EMPOWR 3D KNEETM FEMUR 5-ORTHO $3,386.00ENA SCREEN (B) $21.00ENALAPRIL MAL 10 MG TABLET (VASOTEC) $6.00ENALAPRIL MAL 2.5 MG TABLET (VASOTEC) $6.00ENALAPRIL MAL 5 MG TABLET (VASOTEC) $8.00ENALAPRIL/HCTZ 10/25MG TAB (VASERETIC) $8.00ENALAPRILAT (VASOTEC) 1.25MG/1ML VIAL $9.00ENALAPRILAT 1.25MG/ML 2ML $16.00ENAOSCOPIC LINEAR CUTTER $872.00ENDO CANN DRIL BIT 4.5- ORTHO $311.00ENDO CHOLANGIOPANCREATOGRAPH $828.00ENDO POUCH-GENICON $363.00ENDO RETRIEVER (SPECIMEN RETRIEVAL BAG) $285.00ENDO STAPLER 28MM $1,125.00ENDO TUBE HOLDER $34.00ENDOBUTTON CL ULTREA 15MM-ORTHO $684.00ENDOBUTTON ULTRA 20MM $716.00ENDOCERVICAL CURETTE $28.00ENDOCERVICAL CURRETTE $185.00ENDOCERVICAL CURRETTE $185.00ENDOCERVICAL CURRETTE $27.00ENDOCUFF- LARGE GREEN $138.00ENDOCUFF- PURPLE $138.00ENDOGATOR- CONNECTOR KIT $48.00ENDOGATOR TUBING $131.00ENDOMETRIAL ABLATION THERM W/O SCOPE $401.00ENDOMETRIAL ABLATION THERM W/O SCOPE $401.00ENDOMETRIAL ABLATION, THERMAL, W/O $156.00ENDOMETRIAL ABLATION, THERMAL, WITHOUT H $422.00ENDOMETRIAL SAMPLING $244.00ENDOMETRIAL SAMPLING $244.00ENDOMETRIAL SAMPLING $257.00ENDOMETRIAL SAMPLING (BIOPSY) PERFORMED $123.00ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WI $257.00ENDOMYSIAL ANTIBODY IGA $229.00ENDOPATH ETS-FLEX 45 $515.00ENDOSCOPIC DISSECTOR $44.00ENDOSCOPIC MANIPULATOR 5MM $524.00ENDOSCOPY/ESOPHAGUS/WI $506.00

ENDOSCOPY/ESOPHAGUS/WI $506.00ENDOSCOPY/LARYNX/WITH $361.00ENDOSCOPY/LARYNX/WITH $226.00ENDOSCOPY/LARYNX/WITH $149.00ENDOSCOPY/UPPER GI W/R $326.00ENDOSCOPY/UPPER GI W/R $326.00ENDOSCOPY/UPPER GI/DIA $493.00ENDOSCOPY/UPPER GI/DIA $493.00ENDOSCOPY/UPPER GI/WIT $677.00ENDOSCOPY/UPPER GI/WIT $677.00ENDOTRACHEAL INTUBATION $500.00ENEMA MINERAL OIL(ORANGE TIP) $7.00ENEMA SALINE FLEET(BLUE TIP) $7.00ENFAMIL HUMAN MILK PCKT FORTFT $15.00ENGERIX-B PED (HEPATITIS B)10MCG/0.5ML $131.00ENGERIX-B (HEPATITIS B) 10MCG/0.5ML $25.00ENLON PLUS(EDROPHONIUM/ATROPINE)MDV 10MG $62.00ENOXAPARIN (LOVENOX) 30 MG SYRINGE $45.00ENOXAPARIN (LOVENOX) 40 MG SYRINGE $41.00ENOXAPARIN (LOVENOX) 60 MG SYRINGE $81.00ENOXAPARIN (LOVENOX) 80 MG SYRINGE $104.00ENOXAPARIN 100 MG SYRINGE (LOVENOX) $128.00ENOXAPARIN 150 MG SYRINGE (LOVENOX) $529.00ENTER SM INTE $3,433.00ENTERECTOMY SM INTESTINE;SNGL RESECT $3,433.00ENTERECTOMY, RESECTION OF SMALL INTESTIN $3,433.00ENTERIC COATED ASA 500 MG TAB $4.00ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB $2,397.00ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB $2,397.00ENTEROTOMY, SMALL INTESTINE, OTHER THAN $2,397.00ENTEROVIRUS PCR $596.00ENTEX LA (GUIAFENSIN/PPA) LA TABS $4.00ENTYVIO 300MG VIAL (VEDOLIZUMAB) $9,688.00EOSINOPHIL STAIN $58.00EOSINOPHIL URINE $75.00EpheDRINE 50 MG VIAL $21.00EPI PRO COLON $709.00EPIDRM AGRFT FACE/NCK/HND/FT/GNT 1ST 100 $1,890.00EPIDRM AGRFT FACE/NCK/HND/FT/GNT 1ST 100 $1,890.00EPIDURAL PERIFIX 18ga.x4 3/4 TOUHY NEED $38.00EPIDURAL TRAY SST 18G3.5 S/L1T5082 $170.00EPIFIX 2x2 ALLOGRAFT $1,746.00EPIFIX 2x4 ALLOGRAFT $1,691.00EPIFIX 4x4.5 ALLOGRAFT $2,379.00EpiNEPHrine 1MG/ML 1ML VIAL (1:1000) $21.00EpiNEPHrine CARDIAC 0.1MG/ML (1:10,000) $44.00EPIRUBICIN 200MG/100ML (ELLENCE) $2,147.00

EPLERENONE 25MG TABLET (INSPRA) $18.00EPOGEN FOR ESRD (EPOETIN ALFA) 10,000U $578.00EPOGEN FOR ESRD (EPOETIN ALFA) 4,000U $274.00EPOGEN FOR ESRD (EPOETIN ALFA) 40,000U $1,066.00EPSOM SALT (MAGNESIUM SULF) GRAN 4 LB $8.00EPSTEIN BARR VIRUS $201.00EPSTEIN BARR VIRUS NUC ANTIGEN Ab IgG $113.00EPSTEIN BARR VIRUS VCA IgG/IgM $135.00ER PHYSICIAN LEVEL 5 $668.00ER PHYSICIAN LEVEL 1 $117.00ER PHYSICIAN LEVEL 2 $222.00ER PHYSICIAN LEVEL 3 $406.00ER PHYSICIAN LEVEL 4 $448.00ER VISIT E & M HIGH-SEVER SIG THREAT $636.00ER VISIT LEVEL ONE $111.00ER/PR $206.00ERBEFLO CLEVERCAP $156.00ERBITUX 100MG (CETUXIMAB) VIAL $2,245.00ERBITUX 200MG (CETUXIMAB) VIAL $4,439.00ER-PAK IBUPROFEN CHILD SYRUP 100MG/5ML $28.00ER-PAK (NEO/POLY/POLMIX) OPTH OINT $31.00ER-PAK ACETAMINOPHEN EL 160MG/5ML $28.00ER-PAK ACETAMINOPHEN/COD 300/30MG TAB#4 $11.00ER-PAK AMOXICILLIN 125MG/5ML ORAL SUSP $10.00ER-PAK AMOXICILLIN 250MG/5ML SUSPENSION $10.00ER-PAK AMOXICILLIN 500MG CAPSULES #4 $9.00ER-PAK AMOXICILLIN/CLAVUL 875MG TABS # 2 $20.00ER-PAK AMOXICILLIN/CLAVULANATE 250MG # 4 $43.00ER-PAK AUGMENTIN 125MG/5ML ORAL SUSP $101.00ER-PAK AUGMENTIN 250MG/5ML SUSPENSION $138.00ER-PAK AZITHROMYCIN 100MG/5ML ORAL SUSP $35.00ER-PAK CEFACLOR 125MG/5ML $50.00ER-PAK CEFACLOR 250MG/5ML (CECLOR) $82.00ER-PAK CEFALCOR 250MG #4 $47.00ER-PAK CEPHALEXIN 125MG/5ML SUSPENSION $19.00ER-PAK CEPHALEXIN 250MG/5ML SUSPENSION $21.00ER-PAK CHARCOAL/SORBITOL 25GM $29.00ER-PAK CIPROFLOXACIN 250MG TABLETS #4 $10.00ER-PAK CLARITHROMYCIN 500MG #2 $36.00ER-PAK CYCLOBENZAPRINE 10MG TABLETS #4 $10.00ER-PAK DIAZEPAM 5MG #4 $7.80ER-PAK DIPHENHYDRAMINE 25MG #4 $10.00ER-PAK DIPHENHYRADMINE 12.5MG/5ML $28.00ER-PAK DIPHENOXYLATE ATROP 2.5MG #4 $10.00ER-PAK ERYTHROMYCIN 200MG/5ML SUSPENSION $112.00ER-PAK ERYTHROMYCIN 250MG TAB #4 $10.00ER-PAK ERYTHROMYCIN OPHTHALMIC OINT 1GM $27.00

ER-PAK ERYTHROMYCIN/SULFISOXAZOLE 250MG $54.00ER-PAK GENTAMYCIN 0.3% OPHTH OINTMENT $28.00ER-PAK GENTAMYCIN 0.3% OPHTH SOLUTION $41.00ER-PAK GUAIFENSIN/COD 30ML SYRUP $12.00ER-PAK HYDROCODONE/APAP 5/325MG TAB #4 $13.00ER-PAK HYDROCODONE/APAP 5/500MG #4 $10.00ER-PAK HYDROCODONE/APAP 7.5/325MG TAB #4 $20.00ER-PAK HYDROCODONE/APAP ES 7.5/750MG #4 $7.80ER-PAK IBUPROFEN 400MG #4 $10.00ER-PAK IBUPROFEN 600MG TABLETS #4 $6.00ER-PAK METRONIDAZOLE 250 MG TABLET #4 $6.00ER-PAK NEO/POLY/BACT HC OPTH OINT $16.00ER-PAK NEO/POLY/HYDROCORT OPTH $159.00ER-PAK NEOMYC/PLOYMYX/HYDCRT 1%OTIC SUSP $50.00ER-PAK NEOMYC/POLYMYX/HYDRCRT SUSP $79.00ER-PAK OXYCODONE 5MG TABLETS #4 $6.00ER-PAK OXYCODONE/APAP 5/325MG TABLETS #4 $50.00ER-PAK PENICILLIN V POT 250MG #4 $10.00ER-PAK PHENAZOPYRIDINE 100MG #4 $10.00ER-PAK PHENYLEPHRINE 0.25% SPRAY $20.00ER-PAK POLY/NEO/GRAMICID OPTH SOLN $51.00ER-PAK PROMETHAZINE 25MG TABLETS #4 $14.00ER-PAK PROPOXY NAP/APAP 100 #4 $10.00ER-PAK SILVADENE 400G (SILVER SULFA 1%) $94.00ER-PAK SILVADENE 50G (SILVER SULFA 1%)EA $25.00ER-PAK SILVER SULFADIAZINE 400GM JAR $49.00ER-PAK SILVER SULFADIAZINE 50GM JAR $28.00ER-PAK SMP/TMX 800/160MG TABLETS #4 $11.00ER-PAK SOD SULFACETAMDIE 10% OPTH OINT $47.00ER-PAK SULFACETAMIDE SOD 10% OPTH SOLN $118.00ER-PAK ZITHROMAX 200 MG/5ML ORAL SUSP $31.00ERTAPENEM: 1GM (INVANZ) VIAL $223.00ERYTHROMYCIN 250 MG CAPSULE (ERYC) $4.00ERYTHROMYCIN 250 MG TABLET (ERY-TAB) $11.00ERYTHROMYCIN 500 MG ADD-VANTAGE $48.00ERYTHROMYCIN 500 MG VIAL (ERYTHROCIN) $295.00ERYTHROMYCIN OPTHALMIC OINTMENT 1GM $27.00ERYTHROMYCIN/ETHYLSUS 200MG/5ML SUSP $11.00ERYTHROPOIETIN $97.00ESCITALOPRAM (LEXAPRO)10MG TAB $26.00ESMARK BANDAGE 3 STERILE OR $15.00ESMARK BANDAGE 4 STERILE OR $20.00ESMARK BANDAGE 6 ORTHO $28.00ESMOLOL 10MG/ML 10ML VIAL $30.00ESMOLOL 2500MG/250ML NS RTU $822.00ESOPHAGEAL STETHOSCOPE 12 $27.00ESOPHAGEAL STETHOSCOPE 18 W/TEMP PROBE $53.00

ESOPHAGEAL STETHOSCOPE 24 $27.00ESOPHAGOGASTROD UODENOSCOPY, FLEXIBLE, T $440.00ESOPHAGOGASTROD UODENOSCOPY, FLEXIBLE, T $425.00ESOPHAGOGASTROD UODENOSCOPY, FLEXIBLE, T $343.00ESOPHAGOSCOPY DX SEP PROCEDURE $395.00ESOPHAGOSCOPY DX SEP PROCEDURE $395.00ESOPHAGOSCOPY ENDOSCOPY $319.00ESOPHAGOSCOPY ENDOSCOPY $319.00ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; DIAG $415.00ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH $335.00ESOPHAGRAM/BA SWALLOW $291.00ESSENTIAL KIT- ENDOGATOR $102.00ESTABLISHED PATIENT LEVEL 2 OV SURGEON $105.00ESTABLISHED PATIENT LEVEL 3 OV SURGEON $124.00ESTABLISHED PATIENT LEVEL 3 OV SURGEON $124.00ESTABLISHED PATIENT LEVEL 4 OV SURGEON $188.00ESTABLISHED PATIENT LEVEL 4 OV SURGEON $188.00ESTRADERM (ESTRADIOL) 0.1MG PATCH $16.00ESTRADIOL $105.00ESTRADIOL $105.00ESTRADIOL 0.05 PATCH (ESTRADERM) $14.00ESTRADIOL 0.5MG TABLET (ESTRACE) $5.00ESTRADIOL 2MG TABLET (ESTRACE) $5.00ESTRADIOL TAB 1MG $6.00ESTRADIOL VAG CREAM 42.5GM (ESTRACE) $316.00ESTRATAB HS ESTROGEN/METHYLTESTOS TAB $10.00ESTRATEST TAB $11.00ESTRIOL $170.00ESTROGEN 0.075MG PATCH (CLIMARA) $43.00ESTROGEN 3.9 MG PATCH (CLIMARA) $14.00ESTROGENS $216.00ESTROGENS, FRACTIONATED $181.00ESTRONE $121.00ESTROPIPATE 1.25MG (ORTHO-EST) $4.00ESTROPIPATE 1.5MG TABLET (OGEN) $5.00ETHACRYNATE 50MG VIAL (EDECRIN SODIUM) $123.00ETHAMBUTOL HCL 400 MG TAB (MYAMBUTOL) $7.80ETHOSUXIMIDE $63.00ETHRANE ANESTHETIC PER CC $9.00ETHYL CHLORIDE SPRAY $62.00ETHYOL (AMIFOSTINE) 500 MG VIAL $887.00ETODOLAC 300 MG CAPSULE (LODINE) $9.00ETODOLAC 400MG TABLET (LODINE) $10.00ETOMIDATE 40 MG VIAL $135.00ETOPOSIDE 100 MG VIAL (VEPESIDE) $54.00ETOPOSIDE 50 MG CAPSULE (VEPESID) $180.00ETOPOSIDE 500 MG VIAL (VEPESIDE) $52.00

EUGLOBULIN CLOT LYSIS $236.00EVAC 70 XTRA $567.00EVACUATE MOLE OF UTERUS $1,106.00EVACUATION OF SUBUNGUAL HEMATOMA $147.00EVACUATION OF SUBUNGUAL HEMATOMA $147.00EVACUATOR BULB- 100CC $28.00EVENT RECORDER $1,035.00EVENT RECORDER SCAN ANALYSIS $773.00EVEROLIMUS $277.00EVISTA (RALOXIFENE HCL) 60 MG TAB $49.00EXAM PELVIC;ANEST $253.00EXAM PELVIC;ANEST $253.00EXC ABD LES SC > 3 CM $1,073.00EXC BEN LES FACE/EAR/EYES/NOSE $269.00EXC BEN LES FACE/EAR/EYES/NOSE 0.6-1.0CM $278.00EXC BEN LES FACE/EAR/EYES/NOSE 0.6-1.0CM $264.00EXC BEN LES FACE/EAR/EYES/NOSE 0.6-1.0CM $264.00EXC BEN LES FACE/EAR/EYES/NOSE 0.6-1.0CM $278.00EXC BEN LES FACE/EAR/EYES/NOSE 1.1-2.0CM $340.00EXC BEN LES FACE/EAR/EYES/NOSE 1.1-2.0CM $340.00EXC BEN LES FACE/EAR/EYES/NOSE 1.1-2.0CM $357.00EXC BEN LES FACE/EAR/EYES/NOSE 2.1-3.0CM $363.00EXC BEN LES FACE/EAR/EYES/NOSE 2.1-3.0CM $363.00EXC BEN LES FACE/EAR/EYES/NOSE 2.1-3.0CM $382.00EXC BEN LES FACE/EAR/EYES/NOSE 4CM & MOR $819.00EXC BEN LES FACE/EAR/EYES/NOSE 4CM & MOR $819.00EXC BEN LES FACE/EAR/EYES/NOSE<.5CM $256.00EXC BEN LES FACE/EAR/EYES/NOSE<.5CM $256.00EXC BEN LES SCALP HND FT GENT/ $201.00EXC BEN LES SCALP/NECK $81.00EXC BEN LES SCLP HND FT GNT 3.1-4.0 CM $91.00EXC BEN LES SCLP/HAND/FT GNT 1.1-2.0 CM $328.00EXC BEN LES SCLP/HN/ FT/GNT/NEC <.5CM $191.00EXC BEN LES SCLP/HND/FT/GNT/NEC .6-1CM $280.00EXC BEN LES SCLP/HND/FT/GNT/NEC .6-1CM $280.00EXC BEN LES SCLP/HND/FT/GNT/NEC .6-1CM $294.00EXC BEN LES SCLP/HND/FT/GNT/NEC <.5CM $191.00EXC BEN LES SCLP/HND/FT/GNT/NEC 1.1-2CM $328.00EXC BEN LES SCLP/HND/FT/GNT/NEC 1.1-2CM $312.00EXC BEN LES SCLP/HND/FT/GNT/NEC 1.1-2CM $312.00EXC BEN LES SCLP/HND/FT/GNT/NEC 2.1-3CM $325.00EXC BEN LES SCLP/HND/FT/GNT/NEC 2.1-3CM $325.00EXC BEN LES SCLP/HND/FT/GNT/NEC 3.1-4CM $350.00EXC BEN LES SCLP/HND/FT/GNT/NEC 3.1-4CM $350.00EXC BEN LES SCLP/HND/FT/GNT/NEC OVER 4CM $775.00EXC BEN LES SCLP/HND/FT/GNT/NEC OVER 4CM $775.00EXC BEN LES SCLP/HND/FT/GNT/NECK .6-1.0 $294.00

EXC BEN LES/TRUNK-ARM/LEG 5CM $238.00EXC BEN LES/TRUNK-ARM/LEG 5CM $226.00EXC BEN LES/TRUNK-ARM/LEG 5CM $226.00EXC BEN LES/TRUNK-ARM-LEG 0.6-1.0 CM $260.00EXC BEN LES/TRUNK-ARM-LEG 0.6-1.0 CM $260.00EXC BEN LES/TRUNK-ARM-LEG 1.1-2.0 CM $428.00EXC BEN LES/TRUNK-ARM-LEG 1.1-2.0 CM $407.00EXC BEN LES/TRUNK-ARM-LEG 1.1-2.0 CM $407.00EXC BEN LES/TRUNK-ARM-LEG 1.1-2.0 CM $428.00EXC BEN LES/TRUNK-ARM-LEG 2.1-3.0 CM $369.00EXC BEN LES/TRUNK-ARM-LEG 2.1-3.0 CM $351.00EXC BEN LES/TRUNK-ARM-LEG 2.1-3.0 CM $351.00EXC BEN LES/TRUNK-ARM-LEG 2.1-3.0 CM $369.00EXC BEN LES/TRUNK-ARM-LEG 3.1-4.0 CM $352.00EXC BEN LES/TRUNK-ARM-LEG 3.1-4.0 CM $335.00EXC BEN LES/TRUNK-ARM-LEG 3.1-4.0 CM $352.00EXC BEN LES/TRUNK-ARM-LEG 4.0 CM $418.00EXC BEN LES/TRUNK-ARM-LEG 4.0 CM $418.00EXC BEN LES/TRUNK-ARM-LEG 4.0 CM $439.00EXC BONE CYST/BEN TUMOR FEMUR $1,462.00EXC BREAST CYST TUMR LES OPEN M/F1 $721.00EXC BREAST CYST TUMR LES OPEN M/F1 $721.00EXC BREAST LE $892.00EXC BREAST LES;ID'D BY PREOP $892.00EXC FACE B9 INC. MARG 3.1 TO 4.0 CM $541.00EXC FACE LES SC <2 CM $863.00EXC FACE-MM MALIG MARG 2,1-3 $556.00EXC FOREARM LESS SC 3 CM/> $1,079.00EXC GAGLION CYST $555.00EXC GAGLION CYST $555.00EXC H-F-NK-SPB9 & MARG 0.5< $201.00EXC HYDROCELE;UNI $958.00EXC HYDROCELE;UNI $958.00EXC LES SPERMATIC CORD $1,013.00EXC LES SPERMATIC CORD $1,013.00EXC LES TEND/SHETH/JNT/HND/FING $596.00EXC LES TEND/SHETH/JNT/HND/FING $596.00EXC MAL LES SCLP/HND/FT/GNT 3.1-4.CM $697.00EXC MAL LES SCLP/HND/FT/GNT 3.1-4.CM $697.00EXC MAL LES TRNK/ARMS/LEGS 4.0CM & MORE $915.00EXC MAL LES TRNK/ARMS/LEGS 4.0CM & MORE $915.00EXC MAL/LES FACE/EARS/EYLDS/NOSE >4.0 $834.00EXC MAL/LES FACE/EARS/EYLDS/NOSE >4.0 $834.00EXC MAL/LES FACE/EARS/EYLDS/NOSE >4.0 $876.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 0.6-1.0 $303.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 0.6-1.0 $303.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 0.6-1.0 $319.00

EXC MAL/LES FACE/EARS/EYLDS/NOSE 1.1-2.0 $416.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 1.1-2CM $396.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 1.1-2CM $396.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 2.1-3.0 $458.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 2.1-3.0 $458.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 2.1-3.0 $132.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 3.1-4.0 $613.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 3.1-4.0 $613.00EXC MAL/LES FACE/EARS/EYLDS/NOSE 3.1-4.0 $161.00EXC MAL/LES FACE/EARS/EYLDS/NOSE<.5CM $274.00EXC MAL/LES FACE/EARS/EYLDS/NOSE<.5CM $274.00EXC MAL/LES FACE/EARS/EYLDS/NOSE<.5CM $288.00EXC MAL/LES SCALP/HAND/FOOT/GNT ,0.5 $273.00EXC MAL/LES SCALP/HAND/FOOT/GNT ,0.6-1.0 $105.00EXC MAL/LES SCALP/HAND/FOOT/GNT ,1.1-2.0 $349.00EXC MAL/LES SCLP/HND/FT/GNT 0.6-1.CM $308.00EXC MAL/LES SCLP/HND/FT/GNT 0.6-1.CM $308.00EXC MAL/LES SCLP/HND/FT/GNT 1.1-2.CM $332.00EXC MAL/LES SCLP/HND/FT/GNT 1.1-2.CM $332.00EXC MAL/LES SCLP/HND/FT/GNT 2.1-3.CM $580.00EXC MAL/LES SCLP/HND/FT/GNT 2.1-3.CM $580.00EXC MAL/LES SCLP/HND/FT/GNT;0.5CM $260.00EXC MAL/LES SCLP/HND/FT/GNT;0.5CM $260.00EXC MAL/LES TRNK/ARMS/LEGS 1.1-2.0 $378.00EXC MAL/LES TRNK/ARMS/LEGS 1.1-2.0 $378.00EXC MAL/LES TRNK/ARMS/LEGS 1.1-2.0 $114.00EXC MAL/LES TRNK/ARMS/LEGS 2.1-3.0 $346.00EXC MAL/LES TRNK/ARMS/LEGS 2.1-3.0 $346.00EXC MAL/LES TRNK/ARMS/LEGS 2.1-3.0 $364.00EXC MAL/LES TRNK/ARMS/LEGS 3.1-4.0CM $461.00EXC MAL/LES TRNK/ARMS/LEGS 3.1-4.0CM $461.00EXC MAL/LES TRNK/ARMS/LEGS 3.1-4.0CM $143.00EXC MAL/LESTRUNK-ARM/LEGS <0.5 $270.00EXC MAL/LESTRUNK-ARM/LEGS <0.5 $270.00EXC MAL/LESTRUNK-ARM/LEGS <0.5 $284.00EXC NAIL;PARTIAL $746.00EXC NAIL;PARTIAL $746.00EXC OF CARCINOID TUMOR IN RECTUM $1,648.00EXC OF EXTERNAL HEMORRHOID TAGS/MULT PAP $522.00EXC OF EXTERNAL HEMORRHOID TAGS/MULT PAP $522.00EXC OF LIPOMA OF FACE $665.00EXC PILONIDAL CYST $1,310.00EXC PILONIDIAL CYST;EXT $398.00EXC PILONIDIAL CYST;EXT $492.00EXC PILONIDIAL CYST;EXT $492.00EXC PILONIDIAL CYST;EXT SIMPLE $398.00EXC RESECTION TUMOR;SOFT TISS $1,748.00

EXC RESECTION TUMOR;SOFT TISS $1,748.00EXC SKIN OF NAIL FOLD $173.00EXC SKIN OF NAIL FOLD $173.00EXC THIGH/KNEE LES SC<3CM $753.00EXC TR-EXT B9+MARG 0,6-1CM $273.00EXC TR-EXT MLG T MARG 0,6-1CM $359.00EXC TUMOR SOFT TISSUE BACK/FLANK 3CM> $1,770.00EXC TUMOR SOFT TISSUE SHOULDER 3CM/> $1,018.00EXC TUMOR/SOFT TISSUE $704.00EXC TUMOR/SOFT TISSUE $771.00EXC TUMOR/SOFT TISSUE $704.00EXC TUMOR/SOFT TISSUE $771.00EXC TUMOR:THI $998.00EXC TUMOR:THIGH/KNEE;SUBCUT,DEEP $998.00EXC VAG CYST/TUMOR $438.00EXC VAG CYST/TUMOR $438.00EXC, ABD. TUM 5cm $2,769.00EXC. ABD. LES. SC<3CM $843.00EXC. ABD. LES. SC<3CM LIPOMAS $843.00EXC. BACK TUM. DEEP =5CM $1,770.00EXC. BACK TUM. DEEP =5CM $1,770.00EXC. LEG/ ANKLE TUM DEEP 5TCM $1,637.00EXC. NECK LES SC 3FCM $1,091.00EXC. NECK LESION $1,091.00EXC. OF THROMB. HEMORR. EXT. $470.00EXC. TR-EXT MLG & MARG 0.6-1 CM $359.00EXC/BIO LYMPH $552.00EXC/CURETTAGE BONE CYST/BENIGN TUMOR $1,279.00EXC/CURETTAGE BONE CYST/BENIGN TUMOR $1,279.00EXC/SOFT TISSUE TUMOR $291.00EXC/SOFT TISSUE TUMOR $291.00EXC/SOFT TISSUE TUMOR;SHOULDER $1,332.00EXC/SOFT TISSUE TUMOR;SHOULDER $1,332.00EXC/UNROOFING CYST KIDNEY $1,575.00EXCHANGE TRANSFUSION SETG $31.00EXCISE EXCESSIVE SKIN TISSUE $1,153.00EXCISE EXCESSIVE SKIN TISSUE $1,153.00EXCISE EXCESSIVE SKIN TISSUE LEG $1,903.00EXCISE INTESTINE LESION(S) $1,815.00EXCISE INTESTINE LESION(S) $1,815.00EXCISION ABD WALL TUMOR SUBFASCIAL $649.00EXCISION ABD WALL TUMOR SUBFASCIAL $649.00EXCISION ARM/ELBOW LES SC<3 CM $1,231.00EXCISION ARM/ELBOW LES SC<3 CM $1,231.00EXCISION BARTHOLINS GLAND OR CYST $728.00EXCISION HND/FNGR SOFT TISS SUBCUT $1,745.00EXCISION HND/FNGR SOFT TISS SUBCUT $1,745.00

EXCISION MAL. LESION W/MARGINS, SCALP ET $632.00EXCISION NAIL/PARTIAL $784.00EXCISION NASAL POLYP(S) SIMPLE $325.00EXCISION OF ANAL LESION $509.00EXCISION OF ANAL LESION $509.00EXCISION OF ANAL LESION $509.00EXCISION OF BARTHOLIN'S GLAND OR CYST $728.00EXCISION OF CYST, FIBROADENOMA, OR OTHER $758.00EXCISION OF GANGLION, WRIST (DORSAL OR V $583.00EXCISION OF GANGLION, WRIST, RECURRENT $884.00EXCISION OF GANGLION, WRIST, RECURRENT $744.00EXCISION OF HYDROCELE; BILATERAL $1,258.00EXCISION OF HYDROCELE; UNILATERAL $958.00EXCISION OF INFECTED GRAFT; EXTREMITY $1,255.00EXCISION OF LIPOMA 3 CM OR GREATER $1,073.00EXCISION OF LIPOMA UPPER ARM $1,011.00EXCISION OF LYMPH NODE $580.00EXCISION OF MULTIPLE EXTERNAL PAPILLAE O $549.00EXCISION OF NAIL NAIL MATRIX PARTIAL/COM $784.00EXCISION OF PILONIDAL CYST OR SINUS; SIM $398.00EXCISION OF RECTAL PROCIDENTIA, WITH ANA $3,209.00EXCISION OF RECTAL TUMOR, TRANSANAL APPR $1,648.00EXCISION OF SKIN AND SUBCUTANEOUS TISSUE $630.00EXCISION OF SKIN AND SUBCUTANEOUS TISSUE $1,205.00EXCISION OF SKIN AND SUBCUTANEOUS TISSUE $1,024.00EXCISION OF THROMBOSED HEMORRHOID, EXTER $470.00EXCISION OR DESTRUCTION, OPEN, INTRA-ABD $2,769.00EXCISION OR DESTRUCTION, OPEN, INTRA-ABD $1,892.00EXCISION PARATUBAL CYST $1,892.00EXCISION SACRAL PRESS ULCER W PRIM SUTUR $1,642.00EXCISION SKIN SUBQ TISSUE ABDOMINAL PANN $2,666.00EXCISION SKIN W/SUBQ TISSUE, ABDOMINAL P $2,666.00EXCISION SKIN W/SUBQ TISSUE, ABDOMINAL P $2,666.00EXCISION, BENIGN LESION INCLUDING MARGIN $369.00EXCISION, BENIGN LESION INCLUDING MARGIN $352.00EXCISION, BENIGN LESION INCLUDING MARGIN $439.00EXCISION, BENIGN LESION INCLUDING MARGIN $201.00EXCISION, BENIGN LESION INCLUDING MARGIN $294.00EXCISION, BENIGN LESION INCLUDING MARGIN $328.00EXCISION, BENIGN LESION INCLUDING MARGIN $369.00EXCISION, BENIGN LESION INCLUDING MARGIN $775.00EXCISION, EXCESSIVE SKIN/SUBC. TISSUE $1,104.00EXCISION, MALIGNANT LESION INCLUDING MAR $284.00EXCISION, MALIGNANT LESION INCLUDING MAR $359.00EXCISION, MALIGNANT LESION INCLUDING MAR $359.00EXCISION, MALIGNANT LESION INCLUDING MAR $364.00EXCISION, MALIGNANT LESION INCLUDING MAR $915.00

EXCISION, MALIGNANT LESION INCLUDING MAR $273.00EXCISION, MALIGNANT LESION INCLUDING MAR $349.00EXCISION, MALIGNANT LESION INCLUDING MAR $288.00EXCISION, MALIGNANT LESION INCLUDING MAR $319.00EXCISION, MALIGNANT LESION INCLUDING MAR $416.00EXCISION, NASAL POLYP(S), SIMPLE $370.00EXCISION, OLECRANON BURSA $762.00EXCISION, OTHER BENIGN LESION INCLUDING $269.00EXCISION, OTHER BENIGN LESION INCLUDING $278.00EXCISION, OTHER BENIGN LESION INCLUDING $357.00EXCISION, OTHER BENIGN LESION INCLUDING $382.00EXCISION, OTHER BENIGN LESION INCLUDING $819.00EXCISION, TUMOR, SOFT TISSUE OF ABDOMINA $1,635.00EXCISION, TUMOR, SOFT TISSUE OF ABDOMINA $843.00EXCISION, TUMOR, SOFT TISSUE OF ABDOMINA $1,073.00EXCISION, TUMOR, SOFT TISSUE OF BACK OR $810.00EXCISION, TUMOR, SOFT TISSUE OF BACK OR $1,155.00EXCISION, TUMOR, SOFT TISSUE OF LEG OR A $1,128.00EXCISION, TUMOR, SOFT TISSUE OF NECK OR $1,091.00EXCISION, TUMOR, SOFT TISSUE OF NECK OR $740.00EXCISION, TUMOR, SOFT TISSUE OF PELVIS A $1,170.00EXCISION, TUMOR, SOFT TISSUE OF UPPER AR $997.00EXCISIONAL BIOPSY OF LYMPH NODE $776.00EXCISIONAL BIOPSY OF LYMPH NODE $776.00EXE. FACE-MM B9 T MARG 0.5<CM $269.00EXELON (RIVASTIGMINE TART) 1.5MG CAPSULE $34.00EXELON PATCH 4.6MG/24HR (RIVASTIGMINE) $44.00EXERCISER HAND $76.00EXP FOR PO HEMORRHAGE ABDOMEN $1,602.00EXPAREL 1.3% 266MG/20ML(BUPIVACAINE LIP) $2,005.00EXPL PENETRAT WOUND SEP PROC EXTREME $1,069.00EXPL PENETRAT WOUND SEP PROC EXTREME $978.00EXPL PENETRAT WOUND SEP PROC EXTREME $978.00EXPL PENETRAT WOUND SEP PROC EXTREME $114.00EXPL PENETRAT WOUND;ABDM/BCK/FLNK $1,125.00EXPL PENETRAT WOUND;ABDM/BCK/FLNK $1,125.00EXPLORATION FOR POSTOPERATIVE HEMORRHAGE $1,602.00EXPLORATION OF PENETRATING WOUND (SEPARA $1,125.00EXPLORATION OF PENETRATING WOUND CHEST $460.00EXPLORATION PENETRATING WOUND SPX NECK $1,524.00EXPLORATORY LAPAROTOMY, EXPLORATORY CELI $1,339.00EXPLORE/ TREAT FINGER JOINT $675.00EXTENDED ELECTRODES $36.00EXTENSION SET $13.00EXTENSION SET 2 INJECTION SITE $41.25EXTENSION SET 21 MALE LUER LOCK ADAPTER $7.00EXTENSION SET TUBING $6.00

EXTENSION SET W/4WAY STOPCOCK $62.00EXTENSION TUBING W CONNECTOR $14.00EXTERNAL CEPHALIC VERSION W/ W/O TOCOLYS $262.00EXTERNAL CEPHALIC VERSION, WITH OR WITHO $262.00EXTREMITY (T) DRAPE- ORTHO $75.00EXTREMITY PACK $90.00EYE IMAGING VALIDATED TO MATCH DIAGNOSIS $1.00EYE SPEAR $21.00EYE TRAY $96.00EYE-FB DETECTION $96.00EYESTREAM SOLUTION 30ML $10.00EZ CLEAN DISP LAP ELECTRODES $432.00EZ DISK 700MG TABLET (BARIUM SULFATE) $10.00EZ HUBER W/WING 20GA1-1/2 $27.00EZ HUBER W/WINGS 20GA X 1 $27.00EZ HUBER W/WINGS 20ga x 3/4 $27.00EZ-IO 15G PED INTRAOSSEOUS NEEDLE SET $440.00EZ-IO 25MM 15G ADULT INTRA NEEDLE SET $456.00EZ-IO 45MM 15G INTRA NEEDLE SET $456.00EZ-STABILIZER $102.00FACE TENT $14.00FACE TENT SHIELD W / HUMIDFIER $7.00FACIAL BONES MIN 3V $445.00FACTOR II ACTIVITY $230.00FACTOR II DNA ANALYSIS $55.00FACTOR IX ACTIVITY $102.00FACTOR V ACTIVITY $212.00FACTOR V LEIDEN $101.00FACTOR VII ACTIVITY $203.00FACTOR VII ANTIGEN $388.00FACTOR VIII $137.00FACTOR VIII CHROMOGENIC ACTIVITY $181.00FACTOR VIII ANTIGEN $212.00FACTOR X ACTIVITY $240.00FACTOR X ANTIGEN $367.00FACTOR X CHROMOGENIC ASSAY $371.00FACTOR XI ACTIVITY $192.00FACTOR XII ACTIVITY $230.00FACTOR XII INHIBITOR B $20.00FACTOR XIII ACTIVITY $146.00FACTREL (GONADORELINE HCL) 500 MCG VIAL $630.00FALLS RISK ASSESSMENT DOCUMENTED (GER) $1.00FAMCICLOVIR 500MG TABLET (FAMVIR) $40.00FAMOTIDINE 20 MG TABLET (PEPCID) $6.00FAMOTIDINE 20 MG VIAL (PEPCID) $14.00FAMOTIDINE 40 MG TABLET (PEPCID) $17.00FASCIA (LARGE)151-20cm2 $1,615.00

FASCIOTOMY PALMAR; OPEN PARTIAL $807.00FASCIOTOMY PALMAR; OPEN PARTIAL $807.00FASENRA 30MG/1ML SUBQ $9,696.00FASLODEX (FULVESTRANT) 500MG/10ML (2SYR) $3,613.00FAST FIX 360 CURVE-ORTHO $1,006.00FAST FIX 360 REV CURVE-ORTHO $1,006.00FAST FIX KPSC/SLOTTED CANNULA-ORTHO $329.00FB LOCATE CHILD 1 VW $153.00FECAL ELASTASE $567.00FECAL FAT QUALITATIVE $66.00FECAL FAT QUANTITATIVE $78.00FECAL IMMUNOASSAY OCCULT BLOOD $62.00FECAL LACTOFERRIN $160.00FECAL OSMOLALITY $13.00FEEDING TUBE 8FR DOBHOFF $68.00FEEDING TUBE BAG $30.00FEEDING TUBE BOLUS STRAIGHT 24F 10IN $33.00FELBAMATE 600 MG TABLET (FELBATOL) $41.00FELODIPINE E.R. 2.5MG TABLET (PLENDIL) $9.00FELODIPINE E.R. 5 MG TAB (PLENDIL) $6.00FEMALE CATH KIT $14.00FEMALE LL CONNECTOR $8.00FEMHRT 1/5 (ETHINYL ESTRA/NORETH) TABLET $9.00FEMORAL HEAD 36MM-ORTHO $3,218.00FEMORAL HEAD 36MM-ORTHO $3,218.00FEMORAL HEAD 36MM-ORTHO $3,413.00FEMORAL HEAD SIZE 11-ORTHO $8,933.00FEMORAL HIP SIZ 9-ORTHO $9,198.00FEMORAL HIP SIZE7 $9,196.00FEMORAL HIP-ORTHO $8,933.00FEMORAL HIP-ORTHO $9,198.00FEMUR 1 VIEW LT $163.00FEMUR 1 VIEW RT $163.00FEMUR LEFT NONPOR SIZE 8 $6,613.00FEMUR NP SZ4-ORTHO $6,298.00FEMUR POST LEG SPLINT MED $183.00FEMUR SZ5-ORTHO $6,300.00FENOPROFEN CA (NALFON) 600MG TAB $4.00FENTANYL 100 MCG PATCH (DURAGESIC) $86.00FENTANYL 200MCG/ROPIVACAINE 0.2%/NS100ML $317.00FENTANYL 25 MCG PATCH (DURAGESIC) $34.00FENTANYL 50 MCG PATCH (DURAGESIC) $45.00FENTANYL 50MCG/ML 2 ML (SUBLIMAZE) $12.00FENTANYL 50MCG/ML 5 ML AMP (SUBLIMAZE) $12.00FENTANYL 75 MCG PATCH (DURAGESIC) $75.00FERAHEME 510MG/17ML (FERUMOXYTOL) VIAL $1,828.00FERRITIN $96.00

FERROUS GLUCONATE 240MG TABLET (FERGON) $4.00FERROUS GLUCONATE 324MG TABLET $1.00FERROUS SULFATE 15 MG DROPS (FER-IN-SOL) $17.00FERROUS SULFATE 160MG TABLET (SLOW FE) $4.00FERROUS SULFATE 220MG/5ML LIQUID $6.00FERROUS SULFATE 325MG TABLET (FEOSOL) $1.00FETAL BLOOD SAMPLE KIT $109.00FETAL CONTRACTION STRESS TEST $170.00FETAL FIBRONECTIN $523.00FETAL HEMOGLOBIN $134.00FETAL NON-STRESS TEST $287.00FETAL NST $287.00FETAL NST REA $66.00FEXOFENADINE HCL 180 MG TABLET (ALLEGRA) $11.00FEXOFENADINE/P-EPHED60/120MG (ALLEGRA D) $10.00FIBERCON (CALCIUM POLYCARBOPHIL) TAB $4.00FIBERGLASS CAST LONG ARM $111.00FIBERGLASS CAST SHORT ARM $106.00FIBRIN MONOMER $213.00FIBRIN SPLIT PRODUCTS $104.00FIBRINOGEN $202.00FIBRINOGEN ANTIGEN $132.00FIBRINOGEN EVALUATION PROFILE $198.00FIBRINOGEN EVALUATION PROFILE $710.00FIBRINOGEN EVALUATION PROFILE $94.00FILTER CONTINU-FLO 0.2 MICRON 104 $28.00FILTERED NEBULIZER SYSTEM ISO NEB $46.00FINASTERIDE 5 MG TABLET (PROSCAR) $14.00FINE NEEDLE ASPIRATION W/IMAGING GUIDANC $250.00FINE NEEDLE ASPIRATION W/O IMAGING GUIDA $250.00FINE NEEDLE ASPIRATION W/O IMAGING GUIDA $250.00FINE NEEDLE ASPIRATION W/O IMAGING GUIDE $238.00FINE NEEDLE ASPIRATION W/O IMAGING GUIDE $238.00FINGER COT 1 1/2 SMALL $21.00FINGER COT 1 INCH $21.00FINGER COT 2 INCH MEDIUM $21.00FINGER COT 3 1/2 INCH MEDIUM $21.00FINGER COT 3 1/4 INCH LARGE $21.00FINGER COT 5 1/2 INCH X 7/8 $21.00FINGER COT UNPADDED 2 1/2 $21.00FINGER IMMOBILIZER- LG/XL LEFT $137.00FINGER IMMOBILIZER- LG/XL RIGHT $137.00FINGER IMMOBILIZER- S/M LEFT $137.00FINGER IMMOBILIZER- S/M RIGHT $137.00FINGER SPLINT $90.00FINGER SPLINT $85.00FINGER SPLINT $85.00

FINGER SPLINT 2 1/4 INCH SMALL $21.00FINGER SPLINT 2 3/4 INCH MEDIUM $10.00FINGER SPLINT 3 1/4 LARGE $24.00FINGER SPLINT 7/8 X 1 1/2 $10.00FINGER SPLINT SMALL $24.00FINGER STICK GLUCOSE $91.00FINGER STICK GLUCOSE - NOVA $91.00FINNED BASEPLATESIZE 8-ORTHO $3,210.00FIORINAL (ASP/CAFF/BUTALBITAL) CAPSULE $6.00FIRMAGON (DEGARELIX) 240MG INJECTION $3,256.00FIRMAGON (DEGARELIX) 80MG INJECTION $687.00FIRST-MOUTHWASH BLM KIT $64.00FIRSTPASS STR PASSR-ORTHO $2,040.00FISCHER LG SHALLOW CONE BIOPSY ESCISOR $136.00FISCHER MIX CONE BIOPSY ESCISOR $136.00FISCHER SM WIDE CONE BIOPSY ESCISOR $136.00FISTULA/SINUS TRACT XRAY $231.00FIT MASK TESTING $82.00FITTING AND INSERTION OF PESSARY OR OTHE $282.00FIXATION STAPLE 11X11 MM $214.00FIXATION STAPLE 6.35 MM $214.00FIXATION STAPLE 7.94 MM $214.00FLAT SUCTION DRAIN $78.00FLAVOXATE 100 MG TABLET (URISPAS) $6.00FLECAINIDE $100.00FLECAINIDE 100 MG TAB (TAMBOCOR) $6.00FLEET'S PHOSPHO SODA (SODIUM PHOSPHATE) $7.00FLEX SIGMOIDOSCOPY W/ SUBMUC INJ $234.00FLEXBUMIN 25% (HUMAN ALBUMIN) SOLN 100ML $430.00FLEXI TRUNK 100MM $82.00FLEXI TRUNK 70MM $82.00FLEXIBLE SIGMOIDOSCOPY $216.00FLEXIBLE SIGMOIDOSCOPY;COLORECTAL CANCER $332.00FLOSEAL ENDO APPL $325.10FLOSEAL HEMOSTATIC 5MM $531.00FLOVENT (FLUTICASONE) 44 MCG INHALER $120.00FLOVENT HFA (FLUTICASONE) 110MCG INHALER $261.00FLOVENT HFA (FLUTICASONE) 44 MCG INHALER $196.00FLOVENT HFA 220MCG INHALER (FLUTICASONE) $403.00FLOW CYTOMETRY $385.00FLOW CYTOMETRY $272.00FLOW CYTOMETRY TECH COMPONENT ONLY $125.00FLOW CYTOMETRY, FIRST MARKER $1,860.00FLOW CYTOMETRY, GENZYME $760.00FLOW CYTOMETRY, PANEL $2,032.00FLOW DIRECTED MONT CATHSF $497.00FLOXIN (OFLOXACIN) 0.3% OTIC SOLN $24.00

FLU B ANTIGEN $71.00FLU RAPID A $71.00FLU VACCINE NO PRESERV 6-35M $25.00FLUCONAZOLE 100 MG TABLET (DIFLUCAN) $12.00FLUCONAZOLE 10MG/ML ORAL SUSP (DIFLUCAN) $49.00FLUCONAZOLE 150MG TABLET (DIFLUCAN) $16.00FLUCONAZOLE 400MG/NS 200ML (DIFLUCAN) $59.00FLUDARABINE 50 MG VIAL (FLUDARA) $1,050.00FLUDROCORTISONE 0.1 MG TABLET (FLORINEF) $8.00FLUENT DISPOSABLE SET $594.00FLULAVAL (ADULT 18+) FLU VACCINE 08-09 $21.00FLUMAZENIL 0.5MG/5ML VIAL (ROMAZICON) $112.00FLUMIST $38.00FLUMIST INTRANASAL INFLUENZA VACCINE $40.00FLUNISOLIDE NASAL INHALER (NASAREL) $106.00FLUOCINOLONE 0.01% CREAM 60GM $9.00FLUOCINOLONE CREAM 0.01% CREAM 15GM $11.00FLUOCINOLONE CREAM 0.025% CR 15 GM M $27.00FLUOCINONIDE 0.05% CREAM 15 GM $15.00FLUOCINONIDE 0.05% CREAM 15 GM $83.00FLUOCINONIDE 0.05% GEL $51.00FLUOCINONIDE ACET 0.01% SOLUTION (LIDEX) $50.00FLUORESCEIN 10% INJECTION $129.00FLUORI-METHANE (DICL-DIFLUOMETH/TRI-FLU) $83.00FLUOR-I-STRIP (FLUORESCEIN) OPHT STRIP $6.00FLUORO GUIDANCE FOR NEEDLE PLCMT $209.00FLUORO GUIDED EPIDURAL $279.00FLUORO PHARYNX OR LARYNX $102.00FLUORO UP TO 1 HR PHY QHP TIME $231.00FLUORO UP TO 1 HR PHY QHP TIME $231.00FLUOROGUIDE FOR SPINE INJECT $182.00FLUOROGUIDE FOR SPINE INJECT $182.00FLUOROMETHOLONE 0.1% OPTH SUSP 5ML $68.00FLUOROSCOPIC GUIDANCE $130.00FLUOROURACIL (5 F U) 500 MG VIAL $26.00FLUOROURACIL 2.5GM VIAL $53.00FLUOROURACIL 500MG VIAL $69.00FLUOROURACIL 50MG/ML 100ML VIAL $137.00FLUOROURACIL: 1GM VIAL $37.00FLUOXETINE $277.00FLUOXETINE (PROZAC) 20 MG CAP $6.00FLUOXETINE 10 MG CAPSULE (PROZAC) $7.00FLUOXETINE 90MG WEEKLY (PROZAC) $110.00FLUOXETINE ORAL SOLN 20MG/5ML (PROZAC) $21.00FLUPHENAZINE DECON 25 MG (PROLIXIN) $574.00FLUPHENAZINE HCL 2.5MG TAB (PROLIXIN) $7.00FLURAZEPAM 15 MG CAPSULE (DALMANE) $4.00

FLURAZEPAM 30 MG CAPSULE (DALMANE) $4.00FLURBIPROFEN 100MG TABLET $9.00FLURBIPROFEN OPTH 0.03% (OCUFEN) 2.5 ML $14.00FLURO-ETHYL (ETHY CL/C2CCL2F4 AEORSAL $71.00FLUSH PUMP TUBING $90.00FLUSH PUMP TUBING ADAPTER $35.00FLUTICASONE 0.05% 50 MCG (FLONASE) $19.00FLUTICASONE 220MCG INHALER (FLOVENT) $179.00FLUTICASONE CR 0.05% 15GM (CUTIVATE) $91.00FLUVASTATIN 80 MG TABLET (LESCOL XL) $13.00FLUVIRIN (4+) FLU VACCINE $15.00FLUVOXAMINE 50 MG TAB (LUVOX) $13.00FLUZONE $17.55FLUZONE $17.55FLUZONE (INFLUENZA VIRUS VAC) 02-03 $29.00FLUZONE (INFLUENZA VIRUS VACCINE) $25.00FLUZONE 45MCG/0.5ML (FLU VACCINE) 07-08 $21.00FLUZONE HIGH-DOSE (INFLUENZA VIRUS VAC) $45.00FLUZONE PEDIATRIC (6-36MO) FLU VAC PFS $31.00FLYTE HOOD W/ PEEL ORTHO $193.00FMP ACETABULAR HEAD- ORTHO $3,032.00FOAM THERAPY ROLLS- 36X4 $52.00FOGARTY ARTERIAL CATHETER 3F $381.00FOGARTY ARTERIAL CATHETER 4F $354.00FOGARTY ARTERIAL CATHETER 5F $437.00FOLATE $103.00FOLATE $103.00FOLBEE PLUS (DIATX)(FOL ACID/VIT B/VITC) $7.00FOLEY CATHETER 16FR 30CC $42.00FOLEY CATHETER 18FR 30CC 2WAY $38.00FOLEY CATHETER 20FR 30CC 3WAY $107.00FOLEY CATHETER 22FR 30CC 3WAY $20.00FOLEY CATHETER 24FR 30CC 3WAY $67.00FOLEY CATHETER 26FR 30CC 2WAY $13.00FOLIC ACID 1 MG TAB (FOLVITE) $6.00FOLIC ACID 5 MG /ML VIAL $39.00FOLIC ACID-RBC $27.00FOLIC ACID-RBC HGB $24.00FOLTX (CYANOCOBAL/FA/DOXINE) TABLET $5.00FOOT EXAMINATION PERFORMED (INCLUDES EXA $1.00FOOT LT 2V $249.00FOOT RT 2V $249.00FOOTPRINT ANCHOR 4.5- ORTHO $581.00FOOTPRINT ANCHOR 5.5- ORTHO $581.00FOOTPRINT SUT ANCHOR 4.5-ORTHO $993.00FORANE (ISOFLURANE) 100 ML BOTTLE $565.00FORCEP DISPSOSABLE $107.00

FORESKIN MANI $139.00FORESKIN MANIP $139.00FORTICAL (CALCITONIN) NASAL SPRAY 3.7ML $114.00FOSAMAX (ALENDRONATE) 10 MG TAB $19.00FOSAMAX (ALENDRONATE) 5 MG TAB $13.00FOSAPREPITANT (EMEND) 150MG VIAL $1,146.00FOSINOPRIL 10 MG TABLET (MONOPRIL) $7.00FOSPHENYTOIN 500MG/10ML VIAL (CeREByx) $90.00FOSRENOL (LANTHANUM CARB) 500MG CHEW TAB $12.00FRACTURE CLAVICLE $325.00FRACTURE DISTAL PHALANX $288.00FRACTURE NASAL BONES $260.00FRAGILE X SYNDROME $303.00FREE KAPPA LIGHT CHAIN $215.00FREE LAMDA LIGHT CHAIN $60.00FREE SKIN FLAP W/MICROVASCULAR ANASTOMOS $5,578.00FRIGITRONICS PROBE PACK $775.00FRUCTOSAMINE $120.00FS-30 CERVICAL CUP $505.00FS-35 CERVICAL CUP $505.00FS-40 CERVICAL CUP $505.00FSH $120.00FSH $105.00FSH & LH $118.00FULL GRAFT/NOSE-EARS-EYLDS $1,414.00FULL GRAFT/NOSE-EARS-EYLDS $1,414.00FULL GRAFT/NOSE-EARS-EYLDS $128.00FULL RADIUS 4.5 PLATINUM-ORTHO $438.00FULL RADIUS BONECUTTER 5.5-ORTHO $507.00FULL RADIUS CONCAVE BLADE-ORTHO $460.00FUNGAL SEROLO $156.00FUNGAL SEROLOGY C $34.00FUNGIZONE (AMPHOTERICIN B) 50 MG VIAL $137.00FURACIN (NITROFURAZONE)SOLUBLE DRESSING $60.00FUROSEMIDE 10 MG/ML ORAL SOLN (LASIX) $22.00FUROSEMIDE 20 MG TABLET (LASIX) $6.00FUROSEMIDE 40 MG TAB (LASIX) $6.00FUROSEMIDE 80 MG TABLET (LASIX) $6.00FUROSEMIDE INJ 100MG/10ML VIAL (LASIX) $20.00FUROSEMIDE INJ 20 MG/2 ML VIAL (LASIX) $22.00FUROSEMIDE INJ 40MG/4ML VIAL (LASIX) $14.00FX CARE/CLAVICLE/CLOS $27.00FX CARE/PROXIMAL HUME $73.00FX CARE/RADIAL SHAFT $65.00FX GREAT TOE W/MANIP $682.00FX GREAT TOE W/O MANIP $256.00FX TOE;CLOSED TX W/MANIP;EACH $646.00

FX TOE;CLOSED TX W/O MANIP;EACH $256.00FX TOE;CLOSED TX W/O MANIP;EACH $233.00FX TOE;CLOSED TX W/O MANIP;EACH $274.00G0402 CL INITIAL PREVENTIVE PHYSICAL EXA $245.00G0438 CL INITIAL ANNUAL WELLNESS VISIT $378.00G0439 CL SUBSEQUENT ANNUAL WELLNESS VISI $105.00G6PD $71.00GABAPENTIN $204.00GABAPENTIN 100 MG CAPS (NEURONTIN) $6.00GABAPENTIN 300 MG CAPS (NEURONTIN) $6.00GABAPENTIN 400 MG CAPS (NEURONTIN) $6.00GALANTAMINE 4MG TABLET (RAZADYNE) $15.00GAMEDAY ANKLE BRACE-LG $26.00GAMEDAY ANKLE BRACE-MED $26.00GAMEDAY ANKLE BRACE-SM $26.00GAMEDAY ANKLE BRACE-XLG $26.00GAMMA GLUTAMYL TRANSPEPTIDASE $113.00GAMMAGARD 10GM (HUMAN IMMUNE GLOBULIN) $2,140.00GAMMAGARD 2.5GM (HUMAN IMM GLOBULIN) $1,050.00GAMMAGARD 20GM (HUMAN IMMUNE GLOBULIN) $3,600.00GAMMAGARD 30GM (HUMAN IMMUNE GLOBULIN) $5,000.00GAMMAGARD 5GM (HUMAN IMMUNE GLOBULIN) $1,095.00GAMMAGARD SD 10GM(HUMAN IMMUNE GLOBULIN) $2,872.00GAMMAGARD SD 5GM(HUMAN IMMUNE GLOBULIN) $1,460.00GAMMAR IV (IMMUNE GLOBULIN HUMAN) 10GM $1,354.00GAMMAR IV (IMMUNE GLOBULIN HUMAN) 5GM $772.00GAMUNEX (IMMUNE GLOBULIN) 10% 1 GRAM $412.00GAMUNEX C (IMMUNE GLOBULIN) 10% 1GRAMS $446.00GAMUNEX C (IMMUNE GLOBULIN) 10% 2.5GRAMS $906.00GAMUNEX C (IMMUNE GLOBULIN) 10% 20GRAMS $3,459.00GAMUNEX C (IMMUNE GLOBULIN) 10% 40GRAMS $6,960.00GAMUNEX C (IMMUNE GLOBULIN) 10% 5GRAMS $1,508.00GAMUNEX C(IMMUNE GLOBULIN) 10% 10GRAMS $4,403.00GARDASIL $235.00GARDASIL (HUMAN PAPILLOMAVIRUS VACCINE) $222.00GASTRIC BUTTON KIT 24FR X 2.4CM $424.00GASTRIC LAVAGE EASI-LAV 34FR N/S DISP CH $220.00GASTRIN $55.00GASTROROMY DEVICE BUTTON 24FR $451.00GASTRORRHAPHY, SUTURE OF PERFORATED DUOD $3,354.00GASTROSCOPY $364.00GASTROSTOMY OPEN W/O CONST GASTRIC TUBE $1,752.00GASTROSTOMY TUBE 18 FR $362.00GATOR CUTTER $298.00GAUZE 4X4 10 SPONGES $5.00GAUZE 4X4 10 SPONGES $5.00GAUZE 4X4 10 SPONGES $5.00

GAUZE 4X4 10 SPONGES $5.00GAUZE 4X4 2'SPONGE STERILE $4.00GAUZE FINE MESH $8.00GAVISCON (ALUMINUM HYDRO/MAG) TABLET $4.00GAZYVA 1000MG VIAL (OBINUTUZUMAB) $908.00GC AMPLIFICATION $121.00GD1A ANTIBODY TEST $159.00GELFOAM SG SZ 12-7 $62.00GELFOAM SG SZ 4 6X2 $74.00GELPORT 120MM $975.00GEMCITABINE 2GM VIAL (GEMZAR) $264.00GEMFIBROZIL 600 MG TABLET (LOPID) $6.00GEMZAR (GEMCITABINE HCL) 1 GM $3,243.00GEMZAR (GEMCITABINE HCL) 200 MG $760.00GENAC TABLETS (ACTIFED) $4.00GENE MUTATION ANALYSIS, EXON 9 $2,396.00GENETIC SCREENING $122.00GENTAMICIN 20 MG VIAL $36.00GENTAMICIN 80 MG VIAL $30.00GENTAMICIN 80MG/NS 100ML PREMIX $19.00GENTAMICIN OINT 0.1% 15 GM (GARAMYCIN) $7.00GENTAMICIN OPHT OINT 0.3% 3.5 GM $28.00GENTAMICIN OPTH SOLN 0.3% $14.00GENTAMICIN PEAK CONVENTIONAL DOSE $168.00GENTAMICIN PEAK ONCE DAILY $172.00GENTAMICIN TROUGH CONVENTIONAL DOSE $168.00GENTAMICIN TROUGH ONCE DAILY $172.00GEOCILLIN (CARBENICILLIN) 382 MG TABLET $11.00GEVRABON (MVI/MIN/W IRON) 2 OZ BOTTLE $8.00GI PROFILE PCR $520.00GIARDIA LAMBLIA EIA $79.00GIGLI SAW 20 $20.00GII QUICKANCHOR PLUS $649.00GLENOID HEAD SCREW $1,181.00GLENOID, HEAD W/RETAINING SCREW 36MM $1,181.00GLIADIN IgA $199.00GLIADIN IgG $199.00GLIADIN IgG ANTIBODY $181.00GLIDESCOPE #3 $109.00GLIDESCOPE #4 $109.00GLIMPERIDE 2 MG TABLET (AMARYL) $5.00GliPIZIDE 5 MG TABLET (GLUCOTROL) $6.00GliPIZIDE XL 2.5MG TABLET (GLUCOTROL) $8.00GliPIZIDE XL 5MG TABLET (GLUCOTROL) $7.00GLOVE ISOTONER THERAPEUTIC $103.00GLOVE PREOP HAIR REMOVAL $4.00GLUCAGEN RDNA KIT (GLUCAGON) $248.00

GLUCAGON 1MG KIT $474.00GLUCAGON PLASMA $68.00GLUCOSE 2HR-PP $115.00GLUCOSE 4GM TABLET $14.00GLUCOSE FINGER STICK $68.00GLUCOSE GEL (ORAL) 12.5GM TUBE $17.00GLUCOSE RANDOM $74.00GLUCOSE TOLERANCE 2 HR $94.00GLUCOSE TOLERANCE 3 HR $224.00GLUCOSE TOLERANCE 5 HOUR $147.00GLUCOSE TOLERANCE OB $224.00GLUCOSE URINE $88.00GLUCOVANCE (GLYBURIDE\METFOR) 1.25/250MG $7.00GLUCOVANCE (GLYBURIDE\METFORMIN) 2.5/500 $6.00GLUTAMIC ACID DECARBOXYLATE AUTO AB $172.00GLYBURIDE 2.5 MG TABLET (DIABETA) $4.00GLYBURIDE 3 MG TABLET (GLYNASE PRESTAB) $4.00GLYBURIDE 5 MG TABLET (DIABETA) $7.00GLYCERIN (GLYCERIN) INFANT RECTAL SUPP $4.00GLYCERIN (GLYCERIN) PED RECTAL SUPP $6.00GLYCERIN (GLYCERIN) PEDIATRIAC REC SUP $4.00GLYCERIN ADULT SUPP $4.00GLYCERIN SOLUTION 4 OZ $13.00GLYCOPYRROLATE 0.2MG/ML VIAL (ROBINUL) $21.00GOLD PROBE 7F $662.00GOLYTELY (ELECTROLYTE SOLN/PEG'S) 1 GAL $39.00GOMCO SUCTION MACH $17.00GONADOTROPOIN CHRONIC 5MU $48.00GONORRHEA BY PCR $132.00GRAFT/COMPOSITE/INC CL $1,324.00GRAFT/COMPOSITE/INC CL $1,324.00GRAM STAIN $98.00GRANISETRON 1 MG TABLET (KYTRIL) $28.00GRANISETRON 1MG INJ (KYTRIL) $162.00GRANUL-DERM (TRYPSIN/BALSM PERU/CASTER) $78.00GRANULEX (TRYPSIN/BALSM PERU/CASTOR) SPR $52.00GREAT TOE JOINT- POROUS COATED COBALT $3,456.00GREEN RELOAD FOR ECHELON 45 $463.00GREY RELOAD FOR ECHELON 45 $442.00GROUP B STREP 24 HOUR $143.00GROUP B STREP RAPID $143.00GROWTH HORMONE $69.00GUAIFEN/HYDROCOD 100/5MG 2 OZ (HYCOTUSS) $46.00GUAIFEN/PSEUDO/HYCOD ELIX (DURATUSS HD) $24.00GUAIFENESIN 200MG/10ML UD (ROBITUSSIN) $8.00GUAIFENESIN 600 MG TABLET (MUCINEX) $6.00GUAIFENESIN AC (ROBITUSSIN/COD PHOS)10ML $5.00

GUAIFENESIN/CODEINE 100/10MG 5ML $11.00GUAIFENESIN-DM SYRUP 100MG-10MG/5ML $5.00GUAIFENESIN-DM SYRUP 200MG-20MG/10ML $8.00GUAIFENSIN 300MG CAP (HUMIBID SPRINKLE) $4.00GUAIFENSIN/PHENYLEPH TAB (DURATUSS GP) $8.00GUANFACINE 1 MG TABLET (TENEX) $8.00GUARDIAN CANISTER LINER $98.00GUIDE PIN 230 X 2.4 $419.00GUIDE PIN TEMPLATE $300.00GUIDE WIRE .035X5.75 $198.00GUIDE WIRE .045 TROCAR TIP $219.00GUIDE WIRE .045X6 $51.00GUIDE WIRE .05X7 $51.00GUIDE WIRE .062 TROCAR $150.00GUIDE WIRE .86 TROCAR $253.00GUIDE WIRE .86 TROCAR TIP $176.00GUIDE WIRE 1X18- ORTHO $105.00GUIDE WIRE W/TROCAR TIP $132.00GYN PACK $49.00GYNECARE TVT EXACT CONTINENCE SYSTEM $1,375.00H PYLORI AG STOOL $154.00H PYLORI AG TISSUE $67.00H PYLORI BREATH TEST $240.00H PYLORI IGA $121.00H PYLORI IgG Serum/In-House $123.00HAEMOPHILUS INFLUENZA AB IGG $271.00HALAVEN 1MG/2ML (ERIBULIN) VIAL 340B $653.65HALDOL $110.00HALF SET PUMP TUBING $66.00HALF SHEET $7.00HALL DRILL REAMER $78.00HALOPERIDOL 1MG TABLET (HALDOL) $7.00HALOPERIDOL 2MG TABLET (HALDOL) $10.00HALOPERIDOL 50MG AMP (HALDOL DECONATE) $170.00HALOPERIDOL 5MG TAB (HALDOL) $7.00HALOPERIDOL 5MG VIAL (HALDOL) $15.00HAND EXERCISER HELPER $112.00HAND LT 2V $244.00HAND RT 2V $244.00HAND SMALL RIGHT $107.00HANDLE SPONGE HOURGLASS 17 $7.00HANTA VIRUS ANTIBODIES $474.00HANTA VIRUS IGG $167.00HANTA VIRUS IGM $167.00HAPTOGLOBIN $72.00HAVRIX PEDIATRIC (HEP A) 720EL U/0.5ML $55.00HBS AB EMP $63.00

HBS AB REF LAB $63.00HCT - SPUN - NB $49.00HCT,SPUN $53.00HDL $117.00HEAD GEAR 29-36CM $117.00HEAD GEAR 40-45CM $117.00HEAD HALTER UNIVERSAL $38.00HEALICOIL SA PK 5.5MM-ORTHO $919.00HEALON (SODIUM HYLAURONATE) 0.55 ML $421.00HEALTH FAIR PSA $20.00HEARING TEST IN & OUT PATIENT $141.00HEART CONTINUES NEBULIZER $40.00HEART DISEASE/STROKE RISK (C) $161.00HEAVY JEWETT NAIL 2 3/4 $572.00HEEL SNUGGLER (INFANT) $7.00HEINZ BODY $25.00HEMABATE (CARBOPROST TROMETH) 250 MCG $819.00HEMATOCRIT $37.00HEMCON BANDAGE PRO 4X4 BLOOD STOPPER $215.00HEMI ARM SLING CUFF SMALL LEFT $77.00HEMI SHELL 54MM- ORTHO $3,308.00HEMI SHELL- ORTHO $3,407.00HEMIARTHROPLASTY,HIP,PARTIAL $2,719.00HEMISPHERICAL SHELL-ORTHO $3,309.00HEMMORHOIDS BIOPSY $149.00HEMOCHROMATOSIS DNA $52.00HEMODEALYSIS CATHETER KIT $604.00HEMODIALYSIS 14.5 19 cm CATHETER KIT $605.00HEMODIALYSIS 14.5 23cm CATHETER KIT $634.00HEMODIALYSIS, ONE EVALUATION $321.00HEMOGLOBIN $45.00HEMOGLOBIN A1C $89.00HEMOGLOBIN A1C $89.00HEMOGLOBIN ELECTRO CASCADE $134.00HEMOGLOBIN ELECTROPHORESIS $134.00HEMOGLOBIN, UNSTABLE $134.00HEMOGLOBINOPATHY PROFILE W/ALPHA THALASS $25.00HEM-O-LOCK 5mm. $452.00HEM-O-LOK POLYMER LIGATE CLIP XL $255.75HEMORRHOIDAL OINTMENT 57GM $11.00HEMORRHOIDECTO MY, INTERNAL AND EXTERNAL $1,435.00HEMORRHOIDECTO MY, INTERNAL AND EXTERNAL $1,170.00HEMORRHOIDECTO MY, INTERNAL, BY RUBBER B $401.00HEMORRHOIDECTOMY;EXT,COMP $1,102.00HEMORRHOIDECTOMY;EXT,COMP $1,102.00HEMORRHOIDECTOMY;INT/EXT $1,435.00HEMORRHOIDECTOMY;INT/EXT $1,435.00

HEMORRHOIDOPEXY (EG, FOR PROLAPSING INTE $959.00HEMORRHOIDOPEXY BY STAPLING $959.00HEMORRHOIDOPEXY BY STAPLING $959.00HEMORROIDECTOMY/SIMPLE $381.00HEMORROIDECTOMY/SIMPLE $381.00HEMORROIDECTOMY/SIMPLE $401.00HEMOSTAT ABSORBABLE 4X8 $496.00HEP A IGM 006734 $69.00HEP A PROFILE 028928 $39.00HEP A TOTAL 006726 $131.00HEP B CORE AB IGG IGM 098418 $37.00HEP B CORE AB TOTAL 006718 $37.00HEP B CORE AB, IGM 016881 $98.00HEP B HIB VACCINE $106.00HEP B HIB VACCINE $106.00HEP B QUANT DNA REAL TIME PCR $233.00HEP B SURFACE AB 006395 $71.00HEP B SURFACE ANTIGEN $129.00HEP B SURFACE ANTIGEN - CONFIRMATION $129.00HEP C AB / RFLX TO QUAL NAA 144045 $101.00HEP C ANTIBODY ( IN HOUSE) $86.00HEP C ANTIBODY 140659 $86.00HEP C ANTIBODY CONFIRMATION $86.00HEP C FIBROSURE 550123 $47.00HEP C FIBROSURE 550123 $301.00HEP C GENOTYPE 1a SUBTYPE 550615 $492.00HEP C GENOTYPE NON REFLEX 550475 $270.00HEP C QUANT PCR / RFLX GENOSURE 550072 $368.00HEP C QUANT PCR 550080 $235.00HEP C QUANT RNA 551300 $263.00HEP C QUANT RNA PCR 550090 $223.00HEP C RNA QUAL / RFLX TO QUANT 550840 $333.00HEP C RNA QUAL NAA/RFLX GENOTYPE 550825 $333.00HEP CHRONIC PROFILE 303744 $30.00HEP PANEL, ACUTE 322744 $145.00HEP PROFILE VI 058545 $30.00HEP PROFILE VIII 255505 $30.00HEPARIN (HEPARIN SOD) 1,000 UNITS/ML $24.00HEPARIN (HEPARIN SOD) 100UNIT/1 ML VIAL $17.00HEPARIN (HEPARIN SOD) 20,000 VIAL $46.00HEPARIN (HEPARIN SOD) 5,000 U/ML MDV $30.00HEPARIN (HEPARIN SOD) 5,000 UNIT VIAL $17.00HEPARIN 100UNITS/ML 5ML PREFILL SYRINGE $1.00HEPARIN 50,000 UN/500ML D5W(100 UNIT/ML) $132.00HEPARIN 50,000 UN/500ML NS (100 UNIT/ML) $132.00HEPARIN ANTI XA $110.00HEPARIN FLUSH 10UNITS/ML 10ML LOC FLUSH* $18.00

HEPARIN INDUCED AB ASSAY $140.00HEPARIN LOCK FLUSH 10U/1ML SDV $18.00HEPARIN SOD 25000UNITS/D5W 250ML BAG $43.00HEPARINIZED VENOUS CATH SHUNT $627.00HEPATIC FUNCTION PANEL $236.00HEPATITIS B CORE IgM $40.00HEPATITIS B VACCINE $361.00HEPATITIS C RIBA $82.00HEPATITIS D ANTIGEN $123.00HER 2 NEU $352.00HERPES 1&2 IGM 165180 $224.00HERPES CULTURE & TYPING 008250 $116.00HERPES SIMPLEX VIRUS 1/2 DNA PCR 138651 $158.00HERPES SIMPLEX VIRUS 2 IGG 163033 $76.00HERPES VIRUS 6 IgG $102.00HESPAN 6% (HETASTARCH/NACL) IV 500 ML $75.00HEXAGONAL PHOSPHOILIPID $159.00HF 1-BASIC $25.00HF 2 - MEN $45.00HF 3 - WOMEN $45.00HGB ELECTRO $79.00HIB-PEDVAX $54.00HIB-PEDVAX $54.00HIGH FLOW CANNULA 25FT. $54.00HIP 1 VIEW W/PELVIS LT $167.00HIP 1 VIEW W/PELVIS RT $167.00HIP PLATE 130 4 5 $762.00HIP PLATE 135 4 5 $762.00HIP PLATE 135 5 5 $762.00HIP PLATE 135 6 5 $762.00HIP PLATE 140 4 5 $762.00HIP PLATE 140 5 5 $762.00HIP PLATE 145 @ $762.00HIP PLATE 150 4 5 $762.00HIP SCREW PLATE 5 140 $559.00HIP SCREW PLATE 5 SLOT 130 $897.00HIP SCREW PLATE 6 135 $559.00HIP SCREW PLATE 6 140 $951.00HIP SCREW PLATE 6 145 $556.00HIP W/PELVIS MINIMUM 4 VIEW LT $272.00HIP W/PELVIS MINIMUM 4 VIEW RT $272.00HIPS BILAT W/PELVIS 3-4 VIEW $273.00HIPS BILAT W/PELVIS 5 VIEW $492.00HISMANAL (ASTEMIZOLE) $9.00HISTAMINE $233.00HISTONE ANTIBODIES $84.00HISTOPLASMA AB $164.00

HISTOPLASMA AB (B) $150.00HISTOPLASMA ANTIGEN URINE $760.00HISTOPLASMIN (HISTOPLASMIN DILUTED) VIAL $20.00HIV 1 DNA DIRECT PROBE TECHNIQUE $69.00HIV 1/2 AG/AB ( IN HOUSE ) $150.00HIV 1/2 AG/AB 083935 $76.00HIV 1/2 CONFIRMATION $150.00HIV 2 DNA DIRECT PROBE TECHNIQUE $69.00HIV QUANITATIVE PCR $856.00HIV-1 ANTIBODY W/CONFIRM. BY MULTISPOT $137.00HIV-1 QUAL RNA $660.00HIV-1 QUANTITAIVE BY PCR $856.00HIV-2 ANTIBODY W/CONFIRM.BY MULTISPOT $94.00HIV-2 QPCR $237.00HIV-RAPID $131.00HIV-RNA QUANTITATIVE PCR $839.00HLA A, B, C PROFILE $2,642.00HLA-B 27 DISEASE ASSOCIATION $273.00HOLTER MONITOR RECORDING $801.00HOLTER MONITOR SCAN ANALYSIS $304.00HOMATROPINE HYDROBROMIDE OPHT 5% SOLN $13.00HOMOCYSTEINE $293.00HOMOCYSTEINE URINE $296.00HOMOVANYLLIC ACID $228.00HOOK BLADE 5MMX32CM $162.00HORMONE REPLACEMENT THERAPY PELLE FEMALE $573.00HORMONE REPLACEMENT THERAPY PELLET MALE $1,152.00HOSP DISCHARGE 30 MIN OR LESS $176.00HOSP DISCHARGE 30 MIN OR LESS $176.00HOSP DISCHARGE 30 MIN OR MORE $214.00HOSP DISCHARGE 30 MIN OR MORE $214.00HOT LINE BLOOD WARMER $88.00HOYA IOL $61.00HPV 16 AND 18, 45 $150.00HPV BY PCR $121.00H-PYLORI IgM $77.00H-PYLORI PANEL $110.00HSG CATHETER 5 fr. 29cm $168.00HSG CATHETER 7 fr. 29cm $168.00HTLV I & II 164277 $167.00HTLV I/II $137.00HUMALOG 100 UNITS/ML: 3ML VIAL $14.00HUMAN HERPES 6 VIRUS IGM $167.00HUMAN IMMUNODEFICIENCY VIRUS $99.00HUMAN IMMUNODEFICIENCY VIRUS 1 GENOTYPE $1,332.00HUMERAL SOCKET INSERT 36MM $1,342.00HUMERAL STEM REVERSE $10,171.00

HUMID VENT MINI $10.00HUMIDIFIER 340 ML $7.00HUMIDIFIER 350cc.HIGH FLOW 6-15LPM $22.00HUMIDIFIER DISPOSABLE 20/CA $65.00HUMIDIFIER FOR ROOM $47.00HUMIDVENT I $11.00HUMIRA 40MG/0.8ML (ADALIMUMAB) PFS $3,664.00HUMULIN 70/30 100 UNITS/ML: 3ML VIAL $12.00HUMULIN N (NPH) 100 UNITS/ML: 3ML VIAL $12.00HUMULIN R 100 UNITS/ML: 3ML VIAL $12.00HURRICAINE (BENZOCAINE) 20% SPRAY $76.00HURRICAINE ONE SPRAY 20% (BENZOCAINE) $43.00HYALGAN (HYALURONATE SODIUM) 20 MG/2ML $506.00HYALGAN FOR INJECTION 2 CC $253.00HYDERGINE (ERGOLOID MESYLATES)1MG TABLET $6.00HydRALAZINE 10 MG TABLET (APRESOLINE) $6.00HydRALAZINE 20 MG VIAL (APRESOLINE) $29.00HydRALAZINE 25 MG TABLET (APRESOLINE) $6.00HYDRALAZINE 50MG TABLET $6.00HYDRATION 1ST HR $155.00HYDRATION, MINIMUM OF 31 MIN $78.00HYDROCHLOROTHIAZIDE 25MG TABLET $6.00HYDROCOD/APAP ELIX 7.5/500/15 (LORTAB) $5.00HYDROCOD/CHLOR E/R SUSP 4OZ (TUSSIONEX) $234.00HYDROCODONE $230.00HYDROCODONE & APAP 5/325MG TABLET(NORCO) $11.00HYDROCODONE & APAP 5MG/217MG/10ML $24.00HYDROCODONE & APAP 7.5/325MG TAB (NORCO) $11.00HYDROCODONE/APAP 10/650 TABLET (LORCET) $6.00HYDROCODONE/APAP 2.5/108MG/5ML UD $16.00HYDROCODONE/APAP 5/500MG TAB (VICODIN) $4.00HYDROCODONE/APAP 7.5/650 (LORCET PLUS) $4.00HYDROCODONE/APAP 7.5/750MG TAB (VICODIN) $4.00HYDROCORTISONE (HYDROCORTISONE) PWD 100 $15.00HYDROCORTISONE 0.5% CREAM $8.00HYDROCORTISONE 0.5% CREAM $11.00HYDROCORTISONE 1% OINTMENT 30GM $10.00HYDROCORTISONE 2.5% CREAM 30GM $11.00HYDROCORTISONE 2.5%CR (PROCTOCREAM-HC) $154.00HYDROCORTISONE 25MG RECTAL SUPPOSITORY $10.00HYDROCORTISONE 5MG TABLET (CORTEF) $7.00HYDROCORTISONE CREAM 1% $8.00HYDROGEL WOUND DRESSING $25.00HYDROGEN PEROXIDE 8OZ $7.00HYDROMORPHONE 0.5MG/0.5ML SYRINGE $12.00HYDROMORPHONE 1MG/ML VIAL (DILAUDID) $16.00HYDROmorPHONE 2MG TAB (DILAUDID) $11.00

HYDROmorPHONE 2MG/1ML VIAL (DILAUDID) $25.00HYDROMORPHONE HCL TAB 4MG $11.00HYDROXYCHLOROQUINE (PLAQUENIL)200MGTAB $6.00HYDROXYUREA 500 MG CAPSULE (HYDREA) $10.00HydrOXYzine 10 MG TABLET (ATARAX) $4.00hydrOXYzine 50MG/ML 1ML VIAL (VISTARIL) $27.00HydrOXYzine HCL 25 MG TABLET (ATARAX) $6.00HydrOXYzine HCL 50MG/1ML VIAL (VISTARIL) $33.00HYDROXYZINE HCL 50MG/ML MDV (VISTARIL) $16.00HYOSCYAMINE 0.125MG SL (SYMAX) $4.00HYOSCYAMINE 0.125MG SL TABLET (LEVSIN) $7.00HYOSCYAMINE 0.125MG SL TABLET (LEVSIN) $5.00HYOSCYAMINE 0.375MG TABLET (LEVBID SR) $8.00HYPERAB 300IU/ML 5ML (RABIES IG) $490.00HYPERHEP B S/D (HEP B IMM GLOB) 220IU $684.00HYPERLYTE R (MULTI-ELECTROLYTE CONC) $27.00HYPERSENSITIVITY PNEUMONITIS PROFILE $246.00HYPERTENSION PLAN OF CARE DOCUMENTED AS $1.00HYPERTET (TETANUS IMMUNE GLOB) 250 UNIT $399.00HYSEPT 0.5% SOLUTION $30.00HYSTERECT VAGINAL $1,673.00HYSTERECT VAGINAL $1,673.00HYSTERECT VAGINAL W/TUBE REMOVAL $1,879.00HYSTERECT VAGINAL W/TUBE REMOVAL $1,879.00HYSTERORRHAPHY REPAIR OF RUPTURED UTERUS $1,917.00HYSTEROSALPINGOGRAM $517.00HYSTEROSALPINGOGRAPHY RAD S&I $149.00HYSTEROSALPINGOGRAPHY RAD S&I $149.00HYSTEROSC SURG;W/ENDOMETRIAL ABLA $4,264.00HYSTEROSC SURG;W/ENDOMETRIAL ABLA $4,264.00HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDU $478.00HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDU $478.00HYSTEROSCOPY REMOVAL IMPACTED FB $886.00HYSTEROSCOPY REMOVAL LEIOMYOMATA $981.00HYSTEROSCOPY REMOVAL LEIOMYOMATA $981.00HYSTEROSCOPY STERILIZATION $2,084.00HYSTEROSCOPY STERILIZATION $2,084.00HYSTEROSCOPY, DIAGNOSTIC $89.00HYSTEROSCOPY, DIAGNOSTIC (SEPARATE PROCE $478.00HYSTEROSCOPY, SURGICAL; WITH BILATERAL F $2,084.00HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL $4,478.00HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF $981.00HYSTEROSCOPY, SURGICAL; WITH SAMPLING (B $623.00HYSTEROSCOPY,SURGICAL W/BIOPSY W/WO D/C $153.00HYSTEROSCOPY,W THERMOABLATION $231.00HYSTEROSCOPY/SURGICAL $593.00HYSTEROSCOPY/SURGICAL $593.00

I & D ABCESS PERITONSILLAR $462.00I & D ABSCESS $235.00I & D ABSCESS CYST HEMATOMA SIMPLE $221.00I & D BARTHOLINS GLAND CYST $366.00I & D DENTAL ABCESS $481.00I & D DENTAL ABCESS $490.00I & D DENTAL ABCESS $490.00I & D HEMATOMA SIMPLE $248.00I & D ISCHIORECTAL ABSCESS $72.00I & D OF SUBCUTANEOUS ABSCESS $235.00I & D PILONIDAL CYST COMPLICATED $740.00I & D PILONIDAL CYST COMPLICATED $740.00I & D THROMBOSED EXT HEMORRHOID $470.00I&D ABCESS CO $355.00I&D BARTHOLINS GLSND ABSCESS $366.00I&D BELOW FASCIA W/WO TENDON,FT SINGLE $1,157.00I&D BELOW FASCIA W/WO TENDON,FT SINGLE $1,157.00I&D DP ABSC B $1,351.00I&D DP ABSC BURSA/HEMAT THIGH/KNEE $1,351.00I&D FOOT $1,202.00I&D FOOT $1,202.00I&D ISCHIOREC $683.00I&D ISCHIOREC ABSCESS W/ WO FISTULOTOMY $1,179.00I&D OF HEMATOMA $236.00I&D OF HEMATOMA $236.00I&D OF HEMATOMA $248.00I&D OF VULVA OR PERINEAL ABSCESS $15.00I&D PILONIDAL CYST COMPLEX $740.00I&D PILONIDAL CYST SIMPLE $418.00I&D PILONIDAL CYST; SIMPLE $418.00I&D PILONIDAL CYST; SIMPLE $418.00I&D PILONIDAL CYST; SIMPLE $418.00I&D SHLDR ABSCESS/HEMA $458.00I&D SUBCUT ABSCESS $235.00I&D SUBCUT ABSCESS $223.00I&D SUBCUT ABSCESS $223.00I&D SUBMUCOSA $485.00I&D SUBMUCOSAL ABCESS;RECTUM $485.00I&D VULVA/PERINEAL ABSCESS $205.00I&D VULVA/PERINEAL ABSCESS $187.00I&D VULVA/PERINEAL ABSCESS $187.00I&D;COMPLEX,POSTOP WOUND $536.00I&D;COMPLEX,POSTOP WOUND $536.00I&R FB,SUBCUT TISS;COMP $454.00I&R FB,SUBCUT TISS;COMP $415.00I&R FB,SUBCUT TISS;COMP $415.00I&R FB,SUBCUT TISS;SIMP $299.00

I&R FB,SUBCUT TISS;SIMP $284.00I&R FB,SUBCUT TISS;SIMP $284.00IA2 AUTOANTIBODIES $186.00IBANDRONATE SOD 3MG/3ML KIT (BONIVA) $1,265.00IBD PROFILE $546.00IB-STAT SPRAY (HYOSCYAMINE) 0.125MG/ML $8.00IBUPROFEN 100MG/5ML SUSPENSION 118ML $13.00IBUPROFEN 200 MG TABLET (MOTRIN) $6.00IBUPROFEN 200MG/10ML SUSPENSION UD $4.00IBUPROFEN 400 MG TABLET (MOTRIN) $6.00IBUPROFEN 50 MG TAB (CHEWABLE) (MOTRIN) $4.00IBUPROFEN 600 MG TABLET (MOTRIN) $6.00IBUPROFEN 800MG TABLET (MOTRIN) $6.00IBUPROFEN CHILD SYRUP 100MG/5ML (MOTRIN) $8.00ICU/CCU NURSING CARE $426.00ICY HOT (METYLSAL/METHOL) CREAM TUBE $12.00ID & SENSITIVITY SEND OUT $561.00IDH1 / IDH2 MUTATION ANALYSIS $420.00IFE & PE RANDOM URINE $67.00IFE & PE SERUM $65.00IFS 2.0 DRILL $552.00IFS SCREW 2.4MM $1,995.00IgA $65.00IGE $72.00IgG $65.00IgG SUBCLASS 1 $30.00IgG SUBCLASS 2 $30.00IgG SUBCLASS 3 $30.00IgG SUBCLASS 4 $30.00IgM $65.00IGVH HYPERMUTATION $1,363.00ILEOSTOMY OR JEJUNOSTOMY NON TUBE $2,631.00IMAGE-GUIDED FLUID COLLECTION DRAINAGE B $1,655.00IMFINZI 120MG/2.4ML (DURVALUMAB) $3,951.00IMFINZI 500MG/10ML (DURVALUMAB) $7,272.00IMIPENEM/CILASTATIN 250 MG IV VIAL $69.00IMIPENEM/CILASTATIN VIAL :500 MG IV $192.00IMIPRAMINE 50MG TABLET $6.00IMITREX (SUMATRIPTAN SUCCIANTE) 6MG $300.00IMITREX (SUMATRIPTAN) NASAL SPAY 20 MG $565.00IMMOB SHOU XLG $58.00IMMOB SHOULD XLARGE $41.00IMMOBIL SHOUL VELP DRS MD $28.00IMMOBIL SHOUL VELP DRS SM $28.00IMMOBILIZER ARM SMALL $35.00IMMOBILIZER SHOULDER LARGE $41.00IMMOBILIZER SHOULDER MEDIUM MEN $34.00

IMMUNO ELECTROPHORESIS URINE $26.00IMMUNOASSY QUANITATIVE NOT SPECIFIC $205.00IMMUNOELECTROPHORESIS (IPEP) D $16.00IMMUNOELECTROPHORESIS PROCEDURE $58.00IMMUNOFIXATION $27.00IMMUNOGLOBULIN G (SUBCLASSES 1-4) $65.00IMOGAM 2ML (RABIES IMMUN GLOB) 150IU/ML $1,357.00IMOVAX (RABIES VAC/HUM DIP) $343.65IMOVAX (RABIES VAC/HUM DIP) $397.00IMPERI STOCKINETTE . $21.00IMPLANT INTRAOCULAR LENS $534.00IMPLANT NEUROELECTRODES $871.00IMPLANT NEUROELECTRODES $831.00IMPLANT NEUROELECTRODES $871.00IMPLANT NEUROELECTRODES $831.00IMPLANTATION OF BIOLOGIC IMPLANT (EG, AC $533.00IMPLANTATION OF MESH OR OTHER PROSTHESIS $578.00IMV MANIFOLD $41.00INC IMPLT NEUROSTIMULATOR ELTRD ARRAY $1,689.00INC IMPLT NEUROSTIMULATOR ELTRD ARRAY $1,689.00INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL $15,685.00INCENTIVE SPIROMETER $15.00INCISE PLUS CONCAVE 4.5-ORTHO $471.00INCISE PLUS PLATINUM 4.5-ORTHO $490.00INCISION & DRAINAGE OR A $510.00INCISION & REMOVAL FBSUBQTISS;SMPL $299.00INCISION AND DRAINAGE ABSCESS; PERITONSI $462.00INCISION AND DRAINAGE OF BARTHOLIN'S GLA $366.00INCISION AND DRAINAGE OF EPIDIDYMIS, TES $1,027.00INCISION AND DRAINAGE OF INTRAMURAL, INT $1,073.00INCISION AND DRAINAGE OF ISCHIORECTAL AN $718.00INCISION AND DRAINAGE OF ISCHIORECTAL OR $1,171.00INCISION AND DRAINAGE OF SUBMUCOSAL ABSC $510.00INCISION AND DRAINAGE, DEEP ABSCESS, BUR $1,419.00INCISION AND DRAINAGE, FOREARM AND/OR WR $1,289.00INCISION AND DRAINAGE, LEG OR ANKLE; DEE $881.00INCISION AND DRAINAGE, PERIANAL ABSCESS, $453.00INCISION FOR IMPLANTATION OF NEUROSTIMUL $1,689.00INCISION OF TENDON COVERING $1,378.00INCISION OF TENDON COVERING $1,378.00INCISION OF WINDPIPE $1,491.00INCISION OF WINDPIPE $1,491.00INCISION THROMBOSED EXT HEMORRHOID $452.00INCISION THROMBOSED EXT HEMORRHOID $467.00INCISION THROMBOSED EXT HEMORRHOID $467.00INCISOR PLAT BLADE 4.5MM- ORTHO $347.00INDAPAMIDE 2.5 MG TABLET (LOZOL) $6.00

INDIA INK PREP $62.00INDIGO CARMINE 0.8% 5ML AMPULE $34.00INDINAVIR 400 MG CAPSULE (CRIXIVAN) $14.00INDOMETHACIN 25 MG CAPSULE (INDOCIN) $6.00INDOMETHACIN 50MG RECT SUPP (INDOCIN) $10.00INDOMETHACIN 75 MG CAPSULE (INDOCIN SR) $10.00INDUCED ABORTION W/WO CERVICAL DILATION $1,023.00INDUCED ABORTION W/WO CERVICAL DILATION $1,023.00INFANRIX (DIPHTH/PERTUSS(ACELL)/TET) SDV $36.00INFANT 02 CANNULA $38.00INFANT CIRCUIT BUBBLE CPAP SYSTEM $401.00INFANT DONNETT MED $70.00INFANT OX 1 PROBE $142.00INFANT OXY HOOD ADDL DAY $144.00INFANT OXY HOOD FIRST DAY $52.00INFANT OXYGEN MASK $14.00INFANT OXYGEN SENSOR $74.00INFANT RESPIRATOR SYSTEM $88.00INFED (IRON DEXTRAN) 100 MG VIAL $167.00INFLECTRA (INFLIXIMAB) 100MG VIAL $122.00INFLIXIMAB + AB (SERIAL MONITORING) $188.00INFLUENZA A & B $160.00INFLUENZA A ANTIBODY $38.00INFLUENZA B ANTIBODY $38.00INFLUENZA IMMUNIZATION ORDERED OR ADMINI $1.00INFLUENZA VAC 36 MONTHS AND OLDER $15.00INFLUENZA VAC 36 MONTHS AND OLDER $15.00INFLUENZA VAC PRES FREE 36MO+ $21.00INFLUENZA VIRUS VACCINE 2000-2001 FORM $15.00INFUSABLE PRESSURE INFUSOR $114.00INFUSION KIT LOCAL $833.00INFUSION PUMP TUBING $100.00INFUSION, 1ST HOUR $299.00INFUSION, EA ADDTL HR $107.00INFUSION, NON-CHEMO ADDL HR SEQUENTIAL $61.00INFUSION, SEQUENTIAL $121.00INFUSION,CONCURRENT $63.00INFUVITE (MULTIVITAMINS) VIAL $49.00INHALER/AEROSOL INSTRICT $98.00INHERITEST CARRIER - 451920 $263.00INHERITEST CARRIER SCREEN $153.00INHERITEST CHARGE $250.00INHERITEST CHARGE $250.00INHERITEST CHARGE $2,000.00INHIBIN A $77.00INIT PREV PE; NEW BENEFICIARY $256.00INIT PREV PE; NEW BENEFICIARY $256.00

INIT PREV PHYSICAL EXAM $238.00INITIAL HOSP CARE PER DAY, FOR EVAL $149.00INITIAL HOSP CARE PER DAY, FOR EVAL $80.00INITIAL HOSPITAL CARE H&P $244.00INITIAL HOSPITAL CARE H&P $251.00INITIAL HOSPITAL CARE H&P $486.00INITIAL HOSPITAL CARE H&P $244.00INITIAL HOSPITAL CARE H&P $251.00INITIAL HOSPITAL CARE H&P $486.00INITIAL INPATIENT CONSULT $83.00INITIAL INPATIENT CONSULT $179.00INITIAL INPATIENT CONSULT $278.00INITIAL INPATIENT CONSULT $83.00INITIAL INPATIENT CONSULT $166.00INITIAL INPATIENT CONSULT $278.00INITIAL OBS HIGH SEVERITY $340.00INITIAL OBS HIGH SEVERITY $340.00INITIAL OBS LOW SEVERITY $177.00INITIAL OBS LOW SEVERITY $177.00INITIAL OBS MODERATE SEVERITY $367.00INITIAL OBS MODERATE SEVERITY $367.00INJ CYSTOGRAM $508.00INJ FORAMEN EPIDURAL ADD-ON $379.00INJ FORAMEN EPIDURAL ADD-ON $397.00INJ FORAMEN EPIDURAL ADD-ON $379.00INJ FORAMEN EPIDURAL ADD-ON $397.00INJ FORAMEN EPIDURAL C/T $832.00INJ FORAMEN EPIDURAL C/T $832.00INJ FORAMEN EPIDURAL L/S $840.00INJ FORAMEN EPIDURAL L/S $840.00INJ METYCAINE $41.00INJ OF SINUS TRACT SINOGRAM $334.00INJ RISPERIDONE 0.5MG $793.00INJ SINGLE/MULTI TRIGGER 3 OR MORE MUSC $116.00INJ SINGLE/MULTI TRIGGER POINT 3 OR MORE $110.00INJ SINGLE/MULTI TRIGGER POINT 3 OR MORE $116.00INJ TX NERVE $608.00INJ TX NERVE $608.00INJ URETHROCYSTOGRAM $308.00INJ/SINGLE MULTI TRIGGER PT 1OR 2 MUSCLE $450.00INJ/SINGLE MULTI TRIGGER PT 1OR 2 MUSCLE $450.00INJ/SINGLE MULTI TRIGGER PT 1OR 2 MUSCLE $450.00INJECT EPIDURAL PATCH $476.00INJECT EPIDURAL PATCH $421.00INJECT INTERLAMINAR CRV/THRC $419.00INJECTAFER 750MG/15ML VIAL $2,264.00INJECTION CONTRAST ABCESSOGRAM $372.00

INJECTION PROCEDURE FOR MYELOGRAM $218.00INJECTION PROCEDURE FOR SHOULDER ARTHROG $152.00INJECTION PROCEDURE FOR WRIST ARTHROGRAP $416.00INJECTION SINGLE TENDON ORGIN/INSERTION $95.00INJECTION SINGLE TENDON ORGIN/INSERTION $95.00INJECTION SINGLE TENDON SHEATH $128.00INJECTION SINGLE TENDON SHEATH $128.00INJECTION SQ/IM NON-CHEMO $35.00INJECTION THERAPEUTIC CARPAL TUNNEL $164.00INJECTION THERAPEUTIC CARPAL TUNNEL $164.00INJECTION, ANESTHETIC AGENT; OTHER PERIP $221.00INLINE ADAPTER CAPNOGRAPHY(ETCO2) $40.00INNOHEP (TINZAPARINE) 20MUML MDV $582.00INS TUNNELED CRT VAD W/SUBQ PUMP $962.00INS TUNNELED CRT VAD W/SUBQ PUMP $962.00INSERT BLADDER CATH $250.00INSERT BLADDER CATHETER $195.00INSERT CATH PLEURA W/O IMAGING GUIDANCE $317.00INSERT CATH URINARY BLADDER SIMPLE $195.00INSERT CENTRAL VENOUS ACCESS W/SQ PORT $2,676.00INSERT CERVICAL CAP $235.00INSERT CERVICAL CAP $235.00INSERT INDWELLING TUNNELED PLEURAL CATH $571.00INSERT INDWELLING TUNNELED PLEURAL CATH $571.00INSERT MESH PROSTH PELVIC FLOOR DEFECT $425.00INSERT MESH PROSTH PELVIC FLOOR DEFECT $425.00INSERT PICC C $886.00INSERT PICC W/O PORT/PUMP >5YRS $892.00INSERT TUN IP CATH W/PORT $1,115.00INSERT TUN IP CATH W/PORT $1,115.00INSERT TUNNELED CATHETER PERCUTANEOUS $576.00INSERTA PIN 035X2INCH $69.00INSERTION CATHETER, ARTERY $264.00INSERTION CENTRAL VENOUS CATH W/O PORT $892.00INSERTION NEXPLANON $201.00INSERTION NON BIODEGRADABLE DRUG IMPLANT $201.00INSERTION NON BIODEGRADABLE DRUG IMPLANT $201.00INSERTION OF CHEST TUBE $498.00INSERTION OF CHEST TUBE $498.00INSERTION OF INDWELLING TUNNELED PLEURAL $571.00INSERTION OF INTRAUTERINE DEVICE (IUD) $296.00INSERTION OF IUD $281.00INSERTION OF IUD $281.00INSERTION OF IUD $296.00INSERTION OF MESH OR OTHER PROSTHESIS FO $425.00INSERTION OF NON-INDWELLING BLADDER CATH $195.00INSERTION OF NON-TUNNELED CENTRALLY INSE $239.00

INSERTION OF PERIPHERALLY INSERTED CENTR $886.00INSERTION OF PERIPHERALLY INSERTED CENTR $892.00INSERTION OF PERIPHERALLY INSERTED CENTR $2,676.00INSERTION OF TEMPORARY INDWELLING BLADDE $250.00INSERTION OF TEMPORARY PACEMAKER $899.00INSERTION OF TUNNELED CENTRALLY INSERTED $1,847.00INSERTION OF TUNNELED CENTRALLY INSERTED $2,894.00INSERTION OF TUNNELED CENTRALLY INSERTED $962.00INSERTION OF TUNNELED INTRAPERITONEAL CA $576.00INSERTION OF TUNNELED IP CATH $576.00INSERTION OR REPLACEMENT OF PERIPHERAL O $515.00INSERTION/CEN $2,756.00INSERTION/CENTRAL VENOUS $2,756.00INSERTION/CENTRAL VENOUS $2,548.00INSORB STAPLER $272.00INSPIREASE (DRUG DELIVERY SYSTEM) KIT $94.00INSPIREASE BAG $11.00INSPIREASE UNIT $60.00INSPRA (EPLERENONE) 25MG TABLET $20.00INSRT TUNNL CVC NO PORT/PUMP 5 Y/> $1,847.00INSRT TUNNL CVC NO PORT/PUMP 5 Y/> $1,759.00INSRT/REDO SPINE N GENERATOR $1,013.00INSRT/REDO SPINE N GENERATOR $1,013.00INSRT/RPLCMT PERIPHERAL/GASTRIC NPGR $48,605.00INSRT/RPLCMT PERIPHERAL/GASTRIC NPGR $515.00INSRT/RPLCMT PERIPHERAL/GASTRIC NPGR $515.00INST KNEE EMPOWR STR PIN- ORTHO $1,120.00INSTILLATION, VIA CHEST TUBE/CATHETER, A $611.00INSTINCT ENDO HEMOCLIP $531.00INSTRUMENT KIT-SINGLE USE $792.00INSTRUMENT POUCH $7.00INSUFFLATION NEEDLE 14G $83.00INSUFFLATION TUBING W/FILTER $46.00INSULATED BOVIE BLADE (ELECTRODE) $28.00INSULIN 70/30 (70HN/30HR) U-100 10 ML $9.00INSULIN AND C PEPTIDE LEVEL $73.00INSULIN ANTIBODY $323.00INSULIN APIDRA (GLULISINE) 100 UNITS/ML $39.00INSULIN DRIP 100UN/1000ML NS(0.1UN/ML) $60.00INSULIN GROWTH FACTOR 1 $99.00INSULIN HUMALOG (LISPRO) INJ $11.00INSULIN HUMALOG MIX (NPL/LISPRO) INJ $40.00INSULIN HUMULIN L HUMULIN ZINC) 10 ML $9.00INSULIN HUMULIN N U-100 10 ML $9.00INSULIN HUMULIN U U-100 10 ML $9.00INSULIN LENTE U-100 10ML $9.00INSULIN LEVEL $73.00

INSULIN LIKE GROWTH FACTOR $370.00INSULIN PER FIVE UNITS $9.00INTACT N-TERMINAL PROPEPTIDE OF TYPE 1 $214.00INTAL INHALATION SOLN (CROMOLYN) 20 MG $6.00INTAL INHALER (CROMOLYN SOD) 112 800 MCG $135.00INTAL INHALER (CROMOLYN SOD) 200 14.2GM $120.00INTER REPAIR I 12.6-20CM $724.00INTER REPAIR I 12.6-20CM $724.00INTER REPAIR I 12.6-20CM $724.00INTER REPAIR I 12.6-20CM $724.00INTER REPAIR I 2.6-7.5CM $566.00INTER REPAIR I 2.6-7.5CM $566.00INTER REPAIR I 2.6-7.5CM $566.00INTER REPAIR I 20.1-30CM $1,616.00INTER REPAIR I 7.6-12.5CM $556.00INTER REPAIR I OVER 30 CM $1,873.00INTER REPAIR II 12.6-20CM $707.00INTER REPAIR II 2.6-7.5CM $507.00INTER REPAIR II 20.1-30CM $1,769.00INTER REPAIR II 7.6-12.5CM $632.00INTER REPAIR II OVER 30 CM $2,020.00INTER REPAIR II UP TO 2.5 CM $405.00INTER REPAIR II UP TO 2.5 CM $405.00INTER REPAIR III 12.6 CM TO 20 CM $811.00INTER REPAIR III 2.6 CM TO 5.0 CM $556.00INTER REPAIR III 2.6 CM TO 5.0 CM $613.00INTER REPAIR III 2.6 CM TO 5.0 CM $613.00INTER REPAIR III 20.1 CM TO 30 CM $2,321.00INTER REPAIR III 5.1 CM TO 7.5 CM $660.00INTER REPAIR III 7.6 CM TO 12.5 CM $737.00INTER REPAIR III OVER 30 CM $2,624.00INTER REPAIR III UP TO 2.5CM $477.00INTER REPAIR III UP TO 2.5CM $524.00INTER REPAIR III UP TO 2.5CM $524.00INTERFERON A 3 MU VIAL (INTRON A) $189.00INTERFERON A 5 MU VIAL (INTRON A) $355.00INTERLEUKIN - 2 RECEPTOR $410.00INTERM OPTHALMOLOGIC EXAM $288.00INTERMEDIATE REPAIR I UP TO 2.5 CM $326.00INTERNAL NERVE REVISION $421.00INTERNAL NERVE REVISION $421.00INTERNALBRACE LIGAMENT $2,688.00INTERPHASE IN SITU HYBRIDIZATION $304.00INTERPRETATION AND REPORT. GENETICS $304.00INTERPULSE HANDPIECE ORTHO $174.00INTESTINAL STRICTUROPLASTY $1,473.00INTMD WND REPAIR S/TR/EXT $390.00

INTMD WOUND REPAIR S/TR/EXT $476.00INTRAABDOMINAL PRESSURE TEST $282.00INTRAABDOMINAL PRESSURE TEST $282.00INTRACATH 16 GA $25.00INTRACATH 16 GA $28.00INTRACATH 19 GA $28.00INTRACRANIAL COMPLETE STUDY $457.00INTRALIPID 20% 250ML (FAT EMULSION) $73.00INTRAOSSEOUS INFUSION $129.00INTRAOSSEOUS INFUSION NEEDLES $260.00INTRAVENOUS CHOLANGIOGRAM $838.00INTRINSIC FACTOR AB $187.00INTRO, GASTRO-INTESTINAL TUBE $63.00INTRODUCER 5 FR $580.00INTRON A (INTERFERON ALFA) 18MILL IU INJ $944.00INTRON A 10 MMU (INTERFERON ALFA 2B) $588.00INTRRACATH 19 GA $24.00INTUBATION, ENDOTRACHEAL EMERGENCY PROC $500.00INTUBATION, ENDOTRACHEAL, EMERGENCY PROC $500.00INVANZ (ERTAPENEM SOD) 1GM $247.00IODINE $94.00IODOFORM PACKING STRIP 1 1/4X5 $17.00IODOFORM PACKING STRIP 1/2 X5yds $28.00IODOFORM PACKING STRIP 1in x 5 yd $14.00IODOFORM PACKING STRIP 2X5 $28.00IPECAC EMESIS W OBS $285.00IPOL $44.75IPOL $44.75IPOL (POLIOMYELEITIS VAC. KILLED) VIAL $47.00IPRATROPIUM INHALANT SOL 0.02%(ATROVENT) $6.00IPRATROPIUM NASAL SPRAY 0.3% (ATROVENT) $100.00IPRATROPIUM NASAL SPRAY 0.6% (ATROVENT) $97.00IRBESARTAN (AVAPRO) 150 MG TABLET $9.00IRINOTECAN (CAMPTOSAR) 100 MG VIAL $694.00IRINOTECAN (CAMPTOSAR) 100 MG VIAL $1,304.00IRINOTECAN (CAMPTOSAR) 40 MG VIAL $235.00IRINOTECAN (CAMPTOSAR) 40 MG VIAL $791.00IRON 24 HR URINE $215.00IRON AND TIBC WITH %SAT $110.00IRON DEXTRAN COMPLEX 100 MG VIAL (INFED) $190.00IRON SERUM $92.00IRRIG VAD $75.00IRRIGATION ADMINISTRATION SET W/FILTER $21.00IRRIGATION OF VAGINA AND/OR APPLICATION $118.00ISENTRESS (RALTEGRAVIR) 400MG TABLET $117.00ISOETHARINE INHAL SOLN 0.25% 2 ML VIAL $6.00ISONIAZID (INH) 100 MG TAB $4.00

ISOOFORANE/CC $9.00ISOPROTERENOL 0.2 ML AMPS (ISUPREL) $51.00ISOPROTERENOL 1:5000 SOLN 5ML (ISUPREL) $123.00ISOPTO CARBACHOL 3% OPHT SOLN $98.00ISOSORBIDE 40 MG TABLET (SORBITRATE) $4.00ISOSORBIDE 5 MG TABLET (SORBITRATE) $5.00ISOSORBIDE DINITRATE 10 MG TABLET $11.00ISOSORBIDE ER 60 MG TAB (IMDUR ER) $9.00ISOSORBIDE MONONITRATE 20 MG TAB (ISMO) $6.00ISOSORBIDE MONONITRATE 30MG TAB(IMDUR ER $8.00ISOVUE M 200 20ML BOTTLES $87.00ISOVUE M 200 20ML BOTTLES $87.00ISOVUE M 300 15ML BOTTLES $87.00ISTAT BMP $141.00ISTAT BUN/CREATININE $71.00ISTAT H & H $37.00ITRACONAZOLE 100 MG CAP (SPORANOX) $10.00IUD INSERTION KIT $168.00IUD SUPPLY (PARAGARD) $684.00IUD TRAY $76.00IUD TRAY $17.00IV CATH 16 X 2 $12.00IV CONSCIOUS SEDIATION 1ST 30 MIN $93.00IV CONSCIOUS SEDIATION EA ADDTL 15 MIN $50.00IV KIT INCLUDES INSERTION $55.00IV LOOP CONNECTOR $14.00IV PUMP TUBING $53.00IV PUMP TUBING $91.00IV PUSH, EA NEW DRUG $114.00IV PUSH, EA SAME DRUG $46.00IV PUSH, INITIAL $185.00IV PUSH, INITIAL $68.00IVEX-2 FILTERSET $24.00IVEZ 2 FILTERSET $28.00IVP-INTRAVENOUS PYELOGRAM $447.00IVY BLEEDING TIME $93.00IXEMPRA (IXABEPILONE) 15MG KIT $4,324.00IXEMPRA (IXABEPILONE) 45MG KIT $5,749.00JABCZENSKI DUCTOGRAM CANNULA 30GA $171.00JACKSON PRATT 100CC BULB RESERVOIR $27.00JACKSON PRATT KIT $205.00JAK2 MUTATION ANALYSIS QUAL REFLEX EXAM $546.00JAK2 MUTATION ANALYSIS QUALITATIVE $514.00JAK2 MUTATION ANALYSIS QUANTITATIVE $1,070.00JAMSHIDI TRAY BONE MARROW BIOPSY $134.00JARDIANCE (EMPAGLIFLOZIN) 10MG TABLET $185.00JELCO 20 X 1 $10.00

JELCO IV CATH 18 X 1 1/4 $18.00JELCO IV CATH 18 X 1 3/4 $24.00JET VENTILATION CATHETER $423.00JEVTANA 60MG (CABAZITAXEL) VIAL $14,260.00JEWETT NAIL 2 1/2 X 5 $577.00JEWETT NAIL 3 1/4 X 5 $572.00JEWETT NAIL 3 3/4 X 5 $572.00JEWETT NAIL 3 X 5 $572.00JEWETT NAIL 3.5 X 5 $572.00JEWETT NAIL 4 X 5 $572.00JEWETT NAIL 4.5 X 5 $583.00K WIRE 1.25 $351.00K WIRE 1.6MM $267.00K WIRE CAP $78.00K WIRE.062 $57.00KA2 UNIT- ORTHO $1,620.00KALETRA 200/50MG (LOPINAVIR/RITONAVIR) $50.00KALTOSTAT PACKING $25.00KANGAROO FEEDING TUBE W/DOBBHOFF TIP $190.00KANGAROO PUMP SET $21.00KAOPECTATE (BISMUTH SUBSALICYLATE) 3 OZ $10.00KARAYA GUM POWDER 4OZ $87.00KARAYA PASTE $51.00KCI CANIST 500ML $153.00KCI GRANUFOAM- SILVER LG $341.00KCI GRANUFOAM- SILVER MED $286.00KCI GRANUFOAM- SILVER SMALL $231.00KCI VAC GRANUFORM DRESSING LG $256.00KCI VAC GRANUFORM DRESSING MD $222.00KCI VAC GRANUFORM DRESSING SM $169.00KCI WND VAC - NEG PRESS WOUND TX, >50CM $166.00KENALOG (TRIAMCINALONE ACET) 0.1% LOTION $187.00KENALOG (TRIAMCINOLONE) INJ 40 MG VIAL $75.00KENALOG (TRIAMCINOLONE) INJ 40MG/ML -MDV $59.00KENALOG INJ 40 MG VIAL $31.00KEPPRA $282.00KERLIX 3.4 $9.00KERLIX 4 1/2 $9.00KERODEX (HYDROPHILIC CREAM) 51 DRY $21.00KETAMINE 10MG/ML 20ML VIAL (KETALAR) $90.00KETO DIASTIX $91.00KETOCONAZOL 2% CREAM 30 GM (NIZORAL) $123.00KETOCONAZOLE 2% CREAM 15 GM (NIZORAL) $75.00KETOCONAZOLE 2% SHAMPOO 4OZ (NIZORAL) $37.00KETOROLAC 15 MG VIAL (TORADOL) $16.00KETOROLAC 30 MG VIAL (TORADOL) $14.00KETOROLAC 60 MG VIAL (TORADOL) $15.00

KEYTRUDA (PEMBROLIZUMAB) 25MG/ML 4ML $7,832.00KIDNEY SHAPE BALLOON $694.00KIDNEY STONE RISK ANALYSIS $18.00KIDNEY STONE TEST $20.00KINEVAC $230.00KINEVAC (SINCALIDE) SDV 5MCG $623.00KING LT-D AIRWAY KIT 3 $77.00KING LT-D AIRWAY KIT 4 $77.00KING LT-D AIRWAY KIT 5 $77.00KINRIX $89.00KINRIX (DIPHTH/TET/POLIO)0.5ML VACCINE $80.00KIRSCHNER WIRE 035 $32.00KIRSCHNER WIRE 045 $31.00KIRSCHNER WIRES $43.00KIRSNR WIRE TYPE E 065 $32.00KIT, SHOULDER STABILIZATION-ORTHO $297.00KIWI VACUUM DELIVERY SYSTEM $146.00KLEIHAUER-BETKE $127.00KLONOPIN $173.00KLOR-CON (POTASSIUM CHL) 20 MEQ DONT USE $4.00KLOR-CON PACKET (POTASSIUM CHL) 20 MEQ $36.00KNEE ARTHROGRAPHY LT $552.00KNEE ARTHROGRAPHY RT $552.00KNEE ARTHROSCOPY/SURGERY $1,828.00KNEE ARTHROSCOPY/SURGERY $2,196.00KNEE ARTHROSCOPY/SURGERY $1,828.00KNEE ARTHROSCOPY/SURGERY $2,196.00KNEE BILAT WB W/MERCHANT $305.00KNEE BILAT WB W/MERCHANT & W/ROSENBER $269.00KNEE BILAT WB W/MERCHANT & W/ROSENBERG $448.00KNEE FIN 5L-ORTHO $3,302.00KNEE IMMOBILIZER 20 XLG $48.00KNEE IMMOBILIZER 20 XXLG $48.00KNEE INSERT SIZE 9 $3,555.00KNEE LT 1-2V $244.00KNEE LT 3V $305.00KNEE PACK $223.00KNEE RT 1-2V $244.00KNEE RT 3V $305.00KNEE SUPP 1/4 SLV LG BLK FITS 14.5 -16 $24.00KNEE SUPP STABILIZER MEDIUM $60.00KNEE SUPP W/ STAB PAT-LG $60.00KNEE SUPP W/ STAB PAT-XLG $60.00KNEE TIBIA INSERT SZ4-ORTHO $3,385.00KNEES BILAT AP STANDING $269.00KNEES BILAT WB W/MERCHANT $269.00KNIFE CAUTRY $33.00

KNOWLES PIN 5/32 X 3 1/2 $183.00KNOWLES PIN 5/32 X 3 1/4 $183.00KOALA INTRAUTERINE PRESSURE SYSTEM $233.00KOH PREP $206.00K-PAD HEATING $8.00K-PHOS ORIGINAL(POT ACID PHOS) 500MG TAB $7.00KRAVENEDONK PIN 11 1/2 LG $197.00K-TAB SA (POTASSIUM CL) 10 MEQ TAB $4.00KUB ABDOMEN 1 VW $206.00KUMAR CATHETERS $204.00K-WIRE .035INX9IN (0.9MMX229MM) $38.00K-WIRE .045 X 9 IN $11.00K-WIRE .062- DEPUY $99.00K-WIRE .062X9IN $11.00K-WIRE .8ML $99.00K-WIRE 10 PK $75.00K-WIRE 186-52 0.035 K WIRE X 3 $186.00K-WIRE 186-62 0.045 K WIRE $186.00KWIRE DBL TROCAR TIP SMOOTH 0.9X150MM $193.00K-WIRE SINGLE TOCAR 0.9 $172.00KWIRE-W/ETCH 1.1 $172.00KWIRE-W/ETCH 2.4 NEUTRAL $1,995.00K-Y LUBRICATING(CHLORHEX GL/GLYC/HE-CE) $16.00KYPROLIS 60MG (CARFILZOMIB) VIAL $3,945.00L & DL. LEG/ANKLE JT, DEEP ABSCESS/HEMAT $881.00L L ADAPTER $22.00L L MALE ADATER SHORT $8.00L L NEPHROSTOMY SET $580.00L.L. ADAPTER $24.00L3908 CL WRIST HAND ORTHOSIS EXTENSION $50.00L4386 CL WALK BOOT W/W/O JOINTS NON PNEU $219.00L4387 CL WALK BOOT NON PNEUMATIC W/WO J $130.00LAB ABDOMEN PERITONEUM W/BIO $816.00LAB ABDOMEN PERITONEUM W/BIO $919.00LABETALOL 100 MG TABLET (TRANDATE) $7.00LABETALOL 100MG/20 ML VIAL (TRANDATE) $35.00LABETALOL 100MG/20ML VIAL (NORMODYNE) $350.00LABETALOL 20 MG SYRINGE (NORMODYNE) $35.00LAC-HYDRIN (AMMONIUM LACT) 12% CREAM $21.00LAC-HYDRIN (AMMONIUM LACT) 12% LOTION $129.00LACOSAMIDE $263.00LACOSAMIDE $178.00LACRI-LUBE OPTH (LANOLIN/MIN OIL/PET)OIT $8.00LACRIMAL INTUBATION SET $393.00LACTASE TABLET 9MU (LACTAID) $6.00LACTATE $99.00LACTATE $99.00

LACTATED RINGERS 1000ML $18.00LACTATED RINGERS 500ML $21.00LACTATED RINGERS IRRIG 3000 $43.00LACTOBACILLUS TABLET (LACTINEX,FLORANEX) $6.00LACTULOSE 20G/30ML SOLUTION (CHRONULAC) $14.00LAG SCREW 100MM S $626.00LAG SCREW 105 MM $605.00LAG SCREW 105MM S $605.00LAG SCREW 110 MM R $577.00LAG SCREW 110MM S $623.00LAG SCREW 3 1/2 $681.00LAG SCREW 3 1/2 X 1 1/8TH $623.00LAG SCREW 3 1/4 $636.00LAG SCREW 3 3/4 3/4 $333.00LAG SCREW 3 3/4 LENGTH $635.00LAG SCREW 3 INCH $569.00LAG SCREW 3/4 2 1/2 $313.00LAG SCREW 3/4 2 3/4 $556.00LAG SCREW 3/4 3 1/2 $551.00LAG SCREW 3/4 3 1/4 $616.00LAG SCREW 3/4 3 3/4 $635.00LAG SCREW 3/4 4 $381.00LAG SCREW 3/4 4 1/2 $635.00LAG SCREW 4 3/4 X 4 3/4 $381.00LAG SCREW 4 1/2 X 1 1/8 $409.00LAG SCREW 4 1/2 X 3/4 $409.00LAG SCREW 4 1/4 1 1/8 $409.00LAG SCREW 4 3/4 1 1/8 $381.00LAG SCREW 5 1 1/8 $383.00LAG SCREW 5 3/4 $381.00LAG SCREW REGULAR 2 $306.00LAG SCREW REGULAR 3 $306.00LAMICTAL $282.00LAMICTAL (LAMOTRIGINE) 100 MG TABS $6.00LAMIVUDINE 150 MG TABLETS (EPIVIR) $48.00LAMOTRIGINE (LAMICTAL) 25 MG TAB $11.00LANOLIN/MIN OIL/PET OPTH UD (LACRI-LUBE) $14.00LANOLIN/MIN.OIL LOTION 8 OZ (KERI) $20.00LANREOTIDE(SOMATULINE DEPOT) 120MG/0.5ML $11,066.00LANTUS 100 UNITS/ML: 10ML VIAL $32.00LAP ABLTJ UTERINE FIBROIDS W/INTRAOP US $1,750.00LAP ABLTJ UTERINE FIBROIDS W/INTRAOP US $1,750.00LAP BAND ADJUSTMENT $183.00LAP DIAPHRAGMATIC HERNIA REPAIR $4,435.00LAP INGUINAL MESH $750.00LAP MOBLJ SPLENIC FLXR PRFMD W/PRTL COLE $464.00LAP MYOMECTOMY EXC 1-4 MYOMAS 250 GM/< $2,016.00

LAP MYOMECTOMY EXC 1-4 MYOMAS 250 GM/< $2,016.00LAP REPAIR INCISIONAL HERNIA REDUCIBLE $1,955.00LAP SPONGE 18 X 36 $18.00LAP SPONGES 18 X 18 $11.00LAP SUPRACERVICAL HYSTERE>250 GM REMOVAL $2,133.00LAP SUPRACERVICAL HYSTERE>250 GM REMOVAL $2,133.00LAP SUPRACERVICAL HYSTERECTOMY 250 GM/< $1,598.00LAP SUPRACERVICAL HYSTERECTOMY 250 GM/< $1,598.00LAP SUPRACRV HYSTERECT 250 GM/< RMVL $1,824.00LAP SUPRACRV HYSTERECT 250 GM/< RMVL $1,824.00LAP SURG REPAIR INITI INGUINAL HERNIA $1,065.00LAP SURG;W/FULG/EXCIS LES-OVARY $1,264.00LAP SURG;W/FULG/EXCIS LES-OVARY $1,264.00LAP TOT HYSTERECT >250 G W/TUBE/OVAR $2,709.00LAP TOT HYSTERECT >250 G W/TUBE/OVAR $2,709.00LAP TOTAL HYSTERECT 250 GM/< W/RMVL T/O $2,146.00LAP TOTAL HYSTERECT 250 GM/< W/RMVL T/O $2,146.00LAP TOTAL HYSTERECT UTERUS >250 GM $2,273.00LAP TOTAL HYSTERECT UTERUS >250 GM $2,273.00LAP VENT/ABD HERNIA REPAIR $1,815.00LAP VENT/ABD HERNIA REPAIR $1,815.00LAP W TOTAL HYSTERECTOMY UTERUS 250 GM/< $1,416.00LAP W TOTAL HYSTERECTOMY UTERUS 250 GM/< $1,416.00LAP W/ SMALL INTESTINE AND ANASTOMOSIS $3,417.00LAP W/ SMALL INTESTINE AND ANASTOMOSIS $3,417.00LAP. VENT. INCISION HERNIA REPAIR W/MESH $1,955.00LAPAR MECKEL DIVERTICULECTOMY $1,848.00LAPARO HERNIA REPAIR INIT $1,065.00LAPARO HERNIA REPAIR RECUR $919.00LAPARO HERNIA REPAIR RECUR $919.00LAPARO PARTIAL COLECTOMY $3,882.00LAPARO SLING OPERATION FOR STRESS INCONT $2,118.00LAPARO SLING OPERATION FOR STRESS INCONT $2,118.00LAPARO W/LYSIS;OCCLUSION OVIDUCTS $604.00LAPARO W/LYSIS;OCCLUSION OVIDUCTS $604.00LAPAROSCOPIC CHOLANGIOGRAPHY CATH $134.00LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNA $1,759.00LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNA $1,925.00LAPAROSCOPIC WIRE L HOOK 33CM $180.00LAPAROSCOPY APPENDECTOMY $1,409.00LAPAROSCOPY APPENDECTOMY $1,409.00LAPAROSCOPY COLPOPEXY SUSPEN VAG APEX $2,471.00LAPAROSCOPY DX;W OR W/O $660.00LAPAROSCOPY DX;W OR W/O $660.00LAPAROSCOPY PACK $67.00LAPAROSCOPY PROCEDURE $1,710.00LAPAROSCOPY PROCEDURE $1,710.00

LAPAROSCOPY W/LYSIS OF ADHESIONS $1,696.00LAPAROSCOPY W/LYSIS OF ADHESIONS $1,696.00LAPAROSCOPY W/VAG HYSTERECTOMY $2,297.00LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OM $693.00LAPAROSCOPY, REMOVE ADNEXA $1,634.00LAPAROSCOPY, REMOVE ADNEXA $1,634.00LAPAROSCOPY, SURGICAL, ABLATION OF UTERI $1,750.00LAPAROSCOPY, SURGICAL, APPENDECTOMY $1,480.00LAPAROSCOPY, SURGICAL, CLOSURE OF ENTERO $4,110.00LAPAROSCOPY, SURGICAL, COLPOPEXY (SUSPEN $2,471.00LAPAROSCOPY, SURGICAL, ENTEROLYSIS (FREE $2,254.00LAPAROSCOPY, SURGICAL, MOBILIZATION (TAK $464.00LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCIS $2,016.00LAPAROSCOPY, SURGICAL, REPAIR, INCISIONA $1,955.00LAPAROSCOPY, SURGICAL, REPAIR, INCISIONA $2,539.00LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT $3,257.00LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, $1,815.00LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, $2,195.00LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYS $1,598.00LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYS $1,824.00LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTER $1,416.00LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTER $2,146.00LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTER $2,273.00LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTER $2,709.00LAPAROSCOPY, SURGICAL, WITH VAGINAL HYST $2,297.00LAPAROSCOPY, SURGICAL, WITH VAGINAL HYST $2,901.00LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY $2,351.00LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY W $1,311.00LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY W $2,151.00LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIA $3,882.00LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIA $4,312.00LAPAROSCOPY, SURGICAL; REPAIR INITIAL IN $1,065.00LAPAROSCOPY, SURGICAL; REPAIR RECURRENT $919.00LAPAROSCOPY, SURGICAL; SLING OPERATION F $2,118.00LAPAROSCOPY, SURGICAL; WITH ASPIRATION O $658.00LAPAROSCOPY, SURGICAL; WITH FULGURATION $1,328.00LAPAROSCOPY, SURGICAL; WITH FULGURATION $668.00LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADH $1,696.00LAPAROSCOPY, SURGICAL; WITH REMOVAL OF A $1,634.00LAPAROSCOPY, SURGICAL; WITH SALPINGOSTOM $1,917.00LAPAROSCOPY/SURG/URETHR $1,375.00LAPAROSCOPY/SURG/URETHR $1,375.00LAPAROSCOPY;ENTEROLYSIS $2,254.00LAPAROSCOPY;ENTEROLYSIS $2,254.00LAPAROSHIELD- FILTRATION SYSTEM $116.00LAPAROTOMY/EXPLORATORY $1,275.00LAPAROTOMY/EXPLORATORY $1,275.00

LAPARO-VAG HYST INCL T/O $2,901.00LAPARO-VAG HYST INCL T/O $2,901.00LAPARSCPY SURG CHOLECT W/CHOLANGIO $1,248.00LAPARSCPY SURG CHOLECT W/CHOLANGIO $1,248.00LAPARSCPY SURG; W/ASPIR CAVITY/CYST $626.00LAPARSCPY SURG; W/ASPIR CAVITY/CYST $626.00LAPARSCPY SURGICAL; W/FULG OVIDUCTS $636.00LAPARSCPY SURGICAL; W/FULG OVIDUCTS $636.00LAPARSCPY SURGICAL; W/FULG OVIDUCTS $668.00LAPROSCOPIC INCISIONAL HERNIA REP 1-4 YR $2,195.00LAPROSCOPIC INCISIONAL HERNIA REP 1-4 YR $2,195.00LAPROSCOPIC INCISIONAL HERNIA REP W/MESH $1,777.00LAPROSCOPIC VENT INCISION HERNIA REPARI $1,777.00LAPROSCOPIC VENT INCISION HERNIA REPARI $1,777.00LAPS TX ECTOPIC PREG W/SALPING/OOPHORECT $1,925.00LARGETEAR CROSS CUT RASP $412.00LARYNGOSCOPE BLADE MAC # CHILD $47.00LARYNGOSCOPE BLADE MAC # INFANT $47.00LARYNGOSCOPE BLADE MAC #2 $47.00LARYNGOSCOPE BLADE MAC #3 $47.00LARYNGOSCOPE BLADE MAC #4 $47.00LARYNGOSCOPE BLADE MILLER #0 $47.00LARYNGOSCOPE BLADE MILLER #1 $47.00LARYNGOSCOPE BLADE MILLER #2 $47.00LARYNGOSCOPE BLADE MILLER #3 $47.00LARYNGOSCOPE BLADE MILLER #4 $47.00LARYNGOSCOPE SIZE 3 MACGRATH $156.00LARYNGOSCOPE SIZE 4 MACGRATH $156.00LASER SURGERY YAG $1,155.00LATANOPROST OPTH SOLN 0.005% (XALATAN) $36.00LDH $97.00LDH BODY FLUID $97.00LDL $78.00LDS 15W STAPLES $123.00LDS 6W STAPLES $109.00LEAD 28 $3,880.00LEAD INTRODUCER- INTERSTIM $605.00LEAD PLASMA (ADULT) $55.00LEAD PLASMA (PEDIATRIC) $57.00LEAD- TEST- INTERSTIM $220.00LEAD URINE $55.00LEAD, BLOOD, FILTER PAPER $79.00LEEP LOOP ELECTRODE EXCISION $108.00LEFLUNOMIDE 10 MG TABLET $43.00LEFLUNOMIDE 20 MG TABLET (ARAVA) $46.00LEFT VENTRICULAR EJECTION FRACTION (LVEF $1.00LEG SCREW 1 1/8 X 4 $361.00

LEGAL SPECIMEN COLLECTION $24.00LEGIONELLA AG URINE $236.00LEGIONELLA PNEUMOPHILA ANTIBODY $84.00LENS, AMOTECNIS Z9002 IOL $39.00LEPTIN $119.00LESCOL (FLUVASTATIN) 20 MG CAP $9.00LEUCOVORIN 350 MG VIAL $121.00LEUCOVORIN 100MG VIAL $95.00LEUCOVORIN 200MG VIAL $125.00LEUCOVORIN 350 MG $67.00LEUCOVORIN 50 MG $21.00LEUCOVORIN 500 MG VIAL $83.00LEUCOVORIN CALC 5 MG TAB $10.00LEUKOCYTE ALKALINE PHOSPHATASE $80.00LEUKOCYTE ALKPHOS STAIN $79.00LEVALBUTEROL (XOPENEX) 1.25MG U/D $36.00LEVALBUTEROL HFA 45MCG INHALER (XOPENEX) $120.00LEVAQUIN (LEVOFLOXACIN) 250 MG TAB $6.00LEVAQUIN (LEVOFLOXACIN) 750 MG INJ $321.00LEVAQUIN IV 250 MG PREMIX (LEVOFLOXACIN) $40.00LEVAQUIN IV 500MG VIAL (LEVOFLOXACIN) $208.00LEVAQUIN IV 750MG PREMIX (LEVOFLOXACIN) $91.00LEVEL 1 BOARDER $2,203.00LEVEL 1 DELIVERY $2,422.00LEVEL 1 LABOR $1,818.00LEVEL 1 NEWBORN $1,307.00LEVEL 2 BOARDER $1,950.00LEVEL 2 DELIVERY $3,068.00LEVEL 2 LABOR $2,302.00LEVEL 2 NEWBORN $2,334.00LEVEL 3 DELIVERY $3,713.00LEVEL 3 LABOR $2,785.00LEVEL 3 NEWBORN $2,016.00LEVEMIR FLEXPEN (INSUL DETEMIR) 100U/1ML $158.00LEVETIRACETAM 100MG/ML ORAL SOL 5MLDOSE $8.00LEVETIRACETAM 250MG TABLET (KEPPRA) $6.00LEVETIRACETAM 500MG/5ML VIAL (KEPPRA) $112.00LEVETIRACETAM/NS 100ML $110.00LEVIN TUBE 14 FR $22.00LEVIN TUBE 16FR $8.00LEVIN TUBE 18FR $8.00LEVINE TUBE 12 FR $8.00LEVOFLOXACIN 500 MG TABLET (LEVAQUIN) $7.00LEVOFLOXACIN IV 500 MG PREMIX (LEVAQUIN) $45.00LEVOTHYROXINE (SYNTHROID) 500MCG INJ $10.00LEVOTHYROXINE 100 MCG TAB (SYNTHROID) $6.00LEVOTHYROXINE 100MCG VIAL (SYNTHROID) $537.00

LEVOTHYROXINE 112 MCG TAB (SYNTHROID) $4.00LEVOTHYROXINE 125MCG TABLET (SYNTHROID) $7.00LEVOTHYROXINE 175 MCG TAB (SYNTHROID) $4.00LEVOTHYROXINE 25 MCG TABLET (SYNTHROID) $6.00LEVOTHYROXINE 50 MCG TABLET (SYNTHROID) $7.00LEVOTHYROXINE 75 MCG TABLET (SYNTHROID) $7.00LEVOTHYROXINE 88 MCG TABLET (SYNTHROID) $6.00LG HINGED KNEE BRACE $219.00LG LAP VENTRAL MESH $2,975.00LG MED SACRO BELT $98.00LG OPEN TOE HEEL BOOT $59.00LG WOMENS SHOULDER IMOBL $126.00LIBRIUM (CHLORDIAZEPOXIDE) 100 MG AMPS $42.00LIDOCAIN/PRILOCAINE CREAM 2.5% (EMLA) $14.00LIDOCAINE $74.00LIDOCAINE (LIDODERM) 5% PATCH $32.00LIDOCAINE 0.5%MPF 50 ML VIAL (XYLOCAINE) $26.00LIDOCAINE 1 GM/250 D5W (4MG/ML) $43.00LIDOCAINE 1% (50MG) SYRINGE $68.00LIDOCAINE 1% (XYLOCAINE) 20ML BOTTLE $17.00LIDOCAINE 1% MPF 2ML (XYLOCAINE) $16.00LIDOCAINE 1.5% EPINEPHRINE 1:200,000 $22.00LIDOCAINE 2 GM/250 D5W (8MG/ML) $40.00LIDOCAINE 2% (100MG) SYRINGE $28.00LIDOCAINE 2% (XYLOCAINE) MDV $24.00LIDOCAINE 2% MPF 10ML AMPULE (XYLOCAINE) $27.00LIDOCAINE 2% MPF AMPULES (XYLOCAINE) $11.00LIDOCAINE 2%/EPI-MPF 20ML SDV $71.00LIDOCAINE 4% AMPULES 5ML $33.00LIDOCAINE 5% DEXTROSE AMPULE (XYLOCAINE) $46.00LIDOCAINE 5% OINTMENT (XYLOCAINE) $68.00LIDOCAINE JELLY 2% 30ML (XYLOCAINE) $20.00LIDOCAINE JELLY 2% 5ML TUBE (XYLOCAINE) $10.00LIDOCAINE TOPICAL 4% SOLUTION $12.00LIDOCAINE TOPICAL SOLUTION 4% 160MG/4ML $126.00LIDOCAINE VISCOUS 2% 15ML $7.00LIDOCAINE VISCOUS 2% 100ML (XYLOCAINE) $101.00LIDOCAINE/EPI 1% (XYLOCAIN/EPI) 20ML MDV $18.00LIDOCAINE/EPI 2% (XYLOCAIN/EPI)20ML MDV $23.00LIFE SAVER KIT $55.00LIG INTRL HEMORRHOIDS; SINGLE PRO $358.00LIG INTRL HEMORRHOIDS; SINGLE PRO $358.00LIG INTRL HEMORRHOIDS; SINGLE PRO $61.00LIG RECONSTRUCT KNEE INTRA ARTICLE $1,835.00LIG RECONSTRUCT KNEE INTRA ARTICLE $1,835.00LIGAMAX 5mm. $458.00LIGASURE LAP $819.00

LIGASURE LAPAROSCOPIC SEALER/DIVIDER $889.00LIGASURE OPEN BX/6 $1,133.00LIGASURE SMALL $796.00LIGATION INTERNAL HEMORRHOIDS $726.00LIGATION INTERNAL HEMORRHOIDS $726.00LIGATION OR BANDING OF A-V FISTULA $922.00LIGATION OR TRANSECTION OF FALLOPIAN TUB $749.00LIGATION OR TRANSECTION OF FALLOPIAN TUB $720.00LIGATION OR TRANSECTION OF FALLOPIAN TUB $151.00LIGATION, MAJOR ARTERY; ABDOMEN $3,137.00LIGATION, MAJOR ARTERY; EXTREMITY $953.00LIGATION/BIOPSY/TEMP $468.00LINDANE LOTION 60 ML (KWELL) $19.00LINDANE SHAMPOO 60 ML (KWELL) $22.00LINER CANISTER SUCTION $13.00LINEZOLID (ZYVOX) 600MG TABLETS $20.00LINEZOLID 600MG/300ML IV RTU (ZYVOX) $625.00LINT ROLLER REFILL $25.00LIPASE $97.00LIPID ASSOCIATED SIALIC ACID $79.00LIPID PANEL $123.00LIPOPROFILE $72.00LIPOPROTEIN a $266.00LIPOPROTEIN ELECTROPHORESIS $67.00LIPOSYN 500 $76.00LISINOPRIL 10 MG TAB (PRINIVIL) $6.00LISINOPRIL 20MG TABLET (PRINIVIL) $6.00LISINOPRIL 5 MG TABLET (PRINIVIL) $6.00LISTERIA ANTIBODY $173.00LITHIUM $116.00LITHIUM $150.00LITHIUM CARBONATE 300 MG TABLET $6.00LITHIUM CARBONATE ER 450 MG TABLET $4.00LIVER BX $246.00LIVER KIDNEY MICOSOMAL ANTIBODIES $93.00L-LYSINE 500MG TABLET $4.00LNG T TUBE SILCONE 12MM $123.00LOCKING SCRW 3.5MM $377.00LOCKING SCRW 3.5MMx20 $377.00LOCKING SCRW 3.5MMx24 $377.00LODINE XL 500MG $10.00LONG ARM CAST $182.00LONG ARM CAST $182.00LONG ARM SPLINT $130.00LONG ARM SPLINT $173.00LONG ARM SPLINT $173.00LONG LEG CAST $226.00

LONG LEG CAST $226.00LONG LEG SPLINT $164.00LONG LEG SPLINT $129.00LONG LEG SPLINT $129.00LOOP-LOCK COCKUP SPLINT LT,SM $46.00LOPERAMIDE 1MG/5ML (IMODIUM) $14.00LOPERAMIDE 2 MG CAPSULE (IMODIUM) $6.00LOPRO SCRW 3.5 MMX 18MM $411.00LOPRO SCRW 3.5 MMX 20MM $411.00LOPRO SCRW 3.5 MMX 26MM $411.00LOPRO SCRW 4.0MM 16MM $411.00LOPRO SCRW 4.0MM 32MM $411.00LO-PRO SCRW 4X28 $150.00LORABID (LORACEF) 250 MG/5ML SUSP $120.00LORACARBEF 100 MG SUSP (LORABID) $72.00LORACARBEF 200 MG CAP (LORABID) $17.00LORATADINE 10MG/10ML SYRUP (CLARITIN) $93.00LORAZEPAM 0.5 MG TABLETS (ATIVAN) $11.00LORAZEPAM 1MG TABLET (ATIVAN) $11.00LORAZepam 2 MG VIAL (ATIVAN) $23.00LORAZEPAM 2MG/1ML ORAL CONCENTRATE $60.00LOSARTAN POT/HCTZ 50-12.5MG TAB (HYZAAR) $6.00LOSARTAN POTASSIUM 25MG TABLET (COZAAR) $7.00LOSARTAN POTASSIUM 50 MG TABLET (COZAAR) $8.00LOTRISONE (CLOTRIMAZOLE/BETAMETHA)LOTION $95.00LOVASTATIN 20 MG TABLET (MEVACOR) $13.00LOVENOX (ENOXAPARIN) 60 MG SYRINGE $184.00LOVENOX (ENOXAPARIN) 100 MG SYRINGE $306.00LOVENOX (ENOXAPARIN) 120MG SYRINGE $246.00LOVENOX DOSE (MLWH) $314.00LOW RISK FOR RETINOPATHY (NO EVIDENCE OF $1.00LRG FROG FINGER SPLINT $24.00L-S RATIO W/PG $55.00LTA 360 KIT $71.00LUKEN TUBE $32.00LUMBAR TAP DIAGNOSTIC $299.00LUMIGAN (BIMATOPROST) 0.01% OPTH SOLN $121.00LUNESTA 2MG TABLET (ESZOPICLONE) $40.00LUPRON DEPO KIT $1,071.00LUPRON DEPOT (LEUPROLIDE) 3.75 MG KIT $1,020.00LUPRON DEPOT KIT(LEUPROLIDE) 11.25 MG $1,691.00LUPRON DEPOT KIT(LEUPROLIDE) 22.5 MG $3,860.00LUPRON DEPOT KIT(LEUPROLIDE) 30 MG KIT $7,794.00LUPRON DEPOT KIT(LEUPROLIDE) 7.5 MG $2,703.00LUPRON DEPOT KIT(LEUPROLIDE) 7.5 MG KI $1,188.00LUPUS ANTICOAGUAN/PHOSPHOLIPIS AB (4) $76.00LUPUS ANTICOAGULAN/PHOSPHOLIPID AB (B) $80.00

LUPUS ANTICOAGULAN/PHOSPHOLIPID AB (D) $76.00LUPUS ANTICOAGULANT $85.00LUPUS ANTICOAGULANT/CARDIOLIPIN $104.00LUPUS ANTICOAGULATION $269.00LUTEINIZING HORMONE $120.00LUTEINIZING HORMONE $105.00LYME DISEASE IGG $88.00LYME DISEASE IGM $86.00LYNC 2.3 MM DRILL BIT $509.00LYNC, M-O $1,846.00LYNCH SYNDROME $204.00LYRICA 50MG CAPSULE (PREGABALIN) $25.00LYRICA 75MG CAPSULE (PREGABALIN) $25.00LYSIS OF ADHESIONS $1,519.00LYSIS OF ADHESIONS $1,519.00LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARI $1,595.00LYSIS OF LABIAL ADHESIONS $270.00LYSIS OF LABIAL ADHESIONS $270.00LYSOSOMAL ENZYME SCREEN $92.00MA60AC IOL ALCON $164.00MACROPROLACTIN $121.00MAG-AL PLUS 200/200/20MG(MAG/ALUM/SIMET) $1.00MAG-AL PLUS ES 400/400/40MG/5ML 30ML $1.00MAGNA-DRAPE $68.00MAGNESIA CITRATE (CITRATE MAG) 10 OZ SOL $8.00MAGNESIUM $78.00MAGNESIUM GLUCONATE(MAG.GLUFC)500MG TAB $4.00MAGNESIUM OXIDE (MAGNESIUM) 400 MG TAB $6.00MAGNESIUM RBC $78.00MAGNESIUM SULF 4G/100ML ST WATER **OB** $46.00MAGNESIUM SULF/ST WATER 20GM/500ML**OB** $40.00MAGNESIUM SULFATE (MAG SULF)50% 10 GM $26.00MAGNESIUM SULFATE (MAG.SULF) 50% 25GM $39.00MAGNESIUM SULFATE 1G/100ML D5W PREMIX $45.00MAGNESIUM SULFATE 1G/100ML NS $55.00MAGNESIUM SULFATE 2G/100ML NS $80.00MAGNESIUM SULFATE 2G/50ML $43.00MAGNESIUM SULFATE 50 % VIAL 5 GM $26.00MAGNESIUM SULFATE 50% 1G/2ML $30.00MAGNESIUM SULFATE 50% 5GM SYRINGE $26.00MAGNESIUM URINE $75.00MALARIA SMEAR $67.00MAMMOL BREAST CREAM $18.00MAMMOL BREAST CREAM $51.00MANDIBLE COMPLETE-MIN 4V $216.00MANDIBULAR FRACTURE $1,237.00MANGANESE PLASMA $93.00

MANIFOLD EXTENSION SET $68.00MANIP FNG JNT;ANESTH EA JNT $521.00MANIP FNG JNT;ANESTH;EA JNT $521.00MANIPULATION SPINE REQUIRING ANESTHESIA $1,878.00MANIPULATION SPINE REQUIRING ANESTHESIA $327.00MANNITOL (MANNITOL 25%) 12.5 GM VIAL $32.00MANNITOL20% 500ML (OSMITROL ) $64.00MANUAL SCREENING LIQUID-BASED PAP $57.00MARCAINE/EPI (BUPIVACAINE/EPINEPH) 0.75% $49.00MARINOL (DRONABINOL) 2.5MG CAPSULE $28.00MARLIX MESH 10X14 26X26 $556.00MARSHAL MARCH $1,206.00MARSUPIAL BARTHOLIN GLAND $327.00MARSUPIAL BARTHOLIN GLAND $327.00MARSUPIALIZATION OF BARTHOLIN'S GLAND CY $349.00MASIMO DISPOSIBLE EAR PROBE $120.00MASK 02 PED $14.00MASK ADULT $5.00MASK ADULT 02 $9.00MASK ADULT AEROSOL $8.00MASK AEROSOL ADULT DO NOT USE $9.00MASK AEROSOL PED $9.00MASK BIPAP LARGE $150.00MASK BIPAP MEDIUM $150.00MASK BIPAP SMAILL $150.00MASK CPAP HARNESS ADULT $41.00MASK FACE INFANT $14.00MASK ISOLATION $29.00MASK JEMSDALE ADULT O2/CO2 $40.00MASK MULTIVENT PEDS $20.00MASK NON REBREATH $7.00MASK NON REBREATH $28.00MASK PEDIATRIC NON REBREATHER $21.00MASK PEDS AEROSOL $8.00MASK PEDS OXYGEN $11.00MASK PERFORMANCE BIPAP LARGE $164.00MASK PERFORMANCE BIPAP MEDIUM $164.00MASK PERFORMANCE PIPAP SMALL $164.00MASK RE BREATHING $14.00MASK REBREATHER $12.00MASK VENTURI $35.00MASK, CUSH, SM, SZ 0, NEONATE $10.00MAST, SIMPLE, COMP. $2,249.00MASTECTOMY FOR GYNECOMASTIA $916.00MASTECTOMY PARTIAL $1,626.00MASTECTOMY SIMPLE $1,030.00MASTECTOMY SIMPLE COMPLETE $1,126.00

MASTECTOMY, MOD. RADICAL, INC AUX LYNPH $2,494.00MASTECTOMY, MOD. RADICAL, INC AUX LYNPH $2,494.00MASTISOL 15ML BOTTLE UNIT $60.00MASTISOL LIQUID ADHESIVE 2/3ML $12.00MASTOID MIN 3V/SIDE $381.00MASTOTOMY WITH EXPLORATION OR DRAINAGE O $1,010.00MASTOTOMY/INCISION OF BREAST LESION $1,010.00MASTOTOMY/INCISION OF BREAST LESION $1,010.00MATERNIT GENOME $893.00MATTRESS CUSHION SOFCARE $165.00MATULANE (PROCARBAZINE) 50 MG. CAPS $6.00MAXAIRE (PIRBUTEROL) AUTOHALER 400 INHAL $119.00MAXCORE 14GA NEEDLE $308.00MAXCORE 16GA NEEDLE $308.00MAXCORE 18GA NEEDLE $308.00MAXORB EXTRA AG+(SILVER)4X4.75 $37.00MD OPEN TOE HEEL BOOT $59.00MECHOL $132.00MECLIZINE 25 MG TABLET (ANTIVERT) $10.00MECLOFENAMATE 50 MG CAP $10.00MECONIUM ASPIRATOR $31.00MED FROG FINGER SPLINT $24.00MEDI FLOW LENS $242.00MEDICAL NUTRITION THERAPY GROUP $87.00MEDICAL NUTRITION TX PER 15 MIN $39.00MEDICAL SERVICES AFTER HRS $30.00MEDI-DRAW FEE $22.00MEDI-FLOW LENS $102.00MEDIHONEY DRESSING MEDHNY CALCM ALGT $29.31MEDIHONEY GEL IN TUBE 1.5 OZ $72.00MEDIHONEY HYDROGEL 4.3 X 4.3 $33.00MEDIHONEY HYDROGEL GEL 2.4 X 2.4 $26.00MEDIPORE +PAD 15X15 $9.00MEDIPORE +PAD 2X2 3/4 $5.00MEDIPORE +PAD 3.5X4 $5.00MEDIPORE +PAD 3.5X8 $8.00MEDROXYPROGESTERONE 10MG TABLET(PROVERA) $10.00MEDROXYPROGESTERONE 150MG (DEPO-PROVERA) $81.00MEDROXYPROGESTERONE 2.5 MG TAB (PROVERA) $6.00MEGESTROL ORAL SUSP 40MG/1ML 10ML $10.00MEGESTROL (MEGACE) 20 MG TABS $7.00MELATONIN $248.00MELLARIL $61.00MELLARIL (THIORIDAZINE CONC) 30MG/ML $80.00MELOXICAM 7.5 MG TABLET (MOBIC) $6.00MEMANTINE (NAMENDA) 10MG TABLET $34.00MEMANTINE XR 7MG CAPSULE (NAMENDA) $70.00

MENACTRA (MENINGOC ACY) VACCINE $192.00MENACTRA/MENVEO $178.54MENISCAL ROOT REPAIR PK-ORTHO $3,383.00MENOMUNE $191.01MENOMUNE 0.05MG(MENINGOCOCCAL VACC) $195.00MENVEO (MENINGOCOCCAL) VACCINE SDV $157.00MEPHOBARBITO $95.00MEPHYTON (PHYTONADIONE) 5MG TABLET $74.00MEPILEX 4X4 10X10 DRESSING $26.00MEPILEX BORDER LITE 7.5 X 7.5 3 X 3 $7.00MEPILEX BORDER LITE 7.5 X 7.5 6X6 $7.00MEPILEX DRESSING 4X10 ORTHO $38.00MEPILEX DRESSING 4X12 ORTHO $38.00MEPIVACAINE 1% VIAL (POLOCAINE) $62.00MEPIVACAINE 1.5% VIAL (POLOCAINE) $75.00MERCURY LEVEL $153.00MERCURY LEVEL URINE $58.00MEROPENEM 1G VIAL (MERREM) $192.00MEROPENEM 1GM/NS 50ML *DUPLEX* $103.00MEROPENEM 500MG VIAL (MERREM) $58.00MERSELENE 10-0 $173.00MESH ELLIPSE ECHO $2,578.00MESH ELLIPSE ECHO $2,578.00MESH LG LEFT 3D MAX 4 X6 $553.00MESH LG RIGHT 3D MAX 4 X6 $553.00MESH MED LEFT 3D MAX 3 X5 $539.00MESH MED RIGHT 3D MAX 3 X5 $539.00MESH PARIETEX 9CM $665.00MESH- SELF FIX PROGRIP $925.00MESH VENTRALIGHT 11.4CM CIRCLE $905.00MESH VENTRALIGHT 15X20CM ELIPSE $1,385.00MESH VENTRALIGHT 20X25CM $2,846.00MESNA 1G/10ML VIAL $18.00METACARPAL FX W/MANIP $1,210.00METACARPAL FX W/MANIP $1,152.00METACARPAL FX W/MANIP $1,152.00METACARPAL FX W/O MANIP $498.00METACARPAL FX W/O MANIP $424.00METACARPAL FX W/O MANIP $455.00METACARPEL SPLINT PAD LG LEFT $15.00METACARPEL SPLINT PAD LG RIGHT $15.00METACARPEL SPLINT PAD MD LEFT $15.00METACARPEL SPLINT PAD MD RIGHT $15.00METACARPEL SPLINT PAD SM LEFT $15.00METACARPEL SPLINT PAD SM RIGHT $15.00METAL CHARGE $142.00METAMUCIL (PSYLLIUM FIBER) PACKETS $6.00

METANEPHRINES 24-HOUR URINE $150.00METANEPHRINES PLASMA $382.00METANEPHRINES RANDOM URINE $78.00METAPROTERANOL 10MG TABLET (ALUPENT) $4.00METAPROTERENOL 10MG/5ML 2 OZ $10.00METAPROTERENOL 200/INH NEB 650MCG $109.00METAPROTERENOL INHAL SOLN 5% $79.00METATARSAL FX $459.00MetFORmin 500 MG TAB (GLUCOPHAGE) $6.00MetFORmin 850 MG TABS (GLUCOPHAGE) $8.00METHIMAZOLE 10MG TABLET (TAPAZOLE) $4.00METHIMAZOLE 5MG TAB (TAPAZOLE) $6.00METHOCARBAMOL 500MG TABLET (ROBAXIN) $6.00METHOTREXATE $100.00METHOTREXATE 2.5 MG TAB $10.00METHOTREXATE 50 MG VIAL $65.00METHOTREXATE SODIUM $50.00METHYLDOPA 250 MG TABLET $6.00METHYLDOPA/HCTZ 250/25 TABLET (ALDORIL) $4.00METHYLDOPA/HCTZ 250MG/15 TABLET $4.00METHYLDOPATE 250MG/5ML VIAL $57.00METHYLENE BLUE 0.5% 50MG/5ML AMP $754.00METHYLENE BLUE 1% 10ML SINGLE DOSE VIAL $102.00METHYLERGONOVINE 0.2 MG TAB (METHERGINE) $101.00METHYLERGONOVINE 0.2MG (METHERGINE) $28.00METHYLMALONIC ACID SERUM $144.00METHYLMALONIC ACID URINE $141.00METHYLPHENIDATE 5MG TABLET (RITALIN) $4.00METHYLPREDNISOLONE (DEPO-MEDROL) 40MG $11.00METHYLPREDNISOLONE (SOLU-MEDROL): 125MG $32.00METHYLPREDNISOLONE 1GM (SOLU-MEDROL) $120.00METHYLPREDNISOLONE 4MG TABLET (MEDROL) $11.00METHYLPREDNISOLONE 500MG (SOLU-MEDROL) $86.00METHYLPREDNISOLONE 80MG (DEPO-MEDROL) $71.00METHYLTETRAHYDROFOLATE REDUCRTASE $45.00METHYLTETRAHYDROFOLATE REDUCTASE $195.00METOCLOPRAMIDE 1 MG/ML 2 0Z (REGLAN) $15.00METOCLOPRAMIDE 10 MG TAB (REGLAN) $6.00METOCLOPRAMIDE 10MG/2ML INJ (REGLAN) $18.00METOCLOPRAMIDE 5 MG TABLET (REGLAN) $4.00METOLAZONE 2.5 MG TABLET (ZAROXOLYN) $8.00METOLAZONE 5MG TABLET (ZAROXOLYN) $8.00METOPROLOL 25 MG TABLET (LOPRESSOR) $6.00METOPROLOL 50 MG TABLET (LOPRESSOR) $6.00METOPROLOL 5MG/5ML VIAL (LOPRESSOR) $18.00METOPROLOL SUCC XL 100 MG TABLET $16.00METOPROLOL SUCC XL 25MG TAB (TOPROL XL) $10.00

METRONIDAZOLE 0.75% VAG 70G GEL $57.00MetroNIDAZOLE 250 MG TAB (FLAGYL) $8.00MetroNIDAZOLE 500MG PREMIX (FLAGYL) $16.00MEXILETINE 150 MG CAP $8.00MIACALCIN (CALCITONIN) NASAL 2 ML VIAL $165.00MICAFUNGIN (MYCAMINE) 100MG VIAL $420.00MICONAZOLE 100 MG VAG SUPP (MONISTAT-7) $64.00MICONAZOLE CREAM C APPLIC (MONISTAT-7) $13.00MICONAZOLE NITRATE CREAM 2% $13.00MICRO EXTENSION SET 1.2MIC $19.00MICRO OSCILLATOR BLADE $111.00MICRO OSCILLATOR BLADE 10 X 35 X 0.4MM $36.00MICRO SAGITTAL BLADE 10X18.5X0.4mm FINE $68.00MICRO SURG SCALPEL 15 $17.00MICRO SURG SCALPEL 32 MM $179.00MICRO-ACUTRAK 2 DRILL $915.00MICRO-ACUTRAK 2 DRILL LONG $1,020.00MICRO-ACUTRAK BONE SCREW 14MM $1,428.00MICROALBUMIN 24 HOUR $78.00MICROALBUMIN URINE $78.00MICROALBUMIN URINE $78.00MICRODRIP $8.00MICROSCOPIC EXAM PARASITE $119.00MICROSOMAL ANTIBODY $93.00MICROSURG SCAPEL 715 $17.00MICROSURG SCAPEL 762B $49.00MICRO-VOLUME 36 IV EXTENSION SET $16.00MIDAZOLAM 1 MG/ML 2ML VIAL (VERSED) $11.00MIDAZOLAM 10 MG /2 ML VIAL (VERSED) $15.00MIDAZOLAM 2 MG/ML SYRUP 1ML (VERSED) $2.00MIDAZOLAM 2 MG/ML SYRUP 5ML (VERSED) $20.00MIDAZOLAM 50MG/10ML *USE FOR DRIP ONLY* $35.00MIDAZOLAM 5MG/ML 1ML VIAL (VERSED) $12.00MIDODRINE 5MG TABLET (PROAMATINE) $9.00MIGRANAL NASAL (DIHYDROERGOTAMINE MES)NS $219.00MILITARY TOURNIQUET $174.00MILK OF MAGNESIA (MAG HYDROX) 30ML $7.00MILK OF MAGNESIA (MAG HYOX) MOM TAB $4.00MINERAL OIL (MINERAL OIL) 16 OZ HEAVY $11.00MINERAL OIL (MINERAL OIL) 6 OZ $10.00MINERAL OIL LIGHT TOPICAL 25ML $10.00MINERAL OIL/PET CREAM 4 OZ (EUCERIN) $16.00MINI ACUTRACK 2 DRILL $916.00MINI ACUTRACK 2 DRILL LONG $1,017.00MINOR PACK $223.00MINOR SET $24.00MINOXIDIL 10MG TABLET (LONITEN) $7.00

MINOXIDIL 2.5MG TABLET (LONITEN) $6.00MIOCHOL W/STERI-TA SOLN 1:100 $109.00MIOSTAT (CARBACHOL) 0.01% 1.5 ML SOLN $144.00MIRAPEX 0.125MG (PRAMIPEXOLE) TABLET $12.00MIRENA INTRAUTERINE (LEVONORGESTREL) $1,060.00MIRTAZAPINE 15MG TABLET (REMERON) $6.00MISOPROSTOL 100 MCG TABLET (CYTOTEC) $27.00MITOCHONDRIAL AB $203.00MITOMYCIN (MITOMYCIN) 5 MG SDV $439.00MITOXANTRONE 20MG VIAL (NOVANTRONE) $1,535.00MIVACRON (MIVACURIUM) 20MG/10ML VIAL $79.00MM 2D DIAG MAMM-BLT 77066 $312.00MM 2D DIAG MAMM-UNILAT LT $287.00MM 2D DIAG MAMM-UNILAT RT $287.00MM 2D POST CLIP PLCMNT-LT $287.00MM 2D POST CLIP PLCMNT-RT $287.00MM 2D SCREENING MAMM BLT W/CAD $312.00MM 2D SCREENING UNI LT BREAST $53.00MM 2D SCREENING UNI RT BREAST $53.00MM 3D DIAG MAMM UNILAT-LT $287.00MM 3D DIAG MAMM UNILAT-RT $287.00MM 3D DIAG MAMM-BLT $365.00MM 3D SCREENING BLT BREAST TOMOSYNTHESIS $53.00MM 3D SCREENING BLT BREAST TOMOSYNTHESIS $312.00MM 3D SCREENING UNI LT BREAST $287.00MM 3D SCREENING UNI RT BREAST $287.00MM CAN SHRT THREAD SCREW 2.5X11MM $675.00MM CAN SHRT THREAD SCREW 2.5X14MM $675.00MM CCW SCREENING MAMM $261.00MM DIAG DIGITAL BREAST TOMOSYNTHESIS $261.00MMR II VACCINE (MEASLES,MUMPS,RUBELLA) $91.00MMR PROFILE $26.00MMR-II $87.31MMR-II $87.31MODAFINIL 100MG TABLET (PROVIGIL) $17.00MODULAR CATHCART BALL 60MM OD $750.00MODURETIC (AMILORIDE/HCTZ) 5/50 MG TAB $5.00MOEXIPRIL HCL 15 MG TAB (UNIVASC) $4.00MOISTURE TRAP $43.00MOMETASONE 0.1% OINT 15G (ELOCON) $13.00MOMETASONE TWISTHALER 110MCG (ASMANEX) $186.00MONARC SF HAMMOCK $1,674.00MONITOR VENOUS PRESSURE $67.00MONITORING KIT $96.00MONO TEST $112.00MONSEL'S PASTE (FERRIC SUBSULFATE) $45.00MONTELUKAST (SINGULAIR) 5 MG TAB $10.00

MONTELUKAST SOD (SINGULAIR) 10MG TABLET $8.00MONTGOMERY STRAP $11.00MONUROL (FOSFOMYCIN TRMETHAMINE) 3GM PKT $161.00MOORE PROSETHESI 44MM $1,162.00MOORE PROSHESIS 45MM $1,063.00MOORE PROST 42 MM $1,162.00MOORE PROST 44 MM' $1,063.00MOORE PROSTHESIS 1 5/8 $1,162.00MOORE PROSTHESIS 1.5 $1,162.00MOORE PROSTHESIS 41 124 MM $1,162.00MOORE PROSTHESIS 41MM $1,162.00MOORE PROSTHESIS 43MM $1,063.00MOORE PROSTHESIS 45MM $1,063.00MOORE PROSTHESIS 47MM $1,162.00MOORE PROSTHESIS 47MM $1,063.00MOORE PROSTHESIS 48MM 1 7/8 $1,162.00MOORE PROSTHESIS 49MM 15/16 $1,162.00MOORE PROSTHESIS 51MM $1,162.00MOORE PROSTHESIS 54 MM $1,162.00MOORE PROSTHESIS 54MM $1,162.00MOORE PROSTHESIS 55MM $1,162.00MOORE PROSTHESIS 6 INCH $1,162.00MOORE PROTHESIS 46MM $1,162.00MORPHINE $282.00MORPHINE 150MG/30ML PCA CARTRIDGE $110.00MORphine 30MG/30ML PCA CARTRIDGE $46.00MORPHINE 0.5MG/ML 10ML AMP (DURAMORPH) $70.00MORphine 10 MG TUBEX $19.00MORPHINE 15MGML 20ML MDV $70.00MORPHINE 1MG/ML 10 ML AMP (ASTRAMORPH) $72.00MORPHINE 20MG/ML ORAL SOLN BOTTLE $24.00MORphine 2MG TUBEX $18.00MORphine 4MG TUBEX $18.00MORphine CONC 10MG/0.5ML ORAL SOLN SYR $16.00MORphine ER 15 MG TABLET (MS CONTIN) $11.00MORphine ER 30 MG TABLET (MS CONTIN) $12.00MORphine IMMEDIATE RELEASE 30MG TABLETS $5.00MORPHINE ORAL SOLN 20MG/ML BOTTLE $60.00MORphine PF 10MG/10 ML AMP (ASTRAMORPH) $25.00MORPHINE PF 1MG/ML 10ML AMP (DURAMORPH) $12.00MORphine PF 5MG/10 ML AMP (ASTRAMORPH) $77.00MORPhine SULF 15MG IMMEDIATE RELEASE TAB $11.00MORphine SULF CONCEN 5MG/0.25ML ORAL SOL $9.00MORphine SULF CONCENT20MG/ML ORAL SOLN $11.00MORPHINE SULFATE ORAL SOLUTION 10MG/5ML $38.00MORRHUATE (SODIUM MORRHUATE) 5% VIAL $212.00MOSS GASTROSTOMY TUBE 18 FR $805.00

MOST RECENT HEMOGLOBIN A1C (HBA1C) LEVEL $1.00MOST RECENT HEMOGLOBIN A1C LEVEL GREATER $1.00MOTION FLUOROSCOPY/SWALLOW SP $201.00MOTION FLUOROSCOPY/SWALLOW SP $201.00MOVANTIK (NALOXEGOL) 12.5MG TABLET $65.00MOXIFLOXACIN AVELOX() 400MG/250ML NS RTU $250.00MOXIFLOXACIN OPTH SOLN 0.5%3ML (VIGAMOX) $94.00MPL MUTATION ANALYSIS $1,124.00MRA ABD W/ OR W/O CONTRAST $1,548.00MRA CHEST W & W/O CONTRAST $2,011.00MRA HEAD W&W/O CONTRAST $3,440.00MRA HEAD W/O CONTRAST $2,348.00MRA LOWER EXT W/ OR W/O CONTRAST LT $1,551.00MRA LOWER EXT W/ OR W/O CONTRAST RT $1,551.00MRA NECK/CAROTIDS W & W/O CONTRAST $2,133.00MRA NECK/CAROTIDS W/O CONTRAST $1,841.00MRA NECK/CAROTIDS WITH CONTRAST $1,952.00MRA PELVIS W OR W/O CONTRAST $1,337.00MRA SPINAL CANAL W OR W/O CONTRAST $2,302.00MRA UPPER EXTR W/ OR W/O CONTRAST LT $1,684.00MRA UPPER EXTR W/ OR W/O CONTRAST RT $1,684.00MRI ABD W & W/O CONTRAST $2,746.00MRI ABD W/O CONTRAST $1,445.00MRI ABD WITH CONTRAST $1,599.00MRI BRAIN W & W/O CONTRAST $2,991.00MRI BRAIN W/O CONTRAST $1,987.00MRI BRAIN WITH CONTRAST $2,355.00MRI C SPINE W & W/O CONTRAST $2,991.00MRI C SPINE W/O CONTRAST $1,666.00MRI C SPINE WITH CONTRAST $2,363.00MRI CHEST W/O & W CONTRAST $1,749.00MRI CHEST W/O CONTRAST $1,443.00MRI L SPINE W & W/O CONTRAST $2,462.00MRI L SPINE W/O CONTRAST $2,304.00MRI L SPINE WITH CONTRAST $1,987.00MRI LOWER EXT JOINT W/ & W/O CONTRAST LT $2,130.00MRI LOWER EXT JOINT W/ & W/O CONTRAST RT $2,130.00MRI LOWER EXT JOINT W/CONTRAST LT $2,352.00MRI LOWER EXT JOINT W/CONTRAST RT $2,352.00MRI LOWER EXT JOINT W/O LT $2,075.00MRI LOWER EXT JOINT W/O RT $2,075.00MRI LOWER EXT NON JOINT W & W/O LT $2,117.00MRI LOWER EXT NON JOINT W & W/O RT $2,117.00MRI LOWER EXTR NON JOINT W/CONTRAST LT $1,684.00MRI LOWER EXTR NON JOINT W/CONTRAST RT $1,684.00MRI LOWER EXTR NON JOINT W/O CONTRAST LT $1,200.00MRI LOWER EXTR NON JOINT W/O CONTRAST RT $1,200.00

MRI NECK ORBIT FACE W & W/O CONTRAST $2,117.00MRI NECK ORBIT FACE W/CONTRAST $1,118.00MRI NECK ORBIT FACE W/O $1,841.00MRI PELVIS FETUS $1,005.00MRI PELVIS FETUS ADDL GEST $552.00MRI PELVIS W & W/O CONTRAST $2,272.00MRI PELVIS W/O CONTRAST $1,969.00MRI PELVIS WITH CONTRAST $2,188.00MRI T SPINE W & W/O CONTRAST $2,462.00MRI T SPINE W/O CONTRAST $2,091.00MRI T SPINE WITH CONTRAST $2,355.00MRI UPPER EXT JOINT W/ & W/O CONTRAST LT $2,270.00MRI UPPER EXT JOINT W/ & W/O CONTRAST RT $2,270.00MRI UPPER EXT JOINT W/CONTRAST LT $2,315.00MRI UPPER EXT JOINT W/CONTRAST RT $2,315.00MRI UPPER EXT JOINT W/O CONTRAST LT $1,944.00MRI UPPER EXT JOINT W/O CONTRAST RT $1,944.00MRI UPPER EXT NON JOINT W & W/O LT $2,130.00MRI UPPER EXT NON JOINT W & W/O RT $2,130.00MRI UPPER EXT NON JOINT W/ CONTRAST LT $1,565.00MRI UPPER EXT NON JOINT W/ CONTRAST RT $1,565.00MRI UPPER EXT NON JOINT W/O CONTRAST LT $1,974.00MRI UPPER EXT NON JOINT W/O CONTRAST RT $1,974.00MRSA NASAL SWAB BY PCR $166.00MRSA/MSSA - WOUND BY PCR $240.00MUCIN CLOT TEST $38.00MUCUS 10FR TRAP $38.00MUCUS 6FR TRAP $28.00MUCUS 8FR TRAP $28.00MULTI BOOT REGULAR $396.00MULTI-LENGHT SILHOUETTE 6FRX22-30CM $520.00MULTIPLE VIT DROPS (POLY-VI-SOL) $13.00MULTITRACE-5 (TRACE METALS) 1 ML VIAL $43.00MULTIVITAMIN ORAL LIQUID 5ML $8.00MULTIVITAMIN W/ MINERALS TAB (OCUVITE) $6.00MULTIVITAMIN W/MINERAL TAB (THERAGRAN M) $1.00MUMPS IGG AB $69.00MUMPS IGM AB $69.00MUMPS SKIN TEST (MUMPS ANTIGEN) 10 TEST $25.00MUMPS VIRAL CULTURE 186150 $499.00MUPIROCIN OINTMENT 22GRAMS (BACTROBAN) $18.00MUPIROCIN TOP CREAM 15 GM (BACTROBAN) $130.00MUPIROCIN TOP OINT 30 GM (BACTROBAN) $90.00MUSHROOM CUP VAC $209.00MUSTARGEN (MECHLORETHAMINE) 10 MG VIAL $79.00MVI PED PAK (MULTIVITAMINS) VIAL $70.00MX60 ENVISTA POSTERIOR CHAMBER IOL B&L $72.00

MYCOBACTERIUM DETECTION $176.00MYCOPHENYLATE $277.00MYCOPLASMA PNEUMONIA ANTIBODIES IGG IGM $50.00MYELOGRAM 2 OR MORE REGIONS $1,634.00MYELOGRAM CERVICAL $1,634.00MYELOGRAM LUBOSACRAL $1,634.00MYELOGRAM THORACIC $1,634.00MYELOPEROXIDASE ANTIBODY $99.00MYFORTIC 180MG DR TABLET (MYCOPHENOLIC) $33.00MYLANTA (CALCIUM CARB/MAG CARB) GELCAP $4.00MYOGLOBIN $89.00MYOGLOBIN URINE $91.00MYOMECTOMY EXC OF FIBRIOD TUMOR UTERUS $1,377.00MYOMECTOMY VAG METHOD $1,377.00MYOMECTOMY, E $1,563.00MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) $1,642.00MYOSURE DISPOSABLE DEVICE $1,150.00MYRINGOTOMY KNIFE DISP $78.00N BLOCK INJ, CELIAC PELUS $519.00N BLOCK INJ, CELIAC PELUS $519.00N BLOCK INJ, ILIO-ING/HYPOGI $296.00N BLOCK INJ, ILIO-ING/HYPOGI $296.00N BLOCK INJ, INTERCOST, MLT $667.00N BLOCK INJ, INTERCOST, MLT $667.00N BLOCK INJ, INTERCOST, SNG $435.00N BLOCK INJ, INTERCOST, SNG $435.00N BLOCK INJ, OCCIPITAL $240.00N BLOCK INJ, OCCIPITAL $240.00N BLOCK INJ, SCIATIC SNG/POPLITEAL $331.00N BLOCK INJ, SCIATIC SNG/POPLITEAL $331.00N BLOCK, LUMBAR/THORACIC $557.00N BLOCK, LUMBAR/THORACIC $557.00N BLOCK, STELLATE GANGLION $402.00N BLOCK, STELLATE GANGLION $402.00NABUMETONE 500 MG TABLET (RELAFEN) $7.00NABUMETONE 750 MG TABLET (RELAFEN) $10.00NADOLOL 40MG TABLET (CORGARD) $7.00NAFCILLIN 1 GM VIAL (NAFCIL) $59.00NAFCILLIN 250 MG CAP $9.00NAIL/AVULSION OF NAIL SIMPLE 1 $199.00NALBUPHINE 100 MG VIAL (NUBAIN) $142.00NALOXONE 0.4 MG/ML 1ML (NARCAN) $65.00NALOXONE HCL INJECTION 2MG/2ML $111.00NAPHCON EYE (NAPHAZOLINE) DROPS 15 ML $59.00NAPHCON-A OPHT (NAPHAZOLINE/ANTAZOLINE) $41.00NAPROXEN 250 MG TABLET (NAPROSYN) $6.00NAPROXEN 275 MG TAB $4.00

NAPROXEN 375 MG TABLET (NAPROSYN) $4.00NAPROXEN 500MG TABLET $6.00NAPROXYN 220MG GELCAP (ALEVE) $5.00NARCAN (NALOXONE) 0.02 MG AMP $55.00NARCAN (NALOXONE) 1 MG MDV $435.00NAROPIN (ROPIVACAINE) 0.2% 200ML VIAL $391.00NAROPIN 0.2% (2MG/ML)/100ML(ROPIVACAINE) $233.00NAROPIN 0.5% 5MG/ML 30ML (ROPIVACAINE) $27.00NAROPIN 1% 20ML AMP (ROPIVACAINE) $68.00NARROW ACP PLATE $258.00NARROW ACP PLATE 8 HOLE $240.00NAS SIN ENDO SURG W/BIO POLY $569.00NAS SIN ENDO SURG W/BIO POLY $569.00NASACORT (TRIAMCINOLONE) NASAL INHALER $128.00NASAL C02 SAMPLING $140.00NASAL CANNULA EAR CUSHION $4.00NASAL CANNULA LARGE $138.12NASAL CANNULA MEDIUM $138.12NASAL MASK LG $62.00NASAL MASK MED $62.00NASAL OROGASTRIC W/TUBE PLMT $100.00NASAL SPLINT $28.00NASAL TIP LITTLE SUCKERS $14.00NASAL TRACH TUBE 5.5 $31.00NASAL TRACH TUBE 7.0 $31.00NASAL TRACH TUBE 7.5 $31.00NASALCROM NASAL SOLN (CROMOLYN) 4% $213.00NASH FIBROSURE $82.00NASO- OR ORO-GASTRIC TUBE PLACEMENT, REQ $100.00NASONEX (MOMETASONE) SPRAY 50MCG $230.00NASOPHARYGEAL AIRWAY 20FR. $41.00NASOPHARYGEAL AIRWAY 22FR. $41.00NASOPHARYGEAL AIRWAY 24FR. $41.00NASOPHARYGEAL AIRWAY 26FR. $41.00NASOPHARYGEAL AIRWAY 28FR. $18.00NASOPHARYGEAL AIRWAY 30FR. $41.00NASOPHARYGEAL AIRWAY 32FR. $41.00NASOPHARYGEAL AIRWAY 34FR. $41.00NASOPHARYGEAL AIRWAY 36FR. $18.00NASOTRACHEAL ASPIRATION CLEARANCE AIRWAY $131.00NATRECOR (NESIRITIDE) 1.5MG VIAL $2,312.00NAVICULAR FX $1,078.00NCS 4.6 DRILL $460.00NEBULIZER AEROMIST $150.00NEBULIZER T HAND $5.00NEBUPENT (PENTAMIDINE) 300MG VIAL INHAL $257.00NECC PAK $18.00

NEEDLE BIO ANY SITE $794.00NEEDLE BIOPSY W/FLUORO GUIDANCE $2,587.00NEEDLE BIOPSY W/FLUORO GUIDANCE $209.00NEEDLE BIOPSY W/US GUIDANCE $2,587.00NEEDLE BIOPSY W/US GUIDANCE $810.00NEEDLE INSUL 21GX4-STIMUPLEX $42.00NEEDLE INSUL 22GX2-STIMUPLEX $42.00NEEDLE JAMSHIDI BONE MARROW BIOPSY $141.00NEEDLE MAGNETIC COUNTER $24.00NEFAZODONE HCL 100 MG TABLET (SERZONE) $9.00NEO HINGED KNEE SUPP 2XLG $46.00NEO HINGED KNEE SUPP 3XLG $46.00NEO HINGED KNEE SUPP LG $46.00NEO HINGED KNEE SUPP MED $46.00NEO HINGED KNEE SUPP SMALL $46.00NEO HINGED KNEE SUPP XLG $46.00NEO KNIFE 11 $33.00NEO/BACIT/POLYMX OPTH OINT (NEOSPORIN) $90.00NEO/POLY/BACT OPHT OINT (NEOTRICIN HC) $16.00NEO/POLY/HC 10ML OTIC SOLN (CORTISPORIN) $50.00NEO/POLY/POLMIX OPTH OINT (NEOSPORIN) $31.00NEOM/POLYMIX/HC OTIC SOLN (NEOSPORIN) $43.00NEOMY/BACIT/POLY 15 GM OINT (NEOSPORIN) $14.00NEOMYC/POLYM/HC 10ML OTIC SUSP (CORTISP) $79.00NEOMYCIN SULFATE 500 MG TABLET $4.00NEOMYCIN/BACITRACIN/POLMIXIN OINT PACKET $6.00NEONATAL TIP (TRUSIGNAL SPO20 $87.00NEOSTIGMINE 10MG VIAL (PROSTIGMIN) $352.00NEOSTIGMINE 1MG/ML 3ML SYR (PROSTIGMIN) $213.00NEO-SYNEPHRINE (PHENYLEPHRINE) 0.5% SPR $20.00NEOTECH N204 LITTLE SUCKER $11.00NEOTECH N205 LITTLE SUCKER $11.00NEOTECH SUCTION CADDY $10.00NEPHROSTOMY SET 14 FR $583.00NEPHRO-VITE (B & C COMPLEX) TABLET $6.00NERVE BLOCK OTHER PERIPHERAL $221.00NERVE BLOCK OTHER PERIPHERAL $221.00NERVE BLOCK OTHER PERIPHERAL $221.00NERVE BLOCK OTHER PERIPHERAL $187.00NERVE FOAM POSITIONER W STRAP $14.00NESACAINE-MPF 2% 20ML SDV $135.00NEULASTA 6MG/0.6ML SYR (PEGFILGRASTIM) $8,291.00NEULASTA 6MG/0.6ML ONPRO (PEGFILGRASTIM) $9,218.00NEULASTA(PEGFILGRASTIM)6MG/0.6ML 340B $6,311.00NEUMEGA (OPRELVEKIN) 5 MG VIAL $696.00NEUPOGEN (FILGRASTIM) 300 MCG VIAL $679.00NEUPOGEN (FILGRASTIM) 480 MCG VIAL $1,202.00

NEURON SPECIFIC ENOLASE $104.00NEUROPLASTY MEDIUM CARPAL TUNNEL $706.00NEUROPLASTY MEDIUM CARPAL TUNNEL $706.00NEUROPLASTY/ULNAR NERVE AT WRIST $694.00NEUROPLASTY/ULNAR NERVE AT WRIST $694.00NEUROSTIMULATOR $11,775.00NEURP MAJOR PRPH NRV ARM/LEG OPN OTH $1,270.00NEW PATIENT LEVEL 3 OV $209.00NEW PT NHOME VISIT DETAILED HIGH COMP $395.00NEW PT NHOME VISIT DETAILED HIGH COMP $395.00NEW PT NHOME VISIT DETAILED MOD COMP $309.00NEW PT NHOME VISIT DETAILED MOD COMPL $309.00NEW SKIN (FLEX COLLOID) SPRAY 1 OZ $19.00NEWBORN DRUG TESTING $437.00NEXIS CANNULATED DRILL BIT 3.2 $546.00NEXIS COMPRESS SCREW $772.00NEXIS COMPRESS SCREW 2.3MMX10MM $773.00NEXIS COMPRESS SCREW 2.3MMX12MM $773.00NEXIS COMPRESS SCREW 2.3MMX14MM $773.00NEXIS COMPRESS SCREW 2.3MMX16MM $773.00NEXIS COMPRESS SCREW 2.3MMX18MM $773.00NEXIS COMPRESS SCREW 2.3MMX28MM $773.00NEXIS COMPRESS SCREW 2.9MMX34MM $773.00NEXIS COMPRESS SCREW 4MMX30MM $964.00NEXIS COMPRESS SCREW 4MMX40MM $661.00NEXIS LOCKING SCREW 3MMX20MM $582.00NEXIS LOCKING SCREW 3MMX22MM $470.00NEXIS NON LOCKING SCREW 3MMX22MM $471.00NEXIS NON LOCKING SCREW 3MMX24MM $471.00NEXIS NON LOCKING SCREW 3MMX28MM $471.00NEXIS REAMER 2.75 $546.00NEXIS REAMER 3.7 $546.00NEXIUM (ESOMEPRAZOLE SOD) I.V. 40MG $107.00NEXIUM (ESOMEPRAZOLE) 20MG CAP $22.00NEXIUM 5MG DR ORAL SUSP (ESOMEPRAZOLE) $57.00NEXPLANON (ETONOGESTREL IMPLANT) 68MG $994.00NIACIN (VITAMIN B-3) 100MG TAB $5.00NIACIN (VITAMIN B-3) 50 MG TAB $4.00NIACIN T.R.(VITAMIN B-3) 250 MG CAP $4.00NIACIN T.R.(VITAMIN B-3) 500 MG TAB $6.00NIASPAN ER 500MG (NIACIN) TABLETS $29.00NICARDIPINE 25MG/240ML NS $73.00NICARDIPINE HCL 20MG CAPSULE $4.00NICORETTE NICOTINE POLARILEX 4MG GUM $6.00NICOTINE 14 MG PATCH (NICODERM CQ) $11.00NICOTINE 15 MG PATCH (NICOTROL) $21.00NICOTINE CQ 21 MG PATCH (NICODERM) $11.00

NICOTINE CQ 7 MG PATCH (NICODERM) $17.00NICOTINE METABOLITE $70.00NIFEDIPINE 10 MG CAPSULE (PROCARDIA) $12.00NIFEDIPINE ER 30 MG TABLET (PROCARDIA) $11.00NIFEDIPINE XL 60 MG TABLET (PROCARDIA) $14.00NIFEREX-150(POLYSAC.IRON COMPLEX) CAP $4.00NIGHT SPLINT SMALL $75.00NILANDRON (NILUTAMIDE) 50 MG TABS $15.00NIMBEX (CISATRACURIUM) 2 MG/ML VIAL $276.00NIMODIPINE 30MG CAPSULE $63.00NISOLDIPINE 10 MG TABLET (SULAR) $6.00NITRO BLUE TETRAZOL $271.00NITRO DRIP 50MG/250ML D5W* (200MCG/ML) $61.00NITRO DRIP 50MG/250ML N.S. (200MCG/ML) $61.00NITRO IV PUMP SET OL $83.00NITRO PREMIX DRIP 50MG/250ML D5W RTU $34.00NITROFURANTOIN 100 MG CAP (MACRODANTIN) $9.00NITROFURANTOIN 50 MG CAP (MACRODANTIN) $5.00NITROFURANTOIN MAC 100MG CAP (MACROBID) $19.00NITROGLYCERIN (NITROGLYC) 0.2 MG/H PATCH $10.00NITROGLYCERIN 0.1 MG/H PATCH $7.00NITROGLYCERIN 0.2 MG/H PATCH $7.00NITROGLYCERIN 0.3 MG/H PATCH $10.00NITROGLYCERIN 0.4 MG/H PATCH $7.00NITROGLYCERIN 0.6 MG/H PATCH $9.00NITROGLYCERIN 2% OINT 60 GM TUBE $68.00NITROGLYCERIN 2% OINT UD $11.00NITROGLYCERIN 50 MG VIAL $31.00NITROGLYCERIN E.R. 6.5 MG CAPSULE $4.00NITROGLYCERIN E.R.(NTG) 2.5 MG CAP $4.00NITROGLYCERIN E.R.(NTG) 9 MG CAP $4.00NITROGLYCERIN SET $33.00NITROPRESS (NITROPRUSSIDE) 50 MG VIAL $325.00NITROSTAT S.L. 0.4MG TABLET $8.00NIX COMPLETE LICE TREATMENT (PERMETHRIN) $44.00NIZATIDINE 150MG CAPSULE $10.00NM ADENOSINE $912.00NM AMINO PAGLINE $912.00NM BONE SCAN 3 PHASE $1,301.00NM BONE SCAN EXTREMITY ONLY - LEFT $586.00NM BONE SCAN EXTREMITY ONLY - RIGHT $586.00NM BONE SCAN LIMITED AREA $586.00NM BONE SCAN WHOLE BODY $1,027.00NM GA-67 PER MCI $71.00NM GASTRIC EMPTYING STUDY $887.00NM H I D A SCAN DELAYS $1,064.00NM H I D A WITH EJECTION $1,166.00

NM KINEVAC INJ 5MCG $394.00NM LIVER SPLEEN SCAN $867.00NM MECKELS SCAN $1,043.00NM NUCLEAR CYSTO GRAM $809.00NM NUCLEAR VOIDING CYSTOGRAM $877.00NM PERSANTINE $1,027.00NM PULMONARY PERFUSION IMAGING $598.00NM RENAL FLO SCAN $994.00NM RENAL FLOW/FUNCTION W/DRUG $818.00NM RENAL FLOW/FUNCTION W/O DRUG $618.00NM TC 99 M HDP PER VIAL $128.00NM TC 99 M MAG 3 PER VIAL $223.00NM TC 99 M HEPATOLITE PER VIAL $186.00NM TC 99 M LABELED RBC'S PER TEST $173.00NM TC 99 M MEDRONATE DOSE $99.00NM TC 99 M SULFUR COLLOID PER VIAL $87.00NM TC 99M - CHOLETEC PER VIAL $203.00NM TC 99M - DTPA PER VIAL $77.00NM TC 99M - MAA -PER VIAL $77.00NM TC 99M MEBROFENIN $113.00NM VENT AND PERFUSION LUNG SCAN $1,059.00NM VENTILATION LUNG SCAN $753.00NMR LIPOPROFILE $224.00NO FILTER CONTINU FLO $24.00NO FILTER CONTINU-FLO 2 LUER VALVES 113 $31.00NO FILTER CONTINU-FLO 3 LUER VALVES 110 $21.00NON BIODEGRADABLE DRUG REINSER REMOVAL $419.00NON DEHP EXT SET 0.22 MICRON $25.00NON GEL PAD $31.00NON STRESS TEST $287.00NON VENTED TUR SET $28.00NOREPINEPHRINE INJ 4 MG VIAL (LEVOPHED) $86.00NOREPINEPHRINE LEVEL $103.00NORFLEX 60 MG $28.00NORFLOXACIN 400 MG TABLET (NOROXIN) $15.00NORGESTIMATE/ETHINYL ESTRA 0.25MG/35MCG $8.00NORMAL SALINE (HYPERTONIC) 3% $15.00NORMAL SALINE : 250ML ADD-V $15.00NORMAL SALINE 1000ML W/20MEQ KCL $31.00NORMAL SALINE ADV 100 $33.00NORMAL SALINE: 50ML $16.00NOROVIRUS DETECTION REAL TIME PCR $273.00NORPACE $100.00NORPORT POWER PORT $545.00NORTRIPTYLINE 25 MG CAP (PAMELOR) $6.00NORTRIPTYLINE 50 MG CAPSULE (PAMELOR) $10.00NOVA KWIRE .9 $164.00

NOVA KWIRE .9 $164.00NOVA KWIRE 1.4 $164.00NOVA KWIRE 1.6 $212.00NOVA NEXIS 1.75 DRILL BIT $509.00NOVA NEXIS 2.75 REAMER $546.00NOVA NEXIS 2.9 18MM $773.00NOVA NEXIS 2.9MM L20MM SCREW $772.00NOVASURE DEVICE $1,375.00NOVOLIN 70/30 INNOLET (NPH/REG) 100U/ML $89.00NOVOLIN N INNOLET (INSULIN NPH) 100U/ML $89.00NOVOLIN R INNOLET (INSULIN REG) 100U/ML $89.00NOVOLOG FLEXPEN (INSULIN ASPART)100U/1ML $167.00N-TELOPEPTIDE CROSS LINKS $134.00NUBAIN 20 MG $42.00NUCALA 100MG/1ML SYRINGE $5,650.00NUCLEOTIDASE $71.00NUPERCAINAL $29.00NURSE VISIT $53.00NURSE VISIT $105.00NURSE VISIT $50.00NURSE VISIT $53.00NURSING FACIL $237.00NURSING FACILITY $237.00NYSTATIN 500,000U TABLET (MYCOSTATIN) $4.00NYSTATIN SUSP 100,000U/1ML 5ML UD $6.00NYSTATIN TOP OINT 15G (MYCOSTATIN) $25.00NYSTATIN TOP POWDER 15 GM (MYCOSTATIN) $41.00NYSTATIN/TRIAMCINAL 60 GM (MYCOLOG II) $128.00O P SITE 5 1/2 X 10 $35.00O P SITE 5.5 X 4 $24.00OBSERVATION CARE DISC $139.00OBSERVATION CARE DISC $139.00OBSERVATION INPT CARE LEVEL THREE $498.00OBSERVATION INPT CARE LEVEL THREE $498.00OBSERVATION INPT CARE LEVEL TWO $412.00OBSERVATON INPT CARE LEVEL ONE $320.00OBSERVATON INPT CARE LEVEL ONE $320.00OBSERVATON INPT CARE LEVEL TWO $412.00OBSTETRIC PANEL $597.00OCCLUDE FALLOPIAN TUBE(S) $802.00OCCLUDE FALLOPIAN TUBE(S) $802.00OCCULT BLOOD 1 SAMPLE $104.00OCCULT BLOOD 3 SAMPLE $137.00OCCULT BLOOD, OTHER SOURCE $61.00OCREVUS 30MG/ML(OCRELIZUMAB) 300MG/10ML $24,425.00OCTAGAM (IMMUNE GLOBULIN) 5% 10GRAMS $3,448.00OCTAGAM 5% 10G (HUMAN IMMUNE GLOBULIN) $1,713.00

OCTAGAM 5% 5GM (HUMAN IMMUNE GLOBULIN) $1,024.00OCTREOTIDE 1000MCG/ML 5ML (SANDOSTATIN) $5.00OCTREOTIDE 1250MCG/250ML NS $2,106.00OCTREOTIDE 50MCG/ML VIAL(SANDOSTATIN) $26.00OFFICE CONSULT LEVEL 4 $280.00OFFICE CONSULT LEVEL 4 $280.00OFFICE CONSULT LEVEL 5 $480.00OFFICE CONSULT LEVEL 5 $480.00OFFICE EMERGENCY CARE $36.00OFLOXACIN 200 MG TABLET (FLOXIN) $17.00OFLOXACIN OPHTH SOLN 0.3% 5ML $9.00OLANZAPINE $205.00OLIGOCLONAL BANDING $142.00OLIVE TIP CATH 8 FR $234.00OMACOR (OMEGA-3 ACID ETHYL ESTER) 1G CAP $7.00OMENTECTOMY/EPIPLOECTOMY $2,234.00OMENTECTOMY/EPIPLOECTOMY $2,234.00OMEPRAZOLE 20 MG CAPSULE (PRILOSEC) $6.00ONDANSETRON 40MG/20ML VIAL (ZOFRAN) $22.00ONDANSETRON 4MG TABLET (ZOFRAN) $7.00ONDANSETRON 4MG/2ML VIAL (ZOFRAN) $13.00ONDANSETRON 4MG/5ML 50ML VIAL (ZOFRAN) $576.00ONDANSETRON 4MG/5ML ORAL SOLUTION $12.00ONDANSETRON 8 MG TAB (ZOFRAN) $98.00ONDANSETRON ODT 4 MG TAB (ZOFRAN) $9.00ONE A DAY 50 PLUS (MULTI VIT/MINERALS) $5.00ONE-THIRD TUBULAR LCP PLATES, W/COLLAR $492.00OnQ 7.5 SOAKER LINES $444.00ON-Q C-BLOC W/SEL FLOW DUAL PUMP 600ML $796.00ON-Q FIXED FLOW 2ML/HR PUMP 270ML $426.00ON-Q FIXED FLOW 4ML/HR PUMP 550ML FILL $460.00OOPHORECTOMY, PARTIAL OR TOTAL, UNILATER $1,292.00OP SITE 14 CM X 25 CM $46.00OPDIVO (NIVOLUMAB) 100MG/10ML VIAL $5,609.00OPDIVO (NIVOLUMAB) 40MG/4ML VIAL $4,497.00OPDIVO 240MG/24ML (NIVOLUMAB) VIAL $11,063.00OPEN HEMORRHOIDECTOMY $348.00OPEN INGUINAL MESH $700.00OPEN TX AC DISLOC ACUTE/CHRONIC $986.00OPEN TX AC DISLOC ACUTE/CHRONIC $986.00OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION $1,815.00OPEN TX BIMAL $1,610.00OPEN TX BIMALLEOLAR ANKLE FX W/WO FIX $1,610.00OPEN TX DISTA $1,006.00OPEN TX DISTAL RADIUS INTRA-ARTIC FX W/F $2,093.00OPEN TX DISTAL RADIUS INTRA-ARTIC FX W/F $2,093.00OPEN TX DISTAL RADIUS W/FX 2 FRAGMENTS $1,806.00

OPEN TX DISTAL RADIUS W/FX 2 FRAGMENTS $1,806.00OPEN TX DISTAL RADIUS W/FX 3/> FRA $2,645.00OPEN TX DISTAL RADIUS W/FX 3/> FRAG $2,645.00OPEN TX FEMUR $2,017.00OPEN TX FEMUR $1,865.00OPEN TX FEMUR FX PROX END FIX PROSTH $2,017.00OPEN TX HUMERAL FX $1,911.00OPEN TX HUMERAL FX $1,911.00OPEN TX MC FX SNGL W W/O INTRL/EXTRL $1,130.00OPEN TX MC FX SNGL W W/O INTRL/EXTRL $1,130.00OPEN TX OF RA $1,340.00OPEN TX OF RADIAL SHAFT FX W/WO FIX $1,605.00OPEN TX PATELLAR FX W/FIX PATELLECT $1,327.00OPEN TX PATELLAR FX W/FIX PATELLECT $1,327.00OPEN TX TROCHANTERIC FX $1,697.00OPEN TX TROCHANTERIC FX $1,697.00OPEN TX ULNAR FX PROX END W/WO FIX $1,361.00OPEN TX ULNAR FX PROX END W/WO FIX $1,361.00OPEN TX ULNAR SHAFT FX W/WO FIX $1,200.00OPEN TX ULNAR STYLOID FX $1,543.00OPEN TX ULNAR STYLOID FX $1,543.00OPERATING RM 01-15 MIN $926.00OPERATING RM 106-120 MIN $3,291.00OPERATING RM 121-135 MIN $4,410.00OPERATING RM 136-150 MIN $4,826.00OPERATING RM 151-165 MIN $5,236.00OPERATING RM 16-30 MIN $1,281.00OPERATING RM 166-180 MIN $4,719.00OPERATING RM 181-195 MIN $4,347.00OPERATING RM 196-210 MIN $3,672.00OPERATING RM 211-225 MIN $4,729.00OPERATING RM 226-240 MIN $5,296.00OPERATING RM 241-255 MIN $5,310.00OPERATING RM 256-270 MIN $5,888.00OPERATING RM 271-285 MIN $7,111.00OPERATING RM 286-300 MIN $6,489.00OPERATING RM 31-45 MIN $1,634.00OPERATING RM 46-60 MIN $2,360.00OPERATING RM 61-75 MIN $2,780.00OPERATING RM 76-90 MIN $3,190.00OPERATING RM 91-105 MIN $3,590.00OPERATING RM PER MIN AFTER 300 MIN $23.00OPERATIVE CHOLANGIOGRAM $343.00OPERATIVE UPPER GI ENDOSCOPY $513.00OPERATIVE UPPER GI ENDOSCOPY $513.00OPIATE/OXY CONFIRMATION $110.00OPIUM TINCTURE USP $5.00

OPPENHEIMER WRIST BRACE MEDIUM $179.00OPSITE 17 3/4X21 5/8 $63.00OPSITE 5.5 X 4 $10.00OPSITE DESSING 6X11 $28.00OPSITE DRESSING 4 X 5 1/2 $7.00OPTIC NERVE HEAD EVALUATION PERFORMED (E $1.00OPTIFLOW JR 2 S $300.00OPTIFLOW JR 2 XS $300.00OPTIFLOW JR INFANT CANNULA $260.00OPTIFLOW JUNIOR TUBING KIT $289.00OPTIRAY 320 (IOVERSOL) 320 $1,666.00OPTIVAC KIT 80 GR- ORTHO $490.00OPTIVAC KIT DOUBLE MIX-ORTHO $490.00OPTP SILVER AXIS STANDARD ROLLER 36X3 $73.00OR BONE WAX/AMP $14.00OR CAUTERY TIP CLEANER $10.00OR COMPRESSION LAG SCREW $204.00OR INJECTION SITE $9.00OR KERATOME BLADE $31.00OR KIRCHNNER WIRE 045X9 $30.00OR KIRCHNNER WIRE 062X9 $11.00OR LOCAL PACK $34.00OR LONG ARM CAST SYN $296.00OR LONG LEG CAST SYN $331.00OR MAJOR LAP PACK $37.00OR MARLEX SUTURE $34.00OR MINI BLADE $13.00OR OPTIC PACK $168.00OR PROCEEDURE 10 $176.00OR SCLERATOME $31.00OR SHORT ARM CAST SYN $224.00OR SHORT LEG CAST SYN $224.00OR SILVER CLIP $10.00OR SMITH PETE CANN NAIL $158.00OR STEINMAN PIN $270.00OR SUT 751903 DEXON 70 $34.00OR SUT NUROLON $34.00OR SUTURE SURGILION $34.00OR TWIST DRILL $51.00ORAL SPEECH DEVICE EVAL $250.00ORAL SPEECH DEVICE EVAL $250.00ORAL SUCTION MACHINE $17.00ORBITS MIN 4V $207.00ORCHIECTOMY/SIMPLE $580.00ORCHIECTOMY/SIMPLE $580.00ORENCIA 250MG VIAL (ABATACEPT) $1,084.00ORGANIC ACID ANALYSIS URINE $288.00

ORGANISM ID URINE $119.00ORGANISM IDENTIFICATION $142.00ORGANISM SENSITIVITY $149.00ORIMUNE (POLIOMYELEITIS VAC LIVE ORAL) $615.00ORPHENADRINE 100MG TABLET (NORFLEX) $9.00ORPHENADRINE 60 MG (NORFLEX) $79.00ORTHO (APPLICATOR) INTRODUCER $17.00ORTHO (DIAPHRAGM) 70 MM ALL-FLEX $105.00ORTHOSORB PIN KIT 2.0MM $1,768.00ORTHOTIC MGMT AND TRAINING $92.00ORTHOTIC MGMT AND TRAINING $92.00ORTHOTIC MGMT AND TRAINING $92.00ORTHOVISC INJECTION SOLUTION 15MG/1ML $1,140.00ORVAC REPLACEMENT BOTTLE $61.00OSELTAMIVIR (TAMIFLU) 6MG/ML ORAL SUSP $124.00OSELTAMIVIR (TAMIFLU) 75 MG CAP $80.00OSMOLALITY SERUM $47.00OSMOLALITY URINE $47.00OSTEOCALCIN $150.00OSTEOPATH MANIPULATIVE TX 1-2 BODY REGIO $61.00OSTEOPATH MANIPULATIVE TX 3-4 BODY REGIO $92.00OSTEOPATH MANIPULATIVE TX 5-6 BODY REGIO $121.00OSTEOPATH MANIPULATIVE TX 7-8 BODY REGIO $151.00OSTEOPATH MANIPULATIVE TX 9-10 BODY REGI $182.00OSTEOSYNTHESIS PLATE $1,732.00OSTOMY POUCH- SPECIAL ORDER $313.00OT COGNITIVE THERAPY EA ADDL 15 MIN-GO $72.00OT COGNITIVE THERAPY EA ADDL 15 MIN-GOKX $72.00OT COGNITIVE THERAPY INITIAL 15 MIN-GO $72.00OT COGNITIVE THERAPY INITIAL 15 MIN-GOKX $72.00OT COMMUNITY/WORK REINTEG TRAINING $76.00OT COMMUNITY/WORK REINTEG TRAINING $76.00OT COMMUNITY/WORK REINTEG TRAINING $76.00OT COMMUNITY/WORK REINTEG TRAINING $76.00OT CONTRAST BATH/15 MIN $57.00OT CONTRAST BATH/15 MIN $57.00OT DYNAMIC FINGER SPLINTING $72.00OT DYNAMIC SHORT ARM SPLINT(FOREARM/HAND $120.00OT E STIM UNATTENDED $55.00OT E STIM UNATTENDED $55.00OT ELEC STIM $59.00OT E-STIM ATTENDED/15 MIN $67.00OT E-STIM ATTENDED/15 MIN $67.00OT E-STIM ATTENDED/15 MIN $67.00OT E-STIM ATTENDED/15 MIN $67.00OT EVALUATION $213.00OT EVALUATION HIGH COMPLEXITY $213.00

OT EVALUATION HIGH COMPLEXITY $213.00OT EVALUATION LOW COMPLEXITY $213.00OT EVALUATION LOW COMPLEXITY $213.00OT EVALUATION MODERATE COMPLEXITY $213.00OT EVALUATION MODERATE COMPLEXITY $213.00OT GROUP OT $32.00OT GROUP OT $32.00OT GROUP OT $32.00OT GROUP OT $32.00OT IONTOPHORESIS/15 MIN $67.00OT IONTOPHORESIS/15 MIN $67.00OT MANUAL THERAPY/15 MIN $94.00OT MANUAL THERAPY/15 MIN $94.00OT MANUAL THERAPY/15 MIN $94.00OT MANUAL THERAPY/15 MIN $94.00OT NEUROMUSCULAR REEDUCATION $91.00OT NEUROMUSCULAR REEDUCATION $91.00OT NEUROMUSCULAR REEDUCATION $91.00OT NEUROMUSCULAR REEDUCATION $91.00OT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00OT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00OT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00OT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00OT ORTHOTIC MANAGEMENT INITIAL $96.00OT ORTHOTIC MANAGEMENT INITIAL $96.00OT ORTHOTIC MANAGEMENT INITIAL $96.00OT ORTHOTIC MANAGEMENT INITIAL $96.00OT PARAFFIN BATH $40.00OT PARAFFIN BATH $40.00OT PARAFFIN BATH $40.00OT PARAFFIN BATH $40.00OT PHYSICAL PERFORMANCE TEST $82.00OT PHYSICAL PERFORMANCE TEST $82.00OT PHYSICAL PERFORMANCE TEST $82.00OT PHYSICAL PERFORMANCE TEST $82.00OT PROSTHETIC MGMT INITIAL/15 MIN $82.00OT PROSTHETIC MGMT INITIAL/15 MIN $82.00OT PROSTHETIC MGMT INITIAL/15 MIN $82.00OT PROSTHETIC MGMT INITIAL/15 MIN $82.00OT RE EVALUATION $132.00OT RE EVALUATION $132.00OT RE EVALUATION $132.00OT RE EVALUATION $132.00OT RE EVALUATION $132.00OT SELF CARE/HOME MANAGEMENT ADL $88.00OT SELF CARE/HOME MANAGEMENT ADL $88.00OT SELF CARE/HOME MANAGEMENT ADL $88.00

OT SELF CARE/HOME MANAGEMENT ADL $88.00OT STATIC FINGER SPLINT $48.00OT STATIC SHORT ARM SPLINT $117.00OT STRAPPING HAND OR FINGER $70.00OT STRAPPING WRIST OR ELBOW $70.00OT THERAPEUTIC ACTIVITY/15 MIN $76.00OT THERAPEUTIC ACTIVITY/15 MIN $76.00OT THERAPEUTIC ACTIVITY/15 MIN $76.00OT THERAPEUTIC ACTIVITY/15 MIN $76.00OT THERAPEUTIC EX'S/15 MIN $75.00OT THERAPEUTIC EX'S/15 MIN $75.00OT THERAPEUTIC EX'S/15 MIN $75.00OT THERAPEUTIC EX'S/15 MIN $75.00OT ULTRASOUND/15 MIN $74.00OT ULTRASOUND/15 MIN $74.00OT WHEELCHAIR MANAGEMENT $77.00OT WHEELCHAIR MANAGEMENT $77.00OT WHEELCHAIR MANAGEMENT $77.00OT WHEELCHAIR MANAGEMENT $77.00OTHER LYSIS OF PERITONEAL ADHESIONS $2,423.00OTHER LYSIS OF PERITONEAL ADHESIONS $2,423.00OTRIVIN PED (XYLOMETAZOLINE).05% NASAL $30.00OVA & PARASITE EXAMINATION $54.00OVAL BELT 1 $67.00OVAL OLYMPUS SNARE $119.00OVARIAN CANCER MONITORING $288.00OVARIAN CYSTECTOMY, UNILATERAL OR BILATE $1,329.00OXACILLIN (OXACILL/NA) 500 MG CAPSULE $4.00OXACILLIN 1 GM VIAL $45.00OXACILLIN 2 GM VIAL $116.00OXACILLIN 2GM/NS+ 100ML $66.00OXALATE URINE $89.00OXALIPLATIN 100MG/20ML VIAL (ELOXATIN) $334.00OXALIPLATIN 200MG/40ML VIAL (ELOXATIN) $8,095.00OXALIPLATIN 50MG/10ML (ELOXATIN) $190.00OXAZEPAM 10 MG CAPSULE (SERAX) $6.00OXAZEPAM 15 MG CAPSULE (SERAX) $8.00OXCARBAZEPINE $95.00OXCARBAZEPINE 150MG TABLET (TRILEPTAL) $6.00OXIMETRY CHECK $79.00OXIMETRY CK OVERNIGHT (CONT) $270.00OXIMETRY NEONATAL-ADULT SENSOR GE $83.00OXIMETRY STUDY FOR HOME O2 $197.00OXISENSOR ADULT D25L $60.00OXISENSOR ADULT MAX-A DISPOSABLE $51.00OXISENSOR ADULT NASAL SENSOR $66.00OXISENSOR NEO/NATAL N25 $66.00

OXISENSOR PEDS MAS1860 $54.00OXYBUTYNIN 10MG ER TABLET (DITROPAN XL) $14.00OXYBUTYNIN 3.9MG/24HR PATCH (OXYTROL) $54.00OXYBUTYNIN 5 MG TABLET (DITROPAN) $6.00OXYBUTYNIN XL 5MG TABLET (DITROPAN XL) $15.00OXYCODONE $110.00OXYCODONE 15MG IMMEDIATE RELEASE TABLET $11.00OXYCODONE 5 MG IMMEDIATE RELEASE TABLET $11.00OXYCODONE AND METABOLITE $160.00OXYCODONE/APAP 5/325MG TABLET (PERCOCET) $11.00OXYCODONE/ASA TABLET (PERCODAN) $6.00OXYCONTIN CR (OXYCODONE) 10 MG TABLET $16.00OXYCONTIN CR (OXYCODONE) 20 MG TABLET $21.00OXYCONTIN CR (OXYCODONE) 40 MG TABLET $22.00OXYFAST (OXYCODONE)ORAL SOL 20MG/ML 30ML $214.00OXYGEN 10 LT/HR $25.00OXYGEN 1-4 LT /HOUR $11.00OXYGEN 5-9 LT/HOUR $19.00OXYGEN TUBING $8.00OXYGEN TUBING $11.00OXYMASK/ KID $26.00OXYMASK/ ADULT $24.00OXYMASK/ ADULT LARGE 7FT $26.17OXYMETAZOLINE 0.05% NASAL SPRAY $7.00OXYTOCIN 10 UNIT VIAL (PITOCIN) $11.00OXYTOCIN 10UNITS/LR 1000ML PREMIX $61.00OXYTOCIN 30 UNITS/ NS 500ML PREMIX $70.00OYSTER SHELL CALCIUM 250MG/D TAB (OSCAL) $4.00OYSTER SHELL CALCIUM 500MG/D TAB (OSCAL) $5.00PACEMAKER EVAL DUAL LEAD $153.00PACEMAKER EVAL ICD DUAL LEAD $209.00PACEMAKER EVAL ICD MULTI LEAD $233.00PACEMAKER EVAL ICD SINGLE LEAD $195.00PACEMAKER EVAL LOOP RECORDER $109.00PACEMAKER EVAL MULTI LEAD $178.00PACEMAKER EVAL SINGLE LEAD $124.00PACEMAKER, EXTERNAL $36.00PACIFIER NEBULIZER PEDI $29.00PACING LEADS CARDIAC CATH BIPOLAR $563.00PACK STERILE BASIN $8.00PACK STERILE LINEN BURN $31.00PACLITAXEL 100 MG VIAL (TAXOL) $1.00PACLITAXEL 30 MG VIAL (TAXOL) $1.00PACLITAXEL 300 MG MDV (TAXOL) $1.00PAD ABD 8X 7.5 $5.00PAD THERAPEUTIC 26 X18 WARMING $26.00PALONOSETRON (ALOXI) 0.05MG/ML 5ML $220.00

PAMIDRONATE 30MG/VIAL (AREDIA) $250.00pANCA $89.00PANCREATITIS FULL GENE SEQUENCING $2,396.00PANCRELIPASE CAP DR 5000U-17000U-24000U $11.00PANCRELIPASE CAPS 4500U (PANCREASE EC) $4.00PANNICULECTOMY $326.00PANTOPRAZOLE SODIUM (PROTONIX IV) 40MG $38.00PAP & HPV HR $132.00PAP & HPV REFLEX 16 & 18 $132.00PAP SMEAR COLLECTION $71.00PAP W/CT/NG R $133.00PAP W/CT/NG R $60.00PAP W/CT/NG REFLEX HPV ASC-U $119.00PAP W/CT/NG/HR-HPV REFLEX 16 & 18 $69.00PAP W/CT/NG/TRICH/HR-HPV REFLEX 16 & 18 $69.00PAP W/CT/NG/TRICH/HSV/HR-HPV 16 & 18 $69.00PAP W/CT/NG/TV/HSV/HR/HPV REFLEX16 & 18 $32.00PAP W/HPV CT NG $3.00PAPAIN/UREA OINT 30 GM (ACCUZYME) $283.00PAPAVERINE (PAPAVERINE) 300 MG VIAL $44.00PAPIN/UREA OINT 30 GM (PANAFIL) $283.00PAP-THIN PREP $109.00PARAGARD T380A INTRAUTERINE DEVICE $857.00PARANEOPLASTIC AUTO ANTIBODY PANEL $229.00PARANEOPLASTIC AUTO ANTIBODY PANEL $209.00PARASITE PANEL-STOOL $53.00PARASITE SCREEN $88.00PARATHYROID HORMONE WITH CA $74.00PARATHYROID HORMONE-RELATED PEPTITDE $83.00PARAVAGINAL DEFECT REPAIR (INCLUDING REP $2,048.00PARAVAGINAL DEFECT REPAIR/OPEN ABD APPRO $2,048.00PARING/CUTTING BEN HYPERK LESION, SINGLE $58.00PARING/CUTTING BEN HYPERK LESION, SINGLE $58.00PARING/CUTTING BEN LES; 2-4 LES $88.00PARING/CUTTING BEN LES; 2-4 LES $88.00PAROXETINE 20 MG TABLET (PAXIL) $6.00PARTIAL AMPUTATION OF TOE $944.00PARTIAL AMPUTATION OF TOE $944.00PARTIAL COLECTOMY $3,081.00PARTIAL EXCISION (CRATERIZATION, SAUCERI $1,122.00PARTIAL EXCISION DISTAL PHALANX FINGER $1,122.00PARTIAL EXCISION DISTAL PHALANX FINGER $1,122.00PARTIAL EXCISION OF LIP $1,120.00PARTIAL EXCISION OF LIP $1,120.00PARTIAL REMOVAL OF FINGER BONE $1,122.00PARTIAL REMOVAL OF RECTUM $1,455.00PARTIAL REMOVAL OF TOE $1,223.00

PARTIAL REMOVAL OF TOE $1,223.00PARTIAL REMOVAL OF TOE $1,026.00PARTIAL REMOVAL OF TOE $1,223.00PARTIAL THYROIDECTOMY $1,589.00PARVO B19 IGM $96.00PARVO-B19 ANTIBODY IGG $98.00PATANOL (OLOPATIDINE) OPTH SOLN 0.1% 5ML $194.00PATELLA SZ29 8MM-ORTHO $1,580.00PATELLA TRI-PEG-ORTHO $6,299.00PATH - FLOW CYTOMETRY BONE MARROW $229.00PATH85060 $107.00PATH88104 $212.00PATH88108 $200.00PATH88160 $200.00PATH88161 $207.00PATH88162 $270.00PATH88173 $360.00PATH88184 $137.00PATH88185 $396.00PATH88185 $89.00PATH88189 $269.00PATH88271 $95.00PATH88274 $296.00PATH88275 $157.00PATH88300 $103.00PATH88302 $189.00PATH88304 $242.00PATH88305 $305.00PATH88307 $717.00PATH88309 $977.00PATH88311 $93.00PATH88312 $317.00PATH88313 $273.00PATH88341 $305.00PATH88342 $345.00PATH88342 $246.00PATH88360 $383.00PATH88361 $683.00PATH88377 $1,180.00PATH88381 $853.00PATH-BONE MARROW ASPIRATION $139.00PATH-BONE MARROW BIOPSY $332.00PATIENT PROGRAMMER $1,515.00PATIENT SCREENED FOR DEPRESSION (SUD) $1.00PATIENT SCREENED FOR TOBACCO USE AND REC $1.00PCA SET W/INJECTION $67.00PEAK FLOW METER $61.00

PEAK PLASMA BLADE-ORTHO $498.00PED TRACHEOSTOMY TUBE 3.5 CUFFLESS $226.00PEDIACARE (D-METHORPH/P-EPHED/CPM) COUGH $23.00PEDIARIX $117.69PEDIARIX (HEP B/DTAP/POLIO) PREFILL SYR $118.00PEDIATRIC URINE METER 5 FR FOLEY KIT $75.00PEDIATRIC/ADULT AIRWAY ADAPTER $43.00PEDIAZOLE (ERTHYOM/SULFISOX) 200 MG SUSP $54.00PEDIOTIC OTIC (NEO/POLY) SUSP 7.5 ML $79.00PEDS INTUBATING STYLET $28.00PEDVAXHIB (HAEMOPH B POLYSAC CONJ) $38.00PEEP VALUE DISPOSABLE $43.00PEG SMOOTH 2.0 X 24MM $439.00PEG SMOOTH 2.0MM 20MM $435.00PEG SMOOTH 2.0MM X 14MM LONG $445.00PEG TUBE PLACEMENT SMALL BOWEL ENDOSCOPY $648.00PELVIC SLING/BINDER $405.00PELVIC TRACT KIT $191.00PELVIC TRACTION BELT38 42 $85.00PELVIC/BREAST EXAM $86.00PELVIS W/HIP UNILATERAL 1 VIEW $167.00PEN SURGICAL $2.50PENCAN SPINAL TRAY 25GX3.5 W/INTRODUCER $81.00PENCIL SMOKE EVACUATOR $174.00PENICILLIN 125 MG/5ML SUSP 100ML $11.00PENICILLIN 250 MG/5ML SUSPENSION 100ML $12.00PENICILLIN G POT. (PENICILLIN G POT) 5MU $46.00PENICILLIN G POT. (PENICILLIN G) 1MU $32.00PENICILLIN V POT 250 MG TABLET $6.00PENROSE DRAIN 1 X 8 $6.00PENROSE DRAIN 1/4 X 12 $8.00PENROSE DRAIN 1/4 X 18 $6.00PENROSE DRAIN 1X12 $8.00PENROSE DRAINS 1/2X12 $6.00PENT 500 MG $31.00PENT SY 250 $28.00PENTACEL $149.00PENTACEL VACCINE (DTAP/POLIO/HIB/TET) $135.00PENTAMIDINE AEROSOL $262.00PENTAMIDINE ISETHIONATE 300MG VIAL $458.00PENTAZOCINE/APAP TABLET 25/650 (TALACEN) $6.00PENTAZOCINE/NALONE TABLET (TALWIN NX) $7.00PENTOBARBITAL 100 MG CAPSULE (NEMBUTAL) $5.00PENTOSAN 100MG CAPSULE (ELMIRON) $11.00PEPCID (FAMOTIDINE) 10 MG AC TABS $10.00PEPTO-BISMOL LIQUID (BISMUTH SUBSAL) $6.00PEPTO-BISMOL(BISMUTH SUBSAL) PINK 2 OZ $6.00

PERCISION MEDIUM/MEDIUM BLADE $153.00PERCUT FIX METACARPAL FX $1,091.00PERCUT FIX METACARPAL FX $1,091.00PERCUT FIX THUMB FX W/MANIP $889.00PERCUT FIX THUMB FX W/MANIP $889.00PERCUTANEOUS IMPLANTATION OF NEUROSTIMUL $831.00PERCUTANEOUS INTRODUCER NEEDLE $93.00PERDIEM (PSYLLIUM FIBER) BOTTLE $64.00PERFIX PLUG EXTRA LARGE $598.00PERI BOTTLE 8 OZ $2.50PERIANAL ABSCESS I & D $453.00PERIANAL ABSCESS I & D $453.00PERI-COLACE (CASANTHRANOL & DOCUSATE SOD $4.00PERIPHERAL VASCULAR ARTERIAL PHYSIOLOGIC $270.00PERITONEAL LAVAGE $195.00PERITONEAL LAVAGE $279.00PERITONEOCENTESIS ABD PARACENTESIS $445.00PERJETA (PERTUZUMAB) 420MG VIAL $8,201.00PERMAFIX 30 BX/5 $826.00PERMETHRIN 5% CREAM (ELIMITE) $120.00PERTUSSIS ANTIBODIES IGG (SERUM) $122.00PERTUSSIS BY PCR $285.00PESSARY FITTING $282.00PET-CT LIMITED AREA $3,378.00PET-CT SKULL BASE MID THIGH $3,378.00PET-CT WHOLE BODY $3,378.00PET-FDG PER DOSE;TRACER $1,074.00PEZZER CATHETER 26 FR $84.00PEZZER CATHETER 30 FR $68.00PFT BASIC $265.00PFT PRE/POST $417.00PH $81.00PH BODY FLUID $74.00PH STOOL $74.00PH URINE DIPSTIX $88.00PHACO TUBE SET $258.00PHALANGEAL TX W/MANIP $956.00PHALANGEAL TX W/O MAN $327.00PHARMACY MISC. TAB - F $60.00PHARYNGOSCOPY $432.00PHENAZOPYRIDINE 100 MG TAB (PYRIDIUM) $6.00PHENEGRAN 25 MG $28.00PHENOBARBITAL $97.00PHENOBARBITAL (PHENOBARB) 130 MG TUBEX $39.00PHENOBARBITAL (PHENOBARB) 15 MG TABS $4.00PHENOBARBITAL (PHENOBARB) 20MG/5 ML $11.00PHENOBARBITAL 32.4 MG TABLET $11.00

PHENOBARBITAL 60 MG TABLET $4.00PHENOBARBITAL 65MG VIAL $88.00PHENOL (CARBOLIC ACID) SOLUTION 480 ML $291.00PHENOLPHTHALENE TABLET (CORRECTOL) $4.00PHENTERMINE 37.5MG TABLET (ADIPEX) $8.00PHENTOLAMINE 10 MG VIAL $506.00PHENYLEPH/HCOD/CDM 5ML (HISTUSSIN HC) $5.00PHENYLEPHRINE OPTH SOLN 2.5% $54.00PHENYLEPHRINE 0.25% SPR (NEO-SYNEPHRINE) $13.00PHENYLEPHRINE 10MG VIAL (NEO-SYNEPHRINE) $13.00PHENYTOIN 250 MG VIAL (DILANTIN) $33.00PHENYTOIN E.R. 100MG CAPSULE (DILANTIN) $7.00PHENYTOIN SUSP 125MG/5ML (DILANTIN) $8.00PHIL COLLAR INFANT $118.00PHIL COLLARS PEDS $118.00PHILA COLLAR 5 1/4 SM $90.00PHILLIPS CATH FOLLOWER 10 FR $76.00PHILLIPS CATH FOLLOWER 12 FR $76.00PHILLIPS CATH FOLLOWER 14 FR $76.00PHILLIPS CATH FOLLOWER 16 FR $76.00PHILLIPS CATH FOLLOWER 20 FR $76.00PHILLIPS CATH FOLLOWER 22 FR $76.00PHILLIPS CATH FOLLOWER 24 FR $76.00PHILLIPS CATH FOLLOWER 26 FR $76.00PHILLIPS CATH FOLLOWER 28 FR $76.00PHILLIPS CATH FOLLOWER 30 FR $76.00PHILLIPS CATH FOLLOWER 8 FR $76.00PHISODERM (LANOLIN/PET) SOAP 9 OZ $28.00PHISOHEX (HEXACHLOROPHENE) CLEANSER 1 GA $251.00PHISOHEX (HEXACHLOROPHENE) CLEANSER 1 PT $68.00PHISOHEX (HEXACHLOROPHENE) CLEANSER 5 OZ $68.00PHLEBOTOMY $135.00PHOSPHATIDYLETHANOL $650.00PHOSPHATIDYLGLYCEROL $58.00PHOSPHATIDYLGLYCEROL $55.00PHOSPHOLIPID NEUTRALIZATION $85.00PHOSPHOLIPIDS SERUM $94.00PHOSPHOROUS $80.00PHOSPHORUS URINE $68.00PHYSICAL PEFORMANCE/FCE W REPORT $79.00PHYSICAL PEFORMANCE/FCE W REPORT $79.00PHYSICAL PEFORMANCE/FCE W REPORT $79.00PHYSICAL PEFORMANCE/FCE W REPORT $79.00PHYSOTIGMINE 2MG AMP $73.00PHYTONADIONE 1MG/0.5ML PFS (VITAMIN K) $41.00PICC ACCESS FOR BLOOD SPECIMEN $65.00PICO WOUND DRESSING 10X20 $200.00

PICO WOUND DRESSING 10X20 2 DRESSING KIT $200.00PICO WOUND DRESSING 10X30 $200.00PILOCARPINE 1% OPTH DROPS $13.00PILOCARPINE 2% OPTH SOLN (PILOCAR) $68.00PILOCARPINE 4% OPTH SOLN 15 ML $47.00PILOCARPINE 5MG TABLET (SALAGEN) $10.00PIN HEADED 46MM- ORTHO $167.00PIN HEADLESS 65MM- ORTHO $167.00PIN KNOWLES 1/8 X 3 3/4 $172.00PIN KNOWLES 1/8 X 4 1/4 $172.00PIN PASSING 2.4MM- ORTHO $276.00PIN PASSING DRILL TIP- ORTHO $292.00PINCH GRAFT,SNGL/MULT <2CM $1,552.00PINCH GRAFT,SNGL/MULT <2CM $1,552.00PINDOLOL 5MG TABLET (VISKEN) $5.00PINTRAC -15 SURGI MESH $1,945.00PINWORM SMEAR $72.00PIOGLITAZONE 15 MG TABLET (ACTOS) $8.00PIP DART 2.5X30MM STRAIGHT $1,175.00PIP DART 3X30MM 10 DEGREE $1,175.00PIP DART PEEK STRAIGHT 3X30 $1,175.00PIPERACILLIN/TAZOBACTAM 2.25GM/NS 100ML $86.00PIPERACILLIN/TAZOBACTAM 3.375GM VIAL $54.00PKU $322.00PLACE CATHETER IN VEIN $303.00PLACE CATHETER IN VEIN $303.00PLACEMENT MESH IMPLANT $550.00PLACEMENT MESH IMPLANT $550.00PLACEMENT OF ON-Q PAIN PUMP $884.00PLACEMENT OF SETON $690.00PLAIN PACKING STRIP 1 X 5yds $15.00PLAIN PACKING STRIP 1/2INx5YDS $20.00PLAIN PACKING STRIP 1/4 X 5YDS $10.00PLAK-VAC $51.00PLANTAR LAP PLATE $3,738.00PLASMINOGEN ACTIVATOR INHIBITOR ACTIVITY $107.00PLASMODIUM SPECIES, PCR $461.00PLATE NARROW ACP 11 HOLE $306.00PLATE NARROW ACP 7 HOLE $294.00PLATE WIDE ACP 11MM $234.00PLATE WIDE COMP 10 HOLE $448.00PLATE WIDE COMP 11 HOLE $428.00PLATELET ANTIBODY DIRECT $236.00PLATELET COUNT $36.00PLATELET FACTOR 4 $312.00PLEURAL DRAINAGE, PERCUTANEOUS, WITH INS $317.00PLEUR-EVAC ADULT/PEDS $156.00

PML-RARA $89.00PNEUMOCOCCAL IMMUNITY PANEL (7 SERO) (2) $44.00PNEUMONIA PCV7 UNDER 5 YEARS $160.00PNEUMOSURE FLOW (NON HEAT) $58.34PNEUMOSURE HEAT FLOW $203.00PNEUMOVAX (PNEUMOCOCCAL VACCINE) $87.00PNEUMOVAX 23 $104.74PNEUMOVAX 23 $104.74PNEUMOVAX 23 (PNEUMONOCOCAL VAC) 23 $111.00PNUE CUFF-34 DISP ORTHO $180.00PNUE CUFF-42 DISP ORTHO $186.00PODOUS BOOT RG $79.00PODUS BOOT XL $172.37PODUS LINER XL $139.62POLIOVIRUS 1 2 3 ANTIBODY (2) $184.00POLIOVIRUS IMMUNE STATUS ANTIBODY $508.00POLLACK 4FR $75.00POLLACK 5 FR $75.00POLY ROTH NET (POLY-PAK) $557.00POLY/NEO/HYDROC OPTH SUSP (CORTISPORIN) $159.00POLYCITRA (CITRIC ACID/K-NA CITRATES) $5.00POLYESTER 10X8 MESH PRIETEX COMPOSITE $1,439.00POLYESTER 15X10cm 6 x 4 MESH PRIETEX $908.00POLYESTER 20X30 MESH PRIETEX COMPOSITE $1,627.00POLYETHYLENE GLY PWDR 238G(MIRALAX) $56.00POLYETHYLENE GLYCOL PWDR 17GM (MIRALAX) $10.00POLYP TRAP $90.00POLYPEC SNARE & NET PACK $450.00POLY-VI-SOL FE (MULTIPLE VIT/IRON) DROPS $13.00PONSKY PULL FEEDING TUBE $360.00POOLE SUCTION HANDLE $17.00POPE BRACE MEDIUM $409.00PORPHOBILINOGEN QUANTITATIVE 24HR URINE $61.00PORPHOBILINOGEN, QUANT RANDOM URINE $46.00PORPHYRINS 24 HOUR URINE $45.00PORPHYRINS QUANTITATIVE URINE RANDOM $51.00PORT ACCESS FOR BLOOD SPECIMEN $58.00POSEY OX WRAP SENSOR $8.00POSITIONER HEAD RING CUSHION 9 $7.00POSITIONING KIT- PINK PAD $441.00POST OP SHOE SOFT MEN XLG $9.00POSTERIOR COLPORRHAPHY, REPAIR OF RECTOC $701.00POSTERIOR LEG SPLINT LG $335.00POSTERIOR LEG SPLINT MED $183.00POSTERIOR TIBIALIS TENDON $4,681.00POSTPARTUM CARE ONLY $292.00POT 10 MEQ IN 5% DEXT & 0.2% SOD CHL INJ $21.00

POT 10 MEQ IN 5% DEXT & 0.45% SOD CHLO $19.00POT 20 MEQ IN 0.45% SODIUM CHLORIDE $21.00POT 20 MEQ IN 0.9% SODIUM CHLORIDE $21.00POT 20 MEQ IN 5% DEXTROSE WATER INJ $20.00POT 20 MEQ IN D5% 0.45 NS $20.00POT 20 MEQ IN D5% LR $30.00POT 20 MEQ IN D5% NS $23.00POT 40 MEQ IN 0.9% SODIUM CHLORIDE $36.00POT 40 MEQ IN 5% DEXTROSE/0.45%NORM $26.00POT CHLORIDE 10MEQ/100ML NS $57.00POT CHLORIDE 10MEQ/100ML STERILE WATER $21.00POT CHLORIDE 20MEQ/100ML NS $57.00POT CHLORIDE 20MEQ/100ML STERILE WATER $18.00POTASS BICAR/CA 25 MEQ EFF TAB (K-LYTE) $6.00POTASS.BICAR/POT.CL/CA TAB (K-LYTE/CL) $7.00POTASSIUM $73.00POTASSIUM CHL 20% 40MEQ/15ML ORAL SOLN $5.00POTASSIUM CHL 10MEQ ER TABLET $7.00POTASSIUM CHL 20 MEQ TABLET(K-DUR) $7.00POTASSIUM CHL 20 MEQ/15ML ORAL SOLN UD $4.00POTASSIUM CHLORIDE 20 MEQ VIAL $31.00POTASSIUM CHLORIDE (KCL 10 MEQ) VIAL $28.00POTASSIUM CHLORIDE 30 MEQ VIAL $29.00POTASSIUM CHLORIDE 40 MEQ VIAL $41.00POTASSIUM PHOSPHATE (KPO4) 45 MM VIAL $30.00POTASSIUM URINE $68.00POUCH FLANGE DRAIN 4 $18.00POUCH W/FLANGE 1 1/2 $18.00POVIDONE IODINE OINTMENT 1OZ $8.00POVIDONE-IOD DOUCHE (BETADINE) $14.00POVIDONE-IODINE BOTTLE $9.00POWER LOC 20GA X 3/4IN $41.00POWERED VASCULAR STAPLER 35MM $548.00PPH STAPLER $695.00PR PHASE III $20.00PRADAXA 150MG CAPSULE (DABIGATRAN) $30.00PRADAXA 75MG CAPSULE (DABIGATRAN) $30.00PRAMIPEXOLE 0.25MG TABLET (MIRAPEX) $28.00PRAMIPEXOLE 1.5MG TABLET (MIRAPEX) $6.00PRAVASTATIN 20 MG TAB (PRAVACHOL) $6.00PRAZOSIN 1 MG CAPSULE (MINIPRESS) $4.00PRAZOSIN 2 MG CAPSULE (MINIPRESS) $4.00PRAZOSIN 5 MG CAPSULE (MINIPRESS) $8.00PRE EMPLOYMENT SENDOUT $23.00PRE-ALBUMIN $94.00PREC FALCON OSCILLATING SAW TIP ORTHO $475.00PRECISION BLADE 5.5X0.51X25MM $153.00

PRECISION BLADE 9.0 X 0.51 X 31.0MM $153.00PRECISION BLADE 9.0X0.64X25MM $153.00PRECISION OSCILL TIP BLADE- ORTHO $425.00PRED MILD OPTH SUSP 0.12% (PREDNISOLONE) $94.00PREDNISOLONE 15 MG/5ML (PRELONE) $8.00PREDNISOLONE SOD PHOS 5MG/5ML(PEDIAPRED) $5.00PREDNISONE 1 MG TABLET $6.00PREDNISONE 1 MG TABLET (ORASONE) $4.00PREDNISONE 10 MG TABLET $6.00PREDNISONE 20 MG TABLET $6.00PREDNISONE 5 MG TABS $6.00PREDNISONE ORAL SOLUTION 5 MG/ 5 ML $23.00PREFIL BOTTLE 300 $17.00PREFIL BOTTLE 500 $18.00PREFIL WITH ADAPTER 500 $31.00PRE-FILTER $41.00PRE-FILTER ADAPTER $13.00PREGESTIMNUL FORMULA $31.00PREGNANCY TEST SERUM $117.00PREGNANCY TEST SERUM REFLEX BETA HCG $117.00PREGNANCY TEST URINE $89.00PREGNANCY TEST URINE $104.00PREGNENOLONE $126.00PREMARIN (CONJUG. ESTRO.) 0.3 MG TAB $4.00PREMARIN (CONJUG. ESTRO.) 0.625 MG TAB $25.00PREMARIN (CONJUG.ESTROGEN) 25 MG VIAL $1,130.00PREMARIN (ESTROGEN CONJUGATED) VAG CREAM $180.00PREMEE FEED TUBE 5 FR $16.00PREMEE FEED TUBE 8 FR $21.00PREMPRO (ESTROGEN/MEDROXYPROGE)0.625/2.5 $6.00PREPIDIL GEL (DINOPROSTONE) 0.5 MG GEL $649.00PRESSURE LINE ADAPTOR $6.78PRESSURE TRANSDUCER $135.00PRESSURIZED OR NONPRESSURIZED INHALATION $73.00PREV, VISIT, NEW, AGE 18-39 $110.00PREVACID (LANSOPRAZOLE) 15 MG CAP $19.00PREVACID (LANSOPRAZOLE) 30 MG CAP $20.00PREVACID IV (LANSOPRAZOLE) 30MG $121.00PREVACID SOLUTAB (LANSOPRAZOLE) 15 MG $19.00PREVACID SOLUTAB (LANSOPRAZOLE) 30 MG $19.00PREVNAR 13 (PNEUMOCOCCAL VACCINE) $226.00PRIMAXIN (IMIPENEM/CILASTIN) 500 MG IM $155.00PRIMAXIN IM 500MG (IMIPENEM/CILASTATIN) $183.00PRIMAXIN IVPB 500MG/D5W 100ML $184.00PRIMIDONE $90.00PRIMIDONE 250 MG TABLET (MYSOLINE) $6.00PRIMIDONE 50 MG TABLET (MYSOLINE) $6.00

PR-INDIVIDUAL EXERCISE $30.00PRINEO DERMABOND $394.00PRISCOLINE (TOLZOLINE) 100 MG AMP $90.00PRISTIQ ER 50MG TABLET (DESVENLAFAXINE) $48.00PROBE RECTAL ESOPHAGEAL $158.00PROCAINAMIDE 1 GM VIAL $400.00PROCAINAMIDE 500 MG CAPSULE $4.00PROCALCITONIN $240.00PROCANBID (PROCAINAMIDE) 500 MG E.R. $6.00PROCEDURE TRAY $144.00PROCEED 4.3 X 4.3 SMALL VENTRAL PATCH $635.00PROCEED 6.4 X 6.4 VENTRAL PATCH $747.00PROCEED MESH OVAL 10 X13 $3,155.00PROCEED MESH OVAL 8 X10 $2,200.00PROCHLORPERAZINE 10MG SUPP (COMPAZINE) $19.00PROCHLORPERAZINE 10MG VIAL (COMPAZINE) $22.00PROCHLORPERAZINE 25MG RS (COMPAZINE) $29.00PROCHLORPERAZINE 5MG TABLET (COMPAZINE) $6.00PROCHLORPERAZINE SPAN 15MG $10.00PROCRIT 10,000U (EPOETIN ALFA) $461.00PROCRIT 20,000U (EPOETIN ALFA) $743.00PROCRIT 4,000U (EPOETIN ALFA) $492.00PROCRIT 40,000U (EPOETIN ALFA) $1,922.00PROCTOFOAM-HC (PRAMOXINE HCL/HYDCT) 10GM $107.00PROCTOPEXY PE $1,964.00PROCTOSIGMOIDOSC OPY, RIGID; DIAGNOSTIC, $221.00PROGESTERONE $93.00PROGESTERONE $105.00PROGESTERONE IN OIL(PROGESTER) 500 MG $118.00PROGRAF $137.00PROGRAF (TACROLIMUS) 1MG CAP $15.00PROHIBIT VACCINE (HAEOPHILUS B VACC) $523.00PROIMAL TENODESIS IMPLANT-ORTHO $1,689.00PROINSULIN $115.00PROLACTIN 1:10 $124.00PROLACTIN 1:100 $150.00PROLACTIN LEVEL $78.00PROLENE MESH HERNIA $560.00PROLENE MESH PHSM MEDIUM (HAT) $798.00PROLENE MESH PMH LG 6X6 $493.00PROLEUKIN (ALDESLEUKIN) 22MU/1.2ML $3,550.00PROLIA 60MG/1ML SYRINGE (DENOSUMAB) $2,653.00PROLONG PHY SVC, W/O DIR PAT CONTACT $474.00PROMETHAZINE 25 MG TABLET (PHENERGAN) $6.00PROMETHAZINE 25 MG VIAL (PHENERGAN) $16.00PROMETHAZINE 6.25MG/5 ML ORAL(PHENERGAN) $8.00PROMETHAZINE SUPP 12.5MG (PHENERGAN) $23.00

PROMETHAZINE SUPP 25MG (PHENERGAN) $6.00PROMETHAZINE SUPP 50MG (PHENERGAN) $19.00PROMETRIUM (PROGESTERONE)100MG CAP $5.00PROPAFENONE 150 MG TAB (RYTHMOL) $7.00PROPAFENONE 150MG TABLET $6.00PROPOFOL 1000MG/100ML VIAL (DIPRIVAN) $54.00PROPOFOL 200MG/20ML VIAL (DIPRIVAN) $27.00PROPOFOL 500MG/50ML VIAL (DIPRIVAN) $90.00PROPOXYPHENE 65 MG CAPSULE (DARVON) $5.00PROPOXYPHENE NAP/APAP 100/650 (DARVOCET) $5.00PROPRANOLOL 1 MG AMPULE (INDERAL) $25.00PROPRANOLOL 10 MG TABLET (INDERAL) $6.00PROPRANOLOL 40 MG TABLET (INDERAL) $4.00PROPRANOLOL 80MG TABLET $6.00PROPULSID (CISAPRIDE) 10 MG TAB $6.00PROPYLTHIOURACIL 50 MG TABS $4.00PROQUAD $233.10PROQUAD (MMR/VARICELLA) VACCINE $219.00PROSTHESIS 10 MM $682.00PROSTHESIS 8MM $682.00PROSTIN E2 (DINOPROSTONE) 20 MG SUPP $526.00PROSTIN VR PED (ALPROSTADIL) 500 MCG $263.00PROTAMINE 50 MG VIAL $48.00PROTEIN C ACTIVITY $113.00PROTEIN C ANTIGEN $134.00PROTEIN ELECTRO URINE 24 HOUR $186.00PROTEIN ELECTRO URINE RANDOM $186.00PROTEIN ELECTROPHORESIS INTERPRETATION $39.00PROTEIN ELECTROPHORESIS SERUM $161.00PROTEIN REFERENCE LAB $33.00PROTEIN S ACTIVITY $123.00PROTEIN S ANTIGEN $53.00PROTEIN S FREE $55.00PROTEIN URINE RANDOM $61.00PROTEINASE 3 $94.00PROTIME/INR $89.00PROTONIX (PANTOPRAZOLE) 40 MG TABLET $29.00PROTONIX DR ORAL SUSP 40MG (PANTOPRAZOLE $16.00PROTOPAM CHLORIDE (PRALIDOXIME) 1 GM $674.00PROTOPORPHYRIN FRAC. ERYTH $90.00PROTUSS EXPT (POTGUAIACOL/HYDRODO) $44.00PROVIGIL (MODAFINIL) 200MG TAB $64.00PROVISC(SODIUM HYDAURONATE) 0.55 ML $555.00PROXIMATE SKIN STAPLER 35 REGULAR $47.00PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE/W $15,685.00PR-STRENGTH ENDURANCE $28.00PS FEMUR NON POROUS-ORTHO $6,118.00

PS FEMUR SIZE 6- NONPOR- ORTHO $5,621.00PSA DIAGNOSTIC $174.00PSA FREE $59.00PSA SCREEN $174.00PSA TOTAL $59.00PSEUDOCHLOLINESTERASE $92.00PSEUDOEPHED 120MG CAPLET (SUDAFED) $5.00PSEUDOEPHEDRINE 30 MG TABLET (SUDAFED) $6.00PSEUDOEPHEDRINE HCL 4 OZ (SUDAFED) $20.00PSEUDOEPHEDRINE/CARBINOX DROPS (RONDEC) $113.00PT COMMUNITY WORK REINTEG/15 MIN $76.00PT COMMUNITY WORK REINTEG/15 MIN $76.00PT COMMUNITY WORK REINTEG/15 MIN $76.00PT COMMUNITY WORK REINTEG/15 MIN $76.00PT CONTRAST BATH/15 MIN $59.00PT CONTRAST BATH/15 MIN $59.00PT DEBRIDEMENT <20 SQ CM $152.00PT DEBRIDEMENT <20 SQ CM $152.00PT DEBRIDEMENT EA ADDTL >20 SQ CM $160.00PT DEBRIDEMENT EA ADDTL >20 SQ CM $160.00PT ELEC STIM NON ATTENDED $59.00PT ELEC STIM UNATTENDED $59.00PT ELEC STIM UNATTENDED $59.00PT E-STIM ATTENDED/15 MIN $67.00PT E-STIM ATTENDED/15 MIN $67.00PT E-STIM ATTENDED/15 MIN $67.00PT E-STIM ATTENDED/15 MIN $67.00PT EVALUATION HIGH COMPLEXITY $331.00PT EVALUATION HIGH COMPLEXITY $331.00PT EVALUATION LOW COMPLEXITY $331.00PT EVALUATION LOW COMPLEXITY $331.00PT EVALUATION MODERATE COMPLEXITY $331.00PT EVALUATION MODERATE COMPLEXITY $331.00PT EVALUATION NEW $331.00PT FDN 1-2 MM $75.00PT FDN 3 OR MORE MM $75.00PT GAIT TRAIN/15 MIN $60.00PT GAIT TRAIN/15 MIN $60.00PT GAIT TRAIN/15 MIN $60.00PT GAIT TRAIN/15 MIN $60.00PT INIT SPIROM-30DAY;PHYS R&I ONLY $48.00PT INIT SPIROM-30DAY;PHYS R&I ONLY $53.00PT IONTOPHORESIS/15 MIN $93.00PT IONTOPHORESIS/15 MIN $93.00PT LOWER EXTREMITY APPLICATION OF CASTS $326.00PT LOWER EXTREMITY APPLICATION OF CASTS $326.00PT LOWER EXTREMITY APPLICATION OF CASTS $326.00

PT LOWER EXTREMITY APPLICATION OF CASTS $326.00PT MANUAL THERAPY/15 MIN $94.00PT MANUAL THERAPY/15 MIN $94.00PT MANUAL THERAPY/15 MIN $94.00PT MANUAL THERAPY/15 MIN $94.00PT MECH TRACTION $93.00PT MECH TRACTION $93.00PT NEG PRESS WOUND < 50 CM $194.00PT NEG PRESS WOUND < 50 CM $194.00PT NEG PRESS WOUND < 50 CM $194.00PT NEG PRESS WOUND < 50 CM $194.00PT NEG PRESS WOUND < 50 CM $194.00PT NEG PRESS WOUND > 50 CM $120.00PT NEG PRESS WOUND > 50 CM $120.00PT NEG PRESS WOUND > 50 CM $120.00PT NEG PRESS WOUND > 50 CM $120.00PT NEUROMUSCULAR RE-ED/15 MIN $113.00PT NEUROMUSCULAR RE-ED/15 MIN $113.00PT NEUROMUSCULAR RE-ED/15 MIN $113.00PT NEUROMUSCULAR RE-ED/15 MIN $113.00PT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00PT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00PT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00PT ORTHC &/OR PROSTH MGMT&TRAIN SBSQ $121.00PT ORTHOTIC MGMT AND TRAINING $92.00PT OUTPATIENT ASSESSMENT AND MANAGEMENT $280.00PT PARRAFIN BATH $42.00PT PARRAFIN BATH $42.00PT PARRAFIN BATH $42.00PT PARRAFIN BATH $42.00PT PROSTHETIC MGMT INITIAL /15 MIN $82.00PT PROSTHETIC MGMT INITIAL /15 MIN $82.00PT PROSTHETIC MGMT INITIAL /15 MIN $82.00PT PROSTHETIC MGMT INITIAL /15 MIN $82.00PT RE EVALUATION $159.00PT RE EVALUATION $159.00PT RE EVALUATION $159.00PT RE EVALUATION $159.00PT RE-EVALUATION $159.00PT SELF CARE MGMT TRAINING $88.00PT SELF CARE MGMT TRAINING $88.00PT SELF CARE MGMT TRAINING $88.00PT SELF CARE MGMT TRAINING $88.00PT THERAPEUTIC ACTIVITY/15 MIN $74.00PT THERAPEUTIC ACTIVITY/15 MIN $74.00PT THERAPEUTIC ACTIVITY/15 MIN $74.00PT THERAPEUTIC ACTIVITY/15 MIN $74.00

PT THERAPEUTIC EX/15 MIN $75.00PT THERAPEUTIC EX/15 MIN $75.00PT THERAPEUTIC EX/15 MIN $75.00PT THERAPEUTIC EX/15 MIN $75.00PT THERAPEUTIC EX'S GRP $59.00PT THERAPEUTIC EX'S GRP $59.00PT THERAPEUTIC EX'S GRP $59.00PT THERAPEUTIC EX'S GRP $59.00PT THERAPEUTIC EX'S GRP $59.00PT ULTRASOUND/15 MIN $74.00PT ULTRASOUND/15 MIN $74.00PT UNNA BOOT $118.00PT UNNA BOOT $118.00PT UNNA BOOT $118.00PT UNNA BOOT $118.00PT WHEELCHAIR MGMT/15 MIN $77.00PT WHEELCHAIR MGMT/15 MIN $77.00PT WHEELCHAIR MGMT/15 MIN $77.00PT WHEELCHAIR MGMT/15 MIN $77.00PTA COMM WRK INT 97537GPCQ $76.00PTA COMM WRK INT 97537GPCQ59 $76.00PTA COMM WRK INT 97537GPCQ59KX $76.00PTA COMM WRK INT 97537GPCQKX $76.00PTA ESTIM ATT 97032GPCQ $67.00PTA ESTIM ATT 97032GPCQ59 $67.00PTA ESTIM ATT 97032GPCQ59KX $67.00PTA ESTIM ATT 97032GPCQKX $67.00PTA ESTIM NON ATT 97014GPCQ $59.00PTA ESTIM UNATT G0283GPCQ $59.00PTA ESTIM UNATT G0283GPCQKX $59.00PTA GAIT TRNG 97116GPCQ $60.00PTA GAIT TRNG 97116GPCQ59 $60.00PTA GAIT TRNG 97116GPCQ59KX $60.00PTA GAIT TRNG 97116GPCQKX $60.00PTA GROUP THER EX 97150GPCQ $59.00PTA GROUP THER EX 97150GPCQ59 $59.00PTA GROUP THER EX 97150GPCQ59KX $59.00PTA GROUP THER EX 97150GPCQKX $59.00PTA IONTO 97033GPCQ $93.00PTA IONTO 97033GPCQKX $93.00PTA MANUAL THER 97140GPCQ $94.00PTA MANUAL THER 97140GPCQ59 $94.00PTA MANUAL THER 97140GPCQ59KX $94.00PTA MANUAL THER 97140GPCQKX $94.00PTA MECH TX 97012GPCQ $93.00PTA MECH TX 97012GPCQKX $93.00PTA NEURO RE-ED 97112GPCQ $113.00

PTA NEURO RE-ED 97112GPCQ59 $113.00PTA NEURO RE-ED 97112GPCQ59KX $113.00PTA NEURO RE-ED 97112GPCQKX $113.00PTA ORT/PRS M/T 5 97763GPCQ $121.00PTA ORT/PRS M/T 5 97763GPCQ59 $121.00PTA ORT/PRS M/T 5 97763GPCQ59KX $121.00PTA ORT/PRS M/T 5 97763GPCQKX $121.00PTA ORTHO M/T 97760GPCQ $92.00PTA ORTHO M/T 97760GPCQ59 $92.00PTA ORTHO M/T 97760GPCQ59KX $92.00PTA ORTHO M/T 97760GPCQKX $92.00PTA PARAFFIN BTH 97018GPCQ $42.00PTA PARAFFIN BTH 97018GPCQ59 $42.00PTA PARAFFIN BTH 97018GPCQ59KX $42.00PTA PARAFFIN BTH 97018GPCQKX $42.00PTA PROS MGMT INT 97761GPCQ $82.00PTA PROS MGMT INT 97761GPCQ59 $82.00PTA PROS MGMT INT 97761GPCQ59KX $82.00PTA PROS MGMT INT 97761GPCQKX $82.00PTA SLF CARE TRNG 97535GPCQ $88.00PTA SLF CARE TRNG 97535GPCQ59 $88.00PTA SLF CARE TRNG 97535GPCQ59KX $88.00PTA SLF CARE TRNG 97535GPCQKX $88.00PTA THER ACT 97530GPCQ $74.00PTA THER ACT 97530GPCQ59 $74.00PTA THER ACT 97530GPCQ59KX $74.00PTA THER ACT 97530GPCQKX $74.00PTA THER EX 97110GPCQ $75.00PTA THER EX 97110GPCQ59 $75.00PTA THER EX 97110GPCQ59KX $75.00PTA THER EX 97110GPCQKX $75.00PTA ULTRASOUND 97035GPCQ $74.00PTA ULTRASOUND 97035GPCQKX $74.00PTA UNNABOOT 29580GPCQ $118.00PTA UNNABOOT 29580GPCQ59 $118.00PTA UNNABOOT 29580GPCQ59KX $118.00PTA UNNABOOT 29580GPCQKX $118.00PTA W/C MGMT 97542GPCQ $77.00PTA W/C MGMT 97542GPCQ59 $77.00PTA W/C MGMT 97542GPCQ59KX $77.00PTA W/C MGMT 97542GPCQKX $77.00PTH CA $30.00PTH INTACT $125.00PTH INTACT $66.00PTH RELATED PROTEIN $92.00PTT $89.00PUDENDAL BLOCK TRAY $81.00

PULLEY- HAND $66.00PULMICORT (BUDESONIDE) NEB AMP 0.25/2ML $50.00PULMICORT (BUDESONIDE) NEB AMP 0.5MG/2ML $58.00PULMICORT(BUDESONIDE) INHALER 90MCG $176.00PULMONARY ASSIST CIRCUIT $67.00PULMONARY REHAB GROUP EXERCISE $31.00PULMONARY REHABILITATION $124.00PULMONARY STRESS TESTING;SIMPLE $177.00PULSE OXIMETER DISPOSABLE PROBE $67.00PULSEWAVE IRRIGATION $202.00PUNCH BIOPSY OF SKIN SINGLE LESION $180.00PUNCH BIOPSY SKIN EA SEP/ADDL LESION $147.00PUNCT ASPIR OF ABS/HEMA/BULLA/CYST $229.00PUNCTURE ASPIRATION OF BREAST/CYST $1,011.00PUNCTURE ASPIRATION OF CYST OF BREAST; $1,011.00PUNCTURE ASPIRATION OF CYST OF BREAST; E $55.00PYRAZINAMIDE 500 MG TAB $9.00PYRIDOSTIGMINE 60 MG TAB (MESTINON) $8.00PYRIDOXINE (VITAMIN B6) 100 MG/ML $49.00PYRIDOXINE (VITAMIN B-6) 50 MG TAB $6.00PYRUVIC ACID $143.00Q FEVER IGG $72.00Q0091 CL SCREENING PAP SMEAR $75.00QUANITATIVE RADIOIMMUNOASSAY $156.00QUANTIFERON TB GOLD $256.00QUETIAPINE $154.00QUETIAPINE 100MG TABLET (SEROQUEL) $8.00QUETIAPINE 25MG TABLET (SEROQUEL) $7.00QUINAPRIL 10 MG TABLET (ACCUPRIL) $7.00QUINIDINE $67.00QUINIDINE GLUCONATE 10 ML VIAL $96.00QUINIDINE GLUCONATE 324MG (QUINAGLUTE) $4.00QUINIDINE SULFATE(QUINID.SULF) 200 MG $4.00QUININE SULFATE 200 MG CAPSULE $4.00QUININE SULFATE 260MG TABLET $4.00QVAR 40MCG INHALER (BECLOMETHASONE)7.3G $104.00QVAR 80MCG INHALER (BECLOMETHASONE) $343.00R T DRUG ALUPENT INHALER $22.00R T DRUG BRONKOSOL $9.00R T DRUG ISUPREL $9.00RABIES VACCINE TITER $166.00RACEPINEPHRINE 2.25% (S-2) $13.00RADIAL HD/NECK FX $920.00RADIAL SHAFT FX $968.00RADIAL-ULNAR FX DISTAL COLLES TX $607.00RAINBOW CAST SANDAL SMALL $33.00RAISED TOILET SEAT $90.00

RALLY BAG $186.00RAMIPRIL 10MG CAPSULE (ALTACE) $5.00RAMIPRIL 2.5 MG CAPSULE (ALTACE) $6.00RAMIPRIL 5 MG CAPSULE (ALTACE) $12.00RANEXA 500MG ER TABLET (RANOLAZINE) $29.00RANITIDINE 50 MG VIAL (ZANTAC) $26.00RANITIDINE GRANULES 150 MG (ZANTAC) $4.00RANITIdine SYRUP 15MG/ML (ZANTac) $10.00RAPAMUNE $100.00RAPID HIV TEST KIT CLEARVIEW $89.00RAPID RHINO ANT/POST W/AIRWAY 7.5CM $200.00RAPID RHINO ANTERIOR 4.5CM $209.00RAPID RHINO LUMEN 5.5 CM $171.00RAPID STREP $28.00RAPID STREP $28.00RAPLON (RAPACURONIUM BR) 100 MG VIAL $86.00RASP TEAR LARGE ORTHO $410.00RAST PER ALLERGEN $65.00RAST PER ALLERGEN CPT 86005 $54.00RAYNER 570C $39.00RAYTEC SPONGES 8X4 $8.00RBC OSMOTIC FRAGILITY $344.00REAMER LOW PROFILE-ORTHO $488.00RE-ASSESSMENT MED NUTR PER 15 MIN $31.00REBOUND ANDLE STAB STRAP MD RT $136.00RECIPIENT SET (COMPONENT) $22.00RECIPRO BLADE ORTHO $150.00RECIPROCATING BLADE- 2SIDED $171.00RECOMBIVAX HB (HEPATITIS B) 40 ADULT $56.00RECOMBIVAX HP-ADULT $55.09RECOMBIVAX HP-PED $16.36RECOMBIVAX HP-PED $16.36RECOMBIVAX PEDHB(HEPATITIS B) 0.5ML DOSE $18.00RECON CONTOURING BENIGN TUMOR CRANIAL BN $1,833.00RECON CONTOURING BENIGN TUMOR CRANIAL BN $1,833.00RECON KNEE INTRA&EXTRA-ARTICULAR $2,540.00RECON KNEE INTRA&EXTRA-ARTICULAR $2,540.00RECON POLYDAC $2,430.00RECOVERY CHARGE 01 30 MIN $491.00RECOVERY CHARGE 121 150 MIN $924.00RECOVERY CHARGE 151 180 MIN $870.00RECOVERY CHARGE 181 210 MIN $1,273.00RECOVERY CHARGE 211 240 MIN $1,103.00RECOVERY CHARGE 241 270 MIN $1,193.00RECOVERY CHARGE 271 300 MIN $1,301.00RECOVERY CHARGE 31 60 MIN $682.00RECOVERY CHARGE 61 90 MIN $878.00

RECOVERY CHARGE 91 120 MIN $893.00RECTANGLE MESH 10X15 $750.00RED BLOOD COUNT $71.00REDUCE DISLOCATION OF ELBOW $491.00REDUCE DISLOCATION OF FINGER OR TOE $164.00REDUCE DISLOCATION OF FINGER OR TOE $239.00REDUCE DISLOCATION OF PATELLA $288.00REDUCE DISLOCATION OF SHOULDER $471.00REDUCING SUBSTANCES-FECES $47.00REDUCTION OF RECTAL PROLAPSE $560.00REDUCTION OF VOLVULUS, INTUSSUSCEPTION, $2,297.00REF LAB URINE CREATINE $95.00REFILLING/MAINTENANCE OF PORTALBE PUMP $412.00REFLEX 45 $550.00REGRANEX (BECAPLERMIN) GEL 15 GM $943.00REGULAR BILE BAG $58.00REGULAR VENA CAVA CLIP $258.00REHABILITATION PHASE III $34.00RELEASE CATHETER 16FR.TRAY $114.00RELISTOR (METHYLNATREXONE) 12MG/0.6ML $768.00RELOAD 45MM WHITE- THICK $400.00RELOAD ENDO SCOPIC $913.00RELPAX (ELETRIPTAN HYDROBROMIDE)40MG TAB $67.00REMICADE (INFLIXIMAB) 100 MG SDV $225.00REMOVAL OF ARM FOREIGN BODY $434.00REMOVAL OF ARM FOREIGN BODY $434.00REMOVAL FB DP THI REGION/KNEE AREA $1,067.00REMOVAL FB DP THI REGION/KNEE AREA $1,067.00REMOVAL FB EXT EYE; CONJUNCT SUP $94.00REMOVAL FB EXT EYE; CONJUNCT SUP $94.00REMOVAL FB EXT EYE; CONJUNCT SUP $78.00REMOVAL FB INTRANASL; OFC TYPE PROC $389.00REMOVAL FB INTRANASL; OFC TYPE PROC $389.00REMOVAL FB INTRANASL; OFC TYPE PROC $409.00REMOVAL FB INTRANASL; OFC TYPE PROC $409.00REMOVAL FB VESTIBULE OF MOUNTH SIMPLE $343.00REMOVAL FOOT LESION $954.00REMOVAL FOOT LESION $847.00REMOVAL FOREARM LESION SUBCU $960.00REMOVAL FOREARM LESION SUBCU $960.00REMOVAL FOREIGN BODY FROM EXTERNAL AUDIT $270.00REMOVAL FOREIGN BODY, INTRANASAL GEN ANE $426.00REMOVAL FOREIGN BODY, INTRANASAL; BY LAT $1,110.00REMOVAL FOREIGN BODY, INTRANASAL; OFFICE $409.00REMOVAL GALLBLADDER $2,297.00REMOVAL GALLBLADDER $2,297.00REMOVAL IMPACT CERUMEN ONE/BOTH EARS $123.00

REMOVAL IMPACT CERUMEN ONE/BOTH EARS $123.00REMOVAL IMPACT CERUMEN ONE/BOTH EARS $130.00REMOVAL IMPACTED CERUMEN $130.00REMOVAL IMPACTED CERUMEN $130.00REMOVAL IMPACTED CERUMEN (SEPARATE PROCE $130.00REMOVAL IMPLANT DEEP $613.00REMOVAL IMPLANT DEEP $613.00REMOVAL IMPLANT SUPERFICIAL $943.00REMOVAL IMPLANT SUPERFICIAL $943.00REMOVAL KNEE CARTILAGE $1,396.00REMOVAL KNEE CARTILAGE $1,396.00REMOVAL NEXPLANON $239.00REMOVAL NON BIO DRUG DELIVERY IMPLANT $239.00REMOVAL NON BIO DRUG DELIVERY IMPLANT $239.00REMOVAL OF ANAL FISSURE $643.00REMOVAL OF CERCLAGE SUTURE UNDER ANESTHE $344.00REMOVAL OF CERCLAGE UNDER ANESTHESIA $344.00REMOVAL OF CONTRACEPTIVE CAP $458.00REMOVAL OF FECAL IMPACTION OR FOREIGN BO $570.00REMOVAL OF FOOT FOREIGN BODY $471.00REMOVAL OF FOREIGN BODY, FOOT; SUBCUTANE $471.00REMOVAL OF FOREIGN BODY, PELVIS OR HIP; $1,506.00REMOVAL OF IMPLANT MATERIAL $1,445.00REMOVAL OF INTRAUTERINE DEVICE (IUD) $231.00REMOVAL OF IUD $220.00REMOVAL OF IUD $220.00REMOVAL OF NAIL BED $784.00REMOVAL OF NAIL BEDL $784.00REMOVAL OF PERITONEAL $491.00REMOVAL OF PICC W/OUT SUB. PORT $914.00REMOVAL OF PICC W/OUT SUB. PORT TECH. $914.00REMOVAL OF SKIN TAG $163.00REMOVAL OF SKIN TAG (1-15) $172.00REMOVAL OF SKIN TAG (1-15) $163.00REMOVAL OF SKIN TAG (EACH ADDTL 10) $38.00REMOVAL OF SNG ANAL TAG $402.00REMOVAL OF SNG ANAL TAG $402.00REMOVAL OF SPLEEN TOTAL $2,417.00REMOVAL OF SUTURES UNDER ANESTHESIA (OTH $243.00REMOVAL OF TUNNELED CENTRAL VENOUS ACCES $482.00REMOVAL OF TUNNELED CENTRAL VENOUS CATHE $914.00REMOVAL OF TUNNELED INTRAPERITONEAL CATH $956.00REMOVAL OR REVISION OF SLING FOR STRESS $1,084.00REMOVAL PELVIC LYMPH NODES $1,085.00REMOVAL PROSTHETIC MATERIAL ABDOMINAL WA $648.00REMOVAL PROSTHETIC MATERIAL ABDOMINAL WA $648.00REMOVAL SWEAT GLAND LESION $630.00

REMOVAL TENDON LESION $1,294.00REMOVAL TENDON LESION $1,294.00REMOVAL VITREOUS ANTERIOR APPROACH $4,484.00REMOVAL W/INSERTION NEXPLANON $419.00REMOVAL W/REINSERTION DRUG DELIVERY IMPL $419.00REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSU $458.00REMOVAL/CENTR $870.00REMOVAL/CENTRAL TUNNEL $459.00REMOVAL/CENTRAL VENOUS $870.00REMOVAL/CENTRAL VENOUS $914.00REMOVAL/CENTRAL VENOUS $482.00REMOVAL/GALLBLADDER/WI $1,699.00REMOVAL/GALLBLADDER/WI $1,699.00REMOVAL/REVISE SLING STRESS INCONTINENCE $1,084.00REMOVAL/REVISE SLING STRESS INCONTINENCE $1,084.00REMOVE CONJUNCTIVAL FOREIGN BODY $107.00REMOVE CORNEAL FOREIGN BODY W/O LAM $164.00REMOVE F B EXT EYE CORN W/LAMP $434.00REMOVE F B EXT EYE EMBEDDED $256.00REMOVE FB EXT AUDITORY CANAL $270.00REMOVE FB FOOT;COMPLEX $1,154.00REMOVE FB FOOT;COMPLICATED $1,169.00REMOVE FB FT;DEEP $1,578.00REMOVE FB FT;SUBCUT $471.00REMOVE FB MUSCLE/TENDON;COMPLEX $1,642.00REMOVE FB MUSCLE/TENDON;SIMP $333.00REMOVE FB MUSCLE/TENDON;SIMP $333.00REMOVE FB MUSCLE/TENDON;SIMP $333.00REMOVE FB-EAR W/O ANESTH $257.00REMOVE FB-EAR W/O ANESTH $257.00REMOVE FECAL IMPACTION FOREIGN ANEST $570.00REMOVE FECAL IMPACTION OR FOREIGN $198.00REMOVE FECAL IMPACTION OR FOREIGN $570.00REMOVE FOREIGN BODY PHARYNX $164.00REMOVE INTRANASAL FOREIGN BODY $409.00REMOVE LES NECK/CHEST $860.00REMOVE LES NECK/CHEST $860.00REMOVE OF SKIN TAGS, MULT. FIBRO TAGS $40.00REMOVE SHOULDER BONE, PART $1,328.00REMOVE SHOULDER BONE, PART $1,328.00REMOVE SUTURES DIFF SURGEON UNDER ANESTH $117.00RENAGEL (SEVELAMER) 400MG TABLET $17.00RENAGEL (SEVELAMER) 800MG TABLET $10.00RENAL FUNCTION PANEL $176.00RENIN $77.00RENIN ACTIVITY AND ALDOSTERONE $77.00REP. CENT. VENOUS ACC. DEVICE W/SUB PORT $468.00

REP. CENT. VENOUS ACC. DEVICE W/SUB PORT $468.00REPAIR BLOOD VESSEL LESION $1,921.00REPAIR BOWEL FISTULA $1,892.00REPAIR COMPLEX FACIAL&/FEET 5CM OR LESS $309.00REPAIR DEFECT OF ARTERY $3,380.00REPAIR ENTEROCELE ABD APPROACH SPX $1,355.00REPAIR ENTEROCELE ABD APPROACH SPX $1,355.00REPAIR EPIGAS $833.00REPAIR EPIGASTRIC HERNIA $759.00REPAIR EPIGASTRIC HERNIA $759.00REPAIR EPIGASTRIC HERNIA $793.00REPAIR EPIGASTRIC HERNIA (EG, PREPERITON $797.00REPAIR EPIGASTRIC HERNIA (EG, PREPERITON $833.00REPAIR ING HERNIA SLIDING ANY AGE $915.00REPAIR ING HERNIA SLIDING ANY AGE $915.00REPAIR INGUINAL HERNIA, SLIDING, ANY AGE $961.00REPAIR INIT ING HERNIA >5 YR; INCARC $1,016.00REPAIR INIT ING HERNIA >5 YR; INCARC $1,016.00REPAIR INITIAL FEMORAL $1,038.00REPAIR INITIAL FEMORAL HERNIA ANY AGE RE $1,090.00REPAIR INITIAL FEMORAL HERNIA, ANY AGE; $1,090.00REPAIR INITIAL INC/VENTRAL HERNIA $1,149.00REPAIR INITIAL INC/VENTRAL HERNIA $1,149.00REPAIR INITIAL INCISIONAL OR VENTRAL HER $1,207.00REPAIR INITIAL INCISIONAL OR VENTRAL HER $1,928.00REPAIR INITIAL INGUINAL $977.00REPAIR INITIAL INGUINAL $977.00REPAIR INITIAL INGUINAL HERNIA, AGE 5 YE $1,026.00REPAIR INITIAL INGUINAL HERNIA, AGE 5 YE $1,067.00REPAIR INTERMEDIATE 7.6-12.5 CM $556.00REPAIR LACERATION TONGUE POSTERIOR 2/3 $508.00REPAIR LACERATION TONGUE POSTERIOR 2/3 $508.00REPAIR LACERATION/TONGUE $327.00REPAIR LACERATION/TONGUE $327.00REPAIR LACERATION/TONGUE W/O CLOUSURE $305.00REPAIR MENISCUS KNEE $1,407.00REPAIR MENISCUS KNEE $1,407.00REPAIR OF BOWEL BULDGE $1,157.00REPAIR OF DUODENAL ULCER $3,354.00REPAIR OF ENTEROCELE, ABDOMINAL APPROACH $1,355.00REPAIR OF ENTEROCELE, VAGINAL APPROACH ( $1,157.00REPAIR OF IRIS $1,322.00REPAIR OF LACERATION; CONJUNCTIVA, WITH $674.00REPAIR OF LACERATION; CORNEA, NONPERFORA $1,410.00REPAIR OF NAIL BED $784.00REPAIR OF PERINEUM PERINEOPLASTY NONOBST $649.00REPAIR OF RECTOCELE $975.00

REPAIR OF TUNICA VAGINALIS HYDROCELE $977.00REPAIR OF WOUND OR LESION $1,518.00REPAIR OF WOUND OR LESION $593.00REPAIR RECURRENT FEMORAL HERNIA; INCARCE $1,777.00REPAIR RECURRENT INCISIONAL OR VENTRAL H $1,831.00REPAIR RECURRENT INCISIONAL OR VENTRAL H $1,949.00REPAIR RECURRENT INGUINAL $1,055.00REPAIR RECURRENT INGUINAL HERNIA, ANY AG $1,108.00REPAIR RECURRENT INGUINAL HERNIA, ANY AG $1,634.00REPAIR RECURRING HERNIA REDUCE $1,055.00REPAIR UMBILICAL HERNIA $1,385.00REPAIR UMBILICAL HERNIA $971.00REPAIR UMBILICAL HERNIA $1,385.00REPAIR UMBILICAL HERNIA $971.00REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR $1,455.00REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR $1,020.00REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, $2,522.00REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEG $2,020.00REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEG $391.00REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM $1,518.00REPAIR, INTERMEDIATE, WOUNDS OF SCALP, A $566.00REPAIR, INTERMEDIATE, WOUNDS OF SCALP, A $724.00REPAIR,COMPLEX,TRUNK;EA ADDIT 5CM OR LES $174.00REPAIR/SIMPLE/SCALP EC $326.00REPLACEMENT DUAD/JEJ TUBE PERC $468.00REPLACEMENT GASTROSTOMY TUBE W/O IMAGING $538.00REPLACEMENT, COMPLETE, OF A PERIPHERALLY $2,827.00REPLCMNT PICVAD W/SUBCUT PORT $2,827.00REPLCMNT PICVAD W/SUBCUT PORT $2,827.00REPOSITION VENOUS CATHETER $350.00REPR BLD VESSEL DIR; UPPER EXTREM $1,438.00REPR CMPLX FORHEAD &/FT 2.6-7.5 CM $2,401.00REPR CMPLX FORHEAD &/FT 2.6-7.5 CM $2,401.00REPR CMPLX FORHEAD &/FT 2.6-7.5 CM $2,522.00REPRODUCTIVE HEALTH THROMBOPHILIA PROFIL $231.00REQUIP (ROPINIROLE HCL) 0.25MG TAB $8.00REREMOVE WRIST TENDON LESION $744.00REREPAIR VENTRL HERN, BLOCK $1,856.00REREPAIR VENTRL HERN, BLOCK $1,856.00REREPAIR VENTRL HERN;REDUCE $1,743.00REREPAIR VENTRL HERN;REDUCE $1,743.00REREPAIRING HERNIA, BLOCKED $1,556.00REREPAIRING HERNIA, BLOCKED $1,556.00RESECTOR SHAVER BLADE $65.00RESP MUSCLE TRAINER $51.00RESP THER PROC OTHER $80.00RESPIRATORY FLOW VOLUME LOOP $74.00

RESPIRATORY PROFILE $414.00RESPIRATORY VIRUS PROFILE, PCR (2) $483.00RESTOR, RESOOM CR 5-0 OR $929.00RESUCITATION BAG ADULT CPR $55.00RESUCITATION BAG CHILD CPR $174.00RESUCITATION BAG INFANT CPR $182.00RETENTION SUTURE BOLSTER $13.00RETICULOCYTE COUNT $72.00RETROGRADE PYELOGRAM $596.00RETROVIR (ZIDOVUDINE INF) 200 MG VIAL $113.00RETURN ELECTRODE $25.00REV/REMOVAL OF PERIPHERAL GASTRIC NPGR $622.00REVERSE T3 SERUM $259.00REVEX (NALMEFENE HCL) 100 MCG AMP $40.00REVISE/REMOVE NEUROELECTRODE $7,346.00REVISE/REMOVE NEUROELECTRODE $478.00REVISE/REMOVE NEUROELECTRODE $478.00REVISION AV FISTULA $1,402.00REVISION AV FISTULA $1,402.00REVISION OF COLOSTOMY; SIMPLE (RELEASE O $1,570.00REVISION OF PROSTHETIC VAGINAL GRAFT $1,153.00REVISION OR REMOVAL OF PERIPHERAL NEUROS $478.00REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GEN $945.00RF FACTOR (ASSOCIATED CHARGE) $154.00RHEUMATOID ARTHRITIS PANEL $162.00RHEUMATOID FACTOR $114.00RHEUMATOID TITER $120.00RHINOCORT AQ (BUDESONIDE) NASAL SPRAY $308.00RHO D IMMUNE GLOBULIN $184.00RHO(D) IMMUNE GLOBULIN (RHIG), HUMAN, FU $220.00RHOGAM ULT-FILTER SYRINGE $538.00RHOPHYLAC 300MCG/2ML $83.00RHYTHM ECG INTERP FROM STRIP $67.00RHYTHM STRIP $98.00RIBONUCLEOPROTEIN ANTIBODY $75.00RIBS BILATERAL W/O CHEST $680.00RIBS LT W/O CHEST $423.00RIBS RT W/O CHEST $423.00RIFAMPIN 300 MG CAPSULE (RIFADIN) $11.00RIFAMPIN 600MG VIAL $573.00RIGHT WRIST SUPPORT SM $126.00RiMANTADine 100MG TABLET (FLUMADINE) $12.00RISPERDAL (RISPERIDONE) 2MG TABLET $24.00RISPERDAL CONSTA 50MG KIT $2,215.00RISPERDAL LEVEL $277.00RISPERIDONE 0.25MG TABLET (RISPERDAL) $22.00RISPERIDONE 1MG TAB (RISPERDAL) $7.00

RISTOCETIN COFACTOR- VW ACTIVITY $135.00RITALIN $277.00RITUXAN (RITUXIMAB) 100 MG VIAL $3,038.00RITUXAN (RITUXIMAB) 500 MG VIAL $6,690.00RIVAROXABAN $138.00RM TURNOVER PACK $55.00RMVL TUN CTR VAD W/SUBQ $459.00ROBITUSSIN (GUAIFENESIN/D-METH) 4 OZ $14.00ROCEPHIN 1 GRAM VIAL $229.00ROCEPHIN 250 MG $51.00ROCKER CAST BOOT M $27.00ROCKER CAST BOOT S/M $27.00ROCKER SWITCH PENCIL $71.00ROCKY MOUNTAIN SPOTTED FEVER IGG $80.00ROCKY MOUNTAIN SPOTTED FEVER IGM $61.00ROCURONIUM 100MG/10ML (ZEMURON) $42.00ROLLATOR, DELUXE BURG. 250 LBS $194.00ROLYAN FABIFROM GAUNTLET $66.00RONDEC DM (D-METHORP/P-EPHED/CARBIN) 30 $26.00ROPINIROLE 0.5MG TABLET (REQUIP) $6.00ROPINIROLE 1MG TABLET (REQUIP) $8.00ROPINIROLE 2MG TABLET $10.00ROPINIROLE HCL 2MG TAB (REQUIP) $14.00ROPIVACAINE 10MG/ML 1% 20ML AMP $71.00ROTATABLE SNARE $281.00ROTATEQ (ROTAVIRUS VACCINE) $116.00ROTATEQ/ROTARIX $182.00ROTATOR POLYPECTOMY SNARE $203.00ROTAVIRUS $51.00ROTICULATOR 55-4.8 $1,044.00ROTOLASE FIBER $1,325.00ROUTINE FT CARE;RMVL/TRIM NAILS/CALLUSES $32.00ROUTINE OBSTETRIC CARE INCLUDING ANTEPAR $3,678.00ROUTINE OBSTETRIC CARE INCLUDING ANTEPAR $4,169.00ROUTINE OBSTETRIC CARE INCLUDING ANTEPAR $5,381.00ROUTINE OBSTETRIC CARE INCLUDING ANTEPAR $5,780.00RPLCMNT/CATH ONLY/CENTRAL VENOUS W/SUBCU $1,383.00RPLCMNT/CATH ONLY/CENTRAL VENOUS W/SUBCU $1,383.00RPLCMNT/CENTRAL VENOUS W/SUBCUT PORT $1,906.00RPR $77.00RPR VENTRAL HERN INIT, BLOCK $1,836.00RPR VENTRAL HERN INIT, BLOCK $1,836.00RPR W/REFLEX TO QUANTITATIVE $57.00RSP BASEPLATE 30MM $2,316.00RSV $134.00RT ATRIAL CATH $280.00RT. 2ND TOE DISARTICULATION AMPUTATION $797.00

RUBELLA $107.00RUBELLA IGG $107.00RUBELLA IGG ( IN HOUSE ) $107.00RUBELLA IGM $107.00RUBEOLA IGG $77.00RUBEOLA IGM $77.00RUFINAMIDE $202.00RUFINAMIDE $263.00RUSSELS VIPER VENOM TIME $168.00S2 6 CUFFLESS TRACH TUBE $297.00SACRO BELT LGE LOOP LOCK $200.00SACRO BELT X LRG 13 X 44 $130.00SACRO LUMBAR SUPPORT $497.00SACRO-ILIAC JNTS MIN 3V $267.00SADDLE BLOCK TRAP $33.00SAGITTAL BLADE ORTHO $275.00SALEM SUMP 10FR $14.00SALEM SUMP 12FR $28.00SALEM SUMP 14FR $12.00SALEM SUMP 18FR. $7.00SALEM SUMP 6 FR $79.00SALICYLATES $123.00SALINE $9.00SALIVARY GLANDS XRAY $195.00SALPINGECTOMY $2,198.00SALPINGECTOMY $2,198.00SALPINGECTOMY, COMPLETE OR PARTIAL, UNIL $2,198.00SALPINGO-OOPHORE CTOMY, COMPLETE OR PART $1,267.00SALPINGO-OOPHORECTOMY $1,206.00SALPINGO-OOPHORECTOMY $1,206.00SALSALATE 500 MG TABLET (DISALCID) $6.00SALSALATE 750 MG TABLET (DISALCID) $4.00SAMPLING TUBING KIT $40.00SANDOSTATIN LAR DEPOT (OCTREOTIDE) 20MG $3,303.00SANDOSTATIN LAR DEPOT (OCTREOTIDE) 30MG $9,476.00SANTYL (COLLAGENASE) OINT 30GM $229.00SAW BLADE 7.0X0.3 YAKEL $66.00SAW BLADE 9.0X0.3 YAKEL $96.00SCALPEL # 10 $5.00SCALPEL # 11 $8.00SCALPEL # 15 $8.00SCALPEL # 20 $8.00SCAPULAR FX $959.00SCAR REVISION $326.00SCAR REVISION $326.00SCAR REVISION $326.00SCISSOR METZENBAUM INSRT 12MM $176.00

SCOLIOSIS SCREEN 1 VIEW AP ENTIRE SPINE $176.00SCOPE KNEE DX W/WO SYN BX SEP PROC $718.00SCOPE KNEE SURG DEBRIDE SHAVE CART $970.00SCOPE KNEE SURG DEBRIDE SHAVE CART $970.00SCOPE KNEE W/MENISCUS MEDIAL/LATERAL $1,155.00SCOPE KNEE W/MENISCUS MEDIAL/LATERAL $1,155.00SCREENING COLONSCOPY $485.00SCREENING FOR DEPRESSION PERFORMED (DEM) $1.00SCREENING MAMMOGRAPHY RESULTS DOCUMENTED $1.00SCREW 47-1162-22 COMPRESSION $293.00SCREW 6.5 X 60MM $820.00SCREW 6.5 X 65MM $820.00SCREW 6.5 X 75MM $820.00SCREW 6.5MM 20MM $168.00SCREW 6.5MM 35MM $168.00SCREW BIOSURE REGENE-ORTHO $1,135.00SCREW CANNULATED - ZMS $583.00SCREW CANNULATED - ZMS $583.00SCREW CANNULATED - ZMS $583.00SCREW CANNULATED - ZMS $583.00SCREW CANNULATED SHORT 4MM $639.00SCREW CANNULATED -ZMS $583.00SCREW LAG R 75MM - ZIMMER $587.00SCREW LAG R 80MM - ZIMMER $555.00SCREW LAG R 85MM - ZIMMER $613.00SCREW LAG R 90MM - ZIMMER $591.00SCREW LAG R 95MM - ZIMMER $623.00SCREW LAG S 70MM - ZIMMER $573.00SCREW LAG S 75MM - ZIMMER $573.00SCREW LAG S 80MM - ZIMMER $573.00SCREW LAG S 85MM - ZIMMER $620.00SCREW LAG S 90MM - ZIMMER $580.00SCREW LAG S 95MM - ZIMMER $620.00SCREW LOCK BONE 5X18 $119.00SCREW LOCK BONE 5X22 $119.00SCREW LOCK BONE RSP 5X30- ORTHO $375.00SCREW LOCKING 3.5MM 18MM $377.00SCREW LOCKING 3.5MM 22MM $447.00SCREW LOCKING 3.5MM 28MM $447.00SCREW LOCKING 3.5MM 30MM $447.00SCREW LOCKING BONE RSP 5X14 $119.00SCREW LOCKING BONE RSP 5X22 $119.00SCREW LOCKING BONE RSP 5X26 $119.00SCREW SNAP OFF 2M L 12MM $804.00SCREW, CANLT SHT THREAD 2.0X18 HDLS $718.00SCREW, CORTEX 3.5TI 12MM $144.00SCREW, CORTEX 3.5TI 14MM $144.00

SCREW, CORTEX 3.5TI 16MM $144.00SCROTAL EXPLORATION $954.00SD CANNULATED SCREW- 2.5X114MM $635.00SD CANNULATED SCREW- 2.5X12MM $635.00SECONDARY CLOSURE OF SURG WOUND $2,036.00SECONDARY CLOSURE OF SURG WOUND $2,036.00SECONDARY MED SET $13.00SECONDARY MED SET CLEARLINK $7.00SECURE STRAP STAPLER $896.00SECURE-A-PEN REPLACEMENT $57.72SED RATE $102.00SELEGILINE 5 MG CAPSULE (ELDEPRYL) $13.00SELENIUM SERUM OR PLASMA $125.00SELF MGMNT EDU & TRAINING 30MIN $71.00SELF MGMNT EDU & TRAINING 30MIN $59.00SELF SEAL CAP/GYNECOLOGY $48.51SELLA TURCICA XRAY $159.00SEMEN CHECK POST VAS $98.00SEMI-TUBULAR PLATE ECT $194.00SENNA 8.6MG TABLET (SENOKOT) $6.00SENSOR LNCS NEO-3 NEONATAL/ADULT 3 FT $64.00SEPRA-FILM PRECISION PACK 3X5 (sheets) $450.00SEREVENT (SALMETEROL) DISKUS INHALER $165.00SERFAS 50-S SWEEP $315.00SERFAS ENERGY 90-S CRUISE $278.00SERFAS ENERGY 90-S CRUISE $278.00SEROTONIN $213.00SERTRALINE 50 MG TABLET (ZOLOFT) $6.00SERVICE OUT OF OFFICE; PT REQUEST $49.00SEX HORMONE BINDING GLOBULIN $82.00SHANNON 44 BURR 55ML $206.00SHANNON 44 BURR 65ML $206.00SHANNON 44 BURR 75ML $206.00SHAVE SKIN LESION 1 TRUNK/ARM/LEGS>2.0CM $182.00SHAVE SKIN LESION 1 TRUNK/ARMS/LEGS 0.5< $203.00SHAVING SKIN LESION $150.00SHAVING SKIN LESION $70.00SHAVING SKIN LESION $209.00SHAVING SKIN LESION $203.00SHAVING SKIN LESION $363.00SHAVING SKIN LESION $203.00SHAVING SKIN LESION 0.6-1.0CM $81.00SHEATH INTRODUCER 8.5 $239.00SHEATH INTRODUCER KIT 6 F $177.00SHEATH INTRODUCER KIT 8.5 FR $208.00SHEPARD DRAIN TUBE 040 DT $84.00SHILEY TRACH 6.0 $205.00

SHILEY TRACH 6.0 NON FINSTRATED $160.00SHOE CAST LG CANVAS $27.00SHOE POST OP FEMALE LARGE $27.00SHOE POST OP FEMALE MEDIUM $27.00SHOE POST OP FEMALE SMALL $27.00SHOE POST OP MALE LARGE $27.00SHOE POST OP MALE MEDIUM $27.00SHOE POST OP MALE SMALL $27.00SHORT LEG CAST $171.00SHORT LEG CAST $171.00SHORT LEG CAST $180.00SHORT LEG SPLINT $130.00SHORT LEG SPLINT $123.00SHORT LEG SPLINT $123.00SHORT LEG SPLINT PED $106.00SHORT LEG WALKING CAST SYNTHETIC $210.00SHORT NARR0W BLADE 11.5MMX5.5MM $153.00SHOULDER IMMOB SMALL FEM $101.00SHOULDER IMMOBILIZER $57.00SHOULDER IMMOBILIZER- UNIVERSAL $20.00SHOULDER LT 1V $188.00SHOULDER REPAIR SET-ORTHO $700.00SHOULDER REVERSE HUMERAL STEM $9,880.00SHOULDER RT 1V $188.00SHOULDER SLING & SWATHE $171.00SICKLE CELL SCREEN $72.00SIDE CUTTING BUR MED $122.00SIGMOID COLON RESECTION W/COLOSTOMY $4,527.00SIGMOID COLON RESECTION W/COLOSTOMY $4,527.00SIGMOIDOSCOPY $364.00SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, INC $221.00SIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SI $287.00SIGMOIDOSCOPY/DX W OR $210.00SIGMOIDOSCOPY/DX W OR $210.00SIGMOIDOSCOPY;DECOMPRESSION $300.00SIGMOIDOSCOPY;DX BIOPSY $273.00SIGMOIDOSCOPY;DX BIOPSY $273.00SIGMOIDOSCOPY;REMOVAL $518.00SIGMOIDOSCOPY;REMOVAL $518.00SILICONE DIAPHRAM LEAFFLET VALVE $15.00SILOLGRAPHY SET 16 $61.00SILVER NITRATE APPLICATORS $6.00SILVER SULFADIAZINE 400 GM (SILVADENE) $49.00SILVER SULFADIAZINE 50GM TUBE(SILVADENE) $39.00SILVERLON DRESSING 4X10- ORTHO $180.00SILVERLON DRESSING 4X12-ORTHO $180.00SIMETHICONE 80 MG TABS $6.00

SIMETHICONE DROPS 30 ML (MYLICON) $9.00SIMPL REPR FACE&/MUCOUS;2.6-5.0 CM $101.00SIMPLE LACERATION REPAIR FACE <2.5 CM $102.00SIMPLE REMOVAL OF EACH ADDTIONAL TOENAIL $191.00SIMPLE REPAIR 20.CM TO 30.CM $1,350.00SIMPLE REPAIR I 2.6 CM 7.5 CM $326.00SIMPLE REPAIR I 2.6-7.5CM $310.00SIMPLE REPAIR I 2.6-7.5CM $310.00SIMPLE REPAIR I 20.1 CM TO 30 CM $1,310.00SIMPLE REPAIR I 7.6 CM TO 12.5 CM $456.00SIMPLE REPAIR I 7.6 CM TO 12.5 CM $434.00SIMPLE REPAIR I 7.6 CM TO 12.5 CM $434.00SIMPLE REPAIR I OVER 30 CM $1,518.00SIMPLE REPAIR I UP TO 2.5 CM $327.00SIMPLE REPAIR I UP TO 2.5CM $311.00SIMPLE REPAIR I UP TO 2.5CM $311.00SIMPLE REPAIR II 12.6-20CM $707.00SIMPLE REPAIR II 2.6-5.0CM $456.00SIMPLE REPAIR II 2.6-5.0CM $298.00SIMPLE REPAIR II 2.6-5.0CM $298.00SIMPLE REPAIR II 2.6-5.0CM $114.00SIMPLE REPAIR II 20.1-30CM $1,415.00SIMPLE REPAIR II 5.1-7.5CM $556.00SIMPLE REPAIR II 7.6-12.5CM $660.00SIMPLE REPAIR II OVER 30 CM $1,664.00SIMPLE REPAIR II UP TO 2.5 CM $285.00SIMPLE REPAIR II UP TO 2.5 CM $260.00SIMPLE REPAIR II UP TO 2.5 CM $260.00SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S $327.00SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S $326.00SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S $456.00SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF S $1,518.00SIMPLE RREPAIR I 12.6 CM TO 20 CM $507.00SIMPONI ARIA (GOLIMUMAB) 50MG/4ML VIAL $3,600.00SIMVASTATIN 5 MG TAB (ZOCOR) $8.00SINGLE TISSUE BIOPSY $158.00SINUS 1V/2V $186.00SINUS RINSE KIT (SODIUM CHLORIDE) $43.00SINUS SERIES MIN 3V $470.00SIOLO/HYSTSALP TRAY XRAY $47.00SIOLOGRAPHY SET 12 $61.00SIROLIMUS $84.00SIROLIMUS 1MG TABLET (RAPAMUNE) $36.00SIS;COLOR FLOW DOPPLER $203.00SIS;COLOR FLOW DOPPLER $203.00SITZ BATH $11.00SKELETAL SURVEY COMPLETE $600.00

SKIN BARRIER 1 3/4 W FLANGE $28.00SKIN BARRIER 4 X 4 $10.00SKIN BARRIER 4X4 $17.00SKIN BARRIER 8X8 $31.00SKIN BARRIER CONVEX 11/2 SIZE 21/4 $12.00SKIN BARRIER FLANGE 4 $38.00SKIN BARRIER W/FLANGE 2 3/4 (NEW IMAGE $9.00SKIN BARRIER W/FLANGE 4 $15.00SKIN BIOPSY $158.00SKIN FULL GRAFT $1,392.00SKIN FULL GRAFT FACE/GENIT/HF $1,176.00SKIN FULL GRAFT HAND $1,172.00SKIN GRAFT BLADES STERILE $41.00SKIN MARKER PREP RESISTANT $5.00SKIN MARKER- STERILE ORTHO $28.00SKIN PREP TRAY $35.00SKIN SKRIBE PENS $17.00SKIN STAPLER 15 $58.00SKIN STAPLER 35W $36.00SKIN STAPLER MDS-5 $28.00SKIN SUB GRAFT 25 SQ CM TO 100 SQ CM $4,086.00SKIN TEMPERATURE PROBE DISPOSABLE $49.00SKIN TEMPERATURE SENSOR $11.00SKULL SERIES ROUTINE-MIN 4V $383.00SKULL SERIES<4V $203.00SKYLA IUD 13.5MG (LEVONORGESTREL) $980.00SLEEP STUDY $2,779.00SLEEP STUDY CHILD YOUNGER THAN 6 YEARS $2,779.00SLEEP STUDY CPAP TITRATION $3,515.00SLEEVE STABILITY 5MM $120.00SLING OPEATION/STRESS INCONTINENCE $1,969.00SLING OPEATION/STRESS INCONTINENCE $1,969.00SLING OPERATION FOR STRESS INCONTINENCE $1,969.00SLING OPERATION STRESS INCONTINENCE $1,969.00SLITTING OF PREPUCE, DORSAL OR LATERAL ( $375.00SLO-MAG64 (MAGNESIUM CL) 64 MG TAB $6.00SLO-PHYLLIN (THOPHY.ANHY) 80MG/15ML 2 OZ $16.00SM FROG FINGER SPLINT $24.00SM HINGED KNEE BRACE $219.00SM OPEN CLIPPER $432.00SM PLATE 2MM X 11 $255.00SMALL BOWEL ANASTOMOSIS $1,671.00SMALL BOWEL ENDOSCOPY $368.00SMALL BOWEL ENDOSCOPY $368.00SMALL BOWEL SERIES $330.00SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY $648.00SMALL KNEE SPLINT $208.00

SMALL PETELLA SPLINT $157.00SMALL TEAR CROSS CUT RASP $412.00SMALL TRACT SPLINT $139.00SMOKE EVACUATOR $92.00SMOOTH BITE SHAVER BLADE $131.00SMOOTH MUSCLE ANTIBODY $203.00SN60WF IOL ALCON $164.00SNP MICROARRAY-PEDIATRIC $2,103.00SO/SI PERMA PURE $15.00SOD CITRATE/CITRIC ACID 30ML (BICITRA) $8.00SOD/POT PHOS 250MG POWDER (NEUTRA-PHOS) $7.00SODIUM $74.00SODIUM BICARBONATE 4.2% INFANT SYRINGE $83.00SODIUM BICARBONATE 650MG TABLET $6.00SODIUM BICARBONATE 8.4% ADULT 50MEQ SYR $56.00SODIUM BICARBONATE 8.4% PED SYRINGE $93.00SODIUM BICARBONATE 8.4% VIAL 50MEQ/50ML $47.00SODIUM CHL AVIVA 0.9% 500ML $48.00SODIUM CHL IRR 1000 $14.00SODIUM CHL IRR 500 $13.00SODIUM CHL VIAFLO 0.9% 250ML $24.00SODIUM CHLORIDE 0.65% NASAL SPRAY(OCEAN) $1.00SODIUM CHLORIDE 0.9% 250ML IN GLASS $21.00SODIUM CHLORIDE 0.9% 500ML AVIVA $55.00SODIUM CHLORIDE 0.9% FLUSH 3ML IN 3ML $15.00SODIUM CHLORIDE 0.9% FOR INHALATION 3ML $6.00SODIUM CHLORIDE 0.9% INHALATION 3ML VIAL $5.00SODIUM CHLORIDE 0.9% VIAL 20ML $17.00SODIUM CHLORIDE 23.4% 30ML VIAL $57.00SODIUM CHLORIDE 3% (HYPERTONIC) 500ML $21.00SODIUM CHLORIDE 5% 500 $31.00SODIUM CHLORIDE 9% 3000ML $41.00SODIUM CHLORIDE BACT.(NACL/BACTERIOSTAT $27.00SODIUM CHLORIDE IRR 250ML $9.00SODIUM CHLORIDE IRRIG.1500 $15.00SODIUM CHLORIDE/POT 452MG TAB(THERMOTAB) $6.00SODIUM CIT/CITRIC ACID 30ML (BICITRA) $7.00SODIUM CLOR IRRIG 2000CC $35.00SODIUM FERRIC GLUCONATE 62.5MG VIAL $115.00SODIUM PHOSPHATE 15MM/5ML SDV $5.00SODIUM PHOSPHATE 20MM/20ML SDV $102.00SODIUM PHOSPHATE 250MG TABLET $6.00SODIUM POLYSTR/SORB 15G/60ML(KAYEXALATE) $45.00SODIUM THIOSULFATE (SOD. THIOSUL) 12.5GM $722.00SODIUM URINE - RANDOM URINE $57.00SODIUM URINE 24 HR $57.00SOFT CAST 2 $60.00

SOFT TOUCH HEAD POSITIONER $65.00SOFTEC HD IOL $61.00SOLUBLE LIVER ANTIGEN IGG $199.00SOLUBLE TRANSFERRIN RECEPTOR - 143305 $118.00SOLU-CORTEF (HYDROCORTISONE) 1 GM VIAL $223.00SOLU-CORTEF (HYDROCORTISONE) 100 MG $53.00SOLU-CORTEF (HYDROCORTISONE) 5OO MG VIAL $181.00SOLUCORTEF HYDROCOR $63.00SOLUMEDROL INJECTION $16.00SOLUMEDROL UP TO 40 MG $16.00SOLUSET 100 $28.00SOLUTION SET- DUOVENT-NONDEHP $30.34SOLUTION SET- DUOVENT-NONDEHP $30.00SOLUTION SET WITH DUO-VENT SPIKE $15.00SOLUTION SET WITH VENT CAP INTERLINK $43.00SOLYX SLING $1,691.00SOTALOL HCL 80 MG TABLET (BETAPACE) $6.00SPARINE (PROMETHAZINER) 100 MG VIAL $62.00SPECIAL REPORT IME/REPROT W/ PT. EXAM $355.00SPECIFIC GRAVITY $88.00SPECTRACEF (CEFDITOREN) 200MG TABLETS $11.00SPECTROPHOTOMETRY $206.00SPEECH EVAL FOR RX FOR AAC DEVICE 1 HR $357.00SPEECH EVAL FOR RX FOR AAC DEVICE 1 HR $357.00SPEECH THERAPY EVAL FLUENCY $312.00SPEECH THERAPY EVAL FLUENCY $312.00SPEECH THERAPY EVAL SOUND PROD $258.00SPEECH THERAPY EVAL SOUND PROD $258.00SPEECH TREATEMENT FOR USE OF AAC DEVICE $309.00SPEECH TREATEMENT FOR USE OF AAC DEVICE $309.00SPEECH TREATEMENT FOR USE OF AAC DEVICE $309.00SPEECH TREATEMENT FOR USE OF AAC DEVICE $309.00SPEECH/HEARING THERAPY $149.00SPEECH/HEARING THERAPY $149.00SPEECH/HEARING THERAPY $149.00SPEECH/HEARING THERAPY $149.00SPEEDBRG IMPLANT-ORTHO $4,776.00SPHERICAL BURR $372.00SPHINCTERECTOMY $345.00SPHINCTERECTOMY/ANAL $345.00SPHINCTEROTOMY, ANAL, DIVISION OF SPHINC $363.00SPINAL 20gx3.5 NEEDLE $18.00SPINAL 22g x 1.50 NEEDLE $18.00SPINAL 22g X 3.5 NEEDLE $39.00SPINAL 25g x 3.5 WHITCARE NEEDLE $34.00SPINAL NEEDLE WHITCARE 25Gx.5 $41.00SPINAL NEEDLE 20g x .5 $18.00

SPINAL NEEDLE 22gX.5 $20.00SPINAL NEEDLE 5 20 GAUGE $116.00SPINAL NEEDLE 6 20 GAUGE $116.00SPINAL NEEDLE PENCIL-PNT 22GX3 1/2 $37.00SPINAL NEEDLE PENCIL-PNT 25GX3 1/2 $39.00SPINAL PUNCTU $284.00SPINAL PUNCTURE DIAGNOSTIC $284.00SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC $299.00SPINAL18gx3.5 NEEDLE $18.00SPINE 1V $134.00SPINE CERVICAL COMP W FLEX/EXT $612.00SPINE CERVICAL MIN 4V $430.00SPINE ENTIRE SCOLIOSIS MIN 6 VIEW $501.00SPINE LUMB W/BENDING VIEWS - MIN 6 VIEWS $469.00SPINE LUMBOSACRAL-MIN 4V $565.00SPINE THORACIC 2V $271.00SPINE THORACOLUMBAR 2V $205.00SPIRAL ELECTRODE $56.00SPIRAL ELECTRODES QUIK CONNECT $23.00SPIRIVA 18MCG/CAPSULE HANDIHALER $106.00SPIROMETRY $59.00SPIROMETRY, INCLUDING GRAPHIC RECORD, TO $62.00SPIRONOLACTONE 100MG TABLET (ALDACTONE) $6.00SPIRONOLACTONE 25MG TABLET (ALDACTONE) $6.00SPIRONOLACTONE 50MG TABLET (ALDACTONE) $4.00SPIRONOLACTONE/HCTZ 25/25MG TABLET $4.00SPIT HOOD $45.00SPLASH CAP $28.00SPLINT AC $107.00SPLINT BASEBALL 2 13/16 IN $17.00SPLINT CARPAL TUNNEL RT LG $126.00SPLINT CARPAL TUNNEL RT MED $126.00SPLINT CARPAL TUNNEL SM LEFT $123.00SPLINT COLLER SMALL RIGHT $71.00SPLINT COLLES INFANT LEFT $61.00SPLINT COLLES INFANT RT $61.00SPLINT COLLES LARGE LEFT $126.00SPLINT COLLES LARGE RIGHT $107.00SPLINT COLLES MEDIUM LEFT $58.00SPLINT COLLES MEDIUM LEFT $126.00SPLINT COLLES MEDIUM RIGHT $107.00SPLINT COLLES MEDIUM RT $58.00SPLINT COLLES SMALL LEFT $107.00SPLINT FINGER 2 5/8 INCH $17.00SPLINT FINGER LARGE $13.00SPLINT FINGER MEDIUM $13.00SPLINT FOREARM MEDIUM RT $38.00

SPLINT HAND LARGE LEFT $96.00SPLINT HAND LARGE LEFT $107.00SPLINT HAND LARGE RIGHT $110.00SPLINT HAND MEDIUM LEFT $126.00SPLINT HAND MEDIUM RIGHT $83.00SPLINT HAND MEDIUM RIGHT $110.00SPLINT HAND SMALL LEFT $91.00SPLINT HAND SMALL LEFT $110.00SPLINT LEFT PEDS X-SMALL $66.00SPLINT LEG POSTERIOR FEMUR SMALL $335.00SPLINT LEG POSTERIOR LARGE $322.00SPLINT LEG POSTERIOR MEDIUM $322.00SPLINT LEG POSTERIOR SMALL $322.00SPLINT NASAL $24.00SPLINT PETELLA LARGE $169.00SPLINT PETELLA MEDIUM $157.00SPLINT PLASTER 4 $31.00SPLINT SHORT LEG $46.00SPLINT TIBIA & FIBULA MED $135.00SPLINT UNIVERSAL FOREARM LEFT $33.00SPLINT UNIVERSAL FOREMAN RIG $113.00SPLINT UTILITY 11 INCH $28.00SPLINT WAISTBAND FINGER $61.00SPLINT WRIST HAND $164.00SPLINTS PLASTER 5 INCH $58.00SPLIT GFT TRUNK 1ST 100 SQ CM <1% $1,531.00SPLIT GFT TRUNK 1ST 100 SQ CM <1% $1,531.00SPLIT GRAFT/FACE-OTHER $1,471.00SPLIT GRAFT/FACE-OTHER $1,471.00SPONGE PEANUT $5.13SPONGES TONSIL $32.00SPONGES TONSIL 7/8 MEDIUM DOUBLE STRONG $7.00SPOT DYE $135.00ST ASSESSMENT OF APHASIA $192.00ST ASSESSMENT OF APHASIA $192.00ST ASSESSMENT OF APHASIA $192.00ST ASSESSMENT OF APHASIA $192.00ST COGNITIVE THERAPY EA ADDL 15 MIN-GN $72.00ST COGNITIVE THERAPY EA ADDL 15 MIN-GNKX $72.00ST COGNITIVE THERAPY INITIAL 15 MIN-GN $72.00ST COGNITIVE THERAPY INITIAL 15 MIN-GNKX $72.00ST EVAL BEHAVIORAL & QUAL ANAL OF VOICE $265.00ST EVAL BEHAVIORAL & QUAL ANAL OF VOICE $265.00ST EVAL FOR RX AAC DEVICE ADDL 30 MIN $149.00ST EVAL FOR RX AAC DEVICE ADDL 30 MIN $149.00ST EVAL SOUND PROD W/LANG COMP & EXP $464.00ST EVAL SOUND PROD W/LANG COMP & EXP $464.00

STAAR TORIC (ASTIGMATISM) $1,174.00STAAR TORIC (PREBYOPOPIA) $1,174.00STANDARD CANALITH REPOSITIONING PROCEDUR $126.00STANDARD CANALITH REPOSITIONING PROCEDUR $126.00STANDARDIZED COGNITIVE PERFORMANCE TEST $315.00STANDARDIZED COGNITIVE PERFORMANCE TEST $315.00STANDARDIZED COGNITIVE PERFORMANCE TEST $315.00STANDARDIZED COGNITIVE PERFORMANCE TEST $315.00STAPHCILLIN (METHICILLIN) 1 GM VIAL $52.00STAPLER CONTOUR CURVED CUTTER BLU $675.00STAPLER LINEAR CUTTER 55 $414.00STAPLER LINEAR RELOAD 60MM $429.00STAPLER LINEAR RELOADABLE 30 $402.00STAPLER LINEAR RELOADS 60 $519.00STAPLER RELOAD 30 STANDARD $200.00STAPLER RELOAD 60 STANDARD $200.00STAPLES- FIXATION W/SPIKE 11X23 $572.00STAPLES FIXATION W/SPIKES 8X23 $572.00STARR COLLAMER NONOFLES IOL'S $61.00STATLOCK PICC DEVICE $28.00STAVUDINE 40 MG TABLET (ZERIT) $24.00STEINMAN PIN HOLDER $100.00STERI SHUR 91/2 X100 $94.00STERILE BASIN $7.00STERILE SYRINGE SINGLE USE ALLIANCE II $212.00STERILE TALC POWDER $261.00STERILE WATER (WATER FOR INJECT) 50 ML $9.00STERILE WATER 1000 ML BAG $122.00STERILE WATER 1500 $21.00STERILE WATER 250 $14.00STERILE WATER 500 $14.00STERILE WATER BACTERIOSTATIC 30 ML VIAL $17.00STERILE WATER FOR INJ 20ML $18.00STERILE WATER FOR INJ 50 ML VIAL $24.00STERILE WATER IRRIG 2000CC $30.00STERILS WATER FOR INHALATION $12.00STERNOCLAVICULAR JNTS-MIN 3V $195.00STEROID INJ JOINT $420.00STIF NECK COLLAR INFANT $57.00STIF NECK COLLAR PEDS $57.00STIF NECK COLLAR UNIVERSAL $82.00STIFF GUIDE WIRE TYPE 0.035 X 80cm 3cm $308.00STIFF NECK COLLAR UNIVERSAL $48.00STIMUBLAST PUDDY $1,125.00STIMULATOR EXTERNAL- INTERSTIM $725.00STOCKINETTE SURGICAL $20.00STOCKING ANTI EMBOLISM KNEE MED REG $16.00

STOCKING ANTI EMBOLISM KNEE SMALL $16.00STOCKING ANTI EMBOLISM KNEE XLG $16.00STOCKING ANTI EMBOLISM KNEE XXLG $28.00STOCKING ANTI EMBOLISM THIGH LG REG $28.00STOCKING ANTI EMBOLISM THIGH MED $29.00STOCKING ANTI EMBOLISM THIGH SMALL $29.00STOCKING ANTI EMBOLISM THIGH XLG $38.00STOCKING ANTI-EMBOLISM KNEE LARGE $16.00STOMA BAG W/FLANGE 1 3/4 $33.00STOMAHESIVE PASTE $14.00STOMAHESIVE POWDER $13.00STONE ANALYSIS $65.00STONE ANALYSIS $65.00STONE RETRIEV W/ FIL TIP 11MM $394.00STONE RETRIEV W/ FIL TIP 8MM $394.00STONE RETRIEV W/O FIL TIP 11MM $335.00STONE RETRIEV W/O FIL TIP 8MM $394.00STONECUTTER BURR-ORTHO $448.00STOP COCK 4 WAY $21.00STOP COCK 4 WAY $8.00STOP COCK 4 WAY 20 EXIT $25.00STRAP ARMBOARD ORTHO $14.00STRAP MCLEOD CLAVICLE LG $68.00STRAPPING OF SHOULDER $107.00STRAPPING; UNNA BOOT $118.00STREP $121.00STREPTASE (STREPTOKINASE) 1.5MMU VIAL $1,289.00STREPTOCOCCUS PNEUMONIAE ANTIGEN $104.00STREPTOZYME $108.00STRESS TEST W/PMC TECH $1,133.00STRESS TEST-TRACING ONLY $469.00STRETCH A TRAY $24.00STRIATIONAL ANTIBODIES $61.00STRONG IODINE (POT.IOD/IODINE) 14 ML $80.00STRUCTURAL BALLOON TROCAR $610.00STYLET 10FR.SATIN SLIP $21.00STYLET 14FR.SATIN SLIP $14.00STYLET 6FR.SATIN SLIP $20.00SUBCLAVIAN CANNULAE $161.00SUBCLAVIAN CATH 14 $69.00SUBSEQ NHOME VISIT HX/EXAM $110.00SUBSEQ NHOME VISIT HX/EXAM $110.00SUBSEQ NHOME VISIT HX/EXAM LOW COMP $168.00SUBSEQ NHOME VISIT HX/EXAM LOW COMP $168.00SUBSEQ NHOME VISIT HX/EXAM MOD COMP $222.00SUBSEQ NHOME VISIT HX/EXAM MOD COMP $222.00SUBSEQUENT HOSP CARE LEVEL ONE $80.00

SUBSEQUENT HOSP CARE LEVEL ONE $80.00SUBSEQUENT HOSPITAL CARE LEVEL THREE $307.00SUBSEQUENT HOSPITAL CARE LEVEL THREE $307.00SUBSEQUENT HOSPITAL CARE LEVEL TWO $175.00SUBSEQUENT HOSPITAL CARE LEVEL TWO $175.00SUBSEQUENT OBSERVATION CARE $95.00SUBSEQUENT OBSERVATION CARE $99.00SUBSEQUENT OBSERVATION CARE $181.00SUBTOTAL OR TOTAL HYSTERECTOMY AFTER CES $1,223.00SUBTOTAL/TOTAL HYSTERECTOMY C SECTION $1,223.00SUCCINYLCHOLINE 200 MG VIAL (ANECTINE) $20.00SUCRALFATE 1 GRAM TABLET (CARAFATE) $8.00SUCRALFATE SUSP 1GM/10ML UD (CARAFATE) $26.00SUCTION CANNULA CURETTE 9 FR $49.00SUCTION CATH 10FR REPLOGLE $48.00SUCTION CATH 6 FR REPLOGE $48.00SUCTION CATH 8 FR REPLOGLE $48.00SUCTION COAGULATION(BOVIE) FOOT $39.00SUCTION DISK $83.00SUCTION KITY 6 1/2 $8.00SUCTION RESEVVIOL 100 CC $11.00SUCTION SYSTEM- ORTHO $232.00SUCTION TUBING 10' $3.10SUDAFED COUGH(GUAIFENSEN/DM/P-EPHED) 2OZ $20.00SUFENTA (SUFENTANIL)50MCG 2ML*DO NOT USE $155.00SUFENTANIL (SULFENTANIL) 50 MCG 2ML AMP $213.00SUGAMMADEX (BRIDION) 500MG/5ML $855.00SUGAMMADEX 200MG/2ML SDV $593.00SUICIDE RISK ASSESSED (MDD, MDD ADOL) $1.00SULFACETAMIDE 10% OPHT SOLN 15 ML $118.00SULFACETAMIDE 10% OPTHALMIC OINTMENT $47.00SULFADIAZINE 500MG TAB $6.00SULFAMETH 200/40MG/5ML 5ML DOSE(SEPTRA) $8.00SULFAMETH/TMP 800-160MG/10ML VIAL $85.00SULFAMETHOX/TRIMETHOPRIM 800/160MG TAB $6.00SULFAMETHOXAZOLE/TRIMETHOPRIM 400/80 TAB $4.00SULFASALAZINE 500MG TABLET (AZULFIDINE) $6.00SULINDAC 150 MG TABLET (CLINORIL) $6.00SULINDAC 200 MG TABLET (CLINORIL) $7.00SUMATRIPTAN 6 MG SDV (IMITREX) $103.00SUMATRIPTAN 25 MG TAB (IMITREX) $9.00SUMATRIPTAN TABLET 100MG (IMITREX) $7.00SUPPLY/IMPLANTS $4,304.00SUPPLY/IMPLANTS $4,434.00SUPPORT ANKLE MALE MED LT $46.00SUPPORT KNEE HINGED XLRG $282.00SUPPORTER ATHLETIC LARGE $34.00

SUPPORTER ATHLETIC MED $34.00SUPPORTER ATHLETIC SM $34.00SUPPORTER ATHLETIC XLG $53.00SUPRA PUBIC CATH KIT 10FR $317.00SUPRACERVICAL ABCOMIN $1,543.00SUPRACERVICAL ABCOMIN $1,543.00SUPRACERVICAL ABDOMINAL HYSTERECTOMY (SU $1,621.00SUPRACONDYLAR PLATE 10 $696.00SUPRACONDYLAR PLATE 6 $613.00SUPRACONDYLAR PLATE 8 $613.00SUPRAPUBIC CATHETER 14 FR $315.00SUPRAPUBIC INTRODUCER ONE STEP 16FR $404.00SUPRAX (CEFIXIME) 100MG/5ML 50ML SUSP $162.00SURE CLOSURE SKIN STRETCHING $860.00SURFACAINE 1% $24.00SURG STAPLES SM SHORT W/SPIKES $506.00SURG TREATMENT ECTOPIC PREGNANCY $1,448.00SURG TREATMENT ECTOPIC PREGNANCY $1,448.00SURG TX OF EC $1,343.00SURGI/COVER ULTRASOUND PROBE $96.00SURGICAL BOOT/SHOE $174.00SURGICAL LIGHT HANDLES $13.00SURGICAL PATHOLOGY REVIEW-LEVELIV GROSS $273.00SURGICAL SNOW $499.00SURGICAL SUPPLIES $129.00SURGICAL TRAY $67.00SURGICAL TREATMENT OF ANAL FISTULA (FIST $998.00SURGICAL TREATMENT OF ECTOPIC PREGNANCY; $1,411.00SURGICAL TREATMENT OF ECTOPIC PREGNANCY; $1,521.00SURGICAL TX ANAL FISTUAL;SUBCUT $998.00SURGICEL-HEMOSTAT ABSORBABLE .5in x 2 $418.00SURGIMESH 2X4 IN $611.00SURGIMESH OPEN UMBILICAL $1,575.00SURGIMESH OPEN VENTRAL $1,975.00SURGIMESH WN 1/2 OVALE 6X13 CM $575.00SURGIMESH WN 10X15 $725.00SURGIMESH WN 14X15 $1,050.00SURGIMESH XB 11X13 $3,275.00SURGIMESH XB 26X22X14.6cm $3,075.00SURGIMESH XB 30X30 $3,180.00SURGIMESHXB 10 $1,500.00SURGIMESHXB 15 $1,985.00SURGIMESHXB 15-22 $2,975.00SURGIMESHXB- 7 $1,175.00SURGIPRO MESH UNDYED 3X5 $584.00SURGSTAPLER EEA 28 $907.00SURMONTIL (TRIMIPRAMINE) 25 MG CAP $6.00

SURROUND ELBOW W/ FLOAM, UNIV $45.00SURVANTA (BERACTANT) 8 ML VIAL $3,029.00SUS-PRINE (EPINEPHRINE) 1:200 AMP $47.00SUTR ANCH MINI $814.00SUTURE $51.00SUTURE $30.00SUTURE 2 STEEL $37.00SUTURE 3-0 ETHILON $17.00SUTURE 4 STEEL $37.00SUTURE 4.0 ETHILON $17.00SUTURE 4.0 VICRYL $21.00SUTURE 6-0 ETHILON $17.00SUTURE CHROMIC 2-0 UR6 $82.34SUTURE CHROMIC EYE 50 $35.00SUTURE CHROMIC EYE 60 $35.00SUTURE CHROMIC GUT 2/0 27 UR $82.34SUTURE EJ10G VICRYL ENDOSCOPIC SIZE 0 $196.00SUTURE LARGE INTESTINE $2,596.00SUTURE MINI ANCHOR QFIX 1.8MM-ORTHO $1,251.00SUTURE OF LARGE INTESTINE (COLORRHAPHY) $2,596.00SUTURE OF SMALL INTESTINE (ENTERORRHAPHY $3,220.00SUTURE PACK $27.00SUTURE PLAIN EYE 50 $35.00SUTURE PLAIN EYE 60 $35.00SUTURE PROLENE EYE 10 0 $146.00SUTURE QUILL 2.5 CIRCLE (ORTHO) $112.00SUTURE QUILL MONO QUILL 2-0 3/8 (ORTHO) $112.00SUTURE QUILL O (3.5M) (ORTHO) $110.00SUTURE QUILL SRS 0 .5 CIRCLE TAPE ORTHO $110.00SUTURE STEEL 2 $51.00SUTURE VICRYL EYE 60 $35.00SUTURE VICRYL EYE 70 $35.00SUTURE, SMALL INTESTINE $3,220.00SWALLOWING & ORAL FUNCTION EVALUATION $185.00SWALLOWING & ORAL FUNCTION EVALUATION $185.00SWALLOWING & ORAL FUNCTION EVALUATION $185.00SWALLOWING & ORAL FUNCTION EVALUATION $185.00SWALLOWING FUNCTION W/VIDEO $228.00SWALLOWING/ORAL TX $185.00SWALLOWING/ORAL TX $185.00SYMBICORT 160/4.5 INHALER (BUDES/FORMOT) $174.00SYNAGIS (PALIVIZUMAB) 100MG VIAL $11,709.00SYNAGIS (PALIVIZUMAB) 50 MG VIAL $7,445.00SYNERCID (QUINUPRISIN/DALFORPRISTINE) IV $558.00SYNTHETIC DRUG PROFILE $1,420.00SYNVISC (HYLAN G-F20) 2ML SYRINGE $1,795.00SYNVISC INJECTION FOR 2 CC $623.00

SYNVISC ONE 8MG/1ML 6ML SYRINGE - BIL $1,818.00SYNVISC ONE 8MG/1ML 6ML SYRINGE - LT $1,818.00SYNVISC ONE 8MG/1ML 6ML SYRINGE -RT $1,818.00SYRINGE 140 CC $31.00SYRINGE 50CC BULB $4.00SYRINGE CONTROL 20 CC $11.00SYRINGE TOOMEY 60ML $8.20SYRINGES STELLANT CT $78.00SYSTANE OPTH SOLUTION 0.4%-0.3% $6.00T & B CELL QUANTITATION (C) $167.00T TUBE 10 FR CATH $61.00T TUBE 22 FR. $53.00T TUBE 5 FR. $87.00T TUBE 8FR $53.00T TUBE DRAIN 12FR. $61.00T TUBE DRAIN 14FR $101.00T TUBING 10 FR $18.00T U R IRRIGATION $31.00T U R SYSTEM $51.00T/ FLEX TUBE $5.00T3 FREE $104.00T3 UPTAKE $99.00T3-TOTAL $72.00T4 $97.00T4 FREE $116.00TA 30 48 STAPLES $230.00TA 30 STAPLES 35 $230.00TA 55 STAPLES 35 $350.00TA 55 STAPLES 48 $251.00TA 90 3.5 SUTURE $362.00TABLE COVER- 2 TIER BIG CASE $110.00TACRINE HCL 10 MG CAP (COGNEX) $9.00TAGAMET HB (CIMETADINE) 200 MG TABLET $4.00TALUS FRACTURE $885.00TALUS FRACTURE W/O MANIPULATION $456.00TAMBOCOR (FLECAINIDE) 50 MG TAB $6.00TAMIFLU (OSELTAMIVIR) 12MG/ML ORAL SUSP $184.00TAMOXIFEN 10 MG TABLET (NOLVADEX) $9.00TAMSULOSIN HCL 0.4MG CAP (FLOMAX) $7.00TANGENTIAL BIOPSY OF SINGLE SKIN LESION $239.00TAPE STRIPS $8.00TAPERFILL HIP STEM SIZE 12-ORTHO $9,196.00TARSAL FRACTURE $2,529.00TASMAR (TOLCAPONE) 100 MG TABS $10.00TAVIST (CLEMASTINE FUM) SYURP 2 OZ $66.00TAVIST-1 (CLEMASTINE FUMAR) 1.34 MG TAB $4.00TAVIST-D (PHENYLPROP/CLEMAST) TAB $4.00

TAXOL PUMP TUBING $62.00TAXOTERE W DIL (DOCETAXEL) 20 MG VIAL $1,223.00TAXOTERE W DIL (DOCETAXEL) 80 MG VIAL $3,117.00TAZAROTENE 0.05% GEL 30GM (TAZORAC) $348.00TAZORAC CREAM 0.1% 30GM (TAZAROTENE) $270.00TCR 55 RELOADS $226.00TCR 75 RELOADS $505.00TECENTRIQ 60MG/ML 20ML (1200MG) SDV $128.00TEFLARO 600MG (CEFTAROLINE FOSAMIL) VIAL $779.00TEGADERM + PAD 3 1/2X6 $1.35TEGADERM DRESSING W/LABEL 2 3/8 X 2 3/4 $7.00TEGADERM FILM 4 X 4 3/4 $7.00TEGADERM FILM 6X8IN $21.00TEGASORB(USHAPE) HYDROCOLLOID DRESSING $54.00TEGRETOL $107.00TEGRETOL $107.00TEGRETOL FREE $147.00TELEHEALTH ORIGINATING SITE FACILITY FEE $61.00TELFA 2X3 NON-ADHERENT PAD $3.00TELFA 2X3 OUCHLESS ADHESIVE PAD $5.00TELFA 8X3 NON-ADHERENT DRESSING PAD $7.00TEMAZEPAM 15MG CAPSULE (RESTORIL) $11.00TEMNO BIOPSY NEEDLE 14GX11CM $305.00TEMNO BIOPSY NEEDLE 16GX11CM $252.00TEMNO BIOPSY NEEDLE 18GX11CM $262.00TEMP DISPOSABLE PROBE $46.00TEMPORAL ARTERY BIOPSY $686.00TEMSIROLIMUS 25MG/ML KIT (TORISEL) $3,196.00TENDON ANCHOR 1- ORTHO $735.00TENDON ANCHOR 8- ORTHO $2,856.00TENNIS ELBOW WRAP S/M $18.00TENODESIS LONG TENDON BICEPS $1,823.00TENODESIS LONG TENDON BICEPS $1,823.00TENOLYSIS FLEXOR/EXT TENDON FOREARM/WRIS $1,948.00TENOLYSIS FLEXOR/EXT TENDON FOREARM/WRIS $1,948.00TENOLYSIS,FLEX;TEND/HN/FNG;EACH $1,992.00TENOLYSIS,FLEX;TEND/HN/FNG;EACH $1,992.00TENORETIC (ATENOL/CHLORTHAL) 50/25MG TAB $10.00TERAZOSIN 1 MG CAPSULE (HYTRIN) $6.00TERAZOSIN 5 MG CAPSULE (HYTRIN) $6.00TERBINAFINE 250MG TABLET (LAMISIL) $6.00TERBINAFINE CREAM 1% 15 GM $18.00TERBUTALINE 1 MG $11.00TERBUTALINE 1MG/1ML VIAL (BRETHINE) $19.00TERCONAZOLE 3 VAG SUPP (TERAZOL) $27.00TERCONAZOLE 7 VAG CREAM (TERAZOL) $128.00TERCONAZOLE VAG CR 0.4% (TERAZOL) 45GM $25.00

TEST KIT- INTERSTIM $405.00TEST PROCEDURE. SHOULD NOT BE USED PROFE $1.00TESTICULAR PROSTHESIS LG $511.00TESTICULAR PROSTHESIS MED $511.00TESTICULAR PROSTHESIS SM $497.00TESTOSTERONE FREE $62.00TESTOSTERONE FREE & WEEKLY BOUND $129.00TESTOSTERONE TOTAL $175.00TESTOSTERONE TOTAL $105.00TETANUS ANTIBODY IGG $262.00TETANUS ANTIBODY IGM $42.00TETANUS DIPTH (TET/DIP.TOX) ADULT SDV $33.00TETANUS DIPTH PED PED VIAL $39.00TETANUS TOX ADSORB(TENTAN.TOXOID) $36.00TETANUS TOXOID $17.00TETRACAINE 0.5% O.S. $24.00TETRACAINE 0.5% OPTH SOLN $14.00TETRACAINE 1% AMP (PONTOCAINE) $52.00TETRACAINE 2% TOP SOLN (PONTOCAINE) $142.00TETRACYCLINE 250 MG CAP $6.00TEVETEN (EPROSARTAN MSYL) 400MG TAB $8.00TEVETEN (EPROSARTAN MSYL) 600MG TAB $10.00T-GROMMET POPE BEV TUBES 1.14MMST $96.00THEO-24 (THEOPHYLLIN ANHYDROUS) 200 MG $4.00THEO-24 (THEOPHYLLIN ANHYDROUS) 300 MG $6.00THEOPHYLLIN 400 MG CR TABS (UNIPHYL) $4.00THEOPHYLLIN 50 MG CAPSULE (SLO-BID) $4.00THEOPHYLLIN E.R. 300MG CAPSULE (SLO-BID) $4.00THEOPHYLLINE $108.00THEOPHYLLINE ANHYDROUS 100MG CAPSULE $13.00THEOPHYLLINE E.R.100MG CAPSULE (SLO-BID) $4.00THEOPHYLLINE E.R.200MG CAPSULE (SLO-BID) $4.00THEOPHYLLINE S.R. 250MG TABLET(THEOLAIR) $4.00THER PUTTY GREEN 4OZ $22.00THERAPEUTIC MVI TAB (THERAGRAN) $1.00THERAPY PUTTY RED 4OZ $22.00THERAPY PUTTY TAN 4 OZ $34.00THERAPY PUTTY YELLOW 4OZ $22.00THIAMINE (VIT B-1) 200MG/2ML VIAL $59.00THIAMINE (VITAMIN B-1) 100 MG TAB $6.00THIGH GARMENT DVT $251.00THIOPURINE METABOLITES $378.00THIOPURINE METHYLTRANSFERASE $277.00THIORIDAZINE 10 MG TABLET (MELLARIL) $4.00THIORIDAZINE 100 MG TABLET (MELLARIL) $5.00THIOTHIXENE 2 MG CAP (NAVANE) $4.00THORACENTESIS W IMAGING GUIDANCE $1,015.00

THORACENTESIS W/O IMAGING GUIDANCE $222.00THORACENTESIS W/O IMAGING GUIDANCE $222.00THORACENTESIS, NEEDLE OR CATHETER, ASPIR $222.00THORACENTESIS, NEEDLE OR CATHETER, ASPIR $1,015.00THORACENTESIS/PARACENTESIS TRAY $142.00THORACOSCOPY, SURGICAL; WITH PLEURODESIS $1,634.00THREADED STEINMAN PIN 9 $172.00THROMBIN AID $25.00THROMBIN MIXING STUDY $269.00THROMBIN TIME $102.00THROMBINAR SPRAY (THROMBIN) 20MU KIT $388.00THROMBOLYSIS,CORONARY $215.00THROMBOPLASTIN TIME, PARTIAL REF LAB $181.00THUMB SPICA 8 EX LARGE LT $102.00THUMB SPICA 8 EX LARGE RT $102.00THUMB SPICA 8 LARGE LT $102.00THUMB SPICA 8 LARGE RT $102.00THUMB SPICA 8 MEDIUM LT $76.00THUMB SPICA 8 MEDIUM RT $76.00THUMB SPICA 8 SMALL LT $76.00THUMB SPICA 8 SMALL RT $102.00THUMB SPICA ORTH SMALL LEFT $61.00THUMB SPLINT, LEFT, SMALL $70.00THUMB SUPPORT LARGE LEFT $174.00THYROGLOBULIN AB AND IMA OR RIA $88.00THYROGLOBULIN ANTIBODY $84.00THYROGLOBULIN COMPREHENSIVE $107.00THYROGLOBULIN LYMPH NODE ASPIRATE $65.00THYROID 1 GR (60MG) TABLET $6.00THYROID BINDING GLOBULIN $75.00THYROID CASCADE PROFILE $126.00THYROID PEROXIDASE ANTIBODY $95.00THYROID PROFILE W/ TSH $28.00THYROID STIMULATING IMMUNOGLOBULIN $143.00THYROTROPIN RECEPTOR ANTIBODY $96.00TI CRON/ETHIBOND $180.00TIBC $110.00TIBIA BOLT THREAD 1 END $234.00TIBIA BOLT THREAD 2 END $226.00TIBIA BOLT WASHER 5/8 $36.00TIBIA BOLT WASHER 7/16 $36.00TIBIA FIBULA SPLINT MED $76.00TIBIA FIBULA SPLINT SMALL $59.00TIBIA FIBULA SPLINT YOUTH $61.00TIBIA SHAFT TX (W/W/O) FIBULA $732.00TIBIAL GUIDE WIRE $586.00TIBIAL INSERT SZ5-ORTHO $3,386.00

TICE BCG(BCG VACCINE)DSHP SDV 50MG $601.00TICLOPIDINE 250 MG TABLET (TICLID) $4.00TIGAN (TRIMETHOBENZAMIDE) 100 MG RECT SU $10.00TIMENTIN (TICARCILIN/K CLAVULAN) 3.1 G $94.00TIMOLOL OPHT .25% SOLN 5 ML (TIMOPTIC) $43.00TIMOLOL OPHT 0.5% SOLN 5 ML (TIMOPTIC) $12.00TIMOLOL XE OPHT.25% SOLN 2.5ML(TIMOPTIC) $67.00TIMOPTIC XE OPTH 0.5%(TIMOLOL)SOLN 2.5ML $87.00TIPS CRUTCH RUBBER LGE $31.00TIS TRNFR TRUNK 10.1-30SQCM $1,594.00TISSUE CULTURE NEOPLASTIC DISORDER BM/B $304.00TISSUE GLUE $582.00TISSUE TRANSFER 10 SQ CM OR LESS $1,719.00TISSUE TRANSFER 10 SQ CM OR LESS $1,442.00TISSUE TRANSFER 10 SQ CM OR LESS $1,719.00TIZANIDINE 4MG TABLET (ZANAFLEX) $8.00T-LYMPH HELPER-CD4 $268.00T-LYMPH MARKERS + NK $268.00T-LYMPH MARKERS +NK $268.00T-LYMPH MARKERS +NK $268.00TMJ'S BILATERAL $393.00TNKASE (TENECTEPLASE) KIT 50MG $3,705.00TOBI INH SOLN 300MG/5ML (TOBRAMYCIN) $223.00TOBRADEX (TOBRA/DEXAMETH) OPTH SOLN 5ML $114.00TOBRADEX (TOBRAM/DEXAMETH)OPTH OINT 3.5G $237.00TOBRAMYCIN $153.00TOBRAMYCIN 0.3% 2.5ML (TOBREX OPTH SUSP) $13.00TOCILIZUMAB 200MG VIAL (ACTEMRA) $4,528.00TOCILIZUMAB 400MG VIAL (ACTEMRA) $3,178.00TOCILIZUMAB 80MG VIAL (ACTEMRA) $1,841.00TOE JOINT- POROUS COATED COBALT $3,456.00TOE SPREADER $8.00TOES STRAPPING $144.00TOETAC HAMMERTOE IMPLANT $2,613.00TOLBUTAMIDE 500 MG TABLET (ORINASE) $4.00TOLECTIN DS (TOLMETIN) 400 MG CAPSULE $8.00TOLTERODINE TARTRATE 1MG (DETROL) $21.00TOLTERODINE TARTRATE LA 2 MG (DETROL) $33.00TONSIL SPONGES 1 1/4 $35.00TONSILECTOMY UNDER AGE 12 $462.00TONSILECTOMY AGE 12 AND ABOVE $453.00TONSILECTOMY AGE 12 AND ABOVE $453.00TONSILLECTOMY, PRIMARY OR SECONDARY; AGE $476.00TOPAZ EZ IFS $857.00TOPIRAMATE (TopaMAX) 25 MG TABS $6.00TOPIRAMATE SERUM $150.00TOPOTECAN 4MG VIAL $584.00

TORADOL PER 15 MG $17.00TORCH ANTIBODIES (PRENATAL INFECT PANEL) $28.00TORISEL 25MG/NS 250ML AVIVA $3,196.00TORSEMIDE 10MG TABLET (DEMADEX) $6.00TORSEMIDE 20 MG TABLET (DEMADEX) $6.00TORSEMIDE 50 MG AMPULE (DEMADEX) $28.00TOTAL ABD HYST S & O $2,161.00TOTAL ABD HYST S & O $2,270.00TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND $2,270.00TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND $2,183.00TOTAL HIP ARTHROPLASTY $3,329.00TOTAL HIP ARTHROPLASTY $3,329.00TOTAL JOINT PACK- ALLIANCE $292.00TOTAL JOINT PACK- ORTHO $596.00TOTAL KNEE ARTHROPLASTY $3,327.00TOTAL KNEE ARTHROPLASTY $3,327.00TOTAL PROTEIN $73.00TOTAL SHOULDER REPLACEMENT $3,570.00TOTAL SHOULDER REPLACEMENT $3,570.00TOWEL 6/PK OR DISP ST BLUE STD $15.00TOWEL OR 4/PK DSP ST BLUE STD $13.00TOXOPLASMA GONDII PCR $498.00TOXOPLASMA IGG $144.00TOXOPLASMA IGM $144.00T-PIECE NEONATAL PATIENT CIRCUIT KIT $100.00TRACE ELEMENTS PEDIATRIC 3ML VIAL $18.00TRACH 3.5MM TUBE $7.00TRACH 7.0MM FLEX DIC UNCF $141.00TRACH COLLAR ADULT $23.00TRACH COLLAR PED $12.00TRACH INTRODUCER PED10FR X 70CM (BOUGIE) $50.00TRACH TRANSDU ADULT 15FR X 70CM (BOUGIE) $50.00TRACH TUBE 2 MM $11.00TRACH TUBE 2.5 $31.00TRACH TUBE 3 MM UNCUFFED $17.00TRACH TUBE 3.5MM CUFFED PREFORMED $31.00TRACH TUBE 4 MM $21.00TRACH TUBE 4.0MM CUFFED PREFORMED $31.00TRACH TUBE 4.5 PEDS $11.00TRACH TUBE 4.5 UNCUFFED $17.00TRACH TUBE 4.5MM CUFFED PREFORMED $31.00TRACH TUBE 4MM $7.00TRACH TUBE 5.0 UNCUFFED $31.00TRACH TUBE 5.0MM CUFFED PREFORMED $31.00TRACH TUBE 5.5MM $31.00TRACH TUBE 5.5MM CUFFED PREFORMED $31.00TRACH TUBE 5MM $8.00

TRACH TUBE 6.0MM CUFFED PREFORMED $31.00TRACH TUBE 6.5MM CUFFED PREFORMED $31.00TRACH TUBE 6MM $14.00TRACH TUBE 7.0MM CUFFED PREFORMED $31.00TRACH TUBE 7.5MM CUFFED PREFORMED $31.00TRACH TUBE 7.5mm HI-LO ORAL/NASAL $16.00TRACH TUBE 7MM.HI-LO ORAL/NASAL $16.00TRACH TUBE 8.0MM CUFFED PREFORMED $31.00TRACH TUBE 8.5MM $14.00TRACH TUBE 8MM.HI-LO ORAL/NASAL $16.00TRACH TUBE 9mm HI-LO ORAL/NASAL $24.00TRACH TUBE GR 7.0 IN CAN DIC $13.00TRACH TUBE HOLDER $21.00TRACH TUBE PED 6.5MM.HI-LO ORAL/NASAL $16.00TRACH TUBE UNCUFFED 2.5MM $59.00TRACHELECTOMY (CERVICECTOMY), AMPUTATION $856.00TRACHEOLIFE HME $11.65TRACHEOSTOMY $240.00TRACHEOSTOMY CLEANING TRAY $26.00TRACHEOSTOMY TUBE $160.00TRACHEOSTOMY TUBE 10.MM O.D 14.MM $176.00TRACHEOSTOMY TUBE 8.0MM O.D.11.3MM $176.00TRACTION SM BUCK $59.00TRADJENTA 5MG TABLET (LINAGLIPTIN) $54.00TRAMADOL $139.00TraMADOL 50 MG TABLET (ULTRAM) $6.00TraMADOL/APAP 37.5/325 TABLET (ULTRACET) $6.00TRANDOLAPRIL 1 MG TABLET (MAVIK) $6.00TRANEXAMIC ACID 1000MG/10ML VIAL $199.00TRANS TRACHEAL O-2 SYSTEM $1,027.00TRANSCERVICAL INTRAUT KIT $44.00TRANSCERVICAL INTRODUCTION OF FALLOPIAN $672.00TRANSDERM-SCOP PATCH 1.5MG $63.00TRANSFERRIN $89.00TRANSFUSION OF BLOOD OR COMPONENTS $219.00TRANSGLUTAMINASE IGA $203.00TRANSGLUTAMINASE IGG $203.00TRANSPORT CHAIR $227.00TRANSURETHRAL DEL KIT $183.00TRANXENE (CLORAZEPATE DIPOT) 3.75 MG $9.00TRASTUZUMAB 150MG KIT (HERCEPTIN) $3,355.00TRAVATAN Z (TRAVOPROST) OPTH SOLN 2.5ML $149.00TRAVEL, ONE WAY $12.00TRAY A&D ABSCESS3 $61.00TRAY ACUTE BURN $96.00TRAY ADULT LUMBAR $53.00TRAY ASPIRATION $83.00

TRAY BONE MARROW $83.00TRAY CHEST $76.00TRAY DR DRESSING PACK $17.00TRAY EAR $8.00TRAY ER NASAL $21.00TRAY LAVAGE $61.00TRAY NASAL $61.00TRAY ORAL OR MOUTH CARE $8.00TRAY PACE MAKER $76.00TRAY PAP SMEAR $38.00TRAY PARACENTECIS $91.00TRAY PED LUMBAR PUNCT WO $48.00TRAY SUTURE $18.00TRAY TRACH SET $91.00TRAY VACINAL IRRIGATION $13.00TRAY VENOUS CUT DOWN $59.00TRAY WET SALINE $17.00TRAZODONE $204.00TRAZODONE 150MG TABLET $6.00TraZODONE 50 MG TABLET (DESYREL) $6.00TRB@GENE REARRANGE AMPLIFY $464.00TREAT ANKLE FRACTURE $2,578.00TREAT FINGER DISLOCATION $570.00TREAT FRACTURE OF ULMA $537.00TREAT METACARPAL FX $632.00TREAT THIGH FRACTURE $1,029.00TREATEMENT OF ANKLE FX W/MANIPULATION $1,091.00TREATMENT OF ANKLE FRACTURE $662.00TREATMENT OF INCOMPLETE ABORTION, ANY TR $629.00TREATMENT OF MISSED ABORTION, COMPLETED $779.00TREATMENT OF MISSED ABORTION, COMPLETED $809.00TREATMENT RM 01-15 MIN $69.00TREATMENT RM 106-120 MIN $539.00TREATMENT RM 16-30 MIN $154.00TREATMENT RM 31-45 MIN $204.00TREATMENT RM 46-60 MIN $270.00TREATMENT RM 61-75 MIN $338.00TREATMENT RM 76-90 MIN $405.00TREATMENT RM 91-105 MIN $473.00TREATMENT RM PER MIN AFTER 120 MIN $13.00TREATMENT ULNAR FRACTURE $601.00TREPONEMA PALLIDUM FLOURESCENT ABS $70.00TRG@GENE REARRANGEMENT ANALYSIS $464.00TRIAMCINALONE ACET 0.1% CREAM 80GM $27.00TRIAMCINOLONE (TRIAMCN.ACET) 0.025% CR $10.00TRIAMCINOLONE 0.055MG/SPRAY NASAL INH $96.00TRIAMCINOLONE ACET 0.025% CREAM 15G $10.00

TRIAMCINOLONE ACETONIDE OINT 0.1% 80G $30.00TRIAMCINOLONE HP 0.5% OINTMENT $19.00TRIAMCINOLONE LOTION 0.025% (KENALOG) $161.00TRIAMTERE/HCTZ 37.5/25 MG TAB (MAXZIDE) $7.00TRIAMTERENE/HCTZ 37.5/25MG CAPSULE $5.00TRIAMTERENE/HCTZ 50/25 CAP $4.00TRIAVIL (PERPHEN/AMIT) 2/25MG TAB $5.00TRIAZOLAM 0.25 MG TABLET (HALCION) $6.00TRICHLORACETIC ACID(TRICHLOR ACID) 30 GM $87.00TRICHLORACETIC ACID(TRICHLOR ACID) 30 GM $87.00TRICHOMONAS, NAA $153.00TRICHROM STAIN FOR OVA AND PARASITES $97.00TRICOR (FENOFIBRATE) 145MG TAB $613.00TRICOR (FENOFIBRATE) 160MG TAB $14.00TRICOR (FENOFIBRATE) 54MG TAB $8.00TRICOR (FENOFIBRATE) 67MG CAP $14.00TRIFLUOPERAZINE 10 MG TABLET (STELAZINE) $9.00TRIFLUOPERAZINE 5 MG TABLET (STELAZINE) $8.00TRIGLYCERIDES $182.00TRIHEXYLPHENIDYL 2MG TABLET $4.00TRI-IMMUNOL (DIPTH/PERTUSS/TETA VAC) VIA $681.00TRILEPTAL $95.00TRILEPTAL $257.00TRIM DYSTROPHIC NAILS, ANY NUMBER $68.00TRIM DYSTROPHIC NAILS, ANY NUMBER $68.00TRIM IT DRILL PIN- ORTHO $875.00TRIM NONDYSTROPIC NAILS ANY NUMBER $28.00TRIM NONDYSTROPIC NAILS ANY NUMBER $28.00TRIM NONDYSTROPIC NAILS ANY NUMBER $14.00TRIMALLEOLAR ANKLE FX $1,185.00TRIMETHOBENZAMIDE 250MG CAP (TIGAN) $6.00TRIMETOBENZAMIDE 200 MG REC SUPP (TIGAN) $5.00TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER $79.00TRIP NO MORE 8 X3 $26.00TRIPEDIA/INFANRIX $39.00TRIPEDIA/INFANRIX $39.00TRIPEG PATELLA SZ35MM-ORTHO $1,657.00TRIPLE ANTI-B OPHT (NEO/BACIT/POLYM)OINT $19.00TROCAR 10MM X 150MM $169.00TROCAR 12MM LG 512 X D $370.00TROCAR 5MM X 75MM $293.00TROCAR CLOSURE SUTURE GRASPER $132.00TROCAR REDUCER 5MM $41.00TROLAMINE SALICYLATE CREAM $9.00TROPHAMINE (AMINO ACID 6%) IV SOL 500 ML $278.00TROPICAMIDE (MYDRIACYL) 1% OPTH SOLN $29.00TROPONIN I $164.00

TROPONIN T $164.00TROVAN IV (ALATROFLOXACIN MESC) 200MG IV $186.00TRU CUT BIOPSY NEEDLES 6 $121.00TRUSOPT OPTH SOLN (DOROZOLAMIDE) 5ML $60.00TRUVADA 200MG/300MG (EMTRICIT/TENOFOVIR) $261.00TRYPAN BLUE OPTH SOLN 0.06% 2.25ML SYR $110.00TRYPSIN $172.00TRYPTASE $225.00TSH $126.00TSH IN PREGNANCY (SEND OUT) $126.00TSH W/ FREE T4 REFLEX $126.00TUBAL LIGATION DURING POST PARTUM $685.00TUBAL LIGATION DURING POST PARTUM $685.00TUBAL LIGATION NOT POST PARTUM $713.00TUBAL LIGATION NOT POST PARTUM $713.00TUBAL LIGATION W/C SECTION $143.00TUBAL LIGATION W/C SECTION $143.00TUBE CONNECTING $6.00TUBE ENDOTRACHEAL 9.5MMID $22.00TUBE ESOPHAGEAL $613.00TUBE FEEDING 10FR 42 INCH $8.00TUBE FEEDING 8FR 15 INCH $11.00TUBE GASTROSTOMY 22 FR $349.00TUBE GASTROSTOMY 24 FR $349.00TUBE HALFSET FOR PUMP $31.00TUBE MILLER 16 FR $256.00TUBE MILLER ABBOTT 14 $130.00TUBE MILLER ABBOTT 18 $130.00TUBE OXYGEN CONNECTIVE $8.00TUBE SET A127 PUMP-ORTHO $419.00TUBE SUCTION YANKAUR SET $47.00TUBE T MODIFIER UTRASIL $199.00TUBE THORACOSTOMY $474.00TUBE THORACOSTOMY $474.00TUBE THORACOSTOMY W/WATER SEAL $498.00TUBE THORACOSTOMY, INCLUDES WATER SEAL ( $498.00TUBERCULOSIS, INTRADERMAL $19.00TUBERCULOSIS, INTRADERMAL $19.00TUBETRACHEAL PED 5MM ID $17.00TUBING 25 FT. $13.00TUBING NON-DEHP SOLUTION SET $30.00TUBO-CURARE (TUBOCURARINE) 3 MG/ML VIAL $31.00TUBOCURARINE CHLORIDE INJ $8.00TUBULAR PLATE 8 HOLE $527.00TUCKS $31.00TUMOR NECROSIS FACTOR ALPHA $189.00TUNNELER DISPOSABLE 8 X17GA $166.00

TURY SET $50.00TWINRIX (HEP A/ HEP B) VACCINE $153.00TWIST DRILL 4.7MM $117.00TWIST LOCK CABLE- INTERSTIM $300.00TWO WAY AIRWAY LARGE $13.00TX ANKLE FX $1,414.00TX ANKLE FX $1,414.00TX CLOSED ACROMIOCLAVICULAR DISLOC $471.00TX CLOSED DIS FIBULAR FX LAT MALL $658.00TX CLOSED EPICONDYLAR FX MED/LAT W/ $544.00TX CLOSED HUMERAL FX W/O MANIP $559.00TX CLOSED HUMERAL SHAFT FX W/O MANI $471.00TX CLOSED IP JOINT DISLOC W/O ANES $362.00TX CLOSED METACARPAL DISLOC W/O AN $325.00TX CLOSED PATELLAR FX W/O MANIP $940.00TX CLOSED RADIAL/ULNAR SHAFT FX W/O $1,049.00TX CLOSED ULNAR FX PROXIMAL END $724.00TX CLOSED ULNAR SHFT FX W/O MANIP $974.00TX CLOSED ULNAR STYLOID FX $2,273.00TX ECTOPIC PREGNANCY $1,675.00TX ECTOPIC PREGNANCY $1,675.00TX FEMORAL FX W W/O SCREWS $3,109.00TX FEMORAL FX W W/O SCREWS $3,109.00TX FEMORAL FX W/IMPLANT $1,958.00TX FEMORAL FX W/IMPLANT $1,958.00TX FX RADIUS & ULNA $1,283.00TX FX RADIUS & ULNA $1,283.00TX FX RADIUS/ULNA $1,808.00TX FX RADIUS/ULNA $1,808.00TX HIP DISLOCATION $1,481.00TX HIP DISLOCATION $1,481.00TX INCOMPLETE ABORTION $599.00TX INCOMPLETE ABORTION $599.00TX MISCARRIAGE $770.00TX MISCARRIAGE $770.00TX MISSED ABORTION $741.00TX MISSED ABORTION $741.00TX OF CLOSED ELBOW DISLOCATION W/O ANEST $491.00TX RADIAL HEAT SUBLUXATION $724.00TX SUPERFICIAL WOUND $449.00TX SUPERFICIAL WOUND $449.00TX TARSAL BONE FRACTURE W/O MANIP, EACH $62.00TX TARSAL BONE FX W/O MANIP, EACH $500.00TX TARSAL BONE FX W/O MANIP, EACH $443.00TX THIGH FX $2,789.00TX THIGH FX $2,789.00TYLENOL JR. (ACETAMINOPHEN) 160MG TABLET $4.00

TYLOX (OXYCODONONE/APAP) CAPSULE $8.00TYMPANOMETRY (IMPEDANCE TESTING) $49.00TYSABRI (NATALIZUMAB) 300MG/15ML VIAL $6,633.00U/S GUIDE NEEDLE PLACE $726.00UGI ENDO W/GASTRO TUBE $404.00UGI ENDO W/GASTRO TUBE $404.00UGI W/KUB $277.00UGI W/O KUB $249.00ULORIC 40MG TABLET (FEBUXOSTAT) $40.00ULTANE (SEVOFLURANE) 250 ML BOTTLE $858.00ULTANE ANESTHETIC AGENT $9.00ULTRATAPE BLUE SUTURE- ORTHO $120.00ULTRATAPE COBRAID 2MM- ORTHO $470.00UMBILECTOMY OMPHALECTOMY $899.00UMBILECTOMY OMPHALECTOMY $899.00UMBILICAL CATH 5f W/LUER LOCK $56.00UMBILICAL CATH PACK $31.00UMBILICAL CATH TRAY $80.00UMBILICAL CATH UMBILICAL D/L 4f 40cm 10c $150.00UMBILICAL CATH VESSEL 3.5FR $100.00UMBILICAL VESSEL CATHETER KIT $290.00UMBILI-CATH DUAL-LUMEN 3.5 $171.00UNCOMPLICATED TX T M DISLOCATION $1,443.00UNIPOLAR HEAD ADAPTER $497.00UNISCOPE $17.00UNIV 19 KNEE IMMOBILIZER $32.00UNIV 24 KNEE IMMOBILIZER $87.00UNIV CERVICLE KIT $117.00UNIV TIBIA MOD STEM- 10MM-ORTHO $3,494.00UNIV TIBIA SZ5- LEFT-ORTHO $5,729.00UNIVERSAL ANESTHESIA SET $20.00UNIVERSAL BINDER $117.00UNIVERSAL BUCKS TRACTION $267.00UNIVERSAL FOAM COLLAR $12.00UNIVERSAL RIB BELT FEMALE $30.00UNIVERSAL RIB BELT MALE $28.00UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS $332.00UNLISTED LAPAROSCOPIC PROCEDURE, LIVER $1,295.00UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, $1,710.00UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPL $1,777.00UNLISTED LAPOROSCOPY PROCEDURE $1,233.00UNLISTED LAPOROSCOPY PROCEDURE $1,233.00UNLISTED PROCEDURE DENTOALVEOLAR STRUCTU $435.00UNLISTED PROCEDURE OF ABDOMEN, PERTONEUM $1,659.00UNLISTED PROCEDURE OF ABDOMEN, PERTONEUM $1,659.00UNLISTED PROCEDURE ON FEM GEN ORGAN $1,971.00UNLISTED PROCEDURE URINARY SYSTEM $79.00

UNLISTED PROCEDURE, FEMALE GENITAL SYSTE $1,971.00UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRAN $326.00UNLISTED THERAPEUTIC PHOPH/DX IV/IA NJX/ $87.00UNNA BOOT $118.00UNNA BOOT $118.00UNNA BOOT $118.00UNNA BOOT-CALAM/ZINC/OXYGEL/GLY $17.00UPPER EXT INFANT 2 V $213.00UPPER GASTROINTESTINAL ENDOSCOPY INCLUDI $518.00UPPER GASTROINTESTINAL ENDOSCOPY INCLUDI $711.00UPPER GI ENDO,ESOPHAGUS/STOMACH W/TRAN $367.00UPPER GI ENDO,ESOPHAGUS/STOMACH W/TRAN $367.00UPSYLON Y MESS $1,208.00UREA NITROGEN URINE $73.00UREAPLASMA UREALYTICUM CULTURE $75.00URETEROURETEROSTOMY $2,719.00URETEROURETEROSTOMY $2,719.00URETHRAL FILIFORM W OLIVE TIP 3FR $51.00URETHRAL FILIFORM W OLIVE TIP 4FR $51.00URETHRAL FILIFORM W OLIVE TIP 6FR $51.00URETHRAL FILIFORM W SPINAL TIP 3FR $60.00URETHRAL FILIFORM W SPINAL TIP 4FR $60.00URETHRAL FILIFORM W SPINAL TIP 6FR $60.00URETHROCYSTOGRAM $187.00URIC ACID $97.00URIC ACID URINE 24 $72.00URIMETER $112.00URINALYSIS $74.00URINALYSIS, CULTURE IF INDICATED $67.00URINARY DRAINAGE BAG $93.00URINARY DRAINAGE LEG BAG $14.00URINE 24HR PROTEIN $67.00URINE CREATININE REF LAB $58.00URINE DIPSTICK $90.00URINE DIPSTICK ONLY - OB ONLY $85.00URINE DRAINAGE LEG BAG WITH EXT TUBING $18.00URINE DRUG SCREEN SUBSTANCE ABUSE $219.00URINE METER FOLEY TRAY 14 FR $144.00URINE METER FOLEY TRAY 16 FR $120.00URINE STRAINER $14.00URO CATCHER BAG STERILE $90.00UROCIT-K TAB (POT CITRATE) 1080MG $5.00UROKINASE 5 MU VIAL $304.00UROLOGICAL TRAY $21.00UROSTOMY POUCH W/FLANGE $18.00US ABDOMEN LIMITED $625.00US ABDOMEN ROUTINE $1,075.00

US ABI 1-2 LEVEL W/LE ART BLT $368.00US ABI 1-2 LEVEL W/LE ART BLT $1,247.00US ABI 1-2 LEVEL W/LE ART UNI $368.00US ABI 1-2 LEVEL W/LE ART UNI $551.00US ABI MIN 3 LEVELS $307.00US ABI's 1 OR 2 LEVELS $368.00US AORTA $266.00US BLADDER $666.00US BLADDER POST VOID $86.00US BREAST BX ADDITIONAL LEASION $207.00US BREAST BX W/CLIP PLACEMENT RT/LT $1,727.00US BREAST CYST ASPIRATION $1,011.00US BREAST CYST ASPIRATION ADD LEASION $55.00US BREAST UNILATERAL COMPLETE LEFT $683.00US BREAST UNILATERAL COMPLETE RIGHT $683.00US BREAST UNILATERAL LIMITED LEFT $651.00US BREAST UNILATERAL LIMITED RIGHT $651.00US CAROTID LT $468.00US CAROTID RT $468.00US CAROTID-BILAT $1,035.00US CHEST $501.00US DUPLEX KIDNEY TRANSPLANT $364.00US DUPLEX SCAN ABD ORGANS LIMITED $407.00US DUPLEX SCAN ABD/PELVIC/RENAL ORGANS $901.00US DUPLEX SCAN OF AORTA IVC ILIAC $754.00US ECHO DOPPLER-COLOR FLOWMAP $297.00US ECHOCARDIOGRAM-COMPLETE $1,310.00US ECHOCARDIOGRAM-LMTD STUDY $1,246.00US EXT A-V FISTULA $332.00US EXT/AXILLA LIMITED LEFT $226.00US EXT/AXILLA LIMITED RIGHT $226.00US EXTR VEIN MAPPING BILAT $742.00US EXTR VEIN MAPPING LT $659.00US EXTR VEIN MAPPING RT $659.00US EXTR VEN BLT $1,250.00US EXTR VEN LT $659.00US EXTR VEN RT $659.00US EXTREMITIES LT-NONVASCULAR $584.00US EXTREMITIES RT-NONVASCULAR $584.00US FETAL BPP W/NST $495.00US FETAL BPP W/O NST $376.00US FINE NEEDLE ASPIRATION EACH ADDL LESI $146.00US FINE NEEDLE ASPIRATION FIRST LESION $1,370.00US GUID AMNIO IMAG S&I $38.00US GUIDE VASCULAR ACCE $415.00US GUIDED AMNIO $741.00US HYSTERO CATHERIZATION $338.00

US HYSTEROSONOGRAPHY $651.00US KIDNEYS LIMITED $558.00US LE ART BILAT $1,247.00US LE ART LT $551.00US LE ART RT $551.00US NEEDLE GUIDANCE PLACEMENT $810.00US OB FETAL ANATOMY DETAIL ADDL GEST $284.00US OB FETAL ANATOMY DETAIL SINGLE GEST $724.00US OB FOLLOW UP $915.00US OB LIMITED $538.00US OB NUCHAL TRANSLUCENCY ADD'L GEST $206.00US OB NUCHAL TRANSLUCENCY SINGLE GEST $332.00US OB TRANSVAGINAL $324.00US OB<14 WK TRANSAB & ENDOVAG $324.00US OB<14WKS ADDL GEST $124.00US OB<14WKS TRANSAB & ENDOVAG $637.00US OB>14WKS ADDL GEST $284.00US OB>14WKS SINGLE GEST. $934.00US PARACENTESIS - ABDOMINAL $557.00US PELVIC COMPLETE TRANSAB & ENDOVAG $388.00US PELVIC EV $388.00US PELVIS COMP $908.00US PELVIS COMPLETE TRANSAB & ENDOVAG $908.00US PELVIS LIMITED $666.00US RETROPERITONEAL W/POST-VOID RESIDU $653.00US RETROPERITONEAL W/POST-VOID RESIDUAL $86.00US RETROPEROTINEAL COMPLETE $653.00US SCROTUM ULTRASOUND $829.00US ST HEAD/NECK/THYROID $844.00US STRESS ECHOCARDIOGRAM $84.00US THORACENTESIS $1,465.00US THORACENTESIS $1,193.00US UE ART BILAT $1,000.00US UE ART LT $515.00US UE ART RT $515.00US UMBILICAL ART DOPPLER $260.00US UPPER EXT DIALYSIS VEIN MAPPING $742.00UTERINE EXPLORA CURETTE $51.00UTERINE MANIPULATOR INJECTOR $125.00UTERINE SUSPENSION W-W/O SHRTING RND/SAC $1,082.00UTILITY RUBBER TIPS 1 IN $46.00UTILITY RUBBER TIPS 5/8 $47.00UTILITY RUBBER TIPS 7/8 $47.00V LOC 6 ABSORB WOUND CLOSURE DEVICE $162.00V LOC 9 ABSORB WOUND CLOSURE DEVICE $160.80VACCINE ADMIN 1ST 19YRS+ $21.68VACCINE ADMIN FEE ADDTL INJ 19YRS+ $21.68

VACURETTE 10MM STRAIGHT $28.00VACURETTE 11MM STRAIGHT $213.00VACURETTE 12MM STRAIGHT $28.00VACURETTE 8MM STRAIGHT $25.00VACURETTE 9MM STRAIGHT $25.00VACUUM BOTTLE- DENVER PLEURX $275.00VACUUM MIXING BOWL-ORTHO $465.00VAG CERVICAL RETRACTOR- LG $405.00VAG DELIVER W $1,636.00VAG HYST COMPLEX $2,523.00VAG HYST COMPLEX $2,523.00VAG HYST W/URINARY REPAIR $2,279.00VAG HYST W/URINARY REPAIR $2,279.00VAG HYST W/URO REPAIR;COMP $3,027.00VAG HYST W/URO REPAIR;COMP $3,027.00VAG HYSTERECTOMY >250 GM RPR ENTEROCELE $2,703.00VAG HYSTERECTOMY >250 GM RPR ENTEROCELE $2,703.00VAG HYSTERECTOMY 250 GM/< W/RPR ENTEROCE $1,964.00VAG HYSTERECTOMY 250 GM/< W/RPR ENTEROCE $1,964.00VAG-CERVICAL RETRACTOR-MED $408.00VAGINAL COLPOCLEISIS $1,265.00VAGINAL DELIVERY AFTER PREVIOUS CSECTION $2,949.00VAGINAL DELIVERY GLOBAL $3,502.00VAGINAL DELIVERY ONLY (WITH OR WITHOUT E $1,602.00VAGINAL DELIVERY ONLY (WITH OR WITHOUT E $1,718.00VAGINAL DELIVERY ONLY, AFTER PREVIOUS CE $2,949.00VAGINAL DELIVERY ONLY, AFTER PREVIOUS CE $2,781.00VAGINAL HYSTERECTOMY, FOR UTERUS 250 G O $1,757.00VAGINAL HYSTERECTOMY, FOR UTERUS 250 G O $1,973.00VAGINAL HYSTERECTOMY, FOR UTERUS 250 G O $2,393.00VAGINAL HYSTERECTOMY, FOR UTERUS 250 G O $1,964.00VAGINAL HYSTERECTOMY, FOR UTERUS GREATER $2,650.00VAGINAL HYSTERECTOMY, FOR UTERUS GREATER $3,179.00VAGINAL HYSTERECTOMY, FOR UTERUS GREATER $2,703.00VAGINAL PACKING $24.00VAGINAL SPECULUM LARGE $24.00VALACYCLOVIR 1 GM TABS $14.00VALPORIC ACID 250MG/5ML $6.00VALPROATE SODIUM 100MG/ML 5ML SDV $25.00VALPROIC ACID $79.00VALPROIC ACID 250 MG CAPSULE (DEPAKENE) $6.00VALSARTAN 40 MG TABLET (DIOVAN) $10.00VALSARTAN 80 MG TABLET (DIOVAN) $23.00VALTREX (VALACYCLOVIR) 500MG TABS $20.00VANCERIL (BECLOMETHASONE) DS INHALER $110.00VANCOMYCIN :750MG VIAL $47.00VANCOMYCIN 125MG CAPSULE $43.00

VANCOMYCIN 1500MG/300ML PREMIX BAG $135.00VANCOMYCIN 1G/200ML PREMIX BAG $93.00VANCOMYCIN 250 MG CAPSULE (VANCOCIN) $57.00VANCOMYCIN 500 MG VIAL $32.00VANCOMYCIN PEAK $100.00VANCOMYCIN RANDOM $100.00VANCOMYCIN TROUGH $100.00VANCOMYCIN: 1 GM VIAL $53.00VAP (B) $166.00VAQTA (HEPATITIS A VACCCINE) ADULT $92.00VAQTA PED (HEPATITIS A) 25U/0.5ML $39.00VAQTA-ADULT $85.70VAQTA-PED $38.10VAQTA-PED $38.10VARICELLA ZOSTER IGG $125.00VARICELLA ZOSTER IGM $125.00VARICELLA ZOSTER VIRUS DNA PCR $242.00VARIVAX $158.31VARIVAX $158.31VARIVAX (VARICELL VIRUS VAC) 0.5 VIAL $153.00VAS SET $21.00VASCULAR PROSTHESIS 6MM $1,322.00VASCULAR RELOAD 35MM $570.00VASCULAR RELOAD ECHELON FLEX 45 $463.00VASCULOUR II PROSTH 16 X 8 $1,666.00VASCULOUR II PROSTH 24 X 12 $1,026.00VASCULOUR II PROSTH 9.5 $1,032.00VASECTOMY $964.00VASECTOMY, UNILATERAL OR BILATERAL (SEPA $1,013.00VASELINE 3/5 OZ $3.50VASELINE GAUZE 1 X 8 $3.00VASELINE GAUZE 1/2 X 72 $18.00VASELINE GAUZE 3 X 9 $3.00VASELINE GUAZE 3 X 36 $5.00VASOACTIVE INTESTINAL POLYPEPTIDE $172.00VASOPRESSIN 20 UNIT VIAL (PITRESSIN) $18.00VASOPRESSIN 20UNIT/100ML (PITRESSIN) $18.00VCARE LG CERVICAL CUP(37MM) $430.00VCARE MED CERVICAL CUP(34MM) $430.00VDRL CSF $76.00VECTIBIX (PANITUMUMAB) 100MG VIAL $4,004.00VECTIBIX (PANITUMUMAB) 400MG VIAL $7,149.00VECTRA DA $2,493.00VECURONIUM 10 MG VIAL (NORCURON) $28.00VEDOLIZUMAB AND ANTI VEDOLIZUMAB $82.00VEIN STRIPPER $76.00VELCADE (BORTEZOMIB) 3.5MG VIAL $3,196.00

VENIPUNCTURE $24.00VENIPUNCTURE COMPLEX 3 YRS > NON ROUTINE $86.00VENIPUNCTURE CUTDOWN <1 Y/O $147.00VENIPUNCTURE UNDER AGE 3 SCALP $221.00VENIPUNCTURE, <1 $63.00VENLAFAXINE 37.5 MG TAB (EFFEXOR) $6.00VENLAFAXINE XR 37.5MG CAPS (EFFEXOR) $7.00VENLAFAXINE XR 150MG CAP (EFFEXOR XR) $6.00VENO PAK SECONDARY $17.00VENOCATH 14 $13.00VENOCATH 14 FR $14.00VENOCATH 16 $8.00VENOCATH 16 FR $12.00VENOCATH 18 $17.00VENOCATH 18 FR $19.00VENOFER (IRON SUCROSE COMP) 20MG/ML 5ML $231.00VENOUS BLOOD GAS $180.00VENTED PACLITAXEL SET W/POLY $88.00VENTED SPIKE ADAPTER $18.00VENTED SPIKE ADAPTER DO NOT USE $10.00VENTILATION A $136.00VENTILATION ASSIST AND MANAGEMENT, INITI $143.00VENTILATION ASST & MGMT; 1ST DAY $136.00VENTILATOR EACH ADDL DAY $1,451.00VENTILATOR INITIAL SET UP $2,140.00VENTILATOR PER HOUR SUBSEQUENT $21.00VENTOLIN HFA (ALBUTEROL) INHALER 8G $45.00VENTRALEX ST HERNIA PATCH $713.00VERAPAMIL 200 MG PM CAPS (VERELAN PM) $9.00VERAPAMIL 40 MG TABLET (CALAN) $4.00VERAPAMIL 5 MG AMPULE (CALAN) $43.00VERAPAMIL 80 MG TABLET (CALAN) $6.00VERAPAMIL PM 100MG (VERELAN) $10.00VERAPAMIL SR 120 MG TABLET (CALAN) $6.00VERAPAMIL SR 180 MG TABLET (CALAN) $6.00VERESS NEEDLE $155.00VERSED (MIDAZOLAM) 10 MG SYRINGE $136.00VESCURA RETAINER MEDIUM $150.00VESICARE (SOLIFENACIN SUCC) 5MG TABLET $50.00VEST WRAP SIZE LG $402.00VEST WRAP SIZE MEDIUM $402.00VIAFLOW 800V $12.00VICOPROFEN (HYDROCOD/IBUPRO) 7.5/200 TAB $5.00VIDEX (DIDAN/NA CIT/MGOH2/AL SOD CAR)100 $7.00VIGILON WOUND DRESSING $31.00VIMPAT 10MG/ML 1ML ORAL SOLUTION $6.00VINBLASTINE 10 MG VIAL (VELBAN) $108.00

VINCRISTINE 1 MG VIAL $71.00VINCRISTINE 2 MG VIAL (ONCOVIN) $89.00VINORELBINE 10MG/ML 5ML VIAL $215.00VINORELBINE TART 10MG (NAVELBINE) $94.00VINYL COCK UP WRIST BRACE LT LG $54.00VINYL COCK UP WRIST BRACE LT SMALL $54.00VINYL COCK UP WRIST BRACE LT XLG $54.00VINYL COCK UP WRIST BRACE RT LG $54.00VINYL COCK UP WRIST BRACE RT MED $54.00VINYL COCK UP WRIST BRACE RT SMALL $54.00VINYL COCK UP WRIST BRACE RT XLG $54.00VINYL COCK UP WRIST BRACE LT MED $54.00VIOXX (ROBECOXIB) 12.5 MG DONT USE $14.00VIRAL CULTURE $77.00VISCOAT (CHONDROITIN/SOD HYALURONA) 0.5 $486.00VISCOELASTIC EXTRA VIS/DUO $143.00VISCOSITY $51.00VISIPAQUE 320MG/100ML (IODIXANOL) $816.00VISTRIL HYDROXYZINE $16.00VIT B12 UP TO 1000MCG $17.00VIT. A& D (VITAMIN A&D) OINT 60 GM $10.00VITAMIN A $69.00VITAMIN B 12 $47.00VITAMIN B COMPLEX (B COMPLEX/VIT C 500MG $4.00VITAMIN B1 $104.00VITAMIN B-12 (CYANOCOBALAMIN) 30ML VIAL $40.00VITAMIN B-12 100MCG TAB (CYANOCOBALAMIN) $6.00VITAMIN B2 $121.00VITAMIN B3 $88.00VITAMIN B5 $171.00VITAMIN B6 $137.00VITAMIN B7 $171.00VITAMIN C $91.00VITAMIN D 25-HYDROXY $374.00VITAMIN D 25-HYDROXY $374.00VITAMIN D 1,000 UNITS TABLET $5.00VITAMIN D 400 I.U. TABLET $1.00VITAMIN D 5000 UNITS CAPSULE $6.00VITAMIN D CAP 50,000IU (ERGOCALCIFEROL) $6.00VITAMIN E $87.00VITAMIN E (TOCOPHERYL ACET) 100 I.U.CAP $4.00VITAMIN E (TOCOPHERYL ACET) 1000 IU CAPS $4.00VITAMIN E (VITAMIN E) 400 I.U. CAPS $1.00VITAMIN E 400 I.U.CAP $4.00VITAMIN E 50U/ML 30ML $60.00VITAMIN K $273.00VITAMIN K $49.00

VITAMIN K (PHYTONADIONE) 10 MG AMP $91.00VITAMIN K 1 MG AMP $38.00VITOSS FOAM PACK 5CC $2,989.00VIVACTIL (PROTRIPTYLINE) 10MG TAB $7.00VIVITROL 380MG (NALTREXONE) INJ $8,694.00VIVOTIF CAPSULE (TYPHOID VACCINE LIVE) $60.00VMA 24 HOUR URINE $99.00VMA RANDOM URINE $44.00VOIDING PRESSURE STUDIES, INTRA-ABDOMINA $282.00VOLUME $40.00VON WILLEBRAND FACTOR ACTIVITY $149.00VON WILLEBRAND FACTOR ANTIGEN $192.00VONWILLEBRAND PROFILE (C) $125.00VP (VENIPUNCTURE UNDER 3 YR $63.00VULVECTOMY SIMPLE PARTIAL $1,317.00VULVECTOMY SIMPLE; PARTIAL $1,317.00WALK ER EQUALIZR SMALL $126.00WALKER 2 BUTTON ADULT $77.00WALKER 2 BUTTON JR $77.00WALKER EQUALIZER EX LG $126.00WALKER EQUALIZER LARGE BLK $126.00WALKER EQUALIZER MEDIUM BLK $126.00WALKER EQUALIZER XS $123.00WALKER EX LG 5IN WHEELS $195.00WALKER MEDIUM NEXTEP CONTOUR WITH AIR $311.00WALKER, SIDE STEPPER, HEMI $86.00WALKING BOOT NON-PNEUMATIC $208.00WALKING BOOT PNEUMATIC $174.00WALKING HEEL UNIVERSAL $24.00WARFARIN 5MG INJ (COUMADIN) $108.00WATER (STERILE WATER) 100 ML VIAL $6.00WAX BONE NATURAL $28.00WAX CURETTE SIZE 2 DISP $62.00WBC STAIN $82.00WEBRIL 4 STERILE $22.00WEBRIL 4 STERILE $10.00WEDGE EXCISION OF SKIN OF NAIL FOLD $182.00WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, $182.00WEST NILE VIRUS $162.00WEST NILE VIRUS IGG $80.00WEST NILE VIRUS, PCR $647.00WESTERN EQUINE ENCEPHALTIS IGG $174.00WESTERN EQUINE ENCEPHALTIS IGM $174.00WET PREP $16.00WET PREP $67.00WET PREP-GENITAL $68.00WET PREP-NON GENITAL $68.00

WET SALINE PAK $44.00WHEELCHAIR- BARIATRIC $714.00WHEELCHAIR- STANDARD $425.00WHITE BLOOD COUNT $53.00WINSTROL(STANOZOLOL) 2 MG TABS $4.00WIRE PASS DRILL 1.5M9 (STYKER) $219.00WITCH HAZEL PADS (TUCKS) $9.00WND VAC - NEG PRESS WOUND TX, <50CM $166.00WND VAC - NEG PRESS WOUND TX, <50CM $166.00WOUND DEBRIDE, DEEP $217.00WOUND DEBRIDE, SUPERFICIAL $217.00WOUND DRAIN COLL $56.00WOUND DRAINAGE COLLECTION $30.00WOUND DRAINAGE COLLECTOR 4X8 $52.00WOUND PREP TRK/ARM/LEG $541.00WRAP AROUND KNEE 1/8 MD $165.00WRIST BRACE LG LEFT $51.00WRIST BRACE LG RIGHT $51.00WRIST BRACE MD LEFT $51.00WRIST BRACE MD RIGHT $49.50WRIST BRACE SM LEFT $49.50WRIST BRACE SM RIGHT $49.50WRIST BRACE XLG LT $53.00WRIST BRACE XLG RT $23.00WRIST BRACE XS LEFT $17.00WRIST BRACE XS RIGHT $17.00WRIST FIXATOR $3,162.00WRIST LT 2V $174.00WRIST RESTRAIN DISP $20.00WRIST RT 2V $174.00WRIST SPLINT $63.00WRIST SPLINT REHAB $78.00WRIST SUPPORT RIGHT X LRG $90.00WRIST SUPPORT XSM LEFT $91.00WRISTBAND DISPOSIBLE $32.00WYCILLIN (PEN G) 2,400,000 UNIT TUBEX $78.00WYCILLIN (PENIC G) 1,200,000 UNIT TUBE $50.00WYCILLIN (PENIC G) 600,000 UNTS TUBEX $41.00X - ISTAT BUN/CREATININE $67.00X - ISTAT H & H $42.00XALLERGEN PROFILE PERENNIAL ALLERGEN $11.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00

XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XALLERGEN PROFILE PERENNIAL ALLERGEN $12.00XANAX (ALPRAZOLAM) 0.5 MG DO NOT USE $6.00XARELTO 10MG TABLET (RIVAROXABAN) $58.00XARELTO 15MG TABLET (RIVAROXABAN) $58.00XCEL BLADELESS TROCAR 12MM $165.00XC-PEPTIDE $77.00XEROFORM 1X8 DRESSING $8.00XEROFORM 2X2 DRESSING $7.00XEROFORM 5X9 DRESSING $4.00XGEVA (DENOSUMAB) 120MG/1.7ML VIAL $3,781.00XHEMOGLOBINOPATHY PROFILE /ALPHA THALASS $25.00XHEMOGLOBINOPATHY PROFILE ALPHA THALASS $25.00XHEMOGLOBINOPATHY PROFILE ALPHA THALASS $25.00XHEMOGLOBINOPATHY PROFILE/ALPHA THALASS $25.00XIFAXAN 200MG (RIFAXIMIN) TABLET $95.00XIFAXAN 550MG (RIFAXIMIN) TABLET $151.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XINHERITEST CARRIER SCREEN $161.00XMMR PROFILE $26.00XMMR PROFILE $26.00XOLAIR (OMALIZUMAB) 150MG SDV $4,140.00XOPENEX (LEVABUTEROL) 0.63MG/3ML UD $29.00XOPENEX (LEVALBUTEROL) 0.31MG/3ML $36.00XPAP SMEAR CONVENTIONAL $54.00XR ABD SERIES W/PA CHEST ROUTINE $542.00XR AC JOINTS $251.00XR BONE SURVEY LIMITED $174.00XR CLAVICLE $299.00

XR ELBOW LT ROUTINE MIN 3V $263.00XR ELBOW RT ROUTINE MIN 3V $263.00XR EXT LOWER INFANT MIN 2 VW $144.00XR FEMUR MIN 2V LT $168.00XR FEMUR MIN 2V RT $168.00XR FINGER LT $206.00XR FINGER RT $206.00XR FOOT LT ROUTINE MIN 3V $321.00XR FOOT RT ROUTINE MIN 3V $321.00XR FOREARM LT 2V $297.00XR FOREARM RT 2V $297.00XR HAND LT ROUTINE MIN 3V $321.00XR HAND RT ROUTINE MIN 3V $321.00XR HEEL XRAY LT MIN 2V $263.00XR HEEL XRAY RT MIN 2V $263.00XR HIP W/PELVIS 2-3 VIEW LT $172.00XR HIP W/PELVIS 2-3 VIEW RT $172.00XR HIPS BILAT W/PELVIS 2 VIEW $266.00XR HUMERUS LT MIN 2V $299.00XR HUMERUS RT MIN 2V $299.00XR KNEE LT ROUTINE MIN 4V $448.00XR KNEE RT ROUTINE MIN 4V $448.00XR NASAL BONES ROUTINE MIN 3V $246.00XR PELVIS XRAY 1V OR 2V $216.00XR RIBS BILAT W/PA CHEST MIN 4V $546.00XR RIBS LT W/PA CHEST MIN 3V $479.00XR RIBS RT W/PA CHEST MIN 3V $479.00XR SACRUM AND COCCYX-MIN 2V $246.00XR SCAPULA $305.00XR SHOULDER LT ROUTINE MIN 2V $312.00XR SHOULDER RT ROUTINE MIN 2V $312.00XR SOFT TISSUE NECK ROUTINE $204.00XR SPINE CERVICAL 2-3V TRAUMA $238.00XR SPINE LUMBAR - 2 OR 3 VIEWS $366.00XR SPINE THORACIC 3V $311.00XR STERNUM XRAY MIN 2V $299.00XR TIB/FIB LT 2V $383.00XR TIB/FIB RT 2V $383.00XR TOE LT MIN 2V $245.00XR TOE RT MIN 2V $245.00XR WRIST LT ROUTINE MIN 3V $328.00XR WRIST RT ROUTINE MIN 3V $328.00XXXXXXXX UNIV NEO THUMB SUPPORT $17.00XYLOCAINE (LIDOCAINE) : 1 GM VIAL $33.00XYLOCAINE 2% MPF 5ML VIAL (LIDOCAINE) $10.00XYLOCAINE/EPI (LIDOCAINE/EPI) 1.5% VIAL $40.00XYLOMETAZOLINE 1% NASAL SPRAY (OTRIVIN) $27.00

Y TYPE BLOOD SOLUTION SET CLEARLINK $40.00Y TYPE CATH EXT SET $31.00YANKAUER SUCTION TUBE $2.00YERVOY (IPILIMUMAB) 200MG VIAL $39,364.00YERVOY (IPILIMUMAB) 50MG VIAL $11,481.00Y-TYPE CATH EXTENSION $27.00Z SUTURE SADDLE BAG $20.00Z0601 75 PER 15 MIN TELEPHONIC MEETI $79.00Z0701 75 PER 15 MIN OF TIME ATTENDING T $79.00Z0751 W/C PROGRESS REPORT $50.00Z0751 Z0752 Z0753 PHYS WRIT REP PER 15 M $79.00Z0752 W/C CLOSING REPORT $50.00Z0753 W/C INITIAL & CLOSING REPORTS $50.00Z0754 WORKCOMP ADDL FORMS FOR PAYER $53.00Z0755 WRITTEN REPORT ONLY SPECIAL $97.00Z0756 RESPONDENT RQSTD INDEPENDENT MEDIC $97.00Z0757 SPEC REPORTS LENGTHY FORM COMPLET $97.00Z0759 WRK RELATED MED DIABILITY EXAM B $604.00Z0760 WRK RELATED/MED DISABILITY EXAM $814.00ZALEPLON 10MG CAPSULE (SONATA) $10.00ZALEPLON 5MG CAPSULE (SONATA) $10.00ZANAMIVIR DISKHALER PWD 5MG (RELENZA) $120.00ZARXIO 480MCG/0.8ML SYRINGE $1,076.00ZEBETA (BISOPROLOL FUM) 5 MG TAB $4.00ZELNORM (TEGASEROD) 2MG TABLET $17.00ZEMURON (ROCURONIUM) 50MG/5ML:10ML $49.00ZETIA (EZETIMIBE) 10MG TAB $22.00ZIDOVUDINE 10 MG/ML 4 OZ (RETROVIR) $97.00ZIDOVUDINE 100 MG CAPSULE (RETROVIR) $10.00ZIDOVUDINE 300 MG TABLET (RETROVIR) $28.00ZIKA COMPREHENSIVE $461.00ZILRETTA 32MG (TRIAMCINOLONE) SDV $2,615.00ZINC - WHOLE BLOOD $104.00ZINC (CHLORIDE) 1 MG/ML 10 ML VIAL $16.00ZINC GLUCONATE 50 MG TABS $4.00ZINC OXIDE (ZINC OXIDE) 20% OINT 30 GM $10.00ZINC PROTOPORPHYRIN $117.00ZINC SERUM OR PLASMA $104.00ZIPRASIDONE 20MG CAPSULE (GEODON) $28.00ZOLADEX (GOSERELIN ACE) 10.8 MG $2,049.00ZOLADEX (GOSERELIN ACE) 3.6 MG $1,563.00ZOLEDRONIC ACID 4MG VIAL (ZOMETA) $2,942.00ZOLEDRONIC ACID 5MG/100ML (RECLAST) $1,788.00ZOLPIDEM 5 MG TABLET (AMBIEN) $11.00ZOMIG-ZMT (ZOLMITRIPTAN) 2.5MG TAB $64.00ZONALON (DOXEPIN CR) 5% 45GM CREAM $188.00ZONEGRAN (ZONISAMIDE) 100MG CAPSULE $12.00

ZONISAMIDE $277.00ZOSYN 2.25GM (PIPERCILLIN/TAZOBACTAM) $50.00ZOSYN 3.375GM (PIPERCILLIN/TAZOBACTAM) $123.00ZOSYN 4.5GM (PIPERCILLIN/TAZOBACTAM) $117.00ZOSYN 4.5GM/ NS 100ML $137.00ZYBAN SR (BUPROPION HCL) 150 MG TABS $9.00ZYMAR (GATIFLOXACIN) 0.3% OPTH SOLN 5ML $299.00ZYPREXA $110.00ZyPREXA (OLANZAPINE) 5 MG TABS $7.00ZYRTEC-D(PSUEDO-CETIRIZINE) 120/5 TAB $8.00

PMC PRICING AS OF 3-27-2020.csv - Prowers Medical Center

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