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Injection, fentanyl citrate, 0.1 mg
$43.54 Standard Charge See All Rates |
Injection, propofol, 10 mg
$60.80 Standard Charge See All Rates |
Injection, acetaminophen, 10 mg
$34.78 Standard Charge See All Rates |
Injection, azithromycin, 500 mg
$27.10 Standard Charge See All Rates |
Injection, furosemide, up to 20 mg
$26.40 Standard Charge See All Rates |
Injection, ropivacaine hydrochloride, 1 mg
$38.39 Standard Charge See All Rates |
Unclassified drugs
$67.60 Standard Charge See All Rates |
Injection, omalizumab, 5 mg
$1,484.96 Standard Charge See All Rates |
Injection, ondansetron hydrochloride, per 1 mg
$20.96 Standard Charge See All Rates |
Infusion, normal saline solution , 1000 cc
$66.80 Standard Charge See All Rates |
Infusion, normal saline solution, 250 cc
$65.88 Standard Charge See All Rates |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
$32.51 Standard Charge See All Rates |
Injection, magnesium sulfate, per 500 mg
$79.95 Standard Charge See All Rates |
Injection, lidocaine hcl for intravenous infusion, 10 mg
$63.38 Standard Charge See All Rates |
Infusion, normal saline solution, sterile (500 ml = 1 unit)
$66.70 Standard Charge See All Rates |
Posterior chamber intraocular lens
$270.00 Standard Charge See All Rates |
Injection, morphine sulfate, up to 10 mg
$45.89 Standard Charge See All Rates |
Injection, potassium chloride, per 2 meq
$59.32 Standard Charge See All Rates |
Non-covered item or service
$1.43 Standard Charge See All Rates |
Injection, lorazepam, 2 mg
$44.20 Standard Charge See All Rates |
Injection, midazolam hydrochloride, per 1 mg
$41.09 Standard Charge See All Rates |
Esketamine, nasal spray, 1 mg
$2,938.16 Standard Charge See All Rates |
Injection, denosumab, 1 mg
$3,451.70 Standard Charge See All Rates |
Injection, infliximab, excludes biosimilar, 10 mg
$973.38 Standard Charge See All Rates |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
$172.76 Standard Charge See All Rates |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)
$198.00 Standard Charge See All Rates |
Hospital observation service, per hour
$62.00 Standard Charge See All Rates |
Injection, ceftriaxone sodium, per 250 mg
$23.86 Standard Charge See All Rates |
Direct admission of patient for hospital observation care
$460.00 Standard Charge See All Rates |
Hospital outpatient clinic visit for assessment and management of a patient
$200.00 Standard Charge See All Rates |
Injection, diphenhydramine hcl, up to 50 mg
$24.31 Standard Charge See All Rates |
Injection, heparin sodium, (heparin lock flush), per 10 units
$21.27 Standard Charge See All Rates |
Injection, enoxaparin sodium, 10 mg
$28.21 Standard Charge See All Rates |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed
$139.00 Standard Charge See All Rates |
Injection, cefazolin sodium, 500 mg
$25.90 Standard Charge See All Rates |
Injection, dexamethasone sodium phosphate, 1 mg
$36.31 Standard Charge See All Rates |
Injection, hydromorphone, up to 4 mg
$108.56 Standard Charge See All Rates |
Injection, iron sucrose, 1 mg
$140.90 Standard Charge See All Rates |
Injection, insulin, per 5 units
$92.93 Standard Charge See All Rates |
Injection, ketorolac tromethamine, per 15 mg
$27.60 Standard Charge See All Rates |
5% dextrose/water (500 ml = 1 unit)
$71.36 Standard Charge See All Rates |
Ringers lactate infusion, up to 1000 cc
$74.52 Standard Charge See All Rates |