"The information provided below is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital, also known as a chargemaster. It is not a helpful tool for patients to comparison shop between hospitals or to estimate what health care services are going to cost them out of their own pocket. For more information about the cost of your care, please contact our patient financial services staff at (435)725-2060.",,,,,
Description,Base Charge,Inpatient Charge,Room Rate,Professional Charge,Pharmacy Charge
% Alpha-Beta ARUP,$97.25 ,,,,
% Alpha-Beta ARUP,$97.25 ,,,,
% Alpha-Beta ARUP,$97.25 ,,,,
% bcl-2 ARUP,$97.25 ,,,,
% bcl-2 ARUP,$97.25 ,,,,
% bcl-2 ARUP,$97.25 ,,,,
% CD1 ARUP,$97.25 ,,,,
% CD1 ARUP,$97.25 ,,,,
% CD1 ARUP,$97.25 ,,,,
% CD10 ARUP,$97.25 ,,,,
% CD10 ARUP,$97.25 ,,,,
% CD10 ARUP,$97.25 ,,,,
% CD103 ARUP,$97.25 ,,,,
% CD103 ARUP,$97.25 ,,,,
% CD103 ARUP,$97.25 ,,,,
% CD117 ARUP,$97.25 ,,,,
% CD117 ARUP,$97.25 ,,,,
% CD117 ARUP,$97.25 ,,,,
% CD11b ARUP,$97.25 ,,,,
% CD11b ARUP,$97.25 ,,,,
% CD11b ARUP,$97.25 ,,,,
% CD11c ARUP,$97.25 ,,,,
% CD11c ARUP,$97.25 ,,,,
% CD11c ARUP,$97.25 ,,,,
% CD13 ARUP,$97.25 ,,,,
% CD13 ARUP,$97.25 ,,,,
% CD13 ARUP,$97.25 ,,,,
% CD14 (MO2) ARUP,$97.25 ,,,,
% CD14 (MO2) ARUP,$97.25 ,,,,
% CD14 (MO2) ARUP,$97.25 ,,,,
% CD14 (MY4) ARUP,$97.25 ,,,,
% CD14 (MY4) ARUP,$97.25 ,,,,
% CD14 (MY4) ARUP,$97.25 ,,,,
% CD15 ARUP,$97.25 ,,,,
% CD15 ARUP,$97.25 ,,,,
% CD15 ARUP,$97.25 ,,,,
% CD16 ARUP,$97.25 ,,,,
% CD16 ARUP,$97.25 ,,,,
% CD16 ARUP,$97.25 ,,,,
% CD18 ARUP,$97.25 ,,,,
% CD18 ARUP,$97.25 ,,,,
% CD18 ARUP,$97.25 ,,,,
% CD19 ARUP,$97.25 ,,,,
% CD19 ARUP,$97.25 ,,,,
% CD19 ARUP,$97.25 ,,,,
% CD2 ARUP,$371.00 ,,,,
% CD2 ARUP,$97.25 ,,,,
% CD2 ARUP,$97.25 ,,,,
% CD20 ARUP,$97.25 ,,,,
% CD20 ARUP,$97.25 ,,,,
% CD20 ARUP,$97.25 ,,,,
% CD21 ARUP,$97.25 ,,,,
% CD21 ARUP,$97.25 ,,,,
% CD21 ARUP,$97.25 ,,,,
% CD22 ARUP,$97.25 ,,,,
% CD22 ARUP,$97.25 ,,,,
% CD22 ARUP,$97.25 ,,,,
% CD23 ARUP,$97.25 ,,,,
% CD23 ARUP,$97.25 ,,,,
% CD23 ARUP,$97.25 ,,,,
% CD24 ARUP,$97.25 ,,,,
% CD24 ARUP,$97.25 ,,,,
% CD24 ARUP,$97.25 ,,,,
% CD25 ARUP,$97.25 ,,,,
% CD25 ARUP,$97.25 ,,,,
% CD25 ARUP,$97.25 ,,,,
% CD3 ARUP,$97.25 ,,,,
% CD3 ARUP,$97.25 ,,,,
% CD3 ARUP,$97.25 ,,,,
% CD30 ARUP,$97.25 ,,,,
% CD30 ARUP,$97.25 ,,,,
% CD30 ARUP,$97.25 ,,,,
% CD33 ARUP,$97.25 ,,,,
% CD33 ARUP,$97.25 ,,,,
% CD33 ARUP,$97.25 ,,,,
% CD34 ARUP,$97.25 ,,,,
% CD34 ARUP,$97.25 ,,,,
% CD34 ARUP,$97.25 ,,,,
% CD38 ARUP,$97.25 ,,,,
% CD38 ARUP,$97.25 ,,,,
% CD38 ARUP,$97.25 ,,,,
% CD4 ARUP,$97.25 ,,,,
% CD4 ARUP,$97.25 ,,,,
% CD4 ARUP,$97.25 ,,,,
% CD41 ARUP,$97.25 ,,,,
% CD41 ARUP,$97.25 ,,,,
% CD41 ARUP,$97.25 ,,,,
% CD42b ARUP,$97.25 ,,,,
% CD42b ARUP,$97.25 ,,,,
% CD42b ARUP,$97.25 ,,,,
% CD5 ARUP,$97.25 ,,,,
% CD5 ARUP,$97.25 ,,,,
% CD5 ARUP,$97.25 ,,,,
% CD56 ARUP,$97.25 ,,,,
% CD56 ARUP,$97.25 ,,,,
% CD56 ARUP,$97.25 ,,,,
% CD57 ARUP,$97.25 ,,,,
% CD57 ARUP,$97.25 ,,,,
% CD57 ARUP,$97.25 ,,,,
% CD61 ARUP,$97.25 ,,,,
% CD61 ARUP,$97.25 ,,,,
% CD61 ARUP,$97.25 ,,,,
% CD64 ARUP,$97.25 ,,,,
% CD64 ARUP,$97.25 ,,,,
% CD64 ARUP,$97.25 ,,,,
% CD7 ARUP,$97.25 ,,,,
% CD7 ARUP,$97.25 ,,,,
% CD7 ARUP,$97.25 ,,,,
% CD79b ARUP,$97.25 ,,,,
% CD79b ARUP,$97.25 ,,,,
% CD79b ARUP,$97.25 ,,,,
% CD8 ARUP,$97.25 ,,,,
% CD8 ARUP,$97.25 ,,,,
% CD8 ARUP,$97.25 ,,,,
% CD9 ARUP,$97.25 ,,,,
% CDw65 ARUP,$371.00 ,,,,
% CDw65 ARUP,$371.00 ,,,,
% CDw65 ARUP,$97.25 ,,,,
% Cytoplasmic CD3 ARUP,$97.25 ,,,,
% Cytoplasmic CD3 ARUP,$97.25 ,,,,
% Cytoplasmic CD3 ARUP,$97.25 ,,,,
% Cytoplasmic Kappa ARUP,$97.25 ,,,,
% Cytoplasmic Kappa ARUP,$97.25 ,,,,
% Cytoplasmic Kappa ARUP,$97.25 ,,,,
% Cytoplasmic Lambda ARUP,$97.25 ,,,,
% Cytoplasmic Lambda ARUP,$97.25 ,,,,
% Cytoplasmic Lambda ARUP,$97.25 ,,,,
% FMC7 ARUP,$97.25 ,,,,
% FMC7 ARUP,$97.25 ,,,,
% FMC7 ARUP,$97.25 ,,,,
% Gamma-Delta ARUP,$97.25 ,,,,
% Gamma-Delta ARUP,$97.25 ,,,,
% Gamma-Delta ARUP,$97.25 ,,,,
% Glycophorin ARUP,$97.25 ,,,,
% Glycophorin ARUP,$97.25 ,,,,
% Glycophorin ARUP,$97.25 ,,,,
% HLA-DR ARUP,$97.25 ,,,,
% HLA-DR ARUP,$97.25 ,,,,
% HLA-DR ARUP,$97.25 ,,,,
% Kappa ARUP,$97.25 ,,,,
% Kappa ARUP,$97.25 ,,,,
% Kappa ARUP,$97.25 ,,,,
% Lambda ARUP,$97.25 ,,,,
% Lambda ARUP,$97.25 ,,,,
% Lambda ARUP,$97.25 ,,,,
% Myeloperoxidase ARUP,$97.25 ,,,,
% Myeloperoxidase ARUP,$97.25 ,,,,
% Myeloperoxidase ARUP,$97.25 ,,,,
% TdT ARUP,$97.25 ,,,,
% TdT ARUP,$97.25 ,,,,
% TdT ARUP,$97.25 ,,,,
.GTT- 2 Hr,$85.00 ,,,,
.GTT 4 Hour,$125.00 ,,,,
.GTT 5 Hour,$125.00 ,,,,
.GTT-1 Hr,$85.00 ,,,,
.GTT-2 Hr,$125.00 ,,,,
.GTT-3 Hr,$125.00 ,,,,
".HIV 1 Antibody Confirm, Western Blot ARUP",$120.00 ,,,,
.Man Diff 4,$34.50 ,,,,
".Smooth Muscle Antibody Titer, IgG ARUP",$71.32 ,,,,
0 VICRYL CT-1 NEEDLE,$8.00 ,,,,
0.3 POLYMER I/A TIP CURVED,$57.50 ,,,,
0.5MM X 64MM XOMED BUR,$228.75 ,,,,
0.5MM X 75MM XOMED BUR,$228.75 ,,,,
00000-0000-88 - ANES- Bupivacaine 0.125% - NS 100 ml [UBMC],,,,,$15.75 
00002-3237-33 - duloxetine 60 mg Cap [UBMC],,,,,$10.70 
00002-3240-01 - duloxetine 30 mg Cap [UBMC],,,,,$11.60 
00002-3240-33 - duloxetine 30 mg Cap [UBMC],,,,,$18.05 
00002-3270-01 - duloxetine 60 mg Cap [UBMC],,,,,$10.70 
00002-4115-01 - olanzapine 5 mg Tab UD[UBMC],,,,,$30.40 
00002-4115-33 - olanzapine 5 mg Tab UD[UBMC],,,,,$30.40 
00002-7140-01 - abciximab 2 mg/mL Sol [UBMC],,,,,$582.35 
00002-7501-01 - gemcitabine 200 mg IV Inj [UBMC],,,,,$316.45 
00002-7502-01 - gemcitabine 1 g IV Inj [UBMC],,,,,"$1,582.25 "
00002-7510-17 - insulin lispro 100 units/mL SubQ Inj 3ml [UBMC],,,,,$79.50 
00002-7597-01 - olanzapine 10 mg IM Inj SDV [UBMC],,,,,$97.00 
00002-8031-01 - glucagon recombinant 1 mg Inj [UBMC],,,,,$653.95 
00002-8215-17 - Insulin Regular 3mL [UBMC],,,,,$43.00 
00002-8315-01 - insulin N isophane 100 units/mL SubQ Inj 10ML [UBMC],,,,,$18.50 
00002-8315-17 - insulin N isophane 100 units/mL SubQ Inj 3ml [UBMC],,,,,$43.00 
00002-8715-01 - insulin 70/30 units/mL SubQ Inj 10 mL [UBMC],,,,,$43.00 
00003-0293-05 - triamcinolone 40 mg/mL Inj Susp SDV 1 mL [UBMC],,,,,$28.25 
00003-0293-20 - triamcinolone 40 mg/mL Inj Susp SDV 5 mL [UBMC],,,,,$28.70 
00003-0494-20 - triamcinolone 10 mg/mL Inj Susp [UBMC],,,,,$24.50 
00003-0893-21 - apixaban 2.5 mg Tab,,,,,$17.35 
00003-0893-31 - apixaban 2.5 mg Tab,,,,,$16.10 
00003-2187-10 - abatacept 250 mg REC,,,,,"$2,174.55 "
00004-0800-85 - oseltamivir 75 mg Cap [UBMC],,,,,$35.60 
00004-0822-05 - oseltamivir 6 mg/mL REC,,,,,$7.45 
00005-1971-02 - pneumococcal 13-valent conjugate vaccine - Sus,,,,,$791.95 
00006-0117-01 - montelukast 10 mg Tab [UBMC],,,,,$11.05 
00006-0117-54 - montelukast 10 mg Tab [UBMC],,,,,$14.60 
00006-0227-61 - raltegravir 400 mg Tab,,,,,$57.00 
00006-0462-01 - aprepitant 125 mg Cap [UBMC],,,,,$350.60 
00006-0462-06 - aprepitant 125 mg Cap [UBMC],,,,,$731.55 
00006-0951-54 - losartan 25 mg Tab,,,,,$8.15 
00006-3061-00 - fosaprepitant 150 mg REC,,,,,$715.50 
00006-3843-71 - ertapenem 1 g Inj [UBMC],,,,,$269.50 
00006-4681-00 - measles/mumps/rubella virus vac SQ Inj [UBMC],,,,,$165.60 
00006-4837-03 - pneumococcal 23-polyvalent vaccine - Sol,,,,,$407.90 
00006-4943-00 - pneumococcal 23-valent vaccine Inj Sol [UBMC],,,,,$407.90 
00006-5423-12 - sugammadex 100 mg/mL Sol,,,,,$107.25 
00007-4140-20 - carvedilol 6.25 mg Tab,,,,,$10.40 
00008-0923-55 - pantoprazole 40 mg REC,,,,,$18.80 
00008-2001-25 - pantoprazole 40 mg REC,,,,,$18.80 
00009-0011-03 - hydrocortisone 100 mg PF IM/IV SDV [UBMC],,,,,$32.25 
00009-0011-04 - hydrocortisone 100 mg preservative-free REC,,,,,$32.20 
00009-0018-20 - methylPREDNISolone 1 g PF SDV AOV [UBMC],,,,,$124.45 
00009-0039-28 - methylPREDNISolone 40 mg preservative-free REC[UBMC],,,,,$19.90 
00009-0039-30 - methylPREDNISolone 40 mg preservative-free REC[UBMC],,,,,$19.00 
00009-0047-22 - methylPREDNISolone 125 mg preservative-free REC[UBMC],,,,,$26.65 
00009-0047-25 - methylPREDNISolone 125 mg preservative-free REC[UBMC],,,,,$18.25 
00009-0233-01 - bacitracin 50000 units REC [UBMC],,,,,$34.60 
00009-0271-01 - estradiol cypionate 5 mg/mL IM Sol [UBMC],,,,,$57.15 
00009-0347-02 - testosterone cypionate 100 mg/mL Sol,,,,,$65.15 
00009-0417-02 - testosterone cypionate 200 mg/mL Sol,,,,,$80.70 
00009-0698-01 - methylPREDNISolone 1 g REC,,,,,$91.75 
00009-0746-30 - medroxyPROGESTERone 150 mg/mL Sus[UBMC],,,,,$410.00 
00009-0746-35 - medroxyPROGESTERone 150 mg/mL Sus[UBMC],,,,,$410.00 
00009-0758-01 - methylPREDNISolone 500 mg Inj SDV [UBMC],,,,,$63.60 
00009-0775-20 - clindamycin 150 mg/mL Sol,,,,,$18.25 
00009-0775-26 - clindamycin 150 mg/mL Sol,,,,,$20.35 
00009-0827-03 - dinoprostone 20 mg Vag Supp [UBMC],,,,,"$4,353.80 "
00009-0856-05 - carboprost 250 mcg/mL Sol[UBMC],,,,,$16.55 
00009-0856-08 - carboprost 250 mcg/mL Sol[UBMC],,,,,$641.10 
00009-0902-11 - clindamycin 150 mg/mL Sol,,,,,$16.20 
00009-0902-18 - clindamycin 150 mg/mL Sol,,,,,$19.65 
00009-3124-01 - clindamycin 150 mg/mL Sol,,,,,$19.35 
00009-3169-01 - alprostadil 0.5 mg/mL Sol,,,,,$223.55 
00009-3169-06 - alprostadil 0.5 mg/mL Sol,,,,,$269.15 
00009-3375-01 - clindamycin 600 mg-5%/50 mL Sol,,,,,$15.75 
00009-3375-02 - clindamycin 600 mg-5%/50 mL Sol,,,,,$18.25 
00009-3382-01 - clindamycin 900 mg-5%/50 mL Sol,,,,,$15.75 
00009-3447-01 - clindamycin 150 mg/mL IV Sol ADV 900MG [UBMC],,,,,$17.00 
00009-3475-01 - methylPREDNISolone 80 mg/mL Inj Susp 1mL [UBMC],,,,,$48.40 
00009-3475-03 - methylPREDNISolone 80 mg/mL Inj Susp 1mL [UBMC],,,,,$48.40 
00009-3794-01 - ibutilide 0.1 mg/mL IV Sol 10ml vial [UBMC],,,,,$112.35 
00009-3794-44 - ibutilide 0.1 mg/mL IV Sol 10ml vial [UBMC],,,,,$117.05 
00009-5140-01 - linezolid 2 mg/mL IV Sol [UBMC],,,,,$13.25 
00009-5191-01 - tolterodine 4 mg ER [UBMC],,,,,$27.60 
00013-1114-21 - tranexamic acid 100 mg/mL Sol,,,,,$24.10 
00023-0312-04 - ocular lubricant - Oin,,,,,$8.70 
00023-0312-07 - ocular lubricant - Oin,,,,,$7.55 
00023-4491-30 - ocular lubricant - Sol,,,,,$3.70 
00024-2792-10 - sodium ferric gluconate complex 12.5 mg/mL Sol [UBMC],,,,,$23.90 
00025-1520-34 - celecoxib 100 mg Cap [UBMC],,,,,$15.30 
00029-1526-03 - mupirocin Top 2% Oint [UBMC],,,,,$37.85 
00029-6571-26 - ticarcillin-clavulanate 3.1 g IV Inj [UBMC],,,,,$41.60 
00032-1711-01 - progesterone 200 mg Cap[UBMC],,,,,$23.95 
00039-0018-01 - cefotaxime 1 g Inj [UBMC],,,,,$18.35 
00039-0018-10 - cefotaxime 1 g Inj [UBMC],,,,,$19.45 
00039-0018-11 - cefotaxime 1 g Inj [UBMC],,,,,$18.35 
00039-0019-01 - cefotaxime 2 g Inj [UBMC],,,,,$68.60 
00039-0019-10 - cefotaxime 2 g Inj [UBMC],,,,,$17.00 
00039-0019-11 - cefotaxime 2 g Inj [UBMC],,,,,$68.60 
00039-0223-10 - glimepiride 4 mg Tab [UBMC],,,,,$12.65 
00049-0014-83 - ampicillin-sulbactam 2 g-1 g REC,,,,,$44.75 
"00049-0520-83 - Penicillin G Potassium 5,000,000 units[UBMC]",,,,,$39.50 
00049-3920-83 - ziprasidone mesylate 20 mg/mL [UBMC],,,,,$112.75 
00053-7680-32 - albumin human 25% Sol,,,,,$25.30 
00054-0007-25 - calcitriol cap 0.25 mcg [UBMC],,,,,$4.75 
00054-0017-20 - predniSONE 10 mg Tab,,,,,$2.55 
00054-0018-20 - predniSONE 20 mg Tab [UBMC],,,,,$2.70 
00054-0018-20 - predniSONE 20 mg Tab UD home pack[UBMC],,,,,$2.05 
00054-0018-25 - predniSONE 20 mg Tab,,,,,$2.75 
00054-0037-21 - clarithromycin 500 mg Tab,,,,,$12.45 
00054-0088-13 - calcium acetate 667 mg Cap,,,,,$4.05 
00054-0088-26 - calcium acetate 667 mg Cap,,,,,$4.05 
00054-0108-20 - ramipril 5 mg Cap [UBMC],,,,,$4.95 
00054-0229-20 - QUEtiapine 50 mg Tab,,,,,$13.60 
00054-0235-24 - morphine 15 mg Tab [UBMC],,,,,$5.55 
00054-0264-24 - HYDROmorphone 4 mg Tab,,,,,$7.60 
00054-3026-02 - acetylcysteine 20% Sol,,,,,$3.70 
00054-3270-99 - fluticasone Nasal 0.05 mg/inh Spry [UBMC],,,,,$29.80 
00054-4527-25 - lithium 300 mg Tab,,,,,$2.30 
00054-8175-25 - dexamethasone 4 mg Tab [UBMC],,,,,$4.30 
00054-8299-25 - furosemide 40 mg Tab [UBMC],,,,,$4.05 
00054-8500-16 - lidocaine topical 2% Sol[UBMC],,,,,$1.85 
00054-8528-25 - lithium 300 mg Tab [UBMC],,,,,$2.75 
00054-8595-11 - meperidine 50 mg Tab [UBMC],,,,,$19.10 
00054-8724-25 - predniSONE 5 mg Tab,,,,,$2.65 
00054-8859-25 - triazolam 0.25 mg Tab [UBMC],,,,,$7.15 
00056-0169-01 - warfarin 1 mg Tab UD [UBMC],,,,,$4.50 
00056-0169-75 - warfarin 1 mg Tab UD [UBMC],,,,,$6.25 
00056-0170-01 - warfarin 2 mg Tab [UBMC],,,,,$4.70 
00056-0170-75 - warfarin 2 mg Tab [UBMC],,,,,$6.50 
00056-0172-01 - warfarin 5 mg Tab [UBMC],,,,,$5.05 
00056-0172-75 - warfarin 5 mg Tab [UBMC],,,,,$7.00 
00056-0172-75 - warfarin 5 mg Tab UD home pack [UBMC],,,,,$5.05 
00056-0176-01 - warfarin 2.5 mg Tab [UBMC],,,,,$4.85 
00056-0176-75 - warfarin 2.5 mg Tab [UBMC],,,,,$6.70 
00056-0188-01 - warfarin 3 mg Tab [UBMC],,,,,$4.85 
00056-0188-75 - warfarin 3 mg Tab [UBMC],,,,,$6.75 
00065-0023-15 - carbachol Opth 0.01% Sol [UBMC],,,,,$55.75 
00065-0215-35 - pilocarpine ophthalmic 4% Gel[UBMC],,,,,$49.50 
00065-0359-02 - cyclopentolate-phenylephrine Opth Sol [UBMC],,,,,$40.95 
00065-0411-30 - povidone iodine Opth 5% Sol [UBMC],,,,,$3.55 
00065-0647-05 - dexameth-tobramycin Ophth 0.1%-0.3% Susp [UBMC],,,,,$83.70 
00065-0648-35 - dexamethasone-tobramycin ophthalmic 0.1%-0.3% Oin [UBMC],,,,,$132.85 
00065-0741-12 - tetracaine ophthalmic 0.5% Sol [UBMC],,,,,$11.40 
00065-0795-50 - Balanced Salt Solution Sol [UBMC],,,,,$1.45 
00065-4013-03 - moxifloxacin 0.5% Opth Sol [UBMC],,,,,$121.50 
00065-8533-02 - ciprofloxacin-dexameth 0.3%-0.1% Otic Susp [UBMC],,,,,$74.75 
00067-5124-14 - nicotine 7 mg/24 hr ER,,,,,$5.55 
00067-5125-09 - nicotine 14 mg/24 hr Transderm Patch [UBMC],,,,,$5.55 
00067-5125-14 - nicotine 14 mg/24 hr Transderm Patch [UBMC],,,,,$5.55 
00067-5126-09 - nicotine 21 mg/24 hr Transderm Patch [UBMC],,,,,$5.55 
00067-5126-14 - nicotine 21 mg/24 hr Transderm Patch [UBMC],,,,,$5.55 
00069-0006-02 - etomidate 2 mg/mL Soln,,,,,$17.20 
00069-0006-04 - etomidate 2 mg/mL Soln,,,,,$31.20 
00069-0059-03 - heparin 5000 units/mL Sol,,,,,$22.70 
"00069-0059-04 - heparin 5,000 unit(s) / 1 mL Soln",,,,,$22.70 
00069-0094-01 - vecuronium 10 mg REC Injection,,,,,$18.80 
00069-0105-01 - flumazenil 0.1 mg/mL Soln,,,,,$20.75 
00069-0113-01 - haloperidol 5 mg/mL Soln,,,,,$22.90 
00069-0146-02 - methotrexate 25 mg/mL preservative-free Sol,,,,,$23.00 
00069-0314-10 - meropenem 1000 mg REC,,,,,$151.55 
00069-0400-10 - azithromycin 500 mg REC,,,,,$22.55 
00069-0809-01 - inFLIXimab 100 mg REC,,,,,"$2,225.65 "
00069-2670-66 - NIFEdipine 90 mg ER [UBMC],,,,,$25.65 
00069-3110-19 - azithromycin 100 mg/5 mL Oral Liq [UBMC],,,,,$20.10 
00069-3150-83 - azithromycin 500 mg REC [UBMC],,,,,$22.55 
00069-3150-84 - azithromycin 500 mg REC Powder,,,,,$22.55 
00071-0155-40 - atorvastatin 10 mg Tab [UBMC],,,,,$20.70 
00071-0369-40 - phenytoin 100 mg ER  UD[UBMC],,,,,$4.65 
00071-0369-40 - Phenytoin Sodium Extend Oral Cap 100 mg [UBMC],,,,,$3.95 
00071-0418-13 - nitroglycerin 0.4 mg sublingual Tab [UBMC],,,,,$4.90 
00071-1013-68 - pregabalin 50 mg Cap,,,,,$21.70 
00071-1014-41 - pregabalin 75 mg Cap UD [UBMC],,,,,$26.00 
00071-1015-41 - pregabalin 100 mg Cap UD [UBMC],,,,,$26.00 
00071-1015-68 - pregabalin 100 mg Cap,,,,,$21.70 
00071-1703-16 - witch hazel-glycerin Top 10%-50% Pad [UBMC],,,,,$2.05 
00071-2214-20 - phenytoin 125 mg/5 mL Oral Susp [UBMC],,,,,$4.10 
00074-1040-08 - beractant 25 mg/mL Sus [UBMC],,,,,$210.50 
00074-2586-60 - clarithromycin 500 mg Tab [UBMC],,,,,$24.20 
00074-3683-03 - leuprolide 30 mg/4 months PWD,,,,,"$11,738.05 "
00074-3727-90 - levothyroxine 137 mcg (0.137 mg) Tab,,,,,$4.60 
00074-4552-11 - levothyroxine 50 mcg (0.05 mg) Tab,,,,,$4.85 
00074-4712-01 - lidocaine 7.5%-5% Sol[UBMC],,,,,$21.50 
00074-6214-11 - divalproex sodium 250 mg Oral EC Tab [UBMC],,,,,$6.45 
00074-6215-11 - divalproex sodium 500 mg Oral EC Tab [UBMC],,,,,$11.90 
00074-6594-90 - levothyroxine 88 mcg (0.088 mg) Tab,,,,,$4.75 
00074-6624-11 - levothyroxine 100 mcg (0.1 mg) Tab,,,,,$4.95 
00074-6799-22 - lopinavir-ritonavir 200 mg-50 mg Tab,,,,,$20.00 
00074-9296-90 - levothyroxine 112 mcg (0.112 mg) Tab,,,,,$4.60 
00075-0620-40 - enoxaparin 40 mg/0.4 mL SC Sol [UBMC],,,,,$205.40 
00075-0621-60 - enoxaparin 60 mg/0.6 mL SC Sol [UBMC],,,,,$205.65 
00075-0622-80 - enoxaparin 80 mg/0.8 mL SC Sol [UBMC],,,,,$205.65 
00075-0623-00 - enoxaparin 100 mg/mL SC Sol [UBMC],,,,,$205.65 
00075-0624-30 - enoxaparin 30 mg/0.3 mL SC Sol [UBMC],,,,,$205.40 
00075-2912-01 - enoxaparin 120 mg/0.8 mL SC Sol [UBMC],,,,,$308.55 
00078-0053-03 - methylergonovine 0.2 mg/mL Sol [UBMC],,,,,$29.55 
00078-0053-61 - methylergonovine 0.2 mg/mL Sol [UBMC],,,,,$26.90 
00078-0054-05 - methylergonovine 0.2 mg Tab [UBMC],,,,,$4.45 
00078-0149-23 - calcitonin 200 intl units/mL Sol [UBMC],,,,,"$2,337.15 "
00078-0347-51 - Desferal 2 g per vial [UBMC],,,,,$296.40 
00078-0347-61 - Desferal 2 g per vial [UBMC],,,,,$214.40 
00078-0358-06 - valsartan 80 mg Tab [UBMC],,,,,$7.65 
00078-0358-06 - valsartan 80 mg Tab UD [UBMC],,,,,$8.80 
00078-0358-34 - valsartan 80 mg Tab,,,,,$16.90 
00078-0358-61 - valsartan 80 mg Tab [UBMC],,,,,$7.65 
00078-0387-25 - zoledronic acid 4 mg/5 mL IV Sol [UBMC],,,,,$421.30 
00078-0435-61 - zoledronic acid 5 mg/100 mL IV Sol [UBMC],,,,,$33.80 
00085-1132-01 - albuterol 90 mcg/inh Inh Aer w/Adapt [UBMC],,,,,$27.95 
00085-1132-01 - albuterol CFC free 90 mcg/inh Aer Home pk[UBMC],,,,,$16.00 
00085-1136-01 - eptifibatide 0.75 mg/mL Sol[UBMC],,,,,$20.45 
00085-1177-01 - eptifibatide 2 mg/mL Sol [UBMC],,,,,$54.25 
00085-1288-01 - mometasone nasal 50 mcg/inh Spr [UBMC],,,,,$34.65 
00088-2220-33 - insulin glargine 100 units/mL Sol [UBMC],,,,,$77.55 
00093-0109-01 - carbamazepine 200 mg Tab [UBMC],,,,,$4.15 
00093-0311-01 - loperamide 2 mg Cap,,,,,$4.65 
00093-0314-01 - ketorolac 10 mg Tab [UBMC],,,,,$5.60 
00093-0794-01 - niCARdipine 30 mg Cap[UBMC],,,,,$4.15 
00093-0926-19 - lovastatin 10 mg Tab [UBMC],,,,,$4.55 
00093-1010-42 - mupirocin topical 2% Oin,,,,,$10.10 
00093-1049-01 - metFORMIN 850 mg Tab,,,,,$4.70 
00093-1172-01 - penicillin V potassium 250 mg Tab,,,,,$4.65 
00093-1714-01 - warfarin 2.5 mg Tab,,,,,$4.20 
00093-2026-31 - azithromycin 200 mg/5 mL REC,,,,,$4.55 
00093-2027-23 - azithromycin 100 mg/5 mL REC,,,,,$6.05 
00093-2047-56 - pioglitazone 30 mg Tab,,,,,$22.20 
00093-2049-56 - tolterodine 4 mg ER,,,,,$16.65 
00093-2203-01 - metoclopramide 10 mg Tab,,,,,$2.65 
00093-2204-01 - metoclopramide 5 mg Tab,,,,,$2.80 
00093-2275-34 - amoxicillin-clavulanate 875 mg-125 mg 4 tab Home pk[UBMC],,,,,$5.25 
00093-2275-34 - amoxicillin-clavulanate 875 mg-125mg Tab [UBMC],,,,,$10.45 
00093-2929-01 - cyproheptadine 4 mg Tab [UBMC],,,,,$4.20 
00093-2931-01 - methyldopa 250 mg Tab [UBMC],,,,,$4.20 
00093-3107-01 - amoxicillin 250 mg Cap [UBMC],,,,,$2.65 
00093-3107-19 - amoxicillin 250 mg Cap [UBMC],,,,,$2.65 
00093-3109-19 - amoxicillin 500 mg Cap [UBMC],,,,,$3.90 
00093-3109-93 - amoxicillin 500 mg 6 cap Home pk[UBMC],,,,,$3.90 
00093-3109-93 - amoxicillin 500 mg Cap [UBMC],,,,,$3.90 
00093-3123-01 - dicloxacillin 250 mg Cap [UBMC],,,,,$4.95 
00093-3147-01 - cephalexin 500 mg Cap [UBMC],,,,,$4.70 
00093-3147-01 - cephalexin 500 mg Cap home pack[UBMC],,,,,$4.70 
00093-4136-64 - cefdinir 125 mg/5 mL Oral Susp [UBMC],,,,,$4.45 
00093-4137-64 - cefdinir 250 mg/5 mL Oral Susp [UBMC],,,,,$4.30 
00093-4148-64 - levalbuterol 1.25 mg/3 mL Sol,,,,,$5.80 
00093-4155-79 - amoxicillin 250 mg/5 mL Oral Liq [UBMC],,,,,$1.50 
00093-4177-73 - cephalexin 250 mg/5 mL Oral Liq [UBMC],,,,,$2.75 
00093-4233-01 - bumetanide 1 mg Tab,,,,,$4.65 
00093-4741-01 - citalopram 20 mg Tab [UBMC],,,,,$6.30 
00093-5385-06 - lamiVUDine-zidovudine 150 mg-300 mg Tab,,,,,$31.50 
00093-5768-56 - OLANZapine 5 mg Tab,,,,,$27.35 
00093-5851-19 - escitalopram 10 mg Tab,,,,,$11.45 
00093-5851-93 - escitalopram 10 mg Tab,,,,,$11.45 
00093-6451-56 - esomeprazole 40 mg ER,,,,,$17.65 
00093-6815-73 - budesonide 0.25 mg/2 mL Sus,,,,,$12.25 
00093-7148-23 - azithromycin 100 mg/5 mL REC,,,,,$6.05 
00093-7149-31 - azithromycin 200 mg/5 mL REC,,,,,$4.55 
00093-7169-56 - azithromycin 500 mg Tab,,,,,$32.20 
00093-7256-01 - glimepiride 4 mg Tab,,,,,$3.25 
00093-7364-98 - losartan 25 mg Tab[UBMC],,,,,$4.35 
00093-7387-56 - moxifloxacin 400 mg Tab,,,,,$56.35 
00093-8122-01 - doxazosin 4 mg Tab [UBMC],,,,,$4.80 
00093-8947-01 - acyclovir 800 mg Tab [UBMC],,,,,$9.55 
00093-8947-19 - acyclovir 800 mg Tab [UBMC],,,,,$9.55 
00115-9822-01 - digoxin 250 mcg (0.25 mg) Tab,,,,,$4.85 
00121-0431-30 - magnesium hydroxide 8% Oral Susp 30 mL [UBMC],,,,,$2.40 
00121-0489-10 - diphenhydrAMINE 12.5 mg/5 mL Oral Liq [UBMC],,,,,$2.15 
00121-0504-05 - acetaminophen-codeine 120 mg-12 mg/5 mL Liq UD home pack[UBMC],,,,,$5.25 
00121-0504-05 - apap-codeine 120 mg-12 mg/5 mL Liq 5 mL [UBMC],,,,,$5.25 
00121-0544-10 - docusate 10 mg/mL Liq,,,,,$1.65 
00121-0547-05 - codeine-promethazine 10 mg-6.25 mg/5 mL Syr UD home pack[UBMC],,,,,$2.10 
00121-0547-05 - promethazine-cod 6.25 mg-10 mg/5 mL Oral Syrup 5 mL [UBMC],,,,,$5.25 
00121-0595-15 - citric acid-sod cit 334 mg-500 mg/5 mL Oral Sol 15 mL [UBMC],,,,,$2.00 
00121-0638-05 - dextromethorphan-guaifenesin 10 mg-100 mg/5 mL Liq UD [UBMC],,,,,$1.95 
00121-0657-05 - acetaminophen 160 mg/5 mL Liq,,,,,$2.70 
00121-0743-25 - docusate sodium 100 mg/25 mL Syr UD[UBMC],,,,,$1.45 
00121-0747-10 - sucralfate 1 g/10 mL Sus,,,,,$4.80 
00121-0759-08 - prednisoLONE sodium phosphate 15 mg/5 mL Liq,,,,,$2.45 
00121-0772-16 - acetaminophen-HYDROcodone 325 mg-7.5 mg/15 mL Sol,,,,,$5.25 
00121-0978-10 - diphenhydrAMINE 12.5 mg/5 mL Liq,,,,,$2.15 
00121-1154-40 - lactulose 10 g/15 mL Syr,,,,,$1.35 
00121-1465-15 - potassium chloride 20 mEq/15 mL Oral Liq [UBMC],,,,,$3.05 
00121-1576-10 - metoclopramide 5 mg/5 mL Oral Syrup [UBMC],,,,,$1.45 
00121-1744-05 - guaifenesin 100 mg/5 mL Oral Liq [UBMC],,,,,$1.80 
00121-1761-30 - Al hyd/Mg hyd/simeth 200mg-200mg-20mg/5mL Susp 30 mL [UBMC],,,,,$1.50 
00121-1762-30 - Al hyd/Mg hyd/simeth 400mg-400mg-40mg/5mL Susp 30 mL [UBMC],,,,,$1.60 
00121-1775-05 - guaifenesin-cod 100 mg-10 mg/5 mL Oral Syrup 5 mL [UBMC],,,,,$5.25 
00121-1836-05 - ibuprofen 100 mg/5 mL Sus,,,,,$2.05 
00121-2316-40 - acetaminophen-hydrocodone 325 mg-7.5 mg/15 mL Sol,,,,,$5.25 
00121-4577-30 - lactulose 10 g/15 mL Oral Syrup [UBMC],,,,,$1.40 
00121-4655-15 - acetaminophen-hydrocodone 500 mg-7.5 mg/15 mL Eli UD home pack [UBMC],,,,,$5.25 
00121-4655-15 - hydrocodone-APAP 7.5 mg-500 mg/15mL Elix [UBMC],,,,,$5.25 
00121-4772-15 - acetaminophen-HYDROcodone 325 mg-7.5 mg/15 mL Sol,,,,,$5.25 
"00121-4785-05 - nystatin 100,000 units/mL Oral Susp [UBMC]",,,,,$2.65 
00132-0201-42 - sodium biphosphate/phosphate 19 g-7 g Rectal Enema 133 mL [UBMC],,,,,$5.25 
00132-0801-99 - sodium biphosphate/phosphate 19 g-7 g Rectal Enema 133 mL [UBMC],,,,,$5.25 
00135-0196-02 - nicotine 7 mg/24 hr ER,,,,,$9.35 
00143-1172-01 - captopril 25 mg Tab [UBMC],,,,,$4.35 
00143-1201-01 - colchicine 0.6 mg Tab [UBMC],,,,,$3.90 
00143-1240-01 - digoxin 125 mcg (0.125 mg) Tab,,,,,$6.00 
00143-1290-01 - methocarbamol 500 mg Tab [UBMC],,,,,$3.10 
00143-1771-01 - isosorbide dinitrate 10 mg Tab,,,,,$4.25 
00143-2230-01 - isosorbide mononitrate 30 mg ER Tab [UBMC],,,,,$4.40 
00143-3142-50 - doxycycline hyclate 100 mg Cap,,,,,$11.45 
00143-9506-10 - etomidate 2 mg/mL Sol,,,,,$17.45 
00143-9506-10 - etomidate 2 mg/mL Sol,,,,,$17.45 
00143-9564-01 - phentolamine 5 mg REC,,,,,"$1,055.70 "
00143-9621-25 - cyanocobalamin 1000 mcg/mL Sol,,,,,$26.00 
00143-9622-01 - labetalol 5 mg/mL Sol,,,,,$15.75 
00143-9673-10 - levETIRAcetam 100 mg/mL Sol,,,,,$21.95 
00143-9679-01 - glycopyrrolate 0.2 mg/mL Soln,,,,,$18.15 
00143-9689-10 - niCARdipine 2.5 mg/mL Sol,,,,,$21.10 
00143-9717-01 - folic acid 1 mg Tab,,,,,$2.90 
00143-9729-05 - benztropine 1 mg/mL Sol,,,,,$77.65 
00143-9738-01 - predniSONE 20 mg Tab,,,,,$2.45 
00143-9746-10 - terbutaline 1 mg/mL Inj Sol [UBMC],,,,,$25.25 
00143-9782-10 - fosphenytoin (PE) 500 mg/10 mL Inj Sol [UBMC],,,,,$19.30 
00143-9784-10 - flumazenil 0.1 mg/mL IV Sol [UBMC],,,,,$20.70 
00143-9787-10 - enalapril 1.25 mg/mL IV Sol 1ml vial [UBMC],,,,,$18.95 
00143-9856-25 - cefTRIAXone 2 g REC,,,,,$81.25 
00143-9857-25 - cefTRIAXone 1 g REC,,,,,$45.50 
00143-9858-25 - cefTRIAXone 500 mg REC,,,,,$23.45 
00143-9868-22 - promethazine 50 mg/mL Inj Sol (IM ONLY) [UBMC],,,,,$19.60 
00143-9872-01 - propranolol 1 mg/mL Sol,,,,,$31.30 
00143-9873-10 - metoprolol 1 mg/mL Inj Sol [UBMC],,,,,$15.10 
00143-9875-10 - amiodarone 50 mg/mL Sol,,,,,$19.45 
00143-9887-50 - amoxicillin 400 mg/5 mL REC,,,,,$2.20 
00143-9890-01 - ondansetron 2 mg/mL Sol,,,,,$20.55 
00143-9891-05 - ondansetron 2 mg/mL Inj Sol SDV 2 mL [UBMC],,,,,$16.70 
00143-9924-90 - ceFAZolin 1 g REC,,,,,$24.25 
00143-9931-91 - cefotaxime 1 gm REC Injection,,,,,$20.35 
00143-9977-90 - cefuroxime 1.5 g Inj [UBMC],,,,,$34.95 
00149-0752-15 - mesalamine 400 mg Oral EC Tab [UBMC],,,,,$5.65 
00168-0004-15 - triamcinolone Top 0.1% Crm [UBMC],,,,,$3.15 
00168-0012-09 - bacitracin/neomycin/polymyxin B Top Oint [UBMC],,,,,$2.45 
00168-0062-16 - zinc oxide topical 20% Oin [UBMC],,,,,$2.35 
00168-0154-31 - hydrocortisone Top 1% Crm [UBMC],,,,,$1.95 
00172-2083-00 - hydrochlorothiazide 25 mg Tab [UBMC],,,,,$1.90 
00172-3758-00 - lisinopril 5 mg Tab [UBMC],,,,,$4.65 
00172-3758-10 - lisinopril 5 mg Tab [UBMC],,,,,$4.65 
00172-3759-00 - lisinopril 10 mg Tab [UBMC],,,,,$4.50 
00172-3760-00 - lisinopril 20 mg Tab [UBMC],,,,,$4.50 
00172-4285-00 - verapamil 120 mg/12 hours ER [UBMC],,,,,$4.20 
00172-4285-10 - verapamil 120 mg/12 hours ER [UBMC],,,,,$4.20 
00172-4286-00 - verapamil 180 mg/12 hours ER [UBMC],,,,,$4.90 
00172-4286-10 - verapamil 180 mg/12 hours ER [UBMC],,,,,$4.90 
00172-4364-00 - labetalol 100 mg Tab,,,,,$6.05 
00172-5411-00 - fluconazole 100 mg Tab [UBMC],,,,,$18.10 
00172-5411-10 - fluconazole 100 mg Tab [UBMC],,,,,$18.10 
00172-5728-00 - famotidine 20 mg Tab [UBMC],,,,,$4.50 
00172-5728-60 - famotidine 20 mg Tab,,,,,$6.30 
00173-0242-56 - digoxin 0.125 mg Tab [UBMC],,,,,$4.30 
00173-0249-56 - digoxin 250 mcg (0.25 mg) Tab [UBMC],,,,,$4.30 
00173-0441-00 - ranitidine 1 mg/mL IV Sol [UBMC],,,,,$15.75 
00173-0449-02 - sumatriptan 6 mg/0.5 mL SubQ Inj [UBMC],,,,,$828.35 
00173-0682-20 - albuterol 90 mcg/inh Aer,,,,,$9.05 
00173-0682-24 - albuterol CFC free 90 mcg/inh Aer,,,,,$7.90 
00173-0695-00 - fluticasone-salmeterol 100 mcg-50mcg Inh Pwdr [UBMC],,,,,$8.55 
00173-0695-04 - fluticasone-salmeterol 100 mcg-50 mcg Pow 14dose [UBMC],,,,,$23.80 
00173-0696-00 - fluticasone-salmeterol 250 mcg-50mcg Inh Pwdr [UBMC],,,,,$10.60 
00173-0696-04 - fluticasone-salmeterol 250 mcg-50 mcg Pow 14dose [UBMC],,,,,$23.80 
00173-0697-04 - fluticasone-salmeterol 500 mcg-50 mcg Pow,,,,,$38.80 
00173-0718-20 - fluticasone CFC free 44 mcg/inh Aer,,,,,$38.50 
00173-0719-20 - fluticasone CFC free 110 mcg/inh Aer,,,,,$45.55 
00182-0448-01 - aspirin 325 mg Oral EC Tab [UBMC],,,,,$1.25 
00182-0554-00 - hydrALAZINE 25 mg Tab [UBMC],,,,,$2.15 
00182-0554-01 - hydrALAZINE 25 mg Tab [UBMC],,,,,$2.15 
00182-1259-89 - traZODONE 50 mg Tab UD [UBMC],,,,,$3.60 
"00182-7051-37 - ophthalmic irrigation, extraocular - Sol [UBMC]",,,,,$1.40 
00185-0053-01 - benazepril 10 mg Tab,,,,,$4.80 
00185-0070-60 - lovastatin 10 mg Tab [UBMC],,,,,$4.55 
00185-0129-01 - bumetanide 1 mg Tab,,,,,$4.30 
00185-0171-01 - sotalol 80 mg Tab [UBMC],,,,,$6.65 
00185-0613-01 - hydrOXYzine pamoate 25 mg Cap [UBMC],,,,,$2.85 
00185-0613-01 - hydrOXYzine pamoate 25 mg Cap home pack[UBMC],,,,,$2.85 
00186-0235-03 - lidocaine 4% PF TOP Sol Amp 5 mL [UBMC],,,,,$19.20 
00186-0276-13 - lidocaine 1% Inj Sol SDV 2 mL [UBMC],,,,,$16.25 
00186-1030-01 - bupivacaine 0.25% PF Inj Sol 30 mL [UBMC],,,,,$15.75 
00186-1090-39 - metoprolol 50 mg ER Tab [UBMC],,,,,$4.90 
00186-1988-04 - budesonide 0.25 mg/2 mL Inh Susp [UBMC],,,,,$10.80 
00186-5042-28 - esomeprazole 40 mg Oral EC Cap [UBMC],,,,,$19.60 
00186-6040-01 - esomeprazole 40 mg IV Inj [UBMC],,,,,$110.90 
00187-0658-20 - diazepam 10 mg rectal kit [UBMC],,,,,$698.45 
00187-1704-05 - phytonadione 5 mg Tab,,,,,$138.20 
00206-3100-02 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$49.60 
00206-4100-02 - piperacillin-tazobactam 4 g-0.5 g REC,,,,,$62.85 
00206-8852-08 - piperacillin-tazobactam 2g-0.25g IV Inj [UBMC],,,,,$37.20 
00206-8854-08 - piperacillin-tazobactam 3g-0.375g IV Inj [UBMC],,,,,$54.15 
00206-8854-16 - piperacillin-tazobactam 3g-0.375g IV Inj [UBMC],,,,,$29.50 
00206-8855-08 - piperacillin-tazobactam 4 g-0.5 g IV Inj [UBMC],,,,,$68.55 
00206-8855-16 - piperacillin-tazobactam 4 g-0.5 g IV Inj [UBMC],,,,,$68.55 
00228-2497-10 - NIFEdipine 10 mg Cap [UBMC],,,,,$4.20 
00228-2891-03 - DULoxetine 30 mg ER,,,,,$16.25 
00245-0041-01 - potassium chloride 10 mEq ER,,,,,$4.10 
00245-0147-01 - amiodarone 200 mg Tab,,,,,$16.45 
00245-0181-01 - divalproex sodium 250 mg EC,,,,,$4.80 
00245-0182-01 - divalproex sodium 500 mg EC,,,,,$8.80 
00245-0212-01 - midodrine 5 mg Tab,,,,,$11.65 
00256-0185-05 - multivitamin Vitamin B Complex with C and Folic Acid Cap [UBMC],,,,,$4.00 
00256-0185-05 - Vit B Complex w/ C and FA Cap (Nephrocap [UBMC],,,,,$4.45 
00264-1101-55 - IV D5% in Water IV Sol 500 mL Bottle [UBMC],,,,,$15.75 
00264-1915-07 - parenteral nutrition solution w/electrolytes Amino Acids 3% and Glycerin 3% with Ele,,,,,$15.75 
00264-1965-10 - hetastarch 60 mg/mL-NS IV Sol [UBMC],,,,,$15.75 
00264-3105-11 - ceFAZolin 2 g/50 mL Sol,,,,,$27.40 
00264-3125-11 - cefOXitin 2 g REC,,,,,$62.60 
00264-5535-32 - metroNIDAZOLE 500 mg/100 mL Sol,,,,,$15.75 
00264-7510-20 - LVP solution Dextrose 5% in Water Sol,,,,,$15.75 
00264-7751-00 - LVP solution Dextrose 5% in Lactated Ringers Injection Sol,,,,,$15.75 
00264-7800-20 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00264-9200-55 - sterile water for INJ 1000ml Sol [UBMC],,,,,$15.75 
00264-9577-10 - heparin 50 units/mL-D5% Sol,,,,,$15.75 
00264-9594-10 - lidocaine 0.4%-D5W Inj Sol 500 mL [UBMC],,,,,$15.75 
00270-0556-15 - sincalide 5 mcg IV Inj [UBMC],,,,,$251.30 
00281-0326-08 - nitroglycerin 2% Top Oint [UBMC],,,,,$6.50 
00281-0330-10 - antivenin (Crotalidae) polyvalent - Sol [UBMC],,,,,"$4,780.45 "
00281-0365-10 - digoxin immune FAB 40 mg REC [UBMC],,,,,"$1,206.60 "
00281-0365-10 - digoxin immune FAB 40 mg REC [UBMC],,,,,"$1,206.60 "
00310-0321-30 - meropenem 1 g IV Inj [UBMC],,,,,$166.70 
00310-0325-20 - meropenem 500 mg REC[UBMC],,,,,$83.35 
00310-4500-12 - durvalumab 50 mg/mL Sol,,,,,$824.35 
00310-4611-50 - durvalumab 50 mg/mL Sol,,,,,$824.35 
00338-0049-02 - IV NS 0.9% IV Sol 250 mL (VIAFLEX) [UBMC],,,,,$15.75 
00338-0049-11 - IV NS 0.9% IV Sol 50 mL [UBMC],,,,,$15.75 
00338-0049-11 - IV NS 0.9% IV Sol 50ml [UBMC],,,,,$15.75 
00338-0049-18 - IV NS 0.9% IV Sol 100 mL [UBMC],,,,,$15.75 
00338-0054-03 - sodium chloride 3% IV Sol 500 mL [UBMC],,,,,$15.75 
00338-0125-04 - LVP solution Dextrose 5% in Lactated Ringers Injection Sol,,,,,$15.75 
00338-0503-48 - gentamicin 80 mg/100 mL-0.9% Sol,,,,,$15.75 
"00338-0519-48 - Fat Emul, 20% IV 100 mL [UBMC]",,,,,$15.75 
"00338-0519-58 - fat emulsion, intravenous 20% Emu",,,,,$17.00 
00338-0553-11 - IV NS 0.9% IV Sol 50 mL (Minibag) [UBMC],,,,,$15.75 
00338-0553-18 - IV NS 0.9% IV Sol 100 mL (Minibag) [UBMC],,,,,$15.75 
00338-0553-18 - IV NS 0.9% IV Sol 100 mL [UBMC],,,,,$15.75 
00338-1007-03 - DOPamine 1.6 mg/mL-D5W IV Sol [UBMC],,,,,$15.75 
00338-1049-02 - nitroglycerin 50 mg/250 mL-D5W IV Sol [UBMC],,,,,$15.75 
00338-1055-48 - metroNIDAZOLE 500 mg/100 mL Sol,,,,,$15.75 
00338-1073-02 - DOBUTamine 1 mg/mL-D5W IV Sol 250 ml [UBMC],,,,,$15.75 
00338-1136-03 - AA 4.25%-D25% (Clinimix) IV Sol 1000 mL [UBMC],,,,,$15.75 
00338-1149-03 - parenteral nutrition solution w/electrolytes Amino Acids 5% with 25% Dextrose and El,,,,,$15.75 
00338-1305-01 - mesna 100 mg/mL Sol,,,,,$20.85 
00378-0182-01 - propranolol 10 mg Tab,,,,,$3.45 
00378-0415-01 - atropine-diphenoxylate 0.025 mg-2.5 mg Tab,,,,,$9.25 
00378-0751-01 - cyclobenzaprine 10 mg Tab,,,,,$4.30 
00378-1807-77 - levothyroxine 88 mcg (0.088 mg) Tab,,,,,$3.80 
00378-1811-01 - levothyroxine 112 mcg (0.112 mg) Tab,,,,,$4.10 
00378-1811-77 - levothyroxine 112 mcg (0.112 mg) Tab,,,,,$4.10 
00378-1823-01 - levothyroxine 137 mcg (0.137 mg) Tab,,,,,$4.25 
00378-1823-77 - levothyroxine 137 mcg (0.137 mg) Tab,,,,,$4.25 
00378-2500-77 - tamsulosin 0.4 mg Cap,,,,,$10.95 
00378-5813-77 - valsartan 80 mg Tab,,,,,$12.60 
00378-6173-01 - metolazone 5 mg Tab,,,,,$7.00 
00378-7732-93 - ondansetron 4 mg ODT [UBMC],,,,,$46.15 
00378-9112-16 - nitroglycerin 0.4 mg/hr Transderm Patch [UBMC],,,,,$5.65 
00378-9112-93 - nitroglycerin 0.4 mg/hr Transderm Patch [UBMC],,,,,$5.65 
00386-0001-04 - ethyl chloride Top 100% Spry [UBMC],,,,,$3.00 
00395-1003-92 - gentian violet topical 1% Sol,,,,,$2.00 
00406-0125-62 - acetaminophen-HYDROcodone 325 mg-10 mg Tab,,,,,$7.65 
00406-0357-62 - acetaminophen-hydrocodone 500 mg-5 mg Tab UD home pack [UBMC],,,,,$6.05 
00406-0357-62 - hydrocodone-APAP 5 mg-500 mg Tab [UBMC],,,,,$6.05 
00406-0358-62 - hydrocodone-APAP 7.5 mg-500 mg Tab [UBMC],,,,,$6.95 
00406-0363-62 - acetaminophen-HYDROcodone 500 mg-10 mg Tab,,,,,$5.70 
00406-0365-62 - acetaminophen-HYDROcodone 325 mg-5 mg Tab,,,,,$5.75 
00406-0366-62 - acetaminophen-HYDROcodone 325 mg-7.5 mg Tab,,,,,$6.55 
00406-0484-62 - acetaminophen-codeine 300 mg-30 mg Tab [UBMC],,,,,$5.25 
00406-0484-62 - acetaminophen-codeine 300 mg-30 mg Tab UD home pack[UBMC],,,,,$5.25 
00406-0512-62 - acetaminophen-oxycodone 325 mg-5 mg Tab UD home pack[UBMC],,,,,$5.25 
00406-0512-62 - oxycodone-APAP 5 mg-325 mg Tab [UBMC],,,,,$8.65 
00406-0522-01 - acetaminophen-oxycodone 325 mg-7.5 mg Tab,,,,,$17.20 
00406-0523-01 - oxycodone-APAP 10 mg-325 mg Tab [UBMC],,,,,$22.50 
00406-0523-62 - acetaminophen-oxyCODONE 325 mg-10 mg Tab,,,,,$22.50 
00406-0552-01 - oxycodone 5 mg Tab [UBMC],,,,,$5.75 
00406-0552-23 - oxycodone 5 mg Tab,,,,,$6.60 
00406-0552-62 - oxycodone 5 mg Tab [UBMC],,,,,$5.75 
00406-3244-01 - hydromorphone 4 mg Tab [UBMC],,,,,$7.30 
00406-5771-01 - methadone 10 mg Tab,,,,,$5.60 
00406-5771-62 - methadone 10 mg Tab [UBMC],,,,,$5.55 
00406-8315-62 - morphine 15 mg ER Tab [UBMC],,,,,$11.85 
00406-8330-23 - morphine 30 mg/12 hr Tab,,,,,$21.40 
00406-8330-62 - morphine 30 mg ER Tab [UBMC],,,,,$21.40 
00406-9050-76 - fentaNYL 50 mcg/hr ER,,,,,$61.40 
00409-0106-01 - DAPTOmycin 500 mg REC,,,,,"$1,091.35 "
00409-0144-11 - azithromycin 500 mg REC [UBMC],,,,,$30.75 
00409-0220-01 - cefepime 2 g REC,,,,,$28.50 
00409-0528-23 - levoFLOXacin 500 mg/100 mL Sol,,,,,$15.75 
00409-0528-31 - levoFLOXacin 750 mg/150 mL Sol,,,,,$15.75 
00409-0805-01 - cefazolin 1 g Inj [UBMC],,,,,$18.40 
00409-1036-30 - mepivacaine 1% PF Inj Sol 30 mL [UBMC],,,,,$15.75 
00409-1134-03 - morphine 50 mg/mL Sol,,,,,$20.00 
00409-1144-01 - verapamil 2.5 mg/mL IV Sol [UBMC],,,,,$17.95 
00409-1144-05 - verapamil 2.5 mg/mL IV Sol [UBMC],,,,,$45.15 
00409-1159-01 - bupivacaine 0.25% PF Inj Sol 10 mL [UBMC],,,,,$15.75 
00409-1159-02 - bupivacaine 0.25% PF Inj Sol 30 mL [UBMC],,,,,$15.75 
00409-1160-01 - bupivacaine 0.25% Inj Sol 50 mL [UBMC],,,,,$15.75 
00409-1162-01 - bupivacaine 0.5% PF Inj Sol 10 mL [UBMC],,,,,$15.75 
00409-1162-02 - bupivacaine 0.5% PF Inj Sol 30 mL [UBMC],,,,,$15.75 
00409-1163-01 - bupivacaine 0.5% Inj Sol 50 mL [UBMC],,,,,$15.75 
00409-1171-01 - diltiazem 5 mg/mL Sol,,,,,$12.15 
00409-1176-30 - meperidine 25 mg/mL Inj Sol [UBMC],,,,,$52.75 
00409-1178-30 - meperidine 50 mg/mL Inj Sol [UBMC],,,,,$54.55 
00409-1215-01 - naloxone 0.4 mg/mL Inj Sol [UBMC],,,,,$49.40 
00409-1258-30 - morphine 4 mg/mL Inj Sol [UBMC],,,,,$27.50 
00409-1260-69 - morphine 8 mg/mL Inj Sol [UBMC],,,,,$27.65 
00409-1261-30 - morphine 10 mg/mL Inj Sol [UBMC],,,,,$27.50 
00409-1273-05 - diazepam 5 mg/mL Inj Sol 2 ml [UBMC],,,,,$15.05 
00409-1273-32 - diazepam 5 mg/mL Sol,,,,,$83.20 
00409-1283-31 - HYDROmorphone 1 mg/mL Sol,,,,,$35.80 
00409-1304-31 - hydromorphone 4 mg/mL Inj Sol [UBMC],,,,,$35.80 
00409-1312-30 - hydromorphone 2 mg/mL Inj Sol [UBMC],,,,,$38.30 
00409-1312-30 - HYDROmorphone 2 mg/mL Sol,,,,,$38.30 
00409-1323-05 - lidocaine 2% PF Inj Sol PFS Cardiac 5 mL [UBMC],,,,,$18.10 
00409-1410-05 - isoproterenol 0.2 mg/mL IV Sol [UBMC],,,,,$36.55 
00409-1412-10 - bumetanide 0.25 mg/mL Sol,,,,,$19.90 
00409-1443-04 - norepinephrine 1 mg/mL IV Sol [UBMC],,,,,$19.00 
00409-1464-01 - nalbuphine 10 mg/mL Sol,,,,,$44.90 
00409-1465-01 - nalbuphine 20 mg/mL Inj Sol [UBMC],,,,,$21.35 
00409-1522-02 - IV D5% in Water IV Sol 250 Ml Bottle [UBMC],,,,,$15.75 
00409-1522-03 - IV D5% in Water IV Sol 500 mL Bottle [UBMC],,,,,$15.75 
00409-1560-10 - bupivacaine 0.5% preservative-free Sol,,,,,$19.80 
00409-1610-50 - bupivacaine 0.5% Sol,,,,,$15.75 
00409-1630-10 - atropine 0.1 mg/mL Sol[UBMC],,,,,$12.95 
00409-1634-01 - vecuronium 20 mg REC,,,,,$41.15 
"00409-1755-50 - bupivacaine 0.5%-epi 1:200,000 Inj Sol 50 mL [UBMC]",,,,,$15.75 
00409-1761-02 - bupivacaine + dextrose 0.75% intrathecal Sol 2 mL [UBMC],,,,,$25.60 
00409-1762-30 - morphine 2 mg/mL Inj Sol [UBMC],,,,,$27.50 
00409-1775-10 - dextrose 25% IV Sol 10 mL PFS [UBMC],,,,,$21.45 
00409-1778-05 - metoprolol 1 mg/mL Sol,,,,,$15.75 
00409-1782-69 - naloxone 0.4 mg/mL Inj Sol [UBMC],,,,,$48.15 
00409-1886-02 - levETIRAcetam 100 mg/mL Sol,,,,,$18.65 
00409-1890-01 - morphine 2 mg/mL Sol,,,,,$26.30 
00409-1891-01 - morphine 4 mg/mL Sol,,,,,$26.30 
00409-1892-01 - morphine 8 mg/mL Sol,,,,,$26.30 
00409-1893-01 - morphine 10 mg/mL Sol,,,,,$26.30 
00409-1902-01 - Procainamide HCL 1 g/10ml [UBMC],,,,,$29.65 
00409-1903-01 - procainamide 500 mg/mL Inj Sol [UBMC],,,,,$81.35 
00409-1966-07 - sodium chloride bacteriostatic 0.9% Sol 30mL [UBMC],,,,,$15.75 
00409-1985-30 - lorazepam 2 mg/mL Sol 1mL [UBMC],,,,,$20.30 
00409-2029-02 - morphine 1 mg/mL PF Inj Sol PCA [UBMC],,,,,$20.00 
00409-2053-10 - ketamine 50 mg/mL Sol,,,,,$18.80 
00409-2122-02 - enalapril 1.25 mg/mL IV Sol [UBMC],,,,,$17.60 
00409-2267-20 - labetalol 5 mg/mL IV Sol [UBMC],,,,,$15.75 
00409-2287-31 - ketorolac 30 mg/mL Sol,,,,,$23.00 
00409-2305-05 - midazolam 1 mg/mL PF Inj Sol 5 mL [UBMC],,,,,$20.00 
00409-2308-01 - midazolam 5 mg/mL preservative-free Sol,,,,,$14.80 
00409-2336-10 - deferoxamine 500 mg Inj [UBMC],,,,,$29.35 
00409-2339-34 - labetalol 5 mg/mL Sol 4ml[UBMC],,,,,$17.70 
00409-2344-02 - DOBUTamine 12.5 mg/mL IV Sol [UBMC],,,,,$15.75 
00409-2346-32 - DOBUTamine 1 mg/mL-D5W IV Sol 250 ml [UBMC],,,,,$15.75 
00409-2585-01 - ceFAZolin 1 g REC,,,,,$25.75 
00409-2596-05 - midazolam 5 mg/mL Inj Sol **HIGH DOSE** [UBMC],,,,,$20.00 
00409-2723-01 - heparin 5000 units/mL Sol,,,,,$18.10 
00409-2999-14 - piperacillin-tazobactam 12 g-1.5 g REC,,,,,$125.75 
00409-3024-01 - nitroprusside 25 mg/mL IV Sol [UBMC],,,,,$89.95 
00409-3073-31 - ephedrine 50 mg/mL Inj Sol [UBMC],,,,,$20.00 
00409-3178-01 - epinephrine-lidocaine 1:100000-1% 20 ml Sol [UBMC],,,,,$15.75 
00409-3178-03 - epinephrine-lidocaine 1:100000-1% Sol 50 mL[UBMC],,,,,$15.75 
"00409-3182-01 - lidocaine-epinephrine 2%-1:100,000 Inj Sol 20 mL [UBMC]",,,,,$15.75 
00409-3182-03 - epinephrine-lidocaine 1:100000-2% Sol[UBMC],,,,,$15.75 
00409-3213-12 - diazepam 5 mg/mL Inj Sol 10 ml [UBMC],,,,,$46.60 
00409-3294-51 - potassium acetate 2 mEq/mL Sol 50 mL [UBMC],,,,,$15.75 
00409-3308-03 - acetylcysteine 20% Inh Sol 30 mL [UBMC],,,,,$3.40 
00409-3365-01 - HYDROmorphone 2 mg/mL Sol,,,,,$21.80 
00409-3375-04 - norepinephrine 1 mg/mL IV Sol [UBMC],,,,,$19.00 
00409-3378-13 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$27.15 
00409-3380-32 - sufentanil 50 mcg/mL IV Sol [UBMC],,,,,$39.40 
00409-3383-02 - piperacillin-tazobactam 2 g-0.25 g REC,,,,,$23.65 
00409-3385-13 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$29.50 
00409-3390-04 - piperacillin-tazobactam 4 g-0.5 g REC,,,,,$39.30 
00409-3414-01 - metoclopramide 5 mg/mL Inj [UBMC],,,,,$16.85 
00409-3505-01 - meropenem 500 mg REC,,,,,$45.45 
00409-3506-01 - meropenem 1000 mg REC,,,,,$90.90 
00409-3613-01 - bupivacaine 0.75%-D8.25% preservative-free Sol,,,,,$23.85 
00409-3793-01 - ketorolac 15 mg/mL Sol,,,,,$16.75 
00409-3795-01 - ketorolac 30 mg/mL Inj Sol SDV 1 ml 30mg [UBMC],,,,,$21.60 
00409-3796-01 - ketorolac 30 mg/mL Inj Sol SDV 2 ml 60mg [UBMC],,,,,$22.00 
00409-3977-03 - sterile water bacteriostatic Inj 30 mL [UBMC],,,,,$15.75 
00409-4031-01 - mannitol 25% IV Sol 50 mL [UBMC],,,,,$15.75 
00409-4051-01 - clindamycin 150 mg/mL IV Sol FTV [UBMC],,,,,$23.35 
00409-4054-03 - clindamycin 150 mg/mL IV Sol ADV [UBMC],,,,,$18.65 
00409-4276-01 - lidocaine 1% Inj Sol MDV 20 mL [UBMC],,,,,$15.75 
00409-4276-02 - lidocaine 1% Sol,,,,,$15.75 
00409-4277-01 - lidocaine 2% Inj Sol MDV 20 mL [UBMC],,,,,$15.75 
00409-4277-02 - lidocaine 2% Sol,,,,,$15.75 
00409-4282-02 - lidocaine 2% PF Inj Sol Poly Amp 10 mL [UBMC],,,,,$19.95 
00409-4332-01 - vancomycin 500 mg IV Inj [UBMC],,,,,$30.20 
00409-4646-01 - pancuronium 1 mg/mL IV Sol [UBMC],,,,,$13.30 
00409-4688-23 - fluconazole 200 mg/100 mL-NS IV Sol [UBMC],,,,,$15.75 
00409-4699-24 - propofol 10 mg/mL Emu,,,,,$18.05 
00409-4699-30 - propofol 10 mg/mL Emu,,,,,$18.05 
00409-4699-33 - propofol 10 mg/mL IV Emul SDV 50 mL [UBMC],,,,,$18.05 
00409-4755-03 - ondansetron 2 mg/mL Inj Sol SDV 2 mL [UBMC],,,,,$15.75 
00409-4759-01 - ondansetron 2 mg/mL MDV 20mL [UBMC],,,,,$17.65 
00409-4777-02 - ciprofloxacin 400 mg/200 mL IV Sol [UBMC],,,,,$15.75 
00409-4887-10 - sterile water for Inj Sol 10ml [UBMC],,,,,$15.75 
00409-4887-20 - sterile water for Inj Sol 20 ml [UBMC],,,,,$15.75 
00409-4888-10 - sodium chloride 0.9% Inj 10 ml syringes [UBMC],,,,,$15.75 
00409-4888-10 - sodium chloride 0.9% Sol,,,,,$15.75 
00409-4888-20 - IV NS 0.9% Inj Sol 20 mL [UBMC],,,,,$15.75 
00409-4900-34 - sodium bicarb 8.4% IV (1mEq/mL) Sol PED PFS 10 mL [UBMC],,,,,$21.45 
00409-4902-34 - dextrose 50% IV Sol 50 mL PFS [UBMC],,,,,$15.75 
00409-4903-34 - lidocaine 2% PF Inj Sol PFS Cardiac 5 mL [UBMC],,,,,$17.30 
00409-4911-34 - atropine 0.1 mg/mL Sol[UBMC],,,,,$17.65 
"00409-4921-34 - epinephrine 0.1 mg/mL (1:10,000) Syr (Cardiac) [UBMC]",,,,,$12.80 
00409-4928-34 - calcium chloride 100 mg/mL Inj Sol [UBMC],,,,,$16.30 
00409-5082-16 - ceftazidime 1 g Inj [UBMC],,,,,$17.10 
00409-5084-11 - ceftazidime 2 g REC[UBMC],,,,,$34.45 
00409-5534-34 - sodium bicarb 4.2% (0.5mEq/mL)  IV Sol INF PFS 10 mL [UBMC],,,,,$20.65 
00409-5820-01 - DOPamine 40 mg/mL IV Sol [UBMC],,,,,$13.10 
00409-5922-01 - aminophylline 25 mg/mL Sol [UBMC],,,,,$15.75 
00409-6030-04 - meperidine 10 mg/mL Inj Sol PCA [UBMC],,,,,$20.00 
00409-6102-02 - furosemide 10 mg/mL Inj Sol 2ml [UBMC],,,,,$15.75 
00409-6102-04 - furosemide 10 mg/mL Sol,,,,,$20.25 
00409-6102-10 - furosemide 10 mg/mL Inj Sol 10ml [UBMC],,,,,$15.75 
00409-6138-03 - sodium chloride 0.9% Irr Sol 500 mL [UBMC],,,,,$1.25 
00409-6509-01 - vancomycin 5 g REC,,,,,$220.90 
00409-6533-01 - vancomycin 1 g IV Inj [UBMC],,,,,$50.05 
00409-6534-01 - vancomycin 500 mg REC,,,,,$33.35 
00409-6535-01 - vancomycin 1 g REC,,,,,$64.45 
00409-6625-02 - sodium bicarbonate 8.4% (1mEq/mL) IV Sol SDV 50 mL [UBMC],,,,,$15.75 
00409-6629-02 - succinylcholine 20 mg/mL Inj Sol [UBMC],,,,,$20.05 
00409-6635-01 - potassium CL 2 mEq/mL IV Sol 10 mEq 5 mL [UBMC],,,,,$21.70 
00409-6637-34 - sodium bicarb 8.4% IV (1mEq/mL) Sol ADLT PFS 50 mL [UBMC],,,,,$15.75 
00409-6648-02 - dextrose 50% IV Sol 50 mL FTV SDV [UBMC],,,,,$15.75 
00409-6651-06 - potassium CL 2 mEq/mL IV Sol 20 mEq 10mL [UBMC],,,,,$15.75 
00409-6653-05 - potassium CL 2 mEq/mL IV Sol 40 mEq 20mL [UBMC],,,,,$15.75 
00409-6695-01 - etomidate 2 mg/mL IV Sol 10 ml [UBMC],,,,,$15.60 
00409-6727-23 - magnesium sulfate 10 mg/mL-D5% Sol,,,,,$15.75 
00409-6729-03 - magnesium sulfate 40 mg/mL Inj Sol 500 mL[UBMC],,,,,$15.75 
00409-6729-23 - magnesium sulfate 40 mg/mL Sol,,,,,$15.75 
00409-6729-24 - magnesium sulfate 40 mg/mL Sol,,,,,$15.75 
00409-6778-02 - LORazepam 2 mg/mL Sol,,,,,$8.15 
00409-6780-02 - lorazepam 2 mg/mL Sol 10mL [UBMC],,,,,$12.05 
00409-7074-26 - potassium chloride 10 mEq/100 mL Sol,,,,,$15.75 
00409-7077-14 - potassium chloride 20 mEq/50 mL Sol,,,,,$15.75 
00409-7077-26 - potassium chloride 40 mEq/100 mL Sol,,,,,$15.75 
00409-7101-02 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7101-67 - IV NS 0.9% IV Sol 100 mL (ADV) [UBMC],,,,,$15.75 
00409-7138-09 - sodium chloride 0.9% Irr Sol 1000 mL [UBMC],,,,,$1.25 
"00409-7241-01 - epinephrine 1 mg/mL (1:1,000) Inj Sol Amp 1ml [UBMC]",,,,,$16.05 
00409-7248-03 - hetastarch 60 mg/mL-NS IV Sol [UBMC],,,,,$15.75 
00409-7299-73 - sodium acetate 2 mEq/mL IV Sol [UBMC],,,,,$15.75 
00409-7332-01 - ceftriaxone 1 g Inj [UBMC],,,,,$22.90 
00409-7335-03 - ceftriaxone 2 g Inj [UBMC],,,,,$18.15 
00409-7337-01 - ceftriaxone 250 mg Inj [UBMC],,,,,$17.35 
00409-7338-01 - ceftriaxone 500 mg Inj [UBMC],,,,,$21.95 
00409-7517-16 - glucose 50% Sol,,,,,$15.75 
00409-7651-03 - heparin 50 U/mL-NaCl 0.45% IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7715-03 - mannitol 20% IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7809-22 - DOPamine 1.6 mg/mL-D5% Sol,,,,,$15.75 
00409-7811-24 - metronidazole 500 mg/100 mL IV Sol [UBMC],,,,,$15.75 
00409-7884-23 - gentamicin 80 mg/100 mL-NS IV Sol [UBMC],,,,,$15.75 
00409-7902-09 - IV D5%-NS 0.45%-KCl 20 mEq/l IV Sol 1000 mL [UBMC],,,,,$15.75 
00409-7922-03 - IV D5% in Water IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7922-09 - IV D5% in Water IV Sol 1000 mL [UBMC],,,,,$15.75 
00409-7922-25 - IV D5% in Water IV Sol 250 mL [UBMC],,,,,$15.75 
00409-7923-23 - IV D5% in Water 100ml Bag[UBMC],,,,,$15.75 
00409-7923-37 - IV D5% in Water 100ml Bag[UBMC],,,,,$15.75 
00409-7924-03 - IV D5%-NS 0.225% IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7924-09 - IV D5%-NS 0.225% IV Sol 1000mL [UBMC],,,,,$15.75 
00409-7926-03 - IV D5%-NS 0.45% IV Sol 500mL [UBMC],,,,,$15.75 
00409-7926-09 - IV D5%-NS 0.45% IV Sol 1000ml [UBMC],,,,,$15.75 
00409-7929-03 - IV D5%-LR IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7929-09 - IV D5%-LR IV Sol 1000 mL [UBMC],,,,,$15.75 
00409-7930-02 - IV D10% in Water IV Sol 250 mL [UBMC],,,,,$15.75 
00409-7931-24 - lidocaine 0.4%-D5W Inj Sol 500 mL [UBMC],,,,,$15.75 
00409-7941-03 - IV D5%-NS IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7941-09 - IV D5%-NS 0.9% IV Sol 1000 mL [UBMC],,,,,$15.75 
00409-7941-09 - IV D5%-NS 0.9% IV Sol 1000 mL [UBMC],,,,,$15.75 
00409-7953-03 - IV LR Sol 500 mL [UBMC],,,,,$15.75 
00409-7953-09 - IV LR Sol 1000 mL [UBMC],,,,,$15.75 
00409-7983-02 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7983-03 - IV NS 0.9% IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7983-09 - IV NS 0.9% IV Sol 1000 mL [UBMC],,,,,$15.75 
00409-7983-25 - IV NS 0.9% IV Sol 250 mL (VIAFLEX) [UBMC],,,,,$15.75 
00409-7983-53 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7984-06 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7984-13 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7984-20 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7984-37 - LVP solution Sodium Chloride 0.9% Sol,,,,,$15.75 
00409-7985-03 - IV NS 0.45% IV Sol 500 mL [UBMC],,,,,$15.75 
00409-7985-09 - IV NS 0.45% IV Sol 1000 Ml [UBMC],,,,,$15.75 
00409-8061-01 - etomidate 2 mg/mL IV Sol 20 ml [UBMC],,,,,$18.15 
00409-8183-01 - potassium acetate 2 mEq/mL IV Sol SDV 20 mL [UBMC],,,,,$15.75 
"00409-9046-01 - bupivacaine 0.5%-epi 1:200,000 Inj Sol 50 mL [UBMC]",,,,,$15.75 
00409-9093-32 - fentaNYL 50 mcg/mL Sol,,,,,$20.00 
00409-9093-35 - fentanyl 50 mcg/mL PF Inj Sol 5ml Amp [UBMC],,,,,$20.00 
00409-9094-22 - fentanyl 0.05 mg/mL (2ml) Inj Sol (UD)[WCDH],,,,,
00409-9094-22 - fentanyl 50 mcg/mL Inj Sol 2ml Vial [UBMC],,,,,$20.00 
00409-9094-25 - fentaNYL 50 mcg/mL Sol,,,,,$20.00 
00409-9104-20 - DOPamine 40 mg/mL Sol,,,,,$15.75 
00409-9157-01 - phytonadione 1 mg/0.5 mL Inj Sol [UBMC],,,,,$29.05 
00409-9158-01 - phytonadione 10 mg/mL Sol[UBMC],,,,,$109.50 
00409-9558-10 - rocuronium 10 mg/mL Sol,,,,,$22.15 
00430-0752-27 - mesalamine 400 mg EC,,,,,$6.55 
00430-0753-27 - mesalamine 400 mg ER,,,,,$8.40 
00456-2010-01 - escitalopram 10 mg Tab [UBMC],,,,,$21.80 
00456-2010-11 - escitalopram 10 mg Tab [UBMC],,,,,$9.80 
00456-4123-63 - dinoprostone 10 mg Vag Insert (Cervidil) [UBMC],,,,,$720.35 
00469-0871-30 - adenosine 3 mg/mL IV Sol [UBMC],,,,,$29.45 
00469-3211-10 - micafungin 100 mg REC[UBMC],,,,,$439.80 
00469-8234-12 - adenosine 3 mg/mL IV Sol [UBMC],,,,,$56.45 
00472-0321-26 - hydrocortisone Top 1% Crm [UBMC],,,,,$2.40 
00472-0339-56 - hydrocortisone topical 1% Cre,,,,,$1.80 
00472-1627-04 - codeine-promethazine 10 mg-6.25 mg/5 mL Syr,,,,,$5.25 
00486-1111-01 - K-PHOS orgainal(Sodium-Free) Potassium Acid Phosphate [UBMC],,,,,$3.85 
00486-1111-01 - potassium acid phosphate 500 mg Tab[UBMC],,,,,$2.30 
00487-0201-01 - albuterol-ipratropium Inh Sol 3 mL [UBMC],,,,,$4.25 
00487-0201-60 - albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Sol,,,,,$4.45 
00487-5901-99 - racepinephrine 2.25% Sol UD [UBMC],,,,,$9.35 
00487-9007-60 - sodium chloride 7% Sol,,,,,$2.25 
00487-9501-01 - albuterol 2.5 mg/3 mL (0.083%) Sol,,,,,$2.55 
00487-9501-03 - albuterol 2.5 mg/3 mL (0.083%) Sol,,,,,$2.55 
00487-9501-60 - albuterol 2.5 mg/3 mL (0.083%) Sol 10 vial Home pk[UBMC],,,,,$2.55 
00487-9501-60 - albuterol 2.5mg/ 3mL (0.083%) Inh Sol 3 mL [UBMC],,,,,$2.55 
00487-9801-01 - ipratropium 500 mcg/2.5 mL Sol,,,,,$3.60 
00487-9801-30 - ipratropium 0.02% Inh Sol 2.5 mL [UBMC],,,,,$3.60 
00487-9904-01 - albuterol 1.25 mg/3 mL (0.042%) Inh Sol 3 mL [UBMC],,,,,$3.80 
00487-9904-25 - albuterol 1.25 mg/3 mL (0.042%) Sol,,,,,$3.80 
00517-0031-25 - cyanocobalamin 1000 mcg/mL Inj Sol [UBMC],,,,,$19.10 
00517-0031-25 - cyanocobalamin 1000 mcg/mL Sol,,,,,$27.35 
00517-0033-25 - neostigmine 1 mg/mL Inj Sol [UBMC],,,,,$21.80 
00517-0130-05 - cyanocobalamin 1000 mcg/mL Inj Sol [UBMC],,,,,$23.45 
00517-0234-10 - iron dextran 50 mg/mL Inj Sol IV Only [UBMC],,,,,$58.50 
00517-0310-10 - methylene blue 10 mg/mL Inj Sol [UBMC],,,,,$22.85 
00517-0374-05 - methylene blue 5 mg/mL Sol,,,,,$59.00 
00517-0375-10 - indigo carmine 8 mg/mL Sol[UBMC],,,,,$4.50 
00517-0650-01 - ferric carboxymaltose (as elemental iron) 50 mg/mL Sol,,,,,$161.40 
00517-0720-01 - betamethasone 6 mg/mL Sus [UBMC],,,,,$32.15 
00517-0740-20 - methylergonovine 0.2 mg/mL Sol,,,,,$80.30 
00517-0955-01 - OLANZapine 10 mg REC,,,,,$85.40 
00517-1010-25 - atropine 1 mg/mL Sol[UBMC],,,,,$21.50 
00517-1020-25 - vasopressin 20 units/mL Inj Sol [UBMC],,,,,$16.20 
"00517-1130-05 - epinephrine 1 mg/mL (1:1,000) Inj Sol MDV [UBMC]",,,,,$15.75 
00517-2340-10 - iron sucrose 20 mg/mL IV Sol [UBMC],,,,,$31.20 
00517-2350-25 - potassium phosphate 3 mmol/mL Sol 50ml[UBMC],,,,,$15.75 
00517-2710-25 - calcium chloride 100 mg/mL Inj Sol [UBMC],,,,,$17.70 
00517-2930-25 - Sodium Chloride 23.4% Conc 4mEq/ml Sol[UBMC],,,,,$15.75 
00517-3450-25 - sodium phosphate 3 mmol/mL Inj Sol [UBMC],,,,,$15.75 
00517-4201-25 - hydrOXYzine HCl 25 mg/mL IM Sol [UBMC],,,,,$62.90 
00517-4605-25 - glycopyrrolate 0.2 mg/mL Sol,,,,,$28.60 
00517-4620-25 - glycopyrrolate 0.2 mg/mL Inj Sol [UBMC],,,,,$25.00 
00517-5601-25 - hydrOXYzine hydrochloride 50 mg/mL Sol 1ml [UBMC],,,,,$69.40 
00517-5602-25 - hydrOXYzine HCl 50 mg/mL IM Sol [UBMC],,,,,$20.95 
00517-5704-25 - furosemide 10 mg/mL Inj Sol 4ml [UBMC],,,,,$12.80 
00517-7604-25 - acetylcysteine 20% Sol,,,,,$9.75 
00517-7630-03 - acetylcysteine 20% Inh Sol 30 mL [UBMC],,,,,$3.40 
00517-8201-25 - trace elements with selenium 10 mcg-1 mg-0.5 mg-60 mcg-5 mg/mL Sol[UBMC,,,,,$31.30 
00517-9702-25 - droperidol 2.5 mg/mL Inj Sol [UBMC],,,,,$17.80 
00521-2384-00 - petrolatum topical 100% Oint 75 g [UBMC],,,,,$1.40 
00527-1311-01 - terbutaline 5 mg Tab [UBMC],,,,,$13.75 
00527-1324-01 - digoxin 125 mcg (0.125 mg) Tab,,,,,$6.00 
00527-1393-30 - rifampin 150 mg Cap,,,,,$8.45 
00527-1728-74 - cocaine Top 40 mg/mL Sol [UBMC],,,,,$109.70 
00536-1048-15 - calcium carbonate 500 mg Che,,,,,$1.25 
00536-5894-88 - nicotine 7 mg/24 hr ER,,,,,$5.55 
00536-6550-91 - ocular lubricant - Oin [UBMC],,,,,$6.70 
00536-6550-91 - ocular lubricant Oint [UBMC],,,,,$4.15 
00536-7180-01 - lactobacillus acidophilus - Tab,,,,,$1.95 
00548-1140-00 - phytonadione 1 mg/0.5 mL Inj Sol [UBMC],,,,,$27.65 
00548-1140-00 - phytonadione 1 mg/0.5 mL Sol [UBMC],,,,,$30.05 
00548-1240-00 - phytonadione 1 mg/0.5 mL Inj Sol [UBMC],,,,,$26.50 
00548-3301-00 - dextrose 50% IV Sol 50 mL PFS [UBMC],,,,,$15.75 
00548-3315-00 - dextrose 25% IV Sol 10 mL PFS [UBMC],,,,,$20.95 
00548-3369-00 - naloxone 1 mg/mL Sol[UBMC],,,,,$26.45 
00548-5601-00 - enoxaparin 30 mg/0.3 mL Sol,,,,,$136.60 
00548-5602-00 - enoxaparin 40 mg/0.4 mL Sol,,,,,$136.60 
00548-5604-00 - enoxaparin 80 mg/0.8 mL Sol,,,,,$136.60 
00548-5605-00 - enoxaparin 100 mg/mL Sol,,,,,$136.60 
00548-5606-00 - enoxaparin 120 mg/0.8 mL Sol,,,,,$204.95 
00548-5631-00 - enoxaparin 30 mg/0.3 mL Sol,,,,,$136.60 
00548-5632-00 - enoxaparin 40 mg / 0.4 mL Soln,,,,,$136.60 
00548-5633-00 - enoxaparin 60 mg/0.6 mL Sol,,,,,$136.60 
00548-5634-00 - enoxaparin 80 mg/0.8 mL Sol,,,,,$136.60 
00548-5635-00 - enoxaparin 100 mg/mL Sol,,,,,$136.60 
00548-5636-00 - enoxaparin 120 mg/0.8 mL Sol,,,,,$204.95 
00548-5900-00 - cosyntropin 0.25 mg Inj [UBMC],,,,,$264.75 
"00548-9061-00 - epinephrine 1 mg/mL (1:1,000) Inj Sol MDV [UBMC]",,,,,$15.75 
00555-0159-02 - chlordiazePOXIDE 25 mg Cap,,,,,$5.90 
00555-0872-02 - medroxyPROGESTERone 2.5 mg Tab,,,,,$2.65 
00555-1009-16 - clonidine 0.1 mg/24 hr Transderm Patch [UBMC],,,,,$68.65 
00574-0043-16 - lanolin topical - Oin [UBMC],,,,,$2.35 
00574-0069-15 - glutose 15 lemon favor [UBMC],,,,,$2.50 
00574-0069-30 - glutose 15 lemon favor [UBMC],,,,,$2.50 
00574-0120-08 - charcoal-sorbitol 50 g Oral Susp 240 mL [UBMC],,,,,$2.20 
00574-0120-76 - charcoal-sorbitol 50 g Oral Susp 240 mL [UBMC],,,,,$2.20 
00574-0412-07 - polyethylene glycol 3350 Oral Powder [UBMC],,,,,$7.80 
00574-0618-16 - mineral oil 100% Oral Liq 480 mL [UBMC],,,,,$1.25 
00574-0805-00 - acetylcysteine 0.2 Soln,,,,,$23.55 
00574-0805-30 - acetylcysteine 20% Sol,,,,,$23.55 
00574-0840-01 - ibutilide 0.1 mg/mL IV Sol 10ml vial [UBMC],,,,,$87.35 
00574-0850-10 - dihydroergotamine 1 mg/mL Sol,,,,,$309.95 
00574-2008-02 - nystatin topical 100000 units/g Pow,,,,,$4.15 
00574-2008-30 - nystatin topical 100000 units/g Pow,,,,,$4.65 
00574-4024-50 - erythromycin ophthalmic 0.5% Oin,,,,,$18.00 
00574-7034-12 - aspirin 300 mg Sup,,,,,$4.95 
00574-7045-12 - belladonna-opium 16.2 mg-30 mg Sup UD[UBMC],,,,,$64.10 
00574-7090-12 - hydrocortisone topical 25 mg Sup,,,,,$36.55 
00591-0406-01 - lisinopril 5 mg Tab,,,,,$4.55 
00591-0582-01 - propafenone 150 mg Tab,,,,,$4.25 
00591-0796-01 - sulfaSALAzine 500 mg Tab,,,,,$2.70 
00591-0810-46 - silver sulfADIAZINE topical 1% Cre,,,,,$2.35 
00591-0810-55 - silver sulfADIAZINE Top 1% Crm 50 G [UBMC],,,,,$2.85 
00591-2136-51 - propofol 10 mg/mL Emu,,,,,$15.75 
00591-3198-54 - fentanyl 25 mcg/hr Transderm Patch [UBMC],,,,,$37.55 
00591-3198-72 - fentanyl 25 mcg/hr Transderm Patch [UBMC],,,,,$37.55 
00591-3212-54 - fentanyl 50 mcg/hr Transderm Patch [UBMC],,,,,$61.45 
00591-3212-72 - fentanyl 50 mcg/hr Transderm Patch [UBMC],,,,,$61.45 
00591-3214-54 - fentanyl 100 mcg/hr Transderm Patch [UBMC],,,,,$110.55 
00591-3214-72 - fentanyl 100 mcg/hr Transderm Patch [UBMC],,,,,$110.55 
00591-3222-02 - orphenadrine 30 mg/mL Inj Sol [UBMC],,,,,$29.25 
00591-3222-47 - orphenadrine 30 mg/mL Inj Sol [UBMC],,,,,$29.25 
00591-3468-53 - albuterol 1.25 mg/3 mL (0.042%) Sol,,,,,$3.80 
00591-3561-15 - vancomycin 250 mg Cap,,,,,$113.25 
00591-5642-01 - minoxidil 2.5 mg Tab [UBMC],,,,,$4.05 
00597-0013-14 - albuterol-ipratropium Inh Aer w/Adapt [UBMC],,,,,$27.00 
00597-0024-02 - albuterol-ipratropium CFC free 100 mcg-20 mcg/inh Aer,,,,,$187.80 
00597-0031-34 - clonidine 0.1 mg/24 hr Transderm Patch [UBMC],,,,,$132.85 
00597-0032-34 - clonidine 0.2 mg/24 hr Transderm Patch [UBMC],,,,,$223.70 
00597-0033-34 - clonidine 0.3 mg/24 hr Transderm Patch [UBMC],,,,,$310.30 
00597-0075-41 - tiotropium 18 mcg Cap [UBMC],,,,,$18.30 
00597-0075-75 - tiotropium 18 mcg Cap 5dose [UBMC],,,,,$39.15 
00597-0087-17 - ipratropium CFC free 17 mcg/inh Aer [UBMC],,,,,$64.05 
00603-0179-29 - ferrous sulfate 325 mg Tab [UBMC],,,,,$1.95 
00603-0535-50 - hydrocortisone topical 1% Cre,,,,,$2.10 
00603-0838-73 - acetaminophen 80 mg/0.8 mL Oral Liq [UBMC],,,,,$2.75 
00603-0894-50 - simethicone 40 mg/0.6 mL Liq [UBMC],,,,,$2.30 
00603-1075-58 - codeine-guaiFENesin 10 mg-100 mg/5 mL Syr,,,,,$5.25 
00603-1393-64 - lidocaine topical 2% Sol,,,,,$2.10 
00603-1535-58 - potassium chloride 20 mEq/15 mL Oral Liq [UBMC],,,,,$1.65 
00603-1584-54 - promethazine 6.25 mg/5 mL Syr,,,,,$1.40 
00603-1585-54 - codeine-promethazine 10 mg-6.25 mg/5 mL Syr,,,,,$5.25 
00603-1585-58 - codeine-promethazine 10 mg-6.25 mg/5 mL Syr,,,,,$5.25 
00603-1586-54 - promethazine DM 6.25 mg-15mg/5 mL Syr [UBMC],,,,,$1.35 
00603-2406-02 - baclofen 10 mg Tab,,,,,$6.40 
00603-2434-21 - benztropine 1 mg Tab,,,,,$3.45 
00603-2714-21 - chlordiazepoxide-clidinium 5mg-2.5mg Cap [UBMC],,,,,$4.55 
00603-3856-21 - hydrochlorothiazide 25 mg Tab [UBMC],,,,,$1.90 
00603-4110-21 - isosorbide mononitrate 30 mg ER,,,,,$4.40 
00603-4210-21 - lisinopril 5 mg Tab,,,,,$4.60 
00603-5482-21 - propranolol 10 mg Tab,,,,,$3.45 
00603-6160-21 - traZODone 50 mg Tab,,,,,$3.90 
00603-7818-74 - nystatin topical 100000 units/g Cre,,,,,$4.60 
00641-0121-25 - HYDROmorphone 2 mg/mL Sol,,,,,$20.15 
00641-0367-21 - dexamethasone 10 mg/mL Inj Sol 1 ml [UBMC],,,,,$19.55 
00641-0367-25 - dexamethasone 10 mg/mL Sol,,,,,$19.85 
00641-0376-21 - diphenhydrAMINE 50 mg/mL Inj Sol [UBMC],,,,,$18.45 
00641-0376-25 - diphenhydrAMINE 50 mg/mL Inj Sol [UBMC],,,,,$23.00 
00641-0476-21 - phenobarbital 65 mg/mL Inj Sol [UBMC],,,,,$19.00 
00641-0476-25 - phenobarbital 65 mg/mL Inj Sol [UBMC],,,,,$144.50 
00641-0928-21 - promethazine 25 mg/mL Sol,,,,,$22.90 
00641-0928-25 - promethazine 25 mg/mL Sol,,,,,$20.15 
00641-0929-21 - promethazine 50 mg/mL Sol,,,,,$19.35 
00641-0929-25 - promethazine 50 mg/mL Sol,,,,,$17.35 
00641-1397-31 - chlorproMAZINE 25 mg/mL Inj Sol [UBMC],,,,,$25.15 
00641-1397-35 - chlorproMAZINE 25 mg/mL Inj Sol [UBMC],,,,,$78.20 
00641-1410-31 - digoxin 250 mcg/mL (0.25 mg/mL) Sol [UBMC],,,,,$14.25 
00641-1410-35 - digoxin 250 mcg/mL (0.25 mg/mL) Sol [UBMC],,,,,$17.35 
00641-1495-31 - promethazine 25 mg/mL Inj Sol [UBMC],,,,,$22.90 
00641-1496-31 - promethazine 50 mg/mL Inj Sol (IM ONLY) [UBMC],,,,,$19.35 
00641-2555-41 - phenytoin 50 mg/mL Inj Sol [UBMC],,,,,$17.25 
00641-2555-45 - phenytoin 50 mg/mL Inj Sol [UBMC],,,,,$17.25 
00641-2569-41 - dipyridamole 5 mg/mL IV Sol [UBMC],,,,,$12.50 
00641-2569-44 - dipyridamole 5 mg/mL IV Sol [UBMC],,,,,$12.50 
00641-6006-01 - atropine 0.4 mg/mL Soln,,,,,$18.30 
00641-6013-01 - diltiazem 5 mg/mL Sol 5ml vial [UBMC],,,,,$16.40 
00641-6013-10 - diltiazem 5 mg/mL Sol 5ml vial [UBMC],,,,,$12.25 
00641-6019-10 - morphine 1 mg/mL preservative-free Sol,,,,,$19.90 
00641-6019-10 - morphine 1 mg/mL preservative-free Sol,,,,,$22.05 
00641-6027-01 - fentanyl 50 mcg/mL Soln,,,,,$20.00 
00641-6027-25 - fentaNYL 50 mcg/mL Sol,,,,,$20.00 
00641-6028-25 - fentanyl 50 mcg/mL PF Inj Sol 5ml Amp [UBMC],,,,,$20.00 
00641-6033-25 - glycopyrrolate 0.2 mg/mL Sol,,,,,$24.25 
00641-6036-01 - glycopyrrolate 0.2 mg/mL Soln,,,,,$16.85 
00641-6044-01 - lorazepam 2 mg/mL Soln,,,,,$58.50 
00641-6044-25 - LORazepam 2 mg/mL Sol,,,,,$9.55 
00641-6046-10 - LORazepam 2 mg/mL Sol,,,,,$20.00 
00641-6052-25 - meperidine 25 mg/mL Sol,,,,,$16.80 
00641-6053-25 - meperidine 50 mg/mL Sol,,,,,$30.60 
00641-6057-25 - midazolam 1 mg/mL Sol,,,,,$20.00 
00641-6060-01 - midazolam 5 mg/mL Soln,,,,,$61.20 
00641-6060-10 - midazolam 5 mg/mL Sol,,,,,$20.00 
00641-6078-01 - ondansetron 2 mg/mL Inj Sol SDV 2 mL [UBMC],,,,,$18.15 
00641-6088-01 - phenylephrine 10 mg/mL Soln,,,,,$37.45 
00641-6099-01 - promethazine 25 mg/mL Inj Sol [UBMC],,,,,$20.85 
00641-6114-01 - oxytocin 10 intl units/mL Inj Sol [UBMC],,,,,$20.05 
00641-6116-10 - ampicillin-sulbactam 1 g-0.5 g REC,,,,,$22.10 
00641-6117-10 - ampicillin-sulbactam 2 g-1 g REC,,,,,$23.85 
00641-6125-25 - morphine 4 mg/mL preservative-free Sol,,,,,$13.85 
00641-6127-25 - morphine 10 mg/mL preservative-free Sol,,,,,$14.10 
00641-6132-25 - naloxone 0.4 mg/mL Sol,,,,,$48.20 
00677-0131-10 - sodium bicarbonate 650 mg Tab [UBMC],,,,,$1.25 
00703-1153-03 - norepinephrine 1 mg/mL Sol,,,,,$16.90 
00703-2804-01 - pancuronium 1 mg/mL IV Sol [UBMC],,,,,$15.75 
00703-2804-03 - pancuronium 1 mg/mL IV Sol [UBMC],,,,,$15.75 
00703-2914-01 - vecuronium 10 mg IV Inj [UBMC],,,,,$19.05 
00703-2914-03 - vecuronium 10 mg IV Inj [UBMC],,,,,$19.05 
00703-3671-03 - methotrexate 25 mg/mL preservative-free Sol,,,,,$19.90 
00703-4502-04 - metoclopramide 5 mg/mL Sol,,,,,$15.50 
00703-4767-01 - PACLitaxel 6 mg/mL Sol,,,,,$25.35 
00703-7221-01 - ondansetron 2 mg/mL Inj Sol SDV 2 mL [UBMC],,,,,$15.75 
00703-7221-04 - ondansetron 2 mg/mL Inj Sol SDV 2 mL [UBMC],,,,,$19.10 
00703-8540-21 - enoxaparin 40 mg/0.4 mL Sol,,,,,$56.15 
00713-0109-06 - bisacodyl 10 mg Supp [UBMC],,,,,$2.40 
00713-0109-50 - bisacodyl 10 mg Supp [UBMC],,,,,$2.40 
00713-0118-06 - acetaminophen 120 mg Supp [UBMC],,,,,$4.05 
00713-0118-12 - acetaminophen 120 mg Supp [UBMC],,,,,$4.15 
00713-0132-06 - promethazine 50 mg Supp [UBMC],,,,,$29.70 
00713-0132-12 - promethazine 50 mg Supp [UBMC],,,,,$83.35 
00713-0164-12 - acetaminophen 325 mg Sup [UBMC],,,,,$4.15 
00713-0165-06 - acetaminophen 650 mg Supp [UBMC],,,,,$3.90 
00713-0165-12 - acetaminophen 650 mg Supp [UBMC],,,,,$4.45 
00713-0503-06 - hydrocortisone 25 mg Supp [UBMC],,,,,$5.95 
00713-0503-12 - hydrocortisone 25 mg Supp [UBMC],,,,,$46.90 
00713-0526-06 - promethazine 25 mg Supp [UBMC],,,,,$12.95 
00713-0526-12 - promethazine 25 mg Supp [UBMC],,,,,$36.65 
0074-6624-11 - levothyroxine 100 mcg (0.1 mg) Tab [UBMC],,,,,$3.20 
00766-1440-20 - nicotine 7 mg/24 hr Transderm Patch [UBMC],,,,,$8.80 
00781-1008-01 - hydrochlorothiazide-triamterene 50 mg-75 mg Tab,,,,,$4.35 
00781-1008-05 - hydrochlorothiazide-triamterene 50 mg-75 mg Tab UD[UBMC],,,,,$4.25 
00781-1205-01 - penicillin V potassium 250 mg Tab [UBMC],,,,,$4.35 
00781-1392-01 - haloperidol 1 mg Tab [UBMC],,,,,$3.65 
00781-1392-13 - haloperidol 1 mg Tab,,,,,$3.85 
00781-1496-69 - azithromycin 250 mg 4 tab Home pk[UBMC],,,,,$16.10 
00781-1496-69 - azithromycin 250 mg Tab [UBMC],,,,,$16.10 
00781-1556-01 - isosorbide dinitrate 10 mg Tab,,,,,$4.25 
00781-1962-60 - clarithromycin 500 mg Tab [UBMC],,,,,$12.45 
00781-1962-60 - clarithromycin 500 mg Tab home pack[UBMC],,,,,$11.75 
00781-1966-01 - furosemide 40 mg Tab,,,,,$2.30 
00781-2048-01 - amantadine 100 mg Cap [UBMC],,,,,$5.25 
00781-2053-01 - terazosin 5 mg Cap,,,,,$4.15 
00781-2176-60 - cefdinir 300 mg Cap,,,,,$10.60 
00781-3009-70 - succinylcholine 20 mg/mL Inj Sol [UBMC],,,,,$15.75 
00781-3009-95 - succinylcholine 20 mg/mL Inj Sol [UBMC],,,,,$16.45 
00781-3071-75 - metoprolol 1 mg/mL Inj Sol [UBMC],,,,,$21.00 
00781-3071-95 - metoprolol 1 mg/mL Inj Sol [UBMC],,,,,$21.40 
00781-3098-95 - meropenem 1000 mg REC,,,,,$76.50 
00781-3110-95 - piperacillin-tazobactam 2 g-0.25 g REC,,,,,$32.00 
00781-3124-85 - nafcillin 1 g Inj [UBMC],,,,,$27.05 
00781-3125-85 - nafcillin 2 g Inj [UBMC],,,,,$43.55 
00781-3159-72 - OLANZapine 10 mg REC,,,,,$85.90 
00781-3174-14 - SUMAtriptan 6 mg/0.5 mL Sol,,,,,$356.10 
00781-3204-70 - niCARdipine 2.5 mg/mL Inj Sol [UBMC],,,,,$65.75 
00781-3204-95 - niCARdipine 2.5 mg/mL Inj Sol [UBMC],,,,,$65.75 
00781-3206-85 - cefTRIAXone 250 mg REC,,,,,$38.55 
00781-3207-85 - ceftriaxone 500 mg REC Injection,,,,,$69.90 
00781-3208-95 - cefTRIAXone 1 g REC,,,,,$95.20 
00781-3220-92 - rocuronium 10 mg/mL Sol,,,,,$19.85 
00781-3240-09 - ciprofloxacin 400 mg/200 mL-5% Sol,,,,,$15.75 
00781-3253-94 - azaCITIDine 100 mg REC,,,,,"$1,210.55 "
00781-3255-94 - cyclophosphamide 2 g REC,,,,,"$3,239.40 "
00781-3265-80 - meropenem 500 mg REC Injection,,,,,$72.85 
00781-3267-95 - meropenem 1000 mg REC,,,,,$147.75 
00781-3289-09 - clindamycin 600 mg-5%/50 mL Sol,,,,,$15.75 
00781-3290-09 - clindamycin 900 mg-5%/50 mL Sol,,,,,$15.80 
00781-3342-46 - levofloxacin 500 mg/100 mL IV Sol [UBMC],,,,,$15.75 
00781-3343-55 - levofloxacin 750 mg Soln,,,,,$15.75 
00781-3350-95 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$48.00 
00781-3367-95 - piperacillin-tazobactam 4 g-0.5 g REC,,,,,$60.80 
00781-3412-92 - ampicillin 1 g Inj [UBMC],,,,,$46.55 
00781-3440-71 - cosyntropin 0.25 mg REC Injection,,,,,$199.20 
00781-3451-70 - cefazolin 1 gm REC Powder,,,,,$20.20 
00781-3451-96 - ceFAZolin 1 g REC,,,,,$23.45 
00781-5184-92 - levothyroxine 100 mcg (0.1 mg) Tab,,,,,$4.00 
00781-5238-06 - ondansetron 4 mg ODT [UBMC],,,,,$47.85 
00781-5238-64 - ondansetron 4 mg ODT [UBMC],,,,,$46.15 
00781-5275-13 - donepezil 10 mg Tab,,,,,$16.10 
00781-5402-92 - rosuvastatin 20 mg Tab,,,,,$4.90 
00781-5421-92 - pioglitazone 30 mg Tab,,,,,$22.15 
00781-6041-58 - amoxicillin 250 mg/5 mL REC,,,,,$1.50 
00781-6141-16 - Levetiracetam Oral Solution 100 mg/ml 16 fl oz (473 mL) [UBMC],,,,,$4.30 
00781-6157-52 - amoxicillin 400 mg/5 mL Oral Liq [UBMC],,,,,$2.20 
00781-6355-87 - mometasone nasal 50 mcg/inh Spr,,,,,$32.50 
00781-7241-55 - fentaNYL 25 mcg/hr ER,,,,,$37.55 
00781-7243-55 - fentaNYL 75 mcg/hr ER,,,,,$93.75 
00781-7244-55 - fentaNYL 100 mcg/hr ER,,,,,$110.55 
00781-7515-87 - budesonide 0.25 mg/2 mL Sus,,,,,$12.25 
00781-8061-01 - captopril 25 mg Tab,,,,,$4.70 
00832-0465-30 - nystatin topical 100000 units/g Pow,,,,,$6.35 
00869-0686-38 - magnesium citrate - Liq [UBMC],,,,,$1.25 
00869-0831-43 - mineral oil 100% Oral Liq 480 mL [UBMC],,,,,$1.25 
00869-3400-10 - gentian violet Top 1% Sol [UBMC],,,,,$2.00 
00869-4206-10 - mineral oil 100% Oral Liq 480 mL [UBMC],,,,,$1.25 
00904-0201-61 - amitriptyline 25 mg Tab [UBMC],,,,,$4.05 
00904-0411-61 - propranolol 10 mg Tab [UBMC],,,,,$2.70 
00904-0430-61 - doxycycline hyclate 100 mg Tab [UBMC],,,,,$4.70 
00904-0430-61 - doxycycline hyclate 100 mg Tab UD home pack[UBMC],,,,,$4.70 
00904-0539-61 - multivitamin Therapeutic Multiple Vitamins Tab,,,,,$2.35 
00904-0544-60 - thiamine 100 mg Tab[UBMC],,,,,$1.50 
00904-1257-92 - calcium carbonate 500 mg Che,,,,,$1.25 
00904-1258-92 - calcium carbonate 500 mg [UBMC],,,,,$1.25 
00904-1883-61 - calcium carbonate 1250 mg Tab [UBMC],,,,,$2.40 
00904-1982-51 - acetaminophen 325 mg Tab,,,,,$1.45 
00904-1982-61 - acetaminophen 325 mg Tab [UBMC],,,,,$1.45 
00904-2056-61 - diphenhydrAMINE 50 mg Cap [UBMC],,,,,$2.00 
00904-2151-61 - isosorbide dinitrate 10 mg Tab [UBMC],,,,,$5.00 
00904-2244-61 - docusate sodium 100 mg Cap [UBMC],,,,,$2.00 
00904-2725-61 - sulfamethoxazole-trimethoprim 800 mg-160 mg Tab [UBMC],,,,,$3.15 
00904-2725-61 - sulfamethoxazole-trimethoprim 800 mg-160 mg Tab home pack[UBMC],,,,,$4.50 
00904-3232-61 - calcium carbonate 600 mg Tab,,,,,$2.45 
00904-3232-92 - calcium carbonate 600 mg Tab,,,,,$1.35 
00904-3365-61 - baclofen 10 mg Tab [UBMC],,,,,$3.70 
00904-3990-61 - traZODone 50 mg Tab,,,,,$3.70 
00904-5046-61 - captopril 25 mg Tab [UBMC],,,,,$4.20 
00904-5053-24 - pseudoephedrine 30 mg Tab[UBMC],,,,,$1.55 
00904-5053-24 - Pseudoephedrine HCL 30 mg [UBMC],,,,,$1.55 
00904-5053-59 - pseudoephedrine 30 mg Tab,,,,,$1.35 
00904-5165-61 - senna 8.6 mg Tab UD[UBMC],,,,,$1.70 
00904-5306-61 - diphenhydrAMINE 25 mg Cap [UBMC],,,,,$1.85 
00904-5309-20 - ibuprofen 100 mg/5 mL Oral Susp [UBMC],,,,,$1.95 
00904-5309-20 - ibuprofen 100 mg/5 mL Oral Susp [UBMC],,,,,$2.00 
"00904-5377-20 - ophthalmic irrigation, extraocular - Sol [UBMC]",,,,,$1.25 
00904-5492-61 - multivitamin with minerals Therapeutic Multiple Vitamins with Minerals Tab,,,,,$2.40 
00904-5495-46 - nitroglycerin 0.2 mg/hr Transderm Patch [UBMC],,,,,$4.20 
00904-5512-61 - docusate-senna 50 mg-8.6 mg Tab UD[UBMC],,,,,$1.90 
00904-5524-61 - doxazosin 4 mg Tab,,,,,$4.00 
00904-5591-61 - naproxen 500 mg Tab,,,,,$4.60 
00904-5631-61 - gabapentin 100 mg Cap,,,,,$4.40 
00904-5651-61 - terazosin 2 mg Cap [UBMC],,,,,$4.90 
00904-5711-30 - oxymetazoline nasal 0.05% Spr,,,,,$2.20 
00904-5785-61 - FLUoxetine 20 mg Cap,,,,,$6.45 
00904-5794-61 - metFORMIN 500 mg ER,,,,,$4.30 
00904-5797-61 - furosemide 40 mg Tab,,,,,$2.00 
00904-5809-61 - lisinopril 20 mg Tab,,,,,$3.90 
00904-5811-61 - lisinopril 5 mg Tab,,,,,$3.80 
00904-5852-61 - cetirizine 10 mg Tab,,,,,$6.30 
00904-5854-61 - ibuprofen 600 mg Tab,,,,,$2.90 
00904-5855-61 - ibuprofen 800 mg Tab,,,,,$3.40 
00904-5860-61 - ALPRAZolam 1 mg Tab,,,,,$9.50 
00904-5888-61 - theophylline 200 mg ER [UBMC],,,,,$4.45 
00904-5894-30 - simethicone 40 mg/0.6 mL Liq,,,,,$1.75 
00904-5921-61 - digoxin 125 mcg (0.125 mg) Tab,,,,,$4.40 
00904-5922-61 - digoxin 250 mcg (0.25 mg) Tab,,,,,$4.40 
00904-5923-61 - haloperidol 1 mg Tab,,,,,$4.60 
00904-5928-61 - labetalol 100 mg Tab,,,,,$5.95 
00904-5951-61 - spironolactone 25 mg Tab,,,,,$3.90 
00904-5959-61 - clindamycin 150 mg Cap,,,,,$4.25 
00904-6025-61 - polyethylene glycol 3350 - REC,,,,,$3.95 
00904-6068-61 - potassium chloride 10 mEq ER [UBMC],,,,,$10.95 
00904-6074-61 - loratadine 10 mg Tab UD [UBMC],,,,,$4.50 
00904-6078-61 - gabapentin 100 mg Cap [UBMC],,,,,$4.40 
00904-6083-61 - zolpidem 10 mg Tab,,,,,$2.45 
00904-6085-61 - citalopram 20 mg Tab,,,,,$7.00 
00904-6090-61 - metformin 500 mg Tab [UBMC],,,,,$4.50 
00904-6107-61 - metformin 500 mg ER Tab [UBMC],,,,,$4.30 
00904-6119-61 - traMADol 50 mg Tab,,,,,$4.40 
00904-6237-61 - carbidopa-levodopa 25 mg-100 mg Tab,,,,,$4.10 
00904-6250-61 - levofloxacin 500 mg Tab,,,,,$20.65 
00904-6255-49 - benzocaine-menthol topical 15 mg-3.6 mg Loz,,,,,$1.90 
00904-6284-61 - OLANZapine 5 mg Tab,,,,,$27.35 
00904-6290-61 - atorvastatin 10 mg Tab,,,,,$3.95 
00904-6292-61 - atorvastatin 40 mg Tab,,,,,$4.35 
00904-6294-61 - clopidogrel 75 mg Tab,,,,,$11.35 
00904-6308-20 - acetaminophen 160 mg/5 mL Sus,,,,,$1.25 
00904-6323-61 - metoprolol 50 mg ER,,,,,$4.85 
00904-6326-61 - metFORMIN 500 mg Tab,,,,,$4.20 
00904-6339-61 - docusate-senna 50 mg-8.6 mg Tab,,,,,$1.90 
00904-6340-61 - metoprolol 25 mg Tab,,,,,$2.65 
00904-6341-61 - metoprolol 50 mg Tab,,,,,$4.00 
00904-6351-61 - levofloxacin 250 mg Tab,,,,,$30.50 
00904-6352-61 - levofloxacin 500 mg Tab,,,,,$34.80 
00904-6359-61 - risperiDONE 1 mg Tab,,,,,$11.85 
00904-6365-61 - traMADol 50 mg Tab,,,,,$4.60 
00904-6367-61 - DULoxetine 30 mg ER,,,,,$12.25 
00904-6370-61 - amLODIPine 5 mg Tab,,,,,$4.25 
00904-6373-61 - rOPINIRole 0.25 mg Tab,,,,,$4.05 
00904-6391-61 - losartan 25 mg Tab,,,,,$4.40 
00904-6407-61 - bisacodyl 5 mg EC,,,,,$1.60 
00904-6409-61 - donepezil 10 mg Tab,,,,,$13.20 
00904-6421-61 - acetaminophen-hydrocodone 325 mg-10 mg Tab,,,,,$6.85 
00904-6422-81 - polyethylene glycol 3350 - REC,,,,,$3.95 
00904-6426-61 - escitalopram 10 mg Tab,,,,,$11.40 
00904-6453-61 - DULoxetine 30 mg DR,,,,,$12.25 
00904-6461-61 - promethazine 25 mg Tab,,,,,$4.55 
00904-6475-61 - baclofen 10 mg Tab,,,,,$4.00 
00904-6500-61 - fluconazole 100 mg Tab,,,,,$20.10 
00904-6554-61 - traZODone 50 mg Tab,,,,,$3.70 
00904-6593-04 - tolterodine 4 mg ER,,,,,$29.35 
00904-7591-61 - ferrous sulfate 325 mg Tab,,,,,$1.50 
00904-7809-61 - cyclobenzaprine 10 mg Tab,,,,,$4.75 
00904-7927-61 - bisacodyl 5 mg EC  UD[UBMC],,,,,$2.00 
00934-0741-19 - citalopram 20 mg Tab [UBMC],,,,,$6.30 
00944-0490-02 - albumin human 25% Sol [UBMC],,,,,$19.10 
00944-2700-04 - immune globulin intravenous and subcutaneous 10% Sol,,,,,$33.75 
00944-2700-05 - immune globulin intravenous and subcutaneous 10% Sol,,,,,$40.75 
00944-2700-06 - immune globulin intravenous and subcutaneous 10% Sol,,,,,$33.75 
00944-2700-07 - immune globulin intravenous and subcutaneous 10% Sol,,,,,$35.85 
00955-1003-10 - enoxaparin 30 mg/0.3 mL Sol,,,,,$184.65 
00955-1004-10 - enoxaparin 40 mg/0.4 mL Sol,,,,,$184.65 
00955-1008-10 - enoxaparin 80 mg/0.8 mL Sol,,,,,$184.90 
02450-0058-89 - potassium chloride 20 mEq ER [UBMC],,,,,$4.45 
05047-4508-54 - sodium hyaluronate ophthalmic 14 mg/mL Liq[UBMC],,,,,$421.70 
08065-1839-05 - sodium chondroitin-hyaluronate ophthalmic 40 mg-30 mg/mL Sol [UBMC],,,,,$675.95 
08290-0940-10 - sodium chloride 0.9% Inj 10 ml syringes [UBMC],,,,,$15.75 
08290-3064-14 - heparin flush 10 units/mL Sol,,,,,$15.75 
08290-3065-11 - heparin flush 10 units/mL Sol,,,,,$15.75 
08290-3065-13 - heparin flush 100 units/mL Sol PFS 5ml [UBMC],,,,,$15.75 
08290-3065-46 - sodium chloride 0.9% Sol,,,,,$15.75 
08290-3065-47 - sodium chloride 0.9% Inj 10 ml syringes [UBMC],,,,,$15.75 
08290-3065-53 - sodium chloride 0.9% Sol,,,,,$15.75 
08881-5701-21 - sodium chloride 0.9% Sol,,,,,$15.75 
1 Hr GTT,$85.00 ,,,,
1.0MM X 64MM XOMED BUR,$228.75 ,,,,
1.5MM X 64MM XOMED BUR,$228.75 ,,,,
10019-0016-29 - glycopyrrolate 0.2 mg/mL Inj Sol [UBMC],,,,,$15.75 
10019-0027-10 - midazolam 5 mg/mL Inj Sol **HIGH DOSE** [UBMC],,,,,$20.00 
10019-0027-39 - midazolam 5 mg/mL Inj Sol **HIGH DOSE** [UBMC],,,,,$20.00 
10019-0033-39 - fentanyl 50 mcg/mL PF Inj Sol 5ml Amp [UBMC],,,,,$20.00 
10019-0033-72 - fentanyl 50 mcg/mL PF Inj Sol 5ml Amp [UBMC],,,,,$20.00 
10019-0037-02 - fentanyl 50 mcg/mL Inj Sol 2ml Vial [UBMC],,,,,$20.00 
10019-0037-27 - fentanyl 50 mcg/mL Inj Sol 2ml Vial [UBMC],,,,,$20.00 
10019-0097-01 - promethazine 25 mg/mL Inj Sol [UBMC],,,,,$20.85 
10019-0097-44 - promethazine 25 mg/mL Inj Sol [UBMC],,,,,$20.85 
10019-0163-12 - phenylephrine 10 mg/mL Inj Sol [UBMC],,,,,$25.95 
10019-0163-39 - phenylephrine 10 mg/mL Inj Sol [UBMC],,,,,$19.15 
10019-0178-39 - morphine 10 mg/mL Inj Sol [UBMC],,,,,$17.80 
10019-0178-44 - morphine 10 mg/mL Inj Sol [UBMC],,,,,$14.10 
10019-0250-20 - atropine 0.4 mg/mL Sol[UBMC],,,,,$22.30 
10019-0250-37 - atropine 0.4 mg/mL Sol[UBMC],,,,,$21.05 
10019-0291-02 - oxytocin 10 intl units/mL Inj Sol [UBMC],,,,,$20.05 
10019-0291-12 - oxytocin 10 intl units/mL Inj Sol [UBMC],,,,,$23.65 
10019-0321-01 - flumazenil 0.1 mg/mL IV Sol [UBMC],,,,,$24.85 
10019-0321-54 - flumazenil 0.1 mg/mL IV Sol [UBMC],,,,,$24.85 
10019-0510-01 - diltiazem 5 mg/mL Sol [UBMC],,,,,$15.75 
10019-0510-01 - diltiazem 5 mg/mL Sol 5ml vial [UBMC],,,,,$15.75 
10019-0510-79 - diltiazem 5 mg/mL Sol 5ml vial [UBMC],,,,,$15.75 
10019-0553-01 - scopolamine 1.5 mg ER,,,,,$52.90 
10019-0553-03 - scopolamine 1.5 mg ER,,,,,$52.90 
10019-0631-31 - ampicillin-sulbactam 1 g-0.5 g Inj [UBMC],,,,,$18.40 
10019-0633-02 - ampicillin-sulbactam 2 g-1 g Inj [UBMC],,,,,$28.55 
10019-0633-33 - ampicillin-sulbactam 2 g-1 g Inj [UBMC],,,,,$28.55 
10019-0634-31 - ampicillin-sulbactam 1 g-0.5 g Inj [UBMC],,,,,$18.40 
10019-0641-24 - desflurane 100% Liq[UBMC],,,,,$17.65 
10019-0653-64 - sevoflurane Inh Liq 250 mL [UBMC],,,,,$4.15 
10019-0685-71 - ceftriaxone 250 mg Inj [UBMC],,,,,$34.30 
10019-0687-03 - ceftriaxone 1 g Inj [UBMC],,,,,$24.35 
10019-0688-27 - ceftriaxone 2 g Inj [UBMC],,,,,$35.90 
10019-0956-01 - cyclophosphamide 1 g REC [UBMC],,,,,"$1,722.85 "
10019-0956-16 - cyclophosphamide 1 g REC [UBMC],,,,,$355.85 
"100B S-100B Protein, Serum ARUP",$498.50 ,,,,
10139-0235-10 - rocuronium 10 mg/mL Sol[UBMC],,,,,$19.35 
10139-0235-11 - rocuronium 10 mg/mL Sol[UBMC],,,,,$19.65 
10223-0201-01 - benzocaine/butamben/tetracaine Top Aer [UBMC],,,,,$4.80 
10223-0201-04 - benzocaine/butamben/tetracaine topical 14%-2%-2% Aer,,,,,$26.10 
10361-0793-01 - citric acid/simethicone/sodium bicarbonate 1.53 g-0.04 g-2.21g/4 g EFF UD [UBMC],,,,,$7.35 
11098-0526-03 - Dimercaprol inj 100 mg per ML [UBMC],,,,,$120.90 
11509-0205-18 - menthol oral lozenge [UBMC],,,,,$2.30 
11523-7234-01 - polyethylene glycol 3350 Oral Powder [UBMC],,,,,$1.90 
11523-7234-03 - polyethylene glycol 3350 Oral Powder [UBMC],,,,,$1.75 
11523-7234-05 - polyethylene glycol 3350 - REC,,,,,$4.25 
11523-7268-03 - polyethylene glycol 3350 Oral Powder [UBMC],,,,,$4.65 
"11-Deoxycortisol Quantitative, Serum ARUP",$127.50 ,,,,
12 Lead EKG Tracing only,$173.00 ,,,,
12 LEAD ELECTROCARDIOGRAM WITH INTERPRETATION AND REPORT CHARGE,$173.00 ,,,,
12 LEAD ELECTROCARDIOGRAM; INTERPRETATION AND REPORT ONLY CHARGE,,,,$46.50 ,
12870-0001-01 - silver nitrate topical [UBMC],,,,,$4.20 
12MM SORENSON SUCTION CURRETTE,$8.75 ,,,,
13107-0145-01 - carvedilol 25 mg Tab,,,,,$5.05 
13310-0119-07 - colchicine 0.6 mg Tab [UBMC],,,,,$12.05 
13310-0153-07 - quinine 324 mg Cap [UBMC],,,,,$16.25 
"13533-0618-02 - rabies immune globulin, human 150 intl units/mL Sol",,,,,$439.15 
"13533-0618-10 - rabies immune globulin, human 150 intl units/mL Sol",,,,,$762.30 
13533-0634-02 - tetanus immune globulin 250 units IM Sol [UBMC],,,,,$888.15 
13533-0684-20 - albumin human 25% Sol,,,,,$17.65 
13533-0800-24 - immune globulin intravenous and subcutaneous 10% Sol,,,,,$30.15 
13668-0103-30 - donepezil 10 mg Tab,,,,,$16.15 
13668-0113-90 - losartan 25 mg Tab,,,,,$4.65 
13811-0525-01 - multivitamin Vitamin B Complex with C and Folic Acid Cap,,,,,$4.25 
14789-0012-02 - sodium nitroprusside 25 mg/mL Sol,,,,,$323.40 
14789-0400-05 - levetiracetam 100 mg/mL Sol[UBMC],,,,,$11.25 
15 DEGREE GREAT WHITE BENDABLE,"$1,619.50 ",,,,
16714-0082-10 - hydrOXYzine hydrochloride 25 mg Tab,,,,,$4.35 
16714-0232-02 - cefuroxime 250 mg Tab [UBMC],,,,,$11.45 
16714-0293-01 - amoxicillin-clavulanate 400 mg-57 mg/5 mL REC,,,,,$4.45 
16714-0297-01 - amoxicillin-clavulanate 875 mg-125 mg Tab,,,,,$10.45 
16714-0299-03 - amoxicillin 500 mg Cap,,,,,$3.70 
16714-0332-01 - gabapentin 800 mg Tab,,,,,$7.90 
16714-0341-03 - cloNIDine 0.1 mg Tab,,,,,$2.75 
16714-0355-01 - levETIRAcetam 500 mg Tab,,,,,$9.15 
16714-0391-02 - cefdinir 300 mg Cap,,,,,$10.60 
16714-0393-01 - cefdinir 250 mg/5 mL REC,,,,,$4.30 
16714-0478-01 - amoxicillin-clavulanate 875 mg-125 mg Tab,,,,,$10.45 
16714-0478-02 - amoxicillin-clavulanate 875 mg-125 mg Tab,,,,,$12.80 
16714-0504-01 - gabapentin 300 mg Cap,,,,,$4.50 
16714-0581-02 - losartan 25 mg Tab,,,,,$4.35 
16714-0691-01 - fluconazole 100 mg Tab,,,,,$18.10 
16714-0736-01 - esomeprazole 40 mg DR,,,,,$18.30 
16714-0747-02 - omeprazole 20 mg DR,,,,,$11.15 
16729-0137-00 - clonazePAM 1 mg Tab,,,,,$4.50 
17314-9600-01 - DOXOrubicin liposomal 2 mg/mL DSP [UBMC],,,,,$267.75 
17478-0040-01 - lorazepam 2 mg/mL Sol 1mL [UBMC],,,,,$25.70 
17478-0050-02 - SUFentanil 50 mcg/mL Sol,,,,,$52.95 
17478-0050-05 - SUFentanil 50 mcg/mL Sol,,,,,$44.75 
17478-0064-12 - hydroxypropyl methylcellulose Opth 2.5% Sol [UBMC],,,,,$7.90 
17478-0070-31 - erythromycin Opth 0.5% Oint [UBMC],,,,,$21.15 
17478-0102-12 - tropicamide ophthalmic 1% Sol,,,,,$15.80 
17478-0121-50 - clindamycin 600 mg-5%/50 mL Sol,,,,,$15.75 
17478-0122-50 - clindamycin 150 mg/mL Soln,,,,,$30.10 
17478-0201-02 - phenylephrine ophthalmic 2.5% Sol,,,,,$42.05 
17478-0235-35 - bacitracin/neomycin/polymyxin B ophthalmic 400 units-3.5 mg-10000 units/g Oin,,,,,$32.70 
17478-0253-10 - fluorescein 10% Sol,,,,,$24.55 
17478-0284-35 - gentamicin Opth 0.3% Oint [UBMC],,,,,$17.60 
17478-0403-03 - fluorescein ophthalmic 0.6 mg [UBMC],,,,,$1.85 
17478-0501-01 - methylergonovine 0.2 mg/mL Sol,,,,,$26.85 
17478-0508-01 - indigo carmine 8 mg/mL Sol[UBMC],,,,,$4.95 
17478-0510-02 - physostigmine 1 mg/mL Inj Sol [UBMC],,,,,$57.90 
17478-0515-00 - ephedrine 50 mg/mL Inj Sol [UBMC],,,,,$117.45 
17478-0526-03 - dimercaprol 10% Sol [UBMC],,,,,$132.85 
17478-0538-02 - orphenadrine 30 mg/mL Sol,,,,,$28.85 
17478-0542-02 - adenosine 3 mg/mL Sol,,,,,$19.55 
17478-0711-30 - lidocaine Top 2% Gel w/Appl [UBMC],,,,,$3.80 
17478-0741-02 - vancomycin 125 mg Cap,,,,,$64.85 
17478-0931-01 - Calcitriol Inj 1 mcg/mL [UBMC],,,,,$29.35 
17478-0934-01 - hydrALAZINE 20 mg/mL Sol,,,,,$109.85 
17478-0937-05 - diltiazem 5 mg/mL Sol,,,,,$12.70 
17478-0937-25 - diltiazem 5 mg/mL Sol,,,,,$19.40 
17-Hydroxyprogesterone ARUP,$78.75 ,,,,
"17-Hydroxyprogesterone Qnt by MS/MS, Ser ARUP",$78.75 ,,,,
"17-Ketosteroids, Urine ARUP",$88.50 ,,,,
19515-0888-07 - Influenza Virus Vaccine Fluzone for 6 months of age and older 5 ml [UBMC],,,,,$66.05 
"19515-0894-52 - influenza virus vaccine, inactivated preservative-free quadrivalent Sus",,,,,$75.25 
"19515-0912-52 - influenza virus vaccine, inactivated preservative-free quadrivalent Sus",,,,,$83.55 
2 Hr GTT,$85.00 ,,,,
2.4 VA LP two column volar distal radius plate RT,"$2,892.75 ",,,,
2.4mm VA Locking Screw 14mm,$658.50 ,,,,
2.4mm VA Locking Screw 16mm,$658.50 ,,,,
2.4mm VA Locking Screw 18mm,$658.50 ,,,,
2.5 REAMING ROD W/ BALL TIP,$580.00 ,,,,
2.5mm threaded guide wire,$242.25 ,,,,
2.5MM X 64MM XOMED BUR,$228.75 ,,,,
2.7mm screw slf-tpng 12mm,$221.00 ,,,,
2.7MM X 64MM XOMED BUR,$79.75 ,,,,
21-Hydroxylase Antibody ARUP,$181.25 ,,,,
23155-0010-01 - indomethacin 25 mg Cap,,,,,$3.25 
23155-0118-01 - calcitriol 0.25 mcg Cap,,,,,$4.75 
23155-0168-31 - ondansetron 2 mg/mL Sol,,,,,$19.90 
23155-0194-01 - NIFEdipine 10 mg Cap,,,,,$4.20 
23155-0196-31 - ondansetron - Soln,,,,,$15.75 
23155-0196-42 - ondansetron 2 mg/mL Sol,,,,,$15.75 
23155-0294-42 - prochlorperazine 5 mg/mL Sol,,,,,$28.85 
23155-0473-42 - furosemide 10 mg/mL Sol,,,,,$16.85 
23155-0547-41 - ondansetron 2 mg/mL Sol,,,,,$15.75 
23155-0549-31 - ondansetron 2 mg/mL Sol,,,,,$15.75 
24 Hour EEG Attended by Technologist,"$1,941.25 ",,,,
24 Hour Holter Monitor,$447.25 ,,,,
24 Hour Holter Monitor,$447.25 ,,,,
24208-0399-15 - Ipratropium Bromide Nasal Solution 0.06% 15 ml [UBMC],,,,,$7.90 
24208-0434-05 - ofloxacin Opth 0.3% Sol [UBMC],,,,,$28.50 
24208-0585-64 - tropicamide ophthalmic 1% Sol,,,,,$15.80 
24208-0601-10 - ketotifen ophthalmic 0.025% Sol,,,,,$4.05 
24208-0635-62 - hydrocortisone/neomycin/polymyxin B Otic Susp [UBMC],,,,,$26.20 
24208-0670-04 - sodium sulfacetamide Opth 10% Sol [UBMC],,,,,$10.55 
24208-0670-04 - sulfacetamide sodium ophthalmic 10% Sol [UBMC],,,,,$4.35 
24208-0676-15 - pilocarpine Opth 1% Sol [UBMC],,,,,$10.05 
24208-0720-02 - dexamethasone Ophth 0.1% Sol [UBMC],,,,,$35.05 
24208-0730-06 - proparacaine ophthalmic 0.5% Sol [UBMC],,,,,$7.30 
24208-0732-05 - benoxinate-fluorescein Opth Sol [UBMC],,,,,$26.75 
24208-0780-55 - bacitracin/neomycin/polymyxin B ophthalmic 400 units-3.5 mg-10000 units/g Oin,,,,,$33.70 
24208-0790-62 - gramicidin/neomycin/polymyxin B ophthalmic 0.025 mg-1.75 mg-10000 units/mL Sol [UBMC],,,,,$12.65 
24208-0910-19 - erythromycin Opth 0.5% Oint [UBMC],,,,,$25.70 
24385-0785-30 - simethicone 40 mg/0.6 mL Liq [UBMC],,,,,$1.70 
24987-0260-10 - digoxin 250 mcg/mL (0.25 mg/mL) Sol,,,,,$88.40 
24987-0378-10 - cefTAZidime 1 g REC,,,,,$37.00 
25010-0405-15 - phytonadione 5 mg Tab [UBMC],,,,,$23.75 
25021-0101-10 - ceFAZolin 1 g REC,,,,,$24.40 
25021-0106-10 - ceftriaxone 1 g Inj [UBMC],,,,,$25.10 
25021-0107-20 - cefTRIAXone 2 g REC,,,,,$16.55 
25021-0110-20 - cefOXitin 2 g REC,,,,,$31.20 
25021-0112-10 - azithromycin 500 mg REC,,,,,$22.55 
25021-0113-82 - fluconazole 200 mg/100 mL-0.9% Sol,,,,,$15.75 
25021-0121-20 - cefepime 1 g REC,,,,,$22.55 
25021-0122-50 - cefepime 2 g REC,,,,,$31.20 
25021-0127-20 - cefTAZidime 1 g REC,,,,,$19.55 
25021-0128-50 - cefTAZidime 2 g REC,,,,,$34.30 
25021-0132-83 - levofloxacin 750 mg/150 mL Sol,,,,,$15.75 
25021-0135-10 - ampicillin 500 mg REC,,,,,$18.95 
25021-0136-10 - ampicillin 1 g REC,,,,,$18.80 
25021-0137-20 - ampicillin 2 g REC,,,,,$28.15 
25021-0140-10 - nafcillin 2 g REC,,,,,$70.20 
25021-0142-20 - ampicillin-sulbactam 1 g-0.5 g REC,,,,,$18.95 
25021-0143-30 - ampicillin-sulbactam 2 g-1 g Inj [UBMC],,,,,$22.55 
25021-0156-30 - meropenem 1000 mg REC,,,,,$33.70 
25021-0165-30 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$34.30 
25021-0184-82 - fluconazole 200 mg/100 mL-0.9% Sol,,,,,$15.75 
25021-0235-50 - gemcitabine 1 g REC,,,,,$329.30 
25021-0301-67 - adenosine 3 mg/mL Sol,,,,,$30.05 
25021-0301-68 - adenosine 3 mg/mL Sol,,,,,$24.40 
25021-0400-01 - heparin 1000 units/mL Inj Sol MDV 1ml [UBMC],,,,,$25.10 
25021-0400-30 - heparin 1000 units/mL Sol,,,,,$15.75 
25021-0402-01 - heparin 5000 units/mL Inj Sol MDV 1ml [UBMC],,,,,$16.40 
25021-0402-10 - heparin 5000 units/mL Sol,,,,,$16.05 
25021-0403-01 - heparin 10000 units/mL Sol,,,,,$25.25 
25021-0452-01 - octreotide 100 mcg/mL Sol,,,,,$24.40 
25021-0608-20 - propofol 10 mg/mL Emu,,,,,$15.75 
25021-0608-50 - propofol 10 mg/mL Emu,,,,,$15.75 
25021-0608-51 - propofol 10 mg/mL Emu,,,,,$15.75 
25021-0701-01 - ketorolac 30 mg/mL Sol,,,,,$22.90 
25021-0703-60 - sumatriptan 6 mg/0.5 mL SubQ Inj [UBMC],,,,,$129.15 
25021-0777-02 - ondansetron 2 mg/mL Sol,,,,,$16.70 
25021-0780-05 - levETIRAcetam 100 mg/mL Sol,,,,,$24.40 
25021-0801-66 - zoledronic acid 4 mg/5 mL Sol,,,,,$89.40 
25021-0803-10 - pamidronate 9 mg/mL Sol,,,,,$22.55 
25021-0806-01 - haloperidol 5 mg/mL Sol,,,,,$30.05 
25021-0810-30 - methylPREDNISolone 1 g REC,,,,,$74.50 
25021-0830-82 - zoledronic acid 5 mg/100 mL Sol,,,,,$22.10 
25208-0002-02 - tirofiban 50 mcg/mL IV Sol [UBMC],,,,,$21.65 
"25-Hydroxyvitamin D2 and D3, Serum ARUP",$594.00 ,,,,
27437-0050-56 - methylergonovine 0.2 mg Tab,,,,,$146.35 
28400-0105-01 - thrombin topical recombinant 5000 IU [UBMC],,,,,$202.25 
28400-0105-41 - thrombin topical recombinant 5000 IU [UBMC],,,,,$202.25 
29336-0400-10 - edetate calcium disodium 200 mg/mL Inj Sol [UBMC],,,,,$94.40 
29445 Application of rigid total contact leg cast,$362.25 ,,,,
29580 Application of unna boot,$205.50 ,,,,
"29581 Application of multi-layer venous wound compression system, below knee",$205.50 ,,,,
2MM X75MM XOMED BUR,$237.50 ,,,,
3 Hr GTT.,$125.00 ,,,,
3.0 GUIDE ROD W/SMOOTH TIP STERILE,$762.75 ,,,,
3.0MM X 64MM XOMED BUR,$228.75 ,,,,
3.5mm GREAT WHITE SHAVER,$181.00 ,,,,
30 DEG. ROUND 0.9mm TAPERED TIP,$217.26 ,,,,
31722-0713-90 - pantoprazole 40 mg DR,,,,,$10.90 
31722-0726-30 - montelukast 10 mg Tab,,,,,$11.70 
31722-0778-01 - acyclovir 800 mg Tab,,,,,$10.95 
32554 THORACENT NDLE/CATH W/O IMAG ED CHARGE,"$1,004.75 ",,,,
36000-0002-06 - fluconazole 200 mg/100 mL-0.9% Sol,,,,,$15.75 
36000-0009-24 - ciprofloxacin 400 mg/200 mL-5% Sol,,,,,$15.75 
36000-0033-10 - metoprolol 1 mg/mL Sol,,,,,$17.00 
36000-0283-25 - furosemide 10 mg/mL Sol,,,,,$22.40 
37 Cm Ligasure Maryland,"$1,290.50 ",,,,
37000-0023-04 - psyllium 3.4 g/11 g Oral Pwdr [UBMC],,,,,$4.25 
39822-0127-06 - piperacillin-tazobactam 4 g-0.5 g REC,,,,,$40.55 
39822-0190-01 - acetaZOLAMIDE 500 mg REC [UBMC],,,,,$103.10 
39822-0710-01 - fomepizole 1 g/mL IV Sol [UBMC],,,,,"$1,714.35 "
39822-1055-05 - amphotericin B 50 mg REC [UBMC],,,,,$94.40 
39822-4000-01 - levETIRAcetam 100 mg/mL Sol,,,,,$23.65 
39822-4200-02 - rocuronium 10 mg/mL Sol,,,,,$17.20 
39822-5500-02 - promethazine 25 mg/mL Inj Sol [UBMC],,,,,$19.70 
39822-5500-05 - promethazine 50 mg/mL Soln,,,,,$18.85 
39822-5525-03 - promethazine 25 mg/mL Sol,,,,,$20.95 
4 Hr GTT,$125.00 ,,,,
4.0 mm AGGRESSIVE DEBRIDER ANGLED,$219.00 ,,,,
4.0 mm AGGRESSIVE SERRATED DEBRIDER,$374.25 ,,,,
4.2mm GREAT WHITE SHAVER,$181.00 ,,,,
405 POPLOK SUTURE ANCHOR,"$1,301.50 ",,,,
42023-0105-01 - methohexital 500 mg REC,,,,,$153.85 
42023-0112-01 - estradiol valerate 40 mg/mL IM Sol [UBMC],,,,,$154.15 
42023-0114-10 - ketamine 50 mg/mL Sol,,,,,$14.85 
42023-0116-01 - oxytocin 10 units/mL Sol,,,,,$20.15 
42023-0116-02 - oxytocin 10 intl units/mL Inj Sol [UBMC],,,,,$22.45 
42023-0116-25 - oxytocin 10 intl units/mL Inj Sol [UBMC],,,,,$17.60 
42023-0117-25 - vasopressin 20 units/mL Sol,,,,,$16.05 
42023-0123-06 - dantrolene 20 mg REC,,,,,$220.20 
42023-0138-10 - ketamine 50 mg/mL Sol,,,,,$12.25 
42023-0140-25 - oxytocin 10 units/mL Sol,,,,,$17.80 
42023-0159-25 - EPINEPHrine 1 mg/mL Sol,,,,,$46.70 
42023-0163-01 - zoledronic acid 5 mg/100 mL Sol,,,,,$27.90 
42023-0164-25 - vasopressin 20 units/mL Sol,,,,,$325.70 
42023-0168-01 - EPINEPHrine 1 mg/mL Sol,,,,,$25.20 
42023-0192-10 - meropenem 1000 mg REC,,,,,$39.00 
42192-0605-10 - tranexamic acid 100 mg/mL Sol,,,,,$26.15 
42291-0621-30 - montelukast 10 mg Tab,,,,,$11.70 
42292-0010-16 - esomeprazole 40 mg ER,,,,,$17.85 
42292-0018-20 - clindamycin 150 mg Cap,,,,,$4.50 
42702-0102-15 - phenylephrine ophthalmic 2.5% Sol,,,,,$14.90 
42858-0302-25 - HYDROmorphone 4 mg Tab,,,,,$7.60 
42937-0701-10 - phenazopyridine 100 mg Tab,,,,,$4.50 
43386-0060-19 - polyethylene glycol 3350 with electrolytes - REC,,,,,$1.25 
43386-0090-19 - polyethylene glycol 3350 with electrolytes - REC,,,,,$1.25 
43386-0140-01 - methylergonovine 0.2 mg Tab,,,,,$15.15 
43386-0140-12 - methylergonovine 0.2 mg Tab,,,,,$131.75 
43386-0140-28 - methylergonovine 0.2 mg Tab,,,,,$56.10 
43386-0440-24 - NIFEdipine 10 mg Cap [UBMC],,,,,$4.35 
43547-0269-10 - rOPINIRole 0.5 mg Tab,,,,,$6.50 
43547-0352-10 - lisinopril 5 mg Tab,,,,,$4.55 
43547-0368-09 - valsartan 80 mg Tab,,,,,$12.15 
43598-0004-51 - amox-clav 250 mg-62.5 mg/5 mL Liq 75 mL [UBMC],,,,,$20.25 
43598-0204-51 - amoxicillin-clavulanate 250 mg-62.5 mg/5 mL REC,,,,,$4.95 
43598-0210-40 - silver sulfADIAZINE topical 1% Cre,,,,,$2.35 
43598-0210-55 - silver sulfADIAZINE topical 1% Cre,,,,,$2.85 
43598-0446-74 - nicotine 7 mg/24 hr ER,,,,,$5.55 
43598-0447-74 - nicotine 14 mg/24 hr ER,,,,,$5.55 
43598-0448-74 - nicotine 21 mg/24 hr ER,,,,,$5.55 
43598-0510-30 - esomeprazole 40 mg ER,,,,,$18.70 
43825-0102-01 - acetaminophen 10 mg/mL Sol,,,,,$19.65 
44206-0251-05 - albumin human 25% IV Sol 50 mL [UBMC],,,,,$18.45 
44206-0300-10 - RHo (D) immune globln 150 mcg/mL Inj Sol [UBMC],,,,,$188.65 
44206-0436-05 - immune globulin intravenous 10% Sol,,,,,$34.65 
44206-0437-10 - immune globulin intravenous 10% Sol,,,,,$34.65 
44206-0438-20 - immune globulin intravenous 10% Sol,,,,,$34.65 
44206-0439-40 - immune globulin intravenous 10% Sol,,,,,$34.65 
44567-0211-10 - ampicillin-sulbactam 2 g-1 g REC,,,,,$49.75 
44567-0240-10 - cefepime 1 g REC,,,,,$21.40 
44567-0246-25 - cefOXitin 2 g REC,,,,,$37.45 
"44567-0311-10 - penicillin G potassium 5,000,000 units REC",,,,,$76.90 
44567-0701-25 - cefTRIAXone 1 g REC,,,,,$18.95 
44567-0707-25 - ceFAZolin 1 g REC,,,,,$25.20 
45802-0059-35 - nystatin topical 100000 units/g Cre,,,,,$4.60 
45802-0060-70 - bacitracin Top 500 units/g Oint TOPICAL [UBMC],,,,,$2.35 
45802-0061-70 - bacitracin/neomycin/polymyxin B topical 400 units-3.5 mg-5000 units/g Oin,,,,,$2.65 
45802-0112-22 - mupirocin Top 2% Oint [UBMC],,,,,$3.50 
45802-0210-02 - nitroglycerin 0.4 mg Spr,,,,,$57.80 
45802-0434-01 - clotrimazole topical 1% Cream 15g [UBMC],,,,,$3.40 
45802-0438-03 - hydrocortisone topical 1% Cre,,,,,$2.10 
45802-0730-30 - acetaminophen 650 mg Sup,,,,,$4.20 
45802-0732-00 - acetaminophen 120 mg Supp [UBMC],,,,,$3.65 
45802-0732-30 - acetaminophen 120 mg Supp [UBMC],,,,,$4.00 
45802-0759-00 - promethazine 25 mg Supp [UBMC],,,,,$12.95 
45802-0759-30 - promethazine 25 mg Supp [UBMC],,,,,$36.65 
46017-0018-16 - caffeine 200 mg Tab,,,,,$2.55 
46287-0006-60 - sodium polystyrene sulfonate 15 g/60 mL Oral Susp [UBMC],,,,,$2.20 
47335-0154-40 - gemcitabine 1 g REC,,,,,"$1,258.30 "
47335-0330-40 - chlorothiazide 0.5 g REC,,,,,$682.10 
47335-0361-41 - decitabine 50 mg REC,,,,,"$3,617.75 "
47335-0509-44 - esomeprazole 40 mg REC,,,,,$86.70 
47335-0903-88 - QUEtiapine 50 mg Tab,,,,,$13.60 
47335-0924-83 - lansoprazole 30 mg ER,,,,,$12.20 
47781-0297-03 - nitroglycerin 0.2 mg/hr Transderm Patch [UBMC],,,,,$6.75 
47781-0298-03 - nitroglycerin 0.4 mg/hr Transderm Patch [UBMC],,,,,$7.55 
47781-0384-26 - oseltamivir 6 mg/mL REC,,,,,$7.10 
47781-0584-68 - ketorolac 30 mg/mL Sol,,,,,$21.40 
47781-0586-29 - labetalol 5 mg/mL Sol,,,,,$16.05 
47781-0597-91 - vancomycin 1 g REC,,,,,$22.50 
47781-0598-91 - vancomycin 500 mg REC,,,,,$18.95 
47781-0729-02 - vancomycin 125 mg Cap,,,,,$64.80 
47781-0730-02 - vancomycin 250 mg Cap,,,,,$113.10 
48 Hour Holter Monitor,$447.25 ,,,,
48 Hour Holter Monitor,$447.25 ,,,,
48102-0007-35 - bacitracin OPHTH 500 units/g  OPHTH [UBMC],,,,,$51.50 
"49281-0011-50 - influenza virus vaccine, inactivated preservative-free Sus[UBMC]",,,,,$64.55 
"49281-0190-20 - rabies immune globulin, human 150 intl units/mL Sol [UBMC]",,,,,$849.70 
49281-0215-15 - tetanus-diphth toxoids (Td) adult/adol 5 units-2units/0.5 mL Sus,,,,,$301.30 
49281-0291-10 - tetanus-diphtheria toxoids adult IM Susp [UBMC],,,,,$121.15 
49281-0388-15 - Influenza Virus Vaccine Fluzone for 6 months of age and older 5 ml [UBMC],,,,,$87.40 
"49281-0389-65 - influenza virus vaccine, inactivated high-dInfluenza Virus Vaccine High-Dose for 65 years of age and older .5 ml syringe [UBMC]",,,,,$156.85 
"49281-0392-15 - influenza virus vaccine, inactivated - Susp",,,,,$66.05 
"49281-0393-65 - influenza virus vaccine, inactivated high-dose preservative-fr Susp",,,,,$138.70 
"49281-0393-88 - influenza virus vaccine, inactivated high-dose preservative-fr Susp",,,,,$137.25 
"49281-0395-65 - influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus",,,,,$145.45 
"49281-0400-10 - tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2 units-15.5 mcg/0.5 mL IM Susp [UBMC]",,,,,$213.85 
"49281-0400-15 - tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2 units-15.5 mcg/0.5 mL IM Susp [UBMC]",,,,,$213.85 
"49281-0401-65 - influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus",,,,,$213.65 
"49281-0403-65 - influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus",,,,,$213.65 
"49281-0413-50 - influenza virus vaccine, inactivated - Susp",,,,,$84.60 
49281-0752-22 - tuberculin derivative 5 TU/0.1 mL ID Sol [UBMC],,,,,$142.20 
49348-0260-45 - Therapeutic Multiple Vitamins with Minerals Tab [UBMC],,,,,$1.70 
49348-0616-10 - docusate sodium 100 mg Cap [UBMC],,,,,$2.55 
49348-0797-34 - acetaminophen 160 mg/5 mL Oral Susp [UBMC],,,,,$2.15 
49348-0804-38 - mineral oil 100% Liq,,,,,$1.25 
49348-0818-44 - loratadine 10 mg Tab,,,,,$3.10 
49502-0102-02 - EPINEPHrine 0.3 mg Kit,,,,,$367.50 
49502-0500-01 - epinephrine 0.3 mg Inj kit [UBMC],,,,,$204.90 
49502-0500-02 - epinephrine 0.3 mg Inj kit [UBMC],,,,,$715.70 
49502-0501-01 - epinephrine 0.15 mg Inj kit [UBMC],,,,,$204.90 
49502-0501-02 - epinephrine 0.15 mg Inj kit [UBMC],,,,,$715.70 
49580-0300-02 - hydrogen peroxide Top 3% Sol [UBMC],,,,,$1.25 
49643-0138-01 - candida albicans extract ID Sol 1 mL [UBMC],,,,,$295.60 
49730-0111-30 - nitroglycerin 0.2 mg/hr ER,,,,,$4.35 
49884-0465-65 - cholestyramine 4 g/9 g REC UD[UBMC],,,,,$8.75 
49884-0600-40 - silver sulfADIAZINE Top 1% Crm 400 G [UBMC],,,,,$1.95 
5 Hr GTT.,$125.00 ,,,,
5 MM RIGHT ANGLE ELECTROSURGERY PROBE,$588.00 ,,,,
5' Nucleotidase ARUP,$63.00 ,,,,
5.0 MM SUTURE ANCHOR W/3 HI-FI #2 SUT W/ NEEDLE,$957.50 ,,,,
50111-0467-01 - propranolol 10 mg Tab,,,,,$3.45 
50111-0648-01 - FLUoxetine 20 mg Cap,,,,,$6.95 
50111-0787-51 - azithromycin 250 mg Tab,,,,,$16.10 
"50111-0990-01 - ergocalciferol 50,000 intl units Cap [UBMC]",,,,,$4.40 
50242-0038-61 - tenecteplase 50 mg IV Inj [UBMC],,,,,"$6,919.30 "
50242-0041-63 - alteplase 2 mg REC [UBMC],,,,,$180.80 
50242-0041-64 - alteplase 2 mg REC [UBMC],,,,,$320.05 
50242-0051-21 - riTUXimab 10 mg/mL Sol,,,,,$207.45 
50242-0053-06 - riTUXimab 10 mg/mL Sol,,,,,$207.45 
50242-0061-01 - bevacizumab 25 mg/mL Sol [UBMC],,,,,$388.45 
50242-0085-27 - alteplase 100 mg REC [UBMC],,,,,"$19,510.25 "
50242-0120-01 - tenecteplase 50 mg IV Inj [UBMC],,,,,"$12,648.70 "
50242-0132-01 - trastuzumab 150 mg REC,,,,,"$3,354.35 "
50242-0134-68 - trastuzumab 440 mg IV kit [UBMC],,,,,"$9,839.40 "
50242-0150-01 - ocrelizumab 300 mg/10 mL Sol,,,,,"$3,822.00 "
50268-0098-15 - azithromycin 250 mg Tab,,,,,$15.30 
50268-0099-13 - azithromycin 500 mg Tab,,,,,$39.30 
50268-0100-15 - azithromycin 250 mg Tab,,,,,$15.30 
50268-0152-15 - cephalexin 500 mg Cap,,,,,$4.80 
50268-0408-15 - acetaminophen-HYDROcodone 325 mg-10 mg Tab,,,,,$9.90 
50268-0575-15 - montelukast 10 mg Tab,,,,,$12.95 
50268-0597-15 - NIFEdipine 30 mg ER,,,,,$4.45 
50289-3250-01 - witch hazel-glycerin Top 10%-50% Pad [UBMC],,,,,$1.35 
50383-0040-04 - prednisoLONE sod phos 5 mg/5 mL Oral Liq [UBMC],,,,,$4.30 
50383-0063-07 - guaiFENesin 100 mg/5 mL Liq,,,,,$2.40 
50383-0079-16 - acetaminophen-codeine 120 mg-12 mg/5 mL Liq,,,,,$5.25 
50383-0700-16 - fluticasone nasal 50 mcg/inh Spr,,,,,$16.50 
50383-0741-20 - albuterol 0.5% Inh Sol [UBMC],,,,,$5.20 
50383-0771-11 - docusate 10 mg/mL Liq,,,,,$1.50 
50383-0775-04 - lidocaine Top 2% Vis Sol 100 mL [UBMC],,,,,$1.95 
50383-0775-17 - lidocaine topical 2% Sol,,,,,$1.60 
50383-0779-31 - lactulose 10 g/15 mL Syr,,,,,$2.20 
50383-0781-30 - lidocaine topical 2% Gel,,,,,$3.80 
50383-0801-16 - promethazine 6.25 mg/5 mL Oral Syrup [UBMC],,,,,$2.00 
50383-0801-16 - promethazine 6.25 mg/5 mL Syr home pack[UBMC],,,,,$2.00 
50383-0810-16 - acyclovir 200 mg/5 mL Sus[UBMC],,,,,$4.50 
50383-0823-16 - SMZ-TMP 200 mg-40 mg/5 mL Oral Sus 473mL [UBMC],,,,,$3.85 
50419-0452-01 - estradiol 0.1 mg/24hr  Transderm Patch [UBMC],,,,,$39.15 
50419-0452-04 - estradiol 0.1 mg/24hr  Transderm Patch [UBMC],,,,,$70.95 
50458-0166-01 - levofloxacin 750 mg/150 mL IV Sol [UBMC],,,,,$16.90 
50458-0168-01 - levofloxacin 500 mg/100 mL IV Sol [UBMC],,,,,$19.10 
50458-0255-01 - haloperidol 5 mg/mL Inj Sol [UBMC],,,,,$64.40 
50458-0320-01 - risperidone 2 mg Tab [UBMC],,,,,$40.85 
50458-0580-10 - rivaroxaban 10 mg Tab,,,,,$32.15 
50458-0920-10 - levofloxacin 250 mg Tab [UBMC],,,,,$65.10 
50458-0925-10 - Levofloxacin 500 mg  Tab [UBMC],,,,,$70.65 
50474-0910-01 - acetaminophen-HYDROcodone 500 mg-10 mg Tab,,,,,$14.70 
50580-0600-02 - acetaminophen 325 mg Tab,,,,,$3.75 
50633-0110-12 - antivenin (Crotalidae) polyvalent - Sol,,,,,"$6,045.80 "
50633-0120-11 - digoxin immune FAB 40 mg REC,,,,,"$7,397.05 "
50742-0616-01 - metoprolol 50 mg ER,,,,,$4.35 
51079-0024-20 - metolazone 5 mg Tab,,,,,$9.70 
51079-0035-01 - Levofloxacin 500 mg  Tab [UBMC],,,,,$44.35 
51079-0035-20 - Levofloxacin 500 mg  Tab [UBMC],,,,,$39.90 
51079-0051-20 - pantoprazole 40 mg DR,,,,,$10.90 
51079-0058-20 - chlorthalidone 25 mg Tab,,,,,$5.95 
51079-0067-20 - diphenoxylate-atropine 2.5mg-0.025mg Tab [UBMC],,,,,$6.60 
51079-0073-01 - furosemide 40 mg Tab,,,,,$1.95 
51079-0073-19 - furosemide 40 mg Tab,,,,,$2.25 
51079-0073-20 - furosemide 40 mg Tab,,,,,$1.95 
51079-0077-01 - hydrOXYzine pamoate 25 mg Cap [UBMC],,,,,$2.85 
51079-0077-20 - hydrOXYzine pamoate 25 mg Cap [UBMC],,,,,$2.85 
51079-0090-01 - meclizine 25 mg Tab UD [UBMC},,,,,$4.50 
51079-0090-20 - meclizine 25 mg Tab UD [UBMC},,,,,$4.55 
51079-0103-01 - spironolactone 25 mg Tab UD [UBMC],,,,,$3.60 
51079-0103-20 - spironolactone 25 mg Tab UD [UBMC],,,,,$3.60 
51079-0105-20 - folic acid 1 mg Tab,,,,,$3.05 
51079-0107-01 - amitriptyline 25 mg Tab,,,,,$3.10 
51079-0119-01 - dicyclomine 20 mg Tab [UBMC],,,,,$2.95 
51079-0119-20 - dicyclomine 20 mg Tab [UBMC],,,,,$4.10 
51079-0121-01 - lansoprazole 30 mg Oral EC Cap [UBMC],,,,,$11.70 
51079-0121-08 - lansoprazole 30 mg Oral EC Cap [UBMC],,,,,$11.70 
51079-0126-01 - metronidazole 500 mg Tab [UBMC],,,,,$4.35 
51079-0126-20 - metronidazole 500 mg Tab [UBMC],,,,,$4.35 
51079-0141-01 - chlordiazepoxide 25 mg Cap [UBMC],,,,,$5.30 
51079-0141-20 - chlordiazepoxide 25 mg Cap [UBMC],,,,,$7.10 
51079-0145-01 - benazepril 10 mg Tab [UBMC],,,,,$4.55 
51079-0145-20 - benazepril 10 mg Tab [UBMC],,,,,$4.55 
51079-0161-20 - acetaminophen-codeine 300 mg-30 mg Tab,,,,,$5.25 
51079-0182-01 - ciprofloxacin 500 mg Tab,,,,,$10.55 
51079-0190-01 - indomethacin 25 mg Cap [UBMC],,,,,$3.40 
51079-0190-20 - indomethacin 25 mg Cap [UBMC],,,,,$3.40 
51079-0198-03 - tolterodine 4 mg ER,,,,,$25.10 
51079-0199-20 - celecoxib 100 mg Cap,,,,,$12.00 
51079-0205-20 - allopurinol 100 mg Tab,,,,,$3.20 
51079-0208-20 - atorvastatin 10 mg Tab,,,,,$3.10 
51079-0210-20 - atorvastatin 40 mg Tab,,,,,$3.70 
51079-0217-01 - metronidazole 500 mg Tab,,,,,$4.35 
51079-0217-20 - metroNIDAZOLE 500 mg Tab,,,,,$4.35 
51079-0254-01 - hydrocodone-APAP 10 mg-500 mg Tab [UBMC],,,,,$8.30 
51079-0254-21 - acetaminophen-hydrocodone 500 mg-10 mg Tab UD home pack [UBMC],,,,,$8.30 
51079-0254-21 - hydrocodone-APAP 10 mg-500 mg Tab [UBMC],,,,,$8.30 
51079-0285-01 - diazepam 5 mg Tab [UBMC],,,,,$5.25 
51079-0285-20 - diazepam 5 mg Tab [UBMC],,,,,$5.25 
51079-0285-20 - diazepam 5 mg Tab UD home pack [UBMC],,,,,$5.25 
51079-0294-01 - Tamsulosin HCL Cap 0.4 mg [UBMC],,,,,$10.95 
51079-0294-20 - Tamsulosin HCL Cap 0.4 mg [UBMC],,,,,$10.95 
51079-0299-01 - clonidine 0.1 mg Tab [UBMC],,,,,$2.50 
51079-0299-20 - clonidine 0.1 mg Tab [UBMC],,,,,$2.50 
51079-0306-01 - polyethylene glycol 3350 Oral Powder [UBMC],,,,,$2.30 
51079-0306-30 - polyethylene glycol 3350 Oral Powder [UBMC],,,,,$4.90 
51079-0348-01 - nitrofurantoin macrocrystals 100 mg Cap [UBMC],,,,,$8.35 
51079-0348-20 - nitrofurantoin macrocrystals 100 mg Cap [UBMC],,,,,$10.55 
51079-0348-20 - nitrofurantoin macrocrystals-monohydrate 100 mg Cap UD home pack[UBMC],,,,,$8.35 
51079-0385-01 - carbamazepine 200 mg Tab,,,,,$3.00 
51079-0386-01 - lorazepam 1 mg Tab [UBMC],,,,,$9.60 
51079-0386-20 - lorazepam 1 mg Tab [UBMC],,,,,$9.60 
51079-0386-20 - lorazepam 1 mg Tab UD home pack[UBMC],,,,,$9.60 
51079-0406-01 - benztropine 1 mg Tab UD [UBMC],,,,,$2.75 
51079-0406-20 - benztropine 1 mg Tab UD [UBMC],,,,,$2.75 
51079-0406-20 - Benztropine Mesylate 1 mg tab [UBMC],,,,,$2.75 
51079-0418-01 - temazepam 15 mg Cap [UBMC],,,,,$7.55 
51079-0418-20 - temazepam 15 mg Cap [UBMC],,,,,$7.55 
51079-0426-01 - glimepiride 4 mg Tab,,,,,$4.80 
51079-0426-20 - glimepiride 4 mg Tab [UBMC],,,,,$4.85 
51079-0433-20 - hydrochlorothiazide-triamterene 50 mg-75 mg Tab UD[UBMC],,,,,$4.35 
51079-0440-01 - levothyroxine 50 mcg (0.05 mg) Tab [UBMC],,,,,$2.85 
51079-0440-20 - levothyroxine 50 mcg (0.05 mg) Tab [UBMC],,,,,$3.75 
51079-0442-01 - levothyroxine 100 mcg (0.1 mg) Tab [UBMC],,,,,$3.20 
51079-0442-20 - levothyroxine 100 mcg (0.1 mg) Tab [UBMC],,,,,$3.95 
51079-0451-01 - amlodipine 5 mg Tab [UBMC],,,,,$4.50 
51079-0451-20 - amlodipine 5 mg Tab [UBMC],,,,,$4.50 
51079-0454-01 - simvastatin 10 mg Tab,,,,,$7.25 
51079-0454-20 - simvastatin 10 mg Tab,,,,,$7.25 
51079-0455-20 - simvastatin 20 mg Tab,,,,,$12.80 
51079-0462-01 - risperidone 1 mg Tab [UBMC],,,,,$11.80 
51079-0462-20 - risperidone 1 mg Tab [UBMC],,,,,$11.80 
51079-0475-08 - divalproex sodium 500 mg EC,,,,,$9.35 
51079-0511-20 - meclizine 25 mg Tab,,,,,$4.55 
51079-0541-01 - prochlorperazine 5 mg Tab [UBMC],,,,,$3.90 
51079-0541-20 - prochlorperazine 5 mg Tab [UBMC],,,,,$3.90 
51079-0543-20 - escitalopram 10 mg Tab,,,,,$2.85 
51079-0557-01 - clopidogrel 75 mg Tab,,,,,$1.80 
51079-0597-01 - cetirizine 10 mg Tab [UBMC],,,,,$6.50 
51079-0597-20 - cetirizine 10 mg Tab [UBMC],,,,,$6.50 
51079-0598-01 - clindamycin 150 mg Cap [UBMC],,,,,$4.50 
51079-0598-20 - clindamycin 150 mg Cap [UBMC],,,,,$4.50 
51079-0598-20 - clindamycin 150 mg Cap UD home pack [UBMC],,,,,$4.50 
51079-0624-85 - mafenide topical 5% REC [UBMC],,,,,$456.80 
51079-0628-01 - oxybutynin 5 mg Tab UD [UBMC],,,,,$3.75 
51079-0628-20 - oxybutynin 5 mg Tab UD [UBMC],,,,,$3.75 
51079-0629-01 - metoclopramide 5 mg Tab [UBMC],,,,,$3.40 
51079-0629-20 - metoclopramide 5 mg Tab [UBMC],,,,,$3.40 
51079-0644-01 - cyclobenzaprine 10 mg Tab [UBMC],,,,,$4.65 
51079-0644-20 - cyclobenzaprine 10 mg Tab [UBMC],,,,,$4.60 
51079-0684-01 - atenolol 50 mg Tab [UBMC],,,,,$4.70 
51079-0684-20 - atenolol 50 mg Tab [UBMC],,,,,$4.70 
51079-0690-01 - loperamide 2 mg Cap [UBMC],,,,,$4.45 
51079-0690-20 - loperamide 2 mg Cap [UBMC],,,,,$4.60 
51079-0725-01 - zolpidem 10 mg Tab [UBMC],,,,,$12.00 
51079-0725-20 - zolpidem 10 mg Tab [UBMC],,,,,$12.00 
51079-0734-01 - haloperidol 1 mg Tab [UBMC],,,,,$3.00 
51079-0763-01 - sertraline 50 mg Tab [UBMC],,,,,$7.40 
51079-0763-20 - sertraline 50 mg Tab [UBMC],,,,,$7.40 
51079-0774-01 - paroxetine 20 mg Tab UD [UBMC],,,,,$7.10 
51079-0774-20 - paroxetine 20 mg Tab UD [UBMC],,,,,$7.10 
51079-0795-01 - naproxen 500 mg Tab [UBMC],,,,,$4.55 
51079-0795-20 - naproxen 500 mg Tab [UBMC],,,,,$4.55 
51079-0801-01 - metoprolol 50 mg Tab [UBMC],,,,,$3.90 
51079-0801-20 - metoprolol 50 mg Tab [UBMC],,,,,$3.90 
51079-0806-20 - hydrOXYzine hydrochloride 25 mg Tab,,,,,$4.35 
51079-0810-01 - glipiZIDE 5 mg Tab [UBMC],,,,,$3.15 
51079-0810-20 - glipiZIDE 5 mg Tab [UBMC],,,,,$3.15 
51079-0873-01 - glyBURIDE 5 mg Tab [UBMC],,,,,$3.60 
51079-0873-20 - glyBURIDE 5 mg Tab [UBMC],,,,,$3.60 
51079-0879-01 - ranitidine 150 mg Tab [UBMC],,,,,$4.10 
51079-0879-20 - ranitidine 150 mg Tab [UBMC],,,,,$4.10 
51079-0882-01 - clonazepam 1 mg Tab [UBMC],,,,,$4.75 
51079-0882-20 - clonazepam 1 mg Tab [UBMC],,,,,$4.75 
51079-0882-20 - clonazepam 1 mg Tab UD home pack[UBMC],,,,,$4.75 
51079-0892-01 - bumetanide 1 mg Tab UD [UBMC],,,,,$3.45 
51079-0892-20 - bumetanide 1 mg Tab UD [UBMC],,,,,$3.45 
51079-0894-20 - verapamil 120 mg/12 hours ER,,,,,$6.00 
51079-0895-01 - promethazine 25 mg Tab UD [UBMC],,,,,$3.60 
51079-0895-20 - promethazine 25 mg Tab home pack[UBMC],,,,,$3.60 
51079-0895-20 - promethazine 25 mg Tab UD [UBMC],,,,,$3.60 
51079-0905-20 - phenytoin 100 mg ER,,,,,$4.30 
51079-0923-01 - carbidopa-levodopa 50 mg-200 mg ER  UD [UBMC],,,,,$4.55 
51079-0923-20 - carbidopa-levodopa 50 mg-200 mg ER  UD [UBMC],,,,,$4.55 
51079-0928-01 - labetalol 100 mg Tab [UBMC],,,,,$3.80 
51079-0928-20 - labetalol 100 mg Tab [UBMC],,,,,$3.90 
51079-0930-01 - carvedilol 6.25 mg Tab UD[UBMC],,,,,$5.55 
51079-0930-20 - carvedilol 6.25 mg Tab UD[UBMC],,,,,$5.55 
51079-0932-01 - carvedilol 25 mg Tab [UBMC],,,,,$5.55 
51079-0932-20 - carvedilol 25 mg Tab [UBMC],,,,,$5.55 
51079-0935-01 - hydrochlorothiazide-triamterene 25 mg-37.5 mg Cap [UBMC],,,,,$3.80 
51079-0935-20 - hydrochlorothiazide-triamterene 25 mg-37.5 mg Cap [UBMC],,,,,$3.80 
51079-0938-01 - terazosin 5 mg Cap [UBMC],,,,,$4.15 
51079-0938-20 - terazosin 5 mg Cap [UBMC],,,,,$4.15 
51079-0940-01 - NIFEdipine 30 mg ER Tab [UBMC],,,,,$4.50 
51079-0940-20 - NIFEdipine 30 mg ER Tab [UBMC],,,,,$4.50 
51079-0952-01 - enalapril 10 mg Tab [UBMC],,,,,$4.20 
51079-0952-20 - enalapril 10 mg Tab [UBMC],,,,,$5.05 
51079-0959-01 - doxazosin 4 mg Tab,,,,,$4.60 
51079-0959-20 - doxazosin 4 mg Tab,,,,,$10.25 
51079-0966-20 - famotidine 20 mg Tab,,,,,$4.50 
51079-0971-01 - fluoxetine 20 mg Cap [UBMC],,,,,$6.95 
51079-0971-20 - fluoxetine 20 mg Cap [UBMC],,,,,$6.95 
51079-0972-01 - metformin 500 mg Tab [UBMC],,,,,$4.45 
51079-0972-20 - metformin 500 mg Tab [UBMC],,,,,$4.45 
51079-0973-01 - metformin 850 mg Tab [UBMC],,,,,$4.70 
51079-0973-20 - metformin 850 mg Tab [UBMC],,,,,$4.70 
51079-0981-01 - lisinopril 5 mg Tab [UBMC],,,,,$4.65 
51079-0982-01 - lisinopril 10 mg Tab [UBMC],,,,,$4.50 
51079-0982-20 - lisinopril 10 mg Tab [UBMC],,,,,$4.50 
51079-0983-01 - lisinopril 20 mg Tab,,,,,$3.95 
51079-0989-01 - nabumetone 500 mg Tab [UBMC],,,,,$4.35 
51079-0989-20 - nabumetone 500 mg Tab [UBMC],,,,,$4.35 
51079-0991-01 - traMADOL 50 mg [UBMC],,,,,$4.60 
51079-0991-20 - traMADOL 50 mg [UBMC],,,,,$4.60 
51079-0996-01 - propafenone 150 mg Tab UD[UBMC],,,,,$4.40 
51079-0996-20 - propafenone 150 mg Tab UD[UBMC],,,,,$4.40 
51079-7088-01 - alprazolam 0.25 mg Tab [UBMC],,,,,$7.20 
51285-0942-88 - levonorgestrel 1.5 mg Tab [UBMC],,,,,$79.60 
51293-0801-01 - phenazopyridine 100 mg Tab,,,,,$7.00 
51552-0106-09 - lidocaine - compounding[UBMC],,,,,$13.45 
51645-0785-08 - magnesium oxide 400 mg Tab,,,,,$1.40 
"51672-1289-01 - nystatin Top 100,000 units/g Crm [UBMC]",,,,,$4.60 
51672-1312-00 - mupirocin topical 2% Oin,,,,,$4.45 
51672-1312-01 - mupirocin topical 2% Oin,,,,,$4.45 
51672-2030-05 - oxymetazoline nasal 0.05% Spr [UBMC],,,,,$3.20 
51672-2089-02 - diphenhydrAMINE-zinc acet Top2%-0.1% Crm [UBMC],,,,,$1.95 
51672-4005-01 - carBAMazepine 200 mg Tab,,,,,$4.15 
51754-0203-02 - verapamil 2.5 mg/mL Sol,,,,,$50.15 
51754-2001-04 - potassium acetate 2 mEq/mL Sol,,,,,$13.75 
51862-0185-01 - morphine 15 mg/8 hr ER,,,,,$10.60 
51862-0186-01 - morphine 30 mg/8 hr ER,,,,,$20.10 
51991-0941-17 - vancomycin 1 g REC,,,,,$23.45 
51991-0943-33 - moxifloxacin 400 mg Tab,,,,,$56.35 
52268-0100-01 - polyethylene glycol 3350 with electrolytes - REC,,,,,$1.25 
52533-0024-75 - fentanyl 10 mcg/mL Soln,,,,,$20.00 
52533-0203-37 - promethazine 12.5 mg / 50 mL Soln,,,,,$15.75 
52533-0272-60 - lidocaine/epi/tetracaine topical solutio 3 mL Gel,,,,,$13.00 
52544-0931-02 - iron dextran 50 mg/mL Inj Sol IV/IM [UBMC],,,,,$37.55 
52544-0931-02 - iron dextran 50 mg/mL Sol,,,,,$39.40 
52544-0931-07 - iron dextran 50 mg/mL Inj Sol IV/IM [UBMC],,,,,$37.55 
53489-0141-01 - quinidine 324 mg ER [UBMC],,,,,$18.75 
54288-0103-10 - EPINEPHrine 1 mg/mL Sol,,,,,$45.50 
54643-5649-01 - Multiple Vitamins IV Sol 10 mL [UBMC],,,,,$21.15 
54643-5649-09 - Multiple Vitamins IV Sol 10 mL [UBMC],,,,,$19.15 
54799-0507-21 - fluorescein-proparacaine ophthalmic 0.25%-0.5% Sol,,,,,$18.30 
54799-0508-05 - benoxinate-fluorescein ophthalmic 0.4%-0.25% Sol,,,,,$31.65 
55111-0154-13 - Ondansetron HCL 8 mg tab [UBMC],,,,,$80.90 
55111-0164-30 - OLANZapine 5 mg Tab,,,,,$4.60 
55111-0556-10 - decitabine 50 mg REC,,,,,"$3,823.05 "
55111-0688-52 - zoledronic acid 5 mg/100 mL Sol [UBMC],,,,,$26.10 
55111-0725-30 - montelukast 10 mg Tab,,,,,$3.50 
55150-0111-10 - ampicillin 250 mg REC,,,,,$20.95 
55150-0112-10 - ampicillin 500 mg REC,,,,,$22.00 
55150-0113-10 - ampicillin 1 g REC,,,,,$25.70 
55150-0114-20 - ampicillin 2 g REC,,,,,$41.40 
55150-0116-20 - ampicillin-sulbactam 1 g-0.5 g REC,,,,,$24.20 
55150-0117-20 - ampicillin-sulbactam 2 g-1 g REC,,,,,$37.95 
55150-0120-30 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$56.55 
55150-0121-50 - piperacillin-tazobactam 4 g-0.5 g REC,,,,,$71.65 
55150-0122-15 - nafcillin 1 g REC,,,,,$37.70 
55150-0123-15 - nafcillin 2 g REC,,,,,$73.50 
55150-0125-02 - ondansetron 2 mg/mL Sol,,,,,$19.10 
55150-0126-20 - ondansetron 2 mg/mL Sol,,,,,$19.90 
55150-0154-10 - acyclovir 50 mg/mL Sol,,,,,$20.35 
55150-0168-30 - bupivacaine 0.25% preservative-free Sol,,,,,$15.75 
55150-0173-01 - SUMAtriptan 6 mg/0.5 mL Sol,,,,,$333.20 
55150-0202-10 - pantoprazole 40 mg REC,,,,,$26.60 
55150-0207-20 - meropenem 500 mg REC,,,,,$67.60 
55150-0208-30 - meropenem 1000 mg REC,,,,,$107.65 
55150-0209-02 - dexmedetomidine 100 mcg/mL Sol,,,,,$72.80 
55150-0216-05 - atracurium 10 mg/mL Sol,,,,,$24.15 
55150-0218-99 - eptifibatide 0.75 mg/mL Sol,,,,,$22.05 
55150-0219-10 - eptifibatide 2 mg/mL Sol,,,,,$58.50 
55150-0221-10 - etomidate 2 mg/mL Sol,,,,,$22.45 
55150-0237-01 - dexamethasone 4 mg/mL Sol,,,,,$23.60 
55150-0282-20 - ertapenem 1 g REC,,,,,$310.50 
55390-0003-10 - propranolol 1 mg/mL Sol [UBMC],,,,,$26.50 
55390-0009-01 - leucovorin 10 mg/mL Inj Sol [UBMC],,,,,$15.95 
55390-0011-10 - enalapril 1.25 mg/mL IV Sol [UBMC],,,,,$21.35 
55390-0031-10 - methotrexate 25 mg/mL PF Inj Sol [UBMC],,,,,$20.95 
55390-0039-10 - vecuronium 20 mg IV Inj [UBMC],,,,,$37.45 
55390-0051-10 - leucovorin 50 mg IV Inj [UBMC],,,,,$24.40 
55390-0073-10 - metoprolol 1 mg/mL Sol,,,,,$20.95 
55390-0077-01 - prochlorperazine 5 mg/mL Inj Sol [UBMC],,,,,$17.65 
55390-0101-10 - terbutaline 1 mg/mL Inj Sol [UBMC],,,,,$25.25 
55390-0113-01 - phentolamine 5 mg Inj [UBMC],,,,,$372.60 
55390-0126-10 - midazolam 5 mg/mL Inj Sol **HIGH DOSE** [UBMC],,,,,$20.95 
55390-0129-01 - pamidronate 90 mg IV Inj [UBMC],,,,,$298.10 
55390-0137-05 - midazolam 1 mg/mL PF Inj Sol 5 mL [UBMC],,,,,$20.00 
55390-0375-10 - octreotide 100 mcg/mL Inj Sol [UBMC],,,,,$62.60 
55390-0500-10 - bumetanide 0.25 mg/mL Sol [UBMC],,,,,$14.00 
55390-0612-10 - acyclovir 500 mg IV Inj [UBMC],,,,,$30.05 
55513-0021-01 - darbepoetin alfa 40 mcg/0.4 mL Sol [UBMC],,,,,"$1,161.90 "
55513-0021-04 - darbepoetin alfa 40 mcg/0.4 mL Sol [UBMC],,,,,"$1,317.10 "
55513-0021-04 - darbepoetin alfa 40 mcg/0.4 mL Sol [UBMC],,,,,"$1,820.45 "
55513-0023-01 - darbepoetin alfa 60 mcg/0.3 mL Sol [UBMC],,,,,"$2,323.80 "
55513-0023-04 - darbepoetin alfa 60 mcg/0.3 mL Sol [UBMC],,,,,"$2,634.25 "
55513-0023-04 - darbepoetin alfa 60 mcg/0.3 mL Sol [UBMC],,,,,"$3,640.90 "
55513-0025-01 - darbepoetin alfa 100 mcg/0.5 mL Sol [UBMC],,,,,"$2,323.80 "
55513-0025-04 - darbepoetin alfa 100 mcg/0.5 mL Sol [UBMC],,,,,"$3,640.90 "
55513-0027-01 - darbepoetin alfa 150 mcg/0.3 mL Sol [UBMC],,,,,"$5,809.45 "
55513-0027-04 - darbepoetin alfa 150 mcg/0.3 mL Sol [UBMC],,,,,"$9,102.25 "
55513-0028-01 - darbepoetin alfa 200 mcg/0.4 mL Sol [UBMC],,,,,"$6,585.60 "
55513-0028-01 - darbepoetin alfa 200 mcg/0.4 mL Sol [UBMC],,,,,"$9,102.25 "
55513-0057-01 - darbepoetin alfa 25 mcg/0.42 mL Sol [UBMC],,,,,$708.95 
55513-0057-04 - darbepoetin alfa 25 mcg/0.42 mL Sol [UBMC],,,,,$784.00 
55513-0057-04 - darbepoetin alfa 25 mcg/0.42 mL Sol [UBMC],,,,,"$1,094.85 "
55513-0073-30 - cinacalcet 30 mg Tab,,,,,$66.80 
55513-0111-01 - darbepoetin alfa 300 mcg/0.6 mL Sol [UBMC],,,,,"$9,102.25 "
55513-0190-01 - pegfilgrastim 6 mg/0.6 mL Sol[UBMC],,,,,"$22,239.55 "
55513-0530-10 - filgrastim 300 mcg/mL Sol,,,,,$709.00 
55513-0710-01 - denosumab 60 mg/mL Sol,,,,,"$2,534.40 "
55513-0730-01 - denosumab 120 mg/1.7 mL SQ Inj [UBMC],,,,,"$2,897.10 "
55566-2800-01 - dinoprostone topical 10 mg Ins,,,,,$839.90 
55566-5030-01 - desmopressin 4 mcg/mL Sol,,,,,$146.05 
57237-0019-90 - DULoxetine 60 mg DR,,,,,$16.25 
57237-0077-10 - ondansetron 4 mg DIS,,,,,$46.15 
57664-0116-88 - verapamil 120 mg/12 hours ER,,,,,$4.65 
57664-0185-31 - codeine-promethazine 10 mg-6.25 mg/5 mL Syr,,,,,$5.25 
57664-0185-34 - codeine-promethazine 10 mg-6.25 mg/5 mL Syr,,,,,$5.25 
57664-0223-88 - oxycodone 5 mg Tab [UBMC],,,,,$6.60 
57664-0600-88 - isosorbide dinitrate 40 mg ER Tab [UBMC],,,,,$6.20 
57664-0634-45 - midazolam 5 mg/mL Sol,,,,,$12.85 
57894-0030-01 - infliximab 100 mg REC [UBMC],,,,,"$2,746.70 "
57894-0061-03 - ustekinumab 90 mg/mL Sol,,,,,"$44,746.45 "
58016-0204-00 - cefuroxime 250 mg Tab [UBMC],,,,,$15.50 
58016-0204-00 - cefuroxime 250 mg Tab home pack [UBMC],,,,,$15.50 
58160-0820-11 - hepatitis B pediatric vaccine 10 mcg/0.5 mL Sus[UBMC],,,,,$110.65 
58160-0820-52 - hepatitis B pediatric vaccine 10 mcg/0.5 mL Sus,,,,,$105.55 
"58160-0842-43 - tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2.5 units-18.5 mcg/0.5 mL IM Susp [UBMC]",,,,,$175.35 
"58160-0842-51 - tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2.5 units-18.5 mcg/0.5 mL IM Susp [UBMC]",,,,,$175.35 
"58160-0842-52 - tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2.5 units-18.5 mcg/0.5 mL IM Susp [UBMC]",,,,,$193.40 
"58160-0878-52 - influenza virus vaccine, inactivated preservative-free Sus[UBMC]",,,,,$57.10 
"58160-0901-52 - influenza virus vaccine, inactivated preservative-free quadrivalent Sus",,,,,$79.00 
"58160-0903-52 - influenza virus vaccine, inactivated preservative-free quadrivalent Sus",,,,,$79.10 
"58160-0905-52 - influenza virus vaccine, inactivated preservative-free quadrivalent Sus",,,,,$83.55 
"58160-0907-52 - influenza virus vaccine, inactivated preservative-free quadrivalent Sus",,,,,$83.55 
58468-0021-01 - sevelamer 800 mg Tab [UBMC],,,,,$17.55 
58468-0123-01 - doxercalciferol 2 mcg/mL Inj Sol [UBMC],,,,,$23.45 
58790-0000-32 - ocular lubricant - Sol [UBMC],,,,,$2.60 
58914-0080-52 - dicyclomine 10 mg/mL Inj Sol [UBMC],,,,,$90.90 
59011-0100-20 - oxycodone 10 mg ER Tab [UBMC],,,,,$13.95 
59011-0260-10 - morphine 15 mg/8 hr ER,,,,,$24.85 
59011-0410-20 - oxycodone 10 mg ER Tab [UBMC],,,,,$26.15 
59011-0420-20 - oxyCODONE 20 mg ER  UD [UBMC],,,,,$24.10 
59011-0454-01 - hydromorphone 4 mg Tab [UBMC],,,,,$20.45 
59148-0007-13 - aripiprazole 5 mg Tab [UBMC],,,,,$69.95 
59338-0775-01 - ferumoxytol 30 mg/mL Sol,,,,,$113.15 
59365-6064-01 - iodine-potassium iodide 5%-10% Sol [UBMC],,,,,$4.50 
59365-6065-01 - ferric subsulfate Top Sol [UBMC],,,,,$4.15 
59572-0102-01 - azacitidine 100 mg REC [UBMC],,,,,"$1,097.35 "
59630-0300-20 - nitroglycerin 0.4 mg SubL Spray [UBMC],,,,,$57.40 
59630-0710-08 - prednisoLONE sodium phosphate 15 mg/5 mL Liq [UBMC],,,,,$6.20 
59676-0340-01 - epoetin alfa 40000 units/mL Sol,,,,,"$2,306.85 "
59730-4202-01 - hepatitis B immune globulin - Sol,,,,,$360.05 
59730-4203-01 - hepatitis B immune globulin - Sol,,,,,$315.35 
59746-0385-06 - terazosin 5 mg Cap,,,,,$4.15 
59762-1004-01 - NIFEdipine 10 mg Cap,,,,,"$20,940.65 "
59762-1061-01 - atropine-diphenoxylate 0.025 mg-2.5 mg Tab,,,,,$7.40 
59762-1530-05 - amLODIPine 5 mg Tab,,,,,$2.60 
59762-1530-06 - amlodipine 5 mg Tab,,,,,$4.50 
59762-3060-03 - azithromycin 250 mg Tab,,,,,$16.10 
59762-3110-01 - azithromycin 100 mg/5 mL Oral Liq [UBMC],,,,,$6.05 
59762-3140-01 - azithromycin 200 mg/5 mL Oral Liq [UBMC],,,,,$4.55 
59762-3718-04 - triazolam 0.25 mg Tab,,,,,$9.55 
59762-3740-01 - medroxyPROGESTERone 2.5 mg Tab [UBMC],,,,,$2.65 
59762-4537-01 - medroxyPROGESTERone 150 mg/mL Sus[UBMC],,,,,$202.55 
59762-4537-02 - medroxyPROGESTERone 150 mg/mL Sus[UBMC],,,,,$202.35 
59762-4900-01 - sertraline 50 mg Tab,,,,,$1.70 
59762-4900-03 - sertraline 50 mg Tab,,,,,$7.05 
59762-5000-01 - sulfasalazine 500 mg Tab [UBMC],,,,,$2.55 
59762-6690-03 - NIFEdipine 30 mg ER Tab [UBMC],,,,,$4.50 
"5-Hydroxyindoleacetic Acid (HIAA), Urine ARUP",$70.50 ,,,,
6.6 Latex Ortho Gel Gloves w/hydrogel,$143.50 ,,,,
60432-0065-75 - amox-clav 250 mg-62.5 mg/5 mL Liq 75 mL [UBMC],,,,,$4.55 
60432-0131-08 - phenytoin 25 mg/mL Sus,,,,,$2.10 
60432-0212-08 - prednisoLONE sodium phosphate 15 mg/5 mL Liq [UBMC],,,,,$2.65 
60432-0264-15 - fluticasone nasal 50 mcg/inh Spr,,,,,$16.70 
60432-0537-16 - nystatin 100000 units/mL Sus,,,,,$2.60 
60505-0065-07 - omeprazole 20 mg ER,,,,,$10.85 
60505-0141-00 - glipiZIDE 5 mg Tab,,,,,$3.10 
60505-0147-01 - loratadine 10 mg Tab,,,,,$4.35 
60505-0183-00 - carBAMazepine 200 mg Tab,,,,,$4.15 
60505-0686-04 - piperacillin-tazobactam 2g-0.25g IV Inj [UBMC],,,,,$29.75 
60505-0687-01 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$44.65 
60505-0749-01 - ceFAZolin 1 g REC,,,,,$22.75 
60505-0749-05 - cefazolin 1 g Inj [UBMC],,,,,$22.75 
60505-0750-04 - cefTRIAXone 250 mg REC,,,,,$38.55 
60505-0752-04 - cefTRIAXone 1 g REC,,,,,$95.10 
60505-0753-04 - cefTRIAXone 2 g REC,,,,,$189.00 
60505-0760-01 - cefOXitin 2 g REC,,,,,$58.50 
60505-0760-05 - cefOXitin 2 g REC,,,,,$58.50 
60505-0829-01 - fluticasone nasal 50 mcg/inh Spr,,,,,$16.70 
60505-0830-01 - mometasone nasal 50 mcg/inh Spr,,,,,$31.20 
60505-2578-09 - atorvastatin 10 mg Tab,,,,,$10.50 
60505-2653-00 - traZODone 50 mg Tab,,,,,$3.70 
60505-2653-05 - traZODone 50 mg Tab,,,,,$4.40 
60505-2657-01 - hydrochlorothiazide-triamterene 50 mg-75 mg Tab,,,,,$4.35 
60505-3111-00 - OLANZapine 5 mg Tab,,,,,$27.35 
60505-3132-01 - QUEtiapine 50 mg Tab,,,,,$13.60 
60505-3848-01 - celecoxib 100 mg Cap,,,,,$12.00 
60505-6076-04 - azithromycin 500 mg REC,,,,,$51.50 
60505-6130-05 - ondansetron 2 mg/mL Sol,,,,,$15.75 
60569-0494-12 - magnesium oxide 400 mg Tab [UBMC],,,,,$1.75 
60687-0115-01 - benzonatate 100 mg Cap,,,,,$4.20 
60687-0145-01 - predniSONE 20 mg Tab,,,,,$2.50 
60687-0163-01 - cephalexin 500 mg Cap,,,,,$4.60 
60687-0195-01 - dilTIAZem 120 mg/24 hours ER,,,,,$3.65 
60687-0242-01 - sertraline 50 mg Tab,,,,,$3.40 
60687-0263-01 - amLODIPine 5 mg Tab,,,,,$3.35 
60687-0271-21 - azithromycin 500 mg Tab,,,,,$14.20 
60687-0303-01 - donepezil 10 mg Tab,,,,,$4.50 
60758-0119-10 - prednisoLONE ophthalmic acetate 1% Sus,,,,,$21.85 
60758-0119-15 - prednisoLONE ophthalmic acetate 1% Sus,,,,,$21.85 
60793-0411-30 - diclofenac topical 1.3% ER [UBMC],,,,,$27.25 
"60793-0600-02 - penicillin benzathine-penicillin procaine 600,000 units-600,000 units/2 mL Sus [UBMC]",,,,,$63.85 
"60793-0600-10 - penicillin benzathine-penicillin procaine 600,000 units-600,000 units/2 mL Sus [UBMC]",,,,,$130.10 
"60793-0602-02 - penicillin benzathine-penicillin procaine 900,000 units-300,000 units/2 mL Sus [UBMC]",,,,,$60.50 
"60793-0602-10 - penicillin benzathine-penicillin procaine 900,000 units-300,000 units/2 mL Sus [UBMC]",,,,,$130.10 
"60793-0700-01 - penicillin G benzathine 600,000 units/mL Sus [UBMC]",,,,,$73.65 
"60793-0700-10 - penicillin G benzathine 600,000 units/mL Sus [UBMC]",,,,,$188.45 
"60793-0701-10 - penicillin G benzathine 1,200,000 units/2 mL Sus [UBMC]",,,,,$163.20 
60977-0002-43 - promethazine 50 mg/mL Inj Sol (IM ONLY) [UBMC],,,,,$19.35 
60977-0141-27 - pralidoxime 1 g IV Inj [UBMC],,,,,$215.35 
60977-0451-02 - metoclopramide 5 mg/mL Inj Sol [UBMC],,,,,$15.75 
60977-0451-71 - metoclopramide 5 mg/mL Inj Sol [UBMC],,,,,$15.75 
61314-0015-05 - ofloxacin Otic 0.3% Sol [UBMC],,,,,$38.50 
61314-0016-01 - proparacaine ophthalmic 0.5% Sol [UBMC],,,,,$7.60 
61314-0203-15 - pilocarpine Opth 1% Sol [UBMC],,,,,$20.55 
61314-0227-05 - timolol o/s 0.5% DRP 5mL [UBMC],,,,,$8.85 
61314-0342-01 - phenylephrine Opth 2.5% Sol [UBMC],,,,,$16.15 
61314-0355-02 - tropicamide Opth 1% Sol [UBMC],,,,,$20.10 
61314-0628-10 - polymyxin B-trimethoprim ophthalmic 10000 units-1 mg/mL Sol [UBMC],,,,,$4.55 
61314-0630-06 - dexameth/neomycin/polymyxin B Ophth Susp [UBMC],,,,,$27.55 
61314-0633-05 - gentamicin ophthalmic 0.3% Sol [UBMC],,,,,$22.85 
61314-0637-05 - prednisoLONE ophthalmic acetate 1% Sus,,,,,$22.90 
61314-0637-10 - prednisoLONE Opth acetate 1% Susp [UBMC],,,,,$22.90 
61314-0637-15 - prednisoLONE ophthalmic acetate 1% Sus,,,,,$22.05 
61314-0656-05 - ciprofloxacin Opth 0.3% Sol [UBMC],,,,,$29.60 
61442-0113-01 - acyclovir 800 mg Tab [UBMC],,,,,$11.40 
61442-0141-01 - lovastatin 10 mg Tab,,,,,$4.20 
61442-0141-60 - lovastatin 10 mg Tab,,,,,$4.15 
61553-0112-52 - fentanyl 10 mcg/mL Soln,,,,,$20.00 
61553-0307-72 - phenylephrine 1 mg/10 mL-NaCl 0.9% Sol,,,,,$23.35 
61553-0326-33 - neostigmine 1 mg/mL Sol,,,,,$27.90 
61553-0702-68 - HYDROmorphone 0.2 mg/mL-NaCl 0.9% Sol,,,,,$15.10 
61553-0710-68 - hydromorphone 1 mg/mL-NaCl 0.9% Sol PCA [UBMC],,,,,$20.35 
61553-0716-68 - meperidine 10 mg/mL Inj Sol PCA [UBMC],,,,,$20.00 
61703-0309-16 - vinCRIStine 1 mg/mL IV Sol [UBMC],,,,,$20.20 
61703-0332-18 - bleomycin 15 units REC[UBMC],,,,,$123.50 
61703-0350-38 - methotrexate 25 mg/mL Sol[UBMC],,,,,$18.80 
61703-0350-38 - methotrexate 25 mg/mL Sol[UBMC],,,,,$16.25 
61748-0013-01 - isoniazid 300 mg Tab [UBMC],,,,,$2.45 
61748-0015-30 - rifampin 150 mg Cap [UBMC],,,,,$4.10 
61953-0004-04 - immune globulin intravenous 5% Sol [UBMC],,,,,$25.45 
61958-0701-01 - emtricitabine-tenofovir 200 mg-300 mg Tab,,,,,$114.95 
62037-0839-20 - enoxaparin 30 mg/0.3 mL Sol,,,,,$168.50 
62103-0333-04 - zinc oxide topical - Oin 120 gm [UBMC],,,,,$2.35 
62175-0446-01 - polyethylene glycol 3350 with electrolytes - REC 4L [UBMC],,,,,$1.25 
62332-0031-31 - rOPINIRole 0.5 mg Tab,,,,,$6.50 
62332-0141-31 - celecoxib 100 mg Cap,,,,,$12.00 
62559-0391-20 - vancomycin 250 mg Cap,,,,,$113.10 
62584-0259-01 - metformin 500 mg Tab [UBMC],,,,,$4.45 
62584-0259-11 - metformin 500 mg Tab [UBMC],,,,,$4.45 
62584-0266-01 - metoprolol 50 mg Tab,,,,,$1.65 
62584-0332-01 - metFORMIN 850 mg Tab,,,,,$4.75 
62584-0332-11 - metformin 850 mg Tab,,,,,$4.70 
62584-0693-01 - doxycycline hyclate 100 mg Tab,,,,,$4.35 
62584-0738-01 - hydrocodone-APAP 5 mg-500 mg Tab [UBMC],,,,,$5.25 
62584-0897-11 - folic acid 1 mg Tab [UBMC],,,,,$2.80 
62584-0975-11 - diltiazem 180 mg/24 hours ERCap [UBMC],,,,,$4.90 
62584-0975-90 - diltiazem 180 mg/24 hours ERCap [UBMC],,,,,$4.90 
62584-0988-11 - allopurinol 100 mg Tab [UBMC],,,,,$3.15 
62584-0988-85 - allopurinol 100 mg Tab [UBMC],,,,,$3.15 
62756-0240-64 - ondansetron 4 mg ODT [UBMC],,,,,$46.05 
62756-0294-88 - cephalexin 500 mg Cap,,,,,$4.70 
62756-0457-88 - carbidopa-levodopa 50 mg-200 mg ER,,,,,$4.70 
62756-0521-69 - SUMAtriptan 50 mg Tab,,,,,$52.05 
62756-0798-88 - divalproex sodium 500 mg DR,,,,,$8.35 
62856-0243-30 - RABEprazole 20 mg EC,,,,,$43.45 
62856-0243-41 - rabeprazole 20 mg EC [UBMC],,,,,$17.20 
62856-0243-90 - rabeprazole 20 mg EC [UBMC],,,,,$31.60 
62856-0246-41 - donepezil 10 mg Tab [UBMC],,,,,$38.15 
62856-0600-01 - decitabine 50 mg IV Inj [UBMC],,,,,"$4,024.25 "
62856-0797-01 - palonosetron 0.25 mg/5 mL IV Sol [UBMC],,,,,$225.05 
63020-0049-01 - bortezomib 3.5 mg REC [UBMC],,,,,"$3,770.25 "
63304-0338-01 - benazepril 10 mg Tab,,,,,$4.15 
63323-0010-20 - gentamicin 40 mg/mL Inj Sol [UBMC],,,,,$19.35 
63323-0012-01 - oxytocin 10 intl units/mL Inj Sol [UBMC],,,,,$22.75 
63323-0013-02 - thiamine 100 mg/mL Inj Sol [UBMC],,,,,$19.45 
63323-0017-10 - heparin flush 10 units/mL Sol SDV 10ml [UBMC],,,,,$22.25 
63323-0026-05 - sodium bicarbonate 4.2% (0.5mEq/mL)  IV Sol SDV 5ml [UBMC],,,,,$14.30 
63323-0044-01 - cyanocobalamin 1000 mcg/mL Sol,,,,,$26.15 
63323-0044-01 - cyanocobalamin 1000 mcg/mL Sol,,,,,$31.15 
63323-0047-10 - heparin 5000 units/mL Inj Sol MDV 10ml [UBMC],,,,,$25.35 
63323-0064-02 - magnesium sulfate 50% Inj Sol 2 mL [UBMC],,,,,$22.15 
63323-0117-10 - fluorouracil 50 mg/mL IV Sol [UBMC],,,,,$15.75 
63323-0130-11 - doxycycline 100 mg IV Inj [UBMC],,,,,$75.40 
63323-0162-01 - ketorolac 30 mg/mL Sol,,,,,$18.80 
63323-0162-02 - ketorolac 30 mg/mL Sol,,,,,$19.70 
63323-0165-01 - dexamethasone 4 mg/mL Sol 1mL [UBMC],,,,,$23.00 
63323-0170-15 - sodium phosphate 3 mmol/mL Sol,,,,,$21.10 
63323-0173-02 - gentamicin 10 mg/mL Inj Sol 2ml [UBMC],,,,,$20.60 
63323-0180-01 - pyridoxine 100 mg/mL Inj Sol [UBMC],,,,,$47.40 
63323-0184-10 - folic acid 5 mg/mL Inj Sol [UBMC],,,,,$16.95 
63323-0186-10 - IV NS 0.9% Inj Sol 10ml Vial [UBMC],,,,,$15.75 
63323-0186-20 - IV NS 0.9% Inj Sol 20 mL [UBMC],,,,,$15.75 
63323-0187-30 - Sodium Chloride 23.4% Conc 4mEq/ml Sol[UBMC],,,,,$15.75 
63323-0208-05 - lidocaine 2% PF Inj Sol PFS Cardiac 5 mL [UBMC],,,,,$15.30 
63323-0221-10 - vancomycin 500 mg REC,,,,,$26.30 
63323-0229-05 - protamine 10 mg/mL Inj Sol [UBMC],,,,,$24.50 
63323-0247-10 - levothyroxine 200 mcg (0.2 mg) Inj [UBMC],,,,,$105.45 
63323-0262-01 - heparin 5000 units/mL Inj Sol MDV 1ml [UBMC],,,,,$16.30 
63323-0265-30 - methylPREDNISolone 1 g REC,,,,,$85.00 
63323-0269-29 - propofol 10 mg/mL Emu,,,,,$15.75 
63323-0269-50 - propofol 10 mg/mL IV Emul SDV 50 mL [UBMC],,,,,$16.35 
63323-0270-25 - propofol 10 mg/mL IV Emu SDV 20 mL [UBMC],,,,,$15.75 
63323-0272-05 - fluphenazine decanoate 25 mg/mL Inj Sol [UBMC],,,,,$77.00 
63323-0273-01 - sumatriptan 6 mg/0.5 mL SubQ Inj [UBMC],,,,,$253.55 
63323-0276-02 - heparin 1000 units/mL Inj Sol SDV 2ml [UBMC],,,,,$25.80 
63323-0280-04 - furosemide 10 mg/mL Inj Sol 4ml [UBMC],,,,,$19.60 
63323-0284-20 - vancomycin 1 g REC,,,,,$42.25 
63323-0286-35 - ropivacaine 0.5% Sol,,,,,$17.95 
63323-0292-80 - morphine 1 mg/mL PF Inj Sol AMP [UBMC],,,,,$40.20 
63323-0300-30 - piperacillin-tazobactam 3 g-0.375 g REC,,,,,$43.25 
63323-0302-01 - vasopressin 20 units/mL Sol,,,,,$91.90 
63323-0311-10 - calcium gluconate 100 mg/mL Inj Sol [UBMC],,,,,$15.15 
63323-0311-19 - calcium gluconate 100 mg/mL Sol,,,,,$19.70 
63323-0315-10 - ganciclovir 500 mg REC,,,,,$241.60 
63323-0325-10 - acyclovir 50 mg/mL Sol,,,,,$19.65 
63323-0328-20 - nafcillin 2 g REC,,,,,$90.15 
63323-0341-20 - cefoxitin 1 g Inj [UBMC],,,,,$24.00 
63323-0341-25 - cefotaxime 1 g Inj [UBMC],,,,,$24.00 
63323-0342-20 - cefoxitin 2 g Inj [UBMC],,,,,$39.80 
63323-0342-25 - cefoxitin 1 g Inj [UBMC],,,,,$39.80 
63323-0342-25 - cefOXitin 2 g REC,,,,,$39.80 
63323-0360-19 - calcium gluconate 100 mg/mL Sol,,,,,$17.45 
63323-0360-61 - calcium gluconate 100 mg/mL Sol,,,,,$20.00 
63323-0373-02 - ondansetron 2 mg/mL Sol,,,,,$21.50 
63323-0374-20 - ondansetron 2 mg/mL Sol,,,,,$19.35 
63323-0376-01 - octreotide 100 mcg/mL Sol,,,,,$31.00 
63323-0377-01 - octreotide 500 mcg/mL Sol,,,,,$123.45 
63323-0383-10 - neostigmine 1 mg/mL Sol,,,,,$17.45 
63323-0387-10 - ampicillin 250 mg Inj [UBMC],,,,,$23.55 
63323-0388-10 - ampicillin 500 mg Inj [UBMC],,,,,$25.70 
63323-0389-10 - ampicillin 1 g Inj [UBMC],,,,,$22.15 
63323-0398-10 - azithromycin 500 mg REC [UBMC],,,,,$27.90 
63323-0399-23 - ampicillin 2 g Inj [UBMC],,,,,$29.85 
63323-0403-02 - fosphenytoin 100 mg PE/2 mL Sol,,,,,$23.35 
63323-0407-03 - caffeine citrate 20 mg/mL Sol [UBMC],,,,,$29.55 
63323-0411-12 - midazolam 1 mg/mL Sol,,,,,$20.00 
63323-0411-25 - midazolam 1 mg/mL Sol,,,,,$20.00 
63323-0424-05 - flumazenil 0.1 mg/mL IV Sol [UBMC],,,,,$20.70 
63323-0461-57 - Sensorcaine 0.25% with epinephrine 50mL vial,,,,,$15.75 
"63323-0463-50 - bupivacaine 0.5%-epi 1:200,000 Inj Sol 50 mL [UBMC]",,,,,$15.75 
"63323-0463-57 - bupivacaine 0.5%-epi 1:200,000 Inj Sol 50 mL [UBMC]",,,,,$15.75 
63323-0464-37 - bupivacaine 0.25% preservative-free Sol,,,,,$15.75 
63323-0466-10 - bupivacaine 0.5% PF Inj Sol 10 mL [UBMC],,,,,$19.90 
63323-0466-17 - bupivacaine 0.5% preservative-free Sol,,,,,$12.80 
63323-0466-37 - bupivacaine 0.5% preservative-free Sol,,,,,$15.75 
63323-0467-57 - bupivacaine 0.5% Sol,,,,,$15.75 
63323-0469-01 - haloperidol decanoate 50 mg/mL Sol[UBMC],,,,,$87.60 
63323-0472-10 - bupivacaine 0.75% preservative-free 10 ml Sol[UBMC],,,,,$20.70 
63323-0472-17 - bupivacaine 0.75% preservative-free Sol,,,,,$13.30 
63323-0474-01 - haloperidol 5 mg/mL Inj Sol [UBMC],,,,,$22.50 
63323-0481-50 - epinephrine-lidocaine 1:200000-0.5% Sol[UBMC],,,,,$15.75 
"63323-0482-17 - lidocaine-epinephrine 1%-1:100,000 Inj Sol 10 mL [UBMC]",,,,,$15.75 
63323-0483-27 - EPINEPHrine-lidocaine 1:100000-2% Sol,,,,,$15.75 
63323-0483-27 - Lidocaine 2% with epinephrine 20mL via,,,,,$15.75 
63323-0485-27 - lidocaine 1% Sol,,,,,$15.75 
63323-0485-50 - lidocaine 1% Sol 50 mL [UBMC],,,,,$15.75 
63323-0486-50 - lidocaine 2% Inj Sol MDV 50 mL [UBMC],,,,,$15.75 
63323-0486-57 - lidocaine 2% Sol,,,,,$15.75 
63323-0490-89 - lidocaine 4% PF TOP Sol Amp 5 mL [UBMC],,,,,$19.20 
63323-0491-50 - lidocaine 0.5% PF Inj Sol [UBMC],,,,,$15.75 
63323-0492-27 - lidocaine 1% preservative-free Sol 5ml[UBMC],,,,,$19.50 
63323-0492-57 - lidocaine 1% preservative-free Sol 5ml[UBMC],,,,,$19.00 
63323-0492-89 - lidocaine 1% preservative-free Sol,,,,,$13.55 
63323-0492-97 - lidocaine 1% PF Inj Sol Poly Amp 10 mL [UBMC],,,,,$14.50 
63323-0493-97 - lidocaine 1.5% 15 mg/ml 10ml Polyamp [UBMC],,,,,$18.65 
63323-0494-05 - valproic acid 100 mg/mL Sol,,,,,$20.45 
63323-0495-07 - lidocaine 2% preservative-free Sol,,,,,$16.00 
63323-0496-97 - lidocaine 2% PF Inj Sol Poly Amp 10 mL [UBMC],,,,,$16.90 
63323-0507-20 - meropenem 500 mg REC,,,,,$31.20 
63323-0508-30 - meropenem 1000 mg REC,,,,,$62.40 
63323-0513-02 - gentamicin 10 mg/mL Inj Sol 2ml [UBMC],,,,,$21.80 
63323-0540-01 - heparin 1000 units/mL Inj Sol MDV 1ml [UBMC],,,,,$25.30 
63323-0540-31 - heparin 1000 units/mL Inj Sol MDV 30ml [UBMC],,,,,$15.75 
"63323-0542-01 - heparin 10,000 units/mL Inj Sol MDV 1ml [UBMC]",,,,,$27.40 
63323-0544-01 - heparin flush 10 units/mL Sol MDV 1ml [UBMC],,,,,$17.55 
63323-0545-01 - heparin flush 100 units/mL Sol MDV 1ml [UBMC],,,,,$24.55 
63323-0549-01 - heparin flush 100 units/mL Sol,,,,,$17.75 
63323-0557-01 - heparin flush 10 units/mL Sol PF SDV 1ml [UBMC],,,,,$25.20 
63323-0563-10 - tranexamic acid 100 mg/mL Sol,,,,,$20.95 
63323-0568-87 - enoxaparin 40 mg/0.4 mL Sol,,,,,$61.95 
63323-0614-01 - hydrALAZINE 20 mg/mL Inj Sol [UBMC],,,,,$46.15 
63323-0616-03 - amiodarone 50 mg/mL Sol,,,,,$13.15 
63323-0616-09 - amiodarone 50 mg/mL Sol,,,,,$13.65 
63323-0649-07 - levothyroxine 100 mcg (0.1 mg) REC,,,,,$262.25 
63323-0659-03 - indomethacin 1 mg REC[UBMC],,,,,"$1,244.05 "
63323-0660-05 - metoprolol 1 mg/mL Inj Sol [UBMC],,,,,$15.75 
63323-0664-01 - diphenhydrAMINE 50 mg/mL Sol,,,,,$17.35 
63323-0665-01 - terbutaline 1 mg/mL Inj Sol [UBMC],,,,,$56.15 
63323-0690-30 - acetylcysteine 20% Sol,,,,,$4.40 
63323-0705-08 - ampicillin 2 g REC,,,,,$29.80 
"63323-0712-25 - parenteral nutrition solution w/electrolytes Amino Acids 3.31% with 9.8% Dextrose, 3",,,,,$15.75 
63323-0781-10 - vecuronium 10 mg REC,,,,,$19.55 
63323-0965-05 - potassium chloride 2 mEq/mL Sol,,,,,$15.75 
63323-0965-10 - potassium chloride 2 mEq/mL Sol,,,,,$15.75 
63323-0966-00 - zoledronic acid 5 mg/100 mL Sol,,,,,$18.95 
63402-0512-00 - levalbuterol 0.63 mg/3 mL Inh Sol [UBMC],,,,,$4.90 
63402-0512-24 - levalbuterol 0.63 mg/3 mL Inh Sol [UBMC],,,,,$9.60 
63402-0513-00 - levalbuterol 1.25 mg/3 mL Inh Sol [UBMC],,,,,$4.90 
63402-0513-24 - levalbuterol 1.25 mg/3 mL Inh Sol [UBMC],,,,,$8.50 
63402-0515-30 - levalbuterol 1.25 mg/0.5 mL Sol,,,,,$15.45 
63653-1171-03 - clopidogrel 75 mg Tab [UBMC],,,,,$16.00 
63739-0004-10 - acetaminophen-codeine 300 mg-30 mg Tab [UBMC],,,,,$6.80 
63739-0007-10 - baclofen 10 mg Tab,,,,,$4.25 
63739-0015-10 - dilTIAZem 180 mg/24 hours ER,,,,,$3.50 
63739-0023-01 - aspirin 325 mg Oral EC Tab [UBMC],,,,,$1.35 
63739-0031-10 - baclofen 10 mg Tab [UBMC],,,,,$4.20 
63739-0047-10 - carbidopa-levodopa 25 mg-100 mg Tab [UBMC],,,,,$4.30 
63739-0049-10 - carisoprodol 350 mg Tab [UBMC],,,,,$4.50 
63739-0059-10 - clindamycin 150 mg Cap,,,,,$4.35 
63739-0060-10 - cloNIDine 0.1 mg Tab,,,,,$2.70 
63739-0066-10 - cyclobenzaprine 10 mg Tab [UBMC],,,,,$4.65 
63739-0066-10 - cyclobenzaprine 10 mg Tab UD home pack [UBMC],,,,,$4.65 
63739-0073-10 - diazepam 5 mg Tab,,,,,$5.25 
63739-0079-10 - diltiazem 30 mg Tab [UBMC],,,,,$3.80 
63739-0103-10 - metoclopramide 5 mg Tab,,,,,$2.00 
63739-0119-10 - glyBURIDE 5 mg Tab,,,,,$2.55 
63739-0126-10 - hydrALAZINE 25 mg Tab,,,,,$2.70 
63739-0128-10 - hydrochlorothiazide 25 mg Tab,,,,,$1.90 
63739-0130-10 - hydrocodone-APAP 5 mg-500 mg Tab [UBMC],,,,,$5.55 
63739-0141-10 - acetaminophen-hydrocodone 500 mg-7.5 mg Tab UD home pack [UBMC],,,,,$6.40 
63739-0141-10 - hydrocodone-APAP 7.5 mg-500 mg Tab [UBMC],,,,,$6.40 
63739-0166-10 - methocarbamol 500 mg Tab,,,,,$3.60 
63739-0201-10 - phenobarbital 32.4 mg Tab [UBMC],,,,,$4.45 
63739-0208-10 - predniSONE 10 mg Tab [UBMC],,,,,$3.60 
63739-0213-10 - promethazine 25 mg Tab,,,,,$4.10 
63739-0217-10 - acetaminophen-oxycodone 325 mg-10 mg Tab,,,,,$9.10 
63739-0225-10 - simethicone 80 mg Chew Tab [UBMC],,,,,$2.30 
63739-0228-10 - sulfamethoxazole-trimethoprim 800 mg-160 mg Tab,,,,,$3.15 
63739-0231-10 - temazepam 15 mg Cap,,,,,$9.15 
63739-0236-10 - gabapentin 300 mg Cap,,,,,$2.35 
63739-0264-10 - clonazePAM 1 mg Tab,,,,,$4.35 
63739-0283-10 - diltiazem 120 mg/24 hours ERCap [UBMC],,,,,$5.10 
63739-0284-10 - diltiazem 180 mg/24 hours ERCap [UBMC],,,,,$4.70 
63739-0349-10 - lisinopril 10 mg Tab,,,,,$4.85 
63739-0350-10 - lisinopril 20 mg Tab [UBMC],,,,,$4.50 
63739-0358-10 - omeprazole 20 mg ER,,,,,$7.60 
63739-0374-10 - gabapentin 100 mg Cap [UBMC],,,,,$4.20 
63739-0375-10 - gabapentin 300 mg Cap [UBMC],,,,,$4.30 
63739-0387-10 - amiodarone 200 mg Tab [UBMC],,,,,$8.80 
63739-0403-10 - naproxen 500 mg Tab,,,,,$2.70 
63739-0404-10 - metolazone 5 mg Tab [UBMC],,,,,$5.05 
63739-0432-10 - docusate-senna 50 mg-8.6 mg Tab,,,,,$2.10 
63739-0434-01 - aspirin 81 mg Chew Tab [UBMC],,,,,$2.10 
63739-0436-10 - simvastatin 10 mg Tab [UBMC],,,,,$9.15 
63739-0437-10 - simvastatin 20 mg Tab [UBMC],,,,,$12.75 
63739-0440-01 - acetaminophen 325 mg Tab,,,,,$1.40 
63739-0443-10 - ibuprofen 600 mg Tab [UBMC],,,,,$2.85 
63739-0444-10 - ibuprofen 800 mg Tab [UBMC],,,,,$3.20 
63739-0447-10 - potassium chloride 20 mEq ER [UBMC],,,,,$4.45 
63739-0455-10 - acetaminophen-HYDROcodone 500 mg-5 mg Tab,,,,,$5.25 
63739-0478-10 - docusate sodium 100 mg Cap [UBMC],,,,,$1.95 
63739-0479-10 - baclofen 10 mg Tab,,,,,$3.80 
63739-0481-10 - metoclopramide 5 mg Tab [UBMC],,,,,$3.50 
63739-0484-10 - famotidine 20 mg Tab [UBMC],,,,,$1.95 
63739-0500-10 - LORazepam 1 mg Tab,,,,,$5.25 
63739-0518-10 - predniSONE 5 mg Tab [UBMC],,,,,$2.40 
63739-0519-10 - predniSONE 10 mg Tab,,,,,$2.45 
63739-0523-01 - aspirin 325 mg EC,,,,,$2.45 
63739-0526-10 - zolpidem 10 mg Tab,,,,,$12.10 
63739-0537-10 - folic acid 1 mg Tab,,,,,$3.05 
63739-0542-10 - furosemide 40 mg Tab,,,,,$2.35 
63739-0544-10 - spironolactone 25 mg Tab,,,,,$3.60 
63739-0556-10 - midodrine 5 mg Tab,,,,,$4.45 
63739-0559-10 - ciprofloxacin 500 mg Tab,,,,,$2.30 
63739-0564-10 - pantoprazole 40 mg DR,,,,,$2.90 
63739-0567-10 - tamsulosin 0.4 mg Cap,,,,,$3.75 
63739-0569-10 - isosorbide dinitrate 10 mg Tab,,,,,$4.65 
63739-0591-10 - gabapentin 100 mg Cap,,,,,$2.40 
63739-0640-10 - metFORMIN 500 mg Tab,,,,,$1.80 
63739-0644-10 - ALPRAZolam 0.25 mg Tab,,,,,$5.25 
63739-0671-10 - traMADol 50 mg Tab,,,,,$1.90 
63739-0673-10 - losartan 25 mg Tab,,,,,$4.10 
63739-0675-10 - gabapentin 100 mg Cap,,,,,$2.10 
63739-0678-10 - donepezil 10 mg Tab,,,,,$2.05 
63739-0684-10 - ibuprofen 600 mg Tab,,,,,$1.75 
63739-0689-10 - gabapentin 300 mg Cap,,,,,$2.15 
63739-0691-01 - ibuprofen 800 mg Tab,,,,,$1.65 
63739-0691-10 - ibuprofen 800 mg Tab,,,,,$1.75 
63739-0694-57 - lidocaine topical 2% Sol,,,,,$1.90 
63739-0726-10 - morphine 30 mg/8 to 12 hr ER,,,,,$8.80 
63739-0920-25 - heparin 1000 units/mL Sol,,,,,$15.85 
63739-0963-10 - PARoxetine 20 mg Tab,,,,,$2.55 
63824-0008-15 - guaiFENesin 600 mg ER,,,,,$3.75 
63824-0008-32 - guaifenesin 600 mg ER Tab [UBMC],,,,,$4.00 
63824-0008-34 - guaiFENesin 600 mg ER,,,,,$3.50 
63824-0713-16 - benzocaine-menthol topical 15 mg-3.6 mg Loz,,,,,$2.10 
63824-0721-16 - menthol topical - Lozenge,,,,,$2.10 
63833-0386-02 - prothrombin complex - REC,,,,,"$1,924.90 "
63833-0387-02 - prothrombin complex - REC,,,,,"$1,924.90 "
63851-0501-01 - rabies vaccine [UBMC],,,,,$599.20 
64253-0111-30 - sodium chloride 0.9% Inj 10 ml syringes [UBMC],,,,,$15.90 
64253-0222-35 - heparin flush 10 units/mL Sol,,,,,$16.85 
64253-0333-35 - heparin flush 100 units/mL Sol,,,,,$17.35 
64376-0130-55 - levofloxacin 250 mg Tab,,,,,$34.80 
64376-0131-55 - levofloxacin 500 mg Tab,,,,,$39.90 
64376-0438-15 - antipyrine-benzocaine Otic Sol [UBMC],,,,,$9.10 
64406-0008-01 - natalizumab 300 mg/15 mL Con,,,,,$940.80 
64679-0727-01 - ondansetron 2 mg/mL MDV 20mL [UBMC],,,,,$30.20 
64679-0728-01 - sumatriptan 6 mg/0.5 mL SubQ Inj [UBMC],,,,,$318.85 
64679-0729-01 - fosphenytoin 100 mgPE/2 mL Sol,,,,,$34.60 
64679-0758-02 - ketorolac 30 mg/mL Sol,,,,,$16.15 
64679-0921-01 - cefuroxime 250 mg Tab,,,,,$11.40 
64679-0925-02 - enalapril 10 mg Tab,,,,,$5.05 
64764-0119-01 - colchicine 0.6 mg Tab,,,,,$16.85 
64764-0119-07 - colchicine 0.6 mg Tab,,,,,$16.85 
64764-0300-20 - vedolizumab 300 mg REC,,,,,"$14,341.50 "
64764-0301-14 - pioglitazone 30 mg Tab [UBMC],,,,,$49.15 
64980-0182-10 - sodium bicarbonate 650 mg Tab,,,,,$1.25 
65162-0253-10 - raNITIdine 150 mg Tab,,,,,$4.05 
65162-0361-10 - folic acid 1 mg Tab [UBMC],,,,,$2.80 
65162-0442-10 - meclizine 25 mg Tab,,,,,$3.40 
65162-0536-10 - benzonatate 100 mg Cap,,,,,$6.50 
65162-0664-90 - Ranitidine Syrup oral solution 15 mg/ml (473 mL) [UBMC],,,,,$4.30 
65250-0266-20 - bupivacaine liposome 1.3% (13.3 mg/mL) Sus,,,,,$49.15 
65580-0644-71 - metolazone 5 mg Tab,,,,,$5.15 
65649-0303-03 - rifaximin 550 mg Tab,,,,,$78.45 
65649-0303-04 - rifaximin 550 mg Tab,,,,,$69.15 
65649-0701-41 - sodium biphosphate-sodium phosphate 1.5 g Tab [UBMC],,,,,$15.20 
65862-0019-01 - cephalexin 500 mg Cap,,,,,$4.50 
65862-0177-60 - cefdinir 300 mg Cap,,,,,$10.55 
65862-0201-90 - losartan 25 mg Tab,,,,,$4.35 
65862-0226-60 - clarithromycin 500 mg Tab,,,,,$12.45 
65862-0390-10 - ondansetron 4 mg DIS,,,,,$46.15 
65862-0420-01 - sulfamethoxazole-trimethoprim 800 mg-160 mg Tab,,,,,$4.55 
65862-0536-50 - levofloxacin 250 mg Tab,,,,,$34.80 
65862-0560-90 - pantoprazole 40 mg DR,,,,,$10.90 
65862-0597-60 - lamiVUDine-zidovudine 150 mg-300 mg Tab,,,,,$30.30 
65862-0603-30 - moxifloxacin 400 mg Tab,,,,,$56.35 
"66019-0109-05 - influenza virus vaccine, live, trivalent [UBMC]",,,,,$51.20 
66213-0423-04 - hyoscyamine/PB/atropine/scop Oral Elixr 480 mL [UBMC],,,,,$5.70 
66213-0423-16 - hyoscyamine/PB/atropine/scop Oral Elixr 480 mL [UBMC],,,,,$5.60 
66220-0107-30 - acetylcysteine 20% IV Sol 30mL Acetadote [UBMC],,,,,$20.80 
66220-0207-30 - acetylcysteine 20% IV Sol 30mL Acetadote [UBMC],,,,,$27.00 
66479-0541-25 - morphine 30 mg ER Tab [UBMC],,,,,$15.55 
66553-0004-01 - calcium carbonate 500 mg Che,,,,,$1.50 
66553-0008-01 - sodium bicarbonate 650 mg Tab [UBMC],,,,,$1.60 
66593-3126-01 - vancomycin 250 mg Cap [UBMC],,,,,$115.00 
66593-3126-02 - vancomycin 250 mg Cap [UBMC],,,,,$125.85 
66685-1001-01 - amoxicillin-clavulanate 875 mg-125 mg Tab,,,,,$12.75 
66685-1012-00 - amox-clav 400 mg-57 mg/5 mL Liq 50 mL [UBMC],,,,,$4.45 
66689-0009-01 - ibuprofen 100 mg/5 mL Oral Susp [UBMC],,,,,$1.95 
66689-0009-50 - ibuprofen 100 mg/5 mL Oral Susp [UBMC],,,,,$1.95 
66689-0023-50 - acetaminophen-HYDROcodone 325 mg-7.5 mg/15 mL Sol,,,,,$5.25 
66689-0037-50 - nystatin 100000 units/mL Sus,,,,,$2.50 
66689-0038-01 - lactulose 10 g/15 ml Syrup,,,,,$1.70 
66689-0047-50 - potassium chloride 20 mEq/15 mL Liq,,,,,$4.10 
66689-0201-08 - charcoal 50 g Sus[UBMC],,,,,$1.70 
66689-0203-04 - charcoal-sorbitol 25 g Sus[UBMC],,,,,$1.90 
66689-0401-50 - oxyCODONE 5 mg/5 mL Sol,,,,,$10.90 
66689-0790-01 - sucralfate 1 g/10 mL Oral Susp [UBMC],,,,,$4.75 
66689-0790-50 - sucralfate 1 g/10 mL Sus,,,,,$4.75 
66758-0048-02 - irinotecan 20 mg/mL IV Sol [UBMC],,,,,$285.80 
66993-0068-80 - pantoprazole 40 mg EC,,,,,$3.80 
66993-0165-02 - colchicine 0.6 mg Tab,,,,,$13.95 
67066-0005-01 - secretin synthetic human 16 mcg IV Inj [UBMC],,,,,$976.10 
67253-0320-10 - Methotrexate 2.5 mg tab [UBMC],,,,,$9.25 
67253-0382-10 - doxazosin 4 mg Tab,,,,,$4.80 
67253-0660-10 - pyrazinamide 500 mg Tab [UBMC],,,,,$7.45 
67386-0201-11 - succimer 100 mg Cap [UBMC],,,,,$20.45 
67386-0611-52 - benztropine 1 mg/mL Sol [UBMC],,,,,$145.10 
67386-0711-55 - chlorothiazide 0.5 g Inj [UBMC],,,,,"$1,018.45 "
67457-0001-10 - ketamine 50 mg/mL Sol[UBMC],,,,,$16.85 
67457-0118-50 - ascorbic acid 500 mg/mL Sol [UBMC],,,,,$18.95 
67457-0153-00 - amiodarone 50 mg/mL Soln,,,,,$23.05 
67457-0153-03 - amiodarone 50 mg/mL IV Sol [UBMC],,,,,$23.10 
67457-0181-20 - ketamine 10 mg/mL Sol,,,,,$16.40 
67457-0182-10 - esmolol 10 mg/mL Sol,,,,,$20.45 
67457-0192-05 - atropine-edrophonium 0.14 mg-10 mg/mL Sol[UBMC],,,,,$16.55 
67457-0196-00 - thiamine 100 mg/mL Soln,,,,,$16.70 
67457-0196-02 - thiamine 100 mg/mL Sol,,,,,$16.95 
67457-0197-10 - tranexamic acid 100 mg/mL Sol,,,,,$27.15 
67457-0228-99 - rocuronium 10 mg/mL Soln,,,,,$19.65 
67457-0291-01 - hydrALAZINE 20 mg/mL Sol,,,,,$264.40 
67457-0292-02 - naloxone 0.4 mg/mL Sol,,,,,$62.55 
67457-0340-01 - vancomycin 1 g REC,,,,,$50.05 
67457-0349-10 - ampicillin-sulbactam 2 g-1 g REC,,,,,$39.95 
67457-0366-10 - ibutilide 0.1 mg/mL IV Sol 10ml vial [UBMC],,,,,$77.20 
67457-0423-12 - dexamethasone 4 mg/mL Sol,,,,,$23.15 
67457-0426-12 - haloperidol 5 mg/mL Sol,,,,,$22.90 
67457-0440-22 - ondansetron 2 mg/mL Sol,,,,,$15.75 
67457-0521-22 - piperacillin-tazobactam 2 g-0.25 g REC,,,,,$37.70 
67457-0523-45 - piperacillin-tazobactam 4 g-0.5 g REC,,,,,$71.65 
67457-0790-05 - levETIRAcetam 100 mg/mL Sol,,,,,$21.95 
67457-0815-04 - clindamycin 150 mg/mL Sol,,,,,$18.30 
67467-0643-01 - albumin human 25% IV Sol 50 mL [UBMC],,,,,$20.50 
67546-0212-21 - nitazoxanide 100 mg/5 mL Susp [UBMC],,,,,$4.75 
67877-0105-01 - benzonatate 100 mg Cap,,,,,$6.50 
67877-0124-40 - silver sulfADIAZINE topical 1% Cre,,,,,$1.90 
67877-0124-50 - silver sulfADIAZINE topical 1% Cre,,,,,$2.90 
67877-0198-90 - amLODIPine 5 mg Tab,,,,,$4.65 
67877-0223-01 - gabapentin 300 mg Cap,,,,,$4.55 
67877-0251-15 - triamcinolone topical 0.1% Cre,,,,,$3.30 
67919-0011-01 - daptomycin 500 mg REC [UBMC],,,,,$602.80 
67919-0011-01 - daptomycin 500 mg REC [UBMC],,,,,"$1,047.80 "
68084-0018-11 - alprazolam 0.25 mg Tab [UBMC],,,,,$7.20 
68084-0018-85 - alprazolam 0.25 mg 6 tab Home pk[UBMC],,,,,$4.30 
68084-0018-85 - alprazolam 0.25 mg Tab [UBMC],,,,,$7.20 
68084-0022-01 - NIFEdipine 10 mg Cap,,,,,$4.95 
68084-0041-01 - misoprostol 200 mcg Tab,,,,,$5.00 
68084-0045-01 - PARoxetine 20 mg Tab,,,,,$7.25 
68084-0045-11 - paroxetine 20 mg Tab,,,,,$7.25 
68084-0070-01 - ciprofloxacin 500 mg Tab [UBMC],,,,,$12.80 
68084-0070-01 - ciprofloxacin 500 mg Tab UD home pack [UBMC],,,,,$8.25 
68084-0070-11 - ciprofloxacin 500 mg Tab [UBMC],,,,,$8.25 
68084-0097-11 - atorvastatin 10 mg Tab,,,,,$4.00 
68084-0099-01 - atorvastatin 40 mg Tab,,,,,$4.50 
68084-0127-01 - naproxen 500 mg Tab,,,,,$4.55 
68084-0128-01 - omeprazole 20 mg ER  UD [UBMC],,,,,$4.40 
68084-0128-11 - omeprazole 20 mg ER  UD [UBMC],,,,,$4.40 
68084-0181-01 - sertraline 50 mg Tab,,,,,$3.40 
68084-0214-01 - benzonatate 100 mg Cap UD [UBMC],,,,,$4.20 
68084-0214-11 - benzonatate 100 mg Cap UD [UBMC],,,,,$4.20 
68084-0241-01 - midodrine 5 mg Tab [UBMC],,,,,$5.35 
68084-0241-11 - midodrine 5 mg Tab [UBMC],,,,,$5.35 
68084-0248-01 - loratadine 10 mg Tab,,,,,$4.45 
68084-0254-01 - hydrOXYzine HCl 25 mg Tab [UBMC],,,,,$3.35 
68084-0254-11 - hydrOXYzine HCl 25 mg Tab [UBMC],,,,,$3.35 
68084-0262-01 - carvedilol 6.25 mg Tab,,,,,$5.05 
68084-0279-11 - azithromycin 500 mg Tab [UBMC],,,,,$42.30 
68084-0279-21 - azithromycin 500 mg Tab [UBMC],,,,,$14.20 
68084-0292-01 - phenazopyridine 100 mg Tab [UBMC],,,,,$4.00 
68084-0292-11 - phenazopyridine 100 mg Tab [UBMC],,,,,$4.00 
68084-0299-01 - tamsulosin 0.4 mg Cap,,,,,$10.95 
68084-0304-01 - metoprolol 50 mg ER,,,,,$4.40 
68084-0337-01 - levetiracetam 500 mg Tab [UBMC],,,,,$4.15 
68084-0337-11 - levetiracetam 500 mg Tab [UBMC],,,,,$4.15 
68084-0355-01 - oxycodone-APAP 5 mg-325 mg Tab [UBMC],,,,,$8.75 
68084-0366-01 - digoxin 125 mcg (0.125 mg) Tab,,,,,$6.65 
68084-0372-01 - acetaminophen-codeine 300 mg-30 mg Tab,,,,,$6.45 
68084-0388-01 - benztropine 1 mg Tab,,,,,$3.95 
68084-0435-01 - isosorbide mononitrate 30 mg ER Tab [UBMC],,,,,$4.35 
68084-0435-11 - isosorbide mononitrate 30 mg ER Tab [UBMC],,,,,$4.35 
68084-0446-01 - nitrofurantoin macrocrystals-monohydrate 100 mg Cap,,,,,$6.70 
"68084-0463-01 - ergocalciferol 50,000 intl units Cap",,,,,$5.30 
68084-0475-01 - calcitriol 0.25 mcg Cap,,,,,$4.30 
68084-0481-01 - levofloxacin 250 mg Tab,,,,,$34.15 
68084-0481-11 - levofloxacin 250 mg Tab,,,,,$34.00 
68084-0482-01 - levofloxacin 500 mg Tab,,,,,$39.15 
68084-0512-01 - simvastatin 20 mg Tab,,,,,$12.80 
68084-0512-11 - simvastatin 20 mg Tab,,,,,$12.80 
68084-0542-01 - nabumetone 500 mg Tab,,,,,$4.40 
68084-0563-01 - gabapentin 300 mg Cap,,,,,$4.20 
68084-0591-01 - isosorbide mononitrate 30 mg ER,,,,,$4.35 
68084-0603-21 - NIFEdipine 90 mg ER,,,,,$6.80 
68084-0605-01 - FLUoxetine 20 mg Cap,,,,,$6.55 
68084-0605-11 - fluoxetine 20 mg Cap,,,,,$6.55 
68084-0617-01 - escitalopram 10 mg Tab,,,,,$11.25 
68084-0620-01 - montelukast 10 mg Tab,,,,,$11.40 
68084-0647-01 - ALPRAZolam 0.25 mg Tab,,,,,$6.90 
68084-0666-01 - metoprolol 50 mg ER,,,,,$4.40 
68084-0674-01 - verapamil 180 mg/12 hours ER,,,,,$4.45 
68084-0683-01 - DULoxetine 30 mg ER,,,,,$15.95 
68084-0692-01 - DULoxetine 60 mg ER,,,,,$15.95 
68084-0722-65 - moxifloxacin 400 mg Tab,,,,,$55.70 
68084-0723-01 - OLANZapine 5 mg Tab,,,,,$22.55 
68084-0762-01 - gabapentin 300 mg Cap,,,,,$4.70 
68084-0772-01 - ibuprofen 800 mg Tab,,,,,$3.60 
68084-0776-01 - divalproex sodium 250 mg EC,,,,,$4.60 
68084-0776-35 - divalproex sodium 250 mg EC,,,,,$3.90 
68084-0782-01 - divalproex sodium 500 mg EC,,,,,$8.40 
68084-0847-01 - hydrOXYzine pamoate 25 mg Cap,,,,,$2.85 
68084-0854-01 - carvedilol 6.25 mg Tab,,,,,$5.05 
68084-0870-01 - levETIRAcetam 500 mg Tab,,,,,$4.15 
68084-0913-32 - azithromycin 500 mg Tab,,,,,$32.20 
68084-0947-32 - quiNINE 324 mg Cap,,,,,$10.95 
68084-0966-01 - metroNIDAZOLE 500 mg Tab,,,,,$4.40 
68084-0969-01 - celecoxib 100 mg Cap,,,,,$12.00 
68094-0171-59 - sucralfate 1 g/10 mL Sus,,,,,$4.50 
68094-0494-58 - ibuprofen 100 mg/5 mL Oral Susp [UBMC],,,,,$2.70 
68180-0166-13 - vancomycin 125 mg Cap,,,,,$64.90 
68180-0302-20 - cefuroxime 250 mg Tab [UBMC],,,,,$11.45 
68180-0467-07 - lovastatin 10 mg Tab,,,,,$4.55 
68180-0644-10 - cefTRIAXone 2 g REC,,,,,$189.20 
68180-0722-20 - cefdinir 125 mg/5 mL REC,,,,,$4.45 
68180-0852-11 - levonorgestrel 1.5 mg Tab,,,,,$71.85 
68209-0643-01 - albumin human 25% Sol [UBMC],,,,,$20.50 
68209-0843-04 - immune globulin intravenous 5% Sol [UBMC],,,,,$21.60 
68382-0247-01 - benzonatate 100 mg Cap,,,,,$4.00 
68382-0310-30 - nitroglycerin 0.4 mg/hr ER,,,,,$5.65 
68382-0422-02 - ranitidine 25 mg/mL Sol,,,,,$24.20 
68382-0544-01 - lansoprazole 30 mg DR,,,,,$12.20 
68462-0157-13 - ondansetron 4 mg ODT [UBMC],,,,,$47.85 
68462-0157-13 - THP ondansetron 4 mg DIS home pack[UBMC],,,,,$47.85 
68462-0157-40 - ondansetron 4 mg ODT [UBMC],,,,,$47.85 
68462-0292-01 - verapamil 120 mg/12 hours ER,,,,,$4.20 
68462-0358-01 - nabumetone 500 mg Tab,,,,,$4.70 
68462-0406-01 - indomethacin 25 mg Cap,,,,,$3.40 
68516-5216-01 - albumin human 25% Sol,,,,,$22.90 
68585-0006-12 - magnesium oxide 400 mg Tab,,,,,$2.05 
68585-0061-20 - magnesium oxide 400 mg Tab,,,,,$1.65 
68817-0134-50 - PACLitaxel protein-bound 100 mg REC,,,,,"$2,906.15 "
68982-0623-03 - albumin human 5% Sol,,,,,$15.75 
68982-0643-01 - albumin human 25% Sol,,,,,$18.65 
68982-0643-02 - albumin human 25% Sol,,,,,$18.25 
68982-0840-04 - immune globulin intravenous 5% Sol,,,,,$19.10 
69097-0422-07 - celecoxib 100 mg Cap,,,,,$12.00 
69097-0813-07 - gabapentin 100 mg Cap,,,,,$3.65 
"69209 Removal impacted cerumen using irrigation/lavage, unilateral",$89.50 ,,,,
"69210 Removal impacted cerumen requiring instrumentation, unilateral",$89.50 ,,,,
69315-0211-01 - NIFEdipine 10 mg Cap,,,,,$4.20 
"69452-0151-20 - ergocalciferol 50,000 intl units Cap",,,,,$4.15 
6MM X 51MM XOMED BUR,$235.75 ,,,,
70003-0300-20 - nitroglycerin 0.4 mg Spr,,,,,$49.20 
70010-0754-01 - methocarbamol 500 mg Tab,,,,,$4.00 
70069-0005-10 - cyanocobalamin 1000 mcg/mL Sol,,,,,$29.95 
70069-0014-10 - glycopyrrolate 0.2 mg/mL Sol,,,,,$23.45 
70121-1381-05 - fosphenytoin 100 mgPE/2 mL Sol,,,,,$28.15 
70121-1453-07 - meropenem 1000 mg REC,,,,,$34.30 
70860-0104-10 - vancomycin 500 mg REC,,,,,$26.30 
70860-0105-20 - vancomycin 1 g REC,,,,,$28.15 
70860-0400-10 - tranexamic acid 100 mg/mL Sol,,,,,$18.95 
70860-0701-02 - ketorolac 60 mg/2 mL Sol,,,,,$19.10 
70860-0776-02 - ondansetron 2 mg/mL Sol,,,,,$18.70 
75137-0857-00 - benzethonium Cl-benzocaine 0.2%-20% Spr [UBMC],,,,,$1.55 
75826-0114-10 - phenazopyridine 100 mg Tab,,,,,$6.25 
76075-0101-01 - carfilzomib 60 mg REC,,,,,"$3,541.70 "
76204-0600-05 - albuterol-ipratropium 2.5 mg-0.5 mg/3 mL Sol,,,,,$4.20 
76204-0900-24 - levalbuterol 1.25 mg/3 mL Sol,,,,,$4.10 
76329-1240-01 - phytonadione 1 mg/0.5 mL Sol,,,,,$89.40 
76329-1240-05 - phytonadione 1 mg/0.5 mL Sol,,,,,$26.50 
76329-1469-01 - naloxone 1 mg/mL Sol,,,,,$51.50 
76329-3301-01 - glucose 50% Sol,,,,,$15.75 
76329-3352-01 - sodium bicarbonate 8.4% Sol,,,,,$15.75 
76329-3369-01 - naloxone 1 mg/mL Sol,,,,,$51.50 
76329-3390-01 - lidocaine 2% preservative-free Sol,,,,,$22.45 
83490-0107-60 - sodium chloride 7% Inh Sol 4 mL [UBMC],,,,,$2.95 
85060 AP Bill Peripheral Smear with Path Interp,$48.75 ,,,,
85095 AP Bill Bone Marrow Aspiration,"$2,210.75 ",,,,
88104 AP Bill Non-Gyn Cytology,$111.25 ,,,,
88108 Bill Cyto Non-Gyn Conc Tech,$80.00 ,,,,
88170 AP Bill FNA Superficial,$514.50 ,,,,
88172 - TC Bill FNA Adequacy,$266.25 ,,,,
88172 AP Bill FNA Immediate read,$266.25 ,,,,
88173 - TC Bill FNA Report,$164.50 ,,,,
88173 AP Bill FNA Interp and report,$164.50 ,,,,
88177 - TC Bill FNA Add Adequacy,$44.50 ,,,,
88300 AP Bill Surgical Pathology Level I Complexity,$56.25 ,,,,
88302 AP Bill Surgical Pathology Level II Complexity,$89.25 ,,,,
88304 AP Bill Surgical Pathology Level III Complexity,$130.00 ,,,,
88305 AP Bill Surgical Pathology Level IV Complexity,$170.50 ,,,,
88307 AP Bill Surgical Pathology Level V Complexity,$353.25 ,,,,
88309 AP Bill Surgical Pathology Level VI Complexity,$887.25 ,,,,
88311 AP Bill Decalcification,$50.50 ,,,,
88312 AP Bill Special Stains Group I,$100.75 ,,,,
88313 AP Bill Special Stains Group II,$113.75 ,,,,
88321 AP Bill Consultation Fee Outside slides and report,$58.75 ,,,,
88323 AP Bill Consultation Fee Outside slides/report prep,$142.50 ,,,,
88325 AP Bill Consultation Fee Comprehensive,$88.75 ,,,,
88329 AP Bill Surgical Intraoperative Consult,$85.25 ,,,,
88331 AP Bill Frozen single specimen,$211.75 ,,,,
88332 AP Bill Frozen add'l block,$82.00 ,,,,
88333 AP Bill Touch Prep First Site,$887.25 ,,,,
88334 AP Bill Non-Gyn Cytology Add'l Site,$80.00 ,,,,
92506 EVAL SPEECH CHARGE,$342.50 ,,,,
92521 EVAL OF SPEECH FLUENCY CHARGE,$197.75 ,,,,
92522 EVAL SPEECH SOUND PRODUCTION CHARGE,$160.00 ,,,,
92586 Automated brain response,$241.25 ,,,,
"94060- Bronchodilation responsiveness, spirometry as in 94010, pre-",$423.75 ,,,,
"94726- Plethysmography for determination of lung volumes and, when",$409.50 ,,,,
"94729 Diffusing capacity (eg, carbon monoxide, membrane) (List sep",$229.50 ,,,,
"94729- Diffusing capacity (eg, carbon monoxide, membrane) (List sep",$229.50 ,,,,
95813 EEG over 1 hour,$725.50 ,,,,
"96360 - HYDRATION, FIRST HOUR",$313.50 ,,,,
"96367 - IV tx, sequential infusion",$119.75 ,,,,
"96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular",$87.25 ,,,,
"96376 - IV Push, add same drug",$82.00 ,,,,
"97602 Removal of devitalized tissue from wound(s), non-selective debridement",$251.25 ,,,,
97607 Negative Pressure Wound Therapy (disposable) < 50 sq cm,$480.00 ,,,,
97608 Negative Pressure Wound Therapy (disposable) > 50 sq cm,$480.00 ,,,,
99281 - ED Level 1,$118.25 ,,,,
99281 - Level 1,$118.25 ,,,,
99281 - Level 1 - Lynx Visit Level,$118.25 ,,,,
99282 - ED Level 2,$249.25 ,,,,
99282 - Level 2,$249.25 ,,,,
99282 - Level 2 - Lynx Visit Level,$249.25 ,,,,
99283 - ED Level 3,$611.00 ,,,,
99283 - Level 3,$611.00 ,,,,
99283 - Level 3 - Lynx Visit Level,$611.00 ,,,,
99284 - ED Level 4,$988.25 ,,,,
99284 - Level 4,$988.25 ,,,,
99284 - Level 4 - Lynx Visit Level,$988.25 ,,,,
99285 - ED Level 5,"$1,926.00 ",,,,
99285 - Level 5,"$1,926.00 ",,,,
99285 - Level 5 - Lynx Visit Level,"$1,926.00 ",,,,
99291 - Critical Care,"$2,195.75 ",,,,
99291 - Critical Care - Lynx Visit Level,"$2,700.00 ",,,,
99999-9999-01 - GI Cocktail (Pink) [UBMC],,,,,$1.70 
99999-9999-02 - GI Cocktail (Green) [UBMC],,,,,$1.40 
99999-9999-03 - Magic Mouthwash [UBMC],,,,,$1.35 
99999-9999-04 - butt paste [UBMC],,,,,$5.30 
99999-9999-05 - oseltamivir suspension 30mg/5mL [UBMC],,,,,$4.40 
99999-9999-05 - vancomycin syrup 100mg/5mL[UBMC],,,,,$1.70 
99999-9999-07 - LET Gel [UBMC],,,,,$2.70 
A/E STOCKIN K/H LG RE,$20.00 ,,,,
A/E STOCKIN K/H MD RE,$20.00 ,,,,
A/E STOCKIN K/H SM RE,$20.00 ,,,,
A/E STOCKIN K/H XLG REG,$20.00 ,,,,
A/E STOCKIN T/H LG LO,$33.50 ,,,,
A/E STOCKIN T/H LG RE,$33.50 ,,,,
A/E STOCKIN T/H MD LO,$33.50 ,,,,
A/E STOCKIN T/H MD RE,$32.50 ,,,,
A/E STOCKIN T/H SM RE,$32.50 ,,,,
A/E STOCKIN T/H XLG L,$56.50 ,,,,
A/E STOCKIN T/H XLG R,$57.00 ,,,,
AB Ident Panel-LISS (IRL) ARUP,$353.50 ,,,,
AB Ident Panel-PEG (IRL) ARUP,$353.50 ,,,,
AB Ident Panel-Solid Phase (IRL) ARUP,$353.50 ,,,,
ABDOM PARACENTESIS/PERIN Charge,"$1,230.25 ",,,,
ABDOM SUP 24-28  SM,$44.50 ,,,,
ABDOM SUP 28-32  MED,$44.25 ,,,,
ABDOM SUP 32-36  LRG,$40.00 ,,,,
ABDOM SUP 36 -40,$128.75 ,,,,
ABDOM SUP 40-45  XL,$40.00 ,,,,
ABDOM SUP 45-50  XXL,$40.00 ,,,,
ABDOM SUP UNIVERSAL,$38.00 ,,,,
Abdoman Paracentesis,$569.50 ,,,,
ABG KIT,$7.00 ,,,,
ABG.BGHO,$93.25 ,,,,
ABORh,$172.25 ,,,,
Acetaminophen Level,$129.50 ,,,,
Acetone Ql,$54.25 ,,,,
Acetylcholine Binding Ab ARUP,$173.25 ,,,,
Acetylcholine Blocking Ab ARUP,$142.00 ,,,,
Acetylcholine Modulating Ab ARUP,$142.00 ,,,,
Acetylcholine Receptor Ab Reflex Panel ARUP,$426.00 ,,,,
ACHILLES SUTURE BRIDGE,"$2,941.50 ",,,,
ACLS ADVANCED W/RN Charge,"$1,490.00 ",,,,
ACRON 1.4MM X64MM XOMED BUR,$79.75 ,,,,
ACRON 1MM X 64MM XOMED BUR,$79.75 ,,,,
ACRON 2.3MM X 64MM XOMED BUR,$79.75 ,,,,
ACTH Stimulating Cortisol 0 Min ARUP,$95.25 ,,,,
ACTH Stimulating Cortisol 30 Min ARUP,$95.25 ,,,,
ACTH Stimulating Cortisol 60 Min ARUP,$95.25 ,,,,
Actigraphy,$161.25 ,,,,
Acylcarnitines Quantitative ARUP,$476.50 ,,,,
ADAMTS13  ARUP,$218.75 ,,,,
"ADJACENT TISSUE TRANSFER FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET",,,,"$1,529.75 ",
"ADJACENT TISSUE TRANSFER SCALP, ARMS AND/OR LEGS <= 10 SQ CM CHARGE",,,,"$1,217.75 ",
"ADJACENT TISSUE TRANSFER SCALP, ARMS AND/OR LEGS 10.1 TO 30.0 SQ CM CHARGE",,,,"$1,655.75 ",
ADL/HOME MANAGEMENT,$83.00 ,,,,
Adrenocorticotropic Hormone ARUP,$144.00 ,,,,
"Adult SPO2 Sensor, disposable",$43.75 ,,,,
"AE1,3 by IHC ARUP",$370.50 ,,,,
AEROCHAMBER (SPACER),$43.25 ,,,,
AEROSOL RX INITIAL,$305.75 ,,,,
Aerosol Rx Initial,$305.75 ,,,,
AEROSOL RX PRN,$305.75 ,,,,
Aerosol Rx Subsequent,$305.75 ,,,,
AEROSOL TENT SET UP,$351.50 ,,,,
AEROSOL TENT SUBSEQUENT DAYS,$280.75 ,,,,
AEROSOL TUBING,$24.75 ,,,,
AIRWAY  NASAL 20 FR,$220.50 ,,,,
AIRWAY  NASAL 22 FR,$54.50 ,,,,
AIRWAY  NASAL 24 FR,$220.50 ,,,,
AIRWAY  NASAL 26 FR,$220.50 ,,,,
AIRWAY  NASAL 28 FR,$72.75 ,,,,
AIRWAY  NASAL 30 FR,$41.50 ,,,,
AIRWAY  NASAL 32 FR,$57.50 ,,,,
AIRWAY  NASAL 34 FR,$220.50 ,,,,
AIRWAY  NASAL 36 FR,$220.50 ,,,,
AKAH OSHI CANNULA 27G,$230.50 ,,,,
Alanine Aminotransferase,$54.50 ,,,,
"Alanine Aminotransferase, Serum/Plasma ARUP",$54.50 ,,,,
Albumin Level,$54.00 ,,,,
"Albumin, Body Fluid ARUP",$36.25 ,,,,
"Albumin, CSF ARUP",$36.25 ,,,,
"Aldolase, Serum ARUP",$92.50 ,,,,
Aldosterone ARUP,$113.00 ,,,,
"Algidex 1/4"" packing",$45.50 ,,,,
Alkaline Phosphatase,$53.75 ,,,,
Alkaline Phosphatase Isoenzymes ARUP,$72.00 ,,,,
"Allergen, Animal, Cat Dander ARUP",$40.00 ,,,,
"Allergen, Animal, Dog Dander ARUP",$40.00 ,,,,
"Allergen, Animal, Feather Mix ARUP",$40.00 ,,,,
"Allergen, Animal, Feather Mix IgE ARUP",$187.00 ,,,,
"Allergen, Food, Almond ARUP",$40.00 ,,,,
"Allergen, Food, Beef ARUP",$40.00 ,,,,
"Allergen, Food, Beef IgE ARUP",$187.00 ,,,,
"Allergen, Food, Brazil Nut ARUP",$40.00 ,,,,
"Allergen, Food, Cashew ARUP",$40.00 ,,,,
"Allergen, Food, Chestnut ARUP",$40.00 ,,,,
"Allergen, Food, Clam ARUP",$40.00 ,,,,
"Allergen, Food, Codfish ARUP",$40.00 ,,,,
"Allergen, Food, Common Adult Profile ARUP",$40.00 ,,,,
"Allergen, Food, Comprehensive Profile 1 ARUP",$40.00 ,,,,
"Allergen, Food, Corn ARUP",$40.00 ,,,,
"Allergen, Food, Crab ARUP",$40.00 ,,,,
"Allergen, Food, Egg White ARUP",$40.00 ,,,,
"Allergen, Food, Egg Whole ARUP",$40.00 ,,,,
"Allergen, Food, Hazelnut (Filbert) ARUP",$40.00 ,,,,
"Allergen, Food, Lobster ARUP",$40.00 ,,,,
"Allergen, Food, Milk (Cow's) ARUP",$40.00 ,,,,
"Allergen, Food, Mixed Nuts ARUP",$40.00 ,,,,
"Allergen, Food, Peanut ARUP",$40.00 ,,,,
"Allergen, Food, Pecan ARUP",$40.00 ,,,,
"Allergen, Food, Pistachio ARUP",$40.00 ,,,,
"Allergen, Food, Pork ARUP",$40.00 ,,,,
"Allergen, Food, Pork IgE ARUP",$187.00 ,,,,
"Allergen, Food, Red Dye IgE ARUP",$40.00 ,,,,
"Allergen, Food, Salmon ARUP",$40.00 ,,,,
"Allergen, Food, Scallop ARUP",$40.00 ,,,,
"Allergen, Food, Sesame Seed ARUP",$40.00 ,,,,
"Allergen, Food, Shrimp ARUP",$40.00 ,,,,
"Allergen, Food, Soybean ARUP",$40.00 ,,,,
"Allergen, Food, Tuna ARUP",$40.00 ,,,,
"Allergen, Food, Walnut/Black Walnut ARUP",$40.00 ,,,,
"Allergen, Food, Wheat ARUP",$40.00 ,,,,
"Allergen, Fungi/Mold, A. alternatas ARUP",$40.00 ,,,,
"Allergen, Fungi/Mold, A. fumigatus ARUP",$40.00 ,,,,
"Allergen, Fungi/Mold, Hormodendrum ARUP",$40.00 ,,,,
"Allergen, Fungi/Mold, Phoma betae ARUP",$40.00 ,,,,
"Allergen, Grass, Bent Grass/Redtop Grass ARUP",$40.00 ,,,,
"Allergen, Grass, Bermuda Grass ARUP",$40.00 ,,,,
"Allergen, Insect, Cockroach, German ARUP",$40.00 ,,,,
"Allergen, Insect, Mosquito, IgE ARUP",$40.00 ,,,,
"Allergen, Isocyanate Panel ARUP",$40.00 ,,,,
"Allergen, Latex Specific IgE Panel RIA ARUP",$40.00 ,,,,
"Allergen, Mites, D. farinae ARUP",$40.00 ,,,,
"Allergen, Mites, D. pteronyssinus ARUP",$40.00 ,,,,
"Allergen, Occupational, Isocyanate  MDI ARUP",$40.00 ,,,,
"Allergen, Occupational, Isocyanate HDI ARUP",$40.00 ,,,,
"Allergen, Occupational, Isocyanate TDI ARUP",$40.00 ,,,,
"Allergen, Occupational, Sunflower ARUP",$40.00 ,,,,
"Allergen, Reg 11 Upper Resp Disease Pan ARUP",$40.00 ,,,,
"Allergen, Tree, Alder Tree ARUP",$40.00 ,,,,
"Allergen, Tree, Box Elder/Maple Tree ARUP",$40.00 ,,,,
"Allergen, Tree, Cottonwood Tree ARUP",$40.00 ,,,,
"Allergen, Tree, Elm Tree ARUP",$40.00 ,,,,
"Allergen, Tree, Mountain Cedar Tree ARUP",$40.00 ,,,,
"Allergen, Tree, Oak Tree ARUP",$40.00 ,,,,
"Allergen, Weed, Kochia/Firebush ARUP",$40.00 ,,,,
"Allergen, Weed, Russian Thistle ARUP",$40.00 ,,,,
Alpha Fetoprotein Tumor Marker ARUP,$139.50 ,,,,
Alpha-1-Antitrypsin ARUP,$73.25 ,,,,
Alpha-1-Antitrypsin Phenotype ARUP,$116.00 ,,,,
ALS LEVEL #2 MIL/SUP SEPARATE Charge,"$1,490.00 ",,,,
AM Surgical Blade Single,"$2,352.00 ",,,,
AMBULANCE ALS/BLS WAITING TIME PER 1/2 HOUR CHARGE,$60.00 ,,,,
AMBULANCE GROUND MILEAGE PER STATUTE 1.0 MILE MULTIPLE PT CHARGE,$15.82 ,,,,
AMBULANCE GROUND MILEAGE PER STATUTE 1.0 MILE SINGLE PT CHARGE,$31.65 ,,,,
Ambulance Mileage ALS,$31.65 ,,,,
Ambulance Mileage BLS,$15.82 ,,,,
"AMBULANCE OFF ROAD 10+ MILES, PER MILE Charge",$1.50 ,,,,
"AMBULANCE SERVICE ALS, EMERGENCY TRANSPORT LEVEL 1 CHARGE","$1,018.00 ",,,,
"AMBULANCE SERVICE ALS, EMERGENCY TRANSPORT LEVEL 1 PARAMEDIC CHARGE","$1,490.00 ",,,,
"AMBULANCE SERVICE ALS, NON-EMERGENCY TRANSPORT LEVEL 1 CHARGE","$1,490.00 ",,,,
"AMBULANCE SERVICE, BLS NON-EMERGENCY TRANSPORT CHARGE",$772.00 ,,,,
"Ambulatory infusion pump, won bt patient",$454.00 ,,,,
"Amino Acids Quantitative, Plasma ARUP",$378.00 ,,,,
Amiodarone and Metabolite ARUP,$198.50 ,,,,
Amitriptyline and Nortriptyline ARUP,$100.75 ,,,,
Ammonia Level,$115.00 ,,,,
Ammonia Level.,$115.00 ,,,,
AMNIOCENTESIS TRAY,$53.50 ,,,,
Amnisure ROM,$173.25 ,,,,
AMPUTATION  METATARSOL WITH TOE SINGLE,,,,"$1,192.25 ",
AMPUTATION FINGER OR THUMB PRIMARY OR SECONDARY ANY JOINT WITH DIRECT CLOSURE SINGLE CHARGE,"$4,338.25 ",,,,
AMPUTATION FINGER OR THUMB PRIMARY OR SECONDARY ANY JOINT WITH LOCAL ADVANCEMENT FLAP SINGLE CHARGE,,,,"$2,239.75 ",
Amylase Level,$78.25 ,,,,
"Amylase, Body Fluid ARUP",$78.25 ,,,,
Anabolic Steroids ARUP,$548.75 ,,,,
Anaerobic Culture,$146.75 ,,,,
ANCHOR FASTIN RC,"$1,395.00 ",,,,
ANCHOR G II,$608.75 ,,,,
Androstenedione by TMS ARUP,$146.25 ,,,,
ANGIOCATH 14GA X 3.5,$16.00 ,,,,
"Angiotensin Converting Enzyme, Serum ARUP",$68.50 ,,,,
ANGLED AGGRESSIVE MICRODEBRIDER 4.0,$374.25 ,,,,
ANKLE BRACE LACE UP S,$45.25 ,,,,
ANKLE BRACE LACE-UP L,$44.75 ,,,,
ANKLE BRACE LACE-UP M,$44.75 ,,,,
ANKLE BRACE LEFT GEL,$116.50 ,,,,
ANKLE BRACE RIGHT GEL,$116.50 ,,,,
ANKLE STRAPPING Charge,$423.75 ,,,,
ANOSCOPY - CHARGE,$175.75 ,,,,
ANTERIOR VITRECTOMY PAK,$481.50 ,,,,
Antibody ID Package (IRL) ARUP,$232.00 ,,,,
"Antibody ID, RBC  (Prenatal Only) ARUP",$232.00 ,,,,
Antibody Screen Gel,$90.00 ,,,,
Antibody Titer (IRL) ARUP,$211.75 ,,,,
"Antigen Testing, AHG-RBC ARUP",$211.75 ,,,,
"Antigen Testing, Direct-RBC ARUP",$211.75 ,,,,
"Antigen Testing, Rh Phenotype ARUP",$353.25 ,,,,
Anti-Mullerian Hormone ARUP,$170.50 ,,,,
Anti-Neutrophil Cytoplasmic Ab ARUP,$156.75 ,,,,
Anti-nuclear Ab (ANA) Reflex ARUP,$78.75 ,,,,
"Anti-Nuclear Ab (ANA), IgG by ELISA ARUP",$78.75 ,,,,
"Anti-Nuclear Ab (ANA), IgG by ELISA ARUP",$78.75 ,,,,
"Anti-Nuclear Ab, IgG w/Rflx to IFA ARUP",$86.75 ,,,,
"Antinuclear Antibody (ANA) with HEp-2 Substrate, IgG by IFA ARUP",$27.15 ,,,,
ANTI-REFLUX VALVES,$18.75 ,,,,
Antistreptolysin O Screen ARUP,$130.25 ,,,,
"Antithrombin, Antigen ARUP",$214.50 ,,,,
"Antithrombin, Enzymatic (Activity) ARUP",$120.50 ,,,,
APC Resistance ARUP,$89.50 ,,,,
APC Resistance Panel ARUP,$89.50 ,,,,
Aph Plt ACDA LR 1,"$1,017.75 ",,,,
Aph Plt ACDA LR 2,"$1,017.75 ",,,,
Aph Plt ACDA LR Irr 1,"$1,017.75 ",,,,
Aph Plt ACDA LR Irr 2,$969.50 ,,,,
APHASIA EVAL,$467.75 ,,,,
"App low cost skin sub graft f/s/e/m/n/e/o/g/h/f >= 100 sq cm; 100 sq cm, or 1% - MC",$743.25 ,,,,
"App low cost skin sub graft f/s/e/m/n/e/o/g/h/f >= 100 sq cm; ea add 100 sq cm, or ea add 1% - MC",$406.50 ,,,,
App low cost skin sub graft f/s/e/m/n/e/o/g/h/f up to 100 sq cm; 25 sq cm or less - MC,$743.25 ,,,,
App low cost skin sub graft f/s/e/m/n/e/o/g/h/f up to 100 sq cm; ea add 25 sq cm - MC,$406.50 ,,,,
App low cost skin sub graft t/a/l >= 100 sq cm; 100 sq cm - MC,"$2,341.75 ",,,,
App low cost skin sub graft t/a/l >= 100 sq cm; ea add 100 sq cm or ea add 1% - MC,$684.00 ,,,,
App low cost skin sub graft t/a/l up to 100 sq cm; 25 sq cm or less - MC,$743.25 ,,,,
App low cost skin sub graft t/a/l up to 100 sq cm; ea add 25 sq cm - MC,$406.50 ,,,,
App skin sub graft f/s/e/m/n/e/o/g/h/f >= 100 sq cm; 100 sq cm or 1% (HIGH),"$2,341.75 ",,,,
App skin sub graft f/s/e/m/n/e/o/g/h/f >= 100 sq cm; ea add 100 sq cm or ea add 1% (HIGH),$684.00 ,,,,
App skin sub graft f/s/e/m/n/e/o/g/h/f up to 100 sq cm; 25 sq cm or less (HIGH),"$2,341.75 ",,,,
App skin sub graft f/s/e/m/n/e/o/g/h/f up to 100 sq cm; ea add 25 sq cm (HIGH),$684.00 ,,,,
"App skin sub graft t/a/l >= 100 sq cm; 100 sq cm, or 1% (HIGH)","$4,108.00 ",,,,
"App skin sub graft t/a/l >= 100 sq cm; ea add 100 sq cm, or ea add 1% (HIGH)",$222.00 ,,,,
App skin sub graft t/a/l up to 100 sq cm; 25 sq cm or less (HIGH),"$2,341.75 ",,,,
App skin sub graft t/a/l up to 100 sq cm; ea add 25 sq cm (HIGH),$684.00 ,,,,
APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM) CHARGE,,,,$229.25 ,
APPLICATION OF CAST HAND AND LOWER FOREARM CHARGE,,,,$229.25 ,
APPLICATION OF CAST SHOULDER TO HAND CHARGE,,,,$264.75 ,
APPLICATION OF LONG ARM SPLINT CHARGE,$222.00 ,,,,
APPLICATION OF LONG LEG CAST CHARGE,,,,$336.25 ,
APPLICATION OF LONG LEG CAST CYLINDER TYPE CHARGE,$389.25 ,,,,
APPLICATION OF LONG LEG CAST WALKER OR AMBULATORY TYPE CHARGE,,,,$370.00 ,
APPLICATION OF LONG LEG SPLINT CHARGE,$299.25 ,,,,
APPLICATION OF SH ARM SP,$389.25 ,,,,
"APPLICATION OF SHORT ARM SPLINT, STATIC CHARGE",$172.25 ,,,,
APPLICATION OF SHORT LEG CAST BELOW KNEE CHARGE,$423.75 ,,,,
APPLICATION OF SHORT LEG SPLINT CHARGE,$222.00 ,,,,
APPLICATION OF SHORT LEG WALKING CAST CHARGE,$389.25 ,,,,
APPLICATION OF STATIC FINGER SPLINT CHARGE,$106.50 ,,,,
APPLIER LIGAMAX 5 MM ENDO CLIP,"$1,399.00 ",,,,
Aquaporin-4 Receptor Antibody ARUP,$527.25 ,,,,
Aquatic Therapy Charges,$80.50 ,,,,
AQUATIC THERP W/THER EX,$80.50 ,,,,
AR-7281,$76.00 ,,,,
Arginine Vasopressin Hormone ARUP,$100.75 ,,,,
ARM SLING EX-SMALL PED,$21.75 ,,,,
ARM SLING W/VELCRO LA,$14.25 ,,,,
ARM SLING W/VELCRO ME,$14.25 ,,,,
ARM SLING W/VELCRO SM,$14.25 ,,,,
ARM SLING W/VELCRO XL,$14.25 ,,,,
Arsenic Blood ARUP,$63.00 ,,,,
Arsenic Blood ARUP,$63.00 ,,,,
Arsenic Urine ug/L ARUP,$63.00 ,,,,
"Arsenic, Blood ARUP",$63.00 ,,,,
"Arsenic, Fractionated, Urine ARUP",$429.00 ,,,,
ART LINE KIT Charge,$53.50 ,,,,
ARTERIAL BLOOD GAS,$182.50 ,,,,
"ARTERIAL LINE FOR SAMPLING, MONITORING, OR TRANSFUSION PERCUTANEOUS CHARGE",,,,$246.50 ,
ARTERIAL WRIST SUPPOR,$61.25 ,,,,
ARTHREX FIBER WIRE 2 TAPER NEEDLE,$88.00 ,,,,
ARTHREX FIBERWIRE,$47.75 ,,,,
ARTHROCENTESIS INTERMEDIATE JOINT OR BURSA ELBOW/ANKLE CHARGE,$401.50 ,,,,
ARTHROCENTESIS MAJOR JOINT OR BURSA CHARGE,$401.50 ,,,,
ARTHROCENTESIS SMALL JOINT OR BURSA CHARGE,$406.25 ,,,,
ARTHROSCOPY INFLOW/OUTFLOW TUBE SET,$124.25 ,,,,
ARTHROSCOPY PACK II,$95.00 ,,,,
Artificial rupture,$135.00 ,,,,
Artificial rupture,$135.00 ,,,,
ASH CATH 14 FR X 32 CM,$729.00 ,,,,
Ashtma Kit,$30.00 ,,,,
Aspartate Aminotransferase,$54.50 ,,,,
"Aspartate Aminotransferase, Serum/Plasma ARUP",$54.50 ,,,,
Aspergillus flavus ARUP,$199.25 ,,,,
Aspergillus fumigatus #1 ARUP,$199.25 ,,,,
Aspergillus fumigatus #2 ARUP,$199.25 ,,,,
Aspergillus fumigatus #3 ARUP,$199.25 ,,,,
Aspergillus fumigatus #6 ARUP,$199.25 ,,,,
ASPIRATION OF BLADDER WITH INSERTION OF SUPRAPUBIC CATHETER CHARGE,"$2,891.75 ",,,,
"Aspiration of bladder, by needle",$974.75 ,,,,
ASPIRATION OR INJECTION GANGLION CYST CHARGE,$416.00 ,,,,
Asthma Education Clinic,$57.00 ,,,,
ASV titration,"$4,072.50 ",,,,
ATHLETIC SUPPORTER,$7.00 ,,,,
Aureobasidium pullulans ARUP,$199.25 ,,,,
AUTO SUTURE BLUNT TIP TROCAR 12MM,$237.25 ,,,,
AUTO VENT CHARGE,$218.50 ,,,,
AUTO VENT CIRCUITS Charge,$109.75 ,,,,
"Autoimmune Hep Panel, Reflx to ANA Titer ARUP",$341.75 ,,,,
"Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Ab (SMA), IgG by IFA ARUP",$341.75 ,,,,
AUTOPULSE LIFE BAND,"$1,065.75 ",,,,
AVAC CANNISTER SUCTION,$47.25 ,,,,
AVULSION OF NAIL PLATE PARTIAL/COMPLETE SIMPLE EACH ADDTL CHARGE,,,,$88.50 ,
AVULSION OF NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE CHARGE,$277.00 ,,,,
"Avulsion of nail plate, partial or complete, simple: 1 nail plate",$251.25 ,,,,
Avulsion of nail plate; each additional nail plate,$125.75 ,,,,
Axillary Block each additional 15 minutes,$175.50 ,,,,
Axillary Block first 30 minutes,$524.25 ,,,,
"B. burgdorferi Ab, IgG/ IgM Wblot (CSF) ARUP",$176.25 ,,,,
"B. pertussis Abs,IgG,IgM,IgA w/Reflex ARUP",$226.75 ,,,,
"B2glycoprotein I Abs, IgG and IgM ARUP",$164.00 ,,,,
bacitracin Top 500 units/g Oint TOPICAL,$4.50 ,,,,
bacitracin/neomycin/polymyxin B Top Oint,$5.25 ,,,,
Bair Hugger Warming Gown Flex,$60.00 ,,,,
Bair Hugger Warming Gown Standard,$46.00 ,,,,
Balanced salt solution 500 mL,$68.25 ,,,,
BALLARD SXN CATHETER,$95.00 ,,,,
Bard 3d Mesh Left Side Large,$969.00 ,,,,
Bard 3d Mesh Left Side Medium,$886.50 ,,,,
Bard 3d Mesh Right Side Large,$969.00 ,,,,
Bard 3d Mesh Right Side Medium,$886.50 ,,,,
BARD MESH PERFIX PLU SMALL,$407.50 ,,,,
Bard Mesh Perfix Plug - Large,"$1,795.40 ",,,,
Bard Mesh Perfix Plug - Medium,"$1,776.75 ",,,,
BASIC PACK,$15.50 ,,,,
Basic Pulmonary Function Testing UBMC,$248.50 ,,,,
"bcr/abl, t(9;22) Trans Qual by RT-PCR ARUP",$386.25 ,,,,
BD Bone Density DEXA App Skeleton,$212.25 ,,,,
BD Bone Density DEXA Axial Skeleton,$419.00 ,,,,
BD Bone Density DEXA Special,$419.00 ,,,,
BD Bone Density DEXA Study,$419.00 ,,,,
BD DEXA App Skeleton,$419.00 ,,,,
BD Dexa Axial Scan,$212.25 ,,,,
BEAR HUGGER Charge,$60.50 ,,,,
belladonna and opium 16.2/6 mg suppository,$56.25 ,,,,
"Bence Jones Protein, Quantitative, Urine ARUP",$271.00 ,,,,
"Beta-hCG, Serum Quant Tumor Marker ARUP",$75.00 ,,,,
Beta-Hydroxybutyrate,$73.25 ,,,,
Beta-Hydroxybutyric Acid ARUP,$73.25 ,,,,
Bi level titration,"$4,072.50 ",,,,
"Bicarbonate (HCO3), Urine ARUP",$30.00 ,,,,
Bier Block each additional 15 minutes,$175.50 ,,,,
Bier Block first 30 minutes,$524.25 ,,,,
Big 60 Inflation Device,$119.00 ,,,,
BIG CASE TABLE COVER,$140.75 ,,,,
"Bile Acids, Total ARUP",$58.50 ,,,,
Bilirubin Conjugated,$58.50 ,,,,
Bilirubin Direct,$58.50 ,,,,
Bilirubin Indirect.,$58.50 ,,,,
Bilirubin Neonatal,$48.50 ,,,,
Bilirubin Total,$48.50 ,,,,
"Bilirubin, Direct, Serum or Plasma ARUP",$58.50 ,,,,
Bill Only Backup Strep Screen,$51.50 ,,,,
BIODESIGN SURGISIS 8 LAYER GRAFT,"$7,628.75 ",,,,
"Biopsy of skin, subcutaneous tissue and/or mucous membrane; 1 lesion",$512.25 ,,,,
"BIOPSY OF SKIN, SUBCUTANEOUS TISSUE, AND/OR MUCOUS MEMBRANE SINGLE LESION CHARGE",,,,$175.25 ,
Biopsy of skin; each separate / additional lesion,$256.25 ,,,,
BiPolar Probe,$356.25 ,,,,
BI-POLAR PROBE 7FR HEMOSTATIC,$490.00 ,,,,
"BK Virus Detection by PCR, Urine ARUP",$877.75 ,,,,
BK Virus Quant PCR Blood 2002304 ARUP,$630.25 ,,,,
BLADDER IRRIGATION SIMPLE LAVAGE AND/OR INSTILLATION CHARGE,,,,$180.00 ,
Bladder scan,$96.00 ,,,,
Bladder scan - UBMC,$96.00 ,,,,
BLADE CRESCENT,$299.00 ,,,,
BLADE MED,$109.00 ,,,,
BLADE MED AVE.,$192.25 ,,,,
BLADE MED. AGGRASSIVE,$192.25 ,,,,
BLOOD ADM >12 HR Charge,"$1,663.50 ",,,,
BLOOD ADM 0-2 HR Charge,$963.50 ,,,,
BLOOD ADM 3-4 HR Charge,"$1,063.50 ",,,,
BLOOD ADM 5-6 HR Charge,"$1,163.50 ",,,,
BLOOD ADM 7-8 HR Charge,"$1,263.50 ",,,,
BLOOD ADM 9-12 HR Charge,"$1,463.50 ",,,,
Blood collection using central or peripheral venous access,$288.25 ,,,,
BLOOD COMP TRANS Charge,$963.50 ,,,,
Blood Culture,$137.00 ,,,,
BLOOD GAS ARTERIAL PH ONLY,$75.50 ,,,,
Blood Gas Kit Bill Only,$7.00 ,,,,
BLOOD GAS VENOUS PH ONLY,$75.50 ,,,,
Blood Glucose Monitoring POC,$15.50 ,,,,
"Blood Glucose, Capillary POC",$7.50 ,,,,
Blood Urea Nitrogen,$54.00 ,,,,
BLS EMERGENCY TRANSPORT MIL/SUP SEPARATE Charge,$772.00 ,,,,
BLUE 75MM RELOAD CUTTER,$281.00 ,,,,
BMP 4,$95.25 ,,,,
BO MOM Estridol,$150.00 ,,,,
BO MOM hCG,$75.00 ,,,,
BO MOM Inhibin,$70.00 ,,,,
BO Patient's AFP,$139.50 ,,,,
BO Patient's Estridol,$150.00 ,,,,
BO Patient's hCG,$75.00 ,,,,
BO Patient's Inhibin,$70.00 ,,,,
BODY BLANKET FULL ADULT,$28.75 ,,,,
BODY BLANKET LOWER,$27.25 ,,,,
BODY BLANKET UPPER,$36.00 ,,,,
Body Fluid Culture.,$116.00 ,,,,
Body Fluid pH,$77.25 ,,,,
BONANNO CATH TRAY 18G,$204.50 ,,,,
BONE CEMENT,$344.50 ,,,,
BONE CEMENT MIXER,$267.25 ,,,,
Bone Cement Simplex HV W Gentamicin Antibiotic,$838.50 ,,,,
BONE MARROW BIOPSY NEEDLE OR TROCAR CHARGE,,,,$238.25 ,
"BONECUTTER DYONICS ELECTROBLAD RESEC, 4.5 MM FULL",$464.00 ,,,,
BOOT CAST SANDAL ROCKER MED,$36.50 ,,,,
Bordetella pertussis by DNA Amplification,$235.00 ,,,,
Bordetella pertussis DFA ARUP,$128.50 ,,,,
"Bordetella pertussis/parapertussis, PCR ARUP",$398.50 ,,,,
"Borrelia burgdorferi Abs, Total by ELISA",$72.50 ,,,,
BRAVO PH CAPSULE,"$1,907.25 ",,,,
Breast Cream,$10.75 ,,,,
BREAST PUMP,$87.00 ,,,,
BUN Level Urine,$43.50 ,,,,
bupivacaine 0.5% PF Inj Sol 10 mL,$43.75 ,,,,
bupivacaine 0.5% PF Inj Sol 30 mL,$24.25 ,,,,
bupivicaine 0.25% Inj Sol 50 mL,$25.75 ,,,,
bupivicaine 0.25% PF Inj Sol 30 mL,$22.75 ,,,,
bupivicaine 0.5% epi 1:200000 Inj Sol 50 mL,$53.75 ,,,,
bupivicaine 0.5% Inj Sol 50 mL,$24.25 ,,,,
bupivicaine 0.75% intrathecal Sol 2 mL,$25.50 ,,,,
bupivicaine 0.75% PF Sol,$45.50 ,,,,
BUR 0.5mm,$79.75 ,,,,
BUR 1.0mm,$79.75 ,,,,
BUR 1.0mm ACORN,$79.75 ,,,,
BUR 1.4mm ACORN,$79.75 ,,,,
BUR 2.0mm,$79.75 ,,,,
BUR 2.3mm ACORN,$79.75 ,,,,
BUR 2.5mm,$79.75 ,,,,
BUR 2.7mm ACORN,$79.75 ,,,,
BUR 3X48 MM DIAMOND,$250.00 ,,,,
BUR 3X48 MM ROUND,$217.25 ,,,,
BUR 4 X 48 MM ROUND DIAMOND,$235.50 ,,,,
"BUR 4.0 MM OVAL, REDUCED HOOD",$164.00 ,,,,
BUR 4X48MM E9000 ROUND,$217.25 ,,,,
BUR 5.0 OVAL,$844.00 ,,,,
BUR 5.0mm,$79.75 ,,,,
BUR 5X48 MM DIAMOND,$246.25 ,,,,
BUR 5X48 MM ROUND,$217.25 ,,,,
BUR 6.0mm,$79.75 ,,,,
BUR 6.5X48MM ROUND,$217.25 ,,,,
BURN 1ST DEGREE INITIAL TREATMENT CHARGE,$277.75 ,,,,
BURN TREATMENT LARGE,$509.75 ,,,,
BURN TREATMENT MED,$442.50 ,,,,
BURN TREATMENT SMALL,$277.00 ,,,,
BURR EGG,$179.50 ,,,,
BURR FAST CUTTING,$165.75 ,,,,
C Trachomatis by PCR,$83.25 ,,,,
"C. difficile toxin B gene (tcdB), RT-PCR ARUP",$207.00 ,,,,
C. trachomatis Amplified ARUP,$140.75 ,,,,
C. trachomatis Amplified ARUP,$83.25 ,,,,
C1 Functional ARUP,$114.50 ,,,,
C-1-Esterase Inhibitor ARUP,$107.50 ,,,,
C282Y Hemochromatosis Mutation ARUP,$114.25 ,,,,
"CA 15-3, Cancer Antigen - Breast ARUP",$170.75 ,,,,
"Cadmium, Blood ARUP",$71.25 ,,,,
"Cadmium, Blood ARUP",$71.25 ,,,,
Calcitonin ARUP,$140.00 ,,,,
Calcium Level 24 Hour Urine,$65.00 ,,,,
Calcium Level Total,$58.00 ,,,,
Calcium Level Urine,$65.00 ,,,,
"Calcium, Ionized, Serum ARUP",$83.50 ,,,,
"Calcium, Serum or Plasma ARUP",$58.00 ,,,,
"Calcium, Urine - mg/day ARUP",$65.00 ,,,,
Calculi (STONE) Analysis ARUP,$112.00 ,,,,
Caldwell Paracentesis Needle,$27.50 ,,,,
California Encephalitis IgG CSF ARUP,$153.75 ,,,,
California Encephalitis IgM CSF ARUP,$153.75 ,,,,
"Calprotectin, Fecal ARUP",$610.00 ,,,,
Campylobacter,$78.50 ,,,,
CANALITH REPOSITIONING,$87.75 ,,,,
CANCELLOUS CHIPS,"$1,058.50 ",,,,
Cancer Antigen 125 ARUP,$113.00 ,,,,
Cancer Antigen 27.29 ARUP,$170.75 ,,,,
Cancer Antigen-GI (CA 19-9) ARUP,$75.50 ,,,,
"Candida albicans Ab IgA, IgG, and IgM by ELISA ARUP",$89.25 ,,,,
CANNULA NASAL 50FT,$15.25 ,,,,
CAPIO DEVICE,"$1,286.50 ",,,,
CAPIO SUTURE,$152.25 ,,,,
Carbamazepine Level,$108.25 ,,,,
Carbon Dioxide Level,$30.00 ,,,,
"Carbon Dioxide, Serum or Plasma ARUP",$30.00 ,,,,
Carboxyhemoglobin,$93.25 ,,,,
Carboxyhemoglobin.,$93.25 ,,,,
Carcinoembryonic Antigen ARUP,$113.75 ,,,,
CARDIAC EVENT MONITORING,$995.50 ,,,,
CARDIAC REHAB W/O ECG,$193.75 ,,,,
CARDIAC REHAB/MONITOR,$193.75 ,,,,
"Cardiolipin Antibodies, IgA, IgG, IgM ARUP",$172.00 ,,,,
Cardiolipin/Non-Criteria APS Abs Panel ARUP,$172.00 ,,,,
CARDIOPULMONARY RESUSCITATION CHARGE,$831.50 ,,,,
CARDIOVASCULAR STRESS TEST,$613.00 ,,,,
Cardioversion (Elective),$868.00 ,,,,
CARDIOVERSION DEFIBRILLA Charge,$354.75 ,,,,
"CARDIOVERSION ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL CHARGE",$868.00 ,,,,
CARDIOVERSION PROCEDURE  CHARGE,$868.00 ,,,,
"Carotene, Total, Serum ARUP",$56.75 ,,,,
CAST PAD 2  COTTON,$29.00 ,,,,
CAST PAD 3  COTTON,$22.00 ,,,,
CAST PAD 4  COTTON,$29.25 ,,,,
CAST PAD 6  COTTON,$22.00 ,,,,
CAST PLACEMENT Charge,$87.50 ,,,,
CAST REMOVAL CHARGE,$32.00 ,,,,
CAST SHOE LARGE,$36.50 ,,,,
CAST SHOE LARGE,$36.50 ,,,,
CAST SHOE MEDIUM,$36.50 ,,,,
CAST SHOE SMALL,$36.75 ,,,,
CAST SHOE SMALL,$36.75 ,,,,
CAST SHOE X-SMALL,$28.00 ,,,,
CAST SPLINT 3  PLASTER,$38.25 ,,,,
CAST SPLINT 5  PLASTER,$96.00 ,,,,
"CAST WALKER LG (BOOT) L1930, L2114",$235.75 ,,,,
"CAST WALKER MED (BOOT) L1930, L2114",$235.75 ,,,,
"CAST WALKER SM (BOOT) L1930, L2114",$235.75 ,,,,
CATARACT LENS,$371.50 ,,,,
"Catecholamines Panel, Urine Free ARUP",$133.75 ,,,,
CATH 3FR OPEN END URE,$20.00 ,,,,
CATH 5FR DUAL LUMEN POLYURETHANE,$215.25 ,,,,
CATH 5FR OPEN END URE,$20.00 ,,,,
CATH ALL PURPOSE 16FR,$8.25 ,,,,
Cath set arterial,$58.25 ,,,,
CATH SET ARTERY Charge,$57.75 ,,,,
CATH SET FEMORAL,$58.50 ,,,,
CATH SET MULTI-LUMEN SUPER KIT,$291.75 ,,,,
Cath set ped radial arterial,$43.75 ,,,,
CATH SET RADIAL ARTER,$43.75 ,,,,
CATHETER KIT 6CM,$584.75 ,,,,
Catheter Tip Culture,$116.00 ,,,,
Caudal Block each additional 15 minutes,$175.50 ,,,,
Caudal Block first 30 minutes,$524.25 ,,,,
CAUTERIZATION BY CHEMICAL OF GRANULATION TISSUE CHARGE,$285.25 ,,,,
CAUTERY TIP #0012AM,$20.75 ,,,,
CAUTERY TIP #0013M,$22.50 ,,,,
CAUTERY TIP #0014AM,$23.00 ,,,,
CAUTERY TIP #0014M,$23.25 ,,,,
CBC w/ Auto Diff,$63.00 ,,,,
C-COLLAR LG SERPENTIN,$22.25 ,,,,
C-COLLAR MED SERPENTI,$93.25 ,,,,
C-COLLAR SM SERPENTIN,$22.25 ,,,,
C-COLLAR SM XLONG SER,$74.75 ,,,,
C-COLLAR UNIV SERPENT,$14.00 ,,,,
"CD57+ NK Cells, Peripheral Blood by Flow Cytometry ARUP",$328.75 ,,,,
Celiac Disease Dual Antigen Screen ARUP,$54.25 ,,,,
Cell Count w/Diff Fluid,$12.50 ,,,,
CEMENT MIXER,$267.25 ,,,,
CEMENT MIXER,$267.25 ,,,,
CEMENT MIXING PREP KIT,$461.75 ,,,,
CENTRAL LINE BUNDLE,$353.75 ,,,,
Central Line Insertion/Care/Removal,"$1,612.25 ",,,,
Central Line Insertion: Pediatric,"$1,612.25 ",,,,
Central Line Insertion: Pediatric under age 5,"$1,612.25 ",,,,
CENTRAL LINE PLACEMENT CHARGE,"$1,612.25 ",,,,
CENTRAL LINE TRAY Charge,$132.75 ,,,,
Central Venous Pressure,$20.75 ,,,,
"Centromere Ab, IgG ARUP",$82.75 ,,,,
"Centromere Ab, IgG ARUP",$82.75 ,,,,
Ceruloplasmin ARUP,$100.75 ,,,,
CERVICAL ATLAS REG COLLAR,$98.75 ,,,,
CERVICAL ATLAS SHORT COLLAR,$100.00 ,,,,
CERVICAL ATLAS TALL COLLAR,$87.00 ,,,,
CERVICAL COLLAR LARGE,$14.75 ,,,,
CERVICAL COLLAR MEDIU,$14.75 ,,,,
CERVICAL COLLAR SM X-WIDE,$21.50 ,,,,
CERVICAL COLLAR SMALL,$14.75 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CH 0% impaired,$0.01 ,,,,
CHANGE GASTROSTOMY TUBE WITHOUT IMAGING CHARGE,,,,$517.75 ,
CHANGE OF CYSTOSTOMY TUBE SIMPLE CHARGE,,,,$337.50 ,
Chem Add On,$111.00 ,,,,
"Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)",$251.25 ,,,,
CHEMO ADMIN INTRA-ARTERIAL 1 HR,$520.75 ,,,,
CHEMO ADMIN INTRA-ARTERIAL 2-8 HR,$78.50 ,,,,
CHEMO ADMIN INTRA-ARTERIAL PUSH,$491.50 ,,,,
CHEMO ADMIN IV INFUSION 1 HR SINGLE,$491.50 ,,,,
CHEMO ADMIN IV INFUSION 2-8HR SINGLE,$255.50 ,,,,
CHEMO ADMIN IV INFUSION EA ADD DRUG 1HR,$285.75 ,,,,
CHEMO ADMIN IV PUSH ADDITIONAL DRUG,$181.25 ,,,,
CHEMO ADMIN IV PUSH SINGLE,$316.25 ,,,,
CHEMO ADMIN SUBQ OR IM HORMONAL,$165.00 ,,,,
CHEMO ADMIN SUBQ OR IM NON HORMONAL,$164.25 ,,,,
Chemotherapy Evaluation,$156.25 ,,,,
Chest Physiotherapy,$172.50 ,,,,
Chest Physiotherapy Subsequent,$172.50 ,,,,
Chest tube,$229.25 ,,,,
CHEST TUBE (INFANT) Charge,$143.50 ,,,,
Chlamydia trachomatis Amplified Detect ARUP,$116.00 ,,,,
Chlamydia trachomatis DNA Probe ARUP,$83.25 ,,,,
Chloride Level,$27.75 ,,,,
"Chloride, Urine ARUP",$33.75 ,,,,
Chloroquin Treatment ARUP,$654.00 ,,,,
Choice each additional 15 minutes,$175.50 ,,,,
Choice first 30 minutes,$524.25 ,,,,
CHOLANGIOCATH 4.5FR 1,$189.75 ,,,,
Cholesterol High Density Lipid,$44.00 ,,,,
Cholesterol Low Density Lipids,$59.25 ,,,,
Cholesterol Total,$37.50 ,,,,
"Cholesterol, Fluid ARUP",$29.00 ,,,,
Chromogranin A ARUP,$181.25 ,,,,
Chromosome Analysis Solid Tumor ARUP,$977.75 ,,,,
"Chromosome Analysis, Peripheral Blood AR",$626.25 ,,,,
"Chromosome FISH, Interphase ARUP",$308.75 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
CI At least 1% but less than 20% impaired,$0.01 ,,,,
ciprofloxacin-dexameth 0.3%-0.1% Otic,$329.50 ,,,,
CIRCLE W/STRAP MD,"$2,138.50 ",,,,
CIRCLE W/STRAP SM,$952.75 ,,,,
"Citric Acid, Urine - mg/day ARUP",$105.00 ,,,,
"Citric Acid, Urine ARUP",$105.00 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CJ At least 20% but less than 40% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CK At least 40% but less than 60% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CL At least 60% but less than 80% impaired,$0.01 ,,,,
CLAVICLE SPLINT LARGE,$37.75 ,,,,
CLAVICLE SPLINT LARGE,$37.75 ,,,,
CLAVICLE SPLINT MEDIU,$57.50 ,,,,
CLAVICLE SPLINT SMALL,$36.75 ,,,,
CLAVICLE SPLINT SMALL,$36.75 ,,,,
CLAVICLE SPLINT XLARG,$56.50 ,,,,
CLAVICLE SPLINT XSMAL,$36.00 ,,,,
Clean-Trace ATP Surface Test,$855.00 ,,,,
Clean-Trace ATP Water Test,$17.75 ,,,,
CLER-TRAC 8.5 X 72 MM CANNULA,$739.50 ,,,,
clindamycin 150 mg/mL IV Sol ADV 900mg,$65.75 ,,,,
Clinic Amylase,$78.25 ,,,,
Clinic Bilirubin Neonatal,$48.50 ,,,,
Clinic BNP,$191.75 ,,,,
Clinic Drug Screen,$72.75 ,,,,
Clinic Group A Strep by Nucleic Acid Amplification,$94.00 ,,,,
Clinic Hepatic Panel,$108.50 ,,,,
Clinic HgbA1c,$61.50 ,,,,
Clinic Influenza A & B by Nucleic Acid Amplification,$207.50 ,,,,
Clinic INR,$45.25 ,,,,
Clinic Microalb/Creat Ratio,$80.75 ,,,,
Clinic Sed Rate Auto,$49.25 ,,,,
CLINICAL SWALLOW STUDY,$273.50 ,,,,
Clinitest,$42.75 ,,,,
CLIP APPLIER 5 MM,$913.50 ,,,,
Clorazepate (Assayed as Nordiazepam) ARUP,$143.00 ,,,,
Closed reduction of toe dislocation,$437.25 ,,,,
CLOSED TREATMENT FO IP JOINT DISLOCATION SINGLE WITH MANIPULATION WITH ANESTHESIA CHARGE,$389.25 ,,,,
CLOSED TREATMENT FO IP JOINT DISLOCATION SINGLE WITH MANIPULATION WITHOUT ANESTHESIA CHARGE,$352.50 ,,,,
CLOSED TREATMENT METACARPAL FRACTURE WITH MANIPULATION EACH BONE SINGLE CHARGE,$383.50 ,,,,
CLOSED TREATMENT METACARPAL FRACTURE WITHOUT MANIPULATION EACH BONE SINGLE CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF ACETABULUM FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION WITH MANIPULATION CHARGE,$867.75 ,,,,
CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF ANKLE DISLOCATION REQUIRING ANESTHESIA CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF ANKLE DISLOCATION WITHOUT ANESTHESIA CHARGE,$437.25 ,,,,
CLOSED TREATMENT OF ARTICULAR FRACTURE INVOLVING MCP OR IP JOINT WITH MANIPULATION EACH CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF ARTICULAR FRACTURE INVOLVING MCP OR IP JOINT WITHOUT MANIPULATION EACH CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF CALCANEAL FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF CARPAL BONE FRACTURE OTHER THAN NAVICULAR WITH MANIPULATION EACH BONE CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF CARPAL BONE FRACTURE OTHER THAN NAVICULAR WITHOUT MANIPULATION EACH BONE CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF CARPAL NAVICULAR FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION (THUMB) WITH MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION OTHER THAN THUMB WITH MANIPULATION EACH JOINT W/O AN,$441.50 ,,,,
CLOSED TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION (THUMB) WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF CLAVICULAR FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF CLAVICULAR FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF COCCYGEAL FRACTURE CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE WITH MANIPULATION CHARGE,$440.50 ,,,,
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE FINGER OR THUMB WITH MANIPULATION EACH CHARGE,$395.00 ,,,,
CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE FINGER OR THUMB WITHOUT MANIPULATION EACH CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF DISTAL RADIAL FRACTURE COLLES OR SMITH TYPE OR EPIPHYSEAL SEPARATION WITH MANIPU,"$2,214.00 ",,,,
CLOSED TREATMENT OF DISTAL RADIAL FRACTURE COLLES OR SMITH TYPE OR EPIPHYSEAL SEPARATION WITHOUT MAN,$352.50 ,,,,
CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITH MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF DISTAL TIBIA FRACTURE WT BEARING WITH SKELETAL TRACTION AND/OR REQUIRING MANIPUL,"$2,214.00 ",,,,
CLOSED TREATMENT OF DISTAL TIBIA FRACTURE WT BEARING WITHOUT MANIPULATION CHARGE,$390.75 ,,,,
CLOSED TREATMENT OF ELBOW DISLOCATION REQUIRING ANESTHESIA CHARGE,,,,"$1,210.75 ",
CLOSED TREATMENT OF ELBOW DISLOCATION WITHOUT ANESTHESIA CHARGE,$433.50 ,,,,
CLOSED TREATMENT OF FEMORAL FRACTURE DISTAL END MEDIAL OR LATERAL CONDYLE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF FEMORAL FRACTURE DISTAL END MEDIAL OR LATERAL CONDYLE WITHOUT MANIPULATION CHARG,$441.50 ,,,,
CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
"CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX, OR PHALANGES WITH MANIPULATION CHARGE",$409.75 ,,,,
"CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX, OR PHALANGES WITHOUT MANIPULATION CHARGE",$352.50 ,,,,
CLOSED TREATMENT OF FRACTURE OF ORBIT EXCEPT BLOWOUT WITHOUT MANIPULATION CHARGE,,,,$440.50 ,
CLOSED TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF HIP DISLOCATION TRAUMATIC WITHOUT ANESTHESIA CHARGE,$635.75 ,,,,
CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE MEDIAL OR LATERAL WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE MEDIAL OR LATERAL WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE MEDIAL OR LATERAL WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE MEDIAL OR LATERAL WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF INTERCONDYLAR SPINES AND OR TUBEROSITY FRACTURES OF KNEE WITH OR WITHOUT MANIPUL,,,,$823.25 ,
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION WITHOUT ANESTHESIA CHARGE,$361.25 ,,,,
CLOSED TREATMENT OF KNEE DISLOCATION REQUIRING ANESTHESIA CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF KNEE DISLOCATION WITHOUT ANESTHESIA CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF MANDIBULAR FRACTURE WITHOUT MANIPULATION CHARGE,$778.25 ,,,,
CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION SINGLE WITH MANIPULATION W/O ANESTHESIA CHARGE,$423.75 ,,,$523.25 ,
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION SINGLE WITH MANIPULATION WITH ANESTHESIA CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF METATARSAL FRACTURE WITH MANIPULATION EACH CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF METATARSAL FRACTURE WITHOUT MANIPULATION EACH CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION REQUIRING ANESTHESIA CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF NASAL BONE FRACTURE WITH STABILIZATION CHARGE,,,,$618.00 ,
CLOSED TREATMENT OF NASAL BONE FRACTURE WITHOUT MANIPULATION CHARGE,,,,$237.00 ,
"Closed treatment of nasal septal fracture, with or without stabilization","$3,821.75 ",,,,
CLOSED TREATMENT OF PATELLAR DISLOCATION REQUIRING ANESTHESIA CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF PATELLAR DISLOCATION WITHOUT ANESTHESIA CHARGE,$400.75 ,,,,
CLOSED TREATMENT OF PATELLAR FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
"CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION, DIASTASIS OR SUBLUXATION WITH MANIPULATION CH",$441.50 ,,,,
"CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION, DIASTASIS OR SUBLUXATION WITHOUT MANIPULATION",$441.50 ,,,,
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE PROXIMAL OR MIDDLE PHALANX FINGER OR THUMB WITH MANIPU,$364.25 ,,,,
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE PROXIMAL OR MIDDLE PHALANX FINGER OR THUMB WITHOUT MAN,$352.50 ,,,,
CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION REQUIRING ANESTHESIA CHARGE,,,,"$1,498.50 ",
CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION WITHOUT ANESTHESIA CHARGE,$726.25 ,,,,
CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF PROXIMAL HUMERAL FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF PROXIMAL HUMERAL FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD WITH MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE AND DISLOCATION OF DISTAL RADIOULNAR JOINT CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
"Closed treatment of rib fracture, uncomplicated, each charge",$207.25 ,,,,
CLOSED TREATMENT OF SCAPULAR FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF SCAPULAR FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF SHOULDER DISLOCATION WITH FRACTURE OF GREATER HUMERAL TUBEROSITY WITH MANIPULATI,,,,"$1,272.50 ",
CLOSED TREATMENT OF SHOULDER DISLOCATION WITH MANIPULATION REQUIRING ANESTHESIA CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF SHOULDER DISLOCATION WITH MANIPULATION WITHOUT ANESTHESIA CHARGE,$752.50 ,,,,
CLOSED TREATMENT OF SHOULDER DISLOCATION WITH SURGICAL OR ANATOMICAL NECK FRACTURE WITH MANIPULATION,"$2,214.00 ",,,,
"CLOSED TREATMENT OF SPONTANEOUS HIP DISLOCATION BY ABDUCTION, SPLINT OR TRACTION, WITHOUT ANESTHESIA",$352.50 ,,,,
CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION WITHOUT MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF STERNUM FRACTURE CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF TALUS FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF TALUS FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF TARSAL BONE FRACTURE WITH MANIPULATION EACH CHARGE,"$2,662.50 ",,,,
CLOSED TREATMENT OF TARSAL BONE FRACTURE WITHOUT MANIPULATION EACH CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION INITIAL OR SUBSEQUENT CHARGE,$359.00 ,,,,
CLOSED TREATMENT OF TIBIAL FRACTURE PROXIMAL WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF TIBIAL FRACTURE PROXIMAL WITHOUT MANIPULATION WITH SKELETAL TRACTION CHARGE,"$4,338.25 ",,,,
CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE WITHOUT MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE WITHOUT MANIPULATION CHARGE,$406.75 ,,,,
CLOSED TREATMENT OF ULNAR FRACTURE PROXIMAL END WITH MANIPULATION CHARGE,"$2,214.00 ",,,,
CLOSED TREATMENT OF ULNAR FRACTURE PROXIMAL END WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF ULNAR SHAFT FRACTURE WITH MANIPULATION CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF ULNAR SHAFT FRACTURE WITHOUT MANIPULATION CHARGE,$352.50 ,,,,
CLOSED TREATMENT OF ULNAR STYLOID FRACTURE CHARGE,$441.50 ,,,,
CLOSED TREATMENT OF VERTEBRAL PROCESS FRACTURE CHARGE,$320.25 ,,,,
CLOSED TREATMENT PHALANX FRACTURE OTHER THAN GREAT TOE WITH MANIPULATION EACH CHARGE,$352.50 ,,,,
CLOSED TREATMENT PHALANX FRACTURE OTHER THAN GREAT TOE WITHOUT MANIPULATION EACH CHARGE,$352.50 ,,,,
CLOSED TREATMENT SESAMOID FRACTURE CHARGE,$352.50 ,,,,
CLOSED TREATMENT TARSAL BONE DISLOCATION REQUIRING ANESTHESIA CHARGE,"$4,452.25 ",,,,
"Closed Tx of Hip Dislocation; traumatic, w/ anesthesia","$2,214.00 ",,,,
CLOSED TX SUPRACONDYLAR HUMERAL FRACTURE W/MANIPULATION,"$2,214.00 ",,,,
Clostridium difficile by DNA Amplification,$132.00 ,,,,
CLOSURE OF LACERATION VESTIBULE OF MOUTH > 2.5 CM OR COMPLEX CHARGE,"$1,281.75 ",,,,
CLOSURE OF LACERATION VESTIBULE OF MOUTH 2.5 CM OR LESS CHARGE,$311.50 ,,,,
"Clozapine and Metabolites, Plasma Quant ARUP",$45.25 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CM At least 80% but less than 100% impaired,$0.01 ,,,,
CMP 5,$120.00 ,,,,
CMV Antibody IgG ARUP,$78.75 ,,,,
CMV Antibody IgG ARUP,$78.75 ,,,,
CMV Antibody IgM ARUP,$46.50 ,,,,
CMV Antibody IgM ARUP,$46.50 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CN 100% impaired,$0.01 ,,,,
CO2 DETECTOR EASY CAP II,$36.75 ,,,,
CO-AXIAL ANTERIOR VITRECTOMY INFUSION SLEEVE,$162.25 ,,,,
COBAN 6  STERILE,$15.50 ,,,,
COBLATOR WAND II,$739.50 ,,,,
cocaine Top 40 mg/mL Sol,$180.75 ,,,,
"Coccidioides Ab, IgG by ELISA ARUP",$47.75 ,,,,
"Coccidioides Ab, IgM by ELISA ARUP",$47.75 ,,,,
Coccidioides Antibody by CF ARUP,$47.75 ,,,,
Cogent XeroGel Nasal Pack,$319.00 ,,,,
Cognitive Function Development,$52.25 ,,,,
COGNITIVE SKILLS DEVELOPMENT,$52.25 ,,,,
COGNITIVE TEST,$216.25 ,,,,
Cold Agglutinins ARUP,$44.00 ,,,,
Collection Fee,$32.00 ,,,,
COLLECTION: Arterial Draw,$172.25 ,,,,
COLLECTION: Venous Draw,$32.00 ,,,,
Colonoscopy,"$1,391.50 ","$1,144.50 ",,,
Colonoscopy HIGH RISK MEDICARE,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy Screening,"$1,711.75 ","$1,362.00 ",,,
"Colonoscopy via stoma, w/wo specimen","$1,391.50 ","$1,144.50 ",,,
Colonoscopy w/Hot Biopsy Forceps/Cautery,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with Biopsy,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with Control of Bleeding,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with or without Specimen,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with Polypectomy,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with Removal of Foreign Body,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with Specimen by Snare,"$1,711.75 ","$1,362.00 ",,,
Colonoscopy with Submucosal Injection,"$1,711.75 ","$1,362.00 ",,,
COLPOPERINEORRHAPHY SUTURE OF INJURY OF VAGINA AND/OR PERINEUM CHARGE,,,,$880.25 ,
COLPORRHAPHY SUTURE OF INJURY OF VAGINA CHARGE,,,,$684.25 ,
COMMUNITY/WORK REINTEGRATION,$106.25 ,,,,
Compatible,$211.75 ,,,,
Compatible,$211.75 ,,,,
"Complement Activity, Total EIA ARUP",$56.00 ,,,,
Complement Component 2 ARUP,$142.00 ,,,,
Complement Component 3 ARUP,$107.50 ,,,,
Complement Component 3 ARUP,$110.50 ,,,,
Complement Component 4 ARUP,$107.50 ,,,,
Complement Component 4 ARUP,$110.50 ,,,,
"Complete bilateral, 3 or more levels, or single level study with provocative functional maneuvers",$208.50 ,,,,
Complex dressing change,$70.25 ,,,,
"CONNECTOR 6-IN-1 ""Y""",$6.75 ,,,,
CONTRAST BATH,$52.50 ,,,,
CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX ANY METHOD CHARGE,$327.25 ,,,,
CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE ANY METHOD CHARGE,$329.25 ,,,,
CONTROL NASAL HEMORRHAGE POSTERIOR ANY METHOD INITIAL CHARGE,$317.50 ,,,,
CONTROL NASAL HEMORRHAGE POSTERIOR ANY METHOD SUBSEQUENT CHARGE,$294.00 ,,,,
"CONTROL OF OROPHARYNGEAL HEMORRHAGE PRIMARY OR SECONDARY, SIMPLE CHARGE",,,,$376.00 ,
COOL MIST NEBULIZER,$24.75 ,,,,
"Copper, Serum ARUP",$56.75 ,,,,
"Copper, Urine ARUP",$56.75 ,,,,
Cord Blood Drug Screen,$675.00 ,,,,
Cord Blood pH (Arterial),$75.50 ,,,,
Cord Blood pH.,$75.50 ,,,,
"Cortisol, Saliva ARUP",$167.00 ,,,,
"Cortisol, Serum or Plasma ARUP",$95.25 ,,,,
"Cortisol, Urine Free by LC-MS/MS ARUP",$81.00 ,,,,
COTTON ROLL (JONES),$8.75 ,,,,
Coude Tip Foley Cath,$35.00 ,,,,
Coxsackie A Serotype 9 Titer ARUP,$454.50 ,,,,
CPAP CIRCUIT,$78.25 ,,,,
CPAP DAILY CHARGE,$491.50 ,,,,
CPAP DAILY CHARGE,$491.50 ,,,,
CPAP MASK,$149.75 ,,,,
CPAP MASK,$149.75 ,,,,
CPAP SET UP,$225.50 ,,,,
CPAP SET UP,$225.50 ,,,,
Cpap titration,"$4,072.50 ",,,,
CPAP/BIPAP Daily,$491.50 ,,,,
CPAP/BIPAP Initial,$491.50 ,,,,
C-Peptide ARUP,$78.50 ,,,,
CPR (Inpatient),$986.25 ,,,,
CPT,$172.50 ,,,,
C-Reactive Protein,$96.50 ,,,,
Creatine Kinase,$72.00 ,,,,
Creatine Kinase-MB,$75.50 ,,,,
Creatinine,$60.50 ,,,,
Creatinine Clearance.,$100.00 ,,,,
Creatinine Level 24 Hour Urine,$59.50 ,,,,
Creatinine Level Urine,$59.50 ,,,,
"Creatinine, Urine - mg/day ARUP",$59.50 ,,,,
CRITICAL CARE 30.00 - 74.00 MINUTES CHARGE,,,,$610.25 ,
CRITICAL CARE EACH ADDITIONAL 30 MINUTES CHARGE,,,,$306.00 ,
"Critical Care, each 30 min","$1,009.25 ",,,,
"CRP, High Sensitivity ARUP",$114.00 ,,,,
CRUTCH LARGE/TALL,$40.50 ,,,,
CRUTCH LARGE/TALL,$40.50 ,,,,
CRUTCH MEDIUM/ADULT,$40.50 ,,,,
CRUTCH MEDIUM/ADULT,$40.50 ,,,,
CRUTCH SMALL/YOUTH,$40.50 ,,,,
CRUTCH SMALL/YOUTH,$40.50 ,,,,
Cryofibrinogen ARUP,$39.50 ,,,,
Cryoglobulin Qualitative with Rflx ARUP,$124.75 ,,,,
C-SECTION PACK,$330.00 ,,,,
C-SECTION PACK,$330.00 ,,,,
C-SECTION PACK LATEX FREE,$142.75 ,,,,
CSF Culture,$116.00 ,,,,
CT Abdomen w/ + w/o Contrast,"$1,827.25 ",,,,
CT Abdomen w/ Contrast,"$1,815.00 ",,,,
CT Abdomen w/o Contrast,"$1,611.25 ",,,,
CT Abdomen/Pelvis w + w/o Contrast,"$3,799.00 ",,,,
CT Abdomen/Pelvis w/ Contrast,"$3,514.75 ",,,,
CT Abdomen/Pelvis w/ Contrast,"$3,514.75 ",,,,
CT Abdomen/Pelvis w/o Contrast,"$3,063.50 ",,,,
CT Angio Neck w/ Contrast,"$2,002.00 ",,,,
CT Angiography Abdomen/Pelvis,"$1,676.50 ",,,,
CT Angiography Chest w/ Contrast,"$1,704.00 ",,,,
CT Angiography Head w/ + w/o Contrast,"$1,740.25 ",,,,
CT Angiography Lower Extremity Left,"$1,921.25 ",,,,
CT Angiography Lower Extremity Right,"$1,921.25 ",,,,
CT Aspiration,"$1,436.50 ",,,,
CT Biopsy Liver,"$3,014.75 ",,,,
CT Cardiac Calcium Score,$332.50 ,,,,
CT Chest w/ Contrast,"$1,576.25 ",,,,
CT Chest W/O Contrast,"$1,231.00 ",,,,
CT Chest W/WO Contrast,"$1,546.50 ",,,,
CT Chest/Abd/Pel w/ Contrast,"$1,576.25 ",,,,
CT Drainage - Abscess or Cyst,"$1,078.50 ",,,,
CT Guided Abdomen Biopsy,"$1,436.50 ",,,,
CT Guided Biopsy Pleura Perc Ndl,"$1,436.50 ",,,,
CT Guided Bx Abd or Retroperitoneal,"$1,436.50 ",,,,
CT Guided Liver Biopsy,"$1,436.50 ",,,,
CT Guided Lung Biopsy,"$1,436.50 ",,,,
CT Guided Ndl Bx Lymph Node,"$1,436.50 ",,,,
CT Guided Needle Biopsy,"$1,436.50 ",,,,
CT Guided Pelvis Biopsy,"$1,436.50 ",,,,
CT Guided Thorax Biopsy,"$1,436.50 ",,,,
CT Head or Brain w/ + w/o Contrast,"$2,006.75 ",,,,
CT Head or Brain w/ Contrast,"$1,632.00 ",,,,
CT Head or Brain w/o Contrast,"$1,485.75 ",,,,
CT Limited or Localized F/U Study,$632.75 ,,,,
CT Low Dose Lung Screening,$532.50 ,,,,
CT Lower Extremity w/ Contrast Left,"$1,555.75 ",,,,
CT Lower Extremity w/ Contrast Right,"$1,555.75 ",,,,
CT Lower Extremity w/o Contrast Left,"$1,522.75 ",,,,
CT Lower Extremity w/o Contrast Right,"$1,522.75 ",,,,
CT Maxillofacial w/ + w/o Contrast,"$1,852.25 ",,,,
CT Maxillofacial w/ Contrast,"$1,680.25 ",,,,
CT Maxillofacial w/o Contrast,"$1,540.00 ",,,,
CT Orbit Sella etc. w/ + w/o Contrast,"$1,654.50 ",,,,
CT Orbit Sella etc. w/ Contrast,"$1,628.75 ",,,,
CT Orbit Sella etc. w/o Contrast,"$1,418.00 ",,,,
CT Pelvis w/ + w/o Contrast,"$2,015.50 ",,,,
CT Pelvis w/ Contrast,"$1,710.75 ",,,,
CT Pelvis w/o Contrast,"$1,590.25 ",,,,
CT Sinus,"$1,540.00 ",,,,
CT Soft Tissue Neck w/ + w/o Contrast,"$1,923.75 ",,,,
CT Soft Tissue Neck w/ Contrast,"$1,860.75 ",,,,
CT Soft Tissue Neck w/o Contrast,"$1,464.00 ",,,,
CT Spine Cervical w/ + w/o Contrast,"$1,998.00 ",,,,
CT Spine Cervical w/ Contrast,"$1,762.00 ",,,,
CT Spine Cervical w/o Contrast,"$1,782.75 ",,,,
CT Spine Lumbar w/ Contrast,"$1,988.25 ",,,,
CT Spine Lumbar w/o Contrast,"$1,777.50 ",,,,
CT Spine Thoracic w/ Contrast,"$1,904.50 ",,,,
CT Spine Thoracic w/o Contrast,"$1,640.25 ",,,,
CT TMJ Open and Closed Bilateral,$342.75 ,,,,
CT TMJ Open and Closed Left,$157.75 ,,,,
CT TMJ Open and Closed Right,$157.75 ,,,,
CT Upper Extremity w/ Contrast Left,"$1,520.00 ",,,,
CT Upper Extremity w/ Contrast Right,"$1,520.00 ",,,,
CT Upper Extremity w/o Contrast Left,"$1,472.75 ",,,,
CT Upper Extremity w/o Contrast Right,"$1,472.75 ",,,,
CUDA ANKLE SHAVER 2.9,$82.50 ,,,,
"Culture, Acid Fast Bacilli ARUP",$229.50 ,,,,
"Culture, Cystic Respiratory ARUP",$278.25 ,,,,
"Culture, Fungal - Skin, Hair or Nails ARUP",$176.25 ,,,,
"Culture, Fungal ARUP",$165.50 ,,,,
"Culture, Herpes Simplex Virus ARUP",$105.25 ,,,,
"Culture, Rubeola (Measles) ARUP",$109.75 ,,,,
"Culture, Viral ARUP",$79.00 ,,,,
"Culture, Yeast ARUP",$165.50 ,,,,
CUTTER PROXIMAL 75mm LINEAR GREEN,$304.50 ,,,,
CVP Daily Monitoring,$132.50 ,,,,
"Cyclic Citrullinated Peptide Ab, IgG ARUP",$88.75 ,,,,
Cyclosporine A ARUP,$106.75 ,,,,
Cystatin C ARUP,$252.50 ,,,,
Cystic Fibrosis (CFTR) 165 Pathogenic Variants ARUP,$974.00 ,,,,
Cystic Fibrosis (CFTR) 32 Mutations ARUP,$503.00 ,,,,
CYSTO DRAIN BAG,$319.50 ,,,,
CYSTO PACK,$25.25 ,,,,
Cytogenomic SNP Microarray ARUP,"$2,678.50 ",,,,
"Cytomegalovirus Antibody, IgG ARUP",$78.75 ,,,,
"Cytomegalovirus Antibody, IgM ARUP",$46.50 ,,,,
Cytomegalovirus by PCR ARUP,$355.00 ,,,,
"Cytomegalovirus by PCR, Whole Bld/Bn Mrw ARUP",$355.00 ,,,,
"Cytomegalovirus by Qualitative PCR, Saliva ARUP",$236.00 ,,,,
Cytomegalovirus DNA Quantitation by PCR ARUP,$769.25 ,,,,
DBX BONE PUTTY,"$2,049.75 ",,,,
D-Dimer,$19.00 ,,,,
"Deamidated Gliadin Peptide (DGP) Ab, IgA ARUP",$134.00 ,,,,
"Deamidated Gliadin Peptide (DGP) Ab, IgG ARUP",$82.75 ,,,,
DEBRIDEMENT BONE <= 20 SQ CM CHARGE,"$2,210.75 ",,,,
DEBRIDEMENT MUSCLES AND/OR FASCIA <= 20 SQ CM CHARGE,$462.50 ,,,,
DEBRIDEMENT OF ECZEMATOUS OR INFECTED SKIN <= 10.00 % OF BODY SURFACE CHARGE,,,,$128.50 ,
DEBRIDEMENT OF ECZEMATOUS OR INFECTED SKIN EACH ADDITIONAL 10% OF BODY SURFACE CHARGE,,,,"$1,035.25 ",
Debridement of nail(s) by any method(s): 1 - 5 nails,$89.50 ,,,,
Debridement of nail(s) by any method(s): 6 or more nails,$89.50 ,,,,
DEBRIDEMENT OF NAILS BY ANY METHOD 1 TO 5 CHARGE,,,,$48.50 ,
"DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, MUSCLE, AND BONE AT SITE OF OPEN FRACTURE C",,,,"$1,499.50 ",
DEBRIDEMENT SUBCUTANEOUS TISSUE AND DERMIS <= 20 SQ CM CHARGE,$509.75 ,,,,
"Debridement, Bone - first 20 sq cm or less","$2,028.25 ",,,,
"Debridement, Bone, Each Addt'l 20 sq cm or Part Thereof",$7.00 ,,,,
"Debridement, Muscle / Fascia - first 20 sq cm or less",$743.25 ,,,,
"Debridement, Muscle/Fascia, Each Addt'l 20 sq cm or Part Thereof",$371.75 ,,,,
"Debridement, Open Wound each additional 20 sq cm, or part thereof",$125.75 ,,,,
"Debridement, Open Wound first 20 sq cm or less",$251.25 ,,,,
"Debridement, Sub Q - first 20 sq cm or less",$480.00 ,,,,
"Debridement, Sub Q, Each Addt'l 20 sq cm or Part Thereof",$240.00 ,,,,
DEEP TRACHEAL SXN,$14.75 ,,,,
Defibrillation,$355.25 ,,,,
Dehydroepiandrosterone by TMS ARUP,$126.00 ,,,,
DEPUY BONE CEMENT,$272.75 ,,,,
DERMABOND/INDERMIL,$94.25 ,,,,
DERMAMATRIX 1X2,$440.75 ,,,,
DERMAMATRIX 2X4,$728.00 ,,,,
DERMOPLAST,$19.00 ,,,,
Desmin by IHC ARUP,$370.50 ,,,,
"DESTRUCTION MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE <= 0.5 CM CHARGE",,,,$319.25 ,
DEV. TEST EXT.,$241.25 ,,,,
Developmental screening,$21.00 ,,,,
dexamethasone 10 mg/mL Inj Sol 1 ml,$21.75 ,,,,
dexamethasone 4 mg/mL,$22.50 ,,,,
"DHEA Sulfate, Serum ARUP",$126.00 ,,,,
"DHT, LC-MS/MS ARUP",$158.00 ,,,,
Diagnostic,"$3,608.50 ",,,,
DIALYSIS CATH KIT 24CM,$314.25 ,,,,
Dietary ½ to ¾ hour,$44.75 ,,,,
Dietary 1 to 1 ½ hour,$56.75 ,,,,
Dietary less than ½ hour,$25.75 ,,,,
Digital Block each additional 15 minutes,$175.50 ,,,,
Digital Block first 30 minutes,$524.25 ,,,,
Digoxin Level,$104.50 ,,,,
"Dilation of cervical canal, instumental","$3,969.50 ",,,,
DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR MALE INITIAL CHARGE,,,,$337.25 ,
DIPYRIDAMOLE STRESS TEST,$613.00 ,,,,
Direct Coombs (Anti-Human Globulin) IRL ARUP,$93.00 ,,,,
Direct Coombs Newborn ARUP,$93.00 ,,,,
Direct. Coombs,$68.25 ,,,,
Disposable suction cup,$119.00 ,,,,
DNA Paternity Test Collection Fee,$30.00 ,,,,
DNase-B Ab ARUP,$54.50 ,,,,
DOBBHOFF 8FR,$44.50 ,,,,
Dobhoff Placement,"$1,230.25 ",,,,
DOYLE EAR DRESSING ADULT,$56.75 ,,,,
"Drainage of abcess, cyst, hematoma from dentoalveolar structures",$350.00 ,,,,
"DRAINAGE OF ABSCESS, CYST, HEMATOMA VESTIBULE OF MOUTH SIMPLE CHARGE",$939.50 ,,,,
"DRAINAGE OF EXTERNAL EAR ABSCESS HEMATOMA, SIMPLE CHARGE",$939.50 ,,,,
DRAINAGE OF FINGER ABSCESS COMPLICATED CHARGE,"$2,210.75 ",,,,
DRAINAGE OF FINGER ABSCESS SIMPLE CHARGE,$350.75 ,,,,
DRAINAGE OF SCROTAL WALL ABCESS CHARGE,,,,$400.75 ,
DRAPE EYE 1040,$274.00 ,,,,
DRAPE IOBAN 2 35x17 INCISE ANITMICROBIAL,$23.25 ,,,,
DRAPE LITHOTOMY,$41.00 ,,,,
DRAPE OPMI (MICRSCOPE),$69.25 ,,,,
"Dressing an/or debmt partial thn burn, initial or subsequent, lg",$480.00 ,,,,
"Dressing an/or debmt partial thn burn, initial or subsequent, med",$251.25 ,,,,
"Dressing an/or debmt partial thn burn, initial or subsequent, small",$251.25 ,,,,
DRESSING AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS INITIAL OR SUBSEQUENT LARGE CHARGE,$509.75 ,,,,
DRESSING AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS INITIAL OR SUBSEQUENT MEDIUM CHARGE,$442.50 ,,,,
DRESSING AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS INITIAL OR SUBSEQUENT SMALL CHARGE,$277.00 ,,,,
DRESSING COMPLEX,$28.50 ,,,,
DRESSING SIMPLE,$19.75 ,,,,
Drill Bit Kit-Continuos Compression Implant,$622.00 ,,,,
DRSNG AQUACEL 6x6,$37.75 ,,,,
DRSNG AQUACEL Ag SILVER 6x6,$97.00 ,,,,
DRSNG DUODERM 2x8 XTRA THIN,$13.50 ,,,,
DRSNG DUODERM 6x6 XTRA THIN,$18.00 ,,,,
DRSNG DUODERM 8x8 SIGNAL,$45.00 ,,,,
"Drug Confirmation, Amphetamines, Urine ARUP",$164.25 ,,,,
"Drug Confirmation, Opiates, Ser/Pla ARUP",$279.25 ,,,,
"Drug Pan 9, Ser/Pla, Scrn w/Rflx to Conf ARUP",$276.25 ,,,,
Drug Screen Collection Charge,$50.00 ,,,,
DRUG SCREEN POCT Charge,$33.25 ,,,,
DRUG SCREEN POCT CONFIRMATION Charge,$74.50 ,,,,
Drugs of Abuse Screen,$148.75 ,,,,
Drugs of Abuse Screen Tox,$148.75 ,,,,
dRVVT Screen ARUP,$66.25 ,,,,
DsDNA Ab IgG by IFA ARUP,$110.50 ,,,,
"dsDNA Ab IgG, ELISA w/Reflex to dsDNA ARUP",$110.50 ,,,,
"dsDNA Ab, IgG w/ Reflex to IFA Titer ARUP",$110.50 ,,,,
DUAL MESH 2,$444.25 ,,,,
DUAL MESH 4,"$1,161.25 ",,,,
DUAL MESH 7,"$2,432.50 ",,,,
DYONICS 4.5 MM CURVED SYNOVATOR BLADE,$110.50 ,,,,
E/R OBSERVATION BED Charge,$63.50 ,,,,
E900 TUBING SET & TIP FOR E9010,$246.25 ,,,,
Ear Culture,$116.00 ,,,,
"Eastern Equine Enceph Ab, IgG, CSF ARUP",$153.75 ,,,,
"Eastern Equine Enceph Ab, IgM, CSF ARUP",$153.75 ,,,,
"EBV Ab to Early (D) Ag, IgG ARUP",$88.50 ,,,,
"EBV Ab to Viral Capsid Ag, IgG ARUP",$120.00 ,,,,
"EBV Ab to Viral Capsid Ag, IgM ARUP",$120.00 ,,,,
EBV Antibody To Early (D) Antigen IgG AR,$88.50 ,,,,
EBV Antibody To Nuclear Antigen IgG ARUP,$55.50 ,,,,
EBV Antibody To Viral Capsid Antigen IgG,$120.00 ,,,,
EBV Antibody To Viral Capsid Antigen IgM,$120.00 ,,,,
ED NEEDLES INTRA-OSSEOUS Charge,$40.00 ,,,,
EEG UBMC,"$1,151.00 ",,,,
EER Chromosome Analysis Peripheral Blood,$66.75 ,,,,
"EER Chromosome FISH, Interphase ARUP",$308.75 ,,,,
EGD with Biopsy,"$1,590.75 ","$1,232.25 ",,,
EGG BUR 4.0 - TPS,$274.50 ,,,,
EGG BUR 6.0 - TPS,$31.50 ,,,,
EKG (Resp),$173.00 ,,,,
EKG (Resp),$173.00 ,,,,
EKG TRACING,$173.00 ,,,,
EKG WITH INTERPRETATION,$173.00 ,,,,
Elastion Single-Use Wireguided Ballon Diator,$948.00 ,,,,
ELASTOPLAST 3,$15.00 ,,,,
ELASTOPLAST 4,$18.75 ,,,,
ELASTOPLAST 6,$28.25 ,,,,
ELECT STIMULAT MANUAL,$61.50 ,,,,
ELECT STIMULATION UNATTEND,$26.25 ,,,,
ELECT STIMULATION UNATTEND,$26.25 ,,,,
ELECTRODE CONDY LOMA,$33.50 ,,,,
ELECTRODE LEEP BALL,$319.25 ,,,,
ELECTRODE LEEP RADIUS,$90.75 ,,,,
ELECTRODE TOP HAT,$90.75 ,,,,
ELECTRODES,$10.75 ,,,,
ELECTRODES,$10.75 ,,,,
ELECTRODES SPIRAL,$12.75 ,,,,
Electrolyte Panel,$69.75 ,,,,
ELR/CPAP,$400.00 ,,,,
"Elution And Antibody Identification, RBC ARUP",$211.75 ,,,,
EMERG CLASS V) EA ADD HR CHARGE,$151.50 ,,,,
Emergency Department Visit Level 1 - 99281,$118.25 ,,,,
ENDO 45mm LINEAR CUTTER (ATS45),$919.50 ,,,,
ENDO 45mm RELOAD GREEN,$205.25 ,,,,
ENDO 45mm RELOADS BLUE,$526.50 ,,,,
ENDO 45mm RELOADS WHITE,$519.00 ,,,,
ENDO BABCOCK,$144.75 ,,,,
ENDO BUTTON 20 MM,"$1,011.50 ",,,,
ENDO BUTTON 25 MM,"$1,011.50 ",,,,
ENDO BUTTON 30MM,"$1,011.50 ",,,,
ENDO BUTTON 40 MM,"$1,011.50 ",,,,
ENDO BUTTON 45 MM,"$1,011.50 ",,,,
ENDO BUTTON 50 MM,"$1,011.50 ",,,,
ENDO BUTTON 55 MM,"$1,011.50 ",,,,
ENDO BUTTON 60 MM,"$1,011.50 ",,,,
ENDO CONTOUR CURVED CUTTER STAPLER,"$1,304.50 ",,,,
ENDO DISSECTOR 5mm CURVED CAUTERY (5DCD),$244.25 ,,,,
ENDO Echelon 60 Reload 6 Row Blue,$261.50 ,,,,
ENDO Echelon 60 Reload 6 Row White,$261.50 ,,,,
ENDO Echelon Flex 60 Powered Endo Linear Cutter,$818.25 ,,,,
ENDO Enseal G2 Curved Jaw 35cm,$805.25 ,,,,
ENDO GIA 30 RELOAD,"$2,365.00 ",,,,
Endo GIA articulating reloads 60 mm Vascular/medium,"$2,788.25 ",,,,
Endo GIA Ultra Universal Stapler 12mm,$336.75 ,,,,
ENDO GRASPER,$136.00 ,,,,
ENDO PEANUT 5mm,$88.25 ,,,,
ENDO SCISSOR 5mm,$145.75 ,,,,
ENDO SHEARS 5mm,$653.50 ,,,,
ENDO SorbaFix 36cm,"$2,249.75 ",,,,
ENDO SUT RELOAD,$43.50 ,,,,
ENDO SUTURE ASSISTANT,$280.50 ,,,,
ENDO SWALLOW (FEEES),$547.50 ,,,,
ENDO UNIVERSAL 65 12mm INSTRUMENT,$368.50 ,,,,
ENDOBUTTON CL PAC,$822.25 ,,,,
Endocatch gold 10 mm Retrival Bag,"$1,145.75 ",,,,
ENDOLOOP,$172.25 ,,,,
ENDOMETRIAL SUCT CURETTE,$494.50 ,,,,
"Endomysial Antibody, IgA Titer ARUP",$89.50 ,,,,
ENDOPATH & TROCAR 12mm B12LT,$247.75 ,,,,
ENDOPATH & TROCAR 5mm B5LT,$187.00 ,,,,
ENDOPATH 11mm SLEEVE CB,$427.00 ,,,,
ENDOPATH 12mm SLEEVE CB12LT,$147.00 ,,,,
ENDOPATH 5mm SLEEVE CB5LT,$109.25 ,,,,
ENDOPATH BABCOCK WITH RATCHET 5 MM,$157.25 ,,,,
ENDOPATH GRAY RELOAD,$196.25 ,,,,
ENDOPATH&TROCAR 10m,$726.00 ,,,,
ENDOPOUCH RETRIEVER 10 MM,$157.25 ,,,,
ENDOSCOPIC CURVED INTRALUMINAL STAPLER 25 MM (ECS25A),"$1,201.25 ",,,,
ENDOSCOPIC ELECTROSURG SWITCHPEN & ELECTRODE,$184.75 ,,,,
ENDOSCOPY UPPER GASTROINTESTINAL DIAGNOSTIC CHARGE,,,,$693.00 ,
ENDOSCOPY UPPER GASTROINTESTINAL DIAGNOSTIC WITH FOREIGN BODY REMOVAL CHARGE,,,,$944.50 ,
Endotracheal Intubation,$311.25 ,,,,
ENDOTRACHEAL INTUBATION,$311.25 ,,,,
Enterovirus Antibodies Pane ARUP,$636.50 ,,,,
Enterovirus Detection by RT-PCR ARUP,$562.00 ,,,,
Environmental Culture,$116.00 ,,,,
ENZOL ENZYMATIC DETERGE,$53.00 ,,,,
EOA Charge,$143.50 ,,,,
"Epidermal autograft, f/s/e/m/n/e/o/g/h/f and/or multiple digits; each additional 100 sq cm","$2,744.75 ",,,,
"Epidermal autograft, f/s/e/m/n/e/o/g/h/f and/or multiple digits; first 100 sq cm or less","$2,341.75 ",,,,
"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm","$2,744.75 ",,,,
"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less","$2,341.75 ",,,,
EPIDURAL CATHETER NYLON 16G/17G,$190.00 ,,,,
Epidural each additional 15 minutes,$175.50 ,,,,
Epidural first 30 minutes,$524.25 ,,,,
EPIDURAL NEEDLE STEVE'S,$17.00 ,,,,
EPIDURAL TRAY,$75.50 ,,,,
EPIDURAL TRAY,$75.50 ,,,,
EPIDURAL TRAY STEVE'S,$95.50 ,,,,
epinephrine 1 mg/mL Inj Sol Ampule,$24.25 ,,,,
epinephrine-lidocaine 1:100000  1% Sol 50 mL,$25.75 ,,,,
epinephrine-lidocaine 1:100000  2% Sol 50 mL,$28.75 ,,,,
EPISTAT Charge,$114.50 ,,,,
Epstein-Barr Virus by PCR ARUP,$295.75 ,,,,
Epstein-Barr Virus by Quantitative PCR ARUP,$630.25 ,,,,
Epstein-Barr Virus Qt PCR ARUP,$630.25 ,,,,
Erythropoietin ARUP,$100.75 ,,,,
ESCHAROTOMY INITIAL INCISION CHARGE,,,,"$1,050.25 ",
ESOPHAGEAL PET BALLOON DILATOR,$361.25 ,,,,
Esophagogastroduodenoscopy,"$1,249.25 ","$1,090.50 ",,,
Esophagogastroduodenoscopy and Colonoscopy,"$2,018.00 ","$1,906.50 ",,,
Esophagogastroduodenoscopy Banding,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy Bravo,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy Dilatation,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with Balloon Dilation,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with Esophageal Dilation,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with Hot Biopsy,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with PEG Placement,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with PEG Replacement,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with Percutaneous Endoscopic Gastrostomy Tube Placement,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with Polypectomy,"$1,590.75 ","$1,232.25 ",,,
Esophagogastroduodenoscopy with Variceal Injection,"$1,590.75 ","$1,232.25 ",,,
ESOPHAGOSCOPY WITH REMOVAL OF FOREIGN BODY CHARGE,,,,"$1,007.50 ",
Estradiol by TMS ARUP,$122.75 ,,,,
"Estradiol, Adult Premenopausal Female ARUP",$122.75 ,,,,
"Estradiol, Free ARUP",$649.25 ,,,,
"Estriol, Serum ARUP",$61.50 ,,,,
"Estrogen/Progesterone Rec Assay,Paraffin ARUP",$613.00 ,,,,
"Estrogens, Fractionated by TMS ARUP",$158.00 ,,,,
Estrone by TMS ARUP,$126.00 ,,,,
ETC02 Probe,$36.00 ,,,,
Ethanol Level,$128.25 ,,,,
Ethosuximide ARUP,$53.00 ,,,,
Ethylene Glycol ARUP,$116.00 ,,,,
ETT KIT,$41.50 ,,,,
EVACUATION SUBUNGUAL HEM Charge,$172.25 ,,,,
EVACUATOR HEMOVAC 1/8,$47.25 ,,,,
EVACUATORS HEMOVAC 1/4,$95.25 ,,,,
EVACUATORS HEMOVAC 3/16,$48.25 ,,,,
Eval for presricption of non-speech generating AAC device,$380.00 ,,,,
"Eval for presricption of non-speech generating AAC device, each additoanl 30 min.",$68.00 ,,,,
EVALUATE  SWALLOWING FUNCTION,$273.50 ,,,,
EVENT MONITOR KIT,$19.00 ,,,,
"Event Monitor, up to 30 days",$995.50 ,,,,
Everolimus by Tandem Mass Spectrometry ARUP,$125.25 ,,,,
"EXCISION BENIGN LESION FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBANE > 4.0 CM CHARGE",,,,$884.00 ,
"EXCISION BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM CHARGE",,,,$264.75 ,
"EXCISION BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM CHARGE",,,,$548.00 ,
"EXCISION BENIGN LESION TRUNK, ARMS OR LEGS > 4.0 CM CHARGE",,,,$691.75 ,
"EXCISION BENIGN LESION TRUNK, ARMS OR LEGS 1.1 TO 2.0 CM CHARGE",,,,$307.25 ,
EXCISION NAIL AND NAIL MATRIX  PARTIAL/COMP CHARGE,$509.75 ,,,,
EXCISION OF EXT THROMBOSED HEMORRHOID Charge,"$3,088.00 ",,,,
"Excision of nail and nail matrix, partial or complete, for permanent removal",$480.00 ,,,,
EXPLORATION PENETRATING ABDOMEN/FLANK/BACK WOUND CHARGE,,,,"$1,229.75 ",
EXPLORATION PENETRATING CHEST WOUND CHARGE,,,,"$1,196.25 ",
EXPLORATION PENETRATING EXTREMITY WOUND CHARGE,,,,"$1,298.75 ",
Extended PACU 2 per hour,$42.25 ,,,,
EXTERNAL NASAL SPLINT MEDTRONIC,$37.25 ,,,,
External Pacing,$217.50 ,,,,
EXTREMITY SHEETS,$24.00 ,,,,
Eye Culture,$116.00 ,,,,
EYE EXAM CHARGE,$34.00 ,,,,
EYE KIT BD CUSTOM,$255.00 ,,,,
EZ EXTRA LONG CAUTERY,$8.50 ,,,,
"F-Actin (SM) Ab, IgG by ELISA with Reflex to Titer(0051174) ARUP",$102.25 ,,,,
Factor V Leiden (F5) R506Q Mutation ARUP,$114.25 ,,,,
Factor V Leiden by PCR ARUP,$114.25 ,,,,
"Factor V, Activity ARUP",$112.00 ,,,,
"Factor VII, Activity ARUP",$119.50 ,,,,
Factor VIII Reflex to Beth Assay ARUP,$412.50 ,,,,
"Factor VIII, Activity ARUP",$109.00 ,,,,
"Factor VIII, Activity ARUP",$164.00 ,,,,
"Factor VIII:C, Activity ARUP",$109.00 ,,,,
FACV REF Specimen ARUP,$71.75 ,,,,
FACV Specimen ARUP,$114.25 ,,,,
"Fat, Fecal Qualitative ARUP",$128.50 ,,,,
"Fecal Fat, Quantitative 24-Hour Collect ARUP",$125.00 ,,,,
FEEDING TUBE 5FR,$26.75 ,,,,
FEEDING TUBE 5FR,$26.75 ,,,,
FEES W/LARNGEAL SEN TEST,$393.50 ,,,,
FEMORAL CANAL IRRIGATION TIP,$36.75 ,,,,
fentanyl Inj. 100mcg/2mL,$22.75 ,,,,
ferric subsulfate top solution,$40.00 ,,,,
Ferritin,$111.50 ,,,,
Fetal Fibronectin,$521.75 ,,,,
Fetal Nonstress Test,$271.50 ,,,,
FFP Thawed [MDMH],$353.25 ,,,,
FHR decelerations,$495.25 ,,,,
Fibrin Degradation Products ARUP,$71.75 ,,,,
Fibrinogen,$59.50 ,,,,
"Fibronectin, Fetal",$521.75 ,,,,
FILSHIE CLIP,$352.00 ,,,,
FILSHIE CLIP,$352.00 ,,,,
FINE NEEDLE ASPIRATION W/O IMAGING Charge,$514.50 ,,,,
FINGER SPLINT W/STRAP,$58.50 ,,,,
FIRSTPASS ST SUTURE PASSER SELF CAPTURE,$557.50 ,,,,
Flecainide ARUP,$198.50 ,,,,
FLUID WARMET SET Charge,$105.25 ,,,,
flumazenil 0.1 mg/mL,$48.50 ,,,,
Fluorescence Polarization ARUP,$122.50 ,,,,
Folate Level,$124.00 ,,,,
"Folate, RBC ARUP",$63.00 ,,,,
FOLEY CATH 10FR 3CC,$33.75 ,,,,
FOLEY CATH 12FR 5CC,$33.75 ,,,,
FOLEY CATH 14FR 5CC,$33.75 ,,,,
FOLEY CATH 16FR 5CC,$33.75 ,,,,
FOLEY CATH 18FR 30CC,$35.75 ,,,,
FOLEY CATH 18FR 3-WA,$56.25 ,,,,
FOLEY CATH 18FR 5CC,$33.75 ,,,,
FOLEY CATH 20FR 30CC,$35.75 ,,,,
FOLEY CATH 20FR 3-WA,$55.75 ,,,,
FOLEY CATH 20FR 5CC,$35.25 ,,,,
FOLEY CATH 22FR 30CC,$35.75 ,,,,
FOLEY CATH 22FR 3-WA,$57.00 ,,,,
FOLEY CATH 22FR 5CC,$34.25 ,,,,
FOLEY CATH 24FR 30CC,$36.00 ,,,,
FOLEY CATH 24FR 3-WA,$55.75 ,,,,
FOLEY CATH 24FR 5CC,$33.75 ,,,,
FOLEY CATH 26FR 30CC,$35.75 ,,,,
FOLEY CATH 26FR 3-WA,$55.75 ,,,,
FOLEY CATH 28FR 30CC,$35.75 ,,,,
FOLEY CATH 28FR 5CC,$35.25 ,,,,
FOLEY CATH 30FR 5CC,$14.75 ,,,,
FOLEY CATH 8FR PED,$33.75 ,,,,
FOLEY CATH TR 16FR,$67.25 ,,,,
FOLEY CATH TR 18FR,$67.25 ,,,,
FORCEPS COLON BX,$48.00 ,,,,
FORCEPS ETID BX,$48.00 ,,,,
FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIAL ADHESIONS AND STRETCHING CHARGE,,,,$185.25 ,
Free T4,$116.50 ,,,,
Free Thyroxine Index Calculation ARUP,$109.00 ,,,,
FSH,$154.50 ,,,,
FSH,$154.50 ,,,,
Full Pulmonary Function Testing UBMC,$248.50 ,,,,
furosemide 10 mg/mL Inj Sol,$17.75 ,,,,
GAIT TRAINING,$70.25 ,,,,
Gait Training Charges,$70.25 ,,,,
Galactose-1-Phosphate in Red Blood Cells ARUP,$485.25 ,,,,
Galactose-1-Phosphate Uridyltransferase ARUP,$355.75 ,,,,
GALLBLADDER BAG NUBERT,$65.25 ,,,,
"Gamma Glutamyl Transferase, Serum/Plasma ARUP",$56.00 ,,,,
GASTRECTOMY KIT FLEXI,$53.50 ,,,,
GASTRIC INTUBATION AND ASPIRATION REQUIRING PHYSICIAN SKILL CHARGE,$408.25 ,,,,
GASTRIC LAVAGE 28 FR,$230.25 ,,,,
GASTRIC LAVAGE 34 FR,$203.00 ,,,,
Gastric Lavage Administer,$149.75 ,,,,
Gastrin Level ARUP,$57.75 ,,,,
Gastro Occult Blood,$50.25 ,,,,
GAUZE 3X3 NON-STERILE,$18.00 ,,,,
GAUZE 4X4 NON-STERILE,$28.50 ,,,,
GAUZE 4x8 NONSTERILE,$64.25 ,,,,
"GBM Antibody, IgA by IFA ARUP",$252.50 ,,,,
"GBM Antibody, IgG by IFA ARUP",$252.50 ,,,,
"GBM Antibody, IgG by MAFD ARUP",$118.25 ,,,,
GEL KNEE W/ 4 PKS,$119.50 ,,,,
GELFILM,$88.00 ,,,,
GELFOAM 12X7,$29.25 ,,,,
GELFOAM 12X7,$29.25 ,,,,
General each additional 15 minutes,$175.50 ,,,,
General Endo each additional 15 minutes,$175.50 ,,,,
General Endo first 30 minutes,$524.25 ,,,,
General first 30 minutes,$524.25 ,,,,
General Health Panel,$274.75 ,,,,
General Mask each additional 15 minutes,$175.50 ,,,,
General Mask first 30 minutes,$524.25 ,,,,
General Rectal each additional 15 minutes,$175.50 ,,,,
General Rectal first 30 minutes,$524.25 ,,,,
Genital Culture,$116.00 ,,,,
gentamicin 40 mg/mL Inj Sol,$52.75 ,,,,
Gentamicin Lvl Peak,$123.75 ,,,,
Gentamicin Lvl Trough,$123.75 ,,,,
Giardia Antigen by EIA ARUP,$121.75 ,,,,
"Gliadin Peptide Antibody, IgA ARUP",$134.00 ,,,,
"Gliadin Peptide Antibody, IgG ARUP",$82.75 ,,,,
GLIDESCOPE #1,$32.25 ,,,,
GLIDESCOPE #2,$32.25 ,,,,
GLIDESCOPE #3,$24.25 ,,,,
GLIDESCOPE #4,$24.25 ,,,,
Glucose,$10.75 ,,,,
Glucose 1 Hour PP,$85.00 ,,,,
Glucose Body Fluid ARUP,$55.75 ,,,,
Glucose Cerebrospinal Fluid,$55.75 ,,,,
Glucose Level,$50.00 ,,,,
Glucose Monitoring Device POC,$15.50 ,,,,
"Glucose, blood by glucose monitoring device(s) - glucometer dependent upon state reimbursement",$5.75 ,,,,
Glucose-6-Phosphate Dehydrogenase ARUP,$63.00 ,,,,
GLUCOSESCAN Charge,$15.50 ,,,,
Glutamic Acid Decarboxylase Antibody ARUP,$165.50 ,,,,
GLYCINE 1. 5% IRRIGATI,$30.00 ,,,,
Gomco,$160.00 ,,,,
GOODMAN NASAL DRESSSING,$199.75 ,,,,
GOWN BAIR PAW L,$44.50 ,,,,
GOWN BAIR PAW XL,$59.25 ,,,,
GOWN XLG X-LONG,$16.50 ,,,,
Gram Stain.,$62.75 ,,,,
"GRIPPER NEEDLE 19 Ga x 1""",$18.75 ,,,,
"GRIPPER NEEDLE 20 Ga x 3/4""",$18.50 ,,,,
GROUND PAD/RETURN MONITOR,$13.50 ,,,,
Group A Strep by Nucleic Acid Amplification,$94.00 ,,,,
Group B Strep Culture,$51.50 ,,,,
Group B Streptococcus by DNA Amplification,$173.75 ,,,,
Growth Hormone ARUP,$63.00 ,,,,
GUAIAC (HEMOCULT) Charge,$8.75 ,,,,
H. Pylori Ag,$194.75 ,,,,
H. Pylori Breath Test,$181.25 ,,,,
H: 99291 - ED Critical Care,"$2,700.00 ",,,,
H63D Hemochromatosis Mutation ARUP,$114.25 ,,,,
HALO DEVICE,"$1,877.50 ",,,,
HAND CONTROL HANDLE PENCIL GRIP (EPH04),$233.00 ,,,,
HAND CONTROL HARMONIC SCALPEL (CATTEN),"$1,641.25 ",,,,
HAND DRAPE,$33.25 ,,,,
HAND-TROL CAUTERY PEN,$17.50 ,,,,
"Hantavirus Antibodies, ELISA w/Reflex ARUP",$165.00 ,,,,
Haptoglobin ARUP,$90.00 ,,,,
HARMONIC ACE,"$1,345.75 ",,,,
HARMONIC ACE 23P,"$1,289.00 ",,,,
HARMONIC CURVED 5 MM SHEARS,$671.00 ,,,,
HARMONIC FOCUS,"$1,368.75 ",,,,
HARMONIC WAVE SCALPEL,$615.00 ,,,,
hCG Beta Subunit Quant,$75.00 ,,,,
hCG Qualitative,$62.00 ,,,,
hCG Urine Qualitative,$62.00 ,,,,
HCV Genotyping by PCR and Sequencing ARUP,$627.00 ,,,,
HEALON-IN FRIDGE,$442.25 ,,,,
Hearing Screen,$409.50 ,,,,
HEAT EXCHANGER HME,$26.75 ,,,,
HEATED AEROSOL (PER DAY),$140.25 ,,,,
HEATED AERSOL SET UP,$33.25 ,,,,
HEATED WIRE CIRCUIT,$49.50 ,,,,
HEATING PADS DISP 12x17,$20.00 ,,,,
HEATING PADS DISP 18x24,$23.50 ,,,,
HEEL AND ELBOW PROTEC,$18.00 ,,,,
HEIMLICH VALVE CHEST,$27.75 ,,,,
"Helicobacter pylori Abs, IgG and IgA ARUP",$136.00 ,,,,
HELICOIL PK 4.5 MM ANCHOR,$902.25 ,,,,
HELICOIL PK 5.5 MM ANCHOR,$946.50 ,,,,
Hematocrit,$27.75 ,,,,
Hematocrit,$27.75 ,,,,
Hemochromatosis Mutation Interp IHC,$163.50 ,,,,
Hemodialysis (inpatient),$985.50 ,,,,
Hemodialysis Inpatient Charge Only,$985.50 ,,,,
Hemodynamics Daily Monitoring,$212.50 ,,,,
Hemoglobin,$41.25 ,,,,
Hemoglobin,$41.25 ,,,,
HEMOGLOBIN,$41.25 ,,,,
Hemoglobin A1c,$90.00 ,,,,
Hemoglobin A1c,$90.00 ,,,,
Hemoglobin A1c 1,$90.00 ,,,,
Hemoglobin Evaluation ARUP,$84.75 ,,,,
"Hemoquant, Feces ARUP",$60.50 ,,,,
heparin 1000 units/mL Inj Sol MDV 1ml,$44.50 ,,,,
"Heparin Anti-Xa, LMWH ARUP",$306.75 ,,,,
heparin flush 100 units/mL Sol MDV 1ml,$28.25 ,,,,
Hepatic Panel 2,$108.50 ,,,,
"Hepatitis A Virus Antibodies, Total ARUP",$162.75 ,,,,
"Hepatitis A Virus Antibody, IgM ARUP",$111.00 ,,,,
Hepatitis B Surface Ag,$93.25 ,,,,
Hepatitis B Surface Ag w/ Reflex to Conf ARUP,$93.25 ,,,,
Hepatitis B Surface Antibody ARUP,$70.75 ,,,,
Hepatitis B Surface Antigen,$93.25 ,,,,
Hepatitis B Surface Antigen ARUP,$93.25 ,,,,
Hepatitis B Virus (HBV) by Quantitative NAAT ARUP,$179.62 ,,,,
"Hepatitis B Virus Core Antibodies, Total ARUP",$100.75 ,,,,
"Hepatitis B Virus Core Antibody, IgM ARUP",$84.75 ,,,,
Hepatitis B Virus Surface Antibody ARUP,$70.75 ,,,,
"Hepatitis B Virus Surface Antigen, Confirmation ARUP",$72.00 ,,,,
Hepatitis Be Antibody ARUP,$60.75 ,,,,
Hepatitis Be Antigen ARUP,$40.75 ,,,,
Hepatitis Be Virus Antibody ARUP,$60.75 ,,,,
Hepatitis Be Virus Antigen ARUP,$40.75 ,,,,
Hepatitis C RNA Qnt w/ Genotype Reflex ARUP,$491.75 ,,,,
Hepatitis C Virus (HCV) by Quantitative NAAT ARUP,$491.75 ,,,,
Hepatitis C Virus Antibody by CIA ARUP,$82.00 ,,,,
Hepatitis C Virus Antibody by CIA with reflex to HCV by Quant NAAT ARUP,$82.00 ,,,,
Hepatitis C Virus RNA Qualitative PCR ARUP,$288.00 ,,,,
"Hepatitis Panel, Acute ARUP",$261.00 ,,,,
HERCEP Reflex to FISH if 2+ ARUP,"$1,876.00 ",,,,
Herpes Simplex Virus By PCR ARUP,$252.50 ,,,,
HEWSON SUTURE RETRIEVER,"$1,447.00 ",,,,
HFE PCR Specimen ARUP,$166.25 ,,,,
HICKMAN 9.6FR SINGLE LUMEN CATH,$456.00 ,,,,
HICKMAN 9FR DUAL LUMEN,$558.25 ,,,,
High Flow Oxygen Initial,$100.00 ,,,,
"Histamine, Plasma ARUP",$107.25 ,,,,
"Histamine, Whole Blood ARUP",$107.25 ,,,,
"HIV 1& 2, Rapid EIA",$75.00 ,,,,
"HIV Combo Antigen/Antibody (HIV-1/O/2) by ELISA, Reflexive Panel ARUP",$551.75 ,,,,
"HIV Types 1&2 (HIV-1/2) Ab Differentiation,Supplemental ARUP",$149.62 ,,,,
HLA-B27 ARUP,$136.00 ,,,,
HOLTER MONITOR SCAN ANALYS,$513.75 ,,,,
HOLTER MONITOR/RECORDING,$447.25 ,,,,
Home Sleep Test,$450.00 ,,,,
"Homocysteine, Total ARUP",$117.00 ,,,,
Hospital OP Clinic Visit - MEDICARE ONLY,$175.00 ,,,,
HOT POLYPECTOMY SNARE,$56.00 ,,,,
"HSV 1 Glycoprotein G Ab, IgG ARUP",$100.75 ,,,,
"HSV 1,2 Ab IgM, CSF ARUP",$47.25 ,,,,
"HSV 1,2 Ab Screen IgG, CSF ARUP",$94.50 ,,,,
"HSV 1,2 Abs, IgG, IgM ARUP",$94.50 ,,,,
"HSV 1,2 Glyco G-Specific, IgG ARUP",$100.75 ,,,,
"HSV 1/2 Ab, IgG, IgM Reflex ARUP",$52.57 ,,,,
"HSV 1/2 Antibody IgM, CSF ARUP",$94.50 ,,,,
"HSV 1/2 Antibody IgM, CSF ARUP",$94.50 ,,,,
"HSV 1/2 Antibody Screen IgG, CSF ARUP",$94.50 ,,,,
"HSV 1/2 Antibody Screen IgG, CSF ARUP",$94.50 ,,,,
"HSV 2 Glycoprotein G Ab, IgG ARUP",$94.50 ,,,,
"HSV Type 1/2 Combined Ab, IgG ARUP",$42.00 ,,,,
"HSV Type 1/2 Combined Ab, IgM by ELISA A",$42.00 ,,,,
"HTLV I/II Antibodies Conf, Western Blot ARUP(0020642)",$162.25 ,,,,
HTLV I/II Antibodies w/Reflex to Confirm ARUP(0051164),$162.25 ,,,,
HULKA CLIPS,$44.50 ,,,,
Human Placental Lactogen ARUP,$504.00 ,,,,
Hyperbaric oxygen under pressure - per 30 min,$181.00 ,,,,
Hyperbaric oxygen under pressure - per session,$181.00 ,,,,
I & D COMPLEX POST OP WOUND INFECTION CHARGE,$514.50 ,,,,
I & D SIMPLE OR SINGLE CHARGE,$351.00 ,,,,
I & D vulva abscess,$484.75 ,,,,
IFE Interpretation ARUP,$114.00 ,,,,
IGF Binding Protein-3 ARUP,$88.50 ,,,,
IGF-1 (Insulin-Like Growth Factor I) w/calculated Z-score ARUP,$46.00 ,,,,
IMMUNIZATION ADDITIONAL VACCINE Charge,$73.50 ,,,,
IMMUNIZATION ADMINISTRATION,$95.50 ,,,,
IMMUNIZATION ADMINISTRATION 1 VACCINE CHARGE,$95.50 ,,,,
IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE CHARGE,$73.50 ,,,,
"Immunofixation, IgD and IgE ARUP",$447.25 ,,,,
Immunoglobulin A ARUP,$60.00 ,,,,
Immunoglobulin A ARUP,$60.00 ,,,,
Immunoglobulin A ARUP,$60.00 ,,,,
Immunoglobulin E ARUP,$54.50 ,,,,
Immunoglobulin G ARUP,$60.00 ,,,,
Immunoglobulin G ARUP,$60.00 ,,,,
"Immunoglobulin G Subclasses (1, 2, 3, 4) ARUP",$242.00 ,,,,
"Immunoglobulin G, CSF ARUP",$60.00 ,,,,
Immunoglobulin M ARUP,$60.00 ,,,,
Immunoglobulin M ARUP,$60.00 ,,,,
Incentive Spirometry Initial,$241.25 ,,,,
INCENTIVE SPIROMETRY SUBSEQUENT,$241.25 ,,,,
Incision & drainage of abscess: complicated / multiple,$480.00 ,,,,
Incision & drainage of abscess: simple / single,$251.25 ,,,,
"INCISION AND DRAINAGE ABSCESS, CYST, HEMATOMA DENTOALVEOLAR STRUCTURE CHARGE",,,,$270.25 ,
INCISION AND DRAINAGE BARTHOLIN GLAND ABSCESS CHARGE,$267.50 ,,,,
INCISION AND DRAINAGE COMPLEX  POST OP WOUND INFECTION CHARGE,,,,$546.50 ,
"INCISION AND DRAINAGE FLUID, HEMATOMA, OR SEROMA SIMPLE CHARGE","$2,210.75 ",,,,
INCISION AND DRAINAGE LEG OR ANKLE DEEP ABSCESS OR HEMATOMA CHARGE,,,,$752.25 ,
INCISION AND DRAINAGE OF ABSCESS COMPLICATED OR MULTIPLE CHARGE,$514.50 ,,,,
INCISION AND DRAINAGE OF ABSCESS SIMPLE OR SINGLE Charge,$351.00 ,,,,
"Incision and drainage of hematoma, seroma or fluid collection","$2,028.25 ",,,,
Incision and drainage of pilonidal cyst; complicated,$884.25 ,,,,
Incision and drainage of pilonidal cyst; simple,$884.25 ,,,,
INCISION AND DRAINAGE PERIANAL ABSCESS SUPERFICIAL CHARGE,"$1,174.00 ",,,,
INCISION AND DRAINAGE PERITONSILLAR ABCESS CHARGE,$581.50 ,,,,
INCISION AND DRAINAGE PILONIDAL CYST COMPLICATED CHARGE,"$1,414.75 ",,,,
INCISION AND DRAINAGE PILONIDAL CYST SIMPLE CHARGE,$947.75 ,,,,
INCISION AND DRAINAGE SHOULDER AREA DEEP ABSCESS OR HEMATOMA CHARGE,,,,$680.00 ,
Incision and Drainage Tray,$45.25 ,,,,
INCISION AND DRAINAGE VULVA/PERINEAL ABSCESS CHARGE,$484.75 ,,,,
"Incision and drainage, complex, post-op wound infection","$3,524.50 ",,,,
INCISION AND REMOVAL FOREIGN BODY SUBCUTANEOUS COMPLICATED CHARGE,"$2,210.75 ",,,,
INCISION AND REMOVAL FOREIGN BODY SUBCUTANEOUS SIMPLE CHARGE,$509.75 ,,,,
"Incision and removal or foreign body, subcutaneous tissues; complicated","$2,028.25 ",,,,
"Incision and removal or foreign body, subcutaneous tissues; simple",$480.00 ,,,,
INCISION OF THROMBOSED EXTERNAL HEMORRHOID CHARGE,$384.25 ,,,,
Incompatible,$211.75 ,,,,
Incompatible,$211.75 ,,,,
INCONTINENT LG BRIEF,$28.75 ,,,,
INCONTINENT LG PULLUP,$25.00 ,,,,
INCONTINENT MED BRIEF,$14.50 ,,,,
INCONTINENT SM/MD PULLUP,$25.00 ,,,,
INCONTINENT X LARGE BRIEFS,$28.75 ,,,,
INCONTINENT XX LARGE BRIEFS,$29.25 ,,,,
indigo carmine 8 mg/mL,$29.00 ,,,,
Infant Code Stabilization,$840.75 ,,,,
Infant SPO2 Sensor disposable,$40.50 ,,,,
Infant Stabilization,$389.00 ,,,,
INFINITI SLEEVES,$498.75 ,,,,
Inflammatory Bowel Disease Panel ARUP,$93.00 ,,,,
Inflammatory Bowel Disease Panel ARUP,$93.00 ,,,,
Influenza A & B by Nucleic Acid Amplification,$210.00 ,,,,
Influenza A + B Rapid,$207.50 ,,,,
"Influenza A Virus Ab, IgG ARUP",$249.25 ,,,,
"Influenza A Virus Ab, IgM ARUP",$249.25 ,,,,
Influenza A&B Rapid,$207.50 ,,,,
"Influenza A, B Virus Abs, IgG, IgM ARUP",$207.50 ,,,,
"Influenza B Virus Ab, IgG ARUP",$249.25 ,,,,
"Influenza B Virus Ab, IgM ARUP",$249.25 ,,,,
INFRARED UNATTENDED,$11.50 ,,,,
Inhibin B ARUP,$313.50 ,,,,
Initial Newborn Hearing Screening -ABR,$409.50 ,,,,
Initiated,$69.50 ,,,,
"Injection , anesthetic agent , facial nerve",$384.00 ,,,,
"Injection , anesthetic agent, axiallary nerve","$1,179.50 ",,,,
INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NERVE CHARGE,$401.25 ,,,,
INJECTION ANESTHETIC AGENT INTERCOSTAL NERVES MULTIPLE REGIONAL BLOCK CHARGE,,,,$802.00 ,
INJECTION ANESTHETIC AGENT OTHER PERIPHERAL NERVE OR BRANCH CHARGE,,,,$270.00 ,
Injection IV push additional diff drug CHARGE,$117.75 ,,,,
INJECTION IV PUSH EACH ADDITIONAL SEQUENTIAL NEW SUBSTANCE OR DRUG CHARGE,$117.75 ,,,,
Injection IV Push single CHARGE,$313.50 ,,,,
INJECTION IV PUSH SINGLE SUBSTANCE OR DRUG CHARGE,$313.50 ,,,,
INJECTION SINGLE OR MULTIPLE TRIGGER POINTS >= 3.0 MUSCLES CHARGE,$416.00 ,,,,
INJECTION SINGLE OR MULTIPLE TRIGGER POINTS 1.0 - 2.0 MUSCLES CHARGE,$401.50 ,,,,
INJECTION SINGLE TENDON ORIGIN/INSERTION CHARGE,$416.00 ,,,,
INJECTION SINGLE TENDON SHEATH OR LIGAMENT APONEUROSIS CHARGE,$401.25 ,,,,
INJECTION THERAP INTRA-ARTERIAL,$313.50 ,,,,
INJECTION THERAP INTRA-ARTERIAL Charge,$313.50 ,,,,
INJECTION THERAP SUBQ INTRAMUSCULAR Charge,$95.50 ,,,,
"Injection, anesthetic agent, cervical plexus",$935.75 ,,,,
"Injection, anesthetic agent, cervical plexus Profee",$935.75 ,,,,
"INJECTION, ANESTHETIC AGENT; SPHENOPALATINE GANGION",$416.00 ,,,,
"Injection, therap subq, IM CHARGE",$95.50 ,,,,
Injections IV Push additional same drug CHARGE,$82.00 ,,,,
INSERTION OF NON-INDWELLING BLADDER CATHETER CHARGE,,,,$162.25 ,
INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER < 5 YEARS OF AGE CHARGE,"$1,612.25 ",,,,
INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER >= 5 YEARS OF AGE CHARGE,"$1,612.25 ",,,,
INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER W/O PORT OR PUMP  < 5 YEARS OF AGE CHARGE,"$1,603.00 ",,,,
INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER W/O PORT OR PUMP  >= 5 YEARS OF AGE CHARG,"$1,612.25 ",,,,
INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER SIMPLE CHARGE,,,,$315.25 ,
INSERTION OR REPLACEMENT OF SINGLE CHAMBER CARDIAC ELECTRODETEMPORARY PACEMAKER CHARGE,"$12,446.50 ",,,,
Instrument pouch Invisishield,$66.00 ,,,,
INSUFFLATION NEEDLE,$75.00 ,,,,
Insulin Antibody ARUP,$164.00 ,,,,
"Insulin, 120 Minutes ARUP",$80.00 ,,,,
"Insulin, 60 Minutes ARUP",$80.00 ,,,,
"Insulin, Fasting ARUP",$80.00 ,,,,
"Insulin, Random ARUP",$80.00 ,,,,
INTERCEED  TC7,$406.75 ,,,,
INTERPULSE SET TUBING(STRYKER),$246.50 ,,,,
Intraosseous needle placement,$541.25 ,,,,
INTRAUTERINE TRANSDUC,$95.25 ,,,,
Intrinsic Factor Blocking Antibody ARUP,$76.25 ,,,,
INTRODUCTION OF CATHETER SUPERIOR OR INFERIOR VENA CAVA CHARGE,,,,$619.50 ,
INTRODUCTION OF NEEDLE OR INTRACATHETER VEIN CHARGE,,,,$95.75 ,
INTRODUCTION OF NEEDLE OR INTRACHATETER EXTREMITY ARTERY CHARGE,,,,$539.00 ,
INTUBATION CHARGE,$87.50 ,,,,
INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE CHARGE,$311.25 ,,,,
Intubation Procedure,$311.25 ,,,,
"Iodide, Serum or Plasma ARUP",$342.50 ,,,,
"Iodine, Urine ARUP",$383.00 ,,$0.00 ,,
Iodine_Serum ARUP,$342.50 ,,,,
iodine-potassium iodide 5%-10% sol,$21.00 ,,,,
IONTOPHORESIS,$79.00 ,,,,
IPPB INITIAL,$305.75 ,,,,
IPPB SETUP,$24.75 ,,,,
IPPB SUBSEQUENT CHARGES,$305.75 ,,,,
Iron and Iron Binding Capacity ARUP,$84.75 ,,,,
Iron Level,$62.00 ,,,,
Irrigation of corpora cavernosa for priapism,$376.50 ,,,,
Irrigation of implanted venous access device for drup delivery system,$140.50 ,,,,
IRRIMAX WOUND IRRIGATOR,$51.75 ,,,,
"Islet Cell Antibody, IgG ARUP",$102.25 ,,,,
ISOVUE,$16.50 ,,,,
IV 0.9% NS : 250ML BAG Hospira,$12.00 ,,,,
IV ANESTH SET CLAVE 3,$20.25 ,,,,
IV Cut-Down Tray,$93.75 ,,,,
IV D10% : 250ML,$12.25 ,,,,
IV D5% : 1000ML,$12.25 ,,,,
IV D5% : 150ML GLASS,$15.25 ,,,,
IV D5% : 500ML,$12.25 ,,,,
IV D5% NS 0.225% : 1000ML,$12.25 ,,,,
IV D5% NS 0.225% : 500ML,$12.25 ,,,,
IV D5% NS 0.45% : 1000ML,$12.25 ,,,,
IV D5% NS 0.45% : 500ML,$12.25 ,,,,
IV D5% NS 0.9% : 1000ML,$12.25 ,,,,
IV D5% NS 0.9% : 500ML,$12.25 ,,,,
IV D5LR : 1000ML,$12.25 ,,,,
IV D5LR : 500ML,$12.25 ,,,,
IV HYDRATION 1ST HR Charge,$313.50 ,,,,
IV HYDRATION EACH ADDITIONAL 1.0 HOUR CHARGE,$121.25 ,,,,
IV HYDRATION EACH ADDITIONAL HOUR,$107.00 ,,,,
IV HYDRATION INITIAL 31.0 TO 60.0 MINUTES CHARGE,$313.50 ,,,,
IV INFUSION 1ST HR Charge,$359.00 ,,,,
IV INFUSION ADD SEQ 1ST HR,$119.75 ,,,,
IV INFUSION CONCURRENT,$120.00 ,,,,
IV INFUSION CONCURRENT Charge,$120.00 ,,,,
IV INFUSION EACH ADDITIONAL HOUR,$115.00 ,,,,
"IV INFUSION FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS EACH ADDITIONAL 1.0 HOUR CHARGE",$126.75 ,,,,
"IV INFUSION FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS INITIAL UP TO ONE HOUR CHARGE",$359.00 ,,,,
"IV Injection, add new drug THERAPEUTIC OR DIAGNOSTIC",$117.75 ,,,,
IV LR Sol 1000 mL,$12.25 ,,,,
IV LR Sol 500 mL,$12.00 ,,,,
IV NS 0.45% IV Sol 1000 Ml,$12.25 ,,,,
IV NS 0.9% IV Sol 100 mL,$26.50 ,,,,
IV NS 0.9% IV Sol 1000 mL,$12.25 ,,,,
IV NS 0.9% IV Sol 50 mL,$32.75 ,,,,
IV NS 0.9% IV Sol 500 mL,$12.00 ,,,,
IV PRIMARY CLAVE MICRO-DRIP,$17.00 ,,,,
IV PRIMARY CLAVE REG,$12.75 ,,,,
IV Regional each additional 15 minutes,$175.50 ,,,,
IV Regional first 30 minutes,$524.25 ,,,,
"IV THERAPY  HYDRATION, EACH ADDITIONAL HOUR",$121.25 ,,,,
IVP INJECTION therapeutic or diagnostic ER,$313.50 ,,,,
J/P 10MM FLT,$23.75 ,,,,
J/PRAT 7MM FLAT,$23.75 ,,,,
J/PRATT RESERVOR,$19.75 ,,,,
"JAK2 Gene, V617F Mutation, Qualitative ARUP",$584.75 ,,,,
"JAK2 Gene, V617F Mutation, Quantitation ARUP",$584.75 ,,,,
JEJUNAL FEEDING TUBE,$329.25 ,,,,
JEJUNAL FEEDING/GASTRIC DECOMPRESSION TUBE,$257.00 ,,,,
"Jo-1 (Histidyl-tRNA Synthetase) Ab, IgG",$88.00 ,,,,
JO-1 Antibody ARUP,$94.50 ,,,,
JOBST MEASURE,$66.25 ,,,,
JOINT MOBILIZATION,$88.25 ,,,,
KANGAROO FEEDING BAG,$22.50 ,,,,
KENNEDY DRESSING LAMI,$113.75 ,,,,
Keppra (Levetiracetam) ARUP,$226.75 ,,,,
KIDNEY BALLOON - DR. K,$520.25 ,,,,
Kleihauer-Betke ARUP,$69.50 ,,,,
KNEE BRACE POST-OP HINGED (T-ROM) L1832,$363.75 ,,,,
KNEE IMMOB LARGE,$55.75 ,,,,
KNEE IMMOB MEDIUM,$55.75 ,,,,
KNEE IMMOB SMALL,$55.75 ,,,,
KNEE IMMOB X-LARGE,$55.75 ,,,,
KNEE IMMOB XXLG,$56.25 ,,,,
KNIFE 2.8 SAFETY SLIT,$37.50 ,,,,
KNIFE CRESANT,$321.00 ,,,,
KNIFE SIDEPORT,$285.00 ,,,,
KNIFE SLIT 3.0 mm,$64.75 ,,,,
KUGEL LG CIRCLE HERNIA,"$2,681.25 ",,,,
KUGEL LG OVAL HERNIA PATCH COMPOSIX,"$2,278.00 ",,,,
KUGEL MD OVAL HERNIA PATCH COMPOSIX,"$2,875.00 ",,,,
KUGEL SM CIRCLE HERNIA,"$1,881.75 ",,,,
KUGEL SM OVAL HERNIA PATCH COMPOSIX,"$1,217.25 ",,,,
KUGEL XLG OVAL HERNIA PATCH COMPOSIX EPT,"$3,545.50 ",,,,
K-WIRES 0.045,$48.00 ,,,,
LABEL MEDICAL,$17.75 ,,,,
Labor / Delivery care,$157.00 ,,,,
LAC 1  UP TO 3  COMPLEX Charge,$800.75 ,,,,
LACERATION TRAY,$53.00 ,,,,
LACERATION TRAY,$53.00 ,,,,
Lactate Dehydrogenase,$37.75 ,,,,
Lactate Dehydrogenase Body Fluid ARUP,$37.75 ,,,,
Lactate Dehydrogenase Isoenzymes ARUP,$86.75 ,,,,
Lactic Acid,$87.50 ,,,,
Lactoferrin,$134.00 ,,,,
"Lactoferrin, Fecal by ELISA ARUP",$134.00 ,,,,
Lamellar Body Count,$40.75 ,,,,
Lamotrigine ARUP,$198.50 ,,,,
LAP CHOLE DRAPE,$31.00 ,,,,
LAP DISC,$71.00 ,,,,
LAP DRAPE 1-HOLE,$20.25 ,,,,
LAP PACK,$148.00 ,,,,
LAP PACK ESSENTIALS,$29.00 ,,,,
LAP PACK TRANSVERSE,$43.75 ,,,,
LAP SPONGES 3 X 17 XRAY,$15.00 ,,,,
LARGE CAST PLACEMENT CHARGE,$150.00 ,,,,
Large joint injection/aspiration,$401.50 ,,,,
LARYNGOSCOPY DIRECT DIAGNOSTIC EXCEPT NEWBORN CHARGE,,,,$624.50 ,
LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGNOSTIC CHARGE,,,,$316.50 ,
LARYNGOSCOPY INDIRECT DIAGNOSTIC CHARGE,,,,$208.00 ,
LAVACUATOR 18FR,$31.75 ,,,,
LAVACUATOR 22 FR,$37.75 ,,,,
LAVACUATOR 28FR,$31.75 ,,,,
LAVACUATOR 32FR,$37.75 ,,,,
LAVACUATOR 36FR,$38.25 ,,,,
LAVH DRAPE,$28.75 ,,,,
"LCM Virus Ab, IgG, CSF ARUP",$98.25 ,,,,
"LCM Virus Ab, IgG, CSF ARUP",$98.25 ,,,,
"LCM Virus Ab, IgM, CSF ARUP",$98.25 ,,,,
"LCM Virus Ab, IgM, CSF ARUP",$98.25 ,,,,
LDRP Delivery,$266.00 ,,,,
LDRP Delivery Extended,$135.75 ,,,,
"Lead, Blood (Capillary) ARUP",$51.50 ,,,,
"Lead, Blood (Venous) ARUP",$51.50 ,,,,
"Lead, Blood (Venous) ARUP",$51.50 ,,,,
"Lead, Blood (Venous) ARUP",$51.50 ,,,,
"Lead, Urine ug/L ARUP",$51.50 ,,,,
LECTROVAC SUCTION COAGULATOR,$43.50 ,,,,
"Legionella Pneumophila 1-6,IgM ARUP",$51.50 ,,,,
"Legionella pneumophila Antibody 1-6, IgG ARUP",$51.50 ,,,,
"Legionella Pneumophila Antigen, Urine ARUP",$124.00 ,,,,
LEUKO TAPING,$11.75 ,,,,
Leukocyte Alkaline Phosphatase Smear ARUP,$252.50 ,,,,
Leukocyte Lysosomal Enzyme ARUP,"$1,484.00 ",,,,
LEVEL 1 IV FLUID ADMIN SET,"$1,994.75 ",,,,
LH,$124.50 ,,,,
lidocaine 0.5% PF Inj Sol,$42.75 ,,,,
lidocaine 1% Inj Sol MDV 20 mL,$20.25 ,,,,
lidocaine 1% PF Inj Sol Poly Amp 10 mL,$21.00 ,,,,
lidocaine 1% sol 50 mL,$48.00 ,,,,
lidocaine 2% Inj Sol MDV 20 mL,$20.25 ,,,,
lidocaine 2% Inj Sol MDV 50 mL,$21.00 ,,,,
lidocaine 2% PF Inj Sol Poly Amp 20 mL,$24.75 ,,,,
Lidocaine 2% with epinephrine 20mL vial,$3.25 ,,,,
lidocaine 4% PF Top Sol AMP 5 mL,$25.75 ,,,,
LIGA CLIP 10 mm,$349.25 ,,,,
Ligasure Impact,"$1,489.00 ",,,,
Ligasure Small Jay,"$1,199.50 ",,,,
LIGATION MAJOR ARTERY EXTREMITY CHARGE,,,,"$1,006.25 ",
LIGATION MAJOR ARTERY HEAD/NECK CHARGE,,,,"$1,192.25 ",
LIGATION OR BIOPSY OF TEMPORAL ARTERY CHARGE,"$2,628.50 ",,,,
"LIGHTWAVE SUCHION ABLA
LIGHTWAVE SUCHION ALAITOR",$307.25 ,,,,
Limited bilateral nonivasive physiological studies of upper and lower extremity arteries,$356.25 ,,,,
"Limited bilateral, 1-2 levels, or report for unilateral study when recording 3 or more levels",$164.25 ,,,,
LINEAR CUTTER 75 mm,$526.75 ,,,,
Lipase Level,$75.00 ,,,,
"Lipase, Fluid ARUP",$74.25 ,,,,
Lipid Panel 3,$79.25 ,,,,
Lipid Panel Healthfair,$79.25 ,,,,
Lipoprotein (a) ARUP,$57.75 ,,,,
Lipoprotein Electrophoresis ARUP,$217.00 ,,,,
Lithium Level,$85.00 ,,,,
"Liver-Kidney Microsome Abs, IgG ARUP",$86.25 ,,,,
Local each additional 15 minutes,$175.50 ,,,,
Local first 30 minutes,$524.25 ,,,,
Local/Sedation each additional 15 minutes,$175.50 ,,,,
Local/Sedation first 30 minutes,$524.25 ,,,,
LONG MEDIUM AGGRESSIVE BLADE 31X9 - TPS,$109.00 ,,,,
LONG NARROW BLADE 25X5.5 - TPS,$109.00 ,,,,
Lopez Valve,$20.75 ,,,,
LUMBAR PUNC TR ADL,$55.00 ,,,,
LUMBAR PUNC TR PED,$49.75 ,,,,
Lumbar Puncture,$49.75 ,,,,
Lumbar Puncture Diagnostic,$892.00 ,,,,
LUMBAR PUNCTURE DIAGNOSTIC CHARGE,$892.00 ,,,,
LVC JUG 1500CC W/FILTER,$63.75 ,,,,
"Lyme Abs, IgG and IgM by Western Blot ARUP",$176.25 ,,,,
Lymphocyte Subset Pan 1-CD4 Abs Cnt Only ARUP,$201.75 ,,,,
Lymphocyte Subset Panel 2-CD4  Per & Abs ARUP,$201.75 ,,,,
"Lysozyme, Serum ARUP",$86.25 ,,,,
MA Breast Ndl Loc Placement Right.,"$1,442.75 ",,,,
MA Ductogram or Galactogram Multi Bilat,$444.75 ,,,,
MA Mammogram Diagnostic Bilateral.,$430.25 ,,,,
MA Mammogram Diagnostic Left.,$356.25 ,,,,
MA Mammogram Diagnostic Right.,$356.25 ,,,,
MA Mammogram Needle Localization Lt.,"$1,442.75 ",,,,
MA Mammogram Needle Localization Rt.,"$1,442.75 ",,,,
MA Mammogram Routine Screening Bilat.,$355.75 ,,,,
MA Mammogram Special Bilat.,$150.00 ,,,,
MA Mammogram Special Left.,$150.00 ,,,,
MA Mammogram Special Right.,$150.00 ,,,,
MA Mammogram Wire Place Lt.,"$1,442.75 ",,,,
MA Mammogram Wire Place Rt.,"$1,442.75 ",,,,
MA Radiological Specimen Left.,$826.25 ,,,,
MA Radiological Specimen Right.,$826.25 ,,,,
Magnesium Level,$70.25 ,,,,
MAGNETIC PAD - DISPOSABLE,$17.25 ,,,,
MAJOR BASIN SET,$74.75 ,,,,
Major each additional 15 minutes,$800.00 ,,,,
Major First 30 Minutes,"$1,700.00 ",,,,
MAKO Blade Narrow,$869.25 ,,,,
MAKO Blade Standard,$869.25 ,,,,
Malaria Rapid Screen and Giemsa Stain 2001547 ARUP,$750.00 ,,,,
MANUAL MUSCLE TEST EXT,$73.75 ,,,,
MANUAL MUSCLE TEST HAND,$56.75 ,,,,
MANUAL RESUSITATOR Charge,$85.75 ,,,,
MANUAL THERAPY,$88.25 ,,,,
MANUAL TRACTION,$88.25 ,,,,
MARLEX LG PLUG & PAT 1.,$295.00 ,,,,
MARLEX MED PLUG & PAT 1,$295.00 ,,,,
MARLEX XLG PLUG & PAT 1,$295.00 ,,,,
Mask for T-piece,$25.00 ,,,,
MASON SPLINT,$42.75 ,,,,
MASSAGE,$65.50 ,,,,
MASTOTOMY WITH EXPLORATION OR DRAINAGE OF DEEP ABSCESS CHARGE,,,,$546.00 ,
"Maternal Serum Screen, Alpha Fetoprotein, hCG, Estriol, and Inhibin A (Quad) ARUP",$268.75 ,,,,
MDI,$13.00 ,,,,
"Measles (Rubeola) Antibody, IgG ARUP",$42.75 ,,,,
"Measles (Rubeola) Antibody, IgM ARUP",$42.75 ,,,,
"Measles, Rubeola, Abs, IgG and IgM ARUP",$85.50 ,,,,
"Measles, Rubeola, Antibody IgG CSF ARUP",$42.75 ,,,,
"Measles, Rubeola, Antibody IgG CSF ARUP",$42.75 ,,,,
"Measles, Rubeola, Antibody IgM CSF ARUP",$42.75 ,,,,
"Measles, Rubeola, Antibody IgM CSF ARUP",$42.75 ,,,,
MECHANICAL TRACTION,$62.25 ,,,,
Meconium,$495.25 ,,,,
Meconium Drug Screen.,$355.25 ,,,,
MECONUIM ASPIRATOR,$16.75 ,,,,
MED ABDUCTION PILLOW,$93.00 ,,,,
MEDIUM CAST PLACEMENT Charge,$118.75 ,,,,
MEDIUM HEMOCLIPS BLUE,$32.75 ,,,,
MEDIUM MEDIUM BLADE 18.5X9 - TPS,$109.00 ,,,,
MEDIUM NARROW BLADE 18X5.5 - TPS,$109.00 ,,,,
MEDTRONIC 4MM X 64MM XOMED BUR,$237.50 ,,,,
MEDTRONIC 6MM X 51MM XOMED BUR,$611.75 ,,,,
meperidine 10 mg/mL Inj Sol PCA,$27.50 ,,,,
meperidine 25 mg/mL Inj Sol,$22.75 ,,,,
meperidine 50 mg/mL Inj Sol,$22.75 ,,,,
MEPORE 9X15 (3.5 X 6 ),$95.75 ,,,,
Mercury Blood ARUP,$52.50 ,,,,
Mercury Blood ARUP,$52.50 ,,,,
"Mercury, Urine - ug/L ARUP",$45.25 ,,,,
Merocel nasal packing,$98.25 ,,,,
MESH 3D LG LEFT,$449.25 ,,,,
MESH 3D LG RIGHT,$449.25 ,,,,
MESH 3D MED LEFT,$423.75 ,,,,
MESH 3D MED RIGHT,$423.75 ,,,,
"Metanephrines Fractionated by HPLC-MS/MS, Ur ARUP",$315.00 ,,,,
"Metanephrines, Plasma (Free) ARUP",$315.00 ,,,,
methylene blue 10 mg/mL Inj Sol,$33.25 ,,,,
methylPREDNISolone 1 g PF SDV AOV,$80.50 ,,,,
methylPREDNISolone 125 mg PF Inj SDV,$19.75 ,,,,
methylPREDNISolone 40 mg Inj SDV AOV,$34.50 ,,,,
methylPREDNISolone 80 mg/mL 1mL,$53.25 ,,,,
Microalb/Creat Ratio,$80.75 ,,,,
Microalbumin/Creat Level 24 Hour Urine,$80.75 ,,,,
MICROINTRODUCTER 5FR,$31.00 ,,,,
Micropolyspora faeni ARUP,$199.25 ,,,,
midazolam 1 mg/mL PF Inj Sol 5 mL,$22.75 ,,,,
MINI C-ARM DRAPE,$710.50 ,,,,
Minor Each Additional 15 minutes,$675.00 ,,,,
Minor First 30 Minutes,"$1,200.00 ",,,,
MINOR SURGERY TRAY Charge,$93.75 ,,,,
MITEK LUPINE BR ANCHOR WITH ORTHROCORD,$628.75 ,,,,
MITEK SUTURE SHUTTLE 45 DEG RIGHT,$340.75 ,,,,
MITEK SUTURE SHUTTLE 90 DEG UP,$340.75 ,,,,
MITEK THREADED CLEAR CANNULA WITH OBTURATOR,$49.25 ,,,,
"Mitochondrial M2 Ab, IgG ARUP",$82.75 ,,,,
Mity vac pump and cup,$153.25 ,,,,
"MMA Serum/Plasma, Vitamin B12 Deficiency ARUP",$258.25 ,,,,
MOD. BARIUM SWALLOW STUDY,$242.00 ,,,,
MODERATE CONSCIOUS SEDATION SAME PHYSICIAN YOUNGER THAN 5 YRS 30 MINUTES CHARGE,,,,$95.00 ,
MODERATE SEDATION SAME PHYSICIAN 5 YEARS OR OLDER 30 MINUTES CHARGE,,,,$176.50 ,
MODERATE SEDATION SAME PHYSICIAN 5 YEARS OR OLDER EACH ADDITIONAL 15 MINUTES CHARGE,,,,$83.00 ,
Mogen,$160.00 ,,,,
Molecular Isolation,"$2,678.50 ",,,,
MoM for AFP ARUP,$139.50 ,,,,
MoM for DIA ARUP,$113.75 ,,,,
MoM For hCG ARUP,$75.00 ,,,,
MoM for uE3 ARUP,$122.75 ,,,,
Monitored Anesthesia Care each additional 15 minutes,$175.50 ,,,,
Monitored Anesthesia Care first 30 minutes,$524.25 ,,,,
MONITORING OF INTERSTITIAL FLUID PRESSURE IN DETECTION OF MUSCLE COMPARTMENT SYNDROME CHARGE,$947.75 ,,,,
Mono Spot,$34.25 ,,,,
Mono Spot 1,$34.25 ,,,,
"Monoclonal Protein Detection Quant/Charac, SPEP, IFE,IgA,IgG,IgM, Serum 0050615 ARUP",$107.47 ,,,,
"Monoclonal Protein Detection, Quant, Charc, SPEP, IFE, IgA, IgG, IgM, FLC 2002715 ARUP",$250.86 ,,,,
MORCELATOR,$937.00 ,,,,
MORGAN EYE LENS Charge,$85.75 ,,,,
morphine 2 mg/mL Inj Sol,$23.50 ,,,,
moxifloxacin 0.5% opth sol,$223.00 ,,,,
"MPS Screen, Urine ARUP",$408.75 ,,,,
MRA Abdomen,"$1,178.50 ",,,,
MRA Chest,$966.50 ,,,,
MRA Head w/ + w/o Contrast,"$3,012.00 ",,,,
MRA Head w/o Contrast,"$2,603.25 ",,,,
MRA Neck w/ + w/o Contrast,"$2,945.25 ",,,,
MRI Abdomen w/ + w/o Contrast,"$3,365.50 ",,,,
MRI Abdomen w/o Contrast,"$2,416.75 ",,,,
MRI Brain w/ + w/o Contrast,"$3,492.25 ",,,,
MRI Brain w/o Contrast,"$2,786.50 ",,,,
MRI Brain w/Stem w/Contrast,"$2,954.25 ",,,,
MRI Breast w/ + w/o Contrast Bilateral,"$2,073.25 ",,,,
MRI Breast w/ + w/o Contrast Left,"$1,205.25 ",,,,
MRI Breast w/ + w/o Contrast Right,"$1,205.25 ",,,,
MRI Breast w/ Contrast Bilateral,"$1,868.50 ",,,,
MRI Breast w/ Contrast Left,"$1,103.00 ",,,,
MRI Breast w/ Contrast Right,"$1,103.00 ",,,,
MRI Breast w/o Contrast Bilateral,"$1,354.75 ",,,,
MRI Breast w/o Contrast Left,$846.00 ,,,,
MRI Breast w/o Contrast Right,$846.00 ,,,,
MRI Chest w/o Contrast,"$2,105.50 ",,,,
MRI Face Neck Orbit w/ + w/o Contrast,"$3,123.75 ",,,,
MRI Face Neck Orbit w/o Contrast,"$2,522.75 ",,,,
MRI LE Joint w/ + w/o Contrast Left,"$3,089.25 ",,,,
MRI LE Joint w/ + w/o Contrast Right,"$3,089.25 ",,,,
MRI LE Joint w/ Contrast Left,"$2,844.25 ",,,,
MRI LE Joint w/ Contrast Right,"$2,844.25 ",,,,
MRI LE Joint w/o Contrast Left,"$2,630.50 ",,,,
MRI LE Joint w/o Contrast Right,"$2,630.50 ",,,,
MRI LE Non Joint w/ + w/o Contrast Left,"$3,238.50 ",,,,
MRI LE Non Joint w/ + w/o Contrast Right,"$3,238.50 ",,,,
MRI LE Non Joint w/o Contrast Left,"$2,380.00 ",,,,
MRI LE Non Joint w/o Contrast Right,"$2,380.00 ",,,,
MRI Pelvis w/ + w/o Contrast,"$3,467.50 ",,,,
MRI Pelvis w/o Contrast,"$1,803.00 ",,,,
MRI Spectroscopy,"$1,566.50 ",,,,
MRI Spine Cervical w/ + w/o Contrast,"$3,102.50 ",,,,
MRI Spine Cervical w/ Contrast,"$2,951.25 ",,,,
MRI Spine Cervical w/o Contrast,"$2,584.25 ",,,,
MRI Spine Lumbar w/ + w/o Contrast,"$3,655.25 ",,,,
MRI Spine Lumbar w/ Contrast,"$3,339.75 ",,,,
MRI Spine Lumbar w/o Contrast,"$2,842.25 ",,,,
MRI Spine Thoracic w/ + w/o Contrast,"$3,337.50 ",,,,
MRI Spine Thoracic w/ Contrast,"$3,262.50 ",,,,
MRI Spine Thoracic w/o Contrast,"$2,665.50 ",,,,
MRI TMJ,"$2,200.75 ",,,,
MRI UE Joint w/ + w/o Contrast Left,"$2,949.00 ",,,,
MRI UE Joint w/ + w/o Contrast Right,"$2,949.00 ",,,,
MRI UE Joint w/o Contrast Left,"$2,551.75 ",,,,
MRI UE Joint w/o Contrast Right,"$2,551.75 ",,,,
MRI UE Non Joint w/ + w/o Contrast Left,"$3,113.75 ",,,,
MRI UE Non Joint w/ + w/o Contrast Right,"$3,113.75 ",,,,
MRI UE Non Joint w/o Contrast Left,"$2,388.25 ",,,,
MRI UE Non Joint w/o Contrast Right,"$2,388.25 ",,,,
MRSA Screen Culture,$47.25 ,,,,
MTHFR Interpretation ARUP,$71.75 ,,,,
MTHFR Mutation: A1298C ARUP,$114.25 ,,,,
MTHFR Mutation: C677T ARUP,$114.25 ,,,,
MTHFR PCR Specimen ARUP,$114.25 ,,,,
MULTIFIRE ENDO 30 GIA RELOADS,$565.00 ,,,,
MULTIFIRE ENDO GIA-30,$614.25 ,,,,
MULTIPLE SLEEP LATENCY TEST (DAY TIME),"$3,779.50 ",,,,
"Mumps Virus Ab, IgG ARUP",$37.75 ,,,,
"Mumps Virus Ab, IgM ARUP",$37.75 ,,,,
Mumps Virus Antibody IgG CSF ARUP,$144.25 ,,,,
Mumps Virus Antibody IgG CSF ARUP,$37.75 ,,,,
Mumps Virus Antibody IgM CSF ARUP,$144.25 ,,,,
Mumps Virus Antibody IgM CSF ARUP,$37.75 ,,,,
mupirocin Top 2% Oint,$109.00 ,,,,
Muscle-Specific Actin by IHC ARUP,$370.50 ,,,,
"Mycoplasma pneumoniae Ab, IgM ARUP",$88.50 ,,,,
"Mycoplasma pneumoniae Abs, G/M ARUP",$88.50 ,,,,
Mycoplasma pneumoniae by PCR ARUP,$365.50 ,,,,
"Myelin Basic Protein, CSF ARUP",$81.75 ,,,,
MYO RELEASE/SOFT TISSUE,$88.25 ,,,,
Myogenin (Myf4) by IHC ARUP,$370.50 ,,,,
"Myoglobin, Serum ARUP",$57.75 ,,,,
"Myoglobin, Urine ARUP",$57.75 ,,,,
N Gonorrhoeae by PCR,$83.25 ,,,,
N. gonorrhoeae Amplified ARUP,$140.75 ,,,,
N. gonorrhoeae Amplified ARUP,$83.25 ,,,,
N/P Rap Rhino 7.5 Charge,$77.00 ,,,,
N/SELEC DEBRID W/O ANESTH,$277.00 ,,,,
nalbuphine 20 mg/mL Inj Sol,$28.00 ,,,,
naloxone 0.4 mg/mL Inj Sol,$25.75 ,,,,
naloxone 1 mg/mL Sol,$49.50 ,,,,
Nasal Culture,$116.00 ,,,,
NASAL DRESSING HOLDER,$15.50 ,,,,
NASAL DRSG MEROGEL SINUS STENT,$159.25 ,,,,
NASO OR ORO-GASTRIC TUBE PLACEMENT REQUIRING PHYSICIAN SKILL AND FLUOROSCOPIC GUIDANCE CHARGE,,,,$80.75 ,
NASOEPTAL SPLINT DOYLE,$197.25 ,,,,
Nasogastric tube,$32.75 ,,,,
NASOPHARYNOGOSCOPY,$262.50 ,,,,
NASOSTAT Charge,$161.00 ,,,,
NEEDLE CYSTITOME 27 G,$21.50 ,,,,
"NEEDLE ENDO INJ 2.3 MM X 230 CM, XENTURA MED",$107.00 ,,,,
NEEDLE INSUFFLATION LONG,$80.25 ,,,,
"NEEDLE SPINAL 22G X 5"" GERTIE",$53.00 ,,,,
NEEDLE SPINAL 22GX3.5,$49.50 ,,,,
"NEEDLE SPINAL 24G X 3.5"" SPROTTE",$357.50 ,,,,
"NEEDLE SPINAL 24G X 5"" GERTIE",$53.00 ,,,,
"NEEDLE SPINAL 25G X 3"" WHITACRE",$104.50 ,,,,
"NEEDLE SPINAL 25G X 5"" WHITACRE",$68.00 ,,,,
NEEDLE TAPERED W/ NITINOL LOOP,$661.25 ,,,,
Negative Pressure Wound  TX <50 CM,$277.00 ,,,,
Negative Pressure Wound  TX >50 CM,$509.75 ,,,,
"Negative pressure wound therapy (e.g., vacuum-assisted drainage collection)<50 sq cm",$251.25 ,,,,
"Negative pressure wound therapy (e.g., vacuum-assisted drainage collection)>50 sq cm",$480.00 ,,,,
Negative Pressure Wound Therapy Pro-to-Go Kit,$610.75 ,,,,
"Negative Pressure Wound Therapy, utilizing diposable equipment < 50 square cm",$542.50 ,,,,
"Negative Pressure Wound Therapy, utilizing diposable equipment > 50 square cm",$542.50 ,,,,
Neonatal DAT,$68.25 ,,,,
Neo-T-Piece,$92.00 ,,,,
Neptune 2 4-port manifold,$83.00 ,,,,
NEUROBEHAVIORAL STATUS EXAM,$409.50 ,,,,
NEUROMUSCULAR RE ED,$77.75 ,,,,
Neuron Specific Enolase ARUP,$142.25 ,,,,
Newborn Hearing Test Type,$409.50 ,,,,
Newborn Recovery,$163.75 ,,,,
Newborn resusitation,$840.75 ,,,,
Newborn Screening Test,$73.50 ,,,,
Niacin (Vitamin B3) ARUP,$256.00 ,,,,
NIM 6.0,"$1,038.25 ",,,,
NIM 7.0,"$1,090.50 ",,,,
NIM 7.0 ET TUBE,"$1,203.50 ",,,,
NIM 8.0,"$1,090.50 ",,,,
NIM TUBE 7.0mm,$442.50 ,,,,
NIM TUBE 8.0mm,$411.50 ,,,,
NM Bone Imaging Whole Body,"$1,392.00 ",,,,
NM Bone Joint Imaging Limited,"$1,336.25 ",,,,
NM Bone Joint Imaging Multi,"$1,627.50 ",,,,
NM Bone Spect,"$1,627.50 ",,,,
NM Bone Three Phase Study,"$1,017.00 ",,,,
NM Bowel Image (Meckel`s),"$1,185.75 ",,,,
NM Cardiac Blood Pool Gated Single,"$1,445.75 ",,,,
NM Cardiolite Rest/Stress,"$3,196.75 ",,,,
NM Cardiovascular Other,"$3,196.75 ",,,,
NM Gastric Emptying Study,"$1,376.25 ",,,,
NM Gastroesophageal Reflux Study,$925.75 ,,,,
NM Gastrointestinal Blood Loss Imaging,"$1,837.00 ",,,,
NM Hepatobiliary Duct System Imaging,"$1,887.00 ",,,,
NM Kidney Imaging Static,$918.25 ,,,,
NM Kidney Imaging w/ Flow w/ Pharm,"$1,397.75 ",,,,
NM Liver Imaging Spect,"$2,351.75 ",,,,
NM Liver/Spleen Imaging,"$1,283.50 ",,,,
NM Loc of Abcess/Inflamm,"$2,143.75 ",,,,
NM Lymphoscintigraphy,"$1,489.75 ",,,,
NM Myocardial Infarct Spect,"$1,174.50 ",,,,
NM Myocardial Perfusion Pln No Spec,"$3,196.75 ",,,,
NM Parathyroid Study,"$1,157.25 ",,,,
NM Pulmonary Perfusion Imaging,"$1,152.75 ",,,,
NM Pulmonary Ventilation Aerosol Multi,"$2,427.75 ",,,,
NM Renogram,$708.75 ,,,,
NM Thyroid Imaging Only,"$1,010.50 ",,,,
NM Thyroid Imaging w/ Uptake Single,$973.75 ,,,,
NM Ureteral Reflux Study,$750.25 ,,,,
Non-Criteria Antiphospholipid Syndrome (APS) Antibody Panel 2012729 ARUP,$604.00 ,,,,
Non-Criteria Antiphospholipid Syndrome (APS) Antibody Panel extended panel 2012730 ARUP,$566.25 ,,,,
Non-Invasive Prenatal Testing For Fetal Aneuploidy ARUP,"$1,328.25 ",,,,
NORM SALINE 3000ML IRRIGATION,$24.25 ,,,,
NovaSure Wand,"$2,390.25 ",,,,
"NPWT Cannister, 300 ml",$318.75 ,,,,
NPWT Granufoam Medium Simplace,$640.75 ,,,,
NPWT Medium Granufoam Dressing,$376.75 ,,,,
NPWT Vacuum Daily Charge,$186.00 ,,,,
NPWT Vacuum Drape,$17.75 ,,,,
NST Extended,$271.50 ,,,,
N-Terminal pro B-Type Natriuretic Peptide,$192.00 ,,,,
NUGAUZE IDO 1,$15.00 ,,,,
NUGAUZE IDO 1/2,$14.75 ,,,,
NUGAUZE IDO 1/4,$14.25 ,,,,
NUGAUZE IDO 2,$19.50 ,,,,
NUGAUZE PL 1/2,$14.25 ,,,,
NUGAUZE PL 2,$16.50 ,,,,
O & P Screen,$134.50 ,,,,
O/P Visit Level 1,$156.25 ,,,,
O/P Visit Level 1,$156.25 ,,,,
O/P Visit Level 1,$156.25 ,,,,
O/P Visit Level 1,$156.25 ,,,,
O/P Visit Level 2,$205.50 ,,,,
O/P Visit Level 2,$205.50 ,,,,
O/P Visit Level 2,$205.50 ,,,,
O/P Visit Level 2,$205.50 ,,,,
O/P Visit Level 3,$229.00 ,,,,
O/P Visit Level 3,$229.00 ,,,,
O/P Visit Level 3,$229.00 ,,,,
O/P Visit Level 3,$229.00 ,,,,
O/P Visit Level 4,$306.50 ,,,,
O/P Visit Level 4,$306.50 ,,,,
O/P Visit Level 4,$306.50 ,,,,
O/P Visit Level 4,$306.50 ,,,,
O/P Visit Level 5,$588.50 ,,,,
O/P Visit Level 5,$588.50 ,,,,
O/P Visit Level 5,$588.50 ,,,,
O/P Visit Level 5,$588.50 ,,,,
Obstetric Panel,$185.00 ,,,,
OBTRYS II SYSTEM,"$3,020.00 ",,,,
OBTRYX II System,"$2,938.50 ",,,,
Occult Blood Stool,$50.25 ,,,,
"Occult Blood, Fecal",$50.25 ,,,,
"Occupational Therapy Evaluation, High Complexity, 60 minutes",$270.50 ,,,,
"Occupational Therapy Evaluation, Low Complexity, 30 minutes",$225.75 ,,,,
"Occupational Therapy Evaluation, Moderate Complexity, 45 minutes",$248.25 ,,,,
Office / Outpatient Visit - Established Patient - Level 1 - Non Medicare Only,$115.25 ,,,,
Office / Outpatient Visit - Established Patient - Level 2 - Non Medicare Only,$149.50 ,,,,
Office / Outpatient Visit - Established Patient - Level 3 - Non Medicare Only,$149.50 ,,,,
Office / Outpatient Visit - Established Patient - Level 4 - Non Medicare Only,$196.75 ,,,,
Office / Outpatient Visit - Established Patient - Level 5 - Non Medicare Only,$260.75 ,,,,
Office / Outpatient Visit - New Patient - Level 1 - Non Medicare Only,$115.25 ,,,,
Office / Outpatient Visit - New Patient - Level 2 - Non Medicare Only,$149.50 ,,,,
Office / Outpatient Visit - New Patient - Level 3 - Non Medicare Only,$196.75 ,,,,
Office / Outpatient Visit - New Patient - Level 4 - Non Medicare Only,$260.75 ,,,,
Office / Outpatient Visit - New Patient - Level 5 - Non Medicare Only,$356.75 ,,,,
Ohio Stabilization CHARGE,$960.25 ,,,,
Oligohydramnios,$495.25 ,,,,
OMNI JUG W/OUT SPEC,$31.75 ,,,,
ON Q PAINBUSTER SOAKER,$197.50 ,,,,
ondansetron 2 mg/mL Inj Sol SDV 2 mL,$17.75 ,,,,
ondansetron 4 mg ODT,$56.25 ,,,,
"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC CHARGE",,,,"$2,498.50 ",
OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE FINGER OR THUMB INCLUDING INTERNAL FIXATION EACH CHARGE,,,,"$1,400.75 ",
"OPEN TREATMENT OF FRACTURE GREAT TOE, PHALANX, OR PHALANGES INCLUDING INTERNAL FIXATION CHARGE",,,,"$1,270.75 ",
OPEN TREATMENT OF FRACTURE PHALANX OR PHALANGES OTHER THAN GREAT TOE INCLUDING INTERNAL FIXATION EAC,,,,"$1,072.75 ",
"OPEN TREATMENT OF PHALANGEAL SHAFT FRACTURE PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB WITH MANIPUL",,,,"$1,848.25 ",
OPTHALMIC BURRS Charge,$21.75 ,,,,
ORAL SPEECH DEVICE,$418.75 ,,,,
ORA-SWAB SUCTION BRUSH,$88.00 ,,,,
"Organic Acids, Plasma ARUP",$504.00 ,,,,
"Organic Acids, Urine ARUP",$504.00 ,,,,
Orogastric tube,$32.75 ,,,,
ORTHO SPLINT,$88.75 ,,,,
ORTHOPEDIC PACK,$39.25 ,,,,
ORTHOTICS FIT & TRAIN EA 15 MIN,$80.50 ,,,,
Osmolality Serum,$82.00 ,,,,
"Osmolality, Serum or Plasma ARUP",$82.00 ,,,,
"Osmolality, Urine ARUP",$72.00 ,,,,
OT ADL/HOME MANAGEMENT,$83.00 ,,,,
OT COMMUNITY/WORK RE-INT,$122.50 ,,,,
OT CONTRAST BATH,$52.50 ,,,,
OT ELEC STIMULA UNATTEN,$79.50 ,,,,
OT ELECT STIMUL MANUAL,$72.00 ,,,,
OT IONTOPHORESIS.,$79.00 ,,,,
OT MANUAL MUSCEL TEST EX,$73.75 ,,,,
OT MANUAL MUSCLE TST HAN,$56.75 ,,,,
OT Manual Therapy,$85.75 ,,,,
OT Manual Therapy,$85.75 ,,,,
OT NEUROMUSCULAR REEDUCA,$77.75 ,,,,
OT ORTHOTICS FIT/TRAINNG,$80.75 ,,,,
OT PARAFFIN BATH,$64.25 ,,,,
OT PHY PERFORMANCE TEST,$90.50 ,,,,
OT PROSTHETICS TRAINING EA 15 MIN,$73.50 ,,,,
OT ROM EXTREMITY,$90.00 ,,,,
OT ROM HAND,$86.00 ,,,,
OT THERAPEUTIC ACTIVITY,$76.75 ,,,,
OT THERAPEUTIC EXERCISE.,$78.25 ,,,,
OT ULTRASOUND.,$60.25 ,,,,
OT WHIRLPOOL.,$73.50 ,,,,
OT WRAPPING/DRESSING,$81.75 ,,,,
OT WRK HARDENING/COND,$299.25 ,,,,
"Ova and Parasite Exam, Fecal. ARUP",$195.00 ,,,,
"Oxalate, Total, Urine ARUP",$60.50 ,,,,
"Oxalate, Urine - mg/day ARUP",$60.50 ,,,,
Oxcarbazepine Metabolite ARUP,$198.50 ,,,,
OXISENSOR II,$57.25 ,,,,
Oxygen Initial,$122.67 ,,,,
Oxygen Medical Gas,$235.00 ,,,,
OXYGEN SET UP 1ST DAY,$122.67 ,,,,
OXYGEN SET UP 1ST DAY,$122.67 ,,,,
Oxygen Titration,"$4,072.50 ",,,,
oxytocin 10 intl units/mL Inj Sol,$43.25 ,,,,
Pacemaker Settings Temporary Transcutaneous,$217.50 ,,,,
PAD KNEE L WO,$117.50 ,,,,
"Pap, High Risk HPV Charge Only",$259.50 ,,,,
"Pap, Low Risk HPV Charge Only",$75.75 ,,,,
"Pap, Thin Prep Auto HPV Charge Only",$117.00 ,,,,
"Pap, Thin Prep Charge Only",$117.00 ,,,,
Paracentesis Charge,"$1,230.25 ",,,,
PARAFFIN BATH CHARGE,$64.25 ,,,,
"Parainfluenza Ab(1,2,3), IgG and IgM ARUP",$318.00 ,,,,
"Parathyroid Hormone, Intact with Calcium ARUP",$182.00 ,,,,
Parathyroid Hormone-Related Peptide ARUP,$604.25 ,,,,
Paring or cutting of benign hyperkeratotic lesion: 1 lesion,$251.25 ,,,,
Paring or cutting of benign hyperkeratotic lesion: 2 - 4 lesions,$251.25 ,,,,
Paring or cutting of benign hyperkeratotic lesion: more than 4 lesions,$251.25 ,,,,
Partial hymenectomy or revision of hymenal ring.,"$3,727.50 ",,,,
Partial Thromboplastin Time,$74.00 ,,,,
Partial Thromboplastin Time ARUP,$70.50 ,,,,
"Parvovirus B 19, by PCR ARUP",$295.75 ,,,,
"Parvovirus B19 Abs, IgG and IgM ARUP",$138.50 ,,,,
Patient Care,$60.50 ,,,,
Patient's AFP ARUP,$139.50 ,,,,
Patient's DIA ARUP,$113.75 ,,,,
Patient's hCG ARUP,$75.00 ,,,,
Patient's uE3 ARUP,$122.75 ,,,,
PEAK FLOW,$223.75 ,,,,
PEAK FLOW METER,$41.25 ,,,,
PEAL FLOW METER,$116.25 ,,,,
PEAR BUR 6.1 - TPS,$185.00 ,,,,
"Pediatric SPO2 Sensor, disposable",$43.75 ,,,,
PEDIPORT 5.5 MM - DR. K,$97.00 ,,,,
PEDS 2 LUMEN CENT LINE Charge,$139.50 ,,,,
PEG TUBE 20FR PONSKY,$329.25 ,,,,
PEG TUBE 28 FR,$361.25 ,,,,
Pelvic binder,$377.00 ,,,,
PELVIC EXAM Charge,$35.50 ,,,,
PERI/GYN PACK,$18.50 ,,,,
PERICARDIOCENTESIS INITIAL CHARGE,"$1,612.25 ",,,,
Peripheral Blood Smear,$48.75 ,,,,
Peripherally Inserted Central Catheter Insertion,"$1,612.25 ",,,,
Peripherally Inserted Central Catheter Insertion: Pediatric,"$1,612.25 ",,,,
Peritoneal lavage,"$1,230.25 ",,,,
PERITONEAL LAVAGE Charge,$894.00 ,,,,
PERITONEAL LAVAGE KIT,$84.00 ,,,,
PFT ADMIN OF AGENT,$737.00 ,,,,
PFT BRONCHOPROVOCATION,$447.75 ,,,,
PFT DLCO,$229.50 ,,,,
PFT MVV,$249.50 ,,,,
PFT PLETH-AIRWAY RESISTANCE,$409.50 ,,,,
PFT PLETH-TGV,$229.50 ,,,,
PFT PRE/POST,$423.75 ,,,,
PFT SCREENING,$223.75 ,,,,
pH Arterial,$182.50 ,,,,
pH Arterial,$182.50 ,,,,
pH Body Fluid ARUP,$30.25 ,,,,
pH Capillary,$182.50 ,,,,
pH Venous,$182.50 ,,,,
"Ph, Fecal ARUP",$30.25 ,,,,
Phenobarbital ARUP,$133.75 ,,,,
Phenobarbital Level,$83.00 ,,,,
Phenytoin Lvl,$126.25 ,,,,
Phosphorus Level,$59.00 ,,,,
"Phosphorus, Inorganic, Plasma or Serum ARUP",$58.00 ,,,,
"Phosphorus, Urine ARUP",$33.75 ,,,,
PHY DIRECTION OF EMS CARE AND ADVANCED LIFE SUPPORT CHARGE,,,,$0.00 ,
PHYS PERFORM TEST/MEASUR,$90.50 ,,,,
"Physical Therapy Evaluation, High Complexity, 45 minutes",$261.75 ,,,,
"Physical Therapy Evaluation, Low Complexity, 20 minutes",$217.00 ,,,,
"Physical Therapy Evaluation, Moderate Complexity, 30 minutes",$239.25 ,,,,
PHYSICIAN SERVICES EMERGENCY DEPARTMENT VISIT LEVEL 1 CHARGE,,,,$129.25 ,
PHYSICIAN SERVICES EMERGENCY DEPARTMENT VISIT LEVEL 2 CHARGE,,,,$174.25 ,
PHYSICIAN SERVICES EMERGENCY DEPARTMENT VISIT LEVEL 4 CHARGE,,,,$392.00 ,
PHYSICIAN SERVICES EMERGENCY DEPARTMENT VISIT LEVEL 5 CHARGE,,,,$584.50 ,
PHYSIO PACE PATCHES Charge,$150.00 ,,,,
PICC LINE DUAL LUMEN 5 FRENCH,$446.00 ,,,,
PICC LINE SINGLE LUMEN 3 FRENCH,$432.00 ,,,,
PICC LINE SINGLE LUMEN 4 FRENCH,$854.25 ,,,,
PICC LINE SINGLE LUMEN 5 FRENCH,$500.00 ,,,,
PICC LINE SUPPORT,$39.50 ,,,,
PICC Line Tray,"$1,612.25 ",,,,
PICC PLUS STATLOCK Charge,$12.25 ,,,,
Pigeon Serum ARUP,$187.00 ,,,,
Pinworm Prep,$11.00 ,,,,
PKU,$12.00 ,,,,
PKU,$12.00 ,,,,
PKU Glyco,$29.75 ,,,,
PKU Glyco,$29.75 ,,,,
PKU T4,$17.25 ,,,,
PKU T4,$17.25 ,,,,
PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION CHARGE,$541.25 ,,,,
Plasma Thawed CPD,$176.00 ,,,,
Plastibell,$160.00 ,,,,
Platelet Count,$31.50 ,,,,
Pneumodart Kit,$130.75 ,,,,
POLAR CARE CUBE,$257.25 ,,,,
"Poliovirus (Types 1,3) Antibodies ARUP",$507.75 ,,,,
"Poliovirus (Types 1,3) Antibodies ARUP",$507.75 ,,,,
PONSKY DELUXE PULL PEG KIT,$667.00 ,,,,
Pooled Cryo AHF Thawed,"$1,023.50 ",,,,
POPE EPISTAXIS PACKING 10 CM,$95.50 ,,,,
POREX TLS DRAIN,$50.75 ,,,,
"Porphyrins, Fractionation and Quant, Urn ARUP",$94.50 ,,,,
PORT SYSTEM 9.6FR VORTEX,"$1,900.75 ",,,,
PORT-A-CATH PROCEDURE Charge,$87.50 ,,,,
Potassium Level,$52.75 ,,,,
Potassium Level Urine,$40.75 ,,,,
povidone iodine Opth 5% Sol,$44.00 ,,,,
PRE SYMP 24 HR HOOK UP,$213.25 ,,,,
PRE SYMP LOOP INTER PROF,$49.75 ,,,,
PRE SYMP RECEIVING 24 HR,$995.50 ,,,,
"Prealbumin, Serum ARUP",$83.25 ,,,,
PRECISION FALCON OSCILLATING TIP SAW,"$1,360.00 ",,,,
PREDNISOLONE,$62.75 ,,,,
Pregnancy Test Serum (Qual),$62.00 ,,,,
"Pregnenolone by MS/MS, Serum ARUP",$127.50 ,,,,
Primidone and Metabolite ARUP,$63.00 ,,,,
PROBE PLUS II 5mm SHAFT (EPS02),$61.00 ,,,,
Progesterone,$142.75 ,,,,
Proinsulin ARUP,$102.25 ,,,,
Prolactin ARUP,$124.25 ,,,,
PROLONGED E&M SERVICE BEFORE AND/OR AFTER DIRECT PATIENT CARE EACH ADDITIONAL 30 MINUTES CHARGE,,,,$162.50 ,
PROLONGED E&M SERVICE BEFORE AND/OR AFTER DIRECT PATIENT CARE FIRST HOUR CHARGE,,,,$325.25 ,
PROLONGED PHYSICIAN SERVICE IN THE OFFICE OR OTHER OUTPATIENT 1.00 HOUR CHARGE,,,,$294.25 ,
PROLONGED PHYSICIAN SERVICE IN THE OFFICE OR OTHER OUTPATIENT EACH ADDITIONAL 30 MINUTES CHARGE,,,,$161.25 ,
promethazine 25 mg/mL Inj Sol,$23.00 ,,,,
propofol 10 mg/mL IV Emul SDV 50 mL,$61.00 ,,,,
Prostate Specific Antigen,$112.50 ,,,,
Prostatic Acid Phosphatase ARUP,$55.50 ,,,,
PROSTHETICS TRAINING,$73.50 ,,,,
PROTACK 5mm,$882.00 ,,,,
Protein 24 Hour Urine,$37.75 ,,,,
Protein C Functional ARUP,$156.75 ,,,,
Protein C Total ARUP,$152.25 ,,,,
"Protein C, Functional ARUP",$156.75 ,,,,
"Protein C, Total Antigen ARUP",$152.25 ,,,,
Protein Cerebrospinal Fluid,$58.50 ,,,,
"Protein Electrophoresis, Serum ARUP",$80.00 ,,,,
Protein S Functional ARUP,$156.75 ,,,,
Protein S Total ARUP,$65.75 ,,,,
"Protein S, Functional ARUP",$156.75 ,,,,
"Protein S, Total Antigen ARUP",$65.75 ,,,,
Protein Total,$44.50 ,,,,
Protein Urine Random,$37.75 ,,,,
"Protein, Urine",$37.75 ,,,,
Prothrombin (F2) G20210A Mutation ARUP,$125.25 ,,,,
Prothrombin Time,$46.00 ,,,,
Prothrombin Time ARUP,$70.50 ,,,,
PROXIMATE 60mm RELOADS,$100.50 ,,,,
PROXIMATE 60mm STAPLER,$200.50 ,,,,
PROXIMATE CURVED INTRALUMINAL STAPLER 33 MM,$567.25 ,,,,
PROXIMATE LINEAR CUTTER GREEN RELOAD 75 MM,$166.75 ,,,,
PROXIMATE LINEAR STAPLER BLUE RELOAD 60 MM,$100.00 ,,,,
PROXIMNATE ILS CURVED INTRALUMINAL STAPLER 29 MM,$567.25 ,,,,
PSA Screen,$112.50 ,,,,
PSA Total with Free PSA ARUP,$97.75 ,,,,
"Pseudocholinesterase, Total ARUP",$54.50 ,,,,
PT Contrast Bath Charges,$52.50 ,,,,
PT PCR Specimen ARUP,$49.75 ,,,,
PT Physical Performance Test Charges,$90.50 ,,,,
PT PROTECTIVE PAD FOR KNEE POSITIONER,$135.25 ,,,,
PT TENS SETUP,$82.75 ,,,,
PTH Intact 1,$182.00 ,,,,
PULMONARY COMPLEX STRESS TEST,$409.50 ,,,,
PULMONARY SIMPLE SIX MINUTE WALK,$175.75 ,,,,
PULSE OXIMETERY MULTIPLE,$139.50 ,,,,
PULSE OXIMETERY SINGLE,$56.50 ,,,,
Pulse Oximetry Overnight,$241.25 ,,,,
"Puncture aspiration of abscess, hematoma, bulla, or cyst",$480.00 ,,,,
"PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST CHARGE",$509.75 ,,,,
PUNCTURE ASPIRATION OF CYST OF BREAST CHARGE,$939.50 ,,,,
Push Enteroscopy,"$1,896.00 ",,,,
Pyruvate Kinase ARUP,$164.00 ,,,,
Quantiferon TB Gold In-Tube ARUP,$102.00 ,,,,
Rapid Plasma Reagin,$48.00 ,,,,
Rapid Plasma Reagin Titer,$48.00 ,,,,
RAPID RHINO NASAL PACK,$209.75 ,,,,
RAPID RHINO NASAL POSTERIOR Charge,$209.75 ,,,,
RAPID STREP SCREEN Charge,$60.25 ,,,,
Rapid Strep Screen Micro,$60.00 ,,,,
Rapid Urease,$51.50 ,,,,
RBC CPDA1 450 LR,$509.75 ,,,,
RBC CPDA1 450 LR Irr,$509.75 ,,,,
RBC CPDA1 500 LR Irr,$509.75 ,,,,
RECONSTRUCTION OF NAIL BED WITH GRAFT CHARGE,,,,$650.75 ,
Recovery,$171.75 ,,,,
RECTAL TUBE 26FR,$19.50 ,,,,
RECTAL TUBE 32FR,$67.50 ,,,,
"Reducing Substances, Fecal ARUP",$40.75 ,,,,
REDUCTION OF PROCIDENTIA UNDER ANESTHESIA CHARGE,"$1,174.00 ",,,,
REEV. SP GEN  DEVICE,$242.00 ,,,,
"Re-Evaluation of Occupational Therapy Established Plan of Care, 30 minutes",$133.50 ,,,,
"Re-Evaluation of Physical Therapy Established Plan of Care, 20 minutes",$174.50 ,,,,
REF Antibody ID,$304.00 ,,,,
REF Antibody Screen,$90.00 ,,,,
Reference ABO/Rh,$172.25 ,,,,
Reference DAT,$68.25 ,,,,
Reference Elution,$211.75 ,,,,
Refilling And Maintenance Of Portable Pump,$316.25 ,,,,
Regional Block each additional 15 minutes,$175.50 ,,,,
Regional Block first 30 minutes,$524.25 ,,,,
Reliatack Articulating Reloadable Fixation Device,"$1,911.50 ",,,,
REM DEVIT TISSUE WOUND >20,$277.00 ,,,,
REM DIVIT TISSUE WOUND <20,$201.50 ,,,,
REMOV TISSUE W/O ANETH,$277.00 ,,,,
REMOVAL EMBEDDED FOREIGN BODY VESTIBULE OF MOUTH SIMPLE CHARGE,,,,$467.00 ,
Removal Foregin body from external auditory canal;without general anesthesia,$222.25 ,,,,
REMOVAL FOREIGN BODY DEEP THIGH REGION OR KNEE CHARGE,,,,"$1,577.00 ",
REMOVAL FOREIGN BODY NOSE CHARGE,$197.00 ,,,,
REMOVAL FULL ARM/LEG CAST CHARGE,,,,$122.50 ,
REMOVAL IMPACT CERUMEN 1 OR BOTH EARS CHARGE,,,,$99.00 ,
REMOVAL IMPACTED CERUMEN 1 OR BOTH EARS CHARGE,$156.00 ,,,,
REMOVAL IMPACTED CERUMEN IRRIG/LAVAGE BILATERAL,$92.00 ,,,,
"REMOVAL OF BIVLAVE, GAUNTLET, BOOT, OR BODY CAST CHARGE",,,,$93.25 ,
REMOVAL OF FECAL IMPACTION OR FOREIGN BODY UNDER ANESTHESIA CHARGE,"$3,088.00 ",,,,
"REMOVAL OF FOREIGN BODY EXTERNAL EYE CONJUNCTIVAL EMBEDDED, SUBCONJUNCTIVAL, OR SCLERAL NONPERFORATI",$541.25 ,,,,
REMOVAL OF FOREIGN BODY EXTERNAL EYE CONJUNCTIVAL SUPERFICIAL CHARGE,$288.25 ,,,,
REMOVAL OF FOREIGN BODY EXTERNAL EYE CORNEAL WITH SLIT LAMP CHARGE,$339.50 ,,,,
REMOVAL OF FOREIGN BODY EXTERNAL EYE CORNEAL WITHOUT SLIT LAMP CHARGE,$541.25 ,,,,
REMOVAL OF FOREIGN BODY EYELID EMBEDDED CHARGE,,,,$306.00 ,
REMOVAL OF FOREIGN BODY FOOT DEEP CHARGE,"$2,628.50 ",,,,
REMOVAL OF FOREIGN BODY FOOT SUBCUTANEOUS CHARGE,"$1,750.50 ",,,,
REMOVAL OF FOREIGN BODY FROM EXTERNAL AUDITORY CANAL WITH ANESTHESIA CHARGE,,,,$988.00 ,
REMOVAL OF FOREIGN BODY FROM EXTERNAL AUDITORY CANAL WITHOUT ANESTHESIA CHARGE,$222.25 ,,,,
REMOVAL OF FOREIGN BODY FROM PHARYNX CHARGE,$541.25 ,,,,
REMOVAL OF FOREIGN BODY MUSCLE OR TENDON SHEATH DEEP OR COMPLICATED CHARGE,,,,$922.75 ,
REMOVAL OF FOREIGN BODY MUSCLE OR TENDON SHEATH SIMPLE CHARGE,,,,$396.25 ,
REMOVAL OF FOREIGN BODY PELVIS/HIP DEEP CHARGE,"$4,452.25 ",,,,
REMOVAL OF FOREIGN BODY PELVIS/HIP SUBCUTANEOUS CHARGE,"$2,628.50 ",,,,
REMOVAL OF FOREIGN BODY UPPER ARM OR ELBOW DEEP CHARGE,"$3,813.00 ",,,,
REMOVAL OF FOREIGN BODY UPPER ARM OR ELBOW SUBCUTANEOUS CHARGE,"$2,210.75 ",,,,
"REMOVAL OF SKIN TAGS, MULTIPLE, ANY AREA <= 15 LESIONS CHARGE",,,,$156.00 ,
REMOVAL OF SUTURES UNDER ANESTHESIA OTHER SURGEON CHARGE,,,,$179.25 ,
Renal Function Panel2,$102.00 ,,,,
Renin Activity ARUP,$88.25 ,,,,
REPAIR BLOOD VESSEL DIRECT LOWER EXTREMITY CHARGE,,,,"$3,079.25 ",
REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY CHARGE,,,,"$3,246.00 ",
"REPAIR COMPLEX LACERATION ARMS, LEGS, AND/OR SCALP 1.10 TO 2.5 CM CHARGE",$800.75 ,,,,
"REPAIR COMPLEX LACERATION ARMS, LEGS, AND/OR SCALP 2.6 TO 7.5 CM CHARGE",$800.75 ,,,,
"REPAIR COMPLEX LACERATION ARMS, LEGS, AND/OR SCALP EACH ADDITIONAL <= 5.0 CM CHARGE",$163.50 ,,,,
"REPAIR COMPLEX LACERATION EYELIDS, EARS, NOSE, AND/OR LIPS 2.6 TO 7.5 CM CHARGE",$800.75 ,,,,
"REPAIR COMPLEX LACERATION EYELIDS, EARS, NOSE, AND/OR LIPS EACH ADDITIONAL <= 5 CM CHARGE",$270.25 ,,,,
"REPAIR COMPLEX LACERATION EYELIDS, NOSE, EARS, AND/OR LIPS 1.1 TO 2.5 CM CHARGE",$800.75 ,,,,
"REPAIR COMPLEX LACERATION TONGUE, FLOOR OF MOUTH > 2.60 CM CHARGE",,,,"$1,004.00 ",
REPAIR COMPLEX LACERATION TRUNK 1.10 TO 2.5 CM CHARGE,"$2,622.75 ",,,,
REPAIR COMPLEX LACERATION TRUNK 2.6 TO 7.5 CM CHARGE,$800.75 ,,,,
REPAIR COMPLEX LACERATION TRUNK ADDITIONAL 5CM OR LESS CHARGE,$149.75 ,,,,
REPAIR EXTENSOR TENDON FINGER PRIMARY OR SECONDARY WITHOUT GRAFT EACH TENDON CHARGE,,,,"$1,236.00 ",
REPAIR EXTENSOR TENDON HAND PRIMARY OR SECONDARY WITHOUT GRAFT EACH TENDON CHARGE,,,,"$1,498.50 ",
REPAIR EXTENSOR TENDON LEG PRIMARY WITHOUT GRAFT EACH CHARGE,,,,$944.50 ,
REPAIR FASCIAL DEFECT LEG CHARGE,,,,$885.00 ,
REPAIR FLEXOR TENDON IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH PRIMARY WITHOUT GRAFT EACH CHARGE,,,,"$2,509.50 ",
REPAIR FLEXOR TENDON NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH PRIMARY OR SECONDARY WITHOUT GRAFT E,,,,"$1,995.25 ",
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, LIPS, NOSE, AND/OR MUCOUS MEMBRANES <= 2.5 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, LIPS, NOSE, AND/OR MUCOUS MEMBRANES 2.6 CM TO 5.0 CM",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, LIPS, NOSE, AND/OR MUCOUS MEMBRANES 5.10 CM TO 7.5 C",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, LIPS, NOSE, AND/OR MUCOUS MEMBRANES 7.6 CM TO 12.5 C",$582.25 ,,,,
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, NOSE, LIPS AND OR MUCOUS MEMBRANES  20.1 CM TO 30.0",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, NOSE, LIPS AND OR MUCOUS MEMBRANES  OVER 30.0 CM CHA",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS FACE, EARS, EYELIDS, NOSE, LIPS AND OR MUCOUS MEMBRANES 12.6 CM TO 20.0 C",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA <= 2.5 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS NECK, HANDS, FEET, AND/OR EXTERNAL GENITALIA  OVER 30 CM CHARGE","$2,572.25 ",,,,
"REPAIR INTERMEDIATE WOUNDS NECK, HANDS, FEET, AND/OR EXTERNAL GENITALIA 12.6 TO 20.0 CM CHARGE",$800.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS NECK, HANDS, FEET, AND/OR EXTERNAL GENITALIA 2.6 TO 7.5 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS NECK, HANDS, FEET, AND/OR EXTERNAL GENITALIA 20.10 TO 30.0 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS NECK, HANDS, FEET, AND/OR EXTERNAL GENITALIA 7.6 TO 12.50 CM CHARGE",$800.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS SCALP,  AXILLAE, TRUNK AND/OR EXTREMITIES <= 2.5 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS SCALP, AXILLAE, TRUNK AND/ OR EXTREMITIES 12.6 CM TO 20.0 CM CHARGE",$526.25 ,,,,
"REPAIR INTERMEDIATE WOUNDS SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES 2.6 CM TO 7.5 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES 7.6 CM TO 12.5 CM CHARGE",$509.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES 20.10 TO 30.0 CM CHARGE",$800.75 ,,,,
"REPAIR INTERMEDIATE WOUNDS SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES OVER 30.0 CM CHARGE","$2,622.75 ",,,,
REPAIR LIP FULL THICKNESS OVER ONE-HALF VERTICAL HEIGHT OR COMPLEX CHARGE,,,,"$2,370.50 ",
REPAIR LIP FULL THICKNESS UP TO HALF VERTICAL HEIGHT CHARGE,,,,"$1,664.00 ",
REPAIR LIP FULL THICKNESS VERMILION ONLY CHARGE,,,,"$1,261.50 ",
REPAIR MUSCLE UNLISTED CHARGE,,,,$0.00 ,
REPAIR OF LACERATION FLOOR OF MOUTH AND OR ANTERIOR TWO-THIRDS OF TONGUE <= 2.5 CM CHARGE,$319.50 ,,,,
REPAIR OF NAIL BED CHARGE,$800.75 ,,,,
"REPAIR OF WOUND EXTRAOCULAR MUSCLES, TENDON AND/OR TENON'S CAPSULE CHARGE",,,,"$1,167.25 ",
REPAIR PRIMARY TORN LIGAMENT AND OR CPSULE KNEE COLLATERAL CHARGE,,,,"$1,739.75 ",
"REPAIR SIMPLE LAC FACE, EARS EYELIDS, NOSE, LIPS AND OR MUCOUS MEMBRANES 12.6 TO 20 CM CHARGE",$704.00 ,,,,
"REPAIR SIMPLE LAC FACE, EARS EYELIDS, NOSE, LIPS AND OR MUCOUS MEMBRANES 20.1 TO 30.0 CM CHARGE",$509.75 ,,,,
"REPAIR SIMPLE LAC FACE, EARS EYELIDS, NOSE, LIPS AND OR MUCOUS MEMBRANES 7.6 TO 12.5 CM CHARGE",$359.00 ,,,,
REPAIR SIMPLE LAC OVER 30.0 CM FACE EARS EYELIDS NOSE LIPS AND OR MUCOUS MEMBRANES CHARGE,$277.00 ,,,,
"REPAIR SIMPLE LAC SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES 12.6CM TO 20CM",$509.75 ,,,,
"REPAIR SIMPLE LAC SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES 20.1 CM TO 30.0",$509.75 ,,,,
"REPAIR SIMPLE LAC SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES OVER 30 CM CHAR",$277.00 ,,,,
"REPAIR SIMPLE LACERATION FACE, EARS, EYELIDS, NOSE LIPS AND OR MUCOUS MEMBRANES <= 2.5 CM CHARGE",$311.00 ,,,,
"REPAIR SIMPLE LACERATION FACE, EARS, EYELIDS, NOSE LIPS AND OR MUCOUS MEMBRANES 2.6 TO 5.0 CM CHARGE",$332.25 ,,,,
"REPAIR SIMPLE LACERATION FACE, EARS, EYELIDS, NOSE LIPS AND OR MUCOUS MEMBRANES 5.1 TO 7.5 CM CHARGE",$335.00 ,,,,
"REPAIR SIMPLE LACERATION SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND OR EXTREMITIES <= 2.5 C",$277.00 ,,,,
"REPAIR SIMPLE LACERATION SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND OR EXTREMITIES 2.6 TO 7",$367.50 ,,,,
"REPAIR SIMPLE LACERATION SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND OR EXTREMITIES 7.6 TO 1",$331.75 ,,,,
"REPAIR TENDON EXTENSOR FOOT SECONDARY WITH FREE GRAFT, EACH TENDON",,,,$732.50 ,
REPAIR TENDON FLEXOR FOOT PRIMARY OR SECONDARY WITHOUT FREE GRAFT EACH CHARGE,,,,"$1,129.75 ",
"REPAIR TENDON OR MUSCLE EXTENSOR, FOREARM AND/OR WRIST PRIMARY SINGLE EACH CHARGE",,,,"$1,220.00 ",
"REPAIR TENDON OR MUSCLE FLEXOR, FOREARM AND/OR WRIST PRIMARY SINGLE EACH CHARGE",,,,"$1,292.50 ",
REPAIR TENDON OR MUSCLE UPPER ARM OR ELBOW PRIMARY OR SECONDARY EACH CHARGE,,,,"$1,931.00 ",
RES-CUE-AIR Charge,$104.25 ,,,,
Respiratory Syncytial Virus,$187.50 ,,,,
Respiratory Syncytial Virus,$187.50 ,,,,
Respiratory Virus Panel ARUP,"$1,275.75 ",,,,
Resuscitation,$986.25 ,,,,
Resuscitation,$986.25 ,,,,
RESUSCITATOR ADULT,$48.25 ,,,,
Resuscitator Adult,$48.25 ,,,,
RESUSCITATOR INFANT,$65.00 ,,,,
RESUSCITATOR INFANT,$65.00 ,,,,
RESUSCITATOR PEDIATRIC,$54.50 ,,,,
RESUSCITATOR PEDIATRIC,$54.50 ,,,,
Reticulocyte Count,$67.50 ,,,,
RH Type Add-on,$52.25 ,,,,
RH Type Ref,$52.25 ,,,,
Rh. Type,$52.25 ,,,,
Rheumatoid Factor ARUP,$58.75 ,,,,
"Rheumatoid Factor IgM, IgG, IgA by EIA ARUP",$461.50 ,,,,
Rheumatoid Factor.,$58.75 ,,,,
RHIG,$262.25 ,,,,
RHYTHM ECG 1-3 LEADS TRACING ONLY WITHOUT INTERPRETATION AND REPORT CHARGE,,,,$33.25 ,
RIB BELT MENS EXTRA-L,$20.75 ,,,,
RIB BELT MENS LARGE,$18.75 ,,,,
RIB BELT MENS MEDIUM,$20.50 ,,,,
RIB BELT MENS SMALL,$20.75 ,,,,
RIB BELT WOMEN LARGE,$19.25 ,,,,
RIB BELT WOMEN MEDIUM,$20.25 ,,,,
RIB BELT WOMEN SMALL,$20.25 ,,,,
RIB BELT WOMEN X-LARG,$20.75 ,,,,
"Ribonucleic Protein (ENA) Antibody, IgG ARUP",$56.75 ,,,,
"Ribonucleic Protein (U1) (ENA) Ab, IgG ARUP",$56.75 ,,,,
RING CUSHION DONUT,$30.75 ,,,,
Rmvl devital tis 20cm/<,$277.00 ,,,,
"RNA Polymerase III Antibody, IgG ARUP",$141.00 ,,,,
Rocky Mountain Spotted Fever IgG and IgM ARUP,$123.25 ,,,,
Rocky Mountain Spotted Fever IgM ARUP,$61.75 ,,,,
ROM EXTREM,$90.00 ,,,,
ROM MEASURE EXTRE/TRUNK,$90.00 ,,,,
ROM MEASURE HAND,$86.00 ,,,,
ROOM/BED: Intensive Care Unit,,,"$3,102.00 ",,
ROOM/BED: Isolation,,,"$1,650.00 ",,
ROOM/BED: Monitored Care Unit,,,"$3,252.00 ",,
ROOM/BED: Nursery,,,$900.00 ,,
ROOM/BED: Nursery Extended,,,"$1,404.00 ",,
ROOM/BED: Nursery ICU,,,"$3,102.00 ",,
ROOM/BED: Nursery Intermediate,,,"$1,752.00 ",,
ROOM/BED: Pediatric Isolation,,,"$1,854.00 ",,
ROOM/BED: Pediatric Semi Private,,,"$1,752.00 ",,
ROOM/BED: Pediatric Telemetry,,,"$1,926.00 ",,
ROOM/BED: Pediatrics,,,"$1,650.00 ",,
ROOM/BED: Private,,,"$1,524.00 ",,
ROOM/BED: Private,,,"$1,524.00 ",,
ROOM/BED: Semi Private,,,"$1,524.00 ",,
ROOM/BED: Semi Private,,,"$1,524.00 ",,
ROOM/BED: Telemetry,,,"$1,854.00 ",,
ROOM/BED: Telemetry Semi Private,,,"$1,854.00 ",,
ROTATING ADAPTERS,$13.75 ,,,,
Rotavirus Ag Stool,$122.00 ,,,,
ROTH NET,$137.50 ,,,,
ROUND 1.5MM X 75MM XOMED BUR,$228.75 ,,,,
ROUND 1MM X 64MM XOMED BUR,$264.50 ,,,,
ROUND 1MM X75MM XOMED BUR,$264.50 ,,,,
ROUND 2MM X 64MM XOMED BUR,$264.50 ,,,,
ROUND 3MM X 64MM XOMED BUR,$266.00 ,,,,
ROUND 4MM X 64MM XOMED BUR,$266.00 ,,,,
ROUND 5MM X 64MM XOMED BUR,$266.00 ,,,,
ROUND 6MM X 64MM XOMED BUR,$237.50 ,,,,
ROUND BUR 4.0,"$1,855.00 ",,,,
ROUND BURR,$185.00 ,,,,
ROUND DISTENTION BALLOON - DR. K,$520.25 ,,,,
ROUND FAST CUTTING BUT 5.5,$165.50 ,,,,
Rubella,$71.00 ,,,,
"Rubella Antibodies, IgG and IgM ARUP",$131.25 ,,,,
Rubella Antibody IgG ARUP,$44.50 ,,,,
Rubella Antibody IgM ARUP,$44.50 ,,,,
"Rubella Antibody, IgG ARUP",$44.50 ,,,,
S-100 Protein by IHC ARUP,$370.50 ,,,,
S65C Hemochromatosis Mutation ARUP,$114.25 ,,,,
Saccharomonospora viridis ARUP,$199.25 ,,,,
Salicylate Level,$127.00 ,,,,
SANE exam professional fee,$559.25 ,,,,
SANE exam room charge,$559.25 ,,,,
SATURATION DIRECT,$27.50 ,,,,
SAW BLADE,$192.25 ,,,,
SAW BLADE MEDIUM (6113-119-090),$243.50 ,,,,
SAW TIP OSCILLATING,"$1,360.00 ",,,,
SAWBLADE LARGE (6125-119-090),$243.50 ,,,,
SCALPEL HARM-CATTE,$674.50 ,,,,
SCALPEL HARMONIC HAND HELD,"$1,641.25 ",,,,
SCD CALF WRAP,$39.75 ,,,,
SCD LEG WRAP,$39.75 ,,,,
SCHINDLE EAR PACKING 9mm X 13mm,$56.50 ,,,,
"Scleroderma (Scl-70) (ENA) Antibody, IgG",$88.00 ,,,,
"Scleroderma (Scl-70) (ENA) Antibody, IgG ARUP",$56.75 ,,,,
SEAL CAP ASSEMBLY,$700.00 ,,,,
SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE EXTENSIVE OR COMPLICATED CHARGE,,,,"$1,429.25 ",
Sedimentation Rate Automated,$50.00 ,,,,
Selected Liq Nitro 2 Red Cell Panel ARUP,$353.50 ,,,,
Selected Liquid Red Cell Panel ARUP,$353.50 ,,,,
"Selenium, Serum or Plasma ARUP",$55.25 ,,,,
"Semen Analysis, Complete",$58.00 ,,,,
Sensorcaine 0.25% with epinephrine 50mL vial,$16.00 ,,,,
"SENSORY INTEGRATION, EA 15 MIN",$59.25 ,,,,
"Serotonin, Serum ARUP",$158.00 ,,,,
Serum Pregnancy Test,$62.00 ,,,,
Sex Hormone Binding Globulin ARUP,$78.25 ,,,,
"Sexually Transmitted Disease Panel 1, ARUP",$216.50 ,,,,
"SHAVING OF EPIDERMAL OR DERMAL LESION SINGLE TRUNK, ARMS OR LEGS <= 0.5 CM CHARGE",$277.00 ,,,,
"SHAVING OF EPIDERMAL OR DERMAL LESION SINGLE TRUNK, ARMS OR LEGS 0.6 TO 1.0 CM CHARGE",,,,$161.00 ,
SHEATH INTRO KIT,$116.00 ,,,,
SHEEPSKIN SYNTHETIC,$48.50 ,,,,
SHEET BILATERAL LIMB,$27.00 ,,,,
SHEET BILATERAL LIMB,$27.00 ,,,,
SHEET SPLIT,$18.00 ,,,,
SHEET SPLIT,$18.00 ,,,,
SHOE POST OP MEN LARGE,$30.50 ,,,,
SHOE POST OP MENS MED,$33.75 ,,,,
SHOE POST OP MENS MED,$33.75 ,,,,
SHOE POST OP MENS SMALL,$33.75 ,,,,
SHOE POST OP WOMENS LARGE,$33.75 ,,,,
SHOE POST OP WOMENS MEDIUM,$30.50 ,,,,
SHOE POST OP WOMENS SMALL,$30.50 ,,,,
SHORT NARROW BLADE 11.5X5.5 - TPS,$192.25 ,,,,
SHORT NARROW BLADE 15X7 - TPS,$109.00 ,,,,
SHOULDER IMMOB LG,$39.75 ,,,,
SHOULDER IMMOB MD,$39.75 ,,,,
SHOULDER IMMOB SM,$30.25 ,,,,
SHOULDER IMMOB XLG,$30.00 ,,,,
SHOULDER IMMOB XXLG,$39.75 ,,,,
SHOULDER PACK,$113.50 ,,,,
SHOULDER SUSPENSION KIT,$221.75 ,,,,
"Sialolithotomy; submadibular, sublingual or parotid, uncomplicated","$3,821.75 ",,,,
silver nitrate topical,$3.25 ,,,,
Simple dressing change,$28.00 ,,,,
SINUS FLOW TUBING,$182.50 ,,,,
Sirolimus by Tandem Mass Spectrometry ARUP,$252.50 ,,,,
SKIN CHLORAPREP 10.5ML,$13.75 ,,,,
SKIN CHLORAPREP 26ML,$18.00 ,,,,
SKIN PREP TRAY,$14.25 ,,,,
SKIN STAPLER PRECISE,$13.25 ,,,,
SKIN STAPLER PROXIMATE 35,$29.00 ,,,,
"Skin substitute, ALLODERM, per 1 sq cm",$55.50 ,,,,
"Skin substitute, APLIGRAF®, per 1 sq cm",$54.25 ,,,,
"Skin substitute, DERMAGRAFT®, per 1 sq cm",$58.25 ,,,,
"Skin substitute, EPIFIX, per 1 sq cm",$289.25 ,,,,
"Skin substitute, GRAFIX PRIME, per 1 sq cm",$243.25 ,,,,
"Skin substitute, GRAFTJACKET, per 1 sq cm",$167.50 ,,,,
"Skin substitute, INTEGRA BILAYER MATRIX WOUND DRESSING, per 1 sq cm",$68.25 ,,,,
"Skin substitute, INTEGRA DERMAL REGENERATION TEMPLATE (DRT), per 1 sq cm",$53.25 ,,,,
"Skin substitute, INTEGRA MATRIX, per 1 sq cm",$70.75 ,,,,
"Skin substitute, MATRISTEM MICRO MATRIX, per 1 sq cm  - Non Medicare only",$5.50 ,,,,
"Skin substitute, OASIS® BURN MATRIX, per 1 sq cm",$19.50 ,,,,
"Skin substitute, OASIS® ULTRA TRI LAYER WOUND MATRIX, per 1 sq cm",$24.25 ,,,,
"Skin substitute, OASIS® WOUND MATRIX, per 1 sq cm",$894.25 ,,,,
"Skin substitute, PRIMATRIX, per 1 sq cm",$89.00 ,,,,
"Skin substitute, PURAPLY, per 1 sq cm",$211.50 ,,,,
"Skin substitute, THERASKIN, per 1 sq cm",$80.00 ,,,,
Sleep Apnea Link Study,$450.00 ,,,,
Sleep Diary Actigraphy Study,$161.25 ,,,,
Sleep Lab Diagnostic Study,"$3,608.50 ",,$0.00 ,,
Sleep Lab MSLT Study,"$3,779.50 ",,,,
Sleep Lab MWT Study,"$3,779.50 ",,,,
Sleep Lab Oxygen Titration Study,"$4,072.50 ",,,,
Sleep Lab Parasomnia Study,"$3,608.50 ",,,,
Sleep Lab Retitration Study,"$4,072.50 ",,,,
Sleep Lab Titration Study,"$4,072.50 ",,,,
Sleep Split-Night Study,"$4,072.50 ",,,,
SLEEP STUDY DIAGNOSIS INTERPRETATION,"$3,608.50 ",,,,
SLEEP STUDY TITRATION INTERPRETATION,"$4,072.50 ",,,,
SLING & SWATHE UNIVER,$27.00 ,,,,
SLING & SWATHE X-LARG,$46.00 ,,,,
"SLITTING OF PREPUCE, DORSAL OR LATERAL EXCEPT NEWBORN CHARGE","$2,891.75 ",,,,
SLOTTED WHISKER SHAVER,$160.50 ,,,,
SMALL CAST PLACEMENT Charge,$60.25 ,,,,
SMALL HEMOCLIPS YELLOW,$59.50 ,,,,
"Smith (ENA) Ab, IgG ARUP",$56.75 ,,,,
"Smith (ENA) Antibody, IgG ARUP",$56.75 ,,,,
"Smith (ENA) Antibody, IgG ARUP",$56.75 ,,,,
sodium hyaluronate opththalmic 14 mg/mL,$444.50 ,,,,
Sodium Level,$41.00 ,,,,
Sodium Level 24 Hour Urine,$53.25 ,,,,
Sodium Level Urine,$53.25 ,,,,
"Sodium, Urine ARUP",$53.25 ,,,,
"Soluble Liver Antigen Antibody, IgG ARUP",$82.75 ,,,,
SORENSON SUCTION CANISTER,$54.00 ,,,,
SPEECH GEN DEIVCE (AAC),$242.00 ,,,,
SPEECH GEN DEVICE,$242.00 ,,,,
SPEECH GEN DEVICE EA ADD 30 MIN,$100.75 ,,,,
Speech Generating Device Eval Additional 30 Min,$100.75 ,,,,
SPEECH THERAPY EVALUATION.,$462.50 ,,,,
Speed Staple Nitinol,"$1,724.50 ",,,,
Sperm Count (post vasectomy),$91.25 ,,,,
Spinal each additional 15 minutes,$175.50 ,,,,
Spinal first 30 minutes,$524.25 ,,,,
SPINAL PUNCTURE LUMBAR THERAPEUTIC FOR DRAINAGE OF CEREBROSPINAL FLUID CHARGE,$892.00 ,,,,
SPINAL TRAY ANESTHESI,$47.00 ,,,,
SPLINT ROLL UNIV 2 ORTHO GLASS,$159.25 ,,,,
SPLINT ROLL UNIV 3 ORTHO GLASS,$220.25 ,,,,
SPLINT ROLL UNIV 4 ORTHO GLASS,$222.25 ,,,,
SPLINT ROLL UNIV 6 ORTHO GLASS,$323.75 ,,,,
Spot urine microalbumin/creatinine ratio,$80.75 ,,,,
Sputum Culture,$116.00 ,,,,
SPUTUM INDUCTION,$305.75 ,,,,
"SSA 52 (Ro) (ENA) Antibody, IgG ARUP",$56.75 ,,,,
"SSA 52 (Ro) (ENA) Antibody, IgG ARUP",$56.75 ,,,,
"SSA 52 and 60 (Ro)(ENA) Antibodies, IgG ARUP",$56.75 ,,,,
"SSB (La) (ENA) Ab, IgG ARUP",$56.75 ,,,,
"SSB (La) (ENA) Antibody, IgG ARUP",$56.75 ,,,,
"SSB (La) (ENA) Antibody, IgG ARUP",$56.75 ,,,,
ST AURAL REHABILITATION,$174.50 ,,,,
"St. Louis Encephalitis Ab, IgG, CSF ARUP",$153.75 ,,,,
"St. Louis Encephalitis Ab, IgM, CSF ARUP",$153.75 ,,,,
STAINLESS STEEL TUBES,$101.25 ,,,,
Statlock PICC Plus,$30.50 ,,,,
STEP 14 G NEEDLE,$65.00 ,,,,
STERI DRAPE 1015,$14.25 ,,,,
STERI-DRAPE - STEVE'S TOTAL DRAPE,$14.25 ,,,,
STERILE WATER 3000ML (BAG),$27.00 ,,,,
sterile water bacteriostatic Inj 30 mL,$17.75 ,,,,
STIFFNECK INFANT,$34.50 ,,,,
STIFFNECK PED,$35.75 ,,,,
STIFFNECK REGULAR 5,$34.25 ,,,,
STIFFNECK SHORT,$34.25 ,,,,
STIFFNECK TALL,$34.25 ,,,,
STOCKINETTE IMP. MED,$70.00 ,,,,
STOCKINETTE TUBULAR 2,$53.00 ,,,,
STOCKINETTE TUBULAR 3,$66.50 ,,,,
STOCKINETTE TUBULAR 4,$75.75 ,,,,
STOCKINETTE TUBULAR 5,$34.75 ,,,,
STOCKING SCD LRG,$226.25 ,,,,
STOCKING SCD MEDIUM,$188.00 ,,,,
STOCKING SCD SMALL,$179.75 ,,,,
Stool Culture,$126.50 ,,,,
STRAIGHT AGGRESSIVE MICRODEBRIDER 4.0,$374.25 ,,,,
STRAIGHTSHOT BLADE 4M,$70.00 ,,,,
STRAPPING OF KNEE Charge,$366.25 ,,,,
STRAPPING OF SHOULDER CHARGE,$172.25 ,,,,
STRAPPING UNNA BOOT CHARGE,$251.75 ,,,,
Strep A Rapid Screen,$60.00 ,,,,
Strep A Screen,$60.00 ,,,,
Strep Confirmation,$94.00 ,,,,
STRUCTURAL BALLOON 10 MM - DR. K,$329.25 ,,,,
STRYKE FLOW,$98.00 ,,,,
STRYKER FLOW II W/TIP,$261.25 ,,,,
SUBDERMAL ELECTRODES,$339.25 ,,,,
Sulfonylurea Hypoglycemics Panel ARUP,$288.00 ,,,,
SUPER ANCHOR,$400.00 ,,,,
Super Rapid 5 Steam-Plus Challage Pack,$30.50 ,,,,
SURGICELL 4x8,$340.00 ,,,,
Surgimesh 1/2 Ovale Fente 6x13cm,$405.00 ,,,,
SURGIMESH XB ROUND 10 CM,"$1,920.00 ",,,,
SURGIMESH XB SKIRTED ROUND 7 MM,"$2,040.00 ",,,,
SURGIPRO MESH 3X5,$131.25 ,,,,
SUT 0 ETHIBOND SH 30,$10.75 ,,,,
SUT 0 MONOCRYL CT-1 36,$11.25 ,,,,
SUT 0 PROLENE CT-2 30,$12.50 ,,,,
SUT 1 CHROMIC GUT CT-1 27,$16.00 ,,,,
SUT 1 CHROMIC GUT CT-1 CR 8 PACK,$126.25 ,,,,
SUT 1 CHROMIC GUT MO-4 27,$8.75 ,,,,
SUT 1 ETHILON TP-1 60,$13.25 ,,,,
SUT 1 NUROLON CT-1,$22.25 ,,,,
SUT 1 PLAIN GUT TIES 54,$6.00 ,,,,
SUT 1 PROLENE TP-1 60,$18.75 ,,,,
SUT 1 VICRYL TIES 8 PACK 27,$57.25 ,,,,
SUT 10-0 ETHILON TG160-6 12,$84.50 ,,,,
SUT 2-0 CHROMIC GUT CT-1 27,$15.00 ,,,,
SUT 2-0 ETHILON PS-2 18,$6.75 ,,,,
SUT 2-0 PROLENE CT-1 30,$12.50 ,,,,
SUT 3-0 CHROMIC GUT CT-1 27,$6.25 ,,,,
SUT 3-0 CHROMIC GUT FS-2 27,$6.25 ,,,,
SUT 3-0 CHROMIC GUT SH 27,$6.25 ,,,,
SUT 3-0 CHROMIC GUT UR-6 27,$18.25 ,,,,
SUT 3-0 ETHIBOND SH 30,$3.75 ,,,,
SUT 3-0 ETHILON KS 30 - STRAIGHT - PURSE STING,$3.00 ,,,,
SUT 3-0 PROLENE FS-2 18,$5.00 ,,,,
SUT 3-0 SILK FS-1 18,$8.50 ,,,,
SUT 3-0 SILK PS-2 18,$7.25 ,,,,
SUT 3-0 SILK TIES 12 PACK 18,$3.00 ,,,,
SUT 3-0 VICRYL SH-1 8 PACK 18,$22.25 ,,,,
SUT 3-0 VICRYL X-1 27,$10.75 ,,,,
SUT 4-0 CHROMIC GUT G-3 18,$28.25 ,,,,
SUT 4-0 ETHILON FS-2,$9.25 ,,,,
SUT 4-0 ETHILON PC-3,$21.25 ,,,,
SUT 4-0 MONOCRYL PS-2 18,$27.75 ,,,,
SUT 4-0 MONOCRYL RB-1 27,$3.25 ,,,,
SUT 4-0 PLAIN GUT SC-1 18,$15.75 ,,,,
SUT 4-0 PROLENE P-3 18,$24.25 ,,,,
SUT 4-0 VICRYL PC-3,$21.25 ,,,,
SUT 4-0 VICRYL PS-2 18,$19.25 ,,,,
SUT 4-0 VICRYL SH-1 18 - 8 PACK,$55.25 ,,,,
SUT 5 ETHIBOND V-37 4 PACK 30,$81.75 ,,,,
SUT 5 SURGICAL STEEL WIRE SUTURE CCS-1 2 PACK 30,$13.50 ,,,,
SUT 5-0 ETHILON P-3 18,$18.00 ,,,,
SUT 5-0 ETHILON PC-3 18,$21.50 ,,,,
SUT 5-0 ETHILON S-24 18,$19.00 ,,,,
SUT 5-0 PDS II RB-1 27,$4.50 ,,,,
SUT 5-0 PLAIN GUT P-3 18,$12.00 ,,,,
SUT 5-0 VICRYL FS-2,$4.50 ,,,,
SUT 5-0 VICRYL PC-3,$8.75 ,,,,
SUT 5-0 VICRYL PS-2 18,$19.00 ,,,,
SUT 5-0 VICRYL PS-3 18,$18.75 ,,,,
SUT 6-0 ETHILON P-3 18,$18.00 ,,,,
SUT 6-0 ETHILONC-2 18,$8.75 ,,,,
SUT 6-0 PLAIN GUT G-1 18,$13.50 ,,,,
SUT 6-0 VICRYL PC-1 18,$7.50 ,,,,
SUT 9-0 ETHILON BV100-4 5,$35.25 ,,,,
SUT CHROMI GUT 5-0 RB-1,$4.50 ,,,,
"SUT CHROMIC GUT 0 27""",$4.50 ,,,,
SUT CHROMIC GUT 0 36  CT-1,$6.75 ,,,,
"SUT CHROMIC GUT 2-0 54""",$5.00 ,,,,
SUT CHROMIC GUT 2-0 CT3,$4.75 ,,,,
SUT CHROMIC GUT 3-0 27  CT-1,$5.50 ,,,,
SUT CHROMIC GUT 4-0 P-3,$30.50 ,,,,
SUT CTD VICRYL 0 27  Vil.UR-5,$9.75 ,,,,
SUT CTD VICRYL 0 27  Vil.UR-6,$9.50 ,,,,
SUT CTD VICRYL 0 TIES,$23.50 ,,,,
SUT CTD VICRYL 0 UND BR CT-1,$8.00 ,,,,
SUT CTD VICRYL 0 VIL BR CT-1 8 PACK,$55.00 ,,,,
SUT CTD VICRYL 1 36  Vil.CT-1,$8.50 ,,,,
SUT CTD VICRYL 1 8-18  Vil.CR MO-4,$74.00 ,,,,
SUT CTD VICRYL 2-0 12-18  Vil.BRAIDED,$16.25 ,,,,
SUT CTD VICRYL 2-0 27  Vil.XLH,$17.50 ,,,,
SUT CTD VICRYL 2-0 36  Und.CT-1,$8.25 ,,,,
SUT CTD VICRYL 2-0 VIL BR 54IN,$3.50 ,,,,
SUT CTD VICRYL 3-0 12-18  Vil.BRAIDED,$14.75 ,,,,
SUT CTD VICRYL 3-0 27  Und.X-1,$11.25 ,,,,
SUT CTD VICRYL 3-0 27  Vil.CT-1,$7.75 ,,,,
SUT CTD VICRYL 3-0 27  Vil.SH,$7.75 ,,,,
SUT CTD VICRYL 3-0 8-18  Und.CR SH,$22.50 ,,,,
SUT CTD VICRYL 4-0 18  Und.PS-4,$18.75 ,,,,
SUT CTD VICRYL 4-0 27  Und.FS-2,$10.75 ,,,,
SUT CTD VICRYL 4-0 27  Vil.SH,$8.00 ,,,,
SUT CTD VICRYL 6-0 18  Vil.D/A S-14,$64.25 ,,,,
SUT ETHIBOND 2-0 36  EXCEL G D/A SH-1,$21.50 ,,,,
SUT ETHIBOND XTRA 1 OS-4 30,$12.75 ,,,,
SUT ETHIBOND XTRA 2 OS-4 30,$12.75 ,,,,
"SUT ETHILON 10-0 6"" C-6",$34.75 ,,,,
SUT ETHILON 3-0 18  PC-5,$49.75 ,,,,
SUT ETHILON 3-0 PC-5,$21.00 ,,,,
SUT ETHILON 4-0 FS-1,$9.75 ,,,,
SUT ETHILON 4-0 P-3,$20.00 ,,,,
SUT ETHILON 5-0 CLEAR MONO P-3,$7.25 ,,,,
SUT ETHILON 5-0 FS-2,$9.00 ,,,,
"SUT ETHILON 5-0 P-3 18""",$7.00 ,,,,
SUT ETHILON 6-0 C-2,$3.50 ,,,,
SUT ETHILON 7-0 P-6,$7.25 ,,,,
SUT MERSILEN 4-0 P3,$7.50 ,,,,
SUT MERSILENE CTX 5mm X 30cm,$140.50 ,,,,
"SUT MONOCRYL 1 27"" CT-1",$3.50 ,,,,
SUT MONOCRYL 3-0 27  Und. SH,$10.25 ,,,,
"SUT MONOCRYL 4-0 18""PC1",$9.25 ,,,,
SUT MONOCRYL 4-0 27  Und. SH,$10.50 ,,,,
SUT NUROLON 0 8-18  CR MO-6,$61.25 ,,,,
SUT PDS II 1 TP-1 VIL 54,$21.00 ,,,,
"SUT PLAIN GUT 3-0 27""CT",$4.50 ,,,,
"SUT PLAIN GUT 6-0 18""G-",$12.25 ,,,,
SUT PROLENE 1 30  CT-1,$12.50 ,,,,
"SUT PROLENE 2-0 30"" SH",$17.00 ,,,,
SUT PROLENE 3-0 PS-1,$27.00 ,,,,
SUT PROLENE 4-0 FS-2,$13.00 ,,,,
SUT PROLENE 5-0 PC-1,$30.00 ,,,,
SUT PROLENE 6-0 P-1,$29.75 ,,,,
SUT SILK 0 SH,$6.50 ,,,,
SUT SILK 2-0 12-18  BRAIDED,$7.75 ,,,,
SUT SILK 2-0 30  SH BRAIDED,$6.50 ,,,,
SUT SILK 3-0 144  BRAIDED,$2.50 ,,,,
SUT SILK 3-0 BLK BR FS-1 18,$8.50 ,,,,
SUT SILK 3-0 BR SH,$6.75 ,,,,
"SUT SILK 4-0 30"" SH",$2.75 ,,,,
"SUT VICRYL 0 27"" CT-1",$3.25 ,,,,
"SUT VICRYL 0 3-27"" CT-1",$9.50 ,,,,
"SUT VICRYL 0 54"" BRAIDE",$4.00 ,,,,
"SUT VICRYL 1 54"" BRAIDE",$4.00 ,,,,
"SUT VICRYL 4-0 18"" P-3",$21.25 ,,,,
SUT VICRYL 4-0 BR X-1,$4.75 ,,,,
SUT VICRYL 5-0 P-1,$21.50 ,,,,
SUT VICRYL 6-0 BR PS-6,$23.50 ,,,,
SUTURE ANCHOR 4.5 FOOTPRINT ULTRA PK,$887.50 ,,,,
SUTURE ANCHOR 5.5 FOOTPRINT ULTRA PK,$872.00 ,,,,
"SUTURE OF ABDOMINAL WALL FOR EVISCERATION OR DEHISCENCE, SECONDARY CHARGE",,,,"$1,475.00 ",
SUTURE OF INFRAPATELLAR TENDON PRIMARY CHARGE,,,,"$1,528.75 ",
SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE PRIMARY CHARGE,,,,"$1,638.50 ",
"SUTURE OF WOUND OF EYELID INVOLVING LID MARGIN, TARSUS, AND/OR PALPEBRAL CONJUNCTIVA DIRECT CLOSURE",,,,"$1,151.75 ",
SUTURE REMOVAL KIT,$14.75 ,,,,
SUTURE SET #1,$18.00 ,,,,
SUTURE SET #2,$59.00 ,,,,
SUTURE SET #3,$114.00 ,,,,
SWALLOW EVALUATION,$273.50 ,,,,
Swan-Ganz Tray,$260.50 ,,,,
T -ting Digital Tourniquet,$31.50 ,,,,
T TUBE CONNECTOR,$8.50 ,,,,
T. vaginalis by TMA ARUP,$140.75 ,,,,
T3 Uptake ARUP,$49.00 ,,,,
T3 Uptake ARUP,$49.00 ,,,,
T4 HOOD,$164.00 ,,,,
"T4, Total",$66.75 ,,,,
Tacrolimus ARUP,$250.50 ,,,,
TAPE MICROFOAM 4,$18.50 ,,,,
TAUT CATHETER,$172.50 ,,,,
"TELFA ISLAND DRESSING 10x20 (4""x8"")",$99.50 ,,,,
TEMPORARY TRANSCUTANEOUS PACING CHARGE,$846.50 ,,,,
TENS Setup Charge,$82.75 ,,,,
Testosterone Free and Total by LC-MS/MS ARUP,$211.75 ,,,,
"Testosterone Free And Total, Adult Male ARUP",$171.25 ,,,,
"Testosterone Free, Adult Male ARUP",$147.00 ,,,,
"Testosterone, Adult Male ARUP",$171.25 ,,,,
"Testosterone, Bio with SHBG by LC-MS/MS ARUP",$211.75 ,,,,
"Testosterone, Bio with SHBG, Adult Male ARUP",$171.25 ,,,,
"Testosterone, Total",$171.25 ,,,,
"Tetanus Antibody, IgG ARUP",$79.50 ,,,,
tetracaine 0.5% 2 mL solution,$30.75 ,,,,
Thawing Fee (UBMC),$353.25 ,,,,
Theophylline ARUP,$65.00 ,,,,
THERAPEUTIC ACTIVITIES,$76.75 ,,,,
THERAPEUTIC EXERCISE,$78.25 ,,,,
Therapeutic Phlebotomy.,$175.75 ,,,,
Therapeutic services for the use of non-speech generating device,$146.25 ,,,,
THERMAL BALLOON,"$1,568.25 ",,,,
Thermoactinomyces candidus ARUP,$199.25 ,,,,
Thermoactinomyces sacchari ARUP,$199.25 ,,,,
Thermoactinomyces vulgaris #1 ARUP,$199.25 ,,,,
Thiopurine Metabolites ARUP,$431.25 ,,,,
"Thiopurine Methyltransferase, RBC ARUP",$871.50 ,,,,
Thoracentesis (Inpatient),$569.50 ,,,,
THORACENTESIS FOR ASPIRATION INITIAL OR SUBSEQUENT CHARGE,"$1,143.25 ",,,,
Thoracentesis Procedure,"$1,203.00 ",,,,
THORACENTESIS TRAY,$202.25 ,,,,
THORACENTESIS TRAY,$202.25 ,,,,
THORACENTESIS WITH CHEST TUBE INSERTION CHARGE,$799.50 ,,,,
Thoracentesis with Chest Tube Placement,$569.50 ,,,,
Thoracostomy with Water Seal,"$1,612.25 ",,,,
THORA-DRAIN III PLEUR,$156.75 ,,,,
Throat Culture,$116.00 ,,,,
Thrombin Time ARUP,$45.25 ,,,,
THROMBOLYSIS CORONARY BY INTRAVENOUS INFUSION CHARGE,,,,$712.25 ,
Thyroglobulin Antibody ARUP,$75.50 ,,,,
"Thyroglobulin by LC-MS/MS, Serum/Plasma ARUP",$90.50 ,,,,
Thyroid Antibodies ARUP,$75.50 ,,,,
Thyroid Peroxidase (TPO) Ab ARUP,$86.25 ,,,,
THYROID SHEET,$23.25 ,,,,
Thyroid Stimulating Hormone,$81.00 ,,,,
Thyroid Stimulating Hormone ARUP,$79.25 ,,,,
Thyroid Stimulating Hormone Receptor Ab ARUP,$136.00 ,,,,
Thyroid Stimulating Immunoglobulins ARUP,$296.50 ,,,,
Thyroxine ARUP,$66.75 ,,,,
Thyroxine ARUP,$66.75 ,,,,
Thyroxine Free ARUP,$109.00 ,,,,
"Tissue marker, implantable, any type, each",$301.50 ,,,,
"Tissue Trans. Ab, IgA with Reflex ARUP",$82.75 ,,,,
"Tissue Transglutaminase Antibody, IgA ARUP",$82.75 ,,,,
"Tissue Transglutaminase Antibody, IgG ARUP",$118.25 ,,,,
TISSUE TRAPS,$16.25 ,,,,
TISSUE TRAPS  SORENSON SUCTION SPECIMAN TRAP,$37.00 ,,,,
T-Max Face Mask,$109.00 ,,,,
"Tobramycin, Peak Level ARUP",$71.00 ,,,,
"Tobramycin, Trough Level ARUP",$71.00 ,,,,
Topical each additional 15 minutes,$175.50 ,,,,
Topical first 30 minutes,$524.25 ,,,,
Topiramate ARUP,$177.75 ,,,,
"TORCH Antibodies, IgG ARUP",$167.50 ,,,,
"TORCH Antibodies, IgM ARUP",$168.00 ,,,,
"Total Iron Binding Capacity
Total Iron Binding Capacity
Total Iron Binding Capacity
Total Iron",$84.75 ,,,,
Total Protein ARUP,$49.25 ,,,,
"Total Protein, Body Fluid ARUP",$58.50 ,,,,
"Total Protein, Urine ARUP",$32.25 ,,,,
"Toxoplasma gondii Ab, IgG ARUP",$41.75 ,,,,
"Toxoplasma gondii Ab, IgG ARUP",$53.75 ,,,,
"Toxoplasma gondii Ab, IgM ARUP",$45.50 ,,,,
"Toxoplasma gondii Ab, IgM ARUP",$54.50 ,,,,
TPN/DRESSING CHANGE TRAY,$71.00 ,,,,
TR Interpretation,$211.75 ,,,,
TR TUBE 3.0 O/R 86263,$12.50 ,,,,
TR TUBE 3.5 N/R CUFF 81035,$16.00 ,,,,
TR TUBE 3.5 O/RAE U/C 86264,$13.50 ,,,,
TR TUBE 4.0 N/R CUFF 81040,$173.00 ,,,,
TR TUBE 4.0 O/ R U/C  86265,$17.25 ,,,,
TR TUBE 4.0 O/R CUFF 86209,$24.00 ,,,,
TR TUBE 4.5 N/R CUFF 81045,$167.75 ,,,,
TR TUBE 4.5 O/R CUFF 86199,$24.00 ,,,,
TR TUBE 4.5 ORAL RAE 86266,$17.25 ,,,,
TR TUBE 5.0 N/R CUFF 81050,$167.75 ,,,,
TR TUBE 5.0 O/ R CUFF 86200,$21.75 ,,,,
TR TUBE 5.0 ORAL RAE 86267,$14.00 ,,,,
TR TUBE 5.5 O/ R CUFF 86201 76255,$21.75 ,,,,
TR TUBE 5.5 ORAL RAE 86268,$19.75 ,,,,
TR TUBE 6.0 N/R CUFF 86212,$142.25 ,,,,
TR TUBE 6.0 O/R CUFF 86202 76260,$22.25 ,,,,
TR TUBE 6.5 N/R CUFF 86213,$142.25 ,,,,
TR TUBE 6.5 O/ R CUFF 86203 76265,$22.25 ,,,,
TR TUBE 6.5 ORAL RAE 86270,$19.50 ,,,,
TR TUBE 7.0 N/R CUFF 86214,$142.25 ,,,,
TR TUBE 7.0 ORAL RAE 86204 76270,$21.75 ,,,,
TR TUBE 7.5 N/R CUFF 86215,$21.25 ,,,,
TR TUBE 8.0 ORAL RAE 86206,$22.50 ,,,,
TR TUBE REINFORCED 7.0,$288.75 ,,,,
TR TUBE REINFORCED 8.0,$288.75 ,,,,
Trach Tray,$144.75 ,,,,
TRACHEOSTOMA REVISION SIMPLE WITHOUT FLAP ROTATION CHARGE,,,,$907.00 ,
Tracheostomy Care,$62.75 ,,,,
Tracheostomy Emergency Placement,"$1,866.75 ",,,,
TRACHEOSTOMY EMERGENCY PROCEDURE CRICOTHYROID MEMBRANE CHARGE,"$1,362.25 ",,,,
TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL CHARGE,"$1,866.75 ",,,,
TRACHEOSTOMY MASK,$5.50 ,,,,
TRACHEOSTOMY PLUG,$8.75 ,,,,
TRACHEOSTOMY SPEAKING VALVE,$246.50 ,,,,
TRACHEOSTOMY TUBE CUFFED,$174.75 ,,,,
TRACHEOSTOMY TUBE NON CUFFED,$150.50 ,,,,
TRACH-QUICK Charge,$408.25 ,,,,
TRANS PAC Charge,$127.25 ,,,,
"Transferrin, Serum ARUP",$138.00 ,,,,
TRANSFUSION-BLOOD Charge,$963.50 ,,,,
Transvenous Pacing Kit,$281.00 ,,,,
Trauma activation (non-EMS) critical care- Level 1,"$2,712.75 ",,,,
Trauma activation (non-EMS) critical care- Level 2,"$1,733.00 ",,,,
Trauma activation (non-EMS) non critical care- Level 1,"$2,477.00 ",,,,
Trauma activation (non-EMS)non critical care- Level 2,"$1,582.25 ",,,,
Trauma resonse team activation non critical care Level 1,"$2,477.00 ",,,,
Trauma resonse team activation non critical care Level 2,"$1,582.25 ",,,,
TRAUMA RESPONSE TEAM ASSOCIATED WITH HOSPITAL CRITICAL CARE SERVICE LEVEL 1 CHARGE,"$2,712.75 ",,,,
TRAUMA RESPONSE TEAM ASSOCIATED WITH HOSPITAL CRITICAL CARE SERVICE LEVEL 2 CHARGE,"$1,733.00 ",,,,
TREAT SWALLOWING DYSFUNCTION,$218.00 ,,,,
Treponema pallidum Ab by TP-PA ARUP,$180.00 ,,,,
TRIAGE Charge,$79.50 ,,,,
triamcinolone 40 mg/mL Inj Susp SDV 1 mL,$32.00 ,,,,
Trichomonas vaginalis by TMA ARUP,$140.75 ,,,,
Triglycerides,$47.00 ,,,,
Triiodothyronine Free,$116.00 ,,,,
"Triiodothyronine, Reverse ARUP",$252.50 ,,,,
"Triiodothyronine, Total (Total T3) ARUP",$92.00 ,,,,
"Trimming of nondystrophic nails, any number",$89.50 ,,,,
TROCAR STEP 10mm,$307.00 ,,,,
TROCAR STEP 5mm & SLEEVE,$241.25 ,,,,
TROCAR STEP 7-8,$218.75 ,,,,
TROCAR SYRINGE 10mm,$266.50 ,,,,
TROCAR/SRYINGE BLUNT TIP,$235.25 ,,,,
tropicamide Opth 1% Sol,$115.50 ,,,,
Troponin I,$95.00 ,,,,
Tryptase ARUP,$469.75 ,,,,
TSH 3rd Generation ARUP,$79.25 ,,,,
T-TUBE 12MM,$151.25 ,,,,
T-TUBE MODIFIED,$83.50 ,,,,
TUBE DURAVENT,$70.75 ,,,,
TUBE REUTER BOBBIN VENT,$82.50 ,,,,
TUBE THORACOSTOMY WITH WATER SEAL CHARGE,"$1,612.25 ",,,,
TUBING ARTHROSCOPY,$75.50 ,,,,
TUBING CONNECTOR 6-IN-1  Y,$17.00 ,,,,
TUBING HUMMER,$154.25 ,,,,
"TUBING INSUFFLATOR 10', .2U FILTER",$17.00 ,,,,
"TUBING SET, GRAVITY 4-SPIKE",$34.75 ,,,,
TUBING SUCTION ROLL 1,$46.25 ,,,,
TUNA KIT,"$2,373.50 ",,,,
TUR SETS,$14.25 ,,,,
TUR Y-SET,$27.00 ,,,,
Turtle tub,$52.50 ,,,,
TUR-Y TUBING,$27.00 ,,,,
TVT OBTURATOR SYSTEM,"$1,687.00 ",,,,
TX COG SKILLS 15 MIN,$78.75 ,,,,
Tx of Speech/Lang/Voice/Comm/Auditory,$229.00 ,,,,
Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid,$229.00 ,,,,
TX OF WOUND DEHISCENCE SIMPLE CHARGE,$800.75 ,,,,
TX OF WOUND DEHISCENCE\packing Charge,$514.50 ,,,,
TX SP/HEARING GROUP,$44.75 ,,,,
TX SPEECH GEN DEVICE,$210.50 ,,,,
TX SPEECH/LANG/AURAL,$229.00 ,,,,
TX SWALLOW,$218.00 ,,,,
TX SWALLOW GENERATING DEVICE,$210.50 ,,,,
TX VOICE PROSTHETIC,$210.50 ,,,,
Tysabri Antibodies ARUP,$429.50 ,,,,
UA Micro 5,$65.00 ,,,,
UBMC AMNIOCENTESIS TRAY,$176.25 ,,,,
"UBMC Arthro Major Joint (Hip, Shoulder)",$401.50 ,,,,
"UBMC Arthro Medium Joint (Ankle, Elbow)",$401.50 ,,,,
"UBMC Arthro Small Joint (Toe, Finger)",$406.25 ,,,,
UBMC CARDIOLITE PER STUDY,$500.00 ,,,,
UBMC CT RECON + 3D,$579.00 ,,,,
UBMC Definity Contrast,$346.75 ,,,,
UBMC DRAINAGE CATH KITS (Any Drainage),"$1,076.75 ",,,,
UBMC Endo Post-Op each 30 minutes,$79.25 ,,,,
UBMC Epidural Technical Component,"$1,087.75 ",,,,
UBMC Hip Injection Under Fluoro,$140.00 ,,,,
UBMC I-123 200 UCI,$96.75 ,,,,
"UBMC Injection, gadolinium based MRI contrast agent, per ML",$63.00 ,,,,
UBMC ISOTOPE ABCESS STUDY,"$2,143.75 ",,,,
UBMC Low Osmolarity Contrast Charge,$15.75 ,,,,
UBMC Low Osmolarity Contrast Charge,$15.75 ,,,,
UBMC MYELOGRAM INJECTION,$957.75 ,,,,
UBMC NONIONIC 100 ML 300 MG,$223.50 ,,,,
UBMC NONIONIC CONTRAST 50ML,$223.50 ,,,,
UBMC NUC MED CAR/MUGA/EF PRO,"$1,337.00 ",,,,
UBMC NUC MED CARDIAC THALLIUM (REST),"$1,972.50 ",,,,
UBMC NUC MED CARDIAC THALLIUM (S/R),"$2,060.00 ",,,,
UBMC NUC MED CARDIOLITE PER STUDY,$500.00 ,,,,
UBMC NUC MED KINEVAC,$212.50 ,,,,
UBMC NUC MED PROV OF ISOTOPE THALLIUM,$142.25 ,,,,
UBMC NUC MED SCROTAL SCAN WITH FLOW,$750.25 ,,,,
UBMC NUC MED THALLIUM 201 PER MCI,$98.50 ,,,,
UBMC NUK MED CARDIAC EF PROCESSING,$682.50 ,,,,
UBMC Post-Op each 30 minutes,$79.25 ,,,,
UBMC Recovery each additional 15 minutes,$87.25 ,,,,
UBMC Recovery first 30 minutes,$261.75 ,,,,
UBMC REGADENOSON 0.1mg,$96.75 ,,,,
UBMC Sevoflurance/Ultane Per Minute,$1.50 ,,,,
UBMC TC99M DISOFENIN,$132.00 ,,,,
UBMC TC99M LABELED RED BLOOD CELLS,$159.00 ,,,,
UBMC TC99M MACROAGGREGATED ALBUMIN,$66.25 ,,,,
UBMC TC99M MEDRONATE,$54.50 ,,,,
UBMC TC99M PENTETATE,$55.50 ,,,,
UBMC TC99M PENTETATE AEROSOL,$58.00 ,,,,
UBMC TC99M SULFUR COLLOID,$81.50 ,,,,
UBMC US OB < 14 Wks each addtl fetus,$324.00 ,,,,
UBMC US OB > 14 Wks each addtl fetus,$338.50 ,,,,
Ultra Pro Mesh,$423.50 ,,,,
Ultra Vac,$48.75 ,,,,
"ULTRABRAID #2 CO-BRAIDED SUTURE AND NEEDLE ASM 38""",$89.50 ,,,,
ULTRASIG II/III DEROT STRAP,$190.25 ,,,,
ULTRASONIC NEBULIZER,$241.25 ,,,,
ULTRASOUND,$63.00 ,,,,
UMBILICAL ARTERY CATH,$107.50 ,,,,
Umbilical Artery Catheter,$114.50 ,,,,
UNATTENDED ELECTRICAL THERAPY,$25.00 ,,,,
UNLISTED PROCEDURE HUMERUS/ELBOW CHARGE,$352.50 ,,,,
UNNABOOT (VISOPASTE),$21.00 ,,,,
Unnaboot application,$251.75 ,,,,
UNNABOOT/GELOICAST 4,$26.75 ,,,,
Upper GI (EGD) w/BA,"$1,590.75 ","$1,232.25 ",,,
Uric Acid,$47.50 ,,,,
"Uric Acid, Urine - mg/day ARUP",$60.00 ,,,,
"Uric Acid, Urine ARUP",$60.00 ,,,,
Urinalysis w/ Microscopic 3,$63.75 ,,,,
URINARY DRAIN BAG,$16.50 ,,,,
URINARY LEG BAG MEDIU,$15.50 ,,,,
Urine Culture,$61.50 ,,,,
Urine Dipstick,$63.75 ,,,,
Urine Drug Screen.,$72.75 ,,,,
URINE METER FOLEY TR 16FR,$91.50 ,,,,
URINE METER W/BAG CNT,$33.75 ,,,,
Urine Micro Albumin,$80.75 ,,,,
Urine Pregnancy Test,$68.00 ,,,,
US Abdomen Complete,$865.25 ,,,,
US Abdomen Limited,$643.50 ,,,,
US Abdomen Limited ED,$643.50 ,,,,
US Abdominal Aorta-Screening,$726.50 ,,,,
US Biophysical Profile,$458.75 ,,,,
US Biopsy Breast Left.,"$2,492.75 ",,,,
US Biopsy Breast Right Addl Lesion.,$142.75 ,,,,
US Biopsy Breast Right.,"$2,492.75 ",,,,
US Biopsy Liver,$671.75 ,,,,
US Biopsy Renal Left,$671.75 ,,,,
US Biopsy Renal Right,$671.75 ,,,,
US Breast Bilateral.,$565.75 ,,,,
US Breast Left.,$565.75 ,,,,
US Breast Right.,$565.75 ,,,,
US Carotid Doppler Bilateral,$966.25 ,,,,
US Drainage Abscess or Cyst,"$1,078.50 ",,,,
US Echo 2D Complete-Stress,"$1,002.00 ",,,,
US Echocardiogram Complete,"$1,267.00 ",,,,
US Echocardiography,$533.25 ,,,,
US Echoencephalogram,$300.75 ,,,,
US Follow Up Study,$403.00 ,,,,
US Guided Abd Paracentesis,"$1,350.00 ",,,,
US Guided Amniocentesis,$118.00 ,,,,
US Guided Asp Cyst Breast Lt Addl.,$515.00 ,,,,
US Guided Asp Cyst Breast Lt.,"$1,053.50 ",,,,
US Guided Asp Cyst Breast Rt Addl.,$515.00 ,,,,
US Guided Asp Cyst Breast Rt.,"$1,053.50 ",,,,
US Guided Asp Cyst Breast.,"$1,053.50 ",,,,
US Guided Thoracentesis,"$1,331.00 ",,,,
US Guided Thyroid Biopsy,$671.75 ,,,,
US Hips Infant Dynamic,$434.25 ,,,,
US Hips Infant Static Limited,$384.00 ,,,,
US Hysterosonogram,$527.50 ,,,,
US LE Arterial Duplex Bilateral,$583.75 ,,,,
US LE Arterial Duplex Left,$393.50 ,,,,
US LE Arterial Duplex Right,$393.50 ,,,,
US LE Venous Duplex Bilateral,"$1,258.25 ",,,,
US LE Venous Duplex Left,$784.25 ,,,,
US LE Venous Duplex Right,$784.25 ,,,,
US Localization,$671.75 ,,,,
US OB < 14 Weeks Single,$637.25 ,,,,
US OB Complete,$637.25 ,,,,
US OB Limited (AFI),$385.75 ,,,,
US Pelvic Complete,$690.50 ,,,,
US Pelvic Limited,$455.00 ,,,,
US Peripheral Flow Study,"$1,258.25 ",,,,
US Renal,$726.50 ,,,,
US Retroper Renal,$726.50 ,,,,
US Scrotum (Contents),$525.00 ,,,,
US Soft Tissue Buttock,$375.00 ,,,,
US Soft Tissue Lower Back,$375.00 ,,,,
US Soft Tissue Lower Extremity,$375.00 ,,,,
US Soft Tissue Neck,$612.00 ,,,,
US Soft Tissue Other Than Neck,$375.00 ,,,,
US Soft Tissue Pelvic Wall,$375.00 ,,,,
US Soft Tissue Perineum,$375.00 ,,,,
US Soft Tissue Upper Extremity,$375.00 ,,,,
US Soft Tissue Abdominal Wall,$375.00 ,,,,
US Soft Tissue Axilla,$375.00 ,,,,
US Soft Tissue Chest Wall,$375.00 ,,,,
US Soft Tissue Groin,$375.00 ,,,,
US Soft Tissue Upper Back,$375.00 ,,,,
US Superficial Mass,$375.00 ,,,,
US Thyroid,$612.00 ,,,,
US Transrectal,$572.25 ,,,,
US TRANSVAGINAL,$594.75 ,,,,
US UE Arterial Duplex Bilateral,$624.75 ,,,,
US UE Arterial Duplex Left,$387.25 ,,,,
US UE Arterial Duplex Right,$387.25 ,,,,
US UE Venous Duplex Bilateral,"$1,258.25 ",,,,
US UE Venous Duplex Left,$784.25 ,,,,
US UE Venous Duplex Right,$784.25 ,,,,
USN INITIAL,$241.25 ,,,,
VAG PREP TRAY,$17.50 ,,,,
Vaginal Delivery Supplies,$348.25 ,,,,
Valproic Acid ARUP,$136.75 ,,,,
Valproic Acid Level,$111.00 ,,,,
vancomycin 1 g IV Inj,$21.25 ,,,,
Vancomycin Lvl Peak,$120.75 ,,,,
Vancomycin Lvl Random,$120.75 ,,,,
Vancomycin Lvl Trough,$120.75 ,,,,
"Varicella-Zoster Virus Ab, IgG ARUP",$100.75 ,,,,
"Varicella-Zoster Virus Ab, IgG ARUP",$100.75 ,,,,
"Varicella-Zoster Virus Antibody, IgM ARUP",$100.75 ,,,,
"Varicella-Zoster Virus Antibody, IgM ARUP",$100.75 ,,,,
Varicella-Zoster Virus by PCR ARUP,$291.50 ,,,,
Vasoactive Intestinal Polypeptide ARUP,$136.00 ,,,,
VASOPNEUMATIC DEVICE,$36.00 ,,,,
vasopressin 20 units/mL Inj Sol,$17.75 ,,,,
"VDRL with Reflex to Titer, Serum ARUP",$48.00 ,,,,
VENIPUNCTURE CUTDOWN < 1 YEAR CHARGE,,,,$188.00 ,
VENIPUNCTURE CUTDOWN >= 1 YEAR CHARGE,,,,$132.50 ,
VENIPUNCTURE NECESSITATING PHYSICIAN SKILL >= 3.0 YEARS OF AGE CHARGE,,,,$70.75 ,
Ventilator Initial,"$1,243.75 ",,,,
Ventilator Management,"$1,065.00 ",,,,
VENTRALEX MEDIUM CIRCLE WITH STRAP,"$2,138.50 ",,,,
VENTRALEX SMALL CIRCLE WITH STRAP,$948.25 ,,,,
Vernal Lab CRP,$96.50 ,,,,
Vernal Lab Uric Acid,$56.75 ,,,,
Versaone Optical Trocar w/fixation cannula,$575.50 ,,,,
Versaone Universal Fixation Cannula,$238.50 ,,,,
VERSAPORT 5-8 W/TROCAR,$547.50 ,,,,
VIGAMOX,$220.50 ,,,,
Vimentin by IHC ARUP,$370.50 ,,,,
Virus Isolation Shell,$149.75 ,,,,
VISCOAT 0.5 ML 40-30 MG/ML,$310.50 ,,,,
visiport plus optical trocar 5-11 mm,$418.50 ,,,,
VITAL CAPACITY SCREEN TEST,$223.75 ,,,,
"Vitamin A (Retinol), Serum or Plasma ARUP",$70.00 ,,,,
"Vitamin B1 (Thiamine), Plasma ARUP",$90.50 ,,,,
"Vitamin B1 (Thiamine), Whole Blood ARUP",$90.50 ,,,,
Vitamin B12 ARUP,$116.00 ,,,,
Vitamin B12 Level,$116.00 ,,,,
Vitamin B6 (Pyridoxal 5-Phosphate) ARUP,$172.00 ,,,,
Vitamin D 25 Hydroxy Level,$145.00 ,,,,
"Vitamin D, 1,25-Dihydroxy ARUP",$134.25 ,,,,
"Vitamin D, 25-Hydroxy ARUP",$145.00 ,,,,
"Vitamin E, Serum or Plasma ARUP",$73.25 ,,,,
"Vitamin K1, Serum ARUP",$233.25 ,,,,
VOICE PROSTHETIC,$418.75 ,,,,
Von Willebrand Factor Activity (RCF) ARUP,$164.00 ,,,,
Von Willebrand Factor Antigen ARUP,$164.00 ,,,,
"von Willebrand Factor, Antigen ARUP",$164.00 ,,,,
Von Willebrand Multimeric Panel ARUP,$451.25 ,,,,
VZV Antibody IgG CSF ARUP,$100.75 ,,,,
VZV Antibody IgG CSF ARUP,$100.75 ,,,,
VZV Antibody IgM CSF ARUP,$100.75 ,,,,
VZV Antibody IgM CSF ARUP,$100.75 ,,,,
WEDGE EXCISION OF SKIN OF NAIL FOLD FOR INGROWN TOENAIL CHARGE,,,,$227.75 ,
WELLNESS PROGRAM,$66.25 ,,,,
"West Nile Virus Ab IgG, Serum ARUP",$75.50 ,,,,
"West Nile Virus Ab IgM, Serum ARUP",$75.50 ,,,,
"West Nile Virus Ab Panel, CSF ARUP",$130.00 ,,,,
"West Nile Virus Ab Panel, Serum ARUP",$90.25 ,,,,
West Nile Virus Antibody IgG CSF ARUP,$144.25 ,,,,
West Nile Virus Antibody IgM CSF ARUP,$144.25 ,,,,
"Western Equine Enceph Ab, IgG, CSF ARUP",$153.75 ,,,,
"Western Equine Enceph Ab, IgM, CSF ARUP",$153.75 ,,,,
WET PREP,$63.25 ,,,,
Wet Prep.,$63.25 ,,,,
WHIRLPOOL.,$73.50 ,,,,
WIRE PASS DRILL 1.5 - TPS,$195.50 ,,,,
WORK HARDENING (2 HOUR),$299.25 ,,,,
Wound Change,$62.75 ,,,,
Wound Culture,$116.00 ,,,,
Wound Culture.,$120.00 ,,,,
WR F/A SPL LG LEFT,$17.75 ,,,,
WR F/A SPL LG LEFT Charge,$17.75 ,,,,
WR F/A SPL LG RIGHT,$18.00 ,,,,
WR F/A SPL MD LEFT,$17.75 ,,,,
WR F/A SPL MD RIGHT,$17.75 ,,,,
WR F/A SPL SM LEFT,$19.25 ,,,,
WR F/A SPL SM RIGHT,$19.50 ,,,,
WR/SPLINT 11  LG LEFT,$27.50 ,,,,
WR/SPLINT 11  MD LEFT,$19.75 ,,,,
WR/SPLINT 11  SM LEFT,$19.50 ,,,,
WR/SPLINT 11 LG RIGHT,$27.50 ,,,,
WR/SPLINT 11 MD RIGHT,$19.75 ,,,,
WR/SPLINT 11 SM RIGHT,$20.25 ,,,,
WR/SPLINT LG LEFT COCKUP,$33.25 ,,,,
WR/SPLINT LG RIGHT COCKUP,$33.00 ,,,,
WR/SPLINT MD LEFT COCKUP,$33.00 ,,,,
WR/SPLINT MD RIGHT COCKUP,$33.00 ,,,,
WR/SPLINT QUICK WTO LEFT,$54.25 ,,,,
WR/SPLINT QUICK WTO RIGHT,$54.25 ,,,,
WR/SPLINT SM LEFT COCKUP,$33.00 ,,,,
WR/SPLINT SM RIGHT COCKUP,$33.00 ,,,,
WR/SPLINT XLG LEFT,$33.00 ,,,,
WR/SPLINT XLG RIGHT,$33.00 ,,,,
WRAPPING/DRESSING CHANGE,$96.00 ,,,,
X-CALIBUR IRRIGATION TUBING SET,$32.75 ,,,,
X-COLLAR,$34.00 ,,,,
XR Abdomen 1 View,$295.00 ,,,,
XR Abdomen 2 View,$455.75 ,,,,
XR Abdomen Series w/ Chest1 View,$459.75 ,,,,
XR AC Joints w/ + w/o weights Bilateral,$368.50 ,,,,
XR Angiography Dialysis,"$2,542.50 ",,,,
XR Ankle Complete Left,$361.25 ,,,,
XR Ankle Complete Right,$361.25 ,,,,
XR Arthrogram Shoulder Left,$840.75 ,,,,
XR Arthrogram Shoulder Right,$840.75 ,,,,
XR Arthrogram Wrist Left,$655.50 ,,,,
XR Arthrogram Wrist Right,$655.50 ,,,,
XR Barium Enema w/ Air Complete,$908.50 ,,,,
XR Bone Age Studies,$214.75 ,,,,
XR Bone Survey Infant,$349.75 ,,,,
XR Bone Survey Long Bone,$783.25 ,,,,
XR Calcaneous Left,$260.00 ,,,,
XR Calcaneous Right,$260.00 ,,,,
XR Chest 1 View,$266.00 ,,,,
XR Chest 2 Views,$333.75 ,,,,
XR Chest 2 Vws w/ Obliques,$353.75 ,,,,
XR Chest 3 Views,$315.50 ,,,,
XR Chest Decubitus,$254.75 ,,,,
XR Child  Nose-Rectum For FB,$394.75 ,,,,
XR Cholangiogram in OR,$779.25 ,,,,
XR Clavicle Left,$290.00 ,,,,
XR Clavicle Right,$290.00 ,,,,
XR Consultation Outside Film w/ Report,$177.75 ,,,,
XR Consultation Outside Film w/Report,$177.75 ,,,,
XR Cystogram Voiding,$535.75 ,,,,
XR Drainage Abscess or Cyst,"$1,078.50 ",,,,
XR Elbow 2 Views Left,$285.75 ,,,,
XR Elbow 2 Views Right,$285.75 ,,,,
XR Elbow Complete Right,$357.00 ,,,,
XR Elbow Complete Right,$357.00 ,,,,
XR Facial Bones < 3 Views,$250.25 ,,,,
XR Facial Bones Minimum 3 Views,$505.25 ,,,,
XR Femur Left,$289.50 ,,,,
XR Femur Right,$289.50 ,,,,
XR Finger 2nd Digit Left,$286.00 ,,,,
XR Finger 2nd Digit Right,$286.00 ,,,,
XR Finger 3rd Digit Left,$286.00 ,,,,
XR Finger 3rd Digit Right,$286.00 ,,,,
XR Finger 4th Digit Left,$286.00 ,,,,
XR Finger 4th Digit Right,$286.00 ,,,,
XR Finger 5th Digit Left,$286.00 ,,,,
XR Finger 5th Digit Right,$286.00 ,,,,
XR Finger Thumb Left,$286.00 ,,,,
XR Finger Thumb Right,$286.00 ,,,,
XR Fistula or Sinus Tract Abscess Study,$574.75 ,,,,
XR Fluoro Barium Enema Single,$753.00 ,,,,
XR Fluoro Esophagus,$530.50 ,,,,
XR Fluoro Guidance for Injection,$77.25 ,,,,
XR Fluoro Guidance for Injection,$53.00 ,,,,
XR Fluoro Modified Esophagram,$696.25 ,,,,
XR Fluoro Upper GI Single,$602.50 ,,,,
XR Fluoro Upper GI Single + KUB,$736.25 ,,,,
XR Fluoroscopy Over 1 Hour,$602.00 ,,,,
XR Fluoroscopy Up to 1 Hour,$602.00 ,,,,
XR Foot 2 Views Left,$287.50 ,,,,
XR Foot 2 Views Right,$287.50 ,,,,
XR Foot Complete Left,$367.25 ,,,,
XR Foot Complete Right,$367.25 ,,,,
XR Forearm 2 Views Left,$311.00 ,,,,
XR Forearm 2 Views Right,$311.00 ,,,,
XR Foreign Body Loc Eye Left,$173.75 ,,,,
XR Foreign Body Loc Eye Right,$173.75 ,,,,
XR Hand Complete Left,$369.75 ,,,,
XR Hand Complete Right,$369.75 ,,,,
XR Hip 1 View Left,$202.00 ,,,,
XR Hip 1 View Right,$202.00 ,,,,
XR Hip Complete Bilateral,$391.75 ,,,,
XR Hip Complete Left,$292.00 ,,,,
XR Hip Complete Right,$292.00 ,,,,
XR Hip Inj for Arth w/o Anesthesia Lt,$55.50 ,,,,
XR Hip Inj for Arth w/o Anesthesia Rt,$55.50 ,,,,
XR Hip Operative Left,$43.00 ,,,,
XR Hip Operative Right,$43.00 ,,,,
XR Humerus Left,$340.75 ,,,,
XR Humerus Right,$340.75 ,,,,
XR Hysterosalpingography,$725.25 ,,,,
XR Intro of GI Tube w/ Fluoro,$632.75 ,,,,
XR IVP,$687.50 ,,,,
XR Knee 3 Views Left,$342.25 ,,,,
XR Knee 3 Views Right,$342.25 ,,,,
XR Knee Complete Left,$411.00 ,,,,
XR Knee Complete Right,$411.00 ,,,,
XR Knee One or Two Views Left,$314.25 ,,,,
XR Knee One or Two Views Right,$314.25 ,,,,
XR Lower Extremity Infant Left,$199.25 ,,,,
XR Lower Extremity Infant Right,$199.25 ,,,,
XR Mandible Complete Minimum 4 Views,$457.25 ,,,,
XR Mandible Partial Less Than 4 Views,$227.50 ,,,,
XR Mastoids Complete Bilateral,$251.50 ,,,,
XR Myelography Lumbosacral,"$1,271.25 ",,,,
XR Nasal Bones Minimum 3 Views,$322.00 ,,,,
XR Neck Soft Tissue,$270.50 ,,,,
XR Orbits Complete Bilateral,$366.75 ,,,,
XR Pelvis + Hips Infant/Child,$140.75 ,,,,
XR Pelvis 1 or 2 Views,$296.25 ,,,,
XR Pelvis Complete Minimum 3 Views,$296.25 ,,,,
XR Retrograde in OR,$863.25 ,,,,
XR Ribs 2 Views Left,$351.25 ,,,,
XR Ribs 2 Views Right,$351.25 ,,,,
XR Ribs 3 Views Bilateral,$362.50 ,,,,
XR Ribs w/ PA Chest Bilateral,$640.50 ,,,,
XR Ribs w/ PA Chest Left,$465.25 ,,,,
XR Ribs w/ PA Chest Right,$465.25 ,,,,
XR Sacroiliac Joints Minimum 3 Views,$392.00 ,,,,
XR Sacrum/Coccyx Minimum 2 Views,$416.75 ,,,,
XR Scapula Left,$309.75 ,,,,
XR Scapula Right,$309.75 ,,,,
XR Scolios Study,$166.25 ,,,,
XR Shoulder 2 Views Left,$408.50 ,,,,
XR Shoulder 2 Views Right,$408.50 ,,,,
XR Sinuses Paranasal < 3 Views,$448.00 ,,,,
XR Sinuses Paranasal Complete,$323.50 ,,,,
XR Skull < 4 Views,$387.50 ,,,,
XR Skull Complete,$433.75 ,,,,
XR Small Bowel Series,$713.75 ,,,,
XR Small Bowel via Enteroclysis Tube,$632.75 ,,,,
XR Spine Cervical + Obl w/ Flext and/or,$614.75 ,,,,
XR Spine Cervical AP/Lat,$375.75 ,,,,
XR Spine Cervical Comp w/ Oblique,$487.75 ,,,,
XR Spine Lumbosacral 2 or 3 Views,$408.50 ,,,,
XR Spine Lumbosacral Bending Only / 4 +,$550.00 ,,,,
XR Spine Lumbosacral Complete w/ Bending,$543.00 ,,,,
XR Spine Thoracic 2 Views,$318.50 ,,,,
XR Spine Thoracic Minimum 4 Views,$435.75 ,,,,
XR Sternoclavicular Joint(s),$350.50 ,,,,
XR Sternum Minimum 2 Views,$355.75 ,,,,
XR Tibia/Fibula Left,$321.00 ,,,,
XR Tibia/Fibula Right,$321.00 ,,,,
XR Toes 2nd Digit Left,$273.75 ,,,,
XR Toes 2nd Digit Right,$273.75 ,,,,
XR Toes 3rd Digit Left,$273.75 ,,,,
XR Toes 3rd Digit Right,$273.75 ,,,,
XR Toes 4th Digit Left,$273.75 ,,,,
XR Toes 4th Digit Right,$273.75 ,,,,
XR Toes 5th Digit Left,$273.75 ,,,,
XR Toes 5th Digit Right,$273.75 ,,,,
XR Toes Great Left,$273.75 ,,,,
XR Toes Great Right,$273.75 ,,,,
XR Upper Extremity Infant Left,$214.75 ,,,,
XR Upper Extremity Infant Right,$214.75 ,,,,
XR Upper GI w/ Air Contrast + KUB,$883.00 ,,,,
XR Upper GI w/ Small Bowel,"$1,068.00 ",,,,
XR Urethrocystography Retrograde,$440.25 ,,,,
XR Wrist 2 Views Left,$234.00 ,,,,
XR Wrist 2 Views Right,$234.00 ,,,,
XR Wrist Complete Left,$342.50 ,,,,
XR Wrist Complete Right,$342.50 ,,,,
ZERO WET Charge,$26.00 ,,,,
"Zinc, Serum ARUP",$62.50 ,,,,
ZOLL PACING ELECTRODE ADULT,$228.75 ,,,,
zzUBMC Epidural Interpretation,$522.25 ,,,,
"ZZZ96365 - IV TX, FIRST HOUR",$359.00 ,,,,
"ZZZ96366 - IV TX, EACH ADDITIONAL HOUR/CRITICAL CARE",$126.75 ,,,,
"ZZZ96368 - IV tx, concurrent infusion",$120.00 ,,,,
zzz96372 - Subq/IM Injection,$95.50 ,,,,
ZZZ96373 - Intra-Arterial injection,$313.50 ,,,,
zzzEsophagogastroduodenoscopy w/wo specimen,"$1,380.25 ","$1,090.50 ",,,
zzzEsophagogastroduodenoscopy with Control of Bleeding,"$1,590.75 ","$1,232.25 ",,,
zzzEsophagogastroduodenoscopy with Dilation of Outlet Obstruction,"$1,590.75 ","$1,232.25 ",,,
zzzEsophagogastroduodenoscopy with Foreign Body Removal,"$1,590.75 ","$1,232.25 ",,,
zzzEsophagogastroduodenoscopy with G-Tube,"$1,380.25 ","$1,090.50 ",,,
zzzEsophagogastroduodenoscopy with hot biopsy forceps,"$1,590.75 ",$130.50 ,,,
zzzEsophagogastroduodenoscopy with Snare,"$1,590.75 ","$1,232.25 ",,,