Service Description CPT Code Charge Type Christiana Facility Price
1/2 OF 25-WEEK MEDICAL WMP PRO Hospital $0.00
1/2 OF FIT4LIFE PROGRAM Hospital $507.00
111 IN DTPA/0.5 MCI A9548 Hospital $922.50
123 IODINE PER 100UC TOT 999UC A9516 Hospital $102.50
123 IODINE,DX,PER MCI(1-4 MCI) A9509 Hospital $540.00
131 IODINE 1 MCI,CAPSULE,TX A9517 Hospital $60.00
133 XENON,DX,PER 10 MCI A9558 Hospital $125.50
17 OH PROG 83498 Hospital $162.00
17-OH PREGNENOLONE 82542 Hospital $185.50
18F SODIUM FLUORIDE,DX,UP TO 3 A9580 Hospital $489.50
25 WEEK MEDICAL WMP Hospital $2,731.00
32 P SODIUM,PER MCI A9563 Hospital $486.00
3D RECONSTRUCTION,INDEPENDENT WORKSTATION,W CT/MRI/US,CONCUR SUPERV,RS&I GLB 76377 Hospital $119.50
3D RECONSTRUCTION,INDEPENDENT WORKSTATION,W CT/MRI/US,CONCUR SUPERV,RS&I GLR 76377 Hospital $262.50
3D RECONSTRUCTION,INDEPENDENT WORKSTATION,W CT/MRI/US,RS&I PFR 76377 Physician $125.00
3D RECONSTRUCTION,NOT INDEPENDENT WORKSTATION,W CT/MRI/US,CONCUR SUPERV,RS&I 76376 Hospital $685.50
5% ALBUMIN 250ML P9045 Hospital $471.00
5' NUCLETOTIDASE 83915 Hospital $83.50
89 STRONTIUM PER MCI A9600 Hospital $3,821.50
99MTC MDP(MEDRONATE),DX,STUDY A9503 Hospital $134.50