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 $526.50
111 IN DTPA/0.5 MCI A9548 Hospital $957.50
123 IODINE PER 100UC TOT 999UC A9516 Hospital $106.50
123 IODINE,DX,PER MCI(1-4 MCI) A9509 Hospital $560.50
131 IODINE 1 MCI,CAPSULE,TX A9517 Hospital $62.50
133 XENON,DX,PER 10 MCI A9558 Hospital $130.50
17 OH PROG 83498 Hospital $168.00
17-OH PREGNENOLONE 82542 Hospital $192.50
18F SODIUM FLUORIDE,DX,UP TO 3 A9580 Hospital $508.00
25 WEEK MEDICAL WMP Hospital $2,835.00
32 P SODIUM,PER MCI A9563 Hospital $504.50
3D RECONSTRUCTION,INDEPENDENT WORKSTATION,W CT/MRI/US,CONCUR SUPERV,RS&I GLB 76377 Hospital $130.00
3D RECONSTRUCTION,INDEPENDENT WORKSTATION,W CT/MRI/US,CONCUR SUPERV,RS&I GLR 76377 Hospital $130.00
3D RECONSTRUCTION,INDEPENDENT WORKSTATION,W CT/MRI/US,RS&I PFR 76377 Physician $130.00
3D RECONSTRUCTION,NOT INDEPENDENT WORKSTATION,W CT/MRI/US,CONCUR SUPERV,RS&I 76376 Hospital $711.50
5% ALBUMIN 250ML P9045 Hospital $489.00
5' NUCLETOTIDASE 83915 Hospital $86.50
80047 BMP BASIC METABOLIC PANEL,CALCIUM,IONIZED 80047 Hospital $273.00
80048 BMP CA BMP, BASIC METABOLIC PANEL,CALCIUM,TOTAL 80048 Hospital $233.50