Updated: 02/09/2024,,,,,, Facility,CPT,Description,Price,Cash Rate,De-Identified Minimum Amount,De-Identified Maximum STAT Specialty Hospital of Eagle Pass,70030,RADEX EYE DETCJ FB,$347 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70100,RADEX MNDBL PRTL LESS THAN < 4 VIEWS,$462 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70110,RADEX MNDBL COMPL MINIMUM 4 VIEWS,$925 ,$275 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70120,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,$404 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70140,RADEX FACIAL B1S < 3 VIEWS,$622 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70150,RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS,$757 ,$225 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70160,RADEX NSL B1S COMPL MINIMUM 3 VIEWS,$617 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70200,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,$591 ,$175 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70210,"Radiologic examination, sinuses, paranasal, less than 3 views",$522 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70220,RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS,$811 ,$245 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70250,RADEX SKL < 4 VIEWS,$624 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70260,RADEX SKL COMPL MINIMUM 4 VIEWS,$825 ,$250 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70328,RADEX TMPRMAND JT OPN&CLSD MOUTH UNI,$578 ,$175 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70330,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,$673 ,$200 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70336,MRI TEMPOROMANDIBULAR JOINT,"$1,986 ",$595 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70350,CEPHALOGRAM ORTHODONTIC,$676 ,$205 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70360,RADEX OF NECK SOFT TISSUE,$899 ,$270 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70450,CT HEAD/BRN C-MATRL,"$5,381 ","$1,615 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70460,CT HEAD/BRN C+ MATRL,"$5,218 ","$1,565 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70470,CT HEAD/BRN C-/C+,"$4,473 ","$1,340 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70480,CT ORBIT SELLA/POST FOSSA/EAR C-MATRL,"$3,075 ",$920 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70481,CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL,"$6,260 ","$1,880 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70482,CT ORBIT SELLA/POST FOSSA/EAR C-/C+,"$5,138 ","$1,540 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70486,CT SCAN MAXLFCL AREA C-MATRL - SINUS AREA,"$5,060 ","$1,520 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70486,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,"$1,265 ",$380 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70487,CT MAXLFCL AREA C+ MATRL,"$4,304 ","$1,290 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70488,CT MAXLFCL AREA C-/C+,"$2,557 ",$765 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70490,CT SOFT TISS NCK C-MATRL,"$2,652 ",$795 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70491,CT SOFT TISS NCK C+ MATRL,"$6,151 ","$1,845 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70492,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,"$3,106 ",$930 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70496,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,"$3,263 ",$980 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70498,"Computed tomographic angiography, neck, with contrast materi...","$4,730 ","$1,420 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70540,MRI ORBIT FACE &/NECK W/O CONTRAST,"$5,581 ","$1,675 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70542,MRI ORBIT/FACE/NECK C+,"$5,785 ","$1,735 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70543,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,"$5,153 ","$1,545 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70544,MRA HEAD C-MATRL,"$4,773 ","$1,430 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70547,MRA NCK C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70549,MRA NECK W/O &W/CONTRAST MATERIAL,"$5,795 ","$1,740 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70551,MRI BRN BRN STEM C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,70553,MRI BRN BRN STEM C-/C+,"$5,381 ","$1,615 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71010,RADEX CH 1 VIEW FRNT,$787 ,$235 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71020,RADEX CH 2 VIEWS FRNT&LAT,"$1,225 ",$365 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71022,RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ,"$1,149 ",$345 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71030,RADEX CH COMPL MINIMUM 4 VIEWS,"$1,381 ",$415 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71045,RADEX CHEST 1 VIEW,$446 ,$135 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71046,RADEX CHEST 2 VIEWS,$685 ,$205 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71047,RADEX CHEST 3 VIEWS,$548 ,$165 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71048,RADEX CHEST 4+ VIEWS,$470 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71100,RADEX RIBS UNI 2 VIEWS,$695 ,$210 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71101,RADEX RIBS UNI W/POSTEROANT CH 3 VIEWS,$637 ,$190 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71101,RADEX RIBS UNI W/POSTEROANT CH 4 VIEWS,$849 ,$255 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71110,RADEX RIBS BI 3 VIEWS,$672 ,$200 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71111,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,"$1,009 ",$305 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71120,RADEX STERNUM MINIMUM 2 VIEWS,$672 ,$200 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71130,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,"$2,111 ",$635 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71250,CT THORAX W/O CONTRAST MATERIAL,"$5,573 ","$1,670 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71260,CT THORAX C+ MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71270,CT THORAX C-/C+,"$4,758 ","$1,425 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71275,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,"$4,501 ","$1,350 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,71550,MRI CH C-MATRL,"$4,564 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72020,RADEX SPI 1 VIEW SPEC LVL,$518 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72040,RADEX SPI CRV 2/3 VIEWS,$677 ,$205 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72050,RADEX SPI CRV MINIMUM 4 VIEWS,"$1,291 ",$385 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72052,RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS,"$1,107 ",$330 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72069,RADEX SPI THORACOLMBR STANDING SCOLIOSIS,$492 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72070,RADEX SPI THRC 2 VIEWS,$714 ,$215 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72072,RADEX SPI THRC 3 VIEWS,$730 ,$220 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72074,RADEX SPI THRC MINIMUM 4 VIEWS,$705 ,$210 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72080,X RAY EXAM TRUNK SPINE 2VWS,$365 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72081,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,$434 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72082,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,$701 ,$210 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72083,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,$844 ,$255 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72084,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,$983 ,$295 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72100,RADEX SPI LUMBOSAC 2/3 VIEWS,$769 ,$230 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72110,LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS,"$1,307 ",$390 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72114,RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS,$769 ,$230 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72120,RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS,$730 ,$220 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72125,CT CRV SPI C-MATRL,"$4,041 ","$1,210 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72126,CT CRV SPI C+ MATRL,"$3,130 ",$940 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72127,CT CRV SPI C-/C+,"$7,909 ","$2,375 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72128,CT THRC SPI C-MATRL,"$5,877 ","$1,765 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72129,CT THRC SPI C+ MATRL,"$6,260 ","$1,880 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72130,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,"$2,307 ",$690 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72131,CT LUMBAR SPINE W/O CONTRAST MATERIAL,"$4,813 ","$1,445 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72132,CT LMBR SPI C+ MATRL,"$5,993 ","$1,800 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72133,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,"$5,678 ","$1,705 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72141,MRI SPI CANAL&CNTS CRV C-MATRL,"$4,919 ","$1,475 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72146,MRI SPI CANAL&CNTS THRC C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72148,MRI SPI CANAL&CNTS LMBR C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72150,72150,$0 ,$0 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72156,MRI SPI CANAL&CNTS C-/C+ CRV,"$5,381 ","$1,615 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72157,MRI SPI CANAL&CNTS C-/C+,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72158,MRI SPI CANAL&CNTS C-/C+ LMBR,"$4,612 ","$1,385 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72170,RADEX PELVIS 1/2 VIEWS,$625 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72175,"Computed tomography, cervical spine; without contrast materi...","$1,103 ",$330 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72190,RADEX PELVIS COMPL MINIMUM 3 VIEWS,$572 ,$170 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72191,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,"$3,978 ","$1,195 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72192,CT PELVIS C-MATRL,"$7,321 ","$2,195 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72193,CT PELVIS C+ MATRL,"$4,830 ","$1,450 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72194,CT PELVIS C-/C+,"$6,651 ","$1,995 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72195,MRI PELVIS C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72196,MRI PELVIS C+ MATRL,"$6,149 ","$1,845 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72197,MRI PELVIS W/O & W/CONTRAST MATERIAL,"$5,173 ","$1,550 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72200,RADEX SACROILIAC JNTS <3 VIEWS,"$1,652 ",$495 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72220,RADEX SACRUM&COCCYX MINIMUM 2 VIEWS,$467 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72255,MYELOGRAPY THRC RS&I,"$3,458 ","$1,035 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,72265,MYELOGRAPY LUMBOSAC RS&I,"$3,843 ","$1,155 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73000,RADEX CLAV COMPL,$735 ,$220 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73010,RADEX SCAPULA COMPL,$531 ,$160 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73020,RADEX SHO 1 VIEW,$381 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73030,RADEX SHO COMPL MINIMUM 2 VIEWS,$643 ,$195 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73050,RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ,$489 ,$145 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73060,RADEX HUM MINIMUM 2 VIEWS,$605 ,$180 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73070,RADEX ELBW 2 VIEWS,$617 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73080,RADEX ELBW COMPL MINIMUM 3 VIEWS,$444 ,$135 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73090,RADEX F/ARM 2 VIEWS,$461 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73092,RADEX UXTR INFT MINIMUM 2 VIEWS,$332 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73100,RADEX WRST 2 VIEWS,$498 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73110,RADEX WRST COMPL MINIMUM 3 VIEWS,$604 ,$180 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73120,RADEX HAND 2 VIEWS,$530 ,$160 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73130,RADEX HAND MINIMUM 3 VIEWS,$548 ,$165 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73140,RADEX Fingers MINIMUM 2 VIEWS,$469 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73200,CT UXTR C-MATRL,"$3,852 ","$1,155 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73200,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,$963 ,$290 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73201,CT UPPER EXT W/DYE,"$2,317 ",$695 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73202,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,"$2,111 ",$635 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73206,CT ANGIOGRPHY W/WO CONTRAST UPPER EXTREMITY,"$3,809 ","$1,145 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73218,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,"$4,657 ","$1,395 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73220,MRI UXTR OTH/THN JT C-/C+,"$5,381 ","$1,615 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73221,MRI ANY JT UXTR C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73223,MRI ANY JT UXTR C-/C+,"$5,132 ","$1,540 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73500,(*DELETED 1/1/16*) RADEX HIP UNI 1 VIEW,$427 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73501,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,$612 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73502,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,$600 ,$180 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73503,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,$750 ,$225 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73510,(*DELETED 1/1/16*) RADEX HIP UNI COMPL MINIMUM 2 VIEWS,$627 ,$190 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73520,(DELETED 1/1/16) RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS,$836 ,$250 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73521,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,$459 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73522,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,"$1,134 ",$340 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73523,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,$486 ,$145 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73540,"Radiologic examination, pelvis and hips, infant or child, mi...",$397 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73550,RADEX FEMUR 2 VIEWS (DELETED CODE),$820 ,$245 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73551,X-RAY EXAM OF FEMUR 1V,$646 ,$195 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73552,"RADEX, Femur; 2V","$1,251 ",$375 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73560,RADEX KNE 1/2 VIEWS,$515 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73562,RADEX KNE 3 VIEWS,$686 ,$205 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73564,RADEX KNE COMPL 4/MORE VIEWS,$518 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73565,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,$402 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73590,RADEX TIBFIB 2 VIEWS,$626 ,$190 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73592,RADEX LXTR INFT MINIMUM 2 VIEWS,$393 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73600,RADEX ANKLE 2 VIEWS,$617 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73610,RADEX ANKLE COMPL MINIMUM 3 VIEWS,$638 ,$190 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73620,RADEX FOOT 2 VIEWS,$504 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73630,RADEX FOOT COMPL MINIMUM 3 VIEWS,$707 ,$210 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73650,RADEX CALCANEUS MINIMUM 2 VIEWS,$528 ,$160 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73660,RADEX TOE MINIMUM 2 VIEWS,$384 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73700,CT LXTR C-MATRL,"$4,025 ","$1,205 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73701,CT LXTR C+ MATRL,"$6,651 ","$1,995 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73702,CT LOWER EXTREMITY C-/C+,"$3,867 ","$1,160 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73706,CT ANGIOGRAPHY LOWER EXTREMITY,"$4,573 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73718,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,"$5,514 ","$1,655 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73720,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; C-/C+","$7,621 ","$2,285 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73721,MRI ANY JT LXTR C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73722,MRI ANY JT LXTR C+ MATRL,"$4,052 ","$1,215 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73723,MRI ANY JT LXTR C-/C+,"$6,651 ","$1,995 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,73725,MRA LXTR C+-MATRL,"$6,149 ","$1,845 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74000,RADEX ABD 1 ANTEROPOST VIEW,"$1,999 ",$600 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74010,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,"$1,122 ",$335 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74018,RADEX ABD 1 VIEW,$613 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74019,RADEX ABD 2 VIEWS,$749 ,$225 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74020,RADEX ABD COMPL W/DCBTS&/ERC VIEWS,$748 ,$225 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74021,RADEX ABD 3+ VIEWS,$547 ,$165 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74022,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,$751 ,$225 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74150,CT ABD C-MATRL,"$5,736 ","$1,720 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74160,CT ABD C+ MATRL,"$6,744 ","$2,025 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74170,CT ABD C-/C+,"$4,966 ","$1,490 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74174,CT ANGIO ABD&PELV W/ O&W / DYE,"$2,929 ",$880 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74175,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,"$4,258 ","$1,275 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74176,Ct Abd & pelvis W/o Contrast,"$4,612 ","$1,385 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74177,Ct Abdomen&pelvis W/contrast,"$6,764 ","$2,030 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74177,CT ABDOEN & PELVIS W/CONTRAST MATERIAL,"$1,691 ",$505 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74178,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,"$7,957 ","$2,385 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74178,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,"$1,989 ",$595 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74181,MRI ABD C-MATRL,"$4,565 ","$1,370 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74183,MRI ABD C-/C+,"$5,381 ","$1,615 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74185,MRA ABDOMEN W/WO CONTRAST MATERIAL,"$5,816 ","$1,745 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74210,Radiologic examination; pharynx a/o cervical esophagus,"$2,067 ",$620 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74210,Radiologic examination; pharynx a/o cervical esophagus,"$2,170 ",$650 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74220,ESOPHOGRAM/ CONTRAST X-RAY ESOPHAGUS,"$1,152 ",$345 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74241,RADEX GI TRC UPR +-DLYD FLMS W/KUB,"$1,643 ",$495 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74247,RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB,"$1,329 ",$400 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74400,"Urography (pyelography), intravenous, with or without KUB, w...","$1,597 ",$480 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,74450,URETHROCYSTOGRAPHY RETROGRADE RS&I,$375 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,75635,CT ANGIO ABDOMINAL ARTERIES,"$3,011 ",$905 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76010,RADEX FROM NOSE RECTUM FB 1 VIEW CHLD,$344 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76376,3D RNDR I&R CT MRI US/OTH X REQ POSTPCX,"$1,691 ",$505 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76380,CT LIMITED/LOCALIZED FOLLOW UP STUDY,"$1,637 ",$490 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76512,OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,"$1,061 ",$320 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76536,US SOFT TISS HEAD&NCK R-T IMG,"$1,314 ",$395 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76604,US CHEST REAL TIME W/IMAGE DOCUMENTATION,"$1,243 ",$375 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76641,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,"$1,209 ",$365 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76642,US BREAST UNI REAL TIME WITH IMAGE LIMITED,"$1,036 ",$310 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76645,(DO NOT USE)US BREAST R-T W/IMAGE DOCUMENTATION,$861 ,$260 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76700,US ABDOMINAL R-T W/IMAGE DOCUMENTATION,"$1,903 ",$570 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76705,ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED,"$1,692 ",$510 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76706,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,$850 ,$255 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76770,US RETROPERITONEAL R-T W/IMAGE COMPL,"$1,372 ",$410 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76775,US RPR B-SCAN&/R-T IMG LMTD,"$1,235 ",$370 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76801,ULTRASOUND 14 WK TABDL 1/1ST GESTATION,$956 ,$285 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76802,US PREG UTERUS 14 WK TRANSABDL EACH ADDL GESTATION,$763 ,$230 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76805,ULTRASOUND AFTER 1ST TRI 1/1ST GESTATION,"$1,089 ",$325 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76810,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,"$1,099 ",$330 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76813,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,"$1,425 ",$430 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76814,"Ultrasound, pregnant uterus, real time with image documentat...",$410 ,$125 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76815,US PREGNANT UTERUS LIMITED 1/> FETUSES,"$1,237 ",$370 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76816,"Ultrasound, pregnant uterus, real time with image documentat...",$781 ,$235 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76817,US PG UTER R-T IMG TRVG,$991 ,$295 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76827,"DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE; Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete",$450 ,$135 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76830,US TRVG,"$1,190 ",$355 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76856,US PELVIC NONOB REAL-TIME IMG COMPLETE,"$1,382 ",$415 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76857,US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97,"$1,153 ",$345 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76870,US SCROTUM&CNTS,"$1,255 ",$375 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76880,US EXTREMITY NON-VASC REAL-TIME IMG,"$1,202 ",$360 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76881,US EXTREMITY NON-VASC REAL-TIME IMG COMPL,$888 ,$265 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76882,US EXTREMITY NON-VASC REAL-TIME IMG LMTD,$359 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76937,US GUIDE VASCULAR ACCESS,"$1,123 ",$335 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76942,US GUIDANCE NEEDLE PLACEMENT IMG S&I,$678 ,$205 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76942,US GUIDANCE NEEDLE PLACEMENT IMG S&I,"$1,357 ",$405 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,76999,UNLISTED US PROCEDURE,"$1,100 ",$330 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,77074,"Radiologic examination, osseous survey; limited (eg, for metastases)",$518 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,77076,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,"$2,164 ",$650 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,77077,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,"$2,143 ",$645 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,77079,CT BONE MINERAL DENSITY STUDY 1+ SITS APPND,$673 ,$200 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78075,ADRNL IMG CORTEX&/MEDULLA,"$4,766 ","$1,430 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78223,HIDA SCAN - HEPATBL DUX SYS IMG GLBLDR,"$3,305 ",$990 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78306,B1&/JT IMG WHBDY,"$2,371 ",$710 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78315,B1&/JT IMG 3 PHASE STD,"$2,371 ",$710 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78320,B1&/JT IMG TOMOG SPECT,"$2,433 ",$730 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78472,CARD BPI GTD =BRM PLNR 1 STD REST/STRS,"$2,686 ",$805 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,78808,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,"$2,767 ",$830 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80010,(DO NOT USE) PIC PANEL LIVER+ 10/BX,$770 ,$230 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80047,BASIC METABOLIC PANEL CALCIUM IONIZED,$370 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80048,BASIC METABOLIC PANEL CALCIUM TOTAL,$391 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80048,PIC PANEL BASIC METABOLIC,$611 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80048,PIC PANEL BASIC METABOLIC,$635 ,$190 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80050,GENERAL HLTH PANEL,"$1,403 ",$420 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80051,ELECTROLYTE PANEL,$403 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80053,COMPRE METAB PANEL,$788 ,$235 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80053,PIC PANEL COMPREHENS METABOLBX,$635 ,$190 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80061,LIPID PANEL,$402 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80069,RENAL FUNCTION PANEL,$391 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80074,AQT HEP PANEL,$798 ,$240 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80076,HEPATC FUNCJ PANEL,$411 ,$125 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80081,OBSTETRIC PANEL,$924 ,$275 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80100,DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX,$303 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80104,DRUG SCRN QUAL 1+ CLASS NONCHROMOTOGRAPHIC EA,$461 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80143,DRUG ASSAY ACETAMINOPHEN,$149 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80156,Carbamazepine; total,$208 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80159,DRUG ASSAY CLOZAPINE,$161 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80162,ASSAY OF DIGOXIN,$116 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80164,Valproic acid (dipropylacetic acid); total ,$194 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80165,DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE,$167 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80170,DRUG SCREEN QUANTITATIVE GENTAMICIN,$202 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80175,DRUG SCREEN QUANTITATIVE LAMOTRIGINE,$181 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80177,DRUG SCREEN QUANTITATIVE LEVETIRACETAM,$182 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80178,LITHIUM,$78 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80179,DRUG ASSAY SALICYLATE,$149 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80183,DRUG SCREEN QUANTITATIVE OXCARBAZEPINE,$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80184,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,$153 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80185,ASSAY OF PHENYTOIN TOTAL,$190 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80196,SALICYLATE,$148 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80197,TACROLIMUS,$461 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80198,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,$175 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80201,Topiramate,$171 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80202,DRUG SCREEN QUANT VANCOMYCIN,$301 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80300,"Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) ",$303 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80301,DRUG SCREEN LIST A SINGLE DRUG CLASS METHOD,$300 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80303,DRUG SCREEN PRSMPTV 1/MULT CLASS METHOD TLC,$300 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80305,DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY,$300 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80307,DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS,$610 ,$185 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80320,DRUG SCREEN QUANTITATIVE ALCOHOLS,$295 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80329,"Analgesics, non-opioid; 1 or 2",$347 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80330,DRUG SCREEN ANALGESICS NON-OPIOID 3-5,$347 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80335,ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2,$295 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80339,"Antiepileptics, not otherwise specified; 1-3",$295 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,80346,DRUG SCREENING BENZODIAZEPINES 1-12,"$1,200 ",$360 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81000,URNLS DIP STICK/TABLET RGNT NON-AUTO MIC,$169 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81001,URINALYSIS - URNLS DIP STICK/TABLET RGNT AUTO MIC,$102 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81002,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC,$169 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81003,URNLS DIP STICK/TABLET RGNT AUTO W/O MIC,$169 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81015,"Urinalysis, microscopic only ",$87 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81025,URINE PREGNANCY TST VIS COLOR CMPRSN METHS,$125 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81206,BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE,$820 ,$245 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81225,CYP2C19 GENE ANALYSIS COMMON VARIANTS,"$2,331 ",$700 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81270,AK2 GENE ANALYSIS P.VAL617PHE VARIANT,$733 ,$220 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,81596,NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR,$722 ,$215 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82000,ACETALDEHYDE BLD,$78 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82003,ACETAMINOPHEN LAB TESTING (DISCONTINUED CODE),$287 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82009,KETONE BODIES SERUM QUALITATIVE,$60 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82010,ACETONE/OTH KETONE BODIES SERUM QUAN,$48 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82024,Adrenocorticotropic hormone (ACTH),$477 ,$145 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82040,ALBUMIN SERUM PLASMA/WHOLE BLOOD,$43 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82043,URINE ALBUMIN QUANTITATIVE,$71 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82055,ALCOHOL ANY SPEC XCPT BRTH,$253 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82075,ALCOHOL BRTH,$133 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82085,ASSAY OF ALDOLASE,$97 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82103,ALPHA-1-ANTITRYPSIN TOTAL,$134 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82105,ALPHA-FETOPROTEIN SERUM,$168 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82135,AMINOLEVULINIC ACID DELTA,$226 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82140,Ammonia,$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82150,AMYLASE,$277 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82175,ASSAY OF ARSENIC,$190 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82180,"Ascorbic acid (Vitamin C), blood",$99 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82190,ATOMIC ABSRPJ SPECTROSCOPY EA ANAL,$162 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82232,BETA-2 MICROGLOBULIN,$162 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82247,BILIRUBIN TOT,$103 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82248,Bilirubin; direct ,$72 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82270,BLD OCLT PROXIDASE ACTV QUAL FECES 1 DETER,$200 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82271,"Blood, occult, by peroxidase activity (eg, guaiac), qualitat...",$28 ,$10 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82272,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,$154 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82274,BLD OCLT FECAL HGB DETER IA QUAL FECES 1-3,$103 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82300,CADMIUM,$236 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82306,VITAMIN D 25 HYDROXY,$214 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82310,CALCIUM TOT,$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82330,Calcium; ionized,$196 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82355,Calculus; qualitative analysis,$166 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82365,Calculus; infrared spectroscopy,$177 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82374,CARBON DIOXIDE,$102 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82375,Carboxyhemoglobin; quantitative,$176 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82378,CARCINOEMBRYONIC ANTIGEN CEA,$234 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82390,CERULOPLASMIN,$107 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82435,CHLORIDE BLD,$84 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82465,CHOLESTEROL SERUM/WHL BLD TOT,$140 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82491,CHROM QUAN COLUMN 1 ANAL NES,$65 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82525,Copper,$99 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82530,CORTISOL FREE,$239 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82533,Cortisol; total (Random),$201 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82540,CREATINE,$90 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82541,COL-CHR/MS QUAL 1 STATIONARY&MOBILE PHASE,$159 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82550,CREATINE KINASE TOT,$231 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82550,TRIAGE CARDIAC PANEL 25/BX,$15 ,$5 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82552,CREATINE KINASE ISOENZYMES,$230 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82553,CKMB - CREATINE KINASE MB FXJ ONLY,$346 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82554,CREATINE KINASE ISOFORMS,$269 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82565,CREATININE BLD,$192 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82570,CREATININE OTHER SOURCE,$64 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82607,CYANOCOBALAMIN,$97 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82626,DEHYDROEPIANDROSTERONE,$253 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82627,Dehydroepiandrosterone-sulfate (DHEA-S),$318 ,$95 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82653,"Elastase, pancreatic (EL-1), fecal; quantitative",$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82656,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative",$92 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82657,NZM ACTV CELLS/TISS NONRADACT SUBSTRATE EA,$195 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82668,Erythropoietin,$150 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82670,ASSAY OF ESTRADIOL,$383 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82672,ASSAY OF ESTROGENS TOTAL,$120 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82679,ASSAY OF ESTRONE,$200 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82705,FAT/LIPIDS FECES QUALITATIVE,$63 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82728,Ferritin,$195 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82746,Folic Acid: Serum,$210 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82784,ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH,$133 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82787,GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,$64 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82800,GASES BLD PH ONLY,$171 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82803,GASES BLD PH CALCULATED O2 SATURATION,$504 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82941,ASSAY OF GASTRIN,$252 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82945,"Glucose, body fluid, other than blood",$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82947,GLUC QUAN BLD,$145 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82948,GLUC BLD RGNT STRIP,$102 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82950,CIPROFLOXACIN .3% O/S 5ML,$24 ,$5 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82951,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,$184 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82962,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,$91 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82963,ASSAY OF GLUCOSIDASE BETA,$295 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82977,GGT - GLUTAMYLTRASE GAMMA,$102 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,82985,ASSAY OF GLYCATED PROTEIN,$168 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83001,Gonadotropin; follicle stimulating hormone (FSH),$266 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83002,GONADOTROPIN LUTEINIZING HORMONE,$265 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83003,ASSAY OF GROWTH HORMONE HUMAN,$167 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83013,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,$674 ,$200 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83036,Hemoglobin; glycosylated (A1C),$85 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83090,ASSAY OF HOMOCYSTEINE,$179 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83498,ASSAY OF HYDROXYPROGESTERONE 17-D,$272 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83516,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP,$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83519,IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY,$185 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83520,IMMUNOASSAY ANALYTE QUANTITATIVE NOS,$189 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83521,"Immunoglobulin light chains (ie, kappa, lambda), free, each",$138 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83525,ASSAY OF INSULIN TOTAL,$163 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83540,Iron,$93 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83550,IRON BNDNG CAP,$211 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83605,Grey Top Lactic Acid Plasma Test,$88 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83615,LDH LACTATE DEHYDROGENASE,$156 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83630,LACTOFERRIN FECAL (QUAL),$269 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83631,LACTOFERRIN FECAL QUANTITATIVE,$242 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83655,ASSAY OF LEAD,$121 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83690,LIPASE,$192 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83718,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,$101 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83721,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,$118 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83735,MAGNESIUM,$208 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83825,ASSAY OF MERCURY QUANTITATIVE,$163 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83873,MYELIN BASIC PROTEIN CEREBROSPINAL FLUID,$212 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83874,MYOGLOBIN,$226 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83880,BNP - B TYPE NATRIURETIC PEPTIDE,$423 ,$125 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83921,ORGANIC ACID 1 QUANTITATIVE,$212 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83930,Osmolality: Blood,$70 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83935,Osmolality: Urine,$70 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83970,ASSAY OF PARATHORMONE,$510 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83986,PH BODY FLUID NOT ELSEWHERE SPECIFIED,$51 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,83993,"Calprotectin, fecal",$98 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84075,"Phosphatase, alkaline;",$45 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84100,Phosphorus inorganic (phosphate,$68 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84110,ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE,$116 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84120,PORPHYRINS URINE QUANTITATION & FRACTIONATION,$202 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84132,POTASSIUM SERUM PLASMA/WHOLE BLOOD,$171 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84134,Prealbumin,$121 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84140,Pregnenolone,$165 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84144,ASSAY OF PROGESTERONE,$286 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84145,Procalcitonin (PCT),$383 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84146,Prolactin,$277 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84152,ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED,$227 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84153,Prostate specific antigen (PSA); total ,$195 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84154,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,$184 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84155,PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,$38 ,$10 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84156,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,$45 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84157,PROTEIN TOT XCPT REFRACTOMETRY OTH SRC,$25 ,$5 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84165,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,$107 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84166,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATION,$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84206,ASSAY OF PROINSULIN,$267 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84207,ASSAY OF PYRIDOXAL PHOSPHATE,$281 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84270,ASSAY OF SEX HORMONE BINDING GLOBULIN,$217 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84295,SODIUM SERUM PLASMA OR WHOLE BLOOD,$93 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84300,ASSAY OF URINE SODIUM,$60 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84305,ASSAY OF SOMATOMEDIN,$213 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84402,Testosterone; free,$349 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84403,Testosterone; total ,$369 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84410,"Testosterone; bioavailable, direct measurement (eg, differential precipitation)",$410 ,$125 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84425,Thiamine (Vitamin B-1),$93 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84432,ASSAY OF THYROGLOBULIN,$161 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84435,Thyroxine; total,$108 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84436,Thyroxine; total,$108 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84439,THYROXINE FR,$211 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84443,TSH - THYR STIMULATING HORM,$346 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84445,THYROID STIMULATING IMMUNE GLOBULINS TSI,$509 ,$155 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84446,Tocopherol alpha (Vitamin E),$58 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84450,TRANSFERASE ASPARTATE AMINO,$197 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84460,TRANSFERASE ALANINE AMINO,$176 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84466,ASSAY OF TRANSFERRIN,$158 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84478,Triglycerides,$90 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84479,THYR HORM UPTK/THYR HORM BNDNG RATIO,$287 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84480,TRIIODOTHYRO9 T3 TOT,$209 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84481,TRIIODOTHYRO9 T3 FR,$269 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84482,Triiodothyronine T3; reverse,$110 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84484,TROPONIN QUAN,$346 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84512,TROPONIN QUAL,$203 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84520,UREA N QUAN,$168 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84550,URIC ACID BLD,$198 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84560,URIC ACID OTH SRC,$180 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84590,VITAMIN A,$58 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84597,Vitamin K,$58 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84630,Zinc,$91 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84681,ASSAY OF C-PEPTIDE,$286 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84702,GONAD CHORNC QUAN,$275 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,84703,Blood pregnancy test HCG,$280 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85007,"Blood count; blood smear, microscopic examination w/ manual differential WBC count",$238 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85014,BLD# HEMATOCRIT,$134 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85018,BLD# HGB,$134 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85025,CBC-BLD# COMPL AUTO HHRWP&AUTO DIFFIAL,$269 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85027,BLD# COMPL AUTO HHRWP,$195 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85032,BLD# MNL C-CNT RBC WBC/PLTLT EA,$201 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85044,BLD# RETICULOCYTE MNL,$132 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85045,"Blood count; reticulocyte, automated",$122 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85048,AUTOMATED LEUKOCYTE COUNT,$36 ,$10 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85049,BLOOD COUNT PLATELET AUTOMATED,$45 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85060,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,$295 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85270,CLOTTING FACTOR XI PTA,$256 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85347,COAGJ TM ACTIVATED,$47 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85378,D-DIMER - FIBRIN DGRADJ PRODUXS D-DIMER QUAL/SEMIQUAN,$198 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85379,FIBRIN DGRADJ PRODUXS D-DIMER QUAN,$416 ,$125 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85380,FIBRIN DGRADJ PRODUXS D-DIMER ULTRSENS,$429 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85384,Fibrinogen: Activity ,$121 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85385,FIBRINOGEN ANTIGEN,$145 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85460,HEMOGLOBIN FETAL (KLEIHAUER-BETKE) ,$96 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85520,Heparin assay,$105 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85610,PT - PROTHROMBIN TIME,$226 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85613,RUSSELL VIPER VENOM TIME DILUTED,$118 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85635,REPTILASE TEST,$99 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85651,SEDIMENTATION RATE RBC NON-AUTO,$192 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85652,SEDIMENTATION RATE RBC AUTO,$123 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85670,THROMBIN TIME PLASMA,$71 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,85730,THROMBOPLASTIN TM PRTL PLSM/WHL BLD,$213 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86000,AGGLUTININS FEBRILE EA AG,$75 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86003,ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH,$52 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86015,"Actin (smooth muscle) antibody (ASMA), each",$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86021,ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES,$215 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86036,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,$96 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86038,Antinuclear antibodies (ANA),$190 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86039,ANTINUCLEAR ANTIBODIES ANA TITER,$160 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86060,ANTISTREPTOLYSIN O TITER,$104 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86140,C-reactive protein,$113 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86141,C-reactive protein; high sensitivity (hsCRP),$204 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86157,COLD AGGLUTININ TITER,$111 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86160,COMPLEMENT ANTIGEN EACH COMPONENT,$165 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86162,COMPLEMENT TOTAL HEMOLYTIC,$258 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86200,"Cyclic citrullinated peptide (CCP), antibody",$176 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86225,DNA ANTIBODY NATIVE/DOUBLE STRANDED,$196 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86235,EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD,$246 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86255,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,$165 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86256,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,$121 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86258,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class",$92 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86300,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,$257 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86301,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,$257 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86304,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,$257 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86308,MONO - HTROPHL ANTIBODIES SCR,$140 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86309,,$39 ,$10 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86318,IA INFECTIOUS AGT ANTIBODY QUAL/SEMI 1 STEP METH,$181 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86325,IMMUNOELECTROPHORESIS OTH FLUS CONCENTRATION,$246 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86328,IA INFECTIOUS AGT ANTIBODY SARS-COV-2 COVID-19,$362 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86334,Immunofixation electrophoresis; serum,$179 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86335,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,$235 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86337,Insulin antibodies,$237 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86341,ISLET CELL ANTIBODY,$237 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86343,LEUKOCYTE HISTAMINE RELEASE TEST LHR,$171 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86356,MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,$211 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86360,LACTOFERRIN FECAL QUALITATIVE,$197 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86361,T CELLS ABSOLUTE CD4 COUNT,$331 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86364,"Tissue transglutaminase, each immunoglobulin (Ig) class",$92 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86374,86374,$169 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86376,MICROSOMAL ANTIBODIES EACH,$208 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86381,"Mitochondrial antibody (eg, M2), each",$255 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86403,PART AGGLUJ SCR EA ANTB,$176 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86430,RHEUMATOID FACTOR QUAL,$97 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86431,RHEUMATOID FACTOR QUANTITATIVE,$81 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86480,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFER,$209 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86481,TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP,"$1,000 ",$300 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86580,SKN TST TUBERCULOSIS ID,$23 ,$5 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86592,SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL,$46 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86593,"Syphilis test, non-treponemal antibody; quantitative",$38 ,$10 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86611,Antibody; Bartonella,$112 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86615,ANTIBODY BORDETELLA,$163 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86617,LYME DISEASE ANTIBODY,$222 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86618,Antibody; Borrelia burgdorferi (Lyme disease) ,$134 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86622,"Antibody: Brucella, ",$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86631,ANTB CHLAMYDIA,$172 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86635,Antibody; Coccidioides,$71 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86638,Antibody: Coxiella burnetii (Q fever),$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86644,ANTIBODY CYTOMEGALOVIRUS CMV,$197 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86645,ANTIBODY CYTOMEGALOVIRUS CMV IGM,$112 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86652," Antibody; encephalitis, Eastern equine",$112 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86654,"Antibody; encephalitis, Western equine",$112 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86658,"Antibody; enterovirus (eg, coxsackie, echo, polio)",$161 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86663,ANTB EPSTEIN-BARR EB VIRUS EARLY AG EA,$324 ,$95 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86664,ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA,$210 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86665,ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,$249 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86666,Antibody; Ehrlichia,$129 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86668,Antibody; Francisella tularensis,$149 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86671,ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED,$151 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86677,Antibody; Helicobacter pylori ,$208 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86689,ANTB HTLV/HIV ANTB CONFIRMATORY TST,$283 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86689,CLEARVIEW HIV CTL LVL 1&2,$260 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86694,ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST,$206 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86695,ANTIBODY HERPES SMPLX TYPE 1,$189 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86696,ANTIBODY HERPES SMPLX TYPE 2,$277 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86701,ANTB HIV-1,$191 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86703,ANTIBODY HIV-1&HIV-2 SINGLE RESULT,$196 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86704,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,$165 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86705,HEP B CORE ANTIBODY IGM,$168 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86706,HEPATITIS B SURF ANTIBODY HBSAB,$154 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86708,HEPATITIS A ANTIBODY HAAB,$177 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86709,HEPATITIS ANTIBODY HAAB IGM ANTIBODY,$161 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86710,ANTB INF VIRUS,$188 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86717,Antibody; Leishmania,$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86720,Antibody: Leptospira,$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86735,ANTIBODY MUMPS,$187 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86756,RSV ANTB,$179 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86756,Antibody; respiratory syncytial virus,$127 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86757,Antibody; Rickettsia ,$305 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86759,Antibody; rotavirus,$115 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86762,Antibody; rubella,$206 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86765,ANTIBODY RUBEOLA,$184 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86769,ANTB SEVERE AQT RESPIR SYND SARS-COV-2 COVID19,$362 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86777,ANTIBODY TOXOPLASMA,$144 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86787,ANTB VARICELLA-ZOSTER,$174 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86788,ANTIBODY WEST NILE VIRUS IGM,$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86789,ANTIBODY WEST NILE VIRUS,$197 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86790,ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED,$112 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86800,THYROGLOBULIN ANTIBODY,$218 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86803,HEPATITIS C ANTIBODY,$204 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86812,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen",$354 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86850,ANTB SCR RBC EA SERUM TQ,$250 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86870,ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,$250 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86880,COOMBS TEST DIRECT,$77 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86886,COOMBS TEST INDIRECT TITER,$74 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86900,"Blood typing, serologic; ABO",$43 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86901,BLD TYPING RH D,$113 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86902,BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH,$64 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,86906,BLD TYPING RH PHEXYPING COMPL,$113 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87015,CONCENTRATION INFECTIOUS AGENTS,$95 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87040,Blood Culture Pedi,$346 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87040,Blood Culture Adult,$346 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87040,BLOOD CULTURE - CUL BACT BLD AERC ISOL,$346 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87045,CUL BACT STL AERC ISOL SALMONELLA&SHIGELLA,$338 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87046,STOOL CULTR AEROBIC BACT EA,$82 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87070,Wound Culture Anaerobes/Aerobes,$251 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87070,CUL BACT XCPT URINE BLD/STL AERC ISOL,$216 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87073,CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL,$117 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87075,CUL BACT BLD ANAERC ISOL,$377 ,$115 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87076,CULTURE ANAEROBE IDENT EACH,$71 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87077,Culture Aerobic Identify,$71 ,$20 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87081,CUL PRSMPTV PTHGNC ORGANISMS SCR,$266 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87084,,$52 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87086,CUL BACT QUAN COLONY CNT URINE,$254 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87088,CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,$53 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87101,CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,$95 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87102,CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD,$120 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87103,CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD,$205 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87109,CULTURE MYCOPLASMA ANY SOURCE,$154 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87110,CUL CHLAMYDIA ANY SRC,$341 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87116,CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL,$133 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87140,CULTURE TYPE IMMUNOFLUORESC,$80 ,$25 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87150,ALL TARGETS (N),$217 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87177,"Ova and parasites, direct smears, concentration and identification",$140 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87205,"Smear, primary source with interpretation; Gram or Giemsa st...",$97 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87207,"Smr, prim src, w/ int; spec stain for inclusion bodies or parasites e.g. Malaria......",$169 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87209,SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,$247 ,$75 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87210,SMR PRIM SRC WET MOUNT NFCT AGT,$121 ,$35 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87230,TOXIN/ANTITOXIN ASSAY TISSUE CULTURE,$282 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87252,VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,$358 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87254,VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA,$242 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87255,GENET VIRUS ISOLATE HSV,$465 ,$140 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87265,IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS,$189 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87272,IAADI CRYPTOSPORIDIUM,$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87273,IAADI HERPES SMPLX VIRUS TYPE 2,$171 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87274,HERPES SIMPLEX 1 AG,$100 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87278,LEGION PNEUMOPHILIA AG IF,$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87280,Infectious agent antigen detection by immunofluorescent tech...,$131 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87290,IAADI VARICELLA ZOSTER VIRUS,$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87324,CLOSTRIDIUM AG EIA,$189 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87327,Infectious agent antigen detection .... Cryptococcus neoformans,$94 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87329,IAAD IA GIARDIA,$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87335,IAAD IA ESCHERICHIA COLI 0157,$148 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87337,IAAD IA ENTAMOEBA HISTOLYTICA GRP,$148 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87338,HPYLORI STOOL AG IA,$207 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87340,IAAD IA HEPATITIS B SURFACE ANTIGEN,$148 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87389,Infectious agent antigen detection by enzyme immunoassay tec...,$196 ,$60 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87390,,$106 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87400,INFLUENZA B,$229 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87400,INFLUENZA A,$229 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87420,IAAD EIA RSV,$130 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87425,IAAD IA ROTAVIRUS,$171 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87427,IAAD IA SHIGA-LIKE TOXIN,$148 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87430,IAAD EIA STREPTOCOCCUS GROUP A,$309 ,$95 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87430,IAAD EIA STREPTOCOCCUS GROUP A,$439 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87430,STREP A QUICKVIEW INLINE 25B,$418 ,$125 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87449,IAAD IA MULT STEP METHOD NOS EACH ORGANISM,$148 ,$45 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87476,IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ,$351 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87480,IADNA CANDIDA SPECIES DIRECT PROBE TQ,$275 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87481,IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ,$433 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87483,CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,"$2,859 ",$860 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87483,CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,"$2,573 ",$770 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87486,CHLAMYDOPHILA,$325 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87490,IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ,$287 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87491,"Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe technique",$276 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87493,INF AGENT DET NUC ACID CLOSTRIDIUM AMP PROBE,$260 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87496,IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ,$433 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87498,IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP,$481 ,$145 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87502,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,$958 ,$285 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87507,IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25,"$2,859 ",$860 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87507,IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25,"$2,573 ",$770 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87510,IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ,$275 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87517,IADNA HEPATITIS B VIRUS QUANTIFICATION,$428 ,$130 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87522,IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION,$406 ,$120 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87528,IADNA HERPES SMPLX VIRUS DIR PRB,$316 ,$95 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87529,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,$502 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87536,IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION,$851 ,$255 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87581,MYCOPLASMA PNEUMONIAE,$325 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87590,IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ,$287 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87591,IADNA NEISSERIA GONORRHOEAE AMP PRB,$273 ,$80 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87592,IADNA NEISSERIA GONORRHOEAE QUAN,$184 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87621,Infectious agent detection by nucleic acid (DNA or RNA); pap...,$227 ,$70 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87631,IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS,"$1,426 ",$430 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87633,IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,"$5,717 ","$1,715 ",Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87633,IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,"$2,573 ",$770 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87635,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,$499 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87636,IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ,$950 ,$285 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87641,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique",$502 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87651,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,$351 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87660,IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ,$275 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87661,IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH,$481 ,$145 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87798,IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM,$502 ,$150 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87798,BORDETELLA PERTUSSIS,$325 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87798,BORDETELLA PERTUSSIS,$325 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87798,BORDETELLA PARAPETUSSIS,$325 ,$100 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87801,IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,"$1,004 ",$300 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87802,IAADIADOO STREPTOCOCCUS GROUP B,$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87803,CLOSTRIDIUM TOXIN A W/OPTIC,$189 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87804,IAADIADOO INFLUENZA A/B EACH,$223 ,$65 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87806,IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES,$344 ,$105 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87807,IAADIADOO RSV,$55 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87810,CHYLMD TRACH ASSAY W/OPTIC (Urine),$164 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87850,IAADIADOO NEISSERIA GONORRHOEAE,$172 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87880,IAADIADOO STREPTOCOCCUS GRP,$188 ,$55 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87899,IAADIADOO NOT OTHERWISE SPECIFIED,$161 ,$50 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,87905,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)",$98 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88112,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,$713 ,$215 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88141,"Cytopathology, cervical or vaginal",$297 ,$90 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88233,TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX,"$1,930 ",$580 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88262,CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING,"$1,710 ",$515 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88291,CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP,$366 ,$110 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88305,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,$778 ,$235 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,88346,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,"$1,059 ",$320 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,89050,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, jt fluid), except blood",$102 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,89051,"Cell count, miscellaneous body fluids (eg, cerebrospinal flu...",$48 ,$15 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,89055,Leukocyte assessment,$37 ,$10 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,89060,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,$102 ,$30 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,89220,SPTM OBTG SPEC AERSL INDUCED SPX,$128 ,$40 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,99201,OFFICE OUTPATIENT NEW 10 MINUTES,$285 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,99202,OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES,$285 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,99212,OFFICE OUTPATIENT VISIT 10 MINUTES,$278 ,$85 ,Out of Network,Out of Network STAT Specialty Hospital of Eagle Pass,U0003,Infectious agent detection by nucleic acid (DNA or RNA); sev,$499 ,$150 ,Out of Network,Out of Network