|
Established Patient Office Visit (level 2)
|
$78.97 |
$78.97 |
$599.02 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$119.31 |
$119.31 |
$1,202.12 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$269.87 |
$269.87 |
$1,854.12 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$260.03 |
$260.03 |
$2,612.07 |
$290.68
|
|
Estradiol total
|
$13.94 |
$13.94 |
$409.10 |
$152.10
|
|
Estrogens total-sendout
|
$10.96 |
$10.96 |
$10.96 |
$97.50
|
|
Ethylene glycol -sendout
|
$13.45 |
$13.45 |
$51.42 |
$86.04
|
|
Etoposide 20 mg/ml intravenous solution
|
$15.50 |
$15.50 |
$15.50 |
$235.20
|
|
Euglobulin lysis
|
$4.50 |
$4.50 |
$4.50 |
$63.84
|
|
Eval/fit voice prosthesis iii, st
|
$209.16 |
$209.16 |
$209.16 |
$359.50
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$48.97 |
$48.97 |
$92.25 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$160.76 |
$160.76 |
$160.76 |
$302.50
|
|
Evasc prlng admn rx agnt 1st
|
$1,952.51 |
$1,952.51 |
$2,216.23 |
$4,031.48
|
|
Evasc prlng admn rx agnt add
|
$945.25 |
$945.25 |
$976.38 |
$2,803.24
|
|
Evasc rpr a-ao ndgft 34701
|
$3,917.80 |
$3,917.80 |
$3,917.80 |
$5,403.50
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$6,379.03 |
$6,379.03 |
$6,379.03 |
$4,577.00
|
|
Evasc rpr a-biiliac ndgft rptr
|
$8,202.38 |
$8,202.38 |
$8,202.38 |
$8,565.60
|
|
Evasc rpr a-unilac ndgft 34703
|
$6,491.70 |
$6,491.70 |
$6,491.70 |
$5,741.00
|
|
Evasc rpr a-unilac ndgft rpt
|
$8,228.21 |
$8,228.21 |
$8,228.21 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$4,093.94 |
$4,093.94 |
$4,093.94 |
$7,060.51
|
|
Evasc rpr ilio-iliac rpt
|
$6,588.62 |
$6,588.62 |
$6,588.62 |
$7,922.00
|
|
Evoked potentials auditory screening automated analysis
|
$314.67 |
$314.67 |
$314.67 |
$261.30
|
|
Evoked potentials upper limbs
|
$424.97 |
$424.97 |
$424.97 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$357.07 |
$357.07 |
$357.07 |
$814.61
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$358.43 |
$358.43 |
$358.43 |
$779.35
|
|
Exchange biliary drg cath
|
$1,106.12 |
$1,106.12 |
$3,125.19 |
$3,856.84
|
|
Exchange drainage catheter
|
$802.50 |
$802.50 |
$984.00 |
$2,220.54
|
|
Exchange nephrostomy cath
|
$1,310.58 |
$1,310.58 |
$1,326.19 |
$2,958.80
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$5,115.57 |
$5,115.57 |
$5,115.57 |
$2,421.09
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$3,934.04 |
$3,934.04 |
$4,168.50 |
$4,101.67
|
|
Expose art endoprosth iliac 34820
|
$2,175.87 |
$2,175.87 |
$2,175.87 |
$1,812.80
|
|
Expose endoprosth brachial 34834
|
$154.49 |
$154.49 |
$154.49 |
$1,888.20
|
|
External cannula declotting
|
$1,241.82 |
$1,241.82 |
$1,241.82 |
$1,838.28
|
|
External chromosome analysis 20-25 cells
|
$226.18 |
$226.18 |
$226.18 |
$415.01
|
|
External newborn metabolic screening panel
|
$40.26 |
$40.26 |
$168.27 |
$109.76
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$7.79 |
$7.79 |
$25.59 |
$63.70
|
|
External recharg sys intern
|
$1,789.16 |
$1,789.16 |
$1,836.16 |
$2,931.16
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$141.45 |
$141.45 |
$245.33 |
$457.07
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$19.11 |
$19.11 |
$78.23 |
$109.00
|
|
Extrnl counterpulse, per tx
|
$350.86 |
$350.86 |
$350.86 |
$431.60
|
|
Eye Socket (Orbit) X-ray
|
$128.60 |
$128.60 |
$233.21 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$434.42 |
$434.42 |
$1,282.16 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$362.06 |
$362.06 |
$1,187.20 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$289.56 |
$289.56 |
$1,009.10 |
$1,320.00
|
|
F-18 fdg pet diag
|
$875.38 |
$875.38 |
$875.38 |
$551.72
|
|
F-18 fluciclovine per mci
|
$236.40 |
$236.40 |
$236.40 |
$1,042.30
|
|
F-18 sodium fluoride
|
$241.03 |
$241.03 |
$241.03 |
$492.56
|
|
F9 full gene sequence
|
$318.60 |
$318.60 |
$318.60 |
$1,200.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$518.67 |
$518.67 |
$1,689.53 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$345.78 |
$345.78 |
$760.39 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$94.45 |
$94.45 |
$220.42 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$104.25 |
$104.25 |
$279.71 |
$381.75
|
|
Factor ix
|
$13.67 |
$13.67 |
$166.05 |
$162.50
|
|
Factor ix complex
|
$1.97 |
$1.97 |
$1.97 |
$4.68
|
|
Factor viii
|
$19.72 |
$19.72 |
$148.34 |
$148.00
|
|
Factor viii recombinant nos
|
$4.68 |
$4.68 |
$4.68 |
$5.20
|
|
Fallopian tube recnl
|
$1,160.46 |
$1,160.46 |
$1,160.46 |
$3,740.75
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$13.29 |
$13.29 |
$13.29 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$23.85 |
$23.85 |
$23.85 |
$5,894.50
|
|
Fancc gene
|
$36.04 |
$36.04 |
$60.36 |
$140.00
|
|
Fat/lipids feces qualitative
|
$5.02 |
$5.02 |
$11.29 |
$36.00
|
|
Fatty acids nonesterified
|
$11.45 |
$11.45 |
$18.47 |
$72.15
|
|
#fecal-sodium
|
$9.63 |
$9.63 |
$34.69 |
$37.53
|
|
Feeding tube reposition
|
$279.18 |
$279.18 |
$279.18 |
$520.00
|
|
Fees w/laryngeal sense test
|
$144.20 |
$144.20 |
$144.20 |
$471.00
|
|
Felbamate (felbatol(r)) - sendout
|
$12.28 |
$12.28 |
$18.35 |
$66.43
|
|
Femoral endovas graft add-on 34813
|
$282.90 |
$282.90 |
$282.90 |
$1,245.40
|
|
Fem/popl revasc w/stent
|
$8,162.82 |
$8,162.82 |
$9,459.69 |
$16,129.60
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$86.10 |
$86.10 |
$86.10 |
$101.40
|
|
Fern test
|
$10.96 |
$10.96 |
$17.72 |
$37.03
|
|
Ferritin
|
$36.85 |
$36.85 |
$89.30 |
$102.48
|
|
Fetal biophys profile w/nst 76818
|
$336.66 |
$336.66 |
$572.69 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$780.56 |
$780.56 |
$780.56 |
$477.50
|
|
Fetal fibronectin
|
$32.20 |
$32.20 |
$279.95 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$10.21 |
$10.21 |
$102.09 |
$102.00
|
|
Fetal hemoglobin rosette
|
$5.02 |
$5.02 |
$54.86 |
$67.20
|
|
Fetal non stress test
|
$241.82 |
$241.82 |
$534.60 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$11.12 |
$11.12 |
$11.12 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$55.36 |
$55.36 |
$189.42 |
$120.64
|
|
Fibrin degradation products
|
$13.84 |
$13.84 |
$118.33 |
$75.02
|
|
Fibrinogen activity
|
$37.02 |
$37.02 |
$83.89 |
$87.00
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$25.43 |
$25.43 |
$49.20 |
$61.00
|
|
Fibrinolytic antiplasmin
|
$4.15 |
$4.15 |
$34.75 |
$72.80
|
|
Fibrinolytic plasminogen
|
$14.53 |
$14.53 |
$16.92 |
$107.50
|
|
Fibrinolytic plasminogen
|
$5.36 |
$5.36 |
$5.36 |
$103.60
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$6.43 |
$6.43 |
$12.28 |
$66.60
|
|
Filter spider fx 3mmx320cm
|
$6,571.20 |
$6,571.20 |
$8,648.63 |
$7,358.16
|
|
Filter vena cava fem denali
|
$2,779.50 |
$2,779.50 |
$5,115.57 |
$3,718.18
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$752.15 |
$752.15 |
$752.15 |
$1,081.52
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$656.67 |
$656.67 |
$656.67 |
$694.14
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$399.41 |
$399.41 |
$399.41 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$411.32 |
$411.32 |
$437.47 |
$504.45
|
|
Finger X-ray (both hands)
|
$77.22 |
$77.22 |
$77.22 |
$241.50
|
|
Fix g/colon tube w/device
|
$206.00 |
$206.00 |
$206.00 |
$1,183.00
|
|
Flecainide (tambocor)-sendout
|
$11.29 |
$11.29 |
$18.35 |
$65.65
|
|
Fl exam g/colon tube w contrast
|
$111.75 |
$111.75 |
$668.88 |
$540.80
|
|
Flotufolastat f18 diag 1 mci
|
$571.84 |
$571.84 |
$571.84 |
$2,091.04
|
|
Flow cytometry marker each additional
|
$54.50 |
$54.50 |
$116.90 |
$97.50
|
|
Flow cytometry one marker technical component
|
$141.73 |
$141.73 |
$377.37 |
$285.00
|
|
Flt3 gene
|
$141.25 |
$141.25 |
$162.87 |
$366.29
|
