|
Established Patient Office Visit (level 5)
|
$107.80 |
$107.80 |
$107.80 |
$280.33
|
|
Estradiol total
|
$130.24 |
$130.24 |
$130.24 |
$146.50
|
|
Estrogens total-sendout
|
$5.72 |
$5.72 |
$5.72 |
$96.20
|
|
Ethanolamine oleate 100 mg
|
$322.77 |
$322.77 |
$322.77 |
$751.36
|
|
Etoposide 20 mg/ml intravenous solution
|
$1.36 |
$1.36 |
$1.36 |
$235.20
|
|
Evacuate mole of uterus
|
$348.92 |
$348.92 |
$348.92 |
$3,762.53
|
|
Eval/fit voice prosthesis iii, st
|
$224.62 |
$224.62 |
$224.62 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$100.32 |
$100.32 |
$100.32 |
$219.60
|
|
Evaluation heart device
|
$521.18 |
$521.18 |
$521.18 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$141.90 |
$141.90 |
$141.90 |
$311.50
|
|
Evasc rpr a-ao ndgft 34701
|
$5,340.06 |
$5,340.06 |
$5,340.06 |
$5,230.40
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$8,618.72 |
$8,618.72 |
$8,618.72 |
$4,670.40
|
|
Event monitor
|
$98.12 |
$98.12 |
$98.12 |
$242.65
|
|
Evoked oa emissions ltd
|
$160.38 |
$160.38 |
$160.38 |
$234.32
|
|
Evoked potentials auditory screening automated analysis
|
$92.84 |
$92.84 |
$92.84 |
$249.71
|
|
Evok oa screening qual
|
$87.78 |
$87.78 |
$87.78 |
$109.13
|
|
Exam pelvic add-on
|
$10.78 |
$10.78 |
$10.78 |
$41.60
|
|
Exchange biliary drg cath
|
$3,159.42 |
$3,159.42 |
$3,159.42 |
$3,909.56
|
|
Exchange drainage catheter
|
$1,502.38 |
$1,502.38 |
$1,502.38 |
$2,205.50
|
|
Exchange nephrostomy cath
|
$1,657.48 |
$1,657.48 |
$1,657.48 |
$2,958.80
|
|
Excision tongue lesion without closure 41110
|
$64.68 |
$64.68 |
$64.68 |
$3,786.00
|
|
Exercise w/hemodynamic meas
|
$215.38 |
$215.38 |
$215.38 |
$901.60
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$2,385.02 |
$2,385.02 |
$2,385.02 |
$2,470.50
|
|
Ext ecg>48hr<7d rev&interpj
|
$44.00 |
$44.00 |
$44.00 |
$57.00
|
|
Ext ecg>48hr<7d scan a/r
|
$161.04 |
$161.04 |
$161.04 |
$241.92
|
|
External chromosome analysis 20-25 cells
|
$40.04 |
$40.04 |
$40.04 |
$384.15
|
|
External newborn metabolic screening panel
|
$82.94 |
$82.94 |
$82.94 |
$109.76
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$27.50 |
$27.50 |
$27.50 |
$61.10
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$40.04 |
$40.04 |
$40.04 |
$454.20
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$21.34 |
$21.34 |
$21.34 |
$108.60
|
|
F-18 fdg pet diag
|
$578.38 |
$578.38 |
$578.38 |
$551.72
|
|
F-18 fluciclovine per mci
|
$223.96 |
$223.96 |
$223.96 |
$940.00
|
|
F-18 sodium fluoride
|
$515.02 |
$515.02 |
$515.02 |
$392.60
|
|
Facial bones <3
|
$299.64 |
$299.64 |
$299.64 |
$252.60
|
|
Factor ix
|
$33.00 |
$33.00 |
$33.00 |
$156.13
|
|
Factor ix recombinant nos
|
$1.08 |
$1.08 |
$1.08 |
$4.65
|
|
Factor viii
|
$39.60 |
$39.60 |
$39.60 |
$133.81
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$17.10 |
$17.10 |
$17.10 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$1,135.14 |
$1,135.14 |
$1,135.14 |
$5,800.72
|
|
Fat/lipids feces qualitative
|
$14.74 |
$14.74 |
$14.74 |
$38.35
|
|
Fatty acids nonesterified
|
$7.48 |
$7.48 |
$7.48 |
$64.28
|
|
#fecal-sodium
|
$20.68 |
$20.68 |
$20.68 |
$37.50
|
|
Felbamate (felbatol(r)) - sendout
|
$3.33 |
$3.33 |
$3.33 |
$65.00
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$13.20 |
$13.20 |
$13.20 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$933.91 |
$933.91 |
$933.91 |
$2,590.25
|
|
Ferritin
|
$146.74 |
$146.74 |
$146.74 |
$100.94
|
|
Fetal biophys profile w/nst 76818
|
$953.04 |
$953.04 |
$953.04 |
$535.37
|
|
Fetal chrmoml microdeltj
|
$9.90 |
$9.90 |
$9.90 |
$834.96
|
|
Fetal contract stress test 59020 - 26
|
$281.16 |
$281.16 |
$281.16 |
$475.50
|
|
Fetal fibronectin
|
$389.84 |
$389.84 |
$389.84 |
$373.41
|
|
Fetal hemoglobin (kleihauer betke)
|
$41.58 |
$41.58 |
$41.58 |
$105.12
|
|
Fetal hemoglobin rosette
|
$89.98 |
$89.98 |
$89.98 |
$67.20
|
|
Fetal non stress test
|
$288.20 |
$288.20 |
$288.20 |
$463.03
|
|
#_fet/norfentcnfrmur
|
$111.98 |
$111.98 |
$111.98 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$166.32 |
$166.32 |
$166.32 |
$117.70
|
|
Fibrin degradation products
|
$29.92 |
$29.92 |
$29.92 |
$62.64
|
|
Fibrinogen activity
|
$230.34 |
$230.34 |
$230.34 |
$83.50
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$8.80 |
$8.80 |
$8.80 |
$64.05
|
|
Fibrinolytic antiplasmin
|
$31.46 |
$31.46 |
$31.46 |
$72.80
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$350.23 |
$350.23 |
$350.23 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$534.40 |
$534.40 |
$534.40 |
$1,096.24
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$443.33 |
$443.33 |
$443.33 |
$869.18
|
|
Filter spider fx 3mmx320cm
|
$2,873.20 |
$2,873.20 |
$2,873.20 |
$7,160.28
|
|
Filter vena cava fem denali
|
$2,283.16 |
$2,283.16 |
$2,283.16 |
$3,718.18
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$543.84 |
$543.84 |
$543.84 |
$1,081.52
|
|
Fine needle aspiration biopsy without img gdn; ea addtl 10004
|
$204.16 |
$204.16 |
$204.16 |
$272.70
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$590.48 |
$590.48 |
$590.48 |
$823.90
|
|
Fine needle asp without image guide 10021
|
$481.58 |
$481.58 |
$481.58 |
$503.76
|
|
Flebogamma injection
|
$225.55 |
$225.55 |
$225.55 |
$3,438.30
|
|
Flecainide (tambocor)-sendout
|
$15.18 |
$15.18 |
$15.18 |
$66.43
|
|
Fl exam g/colon tube w contrast
|
$456.50 |
$456.50 |
$456.50 |
$511.92
|
|
Flow cytometry marker each additional
|
$66.88 |
$66.88 |
$66.88 |
$97.50
|
|
Flow cytometry one marker technical component
|
$101.86 |
$101.86 |
$101.86 |
$284.40
|
|
Flt3 gene
|
$46.20 |
$46.20 |
$46.20 |
$355.00
|
|
Flt3 gene analysis
|
$19.80 |
$19.80 |
$19.80 |
$213.92
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$20.84 |
$20.84 |
$20.84 |
$64.22
|
|
Fluidotherapy charges pt
|
$58.30 |
$58.30 |
$58.30 |
$91.00
|
|
Fluorescent antibody titer dna
|
$49.50 |
$49.50 |
$49.50 |
$122.82
|
|
Fluoroguide for spine inject 77003-26
|
$619.74 |
$619.74 |
$619.74 |
$496.03
|
|
Fluoroguide needle placement
|
$502.04 |
$502.04 |
$502.04 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$598.62 |
$598.62 |
$598.62 |
$492.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$54.66 |
$54.66 |
$54.66 |
$94.86
|
|
Fmri brain by tech
|
$1,213.08 |
$1,213.08 |
$1,213.08 |
$1,500.00
|
|
Fna bx w/ct gdn 1st les
|
$3,704.80 |
$3,704.80 |
$3,704.80 |
$1,420.80
|
|
Folic acid
|
$176.22 |
$176.22 |
$176.22 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$11.00 |
$11.00 |
$11.00 |
$54.75
|
|
Follow-up angiography
|
$1,325.72 |
$1,325.72 |
$1,325.72 |
$2,040.78
|
|
Fomepizole 1 gram/ml intravenous solution
|
$950.40 |
$950.40 |
$950.40 |
$2,581.14
|
|
Fondaparinux sodium
|
$117.94 |
$117.94 |
$117.94 |
$185.12
|
|
Foot X-ray
|
$462.66 |
$462.66 |
$462.66 |
$362.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$337.70 |
$337.70 |
$337.70 |
$457.50
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$122.69 |
$122.69 |
$122.69 |
$106.10
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$136.84 |
$136.84 |
$136.84 |
$151.58
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$136.84 |
$136.84 |
$136.84 |
$156.60
|
|
Fresh frozen plasma thawing ea un
|
$56.32 |
$56.32 |
$56.32 |
$122.00
|
|
Fructosamine glycated protein
|
$8.14 |
$8.14 |
$8.14 |
$60.75
|
|
Furosemide 10 mg/ml injection solution
|
$10.41 |
$10.41 |
$10.41 |
$19.00
|
|
G6pd full gene sequence
|
$198.00 |
$198.00 |
$198.00 |
$1,320.00
|
|
Ga-67 gallium 0.1 mci
|
$33.66 |
$33.66 |
$33.66 |
$118.56
|
|
Gabapentin non-blood
|
$3.52 |
$3.52 |
$3.52 |
$36.30
|
