|
Epstein barr viral capsid antigen antibody igm
|
$6.23 |
$6.23 |
$6.23 |
$95.04
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$907.15 |
$907.15 |
$907.15 |
$364.08
|
|
ER Visit (level 1, minor)
|
$609.18 |
$609.18 |
$609.18 |
$276.70
|
|
ER Visit (level 2)
|
$1,162.34 |
$1,162.34 |
$1,162.34 |
$487.50
|
|
ER Visit (level 3)
|
$1,715.49 |
$1,715.49 |
$1,715.49 |
$850.50
|
|
ER Visit (level 4)
|
$3,763.97 |
$3,763.97 |
$3,763.97 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$5,534.70 |
$5,534.70 |
$5,534.70 |
$2,007.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$2,517,219.00 |
$2,517,219.00 |
$2,517,219.00 |
$540.00
|
|
Established Patient Office Visit (level 1)
|
$126.04 |
$126.04 |
$126.04 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$80.92 |
$80.92 |
$80.92 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$115.93 |
$115.93 |
$115.93 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$2,289.66 |
$2,289.66 |
$2,289.66 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$210.06 |
$210.06 |
$210.06 |
$287.10
|
|
Estradiol total
|
$53.63 |
$53.63 |
$53.63 |
$153.00
|
|
Estrogens total-sendout
|
$113.59 |
$113.59 |
$113.59 |
$89.25
|
|
Ethylene glycol -sendout
|
$139.24 |
$139.24 |
$139.24 |
$75.00
|
|
Euglobulin lysis
|
$71.58 |
$71.58 |
$71.58 |
$39.75
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$273.08 |
$273.08 |
$273.08 |
$219.60
|
|
Evasc prlng admn rx agnt 1st
|
$9,273.76 |
$9,273.76 |
$9,273.76 |
$4,462.80
|
|
Evasc prlng admn rx agnt add
|
$9,273.76 |
$9,273.76 |
$9,273.76 |
$3,484.88
|
|
Evoked potentials auditory screening automated analysis
|
$424.01 |
$424.01 |
$424.01 |
$283.62
|
|
Exchange biliary drg cath
|
$3,020.20 |
$3,020.20 |
$3,020.20 |
$4,176.15
|
|
Exchange drainage catheter
|
$5,042.22 |
$5,042.22 |
$5,042.22 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$4,939.53 |
$4,939.53 |
$4,939.53 |
$3,097.16
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$7,955.83 |
$7,955.83 |
$7,955.83 |
$2,647.92
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$3,617.70 |
$3,617.70 |
$3,617.70 |
$3,473.04
|
|
External chromosome analysis 20-25 cells
|
$136.15 |
$136.15 |
$136.15 |
$389.35
|
|
External newborn metabolic screening panel
|
$175.05 |
$175.05 |
$175.05 |
$114.75
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$81.69 |
$81.69 |
$81.69 |
$61.32
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$137.30 |
$137.30 |
$137.30 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$61.86 |
$61.86 |
$61.86 |
$102.78
|
|
F-18 fdg pet diag
|
$652.75 |
$652.75 |
$652.75 |
$602.25
|
|
Facial bones <3
|
$242.74 |
$242.74 |
$242.74 |
$248.60
|
|
Factor ix
|
$25.61 |
$25.61 |
$25.61 |
$131.30
|
|
Factor viii
|
$37.21 |
$37.21 |
$37.21 |
$144.30
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$47.46 |
$47.46 |
$47.46 |
$27.81
|
|
Fancc gene
|
$31.60 |
$31.60 |
$31.60 |
$147.31
|
|
Fat/lipids feces qualitative
|
$10.90 |
$10.90 |
$10.90 |
$34.56
|
|
Fatty acids nonesterified
|
$23.34 |
$23.34 |
$23.34 |
$57.60
|
|
#fecal-sodium
|
$10.34 |
$10.34 |
$10.34 |
$37.50
|
|
Felbamate (felbatol(r)) - sendout
|
$13.25 |
$13.25 |
$13.25 |
$66.43
|
|
Fem/popl revasc w/stent
|
$21,058.91 |
$21,058.91 |
$21,058.91 |
$18,599.10
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$91.03 |
$91.03 |
$91.03 |
$120.15
|
|
Ferritin
|
$232.63 |
$232.63 |
$232.63 |
$103.68
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$5,446.00 |
$5,446.00 |
$5,446.00 |
$1,776.61
|
|
Fetal biophys profile w/nst 76818
|
$872.14 |
$872.14 |
$872.14 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$695.54 |
$695.54 |
$695.54 |
$540.54
|
|
Fetal fibronectin
|
$343.88 |
$343.88 |
$343.88 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$164.16 |
$164.16 |
$164.16 |
$88.80
|
|
Fetal hemoglobin rosette
|
$52.91 |
$52.91 |
$52.91 |
$76.70
|
|
Fetal non stress test
|
$623.96 |
$623.96 |
$623.96 |
$507.90
|
|
Fibrin degradation d dimer quantitative
|
$181.28 |
$181.28 |
$181.28 |
$112.80
|
|
Fibrin degradation products
|
$27.48 |
$27.48 |
$27.48 |
$62.40
|
|
Fibrinogen activity
|
$171.94 |
$171.94 |
$171.94 |
$82.38
|
|
Fibrinolytic antiplasmin
|
$27.48 |
$27.48 |
$27.48 |
$56.00
|
|
Fibrinolytic plasminogen
|
$43.48 |
$43.48 |
$43.48 |
$109.45
|
|
Filter spider fx 3mmx320cm
|
$7,955.83 |
$7,955.83 |
$7,955.83 |
$6,152.59
|
|
Filter vena cava fem denali
|
$4,704.57 |
$4,704.57 |
$4,704.57 |
$3,467.25
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$406.90 |
$406.90 |
$406.90 |
$1,081.52
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$324.43 |
$324.43 |
$324.43 |
$806.40
|
|
Fixation of knee joint
|
$2,348.79 |
$2,348.79 |
$2,348.79 |
$1,963.35
|
|
Fix g/colon tube w/device
|
$470.69 |
$470.69 |
$470.69 |
$1,236.90
|
|
Flecainide (tambocor)-sendout
|
$19.62 |
$19.62 |
$19.62 |
$66.43
|
|
Fl exam g/colon tube w contrast
|
$313.54 |
$313.54 |
$313.54 |
$546.86
|
|
Flotufolastat f18 diag 1 mci
|
$2,895.72 |
$2,895.72 |
$2,895.72 |
$926.28
|
|
Flow cytometry marker each additional
|
$9.34 |
$9.34 |
$9.34 |
$103.00
|
|
Flow cytometry one marker technical component
|
$93.36 |
$93.36 |
$93.36 |
$270.75
|
|
Flt3 gene
|
$116.70 |
$116.70 |
$116.70 |
$352.95
|
|
Flt3 gene analysis
|
$116.70 |
$116.70 |
$116.70 |
$229.92
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$694.76 |
$694.76 |
$694.76 |
$86.42
|
|
Fluorescent antibody titer dna
|
$257.72 |
$257.72 |
$257.72 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$1,727.16 |
$1,727.16 |
$1,727.16 |
$507.00
|
|
Fluoroguide needle placement
|
$1,520.99 |
$1,520.99 |
$1,520.99 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$592.06 |
$592.06 |
$592.06 |
$494.52
|
|
Fmri brain by tech
|
$1,847.75 |
$1,847.75 |
$1,847.75 |
$1,486.75
|
|
Fna bx w/ct gdn 1st les
|
$433.35 |
$433.35 |
$433.35 |
$1,588.65
|
|
Fna bx w/ct gdn ea addl
|
$324.43 |
$324.43 |
$324.43 |
$775.14
|
|
Folic acid
|
$147.82 |
$147.82 |
$147.82 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$417.79 |
$417.79 |
$417.79 |
$55.66
|
|
Follow-up angiography
|
$1,122.66 |
$1,122.66 |
$1,122.66 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$5,446.00 |
$5,446.00 |
$5,446.00 |
$2,860.43
|
|
Fracture assessment via dxa
|
$178.94 |
$178.94 |
$178.94 |
$146.80
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$361.77 |
$361.77 |
$361.77 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$709.54 |
$709.54 |
$709.54 |
$149.50
|
|
Fresh frozen plasma thawing ea un
|
$225.62 |
$225.62 |
$225.62 |
$123.90
|
|
Fructosamine glycated protein
|
$7.33 |
$7.33 |
$7.33 |
$60.42
|
|
Ftl cgen abnor four anal
|
$33.07 |
$33.07 |
$33.07 |
$211.83
|
|
Furosemide 10 mg/ml injection solution
|
$153.27 |
$153.27 |
$153.27 |
$27.69
|
|
G6pc gene
|
$31.60 |
$31.60 |
$31.60 |
$104.65
|
|
G6pd full gene sequence
|
$700.20 |
$700.20 |
$700.20 |
$1,320.00
|
|
G6pd gene alys cmn variant
|
$110.92 |
$110.92 |
$110.92 |
$243.00
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$813.79 |
$813.79 |
$813.79 |
$162.68
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$73.91 |
$73.91 |
$73.91 |
$138.37
|
|
Galac-1-phosphate uridyltran - sendout
|
$84.07 |
$84.07 |
$84.07 |
$82.50
|
|
Galectin-3
|
$78.58 |
$78.58 |
$78.58 |
$110.65
|
|
Gamma globulin 1 cc inj
|
$266.86 |
$266.86 |
$266.86 |
$158.67
|
|
Gammaglobulin iga
|
$23.78 |
$23.78 |
$23.78 |
$75.30
|
|
Gammaglobulin ige
|
$7.78 |
$7.78 |
$7.78 |
$85.00
|
|
Gamma glutamyltransferase
|
$81.69 |
$81.69 |
$81.69 |
$55.28
|
|
Gamunex-c/gammaked
|
$5,446.00 |
$5,446.00 |
$5,446.00 |
$7,372.04
|
