|
Extended visual field xm
|
$296.80 |
$296.80 |
$296.80 |
$162.75
|
|
Extension per extension per
|
$86.80 |
$86.80 |
$86.80 |
$134.44
|
|
Extensive ear canal surgery 69150
|
$9,307.20 |
$9,307.20 |
$9,307.20 |
$5,395.75
|
|
Extensive hand surgery
|
$7,285.60 |
$7,285.60 |
$7,285.60 |
$3,954.60
|
|
Extensive mastoid surgery
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$7,000.36
|
|
Extensive mastoid surgery
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$8,120.00
|
|
Extensive surgery of throat
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,966.64
|
|
Extensive surgery of throat
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,547.81
|
|
Extensive testis surgery
|
$9,592.80 |
$9,592.80 |
$9,592.80 |
$4,081.37
|
|
External cannula declotting
|
$2,055.20 |
$2,055.20 |
$2,055.20 |
$1,838.28
|
|
External chromosome analysis 20-25 cells
|
$369.60 |
$369.60 |
$369.60 |
$403.00
|
|
External newborn metabolic screening panel
|
$109.76 |
$109.76 |
$109.76 |
$108.00
|
|
External ocular photography
|
$246.96 |
$246.96 |
$246.96 |
$86.03
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$210.56 |
$210.56 |
$210.56 |
$61.10
|
|
External profiling gene expression oncology (breast) mrna 21 genes
|
$8,853.60 |
$8,853.60 |
$8,853.60 |
$4,388.25
|
|
External recharg sys extern
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$1,383.20
|
|
External recharg sys intern
|
$3,582.39 |
$3,582.39 |
$3,582.39 |
$2,931.16
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$319.20 |
$319.20 |
$319.20 |
$445.60
|
|
Extnd color vision xm
|
$227.36 |
$227.36 |
$227.36 |
$105.04
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$38.08 |
$38.08 |
$38.08 |
$109.00
|
|
Extraction erupted tooth/exr
|
$4,099.20 |
$4,099.20 |
$4,099.20 |
$1,817.06
|
|
Extraction of lens
|
$10,466.40 |
$10,466.40 |
$10,466.40 |
$4,452.74
|
|
Extraction of lens
|
$5,224.80 |
$5,224.80 |
$5,224.80 |
$2,685.92
|
|
Extraction of lens 66920
|
$6,126.40 |
$6,126.40 |
$6,126.40 |
$3,737.60
|
|
Extrnl counterpulse, per tx
|
$694.40 |
$694.40 |
$694.40 |
$431.60
|
|
Eye allergy tests
|
$436.80 |
$436.80 |
$436.80 |
$142.80
|
|
Eye implant band 40
|
$9,529.80 |
$9,529.80 |
$9,529.80 |
$6,152.93
|
|
Eye photodynamic ther add-on
|
$963.20 |
$963.20 |
$963.20 |
$821.60
|
|
Eye surgery follow-up add-on
|
$4,670.40 |
$4,670.40 |
$4,670.40 |
$1,914.01
|
|
Eye suture during surgery
|
$1,612.80 |
$1,612.80 |
$1,612.80 |
$817.53
|
|
Ezh2 gene common variants
|
$403.20 |
$403.20 |
$403.20 |
$288.21
|
|
Ezh2 gene full gene sequence
|
$644.00 |
$644.00 |
$644.00 |
$333.20
|
|
F-18 fdg pet diag
|
$768.88 |
$768.88 |
$768.88 |
$551.72
|
|
F-18 florbetapir less than or equal to 10 mci
|
$5,928.72 |
$5,928.72 |
$5,928.72 |
$5,145.00
|
|
F-18 fluciclovine per mci
|
$9,619.08 |
$9,619.08 |
$9,619.08 |
$1,042.30
|
|
F-18 sodium fluoride
|
$3,170.16 |
$3,170.16 |
$3,170.16 |
$492.56
|
|
F9 full gene sequence
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$1,200.00
|
|
Fabrication & fitting
|
$369.04 |
$369.04 |
$369.04 |
$182.27
|
|
Face bone graft
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,700.98
|
|
Facial bones <3
|
$476.00 |
$476.00 |
$476.00 |
$252.60
|
|
Facial nerve function test
|
$851.20 |
$851.20 |
$851.20 |
$368.50
|
|
Facility svs dental rehab
|
$4,838.40 |
$4,838.40 |
$4,838.40 |
$4,558.89
|
|
Factor ix
|
$341.60 |
$341.60 |
$341.60 |
$154.50
|
|
Factor ix alprolix recomb
|
$11.69 |
$11.69 |
$11.69 |
$9.46
|
|
Factor ix complex
|
$6.36 |
$6.36 |
$6.36 |
$5.91
|
|
Factor ix idelvion inj
|
$15.46 |
$15.46 |
$15.46 |
$14.35
|
|
Factor ix non-recombinant
|
$6.89 |
$6.89 |
$6.89 |
$4.63
|
|
Factor ix recomb gly rebinyn
|
$14.39 |
$14.39 |
$14.39 |
$13.36
|
|
Factor ix recombinan rixubis
|
$7.03 |
$7.03 |
$7.03 |
$7.03
|
|
Factor viia recomb sevenfact
|
$9.08 |
$9.08 |
$9.08 |
$8.43
|
|
Factor viii
|
$91.84 |
$91.84 |
$91.84 |
$144.82
|
|
Factor viii
|
$6.57 |
$6.57 |
$6.57 |
$4.85
|
|
Factor viii fc fusion recomb
|
$8.92 |
$8.92 |
$8.92 |
$8.28
|
|
Factor viii nuwiq recomb 1iu
|
$7.26 |
$7.26 |
$7.26 |
$5.20
|
|
Factor viii pegylated recomb
|
$8.67 |
$8.67 |
$8.67 |
$8.05
|
|
Factor viii recombinant nos
|
$7.41 |
$7.41 |
$7.41 |
$5.40
|
|
Factor viii recomb novoeight
|
$7.96 |
$7.96 |
$7.96 |
$7.39
|
|
Factor viii recomb obizur
|
$9.54 |
$9.54 |
$9.54 |
$8.11
|
|
Factor xiii anti-hem factor
|
$32.00 |
$32.00 |
$32.00 |
$23.98
|
|
Factor xiii recomb a-subunit
|
$46.05 |
$46.05 |
$46.05 |
$46.05
|
|
Fallopian tube recnl
|
$9,794.40 |
$9,794.40 |
$9,794.40 |
$3,624.75
|
|
Fam adapt bhv tx gdn phy/qhp
|
$89.04 |
$89.04 |
$89.04 |
$66.40
|
|
Family therapy without pt 50min 90846
|
$476.00 |
$476.00 |
$476.00 |
$241.60
|
|
Family therapy with patient 50 min 90847
|
$593.60 |
$593.60 |
$593.60 |
$230.36
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$29.99 |
$29.99 |
$29.99 |
$22.23
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$5,417.88 |
$5,417.88 |
$5,417.88 |
$5,894.50
|
|
Fancc gene
|
$133.84 |
$133.84 |
$133.84 |
$140.00
|
|
Fat/lipids feces qualitative
|
$9.52 |
$9.52 |
$9.52 |
$36.00
|
|
Fatty acids nonesterified
|
$50.96 |
$50.96 |
$50.96 |
$64.28
|
|
Fda ide #g240020 carry bag
|
$198.80 |
$198.80 |
$198.80 |
$933.57
|
|
Fecal bilirubin test
|
$45.92 |
$45.92 |
$45.92 |
$12.00
|
|
Fecal microbiota, live-jslm 150 ml rectal suspension enema
|
$14,956.68 |
$14,956.68 |
$14,956.68 |
$14,956.68
|
|
Fecal microbiota prep instil
|
$1,164.80 |
$1,164.80 |
$1,164.80 |
$1,059.00
|
|
#fecal-sodium
|
$42.56 |
$42.56 |
$42.56 |
$37.50
|
|
Feeding tube reposition
|
$1,484.00 |
$1,484.00 |
$1,484.00 |
$520.00
|
|
Fees w/laryngeal sense i&r
|
$174.72 |
$174.72 |
$174.72 |
$174.72
|
|
Fees w/laryngeal sense test
|
$515.20 |
$515.20 |
$515.20 |
$433.50
|
|
Felbamate (felbatol(r)) - sendout
|
$43.68 |
$43.68 |
$43.68 |
$61.00
|
|
Fem focal defic constant fri
|
$5,703.60 |
$5,703.60 |
$5,703.60 |
$5,703.60
|
|
Femoral lgth sock fx or equa
|
$81.20 |
$81.20 |
$81.20 |
$126.42
|
|
Feno poc
|
$280.00 |
$280.00 |
$280.00 |
$99.60
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$173.43 |
$173.43 |
$173.43 |
$101.40
|
|
Fern test
|
$89.04 |
$89.04 |
$89.04 |
$37.50
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,704.36 |
$2,704.36 |
$2,704.36 |
$2,590.25
|
|
Ferritin
|
$127.68 |
$127.68 |
$127.68 |
$102.07
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$2,088.31 |
$2,088.31 |
$2,088.31 |
$1,636.50
|
|
Ferumoxytol, esrd use
|
$0.56 |
$0.56 |
$0.56 |
$0.50
|
|
Fetal aneuploidy trisom risk
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$1,077.00
|
|
Fetal biophys profile w/nst 76818
|
$1,030.40 |
$1,030.40 |
$1,030.40 |
$541.74
|
|
Fetal chrmoml microdeltj
|
$1,736.00 |
$1,736.00 |
$1,736.00 |
$879.51
|
|
Fetal chrom aneuploidy gsa panel
|
$1,736.00 |
$1,736.00 |
$1,736.00 |
$1,166.15
|
|
Fetal contract stress test 59020 - 26
|
$1,204.00 |
$1,204.00 |
$1,204.00 |
$475.50
|
|
Fetal cord puncture prenatal
|
$1,624.00 |
$1,624.00 |
$1,624.00 |
$648.90
|
|
Fetal fibronectin
|
$812.00 |
$812.00 |
$812.00 |
$387.60
|
|
Fetal fluid drainage w/us
|
$1,624.00 |
$1,624.00 |
$1,624.00 |
$612.00
|
|
Fetal hemoglobin (kleihauer betke)
|
$94.08 |
$94.08 |
$94.08 |
$104.00
|
|
Fetal hemoglobin rosette
|
$67.20 |
$67.20 |
$67.20 |
$67.20
|
|
Fetal lung maturity assess lam body dnst
|
$240.24 |
$240.24 |
$240.24 |
$67.00
|
|
Fetal non stress test
|
$498.40 |
$498.40 |
$498.40 |
$478.50
|
|
Fetal scalp blood sampling 59030
|
$1,624.00 |
$1,624.00 |
$1,624.00 |
$419.01
|
