|
ER Visit (level 2)
|
$352.10 |
$352.10 |
$352.10 |
$487.50
|
|
ER Visit (level 3)
|
$569.45 |
$569.45 |
$569.45 |
$850.50
|
|
ER Visit (level 4)
|
$1,169.35 |
$1,169.35 |
$1,169.35 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$1,809.85 |
$1,809.85 |
$1,809.85 |
$2,007.00
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$75.48 |
$75.48 |
$75.48 |
$260.24
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$267.96 |
$267.96 |
$267.96 |
$540.00
|
|
Esophageal dilat s&i
|
$2,395.75 |
$2,395.75 |
$2,395.75 |
$525.00
|
|
Esophageal motility
|
$803.95 |
$803.95 |
$803.95 |
$573.20
|
|
Esophagoscopy/flex/diagnostic 43200
|
$508.20 |
$508.20 |
$508.20 |
$1,109.47
|
|
Esophagoscopy flex remove fb
|
$1,019.55 |
$1,019.55 |
$1,019.55 |
$2,109.53
|
|
Esoph egd dilation <30 mm
|
$1,019.55 |
$1,019.55 |
$1,019.55 |
$2,656.80
|
|
Estradiol total
|
$103.60 |
$103.60 |
$103.60 |
$153.00
|
|
Estradiol valerate 10 mg inj
|
$55.79 |
$55.79 |
$55.79 |
$63.50
|
|
Etonogestrel implant system
|
$1,976.81 |
$1,976.81 |
$1,976.81 |
$3,016.77
|
|
Etoposide 20 mg/ml intravenous solution
|
$111.46 |
$111.46 |
$111.46 |
$213.17
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$107.10 |
$107.10 |
$107.10 |
$219.60
|
|
Evaluation heart device
|
$1,358.70 |
$1,358.70 |
$1,358.70 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$292.95 |
$292.95 |
$292.95 |
$347.75
|
|
Evasc prlng admn rx agnt 1st
|
$7,889.70 |
$7,889.70 |
$7,889.70 |
$4,462.80
|
|
Evasc prlng admn rx agnt add
|
$6,039.60 |
$6,039.60 |
$6,039.60 |
$3,484.88
|
|
Evasc repair of iliac artery; endograft 34718
|
$5,693.45 |
$5,693.45 |
$5,693.45 |
$10,843.20
|
|
Evasc rpr a-ao ndgft 34701
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$6,020.00
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$4,537.60
|
|
Evasc rpr a-biiliac ndgft rptr
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$10,294.05
|
|
Evasc rpr a-iliac ndgft 34717
|
$3,792.60 |
$3,792.60 |
$3,792.60 |
$6,925.05
|
|
Evasc rpr a-unilac ndgft 34703
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$7,465.20
|
|
Evasc rpr a-unilac ndgft rpt
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$9,282.60
|
|
Evasc rpr ilio-iliac ndgft
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$8,412.85
|
|
Evasc rpr ilio-iliac rpt
|
$9,122.40 |
$9,122.40 |
$9,122.40 |
$9,122.40
|
|
Event monitor
|
$44.45 |
$44.45 |
$44.45 |
$242.12
|
|
Evoked potentials upper limbs
|
$1,226.75 |
$1,226.75 |
$1,226.75 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$1,130.15 |
$1,130.15 |
$1,130.15 |
$829.44
|
|
Evok oa screening qual
|
$89.60 |
$89.60 |
$89.60 |
$120.90
|
|
Exam plvc w/anes othr thn lcl
|
$1,992.55 |
$1,992.55 |
$1,992.55 |
$3,649.80
|
|
Exc arm/elbo les sc <3cm 24075
|
$1,216.25 |
$1,216.25 |
$1,216.25 |
$1,917.33
|
|
Exc bartholins gland/cyst
|
$1,992.55 |
$1,992.55 |
$1,992.55 |
$3,744.41
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,184.60
|
|
Exc benign feenlm >4.0cm 11446
|
$1,800.75 |
$1,800.75 |
$1,800.75 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,244.06
|
|
Exc benign tal 0.5 < cm 11400
|
$537.95 |
$537.95 |
$537.95 |
$837.48
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$472.85 |
$472.85 |
$472.85 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$472.85 |
$472.85 |
$472.85 |
$1,045.20
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$438.20 |
$438.20 |
$438.20 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$1,800.75 |
$1,800.75 |
$1,800.75 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$242.20 |
$242.20 |
$242.20 |
$818.53
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$537.95 |
$537.95 |
$537.95 |
$1,301.30
|
|
Exchange biliary drg cath
|
$3,647.00 |
$3,647.00 |
$3,647.00 |
$4,176.15
|
|
Exchange drainage catheter
|
$5,992.00 |
$5,992.00 |
$5,992.00 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$1,699.25 |
$1,699.25 |
$1,699.25 |
$3,097.16
|
|
Excise/repair mouth lesion
|
$1,027.25 |
$1,027.25 |
$1,027.25 |
$2,133.48
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$472.85 |
$472.85 |
$472.85 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$1,981.25
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$537.95 |
$537.95 |
$537.95 |
$1,064.30
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,916.96
|
|
Excision of gum lesion 41825
|
$1,699.95 |
$1,699.95 |
$1,699.95 |
$3,920.70
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$472.85 |
$472.85 |
$472.85 |
$973.71
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$2,048.55 |
$2,048.55 |
$2,048.55 |
$3,588.30
|
|
Exc prtl bn phlnx toe
|
$2,377.90 |
$2,377.90 |
$2,377.90 |
$3,752.25
|
|
Exc sq tumor/forearm/wrist/<3cm 25075
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,473.60
|
|
Exc tendon sheath or cap lesion 26160
|
$1,058.05 |
$1,058.05 |
$1,058.05 |
$2,650.53
|
|
Exc thrombosed hemorrhoid 46320
|
$896.00 |
$896.00 |
$896.00 |
$2,491.20
|
|
Exc vagina lesion 57135
|
$2,202.20 |
$2,202.20 |
$2,202.20 |
$4,107.36
|
|
Exercise tst brncspsm w/ecg
|
$784.00 |
$784.00 |
$784.00 |
$337.50
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$7,690.25 |
$7,690.25 |
$7,690.25 |
$3,473.04
|
|
Exploration of knee joint
|
$2,150.75 |
$2,150.75 |
$2,150.75 |
$3,850.53
|
|
Exploration retroperitoneal area 49010
|
$1,694.00 |
$1,694.00 |
$1,694.00 |
$2,276.00
|
|
Explore/irrigate tear ducts
|
$351.75 |
$351.75 |
$351.75 |
$436.44
|
|
Explore penetrating wnd/extremity 20103
|
$537.95 |
$537.95 |
$537.95 |
$1,917.33
|
|
Explore/repair chest 32110
|
$3,020.15 |
$3,020.15 |
$3,020.15 |
$3,668.70
|
|
Explore/treat finger joint
|
$1,058.05 |
$1,058.05 |
$1,058.05 |
$2,615.25
|
|
Explore wound abdomen 20102
|
$1,480.50 |
$1,480.50 |
$1,480.50 |
$2,837.09
|
|
Explore woundchest 20101
|
$1,480.50 |
$1,480.50 |
$1,480.50 |
$2,179.44
|
|
Explore wound neck 20100
|
$385.35 |
$385.35 |
$385.35 |
$1,185.00
|
|
Exp w remove/deep fb/forearm/wrist 25248
|
$1,203.65 |
$1,203.65 |
$1,203.65 |
$3,559.50
|
|
External cannula declotting
|
$863.10 |
$863.10 |
$863.10 |
$1,829.42
|
|
External newborn metabolic screening panel
|
$73.50 |
$73.50 |
$73.50 |
$114.75
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$13.57 |
$13.57 |
$13.57 |
$61.32
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$32.81 |
$32.81 |
$32.81 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$30.80 |
$30.80 |
$30.80 |
$102.78
|
|
Eye implant band 40
|
$43.32 |
$43.32 |
$43.32 |
$125.00
|
|
Facial bones <3
|
$264.25 |
$264.25 |
$264.25 |
$248.60
|
|
Factor ix
|
$58.45 |
$58.45 |
$58.45 |
$131.30
|
|
Factor viii
|
$123.90 |
$123.90 |
$123.90 |
$144.30
|
|
Factor viii recombinant nos
|
$7,469.13 |
$7,469.13 |
$7,469.13 |
$4.68
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$32.75 |
$32.75 |
$32.75 |
$27.81
|
|
Fda ide #g240020 carry bag
|
$601.97 |
$601.97 |
$601.97 |
$933.57
|
|
#fecal-sodium
|
$89.60 |
$89.60 |
$89.60 |
$37.50
|
|
Femoral endovas graft add-on 34813
|
$2,702.70 |
$2,702.70 |
$2,702.70 |
$1,304.00
|
|
Fem/popl revasc w/stent
|
$12,728.45 |
$12,728.45 |
$12,728.45 |
$18,599.10
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$132.56 |
$132.56 |
$132.56 |
$120.15
|
|
Ferritin
|
$203.70 |
$203.70 |
$203.70 |
$103.68
|
|
Fetal biophys profile w/nst 76818
|
$629.30 |
$629.30 |
$629.30 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$242.20 |
$242.20 |
$242.20 |
$540.54
|
|
Fetal fibronectin
|
$334.60 |
$334.60 |
$334.60 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$93.10 |
$93.10 |
$93.10 |
$88.80
|
|
Fetal hemoglobin rosette
|
$49.35 |
$49.35 |
$49.35 |
$76.70
|
|
Fetal non stress test
|
$274.75 |
$274.75 |
$274.75 |
$507.90
|
|
Fibrin degradation d dimer quantitative
|
$29.40 |
$29.40 |
$29.40 |
$112.80
|