|
Established Patient Office Visit (level 2)
|
$88.23 |
$88.23 |
$88.23 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$101.38 |
$101.38 |
$101.38 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$126.32 |
$126.32 |
$126.32 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$133.72 |
$133.72 |
$133.72 |
$287.10
|
|
Estrogens total-sendout
|
$6.11 |
$6.11 |
$6.11 |
$89.25
|
|
Etanercept injection
|
$1,962.39 |
$1,962.39 |
$1,962.39 |
$2,306.67
|
|
Ethylene glycol -sendout
|
$8.70 |
$8.70 |
$8.70 |
$75.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$17.27 |
$17.27 |
$17.27 |
$232.87
|
|
Etoposide 50 mg cap
|
$77.82 |
$77.82 |
$77.82 |
$184.44
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$149.33 |
$149.33 |
$149.33 |
$219.60
|
|
Evaluation heart device
|
$1,342.88 |
$1,342.88 |
$1,342.88 |
$2,368.17
|
|
Evasc prlng admn rx agnt 1st
|
$5,289.30 |
$5,289.30 |
$5,289.30 |
$4,462.80
|
|
Evasc prlng admn rx agnt add
|
$5,289.30 |
$5,289.30 |
$5,289.30 |
$3,484.88
|
|
Evasc rpr a-ao ndgft 34701
|
$3,957.66 |
$3,957.66 |
$3,957.66 |
$6,020.00
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$1,239.58 |
$1,239.58 |
$1,239.58 |
$4,537.60
|
|
Evasc rpr a-biiliac ndgft rptr
|
$3,957.66 |
$3,957.66 |
$3,957.66 |
$10,294.05
|
|
Evasc rpr a-iliac ndgft 34717
|
$2,959.75 |
$2,959.75 |
$2,959.75 |
$6,925.05
|
|
Evasc rpr a-unilac ndgft 34703
|
$3,957.66 |
$3,957.66 |
$3,957.66 |
$7,465.20
|
|
Evasc rpr a-unilac ndgft rpt
|
$2,639.72 |
$2,639.72 |
$2,639.72 |
$9,282.60
|
|
Evasc rpr ilio-iliac ndgft
|
$3,957.66 |
$3,957.66 |
$3,957.66 |
$8,412.85
|
|
Evasc rpr ilio-iliac rpt
|
$1,239.58 |
$1,239.58 |
$1,239.58 |
$9,122.40
|
|
Event monitor
|
$50.97 |
$50.97 |
$50.97 |
$242.12
|
|
Exchange biliary drg cath
|
$3,154.02 |
$3,154.02 |
$3,154.02 |
$4,176.15
|
|
Exchange drainage catheter
|
$2,283.52 |
$2,283.52 |
$2,283.52 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$3,582.01 |
$3,582.01 |
$3,582.01 |
$3,097.16
|
|
Exercise w/hemodynamic meas
|
$2,693.15 |
$2,693.15 |
$2,693.15 |
$971.00
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$2,859.19 |
$2,859.19 |
$2,859.19 |
$2,551.50
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$2,198.85 |
$2,198.85 |
$2,198.85 |
$4,135.20
|
|
Ext ecg>48hr<7d scan a/r
|
$153.17 |
$153.17 |
$153.17 |
$251.71
|
|
Ext ecg>7d<15d scan a/r
|
$153.17 |
$153.17 |
$153.17 |
$262.20
|
|
External chromosome analysis 20-25 cells
|
$49.32 |
$49.32 |
$49.32 |
$389.35
|
|
External newborn metabolic screening panel
|
$61.65 |
$61.65 |
$61.65 |
$102.52
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$102.41 |
$102.41 |
$102.41 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$6.85 |
$6.85 |
$6.85 |
$102.78
|
|
F-18 fdg pet diag
|
$142.48 |
$142.48 |
$142.48 |
$602.25
|
|
F-18 fluciclovine per mci
|
$1,243.96 |
$1,243.96 |
$1,243.96 |
$1,307.52
|
|
Facial bones <3
|
$262.50 |
$262.50 |
$262.50 |
$248.60
|
|
Factor ix
|
$9.02 |
$9.02 |
$9.02 |
$131.30
|
|
Factor ix alprolix recomb
|
$3.29 |
$3.29 |
$3.29 |
$5.61
|
|
Factor ix recombinant nos
|
$1.92 |
$1.92 |
$1.92 |
$5.40
|
|
Factor viii
|
$5.48 |
$5.48 |
$5.48 |
$144.30
|
|
Factor viii recombinant nos
|
$2.47 |
$2.47 |
$2.47 |
$7.00
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$16.44 |
$16.44 |
$16.44 |
$22.46
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$3,019.76 |
$3,019.76 |
$3,019.76 |
$5,894.50
|
|
Fat/lipids feces qualitative
|
$3.84 |
$3.84 |
$3.84 |
$34.56
|
|
Fda ide #g240020 carry bag
|
$768.57 |
$768.57 |
$768.57 |
$933.57
|
|
#fecal-sodium
|
$3.22 |
$3.22 |
$3.22 |
$37.50
|
|
Feeding tube reposition
|
$528.82 |
$528.82 |
$528.82 |
$441.86
|
|
Fem/popl revasc w/stent
|
$8,092.59 |
$8,092.59 |
$8,092.59 |
$18,599.10
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$146.05 |
$146.05 |
$146.05 |
$112.95
|
|
Fern test
|
$38.91 |
$38.91 |
$38.91 |
$32.50
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,360.14 |
$1,360.14 |
$1,360.14 |
$1,812.62
|
|
Ferritin
|
$204.41 |
$204.41 |
$204.41 |
$103.68
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,524.27 |
$1,524.27 |
$1,524.27 |
$1,367.56
|
|
Ferumoxytol, esrd use
|
$1,524.27 |
$1,524.27 |
$1,524.27 |
$56.05
|
|
Fetal biophys profile w/nst 76818
|
$590.47 |
$590.47 |
$590.47 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$498.68 |
$498.68 |
$498.68 |
$540.54
|
|
Fetal fibronectin
|
$296.20 |
$296.20 |
$296.20 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$82.20 |
$82.20 |
$82.20 |
$88.80
|
|
Fetal hemoglobin rosette
|
$31.79 |
$31.79 |
$31.79 |
$76.70
|
|
Fetal non stress test
|
$255.10 |
$255.10 |
$255.10 |
$507.90
|
|
Fibrin degradation d dimer quantitative
|
$84.12 |
$84.12 |
$84.12 |
$112.80
|
|
Fibrin degradation products
|
$94.26 |
$94.26 |
$94.26 |
$62.40
|
|
Fibrinogen activity
|
$80.83 |
$80.83 |
$80.83 |
$82.38
|
|
Fibrinolytic antiplasmin
|
$2.30 |
$2.30 |
$2.30 |
$56.00
|
|
Fibrinolytic plasminogen
|
$5.13 |
$5.13 |
$5.13 |
$109.45
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$1.68 |
$1.68 |
$1.68 |
$59.89
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$460.87 |
$460.87 |
$460.87 |
$519.20
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$698.98 |
$698.98 |
$698.98 |
$1,214.53
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$577.60 |
$577.60 |
$577.60 |
$926.54
|
|
Filter spider fx 3mmx320cm
|
$6,285.56 |
$6,285.56 |
$6,285.56 |
$6,878.20
|
|
Filter vena cava fem denali
|
$3,718.18 |
$3,718.18 |
$3,718.18 |
$3,487.80
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$554.58 |
$554.58 |
$554.58 |
$1,081.52
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$399.22 |
$399.22 |
$399.22 |
$624.65
|
|
Fine needle aspiration biopsy without img gdn; ea addtl 10004
|
$216.19 |
$216.19 |
$216.19 |
$261.80
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$415.94 |
$415.94 |
$415.94 |
$806.40
|
|
Fine needle asp without image guide 10021
|
$354.83 |
$354.83 |
$354.83 |
$547.53
|
|
Fix g/colon tube w/device
|
$525.26 |
$525.26 |
$525.26 |
$1,236.90
|
|
Flebogamma injection
|
$1,872.79 |
$1,872.79 |
$1,872.79 |
$1,872.79
|
|
Flecainide (tambocor)-sendout
|
$6.91 |
$6.91 |
$6.91 |
$66.43
|
|
Fl exam g/colon tube w contrast
|
$156.46 |
$156.46 |
$156.46 |
$546.86
|
|
Flow cytometry marker each additional
|
$31.43 |
$31.43 |
$31.43 |
$103.00
|
|
Flow cytometry one marker technical component
|
$32.88 |
$32.88 |
$32.88 |
$270.75
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$139.74 |
$139.74 |
$139.74 |
$73.89
|
|
Fluorescent antibody titer dna
|
$39.32 |
$39.32 |
$39.32 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$634.04 |
$634.04 |
$634.04 |
$507.00
|
|
Fluoroguide needle placement
|
$817.89 |
$817.89 |
$817.89 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$667.47 |
$667.47 |
$667.47 |
$494.52
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$76.45 |
$76.45 |
$76.45 |
$128.69
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$197.28 |
$197.28 |
$197.28 |
$75.62
|
|
Fna bx w/ct gdn 1st les
|
$554.58 |
$554.58 |
$554.58 |
$1,588.65
|
|
Fna bx w/ct gdn ea addl
|
$415.94 |
$415.94 |
$415.94 |
$775.14
|
|
Folic acid
|
$226.05 |
$226.05 |
$226.05 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$84.12 |
$84.12 |
$84.12 |
$56.70
|
|
Follow-up angiography
|
$1,041.75 |
$1,041.75 |
$1,041.75 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$2,277.49 |
$2,277.49 |
$2,277.49 |
$2,461.93
|
|
Fondaparinux sodium
|
$172.35 |
$172.35 |
$172.35 |
$174.74
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$440.32 |
$440.32 |
$440.32 |
$378.00
|
|
Foscarnet sodium injection
|
$621.98 |
$621.98 |
$621.98 |
$970.94
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$631.30 |
$631.30 |
$631.30 |
$86.40
|
