|
Electron microscopy diagnostic
|
$994.22 |
$994.22 |
$994.22 |
$1,011.98
|
|
Encephalitis, california igg/igm
|
$48.03 |
$48.03 |
$48.03 |
$56.50
|
|
Encephalitis, st louis igg/igm
|
$48.03 |
$48.03 |
$48.03 |
$51.84
|
|
Encephalitis, western equine igg/igm
|
$48.03 |
$48.03 |
$48.03 |
$54.99
|
|
Entamoeba histolytica ag eia - sendout
|
$48.76 |
$48.76 |
$48.76 |
$56.89
|
|
Epidural/lumbar/sacral/ea add level64484
|
$1,684.58 |
$1,684.58 |
$1,684.58 |
$1,182.00
|
|
Epoetin alfa, 100 units esrd
|
$18.60 |
$18.60 |
$18.60 |
$6.00
|
|
Epstein barr early antigen antibody
|
$40.64 |
$40.64 |
$40.64 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$39.91 |
$39.91 |
$39.91 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$45.82 |
$45.82 |
$45.82 |
$85.50
|
|
ER Visit (level 1, minor)
|
$254.58 |
$254.58 |
$254.58 |
$252.60
|
|
ER Visit (level 2)
|
$324.72 |
$324.72 |
$324.72 |
$463.00
|
|
ER Visit (level 3)
|
$668.99 |
$668.99 |
$668.99 |
$812.18
|
|
ER Visit (level 4)
|
$1,665.19 |
$1,665.19 |
$1,665.19 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$2,627.34 |
$2,627.34 |
$2,627.34 |
$1,871.60
|
|
Established Patient Office Visit (level 1)
|
$96.70 |
$96.70 |
$96.70 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$261.56 |
$261.56 |
$261.56 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$513.00 |
$513.00 |
$513.00 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$788.38 |
$788.38 |
$788.38 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$1,112.57 |
$1,112.57 |
$1,112.57 |
$290.68
|
|
Estradiol total
|
$51.74 |
$51.74 |
$51.74 |
$152.10
|
|
Estrogens total-sendout
|
$40.66 |
$40.66 |
$40.66 |
$97.50
|
|
Ethylene glycol -sendout
|
$57.90 |
$57.90 |
$57.90 |
$86.04
|
|
Eval/fit voice prosthesis iii, st
|
$215.84 |
$215.84 |
$215.84 |
$359.50
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$181.72 |
$181.72 |
$181.72 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$198.32 |
$198.32 |
$198.32 |
$302.50
|
|
Event monitor
|
$253.79 |
$253.79 |
$253.79 |
$231.00
|
|
Evoked potentials auditory screening automated analysis
|
$158.02 |
$158.02 |
$158.02 |
$261.30
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$153.92 |
$153.92 |
$153.92 |
$1,314.67
|
|
Exchange nephrostomy cath
|
$3,547.84 |
$3,547.84 |
$3,547.84 |
$2,958.80
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$257.54 |
$257.54 |
$257.54 |
$2,865.00
|
|
Excision nasal polyp(s) simple 30110
|
$201.70 |
$201.70 |
$201.70 |
$1,752.89
|
|
Exc thrombosed hemorrhoid 46320
|
$117.20 |
$117.20 |
$117.20 |
$2,175.36
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$4,956.78 |
$4,956.78 |
$4,956.78 |
$4,101.67
|
|
Explore penetrating wnd/extremity 20103
|
$363.67 |
$363.67 |
$363.67 |
$1,788.80
|
|
Explore wound neck 20100
|
$951.68 |
$951.68 |
$951.68 |
$1,185.00
|
|
External newborn metabolic screening panel
|
$138.32 |
$138.32 |
$138.32 |
$109.76
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$36.95 |
$36.95 |
$36.95 |
$63.70
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$96.07 |
$96.07 |
$96.07 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$345.28 |
$345.28 |
$345.28 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,083.42 |
$2,083.42 |
$2,083.42 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$1,736.38 |
$1,736.38 |
$1,736.38 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,388.76 |
$1,388.76 |
$1,388.76 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$2,950.70 |
$2,950.70 |
$2,950.70 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$1,967.14 |
$1,967.14 |
$1,967.14 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$260.29 |
$260.29 |
$260.29 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$304.11 |
$304.11 |
$304.11 |
$381.75
|
|
Factor ix
|
$49.22 |
$49.22 |
$49.22 |
$162.50
|
|
Factor viii
|
$41.12 |
$41.12 |
$41.12 |
$148.00
|
|
Fat/lipids feces qualitative
|
$41.89 |
$41.89 |
$41.89 |
$36.00
|
|
Fatty acids nonesterified
|
$42.50 |
$42.50 |
$42.50 |
$72.15
|
|
#fecal-sodium
|
$35.73 |
$35.73 |
$35.73 |
$37.53
|
|
Felbamate (felbatol(r)) - sendout
|
$45.58 |
$45.58 |
$45.58 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$0.90 |
$0.90 |
$0.90 |
$101.40
|
|
Fern test
|
$40.66 |
$40.66 |
$40.66 |
$37.03
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1.71 |
$1.71 |
$1.71 |
$2,590.25
|
|
Ferritin
|
$36.96 |
$36.96 |
$36.96 |
$102.48
|
|
Fetal biophys profile w/nst 76818
|
$660.59 |
$660.59 |
$660.59 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$651.23 |
$651.23 |
$651.23 |
$477.50
|
|
Fetal fibronectin
|
$119.50 |
$119.50 |
$119.50 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$36.76 |
$36.76 |
$36.76 |
$102.00
|
|
Fetal hemoglobin rosette
|
$18.07 |
$18.07 |
$18.07 |
$67.20
|
|
Fetal non stress test
|
$559.44 |
$559.44 |
$559.44 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$41.27 |
$41.27 |
$41.27 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$19.31 |
$19.31 |
$19.31 |
$120.64
|
|
Fibrin degradation products
|
$49.84 |
$49.84 |
$49.84 |
$75.02
|
|
Fibrinogen activity
|
$18.69 |
$18.69 |
$18.69 |
$87.00
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$29.28 |
$29.28 |
$29.28 |
$61.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$44.23 |
$44.23 |
$44.23 |
$66.60
|
|
Filter spider fx 3mmx320cm
|
$6,195.30 |
$6,195.30 |
$6,195.30 |
$7,358.16
|
|
Filter vena cava fem denali
|
$4,956.78 |
$4,956.78 |
$4,956.78 |
$3,718.18
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$99.84 |
$99.84 |
$99.84 |
$1,081.52
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$65.54 |
$65.54 |
$65.54 |
$694.14
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$934.46 |
$934.46 |
$934.46 |
$825.00
|
|
Finger X-ray (both hands)
|
$173.97 |
$173.97 |
$173.97 |
$241.50
|
|
Flecainide (tambocor)-sendout
|
$41.89 |
$41.89 |
$41.89 |
$65.65
|
|
Flow cytometry marker each additional
|
$82.15 |
$82.15 |
$82.15 |
$97.50
|
|
Flow cytometry one marker technical component
|
$468.14 |
$468.14 |
$468.14 |
$285.00
|
|
Flt3 gene
|
$314.10 |
$314.10 |
$314.10 |
$366.29
|
|
Flt3 gene analysis
|
$157.37 |
$157.37 |
$157.37 |
$216.00
|
|
Fluidotherapy charges pt
|
$82.70 |
$82.70 |
$82.70 |
$101.40
|
|
Fluid pressure muscle 20950
|
$488.24 |
$488.24 |
$488.24 |
$779.45
|
|
Fluorescent antibody titer dna
|
$618.54 |
$618.54 |
$618.54 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$322.70 |
$322.70 |
$322.70 |
$495.00
|
|
Fluoroguide needle placement
|
$448.20 |
$448.20 |
$448.20 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$498.00 |
$498.00 |
$498.00 |
$503.80
|
|
Fna bx w/ct gdn 1st les
|
$2,100.77 |
$2,100.77 |
$2,100.77 |
$1,462.20
|
|
Fna bx w/ct gdn ea addl
|
$1,227.99 |
$1,227.99 |
$1,227.99 |
$834.90
|
|
Folic acid
|
$27.72 |
$27.72 |
$27.72 |
$101.50
|
|
Foot X-ray
|
$294.82 |
$294.82 |
$294.82 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$205.84 |
$205.84 |
$205.84 |
$290.40
|
|
Forearm X-ray (both sides)
|
$213.81 |
$213.81 |
$213.81 |
$324.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$53.38 |
$53.38 |
$53.38 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$53.38 |
$53.38 |
$53.38 |
$164.84
|
|
Fructosamine glycated protein
|
$32.65 |
$32.65 |
$32.65 |
$63.50
|
|
Ftl cgen abnor two proteins
|
$164.32 |
$164.32 |
$164.32 |
$109.00
|
|
Full Spine X-ray (Scoliosis Survey)
|
$330.67 |
$330.67 |
$330.67 |
$355.00
|
|
Gabapentin non-blood
|
$34.50 |
$34.50 |
$34.50 |
$42.35
|
|
Galactose transferase test
|
$22.18 |
$22.18 |
$22.18 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,097.36 |
$1,097.36 |
$1,097.36 |
$1,494.00
|
