|
Established Patient Office Visit (level 5)
|
$668.62 |
$668.62 |
$668.62 |
$287.10
|
|
Estradiol total
|
$95.00 |
$95.00 |
$95.00 |
$151.80
|
|
Ethylene glycol -sendout
|
$39.96 |
$39.96 |
$39.96 |
$77.40
|
|
Etoposide 20 mg/ml intravenous solution
|
$285.52 |
$285.52 |
$285.52 |
$213.17
|
|
Euflexxa inj per dose
|
$587.51 |
$587.51 |
$587.51 |
$727.80
|
|
Evaluation of speech fluency 92521
|
$354.24 |
$354.24 |
$354.24 |
$347.75
|
|
Exchange biliary drg cath
|
$7,658.53 |
$7,658.53 |
$7,658.53 |
$4,176.15
|
|
Exchange drainage catheter
|
$4,761.34 |
$4,761.34 |
$4,761.34 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$5,949.35 |
$5,949.35 |
$5,949.35 |
$3,131.93
|
|
External chromosome analysis 20-25 cells
|
$206.80 |
$206.80 |
$206.80 |
$389.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$897.69 |
$897.69 |
$897.69 |
$454.35
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$277.39 |
$277.39 |
$277.39 |
$104.80
|
|
Facial bones <3
|
$514.90 |
$514.90 |
$514.90 |
$242.74
|
|
Factor ix
|
$65.14 |
$65.14 |
$65.14 |
$138.60
|
|
Factor viii
|
$65.14 |
$65.14 |
$65.14 |
$144.82
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$24.21 |
$24.21 |
$24.21 |
$26.87
|
|
Fat/lipids feces qualitative
|
$6.52 |
$6.52 |
$6.52 |
$36.75
|
|
Fatty acids nonesterified
|
$120.05 |
$120.05 |
$120.05 |
$56.70
|
|
#fecal-sodium
|
$35.05 |
$35.05 |
$35.05 |
$37.50
|
|
Fem/popl revasc w/stent
|
$38,056.99 |
$38,056.99 |
$38,056.99 |
$18,697.29
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$91.19 |
$91.19 |
$91.19 |
$123.82
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$200.90 |
$200.90 |
$200.90 |
$1,896.25
|
|
Ferritin
|
$189.90 |
$189.90 |
$189.90 |
$103.95
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,934.11 |
$1,934.11 |
$1,934.11 |
$1,776.61
|
|
Fetal biophys profile w/nst 76818
|
$1,729.70 |
$1,729.70 |
$1,729.70 |
$541.74
|
|
Fetal non stress test
|
$463.03 |
$463.03 |
$463.03 |
$507.90
|
|
#_fet/norfentcnfrmur
|
$152.52 |
$152.52 |
$152.52 |
$120.85
|
|
Fibrin degradation d dimer quantitative
|
$333.46 |
$333.46 |
$333.46 |
$113.40
|
|
Fibrin degradation products
|
$269.82 |
$269.82 |
$269.82 |
$63.90
|
|
Fibrinogen activity
|
$240.24 |
$240.24 |
$240.24 |
$82.38
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$178.06 |
$178.06 |
$178.06 |
$66.00
|
|
Fibrinolytic plasminogen
|
$162.90 |
$162.90 |
$162.90 |
$110.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$42.84 |
$42.84 |
$42.84 |
$59.89
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,776.26 |
$1,776.26 |
$1,776.26 |
$1,411.44
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$749.23 |
$749.23 |
$749.23 |
$973.70
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$1,138.87 |
$1,138.87 |
$1,138.87 |
$794.80
|
|
Fl exam g/colon tube w contrast
|
$276.75 |
$276.75 |
$276.75 |
$540.80
|
|
Flow cytometry interp 16 or more
|
$95.72 |
$95.72 |
$95.72 |
$208.80
|
|
Flow cytometry marker each additional
|
$45.92 |
$45.92 |
$45.92 |
$103.00
|
|
Flow cytometry one marker technical component
|
$983.82 |
$983.82 |
$983.82 |
$270.75
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$79.71 |
$79.71 |
$79.71 |
$86.84
|
|
Fluidotherapy charges pt
|
$522.14 |
$522.14 |
$522.14 |
$95.40
|
|
Fluorescent antibody titer dna
|
$184.61 |
$184.61 |
$184.61 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$557.68 |
$557.68 |
$557.68 |
$507.00
|
|
Fluoroguide needle placement
|
$410.06 |
$410.06 |
$410.06 |
$539.38
|
|
Fluoroscopy up to 1 hour
|
$977.56 |
$977.56 |
$977.56 |
$492.75
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$971.82 |
$971.82 |
$971.82 |
$107.00
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$49.25 |
$49.25 |
$49.25 |
$148.04
|
|
Folic acid
|
$209.52 |
$209.52 |
$209.52 |
$89.40
|
|
Folic acid 5 mg/ml injection solution
|
$22.15 |
$22.15 |
$22.15 |
$56.70
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,270.72 |
$1,270.72 |
$1,270.72 |
$2,860.43
|
|
Fondaparinux sodium
|
$67.93 |
$67.93 |
$67.93 |
$178.47
|
|
Foot X-ray
|
$767.08 |
$767.08 |
$767.08 |
$364.00
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$110.69 |
$110.69 |
$110.69 |
$110.69
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$347.50 |
$347.50 |
$347.50 |
$168.75
|
|
Fructosamine glycated protein
|
$16.52 |
$16.52 |
$16.52 |
$61.20
|
|
Ftl cgen abnor four anal
|
$423.09 |
$423.09 |
$423.09 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$59.02 |
$59.02 |
$59.02 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$87.55 |
$87.55 |
$87.55 |
$176.62
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$144.98 |
$144.98 |
$144.98 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$206.75 |
$206.75 |
$206.75 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$264.52 |
$264.52 |
$264.52 |
$210.50
|
|
Gammaglobulin iga
|
$40.22 |
$40.22 |
$40.22 |
$76.59
|
|
Gammaglobulin ige
|
$103.85 |
$103.85 |
$103.85 |
$85.00
|
|
Gamma glutamyltransferase
|
$233.92 |
$233.92 |
$233.92 |
$55.28
|
|
Gamunex-c/gammaked
|
$9,748.32 |
$9,748.32 |
$9,748.32 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$388.63 |
$388.63 |
$388.63 |
$257.28
|
|
General health panel
|
$793.29 |
$793.29 |
$793.29 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$80.31 |
$80.31 |
$80.31 |
$62.80
|
|
Gentamicin peak therapeutic drug level
|
$286.47 |
$286.47 |
$286.47 |
$119.90
|
|
Ghs abscess perianal iandd
|
$2,680.66 |
$2,680.66 |
$2,680.66 |
$1,530.50
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$157.44 |
$157.44 |
$157.44 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$92.31 |
$92.31 |
$92.31 |
$74.88
|
|
Ghs bladder cath - complex-foley
|
$718.78 |
$718.78 |
$718.78 |
$344.48
|
|
Ghs change cysto/gastrost
|
$662.35 |
$662.35 |
$662.35 |
$689.92
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$943.50 |
$943.50 |
$943.50 |
$595.20
|
|
Ghs closed reduction ankle dislocation
|
$1,762.03 |
$1,762.03 |
$1,762.03 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$4,704.96 |
$4,704.96 |
$4,704.96 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$696.23 |
$696.23 |
$696.23 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$4,704.96 |
$4,704.96 |
$4,704.96 |
$2,578.79
|
|
Ghs cl tx knee disl; wo anesth
|
$3,520.92 |
$3,520.92 |
$3,520.92 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$943.50 |
$943.50 |
$943.50 |
$547.94
|
|
Ghs conjunctiva foreign body-superf bil
|
$380.89 |
$380.89 |
$380.89 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$916.78 |
$916.78 |
$916.78 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$380.89 |
$380.89 |
$380.89 |
$368.16
|
|
Ghs dislocation elbow closed treatment
|
$1,762.03 |
$1,762.03 |
$1,762.03 |
$687.73
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$1,195.95 |
$1,195.95 |
$1,195.95 |
$1,439.40
|
|
Ghs excision ingrown nail
|
$880.99 |
$880.99 |
$880.99 |
$453.39
|
|
Ghs fb removal - incisional
|
$5,641.49 |
$5,641.49 |
$5,641.49 |
$2,355.20
|
|
Ghs fb removal - non-incisional
|
$4,752.85 |
$4,752.85 |
$4,752.85 |
$1,793.38
|
|
Ghs fish cytogen
|
$75.97 |
$75.97 |
$75.97 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$301.72 |
$301.72 |
$301.72 |
$229.45
|
|
Ghs histoplasma antigen
|
$162.53 |
$162.53 |
$162.53 |
$137.80
|
|
Ghs i and d abscess/hematoma scrotum
|
$6,048.26 |
$6,048.26 |
$6,048.26 |
$3,786.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,102.05 |
$2,102.05 |
$2,102.05 |
$1,549.80
|
|
Ghs i and d pilonidal cyst simple
|
$2,102.05 |
$2,102.05 |
$2,102.05 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$959.13 |
$959.13 |
$959.13 |
$543.21
|
|
Ghs inf midline insertion
|
$963.44 |
$963.44 |
$963.44 |
$1,228.50
|
|
Ghs init tx 1st degree burn
|
$499.86 |
$499.86 |
$499.86 |
$298.10
|
|
Ghs insertion of needle - bone
|
$562.34 |
$562.34 |
$562.34 |
$460.65
|
