|
Established Patient Office Visit (level 1)
|
$543.34 |
$543.34 |
$543.34 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$462.63 |
$462.63 |
$462.63 |
$137.91
|
|
Established Patient Office Visit (level 3)
|
$616.46 |
$616.46 |
$616.46 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$650.55 |
$650.55 |
$650.55 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$828.10 |
$828.10 |
$828.10 |
$287.10
|
|
Estradiol total
|
$97.03 |
$97.03 |
$97.03 |
$149.43
|
|
Ethylene glycol -sendout
|
$46.94 |
$46.94 |
$46.94 |
$77.40
|
|
Etoposide 20 mg/ml intravenous solution
|
$709.04 |
$709.04 |
$709.04 |
$213.17
|
|
Euflexxa inj per dose
|
$3,906.32 |
$3,906.32 |
$3,906.32 |
$727.80
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$452.81 |
$452.81 |
$452.81 |
$454.00
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$633.92 |
$633.92 |
$633.92 |
$102.78
|
|
Facial bones <3
|
$1,445.67 |
$1,445.67 |
$1,445.67 |
$241.75
|
|
Factor ix
|
$59.98 |
$59.98 |
$59.98 |
$139.15
|
|
Factor viii
|
$56.39 |
$56.39 |
$56.39 |
$144.82
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$89.53 |
$89.53 |
$89.53 |
$24.21
|
|
Fat/lipids feces qualitative
|
$16.07 |
$16.07 |
$16.07 |
$37.39
|
|
Fem/popl revasc w/stent
|
$89,019.82 |
$89,019.82 |
$89,019.82 |
$18,697.29
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$563.59 |
$563.59 |
$563.59 |
$116.23
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,317.39 |
$1,317.39 |
$1,317.39 |
$1,812.62
|
|
Ferritin
|
$414.15 |
$414.15 |
$414.15 |
$103.95
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$9,172.48 |
$9,172.48 |
$9,172.48 |
$1,907.62
|
|
#_fet/norfentcnfrmur
|
$332.61 |
$332.61 |
$332.61 |
$120.85
|
|
Fibrin degradation d dimer quantitative
|
$900.48 |
$900.48 |
$900.48 |
$112.89
|
|
Fibrin degradation products
|
$25.53 |
$25.53 |
$25.53 |
$62.40
|
|
Fibrinogen activity
|
$216.90 |
$216.90 |
$216.90 |
$82.38
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$406.91 |
$406.91 |
$406.91 |
$66.00
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$11,934.64 |
$11,934.64 |
$11,934.64 |
$1,455.09
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$4,998.47 |
$4,998.47 |
$4,998.47 |
$973.70
|
|
Fl exam g/colon tube w contrast
|
$1,090.08 |
$1,090.08 |
$1,090.08 |
$540.80
|
|
Flow cytometry interp 16 or more
|
$815.94 |
$815.94 |
$815.94 |
$208.80
|
|
Flow cytometry marker each additional
|
$105.15 |
$105.15 |
$105.15 |
$102.00
|
|
Flow cytometry one marker technical component
|
$1,033.01 |
$1,033.01 |
$1,033.01 |
$270.75
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$246.54 |
$246.54 |
$246.54 |
$86.42
|
|
Fluidotherapy charges pt
|
$223.31 |
$223.31 |
$223.31 |
$98.76
|
|
Fluorescent antibody titer dna
|
$225.86 |
$225.86 |
$225.86 |
$123.65
|
|
Fluoroscopy up to 1 hour
|
$1,821.13 |
$1,821.13 |
$1,821.13 |
$494.52
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$2,552.55 |
$2,552.55 |
$2,552.55 |
$106.20
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$260.46 |
$260.46 |
$260.46 |
$148.04
|
|
Folic acid
|
$688.39 |
$688.39 |
$688.39 |
$87.75
|
|
Folic acid 5 mg/ml injection solution
|
$77.82 |
$77.82 |
$77.82 |
$56.70
|
|
Fomepizole 1 gram/ml intravenous solution
|
$8,520.44 |
$8,520.44 |
$8,520.44 |
$2,926.05
|
|
Fondaparinux sodium
|
$376.02 |
$376.02 |
$376.02 |
$176.54
|
|
Foot X-ray
|
$1,233.74 |
$1,233.74 |
$1,233.74 |
$364.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$943.82 |
$943.82 |
$943.82 |
$584.12
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$697.58 |
$697.58 |
$697.58 |
$110.69
|
|
Fragmenting of kidney stone
|
$37,661.94 |
$37,661.94 |
$37,661.94 |
$9,382.20
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$257.29 |
$257.29 |
$257.29 |
$168.75
|
|
Fructosamine glycated protein
|
$52.79 |
$52.79 |
$52.79 |
$60.42
|
|
Ftl cgen abnor four anal
|
$483.53 |
$483.53 |
$483.53 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$319.26 |
$319.26 |
$319.26 |
$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
|
$33.09 |
$33.09 |
$33.09 |
$76.05
|
|
Gammaglobulin ige
|
$57.16 |
$57.16 |
$57.16 |
$85.00
|
|
Gamma glutamyltransferase
|
$709.77 |
$709.77 |
$709.77 |
$55.28
|
|
Gamunex-c/gammaked
|
$44,952.79 |
$44,952.79 |
$44,952.79 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$978.28 |
$978.28 |
$978.28 |
$263.34
|
|
General health panel
|
$215.52 |
$215.52 |
$215.52 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$310.95 |
$310.95 |
$310.95 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$1,173.15 |
$1,173.15 |
$1,173.15 |
$119.90
|
|
Ghs abscess perianal iandd
|
$2,814.69 |
$2,814.69 |
$2,814.69 |
$1,530.50
|
|
Ghs antibodies (torch) igm
|
$45.33 |
$45.33 |
$45.33 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$1,642.62 |
$1,642.62 |
$1,642.62 |
$344.48
|
|
Ghs central line insert < age 5, failed
|
$10,153.40 |
$10,153.40 |
$10,153.40 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$935.50 |
$935.50 |
$935.50 |
$695.93
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$731.04 |
$731.04 |
$731.04 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$731.04 |
$731.04 |
$731.04 |
$732.75
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$4,940.21 |
$4,940.21 |
$4,940.21 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$731.04 |
$731.04 |
$731.04 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$4,940.21 |
$4,940.21 |
$4,940.21 |
$2,578.79
|
|
Ghs cl tx metacarpophal disloc without anes
|
$731.04 |
$731.04 |
$731.04 |
$547.94
|
|
Ghs conjunctiva foreign body-superf bil
|
$399.93 |
$399.93 |
$399.93 |
$317.85
|
|
Ghs corneal fb without slit lamp bilat
|
$1,008.91 |
$1,008.91 |
$1,008.91 |
$435.07
|
|
Ghs dislocation elbow closed treatment
|
$731.04 |
$731.04 |
$731.04 |
$687.73
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$1,991.70 |
$1,991.70 |
$1,991.70 |
$586.80
|
|
Ghs excision ingrown nail
|
$1,150.39 |
$1,150.39 |
$1,150.39 |
$453.39
|
|
Ghs fb removal foot - deep - left
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$2,873.34
|
|
Ghs fb removal - non-incisional
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$1,793.38
|
|
Ghs i and d abscess/hematoma scrotum
|
$6,350.67 |
$6,350.67 |
$6,350.67 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$3,677.98 |
$3,677.98 |
$3,677.98 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$7,523.93 |
$7,523.93 |
$7,523.93 |
$1,549.80
|
|
Ghs i and d pilonidal cyst simple
|
$7,523.93 |
$7,523.93 |
$7,523.93 |
$794.82
|
|
Ghs incision thrombosed ext hemorrhoid
|
$882.72 |
$882.72 |
$882.72 |
$542.18
|
|
Ghs inf midline insertion
|
$3,113.90 |
$3,113.90 |
$3,113.90 |
$1,234.20
|
|
Ghs init tx 1st degree burn
|
$1,050.16 |
$1,050.16 |
$1,050.16 |
$298.10
|
|
Ghs insertion of needle - bone
|
$1,008.91 |
$1,008.91 |
$1,008.91 |
$448.00
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$943.20
|
|
Ghs irrigate corpora cavernosa for priapism
|
$943.82 |
$943.82 |
$943.82 |
$633.05
|
|
Ghs IV thrombolytics - cerebral
|
$16.33 |
$16.33 |
$16.33 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$2,979.91 |
$2,979.91 |
$2,979.91 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$1,920.57 |
$1,920.57 |
$1,920.57 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,546.24 |
$1,546.24 |
$1,546.24 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$1,614.77 |
$1,614.77 |
$1,614.77 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$1,150.39 |
$1,150.39 |
$1,150.39 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$818.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$1,857.61 |
$1,857.61 |
$1,857.61 |
$782.40
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,225.93 |
$1,225.93 |
$1,225.93 |
$776.10
|