|
Eculizumab 300 mg/30 ml intravenous solution
|
$35,616.00 |
$35,616.00 |
$35,616.00 |
$17,641.10
|
|
Edetate calcium disodium inj
|
$38,968.00 |
$38,968.00 |
$38,968.00 |
$6,086.32
|
|
Eeg monitor/record/awake/drowsy 95816
|
$4,159.00 |
$4,159.00 |
$4,159.00 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$1,732.00 |
$1,732.00 |
$1,732.00 |
$1,100.40
|
|
Eeg recording awake and asleep
|
$3,703.00 |
$3,703.00 |
$3,703.00 |
$1,030.27
|
|
E equine encephalitis igg
|
$193.00 |
$193.00 |
$193.00 |
$48.73
|
|
Egfr gene com variants
|
$3,138.00 |
$3,138.00 |
$3,138.00 |
$646.75
|
|
Electrolyte panel
|
$943.00 |
$943.00 |
$943.00 |
$86.33
|
|
Encephalitis, california igg/igm
|
$193.00 |
$193.00 |
$193.00 |
$48.57
|
|
Encephalitis, st louis igg/igm
|
$193.00 |
$193.00 |
$193.00 |
$48.57
|
|
Encephalitis, western equine igg/igm
|
$193.00 |
$193.00 |
$193.00 |
$50.35
|
|
Endo cath bile duct s&i
|
$5,406.00 |
$5,406.00 |
$5,406.00 |
$545.37
|
|
Endo cath panc duct s&i
|
$5,406.00 |
$5,406.00 |
$5,406.00 |
$637.65
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$134.39 |
$134.39 |
$134.39 |
$59.36
|
|
Epinephrine 1 mg/ml im kit - adult
|
$50.00 |
$50.00 |
$50.00 |
$25.61
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$17.00 |
$17.00 |
$17.00 |
$46.16
|
|
Epstein barr early antigen antibody
|
$434.00 |
$434.00 |
$434.00 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$704.00 |
$704.00 |
$704.00 |
$82.55
|
|
Ercp biliary & pancreas
|
$6,596.00 |
$6,596.00 |
$6,596.00 |
$922.35
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$859.00 |
$859.00 |
$859.00 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$386.00 |
$386.00 |
$386.00 |
$232.84
|
|
Esophageal dilat s&i
|
$1,527.00 |
$1,527.00 |
$1,527.00 |
$525.00
|
|
Established Patient Office Visit (level 2)
|
$343.00 |
$343.00 |
$343.00 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$343.00 |
$343.00 |
$343.00 |
$186.04
|
|
Established Patient Office Visit (level 4)
|
$450.00 |
$450.00 |
$450.00 |
$231.00
|
|
Estradiol total
|
$762.00 |
$762.00 |
$762.00 |
$147.79
|
|
Estrogens total-sendout
|
$447.00 |
$447.00 |
$447.00 |
$89.25
|
|
Ethylene glycol -sendout
|
$591.00 |
$591.00 |
$591.00 |
$78.00
|
|
Eval/fit voice prosthesis iii, st
|
$2,888.00 |
$2,888.00 |
$2,888.00 |
$375.20
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$347.00 |
$347.00 |
$347.00 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$1,913.00 |
$1,913.00 |
$1,913.00 |
$347.75
|
|
Facial bones <3
|
$451.00 |
$451.00 |
$451.00 |
$241.75
|
|
Factor ix
|
$990.00 |
$990.00 |
$990.00 |
$139.75
|
|
Factor viii
|
$990.00 |
$990.00 |
$990.00 |
$148.34
|
|
Factor viii recombinant nos
|
$15.00 |
$15.00 |
$15.00 |
$4.68
|
|
Fat/lipids feces qualitative
|
$307.00 |
$307.00 |
$307.00 |
$37.40
|
|
Fatty acids nonesterified
|
$131.00 |
$131.00 |
$131.00 |
$55.25
|
|
Ferritin
|
$246.00 |
$246.00 |
$246.00 |
$103.40
|
|
Fetal biophys profile w/nst 76818
|
$3,951.00 |
$3,951.00 |
$3,951.00 |
$541.74
|
|
Fetal fibronectin
|
$3,680.00 |
$3,680.00 |
$3,680.00 |
$342.47
|
|
Fetal hemoglobin (kleihauer betke)
|
$1,190.00 |
$1,190.00 |
$1,190.00 |
$85.00
|
|
Fetal hemoglobin rosette
|
$940.00 |
$940.00 |
$940.00 |
$74.25
|
|
Fetal non stress test
|
$1,318.00 |
$1,318.00 |
$1,318.00 |
$500.57
|
|
#_fet/norfentcnfrmur
|
$65.00 |
$65.00 |
$65.00 |
$120.85
|
|
Fibrin degradation d dimer quantitative
|
$153.00 |
$153.00 |
$153.00 |
$111.55
|
|
Fibrin degradation products
|
$1,336.00 |
$1,336.00 |
$1,336.00 |
$63.90
|
|
Fibrinogen activity
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$80.83
|
|
Flecainide (tambocor)-sendout
|
$968.00 |
$968.00 |
$968.00 |
$66.43
|
|
Flow cytometry marker each additional
|
$500.00 |
$500.00 |
$500.00 |
$102.00
|
|
Flow cytometry one marker technical component
|
$803.00 |
$803.00 |
$803.00 |
$298.04
|
|
Fludarabine 50 mg intravenous solution
|
$2,419.00 |
$2,419.00 |
$2,419.00 |
$592.00
|
|
Fluidotherapy charges pt
|
$869.00 |
$869.00 |
$869.00 |
$101.40
|
|
Fluorescent antibody titer dna
|
$39.00 |
$39.00 |
$39.00 |
$128.05
|
|
Fluoroguide needle placement
|
$839.00 |
$839.00 |
$839.00 |
$536.26
|
|
Folic acid
|
$529.00 |
$529.00 |
$529.00 |
$87.50
|
|
Folic acid 5 mg/ml injection solution
|
$15.00 |
$15.00 |
$15.00 |
$48.78
|
|
Fomepizole 1 gram/ml intravenous solution
|
$10,390.00 |
$10,390.00 |
$10,390.00 |
$3,035.46
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$305.00 |
$305.00 |
$305.00 |
$462.82
|
|
Ga-67 gallium 0.1 mci
|
$1,628.00 |
$1,628.00 |
$1,628.00 |
$163.80
|
|
Gammaglobulin ige
|
$603.00 |
$603.00 |
$603.00 |
$85.00
|
|
Gamma glutamyltransferase
|
$1,171.00 |
$1,171.00 |
$1,171.00 |
$55.28
|
|
Gastroesophageal reflux study
|
$2,024.00 |
$2,024.00 |
$2,024.00 |
$911.04
|
|
Gemcitabine 1 gram intravenous solution
|
$3,428.00 |
$3,428.00 |
$3,428.00 |
$240.65
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$47,524.00 |
$47,524.00 |
$47,524.00 |
$21,306.71
|
|
Ghs community re-entry 15 minutes
|
$676.00 |
$676.00 |
$676.00 |
$87.60
|
|
Ghs flow volume loop
|
$309.00 |
$309.00 |
$309.00 |
$308.69
|
|
Ghs histoplasma antigen
|
$183.00 |
$183.00 |
$183.00 |
$144.50
|
|
Ghs low level laser therapy
|
$637.00 |
$637.00 |
$637.00 |
$124.20
|
|
Ghs pacing - transcutaneous
|
$5,325.00 |
$5,325.00 |
$5,325.00 |
$842.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$704.00 |
$704.00 |
$704.00 |
$101.15
|
|
Ghs sensitivity (per antimicro)
|
$356.00 |
$356.00 |
$356.00 |
$59.90
|
|
Ghs speech-gen aug dev eval iii, st
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
$118.20
|
|
Ghs sp train/fitting sp device - kx
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$249.60
|
|
Gi inhouse confirmation
|
$1,010.00 |
$1,010.00 |
$1,010.00 |
$83.85
|
|
Glucagon 1 mg solution for injection
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$591.50
|
|
Glucose blood quantitative
|
$737.00 |
$737.00 |
$737.00 |
$44.40
|
|
Glucose tolerance test (gtt) 3 specimens
|
$2,605.00 |
$2,605.00 |
$2,605.00 |
$97.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$873.00 |
$873.00 |
$873.00 |
$33.57
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$36.00 |
$36.00 |
$36.00 |
$54.00
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$642.00 |
$642.00 |
$642.00 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$591.00 |
$591.00 |
$591.00 |
$124.00
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$7,700.00 |
$7,700.00 |
$7,700.00 |
$608.58
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$106.00 |
$106.00 |
$106.00 |
$27.12
|
|
Haptoglobin quantitative
|
$510.00 |
$510.00 |
$510.00 |
$80.24
|
|
Hcg qualitative
|
$1,552.00 |
$1,552.00 |
$1,552.00 |
$77.50
|
|
Head CT scan (with and without contrast)
|
$15,133.00 |
$15,133.00 |
$15,133.00 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$12,613.00 |
$12,613.00 |
$12,613.00 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$11,462.00 |
$11,462.00 |
$11,462.00 |
$1,268.90
|
|
Heart infarct image
|
$1,649.00 |
$1,649.00 |
$1,649.00 |
$840.74
|
|
Hematocrit
|
$271.00 |
$271.00 |
$271.00 |
$33.57
|
|
Hemoglobin
|
$220.00 |
$220.00 |
$220.00 |
$32.50
|
|
Hemoglobin methemoglobin quantitative
|
$55.00 |
$55.00 |
$55.00 |
$47.49
|
|
Hemolysins/agglutinins auto
|
$109.00 |
$109.00 |
$109.00 |
$53.96
|
|
Heparin assay
|
$169.00 |
$169.00 |
$169.00 |
$129.80
|
|
Hepatitis a antibody igm
|
$435.00 |
$435.00 |
$435.00 |
$83.91
|
|
Hepatitis b core antibody igm
|
$267.00 |
$267.00 |
$267.00 |
$83.91
|
|
Hepatitis b core antibody total
|
$644.00 |
$644.00 |
$644.00 |
$79.34
|
|
Hepatitis b surface antibody
|
$562.00 |
$562.00 |
$562.00 |
$81.12
|
|
Hepatitis c antibody
|
$404.00 |
$404.00 |
$404.00 |
$108.00
|
|
Hepatobiliary system imaging
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,521.10
|
