|
Established Patient Office Visit (level 2)
|
$318.21 |
$318.21 |
$318.21 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$401.21 |
$401.21 |
$401.21 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$524.29 |
$524.29 |
$524.29 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$637.55 |
$637.55 |
$637.55 |
$287.10
|
|
Estradiol total
|
$95.00 |
$95.00 |
$95.00 |
$153.00
|
|
Ethylene glycol -sendout
|
$31.78 |
$31.78 |
$31.78 |
$75.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$436.89 |
$436.89 |
$436.89 |
$213.17
|
|
Euflexxa inj per dose
|
$784.57 |
$784.57 |
$784.57 |
$727.80
|
|
Eval/fit voice prosthesis iii, st
|
$430.57 |
$430.57 |
$430.57 |
$370.41
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$365.98 |
$365.98 |
$365.98 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$307.75 |
$307.75 |
$307.75 |
$347.75
|
|
Exchange biliary drg cath
|
$3,427.29 |
$3,427.29 |
$3,427.29 |
$4,176.15
|
|
Exchange drainage catheter
|
$5,153.85 |
$5,153.85 |
$5,153.85 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$3,097.16 |
$3,097.16 |
$3,097.16 |
$3,097.16
|
|
External chromosome analysis 20-25 cells
|
$525.91 |
$525.91 |
$525.91 |
$389.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$303.94 |
$303.94 |
$303.94 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$254.54 |
$254.54 |
$254.54 |
$102.78
|
|
Facial bones <3
|
$522.68 |
$522.68 |
$522.68 |
$248.60
|
|
Factor ix
|
$61.91 |
$61.91 |
$61.91 |
$131.30
|
|
Factor viii
|
$86.30 |
$86.30 |
$86.30 |
$144.30
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$22.77 |
$22.77 |
$22.77 |
$27.81
|
|
Fat/lipids feces qualitative
|
$38.84 |
$38.84 |
$38.84 |
$34.56
|
|
#fecal-sodium
|
$30.04 |
$30.04 |
$30.04 |
$37.50
|
|
Fem/popl revasc w/stent
|
$24,662.96 |
$24,662.96 |
$24,662.96 |
$18,599.10
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$116.23 |
$116.23 |
$116.23 |
$120.15
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$267.29 |
$267.29 |
$267.29 |
$2,027.60
|
|
Ferritin
|
$150.88 |
$150.88 |
$150.88 |
$103.68
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,907.62 |
$1,907.62 |
$1,907.62 |
$1,776.61
|
|
Fetal chrom aneuploidy gsa panel
|
$698.92 |
$698.92 |
$698.92 |
$1,217.45
|
|
#_fet/norfentcnfrmur
|
$153.30 |
$153.30 |
$153.30 |
$120.85
|
|
Fibrin degradation d dimer quantitative
|
$333.46 |
$333.46 |
$333.46 |
$112.80
|
|
Fibrin degradation products
|
$103.19 |
$103.19 |
$103.19 |
$62.40
|
|
Fibrinogen activity
|
$206.57 |
$206.57 |
$206.57 |
$82.38
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$163.39 |
$163.39 |
$163.39 |
$66.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$18.91 |
$18.91 |
$18.91 |
$59.89
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$2,390.23 |
$2,390.23 |
$2,390.23 |
$1,405.40
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$973.70
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$1,174.79 |
$1,174.79 |
$1,174.79 |
$806.40
|
|
Fl exam g/colon tube w contrast
|
$532.39 |
$532.39 |
$532.39 |
$546.86
|
|
Flow cytometry interp 16 or more
|
$327.64 |
$327.64 |
$327.64 |
$208.80
|
|
Flow cytometry marker each additional
|
$42.14 |
$42.14 |
$42.14 |
$103.00
|
|
Flow cytometry one marker technical component
|
$983.82 |
$983.82 |
$983.82 |
$270.75
|
|
#flow interp 9 - 15 markers
|
$193.56 |
$193.56 |
$193.56 |
$194.04
|
|
Flt3 gene
|
$547.43 |
$547.43 |
$547.43 |
$352.95
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$112.42 |
$112.42 |
$112.42 |
$86.42
|
|
Fluidotherapy charges pt
|
$97.07 |
$97.07 |
$97.07 |
$95.00
|
|
Fluorescent antibody titer dna
|
$169.41 |
$169.41 |
$169.41 |
$123.65
|
|
Fluoroguide needle placement
|
$490.10 |
$490.10 |
$490.10 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$830.03 |
$830.03 |
$830.03 |
$494.52
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$1,376.21 |
$1,376.21 |
$1,376.21 |
$107.46
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$57.91 |
$57.91 |
$57.91 |
$142.87
|
|
Folic acid
|
$179.59 |
$179.59 |
$179.59 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$20.16 |
$20.16 |
$20.16 |
$55.66
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,707.39 |
$1,707.39 |
$1,707.39 |
$2,860.43
|
|
Fondaparinux sodium
|
$78.28 |
$78.28 |
$78.28 |
$176.81
|
|
Foot X-ray
|
$705.51 |
$705.51 |
$705.51 |
$362.40
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$143.08 |
$143.08 |
$143.08 |
$107.31
|
|
Fragmenting of kidney stone
|
$24,987.27 |
$24,987.27 |
$24,987.27 |
$9,827.25
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$287.48 |
$287.48 |
$287.48 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$265.94 |
$265.94 |
$265.94 |
$149.50
|
|
Fructosamine glycated protein
|
$43.66 |
$43.66 |
$43.66 |
$60.42
|
|
Ftl cgen abnor four anal
|
$100.61 |
$100.61 |
$100.61 |
$211.83
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$66.96 |
$66.96 |
$66.96 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$87.55 |
$87.55 |
$87.55 |
$162.68
|
|
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
|
$27.69 |
$27.69 |
$27.69 |
$75.30
|
|
Gammaglobulin ige
|
$42.88 |
$42.88 |
$42.88 |
$85.00
|
|
Gamma glutamyltransferase
|
$200.50 |
$200.50 |
$200.50 |
$55.28
|
|
Gamunex-c/gammaked
|
$10,844.95 |
$10,844.95 |
$10,844.95 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$601.34 |
$601.34 |
$601.34 |
$252.84
|
|
General health panel
|
$235.00 |
$235.00 |
$235.00 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$85.59 |
$85.59 |
$85.59 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$245.55 |
$245.55 |
$245.55 |
$119.00
|
|
Ghs abscess perianal iandd
|
$3,082.76 |
$3,082.76 |
$3,082.76 |
$1,530.50
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$130.02 |
$130.02 |
$130.02 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$85.13 |
$85.13 |
$85.13 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$758.52 |
$758.52 |
$758.52 |
$344.48
|
|
Ghs change cysto/gastrost
|
$1,134.31 |
$1,134.31 |
$1,134.31 |
$699.60
|
|
Ghs chemo >8 hrs
|
$1,084.17 |
$1,084.17 |
$1,084.17 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$427.19 |
$427.19 |
$427.19 |
$291.60
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,043.72 |
$1,043.72 |
$1,043.72 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$1,043.72 |
$1,043.72 |
$1,043.72 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$5,410.70 |
$5,410.70 |
$5,410.70 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$800.66 |
$800.66 |
$800.66 |
$534.99
|
|
Ghs cl tx metacarpophal disloc without anes
|
$1,043.72 |
$1,043.72 |
$1,043.72 |
$547.94
|
|
Ghs conjunctiva foreign body-superf bil
|
$454.50 |
$454.50 |
$454.50 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$916.78 |
$916.78 |
$916.78 |
$435.07
|
|
Ghs dislocation elbow closed treatment
|
$1,043.72 |
$1,043.72 |
$1,043.72 |
$687.73
|
|
Ghs excision ingrown nail
|
$1,043.72 |
$1,043.72 |
$1,043.72 |
$457.60
|
|
Ghs fb removal - incisional
|
$5,953.44 |
$5,953.44 |
$5,953.44 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$5,465.78 |
$5,465.78 |
$5,465.78 |
$1,794.93
|
|
Ghs fish cytogen
|
$149.76 |
$149.76 |
$149.76 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$252.31 |
$252.31 |
$252.31 |
$229.45
|
|
Ghs flow volume loop
|
$670.50 |
$670.50 |
$670.50 |
$309.12
|
|
Ghs histoplasma antigen
|
$163.39 |
$163.39 |
$163.39 |
$137.80
|
|
Ghs i and d abscess/hematoma scrotum
|
$6,955.50 |
$6,955.50 |
$6,955.50 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$4,028.27 |
$4,028.27 |
$4,028.27 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$2,430.50 |
$2,430.50 |
$2,430.50 |
$1,572.00
|