|
Eeg/cerebral death evaluation only 95824 -26
|
$4,753.50 |
$4,753.50 |
$4,753.50 |
$1,048.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$4,171.00 |
$4,171.00 |
$4,171.00 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$3,369.50 |
$3,369.50 |
$3,369.50 |
$1,100.40
|
|
Eeg recording awake and asleep
|
$5,210.00 |
$5,210.00 |
$5,210.00 |
$1,030.27
|
|
Egfr gene com variants
|
$282.75 |
$282.75 |
$282.75 |
$646.75
|
|
Ehrlicha chaffeensis amp prb
|
$406.25 |
$406.25 |
$406.25 |
$105.00
|
|
Electrolyte panel
|
$726.50 |
$726.50 |
$726.50 |
$86.33
|
|
Endoscopy swallow (fees) vid
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$420.00
|
|
Entamoeba histolytica ag eia - sendout
|
$362.25 |
$362.25 |
$362.25 |
$66.60
|
|
Enzyme histochemistry
|
$367.50 |
$367.50 |
$367.50 |
$460.32
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$91.00 |
$91.00 |
$91.00 |
$824.16
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$91.00 |
$91.00 |
$91.00 |
$726.28
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$475.00 |
$475.00 |
$475.00 |
$364.08
|
|
ER Visit (level 1, minor)
|
$2,398.00 |
$2,398.00 |
$2,398.00 |
$271.88
|
|
ER Visit (level 2)
|
$3,696.00 |
$3,696.00 |
$3,696.00 |
$481.37
|
|
ER Visit (level 3)
|
$5,298.50 |
$5,298.50 |
$5,298.50 |
$850.50
|
|
ER Visit (level 4)
|
$7,707.75 |
$7,707.75 |
$7,707.75 |
$1,334.25
|
|
ER Visit (level 5, high severity)
|
$9,269.75 |
$9,269.75 |
$9,269.75 |
$1,930.40
|
|
Euglobulin lysis
|
$619.50 |
$619.50 |
$619.50 |
$37.70
|
|
Eval/fit voice prosthesis iii, st
|
$1,780.25 |
$1,780.25 |
$1,780.25 |
$375.20
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$261.50 |
$261.50 |
$261.50 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$347.75
|
|
External chromosome analysis 20-25 cells
|
$1,008.75 |
$1,008.75 |
$1,008.75 |
$389.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$1,019.00 |
$1,019.00 |
$1,019.00 |
$466.15
|
|
Facial bones <3
|
$1,432.50 |
$1,432.50 |
$1,432.50 |
$241.75
|
|
Factor ix
|
$43.75 |
$43.75 |
$43.75 |
$139.75
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$28.00 |
$28.00 |
$28.00 |
$22.20
|
|
Fatty acids nonesterified
|
$261.50 |
$261.50 |
$261.50 |
$55.25
|
|
Felbamate (felbatol(r)) - sendout
|
$411.75 |
$411.75 |
$411.75 |
$66.43
|
|
Fern test
|
$386.50 |
$386.50 |
$386.50 |
$17.72
|
|
Ferritin
|
$271.25 |
$271.25 |
$271.25 |
$103.40
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,295.00 |
$1,295.00 |
$1,295.00 |
$2,232.93
|
|
Fetal chrom aneuploidy gsa panel
|
$916.75 |
$916.75 |
$916.75 |
$1,222.00
|
|
Fetal fibronectin
|
$1,923.75 |
$1,923.75 |
$1,923.75 |
$342.47
|
|
Fetal hemoglobin (kleihauer betke)
|
$390.00 |
$390.00 |
$390.00 |
$85.00
|
|
Fetal lung maturity assess lam body dnst
|
$567.25 |
$567.25 |
$567.25 |
$64.28
|
|
Fibrin degradation d dimer quantitative
|
$194.25 |
$194.25 |
$194.25 |
$111.55
|
|
Fibrin degrade semiquant
|
$227.25 |
$227.25 |
$227.25 |
$90.35
|
|
Fibrinogen activity
|
$119.00 |
$119.00 |
$119.00 |
$80.83
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$146.75 |
$146.75 |
$146.75 |
$66.00
|
|
Fibrinolytic antiplasmin
|
$47.00 |
$47.00 |
$47.00 |
$56.00
|
|
Flecainide (tambocor)-sendout
|
$411.75 |
$411.75 |
$411.75 |
$66.43
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$910.00 |
$910.00 |
$910.00 |
$79.71
|
|
Fluoroguide for spine inject 77003-26
|
$2,011.25 |
$2,011.25 |
$2,011.25 |
$507.00
|
|
Fluoroguide needle placement
|
$475.75 |
$475.75 |
$475.75 |
$536.26
|
|
Fluoro polarize fetal lung
|
$567.25 |
$567.25 |
$567.25 |
$62.81
|
|
Fluoroscopy up to 1 hour
|
$490.50 |
$490.50 |
$490.50 |
$489.84
|
|
Folic acid
|
$179.25 |
$179.25 |
$179.25 |
$87.50
|
|
Folic acid 5 mg/ml injection solution
|
$0.56 |
$0.56 |
$0.56 |
$48.78
|
|
Follow-up angiography
|
$4,766.50 |
$4,766.50 |
$4,766.50 |
$1,875.00
|
|
Fractionation ketosteroids
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$72.00
|
|
_fragile x methylation-sendout
|
$207.00 |
$207.00 |
$207.00 |
$175.75
|
|
Frozen blood thaw
|
$512.25 |
$512.25 |
$512.25 |
$189.84
|
|
Ga-67 gallium 0.1 mci
|
$690.75 |
$690.75 |
$690.75 |
$163.80
|
|
Galac-1-phosphate uridyltran - sendout
|
$635.00 |
$635.00 |
$635.00 |
$82.50
|
|
Galactokinase - sendout
|
$646.50 |
$646.50 |
$646.50 |
$175.00
|
|
Galactose transferase test
|
$256.25 |
$256.25 |
$256.25 |
$22.18
|
|
Galectin-3
|
$52.00 |
$52.00 |
$52.00 |
$96.99
|
|
General health panel
|
$143.00 |
$143.00 |
$143.00 |
$280.00
|
|
Ghs alpha thalasemia, 7 deletions
|
$455.75 |
$455.75 |
$455.75 |
$433.58
|
|
Ghs bleeding time (ivy)
|
$696.00 |
$696.00 |
$696.00 |
$55.90
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$896.50 |
$896.50 |
$896.50 |
$130.70
|
|
Ghs diphtheria toxoid ab igg
|
$463.50 |
$463.50 |
$463.50 |
$74.53
|
|
Ghs fat & muscle
|
$113.50 |
$113.50 |
$113.50 |
$33.00
|
|
Ghs heavy metals bld (ars,lead,merc)
|
$520.00 |
$520.00 |
$520.00 |
$27.56
|
|
Ghs hgb stability-thal
|
$256.25 |
$256.25 |
$256.25 |
$85.28
|
|
Ghs hla-dr/dq, multiple antigens
|
$1,923.75 |
$1,923.75 |
$1,923.75 |
$462.60
|
|
Ghs immun0electrophoresis
|
$671.75 |
$671.75 |
$671.75 |
$102.70
|
|
Ghs inhibitor screen
|
$390.00 |
$390.00 |
$390.00 |
$158.60
|
|
Ghs moderate sedation ea addtl 15 min
|
$1,047.75 |
$1,047.75 |
$1,047.75 |
$144.46
|
|
Ghs pacing - transcutaneous
|
$3,328.00 |
$3,328.00 |
$3,328.00 |
$842.40
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$373.50 |
$373.50 |
$373.50 |
$45.05
|
|
Ghs quinidine
|
$168.00 |
$168.00 |
$168.00 |
$68.40
|
|
Ghs respiratory syncytical virus igg/m
|
$390.00 |
$390.00 |
$390.00 |
$42.40
|
|
Ghs reticulocyte count
|
$206.75 |
$206.75 |
$206.75 |
$33.57
|
|
Ghs speech-gen aug dev eval iii, st
|
$368.50 |
$368.50 |
$368.50 |
$118.20
|
|
Ghs sp train/fitting sp device - kx
|
$775.75 |
$775.75 |
$775.75 |
$249.60
|
|
Ghs st - re-eval for alt comm
|
$1,086.00 |
$1,086.00 |
$1,086.00 |
$313.80
|
|
Ghs trypsin (fecal)
|
$223.25 |
$223.25 |
$223.25 |
$21.84
|
|
Ghs urine, hydroxproline total
|
$250.75 |
$250.75 |
$250.75 |
$61.60
|
|
Gi inhouse confirmation
|
$137.50 |
$137.50 |
$137.50 |
$83.85
|
|
Glucagon 1 mg solution for injection
|
$613.00 |
$613.00 |
$613.00 |
$591.50
|
|
Glucose-6-phosphate dhydrogenase screen
|
$179.25 |
$179.25 |
$179.25 |
$39.00
|
|
Glucose blood quantitative
|
$241.50 |
$241.50 |
$241.50 |
$44.40
|
|
Growth hormone antibody
|
$483.25 |
$483.25 |
$483.25 |
$40.00
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$108.00 |
$108.00 |
$108.00 |
$27.12
|
|
Hcg qualitative
|
$900.00 |
$900.00 |
$900.00 |
$77.50
|
|
Hc nm kidney imaging with flow
|
$8,981.75 |
$8,981.75 |
$8,981.75 |
$1,008.39
|
|
Head CT scan (with and without contrast)
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$11,792.50 |
$11,792.50 |
$11,792.50 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$1,268.90
|
|
Heinz bodies direct
|
$133.50 |
$133.50 |
$133.50 |
$31.22
|
|
Hemagglutination inhibition
|
$250.75 |
$250.75 |
$250.75 |
$17.60
|
|
Hemoglobin
|
$386.50 |
$386.50 |
$386.50 |
$32.50
|
|
Hemoglobin fetal qualitative
|
$146.75 |
$146.75 |
$146.75 |
$51.75
|
|
Hemoglobin f (fetal) chemical
|
$256.25 |
$256.25 |
$256.25 |
$45.82
|
|
Hemoglobin-oxygen affinity
|
$305.25 |
$305.25 |
$305.25 |
$73.00
|
|
Hemoglobin urine
|
$129.75 |
$129.75 |
$129.75 |
$23.31
|
|
Hemolysin acid
|
$268.75 |
$268.75 |
$268.75 |
$29.49
|
|
Heparin neutralization
|
$289.25 |
$289.25 |
$289.25 |
$45.00
|
