|
Epirubicin 200 mg/100 ml intravenous solution
|
$480.26 |
$480.26 |
$480.26 |
$195.23
|
|
Epstein barr early antigen antibody
|
$70.18 |
$70.18 |
$70.18 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$98.46 |
$98.46 |
$98.46 |
$82.55
|
|
Ercp biliary & pancreas
|
$11,241.10 |
$11,241.10 |
$11,241.10 |
$922.35
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$473.83 |
$473.83 |
$473.83 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$486.26 |
$486.26 |
$486.26 |
$232.84
|
|
Esophagus motility study
|
$5,627.97 |
$5,627.97 |
$5,627.97 |
$1,274.00
|
|
Established Patient Office Visit (level 3)
|
$1,173.83 |
$1,173.83 |
$1,173.83 |
$186.04
|
|
Established Patient Office Visit (level 4)
|
$1,675.60 |
$1,675.60 |
$1,675.60 |
$231.00
|
|
Established Patient Office Visit (level 5)
|
$1,842.24 |
$1,842.24 |
$1,842.24 |
$280.50
|
|
Estrogens total-sendout
|
$6.16 |
$6.16 |
$6.16 |
$89.25
|
|
Ethylene glycol -sendout
|
$13.35 |
$13.35 |
$13.35 |
$78.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$6.57 |
$6.57 |
$6.57 |
$213.17
|
|
Etoposide 50 mg cap
|
$835.63 |
$835.63 |
$835.63 |
$196.27
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$1,462.36 |
$1,462.36 |
$1,462.36 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$855.84 |
$855.84 |
$855.84 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$939.86 |
$939.86 |
$939.86 |
$324.00
|
|
External chromosome analysis 20-25 cells
|
$145.50 |
$145.50 |
$145.50 |
$389.35
|
|
Facial bones <3
|
$806.18 |
$806.18 |
$806.18 |
$241.75
|
|
Factor ix complex
|
$8.49 |
$8.49 |
$8.49 |
$3.23
|
|
Fat/lipids feces qualitative
|
$5.40 |
$5.40 |
$5.40 |
$37.40
|
|
Fatty acids nonesterified
|
$40.00 |
$40.00 |
$40.00 |
$55.25
|
|
#fecal-sodium
|
$43.45 |
$43.45 |
$43.45 |
$37.50
|
|
Felbamate (felbatol(r)) - sendout
|
$12.00 |
$12.00 |
$12.00 |
$66.43
|
|
Fern test
|
$274.05 |
$274.05 |
$274.05 |
$17.72
|
|
Ferritin
|
$724.61 |
$724.61 |
$724.61 |
$103.40
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,852.69 |
$1,852.69 |
$1,852.69 |
$2,232.93
|
|
Fetal biophys profile w/nst 76818
|
$3,422.55 |
$3,422.55 |
$3,422.55 |
$541.74
|
|
Fetal chrom aneuploidy gsa panel
|
$349.00 |
$349.00 |
$349.00 |
$1,222.00
|
|
Fetal contract stress test 59020 - 26
|
$764.14 |
$764.14 |
$764.14 |
$560.99
|
|
Fetal fibronectin
|
$2,151.06 |
$2,151.06 |
$2,151.06 |
$342.47
|
|
Fetal hemoglobin (kleihauer betke)
|
$83.16 |
$83.16 |
$83.16 |
$85.00
|
|
Fetal hemoglobin rosette
|
$332.70 |
$332.70 |
$332.70 |
$74.25
|
|
Fetal non stress test
|
$1,518.86 |
$1,518.86 |
$1,518.86 |
$500.57
|
|
#_fet/norfentcnfrmur
|
$17.50 |
$17.50 |
$17.50 |
$120.85
|
|
Fibrin degradation d dimer quantitative
|
$2,130.76 |
$2,130.76 |
$2,130.76 |
$111.55
|
|
Fibrin degradation products
|
$98.46 |
$98.46 |
$98.46 |
$63.90
|
|
Fibrinolytic antiplasmin
|
$40.73 |
$40.73 |
$40.73 |
$56.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$467.28 |
$467.28 |
$467.28 |
$59.89
|
|
Flecainide (tambocor)-sendout
|
$25.00 |
$25.00 |
$25.00 |
$66.43
|
|
Floxuridine injection
|
$2,720.39 |
$2,720.39 |
$2,720.39 |
$774.69
|
|
Fludarabine 50 mg intravenous solution
|
$851.16 |
$851.16 |
$851.16 |
$592.00
|
|
Fluoroscopy up to 1 hour
|
$2,845.99 |
$2,845.99 |
$2,845.99 |
$489.84
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$56.23 |
$56.23 |
$56.23 |
$97.74
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$1,284.49 |
$1,284.49 |
$1,284.49 |
$171.99
|
|
Folic acid 5 mg/ml injection solution
|
$428.97 |
$428.97 |
$428.97 |
$48.78
|
|
Follow-up angiography
|
$19,352.05 |
$19,352.05 |
$19,352.05 |
$1,875.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$496.41 |
$496.41 |
$496.41 |
$462.82
|
|
Fructosamine glycated protein
|
$4.86 |
$4.86 |
$4.86 |
$64.20
|
|
Ftl cgen abnor four anal
|
$106.00 |
$106.00 |
$106.00 |
$205.80
|
|
Ga-67 gallium 0.1 mci
|
$934.85 |
$934.85 |
$934.85 |
$163.80
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$19.25 |
$19.25 |
$19.25 |
$144.98
|
|
Galac-1-phosphate uridyltran - sendout
|
$243.80 |
$243.80 |
$243.80 |
$82.50
|
|
Gemcitabine 1 gram intravenous solution
|
$109.68 |
$109.68 |
$109.68 |
$240.65
|
|
G-esoph reflx tst w/electrod
|
$4,825.38 |
$4,825.38 |
$4,825.38 |
$1,352.03
|
|
Ghs chemo IV push, ea addtl
|
$554.68 |
$554.68 |
$554.68 |
$291.87
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$75.00 |
$75.00 |
$75.00 |
$130.70
|
|
Ghs fat & muscle
|
$5.00 |
$5.00 |
$5.00 |
$33.00
|
|
Ghs fish cytogen
|
$63.99 |
$63.99 |
$63.99 |
$176.93
|
|
Ghs fish hybrid in situ 100-300
|
$177.52 |
$177.52 |
$177.52 |
$229.45
|
|
Ghs flow volume loop
|
$571.55 |
$571.55 |
$571.55 |
$308.69
|
|
Ghs HIV antibody
|
$619.88 |
$619.88 |
$619.88 |
$93.00
|
|
Ghs inhibitor screen
|
$49.28 |
$49.28 |
$49.28 |
$158.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$10.80 |
$10.80 |
$10.80 |
$59.40
|
|
Ghs mbp
|
$14.21 |
$14.21 |
$14.21 |
$77.35
|
|
Ghs myocardial strain img spckl track
|
$660.31 |
$660.31 |
$660.31 |
$500.00
|
|
Ghs ppd (tb intradermal)
|
$34.02 |
$34.02 |
$34.02 |
$43.45
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$12.50 |
$12.50 |
$12.50 |
$45.05
|
|
Ghs sedimentation rate
|
$1,436.66 |
$1,436.66 |
$1,436.66 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$417.08 |
$417.08 |
$417.08 |
$59.90
|
|
Ghs sleep study unattended
|
$906.80 |
$906.80 |
$906.80 |
$503.38
|
|
Ghs urine, porphyrins quant
|
$8.65 |
$8.65 |
$8.65 |
$72.60
|
|
Gi inhouse confirmation
|
$3,250.85 |
$3,250.85 |
$3,250.85 |
$83.85
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$13,800.09 |
$13,800.09 |
$13,800.09 |
$2,418.92
|
|
Glucagon 1 mg solution for injection
|
$1,497.66 |
$1,497.66 |
$1,497.66 |
$591.50
|
|
Glucagon hcl 1 mg/ml solution for injection
|
$780.15 |
$780.15 |
$780.15 |
$509.06
|
|
Glucagon plasma - sendout
|
$17.10 |
$17.10 |
$17.10 |
$58.00
|
|
Glucose tolerance test (gtt) 3 specimens
|
$2,413.75 |
$2,413.75 |
$2,413.75 |
$97.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$1,376.82 |
$1,376.82 |
$1,376.82 |
$33.57
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$51.69 |
$51.69 |
$51.69 |
$107.55
|
|
Gonadotropin luteinizing hormone (lh)
|
$51.69 |
$51.69 |
$51.69 |
$124.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$4,833.53 |
$4,833.53 |
$4,833.53 |
$63.51
|
|
Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm
|
$11,235.77 |
$11,235.77 |
$11,235.77 |
$2,114.00
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$2,824.30 |
$2,824.30 |
$2,824.30 |
$821.11
|
|
Gu dilat ureter/urethra s&i
|
$13,706.36 |
$13,706.36 |
$13,706.36 |
$1,712.25
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$371.32 |
$371.32 |
$371.32 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$38.50 |
$38.50 |
$38.50 |
$27.12
|
|
Haptoglobin quantitative
|
$72.89 |
$72.89 |
$72.89 |
$80.24
|
|
Hbot, full body chamber, 30m
|
$3,338.73 |
$3,338.73 |
$3,338.73 |
$479.75
|
|
Hcg qualitative
|
$72.75 |
$72.75 |
$72.75 |
$77.50
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$8,883.73 |
$8,883.73 |
$8,883.73 |
$1,186.80
|
|
Head CT scan (with and without contrast)
|
$22,647.73 |
$22,647.73 |
$22,647.73 |
$1,849.90
|
|
Head CT scan (with contrast)
|
$19,919.51 |
$19,919.51 |
$19,919.51 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$23,586.32 |
$23,586.32 |
$23,586.32 |
$1,268.90
|
|
Hemoglobin
|
$428.42 |
$428.42 |
$428.42 |
$32.50
|
|
Hemoglobin-oxygen affinity
|
$125.68 |
$125.68 |
$125.68 |
$73.00
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$28.89 |
$28.89 |
$28.89 |
$24.26
|
|
Hepatitis b core antibody total
|
$5.00 |
$5.00 |
$5.00 |
$79.34
|
|
Hepatobiliary system imaging
|
$13,120.05 |
$13,120.05 |
$13,120.05 |
$1,521.10
|
|
Herpes simplex type 1 antibody igg
|
$10.00 |
$10.00 |
$10.00 |
$71.20
|
