|
ER Visit (level 3)
|
$450.22 |
$450.22 |
$450.22 |
$850.50
|
|
ER Visit (level 4)
|
$529.25 |
$529.25 |
$529.25 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$789.73 |
$789.73 |
$789.73 |
$2,007.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$16.60 |
$16.60 |
$16.60 |
$671.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$132.38 |
$132.38 |
$132.38 |
$540.00
|
|
Esophageal dilat s&i
|
$102.42 |
$102.42 |
$102.42 |
$525.00
|
|
Esoph imped function test
|
$392.20 |
$392.20 |
$392.20 |
$597.03
|
|
Established Patient Office Visit (level 1)
|
$54.17 |
$54.17 |
$54.17 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$67.20 |
$67.20 |
$67.20 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$71.04 |
$71.04 |
$71.04 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$109.52 |
$109.52 |
$109.52 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$279.72 |
$279.72 |
$279.72 |
$287.10
|
|
Estradiol total
|
$33.45 |
$33.45 |
$33.45 |
$153.00
|
|
Estradiol valerate 10 mg inj
|
$50.72 |
$50.72 |
$50.72 |
$63.50
|
|
Estrogens total-sendout
|
$25.16 |
$25.16 |
$25.16 |
$89.25
|
|
Ethylene glycol -sendout
|
$17.76 |
$17.76 |
$17.76 |
$75.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$242.33 |
$242.33 |
$242.33 |
$213.17
|
|
Etoposide 50 mg cap
|
$408.17 |
$408.17 |
$408.17 |
$196.27
|
|
Evaluation of speech fluency 92521
|
$93.54 |
$93.54 |
$93.54 |
$347.75
|
|
Evasc prlng admn rx agnt 1st
|
$619.53 |
$619.53 |
$619.53 |
$4,462.80
|
|
Evasc prlng admn rx agnt add
|
$298.96 |
$298.96 |
$298.96 |
$3,484.88
|
|
Evasc repair of iliac artery; endograft 34718
|
$1,902.40 |
$1,902.40 |
$1,902.40 |
$10,843.20
|
|
Evasc rpr a-ao ndgft 34701
|
$3,125.76 |
$3,125.76 |
$3,125.76 |
$6,020.00
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$3,034.60 |
$3,034.60 |
$3,034.60 |
$4,537.60
|
|
Evasc rpr a-biiliac ndgft rptr
|
$1,997.12 |
$1,997.12 |
$1,997.12 |
$10,294.05
|
|
Evasc rpr a-iliac ndgft 34717
|
$1,664.12 |
$1,664.12 |
$1,664.12 |
$6,925.05
|
|
Evasc rpr a-unilac ndgft 34703
|
$1,664.71 |
$1,664.71 |
$1,664.71 |
$7,465.20
|
|
Evasc rpr a-unilac ndgft rpt
|
$1,664.71 |
$1,664.71 |
$1,664.71 |
$9,282.60
|
|
Evasc rpr ilio-iliac ndgft
|
$387.76 |
$387.76 |
$387.76 |
$8,412.85
|
|
Evasc rpr ilio-iliac rpt
|
$1,901.80 |
$1,901.80 |
$1,901.80 |
$9,122.40
|
|
Exc back les sbq <3 cm 21930
|
$1,597.52 |
$1,597.52 |
$1,597.52 |
$2,271.01
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$2,184.60
|
|
Exc benign feenlm >4.0cm 11446
|
$1,462.24 |
$1,462.24 |
$1,462.24 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$1,334.37 |
$1,334.37 |
$1,334.37 |
$2,244.06
|
|
Exc benign tal 0.5 < cm 11400
|
$721.95 |
$721.95 |
$721.95 |
$837.48
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$803.94 |
$803.94 |
$803.94 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,045.20
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$1,184.60 |
$1,184.60 |
$1,184.60 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$1,462.24 |
$1,462.24 |
$1,462.24 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$721.95 |
$721.95 |
$721.95 |
$818.53
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,052.28 |
$1,052.28 |
$1,052.28 |
$1,301.30
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,061.40
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$2,101.45
|
|
Exchange biliary drg cath
|
$2,664.89 |
$2,664.89 |
$2,664.89 |
$4,176.15
|
|
Exchange drainage catheter
|
$288.60 |
$288.60 |
$288.60 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$752.73 |
$752.73 |
$752.73 |
$3,097.16
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$773.75 |
$773.75 |
$773.75 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,981.25
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$721.95 |
$721.95 |
$721.95 |
$1,064.30
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,334.37 |
$1,334.37 |
$1,334.37 |
$2,916.96
|
|
Excision graft extremity
|
$2,787.14 |
$2,787.14 |
$2,787.14 |
$3,982.97
|
|
Exc malig feenl <0.5cm 11640
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,206.78
|
|
Exc malig feenl 1.1-2 11642
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,113.60
|
|
Exc malig feenl 3.1-4.0 11644
|
$1,334.37 |
$1,334.37 |
$1,334.37 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$1,462.24 |
$1,462.24 |
$1,462.24 |
$3,386.84
|
|
Exc malig snhfg 0.5cm or less 11620
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,273.80
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$773.75 |
$773.75 |
$773.75 |
$973.71
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$1,354.20 |
$1,354.20 |
$1,354.20 |
$1,917.33
|
|
Exc malig tal <0.5cm 11600
|
$942.76 |
$942.76 |
$942.76 |
$894.66
|
|
Exc malig tal 0.6-1.0cm 11601
|
$773.75 |
$773.75 |
$773.75 |
$828.59
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$932.35
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,246.00
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$1,209.16 |
$1,209.16 |
$1,209.16 |
$1,322.10
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$1,329.08
|
|
Exc snhfg mal+mrg 3.1-4 11624
|
$1,337.04 |
$1,337.04 |
$1,337.04 |
$2,171.00
|
|
Exc snhfg mal+mrg >4 cm 11626
|
$1,462.24 |
$1,462.24 |
$1,462.24 |
$3,370.52
|
|
Exc tr-ext mal+marg tal >4 cm 11606
|
$1,334.37 |
$1,334.37 |
$1,334.37 |
$1,917.33
|
|
Expl lap celiotomy w/wo bx 49000
|
$2,357.35 |
$2,357.35 |
$2,357.35 |
$2,232.75
|
|
Exploration carotid artery 35701
|
$481.00 |
$481.00 |
$481.00 |
$2,145.00
|
|
Exploration of chest 39010
|
$819.92 |
$819.92 |
$819.92 |
$1,920.00
|
|
Explore limb vessels 35860
|
$3,079.00 |
$3,079.00 |
$3,079.00 |
$3,965.00
|
|
Explor not followed by surg repair artery; low extrem 35703
|
$999.89 |
$999.89 |
$999.89 |
$2,559.50
|
|
Explor not followed by surg repair artery; up extrem 35702
|
$999.89 |
$999.89 |
$999.89 |
$1,851.20
|
|
Expose art endoprosth iliac 34820
|
$5,458.24 |
$5,458.24 |
$5,458.24 |
$1,820.00
|
|
Expose endoprosth brachial 34834
|
$2,843.97 |
$2,843.97 |
$2,843.97 |
$1,807.40
|
|
External chromosome analysis 20-25 cells
|
$194.77 |
$194.77 |
$194.77 |
$389.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$193.29 |
$193.29 |
$193.29 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$138.53 |
$138.53 |
$138.53 |
$102.78
|
|
F-18 fdg pet diag
|
$107.16 |
$107.16 |
$107.16 |
$602.25
|
|
Facial bones <3
|
$243.02 |
$243.02 |
$243.02 |
$248.60
|
|
Factor ix
|
$160.14 |
$160.14 |
$160.14 |
$131.30
|
|
Factor ix recombinant nos
|
$106.72 |
$106.72 |
$106.72 |
$3.04
|
|
Factor viii
|
$34.34 |
$34.34 |
$34.34 |
$144.30
|
|
Fat/lipids feces qualitative
|
$8.59 |
$8.59 |
$8.59 |
$34.56
|
|
Fatty acids nonesterified
|
$25.16 |
$25.16 |
$25.16 |
$57.60
|
|
#fecal-sodium
|
$6.52 |
$6.52 |
$6.52 |
$37.50
|
|
Femoral endovas graft add-on 34813
|
$3,313.72 |
$3,313.72 |
$3,313.72 |
$1,304.00
|
|
Fem/popl revasc w/stent
|
$7,777.11 |
$7,777.11 |
$7,777.11 |
$18,599.10
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$43.09 |
$43.09 |
$43.09 |
$120.15
|
|
Ferritin
|
$96.50 |
$96.50 |
$96.50 |
$103.68
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$279.79 |
$279.79 |
$279.79 |
$1,776.61
|
|
Fetal hemoglobin (kleihauer betke)
|
$44.40 |
$44.40 |
$44.40 |
$88.80
|
|
Fibrin degradation d dimer quantitative
|
$161.62 |
$161.62 |
$161.62 |
$112.80
|
|
Fibrin degradation products
|
$8.88 |
$8.88 |
$8.88 |
$62.40
|
|
Fibrinogen activity
|
$121.66 |
$121.66 |
$121.66 |
$82.38
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$13.32 |
$13.32 |
$13.32 |
$66.00
|
|
Fibrinolytic plasminogen
|
$61.28 |
$61.28 |
$61.28 |
$109.45
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$162.51 |
$162.51 |
$162.51 |
$59.89
|