|
Diagnostic digital breast tomosynthesis unil
|
$53.40 |
$53.40 |
$53.40 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$324.00 |
$324.00 |
$324.00 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$259.20 |
$259.20 |
$259.20 |
$276.60
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.22 |
$0.22 |
$0.22 |
$58.24
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$80.83 |
$80.83 |
$80.83 |
$42.12
|
|
Dicyclomine injection
|
$193.54 |
$193.54 |
$193.54 |
$153.53
|
|
Diffusing capacity
|
$357.60 |
$357.60 |
$357.60 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$41.63 |
$41.63 |
$41.63 |
$29.85
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,815.78 |
$6,815.78 |
$6,815.78 |
$6,815.78
|
|
Digoxin total therapeutic drug level
|
$130.80 |
$130.80 |
$130.80 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$308.90 |
$308.90 |
$308.90 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$38.75 |
$38.75 |
$38.75 |
$9.29
|
|
Disability dlco
|
$402.00 |
$402.00 |
$402.00 |
$289.08
|
|
Dna antibody native/double stranded
|
$130.80 |
$130.80 |
$130.80 |
$101.40
|
|
Dna gardnerella
|
$61.80 |
$61.80 |
$61.80 |
$67.68
|
|
Dna probe chlamydia
|
$138.60 |
$138.60 |
$138.60 |
$98.40
|
|
Dna probe gc
|
$153.60 |
$153.60 |
$153.60 |
$88.67
|
|
Dna trichomonas
|
$61.80 |
$61.80 |
$61.80 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$65.84 |
$65.84 |
$65.84 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$104.59 |
$104.59 |
$104.59 |
$60.21
|
|
Doppler echo complete
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
$517.94
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,238.40 |
$1,238.40 |
$1,238.40 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$657.60 |
$657.60 |
$657.60 |
$463.20
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$441.60 |
$441.60 |
$441.60 |
$353.60
|
|
Drug of abuse screen urine
|
$137.40 |
$137.40 |
$137.40 |
$58.50
|
|
Drug test def 1-7 classes
|
$379.20 |
$379.20 |
$379.20 |
$316.80
|
|
Drug test def 8-14 classes
|
$379.80 |
$379.80 |
$379.80 |
$249.10
|
|
Drug test prsmv instrmnt
|
$137.40 |
$137.40 |
$137.40 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$214.20 |
$214.20 |
$214.20 |
$278.85
|
|
Drvvt confirm - quest
|
$138.60 |
$138.60 |
$138.60 |
$108.55
|
|
Ductogram sgl duct
|
$382.80 |
$382.80 |
$382.80 |
$346.42
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$740.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,384.20 |
$1,384.20 |
$1,384.20 |
$852.57
|
|
Ear irrigation 69209
|
$192.00 |
$192.00 |
$192.00 |
$152.50
|
|
Ecg 12 lead tracing only
|
$322.20 |
$322.20 |
$322.20 |
$222.30
|
|
Ecg/1-3 leads/tracing only 93041
|
$162.00 |
$162.00 |
$162.00 |
$129.83
|
|
Ecg external < 48 hours scanning analysis w/report
|
$936.00 |
$936.00 |
$936.00 |
$541.73
|
|
Echocardiogram (Heart Ultrasound)
|
$2,463.60 |
$2,463.60 |
$2,463.60 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$772.80 |
$772.80 |
$772.80 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$866.40 |
$866.40 |
$866.40 |
$720.60
|
|
Echo transthoracic
|
$1,573.80 |
$1,573.80 |
$1,573.80 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,876.20 |
$1,876.20 |
$1,876.20 |
$997.40
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$837.00 |
$837.00 |
$837.00 |
$970.07
|
|
Eeg monitor/record/awake/drowsy 95816
|
$859.80 |
$859.80 |
$859.80 |
$835.00
|
|
Eeg recording awake and asleep
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$937.95
|
|
Egfr gene com variants
|
$522.00 |
$522.00 |
$522.00 |
$619.04
|
|
EKG tracing for initial prev
|
$132.00 |
$132.00 |
$132.00 |
$115.70
|
|
Electrical stimulation/unattended 97014
|
$85.20 |
$85.20 |
$85.20 |
$79.20
|
|
Electrolyte panel
|
$138.60 |
$138.60 |
$138.60 |
$68.56
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$43.20 |
$43.20 |
$43.20 |
$43.20
|
|
Entamoeba histolytica ag eia - sendout
|
$114.00 |
$114.00 |
$114.00 |
$68.90
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$614.91 |
$614.91 |
$614.91 |
$336.66
|
|
Epstein barr early antigen antibody
|
$140.40 |
$140.40 |
$140.40 |
$85.20
|
|
Epstein barr nuclear antigen antibody
|
$152.40 |
$152.40 |
$152.40 |
$88.80
|
|
Epstein barr viral capsid antigen antibody igm
|
$172.80 |
$172.80 |
$172.80 |
$112.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$15.59 |
$15.59 |
$15.59 |
$62.40
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$364.08 |
$364.08 |
$364.08 |
$138.28
|
|
ER Visit (level 1, minor)
|
$251.40 |
$251.40 |
$251.40 |
$270.00
|
|
ER Visit (level 2)
|
$482.40 |
$482.40 |
$482.40 |
$469.39
|
|
ER Visit (level 3)
|
$898.20 |
$898.20 |
$898.20 |
$821.52
|
|
ER Visit (level 4)
|
$1,615.80 |
$1,615.80 |
$1,615.80 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$2,077.80 |
$2,077.80 |
$2,077.80 |
$1,900.20
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$45.48 |
$45.48 |
$45.48 |
$406.83
|
|
Established Patient Office Visit (level 1)
|
$181.20 |
$181.20 |
$181.20 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$214.20 |
$214.20 |
$214.20 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$268.20 |
$268.20 |
$268.20 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$313.20 |
$313.20 |
$313.20 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$491.40 |
$491.40 |
$491.40 |
$270.09
|
|
Estradiol total
|
$265.80 |
$265.80 |
$265.80 |
$142.20
|
|
Estrogens total-sendout
|
$292.80 |
$292.80 |
$292.80 |
$111.00
|
|
Ethylene glycol -sendout
|
$177.60 |
$177.60 |
$177.60 |
$81.25
|
|
Evaluation of speech fluency 92521
|
$169.80 |
$169.80 |
$169.80 |
$347.75
|
|
Event monitor
|
$960.60 |
$960.60 |
$960.60 |
$228.60
|
|
Evoked auditory tst complete
|
$165.00 |
$165.00 |
$165.00 |
$374.62
|
|
Evoked oa emissions ltd
|
$176.40 |
$176.40 |
$176.40 |
$234.32
|
|
Evoked potentials auditory screening automated analysis
|
$202.20 |
$202.20 |
$202.20 |
$328.16
|
|
Exc benign tal 0.5 < cm 11400
|
$2,670.60 |
$2,670.60 |
$2,670.60 |
$805.70
|
|
External chromosome analysis 20-25 cells
|
$501.60 |
$501.60 |
$501.60 |
$457.50
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$883.80 |
$883.80 |
$883.80 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$154.80 |
$154.80 |
$154.80 |
$102.50
|
|
Facial bones <3
|
$217.20 |
$217.20 |
$217.20 |
$216.45
|
|
Factor viii
|
$250.80 |
$250.80 |
$250.80 |
$152.50
|
|
Fat/lipids feces qualitative
|
$93.60 |
$93.60 |
$93.60 |
$43.66
|
|
#fecal-sodium
|
$70.20 |
$70.20 |
$70.20 |
$40.30
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$43.23 |
$43.23 |
$43.23 |
$48.88
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,172.80 |
$2,172.80 |
$2,172.80 |
$2,131.58
|
|
Ferritin
|
$172.80 |
$172.80 |
$172.80 |
$86.45
|
|
Fetal hemoglobin (kleihauer betke)
|
$195.60 |
$195.60 |
$195.60 |
$59.85
|
|
Fetal hemoglobin rosette
|
$68.40 |
$68.40 |
$68.40 |
$48.35
|
|
Fibrin degradation d dimer quantitative
|
$194.40 |
$194.40 |
$194.40 |
$87.60
|
|
Fibrin degradation products
|
$112.80 |
$112.80 |
$112.80 |
$56.16
|
|
Fibrin degrade semiquant
|
$167.40 |
$167.40 |
$167.40 |
$88.00
|
|
Fibrinogen activity
|
$153.60 |
$153.60 |
$153.60 |
$61.80
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,223.60 |
$1,223.60 |
$1,223.60 |
$1,223.60
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$1,909.80 |
$1,909.80 |
$1,909.80 |
$738.00
|
|
Flow cytometry marker each additional
|
$229.80 |
$229.80 |
$229.80 |
$103.00
|
|
Flow cytometry one marker technical component
|
$334.80 |
$334.80 |
$334.80 |
$304.43
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$63.52 |
$63.52 |
$63.52 |
$48.56
|
|
Fluidotherapy charges pt
|
$164.40 |
$164.40 |
$164.40 |
$101.40
|
|
Fluorescent antibody titer dna
|
$184.80 |
$184.80 |
$184.80 |
$123.65
|
