|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$49.75 |
$49.75 |
$49.75 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$78.86 |
$78.86 |
$78.86 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$530.40 |
$530.40 |
$530.40 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$178.80 |
$178.80 |
$178.80 |
$70.00
|
|
Diagnostic digital breast tomosynthesis bil
|
$53.40 |
$53.40 |
$53.40 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$53.40 |
$53.40 |
$53.40 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$265.20 |
$265.20 |
$265.20 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$210.00 |
$210.00 |
$210.00 |
$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
|
|
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
|
$223.80 |
$223.80 |
$223.80 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$308.90 |
$308.90 |
$308.90 |
$297.86
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,001.55 |
$1,001.55 |
$1,001.55 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$38.75 |
$38.75 |
$38.75 |
$9.29
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$43.03 |
$43.03 |
$43.03 |
$67.32
|
|
Disaccharidases
|
$127.80 |
$127.80 |
$127.80 |
$224.58
|
|
Dna antibody native/double stranded
|
$260.40 |
$260.40 |
$260.40 |
$101.40
|
|
Dna gardnerella
|
$162.00 |
$162.00 |
$162.00 |
$67.68
|
|
Dna probe chlamydia
|
$248.40 |
$248.40 |
$248.40 |
$98.40
|
|
Dna probe gc
|
$302.40 |
$302.40 |
$302.40 |
$88.67
|
|
Dna trichomonas
|
$162.00 |
$162.00 |
$162.00 |
$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
|
$917.40 |
$917.40 |
$917.40 |
$517.94
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$997.80 |
$997.80 |
$997.80 |
$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
|
|
Droperidol 2.5 mg/ml injection solution
|
$40.32 |
$40.32 |
$40.32 |
$32.82
|
|
Drug assay caffeine
|
$347.40 |
$347.40 |
$347.40 |
$89.17
|
|
Drug of abuse screen urine
|
$143.40 |
$143.40 |
$143.40 |
$58.50
|
|
Drug test def 1-7 classes
|
$394.20 |
$394.20 |
$394.20 |
$316.80
|
|
Drug test def 8-14 classes
|
$394.20 |
$394.20 |
$394.20 |
$249.10
|
|
Drug test prsmv instrmnt
|
$142.80 |
$142.80 |
$142.80 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$214.20 |
$214.20 |
$214.20 |
$278.85
|
|
Drvvt confirm - quest
|
$288.00 |
$288.00 |
$288.00 |
$108.55
|
|
Ductogram sgl duct
|
$552.60 |
$552.60 |
$552.60 |
$346.42
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,402.80 |
$1,402.80 |
$1,402.80 |
$852.57
|
|
Dxa bone density axl vrt fx
|
$466.80 |
$466.80 |
$466.80 |
$365.14
|
|
Ear irrigation 69209
|
$184.80 |
$184.80 |
$184.80 |
$152.50
|
|
Ecg 12 lead tracing only
|
$280.20 |
$280.20 |
$280.20 |
$222.30
|
|
Ecg/1-3 leads/tracing only 93041
|
$204.60 |
$204.60 |
$204.60 |
$129.83
|
|
Ecg external < 48 hours recording
|
$633.60 |
$633.60 |
$633.60 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$949.80 |
$949.80 |
$949.80 |
$541.73
|
|
Echocardiogram (Heart Ultrasound)
|
$2,909.40 |
$2,909.40 |
$2,909.40 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$793.80 |
$793.80 |
$793.80 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,087.20 |
$1,087.20 |
$1,087.20 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$588.60 |
$588.60 |
$588.60 |
$348.80
|
|
Echo transthoracic
|
$1,988.40 |
$1,988.40 |
$1,988.40 |
$1,361.75
|
|
Echo transthoracic
|
$1,288.20 |
$1,288.20 |
$1,288.20 |
$765.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$2,004.60 |
$2,004.60 |
$2,004.60 |
$997.40
|
|
E equine encephalitis igg
|
$96.60 |
$96.60 |
$96.60 |
$49.92
|
|
EKG tracing for initial prev
|
$154.80 |
$154.80 |
$154.80 |
$115.70
|
|
Electrical stimulation/unattended 97014
|
$90.00 |
$90.00 |
$90.00 |
$79.20
|
|
Electrolyte panel
|
$187.20 |
$187.20 |
$187.20 |
$68.56
|
|
Encephalitis, california igg/igm
|
$96.60 |
$96.60 |
$96.60 |
$49.92
|
|
Encephalitis, st louis igg/igm
|
$96.60 |
$96.60 |
$96.60 |
$55.75
|
|
Encephalitis, western equine igg/igm
|
$96.60 |
$96.60 |
$96.60 |
$55.25
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$43.20 |
$43.20 |
$43.20 |
$43.20
|
|
Entamoeba histolytica ag eia - sendout
|
$88.20 |
$88.20 |
$88.20 |
$68.90
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$426.33 |
$426.33 |
$426.33 |
$379.58
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$182.13 |
$182.13 |
$182.13 |
$178.29
|
|
Epstein barr early antigen antibody
|
$214.20 |
$214.20 |
$214.20 |
$85.20
|
|
Epstein barr nuclear antigen antibody
|
$181.20 |
$181.20 |
$181.20 |
$88.80
|
|
Epstein barr viral capsid antigen antibody igm
|
$259.80 |
$259.80 |
$259.80 |
$112.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$15.59 |
$15.59 |
$15.59 |
$62.40
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$3,178.18 |
$3,178.18 |
$3,178.18 |
$3,590.11
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$364.08 |
$364.08 |
$364.08 |
$138.28
|
|
ER Visit (level 1, minor)
|
$315.60 |
$315.60 |
$315.60 |
$270.00
|
|
ER Visit (level 2)
|
$582.60 |
$582.60 |
$582.60 |
$469.39
|
|
ER Visit (level 3)
|
$1,171.80 |
$1,171.80 |
$1,171.80 |
$821.52
|
|
ER Visit (level 4)
|
$1,507.80 |
$1,507.80 |
$1,507.80 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$1,900.20 |
$1,900.20 |
$1,900.20 |
$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)
|
$180.60 |
$180.60 |
$180.60 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$199.20 |
$199.20 |
$199.20 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$241.80 |
$241.80 |
$241.80 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$289.20 |
$289.20 |
$289.20 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$452.40 |
$452.40 |
$452.40 |
$270.09
|
|
Estradiol total
|
$489.00 |
$489.00 |
$489.00 |
$142.20
|
|
Estrogens total-sendout
|
$273.60 |
$273.60 |
$273.60 |
$111.00
|
|
Ethylene glycol -sendout
|
$187.20 |
$187.20 |
$187.20 |
$81.25
|
|
Etoposide 20 mg/ml intravenous solution
|
$1.82 |
$1.82 |
$1.82 |
$20.35
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$216.60 |
$216.60 |
$216.60 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$181.80 |
$181.80 |
$181.80 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$246.00 |
$246.00 |
$246.00 |
$325.65
|
|
Event monitor
|
$437.40 |
$437.40 |
$437.40 |
$228.60
|
|
Exc benign tal 0.5 < cm 11400
|
$2,670.60 |
$2,670.60 |
$2,670.60 |
$805.70
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$234.60 |
$234.60 |
$234.60 |
$102.50
|
|
Facial bones <3
|
$267.60 |
$267.60 |
$267.60 |
$216.45
|
|
Factor ix
|
$311.40 |
$311.40 |
$311.40 |
$139.75
|
|
Factor viii
|
$490.80 |
$490.80 |
$490.80 |
$152.50
|
|
Family therapy without pt 50min 90846
|
$228.60 |
$228.60 |
$228.60 |
$230.40
|
|
Family therapy with patient 50 min 90847
|
$228.60 |
$228.60 |
$228.60 |
$224.80
|
|
Fat/lipids feces qualitative
|
$260.40 |
$260.40 |
$260.40 |
$43.66
|
|
#fecal-sodium
|
$30.00 |
$30.00 |
$30.00 |
$40.30
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$74.80 |
$74.80 |
$74.80 |
$48.88
|
