|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$66.70 |
$66.70 |
$66.70 |
$232.12
|
|
ER Visit (level 1, minor)
|
$273.00 |
$273.00 |
$273.00 |
$252.60
|
|
ER Visit (level 2)
|
$646.75 |
$646.75 |
$646.75 |
$463.00
|
|
ER Visit (level 3)
|
$1,092.55 |
$1,092.55 |
$1,092.55 |
$812.18
|
|
ER Visit (level 4)
|
$2,785.31 |
$2,785.31 |
$2,785.31 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$4,744.80 |
$4,744.80 |
$4,744.80 |
$1,871.60
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$908.50 |
$908.50 |
$908.50 |
$223.99
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$271.25 |
$271.25 |
$271.25 |
$279.72
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$427.50 |
$427.50 |
$427.50 |
$516.71
|
|
Esophagosc dilate balloon 30
|
$13,856.60 |
$13,856.60 |
$13,856.60 |
$2,244.82
|
|
Esophagoscopy/flex/diagnostic 43200
|
$318.00 |
$318.00 |
$318.00 |
$1,296.00
|
|
Esoph egd dilation <30 mm
|
$12,118.34 |
$12,118.34 |
$12,118.34 |
$2,656.80
|
|
Esrd home pt serv p mo 20+
|
$882.00 |
$882.00 |
$882.00 |
$540.80
|
|
Esrd serv 1 visit p mo 20+
|
$606.00 |
$606.00 |
$606.00 |
$409.60
|
|
Esrd srv 2-3 vsts p mo 20+
|
$883.00 |
$883.00 |
$883.00 |
$540.80
|
|
Esrd srv 4 visits p mo 20+
|
$1,063.00 |
$1,063.00 |
$1,063.00 |
$652.00
|
|
Established Patient Office Visit (level 1)
|
$25.00 |
$25.00 |
$25.00 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$76.00 |
$76.00 |
$76.00 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$141.00 |
$141.00 |
$141.00 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$209.00 |
$209.00 |
$209.00 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$307.00 |
$307.00 |
$307.00 |
$290.68
|
|
Estradiol total
|
$195.00 |
$195.00 |
$195.00 |
$152.10
|
|
Etonogestrel implant system
|
$6,376.80 |
$6,376.80 |
$6,376.80 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$174.75 |
$174.75 |
$174.75 |
$235.20
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$122.20 |
$122.20 |
$122.20 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$186.55 |
$186.55 |
$186.55 |
$302.50
|
|
Evoked oa emissions ltd
|
$276.25 |
$276.25 |
$276.25 |
$244.00
|
|
Exam of vagina w/scope 57420
|
$195.00 |
$195.00 |
$195.00 |
$486.03
|
|
Ex arm/elbow tum deep 5 cm/>
|
$2,371.00 |
$2,371.00 |
$2,371.00 |
$3,412.80
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$16,005.99 |
$16,005.99 |
$16,005.99 |
$2,443.20
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$14,914.34 |
$14,914.34 |
$14,914.34 |
$2,306.25
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$969.60
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$651.95 |
$651.95 |
$651.95 |
$1,152.96
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$2,991.30 |
$2,991.30 |
$2,991.30 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$516.00 |
$516.00 |
$516.00 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$15,446.89 |
$15,446.89 |
$15,446.89 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,215.50 |
$1,215.50 |
$1,215.50 |
$1,314.67
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$898.30 |
$898.30 |
$898.30 |
$999.50
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$17,391.40 |
$17,391.40 |
$17,391.40 |
$3,484.00
|
|
Exc forearm les sc 3 cm/>
|
$14,994.78 |
$14,994.78 |
$14,994.78 |
$3,628.50
|
|
Exc hand les sc < 1.5 cm
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$1,908.09
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$15,281.17 |
$15,281.17 |
$15,281.17 |
$3,486.52
|
|
Excise inferior turbinate
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$3,819.23
|
|
Excise lip or cheek fold
|
$735.00 |
$735.00 |
$735.00 |
$1,855.10
|
|
Excise/repair mouth lesion
|
$680.00 |
$680.00 |
$680.00 |
$1,915.20
|
|
Excise submaxillary gland
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$6,465.11
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$765.05 |
$765.05 |
$765.05 |
$914.34
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$14,636.76 |
$14,636.76 |
$14,636.76 |
$2,064.75
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,083.55 |
$1,083.55 |
$1,083.55 |
$1,072.24
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$17,301.24 |
$17,301.24 |
$17,301.24 |
$2,865.00
|
|
Excision graft extremity
|
$1,829.00 |
$1,829.00 |
$1,829.00 |
$4,881.00
|
|
Excision of tongue lesion
|
$2,580.50 |
$2,580.50 |
$2,580.50 |
$3,837.72
|
|
Excision tongue lesion without closure 41110
|
$5,430.10 |
$5,430.10 |
$5,430.10 |
$3,819.23
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$15,258.32 |
$15,258.32 |
$15,258.32 |
$4,420.32
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$17,642.26 |
$17,642.26 |
$17,642.26 |
$3,386.84
|
|
Exc prtl bn phlnx toe
|
$1,423.00 |
$1,423.00 |
$1,423.00 |
$3,839.54
|
|
Exc rect tum transanal full
|
$3,002.00 |
$3,002.00 |
$3,002.00 |
$4,119.00
|
|
Exc shoulder tum deep < 5 cm
|
$1,865.00 |
$1,865.00 |
$1,865.00 |
$3,849.30
|
|
Exc sq tum/neck/ant thorax 3cm/> 21552
|
$16,263.65 |
$16,263.65 |
$16,263.65 |
$4,744.88
|
|
Exc sq tum/neck or ant thorax <3cm 21555
|
$1,057.00 |
$1,057.00 |
$1,057.00 |
$3,322.80
|
|
Exc sq tumor/leg/ankle 3cm/> 27632
|
$17,479.64 |
$17,479.64 |
$17,479.64 |
$4,425.20
|
|
Exc sq tumor/shoulder area 3cm/> 23071
|
$15,773.12 |
$15,773.12 |
$15,773.12 |
$4,014.40
|
|
Exc tendon sheath or cap lesion 26160
|
$1,103.00 |
$1,103.00 |
$1,103.00 |
$2,797.08
|
|
Exc thigh/knee tum dep 5cm/>
|
$2,572.00 |
$2,572.00 |
$2,572.00 |
$3,700.80
|
|
Exc tr-ext mal+marg tal >4 cm 11606
|
$1,033.00 |
$1,033.00 |
$1,033.00 |
$2,054.40
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$2,420.11 |
$2,420.11 |
$2,420.11 |
$2,421.09
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$2,952.42 |
$2,952.42 |
$2,952.42 |
$4,101.67
|
|
Explore/treat ankle joint
|
$1,547.00 |
$1,547.00 |
$1,547.00 |
$3,839.54
|
|
Ex sq tumor/face or scalp < 2 cm 21011
|
$899.00 |
$899.00 |
$899.00 |
$2,286.96
|
|
Ex sq tumor/face or scalp 2 cm/> 21012
|
$1,166.00 |
$1,166.00 |
$1,166.00 |
$2,896.40
|
|
External chromosome analysis 20-25 cells
|
$159.25 |
$159.25 |
$159.25 |
$415.01
|
|
External newborn metabolic screening panel
|
$123.50 |
$123.50 |
$123.50 |
$109.76
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$50.70 |
$50.70 |
$50.70 |
$63.70
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$737.75 |
$737.75 |
$737.75 |
$457.07
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$55.90 |
$55.90 |
$55.90 |
$109.00
|
|
Extraction of lens 66920
|
$11,774.72 |
$11,774.72 |
$11,774.72 |
$3,737.60
|
|
Eye implant band 40
|
$1,141.56 |
$1,141.56 |
$1,141.56 |
$5,641.12
|
|
Eye Socket (Orbit) X-ray
|
$500.50 |
$500.50 |
$500.50 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$1,587.30 |
$1,587.30 |
$1,587.30 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,550.90 |
$1,550.90 |
$1,550.90 |
$1,320.00
|
|
F-18 fdg pet diag
|
$1,768.20 |
$1,768.20 |
$1,768.20 |
$551.72
|
|
F-18 florbetapir less than or equal to 10 mci
|
$15,145.00 |
$15,145.00 |
$15,145.00 |
$5,224.83
|
|
F-18 fluciclovine per mci
|
$27,455.00 |
$27,455.00 |
$27,455.00 |
$1,042.30
|
|
F-18 sodium fluoride
|
$1,391.25 |
$1,391.25 |
$1,391.25 |
$492.56
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$2,321.80 |
$2,321.80 |
$2,321.80 |
$2,821.87
|
|
Facial Bones X-ray (1 to 2 views)
|
$159.25 |
$159.25 |
$159.25 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$424.45 |
$424.45 |
$424.45 |
$381.75
|
|
Factor ix
|
$340.60 |
$340.60 |
$340.60 |
$162.50
|
|
Factor viii
|
$227.50 |
$227.50 |
$227.50 |
$148.00
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$40.90 |
$40.90 |
$40.90 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$9,722.40 |
$9,722.40 |
$9,722.40 |
$5,894.50
|
|
Fat/lipids feces qualitative
|
$37.70 |
$37.70 |
$37.70 |
$36.00
|
|
Fatty acids nonesterified
|
$79.95 |
$79.95 |
$79.95 |
$72.15
|
|
Fecal microbiota, live-jslm 150 ml rectal suspension enema
|
$28,233.45 |
$28,233.45 |
$28,233.45 |
$14,956.68
|
|
Felbamate (felbatol(r)) - sendout
|
$90.35 |
$90.35 |
$90.35 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$16,005.99 |
$16,005.99 |
$16,005.99 |
$101.40
|
|
Fern test
|
$39.65 |
$39.65 |
$39.65 |
$37.03
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$5,262.00 |
$5,262.00 |
$5,262.00 |
$2,590.25
|
|
Ferritin
|
$603.20 |
$603.20 |
$603.20 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$712.85 |
$712.85 |
$712.85 |
$1,636.50
|