|
Established Patient Office Visit (level 3)
|
$123.20 |
$123.20 |
$123.20 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$160.00 |
$160.00 |
$160.00 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$214.40 |
$214.40 |
$214.40 |
$290.68
|
|
Estradiol total
|
$201.60 |
$201.60 |
$201.60 |
$152.10
|
|
Estrogens total-sendout
|
$52.80 |
$52.80 |
$52.80 |
$97.50
|
|
Ethylene glycol -sendout
|
$200.00 |
$200.00 |
$200.00 |
$86.04
|
|
Etonogestrel implant system
|
$1,708.74 |
$1,708.74 |
$1,708.74 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$203.85 |
$203.85 |
$203.85 |
$235.20
|
|
Eval/fit voice prosthesis iii, st
|
$531.20 |
$531.20 |
$531.20 |
$359.50
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$296.00 |
$296.00 |
$296.00 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$372.80 |
$372.80 |
$372.80 |
$302.50
|
|
Event monitor
|
$404.00 |
$404.00 |
$404.00 |
$231.00
|
|
Evoked oa emissions ltd
|
$279.20 |
$279.20 |
$279.20 |
$244.00
|
|
Exc benign tal 0.5 < cm 11400
|
$1,322.40 |
$1,322.40 |
$1,322.40 |
$832.60
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$1,271.20 |
$1,271.20 |
$1,271.20 |
$969.60
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$2,084.80 |
$2,084.80 |
$2,084.80 |
$1,152.96
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$2,069.20
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,196.00 |
$1,196.00 |
$1,196.00 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$2,974.40 |
$2,974.40 |
$2,974.40 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$4,474.40 |
$4,474.40 |
$4,474.40 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$658.40 |
$658.40 |
$658.40 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$1,314.67
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$1,271.20 |
$1,271.20 |
$1,271.20 |
$999.50
|
|
Excise anal ext tag/papilla
|
$1,956.80 |
$1,956.80 |
$1,956.80 |
$2,272.02
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$1,363.20 |
$1,363.20 |
$1,363.20 |
$914.34
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$2,374.40 |
$2,374.40 |
$2,374.40 |
$2,064.75
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$855.20 |
$855.20 |
$855.20 |
$1,072.24
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$3,984.00 |
$3,984.00 |
$3,984.00 |
$2,865.00
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$2,272.00 |
$2,272.00 |
$2,272.00 |
$4,420.32
|
|
Exc malig feenl 1.1-2 11642
|
$1,090.40 |
$1,090.40 |
$1,090.40 |
$1,082.00
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$692.00 |
$692.00 |
$692.00 |
$889.20
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$6,529.60 |
$6,529.60 |
$6,529.60 |
$3,386.84
|
|
Exc thrombosed hemorrhoid 46320
|
$3,725.60 |
$3,725.60 |
$3,725.60 |
$2,175.36
|
|
Exercise tst brncspsm w/ecg
|
$254.40 |
$254.40 |
$254.40 |
$335.52
|
|
Explore penetrating wnd/extremity 20103
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$1,788.80
|
|
Explore wound abdomen 20102
|
$4,564.80 |
$4,564.80 |
$4,564.80 |
$2,784.80
|
|
Explore woundchest 20101
|
$2,262.40 |
$2,262.40 |
$2,262.40 |
$2,227.68
|
|
Explore wound neck 20100
|
$5,156.00 |
$5,156.00 |
$5,156.00 |
$1,185.00
|
|
External chromosome analysis 20-25 cells
|
$578.40 |
$578.40 |
$578.40 |
$415.01
|
|
External newborn metabolic screening panel
|
$211.20 |
$211.20 |
$211.20 |
$109.76
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$687.20 |
$687.20 |
$687.20 |
$457.07
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$152.80 |
$152.80 |
$152.80 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$416.80 |
$416.80 |
$416.80 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,783.20 |
$2,783.20 |
$2,783.20 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$2,556.80 |
$2,556.80 |
$2,556.80 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$2,129.60 |
$2,129.60 |
$2,129.60 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$4,310.40 |
$4,310.40 |
$4,310.40 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$3,165.60 |
$3,165.60 |
$3,165.60 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$284.80 |
$284.80 |
$284.80 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$413.60 |
$413.60 |
$413.60 |
$381.75
|
|
Factor ix
|
$222.40 |
$222.40 |
$222.40 |
$162.50
|
|
Factor viii
|
$193.60 |
$193.60 |
$193.60 |
$148.00
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$60.52 |
$60.52 |
$60.52 |
$22.20
|
|
Fat/lipids feces qualitative
|
$80.00 |
$80.00 |
$80.00 |
$36.00
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$137.87 |
$137.87 |
$137.87 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,254.94 |
$1,254.94 |
$1,254.94 |
$2,590.25
|
|
Ferritin
|
$109.60 |
$109.60 |
$109.60 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,195.88 |
$1,195.88 |
$1,195.88 |
$1,636.50
|
|
Fetal biophys profile w/nst 76818
|
$898.40 |
$898.40 |
$898.40 |
$541.74
|
|
Fetal fibronectin
|
$516.80 |
$516.80 |
$516.80 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$121.60 |
$121.60 |
$121.60 |
$102.00
|
|
Fetal hemoglobin rosette
|
$31.20 |
$31.20 |
$31.20 |
$67.20
|
|
Fetal non stress test
|
$547.20 |
$547.20 |
$547.20 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$139.20 |
$139.20 |
$139.20 |
$120.64
|
|
Fibrin degrade semiquant
|
$160.80 |
$160.80 |
$160.80 |
$84.50
|
|
Fibrinogen activity
|
$48.00 |
$48.00 |
$48.00 |
$87.00
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$758.88 |
$758.88 |
$758.88 |
$1,197.83
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$470.88 |
$470.88 |
$470.88 |
$891.02
|
|
Fine needle asp without image guide 10021
|
$716.00 |
$716.00 |
$716.00 |
$504.45
|
|
Finger X-ray (both hands)
|
$284.00 |
$284.00 |
$284.00 |
$241.50
|
|
Flexible Sigmoidoscopy
|
$1,744.00 |
$1,744.00 |
$1,744.00 |
$1,284.13
|
|
Flow cytometry marker each additional
|
$194.40 |
$194.40 |
$194.40 |
$97.50
|
|
Flow cytometry one marker technical component
|
$344.00 |
$344.00 |
$344.00 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$122.71 |
$122.71 |
$122.71 |
$64.22
|
|
Fluidotherapy charges pt
|
$125.60 |
$125.60 |
$125.60 |
$101.40
|
|
Fluoroguide for spine inject 77003-26
|
$696.00 |
$696.00 |
$696.00 |
$495.00
|
|
Fluoroguide needle placement
|
$745.60 |
$745.60 |
$745.60 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$636.80 |
$636.80 |
$636.80 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$196.77 |
$196.77 |
$196.77 |
$107.00
|
|
Folic acid
|
$116.80 |
$116.80 |
$116.80 |
$101.50
|
|
Foot arch support remov prem
|
$269.60 |
$269.60 |
$269.60 |
$141.41
|
|
Foot X-ray
|
$348.80 |
$348.80 |
$348.80 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$282.40 |
$282.40 |
$282.40 |
$290.40
|
|
Forearm X-ray (both sides)
|
$317.60 |
$317.60 |
$317.60 |
$324.00
|
|
Foscarnet sodium injection
|
$732.00 |
$732.00 |
$732.00 |
$988.21
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$65.25 |
$65.25 |
$65.25 |
$103.62
|
|
_fragile x methylation-sendout
|
$120.80 |
$120.80 |
$120.80 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$319.20 |
$319.20 |
$319.20 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$108.00 |
$108.00 |
$108.00 |
$131.25
|
|
Fructosamine glycated protein
|
$51.20 |
$51.20 |
$51.20 |
$63.50
|
|
Ftl cgen abnor four anal
|
$545.60 |
$545.60 |
$545.60 |
$211.83
|
|
Full Spine X-ray (Scoliosis Survey)
|
$557.60 |
$557.60 |
$557.60 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$62.02 |
$62.02 |
$62.02 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$136.00 |
$136.00 |
$136.00 |
$108.40
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$9.60 |
$9.60 |
$9.60 |
$120.00
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$136.00 |
$136.00 |
$136.00 |
$249.80
|
|
Galactose transferase test
|
$42.40 |
$42.40 |
$42.40 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,784.00 |
$1,784.00 |
$1,784.00 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$2,092.80 |
$2,092.80 |
$2,092.80 |
$1,615.00
|
|
Gammaglobulin iga
|
$75.20 |
$75.20 |
$75.20 |
$69.60
|