|
Established Patient Office Visit (level 5)
|
$313.60 |
$313.60 |
$313.60 |
$270.09
|
|
Estradiol total
|
$138.00 |
$138.00 |
$138.00 |
$142.20
|
|
Eval/fit voice prosthesis iii, st
|
$114.80 |
$114.80 |
$114.80 |
$384.94
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$72.00 |
$72.00 |
$72.00 |
$219.60
|
|
Evaluation heart device
|
$874.40 |
$874.40 |
$874.40 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$211.20 |
$211.20 |
$211.20 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$86.40 |
$86.40 |
$86.40 |
$325.65
|
|
Event monitor
|
$160.00 |
$160.00 |
$160.00 |
$228.60
|
|
Exc benign tal 0.5 < cm 11400
|
$578.00 |
$578.00 |
$578.00 |
$805.70
|
|
Exchange drainage catheter
|
$845.20 |
$845.20 |
$845.20 |
$2,178.16
|
|
Exchange nephrostomy cath
|
$1,219.60 |
$1,219.60 |
$1,219.60 |
$2,752.00
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$2,001.20 |
$2,001.20 |
$2,001.20 |
$2,925.00
|
|
External chromosome analysis 20-25 cells
|
$393.60 |
$393.60 |
$393.60 |
$457.50
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$588.80 |
$588.80 |
$588.80 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$89.60 |
$89.60 |
$89.60 |
$102.50
|
|
Facial bones <3
|
$78.80 |
$78.80 |
$78.80 |
$216.45
|
|
Factor ix
|
$72.00 |
$72.00 |
$72.00 |
$139.75
|
|
Factor viii
|
$198.80 |
$198.80 |
$198.80 |
$152.50
|
|
Family therapy with patient 50 min 90847
|
$81.20 |
$81.20 |
$81.20 |
$224.80
|
|
Fat/lipids feces qualitative
|
$70.00 |
$70.00 |
$70.00 |
$43.66
|
|
#fecal-sodium
|
$16.80 |
$16.80 |
$16.80 |
$40.30
|
|
Ferritin
|
$52.80 |
$52.80 |
$52.80 |
$86.45
|
|
Fetal biophys profile w/nst 76818
|
$365.60 |
$365.60 |
$365.60 |
$525.33
|
|
Fetal hemoglobin (kleihauer betke)
|
$35.20 |
$35.20 |
$35.20 |
$59.85
|
|
Fetal non stress test
|
$333.20 |
$333.20 |
$333.20 |
$507.90
|
|
Fibrin degradation d dimer quantitative
|
$80.80 |
$80.80 |
$80.80 |
$87.60
|
|
Fibrinogen activity
|
$51.20 |
$51.20 |
$51.20 |
$61.80
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$32.00 |
$32.00 |
$32.00 |
$69.55
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$1,194.80 |
$1,194.80 |
$1,194.80 |
$1,070.00
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$500.00 |
$500.00 |
$500.00 |
$612.97
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$500.00 |
$500.00 |
$500.00 |
$738.00
|
|
Flow cytometry marker each additional
|
$148.00 |
$148.00 |
$148.00 |
$103.00
|
|
Flow cytometry one marker technical component
|
$176.80 |
$176.80 |
$176.80 |
$304.43
|
|
Fluidotherapy charges pt
|
$24.40 |
$24.40 |
$24.40 |
$101.40
|
|
Fluorescent antibody titer dna
|
$70.80 |
$70.80 |
$70.80 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$426.80 |
$426.80 |
$426.80 |
$497.25
|
|
Fluoroguide needle placement
|
$648.00 |
$648.00 |
$648.00 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$298.00 |
$298.00 |
$298.00 |
$474.50
|
|
Fna bx w/ct gdn 1st les
|
$1,320.40 |
$1,320.40 |
$1,320.40 |
$1,320.40
|
|
Fna bx w/ct gdn ea addl
|
$500.00 |
$500.00 |
$500.00 |
$737.83
|
|
Folic acid
|
$40.40 |
$40.40 |
$40.40 |
$85.50
|
|
Foot X-ray
|
$233.60 |
$233.60 |
$233.60 |
$339.50
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$57.60 |
$57.60 |
$57.60 |
$186.55
|
|
Fresh frozen plasma thawing ea un
|
$89.60 |
$89.60 |
$89.60 |
$114.35
|
|
Full mouth x-ray of teeth
|
$196.40 |
$196.40 |
$196.40 |
$242.99
|
|
Gammaglobulin iga
|
$66.40 |
$66.40 |
$66.40 |
$78.60
|
|
Gammaglobulin ige
|
$77.60 |
$77.60 |
$77.60 |
$87.10
|
|
Gamma glutamyltransferase
|
$50.00 |
$50.00 |
$50.00 |
$54.60
|
|
Gentamicin peak therapeutic drug level
|
$39.60 |
$39.60 |
$39.60 |
$114.00
|
|
Ghs acetylcholinesterase, rbc
|
$66.80 |
$66.80 |
$66.80 |
$44.20
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$40.40 |
$40.40 |
$40.40 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$62.00 |
$62.00 |
$62.00 |
$82.50
|
|
Ghs block ilioinguinal/gentitofemoral
|
$750.40 |
$750.40 |
$750.40 |
$1,000.08
|
|
Ghs change cysto/gastrost
|
$406.80 |
$406.80 |
$406.80 |
$727.35
|
|
Ghs chemo IV push, ea addtl
|
$174.80 |
$174.80 |
$174.80 |
$292.80
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$68.40 |
$68.40 |
$68.40 |
$135.85
|
|
Ghs community re-entry 15 minutes
|
$58.00 |
$58.00 |
$58.00 |
$85.00
|
|
Ghs conjunctiva foreign body-embed bil
|
$55.60 |
$55.60 |
$55.60 |
$419.22
|
|
Ghs conjunctiva foreign body-superf bil
|
$63.20 |
$63.20 |
$63.20 |
$278.00
|
|
Ghs corneal fb without slit lamp bilat
|
$68.00 |
$68.00 |
$68.00 |
$422.25
|
|
Ghs diphtheria toxoid ab igg
|
$32.00 |
$32.00 |
$32.00 |
$91.80
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$808.00 |
$808.00 |
$808.00 |
$1,360.20
|
|
Ghs fat & muscle
|
$70.00 |
$70.00 |
$70.00 |
$45.75
|
|
Ghs fb removal from muscle - complicated
|
$689.20 |
$689.20 |
$689.20 |
$3,136.84
|
|
Ghs febrile agglutinns(mayo)
|
$95.60 |
$95.60 |
$95.60 |
$51.99
|
|
Ghs histoplasma antigen
|
$105.20 |
$105.20 |
$105.20 |
$157.30
|
|
Ghs HIV antibody
|
$66.00 |
$66.00 |
$66.00 |
$90.14
|
|
Ghs immun0electrophoresis
|
$84.80 |
$84.80 |
$84.80 |
$110.00
|
|
Ghs inhibitor screen
|
$33.20 |
$33.20 |
$33.20 |
$138.06
|
|
Ghs init tx 1st degree burn
|
$204.80 |
$204.80 |
$204.80 |
$295.00
|
|
Ghs inj neurolytic other perph nerve
|
$1,054.40 |
$1,054.40 |
$1,054.40 |
$1,838.37
|
|
Ghs inj tendon origin/insertion
|
$398.80 |
$398.80 |
$398.80 |
$412.50
|
|
Ghs inj transforaminal cerv ea add bil
|
$809.60 |
$809.60 |
$809.60 |
$1,126.23
|
|
Ghs inj transforaminal cerv single bil
|
$1,365.20 |
$1,365.20 |
$1,365.20 |
$1,706.32
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$227.20 |
$227.20 |
$227.20 |
$558.97
|
|
Ghs mbp
|
$79.60 |
$79.60 |
$79.60 |
$97.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$86.80 |
$86.80 |
$86.80 |
$125.34
|
|
Ghs myocardial strain img spckl track
|
$260.00 |
$260.00 |
$260.00 |
$503.85
|
|
Ghs nerve blk intercostal, ea addtl level
|
$728.40 |
$728.40 |
$728.40 |
$1,546.50
|
|
Ghs nerve blk intercostal, single level
|
$764.40 |
$764.40 |
$764.40 |
$1,232.23
|
|
Ghs nerve block interscaline
|
$750.40 |
$750.40 |
$750.40 |
$1,574.21
|
|
Ghs nerve block lumbar or thoracic symp
|
$866.40 |
$866.40 |
$866.40 |
$2,079.21
|
|
Ghs nerve block sciatic nerve
|
$750.40 |
$750.40 |
$750.40 |
$1,745.25
|
|
Ghs nerve block suprascapular
|
$469.60 |
$469.60 |
$469.60 |
$1,220.00
|
|
Ghs ng placement w fluoro guidance
|
$207.60 |
$207.60 |
$207.60 |
$423.76
|
|
Ghs ot prosthetic training/15 min
|
$62.00 |
$62.00 |
$62.00 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$79.60 |
$79.60 |
$79.60 |
$89.73
|
|
Ghs ot work hardening-additional hours
|
$128.80 |
$128.80 |
$128.80 |
$113.35
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$640.40 |
$640.40 |
$640.40 |
$880.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$713.60 |
$713.60 |
$713.60 |
$849.47
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$33.20 |
$33.20 |
$33.20 |
$82.80
|
|
Ghs ppd (tb intradermal)
|
$16.80 |
$16.80 |
$16.80 |
$39.77
|
|
Ghs protoporphyrins fract
|
$36.00 |
$36.00 |
$36.00 |
$68.38
|
|
Ghs pr without cont pulse ox
|
$164.40 |
$164.40 |
$164.40 |
$165.60
|
|
Ghs pt - work hardening/int 2hrs
|
$149.60 |
$149.60 |
$149.60 |
$230.40
|
|
Ghs rsv eia (respir synctial vrs)
|
$95.20 |
$95.20 |
$95.20 |
$117.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$96.80 |
$96.80 |
$96.80 |
$399.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$52.80 |
$52.80 |
$52.80 |
$134.50
|
|
Ghs sp train/fitting sp device - kx
|
$114.80 |
$114.80 |
$114.80 |
$240.80
|
|
Ghs urine, porphyrins quant
|
$49.20 |
$49.20 |
$49.20 |
$85.15
|
