|
Emg 3 ext w-w/o paraspinal area 95863
|
$1,543.96 |
$1,543.96 |
$1,543.96 |
$487.20
|
|
Emg needle test 1-extremity
|
$1,543.96 |
$1,543.96 |
$1,543.96 |
$342.24
|
|
Emg needle test 4-extremities
|
$1,543.96 |
$1,543.96 |
$1,543.96 |
$590.00
|
|
Emg thor paraspinal without t1/t2
|
$1,405.53 |
$1,405.53 |
$1,405.53 |
$308.80
|
|
Endoscopy swallow (fees) vid
|
$287.74 |
$287.74 |
$287.74 |
$402.35
|
|
Entamoeba histolytica ag eia - sendout
|
$642.29 |
$642.29 |
$642.29 |
$56.89
|
|
Ep & ablate supravent arrhyt
|
$96,612.88 |
$96,612.88 |
$96,612.88 |
$26,232.69
|
|
Ep & ablate ventric tachy
|
$134,957.92 |
$134,957.92 |
$134,957.92 |
$27,778.40
|
|
Ep induct arrhy by elect pacing
|
$18,402.43 |
$18,402.43 |
$18,402.43 |
$2,702.70
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$140.47 |
$140.47 |
$140.47 |
$253.77
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$410.97 |
$410.97 |
$410.97 |
$227.20
|
|
Esophageal dilat s&i
|
$3,788.41 |
$3,788.41 |
$3,788.41 |
$550.00
|
|
Esophagus motility study
|
$4,731.13 |
$4,731.13 |
$4,731.13 |
$1,257.17
|
|
Estradiol valerate 10 mg inj
|
$18.60 |
$18.60 |
$18.60 |
$57.35
|
|
Etoposide 50 mg cap
|
$25.00 |
$25.00 |
$25.00 |
$135.02
|
|
Euglobulin lysis
|
$335.63 |
$335.63 |
$335.63 |
$63.84
|
|
Eval/fit voice prosthesis iii, st
|
$712.10 |
$712.10 |
$712.10 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$735.93 |
$735.93 |
$735.93 |
$211.12
|
|
Evaluation of speech fluency 92521
|
$1,104.60 |
$1,104.60 |
$1,104.60 |
$307.75
|
|
Evaluation psychiatric diagnostic
|
$458.34 |
$458.34 |
$458.34 |
$315.00
|
|
Exercise tst brncspsm w/ecg
|
$2,441.68 |
$2,441.68 |
$2,441.68 |
$324.00
|
|
Exome sequence analysis
|
$4,690.44 |
$4,690.44 |
$4,690.44 |
$5,258.00
|
|
Exome sequence analysis
|
$1,002.24 |
$1,002.24 |
$1,002.24 |
$12,000.00
|
|
External chromosome analysis 20-25 cells
|
$2,439.81 |
$2,439.81 |
$2,439.81 |
$403.00
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$267.09 |
$267.09 |
$267.09 |
$61.10
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$8,941.85 |
$8,941.85 |
$8,941.85 |
$445.60
|
|
F-18 fdg pet diag
|
$5,830.00 |
$5,830.00 |
$5,830.00 |
$551.72
|
|
Factor ix non-recombinant
|
$2.73 |
$2.73 |
$2.73 |
$4.63
|
|
Factor viii
|
$2.70 |
$2.70 |
$2.70 |
$4.85
|
|
Family therapy without pt 50min 90846
|
$290.19 |
$290.19 |
$290.19 |
$241.60
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$9,271.12 |
$9,271.12 |
$9,271.12 |
$5,894.50
|
|
Fat/lipids feces qualitative
|
$354.62 |
$354.62 |
$354.62 |
$36.00
|
|
Feeding tube reposition
|
$12,061.76 |
$12,061.76 |
$12,061.76 |
$520.00
|
|
Felbamate (felbatol(r)) - sendout
|
$130.45 |
$130.45 |
$130.45 |
$61.00
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,776.94 |
$2,776.94 |
$2,776.94 |
$2,590.25
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$933.80 |
$933.80 |
$933.80 |
$1,636.50
|
|
Ferumoxytol, esrd use
|
$933.80 |
$933.80 |
$933.80 |
$0.50
|
|
Fetal hemoglobin rosette
|
$361.28 |
$361.28 |
$361.28 |
$67.20
|
|
#_fet/norfentcnfrmur
|
$677.99 |
$677.99 |
$677.99 |
$95.68
|
|
Fibrin degrade semiquant
|
$740.41 |
$740.41 |
$740.41 |
$78.80
|
|
Flecainide (tambocor)-sendout
|
$449.37 |
$449.37 |
$449.37 |
$65.24
|
|
Florbetaben f18 diagnostic
|
$4,050.56 |
$4,050.56 |
$4,050.56 |
$5,705.04
|
|
Floxuridine injection
|
$525.00 |
$525.00 |
$525.00 |
$5,929.92
|
|
Flt3 gene
|
$2,090.77 |
$2,090.77 |
$2,090.77 |
$355.00
|
|
Flt3 gene analysis
|
$617.30 |
$617.30 |
$617.30 |
$215.20
|
|
Fludarabine 50 mg intravenous solution
|
$951.34 |
$951.34 |
$951.34 |
$493.35
|
|
Fluoro polarize fetal lung
|
$1,445.15 |
$1,445.15 |
$1,445.15 |
$153.92
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$134.80 |
$134.80 |
$134.80 |
$72.52
|
|
Fluzone vacc, 3 yrs & >, im
|
$150.00 |
$150.00 |
$150.00 |
$60.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,990.87 |
$1,990.87 |
$1,990.87 |
$2,481.61
|
|
Forearm/arm cuffs ext/flex a
|
$7,154.00 |
$7,154.00 |
$7,154.00 |
$669.13
|
|
Formoterol fumarate, inh
|
$6.00 |
$6.00 |
$6.00 |
$59.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$861.15 |
$861.15 |
$861.15 |
$490.67
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$200.57 |
$200.57 |
$200.57 |
$153.02
|
|
Fructosamine glycated protein
|
$408.11 |
$408.11 |
$408.11 |
$61.75
|
|
Ft arch suprt premold longit
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$94.69
|
|
Ga-67 gallium 0.1 mci
|
$463.22 |
$463.22 |
$463.22 |
$121.73
|
|
Ga-68 gallium 68 dotatate
|
$162.47 |
$162.47 |
$162.47 |
$139.70
|
|
Galactose transferase test
|
$181.73 |
$181.73 |
$181.73 |
$32.00
|
|
Gallium illuccix 1 millicure
|
$2,072.31 |
$2,072.31 |
$2,072.31 |
$2,046.76
|
|
Gamma globulin > 10 cc inj
|
$193.44 |
$193.44 |
$193.44 |
$498.52
|
|
Gastric emptying imag study
|
$7,852.73 |
$7,852.73 |
$7,852.73 |
$1,364.00
|
|
Gastric emptying imag study
|
$7,852.73 |
$7,852.73 |
$7,852.73 |
$1,665.50
|
|
Gastroesophageal reflux study
|
$2,382.43 |
$2,382.43 |
$2,382.43 |
$1,031.60
|
|
General health panel
|
$2,880.28 |
$2,880.28 |
$2,880.28 |
$262.44
|
|
G-esoph reflx tst w/electrod
|
$6,410.53 |
$6,410.53 |
$6,410.53 |
$1,500.00
|
|
Ghs chemo >8 hrs
|
$2,246.94 |
$2,246.94 |
$2,246.94 |
$714.87
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$1,354.06 |
$1,354.06 |
$1,354.06 |
$560.00
|
|
Ghs fat & muscle
|
$354.62 |
$354.62 |
$354.62 |
$38.08
|
|
Ghs febrile agglutinns(mayo)
|
$408.11 |
$408.11 |
$408.11 |
$48.10
|
|
Ghs fish cytogen
|
$1,464.10 |
$1,464.10 |
$1,464.10 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$2,439.81 |
$2,439.81 |
$2,439.81 |
$225.00
|
|
Ghs hcv amplificaiton
|
$1,803.09 |
$1,803.09 |
$1,803.09 |
$203.45
|
|
Ghs hepatitis c virus (hcv riba)
|
$787.24 |
$787.24 |
$787.24 |
$144.60
|
|
Ghs histoplasma antigen
|
$1,938.02 |
$1,938.02 |
$1,938.02 |
$141.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$5,915.53 |
$5,915.53 |
$5,915.53 |
$507.65
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$109.95 |
$109.95 |
$109.95 |
$242.64
|
|
Ghs musc test done w/n test comp
|
$1,066.10 |
$1,066.10 |
$1,066.10 |
$324.80
|
|
Ghs musc tst done w/nerv tst lim
|
$1,066.10 |
$1,066.10 |
$1,066.10 |
$272.25
|
|
Ghs musc tst done w/n tst non ext
|
$560.24 |
$560.24 |
$560.24 |
$184.80
|
|
Ghs o2 saturation
|
$1,381.58 |
$1,381.58 |
$1,381.58 |
$69.50
|
|
Ghs o2 uptake rest & indirect
|
$3,535.17 |
$3,535.17 |
$3,535.17 |
$173.50
|
|
Ghs phenylketonurid
|
$181.73 |
$181.73 |
$181.73 |
$53.76
|
|
Ghs quinidine
|
$396.95 |
$396.95 |
$396.95 |
$83.20
|
|
Ghs respiratory syncytical virus igg/m
|
$172.85 |
$172.85 |
$172.85 |
$74.82
|
|
Ghs sleep study unattended
|
$2,250.72 |
$2,250.72 |
$2,250.72 |
$503.38
|
|
Ghs somatosensory testing upper & lower limbs
|
$2,344.77 |
$2,344.77 |
$2,344.77 |
$1,405.20
|
|
Ghs speech-gen aug dev eval iii, st
|
$702.89 |
$702.89 |
$702.89 |
$161.76
|
|
Ghs trypsin (fecal)
|
$56.87 |
$56.87 |
$56.87 |
$55.59
|
|
Ghs urine, hydroxproline total
|
$601.04 |
$601.04 |
$601.04 |
$110.77
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,843.87 |
$1,843.87 |
$1,843.87 |
$1,932.00
|
|
Gi inhouse confirmation
|
$436.03 |
$436.03 |
$436.03 |
$86.40
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$6,182.37 |
$6,182.37 |
$6,182.37 |
$2,195.76
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$6,818.84 |
$6,818.84 |
$6,818.84 |
$4,977.60
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$139.60 |
$139.60 |
$139.60 |
$601.50
|
|
Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm
|
$2,565.20 |
$2,565.20 |
$2,565.20 |
$3,432.00
|
|
Granisetron hcl injection
|
$148.87 |
$148.87 |
$148.87 |
$47.04
|
|
Gu dilat ureter/urethra s&i
|
$27,743.36 |
$27,743.36 |
$27,743.36 |
$1,980.66
|
|
Halo cervical into jckt vest
|
$20,575.00 |
$20,575.00 |
$20,575.00 |
$5,015.12
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$137.49 |
$137.49 |
$137.49 |
$24.41
|
