|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$90.80 |
$90.80 |
$90.80 |
$278.85
|
|
Drvvt confirm - quest
|
$119.60 |
$119.60 |
$119.60 |
$108.55
|
|
Ecg 12 lead tracing only
|
$72.40 |
$72.40 |
$72.40 |
$222.30
|
|
Ecg/1-3 leads/tracing only 93041
|
$32.40 |
$32.40 |
$32.40 |
$129.83
|
|
Ecg external < 48 hours recording
|
$239.60 |
$239.60 |
$239.60 |
$461.76
|
|
Echocardiogram (Heart Ultrasound)
|
$1,342.80 |
$1,342.80 |
$1,342.80 |
$2,021.12
|
|
Echocardiography transthoracic 2d followup/limited
|
$320.80 |
$320.80 |
$320.80 |
$720.60
|
|
Echo stress
|
$486.80 |
$486.80 |
$486.80 |
$1,401.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$674.40 |
$674.40 |
$674.40 |
$997.40
|
|
E coli 0157 ag ia
|
$83.20 |
$83.20 |
$83.20 |
$32.00
|
|
Egd remove lesion snare
|
$858.40 |
$858.40 |
$858.40 |
$2,200.46
|
|
Ehrlicha chaffeensis amp prb
|
$88.00 |
$88.00 |
$88.00 |
$112.50
|
|
Electrical stimulation/unattended 97014
|
$85.20 |
$85.20 |
$85.20 |
$79.20
|
|
Electric stim/w chemodenervation 95873
|
$112.00 |
$112.00 |
$112.00 |
$128.40
|
|
Electrolyte panel
|
$64.40 |
$64.40 |
$64.40 |
$68.56
|
|
Epidural/lumbar/sacral/ea add level64484
|
$716.80 |
$716.80 |
$716.80 |
$1,341.04
|
|
Epstein barr early antigen antibody
|
$113.60 |
$113.60 |
$113.60 |
$85.20
|
|
Epstein barr nuclear antigen antibody
|
$76.40 |
$76.40 |
$76.40 |
$88.80
|
|
Epstein barr viral capsid antigen antibody igm
|
$80.00 |
$80.00 |
$80.00 |
$112.50
|
|
ER Visit (level 1, minor)
|
$100.80 |
$100.80 |
$100.80 |
$270.00
|
|
ER Visit (level 2)
|
$157.60 |
$157.60 |
$157.60 |
$469.39
|
|
ER Visit (level 3)
|
$242.00 |
$242.00 |
$242.00 |
$821.52
|
|
ER Visit (level 4)
|
$412.80 |
$412.80 |
$412.80 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$640.80 |
$640.80 |
$640.80 |
$1,900.20
|
|
Established Patient Office Visit (level 1)
|
$63.60 |
$63.60 |
$63.60 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$95.20 |
$95.20 |
$95.20 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$116.00 |
$116.00 |
$116.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$137.20 |
$137.20 |
$137.20 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$158.40 |
$158.40 |
$158.40 |
$270.09
|
|
Estradiol total
|
$103.20 |
$103.20 |
$103.20 |
$142.20
|
|
Estrogens total-sendout
|
$205.20 |
$205.20 |
$205.20 |
$111.00
|
|
Eval/fit voice prosthesis iii, st
|
$123.20 |
$123.20 |
$123.20 |
$384.94
|
|
Evaluation of speech fluency 92521
|
$155.60 |
$155.60 |
$155.60 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$145.20 |
$145.20 |
$145.20 |
$325.65
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$240.00 |
$240.00 |
$240.00 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$128.80 |
$128.80 |
$128.80 |
$102.50
|
|
Facial bones <3
|
$192.40 |
$192.40 |
$192.40 |
$216.45
|
|
Factor viii
|
$80.40 |
$80.40 |
$80.40 |
$152.50
|
|
Family therapy without pt 50min 90846
|
$153.60 |
$153.60 |
$153.60 |
$230.40
|
|
Family therapy with patient 50 min 90847
|
$153.60 |
$153.60 |
$153.60 |
$224.80
|
|
Fat/lipids feces qualitative
|
$58.00 |
$58.00 |
$58.00 |
$43.66
|
|
Fatty acids nonesterified
|
$38.00 |
$38.00 |
$38.00 |
$64.28
|
|
#fecal-sodium
|
$48.80 |
$48.80 |
$48.80 |
$40.30
|
|
Ferritin
|
$79.20 |
$79.20 |
$79.20 |
$86.45
|
|
Fibrin degradation products
|
$38.40 |
$38.40 |
$38.40 |
$56.16
|
|
Fibrin degrade semiquant
|
$64.40 |
$64.40 |
$64.40 |
$88.00
|
|
Fibrinogen activity
|
$105.60 |
$105.60 |
$105.60 |
$61.80
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$32.00 |
$32.00 |
$32.00 |
$69.55
|
|
Flow cytometry marker each additional
|
$55.60 |
$55.60 |
$55.60 |
$103.00
|
|
Flow cytometry one marker technical component
|
$188.80 |
$188.80 |
$188.80 |
$304.43
|
|
Fluidotherapy charges pt
|
$77.20 |
$77.20 |
$77.20 |
$101.40
|
|
Fluorescent antibody titer dna
|
$104.00 |
$104.00 |
$104.00 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$200.40 |
$200.40 |
$200.40 |
$497.25
|
|
Fluoroguide needle placement
|
$200.40 |
$200.40 |
$200.40 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$81.20 |
$81.20 |
$81.20 |
$474.50
|
|
Folic acid
|
$86.00 |
$86.00 |
$86.00 |
$85.50
|
|
Foot X-ray
|
$165.20 |
$165.20 |
$165.20 |
$339.50
|
|
Fractionation ketosteroids
|
$92.80 |
$92.80 |
$92.80 |
$128.26
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$68.00 |
$68.00 |
$68.00 |
$186.55
|
|
Fresh frozen plasma thawing ea un
|
$98.40 |
$98.40 |
$98.40 |
$114.35
|
|
Fructosamine glycated protein
|
$61.20 |
$61.20 |
$61.20 |
$69.55
|
|
Gammaglobulin iga
|
$56.80 |
$56.80 |
$56.80 |
$78.60
|
|
Gammaglobulin ige
|
$105.60 |
$105.60 |
$105.60 |
$87.10
|
|
Gamma glutamyltransferase
|
$68.80 |
$68.80 |
$68.80 |
$54.60
|
|
Gba gene
|
$156.00 |
$156.00 |
$156.00 |
$140.00
|
|
General health panel
|
$215.60 |
$215.60 |
$215.60 |
$270.40
|
|
Gentamicin peak therapeutic drug level
|
$98.00 |
$98.00 |
$98.00 |
$114.00
|
|
Ghs abscess perianal iandd
|
$542.00 |
$542.00 |
$542.00 |
$1,512.80
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$29.60 |
$29.60 |
$29.60 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$62.00 |
$62.00 |
$62.00 |
$82.50
|
|
Ghs block ilioinguinal/gentitofemoral
|
$714.80 |
$714.80 |
$714.80 |
$1,000.08
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$68.40 |
$68.40 |
$68.40 |
$135.85
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$402.40 |
$402.40 |
$402.40 |
$540.80
|
|
Ghs closed reduction ankle dislocation
|
$402.40 |
$402.40 |
$402.40 |
$720.00
|
|
Ghs community re-entry 15 minutes
|
$23.60 |
$23.60 |
$23.60 |
$85.00
|
|
Ghs corneal fb without slit lamp bilat
|
$269.20 |
$269.20 |
$269.20 |
$422.25
|
|
Ghs diphtheria toxoid ab igg
|
$32.00 |
$32.00 |
$32.00 |
$91.80
|
|
Ghs febrile agglutinns(mayo)
|
$33.60 |
$33.60 |
$33.60 |
$51.99
|
|
Ghs fish cytogen
|
$152.00 |
$152.00 |
$152.00 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$180.00 |
$180.00 |
$180.00 |
$229.45
|
|
Ghs hcv amplificaiton
|
$304.80 |
$304.80 |
$304.80 |
$198.90
|
|
Ghs histoplasma antigen
|
$77.60 |
$77.60 |
$77.60 |
$157.30
|
|
Ghs i and d perirectal abscess 46040
|
$1,158.00 |
$1,158.00 |
$1,158.00 |
$3,034.00
|
|
Ghs i and d pilonidal cyst simple
|
$488.80 |
$488.80 |
$488.80 |
$762.75
|
|
Ghs inhibitor screen
|
$72.80 |
$72.80 |
$72.80 |
$138.06
|
|
Ghs init tx 1st degree burn
|
$85.60 |
$85.60 |
$85.60 |
$295.00
|
|
Ghs inj neurolytic other perph nerve
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$1,838.37
|
|
Ghs insertion of needle - bone
|
$204.80 |
$204.80 |
$204.80 |
$436.10
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$907.20 |
$907.20 |
$907.20 |
$876.00
|
|
Ghs IV thrombolytics - cerebral
|
$220.40 |
$220.40 |
$220.40 |
$752.80
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$236.40 |
$236.40 |
$236.40 |
$536.80
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$224.80 |
$224.80 |
$224.80 |
$558.97
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$264.80 |
$264.80 |
$264.80 |
$573.60
|
|
Ghs layer closure 2.5cm or less - 12051
|
$355.60 |
$355.60 |
$355.60 |
$610.40
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$224.80 |
$224.80 |
$224.80 |
$675.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$351.60 |
$351.60 |
$351.60 |
$738.40
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$484.00 |
$484.00 |
$484.00 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$770.40 |
$770.40 |
$770.40 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$402.40 |
$402.40 |
$402.40 |
$740.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$527.60 |
$527.60 |
$527.60 |
$740.00
|
