|
Drvvt confirm - quest
|
$195.60 |
$195.60 |
$195.60 |
$109.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$693.00 |
$693.00 |
$693.00 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$11,861.40 |
$11,861.40 |
$11,861.40 |
$7,973.90
|
|
Ear irrigation 69209
|
$213.60 |
$213.60 |
$213.60 |
$149.76
|
|
Ecg 12 lead tracing only
|
$255.00 |
$255.00 |
$255.00 |
$226.50
|
|
Ecg external < 48 hours recording
|
$127.20 |
$127.20 |
$127.20 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$403.80 |
$403.80 |
$403.80 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$51.60 |
$51.60 |
$51.60 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$82.20 |
$82.20 |
$82.20 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$2,375.40 |
$2,375.40 |
$2,375.40 |
$2,001.17
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,375.40 |
$2,375.40 |
$2,375.40 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$727.80 |
$727.80 |
$727.80 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$844.80 |
$844.80 |
$844.80 |
$851.50
|
|
Echograp trans r pros study
|
$192.00 |
$192.00 |
$192.00 |
$459.40
|
|
Echo tee probe placement image acquisition interpretation & report
|
$793.80 |
$793.80 |
$793.80 |
$1,849.50
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$21,747.60 |
$21,747.60 |
$21,747.60 |
$18,199.20
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$359.40 |
$359.40 |
$359.40 |
$1,000.42
|
|
Eeg recording awake and asleep
|
$484.20 |
$484.20 |
$484.20 |
$931.20
|
|
Electrical stimulation/unattended 97014
|
$172.80 |
$172.80 |
$172.80 |
$79.20
|
|
Emb without cervical dilation 58100
|
$89.40 |
$89.40 |
$89.40 |
$370.50
|
|
Emg needle test 1-extremity
|
$62.40 |
$62.40 |
$62.40 |
$334.34
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$373.20 |
$373.20 |
$373.20 |
$109.71
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$54.90 |
$54.90 |
$54.90 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$897.90 |
$897.90 |
$897.90 |
$393.15
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$45.00 |
$45.00 |
$45.00 |
$34.13
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,471.20 |
$1,471.20 |
$1,471.20 |
$809.08
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$1,716.00 |
$1,716.00 |
$1,716.00 |
$1,289.71
|
|
Epstein barr early antigen antibody
|
$37.80 |
$37.80 |
$37.80 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$25.80 |
$25.80 |
$25.80 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$60.00 |
$60.00 |
$60.00 |
$91.00
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$429.60 |
$429.60 |
$429.60 |
$222.98
|
|
ER Visit (level 1, minor)
|
$63.60 |
$63.60 |
$63.60 |
$246.24
|
|
ER Visit (level 2)
|
$150.00 |
$150.00 |
$150.00 |
$452.20
|
|
ER Visit (level 3)
|
$288.00 |
$288.00 |
$288.00 |
$770.04
|
|
ER Visit (level 4)
|
$1,811.40 |
$1,811.40 |
$1,811.40 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$3,091.20 |
$3,091.20 |
$3,091.20 |
$1,820.02
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$248.40 |
$248.40 |
$248.40 |
$223.99
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$1,298.40 |
$1,298.40 |
$1,298.40 |
$553.88
|
|
Established Patient Office Visit (level 1)
|
$413.40 |
$413.40 |
$413.40 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$165.60 |
$165.60 |
$165.60 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$420.00 |
$420.00 |
$420.00 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$695.40 |
$695.40 |
$695.40 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$916.20 |
$916.20 |
$916.20 |
$280.33
|
|
Estradiol total
|
$192.00 |
$192.00 |
$192.00 |
$146.50
|
|
Estrogens total-sendout
|
$252.60 |
$252.60 |
$252.60 |
$96.20
|
|
Ethylene glycol -sendout
|
$235.80 |
$235.80 |
$235.80 |
$89.40
|
|
Etonogestrel implant system
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$34.80 |
$34.80 |
$34.80 |
$235.20
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$130.20 |
$130.20 |
$130.20 |
$219.60
|
|
Event monitor
|
$181.20 |
$181.20 |
$181.20 |
$242.65
|
|
Evok oa screening qual
|
$197.40 |
$197.40 |
$197.40 |
$109.13
|
|
Exc benign tal 0.5 < cm 11400
|
$112.80 |
$112.80 |
$112.80 |
$827.40
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$180.60 |
$180.60 |
$180.60 |
$1,135.40
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$145.20 |
$145.20 |
$145.20 |
$1,372.15
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$136.20 |
$136.20 |
$136.20 |
$765.50
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$123.60 |
$123.60 |
$123.60 |
$1,247.50
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$201.60 |
$201.60 |
$201.60 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$165.60 |
$165.60 |
$165.60 |
$1,973.12
|
|
Excision breast lesion
|
$3,675.60 |
$3,675.60 |
$3,675.60 |
$3,749.85
|
|
External recharg sys intern
|
$1,587.60 |
$1,587.60 |
$1,587.60 |
$2,635.20
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$198.00 |
$198.00 |
$198.00 |
$108.60
|
|
F-18 fdg pet diag
|
$1,088.40 |
$1,088.40 |
$1,088.40 |
$551.72
|
|
Facial bones <3
|
$230.40 |
$230.40 |
$230.40 |
$252.60
|
|
Factor ix
|
$580.80 |
$580.80 |
$580.80 |
$156.13
|
|
Factor viii
|
$554.40 |
$554.40 |
$554.40 |
$133.81
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$4.20 |
$4.20 |
$4.20 |
$22.20
|
|
Fat/lipids feces qualitative
|
$40.80 |
$40.80 |
$40.80 |
$38.35
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$37.20 |
$37.20 |
$37.20 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$3,310.20 |
$3,310.20 |
$3,310.20 |
$2,590.25
|
|
Ferritin
|
$215.40 |
$215.40 |
$215.40 |
$100.94
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$3,750.00 |
$3,750.00 |
$3,750.00 |
$1,776.61
|
|
Fetal biophys profile w/nst 76818
|
$868.80 |
$868.80 |
$868.80 |
$535.37
|
|
Fetal chrom aneuploidy gsa panel
|
$2,164.80 |
$2,164.80 |
$2,164.80 |
$1,206.81
|
|
Fetal hemoglobin (kleihauer betke)
|
$102.00 |
$102.00 |
$102.00 |
$105.12
|
|
Fetal non stress test
|
$236.40 |
$236.40 |
$236.40 |
$463.03
|
|
Fibrin degradation products
|
$172.20 |
$172.20 |
$172.20 |
$62.64
|
|
Fibrin degrade semiquant
|
$104.40 |
$104.40 |
$104.40 |
$78.09
|
|
Fibrinogen activity
|
$136.20 |
$136.20 |
$136.20 |
$83.50
|
|
Fibrinolytic antiplasmin
|
$152.40 |
$152.40 |
$152.40 |
$72.80
|
|
Fibrinolytic plasminogen
|
$129.00 |
$129.00 |
$129.00 |
$107.50
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$1,464.60 |
$1,464.60 |
$1,464.60 |
$869.18
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$466.20 |
$466.20 |
$466.20 |
$823.90
|
|
Flow cytometry marker each additional
|
$24.00 |
$24.00 |
$24.00 |
$97.50
|
|
Flow cytometry one marker technical component
|
$567.00 |
$567.00 |
$567.00 |
$284.40
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$21.00 |
$21.00 |
$21.00 |
$64.22
|
|
Fluidotherapy charges pt
|
$133.20 |
$133.20 |
$133.20 |
$91.00
|
|
Fluorescent antibody titer dna
|
$468.00 |
$468.00 |
$468.00 |
$122.82
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$184.20 |
$184.20 |
$184.20 |
$94.86
|
|
Folic acid
|
$235.80 |
$235.80 |
$235.80 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$139.80 |
$139.80 |
$139.80 |
$54.75
|
|
Foot X-ray
|
$479.40 |
$479.40 |
$479.40 |
$362.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$96.60 |
$96.60 |
$96.60 |
$457.50
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$156.60 |
$156.60 |
$156.60 |
$156.60
|
|
Fructosamine glycated protein
|
$136.20 |
$136.20 |
$136.20 |
$60.75
|
|
Furosemide 10 mg/ml injection solution
|
$14.40 |
$14.40 |
$14.40 |
$19.00
|
|
G0180 home health certification
|
$54.60 |
$54.60 |
$54.60 |
$116.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$363.00 |
$363.00 |
$363.00 |
$177.52
|
|
Gammaglobulin iga
|
$16.80 |
$16.80 |
$16.80 |
$67.20
|
|
Gammaglobulin ige
|
$171.00 |
$171.00 |
$171.00 |
$83.85
|
|
Gamma glutamyltransferase
|
$115.80 |
$115.80 |
$115.80 |
$57.54
|
