|
ER Visit (level 5, high severity)
|
$1,815.30 |
$1,815.30 |
$1,815.30 |
$1,871.60
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$338.14 |
$338.14 |
$338.14 |
$223.99
|
|
Escharotomy ea addl incision
|
$438.10 |
$438.10 |
$438.10 |
$203.20
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$1,785.52 |
$1,785.52 |
$1,785.52 |
$516.71
|
|
Established Patient Office Visit (level 1)
|
$160.60 |
$160.60 |
$160.60 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$286.10 |
$286.10 |
$286.10 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$441.30 |
$441.30 |
$441.30 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$701.80 |
$701.80 |
$701.80 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$962.80 |
$962.80 |
$962.80 |
$290.68
|
|
Estradiol total
|
$289.15 |
$289.15 |
$289.15 |
$152.10
|
|
Estrogens total-sendout
|
$200.90 |
$200.90 |
$200.90 |
$97.50
|
|
Ethylene glycol -sendout
|
$178.15 |
$178.15 |
$178.15 |
$86.04
|
|
Etoposide 20 mg/ml intravenous solution
|
$603.62 |
$603.62 |
$603.62 |
$235.20
|
|
Eval/fit voice prosthesis iii, st
|
$523.70 |
$523.70 |
$523.70 |
$359.50
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$545.25 |
$545.25 |
$545.25 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$315.85 |
$315.85 |
$315.85 |
$302.50
|
|
Evaluation psychiatric diagnostic
|
$344.45 |
$344.45 |
$344.45 |
$318.24
|
|
Event monitor
|
$270.00 |
$270.00 |
$270.00 |
$231.00
|
|
Evoked potentials auditory screening automated analysis
|
$79.65 |
$79.65 |
$79.65 |
$261.30
|
|
Ewho w/joint(s) cf
|
$3,308.80 |
$3,308.80 |
$3,308.80 |
$830.70
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$311.00 |
$311.00 |
$311.00 |
$1,152.96
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,051.70 |
$1,051.70 |
$1,051.70 |
$1,501.50
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$556.30 |
$556.30 |
$556.30 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,029.20 |
$1,029.20 |
$1,029.20 |
$1,314.67
|
|
Exchange nephrostomy cath
|
$3,026.05 |
$3,026.05 |
$3,026.05 |
$2,958.80
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$336.25 |
$336.25 |
$336.25 |
$1,072.24
|
|
Exc malig tal <0.5cm 11600
|
$434.55 |
$434.55 |
$434.55 |
$973.71
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$581.25 |
$581.25 |
$581.25 |
$1,207.80
|
|
Exc thrombosed hemorrhoid 46320
|
$1,776.05 |
$1,776.05 |
$1,776.05 |
$2,175.36
|
|
Exercise tst brncspsm w/ecg
|
$2,105.50 |
$2,105.50 |
$2,105.50 |
$335.52
|
|
Ext ecg>48hr<7d rev&interpj
|
$72.55 |
$72.55 |
$72.55 |
$57.00
|
|
Ext ecg>7d<15d rev&interpj
|
$72.55 |
$72.55 |
$72.55 |
$63.20
|
|
External chromosome analysis 20-25 cells
|
$551.45 |
$551.45 |
$551.45 |
$415.01
|
|
External newborn metabolic screening panel
|
$67.75 |
$67.75 |
$67.75 |
$109.76
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$311.40 |
$311.40 |
$311.40 |
$457.07
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$81.45 |
$81.45 |
$81.45 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$645.15 |
$645.15 |
$645.15 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$3,247.35 |
$3,247.35 |
$3,247.35 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$3,248.75 |
$3,248.75 |
$3,248.75 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,382.10 |
$1,382.10 |
$1,382.10 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,347.25 |
$3,347.25 |
$3,347.25 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,181.10 |
$2,181.10 |
$2,181.10 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$473.75 |
$473.75 |
$473.75 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$645.15 |
$645.15 |
$645.15 |
$381.75
|
|
Factor ix
|
$218.65 |
$218.65 |
$218.65 |
$162.50
|
|
Factor viii
|
$206.55 |
$206.55 |
$206.55 |
$148.00
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$68.04 |
$68.04 |
$68.04 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$7,724.85 |
$7,724.85 |
$7,724.85 |
$5,894.50
|
|
Fancc gene
|
$188.75 |
$188.75 |
$188.75 |
$140.00
|
|
Fat/lipids feces qualitative
|
$83.20 |
$83.20 |
$83.20 |
$36.00
|
|
Fatty acids nonesterified
|
$130.85 |
$130.85 |
$130.85 |
$72.15
|
|
#fecal-sodium
|
$52.30 |
$52.30 |
$52.30 |
$37.53
|
|
Felbamate (felbatol(r)) - sendout
|
$145.05 |
$145.05 |
$145.05 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$258.17 |
$258.17 |
$258.17 |
$101.40
|
|
Fern test
|
$73.95 |
$73.95 |
$73.95 |
$37.03
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$3,876.17 |
$3,876.17 |
$3,876.17 |
$2,590.25
|
|
Ferritin
|
$171.45 |
$171.45 |
$171.45 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$3,141.85 |
$3,141.85 |
$3,141.85 |
$1,636.50
|
|
Fetal biophys profile w/nst 76818
|
$858.35 |
$858.35 |
$858.35 |
$541.74
|
|
Fetal chrom aneuploidy gsa panel
|
$3,411.25 |
$3,411.25 |
$3,411.25 |
$1,166.15
|
|
Fetal contract stress test 59020 - 26
|
$587.15 |
$587.15 |
$587.15 |
$477.50
|
|
Fetal fibronectin
|
$600.65 |
$600.65 |
$600.65 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$122.80 |
$122.80 |
$122.80 |
$102.00
|
|
Fetal hemoglobin rosette
|
$78.30 |
$78.30 |
$78.30 |
$67.20
|
|
Fetal non stress test
|
$834.15 |
$834.15 |
$834.15 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$286.40 |
$286.40 |
$286.40 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$140.35 |
$140.35 |
$140.35 |
$120.64
|
|
Fibrinogen activity
|
$128.25 |
$128.25 |
$128.25 |
$87.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$61.10 |
$61.10 |
$61.10 |
$66.60
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$1,555.49 |
$1,555.49 |
$1,555.49 |
$891.02
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$539.85 |
$539.85 |
$539.85 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$300.50 |
$300.50 |
$300.50 |
$504.45
|
|
Finger X-ray (both hands)
|
$473.75 |
$473.75 |
$473.75 |
$241.50
|
|
Fixtn pq skel dstl rad fx/epiphysl sep
|
$755.75 |
$755.75 |
$755.75 |
$4,499.12
|
|
Flecainide (tambocor)-sendout
|
$145.05 |
$145.05 |
$145.05 |
$65.65
|
|
Floor of mouth biopsy 41108
|
$2,236.90 |
$2,236.90 |
$2,236.90 |
$2,168.40
|
|
Flow cytometry marker each additional
|
$126.85 |
$126.85 |
$126.85 |
$97.50
|
|
Flow cytometry one marker technical component
|
$184.85 |
$184.85 |
$184.85 |
$285.00
|
|
Flt3 gene
|
$579.80 |
$579.80 |
$579.80 |
$366.29
|
|
Flt3 gene analysis
|
$291.00 |
$291.00 |
$291.00 |
$216.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$109.34 |
$109.34 |
$109.34 |
$64.22
|
|
Fluidotherapy charges pt
|
$103.90 |
$103.90 |
$103.90 |
$101.40
|
|
Fluid pressure muscle 20950
|
$1,065.20 |
$1,065.20 |
$1,065.20 |
$779.45
|
|
Fluorescent antibody titer dna
|
$190.00 |
$190.00 |
$190.00 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$610.05 |
$610.05 |
$610.05 |
$495.00
|
|
Fluoroguide needle placement
|
$521.00 |
$521.00 |
$521.00 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$946.05 |
$946.05 |
$946.05 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$360.82 |
$360.82 |
$360.82 |
$107.00
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$94.77 |
$94.77 |
$94.77 |
$72.52
|
|
Folic acid
|
$180.85 |
$180.85 |
$180.85 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$6.22 |
$6.22 |
$6.22 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$3,493.80 |
$3,493.80 |
$3,493.80 |
$2,511.73
|
|
Fondaparinux sodium
|
$234.88 |
$234.88 |
$234.88 |
$186.20
|
|
Foot X-ray
|
$473.75 |
$473.75 |
$473.75 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$473.75 |
$473.75 |
$473.75 |
$290.40
|
|
Forearm X-ray (both sides)
|
$473.75 |
$473.75 |
$473.75 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$332.35 |
$332.35 |
$332.35 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$230.33 |
$230.33 |
$230.33 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$331.79 |
$331.79 |
$331.79 |
$103.62
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$402.25 |
$402.25 |
$402.25 |
$155.25
|