|
Ercp biliary & pancreas
|
$420.42 |
$420.42 |
$420.42 |
$885.80
|
|
ER Visit (level 2)
|
$222.18 |
$222.18 |
$222.18 |
$469.39
|
|
ER Visit (level 3)
|
$433.86 |
$433.86 |
$433.86 |
$821.52
|
|
ER Visit (level 4)
|
$885.36 |
$885.36 |
$885.36 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$1,047.48 |
$1,047.48 |
$1,047.48 |
$1,900.20
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$138.56 |
$138.56 |
$138.56 |
$195.33
|
|
Esophagus motility study
|
$753.48 |
$753.48 |
$753.48 |
$1,257.17
|
|
Established Patient Office Visit (level 1)
|
$61.32 |
$61.32 |
$61.32 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$78.12 |
$78.12 |
$78.12 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$102.06 |
$102.06 |
$102.06 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$132.72 |
$132.72 |
$132.72 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$171.78 |
$171.78 |
$171.78 |
$270.09
|
|
Estradiol total
|
$60.06 |
$60.06 |
$60.06 |
$142.20
|
|
Estrogens total-sendout
|
$15.75 |
$15.75 |
$15.75 |
$111.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$1.15 |
$1.15 |
$1.15 |
$20.35
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$5,376.00 |
$5,376.00 |
$5,376.00 |
$2,941.80
|
|
Explore penetrating wnd/extremity 20103
|
$1,509.48 |
$1,509.48 |
$1,509.48 |
$1,908.09
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$254.10 |
$254.10 |
$254.10 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$118.13 |
$118.13 |
$118.13 |
$102.50
|
|
F-18 fdg pet diag
|
$189.00 |
$189.00 |
$189.00 |
$750.58
|
|
Facial bones <3
|
$104.16 |
$104.16 |
$104.16 |
$216.45
|
|
Factor ix
|
$15.62 |
$15.62 |
$15.62 |
$139.75
|
|
Factor ix recombinant nos
|
$1,323.00 |
$1,323.00 |
$1,323.00 |
$1.88
|
|
Factor viii
|
$69.51 |
$69.51 |
$69.51 |
$152.50
|
|
Factor viii recombinant nos
|
$1.42 |
$1.42 |
$1.42 |
$3.30
|
|
Fat/lipids feces qualitative
|
$20.79 |
$20.79 |
$20.79 |
$43.66
|
|
Fatty acids nonesterified
|
$12.91 |
$12.91 |
$12.91 |
$64.28
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$1.32 |
$1.32 |
$1.32 |
$48.88
|
|
Ferritin
|
$29.82 |
$29.82 |
$29.82 |
$86.45
|
|
Fetal biophys profile w/nst 76818
|
$231.00 |
$231.00 |
$231.00 |
$525.33
|
|
Fetal fibronectin
|
$140.28 |
$140.28 |
$140.28 |
$309.40
|
|
Fetal hemoglobin (kleihauer betke)
|
$15.96 |
$15.96 |
$15.96 |
$59.85
|
|
Fetal hemoglobin rosette
|
$14.70 |
$14.70 |
$14.70 |
$48.35
|
|
Fetal non stress test
|
$289.80 |
$289.80 |
$289.80 |
$507.90
|
|
#_fet/norfentcnfrmur
|
$96.12 |
$96.12 |
$96.12 |
$120.85
|
|
Fibrin degrade semiquant
|
$14.70 |
$14.70 |
$14.70 |
$88.00
|
|
Fibrinogen activity
|
$18.48 |
$18.48 |
$18.48 |
$61.80
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$15.99 |
$15.99 |
$15.99 |
$70.80
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$8.29 |
$8.29 |
$8.29 |
$48.56
|
|
Fludarabine 50 mg intravenous solution
|
$121.96 |
$121.96 |
$121.96 |
$417.96
|
|
Fluorescent antibody titer dna
|
$23.44 |
$23.44 |
$23.44 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$213.36 |
$213.36 |
$213.36 |
$497.25
|
|
Fluoroguide needle placement
|
$218.40 |
$218.40 |
$218.40 |
$510.00
|
|
Fluoro polarize fetal lung
|
$4.73 |
$4.73 |
$4.73 |
$127.20
|
|
Fluoroscopy up to 1 hour
|
$362.88 |
$362.88 |
$362.88 |
$474.50
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$3.90 |
$3.90 |
$3.90 |
$73.16
|
|
Folic acid
|
$31.92 |
$31.92 |
$31.92 |
$85.50
|
|
Follow-up angiography
|
$1,320.06 |
$1,320.06 |
$1,320.06 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$7.90 |
$7.90 |
$7.90 |
$18.44
|
|
Fondaparinux sodium
|
$12.07 |
$12.07 |
$12.07 |
$121.83
|
|
Foot X-ray
|
$110.88 |
$110.88 |
$110.88 |
$339.50
|
|
Fractionation ketosteroids
|
$120.67 |
$120.67 |
$120.67 |
$128.26
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$277.20 |
$277.20 |
$277.20 |
$217.30
|
|
Frozen blood freeze/thaw
|
$60.06 |
$60.06 |
$60.06 |
$179.01
|
|
Ftl cgen abnor four anal
|
$26.46 |
$26.46 |
$26.46 |
$267.15
|
|
Ga-67 gallium 0.1 mci
|
$23.52 |
$23.52 |
$23.52 |
$156.23
|
|
Gammaglobulin iga
|
$30.45 |
$30.45 |
$30.45 |
$78.60
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$121.68 |
$121.68 |
$121.68 |
$154.86
|
|
Gastric analy w/ph ea spec
|
$16.38 |
$16.38 |
$16.38 |
$25.61
|
|
Gastrin test
|
$5.04 |
$5.04 |
$5.04 |
$61.80
|
|
Gastroesophageal reflux study
|
$863.10 |
$863.10 |
$863.10 |
$887.62
|
|
Gastroesophageal reflux test
|
$914.34 |
$914.34 |
$914.34 |
$1,110.80
|
|
Gemcitabine 1 gram intravenous solution
|
$12.12 |
$12.12 |
$12.12 |
$168.02
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$8.53 |
$8.53 |
$8.53 |
$30.76
|
|
Gentamicin peak therapeutic drug level
|
$20.58 |
$20.58 |
$20.58 |
$114.00
|
|
Ghs abscess postoperative iandd complex
|
$2,098.74 |
$2,098.74 |
$2,098.74 |
$3,776.00
|
|
Ghs acetylcholinesterase, rbc
|
$7.16 |
$7.16 |
$7.16 |
$44.20
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$12.60 |
$12.60 |
$12.60 |
$103.14
|
|
Ghs antibodies (torch) igm
|
$7.35 |
$7.35 |
$7.35 |
$82.50
|
|
Ghs bleeding time (ivy)
|
$25.62 |
$25.62 |
$25.62 |
$55.90
|
|
Ghs ed rmvl or bivalving cast
|
$456.54 |
$456.54 |
$456.54 |
$351.46
|
|
Ghs febrile agglutinns(mayo)
|
$32.97 |
$32.97 |
$32.97 |
$51.99
|
|
Ghs hepatitis c virus (hcv riba)
|
$37.97 |
$37.97 |
$37.97 |
$105.00
|
|
Ghs histoplasma antigen
|
$14.70 |
$14.70 |
$14.70 |
$157.30
|
|
Ghs hla-dr/dq, multiple antigens
|
$151.10 |
$151.10 |
$151.10 |
$475.80
|
|
Ghs immun0electrophoresis
|
$21.84 |
$21.84 |
$21.84 |
$110.00
|
|
Ghs inhibitor screen
|
$50.40 |
$50.40 |
$50.40 |
$138.06
|
|
Ghs intro needle/intracath vein - 36000
|
$55.02 |
$55.02 |
$55.02 |
$213.75
|
|
Ghs leukocyte alkaline phos (mayo)
|
$18.90 |
$18.90 |
$18.90 |
$62.28
|
|
Ghs mbp
|
$9.98 |
$9.98 |
$9.98 |
$97.20
|
|
Ghs nerve block celiac plexus
|
$819.84 |
$819.84 |
$819.84 |
$1,681.24
|
|
Ghs pacing - transcutaneous
|
$1,617.84 |
$1,617.84 |
$1,617.84 |
$872.95
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$28.56 |
$28.56 |
$28.56 |
$82.80
|
|
Ghs plt ct-manual
|
$9.66 |
$9.66 |
$9.66 |
$40.80
|
|
Ghs ppd (tb intradermal)
|
$12.18 |
$12.18 |
$12.18 |
$39.77
|
|
Ghs prostatic acid phosphatase (mayo)
|
$5.61 |
$5.61 |
$5.61 |
$49.77
|
|
Ghs protoporphyrins fract
|
$22.13 |
$22.13 |
$22.13 |
$68.38
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$8.98 |
$8.98 |
$8.98 |
$55.25
|
|
Ghs quinidine
|
$10.10 |
$10.10 |
$10.10 |
$70.85
|
|
Ghs respiratory syncytical virus igg/m
|
$22.68 |
$22.68 |
$22.68 |
$48.57
|
|
Ghs reticulocyte count
|
$16.38 |
$16.38 |
$16.38 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$31.29 |
$31.29 |
$31.29 |
$117.60
|
|
Ghs sedimentation rate
|
$22.68 |
$22.68 |
$22.68 |
$36.57
|
|
Ghs urine, hydroxproline total
|
$22.00 |
$22.00 |
$22.00 |
$119.40
|
|
Ghs urine, porphyrins quant
|
$9.24 |
$9.24 |
$9.24 |
$85.15
|
|
Gi inhouse confirmation
|
$42.00 |
$42.00 |
$42.00 |
$79.50
|
|
Glucagon 1 mg solution for injection
|
$234.05 |
$234.05 |
$234.05 |
$351.53
|
|
Glucagon plasma - sendout
|
$7.81 |
$7.81 |
$7.81 |
$67.50
|
|
Glucose 1 hr post dose
|
$9.24 |
$9.24 |
$9.24 |
$40.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$6.72 |
$6.72 |
$6.72 |
$20.00
|
