|
Exc malig snhfg 0.6-1.0 cm 11621
|
$1,921.60 |
$1,921.60 |
$1,921.60 |
$1,064.70
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$3,139.20 |
$3,139.20 |
$3,139.20 |
$1,954.00
|
|
Exc malig tal 0.6-1.0cm 11601
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$1,684.00 |
$1,684.00 |
$1,684.00 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$2,200.80 |
$2,200.80 |
$2,200.80 |
$1,207.80
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$2,640.80 |
$2,640.80 |
$2,640.80 |
$1,294.80
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$6,523.20 |
$6,523.20 |
$6,523.20 |
$3,386.84
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$2,365.60 |
$2,365.60 |
$2,365.60 |
$1,274.00
|
|
Exc sq tum/neck/ant thorax 3cm/> 21552
|
$6,457.60 |
$6,457.60 |
$6,457.60 |
$4,744.88
|
|
Exc sq tumor/shoulder area 3cm/> 23071
|
$5,573.60 |
$5,573.60 |
$5,573.60 |
$4,014.40
|
|
Exc thrombosed hemorrhoid 46320
|
$3,876.80 |
$3,876.80 |
$3,876.80 |
$2,175.36
|
|
Exercise tst brncspsm w/ecg
|
$378.40 |
$378.40 |
$378.40 |
$335.52
|
|
Explore penetrating wnd/extremity 20103
|
$3,280.00 |
$3,280.00 |
$3,280.00 |
$1,788.80
|
|
Ex sq tumor/face or scalp 2 cm/> 21012
|
$5,643.20 |
$5,643.20 |
$5,643.20 |
$2,896.40
|
|
Ext ecg>48hr<7d scan a/r
|
$396.80 |
$396.80 |
$396.80 |
$241.92
|
|
Ext ecg>7d<15d scan a/r
|
$380.00 |
$380.00 |
$380.00 |
$345.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$84.00 |
$84.00 |
$84.00 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$472.00 |
$472.00 |
$472.00 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,569.60 |
$2,569.60 |
$2,569.60 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$2,384.80 |
$2,384.80 |
$2,384.80 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$2,116.00 |
$2,116.00 |
$2,116.00 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$4,304.00 |
$4,304.00 |
$4,304.00 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$3,376.00 |
$3,376.00 |
$3,376.00 |
$1,883.25
|
|
Facial Bones X-ray (complete)
|
$477.60 |
$477.60 |
$477.60 |
$381.75
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$60.81 |
$60.81 |
$60.81 |
$22.20
|
|
Felbamate (felbatol(r)) - sendout
|
$71.20 |
$71.20 |
$71.20 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$61.52 |
$61.52 |
$61.52 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,204.66 |
$1,204.66 |
$1,204.66 |
$2,590.25
|
|
Ferritin
|
$133.60 |
$133.60 |
$133.60 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$637.73 |
$637.73 |
$637.73 |
$1,636.50
|
|
Ferumoxytol, esrd use
|
$637.73 |
$637.73 |
$637.73 |
$0.50
|
|
Fetal fibronectin
|
$329.60 |
$329.60 |
$329.60 |
$389.95
|
|
Fetal non stress test
|
$378.40 |
$378.40 |
$378.40 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$115.20 |
$115.20 |
$115.20 |
$120.64
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$714.34 |
$714.34 |
$714.34 |
$1,197.83
|
|
Fine needle asp without image guide 10021
|
$731.20 |
$731.20 |
$731.20 |
$504.45
|
|
Finger X-ray (both hands)
|
$315.20 |
$315.20 |
$315.20 |
$241.50
|
|
Flow cytometry marker each additional
|
$121.60 |
$121.60 |
$121.60 |
$97.50
|
|
Flow cytometry one marker technical component
|
$558.40 |
$558.40 |
$558.40 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$107.70 |
$107.70 |
$107.70 |
$64.22
|
|
Fluidotherapy charges pt
|
$156.00 |
$156.00 |
$156.00 |
$101.40
|
|
Fluorescent antibody titer dna
|
$96.00 |
$96.00 |
$96.00 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$632.00 |
$632.00 |
$632.00 |
$495.00
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$664.00 |
$664.00 |
$664.00 |
$503.80
|
|
Folic acid
|
$140.00 |
$140.00 |
$140.00 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$60.09 |
$60.09 |
$60.09 |
$45.00
|
|
Foot X-ray
|
$368.80 |
$368.80 |
$368.80 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$313.60 |
$313.60 |
$313.60 |
$290.40
|
|
Forearm X-ray (both sides)
|
$329.60 |
$329.60 |
$329.60 |
$324.00
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$61.55 |
$61.55 |
$61.55 |
$103.62
|
|
_fragile x methylation-sendout
|
$120.80 |
$120.80 |
$120.80 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$233.60 |
$233.60 |
$233.60 |
$164.84
|
|
Fructosamine glycated protein
|
$57.60 |
$57.60 |
$57.60 |
$63.50
|
|
Ftl cgen abnor four anal
|
$371.20 |
$371.20 |
$371.20 |
$211.83
|
|
Full Spine X-ray (Scoliosis Survey)
|
$440.80 |
$440.80 |
$440.80 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$61.24 |
$61.24 |
$61.24 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$132.00 |
$132.00 |
$132.00 |
$108.40
|
|
Galactose transferase test
|
$33.60 |
$33.60 |
$33.60 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,938.40 |
$1,938.40 |
$1,938.40 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$2,146.40 |
$2,146.40 |
$2,146.40 |
$1,615.00
|
|
Gammaglobulin iga
|
$60.80 |
$60.80 |
$60.80 |
$69.60
|
|
Gammaglobulin ige
|
$137.60 |
$137.60 |
$137.60 |
$83.85
|
|
Gamma glutamyltransferase
|
$46.40 |
$46.40 |
$46.40 |
$57.54
|
|
Gamunex-c/gammaked
|
$3,551.52 |
$3,551.52 |
$3,551.52 |
$7,435.88
|
|
Gastroesophageal reflux study
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$1,031.60
|
|
Gemcitabine 1 gram intravenous solution
|
$382.23 |
$382.23 |
$382.23 |
$207.51
|
|
General health panel
|
$404.80 |
$404.80 |
$404.80 |
$262.44
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$106.82 |
$106.82 |
$106.82 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$157.60 |
$157.60 |
$157.60 |
$123.84
|
|
Ghs change cysto/gastrost
|
$733.60 |
$733.60 |
$733.60 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$234.40 |
$234.40 |
$234.40 |
$277.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$630.40 |
$630.40 |
$630.40 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$748.00 |
$748.00 |
$748.00 |
$671.50
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,542.40 |
$1,542.40 |
$1,542.40 |
$1,592.00
|
|
Ghs cl tx knee disl; wo anesth
|
$400.80 |
$400.80 |
$400.80 |
$581.90
|
|
Ghs community re-entry 15 minutes
|
$124.80 |
$124.80 |
$124.80 |
$89.28
|
|
Ghs conjunctiva foreign body-superf bil
|
$350.40 |
$350.40 |
$350.40 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$440.80 |
$440.80 |
$440.80 |
$422.25
|
|
Ghs excision ingrown nail
|
$416.00 |
$416.00 |
$416.00 |
$449.25
|
|
Ghs fish cytogen
|
$58.40 |
$58.40 |
$58.40 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$124.80 |
$124.80 |
$124.80 |
$226.20
|
|
Ghs i and d pilonidal cyst simple
|
$799.20 |
$799.20 |
$799.20 |
$707.25
|
|
Ghs incision thrombosed ext hemorrhoid
|
$658.40 |
$658.40 |
$658.40 |
$526.50
|
|
Ghs inhibitor screen
|
$360.80 |
$360.80 |
$360.80 |
$191.88
|
|
Ghs insertion of needle - bone
|
$358.40 |
$358.40 |
$358.40 |
$431.28
|
|
Ghs IV inf sq injection, on-body injector
|
$139.20 |
$139.20 |
$139.20 |
$110.00
|
|
Ghs IV thrombolytics - cerebral
|
$859.20 |
$859.20 |
$859.20 |
$663.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$994.40 |
$994.40 |
$994.40 |
$591.00
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$805.60 |
$805.60 |
$805.60 |
$583.10
|
|
Ghs layer closure 2.5cm or less - 12051
|
$358.40 |
$358.40 |
$358.40 |
$603.20
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$903.20 |
$903.20 |
$903.20 |
$700.33
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$928.80 |
$928.80 |
$928.80 |
$741.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$1,008.80 |
$1,008.80 |
$1,008.80 |
$779.35
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$212.80 |
$212.80 |
$212.80 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$115.20 |
$115.20 |
$115.20 |
$142.40
|
|
Ghs myocardial strain img spckl track
|
$566.40 |
$566.40 |
$566.40 |
$457.80
|
|
Ghs ng placement w fluoro guidance
|
$326.40 |
$326.40 |
$326.40 |
$485.00
|
|
Ghs ot group caregiver training
|
$50.40 |
$50.40 |
$50.40 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$124.80 |
$124.80 |
$124.80 |
$93.00
|
|
Ghs ppd (tb intradermal)
|
$66.40 |
$66.40 |
$66.40 |
$37.44
|
