|
Culture screening strep group a
|
$46.28 |
$46.28 |
$46.28 |
$81.00
|
|
Culture typing immunologic
|
$36.40 |
$36.40 |
$36.40 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$382.20 |
$382.20 |
$382.20 |
$392.50
|
|
Cyclic citrullinated peptide antibody
|
$70.72 |
$70.72 |
$70.72 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,673.49 |
$1,673.49 |
$1,673.49 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$41.08 |
$41.08 |
$41.08 |
$129.48
|
|
Cystic fibrosis cftr
|
$875.68 |
$875.68 |
$875.68 |
$1,100.00
|
|
Cystine urine quantitative
|
$30.16 |
$30.16 |
$30.16 |
$103.35
|
|
Cystourethroscop/calib/dilat stric 52281
|
$1,382.16 |
$1,382.16 |
$1,382.16 |
$3,065.15
|
|
Cytogenetics 25-99
|
$221.00 |
$221.00 |
$221.00 |
$190.00
|
|
Cytogenomic neo microra alys
|
$2,117.44 |
$2,117.44 |
$2,117.44 |
$2,020.20
|
|
Cytog genom-wid alys hem mal
|
$1,149.20 |
$1,149.20 |
$1,149.20 |
$1,263.53
|
|
Cytomegalovirus (cmv) antibody igg
|
$37.96 |
$37.96 |
$37.96 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$37.96 |
$37.96 |
$37.96 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$47.84 |
$47.84 |
$47.84 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$39.52 |
$39.52 |
$39.52 |
$87.50
|
|
Dactinomycin 0.5 mg intravenous solution
|
$2,191.50 |
$2,191.50 |
$2,191.50 |
$3,024.59
|
|
Daptomycin (xellia) unrefrig
|
$64.93 |
$64.93 |
$64.93 |
$56.19
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$445.94 |
$445.94 |
$445.94 |
$257.10
|
|
Dch glucoscan
|
$14.56 |
$14.56 |
$14.56 |
$28.10
|
|
Dch validity tests
|
$14.56 |
$14.56 |
$14.56 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$19.76 |
$19.76 |
$19.76 |
$43.60
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$207.48 |
$207.48 |
$207.48 |
$810.50
|
|
Debride nail1-5 11720
|
$79.04 |
$79.04 |
$79.04 |
$148.80
|
|
Delivery of placenta 59414
|
$1,751.88 |
$1,751.88 |
$1,751.88 |
$3,070.56
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$130.00 |
$130.00 |
$130.00 |
$408.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,159.63 |
$1,159.63 |
$1,159.63 |
$89.78
|
|
Detect agent nos dna dir
|
$75.40 |
$75.40 |
$75.40 |
$115.20
|
|
Devel tst phys/qhp 1st hr
|
$413.92 |
$413.92 |
$413.92 |
$337.50
|
|
Devlopment test interpt&rep
|
$46.28 |
$46.28 |
$46.28 |
$109.46
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$282.86 |
$282.86 |
$282.86 |
$858.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$140.92 |
$140.92 |
$140.92 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$34.84 |
$34.84 |
$34.84 |
$79.20
|
|
Digoxin total therapeutic drug level
|
$56.68 |
$56.68 |
$56.68 |
$102.00
|
|
Disaccharidases
|
$33.28 |
$33.28 |
$33.28 |
$216.00
|
|
Dna antibody native/double stranded
|
$35.88 |
$35.88 |
$35.88 |
$97.50
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$503.36 |
$503.36 |
$503.36 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$634.92 |
$634.92 |
$634.92 |
$471.17
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,803.95 |
$1,803.95 |
$1,803.95 |
$1,718.24
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$453.44 |
$453.44 |
$453.44 |
$800.00
|
|
Drainage external ear simple 69000
|
$191.36 |
$191.36 |
$191.36 |
$789.60
|
|
Drainage of arm bursa 23931
|
$1,895.92 |
$1,895.92 |
$1,895.92 |
$2,197.48
|
|
Drainage of eye
|
$3,643.12 |
$3,643.12 |
$3,643.12 |
$2,360.00
|
|
Drainage of mouth lesion
|
$4,277.52 |
$4,277.52 |
$4,277.52 |
$3,544.29
|
|
Drain blood from under nail 11740
|
$110.76 |
$110.76 |
$110.76 |
$170.50
|
|
Drain finger abscess;simple 26010
|
$190.84 |
$190.84 |
$190.84 |
$419.00
|
|
Drain thigh/knee lesion 27301
|
$1,488.24 |
$1,488.24 |
$1,488.24 |
$3,620.47
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$110.76 |
$110.76 |
$110.76 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$280.28 |
$280.28 |
$280.28 |
$523.00
|
|
Drng of scrotum abscess 55100
|
$1,038.96 |
$1,038.96 |
$1,038.96 |
$1,917.33
|
|
Drug assay rufinamide
|
$40.04 |
$40.04 |
$40.04 |
$85.80
|
|
Drug asy hydroxychloroquine
|
$32.24 |
$32.24 |
$32.24 |
$66.43
|
|
Drug of abuse screen urine
|
$29.12 |
$29.12 |
$29.12 |
$63.75
|
|
Drug test prsmv instrmnt
|
$37.96 |
$37.96 |
$37.96 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$153.92 |
$153.92 |
$153.92 |
$278.85
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$303.16 |
$303.16 |
$303.16 |
$887.25
|
|
Ear irrigation 69209
|
$48.88 |
$48.88 |
$48.88 |
$149.76
|
|
Ecg 12 lead tracing only
|
$136.76 |
$136.76 |
$136.76 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$132.08 |
$132.08 |
$132.08 |
$135.80
|
|
Ecg external < 48 hours recording
|
$143.52 |
$143.52 |
$143.52 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$72.28 |
$72.28 |
$72.28 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$568.88 |
$568.88 |
$568.88 |
$2,001.17
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,003.08 |
$1,003.08 |
$1,003.08 |
$985.15
|
|
Edetate calcium disodium inj
|
$22,549.31 |
$22,549.31 |
$22,549.31 |
$8,569.35
|
|
Eeg monitor/record/awake/drowsy 95816
|
$281.84 |
$281.84 |
$281.84 |
$835.00
|
|
Eeg recording awake and asleep
|
$281.84 |
$281.84 |
$281.84 |
$931.20
|
|
E equine encephalitis igg
|
$49.92 |
$49.92 |
$49.92 |
$49.92
|
|
Ehrlicha chaffeensis amp prb
|
$58.76 |
$58.76 |
$58.76 |
$93.00
|
|
Electrolyte panel
|
$49.92 |
$49.92 |
$49.92 |
$84.24
|
|
Encephalitis, california igg/igm
|
$42.12 |
$42.12 |
$42.12 |
$53.55
|
|
Encephalitis, st louis igg/igm
|
$121.68 |
$121.68 |
$121.68 |
$48.57
|
|
Encephalitis, western equine igg/igm
|
$42.12 |
$42.12 |
$42.12 |
$53.10
|
|
Epstein barr early antigen antibody
|
$47.84 |
$47.84 |
$47.84 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$162.24 |
$162.24 |
$162.24 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$75.92 |
$75.92 |
$75.92 |
$91.00
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$360.83 |
$360.83 |
$360.83 |
$393.98
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$1,834.67 |
$1,834.67 |
$1,834.67 |
$2,488.75
|
|
ER Visit (level 1, minor)
|
$106.60 |
$106.60 |
$106.60 |
$246.24
|
|
ER Visit (level 2)
|
$149.24 |
$149.24 |
$149.24 |
$452.20
|
|
ER Visit (level 3)
|
$234.52 |
$234.52 |
$234.52 |
$770.04
|
|
ER Visit (level 4)
|
$284.44 |
$284.44 |
$284.44 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$355.68 |
$355.68 |
$355.68 |
$1,820.02
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$290.43 |
$290.43 |
$290.43 |
$223.99
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$368.16 |
$368.16 |
$368.16 |
$279.72
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$597.09 |
$597.09 |
$597.09 |
$553.88
|
|
Established Patient Office Visit (level 1)
|
$26.00 |
$26.00 |
$26.00 |
$120.25
|
|
Estradiol total
|
$47.84 |
$47.84 |
$47.84 |
$146.50
|
|
Estrogens total-sendout
|
$42.64 |
$42.64 |
$42.64 |
$96.20
|
|
Eth estr and eton monthly
|
$84.50 |
$84.50 |
$84.50 |
$266.45
|
|
Etoposide 50 mg cap
|
$45.30 |
$45.30 |
$45.30 |
$135.02
|
|
Euflexxa inj per dose
|
$1,301.10 |
$1,301.10 |
$1,301.10 |
$587.51
|
|
Eval/fit voice prosthesis iii, st
|
$110.76 |
$110.76 |
$110.76 |
$356.00
|
|
Evaluation of speech fluency 92521
|
$199.68 |
$199.68 |
$199.68 |
$311.50
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,013.48 |
$1,013.48 |
$1,013.48 |
$1,372.15
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$2,530.32 |
$2,530.32 |
$2,530.32 |
$3,230.00
|
|
Excision olecranon bursa
|
$4,374.76 |
$4,374.76 |
$4,374.76 |
$2,889.60
|
|
Exc sq tum/neck or ant thorax <3cm 21555
|
$1,844.44 |
$1,844.44 |
$1,844.44 |
$3,322.80
|
|
Exercise tst brncspsm w/ecg
|
$116.48 |
$116.48 |
$116.48 |
$318.50
|
|
Exercise tst brncspsm wo ecg
|
$93.08 |
$93.08 |
$93.08 |
$114.50
|
|
Exp w remove/deep fb/forearm/wrist 25248
|
$2,265.64 |
$2,265.64 |
$2,265.64 |
$3,623.43
|
