|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$309.32 |
$309.32 |
$562.40 |
$1,247.50
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$673.86 |
$673.86 |
$1,225.20 |
$3,230.00
|
|
Exchange biliary drg cath
|
$1,348.82 |
$1,348.82 |
$2,452.40 |
$3,909.56
|
|
Exchange drainage catheter
|
$801.46 |
$801.46 |
$1,457.20 |
$2,205.50
|
|
Exchange nephrostomy cath
|
$801.46 |
$801.46 |
$1,457.20 |
$2,958.80
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$358.82 |
$358.82 |
$652.40 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$673.86 |
$673.86 |
$1,225.20 |
$1,973.12
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$309.32 |
$309.32 |
$562.40 |
$1,012.86
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$309.32 |
$309.32 |
$562.40 |
$973.71
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$280.72 |
$280.72 |
$510.40 |
$889.20
|
|
External chromosome analysis 20-25 cells
|
$132.00 |
$132.00 |
$240.00 |
$384.15
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$133.76 |
$133.76 |
$243.20 |
$454.20
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$52.36 |
$52.36 |
$95.20 |
$108.60
|
|
F-18 sodium fluoride
|
$209.43 |
$209.43 |
$380.78 |
$392.60
|
|
Facial bones <3
|
$79.20 |
$79.20 |
$144.00 |
$252.60
|
|
Factor ix
|
$30.36 |
$30.36 |
$55.20 |
$156.13
|
|
Factor viii
|
$19.36 |
$19.36 |
$35.20 |
$133.81
|
|
Fat/lipids feces qualitative
|
$44.44 |
$44.44 |
$80.80 |
$38.35
|
|
Fecal microbiota prep instil
|
$205.92 |
$205.92 |
$374.40 |
$1,059.00
|
|
#fecal-sodium
|
$23.10 |
$23.10 |
$42.00 |
$37.50
|
|
Fem/popl revasc w/stent
|
$5,061.76 |
$5,061.76 |
$9,203.20 |
$16,843.00
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$86.07 |
$86.07 |
$156.50 |
$101.40
|
|
Ferritin
|
$37.84 |
$37.84 |
$68.80 |
$100.94
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$305.30 |
$305.30 |
$555.08 |
$1,776.61
|
|
Fetal biophys profile w/nst 76818
|
$136.84 |
$136.84 |
$248.80 |
$535.37
|
|
Fetal contract stress test 59020 - 26
|
$169.84 |
$169.84 |
$308.80 |
$475.50
|
|
Fetal hemoglobin (kleihauer betke)
|
$58.74 |
$58.74 |
$106.80 |
$105.12
|
|
Fetal hemoglobin rosette
|
$7.92 |
$7.92 |
$14.40 |
$67.20
|
|
Fetal non stress test
|
$118.36 |
$118.36 |
$215.20 |
$463.03
|
|
#_fet/norfentcnfrmur
|
$82.28 |
$82.28 |
$149.60 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$36.52 |
$36.52 |
$66.40 |
$117.70
|
|
Fibrin degradation products
|
$75.02 |
$75.02 |
$136.40 |
$62.64
|
|
Fibrinogen activity
|
$27.28 |
$27.28 |
$49.60 |
$83.50
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$405.46 |
$405.46 |
$737.20 |
$823.90
|
|
Fine needle asp without image guide 10021
|
$133.98 |
$133.98 |
$243.60 |
$503.76
|
|
Flebogamma injection
|
$2,470.51 |
$2,470.51 |
$4,491.84 |
$3,438.30
|
|
Fl exam g/colon tube w contrast
|
$272.80 |
$272.80 |
$496.00 |
$511.92
|
|
Flow cytometry marker each additional
|
$21.56 |
$21.56 |
$39.20 |
$97.50
|
|
Flow cytometry one marker technical component
|
$133.54 |
$133.54 |
$242.80 |
$284.40
|
|
#flow interp 9 - 15 markers
|
$78.10 |
$78.10 |
$142.00 |
$172.50
|
|
Flt3 gene
|
$240.24 |
$240.24 |
$436.80 |
$355.00
|
|
Flt3 gene analysis
|
$48.40 |
$48.40 |
$88.00 |
$213.92
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$74.58 |
$74.58 |
$135.60 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$3,036.00 |
$3,036.00 |
$5,520.00 |
$493.35
|
|
Fluorescent antibody titer dna
|
$29.70 |
$29.70 |
$54.00 |
$122.82
|
|
Fluoroguide for spine inject 77003-26
|
$98.12 |
$98.12 |
$178.40 |
$496.03
|
|
Fluoroguide needle placement
|
$98.12 |
$98.12 |
$178.40 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$137.28 |
$137.28 |
$249.60 |
$492.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$72.60 |
$72.60 |
$132.00 |
$94.86
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$473.05 |
$473.05 |
$860.10 |
$72.52
|
|
Fna bx w/ct gdn 1st les
|
$309.32 |
$309.32 |
$562.40 |
$1,420.80
|
|
Folic acid
|
$11.88 |
$11.88 |
$21.60 |
$101.50
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,204.02 |
$1,204.02 |
$2,189.13 |
$2,581.14
|
|
Fondaparinux sodium
|
$168.82 |
$168.82 |
$306.95 |
$185.12
|
|
Foot X-ray
|
$78.76 |
$78.76 |
$143.20 |
$362.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$118.44 |
$118.44 |
$215.35 |
$457.50
|
|
Foscarnet sodium injection
|
$1,298.55 |
$1,298.55 |
$2,361.00 |
$879.58
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$68.71 |
$68.71 |
$124.92 |
$106.10
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$50.82 |
$50.82 |
$92.40 |
$151.58
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$103.84 |
$103.84 |
$188.80 |
$156.60
|
|
Fructosamine glycated protein
|
$10.12 |
$10.12 |
$18.40 |
$60.75
|
|
Ftl cgen abnor four anal
|
$51.26 |
$51.26 |
$93.20 |
$204.52
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$51.81 |
$51.81 |
$94.20 |
$27.08
|
|
G6pd gene alys cmn variant
|
$2.42 |
$2.42 |
$4.40 |
$243.00
|
|
Gabapentin non-blood
|
$14.74 |
$14.74 |
$26.80 |
$36.30
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$51.68 |
$51.68 |
$93.96 |
$102.00
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$260.53 |
$260.53 |
$473.70 |
$177.52
|
|
Gammaglobulin iga
|
$22.44 |
$22.44 |
$40.80 |
$67.20
|
|
Gammaglobulin ige
|
$40.92 |
$40.92 |
$74.40 |
$83.85
|
|
Gamma glutamyltransferase
|
$9.46 |
$9.46 |
$17.20 |
$57.54
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$89.20 |
$89.20 |
$162.18 |
$197.40
|
|
Gardner vag dna amp probe
|
$16.50 |
$16.50 |
$30.00 |
$65.30
|
|
Gastroesophageal reflux test
|
$387.64 |
$387.64 |
$704.80 |
$1,321.45
|
|
Gefitinib oral
|
$90.36 |
$90.36 |
$164.28 |
$423.82
|
|
Gemcitabine 1 gram intravenous solution
|
$157.15 |
$157.15 |
$285.72 |
$207.51
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$76.23 |
$76.23 |
$138.60 |
$57.84
|
|
Gentamicin peak therapeutic drug level
|
$24.42 |
$24.42 |
$44.40 |
$126.00
|
|
G-esoph reflx tst w/electrod
|
$387.64 |
$387.64 |
$704.80 |
$1,418.18
|
|
Ghs abscess perianal iandd
|
$189.42 |
$189.42 |
$344.40 |
$1,410.90
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$11.88 |
$11.88 |
$21.60 |
$100.30
|
|
Ghs analysis neurostim without reprogramming
|
$66.00 |
$66.00 |
$120.00 |
$246.50
|
|
Ghs antibodies (torch) igm
|
$115.72 |
$115.72 |
$210.40 |
$69.30
|
|
Ghs bladder cath - complex-foley
|
$34.32 |
$34.32 |
$62.40 |
$344.00
|
|
Ghs central line insert < age 5, failed
|
$1,073.16 |
$1,073.16 |
$1,951.20 |
$2,535.60
|
|
Ghs change cysto/gastrost
|
$194.70 |
$194.70 |
$354.00 |
$565.49
|
|
Ghs chemo >8 hrs
|
$397.76 |
$397.76 |
$723.20 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$135.08 |
$135.08 |
$245.60 |
$286.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$17.82 |
$17.82 |
$32.40 |
$132.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$78.76 |
$78.76 |
$143.20 |
$512.40
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$541.20 |
$541.20 |
$984.00 |
$1,592.00
|
|
Ghs closed tx tibial fracture w/manip
|
$541.20 |
$541.20 |
$984.00 |
$2,148.00
|
|
Ghs clsd red med malleolus fx without manip
|
$78.76 |
$78.76 |
$143.20 |
$496.80
|
|
Ghs cl tx knee disl; wo anesth
|
$84.48 |
$84.48 |
$153.60 |
$592.80
|
|
Ghs cl tx metacarpophal disloc without anes
|
$78.76 |
$78.76 |
$143.20 |
$495.55
|
|
Ghs community re-entry 15 minutes
|
$45.54 |
$45.54 |
$82.80 |
$88.50
|
|
Ghs conjunctiva foreign body-superf bil
|
$144.54 |
$144.54 |
$262.80 |
$283.80
|
|
Ghs corneal fb without slit lamp bilat
|
$128.92 |
$128.92 |
$234.40 |
$419.65
|
|
Ghs corneal fb with slit lamp bilat
|
$55.44 |
$55.44 |
$100.80 |
$339.60
|
|
Ghs dislocation elbow closed treatment
|
$78.76 |
$78.76 |
$143.20 |
$578.00
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$810.70 |
$810.70 |
$1,474.00 |
$1,432.20
|
