|
Epstein barr viral capsid antigen antibody igm
|
$254.25 |
$254.25 |
$254.25 |
$112.50
|
|
ER Visit (level 1, minor)
|
$24.75 |
$24.75 |
$24.75 |
$270.00
|
|
ER Visit (level 2)
|
$47.25 |
$47.25 |
$47.25 |
$469.39
|
|
ER Visit (level 3)
|
$81.00 |
$81.00 |
$81.00 |
$821.52
|
|
ER Visit (level 4)
|
$136.50 |
$136.50 |
$136.50 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$198.75 |
$198.75 |
$198.75 |
$1,900.20
|
|
Established Patient Office Visit (level 1)
|
$24.00 |
$24.00 |
$24.00 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$59.25 |
$59.25 |
$59.25 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$78.75 |
$78.75 |
$78.75 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$96.75 |
$96.75 |
$96.75 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$131.25 |
$131.25 |
$131.25 |
$270.09
|
|
Estradiol total
|
$49.50 |
$49.50 |
$49.50 |
$142.20
|
|
Estradiol valerate 10 mg inj
|
$50.32 |
$50.32 |
$50.32 |
$137.64
|
|
Estrogens total-sendout
|
$48.75 |
$48.75 |
$48.75 |
$111.00
|
|
Evaluation psychiatric diagnostic
|
$188.25 |
$188.25 |
$188.25 |
$325.65
|
|
Event monitor
|
$33.75 |
$33.75 |
$33.75 |
$228.60
|
|
Exam pelvic add-on
|
$26.25 |
$26.25 |
$26.25 |
$41.60
|
|
Exam plvc w/anes othr thn lcl
|
$230.25 |
$230.25 |
$230.25 |
$2,498.48
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$346.50 |
$346.50 |
$346.50 |
$1,874.89
|
|
Exc benign tal 0.5 < cm 11400
|
$113.25 |
$113.25 |
$113.25 |
$805.70
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$127.50 |
$127.50 |
$127.50 |
$828.59
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$213.75 |
$213.75 |
$213.75 |
$973.71
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$188.25 |
$188.25 |
$188.25 |
$1,224.75
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$236.25 |
$236.25 |
$236.25 |
$1,967.25
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$339.00 |
$339.00 |
$339.00 |
$3,335.67
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$127.50 |
$127.50 |
$127.50 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$236.25 |
$236.25 |
$236.25 |
$1,228.50
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$309.00 |
$309.00 |
$309.00 |
$973.71
|
|
Exc im tumor/foot/toe < 1.5 cm 28045
|
$894.00 |
$894.00 |
$894.00 |
$3,155.77
|
|
Excise lip or cheek fold
|
$890.25 |
$890.25 |
$890.25 |
$1,640.99
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$200.25 |
$200.25 |
$200.25 |
$765.00
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$213.75 |
$213.75 |
$213.75 |
$1,855.89
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$146.25 |
$146.25 |
$146.25 |
$973.71
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$179.25 |
$179.25 |
$179.25 |
$2,925.00
|
|
Exc malig feenl <0.5cm 11640
|
$237.75 |
$237.75 |
$237.75 |
$973.71
|
|
Exc malig feenl 1.1-2 11642
|
$171.00 |
$171.00 |
$171.00 |
$1,082.00
|
|
Exc malig snhfg 0.5cm or less 11620
|
$228.75 |
$228.75 |
$228.75 |
$984.27
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$301.50 |
$301.50 |
$301.50 |
$869.48
|
|
Exc malig tal <0.5cm 11600
|
$189.75 |
$189.75 |
$189.75 |
$805.38
|
|
Exc malig tal 0.6-1.0cm 11601
|
$273.75 |
$273.75 |
$273.75 |
$817.00
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$299.25 |
$299.25 |
$299.25 |
$932.35
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$341.25 |
$341.25 |
$341.25 |
$1,154.00
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$378.75 |
$378.75 |
$378.75 |
$1,322.10
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$311.25 |
$311.25 |
$311.25 |
$1,329.08
|
|
Exc snhfg mal+mrg >4 cm 11626
|
$372.75 |
$372.75 |
$372.75 |
$2,850.35
|
|
Exc tmr sft tiss shldr subq <3cm
|
$384.00 |
$384.00 |
$384.00 |
$1,908.09
|
|
Ext ecg>48hr<7d scan a/r
|
$364.50 |
$364.50 |
$364.50 |
$238.50
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$53.25 |
$53.25 |
$53.25 |
$102.50
|
|
Factor ix
|
$123.75 |
$123.75 |
$123.75 |
$139.75
|
|
Factor viii
|
$123.75 |
$123.75 |
$123.75 |
$152.50
|
|
Family therapy without pt 50min 90846
|
$188.25 |
$188.25 |
$188.25 |
$230.40
|
|
Family therapy with patient 50 min 90847
|
$222.75 |
$222.75 |
$222.75 |
$224.80
|
|
Fat/lipids feces qualitative
|
$27.00 |
$27.00 |
$27.00 |
$43.66
|
|
Fatty acids nonesterified
|
$33.00 |
$33.00 |
$33.00 |
$64.28
|
|
Feno poc
|
$76.50 |
$76.50 |
$76.50 |
$97.18
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$3.75 |
$3.75 |
$3.75 |
$48.88
|
|
Ferritin
|
$40.50 |
$40.50 |
$40.50 |
$86.45
|
|
Fibrin degradation d dimer quantitative
|
$135.75 |
$135.75 |
$135.75 |
$87.60
|
|
Fibrinogen activity
|
$57.75 |
$57.75 |
$57.75 |
$61.80
|
|
Fibrinolytic plasminogen
|
$168.00 |
$168.00 |
$168.00 |
$120.00
|
|
Fine needle asp without image guide 10021
|
$174.00 |
$174.00 |
$174.00 |
$547.53
|
|
Flow cytometry interp 16 or more
|
$162.00 |
$162.00 |
$162.00 |
$208.80
|
|
Flow cytometry marker each additional
|
$12.00 |
$12.00 |
$12.00 |
$103.00
|
|
Flow cytometry one marker technical component
|
$60.75 |
$60.75 |
$60.75 |
$304.43
|
|
Fluorescent antibody titer dna
|
$24.00 |
$24.00 |
$24.00 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$143.25 |
$143.25 |
$143.25 |
$497.25
|
|
Fluoroguide needle placement
|
$190.50 |
$190.50 |
$190.50 |
$510.00
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$75.62 |
$75.62 |
$75.62 |
$66.60
|
|
Folic acid
|
$43.50 |
$43.50 |
$43.50 |
$85.50
|
|
Foot X-ray
|
$96.75 |
$96.75 |
$96.75 |
$339.50
|
|
Furosemide 10 mg/ml injection solution
|
$2.07 |
$2.07 |
$2.07 |
$7.15
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$3.75 |
$3.75 |
$3.75 |
$5.08
|
|
G0180 home health certification
|
$80.25 |
$80.25 |
$80.25 |
$97.50
|
|
Gammaglobulin iga
|
$29.25 |
$29.25 |
$29.25 |
$78.60
|
|
Gammaglobulin ige
|
$39.75 |
$39.75 |
$39.75 |
$87.10
|
|
Gamma glutamyltransferase
|
$24.00 |
$24.00 |
$24.00 |
$54.60
|
|
General health panel
|
$128.25 |
$128.25 |
$128.25 |
$270.40
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$7.64 |
$7.64 |
$7.64 |
$30.76
|
|
Ghs antibodies (torch) igm
|
$190.50 |
$190.50 |
$190.50 |
$82.50
|
|
Ghs change cysto/gastrost
|
$66.00 |
$66.00 |
$66.00 |
$727.35
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$543.75 |
$543.75 |
$543.75 |
$540.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$122.25 |
$122.25 |
$122.25 |
$278.00
|
|
Ghs corneal fb without slit lamp bilat
|
$87.75 |
$87.75 |
$87.75 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$84.75 |
$84.75 |
$84.75 |
$362.21
|
|
Ghs dislocation elbow closed treatment
|
$713.25 |
$713.25 |
$713.25 |
$687.73
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$344.25 |
$344.25 |
$344.25 |
$441.35
|
|
Ghs eye exam
|
$95.25 |
$95.25 |
$95.25 |
$162.24
|
|
Ghs fb removal - incisional
|
$239.25 |
$239.25 |
$239.25 |
$2,454.00
|
|
Ghs flow volume loop
|
$84.00 |
$84.00 |
$84.00 |
$291.75
|
|
Ghs hcv amplificaiton
|
$86.25 |
$86.25 |
$86.25 |
$198.90
|
|
Ghs HIV antibody
|
$29.25 |
$29.25 |
$29.25 |
$90.14
|
|
Ghs i and d pilonidal cyst simple
|
$209.25 |
$209.25 |
$209.25 |
$762.75
|
|
Ghs incision thrombosed ext hemorrhoid
|
$295.50 |
$295.50 |
$295.50 |
$534.60
|
|
Ghs init tx 1st degree burn
|
$85.50 |
$85.50 |
$85.50 |
$295.00
|
|
Ghs inj tendon origin/insertion
|
$59.25 |
$59.25 |
$59.25 |
$412.50
|
|
Ghs insertion of needle - bone
|
$152.25 |
$152.25 |
$152.25 |
$436.10
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$256.50 |
$256.50 |
$256.50 |
$558.97
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$297.00 |
$297.00 |
$297.00 |
$573.60
|
|
Ghs layer closure 2.5cm or less - 12051
|
$288.00 |
$288.00 |
$288.00 |
$610.40
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$537.00 |
$537.00 |
$537.00 |
$675.00
|