|
Drvvt confirm - quest
|
$153.25 |
$153.25 |
$307.00 |
$109.20
|
|
Duplex scan bilateral study 93985
|
$1,012.78 |
$1,012.78 |
$1,012.78 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$487.13 |
$487.13 |
$487.13 |
$375.60
|
|
Ecg 12 lead tracing only
|
$665.50 |
$665.50 |
$665.50 |
$226.50
|
|
Ecg external < 48 hours recording
|
$487.53 |
$487.53 |
$487.53 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$6,076.71 |
$6,076.71 |
$6,076.71 |
$541.20
|
|
Echocardiography doppler color flow mapping
|
$4,143.43 |
$4,143.43 |
$4,143.43 |
$499.20
|
|
Echocardiography transthoracic 2d followup/limited
|
$4,913.28 |
$4,913.28 |
$4,913.28 |
$711.00
|
|
Echograp trans r pros study
|
$2,264.08 |
$2,264.08 |
$2,264.08 |
$466.20
|
|
Echo guidance radiotherapy
|
$3,708.51 |
$3,708.51 |
$3,708.51 |
$812.00
|
|
Echo guide for amniocentesis
|
$9,219.39 |
$9,219.39 |
$9,219.39 |
$446.60
|
|
Echo guide for heart biopsy
|
$8,666.10 |
$8,666.10 |
$8,666.10 |
$666.40
|
|
Echo guide ova aspiration
|
$6,966.30 |
$6,966.30 |
$6,966.30 |
$214.40
|
|
Echo stress
|
$2,079.75 |
$2,079.75 |
$6,259.54 |
$1,606.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$8,333.56 |
$8,333.56 |
$8,333.56 |
$1,889.20
|
|
Echo transesophageal
|
$8,333.56 |
$8,333.56 |
$8,333.56 |
$1,599.50
|
|
Echo transesophageal intraop
|
$8,333.56 |
$8,333.56 |
$8,333.56 |
$1,578.00
|
|
Echo transthoracic
|
$3,621.33 |
$3,621.33 |
$3,621.33 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$6,256.27 |
$6,256.27 |
$6,256.27 |
$1,022.30
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$22,830.50 |
$22,830.50 |
$22,830.50 |
$19,540.29
|
|
Eeg 41-60 minutes 95812-26
|
$1,714.75 |
$1,714.75 |
$4,017.92 |
$923.88
|
|
Eeg during surgery
|
$13,163.08 |
$13,163.08 |
$13,163.08 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$4,017.92 |
$4,017.92 |
$4,017.92 |
$831.00
|
|
Eeg over 1 hour 95813 - 26
|
$2,288.75 |
$2,288.75 |
$6,002.12 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$7,059.20 |
$7,059.20 |
$7,059.20 |
$865.00
|
|
Eeg recording awake and asleep
|
$1,834.00 |
$1,834.00 |
$4,017.92 |
$929.00
|
|
Eeg without vid 2-12hr cont mntr
|
$5,641.12 |
$5,641.12 |
$5,641.12 |
$826.15
|
|
Eeg without vid 2-12 hr unmntr
|
$5,641.12 |
$5,641.12 |
$5,641.12 |
$681.02
|
|
Eeg without vid ea 12-26hr cont
|
$5,641.12 |
$5,641.12 |
$5,641.12 |
$1,584.70
|
|
Eeg without vid ea 12-26hr intmt
|
$18,913.66 |
$18,913.66 |
$18,913.66 |
$1,402.50
|
|
Eeg wo vid 2-12hr intmt mntr
|
$5,641.12 |
$5,641.12 |
$5,641.12 |
$704.79
|
|
Eeg wo vid ea 12-26hr unmntr
|
$18,913.66 |
$18,913.66 |
$18,913.66 |
$1,591.10
|
|
E equine encephalitis igg
|
$874.75 |
$874.75 |
$874.75 |
$50.88
|
|
Egfr gene com variants
|
$2,976.75 |
$2,976.75 |
$6,503.10 |
$657.00
|
|
Ehrlicha chaffeensis amp prb
|
$1,060.81 |
$1,060.81 |
$1,060.81 |
$93.00
|
|
Eia hiv-1/hiv-2 screen
|
$173.25 |
$173.25 |
$376.52 |
$48.57
|
|
Elec stim unattend for press
|
$724.63 |
$724.63 |
$724.63 |
$89.10
|
|
Electroconvulsive therapy 90870
|
$2,262.75 |
$2,262.75 |
$8,731.37 |
$1,296.90
|
|
Electrolyte panel
|
$62.00 |
$62.00 |
$941.28 |
$78.65
|
|
Electron microscopy diagnostic
|
$4,379.71 |
$4,379.71 |
$4,379.71 |
$1,006.20
|
|
Electrophysiologic study
|
$35,617.00 |
$35,617.00 |
$35,617.00 |
$7,023.00
|
|
Electrophysiology evaluation
|
$27,234.02 |
$27,234.02 |
$27,234.02 |
$8,979.45
|
|
Electrophysiology evaluation
|
$35,617.00 |
$35,617.00 |
$35,617.00 |
$10,593.00
|
|
Electrophysiology evaluation
|
$32,906.57 |
$32,906.57 |
$32,906.57 |
$6,760.00
|
|
Electrophysiology evaluation
|
$19,666.96 |
$19,666.96 |
$19,666.96 |
$5,854.80
|
|
Electrophysiology evaluation
|
$12,118.39 |
$12,118.39 |
$12,118.39 |
$2,504.00
|
|
Electrophysiology evaluation
|
$12,118.39 |
$12,118.39 |
$12,118.39 |
$2,902.81
|
|
Electrophys map 3d add-on
|
$19,666.96 |
$19,666.96 |
$19,666.96 |
$5,881.00
|
|
Elisa hiv-1/hiv-2 screen
|
$173.25 |
$173.25 |
$376.52 |
$45.34
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$1,558.70 |
$1,558.70 |
$1,558.70 |
$377.36
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$1,871.91 |
$1,871.91 |
$1,871.91 |
$487.20
|
|
Emg cranial nerve bilateral
|
$1,286.78 |
$1,286.78 |
$1,286.78 |
$518.00
|
|
Emg needle test 1-extremity
|
$1,243.28 |
$1,243.28 |
$1,243.28 |
$342.24
|
|
Emg needle test 4-extremities
|
$1,990.07 |
$1,990.07 |
$1,990.07 |
$590.00
|
|
Emg thor paraspinal without t1/t2
|
$1,187.00 |
$1,187.00 |
$1,187.00 |
$308.80
|
|
Encephalitis, california igg/igm
|
$874.75 |
$874.75 |
$874.75 |
$54.14
|
|
Encephalitis, st louis igg/igm
|
$874.75 |
$874.75 |
$874.75 |
$50.88
|
|
Encephalitis, western equine igg/igm
|
$874.75 |
$874.75 |
$874.75 |
$53.90
|
|
Endoscopy swallow (fees) vid
|
$2,004.87 |
$2,004.87 |
$2,004.87 |
$402.35
|
|
Entamoeba histolytica ag eia - sendout
|
$515.60 |
$515.60 |
$515.60 |
$56.89
|
|
Ep induct arrhy by elect pacing
|
$6,958.34 |
$6,958.34 |
$6,958.34 |
$2,702.70
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$91.53 |
$91.53 |
$91.53 |
$36.86
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$117.50 |
$117.50 |
$180.96 |
$253.77
|
|
Epoetin alfa, 100 units esrd
|
$241.69 |
$241.69 |
$241.69 |
$6.00
|
|
Epstein barr early antigen antibody
|
$470.00 |
$470.00 |
$941.28 |
$60.00
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$315.70 |
$315.70 |
$315.70 |
$2,488.75
|
|
ER Visit (level 3)
|
$868.00 |
$868.00 |
$868.00 |
$793.20
|
|
ER Visit (level 4)
|
$2,041.25 |
$2,041.25 |
$2,041.25 |
$1,277.65
|
|
ER Visit (level 5, high severity)
|
$3,585.75 |
$3,585.75 |
$3,585.75 |
$1,844.80
|
|
Esophageal dilat s&i
|
$18,725.98 |
$18,725.98 |
$18,725.98 |
$550.00
|
|
Estradiol total
|
$553.75 |
$553.75 |
$1,113.16 |
$149.43
|
|
Estrogens total-sendout
|
$514.00 |
$514.00 |
$1,035.44 |
$96.63
|
|
Ethylene glycol -sendout
|
$123.50 |
$123.50 |
$245.93 |
$85.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$81.94 |
$81.94 |
$81.94 |
$235.20
|
|
Etoposide 50 mg cap
|
$26.25 |
$26.25 |
$26.25 |
$135.02
|
|
Euglobulin lysis
|
$410.35 |
$410.35 |
$410.35 |
$63.84
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$1,473.58 |
$1,473.58 |
$1,473.58 |
$211.12
|
|
Evaluation heart device
|
$482.98 |
$482.98 |
$482.98 |
$2,221.96
|
|
Evaluation of speech fluency 92521
|
$1,112.29 |
$1,112.29 |
$1,112.29 |
$307.75
|
|
Evoked potentials upper limbs
|
$4,355.16 |
$4,355.16 |
$4,355.16 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$3,939.43 |
$3,939.43 |
$3,939.43 |
$812.40
|
|
Exome sequence analysis
|
$8,892.45 |
$8,892.45 |
$8,892.45 |
$5,258.00
|
|
Exome sequence analysis
|
$983.70 |
$983.70 |
$983.70 |
$12,000.00
|
|
External chromosome analysis 20-25 cells
|
$1,488.62 |
$1,488.62 |
$1,488.62 |
$403.00
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$225.19 |
$225.19 |
$225.19 |
$61.10
|
|
External profiling gene expression oncology (breast) mrna 21 genes
|
$18,849.92 |
$18,849.92 |
$18,849.92 |
$4,388.25
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$755.15 |
$755.15 |
$755.15 |
$445.60
|
|
F-18 fdg pet diag
|
$7,031.74 |
$7,031.74 |
$7,031.74 |
$551.72
|
|
F-18 florbetapir less than or equal to 10 mci
|
$7,110.57 |
$7,110.57 |
$7,110.57 |
$5,145.00
|
|
F-18 fluciclovine per mci
|
$2,690.57 |
$2,690.57 |
$2,690.57 |
$1,042.30
|
|
Facial bones <3
|
$655.50 |
$655.50 |
$655.50 |
$252.60
|
|
Factor ix
|
$651.50 |
$651.50 |
$651.50 |
$154.50
|
|
Factor ix complex
|
$3.99 |
$3.99 |
$3.99 |
$5.91
|
|
Factor ix non-recombinant
|
$2.73 |
$2.73 |
$3.00 |
$4.63
|
|
Factor ix recombinant nos
|
$5.31 |
$5.31 |
$5.31 |
$4.65
|
|
Factor viii
|
$288.75 |
$288.75 |
$577.49 |
$144.82
|
|
Factor viii
|
$3.00 |
$3.00 |
$3.00 |
$4.85
|
|
Fat/lipids feces qualitative
|
$141.25 |
$141.25 |
$285.03 |
$36.00
|
|
Fecal microbiota, live-jslm 150 ml rectal suspension enema
|
$857.01 |
$857.01 |
$857.01 |
$14,956.68
|
|
Feeding tube reposition
|
$7,518.68 |
$7,518.68 |
$7,518.68 |
$520.00
|
