|
Diagnostic Mammogram (both breasts)
|
$772.07 |
$772.07 |
$772.07 |
$413.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$49.99 |
$49.99 |
$49.99 |
$77.25
|
|
Dicyclomine injection
|
$213.30 |
$213.30 |
$213.30 |
$150.91
|
|
Diffusing capacity
|
$505.84 |
$505.84 |
$505.84 |
$335.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$39.60 |
$39.60 |
$39.60 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$16,130.21 |
$16,130.21 |
$16,130.21 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$366.88 |
$366.88 |
$366.88 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$106.92 |
$106.92 |
$106.92 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$37.80 |
$37.80 |
$37.80 |
$18.35
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$288.38 |
$288.38 |
$288.38 |
$98.56
|
|
Dna antibody native/double stranded
|
$214.75 |
$214.75 |
$214.75 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$12.38 |
$12.38 |
$12.38 |
$98.29
|
|
Dolasetron mesylate oral
|
$0.13 |
$0.13 |
$0.13 |
$156.80
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$25.68 |
$25.68 |
$25.68 |
$67.28
|
|
Doppler echo complete
|
$806.53 |
$806.53 |
$806.53 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$5,589.56 |
$5,589.56 |
$5,589.56 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$3,047.34 |
$3,047.34 |
$3,047.34 |
$473.76
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$52.05 |
$52.05 |
$52.05 |
$84.80
|
|
Dronabinol 2.5mg oral
|
$35.12 |
$35.12 |
$35.12 |
$13.36
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$33.00 |
$33.00 |
$33.00 |
$58.20
|
|
Drug assay caffeine
|
$72.62 |
$72.62 |
$72.62 |
$81.61
|
|
Drug of abuse screen urine
|
$417.98 |
$417.98 |
$417.98 |
$64.50
|
|
Drug screen quant tiagabine
|
$177.67 |
$177.67 |
$177.67 |
$107.59
|
|
Drug test def 1-7 classes
|
$1,313.26 |
$1,313.26 |
$1,313.26 |
$263.25
|
|
Drug test def 8-14 classes
|
$1,313.26 |
$1,313.26 |
$1,313.26 |
$289.80
|
|
Drug test prsmv instrmnt
|
$551.46 |
$551.46 |
$551.46 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$218.40 |
$218.40 |
$218.40 |
$280.95
|
|
Drvvt confirm - quest
|
$190.04 |
$190.04 |
$190.04 |
$109.20
|
|
Ductogram sgl duct
|
$2,920.44 |
$2,920.44 |
$2,920.44 |
$469.44
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$5,116.09 |
$5,116.09 |
$5,116.09 |
$903.50
|
|
Ecg 12 lead tracing only
|
$420.41 |
$420.41 |
$420.41 |
$226.50
|
|
Ecg external < 48 hours recording
|
$325.37 |
$325.37 |
$325.37 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$2,633.55 |
$2,633.55 |
$2,633.55 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$3,736.58 |
$3,736.58 |
$3,736.58 |
$1,977.50
|
|
Echocardiography doppler color flow mapping
|
$1,050.84 |
$1,050.84 |
$1,050.84 |
$499.20
|
|
Echocardiography transthoracic 2d followup/limited
|
$806.53 |
$806.53 |
$806.53 |
$711.00
|
|
Echocardiograpy doppler follow up/limited study
|
$806.53 |
$806.53 |
$806.53 |
$371.25
|
|
Echo stress
|
$1,874.14 |
$1,874.14 |
$1,874.14 |
$1,606.44
|
|
Eeg monitor/record/awake/drowsy 95816
|
$3,128.05 |
$3,128.05 |
$3,128.05 |
$831.00
|
|
Eeg recording awake and asleep
|
$2,788.20 |
$2,788.20 |
$2,788.20 |
$929.00
|
|
Egfr gene com variants
|
$961.01 |
$961.01 |
$961.01 |
$657.00
|
|
Ehrlicha chaffeensis amp prb
|
$525.29 |
$525.29 |
$525.29 |
$93.00
|
|
Electrolyte panel
|
$872.91 |
$872.91 |
$872.91 |
$78.65
|
|
Electron microscopy diagnostic
|
$3,365.01 |
$3,365.01 |
$3,365.01 |
$1,006.20
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$784.67 |
$784.67 |
$784.67 |
$487.20
|
|
Emg thor paraspinal without t1/t2
|
$1,094.08 |
$1,094.08 |
$1,094.08 |
$308.80
|
|
Entamoeba histolytica ag eia - sendout
|
$352.27 |
$352.27 |
$352.27 |
$56.89
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$42.00 |
$42.00 |
$42.00 |
$36.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$28.06 |
$28.06 |
$28.06 |
$25.61
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$161.91 |
$161.91 |
$161.91 |
$253.77
|
|
Epstein barr early antigen antibody
|
$593.28 |
$593.28 |
$593.28 |
$60.00
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$4,418.25 |
$4,418.25 |
$4,418.25 |
$3,788.80
|
|
Ercp biliary & pancreas
|
$1,811.10 |
$1,811.10 |
$1,811.10 |
$951.20
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$666.75 |
$666.75 |
$666.75 |
$227.20
|
|
ER Visit (level 1, minor)
|
$503.93 |
$503.93 |
$503.93 |
$252.35
|
|
ER Visit (level 2)
|
$821.40 |
$821.40 |
$821.40 |
$463.00
|
|
ER Visit (level 3)
|
$1,548.65 |
$1,548.65 |
$1,548.65 |
$793.20
|
|
ER Visit (level 4)
|
$2,574.98 |
$2,574.98 |
$2,574.98 |
$1,277.65
|
|
ER Visit (level 5, high severity)
|
$4,610.93 |
$4,610.93 |
$4,610.93 |
$1,844.80
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$124.13 |
$124.13 |
$124.13 |
$223.99
|
|
Estradiol total
|
$699.89 |
$699.89 |
$699.89 |
$149.43
|
|
Estrogens total-sendout
|
$644.28 |
$644.28 |
$644.28 |
$96.63
|
|
Ethylene glycol -sendout
|
$156.05 |
$156.05 |
$156.05 |
$85.00
|
|
Euflexxa inj per dose
|
$841.70 |
$841.70 |
$841.70 |
$510.68
|
|
Euglobulin lysis
|
$347.63 |
$347.63 |
$347.63 |
$63.84
|
|
Evaluation of speech fluency 92521
|
$1,372.36 |
$1,372.36 |
$1,372.36 |
$307.75
|
|
Exc forearm tum deep < 3 cm
|
$1,935.00 |
$1,935.00 |
$1,935.00 |
$2,149.50
|
|
Exc shoulder tum deep < 5 cm
|
$2,194.00 |
$2,194.00 |
$2,194.00 |
$3,495.54
|
|
Exc tendon sheath or cap lesion 26160
|
$1,783.00 |
$1,783.00 |
$1,783.00 |
$2,650.53
|
|
Exc tmr sft tiss shldr subq <3cm
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$2,776.16
|
|
External chromosome analysis 20-25 cells
|
$1,015.07 |
$1,015.07 |
$1,015.07 |
$403.00
|
|
External profiling gene expression oncology (breast) mrna 21 genes
|
$5,382.78 |
$5,382.78 |
$5,382.78 |
$4,388.25
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$2,118.20 |
$2,118.20 |
$2,118.20 |
$445.60
|
|
F-18 fdg pet diag
|
$3,740.49 |
$3,740.49 |
$3,740.49 |
$551.72
|
|
Facial bones <3
|
$482.57 |
$482.57 |
$482.57 |
$252.60
|
|
Factor ix
|
$444.96 |
$444.96 |
$444.96 |
$154.50
|
|
Factor viii
|
$366.16 |
$366.16 |
$366.16 |
$144.82
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$3.08 |
$3.08 |
$3.08 |
$22.23
|
|
Fat/lipids feces qualitative
|
$169.96 |
$169.96 |
$169.96 |
$36.00
|
|
Felbamate (felbatol(r)) - sendout
|
$366.16 |
$366.16 |
$366.16 |
$61.00
|
|
Ferritin
|
$237.93 |
$237.93 |
$237.93 |
$102.07
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$933.80 |
$933.80 |
$933.80 |
$1,636.50
|
|
Ferumoxytol, esrd use
|
$933.80 |
$933.80 |
$933.80 |
$0.50
|
|
Fetal biophys profile w/nst 76818
|
$2,762.25 |
$2,762.25 |
$2,762.25 |
$541.74
|
|
Fetal fibronectin
|
$760.14 |
$760.14 |
$760.14 |
$387.60
|
|
Fetal hemoglobin rosette
|
$284.29 |
$284.29 |
$284.29 |
$67.20
|
|
#_fet/norfentcnfrmur
|
$278.10 |
$278.10 |
$278.10 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$540.75 |
$540.75 |
$540.75 |
$120.05
|
|
Fibrin degradation products
|
$290.46 |
$290.46 |
$290.46 |
$74.25
|
|
Fibrin degrade semiquant
|
$290.46 |
$290.46 |
$290.46 |
$78.80
|
|
Fibrinogen activity
|
$290.46 |
$290.46 |
$290.46 |
$85.86
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$592.74 |
$592.74 |
$592.74 |
$66.60
|
|
Filtered speech hearing test
|
$31.00 |
$31.00 |
$31.00 |
$99.32
|
|
Flecainide (tambocor)-sendout
|
$285.83 |
$285.83 |
$285.83 |
$65.24
|
|
Floxuridine injection
|
$30.00 |
$30.00 |
$30.00 |
$5,929.92
|
|
Flt3 gene analysis
|
$1,436.86 |
$1,436.86 |
$1,436.86 |
$215.20
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$7.20 |
$7.20 |
$7.20 |
$64.15
|
|
Fludarabine 50 mg intravenous solution
|
$191.15 |
$191.15 |
$191.15 |
$493.35
|
|
Fluoroguide for spine inject 77003-26
|
$887.08 |
$887.08 |
$887.08 |
$495.95
|
|
Fluoro polarize fetal lung
|
$724.60 |
$724.60 |
$724.60 |
$153.92
|
