|
ER Visit (level 5, high severity)
|
$1,457.30 |
$1,457.30 |
$1,457.30 |
$1,828.80
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$43.44 |
$43.44 |
$43.44 |
$228.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$0.26 |
$0.26 |
$0.26 |
$279.72
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$0.97 |
$0.97 |
$0.97 |
$562.34
|
|
Esophagoscopy flex remove fb
|
$1,397.12 |
$1,397.12 |
$1,397.12 |
$2,086.80
|
|
Establish access to aorta
|
$441.32 |
$441.32 |
$441.32 |
$1,280.06
|
|
Established Patient Office Visit (level 1)
|
$157.53 |
$157.53 |
$157.53 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$199.42 |
$199.42 |
$199.42 |
$134.30
|
|
Established Patient Office Visit (level 3)
|
$243.08 |
$243.08 |
$243.08 |
$184.80
|
|
Established Patient Office Visit (level 4)
|
$358.72 |
$358.72 |
$358.72 |
$235.00
|
|
Established Patient Office Visit (level 5)
|
$481.44 |
$481.44 |
$481.44 |
$287.10
|
|
Estradiol total
|
$112.69 |
$112.69 |
$112.69 |
$151.20
|
|
Estradiol valerate 10 mg inj
|
$20.19 |
$20.19 |
$20.19 |
$57.35
|
|
Ethylene glycol -sendout
|
$120.36 |
$120.36 |
$120.36 |
$89.40
|
|
Etoposide 20 mg/ml intravenous solution
|
$91.93 |
$91.93 |
$91.93 |
$235.20
|
|
Etoposide 50 mg cap
|
$40.65 |
$40.65 |
$40.65 |
$135.02
|
|
Euflexxa inj per dose
|
$31.48 |
$31.48 |
$31.48 |
$587.51
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$123.31 |
$123.31 |
$123.31 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$119.18 |
$119.18 |
$119.18 |
$320.10
|
|
Evaluation psychiatric diagnostic
|
$218.30 |
$218.30 |
$218.30 |
$313.30
|
|
Evasc prlng admn rx agnt 1st
|
$2,025.47 |
$2,025.47 |
$2,025.47 |
$4,031.48
|
|
Evasc prlng admn rx agnt add
|
$938.69 |
$938.69 |
$938.69 |
$2,803.24
|
|
Evasc rpr a-biiliac ndgft rptr
|
$9,574.52 |
$9,574.52 |
$9,574.52 |
$8,565.60
|
|
Evasc rpr ilio-iliac ndgft
|
$7,806.29 |
$7,806.29 |
$7,806.29 |
$7,150.44
|
|
Evoked oa emissions ltd
|
$145.73 |
$145.73 |
$145.73 |
$234.32
|
|
Evoked potentials auditory screening automated analysis
|
$663.75 |
$663.75 |
$663.75 |
$268.94
|
|
Evoked potentials upper limbs
|
$490.29 |
$490.29 |
$490.29 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$929.84 |
$929.84 |
$929.84 |
$844.00
|
|
Exam plvc w/anes othr thn lcl
|
$3,355.92 |
$3,355.92 |
$3,355.92 |
$3,762.53
|
|
Exc benign tal 0.5 < cm 11400
|
$800.63 |
$800.63 |
$800.63 |
$827.77
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$1,439.60 |
$1,439.60 |
$1,439.60 |
$2,166.78
|
|
Exchange biliary drg cath
|
$2,839.08 |
$2,839.08 |
$2,839.08 |
$3,872.60
|
|
Exchange drainage catheter
|
$1,219.53 |
$1,219.53 |
$1,219.53 |
$2,234.01
|
|
Exchange nephrostomy cath
|
$1,049.61 |
$1,049.61 |
$1,049.61 |
$2,958.80
|
|
Excise lip or cheek fold
|
$1,968.83 |
$1,968.83 |
$1,968.83 |
$1,843.82
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,939.33 |
$1,939.33 |
$1,939.33 |
$2,865.00
|
|
Exc thrombosed hemorrhoid 46320
|
$2,308.08 |
$2,308.08 |
$2,308.08 |
$2,122.20
|
|
Exercise tst brncspsm w/ecg
|
$358.13 |
$358.13 |
$358.13 |
$324.00
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$2,915.19 |
$2,915.19 |
$2,915.19 |
$2,470.50
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$3,484.69 |
$3,484.69 |
$3,484.69 |
$4,135.20
|
|
Explore penetrating wnd/extremity 20103
|
$817.74 |
$817.74 |
$817.74 |
$1,788.80
|
|
Explore/treat finger joint
|
$2,044.94 |
$2,044.94 |
$2,044.94 |
$2,146.20
|
|
Explore wound abdomen 20102
|
$1,902.16 |
$1,902.16 |
$1,902.16 |
$2,609.00
|
|
Ext ecg>48hr<7d scan a/r
|
$1,168.79 |
$1,168.79 |
$1,168.79 |
$241.92
|
|
Ext ecg>7d<15d scan a/r
|
$1,168.79 |
$1,168.79 |
$1,168.79 |
$354.25
|
|
External chromosome analysis 20-25 cells
|
$495.60 |
$495.60 |
$495.60 |
$390.60
|
|
External recharg sys intern
|
$3,239.10 |
$3,239.10 |
$3,239.10 |
$2,744.33
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$431.29 |
$431.29 |
$431.29 |
$454.00
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$107.38 |
$107.38 |
$107.38 |
$109.18
|
|
F-18 fdg pet diag
|
$174.05 |
$174.05 |
$174.05 |
$551.72
|
|
F-18 sodium fluoride
|
$247.80 |
$247.80 |
$247.80 |
$532.20
|
|
Fabrication & fitting
|
$129.57 |
$129.57 |
$129.57 |
$182.27
|
|
Facial bones <3
|
$87.32 |
$87.32 |
$87.32 |
$252.60
|
|
Factor ix
|
$76.70 |
$76.70 |
$76.70 |
$165.96
|
|
Factor ix complex
|
$0.68 |
$0.68 |
$0.68 |
$5.91
|
|
Factor ix recombinant nos
|
$0.61 |
$0.61 |
$0.61 |
$4.65
|
|
Factor viii
|
$142.19 |
$142.19 |
$142.19 |
$137.50
|
|
Factor viii
|
$0.55 |
$0.55 |
$0.55 |
$5.02
|
|
Factor viii recombinant nos
|
$1.06 |
$1.06 |
$1.06 |
$6.56
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$1,725.45 |
$1,725.45 |
$1,725.45 |
$5,508.16
|
|
Fat/lipids feces qualitative
|
$46.02 |
$46.02 |
$46.02 |
$36.75
|
|
Fecal microbiota, live-jslm 150 ml rectal suspension enema
|
$35.40 |
$35.40 |
$35.40 |
$14,956.68
|
|
#fecal-sodium
|
$49.56 |
$49.56 |
$49.56 |
$39.65
|
|
Feeding tube reposition
|
$516.25 |
$516.25 |
$516.25 |
$532.61
|
|
Fem/popl revasc w/stent
|
$14,427.86 |
$14,427.86 |
$14,427.86 |
$16,843.00
|
|
Feno poc
|
$89.09 |
$89.09 |
$89.09 |
$97.18
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$1.20 |
$1.20 |
$1.20 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$52.98 |
$52.98 |
$52.98 |
$2,590.25
|
|
Ferritin
|
$102.07 |
$102.07 |
$102.07 |
$102.60
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$6.35 |
$6.35 |
$6.35 |
$1,713.43
|
|
Fetal biophys profile w/nst 76818
|
$502.09 |
$502.09 |
$502.09 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$188.21 |
$188.21 |
$188.21 |
$477.50
|
|
Fetal fibronectin
|
$224.20 |
$224.20 |
$224.20 |
$380.10
|
|
Fetal hemoglobin (kleihauer betke)
|
$108.56 |
$108.56 |
$108.56 |
$105.30
|
|
Fetal hemoglobin rosette
|
$97.35 |
$97.35 |
$97.35 |
$68.00
|
|
Fetal monitor w/report
|
$94.40 |
$94.40 |
$94.40 |
$295.50
|
|
Fetal non stress test
|
$343.38 |
$343.38 |
$343.38 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$179.36 |
$179.36 |
$179.36 |
$120.96
|
|
Fibrin degradation products
|
$89.68 |
$89.68 |
$89.68 |
$67.55
|
|
Fibrinogen activity
|
$88.50 |
$88.50 |
$88.50 |
$86.40
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$34.22 |
$34.22 |
$34.22 |
$64.05
|
|
Fibrinolytic plasminogen
|
$186.44 |
$186.44 |
$186.44 |
$107.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$74.34 |
$74.34 |
$74.34 |
$66.60
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$92.67 |
$92.67 |
$92.67 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$69.06 |
$69.06 |
$69.06 |
$1,141.77
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$225.52 |
$225.52 |
$225.52 |
$891.02
|
|
Filter spider fx 3mmx320cm
|
$4,777.68 |
$4,777.68 |
$4,777.68 |
$7,180.66
|
|
Filter vena cava fem denali
|
$3,228.31 |
$3,228.31 |
$3,228.31 |
$3,816.40
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$762.28 |
$762.28 |
$762.28 |
$1,087.02
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$762.28 |
$762.28 |
$762.28 |
$685.00
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$762.28 |
$762.28 |
$762.28 |
$833.25
|
|
Fine needle asp without image guide 10021
|
$248.98 |
$248.98 |
$248.98 |
$515.55
|
|
Finger joint sz00 swanson w/grommets
|
$3,309.57 |
$3,309.57 |
$3,309.57 |
$4,584.72
|
|
Fixation of knee joint
|
$1,388.86 |
$1,388.86 |
$1,388.86 |
$1,893.86
|
|
Fix g/colon tube w/device
|
$638.38 |
$638.38 |
$638.38 |
$1,196.58
|
|
Fl exam g/colon tube w contrast
|
$255.47 |
$255.47 |
$255.47 |
$523.20
|
|
Flow cytometry marker each additional
|
$68.44 |
$68.44 |
$68.44 |
$97.50
|
|
Flow cytometry one marker technical component
|
$264.91 |
$264.91 |
$264.91 |
$279.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$0.11 |
$0.11 |
$0.11 |
$64.41
|
|
Fludarabine 50 mg intravenous solution
|
$73.36 |
$73.36 |
$73.36 |
$493.35
|
