|
Esophageal motility
|
$523.80 |
$523.80 |
$523.80 |
$655.45
|
|
Established Patient Office Visit (level 1)
|
$285.79 |
$285.79 |
$285.79 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$721.49 |
$721.49 |
$721.49 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$1,447.67 |
$1,447.67 |
$1,447.67 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$2,234.75 |
$2,234.75 |
$2,234.75 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$3,148.32 |
$3,148.32 |
$3,148.32 |
$290.68
|
|
Estradiol total
|
$40.49 |
$40.49 |
$40.49 |
$152.10
|
|
Estrogens total-sendout
|
$31.81 |
$31.81 |
$31.81 |
$97.50
|
|
Ethylene glycol -sendout
|
$39.04 |
$39.04 |
$39.04 |
$86.04
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$142.19 |
$142.19 |
$142.19 |
$213.15
|
|
Event monitor
|
$177.35 |
$177.35 |
$177.35 |
$231.00
|
|
Evoked oa emissions ltd
|
$95.45 |
$95.45 |
$95.45 |
$244.00
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$5,327.38 |
$5,327.38 |
$5,327.38 |
$4,101.67
|
|
External newborn metabolic screening panel
|
$118.85 |
$118.85 |
$118.85 |
$109.76
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$74.88 |
$74.88 |
$74.88 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$212.79 |
$212.79 |
$212.79 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$864.36 |
$864.36 |
$864.36 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$720.30 |
$720.30 |
$720.30 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$576.24 |
$576.24 |
$576.24 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$2,477.12 |
$2,477.12 |
$2,477.12 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$1,651.41 |
$1,651.41 |
$1,651.41 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$134.54 |
$134.54 |
$134.54 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$229.41 |
$229.41 |
$229.41 |
$381.75
|
|
Factor ix
|
$38.08 |
$38.08 |
$38.08 |
$162.50
|
|
Factor viii
|
$54.95 |
$54.95 |
$54.95 |
$148.00
|
|
Fat/lipids feces qualitative
|
$32.78 |
$32.78 |
$32.78 |
$36.00
|
|
Fatty acids nonesterified
|
$33.26 |
$33.26 |
$33.26 |
$72.15
|
|
#fecal-sodium
|
$27.96 |
$27.96 |
$27.96 |
$37.53
|
|
Felbamate (felbatol(r)) - sendout
|
$35.67 |
$35.67 |
$35.67 |
$66.43
|
|
Fern test
|
$31.81 |
$31.81 |
$31.81 |
$37.03
|
|
Ferritin
|
$28.92 |
$28.92 |
$28.92 |
$102.48
|
|
Fetal biophys profile w/nst 76818
|
$535.37 |
$535.37 |
$535.37 |
$541.74
|
|
Fetal chrom aneuploidy gsa panel
|
$1,107.11 |
$1,107.11 |
$1,107.11 |
$1,166.15
|
|
Fetal contract stress test 59020 - 26
|
$717.42 |
$717.42 |
$717.42 |
$477.50
|
|
Fetal fibronectin
|
$93.51 |
$93.51 |
$93.51 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$28.44 |
$28.44 |
$28.44 |
$102.00
|
|
Fetal hemoglobin rosette
|
$13.98 |
$13.98 |
$13.98 |
$67.20
|
|
Fetal non stress test
|
$700.03 |
$700.03 |
$700.03 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$32.29 |
$32.29 |
$32.29 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$14.94 |
$14.94 |
$14.94 |
$120.64
|
|
Fibrin degradation products
|
$38.56 |
$38.56 |
$38.56 |
$75.02
|
|
Fibrinogen activity
|
$14.46 |
$14.46 |
$14.46 |
$87.00
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$22.65 |
$22.65 |
$22.65 |
$61.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$34.22 |
$34.22 |
$34.22 |
$66.60
|
|
Filter spider fx 3mmx320cm
|
$6,658.50 |
$6,658.50 |
$6,658.50 |
$7,358.16
|
|
Filter vena cava fem denali
|
$5,327.38 |
$5,327.38 |
$5,327.38 |
$3,718.18
|
|
Finger X-ray (both hands)
|
$157.05 |
$157.05 |
$157.05 |
$241.50
|
|
Fl exam g/colon tube w contrast
|
$90.44 |
$90.44 |
$90.44 |
$540.80
|
|
Flow cytometry marker each additional
|
$27.22 |
$27.22 |
$27.22 |
$97.50
|
|
Flow cytometry one marker technical component
|
$164.59 |
$164.59 |
$164.59 |
$285.00
|
|
Flt3 gene
|
$241.54 |
$241.54 |
$241.54 |
$366.29
|
|
Flt3 gene analysis
|
$121.01 |
$121.01 |
$121.01 |
$216.00
|
|
Fluidotherapy charges pt
|
$42.56 |
$42.56 |
$42.56 |
$101.40
|
|
Fluid pressure muscle 20950
|
$387.60 |
$387.60 |
$387.60 |
$779.45
|
|
Fluorescent antibody titer dna
|
$482.11 |
$482.11 |
$482.11 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$247.10 |
$247.10 |
$247.10 |
$495.00
|
|
Fluoroguide needle placement
|
$448.63 |
$448.63 |
$448.63 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$360.19 |
$360.19 |
$360.19 |
$503.80
|
|
Folic acid
|
$21.69 |
$21.69 |
$21.69 |
$101.50
|
|
Foot X-ray
|
$216.01 |
$216.01 |
$216.01 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$101.30 |
$101.30 |
$101.30 |
$290.40
|
|
Forearm X-ray (both sides)
|
$108.81 |
$108.81 |
$108.81 |
$324.00
|
|
Fracture assessment via dxa
|
$117.38 |
$117.38 |
$117.38 |
$175.50
|
|
_fragile x methylation-sendout
|
$65.61 |
$65.61 |
$65.61 |
$183.74
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$27.99 |
$27.99 |
$27.99 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$27.99 |
$27.99 |
$27.99 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$276.30 |
$276.30 |
$276.30 |
$131.25
|
|
Fructosamine glycated protein
|
$25.55 |
$25.55 |
$25.55 |
$63.50
|
|
Ftl cgen abnor two proteins
|
$126.36 |
$126.36 |
$126.36 |
$109.00
|
|
Full Spine X-ray (Scoliosis Survey)
|
$233.70 |
$233.70 |
$233.70 |
$355.00
|
|
Gabapentin non-blood
|
$26.99 |
$26.99 |
$26.99 |
$42.35
|
|
Galac-1-phosphate uridyltran - sendout
|
$83.39 |
$83.39 |
$83.39 |
$100.00
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$498.42 |
$498.42 |
$498.42 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,252.26 |
$1,252.26 |
$1,252.26 |
$1,615.00
|
|
Gammaglobulin iga
|
$30.37 |
$30.37 |
$30.37 |
$69.60
|
|
Gammaglobulin ige
|
$27.96 |
$27.96 |
$27.96 |
$83.85
|
|
Gamma glutamyltransferase
|
$29.88 |
$29.88 |
$29.88 |
$57.54
|
|
Gastroesophageal reflux study
|
$716.58 |
$716.58 |
$716.58 |
$1,031.60
|
|
Gated heart multiple
|
$1,496.88 |
$1,496.88 |
$1,496.88 |
$1,405.04
|
|
Generator barostim neo2 2014
|
$62,964.80 |
$62,964.80 |
$62,964.80 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$49,772.21 |
$49,772.21 |
$49,772.21 |
$36,467.76
|
|
Gentamicin peak therapeutic drug level
|
$39.52 |
$39.52 |
$39.52 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$1,351.62 |
$1,351.62 |
$1,351.62 |
$1,514.00
|
|
Ghs acetylcholinesterase, rbc
|
$28.44 |
$28.44 |
$28.44 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$88.69 |
$88.69 |
$88.69 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$403.38 |
$403.38 |
$403.38 |
$394.20
|
|
Ghs antibodies (torch) igm
|
$25.34 |
$25.34 |
$25.34 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$85.27 |
$85.27 |
$85.27 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$407.95 |
$407.95 |
$407.95 |
$1,059.85
|
|
Ghs chemo >8 hrs
|
$104.81 |
$104.81 |
$104.81 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$75.81 |
$75.81 |
$75.81 |
$277.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$174.17 |
$174.17 |
$174.17 |
$133.70
|
|
Ghs diphtheria toxoid ab igg
|
$36.29 |
$36.29 |
$36.29 |
$55.29
|
|
Ghs fat & muscle
|
$117.34 |
$117.34 |
$117.34 |
$38.08
|
|
Ghs febrile agglutinns(mayo)
|
$12.10 |
$12.10 |
$12.10 |
$48.10
|
|
Ghs fish cytogen
|
$58.75 |
$58.75 |
$58.75 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$33.26 |
$33.26 |
$33.26 |
$226.20
|
|
Ghs flow volume loop
|
$93.74 |
$93.74 |
$93.74 |
$308.69
|
|
Ghs hcv amplificaiton
|
$56.29 |
$56.29 |
$56.29 |
$196.20
|
|
Ghs hepatitis c virus (hcv riba)
|
$137.66 |
$137.66 |
$137.66 |
$144.54
|
