|
Fitting of diaphragm/cap 57170
|
$219.85 |
$3,986.00 |
$6,839.00 |
|
|
Fixation of ankle joint
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Fixation of knee joint
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Fixation of shoulder blade
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Fix g/colon tube w/device
|
$1,024.64 |
$3,986.00 |
$6,839.00 |
|
|
Fixtn pq skel dstl rad fx/epiphysl sep
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Flebogamma injection
|
$55.76 |
$55.76 |
$56.12 |
|
|
Flecainide (tambocor)-sendout
|
$18.64 |
$20.50 |
$20.50 |
|
|
Fl exam g/colon tube w contrast
|
$264.17 |
$3,986.00 |
$6,839.00 |
|
|
Flexible Sigmoidoscopy
|
$996.39 |
$3,986.00 |
$6,839.00 |
|
|
Flexor-plasty elbow
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Flexor-plasty elbw w/advmnt
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Floor of mouth biopsy 41108
|
$1,770.73 |
$3,986.00 |
$6,839.00 |
|
|
Florbetaben f18 diagnostic
|
$1,273.76 |
$1,273.76 |
$1,273.76 |
|
|
Flortaucipir inj 1 millicuri
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
|
|
Flotufolastat f18 diag 1 mci
|
$651.67 |
$671.22 |
$671.22 |
|
|
Flow cytometry interp 16 or more
|
$24.51 |
$36.90 |
$110.76 |
|
|
Flow cytometry marker each additional
|
$28.04 |
$47.58 |
$54.43 |
|
|
Flow cytometry one marker technical component
|
$62.04 |
$141.12 |
$423.63 |
|
|
Floxuridine injection
|
$3,858.03 |
$4,125.55 |
$4,125.55 |
|
|
Flt3 gene
|
$165.51 |
$182.06 |
$182.06 |
|
|
Flt3 gene analysis
|
$83.00 |
$91.30 |
$91.30 |
|
|
Fludarabine 50 mg intravenous solution
|
$71.65 |
$71.65 |
$134.15 |
|
|
Fluidotherapy charges pt
|
$20.16 |
$20.16 |
$45.50 |
|
|
Fluid pressure muscle 20950
|
$768.94 |
$3,986.00 |
$6,839.00 |
|
|
Fluocinol acet intravit imp
|
$495.38 |
$497.80 |
$497.80 |
|
|
Fluocinolone acetonide implt
|
$333.48 |
$339.76 |
$339.76 |
|
|
Fluorescein angioscopy i&r
|
$579.88 |
$587.30 |
$624.87 |
|
|
Fluorescein angrph mltiframe
|
$118.03 |
$344.68 |
$366.72 |
|
|
Fluorescein&icg angiography
|
$340.32 |
$344.68 |
$366.72 |
|
|
Fluorescent antibody titer dna
|
$12.05 |
$13.26 |
$70.00 |
|
|
Fluorodopa f-18 diag per mci
|
$498.62 |
$498.62 |
$498.62 |
|
|
Fluoroestradiol f 18
|
$498.67 |
$498.67 |
$498.67 |
|
|
Fluoroguide for spine inject 77003-26
|
$68.49 |
$133.77 |
$171.49 |
|
|
Fluoroguide needle placement
|
$132.35 |
$179.53 |
$205.37 |
|
|
Fluoro polarize fetal lung
|
$18.91 |
$20.80 |
$20.80 |
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$90.81 |
$211.90 |
$284.66 |
|
|
Flurpiridaz f18, diag, 1 mci
|
$530.00 |
$530.00 |
$530.00 |
|
|
Flutemetamol f18 diagnostic
|
$874.40 |
$1,866.58 |
$1,866.58 |
|
|
Fmri brain by phys/psych
|
$264.17 |
$267.78 |
$824.43 |
|
|
Fmri brain by tech
|
$264.17 |
$267.78 |
$640.20 |
|
|
Fna bx w/ct gdn 1st les
|
$768.94 |
$3,986.00 |
$6,839.00 |
|
|
Fna bx w/ct gdn ea addl
|
$4,881.00 |
$5,339.00 |
$6,311.00 |
|
|
Fna bx w/mr gdn 1st les
|
$768.94 |
$3,986.00 |
$6,839.00 |
|
|
Foam stability fetal lung
|
$18.91 |
$20.80 |
$20.80 |
|
|
Folic acid
|
$14.70 |
$16.17 |
$78.40 |
|
|
Follow-up angiography
|
$531.75 |
$997.62 |
$3,706.68 |
|
|
Followup eval of foot pt lop
|
$140.84 |
$142.64 |
$151.77 |
|
|
Follow-up surgery of eye
|
$2,549.65 |
$3,986.00 |
$6,839.00 |
|
|
Fomepizole 1 gram/ml intravenous solution
|
$6.03 |
$6.03 |
$6.44 |
|
|
Fo nontorsion joint cf
|
$61.46 |
$72.11 |
$101.63 |
|
|
Foot X-ray
|
$96.23 |
$97.54 |
$279.00 |
|
|
Foot X-ray (2 views, both feet)
|
$96.23 |
$97.54 |
$231.00 |
|
|
Forearm/arm cuffs free motio
|
$85.06 |
$99.80 |
$140.65 |
|
|
Forearm X-ray (both sides)
|
$96.23 |
$97.54 |
$231.20 |
|
|
Forehead flap w/vasc pedicle 15731
|
$3,786.00 |
$4,311.38 |
$6,839.00 |
|
|
Forensic cytopathology
|
$58.39 |
$59.14 |
$62.92 |
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$265.80 |
$3,986.00 |
$6,839.00 |
|
|
Foscarnet sodium injection
|
$15.58 |
$15.58 |
$50.32 |
|
|
Fractionation ketosteroids
|
$28.50 |
$31.35 |
$31.35 |
|
|
Fracture assessment via dxa
|
$55.18 |
$96.23 |
$103.69 |
|
|
_fragile x methylation-sendout
|
$44.89 |
$49.38 |
$49.38 |
|
|
Fragmenting of kidney stone
|
$3,769.31 |
$4,061.71 |
$6,839.00 |
|
|
Frenectomy 41115
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Frenotomy 40806
|
$556.55 |
$3,986.00 |
$6,839.00 |
|
|
Frenulotomy of penis
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$27.60 |
$36.36 |
$83.72 |
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$27.60 |
$36.36 |
$99.27 |
|
|
Fresh frozen plasma thawing ea un
|
$44.35 |
$189.67 |
$201.80 |
|
|
Fr frz plasma donor retested
|
$28.71 |
$54.16 |
$57.62 |
|
|
Frozen blood freeze/thaw
|
$42.90 |
$43.44 |
$46.22 |
|
|
Frozen blood prep
|
$187.28 |
$189.67 |
$201.80 |
|
|
Frozen blood thaw
|
$98.85 |
$187.28 |
$201.80 |
|
|
Frozen cell preparation
|
$12.09 |
$13.30 |
$13.30 |
|
|
Frozen plasma, pooled, sd
|
$68.10 |
$68.97 |
$310.79 |
|
|
Fructosamine glycated protein
|
$16.76 |
$18.44 |
$82.00 |
|
|
Ftl cgen abnor 3 proteins
|
$1,487.37 |
$1,636.11 |
$1,636.11 |
|
|
Ftl cgen abnor five anal
|
$69.52 |
$76.47 |
$76.47 |
|
|
Ftl cgen abnor four anal
|
$153.50 |
$168.85 |
$168.85 |
|
|
Ftl cgen abnor three anal
|
$55.54 |
$61.09 |
$61.09 |
|
|
Ftl cgen abnor two proteins
|
$54.30 |
$59.73 |
$59.73 |
|
|
Full field erg w/i&r
|
$340.32 |
$344.68 |
$366.72 |
|
|
Full mouth x-ray of teeth
|
$264.17 |
$267.55 |
$284.66 |
|
|
Full Spine X-ray (Scoliosis Survey)
|
$67.03 |
$117.81 |
$227.00 |
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Full thick gft/scalp/arm/leg/20sqcm or< 15220
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Fundus photography with i&r 92250
|
$78.75 |
$142.67 |
$151.80 |
|
|
Fusion/graft of finger joint
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Fusion/graft of hand joint
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Fusion of ankle joint open
|
$3,786.00 |
$6,311.00 |
$15,152.74 |
|
|
Fusion of big toe joint
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Fusion of big toe joint
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Fusion of finger joint
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Fusion of finger tendons
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Fusion of finger tendons
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Fusion of foot bones
|
$3,786.00 |
$6,311.00 |
$15,152.74 |
|
|
Fusion of foot bones
|
$3,786.00 |
$6,311.00 |
$15,152.74 |
|
|
Fusion of foot bones
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Fusion of hand joint
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
