|
Ext ecg>48hr<7d scan a/r
|
$394.40 |
$394.40 |
$394.40 |
$241.92
|
|
Ext ecg>7d<15d scan a/r
|
$402.40 |
$402.40 |
$402.40 |
$345.60
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$336.80 |
$336.80 |
$336.80 |
$457.07
|
|
Eye Socket (Orbit) X-ray
|
$267.20 |
$267.20 |
$267.20 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,053.60 |
$2,053.60 |
$2,053.60 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$1,847.20 |
$1,847.20 |
$1,847.20 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,560.80 |
$1,560.80 |
$1,560.80 |
$1,320.00
|
|
F-18 fdg pet diag
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$551.72
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,626.40 |
$3,626.40 |
$3,626.40 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,340.80 |
$2,340.80 |
$2,340.80 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$185.60 |
$185.60 |
$185.60 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$218.40 |
$218.40 |
$218.40 |
$381.75
|
|
Factor ix recombinant nos
|
$24.92 |
$24.92 |
$24.92 |
$4.65
|
|
Factor viii recombinant nos
|
$1,980.00 |
$1,980.00 |
$1,980.00 |
$5.20
|
|
Factor viii recomb obizur
|
$2,275.00 |
$2,275.00 |
$2,275.00 |
$7.29
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$50.24 |
$50.24 |
$50.24 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$2,810.41 |
$2,810.41 |
$2,810.41 |
$5,894.50
|
|
Femoral endovas graft add-on 34813
|
$7,224.80 |
$7,224.80 |
$7,224.80 |
$1,245.40
|
|
Feno poc
|
$155.20 |
$155.20 |
$155.20 |
$99.60
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$410.00 |
$410.00 |
$410.00 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,381.04 |
$1,381.04 |
$1,381.04 |
$2,590.25
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,367.56 |
$1,367.56 |
$1,367.56 |
$1,636.50
|
|
Fetal biophys profile w/nst 76818
|
$524.80 |
$524.80 |
$524.80 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$314.40 |
$314.40 |
$314.40 |
$477.50
|
|
Fetal non stress test
|
$386.40 |
$386.40 |
$386.40 |
$478.50
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$284.80 |
$284.80 |
$284.80 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$812.80 |
$812.80 |
$812.80 |
$1,197.83
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$365.44 |
$365.44 |
$365.44 |
$891.02
|
|
Filter spider fx 3mmx320cm
|
$8,008.00 |
$8,008.00 |
$8,008.00 |
$7,358.16
|
|
Filter vena cava fem denali
|
$2,948.00 |
$2,948.00 |
$2,948.00 |
$3,718.18
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$1,302.40 |
$1,302.40 |
$1,302.40 |
$1,081.52
|
|
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008
|
$580.80 |
$580.80 |
$580.80 |
$694.14
|
|
Fine needle aspiration biopsy without img gdn; ea addtl 10004
|
$325.60 |
$325.60 |
$325.60 |
$306.93
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$617.60 |
$617.60 |
$617.60 |
$825.00
|
|
Fine needle asp without image guide 10021
|
$604.00 |
$604.00 |
$604.00 |
$504.45
|
|
Finger X-ray (both hands)
|
$160.80 |
$160.80 |
$160.80 |
$241.50
|
|
Fixation of knee joint
|
$2,523.20 |
$2,523.20 |
$2,523.20 |
$1,963.35
|
|
Fix g/colon tube w/device
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$1,183.00
|
|
Fl exam g/colon tube w contrast
|
$500.00 |
$500.00 |
$500.00 |
$540.80
|
|
Flow cytometry marker each additional
|
$124.80 |
$124.80 |
$124.80 |
$97.50
|
|
Flow cytometry one marker technical component
|
$508.00 |
$508.00 |
$508.00 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$91.52 |
$91.52 |
$91.52 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$207.88 |
$207.88 |
$207.88 |
$493.35
|
|
Fluidotherapy charges pt
|
$84.80 |
$84.80 |
$84.80 |
$101.40
|
|
Fluid pressure muscle 20950
|
$991.20 |
$991.20 |
$991.20 |
$779.45
|
|
Fluoroguide for spine inject 77003-26
|
$287.20 |
$287.20 |
$287.20 |
$495.00
|
|
Fluoroguide needle placement
|
$243.20 |
$243.20 |
$243.20 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$387.20 |
$387.20 |
$387.20 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$205.20 |
$205.20 |
$205.20 |
$107.00
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$60.16 |
$60.16 |
$60.16 |
$72.52
|
|
Fna bx w/ct gdn 1st les
|
$1,459.20 |
$1,459.20 |
$1,459.20 |
$1,462.20
|
|
Fna bx w/ct gdn ea addl
|
$774.40 |
$774.40 |
$774.40 |
$834.90
|
|
Folic acid 5 mg/ml injection solution
|
$24.13 |
$24.13 |
$24.13 |
$45.00
|
|
Follow-up angiography
|
$1,924.00 |
$1,924.00 |
$1,924.00 |
$1,983.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,407.00 |
$1,407.00 |
$1,407.00 |
$2,511.73
|
|
Fondaparinux sodium
|
$90.55 |
$90.55 |
$90.55 |
$186.20
|
|
Foot drp splt w/exp heel lg
|
$108.80 |
$108.80 |
$108.80 |
$143.14
|
|
Foot lamin/prepreg composite
|
$229.92 |
$229.92 |
$229.92 |
$289.76
|
|
Foot longitud/metatarsal sup
|
$224.80 |
$224.80 |
$224.80 |
$221.20
|
|
Foot plas heel stabi pre ots
|
$30.47 |
$30.47 |
$30.47 |
$76.32
|
|
Foot X-ray
|
$193.60 |
$193.60 |
$193.60 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$160.80 |
$160.80 |
$160.80 |
$290.40
|
|
Forearm X-ray (both sides)
|
$160.80 |
$160.80 |
$160.80 |
$324.00
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$659.20 |
$659.20 |
$659.20 |
$534.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$699.71 |
$699.71 |
$699.71 |
$490.67
|
|
Foscarnet sodium injection
|
$745.00 |
$745.00 |
$745.00 |
$988.21
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$66.24 |
$66.24 |
$66.24 |
$103.62
|
|
Fracture assessment via dxa
|
$153.60 |
$153.60 |
$153.60 |
$175.50
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$300.00 |
$300.00 |
$300.00 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$374.00 |
$374.00 |
$374.00 |
$164.84
|
|
Full Spine X-ray (Scoliosis Survey)
|
$301.60 |
$301.60 |
$301.60 |
$355.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$4,473.60 |
$4,473.60 |
$4,473.60 |
$2,798.50
|
|
Fundus photography with i&r 92250
|
$224.80 |
$224.80 |
$224.80 |
$182.95
|
|
Furosemide 10 mg/ml injection solution
|
$26.02 |
$26.02 |
$26.02 |
$19.53
|
|
Ga-68 gallium 68 dotatate
|
$136.00 |
$136.00 |
$136.00 |
$140.35
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$180.00 |
$180.00 |
$180.00 |
$108.40
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$208.00 |
$208.00 |
$208.00 |
$249.80
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,564.80 |
$1,564.80 |
$1,564.80 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,972.00 |
$1,972.00 |
$1,972.00 |
$1,615.00
|
|
Gallium illuccix 1 millicure
|
$1,304.80 |
$1,304.80 |
$1,304.80 |
$1,696.55
|
|
Gamma globulin 1 cc inj
|
$227.11 |
$227.11 |
$227.11 |
$407.60
|
|
Gammagraft
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$1.00
|
|
Gamunex-c/gammaked
|
$4,993.20 |
$4,993.20 |
$4,993.20 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$193.29 |
$193.29 |
$193.29 |
$197.40
|
|
Gastroesophageal reflux study
|
$1,348.00 |
$1,348.00 |
$1,348.00 |
$1,031.60
|
|
Gastroesophageal reflux test
|
$1,057.60 |
$1,057.60 |
$1,057.60 |
$1,352.00
|
|
Gel cap for trach voice pros
|
$67.84 |
$67.84 |
$67.84 |
$2.80
|
|
Gemcitabine 1 gram intravenous solution
|
$224.09 |
$224.09 |
$224.09 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$9,179.38 |
$9,179.38 |
$9,179.38 |
$19,305.62
|
|
Generator barostim neo2 2014
|
$66,916.68 |
$66,916.68 |
$66,916.68 |
$52,020.00
|
|
Generator emblem MRI sicd subq
|
$62,726.40 |
$62,726.40 |
$62,726.40 |
$36,467.76
|
|
Gen, neuro, clo loop, rechg
|
$35,200.00 |
$35,200.00 |
$35,200.00 |
$38,632.78
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$60.07 |
$60.07 |
$60.07 |
$52.54
|
|
G-esoph reflx tst w/electrod
|
$1,871.20 |
$1,871.20 |
$1,871.20 |
$1,514.00
|
|
Ghs abscess perianal iandd
|
$1,421.60 |
$1,421.60 |
$1,421.60 |
$1,465.00
|
|
Ghs abscess postoperative iandd complex
|
$4,176.80 |
$4,176.80 |
$4,176.80 |
$3,776.00
|
|
Ghs analysis neurostim without reprogramming
|
$216.00 |
$216.00 |
$216.00 |
$262.35
|
|
Ghs aspiration bladder - needle
|
$827.20 |
$827.20 |
$827.20 |
$582.00
|
|
Ghs bladder cath - complex-foley
|
$332.00 |
$332.00 |
$332.00 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$1,270.40 |
$1,270.40 |
$1,270.40 |
$1,059.85
|