|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$183.00 |
$183.00 |
$183.00 |
$223.99
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$212.00 |
$212.00 |
$212.00 |
$521.65
|
|
Esophageal dilat s&i
|
$551.20 |
$551.20 |
$551.20 |
$550.00
|
|
Established Patient Office Visit (level 1)
|
$312.00 |
$312.00 |
$312.00 |
$122.40
|
|
Established Patient Office Visit (level 2)
|
$312.00 |
$312.00 |
$312.00 |
$138.82
|
|
Established Patient Office Visit (level 3)
|
$421.60 |
$421.60 |
$421.60 |
$186.60
|
|
Established Patient Office Visit (level 4)
|
$553.60 |
$553.60 |
$553.60 |
$235.00
|
|
Established Patient Office Visit (level 5)
|
$696.80 |
$696.80 |
$696.80 |
$287.10
|
|
Estradiol total
|
$140.00 |
$140.00 |
$140.00 |
$149.43
|
|
Estrogens total-sendout
|
$108.00 |
$108.00 |
$108.00 |
$96.63
|
|
Ethylene glycol -sendout
|
$62.40 |
$62.40 |
$62.40 |
$85.00
|
|
Etonogestrel implant system
|
$2,915.20 |
$2,915.20 |
$2,915.20 |
$2,071.74
|
|
Etoposide 20 mg/ml intravenous solution
|
$333.80 |
$333.80 |
$333.80 |
$235.20
|
|
Eval/fit voice prosthesis iii, st
|
$373.60 |
$373.60 |
$373.60 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$510.40 |
$510.40 |
$510.40 |
$211.12
|
|
Evaluation of speech fluency 92521
|
$340.00 |
$340.00 |
$340.00 |
$307.75
|
|
Evaluation psychiatric diagnostic
|
$664.80 |
$664.80 |
$664.80 |
$315.00
|
|
Evoked potentials auditory screening automated analysis
|
$108.00 |
$108.00 |
$108.00 |
$259.20
|
|
Exchange biliary drg cath
|
$6,028.00 |
$6,028.00 |
$6,028.00 |
$3,797.76
|
|
Exchange drainage catheter
|
$2,845.60 |
$2,845.60 |
$2,845.60 |
$2,191.20
|
|
Exchange nephrostomy cath
|
$3,552.80 |
$3,552.80 |
$3,552.80 |
$2,958.80
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$542.40 |
$542.40 |
$542.40 |
$1,064.30
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$1,872.00 |
$1,872.00 |
$1,872.00 |
$1,274.00
|
|
Exercise tst brncspsm wo ecg
|
$188.80 |
$188.80 |
$188.80 |
$129.92
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$1,049.40 |
$1,049.40 |
$1,049.40 |
$2,421.09
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$2,527.80 |
$2,527.80 |
$2,527.80 |
$4,136.83
|
|
External chromosome analysis 20-25 cells
|
$722.40 |
$722.40 |
$722.40 |
$403.00
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$718.40 |
$718.40 |
$718.40 |
$445.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$75.20 |
$75.20 |
$75.20 |
$109.00
|
|
F-18 fdg pet diag
|
$903.20 |
$903.20 |
$903.20 |
$551.72
|
|
Facial bones <3
|
$224.00 |
$224.00 |
$224.00 |
$252.60
|
|
Factor ix
|
$111.20 |
$111.20 |
$111.20 |
$154.50
|
|
Factor ix recombinant nos
|
$2,557.20 |
$2,557.20 |
$2,557.20 |
$4.65
|
|
Factor viii
|
$124.00 |
$124.00 |
$124.00 |
$144.82
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$16.80 |
$16.80 |
$16.80 |
$22.23
|
|
Fat/lipids feces qualitative
|
$21.60 |
$21.60 |
$21.60 |
$36.00
|
|
Fatty acids nonesterified
|
$78.40 |
$78.40 |
$78.40 |
$64.28
|
|
#fecal-sodium
|
$19.20 |
$19.20 |
$19.20 |
$37.50
|
|
Fem/popl revasc w/stent
|
$16,129.60 |
$16,129.60 |
$16,129.60 |
$16,782.48
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$20.00 |
$20.00 |
$20.00 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,096.60 |
$2,096.60 |
$2,096.60 |
$2,590.25
|
|
Ferritin
|
$40.00 |
$40.00 |
$40.00 |
$102.07
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$3,524.40 |
$3,524.40 |
$3,524.40 |
$1,636.50
|
|
Fetal hemoglobin (kleihauer betke)
|
$86.40 |
$86.40 |
$86.40 |
$104.00
|
|
Fetal hemoglobin rosette
|
$70.40 |
$70.40 |
$70.40 |
$67.20
|
|
Fetal non stress test
|
$1,448.80 |
$1,448.80 |
$1,448.80 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$163.20 |
$163.20 |
$163.20 |
$120.05
|
|
Fibrin degradation products
|
$36.80 |
$36.80 |
$36.80 |
$74.25
|
|
Fibrinogen activity
|
$106.40 |
$106.40 |
$106.40 |
$85.86
|
|
Filter spider fx 3mmx320cm
|
$1,820.28 |
$1,820.28 |
$1,820.28 |
$7,188.75
|
|
Filter vena cava fem denali
|
$1,583.98 |
$1,583.98 |
$1,583.98 |
$3,816.40
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$2,478.40 |
$2,478.40 |
$2,478.40 |
$823.90
|
|
Flecainide (tambocor)-sendout
|
$92.80 |
$92.80 |
$92.80 |
$65.24
|
|
Fl exam g/colon tube w contrast
|
$488.00 |
$488.00 |
$488.00 |
$523.95
|
|
Flow cytometry marker each additional
|
$156.00 |
$156.00 |
$156.00 |
$97.50
|
|
Flow cytometry one marker technical component
|
$948.00 |
$948.00 |
$948.00 |
$276.60
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$21.20 |
$21.20 |
$21.20 |
$64.15
|
|
Fluorescent antibody titer dna
|
$49.60 |
$49.60 |
$49.60 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$700.00 |
$700.00 |
$700.00 |
$495.95
|
|
Fluoroguide needle placement
|
$423.20 |
$423.20 |
$423.20 |
$497.20
|
|
Fluoroscopy up to 1 hour
|
$659.20 |
$659.20 |
$659.20 |
$497.40
|
|
Fna bx w/ct gdn 1st les
|
$1,301.60 |
$1,301.60 |
$1,301.60 |
$1,427.65
|
|
Folic acid
|
$45.00 |
$45.00 |
$45.00 |
$99.96
|
|
Folic acid 5 mg/ml injection solution
|
$58.40 |
$58.40 |
$58.40 |
$50.70
|
|
Fomepizole 1 gram/ml intravenous solution
|
$2,718.00 |
$2,718.00 |
$2,718.00 |
$2,481.61
|
|
Fondaparinux sodium
|
$77.60 |
$77.60 |
$77.60 |
$186.87
|
|
Foot X-ray
|
$460.00 |
$460.00 |
$460.00 |
$352.08
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$724.80 |
$724.80 |
$724.80 |
$532.80
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$892.80 |
$892.80 |
$892.80 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$43.20 |
$43.20 |
$43.20 |
$106.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$369.60 |
$369.60 |
$369.60 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$870.40 |
$870.40 |
$870.40 |
$130.98
|
|
Frozen blood thaw
|
$1,348.80 |
$1,348.80 |
$1,348.80 |
$209.50
|
|
Fructosamine glycated protein
|
$69.60 |
$69.60 |
$69.60 |
$61.75
|
|
Ftl cgen abnor four anal
|
$639.20 |
$639.20 |
$639.20 |
$205.80
|
|
Furosemide 10 mg/ml injection solution
|
$11.20 |
$11.20 |
$11.20 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$13.60 |
$13.60 |
$13.60 |
$107.11
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$49.60 |
$49.60 |
$49.60 |
$249.80
|
|
Gammaglobulin iga
|
$35.00 |
$35.00 |
$35.00 |
$69.42
|
|
Gammaglobulin ige
|
$68.00 |
$68.00 |
$68.00 |
$83.40
|
|
Gamma glutamyltransferase
|
$29.60 |
$29.60 |
$29.60 |
$57.54
|
|
Gamunex-c/gammaked
|
$294.00 |
$294.00 |
$294.00 |
$7,435.88
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$77.20 |
$77.20 |
$77.20 |
$197.40
|
|
Gemcitabine 1 gram intravenous solution
|
$31.20 |
$31.20 |
$31.20 |
$208.92
|
|
General health panel
|
$70.00 |
$70.00 |
$70.00 |
$262.44
|
|
Generator barostim neo2 2014
|
$52,962.36 |
$52,962.36 |
$52,962.36 |
$49,450.20
|
|
Generator emblem MRI sicd subq
|
$27,720.00 |
$27,720.00 |
$27,720.00 |
$36,771.84
|
|
Genetic tstg severe inh cond
|
$10,186.40 |
$10,186.40 |
$10,186.40 |
$3,978.65
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$14.40 |
$14.40 |
$14.40 |
$53.78
|
|
Gentamicin peak therapeutic drug level
|
$81.60 |
$81.60 |
$81.60 |
$123.84
|
|
Ghs abscess perianal iandd
|
$2,531.20 |
$2,531.20 |
$2,531.20 |
$1,452.00
|
|
Ghs alpha thalasemia, 7 deletions
|
$408.80 |
$408.80 |
$408.80 |
$403.38
|
|
Ghs bladder cath - complex-foley
|
$614.40 |
$614.40 |
$614.40 |
$343.68
|
|
Ghs change cysto/gastrost
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$594.55
|
|
Ghs chemo IV push, ea addtl
|
$148.00 |
$148.00 |
$148.00 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$211.20 |
$211.20 |
$211.20 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$774.40 |
$774.40 |
$774.40 |
$510.40
|
|
Ghs closed reduction ankle dislocation
|
$900.00 |
$900.00 |
$900.00 |
$677.25
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$1,554.70
|
|
Ghs closed tx tibial fracture w/manip
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$2,187.20
|
