|
Excision addl breast lesion 19126
|
$1,841.40 |
$1,841.40 |
$1,841.40 |
$761.80
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$914.34
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,398.60 |
$1,398.60 |
$1,398.60 |
$2,865.00
|
|
Excision breast lesion
|
$1,841.40 |
$1,841.40 |
$1,841.40 |
$4,064.45
|
|
Exc leg/ankle tum subfasc<5cm 27619
|
$1,453.80 |
$1,453.80 |
$1,453.80 |
$3,127.88
|
|
Exc malig feenl <0.5cm 11640
|
$972.60 |
$972.60 |
$972.60 |
$1,186.00
|
|
Exc malig feenl 1.1-2 11642
|
$658.80 |
$658.80 |
$658.80 |
$1,082.00
|
|
Exc malig feenl 3.1-4.0 11644
|
$1,239.60 |
$1,239.60 |
$1,239.60 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,253.05
|
|
Exc malig snhfg 0.5cm or less 11620
|
$1,273.80 |
$1,273.80 |
$1,273.80 |
$1,377.57
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$972.00 |
$972.00 |
$972.00 |
$1,064.70
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$1,273.20 |
$1,273.20 |
$1,273.20 |
$1,954.00
|
|
Exc malig tal <0.5cm 11600
|
$973.20 |
$973.20 |
$973.20 |
$973.71
|
|
Exc malig tal 0.6-1.0cm 11601
|
$496.80 |
$496.80 |
$496.80 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$496.20 |
$496.20 |
$496.20 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$972.00 |
$972.00 |
$972.00 |
$1,207.80
|
|
Exc skn hdrdnt ing complex
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,994.09
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$972.00 |
$972.00 |
$972.00 |
$1,274.00
|
|
Exc snhfg mal+mrg 3.1-4 11624
|
$1,239.60 |
$1,239.60 |
$1,239.60 |
$2,171.00
|
|
Exc snhfg mal+mrg >4 cm 11626
|
$2,174.40 |
$2,174.40 |
$2,174.40 |
$3,386.84
|
|
Exc sq tumor/thigh/knee area 3cm/> 27337
|
$2,748.00 |
$2,748.00 |
$2,748.00 |
$4,019.60
|
|
Exc thrombosed hemorrhoid 46320
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$2,175.36
|
|
Explore/treat finger joint
|
$2,511.00 |
$2,511.00 |
$2,511.00 |
$3,839.54
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$901.80 |
$901.80 |
$901.80 |
$457.07
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$97.80 |
$97.80 |
$97.80 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$160.80 |
$160.80 |
$160.80 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$1,050.60 |
$1,050.60 |
$1,050.60 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$879.00 |
$879.00 |
$879.00 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$4,325.40 |
$4,325.40 |
$4,325.40 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,191.80 |
$2,191.80 |
$2,191.80 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$124.20 |
$124.20 |
$124.20 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$159.00 |
$159.00 |
$159.00 |
$381.75
|
|
Factor ix
|
$333.60 |
$333.60 |
$333.60 |
$162.50
|
|
Factor viii
|
$309.00 |
$309.00 |
$309.00 |
$148.00
|
|
Fat/lipids feces qualitative
|
$108.00 |
$108.00 |
$108.00 |
$36.00
|
|
#fecal-sodium
|
$94.80 |
$94.80 |
$94.80 |
$37.53
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$54.60 |
$54.60 |
$54.60 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,082.00 |
$2,082.00 |
$2,082.00 |
$2,590.25
|
|
Ferritin
|
$134.40 |
$134.40 |
$134.40 |
$102.48
|
|
Fetal biophys profile w/nst 76818
|
$286.20 |
$286.20 |
$286.20 |
$541.74
|
|
Fetal fibronectin
|
$111.60 |
$111.60 |
$111.60 |
$389.95
|
|
#_fet/norfentcnfrmur
|
$186.00 |
$186.00 |
$186.00 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$125.40 |
$125.40 |
$125.40 |
$120.64
|
|
Fibrin degradation products
|
$219.60 |
$219.60 |
$219.60 |
$75.02
|
|
Fibrinogen activity
|
$174.60 |
$174.60 |
$174.60 |
$87.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$225.00 |
$225.00 |
$225.00 |
$66.60
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,943.40 |
$1,943.40 |
$1,943.40 |
$1,197.83
|
|
Filter vena cava fem denali
|
$2,689.20 |
$2,689.20 |
$2,689.20 |
$3,718.18
|
|
Finger X-ray (both hands)
|
$118.80 |
$118.80 |
$118.80 |
$241.50
|
|
Fitting of diaphragm/cap 57170
|
$232.80 |
$232.80 |
$232.80 |
$238.06
|
|
Flow cytometry interp 16 or more
|
$550.20 |
$550.20 |
$550.20 |
$200.00
|
|
Flow cytometry marker each additional
|
$112.20 |
$112.20 |
$112.20 |
$97.50
|
|
Flow cytometry one marker technical component
|
$247.20 |
$247.20 |
$247.20 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$19.20 |
$19.20 |
$19.20 |
$64.22
|
|
Fluidotherapy charges pt
|
$123.00 |
$123.00 |
$123.00 |
$101.40
|
|
Fluorescent antibody titer dna
|
$387.60 |
$387.60 |
$387.60 |
$123.65
|
|
Fluoroguide needle placement
|
$462.60 |
$462.60 |
$462.60 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$309.00 |
$309.00 |
$309.00 |
$503.80
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$34.20 |
$34.20 |
$34.20 |
$72.52
|
|
Folic acid
|
$79.20 |
$79.20 |
$79.20 |
$101.50
|
|
Fomepizole 1 gram/ml intravenous solution
|
$2,254.80 |
$2,254.80 |
$2,254.80 |
$2,511.73
|
|
Foot X-ray
|
$355.20 |
$355.20 |
$355.20 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$201.00 |
$201.00 |
$201.00 |
$290.40
|
|
Forearm X-ray (both sides)
|
$209.40 |
$209.40 |
$209.40 |
$324.00
|
|
Fractionation ketosteroids
|
$526.20 |
$526.20 |
$526.20 |
$160.89
|
|
Fragmenting of kidney stone
|
$5,029.20 |
$5,029.20 |
$5,029.20 |
$10,312.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$312.60 |
$312.60 |
$312.60 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$216.60 |
$216.60 |
$216.60 |
$131.25
|
|
Fructosamine glycated protein
|
$126.60 |
$126.60 |
$126.60 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$211.80 |
$211.80 |
$211.80 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$11.40 |
$11.40 |
$11.40 |
$19.53
|
|
Ga-67 gallium 0.1 mci
|
$363.00 |
$363.00 |
$363.00 |
$121.73
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$376.20 |
$376.20 |
$376.20 |
$120.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$651.60 |
$651.60 |
$651.60 |
$1,615.00
|
|
Gammaglobulin iga
|
$145.20 |
$145.20 |
$145.20 |
$69.60
|
|
Gammaglobulin ige
|
$180.60 |
$180.60 |
$180.60 |
$83.85
|
|
Gamma glutamyltransferase
|
$46.20 |
$46.20 |
$46.20 |
$57.54
|
|
Gastric analy w/ph ea spec
|
$55.80 |
$55.80 |
$55.80 |
$31.50
|
|
Gastroesophageal reflux study
|
$639.60 |
$639.60 |
$639.60 |
$1,031.60
|
|
Gated heart multiple
|
$1,120.20 |
$1,120.20 |
$1,120.20 |
$1,405.04
|
|
Gc stocking thighlngth 18-30
|
$93.00 |
$93.00 |
$93.00 |
$68.30
|
|
Gc stocking thighlngth 30-40
|
$44.40 |
$44.40 |
$44.40 |
$44.40
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$8.40 |
$8.40 |
$8.40 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$240.00 |
$240.00 |
$240.00 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$1,465.00
|
|
Ghs acetylcholinesterase, rbc
|
$145.20 |
$145.20 |
$145.20 |
$43.06
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$202.80 |
$202.80 |
$202.80 |
$100.30
|
|
Ghs antibodies (torch) igm
|
$178.20 |
$178.20 |
$178.20 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$470.40 |
$470.40 |
$470.40 |
$344.00
|
|
Ghs block ilioinguinal/gentitofemoral
|
$940.80 |
$940.80 |
$940.80 |
$1,059.85
|
|
Ghs change cysto/gastrost
|
$77.40 |
$77.40 |
$77.40 |
$594.55
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$595.20 |
$595.20 |
$595.20 |
$513.15
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$1,757.40 |
$1,757.40 |
$1,757.40 |
$2,319.00
|
|
Ghs community re-entry 15 minutes
|
$94.20 |
$94.20 |
$94.20 |
$89.28
|
|
Ghs conjunctiva foreign body-embed bil
|
$326.40 |
$326.40 |
$326.40 |
$436.10
|
|
Ghs corneal fb without slit lamp bilat
|
$326.40 |
$326.40 |
$326.40 |
$422.25
|
|
Ghs diphtheria toxoid ab igg
|
$235.20 |
$235.20 |
$235.20 |
$55.29
|
|
Ghs dislocation elbow closed treatment
|
$397.80 |
$397.80 |
$397.80 |
$602.00
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$301.20 |
$301.20 |
$301.20 |
$467.00
|
