|
Echo transthoracic
|
$2,808.80 |
$2,808.80 |
$2,808.80 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$717.40 |
$717.40 |
$717.40 |
$1,022.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$831.00
|
|
Eeg recording awake and asleep
|
$1,430.20 |
$1,430.20 |
$1,430.20 |
$929.00
|
|
Ehrlicha chaffeensis amp prb
|
$162.40 |
$162.40 |
$162.40 |
$93.00
|
|
Electrical stimulation/unattended 97014
|
$114.60 |
$114.60 |
$114.60 |
$81.00
|
|
Electrolyte panel
|
$147.60 |
$147.60 |
$147.60 |
$78.65
|
|
Endoluminl ivus oct c 1st
|
$5,707.20 |
$5,707.20 |
$5,707.20 |
$3,290.30
|
|
Epidural/lumbar/sacral/ea add level64484
|
$903.80 |
$903.80 |
$903.80 |
$1,170.60
|
|
Epstein barr early antigen antibody
|
$89.40 |
$89.40 |
$89.40 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$116.20 |
$116.20 |
$116.20 |
$76.70
|
|
Epstein barr viral capsid antigen antibody igm
|
$128.40 |
$128.40 |
$128.40 |
$85.15
|
|
ER Visit (level 1, minor)
|
$320.20 |
$320.20 |
$320.20 |
$252.35
|
|
ER Visit (level 2)
|
$562.40 |
$562.40 |
$562.40 |
$463.00
|
|
ER Visit (level 3)
|
$995.00 |
$995.00 |
$995.00 |
$793.20
|
|
ER Visit (level 4)
|
$1,600.60 |
$1,600.60 |
$1,600.60 |
$1,277.65
|
|
ER Visit (level 5, high severity)
|
$1,752.00 |
$1,752.00 |
$1,752.00 |
$1,844.80
|
|
Established Patient Office Visit (level 1)
|
$159.20 |
$159.20 |
$159.20 |
$122.40
|
|
Established Patient Office Visit (level 2)
|
$212.00 |
$212.00 |
$212.00 |
$138.82
|
|
Established Patient Office Visit (level 3)
|
$239.20 |
$239.20 |
$239.20 |
$186.60
|
|
Established Patient Office Visit (level 4)
|
$266.40 |
$266.40 |
$266.40 |
$235.00
|
|
Established Patient Office Visit (level 5)
|
$316.00 |
$316.00 |
$316.00 |
$287.10
|
|
Estradiol total
|
$407.60 |
$407.60 |
$407.60 |
$149.43
|
|
Estrogens total-sendout
|
$402.40 |
$402.40 |
$402.40 |
$96.63
|
|
Evoked potentials auditory screening automated analysis
|
$108.40 |
$108.40 |
$108.40 |
$259.20
|
|
Exc benign tal 0.5 < cm 11400
|
$3,178.20 |
$3,178.20 |
$3,178.20 |
$827.40
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$2,249.20 |
$2,249.20 |
$2,249.20 |
$770.70
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$3,178.20 |
$3,178.20 |
$3,178.20 |
$1,064.30
|
|
Ext ecg>7d<15d scan a/r
|
$1,043.00 |
$1,043.00 |
$1,043.00 |
$345.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$171.40 |
$171.40 |
$171.40 |
$109.00
|
|
Factor viii
|
$413.80 |
$413.80 |
$413.80 |
$144.82
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$6.60 |
$6.60 |
$6.60 |
$22.23
|
|
Fat/lipids feces qualitative
|
$246.60 |
$246.60 |
$246.60 |
$36.00
|
|
Fem/popl revasc w/stent
|
$9,074.00 |
$9,074.00 |
$9,074.00 |
$16,782.48
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$19.60 |
$19.60 |
$19.60 |
$101.40
|
|
Ferritin
|
$40.00 |
$40.00 |
$40.00 |
$102.07
|
|
Fetal hemoglobin rosette
|
$91.20 |
$91.20 |
$91.20 |
$67.20
|
|
Fetal non stress test
|
$660.20 |
$660.20 |
$660.20 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$186.20 |
$186.20 |
$186.20 |
$120.05
|
|
Fibrin degradation products
|
$111.80 |
$111.80 |
$111.80 |
$74.25
|
|
Fibrinogen activity
|
$44.00 |
$44.00 |
$44.00 |
$85.86
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$1,392.80 |
$1,392.80 |
$1,392.80 |
$823.90
|
|
Flow cytometry marker each additional
|
$100.00 |
$100.00 |
$100.00 |
$97.50
|
|
Flow cytometry one marker technical component
|
$937.80 |
$937.80 |
$937.80 |
$276.60
|
|
Fluidotherapy charges pt
|
$106.40 |
$106.40 |
$106.40 |
$98.40
|
|
Fluorescent antibody titer dna
|
$45.60 |
$45.60 |
$45.60 |
$123.65
|
|
Fluoroguide needle placement
|
$1,678.00 |
$1,678.00 |
$1,678.00 |
$497.20
|
|
Fluoroscopy up to 1 hour
|
$783.00 |
$783.00 |
$783.00 |
$497.40
|
|
Folic acid
|
$45.00 |
$45.00 |
$45.00 |
$99.96
|
|
Foot X-ray
|
$506.40 |
$506.40 |
$506.40 |
$352.08
|
|
Fructosamine glycated protein
|
$257.40 |
$257.40 |
$257.40 |
$61.75
|
|
Furosemide 10 mg/ml injection solution
|
$35.40 |
$35.40 |
$35.40 |
$19.53
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$1.60 |
$1.60 |
$1.60 |
$177.52
|
|
Gammaglobulin iga
|
$35.00 |
$35.00 |
$35.00 |
$69.42
|
|
Gammaglobulin ige
|
$174.60 |
$174.60 |
$174.60 |
$83.40
|
|
Gamma glutamyltransferase
|
$141.60 |
$141.60 |
$141.60 |
$57.54
|
|
General health panel
|
$70.00 |
$70.00 |
$70.00 |
$262.44
|
|
Ghs change cysto/gastrost
|
$1,112.80 |
$1,112.80 |
$1,112.80 |
$594.55
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$145.60 |
$145.60 |
$145.60 |
$133.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,185.80 |
$1,185.80 |
$1,185.80 |
$510.40
|
|
Ghs corneal fb with slit lamp bilat
|
$644.00 |
$644.00 |
$644.00 |
$339.60
|
|
Ghs dislocation elbow closed treatment
|
$1,225.80 |
$1,225.80 |
$1,225.80 |
$583.80
|
|
Ghs excision ingrown nail
|
$556.00 |
$556.00 |
$556.00 |
$442.61
|
|
Ghs flow volume loop
|
$274.20 |
$274.20 |
$274.20 |
$308.69
|
|
Ghs i and d perirectal abscess 46040
|
$8,921.20 |
$8,921.20 |
$8,921.20 |
$2,766.00
|
|
Ghs i and d pilonidal cyst simple
|
$826.20 |
$826.20 |
$826.20 |
$696.80
|
|
Ghs inj neurolytic other perph nerve
|
$2,824.00 |
$2,824.00 |
$2,824.00 |
$1,710.80
|
|
Ghs inj tendon origin/insertion
|
$1,928.00 |
$1,928.00 |
$1,928.00 |
$434.12
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$1,189.40 |
$1,189.40 |
$1,189.40 |
$865.60
|
|
Ghs IV thrombolytics - cerebral
|
$789.80 |
$789.80 |
$789.80 |
$663.00
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$496.80 |
$496.80 |
$496.80 |
$492.00
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$890.40 |
$890.40 |
$890.40 |
$591.00
|
|
Ghs layer closure 2.5cm or less - 12051
|
$2,249.20 |
$2,249.20 |
$2,249.20 |
$602.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$2,249.60 |
$2,249.60 |
$2,249.60 |
$733.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$2,242.20 |
$2,242.20 |
$2,242.20 |
$750.12
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$1,297.16 |
$1,297.16 |
$1,297.16 |
$737.10
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,703.60 |
$1,703.60 |
$1,703.60 |
$230.55
|
|
Ghs moderate sedation ea addtl 15 min
|
$216.00 |
$216.00 |
$216.00 |
$150.00
|
|
Ghs myocardial strain img spckl track
|
$466.80 |
$466.80 |
$466.80 |
$444.60
|
|
Ghs nailbed repair/nail removal
|
$920.00 |
$920.00 |
$920.00 |
$724.37
|
|
Ghs ng placement w fluoro guidance
|
$1,080.98 |
$1,080.98 |
$1,080.98 |
$478.50
|
|
Ghs o2 saturation
|
$40.80 |
$40.80 |
$40.80 |
$69.50
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,642.60 |
$1,642.60 |
$1,642.60 |
$962.00
|
|
Ghs plngl fx pm cl
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$564.50
|
|
Ghs pr without cont pulse ox
|
$453.20 |
$453.20 |
$453.20 |
$146.86
|
|
Ghs semen analysis fert
|
$380.40 |
$380.40 |
$380.40 |
$124.80
|
|
Ghs sensitivity (per antimicro)
|
$158.60 |
$158.60 |
$158.60 |
$56.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$1,158.20 |
$1,158.20 |
$1,158.20 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$937.40 |
$937.40 |
$937.40 |
$451.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$875.40 |
$875.40 |
$875.40 |
$436.80
|
|
Ghs urine, porphyrins quant
|
$209.20 |
$209.20 |
$209.20 |
$73.80
|
|
Gi inhouse confirmation
|
$128.80 |
$128.80 |
$128.80 |
$86.40
|
|
Glucose 1 hr post dose
|
$54.20 |
$54.20 |
$54.20 |
$48.25
|
|
Glucose blood quantitative
|
$63.00 |
$63.00 |
$63.00 |
$41.40
|
|
Glucose body fluid
|
$67.20 |
$67.20 |
$67.20 |
$51.30
|
|
Glucose tolerance test (gtt) 3 specimens
|
$241.60 |
$241.60 |
$241.60 |
$104.50
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$23.20 |
$23.20 |
$23.20 |
$36.00
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$51.40 |
$51.40 |
$51.40 |
$37.16
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$345.80 |
$345.80 |
$345.80 |
$115.80
|
|
Gonadotropin luteinizing hormone (lh)
|
$315.20 |
$315.20 |
$315.20 |
$129.00
|
