|
Duplex scan bilateral study 93985
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$692.40
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$932.80 |
$932.80 |
$932.80 |
$903.50
|
|
Ear irrigation 69209
|
$225.60 |
$225.60 |
$225.60 |
$150.00
|
|
Ecg 12 lead tracing only
|
$326.40 |
$326.40 |
$326.40 |
$226.50
|
|
Ecg external < 48 hours recording
|
$753.60 |
$753.60 |
$753.60 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,004.80 |
$1,004.80 |
$1,004.80 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$3,146.40 |
$3,146.40 |
$3,146.40 |
$1,977.50
|
|
Echocardiography doppler color flow mapping
|
$499.20 |
$499.20 |
$499.20 |
$499.20
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$711.00
|
|
Echocardiograpy doppler follow up/limited study
|
$568.00 |
$568.00 |
$568.00 |
$371.25
|
|
Echo tee probe placement image acquisition interpretation & report
|
$4,019.20 |
$4,019.20 |
$4,019.20 |
$1,889.20
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,325.60 |
$1,325.60 |
$1,325.60 |
$831.00
|
|
Eeg recording awake and asleep
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$929.00
|
|
Ehrlicha chaffeensis amp prb
|
$162.40 |
$162.40 |
$162.40 |
$93.00
|
|
EKG tracing for initial prev
|
$24.80 |
$24.80 |
$24.80 |
$81.76
|
|
Electrical stimulation/unattended 97014
|
$142.40 |
$142.40 |
$142.40 |
$81.00
|
|
Electrolyte panel
|
$36.80 |
$36.80 |
$36.80 |
$78.65
|
|
Electron microscopy diagnostic
|
$1,398.40 |
$1,398.40 |
$1,398.40 |
$1,006.20
|
|
Embo or occlude vascular hemorrhage s&i
|
$12,410.40 |
$12,410.40 |
$12,410.40 |
$14,586.00
|
|
Emg cranial nerve bilateral
|
$172.00 |
$172.00 |
$172.00 |
$518.00
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$318.20 |
$318.20 |
$318.20 |
$116.08
|
|
Enzyme histochemistry
|
$707.20 |
$707.20 |
$707.20 |
$455.91
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$34.80 |
$34.80 |
$34.80 |
$36.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$35.20 |
$35.20 |
$35.20 |
$25.61
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$33.60 |
$33.60 |
$33.60 |
$31.80
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,018.40 |
$1,018.40 |
$1,018.40 |
$856.06
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$1,219.40 |
$1,219.40 |
$1,219.40 |
$1,329.09
|
|
Epstein barr early antigen antibody
|
$65.60 |
$65.60 |
$65.60 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$63.20 |
$63.20 |
$63.20 |
$76.70
|
|
Epstein barr viral capsid antigen antibody igm
|
$76.00 |
$76.00 |
$76.00 |
$85.15
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$77.00 |
$77.00 |
$77.00 |
$227.20
|
|
ER Visit (level 1, minor)
|
$511.20 |
$511.20 |
$511.20 |
$252.35
|
|
ER Visit (level 2)
|
$584.00 |
$584.00 |
$584.00 |
$463.00
|
|
ER Visit (level 3)
|
$1,228.00 |
$1,228.00 |
$1,228.00 |
$793.20
|
|
ER Visit (level 4)
|
$1,796.80 |
$1,796.80 |
$1,796.80 |
$1,277.65
|
|
ER Visit (level 5, high severity)
|
$2,531.20 |
$2,531.20 |
$2,531.20 |
$1,844.80
|
|
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
|
|
Established Patient Office Visit (level 1)
|
$258.40 |
$258.40 |
$258.40 |
$122.40
|
|
Established Patient Office Visit (level 2)
|
$247.20 |
$247.20 |
$247.20 |
$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
|
|
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
|
|
Facial bones <3
|
$224.00 |
$224.00 |
$224.00 |
$252.60
|
|
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
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$96.00 |
$96.00 |
$96.00 |
$101.40
|
|
Ferritin
|
$40.00 |
$40.00 |
$40.00 |
$102.07
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$819.80 |
$819.80 |
$819.80 |
$1,636.50
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$36.20 |
$36.20 |
$36.20 |
$106.25
|
|
_fragile x methylation-sendout
|
$186.40 |
$186.40 |
$186.40 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$369.60 |
$369.60 |
$369.60 |
$164.16
|
|
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
|
$2,336.40 |
$2,336.40 |
$2,336.40 |
$7,435.88
|
|
General health panel
|
$70.00 |
$70.00 |
$70.00 |
$262.44
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$4.40 |
$4.40 |
$4.40 |
$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 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 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 community re-entry 15 minutes
|
$126.40 |
$126.40 |
$126.40 |
$89.00
|
|
Ghs conjunctiva foreign body-superf bil
|
$504.00 |
$504.00 |
$504.00 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$532.80 |
$532.80 |
$532.80 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$606.40 |
$606.40 |
$606.40 |
$339.60
|
