|
Established Patient Office Visit (level 4)
|
$252.00 |
$252.00 |
$252.00 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$322.40 |
$322.40 |
$322.40 |
$290.68
|
|
Estradiol total
|
$140.00 |
$140.00 |
$140.00 |
$152.10
|
|
Estrogens total-sendout
|
$52.80 |
$52.80 |
$52.80 |
$97.50
|
|
Ethylene glycol -sendout
|
$170.40 |
$170.40 |
$170.40 |
$86.04
|
|
Etoposide 20 mg/ml intravenous solution
|
$232.87 |
$232.87 |
$232.87 |
$235.20
|
|
Eval/fit voice prosthesis iii, st
|
$360.80 |
$360.80 |
$360.80 |
$359.50
|
|
Evaluation of speech fluency 92521
|
$364.80 |
$364.80 |
$364.80 |
$302.50
|
|
Evaluation psychiatric diagnostic
|
$246.40 |
$246.40 |
$246.40 |
$318.24
|
|
Evoked potentials auditory screening automated analysis
|
$192.80 |
$192.80 |
$192.80 |
$261.30
|
|
Exam plvc w/anes othr thn lcl
|
$4,263.20 |
$4,263.20 |
$4,263.20 |
$3,816.40
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,316.80 |
$1,316.80 |
$1,316.80 |
$1,072.24
|
|
External newborn metabolic screening panel
|
$222.40 |
$222.40 |
$222.40 |
$109.76
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$84.80 |
$84.80 |
$84.80 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$451.20 |
$451.20 |
$451.20 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,420.80 |
$2,420.80 |
$2,420.80 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$2,342.40 |
$2,342.40 |
$2,342.40 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$3,111.20 |
$3,111.20 |
$3,111.20 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$332.00 |
$332.00 |
$332.00 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$352.00 |
$352.00 |
$352.00 |
$381.75
|
|
Factor ix
|
$139.20 |
$139.20 |
$139.20 |
$162.50
|
|
Factor viii
|
$142.40 |
$142.40 |
$142.40 |
$148.00
|
|
Family therapy with patient 50 min 90847
|
$224.80 |
$224.80 |
$224.80 |
$236.70
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$182.07 |
$182.07 |
$182.07 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$2,907.57 |
$2,907.57 |
$2,907.57 |
$5,894.50
|
|
Fat/lipids feces qualitative
|
$68.80 |
$68.80 |
$68.80 |
$36.00
|
|
#fecal-sodium
|
$28.80 |
$28.80 |
$28.80 |
$37.53
|
|
Felbamate (felbatol(r)) - sendout
|
$49.60 |
$49.60 |
$49.60 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$61.45 |
$61.45 |
$61.45 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,356.89 |
$1,356.89 |
$1,356.89 |
$2,590.25
|
|
Ferritin
|
$74.40 |
$74.40 |
$74.40 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$332.39 |
$332.39 |
$332.39 |
$1,636.50
|
|
Fetal biophys profile w/nst 76818
|
$839.20 |
$839.20 |
$839.20 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$631.20 |
$631.20 |
$631.20 |
$477.50
|
|
Fetal fibronectin
|
$349.60 |
$349.60 |
$349.60 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$58.40 |
$58.40 |
$58.40 |
$102.00
|
|
Fetal hemoglobin rosette
|
$43.20 |
$43.20 |
$43.20 |
$67.20
|
|
Fetal non stress test
|
$387.20 |
$387.20 |
$387.20 |
$478.50
|
|
Fibrin degradation d dimer quantitative
|
$88.80 |
$88.80 |
$88.80 |
$120.64
|
|
Fibrinogen activity
|
$48.00 |
$48.00 |
$48.00 |
$87.00
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$271.27 |
$271.27 |
$271.27 |
$891.02
|
|
Finger X-ray (both hands)
|
$251.20 |
$251.20 |
$251.20 |
$241.50
|
|
Flow cytometry marker each additional
|
$140.80 |
$140.80 |
$140.80 |
$97.50
|
|
Flow cytometry one marker technical component
|
$241.60 |
$241.60 |
$241.60 |
$285.00
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$227.90 |
$227.90 |
$227.90 |
$64.22
|
|
Fluidotherapy charges pt
|
$117.60 |
$117.60 |
$117.60 |
$101.40
|
|
Fluorescent antibody titer dna
|
$56.80 |
$56.80 |
$56.80 |
$123.65
|
|
Fluoroguide needle placement
|
$627.20 |
$627.20 |
$627.20 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$637.60 |
$637.60 |
$637.60 |
$503.80
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$215.47 |
$215.47 |
$215.47 |
$107.00
|
|
Folic acid
|
$72.80 |
$72.80 |
$72.80 |
$101.50
|
|
Folic acid 5 mg/ml injection solution
|
$60.14 |
$60.14 |
$60.14 |
$45.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$816.00 |
$816.00 |
$816.00 |
$2,511.73
|
|
Foot X-ray
|
$258.40 |
$258.40 |
$258.40 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$228.00 |
$228.00 |
$228.00 |
$290.40
|
|
Forearm X-ray (both sides)
|
$218.40 |
$218.40 |
$218.40 |
$324.00
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$219.91 |
$219.91 |
$219.91 |
$490.67
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$71.24 |
$71.24 |
$71.24 |
$103.62
|
|
_fragile x methylation-sendout
|
$120.80 |
$120.80 |
$120.80 |
$183.74
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$323.20 |
$323.20 |
$323.20 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$148.80 |
$148.80 |
$148.80 |
$131.25
|
|
Fructosamine glycated protein
|
$43.20 |
$43.20 |
$43.20 |
$63.50
|
|
Ftl cgen abnor four anal
|
$371.20 |
$371.20 |
$371.20 |
$211.83
|
|
Full Spine X-ray (Scoliosis Survey)
|
$461.60 |
$461.60 |
$461.60 |
$355.00
|
|
Furosemide 10 mg/ml injection solution
|
$60.51 |
$60.51 |
$60.51 |
$19.53
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$132.00 |
$132.00 |
$132.00 |
$108.40
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$80.00 |
$80.00 |
$80.00 |
$249.80
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,849.60 |
$1,849.60 |
$1,849.60 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,998.40 |
$1,998.40 |
$1,998.40 |
$1,615.00
|
|
Gammaglobulin iga
|
$49.60 |
$49.60 |
$49.60 |
$69.60
|
|
Gammaglobulin ige
|
$84.80 |
$84.80 |
$84.80 |
$83.85
|
|
Gamma glutamyltransferase
|
$42.40 |
$42.40 |
$42.40 |
$57.54
|
|
Gamunex-c/gammaked
|
$5,912.80 |
$5,912.80 |
$5,912.80 |
$7,435.88
|
|
Gastroesophageal reflux study
|
$1,610.40 |
$1,610.40 |
$1,610.40 |
$1,031.60
|
|
Gemcitabine 1 gram intravenous solution
|
$230.00 |
$230.00 |
$230.00 |
$207.51
|
|
General health panel
|
$192.00 |
$192.00 |
$192.00 |
$262.44
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$181.31 |
$181.31 |
$181.31 |
$52.54
|
|
Gentamicin peak therapeutic drug level
|
$66.40 |
$66.40 |
$66.40 |
$123.84
|
|
Ghs abscess perianal iandd
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$1,465.00
|
|
Ghs acetylcholinesterase, rbc
|
$29.60 |
$29.60 |
$29.60 |
$43.06
|
|
Ghs antibodies (torch) igm
|
$132.00 |
$132.00 |
$132.00 |
$69.12
|
|
Ghs chemo >8 hrs
|
$816.80 |
$816.80 |
$816.80 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$296.80 |
$296.80 |
$296.80 |
$277.00
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$640.80 |
$640.80 |
$640.80 |
$513.15
|
|
Ghs closed reduction ankle dislocation
|
$622.40 |
$622.40 |
$622.40 |
$671.50
|
|
Ghs closed tx tibial fracture w/manip
|
$1,343.20 |
$1,343.20 |
$1,343.20 |
$2,227.20
|
|
Ghs conjunctiva foreign body-superf bil
|
$341.60 |
$341.60 |
$341.60 |
$287.40
|
|
Ghs corneal fb without slit lamp bilat
|
$425.60 |
$425.60 |
$425.60 |
$422.25
|
|
Ghs corneal fb with slit lamp bilat
|
$367.20 |
$367.20 |
$367.20 |
$339.60
|
|
Ghs dislocation elbow closed treatment
|
$498.40 |
$498.40 |
$498.40 |
$602.00
|
|
Ghs ed rmvl or bivalving cast
|
$329.60 |
$329.60 |
$329.60 |
$338.40
|
|
Ghs eyelid foreign body-embedded - bil
|
$614.40 |
$614.40 |
$614.40 |
$510.00
|
|
Ghs fb removal foot - deep - left
|
$3,110.40 |
$3,110.40 |
$3,110.40 |
$2,873.34
|
|
Ghs fb removal - incisional
|
$3,872.00 |
$3,872.00 |
$3,872.00 |
$2,323.75
|
|
Ghs fish cytogen
|
$58.40 |
$58.40 |
$58.40 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$124.80 |
$124.80 |
$124.80 |
$226.20
|
|
Ghs gastric intub aspiration lavage
|
$525.60 |
$525.60 |
$525.60 |
$368.50
|
|
Ghs hgb stability-thal
|
$48.00 |
$48.00 |
$48.00 |
$89.91
|
