|
Estradiol valerate 10 mg inj
|
$331.35 |
$331.35 |
$331.35 |
|
|
Estrogens total-sendout
|
$52.80 |
$52.80 |
$269.60 |
|
|
Ethylene glycol -sendout
|
$170.40 |
$170.40 |
$200.00 |
|
|
Etonogestrel implant system
|
$844.52 |
$844.52 |
$1,773.03 |
|
|
Etoposide 20 mg/ml intravenous solution
|
$232.87 |
$267.76 |
$292.92 |
|
|
Eval aud rehab status/first hr 92626
|
$332.00 |
$332.00 |
$386.40 |
|
|
Eval/fit voice prosthesis iii, st
|
$360.80 |
$497.60 |
$516.00 |
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$314.40 |
$314.40 |
$314.40 |
|
|
Evaluation heart device
|
$2,942.40 |
$2,942.40 |
$2,942.40 |
|
|
Evaluation of speech fluency 92521
|
$355.20 |
$366.40 |
$391.20 |
|
|
Evaluation psychiatric diagnostic
|
$185.60 |
$246.40 |
$327.20 |
|
|
Evasc prlng admn rx agnt 1st
|
$11,591.20 |
$11,591.20 |
$11,591.20 |
|
|
Evasc prlng admn rx agnt add
|
$12,959.20 |
$12,959.20 |
$12,959.20 |
|
|
Evasc repair of iliac artery; endograft 34718
|
$10,212.80 |
$10,212.80 |
$10,212.80 |
|
|
Evasc rpr a-ao ndgft 34701
|
$13,264.80 |
$13,264.80 |
$13,264.80 |
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$16,578.40 |
$16,578.40 |
$16,578.40 |
|
|
Evasc rpr a-biiliac ndgft rptr
|
$23,296.00 |
$23,296.00 |
$23,296.00 |
|
|
Evasc rpr a-iliac ndgft 34717
|
$10,212.80 |
$10,212.80 |
$10,212.80 |
|
|
Evasc rpr ilio-iliac ndgft
|
$13,529.60 |
$13,529.60 |
$13,529.60 |
|
|
Evasc rpr ilio-iliac rpt
|
$17,254.40 |
$17,254.40 |
$17,254.40 |
|
|
Event monitor
|
$304.80 |
$310.40 |
$320.00 |
|
|
Evoked oa emissions ltd
|
$17.60 |
$17.60 |
$17.60 |
|
|
Evoked potentials auditory screening automated analysis
|
$144.00 |
$192.80 |
$304.80 |
|
|
Evoked potentials upper limbs
|
$1,917.60 |
$1,917.60 |
$1,917.60 |
|
|
Evoked potential visual not glaucoma
|
$1,285.60 |
$1,285.60 |
$1,285.60 |
|
|
Exam pelvic add-on
|
$82.40 |
$82.40 |
$82.40 |
|
|
Exam plvc w/anes othr thn lcl
|
$4,263.20 |
$4,263.20 |
$4,263.20 |
|
|
Exc arm/elbo les sc <3cm 24075
|
$3,739.20 |
$3,739.20 |
$3,739.20 |
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$3,488.00 |
$3,488.00 |
$3,488.00 |
|
|
Exc benign tal 0.5 < cm 11400
|
$675.20 |
$675.20 |
$1,167.20 |
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$1,526.40 |
$1,526.40 |
$1,568.80 |
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$2,384.00 |
$2,384.00 |
$2,384.00 |
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$2,014.40 |
$2,014.40 |
$2,140.00 |
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$2,560.00 |
$2,560.00 |
$3,206.40 |
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$1,168.00 |
$1,168.00 |
$1,252.00 |
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$2,323.20 |
$2,323.20 |
$2,323.20 |
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$1,841.60 |
$1,841.60 |
$1,841.60 |
|
|
Exc forearm les sc 3 cm/>
|
$4,850.40 |
$4,850.40 |
$4,850.40 |
|
|
Exc forearm tum deep < 3 cm
|
$5,292.00 |
$5,292.00 |
$5,292.00 |
|
|
Exc hand les sc < 1.5 cm
|
$4,308.80 |
$4,308.80 |
$4,308.80 |
|
|
Exc hand tum deep 1.5 cm/>
|
$5,367.20 |
$5,367.20 |
$5,367.20 |
|
|
Exc hand tum deep < 1.5 cm 26116
|
$2,500.00 |
$2,500.00 |
$2,500.00 |
|
|
Exchange biliary drg cath
|
$5,088.80 |
$5,088.80 |
$5,401.60 |
|
|
Exchange drainage catheter
|
$2,091.20 |
$2,091.20 |
$2,667.20 |
|
|
Exchange nephrostomy cath
|
$2,505.60 |
$2,505.60 |
$3,641.60 |
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$4,578.40 |
$4,578.40 |
$4,578.40 |
|
|
Excise wrist tendon sheath
|
$4,113.60 |
$4,113.60 |
$4,113.60 |
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$625.60 |
$1,600.00 |
$1,635.20 |
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$2,464.00 |
$2,464.00 |
$2,678.40 |
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,316.80 |
$1,944.00 |
$1,969.60 |
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$4,201.60 |
$4,201.60 |
$4,201.60 |
|
|
Exc les/mucos/sub/ves mouth/no rpr 40810
|
$3,127.20 |
$3,127.20 |
$3,127.20 |
|
|
Exc malig feenl 1.1-2 11642
|
$2,080.00 |
$2,080.00 |
$2,080.00 |
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$1,604.00 |
$1,604.00 |
$1,604.00 |
|
|
Exc sq tum/leg or ankle area <3 cm 27618
|
$4,634.40 |
$4,634.40 |
$4,634.40 |
|
|
Exc sq tumor/forearm/wrist/<3cm 25075
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
|
|
Exc sq tum/vasc malform/hand/fngr 26111
|
$4,804.80 |
$4,804.80 |
$4,804.80 |
|
|
Exc tendon sheath or cap lesion 26160
|
$4,343.20 |
$4,343.20 |
$4,343.20 |
|
|
Exc thrombosed hemorrhoid 46320
|
$2,576.00 |
$2,576.00 |
$3,485.60 |
|
|
Exc tr-ext mal+marg tal >4 cm 11606
|
$4,169.60 |
$4,169.60 |
$4,169.60 |
|
|
Exercise tst brncspsm w/ecg
|
$226.40 |
$243.20 |
$497.60 |
|
|
Expander breast 300cc mod hght extra proj smth natrelle
|
$4,776.00 |
$4,776.00 |
$4,776.00 |
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$2,628.00 |
$2,628.00 |
$7,434.40 |
|
|
Explore neck vessels 35800
|
$3,625.60 |
$3,625.60 |
$3,625.60 |
|
|
Explore penetrating wnd/extremity 20103
|
$1,685.60 |
$2,150.40 |
$2,480.00 |
|
|
Explore/repair chest 32110
|
$2,525.60 |
$2,525.60 |
$2,525.60 |
|
|
Explore/treat finger joint
|
$4,428.00 |
$4,428.00 |
$4,428.00 |
|
|
Explore/treat finger joint
|
$4,105.60 |
$4,105.60 |
$4,105.60 |
|
|
Explore wound abdomen 20102
|
$2,568.80 |
$2,568.80 |
$4,580.00 |
|
|
Explore woundchest 20101
|
$3,504.80 |
$3,504.80 |
$4,427.20 |
|
|
Explore wound neck 20100
|
$1,258.40 |
$1,258.40 |
$5,173.60 |
|
|
Explor not followed by surg repair artery; low extrem 35703
|
$5,554.40 |
$5,554.40 |
$5,554.40 |
|
|
Expose endoprosth brachial 34834
|
$1,436.80 |
$1,436.80 |
$1,436.80 |
|
|
Ext ecg>48hr<7d scan a/r
|
$396.80 |
$396.80 |
$396.80 |
|
|
Ext ecg>7d<15d scan a/r
|
$380.00 |
$380.00 |
$406.40 |
|
|
External cannula declotting
|
$1,596.00 |
$1,596.00 |
$1,596.00 |
|
|
External chromosome analysis 20-25 cells
|
$429.60 |
$429.60 |
$429.60 |
|
|
External newborn metabolic screening panel
|
$211.20 |
$211.20 |
$222.40 |
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$445.60 |
$480.80 |
$581.60 |
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$56.80 |
$100.00 |
$165.60 |
|
|
Extrnl counterpulse, per tx
|
$635.20 |
$635.20 |
$635.20 |
|
|
Eye Socket (Orbit) X-ray
|
$363.20 |
$451.20 |
$501.60 |
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,420.80 |
$2,709.60 |
$3,222.40 |
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$2,138.40 |
$2,409.60 |
$2,951.20 |
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,682.40 |
$2,098.40 |
$2,235.20 |
|
|
F-18 fdg pet diag
|
$371.20 |
$371.20 |
$371.20 |
|
|
F-18 florbetapir less than or equal to 10 mci
|
$3,076.00 |
$3,076.00 |
$3,076.00 |
|
|
F-18 fluciclovine per mci
|
$548.80 |
$548.80 |
$548.80 |
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,933.60 |
$4,215.20 |
$4,780.00 |
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,892.80 |
$3,095.20 |
$3,367.20 |
|
|
Facial Bones X-ray (1 to 2 views)
|
$160.00 |
$332.00 |
$391.20 |
|
|
Facial Bones X-ray (complete)
|
$345.60 |
$521.60 |
$621.60 |
|
|
Factor ix
|
$133.60 |
$234.40 |
$282.40 |
|
|
Factor ix complex
|
$1.08 |
$1.08 |
$1.08 |
|
|
Factor ix non-recombinant
|
$0.93 |
$0.93 |
$0.93 |
|
|
Factor ix recombinant nos
|
$1.08 |
$1.08 |
$1.08 |
|
|
Factor viia recomb sevenfact
|
$3,319.80 |
$3,319.80 |
$3,319.80 |
|
|
Factor viii
|
$125.60 |
$172.00 |
$250.40 |
|
|
Factor viii pegylated recomb
|
$690.56 |
$690.56 |
$690.56 |
|
|
Factor viii recombinant nos
|
$1,104.16 |
$1,104.16 |
$1,104.16 |
|
