|
Epidrm a-grft face/nck/hf/g 15115
|
$948.60 |
$948.60 |
$948.60 |
$2,478.85
|
|
Epidrm agrft t/a/l 1st 100
|
$1,115.70 |
$1,115.70 |
$1,115.70 |
$2,710.80
|
|
Epidrm autogrft t/a/l add-on
|
$307.20 |
$307.20 |
$307.20 |
$1,113.83
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$478.02 |
$478.02 |
$478.02 |
$248.81
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$451.08 |
$451.08 |
$451.08 |
$809.08
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$1,092.95 |
$1,092.95 |
$1,092.95 |
$1,289.71
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$109.60 |
$109.60 |
$109.60 |
$129.30
|
|
Epstein barr nuclear antigen antibody
|
$12.90 |
$12.90 |
$12.90 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$12.90 |
$12.90 |
$12.90 |
$91.00
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$221.05 |
$221.05 |
$221.05 |
$393.98
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$2,048.98 |
$2,048.98 |
$2,048.98 |
$3,838.45
|
|
Ercp biliary & pancreas
|
$167.40 |
$167.40 |
$167.40 |
$967.04
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$1,441.58 |
$1,441.58 |
$1,441.58 |
$2,488.75
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$241.85 |
$241.85 |
$241.85 |
$222.98
|
|
ER Visit (level 1, minor)
|
$97.50 |
$97.50 |
$97.50 |
$246.24
|
|
ER Visit (level 2)
|
$175.80 |
$175.80 |
$175.80 |
$452.20
|
|
ER Visit (level 3)
|
$225.00 |
$225.00 |
$225.00 |
$770.04
|
|
ER Visit (level 4)
|
$300.00 |
$300.00 |
$300.00 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$343.20 |
$343.20 |
$343.20 |
$1,820.02
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$201.96 |
$201.96 |
$201.96 |
$223.99
|
|
Established Patient Office Visit (level 1)
|
$54.60 |
$54.60 |
$54.60 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$41.70 |
$41.70 |
$41.70 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$49.50 |
$49.50 |
$49.50 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$62.10 |
$62.10 |
$62.10 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$82.80 |
$82.80 |
$82.80 |
$280.33
|
|
Estradiol total
|
$79.80 |
$79.80 |
$79.80 |
$146.50
|
|
Estradiol valerate 10 mg inj
|
$325.94 |
$325.94 |
$325.94 |
$57.35
|
|
Ethanolamine oleate 100 mg
|
$515.19 |
$515.19 |
$515.19 |
$751.36
|
|
Etoposide 20 mg/ml intravenous solution
|
$144.10 |
$144.10 |
$144.10 |
$235.20
|
|
Euflexxa inj per dose
|
$129.83 |
$129.83 |
$129.83 |
$587.51
|
|
Eval/fit voice prosthesis iii, st
|
$85.20 |
$85.20 |
$85.20 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$44.10 |
$44.10 |
$44.10 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$54.60 |
$54.60 |
$54.60 |
$311.50
|
|
Evasc prlng admn rx agnt 1st
|
$718.80 |
$718.80 |
$718.80 |
$3,822.00
|
|
Evasc prlng admn rx agnt add
|
$718.80 |
$718.80 |
$718.80 |
$2,734.40
|
|
Ewho w/joint(s) cf
|
$275.10 |
$275.10 |
$275.10 |
$907.92
|
|
Exchange biliary drg cath
|
$1,759.20 |
$1,759.20 |
$1,759.20 |
$3,909.56
|
|
Exchange drainage catheter
|
$501.00 |
$501.00 |
$501.00 |
$2,205.50
|
|
Exchange nephrostomy cath
|
$2,443.20 |
$2,443.20 |
$2,443.20 |
$2,958.80
|
|
Exc malig feenl <0.5cm 11640
|
$325.50 |
$325.50 |
$325.50 |
$1,055.20
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$512.10 |
$512.10 |
$512.10 |
$1,294.80
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$325.50 |
$325.50 |
$325.50 |
$1,274.00
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$3,667.50 |
$3,667.50 |
$3,667.50 |
$4,048.38
|
|
Ext ecg>48hr<7d rev&interpj
|
$10.10 |
$10.10 |
$10.10 |
$57.00
|
|
Ext ecg>7d<15d rev&interpj
|
$11.14 |
$11.14 |
$11.14 |
$63.20
|
|
External chromosome analysis 20-25 cells
|
$120.00 |
$120.00 |
$120.00 |
$384.15
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$228.00 |
$228.00 |
$228.00 |
$454.20
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$16.50 |
$16.50 |
$16.50 |
$108.60
|
|
F-18 fdg pet diag
|
$102.88 |
$102.88 |
$102.88 |
$551.72
|
|
F-18 sodium fluoride
|
$102.88 |
$102.88 |
$102.88 |
$392.60
|
|
Facial bones <3
|
$48.60 |
$48.60 |
$48.60 |
$252.60
|
|
Factor ix
|
$50.10 |
$50.10 |
$50.10 |
$156.13
|
|
Factor ix complex
|
$1.58 |
$1.58 |
$1.58 |
$5.91
|
|
Factor ix recombinant nos
|
$3.66 |
$3.66 |
$3.66 |
$4.65
|
|
Factor viii
|
$39.90 |
$39.90 |
$39.90 |
$133.81
|
|
Factor viii recombinant nos
|
$4.25 |
$4.25 |
$4.25 |
$6.56
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$3,155.61 |
$3,155.61 |
$3,155.61 |
$5,800.72
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$1,568.31 |
$1,568.31 |
$1,568.31 |
$2,590.25
|
|
Ferritin
|
$41.10 |
$41.10 |
$41.10 |
$100.94
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$2,019.18 |
$2,019.18 |
$2,019.18 |
$1,776.61
|
|
Fetal biophys profile w/nst 76818
|
$145.20 |
$145.20 |
$145.20 |
$535.37
|
|
Fetal contract stress test 59020 - 26
|
$97.50 |
$97.50 |
$97.50 |
$475.50
|
|
Fetal fibronectin
|
$194.70 |
$194.70 |
$194.70 |
$373.41
|
|
Fetal hemoglobin (kleihauer betke)
|
$41.40 |
$41.40 |
$41.40 |
$105.12
|
|
Fetal hemoglobin rosette
|
$20.10 |
$20.10 |
$20.10 |
$67.20
|
|
Fetal non stress test
|
$93.00 |
$93.00 |
$93.00 |
$463.03
|
|
Fibrin degradation d dimer quantitative
|
$45.00 |
$45.00 |
$45.00 |
$117.70
|
|
Fibrinogen activity
|
$25.80 |
$25.80 |
$25.80 |
$83.50
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$25.20 |
$25.20 |
$25.20 |
$64.05
|
|
Fibrinolytic plasminogen
|
$96.00 |
$96.00 |
$96.00 |
$107.50
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$44.40 |
$44.40 |
$44.40 |
$65.00
|
|
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe
|
$358.25 |
$358.25 |
$358.25 |
$595.48
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$543.33 |
$543.33 |
$543.33 |
$1,096.24
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$448.82 |
$448.82 |
$448.82 |
$869.18
|
|
Filter spider fx 3mmx320cm
|
$2,025.00 |
$2,025.00 |
$2,025.00 |
$7,160.28
|
|
Filter vena cava fem denali
|
$2,512.50 |
$2,512.50 |
$2,512.50 |
$3,718.18
|
|
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007
|
$523.50 |
$523.50 |
$523.50 |
$1,081.52
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$588.00 |
$588.00 |
$588.00 |
$823.90
|
|
Fix g/colon tube w/device
|
$421.80 |
$421.80 |
$421.80 |
$1,183.00
|
|
Flebogamma injection
|
$3,390.75 |
$3,390.75 |
$3,390.75 |
$3,438.30
|
|
Fl exam g/colon tube w contrast
|
$109.80 |
$109.80 |
$109.80 |
$511.92
|
|
Flow cytometry marker each additional
|
$21.00 |
$21.00 |
$21.00 |
$97.50
|
|
Flow cytometry one marker technical component
|
$96.90 |
$96.90 |
$96.90 |
$284.40
|
|
Floxuridine injection
|
$4,270.22 |
$4,270.22 |
$4,270.22 |
$5,929.92
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$29.43 |
$29.43 |
$29.43 |
$64.22
|
|
Fludarabine 50 mg intravenous solution
|
$222.37 |
$222.37 |
$222.37 |
$493.35
|
|
Fluidotherapy charges pt
|
$25.80 |
$25.80 |
$25.80 |
$91.00
|
|
Fluorescent antibody titer dna
|
$285.00 |
$285.00 |
$285.00 |
$122.82
|
|
Fluoroguide for spine inject 77003-26
|
$61.50 |
$61.50 |
$61.50 |
$496.03
|
|
Fluoroguide needle placement
|
$61.50 |
$61.50 |
$61.50 |
$510.00
|
|
Fluoroscopy up to 1 hour
|
$109.80 |
$109.80 |
$109.80 |
$492.00
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$61.60 |
$61.60 |
$61.60 |
$94.86
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$27.18 |
$27.18 |
$27.18 |
$72.52
|
|
Fna bx w/ct gdn 1st les
|
$868.50 |
$868.50 |
$868.50 |
$1,420.80
|
|
Fna bx w/ct gdn ea addl
|
$868.50 |
$868.50 |
$868.50 |
$833.25
|
|
Folic acid
|
$44.40 |
$44.40 |
$44.40 |
$101.50
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,770.40 |
$1,770.40 |
$1,770.40 |
$2,581.14
|
|
Fondaparinux sodium
|
$115.70 |
$115.70 |
$115.70 |
$185.12
|
|
Fo nontorsion joint cf
|
$76.80 |
$76.80 |
$76.80 |
$217.50
|
|
Foot X-ray
|
$131.40 |
$131.40 |
$131.40 |
$362.40
|