|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$115.50 |
$115.50 |
$115.50 |
$3,255.75
|
|
Exc les/mucos/sub/ves mouth/no rpr 40810
|
$210.00 |
$210.00 |
$210.00 |
$3,401.25
|
|
Exc malig feenl <0.5cm 11640
|
$165.06 |
$165.06 |
$165.06 |
$1,206.78
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$863.10 |
$863.10 |
$863.10 |
$973.71
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$233.94 |
$233.94 |
$233.94 |
$932.35
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,588.30
|
|
Exc prtl bn phlnx toe
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$3,752.25
|
|
Exc sq tumor/forearm/wrist/<3cm 25075
|
$1,994.16 |
$1,994.16 |
$1,994.16 |
$2,473.60
|
|
Exc sq tumor/shoulder area 3cm/> 23071
|
$168.00 |
$168.00 |
$168.00 |
$2,271.01
|
|
Exc tendon sheath or cap lesion 26160
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$2,650.53
|
|
Exc thrombosed hemorrhoid 46320
|
$1,440.18 |
$1,440.18 |
$1,440.18 |
$2,491.20
|
|
Exc vagina lesion 57135
|
$3,760.68 |
$3,760.68 |
$3,760.68 |
$4,107.36
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$4,461.16 |
$4,461.16 |
$4,461.16 |
$3,473.04
|
|
Exploration of knee joint
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$3,850.53
|
|
Explore/irrigate tear ducts
|
$306.18 |
$306.18 |
$306.18 |
$436.44
|
|
Explore penetrating wnd/extremity 20103
|
$1,994.16 |
$1,994.16 |
$1,994.16 |
$1,917.33
|
|
Explore/repair chest 32110
|
$120.96 |
$120.96 |
$120.96 |
$3,668.70
|
|
Explore/treat finger joint
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$2,615.25
|
|
Explore wound abdomen 20102
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,837.09
|
|
Explore woundchest 20101
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,179.44
|
|
Explore wound neck 20100
|
$607.74 |
$607.74 |
$607.74 |
$1,185.00
|
|
Exp w remove/deep fb/forearm/wrist 25248
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$3,559.50
|
|
External cannula declotting
|
$1,720.74 |
$1,720.74 |
$1,720.74 |
$1,829.42
|
|
External newborn metabolic screening panel
|
$130.20 |
$130.20 |
$130.20 |
$114.75
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$137.76 |
$137.76 |
$137.76 |
$102.78
|
|
Eye implant band 40
|
$133.82 |
$133.82 |
$133.82 |
$125.00
|
|
Facial bones <3
|
$147.00 |
$147.00 |
$147.00 |
$248.60
|
|
Factor viii
|
$110.46 |
$110.46 |
$110.46 |
$144.30
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$56.70 |
$56.70 |
$56.70 |
$27.81
|
|
Fda ide #g240020 carry bag
|
$1,143.98 |
$1,143.98 |
$1,143.98 |
$933.57
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$57.96 |
$57.96 |
$57.96 |
$120.15
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$6,728.35 |
$6,728.35 |
$6,728.35 |
$2,027.60
|
|
Ferritin
|
$73.50 |
$73.50 |
$73.50 |
$103.68
|
|
Fetal biophys profile w/nst 76818
|
$270.06 |
$270.06 |
$270.06 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$236.88 |
$236.88 |
$236.88 |
$540.54
|
|
Fetal fibronectin
|
$346.50 |
$346.50 |
$346.50 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$47.46 |
$47.46 |
$47.46 |
$88.80
|
|
Fetal non stress test
|
$238.14 |
$238.14 |
$238.14 |
$507.90
|
|
Fibrin degradation d dimer quantitative
|
$62.58 |
$62.58 |
$62.58 |
$112.80
|
|
Fibrin degradation products
|
$42.42 |
$42.42 |
$42.42 |
$62.40
|
|
Fibrinogen activity
|
$60.06 |
$60.06 |
$60.06 |
$82.38
|
|
Filleted finger/toe flap
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,164.64
|
|
Filter spider fx 3mmx320cm
|
$7,130.56 |
$7,130.56 |
$7,130.56 |
$6,152.59
|
|
Filter vena cava fem denali
|
$4,073.27 |
$4,073.27 |
$4,073.27 |
$3,467.25
|
|
Fine needle aspiration biopsy without img gdn; ea addtl 10004
|
$247.80 |
$247.80 |
$247.80 |
$261.80
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$837.06 |
$837.06 |
$837.06 |
$806.40
|
|
Fine needle asp without image guide 10021
|
$496.02 |
$496.02 |
$496.02 |
$547.53
|
|
Fixation of knee joint
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$1,963.35
|
|
Fix g/colon tube w/device
|
$1,097.88 |
$1,097.88 |
$1,097.88 |
$1,236.90
|
|
Fixtn pq skel dstl rad fx/epiphysl sep
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$3,981.06
|
|
Flexible Sigmoidoscopy
|
$960.96 |
$960.96 |
$960.96 |
$1,284.13
|
|
Floor of mouth biopsy 41108
|
$1,994.16 |
$1,994.16 |
$1,994.16 |
$2,040.09
|
|
Flow cytometry marker each additional
|
$123.06 |
$123.06 |
$123.06 |
$103.00
|
|
Flow cytometry one marker technical component
|
$232.68 |
$232.68 |
$232.68 |
$270.75
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$116.66 |
$116.66 |
$116.66 |
$86.42
|
|
Fluid pressure muscle 20950
|
$863.10 |
$863.10 |
$863.10 |
$779.45
|
|
Fluoroguide for spine inject 77003-26
|
$68.88 |
$68.88 |
$68.88 |
$507.00
|
|
Fluoroguide needle placement
|
$68.88 |
$68.88 |
$68.88 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$263.34 |
$263.34 |
$263.34 |
$494.52
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$142.87
|
|
Folic acid
|
$78.96 |
$78.96 |
$78.96 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$55.66
|
|
Foot X-ray
|
$147.00 |
$147.00 |
$147.00 |
$362.40
|
|
Forehead flap w/vasc pedicle 15731
|
$4,326.42 |
$4,326.42 |
$4,326.42 |
$4,332.25
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$454.86 |
$454.86 |
$454.86 |
$595.80
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$177.89 |
$177.89 |
$177.89 |
$107.31
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$18.06 |
$18.06 |
$18.06 |
$168.75
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$21.84 |
$21.84 |
$21.84 |
$149.50
|
|
Fresh frozen plasma thawing ea un
|
$155.40 |
$155.40 |
$155.40 |
$123.90
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,919.95
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,501.10
|
|
Furosemide 10 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$27.69
|
|
Fusion of finger joint
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$3,986.00
|
|
Gammaglobulin iga
|
$49.98 |
$49.98 |
$49.98 |
$75.30
|
|
Gammaglobulin ige
|
$88.62 |
$88.62 |
$88.62 |
$85.00
|
|
Gamma glutamyltransferase
|
$38.64 |
$38.64 |
$38.64 |
$55.28
|
|
General health panel
|
$244.02 |
$244.02 |
$244.02 |
$280.50
|
|
Generator barostim neo2 2014
|
$62,253.40 |
$62,253.40 |
$62,253.40 |
$54,121.91
|
|
Generator emblem MRI sicd subq
|
$36,467.76 |
$36,467.76 |
$36,467.76 |
$35,824.13
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$69.30 |
$69.30 |
$69.30 |
$62.84
|
|
Gentamicin peak therapeutic drug level
|
$28.98 |
$28.98 |
$28.98 |
$119.00
|
|
Ghs abscess perianal iandd
|
$362.04 |
$362.04 |
$362.04 |
$1,530.50
|
|
Ghs abscess postoperative iandd complex
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,776.00
|
|
Ghs aspiration bladder - needle
|
$286.02 |
$286.02 |
$286.02 |
$590.84
|
|
Ghs bladder cath - complex-foley
|
$401.52 |
$401.52 |
$401.52 |
$344.48
|
|
Ghs block ilioinguinal/gentitofemoral
|
$856.80 |
$856.80 |
$856.80 |
$1,050.00
|
|
Ghs central line insert < age 5, failed
|
$3,961.86 |
$3,961.86 |
$3,961.86 |
$2,676.75
|
|
Ghs change cysto/gastrost
|
$345.66 |
$345.66 |
$345.66 |
$699.60
|
|
Ghs chemo IV push, ea addtl
|
$78.12 |
$78.12 |
$78.12 |
$291.60
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$310.38 |
$310.38 |
$310.38 |
$596.55
|
|
Ghs closed reduction ankle dislocation
|
$417.90 |
$417.90 |
$417.90 |
$731.04
|
|
Ghs closed tx bimalleolar fracture w/manip
|
$2,540.58 |
$2,540.58 |
$2,540.58 |
$1,707.42
|
|
Ghs closed tx radiocarpal disloc w manip
|
$275.52 |
$275.52 |
$275.52 |
$534.99
|
|
Ghs closed tx tibial fracture w/manip
|
$2,621.64 |
$2,621.64 |
$2,621.64 |
$2,621.64
|
|
Ghs closure surg wound/dehiscence-13160
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,973.33
|
|
Ghs clsd red med malleolus fx without manip
|
$275.52 |
$275.52 |
$275.52 |
$581.60
|
|
Ghs clsd red med malleolus fx w manip
|
$2,621.64 |
$2,621.64 |
$2,621.64 |
$2,459.25
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$2,621.64 |
$2,621.64 |
$2,621.64 |
$2,399.46
|
|
Ghs cl tx knee disl; wo anesth
|
$275.52 |
$275.52 |
$275.52 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$451.92 |
$451.92 |
$451.92 |
$547.94
|
