|
Epstein barr early antigen antibody
|
$668.70 |
$668.70 |
$668.70 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$668.70 |
$668.70 |
$668.70 |
$78.65
|
|
Ercp biliary & pancreas
|
$3,870.02 |
$3,870.02 |
$3,870.02 |
$967.04
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,508.74 |
$1,508.74 |
$1,508.74 |
$222.98
|
|
Esophageal motility
|
$8,820.47 |
$8,820.47 |
$8,820.47 |
$655.45
|
|
Esophagus motility study
|
$4,466.11 |
$4,466.11 |
$4,466.11 |
$1,289.20
|
|
Established Patient Office Visit (level 1)
|
$329.04 |
$329.04 |
$329.04 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$402.16 |
$402.16 |
$402.16 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$476.46 |
$476.46 |
$476.46 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$608.55 |
$608.55 |
$608.55 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$681.67 |
$681.67 |
$681.67 |
$280.33
|
|
Estradiol total
|
$1,947.72 |
$1,947.72 |
$1,947.72 |
$146.50
|
|
Estradiol valerate 10 mg inj
|
$372.43 |
$372.43 |
$372.43 |
$57.35
|
|
Estrogens total-sendout
|
$1,207.31 |
$1,207.31 |
$1,207.31 |
$96.20
|
|
Etanercept injection
|
$4,988.98 |
$4,988.98 |
$4,988.98 |
$3,172.86
|
|
Ethanolamine oleate 100 mg
|
$3,751.47 |
$3,751.47 |
$3,751.47 |
$751.36
|
|
Ethylene glycol -sendout
|
$1,379.08 |
$1,379.08 |
$1,379.08 |
$89.40
|
|
Etoposide 20 mg/ml intravenous solution
|
$15.70 |
$15.70 |
$15.70 |
$235.20
|
|
Etoposide 50 mg cap
|
$1,108.05 |
$1,108.05 |
$1,108.05 |
$135.02
|
|
Euglobulin lysis
|
$918.83 |
$918.83 |
$918.83 |
$56.70
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$2,149.51 |
$2,149.51 |
$2,149.51 |
$219.60
|
|
Evoked potential visual not glaucoma
|
$2,739.31 |
$2,739.31 |
$2,739.31 |
$814.61
|
|
External chromosome analysis 20-25 cells
|
$1,324.05 |
$1,324.05 |
$1,324.05 |
$384.15
|
|
External newborn metabolic screening panel
|
$722.06 |
$722.06 |
$722.06 |
$109.76
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$3,280.11 |
$3,280.11 |
$3,280.11 |
$454.20
|
|
F-18 fdg pet diag
|
$5.48 |
$5.48 |
$5.48 |
$551.72
|
|
Factor ix
|
$1,565.84 |
$1,565.84 |
$1,565.84 |
$156.13
|
|
Factor viii
|
$1,565.84 |
$1,565.84 |
$1,565.84 |
$133.81
|
|
Fat/lipids feces qualitative
|
$286.84 |
$286.84 |
$286.84 |
$38.35
|
|
Fatty acids nonesterified
|
$677.03 |
$677.03 |
$677.03 |
$64.28
|
|
#fecal-sodium
|
$423.56 |
$423.56 |
$423.56 |
$37.50
|
|
Fern test
|
$75.04 |
$75.04 |
$75.04 |
$39.65
|
|
Fetal fibronectin
|
$3,083.33 |
$3,083.33 |
$3,083.33 |
$373.41
|
|
Fetal hemoglobin (kleihauer betke)
|
$985.55 |
$985.55 |
$985.55 |
$105.12
|
|
Fibrin degrade semiquant
|
$695.38 |
$695.38 |
$695.38 |
$78.09
|
|
Fibrinolytic antiplasmin
|
$1,160.63 |
$1,160.63 |
$1,160.63 |
$72.80
|
|
Fibrinolytic plasminogen
|
$1,719.27 |
$1,719.27 |
$1,719.27 |
$95.92
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$1,382.41 |
$1,382.41 |
$1,382.41 |
$65.00
|
|
Filters elec/combo vad, rep
|
$180.00 |
$180.00 |
$180.00 |
$36.40
|
|
Finasteride, 5 mg
|
$109.60 |
$109.60 |
$109.60 |
$7.71
|
|
Fludarabine 50 mg intravenous solution
|
$829.83 |
$829.83 |
$829.83 |
$493.35
|
|
Fluoroguide for spine inject 77003-26
|
$2,831.99 |
$2,831.99 |
$2,831.99 |
$496.03
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$60.17 |
$60.17 |
$60.17 |
$94.86
|
|
Foam drsg <=16 sq in without bdr
|
$46.00 |
$46.00 |
$46.00 |
$21.74
|
|
Folic acid
|
$510.29 |
$510.29 |
$510.29 |
$101.50
|
|
Follow-up angiography
|
$3,302.71 |
$3,302.71 |
$3,302.71 |
$2,040.78
|
|
Fomepizole 1 gram/ml intravenous solution
|
$36,218.61 |
$36,218.61 |
$36,218.61 |
$2,581.14
|
|
Foot insert plastazote or eq
|
$912.00 |
$912.00 |
$912.00 |
$365.48
|
|
Foot longitudinal arch suppo
|
$480.00 |
$480.00 |
$480.00 |
$295.47
|
|
Foot longitud/metatarsal sup
|
$922.00 |
$922.00 |
$922.00 |
$221.20
|
|
Formoterol fumarate, inh
|
$31.10 |
$31.10 |
$31.10 |
$59.40
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$2,727.02 |
$2,727.02 |
$2,727.02 |
$457.50
|
|
Fracture assessment via dxa
|
$277.53 |
$277.53 |
$277.53 |
$173.18
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$376.49 |
$376.49 |
$376.49 |
$156.60
|
|
Ft insert ucb berkeley shell
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$743.29
|
|
Ga-67 gallium 0.1 mci
|
$717.03 |
$717.03 |
$717.03 |
$118.56
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$85.68 |
$85.68 |
$85.68 |
$177.52
|
|
Galac-1-phosphate uridyltran - sendout
|
$2,603.08 |
$2,603.08 |
$2,603.08 |
$96.94
|
|
Gammaglobulin ige
|
$960.52 |
$960.52 |
$960.52 |
$83.85
|
|
Gamma glutamyltransferase
|
$918.83 |
$918.83 |
$918.83 |
$57.54
|
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
$1,019.19 |
$1,019.19 |
$1,019.19 |
$197.40
|
|
Gastric analy w/ph ea spec
|
$273.48 |
$273.48 |
$273.48 |
$31.80
|
|
Gated heart multiple
|
$13,024.24 |
$13,024.24 |
$13,024.24 |
$1,400.64
|
|
Gemcitabine 1 gram intravenous solution
|
$13,017.22 |
$13,017.22 |
$13,017.22 |
$207.51
|
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
$65,694.84 |
$65,694.84 |
$65,694.84 |
$19,305.62
|
|
General health panel
|
$5,357.91 |
$5,357.91 |
$5,357.91 |
$275.00
|
|
Ghs acetylcholinesterase, rbc
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$42.72
|
|
Ghs alpha thalasemia, 7 deletions
|
$1,555.85 |
$1,555.85 |
$1,555.85 |
$371.84
|
|
Ghs antibodies (torch) igm
|
$2,094.48 |
$2,094.48 |
$2,094.48 |
$69.30
|
|
Ghs chemo IV push, ea addtl
|
$335.39 |
$335.39 |
$335.39 |
$286.00
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$1,465.56 |
$1,465.56 |
$1,465.56 |
$132.00
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$4,095.75 |
$4,095.75 |
$4,095.75 |
$593.91
|
|
Ghs fish cytogen
|
$1,834.32 |
$1,834.32 |
$1,834.32 |
$170.80
|
|
Ghs fish hybrid in situ 100-300
|
$1,310.73 |
$1,310.73 |
$1,310.73 |
$223.00
|
|
Ghs hcv amplificaiton
|
$2,454.67 |
$2,454.67 |
$2,454.67 |
$187.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$2,578.08 |
$2,578.08 |
$2,578.08 |
$142.50
|
|
Ghs histoplasma antigen
|
$1,480.81 |
$1,480.81 |
$1,480.81 |
$141.00
|
|
Ghs immun0electrophoresis
|
$2,749.82 |
$2,749.82 |
$2,749.82 |
$110.00
|
|
Ghs IV infusion casirivimab/imdevimab
|
$502.41 |
$502.41 |
$502.41 |
$582.60
|
|
Ghs leukocyte alkaline phos (mayo)
|
$622.02 |
$622.02 |
$622.02 |
$76.20
|
|
Ghs mbp
|
$1,265.68 |
$1,265.68 |
$1,265.68 |
$77.35
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$141.93 |
$141.93 |
$141.93 |
$242.31
|
|
Ghs myocardial strain img spckl track
|
$5,577.84 |
$5,577.84 |
$5,577.84 |
$457.80
|
|
Ghs o2 saturation
|
$755.40 |
$755.40 |
$755.40 |
$70.80
|
|
Ghs ot dds rom
|
$638.42 |
$638.42 |
$638.42 |
$62.28
|
|
Ghs ot sensory integrative tech/15min
|
$240.82 |
$240.82 |
$240.82 |
$94.80
|
|
Ghs pacing - transcutaneous
|
$2,967.46 |
$2,967.46 |
$2,967.46 |
$815.20
|
|
Ghs phenylketonurid
|
$722.06 |
$722.06 |
$722.06 |
$53.76
|
|
Ghs polysom <6 yrs 4/> parameters
|
$16,470.44 |
$16,470.44 |
$16,470.44 |
$3,557.58
|
|
Ghs prostatic acid phosphatase (mayo)
|
$581.97 |
$581.97 |
$581.97 |
$43.55
|
|
Ghs quinidine
|
$713.72 |
$713.72 |
$713.72 |
$85.00
|
|
Ghs respiratory syncytical virus igg/m
|
$725.38 |
$725.38 |
$725.38 |
$71.20
|
|
Ghs semen analysis fert
|
$1,317.37 |
$1,317.37 |
$1,317.37 |
$129.00
|
|
Ghs semen analysis, post-vas
|
$451.91 |
$451.91 |
$451.91 |
$32.37
|
|
Ghs trypsin (fecal)
|
$680.37 |
$680.37 |
$680.37 |
$50.93
|
|
Ghs urine, porphyrins quant
|
$2,494.69 |
$2,494.69 |
$2,494.69 |
$75.00
|
|
Ghs veeg 12-26 hr intmt mont
|
$14,227.17 |
$14,227.17 |
$14,227.17 |
$1,910.25
|
|
Giardia lamblia antibody
|
$732.06 |
$732.06 |
$732.06 |
$83.44
|
|
Gi tract capsule endoscopy (pillcam) 91110
|
$5,995.31 |
$5,995.31 |
$5,995.31 |
$2,098.85
|
|
Glucagon 1 mg solution for injection
|
$1,769.48 |
$1,769.48 |
$1,769.48 |
$601.79
|
