|
Established Patient Office Visit (level 5)
|
$367.50 |
$367.50 |
$367.50 |
$287.10
|
|
Estradiol total
|
$25.00 |
$25.00 |
$25.00 |
$149.43
|
|
Ethylene glycol -sendout
|
$24.50 |
$24.50 |
$24.50 |
$85.00
|
|
Eval/fit voice prosthesis iii, st
|
$433.00 |
$433.00 |
$433.00 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$325.00 |
$325.00 |
$325.00 |
$211.12
|
|
Evaluation of speech fluency 92521
|
$433.00 |
$433.00 |
$433.00 |
$307.75
|
|
Evaluation psychiatric diagnostic
|
$197.00 |
$197.00 |
$197.00 |
$315.00
|
|
Event monitor
|
$43.00 |
$43.00 |
$43.00 |
$237.60
|
|
Evoked oa emissions ltd
|
$193.00 |
$193.00 |
$193.00 |
$244.00
|
|
Evoked potentials upper limbs
|
$1,439.50 |
$1,439.50 |
$1,439.50 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$942.50 |
$942.50 |
$942.50 |
$812.40
|
|
Ewho w/joint(s) cf
|
$107.50 |
$107.50 |
$107.50 |
$830.70
|
|
Exam of vagina w/scope 57420
|
$144.00 |
$144.00 |
$144.00 |
$486.03
|
|
Exome sequence analysis
|
$2,456.50 |
$2,456.50 |
$2,456.50 |
$5,258.00
|
|
Exome sequence analysis
|
$6,600.00 |
$6,600.00 |
$6,600.00 |
$12,000.00
|
|
Ext ecg>48hr<7d scan a/r
|
$131.00 |
$131.00 |
$131.00 |
$241.92
|
|
External chromosome analysis 20-25 cells
|
$288.50 |
$288.50 |
$288.50 |
$403.00
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$169.00 |
$169.00 |
$169.00 |
$445.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$60.50 |
$60.50 |
$60.50 |
$109.00
|
|
Facial bones <3
|
$353.00 |
$353.00 |
$353.00 |
$252.60
|
|
Factor ix
|
$30.00 |
$30.00 |
$30.00 |
$154.50
|
|
Factor viii
|
$34.00 |
$34.00 |
$34.00 |
$144.82
|
|
Factor viii recombinant nos
|
$1,237.25 |
$1,237.25 |
$1,237.25 |
$5.40
|
|
Fancc gene
|
$33.50 |
$33.50 |
$33.50 |
$140.00
|
|
Fat/lipids feces qualitative
|
$9.00 |
$9.00 |
$9.00 |
$36.00
|
|
Fatty acids nonesterified
|
$39.50 |
$39.50 |
$39.50 |
$64.28
|
|
Fecal microbiota prep instil
|
$2,182.00 |
$2,182.00 |
$2,182.00 |
$1,059.00
|
|
#fecal-sodium
|
$9.50 |
$9.50 |
$9.50 |
$37.50
|
|
Fees w/laryngeal sense test
|
$432.00 |
$432.00 |
$432.00 |
$433.50
|
|
Felbamate (felbatol(r)) - sendout
|
$14.50 |
$14.50 |
$14.50 |
$61.00
|
|
Feno poc
|
$105.50 |
$105.50 |
$105.50 |
$99.60
|
|
Ferritin
|
$182.00 |
$182.00 |
$182.00 |
$102.07
|
|
Fetal aneuploidy trisom risk
|
$698.50 |
$698.50 |
$698.50 |
$1,077.00
|
|
Fetal biophys profile w/nst 76818
|
$754.00 |
$754.00 |
$754.00 |
$541.74
|
|
Fetal chrmoml microdeltj
|
$698.50 |
$698.50 |
$698.50 |
$879.51
|
|
Fetal fibronectin
|
$1,187.00 |
$1,187.00 |
$1,187.00 |
$387.60
|
|
Fetal hemoglobin (kleihauer betke)
|
$124.00 |
$124.00 |
$124.00 |
$104.00
|
|
Fetal lung maturity assess lam body dnst
|
$13.50 |
$13.50 |
$13.50 |
$67.00
|
|
Fetal non stress test
|
$750.00 |
$750.00 |
$750.00 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$57.50 |
$57.50 |
$57.50 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$235.00 |
$235.00 |
$235.00 |
$120.05
|
|
Fibrin degradation products
|
$147.00 |
$147.00 |
$147.00 |
$74.25
|
|
Fibrinogen activity
|
$147.00 |
$147.00 |
$147.00 |
$85.86
|
|
Fibrinolysins/coagulopathy screen interpretation/report
|
$83.50 |
$83.50 |
$83.50 |
$61.02
|
|
Fibrinolytic antiplasmin
|
$30.00 |
$30.00 |
$30.00 |
$72.80
|
|
Fibrinolytic plasminogen
|
$40.50 |
$40.50 |
$40.50 |
$105.60
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$16.00 |
$16.00 |
$16.00 |
$66.60
|
|
Flecainide (tambocor)-sendout
|
$14.50 |
$14.50 |
$14.50 |
$65.24
|
|
Flow cytometry interp 16 or more
|
$90.00 |
$90.00 |
$90.00 |
$194.00
|
|
Flow cytometry one marker technical component
|
$331.00 |
$331.00 |
$331.00 |
$276.60
|
|
#flow interp 9 - 15 markers
|
$56.50 |
$56.50 |
$56.50 |
$172.50
|
|
Flt3 gene
|
$172.50 |
$172.50 |
$172.50 |
$355.00
|
|
Flt3 gene analysis
|
$172.50 |
$172.50 |
$172.50 |
$215.20
|
|
Fluidotherapy charges pt
|
$112.00 |
$112.00 |
$112.00 |
$98.40
|
|
Fluorescent antibody titer dna
|
$461.50 |
$461.50 |
$461.50 |
$123.65
|
|
Fluoroscopy up to 1 hour
|
$216.50 |
$216.50 |
$216.50 |
$497.40
|
|
Folic acid
|
$208.00 |
$208.00 |
$208.00 |
$99.96
|
|
Follow-up angiography
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$1,939.14
|
|
Fomepizole 1 gram/ml intravenous solution
|
$1,293.87 |
$1,293.87 |
$1,293.87 |
$2,481.61
|
|
Foot X-ray
|
$324.00 |
$324.00 |
$324.00 |
$352.08
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$225.62 |
$225.62 |
$225.62 |
$106.25
|
|
_fragile x methylation-sendout
|
$356.50 |
$356.50 |
$356.50 |
$183.74
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$52.00 |
$52.00 |
$52.00 |
$153.02
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$192.50 |
$192.50 |
$192.50 |
$164.16
|
|
Fresh frozen plasma thawing ea un
|
$165.50 |
$165.50 |
$165.50 |
$130.98
|
|
Frozen blood thaw
|
$116.50 |
$116.50 |
$116.50 |
$209.50
|
|
Frozen plasma, pooled, sd
|
$159.00 |
$159.00 |
$159.00 |
$170.00
|
|
Fructosamine glycated protein
|
$13.00 |
$13.00 |
$13.00 |
$61.75
|
|
Ftl cgen abnor four anal
|
$94.00 |
$94.00 |
$94.00 |
$205.80
|
|
Ftl cgen abnor two proteins
|
$64.00 |
$64.00 |
$64.00 |
$109.00
|
|
G6pc gene
|
$35.50 |
$35.50 |
$35.50 |
$138.40
|
|
G6pd full gene sequence
|
$675.00 |
$675.00 |
$675.00 |
$1,320.00
|
|
Gabapentin non-blood
|
$105.50 |
$105.50 |
$105.50 |
$42.35
|
|
Galac-1-phosphate uridyltran - sendout
|
$220.50 |
$220.50 |
$220.50 |
$100.00
|
|
Galectin-3
|
$157.00 |
$157.00 |
$157.00 |
$111.60
|
|
Gammaglobulin iga
|
$15.00 |
$15.00 |
$15.00 |
$69.42
|
|
Gammaglobulin ige
|
$11.50 |
$11.50 |
$11.50 |
$83.40
|
|
Gamma glutamyltransferase
|
$188.00 |
$188.00 |
$188.00 |
$57.54
|
|
Gastroesophageal reflux test
|
$2,012.00 |
$2,012.00 |
$2,012.00 |
$1,352.00
|
|
Gba gene
|
$238.00 |
$238.00 |
$238.00 |
$160.72
|
|
Genetic tstg severe inh cond
|
$4,050.00 |
$4,050.00 |
$4,050.00 |
$3,978.65
|
|
Genome sequence analysis
|
$2,516.50 |
$2,516.50 |
$2,516.50 |
$5,031.20
|
|
Genome sequence analysis
|
$2,100.00 |
$2,100.00 |
$2,100.00 |
$3,455.25
|
|
Gentamicin peak therapeutic drug level
|
$275.00 |
$275.00 |
$275.00 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$2,104.50 |
$2,104.50 |
$2,104.50 |
$1,500.00
|
|
Ghs alcohol, methyl (methanol)-medtox
|
$115.00 |
$115.00 |
$115.00 |
$100.30
|
|
Ghs alpha thalasemia, 7 deletions
|
$94.00 |
$94.00 |
$94.00 |
$403.38
|
|
Ghs antibodies (torch) igm
|
$14.00 |
$14.00 |
$14.00 |
$69.12
|
|
Ghs bladder cath - complex-foley
|
$291.50 |
$291.50 |
$291.50 |
$343.68
|
|
Ghs chemo >8 hrs
|
$547.50 |
$547.50 |
$547.50 |
$714.87
|
|
Ghs chemo IV push, ea addtl
|
$211.00 |
$211.00 |
$211.00 |
$276.02
|
|
Ghs chlamydia pneumoniae by pcr (arup) (306630)
|
$200.00 |
$200.00 |
$200.00 |
$133.00
|
|
Ghs community re-entry 15 minutes
|
$112.00 |
$112.00 |
$112.00 |
$89.00
|
|
Ghs diphtheria toxoid ab igg
|
$80.50 |
$80.50 |
$80.50 |
$55.02
|
|
Ghs eeg cont rec w/video by tec min 8 chnls
|
$335.00 |
$335.00 |
$335.00 |
$560.00
|
|
Ghs febrile agglutinns(mayo)
|
$22.50 |
$22.50 |
$22.50 |
$48.10
|
|
Ghs fish cytogen
|
$167.00 |
$167.00 |
$167.00 |
$173.40
|
|
Ghs fish hybrid in situ 100-300
|
$140.50 |
$140.50 |
$140.50 |
$225.00
|
|
Ghs hepatitis c virus (hcv riba)
|
$263.00 |
$263.00 |
$263.00 |
$144.60
|
|
Ghs hgb stability-thal
|
$62.50 |
$62.50 |
$62.50 |
$89.91
|
