|
Epoetin alfa, 100 units esrd
|
$1,347.00 |
$1,347.00 |
$1,347.00 |
$6.00
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$87.50 |
$87.50 |
$87.50 |
$129.30
|
|
Epstein barr early antigen antibody
|
$9.00 |
$9.00 |
$9.00 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$10.50 |
$10.50 |
$10.50 |
$76.70
|
|
Epstein barr viral capsid antigen antibody igm
|
$77.00 |
$77.00 |
$77.00 |
$85.15
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$726.75 |
$726.75 |
$726.75 |
$425.12
|
|
Ercp biliary & pancreas
|
$895.00 |
$895.00 |
$895.00 |
$951.20
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$84.00 |
$84.00 |
$84.00 |
$227.20
|
|
ER Visit (level 1, minor)
|
$262.00 |
$262.00 |
$262.00 |
$252.35
|
|
ER Visit (level 2)
|
$463.00 |
$463.00 |
$463.00 |
$463.00
|
|
ER Visit (level 3)
|
$978.00 |
$978.00 |
$978.00 |
$793.20
|
|
ER Visit (level 4)
|
$1,291.00 |
$1,291.00 |
$1,291.00 |
$1,277.65
|
|
ER Visit (level 5, high severity)
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,844.80
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$157.25 |
$157.25 |
$157.25 |
$223.99
|
|
Esophageal dilat s&i
|
$1,015.00 |
$1,015.00 |
$1,015.00 |
$550.00
|
|
Esophagus motility study
|
$1,043.00 |
$1,043.00 |
$1,043.00 |
$1,257.17
|
|
Esoph balloon distension tst
|
$773.50 |
$773.50 |
$773.50 |
$1,040.00
|
|
Esoph imped funct test > 1hr
|
$674.00 |
$674.00 |
$674.00 |
$1,089.15
|
|
Established Patient Office Visit (level 1)
|
$184.50 |
$184.50 |
$184.50 |
$122.40
|
|
Established Patient Office Visit (level 2)
|
$195.00 |
$195.00 |
$195.00 |
$138.82
|
|
Established Patient Office Visit (level 3)
|
$211.00 |
$211.00 |
$211.00 |
$186.60
|
|
Established Patient Office Visit (level 4)
|
$321.00 |
$321.00 |
$321.00 |
$235.00
|
|
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 heart device
|
$887.50 |
$887.50 |
$887.50 |
$2,221.96
|
|
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 ix complex
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$5.91
|
|
Factor ix recombinant nos
|
$1,726.25 |
$1,726.25 |
$1,726.25 |
$4.65
|
|
Factor viii
|
$34.00 |
$34.00 |
$34.00 |
$144.82
|
|
Factor viii recombinant nos
|
$793.50 |
$793.50 |
$793.50 |
$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
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$79.87 |
$79.87 |
$79.87 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,045.75 |
$2,045.75 |
$2,045.75 |
$2,590.25
|
|
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 marker each additional
|
$122.00 |
$122.00 |
$122.00 |
$97.50
|
|
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
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$29.50 |
$29.50 |
$29.50 |
$64.15
|
|
Fludarabine 50 mg intravenous solution
|
$556.75 |
$556.75 |
$556.75 |
$493.35
|
|
Fluidotherapy charges pt
|
$112.00 |
$112.00 |
$112.00 |
$98.40
|
|
Fluorescent antibody titer dna
|
$461.50 |
$461.50 |
$461.50 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$333.50 |
$333.50 |
$333.50 |
$495.95
|
|
Fluoroguide needle placement
|
$310.00 |
$310.00 |
$310.00 |
$497.20
|
|
Fluoroscopy up to 1 hour
|
$216.50 |
$216.50 |
$216.50 |
$497.40
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$89.75 |
$89.75 |
$89.75 |
$107.00
|
|
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
|
|
Fondaparinux sodium
|
$210.50 |
$210.50 |
$210.50 |
$186.87
|
|
Foot X-ray
|
$324.00 |
$324.00 |
$324.00 |
$352.08
|
|
Fosaprepitant 150 mg intravenous powder for solution
|
$326.50 |
$326.50 |
$326.50 |
$490.67
|
|
Foscarnet sodium injection
|
$775.00 |
$775.00 |
$775.00 |
$1,008.91
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$42.00 |
$42.00 |
$42.00 |
$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
|
