|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$5,410.56 |
$5,410.56 |
$5,410.56 |
$3,855.08
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$152.28 |
$152.28 |
$152.28 |
$364.08
|
|
ER Visit (level 1, minor)
|
$252.96 |
$252.96 |
$252.96 |
$276.70
|
|
ER Visit (level 2)
|
$466.35 |
$466.35 |
$466.35 |
$487.50
|
|
ER Visit (level 3)
|
$720.93 |
$720.93 |
$720.93 |
$850.50
|
|
ER Visit (level 4)
|
$1,092.42 |
$1,092.42 |
$1,092.42 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$1,743.42 |
$1,743.42 |
$1,743.42 |
$2,007.00
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$1,032.91 |
$1,032.91 |
$1,032.91 |
$260.24
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$3,084.15 |
$3,084.15 |
$3,084.15 |
$671.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$2,238.90 |
$2,238.90 |
$2,238.90 |
$540.00
|
|
Established Patient Office Visit (level 1)
|
$488.53 |
$488.53 |
$488.53 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$118.20 |
$118.20 |
$118.20 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$306.77 |
$306.77 |
$306.77 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$431.79 |
$431.79 |
$431.79 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$361.63 |
$361.63 |
$361.63 |
$287.10
|
|
Estradiol total
|
$424.92 |
$424.92 |
$424.92 |
$153.00
|
|
Estrogens total-sendout
|
$242.37 |
$242.37 |
$242.37 |
$89.25
|
|
Etoposide 20 mg/ml intravenous solution
|
$261.53 |
$261.53 |
$261.53 |
$213.17
|
|
Euflexxa inj per dose
|
$353.91 |
$353.91 |
$353.91 |
$727.80
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$2,281.07 |
$2,281.07 |
$2,281.07 |
$1,064.30
|
|
Exc malig tal 0.6-1.0cm 11601
|
$3,846.19 |
$3,846.19 |
$3,846.19 |
$828.59
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$5,113.76 |
$5,113.76 |
$5,113.76 |
$932.35
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$371.45 |
$371.45 |
$371.45 |
$102.78
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$25.65 |
$25.65 |
$25.65 |
$27.81
|
|
Fat/lipids feces qualitative
|
$161.72 |
$161.72 |
$161.72 |
$34.56
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$84.45 |
$84.45 |
$84.45 |
$120.15
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$180.44 |
$180.44 |
$180.44 |
$2,027.60
|
|
Ferritin
|
$234.89 |
$234.89 |
$234.89 |
$103.68
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$9,949.05 |
$9,949.05 |
$9,949.05 |
$1,776.61
|
|
Fibrin degradation d dimer quantitative
|
$497.97 |
$497.97 |
$497.97 |
$112.80
|
|
Fibrin degradation products
|
$119.58 |
$119.58 |
$119.58 |
$62.40
|
|
Fibrinogen activity
|
$200.81 |
$200.81 |
$200.81 |
$82.38
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,053.38 |
$1,053.38 |
$1,053.38 |
$1,405.40
|
|
Filgrastim-sndz 300 mcg/0.5 ml injection syringe
|
$449.07 |
$449.07 |
$449.07 |
$973.70
|
|
Flow cytometry interp 16 or more
|
$145.79 |
$145.79 |
$145.79 |
$208.80
|
|
Flow cytometry marker each additional
|
$484.33 |
$484.33 |
$484.33 |
$103.00
|
|
Flow cytometry one marker technical component
|
$1,027.57 |
$1,027.57 |
$1,027.57 |
$270.75
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$317.92 |
$317.92 |
$317.92 |
$86.42
|
|
Fluorescent antibody titer dna
|
$159.05 |
$159.05 |
$159.05 |
$123.65
|
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
$883.31 |
$883.31 |
$883.31 |
$107.46
|
|
Fluphenazine decanoate 25 mg/ml injection solution
|
$40.50 |
$40.50 |
$40.50 |
$142.87
|
|
Folic acid
|
$267.00 |
$267.00 |
$267.00 |
$90.60
|
|
Folic acid 5 mg/ml injection solution
|
$23.89 |
$23.89 |
$23.89 |
$55.66
|
|
Fomepizole 1 gram/ml intravenous solution
|
$755.92 |
$755.92 |
$755.92 |
$2,860.43
|
|
Fondaparinux sodium
|
$53.66 |
$53.66 |
$53.66 |
$176.81
|
|
Foot X-ray
|
$474.26 |
$474.26 |
$474.26 |
$362.40
|
|
Fosphenytoin 50 mg pe/ml injection (wrapper)
|
$101.52 |
$101.52 |
$101.52 |
$107.31
|
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
$47.54 |
$47.54 |
$47.54 |
$26.40
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$233.48 |
$233.48 |
$233.48 |
$162.68
|
|
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper)
|
$386.61 |
$386.61 |
$386.61 |
$138.37
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$551.33 |
$551.33 |
$551.33 |
$86.54
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$705.38 |
$705.38 |
$705.38 |
$210.50
|
|
Gammaglobulin iga
|
$285.30 |
$285.30 |
$285.30 |
$75.30
|
|
Gammaglobulin ige
|
$140.91 |
$140.91 |
$140.91 |
$85.00
|
|
Gamma glutamyltransferase
|
$128.99 |
$128.99 |
$128.99 |
$55.28
|
|
Gamunex-c/gammaked
|
$5,629.28 |
$5,629.28 |
$5,629.28 |
$7,372.04
|
|
Gemcitabine 1 gram intravenous solution
|
$354.92 |
$354.92 |
$354.92 |
$252.84
|
|
General health panel
|
$891.83 |
$891.83 |
$891.83 |
$280.50
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$217.65 |
$217.65 |
$217.65 |
$62.84
|
|
Ghs antibodies (torch) igm
|
$168.60 |
$168.60 |
$168.60 |
$73.70
|
|
Ghs bladder cath - complex-foley
|
$1,655.93 |
$1,655.93 |
$1,655.93 |
$344.48
|
|
Ghs closd tx interphalang jt disloc w/ma
|
$1,683.61 |
$1,683.61 |
$1,683.61 |
$596.55
|
|
Ghs closed tx radiocarpal disloc w manip
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$534.99
|
|
Ghs corneal fb without slit lamp bilat
|
$1,557.44 |
$1,557.44 |
$1,557.44 |
$435.07
|
|
Ghs excision ingrown nail
|
$1,162.94 |
$1,162.94 |
$1,162.94 |
$457.60
|
|
Ghs incision thrombosed ext hemorrhoid
|
$405.11 |
$405.11 |
$405.11 |
$543.60
|
|
Ghs init tx 1st degree burn
|
$832.60 |
$832.60 |
$832.60 |
$300.30
|
|
Ghs insertion of needle - bone
|
$443.23 |
$443.23 |
$443.23 |
$461.58
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$2,406.01 |
$2,406.01 |
$2,406.01 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$2,440.84 |
$2,440.84 |
$2,440.84 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$2,253.74 |
$2,253.74 |
$2,253.74 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$2,237.20 |
$2,237.20 |
$2,237.20 |
$741.00
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$2,406.44 |
$2,406.44 |
$2,406.44 |
$879.60
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$1,835.31 |
$1,835.31 |
$1,835.31 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$1,835.31 |
$1,835.31 |
$1,835.31 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,835.31 |
$1,835.31 |
$1,835.31 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$135.61 |
$135.61 |
$135.61 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$230.79 |
$230.79 |
$230.79 |
$140.00
|
|
Ghs nailbed repair/nail removal
|
$1,683.77 |
$1,683.77 |
$1,683.77 |
$808.80
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$189.06 |
$189.06 |
$189.06 |
$90.15
|
|
Ghs ppd (tb intradermal)
|
$176.41 |
$176.41 |
$176.41 |
$43.45
|
|
Ghs pr without cont pulse ox
|
$389.91 |
$389.91 |
$389.91 |
$156.70
|
|
Ghs removal intranasal foreign body
|
$793.37 |
$793.37 |
$793.37 |
$324.35
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$2,273.04 |
$2,273.04 |
$2,273.04 |
$590.40
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$470.47
|
|
Ghs sphenopalatine ganglion block
|
$1,513.92 |
$1,513.92 |
$1,513.92 |
$706.56
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$609.56 |
$609.56 |
$609.56 |
$351.45
|
|
Glucose 1 hr post dose
|
$80.40 |
$80.40 |
$80.40 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$41.28 |
$41.28 |
$41.28 |
$22.00
|
|
Glucose blood quantitative
|
$158.09 |
$158.09 |
$158.09 |
$44.76
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$36.42 |
$36.42 |
$36.42 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$992.08 |
$992.08 |
$992.08 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$320.13 |
$320.13 |
$320.13 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$310.88 |
$310.88 |
$310.88 |
$123.75
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$55.19 |
$55.19 |
$55.19 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$20.03 |
$20.03 |
$20.03 |
$35.40
|
|
Hand X-ray
|
$395.22 |
$395.22 |
$395.22 |
$338.58
|
|
Haptoglobin quantitative
|
$154.31 |
$154.31 |
$154.31 |
$89.95
|
|
Hcg qualitative
|
$208.68 |
$208.68 |
$208.68 |
$77.50
|