|
ER Visit (level 4)
|
$805.00 |
$1,259.28 |
$1,259.28 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$1,110.00 |
$1,723.92 |
$1,723.92 |
$1,820.02
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$360.72 |
$360.72 |
$360.72 |
$223.99
|
|
Escharotomy ea addl incision
|
$207.24 |
$207.24 |
$207.24 |
$203.20
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$3.25 |
$3.25 |
$3.25 |
$279.72
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$8.09 |
$8.09 |
$16.17 |
$553.88
|
|
Esophagus motility study
|
$1,895.00 |
$1,895.00 |
$1,895.00 |
$1,289.20
|
|
Esoph balloon distension tst
|
$1,435.00 |
$1,435.00 |
$1,435.00 |
$1,040.00
|
|
Establish access to aorta
|
$374.22 |
$374.22 |
$695.00 |
$1,280.06
|
|
Establish access to artery
|
$1,450.68 |
$1,450.68 |
$1,450.68 |
$1,418.50
|
|
Established Patient Office Visit (level 1)
|
$125.00 |
$191.40 |
$321.42 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$177.50 |
$199.32 |
$199.32 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$240.00 |
$243.54 |
$243.54 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$268.62 |
$268.62 |
$382.50 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$339.24 |
$339.24 |
$725.00 |
$280.33
|
|
Estradiol total
|
$122.50 |
$170.94 |
$170.94 |
$146.50
|
|
Estrogens total-sendout
|
$134.64 |
$134.64 |
$134.64 |
$96.20
|
|
Ethylene glycol -sendout
|
$112.50 |
$321.42 |
$321.42 |
$89.40
|
|
Etonogestrel implant system
|
$1,165.00 |
$1,165.00 |
$1,165.00 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$6.12 |
$6.12 |
$6.12 |
$235.20
|
|
Eval/fit voice prosthesis iii, st
|
$350.00 |
$350.00 |
$350.00 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$392.50 |
$396.00 |
$396.00 |
$219.60
|
|
Evaluation heart device
|
$2,523.84 |
$2,523.84 |
$2,523.84 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$181.50 |
$181.50 |
$227.50 |
$311.50
|
|
Evaluation psychiatric diagnostic
|
$232.32 |
$232.32 |
$379.50 |
$312.00
|
|
Evasc prlng admn rx agnt 1st
|
$1,701.48 |
$1,701.48 |
$4,365.00 |
$3,822.00
|
|
Evasc prlng admn rx agnt add
|
$866.58 |
$866.58 |
$3,265.00 |
$2,734.40
|
|
Evasc repair of iliac artery; endograft 34718
|
$17,216.76 |
$17,216.76 |
$17,216.76 |
$6,925.05
|
|
Evasc rpr a-ao ndgft 34701
|
$17,216.76 |
$17,216.76 |
$25,620.00 |
$5,230.40
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$23,954.04 |
$23,954.04 |
$23,954.04 |
$4,670.40
|
|
Evasc rpr a-biiliac ndgft rptr
|
$18,785.00 |
$23,954.04 |
$23,954.04 |
$8,565.60
|
|
Evasc rpr a-iliac ndgft 34717
|
$7,485.72 |
$7,485.72 |
$7,485.72 |
$4,846.34
|
|
Evasc rpr a-unilac ndgft 34703
|
$17,216.76 |
$17,216.76 |
$18,920.00 |
$5,578.73
|
|
Evasc rpr a-unilac ndgft rpt
|
$18,920.00 |
$23,954.04 |
$23,954.04 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$17,216.76 |
$17,216.76 |
$17,216.76 |
$6,931.00
|
|
Evasc rpr ilio-iliac rpt
|
$23,954.04 |
$23,954.04 |
$23,954.04 |
$8,996.13
|
|
Event monitor
|
$210.00 |
$231.00 |
$231.00 |
$242.65
|
|
Evoked oa emissions ltd
|
$115.00 |
$115.00 |
$359.70 |
$234.32
|
|
Evoked potentials auditory screening automated analysis
|
$85.00 |
$85.00 |
$174.90 |
$249.71
|
|
Evoked potentials upper limbs
|
$906.18 |
$906.18 |
$1,130.00 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$730.00 |
$730.00 |
$1,431.54 |
$814.61
|
|
Ewho w/joint(s) cf
|
$573.54 |
$573.54 |
$573.54 |
$907.92
|
|
Exam plvc w/anes othr thn lcl
|
$3,235.00 |
$3,235.00 |
$3,235.00 |
$3,762.53
|
|
Exc benign tal 0.5 < cm 11400
|
$1,475.76 |
$1,475.76 |
$1,475.76 |
$827.40
|
|
Exchange biliary drg cath
|
$3,060.00 |
$3,544.20 |
$3,544.20 |
$3,909.56
|
|
Exchange drainage catheter
|
$1,585.00 |
$2,191.20 |
$2,191.20 |
$2,205.50
|
|
Exchange nephrostomy cath
|
$2,955.48 |
$2,955.48 |
$6,540.00 |
$2,958.80
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,683.00 |
$1,683.00 |
$1,683.00 |
$1,012.86
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$3,509.22 |
$3,509.22 |
$3,509.22 |
$2,865.00
|
|
Exc thrombosed hemorrhoid 46320
|
$2,175.36 |
$2,175.36 |
$2,175.36 |
$2,099.00
|
|
Exercise tst brncspsm w/ecg
|
$187.50 |
$247.50 |
$247.50 |
$318.50
|
|
Exercise tst brncspsm wo ecg
|
$112.50 |
$112.50 |
$112.50 |
$114.50
|
|
Exercise w/hemodynamic meas
|
$567.60 |
$567.60 |
$567.60 |
$901.60
|
|
Exome re-evaluation
|
$1,395.90 |
$1,395.90 |
$1,395.90 |
$441.60
|
|
Exome sequence analysis
|
$5,520.90 |
$5,520.90 |
$5,520.90 |
$5,520.90
|
|
Exome sequence analysis
|
$1,796.52 |
$1,796.52 |
$1,796.52 |
$12,546.29
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$2,819.63 |
$2,819.63 |
$2,819.63 |
$4,048.38
|
|
Expl lap celiotomy w/wo bx 49000
|
$6,337.32 |
$6,337.32 |
$6,337.32 |
$1,944.80
|
|
Explore penetrating wnd/extremity 20103
|
$1,871.10 |
$1,871.10 |
$1,871.10 |
$1,788.80
|
|
Explore wound abdomen 20102
|
$2,163.48 |
$2,163.48 |
$2,163.48 |
$2,568.80
|
|
Expose art endoprosth iliac 34820
|
$7,485.72 |
$7,485.72 |
$7,485.72 |
$1,812.80
|
|
Expose endoprosth brachial 34834
|
$5,988.18 |
$5,988.18 |
$5,988.18 |
$1,560.90
|
|
Ext ecg>48hr<7d scan a/r
|
$157.08 |
$157.08 |
$230.00 |
$241.92
|
|
Ext ecg>7d<15d scan a/r
|
$316.80 |
$316.80 |
$460.00 |
$336.07
|
|
External chromosome analysis 20-25 cells
|
$427.50 |
$737.22 |
$737.22 |
$384.15
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$52.50 |
$52.50 |
$52.50 |
$61.10
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$317.50 |
$339.24 |
$339.24 |
$454.20
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$55.00 |
$118.14 |
$118.14 |
$108.60
|
|
Eye implant band 40
|
$662.35 |
$662.35 |
$662.35 |
$6,394.52
|
|
F-18 fdg pet diag
|
$1,680.01 |
$1,680.01 |
$1,680.01 |
$551.72
|
|
F-18 florbetapir less than or equal to 10 mci
|
$5,145.00 |
$5,145.00 |
$5,145.00 |
$4,960.80
|
|
F-18 fluciclovine per mci
|
$735.00 |
$735.00 |
$735.00 |
$940.00
|
|
F-18 sodium fluoride
|
$580.00 |
$580.00 |
$580.00 |
$392.60
|
|
Facial bones <3
|
$272.50 |
$315.48 |
$315.48 |
$252.60
|
|
Factor ix
|
$170.00 |
$198.00 |
$198.00 |
$156.13
|
|
Factor viii
|
$170.00 |
$195.36 |
$195.36 |
$133.81
|
|
Factor viii recombinant nos
|
$3.57 |
$3.57 |
$3.57 |
$6.56
|
|
Fallopian tube recnl
|
$3,672.24 |
$3,672.24 |
$3,672.24 |
$3,762.53
|
|
Family therapy without pt 50min 90846
|
$217.80 |
$217.80 |
$217.80 |
$241.60
|
|
Family therapy with patient 50 min 90847
|
$217.80 |
$217.80 |
$217.80 |
$230.36
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$0.40 |
$0.40 |
$0.40 |
$22.20
|
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
$64.50 |
$64.50 |
$64.50 |
$5,800.72
|
|
Fancc gene
|
$122.10 |
$122.10 |
$155.00 |
$147.00
|
|
Fat/lipids feces qualitative
|
$28.38 |
$28.38 |
$28.38 |
$38.35
|
|
Fatty acids nonesterified
|
$126.06 |
$126.06 |
$126.06 |
$64.28
|
|
#fecal-sodium
|
$25.00 |
$29.70 |
$29.70 |
$37.50
|
|
Felbamate (felbatol(r)) - sendout
|
$110.00 |
$110.00 |
$110.00 |
$65.00
|
|
Femoral endovas graft add-on 34813
|
$11,977.02 |
$11,977.02 |
$11,977.02 |
$951.36
|
|
Fem/popl revasc w/stent
|
$9,590.00 |
$16,782.48 |
$16,782.48 |
$16,843.00
|
|
Feno poc
|
$97.50 |
$97.50 |
$97.50 |
$97.18
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$32.34 |
$32.34 |
$42.98 |
$101.40
|
|
Fern test
|
$22.50 |
$22.50 |
$22.50 |
$39.65
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$6.73 |
$6.73 |
$6.73 |
$2,590.25
|
|
Ferritin
|
$81.18 |
$81.18 |
$90.00 |
$100.94
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$0.89 |
$11.40 |
$17.29 |
$1,776.61
|
|
Fetal biophys profile w/nst 76818
|
$489.72 |
$489.72 |
$535.00 |
$535.37
|
|
Fetal chrom aneuploidy gsa panel
|
$462.50 |
$462.50 |
$462.50 |
$1,206.81
|
|
Fetal contract stress test 59020 - 26
|
$477.50 |
$494.34 |
$494.34 |
$475.50
|
|
Fetal cord puncture prenatal
|
$790.00 |
$790.00 |
$790.00 |
$714.56
|
|
Fetal fibronectin
|
$320.00 |
$396.00 |
$396.00 |
$373.41
|
