|
ER Visit (level 3)
|
$614.35 |
$614.35 |
$614.35 |
$850.50
|
|
ER Visit (level 4)
|
$920.15 |
$920.15 |
$920.15 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$1,736.35 |
$1,736.35 |
$1,736.35 |
$2,007.00
|
|
Esophageal dilat s&i
|
$587.40 |
$587.40 |
$587.40 |
$525.00
|
|
Esophagus motility study
|
$433.40 |
$433.40 |
$433.40 |
$1,289.20
|
|
Establish access to aorta
|
$961.40 |
$961.40 |
$961.40 |
$1,280.06
|
|
Established Patient Office Visit (level 1)
|
$139.70 |
$139.70 |
$139.70 |
$121.00
|
|
Estradiol total
|
$151.80 |
$151.80 |
$151.80 |
$153.00
|
|
Ethylene glycol -sendout
|
$123.75 |
$123.75 |
$123.75 |
$75.00
|
|
Eval/fit voice prosthesis iii, st
|
$235.40 |
$235.40 |
$235.40 |
$370.41
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$77.55 |
$77.55 |
$77.55 |
$219.60
|
|
Evaluation heart device
|
$491.70 |
$491.70 |
$491.70 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$343.20 |
$343.20 |
$343.20 |
$347.75
|
|
Evasc repair of iliac artery; endograft 34718
|
$6,523.55 |
$6,523.55 |
$6,523.55 |
$10,843.20
|
|
Evasc rpr a-unilac ndgft 34703
|
$14,369.30 |
$14,369.30 |
$14,369.30 |
$7,465.20
|
|
Evasc rpr ilio-iliac ndgft
|
$12,877.15 |
$12,877.15 |
$12,877.15 |
$8,412.85
|
|
Event monitor
|
$311.30 |
$311.30 |
$311.30 |
$242.12
|
|
Evoked oa emissions ltd
|
$454.30 |
$454.30 |
$454.30 |
$273.00
|
|
Evoked potentials auditory screening automated analysis
|
$195.25 |
$195.25 |
$195.25 |
$283.62
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$254.10 |
$254.10 |
$254.10 |
$1,045.20
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$510.40 |
$510.40 |
$510.40 |
$1,372.15
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$965.25 |
$965.25 |
$965.25 |
$1,301.30
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$327.80 |
$327.80 |
$327.80 |
$1,061.40
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$449.90 |
$449.90 |
$449.90 |
$2,101.45
|
|
Exchange biliary drg cath
|
$2,527.80 |
$2,527.80 |
$2,527.80 |
$4,176.15
|
|
Exchange drainage catheter
|
$2,562.45 |
$2,562.45 |
$2,562.45 |
$2,256.80
|
|
Exchange nephrostomy cath
|
$2,789.05 |
$2,789.05 |
$2,789.05 |
$3,097.16
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$207.90 |
$207.90 |
$207.90 |
$1,981.25
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$851.40 |
$851.40 |
$851.40 |
$1,064.30
|
|
Exc malig feenl <0.5cm 11640
|
$260.70 |
$260.70 |
$260.70 |
$1,206.78
|
|
Exc malig feenl 1.1-2 11642
|
$393.80 |
$393.80 |
$393.80 |
$1,113.60
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$399.30 |
$399.30 |
$399.30 |
$1,917.33
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$344.85 |
$344.85 |
$344.85 |
$1,246.00
|
|
Exercise tst brncspsm w/ecg
|
$164.45 |
$164.45 |
$164.45 |
$337.50
|
|
Explore penetrating wnd/extremity 20103
|
$1,070.85 |
$1,070.85 |
$1,070.85 |
$1,917.33
|
|
Extended visual field xm
|
$81.40 |
$81.40 |
$81.40 |
$162.75
|
|
External chromosome analysis 20-25 cells
|
$2,397.45 |
$2,397.45 |
$2,397.45 |
$389.35
|
|
External newborn metabolic screening panel
|
$334.95 |
$334.95 |
$334.95 |
$114.75
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$130.90 |
$130.90 |
$130.90 |
$61.32
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$459.25 |
$459.25 |
$459.25 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$55.00 |
$55.00 |
$55.00 |
$102.78
|
|
F-18 fdg pet diag
|
$1,030.15 |
$1,030.15 |
$1,030.15 |
$602.25
|
|
Facial bones <3
|
$187.55 |
$187.55 |
$187.55 |
$248.60
|
|
Factor ix
|
$139.15 |
$139.15 |
$139.15 |
$131.30
|
|
Factor viii
|
$138.60 |
$138.60 |
$138.60 |
$144.30
|
|
Fat/lipids feces qualitative
|
$12.65 |
$12.65 |
$12.65 |
$34.56
|
|
Fatty acids nonesterified
|
$530.75 |
$530.75 |
$530.75 |
$57.60
|
|
Fecal microbiota prep instil
|
$124.30 |
$124.30 |
$124.30 |
$1,059.00
|
|
#fecal-sodium
|
$38.50 |
$38.50 |
$38.50 |
$37.50
|
|
Fem/popl revasc w/stent
|
$7,893.05 |
$7,893.05 |
$7,893.05 |
$18,599.10
|
|
Ferritin
|
$14.85 |
$14.85 |
$14.85 |
$103.68
|
|
Fetal biophys profile w/nst 76818
|
$603.35 |
$603.35 |
$603.35 |
$541.74
|
|
Fetal chrom aneuploidy gsa panel
|
$978.45 |
$978.45 |
$978.45 |
$1,217.45
|
|
Fetal contract stress test 59020 - 26
|
$460.90 |
$460.90 |
$460.90 |
$540.54
|
|
Fetal fibronectin
|
$155.65 |
$155.65 |
$155.65 |
$352.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$62.70 |
$62.70 |
$62.70 |
$88.80
|
|
Fetal hemoglobin rosette
|
$33.55 |
$33.55 |
$33.55 |
$76.70
|
|
Fetal lung maturity assess lam body dnst
|
$88.00 |
$88.00 |
$88.00 |
$64.28
|
|
Fetal non stress test
|
$287.65 |
$287.65 |
$287.65 |
$507.90
|
|
#_fet/norfentcnfrmur
|
$161.70 |
$161.70 |
$161.70 |
$120.85
|
|
Fibrin degradation d dimer quantitative
|
$73.70 |
$73.70 |
$73.70 |
$112.80
|
|
Fibrin degradation products
|
$58.85 |
$58.85 |
$58.85 |
$62.40
|
|
Fibrin degrade semiquant
|
$68.75 |
$68.75 |
$68.75 |
$92.00
|
|
Fibrinogen activity
|
$56.10 |
$56.10 |
$56.10 |
$82.38
|
|
Fibrinolytic plasminogen
|
$109.45 |
$109.45 |
$109.45 |
$109.45
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$124.85 |
$124.85 |
$124.85 |
$59.89
|
|
Filter spider fx 3mmx320cm
|
$871.35 |
$871.35 |
$871.35 |
$6,152.59
|
|
Filter vena cava fem denali
|
$1,038.31 |
$1,038.31 |
$1,038.31 |
$3,467.25
|
|
Fine needle aspiration biopsy without img gdn; ea addtl 10004
|
$457.60 |
$457.60 |
$457.60 |
$261.80
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$457.60 |
$457.60 |
$457.60 |
$806.40
|
|
Fine needle asp without image guide 10021
|
$391.05 |
$391.05 |
$391.05 |
$547.53
|
|
Fl exam g/colon tube w contrast
|
$399.85 |
$399.85 |
$399.85 |
$546.86
|
|
Flow cytometry marker each additional
|
$187.55 |
$187.55 |
$187.55 |
$103.00
|
|
Flow cytometry one marker technical component
|
$330.00 |
$330.00 |
$330.00 |
$270.75
|
|
Fluidotherapy charges pt
|
$177.65 |
$177.65 |
$177.65 |
$95.00
|
|
Fluorescent antibody titer dna
|
$639.65 |
$639.65 |
$639.65 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$436.70 |
$436.70 |
$436.70 |
$507.00
|
|
Fluoroguide needle placement
|
$377.30 |
$377.30 |
$377.30 |
$536.26
|
|
Fluoroscopy up to 1 hour
|
$323.95 |
$323.95 |
$323.95 |
$494.52
|
|
Folic acid
|
$96.25 |
$96.25 |
$96.25 |
$90.60
|
|
Follow-up angiography
|
$1,009.80 |
$1,009.80 |
$1,009.80 |
$1,939.14
|
|
Foot X-ray
|
$264.00 |
$264.00 |
$264.00 |
$362.40
|
|
Foreskn manip w/lss preputial ads+stretching 54450
|
$372.35 |
$372.35 |
$372.35 |
$595.80
|
|
Fracture assessment via dxa
|
$252.45 |
$252.45 |
$252.45 |
$146.80
|
|
Fragmenting of kidney stone
|
$7,471.20 |
$7,471.20 |
$7,471.20 |
$9,827.25
|
|
Frenectomy 41115
|
$288.20 |
$288.20 |
$288.20 |
$1,744.44
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$389.40 |
$389.40 |
$389.40 |
$168.75
|
|
Frozen blood thaw
|
$212.30 |
$212.30 |
$212.30 |
$189.84
|
|
Fructosamine glycated protein
|
$11.70 |
$11.70 |
$11.70 |
$60.42
|
|
Ftl cgen abnor four anal
|
$46.20 |
$46.20 |
$46.20 |
$211.83
|
|
G6pd full gene sequence
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$1,320.00
|
|
Galac-1-phosphate uridyltran - sendout
|
$82.50 |
$82.50 |
$82.50 |
$82.50
|
|
Gallium locametz 1 millicuri
|
$2,066.13 |
$2,066.13 |
$2,066.13 |
$873.44
|
|
Gammaglobulin iga
|
$68.75 |
$68.75 |
$68.75 |
$75.30
|
|
Gammaglobulin ige
|
$88.00 |
$88.00 |
$88.00 |
$85.00
|
|
Gamma glutamyltransferase
|
$27.50 |
$27.50 |
$27.50 |
$55.28
|
|
Gastric emptying imag study
|
$517.55 |
$517.55 |
$517.55 |
$1,270.50
|
|
Gastric emptying imag study
|
$996.60 |
$996.60 |
$996.60 |
$1,664.33
|
|
General health panel
|
$280.50 |
$280.50 |
$280.50 |
$280.50
|
|
Generator barostim neo2 2014
|
$6,160.82 |
$6,160.82 |
$6,160.82 |
$54,121.91
|
