|
Elbow X-ray (2 views, both sides)
|
$274.56 |
$274.56 |
$274.56 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$338.62 |
$338.62 |
$338.62 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$96.31 |
$96.31 |
$96.31 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$77.33 |
$77.33 |
$77.33 |
$81.75
|
|
Electrolyte panel
|
$47.97 |
$47.97 |
$47.97 |
$79.30
|
|
Electron microscopy diagnostic
|
$1,113.66 |
$1,113.66 |
$1,113.66 |
$1,011.98
|
|
Encephalitis, california igg/igm
|
$45.24 |
$45.24 |
$45.24 |
$56.50
|
|
Encephalitis, st louis igg/igm
|
$45.24 |
$45.24 |
$45.24 |
$51.84
|
|
Encephalitis, western equine igg/igm
|
$45.24 |
$45.24 |
$45.24 |
$54.99
|
|
Epidural/lumbar/sacral/ea add level64484
|
$1,603.80 |
$1,603.80 |
$1,603.80 |
$1,182.00
|
|
Epoetin alfa, 100 units esrd
|
$19.09 |
$19.09 |
$19.09 |
$6.00
|
|
Epstein barr early antigen antibody
|
$38.28 |
$38.28 |
$38.28 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$37.58 |
$37.58 |
$37.58 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$43.15 |
$43.15 |
$43.15 |
$85.50
|
|
ER Visit (level 1, minor)
|
$286.51 |
$286.51 |
$286.51 |
$252.60
|
|
ER Visit (level 2)
|
$365.45 |
$365.45 |
$365.45 |
$463.00
|
|
ER Visit (level 3)
|
$814.19 |
$814.19 |
$814.19 |
$812.18
|
|
ER Visit (level 4)
|
$2,142.59 |
$2,142.59 |
$2,142.59 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$3,272.86 |
$3,272.86 |
$3,272.86 |
$1,871.60
|
|
Established Patient Office Visit (level 1)
|
$116.13 |
$116.13 |
$116.13 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$314.10 |
$314.10 |
$314.10 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$616.04 |
$616.04 |
$616.04 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$946.74 |
$946.74 |
$946.74 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$1,336.05 |
$1,336.05 |
$1,336.05 |
$290.68
|
|
Estradiol total
|
$51.66 |
$51.66 |
$51.66 |
$152.10
|
|
Estrogens total-sendout
|
$40.59 |
$40.59 |
$40.59 |
$97.50
|
|
Ethylene glycol -sendout
|
$57.81 |
$57.81 |
$57.81 |
$86.04
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$181.43 |
$181.43 |
$181.43 |
$213.15
|
|
Evaluation psychiatric diagnostic
|
$259.08 |
$259.08 |
$259.08 |
$318.24
|
|
Event monitor
|
$294.24 |
$294.24 |
$294.24 |
$231.00
|
|
Evoked oa emissions ltd
|
$172.96 |
$172.96 |
$172.96 |
$244.00
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$206.90 |
$206.90 |
$206.90 |
$3,386.84
|
|
Explore penetrating wnd/extremity 20103
|
$387.53 |
$387.53 |
$387.53 |
$1,788.80
|
|
External newborn metabolic screening panel
|
$120.58 |
$120.58 |
$120.58 |
$109.76
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$343.82 |
$343.82 |
$343.82 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$366.08 |
$366.08 |
$366.08 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,204.47 |
$2,204.47 |
$2,204.47 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$1,837.26 |
$1,837.26 |
$1,837.26 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,469.44 |
$1,469.44 |
$1,469.44 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,066.77 |
$3,066.77 |
$3,066.77 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,044.51 |
$2,044.51 |
$2,044.51 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$275.97 |
$275.97 |
$275.97 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$322.43 |
$322.43 |
$322.43 |
$381.75
|
|
Factor ix
|
$50.24 |
$50.24 |
$50.24 |
$162.50
|
|
Factor viii
|
$41.98 |
$41.98 |
$41.98 |
$148.00
|
|
Family therapy without pt 50min 90846
|
$246.16 |
$246.16 |
$246.16 |
$244.07
|
|
Family therapy with patient 50 min 90847
|
$256.92 |
$256.92 |
$256.92 |
$236.70
|
|
Fat/lipids feces qualitative
|
$41.82 |
$41.82 |
$41.82 |
$36.00
|
|
Fatty acids nonesterified
|
$42.44 |
$42.44 |
$42.44 |
$72.15
|
|
#fecal-sodium
|
$35.67 |
$35.67 |
$35.67 |
$37.53
|
|
Felbamate (felbatol(r)) - sendout
|
$45.51 |
$45.51 |
$45.51 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$0.88 |
$0.88 |
$0.88 |
$101.40
|
|
Fern test
|
$40.59 |
$40.59 |
$40.59 |
$37.03
|
|
Ferritin
|
$36.90 |
$36.90 |
$36.90 |
$102.48
|
|
Fetal biophys profile w/nst 76818
|
$709.78 |
$709.78 |
$709.78 |
$541.74
|
|
Fetal contract stress test 59020 - 26
|
$886.61 |
$886.61 |
$886.61 |
$477.50
|
|
Fetal fibronectin
|
$119.31 |
$119.31 |
$119.31 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$37.52 |
$37.52 |
$37.52 |
$102.00
|
|
Fetal hemoglobin rosette
|
$18.44 |
$18.44 |
$18.44 |
$67.20
|
|
Fetal non stress test
|
$761.63 |
$761.63 |
$761.63 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$41.20 |
$41.20 |
$41.20 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$19.72 |
$19.72 |
$19.72 |
$120.64
|
|
Fibrin degradation products
|
$50.88 |
$50.88 |
$50.88 |
$75.02
|
|
Fibrinogen activity
|
$19.08 |
$19.08 |
$19.08 |
$87.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$45.16 |
$45.16 |
$45.16 |
$66.60
|
|
Fine needle aspiration biopsy w/us gdn; ea addtl 10006
|
$889.65 |
$889.65 |
$889.65 |
$825.00
|
|
Finger X-ray (both hands)
|
$184.45 |
$184.45 |
$184.45 |
$241.50
|
|
Flebogamma injection
|
$88.67 |
$88.67 |
$88.67 |
$3,438.30
|
|
Flow cytometry marker each additional
|
$80.26 |
$80.26 |
$80.26 |
$97.50
|
|
Flow cytometry one marker technical component
|
$457.37 |
$457.37 |
$457.37 |
$285.00
|
|
Flt3 gene
|
$533.78 |
$533.78 |
$533.78 |
$366.29
|
|
Flt3 gene analysis
|
$267.43 |
$267.43 |
$267.43 |
$216.00
|
|
Fluidotherapy charges pt
|
$58.31 |
$58.31 |
$58.31 |
$101.40
|
|
Fluorescent antibody titer dna
|
$582.55 |
$582.55 |
$582.55 |
$123.65
|
|
Fluoroguide for spine inject 77003-26
|
$342.14 |
$342.14 |
$342.14 |
$495.00
|
|
Fluoroguide needle placement
|
$475.20 |
$475.20 |
$475.20 |
$497.92
|
|
Fluoroscopy (Live X-ray Guidance, up to 1 hour)
|
$528.00 |
$528.00 |
$528.00 |
$503.80
|
|
Folic acid
|
$27.68 |
$27.68 |
$27.68 |
$101.50
|
|
Foot X-ray
|
$312.58 |
$312.58 |
$312.58 |
$355.20
|
|
Foot X-ray (2 views, both feet)
|
$218.24 |
$218.24 |
$218.24 |
$290.40
|
|
Forearm X-ray (both sides)
|
$226.69 |
$226.69 |
$226.69 |
$324.00
|
|
Fresh frozen plasma 8-24 hours collection each unit
|
$44.55 |
$44.55 |
$44.55 |
$155.25
|
|
Fresh frozen plasma frozen within 8 hours of collection each unit
|
$44.55 |
$44.55 |
$44.55 |
$164.84
|
|
Fresh frozen plasma thawing ea un
|
$264.19 |
$264.19 |
$264.19 |
$131.25
|
|
Fructosamine glycated protein
|
$32.59 |
$32.59 |
$32.59 |
$63.50
|
|
Full Spine X-ray (Scoliosis Survey)
|
$350.59 |
$350.59 |
$350.59 |
$355.00
|
|
Full thick gft w/close donor fccmnaghf <=20sqcm 15240
|
$880.11 |
$880.11 |
$880.11 |
$2,798.50
|
|
Gabapentin non-blood
|
$34.44 |
$34.44 |
$34.44 |
$42.35
|
|
Galac-1-phosphate uridyltran - sendout
|
$106.39 |
$106.39 |
$106.39 |
$100.00
|
|
Galactose transferase test
|
$22.14 |
$22.14 |
$22.14 |
$31.35
|
|
Gallbladder and Bile Duct Scan (HIDA Scan)
|
$1,201.42 |
$1,201.42 |
$1,201.42 |
$1,494.00
|
|
Gallbladder Function Scan (HIDA with Medication)
|
$1,645.29 |
$1,645.29 |
$1,645.29 |
$1,615.00
|
|
Gammaglobulin iga
|
$38.74 |
$38.74 |
$38.74 |
$69.60
|
|
Gammaglobulin ige
|
$35.67 |
$35.67 |
$35.67 |
$83.85
|
|
Gamma glutamyltransferase
|
$38.13 |
$38.13 |
$38.13 |
$57.54
|
|
Gastric mucosa imaging
|
$513.08 |
$513.08 |
$513.08 |
$565.00
|
|
Gentamicin peak therapeutic drug level
|
$30.75 |
$30.75 |
$30.75 |
$123.84
|
|
G-esoph reflx tst w/electrod
|
$771.26 |
$771.26 |
$771.26 |
$1,514.00
|
|
Ghs acetylcholinesterase, rbc
|
$36.28 |
$36.28 |
$36.28 |
$43.06
|
|
Ghs antibodies (torch) igm
|
$30.62 |
$30.62 |
$30.62 |
$69.12
|
