Elliot Health System is a non-profit organization serving your healthcare needs since 1890.

Full Price List

Access to csv file
https://www.elliothospital.org/website/ehs-2020-price-lists/Full-Price-list.csv


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Category

Charge Code

Description

1/1/2020

Unit Charge

2

BREAST HEALTH

7610011971

HC REMOVE TISSUE EXPANDER

$ 3,249.00 

3

BREAST HEALTH

3610019000

HC ASPIRATE BREAST CYST

$ 759.00 

4

BREAST HEALTH

3610019001

HC ASPIRATE BREAST CYST EA ADDL CYST

$ 474.00 

5

BREAST HEALTH

7610019020

HC I&D BREAST ABSCESS W/EXPLORATION DEEP

$ 3,637.00 

6

BREAST HEALTH

3610019081

HC BX BREAST WITH STEREO GUIDANCE 1ST LESION

$ 6,015.00 

7

BREAST HEALTH

3610019082

HC BX BREAST WITH STEREO GUIDANCE EA ADDL LESION

$ 2,276.00 

8

BREAST HEALTH

3610019083

HC BX BREAST WITH US GUIDANCE 1ST LESION

$ 5,765.00 

9

BREAST HEALTH

3610019084

HC BX BREAST WITH US GUIDANCE EA ADDL LESION

$ 1,821.00 

10

BREAST HEALTH

3610019085

HC BX BREAST WITH MR GUIDANCE 1ST LESION

$ 8,020.00 

11

BREAST HEALTH

3610019086

HC BX BREAST WITH MR GUIDANCE EA ADDL LESION

$ 2,883.00 

12

BREAST HEALTH

7610019281

HC PLACE LOCALIZATION DEVICE BREAST WITH MAMMO GUIDANCE 1ST LESION

$ 2,340.00 

13

BREAST HEALTH

7610019282

HC PLACE LOCALIZATION DEVICE BREAST WITH MAMMO GUIDANCE EA ADDL LESION

$ 776.00 

14

BREAST HEALTH

7610019283

HC PLACE LOCALIZATION DEVICE BREAST WITH STEREO GUIDANCE 1ST LESION

$ 490.00 

15

BREAST HEALTH

7610019284

HC PLACE LOCALIZATION DEVICE BREAST WITH STEREO GUIDANCE EA ADDL LESION

$ 490.00 

16

BREAST HEALTH

3610019285

HC PLACE LOCALIZATION DEVICE BREAST WITH US GUIDANCE 1ST LESION

$ 1,149.00 

17

BREAST HEALTH

4020076376

HC 3D RENDERING POST PROCESSING NON-INDEPENDENT WORKSTATN

$ 608.00 

18

BREAST HEALTH

6100077047

HC MRI BREAST W/O CONTRAST BILATERAL

$ 2,194.00 

19

BREAST HEALTH

6100077048

HC MRI BREAST WO/W CONTRAST W/CAD UNI

$ 2,768.00 

20

BREAST HEALTH

6100077049

HC MRI BREAST W & W/O CONTRAST CAD BI

$ 5,535.00 

21

BREAST HEALTH

4010077061

HC TOMOSYNTHESIS DIAGNOSTIC UNILATERAL

$ 189.00 

22

BREAST HEALTH

4010077062

HC TOMOSYNTHESIS DIAGNOSTIC BILATERAL

$ 189.00 

23

BREAST HEALTH

4030077063

HC TOMOSYNTHESIS, SCREENING, BILAT

$ 189.00 

24

BREAST HEALTH

4010077065

HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCL CAD

$ 690.00 

25

BREAST HEALTH

4010077066

HC BIL MAMMO DX INCL CAD

$ 878.00 

26

BREAST HEALTH

4030077067

HC BI MAMMOGRAM SCREENING BILAT

$ 730.00 

27

BREAST HEALTH

61000C8937

HC CAD BREAST MRI

$ 146.00 

28

CARDIOVASCULAR

731000296T

HC EXT ECG RECORDING >48HR TO 21 DAY

$ 350.00 

29

CARDIOVASCULAR

731000297T

HC EXT ECG SCAN W/REPORT >48HR TO 21 DAY

$ 445.00 

30

CARDIOVASCULAR

3610033010

HC PERICARDIOCENTESIS INITIAL

$ 900.00 

31

CARDIOVASCULAR

3610033207

HC INSERT NEW/REPLACE PPM RV

$ 5,850.00 

32

CARDIOVASCULAR

3610033208

HC INSERT NEW/REPLACE PPM RA & RV

$ 7,200.00 

33

CARDIOVASCULAR

3610033210

HC INSERT NEW/REPLACE TEMP PACING LEAD

$ 4,500.00 

34

CARDIOVASCULAR

3610033215

HC REPOSITION LEAD RA OR RV PPM/ICD

$ 3,600.00 

35

CARDIOVASCULAR

3610033216

HC INSERT SINGLE LEAD PPM/ICD

$ 4,500.00 

36

CARDIOVASCULAR

3610033223

HC RELOCATE ICD POCKET

$ 3,725.00 

37

CARDIOVASCULAR

3610033224

HC UPGRADE BIVENTRICULAR PACEMAKER (EXISTING)

$ 8,000.00 

38

CARDIOVASCULAR

3610033225

HC INSERT LV LEAD WITH NEW GENERATOR

$ 6,300.00 

39

CARDIOVASCULAR

3610033227

HC REPLACE PPM SINGLE

$ 7,200.00 

40

CARDIOVASCULAR

3610033228

HC REPLACE PPM DUAL

$ 8,100.00 

41

CARDIOVASCULAR

3610033229

HC REPLACE PPM MULTI

$ 8,100.00 

42

CARDIOVASCULAR

3610033233

HC REMOVE PPM ONLY

$ 2,700.00 

43

CARDIOVASCULAR

3610033234

HC REMOVE LEAD SINGLE

$ 2,430.00 

44

CARDIOVASCULAR

3610033235

HC REMOVE LEAD DUAL

$ 2,250.00 

45

CARDIOVASCULAR

3610033241

HC REMOVE ICD ONLY

$ 2,520.00 

46

CARDIOVASCULAR

3610033249

HC INSERT/REPLACE ICD WITH LEAD(S)

$ 9,000.00 

47

CARDIOVASCULAR

3610033262

HC REPLACE ICD SINGLE

$ 8,100.00 

48

CARDIOVASCULAR

3610033263

HC REPLACE ICD DUAL

$ 9,000.00 

49

CARDIOVASCULAR

3610033264

HC REPLACE ICD MULTI

$ 9,000.00 

50

CARDIOVASCULAR

3610033270

HC INSERT/REPLACE SQ ICD SYSTEM W ALL PROGRAM/TESTING

$ 12,000.00 

51

CARDIOVASCULAR

3610033273

HC REPOSITION LEAD SQ ICD

$ 3,725.00 

52

CARDIOVASCULAR

3610033285

HC INSERT SUBQ CAR RHYTHM MNTR

$ 4,050.00 

53

CARDIOVASCULAR

3610033286

HC RMVL SUBQ CAR RHYTHM MNTR

$ 1,710.00 

54

CARDIOVASCULAR

3610033967

HC INSERT INTRA AORTIC BALLOON PUMP

$ 3,150.00 

55

CARDIOVASCULAR

3610033990

HC INSERT VAD ARTERY ACCESS

$ 13,770.00 

56

CARDIOVASCULAR

3610033992

HC REMOVE VAD DIFFERENT SESSION

$ 10,350.00 

57

CARDIOVASCULAR

3610033993

HC REPOSITION VAD DIFF SESSION

$ 7,650.00 

58

CARDIOVASCULAR

3610034705

HC EVAR AORTO BI-ILIAC GRAFT

$ 15,531.00 

59

CARDIOVASCULAR

3610134707

HC EVASC RPR ILIO-ILIAC NDGFT

$ 12,553.00 

60

CARDIOVASCULAR

3610034709

HC EVAR PROXIMAL/DISTAL EXTENSION

$ 6,750.00 

61

CARDIOVASCULAR

3610034710

HC EVAR DELAYED PROXIMAL/DISTAL EXTENSION

$ 7,425.00 

62

CARDIOVASCULAR

3610034713

HC EVAR ACCESS FEMORAL FOR 12F< SHEATH

$ 5,850.00 

63

CARDIOVASCULAR

4500235206

HC REPR BLD VSL DIRECT UPPER EXTREMITY

$ 6,300.00 

64

CARDIOVASCULAR

4500235226

HC REPAIR BLOOD VSL,LWR EXTREMITY

$ 1,530.00 

65

CARDIOVASCULAR

4500236000

HC NDL INTRO/INTRACATH

$ 187.00 

66

CARDIOVASCULAR

3610036002

HC INJ PSEUDOANEURYSM EXTREMITY

$ 540.00 

67

CARDIOVASCULAR

3610036005

HC INJ EXTREMITY VENOGRAM

$ 315.00 

68

CARDIOVASCULAR

3610136005

HC INJ EXTREMITY VENOGRAM

$ 315.00 

69

CARDIOVASCULAR

3610036010

HC INTRO CATHETER SVC OR IVC

$ 3,616.00 

70

CARDIOVASCULAR

3610036011

HC INTRO CATHETER VEIN 1ST ORDER

$ 765.00 

71

CARDIOVASCULAR

3610036012

HC INTRO CATHETER VEIN 2ND< ORDER

$ 900.00 

72

CARDIOVASCULAR

3610036014

HC INTRO CATHETER RT/LT PULMONARY ARTERY

$ 5,136.00 

73

CARDIOVASCULAR

3610036015

HC INTRO CATHETER PULMONARY SEGMENTAL ARTERY

$ 5,603.00 

74

CARDIOVASCULAR

3610036140

HC INTRO NEEDLE/CATHETER EXTREMITY ARTERY

$ 3,152.00 

75

CARDIOVASCULAR

3610036200

HC INTRO CATHETER AORTA

$ 4,487.00 

76

CARDIOVASCULAR

3610036215

HC INTRO CATHETER UPPER ARTERY 1ST ORDER

$ 7,939.00 

77

CARDIOVASCULAR

3610036216

HC CATH PLACE,ART,THORAX,2ND ORDER

$ 1,957.00 

78

CARDIOVASCULAR

3610036217

HC CATH PLACE,ART,THORAX,3RD ORDER

$ 1,957.00 

79

CARDIOVASCULAR

3610036218

HC CATH PL ART ADD'L 2/3 THORACIC

$ 761.00 

80

CARDIOVASCULAR

3610036221

HC ARCH ANGIOGRAM COMPLETE

$ 8,029.00 

81

CARDIOVASCULAR

3610036245

HC INTRO CATHETER LOWER ARTERY 1ST ORDER

$ 9,823.00 

82

CARDIOVASCULAR

3610036246

HC INTRO CATHETER LOWER ARTERY 2ND ORDER

$ 2,893.00 

83

CARDIOVASCULAR

3610036247

HC INTRO CATHETER LOWER ARTERY 3RD ORDER

$ 3,240.00 

84

CARDIOVASCULAR

3610036248

HC INTRO CATHETER LOWER ARTERY ADDL 2ND OR < ORDER

$ 867.00 

85

CARDIOVASCULAR

3610036251

HC RENAL ANGIOGRAM 1ST ORDER UNILAT COMPLETE

$ 5,784.00 

86

CARDIOVASCULAR

3610036252

HC RENAL ANGIOGRAM 1ST ORDER BILAT COMPLETE

$ 11,569.00 

87

CARDIOVASCULAR

3610036253

HC RENAL ANGIOGRAM 2ND+ ORDER UNILAT COMPLETE

$ 6,363.00 

88

CARDIOVASCULAR

3610036254

HC RENAL ANGIOGRAM 2ND+ ORDER BILAT COMPLETE

$ 12,726.00 

89

CARDIOVASCULAR

3910036430

HC BLOOD TRANSFUSION

$ 940.00 

90

CARDIOVASCULAR

3910236430

HC BLOOD TRANSFUSION

$ 940.00 

91

CARDIOVASCULAR

7610036468

HC INJ SPIDER VEINS SNGL/MULTI

$ 331.00 

92

CARDIOVASCULAR

3610036481

HC INSERT CATH VEIN PERC

$ 1,620.00 

93

CARDIOVASCULAR

7610036555

HC INSERT NON-TUNNEL CV CATH < 5YRS W/CS

$ 1,334.00 

94

CARDIOVASCULAR

3610036556

HC INSERT NON TUNNELED CVC 5+ YRS

$ 2,247.00 

95

CARDIOVASCULAR

4500236556

HC INSERT NON-TUNNEL CV CATH >5

$ 2,247.00 

96

CARDIOVASCULAR

7610036556

HC INSERT NON-TUNNEL CV CATH > 5YRS

$ 2,247.00 

97

CARDIOVASCULAR

3610036558

HC INSERT TUNNELED CVC 5+ YRS

$ 1,897.00 

98

CARDIOVASCULAR

3610036561

HC INSERT TUNNELED CVAD (PORT) 5+ YRS

$ 3,793.00 

99

CARDIOVASCULAR

3610036568

INSJ PICC <5YR W/O IMAGING

$ 1,982.00 

100

CARDIOVASCULAR

3610036569

INSJ PICC 5 YR+ W/O IMAGING

$ 1,937.00 

101

CARDIOVASCULAR

3610136569

HC INSERT PICC 5+ YRS

$ 1,937.00 

102

CARDIOVASCULAR

4500236569

HC INSERT TUNNELED CV CATH,>5 YRS

$ 1,937.00 

103

CARDIOVASCULAR

3610036572

HC INSERTION PICC W/RS&I<5 YR

$ 1,411.00 

104

CARDIOVASCULAR

3610136572

HC INSERTION PICC W/RS&I<5 YR

$ 1,411.00 

105

CARDIOVASCULAR

4500036572

HC INSERTION PICC W/RS&I<5 YR

$ 1,411.00 

106

CARDIOVASCULAR

3610036573

HC INSERTION PICC W/RS&I 5 YR+

$ 1,743.00 

107

CARDIOVASCULAR

3610136573

HC INSERTION PICC W/RS&I 5 YR+

$ 1,743.00 

108

CARDIOVASCULAR

4500036573

HC INSERTION PICC W/RS&I 5 YR+

$ 1,743.00 

109

CARDIOVASCULAR

3610036575

HC REP TUN CV CATH W/O SUBQ PRT/PMP

$ 1,254.00 

110

CARDIOVASCULAR

3610036576

HC REPAIR CVAD (PORT)

$ 3,560.00 

111

CARDIOVASCULAR

3610036580

HC REPLACE NON TUNNELED CVC SAME ACCESS

$ 2,402.00 

112

CARDIOVASCULAR

3610036581

HC REPLACE TUNNELED CVC SAME ACCESS

$ 3,793.00 

113

CARDIOVASCULAR

3610036582

HC REPLACE TUNNELED CVAD (PORT) SAME ACCESS

$ 5,690.00 

114

CARDIOVASCULAR

3610036584

COMPLETE RPLCMT PICC W/IMAGE GDN

$ 1,517.00 

115

CARDIOVASCULAR

3610036589

HC REMOVE TUNNELED CVC

$ 1,982.00 

116

CARDIOVASCULAR

3610036590

HC REMOVE TUNNELED CVAD (PORT)

$ 2,402.00 

117

CARDIOVASCULAR

3610036593

HC DECLOT/THROMBOLYSIS CVC OR CVAD

$ 809.00 

118

CARDIOVASCULAR

3610036595

HC FIBRIN SHEATH REMOVAL CVAD CVC SEPARATE ACCESS

$ 3,793.00 

119

CARDIOVASCULAR

3610036596

HC MECH REMOV TUNNELED CV CATH

$ 2,478.00 

120

CARDIOVASCULAR

3610036597

HC REPOSITION CVC WITH FLUORO

$ 1,644.00 

121

CARDIOVASCULAR

7610036598

HC INJ EVALUATION CVC CVAD WITH FLUORO

$ 728.00 

122

CARDIOVASCULAR

3610036620

HC INTRO CATHETER/CANNULA SAMPLING/MONITORING/TRANSFUSION PERC

$ 270.00 

123

CARDIOVASCULAR

3610136620

HC ARTERIAL LINE

$ 270.00 

124

CARDIOVASCULAR

4500236620

HC ARTERIAL CATH, SAMPLING,PERC

$ 270.00 

125

CARDIOVASCULAR

4500236680

HC PLACE NEEDLE,INTRAOSSEOUS INFUSION

$ 430.00 

126

CARDIOVASCULAR

7610036680

HC PLACE NDL INTRAOSSEOUS INFUSION

$ 430.00 

127

CARDIOVASCULAR

3610036901

HC AV FISTULOGRAM DIAGNOSTIC COMPLETE

$ 5,962.00 

128

CARDIOVASCULAR

3610036902

HC AV FISTULOGRAM PTA PERIPHERAL COMPLETE

$ 11,700.00 

129

CARDIOVASCULAR

3610036903

HC AV FISTULOGRAM STENT PERIPHERAL COMPLETE

$ 9,900.00 

130

CARDIOVASCULAR

3610036904

HC AV FISTULOGRAM THROMBOLYSIS COMPLETE

$ 6,570.00 

131

CARDIOVASCULAR

3610036905

HC AV FISTULOGRAM THROMBOLYSIS WITH PTA PERIPHERAL COMPLETE

$ 14,220.00 

132

CARDIOVASCULAR

3610036906

HC AV FISTULOGRAM THROMBOLYSIS WITH STENT PERIPHERAL COMPLETE

$ 14,400.00 

133

CARDIOVASCULAR

3610036907

HC AV FISTULOGRAM PTA CENTRAL

$ 10,116.00 

134

CARDIOVASCULAR

3610036908

HC AV FISTULOGRAM STENT CENTRAL

$ 9,900.00 

135

CARDIOVASCULAR

3610036909

HC AV FISTULOGRAM EMBOLIZATION/OCCLUSION

$ 9,900.00 

136

CARDIOVASCULAR

3610037182

HC INSERT TIPS COMPLETE

$ 11,380.00 

137

CARDIOVASCULAR

3610037183

HC REIVSE TIPS COMPLETE

$ 10,115.00 

138

CARDIOVASCULAR

3610037184

HC MECH THROMBECTOMY 1ST ARTERY WITH GUIDANCE

$ 14,412.00 

139

CARDIOVASCULAR

3610037185

HC MECH THROMBECTOMY 2ND+ ARTERY(S) SAME FAMILY WITH GUIDANCE

$ 6,069.00 

140

CARDIOVASCULAR

3610037187

HC MECH THROMBECTOMY 1ST DAY VENOUS WITH GUIDANCE

$ 8,344.00 

141

CARDIOVASCULAR

3610037188

HC MECH THROMBECTOMY FU DAY VENOUS WITH GUIDANCE

$ 8,344.00 

142

CARDIOVASCULAR

3610037191

HC INSERT INTRAVASCULAR VENA CAVA FILTER W/IMAGE W/CS

$ 7,586.00 

143

CARDIOVASCULAR

3610037193

HC RETRIEVAL INTRAVASCULAR VENA CAVA FILTER W/CS

$ 3,600.00 

144

CARDIOVASCULAR

3610037197

HC TRANSCATH RETREVE PERC,FB,RAD,SUP IMAGE GUIDE W/CS

$ 9,103.00 

145

CARDIOVASCULAR

3610037200

HC TRANSCATHETER BIOPSY

$ 9,103.00 

146

CARDIOVASCULAR

3610037211

HC TRANSCATH THER,ART INFU THROMBOLYSIS INI DAY

$ 3,034.00 

147

CARDIOVASCULAR

3610037212

HC TRANSCATH THER,VEN INFUS THROMBOLYSIS INI DAY

$ 3,034.00 

148

CARDIOVASCULAR

3610037213

HC TRANSCATH THER,ART/VEN INFS THROMBOLYSIS SUBS DAY

$ 6,827.00 

149

CARDIOVASCULAR

3610037214

HC CESSATION OF THROMBOLYSIS REM CATH/VESSEL CLOSURE

$ 6,827.00 

150

CARDIOVASCULAR

3610037220

HC ILIAC UNI INIT VSL W/ANGIOPL W/CS

$ 9,000.00 

151

CARDIOVASCULAR

3610037221

ILIAC INIT VSL W/STNT/ANGIOPL W/CS

$ 13,500.00 

152

CARDIOVASCULAR

3610037223

HC ILIAC EA ADDL IPSILAT VSL W/STNT/ANGIOPL W/CS

$ 7,200.00 

153

CARDIOVASCULAR

3610037224

HC FEM/POPL UNI W/ANGIOPL W/CS

$ 9,900.00 

154

CARDIOVASCULAR

3610037225

HC FEM/POPL UNI W/ATHERECT/ANGIOPL W/CS

$ 13,500.00 

155

CARDIOVASCULAR

3610037226

HC FEM/POPL UNI W/STNT/ANGIOPL W/CS

$ 13,500.00 

156

CARDIOVASCULAR

3610037227

HC FEM/POPL UNI W/STNT/ATHERECT/ANGIOPL W/CS

$ 18,000.00 

157

CARDIOVASCULAR

3610037228

HC TIB/PERONEAL UNI INIT VSL W/ANGIOPL W/CS

$ 7,200.00 

158

CARDIOVASCULAR

3610037229

HC TIB/PERONEAL UNI INIT VSL W/ATHERECT/ANGIOPL W/CS

$ 13,500.00 

159

CARDIOVASCULAR

3610037230

HC TIB/PERONEAL UNI INIT VSL W/STNT/ANGIOPL W/CS

$ 13,500.00 

160

CARDIOVASCULAR

3610037232

HC TIB/PERONEAL UNI ADDL VSL W/ANGIOPL W/CS

$ 6,500.00 

161

CARDIOVASCULAR

3610037233

HC TIB/PERONEAL UNI ADDL VSL W/ATHERECT/ANGIOPL W/CS

$ 8,100.00 

162

CARDIOVASCULAR

3610037236

HC OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITAL ART

$ 7,650.00 

163

CARDIOVASCULAR

3610037237

HC OPEN/PERQ PLMT INTRAVASC STENT SAME 1ST, EA ADDL ART

$ 4,050.00 

164

CARDIOVASCULAR

3610037238

HC OPEN/PERQ PLACEMENT INTRAVSC STENT SAME 1ST VEIN

$ 8,100.00 

165

CARDIOVASCULAR

3610037241

HC VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I

$ 21,239.00 

166

CARDIOVASCULAR

3610037242

HC VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I

$ 21,239.00 

167

CARDIOVASCULAR

3610037243

HC VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT

$ 21,239.00 

168

CARDIOVASCULAR

3610037244

HC VASCULAR EMBOLIZATION OR OCCULSION HEMORRHAGE

$ 21,239.00 

169

CARDIOVASCULAR

3610037246

HC TRLUML BALO ANGIOP 1ST ART

$ 13,162.00 

170

CARDIOVASCULAR

3610037247

HC TRLUML BALO ANGIOP ADDL ART

$ 6,581.00 

171

CARDIOVASCULAR

3610037248

HC TRLUML BALO ANGIOP 1ST VEIN

$ 12,262.00 

172

CARDIOVASCULAR

3610037252

HC INTRVASC US NONCORONARY 1ST VSL

$ 759.00 

173

CARDIOVASCULAR

7610037609

HC LIGATION/BIOPSY, TEMPORAL ARTERY

$ 4,060.00 

174

CARDIOVASCULAR

3610037799

HC SUCTION THROMBECTOMY BILATERAL PULMONARY ARTERIES

$ 9,072.00 

175

CARDIOVASCULAR

3610038221

HC DX BONE MARROW BIOPSIES

$ 1,719.00 

176

CARDIOVASCULAR

3610038222

HC DX BONE MARROW BX & ASPIR

$ 1,635.00 

177

CARDIOVASCULAR

3610038505

HC BIOPSY,LYMPH,NEEDLE,SUPER (38505)

$ 1,897.00 

178

CARDIOVASCULAR

3610038792

HC INJ SENTINEL NODE W/O IMAGE (RADIOACTIVE TRACER)

$ 823.00 

179

CARDIOVASCULAR

4810092920

HC CORONARY TX PTA

$ 8,262.00 

180

CARDIOVASCULAR

4810092921

HC CORONARY TX PTA EA ADDL

$ 8,262.00 

181

CARDIOVASCULAR

4810092928

HC CORONARY TX DE STENT

$ 11,475.00 

182

CARDIOVASCULAR

4810092929

HC CORONARY TX DE STENT EA ADDL

$ 11,475.00 

183

CARDIOVASCULAR

4810092937

HC PRQ TRLUML CORONARY BYP GRAFT REVASC ONE VESSEL

$ 13,770.00 

184

CARDIOVASCULAR

4810092941

HC CORONARY TX ACUTE DE STENT

$ 12,852.00 

185

CARDIOVASCULAR

4810192941

HC PRQ CARD REVASC MI 1 VSL

$ 14,280.00 

186

CARDIOVASCULAR

4810092943

HC CORONARY TX CTO DE STENT

$ 13,770.00 

187

CARDIOVASCULAR

4810192943

HC PERC TRANSLUM REVASCU CHRONIC TOTL OCCL SNT SNG W/CS

$ 15,300.00 

188

CARDIOVASCULAR

4500092950

HC CPR CODE 9

$ 437.00 

189

CARDIOVASCULAR

4500192950

HC CPR

$ 437.00 

190

CARDIOVASCULAR

4500292950

HC CPR

$ 437.00 

191

CARDIOVASCULAR

4500092960

HC CARDIOVERSION EXTERNAL W/CS

$ 1,586.00 

192

CARDIOVASCULAR

4500292960

HC CARDIOVERSION EXTERNAL W/CS

$ 1,586.00 

193

CARDIOVASCULAR

4800092961

HC CARDIOVERSION PPM ELECTIVE

$ 1,556.00 

194

CARDIOVASCULAR

4800092973

HC CORONARY MECH THROMBECTOMY

$ 6,750.00 

195

CARDIOVASCULAR

4810092978

ENDOLUMINL IVUS OCT C 1ST

$ 3,247.00 

196

CARDIOVASCULAR

4810092979

ENDOLUMINL IVUS OCT C EA

$ 1,990.00 

197

CARDIOVASCULAR

7300093005

HC EKG

$ 212.00 

198

CARDIOVASCULAR

4820093017

HC ECG STRESS

$ 731.00 

199

CARDIOVASCULAR

7300093041

HC RHYTHM ECG TRACING 1-3 LEADS

$ 139.00 

200

CARDIOVASCULAR

7310093225

HC CARDIAC MONITOR UPTO 48HR CONT RHYTHM

$ 406.00 

201

CARDIOVASCULAR

7310093226

HC HOLTER MONITOR SCAN W/REPORT CONT RHYTHM

$ 516.00 

202

CARDIOVASCULAR

4800093260

HC PROGRAMMING (INC INTERROGATION) SUBQ ICD

$ 326.00 

203

CARDIOVASCULAR

4800093261

HC INTERROGATION SUBQ ICD

$ 326.00 

204

CARDIOVASCULAR

7310093270

HC MONITOR RECORDING EXT AUTO ACT 30 DAYS

$ 306.00 

205

CARDIOVASCULAR

7310093271

HC LONG TERM MONITOR/ANALYSIS (WEARABLE PT ACT)

$ 882.00 

206

CARDIOVASCULAR

7390093279

HC PROGRAMMING DEV EVAL SINGLE LEAD PACEMAKER

$ 193.00 

207

CARDIOVASCULAR

4830093280

HC PROGRAMMING (INC INTERROGATION) PPM DUAL

$ 159.00 

208

CARDIOVASCULAR

4830093281

HC PROGRAMMING (INC INTERROGATION) PPM MULTI

$ 177.00 

209

CARDIOVASCULAR

4830093282

HC PROGRAMMING (INC INTERROGATION) ICD SINGLE

$ 182.00 

210

CARDIOVASCULAR

4830093283

HC PROGRAMMING (INC INTERROGATION) ICD DUAL

$ 290.00 

211

CARDIOVASCULAR

4830093284

HC PROGRAMMING (INC INTERROGATION) ICD MULTI

$ 320.00 

212

CARDIOVASCULAR

4830093288

HC INTERROGATION IN PERSON PPM

$ 366.00 

213

CARDIOVASCULAR

4830093289

HC INTERROGATION IN PERSON ICD

$ 588.00 

214

CARDIOVASCULAR

4830093291

HC INTERROGATION IN PERSON LOOP RECORDER

$ 350.00 

215

CARDIOVASCULAR

4830093293

HC TELEPHONIC PPM UP TO 90 DAYS

$ 239.00 

216

CARDIOVASCULAR

4830093296

HC INTERROGATION REMOTE TECHNICAL PPM UP TO 90 DAYS

$ 237.00 

217

CARDIOVASCULAR

4830093299

HC INTERROGATION REMOTE TECHNICAL LOOP RECORDER UP TO 90 DAYS

$ 269.00 

218

CARDIOVASCULAR

4830093303

HC ECHO TTE CONGENITAL COMPLETE

$ 1,489.00 

219

CARDIOVASCULAR

4830193303

HC ECHOCARD CONGENITAL COMPLETE

$ 1,489.00 

220

CARDIOVASCULAR

4830093304

HC ECHO TTE CONGENITAL FU/LIMITED

$ 934.00 

221

CARDIOVASCULAR

4830093306

HC ECHO TTE COMPLETE W CF & SW DOPPLER

$ 1,614.00 

222

CARDIOVASCULAR

4830193306

HC ECHO CARD REALTIME COMPL W/DOPPLER (M-MODE)

$ 1,614.00 

223

CARDIOVASCULAR

4830093308

HC ECHO TTE FU/LIMITED

$ 817.00 

224

CARDIOVASCULAR

4830193308

HC ECHOCARD REAL TIME LIMITED (FAST)

$ 817.00 

225

CARDIOVASCULAR

4830293308

HC ECHOCARD REAL TIME LIMITED (FAST)

$ 817.00 

226

CARDIOVASCULAR

4830393308

HC ECHOCARD REALTIME LIMIT OR F/U (M-MODE)

$ 817.00 

227

CARDIOVASCULAR

4830093312

HC ECHO TEE

$ 2,234.00 

228

CARDIOVASCULAR

4830193312

HC ECHO-TRANSESOPHAGEAL INT/REP W/CS

$ 2,234.00 

229

CARDIOVASCULAR

4830093320

HC ECHO DOPPLER SPECTRAL WAVE COMPLETE

$ 639.00 

230

CARDIOVASCULAR

4830093321

HC ECHO DOPPLER SPECTRAL WAVE LIMITED

$ 409.00 

231

CARDIOVASCULAR

4830093325

HC ECHO DOPPLER COLOR FLOW

$ 621.00 

232

CARDIOVASCULAR

4830093350

HC ECHO STRESS STATIC

$ 1,489.00 

233

CARDIOVASCULAR

4830093351

HC ECHO STRESS CONTINUOUS

$ 1,986.00 

234

CARDIOVASCULAR

4830193351

HC STRESS TTE COMPLETE W/CONT ECG

$ 1,986.00 

235

CARDIOVASCULAR

4810093451

HC RHC

$ 6,703.00 

236

CARDIOVASCULAR

4810093452

HC LHC

$ 7,344.00 

237

CARDIOVASCULAR

4810093454

HC CORONARY ANGIO

$ 7,488.00 

238

CARDIOVASCULAR

4810093455

HC CORONARY ANGIO WITH GRAFTS

$ 8,620.00 

239

CARDIOVASCULAR

4810093456

HC CORONARY ANGIO WITH RHC

$ 10,373.00 

240

CARDIOVASCULAR

4810093457

HC CORONARY ANGIO WITH GRAFTS WITH RHC

$ 10,373.00 

241

CARDIOVASCULAR

4810093458

HC CORONARY ANGIO WITH LHC

$ 9,828.00 

242

CARDIOVASCULAR

4810093459

HC CORONARY ANGIO WITH GRAFTS WITH LHC

$ 10,296.00 

243

CARDIOVASCULAR

4810093460

HC CORONARY ANGIO WITH RHC WITH LHC

$ 10,296.00 

244

CARDIOVASCULAR

4810093461

HC CORONARY ANGIO WITH GRAFTS WITH RHC WITH LHC

$ 12,168.00 

245

CARDIOVASCULAR

4120093463

HC DRUG ADMIN & HEMODYNMIC MEAS

$ 565.00 

246

CARDIOVASCULAR

4810093567

HC INJ SUPRAVALVULAR AORTA DURING CORONARY ANGOP

$ 627.00 

247

CARDIOVASCULAR

4800093571

HC CORONARY FFR DOPPLER

$ 3,243.00 

248

CARDIOVASCULAR

4800093609

HC EP MAPPING 2D

$ 4,233.00 

249

CARDIOVASCULAR

4800093613

HC EP MAPPING 3D

$ 2,684.00 

250

CARDIOVASCULAR

4800093619

HC EP COMPREHENSIVE STUDY WO INDUCTION ARRHYTHMIA

$ 7,650.00 

251

CARDIOVASCULAR

4800093620

HC EP COMPREHENSIVE STUDY WITH INDUCTION ARRHYTHMIA

$ 8,100.00 

252

CARDIOVASCULAR

4800093621

HC EP LA PACING/RECORDING FROM CS OR LA

$ 3,600.00 

253

CARDIOVASCULAR

4800093623

HC EP PROGRAMMED STIMULATION AFTER IV INFUSION

$ 3,150.00 

254

CARDIOVASCULAR

4800093641

HC DFT TESTING OF ICD AT TIME OF IMPLANT ALL LEADS AND GENERATOR

$ 3,334.00 

255

CARDIOVASCULAR

4800093644

HC SUBQ EVAL W ARRYTHMIA INDUCTION

$ 3,634.00 

256

CARDIOVASCULAR

4800093650

HC EP ABLATION AV NODE

$ 9,450.00 

257

CARDIOVASCULAR

4800093653

HC EP ABLATION SVT WITH COMPREHENSIVE STUDY

$ 16,200.00 

258

CARDIOVASCULAR

4800093654

HC EP & ABLATE VENTRIC TACHY

$ 11,298.00 

259

CARDIOVASCULAR

4800093660

HC TILT TABLE CARDIOVASCULAR EVAL

$ 1,842.00 

260

CARDIOVASCULAR

9210093786

HC AMBULATORY BP RECORDING 24 HRS/LONGER

$ 382.00 

261

CARDIOVASCULAR

9210093788

HC AMBULATORY BP ANALYSIS 24 HRS/LONGER

$ 382.00 

262

CARDIOVASCULAR

9430093797

HC CARDIAC REHAB PHASE 2 W/O MONITOR

$ 212.00 

263

CARDIOVASCULAR

9430093798

HC CARDIAC REHAB PHASE 2 W/MONITOR

$ 236.00 

264

CARDIOVASCULAR

3610093998

HC UNLISTED NONINVASIVE VASCULAR DX STUDY

$ 1,055.00 

265

CARDIOVASCULAR

36100C9755

HC RF MAGNETIC GUIDE AV FISTULA

$ 11,700.00 

266

CARDIOVASCULAR

48100G0278

HC M'DCRE ILIAC ART ANGIO CARD CATH

$ 3,033.00 

267

CARDIOVASCULAR

92100G0365

HC USV PRE-OP MAPPING AV FISTULA CREATION

$ 1,035.00 

268

CARDIOVASCULAR

73000G0404

HC EKG COMP IPPE PBB/MEDICARE

$ 95.00 

269

DERMATOLOGY

4500010004

HC FNA BX W/O IMG GDN EA ADDL

$ 135.00 

270

DERMATOLOGY

7610010004

HC FNA BX W/O IMG GDN EA ADDL

$ 135.00 

271

DERMATOLOGY

7610110004

HC FNA BX W/O IMG GDN EA ADDL-UC

$ 135.00 

272

DERMATOLOGY

7610010005

HC FNA BX W/US GDN 1ST LESION

$ 1,710.00 

273

DERMATOLOGY

7610010006

HC FNA BX W/US GDN EA ADDL

$ 180.00 

274

DERMATOLOGY

7610010007

HC FNA BX W/FLUOR GDN 1ST LESION

$ 1,170.00 

275

DERMATOLOGY

7610010008

HC FNA BX W/FLUOR GDN EA ADDL

$ 232.00 

276

DERMATOLOGY

7610010009

HC FNA BX W/CT GDN 1ST LES

$ 2,070.00 

277

DERMATOLOGY

7610010010

HC FNA BX W/CT GDN EA ADDL

$ 261.00 

278

DERMATOLOGY

7610010011

HC FNA BX W/MR GDN 1ST LESION

$ 2,430.00 

279

DERMATOLOGY

7610010012

HC FNA BX W/MR GDN EA ADDL

$ 203.00 

280

DERMATOLOGY

3610010021

FNA BX W/O IMG GDN 1ST LESION

$ 451.00 

281

DERMATOLOGY

7610010021

FNA BX W/O IMG GDN 1ST LESION

$ 451.00 

282

DERMATOLOGY

3610010030

HC SOFT TISSUE CATHETER DRAINAGE WITH GUIDANCE

$ 1,012.00 

283

DERMATOLOGY

3610010035

HC PLACE S.T. LOCALIZATION DEVICE WITH GUIDANCE 1ST LESION

$ 2,364.00 

284

DERMATOLOGY

7610010040

HC ACNE SURG

$ 485.00 

285

DERMATOLOGY

3610010060

HC I&D SOFT TISSUE SIMPLE/SINGLE

$ 588.00 

286

DERMATOLOGY

4500210060

HC I&D ABSCESS SIMPLE/SINGLE

$ 588.00 

287

DERMATOLOGY

7610010060

HC I&D ABSCESS SIMPLE/SINGLE

$ 588.00 

288

DERMATOLOGY

3610010061

HC I&D SOFT TISSUE COMPLICATED/MULTIPLE

$ 1,030.00 

289

DERMATOLOGY

4500210061

HC I&D ABSCESS COMPLIC/MU

$ 1,030.00 

290

DERMATOLOGY

7610010061

HC I&D ABSCESS COMPLIC/MU

$ 1,030.00 

291

DERMATOLOGY

4500210080

HC I&D PILONIDAL CYST SIMPLE

$ 661.00 

292

DERMATOLOGY

7610110080

HC I&D PILONIDAL CYST SIMPLE

$ 661.00 

293

DERMATOLOGY

7610010081

HC I&D PILONIDAL CYST COMP

$ 2,424.00 

294

DERMATOLOGY

4500210120

HC REMOVAL FB SUBCUTANEOUS

$ 661.00 

295

DERMATOLOGY

7610010120

HC REMOVAL FB SUBCUTANEOUS

$ 661.00 

296

DERMATOLOGY

7610110120

HC REMOVAL FB SUBCUTANEOUS

$ 661.00 

297

DERMATOLOGY

4500010121

HC FB REMOVAL COMPLEX

$ 3,274.00 

298

DERMATOLOGY

4500210121

HC FB REMOVAL COMPLEX

$ 3,274.00 

299

DERMATOLOGY

7610010121

HC FB REMOVAL COMPLEX

$ 3,274.00 

300

DERMATOLOGY

4500210140

HC I&D HEMATOMA

$ 2,090.00 

301

DERMATOLOGY

7610010140

HC I&D HEMATOMA

$ 2,424.00 

302

DERMATOLOGY

7610110140

HC I&D HEMATOMA

$ 2,424.00 

303

DERMATOLOGY

3610010160

HC ASPIRATE ABSCESS/HEMATOMA/CYST

$ 727.00 

304

DERMATOLOGY

4500210160

HC ASPIRATION CYST/HEMATOMA

$ 727.00 

305

DERMATOLOGY

7610010160

HC ASPIRATION CYST/HEMATOMA

$ 727.00 

306

DERMATOLOGY

4500210180

HC I&D CMPLX,POSTOP WOUND INFECT

$ 3,274.00 

307

DERMATOLOGY

7610010180

HC I&D CMPLX,POSTOP WOUND INFECT

$ 3,274.00 

308

DERMATOLOGY

4500211000

HC DEBRIDE EXTENSV INFECTED SKIN UPTO 10% BODY SURFC

$ 909.00 

309

DERMATOLOGY

7610111000

HC DEBRID EXTEN INFEC SKIN; TO 10% SUR

$ 909.00 

310

DERMATOLOGY

4500011010

HC DEBRIDE W/RMVL FOREIGN MATERIAL

$ 1,668.00 

311

DERMATOLOGY

7610011010

HC DEBRIDE W/RMVL FOREIGN MATERIAL

$ 1,568.00 

312

DERMATOLOGY

7610111010

HC DEBRIDE W/RMVL FOREIGN MATERIAL

$ 1,819.00 

313

DERMATOLOGY

3610011042

HC DEB SUBQ TISSUE 20 SQCM/<

$ 1,455.00 

314

DERMATOLOGY

4500211042

HC DEBRIDE SUBCUT TISSUE 1ST 20 SQCM/LESS

$ 1,455.00 

315

DERMATOLOGY

7610011042

HC DEBRIDE SUBCUT TISSUE 1ST 20 SQCM/LESS

$ 1,455.00 

316

DERMATOLOGY

3610011043

HC DEB MUSC/FASCIA 20 SQCM/<

$ 1,740.00 

317

DERMATOLOGY

4500011043

HC DEB MUSC/FASCIA 20 SQCM/<

$ 1,500.00 

318

DERMATOLOGY

3610011044

HC DEB BONE/MUSC/FASCIA 20 SQCM/<

$ 2,642.00 

319

DERMATOLOGY

3610011045

HC DEBRIDE SUBCUT TISSUE EA ADDL 20 SQCM

$ 858.00 

320

DERMATOLOGY

7610011045

HC DEBRIDE SUBCUT TISS EA ADDL 20 SQCM

$ 858.00 

321

DERMATOLOGY

3610011046

HC DEBRIDE MUSCLE/FASCIA EA ADDL 20 SQCM ADD ON TO 11043

$ 899.00 

322

DERMATOLOGY

3610011047

HC DEBRIDEMENT, BONE ADD ON TO 11044

$ 1,508.00 

323

DERMATOLOGY

3610011055

HC PARING BENIGN LESION

$ 205.00 

324

DERMATOLOGY

7610011055

HC PARING BENIGN LESION

$ 205.00 

325

DERMATOLOGY

3610011056

HC PARE LESION 2-4

$ 205.00 

326

DERMATOLOGY

3610011101

HC BX SKN/SUBQ TIS/MUCO MEM EA ADDL

$ 166.00 

327

DERMATOLOGY

7610011102

HC TANGNTL BX SKIN SINGLE LES

$ 296.00 

328

DERMATOLOGY

7610011103

HC TANGNTL BX SKIN EA SEP/ADDL

$ 129.00 

329

DERMATOLOGY

7610011104

HC PUNCH BX SKIN SINGLE LESION

$ 296.00 

330

DERMATOLOGY

7610011105

HC PUNCH BX SKIN EA SEP/ADDL

$ 129.00 

331

DERMATOLOGY

7610011106

HC INCAL BX SKN SINGLE LES

$ 405.00 

332

DERMATOLOGY

7610011107

HC INCISIONAL BX SKN EA SEP/ADDL

$ 180.00 

333

DERMATOLOGY

3610011200

HC RMVL SKIN TAGS LESS THAN 16

$ 469.00 

334

DERMATOLOGY

7610011200

HC REMOVAL SKIN TAGS LESS THAN 16

$ 469.00 

335

DERMATOLOGY

7610011201

HC RMVL SKIN TAGS ANY AREA EA ADDL 10

$ 137.00 

336

DERMATOLOGY

7610011300

HC SHV SKN LSN TRK/AM/LG 0.5CM/LESS

$ 226.00 

337

DERMATOLOGY

7610011301

HC SHV LSN,TRK/ARM/LG.6-1CM

$ 262.00 

338

DERMATOLOGY

7610011302

HC SHV LSN,TRK/ARM/LG1.1-2CM

$ 325.00 

339

DERMATOLOGY

7610011303

HC SHV LSN,TRK/ARM/LG>2CM

$ 793.00 

340

DERMATOLOGY

3610011305

HC SHV LSN SCLP/NK/HD/FT/GNTL 0.5CM/LESS

$ 212.00 

341

DERMATOLOGY

7610011305

HC SHV LSN SCLP/NK/HD/FT/GNTL 0.5 CM/LESS

$ 212.00 

342

DERMATOLOGY

7610011306

HC SHV LSN,SCLP/NK/HND/FT.6-1CM

$ 290.00 

343

DERMATOLOGY

3610011307

HC SHV LSN,SCLP/NK/HND1.1-2CM

$ 371.00 

344

DERMATOLOGY

3610011308

HC SHV LSN,SCLP/NK/HND/FT>2.0CM

$ 403.00 

345

DERMATOLOGY

7610011310

HC SHV LSN FC/EAR/EYE/NS 0.5CM/LESS

$ 273.00 

346

DERMATOLOGY

7610011311

HC SHV LSN,FC/EAR/EYE/NS.6-1CM

$ 322.00 

347

DERMATOLOGY

7610011400

HC EXC SKN LSN B9+MARG.5CM/<

$ 1,102.00 

348

DERMATOLOGY

7610011401

HC EXC TR-EXT B9+MARG 0.6-1CM

$ 1,131.00 

349

DERMATOLOGY

7610011402

HC EXC TR-EXT B9+MARG 1.1-2CM

$ 1,276.00 

350

DERMATOLOGY

7610011403

HC EXC BEN LES TRUNK; 2.1 TO 3.0 CM

$ 1,624.00 

351

DERMATOLOGY

7610011404

HC EXC TR-EXT B9+MARG 3.1-4CM

$ 2,182.00 

352

DERMATOLOGY

4500011406

HC EXT TR-EXT B9+MARG >4.0CM

$ 2,424.00 

353

DERMATOLOGY

7610011420

HC EXC SCLP,NCK,HD,EXT 0.5CM<

$ 1,455.00 

354

DERMATOLOGY

7610111420

HC EXC SCLP NCK HD EXT 0.5 CM/LESS

$ 1,455.00 

355

DERMATOLOGY

7610011421

HC EXC H-F-NK-SP B9+MARG 0.6-1.0CM

$ 1,576.00 

356

DERMATOLOGY

7610011422

HC EXC H-F-NK-SP B9+MARG 1.1-2CM

$ 1,576.00 

357

DERMATOLOGY

4500011423

HC EXC H-F-NK-SP B9+MARG; 2.1-3 CM

$ 2,424.00 

358

DERMATOLOGY

7610011423

EXC H-F-NK-SP B9+MARG; 2.1-3 CM

$ 2,424.00 

359

DERMATOLOGY

7610011440

HC EXC FC/EAR/EYELD/NS/LIP 0.5CM<

$ 1,152.00 

360

DERMATOLOGY

7610011441

HC EXC FACE-MM B9+MARG 0.6-1CM

$ 1,212.00 

361

DERMATOLOGY

7610011442

HC EXC BEN LES FACE; 1.1 TO 2.0 CM

$ 1,624.00 

362

DERMATOLOGY

7610011443

HC EXC BEN LES FACE; 2.1 TO 3 CM

$ 1,972.00 

363

DERMATOLOGY

7610011444

HC EXC BEN LES FACE; 3.1 TO 4 CM

$ 1,900.00 

364

DERMATOLOGY

7610011600

HC EXC MALIG LES TRUNK; 0.5 CM/LESS

$ 1,060.00 

365

DERMATOLOGY

7610011601

HC EXC MALIG LES TRUNK; 0.6 TO 1.0 CM

$ 1,160.00 

366

DERMATOLOGY

7610011602

HC EXC TR-EXT MLG+MARG 1.1-2CM

$ 1,276.00 

367

DERMATOLOGY

7610011603

HC EXC MALIG LES TRUNK; 2.1 TO 3.0 CM

$ 1,740.00 

368

DERMATOLOGY

7610011604

HC EXC MALIG LES TRUNK; 3.1 TO 4.0 CM

$ 1,856.00 

369

DERMATOLOGY

7610011606

HC EXC MALIG LES TRUNK; > 4.0 CM

$ 2,900.00 

370

DERMATOLOGY

7610011620

HC EXC MALIG LES SCLP; 0.5 CM/LESS

$ 1,392.00 

371

DERMATOLOGY

7610011622

HC EXC MALIG LES SCLP; 1.1 TO 2.0 CM

$ 1,740.00 

372

DERMATOLOGY

7610011623

HC EXC MALIG LES SCLP; 2.1 TO 3 CM

$ 2,320.00 

373

DERMATOLOGY

7610011624

HC EXC MALIG LES SCLP; 3.1 TO 4 CM

$ 2,500.00 

374

DERMATOLOGY

7610011626

HC EXC MALIG LES SCLP; > 4.0 CM

$ 3,480.00 

375

DERMATOLOGY

7610011640

HC EXC FACE-MM MALIG+MARG 0.5<

$ 1,200.00 

376

DERMATOLOGY

7610011641

HC EXC MALIG LES FACE; 0.6 TO 1.0 CM

$ 1,392.00 

377

DERMATOLOGY

7610011642

HC EXC MALIG LES FACE; 1.1 TO 2.0 CM

$ 1,740.00 

378

DERMATOLOGY

7610011643

HC EXC MALIG LES FACE; 2.1 TO 3 CM

$ 1,700.00 

379

DERMATOLOGY

3610011719

HC TRIMMING OF NONDYSTROPHIC NAILS

$ 100.00 

380

DERMATOLOGY

7610011719

HC TRIM NAILS

$ 100.00 

381

DERMATOLOGY

3610011720

HC DEBRIDEMENT OF NAILS

$ 62.00 

382

DERMATOLOGY

7610011721

HC DEBRIDE NAIL, 6 OR MORE

$ 62.00 

383

DERMATOLOGY

3610011730

HC REMOVAL OF NAIL PLATE

$ 350.00 

384

DERMATOLOGY

4500211730

HC NAILPLATE AVULDSION

$ 350.00 

385

DERMATOLOGY

7610011730

HC NAIL PLATE AVULSION PART/COMPL SMPL SNGL

$ 350.00 

386

DERMATOLOGY

4500011740

HC SUBUNGUAL HEMATOMA EVAC

$ 205.00 

387

DERMATOLOGY

4500211740

HC SUBUNGUAL HEMATOMA EVAC

$ 205.00 

388

DERMATOLOGY

7610011740

HC SUBUNGUAL HEMATOMA EVAC

$ 205.00 

389

DERMATOLOGY

3610011750

HC REMOVAL OF NAIL BED

$ 1,152.00 

390

DERMATOLOGY

4500211750

HC EXC NAIL MATRIX PART/COMP PERM RMVL

$ 1,152.00 

391

DERMATOLOGY

7610011750

HC EXC NAIL & MATRIX PART/COMPL PERM RMVL

$ 1,152.00 

392

DERMATOLOGY

4500211760

HC RECONSTRUCT NAIL BED

$ 746.00 

393

DERMATOLOGY

7610111760

HC RECONSTRUCT NAIL BED

$ 746.00 

394

DERMATOLOGY

4500211765

HC WEDGE EXCISION:SKN OF NAIL FOLD

$ 529.00 

395

DERMATOLOGY

7610011765

HC WEDGE EXCISION SKIN OF NAIL FOLD TOE

$ 529.00 

396

DERMATOLOGY

4900011900

HC INJ INTRALES; UP TO & INCL 7 LES

$ 217.00 

397

DERMATOLOGY

4500212001

HC 2.5CM SCALP,NECK,TRNK,EXT SM

$ 440.00 

398

DERMATOLOGY

7610012001

HC SMPL REPR SCALP NECK TRNK EXT 2.5 CM/LESS

$ 440.00 

399

DERMATOLOGY

7610112001

HC SMPL REPR SCALP NECK TRNK EXT 2.5 CM/LESS

$ 440.00 

400

DERMATOLOGY

3610012002

HC SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5 SCM

$ 480.00 

401

DERMATOLOGY

4500212002

HC SIM-2.6-7.5CMSCL,NK,TRUNK,EX

$ 557.00 

402

DERMATOLOGY

7610012002

HC SMPL REPR SCALP NECK TRNK EXT 2.6 - 7.5 CM

$ 557.00 

403

DERMATOLOGY

3610012004

HC SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5SCM

$ 626.00 

404

DERMATOLOGY

4500212004

HC SIM-7.6-12.5CM SC,NK,TRK,EXT

$ 626.00 

405

DERMATOLOGY

7610012004

HC SMPL REPR SCALP NECK TRNK EXT 7.6 - 12.5 CM

$ 626.00 

406

DERMATOLOGY

3610012005

HC CAUTERIZATION WOUND, TRUNK 12.6-20 CM

$ 792.00 

407

DERMATOLOGY

4500212005

HC SIM-OV 12.6CM SCL,NK,TRNK,EX

$ 792.00 

408

DERMATOLOGY

7610112005

HC SMPL REPR SCALP NECK TRNK EXT 12.6 - 20.0 CM

$ 792.00 

409

DERMATOLOGY

4500012006

HC SPL REP SUPERFCL WNDS 20.1-30CM

$ 784.00 

410

DERMATOLOGY

7610012006

HC SMPL REPR SCALP NECK TRNK EXT 20.1 - 30.0 CM

$ 909.00 

411

DERMATOLOGY

4500212007

HC SMPL REP SUPERFCL WNDS >30.0CM

$ 1,060.00 

412

DERMATOLOGY

7610012007

HC SMPL REPR SCALP NECK TRNK EXT > 30.0 CM

$ 1,060.00 

413

DERMATOLOGY

4500212011

HC SIM-O-2.5CM FACE,EAR,NSE,LIP

$ 487.00 

414

DERMATOLOGY

7610112011

HC SMPL REPR FACE EAR EYELID NOSE LIP MCS MEMBR 2.5 CM/LESS

$ 487.00 

415

DERMATOLOGY

4500212013

HC SIM-2.6-5CM EYELID,NOSE,LIP

$ 557.00 

416

DERMATOLOGY

7610112013

HC SMPL REPR FACE EAR EYELID NOSE LIP MCS MEMBR 2.6-5.0 CM

$ 557.00 

417

DERMATOLOGY

4500212014

HC 5.1-7.5CMFACE,EAR,EYELID,NOSE

$ 661.00 

418

DERMATOLOGY

7610112014

HC SMPL REPR FACE EAR EYELID NOSE LIP MCS MEMBR 5.1-7.5 CM

$ 661.00 

419

DERMATOLOGY

4500212015

HC SIM-7.6-12.5CMEYELID,NOSE,LIP

$ 760.00 

420

DERMATOLOGY

7610012015

HC SMPL REPR FACE EAR EYELID NOSE LIP MCS MEMBR 7.6-12.5 CM

$ 760.00 

421

DERMATOLOGY

4500212016

HC SIM-12.6-20.0CM FC,EAR,LIP,NOS

$ 858.00 

422

DERMATOLOGY

7610112016

HC SMPL REPR FACE EAR EYELID NOSE LIP MCS MEMBR 12.6-20.0 CM

$ 858.00 

423

DERMATOLOGY

7610112018

HC SMPL REPR FACE EAR EYELID NOSE LIP MCS MEMBR > 30.0 CM

$ 1,334.00 

424

DERMATOLOGY

7610112020

HC TX SPRFCL WND DEHISCENCE SMPL CLOSURE

$ 1,212.00 

425

DERMATOLOGY

7610012021

HC TX SPRFCL WND DEHISCENCE W/PACKING

$ 879.00 

426

DERMATOLOGY

4500212031

HC REPR INTERM WOUND < 2.5CM SCL TRK EXT

$ 727.00 

427

DERMATOLOGY

7610012031

HC REPR INTERM WND SCLP TRNK EXT 2.5 CM/LESS

$ 727.00 

428

DERMATOLOGY

7610112031

HC REPR INTERM WND SCLP TRNK EXT 2.5 CM/LESS

$ 727.00 

429

DERMATOLOGY

4500012032

HC REPR INTERM WND SCLP TRNK EXT 2.6 - 7.5 CM

$ 980.00 

430

DERMATOLOGY

4500212032

HC REPR INTERM WOUND 2.6-7.5 CM SCL TRK EXT

$ 980.00 

431

DERMATOLOGY

7610012032

HC REPR INTERM WND SCLP TRNK EXT 2.6 - 7.5 CM

$ 980.00 

432

DERMATOLOGY

4500012034

HC REPR INTERM WND SCLP TRNK EXT 7.6 - 12.5 CM

$ 1,334.00 

433

DERMATOLOGY

4500212034

HC REPR INTERM WOUND 7.6-12.5 CM SCL TRK EXT

$ 1,334.00 

434

DERMATOLOGY

7610012034

HC REPR INTERM WND SCLP TRNK EXT 7.6 - 12.5 CM

$ 1,334.00 

435

DERMATOLOGY

4500212035

HC REPR INTERM WOUND 12.6-20 CM SCL TRK EXT

$ 1,586.00 

436

DERMATOLOGY

7610012035

HC REPR INTERM WND SCLP TRNK EXT 12.6 - 20.0 CM

$ 1,586.00 

437

DERMATOLOGY

4500212036

HC REPR INTERM WOUND 20.1-30 CM SCL TRK EXT

$ 1,850.00 

438

DERMATOLOGY

7610012036

HC REPR INTERM WND SCLP TRNK EXT 20.1 - 30.0 CM

$ 1,850.00 

439

DERMATOLOGY

7610012037

HC REPR INTERM WND SCLP TRNK EXT > 30.0 CM

$ 2,061.00 

440

DERMATOLOGY

4500212041

HC REPR INTERM < 2.5 CM NK HND FT EXT GEN

$ 958.00 

441

DERMATOLOGY

7610012041

HC REPR INTERM < 2.5 CM NK HND FT EXT GEN

$ 958.00 

442

DERMATOLOGY

7610112041

HC REPR INTERM WND NECK HND FT EXT GEN 2.5 CM/LESS

$ 958.00 

443

DERMATOLOGY

4500212042

HC REPR INTERM 2.6-7.5 CM NK HND FT EXT GEN

$ 1,090.00 

444

DERMATOLOGY

7610012042

HC REPR INTERM 2.6-7.5 CM NK HND FT EXT GEN

$ 1,090.00 

445

DERMATOLOGY

7610112042

HC REPR INTERM WND NECK HND FT EXT GEN 2.6 - 7.5 CM

$ 1,090.00 

446

DERMATOLOGY

4500212044

HC REPR INTERM 7.6-12.5 CM NK HND FT EXT GEN

$ 1,334.00 

447

DERMATOLOGY

7610012044

HC REPR INTERM WND NECK HND FT EXT GEN 7.6 - 12.5 CM

$ 1,334.00 

448

DERMATOLOGY

7610012045

HC REPR INTERM WND NECK HND FT EXT GEN 12.6 - 20.0 CM

$ 1,576.00 

449

DERMATOLOGY

7610012046

HC REPR INTERM WND NECK HND FT EXT GEN 20.1 - 30.0 CM

$ 1,819.00 

450

DERMATOLOGY

7610012047

HC REPR INTERM WND NECK HND FT EXT GEN > 30.0 CM

$ 2,061.00 

451

DERMATOLOGY

4500012051

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 2.5CM/LESS

$ 1,321.00 

452

DERMATOLOGY

4500212051

HC REPR INTERM < 2.5CM FACE EAR EYLD NSE LIP MCS M

$ 1,321.00 

453

DERMATOLOGY

7610012051

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 2.5CM/LESS

$ 1,321.00 

454

DERMATOLOGY

4500012052

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 2.6 - 5.0 CM

$ 1,586.00 

455

DERMATOLOGY

4500212052

HC REPR INTERM 2.5-5.0CM FACE EAR EYLD NSE LIP MCS M

$ 1,586.00 

456

DERMATOLOGY

7610012052

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 2.6 - 5.0 CM

$ 1,586.00 

457

DERMATOLOGY

4500212053

HC REPR INTERM 5.1-7.5CM FACE EAR EYLD NSE LIP MCS M

$ 1,455.00 

458

DERMATOLOGY

7610012053

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 5.1 - 7.5 CM

$ 1,455.00 

459

DERMATOLOGY

7610112053

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 5.1 - 7.5 CM

$ 1,254.00 

460

DERMATOLOGY

4500212054

HC REPR INTERM 7.6-12.5CM FACE EAR EYLD NSE LIP MCS M

$ 1,321.00 

461

DERMATOLOGY

7610012054

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 7.6 - 12.5 CM

$ 1,321.00 

462

DERMATOLOGY

7610112054

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 7.6 - 12.5 CM

$ 1,367.00 

463

DERMATOLOGY

4500012055

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 12.6 - 20.0 CM

$ 1,359.00 

464

DERMATOLOGY

7610012055

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 12.6 - 20.0 CM

$ 1,819.00 

465

DERMATOLOGY

7610012056

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR 20.1 - 30.0 CM

$ 2,304.00 

466

DERMATOLOGY

7610012057

HC REPR INTERM FACE EAR EYELID NOSE LIP MCS MEMBR > 30.0 CM

$ 2,424.00 

467

DERMATOLOGY

1240000001

HC SEMI PRIVATE GPU/PATHWAYS

$ 1,370.00 

468

DERMATOLOGY

7610013100

HC REPR TRUNK COMPLEX 1.1 - 2.5 CM

$ 1,576.00 

469

DERMATOLOGY

7610013101

HC REPR TRUNK COMPLEX 2.6 - 7.5 CM

$ 2,061.00 

470

DERMATOLOGY

7610113101

HC REPR TRUNK COMPLEX 2.6 - 7.5 CM

$ 1,777.00 

471

DERMATOLOGY

7610013102

HC REPR TRUNK COMPLEX EA ADDL 5.0 CM/LESS

$ 667.00 

472

DERMATOLOGY

7610113102

HC REPR TRUNK COMPLEX EA ADDL 5.0 CM/LESS

$ 575.00 

473

DERMATOLOGY

7610013120

HC REPR COMPL SCALP/ARM/LEG 1.1 - 2.5 CM

$ 1,819.00 

474

DERMATOLOGY

4500013121

HC SCLP,ARM,LEGS 2.6-7.5CM

$ 2,182.00 

475

DERMATOLOGY

7610013121

HC REPR COMPL SCALP/ARM/LEG 2.6 - 7.5 CM

$ 2,182.00 

476

DERMATOLOGY

7610113121

HC REPR COMPL SCALP/ARM/LEG 2.6 .5 CM

$ 2,182.00 

477

DERMATOLOGY

4500013122

HC REPR COMPL SCALP/ARM/LEG EA ADDL 5.0 CM/LESS

$ 496.00 

478

DERMATOLOGY

7610013122

HC REPR COMPL SCALP/ARM/LEG EA ADDL 5.0 CM/LESS

$ 575.00 

479

DERMATOLOGY

7610113122

HC REPR COMPL SCALP/ARM/LEG EA ADDL 5.0 CM/LESS

$ 496.00 

480

DERMATOLOGY

4500013131

HC REPR COMPL CHEEK/CHIN/MOUTH/NECK 1.1 - 2.5 CM

$ 1,954.00 

481

DERMATOLOGY

7610013131

HC REPR COMPL CHEEK/CHIN/MOUTH/NECK 1.1 - 2.5 CM

$ 1,819.00 

482

DERMATOLOGY

7610113131

HC REPR COMPL CHEEK/CHIN/MOUTH/NECK 1.1-2.5CM

$ 1,819.00 

483

DERMATOLOGY

7610013132

HC REPR COMPL CHEEK/CHIN/MOUTH/NECK 2.6- 7.5 CM

$ 2,424.00 

484

DERMATOLOGY

7610113132

HC REPR COMPL CHEEK/CHIN/MOUTH/NECK 2.6-7.5CM

$ 2,424.00 

485

DERMATOLOGY

7610013133

HC REPR COMPL CHEEK/CHIN/MOUTH/NECK ADDL 5 CM/LESS

$ 694.00 

486

DERMATOLOGY

4500013151

HC REPR COMPL EYELID NOSE EAR LIP 1.1-2.5C

$ 2,247.00 

487

DERMATOLOGY

7610013151

HC REPR COMPL EYELID NOSE EAR LIP 1.1 - 2.5 CM

$ 2,247.00 

488

DERMATOLOGY

4500013152

HC REPR COMPL EYELID NOSE EAR LIP 2.6 - 7.5 CM

$ 2,613.00 

489

DERMATOLOGY

7610013152

HC REPR COMPL EYELID NOSE EAR LIP 2.6 - 7.5 CM

$ 3,031.00 

490

DERMATOLOGY

7610113152

REPR COMPL EYELID NOSE EAR LIP 2.6 - 7.5 CM

$ 3,031.00 

491

DERMATOLOGY

7610013153

HC REPR COMPL EYELID NOSE EAR LIP EA ADDL 5 CM/LESS

$ 970.00 

492

DERMATOLOGY

7610013160

HC 2ND CLX SURG WND/DEHISCENCE COMPLICATED

$ 5,946.00 

493

DERMATOLOGY

7610113160

HC 2ND CLX SURG WND/DEHISCENCE COMPLICATED

$ 5,946.00 

494

DERMATOLOGY

4500214020

HC TIS TRNFR S/A/L 10 SQ CM/<

$ 1,290.00 

495

DERMATOLOGY

7610014041

HC TIS TRNFR REARAGMT 10.1-30.0SQCM

$ 4,872.00 

496

DERMATOLOGY

3610015050

HC PINCH GRAFT SINGLE/MULTI 2CM OR LESS

$ 1,517.00 

497

DERMATOLOGY

7610015240

HC SKIN FULL GRFT FACE/GENIT/HF

$ 3,616.00 

498

DERMATOLOGY

3610015271

HC APPL SKIN SUBST GFT TRN,ARM,LEG UP TO 100SQCM

$ 986.00 

499

DERMATOLOGY

3610015272

HC APPL SKIN SUBST GRFT TRNK,ARM,LEG ADDL UP TO/PART OF

$ 342.00 

500

DERMATOLOGY

3610015273

HC APPL SKIN SUBST GRFT TRNK,ARM,LEG >/=

$ 1,990.00 

501

DERMATOLOGY

3610015274

HC APPL SKIN SUBST GRFT TRNK,ARM,LEG ADDL >/= PART THEREOF

$ 759.00 

502

DERMATOLOGY

3610015275

HC APPL SKIN SUBST GFT FACE/NK/HF/G

$ 986.00 

503

DERMATOLOGY

3610015276

HC APPL SKIN SUBST GFT FACE/NK/HF/G ADD'L 25 SQ CM

$ 243.00 

504

DERMATOLOGY

7610015576

HC FRMJ DIRECT/TUBED PEDICAL E/N/E/L/NTRORAL

$ 1,661.00 

505

DERMATOLOGY

7610015630

HC DELAY FLAP EYE/NOSE/EAR/LIP

$ 3,923.00 

506

DERMATOLOGY

7610015781

HC DERMABRASION SEGMENTAL FACE

$ 4,508.00 

507

DERMATOLOGY

4500216000

HC 1ST DGE BRN LOC RX ONLY

$ 317.00 

508

DERMATOLOGY

7610016000

HC INIT TX 1ST DEGR BRN MORE THAN LOCAL TX REQ

$ 317.00 

509

DERMATOLOGY

3610016020

HC DRESS/DEBRID P THICK BURN SBSQ SMALL

$ 397.00 

510

DERMATOLOGY

4500216020

HC DRS/DEBRDMNT INIT/SUB SMALL

$ 397.00 

511

DERMATOLOGY

7610016020

HC DRS/DEBRIDE BURN INIT/SUBSEQ SMALL

$ 397.00 

512

DERMATOLOGY

3610016025

HC DRS/DEBRIDE BURN INIT/SUBSEQ MEDIUM

$ 792.00 

513

DERMATOLOGY

7610016025

HC DRS/DEBRIDE BURN INIT/SUBSEQ MEDIUM

$ 792.00 

514

DERMATOLOGY

7610016030

HC DRS/DEBRIDE BURN INIT/SUBSEQ LARGE

$ 849.00 

515

DERMATOLOGY

7610017000

HC DSTRCT BEN/PREM LESION

$ 364.00 

516

DERMATOLOGY

7610017003

HC DSTCRT BEN LESIONS 2-14 EA

$ 64.00 

517

DERMATOLOGY

7610017004

HC DESTR LESIONS, 15 OR MORE

$ 667.00 

518

DERMATOLOGY

4500017110

HC DEST BEN LSN NOT SKIN TAGS/CUT VASC PROLIF UPTO 14

$ 274.00 

519

DERMATOLOGY

7610017110

HC DEST BEN LSN CUT VASC PROLIF LES 1-14

$ 274.00 

520

DERMATOLOGY

7610017111

HC DEST BEN LSN CUT VASC PROLIF LES 15+

$ 321.00 

521

DERMATOLOGY

3610017250

HC CHEM CAUTERY,GRAN TISSUE

$ 363.00 

522

DERMATOLOGY

7610017250

HC CAUT CHEM GRANULATION TISS

$ 363.00 

523

DERMATOLOGY

7610017262

HC DESTRCT MALIG LES TRUNK; 1.1-2.0 CM

$ 400.00 

524

DERMATOLOGY

7610017263

HC DESTRCT MALIG LES TRUNK; 2.1-3.0CM

$ 536.00 

525

DERMATOLOGY

7610017264

HC DSTR SKN LSN TRK/ARS/LG 3.1-4.0CM

$ 637.00 

526

DERMATOLOGY

7610017266

HC DESTRCT MALIG LES TRUNK; OVER 4.0CM

$ 719.00 

527

DERMATOLOGY

7610017271

HC DESTRCT MALIG LES SCLP; 0.6-1.0 CM

$ 450.00 

528

DERMATOLOGY

7610017272

HC DESTR MALIG SCAL,NCK,HAND 1.1-2 CM

$ 650.00 

529

DERMATOLOGY

7610017281

HC DESTRCT MALIG LES FACE; 0.6-1.0 CM

$ 429.00 

530

DERMATOLOGY

7610017282

HC DESTR MALIG FACE,NOSE,LIP 1.1-2 CM

$ 500.00 

531

DERMATOLOGY

7610017283

HC DESTR MALIG FACE,NOSE,LIP 2.1-3 CM

$ 850.00 

532

DERMATOLOGY

3610117999

HC PINCH GRAFT PROC, MULT BY NEEDLE

$ 809.00 

533

DERMATOLOGY

7610021552

HC BIOPSY SOFT TISSUE OF NECK OR THORAX >3CM

$ 4,060.00 

534

DERMATOLOGY

7610021555

HC EXCISE LESN NECK/CHEST,SUBCUTAN

$ 3,248.00 

535

DERMATOLOGY

7610021933

HC EXC BACK TUM DEEP <5CM

$ 2,800.00 

536

DERMATOLOGY

7610025071

HC EXC FOREARM LES SC 3CM/>

$ 3,712.00 

537

DERMATOLOGY

7610095044

HC ALLERGY PATCH TESTS

$ 89.00 

538

DERMATOLOGY

7610096567

HC PHOTODYNAMIC TX SKIN

$ 417.00 

539

DERMATOLOGY

7610096900

HC PHOTO THERAPY

$ 142.00 

540

DERMATOLOGY

7610096920

HC LASER TX SKIN <250 SQCM

$ 318.00 

541

DERMATOLOGY

7610096921

HC LASER TX SKIN 250-500 SQCM

$ 440.00 

542

DERMATOLOGY

36100C5271

HC APPL LOW COST SKIN SUBST GFT T/A/L, 1ST 25 SQCM

$ 986.00 

543

DERMATOLOGY

76100G0127

HC TRIM NAIL(S)

$ 62.00 

544

EAR PROCEDURES

4500269000

HC DRAIN EXTERNAL EAR,ABSCESS/HEMA

$ 463.00 

545

EAR PROCEDURES

7610069000

HC DRAINAGE EXT EAR ABSCESS/HEMATOMA SMPL

$ 463.00 

546

EAR PROCEDURES

7610069020

HC DRAIN EXT AUDITORY CANAL; ABSCESS

$ 485.00 

547

EAR PROCEDURES

4500069200

HC REMOVAL FB EXT EAR CANAL W/O ANEST

$ 297.00 

548

EAR PROCEDURES

4500269200

HC EAR FB REMOVAL

$ 297.00 

549

EAR PROCEDURES

7610069200

HC REMOVAL FB EXT EAR CANAL W/O ANESTH

$ 297.00 

550

EAR PROCEDURES

4500269205

HC RML FB,EXT AUDIT CANAL W/ANES

$ 2,642.00 

551

EAR PROCEDURES

4500069209

REM IMPACT CERUMEN W/IRRIGATION

$ 158.00 

552

EAR PROCEDURES

7610069209

REM IMPACT CERUMEN W/IRRIGATION

$ 158.00 

553

EAR PROCEDURES

7610169209

HC REMOVE IMPACTED EAR WAX UNI

$ 158.00 

554

EAR PROCEDURES

3610069210

REMVL IMPACTED CERUMEN REQ INSTRUMENTATION

$ 172.00 

555

EAR PROCEDURES

4500269210

HC REMVL IMPACTED CERUMEN REQ INSTRUMENTATION UNILAT

$ 172.00 

556

EAR PROCEDURES

7610069210

REMVL IMPACTED CERUMEN REQ INSTRUMENTATION

$ 172.00 

557

EMERGENCY ROOM VISIT

7610021400

HC CLSD TX FX ORBIT W/O MANIP

$ 1,900.00 

558

EMERGENCY ROOM VISIT

7610021440

HC CLD TX MAND/MAX FRACTURE

$ 5,117.00 

559

EMERGENCY ROOM VISIT

4500221480

HC TMJ DISLOCATION

$ 495.00 

560

EMERGENCY ROOM VISIT

7610021480

HC CLSD TX TMJ DISLOCATION

$ 495.00 

561

EMERGENCY ROOM VISIT

7610021820

HC CLSD TX STERNUM FX

$ 768.00 

562

EMERGENCY ROOM VISIT

4500029065

HC APPL CAST LONG ARM SHLDR TO HAND

$ 455.00 

563

EMERGENCY ROOM VISIT

7610029065

HC APPL CAST LONG ARM SHLDR TO HAND

$ 455.00 

564

EMERGENCY ROOM VISIT

7000029075

APPL CAST ELBW-FNGR

$ 425.00 

565

EMERGENCY ROOM VISIT

7610029075

HC APPL CAST ELBOW-FINGER (SHORT ARM)

$ 425.00 

566

EMERGENCY ROOM VISIT

4500029105

HC SPLINT-LONG ARM

$ 430.00 

567

EMERGENCY ROOM VISIT

4500229105

HC SPLINT-LONG ARM

$ 430.00 

568

EMERGENCY ROOM VISIT

7610029105

HC APPL SPLINT LONG ARM

$ 430.00 

569

EMERGENCY ROOM VISIT

4500229125

HC SHORT ARM SPLINT

$ 329.00 

570

EMERGENCY ROOM VISIT

7000029125

HC SHORT ARM SPLINT

$ 329.00 

571

EMERGENCY ROOM VISIT

7610029125

HC APPL SPLINT SHORT ARM STATIC

$ 329.00 

572

EMERGENCY ROOM VISIT

4500229126

HC APPL,SHRT ARM SPLNT,DYNAMIC

$ 364.00 

573

EMERGENCY ROOM VISIT

7610029126

HC APPL SPLINT SHORT ARM DYNAMIC

$ 364.00 

574

EMERGENCY ROOM VISIT

4500229130

HC SPLINT-FINGER (STATIC)

$ 231.00 

575

EMERGENCY ROOM VISIT

7000029130

HC SPLINT-FINGER (STATIC)

$ 231.00 

576

EMERGENCY ROOM VISIT

7610029130

HC APPL SPLINT FINGER STATIC

$ 231.00 

577

EMERGENCY ROOM VISIT

7610029131

HC APPL SPLINT FINGER DYNAMIC

$ 212.00 

578

EMERGENCY ROOM VISIT

3610029345

HC APPL,LONG LEG CAST

$ 561.00 

579

EMERGENCY ROOM VISIT

7610029345

HC APPL LONG LEG CAST

$ 561.00 

580

EMERGENCY ROOM VISIT

4500029405

HC APPL,SHORT LEG CAST

$ 463.00 

581

EMERGENCY ROOM VISIT

7610029405

HC APPL SHORT LEG CAST

$ 463.00 

582

EMERGENCY ROOM VISIT

7000029425

HC APPLY SHORT LEG CAST WALKING

$ 382.00 

583

EMERGENCY ROOM VISIT

4500029445

APPL RIGID LEG CAST

$ 809.00 

584

EMERGENCY ROOM VISIT

4500229505

HC SPLINT-LONG LEG

$ 495.00 

585

EMERGENCY ROOM VISIT

7610029505

HC APPL LONG LEG SPLINT

$ 495.00 

586

EMERGENCY ROOM VISIT

4500229515

HC SPLINT-SHORT LEG

$ 474.00 

587

EMERGENCY ROOM VISIT

7000029515

HC SPLINT-SHORT LEG

$ 474.00 

588

EMERGENCY ROOM VISIT

7610029515

HC APPL SHORT LEG SPLINT

$ 474.00 

589

EMERGENCY ROOM VISIT

7610029520

HC STRAPPING HIP

$ 242.00 

590

EMERGENCY ROOM VISIT

7610029530

HC STRAPPING KNEE

$ 242.00 

591

EMERGENCY ROOM VISIT

7610029540

HC STRAPPING ANKLE

$ 198.00 

592

EMERGENCY ROOM VISIT

7610029550

HC STRAPPING TOES

$ 154.00 

593

EMERGENCY ROOM VISIT

7610029580

STRAP UNNA BOOT COMPRESS (PASTE WRAP)

$ 283.00 

594

EMERGENCY ROOM VISIT

7610129580

HC UNNA STRAPPING BOOT (PASTE WRAP)

$ 283.00 

595

EMERGENCY ROOM VISIT

4900029581

APPL MULTILAYER VENOUS WOUND COMPRESSION (DISTINCT)

$ 330.00 

596

EMERGENCY ROOM VISIT

7610029581

APPL MULTLYR VENOUS WND COMPRESSION BELOW KNEE

$ 330.00 

597

EMERGENCY ROOM VISIT

7610029705

HC RMVL/BIVALVING FULL ARM/LEG CAST

$ 303.00 

598

EMERGENCY ROOM VISIT

7610030000

HC DRAINAGE NASAL ABSCESS HEMATOMA INTERNAL

$ 788.00 

599

EMERGENCY ROOM VISIT

7610030020

HC DRAINAGE ABSCESS/HEMATOMA NOSE LESION

$ 818.00 

600

EMERGENCY ROOM VISIT

4500230300

HC NASAL FB REMOVAL

$ 231.00 

601

EMERGENCY ROOM VISIT

7610030300

HC NASAL FB REMOVAL

$ 231.00 

602

EMERGENCY ROOM VISIT

3610030901

HC CONTROL OF NOSEBLEED SIMPLE

$ 430.00 

603

EMERGENCY ROOM VISIT

4500230901

HC NASAL HEMORRHAGE SIMPLE

$ 430.00 

604

EMERGENCY ROOM VISIT

7610030901

CTRL NASAL HEMMORRH ANTERIOR SIMPLE

$ 430.00 

605

EMERGENCY ROOM VISIT

4500230903

HC NASL HEMORRHAGE COMPLEX

$ 529.00 

606

EMERGENCY ROOM VISIT

7610130903

CTRL NASAL HEMMORH ANTERIOR COMPLEX

$ 529.00 

607

EMERGENCY ROOM VISIT

4500230905

HC NASAL HEMORRHAGE PSTERIOR

$ 495.00 

608

EMERGENCY ROOM VISIT

7610030905

HC CTRL NASAL HEMORRH POSTERIOR INITIAL

$ 495.00 

609

EMERGENCY ROOM VISIT

7610030906

HC CTRL NASAL HEMORRH POSTERIOR SUBSQNT

$ 545.00 

610

EMERGENCY ROOM VISIT

7610040490

HC BIOPSY OF LIP

$ 472.00 

611

EMERGENCY ROOM VISIT

4500240650

HC REPAIR LIP, FULL THICK, VERMILION

$ 1,718.00 

612

EMERGENCY ROOM VISIT

7610040650

HC REPAIR LIP FULL THICK VERMILION

$ 1,718.00 

613

EMERGENCY ROOM VISIT

7610140654

HC REPR LIP FULL THICK COMPLX >1/2 VERT HEIGHT

$ 2,182.00 

614

EMERGENCY ROOM VISIT

7610040800

HC DRAINAGE MOUTH LESION SIMPLE

$ 394.00 

615

EMERGENCY ROOM VISIT

7610040830

HC REPR LACERATION VESTIBULE MOUTH 2.5 CM/LESS

$ 637.00 

616

EMERGENCY ROOM VISIT

7610040831

HC REPR LACERATION VESTIBULE MOUTH > 2.5 CM/COMPLEX

$ 1,576.00 

617

EMERGENCY ROOM VISIT

4500041008

HC DRAINAGE OF MOUTH LESION

$ 3,393.00 

618

EMERGENCY ROOM VISIT

7610041250

HC REPR LACER MTH FLR/ANTERIOR 2/3 TONGUE 2.5 CM/LESS

$ 303.00 

619

EMERGENCY ROOM VISIT

7610041251

HC REPR LACER POSTERIOR 1/3 TONGUE 2.5 CM/LESS

$ 515.00 

620

EMERGENCY ROOM VISIT

7610041252

HC REPR LACER TONGUE MTH FLR > 2.6 CM/COMLEX

$ 2,047.00 

621

EMERGENCY ROOM VISIT

4500241800

HC ER-DRNG ABSCS CYST,HEMATMA-DENTLVLR

$ 487.00 

622

EMERGENCY ROOM VISIT

7610041800

HC DRAINAGE ABSCESS CYST HEMATOMA GUM LESION

$ 487.00 

623

EMERGENCY ROOM VISIT

7610042000

HC DRAINAGE MOUTH ROOF LESION

$ 697.00 

624

EMERGENCY ROOM VISIT

4500265205

HC CONJ FB SIMPLE REMOVAL

$ 325.00 

625

EMERGENCY ROOM VISIT

7610065205

HC REMOVAL FB EXT EYE CONJ SUPERFICIAL

$ 325.00 

626

EMERGENCY ROOM VISIT

4500265210

HC CONJ FB REMOVAL

$ 357.00 

627

EMERGENCY ROOM VISIT

7610065210

HC REMOVAL FB EXT EYE CONJ EMBEDDED SUBCONJ

$ 357.00 

628

EMERGENCY ROOM VISIT

4500265220

HC CORNEAL FB REMOVAL

$ 292.00 

629

EMERGENCY ROOM VISIT

7610065220

HC REMOVAL FB EXT EYE CORNEAL W/O SLIT LAMP

$ 292.00 

630

EMERGENCY ROOM VISIT

4500265222

HC CORNEAL FB REMOVAL W/SL

$ 421.00 

631

EMERGENCY ROOM VISIT

7610065222

HC REMOVAL FB EXT EYE CORNEAL W/ SLIT LAMP

$ 421.00 

632

EMERGENCY ROOM VISIT

4500267700

HC DRAINAGE EYELID ABSCESS

$ 694.00 

633

EMERGENCY ROOM VISIT

7610067700

HC DRAINAGE EYELID ABSCESS

$ 694.00 

634

EMERGENCY ROOM VISIT

7610067810

HC INCISIONAL BIOPSY OF EYELID

$ 638.00 

635

EMERGENCY ROOM VISIT

7610067900

HC REPAIR BROW DEFECT

$ 3,353.00 

636

EMERGENCY ROOM VISIT

7610167938

HC REMOVAL EMBEDDED FB EYELID

$ 476.00 

637

EMERGENCY ROOM VISIT

5160199201

HC UC NEW PT LVL 1

$ 137.00 

638

EMERGENCY ROOM VISIT

5160199202

HC UC NEW PT LVL 2

$ 180.00 

639

EMERGENCY ROOM VISIT

5160199203

HC UC NEW PT LVL 3

$ 239.00 

640

EMERGENCY ROOM VISIT

5160199204

HC UC NEW PT LVL 4

$ 360.00 

641

EMERGENCY ROOM VISIT

5160199205

HC UC NEW PT LVL 5

$ 598.00 

642

EMERGENCY ROOM VISIT

5160199211

HC UC EST LEVEL 1

$ 137.00 

643

EMERGENCY ROOM VISIT

5160199212

HC UC EST LEVEL 2

$ 180.00 

644

EMERGENCY ROOM VISIT

5160199213

HC UC EST LEVEL 3

$ 239.00 

645

EMERGENCY ROOM VISIT

5160199214

HC UC EST LEVEL 4

$ 360.00 

646

EMERGENCY ROOM VISIT

5160199215

HC UC EST LEVEL 5

$ 598.00 

647

EMERGENCY ROOM VISIT

4500299281

HC E/R LEVEL 1/ REMVL SUT ELSEWHERE

$ 284.00 

648

EMERGENCY ROOM VISIT

4500299282

HC E/R LEVEL 2

$ 464.00 

649

EMERGENCY ROOM VISIT

4500299283

HC E/R LEVEL 3

$ 831.00 

650

EMERGENCY ROOM VISIT

4500299284

HC E/R LEVEL 4

$ 1,663.00 

651

EMERGENCY ROOM VISIT

4500299285

HC E/R LEVEL 5

$ 2,512.00 

652

EMERGENCY ROOM VISIT

4500299291

HC CRITICAL CARE 1ST HOUR

$ 2,978.00 

653

EMERGENCY ROOM VISIT

4500299292

HC CRITICAL CARE EA ADD'L 30 MIN

$ 1,192.00 

654

EMERGENCY ROOM VISIT

68302G0390

HC TRAUMA RESPONSE TEAM

$ 3,973.00 

655

EVALUATION & MANAGEMENT

4100000001

HC TRANSITIONAL CARE

$ 450.00 

656

EVALUATION & MANAGEMENT

4710092587

HC AUDX (OTOACOUSTIC EMMISIONS) LTD

$ 405.00 

657

EVALUATION & MANAGEMENT

7610096127

HC BRIEF EMOTIONAL/BEH ASSMT

$ 41.00 

658

EVALUATION & MANAGEMENT

9420097802

HC INITIAL NUTR 15 MI-UNIT

$ 104.00 

659

EVALUATION & MANAGEMENT

9420197802

HC INITIAL NUTR 15MIN UNIT (DH)

$ 104.00 

660

EVALUATION & MANAGEMENT

9420097803

HC F/U NUTR 15 MIN-UNIT

$ 82.00 

661

EVALUATION & MANAGEMENT

9420197803

HC F/U NUTR 15MIN UNIT (DH)

$ 82.00 

662

EVALUATION & MANAGEMENT

5300098925

HC OSTEOPATHIC MANIPULATION 1-2

$ 59.00 

663

EVALUATION & MANAGEMENT

5300098926

HC OSTEOPATHIC MANIPULATION 3-4

$ 64.00 

664

EVALUATION & MANAGEMENT

5300098927

HC OSTEOPATHIC MANIPULATION 5-6

$ 70.00 

665

EVALUATION & MANAGEMENT

5300198928

HC OSTEOPATHIC MANIPULATION 7-8

$ 71.00 

666

EVALUATION & MANAGEMENT

2800099211

MEDICATION MANAGEMENT VISIT FACILITY

$ 101.00 

667

EVALUATION & MANAGEMENT

5160099213

HC FACILITY CLINIC ASSESS/MGMT SERVICES

$ 125.00 

668

EVALUATION & MANAGEMENT

9420199406

HC SMOKING CESSATION ASYMPTOMATIC INTERMEDIATE 3-10MIN

$ 67.00 

669

EVALUATION & MANAGEMENT

9420199407

HC SMOKING CESSATION SYMPTOMATIC INTENSIVE > 10 MIN

$ 148.00 

670

EVALUATION & MANAGEMENT

7610099495

HC TRANSITIONAL CARE MANAGEMENT, MDM MOD COMPLEX

$ 225.00 

671

EVALUATION & MANAGEMENT

7610099496

HC TRANSITIONAL CARE MANAGEMENT, MDM HIGH COMPLEX

$ 257.00 

672

EVALUATION & MANAGEMENT

7610099497

HC ADVNCD CARE PLAN 30 MIN

$ 89.00 

673

EVALUATION & MANAGEMENT

77000G0101

HC CA SCREEN,PELVIC/BREAST EXAM

$ 96.00 

674

EVALUATION & MANAGEMENT

77000G0296

HC VISIT TO DETERM LDCT ELIG

$ 97.00 

675

EVALUATION & MANAGEMENT

51000G0402

HC IPPE VISIT

$ 138.00 

676

EVALUATION & MANAGEMENT

77001G0444

HC ANNUAL DEPRESSION SCREEN

$ 151.00 

677

EVALUATION & MANAGEMENT

90600H0001

IOP, INITIAL EVALUATION

$ 160.00 

678

EVALUATION & MANAGEMENT

90600H0015

IOP, GROUP THERAPY, PER 60 MIN

$ 75.00 

679

EVALUATION & MANAGEMENT

90601H0015

IOP, INDIVIDUAL PSYCHOTHERAPY, 30 MIN

$ 75.00 

680

EVALUATION & MANAGEMENT

90602H0015

IOP, INDIVIDUAL PSYCHOTHERAPY, 45 MIN

$ 100.00 

681

EVALUATION & MANAGEMENT

90603H0015

IOP, INDIVIDUAL PSYCHOTHERAPY, 60 MIN

$ 125.00 

682

EVALUATION & MANAGEMENT

9140090832

PHP, INDIVIDUAL PSYCHOTHERAPY, 30 MIN

$ 100.00 

683

EVALUATION & MANAGEMENT

9140190832

PHP, INDIVIDUAL PSYCHOTHERAPY, 45 MIN

$ 150.00 

684

EVALUATION & MANAGEMENT

9140290832

PHP, INDIVIDUAL PSYCHOTHERAPY, 60 MIN

$ 200.00 

685

EVALUATION & MANAGEMENT

91500G0410

PHP, GROUP PSYCH

$ 100.00 

686

EVALUATION & MANAGEMENT

91500G0411

PHP, FAMILY GROUP PSYCH

$ 100.00 

687

EVALUATION & MANAGEMENT

94200G0177

PHP, TRAINING & EDUC SVCS

$ 100.00 

688

FEMALE SURGERY

3610056405

HC I&D VULVA/PERINEAL ABSCESS

$ 628.00 

689

FEMALE SURGERY

4500256405

HC I & D ABSCESS VULVA

$ 628.00 

690

FEMALE SURGERY

7610056405

HC I & D VULVA/PERINEAL ABSCESS

$ 628.00 

691

FEMALE SURGERY

3610056420

HC I&D BARTHOLINS GLAND ABSCESS

$ 455.00 

692

FEMALE SURGERY

4500256420

HC BARTHOLIN ABSCESS I&DRNAGE

$ 455.00 

693

FEMALE SURGERY

7610056420

HC I & D BARTHOLIN GLAND ABSCESS

$ 455.00 

694

FEMALE SURGERY

1501266

INSRT VAGNL RAD AFTERLOADING APP BRACHYTHERAPY

$ 1,330.00 

695

FEMALE SURGERY

3610057410

HC PELVIC EXAM W/ANES OTHR THAN LOCAL

$ 3,417.00 

696

FEMALE SURGERY

7610057454

HC COLPOSCOPY W BIOPSY & ECC

$ 405.00 

697

FEMALE SURGERY

7610057500

HC BX OF CERVIX SNGL/MULT W/WO FULG

$ 1,276.00 

698

FEMALE SURGERY

4500258100

HC BIOPSY OF UTERUS LINING

$ 474.00 

699

FEMALE SURGERY

7610058100

HC BIOPSY OF UTERUS LINING

$ 474.00 

700

FEMALE SURGERY

7610058301

HC REMOVAL IUD

$ 333.00 

701

FEMALE SURGERY

7610158301

HC REMOVAL I.U.D.

$ 333.00 

702

FEMALE SURGERY

3610058340

HC INJECTION,HYSTEROSALPING

$ 837.00 

703

FEMALE SURGERY

3610058611

HC LIGATE OVIDUCT POST C-SECTION

$ 1,500.00 

704

FEMALE SURGERY

3610058700

HC REMOVAL OF FALLOPIAN TUBE

$ 1,500.00 

705

FEMALE SURGERY

3610059000

HC AMNIOCENTESIS (SURG)(59000)

$ 809.00 

706

FEMALE SURGERY

3610059160

HC CURETTAGE, POSTPARTUM

$ 5,310.00 

707

FEMALE SURGERY

3610059812

HC TX MISCARRIAGE AMY TRIMESTER SURGICALLY

$ 3,274.00 

708

FEMALE SURGERY

7610059812

HC TX MISCARRIAGE AMY TRIMESTER SURGICALLY

$ 3,274.00 

709

FEMALE SURGERY

3610059871

HC RMVL CERCLAGE SUTURE W/ANESTESIA

$ 1,264.00 

710

FUNCTION SCANNING

3410078072

HC NM PARATHYROID PLANAR WITH SPECT/CT

$ 2,953.00 

711

FUNCTION SCANNING

3410078205

HC NM LIVER SPECT

$ 1,687.00 

712

FUNCTION SCANNING

3410078264

HC NM GASTRIC EMPTYING IMAGING

$ 2,596.00 

713

FUNCTION SCANNING

3410078278

HC NM ACUTE GI BLEED IMAGING

$ 2,708.00 

714

FUNCTION SCANNING

3410078290

HC NM INTESTINAL IMAGING (MECKEL'S)

$ 2,706.00 

715

FUNCTION SCANNING

3410078451

HC NM MYOCARDIAL PERFUSION SINGLE SPECT

$ 2,477.00 

716

FUNCTION SCANNING

3410078452

HC NM MYOCARDIAL PERFUSION MULTI SPECT

$ 3,918.00 

717

FUNCTION SCANNING

3410078472

HC NM CARDIAC BLOOD POOL PLANAR SINGLE

$ 1,854.00 

718

FUNCTION SCANNING

3410078580

HC NM PULMONARY PERFUSION IMAGING

$ 2,073.00 

719

FUNCTION SCANNING

3410078582

HC NM PULMONARY VENTILATION AND PERFUSION IMAGING

$ 2,551.00 

720

FUNCTION SCANNING

3410078597

HC NM QUANTITATIVE DIFF ERENTIAL PULMONARY PERFUSION

$ 1,504.00 

721

FUNCTION SCANNING

3410078606

HC NM BRAIN IMAGING 4+ VIEWS WITH VASCULAR FLOW

$ 2,703.00 

722

FUNCTION SCANNING

3410078607

HC NM BRAIN SPECT

$ 2,639.00 

723

FUNCTION SCANNING

3410078700

HC RENAL SCAN STATIC

$ 1,243.00 

724

FUNCTION SCANNING

3410078707

HC NM KIDNEY IMAGING WITH FLOW/FUNCTION SINGLE WO PHARM

$ 1,730.00 

725

FUNCTION SCANNING

3410078708

HC NM KIDNEY IMAGING WITH FLOW/FUNCTION SINGLE WITH PHARM

$ 1,678.00 

726

FUNCTION SCANNING

3410078740

HC CYSTOGRAM-VOIDING

$ 1,578.00 

727

FUNCTION SCANNING

3410078804

HC NM LOCALIZATION/DISTRIBUTION RADIOPHARM WHOLE BODY 2+ DAYS

$ 4,377.00 

728

FUNCTION SCANNING

1905199

RADIOPHARM THRPY ORAL ADMIN

$ 925.00 

729

GASTROLOGY/ENDOSCOPY

3610042400

HC BIOPSY OF SALIVARY GLAND

$ 1,264.00 

730

GASTROLOGY/ENDOSCOPY

4500242700

HC I&D PERITONSILLAR ABSCESS

$ 958.00 

731

GASTROLOGY/ENDOSCOPY

4500242720

HC I&D ABSCESS, PARAPHARYNGEAL

$ 2,378.00 

732

GASTROLOGY/ENDOSCOPY

4500242809

HC REMOVAL FB PHARYNX

$ 397.00 

733

GASTROLOGY/ENDOSCOPY

7500043197

HC ESOPHAGOSCOP FLES DX BRUSH

$ 2,156.00 

734

GASTROLOGY/ENDOSCOPY

4500043200

HC ESOPHAGUS DX W/CS

$ 1,543.00 

735

GASTROLOGY/ENDOSCOPY

4500243215

HC ESOPHAGOSCOPY W/RMVL FB(S) W/CS

$ 2,205.00 

736

GASTROLOGY/ENDOSCOPY

7500043220

HC ESOPHAGUS W/BALLOON DIL W/CS

$ 2,205.00 

737

GASTROLOGY/ENDOSCOPY

7500043231

HC ESOPH ENDOSCOPY W/ US EXAM

$ 2,756.00 

738

GASTROLOGY/ENDOSCOPY

7500043232

HC ESOPH ENDOSCOPY W/ US EXAM FN NDL BX

$ 3,086.00 

739

GASTROLOGY/ENDOSCOPY

7500043235

HC EGD W/CS

$ 2,205.00 

740

GASTROLOGY/ENDOSCOPY

7500043236

HC EGD W/INJ ANY SUBSTANCE W/CS

$ 3,004.00 

741

GASTROLOGY/ENDOSCOPY

7500043237

HC UPPER GI ENDOSC W/US EXAM ESOPH

$ 2,866.00 

742

GASTROLOGY/ENDOSCOPY

7500043238

HC UPPER GI ENDOSC W/ US FN NDL BX ESOPH

$ 3,086.00 

743

GASTROLOGY/ENDOSCOPY

7500043239

HC EGD/BIOPSY/SNGL/MULTI W/CS

$ 3,004.00 

744

GASTROLOGY/ENDOSCOPY

7500043240

HC EGD W/TRANSMURAL DRAIN CYST

$ 3,206.00 

745

GASTROLOGY/ENDOSCOPY

4900043241

HC EGD TUBE/CATH INSERTION

$ 1,965.00 

746

GASTROLOGY/ENDOSCOPY

7500043242

HC UPPER GI ENDOSCOPY W/US FINE NDL BX

$ 3,196.00 

747

GASTROLOGY/ENDOSCOPY

7500043244

HC BAND OF VARICES-EGD W/CS

$ 3,196.00 

748

GASTROLOGY/ENDOSCOPY

7500043245

HC EGD/DILATION/PYLORUS W/CS

$ 2,756.00 

749

GASTROLOGY/ENDOSCOPY

7500043246

HC EGDE PEG TUBE INSERTION W/CS

$ 2,976.00 

750

GASTROLOGY/ENDOSCOPY

4500043247

HC EGD/TRNSORAL FB(S) REMOVAL W/CS

$ 2,976.00 

751

GASTROLOGY/ENDOSCOPY

7500043248

HC EGD/DIL OVER WIRE ESOPH W/CS

$ 3,004.00 

752

GASTROLOGY/ENDOSCOPY

7500043249

HC EGD/DIL BALLOON W/CS

$ 2,756.00 

753

GASTROLOGY/ENDOSCOPY

7500043251

HC EGD/POLYPECTOMY W/CS

$ 3,524.00 

754

GASTROLOGY/ENDOSCOPY

7500043253

HC EGD,TRNSORAL W/ENDO US GUID TRNSMURL INJ DX/THER

$ 3,196.00 

755

GASTROLOGY/ENDOSCOPY

7500043254

HC ENDOSCOPIC MUCOSAL RESECTION

$ 3,307.00 

756

GASTROLOGY/ENDOSCOPY

7500043255

HC EGD/BICAP CONTROL BLEED W/CS

$ 3,858.00 

757

GASTROLOGY/ENDOSCOPY

7500043259

HC UPPER GI ENDOSCOPIC US EXAM

$ 3,086.00 

758

GASTROLOGY/ENDOSCOPY

7500043260

HC ERCP W/CS

$ 2,205.00 

759

GASTROLOGY/ENDOSCOPY

7500043261

HC ERCP W/BIOPSY SNGL/MULTI W/CS

$ 3,803.00 

760

GASTROLOGY/ENDOSCOPY

7500043262

HC ERCP/SPHINCTEROTOMY W/CS

$ 3,801.00 

761

GASTROLOGY/ENDOSCOPY

7500043264

HC ERCP/STONE REMOVAL W/CS

$ 3,801.00 

762

GASTROLOGY/ENDOSCOPY

7500043265

HC ERCP/LITHOTRIPSY W/CS

$ 2,756.00 

763

GASTROLOGY/ENDOSCOPY

7500043266

HC EGD W/ENDO STENT PLACEMENT

$ 3,086.00 

764

GASTROLOGY/ENDOSCOPY

7500043270

HC EGD, TRNSORAL W/TUMOR ABLATION

$ 3,305.00 

765

GASTROLOGY/ENDOSCOPY

7500043273

HC ENDO CANNULATION OF PAPILLA W/DIRECT VIS OF PANCREATIC/BILE DUCT(S)

$ 1,182.00 

766

GASTROLOGY/ENDOSCOPY

7500043274

HC ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT

$ 4,974.00 

767

GASTROLOGY/ENDOSCOPY

7500043275

HC ERCP W/REMVL OF FB(S)/STENT(S) BILRY/PNCRTC DUCT

$ 4,369.00 

768

GASTROLOGY/ENDOSCOPY

7500043276

HC ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE

$ 4,977.00 

769

GASTROLOGY/ENDOSCOPY

7500043277

HC ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA

$ 4,369.00 

770

GASTROLOGY/ENDOSCOPY

7500043460

HC ESOPG/GSTR TAMPONADE W/BALO

$ 1,200.00 

771

GASTROLOGY/ENDOSCOPY

3610043752

HC NASO/ORO-GASTRIC TUBE PLCMNT W/FLUORO I&R

$ 463.00 

772

GASTROLOGY/ENDOSCOPY

4500243752

HC NASO/ORO GASTRIC TUBE PLCMT W/FLUORO

$ 463.00 

773

GASTROLOGY/ENDOSCOPY

7610043752

HC NASO/ORO-GASTRIC TUBE PLCMNT W/FLUORO I&R

$ 463.00 

774

GASTROLOGY/ENDOSCOPY

4500243753

HC GASTR INTUBATION/ASP THERAP INCL LAVAGE

$ 231.00 

775

GASTROLOGY/ENDOSCOPY

7610043753

HC GASTR INTUBATION/ASP THERAP INCL LAVAGE

$ 231.00 

776

GASTROLOGY/ENDOSCOPY

7610043754

HC GASTR INTUBATION/ASP DX SNGL SPECIMEN

$ 242.00 

777

GASTROLOGY/ENDOSCOPY

3610043761

HC REPOS NASO/ORO GASTR FEED TUBE THRU DUOD NUTR

$ 1,982.00 

778

GASTROLOGY/ENDOSCOPY

4500043762

HC RPLC GTUBE NO REVJ TRC

$ 590.00 

779

GASTROLOGY/ENDOSCOPY

7610043762

HC RPLC GTUBE NO REVJ TRC

$ 590.00 

780

GASTROLOGY/ENDOSCOPY

7610143762

HC RPLC GTUBE NO REVJ TRC

$ 655.00 

781

GASTROLOGY/ENDOSCOPY

4500043763

HC RPLC GTUBE REVJ GSTRST TRC

$ 1,040.00 

782

GASTROLOGY/ENDOSCOPY

7610043763

HC RPLC GTUBE REVJ GSTRST TRC

$ 1,040.00 

783

GASTROLOGY/ENDOSCOPY

7500044360

HC SMALL BOWEL ENDOSCOPY INCL SPEC COLL W/CS

$ 1,260.00 

784

GASTROLOGY/ENDOSCOPY

7500044361

HC SM BOWEL W/BIOPSY W/CS

$ 1,710.00 

785

GASTROLOGY/ENDOSCOPY

7500044364

HC SM BOWEL W/REMOVAL SNARE W/CS

$ 2,114.00 

786

GASTROLOGY/ENDOSCOPY

7500044366

HC SM BOWEL CONTROL BLEED W/CS

$ 2,250.00 

787

GASTROLOGY/ENDOSCOPY

7500044369

HC SMALL BOWEL W/ABLATION OF LESION

$ 1,800.00 

788

GASTROLOGY/ENDOSCOPY

7500044380

HC ILEOSCOPY VIA STOMA INCL SPEC COLL W/CS

$ 1,620.00 

789

GASTROLOGY/ENDOSCOPY

7500044381

HC ILLEOSCOPY THRU STOMA WITH DILATION

$ 2,160.00 

790

GASTROLOGY/ENDOSCOPY

7500044382

HC SM BOWEL ILEOSCOPY VIA STOMA W/BX W/CS

$ 1,980.00 

791

GASTROLOGY/ENDOSCOPY

7500044385

HC ENDOSCOPY BOWEL POUCH (KOCH, ILEAL S/J RESV) INCL SPEC COLL

$ 1,350.00 

792

GASTROLOGY/ENDOSCOPY

7500044386

HC ENDOSCOPY BOWEL POUCH (KOCH, ILEAL S/J RESV) W/BX(S)

$ 1,620.00 

793

GASTROLOGY/ENDOSCOPY

7500044388

HC COLONOSCOPY VIA STOMA INCL SPEC COLL BRUSH/WASHING W/CS

$ 2,420.00 

794

GASTROLOGY/ENDOSCOPY

7500044389

HC COLONOSCOPY THRU STOMA/BIOP/SNG/MULTI W/CS

$ 3,024.00 

795

GASTROLOGY/ENDOSCOPY

7500044394

HC COLON/COLOSTOMY/POLYPECTOMY W/CS

$ 2,873.00 

796

GASTROLOGY/ENDOSCOPY

7500044401

HC COLONOSCOPY STOMA W/ABLAT TUMOR/POLYP/LESN

$ 3,024.00 

797

GASTROLOGY/ENDOSCOPY

7500044404

HC COLONOSCOPY STOMA W/INJECTION

$ 2,179.00 

798

GASTROLOGY/ENDOSCOPY

4900044405

HC COLONOSCOPY STOMA W/DILATION

$ 3,096.00 

799

GASTROLOGY/ENDOSCOPY

4500044500

HC PASS INTESTINE BLEEDING TUBE W/CS

$ 958.00 

800

GASTROLOGY/ENDOSCOPY

7500045330

HC SIGMOIDOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING

$ 1,922.00 

801

GASTROLOGY/ENDOSCOPY

7500045331

HC FLEX SIGMOID W/BIOPSY SNGL/MULTI

$ 2,435.00 

802

GASTROLOGY/ENDOSCOPY

7500045334

HC SIGMOIDOSCOPY INCL CONTROL OF BLEEDING W/CS

$ 3,204.00 

803

GASTROLOGY/ENDOSCOPY

7500045335

HC SIGMOID W/INJ ANY SUBSTANCE W/CS

$ 2,435.00 

804

GASTROLOGY/ENDOSCOPY

7500045338

HC FLEX. SIGMOIDOSCOPY/POLYPECTOMY W/CS

$ 3,204.00 

805

GASTROLOGY/ENDOSCOPY

7500045340

HC SIGMOIDOSCOPY W/TRANENDO BALLOON DILATION W/CS

$ 2,234.00 

806

GASTROLOGY/ENDOSCOPY

7500045341

HC SIGMOIDOSCOPY FLEX W/ US EXAM

$ 3,204.00 

807

GASTROLOGY/ENDOSCOPY

7500045346

HC SIGMOIDOSCOPY W/ABLAT TUMOR/POLYP/LESN

$ 3,331.00 

808

GASTROLOGY/ENDOSCOPY

7500045347

HC SIGMOIDOSCOPY W/ENDOCOPIC STENT PLCMNT

$ 3,331.00 

809

GASTROLOGY/ENDOSCOPY

7500045350

HC SGMDSC W/BAND LIGATION

$ 2,283.00 

810

GASTROLOGY/ENDOSCOPY

7500045378

HC COLONOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING W/CS

$ 3,024.00 

811

GASTROLOGY/ENDOSCOPY

7500045379

HC COLONOSCOPY W/RMVL FB(S) W/CS

$ 3,894.00 

812

GASTROLOGY/ENDOSCOPY

7500045380

HC COLONOSCOPY W/BIOPSY SNGL/MULTI W/CS

$ 3,399.00 

813

GASTROLOGY/ENDOSCOPY

7500045381

HC COLONOSCOPY W/INJ ANY SUBSTANCE W/CS

$ 3,780.00 

814

GASTROLOGY/ENDOSCOPY

7500045382

HC COLONOSCOPY W/ CONTROL BLEEDING W/CS

$ 5,523.00 

815

GASTROLOGY/ENDOSCOPY

7500045385

HC COLONOSCOPY W/RMVL TMR/POLYP/LSN SNARE W/CS

$ 4,536.00 

816

GASTROLOGY/ENDOSCOPY

7500045386

HC COLONOSCOPY W/TRANENDO BALLOON DILATION W/CS

$ 3,780.00 

817

GASTROLOGY/ENDOSCOPY

7500045388

HC COLONOSCOPY W/ABLAT TUMOR/POLYP/LESN

$ 4,536.00 

818

GASTROLOGY/ENDOSCOPY

7500045389

HC COLONOSCOPY W/STENT PLCMT

$ 4,536.00 

819

GASTROLOGY/ENDOSCOPY

7500045390

HC COLONOSCOPY WITH ENDO MUCOSAL RESECTION

$ 3,808.00 

820

GASTROLOGY/ENDOSCOPY

7500045398

HC COLONOSCOPY W/BAND LIGATION

$ 3,315.00 

821

GASTROLOGY/ENDOSCOPY

7500045910

HC DILATION OF RECTAL NARROWING

$ 1,990.00 

822

GASTROLOGY/ENDOSCOPY

4500045915

HC REM OF FECAL IMPACTION OF FB UNDER ANESTHESIA

$ 3,964.00 

823

GASTROLOGY/ENDOSCOPY

4500246040

HC I&D PERIRECTAL ABSCESS

$ 3,964.00 

824

GASTROLOGY/ENDOSCOPY

7610046040

HC I & D ISCHIO/PERIRECTAL ABSCESS

$ 3,964.00 

825

GASTROLOGY/ENDOSCOPY

4500246050

HC I&D PERIANAL ABSCESS

$ 1,455.00 

826

GASTROLOGY/ENDOSCOPY

7610046050

HC I & D PERIANAL ABSCESS SUPERFICIAL

$ 1,455.00 

827

GASTROLOGY/ENDOSCOPY

7610146050

HC I&D PERIANAL ABSCESS SUPERFICIAL

$ 1,254.00 

828

GASTROLOGY/ENDOSCOPY

4500246083

HC THROMBOSED HEMORRHOID INCIS EXT

$ 515.00 

829

GASTROLOGY/ENDOSCOPY

7610046083

HC INCISION THROMBOSED HEMORRHOID EXT

$ 515.00 

830

GASTROLOGY/ENDOSCOPY

7610146083

HC INCISION THROMBOSED HEMORRHOID EXT

$ 444.00 

831

GASTROLOGY/ENDOSCOPY

7500046221

HC LIGATION HEMORRHOIDS BY RUBBER BAND

$ 1,264.00 

832

GASTROLOGY/ENDOSCOPY

7610046250

HC HEMORRHOID DESTRUCTION EXT 2 > GROUPS

$ 4,243.00 

833

GASTROLOGY/ENDOSCOPY

4500246320

HC EXT THROMBOSED HEMORRHOID EXCISION

$ 3,637.00 

834

GASTROLOGY/ENDOSCOPY

7610046320

HC EXCISION THROMBOSED HEMORRHOID EXT

$ 3,637.00 

835

GASTROLOGY/ENDOSCOPY

4500246600

HC ANOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING W/CS

$ 203.00 

836

GASTROLOGY/ENDOSCOPY

7610046600

HC ANOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING W/CS

$ 203.00 

837

GASTROLOGY/ENDOSCOPY

7610146600

HC ANOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING W/CS

$ 203.00 

838

GASTROLOGY/ENDOSCOPY

7610046608

HC ANOSCOPY W/ FB REMOVAL

$ 1,530.00 

839

GASTROLOGY/ENDOSCOPY

7610046614

HC ANOSCOPY W/ CTRL OF BLEEDING

$ 833.00 

840

GASTROLOGY/ENDOSCOPY

3610047000

HC BIOPSY,LIVER,PERC NEEDLE W/CS

$ 1,897.00 

841

GASTROLOGY/ENDOSCOPY

3610047490

HC DRAINAGE GALLBLADDER

$ 6,596.00 

842

GASTROLOGY/ENDOSCOPY

3610047531

HC CHOLANGIOGRAM THRU EXISTING TUBE

$ 1,072.00 

843

GASTROLOGY/ENDOSCOPY

3610047533

HC PLACE EXTERNAL BILIARY CATH COMPLETE

$ 9,980.00 

844

GASTROLOGY/ENDOSCOPY

3610047534

HC PLACE LNTERNAL & EXTERNAL BILIARY CATH COMPLETE

$ 10,738.00 

845

GASTROLOGY/ENDOSCOPY

3610047536

HC BILILARY DRAIN CATH CHANGE

$ 4,366.00 

846

GASTROLOGY/ENDOSCOPY

3610047538

HC PERQ PLMT BILE DUCT STENT

$ 2,673.00 

847

GASTROLOGY/ENDOSCOPY

3610047542

HC DILATE BILIARY DUCT/AMPULLA

$ 5,328.00 

848

GASTROLOGY/ENDOSCOPY

3610047556

HC TRANSCATH PLACE,STENT,BILIARY

$ 2,500.00 

849

GASTROLOGY/ENDOSCOPY

3610048102

HC BIOPSY,PANCREAS,PERC NEEDLE

$ 3,504.00 

850

GASTROLOGY/ENDOSCOPY

3610049083

HC ABD PARACENTESIS W/IMAGING

$ 1,978.00 

851

GASTROLOGY/ENDOSCOPY

4500249083

HC PERITONEOCENTESIS W/IMAGE GUIDE

$ 1,978.00 

852

GASTROLOGY/ENDOSCOPY

7610049083

HC PERITONEOCENTESIS W/IMAGE GUIDE

$ 1,978.00 

853

GASTROLOGY/ENDOSCOPY

3610049180

HC BIOPSY ABD/RETRO PERC NDL

$ 1,897.00 

854

GASTROLOGY/ENDOSCOPY

3610049185

HC SCLEROTX FLUID COLLECTION

$ 2,970.00 

855

GASTROLOGY/ENDOSCOPY

3610049405

HC IMG GD PERC VISCERA FLUID COLL/DRAIN BY CATH

$ 5,564.00 

856

GASTROLOGY/ENDOSCOPY

3610049406

HC IMG GD PERC PERI/RETRPERI FLUID COLL/DRAIN BY CATH

$ 5,564.00 

857

GASTROLOGY/ENDOSCOPY

3610049418

HC INSRT TUNNELED INTRPERITNL CATH PERC COMPLETE W/CS

$ 6,322.00 

858

GASTROLOGY/ENDOSCOPY

3610049421

HC INSERT PERITONEAL ABD DRAIN

$ 7,586.00 

859

GASTROLOGY/ENDOSCOPY

7610049422

HC REMOVE TUNNELED INTRAPERITONEAL CATHETER

$ 3,248.00 

860

GASTROLOGY/ENDOSCOPY

3610049423

HC EXCHANGE ABSCESS/CYST DRAINAGE CATH W/RAD GUIDANCE

$ 3,504.00 

861

GASTROLOGY/ENDOSCOPY

3610049424

HC CHG PERC TUBE/DRAIN CATH W CONTRAST

$ 793.00 

862

GASTROLOGY/ENDOSCOPY

3610049440

HC GASTROSTOMY TUBE PLACEMENT W/CS

$ 1,897.00 

863

GASTROLOGY/ENDOSCOPY

7500049441

HC INSERT D TUBE/J TUBE WITH FLUORO

$ 2,529.00 

864

GASTROLOGY/ENDOSCOPY

7500049446

HC CONVERT G TUBE TO GJ TUBE WITH FLUORO

$ 2,529.00 

865

GASTROLOGY/ENDOSCOPY

7500049450

HC REPLACE G TUBE/C-TUBE WITH FLUORO

$ 1,264.00 

866

GASTROLOGY/ENDOSCOPY

7500049451

HC REPLACE D TUBE/J-TUBE WITH FLUORO

$ 1,517.00 

867

GASTROLOGY/ENDOSCOPY

7500049452

HC REPLACE GJ TUBE WITH FLUORO

$ 1,517.00 

868

GASTROLOGY/ENDOSCOPY

7500049465

HC INJ EVALUATION GI TUBE WITH GUIDANCE

$ 594.00 

869

GASTROLOGY/ENDOSCOPY

7500091010

HC ESOPHAGUS MOTILITY STUDY

$ 2,000.00 

870

GASTROLOGY/ENDOSCOPY

7500091013

HC ESOPH MOTILITY STDY W/I&R W/STIM/PERFUSION

$ 1,017.00 

871

GASTROLOGY/ENDOSCOPY

7500091020

HC GASTRIC MOTILITY STUDIES

$ 2,182.00 

872

GASTROLOGY/ENDOSCOPY

7500091034

HC ACID REFLUX TEST

$ 1,169.00 

873

GASTROLOGY/ENDOSCOPY

7500091035

HC G-ESOPH REFLX TST W/ELECTROD

$ 1,740.00 

874

GASTROLOGY/ENDOSCOPY

7500091037

HC ESOPH FUNC TEST W/ INTERP

$ 980.00 

875

GASTROLOGY/ENDOSCOPY

7500091038

HC ESOPH FUNC TEST W/INTERP UPTO 24HRS

$ 1,568.00 

876

GASTROLOGY/ENDOSCOPY

4886098

BREATH HYDROGEN/METHANE TEST

$ 480.00 

877

GASTROLOGY/ENDOSCOPY

7500091110

HC GI TRACT CAPSULE ENDOSCOPY

$ 4,361.00 

878

GASTROLOGY/ENDOSCOPY

7500091112

HC GI WIRELESS CAPSULE MEASURE

$ 4,200.00 

879

GASTROLOGY/ENDOSCOPY

7500091120

HC RECTAL SENSATION TEST

$ 3,267.00 

880

GASTROLOGY/ENDOSCOPY

7500091122

HC ANORECTAL MANOMETRY

$ 1,283.00 

881

GASTROLOGY/ENDOSCOPY

7500091132

ELECTROGASTROGRAPHY

$ 403.00 

882

GASTROLOGY/ENDOSCOPY

7500091133

HC ELECTROGASTROPHY W/TEST

$ 433.00 

883

GASTROLOGY/ENDOSCOPY

9240095076

HC INGESTION CHALLENGE TEST INITIAL 120 MINS

$ 1,364.00 

884

GASTROLOGY/ENDOSCOPY

9240095079

HC INGESTION CHALLENGE TEST EA ADDL 60 MINS

$ 718.00 

885

GASTROLOGY/ENDOSCOPY

9200095249

HC CONT GLUC MNTR PT PROV EQP

$ 206.00 

886

GASTROLOGY/ENDOSCOPY

9200095250

HC GLUCOSE MONITOR CONT (MIN 72 HRS)

$ 592.00 

887

GASTROLOGY/ENDOSCOPY

75000G0104

HC SCREENING FLEXIBLE SIGMOIDOSCOPY

$ 1,814.00 

888

GASTROLOGY/ENDOSCOPY

75000G0105

HC SCREENING COLONOSCOPY HIGH RISK

$ 3,024.00 

889

GASTROLOGY/ENDOSCOPY

75000G0121

HC SCREENING COLONOSCOPY LOW RISK

$ 3,326.00 

890

IMMUNINZATIONS

5101114

RABIES IG, IM/SC

$ 1,300.00 

891

IMMUNINZATIONS

5101262

RSV MONOCLONAL ANTIBODY RECOMBINANT 50MG IM

$ 975.00 

892

IMMUNINZATIONS

5101292

VACCINA IG, IM

$ 31.00 

893

IMMUNINZATIONS

5101212

VARICELLA-ZOSTER IG, IM

$ 257.00 

894

IMMUNINZATIONS

7710090471

HC ADMINISTRATION VACCINE SINGLE INJECTION

$ 22.00 

895

IMMUNINZATIONS

7710190471

HC ADMIN IMMUN VAC/TOX

$ 22.00 

896

IMMUNINZATIONS

7710290471

HC ADMIN IMMUN VAC/TOX

$ 22.00 

897

IMMUNINZATIONS

7710090472

HC ADMINISTRATION VACCINE EA ADDL INJECTION

$ 22.00 

898

IMMUNINZATIONS

7710190472

HC ADMIN IMMUN ADD'L VAC/TOX

$ 22.00 

899

IMMUNINZATIONS

7710290472

HC INJ IMMUN ADD'L VAC/TOX

$ 26.00 

900

IMMUNINZATIONS

7710090474

HC ADMINISTRATION VACCINE EA ADDL INTRANASAL/ORAL

$ 26.00 

901

IMMUNINZATIONS

7710290474

HC IMMUNE ADMIN ORAL/NASAL ADDL

$ 26.00 

902

IMMUNINZATIONS

5106775

MENB-4C VACC 2 DOSE IM

$ 175.00 

903

IMMUNINZATIONS

5100045

HEP A VACCINE ADULT IM (PHARM)

$ 110.00 

904

IMMUNINZATIONS

5101139

HEP A VACCINE PED/ADOL2DOSE IM

$ 88.00 

905

IMMUNINZATIONS

5101213

HEPA/HEPB VACCINE ADULT IM

$ 292.00 

906

IMMUNINZATIONS

5101118

HIB VACCINE PRP-T 4 DOSE IM

$ 45.00 

907

IMMUNINZATIONS

5153120

HPV IMMUNIZATION 4 VALENT

$ 315.00 

908

IMMUNINZATIONS

5150516

HPV IMMUNIZATION 9 VALENT

$ 249.00 

909

IMMUNINZATIONS

5101119

INF VACCINE, TRIVALENT, SPLIT, PRESERV FREE 0.25ML,IM

$ 40.00 

910

IMMUNINZATIONS

5101120

INF VAC,SPLIT 0.5ML(PRESERVATIVE FREE)

$ 45.00 

911

IMMUNINZATIONS

5101121

INF VACCINE, TRIVALENT, SPLIT, 0.25ML,IM

$ 47.00 

912

IMMUNINZATIONS

5155103

FLUZONE HIGH DOSE

$ 71.94 

913

IMMUNINZATIONS

5100096

PNEUMOCOCCAL IMMUN 13 VALENT

$ 438.00 

914

IMMUNINZATIONS

5102250

FLUMIST, QUADRIVALENT, NASAL FLU VACCINE

$ 72.00 

915

IMMUNINZATIONS

5101122

RABIES VACCINE IM USE

$ 850.00 

916

IMMUNINZATIONS

5101215

RABIES VACCINE INTRADERMAL

$ 500.00 

917

IMMUNINZATIONS

5101123

ROTAVIRUS VACCINE ORAL USE 3 DOSE

$ 184.00 

918

IMMUNINZATIONS

5102360

FLUZONE QUADRIVALENT PRESERV FREE 0.25ML

$ 45.00 

919

IMMUNINZATIONS

5102361

FLUARIX QUADRIVALENT PRESERV FREE 0.5ML

$ 45.00 

920

IMMUNINZATIONS

5101275

DTAP-IPV/HIB POLIO VACCINE

$ 500.00 

921

IMMUNINZATIONS

5101125

DTAP IMMUNIZATION INDIV < AGE 7

$ 93.00 

922

IMMUNINZATIONS

5101127

DT IMMUNIZATION INDIV AGE < 7 IM

$ 99.00 

923

IMMUNINZATIONS

5101217

RUBELLA IMMUNIZATION

$ 79.00 

924

IMMUNINZATIONS

5100078

MMR VIRUS IMMUN (PHARM)

$ 110.00 

925

IMMUNINZATIONS

5155102

COMBINED VACCINE,MMR+VARICELLA,LIVE,SC

$ 110.00 

926

IMMUNINZATIONS

5101129

POLIOMYELITIS IMMUNIZATION

$ 133.00 

927

IMMUNINZATIONS

5100086

TD IMMUN/VAC PRSRV FREE INDIV AGE 7+IM (PHA

$ 57.00 

928

IMMUNINZATIONS

5101130

TDAP INDIV AGE 7+ IM

$ 80.00 

929

IMMUNINZATIONS

5100094

PNEUMOCOCCAL IMMUN 23 VALENT

$ 64.00 

930

IMMUNINZATIONS

5100623

MENINGOCOCCAL IMM INJ (PHARM)

$ 292.00 

931

IMMUNINZATIONS

5101131

MENING VAC - GRP A, C,Y, W-135

$ 144.00 

932

IMMUNINZATIONS

5101219

ZOSTER(SHINGLES)VACC, SUBCU

$ 266.00 

933

IMMUNINZATIONS

5101132

HEPATITIS B VACCINE (PED/ADOL)

$ 39.00 

934

IMMUNINZATIONS

5100599

HEP B VACCINE (PHARM)

$ 157.00 

935

IMMUNINZATIONS

5106761

SHINGRIX VACC RECOMBINANT IM

$ 257.00 

936

IMMUNINZATIONS

77100G0008

HC ADMINISTRATION VACCINE INFLUENZA VIRUS (FLU)

$ 66.00 

937

IMMUNINZATIONS

77101G0008

HC ADMIN IMMUN FLU VAC

$ 66.00 

938

IMMUNINZATIONS

77102G0008

HC ADMIN IMMUN FLU VAC

$ 22.00 

939

IMMUNINZATIONS

77100G0009

HC ADMINISTRATION VACCINE PNEUMOCOCCAL

$ 85.00 

940

IMMUNINZATIONS

77101G0009

HC ADMIN IMMUN PNEUMOCOCCAL VAC

$ 22.00 

941

IMMUNINZATIONS

77100G0010

HC ADMINISTRATION VACCINE HEPATITIS B

$ 85.00 

942

IMMUNINZATIONS

77102G0010

HC ADMIN IMMUN HEP B (MDCR)

$ 22.00 

943

IMMUNINZATIONS

5100890

AFLURIA VACC, 3 YRS & >, IM

$ 24.00 

944

IMMUNINZATIONS

5101419

VACCINE FLUVIRIN AGE 3+ (PHARM)

$ 24.00 

945

IMMUNINZATIONS

5101420

VACCINE FLUZONE AGE 3+ (PHARM)

$ 24.00 

946

LABORATORY

3702529

VENIPUNCTURE

$ 20.00 

947

LABORATORY

4801296

BLOOD DRAWING

$ 20.00 

948

LABORATORY

5100044

BLD DRAW ROUTINE

$ 20.00 

949

LABORATORY

3000036415

HC VENIPUNCTURE

$ 20.00 

950

LABORATORY

5101180

COLLECTION OF CAPILLARY BLOOD

$ 42.00 

951

LABORATORY

3090036600

HC WITHDRAWAL OF ARTERIAL BLOOD

$ 90.00 

952

LABORATORY

4832080

BMP W/CAL-ION / POC CHEMISTRY

$ 110.00 

953

LABORATORY

4808515

BASIC METABOLIC PANEL (CALC TOT)

$ 89.00 

954

LABORATORY

4832108

BASIC METABOLIC PANEL (CALC TOT)

$ 89.00 

955

LABORATORY

4805594

ELECTROLYTES

$ 101.00 

956

LABORATORY

4832084

ELECTROLYTES PANEL

$ 101.00 

957

LABORATORY

4808523

COMPREHENSIVE METABOLIC PANEL

$ 102.00 

958

LABORATORY

4832109

COMPREHENSIVE META BOLIC PANEL

$ 102.00 

959

LABORATORY

4809042

LDL PROFILE

$ 140.00 

960

LABORATORY

4832150

POC HDLP

$ 140.00 

961

LABORATORY

4810263

RENAL FUNCTION PANEL

$ 84.00 

962

LABORATORY

4832083

RENAL FUNCTION PANEL

$ 84.00 

963

LABORATORY

4810230

GENERAL LAB/SEROLOGY AHP

$ 487.00 

964

LABORATORY

4805628

HEPATIC FUNCTION

$ 108.00 

965

LABORATORY

4832082

HEPATIC FUNCTION PANEL

$ 108.00 

966

LABORATORY

5211130

GENERAL LAB/SEROLOGY OBSP

$ 531.00 

967

LABORATORY

4803581

AMIKACIN

$ 132.00 

968

LABORATORY

4801585

CARBAMAZEPHINE

$ 130.00 

969

LABORATORY

4810495

ASSAY CARBAMAZEPINE FREE

$ 87.00 

970

LABORATORY

4806550

CYCLOSPORIN

$ 215.00 

971

LABORATORY

4820200

CLOZAPINE

$ 158.00 

972

LABORATORY

4802724

DIGOXIN; TOTAL

$ 138.00 

973

LABORATORY

4805206

VALPROIC ACID/DEPAKENE; TOTAL

$ 135.00 

974

LABORATORY

4804357

ZARONTIN ETHOSUXIMIDE

$ 164.00 

975

LABORATORY

4801528

GENTAMYCIN LEVEL

$ 180.00 

976

LABORATORY

4820202

GABAPENTIN WHOLE BLOOD/SERUM/PLASMA

$ 158.00 

977

LABORATORY

4810800

HALOPERIDOL

$ 121.00 

978

LABORATORY

4820203

LAMOTRIGINE

$ 195.00 

979

LABORATORY

4820204

LEVETIRACETAM

$ 195.00 

980

LABORATORY

4800777

LITHIUM

$ 93.00 

981

LABORATORY

4885949

MYCOPHENOLIC ACID AND METABOLITES

$ 136.00 

982

LABORATORY

4820205

OXCARBAZINE

$ 195.00 

983

LABORATORY

4801544

PHENOBARBITAL LEVEL

$ 124.00 

984

LABORATORY

4802732

DILANTIN

$ 113.00 

985

LABORATORY

4807012

FREE DILANTIN (PHENYTON)

$ 182.00 

986

LABORATORY

4804175

PRIMIDONE

$ 133.00 

987

LABORATORY

4801512

SIROLIMUS

$ 162.00 

988

LABORATORY

4807954

ASSAY OF TACROLIMUS

$ 100.00 

989

LABORATORY

4801502

THEOPHYLLIN

$ 124.00 

990

LABORATORY

4804365

TOBRAMYCIN

$ 203.00 

991

LABORATORY

4810164

TOPIRAMATE

$ 137.00 

992

LABORATORY

4805149

VANCOMYCIN

$ 133.00 

993

LABORATORY

4887023

VANCOMYCIN OP

$ 115.00 

994

LABORATORY

4820207

ZONISAMIDE

$ 195.00 

995

LABORATORY

4805164

DRUG QUANTITATION THERAPEUTIC NOS

$ 179.00 

996

LABORATORY

4820351

URINE TRICYCLIC SCREEN

$ 198.00 

997

LABORATORY

4820352

DRUG SCREEN CLASS A (9 PANEL) BY IMMUNO/ENZYME ASSAY; PER DOS

$ 72.00 

998

LABORATORY

4820353

DRUG SCREEN CLASS A (6 PANEL) BY IMMUNO/ENZYME ASSAY; PER DOS

$ 36.00 

999

LABORATORY

4820355

SALICYLATES

$ 239.00 

1000

LABORATORY

4820356

ACETOMINOPHEN

$ 239.00 

1001

LABORATORY

4820363

DRUG SCREEN CLASS A (6 PANEL) BY IMMUNO/ENZYME ASSAY; PER DOS

$ 42.00 

1002

LABORATORY

4820365

DRUG SCREEN CLASS B ELISA/NON-TLC W/O GC/HPLC; EACH

$ 182.00 

1003

LABORATORY

4820366

SALICYLATES

$ 239.00 

1004

LABORATORY

4820368

DRUG SCRN, PRESUMPTV/SNGL/MULTI DRUG CLASS THIN LAYER CHROMATOGRAPHY

$ 117.00 

1005

LABORATORY

4820369

DRUG SCRN, PRESUMPTV/SNGL/MULTI DRUG CLASS METHOD

$ 84.00 

1006

LABORATORY

4886046

DRUG DET PANEL BY HR TOF MASS SPEC, SERUM OR PLASMA

$ 215.00 

1007

LABORATORY

4886047

DRUG SCREEN 9 PANEL, SERUM OR PLASMA, W/REFLEX TO MS

$ 215.00 

1008

LABORATORY

4886052

DRUG PANEL, SERUM/PLASMA

$ 162.00 

1009

LABORATORY

4886053

SCREENING GHB OR ROHYPNOL

$ 464.00 

1010

LABORATORY

4820213

DRUG SCREEN QUANT ALCOHOLS

$ 131.00 

1011

LABORATORY

4820341

ALKALOIDS, NOT OTHERWISE SPECIFIED

$ 190.00 

1012

LABORATORY

4886001

DRUG SCREEN AMPHETAMINES 1-2

$ 133.00 

1013

LABORATORY

4886031

ESCITALOPRAM QUANTITATIVE, SERUM OR PLASMA

$ 467.00 

1014

LABORATORY

4820332

AMITRIPTYLINE

$ 167.00 

1015

LABORATORY

4820333

DESIPRAMINE

$ 130.00 

1016

LABORATORY

4820335

IMIPRAMINE

$ 70.00 

1017

LABORATORY

4820336

NORTRIPTYLINE

$ 126.00 

1018

LABORATORY

4885998

TRICYCLIC SERUM OR PLASMA

$ 116.00 

1019

LABORATORY

4885973

BUPROPION, SERUM

$ 116.00 

1020

LABORATORY

4820343

ANTIEPILEPTICS, NOS; 1-3

$ 133.00 

1021

LABORATORY

4885971

LACOSAMIDE, SERUM

$ 379.00 

1022

LABORATORY

4820344

ANTIPSYCHOTICS, NOS; 1-3

$ 361.00 

1023

LABORATORY

4885972

ARIPIRPAZOLE/ABILIFY, SERUM

$ 75.00 

1024

LABORATORY

4820316

DRUG SCREENING BARBITURATES

$ 116.00 

1025

LABORATORY

4820345

BENZODIAZEPINES; 1-12

$ 133.00 

1026

LABORATORY

4886054

REFLEX ROHYPNOL

$ 590.00 

1027

LABORATORY

4820317

BENZODIAZEPINES; 13 OR MORE

$ 202.00 

1028

LABORATORY

4820318

DRUG SCREENING BUPRENORPHINE

$ 188.00 

1029

LABORATORY

4820346

CANNABINOIDS, NATURAL

$ 259.00 

1030

LABORATORY

4820319

DRUG SCREENING COCAINE

$ 130.00 

1031

LABORATORY

4820320

DRUG SCREENING FENTANYL

$ 64.00 

1032

LABORATORY

4886030

GABAPENTIN, URINE

$ 142.00 

1033

LABORATORY

4820321

HEROIN METABOLITE

$ 198.00 

1034

LABORATORY

4820322

KETAMINE AND NORKETAMINE

$ 191.00 

1035

LABORATORY

4820323

DRUG SCREENING METHADONE

$ 166.00 

1036

LABORATORY

4885982

METHYLENEDIOXYAMPHETAMINES (MDMA)

$ 292.00 

1037

LABORATORY

4886002

MDMA

$ 133.00 

1038

LABORATORY

4886029

METHYLPHENIDATE AND METABOLITES, URINE

$ 211.00 

1039

LABORATORY

4885987

OPIATES, 1 OR MORE

$ 133.00 

1040

LABORATORY

4886095

NATREXONE, URINE

$ 423.00 

1041

LABORATORY

4820325

DRUG SCREENING OXYCODONE TYPE A

$ 190.00 

1042

LABORATORY

4820331

DRUG SCREENING OXYCODONE TYPE B

$ 64.00 

1043

LABORATORY

4885976

TAPENTADOL, URINE

$ 115.00 

1044

LABORATORY

4820326

DRUG SCREENING TRAMADOL

$ 195.00 

1045

LABORATORY

4885980

METFORMIN QUANTITATIVE, SERUM/PLASMA

$ 418.00 

1046

LABORATORY

4886003

DRUG/SUBSTANCE NOS 7/MORE

$ 191.00 

1047

LABORATORY

5101206

URINALYSIS NON AUTO W/MICRO

$ 28.00 

1048

LABORATORY

4802658

URINALYSIS WITH MICROSCOPY

$ 70.00 

1049

LABORATORY

4832002

POC URINE DIP NON AUTO W/O MICRO

$ 21.00 

1050

LABORATORY

4800017

URINALYSIS W/O MICROSCOPY

$ 38.00 

1051

LABORATORY

4832010

POC-URINALYSIS AUTO W/O MICRO

$ 38.00 

1052

LABORATORY

4805644

REDUCING SUBSTANCE URINE

$ 29.00 

1053

LABORATORY

4800116

URINE MICROSCOPIC

$ 30.00 

1054

LABORATORY

4800108

GENERAL LAB/SEROLOGY

$ 56.00 

1055

LABORATORY

4832028

POC GENERAL LAB/SEROLOGY

$ 56.00 

1056

LABORATORY

4802765

VOL MEASURMNT FOR TIME COLLECT

$ 24.00 

1057

LABORATORY

4886086

IDH1 COMMON VARIANTS

$ 573.00 

1058

LABORATORY

4886087

IDH2 COMMON VARIANTS

$ 573.00 

1059

LABORATORY

4887003

MUSC DYSTROPHY DEL/DUP TIER 2

$ 1,475.00 

1060

LABORATORY

4887012

HC BRCA 1&2 GENE FULL SEQ ANALYSIS

$ 3,788.00 

1061

LABORATORY

4886005

ABL1 GENE

$ 506.00 

1062

LABORATORY

4800307

CANAVAN DISEASE

$ 333.00 

1063

LABORATORY

4802078

BCR/ABL 1 TRANSLOC ANALYSIS MAJOR BREAK POINT

$ 495.00 

1064

LABORATORY

4885943

BCR/ABL TRANSLOC ANALYSIS 81206A

$ 184.00 

1065

LABORATORY

4802079

BCR/ABL 1 TRANSLOC ANALYSIS INOR BREAK POINT

$ 697.00 

1066

LABORATORY

4885944

BCR/ABL INOR BREAK POINT ANALYSIS 81207A

$ 184.00 

1067

LABORATORY

4800300

BRAF GENE ANALYSIS V600 VARIANT(S)

$ 1,145.00 

1068

LABORATORY

4886006

CALR GENE COM VARIANTS

$ 795.00 

1069

LABORATORY

4802081

CYSTIC FIBROSIS TRANSMEM CONDUCT REG GENE ANALYSIS

$ 597.00 

1070

LABORATORY

4802082

CYTOGENOMIC CONSTIT MICROARRAY ANALY INTERRO GENOMIC REG

$ 5,084.00 

1071

LABORATORY

4800303

MICROARRAY AT ARUP

$ 3,138.00 

1072

LABORATORY

4886089

CYTOGENOMIC SNP MICRO ON BUCCAL SWAB

$ 2,495.00 

1073

LABORATORY

4887025

HC DYPD, 3 VARIANTS

$ 738.00 

1074

LABORATORY

4887031

DMPK GENE ANALYSIS

$ 2,075.00 

1075

LABORATORY

4800320

EGFR GENE ANALYSIS COMMON VARIANTS

$ 1,462.00 

1076

LABORATORY

4802083

F2 GENE ANALYSIS 20210G>A VARIANT

$ 414.00 

1077

LABORATORY

4802084

F5 GENE ANALYS EVAL DETECT ABNORMAL ALLELES

$ 370.00 

1078

LABORATORY

4802085

FMR1 GENE ANALY EVAL DETECT ABNORM ALLELES

$ 859.00 

1079

LABORATORY

4800306

ARUP REFLEX FOR FRAGX

$ 1,145.00 

1080

LABORATORY

4800314

TAYSACHS 7 MUTATION SCREEN

$ 1,081.00 

1081

LABORATORY

4802086

HFE GENE ANALYSIS COMMON VARIANTS

$ 395.00 

1082

LABORATORY

4802087

HBA1/HBA2 GENE ANALYSIS COMMON DELE/VARIANTS

$ 1,145.00 

1083

LABORATORY

4885941

IGHV MUTATION ANALYSIS

$ 1,780.00 

1084

LABORATORY

4887020

SHORT TANDEM MARKERS - COMPARATIVE ANALYSIS - LEVEL 2

$ 500.00 

1085

LABORATORY

4886091

HBA1/HBA2 GHOST ALPHA GLOBIN

$ 1,078.00 

1086

LABORATORY

4802088

JAK2 GENE ANALYSIS V617 F VARIANT

$ 920.00 

1087

LABORATORY

4885945

JAK2 GENE ANALYSIS 81270A

$ 451.00 

1088

LABORATORY

4887013

HC HTT GENE ANALYSIS

$ 540.00 

1089

LABORATORY

4886007

KIT GENE TARGETED SEQ ANALYS

$ 3,204.00 

1090

LABORATORY

4886008

KIT GENE ANALYS D816 VARIANT

$ 953.00 

1091

LABORATORY

4802089

KRAS GENE ANALYSIS VARIANTS EXON 2

$ 1,399.00 

1092

LABORATORY

4886004

KRAS GENE ADDL VARIANTS

$ 365.00 

1093

LABORATORY

4886035

MGMT METHYLATION, PCR

$ 531.00 

1094

LABORATORY

4885970

MLH1 PROMOTER METHYLATION ANALYSIS

$ 708.00 

1095

LABORATORY

4802090

MTHFR MUTATION COMMON VARIANTS

$ 526.00 

1096

LABORATORY

4887028

MYD88 L265P MUTATION DETECTION BY PCR, QUANTITATIVE

$ 740.00 

1097

LABORATORY

4886009

NRAS GENE VARIANTS EXON 2&3

$ 3,204.00 

1098

LABORATORY

4800105

PML/RARALPHA T (15;17) TRANSLOCATION ANALYSIS

$ 1,253.00 

1099

LABORATORY

4886032

CMT1A, HNPP, PMP22 DEL/DUP

$ 1,424.00 

1100

LABORATORY

4887014

HC SMN1 GENE DOS/DELETION ANALYSIS

$ 836.00 

1101

LABORATORY

4807329

SNRPN/UBE3A GENE

$ 674.00 

1102

LABORATORY

4800302

ALPHA-1 ANTITRYPSIN ENZYME CONCEN/2 MUTATIONS W/REFLEX

$ 540.00 

1103

LABORATORY

4886085

TMPT GENE ANALYSIS COM VARIANTS

$ 691.00 

1104

LABORATORY

4800305

T CELL RECEPTOR GENE REARRANGEMENT

$ 1,218.00 

1105

LABORATORY

4800002

UGT1A1 GENE ANALYSIS, COMMON VARIANTS

$ 953.00 

1106

LABORATORY

4886068

UGT1A1 ENE ANALYSIS, COMMON VARIANTS, LVL 2

$ 2,394.00 

1107

LABORATORY

4885028

HBB GENE COMMON VARIANTS

$ 559.00 

1108

LABORATORY

4886084

HBB FULL GENE SEQUENCE

$ 1,209.00 

1109

LABORATORY

4885938

HLA CLASS I TYPING ONE AG EQUIV

$ 440.00 

1110

LABORATORY

4886012

CELIAC HLA DQ8

$ 739.00 

1111

LABORATORY

4885940

CELIAC HLA DQ2

$ 555.00 

1112

LABORATORY

4800301

HLA-B*5701

$ 572.00 

1113

LABORATORY

4802094

HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS

$ 986.00 

1114

LABORATORY

4885942

CELIAC HLA DQ3

$ 659.00 

1115

LABORATORY

4802095

MOLECULAR PROCEDURE LEVEL 1

$ 986.00 

1116

LABORATORY

4802096

MOLECULAR PROCEDURE LEVEL 2A

$ 1,115.00 

1117

LABORATORY

4802097

MOLECULAR PROCEDURE LEVEL 2 B

$ 836.00 

1118

LABORATORY

4802106

MOLECULAR PATHOLOGY, LEVEL 3

$ 953.00 

1119

LABORATORY

4802098

MOLECULAR PROCEDURE LEVEL 4

$ 365.00 

1120

LABORATORY

4886062

MOLECULAR PATH LVL 4 KNOWN FAMILIAR VARIANT NOS

$ 581.00 

1121

LABORATORY

4802099

MOLECULAR PROCEDURE LEVEL 5

$ 3,204.00 

1122

LABORATORY

4886021

MOLECULAR PROCEDURE LEVEL 5 (PRSS1)

$ 1,276.00 

1123

LABORATORY

4802100

MOLECULAR PROCEDURE LEVEL 6

$ 2,035.00 

1124

LABORATORY

4885950

MOLECULAR PATHOLOGY LEVEL 8 (81406A)

$ 4,739.00 

1125

LABORATORY

4887008

CADASIL NOTCH 3 SEQUENCING

$ 2,825.00 

1126

LABORATORY

4886079

45,XY DISORDER OF SEX DEVELOPMENT SEQ PANEL

$ 6,000.00 

1127

LABORATORY

4887021

FORTY FIVE ,XY DISORDER OF SEX DEVELOPMENT SEQ PANEL - LEVEL 2

$ 3,418.00 

1128

LABORATORY

4885965

NEUROFIBROMATOSIS TYPE 1, SEQ. DEL/DUPL

$ 2,435.00 

1129

LABORATORY

4887009

AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS

$ 6,435.00 

1130

LABORATORY

3100081443

GENETIC TESTING FOR SEVERE INHERITED CONDITIONS

$ 4,200.00 

1131

LABORATORY

4886080

SOLID TUMOR MARKER BY NEXT GENE SEQUENCING

$ 4,588.00 

1132

LABORATORY

4802101

UNLISTED PATHOLOGY PROCEDURE LEVEL I

$ 184.00 

1133

LABORATORY

4802102

UNLISTED PATHOLOGY PROCEDURE LEVEL II

$ 369.00 

1134

LABORATORY

4802103

UNLISTED PATHOLOGY PROCEDURE LEVEL III

$ 731.00 

1135

LABORATORY

4885954

UNLISTED PATHOLOGY PROCEDURE LEVEL IV

$ 1,150.00 

1136

LABORATORY

4885955

UNLISTED PATHOLOGY PROCEDURE LEVEL V

$ 1,725.00 

1137

LABORATORY

4885956

UNLISTED PATHOLOGY PROCEDURE LEVEL VI

$ 2,300.00 

1138

LABORATORY

4885957

UNLISTED PATHOLOGY PROCEDURE LEVEL VII

$ 2,875.00 

1139

LABORATORY

4885958

UNLISTED PATHOLOGY PROCEDURE LEVEL VIII

$ 3,450.00 

1140

LABORATORY

4886022

SURFACTANT PANEL

$ 10,350.00 

1141

LABORATORY

4886088

UNLISTED PATHOLOGY PROCEDURE LEVEL IIB (HHGB)

$ 543.00 

1142

LABORATORY

4887010

UNLISTED PATHOLOGY PROCEDURE LEVEL IX

$ 6,300.00 

1143

LABORATORY

4802075

FETAL CONGEN ABNORMAL BIOCHEM ASSAYS OF 2 PROTEINS

$ 270.00 

1144

LABORATORY

4802076

FETAL CONGEN ABNORMAL BIOCHEM ASSAYS OF 4 ANALYTES

$ 646.00 

1145

LABORATORY

4886096

PSA, 4KSCORE

$ 2,625.00 

1146

LABORATORY

4885961

MULT ANALYTE ASSAY W-ALGORITHMIC ANALYSIS

$ 723.00 

1147

LABORATORY

4808325

QUANTITATIVE ACETONE/KETONE

$ 81.00 

1148

LABORATORY

4886025

QUANTITATIVE ACETONE/KETONE

$ 81.00 

1149

LABORATORY

4808326

ACETYLCHOLINESTERASE ASSAY

$ 116.00 

1150

LABORATORY

4820015

ACYLCARMITINES,QUANT EACH

$ 158.00 

1151

LABORATORY

4803227

ADRENOCORTICOTROPHIC HORMONE

$ 377.00 

1152

LABORATORY

4801635

ALBUMIN SERUM PLASMA OR WHOLE BLD

$ 60.00 

1153

LABORATORY

4885059

ALBUMIN OTHER QUANT EA

$ 51.00 

1154

LABORATORY

4807756

MICROABLUMIN URINE

$ 97.00 

1155

LABORATORY

5100064

POC URINE MICROALBUMIN,SEMIQUANT

$ 43.00 

1156

LABORATORY

4803367

ALDOLASE

$ 104.00 

1157

LABORATORY

4803540

ALDOSTERONE

$ 360.00 

1158

LABORATORY

4800785

ALPHA 1 ANTITRYPSIN

$ 150.00 

1159

LABORATORY

4885323

ALPHA 1 ANTITRYPSIN PHENOTYPE

$ 103.00 

1160

LABORATORY

4803243

ALPHA FETOPROTEIN,SERUM

$ 194.00 

1161

LABORATORY

4806600

ALPHA FETA PROT AMNIOTIC FLD

$ 133.00 

1162

LABORATORY

4805461

ALUMINUM SERUM

$ 179.00 

1163

LABORATORY

5101208

AMINES,VAGINAL FLUID,QUAL

$ 31.00 

1164

LABORATORY

4810669

AMINO ACIDS;MX QUAL EA SPEC

$ 128.00 

1165

LABORATORY

4807996

AMINO ACIDS QUANTITATION

$ 154.00 

1166

LABORATORY

4853164

AMINO ACID QUANT 6 OR MORE EA

$ 449.00 

1167

LABORATORY

4800728

AMMONIA

$ 145.00 

1168

LABORATORY

4800421

AMYLASE

$ 119.00 

1169

LABORATORY

4804910

ANDROSTENEDIONE

$ 331.00 

1170

LABORATORY

4803508

ANGIOTENSIN CONVERTING ENZ

$ 145.00 

1171

LABORATORY

4805362

APOLIPOPROTEIN A-1

$ 150.00 

1172

LABORATORY

4803656

ARSENIC

$ 220.00 

1173

LABORATORY

4806147

VITAMIN C

$ 99.00 

1174

LABORATORY

4806972

ATOMIC ABSORPTION EACH

$ 138.00 

1175

LABORATORY

4808085

BETA 2 MICROGLOBULIN

$ 152.00 

1176

LABORATORY

4800744

TOTAL BILIRUBIN

$ 50.00 

1177

LABORATORY

4832029

POC TOTAL BILI

$ 50.00 

1178

LABORATORY

4803045

BILIRUBIN DIRECT

$ 55.00 

1179

LABORATORY

4832030

POC DIRECT BILI

$ 55.00 

1180

LABORATORY

4810594

BIOTINIDASE EA SPEC

$ 154.00 

1181

LABORATORY

4800124

OCCULT BLOOD STOOL SNGL SCREEN

$ 43.00 

1182

LABORATORY

4832044

POC-OCCULT SCREEN SNGL (CARD)

$ 43.00 

1183

LABORATORY

4802989

OCCULT BLOOD VOMITUS QUAL

$ 28.00 

1184

LABORATORY

4832089

OCCULT BLOOD VOMITUS

$ 28.00 

1185

LABORATORY

4832045

POC DX OCCULT BLD SNGL (DIG RECT)

$ 28.00 

1186

LABORATORY

4832094

OCCULT BLD 1-3 SIMUL DTRM SPEC (DIG RECT EX

$ 28.00 

1187

LABORATORY

4803221

BLOOD OCCULT FECAL HGB DETER IA QUAL FECES

$ 99.00 

1188

LABORATORY

4807897

CADMIUM

$ 232.00 

1189

LABORATORY

4805453

CALCIFEDIOL(25-OH VITAMIN D-3)

$ 275.00 

1190

LABORATORY

4803680

CALCITONIN

$ 342.00 

1191

LABORATORY

4801239

CALCIUM

$ 52.00 

1192

LABORATORY

4832086

CALCIUM

$ 52.00 

1193

LABORATORY

4804688

CALCIUM IONIZED

$ 154.00 

1194

LABORATORY

4803060

URINE CALCIUM 24 HOUR

$ 58.00 

1195

LABORATORY

4819041

STONE CAL,INFARED SPEC,QUAL

$ 119.00 

1196

LABORATORY

4800215

CARBON DIOXIDE

$ 50.00 

1197

LABORATORY

4804936

CARBOXYHEMOGLOBIN

$ 133.00 

1198

LABORATORY

5400312

CARCINOEMBRYONIC ANTIGEN

$ 174.00 

1199

LABORATORY

4810453

CARNITINE, BILE

$ 226.00 

1200

LABORATORY

4803706

CAROTENE

$ 108.00 

1201

LABORATORY

4804944

CATECHOLAMINES FRACT

$ 348.00 

1202

LABORATORY

4803730

CERULOPLASMIN

$ 104.00 

1203

LABORATORY

4818084

CHEMILLUM ASSAY

$ 229.00 

1204

LABORATORY

4886057

VASCULAR ENDOTHELIAL GROWTH FACTOR

$ 229.00 

1205

LABORATORY

4800207

CHLORIDE

$ 46.00 

1206

LABORATORY

4801072

URINE CHLORIDE

$ 64.00 

1207

LABORATORY

4810750

ASSAY FLUID CHLORIDES

$ 45.00 

1208

LABORATORY

4801205

CHOLESTEROL

$ 53.00 

1209

LABORATORY

4804654

ACETYLCHOLINESTERASE RBC

$ 72.00 

1210

LABORATORY

4803441

CHROMIUM

$ 143.00 

1211

LABORATORY

4806816

CITRATE EXCRETION URINE

$ 322.00 

1212

LABORATORY

4810065

COLLAGEN CROSS LINKS ANY METH

$ 215.00 

1213

LABORATORY

4803235

COPPER

$ 155.00 

1214

LABORATORY

4805107

CORTISOL FREE URINE

$ 206.00 

1215

LABORATORY

5400114

CORTISOL TOTAL

$ 160.00 

1216

LABORATORY

4885224

COL CHROMOTOGRAPHY NES EA SPECIMEN LEVEL 4

$ 238.00 

1217

LABORATORY

4885988

COL CHROMOTOGRAPHY NES EA SPECIMEN LEVEL 1

$ 167.00 

1218

LABORATORY

4885989

COL CHROMOTOGRAPHY NES EA SPECIMEN LEVEL 2

$ 175.00 

1219

LABORATORY

4885990

COL CHROMOTOGRAPHY NES EA SPECIMEN LEVEL 3

$ 197.00 

1220

LABORATORY

4885991

COL CHROMOTOGRAPHY NES EA SPECIMEN LEVEL 5

$ 1,108.00 

1221

LABORATORY

4800439

CPK

$ 100.00 

1222

LABORATORY

4801312

CPK ISOENZYME

$ 209.00 

1223

LABORATORY

4803003

CPK-MB CHEM/SPECIFIC

$ 108.00 

1224

LABORATORY

4800793

CREATININE

$ 44.00 

1225

LABORATORY

4832104

CREATININE

$ 44.00 

1226

LABORATORY

4801098

CREATININE URINE

$ 61.00 

1227

LABORATORY

4801031

CREATININE CLEAR

$ 131.00 

1228

LABORATORY

4807723

CRYOFIBRINOGEN

$ 115.00 

1229

LABORATORY

4803789

CRYOGLOBULIN

$ 81.00 

1230

LABORATORY

4803821

CYANIDE

$ 124.00 

1231

LABORATORY

5400056

B12

$ 171.00 

1232

LABORATORY

4805010

B-12 BINDING CAPACITY

$ 132.00 

1233

LABORATORY

4804426

CYSTATIN C

$ 125.00 

1234

LABORATORY

4804712

DHEA

$ 290.00 

1235

LABORATORY

4803839

DHEAS

$ 232.00 

1236

LABORATORY

4807764

DIBUCAINE

$ 115.00 

1237

LABORATORY

4887015

DIHYDROTESTOSTERONE (DHT)

$ 130.00 

1238

LABORATORY

4803425

DIHYDROXYVITAMIN D-1,25

$ 383.00 

1239

LABORATORY

4885208

ENZYME CELL ACTIVITY (ADDEA)

$ 292.00 

1240

LABORATORY

4810057

ELECTROPHORETIC TECHNIQUE

$ 229.00 

1241

LABORATORY

4804720

ERYTHROPORETIN

$ 215.00 

1242

LABORATORY

4803292

ESTRADIOL

$ 249.00 

1243

LABORATORY

4806980

ESTRIOL UNCONJUGATED

$ 169.00 

1244

LABORATORY

4885380

ESTRONE

$ 175.00 

1245

LABORATORY

4806394

ETHYLENE GLYCOL

$ 1,111.00 

1246

LABORATORY

4818001

FATS/LIPIDS,FECES QUAL

$ 45.00 

1247

LABORATORY

4806915

FECES QUANT FAT

$ 219.00 

1248

LABORATORY

4806238

FATTY ACIDS FREE

$ 150.00 

1249

LABORATORY

4885158

FATTY ACIDS, LONG CHAIN

$ 167.00 

1250

LABORATORY

4805669

FERRITIN SERUM

$ 150.00 

1251

LABORATORY

4810602

FETAL FIBROECTIN

$ 615.00 

1252

LABORATORY

4803300

FOLIC ACID (FOLATE)

$ 145.00 

1253

LABORATORY

4808333

FOLATE RED CELL

$ 191.00 

1254

LABORATORY

4810560

GALACTOSE

$ 101.00 

1255

LABORATORY

4801247

IMMUNOGLOBULINS QUANT EA

$ 121.00 

1256

LABORATORY

4804753

IMMUNOGLOBULIN E

$ 150.00 

1257

LABORATORY

4807772

GAMMA GLOBULIN SUBCLASSES EA.

$ 162.00 

1258

LABORATORY

7801988

CAP BLOOD GAS

$ 167.00 

1259

LABORATORY

7801962

ABG ANALYSIS/A LINE

$ 244.00 

1260

LABORATORY

5907456

OXYHEMOGLOBIN

$ 81.00 

1261

LABORATORY

3010082820

HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN

$ 910.00 

1262

LABORATORY

4803359

GASTRIN

$ 177.00 

1263

LABORATORY

4806253

GLUCAGON

$ 132.00 

1264

LABORATORY

4810503

GLU-BDY FLU OTH/BLD

$ 55.00 

1265

LABORATORY

4800801

GLUCOSE QUANTITATIVE

$ 43.00 

1266

LABORATORY

4832112

GLUCOSE QUANTITATIVE

$ 43.00 

1267

LABORATORY

4809240

POST GLUCOSE DOSE

$ 46.00 

1268

LABORATORY

4802260

GLUCOSE TOLERANT (GTT) (1ST 3)

$ 138.00 

1269

LABORATORY

4802187

GLUCOSE ADD'L

$ 36.00 

1270

LABORATORY

4803920

GLUCOSE 6PHOS DEHYDROGENASE

$ 138.00 

1271

LABORATORY

4832036

POC-GLUCOSE

$ 38.00 

1272

LABORATORY

4800918

GAMMA GLUTAMYL TRANSPEPTID

$ 77.00 

1273

LABORATORY

4805065

FRUCTOSAMINE

$ 106.00 

1274

LABORATORY

4803284

FOLLICLE STIMULATING HORMONE

$ 175.00 

1275

LABORATORY

4804050

LUTENIZING HORMONE

$ 165.00 

1276

LABORATORY

4806261

GROWTH HORMONE

$ 140.00 

1277

LABORATORY

4801015

HAPTOGLOBIN

$ 143.00 

1278

LABORATORY

4809257

MERETECK BREATH H-PYLORI

$ 506.00 

1279

LABORATORY

4803953

HEAVY METAL QUANT EA NES

$ 275.00 

1280

LABORATORY

4807111

HEMOGLOBIN ELECTROPHORESIS

$ 171.00 

1281

LABORATORY

4885133

HEMOGLOBIN CHROMATOGRAPHY

$ 126.00 

1282

LABORATORY

4886076

HEMOGLOBIN EVAL REFLEXIVE PANEL

$ 84.00 

1283

LABORATORY

4804757

FETAL HGB

$ 56.00 

1284

LABORATORY

4802963

HEMOGLBN GLYCOSYLATED (A1C)

$ 87.00 

1285

LABORATORY

4832095

HEMOGLBN GLYCO SYLATED (A1C)

$ 87.00 

1286

LABORATORY

4852984

HEMOSIDERIN QUAL

$ 43.00 

1287

LABORATORY

4810818

TAY SACHS (HEXOSAMINIDASE)

$ 441.00 

1288

LABORATORY

4886023

TAY SACHS (LEUKOCYTES)

$ 853.00 

1289

LABORATORY

4806295

HISTAMINE BLOOD

$ 273.00 

1290

LABORATORY

4810693

HOMOCYSTINE

$ 194.00 

1291

LABORATORY

4807780

HOMOVANILLIC ACID (HVA)

$ 215.00 

1292

LABORATORY

4887032

ADMARK TAU 42

$ 450.00 

1293

LABORATORY

4887033

ADMARK PHOSPHO-TAU/TOTAL-TAU/A BETA 42, ANALYSIS, CSF

$ 1,150.00 

1294

LABORATORY

4885935

HYDROXYCORTICOSTEROIDS,17

$ 162.00 

1295

LABORATORY

4804738

HIAA-F SEROTONIN URINE

$ 153.00 

1296

LABORATORY

4806725

HYDROXYPROGESTETONE

$ 227.00 

1297

LABORATORY

4810081

IMMUNOASSAY QUALIT/SEMI

$ 143.00 

1298

LABORATORY

4810082

IMMUNOASSAY QUALIT/SEMI LEVEL II

$ 125.00 

1299

LABORATORY

4886045

IMMUNOASSAY QUALIT/SEMI LEVEL III

$ 148.00 

1300

LABORATORY

4886060

IMMUNOASSAY QUALIT/SEMI LEVEL IV (HSP70)

$ 487.00 

1301

LABORATORY

4886099

NATALIZUMAB ANTIBODIES

$ 831.00 

1302

LABORATORY

4810180

IMMUNOASSAY RIA

$ 244.00 

1303

LABORATORY

4885996

MYASTHENIA GRAVIS EVALUATION (MGE)

$ 528.00 

1304

LABORATORY

4885997

MUSK ANTIBODY (REFLEX FOR MGE)

$ 1,856.00 

1305

LABORATORY

4886075

AUTOIMMUNE ENCEPHALITIS REFLEX PANEL

$ 1,154.00 

1306

LABORATORY

4810412

IMMUNO ANALYTE QUANT UNSP

$ 180.00 

1307

LABORATORY

4886056

TRANSFORMING GROWTH FACTOR

$ 406.00 

1308

LABORATORY

4804019

INSULIN ASSAY FASTING

$ 115.00 

1309

LABORATORY

4885407

INSULIN FREE

$ 119.00 

1310

LABORATORY

4800107

IRON, LEVEL II (TISSUE)

$ 107.00 

1311

LABORATORY

4802153

IRON

$ 72.00 

1312

LABORATORY

4801429

IRON BINDING CAPACITY

$ 101.00 

1313

LABORATORY

4808093

LACTIC ACID

$ 142.00 

1314

LABORATORY

4800710

LACTATE DEHYDROGENASE

$ 60.00 

1315

LABORATORY

4832107

LACTATE DEHYDRO GENASE

$ 60.00 

1316

LABORATORY

4801445

LDH ISO ELECTROPHOESIS

$ 197.00 

1317

LABORATORY

4804622

LACTOFERRIN FECAL QUAL

$ 194.00 

1318

LABORATORY

4887005

LACTOFERRIN FECAL QUANTITATIVE

$ 472.00 

1319

LABORATORY

4804035

LEAD

$ 125.00 

1320

LABORATORY

4800868

LIPASE

$ 90.00 

1321

LABORATORY

4885412

LIPOPROTEIN (A)

$ 155.00 

1322

LABORATORY

4809067

ULTRACENTRIFUGATION/QUANT

$ 186.00 

1323

LABORATORY

4809068

LIPOPROTEIN BLD QUANT PART

$ 222.00 

1324

LABORATORY

4802591

HDL CHOLESTEROL

$ 84.00 

1325

LABORATORY

4885547

LDL CHOLESTEROL,DIRECT MEASURE

$ 96.00 

1326

LABORATORY

4801155

MAGNESIUM

$ 89.00 

1327

LABORATORY

4832106

MAGNESIUM

$ 89.00 

1328

LABORATORY

4806410

MANGANESE

$ 135.00 

1329

LABORATORY

4805826

MASS SPEC & TANDEM MASS SPEC NES EA SPECIMEN

$ 171.00 

1330

LABORATORY

4885657

MASS SPECTROMETRY QUAL/QUANT

$ 161.00 

1331

LABORATORY

4886051

MASS SPEC & TANDEM MASS SPEC NES EA SPECIMEN LEVEL 3

$ 2,517.00 

1332

LABORATORY

4804076

MERCURY

$ 155.00 

1333

LABORATORY

4803383

METANEPHRINES

$ 249.00 

1334

LABORATORY

4804100

CSF MYELIN BASIC PROTEIN

$ 144.00 

1335

LABORATORY

4804126

MYOGLOBIN

$ 143.00 

1336

LABORATORY

4885703

NATRIURETIC PEPTIDE

$ 249.00 

1337

LABORATORY

4806246

FACTOR B

$ 144.00 

1338

LABORATORY

4808119

NICKEL

$ 226.00 

1339

LABORATORY

4806386

NUCLEOTIDASE-5%

$ 94.00 

1340

LABORATORY

4804514

OLIGOCLONAL BAND

$ 168.00 

1341

LABORATORY

4810313

ORGANIC ACIDS-QUANTITATIVE

$ 249.00 

1342

LABORATORY

4885471

ORGANIC ACID,SINGLE QUANT

$ 153.00 

1343

LABORATORY

4885995

ORGANIC ACID,SINGLE QUANT, LEVEL 2

$ 565.00 

1344

LABORATORY

4800819

OSMOLALITY BLOOD

$ 97.00 

1345

LABORATORY

4800173

OSMOLALITY URINE

$ 89.00 

1346

LABORATORY

4810719

OSTEOCALCIN

$ 209.00 

1347

LABORATORY

4804159

OXALATE

$ 171.00 

1348

LABORATORY

4805081

PARATHYROID HORM INTACT SO

$ 336.00 

1349

LABORATORY

4805586

PH BODY FLUID

$ 44.00 

1350

LABORATORY

4832111

POC PH BODY FLUID

$ 44.00 

1351

LABORATORY

4807302

CALPROTECTIN, FECAL

$ 512.00 

1352

LABORATORY

4801908

PKU

$ 250.00 

1353

LABORATORY

4808341

PHOSPHATASE PROSTATIC

$ 94.00 

1354

LABORATORY

4800413

ALKALINE PHOSPHATASE

$ 52.00 

1355

LABORATORY

4803573

ALKALINE PHOSPHATASE ISOENZYME

$ 154.00 

1356

LABORATORY

4800827

PHOSPHORUS INORGANIC

$ 55.00 

1357

LABORATORY

4832088

PHOSPHORUS INORGAN

$ 55.00 

1358

LABORATORY

4801742

PHOSPHORUS URINE

$ 52.00 

1359

LABORATORY

4818167

PORPHOBILINOGEN QUANT URINE

$ 85.00 

1360

LABORATORY

4886074

ROMPLUS

$ 434.00 

1361

LABORATORY

4806907

PORPHOBILINOGEN-QUAN

$ 165.00 

1362

LABORATORY

4800199

POTASSIUM SERUM PLASMA OR WHOLE BLD

$ 44.00 

1363

LABORATORY

4832087

POTASSIUM SERUM PLASMA OR WHOLE BLD

$ 44.00 

1364

LABORATORY

4801064

POTASSIUM URINE

$ 50.00 

1365

LABORATORY

4807608

PREABLUMIN SERUM

$ 138.00 

1366

LABORATORY

4803633

PREGNINOLONE

$ 220.00 

1367

LABORATORY

4885430

17-HYDROXYPREGNENOLONE

$ 158.00 

1368

LABORATORY

4803334

PROGESTERONE

$ 164.00 

1369

LABORATORY

4806900

PROCALCITONIN

$ 249.00 

1370

LABORATORY

4803326

PROLACTIN

$ 181.00 

1371

LABORATORY

4886020

PROLACTIN

$ 181.00 

1372

LABORATORY

4804754

PROSTAGLANDIN EA

$ 754.00 

1373

LABORATORY

4812129

PSA COMPLEXED (DX)

$ 153.00 

1374

LABORATORY

5400668

PSA TOTAL

$ 168.00 

1375

LABORATORY

5401054

PSA FREE

$ 131.00 

1376

LABORATORY

4801114

PROTEIN TL EXC REFRAC SERUM PLASMA OR WHOLE BLD

$ 49.00 

1377

LABORATORY

4885786

PROTEIN TOTAL URINE

$ 30.00 

1378

LABORATORY

4801115

PROTEIN TOTAL OTH SOURCE

$ 30.00 

1379

LABORATORY

4801910

TOTAL PROTEIN BY REFRACTOMETER

$ 36.00 

1380

LABORATORY

4801222

PAPPA SERUM

$ 106.00 

1381

LABORATORY

4801221

ASSAY SERUM PROTEINS

$ 116.00 

1382

LABORATORY

4885794

PROTEIN ELECTROPHORESIS URINE

$ 138.00 

1383

LABORATORY

4818126

PROTEIN WEST BLOT/BLD OTH FLD

$ 191.00 

1384

LABORATORY

4810305

WESTERN BLOT W/INTERP

$ 487.00 

1385

LABORATORY

4804209

FREE ERYTHROCYTE PROTOPORP

$ 155.00 

1386

LABORATORY

4885489

PRO-INSULIN

$ 158.00 

1387

LABORATORY

4804589

VITAMIN B6 SO

$ 302.00 

1388

LABORATORY

4806451

PYRUVIC ACID PYRUVATE

$ 107.00 

1389

LABORATORY

4885604

PYRUVATE KINASE

$ 86.00 

1390

LABORATORY

4852927

RECEPTOR ASSAY OTHER

$ 481.00 

1391

LABORATORY

4803516

RECEPTOR ABS NON ENDOCRINE

$ 260.00 

1392

LABORATORY

4804225

RENIN

$ 206.00 

1393

LABORATORY

4806584

VITAMIN B2

$ 220.00 

1394

LABORATORY

4806444

SELENIUM

$ 180.00 

1395

LABORATORY

4804563

SEROTONIN

$ 400.00 

1396

LABORATORY

4885398

SEX HORMONE BINDING GLOBULIN

$ 152.00 

1397

LABORATORY

4886064

SILICA

$ 302.00 

1398

LABORATORY

4800181

SODIUM SERUM PLASMA OR WHOLE BLD

$ 50.00 

1399

LABORATORY

4801056

SODIUM URINE

$ 50.00 

1400

LABORATORY

4810909

SODIUM OTHER SOURCE

$ 50.00 

1401

LABORATORY

4806469

SOMATOMEDIN-C

$ 171.00 

1402

LABORATORY

4810552

SPECTROPHOTOMETRY ANALYTE NES

$ 104.00 

1403

LABORATORY

4887006

REDUCING SUBSTANCES, FECAL

$ 34.00 

1404

LABORATORY

4809273

SULFATE URINE

$ 65.00 

1405

LABORATORY

4807822

FREE TESTOSTERONE

$ 211.00 

1406

LABORATORY

4803342

TOTAL TESTOSTERONE

$ 211.00 

1407

LABORATORY

4820361

TESTOSTERONE BIOAVAILABLE

$ 189.00 

1408

LABORATORY

4804621

VITAMIN B1 THIAMINE

$ 244.00 

1409

LABORATORY

4809281

THYROGLOBULIN LEVEL

$ 158.00 

1410

LABORATORY

5400130

THYROXINE TOTAL

$ 99.00 

1411

LABORATORY

4804282

FREE T4 THYROXINE FREE

$ 100.00 

1412

LABORATORY

4885117

THYROXINE BIND GLOBULIN (TBG)

$ 138.00 

1413

LABORATORY

5400049

TSH SENSITIVE

$ 145.00 

1414

LABORATORY

4808507

THYROID IMMUNOGLOBULINS (TSI)

$ 510.00 

1415

LABORATORY

4804340

VITAMIN E

$ 140.00 

1416

LABORATORY

4800876

AST (GOT)

$ 68.00 

1417

LABORATORY

4832152

POC AST

$ 68.00 

1418

LABORATORY

4800884

ALT (GPT)

$ 56.00 

1419

LABORATORY

4832151

POC ALT

$ 56.00 

1420

LABORATORY

4804316

TRANSFERRIN

$ 125.00 

1421

LABORATORY

4801213

TRIGLYCERIDE

$ 51.00 

1422

LABORATORY

5400122

T UPTAKE

$ 96.00 

1423

LABORATORY

5400031

TRIIODOTHYRONINE T3 TOTAL

$ 132.00 

1424

LABORATORY

4805404

FREE T3

$ 171.00 

1425

LABORATORY

4810628

TRIIODOTHYRONINE T3/REVERSE

$ 129.00 

1426

LABORATORY

4805750

TROPONIN QUANTITATIVE

$ 138.00 

1427

LABORATORY

4800751

UREA NITROGEN (BUN)

$ 52.00 

1428

LABORATORY

4832105

UREA NITROGEN (BUN)

$ 52.00 

1429

LABORATORY

4806477

UREA NITROGEN (URINE)

$ 46.00 

1430

LABORATORY

4800900

URIC ACID (BLOOD)

$ 42.00 

1431

LABORATORY

4804324

URIC ACID URINE OTHER

$ 56.00 

1432

LABORATORY

4805321

VANILLYLMANDELIC ACID

$ 191.00 

1433

LABORATORY

4806493

VASOACTIVE INTESTINAL PEPTIDE

$ 348.00 

1434

LABORATORY

4818019

ASSAY VASOPRESSIN

$ 285.00 

1435

LABORATORY

4803433

VITAMIN A

$ 183.00 

1436

LABORATORY

4885513

VITAMIN,NOT OTERWISE SPECIFIED

$ 133.00 

1437

LABORATORY

4885695

VITAMIN K

$ 179.00 

1438

LABORATORY

4806683

VOLATILES (ACETIC ANHYDRIDE, DIETHYLETHER)

$ 131.00 

1439

LABORATORY

4803391

ZINC

$ 171.00 

1440

LABORATORY

4806170

C-PEPTIDE

$ 171.00 

1441

LABORATORY

4804423

GENERAL LAB/SEROLOGY HCG

$ 119.00 

1442

LABORATORY

4832085

POC-PREGNANCY,SERUM

$ 70.00 

1443

LABORATORY

4885953

FECAL ELECTROLYTE & OSMOLALITY PROFILE

$ 191.00 

1444

LABORATORY

4886040

ANSER IFX TO PROMETHEUS

$ 2,088.00 

1445

LABORATORY

4800695

BLOOD COUNT AUTOMATED DIFF WBC COUNT

$ 45.00 

1446

LABORATORY

4811006

BLOOD SMEAR, MANUAL

$ 41.00 

1447

LABORATORY

4832103

BLOOD SMEAR, MANUAL

$ 41.00 

1448

LABORATORY

4832102

SPUN HEMATROCRIT

$ 34.00 

1449

LABORATORY

4800629

HEMATOCRIT

$ 41.00 

1450

LABORATORY

4832099

HEMATOCRIT

$ 41.00 

1451

LABORATORY

4800637

HEMOGLOBIN

$ 41.00 

1452

LABORATORY

4832090

HEMOGLOBIN

$ 41.00 

1453

LABORATORY

4800611

CBC WITH DIFFERENTIAL

$ 90.00 

1454

LABORATORY

4832081

CBC WITH DIFFERENTIAL

$ 90.00 

1455

LABORATORY

4801643

CBC WITHOUT DIFFERENTIAL

$ 60.00 

1456

LABORATORY

4832096

CBC WITHOUT DIFFERENTIAL

$ 60.00 

1457

LABORATORY

4800652

RBC COUNT BLOOD, AUTO

$ 27.00 

1458

LABORATORY

4802670

RETICULOCYTE COUNT,AUTO W/1 CELL PAR

$ 60.00 

1459

LABORATORY

4800645

WBC, AUTO

$ 38.00 

1460

LABORATORY

4800660

PLATELET AUTOMATED

$ 42.00 

1461

LABORATORY

4832101

PLATELET AUTOMATED

$ 42.00 

1462

LABORATORY

4852919

CHROMOGENIC SUBSTRATE ASSAY

$ 64.00 

1463

LABORATORY

4809299

CLOT FACTOR II PROTHROMBIN SPECIFIC

$ 232.00 

1464

LABORATORY

4810107

FACTOR 5

$ 239.00 

1465

LABORATORY

4810115

FACTOR 7

$ 230.00 

1466

LABORATORY

4804449

FACTOR VIII (COAG)

$ 235.00 

1467

LABORATORY

4806634

RISTOCETIN COF ACTIVE

$ 218.00 

1468

LABORATORY

4804233

RISTOCETIN,VONWILLEBRAND

$ 232.00 

1469

LABORATORY

4853107

VW FACTOR, MULTIMETRIC ANAL

$ 238.00 

1470

LABORATORY

4803888

FACTOR IX

$ 274.00 

1471

LABORATORY

4810123

FACTOR 11

$ 232.00 

1472

LABORATORY

4810131

FACTOR 12

$ 244.00 

1473

LABORATORY

4809804

FACTOR 13 FIBRIN STABILIZING

$ 486.00 

1474

LABORATORY

4819025

PREKALLIKREIN ASSAY

$ 157.00 

1475

LABORATORY

4800006

CLOTTING FACTORS, HIGH MOLECULAR WEIGH KININOGEN

$ 522.00 

1476

LABORATORY

4803631

ANTITHROMBIN III FUNCT

$ 197.00 

1477

LABORATORY

4804431

ANTITHROMBIN III(AGN)

$ 171.00 

1478

LABORATORY

4804464

PROTEIN C ANTIGEN

$ 193.00 

1479

LABORATORY

4809307

CLOT INHIB OR ANTICOAG PROTEIN C ACTIVITY

$ 278.00 

1480

LABORATORY

4810008

PROTEIN-S TOTAL

$ 220.00 

1481

LABORATORY

4809802

CLOT INHIB OR ANTICOAG PROTEIN S FREE

$ 211.00 

1482

LABORATORY

4853057

ACT PROTEIN C,RESIST ASSAY

$ 166.00 

1483

LABORATORY

4810099

FACTOR INHABITOR

$ 227.00 

1484

LABORATORY

4832110

ACTIVATED CLOTTING TIME

$ 30.00 

1485

LABORATORY

4853149

D-DIMER (QUANTITATIVE)

$ 123.00 

1486

LABORATORY

4800587

FIBRINOGEN ACTIVITY

$ 96.00 

1487

LABORATORY

4809929

CLOTTING ASSAY WHOLE BLOOD ROTEM

$ 290.00 

1488

LABORATORY

4804756

FIBRINOLYTIC ACTIVITY EA

$ 435.00 

1489

LABORATORY

4806717

PLASMINOGEN

$ 107.00 

1490

LABORATORY

5200266

KLEIHAUER-BETKE

$ 64.00 

1491

LABORATORY

5200605

FETAL BLEED SCREEN

$ 55.00 

1492

LABORATORY

4885372

HEPARIN ASSAY

$ 117.00 

1493

LABORATORY

4885374

HEPARIN NEUTRALIZATION

$ 97.00 

1494

LABORATORY

4801460

LEUKO ALK PHOS SCREEN

$ 71.00 

1495

LABORATORY

4806378

MURAMIDASE

$ 131.00 

1496

LABORATORY

4807046

OSMOTIC FRAGILITY

$ 55.00 

1497

LABORATORY

4886033

OSMOTIC FRAGILITY, ERYTHROCYTE

$ 210.00 

1498

LABORATORY

4885729

PLT AGGREGATION EA AGENT

$ 158.00 

1499

LABORATORY

4806709

PLATELET NEUT PROC

$ 145.00 

1500

LABORATORY

4806710

PHOSPOLIPID NEUTRALIZATION

$ 147.00 

1501

LABORATORY

4800561

PROTHROMBIN TIME

$ 64.00 

1502

LABORATORY

4832069

POC-PT

$ 64.00 

1503

LABORATORY

4803029

MIXING PT SCREEN

$ 68.00 

1504

LABORATORY

4885521

RUSSELL VIPER VENOM TIME DIL

$ 95.00 

1505

LABORATORY

4807657

REPTILASE TIME

$ 97.00 

1506

LABORATORY

4800694

SEDRATE WESTERGREN

$ 30.00 

1507

LABORATORY

5101858

RBC SEDIMENTATION RATE

$ 30.00 

1508

LABORATORY

4830006

ESR AUTOMATED

$ 37.00 

1509

LABORATORY

4804258

SICKLING OF RBC REDUCTION

$ 137.00 

1510

LABORATORY

4802419

THROMBIN TIME

$ 70.00 

1511

LABORATORY

4800579

ACTIVATED PTT

$ 89.00 

1512

LABORATORY

4803037

MIXING APT SCREEN

$ 82.00 

1513

LABORATORY

4801684

VISCOSITY

$ 176.00 

1514

LABORATORY

4807095

AGGLUTININS FEBRILE EACH

$ 115.00 

1515

LABORATORY

4810511

ALLERGEN SPEC IGG Q/S EA.

$ 63.00 

1516

LABORATORY

4805925

ALLERGEN SPEC IGE CRUDE EXTRCT EACH

$ 54.00 

1517

LABORATORY

4887004

ALLERGEN SPEC IGE RECOMB/CMPT EACH

$ 109.00 

1518

LABORATORY

4805958

WBC ANTIBODY ID

$ 161.00 

1519

LABORATORY

4807053

PLATELET AB DIRECT

$ 431.00 

1520

LABORATORY

4885985

HEPARIN INDUCED THROMBOCYTOPENIA (HIT)

$ 170.00 

1521

LABORATORY

4800538

ANTINUCLEAR ANTIBODIES

$ 144.00 

1522

LABORATORY

4801601

ANA TITER AND PATTERN

$ 222.00 

1523

LABORATORY

4800512

ANTISTREPTOLYSIN O TITER

$ 96.00 

1524

LABORATORY

4800504

ANTISTREPTOLYSIN SCREEN

$ 89.00 

1525

LABORATORY

5211123

INVIVO CROSSMATCH

$ 358.00 

1526

LABORATORY

5201512

TRANSFUSION REACTION WORKUP

$ 364.00 

1527

LABORATORY

4800470

C-REACTIVE PROTEIN

$ 111.00 

1528

LABORATORY

4853073

C-REACTIVE PROT,HIGHLY SENS

$ 134.00 

1529

LABORATORY

4885638

BETA 2 GLYCORPROTEN AB

$ 173.00 

1530

LABORATORY

4805040

ANTI-CARDIOLIPIN SO

$ 223.00 

1531

LABORATORY

4886078

CIRCULATING TUMOR CELL COUNT

$ 1,375.00 

1532

LABORATORY

4800488

COLD AGGLUTIN

$ 112.00 

1533

LABORATORY

4801403

COMPLEMENT ANTIGEN

$ 223.00 

1534

LABORATORY

4806188

COMP ANTIGEN FUNCT ACTIVITY

$ 151.00 

1535

LABORATORY

4803763

COMPLEMENT TOTAL

$ 326.00 

1536

LABORATORY

4885497

COMPLEMENT FIXATION, EA A.G.

$ 95.00 

1537

LABORATORY

4885415

CYCLIC CITR PEPTIDE ANTIBODY

$ 181.00 

1538

LABORATORY

4806808

DEOXYRIBONUCLEASE ANTIBODY

$ 196.00 

1539

LABORATORY

4804670

ANTI DNA AB DOUBLE STRAND

$ 184.00 

1540

LABORATORY

4800204

DNA ANTIBODY SNG STRANDED

$ 158.00 

1541

LABORATORY

4803623

ANTI-ENA(SM/RNP) ANTIBODIES

$ 213.00 

1542

LABORATORY

4802351

FLUORESCENT ANTIBODY SCREEN

$ 274.00 

1543

LABORATORY

4886090

FLUORESCENT ANTIBODY SCREEN (MOG IGG1)

$ 1,300.00 

1544

LABORATORY

4887011

FLUORESCENT ANTIBODY SCREEN (NMOFS/MOGFS)

$ 1,165.00 

1545

LABORATORY

4802369

FLUORESCENT ANTIBODY TITER

$ 270.00 

1546

LABORATORY

4852968

CA 15-3 QUANT

$ 203.00 

1547

LABORATORY

4886043

IMMUNOASSAY TUMOR CA 19-9

$ 144.00 

1548

LABORATORY

4810529

TUMOR ANTIGEN QUANT CA125

$ 215.00 

1549

LABORATORY

4886048

HUMAN EPIDIDYMIS PROTEIN 4

$ 265.00 

1550

LABORATORY

4800496

INFECTOUS MONO

$ 85.00 

1551

LABORATORY

4832092

INFECTOUS MONO

$ 85.00 

1552

LABORATORY

4804613

IMMUMO TUMOR ANTIGEN EA

$ 353.00 

1553

LABORATORY

4806758

IMMUNOASSAY INFECTIOUS AGENT

$ 249.00 

1554

LABORATORY

4887024

IMMUNOASSAY INFECTIOUS AGENT LEVEL 2

$ 120.00 

1555

LABORATORY

4806329

IMMUNO-ELECTRO-SERUM

$ 215.00 

1556

LABORATORY

4800206

GEL DIFFUSION QUAL EACH ANTIGEN OR ANTIBODY

$ 158.00 

1557

LABORATORY

4806311

IMMUNE COMPLEX ASSAY

$ 447.00 

1558

LABORATORY

4800892

IMMUNOELECTROP SERUM

$ 215.00 

1559

LABORATORY

4885802

IMMUNOELECTROPHORESIS URINE

$ 233.00 

1560

LABORATORY

4885646

INHIBIN A

$ 161.00 

1561

LABORATORY

4804027

INSULIN ANTIBODY SO

$ 328.00 

1562

LABORATORY

4806337

INTRINSIC FACTOR ANTIBODIES

$ 215.00 

1563

LABORATORY

4806667

ISLET CELL AB

$ 326.00 

1564

LABORATORY

4887022

ISLET CELL AB LEVEL 2

$ 737.00 

1565

LABORATORY

4806668

CELL FUNCTION ASSAY W/STIMULATION

$ 760.00 

1566

LABORATORY

4803632

LYMPHOCYTE TRANSFORM:MITO/ANTI

$ 493.00 

1567

LABORATORY

4885810

B CELL TOTAL COUNT

$ 156.00 

1568

LABORATORY

4804623

MONONUCLEAR QUANT EA AG

$ 117.00 

1569

LABORATORY

4885828

NATURAL KILLER CELLS TOTAL CT

$ 155.00 

1570

LABORATORY

4885018

GENERAL LAB/SEROLOGY

$ 223.00 

1571

LABORATORY

4885026

T CELL ABSOLUTE COUNT/RATIO

$ 231.00 

1572

LABORATORY

4887002

T CELLS ABSOLUTE CD4 CT

$ 101.00 

1573

LABORATORY

4803318

MICOSOMAL ANTIBODY

$ 223.00 

1574

LABORATORY

4809612

RABIES ANTIBODY TITER

$ 328.00 

1575

LABORATORY

4802799

PART AGGLUTINATION SCR EA ANTI

$ 105.00 

1576

LABORATORY

4800462

RHEUMATOID FACTOR

$ 87.00 

1577

LABORATORY

4810768

RHEUMATOID FACTOR QUANT

$ 89.00 

1578

LABORATORY

4802123

M TUBERCULOSIS BY QUANTIFERON

$ 464.00 

1579

LABORATORY

4886069

TB AG RESPONSE T-CELL SUSP

$ 257.00 

1580

LABORATORY

5101953

CANDIDA SKIN TEST

$ 75.00 

1581

LABORATORY

5100631

POC TB TEST (INTRADERMAL)

$ 55.00 

1582

LABORATORY

4800454

GENERAL LAB/SEROLOGY RPR

$ 74.00 

1583

LABORATORY

4852992

GENERAL LAB/SEROLOGY

$ 58.00 

1584

LABORATORY

4806568

ADENOVIRUS ANTIBODY

$ 83.00 

1585

LABORATORY

4807848

ASPERGILLUS ANTIBODY

$ 145.00 

1586

LABORATORY

4810446

BACTERIUM NOT SPECIFIED

$ 351.00 

1587

LABORATORY

4885331

BARTONELLA ANTIBODY

$ 105.00 

1588

LABORATORY

4806766

BLASTOMYCES ANTIBODY

$ 117.00 

1589

LABORATORY

4803466

BORDATELLA

$ 223.00 

1590

LABORATORY

4806618

LYME WESTERN BLOT

$ 257.00 

1591

LABORATORY

4802625

LYMES ANTIBODY SCREEN

$ 195.00 

1592

LABORATORY

4886063

BORRELIA MIYAMOTOI (SERUM/PLASMA)

$ 94.00 

1593

LABORATORY

4806774

BRUCELLA ANTIBODY

$ 93.00 

1594

LABORATORY

4806782

CANDIDA ANTIBODY

$ 126.00 

1595

LABORATORY

4805990

CHLAMYDIA SCREEN

$ 166.00 

1596

LABORATORY

4807830

CHLAMYDIA IGM ANTIBODY

$ 184.00 

1597

LABORATORY

4806790

COCCIDIODES ANTIBODY

$ 143.00 

1598

LABORATORY

4806840

Q FEVER ANTIBODIES

$ 126.00 

1599

LABORATORY

4804704

CYTOMEGALOVIRUS IGG

$ 243.00 

1600

LABORATORY

4809091

AB CMV IGM

$ 233.00 

1601

LABORATORY

4810073

DIPTHERIA ANTITOXOID

$ 156.00 

1602

LABORATORY

4807087

CALIFORNIA VIRUS AB

$ 83.00 

1603

LABORATORY

4807517

ENCEPHALITIS EASTERN EQUINE

$ 149.00 

1604

LABORATORY

4806857

ST LOUIS ENCPH AB

$ 136.00 

1605

LABORATORY

4807079

WEST EQUINE ENCEPHAL

$ 103.00 

1606

LABORATORY

4804605

ENTEROVIRUS ANTIBODY (COXSACKE, ECHOVIRUS, POLIO VIRUS)

$ 92.00 

1607

LABORATORY

4805420

EPSTEIN BAR VIRUS ANTIBODY

$ 140.00 

1608

LABORATORY

4809109

AB EPSTEIN-BARR NUCLEAR AG

$ 284.00 

1609

LABORATORY

4809117

AB EPST-BARR VIR CAPSID-VIRAL

$ 284.00 

1610

LABORATORY

4852935

EHRLICHIA ANTIBODY

$ 161.00 

1611

LABORATORY

4810420

FRANCISELLA TULARENSIS

$ 101.00 

1612

LABORATORY

4806865

SPOROTHRIX ANTIBODY

$ 117.00 

1613

LABORATORY

4885034

CYSTIC LGG AB,WSTRN BLOT

$ 249.00 

1614

LABORATORY

4810461

HEMOLPHILUS INFLU TITRE,PRP

$ 383.00 

1615

LABORATORY

4818076

GENERAL LAB/SEROLOGY

$ 145.00 

1616

LABORATORY

4810362

GENERAL LAB/SEROLOGY

$ 264.00 

1617

LABORATORY

4810636

HEP ANTIBODY, DELTA AGENT

$ 177.00 

1618

LABORATORY

4802062

GENERAL LAB/SEROLOGY

$ 222.00 

1619

LABORATORY

4809125

GENERAL LAB/SEROLOGY

$ 153.00 

1620

LABORATORY

4810537

GENERAL LAB/SEROLOGY

$ 264.00 

1621

LABORATORY

4806824

HISTOPLASMA ANTIBODY

$ 109.00 

1622

LABORATORY

4885952

ANTIBODY ID HIV-1

$ 187.00 

1623

LABORATORY

4885947

HIV2 - SINGLE RESULT

$ 212.00 

1624

LABORATORY

5400361

GENERAL LAB/SEROLOGY

$ 181.00 

1625

LABORATORY

4810248

GENERAL LAB/SEROLOGY HBCGM

$ 123.00 

1626

LABORATORY

5400742

GENERAL LAB/SEROLOGY HBSAB

$ 120.00 

1627

LABORATORY

4806675

HEPATITIS BE AB

$ 122.00 

1628

LABORATORY

5400734

GENERAL LAB/SEROLOGY

$ 137.00 

1629

LABORATORY

5400759

GENERAL LAB/SEROLOGY HAVGM

$ 190.00 

1630

LABORATORY

4808150

INFLUENZA A ANTIBODY

$ 166.00 

1631

LABORATORY

4886061

ANTIBODY JC VIRUS II

$ 3,458.00 

1632

LABORATORY

4808143

LEGIONELLA ANTIBODY

$ 158.00 

1633

LABORATORY

4806832

LEPTOSPIROSIS

$ 136.00 

1634

LABORATORY

4805156

MUMPS ANTIBODY IGG

$ 136.00 

1635

LABORATORY

4804498

MYCOPLASMA TITER

$ 131.00 

1636

LABORATORY

4885969

NEISSERIA MENINGITIDES TREVALENT ANTIBODIES

$ 151.00 

1637

LABORATORY

4810875

PARVOVIRUS ANTIBODY

$ 156.00 

1638

LABORATORY

4853065

PROTOZOA ANTIBODY

$ 130.00 

1639

LABORATORY

4886097

WA1 IGG ANTIBODY BY IFA

$ 270.00 

1640

LABORATORY

4810545

RICKETTSIA ANTIBODY

$ 137.00 

1641

LABORATORY

4801023

RUBELLA

$ 160.00 

1642

LABORATORY

4804597

RUBEOLA SCREEN

$ 115.00 

1643

LABORATORY

4807061

SALMONELLA TYPING

$ 127.00 

1644

LABORATORY

4804894

TETANUS AB

$ 180.00 

1645

LABORATORY

4806659

TOXOPLASMOSIS IGM

$ 166.00 

1646

LABORATORY

4804308

TOXOPLASMA IGM ANTIBODY

$ 237.00 

1647

LABORATORY

4805198<