|
Drain thigh/knee lesion 27301
|
$3,174.75 |
$3,174.75 |
$3,174.75 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$954.72 |
$954.72 |
$954.72 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$716.04 |
$716.04 |
$716.04 |
$365.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$954.72 |
$954.72 |
$954.72 |
$554.40
|
|
Dressing change not for burn w/anes 15852
|
$714.00 |
$714.00 |
$714.00 |
$790.56
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$11,419.10 |
$11,419.10 |
$11,419.10 |
$6,501.85
|
|
Drill hole implt ventricular cath/device 61107
|
$2,108.34 |
$2,108.34 |
$2,108.34 |
$1,594.26
|
|
Drng hand tendon sheath 26020
|
$3,657.72 |
$3,657.72 |
$3,657.72 |
$3,981.06
|
|
Drng of eyelid abscess 67700
|
$1,181.67 |
$1,181.67 |
$1,181.67 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$1,842.63 |
$1,842.63 |
$1,842.63 |
$2,048.00
|
|
Drng of mouth lesion 40801
|
$561.51 |
$561.51 |
$561.51 |
$1,145.97
|
|
Drng of pelvic abscess transrectal 45000
|
$1,331.10 |
$1,331.10 |
$1,331.10 |
$1,614.45
|
|
Drng of scrotum abscess 55100
|
$1,299.48 |
$1,299.48 |
$1,299.48 |
$2,069.60
|
|
Drng salivary gland simple 42300
|
$1,705.95 |
$1,705.95 |
$1,705.95 |
$2,133.48
|
|
Drng salivary gland submax/subling 42310
|
$561.51 |
$561.51 |
$561.51 |
$602.63
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,817.01 |
$1,817.01 |
$1,817.01 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$3,075.94 |
$3,075.94 |
$3,075.94 |
$2,608.11
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$517.59 |
$517.59 |
$517.59 |
$189.68
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$5,682.98 |
$5,682.98 |
$5,682.98 |
$6,491.75
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$21,381.84 |
$21,381.84 |
$21,381.84 |
$16,467.61
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$82.62 |
$82.62 |
$82.62 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$544.17 |
$544.17 |
$544.17 |
$3,390.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$661.47 |
$661.47 |
$661.47 |
$903.00
|
|
Duragen 1x1 5ea/bx
|
$11,077.06 |
$11,077.06 |
$11,077.06 |
$13,812.34
|
|
Dxa bone density axl vrt fx
|
$112.71 |
$112.71 |
$112.71 |
$374.00
|
|
Dx bronchoscope/lavage 31624
|
$2,755.53 |
$2,755.53 |
$2,755.53 |
$2,780.40
|
|
Dx bronchoscope/wash 31622
|
$2,755.53 |
$2,755.53 |
$2,755.53 |
$2,587.60
|
|
Dx gastr intub w/asp spec
|
$344.25 |
$344.25 |
$344.25 |
$368.50
|
|
Dx gastr intub w/asp specs
|
$179.01 |
$179.01 |
$179.01 |
$204.96
|
|
Dx laryngoscopy newborn
|
$649.74 |
$649.74 |
$649.74 |
$619.08
|
|
Dx laryngoscopy w/oper scope
|
$2,755.53 |
$2,755.53 |
$2,755.53 |
$2,040.67
|
|
Ear irrigation 69209
|
$95.37 |
$95.37 |
$95.37 |
$165.42
|
|
Ecg 12 lead tracing only
|
$166.26 |
$166.26 |
$166.26 |
$245.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$33.15 |
$33.15 |
$33.15 |
$162.78
|
|
Ecg external >7 days up to 15 days recording
|
$61.71 |
$61.71 |
$61.71 |
$200.00
|
|
Echocardiogram (Heart Ultrasound)
|
$1,140.36 |
$1,140.36 |
$1,140.36 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$576.81 |
$576.81 |
$576.81 |
$469.95
|
|
Echocardiography transthoracic 2d followup/limited
|
$425.85 |
$425.85 |
$425.85 |
$724.20
|
|
Echocardiograpy doppler follow up/limited study
|
$540.09 |
$540.09 |
$540.09 |
$353.46
|
|
Echo exam uterus 76831-
|
$713.49 |
$713.49 |
$713.49 |
$547.20
|
|
Egd remove foreign body
|
$842.01 |
$842.01 |
$842.01 |
$1,588.55
|
|
Egd remove lesion snare
|
$412.08 |
$412.08 |
$412.08 |
$2,506.40
|
|
Egd Ultrasound fine needle bx/aspir
|
$1,776.33 |
$1,776.33 |
$1,776.33 |
$2,664.75
|
|
EKG (Electrocardiogram)
|
$65.79 |
$65.79 |
$65.79 |
$102.44
|
|
Elbow arthroscopy/surgery
|
$1,043.97 |
$1,043.97 |
$1,043.97 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$1,032.75 |
$1,032.75 |
$1,032.75 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$787.44 |
$787.44 |
$787.44 |
$3,839.54
|
|
Elec analys infus pump w/reprog 62368
|
$479.40 |
$479.40 |
$479.40 |
$619.45
|
|
Electrd sq emblem s-icd
|
$7,812.37 |
$7,812.37 |
$7,812.37 |
$9,319.72
|
|
Electrolyte panel
|
$43.86 |
$43.86 |
$43.86 |
$86.33
|
|
Emb without cervical dilation 58100
|
$518.67 |
$518.67 |
$518.67 |
$397.66
|
|
Endocerv curettage w/scope 57456
|
$1,064.88 |
$1,064.88 |
$1,064.88 |
$515.50
|
|
Endocervical curettage 57505
|
$1,362.72 |
$1,362.72 |
$1,362.72 |
$1,030.40
|
|
Endoscpy nsl/sns w/cntrl nsl hmrrgh
|
$2,755.53 |
$2,755.53 |
$2,755.53 |
$2,872.59
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$112.52 |
$112.52 |
$112.52 |
$116.08
|
|
Enterectomy small intestine single 44120
|
$1,832.43 |
$1,832.43 |
$1,832.43 |
$3,002.40
|
|
Epidrm a-grft face/nck/hf/g 15115
|
$1,377.00 |
$1,377.00 |
$1,377.00 |
$2,478.85
|
|
Epidrm agrft t/a/l 1st 100
|
$1,361.19 |
$1,361.19 |
$1,361.19 |
$2,856.87
|
|
Epidrm autogrft t/a/l add-on
|
$231.54 |
$231.54 |
$231.54 |
$1,113.83
|
|
Epidural/lumbar/sacral/ea add level64484
|
$281.52 |
$281.52 |
$281.52 |
$1,182.00
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$458.15 |
$458.15 |
$458.15 |
$351.32
|
|
Episiotomy/vag rpr oth/thn attending phys 59300
|
$3,474.63 |
$3,474.63 |
$3,474.63 |
$3,762.53
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$316.48 |
$316.48 |
$316.48 |
$884.44
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$265.13 |
$265.13 |
$265.13 |
$427.26
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$274.74 |
$274.74 |
$274.74 |
$298.23
|
|
ER Visit (level 1, minor)
|
$546.72 |
$546.72 |
$546.72 |
$276.70
|
|
ER Visit (level 2)
|
$1,005.21 |
$1,005.21 |
$1,005.21 |
$487.50
|
|
ER Visit (level 3)
|
$1,753.38 |
$1,753.38 |
$1,753.38 |
$850.50
|
|
ER Visit (level 4)
|
$2,726.46 |
$2,726.46 |
$2,726.46 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$3,535.32 |
$3,535.32 |
$3,535.32 |
$2,007.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$391.30 |
$391.30 |
$391.30 |
$481.77
|
|
Esophagoscopy/flex/diagnostic 43200
|
$842.01 |
$842.01 |
$842.01 |
$1,109.47
|
|
Esophagoscopy flex remove fb
|
$1,776.33 |
$1,776.33 |
$1,776.33 |
$2,109.53
|
|
Esoph egd dilation <30 mm
|
$1,776.33 |
$1,776.33 |
$1,776.33 |
$2,656.80
|
|
Established Patient Office Visit (level 1)
|
$155.55 |
$155.55 |
$155.55 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$205.02 |
$205.02 |
$205.02 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$302.43 |
$302.43 |
$302.43 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$461.04 |
$461.04 |
$461.04 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$538.56 |
$538.56 |
$538.56 |
$287.10
|
|
Estradiol total
|
$265.71 |
$265.71 |
$265.71 |
$153.00
|
|
Etonogestrel implant system
|
$2,477.85 |
$2,477.85 |
$2,477.85 |
$2,211.36
|
|
Euflexxa inj per dose
|
$278.46 |
$278.46 |
$278.46 |
$632.56
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$229.50 |
$229.50 |
$229.50 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$296.31 |
$296.31 |
$296.31 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$544.68 |
$544.68 |
$544.68 |
$320.00
|
|
Exam plvc w/anes othr thn lcl
|
$3,474.63 |
$3,474.63 |
$3,474.63 |
$3,649.80
|
|
Exc abdl tum deep < 5 cm
|
$1,049.07 |
$1,049.07 |
$1,049.07 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$872.61 |
$872.61 |
$872.61 |
$3,386.84
|
|
Exc arm/elbo les sc <3cm 24075
|
$591.09 |
$591.09 |
$591.09 |
$1,917.33
|
|
Exc back les sbq <3 cm 21930
|
$1,022.04 |
$1,022.04 |
$1,022.04 |
$2,271.01
|
|
Exc back tum deep 5 cm/>
|
$1,359.66 |
$1,359.66 |
$1,359.66 |
$3,370.52
|
|
Exc bartholins gland/cyst
|
$3,474.63 |
$3,474.63 |
$3,474.63 |
$3,744.41
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$1,842.63 |
$1,842.63 |
$1,842.63 |
$2,184.60
|
|
Exc benign feenlm >4.0cm 11446
|
$3,174.75 |
$3,174.75 |
$3,174.75 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$1,842.63 |
$1,842.63 |
$1,842.63 |
$2,244.06
|
|
Exc benign tal 0.5 < cm 11400
|
$1,407.09 |
$1,407.09 |
$1,407.09 |
$837.48
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$797.64 |
$797.64 |
$797.64 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$853.23 |
$853.23 |
$853.23 |
$1,045.20
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,842.63 |
$1,842.63 |
$1,842.63 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,842.63 |
$1,842.63 |
$1,842.63 |
$1,372.15
|