|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$5,187.53 |
$5,187.53 |
$5,187.53 |
$2,608.11
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$787.65 |
$787.65 |
$787.65 |
$203.46
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$11,219.31 |
$11,219.31 |
$11,219.31 |
$6,491.75
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$46,276.42 |
$46,276.42 |
$46,276.42 |
$16,467.61
|
|
Drug assay voriconazole
|
$81.09 |
$81.09 |
$81.09 |
$96.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$623.22 |
$623.22 |
$623.22 |
$278.85
|
|
Drvvt confirm - quest
|
$3.51 |
$3.51 |
$3.51 |
$101.66
|
|
Dup scan/hemodialysis access 93990
|
$475.32 |
$475.32 |
$475.32 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,512.66 |
$1,512.66 |
$1,512.66 |
$903.00
|
|
Duragen 1x1 5ea/bx
|
$23,223.63 |
$23,223.63 |
$23,223.63 |
$13,812.34
|
|
Dxa bone density axl vrt fx
|
$437.07 |
$437.07 |
$437.07 |
$374.00
|
|
Dx bronchoscope/lavage 31624
|
$4,554.30 |
$4,554.30 |
$4,554.30 |
$2,780.40
|
|
Dx bronchoscope/wash 31622
|
$3,706.68 |
$3,706.68 |
$3,706.68 |
$2,587.60
|
|
Dx gastr intub w/asp spec
|
$567.12 |
$567.12 |
$567.12 |
$368.50
|
|
Dx gastr intub w/asp specs
|
$294.78 |
$294.78 |
$294.78 |
$204.96
|
|
Dx laryngoscopy newborn
|
$874.65 |
$874.65 |
$874.65 |
$619.08
|
|
Dx laryngoscopy w/oper scope
|
$3,706.68 |
$3,706.68 |
$3,706.68 |
$2,040.67
|
|
Ear irrigation 69209
|
$122.40 |
$122.40 |
$122.40 |
$165.42
|
|
Ecg 12 lead tracing only
|
$397.29 |
$397.29 |
$397.29 |
$245.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$197.88 |
$197.88 |
$197.88 |
$129.83
|
|
Ecg external < 48 hours recording
|
$1,811.52 |
$1,811.52 |
$1,811.52 |
$461.76
|
|
Echocardiogram (Heart Ultrasound)
|
$2,472.48 |
$2,472.48 |
$2,472.48 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$980.22 |
$980.22 |
$980.22 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,876.40 |
$2,876.40 |
$2,876.40 |
$2,027.90
|
|
Echocardiography transthoracic 2d followup/limited
|
$724.20 |
$724.20 |
$724.20 |
$724.20
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$781.32 |
$781.32 |
$781.32 |
$757.45
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,816.62 |
$1,816.62 |
$1,816.62 |
$1,871.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,435.65 |
$1,435.65 |
$1,435.65 |
$1,014.01
|
|
Eeg 41-60 minutes 95812-26
|
$2,460.75 |
$2,460.75 |
$2,460.75 |
$956.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$2,460.75 |
$2,460.75 |
$2,460.75 |
$861.12
|
|
Eeg without vid 2-12hr cont mntr
|
$673.20 |
$673.20 |
$673.20 |
$704.79
|
|
Eeg without vid 2-12 hr unmntr
|
$673.20 |
$673.20 |
$673.20 |
$586.20
|
|
Eeg without vid ea 12-26hr cont
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$1,353.60
|
|
Eeg without vid ea 12-26hr intmt
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$1,278.57
|
|
Eeg wo vid 2-12hr intmt mntr
|
$673.20 |
$673.20 |
$673.20 |
$639.00
|
|
Eeg wo vid ea 12-26hr unmntr
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$1,251.52
|
|
E equine encephalitis igg
|
$43.76 |
$43.76 |
$43.76 |
$48.73
|
|
Egd remove foreign body
|
$1,519.29 |
$1,519.29 |
$1,519.29 |
$1,588.55
|
|
Egd Ultrasound fine needle bx/aspir
|
$3,205.35 |
$3,205.35 |
$3,205.35 |
$2,664.75
|
|
Elec analys infus pump w/reprog 62368
|
$560.49 |
$560.49 |
$560.49 |
$619.45
|
|
Electrd sq emblem s-icd
|
$16,379.04 |
$16,379.04 |
$16,379.04 |
$9,319.72
|
|
Electrolyte panel
|
$329.46 |
$329.46 |
$329.46 |
$86.33
|
|
Electron microscopy diagnostic
|
$1,200.54 |
$1,200.54 |
$1,200.54 |
$966.69
|
|
Embolization s&i
|
$4,776.66 |
$4,776.66 |
$4,776.66 |
$3,060.05
|
|
Emb without cervical dilation 58100
|
$360.57 |
$360.57 |
$360.57 |
$397.66
|
|
Encephalitis, california igg/igm
|
$43.79 |
$43.79 |
$43.79 |
$46.75
|
|
Encephalitis, st louis igg/igm
|
$43.76 |
$43.76 |
$43.76 |
$48.03
|
|
Encephalitis, western equine igg/igm
|
$68.89 |
$68.89 |
$68.89 |
$50.70
|
|
Endoscopy swallow (fees) vid
|
$321.81 |
$321.81 |
$321.81 |
$402.35
|
|
Endoscpy nsl/sns w/cntrl nsl hmrrgh
|
$3,706.68 |
$3,706.68 |
$3,706.68 |
$2,872.59
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$136.19 |
$136.19 |
$136.19 |
$116.08
|
|
Entamoeba histolytica ag eia - sendout
|
$60.45 |
$60.45 |
$60.45 |
$66.47
|
|
Enzyme histochemistry
|
$1,351.50 |
$1,351.50 |
$1,351.50 |
$460.32
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$398.64 |
$398.64 |
$398.64 |
$351.32
|
|
Episiotomy/vag rpr oth/thn attending phys 59300
|
$5,724.24 |
$5,724.24 |
$5,724.24 |
$3,762.53
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,140.44 |
$1,140.44 |
$1,140.44 |
$884.44
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$894.57 |
$894.57 |
$894.57 |
$1,022.40
|
|
Epstein barr early antigen antibody
|
$45.90 |
$45.90 |
$45.90 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$46.23 |
$46.23 |
$46.23 |
$81.81
|
|
Epstein barr viral capsid antigen antibody igm
|
$46.23 |
$46.23 |
$46.23 |
$95.04
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$274.74 |
$274.74 |
$274.74 |
$298.23
|
|
ER Visit (level 1, minor)
|
$587.01 |
$587.01 |
$587.01 |
$276.70
|
|
ER Visit (level 2)
|
$1,094.46 |
$1,094.46 |
$1,094.46 |
$487.50
|
|
ER Visit (level 3)
|
$1,925.25 |
$1,925.25 |
$1,925.25 |
$850.50
|
|
ER Visit (level 4)
|
$3,274.71 |
$3,274.71 |
$3,274.71 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$4,458.42 |
$4,458.42 |
$4,458.42 |
$2,007.00
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$268.63 |
$268.63 |
$268.63 |
$248.39
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$504.65 |
$504.65 |
$504.65 |
$481.77
|
|
Esophagoscopy/flex/diagnostic 43200
|
$1,519.29 |
$1,519.29 |
$1,519.29 |
$1,109.47
|
|
Esophagoscopy flex remove fb
|
$3,205.35 |
$3,205.35 |
$3,205.35 |
$2,109.53
|
|
Esoph egd dilation <30 mm
|
$3,205.35 |
$3,205.35 |
$3,205.35 |
$2,656.80
|
|
Estradiol total
|
$228.48 |
$228.48 |
$228.48 |
$153.00
|
|
Estradiol valerate 10 mg inj
|
$109.59 |
$109.59 |
$109.59 |
$55.79
|
|
Estrogens total-sendout
|
$73.90 |
$73.90 |
$73.90 |
$89.25
|
|
Ethylene glycol -sendout
|
$51.00 |
$51.00 |
$51.00 |
$75.00
|
|
Etonogestrel implant system
|
$3,890.21 |
$3,890.21 |
$3,890.21 |
$2,211.36
|
|
Euglobulin lysis
|
$46.03 |
$46.03 |
$46.03 |
$39.75
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$432.48 |
$432.48 |
$432.48 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$464.10 |
$464.10 |
$464.10 |
$347.75
|
|
Evoked potentials auditory screening automated analysis
|
$284.07 |
$284.07 |
$284.07 |
$283.62
|
|
Evok oa screening qual
|
$149.94 |
$149.94 |
$149.94 |
$120.90
|
|
Exam plvc w/anes othr thn lcl
|
$5,724.24 |
$5,724.24 |
$5,724.24 |
$3,649.80
|
|
Exc bartholins gland/cyst
|
$5,724.24 |
$5,724.24 |
$5,724.24 |
$3,744.41
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$3,036.03 |
$3,036.03 |
$3,036.03 |
$2,184.60
|
|
Exc benign feenlm >4.0cm 11446
|
$5,230.05 |
$5,230.05 |
$5,230.05 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$3,036.03 |
$3,036.03 |
$3,036.03 |
$2,244.06
|
|
Exc benign tal 0.5 < cm 11400
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$837.48
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$1,045.20
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$3,036.03 |
$3,036.03 |
$3,036.03 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$3,036.03 |
$3,036.03 |
$3,036.03 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$3,036.03 |
$3,036.03 |
$3,036.03 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$5,230.05 |
$5,230.05 |
$5,230.05 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$818.53
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$1,301.30
|
|
Exchange biliary drg cath
|
$7,210.38 |
$7,210.38 |
$7,210.38 |
$4,176.15
|
|
Exchange drainage catheter
|
$3,545.52 |
$3,545.52 |
$3,545.52 |
$2,256.80
|
|
Excise/repair mouth lesion
|
$2,810.61 |
$2,810.61 |
$2,810.61 |
$2,133.48
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$3,036.03 |
$3,036.03 |
$3,036.03 |
$1,981.25
|
