|
Drainage ext aud canal abscess 69020
|
$1,891.49 |
$1,891.49 |
$1,891.49 |
$900.80
|
|
Drainage external ear complex 69005
|
$1,635.15 |
$1,635.15 |
$1,635.15 |
$2,967.58
|
|
Drainage external ear simple 69000
|
$1,635.15 |
$1,635.15 |
$1,635.15 |
$809.25
|
|
Drainage mouth roof lesion
|
$605.74 |
$605.74 |
$605.74 |
$474.39
|
|
Drainage of arm bursa 23931
|
$7,463.75 |
$7,463.75 |
$7,463.75 |
$2,419.30
|
|
Drainage of forearm bursa
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$1,893.86
|
|
Drainage of kidney lesion
|
$5,177.76 |
$5,177.76 |
$5,177.76 |
$1,706.65
|
|
Drainage of mouth lesion
|
$1,331.45 |
$1,331.45 |
$1,331.45 |
$455.56
|
|
Drainage of mouth lesion
|
$4,045.88 |
$4,045.88 |
$4,045.88 |
$2,320.03
|
|
Drainage of mouth lesion
|
$8,292.12 |
$8,292.12 |
$8,292.12 |
$3,986.00
|
|
Drainage of mouth lesion
|
$1,331.45 |
$1,331.45 |
$1,331.45 |
$1,022.40
|
|
Drainage of nose lesion sept 30020
|
$3,115.67 |
$3,115.67 |
$3,115.67 |
$755.95
|
|
Drainage of pelvis lesion 26990
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$3,969.00
|
|
Drainage of rectal abscess
|
$3,156.25 |
$3,156.25 |
$3,156.25 |
$2,299.90
|
|
Drainage of rectal abscess 45020
|
$4,096.00 |
$4,096.00 |
$4,096.00 |
$3,245.23
|
|
Drain bladder by trocar/cath
|
$1,402.98 |
$1,402.98 |
$1,402.98 |
$1,126.11
|
|
Drain blood from under nail 11740
|
$1,340.43 |
$1,340.43 |
$1,340.43 |
$190.33
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$5,005.31 |
$5,005.31 |
$5,005.31 |
$2,614.66
|
|
Drain cath image guided visceral pq
|
$10,622.95 |
$10,622.95 |
$10,622.95 |
$3,073.90
|
|
Drain cerebro spinal fluid 62272
|
$2,107.87 |
$2,107.87 |
$2,107.87 |
$1,113.06
|
|
Drain finger abscess;simple 26010
|
$1,551.82 |
$1,551.82 |
$1,551.82 |
$492.81
|
|
Drain lower leg lesion 27603
|
$7,529.14 |
$7,529.14 |
$7,529.14 |
$3,631.18
|
|
Drain neck/chest lesion 21501
|
$7,529.14 |
$7,529.14 |
$7,529.14 |
$3,386.84
|
|
Drain shoulder lesion
|
$7,529.14 |
$7,529.14 |
$7,529.14 |
$3,571.53
|
|
Drain thigh/knee lesion 27301
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$1,049.26 |
$1,049.26 |
$1,049.26 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$874.38 |
$874.38 |
$874.38 |
$365.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,259.11 |
$1,259.11 |
$1,259.11 |
$554.40
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$289.82 |
$547.00 |
$840.00 |
$9,390.80
|
|
Drng of eyelid abscess 67700
|
$1,138.95 |
$1,138.95 |
$1,138.95 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$4,370.59 |
$4,370.59 |
$4,370.59 |
$2,048.00
|
|
Drng of hydrocele 55000
|
$2,756.59 |
$2,756.59 |
$2,756.59 |
$832.60
|
|
Drng of mouth lesion 40801
|
$1,817.61 |
$1,817.61 |
$1,817.61 |
$1,145.97
|
|
Drng of ovarian cyst(s) 58800
|
$8,240.86 |
$8,240.86 |
$8,240.86 |
$3,474.84
|
|
Drng of scrotum abscess 55100
|
$3,922.28 |
$3,922.28 |
$3,922.28 |
$2,069.60
|
|
Dronabinol 2.5mg oral
|
$65.51 |
$65.51 |
$105.00 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$46.50 |
$46.50 |
$108.52 |
$39.60
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$189.68 |
$189.68 |
$189.68 |
$468.29
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$189.68 |
$189.68 |
$189.68 |
$318.13
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$97.50 |
$97.50 |
$97.50 |
$6,581.45
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$126.18 |
$126.18 |
$126.18 |
$18,384.03
|
|
Drug admin & hemodynmic meas
|
$8,355.00 |
$8,355.00 |
$8,355.00 |
$528.50
|
|
Drug assay caffeine
|
$78.38 |
$419.00 |
$1,254.50 |
$81.61
|
|
Drug assay posaconazole
|
$176.40 |
$263.98 |
$1,192.00 |
$96.39
|
|
Drug assay rufinamide
|
$229.00 |
$229.00 |
$229.00 |
$93.60
|
|
Drug assay vedolizumab
|
$164.16 |
$164.16 |
$164.16 |
$164.16
|
|
Drug assay voriconazole
|
$164.16 |
$252.00 |
$590.00 |
$96.75
|
|
Drug of abuse screen urine
|
$217.75 |
$1,328.75 |
$1,382.83 |
$63.75
|
|
Drug screen quant tiagabine
|
$249.45 |
$249.45 |
$249.45 |
$91.80
|
|
Drug test def 15-21 classes
|
$4,284.75 |
$4,284.75 |
$4,284.75 |
$144.42
|
|
Drug test def 1-7 classes
|
$228.15 |
$565.75 |
$3,025.50 |
$250.52
|
|
Drug test def 22+ classes
|
$5,041.00 |
$5,041.00 |
$5,041.00 |
$246.92
|
|
Drug test def 8-14 classes
|
$3,781.00 |
$3,781.00 |
$3,781.00 |
$172.25
|
|
Drug test prsmv instrmnt
|
$35.18 |
$508.97 |
$1,328.75 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$177.02 |
$575.40 |
$1,328.75 |
$278.85
|
|
Drvvt confirm - quest
|
$229.83 |
$232.00 |
$822.00 |
$101.66
|
|
Dstrj nulyt agt gnclr nrv
|
$11,080.22 |
$11,080.22 |
$11,080.22 |
$3,390.00
|
|
Dstr mal les s/n/h/f/g >4.0
|
$681.12 |
$681.12 |
$681.12 |
$670.00
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$472.99 |
$472.99 |
$472.99 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$567.59 |
$567.59 |
$567.59 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$681.12 |
$681.12 |
$681.12 |
$886.40
|
|
Ductogram sgl duct
|
$1,566.12 |
$1,566.12 |
$4,633.00 |
$413.91
|
|
Duplex scan bilateral study 93985
|
$699.03 |
$835.50 |
$3,989.41 |
$673.00
|
|
Duplex scan unilateral study 93986
|
$336.21 |
$402.00 |
$2,659.60 |
$394.00
|
|
Dup scan/hemodialysis access 93990
|
$2,924.83 |
$6,567.50 |
$7,842.75 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$432.98 |
$432.98 |
$432.98 |
$757.57
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$432.98 |
$2,993.75 |
$3,272.00 |
$903.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$22,536.50 |
$22,536.50 |
$53,053.41 |
$10,021.12
|
|
Dxa bone density axl vrt fx
|
$1,528.69 |
$1,528.69 |
$1,528.69 |
$374.00
|
|
Dx bronchoscope/lavage 31624
|
$1,778.67 |
$1,778.67 |
$1,778.67 |
$2,780.40
|
|
Ear canal biopsy 69105
|
$4,045.88 |
$4,045.88 |
$4,045.88 |
$1,768.50
|
|
Ear irrigation 69209
|
$122.01 |
$122.01 |
$122.01 |
$165.42
|
|
Ecallantide injection
|
$35,351.75 |
$35,351.75 |
$35,351.75 |
$6,132.60
|
|
Ecg 12 lead tracing only
|
$898.71 |
$898.71 |
$898.71 |
$245.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$370.65 |
$524.00 |
$602.75 |
$129.83
|
|
Ecg < 30 days transmission & analysis
|
$1,176.00 |
$1,176.00 |
$3,556.23 |
$429.00
|
|
Ecg external < 48 hours recording
|
$465.50 |
$628.00 |
$3,934.36 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$465.50 |
$628.00 |
$1,527.81 |
$567.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$3,924.26 |
$3,924.26 |
$3,924.26 |
$162.78
|
|
Ecg external >7 days up to 15 days recording
|
$3,884.21 |
$3,884.21 |
$3,884.21 |
$200.00
|
|
Echocardiogram (Heart Ultrasound)
|
$4,220.95 |
$4,220.95 |
$5,914.25 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$774.10 |
$774.10 |
$774.10 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$3,067.59 |
$3,067.59 |
$3,067.59 |
$2,027.90
|
|
Echocardiography transthoracic 2d followup/limited
|
$978.37 |
$2,191.24 |
$2,603.25 |
$724.20
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$978.37 |
$6,412.50 |
$9,327.00 |
$762.00
|
|
Echocardiograpy doppler follow up/limited study
|
$387.06 |
$387.06 |
$387.06 |
$353.46
|
|
Echo exam of fetal heart
|
$1,318.50 |
$2,981.00 |
$5,448.65 |
$855.38
|
|
Echo exam of fetal heart
|
$957.00 |
$2,403.83 |
$2,981.00 |
$503.80
|
|
Echo exam of fetal heart
|
$1,098.00 |
$1,318.50 |
$2,403.83 |
$431.41
|
|
Echo exam of fetal heart
|
$453.75 |
$1,098.00 |
$1,842.92 |
$323.40
|
|
Echo exam uterus 76831-
|
$2,403.83 |
$2,403.83 |
$3,459.00 |
$547.20
|
|
Echograp trans r pros study
|
$1,842.92 |
$1,842.92 |
$2,677.25 |
$459.40
|
|
Echo guidance radiotherapy
|
$2,909.50 |
$2,909.50 |
$7,985.95 |
$774.80
|
|
Echo guide for amniocentesis
|
$627.00 |
$844.25 |
$2,153.70 |
$384.65
|
|
Echo guide for artery repair
|
$2,113.79 |
$2,113.79 |
$2,113.79 |
$680.28
|
|
Echo guide for transfusion
|
$1,790.75 |
$1,790.75 |
$3,116.00 |
$324.60
|
|
Echo guide villus sampling
|
$940.00 |
$940.00 |
$2,692.75 |
$355.80
|
|
Echo stress
|
$2,759.11 |
$3,788.60 |
$9,269.00 |
$1,582.75
|
|
Echo tee guidance
|
$4,807.63 |
$4,807.63 |
$4,807.63 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$4,188.32 |
$4,188.32 |
$4,188.32 |
$1,871.10
|