|
Drug test def 22+ classes
|
$454.62 |
$3,017.66 |
$24,624.37 |
|
|
Drug test def 8-14 classes
|
$1,521.05 |
$10,834.71 |
$16,262.52 |
|
|
Drug test prsmv instrmnt
|
$11.80 |
$35.18 |
$1,328.75 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$101.92 |
$177.02 |
$3,651.38 |
|
|
Drvvt confirm - quest
|
$229.83 |
$423.61 |
$1,417.55 |
|
|
Dstrj nulyt agt gnclr nrv
|
$1,723.36 |
$11,080.22 |
$11,080.22 |
|
|
Dstr mal les s/n/h/f/g >4.0
|
$681.12 |
$681.12 |
$681.12 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$472.99 |
$472.99 |
$472.99 |
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$567.59 |
$567.59 |
$567.59 |
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$681.12 |
$681.12 |
$681.12 |
|
|
Ductogram sgl duct
|
$147.49 |
$1,566.12 |
$4,633.00 |
|
|
Duplex scan bilateral study 93985
|
$673.00 |
$3,989.41 |
$8,191.70 |
|
|
Duplex scan unilateral study 93986
|
$336.21 |
$2,659.60 |
$5,902.60 |
|
|
Dup scan/hemodialysis access 93990
|
$203.11 |
$2,924.83 |
$7,842.75 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$302.02 |
$432.98 |
$738.47 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$289.54 |
$432.98 |
$4,524.00 |
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$136.00 |
$136.00 |
$711.00 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$677.62 |
$53,053.41 |
$53,053.41 |
|
|
Dxa bone density axl vrt fx
|
$170.72 |
$1,528.69 |
$1,528.69 |
|
|
Dx bronchoscope/lavage 31624
|
$1,778.67 |
$1,778.67 |
$1,778.67 |
|
|
Ear canal biopsy 69105
|
$4,045.88 |
$4,045.88 |
$4,045.88 |
|
|
Ear irrigation 69209
|
$122.01 |
$122.01 |
$122.01 |
|
|
Ecallantide injection
|
$35,351.75 |
$35,351.75 |
$35,351.75 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$40.74 |
$370.65 |
$1,120.35 |
|
|
Ecg < 30 days transmission & analysis
|
$404.21 |
$3,556.23 |
$3,626.15 |
|
|
Ecg external < 48 hours recording
|
$163.22 |
$2,873.75 |
$3,934.36 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$243.82 |
$1,527.81 |
$5,218.95 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$129.77 |
$3,924.26 |
$4,013.76 |
|
|
Ecg external >7 days up to 15 days recording
|
$93.09 |
$3,884.21 |
$4,013.76 |
|
|
Echocardiogram (Heart Ultrasound)
|
$672.35 |
$4,220.95 |
$17,912.00 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$257.25 |
$2,191.24 |
$2,909.00 |
|
|
Echocardiography doppler color flow mapping
|
$128.80 |
$774.10 |
$774.10 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$840.70 |
$2,319.90 |
$10,390.55 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$321.65 |
$524.80 |
$9,327.00 |
|
|
Echocardiograpy doppler follow up/limited study
|
$139.65 |
$387.06 |
$3,289.00 |
|
|
Echo exam of fetal heart
|
$624.89 |
$5,448.65 |
$5,448.65 |
|
|
Echo exam of fetal heart
|
$957.00 |
$2,403.83 |
$2,981.00 |
|
|
Echo exam of fetal heart
|
$192.44 |
$1,383.00 |
$2,403.83 |
|
|
Echo exam of fetal heart
|
$453.75 |
$1,842.92 |
$2,280.97 |
|
|
Echo exam uterus 76831-
|
$345.63 |
$2,403.83 |
$10,385.35 |
|
|
Echograp trans r pros study
|
$291.43 |
$1,842.92 |
$4,467.73 |
|
|
Echo guidance radiotherapy
|
$802.96 |
$3,990.25 |
$7,985.95 |
|
|
Echo guide for amniocentesis
|
$199.08 |
$844.25 |
$5,274.51 |
|
|
Echo guide for artery repair
|
$934.20 |
$2,113.79 |
$11,293.97 |
|
|
Echo guide for transfusion
|
$1,784.75 |
$1,784.75 |
$3,116.00 |
|
|
Echo guide villus sampling
|
$940.00 |
$940.00 |
$2,692.75 |
|
|
Echo stress
|
$344.05 |
$3,788.60 |
$9,269.00 |
|
|
Echo tee guidance
|
$373.10 |
$4,807.63 |
$4,807.63 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$538.56 |
$4,188.32 |
$4,188.32 |
|
|
Echo transesophageal
|
$4,193.09 |
$4,193.09 |
$14,192.20 |
|
|
Echo transesophageal intraop
|
$2,367.00 |
$4,193.09 |
$9,167.50 |
|
|
Echo transthoracic
|
$378.00 |
$4,193.09 |
$9,269.00 |
|
|
Echo transthoracic
|
$289.80 |
$3,870.55 |
$9,269.00 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$397.52 |
$3,870.55 |
$6,296.81 |
|
|
Ecmo/ecls daily mgmt artery 33949
|
$5,830.97 |
$5,830.97 |
$5,830.97 |
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$645.55 |
$5,830.97 |
$5,830.97 |
|
|
Ecmo/ecls initiation artery 33947
|
$754.96 |
$6,741.30 |
$6,741.30 |
|
|
Ecmo/ecls initiation venous 33946
|
$679.46 |
$6,741.30 |
$6,741.30 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$972.97 |
$972.97 |
$972.97 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$5,830.97 |
$5,830.97 |
$5,830.97 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$58,978.00 |
$58,978.00 |
$58,978.00 |
|
|
Eculizumab injection
|
$1,593.20 |
$82,163.83 |
$82,163.83 |
|
|
Edetate calcium disodium inj
|
$652.83 |
$723.00 |
$21,541.86 |
|
|
Eeg 41-60 minutes 95812-26
|
$725.21 |
$1,711.46 |
$6,431.74 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$435.22 |
$2,803.84 |
$6,431.74 |
|
|
Eeg during surgery
|
$360.80 |
$362.52 |
$451.20 |
|
|
Eeg monitoring/function test
|
$1,548.52 |
$1,548.52 |
$1,548.52 |
|
|
Eeg monitoring/giving drugs
|
$4,570.75 |
$6,631.90 |
$6,925.31 |
|
|
Eeg monitor/record/awake/drowsy 95816
|
$673.79 |
$3,585.15 |
$10,920.25 |
|
|
Eeg over 1 hour 95813 - 26
|
$895.24 |
$5,305.84 |
$7,071.90 |
|
|
Eeg/record in coma or sleep only 95822
|
$3,451.19 |
$3,451.19 |
$8,995.80 |
|
|
Eeg recording awake and asleep
|
$792.86 |
$4,483.90 |
$10,920.25 |
|
|
Eeg without vid 2-12hr cont mntr
|
$759.21 |
$1,085.59 |
$1,290.72 |
|
|
Eeg without vid 2-12 hr unmntr
|
$667.03 |
$1,085.59 |
$14,512.97 |
|
|
Eeg without vid ea 12-26hr cont
|
$1,167.64 |
$1,853.76 |
$2,476.45 |
|
|
Eeg without vid ea 12-26hr intmt
|
$1,100.89 |
$1,853.76 |
$2,476.45 |
|
|
Eeg wo vid 2-12hr intmt mntr
|
$759.21 |
$1,085.59 |
$1,290.72 |
|
|
Eeg wo vid ea 12-26hr unmntr
|
$1,000.77 |
$2,476.45 |
$14,512.97 |
|
|
E equine encephalitis igg
|
$12.03 |
$198.52 |
$618.93 |
|
|
Egd control bleeding any
|
$4,086.64 |
$4,086.64 |
$4,086.64 |
|
|
Egd dilate stricture
|
$4,086.64 |
$4,086.64 |
$4,086.64 |
|
|
Egd remove foreign body
|
$2,735.55 |
$2,735.55 |
$2,735.55 |
|
|
Egd remove lesion snare
|
$4,086.64 |
$4,086.64 |
$4,086.64 |
|
|
Egfr gene com variants
|
$135.39 |
$2,616.96 |
$9,828.75 |
|
|
Ehrlicha chaffeensis amp prb
|
$29.57 |
$311.69 |
$311.69 |
|
|
Eia hiv-1/hiv-2 screen
|
$418.42 |
$418.42 |
$1,489.07 |
|
|
EKG tracing for initial prev
|
$53.67 |
$53.67 |
$53.67 |
|
|
EKG (Tracing Only)
|
$83.81 |
$898.71 |
$1,503.00 |
|
|
Elbow X-ray (2 views, both sides)
|
$55.26 |
$932.80 |
$932.80 |
|
|
Elbow X-ray (3 or more views, both sides)
|
$66.18 |
$1,049.98 |
$1,049.98 |
|
|
Elec analys infus pump w/reprog 62368
|
$1,516.38 |
$1,516.38 |
$1,516.38 |
|
|
Elec stim unattend for press
|
$259.50 |
$645.70 |
$645.70 |
|
|
Elect analysis of infusion pump 62367
|
$178.48 |
$806.33 |
$806.33 |
|
|
Elect anlys sp inf pmp w/reprg&fill 62369
|
$202.49 |
$1,819.70 |
$1,819.70 |
|
|
Electrd sq emblem s-icd
|
$5,396.28 |
$6,195.30 |
$8,938.87 |
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$11.18 |
$428.84 |
$428.84 |
|
|
Electrical stimulation/unattended 97014
|
$11.18 |
$46.57 |
$76.45 |
|
|
Electrocochleography
|
$423.87 |
$423.87 |
$1,304.50 |
|
|
Electroconvulsive therapy 90870
|
$3,410.24 |
$4,647.26 |
$4,647.26 |
|
|
Electrode stimulation brain
|
$1,492.25 |
$4,356.38 |
$8,050.36 |
|
