|
Drug test def 1-7 classes
|
$159.25 |
$263.25 |
$988.00 |
|
|
Drug test def 22+ classes
|
$988.00 |
$1,012.00 |
$1,012.00 |
|
|
Drug test def 8-14 classes
|
$263.25 |
$263.25 |
$507.00 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$103.60 |
$128.31 |
$3,330.44 |
|
|
Drvvt confirm - quest
|
$90.48 |
$90.48 |
$1,869.91 |
|
|
Dry needling (97799)
|
$114.27 |
$114.27 |
$114.27 |
|
|
Dstrj nulyt agt gnclr nrv
|
$4,967.04 |
$4,967.04 |
$8,936.00 |
|
|
Ductogram sgl duct
|
$450.06 |
$450.06 |
$851.00 |
|
|
Duplex scan bilateral study 93985
|
$285.35 |
$1,034.28 |
$1,042.00 |
|
|
Duplex scan unilateral study 93986
|
$137.35 |
$689.91 |
$689.91 |
|
|
Dup scan/hemodialysis access 93990
|
$221.12 |
$752.70 |
$2,630.92 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$271.14 |
$1,104.09 |
$3,786.43 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$417.96 |
$1,229.77 |
$2,285.00 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$210.73 |
$210.73 |
$45,051.67 |
|
|
Dxa bone density axl vrt fx
|
$152.74 |
$532.35 |
$1,584.86 |
|
|
Dx bronchoscope/brush 31623
|
$1,936.14 |
$3,215.94 |
$3,215.94 |
|
|
Dx bronchoscope/lavage 31624
|
$1,680.10 |
$3,215.94 |
$10,240.66 |
|
|
Dx bronchoscope/wash 31622
|
$1,125.99 |
$3,215.94 |
$5,826.00 |
|
|
Dx intraop epcar Ultrasound chd i&r
|
$928.00 |
$928.00 |
$928.00 |
|
|
Dx intraop epicar car Ultrasound chd
|
$1,228.00 |
$1,228.00 |
$1,228.00 |
|
|
Dx intraop thoracic aorta Ultrasound
|
$742.00 |
$742.00 |
$742.00 |
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
|
|
Dynamic surface emg
|
$268.71 |
$268.71 |
$268.71 |
|
|
Ear cartilage graft
|
$15,440.00 |
$15,440.00 |
$15,440.00 |
|
|
Ear irrigation 69209
|
$149.76 |
$222.00 |
$789.92 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$118.56 |
$118.56 |
$135.00 |
|
|
Ecg < 30 days transmission & analysis
|
$120.12 |
$120.12 |
$1,457.66 |
|
|
Ecg external < 48 hours recording
|
$232.66 |
$461.76 |
$2,393.65 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$584.22 |
$596.15 |
$4,812.94 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$56.84 |
$58.50 |
$2,393.65 |
|
|
Ecg external >7 days up to 15 days recording
|
$94.72 |
$96.72 |
$985.85 |
|
|
Ecg record/review
|
$1,103.00 |
$1,103.00 |
$1,103.00 |
|
|
Echocardiogram (Heart Ultrasound)
|
$850.41 |
$2,407.00 |
$6,986.59 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$575.43 |
$1,117.00 |
$4,390.00 |
|
|
Echocardiography doppler color flow mapping
|
$150.00 |
$344.76 |
$1,100.00 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,190.52 |
$2,070.12 |
$5,737.00 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$615.42 |
$615.42 |
$2,576.00 |
|
|
Echocardiograpy doppler follow up/limited study
|
$231.18 |
$244.53 |
$4,390.00 |
|
|
Echo exam of eye
|
$105.30 |
$105.30 |
$105.30 |
|
|
Echo exam of eye
|
$161.46 |
$161.46 |
$161.46 |
|
|
Echo exam of eye
|
$107.64 |
$107.64 |
$107.64 |
|
|
Echo exam of eye thickness
|
$32.37 |
$32.37 |
$32.37 |
|
|
Echo exam of fetal heart
|
$405.99 |
$405.99 |
$405.99 |
|
|
Echo exam of fetal heart
|
$261.69 |
$261.69 |
$261.69 |
|
|
Echo exam of fetal heart
|
$226.20 |
$226.20 |
$258.00 |
|
|
Echo exam of fetal heart
|
$423.54 |
$423.54 |
$423.54 |
|
|
Echo exam uterus 76831-
|
$448.50 |
$448.50 |
$1,277.00 |
|
|
Echograp trans r pros study
|
$136.16 |
$262.86 |
$1,517.00 |
|
|
Echo guidance radiotherapy
|
$306.36 |
$1,006.00 |
$1,201.98 |
|
|
Echo guide for amniocentesis
|
$493.35 |
$493.35 |
$717.00 |
|
|
Echo guide for artery repair
|
$401.97 |
$1,939.47 |
$2,214.00 |
|
|
Echo guide for heart biopsy
|
$1,116.57 |
$1,116.57 |
$1,270.00 |
|
|
Echo guide for transfusion
|
$497.25 |
$497.25 |
$497.25 |
|
|
Echo guide ova aspiration
|
$493.35 |
$493.35 |
$493.35 |
|
|
Echo guide villus sampling
|
$139.62 |
$139.62 |
$139.62 |
|
|
Echo stress
|
$1,002.26 |
$2,299.44 |
$6,986.59 |
|
|
Echo tee guidance
|
$276.76 |
$1,753.44 |
$7,086.91 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,297.67 |
$2,407.00 |
$6,986.59 |
|
|
Echo transesophageal
|
$405.60 |
$405.60 |
$1,012.03 |
|
|
Echo transesophageal
|
$733.20 |
$923.13 |
$6,794.00 |
|
|
Echo transesophageal
|
$473.85 |
$473.85 |
$473.85 |
|
|
Echo transesophageal intraop
|
$1,093.17 |
$1,093.17 |
$4,446.00 |
|
|
Echo transthoracic
|
$931.52 |
$1,220.31 |
$6,986.59 |
|
|
Echo transthoracic
|
$585.39 |
$585.39 |
$2,941.00 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$661.83 |
$702.12 |
$3,339.08 |
|
|
Ecmo/ecls daily mgmt artery 33949
|
$539.91 |
$7,630.74 |
$7,630.74 |
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$539.91 |
$7,242.30 |
$7,242.30 |
|
|
Ecmo/ecls initiation artery 33947
|
$848.34 |
$13,573.56 |
$13,573.56 |
|
|
Ecmo/ecls initiation venous 33946
|
$389.84 |
$13,573.56 |
$13,573.56 |
|
|
Ecmo/ecls insj cent cannula 6yrs&older 33956
|
$2,420.00 |
$7,346.04 |
$7,346.04 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older opn 33954
|
$1,411.92 |
$8,167.38 |
$8,167.38 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$1,482.67 |
$8,167.38 |
$8,167.38 |
|
|
Ecmo/ecls remove cent cannula 6yrs&older 33986
|
$2,420.00 |
$3,672.63 |
$3,672.63 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older open 33984
|
$2,420.00 |
$3,672.63 |
$3,672.63 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$291.56 |
$4,083.69 |
$4,083.69 |
|
|
Ecmo/ecls repos cent cnula 6yrs&older 33964
|
$3,672.63 |
$3,672.63 |
$3,672.63 |
|
|
Ecmo/ecls repos perph cnula 6yrs&older opn 33962
|
$2,420.00 |
$3,672.63 |
$3,672.63 |
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$741.48 |
$4,083.69 |
$4,083.69 |
|
|
Ecog impltd brn npgt <30 d
|
$105.00 |
$105.00 |
$105.00 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$15,655.20 |
$15,655.20 |
$15,655.20 |
|
|
Eculizumab injection
|
$537.50 |
$537.50 |
$323,744.75 |
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$154.83 |
$154.83 |
$184.00 |
|
|
Eeg 41-60 minutes 95812-26
|
$580.76 |
$934.05 |
$3,786.43 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$1,203.15 |
$1,203.15 |
$5,011.97 |
|
|
Eeg during surgery
|
$260.91 |
$260.91 |
$1,473.00 |
|
|
Eeg monitoring/function test
|
$1,600.95 |
$1,600.95 |
$4,991.00 |
|
|
Eeg monitoring/giving drugs
|
$1,334.00 |
$1,334.00 |
$1,334.00 |
|
|
Eeg monitor/record/awake/drowsy 95816
|
$463.54 |
$1,233.00 |
$2,665.23 |
|
|
Eeg over 1 hour 95813 - 26
|
$580.76 |
$1,279.20 |
$3,786.43 |
|
|
Eeg phy/qhp>36<60 hr without vid
|
$1,018.00 |
$1,018.00 |
$1,018.00 |
|
|
Eeg phy/qhp>60<84 hr without vid
|
$1,244.00 |
$1,244.00 |
$1,244.00 |
|
|
Eeg phy/qhp>60<84 hr w/veeg
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
|
|
Eeg phy/qhp>84 hr without vid
|
$987.00 |
$987.00 |
$987.00 |
|
|
Eeg phy/qhp>84 hr w/veeg
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
|
|
Eeg phy/qhp ea incr w/veeg
|
$1,021.00 |
$1,021.00 |
$1,021.00 |
|
|
Eeg phys/qhp 2-12 hr without vid
|
$499.00 |
$499.00 |
$499.00 |
|
|
Eeg phys/qhp 2-12 hr w/veeg
|
$660.00 |
$660.00 |
$660.00 |
|
|
Eeg phys/qhp ea incr without vid
|
$775.00 |
$775.00 |
$775.00 |
|
|
Eeg/record in coma or sleep only 95822
|
$552.04 |
$1,215.63 |
$4,579.72 |
|
|
Eeg recording awake and asleep
|
$551.75 |
$937.95 |
$3,786.43 |
|
