|
Drng of eyelid abscess 67700
|
$773.25 |
$773.25 |
$773.25 |
|
|
Drng of finger abscess comp 26011
|
$154.56 |
$154.56 |
$4,845.75 |
|
|
Drng of hydrocele 55000
|
$1,869.00 |
$1,869.00 |
$1,869.00 |
|
|
Drng of ovarian cyst(s) 58800
|
$257.92 |
$257.92 |
$257.92 |
|
|
Drng of scrotum abscess 55100
|
$137.60 |
$137.60 |
$1,076.25 |
|
|
Drng open retroperitoneal abscess 49060
|
$850.56 |
$850.56 |
$3,530.25 |
|
|
Drng open subdiaphragmatic/subphrenic absc 49040
|
$2,659.50 |
$2,659.50 |
$2,659.50 |
|
|
Drng peritoneal abscess open 49020
|
$1,237.12 |
$1,237.12 |
$4,209.00 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$7.82 |
$7.82 |
$15.69 |
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$687.24 |
$687.24 |
$2,255.36 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$350.97 |
$350.97 |
$350.97 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$649.94 |
$649.94 |
$649.94 |
|
|
Drsg sht 5.625x4.625in std
|
$412.50 |
$412.50 |
$412.50 |
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$110.11 |
$110.11 |
$110.11 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$10.50 |
$10.50 |
$9,828.16 |
|
|
Drug admin & hemodynmic meas
|
$278.25 |
$278.25 |
$547.52 |
|
|
Drug assay caffeine
|
$25.92 |
$25.92 |
$118.50 |
|
|
Drug assay posaconazole
|
$116.25 |
$116.25 |
$116.25 |
|
|
Drug assay vedolizumab
|
$24.96 |
$24.96 |
$103.50 |
|
|
Drug assay voriconazole
|
$116.25 |
$116.25 |
$116.25 |
|
|
Drug of abuse screen urine
|
$11.84 |
$11.84 |
$60.00 |
|
|
Drug screening tapentadol
|
$6.88 |
$6.88 |
$86.25 |
|
|
Drug screen quant tiagabine
|
$27.84 |
$27.84 |
$83.25 |
|
|
Drug/substance nos 4-6
|
$229.50 |
$229.50 |
$229.50 |
|
|
Drug test def 15-21 classes
|
$1,008.75 |
$1,008.75 |
$1,008.75 |
|
|
Drug test def 1-7 classes
|
$501.75 |
$501.75 |
$501.75 |
|
|
Drug test def 22+ classes
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
|
|
Drug test def 8-14 classes
|
$795.00 |
$795.00 |
$795.00 |
|
|
Drug test prsmv instrmnt
|
$65.92 |
$65.92 |
$65.92 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$320.64 |
$320.64 |
$585.00 |
|
|
Drvvt confirm - quest
|
$17.28 |
$17.28 |
$109.50 |
|
|
Dstrj nulyt agt gnclr nrv
|
$3,813.75 |
$3,813.75 |
$3,813.75 |
|
|
Ductogram sgl duct
|
$134.72 |
$134.72 |
$652.50 |
|
|
Duplex scan bilateral study 93985
|
$271.36 |
$271.36 |
$645.00 |
|
|
Duplex scan unilateral study 93986
|
$135.68 |
$135.68 |
$360.00 |
|
|
Dup scan/hemodialysis access 93990
|
$170.88 |
$170.88 |
$363.00 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$427.52 |
$427.52 |
$765.75 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$342.72 |
$342.72 |
$701.25 |
|
|
Duragen 1x1 5ea/bx
|
$585.00 |
$585.00 |
$585.00 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$2,445.64 |
$2,445.64 |
$2,704.61 |
|
|
Dxa bone density axl vrt fx
|
$296.25 |
$296.25 |
$296.25 |
|
|
Dx bronchoscope/brush 31623
|
$3,139.50 |
$3,139.50 |
$3,139.50 |
|
|
Dx bronchoscope/lavage 31624
|
$1,978.50 |
$1,978.50 |
$1,978.50 |
|
|
Dx bronchoscope/wash 31622
|
$1,825.28 |
$1,825.28 |
$4,758.00 |
|
|
Dx dark adaptation exam i&r
|
$266.25 |
$266.25 |
$266.25 |
|
|
Dx gastr intub w/asp spec
|
$895.50 |
$895.50 |
$895.50 |
|
|
Dx gastr intub w/asp specs
|
$489.75 |
$489.75 |
$489.75 |
|
|
Dx laryngoscopy w/oper scope
|
$124.80 |
$124.80 |
$124.80 |
|
|
Ear and throat examination
|
$77.76 |
$77.76 |
$77.76 |
|
|
Ear canal biopsy 69105
|
$842.88 |
$842.88 |
$842.88 |
|
|
Ear irrigation 69209
|
$42.75 |
$42.75 |
$42.75 |
|
|
Ecallantide injection
|
$13,357.14 |
$13,357.14 |
$13,357.14 |
|
|
Ecg 12 lead tracing only
|
$135.68 |
$135.68 |
$292.50 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$27.20 |
$27.20 |
$126.00 |
|
|
Ecg < 30 days transmission & analysis
|
$541.50 |
$541.50 |
$541.50 |
|
|
Ecg external < 48 hours recording
|
$359.68 |
$359.68 |
$633.75 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$247.50 |
$247.50 |
$256.32 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$33.92 |
$33.92 |
$78.75 |
|
|
Ecg external >7 days up to 15 days recording
|
$93.12 |
$93.12 |
$215.25 |
|
|
Ecg record/review
|
$155.52 |
$155.52 |
$155.52 |
|
|
Ecg/review interpret only
|
$18.88 |
$18.88 |
$18.88 |
|
|
Echocardiogram (Heart Ultrasound)
|
$614.40 |
$614.40 |
$1,425.00 |
|
|
Echocardiography doppler color flow mapping
|
$305.28 |
$305.28 |
$322.50 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$76.16 |
$76.16 |
$76.16 |
|
|
Echocardiography transthoracic 2d followup/limited
|
$298.56 |
$298.56 |
$652.50 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$27.52 |
$27.52 |
$975.00 |
|
|
Echocardiograpy doppler follow up/limited study
|
$7.68 |
$7.68 |
$360.00 |
|
|
Echo exam of eye
|
$305.25 |
$305.25 |
$305.25 |
|
|
Echo exam of eye
|
$305.25 |
$305.25 |
$305.25 |
|
|
Echo exam of eye
|
$255.75 |
$255.75 |
$255.75 |
|
|
Echo exam of eye thickness
|
$85.50 |
$85.50 |
$85.50 |
|
|
Echo exam of fetal heart
|
$1,462.50 |
$1,462.50 |
$1,462.50 |
|
|
Echo exam of fetal heart
|
$700.50 |
$700.50 |
$700.50 |
|
|
Echo exam of fetal heart
|
$404.25 |
$404.25 |
$404.25 |
|
|
Echo exam of fetal heart
|
$305.25 |
$305.25 |
$305.25 |
|
|
Echo exam uterus 76831-
|
$343.36 |
$343.36 |
$690.00 |
|
|
Echograp trans r pros study
|
$588.75 |
$588.75 |
$588.75 |
|
|
Echo guidance radiotherapy
|
$304.50 |
$304.50 |
$304.50 |
|
|
Echo guide for amniocentesis
|
$112.00 |
$112.00 |
$171.00 |
|
|
Echo guide for artery repair
|
$375.68 |
$375.68 |
$830.25 |
|
|
Echo guide for heart biopsy
|
$284.25 |
$284.25 |
$284.25 |
|
|
Echo guide for transfusion
|
$410.25 |
$410.25 |
$410.25 |
|
|
Echo guide ova aspiration
|
$255.75 |
$255.75 |
$255.75 |
|
|
Echo guide villus sampling
|
$307.50 |
$307.50 |
$307.50 |
|
|
Echo stress
|
$679.04 |
$679.04 |
$1,875.00 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$682.56 |
$682.56 |
$1,500.00 |
|
|
Echo transesophageal
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
|
|
Echo transesophageal
|
$95.68 |
$95.68 |
$894.75 |
|
|
Echo transesophageal
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
|
|
Echo transesophageal intraop
|
$559.68 |
$559.68 |
$1,500.00 |
|
|
Echo transthoracic
|
$1,462.50 |
$1,462.50 |
$1,462.50 |
|
|
Echo transthoracic
|
$1,462.50 |
$1,462.50 |
$1,462.50 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$370.24 |
$370.24 |
$697.50 |
|
|
E coli 0157 ag ia
|
$72.75 |
$72.75 |
$72.75 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$28,183.11 |
$28,183.11 |
$28,183.11 |
|
|
Edetate calcium disodium inj
|
$12,605.75 |
$12,605.75 |
$12,605.75 |
|
|
Edetate disodium per 150 mg
|
$296.25 |
$296.25 |
$296.25 |
|
|
Eeg 41-60 minutes 95812-26
|
$1,056.75 |
$1,056.75 |
$1,056.75 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$356.16 |
$356.16 |
$356.16 |
|
|
Eeg during surgery
|
$108.48 |
$108.48 |
$694.50 |
|