|
Delivery of placenta 59414
|
$4,818.60 |
$4,818.60 |
$4,818.60 |
$2,778.27
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$102.00 |
$102.00 |
$102.00 |
$185.40
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$102.60 |
$102.60 |
$102.60 |
$402.36
|
|
Design mlc device for imrt
|
$4,136.40 |
$4,136.40 |
$4,136.40 |
$1,669.85
|
|
Desoxycorticosterone
|
$357.00 |
$357.00 |
$357.00 |
$109.28
|
|
Destroy premlg lesns;1st lesn 17000
|
$208.80 |
$208.80 |
$208.80 |
$199.50
|
|
Destruction benign lesions < 14 lesions
|
$229.80 |
$229.80 |
$229.80 |
$235.13
|
|
Detect agnt mult dna direc
|
$109.20 |
$109.20 |
$109.20 |
$147.75
|
|
Developmental screen/score/document 96110
|
$164.40 |
$164.40 |
$164.40 |
$111.00
|
|
Devel tst phys/qhp 1st hr
|
$331.80 |
$331.80 |
$331.80 |
$307.20
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$186.00 |
$186.00 |
$186.00 |
$196.30
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$426.00 |
$426.00 |
$426.00 |
$221.50
|
|
Dhea-s (dehydroepiand sulfate)
|
$82.80 |
$82.80 |
$82.80 |
$110.38
|
|
Diabetes (HbA1c) Test
|
$71.40 |
$71.40 |
$71.40 |
$79.52
|
|
Diagnostic anoscopy spx 46600
|
$165.60 |
$165.60 |
$165.60 |
$184.80
|
|
Diagnostic laryngoscopy 31575
|
$154.20 |
$154.20 |
$154.20 |
$327.60
|
|
Diagnostic Mammogram (both breasts)
|
$355.20 |
$355.20 |
$355.20 |
$397.50
|
|
Diagnostic Mammogram (one breast)
|
$296.40 |
$296.40 |
$296.40 |
$296.40
|
|
Diagnostic radio unlisted proc
|
$284.40 |
$284.40 |
$284.40 |
$210.00
|
|
Dialysis one evaluation
|
$1,608.60 |
$1,608.60 |
$1,608.60 |
$862.40
|
|
Diatrizoate meglumine 18 % urethral solution
|
$4.20 |
$4.20 |
$4.20 |
$116.21
|
|
Diffusing capacity
|
$1,068.60 |
$1,068.60 |
$1,068.60 |
$331.76
|
|
Digoxin total therapeutic drug level
|
$145.80 |
$145.80 |
$145.80 |
$99.35
|
|
Dilation of salivary duct
|
$1,879.80 |
$1,879.80 |
$1,879.80 |
$602.63
|
|
Dilat xst trc ndurlgc px
|
$2,172.60 |
$2,172.60 |
$2,172.60 |
$3,903.54
|
|
Dilat xst trc new access rcs
|
$2,172.60 |
$2,172.60 |
$2,172.60 |
$4,213.20
|
|
Disability dlco
|
$607.20 |
$607.20 |
$607.20 |
$279.00
|
|
Disaccharidases
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$223.80
|
|
Dna antibody native/double stranded
|
$128.40 |
$128.40 |
$128.40 |
$100.00
|
|
Dna gardnerella
|
$67.20 |
$67.20 |
$67.20 |
$61.20
|
|
Dna probe chlamydia
|
$116.40 |
$116.40 |
$116.40 |
$82.20
|
|
Dna trichomonas
|
$67.20 |
$67.20 |
$67.20 |
$66.05
|
|
Doppler echo complete
|
$244.80 |
$244.80 |
$244.80 |
$548.00
|
|
Doppler intravascular pressure flow initial vessel
|
$607.80 |
$607.80 |
$607.80 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$809.40 |
$809.40 |
$809.40 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$447.00 |
$447.00 |
$447.00 |
$444.60
|
|
Dpyd gene common variants
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$373.75
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$498.00 |
$498.00 |
$498.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,083.60 |
$1,083.60 |
$1,083.60 |
$863.10
|
|
Drainage external ear simple 69000
|
$498.00 |
$498.00 |
$498.00 |
$779.45
|
|
Drainage lymph node lesion 38300
|
$3,437.40 |
$3,437.40 |
$3,437.40 |
$3,088.80
|
|
Drainage mouth roof lesion
|
$280.80 |
$280.80 |
$280.80 |
$381.36
|
|
Drainage of arm bursa 23931
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$2,175.00
|
|
Drainage of kidney lesion
|
$2,053.80 |
$2,053.80 |
$2,053.80 |
$1,484.45
|
|
Drainage of mouth lesion
|
$3,891.00 |
$3,891.00 |
$3,891.00 |
$3,837.72
|
|
Drain blood from under nail 11740
|
$109.20 |
$109.20 |
$109.20 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$4,242.00 |
$4,242.00 |
$4,242.00 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$4,242.00 |
$4,242.00 |
$4,242.00 |
$2,839.24
|
|
Drain finger abscess;simple 26010
|
$1,323.60 |
$1,323.60 |
$1,323.60 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$440.40 |
$440.40 |
$440.40 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$367.80 |
$367.80 |
$367.80 |
$338.25
|
|
Dress/debrid prtl-thick burn l 16030
|
$620.40 |
$620.40 |
$620.40 |
$515.00
|
|
Drng of eyelid abscess 67700
|
$384.00 |
$384.00 |
$384.00 |
$638.01
|
|
Drng of finger abscess comp 26011
|
$3,066.60 |
$3,066.60 |
$3,066.60 |
$1,917.33
|
|
Drng of scrotum abscess 55100
|
$1,020.60 |
$1,020.60 |
$1,020.60 |
$1,917.33
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$60.60 |
$60.60 |
$60.60 |
$143.50
|
|
Drug admin & hemodynmic meas
|
$229.20 |
$229.20 |
$229.20 |
$555.09
|
|
Drug assay caffeine
|
$168.60 |
$168.60 |
$168.60 |
$80.00
|
|
Drug assay posaconazole
|
$156.60 |
$156.60 |
$156.60 |
$96.39
|
|
Drug assay rufinamide
|
$105.00 |
$105.00 |
$105.00 |
$81.60
|
|
Drug assay vedolizumab
|
$359.40 |
$359.40 |
$359.40 |
$141.75
|
|
Drug assay voriconazole
|
$131.40 |
$131.40 |
$131.40 |
$96.75
|
|
Drug test prsmv instrmnt
|
$318.00 |
$318.00 |
$318.00 |
$78.65
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$679.80 |
$679.80 |
$679.80 |
$278.85
|
|
Drvvt confirm - quest
|
$211.80 |
$211.80 |
$211.80 |
$102.30
|
|
Dstrj nulyt agt gnclr nrv
|
$5,107.80 |
$5,107.80 |
$5,107.80 |
$2,979.74
|
|
Ductogram sgl duct
|
$598.80 |
$598.80 |
$598.80 |
$452.50
|
|
Duplex scan bilateral study 93985
|
$3,376.20 |
$3,376.20 |
$3,376.20 |
$660.32
|
|
Duplex scan unilateral study 93986
|
$2,248.80 |
$2,248.80 |
$2,248.80 |
$357.60
|
|
Dup scan/hemodialysis access 93990
|
$448.80 |
$448.80 |
$448.80 |
$498.78
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$670.20 |
$670.20 |
$670.20 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,091.60 |
$2,091.60 |
$2,091.60 |
$859.00
|
|
Dxa bone density axl vrt fx
|
$346.20 |
$346.20 |
$346.20 |
$388.36
|
|
Dx bronchoscope/wash 31622
|
$2,347.80 |
$2,347.80 |
$2,347.80 |
$2,234.82
|
|
Ear irrigation 69209
|
$223.80 |
$223.80 |
$223.80 |
$149.76
|
|
Ecg 12 lead tracing only
|
$285.60 |
$285.60 |
$285.60 |
$226.20
|
|
Ecg/1-3 leads/tracing only 93041
|
$94.20 |
$94.20 |
$94.20 |
$132.03
|
|
Ecg < 30 days transmission & analysis
|
$541.20 |
$541.20 |
$541.20 |
$396.50
|
|
Ecg external < 48 hours recording
|
$541.20 |
$541.20 |
$541.20 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$541.20 |
$541.20 |
$541.20 |
$536.50
|
|
Ecg external > 48 hours up to 7 days recording
|
$190.80 |
$190.80 |
$190.80 |
$146.90
|
|
Ecg external >7 days up to 15 days recording
|
$318.00 |
$318.00 |
$318.00 |
$161.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,689.20 |
$2,689.20 |
$2,689.20 |
$2,020.00
|
|
Echocardiography doppler color flow mapping
|
$490.20 |
$490.20 |
$490.20 |
$463.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$692.40 |
$692.40 |
$692.40 |
$702.00
|
|
Echocardiograpy doppler follow up/limited study
|
$417.60 |
$417.60 |
$417.60 |
$356.40
|
|
Echo exam of fetal heart
|
$1,072.80 |
$1,072.80 |
$1,072.80 |
$914.76
|
|
Echo exam of fetal heart
|
$432.00 |
$432.00 |
$432.00 |
$503.80
|
|
Echo exam of fetal heart
|
$376.80 |
$376.80 |
$376.80 |
$318.34
|
|
Echo guide for amniocentesis
|
$681.00 |
$681.00 |
$681.00 |
$419.59
|
|
Echo guide for artery repair
|
$1,081.20 |
$1,081.20 |
$1,081.20 |
$660.00
|
|
Echo stress
|
$1,704.60 |
$1,704.60 |
$1,704.60 |
$1,565.72
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,821.20 |
$2,821.20 |
$2,821.20 |
$1,849.50
|
|
Echo transthoracic
|
$1,896.00 |
$1,896.00 |
$1,896.00 |
$1,361.75
|
|
Echo transthoracic
|
$1,333.20 |
$1,333.20 |
$1,333.20 |
$950.00
|
|
Eeg 41-60 minutes 95812-26
|
$761.40 |
$761.40 |
$761.40 |
$920.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$1,317.00 |
$1,317.00 |
$1,317.00 |
$970.07
|
|
Eeg monitor/record/awake/drowsy 95816
|
$738.60 |
$738.60 |
$738.60 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$859.20 |
$859.20 |
$859.20 |
$1,086.80
|
|
Eeg/record in coma or sleep only 95822
|
$695.40 |
$695.40 |
$695.40 |
$885.60
|
