|
Drng open subdiaphragmatic/subphrenic absc 49040
|
$1,890.00 |
$1,890.00 |
$2,461.60 |
|
|
Drng ovary abscess perqt 58822
|
$945.00 |
$1,417.80 |
$3,547.20 |
|
|
Drng peritoneal abscess open 49020
|
$945.60 |
$2,998.80 |
$59,210.34 |
|
|
Drng salivary gland simple 42300
|
$412.80 |
$524.80 |
$3,384.72 |
|
|
Drng salivary gland submax/subling 42310
|
$319.20 |
$319.20 |
$1,160.12 |
|
|
Dronabinol 2.5mg oral
|
$2.46 |
$2.46 |
$31.33 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$25.20 |
$36.92 |
$397.42 |
|
|
Drop lock retainer each
|
$705.60 |
$705.60 |
$705.60 |
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$251.78 |
$1,318.98 |
$5,426.51 |
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$5.89 |
$5.89 |
$5.89 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$7.97 |
$40.04 |
$432.60 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$13.48 |
$22.52 |
$756.00 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$38.81 |
$268.88 |
$52,020.00 |
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$280.85 |
$640.58 |
$21,485.52 |
|
|
Drug admin & hemodynmic meas
|
$81.90 |
$237.50 |
$4,757.40 |
|
|
Drug assay caffeine
|
$39.27 |
$133.70 |
$1,321.20 |
|
|
Drug assay posaconazole
|
$37.50 |
$162.00 |
$572.60 |
|
|
Drug assay rufinamide
|
$66.43 |
$130.90 |
$170.00 |
|
|
Drug assay vedolizumab
|
$66.43 |
$347.40 |
$849.80 |
|
|
Drug assay voriconazole
|
$48.95 |
$142.20 |
$315.00 |
|
|
Drug asy hydroxychloroquine
|
$66.43 |
$345.00 |
$409.50 |
|
|
Drug of abuse screen urine
|
$12.60 |
$81.90 |
$400.40 |
|
|
Drug screening tapentadol
|
$17.28 |
$48.95 |
$112.00 |
|
|
Drug screen quant tiagabine
|
$37.50 |
$100.80 |
$129.60 |
|
|
Drug/substance nos 4-6
|
$54.00 |
$54.00 |
$72.14 |
|
|
Drug test def 15-21 classes
|
$322.50 |
$322.50 |
$956.16 |
|
|
Drug test def 1-7 classes
|
$144.00 |
$257.60 |
$1,276.10 |
|
|
Drug test def 22+ classes
|
$140.00 |
$405.30 |
$1,350.72 |
|
|
Drug test def 8-14 classes
|
$289.80 |
$289.80 |
$675.36 |
|
|
Drug test def simple all cl
|
$124.80 |
$124.80 |
$124.80 |
|
|
Drug test prsmv instrmnt
|
$31.25 |
$276.48 |
$949.60 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$53.75 |
$437.50 |
$1,365.60 |
|
|
Drvvt confirm - quest
|
$25.00 |
$116.20 |
$297.60 |
|
|
Dry needling (97799)
|
$21.45 |
$210.00 |
$700.00 |
|
|
Dstrj extensive retinopathy
|
$2,158.40 |
$2,158.40 |
$74,736.62 |
|
|
Dstrj nulyt agt gnclr nrv
|
$1,125.00 |
$4,872.00 |
$17,889.90 |
|
|
Dstr mal les s/n/h/f/g >4.0
|
$702.40 |
$702.40 |
$702.40 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$603.20 |
$603.20 |
$603.20 |
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$688.00 |
$688.00 |
$688.00 |
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$886.40 |
$886.40 |
$886.40 |
|
|
Ductogram sgl duct
|
$253.11 |
$670.00 |
$2,071.20 |
|
|
Duodenal exclusion
|
$4,393.60 |
$4,393.60 |
$4,393.60 |
|
|
Duodenal motility study
|
$367.20 |
$1,143.10 |
$1,143.10 |
|
|
Duplex scan bilateral study 93985
|
$322.08 |
$750.00 |
$4,284.00 |
|
|
Duplex scan unilateral study 93986
|
$154.77 |
$500.00 |
$2,854.80 |
|
|
Dup scan/hemodialysis access 93990
|
$160.80 |
$448.80 |
$1,334.40 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$231.25 |
$898.40 |
$2,569.60 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$385.20 |
$1,177.92 |
$18,401.60 |
|
|
Duragen 1x1 5ea/bx
|
$378.00 |
$10,289.85 |
$35,216.24 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$132.87 |
$710.30 |
$26,890.85 |
|
|
Dxa bone density axl vrt fx
|
$92.50 |
$477.50 |
$568.92 |
|
|
Dx aly aud oi snd prcsr 1st
|
$186.40 |
$210.00 |
$350.40 |
|
|
Dx aly aud oi snd prcsr each
|
$48.00 |
$52.50 |
$87.60 |
|
|
Dx bronchoscope/brush 31623
|
$647.40 |
$3,663.00 |
$46,958.56 |
|
|
Dx bronchoscope/lavage 31624
|
$609.60 |
$3,147.40 |
$44,173.95 |
|
|
Dx bronchoscope/wash 31622
|
$607.20 |
$2,572.20 |
$23,934.78 |
|
|
Dx duod intub w/asp spec 43756
|
$450.60 |
$450.60 |
$608.80 |
|
|
Dx duod intub w/asp specs
|
$837.60 |
$837.60 |
$837.60 |
|
|
Dx gastr intub w/asp spec
|
$441.60 |
$441.60 |
$774.00 |
|
|
Dx gastr intub w/asp specs
|
$421.60 |
$421.60 |
$774.00 |
|
|
Dx intraop epcar Ultrasound chd i&r
|
$64.00 |
$64.00 |
$64.00 |
|
|
Dx intraop epicar car Ultrasound chd
|
$171.20 |
$171.20 |
$171.20 |
|
|
Dx intraop thoracic aorta Ultrasound
|
$55.20 |
$55.20 |
$55.20 |
|
|
Dx laryngoscopy newborn
|
$385.60 |
$408.80 |
$992.88 |
|
|
Dx laryngoscopy w/oper scope
|
$387.20 |
$432.00 |
$15,597.27 |
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$108.80 |
$108.80 |
$108.80 |
|
|
Dynamic cavernosometry
|
$354.40 |
$354.40 |
$354.40 |
|
|
Dynamic surface emg
|
$49.60 |
$49.60 |
$49.60 |
|
|
Ear and throat examination
|
$181.20 |
$181.20 |
$210.40 |
|
|
Ear canal biopsy 69105
|
$276.00 |
$688.00 |
$60,480.97 |
|
|
Ear cartilage graft
|
$1,411.80 |
$1,411.80 |
$1,787.20 |
|
|
Ear irrigation 69209
|
$30.00 |
$150.00 |
$821.40 |
|
|
Ear protector evaluation
|
$141.60 |
$141.60 |
$141.60 |
|
|
Ecallantide injection
|
$4,014.63 |
$4,014.63 |
$93,115.92 |
|
|
Ecg/1-3 leads/interp & report only 93042
|
$16.00 |
$17.40 |
$17.40 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$77.40 |
$177.50 |
$341.40 |
|
|
Ecg < 30 days transmission & analysis
|
$250.00 |
$541.20 |
$1,562.40 |
|
|
Ecg external < 48 hours recording
|
$211.40 |
$583.80 |
$1,593.36 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$149.80 |
$541.20 |
$962.28 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$32.50 |
$216.80 |
$940.50 |
|
|
Ecg external >7 days up to 15 days recording
|
$46.40 |
$318.00 |
$919.80 |
|
|
Ecg record/review
|
$469.60 |
$469.60 |
$681.45 |
|
|
Ecg/review interpret only
|
$50.40 |
$50.40 |
$57.60 |
|
|
Echocardiogram (Heart Ultrasound)
|
$800.00 |
$2,316.00 |
$3,931.20 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$225.00 |
$701.25 |
$2,012.80 |
|
|
Echocardiography doppler color flow mapping
|
$196.56 |
$525.60 |
$916.00 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,151.50 |
$2,180.88 |
$3,414.24 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$558.60 |
$1,332.00 |
$1,692.44 |
|
|
Echocardiograpy doppler follow up/limited study
|
$100.65 |
$393.00 |
$1,010.40 |
|
|
Echo exam of eye
|
$140.80 |
$140.80 |
$140.80 |
|
|
Echo exam of eye
|
$172.00 |
$172.00 |
$172.00 |
|
|
Echo exam of eye
|
$168.00 |
$399.00 |
$412.56 |
|
|
Echo exam of eye thickness
|
$29.60 |
$29.60 |
$80.00 |
|
|
Echo exam of fetal heart
|
$375.00 |
$1,170.40 |
$1,966.80 |
|
|
Echo exam of fetal heart
|
$193.75 |
$835.00 |
$1,408.44 |
|
|
Echo exam of fetal heart
|
$466.62 |
$729.00 |
$987.70 |
|
|
Echo exam of fetal heart
|
$217.47 |
$387.80 |
$788.40 |
|
|
Echo exam uterus 76831-
|
$225.00 |
$687.72 |
$1,861.30 |
|
|
Echograp trans r pros study
|
$243.00 |
$1,224.00 |
$2,797.80 |
|
|
Echo guidance radiotherapy
|
$465.60 |
$655.00 |
$1,528.20 |
|
