|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$959.40 |
$1,973.00 |
$2,072.50 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$538.50 |
$1,384.20 |
$1,881.28 |
|
|
Duragen 1x1 5ea/bx
|
$17,080.35 |
$17,080.35 |
$17,080.35 |
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$8,148.82 |
$8,148.82 |
$8,149.00 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$902.23 |
$28,477.76 |
$28,477.76 |
|
|
Dxa bone density axl vrt fx
|
$466.80 |
$466.80 |
$971.54 |
|
|
Dx aly aud oi snd prcsr 1st
|
$98.40 |
$98.40 |
$98.40 |
|
|
Dx aly aud oi snd prcsr each
|
$24.60 |
$24.60 |
$24.60 |
|
|
Dx bronchoscope/wash 31622
|
$850.20 |
$850.20 |
$850.20 |
|
|
Ear irrigation 69209
|
$38.00 |
$183.00 |
$291.50 |
|
|
Ear protector evaluation
|
$95.40 |
$95.40 |
$95.40 |
|
|
Ecallantide injection
|
$41,575.76 |
$41,575.76 |
$41,575.76 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$126.81 |
$159.00 |
$239.40 |
|
|
Ecg < 30 days transmission & analysis
|
$751.50 |
$766.00 |
$1,131.00 |
|
|
Ecg external < 48 hours recording
|
$388.00 |
$827.50 |
$1,509.60 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$414.50 |
$912.00 |
$1,457.38 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$79.50 |
$384.00 |
$707.40 |
|
|
Ecg external >7 days up to 15 days recording
|
$87.50 |
$766.20 |
$1,143.60 |
|
|
Echocardiogram (Heart Ultrasound)
|
$1,361.00 |
$2,352.00 |
$5,637.08 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$526.50 |
$720.60 |
$3,320.40 |
|
|
Echocardiography doppler color flow mapping
|
$296.50 |
$606.60 |
$1,276.69 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,729.50 |
$1,762.00 |
$5,530.19 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$557.50 |
$568.00 |
$2,133.65 |
|
|
Echocardiograpy doppler follow up/limited study
|
$311.00 |
$362.50 |
$1,268.93 |
|
|
Echo exam of eye
|
$164.40 |
$164.40 |
$164.40 |
|
|
Echo exam of eye thickness
|
$129.00 |
$129.00 |
$129.00 |
|
|
Echo exam of fetal heart
|
$260.00 |
$378.00 |
$861.92 |
|
|
Echo exam of fetal heart
|
$420.00 |
$420.00 |
$861.92 |
|
|
Echo exam of fetal heart
|
$137.15 |
$376.00 |
$544.20 |
|
|
Echo exam of fetal heart
|
$168.75 |
$168.75 |
$540.00 |
|
|
Echo exam uterus 76831-
|
$325.80 |
$453.00 |
$884.00 |
|
|
Echograp trans r pros study
|
$753.00 |
$753.00 |
$753.00 |
|
|
Echo guidance radiotherapy
|
$942.66 |
$1,666.80 |
$1,751.40 |
|
|
Echo guide for amniocentesis
|
$128.70 |
$544.20 |
$807.00 |
|
|
Echo guide for artery repair
|
$324.60 |
$523.80 |
$1,224.70 |
|
|
Echo guide for heart biopsy
|
$258.00 |
$258.00 |
$258.00 |
|
|
Echo guide for transfusion
|
$324.60 |
$324.60 |
$343.80 |
|
|
Echo guide villus sampling
|
$513.05 |
$513.05 |
$513.05 |
|
|
Echo stress
|
$1,401.00 |
$1,401.00 |
$3,736.85 |
|
|
Echo tee guidance
|
$1,414.80 |
$2,323.20 |
$4,026.23 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,337.00 |
$2,496.60 |
$3,923.80 |
|
|
Echo transesophageal
|
$955.50 |
$970.50 |
$2,163.38 |
|
|
Echo transesophageal
|
$2,271.65 |
$3,285.00 |
$3,285.00 |
|
|
Echo transesophageal intraop
|
$1,680.00 |
$1,680.00 |
$3,923.80 |
|
|
Echo transthoracic
|
$919.00 |
$1,335.00 |
$3,177.95 |
|
|
Echo transthoracic
|
$643.20 |
$693.00 |
$2,392.40 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$942.00 |
$1,260.00 |
$2,827.04 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$33.92 |
$33.92 |
$430.84 |
|
|
Eculizumab injection
|
$16,330.48 |
$16,330.48 |
$16,330.48 |
|
|
Ed svc ckd ind per session
|
$108.00 |
$108.00 |
$108.00 |
|
|
Eeg 41-60 minutes 95812-26
|
$681.60 |
$874.50 |
$2,480.87 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$790.80 |
$1,012.50 |
$2,989.47 |
|
|
Eeg during surgery
|
$545.40 |
$2,055.00 |
$2,158.50 |
|
|
Eeg monitoring/function test
|
$2,181.17 |
$2,181.17 |
$2,181.17 |
|
|
Eeg monitoring/giving drugs
|
$1,901.30 |
$1,901.30 |
$1,901.30 |
|
|
Eeg monitor/record/awake/drowsy 95816
|
$675.00 |
$719.00 |
$3,117.56 |
|
|
Eeg over 1 hour 95813 - 26
|
$400.40 |
$946.50 |
$11,817.18 |
|
|
Eeg/record in coma or sleep only 95822
|
$626.69 |
$757.50 |
$783.50 |
|
|
Eeg recording awake and asleep
|
$364.98 |
$1,040.40 |
$3,117.56 |
|
|
Eeg without vid 2-12hr cont mntr
|
$5,733.89 |
$5,733.89 |
$5,733.89 |
|
|
Eeg without vid 2-12 hr unmntr
|
$484.20 |
$621.00 |
$5,733.89 |
|
|
Eeg without vid ea 12-26hr cont
|
$2,734.80 |
$3,508.80 |
$5,908.59 |
|
|
Eeg without vid ea 12-26hr intmt
|
$5,733.89 |
$5,733.89 |
$5,733.89 |
|
|
Eeg wo vid 2-12hr intmt mntr
|
$5,733.89 |
$5,733.89 |
$5,733.89 |
|
|
Eeg wo vid ea 12-26hr unmntr
|
$928.20 |
$1,191.00 |
$5,733.89 |
|
|
E equine encephalitis igg
|
$90.50 |
$92.00 |
$166.66 |
|
|
Efgartigimod alfa-fcab 20 mg/ml intravenous solution
|
$22.76 |
$15,501.95 |
$15,501.95 |
|
|
Egfr gene com variants
|
$376.20 |
$612.00 |
$4,083.35 |
|
|
Ehrlicha chaffeensis amp prb
|
$562.88 |
$562.88 |
$562.88 |
|
|
Eia hiv-1/hiv-2 screen
|
$159.64 |
$159.64 |
$159.64 |
|
|
EKG (Electrocardiogram)
|
$285.60 |
$285.60 |
$285.60 |
|
|
EKG tracing for initial prev
|
$132.00 |
$195.00 |
$249.95 |
|
|
EKG (Tracing Only)
|
$131.25 |
$280.20 |
$359.41 |
|
|
Elbow X-ray (2 views, both sides)
|
$205.50 |
$320.40 |
$1,773.27 |
|
|
Elbow X-ray (3 or more views, both sides)
|
$262.00 |
$516.00 |
$1,897.73 |
|
|
Elec analys infus pump w/reprog 62368
|
$42.88 |
$42.88 |
$1,156.84 |
|
|
Electrd sq emblem s-icd
|
$15,092.00 |
$15,092.00 |
$47,418.53 |
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$60.25 |
$89.50 |
$252.10 |
|
|
Electrical stimulation/unattended 97014
|
$56.40 |
$82.80 |
$113.40 |
|
|
Electric stim/w chemodenervation 95873
|
$69.55 |
$93.00 |
$312.05 |
|
|
Electroacous eval hear aid/biaural 92595
|
$135.60 |
$135.60 |
$135.60 |
|
|
Electrocochleography
|
$139.20 |
$139.20 |
$139.20 |
|
|
Electroconvulsive therapy 90870
|
$1,015.20 |
$1,636.20 |
$3,490.93 |
|
|
Electrocorticography durng sx
|
$2,679.60 |
$2,679.60 |
$2,679.60 |
|
|
Electrode stimulation brain
|
$939.60 |
$939.60 |
$958.80 |
|
|
Electrolyte panel
|
$33.50 |
$138.60 |
$208.80 |
|
|
Electron microscopy diagnostic
|
$1,253.50 |
$1,632.00 |
$2,633.40 |
|
|
Electrophysiologic study
|
$4,854.60 |
$4,854.60 |
$15,511.45 |
|
|
Electrophysiology evaluation
|
$8,060.40 |
$8,392.80 |
$14,859.43 |
|
|
Electrophysiology evaluation
|
$6,692.00 |
$8,395.20 |
$38,631.29 |
|
|
Electrophysiology evaluation
|
$5,503.00 |
$8,395.20 |
$14,169.81 |
|
|
Electrophysiology evaluation
|
$5,503.00 |
$8,395.20 |
$10,463.05 |
|
|
Electrophysiology evaluation
|
$2,869.00 |
$2,997.60 |
$5,357.57 |
|
|
Electrophysiology evaluation
|
$2,356.80 |
$2,997.60 |
$19,257.23 |
|
|
Electrophysiology evaluation
|
$2,856.60 |
$2,997.60 |
$4,618.51 |
|
|
Electrophys map 3d add-on
|
$9,435.00 |
$10,291.80 |
$33,930.98 |
|
|
Elosulfase alfa, injection
|
$2,653.85 |
$2,653.85 |
$2,653.85 |
|
|
Elotuzumab 300 mg intravenous solution
|
$12.05 |
$7,477.60 |
$7,477.60 |
|
|
Elranatamab-bcmm 40 mg/ml subcutaneous solution
|
$267.62 |
$32,652.80 |
$32,652.80 |
|
|
Embolization s&i
|
$575.40 |
$575.40 |
$6,651.51 |
|
