|
Drug asy hydroxychloroquine
|
$66.43 |
$66.43 |
$66.43 |
$66.43
|
|
Drug of abuse screen urine
|
$72.14 |
$72.14 |
$72.14 |
$67.89
|
|
Drug screening tapentadol
|
$36.00 |
$36.00 |
$36.00 |
$47.03
|
|
Drug screen quant tiagabine
|
$66.43 |
$66.43 |
$66.43 |
$107.59
|
|
Drug/substance nos 4-6
|
$72.14 |
$72.14 |
$72.14 |
$72.14
|
|
Drug test def 15-21 classes
|
$397.60 |
$397.60 |
$397.60 |
$322.50
|
|
Drug test def 1-7 classes
|
$229.60 |
$229.60 |
$229.60 |
$263.25
|
|
Drug test def 22+ classes
|
$494.40 |
$494.40 |
$494.40 |
$426.24
|
|
Drug test def 8-14 classes
|
$313.60 |
$313.60 |
$313.60 |
$289.80
|
|
Drug test def simple all cl
|
$124.80 |
$124.80 |
$124.80 |
$68.35
|
|
Drug test prsmv instrmnt
|
$72.14 |
$72.14 |
$72.14 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$127.20 |
$127.20 |
$127.20 |
$278.85
|
|
Drvvt confirm - quest
|
$45.60 |
$45.60 |
$45.60 |
$109.20
|
|
Dry needling (97799)
|
$23.42 |
$23.42 |
$23.42 |
$114.27
|
|
Dstrj extensive retinopathy
|
$2,158.40 |
$2,158.40 |
$2,158.40 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$4,032.82 |
$4,032.82 |
$4,032.82 |
$2,980.00
|
|
Dstr mal les s/n/h/f/g >4.0
|
$702.40 |
$702.40 |
$702.40 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$603.20 |
$603.20 |
$603.20 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$688.00 |
$688.00 |
$688.00 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$886.40 |
$886.40 |
$886.40 |
$886.40
|
|
Ductogram sgl duct
|
$464.02 |
$464.02 |
$464.02 |
$469.80
|
|
Duodenal exclusion
|
$4,393.60 |
$4,393.60 |
$4,393.60 |
$4,393.60
|
|
Duodenal motility study
|
$367.20 |
$367.20 |
$367.20 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$620.00 |
$620.00 |
$620.00 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$357.60 |
$357.60 |
$357.60 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$866.73 |
$866.73 |
$866.73 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,274.09 |
$1,274.09 |
$1,274.09 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$735.52 |
$735.52 |
$735.52 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$100.00 |
$100.00 |
$100.00 |
$401.20
|
|
Dx aly aud oi snd prcsr 1st
|
$186.40 |
$186.40 |
$186.40 |
$186.40
|
|
Dx aly aud oi snd prcsr each
|
$48.00 |
$48.00 |
$48.00 |
$51.52
|
|
Dx bronchoscope/brush 31623
|
$666.40 |
$666.40 |
$666.40 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$2,512.54 |
$2,512.54 |
$2,512.54 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$2,512.54 |
$2,512.54 |
$2,512.54 |
$2,410.50
|
|
Dx duod intub w/asp spec 43756
|
$608.80 |
$608.80 |
$608.80 |
$1,075.20
|
|
Dx duod intub w/asp specs
|
$837.60 |
$837.60 |
$837.60 |
$1,406.58
|
|
Dx gastr intub w/asp spec
|
$441.60 |
$441.60 |
$441.60 |
$441.60
|
|
Dx gastr intub w/asp specs
|
$421.60 |
$421.60 |
$421.60 |
$308.70
|
|
Dx intraop epcar Ultrasound chd i&r
|
$64.00 |
$64.00 |
$64.00 |
$465.29
|
|
Dx intraop epicar car Ultrasound chd
|
$171.20 |
$171.20 |
$171.20 |
$558.11
|
|
Dx intraop thoracic aorta Ultrasound
|
$55.20 |
$55.20 |
$55.20 |
$558.11
|
|
Dx laryngoscopy newborn
|
$385.60 |
$385.60 |
$385.60 |
$658.00
|
|
Dx laryngoscopy w/oper scope
|
$387.20 |
$387.20 |
$387.20 |
$2,755.53
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$108.80 |
$108.80 |
$108.80 |
$558.11
|
|
Dynamic cavernosometry
|
$354.40 |
$354.40 |
$354.40 |
$3,442.40
|
|
Dynamic surface emg
|
$49.60 |
$49.60 |
$49.60 |
$368.50
|
|
Ear and throat examination
|
$210.40 |
$210.40 |
$210.40 |
$602.63
|
|
Ear canal biopsy 69105
|
$688.00 |
$688.00 |
$688.00 |
$1,889.50
|
|
Ear cartilage graft
|
$1,787.20 |
$1,787.20 |
$1,787.20 |
$6,385.40
|
|
Ear irrigation 69209
|
$206.90 |
$206.90 |
$206.90 |
$154.70
|
|
Ear protector evaluation
|
$141.60 |
$141.60 |
$141.60 |
$112.56
|
|
Ecg/1-3 leads/interp & report only 93042
|
$16.00 |
$16.00 |
$16.00 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$12.00 |
$12.00 |
$12.00 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$377.60 |
$377.60 |
$377.60 |
$412.88
|
|
Ecg external < 48 hours recording
|
$367.73 |
$367.73 |
$367.73 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$176.07 |
$176.07 |
$176.07 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$115.43 |
$115.43 |
$115.43 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$115.43 |
$115.43 |
$115.43 |
$173.40
|
|
Ecg record/review
|
$469.60 |
$469.60 |
$469.60 |
$371.28
|
|
Ecg/review interpret only
|
$57.60 |
$57.60 |
$57.60 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$2,213.28 |
$2,213.28 |
$2,213.28 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$501.20 |
$501.20 |
$501.20 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$411.60 |
$411.60 |
$411.60 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,329.76 |
$2,329.76 |
$2,329.76 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$807.65 |
$807.65 |
$807.65 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$296.21 |
$296.21 |
$296.21 |
$371.25
|
|
Echo exam of eye
|
$140.80 |
$140.80 |
$140.80 |
$143.75
|
|
Echo exam of eye
|
$172.00 |
$172.00 |
$172.00 |
$172.00
|
|
Echo exam of eye
|
$168.00 |
$168.00 |
$168.00 |
$169.62
|
|
Echo exam of eye thickness
|
$29.60 |
$29.60 |
$29.60 |
$40.30
|
|
Echo exam of fetal heart
|
$1,461.41 |
$1,461.41 |
$1,461.41 |
$904.80
|
|
Echo exam of fetal heart
|
$515.13 |
$515.13 |
$515.13 |
$538.27
|
|
Echo exam of fetal heart
|
$252.67 |
$252.67 |
$252.67 |
$431.41
|
|
Echo exam of fetal heart
|
$280.98 |
$280.98 |
$280.98 |
$318.34
|
|
Echo exam uterus 76831-
|
$536.40 |
$536.40 |
$536.40 |
$561.00
|
|
Echograp trans r pros study
|
$936.61 |
$936.61 |
$936.61 |
$468.00
|
|
Echo guidance radiotherapy
|
$922.88 |
$922.88 |
$922.88 |
$812.00
|
|
Echo guidance radiotherapy
|
$322.40 |
$322.40 |
$322.40 |
$322.40
|
|
Echo guide for amniocentesis
|
$512.84 |
$512.84 |
$512.84 |
$455.57
|
|
Echo guide for artery repair
|
$1,366.79 |
$1,366.79 |
$1,366.79 |
$696.30
|
|
Echo guide for heart biopsy
|
$192.80 |
$192.80 |
$192.80 |
$666.40
|
|
Echo guide for transfusion
|
$273.60 |
$273.60 |
$273.60 |
$332.39
|
|
Echo guide ova aspiration
|
$144.80 |
$144.80 |
$144.80 |
$174.20
|
|
Echo guide villus sampling
|
$191.20 |
$191.20 |
$191.20 |
$362.88
|
|
Echo stress
|
$760.68 |
$760.68 |
$760.68 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$65.60 |
$65.60 |
$65.60 |
$751.34
|
|
Echo tee guidance
|
$1,963.66 |
$1,963.66 |
$1,963.66 |
$1,878.84
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,963.66 |
$1,963.66 |
$1,963.66 |
$1,913.60
|
|
Echo transesophageal
|
$99.20 |
$99.20 |
$99.20 |
$1,075.20
|
|
Echo transesophageal
|
$564.80 |
$564.80 |
$564.80 |
$602.00
|
|
Echo transesophageal
|
$1,963.66 |
$1,963.66 |
$1,963.66 |
$1,650.00
|
|
Echo transesophageal
|
$603.20 |
$603.20 |
$603.20 |
$603.20
|
|
Echo transesophageal intraop
|
$1,251.20 |
$1,251.20 |
$1,251.20 |
$1,578.00
|
|
Echo transthoracic
|
$2,213.03 |
$2,213.03 |
$2,213.03 |
$1,361.75
|
|
Echo transthoracic
|
$1,116.24 |
$1,116.24 |
$1,116.24 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,316.87 |
$1,316.87 |
$1,316.87 |
$1,033.00
|
|
Ecmo/ecls daily mgmt artery 33949
|
$4,046.50 |
$4,046.50 |
$4,046.50 |
$2,867.22
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$4,179.27 |
$4,179.27 |
$4,179.27 |
$3,099.00
|
|
Ecmo/ecls initiation artery 33947
|
$5,890.62 |
$5,890.62 |
$5,890.62 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$5,316.83 |
$5,316.83 |
$5,316.83 |
$4,084.29
|