|
Drng of hydrocele 55000
|
$220.20 |
$220.20 |
$231.00 |
$867.90
|
|
Drng of mouth lesion 40801
|
$574.20 |
$574.20 |
$603.00 |
$1,350.97
|
|
Drng of ovarian cyst(s) 58800
|
$590.40 |
$590.40 |
$619.80 |
$3,474.84
|
|
Drng of palm multi bursas 26030
|
$904.20 |
$904.20 |
$949.20 |
$3,839.54
|
|
Drng of palm single bursa 26025
|
$895.20 |
$895.20 |
$940.20 |
$3,839.54
|
|
Drng of pelvic abscess transrectal 45000
|
$763.80 |
$763.80 |
$802.20 |
$2,295.30
|
|
Drng of salivary cyst 42409
|
$625.20 |
$625.20 |
$656.40 |
$3,819.23
|
|
Drng of scrotum abscess 55100
|
$463.80 |
$463.80 |
$487.20 |
$1,997.89
|
|
Drng open retroperitoneal abscess 49060
|
$1,986.00 |
$1,986.00 |
$2,085.60 |
$1,924.00
|
|
Drng open subdiaphragmatic/subphrenic absc 49040
|
$1,800.00 |
$1,800.00 |
$1,890.00 |
$1,800.00
|
|
Drng ovary abscess perqt 58822
|
$1,350.00 |
$1,350.00 |
$1,417.80 |
$2,279.50
|
|
Drng peritoneal abscess open 49020
|
$2,856.00 |
$2,856.00 |
$2,998.80 |
$2,520.00
|
|
Drng salivary gland simple 42300
|
$393.00 |
$393.00 |
$412.80 |
$2,039.50
|
|
Drng salivary gland submax/subling 42310
|
$304.20 |
$304.20 |
$319.20 |
$799.40
|
|
Dronabinol 2.5mg oral
|
$21.02 |
$21.02 |
$21.02 |
$17.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$28.27 |
$28.27 |
$31.25 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,956.60 |
$1,956.60 |
$2,015.40 |
$1,818.32
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$411.60 |
$411.60 |
$432.60 |
$53.60
|
|
Drug assay posaconazole
|
$352.20 |
$352.20 |
$370.20 |
$96.75
|
|
Drug assay vedolizumab
|
$180.00 |
$180.00 |
$200.40 |
$154.00
|
|
Drug assay voriconazole
|
$142.20 |
$142.20 |
$142.20 |
$96.75
|
|
Drug of abuse screen urine
|
$12.60 |
$12.60 |
$138.60 |
$67.89
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$516.60 |
$516.60 |
$543.00 |
$278.85
|
|
Drvvt confirm - quest
|
$159.00 |
$159.00 |
$167.40 |
$109.20
|
|
Ductogram sgl duct
|
$267.60 |
$267.60 |
$469.80 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$467.40 |
$467.40 |
$490.80 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$292.20 |
$292.20 |
$306.60 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$292.20 |
$292.20 |
$306.60 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$325.20 |
$325.20 |
$362.40 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$632.40 |
$632.40 |
$703.80 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$7,005.56 |
$7,005.56 |
$7,619.12 |
$8,445.90
|
|
Dx bronchoscope/brush 31623
|
$616.80 |
$616.80 |
$647.40 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$580.80 |
$580.80 |
$609.60 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$578.40 |
$578.40 |
$607.20 |
$2,410.50
|
|
Dx duod intub w/asp spec 43756
|
$429.00 |
$429.00 |
$450.60 |
$1,075.20
|
|
Dx laryngoscopy w/oper scope
|
$411.60 |
$411.60 |
$432.00 |
$2,755.53
|
|
Ear and throat examination
|
$172.80 |
$172.80 |
$181.20 |
$602.63
|
|
Ear canal biopsy 69105
|
$262.80 |
$262.80 |
$276.00 |
$1,889.50
|
|
Ear cartilage graft
|
$1,344.60 |
$1,344.60 |
$1,411.80 |
$6,385.40
|
|
Ear irrigation 69209
|
$96.00 |
$96.00 |
$116.40 |
$154.70
|
|
Ecallantide injection
|
$9,539.70 |
$9,539.70 |
$10,119.91 |
$13,357.14
|
|
Ecg/1-3 leads/interp & report only 93042
|
$16.80 |
$16.80 |
$17.40 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$69.00 |
$69.00 |
$77.40 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$466.20 |
$466.20 |
$519.60 |
$412.88
|
|
Ecg external < 48 hours recording
|
$318.00 |
$318.00 |
$354.60 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$454.80 |
$454.80 |
$506.40 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$63.60 |
$63.60 |
$70.80 |
$147.28
|
|
Ecg/review interpret only
|
$48.00 |
$48.00 |
$50.40 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$994.20 |
$994.20 |
$1,263.60 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$441.60 |
$441.60 |
$491.40 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$316.20 |
$316.20 |
$352.20 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,512.60 |
$1,512.60 |
$1,683.60 |
$1,944.80
|
|
Echocardiograpy doppler follow up/limited study
|
$192.60 |
$192.60 |
$214.20 |
$371.25
|
|
Echo exam uterus 76831-
|
$283.20 |
$283.20 |
$309.60 |
$561.00
|
|
Echograp trans r pros study
|
$231.00 |
$231.00 |
$243.00 |
$468.00
|
|
Echo guidance radiotherapy
|
$426.60 |
$426.60 |
$465.60 |
$812.00
|
|
Echo guide for amniocentesis
|
$555.60 |
$555.60 |
$607.20 |
$455.57
|
|
Echo guide for artery repair
|
$550.80 |
$550.80 |
$601.80 |
$696.30
|
|
Echo stress
|
$830.40 |
$830.40 |
$924.60 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$328.20 |
$328.20 |
$344.40 |
$751.34
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,173.60 |
$1,173.60 |
$1,306.20 |
$1,913.60
|
|
Echo transesophageal
|
$1,075.20 |
$1,075.20 |
$1,287.00 |
$1,075.20
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$329.40 |
$329.40 |
$345.60 |
$1,033.00
|
|
Ecmo/ecls daily mgmt artery 33949
|
$490.80 |
$490.80 |
$515.40 |
$2,867.22
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$2,025.00 |
$2,025.00 |
$2,339.40 |
$3,099.00
|
|
Ecmo/ecls initiation artery 33947
|
$707.40 |
$707.40 |
$742.80 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$640.20 |
$640.20 |
$672.00 |
$4,084.29
|
|
Ecmo/ecls insj cent cannula 0-5yrs 33955
|
$1,855.20 |
$1,855.20 |
$1,948.20 |
$1,948.20
|
|
Ecmo/ecls insj cent cannula 6yrs&older 33956
|
$1,766.40 |
$1,766.40 |
$1,854.60 |
$2,055.20
|
|
Ecmo/ecls insj prph cannula 0-5yrs opn 33953
|
$1,031.40 |
$1,031.40 |
$1,083.00 |
$1,083.00
|
|
Ecmo/ecls insj prph cannula 0-5yrs perq 33951
|
$924.60 |
$924.60 |
$970.80 |
$970.80
|
|
Ecmo/ecls insj prph cannula 6yrs&older opn 33954
|
$1,005.60 |
$1,005.60 |
$1,056.00 |
$1,313.68
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$899.40 |
$899.40 |
$944.40 |
$2,660.16
|
|
Ecmo/ecls remove cent cannula 0-5yrs 33985
|
$1,141.80 |
$1,141.80 |
$1,198.80 |
$925.55
|
|
Ecmo/ecls remove cent cannula 6yrs&older 33986
|
$1,092.00 |
$1,092.00 |
$1,146.60 |
$1,282.40
|
|
Ecmo/ecls remove perph cannula 0-5yrs opn 33969
|
$606.00 |
$606.00 |
$636.60 |
$667.20
|
|
Ecmo/ecls remove perph cannula 0-5yrs perq 33965
|
$411.60 |
$411.60 |
$432.00 |
$520.80
|
|
Ecmo/ecls remove prph cannula 6yrs&older open 33984
|
$598.20 |
$598.20 |
$628.20 |
$1,362.00
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$498.00 |
$498.00 |
$523.20 |
$1,660.50
|
|
Ecmo/ecls repos cent cnula 6yrs&older 33964
|
$1,074.60 |
$1,074.60 |
$1,128.60 |
$1,220.80
|
|
Ecmo/ecls repos cent/perph cnula 0-5yrs 33963
|
$1,045.20 |
$1,045.20 |
$1,097.40 |
$1,097.40
|
|
Ecmo/ecls repos perph cnula 0-5yrs opn 33959
|
$523.20 |
$523.20 |
$549.60 |
$576.80
|
|
Ecmo/ecls repos perph cnula 0-5yrs perq 33957
|
$411.60 |
$411.60 |
$432.00 |
$520.80
|
|
Ecmo/ecls repos perph cnula 6yrs&older opn 33962
|
$494.40 |
$494.40 |
$519.00 |
$953.40
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$399.00 |
$399.00 |
$418.80 |
$1,518.60
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$11,583.15 |
$11,583.15 |
$11,583.15 |
$19,540.29
|
|
Eculizumab injection
|
$11,583.15 |
$11,583.15 |
$11,583.15 |
$16,330.48
|
|
Edetate calcium disodium inj
|
$149.45 |
$149.45 |
$149.45 |
$8,739.98
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$39.00 |
$39.00 |
$41.40 |
$94.32
|
|
Eeg 41-60 minutes 95812-26
|
$534.00 |
$534.00 |
$594.60 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$530.40 |
$530.40 |
$576.60 |
$994.15
|
|
Eeg during surgery
|
$838.80 |
$838.80 |
$934.20 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$752.40 |
$752.40 |
$790.20 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$774.00 |
$774.00 |
$861.60 |
$1,119.54
|
|
Eeg phy/qhp>36<60 hr without vid
|
$678.00 |
$678.00 |
$712.20 |
$1,456.00
|
|
Eeg phy/qhp>36<60 hr w/veeg
|
$3,274.20 |
$3,274.20 |
$3,438.00 |
$1,932.00
|
|
Eeg phy/qhp>60<84 hr without vid
|
$829.80 |
$829.80 |
$871.20 |
$1,932.00
|
|
Eeg phy/qhp>60<84 hr w/veeg
|
$498.00 |
$498.00 |
$523.20 |
$1,932.00
|
|
Eeg phy/qhp>84 hr without vid
|
$427.80 |
$427.80 |
$449.40 |
$1,932.00
|
|
Eeg phy/qhp>84 hr w/veeg
|
$591.60 |
$591.60 |
$621.00 |
$1,932.00
|