|
Esrd home pt serv p mo 20+
|
$540.80 |
$540.80 |
$540.80 |
$540.80
|
|
Esrd home pt serv p mo 2-11
|
$1,064.00 |
$1,064.00 |
$1,064.00 |
$1,064.00
|
|
Esrd home pt serv p mo <2yrs
|
$1,216.80 |
$1,216.80 |
$1,216.80 |
$1,216.80
|
|
Esrd serv 1 visit p mo 20+
|
$409.60 |
$409.60 |
$409.60 |
$409.60
|
|
Esrd serv 1 visit p mo <2yrs
|
$928.80 |
$928.80 |
$928.80 |
$928.80
|
|
Esrd serv 1 vst p mo 12-19
|
$660.80 |
$660.80 |
$660.80 |
$660.80
|
|
Esrd serv 2-3 vsts p mo <2yr
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$1,284.00
|
|
Esrd serv 4 visits p mo <2yr
|
$2,130.40 |
$2,130.40 |
$2,130.40 |
$2,130.40
|
|
Esrd serv 4 vsts p mo 2-11
|
$1,838.40 |
$1,838.40 |
$1,838.40 |
$1,838.40
|
|
Esrd srv 1 visit p mo 2-11
|
$711.20 |
$711.20 |
$711.20 |
$711.20
|
|
Esrd srv 2-3 vsts p mo 12-19
|
$977.60 |
$977.60 |
$977.60 |
$977.60
|
|
Esrd srv 2-3 vsts p mo 20+
|
$540.80 |
$540.80 |
$540.80 |
$540.80
|
|
Esrd srv 2-3 vsts p mo 2-11
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$1,023.20
|
|
Esrd srv 4 visits p mo 20+
|
$652.00 |
$652.00 |
$652.00 |
$652.00
|
|
Esrd srv 4 vsts p mo 12-19
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$1,440.00
|
|
Esrd svc pr day pt 12-19
|
$34.40 |
$34.40 |
$34.40 |
$34.40
|
|
Esrd svc pr day pt <2
|
$40.80 |
$40.80 |
$40.80 |
$40.80
|
|
Esrd svc pr day pt 20+
|
$18.40 |
$18.40 |
$18.40 |
$53.76
|
|
Esrd svc pr day pt 2-11
|
$36.00 |
$36.00 |
$36.00 |
$36.00
|
|
Essure 58565
|
$1,116.80 |
$1,116.80 |
$1,116.80 |
$5,841.60
|
|
Establish access to aorta
|
$1,336.00 |
$1,336.00 |
$1,336.00 |
$1,273.00
|
|
Establish access to artery
|
$2,526.40 |
$2,526.40 |
$2,526.40 |
$1,145.65
|
|
Establish brain cavity shunt
|
$2,464.00 |
$2,464.00 |
$2,464.00 |
$2,464.00
|
|
Establish brain cavity shunt
|
$3,754.40 |
$3,754.40 |
$3,754.40 |
$2,870.05
|
|
Establish brain cavity shunt
|
$2,316.00 |
$2,316.00 |
$2,316.00 |
$2,316.00
|
|
Establish brain cavity shunt
|
$2,338.40 |
$2,338.40 |
$2,338.40 |
$2,338.40
|
|
Established Patient Office Visit (level 1)
|
$40.80 |
$40.80 |
$591.50 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$76.00 |
$76.00 |
$83.20 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$141.00 |
$141.00 |
$160.80 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$192.00 |
$192.00 |
$209.00 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$265.60 |
$265.60 |
$307.00 |
$290.68
|
|
Estim aid bone healg invasiv
|
$430.40 |
$430.40 |
$430.40 |
$2,620.80
|
|
Estradiol total
|
$70.40 |
$70.40 |
$191.10 |
$152.10
|
|
Estradiol valerate 10 mg inj
|
$24.00 |
$24.00 |
$24.00 |
$57.35
|
|
Estrogens total-sendout
|
$55.20 |
$55.20 |
$55.20 |
$97.50
|
|
Etanercept injection
|
$740.80 |
$740.80 |
$740.80 |
$3,172.86
|
|
Eth estr and eton monthly
|
$132.00 |
$132.00 |
$132.00 |
$266.45
|
|
Ethmoidectomy extranasal total 31205
|
$4,593.60 |
$4,593.60 |
$4,593.60 |
$4,593.60
|
|
Ethylene glycol -sendout
|
$37.60 |
$37.60 |
$37.60 |
$86.04
|
|
Etonogestrel implant system
|
$1,345.60 |
$1,345.60 |
$1,345.60 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$14.90 |
$14.90 |
$174.75 |
$235.20
|
|
Euflexxa inj per dose
|
$260.00 |
$260.00 |
$260.00 |
$510.68
|
|
Euglobulin lysis
|
$33.57 |
$33.57 |
$33.57 |
$63.84
|
|
Evacuate mole of uterus
|
$1,229.60 |
$1,229.60 |
$1,229.60 |
$3,762.53
|
|
Eval aud funcj ea addl 15
|
$48.00 |
$48.00 |
$48.00 |
$69.60
|
|
Eval aud rehab status/first hr 92626
|
$201.60 |
$201.60 |
$201.60 |
$329.59
|
|
Eval/fit voice prosthesis iii, st
|
$328.27 |
$328.27 |
$469.30 |
$359.50
|
|
Evaluation cervical mucus
|
$26.40 |
$26.40 |
$26.40 |
$26.40
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$291.41 |
$291.41 |
$460.20 |
$213.15
|
|
Evaluation heart device
|
$918.40 |
$918.40 |
$918.40 |
$2,199.00
|
|
Evaluation of speech fluency 92521
|
$176.80 |
$176.80 |
$341.92 |
$302.50
|
|
Evaluation psychiatric diagnostic
|
$324.00 |
$324.00 |
$377.00 |
$318.24
|
|
Evasc repair of iliac artery; endograft 34718
|
$20,925.40 |
$20,925.40 |
$20,925.40 |
$6,311.00
|
|
Evasc rpr a-ao ndgft 34701
|
$3,042.40 |
$3,042.40 |
$7,166.25 |
$5,403.50
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$4,537.60 |
$4,537.60 |
$4,537.60 |
$4,577.00
|
|
Evasc rpr a-biiliac ndgft rptr
|
$5,647.20 |
$5,647.20 |
$5,647.20 |
$8,565.60
|
|
Evasc rpr a-iliac ndgft 34717
|
$7,498.30 |
$7,498.30 |
$7,498.30 |
$4,919.00
|
|
Evasc rpr a-unilac ndgft 34703
|
$3,355.20 |
$3,355.20 |
$3,355.20 |
$5,741.00
|
|
Evasc rpr a-unilac ndgft rpt
|
$5,584.80 |
$5,584.80 |
$5,584.80 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$5,684.80 |
$5,684.80 |
$5,684.80 |
$7,060.51
|
|
Evasc rpr ilio-iliac rpt
|
$9,081.60 |
$9,081.60 |
$9,081.60 |
$7,922.00
|
|
Event monitor
|
$233.70 |
$233.70 |
$266.50 |
$231.00
|
|
Evoked auditory tst complete
|
$430.11 |
$430.11 |
$430.11 |
$357.41
|
|
Evoked oa emissions ltd
|
$240.07 |
$240.07 |
$240.07 |
$244.00
|
|
Evoked potentials auditory screening automated analysis
|
$317.83 |
$317.83 |
$317.83 |
$261.30
|
|
Evoked potentials upper limbs
|
$328.80 |
$328.80 |
$328.80 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$232.00 |
$232.00 |
$232.00 |
$814.61
|
|
Evok oa screening qual
|
$271.28 |
$271.28 |
$271.28 |
$109.13
|
|
Exam of vagina w/scope 57420
|
$310.40 |
$310.40 |
$310.40 |
$486.03
|
|
Exam pelvic add-on
|
$41.60 |
$41.60 |
$41.60 |
$46.85
|
|
Exam plvc w/anes othr thn lcl
|
$264.80 |
$264.80 |
$264.80 |
$3,816.40
|
|
Ex arm/elbow tum deep < 5 cm
|
$2,668.80 |
$2,668.80 |
$2,668.80 |
$3,386.84
|
|
Ex arm/elbow tum deep 5 cm/>
|
$3,412.80 |
$3,412.80 |
$3,412.80 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$1,073.60 |
$1,073.60 |
$25,966.19 |
$3,994.09
|
|
Exc abdl tum deep < 5 cm
|
$1,378.40 |
$1,378.40 |
$1,378.40 |
$3,786.00
|
|
Exc abdl tum deep 5 cm/>
|
$1,632.80 |
$1,632.80 |
$1,632.80 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$1,987.20 |
$1,987.20 |
$1,987.20 |
$4,529.20
|
|
Exc arm/elbo les sc <3cm 24075
|
$2,532.80 |
$2,532.80 |
$2,532.80 |
$2,532.80
|
|
Exc aurl glomus tum trnscanl
|
$5,099.20 |
$5,099.20 |
$5,099.20 |
$7,000.36
|
|
Exc aurl glomus tum trnsmstd
|
$7,710.40 |
$7,710.40 |
$7,710.40 |
$7,000.36
|
|
Exc back les sbq <3 cm 21930
|
$1,200.80 |
$1,200.80 |
$1,200.80 |
$2,711.00
|
|
Exc back tum deep 5 cm/>
|
$1,807.20 |
$1,807.20 |
$1,807.20 |
$3,994.09
|
|
Exc bartholins gland/cyst
|
$1,534.40 |
$1,534.40 |
$1,534.40 |
$3,902.88
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$696.80 |
$696.80 |
$696.80 |
$2,443.20
|
|
Exc benign feenlm >4.0cm 11446
|
$960.80 |
$960.80 |
$960.80 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$577.60 |
$577.60 |
$577.60 |
$2,306.25
|
|
Exc benign tal 0.5 < cm 11400
|
$1,346.99 |
$1,346.99 |
$1,346.99 |
$832.60
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$343.20 |
$343.20 |
$343.20 |
$969.60
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$468.00 |
$468.00 |
$468.00 |
$1,152.96
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$556.00 |
$556.00 |
$556.00 |
$2,069.20
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$392.00 |
$392.00 |
$392.00 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$500.80 |
$500.80 |
$500.80 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$826.40 |
$826.40 |
$826.40 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$375.20 |
$375.20 |
$375.20 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$479.20 |
$479.20 |
$479.20 |
$1,314.67
|
|
Exc breast duct fistula 19112
|
$2,235.20 |
$2,235.20 |
$2,235.20 |
$4,238.48
|
|
Exc carotid body tumor without exc art 60600
|
$3,356.80 |
$3,356.80 |
$3,356.80 |
$3,356.80
|
|
Exc cervix repair bowel 57556
|
$1,448.80 |
$1,448.80 |
$1,448.80 |
$5,841.60
|
|
Exc cervix/repair vagina 57555
|
$1,528.80 |
$1,528.80 |
$1,528.80 |
$5,468.70
|
|
Exc chest wall tumor w/ribs 21601
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$3,386.84
|
