|
ER Visit (level 1, minor)
|
$156.92 |
$156.92 |
$156.92 |
$252.60
|
|
ER Visit (level 2)
|
$321.00 |
$321.00 |
$321.00 |
$463.00
|
|
ER Visit (level 3)
|
$599.16 |
$599.16 |
$599.16 |
$812.18
|
|
ER Visit (level 4)
|
$966.68 |
$966.68 |
$966.68 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$1,407.20 |
$1,407.20 |
$1,407.20 |
$1,871.60
|
|
Escharotomy ea addl incision
|
$203.20 |
$203.20 |
$203.20 |
$203.20
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$10.42 |
$10.42 |
$10.42 |
$516.71
|
|
Esophageal dilat s&i
|
$323.20 |
$323.20 |
$323.20 |
$551.20
|
|
Esophageal motility
|
$481.60 |
$481.60 |
$481.60 |
$655.45
|
|
Esophageal recording
|
$160.00 |
$160.00 |
$160.00 |
$1,985.34
|
|
Esophageal recording
|
$959.20 |
$959.20 |
$959.20 |
$2,187.60
|
|
Esophagomyotomy abdominal 43330
|
$3,271.20 |
$3,271.20 |
$3,271.20 |
$3,271.20
|
|
Esophagomyotomy thoracic 43331
|
$3,267.20 |
$3,267.20 |
$3,267.20 |
$3,267.20
|
|
Esophagosc dilate balloon 30
|
$485.60 |
$485.60 |
$485.60 |
$2,244.82
|
|
Esophagoscop ultrasound exam
|
$723.20 |
$723.20 |
$723.20 |
$2,605.80
|
|
Esophagoscopy balloon <30mm
|
$2,460.00 |
$2,460.00 |
$2,460.00 |
$2,460.00
|
|
Esophagoscopy control bleed
|
$1,519.20 |
$1,519.20 |
$1,519.20 |
$2,742.00
|
|
Esophagoscopy flex biopsy
|
$826.40 |
$826.40 |
$826.40 |
$2,132.00
|
|
Esophagoscopy/flex/diagnostic 43200
|
$590.40 |
$590.40 |
$590.40 |
$1,296.00
|
|
Esophagoscopy flex remove fb
|
$939.20 |
$939.20 |
$939.20 |
$2,089.60
|
|
Esophagoscopy lesion removal
|
$962.40 |
$962.40 |
$962.40 |
$3,484.00
|
|
Esophagoscopy retro balloon
|
$2,994.40 |
$2,994.40 |
$2,994.40 |
$2,994.40
|
|
Esophagoscopy/rigid/diagnostic 43191
|
$384.00 |
$384.00 |
$384.00 |
$2,660.00
|
|
Esophagoscopy rigid trnso 43180
|
$1,358.40 |
$1,358.40 |
$1,358.40 |
$6,553.49
|
|
Esophagoscopy snare les remv
|
$985.60 |
$985.60 |
$985.60 |
$2,742.00
|
|
Esophagoscopy w/us needle bx
|
$859.20 |
$859.20 |
$859.20 |
$2,244.82
|
|
Esophagoscp guide wire dilat 43196
|
$489.60 |
$489.60 |
$489.60 |
$2,638.57
|
|
Esophagoscp rig trnso biopsy
|
$420.80 |
$420.80 |
$420.80 |
$3,484.00
|
|
Esophagoscp rig trnso inject
|
$421.60 |
$421.60 |
$421.60 |
$3,484.00
|
|
Esophagotomy thrc rmvl fb
|
$3,173.60 |
$3,173.60 |
$3,173.60 |
$3,173.60
|
|
Esophagus endoscopy/ligation
|
$356.80 |
$356.80 |
$356.80 |
$2,392.00
|
|
Esophagus motility study
|
$1,211.37 |
$1,211.37 |
$1,211.37 |
$1,257.17
|
|
Esoph balloon distension tst
|
$1,164.80 |
$1,164.80 |
$1,164.80 |
$1,040.00
|
|
Esoph egd dilation <30 mm
|
$2,656.80 |
$2,656.80 |
$2,656.80 |
$2,656.80
|
|
Esoph endoscopy dilation
|
$874.40 |
$874.40 |
$874.40 |
$2,221.83
|
|
Esoph fundoplasty lap 43327
|
$2,010.40 |
$2,010.40 |
$2,010.40 |
$3,148.00
|
|
Esoph fundoplasty thor 43328
|
$2,748.00 |
$2,748.00 |
$2,748.00 |
$2,748.00
|
|
Esophgl motil w/stim/perfus
|
$56.80 |
$56.80 |
$56.80 |
$1,392.95
|
|
Esoph imped function test
|
$369.60 |
$369.60 |
$369.60 |
$603.00
|
|
Esoph imped funct test > 1hr
|
$944.00 |
$944.00 |
$944.00 |
$1,121.40
|
|
Esoph optical endomicroscopy
|
$703.20 |
$703.20 |
$703.20 |
$2,704.00
|
|
Esoph scope w/sclerosis inj
|
$341.60 |
$341.60 |
$341.60 |
$2,244.82
|
|
Esoph scope w/submucous inj
|
$592.00 |
$592.00 |
$592.00 |
$2,590.33
|
|
Esphg dstl 2/3 w/laps moblj 43287
|
$8,776.00 |
$8,776.00 |
$8,776.00 |
$7,128.80
|
|
Esphg thrsc moblj
|
$9,261.60 |
$9,261.60 |
$9,261.60 |
$7,526.40
|
|
Esphg tot w/laps moblj
|
$7,796.00 |
$7,796.00 |
$7,796.00 |
$6,423.20
|
|
Esrd home pt serv p mo 12-19
|
$1,016.00 |
$1,016.00 |
$1,016.00 |
$1,016.00
|
|
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 |
$40.80 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$83.20 |
$83.20 |
$83.20 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$160.80 |
$160.80 |
$160.80 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$192.00 |
$192.00 |
$192.00 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$265.60 |
$265.60 |
$265.60 |
$290.68
|
|
Estim aid bone healg invasiv
|
$430.40 |
$430.40 |
$430.40 |
$2,620.80
|
|
Estradiol total
|
$70.40 |
$70.40 |
$70.40 |
$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
|
$1.60 |
$1.60 |
$1.60 |
$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
|
$286.40 |
$286.40 |
$286.40 |
$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 |
$291.41 |
$213.15
|
|
Evaluation heart device
|
$3,376.75 |
$3,376.75 |
$3,376.75 |
$2,199.00
|
|
Evaluation of speech fluency 92521
|
$252.00 |
$252.00 |
$252.00 |
$302.50
|
|
Evaluation psychiatric diagnostic
|
$324.00 |
$324.00 |
$324.00 |
$318.24
|
|
Evasc prlng admn rx agnt 1st
|
$1,196.11 |
$1,196.11 |
$1,196.11 |
$4,031.48
|
