|
Esrd srv 2-3 vsts p mo 12-19
|
$977.60 |
$977.60 |
$977.60 |
|
|
Esrd srv 2-3 vsts p mo 20+
|
$418.20 |
$540.80 |
$883.00 |
|
|
Esrd srv 2-3 vsts p mo 2-11
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
|
|
Esrd srv 4 visits p mo 20+
|
$503.40 |
$652.00 |
$1,063.00 |
|
|
Esrd srv 4 vsts p mo 12-19
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
|
|
Esrd svc pr day pt 12-19
|
$34.40 |
$34.40 |
$34.40 |
|
|
Esrd svc pr day pt <2
|
$40.80 |
$40.80 |
$40.80 |
|
|
Esrd svc pr day pt 20+
|
$18.40 |
$18.40 |
$29.00 |
|
|
Esrd svc pr day pt 2-11
|
$36.00 |
$36.00 |
$36.00 |
|
|
Essure 58565
|
$1,116.80 |
$1,116.80 |
$3,633.00 |
|
|
Establish access to aorta
|
$393.54 |
$1,336.00 |
$1,975.80 |
|
|
Establish access to artery
|
$2,526.40 |
$2,526.40 |
$2,526.40 |
|
|
Establish brain cavity shunt
|
$2,126.40 |
$2,464.00 |
$3,133.00 |
|
|
Establish brain cavity shunt
|
$3,754.40 |
$3,754.40 |
$3,754.40 |
|
|
Establish brain cavity shunt
|
$2,316.00 |
$2,316.00 |
$2,316.00 |
|
|
Establish brain cavity shunt
|
$2,338.40 |
$2,338.40 |
$2,338.40 |
|
|
Established Patient Office Visit (level 1)
|
$25.00 |
$40.80 |
$1,397.00 |
|
|
Established Patient Office Visit (level 2)
|
$69.60 |
$83.20 |
$24,050.00 |
|
|
Established Patient Office Visit (level 3)
|
$87.36 |
$160.80 |
$4,372.00 |
|
|
Established Patient Office Visit (level 4)
|
$107.94 |
$192.00 |
$2,900.00 |
|
|
Established Patient Office Visit (level 5)
|
$122.22 |
$265.60 |
$2,950.00 |
|
|
Estim aid bone healg invasiv
|
$430.40 |
$430.40 |
$430.40 |
|
|
Estradiol total
|
$70.40 |
$154.70 |
$294.00 |
|
|
Estradiol valerate 10 mg inj
|
$24.00 |
$24.00 |
$419.18 |
|
|
Estrogens total-sendout
|
$52.80 |
$55.20 |
$301.20 |
|
|
Etanercept injection
|
$740.80 |
$740.80 |
$2,473.03 |
|
|
Ethanolamine oleate 100 mg
|
$863.30 |
$904.93 |
$904.93 |
|
|
Eth estr and eton monthly
|
$132.00 |
$132.00 |
$132.00 |
|
|
Ethmoidectomy extranasal total 31205
|
$1,633.20 |
$4,593.60 |
$4,593.60 |
|
|
Ethylene glycol -sendout
|
$37.60 |
$37.60 |
$200.00 |
|
|
Etonogestrel implant system
|
$1,345.60 |
$1,345.60 |
$6,376.80 |
|
|
Etoposide 20 mg/ml intravenous solution
|
$1.60 |
$174.75 |
$431.00 |
|
|
Etoposide 50 mg cap
|
$95.81 |
$95.81 |
$2,700.73 |
|
|
Euflexxa inj per dose
|
$224.08 |
$260.00 |
$651.16 |
|
|
Euglobulin lysis
|
$33.57 |
$33.57 |
$33.57 |
|
|
Evacuate mole of uterus
|
$925.20 |
$1,229.60 |
$1,229.60 |
|
|
Eval aud funcj ea addl 15
|
$48.00 |
$48.00 |
$48.00 |
|
|
Eval aud rehab status/first hr 92626
|
$111.60 |
$201.60 |
$201.60 |
|
|
Eval/fit voice prosthesis iii, st
|
$148.26 |
$328.27 |
$616.85 |
|
|
Evaluation cervical mucus
|
$26.40 |
$26.40 |
$26.40 |
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$108.55 |
$291.41 |
$460.20 |
|
|
Evaluation heart device
|
$546.00 |
$1,459.50 |
$4,560.49 |
|
|
Evaluation of speech fluency 92521
|
$176.80 |
$252.00 |
$1,091.23 |
|
|
Evaluation psychiatric diagnostic
|
$191.52 |
$324.00 |
$585.00 |
|
|
Evasc prlng admn rx agnt 1st
|
$1,196.11 |
$1,196.11 |
$15,856.26 |
|
|
Evasc prlng admn rx agnt add
|
$1,196.11 |
$1,196.11 |
$6,342.84 |
|
|
Evasc repair of iliac artery; endograft 34718
|
$1,635.00 |
$9,671.52 |
$21,681.16 |
|
|
Evasc rpr a-ao ndgft 34701
|
$1,714.86 |
$7,166.25 |
$11,494.77 |
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$1,389.36 |
$4,537.60 |
$11,045.47 |
|
|
Evasc rpr a-biiliac ndgft rptr
|
$3,469.80 |
$6,567.96 |
$12,721.11 |
|
|
Evasc rpr a-iliac ndgft 34717
|
$644.40 |
$7,204.75 |
$10,479.84 |
|
|
Evasc rpr a-unilac ndgft 34703
|
$1,996.20 |
$3,355.20 |
$11,245.38 |
|
|
Evasc rpr a-unilac ndgft rpt
|
$2,462.46 |
$5,584.80 |
$10,495.24 |
|
|
Evasc rpr ilio-iliac ndgft
|
$1,106.70 |
$5,684.80 |
$13,993.64 |
|
|
Evasc rpr ilio-iliac rpt
|
$9,081.60 |
$9,081.60 |
$13,095.24 |
|
|
Event monitor
|
$110.00 |
$257.16 |
$709.86 |
|
|
Evoked auditory tst complete
|
$37.80 |
$110.40 |
$531.40 |
|
|
Evoked oa emissions ltd
|
$77.28 |
$131.99 |
$357.41 |
|
|
Evoked potentials auditory screening automated analysis
|
$65.60 |
$390.00 |
$1,080.00 |
|
|
Evoked potentials upper limbs
|
$228.00 |
$436.80 |
$1,236.51 |
|
|
Evoked potential visual not glaucoma
|
$181.02 |
$345.60 |
$1,062.48 |
|
|
Evok oa screening qual
|
$38.40 |
$220.29 |
$357.41 |
|
|
Ewhfo w/joint(s) cf
|
$142.96 |
$142.96 |
$142.96 |
|
|
Exam of vagina w/scope 57420
|
$167.40 |
$310.40 |
$591.50 |
|
|
Exam pelvic add-on
|
$41.60 |
$41.60 |
$62.40 |
|
|
Exam plvc w/anes othr thn lcl
|
$225.60 |
$264.80 |
$7,727.20 |
|
|
Ex arm/elbow tum deep < 5 cm
|
$972.00 |
$2,668.80 |
$2,668.80 |
|
|
Ex arm/elbow tum deep 5 cm/>
|
$1,258.80 |
$3,412.80 |
$30,590.20 |
|
|
Exc abd les sc 3 cm/>
|
$686.40 |
$1,073.60 |
$25,966.19 |
|
|
Exc abdl tum deep < 5 cm
|
$988.80 |
$1,378.40 |
$12,819.40 |
|
|
Exc abdl tum deep 5 cm/>
|
$1,207.20 |
$1,632.80 |
$2,263.00 |
|
|
Exc abd tum 5 cm or less 49203
|
$2,154.60 |
$2,262.60 |
$2,262.60 |
|
|
Exc abd tum over 10 cm 49205
|
$786.00 |
$825.60 |
$825.60 |
|
|
Exc arm/elbo les sc >=3cm 24071
|
$738.00 |
$1,987.20 |
$13,115.95 |
|
|
Exc arm/elbo les sc <3cm 24075
|
$492.00 |
$2,532.80 |
$27,453.20 |
|
|
Exc aurl glomus tum trnscanl
|
$5,099.20 |
$5,099.20 |
$5,099.20 |
|
|
Exc aurl glomus tum trnsmstd
|
$7,710.40 |
$7,710.40 |
$7,710.40 |
|
|
Exc back les sbq <3 cm 21930
|
$849.00 |
$1,200.80 |
$3,528.00 |
|
|
Exc back tum deep 5 cm/>
|
$1,339.80 |
$1,807.20 |
$12,216.00 |
|
|
Exc bartholins gland/cyst
|
$552.00 |
$1,534.40 |
$1,534.40 |
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$507.60 |
$696.80 |
$16,005.99 |
|
|
Exc benign feenlm >4.0cm 11446
|
$698.40 |
$960.80 |
$4,314.60 |
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$418.20 |
$577.60 |
$30,837.54 |
|
|
Exc benign tal 0.5 < cm 11400
|
$190.00 |
$307.20 |
$1,346.99 |
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$240.60 |
$999.56 |
$30,152.45 |
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$339.00 |
$468.00 |
$15,533.00 |
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$405.00 |
$556.00 |
$17,368.75 |
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$283.20 |
$465.40 |
$3,514.00 |
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$363.00 |
$516.00 |
$4,238.00 |
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$595.80 |
$826.40 |
$18,711.87 |
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$263.90 |
$387.60 |
$907.40 |
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$342.00 |
$479.20 |
$2,052.00 |
|
|
Exc breast duct fistula 19112
|
$862.20 |
$2,235.20 |
$2,235.20 |
|
|
Exc carotid body tumor without exc art 60600
|
$2,608.80 |
$3,356.80 |
$3,356.80 |
|
|
Exc cervix repair bowel 57556
|
$1,249.20 |
$1,448.80 |
$1,448.80 |
|
|
Exc cervix/repair pelvis 57545
|
$1,525.80 |
$1,602.00 |
$1,602.00 |
|
|
Exc cervix/repair vagina 57555
|
$1,346.40 |
$1,528.80 |
$1,528.80 |
|
|
Exc chest wall tumor w/ribs 21601
|
$1,692.60 |
$2,880.00 |
$2,880.00 |
|
|
Exc ch wal tum without lymphadec
|
$3,872.00 |
$3,872.00 |
$3,872.00 |
|
|
Exc ch wal tum w/lymphadec
|
$4,279.20 |
$4,279.20 |
$4,279.20 |
|
