|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$193.15
|
|
Drsg surg adh 11x11 3/4 occl drap wnd 28x30
|
$21.51 |
$21.51 |
$21.51 |
$19.10
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$94.94
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$7,465.97
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$1.00
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$376.50
|
|
Drug admin & hemodynmic meas
|
$118.11 |
$118.11 |
$118.11 |
$568.64
|
|
Drug assay caffeine
|
$53.23 |
$53.23 |
$53.23 |
$80.00
|
|
Drug assay posaconazole
|
$37.41 |
$37.41 |
$37.41 |
$96.75
|
|
Drug assay rufinamide
|
$37.41 |
$37.41 |
$37.41 |
$87.10
|
|
Drug assay vedolizumab
|
$53.23 |
$53.23 |
$53.23 |
$154.00
|
|
Drug assay voriconazole
|
$37.41 |
$37.41 |
$37.41 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$25.72 |
$25.72 |
$25.72 |
$66.43
|
|
Drug of abuse screen urine
|
$17.39 |
$17.39 |
$17.39 |
$67.50
|
|
Drug screen quant tiagabine
|
$37.41 |
$37.41 |
$37.41 |
$107.59
|
|
Drug test def 15-21 classes
|
$274.26 |
$274.26 |
$274.26 |
$322.50
|
|
Drug test def 1-7 classes
|
$157.91 |
$157.91 |
$157.91 |
$263.25
|
|
Drug test def 22+ classes
|
$340.75 |
$340.75 |
$340.75 |
$426.24
|
|
Drug test def 8-14 classes
|
$216.09 |
$216.09 |
$216.09 |
$289.80
|
|
Drug test def simple all cl
|
$85.75 |
$85.75 |
$85.75 |
$68.35
|
|
Drug test prsmv instrmnt
|
$23.65 |
$23.65 |
$23.65 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$85.75 |
$85.75 |
$85.75 |
$278.85
|
|
Drvvt confirm - quest
|
$24.81 |
$24.81 |
$24.81 |
$109.20
|
|
Dstrj extensive retinopathy
|
$5,405.82 |
$5,405.82 |
$5,405.82 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$2,995.44
|
|
Dstr mal les s/n/h/f/g >4.0
|
$558.97 |
$558.97 |
$558.97 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$558.97 |
$558.97 |
$558.97 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
$886.40
|
|
Dstry eye lesn,fdr vssl tech
|
$756.27 |
$756.27 |
$756.27 |
$756.27
|
|
Ductogram sgl duct
|
$328.08 |
$328.08 |
$328.08 |
$469.80
|
|
Duodenal exclusion
|
$2,528.66 |
$2,528.66 |
$2,528.66 |
$3,917.10
|
|
Duodenal motility study
|
$513.11 |
$513.11 |
$513.11 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$328.08 |
$328.08 |
$328.08 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$143.75 |
$143.75 |
$143.75 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$143.75 |
$143.75 |
$143.75 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$296.91 |
$296.91 |
$296.91 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$328.08 |
$328.08 |
$328.08 |
$904.78
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$171.12 |
$171.12 |
$171.12 |
$16,549.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$119.05 |
$119.05 |
$119.05 |
$8,445.90
|
|
Dxa bone density axl vrt fx
|
$143.75 |
$143.75 |
$143.75 |
$401.20
|
|
Dx aly aud oi snd prcsr 1st
|
$176.93 |
$176.93 |
$176.93 |
$186.40
|
|
Dx aly aud oi snd prcsr each
|
$43.95 |
$43.95 |
$43.95 |
$51.52
|
|
Dx bronchoscope/brush 31623
|
$2,447.43 |
$2,447.43 |
$2,447.43 |
$2,144.41
|
|
Dx bronchoscope/lavage 31624
|
$2,447.43 |
$2,447.43 |
$2,447.43 |
$2,447.43
|
|
Dx bronchoscope/wash 31622
|
$2,447.43 |
$2,447.43 |
$2,447.43 |
$2,410.50
|
|
Dx dark adaptation exam i&r
|
$614.27 |
$614.27 |
$614.27 |
$472.21
|
|
Dx duod intub w/asp spec 43756
|
$1,247.13 |
$1,247.13 |
$1,247.13 |
$1,075.20
|
|
Dx duod intub w/asp specs
|
$1,247.13 |
$1,247.13 |
$1,247.13 |
$1,406.58
|
|
Dx gastr intub w/asp spec
|
$296.91 |
$296.91 |
$296.91 |
$441.60
|
|
Dx gastr intub w/asp specs
|
$176.93 |
$176.93 |
$176.93 |
$299.04
|
|
Dx laryngoscopy newborn
|
$537.80 |
$537.80 |
$537.80 |
$649.74
|
|
Dx laryngoscopy w/oper scope
|
$2,447.43 |
$2,447.43 |
$2,447.43 |
$2,755.53
|
|
Dynamic cavernosometry
|
$343.55 |
$343.55 |
$343.55 |
$3,442.40
|
|
Dynamic surface emg
|
$296.91 |
$296.91 |
$296.91 |
$368.50
|
|
Ear and throat examination
|
$741.60 |
$741.60 |
$741.60 |
$602.63
|
|
Ear canal biopsy 69105
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$1,889.50
|
|
Ear cartilage graft
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,385.40
|
|
Ear irrigation 69209
|
$81.12 |
$81.12 |
$81.12 |
$154.70
|
|
Ear protector evaluation
|
$51.36 |
$51.36 |
$51.36 |
$112.56
|
|
Ecallantide injection
|
$800.05 |
$800.05 |
$800.05 |
$13,357.14
|
|
Ecg/1-3 leads/interp & report only 93042
|
$9.91 |
$9.91 |
$9.91 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$81.12 |
$81.12 |
$81.12 |
$133.60
|
|
Ecg < 30 days transmission & analysis
|
$130.73 |
$130.73 |
$130.73 |
$410.43
|
|
Ecg external < 48 hours recording
|
$182.95 |
$182.95 |
$182.95 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$81.12 |
$81.12 |
$81.12 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$51.36 |
$51.36 |
$51.36 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$51.36 |
$51.36 |
$51.36 |
$170.38
|
|
Ecg record/review
|
$228.11 |
$228.11 |
$228.11 |
$371.28
|
|
Ecg/review interpret only
|
$33.06 |
$33.06 |
$33.06 |
$52.80
|
|
Echocardiogram (Heart Ultrasound)
|
$751.34 |
$751.34 |
$751.34 |
$2,020.00
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$328.08 |
$328.08 |
$328.08 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$27.13 |
$27.13 |
$27.13 |
$520.50
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,077.92 |
$1,077.92 |
$1,077.92 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$479.72 |
$479.72 |
$479.72 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$24.03 |
$24.03 |
$24.03 |
$371.25
|
|
Echo exam of eye
|
$143.75 |
$143.75 |
$143.75 |
$143.75
|
|
Echo exam of eye
|
$143.75 |
$143.75 |
$143.75 |
$172.00
|
|
Echo exam of eye
|
$119.66 |
$119.66 |
$119.66 |
$178.85
|
|
Echo exam of eye thickness
|
$39.77 |
$39.77 |
$39.77 |
$39.77
|
|
Echo exam of fetal heart
|
$751.34 |
$751.34 |
$751.34 |
$904.80
|
|
Echo exam of fetal heart
|
$328.08 |
$328.08 |
$328.08 |
$538.27
|
|
Echo exam of fetal heart
|
$143.75 |
$143.75 |
$143.75 |
$431.41
|
|
Echo exam of fetal heart
|
$143.75 |
$143.75 |
$143.75 |
$318.34
|
|
Echo exam uterus 76831-
|
$328.08 |
$328.08 |
$328.08 |
$561.00
|
|
Echograp trans r pros study
|
$143.75 |
$143.75 |
$143.75 |
$468.00
|
|
Echo guidance radiotherapy
|
$94.07 |
$94.07 |
$94.07 |
$812.00
|
|
Echo guide for amniocentesis
|
$25.72 |
$25.72 |
$25.72 |
$455.57
|
|
Echo guide for artery repair
|
$296.91 |
$296.91 |
$296.91 |
$698.70
|
|
Echo guide for heart biopsy
|
$47.09 |
$47.09 |
$47.09 |
$666.40
|
|
Echo guide ova aspiration
|
$67.05 |
$67.05 |
$67.05 |
$174.20
|
|
Echo guide villus sampling
|
$44.74 |
$44.74 |
$44.74 |
$362.88
|
|
Echo stress
|
$751.34 |
$751.34 |
$751.34 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$751.34 |
$751.34 |
$751.34 |
$751.34
|
|
Echo tee guidance
|
$274.39 |
$274.39 |
$274.39 |
$1,865.50
|
|
Echo tee probe placement image acquisition interpretation & report
|
$751.34 |
$751.34 |
$751.34 |
$1,907.26
|
|
Echo transesophageal
|
$751.34 |
$751.34 |
$751.34 |
$1,067.95
|
|
Echo transesophageal
|
$191.36 |
$191.36 |
$191.36 |
$588.00
|