|
Decalcification
|
$135.20 |
$135.20 |
$135.20 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$720.00 |
$720.00 |
$720.00 |
$572.95
|
|
Delivery of placenta 59414
|
$4,895.20 |
$4,895.20 |
$4,895.20 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$136.00 |
$136.00 |
$136.00 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$879.20 |
$879.20 |
$879.20 |
$401.60
|
|
Desoxycorticosterone
|
$471.20 |
$471.20 |
$471.20 |
$109.28
|
|
Developmental screen/score/document 96110
|
$219.20 |
$219.20 |
$219.20 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$442.40 |
$442.40 |
$442.40 |
$350.40
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$248.00 |
$248.00 |
$248.00 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$248.00 |
$248.00 |
$248.00 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$384.80 |
$384.80 |
$384.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$79.20 |
$79.20 |
$79.20 |
$79.30
|
|
Diab manage trn ind/group
|
$40.80 |
$40.80 |
$40.80 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$609.60 |
$609.60 |
$609.60 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$412.80 |
$412.80 |
$412.80 |
$242.14
|
|
Diagnostic Mammogram (both breasts)
|
$772.80 |
$772.80 |
$772.80 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$654.40 |
$654.40 |
$654.40 |
$314.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$4.80 |
$4.80 |
$4.80 |
$115.15
|
|
Diffusing capacity
|
$236.80 |
$236.80 |
$236.80 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$175.20 |
$175.20 |
$175.20 |
$102.07
|
|
Dilat xst trc ndurlgc px
|
$4,173.60 |
$4,173.60 |
$4,173.60 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$4,173.60 |
$4,173.60 |
$4,173.60 |
$4,258.20
|
|
Disability dlco
|
$260.80 |
$260.80 |
$260.80 |
$293.76
|
|
Disaccharidases
|
$1,906.40 |
$1,906.40 |
$1,906.40 |
$230.40
|
|
Discography cerv/thor spine
|
$5,553.60 |
$5,553.60 |
$5,553.60 |
$2,565.00
|
|
Dna antibody native/double stranded
|
$194.40 |
$194.40 |
$194.40 |
$100.00
|
|
Doppler echo complete
|
$588.00 |
$588.00 |
$588.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$4,567.20 |
$4,567.20 |
$4,567.20 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$599.20 |
$599.20 |
$599.20 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$656.80 |
$656.80 |
$656.80 |
$481.65
|
|
Dpyd gene common variants
|
$2,290.40 |
$2,290.40 |
$2,290.40 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$568.80 |
$568.80 |
$568.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,164.80 |
$1,164.80 |
$1,164.80 |
$964.00
|
|
Drainage external ear simple 69000
|
$896.80 |
$896.80 |
$896.80 |
$790.40
|
|
Drainage mouth roof lesion
|
$356.00 |
$356.00 |
$356.00 |
$405.60
|
|
Drainage of arm bursa 23931
|
$2,143.20 |
$2,143.20 |
$2,143.20 |
$2,271.01
|
|
Drainage of kidney lesion
|
$4,505.60 |
$4,505.60 |
$4,505.60 |
$1,506.00
|
|
Drainage of mouth lesion
|
$4,844.00 |
$4,844.00 |
$4,844.00 |
$3,837.72
|
|
Drain blood from under nail 11740
|
$301.60 |
$301.60 |
$301.60 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$981.60 |
$981.60 |
$981.60 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$7,416.80 |
$7,416.80 |
$7,416.80 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$458.40 |
$458.40 |
$458.40 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$446.40 |
$446.40 |
$446.40 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$924.00 |
$924.00 |
$924.00 |
$541.00
|
|
Drng of eyelid abscess 67700
|
$489.60 |
$489.60 |
$489.60 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$3,701.60 |
$3,701.60 |
$3,701.60 |
$2,079.50
|
|
Drng of scrotum abscess 55100
|
$2,080.80 |
$2,080.80 |
$2,080.80 |
$1,997.89
|
|
Drng open retroperitoneal abscess 49060
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$1,924.00
|
|
Drng peritoneal abscess open 49020
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$2,520.00
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$76.80 |
$76.80 |
$76.80 |
$53.60
|
|
Drug admin & hemodynmic meas
|
$302.40 |
$302.40 |
$302.40 |
$569.75
|
|
Drug assay posaconazole
|
$228.80 |
$228.80 |
$228.80 |
$96.75
|
|
Drug assay rufinamide
|
$152.80 |
$152.80 |
$152.80 |
$87.10
|
|
Drug assay vedolizumab
|
$521.60 |
$521.60 |
$521.60 |
$154.00
|
|
Drug assay voriconazole
|
$190.40 |
$190.40 |
$190.40 |
$96.75
|
|
Drug test prsmv instrmnt
|
$474.40 |
$474.40 |
$474.40 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$953.60 |
$953.60 |
$953.60 |
$278.85
|
|
Drvvt confirm - quest
|
$304.00 |
$304.00 |
$304.00 |
$109.20
|
|
Ductogram sgl duct
|
$588.00 |
$588.00 |
$588.00 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$1,181.60 |
$1,181.60 |
$1,181.60 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$788.00 |
$788.00 |
$788.00 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$439.20 |
$439.20 |
$439.20 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$704.80 |
$704.80 |
$704.80 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,101.60 |
$2,101.60 |
$2,101.60 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$1,317.60 |
$1,317.60 |
$1,317.60 |
$401.20
|
|
Ear irrigation 69209
|
$284.80 |
$284.80 |
$284.80 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$111.20 |
$111.20 |
$111.20 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$613.60 |
$613.60 |
$613.60 |
$412.88
|
|
Ecg external < 48 hours recording
|
$613.60 |
$613.60 |
$613.60 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$613.60 |
$613.60 |
$613.60 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$216.80 |
$216.80 |
$216.80 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$360.80 |
$360.80 |
$360.80 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,796.00 |
$2,796.00 |
$2,796.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$707.20 |
$707.20 |
$707.20 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$999.20 |
$999.20 |
$999.20 |
$511.55
|
|
Echocardiograpy doppler follow up/limited study
|
$633.60 |
$633.60 |
$633.60 |
$371.25
|
|
Echo exam of fetal heart
|
$1,177.60 |
$1,177.60 |
$1,177.60 |
$431.41
|
|
Echo exam of fetal heart
|
$789.60 |
$789.60 |
$789.60 |
$318.34
|
|
Echo exam uterus 76831-
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$561.00
|
|
Echo guidance radiotherapy
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$812.00
|
|
Echo guide for amniocentesis
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$455.57
|
|
Echo guide for artery repair
|
$5,948.80 |
$5,948.80 |
$5,948.80 |
$696.30
|
|
Echo guide for heart biopsy
|
$1,756.00 |
$1,756.00 |
$1,756.00 |
$666.40
|
|
Echo stress
|
$605.60 |
$605.60 |
$605.60 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,297.60 |
$2,297.60 |
$2,297.60 |
$1,913.60
|
|
Echo transesophageal
|
$2,928.00 |
$2,928.00 |
$2,928.00 |
$1,650.00
|
|
Echo transthoracic
|
$1,281.60 |
$1,281.60 |
$1,281.60 |
$1,361.75
|
|
Echo transthoracic
|
$864.80 |
$864.80 |
$864.80 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,312.00 |
$1,312.00 |
$1,312.00 |
$1,033.00
|
|
Eeg 41-60 minutes 95812-26
|
$2,288.80 |
$2,288.80 |
$2,288.80 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$502.40 |
$502.40 |
$502.40 |
$994.15
|
|
Eeg monitoring/function test
|
$3,220.00 |
$3,220.00 |
$3,220.00 |
$1,557.60
|
|
Eeg monitor/record/awake/drowsy 95816
|
$2,086.40 |
$2,086.40 |
$2,086.40 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$2,514.40 |
$2,514.40 |
$2,514.40 |
$1,119.54
|
|
Eeg recording awake and asleep
|
$2,086.40 |
$2,086.40 |
$2,086.40 |
$931.20
|
|
E equine encephalitis igg
|
$61.60 |
$61.60 |
$61.60 |
$51.84
|
|
Egfr gene com variants
|
$3,195.20 |
$3,195.20 |
$3,195.20 |
$672.88
|
|
Ehrlicha chaffeensis amp prb
|
$54.40 |
$54.40 |
$54.40 |
$93.00
|
|
EKG tracing for initial prev
|
$476.00 |
$476.00 |
$476.00 |
$81.76
|
|
EKG (Tracing Only)
|
$221.60 |
$221.60 |
$221.60 |
$226.50
|
