|
D&c after delivery 59160
|
$384.00 |
$384.00 |
$384.00 |
$3,827.25
|
|
Dch glucoscan
|
$23.55 |
$23.55 |
$23.55 |
$28.10
|
|
Dch validity tests
|
$6.14 |
$6.14 |
$6.14 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$14.72 |
$14.72 |
$14.72 |
$43.60
|
|
Debr g/per/abd wall 11006
|
$505.60 |
$505.60 |
$505.60 |
$1,357.80
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$808.96 |
$808.96 |
$808.96 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$136.77 |
$136.77 |
$136.77 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,303.36 |
$2,303.36 |
$2,303.36 |
$2,316.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$759.68 |
$759.68 |
$759.68 |
$810.50
|
|
Debride nail1-5 11720
|
$117.97 |
$117.97 |
$117.97 |
$148.80
|
|
Debride nail6 or more 11721
|
$99.84 |
$99.84 |
$99.84 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$531.20 |
$531.20 |
$531.20 |
$1,012.80
|
|
Debride skin bone at fx site
|
$3,982.72 |
$3,982.72 |
$3,982.72 |
$3,015.00
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$970.24 |
$970.24 |
$970.24 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$771.20 |
$771.20 |
$771.20 |
$1,160.00
|
|
Decompression of leg
|
$752.00 |
$752.00 |
$752.00 |
$3,839.54
|
|
Deferoxamine 500 mg solution for injection
|
$59.97 |
$59.97 |
$59.97 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$145.60 |
$145.60 |
$145.60 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,458.15 |
$4,458.15 |
$4,458.15 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$178.56 |
$178.56 |
$178.56 |
$408.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$225.81 |
$225.81 |
$225.81 |
$89.78
|
|
Destroy cervthor facet jnt 64633
|
$1,116.80 |
$1,116.80 |
$1,116.80 |
$3,011.50
|
|
Destroy premlg lesns;1st lesn 17000
|
$81.92 |
$81.92 |
$81.92 |
$199.50
|
|
Destruction benign lesions < 14 lesions
|
$117.12 |
$117.12 |
$117.12 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,786.88 |
$1,786.88 |
$1,786.88 |
$3,202.98
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$110.40 |
$110.40 |
$110.40 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$41.60 |
$41.60 |
$41.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$25.60 |
$25.60 |
$25.60 |
$79.20
|
|
Diab manage trn ind/group
|
$12.80 |
$12.80 |
$12.80 |
$56.55
|
|
Diag laparo separate proc 49320
|
$240.00 |
$240.00 |
$240.00 |
$6,904.15
|
|
Diagnostic anoscopy spx 46600
|
$178.56 |
$178.56 |
$178.56 |
$190.68
|
|
Diagnostic Mammogram (both breasts)
|
$119.68 |
$119.68 |
$119.68 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$119.68 |
$119.68 |
$119.68 |
$301.55
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$32.69 |
$32.69 |
$32.69 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,938.37 |
$11,938.37 |
$11,938.37 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$54.40 |
$54.40 |
$54.40 |
$102.00
|
|
Dilate urethra stricture
|
$43.36 |
$43.36 |
$43.36 |
$490.00
|
|
Dilation/female urethra/initial 53660
|
$37.18 |
$37.18 |
$37.18 |
$235.61
|
|
Dilation/urethral strict/male/ini 53620
|
$941.44 |
$941.44 |
$941.44 |
$1,372.80
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,964.18 |
$1,964.18 |
$1,964.18 |
$1,258.20
|
|
Disability dlco
|
$267.52 |
$267.52 |
$267.52 |
$282.40
|
|
Disaccharidases
|
$16.00 |
$16.00 |
$16.00 |
$216.00
|
|
Dna antibody native/double stranded
|
$30.27 |
$30.27 |
$30.27 |
$97.50
|
|
Doppler echo complete
|
$115.20 |
$115.20 |
$115.20 |
$540.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$79.20 |
$79.20 |
$79.20 |
$423.95
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$958.08 |
$958.08 |
$958.08 |
$800.00
|
|
Drainage external ear simple 69000
|
$970.24 |
$970.24 |
$970.24 |
$789.60
|
|
Drainage of kidney lesion
|
$600.10 |
$600.10 |
$600.10 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$178.56 |
$178.56 |
$178.56 |
$170.50
|
|
Drain cath image guided visceral pq
|
$1,088.32 |
$1,088.32 |
$1,088.32 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$364.80 |
$364.80 |
$364.80 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$477.60 |
$477.60 |
$477.60 |
$419.00
|
|
Drain shoulder lesion
|
$3,982.72 |
$3,982.72 |
$3,982.72 |
$3,904.61
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$295.68 |
$295.68 |
$295.68 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$295.68 |
$295.68 |
$295.68 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$540.80 |
$540.80 |
$540.80 |
$523.00
|
|
Drng of eyelid abscess 67700
|
$512.00 |
$512.00 |
$512.00 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$2,303.36 |
$2,303.36 |
$2,303.36 |
$1,943.50
|
|
Drng of mouth lesion 40801
|
$854.85 |
$854.85 |
$854.85 |
$1,262.76
|
|
Drug test def 15-21 classes
|
$54.40 |
$54.40 |
$54.40 |
$263.25
|
|
Drug test def 1-7 classes
|
$80.00 |
$80.00 |
$80.00 |
$250.52
|
|
Drug test def 8-14 classes
|
$410.88 |
$410.88 |
$410.88 |
$282.00
|
|
Drug test prsmv instrmnt
|
$22.40 |
$22.40 |
$22.40 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$243.20 |
$243.20 |
$243.20 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$1,926.40 |
$1,926.40 |
$1,926.40 |
$3,020.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$295.36 |
$295.36 |
$295.36 |
$887.25
|
|
Dx bronchoscope/brush 31623
|
$337.92 |
$337.92 |
$337.92 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$360.00 |
$360.00 |
$360.00 |
$2,365.20
|
|
Dx bronchoscope/wash 31622
|
$348.00 |
$348.00 |
$348.00 |
$2,322.60
|
|
Ecg 12 lead tracing only
|
$150.40 |
$150.40 |
$150.40 |
$226.50
|
|
Ecg/1-3 leads/interp & report only 93042
|
$15.49 |
$15.49 |
$15.49 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$67.20 |
$67.20 |
$67.20 |
$135.80
|
|
Ecg external < 48 hours recording
|
$304.00 |
$304.00 |
$304.00 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$360.32 |
$360.32 |
$360.32 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$16.00 |
$16.00 |
$16.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$16.00 |
$16.00 |
$16.00 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$806.40 |
$806.40 |
$806.40 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$268.80 |
$268.80 |
$268.80 |
$469.95
|
|
Echocardiography transthoracic 2d followup/limited
|
$465.28 |
$465.28 |
$465.28 |
$703.25
|
|
Echograp trans r pros study
|
$184.32 |
$184.32 |
$184.32 |
$459.40
|
|
Eeg monitor/record/awake/drowsy 95816
|
$668.80 |
$668.80 |
$668.80 |
$835.00
|
|
Eeg recording awake and asleep
|
$496.00 |
$496.00 |
$496.00 |
$931.20
|
|
EKG (Electrocardiogram)
|
$24.32 |
$24.32 |
$24.32 |
$89.60
|
|
EKG interpret & report preve g0405
|
$8.80 |
$8.80 |
$8.80 |
$19.20
|
|
Elbow arthroscopy/surgery
|
$711.20 |
$711.20 |
$711.20 |
$3,839.54
|
|
Electrical stimulation/unattended 97014
|
$64.00 |
$64.00 |
$64.00 |
$79.20
|
|
Electrolyte panel
|
$67.20 |
$67.20 |
$67.20 |
$84.24
|
|
Electron microscopy diagnostic
|
$699.52 |
$699.52 |
$699.52 |
$983.41
|
|
Emb without cervical dilation 58100
|
$277.76 |
$277.76 |
$277.76 |
$370.50
|
|
Endoscpy nsl/sns w/cntrl nsl hmrrgh
|
$2,844.16 |
$2,844.16 |
$2,844.16 |
$2,756.52
|
|
Enterorrhaphy 1perforation 44602
|
$1,344.64 |
$1,344.64 |
$1,344.64 |
$2,650.80
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$2,668.22 |
$2,668.22 |
$2,668.22 |
$1,289.71
|
|
Epstein barr early antigen antibody
|
$35.49 |
$35.49 |
$35.49 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$35.49 |
$35.49 |
$35.49 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$35.49 |
$35.49 |
$35.49 |
$91.00
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$598.12 |
$598.12 |
$598.12 |
$393.98
|
|
ER Visit (level 1, minor)
|
$116.48 |
$116.48 |
$116.48 |
$246.24
|
|
ER Visit (level 2)
|
$214.40 |
$214.40 |
$214.40 |
$452.20
|
|
ER Visit (level 3)
|
$373.76 |
$373.76 |
$373.76 |
$770.04
|
|
ER Visit (level 4)
|
$603.52 |
$603.52 |
$603.52 |
$1,273.68
|
