|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$206.80 |
$206.80 |
$206.80 |
$1,898.66
|
|
Ecmo/ecls repos cent cnula 6yrs&older 33964
|
$163.22 |
$163.22 |
$163.22 |
$1,128.60
|
|
Ecmo/ecls repos perph cnula 0-5yrs perq 33957
|
$163.22 |
$163.22 |
$163.22 |
$925.55
|
|
Ecmo/ecls repos perph cnula 6yrs&older opn 33962
|
$163.22 |
$163.22 |
$163.22 |
$953.40
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$163.22 |
$163.22 |
$163.22 |
$1,802.40
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$2,665.44 |
$2,665.44 |
$2,665.44 |
$18,199.20
|
|
Eeg 41-60 minutes 95812-26
|
$286.48 |
$286.48 |
$360.94 |
$956.45
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$467.33 |
$467.33 |
$467.33 |
$1,049.59
|
|
Eeg over 1 hour 95813 - 26
|
$433.29 |
$433.29 |
$433.29 |
$1,119.54
|
|
Eeg/record in coma or sleep only 95822
|
$252.54 |
$252.54 |
$252.54 |
$936.00
|
|
Eeg recording awake and asleep
|
$787.24 |
$787.24 |
$991.85 |
$1,030.27
|
|
Eeg without vid 2-12hr cont mntr
|
$222.51 |
$222.51 |
$222.51 |
$704.79
|
|
Eeg without vid 2-12 hr unmntr
|
$180.92 |
$180.92 |
$222.51 |
$586.20
|
|
Eeg without vid ea 12-26hr cont
|
$427.86 |
$427.86 |
$427.86 |
$1,353.60
|
|
Eeg without vid ea 12-26hr intmt
|
$427.86 |
$427.86 |
$427.86 |
$1,278.57
|
|
Eeg wo vid 2-12hr intmt mntr
|
$222.51 |
$222.51 |
$222.51 |
$639.00
|
|
Eeg wo vid ea 12-26hr unmntr
|
$427.86 |
$427.86 |
$427.86 |
$1,251.52
|
|
E equine encephalitis igg
|
$51.08 |
$51.08 |
$64.35 |
$48.73
|
|
Ehrlicha chaffeensis amp prb
|
$26.34 |
$26.34 |
$33.18 |
$105.00
|
|
Electrd sq emblem s-icd
|
$4,293.26 |
$4,293.26 |
$4,293.26 |
$9,761.50
|
|
Electrical stimulation/unattended 97014
|
$129.56 |
$129.56 |
$129.56 |
$81.75
|
|
Electrolyte panel
|
$160.72 |
$160.72 |
$202.49 |
$86.33
|
|
Electron microscopy diagnostic
|
$338.01 |
$338.01 |
$425.86 |
$966.69
|
|
Electrophysiology evaluation
|
$5,710.87 |
$5,710.87 |
$5,710.87 |
$8,979.45
|
|
Electrophysiology evaluation
|
$5,448.23 |
$5,448.23 |
$5,448.23 |
$11,175.42
|
|
Electrophysiology evaluation
|
$1,611.02 |
$1,611.02 |
$1,611.02 |
$7,769.30
|
|
Electrophysiology evaluation
|
$1,611.02 |
$1,611.02 |
$1,611.02 |
$6,516.00
|
|
Electrophysiology evaluation
|
$1,231.48 |
$1,231.48 |
$1,231.48 |
$2,845.10
|
|
Electrophysiology evaluation
|
$1,674.81 |
$1,674.81 |
$1,674.81 |
$2,803.20
|
|
Electrophys map 3d add-on
|
$4,735.91 |
$4,735.91 |
$4,735.91 |
$6,534.00
|
|
Embolization s&i
|
$666.48 |
$666.48 |
$666.48 |
$3,060.05
|
|
Embo or occlude vascular arterial s&i
|
$7,332.56 |
$7,332.56 |
$7,332.56 |
$16,060.54
|
|
Embo or occlude vascular hemorrhage s&i
|
$8,542.24 |
$8,542.24 |
$8,542.24 |
$15,027.40
|
|
Embo or occlude vascular tumor/organ/infarct s&i
|
$7,402.47 |
$7,402.47 |
$7,402.47 |
$15,873.70
|
|
Embo or occlude vascular venous s&i
|
$5,412.37 |
$5,412.37 |
$5,412.37 |
$15,038.25
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$86.09 |
$86.09 |
$86.09 |
$434.00
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$86.09 |
$86.09 |
$86.09 |
$487.20
|
|
Emg needle test 1-extremity
|
$86.09 |
$86.09 |
$86.09 |
$342.24
|
|
Emg needle test 4-extremities
|
$86.09 |
$86.09 |
$86.09 |
$570.50
|
|
Encephalitis, california igg/igm
|
$15.89 |
$15.89 |
$20.02 |
$46.75
|
|
Encephalitis, st louis igg/igm
|
$15.89 |
$15.89 |
$20.02 |
$48.03
|
|
Encephalitis, western equine igg/igm
|
$25.43 |
$25.43 |
$32.04 |
$50.70
|
|
Endo abl/incom vein/ext/rad fre/#1 36475
|
$2,991.56 |
$2,991.56 |
$2,991.56 |
$5,515.40
|
|
Endoluminal bx biliary tree
|
$914.36 |
$914.36 |
$914.36 |
$2,476.50
|
|
Endoluminl ivus oct c 1st
|
$3,142.14 |
$3,142.14 |
$3,142.14 |
$3,335.81
|
|
Endoluminl ivus oct c ea
|
$2,513.80 |
$2,513.80 |
$2,513.80 |
$2,367.97
|
|
Endoscopy swallow (fees) vid
|
$265.14 |
$265.14 |
$334.05 |
$402.35
|
|
Endovasc rpr a-biiliac endogft 34705
|
$496.68 |
$496.68 |
$625.77 |
$10,604.25
|
|
Endovenous rf abl vein addl
|
$1,818.39 |
$1,818.39 |
$1,818.39 |
$3,156.02
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$153.30 |
$153.30 |
$303.50 |
$115.05
|
|
Entamoeba histolytica ag eia - sendout
|
$23.84 |
$23.84 |
$30.03 |
$66.47
|
|
Enzyme histochemistry
|
$80.36 |
$80.36 |
$101.25 |
$460.32
|
|
Ep & ablate supravent arrhyt
|
$13,733.05 |
$13,733.05 |
$13,733.05 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$18,264.88 |
$18,264.88 |
$18,264.88 |
$30,975.00
|
|
Epilepsy gen seq alys panel
|
$1,021.50 |
$1,021.50 |
$1,287.00 |
$2,448.56
|
|
Episiotomy/vag rpr oth/thn attending phys 59300
|
$2,315.40 |
$2,315.40 |
$2,315.40 |
$3,762.53
|
|
Epoetin alfa, 100 units esrd
|
$102.39 |
$102.39 |
$202.94 |
$19.00
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$135.07 |
$135.07 |
$170.17 |
$957.58
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$102.39 |
$102.39 |
$202.94 |
$1,048.72
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$48.36 |
$48.36 |
$48.36 |
$136.00
|
|
Epstein barr early antigen antibody
|
$28.61 |
$28.61 |
$36.04 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$28.61 |
$28.61 |
$36.04 |
$81.81
|
|
Epstein barr viral capsid antigen antibody igm
|
$28.61 |
$28.61 |
$36.04 |
$95.04
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$122.36 |
$122.36 |
$122.36 |
$422.50
|
|
Ercp biliary & pancreas
|
$637.65 |
$637.65 |
$803.38 |
$943.50
|
|
Ercp w/specimen collection
|
$1,468.69 |
$1,468.69 |
$1,850.42 |
$4,440.54
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$123.56 |
$123.56 |
$157.54 |
$282.06
|
|
ER Visit (level 1, minor)
|
$195.68 |
$195.68 |
$246.54 |
$276.70
|
|
ER Visit (level 2)
|
$349.36 |
$349.36 |
$440.16 |
$487.50
|
|
ER Visit (level 3)
|
$614.95 |
$614.95 |
$774.78 |
$850.50
|
|
ER Visit (level 4)
|
$950.23 |
$950.23 |
$1,197.20 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$1,397.42 |
$1,397.42 |
$1,760.62 |
$2,007.00
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$17.94 |
$17.94 |
$17.94 |
$247.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$616.54 |
$616.54 |
$720.72 |
$504.11
|
|
Esophagus motility study
|
$1,549.73 |
$1,549.73 |
$1,952.53 |
$1,289.20
|
|
Esoph imped function test
|
$492.21 |
$492.21 |
$492.21 |
$597.03
|
|
Esoph imped funct test > 1hr
|
$532.55 |
$532.55 |
$670.96 |
$986.40
|
|
Established Patient Office Visit (level 1)
|
$90.58 |
$90.58 |
$114.12 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$90.58 |
$90.58 |
$90.58 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$95.12 |
$95.12 |
$95.12 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$948.18 |
$948.18 |
$948.18 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$146.42 |
$146.42 |
$146.42 |
$287.10
|
|
Estradiol total
|
$57.21 |
$57.21 |
$72.08 |
$153.00
|
|
Estradiol valerate 10 mg inj
|
$5.91 |
$5.91 |
$5.91 |
$63.50
|
|
Estrogens total-sendout
|
$63.34 |
$63.34 |
$79.80 |
$89.25
|
|
Etanercept injection
|
$849.67 |
$849.67 |
$849.67 |
$1,801.80
|
|
Ethanolamine oleate 100 mg
|
$366.38 |
$366.38 |
$366.38 |
$1,032.48
|
|
Ethylene glycol -sendout
|
$32.01 |
$32.01 |
$40.33 |
$75.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$85.36 |
$85.36 |
$85.36 |
$213.17
|
|
Etoposide 50 mg cap
|
$72.42 |
$72.42 |
$72.42 |
$184.44
|
|
Eval/fit voice prosthesis iii, st
|
$216.79 |
$216.79 |
$216.79 |
$370.41
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$169.35 |
$169.35 |
$169.35 |
$219.60
|
|
Evaluation heart device
|
$738.89 |
$738.89 |
$738.89 |
$2,368.17
|
|
Evasc prlng admn rx agnt 1st
|
$1,684.34 |
$1,684.34 |
$1,684.34 |
$4,462.80
|
|
Evasc prlng admn rx agnt add
|
$839.90 |
$839.90 |
$839.90 |
$3,484.88
|
|
Evasc rpr a-ao ndgft 34701
|
$431.08 |
$431.08 |
$543.12 |
$6,020.00
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$391.81 |
$391.81 |
$493.64 |
$4,537.60
|
|
Evasc rpr a-biiliac ndgft rptr
|
$391.81 |
$391.81 |
$493.64 |
$10,294.05
|
|
Evasc rpr a-unilac ndgft 34703
|
$391.81 |
$391.81 |
$493.64 |
$7,465.20
|
|
Evasc rpr a-unilac ndgft rpt
|
$493.64 |
$493.64 |
$493.64 |
$9,282.60
|
