|
Drain ovary abscess open
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,762.53
|
|
Drain penis lesion
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,917.33
|
|
Drain shoulder bone lesion
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,206.33
|
|
Drain shoulder bursa 23031
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,127.88
|
|
Drain shoulder lesion
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,386.84
|
|
Drain thigh/knee lesion 27301
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,606.86
|
|
Drain thyroid/tongue cyst
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,744.44
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$403.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$355.80
|
|
Dress/debrid prtl-thick burn l 16030
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$515.00
|
|
Dressing change not for burn w/anes 15852
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$724.37
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$350.15 |
$350.15 |
$350.15 |
$2,458.05
|
|
Drng hand tendon sheath 26020
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,917.33
|
|
Drng of hydrocele 55000
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$832.60
|
|
Drng of mouth lesion 40801
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,274.04
|
|
Drng of ovarian cyst(s) 58800
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,474.84
|
|
Drng of palm multi bursas 26030
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,591.33
|
|
Drng of palm single bursa 26025
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,545.97
|
|
Drng of pelvic abscess transrectal 45000
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,614.45
|
|
Drng of salivary cyst 42409
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,575.45
|
|
Drng of scrotum abscess 55100
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,997.89
|
|
Drng salivary gland simple 42300
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,863.20
|
|
Drng salivary gland submax/subling 42310
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$573.64
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$203.46 |
$203.46 |
$203.46 |
$189.68
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$7.34 |
$7.34 |
$7.34 |
$327.39
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$2,052.50 |
$2,052.50 |
$2,052.50 |
$5,085.77
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$36.12 |
$36.12 |
$36.12 |
$448.16
|
|
Drug admin & hemodynmic meas
|
$76.57 |
$76.57 |
$76.57 |
$542.23
|
|
Drug assay caffeine
|
$42.43 |
$42.43 |
$42.43 |
$86.45
|
|
Drug assay posaconazole
|
$29.82 |
$29.82 |
$29.82 |
$96.39
|
|
Drug assay rufinamide
|
$29.82 |
$29.82 |
$29.82 |
$94.25
|
|
Drug assay vedolizumab
|
$42.43 |
$42.43 |
$42.43 |
$169.26
|
|
Drug assay voriconazole
|
$29.82 |
$29.82 |
$29.82 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$20.50 |
$20.50 |
$20.50 |
$83.85
|
|
Drug of abuse screen urine
|
$13.86 |
$13.86 |
$13.86 |
$63.75
|
|
Drug screen quant tiagabine
|
$29.82 |
$29.82 |
$29.82 |
$90.75
|
|
Drug test def 15-21 classes
|
$218.61 |
$218.61 |
$218.61 |
$142.17
|
|
Drug test def 1-7 classes
|
$125.87 |
$125.87 |
$125.87 |
$263.86
|
|
Drug test def 22+ classes
|
$271.61 |
$271.61 |
$271.61 |
$246.92
|
|
Drug test def 8-14 classes
|
$172.25 |
$172.25 |
$172.25 |
$172.25
|
|
Drug test prsmv instrmnt
|
$18.85 |
$18.85 |
$18.85 |
$78.65
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$68.35 |
$68.35 |
$68.35 |
$278.85
|
|
Drvvt confirm - quest
|
$19.78 |
$19.78 |
$19.78 |
$102.30
|
|
Dstrj extensive retinopathy
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$4,173.97
|
|
Dstrj nulyt agt gnclr nrv
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,268.20
|
|
Dstr mal les s/n/h/f/g >4.0
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$886.40
|
|
Duplex scan bilateral study 93985
|
$354.83 |
$354.83 |
$354.83 |
$690.95
|
|
Dup scan/hemodialysis access 93990
|
$151.95 |
$151.95 |
$151.95 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$397.20 |
$397.20 |
$397.20 |
$885.60
|
|
Dxa bone density axl vrt fx
|
$176.42 |
$176.42 |
$176.42 |
$374.00
|
|
Dx bronchoscope/brush 31623
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$2,626.00
|
|
Dx bronchoscope/wash 31622
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$2,447.43
|
|
Dx duod intub w/asp spec 43756
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,037.75
|
|
Dx duod intub w/asp specs
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,104.13
|
|
Dx gastr intub w/asp spec
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$344.68
|
|
Dx gastr intub w/asp specs
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$185.15
|
|
Dx laryngoscopy newborn
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$537.80
|
|
Dx laryngoscopy w/oper scope
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,908.75
|
|
Dynamic cavernosometry
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$343.55
|
|
Ear canal biopsy 69105
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,768.50
|
|
Ear cartilage graft
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$5,741.00
|
|
Ear irrigation 69209
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$154.70
|
|
Ecg 12 lead tracing only
|
$71.40 |
$71.40 |
$71.40 |
$243.61
|
|
Ecg external < 48 hours recording
|
$279.45 |
$279.45 |
$279.45 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$409.13 |
$409.13 |
$409.13 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$918.12 |
$918.12 |
$918.12 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$177.21 |
$177.21 |
$177.21 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$242.45 |
$242.45 |
$242.45 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$43.95 |
$43.95 |
$43.95 |
$354.90
|
|
Echo exam of fetal heart
|
$337.73 |
$337.73 |
$337.73 |
$855.38
|
|
Echo exam of fetal heart
|
$165.28 |
$165.28 |
$165.28 |
$481.55
|
|
Echo exam of fetal heart
|
$265.92 |
$265.92 |
$265.92 |
$431.41
|
|
Echo exam of fetal heart
|
$109.39 |
$109.39 |
$109.39 |
$323.40
|
|
Echo exam uterus 76831-
|
$185.77 |
$185.77 |
$185.77 |
$547.23
|
|
Echo guide for amniocentesis
|
$145.39 |
$145.39 |
$145.39 |
$377.11
|
|
Echo guide for transfusion
|
$208.84 |
$208.84 |
$208.84 |
$324.60
|
|
Echo guide villus sampling
|
$84.93 |
$84.93 |
$84.93 |
$355.80
|
|
Echo stress
|
$536.63 |
$536.63 |
$536.63 |
$1,607.45
|
|
Echo tee guidance
|
$386.46 |
$386.46 |
$386.46 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$974.21 |
$974.21 |
$974.21 |
$1,938.95
|
|
Echo transesophageal
|
$767.75 |
$767.75 |
$767.75 |
$1,734.10
|
|
Echo transesophageal intraop
|
$600.67 |
$600.67 |
$600.67 |
$1,571.70
|
|
Echo transthoracic
|
$1,047.80 |
$1,047.80 |
$1,047.80 |
$1,475.25
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$325.79 |
$325.79 |
$325.79 |
$1,020.09
|
|
E coli 0157 ag ia
|
$13.93 |
$13.93 |
$13.93 |
$32.00
|
|
Ecp ciliary body destruction
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$2,526.64
|
|
Eeg 41-60 minutes 95812-26
|
$363.98 |
$363.98 |
$363.98 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$241.26 |
$241.26 |
$241.26 |
$1,048.30
|
|
Eeg monitoring/function test
|
$318.04 |
$318.04 |
$318.04 |
$1,373.60
|
|
Eeg monitor/record/awake/drowsy 95816
|
$366.77 |
$366.77 |
$366.77 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$413.91 |
$413.91 |
$413.91 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$268.51 |
$268.51 |
$268.51 |
$911.00
|
|
Eeg recording awake and asleep
|
$335.54 |
$335.54 |
$335.54 |
$1,030.27
|
|
Eeg without vid 2-12hr cont mntr
|
$436.78 |
$436.78 |
$436.78 |
$684.75
|