|
Dstr mal les s/n/h/f/g >4.0
|
$470.51 |
$470.51 |
$470.51 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$470.51 |
$470.51 |
$470.51 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$720.88 |
$720.88 |
$720.88 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$720.88 |
$720.88 |
$720.88 |
$886.40
|
|
Dstry eye lesn,fdr vssl tech
|
$646.06 |
$646.06 |
$646.06 |
$756.27
|
|
Ductogram sgl duct
|
$284.66 |
$284.66 |
$284.66 |
$469.80
|
|
Duodenal motility study
|
$624.87 |
$624.87 |
$624.87 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$284.66 |
$284.66 |
$284.66 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$125.23 |
$125.23 |
$125.23 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$125.23 |
$125.23 |
$125.23 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$184.26 |
$184.26 |
$184.26 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$284.66 |
$284.66 |
$284.66 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$85.25 |
$85.25 |
$85.25 |
$8,445.90
|
|
Dxa bone density axl vrt fx
|
$125.23 |
$125.23 |
$125.23 |
$401.20
|
|
Dx aly aud oi snd prcsr 1st
|
$184.26 |
$184.26 |
$184.26 |
$186.40
|
|
Dx bronchoscope/brush 31623
|
$2,030.84 |
$2,030.84 |
$2,030.84 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$2,030.84 |
$2,030.84 |
$2,030.84 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$2,030.84 |
$2,030.84 |
$2,030.84 |
$2,410.50
|
|
Dx dark adaptation exam i&r
|
$469.93 |
$469.93 |
$469.93 |
$472.21
|
|
Dx duod intub w/asp spec 43756
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,075.20
|
|
Dx duod intub w/asp specs
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,406.58
|
|
Dx gastr intub w/asp spec
|
$366.72 |
$366.72 |
$366.72 |
$441.60
|
|
Dx gastr intub w/asp specs
|
$184.26 |
$184.26 |
$184.26 |
$308.70
|
|
Dx laryngoscopy newborn
|
$457.30 |
$457.30 |
$457.30 |
$658.00
|
|
Dx laryngoscopy w/oper scope
|
$2,030.84 |
$2,030.84 |
$2,030.84 |
$2,755.53
|
|
Dynamic cavernosometry
|
$286.42 |
$286.42 |
$286.42 |
$3,442.40
|
|
Dynamic surface emg
|
$366.72 |
$366.72 |
$366.72 |
$368.50
|
|
Ear and throat examination
|
$599.72 |
$599.72 |
$599.72 |
$602.63
|
|
Ear canal biopsy 69105
|
$1,744.44 |
$1,744.44 |
$1,744.44 |
$1,889.50
|
|
Ear cartilage graft
|
$6,966.64 |
$6,966.64 |
$6,966.64 |
$6,385.40
|
|
Ear irrigation 69209
|
$69.95 |
$69.95 |
$69.95 |
$154.70
|
|
Ear protector evaluation
|
$46.22 |
$46.22 |
$46.22 |
$112.56
|
|
Ecallantide injection
|
$579.99 |
$579.99 |
$579.99 |
$13,357.14
|
|
Ecg/1-3 leads/tracing only 93041
|
$69.95 |
$69.95 |
$69.95 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$108.10 |
$108.10 |
$108.10 |
$412.88
|
|
Ecg external < 48 hours recording
|
$151.80 |
$151.80 |
$151.80 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$69.95 |
$69.95 |
$69.95 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$46.22 |
$46.22 |
$46.22 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$46.22 |
$46.22 |
$46.22 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$645.71 |
$645.71 |
$645.71 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$284.66 |
$284.66 |
$284.66 |
$720.60
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$930.42 |
$930.42 |
$930.42 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$420.58 |
$420.58 |
$420.58 |
$866.87
|
|
Echo exam of eye
|
$125.23 |
$125.23 |
$125.23 |
$143.75
|
|
Echo exam of eye
|
$125.23 |
$125.23 |
$125.23 |
$172.00
|
|
Echo exam of eye
|
$103.69 |
$103.69 |
$103.69 |
$169.62
|
|
Echo exam of eye thickness
|
$28.84 |
$28.84 |
$28.84 |
$40.30
|
|
Echo exam of fetal heart
|
$645.71 |
$645.71 |
$645.71 |
$904.80
|
|
Echo exam of fetal heart
|
$284.66 |
$284.66 |
$284.66 |
$538.27
|
|
Echo exam of fetal heart
|
$125.23 |
$125.23 |
$125.23 |
$431.41
|
|
Echo exam of fetal heart
|
$125.23 |
$125.23 |
$125.23 |
$318.34
|
|
Echo exam uterus 76831-
|
$284.66 |
$284.66 |
$284.66 |
$561.00
|
|
Echograp trans r pros study
|
$125.23 |
$125.23 |
$125.23 |
$468.00
|
|
Echo guide for artery repair
|
$366.72 |
$366.72 |
$366.72 |
$696.30
|
|
Echo stress
|
$645.71 |
$645.71 |
$645.71 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$645.71 |
$645.71 |
$645.71 |
$751.34
|
|
Echo tee probe placement image acquisition interpretation & report
|
$645.71 |
$645.71 |
$645.71 |
$1,913.60
|
|
Echo transesophageal
|
$645.71 |
$645.71 |
$645.71 |
$1,075.20
|
|
Echo transesophageal
|
$645.71 |
$645.71 |
$645.71 |
$1,650.00
|
|
Echo transesophageal intraop
|
$645.71 |
$645.71 |
$645.71 |
$1,578.00
|
|
Echo transthoracic
|
$645.71 |
$645.71 |
$645.71 |
$1,361.75
|
|
Echo transthoracic
|
$645.71 |
$645.71 |
$645.71 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$284.66 |
$284.66 |
$284.66 |
$1,033.00
|
|
Ecog impltd brn npgt <30 d
|
$43.91 |
$43.91 |
$43.91 |
$148.40
|
|
E coli 0157 ag ia
|
$12.66 |
$12.66 |
$12.66 |
$71.50
|
|
Ecp ciliary body destruction
|
$2,685.92 |
$2,685.92 |
$2,685.92 |
$2,698.92
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$44.77 |
$44.77 |
$44.77 |
$19,540.29
|
|
Edetate calcium disodium inj
|
$6,454.57 |
$6,454.57 |
$6,454.57 |
$8,739.98
|
|
Ed svc ckd grp per session
|
$33.58 |
$33.58 |
$33.58 |
$58.40
|
|
Ed svc ckd ind per session
|
$139.97 |
$139.97 |
$139.97 |
$249.60
|
|
Eeg 41-60 minutes 95812-26
|
$366.72 |
$366.72 |
$366.72 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$624.87 |
$624.87 |
$624.87 |
$994.15
|
|
Eeg monitoring/function test
|
$1,198.14 |
$1,198.14 |
$1,198.14 |
$1,557.60
|
|
Eeg monitoring/giving drugs
|
$624.87 |
$624.87 |
$624.87 |
$809.86
|
|
Eeg monitor/record/awake/drowsy 95816
|
$366.72 |
$366.72 |
$366.72 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$366.72 |
$366.72 |
$366.72 |
$1,119.54
|
|
Eeg/record in coma or sleep only 95822
|
$366.72 |
$366.72 |
$366.72 |
$871.00
|
|
Eeg recording awake and asleep
|
$366.72 |
$366.72 |
$366.72 |
$931.20
|
|
Eeg without vid 2-12hr cont mntr
|
$366.72 |
$366.72 |
$366.72 |
$895.20
|
|
Eeg without vid 2-12 hr unmntr
|
$366.72 |
$366.72 |
$366.72 |
$721.76
|
|
Eeg without vid ea 12-26hr cont
|
$624.87 |
$624.87 |
$624.87 |
$1,584.70
|
|
Eeg without vid ea 12-26hr intmt
|
$624.87 |
$624.87 |
$624.87 |
$1,584.70
|
|
Eeg wo vid 2-12hr intmt mntr
|
$366.72 |
$366.72 |
$366.72 |
$721.76
|
|
Eeg wo vid ea 12-26hr unmntr
|
$624.87 |
$624.87 |
$624.87 |
$1,632.95
|
|
E equine encephalitis igg
|
$13.19 |
$13.19 |
$13.19 |
$51.84
|
|
Efgartigimod alfa-fcab 20 mg/ml intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$13,130.61
|
|
Egd balloon dil esoph30 mm/>
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,244.82
|
|
Egd control bleeding any
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,553.75
|
|
Egd dilate stricture
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,394.60
|
|
Egd endo mucosal resection
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,430.40
|
|
Egd endoscopic stent place
|
$7,010.39 |
$7,010.39 |
$7,010.39 |
$3,986.00
|
|
Egd esophagogastrc fndoplsty
|
$12,260.88 |
$12,260.88 |
$12,260.88 |
$7,229.60
|
|
Egd flx trnsorl dplmnt balo
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,638.57
|
|
Egd flx trnsorl rmvl balo
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,247.13
|
|
Egd guide wire insertion
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,664.00
|
|
Egd injection varices
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,244.82
|
|
Egd/insert intraluminal tube/cath 43241
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,244.82
|
|
Egd lesion ablation
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,354.48
|
|
Egd optical endomicroscopy
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,372.30
|
|
Egd remove foreign body
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,571.40
|