|
Epidrm a-grft face/nck/hf/g 15115
|
$2,154.21 |
$2,154.21 |
$2,154.21 |
$2,536.00
|
|
Epidrm agrft t/a/l 1st 100
|
$2,154.21 |
$2,154.21 |
$2,154.21 |
$2,703.50
|
|
Epidural lysis mult sessions
|
$1,048.46 |
$1,048.46 |
$1,048.46 |
$2,440.50
|
|
Epidural lysis on single day 62264
|
$1,048.46 |
$1,048.46 |
$1,048.46 |
$2,420.73
|
|
Epiglottidectomy
|
$6,966.64 |
$6,966.64 |
$6,966.64 |
$6,547.81
|
|
Epilepsy gen seq alys panel
|
$2,448.56 |
$2,448.56 |
$2,448.56 |
$3,142.35
|
|
Ep induct arrhy by elect pacing
|
$1,429.67 |
$1,429.67 |
$1,429.67 |
$2,702.70
|
|
Epiphysl arrst dstl rds&ulna
|
$3,821.05 |
$3,821.05 |
$3,821.05 |
$3,839.54
|
|
Epiphysl arrst dstl rds/ulna
|
$3,821.05 |
$3,821.05 |
$3,821.05 |
$4,499.12
|
|
Episiotomy/vag rpr oth/thn attending phys 59300
|
$3,744.41 |
$3,744.41 |
$3,744.41 |
$3,778.57
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$7.57 |
$7.57 |
$7.57 |
$865.80
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$7.68 |
$7.68 |
$7.68 |
$1,329.09
|
|
Epoetin beta non esrd
|
$1.41 |
$1.41 |
$1.41 |
$1,010.84
|
|
Epstein barr early antigen antibody
|
$13.12 |
$13.12 |
$13.12 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$15.29 |
$15.29 |
$15.29 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$18.14 |
$18.14 |
$18.14 |
$85.50
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$19.85 |
$19.85 |
$19.85 |
$3,838.45
|
|
Ercp bil/panc duct; each stent plcmt 43274
|
$7,010.39 |
$7,010.39 |
$7,010.39 |
$5,390.40
|
|
Ercp ea duct/ampulla dilate
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,199.25
|
|
Ercp lesion ablate w/dilate 43278
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,502.13
|
|
Ercp lithotripsy calculi
|
$7,010.39 |
$7,010.39 |
$7,010.39 |
$4,379.25
|
|
Ercp remove duct calculi 43264
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,060.00
|
|
Ercp remove forgn body duct 43275
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,859.02
|
|
Ercp sphincter pressure meas
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$3,552.00
|
|
Ercp stent exchange w/dilate
|
$7,010.39 |
$7,010.39 |
$7,010.39 |
$5,718.03
|
|
Ercp w/specimen collection
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,494.90
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$104.58 |
$104.58 |
$104.58 |
$2,488.75
|
|
ER Visit (level 1, minor)
|
$103.69 |
$103.69 |
$103.69 |
$252.60
|
|
ER Visit (level 2)
|
$186.49 |
$186.49 |
$186.49 |
$463.00
|
|
ER Visit (level 3)
|
$326.08 |
$326.08 |
$326.08 |
$812.18
|
|
ER Visit (level 4)
|
$501.47 |
$501.47 |
$501.47 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$722.02 |
$722.02 |
$722.02 |
$1,871.60
|
|
Esd endoscopy or colonoscopy
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,440.75
|
|
Esophageal motility
|
$473.22 |
$473.22 |
$473.22 |
$655.45
|
|
Esophageal recording
|
$1,429.67 |
$1,429.67 |
$1,429.67 |
$1,985.34
|
|
Esophageal recording
|
$1,429.67 |
$1,429.67 |
$1,429.67 |
$2,187.60
|
|
Esophag muc integ w/eso egd
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,214.73
|
|
Esophagosc dilate balloon 30
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,244.82
|
|
Esophagosc flex trnsn biopsy
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,768.00
|
|
Esophagoscop mucosal resect
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$3,484.00
|
|
Esophagoscop stent placement
|
$7,010.39 |
$7,010.39 |
$7,010.39 |
$6,375.00
|
|
Esophagoscop ultrasound exam
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,605.80
|
|
Esophagoscopy balloon <30mm
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,460.00
|
|
Esophagoscopy control bleed
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,742.00
|
|
Esophagoscopy flex biopsy
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,132.00
|
|
Esophagoscopy/flex/diagnostic 43200
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,296.00
|
|
Esophagoscopy flex dx brush
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,879.00
|
|
Esophagoscopy flex remove fb
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,089.60
|
|
Esophagoscopy lesion ablate
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,502.13
|
|
Esophagoscopy lesion removal
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$3,484.00
|
|
Esophagoscopy retro balloon
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,994.40
|
|
Esophagoscopy rigid balloon
|
$4,480.44 |
$4,480.44 |
$4,480.44 |
$4,502.13
|
|
Esophagoscopy/rigid/diagnostic 43191
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,660.00
|
|
Esophagoscopy rigid trnso 43180
|
$6,966.64 |
$6,966.64 |
$6,966.64 |
$6,553.49
|
|
Esophagoscopy snare les remv
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,742.00
|
|
Esophagoscopy w/us needle bx
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,244.82
|
|
Esophagoscp guide wire dilat 43196
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,638.57
|
|
Esophagoscp rig trnso biopsy
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$3,484.00
|
|
Esophagoscp rig trnso inject
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$3,484.00
|
|
Esophagoscp rig trnso rem fb
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,785.75
|
|
Esophagus endoscopy/ligation
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,392.00
|
|
Esophagus motility study
|
$624.87 |
$624.87 |
$624.87 |
$1,257.17
|
|
Esoph balloon distension tst
|
$624.87 |
$624.87 |
$624.87 |
$1,040.00
|
|
Esoph egd dilation <30 mm
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,656.80
|
|
Esoph endoscopy dilation
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,221.83
|
|
Esoph imped function test
|
$366.72 |
$366.72 |
$366.72 |
$603.00
|
|
Esoph imped funct test > 1hr
|
$624.87 |
$624.87 |
$624.87 |
$1,121.40
|
|
Esoph optical endomicroscopy
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,704.00
|
|
Esoph scope w/sclerosis inj
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,244.82
|
|
Esoph scope w/submucous inj
|
$2,234.01 |
$2,234.01 |
$2,234.01 |
$2,590.33
|
|
Essure 58565
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,841.60
|
|
Estradiol total
|
$27.94 |
$27.94 |
$27.94 |
$152.10
|
|
Estrogens total-sendout
|
$21.70 |
$21.70 |
$21.70 |
$97.50
|
|
Etanercept injection
|
$1,080.88 |
$1,080.88 |
$1,080.88 |
$3,172.86
|
|
Ethanolamine oleate 100 mg
|
$519.52 |
$519.52 |
$519.52 |
$824.88
|
|
Ethmoidectomy extranasal total 31205
|
$3,819.23 |
$3,819.23 |
$3,819.23 |
$4,593.60
|
|
Ethylene glycol -sendout
|
$14.90 |
$14.90 |
$14.90 |
$86.04
|
|
Euflexxa inj per dose
|
$114.48 |
$114.48 |
$114.48 |
$510.68
|
|
Euglobulin lysis
|
$8.41 |
$8.41 |
$8.41 |
$63.84
|
|
Evacuate mole of uterus
|
$3,744.41 |
$3,744.41 |
$3,744.41 |
$3,762.53
|
|
Eval aud rehab status/first hr 92626
|
$184.26 |
$184.26 |
$184.26 |
$329.59
|
|
Eval/fit voice prosthesis iii, st
|
$155.22 |
$155.22 |
$155.22 |
$359.50
|
|
Evaluation cervical mucus
|
$10.38 |
$10.38 |
$10.38 |
$26.40
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$98.11 |
$98.11 |
$98.11 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$170.83 |
$170.83 |
$170.83 |
$302.50
|
|
Evaluation psychiatric diagnostic
|
$189.21 |
$189.21 |
$189.21 |
$318.24
|
|
Event monitor
|
$43.91 |
$43.91 |
$43.91 |
$231.00
|
|
Evoked auditory tst complete
|
$366.72 |
$366.72 |
$366.72 |
$357.41
|
|
Evoked oa emissions ltd
|
$366.72 |
$366.72 |
$366.72 |
$244.00
|
|
Evoked potentials upper limbs
|
$366.72 |
$366.72 |
$366.72 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$366.72 |
$366.72 |
$366.72 |
$814.61
|
|
Exam of vagina w/scope 57420
|
$358.23 |
$358.23 |
$358.23 |
$486.03
|
|
Exam plvc w/anes othr thn lcl
|
$3,744.41 |
$3,744.41 |
$3,744.41 |
$3,816.40
|
|
Ex arm/elbow tum deep < 5 cm
|
$3,370.52 |
$3,370.52 |
$3,370.52 |
$3,386.84
|
|
Ex arm/elbow tum deep 5 cm/>
|
$3,370.52 |
$3,370.52 |
$3,370.52 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$3,370.52 |
$3,370.52 |
$3,370.52 |
$3,994.09
|
|
Exc abdl tum deep < 5 cm
|
$3,370.52 |
$3,370.52 |
$3,370.52 |
$3,786.00
|
|
Exc abdl tum deep 5 cm/>
|
$3,370.52 |
$3,370.52 |
$3,370.52 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$3,370.52 |
$3,370.52 |
$3,370.52 |
$4,529.20
|
|
Exc arm/elbo les sc <3cm 24075
|
$1,908.09 |
$1,908.09 |
$1,908.09 |
$2,532.80
|
