|
Esoph balloon distension tst
|
$482.29 |
$482.29 |
$482.29 |
$780.00
|
|
Esoph egd dilation <30 mm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,656.80
|
|
Esoph endoscopy dilation
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,221.83
|
|
Esophgl motil w/stim/perfus
|
$34.94 |
$34.94 |
$34.94 |
$1,075.06
|
|
Esoph imped function test
|
$300.92 |
$300.92 |
$300.92 |
$597.03
|
|
Esoph imped funct test > 1hr
|
$540.29 |
$540.29 |
$540.29 |
$986.40
|
|
Esoph optical endomicroscopy
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,244.82
|
|
Esoph scope w/sclerosis inj
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,234.01
|
|
Esoph scope w/submucous inj
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,244.82
|
|
Essure 58565
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,463.96
|
|
Established Patient Office Visit (level 1)
|
$72.49 |
$72.49 |
$72.49 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$110.53 |
$110.53 |
$110.53 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$121.94 |
$121.94 |
$121.94 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$134.06 |
$134.06 |
$134.06 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$158.07 |
$158.07 |
$158.07 |
$287.10
|
|
Estradiol total
|
$30.73 |
$30.73 |
$30.73 |
$153.00
|
|
Estrogens total-sendout
|
$23.87 |
$23.87 |
$23.87 |
$89.25
|
|
Ethmoidectomy extranasal total 31205
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,837.72
|
|
Ethylene glycol -sendout
|
$16.39 |
$16.39 |
$16.39 |
$75.00
|
|
Euglobulin lysis
|
$9.25 |
$9.25 |
$9.25 |
$39.75
|
|
Evacuate mole of uterus
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,522.35
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$107.92 |
$107.92 |
$107.92 |
$219.60
|
|
Evaluation psychiatric diagnostic
|
$203.94 |
$203.94 |
$203.94 |
$320.00
|
|
Evoked oa emissions ltd
|
$168.76 |
$168.76 |
$168.76 |
$273.00
|
|
Evoked potentials auditory screening automated analysis
|
$61.32 |
$61.32 |
$61.32 |
$283.62
|
|
Evok oa screening qual
|
$59.90 |
$59.90 |
$59.90 |
$120.90
|
|
Exam of vagina w/scope 57420
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$535.00
|
|
Exam plvc w/anes othr thn lcl
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,649.80
|
|
Ex arm/elbow tum deep < 5 cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Ex arm/elbow tum deep 5 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc abdl tum deep < 5 cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc abdl tum deep 5 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc arm/elbo les sc <3cm 24075
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,917.33
|
|
Exc aurl glomus tum trnscanl
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,547.81
|
|
Exc aurl glomus tum trnsmstd
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,969.40
|
|
Exc back les sbq <3 cm 21930
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,271.01
|
|
Exc back tum deep 5 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,370.52
|
|
Exc bartholins gland/cyst
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,744.41
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,184.60
|
|
Exc benign feenlm >4.0cm 11446
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,244.06
|
|
Exc benign tal 0.5 < cm 11400
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$837.48
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,045.20
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$818.53
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,301.30
|
|
Exc breast duct fistula 19112
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,847.45
|
|
Exc cervix repair bowel 57556
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,394.95
|
|
Exc cervix/repair vagina 57555
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,627.00
|
|
Exc chest wall tumor w/ribs 21601
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc coccygl pr ulc flap clsr
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,052.18
|
|
Exc coccygl pr ulc prim sutr
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,167.89
|
|
Exc constrict ring finger w/mlt z-plasties 26596
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,591.33
|
|
Exc/crtg b1 cst/b9 tum rds
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,591.33
|
|
Exc/crtg b1 cst/tum hum agrf
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,886.74
|
|
Exc/crtg b1 cst/tum hum algr
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,886.74
|
|
Exc/crtg b1 cst/tum rds agrf
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Exc/crtg b1 cst/tum rds algr
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,855.00
|
|
Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,741.00
|
|
Exc/curtg b1 cst/b9 tum hum
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Exc excessive skin buttock
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,377.40
|
|
Exc excessive skin hip
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc excessive skin leg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,321.60
|
|
Exc excessive skin thigh
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,074.75
|
|
Exc excsv skin forearm/hand
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,167.89
|
|
Exc excsv submental fat pad
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,170.64
|
|
Exc ext ear/partial/simple repair 69110
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc face tum deep < 2 cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,917.33
|
|
Exc face tum deep 2cm/> 21014
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,061.40
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,101.45
|
|
Exc foot/toe tum dep 1.5cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,786.00
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,424.00
|
|
Exc forearm les sc 3 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,078.40
|
|
Exc forearm tum deep < 3 cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,547.20
|
|
Exc forearm tum deep 3 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc hand les sc < 1.5 cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,897.50
|
|
Exc hand tum deep 1.5 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,271.01
|
|
Exc hand tum deep < 1.5 cm 26116
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,271.01
|
|
Exchange biliary drg cath
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,176.15
|
|
Exchange blood transfusion newborn 36450
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$517.34
|
|
Exchange drainage catheter
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,256.80
|
|
Exchange lens prosthesis
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,504.00
|
|
Exchange nephrostomy cath
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,097.16
|
|
Exc hidradenitis ing simpl 11462
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,170.64
|
|
Exc hidradenitis peri/umb comp 11471
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc hidradenitis peri/umb int 11470
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc hip/pelv tum deep < 5 cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc hip/pelv tum deep 5 cm/>
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,630.40
|
|
Exc im tumor/back/flank/ < 5 cm 21932
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Exc im tumor/foot/toe < 1.5 cm 28045
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,170.64
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,411.20
|
|
Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,696.64
|
|
Exc ischial pr ulc prim sutr
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
