|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,752.89
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,270.40
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,022.40
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$741.60
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,547.81
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,592.74
|
|
Drainage of mouth lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,357.20
|
|
Drainage of nose lesion int 30000
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$586.64
|
|
Drainage of nose lesion sept 30020
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$755.95
|
|
Drainage of pelvis bursa
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,893.86
|
|
Drainage of pelvis lesion 26990
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,839.54
|
|
Drainage of prostate abscess
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,891.34
|
|
Drainage of prostate abscess
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,769.31
|
|
Drainage of prostate abscess
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Drainage of rectal abscess
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,299.90
|
|
Drainage of rectal abscess 45020
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,229.60
|
|
Drainage of salivary gland
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,819.23
|
|
Drainage of salivary gland
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$602.63
|
|
Drainage of throat abscess
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,499.33
|
|
Drainage of urethra abscess
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,820.84
|
|
Drainage of urethra abscess 53060
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,424.12
|
|
Drainage of urinary leakage
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,057.60
|
|
Drainage of urinary leakage
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,424.12
|
|
Drain bladder by trocar/cath
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,078.00
|
|
Drain blood from under nail 11740
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$182.95
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,529.45
|
|
Drain cath image guided visceral pq
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,996.80
|
|
Drain cerebro spinal fluid 62272
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,082.90
|
|
Drain chest lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,594.44
|
|
Drain finger abscess;simple 26010
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$490.80
|
|
Drain lower leg bursa
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,721.84
|
|
Drain lower leg lesion 27603
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,631.18
|
|
Drain neck/chest lesion 21501
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,293.25
|
|
Drain ovarn cyst abd
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,762.53
|
|
Drain ovary abscess open
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,762.53
|
|
Drain penis lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,917.33
|
|
Drain shoulder bone lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,206.33
|
|
Drain shoulder bursa 23031
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,127.88
|
|
Drain shoulder lesion
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,386.84
|
|
Drain thigh/knee lesion 27301
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,606.86
|
|
Drain thyroid/tongue cyst
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,744.44
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$403.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$355.80
|
|
Dress/debrid prtl-thick burn l 16030
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$515.00
|
|
Dressing change not for burn w/anes 15852
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$724.37
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$366.70 |
$366.70 |
$366.70 |
$2,458.05
|
|
Drng hand tendon sheath 26020
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,917.33
|
|
Drng of hydrocele 55000
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$832.60
|
|
Drng of mouth lesion 40801
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,274.04
|
|
Drng of ovarian cyst(s) 58800
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,474.84
|
|
Drng of palm multi bursas 26030
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,591.33
|
|
Drng of palm single bursa 26025
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,545.97
|
|
Drng of pelvic abscess transrectal 45000
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,614.45
|
|
Drng of salivary cyst 42409
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,575.45
|
|
Drng of scrotum abscess 55100
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,997.89
|
|
Drng salivary gland simple 42300
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,863.20
|
|
Drng salivary gland submax/subling 42310
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$573.64
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$213.07 |
$213.07 |
$213.07 |
$189.68
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$7.69 |
$7.69 |
$7.69 |
$327.39
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$2,149.51 |
$2,149.51 |
$2,149.51 |
$5,085.77
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$37.83 |
$37.83 |
$37.83 |
$448.16
|
|
Drug admin & hemodynmic meas
|
$102.90 |
$102.90 |
$102.90 |
$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
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,173.97
|
|
Dstrj nulyt agt gnclr nrv
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,268.20
|
|
Dstr mal les s/n/h/f/g >4.0
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$886.40
|
|
Duplex scan bilateral study 93985
|
$497.42 |
$497.42 |
$497.42 |
$690.95
|
|
Dup scan/hemodialysis access 93990
|
$321.61 |
$321.61 |
$321.61 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$415.14 |
$415.14 |
$415.14 |
$750.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$538.45 |
$538.45 |
$538.45 |
$885.60
|
|
Dxa bone density axl vrt fx
|
$218.09 |
$218.09 |
$218.09 |
$374.00
|
|
Dx aly aud oi snd prcsr 1st
|
$74.77 |
$74.77 |
$74.77 |
$185.15
|
|
Dx bronchoscope/brush 31623
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,626.00
|
|
Dx bronchoscope/wash 31622
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,447.43
|
|
Dx duod intub w/asp spec 43756
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,037.75
|
|
Dx duod intub w/asp specs
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,104.13
|
|
Dx gastr intub w/asp spec
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$344.68
|
|
Dx gastr intub w/asp specs
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$185.15
|
|
Dx laryngoscopy newborn
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$537.80
|
