|
Drng salivary gland simple 42300
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,133.48
|
|
Drng salivary gland submax/subling 42310
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$596.25
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$184.74 |
$184.74 |
$184.74 |
$284.40
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$6.67 |
$6.67 |
$6.67 |
$318.13
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1,863.66 |
$1,863.66 |
$1,863.66 |
$10,375.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$32.80 |
$32.80 |
$32.80 |
$448.16
|
|
Drug admin & hemodynmic meas
|
$49.66 |
$49.66 |
$49.66 |
$528.50
|
|
Drug assay caffeine
|
$42.43 |
$42.43 |
$42.43 |
$83.40
|
|
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 |
$83.46
|
|
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 |
$101.66
|
|
Dstrj extensive retinopathy
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,173.97
|
|
Dstrj nulyt agt gnclr nrv
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,268.20
|
|
Dstr mal les s/n/h/f/g >4.0
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$886.40
|
|
Duplex scan bilateral study 93985
|
$230.13 |
$230.13 |
$230.13 |
$660.32
|
|
Dup scan/hemodialysis access 93990
|
$98.55 |
$98.55 |
$98.55 |
$499.72
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$257.61 |
$257.61 |
$257.61 |
$890.55
|
|
Dxa bone density axl vrt fx
|
$114.42 |
$114.42 |
$114.42 |
$377.65
|
|
Dx bronchoscope/brush 31623
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,671.50
|
|
Dx bronchoscope/wash 31622
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,466.80
|
|
Dx duod intub w/asp spec 43756
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,037.75
|
|
Dx duod intub w/asp specs
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,104.13
|
|
Dx gastr intub w/asp spec
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$368.50
|
|
Dx gastr intub w/asp specs
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$192.50
|
|
Dx laryngoscopy newborn
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$577.32
|
|
Dx laryngoscopy w/oper scope
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,040.67
|
|
Dynamic cavernosometry
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$343.55
|
|
Ear canal biopsy 69105
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,768.50
|
|
Ear cartilage graft
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,741.00
|
|
Ear irrigation 69209
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$161.40
|
|
Ecg 12 lead tracing only
|
$46.31 |
$46.31 |
$46.31 |
$245.30
|
|
Ecg external > 48 hours up to 7 days recording
|
$176.34 |
$176.34 |
$176.34 |
$154.30
|
|
Ecg external >7 days up to 15 days recording
|
$194.01 |
$194.01 |
$194.01 |
$194.01
|
|
Echocardiogram (Heart Ultrasound)
|
$595.46 |
$595.46 |
$595.46 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$190.92 |
$190.92 |
$190.92 |
$462.80
|
|
Echocardiography transthoracic 2d followup/limited
|
$177.37 |
$177.37 |
$177.37 |
$736.80
|
|
Echocardiograpy doppler follow up/limited study
|
$41.92 |
$41.92 |
$41.92 |
$354.90
|
|
Echo exam uterus 76831-
|
$120.48 |
$120.48 |
$120.48 |
$513.00
|
|
Echograp trans r pros study
|
$103.84 |
$103.84 |
$103.84 |
$458.25
|
|
Echo guide for amniocentesis
|
$94.29 |
$94.29 |
$94.29 |
$377.11
|
|
Echo guide for artery repair
|
$168.86 |
$168.86 |
$168.86 |
$680.28
|
|
Echo tee guidance
|
$250.64 |
$250.64 |
$250.64 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$771.42 |
$771.42 |
$771.42 |
$1,875.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$166.53 |
$166.53 |
$166.53 |
$1,014.01
|
|
E coli 0157 ag ia
|
$13.93 |
$13.93 |
$13.93 |
$32.00
|
|
Ecp ciliary body destruction
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,526.64
|
|
Eeg 41-60 minutes 95812-26
|
$236.07 |
$236.07 |
$236.07 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$156.47 |
$156.47 |
$156.47 |
$1,025.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$263.80 |
$263.80 |
$263.80 |
$861.12
|
|
Eeg/record in coma or sleep only 95822
|
$174.15 |
$174.15 |
$174.15 |
$936.00
|
|
Eeg recording awake and asleep
|
$217.62 |
$217.62 |
$217.62 |
$1,030.27
|
|
E equine encephalitis igg
|
$14.51 |
$14.51 |
$14.51 |
$48.73
|
|
Egd balloon dil esoph30 mm/>
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,244.82
|
|
Egd control bleeding any
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,553.75
|
|
Egd dilate stricture
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,721.74
|
|
Egd endo mucosal resection
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,433.60
|
|
Egd endoscopic stent place
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,379.25
|
|
Egd esophagogastrc fndoplsty
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$9,562.50
|
|
Egd flx trnsorl dplmnt balo
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,244.82
|
|
Egd flx trnsorl rmvl balo
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,104.13
|
|
Egd guide wire insertion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,318.75
|
|
Egd injection varices
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,244.82
|
|
Egd/insert intraluminal tube/cath 43241
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,244.82
|
|
Egd lesion ablation
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,805.40
|
|
Egd optical endomicroscopy
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,234.01
|
|
Egd remove foreign body
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,569.73
|
|
Egd remove lesion snare
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,506.40
|
|
Egd/remov tum/polyp/hot bx forcep 43250
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,475.85
|
|
Egd Ultrasound exam duodenum/jejunum
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,527.97
|
|
Egd Ultrasound fine needle bx/aspir
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,638.57
|
|
Egd Ultrasound fine needle bx/aspir
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,664.75
|
|
Egd Ultrasound transmural injxn/mark
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,638.57
|
|
Egd varices ligation
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,576.75
|
|
Egd w/thrml txmnt gerd
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,502.13
|
|
Egd w/transmural drain cyst
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,379.25
|
|
Egfr gene com variants
|
$357.04 |
$357.04 |
$357.04 |
$615.57
|
|
Ehrlicha chaffeensis amp prb
|
$38.60 |
$38.60 |
$38.60 |
$105.00
|
|
Elbow arthroscopy
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,953.01
|
|
Elbow arthroscopy/surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Elec analys infus pump w/reprog 62368
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$619.45
|
|
Elect analysis of infusion pump 62367
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$524.40
|