|
Dx bronchoscope/wash 31622
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,447.43
|
|
Dx duod intub w/asp spec 43756
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,037.75
|
|
Dx duod intub w/asp specs
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,104.13
|
|
Dx gastr intub w/asp spec
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$344.98
|
|
Dx gastr intub w/asp specs
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$185.15
|
|
Dx laryngoscopy newborn
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$537.80
|
|
Dx laryngoscopy w/oper scope
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,910.40
|
|
Dynamic cavernosometry
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$343.55
|
|
Ear canal biopsy 69105
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,768.50
|
|
Ear cartilage graft
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,741.00
|
|
Ear irrigation 69209
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$155.20
|
|
Ecg 12 lead tracing only
|
$60.67 |
$60.67 |
$60.67 |
$245.00
|
|
Ecg < 30 days transmission & analysis
|
$287.13 |
$287.13 |
$287.13 |
$441.40
|
|
Ecg external < 48 hours recording
|
$237.44 |
$237.44 |
$237.44 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$347.63 |
$347.63 |
$347.63 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$780.10 |
$780.10 |
$780.10 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$250.12 |
$250.12 |
$250.12 |
$462.80
|
|
Echocardiography transthoracic 2d followup/limited
|
$232.37 |
$232.37 |
$232.37 |
$762.45
|
|
Echocardiograpy doppler follow up/limited study
|
$54.92 |
$54.92 |
$54.92 |
$354.90
|
|
Echo exam of fetal heart
|
$286.96 |
$286.96 |
$286.96 |
$855.38
|
|
Echo exam of fetal heart
|
$140.43 |
$140.43 |
$140.43 |
$488.15
|
|
Echo exam of fetal heart
|
$225.95 |
$225.95 |
$225.95 |
$431.41
|
|
Echo exam of fetal heart
|
$92.95 |
$92.95 |
$92.95 |
$323.40
|
|
Echo exam uterus 76831-
|
$157.84 |
$157.84 |
$157.84 |
$536.40
|
|
Echograp trans r pros study
|
$136.04 |
$136.04 |
$136.04 |
$453.70
|
|
Echo guide for amniocentesis
|
$123.53 |
$123.53 |
$123.53 |
$377.11
|
|
Echo guide for artery repair
|
$221.22 |
$221.22 |
$221.22 |
$680.28
|
|
Echo guide for transfusion
|
$177.45 |
$177.45 |
$177.45 |
$324.60
|
|
Echo guide villus sampling
|
$72.16 |
$72.16 |
$72.16 |
$355.80
|
|
Echo stress
|
$455.96 |
$455.96 |
$455.96 |
$1,607.45
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,010.62 |
$1,010.62 |
$1,010.62 |
$1,907.26
|
|
Echo transesophageal
|
$652.34 |
$652.34 |
$652.34 |
$1,734.10
|
|
Echo transesophageal intraop
|
$510.38 |
$510.38 |
$510.38 |
$1,571.70
|
|
Echo transthoracic
|
$445.48 |
$445.48 |
$445.48 |
$1,473.15
|
|
Echo transthoracic
|
$173.22 |
$173.22 |
$173.22 |
$925.50
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$218.17 |
$218.17 |
$218.17 |
$1,031.85
|
|
E coli 0157 ag ia
|
$13.93 |
$13.93 |
$13.93 |
$32.00
|
|
Ecp ciliary body destruction
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,526.64
|
|
Eeg 41-60 minutes 95812-26
|
$309.27 |
$309.27 |
$309.27 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$204.99 |
$204.99 |
$204.99 |
$1,025.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$345.60 |
$345.60 |
$345.60 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$351.68 |
$351.68 |
$351.68 |
$1,086.80
|
|
Eeg/record in coma or sleep only 95822
|
$228.15 |
$228.15 |
$228.15 |
$911.00
|
|
Eeg recording awake and asleep
|
$285.10 |
$285.10 |
$285.10 |
$1,025.76
|
|
Eeg without vid 2-12hr cont mntr
|
$371.12 |
$371.12 |
$371.12 |
$684.75
|
|
Eeg without vid 2-12 hr unmntr
|
$213.10 |
$213.10 |
$213.10 |
$555.00
|
|
Eeg without vid ea 12-26hr cont
|
$506.15 |
$506.15 |
$506.15 |
$1,289.00
|
|
Eeg without vid ea 12-26hr intmt
|
$481.81 |
$481.81 |
$481.81 |
$1,139.40
|
|
Eeg wo vid 2-12hr intmt mntr
|
$333.94 |
$333.94 |
$333.94 |
$593.91
|
|
Eeg wo vid ea 12-26hr unmntr
|
$520.01 |
$520.01 |
$520.01 |
$1,178.40
|
|
E equine encephalitis igg
|
$14.51 |
$14.51 |
$14.51 |
$48.73
|
|
Egd balloon dil esoph30 mm/>
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,244.82
|
|
Egd control bleeding any
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,553.75
|
|
Egd dilate stricture
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,775.20
|
|
Egd endo mucosal resection
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,433.60
|
|
Egd endoscopic stent place
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,379.25
|
|
Egd esophagogastrc fndoplsty
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$9,562.50
|
|
Egd flx trnsorl dplmnt balo
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,244.82
|
|
Egd flx trnsorl rmvl balo
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,104.13
|
|
Egd guide wire insertion
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,318.75
|
|
Egd injection varices
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,244.82
|
|
Egd/insert intraluminal tube/cath 43241
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,244.82
|
|
Egd lesion ablation
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,805.40
|
|
Egd optical endomicroscopy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,234.01
|
|
Egd remove foreign body
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,569.73
|
|
Egd remove lesion snare
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,571.00
|
|
Egd/remov tum/polyp/hot bx forcep 43250
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,475.85
|
|
Egd Ultrasound exam duodenum/jejunum
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,527.97
|
|
Egd Ultrasound fine needle bx/aspir
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,638.57
|
|
Egd Ultrasound fine needle bx/aspir
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,657.10
|
|
Egd Ultrasound transmural injxn/mark
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,638.57
|
|
Egd varices ligation
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,576.75
|
|
Egd w/thrml txmnt gerd
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,502.13
|
|
Egd w/transmural drain cyst
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,379.25
|
|
Egfr gene com variants
|
$357.04 |
$357.04 |
$357.04 |
$644.15
|
|
Ehrlicha chaffeensis amp prb
|
$38.60 |
$38.60 |
$38.60 |
$105.00
|
|
Elbow arthroscopy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,953.01
|
|
Elbow arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Elec analys infus pump w/reprog 62368
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$616.00
|
|
Elect analysis of infusion pump 62367
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$524.40
|
|
Elect anlys sp inf pmp w/reprg&fill 62369
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$576.81
|
|
Electroejaculation
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,030.40
|
|
Electrolyte panel
|
$7.71 |
$7.71 |
$7.71 |
$92.30
|
|
Electron microscopy diagnostic
|
$178.97 |
$178.97 |
$178.97 |
$1,006.20
|
|
Electrophysiology evaluation
|
$2,914.40 |
$2,914.40 |
$2,914.40 |
$2,630.40
|
|
Embedded ip cath exit-site 49436
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,244.82
|
|
Embolization s&i
|
$521.70 |
$521.70 |
$521.70 |
$2,869.75
|
|
Embo or occlude vascular arterial s&i
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$16,031.73
|
|
Embo or occlude vascular hemorrhage s&i
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$15,027.40
|
|
Embo or occlude vascular tumor/organ/infarct s&i
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$14,809.85
|
|
Embo or occlude vascular venous s&i
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$15,038.25
|
|
Embryo transfer intrauterine
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$998.79
|
|
Emb/throm/fempop/aor/ilia/leg inc 34201
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$6,396.89
|
|
Emb/throm/pop-tib-pero art/leg inc 34203
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$6,396.89
|
|
Emb without cervical dilation 58100
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$397.66
|
|
Encephalitis, california igg/igm
|
$14.51 |
$14.51 |
$14.51 |
$46.75
|
