|
Drain shoulder bone lesion
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,206.33
|
|
Drain shoulder bursa 23031
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,719.83
|
|
Drain shoulder lesion
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,386.84
|
|
Drain thigh/knee lesion 27301
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,606.86
|
|
Drain thyroid/tongue cyst
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,744.44
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$411.16
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$365.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$532.80
|
|
Dressing change not for burn w/anes 15852
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$755.08
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$365.11 |
$365.11 |
$365.11 |
$5,307.40
|
|
Drng hand tendon sheath 26020
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,972.80
|
|
Drng of hydrocele 55000
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$832.60
|
|
Drng of mouth lesion 40801
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,145.97
|
|
Drng of ovarian cyst(s) 58800
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,474.84
|
|
Drng of palm multi bursas 26030
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,591.33
|
|
Drng of palm single bursa 26025
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,545.97
|
|
Drng of pelvic abscess transrectal 45000
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,614.45
|
|
Drng of salivary cyst 42409
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,575.45
|
|
Drng of scrotum abscess 55100
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,997.89
|
|
Drng salivary gland simple 42300
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,133.48
|
|
Drng salivary gland submax/subling 42310
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$596.25
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$212.15 |
$212.15 |
$212.15 |
$284.40
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$7.66 |
$7.66 |
$7.66 |
$318.13
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$2,140.22 |
$2,140.22 |
$2,140.22 |
$10,375.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$37.67 |
$37.67 |
$37.67 |
$448.16
|
|
Drug admin & hemodynmic meas
|
$129.21 |
$129.21 |
$129.21 |
$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
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$4,173.97
|
|
Dstrj nulyt agt gnclr nrv
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$3,268.20
|
|
Dstr mal les s/n/h/f/g >4.0
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$886.40
|
|
Duplex scan bilateral study 93985
|
$532.39 |
$532.39 |
$532.39 |
$660.32
|
|
Dup scan/hemodialysis access 93990
|
$313.38 |
$313.38 |
$313.38 |
$499.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$413.34 |
$413.34 |
$413.34 |
$759.85
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$529.90 |
$529.90 |
$529.90 |
$890.55
|
|
Dxa bone density axl vrt fx
|
$239.96 |
$239.96 |
$239.96 |
$377.65
|
|
Dx bronchoscope/brush 31623
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,671.50
|
|
Dx bronchoscope/wash 31622
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,466.80
|
|
Dx duod intub w/asp spec 43756
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,037.75
|
|
Dx duod intub w/asp specs
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,104.13
|
|
Dx gastr intub w/asp spec
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$368.50
|
|
Dx gastr intub w/asp specs
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$192.50
|
|
Dx laryngoscopy newborn
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$577.32
|
|
Dx laryngoscopy w/oper scope
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,040.67
|
|
Dynamic cavernosometry
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$343.55
|
|
Ear canal biopsy 69105
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$1,768.50
|
|
Ear cartilage graft
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$5,741.00
|
|
Ear irrigation 69209
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$161.40
|
|
Ecg 12 lead tracing only
|
$74.45 |
$74.45 |
$74.45 |
$245.30
|
|
Ecg external < 48 hours recording
|
$376.43 |
$376.43 |
$376.43 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$462.08 |
$462.08 |
$462.08 |
$567.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$154.30 |
$154.30 |
$154.30 |
$154.30
|
|
Ecg external >7 days up to 15 days recording
|
$152.85 |
$152.85 |
$152.85 |
$194.01
|
|
Echocardiogram (Heart Ultrasound)
|
$854.07 |
$854.07 |
$854.07 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$237.26 |
$237.26 |
$237.26 |
$462.80
|
|
Echocardiography transthoracic 2d followup/limited
|
$345.32 |
$345.32 |
$345.32 |
$736.80
|
|
Echocardiograpy doppler follow up/limited study
|
$165.09 |
$165.09 |
$165.09 |
$354.90
|
|
Echo guide for amniocentesis
|
$371.45 |
$371.45 |
$371.45 |
$377.11
|
|
Echo guide for artery repair
|
$364.81 |
$364.81 |
$364.81 |
$680.28
|
|
Echo guide for transfusion
|
$117.59 |
$117.59 |
$117.59 |
$324.60
|
|
Echo guide villus sampling
|
$153.26 |
$153.26 |
$153.26 |
$355.80
|
|
Echo stress
|
$528.24 |
$528.24 |
$528.24 |
$1,586.90
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,144.84 |
$1,144.84 |
$1,144.84 |
$1,875.00
|
|
Echo transesophageal intraop
|
$955.69 |
$955.69 |
$955.69 |
$1,571.70
|
|
Echo transthoracic
|
$384.51 |
$384.51 |
$384.51 |
$1,475.25
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$421.64 |
$421.64 |
$421.64 |
$1,014.01
|
|
E coli 0157 ag ia
|
$13.93 |
$13.93 |
$13.93 |
$32.00
|
|
Ecp ciliary body destruction
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,526.64
|
|
Eeg 41-60 minutes 95812-26
|
$457.73 |
$457.73 |
$457.73 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$159.28 |
$159.28 |
$159.28 |
$1,025.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$233.94 |
$233.94 |
$233.94 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$419.77 |
$419.77 |
$419.77 |
$1,102.05
|
|
Eeg/record in coma or sleep only 95822
|
$254.89 |
$254.89 |
$254.89 |
$936.00
|
|
Eeg recording awake and asleep
|
$278.74 |
$278.74 |
$278.74 |
$1,030.27
|
|
Eeg without vid 2-12hr cont mntr
|
$460.01 |
$460.01 |
$460.01 |
$700.18
|
|
Eeg without vid 2-12 hr unmntr
|
$275.84 |
$275.84 |
$275.84 |
$568.32
|
|
Eeg wo vid ea 12-26hr unmntr
|
$701.63 |
$701.63 |
$701.63 |
$1,194.00
|
|
E equine encephalitis igg
|
$14.51 |
$14.51 |
$14.51 |
$48.73
|
|
Egd balloon dil esoph30 mm/>
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,244.82
|
|
Egd control bleeding any
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,553.75
|
|
Egd dilate stricture
|
$3,786.00 |
$3,786.00 |
$3,786.00 |
$2,721.74
|