|
Drainage of urethra abscess 53060
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Drainage of urinary leakage
|
$729.46 |
$3,986.00 |
$6,839.00 |
|
|
Drainage of urinary leakage
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Drain bladder by trocar/cath
|
$1,111.89 |
$3,986.00 |
$6,839.00 |
|
|
Drain blood from under nail 11740
|
$140.87 |
$3,986.00 |
$6,839.00 |
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,770.73 |
$3,986.00 |
$6,839.00 |
|
|
Drain cath image guided visceral pq
|
$1,770.73 |
$3,986.00 |
$6,839.00 |
|
|
Drain cerebro spinal fluid 62272
|
$756.84 |
$3,986.00 |
$6,839.00 |
|
|
Drain chest lesion
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Drain finger abscess;simple 26010
|
$217.16 |
$3,986.00 |
$6,839.00 |
|
|
Drain lower leg bursa
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Drain lower leg lesion 27603
|
$3,127.88 |
$3,986.00 |
$6,839.00 |
|
|
Drain neck/chest lesion 21501
|
$3,127.88 |
$3,986.00 |
$6,839.00 |
|
|
Drain ovarn cyst abd
|
$3,474.84 |
$3,986.00 |
$6,839.00 |
|
|
Drain ovary abscess open
|
$3,474.84 |
$3,986.00 |
$6,839.00 |
|
|
Drain penis lesion
|
$1,770.73 |
$3,986.00 |
$6,839.00 |
|
|
Drain shoulder bone lesion
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Drain shoulder bursa 23031
|
$3,127.88 |
$3,986.00 |
$6,839.00 |
|
|
Drain shoulder lesion
|
$3,127.88 |
$3,986.00 |
$6,839.00 |
|
|
Drain thigh/knee lesion 27301
|
$3,127.88 |
$3,986.00 |
$6,839.00 |
|
|
Drain thyroid/tongue cyst
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$217.16 |
$3,986.00 |
$6,839.00 |
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$217.16 |
$3,986.00 |
$6,839.00 |
|
|
Dress/debrid prtl-thick burn l 16030
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Dressing change not for burn w/anes 15852
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$317.93 |
$373.04 |
$525.70 |
|
|
Drng hand tendon sheath 26020
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Drng of eyelid abscess 67700
|
$326.69 |
$3,986.00 |
$6,839.00 |
|
|
Drng of finger abscess comp 26011
|
$1,770.73 |
$3,986.00 |
$6,839.00 |
|
|
Drng of hydrocele 55000
|
$768.94 |
$3,986.00 |
$6,839.00 |
|
|
Drng of mouth lesion 40801
|
$556.55 |
$3,986.00 |
$6,839.00 |
|
|
Drng of ovarian cyst(s) 58800
|
$3,474.84 |
$3,986.00 |
$6,839.00 |
|
|
Drng of palm multi bursas 26030
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Drng of palm single bursa 26025
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Drng of pelvic abscess transrectal 45000
|
$1,288.59 |
$3,986.00 |
$6,839.00 |
|
|
Drng of salivary cyst 42409
|
$3,544.29 |
$3,986.00 |
$6,839.00 |
|
|
Drng of scrotum abscess 55100
|
$1,770.73 |
$3,986.00 |
$6,839.00 |
|
|
Drng salivary gland simple 42300
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Drng salivary gland submax/subling 42310
|
$556.55 |
$3,986.00 |
$6,839.00 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$184.74 |
$216.76 |
$305.47 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$6.67 |
$7.82 |
$11.02 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1,863.66 |
$2,186.65 |
$3,081.54 |
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$32.80 |
$38.48 |
$54.24 |
|
|
Drug admin & hemodynmic meas
|
$49.66 |
$102.90 |
$129.45 |
|
|
Drug assay caffeine
|
$38.57 |
$42.43 |
$42.43 |
|
|
Drug assay posaconazole
|
$27.11 |
$29.82 |
$29.82 |
|
|
Drug assay rufinamide
|
$27.11 |
$29.82 |
$29.82 |
|
|
Drug assay vedolizumab
|
$38.57 |
$42.43 |
$42.43 |
|
|
Drug assay voriconazole
|
$27.11 |
$29.82 |
$29.82 |
|
|
Drug asy hydroxychloroquine
|
$18.64 |
$20.50 |
$20.50 |
|
|
Drug of abuse screen urine
|
$12.60 |
$13.86 |
$13.86 |
|
|
Drug screening tapentadol
|
$37.02 |
$59.52 |
$68.21 |
|
|
Drug screen quant tiagabine
|
$27.11 |
$29.82 |
$29.82 |
|
|
Drug test def 15-21 classes
|
$198.74 |
$218.61 |
$218.61 |
|
|
Drug test def 1-7 classes
|
$114.43 |
$125.87 |
$143.20 |
|
|
Drug test def 22+ classes
|
$246.92 |
$271.61 |
$271.61 |
|
|
Drug test def 8-14 classes
|
$156.59 |
$172.25 |
$172.25 |
|
|
Drug test def simple all cl
|
$62.14 |
$68.35 |
$68.35 |
|
|
Drug test prsmv instrmnt
|
$17.14 |
$18.85 |
$18.85 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$62.14 |
$68.35 |
$68.35 |
|
|
Drvvt confirm - quest
|
$17.98 |
$19.78 |
$19.78 |
|
|
Dstrj extensive retinopathy
|
$3,786.00 |
$4,440.96 |
$6,839.00 |
|
|
Dstrj nulyt agt gnclr nrv
|
$2,134.14 |
$3,986.00 |
$6,839.00 |
|
|
Dstr mal les s/n/h/f/g >4.0
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Dstry eye lesn,fdr vssl tech
|
$599.55 |
$607.22 |
$646.06 |
|
|
Ductogram sgl duct
|
$264.17 |
$267.55 |
$284.66 |
|
|
Duodenal motility study
|
$579.88 |
$587.30 |
$624.87 |
|
|
Duplex scan bilateral study 93985
|
$230.13 |
$292.39 |
$610.17 |
|
|
Duplex scan unilateral study 93986
|
$116.22 |
$117.70 |
$125.23 |
|
|
Dup scan/hemodialysis access 93990
|
$98.55 |
$125.23 |
$359.16 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$170.99 |
$276.99 |
$473.73 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$257.61 |
$327.30 |
$607.32 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$81.82 |
$85.25 |
$85.25 |
|
|
Dxa bone density axl vrt fx
|
$114.42 |
$125.23 |
$253.15 |
|
|
Dx aly aud oi snd prcsr 1st
|
$74.77 |
$173.18 |
$184.26 |
|
|
Dx aly aud oi snd prcsr each
|
$17.70 |
$18.01 |
$18.13 |
|
|
Dx bronchoscope/brush 31623
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Dx bronchoscope/lavage 31624
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Dx bronchoscope/wash 31622
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Dx dark adaptation exam i&r
|
$436.10 |
$441.68 |
$469.93 |
|
|
Dx duod intub w/asp spec 43756
|
$1,024.64 |
$3,986.00 |
$6,839.00 |
|
|
Dx duod intub w/asp specs
|
$1,024.64 |
$3,986.00 |
$6,839.00 |
|
|
Dx gastr intub w/asp spec
|
$340.32 |
$3,986.00 |
$6,839.00 |
|
|
Dx gastr intub w/asp specs
|
$170.99 |
$3,986.00 |
$6,839.00 |
|
|
Dx laryngoscopy newborn
|
$424.38 |
$3,986.00 |
$6,839.00 |
|
|
Dx laryngoscopy w/oper scope
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Dynamic cavernosometry
|
$265.80 |
$3,986.00 |
$6,839.00 |
|
|
Dynamic surface emg
|
$340.32 |
$344.68 |
$366.72 |
|
|
Ear and throat examination
|
$556.55 |
$563.67 |
$599.72 |
|
|
Ear canal biopsy 69105
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Ear cartilage graft
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Ear irrigation 69209
|
$64.92 |
$3,986.00 |
$6,839.00 |
|
|
Ear protector evaluation
|
$42.90 |
$43.44 |
$46.22 |
|
|
Ecallantide injection
|
$565.83 |
$579.99 |
$579.99 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$64.92 |
$65.80 |
$78.61 |
|
|
Ecg < 30 days transmission & analysis
|
$100.32 |
$101.69 |
$287.13 |
|
|
Ecg external < 48 hours recording
|
$140.87 |
$237.44 |
$431.42 |
|