|
Doppler upper/lower extremity arteries complete bilateral
|
$482.35 |
$482.35 |
$517.84 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$335.52 |
$335.52 |
$360.21 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$36,623.70 |
$36,623.70 |
$45,075.32 |
$34,278.00
|
|
Dorsi & plantar flex ass/res
|
$166.66 |
$166.66 |
$205.12 |
$163.44
|
|
Dpyd gene common variants
|
$488.01 |
$488.01 |
$600.63 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,994.36 |
$1,994.36 |
$2,141.10 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,899.40 |
$1,899.40 |
$1,912.34 |
$964.00
|
|
Drainage external ear complex 69005
|
$4,246.30 |
$4,246.30 |
$4,582.16 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$1,994.36 |
$1,994.36 |
$2,141.10 |
$790.40
|
|
Drainage mouth roof lesion
|
$618.08 |
$618.08 |
$663.57 |
$405.60
|
|
Drainage of arm bursa 23931
|
$4,582.16 |
$4,582.16 |
$4,919.31 |
$2,271.01
|
|
Drainage of eye
|
$4,946.91 |
$4,946.91 |
$4,946.91 |
$2,415.65
|
|
Drainage of eye
|
$3,549.34 |
$3,549.34 |
$3,549.34 |
$3,170.00
|
|
Drainage of kidney lesion
|
$1,994.36 |
$1,994.36 |
$2,141.10 |
$1,506.00
|
|
Drainage of mouth lesion
|
$586.66 |
$586.66 |
$722.05 |
$535.20
|
|
Drainage of mouth lesion
|
$3,762.02 |
$3,762.02 |
$4,250.09 |
$2,320.03
|
|
Drainage of mouth lesion
|
$7,267.74 |
$7,267.74 |
$7,390.54 |
$3,837.72
|
|
Drainage of mouth lesion
|
$1,628.32 |
$1,628.32 |
$1,628.32 |
$1,008.80
|
|
Drainage of mouth lesion
|
$11,200.30 |
$11,200.30 |
$14,293.47 |
$6,781.90
|
|
Drainage of mouth lesion
|
$4,858.50 |
$4,858.50 |
$4,858.50 |
$3,459.00
|
|
Drainage of nose lesion int 30000
|
$618.08 |
$618.08 |
$663.57 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$1,628.32 |
$1,628.32 |
$1,628.32 |
$781.44
|
|
Drainage of rectal abscess
|
$3,126.62 |
$3,126.62 |
$3,186.98 |
$2,135.10
|
|
Drainage of rectal abscess 45020
|
$7,499.82 |
$7,499.82 |
$7,499.82 |
$3,816.64
|
|
Drainage of throat abscess
|
$9,633.61 |
$9,633.61 |
$9,633.61 |
$6,499.33
|
|
Drain bladder by trocar/cath
|
$3,243.02 |
$3,243.02 |
$3,243.02 |
$1,203.94
|
|
Drain blood from under nail 11740
|
$335.52 |
$335.52 |
$360.21 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$4,582.16 |
$4,582.16 |
$4,919.31 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$4,582.16 |
$4,582.16 |
$4,919.31 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$852.20 |
$852.20 |
$1,390.48 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$584.21 |
$584.21 |
$627.20 |
$428.40
|
|
Drain lower leg lesion 27603
|
$7,746.22 |
$7,746.22 |
$7,746.22 |
$3,994.09
|
|
Drain neck/chest lesion 21501
|
$5,754.62 |
$5,754.62 |
$5,754.62 |
$3,339.00
|
|
Drain ovarn cyst abd
|
$7,587.16 |
$7,587.16 |
$7,627.40 |
$3,786.00
|
|
Drain thigh/knee lesion 27301
|
$5,776.90 |
$5,776.90 |
$8,316.18 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$584.21 |
$584.21 |
$627.20 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$584.21 |
$584.21 |
$627.20 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$541.00
|
|
Drm agrft t/a/l ea addl
|
$4,141.43 |
$4,141.43 |
$4,141.43 |
$1,793.59
|
|
Drng of eyelid abscess 67700
|
$918.99 |
$918.99 |
$986.61 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$4,582.16 |
$4,582.16 |
$4,919.31 |
$2,079.50
|
|
Drng of mouth lesion 40801
|
$1,628.32 |
$1,628.32 |
$1,628.32 |
$1,350.97
|
|
Drng of palm multi bursas 26030
|
$8,441.76 |
$8,441.76 |
$8,441.76 |
$3,839.54
|
|
Drng of palm single bursa 26025
|
$6,184.83 |
$6,184.83 |
$7,612.10 |
$3,839.54
|
|
Drng of scrotum abscess 55100
|
$4,582.16 |
$4,582.16 |
$4,919.31 |
$1,997.89
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$24.08 |
$24.08 |
$28.17 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$19.24 |
$19.24 |
$36.12 |
$193.15
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$90.64 |
$90.64 |
$90.64 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$121.80 |
$121.80 |
$121.80 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$265.94 |
$265.94 |
$265.94 |
$569.75
|
|
Drug assay caffeine
|
$113.07 |
$113.07 |
$139.17 |
$80.00
|
|
Drug assay posaconazole
|
$75.69 |
$75.69 |
$93.16 |
$96.75
|
|
Drug assay rufinamide
|
$63.86 |
$63.86 |
$78.59 |
$87.10
|
|
Drug assay vedolizumab
|
$80.18 |
$80.18 |
$98.69 |
$154.00
|
|
Drug assay voriconazole
|
$75.69 |
$75.69 |
$93.16 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$43.91 |
$43.91 |
$54.04 |
$66.43
|
|
Drug of abuse screen urine
|
$35.17 |
$35.17 |
$43.29 |
$67.89
|
|
Drug screening tapentadol
|
$99.11 |
$99.11 |
$99.11 |
$47.03
|
|
Drug/substance nos 4-6
|
$671.32 |
$671.32 |
$826.24 |
$72.14
|
|
Drug test def 15-21 classes
|
$582.56 |
$582.56 |
$717.00 |
$322.50
|
|
Drug test def 1-7 classes
|
$186.98 |
$186.98 |
$230.13 |
$263.25
|
|
Drug test def 22+ classes
|
$723.78 |
$723.78 |
$890.81 |
$426.24
|
|
Drug test def 8-14 classes
|
$459.01 |
$459.01 |
$564.94 |
$289.80
|
|
Drug test def simple all cl
|
$210.55 |
$210.55 |
$210.55 |
$68.35
|
|
Drug test prsmv instrmnt
|
$52.64 |
$52.64 |
$64.79 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$121.92 |
$121.92 |
$150.06 |
$278.85
|
|
Drvvt confirm - quest
|
$65.05 |
$65.05 |
$80.06 |
$109.20
|
|
Dstrj extensive retinopathy
|
$9,033.15 |
$9,033.15 |
$9,033.15 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$4,556.99 |
$4,556.99 |
$5,608.60 |
$2,980.00
|
|
Dstr mal les s/n/h/f/g >4.0
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$1,331.20 |
$1,331.20 |
$1,331.20 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$886.40
|
|
Ductogram sgl duct
|
$579.34 |
$579.34 |
$579.34 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$498.22 |
$498.22 |
$646.80 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$312.03 |
$312.03 |
$498.22 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$425.45 |
$425.45 |
$456.76 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$482.35 |
$482.35 |
$517.84 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$875.65 |
$875.65 |
$940.07 |
$904.78
|
|
Dx aly aud oi snd prcsr 1st
|
$328.15 |
$328.15 |
$403.87 |
$186.40
|
|
Dx aly aud oi snd prcsr each
|
$164.07 |
$164.07 |
$201.94 |
$51.52
|
|
Dx bronchoscope/brush 31623
|
$4,480.42 |
$4,480.42 |
$4,810.08 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$4,480.42 |
$4,480.42 |
$4,810.08 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$4,480.42 |
$4,480.42 |
$4,810.08 |
$2,410.50
|
|
Dx gastr intub w/asp spec
|
$825.66 |
$825.66 |
$870.76 |
$441.60
|
|
Dx laryngoscopy w/oper scope
|
$3,404.45 |
$3,404.45 |
$4,190.10 |
$2,755.53
|
|
Ear canal biopsy 69105
|
$3,239.40 |
$3,239.40 |
$3,239.40 |
$1,889.50
|
|
Ear irrigation 69209
|
$192.19 |
$192.19 |
$206.34 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$192.19 |
$192.19 |
$192.19 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$410.43 |
$410.43 |
$410.43 |
$412.88
|
|
Ecg external < 48 hours recording
|
$335.52 |
$335.52 |
$360.21 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$335.52 |
$335.52 |
$360.21 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$89.86 |
$89.86 |
$110.60 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$143.86 |
$143.86 |
$177.06 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,734.50 |
$1,734.50 |
$1,862.10 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$875.65 |
$875.65 |
$940.07 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$164.42 |
$164.42 |
$246.02 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,086.62 |
$2,086.62 |
$2,240.14 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,383.57 |
$1,383.57 |
$1,485.38 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$625.88 |
$625.88 |
$625.88 |
$371.25
|
