|
Drng of mouth lesion 40801
|
$1,191.84 |
$1,191.84 |
$1,191.84 |
$1,392.50
|
|
Drng of ovarian cyst(s) 58800
|
$195.14 |
$195.14 |
$195.14 |
$3,474.84
|
|
Drng of palm multi bursas 26030
|
$308.88 |
$308.88 |
$308.88 |
$3,839.54
|
|
Drng of palm single bursa 26025
|
$262.46 |
$262.46 |
$262.46 |
$3,821.05
|
|
Drng of pelvic abscess transrectal 45000
|
$265.54 |
$265.54 |
$265.54 |
$2,295.30
|
|
Drng of salivary cyst 42409
|
$7,588.62 |
$7,588.62 |
$7,588.62 |
$3,819.23
|
|
Drng of scrotum abscess 55100
|
$104.28 |
$104.28 |
$104.28 |
$1,997.89
|
|
Drng open retroperitoneal abscess 49060
|
$682.88 |
$682.88 |
$682.88 |
$1,905.70
|
|
Drng open subdiaphragmatic/subphrenic absc 49040
|
$622.38 |
$622.38 |
$622.38 |
$1,490.40
|
|
Drng ovary abscess perqt 58822
|
$441.10 |
$441.10 |
$441.10 |
$2,161.64
|
|
Drng peritoneal abscess open 49020
|
$984.50 |
$984.50 |
$984.50 |
$2,520.00
|
|
Drng salivary gland simple 42300
|
$3,466.32 |
$3,466.32 |
$3,466.32 |
$2,113.90
|
|
Drng salivary gland submax/subling 42310
|
$1,191.84 |
$1,191.84 |
$1,191.84 |
$799.40
|
|
Droperidol 2.5 mg/ml injection solution
|
$8.19 |
$8.19 |
$8.19 |
$31.07
|
|
Drug admin & hemodynmic meas
|
$59.40 |
$59.40 |
$59.40 |
$569.75
|
|
Drug assay caffeine
|
$25.52 |
$25.52 |
$25.52 |
$80.00
|
|
Drug assay posaconazole
|
$142.74 |
$142.74 |
$142.74 |
$96.75
|
|
Drug assay rufinamide
|
$142.74 |
$142.74 |
$142.74 |
$87.10
|
|
Drug assay vedolizumab
|
$202.80 |
$202.80 |
$202.80 |
$154.00
|
|
Drug assay voriconazole
|
$142.74 |
$142.74 |
$142.74 |
$96.75
|
|
Drug of abuse screen urine
|
$66.30 |
$66.30 |
$66.30 |
$67.50
|
|
Drug screen quant tiagabine
|
$18.04 |
$18.04 |
$18.04 |
$107.59
|
|
Drug test def 15-21 classes
|
$1,046.76 |
$1,046.76 |
$1,046.76 |
$322.50
|
|
Drug test def 22+ classes
|
$1,300.26 |
$1,300.26 |
$1,300.26 |
$426.24
|
|
Drug test def 8-14 classes
|
$824.46 |
$824.46 |
$824.46 |
$289.80
|
|
Drug test prsmv instrmnt
|
$11.44 |
$11.44 |
$11.44 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$326.82 |
$326.82 |
$326.82 |
$278.85
|
|
Drvvt confirm - quest
|
$95.16 |
$95.16 |
$95.16 |
$109.20
|
|
Dry needling (97799)
|
$0.22 |
$0.22 |
$0.22 |
$114.27
|
|
Dstrj extensive retinopathy
|
$154.22 |
$154.22 |
$154.22 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$90.42 |
$90.42 |
$90.42 |
$3,020.80
|
|
Dstr mal les s/n/h/f/g >4.0
|
$124.74 |
$124.74 |
$124.74 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$105.16 |
$105.16 |
$105.16 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$122.98 |
$122.98 |
$122.98 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$167.86 |
$167.86 |
$167.86 |
$886.40
|
|
Ductogram sgl duct
|
$10.56 |
$10.56 |
$10.56 |
$484.25
|
|
Duodenal exclusion
|
$1,106.60 |
$1,106.60 |
$1,106.60 |
$3,917.10
|
|
Duodenal motility study
|
$43.78 |
$43.78 |
$43.78 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$707.46 |
$707.46 |
$707.46 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$311.22 |
$311.22 |
$311.22 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$14.08 |
$14.08 |
$14.08 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$457.86 |
$457.86 |
$457.86 |
$748.15
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$707.46 |
$707.46 |
$707.46 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$342.42 |
$342.42 |
$342.42 |
$397.65
|
|
Dx bronchoscope/brush 31623
|
$80.30 |
$80.30 |
$80.30 |
$2,144.41
|
|
Dx bronchoscope/lavage 31624
|
$81.40 |
$81.40 |
$81.40 |
$2,457.88
|
|
Dx bronchoscope/wash 31622
|
$80.52 |
$80.52 |
$80.52 |
$2,459.93
|
|
Dx duod intub w/asp spec 43756
|
$30.80 |
$30.80 |
$30.80 |
$1,075.20
|
|
Dx duod intub w/asp specs
|
$47.08 |
$47.08 |
$47.08 |
$1,406.58
|
|
Dx gastr intub w/asp spec
|
$23.54 |
$23.54 |
$23.54 |
$441.60
|
|
Dx gastr intub w/asp specs
|
$36.74 |
$36.74 |
$36.74 |
$299.04
|
|
Dx laryngoscopy newborn
|
$96.58 |
$96.58 |
$96.58 |
$649.74
|
|
Dx laryngoscopy w/oper scope
|
$97.02 |
$97.02 |
$97.02 |
$2,755.53
|
|
Dynamic cavernosometry
|
$71.50 |
$71.50 |
$71.50 |
$3,442.40
|
|
Dynamic fine wire emg
|
$10.34 |
$10.34 |
$10.34 |
$374.29
|
|
Dynamic surface emg
|
$13.20 |
$13.20 |
$13.20 |
$368.50
|
|
Ear and throat examination
|
$58.52 |
$58.52 |
$58.52 |
$602.63
|
|
Ear canal biopsy 69105
|
$39.82 |
$39.82 |
$39.82 |
$1,889.50
|
|
Ear cartilage graft
|
$352.44 |
$352.44 |
$352.44 |
$6,385.40
|
|
Ear irrigation 69209
|
$139.62 |
$139.62 |
$139.62 |
$154.70
|
|
Ecg/1-3 leads/interp & report only 93042
|
$4.18 |
$4.18 |
$4.18 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$139.62 |
$139.62 |
$139.62 |
$133.60
|
|
Ecg < 30 days transmission & analysis
|
$214.50 |
$214.50 |
$214.50 |
$410.43
|
|
Ecg external < 48 hours recording
|
$301.86 |
$301.86 |
$301.86 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$139.62 |
$139.62 |
$139.62 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$92.04 |
$92.04 |
$92.04 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$92.04 |
$92.04 |
$92.04 |
$173.40
|
|
Ecg/review interpret only
|
$14.74 |
$14.74 |
$14.74 |
$52.80
|
|
Echocardiogram (Heart Ultrasound)
|
$1,283.10 |
$1,283.10 |
$1,283.10 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$565.50 |
$565.50 |
$565.50 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$962.52 |
$962.52 |
$962.52 |
$520.50
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,848.60 |
$1,848.60 |
$1,848.60 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$836.16 |
$836.16 |
$836.16 |
$868.56
|
|
Echocardiograpy doppler follow up/limited study
|
$962.52 |
$962.52 |
$962.52 |
$372.60
|
|
Echo exam of eye
|
$13.86 |
$13.86 |
$13.86 |
$143.75
|
|
Echo exam of eye
|
$18.48 |
$18.48 |
$18.48 |
$172.00
|
|
Echo exam of eye
|
$386.10 |
$386.10 |
$386.10 |
$178.85
|
|
Echo exam of eye thickness
|
$4.84 |
$4.84 |
$4.84 |
$39.77
|
|
Echo exam of fetal heart
|
$48.18 |
$48.18 |
$48.18 |
$904.80
|
|
Echo exam of fetal heart
|
$23.98 |
$23.98 |
$23.98 |
$539.56
|
|
Echo exam of fetal heart
|
$16.94 |
$16.94 |
$16.94 |
$431.41
|
|
Echo exam of fetal heart
|
$16.06 |
$16.06 |
$16.06 |
$318.34
|
|
Echo exam uterus 76831-
|
$1,060.80 |
$1,060.80 |
$1,060.80 |
$562.85
|
|
Echograp trans r pros study
|
$46.86 |
$46.86 |
$46.86 |
$468.00
|
|
Echo guidance radiotherapy
|
$41.80 |
$41.80 |
$41.80 |
$812.00
|
|
Echo guidance radiotherapy
|
$19.58 |
$19.58 |
$19.58 |
$322.40
|
|
Echo guide for amniocentesis
|
$580.32 |
$580.32 |
$580.32 |
$456.30
|
|
Echo guide for artery repair
|
$1,366.56 |
$1,366.56 |
$1,366.56 |
$699.76
|
|
Echo guide for heart biopsy
|
$21.56 |
$21.56 |
$21.56 |
$666.40
|
|
Echo guide for transfusion
|
$39.16 |
$39.16 |
$39.16 |
$332.39
|
|
Echo guide ova aspiration
|
$20.46 |
$20.46 |
$20.46 |
$174.20
|
|
Echo guide villus sampling
|
$19.58 |
$19.58 |
$19.58 |
$362.88
|
|
Echo stress
|
$1,283.10 |
$1,283.10 |
$1,283.10 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$15.62 |
$15.62 |
$15.62 |
$751.34
|
|
Echo tee guidance
|
$136.62 |
$136.62 |
$136.62 |
$1,854.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,283.10 |
$1,283.10 |
$1,283.10 |
$1,913.60
|
|
Echo transesophageal
|
$6.82 |
$6.82 |
$6.82 |
$1,067.95
|
|
Echo transesophageal
|
$54.34 |
$54.34 |
$54.34 |
$588.00
|
|
Echo transesophageal
|
$76.34 |
$76.34 |
$76.34 |
$1,650.00
|
|
Echo transesophageal
|
$53.68 |
$53.68 |
$53.68 |
$603.20
|
