|
Drng hand tendon sheath 26020
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
|
|
Drng of eyelid abscess 67700
|
$199.80 |
$353.74 |
$1,896.00 |
|
|
Drng of finger abscess comp 26011
|
$795.60 |
$1,917.33 |
$5,894.00 |
|
|
Drng of hydrocele 55000
|
$832.60 |
$832.60 |
$832.60 |
|
|
Drng of mouth lesion 40801
|
$602.63 |
$602.63 |
$1,693.00 |
|
|
Drng of ovarian cyst(s) 58800
|
$3,762.53 |
$3,762.53 |
$8,558.00 |
|
|
Drng of palm multi bursas 26030
|
$3,839.54 |
$3,839.54 |
$8,441.76 |
|
|
Drng of palm single bursa 26025
|
$3,839.54 |
$3,839.54 |
$7,612.10 |
|
|
Drng of pelvic abscess transrectal 45000
|
$1,395.28 |
$1,395.28 |
$1,395.28 |
|
|
Drng of salivary cyst 42409
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
|
|
Drng of scrotum abscess 55100
|
$795.60 |
$1,917.33 |
$8,553.00 |
|
|
Drng salivary gland simple 42300
|
$1,752.89 |
$1,752.89 |
$3,611.00 |
|
|
Drng salivary gland submax/subling 42310
|
$602.63 |
$602.63 |
$2,892.00 |
|
|
Dronabinol 2.5mg oral
|
$10.17 |
$10.17 |
$10.17 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$12.96 |
$12.96 |
$21.60 |
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,493.40 |
$1,493.40 |
$1,493.40 |
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$9.26 |
$28.17 |
$127.14 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$19.24 |
$127.14 |
$685.67 |
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$90.64 |
$127.14 |
$127.14 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$121.80 |
$127.14 |
$127.14 |
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Drug admin & hemodynmic meas
|
$265.94 |
$265.94 |
$3,234.00 |
|
|
Drug assay caffeine
|
$38.57 |
$38.57 |
$211.00 |
|
|
Drug assay posaconazole
|
$27.11 |
$27.11 |
$425.00 |
|
|
Drug assay rufinamide
|
$27.11 |
$27.11 |
$78.59 |
|
|
Drug assay vedolizumab
|
$38.57 |
$38.57 |
$194.00 |
|
|
Drug assay voriconazole
|
$27.11 |
$27.11 |
$93.16 |
|
|
Drug asy hydroxychloroquine
|
$18.64 |
$18.64 |
$54.04 |
|
|
Drug of abuse screen urine
|
$12.60 |
$12.60 |
$62.56 |
|
|
Drug screening tapentadol
|
$92.85 |
$99.11 |
$102.83 |
|
|
Drug screen quant tiagabine
|
$27.11 |
$27.11 |
$27.11 |
|
|
Drug/substance nos 4-6
|
$602.26 |
$671.32 |
$826.24 |
|
|
Drug test def 15-21 classes
|
$198.74 |
$198.74 |
$717.00 |
|
|
Drug test def 1-7 classes
|
$49.80 |
$114.43 |
$239.05 |
|
|
Drug test def 22+ classes
|
$246.92 |
$246.92 |
$890.81 |
|
|
Drug test def 8-14 classes
|
$156.59 |
$156.59 |
$564.94 |
|
|
Drug test def simple all cl
|
$62.14 |
$62.14 |
$210.55 |
|
|
Drug test prsmv instrmnt
|
$17.14 |
$17.14 |
$64.79 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$52.80 |
$62.14 |
$204.00 |
|
|
Drvvt confirm - quest
|
$17.98 |
$17.98 |
$109.80 |
|
|
Dstrj extensive retinopathy
|
$4,462.45 |
$4,462.45 |
$9,033.15 |
|
|
Dstrj nulyt agt gnclr nrv
|
$1,220.40 |
$2,310.83 |
$5,608.60 |
|
|
Dstr mal les s/n/h/f/g >4.0
|
$472.79 |
$472.79 |
$1,107.30 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$472.79 |
$472.79 |
$1,107.30 |
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$724.37 |
$724.37 |
$1,331.20 |
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$724.37 |
$755.08 |
$1,651.23 |
|
|
Dstry eye lesn,fdr vssl tech
|
$649.19 |
$649.19 |
$649.19 |
|
|
Ductogram sgl duct
|
$286.04 |
$286.04 |
$2,109.00 |
|
|
Duodenal motility study
|
$627.89 |
$627.89 |
$627.89 |
|
|
Duplex scan bilateral study 93985
|
$286.04 |
$286.04 |
$2,169.00 |
|
|
Duplex scan unilateral study 93986
|
$125.84 |
$125.84 |
$1,445.00 |
|
|
Dup scan/hemodialysis access 93990
|
$125.84 |
$125.84 |
$1,355.00 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$185.15 |
$220.60 |
$1,789.00 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$286.04 |
$286.04 |
$3,655.00 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$81.82 |
$81.82 |
$1,444.77 |
|
|
Dxa bone density axl vrt fx
|
$125.84 |
$125.84 |
$827.00 |
|
|
Dx aly aud oi snd prcsr 1st
|
$185.15 |
$185.15 |
$403.87 |
|
|
Dx aly aud oi snd prcsr each
|
$164.07 |
$167.82 |
$201.94 |
|
|
Dx bronchoscope/brush 31623
|
$2,040.67 |
$2,040.67 |
$4,810.08 |
|
|
Dx bronchoscope/lavage 31624
|
$2,040.67 |
$2,040.67 |
$5,668.00 |
|
|
Dx bronchoscope/wash 31622
|
$740.40 |
$2,040.67 |
$4,810.08 |
|
|
Dx dark adaptation exam i&r
|
$472.21 |
$472.21 |
$472.21 |
|
|
Dx duod intub w/asp spec 43756
|
$1,109.47 |
$1,109.47 |
$1,109.47 |
|
|
Dx duod intub w/asp specs
|
$1,109.47 |
$1,109.47 |
$1,109.47 |
|
|
Dx gastr intub w/asp spec
|
$368.50 |
$368.50 |
$870.76 |
|
|
Dx gastr intub w/asp specs
|
$185.15 |
$185.15 |
$185.15 |
|
|
Dx laryngoscopy newborn
|
$459.51 |
$459.51 |
$459.51 |
|
|
Dx laryngoscopy w/oper scope
|
$2,040.67 |
$2,040.67 |
$4,190.10 |
|
|
Dynamic cavernosometry
|
$287.81 |
$287.81 |
$287.81 |
|
|
Dynamic surface emg
|
$368.50 |
$368.50 |
$368.50 |
|
|
Ear and throat examination
|
$602.63 |
$602.63 |
$602.63 |
|
|
Ear canal biopsy 69105
|
$1,752.89 |
$1,752.89 |
$3,239.40 |
|
|
Ear cartilage graft
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
|
|
Ear irrigation 69209
|
$47.40 |
$70.29 |
$882.00 |
|
|
Ear protector evaluation
|
$46.45 |
$46.45 |
$46.45 |
|
|
Ecallantide injection
|
$565.83 |
$565.83 |
$17,228.90 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$70.29 |
$70.29 |
$333.00 |
|
|
Ecg < 30 days transmission & analysis
|
$108.62 |
$108.62 |
$1,961.00 |
|
|
Ecg external < 48 hours recording
|
$152.54 |
$152.54 |
$1,206.00 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$70.29 |
$70.29 |
$1,813.00 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$46.45 |
$46.45 |
$361.00 |
|
|
Ecg external >7 days up to 15 days recording
|
$46.45 |
$46.45 |
$361.00 |
|
|
Echocardiogram (Heart Ultrasound)
|
$648.84 |
$648.84 |
$6,020.00 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$286.04 |
$286.04 |
$2,302.00 |
|
|
Echocardiography doppler color flow mapping
|
$164.42 |
$327.57 |
$2,107.00 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$934.93 |
$934.93 |
$2,240.14 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$422.61 |
$422.61 |
$1,662.25 |
|
|
Echocardiograpy doppler follow up/limited study
|
$264.60 |
$497.00 |
$625.88 |
|
|
Echo exam of eye
|
$125.84 |
$125.84 |
$425.45 |
|
|
Echo exam of eye
|
$125.84 |
$125.84 |
$777.00 |
|
|
Echo exam of eye
|
$104.19 |
$104.19 |
$238.91 |
|
|
Echo exam of eye thickness
|
$28.98 |
$29.55 |
$274.00 |
|
|
Echo exam of fetal heart
|
$648.84 |
$648.84 |
$3,030.00 |
|
|
Echo exam of fetal heart
|
$286.04 |
$286.04 |
$3,131.00 |
|
|
Echo exam of fetal heart
|
$125.84 |
$125.84 |
$1,720.00 |
|
|
Echo exam of fetal heart
|
$125.84 |
$125.84 |
$999.00 |
|
|
Echo exam uterus 76831-
|
$286.04 |
$286.04 |
$3,799.00 |
|
