|
Drng peritoneal abscess open 49020
|
$2,389.50 |
$2,389.50 |
$2,389.50 |
|
|
Drng salivary gland simple 42300
|
$1,542.00 |
$2,353.80 |
$2,353.80 |
|
|
Drng salivary gland submax/subling 42310
|
$620.00 |
$620.00 |
$620.00 |
|
|
Dronabinol 2.5mg oral
|
$672.50 |
$672.50 |
$672.50 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$23.38 |
$23.38 |
$29.72 |
|
|
Drop lock knee
|
$79.18 |
$79.18 |
$79.18 |
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$785.56 |
$785.56 |
$785.56 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$16.04 |
$20.20 |
$20.20 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$18.63 |
$18.63 |
$18.63 |
|
|
Drsg sht 5.625x4.625in std
|
$34.16 |
$34.16 |
$34.16 |
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$2,050.00 |
$2,050.00 |
$2,050.00 |
|
|
Drug admin & hemodynmic meas
|
$261.50 |
$1,443.33 |
$1,443.33 |
|
|
Drug assay caffeine
|
$25.50 |
$88.83 |
$88.83 |
|
|
Drug assay posaconazole
|
$75.00 |
$243.73 |
$243.73 |
|
|
Drug assay rufinamide
|
$73.00 |
$168.45 |
$168.45 |
|
|
Drug assay vedolizumab
|
$104.95 |
$104.95 |
$157.00 |
|
|
Drug assay voriconazole
|
$73.00 |
$243.73 |
$243.73 |
|
|
Drug of abuse screen urine
|
$9.00 |
$96.53 |
$176.82 |
|
|
Drug screening tapentadol
|
$25.38 |
$25.38 |
$78.39 |
|
|
Drug screen quant tiagabine
|
$183.00 |
$183.00 |
$183.00 |
|
|
Drug/substance nos 4-6
|
$66.00 |
$66.00 |
$66.00 |
|
|
Drug test def 15-21 classes
|
$423.00 |
$423.00 |
$423.00 |
|
|
Drug test def 1-7 classes
|
$141.03 |
$141.03 |
$230.00 |
|
|
Drug test def 22+ classes
|
$563.95 |
$563.95 |
$563.95 |
|
|
Drug test def 8-14 classes
|
$282.00 |
$282.00 |
$282.00 |
|
|
Drug test prsmv instrmnt
|
$284.34 |
$284.34 |
$284.34 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$274.47 |
$330.53 |
$554.50 |
|
|
Drvvt confirm - quest
|
$107.00 |
$107.00 |
$150.00 |
|
|
Dry needling (97799)
|
$122.00 |
$122.00 |
$122.00 |
|
|
Dstrj nulyt agt gnclr nrv
|
$2,059.10 |
$2,059.10 |
$8,218.00 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$576.50 |
$576.50 |
$576.50 |
|
|
Ductogram sgl duct
|
$452.50 |
$452.50 |
$452.50 |
|
|
Duplex scan bilateral study 93985
|
$328.00 |
$1,050.83 |
$1,050.83 |
|
|
Duplex scan unilateral study 93986
|
$158.00 |
$525.43 |
$525.43 |
|
|
Dup scan/hemodialysis access 93990
|
$325.60 |
$325.60 |
$468.50 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$702.50 |
$936.03 |
$3,104.00 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$505.58 |
$505.58 |
$1,863.00 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$8,445.90 |
$8,445.90 |
$63,181.52 |
|
|
Dxa bone density axl vrt fx
|
$179.00 |
$179.00 |
$606.00 |
|
|
Dx bronchoscope/brush 31623
|
$1,919.50 |
$1,919.50 |
$1,919.50 |
|
|
Dx bronchoscope/lavage 31624
|
$1,919.50 |
$2,209.48 |
$9,570.00 |
|
|
Dx bronchoscope/wash 31622
|
$1,851.00 |
$1,851.00 |
$1,919.50 |
|
|
Dx intraop thoracic aorta Ultrasound
|
$1,780.05 |
$1,780.05 |
$1,780.05 |
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$1,780.05 |
$1,780.05 |
$1,780.05 |
|
|
Ear canal biopsy 69105
|
$1,643.00 |
$1,643.00 |
$12,907.00 |
|
|
Ear irrigation 69209
|
$54.00 |
$171.43 |
$171.43 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$106.00 |
$129.83 |
$129.83 |
|
|
Ecg < 30 days transmission & analysis
|
$389.00 |
$742.10 |
$742.10 |
|
|
Ecg external < 48 hours recording
|
$209.00 |
$781.90 |
$2,070.39 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$336.00 |
$688.95 |
$1,463.07 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$71.83 |
$71.83 |
$615.00 |
|
|
Ecg external >7 days up to 15 days recording
|
$118.13 |
$118.13 |
$1,231.00 |
|
|
Echocardiogram (Heart Ultrasound)
|
$1,643.50 |
$1,780.05 |
$3,668.28 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$487.10 |
$609.43 |
$3,258.00 |
|
|
Echocardiography doppler color flow mapping
|
$367.00 |
$432.25 |
$926.63 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,641.00 |
$1,780.05 |
$1,780.05 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$609.43 |
$609.43 |
$1,059.50 |
|
|
Echocardiograpy doppler follow up/limited study
|
$236.13 |
$236.13 |
$781.00 |
|
|
Echo exam of eye
|
$412.00 |
$412.00 |
$412.00 |
|
|
Echo exam of eye
|
$251.00 |
$251.00 |
$251.00 |
|
|
Echo exam of fetal heart
|
$765.73 |
$765.73 |
$1,114.50 |
|
|
Echo exam of fetal heart
|
$299.50 |
$481.55 |
$481.55 |
|
|
Echo exam of fetal heart
|
$142.00 |
$342.58 |
$342.58 |
|
|
Echo exam of fetal heart
|
$142.00 |
$279.13 |
$279.13 |
|
|
Echo exam uterus 76831-
|
$497.93 |
$497.93 |
$615.00 |
|
|
Echograp trans r pros study
|
$406.33 |
$406.33 |
$1,189.13 |
|
|
Echo guidance radiotherapy
|
$410.13 |
$410.13 |
$1,162.50 |
|
|
Echo guide for amniocentesis
|
$316.58 |
$316.58 |
$853.50 |
|
|
Echo guide for artery repair
|
$401.68 |
$401.68 |
$472.50 |
|
|
Echo guide for transfusion
|
$285.00 |
$285.00 |
$285.00 |
|
|
Echo guide villus sampling
|
$362.88 |
$362.88 |
$362.88 |
|
|
Echo stress
|
$1,031.28 |
$1,031.28 |
$1,308.00 |
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$688.43 |
$688.43 |
$1,478.50 |
|
|
Echo tee guidance
|
$1,847.00 |
$2,939.05 |
$2,939.05 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,162.50 |
$1,591.63 |
$6,818.00 |
|
|
Echo transesophageal
|
$1,088.33 |
$1,088.33 |
$1,478.50 |
|
|
Echo transesophageal
|
$982.50 |
$2,101.65 |
$2,101.65 |
|
|
Echo transesophageal intraop
|
$1,571.70 |
$1,571.70 |
$1,571.70 |
|
|
Echo transthoracic
|
$881.70 |
$881.70 |
$3,333.65 |
|
|
Echo transthoracic
|
$418.90 |
$418.90 |
$418.90 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$823.50 |
$823.50 |
$856.90 |
|
|
Ecmo/ecls daily mgmt artery 33949
|
$2,250.00 |
$10,638.35 |
$10,638.35 |
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$2,250.00 |
$10,638.35 |
$10,638.35 |
|
|
Ecmo/ecls initiation artery 33947
|
$21,849.00 |
$21,849.00 |
$21,849.00 |
|
|
Ecmo/ecls initiation venous 33946
|
$21,849.00 |
$21,849.00 |
$21,849.00 |
|
|
Ecmo/ecls insj prph cannula 0-5yrs perq 33951
|
$6,452.18 |
$6,452.18 |
$6,452.18 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$6,452.18 |
$6,452.18 |
$6,452.18 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$2,224.45 |
$2,224.45 |
$2,224.45 |
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$6,452.18 |
$6,452.18 |
$6,452.18 |
|
|
Ecog impltd brn npgt <30 d
|
$85.68 |
$85.68 |
$85.68 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$13,071.00 |
$13,071.00 |
$13,071.00 |
|
|
Eculizumab injection
|
$57,747.97 |
$57,747.97 |
$94,944.22 |
|
|
Edetate calcium disodium inj
|
$458.38 |
$458.38 |
$458.38 |
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$50.20 |
$50.20 |
$50.20 |
|
|
Eeg 41-60 minutes 95812-26
|
$283.00 |
$721.73 |
$1,576.00 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$263.00 |
$1,571.65 |
$1,571.65 |
|
|
Eeg during surgery
|
$740.50 |
$1,309.15 |
$1,309.15 |
|
|
Eeg monitoring/function test
|
$565.00 |
$1,165.55 |
$1,165.55 |
|
|
Eeg monitor/record/awake/drowsy 95816
|
$635.50 |
$828.58 |
$980.00 |
|
|
Eeg over 1 hour 95813 - 26
|
$321.50 |
$1,072.93 |
$1,072.93 |
|