|
Esoph scope w/sclerosis inj
|
$1,671.20 |
$1,671.20 |
$1,671.20 |
$2,244.82
|
|
Esoph scope w/submucous inj
|
$2,046.40 |
$2,046.40 |
$2,046.40 |
$2,590.33
|
|
Established Patient Office Visit (level 1)
|
$388.00 |
$388.00 |
$388.00 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$167.20 |
$167.20 |
$167.20 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$193.60 |
$193.60 |
$193.60 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$248.80 |
$248.80 |
$248.80 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$311.20 |
$311.20 |
$311.20 |
$290.68
|
|
Ethanolamine oleate 100 mg
|
$1,257.65 |
$1,257.65 |
$1,257.65 |
$824.88
|
|
Etonogestrel implant system
|
$3,050.70 |
$3,050.70 |
$3,050.70 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$263.35 |
$263.35 |
$263.35 |
$235.20
|
|
Etoposide 50 mg cap
|
$151.13 |
$151.13 |
$151.13 |
$135.02
|
|
Eval aud funcj ea addl 15
|
$68.00 |
$68.00 |
$68.00 |
$69.60
|
|
Eval aud rehab status/first hr 92626
|
$267.20 |
$267.20 |
$267.20 |
$329.59
|
|
Eval/fit voice prosthesis iii, st
|
$473.60 |
$473.60 |
$473.60 |
$359.50
|
|
Evaluation heart device
|
$1,671.20 |
$1,671.20 |
$1,671.20 |
$2,199.00
|
|
Evaluation of speech fluency 92521
|
$388.80 |
$388.80 |
$388.80 |
$302.50
|
|
Evaluation psychiatric diagnostic
|
$426.40 |
$426.40 |
$426.40 |
$318.24
|
|
Evasc prlng admn rx agnt 1st
|
$5,438.40 |
$5,438.40 |
$5,438.40 |
$4,031.48
|
|
Evasc prlng admn rx agnt add
|
$2,734.40 |
$2,734.40 |
$2,734.40 |
$2,803.24
|
|
Evasc repair of iliac artery; endograft 34718
|
$25,407.20 |
$25,407.20 |
$25,407.20 |
$6,311.00
|
|
Evasc rpr a-ao ndgft 34701
|
$13,777.60 |
$13,777.60 |
$13,777.60 |
$5,403.50
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$17,221.60 |
$17,221.60 |
$17,221.60 |
$4,577.00
|
|
Evasc rpr a-biiliac ndgft rptr
|
$22,272.00 |
$22,272.00 |
$22,272.00 |
$8,565.60
|
|
Evasc rpr a-iliac ndgft 34717
|
$25,407.20 |
$25,407.20 |
$25,407.20 |
$4,919.00
|
|
Evasc rpr a-unilac ndgft 34703
|
$15,727.20 |
$15,727.20 |
$15,727.20 |
$5,741.00
|
|
Evasc rpr a-unilac ndgft rpt
|
$20,248.00 |
$20,248.00 |
$20,248.00 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$15,179.20 |
$15,179.20 |
$15,179.20 |
$7,060.51
|
|
Evasc rpr ilio-iliac rpt
|
$19,543.20 |
$19,543.20 |
$19,543.20 |
$7,922.00
|
|
Evoked auditory tst complete
|
$348.80 |
$348.80 |
$348.80 |
$357.41
|
|
Evoked oa emissions ltd
|
$236.00 |
$236.00 |
$236.00 |
$244.00
|
|
Evoked potentials auditory screening automated analysis
|
$282.40 |
$282.40 |
$282.40 |
$261.30
|
|
Evoked potentials upper limbs
|
$410.40 |
$410.40 |
$410.40 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$804.00 |
$804.00 |
$804.00 |
$814.61
|
|
Evok oa screening qual
|
$160.00 |
$160.00 |
$160.00 |
$109.13
|
|
Ewhfo w/joint(s) cf
|
$1,081.57 |
$1,081.57 |
$1,081.57 |
$1,363.60
|
|
Exam of vagina w/scope 57420
|
$684.80 |
$684.80 |
$684.80 |
$486.03
|
|
Exam plvc w/anes othr thn lcl
|
$3,476.00 |
$3,476.00 |
$3,476.00 |
$3,816.40
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$2,769.60 |
$2,769.60 |
$2,769.60 |
$2,306.25
|
|
Exc benign tal 0.5 < cm 11400
|
$763.20 |
$763.20 |
$763.20 |
$832.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$902.40 |
$902.40 |
$902.40 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$2,769.60 |
$2,769.60 |
$2,769.60 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$3,557.60 |
$3,557.60 |
$3,557.60 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$702.40 |
$702.40 |
$702.40 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,597.60 |
$1,597.60 |
$1,597.60 |
$1,314.67
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$3,612.80 |
$3,612.80 |
$3,612.80 |
$3,484.00
|
|
Exc forearm les sc 3 cm/>
|
$2,360.00 |
$2,360.00 |
$2,360.00 |
$3,628.50
|
|
Exc forearm tum deep < 3 cm
|
$3,642.40 |
$3,642.40 |
$3,642.40 |
$2,271.01
|
|
Exc forearm tum deep 3 cm/>
|
$3,943.20 |
$3,943.20 |
$3,943.20 |
$4,247.20
|
|
Exc hand les sc < 1.5 cm
|
$2,290.40 |
$2,290.40 |
$2,290.40 |
$1,908.09
|
|
Exc hand tum deep 1.5 cm/>
|
$4,551.20 |
$4,551.20 |
$4,551.20 |
$2,391.84
|
|
Exc hand tum deep < 1.5 cm 26116
|
$2,441.60 |
$2,441.60 |
$2,441.60 |
$2,391.84
|
|
Exchange biliary drg cath
|
$5,243.20 |
$5,243.20 |
$5,243.20 |
$3,856.84
|
|
Exchange drainage catheter
|
$3,089.60 |
$3,089.60 |
$3,089.60 |
$2,220.54
|
|
Exchange nephrostomy cath
|
$3,080.00 |
$3,080.00 |
$3,080.00 |
$2,958.80
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$2,111.20 |
$2,111.20 |
$2,111.20 |
$2,064.75
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$1,072.24
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$2,211.20 |
$2,211.20 |
$2,211.20 |
$2,865.00
|
|
Excision of gum flap
|
$1,522.40 |
$1,522.40 |
$1,522.40 |
$2,000.80
|
|
Exc malig snhfg 0.5cm or less 11620
|
$3,373.60 |
$3,373.60 |
$3,373.60 |
$1,377.57
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$1,441.60 |
$1,441.60 |
$1,441.60 |
$1,064.70
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$878.40 |
$878.40 |
$878.40 |
$889.20
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$3,041.60 |
$3,041.60 |
$3,041.60 |
$3,386.84
|
|
Exc sq tumor/forearm/wrist/<3cm 25075
|
$2,208.80 |
$2,208.80 |
$2,208.80 |
$2,924.22
|
|
Exc sq tum/vasc malform/hand/fngr 26111
|
$2,468.80 |
$2,468.80 |
$2,468.80 |
$1,917.33
|
|
Exc tendon sheath or cap lesion 26160
|
$2,508.00 |
$2,508.00 |
$2,508.00 |
$2,797.08
|
|
Exc thrombosed hemorrhoid 46320
|
$3,059.20 |
$3,059.20 |
$3,059.20 |
$2,175.36
|
|
Exercise tst brncspsm w/ecg
|
$370.40 |
$370.40 |
$370.40 |
$335.52
|
|
Exercise w/hemodynamic meas
|
$477.60 |
$477.60 |
$477.60 |
$901.60
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$4,625.60 |
$4,625.60 |
$4,625.60 |
$4,101.67
|
|
Expl lap celiotomy w/wo bx 49000
|
$4,859.20 |
$4,859.20 |
$4,859.20 |
$2,357.35
|
|
Exploration of foot joint
|
$3,708.80 |
$3,708.80 |
$3,708.80 |
$3,832.27
|
|
Explore limb vessels 35860
|
$4,551.20 |
$4,551.20 |
$4,551.20 |
$4,341.66
|
|
Explore penetrating wnd/extremity 20103
|
$2,091.20 |
$2,091.20 |
$2,091.20 |
$1,788.80
|
|
Explore/treat finger joint
|
$4,232.00 |
$4,232.00 |
$4,232.00 |
$3,839.54
|
|
Explore/treat finger joint
|
$2,195.20 |
$2,195.20 |
$2,195.20 |
$2,480.83
|
|
Explore wound abdomen 20102
|
$2,860.00 |
$2,860.00 |
$2,860.00 |
$2,784.80
|
|
Explore woundchest 20101
|
$2,690.40 |
$2,690.40 |
$2,690.40 |
$2,227.68
|
|
Expose art endoprosth iliac 34820
|
$2,055.20 |
$2,055.20 |
$2,055.20 |
$1,812.80
|
|
Exp w remove/deep fb/forearm/wrist 25248
|
$2,328.80 |
$2,328.80 |
$2,328.80 |
$3,623.43
|
|
Ext ecg>7d<15d scan a/r
|
$413.60 |
$413.60 |
$413.60 |
$345.60
|
|
Extended culture of oocytes
|
$424.00 |
$424.00 |
$424.00 |
$904.19
|
|
Extrnl counterpulse, per tx
|
$396.00 |
$396.00 |
$396.00 |
$431.60
|
|
Eye Socket (Orbit) X-ray
|
$459.20 |
$459.20 |
$459.20 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,584.00 |
$2,584.00 |
$2,584.00 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$2,128.00 |
$2,128.00 |
$2,128.00 |
$1,320.00
|
|
F-18 fdg pet diag
|
$371.20 |
$371.20 |
$371.20 |
$551.72
|
|
F-18 florbetapir less than or equal to 10 mci
|
$9,759.12 |
$9,759.12 |
$9,759.12 |
$5,224.83
|
|
F-18 fluciclovine per mci
|
$548.80 |
$548.80 |
$548.80 |
$1,042.30
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,974.40 |
$3,974.40 |
$3,974.40 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,872.80 |
$2,872.80 |
$2,872.80 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$250.40 |
$250.40 |
$250.40 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$442.40 |
$442.40 |
$442.40 |
$381.75
|
|
Factor ix complex
|
$16.80 |
$16.80 |
$16.80 |
$4.68
|
|
Factor ix idelvion inj
|
$16.80 |
$16.80 |
$16.80 |
$14.35
|
|
Factor ix non-recombinant
|
$16.80 |
$16.80 |
$16.80 |
$4.63
|
|
Factor ix recombinant nos
|
$16.80 |
$16.80 |
$16.80 |
$4.65
|
|
Factor viii
|
$16.80 |
$16.80 |
$16.80 |
$4.85
|
|
Factor viii recombinant nos
|
$2,219.04 |
$2,219.04 |
$2,219.04 |
$5.20
|
|
Factor viii recomb obizur
|
$2,371.80 |
$2,371.80 |
$2,371.80 |
$7.29
|