|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$3.40 |
$3.40 |
$3.40 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$27.96 |
$27.96 |
$27.96 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$133.60 |
$133.60 |
$133.60 |
$98.15
|
|
Dna antibody native/double stranded
|
$80.00 |
$80.00 |
$80.00 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$142.68 |
$142.68 |
$142.68 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$111.88 |
$111.88 |
$111.88 |
$65.40
|
|
Doppler echo complete
|
$548.00 |
$548.00 |
$548.00 |
$558.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$39.76 |
$39.76 |
$39.76 |
$89.34
|
|
Drainage external ear simple 69000
|
$616.00 |
$616.00 |
$616.00 |
$790.40
|
|
Drainage of arm bursa 23931
|
$2,491.20 |
$2,491.20 |
$2,491.20 |
$2,271.01
|
|
Drain blood from under nail 11740
|
$232.00 |
$232.00 |
$232.00 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$472.80 |
$472.80 |
$472.80 |
$428.40
|
|
Drain lower leg lesion 27603
|
$2,920.00 |
$2,920.00 |
$2,920.00 |
$3,994.09
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$492.00 |
$492.00 |
$492.00 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$353.60 |
$353.60 |
$353.60 |
$349.50
|
|
Drug assay vedolizumab
|
$193.60 |
$193.60 |
$193.60 |
$154.00
|
|
Drug of abuse screen urine
|
$61.60 |
$61.60 |
$61.60 |
$67.89
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$316.80 |
$316.80 |
$316.80 |
$278.85
|
|
Drvvt confirm - quest
|
$167.20 |
$167.20 |
$167.20 |
$109.20
|
|
Dry needling (97799)
|
$108.00 |
$108.00 |
$108.00 |
$114.27
|
|
Ear irrigation 69209
|
$102.40 |
$102.40 |
$102.40 |
$154.70
|
|
Ecg external < 48 hours recording
|
$256.00 |
$256.00 |
$256.00 |
$467.40
|
|
Ecg external > 48 hours up to 7 days recording
|
$364.80 |
$364.80 |
$364.80 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$218.40 |
$218.40 |
$218.40 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,661.60 |
$1,661.60 |
$1,661.60 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$632.00 |
$632.00 |
$632.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$450.40 |
$450.40 |
$450.40 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,002.40 |
$2,002.40 |
$2,002.40 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$348.80 |
$348.80 |
$348.80 |
$371.25
|
|
Echo stress
|
$1,854.40 |
$1,854.40 |
$1,854.40 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,469.60 |
$2,469.60 |
$2,469.60 |
$1,913.60
|
|
Echo transthoracic
|
$1,204.80 |
$1,204.80 |
$1,204.80 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$1,033.00
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$108.00 |
$108.00 |
$108.00 |
$94.32
|
|
Egd dilate stricture
|
$2,283.20 |
$2,283.20 |
$2,283.20 |
$2,394.60
|
|
Egd endo mucosal resection
|
$2,396.80 |
$2,396.80 |
$2,396.80 |
$2,430.40
|
|
Egd remove lesion snare
|
$2,397.60 |
$2,397.60 |
$2,397.60 |
$2,597.25
|
|
EKG (Electrocardiogram)
|
$103.20 |
$103.20 |
$103.20 |
$89.60
|
|
EKG tracing for initial prev
|
$60.00 |
$60.00 |
$60.00 |
$81.76
|
|
EKG (Tracing Only)
|
$177.60 |
$177.60 |
$177.60 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$177.60 |
$177.60 |
$177.60 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$241.60 |
$241.60 |
$241.60 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$67.20 |
$67.20 |
$67.20 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$54.40 |
$54.40 |
$54.40 |
$81.75
|
|
Electrolyte panel
|
$45.60 |
$45.60 |
$45.60 |
$79.30
|
|
Endoscopy swallow (fees) vid
|
$572.80 |
$572.80 |
$572.80 |
$402.35
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$71.21 |
$71.21 |
$71.21 |
$112.79
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$33.67 |
$33.67 |
$33.67 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$7.43 |
$7.43 |
$7.43 |
$31.76
|
|
Episiotomy/vag rpr oth/thn attending phys 59300
|
$1,607.20 |
$1,607.20 |
$1,607.20 |
$3,778.57
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$176.79 |
$176.79 |
$176.79 |
$1,329.09
|
|
Epstein barr nuclear antigen antibody
|
$88.80 |
$88.80 |
$88.80 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$96.00 |
$96.00 |
$96.00 |
$85.50
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$125.84 |
$125.84 |
$125.84 |
$232.12
|
|
ER Visit (level 1, minor)
|
$238.40 |
$238.40 |
$238.40 |
$252.60
|
|
ER Visit (level 2)
|
$395.20 |
$395.20 |
$395.20 |
$463.00
|
|
ER Visit (level 3)
|
$565.60 |
$565.60 |
$565.60 |
$812.18
|
|
ER Visit (level 4)
|
$957.60 |
$957.60 |
$957.60 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$1,411.20 |
$1,411.20 |
$1,411.20 |
$1,871.60
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$252.48 |
$252.48 |
$252.48 |
$516.71
|
|
Esophagoscopy flex biopsy
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
$2,132.00
|
|
Esoph egd dilation <30 mm
|
$2,396.80 |
$2,396.80 |
$2,396.80 |
$2,656.80
|
|
Established Patient Office Visit (level 1)
|
$125.60 |
$125.60 |
$125.60 |
$122.20
|
|
Estradiol total
|
$138.40 |
$138.40 |
$138.40 |
$152.10
|
|
Eval aud rehab status/first hr 92626
|
$300.80 |
$300.80 |
$300.80 |
$329.59
|
|
Eval/fit voice prosthesis iii, st
|
$455.20 |
$455.20 |
$455.20 |
$359.50
|
|
Evaluation of speech fluency 92521
|
$361.60 |
$361.60 |
$361.60 |
$302.50
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$960.00 |
$960.00 |
$960.00 |
$1,072.24
|
|
Ext ecg>48hr<7d scan a/r
|
$221.60 |
$221.60 |
$221.60 |
$241.92
|
|
Ext ecg>7d<15d scan a/r
|
$331.20 |
$331.20 |
$331.20 |
$345.60
|
|
External newborn metabolic screening panel
|
$235.20 |
$235.20 |
$235.20 |
$109.76
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$120.00 |
$120.00 |
$120.00 |
$109.00
|
|
Eye Socket (Orbit) X-ray
|
$500.00 |
$500.00 |
$500.00 |
$328.35
|
|
Eye Socket, Pituitary or Ear CT Scan (with and without contrast)
|
$2,324.00 |
$2,324.00 |
$2,324.00 |
$1,705.20
|
|
Eye Socket, Pituitary or Ear CT Scan (with contrast)
|
$2,100.00 |
$2,100.00 |
$2,100.00 |
$1,543.00
|
|
Eye Socket, Pituitary or Ear CT Scan (without contrast)
|
$1,929.60 |
$1,929.60 |
$1,929.60 |
$1,320.00
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,656.00 |
$3,656.00 |
$3,656.00 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,616.00 |
$2,616.00 |
$2,616.00 |
$1,883.25
|
|
Facial Bones X-ray (1 to 2 views)
|
$328.00 |
$328.00 |
$328.00 |
$252.60
|
|
Facial Bones X-ray (complete)
|
$412.80 |
$412.80 |
$412.80 |
$381.75
|
|
Factor ix
|
$94.40 |
$94.40 |
$94.40 |
$162.50
|
|
Factor viii
|
$70.40 |
$70.40 |
$70.40 |
$148.00
|
|
Family therapy without pt 50min 90846
|
$644.00 |
$644.00 |
$644.00 |
$244.07
|
|
Family therapy with patient 50 min 90847
|
$676.00 |
$676.00 |
$676.00 |
$236.70
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$26.52 |
$26.52 |
$26.52 |
$22.20
|
|
Fat/lipids feces qualitative
|
$28.80 |
$28.80 |
$28.80 |
$36.00
|
|
Felbamate (felbatol(r)) - sendout
|
$71.20 |
$71.20 |
$71.20 |
$66.43
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$27.61 |
$27.61 |
$27.61 |
$101.40
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$675.09 |
$675.09 |
$675.09 |
$2,590.25
|
|
Ferritin
|
$76.80 |
$76.80 |
$76.80 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$434.28 |
$434.28 |
$434.28 |
$1,636.50
|
|
Ferumoxytol, esrd use
|
$434.28 |
$434.28 |
$434.28 |
$0.50
|
|
Fetal biophys profile w/nst 76818
|
$376.00 |
$376.00 |
$376.00 |
$541.74
|
|
Fetal fibronectin
|
$352.80 |
$352.80 |
$352.80 |
$389.95
|
|
Fetal hemoglobin (kleihauer betke)
|
$224.00 |
$224.00 |
$224.00 |
$102.00
|
|
Fetal non stress test
|
$458.40 |
$458.40 |
$458.40 |
$478.50
|
|
#_fet/norfentcnfrmur
|
$74.40 |
$74.40 |
$74.40 |
$95.68
|
|
Fibrin degradation d dimer quantitative
|
$79.20 |
$79.20 |
$79.20 |
$120.64
|
|
Fibrin degrade semiquant
|
$88.00 |
$88.00 |
$88.00 |
$84.50
|
