|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$132.00 |
$132.00 |
$132.00 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$26.00 |
$26.00 |
$26.00 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$111.20 |
$111.20 |
$111.20 |
$79.20
|
|
Diagnostic laryngoscopy 31575
|
$534.40 |
$534.40 |
$534.40 |
$334.95
|
|
Diagnostic Mammogram (both breasts)
|
$217.60 |
$217.60 |
$217.60 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$140.40 |
$140.40 |
$140.40 |
$312.72
|
|
Diagnostic radio unlisted proc
|
$242.80 |
$242.80 |
$242.80 |
$243.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$16,338.40 |
$16,338.40 |
$16,338.40 |
$5,663.50
|
|
Dialysis one evaluation
|
$484.40 |
$484.40 |
$484.40 |
$936.00
|
|
Diffusing capacity
|
$175.20 |
$175.20 |
$175.20 |
$335.20
|
|
Digoxin total therapeutic drug level
|
$122.80 |
$122.80 |
$122.80 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$908.00 |
$908.00 |
$908.00 |
$1,729.70
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,746.80 |
$1,746.80 |
$1,746.80 |
$3,026.10
|
|
Dilate ic vasospasm ea add vsl same territory
|
$1,746.80 |
$1,746.80 |
$1,746.80 |
$1,895.00
|
|
Dilate ic vasospasm init
|
$3,668.00 |
$3,668.00 |
$3,668.00 |
$4,627.52
|
|
Dilate tear duct opening
|
$399.60 |
$399.60 |
$399.60 |
$454.40
|
|
Dilator fascial 10fx20cm
|
$176.40 |
$176.40 |
$176.40 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$2,910.00 |
$2,910.00 |
$2,910.00 |
$3,883.16
|
|
Dilat xst trc new access rcs
|
$4,895.60 |
$4,895.60 |
$4,895.60 |
$4,258.20
|
|
Disability dlco
|
$163.60 |
$163.60 |
$163.60 |
$292.03
|
|
Disaccharidases
|
$647.60 |
$647.60 |
$647.60 |
$224.31
|
|
Discography cerv/thor spine
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$2,481.50
|
|
Dissolve clot heart vessel
|
$1,257.60 |
$1,257.60 |
$1,257.60 |
$1,560.00
|
|
Dlyd plmt xtn prosth ea addl
|
$10,131.60 |
$10,131.60 |
$10,131.60 |
$1,875.00
|
|
Dna antibody native/double stranded
|
$33.20 |
$33.20 |
$33.20 |
$100.00
|
|
Dna gardnerella
|
$35.60 |
$35.60 |
$35.60 |
$61.80
|
|
Dna probe chlamydia
|
$122.40 |
$122.40 |
$122.40 |
$82.20
|
|
Dna probe gc
|
$122.40 |
$122.40 |
$122.40 |
$84.80
|
|
Dna trichomonas
|
$35.60 |
$35.60 |
$35.60 |
$63.00
|
|
Doppler echo complete
|
$610.00 |
$610.00 |
$610.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$400.00 |
$400.00 |
$400.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$534.80 |
$534.80 |
$534.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$303.20 |
$303.20 |
$303.20 |
$473.76
|
|
Dornhoffer fixed part w/window
|
$25,541.78 |
$25,541.78 |
$25,541.78 |
$34,278.00
|
|
Drainage of eye
|
$2,415.60 |
$2,415.60 |
$2,415.60 |
$2,415.65
|
|
Drainage of kidney lesion
|
$1,490.00 |
$1,490.00 |
$1,490.00 |
$1,506.00
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,143.60 |
$2,143.60 |
$2,143.60 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$3,296.80 |
$3,296.80 |
$3,296.80 |
$2,885.30
|
|
Drain cerebro spinal fluid 62272
|
$680.40 |
$680.40 |
$680.40 |
$1,025.00
|
|
Drain finger abscess;simple 26010
|
$103.20 |
$103.20 |
$103.20 |
$428.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$316.00 |
$316.00 |
$316.00 |
$394.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$304.40 |
$304.40 |
$304.40 |
$352.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$790.00 |
$790.00 |
$790.00 |
$540.80
|
|
Drng of eyelid abscess 67700
|
$316.00 |
$316.00 |
$316.00 |
$655.72
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,128.53 |
$1,128.53 |
$1,128.53 |
$1,818.32
|
|
Drug admin & hemodynmic meas
|
$242.40 |
$242.40 |
$242.40 |
$578.59
|
|
Drug assay posaconazole
|
$169.20 |
$169.20 |
$169.20 |
$96.75
|
|
Drug assay voriconazole
|
$66.80 |
$66.80 |
$66.80 |
$96.75
|
|
Drug of abuse screen urine
|
$151.60 |
$151.60 |
$151.60 |
$64.50
|
|
Drug test def 1-7 classes
|
$595.20 |
$595.20 |
$595.20 |
$263.25
|
|
Drug test def 8-14 classes
|
$951.60 |
$951.60 |
$951.60 |
$289.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$370.80 |
$370.80 |
$370.80 |
$280.95
|
|
Drvvt confirm - quest
|
$205.60 |
$205.60 |
$205.60 |
$109.20
|
|
Ductogram sgl duct
|
$458.00 |
$458.00 |
$458.00 |
$469.44
|
|
Duplex scan bilateral study 93985
|
$733.60 |
$733.60 |
$733.60 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$375.60
|
|
Dup scan/hemodialysis access 93990
|
$768.00 |
$768.00 |
$768.00 |
$486.02
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$574.40 |
$574.40 |
$574.40 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$989.20 |
$989.20 |
$989.20 |
$903.50
|
|
Dxa bone density axl vrt fx
|
$167.60 |
$167.60 |
$167.60 |
$410.25
|
|
Ecg 12 lead tracing only
|
$226.00 |
$226.00 |
$226.00 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$49.20 |
$49.20 |
$49.20 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$222.00 |
$222.00 |
$222.00 |
$466.20
|
|
Ecg external < 48 hours recording
|
$587.60 |
$587.60 |
$587.60 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$833.20 |
$833.20 |
$833.20 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$184.40 |
$184.40 |
$184.40 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$184.40 |
$184.40 |
$184.40 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$1,501.20 |
$1,501.20 |
$1,501.20 |
$1,977.50
|
|
Echocardiography doppler color flow mapping
|
$346.00 |
$346.00 |
$346.00 |
$499.20
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,501.20 |
$1,501.20 |
$1,501.20 |
$1,935.00
|
|
Echocardiography transthoracic 2d followup/limited
|
$378.40 |
$378.40 |
$378.40 |
$711.00
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$604.80 |
$604.80 |
$604.80 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$289.20 |
$289.20 |
$289.20 |
$371.25
|
|
Echo exam of eye
|
$95.60 |
$95.60 |
$95.60 |
$143.75
|
|
Echo exam of eye
|
$95.60 |
$95.60 |
$95.60 |
$172.00
|
|
Echo exam of eye thickness
|
$22.40 |
$22.40 |
$22.40 |
$40.30
|
|
Echo exam of fetal heart
|
$904.80 |
$904.80 |
$904.80 |
$904.80
|
|
Echo exam of fetal heart
|
$415.20 |
$415.20 |
$415.20 |
$538.27
|
|
Echo exam of fetal heart
|
$212.80 |
$212.80 |
$212.80 |
$431.41
|
|
Echo exam of fetal heart
|
$202.80 |
$202.80 |
$202.80 |
$319.00
|
|
Echo exam uterus 76831-
|
$538.80 |
$538.80 |
$538.80 |
$552.50
|
|
Echo guidance radiotherapy
|
$195.20 |
$195.20 |
$195.20 |
$812.00
|
|
Echo guide for amniocentesis
|
$343.60 |
$343.60 |
$343.60 |
$446.60
|
|
Echo guide for artery repair
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$687.35
|
|
Echo guide ova aspiration
|
$625.60 |
$625.60 |
$625.60 |
$214.40
|
|
Echo stress
|
$1,434.80 |
$1,434.80 |
$1,434.80 |
$1,606.44
|
|
Echo tee guidance
|
$2,100.80 |
$2,100.80 |
$2,100.80 |
$1,847.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,056.80 |
$1,056.80 |
$1,056.80 |
$1,889.20
|
|
Echo transesophageal intraop
|
$1,784.80 |
$1,784.80 |
$1,784.80 |
$1,578.00
|
|
Echo transthoracic
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,448.80 |
$1,448.80 |
$1,448.80 |
$1,022.30
|
|
Ecmo/ecls daily mgmt artery 33949
|
$2,760.00 |
$2,760.00 |
$2,760.00 |
$2,867.22
|
|
Ecmo/ecls initiation artery 33947
|
$7,605.60 |
$7,605.60 |
$7,605.60 |
$3,950.10
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$7,605.60 |
$7,605.60 |
$7,605.60 |
$2,825.34
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$11,054.40 |
$11,054.40 |
$11,054.40 |
$1,362.00
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$7,605.60 |
$7,605.60 |
$7,605.60 |
$1,073.80
|
|
Eeg 41-60 minutes 95812-26
|
$296.00 |
$296.00 |
$296.00 |
$923.88
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$638.40 |
$638.40 |
$638.40 |
$970.07
|
|
Eeg during surgery
|
$566.40 |
$566.40 |
$566.40 |
$775.45
|
|
Eeg monitoring/function test
|
$1,754.80 |
$1,754.80 |
$1,754.80 |
$1,548.52
|
