|
Drain neck/chest lesion 21501
|
$6,970.00 |
$6,970.00 |
$6,970.00 |
$3,339.00
|
|
Drain shoulder lesion
|
$6,970.00 |
$6,970.00 |
$6,970.00 |
$3,904.61
|
|
Drain thigh/knee lesion 27301
|
$6,970.00 |
$6,970.00 |
$6,970.00 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$560.15 |
$560.15 |
$560.15 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$491.30 |
$491.30 |
$491.30 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,116.90 |
$1,116.90 |
$1,116.90 |
$523.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$5,857.52 |
$5,857.52 |
$5,857.52 |
$8,131.20
|
|
Drill hole evac+/drg subdural hematoma 61108
|
$14,483.15 |
$14,483.15 |
$14,483.15 |
$1,667.40
|
|
Drill hole implt ventricular cath/device 61107
|
$14,483.15 |
$14,483.15 |
$14,483.15 |
$1,515.00
|
|
Drng hand tendon sheath 26020
|
$7,938.15 |
$7,938.15 |
$7,938.15 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$816.00 |
$816.00 |
$816.00 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$3,976.30 |
$3,976.30 |
$3,976.30 |
$1,943.50
|
|
Drng of hydrocele 55000
|
$1,971.15 |
$1,971.15 |
$1,971.15 |
$832.60
|
|
Drng of pelvic abscess transrectal 45000
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$2,111.46
|
|
Drng of scrotum abscess 55100
|
$3,976.30 |
$3,976.30 |
$3,976.30 |
$1,917.33
|
|
Drng peritoneal abscess open 49020
|
$4,102.10 |
$4,102.10 |
$4,102.10 |
$2,520.00
|
|
Drng salivary gland simple 42300
|
$3,740.85 |
$3,740.85 |
$3,740.85 |
$2,133.48
|
|
Drng salivary gland submax/subling 42310
|
$1,541.05 |
$1,541.05 |
$1,541.05 |
$741.60
|
|
Dronabinol 2.5mg oral
|
$11.40 |
$11.40 |
$11.40 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$8.86 |
$8.86 |
$8.86 |
$31.07
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$4,528.80 |
$4,528.80 |
$4,528.80 |
$1,956.48
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$238.67 |
$238.67 |
$238.67 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$1,178.56 |
$1,178.56 |
$1,178.56 |
$289.05
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$133.11 |
$133.11 |
$133.11 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$13,017.58 |
$13,017.58 |
$13,017.58 |
$8,040.27
|
|
Drug admin & hemodynmic meas
|
$1,461.15 |
$1,461.15 |
$1,461.15 |
$569.75
|
|
Drug test def 1-7 classes
|
$461.55 |
$461.55 |
$461.55 |
$250.52
|
|
Drug test def 22+ classes
|
$994.50 |
$994.50 |
$994.50 |
$423.00
|
|
Drug test prsmv instrmnt
|
$69.70 |
$69.70 |
$69.70 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$249.90 |
$249.90 |
$249.90 |
$278.85
|
|
Ductogram sgl duct
|
$1,156.00 |
$1,156.00 |
$1,156.00 |
$463.10
|
|
Duplex scan bilateral study 93985
|
$985.15 |
$985.15 |
$985.15 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$442.00 |
$442.00 |
$442.00 |
$360.75
|
|
Dup scan/hemodialysis access 93990
|
$537.20 |
$537.20 |
$537.20 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$627.30 |
$627.30 |
$627.30 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$963.05 |
$963.05 |
$963.05 |
$887.25
|
|
Duragen 1x1 5ea/bx
|
$2,411.28 |
$2,411.28 |
$2,411.28 |
$10,163.72
|
|
Durvalumab 50 mg/ml intravenous solution
|
$2,771.73 |
$2,771.73 |
$2,771.73 |
$7,973.90
|
|
Dxa bone density axl vrt fx
|
$495.55 |
$495.55 |
$495.55 |
$392.60
|
|
Dx bronchoscope/brush 31623
|
$4,163.30 |
$4,163.30 |
$4,163.30 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$4,163.30 |
$4,163.30 |
$4,163.30 |
$2,365.20
|
|
Dx bronchoscope/wash 31622
|
$4,163.30 |
$4,163.30 |
$4,163.30 |
$2,322.60
|
|
Dx gastr intub w/asp spec
|
$769.25 |
$769.25 |
$769.25 |
$441.60
|
|
Dx laryngoscopy newborn
|
$1,143.25 |
$1,143.25 |
$1,143.25 |
$707.25
|
|
Ear irrigation 69209
|
$133.45 |
$133.45 |
$133.45 |
$149.76
|
|
Ecallantide injection
|
$15,138.10 |
$15,138.10 |
$15,138.10 |
$13,353.39
|
|
Ecg 12 lead tracing only
|
$229.50 |
$229.50 |
$229.50 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$245.65 |
$245.65 |
$245.65 |
$135.80
|
|
Echocardiogram (Heart Ultrasound)
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$272.85 |
$272.85 |
$272.85 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,218.50 |
$2,218.50 |
$2,218.50 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$756.50 |
$756.50 |
$756.50 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,045.50 |
$1,045.50 |
$1,045.50 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$242.25 |
$242.25 |
$242.25 |
$362.50
|
|
Echo exam of eye
|
$569.50 |
$569.50 |
$569.50 |
$143.75
|
|
Echo exam of eye
|
$519.35 |
$519.35 |
$519.35 |
$172.00
|
|
Echo exam of eye thickness
|
$141.10 |
$141.10 |
$141.10 |
$50.91
|
|
Echo exam of fetal heart
|
$2,604.40 |
$2,604.40 |
$2,604.40 |
$939.00
|
|
Echo exam of fetal heart
|
$1,156.85 |
$1,156.85 |
$1,156.85 |
$524.55
|
|
Echo exam of fetal heart
|
$649.40 |
$649.40 |
$649.40 |
$431.41
|
|
Echo exam uterus 76831-
|
$1,156.85 |
$1,156.85 |
$1,156.85 |
$523.71
|
|
Echograp trans r pros study
|
$907.80 |
$907.80 |
$907.80 |
$459.40
|
|
Echo guidance radiotherapy
|
$1,207.00 |
$1,207.00 |
$1,207.00 |
$812.00
|
|
Echo guide for amniocentesis
|
$176.80 |
$176.80 |
$176.80 |
$456.30
|
|
Echo guide for artery repair
|
$1,482.40 |
$1,482.40 |
$1,482.40 |
$664.00
|
|
Echo guide for heart biopsy
|
$693.60 |
$693.60 |
$693.60 |
$666.40
|
|
Echo guide villus sampling
|
$643.45 |
$643.45 |
$643.45 |
$362.88
|
|
Echo stress
|
$1,592.05 |
$1,592.05 |
$1,592.05 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,222.75 |
$2,222.75 |
$2,222.75 |
$1,849.50
|
|
Echo transesophageal
|
$2,218.50 |
$2,218.50 |
$2,218.50 |
$1,087.90
|
|
Echo transesophageal
|
$2,218.50 |
$2,218.50 |
$2,218.50 |
$1,559.35
|
|
Echo transesophageal
|
$946.90 |
$946.90 |
$946.90 |
$603.20
|
|
Echo transesophageal intraop
|
$2,218.50 |
$2,218.50 |
$2,218.50 |
$1,571.70
|
|
Echo transthoracic
|
$2,510.05 |
$2,510.05 |
$2,510.05 |
$1,361.75
|
|
Echo transthoracic
|
$2,218.50 |
$2,218.50 |
$2,218.50 |
$953.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$985.15 |
$985.15 |
$985.15 |
$985.15
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$34,602.25 |
$34,602.25 |
$34,602.25 |
$18,199.20
|
|
Edetate calcium disodium inj
|
$14,286.52 |
$14,286.52 |
$14,286.52 |
$8,569.35
|
|
Edetate disodium per 150 mg
|
$130.48 |
$130.48 |
$130.48 |
$221.20
|
|
Eeg 41-60 minutes 95812-26
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$920.00
|
|
Eeg monitoring/function test
|
$4,204.10 |
$4,204.10 |
$4,204.10 |
$1,548.52
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,079.50 |
$1,079.50 |
$1,079.50 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$1,102.05
|
|
Eeg phy/qhp>36<60 hr without vid
|
$2,290.75 |
$2,290.75 |
$2,290.75 |
$1,932.00
|
|
Eeg phy/qhp>36<60 hr w/veeg
|
$2,777.80 |
$2,777.80 |
$2,777.80 |
$1,932.00
|
|
Eeg phy/qhp>60<84 hr without vid
|
$2,777.80 |
$2,777.80 |
$2,777.80 |
$1,932.00
|
|
Eeg phy/qhp>60<84 hr w/veeg
|
$3,491.80 |
$3,491.80 |
$3,491.80 |
$1,932.00
|
|
Eeg phy/qhp>84 hr without vid
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$1,932.00
|
|
Eeg phy/qhp>84 hr w/veeg
|
$4,482.90 |
$4,482.90 |
$4,482.90 |
$2,072.80
|
|
Eeg phy/qhp ea incr w/veeg
|
$2,290.75 |
$2,290.75 |
$2,290.75 |
$1,103.70
|
|
Eeg phys/qhp 2-12 hr without vid
|
$1,171.30 |
$1,171.30 |
$1,171.30 |
$553.80
|
|
Eeg phys/qhp 2-12 hr w/veeg
|
$1,488.35 |
$1,488.35 |
$1,488.35 |
$586.80
|
|
Eeg phys/qhp ea incr without vid
|
$1,775.65 |
$1,775.65 |
$1,775.65 |
$858.00
|
|
Eeg/record in coma or sleep only 95822
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$907.80
|
|
Eeg recording awake and asleep
|
$1,245.25 |
$1,245.25 |
$1,245.25 |
$931.20
|
|
Eeg without vid 2-12hr cont mntr
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$783.60
|
|
Eeg without vid 2-12 hr unmntr
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$601.30
|
|
Eeg without vid ea 12-26hr cont
|
$2,154.75 |
$2,154.75 |
$2,154.75 |
$1,460.20
|
|
Eeg without vid ea 12-26hr intmt
|
$2,154.75 |
$2,154.75 |
$2,154.75 |
$1,379.30
|
|
Eeg wo vid 2-12hr intmt mntr
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$671.00
|
