|
Ear irrigation 69209
|
$17.40 |
$17.40 |
$17.40 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$19.20 |
$19.20 |
$19.20 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$732.60 |
$732.60 |
$732.60 |
$412.88
|
|
Ecg external < 48 hours recording
|
$207.00 |
$207.00 |
$207.00 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$376.80 |
$376.80 |
$376.80 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$207.00 |
$207.00 |
$207.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$207.00 |
$207.00 |
$207.00 |
$173.40
|
|
Ecg/review interpret only
|
$58.20 |
$58.20 |
$58.20 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$837.00 |
$837.00 |
$837.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$295.20 |
$295.20 |
$295.20 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$105.60 |
$105.60 |
$105.60 |
$511.55
|
|
Echocardiograpy doppler follow up/limited study
|
$67.20 |
$67.20 |
$67.20 |
$371.25
|
|
Echo exam uterus 76831-
|
$330.00 |
$330.00 |
$330.00 |
$561.00
|
|
Echo transesophageal
|
$125.40 |
$125.40 |
$125.40 |
$1,075.20
|
|
Echo transthoracic
|
$511.20 |
$511.20 |
$511.20 |
$1,361.75
|
|
Echo transthoracic
|
$351.60 |
$351.60 |
$351.60 |
$1,052.40
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$16,242.00 |
$16,242.00 |
$16,242.00 |
$19,540.29
|
|
Ed svc ckd grp per session
|
$39.00 |
$39.00 |
$39.00 |
$58.40
|
|
Ed svc ckd ind per session
|
$161.40 |
$161.40 |
$161.40 |
$249.60
|
|
Eeg 41-60 minutes 95812-26
|
$997.80 |
$997.80 |
$997.80 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$122.40 |
$122.40 |
$122.40 |
$994.15
|
|
Eeg monitor/record/awake/drowsy 95816
|
$896.40 |
$896.40 |
$896.40 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$1,100.40 |
$1,100.40 |
$1,100.40 |
$1,119.54
|
|
Eeg/record in coma or sleep only 95822
|
$936.00 |
$936.00 |
$936.00 |
$871.00
|
|
Eeg recording awake and asleep
|
$1,054.80 |
$1,054.80 |
$1,054.80 |
$931.20
|
|
Eeg without vid 2-12 hr unmntr
|
$1,123.20 |
$1,123.20 |
$1,123.20 |
$721.76
|
|
Egd control bleeding any
|
$789.00 |
$789.00 |
$789.00 |
$2,553.75
|
|
Egd dilate stricture
|
$379.20 |
$379.20 |
$379.20 |
$2,394.60
|
|
Egd endo mucosal resection
|
$480.00 |
$480.00 |
$480.00 |
$2,430.40
|
|
Egd endoscopic stent place
|
$417.60 |
$417.60 |
$417.60 |
$3,986.00
|
|
Egd guide wire insertion
|
$526.20 |
$526.20 |
$526.20 |
$1,664.00
|
|
Egd injection varices
|
$480.00 |
$480.00 |
$480.00 |
$2,244.82
|
|
Egd lesion ablation
|
$435.60 |
$435.60 |
$435.60 |
$2,354.48
|
|
Egd remove foreign body
|
$561.00 |
$561.00 |
$561.00 |
$1,571.40
|
|
Egd remove lesion snare
|
$642.60 |
$642.60 |
$642.60 |
$2,597.25
|
|
Egd/remov tum/polyp/hot bx forcep 43250
|
$343.80 |
$343.80 |
$343.80 |
$2,244.82
|
|
Egd varices ligation
|
$822.00 |
$822.00 |
$822.00 |
$2,244.82
|
|
Egfr gene com variants
|
$1,104.60 |
$1,104.60 |
$1,104.60 |
$672.88
|
|
EKG (Electrocardiogram)
|
$154.20 |
$154.20 |
$154.20 |
$89.60
|
|
EKG (Tracing Only)
|
$154.20 |
$154.20 |
$154.20 |
$226.50
|
|
Elbow arthroscopy/surgery
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$3,839.54
|
|
Elbow arthroscopy/surgery
|
$1,057.80 |
$1,057.80 |
$1,057.80 |
$3,545.97
|
|
Elbow X-ray (2 views, both sides)
|
$128.40 |
$128.40 |
$128.40 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$154.20 |
$154.20 |
$154.20 |
$364.20
|
|
Elec analys infus pump w/reprog 62368
|
$54.00 |
$54.00 |
$54.00 |
$616.00
|
|
Elect analysis of infusion pump 62367
|
$40.20 |
$40.20 |
$40.20 |
$563.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$65.40 |
$65.40 |
$65.40 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$135.60 |
$135.60 |
$135.60 |
$81.75
|
|
Electrolyte panel
|
$66.60 |
$66.60 |
$66.60 |
$79.30
|
|
Elotuzumab 300 mg intravenous solution
|
$7,555.20 |
$7,555.20 |
$7,555.20 |
$5,761.81
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$160.20 |
$160.20 |
$160.20 |
$394.80
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$192.00 |
$192.00 |
$192.00 |
$502.80
|
|
Emg cranial nerve bilateral
|
$257.40 |
$257.40 |
$257.40 |
$529.10
|
|
Emg needle test 1-extremity
|
$122.40 |
$122.40 |
$122.40 |
$351.50
|
|
Emg needle test 4-extremities
|
$237.00 |
$237.00 |
$237.00 |
$613.20
|
|
Emg thor paraspinal without t1/t2
|
$54.00 |
$54.00 |
$54.00 |
$309.83
|
|
Endo cholangiopancreatograph
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$4,233.50
|
|
Endo cholangiopancreatograph
|
$1,192.20 |
$1,192.20 |
$1,192.20 |
$4,350.00
|
|
Endoscopic injection/implant
|
$360.60 |
$360.60 |
$360.60 |
$5,304.00
|
|
Endoscopic pancreatoscopy
|
$225.00 |
$225.00 |
$225.00 |
$2,325.00
|
|
Endoscopy maxillary sinus
|
$626.40 |
$626.40 |
$626.40 |
$7,139.50
|
|
Endoscopy of bowel pouch 44385
|
$306.60 |
$306.60 |
$306.60 |
$1,899.00
|
|
Endoscpy nsl/sns w/cntrl nsl hmrrgh
|
$382.20 |
$382.20 |
$382.20 |
$2,787.20
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$10,491.60 |
$10,491.60 |
$10,491.60 |
$8,222.82
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$309.00 |
$309.00 |
$309.00 |
$112.79
|
|
Enterectomy small intestine single 44120
|
$1,956.00 |
$1,956.00 |
$1,956.00 |
$2,170.64
|
|
Enterorrhaphy 1perforation 44602
|
$2,347.80 |
$2,347.80 |
$2,347.80 |
$2,650.80
|
|
Enterorrhaphy multiple perforations 44603
|
$2,757.00 |
$2,757.00 |
$2,757.00 |
$2,901.00
|
|
Enterostomy/cecostomy tube open 44300
|
$1,425.60 |
$1,425.60 |
$1,425.60 |
$1,741.60
|
|
Epidural/lumbar/sacral/ea add level64484
|
$193.20 |
$193.20 |
$193.20 |
$1,182.00
|
|
Epidural lysis on single day 62264
|
$438.00 |
$438.00 |
$438.00 |
$2,420.73
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,098.60 |
$1,098.60 |
$1,098.60 |
$865.80
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$2,661.60 |
$2,661.60 |
$2,661.60 |
$1,329.09
|
|
Epstein barr early antigen antibody
|
$126.00 |
$126.00 |
$126.00 |
$60.00
|
|
Epstein barr viral capsid antigen antibody igm
|
$124.20 |
$124.20 |
$124.20 |
$85.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$682.20 |
$682.20 |
$682.20 |
$427.26
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$4,701.60 |
$4,701.60 |
$4,701.60 |
$3,838.45
|
|
Ercp biliary & pancreas
|
$555.60 |
$555.60 |
$555.60 |
$967.04
|
|
Ercp bil/panc duct; each stent plcmt 43274
|
$858.60 |
$858.60 |
$858.60 |
$5,390.40
|
|
Ercp ea duct/ampulla dilate
|
$724.80 |
$724.80 |
$724.80 |
$4,199.25
|
|
Ercp remove duct calculi 43264
|
$1,431.00 |
$1,431.00 |
$1,431.00 |
$4,060.00
|
|
Ercp remove forgn body duct 43275
|
$706.80 |
$706.80 |
$706.80 |
$2,859.02
|
|
Ercp stent exchange w/dilate
|
$891.00 |
$891.00 |
$891.00 |
$5,718.03
|
|
Ercp w/specimen collection
|
$969.00 |
$969.00 |
$969.00 |
$4,494.90
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$3,510.60 |
$3,510.60 |
$3,510.60 |
$2,488.75
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$163.20 |
$163.20 |
$163.20 |
$232.12
|
|
ER Visit (level 1, minor)
|
$136.20 |
$136.20 |
$136.20 |
$252.60
|
|
ER Visit (level 2)
|
$210.00 |
$210.00 |
$210.00 |
$463.00
|
|
ER Visit (level 3)
|
$274.20 |
$274.20 |
$274.20 |
$812.18
|
|
ER Visit (level 4)
|
$357.00 |
$357.00 |
$357.00 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$630.00 |
$630.00 |
$630.00 |
$1,871.60
|
|
Esophagoscopy balloon <30mm
|
$233.40 |
$233.40 |
$233.40 |
$2,460.00
|
|
Esophagoscopy flex biopsy
|
$350.40 |
$350.40 |
$350.40 |
$2,132.00
|
|
Esophagoscopy/flex/diagnostic 43200
|
$320.40 |
$320.40 |
$320.40 |
$1,296.00
|
|
Esophagoscopy flex remove fb
|
$285.00 |
$285.00 |
$285.00 |
$2,089.60
|
|
Esophagoscopy lesion ablate
|
$372.00 |
$372.00 |
$372.00 |
$4,502.13
|
|
Esophagoscopy rigid trnso 43180
|
$809.40 |
$809.40 |
$809.40 |
$6,553.49
|
|
Esophagus endoscopy/ligation
|
$172.20 |
$172.20 |
$172.20 |
$2,392.00
|
|
Esoph egd dilation <30 mm
|
$487.80 |
$487.80 |
$487.80 |
$2,656.80
|
|
Esoph endoscopy dilation
|
$256.80 |
$256.80 |
$256.80 |
$2,221.83
|
