|
Dhea-s (dehydroepiand sulfate)
|
$241.20 |
$241.20 |
$241.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$128.40 |
$128.40 |
$128.40 |
$79.30
|
|
Diab manage trn ind/group
|
$38.40 |
$38.40 |
$38.40 |
$54.99
|
|
Diagnostic digital breast tomosynthesis bil
|
$126.00 |
$126.00 |
$126.00 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$118.80 |
$118.80 |
$118.80 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$238.80 |
$238.80 |
$238.80 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$186.60 |
$186.60 |
$186.60 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$264.00 |
$264.00 |
$264.00 |
$259.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$44.40 |
$44.40 |
$44.40 |
$79.71
|
|
Dicyclomine injection
|
$52.20 |
$52.20 |
$52.20 |
$154.33
|
|
Diffusing capacity
|
$146.40 |
$146.40 |
$146.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$18.00 |
$18.00 |
$18.00 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$5,502.00 |
$5,502.00 |
$5,502.00 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$108.00 |
$108.00 |
$108.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$385.80 |
$385.80 |
$385.80 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$7.20 |
$7.20 |
$7.20 |
$402.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$9.60 |
$9.60 |
$9.60 |
$18.32
|
|
Disaccharidases
|
$66.60 |
$66.60 |
$66.60 |
$230.40
|
|
Dna antibody native/double stranded
|
$75.00 |
$75.00 |
$75.00 |
$100.00
|
|
Dna gardnerella
|
$104.40 |
$104.40 |
$104.40 |
$61.83
|
|
Dna probe chlamydia
|
$163.80 |
$163.80 |
$163.80 |
$82.20
|
|
Dna probe gc
|
$152.40 |
$152.40 |
$152.40 |
$79.38
|
|
Dna trichomonas
|
$104.40 |
$104.40 |
$104.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$75.60 |
$75.60 |
$75.60 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$37.80 |
$37.80 |
$37.80 |
$65.40
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$771.60 |
$771.60 |
$771.60 |
$679.64
|
|
Drainable plastic pch w fcpl
|
$3.00 |
$3.00 |
$3.00 |
$33.77
|
|
Drainage of kidney lesion
|
$1,338.00 |
$1,338.00 |
$1,338.00 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$100.20 |
$100.20 |
$100.20 |
$182.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$219.60 |
$219.60 |
$219.60 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$219.60 |
$219.60 |
$219.60 |
$349.50
|
|
Drng of finger abscess comp 26011
|
$1,047.60 |
$1,047.60 |
$1,047.60 |
$2,079.50
|
|
Drug screening tapentadol
|
$56.40 |
$56.40 |
$56.40 |
$47.03
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$201.60 |
$201.60 |
$201.60 |
$278.85
|
|
Drvvt confirm - quest
|
$352.20 |
$352.20 |
$352.20 |
$109.20
|
|
Ductogram sgl duct
|
$409.20 |
$409.20 |
$409.20 |
$469.80
|
|
Ear irrigation 69209
|
$41.40 |
$41.40 |
$41.40 |
$154.70
|
|
Ecg external < 48 hours recording
|
$277.20 |
$277.20 |
$277.20 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$422.40 |
$422.40 |
$422.40 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$1,049.40 |
$1,049.40 |
$1,049.40 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$708.60 |
$708.60 |
$708.60 |
$720.60
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$2,037.00 |
$2,037.00 |
$2,037.00 |
$866.87
|
|
Echo guide for artery repair
|
$676.80 |
$676.80 |
$676.80 |
$696.30
|
|
Echo stress
|
$561.60 |
$561.60 |
$561.60 |
$1,609.44
|
|
Eeg monitor/record/awake/drowsy 95816
|
$484.80 |
$484.80 |
$484.80 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$484.80 |
$484.80 |
$484.80 |
$1,119.54
|
|
Eeg recording awake and asleep
|
$484.80 |
$484.80 |
$484.80 |
$931.20
|
|
E equine encephalitis igg
|
$106.20 |
$106.20 |
$106.20 |
$51.84
|
|
Egd control bleeding any
|
$1,787.40 |
$1,787.40 |
$1,787.40 |
$2,553.75
|
|
Egd remove foreign body
|
$927.00 |
$927.00 |
$927.00 |
$1,571.40
|
|
Egd varices ligation
|
$1,341.00 |
$1,341.00 |
$1,341.00 |
$2,244.82
|
|
EKG (Tracing Only)
|
$102.00 |
$102.00 |
$102.00 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$196.20 |
$196.20 |
$196.20 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$227.40 |
$227.40 |
$227.40 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$63.60 |
$63.60 |
$63.60 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$111.00 |
$111.00 |
$111.00 |
$81.75
|
|
Electrodes, pair
|
$1.80 |
$1.80 |
$1.80 |
$15.12
|
|
Electrolyte panel
|
$109.20 |
$109.20 |
$109.20 |
$79.30
|
|
Emb without cervical dilation 58100
|
$379.80 |
$379.80 |
$379.80 |
$373.60
|
|
Encephalitis, california igg/igm
|
$106.20 |
$106.20 |
$106.20 |
$56.50
|
|
Encephalitis, st louis igg/igm
|
$106.20 |
$106.20 |
$106.20 |
$51.84
|
|
Encephalitis, western equine igg/igm
|
$106.20 |
$106.20 |
$106.20 |
$54.99
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$219.60 |
$219.60 |
$219.60 |
$112.79
|
|
Epidural/lumbar/sacral/ea add level64484
|
$84.60 |
$84.60 |
$84.60 |
$1,182.00
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$1,564.20 |
$1,564.20 |
$1,564.20 |
$1,329.09
|
|
Epstein barr early antigen antibody
|
$180.60 |
$180.60 |
$180.60 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$171.60 |
$171.60 |
$171.60 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$98.40 |
$98.40 |
$98.40 |
$85.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$1,144.20 |
$1,144.20 |
$1,144.20 |
$427.26
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$256.80 |
$256.80 |
$256.80 |
$232.12
|
|
ER Visit (level 1, minor)
|
$102.60 |
$102.60 |
$102.60 |
$252.60
|
|
ER Visit (level 2)
|
$151.20 |
$151.20 |
$151.20 |
$463.00
|
|
ER Visit (level 3)
|
$205.20 |
$205.20 |
$205.20 |
$812.18
|
|
ER Visit (level 4)
|
$312.60 |
$312.60 |
$312.60 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$501.00 |
$501.00 |
$501.00 |
$1,871.60
|
|
Esophageal motility
|
$483.60 |
$483.60 |
$483.60 |
$655.45
|
|
Esophagoscopy flex remove fb
|
$1,360.20 |
$1,360.20 |
$1,360.20 |
$2,089.60
|
|
Established Patient Office Visit (level 1)
|
$72.60 |
$72.60 |
$72.60 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$79.20 |
$79.20 |
$79.20 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$79.20 |
$79.20 |
$79.20 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$134.40 |
$134.40 |
$134.40 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$130.80 |
$130.80 |
$130.80 |
$290.68
|
|
Estradiol total
|
$151.20 |
$151.20 |
$151.20 |
$152.10
|
|
Estrogens total-sendout
|
$117.00 |
$117.00 |
$117.00 |
$97.50
|
|
Etonogestrel implant system
|
$1,177.80 |
$1,177.80 |
$1,177.80 |
$2,081.30
|
|
Euflexxa inj per dose
|
$730.80 |
$730.80 |
$730.80 |
$510.68
|
|
Evaluation of speech fluency 92521
|
$252.00 |
$252.00 |
$252.00 |
$302.50
|
|
Event monitor
|
$180.00 |
$180.00 |
$180.00 |
$231.00
|
|
Exc benign tal 0.5 < cm 11400
|
$496.20 |
$496.20 |
$496.20 |
$832.60
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$969.60
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$1,152.96
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,273.20 |
$1,273.20 |
$1,273.20 |
$2,069.20
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$1,096.20 |
$1,096.20 |
$1,096.20 |
$2,271.01
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$1,314.67
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$662.40 |
$662.40 |
$662.40 |
$999.50
|
|
Exc hidradenitis peri/umb comp 11471
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,386.84
|
|
Exc hidradenitis peri/umb int 11470
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,399.24
|
|
Exc hip/pelv tum deep 5 cm/>
|
$2,870.40 |
$2,870.40 |
$2,870.40 |
$3,630.40
|
