|
Drug admin & hemodynmic meas
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$569.75
|
|
Drug assay caffeine
|
$244.20 |
$244.20 |
$244.20 |
$80.00
|
|
Drug assay posaconazole
|
$171.68 |
$171.68 |
$171.68 |
$96.75
|
|
Drug assay rufinamide
|
$171.68 |
$171.68 |
$171.68 |
$87.10
|
|
Drug assay vedolizumab
|
$244.20 |
$244.20 |
$244.20 |
$154.00
|
|
Drug assay voriconazole
|
$171.68 |
$171.68 |
$171.68 |
$96.75
|
|
Drug of abuse screen urine
|
$9.88 |
$9.88 |
$9.88 |
$67.50
|
|
Drug screen quant tiagabine
|
$171.68 |
$171.68 |
$171.68 |
$107.59
|
|
Drug test def 22+ classes
|
$1,562.14 |
$1,562.14 |
$1,562.14 |
$426.24
|
|
Drug test def 8-14 classes
|
$990.86 |
$990.86 |
$990.86 |
$289.80
|
|
Drug test prsmv instrmnt
|
$13.52 |
$13.52 |
$13.52 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$392.94 |
$392.94 |
$392.94 |
$278.85
|
|
Drvvt confirm - quest
|
$113.96 |
$113.96 |
$113.96 |
$109.20
|
|
Dry needling (97799)
|
$0.26 |
$0.26 |
$0.26 |
$114.27
|
|
Dstrj extensive retinopathy
|
$182.26 |
$182.26 |
$182.26 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$106.86 |
$106.86 |
$106.86 |
$3,020.80
|
|
Dstr mal les s/n/h/f/g >4.0
|
$147.42 |
$147.42 |
$147.42 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$124.28 |
$124.28 |
$124.28 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$145.34 |
$145.34 |
$145.34 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$198.38 |
$198.38 |
$198.38 |
$886.40
|
|
Ductogram sgl duct
|
$12.48 |
$12.48 |
$12.48 |
$484.25
|
|
Duodenal exclusion
|
$1,307.80 |
$1,307.80 |
$1,307.80 |
$3,917.10
|
|
Duodenal motility study
|
$51.74 |
$51.74 |
$51.74 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$850.26 |
$850.26 |
$850.26 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$373.70 |
$373.70 |
$373.70 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$373.70 |
$373.70 |
$373.70 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$17.16 |
$17.16 |
$17.16 |
$748.15
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$850.26 |
$850.26 |
$850.26 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$10.40 |
$10.40 |
$10.40 |
$397.65
|
|
Dx bronchoscope/brush 31623
|
$4,849.22 |
$4,849.22 |
$4,849.22 |
$2,144.41
|
|
Dx bronchoscope/lavage 31624
|
$4,849.22 |
$4,849.22 |
$4,849.22 |
$2,457.88
|
|
Dx bronchoscope/wash 31622
|
$4,849.22 |
$4,849.22 |
$4,849.22 |
$2,459.93
|
|
Dx duod intub w/asp spec 43756
|
$36.40 |
$36.40 |
$36.40 |
$1,075.20
|
|
Dx duod intub w/asp specs
|
$55.64 |
$55.64 |
$55.64 |
$1,406.58
|
|
Dx gastr intub w/asp spec
|
$27.82 |
$27.82 |
$27.82 |
$441.60
|
|
Dx gastr intub w/asp specs
|
$43.42 |
$43.42 |
$43.42 |
$299.04
|
|
Dx laryngoscopy newborn
|
$114.14 |
$114.14 |
$114.14 |
$649.74
|
|
Dx laryngoscopy w/oper scope
|
$114.66 |
$114.66 |
$114.66 |
$2,755.53
|
|
Dynamic cavernosometry
|
$84.50 |
$84.50 |
$84.50 |
$3,442.40
|
|
Dynamic fine wire emg
|
$12.22 |
$12.22 |
$12.22 |
$374.29
|
|
Dynamic surface emg
|
$15.60 |
$15.60 |
$15.60 |
$368.50
|
|
Ear and throat examination
|
$69.16 |
$69.16 |
$69.16 |
$602.63
|
|
Ear canal biopsy 69105
|
$47.06 |
$47.06 |
$47.06 |
$1,889.50
|
|
Ear cartilage graft
|
$416.52 |
$416.52 |
$416.52 |
$6,385.40
|
|
Ear irrigation 69209
|
$167.24 |
$167.24 |
$167.24 |
$154.70
|
|
Ecg/1-3 leads/interp & report only 93042
|
$4.94 |
$4.94 |
$4.94 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$167.24 |
$167.24 |
$167.24 |
$133.60
|
|
Ecg external < 48 hours recording
|
$362.60 |
$362.60 |
$362.60 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$167.24 |
$167.24 |
$167.24 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$110.26 |
$110.26 |
$110.26 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$110.26 |
$110.26 |
$110.26 |
$173.40
|
|
Ecg/review interpret only
|
$17.42 |
$17.42 |
$17.42 |
$52.80
|
|
Echocardiogram (Heart Ultrasound)
|
$1,541.42 |
$1,541.42 |
$1,541.42 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$680.06 |
$680.06 |
$680.06 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$1,156.62 |
$1,156.62 |
$1,156.62 |
$520.50
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,221.48 |
$2,221.48 |
$2,221.48 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,004.92 |
$1,004.92 |
$1,004.92 |
$868.56
|
|
Echocardiograpy doppler follow up/limited study
|
$1,156.62 |
$1,156.62 |
$1,156.62 |
$372.60
|
|
Echo exam of eye
|
$16.38 |
$16.38 |
$16.38 |
$143.75
|
|
Echo exam of eye
|
$21.84 |
$21.84 |
$21.84 |
$172.00
|
|
Echo exam of eye
|
$463.98 |
$463.98 |
$463.98 |
$178.85
|
|
Echo exam of eye thickness
|
$5.72 |
$5.72 |
$5.72 |
$39.77
|
|
Echo exam of fetal heart
|
$1,541.42 |
$1,541.42 |
$1,541.42 |
$904.80
|
|
Echo exam of fetal heart
|
$934.62 |
$934.62 |
$934.62 |
$539.56
|
|
Echo exam of fetal heart
|
$298.96 |
$298.96 |
$298.96 |
$431.41
|
|
Echo exam of fetal heart
|
$298.96 |
$298.96 |
$298.96 |
$318.34
|
|
Echo exam uterus 76831-
|
$1,274.28 |
$1,274.28 |
$1,274.28 |
$562.85
|
|
Echograp trans r pros study
|
$560.92 |
$560.92 |
$560.92 |
$468.00
|
|
Echo guidance radiotherapy
|
$1,980.24 |
$1,980.24 |
$1,980.24 |
$812.00
|
|
Echo guidance radiotherapy
|
$23.14 |
$23.14 |
$23.14 |
$322.40
|
|
Echo guide for amniocentesis
|
$697.08 |
$697.08 |
$697.08 |
$456.30
|
|
Echo guide for artery repair
|
$1,642.06 |
$1,642.06 |
$1,642.06 |
$699.76
|
|
Echo guide for heart biopsy
|
$25.48 |
$25.48 |
$25.48 |
$666.40
|
|
Echo guide for transfusion
|
$46.28 |
$46.28 |
$46.28 |
$332.39
|
|
Echo guide ova aspiration
|
$24.18 |
$24.18 |
$24.18 |
$174.20
|
|
Echo guide villus sampling
|
$23.14 |
$23.14 |
$23.14 |
$362.88
|
|
Echo stress
|
$49.40 |
$49.40 |
$49.40 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$18.46 |
$18.46 |
$18.46 |
$751.34
|
|
Echo tee guidance
|
$2,416.84 |
$2,416.84 |
$2,416.84 |
$1,854.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,541.42 |
$1,541.42 |
$1,541.42 |
$1,913.60
|
|
Echo transesophageal
|
$8.06 |
$8.06 |
$8.06 |
$1,067.95
|
|
Echo transesophageal
|
$64.22 |
$64.22 |
$64.22 |
$588.00
|
|
Echo transesophageal
|
$90.22 |
$90.22 |
$90.22 |
$1,650.00
|
|
Echo transesophageal
|
$63.44 |
$63.44 |
$63.44 |
$603.20
|
|
Echo transesophageal intraop
|
$1,541.42 |
$1,541.42 |
$1,541.42 |
$1,578.00
|
|
Echo transthoracic
|
$1,541.42 |
$1,541.42 |
$1,541.42 |
$1,361.75
|
|
Echo transthoracic
|
$1,541.42 |
$1,541.42 |
$1,541.42 |
$1,045.16
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$680.06 |
$680.06 |
$680.06 |
$1,026.40
|
|
Ecmo/ecls daily mgmt artery 33949
|
$167.70 |
$167.70 |
$167.70 |
$3,099.00
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$171.86 |
$171.86 |
$171.86 |
$3,099.00
|
|
Ecmo/ecls initiation artery 33947
|
$246.22 |
$246.22 |
$246.22 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$222.04 |
$222.04 |
$222.04 |
$4,293.60
|
|
Ecmo/ecls insj cent cannula 0-5yrs 33955
|
$589.16 |
$589.16 |
$589.16 |
$1,948.20
|
|
Ecmo/ecls insj cent cannula 6yrs&older 33956
|
$596.44 |
$596.44 |
$596.44 |
$2,055.20
|
|
Ecmo/ecls insj prph cannula 0-5yrs opn 33953
|
$337.22 |
$337.22 |
$337.22 |
$1,083.00
|
|
Ecmo/ecls insj prph cannula 0-5yrs perq 33951
|
$302.12 |
$302.12 |
$302.12 |
$970.80
|
|
Ecmo/ecls insj prph cannula 6yrs&older opn 33954
|
$340.86 |
$340.86 |
$340.86 |
$1,313.68
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$3,820.62 |
$3,820.62 |
$3,820.62 |
$2,825.34
|
|
Ecmo/ecls remove cent cannula 0-5yrs 33985
|
$365.30 |
$365.30 |
$365.30 |
$925.55
|
|
Ecmo/ecls remove cent cannula 6yrs&older 33986
|
$375.70 |
$375.70 |
$375.70 |
$1,282.40
|
