|
ER Visit (level 3)
|
$630.00 |
$630.00 |
$630.00 |
$793.20
|
|
ER Visit (level 4)
|
$975.50 |
$975.50 |
$975.50 |
$1,277.65
|
|
ER Visit (level 5, high severity)
|
$1,291.50 |
$1,291.50 |
$1,291.50 |
$1,844.80
|
|
Esophageal recording
|
$1,877.00 |
$1,877.00 |
$1,877.00 |
$2,112.54
|
|
Esophageal recording
|
$2,253.50 |
$2,253.50 |
$2,253.50 |
$2,363.40
|
|
Esophagoscop ultrasound exam
|
$1,196.00 |
$1,196.00 |
$1,196.00 |
$2,580.50
|
|
Esophagoscopy control bleed
|
$1,138.00 |
$1,138.00 |
$1,138.00 |
$2,638.57
|
|
Esophagoscopy flex biopsy
|
$1,156.50 |
$1,156.50 |
$1,156.50 |
$2,132.00
|
|
Esophagoscopy/flex/diagnostic 43200
|
$681.00 |
$681.00 |
$681.00 |
$1,259.70
|
|
Esophagoscopy flex remove fb
|
$1,154.00 |
$1,154.00 |
$1,154.00 |
$2,065.80
|
|
Esophagoscopy w/us needle bx
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$2,244.82
|
|
Esophagoscp rig trnso rem fb
|
$1,374.00 |
$1,374.00 |
$1,374.00 |
$2,785.75
|
|
Esophagus endoscopy/ligation
|
$1,154.00 |
$1,154.00 |
$1,154.00 |
$2,392.00
|
|
Esophagus motility study
|
$508.50 |
$508.50 |
$508.50 |
$1,257.17
|
|
Esoph endoscopy dilation
|
$1,084.50 |
$1,084.50 |
$1,084.50 |
$2,221.83
|
|
Esoph imped function test
|
$325.00 |
$325.00 |
$325.00 |
$603.00
|
|
Esoph imped funct test > 1hr
|
$634.50 |
$634.50 |
$634.50 |
$1,089.15
|
|
Esoph scope w/sclerosis inj
|
$1,154.00 |
$1,154.00 |
$1,154.00 |
$2,244.82
|
|
Esoph scope w/submucous inj
|
$1,154.00 |
$1,154.00 |
$1,154.00 |
$2,580.50
|
|
Essure 58565
|
$5,143.50 |
$5,143.50 |
$5,143.50 |
$5,841.60
|
|
Establish access to artery
|
$267.50 |
$267.50 |
$267.50 |
$1,145.65
|
|
Established Patient Office Visit (level 1)
|
$518.00 |
$518.00 |
$518.00 |
$122.40
|
|
Established Patient Office Visit (level 2)
|
$43.00 |
$43.00 |
$43.00 |
$138.82
|
|
Established Patient Office Visit (level 3)
|
$43.00 |
$43.00 |
$43.00 |
$186.60
|
|
Established Patient Office Visit (level 4)
|
$43.00 |
$43.00 |
$43.00 |
$235.00
|
|
Established Patient Office Visit (level 5)
|
$43.00 |
$43.00 |
$43.00 |
$287.10
|
|
Estradiol total
|
$133.00 |
$133.00 |
$133.00 |
$149.43
|
|
Estrogens total-sendout
|
$29.50 |
$29.50 |
$29.50 |
$96.63
|
|
Ethylene glycol -sendout
|
$128.00 |
$128.00 |
$128.00 |
$85.00
|
|
Eval/fit voice prosthesis iii, st
|
$213.50 |
$213.50 |
$213.50 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$194.50 |
$194.50 |
$194.50 |
$211.12
|
|
Evaluation heart device
|
$2,147.00 |
$2,147.00 |
$2,147.00 |
$2,221.96
|
|
Evaluation of speech fluency 92521
|
$199.50 |
$199.50 |
$199.50 |
$307.75
|
|
Evaluation psychiatric diagnostic
|
$102.50 |
$102.50 |
$102.50 |
$315.00
|
|
Evasc prlng admn rx agnt 1st
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$3,885.63
|
|
Evasc prlng admn rx agnt add
|
$754.50 |
$754.50 |
$754.50 |
$2,765.60
|
|
Evasc rpr a-ao ndgft 34701
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$5,230.40
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$4,537.60
|
|
Evasc rpr a-biiliac ndgft rptr
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$8,133.60
|
|
Evasc rpr a-unilac ndgft 34703
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$5,608.35
|
|
Evasc rpr a-unilac ndgft rpt
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$7,150.44
|
|
Evasc rpr ilio-iliac rpt
|
$2,357.50 |
$2,357.50 |
$2,357.50 |
$8,996.13
|
|
Event monitor
|
$149.00 |
$149.00 |
$149.00 |
$237.60
|
|
Evoked potentials upper limbs
|
$681.50 |
$681.50 |
$681.50 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$554.50 |
$554.50 |
$554.50 |
$812.40
|
|
Exam of vagina w/scope 57420
|
$365.00 |
$365.00 |
$365.00 |
$486.03
|
|
Exam plvc w/anes othr thn lcl
|
$2,620.50 |
$2,620.50 |
$2,620.50 |
$3,762.53
|
|
Exc back les sbq <3 cm 21930
|
$2,121.00 |
$2,121.00 |
$2,121.00 |
$2,676.58
|
|
Exc bartholins gland/cyst
|
$2,741.00 |
$2,741.00 |
$2,741.00 |
$3,781.65
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$1,207.50 |
$1,207.50 |
$1,207.50 |
$2,271.01
|
|
Exc benign feenlm >4.0cm 11446
|
$2,034.50 |
$2,034.50 |
$2,034.50 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$2,641.00 |
$2,641.00 |
$2,641.00 |
$2,271.01
|
|
Exc benign tal 0.5 < cm 11400
|
$614.00 |
$614.00 |
$614.00 |
$827.40
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$614.00 |
$614.00 |
$614.00 |
$923.06
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$744.00 |
$744.00 |
$744.00 |
$1,051.40
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,207.50 |
$1,207.50 |
$1,207.50 |
$2,061.19
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,880.50 |
$1,880.50 |
$1,880.50 |
$1,467.00
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$2,359.00 |
$2,359.00 |
$2,359.00 |
$2,121.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$2,903.50 |
$2,903.50 |
$2,903.50 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$676.00 |
$676.00 |
$676.00 |
$770.70
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$818.00 |
$818.00 |
$818.00 |
$1,244.03
|
|
Exc ext ear/partial/simple repair 69110
|
$2,293.00 |
$2,293.00 |
$2,293.00 |
$3,170.00
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$630.00 |
$630.00 |
$630.00 |
$973.71
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$1,207.50 |
$1,207.50 |
$1,207.50 |
$2,101.45
|
|
Exchange biliary drg cath
|
$3,192.00 |
$3,192.00 |
$3,192.00 |
$3,797.76
|
|
Exchange drainage catheter
|
$1,741.50 |
$1,741.50 |
$1,741.50 |
$2,191.20
|
|
Exchange lens prosthesis
|
$1,731.50 |
$1,731.50 |
$1,731.50 |
$4,504.00
|
|
Exchange nephrostomy cath
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$2,958.80
|
|
Excise/repair mouth lesion
|
$1,882.50 |
$1,882.50 |
$1,882.50 |
$1,903.93
|
|
Excision aural polyp
|
$2,234.00 |
$2,234.00 |
$2,234.00 |
$2,133.48
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$676.00 |
$676.00 |
$676.00 |
$863.10
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$2,106.00 |
$2,106.00 |
$2,106.00 |
$1,999.20
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$744.00 |
$744.00 |
$744.00 |
$1,064.30
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,207.50 |
$1,207.50 |
$1,207.50 |
$2,641.65
|
|
Excision of anal lesion(s)
|
$2,326.50 |
$2,326.50 |
$2,326.50 |
$3,823.00
|
|
Excision of penis lesion(s) 54060
|
$2,556.50 |
$2,556.50 |
$2,556.50 |
$2,479.33
|
|
Excision of salivary cyst
|
$2,033.50 |
$2,033.50 |
$2,033.50 |
$4,558.89
|
|
Excision of tonsil tags
|
$2,845.00 |
$2,845.00 |
$2,845.00 |
$4,350.00
|
|
Excision of uvula
|
$1,366.00 |
$1,366.00 |
$1,366.00 |
$3,811.00
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$2,872.50 |
$2,872.50 |
$2,872.50 |
$3,986.00
|
|
Exc les conjunctiva <1 cm
|
$1,511.50 |
$1,511.50 |
$1,511.50 |
$2,760.73
|
|
Exc les conjunctiva >1 cm
|
$1,765.50 |
$1,765.50 |
$1,765.50 |
$2,760.73
|
|
Exc malig feenl <0.5cm 11640
|
$630.00 |
$630.00 |
$630.00 |
$1,055.20
|
|
Exc malig feenl 1.1-2 11642
|
$630.00 |
$630.00 |
$630.00 |
$1,082.00
|
|
Exc malig feenl 3.1-4.0 11644
|
$1,022.50 |
$1,022.50 |
$1,022.50 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$2,668.50 |
$2,668.50 |
$2,668.50 |
$3,167.89
|
|
Exc malig snhfg 0.5cm or less 11620
|
$1,678.50 |
$1,678.50 |
$1,678.50 |
$1,377.57
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$1,880.50 |
$1,880.50 |
$1,880.50 |
$1,064.70
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$2,359.00 |
$2,359.00 |
$2,359.00 |
$1,917.33
|
|
Exc malig tal <0.5cm 11600
|
$539.50 |
$539.50 |
$539.50 |
$973.71
|
|
Exc malig tal 0.6-1.0cm 11601
|
$630.00 |
$630.00 |
$630.00 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$646.00 |
$646.00 |
$646.00 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$775.50 |
$775.50 |
$775.50 |
$1,154.00
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$929.50 |
$929.50 |
$929.50 |
$1,294.80
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$2,879.00 |
$2,879.00 |
$2,879.00 |
$3,386.84
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$2,106.00 |
$2,106.00 |
$2,106.00 |
$1,274.00
|
|
Exc snhfg mal+mrg 3.1-4 11624
|
$2,641.00 |
$2,641.00 |
$2,641.00 |
$2,171.00
|
|
Exc snhfg mal+mrg >4 cm 11626
|
$2,903.50 |
$2,903.50 |
$2,903.50 |
$3,386.84
|
|
Exc sq tumor/shoulder area 3cm/> 23071
|
$2,725.50 |
$2,725.50 |
$2,725.50 |
$4,014.40
|
