|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$185.00 |
$185.00 |
$185.00 |
$8,040.27
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$2.00 |
$2.00 |
$2.00 |
$3.11
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$376.50 |
$376.50 |
$376.50 |
$400.98
|
|
Drug admin & hemodynmic meas
|
$233.50 |
$233.50 |
$233.50 |
$578.59
|
|
Drug assay caffeine
|
$62.00 |
$62.00 |
$62.00 |
$81.61
|
|
Drug assay posaconazole
|
$135.50 |
$135.50 |
$135.50 |
$96.75
|
|
Drug assay vedolizumab
|
$429.00 |
$429.00 |
$429.00 |
$157.00
|
|
Drug assay voriconazole
|
$187.00 |
$187.00 |
$187.00 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$84.00 |
$84.00 |
$84.00 |
$66.43
|
|
Drug screen quant tiagabine
|
$156.50 |
$156.50 |
$156.50 |
$107.59
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$774.50 |
$774.50 |
$774.50 |
$280.95
|
|
Drvvt confirm - quest
|
$129.00 |
$129.00 |
$129.00 |
$109.20
|
|
Dstrj extensive retinopathy
|
$2,183.50 |
$2,183.50 |
$2,183.50 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$2,351.00 |
$2,351.00 |
$2,351.00 |
$2,967.48
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$443.00 |
$443.00 |
$443.00 |
$603.20
|
|
Ductogram sgl duct
|
$248.00 |
$248.00 |
$248.00 |
$469.44
|
|
Duodenal motility study
|
$1,743.50 |
$1,743.50 |
$1,743.50 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$441.00 |
$441.00 |
$441.00 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$202.00 |
$202.00 |
$202.00 |
$375.60
|
|
Dup scan/hemodialysis access 93990
|
$203.50 |
$203.50 |
$203.50 |
$486.02
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$736.50 |
$736.50 |
$736.50 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$566.50 |
$566.50 |
$566.50 |
$903.50
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$3,686.50 |
$3,686.50 |
$3,686.50 |
$23,482.80
|
|
Dxa bone density axl vrt fx
|
$582.50 |
$582.50 |
$582.50 |
$410.25
|
|
Dx aly aud oi snd prcsr 1st
|
$145.50 |
$145.50 |
$145.50 |
$186.40
|
|
Dx bronchoscope/wash 31622
|
$2,410.50 |
$2,410.50 |
$2,410.50 |
$2,322.60
|
|
Dx gastr intub w/asp spec
|
$462.50 |
$462.50 |
$462.50 |
$441.60
|
|
Dynamic surface emg
|
$245.50 |
$245.50 |
$245.50 |
$368.50
|
|
Ear and throat examination
|
$469.50 |
$469.50 |
$469.50 |
$602.63
|
|
Ear canal biopsy 69105
|
$1,336.50 |
$1,336.50 |
$1,336.50 |
$1,889.50
|
|
Ear cartilage graft
|
$3,611.00 |
$3,611.00 |
$3,611.00 |
$6,311.00
|
|
Ear irrigation 69209
|
$117.50 |
$117.50 |
$117.50 |
$150.00
|
|
Ecg 12 lead tracing only
|
$73.00 |
$73.00 |
$73.00 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$45.50 |
$45.50 |
$45.50 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$100.00 |
$100.00 |
$100.00 |
$466.20
|
|
Ecg external < 48 hours recording
|
$154.00 |
$154.00 |
$154.00 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$158.50 |
$158.50 |
$158.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$43.00 |
$43.00 |
$43.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$71.50 |
$71.50 |
$71.50 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$1,061.50 |
$1,061.50 |
$1,061.50 |
$1,977.50
|
|
Echocardiography doppler color flow mapping
|
$668.00 |
$668.00 |
$668.00 |
$499.20
|
|
Echocardiography transthoracic 2d followup/limited
|
$500.50 |
$500.50 |
$500.50 |
$711.00
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$790.50 |
$790.50 |
$790.50 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$440.00 |
$440.00 |
$440.00 |
$371.25
|
|
Echo exam of eye
|
$338.00 |
$338.00 |
$338.00 |
$143.75
|
|
Echo exam of eye
|
$338.00 |
$338.00 |
$338.00 |
$172.00
|
|
Echo exam of eye
|
$95.50 |
$95.50 |
$95.50 |
$169.62
|
|
Echo exam of eye thickness
|
$102.00 |
$102.00 |
$102.00 |
$40.30
|
|
Echo exam of fetal heart
|
$408.00 |
$408.00 |
$408.00 |
$904.80
|
|
Echo exam of fetal heart
|
$298.50 |
$298.50 |
$298.50 |
$538.27
|
|
Echo exam of fetal heart
|
$464.00 |
$464.00 |
$464.00 |
$431.41
|
|
Echo exam of fetal heart
|
$354.00 |
$354.00 |
$354.00 |
$319.00
|
|
Echo exam uterus 76831-
|
$368.50 |
$368.50 |
$368.50 |
$552.50
|
|
Echo guide for amniocentesis
|
$266.50 |
$266.50 |
$266.50 |
$446.60
|
|
Echo guide for artery repair
|
$203.50 |
$203.50 |
$203.50 |
$687.35
|
|
Echo guide for heart biopsy
|
$182.50 |
$182.50 |
$182.50 |
$666.40
|
|
Echo guide for transfusion
|
$162.00 |
$162.00 |
$162.00 |
$332.39
|
|
Echo guide villus sampling
|
$175.00 |
$175.00 |
$175.00 |
$362.88
|
|
Echo stress
|
$540.00 |
$540.00 |
$540.00 |
$1,606.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$1,889.20
|
|
Echo transesophageal
|
$509.00 |
$509.00 |
$509.00 |
$1,075.20
|
|
Echo transesophageal
|
$556.00 |
$556.00 |
$556.00 |
$602.00
|
|
Echo transesophageal
|
$1,120.50 |
$1,120.50 |
$1,120.50 |
$1,599.50
|
|
Echo transesophageal
|
$1,010.00 |
$1,010.00 |
$1,010.00 |
$603.20
|
|
Echo transesophageal intraop
|
$938.50 |
$938.50 |
$938.50 |
$1,578.00
|
|
Echo transthoracic
|
$1,008.50 |
$1,008.50 |
$1,008.50 |
$1,361.75
|
|
Echo transthoracic
|
$745.50 |
$745.50 |
$745.50 |
$1,010.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$765.00 |
$765.00 |
$765.00 |
$1,022.30
|
|
Ecmo/ecls daily mgmt artery 33949
|
$11,654.50 |
$11,654.50 |
$11,654.50 |
$2,867.22
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$11,654.50 |
$11,654.50 |
$11,654.50 |
$3,099.00
|
|
Ecmo/ecls initiation artery 33947
|
$13,053.50 |
$13,053.50 |
$13,053.50 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$11,654.50 |
$11,654.50 |
$11,654.50 |
$3,988.60
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$2,110.00 |
$2,110.00 |
$2,110.00 |
$2,825.34
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$13,053.50 |
$13,053.50 |
$13,053.50 |
$1,362.00
|
|
Eeg 41-60 minutes 95812-26
|
$1,126.50 |
$1,126.50 |
$1,126.50 |
$923.88
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$970.07
|
|
Eeg during surgery
|
$892.50 |
$892.50 |
$892.50 |
$775.45
|
|
Eeg monitoring/function test
|
$1,490.00 |
$1,490.00 |
$1,490.00 |
$1,548.52
|
|
Eeg monitor/record/awake/drowsy 95816
|
$774.50 |
$774.50 |
$774.50 |
$831.00
|
|
Eeg over 1 hour 95813 - 26
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$447.50 |
$447.50 |
$447.50 |
$865.00
|
|
Eeg recording awake and asleep
|
$774.50 |
$774.50 |
$774.50 |
$929.00
|
|
Eeg without vid 2-12hr cont mntr
|
$391.00 |
$391.00 |
$391.00 |
$826.15
|
|
Eeg without vid 2-12 hr unmntr
|
$391.00 |
$391.00 |
$391.00 |
$681.02
|
|
Eeg without vid ea 12-26hr cont
|
$1,118.50 |
$1,118.50 |
$1,118.50 |
$1,584.70
|
|
Eeg without vid ea 12-26hr intmt
|
$1,118.50 |
$1,118.50 |
$1,118.50 |
$1,402.50
|
|
Eeg wo vid 2-12hr intmt mntr
|
$391.00 |
$391.00 |
$391.00 |
$704.79
|
|
Eeg wo vid ea 12-26hr unmntr
|
$1,118.50 |
$1,118.50 |
$1,118.50 |
$1,591.10
|
|
E equine encephalitis igg
|
$43.50 |
$43.50 |
$43.50 |
$50.88
|
|
Egd remove foreign body
|
$1,387.50 |
$1,387.50 |
$1,387.50 |
$1,548.00
|
|
Egfr gene com variants
|
$486.00 |
$486.00 |
$486.00 |
$657.00
|
|
Elec analys infus pump w/reprog 62368
|
$518.50 |
$518.50 |
$518.50 |
$606.10
|
|
Elec stim unattend for press
|
$79.00 |
$79.00 |
$79.00 |
$89.10
|
|
Elect analysis of infusion pump 62367
|
$434.00 |
$434.00 |
$434.00 |
$551.20
|
|
Elect anlys sp inf pmp w/reprg&fill 62369
|
$380.00 |
$380.00 |
$380.00 |
$618.80
|
|
Electrd sq emblem s-icd
|
$9,611.00 |
$9,611.00 |
$9,611.00 |
$10,617.22
|
|
Electrical stimulation/unattended 97014
|
$86.00 |
$86.00 |
$86.00 |
$81.00
|
|
Electric stim/w chemodenervation 95873
|
$59.00 |
$59.00 |
$59.00 |
$166.40
|
|
Electroacous eval hear aid/biaural 92595
|
$93.00 |
$93.00 |
$93.00 |
$97.50
|
|
Electrocochleography
|
$363.00 |
$363.00 |
$363.00 |
$423.87
|
