|
Closed tx orbit without manipulj
|
$1,697.80 |
$1,697.80 |
$1,697.80 |
$998.40
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$597.35 |
$597.35 |
$597.35 |
$535.60
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,600.65 |
$2,600.65 |
$2,600.65 |
$1,851.78
|
|
Cmv pcr-sendout
|
$663.65 |
$663.65 |
$663.65 |
$175.70
|
|
Colonoscopy stoma w/snare 44394
|
$2,228.20 |
$2,228.20 |
$2,228.20 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$2,482.35 |
$2,482.35 |
$2,482.35 |
$2,080.00
|
|
Colonoscopy (with biopsy)
|
$2,438.80 |
$2,438.80 |
$2,438.80 |
$2,214.00
|
|
Computed tomographic angiography head and neck with contrast
|
$4,160.00 |
$4,160.00 |
$4,160.00 |
$2,247.00
|
|
Control of nosebleedantersmpl 30901
|
$373.75 |
$373.75 |
$373.75 |
$352.80
|
|
Core ndl bx lng/med perq
|
$4,522.05 |
$4,522.05 |
$4,522.05 |
$2,904.48
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$13,094.90 |
$13,094.90 |
$13,094.90 |
$7,988.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$578.63 |
$578.63 |
$578.63 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$47.45 |
$47.45 |
$47.45 |
$112.00
|
|
Covid-19 administration immunization im inj 1st/only component
|
$70.20 |
$70.20 |
$70.20 |
$49.13
|
|
Creatine kinase
|
$71.50 |
$71.50 |
$71.50 |
$66.30
|
|
CT hrt w/3d image
|
$2,066.35 |
$2,066.35 |
$2,066.35 |
$1,350.03
|
|
Culture anaerobic additional method definitive id each
|
$102.05 |
$102.05 |
$102.05 |
$84.76
|
|
Culture body fluid
|
$155.35 |
$155.35 |
$155.35 |
$126.75
|
|
Culture mycobacteria definitive id each isolate
|
$146.90 |
$146.90 |
$146.90 |
$100.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$158.60 |
$158.60 |
$158.60 |
$140.80
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$163.80 |
$163.80 |
$163.80 |
$191.66
|
|
Debride skn/sq/musc/abd wall 11004
|
$1,184.95 |
$1,184.95 |
$1,184.95 |
$903.00
|
|
Device ablt adv novasure
|
$357.50 |
$357.50 |
$357.50 |
$6,237.48
|
|
Dexamethasone 4 mg tablet
|
$19.17 |
$19.17 |
$19.17 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$27.82 |
$27.82 |
$27.82 |
$20.76
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$121.55 |
$121.55 |
$121.55 |
$46.35
|
|
Dicyclomine injection
|
$133.57 |
$133.57 |
$133.57 |
$154.33
|
|
Digoxin total therapeutic drug level
|
$96.20 |
$96.20 |
$96.20 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,146.60 |
$1,146.60 |
$1,146.60 |
$1,866.73
|
|
Diltiazem 5 mg/ml intravenous solution
|
$27.82 |
$27.82 |
$27.82 |
$45.60
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$27.82 |
$27.82 |
$27.82 |
$18.32
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$144.56 |
$144.56 |
$144.56 |
$89.34
|
|
Drng of finger abscess comp 26011
|
$2,923.05 |
$2,923.05 |
$2,923.05 |
$2,079.50
|
|
Drug assay caffeine
|
$125.45 |
$125.45 |
$125.45 |
$80.00
|
|
Duplex scan bilateral study 93985
|
$432.25 |
$432.25 |
$432.25 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$419.25 |
$419.25 |
$419.25 |
$369.20
|
|
Ear irrigation 69209
|
$399.75 |
$399.75 |
$399.75 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$132.60 |
$132.60 |
$132.60 |
$132.08
|
|
Echo transthoracic
|
$1,779.70 |
$1,779.70 |
$1,779.70 |
$1,361.75
|
|
Echo transthoracic
|
$1,265.55 |
$1,265.55 |
$1,265.55 |
$1,052.40
|
|
Egd guide wire insertion
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$1,664.00
|
|
Egd/remov tum/polyp/hot bx forcep 43250
|
$3,095.95 |
$3,095.95 |
$3,095.95 |
$2,244.82
|
|
EKG (Tracing Only)
|
$292.50 |
$292.50 |
$292.50 |
$226.50
|
|
Electrical stimulation/unattended 97014
|
$118.30 |
$118.30 |
$118.30 |
$81.75
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$429.00 |
$429.00 |
$429.00 |
$502.80
|
|
Emg needle test 1-extremity
|
$332.15 |
$332.15 |
$332.15 |
$351.50
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$189.67 |
$189.67 |
$189.67 |
$112.79
|
|
Episiotomy/vag rpr oth/thn attending phys 59300
|
$5,166.85 |
$5,166.85 |
$5,166.85 |
$3,778.57
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$613.53 |
$613.53 |
$613.53 |
$865.80
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$488.60 |
$488.60 |
$488.60 |
$427.26
|
|
Ercp bil/panc duct; each stent plcmt 43274
|
$5,054.40 |
$5,054.40 |
$5,054.40 |
$5,390.40
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$217.16 |
$217.16 |
$217.16 |
$232.12
|
|
ER Visit (level 2)
|
$513.50 |
$513.50 |
$513.50 |
$463.00
|
|
Escharotomy ea addl incision
|
$598.65 |
$598.65 |
$598.65 |
$203.20
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$66.04 |
$66.04 |
$66.04 |
$516.71
|
|
Esoph balloon distension tst
|
$1,880.45 |
$1,880.45 |
$1,880.45 |
$1,040.00
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$418.60 |
$418.60 |
$418.60 |
$1,207.80
|
|
Exc sq tum/neck or ant thorax <3cm 21555
|
$4,246.45 |
$4,246.45 |
$4,246.45 |
$3,322.80
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$1,698.12 |
$1,698.12 |
$1,698.12 |
$4,101.67
|
|
Fat/lipids feces qualitative
|
$51.35 |
$51.35 |
$51.35 |
$36.00
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$27.82 |
$27.82 |
$27.82 |
$101.40
|
|
Fibrin degradation d dimer quantitative
|
$161.20 |
$161.20 |
$161.20 |
$120.64
|
|
Fine needle asp without image guide 10021
|
$382.85 |
$382.85 |
$382.85 |
$504.45
|
|
Fl exam g/colon tube w contrast
|
$476.45 |
$476.45 |
$476.45 |
$540.80
|
|
Flt3 gene
|
$352.30 |
$352.30 |
$352.30 |
$366.29
|
|
Folic acid
|
$102.05 |
$102.05 |
$102.05 |
$101.50
|
|
Follow-up angiography
|
$2,300.35 |
$2,300.35 |
$2,300.35 |
$1,983.00
|
|
Fomepizole 1 gram/ml intravenous solution
|
$4,520.75 |
$4,520.75 |
$4,520.75 |
$2,511.73
|
|
Fondaparinux sodium
|
$394.29 |
$394.29 |
$394.29 |
$186.20
|
|
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260
|
$2,392.65 |
$2,392.65 |
$2,392.65 |
$3,155.50
|
|
Furosemide 10 mg/ml injection solution
|
$27.82 |
$27.82 |
$27.82 |
$19.53
|
|
Gastroesophageal reflux test
|
$1,448.85 |
$1,448.85 |
$1,448.85 |
$1,352.00
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$67.86 |
$67.86 |
$67.86 |
$52.54
|
|
Ghs ed rmvl or bivalving cast
|
$392.60 |
$392.60 |
$392.60 |
$338.40
|
|
Ghs fb removal - incisional
|
$2,444.00 |
$2,444.00 |
$2,444.00 |
$2,323.75
|
|
Ghs fb removal - non-incisional
|
$3,171.35 |
$3,171.35 |
$3,171.35 |
$1,706.20
|
|
Ghs i and d pilonidal cyst simple
|
$805.35 |
$805.35 |
$805.35 |
$707.25
|
|
Ghs insertion of needle - bone
|
$572.00 |
$572.00 |
$572.00 |
$431.28
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$1,218.75 |
$1,218.75 |
$1,218.75 |
$583.10
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$319.80 |
$319.80 |
$319.80 |
$233.28
|
|
Ghs moderate sedation ea addtl 15 min
|
$160.55 |
$160.55 |
$160.55 |
$150.00
|
|
Ghs myocardial strain img spckl track
|
$488.80 |
$488.80 |
$488.80 |
$457.80
|
|
Ghs ot prosthetic training/15 min
|
$76.05 |
$76.05 |
$76.05 |
$93.00
|
|
Ghs ppd (tb intradermal)
|
$26.65 |
$26.65 |
$26.65 |
$37.44
|
|
Ghs reticulocyte count
|
$34.45 |
$34.45 |
$34.45 |
$34.50
|
|
Ghs vaginal delivery only
|
$4,205.50 |
$4,205.50 |
$4,205.50 |
$3,341.93
|
|
Ghs veeg 12-26 hr intmt mont
|
$1,898.65 |
$1,898.65 |
$1,898.65 |
$1,932.00
|
|
Glucagon 1 mg solution for injection
|
$1,520.09 |
$1,520.09 |
$1,520.09 |
$613.79
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$59.80 |
$59.80 |
$59.80 |
$23,233.80
|
|
Graft nerve adv 3-4x70mm
|
$15,017.36 |
$15,017.36 |
$15,017.36 |
$20,782.10
|
|
Graft xenmtrx sft rect 15x20cm
|
$13,987.51 |
$13,987.51 |
$13,987.51 |
$29,676.26
|
|
Guide wire threaded 1.4x150mm
|
$118.30 |
$118.30 |
$118.30 |
$3,284.36
|
|
Gw stiffened micro access kit
|
$117.00 |
$117.00 |
$117.00 |
$6,893.38
|
|
Hba1/hba2 gene dup/del vrnts
|
$227.50 |
$227.50 |
$227.50 |
$403.25
|
|
Hcg quantitative
|
$152.10 |
$152.10 |
$152.10 |
$139.20
|
|
Heparin bolus from bag
|
$156.52 |
$156.52 |
$156.52 |
$66.06
|
|
Hepatitis b surface antibody
|
$96.85 |
$96.85 |
$96.85 |
$82.32
|
|
Hla class ii high defin qual
|
$1,186.90 |
$1,186.90 |
$1,186.90 |
$569.25
|
|
Hlth bhv ivntj fam 1st 30
|
$325.00 |
$325.00 |
$325.00 |
$147.16
|
|
Home/res vst new mod mdm 60
|
$115.23 |
$115.23 |
$115.23 |
$327.20
|
