|
Duragen 1x1 5ea/bx
|
$42,520.13 |
$42,520.13 |
$42,520.13 |
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$1,046.50 |
$2,454.00 |
$3,686.50 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$21,387.41 |
$21,387.41 |
$24,479.56 |
|
|
Dxa bone density axl vrt fx
|
$351.00 |
$402.00 |
$582.50 |
|
|
Dx aly aud oi snd prcsr 1st
|
$145.50 |
$145.50 |
$145.50 |
|
|
Dx bronchoscope/brush 31623
|
$15,218.63 |
$15,218.63 |
$15,218.63 |
|
|
Dx bronchoscope/lavage 31624
|
$14,510.59 |
$14,510.59 |
$14,510.59 |
|
|
Dx bronchoscope/wash 31622
|
$999.00 |
$2,050.50 |
$6,660.66 |
|
|
Dx gastr intub w/asp spec
|
$334.50 |
$462.50 |
$664.50 |
|
|
Dynamic surface emg
|
$199.00 |
$245.50 |
$245.50 |
|
|
Ear and throat examination
|
$339.50 |
$469.50 |
$469.50 |
|
|
Ear canal biopsy 69105
|
$966.50 |
$1,336.50 |
$1,336.50 |
|
|
Ear cartilage graft
|
$2,660.00 |
$3,611.00 |
$37,133.77 |
|
|
Ear irrigation 69209
|
$85.00 |
$165.50 |
$907.00 |
|
|
Ecallantide injection
|
$29,071.00 |
$29,071.00 |
$29,071.00 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$27.50 |
$45.50 |
$132.60 |
|
|
Ecg < 30 days transmission & analysis
|
$81.50 |
$100.00 |
$100.00 |
|
|
Ecg external < 48 hours recording
|
$125.00 |
$423.00 |
$3,167.00 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$129.00 |
$303.50 |
$2,339.00 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$29.00 |
$43.00 |
$229.50 |
|
|
Ecg external >7 days up to 15 days recording
|
$58.50 |
$71.50 |
$229.50 |
|
|
Echocardiogram (Heart Ultrasound)
|
$856.00 |
$1,880.50 |
$5,611.00 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$500.50 |
$535.50 |
$4,267.00 |
|
|
Echocardiography doppler color flow mapping
|
$221.00 |
$375.50 |
$707.00 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$8,378.00 |
$8,378.00 |
$8,378.00 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$500.00 |
$774.50 |
$8,378.00 |
|
|
Echocardiograpy doppler follow up/limited study
|
$185.00 |
$440.00 |
$1,917.00 |
|
|
Echo exam of eye
|
$304.00 |
$304.00 |
$338.00 |
|
|
Echo exam of eye
|
$304.00 |
$306.50 |
$338.00 |
|
|
Echo exam of eye
|
$95.50 |
$95.50 |
$95.50 |
|
|
Echo exam of eye thickness
|
$92.00 |
$102.00 |
$102.00 |
|
|
Echo exam of fetal heart
|
$367.50 |
$847.50 |
$4,801.00 |
|
|
Echo exam of fetal heart
|
$268.50 |
$298.50 |
$4,801.00 |
|
|
Echo exam of fetal heart
|
$156.00 |
$464.00 |
$2,848.00 |
|
|
Echo exam of fetal heart
|
$156.00 |
$354.00 |
$2,848.00 |
|
|
Echo exam uterus 76831-
|
$280.00 |
$368.50 |
$683.00 |
|
|
Echo guidance radiotherapy
|
$2,487.00 |
$2,487.00 |
$2,487.00 |
|
|
Echo guide for amniocentesis
|
$240.00 |
$308.50 |
$2,033.00 |
|
|
Echo guide for artery repair
|
$123.00 |
$448.00 |
$1,245.00 |
|
|
Echo guide for heart biopsy
|
$182.50 |
$182.50 |
$193.00 |
|
|
Echo guide for transfusion
|
$146.00 |
$162.00 |
$1,832.00 |
|
|
Echo guide villus sampling
|
$157.50 |
$175.00 |
$1,818.00 |
|
|
Echo stress
|
$540.00 |
$1,182.50 |
$5,389.00 |
|
|
Echo tee guidance
|
$2,467.20 |
$2,467.20 |
$2,467.20 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,124.00 |
$1,408.50 |
$4,809.00 |
|
|
Echo transesophageal
|
$509.00 |
$509.00 |
$1,891.20 |
|
|
Echo transesophageal
|
$556.00 |
$556.00 |
$602.00 |
|
|
Echo transesophageal
|
$1,120.50 |
$1,120.50 |
$2,057.50 |
|
|
Echo transesophageal
|
$1,010.00 |
$1,010.00 |
$1,069.00 |
|
|
Echo transesophageal intraop
|
$938.50 |
$1,137.50 |
$4,759.80 |
|
|
Echo transthoracic
|
$1,008.50 |
$1,069.00 |
$5,004.00 |
|
|
Echo transthoracic
|
$745.50 |
$903.00 |
$1,917.00 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$560.40 |
$809.50 |
$5,327.00 |
|
|
Ecmo/ecls daily mgmt artery 33949
|
$9,440.00 |
$11,654.50 |
$12,820.00 |
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$9,440.00 |
$11,654.50 |
$11,654.50 |
|
|
Ecmo/ecls initiation artery 33947
|
$13,053.50 |
$13,053.50 |
$13,053.50 |
|
|
Ecmo/ecls initiation venous 33946
|
$9,440.00 |
$11,654.50 |
$12,820.00 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$1,709.00 |
$2,110.00 |
$2,612.00 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$13,053.50 |
$13,053.50 |
$13,053.50 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$27,396.56 |
$31,310.35 |
$44,027.00 |
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$142.80 |
$142.80 |
$142.80 |
|
|
Eeg 41-60 minutes 95812-26
|
$670.20 |
$1,106.50 |
$4,190.00 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$328.00 |
$883.00 |
$1,710.00 |
|
|
Eeg during surgery
|
$726.50 |
$892.50 |
$1,309.00 |
|
|
Eeg monitoring/function test
|
$1,212.50 |
$1,490.00 |
$1,490.00 |
|
|
Eeg monitor/record/awake/drowsy 95816
|
$630.00 |
$774.50 |
$3,921.00 |
|
|
Eeg over 1 hour 95813 - 26
|
$771.00 |
$1,710.00 |
$4,341.00 |
|
|
Eeg/record in coma or sleep only 95822
|
$364.00 |
$593.00 |
$3,295.00 |
|
|
Eeg recording awake and asleep
|
$630.00 |
$774.50 |
$2,834.50 |
|
|
Eeg without vid 2-12hr cont mntr
|
$210.50 |
$391.00 |
$772.00 |
|
|
Eeg without vid 2-12 hr unmntr
|
$210.50 |
$391.00 |
$772.10 |
|
|
Eeg without vid ea 12-26hr cont
|
$404.00 |
$1,118.50 |
$1,334.34 |
|
|
Eeg without vid ea 12-26hr intmt
|
$404.00 |
$910.00 |
$1,224.00 |
|
|
Eeg wo vid 2-12hr intmt mntr
|
$210.50 |
$369.50 |
$414.50 |
|
|
Eeg wo vid ea 12-26hr unmntr
|
$404.00 |
$1,098.00 |
$1,334.34 |
|
|
E equine encephalitis igg
|
$33.00 |
$47.50 |
$124.20 |
|
|
Egd control bleeding any
|
$13,232.89 |
$13,232.89 |
$15,957.75 |
|
|
Egd dilate stricture
|
$6,803.65 |
$6,803.65 |
$6,803.65 |
|
|
Egd endo mucosal resection
|
$11,988.17 |
$11,988.17 |
$11,988.17 |
|
|
Egd endoscopic stent place
|
$38,375.80 |
$38,375.80 |
$38,375.80 |
|
|
Egd guide wire insertion
|
$2,808.00 |
$7,821.90 |
$12,761.06 |
|
|
Egd lesion ablation
|
$44,610.32 |
$44,610.32 |
$44,610.32 |
|
|
Egd remove foreign body
|
$836.00 |
$1,387.50 |
$8,481.98 |
|
|
Egd remove lesion snare
|
$8,944.00 |
$8,944.00 |
$13,962.12 |
|
|
Egd/remov tum/polyp/hot bx forcep 43250
|
$3,095.95 |
$3,095.95 |
$3,095.95 |
|
|
Egd Ultrasound exam duodenum/jejunum
|
$7,518.60 |
$7,518.60 |
$10,300.19 |
|
|
Egd Ultrasound fine needle bx/aspir
|
$12,301.69 |
$12,301.69 |
$12,301.69 |
|
|
Egd Ultrasound fine needle bx/aspir
|
$11,064.44 |
$11,064.44 |
$11,064.44 |
|
|
Egd Ultrasound transmural injxn/mark
|
$22,047.97 |
$22,047.97 |
$22,047.97 |
|
|
Egd varices ligation
|
$6,921.32 |
$6,921.32 |
$7,084.34 |
|
|
Egd w/transmural drain cyst
|
$34,592.63 |
$34,592.63 |
$34,592.63 |
|
|
Egfr gene com variants
|
$303.00 |
$486.00 |
$1,008.00 |
|
|
EKG (Tracing Only)
|
$59.50 |
$235.80 |
$1,093.00 |
|
|
Elbow X-ray (2 views, both sides)
|
$142.00 |
$237.50 |
$1,066.50 |
|
|
Elbow X-ray (3 or more views, both sides)
|
$208.50 |
$352.00 |
$1,188.00 |
|
|
Elec analys infus pump w/reprog 62368
|
$375.00 |
$518.50 |
$518.50 |
|
|
Elec stim unattend for press
|
$57.00 |
$75.50 |
$121.00 |
|
|
Elect analysis of infusion pump 62367
|
$314.00 |
$434.00 |
$434.00 |
|
|
Elect anlys sp inf pmp w/reprg&fill 62369
|
$279.50 |
$380.00 |
$380.00 |
|
|
Electrd sq emblem s-icd
|
$9,611.00 |
$9,611.00 |
$33,795.30 |
|
