|
Dch pulmonary stress test
|
$1,144.24 |
$1,144.24 |
$1,144.24 |
$963.30
|
|
Debridement (>20 cm) charge pt
|
$238.75 |
$238.75 |
$238.75 |
$260.61
|
|
Decalcification
|
$444.76 |
$444.76 |
$444.76 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$670.68 |
$670.68 |
$670.68 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$744.35 |
$744.35 |
$744.35 |
$185.17
|
|
Dermagraft
|
$604.00 |
$604.00 |
$604.00 |
$85.00
|
|
Dermapure 1 square cm
|
$2,319.00 |
$2,319.00 |
$2,319.00 |
$3,822.00
|
|
Detect agent nos dna dir
|
$935.39 |
$935.39 |
$935.39 |
$115.20
|
|
Detect agnt mult dna direc
|
$1,186.43 |
$1,186.43 |
$1,186.43 |
$162.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$4.61 |
$4.61 |
$4.61 |
$227.15
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$558.54 |
$558.54 |
$558.54 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$651.76 |
$651.76 |
$651.76 |
$45.40
|
|
Dextrose 5 % IV bolus
|
$651.76 |
$651.76 |
$651.76 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$1,104.27 |
$1,104.27 |
$1,104.27 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$401.98 |
$401.98 |
$401.98 |
$79.20
|
|
Diagnostic digital breast tomosynthesis bil
|
$961.41 |
$961.41 |
$961.41 |
$117.94
|
|
Diagnostic Mammogram (both breasts)
|
$1,059.43 |
$1,059.43 |
$1,059.43 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$842.27 |
$842.27 |
$842.27 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$978.71 |
$978.71 |
$978.71 |
$214.08
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$193.58 |
$193.58 |
$193.58 |
$74.76
|
|
Dicyclomine injection
|
$526.40 |
$526.40 |
$526.40 |
$153.29
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$223.56 |
$223.56 |
$223.56 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$24,496.15 |
$24,496.15 |
$24,496.15 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$685.87 |
$685.87 |
$685.87 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,165.30 |
$1,165.30 |
$1,165.30 |
$297.86
|
|
Dimethyl sulfoxide 50% 50 ml
|
$4,155.55 |
$4,155.55 |
$4,155.55 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$89.56 |
$89.56 |
$89.56 |
$17.75
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$759.26 |
$759.26 |
$759.26 |
$91.53
|
|
Dna antibody native/double stranded
|
$896.02 |
$896.02 |
$896.02 |
$97.50
|
|
Dna probe chlamydia
|
$405.42 |
$405.42 |
$405.42 |
$79.38
|
|
Doppler echo complete
|
$1,725.76 |
$1,725.76 |
$1,725.76 |
$540.00
|
|
Dornase alfa non-comp unit
|
$886.46 |
$886.46 |
$886.46 |
$446.75
|
|
Dorsi & plantar flex ass/res
|
$864.00 |
$864.00 |
$864.00 |
$163.50
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$523.55 |
$523.55 |
$523.55 |
$84.80
|
|
Drainable plastic pch w fcpl
|
$171.00 |
$171.00 |
$171.00 |
$33.77
|
|
Drain chst dry seal exp thorastat
|
$336.85 |
$336.85 |
$336.85 |
$119.43
|
|
Drain ostomy pouch w/flange
|
$34.00 |
$34.00 |
$34.00 |
$8.80
|
|
Drop lock knee
|
$1,646.00 |
$1,646.00 |
$1,646.00 |
$204.95
|
|
Drug admin & hemodynmic meas
|
$4,186.80 |
$4,186.80 |
$4,186.80 |
$569.75
|
|
Drug assay voriconazole
|
$362.29 |
$362.29 |
$362.29 |
$96.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$1,298.01 |
$1,298.01 |
$1,298.01 |
$278.85
|
|
Drvvt confirm - quest
|
$635.05 |
$635.05 |
$635.05 |
$109.20
|
|
Ductogram sgl duct
|
$2,870.40 |
$2,870.40 |
$2,870.40 |
$463.10
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$3,424.36 |
$3,424.36 |
$3,424.36 |
$887.25
|
|
Dxa bone density axl vrt fx
|
$437.20 |
$437.20 |
$437.20 |
$392.60
|
|
Ecg 12 lead tracing only
|
$803.37 |
$803.37 |
$803.37 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$549.29 |
$549.29 |
$549.29 |
$135.80
|
|
Ecg < 30 days transmission & analysis
|
$462.91 |
$462.91 |
$462.91 |
$487.60
|
|
Ecg external < 48 hours recording
|
$3,715.50 |
$3,715.50 |
$3,715.50 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$3,715.50 |
$3,715.50 |
$3,715.50 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$6,118.50 |
$6,118.50 |
$6,118.50 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$701.01 |
$701.01 |
$701.01 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$5,963.26 |
$5,963.26 |
$5,963.26 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$5,963.26 |
$5,963.26 |
$5,963.26 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$1,836.25 |
$1,836.25 |
$1,836.25 |
$362.50
|
|
Echo exam of fetal heart
|
$3,748.08 |
$3,748.08 |
$3,748.08 |
$939.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$4,289.25 |
$4,289.25 |
$4,289.25 |
$1,849.50
|
|
Echo transesophageal intraop
|
$4,289.25 |
$4,289.25 |
$4,289.25 |
$1,571.70
|
|
Echo transthoracic
|
$6,118.50 |
$6,118.50 |
$6,118.50 |
$1,361.75
|
|
Echo transthoracic
|
$4,128.41 |
$4,128.41 |
$4,128.41 |
$953.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$3,700.46 |
$3,700.46 |
$3,700.46 |
$985.15
|
|
Eeg 41-60 minutes 95812-26
|
$1,099.95 |
$1,099.95 |
$1,099.95 |
$920.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$1,761.84 |
$1,761.84 |
$1,761.84 |
$1,000.42
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,099.95 |
$1,099.95 |
$1,099.95 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$1,099.95 |
$1,099.95 |
$1,099.95 |
$1,102.05
|
|
Eeg/record in coma or sleep only 95822
|
$1,099.95 |
$1,099.95 |
$1,099.95 |
$907.80
|
|
Eeg recording awake and asleep
|
$1,099.95 |
$1,099.95 |
$1,099.95 |
$931.20
|
|
Egfr gene com variants
|
$5,242.45 |
$5,242.45 |
$5,242.45 |
$657.00
|
|
Ehrlicha chaffeensis amp prb
|
$136.94 |
$136.94 |
$136.94 |
$93.00
|
|
Electrolyte panel
|
$923.93 |
$923.93 |
$923.93 |
$84.24
|
|
Electron microscopy diagnostic
|
$7,720.00 |
$7,720.00 |
$7,720.00 |
$983.41
|
|
Electrophysiology evaluation
|
$29,809.32 |
$29,809.32 |
$29,809.32 |
$8,979.45
|
|
Electrophysiology evaluation
|
$29,809.32 |
$29,809.32 |
$29,809.32 |
$10,233.60
|
|
Electrophysiology evaluation
|
$801.70 |
$801.70 |
$801.70 |
$6,760.00
|
|
Electrophysiology evaluation
|
$1,170.91 |
$1,170.91 |
$1,170.91 |
$5,854.80
|
|
Electrophysiology evaluation
|
$17,927.55 |
$17,927.55 |
$17,927.55 |
$2,451.90
|
|
Electrophysiology evaluation
|
$2,778.85 |
$2,778.85 |
$2,778.85 |
$1,869.13
|
|
Electrophys map 3d add-on
|
$2,915.89 |
$2,915.89 |
$2,915.89 |
$5,881.00
|
|
Emr hd pmp elec/combo, rep
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$255.36
|
|
Endo cath bile duct s&i
|
$3,186.15 |
$3,186.15 |
$3,186.15 |
$694.06
|
|
Endo cath panc duct s&i
|
$3,186.15 |
$3,186.15 |
$3,186.15 |
$672.43
|
|
Endoscopy swallow (fees) vid
|
$217.95 |
$217.95 |
$217.95 |
$402.35
|
|
Entamoeba histolytica ag eia - sendout
|
$551.38 |
$551.38 |
$551.38 |
$56.89
|
|
Enzyme histochemistry
|
$953.33 |
$953.33 |
$953.33 |
$471.60
|
|
Eo elas w/metal jnts pre ots
|
$1,253.00 |
$1,253.00 |
$1,253.00 |
$145.60
|
|
Ep & ablate supravent arrhyt
|
$80,095.45 |
$80,095.45 |
$80,095.45 |
$27,075.00
|
|
Ep & ablate ventric tachy
|
$80,095.45 |
$80,095.45 |
$80,095.45 |
$28,199.40
|
|
Epstein barr early antigen antibody
|
$612.12 |
$612.12 |
$612.12 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$600.67 |
$600.67 |
$600.67 |
$78.65
|
|
Ercp biliary & pancreas
|
$3,336.18 |
$3,336.18 |
$3,336.18 |
$967.04
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,511.36 |
$1,511.36 |
$1,511.36 |
$222.98
|
|
ER Visit (level 1, minor)
|
$1,119.13 |
$1,119.13 |
$1,119.13 |
$246.24
|
|
ER Visit (level 3)
|
$2,235.82 |
$2,235.82 |
$2,235.82 |
$770.04
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$603.55 |
$603.55 |
$603.55 |
$223.99
|
|
Esophageal motility
|
$6,376.58 |
$6,376.58 |
$6,376.58 |
$655.45
|
|
Established Patient Office Visit (level 2)
|
$876.72 |
$876.72 |
$876.72 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$1,121.58 |
$1,121.58 |
$1,121.58 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$1,424.94 |
$1,424.94 |
$1,424.94 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$2,103.85 |
$2,103.85 |
$2,103.85 |
$280.33
|
