|
Drng peritoneal abscess open 49020
|
$2,520.00 |
$2,520.00 |
$2,520.00 |
$2,520.00
|
|
Drng salivary gland simple 42300
|
$2,039.50 |
$2,039.50 |
$2,039.50 |
$2,133.48
|
|
Drng salivary gland submax/subling 42310
|
$820.00 |
$820.00 |
$820.00 |
$741.60
|
|
Drop lock knee
|
$79.18 |
$79.18 |
$79.18 |
$204.95
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,047.89 |
$1,047.89 |
$1,047.89 |
$1,956.48
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$16.04 |
$16.04 |
$16.04 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$18.63 |
$18.63 |
$18.63 |
$289.05
|
|
Drsg sht 5.625x4.625in std
|
$34.16 |
$34.16 |
$34.16 |
$572.00
|
|
Drsg surg adh 11x11 3/4 occl drap wnd 28x30
|
$3.86 |
$3.86 |
$3.86 |
$19.10
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$69.27 |
$69.27 |
$69.27 |
$171.12
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$90.10 |
$90.10 |
$90.10 |
$8,040.27
|
|
Drug admin & hemodynmic meas
|
$1,851.00 |
$1,851.00 |
$1,851.00 |
$569.75
|
|
Drug assay caffeine
|
$25.50 |
$25.50 |
$25.50 |
$83.40
|
|
Drug assay posaconazole
|
$141.50 |
$141.50 |
$141.50 |
$96.75
|
|
Drug assay rufinamide
|
$73.00 |
$73.00 |
$73.00 |
$85.80
|
|
Drug assay vedolizumab
|
$157.00 |
$157.00 |
$157.00 |
$152.79
|
|
Drug assay voriconazole
|
$148.50 |
$148.50 |
$148.50 |
$96.75
|
|
Drug of abuse screen urine
|
$9.00 |
$9.00 |
$9.00 |
$63.75
|
|
Drug screen quant tiagabine
|
$183.00 |
$183.00 |
$183.00 |
$114.62
|
|
Drug test def 1-7 classes
|
$230.00 |
$230.00 |
$230.00 |
$250.52
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$200.50 |
$200.50 |
$200.50 |
$278.85
|
|
Drvvt confirm - quest
|
$208.50 |
$208.50 |
$208.50 |
$109.20
|
|
Dry needling (97799)
|
$84.00 |
$84.00 |
$84.00 |
$108.00
|
|
Dstrj nulyt agt gnclr nrv
|
$3,188.50 |
$3,188.50 |
$3,188.50 |
$3,020.80
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$663.00 |
$663.00 |
$663.00 |
$603.20
|
|
Ductogram sgl duct
|
$452.50 |
$452.50 |
$452.50 |
$463.10
|
|
Duplex scan bilateral study 93985
|
$328.00 |
$328.00 |
$328.00 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$158.00 |
$158.00 |
$158.00 |
$360.75
|
|
Dup scan/hemodialysis access 93990
|
$420.50 |
$420.50 |
$420.50 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$929.00 |
$929.00 |
$929.00 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,104.50 |
$1,104.50 |
$1,104.50 |
$887.25
|
|
Dxa bone density axl vrt fx
|
$834.50 |
$834.50 |
$834.50 |
$392.60
|
|
Dx bronchoscope/brush 31623
|
$2,032.50 |
$2,032.50 |
$2,032.50 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$2,032.50 |
$2,032.50 |
$2,032.50 |
$2,365.20
|
|
Dx bronchoscope/wash 31622
|
$2,032.50 |
$2,032.50 |
$2,032.50 |
$2,322.60
|
|
Ear canal biopsy 69105
|
$1,889.50 |
$1,889.50 |
$1,889.50 |
$1,889.50
|
|
Ear irrigation 69209
|
$110.50 |
$110.50 |
$110.50 |
$149.76
|
|
Ecg 12 lead tracing only
|
$226.50 |
$226.50 |
$226.50 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$77.00 |
$77.00 |
$77.00 |
$135.80
|
|
Ecg < 30 days transmission & analysis
|
$389.00 |
$389.00 |
$389.00 |
$487.60
|
|
Ecg external < 48 hours recording
|
$915.50 |
$915.50 |
$915.50 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$300.50 |
$300.50 |
$300.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$294.50 |
$294.50 |
$294.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$294.50 |
$294.50 |
$294.50 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$2,476.50 |
$2,476.50 |
$2,476.50 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$712.50 |
$712.50 |
$712.50 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,844.00 |
$1,844.00 |
$1,844.00 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$595.50 |
$595.50 |
$595.50 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,190.50 |
$1,190.50 |
$1,190.50 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$491.00 |
$491.00 |
$491.00 |
$362.50
|
|
Echo exam of eye
|
$407.00 |
$407.00 |
$407.00 |
$172.00
|
|
Echo exam of eye
|
$247.50 |
$247.50 |
$247.50 |
$168.00
|
|
Echo exam of eye thickness
|
$96.50 |
$96.50 |
$96.50 |
$50.91
|
|
Echo exam of fetal heart
|
$1,142.50 |
$1,142.50 |
$1,142.50 |
$939.00
|
|
Echo exam of fetal heart
|
$319.00 |
$319.00 |
$319.00 |
$524.55
|
|
Echo exam of fetal heart
|
$815.00 |
$815.00 |
$815.00 |
$431.41
|
|
Echo exam of fetal heart
|
$150.50 |
$150.50 |
$150.50 |
$323.40
|
|
Echo exam uterus 76831-
|
$655.00 |
$655.00 |
$655.00 |
$523.71
|
|
Echograp trans r pros study
|
$581.00 |
$581.00 |
$581.00 |
$459.40
|
|
Echo guidance radiotherapy
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$812.00
|
|
Echo guide for amniocentesis
|
$841.00 |
$841.00 |
$841.00 |
$456.30
|
|
Echo guide for artery repair
|
$437.00 |
$437.00 |
$437.00 |
$664.00
|
|
Echo guide for transfusion
|
$280.00 |
$280.00 |
$280.00 |
$324.60
|
|
Echo stress
|
$1,279.50 |
$1,279.50 |
$1,279.50 |
$1,592.05
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$1,661.50 |
$1,661.50 |
$1,661.50 |
$751.34
|
|
Echo tee guidance
|
$1,821.00 |
$1,821.00 |
$1,821.00 |
$1,821.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,849.50 |
$1,849.50 |
$1,849.50 |
$1,849.50
|
|
Echo transesophageal
|
$1,661.50 |
$1,661.50 |
$1,661.50 |
$1,087.90
|
|
Echo transesophageal
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$1,559.35
|
|
Echo transesophageal intraop
|
$1,792.50 |
$1,792.50 |
$1,792.50 |
$1,571.70
|
|
Echo transthoracic
|
$1,489.50 |
$1,489.50 |
$1,489.50 |
$1,361.75
|
|
Echo transthoracic
|
$888.00 |
$888.00 |
$888.00 |
$953.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$865.00 |
$865.00 |
$865.00 |
$985.15
|
|
Ecmo/ecls daily mgmt artery 33949
|
$2,362.00 |
$2,362.00 |
$2,362.00 |
$2,560.67
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$2,362.00 |
$2,362.00 |
$2,362.00 |
$2,560.67
|
|
Ecmo/ecls initiation artery 33947
|
$771.00 |
$771.00 |
$771.00 |
$3,066.75
|
|
Ecmo/ecls initiation venous 33946
|
$771.00 |
$771.00 |
$771.00 |
$3,468.27
|
|
Ecmo/ecls insj prph cannula 0-5yrs perq 33951
|
$771.00 |
$771.00 |
$771.00 |
$925.55
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$771.00 |
$771.00 |
$771.00 |
$2,825.34
|
|
Ecmo/ecls repos perph cnula 6yrs&older opn 33962
|
$2,070.50 |
$2,070.50 |
$2,070.50 |
$925.55
|
|
Eeg 41-60 minutes 95812-26
|
$286.50 |
$286.50 |
$286.50 |
$920.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$402.00 |
$402.00 |
$402.00 |
$1,000.42
|
|
Eeg during surgery
|
$749.00 |
$749.00 |
$749.00 |
$797.30
|
|
Eeg monitoring/function test
|
$571.50 |
$571.50 |
$571.50 |
$1,548.52
|
|
Eeg monitor/record/awake/drowsy 95816
|
$537.00 |
$537.00 |
$537.00 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$325.00 |
$325.00 |
$325.00 |
$1,102.05
|
|
Eeg phy/qhp>36<60 hr without vid
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,932.00
|
|
Eeg phy/qhp>36<60 hr w/veeg
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,932.00
|
|
Eeg phy/qhp>60<84 hr without vid
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,932.00
|
|
Eeg phy/qhp>60<84 hr w/veeg
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,932.00
|
|
Eeg phy/qhp>84 hr without vid
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,932.00
|
|
Eeg phy/qhp>84 hr w/veeg
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$2,072.80
|
|
Eeg phy/qhp ea incr w/veeg
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,103.70
|
|
Eeg phys/qhp 2-12 hr without vid
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$553.80
|
|
Eeg phys/qhp 2-12 hr w/veeg
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$586.80
|
|
Eeg phys/qhp ea incr without vid
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$858.00
|
|
Eeg/record in coma or sleep only 95822
|
$1,119.50 |
$1,119.50 |
$1,119.50 |
$907.80
|
|
Eeg recording awake and asleep
|
$747.50 |
$747.50 |
$747.50 |
$931.20
|
|
Eeg without vid 2-12hr cont mntr
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$783.60
|
|
Eeg without vid 2-12 hr unmntr
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$601.30
|