|
Doppler upper/lower extremity arteries complete bilateral
|
$137.00 |
$137.00 |
$137.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$216.00 |
$216.00 |
$216.00 |
$481.65
|
|
Double transfer toe-hand
|
$3,942.50 |
$3,942.50 |
$3,942.50 |
$7,413.38
|
|
Dpyd gene common variants
|
$800.00 |
$800.00 |
$800.00 |
$386.00
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$125.00 |
$125.00 |
$125.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$144.00 |
$144.00 |
$144.00 |
$901.80
|
|
Drainage external ear simple 69000
|
$129.00 |
$129.00 |
$129.00 |
$779.45
|
|
Drainage lymph node lesion 38300
|
$239.50 |
$239.50 |
$239.50 |
$3,088.80
|
|
Drainage mouth roof lesion
|
$336.00 |
$336.00 |
$336.00 |
$401.50
|
|
Drainage of arm bursa 23931
|
$1,582.00 |
$1,582.00 |
$1,582.00 |
$2,209.90
|
|
Drainage of eye
|
$81.00 |
$81.00 |
$81.00 |
$2,360.00
|
|
Drainage of eye
|
$448.50 |
$448.50 |
$448.50 |
$3,222.78
|
|
Drainage of forearm bursa
|
$402.00 |
$402.00 |
$402.00 |
$2,054.00
|
|
Drainage of mouth lesion
|
$227.00 |
$227.00 |
$227.00 |
$489.00
|
|
Drainage of mouth lesion
|
$352.00 |
$352.00 |
$352.00 |
$3,544.29
|
|
Drainage of nose lesion int 30000
|
$121.50 |
$121.50 |
$121.50 |
$548.00
|
|
Drainage of pelvis lesion 26990
|
$732.50 |
$732.50 |
$732.50 |
$3,863.70
|
|
Drainage of rectal abscess
|
$194.00 |
$194.00 |
$194.00 |
$2,111.46
|
|
Drain blood from under nail 11740
|
$184.50 |
$184.50 |
$184.50 |
$173.21
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$211.00 |
$211.00 |
$211.00 |
$2,658.46
|
|
Drain cath image guided visceral pq
|
$194.50 |
$194.50 |
$194.50 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,269.50 |
$1,269.50 |
$1,269.50 |
$1,045.65
|
|
Drain finger abscess;simple 26010
|
$335.50 |
$335.50 |
$335.50 |
$428.40
|
|
Drain lower leg lesion 27603
|
$415.00 |
$415.00 |
$415.00 |
$3,994.09
|
|
Drain neck/chest lesion 21501
|
$363.50 |
$363.50 |
$363.50 |
$3,339.00
|
|
Drain ovary abscess open
|
$342.50 |
$342.50 |
$342.50 |
$3,762.53
|
|
Drain shoulder lesion
|
$275.00 |
$275.00 |
$275.00 |
$3,638.88
|
|
Drain thigh/knee lesion 27301
|
$546.50 |
$546.50 |
$546.50 |
$3,638.88
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$115.50 |
$115.50 |
$115.50 |
$394.80
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$362.50 |
$362.50 |
$362.50 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$141.50 |
$141.50 |
$141.50 |
$524.04
|
|
Dressing change not for burn w/anes 15852
|
$838.50 |
$838.50 |
$838.50 |
$755.08
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$8,131.20
|
|
Drill hole implt ventricular cath/device 61107
|
$916.50 |
$916.50 |
$916.50 |
$1,532.85
|
|
Drng hand tendon sheath 26020
|
$591.50 |
$591.50 |
$591.50 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$111.50 |
$111.50 |
$111.50 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$201.50 |
$201.50 |
$201.50 |
$1,994.16
|
|
Drng of hydrocele 55000
|
$87.50 |
$87.50 |
$87.50 |
$854.50
|
|
Drng of mouth lesion 40801
|
$208.50 |
$208.50 |
$208.50 |
$1,350.97
|
|
Drng of scrotum abscess 55100
|
$183.50 |
$183.50 |
$183.50 |
$1,956.40
|
|
Drng open retroperitoneal abscess 49060
|
$1,202.50 |
$1,202.50 |
$1,202.50 |
$1,924.00
|
|
Drng peritoneal abscess open 49020
|
$1,747.00 |
$1,747.00 |
$1,747.00 |
$2,520.00
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$134.00
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$289.05
|
|
Drug assay rufinamide
|
$51.00 |
$51.00 |
$51.00 |
$85.80
|
|
Drug assay voriconazole
|
$119.50 |
$119.50 |
$119.50 |
$97.02
|
|
Drug of abuse screen urine
|
$32.50 |
$32.50 |
$32.50 |
$68.04
|
|
Drug screening tapentadol
|
$5.00 |
$5.00 |
$5.00 |
$36.00
|
|
Drug test def 15-21 classes
|
$165.00 |
$165.00 |
$165.00 |
$274.26
|
|
Drug test def 1-7 classes
|
$163.00 |
$163.00 |
$163.00 |
$263.25
|
|
Drug test def 22+ classes
|
$41.00 |
$41.00 |
$41.00 |
$423.00
|
|
Drug test def 8-14 classes
|
$90.00 |
$90.00 |
$90.00 |
$282.00
|
|
Drug test prsmv instrmnt
|
$32.50 |
$32.50 |
$32.50 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$200.00 |
$200.00 |
$200.00 |
$286.55
|
|
Dstrj nulyt agt gnclr nrv
|
$149.50 |
$149.50 |
$149.50 |
$2,980.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$417.00 |
$417.00 |
$417.00 |
$903.00
|
|
Dx bronchoscope/brush 31623
|
$136.50 |
$136.50 |
$136.50 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$138.50 |
$138.50 |
$138.50 |
$2,329.60
|
|
Dx bronchoscope/wash 31622
|
$138.50 |
$138.50 |
$138.50 |
$2,238.00
|
|
Dx gastr intub w/asp spec
|
$432.50 |
$432.50 |
$432.50 |
$441.60
|
|
Dx laryngoscopy newborn
|
$382.50 |
$382.50 |
$382.50 |
$707.25
|
|
Ear irrigation 69209
|
$114.50 |
$114.50 |
$114.50 |
$150.00
|
|
Ecg 12 lead tracing only
|
$96.00 |
$96.00 |
$96.00 |
$226.50
|
|
Ecg/1-3 leads/interp & report only 93042
|
$8.00 |
$8.00 |
$8.00 |
$16.00
|
|
Ecg < 30 days transmission & analysis
|
$91.00 |
$91.00 |
$91.00 |
$487.60
|
|
Ecg external < 48 hours recording
|
$127.50 |
$127.50 |
$127.50 |
$472.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$56.50 |
$56.50 |
$56.50 |
$545.58
|
|
Ecg external > 48 hours up to 7 days recording
|
$54.50 |
$54.50 |
$54.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$88.50 |
$88.50 |
$88.50 |
$161.85
|
|
Ecg/review interpret only
|
$26.50 |
$26.50 |
$26.50 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$523.50 |
$523.50 |
$523.50 |
$2,030.14
|
|
Echocardiography doppler color flow mapping
|
$108.50 |
$108.50 |
$108.50 |
$490.20
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited
|
$258.50 |
$258.50 |
$258.50 |
$711.00
|
|
Echocardiograpy doppler follow up/limited study
|
$468.50 |
$468.50 |
$468.50 |
$371.25
|
|
Echo exam of eye
|
$72.00 |
$72.00 |
$72.00 |
$172.00
|
|
Echo exam of eye
|
$90.00 |
$90.00 |
$90.00 |
$168.00
|
|
Echo exam of eye thickness
|
$13.00 |
$13.00 |
$13.00 |
$50.91
|
|
Echo exam uterus 76831-
|
$121.00 |
$121.00 |
$121.00 |
$552.50
|
|
Echo stress
|
$75.50 |
$75.50 |
$75.50 |
$1,606.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$251.50 |
$251.50 |
$251.50 |
$1,885.56
|
|
Echo transesophageal
|
$563.00 |
$563.00 |
$563.00 |
$1,608.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$143.00 |
$143.00 |
$143.00 |
$1,003.08
|
|
Eeg monitor/record/awake/drowsy 95816
|
$419.00 |
$419.00 |
$419.00 |
$837.80
|
|
Eeg phy/qhp ea incr w/veeg
|
$196.00 |
$196.00 |
$196.00 |
$1,103.70
|
|
Eeg phys/qhp 2-12 hr w/veeg
|
$127.50 |
$127.50 |
$127.50 |
$586.80
|
|
Eeg/record in coma or sleep only 95822
|
$452.50 |
$452.50 |
$452.50 |
$907.80
|
|
Eeg recording awake and asleep
|
$488.00 |
$488.00 |
$488.00 |
$937.95
|
|
Egd balloon dil esoph30 mm/>
|
$236.50 |
$236.50 |
$236.50 |
$2,101.52
|
|
Egd control bleeding any
|
$216.00 |
$216.00 |
$216.00 |
$2,501.40
|
|
Egd dilate stricture
|
$180.50 |
$180.50 |
$180.50 |
$2,244.82
|
|
Egd endoscopic stent place
|
$221.00 |
$221.00 |
$221.00 |
$3,705.00
|
|
Egd guide wire insertion
|
$169.00 |
$169.00 |
$169.00 |
$1,664.00
|
|
Egd/insert intraluminal tube/cath 43241
|
$145.00 |
$145.00 |
$145.00 |
$2,107.20
|
|
Egd lesion ablation
|
$226.00 |
$226.00 |
$226.00 |
$2,244.82
|
|
Egd remove foreign body
|
$180.00 |
$180.00 |
$180.00 |
$1,473.45
|
|
Egd remove lesion snare
|
$212.00 |
$212.00 |
$212.00 |
$2,506.40
|
|
Egd/remov tum/polyp/hot bx forcep 43250
|
$175.50 |
$175.50 |
$175.50 |
$2,244.82
|
|
Egd Ultrasound fine needle bx/aspir
|
$233.00 |
$233.00 |
$233.00 |
$2,392.00
|
