|
Dressing change not for burn w/anes 15852
|
$944.00 |
$944.00 |
$944.00 |
$724.37
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$3,413.19 |
$3,413.19 |
$3,413.19 |
$5,857.52
|
|
Drill hole implt ventricular cath/device 61107
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$1,485.75
|
|
Drng hand tendon sheath 26020
|
$10,187.50 |
$10,187.50 |
$10,187.50 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$679.00 |
$679.00 |
$679.00 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$2,675.00 |
$2,675.00 |
$2,675.00 |
$2,029.60
|
|
Drng of hydrocele 55000
|
$1,405.50 |
$1,405.50 |
$1,405.50 |
$832.60
|
|
Drng of mouth lesion 40801
|
$790.00 |
$790.00 |
$790.00 |
$1,350.97
|
|
Drng of scrotum abscess 55100
|
$5,383.50 |
$5,383.50 |
$5,383.50 |
$1,997.89
|
|
Drng salivary gland simple 42300
|
$2,424.50 |
$2,424.50 |
$2,424.50 |
$2,039.50
|
|
Drng salivary gland submax/subling 42310
|
$804.00 |
$804.00 |
$804.00 |
$741.60
|
|
Dronabinol 2.5mg oral
|
$38.29 |
$38.29 |
$38.29 |
$13.36
|
|
Droperidol 2.5 mg/ml injection solution
|
$9.71 |
$9.71 |
$9.71 |
$31.26
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$883.50 |
$883.50 |
$883.50 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$159.00 |
$159.00 |
$159.00 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$159.00 |
$159.00 |
$159.00 |
$58.20
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$159.00 |
$159.00 |
$159.00 |
$289.05
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$5,067.35 |
$5,067.35 |
$5,067.35 |
$8,040.27
|
|
Drug admin & hemodynmic meas
|
$2,689.50 |
$2,689.50 |
$2,689.50 |
$578.59
|
|
Drug assay caffeine
|
$170.00 |
$170.00 |
$170.00 |
$81.61
|
|
Drug assay posaconazole
|
$150.00 |
$150.00 |
$150.00 |
$96.75
|
|
Drug assay rufinamide
|
$65.00 |
$65.00 |
$65.00 |
$85.80
|
|
Drug assay vedolizumab
|
$455.00 |
$455.00 |
$455.00 |
$157.00
|
|
Drug assay voriconazole
|
$119.50 |
$119.50 |
$119.50 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$121.00 |
$121.00 |
$121.00 |
$66.43
|
|
Drug of abuse screen urine
|
$87.00 |
$87.00 |
$87.00 |
$64.50
|
|
Drug screening tapentadol
|
$34.50 |
$34.50 |
$34.50 |
$44.25
|
|
Drug screen quant tiagabine
|
$50.00 |
$50.00 |
$50.00 |
$107.59
|
|
Drug/substance nos 4-6
|
$93.50 |
$93.50 |
$93.50 |
$72.14
|
|
Drug test def 15-21 classes
|
$220.50 |
$220.50 |
$220.50 |
$316.00
|
|
Drug test def 1-7 classes
|
$256.00 |
$256.00 |
$256.00 |
$263.25
|
|
Drug test def 22+ classes
|
$423.00 |
$423.00 |
$423.00 |
$423.00
|
|
Drug test def 8-14 classes
|
$204.50 |
$204.50 |
$204.50 |
$289.80
|
|
Drug test prsmv instrmnt
|
$32.00 |
$32.00 |
$32.00 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$3,540.00 |
$3,540.00 |
$3,540.00 |
$280.95
|
|
Dry needling (97799)
|
$54.00 |
$54.00 |
$54.00 |
$114.27
|
|
Dstrj extensive retinopathy
|
$4,613.50 |
$4,613.50 |
$4,613.50 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$8,023.00 |
$8,023.00 |
$8,023.00 |
$2,967.48
|
|
Dstr mal les s/n/h/f/g >4.0
|
$519.50 |
$519.50 |
$519.50 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$519.00 |
$519.00 |
$519.00 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$944.00 |
$944.00 |
$944.00 |
$724.37
|
|
Ductogram sgl duct
|
$216.00 |
$216.00 |
$216.00 |
$469.44
|
|
Duplex scan bilateral study 93985
|
$538.50 |
$538.50 |
$538.50 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$174.50 |
$174.50 |
$174.50 |
$375.60
|
|
Dup scan/hemodialysis access 93990
|
$413.00 |
$413.00 |
$413.00 |
$486.02
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$545.50 |
$545.50 |
$545.50 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$636.50 |
$636.50 |
$636.50 |
$903.50
|
|
Durvalumab 50 mg/ml intravenous solution
|
$25,767.96 |
$25,767.96 |
$25,767.96 |
$7,973.90
|
|
Dxa bone density axl vrt fx
|
$415.00 |
$415.00 |
$415.00 |
$410.25
|
|
Dx aly aud oi snd prcsr each
|
$37.50 |
$37.50 |
$37.50 |
$51.52
|
|
Dx bronchoscope/brush 31623
|
$6,736.00 |
$6,736.00 |
$6,736.00 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$4,836.00 |
$4,836.00 |
$4,836.00 |
$2,400.95
|
|
Dx bronchoscope/wash 31622
|
$5,147.38 |
$5,147.38 |
$5,147.38 |
$2,322.60
|
|
Dx dark adaptation exam i&r
|
$159.50 |
$159.50 |
$159.50 |
$472.21
|
|
Dx laryngoscopy newborn
|
$732.00 |
$732.00 |
$732.00 |
$658.00
|
|
Dx laryngoscopy w/oper scope
|
$17,297.50 |
$17,297.50 |
$17,297.50 |
$2,755.53
|
|
Ear and throat examination
|
$4,256.00 |
$4,256.00 |
$4,256.00 |
$602.63
|
|
Ear canal biopsy 69105
|
$5,141.00 |
$5,141.00 |
$5,141.00 |
$1,889.50
|
|
Ear cartilage graft
|
$11,883.34 |
$11,883.34 |
$11,883.34 |
$6,311.00
|
|
Ear irrigation 69209
|
$4,436.00 |
$4,436.00 |
$4,436.00 |
$150.00
|
|
Ear protector evaluation
|
$135.00 |
$135.00 |
$135.00 |
$112.56
|
|
Ecg 12 lead tracing only
|
$426.00 |
$426.00 |
$426.00 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$87.00 |
$87.00 |
$87.00 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$1,332.50 |
$1,332.50 |
$1,332.50 |
$466.20
|
|
Ecg external < 48 hours recording
|
$340.50 |
$340.50 |
$340.50 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$821.50 |
$821.50 |
$821.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$82.50 |
$82.50 |
$82.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$104.50 |
$104.50 |
$104.50 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$1,737.50 |
$1,737.50 |
$1,737.50 |
$1,977.50
|
|
Echocardiography doppler color flow mapping
|
$2,619.75 |
$2,619.75 |
$2,619.75 |
$499.20
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,819.00 |
$1,819.00 |
$1,819.00 |
$1,935.00
|
|
Echocardiography transthoracic 2d followup/limited
|
$556.00 |
$556.00 |
$556.00 |
$711.00
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$830.50 |
$830.50 |
$830.50 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$2,619.75 |
$2,619.75 |
$2,619.75 |
$371.25
|
|
Echo exam of eye
|
$134.50 |
$134.50 |
$134.50 |
$143.75
|
|
Echo exam of eye
|
$257.00 |
$257.00 |
$257.00 |
$172.00
|
|
Echo exam of eye thickness
|
$60.00 |
$60.00 |
$60.00 |
$40.30
|
|
Echo exam of fetal heart
|
$851.50 |
$851.50 |
$851.50 |
$904.80
|
|
Echo exam of fetal heart
|
$792.00 |
$792.00 |
$792.00 |
$538.27
|
|
Echo exam of fetal heart
|
$1,549.00 |
$1,549.00 |
$1,549.00 |
$431.41
|
|
Echo exam of fetal heart
|
$774.50 |
$774.50 |
$774.50 |
$319.00
|
|
Echo exam uterus 76831-
|
$307.50 |
$307.50 |
$307.50 |
$552.50
|
|
Echograp trans r pros study
|
$300.50 |
$300.50 |
$300.50 |
$466.20
|
|
Echo guidance radiotherapy
|
$872.50 |
$872.50 |
$872.50 |
$812.00
|
|
Echo guide for amniocentesis
|
$210.50 |
$210.50 |
$210.50 |
$446.60
|
|
Echo guide for artery repair
|
$2,550.00 |
$2,550.00 |
$2,550.00 |
$687.35
|
|
Echo guide for heart biopsy
|
$221.00 |
$221.00 |
$221.00 |
$666.40
|
|
Echo guide for transfusion
|
$783.00 |
$783.00 |
$783.00 |
$332.39
|
|
Echo stress
|
$1,392.00 |
$1,392.00 |
$1,392.00 |
$1,606.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$465.00 |
$465.00 |
$465.00 |
$751.34
|
|
Echo tee guidance
|
$2,320.00 |
$2,320.00 |
$2,320.00 |
$1,847.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$5,239.50 |
$5,239.50 |
$5,239.50 |
$1,889.20
|
|
Echo transesophageal
|
$465.00 |
$465.00 |
$465.00 |
$1,075.20
|
|
Echo transesophageal
|
$1,599.50 |
$1,599.50 |
$1,599.50 |
$1,599.50
|
|
Echo transthoracic
|
$1,002.50 |
$1,002.50 |
$1,002.50 |
$1,361.75
|
|
Echo transthoracic
|
$588.00 |
$588.00 |
$588.00 |
$1,010.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$556.00 |
$556.00 |
$556.00 |
$1,022.30
|
|
Ecmo/ecls daily mgmt artery 33949
|
$4,550.50 |
$4,550.50 |
$4,550.50 |
$2,867.22
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$4,550.50 |
$4,550.50 |
$4,550.50 |
$3,099.00
|
|
Ecmo/ecls initiation artery 33947
|
$10,177.50 |
$10,177.50 |
$10,177.50 |
$3,950.10
|
