|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$119.50 |
$143.50 |
$250.40 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$119.50 |
$143.50 |
$1,107.00 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$980.50 |
$3,496.45 |
$5,067.35 |
|
|
Drug admin & hemodynmic meas
|
$160.50 |
$248.40 |
$2,689.50 |
|
|
Drug assay caffeine
|
$42.00 |
$73.50 |
$170.00 |
|
|
Drug assay posaconazole
|
$150.00 |
$150.00 |
$632.00 |
|
|
Drug assay rufinamide
|
$51.00 |
$51.00 |
$103.00 |
|
|
Drug assay vedolizumab
|
$207.00 |
$455.00 |
$640.00 |
|
|
Drug assay voriconazole
|
$19.50 |
$119.50 |
$195.00 |
|
|
Drug asy hydroxychloroquine
|
$121.00 |
$132.00 |
$238.32 |
|
|
Drug of abuse screen urine
|
$16.00 |
$85.50 |
$355.50 |
|
|
Drug screening tapentadol
|
$5.00 |
$20.00 |
$103.00 |
|
|
Drug screen quant tiagabine
|
$50.00 |
$50.00 |
$77.00 |
|
|
Drug/substance nos 4-6
|
$93.50 |
$93.50 |
$93.50 |
|
|
Drug test def 15-21 classes
|
$160.00 |
$165.00 |
$393.50 |
|
|
Drug test def 1-7 classes
|
$163.00 |
$205.00 |
$415.71 |
|
|
Drug test def 22+ classes
|
$41.00 |
$423.00 |
$489.00 |
|
|
Drug test def 8-14 classes
|
$90.00 |
$168.50 |
$415.69 |
|
|
Drug test prsmv instrmnt
|
$32.00 |
$37.00 |
$130.00 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$200.00 |
$336.00 |
$5,062.50 |
|
|
Drvvt confirm - quest
|
$39.50 |
$87.00 |
$229.20 |
|
|
Dry needling (97799)
|
$54.00 |
$54.00 |
$66.00 |
|
|
Dstrj extensive retinopathy
|
$3,862.50 |
$3,862.50 |
$4,613.50 |
|
|
Dstrj nulyt agt gnclr nrv
|
$149.50 |
$2,788.50 |
$8,023.00 |
|
|
Dstr mal les s/n/h/f/g >4.0
|
$467.50 |
$519.50 |
$573.00 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$184.00 |
$467.50 |
$531.00 |
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$826.00 |
$849.50 |
$944.00 |
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$410.00 |
$840.00 |
$849.50 |
|
|
Ductogram sgl duct
|
$216.00 |
$468.00 |
$567.50 |
|
|
Duplex scan bilateral study 93985
|
$306.00 |
$467.00 |
$840.50 |
|
|
Duplex scan unilateral study 93986
|
$145.00 |
$200.50 |
$398.00 |
|
|
Dup scan/hemodialysis access 93990
|
$99.00 |
$345.00 |
$765.00 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$248.00 |
$503.00 |
$832.50 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$42.50 |
$539.50 |
$826.50 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$11,861.40 |
$24,767.40 |
$29,720.88 |
|
|
Dxa bone density axl vrt fx
|
$155.50 |
$335.00 |
$809.00 |
|
|
Dx aly aud oi snd prcsr 1st
|
$209.00 |
$209.00 |
$209.00 |
|
|
Dx aly aud oi snd prcsr each
|
$37.50 |
$37.50 |
$48.50 |
|
|
Dx bronchoscope/brush 31623
|
$135.00 |
$897.50 |
$6,736.00 |
|
|
Dx bronchoscope/lavage 31624
|
$137.00 |
$2,011.00 |
$4,836.00 |
|
|
Dx bronchoscope/wash 31622
|
$136.50 |
$2,046.00 |
$5,147.38 |
|
|
Dx dark adaptation exam i&r
|
$159.50 |
$159.50 |
$159.50 |
|
|
Dx gastr intub w/asp spec
|
$52.00 |
$402.00 |
$432.50 |
|
|
Dx laryngoscopy newborn
|
$364.00 |
$459.00 |
$732.00 |
|
|
Dx laryngoscopy w/oper scope
|
$536.40 |
$2,607.00 |
$17,297.50 |
|
|
Ear and throat examination
|
$175.20 |
$716.17 |
$4,256.00 |
|
|
Ear canal biopsy 69105
|
$1,783.50 |
$1,783.50 |
$5,141.00 |
|
|
Ear cartilage graft
|
$1,546.20 |
$11,258.00 |
$11,883.34 |
|
|
Ear irrigation 69209
|
$73.00 |
$169.00 |
$4,436.00 |
|
|
Ear protector evaluation
|
$135.00 |
$135.00 |
$135.00 |
|
|
Ecg 12 lead tracing only
|
$96.00 |
$243.20 |
$765.00 |
|
|
Ecg/1-3 leads/interp & report only 93042
|
$7.00 |
$8.00 |
$12.80 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$28.50 |
$85.00 |
$166.50 |
|
|
Ecg < 30 days transmission & analysis
|
$91.00 |
$739.00 |
$1,332.50 |
|
|
Ecg external < 48 hours recording
|
$127.20 |
$252.00 |
$416.50 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$56.50 |
$475.00 |
$1,106.00 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$48.50 |
$71.00 |
$237.50 |
|
|
Ecg external >7 days up to 15 days recording
|
$73.00 |
$112.50 |
$160.50 |
|
|
Ecg/review interpret only
|
$24.50 |
$26.50 |
$42.40 |
|
|
Echocardiogram (Heart Ultrasound)
|
$523.50 |
$1,399.50 |
$2,640.00 |
|
|
Echocardiography doppler color flow mapping
|
$4.00 |
$289.50 |
$2,619.75 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$982.50 |
$1,336.00 |
$2,742.00 |
|
|
Echocardiography transthoracic 2d followup/limited
|
$229.00 |
$556.00 |
$1,175.50 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$341.00 |
$674.50 |
$1,348.20 |
|
|
Echocardiograpy doppler follow up/limited study
|
$252.00 |
$409.50 |
$2,619.75 |
|
|
Echo exam of eye
|
$118.00 |
$118.00 |
$134.50 |
|
|
Echo exam of eye
|
$30.50 |
$52.80 |
$493.00 |
|
|
Echo exam of eye
|
$82.50 |
$90.00 |
$145.60 |
|
|
Echo exam of eye thickness
|
$8.00 |
$13.00 |
$60.00 |
|
|
Echo exam of fetal heart
|
$851.50 |
$851.50 |
$851.50 |
|
|
Echo exam of fetal heart
|
$792.00 |
$792.00 |
$792.00 |
|
|
Echo exam of fetal heart
|
$1,549.00 |
$1,549.00 |
$1,549.00 |
|
|
Echo exam of fetal heart
|
$774.50 |
$774.50 |
$774.50 |
|
|
Echo exam uterus 76831-
|
$35.00 |
$307.50 |
$826.00 |
|
|
Echograp trans r pros study
|
$131.00 |
$300.50 |
$369.50 |
|
|
Echo guidance radiotherapy
|
$872.00 |
$872.50 |
$1,303.00 |
|
|
Echo guide for amniocentesis
|
$210.50 |
$268.50 |
$545.50 |
|
|
Echo guide for artery repair
|
$365.50 |
$365.50 |
$2,550.00 |
|
|
Echo guide for heart biopsy
|
$221.00 |
$226.00 |
$256.50 |
|
|
Echo guide for transfusion
|
$783.00 |
$783.00 |
$783.00 |
|
|
Echo stress
|
$69.50 |
$120.80 |
$1,472.00 |
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$465.00 |
$465.00 |
$465.00 |
|
|
Echo tee guidance
|
$1,562.00 |
$1,865.50 |
$2,320.00 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$107.50 |
$1,219.50 |
$5,239.50 |
|
|
Echo transesophageal
|
$221.50 |
$535.00 |
$1,669.00 |
|
|
Echo transesophageal
|
$433.20 |
$433.20 |
$433.20 |
|
|
Echo transesophageal
|
$126.50 |
$220.80 |
$1,599.50 |
|
|
Echo transthoracic
|
$597.50 |
$716.00 |
$1,002.50 |
|
|
Echo transthoracic
|
$546.00 |
$588.00 |
$980.00 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$44.00 |
$143.00 |
$1,142.00 |
|
|
Ecmo/ecls daily mgmt artery 33949
|
$4,550.50 |
$4,550.50 |
$4,550.50 |
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$4,550.50 |
$4,550.50 |
$4,550.50 |
|
|
Ecmo/ecls initiation artery 33947
|
$10,177.50 |
$10,177.50 |
$10,177.50 |
|
|
Ecmo/ecls initiation venous 33946
|
$10,177.50 |
$10,177.50 |
$10,177.50 |
|
|
Ecmo/ecls insj cent cannula 0-5yrs 33955
|
$1,107.50 |
$1,107.50 |
$1,107.50 |
|
|
Ecmo/ecls insj cent cannula 6yrs&older 33956
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
|
|
Ecmo/ecls insj prph cannula 0-5yrs opn 33953
|
$633.50 |
$633.50 |
$633.50 |
|
|
Ecmo/ecls insj prph cannula 0-5yrs perq 33951
|
$564.50 |
$564.50 |
$564.50 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older opn 33954
|
$634.50 |
$634.50 |
$634.50 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$568.00 |
$568.00 |
$568.00 |
|