|
Dup scan/hemodialysis access 93990
|
$900.90 |
$900.90 |
$900.90 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$750.20 |
$750.20 |
$750.20 |
$757.57
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$799.15 |
$799.15 |
$799.15 |
$903.00
|
|
Dx bronchoscope/lavage 31624
|
$1,724.25 |
$1,724.25 |
$1,724.25 |
$2,780.40
|
|
Dx bronchoscope/wash 31622
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$2,587.60
|
|
Ear irrigation 69209
|
$143.55 |
$143.55 |
$143.55 |
$165.42
|
|
Ecg 12 lead tracing only
|
$171.60 |
$171.60 |
$171.60 |
$245.00
|
|
Ecg external < 48 hours recording
|
$462.00 |
$462.00 |
$462.00 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,201.75 |
$1,201.75 |
$1,201.75 |
$567.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$128.15 |
$128.15 |
$128.15 |
$162.78
|
|
Ecg external >7 days up to 15 days recording
|
$128.15 |
$128.15 |
$128.15 |
$200.00
|
|
Echocardiogram (Heart Ultrasound)
|
$1,695.10 |
$1,695.10 |
$1,695.10 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$455.95 |
$455.95 |
$455.95 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,168.65 |
$2,168.65 |
$2,168.65 |
$2,027.90
|
|
Echocardiography transthoracic 2d followup/limited
|
$652.30 |
$652.30 |
$652.30 |
$724.20
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$506.00 |
$506.00 |
$506.00 |
$762.00
|
|
Echocardiograpy doppler follow up/limited study
|
$179.30 |
$179.30 |
$179.30 |
$353.46
|
|
Echo exam of fetal heart
|
$301.40 |
$301.40 |
$301.40 |
$431.41
|
|
Echo exam uterus 76831-
|
$409.20 |
$409.20 |
$409.20 |
$547.20
|
|
Echo guide for artery repair
|
$455.95 |
$455.95 |
$455.95 |
$680.28
|
|
Echo guide villus sampling
|
$370.15 |
$370.15 |
$370.15 |
$355.80
|
|
Echo stress
|
$862.95 |
$862.95 |
$862.95 |
$1,582.75
|
|
Echo tee guidance
|
$1,403.60 |
$1,403.60 |
$1,403.60 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,158.30 |
$1,158.30 |
$1,158.30 |
$1,871.10
|
|
Echo transesophageal
|
$983.95 |
$983.95 |
$983.95 |
$913.33
|
|
Echo transesophageal intraop
|
$843.70 |
$843.70 |
$843.70 |
$1,571.70
|
|
Echo transthoracic
|
$1,199.00 |
$1,199.00 |
$1,199.00 |
$1,492.50
|
|
Echo transthoracic
|
$862.95 |
$862.95 |
$862.95 |
$953.10
|
|
Ecmo/ecls daily mgmt artery 33949
|
$1,023.55 |
$1,023.55 |
$1,023.55 |
$4,409.25
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$1,023.55 |
$1,023.55 |
$1,023.55 |
$4,324.50
|
|
Ecmo/ecls initiation artery 33947
|
$1,728.65 |
$1,728.65 |
$1,728.65 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$1,532.30 |
$1,532.30 |
$1,532.30 |
$4,324.50
|
|
Ecmo/ecls insj prph cannula 6yrs&older opn 33954
|
$2,645.50 |
$2,645.50 |
$2,645.50 |
$1,411.92
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$1,630.75 |
$1,630.75 |
$1,630.75 |
$4,331.00
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$374.55 |
$374.55 |
$374.55 |
$1,898.66
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$182.60 |
$182.60 |
$182.60 |
$1,802.40
|
|
Eeg 41-60 minutes 95812-26
|
$956.45 |
$956.45 |
$956.45 |
$956.45
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$757.35 |
$757.35 |
$757.35 |
$1,049.59
|
|
Eeg during surgery
|
$429.00 |
$429.00 |
$429.00 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$661.65 |
$661.65 |
$661.65 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$851.40 |
$851.40 |
$851.40 |
$1,119.54
|
|
Eeg/record in coma or sleep only 95822
|
$326.70 |
$326.70 |
$326.70 |
$936.00
|
|
Eeg recording awake and asleep
|
$778.80 |
$778.80 |
$778.80 |
$1,030.27
|
|
E equine encephalitis igg
|
$34.10 |
$34.10 |
$34.10 |
$48.73
|
|
Egfr gene com variants
|
$1,037.30 |
$1,037.30 |
$1,037.30 |
$619.04
|
|
Ehrlicha chaffeensis amp prb
|
$64.90 |
$64.90 |
$64.90 |
$105.00
|
|
EKG tracing for initial prev
|
$170.50 |
$170.50 |
$170.50 |
$56.65
|
|
Electrd sq emblem s-icd
|
$6,651.56 |
$6,651.56 |
$6,651.56 |
$9,175.83
|
|
Electrode stimulation brain
|
$497.75 |
$497.75 |
$497.75 |
$1,180.80
|
|
Electrolyte panel
|
$50.60 |
$50.60 |
$50.60 |
$86.33
|
|
Electron microscopy diagnostic
|
$699.05 |
$699.05 |
$699.05 |
$966.69
|
|
Electrophysiology evaluation
|
$9,067.30 |
$9,067.30 |
$9,067.30 |
$8,979.45
|
|
Electrophysiology evaluation
|
$9,067.30 |
$9,067.30 |
$9,067.30 |
$11,175.42
|
|
Electrophysiology evaluation
|
$3,620.10 |
$3,620.10 |
$3,620.10 |
$7,769.30
|
|
Electrophysiology evaluation
|
$3,620.10 |
$3,620.10 |
$3,620.10 |
$6,516.00
|
|
Electrophysiology evaluation
|
$961.95 |
$961.95 |
$961.95 |
$2,845.10
|
|
Electrophysiology evaluation
|
$1,559.80 |
$1,559.80 |
$1,559.80 |
$2,803.20
|
|
Electrophysiology evaluation
|
$1,553.75 |
$1,553.75 |
$1,553.75 |
$1,869.13
|
|
Electrophys map 3d add-on
|
$3,119.05 |
$3,119.05 |
$3,119.05 |
$6,534.00
|
|
Embolization s&i
|
$874.50 |
$874.50 |
$874.50 |
$3,060.05
|
|
Embo or occlude vascular arterial s&i
|
$8,031.65 |
$8,031.65 |
$8,031.65 |
$16,060.54
|
|
Embo or occlude vascular hemorrhage s&i
|
$9,557.90 |
$9,557.90 |
$9,557.90 |
$15,027.40
|
|
Embo or occlude vascular tumor/organ/infarct s&i
|
$9,191.05 |
$9,191.05 |
$9,191.05 |
$15,873.70
|
|
Embo or occlude vascular venous s&i
|
$9,325.25 |
$9,325.25 |
$9,325.25 |
$15,038.25
|
|
Emb/throm/fempop/aor/ilia/leg inc 34201
|
$3,838.45 |
$3,838.45 |
$3,838.45 |
$6,962.27
|
|
Emb without cervical dilation 58100
|
$259.60 |
$259.60 |
$259.60 |
$397.66
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$225.50 |
$225.50 |
$225.50 |
$434.00
|
|
Emg cranial nerve bilateral
|
$361.35 |
$361.35 |
$361.35 |
$518.00
|
|
Emg needle test 1-extremity
|
$166.10 |
$166.10 |
$166.10 |
$342.24
|
|
Encephalitis, california igg/igm
|
$48.95 |
$48.95 |
$48.95 |
$46.75
|
|
Encephalitis, st louis igg/igm
|
$34.10 |
$34.10 |
$34.10 |
$48.03
|
|
Encephalitis, western equine igg/igm
|
$35.20 |
$35.20 |
$35.20 |
$50.70
|
|
Endo abl/incom vein/ext/laser/#1 36478
|
$3,237.85 |
$3,237.85 |
$3,237.85 |
$5,160.00
|
|
Endo abl/incom vein/ext/rad fre/#1 36475
|
$3,525.50 |
$3,525.50 |
$3,525.50 |
$5,515.40
|
|
Endo cath bile duct s&i
|
$276.65 |
$276.65 |
$276.65 |
$612.37
|
|
Endo cath panc duct s&i
|
$276.65 |
$276.65 |
$276.65 |
$645.00
|
|
Endoluminl ivus oct c 1st
|
$2,329.80 |
$2,329.80 |
$2,329.80 |
$3,335.81
|
|
Endoluminl ivus oct c ea
|
$2,215.95 |
$2,215.95 |
$2,215.95 |
$2,367.97
|
|
Endoscopy swallow (fees) vid
|
$394.35 |
$394.35 |
$394.35 |
$402.35
|
|
Endovasc prosth delayed 33886
|
$5,305.30 |
$5,305.30 |
$5,305.30 |
$2,191.65
|
|
Endovasc rpr a-biiliac endogft 34705
|
$12,057.10 |
$12,057.10 |
$12,057.10 |
$10,604.25
|
|
Endovas iliac a device addon
|
$2,690.05 |
$2,690.05 |
$2,690.05 |
$1,764.36
|
|
Endoven ther chem adhes 1st 36482
|
$3,403.95 |
$3,403.95 |
$3,403.95 |
$6,459.57
|
|
Enzyme histochemistry
|
$211.20 |
$211.20 |
$211.20 |
$460.32
|
|
Ep & ablate supravent arrhyt
|
$25,527.15 |
$25,527.15 |
$25,527.15 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$25,527.15 |
$25,527.15 |
$25,527.15 |
$30,975.00
|
|
Epidural/lumbar/sacral/ea add level64484
|
$3,002.45 |
$3,002.45 |
$3,002.45 |
$1,182.00
|
|
Epstein barr early antigen antibody
|
$111.10 |
$111.10 |
$111.10 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$128.70 |
$128.70 |
$128.70 |
$81.81
|
|
Epstein barr viral capsid antigen antibody igm
|
$100.65 |
$100.65 |
$100.65 |
$95.04
|
|
Ercp biliary & pancreas
|
$276.65 |
$276.65 |
$276.65 |
$943.50
|
|
ER Visit (level 1, minor)
|
$179.85 |
$179.85 |
$179.85 |
$276.70
|
|
ER Visit (level 2)
|
$363.55 |
$363.55 |
$363.55 |
$487.50
|
|
ER Visit (level 3)
|
$544.50 |
$544.50 |
$544.50 |
$850.50
|
|
ER Visit (level 4)
|
$1,012.90 |
$1,012.90 |
$1,012.90 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$1,415.70 |
$1,415.70 |
$1,415.70 |
$2,007.00
|
|
Esophageal dilat s&i
|
$276.65 |
$276.65 |
$276.65 |
$525.00
|
|
Esophageal motility
|
$1,936.00 |
$1,936.00 |
$1,936.00 |
$573.20
|
|
Esophagus motility study
|
$1,289.20 |
$1,289.20 |
$1,289.20 |
$1,289.20
|
|
Esoph imped function test
|
$409.75 |
$409.75 |
$409.75 |
$597.03
|
