|
Diagnostic anoscopy spx 46600
|
$160.00 |
$160.00 |
$160.00 |
$184.80
|
|
Diagnostic Mammogram (both breasts)
|
$475.00 |
$475.00 |
$475.00 |
$397.50
|
|
Diagnostic Mammogram (one breast)
|
$412.50 |
$412.50 |
$412.50 |
$296.40
|
|
Diagnostic radio unlisted proc
|
$590.00 |
$590.00 |
$590.00 |
$210.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$12,340.00 |
$12,340.00 |
$12,340.00 |
$5,366.71
|
|
Dialysis one evaluation
|
$845.00 |
$845.00 |
$845.00 |
$862.40
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$62.98 |
$62.98 |
$62.98 |
$74.02
|
|
Diffusing capacity
|
$285.00 |
$285.00 |
$285.00 |
$331.76
|
|
Digoxin total therapeutic drug level
|
$77.50 |
$77.50 |
$77.50 |
$99.35
|
|
Dilate biliary duct/ampulla
|
$4,815.00 |
$4,815.00 |
$4,815.00 |
$1,866.73
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,895.00 |
$1,895.00 |
$1,895.00 |
$3,769.50
|
|
Dilate ic vasospasm ea add vsl same territory
|
$1,895.00 |
$1,895.00 |
$1,895.00 |
$2,299.05
|
|
Dilate ic vasospasm init
|
$1,895.00 |
$1,895.00 |
$1,895.00 |
$5,741.00
|
|
Dilat xst trc ndurlgc px
|
$2,075.00 |
$2,075.00 |
$2,075.00 |
$3,903.54
|
|
Dilat xst trc new access rcs
|
$3,110.00 |
$3,110.00 |
$3,110.00 |
$4,213.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$24.43 |
$24.43 |
$24.43 |
$17.75
|
|
Disability dlco
|
$240.00 |
$240.00 |
$240.00 |
$279.00
|
|
Disaccharidases
|
$357.50 |
$357.50 |
$357.50 |
$223.80
|
|
Discography cerv/thor spine
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$2,404.00
|
|
Dlyd plmt xtn prosth ea addl
|
$730.00 |
$730.00 |
$730.00 |
$1,582.68
|
|
Dna antibody native/double stranded
|
$100.00 |
$100.00 |
$100.00 |
$100.00
|
|
Dna gardnerella
|
$62.50 |
$62.50 |
$62.50 |
$61.20
|
|
Dna trichomonas
|
$62.50 |
$62.50 |
$62.50 |
$66.05
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$60.54 |
$60.54 |
$60.54 |
$98.29
|
|
Doppler echo complete
|
$775.00 |
$775.00 |
$775.00 |
$548.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$540.00 |
$540.00 |
$540.00 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$362.50 |
$362.50 |
$362.50 |
$444.60
|
|
Dpyd gene common variants
|
$175.00 |
$175.00 |
$175.00 |
$373.75
|
|
Drainage of kidney lesion
|
$2,170.00 |
$2,170.00 |
$2,170.00 |
$1,484.45
|
|
Drain blood from under nail 11740
|
$75.00 |
$75.00 |
$75.00 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,540.00 |
$2,540.00 |
$2,540.00 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$2,785.00 |
$2,785.00 |
$2,785.00 |
$2,839.24
|
|
Drain cerebro spinal fluid 62272
|
$910.00 |
$910.00 |
$910.00 |
$1,039.72
|
|
Drain chst dry seal exp thorastat
|
$160.00 |
$160.00 |
$160.00 |
$119.43
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$207.50 |
$207.50 |
$207.50 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$157.50 |
$157.50 |
$157.50 |
$338.25
|
|
Dress/debrid prtl-thick burn l 16030
|
$252.50 |
$252.50 |
$252.50 |
$515.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$60.00 |
$60.00 |
$60.00 |
$5,857.52
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$15.00 |
$15.00 |
$15.00 |
$143.50
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$570.98 |
$570.98 |
$570.98 |
$7,465.97
|
|
Drug assay caffeine
|
$80.00 |
$80.00 |
$80.00 |
$80.00
|
|
Drug assay posaconazole
|
$100.00 |
$100.00 |
$100.00 |
$96.39
|
|
Drug assay rufinamide
|
$135.00 |
$135.00 |
$135.00 |
$81.60
|
|
Drug assay vedolizumab
|
$272.50 |
$272.50 |
$272.50 |
$141.75
|
|
Drug assay voriconazole
|
$137.50 |
$137.50 |
$137.50 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$345.00 |
$345.00 |
$345.00 |
$66.43
|
|
Drug of abuse screen urine
|
$27.50 |
$27.50 |
$27.50 |
$62.40
|
|
Drug screen quant tiagabine
|
$115.00 |
$115.00 |
$115.00 |
$108.48
|
|
Drug test def 15-21 classes
|
$322.50 |
$322.50 |
$322.50 |
$263.25
|
|
Drug test def 22+ classes
|
$140.00 |
$140.00 |
$140.00 |
$325.95
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$352.50 |
$352.50 |
$352.50 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$2,979.74
|
|
Ductogram sgl duct
|
$302.50 |
$302.50 |
$302.50 |
$452.50
|
|
Duplex scan bilateral study 93985
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$660.32
|
|
Duplex scan unilateral study 93986
|
$730.00 |
$730.00 |
$730.00 |
$357.60
|
|
Dup scan/hemodialysis access 93990
|
$600.00 |
$600.00 |
$600.00 |
$498.78
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$745.00 |
$745.00 |
$745.00 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$710.00 |
$710.00 |
$710.00 |
$859.00
|
|
Dxa bone density axl vrt fx
|
$457.50 |
$457.50 |
$457.50 |
$388.36
|
|
Ear and throat examination
|
$2,455.00 |
$2,455.00 |
$2,455.00 |
$600.66
|
|
Ear irrigation 69209
|
$30.00 |
$30.00 |
$30.00 |
$149.76
|
|
Ecg 12 lead tracing only
|
$335.00 |
$335.00 |
$335.00 |
$226.20
|
|
Ecg/1-3 leads/tracing only 93041
|
$155.00 |
$155.00 |
$155.00 |
$132.03
|
|
Ecg < 30 days transmission & analysis
|
$395.00 |
$395.00 |
$395.00 |
$396.50
|
|
Ecg external < 48 hours recording
|
$440.00 |
$440.00 |
$440.00 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$535.00 |
$535.00 |
$535.00 |
$536.50
|
|
Echocardiogram (Heart Ultrasound)
|
$2,255.00 |
$2,255.00 |
$2,255.00 |
$2,020.00
|
|
Echocardiography doppler color flow mapping
|
$525.00 |
$525.00 |
$525.00 |
$463.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,110.00 |
$1,110.00 |
$1,110.00 |
$702.00
|
|
Echocardiograpy doppler follow up/limited study
|
$357.50 |
$357.50 |
$357.50 |
$356.40
|
|
Echo exam of fetal heart
|
$690.00 |
$690.00 |
$690.00 |
$914.76
|
|
Echo exam uterus 76831-
|
$475.00 |
$475.00 |
$475.00 |
$513.00
|
|
Echograp trans r pros study
|
$670.00 |
$670.00 |
$670.00 |
$459.40
|
|
Echo guidance radiotherapy
|
$515.00 |
$515.00 |
$515.00 |
$812.00
|
|
Echo guide for amniocentesis
|
$375.00 |
$375.00 |
$375.00 |
$419.59
|
|
Echo guide for artery repair
|
$660.00 |
$660.00 |
$660.00 |
$660.00
|
|
Echo stress
|
$2,030.00 |
$2,030.00 |
$2,030.00 |
$1,565.72
|
|
Echo tee guidance
|
$3,980.00 |
$3,980.00 |
$3,980.00 |
$1,821.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,725.00 |
$2,725.00 |
$2,725.00 |
$1,849.50
|
|
Echo transesophageal
|
$2,640.00 |
$2,640.00 |
$2,640.00 |
$1,087.90
|
|
Echo transesophageal intraop
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$1,571.70
|
|
Echo transthoracic
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,361.75
|
|
Echo transthoracic
|
$950.00 |
$950.00 |
$950.00 |
$950.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$957.60
|
|
Ecmo/ecls daily mgmt artery 33949
|
$1,030.00 |
$1,030.00 |
$1,030.00 |
$2,822.71
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$1,030.00 |
$1,030.00 |
$1,030.00 |
$2,822.71
|
|
Ecmo/ecls initiation artery 33947
|
$1,030.00 |
$1,030.00 |
$1,030.00 |
$3,066.75
|
|
Ecmo/ecls initiation venous 33946
|
$1,030.00 |
$1,030.00 |
$1,030.00 |
$3,767.25
|
|
Ecog impltd brn npgt <30 d
|
$230.00 |
$230.00 |
$230.00 |
$148.40
|
|
Eeg 41-60 minutes 95812-26
|
$920.00 |
$920.00 |
$920.00 |
$920.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$865.00 |
$865.00 |
$865.00 |
$970.07
|
|
Eeg during surgery
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$775.45
|
|
Eeg monitoring/function test
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,383.98
|
|
Eeg monitor/record/awake/drowsy 95816
|
$680.00 |
$680.00 |
$680.00 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$1,086.80
|
|
Eeg/record in coma or sleep only 95822
|
$865.00 |
$865.00 |
$865.00 |
$885.60
|
|
Eeg recording awake and asleep
|
$740.00 |
$740.00 |
$740.00 |
$929.00
|
|
Eeg without vid ea 12-26hr intmt
|
$2,665.00 |
$2,665.00 |
$2,665.00 |
$1,224.00
|
|
Egfr gene com variants
|
$427.50 |
$427.50 |
$427.50 |
$639.00
|
|
Ehrlicha chaffeensis amp prb
|
$47.50 |
$47.50 |
$47.50 |
$93.00
|
