|
Dup scan/ue art/graft/bilat/comp 93930
|
$710.00 |
$769.56 |
$2,233.05 |
|
|
Duragen 1x1 5ea/bx
|
$3,263.47 |
$3,602.89 |
$3,602.89 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$127.78 |
$163.26 |
$35,545.38 |
|
|
Dxa bone density axl vrt fx
|
$48.76 |
$457.50 |
$859.38 |
|
|
Dx aly aud oi snd prcsr 1st
|
$301.60 |
$301.60 |
$301.60 |
|
|
Dx aly aud oi snd prcsr each
|
$77.60 |
$77.60 |
$77.60 |
|
|
Dx bronchoscope/brush 31623
|
$1,077.49 |
$2,672.16 |
$3,904.51 |
|
|
Dx bronchoscope/lavage 31624
|
$1,651.10 |
$2,910.42 |
$3,945.32 |
|
|
Dx bronchoscope/wash 31622
|
$1,252.92 |
$1,988.16 |
$3,904.51 |
|
|
Dx gastr intub w/asp spec
|
$333.85 |
$642.18 |
$642.18 |
|
|
Dx intraop epcar Ultrasound chd i&r
|
$129.60 |
$129.60 |
$129.60 |
|
|
Dx intraop epicar car Ultrasound chd
|
$351.20 |
$351.20 |
$351.20 |
|
|
Dx intraop thoracic aorta Ultrasound
|
$112.80 |
$112.80 |
$112.80 |
|
|
Dx laryngoscopy newborn
|
$579.20 |
$579.20 |
$589.60 |
|
|
Dx laryngoscopy w/oper scope
|
$1,416.80 |
$1,416.80 |
$1,416.80 |
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$220.80 |
$220.80 |
$220.80 |
|
|
Dynamic surface emg
|
$327.50 |
$327.50 |
$327.50 |
|
|
Ear and throat examination
|
$229.60 |
$2,455.00 |
$2,455.00 |
|
|
Ear canal biopsy 69105
|
$176.49 |
$176.49 |
$2,514.40 |
|
|
Ear cartilage graft
|
$3,452.00 |
$3,452.00 |
$3,452.00 |
|
|
Ear irrigation 69209
|
$27.03 |
$122.10 |
$461.34 |
|
|
Ear protector evaluation
|
$68.37 |
$68.37 |
$68.37 |
|
|
Ecg/1-3 leads/interp & report only 93042
|
$70.49 |
$70.49 |
$118.40 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$91.20 |
$155.00 |
$206.17 |
|
|
Ecg < 30 days transmission & analysis
|
$395.00 |
$395.00 |
$1,329.24 |
|
|
Ecg external < 48 hours recording
|
$204.06 |
$440.00 |
$1,277.30 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$120.31 |
$535.00 |
$1,281.54 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$46.20 |
$128.15 |
$1,302.21 |
|
|
Ecg external >7 days up to 15 days recording
|
$46.20 |
$149.82 |
$1,302.21 |
|
|
Ecg record/review
|
$1,596.80 |
$1,596.80 |
$1,596.80 |
|
|
Ecg/review interpret only
|
$62.70 |
$62.70 |
$372.80 |
|
|
Echocardiogram (Heart Ultrasound)
|
$1,355.00 |
$1,925.00 |
$3,636.02 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$349.80 |
$938.22 |
$3,636.02 |
|
|
Echocardiography doppler color flow mapping
|
$290.70 |
$525.00 |
$677.87 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,628.55 |
$2,006.40 |
$3,983.08 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$470.80 |
$506.00 |
$2,097.37 |
|
|
Echocardiograpy doppler follow up/limited study
|
$174.35 |
$332.50 |
$646.60 |
|
|
Echo exam of eye
|
$169.62 |
$169.62 |
$169.62 |
|
|
Echo exam of fetal heart
|
$389.55 |
$690.00 |
$1,470.70 |
|
|
Echo exam of fetal heart
|
$311.64 |
$550.00 |
$1,191.08 |
|
|
Echo exam of fetal heart
|
$301.40 |
$345.00 |
$919.47 |
|
|
Echo exam of fetal heart
|
$239.03 |
$277.50 |
$919.47 |
|
|
Echo exam uterus 76831-
|
$320.65 |
$475.00 |
$1,225.04 |
|
|
Echograp trans r pros study
|
$180.69 |
$670.00 |
$742.53 |
|
|
Echo guidance radiotherapy
|
$78.09 |
$515.00 |
$562.33 |
|
|
Echo guide for amniocentesis
|
$153.78 |
$375.00 |
$1,046.10 |
|
|
Echo guide for artery repair
|
$373.92 |
$660.00 |
$1,291.40 |
|
|
Echo guide for heart biopsy
|
$110.00 |
$110.00 |
$110.00 |
|
|
Echo guide for transfusion
|
$292.50 |
$445.73 |
$1,531.75 |
|
|
Echo guide villus sampling
|
$370.15 |
$370.15 |
$755.70 |
|
|
Echo stress
|
$436.19 |
$1,606.44 |
$2,641.45 |
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$879.78 |
$879.78 |
$879.78 |
|
|
Echo tee guidance
|
$1,375.00 |
$2,675.44 |
$4,710.00 |
|
|
Echo tee probe placement image acquisition interpretation & report
|
$973.50 |
$2,026.19 |
$3,430.00 |
|
|
Echo transesophageal
|
$808.83 |
$1,092.33 |
$2,640.00 |
|
|
Echo transesophageal
|
$478.59 |
$478.59 |
$1,390.40 |
|
|
Echo transesophageal
|
$803.00 |
$922.90 |
$2,314.68 |
|
|
Echo transesophageal intraop
|
$843.70 |
$1,520.04 |
$2,380.93 |
|
|
Echo transthoracic
|
$876.09 |
$1,500.00 |
$2,441.30 |
|
|
Echo transthoracic
|
$504.35 |
$950.00 |
$1,530.54 |
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$318.00 |
$1,453.98 |
$2,851.91 |
|
|
Ecmo/ecls daily mgmt artery 33949
|
$1,023.55 |
$1,030.00 |
$9,543.98 |
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$1,023.55 |
$1,030.00 |
$9,089.51 |
|
|
Ecmo/ecls initiation artery 33947
|
$1,030.00 |
$1,728.65 |
$9,543.98 |
|
|
Ecmo/ecls initiation venous 33946
|
$1,030.00 |
$1,532.30 |
$9,089.51 |
|
|
Ecmo/ecls insj cent cannula 0-5yrs 33955
|
$6,145.60 |
$6,145.60 |
$6,145.60 |
|
|
Ecmo/ecls insj cent cannula 6yrs&older 33956
|
$4,936.80 |
$4,936.80 |
$4,936.80 |
|
|
Ecmo/ecls insj prph cannula 0-5yrs opn 33953
|
$3,784.00 |
$3,784.00 |
$3,784.00 |
|
|
Ecmo/ecls insj prph cannula 0-5yrs perq 33951
|
$3,396.80 |
$3,396.80 |
$3,396.80 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older opn 33954
|
$2,645.50 |
$2,645.50 |
$9,089.51 |
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$990.00 |
$1,630.75 |
$9,543.98 |
|
|
Ecmo/ecls remove cent cannula 0-5yrs 33985
|
$4,826.40 |
$4,826.40 |
$4,826.40 |
|
|
Ecmo/ecls remove cent cannula 6yrs&older 33986
|
$9,089.51 |
$9,089.51 |
$9,089.51 |
|
|
Ecmo/ecls remove perph cannula 0-5yrs opn 33969
|
$2,609.60 |
$2,609.60 |
$2,609.60 |
|
|
Ecmo/ecls remove perph cannula 0-5yrs perq 33965
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older open 33984
|
$9,089.51 |
$9,089.51 |
$9,089.51 |
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$374.55 |
$374.55 |
$9,089.51 |
|
|
Ecmo/ecls repos cent cnula 6yrs&older 33964
|
$9,089.51 |
$9,089.51 |
$9,089.51 |
|
|
Ecmo/ecls repos cent/perph cnula 0-5yrs 33963
|
$3,414.40 |
$3,414.40 |
$3,414.40 |
|
|
Ecmo/ecls repos perph cnula 0-5yrs opn 33959
|
$2,217.60 |
$2,217.60 |
$2,217.60 |
|
|
Ecmo/ecls repos perph cnula 0-5yrs perq 33957
|
$1,764.80 |
$1,764.80 |
$1,764.80 |
|
|
Ecmo/ecls repos perph cnula 6yrs&older opn 33962
|
$2,785.60 |
$2,785.60 |
$2,785.60 |
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$182.60 |
$182.60 |
$1,802.40 |
|
|
Ecog impltd brn npgt <30 d
|
$230.00 |
$230.00 |
$230.00 |
|
|
E coli 0157 ag ia
|
$39.22 |
$39.22 |
$39.22 |
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$69.72 |
$69.72 |
$117.10 |
|
|
Eculizumab injection
|
$339.00 |
$361.85 |
$39,343.34 |
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$23.65 |
$70.40 |
$125.60 |
|
|
Eeg 41-60 minutes 95812-26
|
$695.36 |
$920.00 |
$1,376.65 |
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$581.90 |
$864.60 |
$865.00 |
|
|
Eeg during surgery
|
$429.00 |
$1,712.04 |
$1,750.00 |
|
|
Eeg monitoring/function test
|
$752.95 |
$1,570.00 |
$1,570.00 |
|
|
Eeg monitoring/giving drugs
|
$770.09 |
$770.09 |
$770.09 |
|
|
Eeg monitor/record/awake/drowsy 95816
|
$194.70 |
$680.00 |
$1,022.40 |
|
|
Eeg over 1 hour 95813 - 26
|
$758.67 |
$1,205.00 |
$3,059.56 |
|
|
Eeg/record in coma or sleep only 95822
|
$326.70 |
$865.00 |
$1,267.80 |
|
|
Eeg recording awake and asleep
|
$485.65 |
$740.00 |
$1,514.64 |
|
|
Eeg without vid 2-12hr cont mntr
|
$528.96 |
$1,330.00 |
$3,153.48 |
|
|
Eeg without vid 2-12 hr unmntr
|
$438.84 |
$1,500.00 |
$2,432.76 |
|
|
Eeg without vid ea 12-26hr cont
|
$1,012.32 |
$2,140.00 |
$3,640.00 |
|
