|
Debridement bone <= 20 sq cm
|
$1,596.29 |
$1,596.29 |
$1,596.29 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$304.90 |
$304.90 |
$304.90 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$537.98 |
$537.98 |
$537.98 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$315.54 |
$315.54 |
$428.16 |
$835.20
|
|
Debride nail1-5 11720
|
$79.49 |
$79.49 |
$79.49 |
$149.60
|
|
Debride nail6 or more 11721
|
$107.14 |
$107.14 |
$107.14 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$135.84 |
$135.84 |
$184.32 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,087.87 |
$1,087.87 |
$1,087.87 |
$1,165.50
|
|
Decalcification
|
$4.60 |
$9.46 |
$40.27 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$148.86 |
$186.20 |
$263.80 |
$572.95
|
|
Delivery of placenta 59414
|
$813.96 |
$813.96 |
$3,190.86 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$2,340.65 |
$2,340.65 |
$2,340.65 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$59.50 |
$72.13 |
$89.95 |
$185.17
|
|
Design mlc device for imrt
|
$756.67 |
$756.67 |
$756.67 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$176.61 |
$176.61 |
$176.61 |
$91.84
|
|
Desoxycorticosterone
|
$7.81 |
$11.81 |
$31.62 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$1,529.61 |
$1,848.51 |
$1,913.37 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$616.94 |
$745.56 |
$771.72 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$541.38 |
$654.25 |
$677.20 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,634.32 |
$1,975.05 |
$2,044.35 |
$3,296.80
|
|
Device ablt adv novasure
|
$1,922.28 |
$2,698.14 |
$3,395.12 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,422.47 |
$1,422.47 |
$2,153.72 |
$4,200.00
|
|
Device sut capio slim opn
|
$2,790.78 |
$3,057.12 |
$3,149.76 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$1,036.91 |
$2,153.72 |
$3,237.54 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$77.76 |
$77.76 |
$77.76 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$1.49 |
$1.49 |
$1.49 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$15.81 |
$15.81 |
$15.81 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$86.45 |
$86.45 |
$86.45 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$86.45 |
$86.45 |
$86.45 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$86.45 |
$86.45 |
$86.45 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$5.63 |
$8.51 |
$47.68 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$14.87 |
$22.48 |
$50.39 |
$79.30
|
|
Diagnostic laryngoscopy 31575
|
$131.03 |
$158.35 |
$163.90 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$236.16 |
$236.16 |
$236.16 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$155.90 |
$155.90 |
$155.90 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,878.68 |
$3,478.82 |
$3,600.89 |
$5,741.00
|
|
Dialysis one evaluation
|
$181.74 |
$181.74 |
$364.82 |
$936.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$27.92 |
$27.92 |
$27.92 |
$79.71
|
|
Dicyclomine injection
|
$211.68 |
$211.68 |
$211.68 |
$154.33
|
|
Diffusing capacity
|
$86.94 |
$169.37 |
$446.29 |
$336.80
|
|
Digital analysis of eeg
|
$51.46 |
$213.86 |
$417.28 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$14.08 |
$14.08 |
$14.08 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,975.82 |
$4,975.82 |
$4,975.82 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$4.45 |
$6.73 |
$49.16 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$196.62 |
$196.62 |
$196.62 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,691.06 |
$1,691.06 |
$1,691.06 |
$1,866.73
|
|
Dilate esophagus
|
$455.24 |
$455.24 |
$455.24 |
$2,142.40
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$5,470.36 |
$5,470.36 |
$5,470.36 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$5,470.36 |
$5,470.36 |
$5,470.36 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$7,293.82 |
$7,293.82 |
$7,293.82 |
$5,151.95
|
|
Dilator fascial 10fx20cm
|
$137.58 |
$334.34 |
$502.58 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$990.78 |
$1,197.34 |
$1,239.35 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$1,679.32 |
$2,029.43 |
$2,100.64 |
$4,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$13.34 |
$13.34 |
$13.34 |
$18.32
|
|
Disability dlco
|
$51.84 |
$100.99 |
$266.11 |
$293.76
|
|
Disaccharidases
|
$30.41 |
$45.97 |
$54.30 |
$230.40
|
|
Discography cerv/thor spine
|
$995.12 |
$1,023.55 |
$1,474.91 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$1,605.04 |
$1,605.04 |
$1,605.04 |
$1,579.93
|
|
#d/lmeth-l-methamphetamine
|
$10.05 |
$10.05 |
$10.05 |
$72.14
|
|
Dlyd plmt xtn prosth ea addl
|
$2,456.05 |
$2,456.05 |
$2,456.05 |
$1,810.80
|
|
Dmpk gene detc abnor allele
|
$363.00 |
$363.00 |
$363.00 |
$313.60
|
|
Dna antibody native/double stranded
|
$10.42 |
$11.47 |
$68.92 |
$100.00
|
|
Dna gardnerella
|
$10.00 |
$13.60 |
$42.49 |
$61.83
|
|
Dna trichomonas
|
$10.00 |
$13.60 |
$44.96 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$86.45 |
$86.45 |
$86.45 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$86.45 |
$86.45 |
$86.45 |
$65.40
|
|
Doppler echo complete
|
$203.20 |
$235.64 |
$281.26 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$972.02 |
$986.46 |
$1,212.91 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$241.11 |
$269.40 |
$330.02 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$206.21 |
$230.40 |
$282.24 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$52,779.96 |
$59,569.09 |
$75,161.86 |
$34,278.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$61.01 |
$61.01 |
$61.01 |
$89.34
|
|
Dpyd gene common variants
|
$56.48 |
$183.77 |
$370.92 |
$423.60
|
|
Drainage of kidney lesion
|
$432.71 |
$522.92 |
$541.27 |
$1,506.00
|
|
Drain bladder by trocar/cath
|
$509.12 |
$615.26 |
$636.85 |
$1,203.94
|
|
Drain cath image guided visceral pq
|
$634.77 |
$767.11 |
$794.02 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$290.36 |
$363.20 |
$393.98 |
$1,044.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$243.46 |
$243.46 |
$243.46 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$160.13 |
$160.13 |
$160.13 |
$349.50
|
|
Drng of hydrocele 55000
|
$329.00 |
$329.00 |
$329.00 |
$867.90
|
|
Droperidol 2.5 mg/ml injection solution
|
$13.34 |
$13.34 |
$13.34 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$291.96 |
$2,232.86 |
$2,520.08 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$101.70 |
$111.41 |
$8,226.09 |
$7,465.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$36.59 |
$36.59 |
$36.59 |
$376.50
|
|
Drug admin & hemodynmic meas
|
$593.27 |
$602.08 |
$740.30 |
$569.75
|
|
Drug assay caffeine
|
$9.74 |
$14.73 |
$17.40 |
$80.00
|
|
Drug assay posaconazole
|
$9.91 |
$14.99 |
$157.34 |
$96.75
|
|
Drug assay rufinamide
|
$17.55 |
$17.55 |
$17.55 |
$87.10
|
|
Drug assay vedolizumab
|
$47.55 |
$47.55 |
$47.55 |
$154.00
|
|
Drug assay voriconazole
|
$10.67 |
$16.13 |
$19.05 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$24.44 |
$36.96 |
$43.65 |
$66.43
|
|
Drug of abuse screen urine
|
$5.38 |
$8.13 |
$9.60 |
$67.89
|
|
Drug screening tapentadol
|
$4.70 |
$7.11 |
$8.40 |
$47.03
|
|
Drug test def 15-21 classes
|
$63.98 |
$63.98 |
$63.98 |
$322.50
|
|
Drug test def 1-7 classes
|
$126.47 |
$126.47 |
$126.47 |
$263.25
|
|
Drug test def 22+ classes
|
$196.37 |
$196.37 |
$196.37 |
$426.24
|
|
Drug test prsmv instrmnt
|
$33.84 |
$33.84 |
$33.84 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$37.72 |
$57.02 |
$167.22 |
$278.85
|
|
Ductogram sgl duct
|
$223.72 |
$223.72 |
$230.11 |
$469.80
|
|
Dup scan/hemodialysis access 93990
|
$144.99 |
$162.00 |
$198.45 |
$489.72
|
