|
Debridement bone <= 20 sq cm
|
$874.06 |
$874.06 |
$874.06 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$232.63 |
$232.63 |
$232.63 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$397.58 |
$397.58 |
$397.58 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$434.02 |
$434.02 |
$434.02 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$187.15 |
$187.15 |
$187.15 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$575.95 |
$575.95 |
$575.95 |
$1,193.40
|
|
Decalcification
|
$30.14 |
$30.14 |
$30.14 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$2,138.30 |
$2,138.30 |
$2,138.30 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$167.97 |
$167.97 |
$167.97 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$137.28 |
$137.28 |
$137.28 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$1,002.57 |
$1,002.57 |
$1,002.57 |
$2,086.82
|
|
Delivery of placenta 59414
|
$1,555.50 |
$1,555.50 |
$1,555.50 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$193.72 |
$193.72 |
$193.72 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,003.59 |
$3,003.59 |
$3,003.59 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$209.61 |
$209.61 |
$209.61 |
$460.50
|
|
Dermagraft
|
$2,198.85 |
$2,198.85 |
$2,198.85 |
$1,912.31
|
|
Desmopressin 4 mcg/ml injection solution
|
$932.43 |
$932.43 |
$932.43 |
$102.32
|
|
Desoxycorticosterone
|
$9.25 |
$9.25 |
$9.25 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$1,368.91 |
$1,368.91 |
$1,368.91 |
$5,698.68
|
|
Destroy cervthor facet jnt 64633
|
$2,036.92 |
$2,036.92 |
$2,036.92 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$1,357.95 |
$1,357.95 |
$1,357.95 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,357.95 |
$1,357.95 |
$1,357.95 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,036.92 |
$2,036.92 |
$2,036.92 |
$3,375.00
|
|
Device ablt adv novasure
|
$8,172.05 |
$8,172.05 |
$8,172.05 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,718.18 |
$3,718.18 |
$3,718.18 |
$4,298.87
|
|
Device intraute mirena
|
$924.75 |
$924.75 |
$924.75 |
$2,618.91
|
|
Device sut capio slim opn
|
$2,198.85 |
$2,198.85 |
$2,198.85 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,198.85 |
$2,198.85 |
$2,198.85 |
$2,440.98
|
|
Dexamethasone 4 mg tablet
|
$2.47 |
$2.47 |
$2.47 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$13.70 |
$13.70 |
$13.70 |
$30.00
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,939.92 |
$1,939.92 |
$1,939.92 |
$560.92
|
|
Dextran 40 infusion
|
$37.82 |
$37.82 |
$37.82 |
$171.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$21.38 |
$21.38 |
$21.38 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$16.44 |
$16.44 |
$16.44 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$142.21 |
$142.21 |
$142.21 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$21.38 |
$21.38 |
$21.38 |
$68.93
|
|
Diabetes (HbA1c) Test
|
$149.06 |
$149.06 |
$149.06 |
$78.03
|
|
Diab manage trn ind/group
|
$44.67 |
$44.67 |
$44.67 |
$49.50
|
|
Diag bronchoscope/catheter
|
$1,294.38 |
$1,294.38 |
$1,294.38 |
$2,040.67
|
|
Diagnostic laryngoscopy 31575
|
$180.84 |
$180.84 |
$180.84 |
$385.20
|
|
Dialysis circuit perm vascular embolization 36909
|
$597.60 |
$597.60 |
$597.60 |
$7,145.00
|
|
Dialysis one evaluation
|
$668.84 |
$668.84 |
$668.84 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$33.43 |
$33.43 |
$33.43 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$32.61 |
$32.61 |
$32.61 |
$72.34
|
|
Dicyclomine injection
|
$110.70 |
$110.70 |
$110.70 |
$211.81
|
|
Diffusing capacity
|
$177.56 |
$177.56 |
$177.56 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$172.90 |
$172.90 |
$172.90 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$2,597.52 |
$2,597.52 |
$2,597.52 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$121.11 |
$121.11 |
$121.11 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,547.83 |
$1,547.83 |
$1,547.83 |
$334.68
|
|
Dilate biliary duct/ampulla
|
$581.71 |
$581.71 |
$581.71 |
$2,304.60
|
|
Dilator fascial 10fx20cm
|
$453.47 |
$453.47 |
$453.47 |
$305.68
|
|
Dilat xst trc ndurlgc px
|
$2,470.39 |
$2,470.39 |
$2,470.39 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$2,470.39 |
$2,470.39 |
$2,470.39 |
$5,020.00
|
|
Dimecaprol injection
|
$211.26 |
$211.26 |
$211.26 |
$199.46
|
|
Dimenhydrinate injection
|
$13.70 |
$13.70 |
$13.70 |
$24.68
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$13.70 |
$13.70 |
$13.70 |
$26.87
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$75.08 |
$75.08 |
$75.08 |
$106.59
|
|
Disability dlco
|
$182.21 |
$182.21 |
$182.21 |
$307.58
|
|
Disaccharidases
|
$36.17 |
$36.17 |
$36.17 |
$223.80
|
|
Dna antibody native/double stranded
|
$3.40 |
$3.40 |
$3.40 |
$102.60
|
|
Dna gardnerella
|
$95.36 |
$95.36 |
$95.36 |
$67.68
|
|
Dna probe gc
|
$2.20 |
$2.20 |
$2.20 |
$88.67
|
|
Dna trichomonas
|
$103.03 |
$103.03 |
$103.03 |
$68.75
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$94.53 |
$94.53 |
$94.53 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$20.28 |
$20.28 |
$20.28 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$25.49 |
$25.49 |
$25.49 |
$84.30
|
|
Doppler echo complete
|
$353.46 |
$353.46 |
$353.46 |
$608.25
|
|
Doppler intravascular pressure flow initial vessel
|
$1,595.78 |
$1,595.78 |
$1,595.78 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$463.06 |
$463.06 |
$463.06 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$315.10 |
$315.10 |
$315.10 |
$482.03
|
|
Doripenem 50 mg/ml inj 10 ml
|
$50.42 |
$50.42 |
$50.42 |
$70.91
|
|
Dornhoffer fixed part w/window
|
$47,681.48 |
$47,681.48 |
$47,681.48 |
$28,091.95
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$13,638.08 |
$13,638.08 |
$13,638.08 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$338.12 |
$338.12 |
$338.12 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$4,106.72 |
$4,106.72 |
$4,106.72 |
$2,417.38
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$3,177.58 |
$3,177.58 |
$3,177.58 |
$99.99
|
|
Dpyd gene common variants
|
$66.31 |
$66.31 |
$66.31 |
$380.50
|
|
Drainage of kidney lesion
|
$1,089.15 |
$1,089.15 |
$1,089.15 |
$1,706.65
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$997.09 |
$997.09 |
$997.09 |
$2,614.66
|
|
Drain cath image guided visceral pq
|
$1,141.21 |
$1,141.21 |
$1,141.21 |
$3,073.90
|
|
Dress/debrid prtl-thick burn l 16030
|
$186.05 |
$186.05 |
$186.05 |
$554.40
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$8,172.05 |
$8,172.05 |
$8,172.05 |
$9,390.80
|
|
Drill hole implt ventricular cath/device 61107
|
$706.10 |
$706.10 |
$706.10 |
$1,594.26
|
|
Droperidol 2.5 mg/ml injection solution
|
$13.70 |
$13.70 |
$13.70 |
$39.60
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$4,834.73 |
$4,834.73 |
$4,834.73 |
$1,778.40
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$347.98 |
$347.98 |
$347.98 |
$468.29
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$590.47 |
$590.47 |
$590.47 |
$318.13
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$18,384.03 |
$18,384.03 |
$18,384.03 |
$18,384.03
|
|
Drug admin & hemodynmic meas
|
$459.50 |
$459.50 |
$459.50 |
$528.50
|
|
Drug assay caffeine
|
$4.22 |
$4.22 |
$4.22 |
$81.61
|
|
Drug assay voriconazole
|
$14.53 |
$14.53 |
$14.53 |
$96.75
|
|
Drug test def 15-21 classes
|
$34.25 |
$34.25 |
$34.25 |
$144.42
|
|
Drug test def 1-7 classes
|
$176.46 |
$176.46 |
$176.46 |
$250.52
|
|
Drug test def 22+ classes
|
$49.32 |
$49.32 |
$49.32 |
$246.92
|
|
Drug test def 8-14 classes
|
$110.97 |
$110.97 |
$110.97 |
$172.25
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$203.86 |
$203.86 |
$203.86 |
$278.85
|
|
Drvvt confirm - quest
|
$5.37 |
$5.37 |
$5.37 |
$101.66
|
|
Dstrj nulyt agt gnclr nrv
|
$1,792.51 |
$1,792.51 |
$1,792.51 |
$3,390.00
|
|
Duplex scan bilateral study 93985
|
$747.75 |
$747.75 |
$747.75 |
$673.00
|