|
Degarelix 120 mg subcutaneous solution
|
$3,071.26 |
$3,071.26 |
$3,071.26 |
$2,086.82
|
|
Delivery of placenta 59414
|
$3,150.10 |
$3,150.10 |
$3,150.10 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$223.09 |
$223.09 |
$223.09 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$7,933.81
|
|
Dermagraft
|
$68.33 |
$68.33 |
$68.33 |
$1,912.31
|
|
Desmopressin 4 mcg/ml injection solution
|
$282.66 |
$282.66 |
$282.66 |
$102.32
|
|
Desoxycorticosterone
|
$88.89 |
$88.89 |
$88.89 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$1,723.97 |
$1,723.97 |
$1,723.97 |
$3,164.80
|
|
Device ablt adv novasure
|
$8,295.72 |
$8,295.72 |
$8,295.72 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,773.23 |
$3,773.23 |
$3,773.23 |
$4,298.87
|
|
Device sut capio slim opn
|
$2,230.88 |
$2,230.88 |
$2,230.88 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,901.32 |
$2,901.32 |
$2,901.32 |
$2,440.98
|
|
Dexamethasone 4 mg tablet
|
$88.19 |
$88.19 |
$88.19 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$376.10 |
$376.10 |
$376.10 |
$30.00
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$560.92
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$43.80 |
$43.80 |
$43.80 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$43.22 |
$43.22 |
$43.22 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$435.67 |
$435.67 |
$435.67 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$43.22 |
$43.22 |
$43.22 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$3.51 |
$3.51 |
$3.51 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$152.43 |
$152.43 |
$152.43 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$310.69 |
$310.69 |
$310.69 |
$424.00
|
|
Dialysis one evaluation
|
$2,946.87 |
$2,946.87 |
$2,946.87 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$102.20 |
$102.20 |
$102.20 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$99.28 |
$99.28 |
$99.28 |
$72.34
|
|
Dicyclomine injection
|
$338.72 |
$338.72 |
$338.72 |
$211.81
|
|
Diffusing capacity
|
$373.18 |
$373.18 |
$373.18 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$529.69 |
$529.69 |
$529.69 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$258.13 |
$258.13 |
$258.13 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$334.68
|
|
Dilator fascial 10fx20cm
|
$598.02 |
$598.02 |
$598.02 |
$305.68
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$26.87 |
$26.87 |
$26.87 |
$26.87
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$230.10 |
$230.10 |
$230.10 |
$106.59
|
|
Disability dlco
|
$454.94 |
$454.94 |
$454.94 |
$307.58
|
|
Disaccharidases
|
$195.64 |
$195.64 |
$195.64 |
$223.80
|
|
Dmd dup/delet analysis
|
$303.28 |
$303.28 |
$303.28 |
$385.02
|
|
Dna antibody native/double stranded
|
$19.86 |
$19.86 |
$19.86 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$289.08 |
$289.08 |
$289.08 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,305.24 |
$1,305.24 |
$1,305.24 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$63.66 |
$63.66 |
$63.66 |
$84.30
|
|
Doppler echo complete
|
$858.48 |
$858.48 |
$858.48 |
$608.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$264.56 |
$264.56 |
$264.56 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$193.31 |
$193.31 |
$193.31 |
$482.03
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$189.80 |
$189.80 |
$189.80 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$2,417.38
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$161.19 |
$161.19 |
$161.19 |
$99.99
|
|
Dpyd gene common variants
|
$141.33 |
$141.33 |
$141.33 |
$380.50
|
|
Drain cath image guided visceral pq
|
$5,815.48 |
$5,815.48 |
$5,815.48 |
$3,073.90
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$354.49 |
$354.49 |
$354.49 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$322.37 |
$322.37 |
$322.37 |
$365.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$412.89 |
$412.89 |
$412.89 |
$554.40
|
|
Drill hole implt ventricular cath/device 61107
|
$1,519.57 |
$1,519.57 |
$1,519.57 |
$1,594.26
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$779.06 |
$779.06 |
$779.06 |
$1,778.40
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$9.35 |
$9.35 |
$9.35 |
$468.29
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$3,773.23 |
$3,773.23 |
$3,773.23 |
$318.13
|
|
Drug assay caffeine
|
$20.69 |
$20.69 |
$20.69 |
$81.61
|
|
Drug assay posaconazole
|
$33.29 |
$33.29 |
$33.29 |
$96.39
|
|
Drug assay vedolizumab
|
$83.08 |
$83.08 |
$83.08 |
$164.16
|
|
Drug assay voriconazole
|
$30.96 |
$30.96 |
$30.96 |
$96.75
|
|
Drug of abuse screen urine
|
$18.69 |
$18.69 |
$18.69 |
$63.75
|
|
Drug test def 15-21 classes
|
$58.40 |
$58.40 |
$58.40 |
$144.42
|
|
Drug test def 1-7 classes
|
$294.34 |
$294.34 |
$294.34 |
$250.52
|
|
Drug test def 22+ classes
|
$105.12 |
$105.12 |
$105.12 |
$246.92
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$391.28 |
$391.28 |
$391.28 |
$278.85
|
|
Drvvt confirm - quest
|
$62.60 |
$62.60 |
$62.60 |
$101.66
|
|
Dstrj nulyt agt gnclr nrv
|
$3,679.79 |
$3,679.79 |
$3,679.79 |
$3,390.00
|
|
Duplex scan bilateral study 93985
|
$358.00 |
$358.00 |
$358.00 |
$673.00
|
|
Duplex scan unilateral study 93986
|
$172.28 |
$172.28 |
$172.28 |
$394.00
|
|
Dup scan/hemodialysis access 93990
|
$784.90 |
$784.90 |
$784.90 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$273.32 |
$273.32 |
$273.32 |
$757.57
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,212.97 |
$1,212.97 |
$1,212.97 |
$903.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$3,739.94 |
$3,739.94 |
$3,739.94 |
$10,021.12
|
|
Dx bronchoscope/brush 31623
|
$1,357.22 |
$1,357.22 |
$1,357.22 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$1,357.22 |
$1,357.22 |
$1,357.22 |
$2,780.40
|
|
Dx bronchoscope/wash 31622
|
$1,954.07 |
$1,954.07 |
$1,954.07 |
$2,587.60
|
|
Dx gastr intub w/asp spec
|
$518.60 |
$518.60 |
$518.60 |
$368.50
|
|
Ear irrigation 69209
|
$101.04 |
$101.04 |
$101.04 |
$165.42
|
|
Ecg 12 lead tracing only
|
$322.96 |
$322.96 |
$322.96 |
$245.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$230.68 |
$230.68 |
$230.68 |
$129.83
|
|
Ecg external < 48 hours recording
|
$109.80 |
$109.80 |
$109.80 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$109.80 |
$109.80 |
$109.80 |
$567.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$84.10 |
$84.10 |
$84.10 |
$162.78
|
|
Ecg external >7 days up to 15 days recording
|
$84.10 |
$84.10 |
$84.10 |
$200.00
|
|
Echocardiogram (Heart Ultrasound)
|
$1,610.68 |
$1,610.68 |
$1,610.68 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$412.31 |
$412.31 |
$412.31 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,610.68 |
$1,610.68 |
$1,610.68 |
$2,027.90
|
|
Echocardiography transthoracic 2d followup/limited
|
$893.52 |
$893.52 |
$893.52 |
$724.20
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$757.45 |
$757.45 |
$757.45 |
$762.00
|
|
Echocardiograpy doppler follow up/limited study
|
$429.24 |
$429.24 |
$429.24 |
$353.46
|
|
Echo exam of fetal heart
|
$904.62 |
$904.62 |
$904.62 |
$855.38
|
|
Echo exam of fetal heart
|
$431.58 |
$431.58 |
$431.58 |
$503.80
|
|
Echo exam of fetal heart
|
$204.40 |
$204.40 |
$204.40 |
$431.41
|
|
Echo exam of fetal heart
|
$204.40 |
$204.40 |
$204.40 |
$323.40
|
|
Echo stress
|
$642.99 |
$642.99 |
$642.99 |
$1,582.75
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,591.40 |
$1,591.40 |
$1,591.40 |
$1,871.10
|
|
Echo transthoracic
|
$1,601.92 |
$1,601.92 |
$1,601.92 |
$1,492.50
|
|
Echo transthoracic
|
$2,242.56 |
$2,242.56 |
$2,242.56 |
$953.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$696.72 |
$696.72 |
$696.72 |
$1,014.01
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$3,858.49 |
$3,858.49 |
$3,858.49 |
$4,324.50
|