|
Debridement/bone/ea add 20 sq cm 11047
|
$863.71 |
$863.71 |
$863.71 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$613.76 |
$613.76 |
$613.76 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$201.59 |
$201.59 |
$201.59 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$870.98 |
$870.98 |
$870.98 |
$1,193.40
|
|
Decalcification
|
$3.53 |
$3.53 |
$3.53 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$4,879.20 |
$4,879.20 |
$4,879.20 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$445.12 |
$445.12 |
$445.12 |
$545.90
|
|
Deep muscle biopsy 20205
|
$2,874.45 |
$2,874.45 |
$2,874.45 |
$3,370.52
|
|
Deferoxamine 500 mg solution for injection
|
$151.52 |
$151.52 |
$151.52 |
$110.82
|
|
Delivery of placenta 59414
|
$3,393.19 |
$3,393.19 |
$3,393.19 |
$3,271.20
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$2,228.17 |
$2,228.17 |
$2,228.17 |
$7,763.47
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$151.09 |
$151.09 |
$151.09 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$12,969.26 |
$12,969.26 |
$12,969.26 |
$7,933.81
|
|
Depo-estradiol cypionate inj
|
$271.78 |
$271.78 |
$271.78 |
$132.72
|
|
Descend thora aorta rpr/lt sub art 33880
|
$6,687.93 |
$6,687.93 |
$6,687.93 |
$5,702.04
|
|
Design mlc device for imrt
|
$663.83 |
$663.83 |
$663.83 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$344.12 |
$344.12 |
$344.12 |
$102.32
|
|
Desoxycorticosterone
|
$29.42 |
$29.42 |
$29.42 |
$109.28
|
|
Des thora aorta/ea add prox prosth 33884
|
$1,511.27 |
$1,511.27 |
$1,511.27 |
$1,285.78
|
|
Des thora aorta rpr without left sub art 33881
|
$5,757.89 |
$5,757.89 |
$5,757.89 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$4,182.42 |
$4,182.42 |
$4,182.42 |
$2,498.88
|
|
Destroy cervthor facet jnt 64633
|
$1,572.90 |
$1,572.90 |
$1,572.90 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$853.44 |
$853.44 |
$853.44 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,183.00 |
$1,183.00 |
$1,183.00 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,073.66 |
$2,073.66 |
$2,073.66 |
$3,375.00
|
|
Developmental screen/score/document 96110
|
$227.27 |
$227.27 |
$227.27 |
$139.10
|
|
Devel tst phys/qhp 1st hr
|
$227.27 |
$227.27 |
$227.27 |
$339.30
|
|
Device ablt adv novasure
|
$2,734.92 |
$2,734.92 |
$2,734.92 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,624.54 |
$4,624.54 |
$4,624.54 |
$4,298.87
|
|
Device intraute mirena
|
$4,163.16 |
$4,163.16 |
$4,163.16 |
$2,618.91
|
|
Device sut capio slim opn
|
$2,734.92 |
$2,734.92 |
$2,734.92 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,555.40 |
$3,555.40 |
$3,555.40 |
$2,440.98
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$113.85 |
$113.85 |
$113.85 |
$196.30
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$315.01 |
$315.01 |
$315.01 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$5.57 |
$5.57 |
$5.57 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$42.80 |
$42.80 |
$42.80 |
$30.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$42.80 |
$42.80 |
$42.80 |
$60.00
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$40.24 |
$40.24 |
$40.24 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$23.12 |
$23.12 |
$23.12 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$5.14 |
$5.14 |
$5.14 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$206.73 |
$206.73 |
$206.73 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$377.93 |
$377.93 |
$377.93 |
$424.00
|
|
Diagnostic radio unlisted proc
|
$281.20 |
$281.20 |
$281.20 |
$239.25
|
|
Dialysis circuit perm vascular embolization 36909
|
$1,572.90 |
$1,572.90 |
$1,572.90 |
$7,145.00
|
|
Dialysis one evaluation
|
$1,432.09 |
$1,432.09 |
$1,432.09 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$270.50 |
$270.50 |
$270.50 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$172.92 |
$172.92 |
$172.92 |
$72.34
|
|
Dicyclomine injection
|
$431.86 |
$431.86 |
$431.86 |
$211.81
|
|
Diffusing capacity
|
$190.46 |
$190.46 |
$190.46 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$674.96 |
$674.96 |
$674.96 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$16,050.00 |
$16,050.00 |
$16,050.00 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$177.20 |
$177.20 |
$177.20 |
$102.00
|
|
Dilate biliary duct/ampulla
|
$751.14 |
$751.14 |
$751.14 |
$2,304.60
|
|
Dilator fascial 10fx20cm
|
$564.54 |
$564.54 |
$564.54 |
$305.68
|
|
Dilat xst trc ndurlgc px
|
$3,333.70 |
$3,333.70 |
$3,333.70 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$5,608.52 |
$5,608.52 |
$5,608.52 |
$5,020.00
|
|
Diltiazem 5 mg/ml intravenous solution
|
$95.45 |
$95.45 |
$95.45 |
$60.25
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$23.12 |
$23.12 |
$23.12 |
$26.87
|
|
Disability dlco
|
$376.64 |
$376.64 |
$376.64 |
$307.58
|
|
Disaccharidases
|
$177.62 |
$177.62 |
$177.62 |
$223.80
|
|
Discography cerv/thor spine
|
$3,076.47 |
$3,076.47 |
$3,076.47 |
$2,404.00
|
|
Dlyd plmt xtn prosth ea addl
|
$2,189.65 |
$2,189.65 |
$2,189.65 |
$2,001.55
|
|
Dmd dup/delet analysis
|
$222.27 |
$222.27 |
$222.27 |
$385.02
|
|
Dmpk gene detc abnor allele
|
$166.92 |
$166.92 |
$166.92 |
$318.75
|
|
Dna antibody native/double stranded
|
$56.18 |
$56.18 |
$56.18 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$104.44 |
$104.44 |
$104.44 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,433.80 |
$1,433.80 |
$1,433.80 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$79.61 |
$79.61 |
$79.61 |
$84.30
|
|
Doppler echo complete
|
$600.92 |
$600.92 |
$600.92 |
$608.25
|
|
Doppler intravascular pressure flow initial vessel
|
$1,402.99 |
$1,402.99 |
$1,402.99 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$566.25 |
$566.25 |
$566.25 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$566.25 |
$566.25 |
$566.25 |
$482.03
|
|
Dornhoffer fixed part w/window
|
$7,817.85 |
$7,817.85 |
$7,817.85 |
$28,091.95
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$659.98 |
$659.98 |
$659.98 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$16,036.74 |
$16,036.74 |
$16,036.74 |
$2,417.38
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$124.12 |
$124.12 |
$124.12 |
$99.99
|
|
Dpyd gene common variants
|
$316.68 |
$316.68 |
$316.68 |
$380.50
|
|
Drainage of kidney lesion
|
$2,095.06 |
$2,095.06 |
$2,095.06 |
$1,706.65
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,851.77 |
$2,851.77 |
$2,851.77 |
$2,614.66
|
|
Drain cath image guided visceral pq
|
$2,287.66 |
$2,287.66 |
$2,287.66 |
$3,073.90
|
|
Drain cerebro spinal fluid 62272
|
$1,644.38 |
$1,644.38 |
$1,644.38 |
$1,113.06
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$376.22 |
$376.22 |
$376.22 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$301.74 |
$301.74 |
$301.74 |
$365.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$584.65 |
$584.65 |
$584.65 |
$554.40
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$3,555.40 |
$3,555.40 |
$3,555.40 |
$9,390.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$23.12 |
$23.12 |
$23.12 |
$39.60
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,617.84 |
$1,617.84 |
$1,617.84 |
$1,778.40
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$1,617.84 |
$1,617.84 |
$1,617.84 |
$318.13
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$24,670.35 |
$24,670.35 |
$24,670.35 |
$18,384.03
|
|
Drug admin & hemodynmic meas
|
$613.76 |
$613.76 |
$613.76 |
$528.50
|
|
Drug assay posaconazole
|
$24.40 |
$24.40 |
$24.40 |
$96.39
|
|
Drug assay rufinamide
|
$25.19 |
$25.19 |
$25.19 |
$93.60
|
|
Drug assay vedolizumab
|
$60.89 |
$60.89 |
$60.89 |
$164.16
|
|
Drug assay voriconazole
|
$22.69 |
$22.69 |
$22.69 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$125.19 |
$125.19 |
$125.19 |
$83.85
|
|
Drug test def 15-21 classes
|
$50.94 |
$50.94 |
$50.94 |
$144.42
|
|
Drug test def 1-7 classes
|
$412.17 |
$412.17 |
$412.17 |
$250.52
|
|
Drug test def 22+ classes
|
$77.04 |
$77.04 |
$77.04 |
$246.92
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$272.21 |
$272.21 |
$272.21 |
$278.85
|
|
Drvvt confirm - quest
|
$44.80 |
$44.80 |
$44.80 |
$101.66
|