|
Devel tst phys/qhp 1st hr
|
$56.43 |
$56.43 |
$56.43 |
$350.40
|
|
Device ablt adv novasure
|
$1,861.62 |
$1,861.62 |
$1,861.62 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,850.00 |
$2,850.00 |
$2,850.00 |
$4,200.00
|
|
Device intraute mirena
|
$776.89 |
$776.89 |
$776.89 |
$2,125.00
|
|
Device sut capio slim opn
|
$831.63 |
$831.63 |
$831.63 |
$1,894.50
|
|
Dev interrog remote 1/2/mlt
|
$28.50 |
$28.50 |
$28.50 |
$115.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$78.09 |
$78.09 |
$78.09 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$1.89 |
$1.89 |
$1.89 |
$6.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$9.39 |
$9.39 |
$9.39 |
$21.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$19.52 |
$19.52 |
$19.52 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$20.70 |
$20.70 |
$20.70 |
$42.50
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$15.40 |
$15.40 |
$15.40 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$19.04 |
$19.04 |
$19.04 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$3.73 |
$3.73 |
$3.73 |
$111.50
|
|
Diabetes (HbA1c) Test
|
$53.01 |
$53.01 |
$53.01 |
$79.20
|
|
Diag laparo separate proc 49320
|
$212.99 |
$212.99 |
$212.99 |
$6,904.15
|
|
Diagnostic anoscopy
|
$60.99 |
$60.99 |
$60.99 |
$392.70
|
|
Diagnostic anoscopy & biopsy
|
$80.18 |
$80.18 |
$80.18 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$27.55 |
$27.55 |
$27.55 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$57.76 |
$57.76 |
$57.76 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$57.76 |
$57.76 |
$57.76 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$33.44 |
$33.44 |
$33.44 |
$235.00
|
|
Diagnostic laryngoscopy 31575
|
$45.79 |
$45.79 |
$45.79 |
$334.95
|
|
Diagnostic Mammogram (both breasts)
|
$181.64 |
$181.64 |
$181.64 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$142.50 |
$142.50 |
$142.50 |
$312.72
|
|
Diagnostic radio unlisted proc
|
$9.50 |
$9.50 |
$9.50 |
$243.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$123.12 |
$123.12 |
$123.12 |
$5,598.45
|
|
Dialysis one evaluation
|
$1,022.39 |
$1,022.39 |
$1,022.39 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.42 |
$0.42 |
$0.42 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$45.01 |
$45.01 |
$45.01 |
$76.76
|
|
Dicyclomine injection
|
$79.50 |
$79.50 |
$79.50 |
$150.91
|
|
Diffusing capacity
|
$109.06 |
$109.06 |
$109.06 |
$332.01
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$12.07 |
$12.07 |
$12.07 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$79.42 |
$79.42 |
$79.42 |
$102.00
|
|
Dilate biliary duct/ampulla
|
$684.76 |
$684.76 |
$684.76 |
$1,841.15
|
|
Dilate esophagus
|
$56.43 |
$56.43 |
$56.43 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$51.87 |
$51.87 |
$51.87 |
$1,490.36
|
|
Dilate tear duct opening
|
$53.96 |
$53.96 |
$53.96 |
$454.40
|
|
Dilate urethra stricture
|
$41.04 |
$41.04 |
$41.04 |
$496.00
|
|
Dilate urethra stricture
|
$34.39 |
$34.39 |
$34.39 |
$200.80
|
|
Dilate urethra stricture
|
$40.66 |
$40.66 |
$40.66 |
$3,863.60
|
|
Dilate urethra stricture
|
$46.17 |
$46.17 |
$46.17 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$26.98 |
$26.98 |
$26.98 |
$235.61
|
|
Dilation of anal sphincter
|
$112.86 |
$112.86 |
$112.86 |
$1,995.20
|
|
Dilation of cervical canal 57800
|
$31.35 |
$31.35 |
$31.35 |
$4,376.00
|
|
Dilation of rectal stricture 45910
|
$127.49 |
$127.49 |
$127.49 |
$2,263.80
|
|
Dilation of urethra
|
$26.03 |
$26.03 |
$26.03 |
$172.00
|
|
Dilation of vagina
|
$83.79 |
$83.79 |
$83.79 |
$3,986.00
|
|
Dilation salivary duct 42650
|
$39.90 |
$39.90 |
$39.90 |
$2,675.71
|
|
Dilation/urethral strict/male/ini 53620
|
$56.05 |
$56.05 |
$56.05 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$603.82 |
$603.82 |
$603.82 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$97.47 |
$97.47 |
$97.47 |
$3,883.16
|
|
Diltiazem 5 mg/ml intravenous solution
|
$17.47 |
$17.47 |
$17.47 |
$46.56
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$8.38 |
$8.38 |
$8.38 |
$18.32
|
|
Disability dlco
|
$101.65 |
$101.65 |
$101.65 |
$292.03
|
|
Disaccharidases
|
$63.99 |
$63.99 |
$63.99 |
$224.58
|
|
Discography cerv/thor spine
|
$1,486.37 |
$1,486.37 |
$1,486.37 |
$2,481.50
|
|
Dise eval slp do brth flx dx
|
$63.46 |
$63.46 |
$63.46 |
$1,120.00
|
|
Diverticulectomy/hypophar/esoph 43130
|
$516.04 |
$516.04 |
$516.04 |
$6,547.81
|
|
Division of fallopian tube 58605
|
$220.02 |
$220.02 |
$220.02 |
$832.00
|
|
Dmd dup/delet analysis
|
$53.01 |
$53.01 |
$53.01 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$20.82 |
$20.82 |
$20.82 |
$313.60
|
|
Dna antibody native/double stranded
|
$1.52 |
$1.52 |
$1.52 |
$100.00
|
|
Dna gardnerella
|
$3.39 |
$3.39 |
$3.39 |
$61.80
|
|
Dna trichomonas
|
$3.39 |
$3.39 |
$3.39 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$46.91 |
$46.91 |
$46.91 |
$97.94
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$23.72 |
$23.72 |
$23.72 |
$65.76
|
|
Doppler echo complete
|
$191.90 |
$191.90 |
$191.90 |
$557.05
|
|
Doppler intravascular pressure flow initial vessel
|
$31.73 |
$31.73 |
$31.73 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$267.52 |
$267.52 |
$267.52 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$169.86 |
$169.86 |
$169.86 |
$473.76
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$37.98 |
$37.98 |
$37.98 |
$84.80
|
|
Dpyd gene common variants
|
$33.21 |
$33.21 |
$33.21 |
$399.75
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$82.27 |
$82.27 |
$82.27 |
$794.82
|
|
Drainage ext aud canal abscess 69020
|
$97.28 |
$97.28 |
$97.28 |
$914.34
|
|
Drainage external ear complex 69005
|
$107.73 |
$107.73 |
$107.73 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$84.36 |
$84.36 |
$84.36 |
$779.45
|
|
Drainage lymph node lesion 38305
|
$324.52 |
$324.52 |
$324.52 |
$3,170.64
|
|
Drainage mouth roof lesion
|
$73.91 |
$73.91 |
$73.91 |
$405.60
|
|
Drainage of arm bursa 23931
|
$109.06 |
$109.06 |
$109.06 |
$2,271.01
|
|
Drainage of bone lesion
|
$663.86 |
$663.86 |
$663.86 |
$2,854.40
|
|
Drainage of bone lesion
|
$428.45 |
$428.45 |
$428.45 |
$3,153.60
|
|
Drainage of eye
|
$58.14 |
$58.14 |
$58.14 |
$2,415.65
|
|
Drainage of eye
|
$309.13 |
$309.13 |
$309.13 |
$3,170.00
|
|
Drainage of forearm bursa
|
$252.51 |
$252.51 |
$252.51 |
$2,170.50
|
|
Drainage of kidney lesion
|
$1,051.46 |
$1,051.46 |
$1,051.46 |
$1,506.00
|
|
Drainage of mouth lesion
|
$80.18 |
$80.18 |
$80.18 |
$535.20
|
|
Drainage of mouth lesion
|
$157.51 |
$157.51 |
$157.51 |
$2,304.00
|
|
Drainage of mouth lesion
|
$151.05 |
$151.05 |
$151.05 |
$2,320.03
|
|
Drainage of mouth lesion
|
$176.51 |
$176.51 |
$176.51 |
$3,837.72
|
|
Drainage of mouth lesion
|
$193.99 |
$193.99 |
$193.99 |
$905.30
|
|
Drainage of mouth lesion
|
$203.68 |
$203.68 |
$203.68 |
$1,008.80
|
|
Drainage of mouth lesion
|
$233.51 |
$233.51 |
$233.51 |
$6,781.90
|
|
Drainage of mouth lesion
|
$231.61 |
$231.61 |
$231.61 |
$3,459.00
|
|
Drainage of mouth lesion
|
$270.18 |
$270.18 |
$270.18 |
$1,752.89
|
|
Drainage of nose lesion int 30000
|
$82.27 |
$82.27 |
$82.27 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$82.46 |
$82.46 |
$82.46 |
$781.44
|
|
Drainage of pelvis bursa
|
$349.03 |
$349.03 |
$349.03 |
$2,211.05
|
|
Drainage of pelvis lesion 26990
|
$454.29 |
$454.29 |
$454.29 |
$3,863.70
|
|
Drainage of rectal abscess
|
$111.15 |
$111.15 |
$111.15 |
$2,135.10
|