|
Destruction rectal tumor 45190
|
$411.91 |
$411.91 |
$411.91 |
$3,245.23
|
|
Destruction vag lesions complex 57065
|
$146.54 |
$146.54 |
$146.54 |
$3,762.53
|
|
Destruction vag lesions simple 57061
|
$717.40 |
$717.40 |
$717.40 |
$4,006.38
|
|
Destruct penis les/smp/electrodesi 54055
|
$58.65 |
$58.65 |
$58.65 |
$2,837.09
|
|
Determine refractive state
|
$11.22 |
$11.22 |
$11.22 |
$19.80
|
|
Developmental screen/score/document 96110
|
$45.56 |
$45.56 |
$45.56 |
$141.93
|
|
Devel tst phys/qhp 1st hr
|
$50.49 |
$50.49 |
$50.49 |
$343.20
|
|
Device ablt adv novasure
|
$1,621.80 |
$1,621.80 |
$1,621.80 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,550.00 |
$2,550.00 |
$2,550.00 |
$4,207.50
|
|
Device intraute mirena
|
$551.99 |
$551.99 |
$551.99 |
$2,125.00
|
|
Device sut capio slim opn
|
$744.09 |
$744.09 |
$744.09 |
$1,894.50
|
|
Dev interrog remote 1/2/mlt
|
$25.50 |
$25.50 |
$25.50 |
$115.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$56.44 |
$56.44 |
$56.44 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$2.89 |
$2.89 |
$2.89 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$21.25 |
$21.25 |
$21.25 |
$21.64
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$45.99 |
$45.99 |
$45.99 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$47.13 |
$47.13 |
$47.13 |
$44.10
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$40.22 |
$40.22 |
$40.22 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$47.29 |
$47.29 |
$47.29 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$8.64 |
$8.64 |
$8.64 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$137.53 |
$137.53 |
$137.53 |
$79.28
|
|
Diabetes training group per 30 min g0109
|
$8.33 |
$8.33 |
$8.33 |
$35.25
|
|
Diab manage trn ind/group
|
$11.22 |
$11.22 |
$11.22 |
$54.99
|
|
Diag laparo separate proc 49320
|
$190.57 |
$190.57 |
$190.57 |
$6,904.15
|
|
Diagnostic anoscopy
|
$54.57 |
$54.57 |
$54.57 |
$392.70
|
|
Diagnostic anoscopy & biopsy
|
$71.74 |
$71.74 |
$71.74 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$70.55 |
$70.55 |
$70.55 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$53.89 |
$53.89 |
$53.89 |
$238.58
|
|
Diagnostic laryngoscopy 31575
|
$122.06 |
$122.06 |
$122.06 |
$327.60
|
|
Diagnostic Mammogram (both breasts)
|
$181.73 |
$181.73 |
$181.73 |
$415.80
|
|
Diagnostic Mammogram (one breast)
|
$125.12 |
$125.12 |
$125.12 |
$311.04
|
|
Diagnostic radio unlisted proc
|
$22.95 |
$22.95 |
$22.95 |
$258.72
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,118.03 |
$2,118.03 |
$2,118.03 |
$5,598.45
|
|
Dialysis one evaluation
|
$446.25 |
$446.25 |
$446.25 |
$934.16
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$63.63 |
$63.63 |
$63.63 |
$75.23
|
|
Dicyclomine injection
|
$57.39 |
$57.39 |
$57.39 |
$149.15
|
|
Diffusing capacity
|
$145.69 |
$145.69 |
$145.69 |
$335.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$16.74 |
$16.74 |
$16.74 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$182.07 |
$182.07 |
$182.07 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$20.57 |
$20.57 |
$20.57 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$75.99 |
$75.99 |
$75.99 |
$1,866.73
|
|
Dilate esophagus
|
$50.49 |
$50.49 |
$50.49 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$411.06 |
$411.06 |
$411.06 |
$1,490.36
|
|
Dilate tear duct opening
|
$58.14 |
$58.14 |
$58.14 |
$469.93
|
|
Dilate urethra stricture
|
$69.53 |
$69.53 |
$69.53 |
$496.08
|
|
Dilate urethra stricture
|
$51.68 |
$51.68 |
$51.68 |
$200.80
|
|
Dilate urethra stricture
|
$36.38 |
$36.38 |
$36.38 |
$3,863.60
|
|
Dilate urethra stricture
|
$97.24 |
$97.24 |
$97.24 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$45.90 |
$45.90 |
$45.90 |
$236.46
|
|
Dilation of anal sphincter
|
$100.98 |
$100.98 |
$100.98 |
$1,995.20
|
|
Dilation of cervical canal 57800
|
$676.43 |
$676.43 |
$676.43 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$114.07 |
$114.07 |
$114.07 |
$2,219.41
|
|
Dilation of urethra
|
$45.22 |
$45.22 |
$45.22 |
$172.00
|
|
Dilation of vagina
|
$74.97 |
$74.97 |
$74.97 |
$3,986.00
|
|
Dilation salivary duct 42650
|
$44.88 |
$44.88 |
$44.88 |
$2,498.32
|
|
Dilation/urethral strict/male/ini 53620
|
$164.73 |
$164.73 |
$164.73 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$421.81 |
$421.81 |
$421.81 |
$408.24
|
|
Dilat xst trc ndurlgc px
|
$87.21 |
$87.21 |
$87.21 |
$4,081.37
|
|
Diltiazem 5 mg/ml intravenous solution
|
$15.33 |
$15.33 |
$15.33 |
$44.96
|
|
Dimethyl sulfoxide 50% 50 ml
|
$239.02 |
$239.02 |
$239.02 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$15.27 |
$15.27 |
$15.27 |
$18.34
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$19.04 |
$19.04 |
$19.04 |
$98.56
|
|
Disability dlco
|
$122.57 |
$122.57 |
$122.57 |
$294.00
|
|
Disaccharidases
|
$57.26 |
$57.26 |
$57.26 |
$223.80
|
|
Discography cerv/thor spine
|
$1,250.01 |
$1,250.01 |
$1,250.01 |
$2,628.00
|
|
Dise eval slp do brth flx dx
|
$56.78 |
$56.78 |
$56.78 |
$1,120.00
|
|
Diverticulectomy/hypophar/esoph 43130
|
$461.72 |
$461.72 |
$461.72 |
$6,547.81
|
|
Division of fallopian tube 58605
|
$196.86 |
$196.86 |
$196.86 |
$832.00
|
|
Dmd dup/delet analysis
|
$47.43 |
$47.43 |
$47.43 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$18.63 |
$18.63 |
$18.63 |
$313.60
|
|
Dna antibody native/double stranded
|
$3.40 |
$3.40 |
$3.40 |
$100.00
|
|
Dna gardnerella
|
$3.03 |
$3.03 |
$3.03 |
$61.83
|
|
Dna trichomonas
|
$80.92 |
$80.92 |
$80.92 |
$66.05
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$87.94 |
$87.94 |
$87.94 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$374.54 |
$374.54 |
$374.54 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$42.74 |
$42.74 |
$42.74 |
$65.40
|
|
Doppler echo complete
|
$282.03 |
$282.03 |
$282.03 |
$548.00
|
|
Doppler intravascular pressure flow initial vessel
|
$2,295.85 |
$2,295.85 |
$2,295.85 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$243.10 |
$243.10 |
$243.10 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$160.14 |
$160.14 |
$160.14 |
$479.73
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$13,322.04 |
$13,322.04 |
$13,322.04 |
$23,126.24
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$54.12 |
$54.12 |
$54.12 |
$435.23
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$3,953.66 |
$3,953.66 |
$3,953.66 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$59.38 |
$59.38 |
$59.38 |
$84.80
|
|
Dpyd gene common variants
|
$29.72 |
$29.72 |
$29.72 |
$386.92
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$73.61 |
$73.61 |
$73.61 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$140.08 |
$140.08 |
$140.08 |
$914.34
|
|
Drainage external ear complex 69005
|
$498.10 |
$498.10 |
$498.10 |
$2,900.80
|
|
Drainage external ear simple 69000
|
$159.97 |
$159.97 |
$159.97 |
$789.60
|
|
Drainage lymph node lesion 38305
|
$290.36 |
$290.36 |
$290.36 |
$3,170.64
|
|
Drainage mouth roof lesion
|
$66.13 |
$66.13 |
$66.13 |
$405.60
|
|
Drainage of arm bursa 23931
|
$482.12 |
$482.12 |
$482.12 |
$2,271.01
|
|
Drainage of bone lesion
|
$593.98 |
$593.98 |
$593.98 |
$2,854.40
|
|
Drainage of bone lesion
|
$383.35 |
$383.35 |
$383.35 |
$3,153.60
|
|
Drainage of eye
|
$52.02 |
$52.02 |
$52.02 |
$2,415.65
|
|
Drainage of eye
|
$276.59 |
$276.59 |
$276.59 |
$3,170.00
|
|
Drainage of forearm bursa
|
$225.93 |
$225.93 |
$225.93 |
$2,054.00
|
|
Drainage of kidney lesion
|
$329.12 |
$329.12 |
$329.12 |
$1,546.28
|
|
Drainage of mouth lesion
|
$71.74 |
$71.74 |
$71.74 |
$535.20
|
|
Drainage of mouth lesion
|
$140.93 |
$140.93 |
$140.93 |
$2,304.00
|
