|
Destruction anal lesion(s) smpl chem 46900
|
$234.90 |
$234.90 |
$234.90 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$110.97 |
$110.97 |
$110.97 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$243.54 |
$243.54 |
$243.54 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$54.00 |
$54.00 |
$54.00 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$270.00 |
$270.00 |
$270.00 |
$3,202.98
|
|
Destruction cryosurgery anal lesion(s) simpl 46916
|
$250.83 |
$250.83 |
$250.83 |
$364.50
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$201.69 |
$201.69 |
$201.69 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$235.17 |
$235.17 |
$235.17 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$199.80 |
$199.80 |
$199.80 |
$472.79
|
|
Destruction mal lsn t/a/l >4cm
|
$226.80 |
$226.80 |
$226.80 |
$569.80
|
|
Destruction penis lesion(s) chem 54050
|
$140.94 |
$140.94 |
$140.94 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$216.27 |
$216.27 |
$216.27 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$161.19 |
$161.19 |
$161.19 |
$436.64
|
|
Destruction rectal tumor 45190
|
$654.21 |
$654.21 |
$654.21 |
$3,245.23
|
|
Destruction vag lesions complex 57065
|
$232.74 |
$232.74 |
$232.74 |
$3,762.53
|
|
Destruction vag lesions simple 57061
|
$160.11 |
$160.11 |
$160.11 |
$3,815.20
|
|
Destruct penis les/smp/electrodesi 54055
|
$93.15 |
$93.15 |
$93.15 |
$2,837.09
|
|
Determine refractive state
|
$17.82 |
$17.82 |
$17.82 |
$19.80
|
|
Developmental screen/score/document 96110
|
$72.36 |
$72.36 |
$72.36 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$80.19 |
$80.19 |
$80.19 |
$337.50
|
|
Device ablt adv novasure
|
$607.50 |
$607.50 |
$607.50 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,050.00 |
$4,050.00 |
$4,050.00 |
$4,200.00
|
|
Device intraute mirena
|
$876.69 |
$876.69 |
$876.69 |
$2,125.00
|
|
Dev interrog remote 1/2/mlt
|
$40.50 |
$40.50 |
$40.50 |
$115.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$9.99 |
$9.99 |
$9.99 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$4.59 |
$4.59 |
$4.59 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$30.42 |
$30.42 |
$30.42 |
$21.17
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$43.47 |
$43.47 |
$43.47 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$43.47 |
$43.47 |
$43.47 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$43.47 |
$43.47 |
$43.47 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$43.47 |
$43.47 |
$43.47 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$36.45 |
$36.45 |
$36.45 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$67.77 |
$67.77 |
$67.77 |
$79.20
|
|
Diabetes training group per 30 min g0109
|
$13.23 |
$13.23 |
$13.23 |
$35.25
|
|
Diab manage trn ind/group
|
$10.80 |
$10.80 |
$10.80 |
$56.55
|
|
Diag laparo separate proc 49320
|
$302.67 |
$302.67 |
$302.67 |
$6,904.15
|
|
Diagnostic anoscopy
|
$86.67 |
$86.67 |
$86.67 |
$391.20
|
|
Diagnostic anoscopy & biopsy
|
$113.94 |
$113.94 |
$113.94 |
$1,905.00
|
|
Diagnostic anoscopy spx 46600
|
$112.05 |
$112.05 |
$112.05 |
$190.68
|
|
Diagnostic laryngoscopy 31505
|
$85.59 |
$85.59 |
$85.59 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$123.12 |
$123.12 |
$123.12 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$166.05 |
$166.05 |
$166.05 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$129.60 |
$129.60 |
$129.60 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$13.50 |
$13.50 |
$13.50 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$174.96 |
$174.96 |
$174.96 |
$5,419.00
|
|
Dialysis one evaluation
|
$771.66 |
$771.66 |
$771.66 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.56 |
$0.56 |
$0.56 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$93.89 |
$93.89 |
$93.89 |
$74.76
|
|
Dicyclomine injection
|
$69.54 |
$69.54 |
$69.54 |
$153.29
|
|
Diffusing capacity
|
$5.67 |
$5.67 |
$5.67 |
$332.00
|
|
Digital analysis of eeg
|
$209.25 |
$209.25 |
$209.25 |
$605.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$31.05 |
$31.05 |
$31.05 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$72.90 |
$72.90 |
$72.90 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$32.67 |
$32.67 |
$32.67 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$120.69 |
$120.69 |
$120.69 |
$1,866.73
|
|
Dilate esophagus
|
$80.19 |
$80.19 |
$80.19 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$181.44 |
$181.44 |
$181.44 |
$1,484.17
|
|
Dilate tear duct opening
|
$92.34 |
$92.34 |
$92.34 |
$472.21
|
|
Dilate urethra stricture
|
$83.70 |
$83.70 |
$83.70 |
$490.00
|
|
Dilate urethra stricture
|
$82.08 |
$82.08 |
$82.08 |
$200.80
|
|
Dilate urethra stricture
|
$57.78 |
$57.78 |
$57.78 |
$3,863.60
|
|
Dilate urethra stricture
|
$154.44 |
$154.44 |
$154.44 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$72.90 |
$72.90 |
$72.90 |
$235.61
|
|
Dilation of anal sphincter
|
$160.38 |
$160.38 |
$160.38 |
$1,969.12
|
|
Dilation of cervical canal 57800
|
$73.44 |
$73.44 |
$73.44 |
$4,376.00
|
|
Dilation of rectal stricture 45910
|
$181.17 |
$181.17 |
$181.17 |
$1,395.28
|
|
Dilation of urethra
|
$71.82 |
$71.82 |
$71.82 |
$172.00
|
|
Dilation of vagina
|
$119.07 |
$119.07 |
$119.07 |
$3,786.00
|
|
Dilation salivary duct 42650
|
$71.28 |
$71.28 |
$71.28 |
$2,498.32
|
|
Dilation/urethral strict/male/ini 53620
|
$160.11 |
$160.11 |
$160.11 |
$1,372.80
|
|
Dilat xst trc ndurlgc px
|
$138.51 |
$138.51 |
$138.51 |
$4,061.71
|
|
Diltiazem 5 mg/ml intravenous solution
|
$30.23 |
$30.23 |
$30.23 |
$47.94
|
|
Dimethyl sulfoxide 50% 50 ml
|
$379.62 |
$379.62 |
$379.62 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$30.11 |
$30.11 |
$30.11 |
$17.75
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$73.17 |
$73.17 |
$73.17 |
$91.53
|
|
Disability dlco
|
$7.83 |
$7.83 |
$7.83 |
$282.40
|
|
Disaccharidases
|
$90.94 |
$90.94 |
$90.94 |
$216.00
|
|
Discography cerv/thor spine
|
$59.40 |
$59.40 |
$59.40 |
$2,565.00
|
|
Dise eval slp do brth flx dx
|
$90.18 |
$90.18 |
$90.18 |
$1,120.00
|
|
Diverticulectomy/hypophar/esoph 43130
|
$733.32 |
$733.32 |
$733.32 |
$6,465.11
|
|
Division of fallopian tube 58605
|
$312.66 |
$312.66 |
$312.66 |
$832.00
|
|
Dmd dup/delet analysis
|
$75.33 |
$75.33 |
$75.33 |
$404.03
|
|
Dmpk gene detc abnor allele
|
$29.59 |
$29.59 |
$29.59 |
$313.60
|
|
Dna antibody native/double stranded
|
$2.16 |
$2.16 |
$2.16 |
$97.50
|
|
Dna gardnerella
|
$4.81 |
$4.81 |
$4.81 |
$62.50
|
|
Dna trichomonas
|
$4.81 |
$4.81 |
$4.81 |
$67.80
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$9.18 |
$9.18 |
$9.18 |
$904.81
|
|
Doppler echo complete
|
$470.07 |
$470.07 |
$470.07 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$45.09 |
$45.09 |
$45.09 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$345.60 |
$345.60 |
$345.60 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$245.97 |
$245.97 |
$245.97 |
$471.17
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$55.62 |
$55.62 |
$55.62 |
$84.80
|
|
Dpyd gene common variants
|
$47.20 |
$47.20 |
$47.20 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$116.91 |
$116.91 |
$116.91 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$222.48 |
$222.48 |
$222.48 |
$914.34
|
|
Drainage external ear complex 69005
|
$208.98 |
$208.98 |
$208.98 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$177.66 |
$177.66 |
$177.66 |
$789.60
|
|
Drainage lymph node lesion 38305
|
$461.16 |
$461.16 |
$461.16 |
$3,170.64
|
|
Drainage mouth roof lesion
|
$105.03 |
$105.03 |
$105.03 |
$390.39
|
|
Drainage of arm bursa 23931
|
$290.79 |
$290.79 |
$290.79 |
$2,197.48
|
