|
Decitabine 50 mg intravenous solution
|
$22,065.68 |
$22,065.68 |
$22,065.68 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$1,322.16 |
$1,322.16 |
$1,322.16 |
$112.87
|
|
Degarelix 120 mg subcutaneous solution
|
$6,348.44 |
$6,348.44 |
$6,348.44 |
$1,963.06
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$972.40 |
$972.40 |
$972.40 |
$182.40
|
|
Deodorant ostmy adapt lube 8ml
|
$5.00 |
$5.00 |
$5.00 |
$5.00
|
|
Design mlc device for imrt
|
$67,564.75 |
$67,564.75 |
$67,564.75 |
$1,641.90
|
|
Detect agent nos dna dir
|
$1,395.85 |
$1,395.85 |
$1,395.85 |
$67.15
|
|
Devel tst phys/qhp 1st hr
|
$1,812.25 |
$1,812.25 |
$1,812.25 |
$343.20
|
|
Dexamethasone 4 mg tablet
|
$58.50 |
$58.50 |
$58.50 |
$5.17
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$4,934.16 |
$4,934.16 |
$4,934.16 |
$465.34
|
|
Dextran 40 infusion
|
$1,257.76 |
$1,257.76 |
$1,257.76 |
$173.97
|
|
Dextrose 5 % IV bolus
|
$785.12 |
$785.12 |
$785.12 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$1,522.80 |
$1,522.80 |
$1,522.80 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$977.59 |
$977.59 |
$977.59 |
$78.03
|
|
Diab manage trn ind/group
|
$343.00 |
$343.00 |
$343.00 |
$49.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$440.72 |
$440.72 |
$440.72 |
$67.89
|
|
Dicyclomine injection
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$210.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$17,954.72 |
$17,954.72 |
$17,954.72 |
$9,684.65
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,984.08 |
$1,984.08 |
$1,984.08 |
$308.90
|
|
Dimenhydrinate injection
|
$382.48 |
$382.48 |
$382.48 |
$24.68
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$505.68 |
$505.68 |
$505.68 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$1,585.92 |
$1,585.92 |
$1,585.92 |
$100.80
|
|
Dna antibody native/double stranded
|
$1,406.70 |
$1,406.70 |
$1,406.70 |
$101.40
|
|
Dna gardnerella
|
$220.26 |
$220.26 |
$220.26 |
$66.05
|
|
Dna trichomonas
|
$220.26 |
$220.26 |
$220.26 |
$68.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$196.56 |
$196.56 |
$196.56 |
$98.43
|
|
Dornase alfa non-comp unit
|
$3,761.52 |
$3,761.52 |
$3,761.52 |
$500.29
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$52,173.52 |
$52,173.52 |
$52,173.52 |
$33,342.33
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1,303.68 |
$1,303.68 |
$1,303.68 |
$89.34
|
|
Dpyd gene common variants
|
$1,508.69 |
$1,508.69 |
$1,508.69 |
$380.50
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$1,055.00 |
$1,055.00 |
$1,055.00 |
$2,458.05
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$152.00 |
$152.00 |
$152.00 |
$327.39
|
|
Drug assay caffeine
|
$1,395.85 |
$1,395.85 |
$1,395.85 |
$86.45
|
|
Drug assay voriconazole
|
$635.81 |
$635.81 |
$635.81 |
$96.75
|
|
Drug test def 1-7 classes
|
$5,177.08 |
$5,177.08 |
$5,177.08 |
$263.86
|
|
Drug test def 22+ classes
|
$454.62 |
$454.62 |
$454.62 |
$246.92
|
|
Drug test def 8-14 classes
|
$16,262.52 |
$16,262.52 |
$16,262.52 |
$172.25
|
|
Drvvt confirm - quest
|
$1,417.55 |
$1,417.55 |
$1,417.55 |
$102.30
|
|
Duplex scan bilateral study 93985
|
$8,191.70 |
$8,191.70 |
$8,191.70 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$5,902.60 |
$5,902.60 |
$5,902.60 |
$392.15
|
|
Dup scan/hemodialysis access 93990
|
$2,928.20 |
$2,928.20 |
$2,928.20 |
$499.38
|
|
Ecg/1-3 leads/tracing only 93041
|
$1,120.35 |
$1,120.35 |
$1,120.35 |
$129.83
|
|
Ecg < 30 days transmission & analysis
|
$3,626.15 |
$3,626.15 |
$3,626.15 |
$441.40
|
|
Ecg external < 48 hours recording
|
$2,873.75 |
$2,873.75 |
$2,873.75 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$5,218.95 |
$5,218.95 |
$5,218.95 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$9,715.75 |
$9,715.75 |
$9,715.75 |
$2,049.45
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$9,719.05 |
$9,719.05 |
$9,719.05 |
$1,818.05
|
|
Echo exam of fetal heart
|
$1,114.85 |
$1,114.85 |
$1,114.85 |
$323.40
|
|
Echo exam uterus 76831-
|
$5,474.70 |
$5,474.70 |
$5,474.70 |
$547.23
|
|
Echo guidance radiotherapy
|
$3,990.25 |
$3,990.25 |
$3,990.25 |
$769.18
|
|
Echo guide for artery repair
|
$4,791.05 |
$4,791.05 |
$4,791.05 |
$676.80
|
|
Echo guide for transfusion
|
$1,784.75 |
$1,784.75 |
$1,784.75 |
$324.60
|
|
Echo transesophageal
|
$14,192.20 |
$14,192.20 |
$14,192.20 |
$1,734.10
|
|
Echo transthoracic
|
$8,828.60 |
$8,828.60 |
$8,828.60 |
$1,475.25
|
|
Echo transthoracic
|
$5,605.05 |
$5,605.05 |
$5,605.05 |
$944.14
|
|
Eeg 41-60 minutes 95812-26
|
$4,504.50 |
$4,504.50 |
$4,504.50 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$6,431.15 |
$6,431.15 |
$6,431.15 |
$1,048.30
|
|
Eeg monitoring/giving drugs
|
$6,631.90 |
$6,631.90 |
$6,631.90 |
$797.51
|
|
Eeg monitor/record/awake/drowsy 95816
|
$10,920.25 |
$10,920.25 |
$10,920.25 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$7,071.90 |
$7,071.90 |
$7,071.90 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$8,995.80 |
$8,995.80 |
$8,995.80 |
$911.00
|
|
Eeg recording awake and asleep
|
$10,920.25 |
$10,920.25 |
$10,920.25 |
$1,030.27
|
|
Eeg without vid 2-12 hr unmntr
|
$13,759.35 |
$13,759.35 |
$13,759.35 |
$526.57
|
|
Eeg wo vid ea 12-26hr unmntr
|
$13,759.35 |
$13,759.35 |
$13,759.35 |
$1,139.40
|
|
Elec stim unattend for press
|
$645.70 |
$645.70 |
$645.70 |
$42.90
|
|
Electron microscopy diagnostic
|
$9,029.91 |
$9,029.91 |
$9,029.91 |
$1,006.20
|
|
Electrophysiologic study
|
$33,946.55 |
$33,946.55 |
$33,946.55 |
$6,758.40
|
|
Electrophysiology evaluation
|
$47,521.65 |
$47,521.65 |
$47,521.65 |
$8,979.45
|
|
Electrophysiology evaluation
|
$53,763.60 |
$53,763.60 |
$53,763.60 |
$11,542.01
|
|
Electrophysiology evaluation
|
$33,946.55 |
$33,946.55 |
$33,946.55 |
$2,630.40
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$2,877.05 |
$2,877.05 |
$2,877.05 |
$436.64
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$4,843.30 |
$4,843.30 |
$4,843.30 |
$512.85
|
|
Emg cranial nerve bilateral
|
$1,024.65 |
$1,024.65 |
$1,024.65 |
$518.00
|
|
Emg needle test 1-extremity
|
$2,007.50 |
$2,007.50 |
$2,007.50 |
$340.80
|
|
Emg needle test 4-extremities
|
$5,519.25 |
$5,519.25 |
$5,519.25 |
$547.00
|
|
Entamoeba histolytica ag eia - sendout
|
$410.67 |
$410.67 |
$410.67 |
$66.60
|
|
Enzyme histochemistry
|
$1,037.80 |
$1,037.80 |
$1,037.80 |
$460.32
|
|
Ep induct arrhy by elect pacing
|
$50,922.85 |
$50,922.85 |
$50,922.85 |
$2,753.40
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$1,230.88 |
$1,230.88 |
$1,230.88 |
$195.23
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$266.00 |
$266.00 |
$266.00 |
$135.20
|
|
Epstein barr early antigen antibody
|
$977.59 |
$977.59 |
$977.59 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$1,406.70 |
$1,406.70 |
$1,406.70 |
$82.55
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$9,436.00 |
$9,436.00 |
$9,436.00 |
$6,313.52
|
|
Ercp biliary & pancreas
|
$4,009.50 |
$4,009.50 |
$4,009.50 |
$922.35
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$698.32 |
$698.32 |
$698.32 |
$232.84
|
|
Esophageal motility
|
$8,668.00 |
$8,668.00 |
$8,668.00 |
$549.70
|
|
Esophagus motility study
|
$5,800.85 |
$5,800.85 |
$5,800.85 |
$1,274.00
|
|
Esoph imped funct test > 1hr
|
$5,800.85 |
$5,800.85 |
$5,800.85 |
$986.40
|
|
Estradiol total
|
$1,469.63 |
$1,469.63 |
$1,469.63 |
$147.79
|
|
Estrogens total-sendout
|
$1,417.55 |
$1,417.55 |
$1,417.55 |
$89.25
|
|
Ethylene glycol -sendout
|
$1,406.70 |
$1,406.70 |
$1,406.70 |
$78.00
|
|
Euglobulin lysis
|
$746.48 |
$746.48 |
$746.48 |
$37.70
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$718.81 |
$718.81 |
$718.81 |
$219.60
|
|
Event monitor
|
$7,335.35 |
$7,335.35 |
$7,335.35 |
$242.12
|
|
Evoked potentials upper limbs
|
$8,294.00 |
$8,294.00 |
$8,294.00 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$4,634.30 |
$4,634.30 |
$4,634.30 |
$844.00
|
|
Exercise tst brncspsm w/ecg
|
$5,368.55 |
$5,368.55 |
$5,368.55 |
$306.08
|
|
F-18 fdg pet diag
|
$4,597.00 |
$4,597.00 |
$4,597.00 |
$609.85
|
|
Factor ix
|
$1,851.55 |
$1,851.55 |
$1,851.55 |
$139.75
|
|
Factor ix complex
|
$6.72 |
$6.72 |
$6.72 |
$3.23
|
