|
Debr musc/fascia 20sq cm/< 11043
|
$728.60 |
$728.60 |
$728.60 |
$1,165.50
|
|
Decalcification
|
$21.10 |
$21.10 |
$21.10 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$162.71 |
$162.71 |
$162.71 |
$572.95
|
|
Delivery of placenta 59414
|
$2,218.10 |
$2,218.10 |
$2,218.10 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$73.55 |
$73.55 |
$73.55 |
$185.17
|
|
Design mlc device for imrt
|
$722.25 |
$722.25 |
$722.25 |
$1,753.00
|
|
Desoxycorticosterone
|
$21.39 |
$21.39 |
$21.39 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$1,955.18 |
$1,955.18 |
$1,955.18 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$781.36 |
$781.36 |
$781.36 |
$1,441.44
|
|
Destruction by injection tx of nerve 64630
|
$630.72 |
$630.72 |
$630.72 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$754.54 |
$754.54 |
$754.54 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,955.18 |
$1,955.18 |
$1,955.18 |
$3,296.80
|
|
Devel tst phys/qhp 1st hr
|
$464.50 |
$464.50 |
$464.50 |
$350.40
|
|
Device ablt adv novasure
|
$3,416.10 |
$3,416.10 |
$3,416.10 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,099.02 |
$4,099.02 |
$4,099.02 |
$4,200.00
|
|
Device sut capio slim opn
|
$4,296.18 |
$4,296.18 |
$4,296.18 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$4,099.02 |
$4,099.02 |
$4,099.02 |
$2,515.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$213.67 |
$213.67 |
$213.67 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$94.34 |
$94.34 |
$94.34 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$15.41 |
$15.41 |
$15.41 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$6.90 |
$6.90 |
$6.90 |
$79.30
|
|
Diagnostic laryngoscopy 31575
|
$206.96 |
$206.96 |
$206.96 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$283.82 |
$283.82 |
$283.82 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$125.15 |
$125.15 |
$125.15 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$5,431.94 |
$5,431.94 |
$5,431.94 |
$5,741.00
|
|
Diffusing capacity
|
$172.79 |
$172.79 |
$172.79 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$12.19 |
$12.19 |
$12.19 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$2,439.28 |
$2,439.28 |
$2,439.28 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$636.31 |
$636.31 |
$636.31 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$3,218.40 |
$3,218.40 |
$3,218.40 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$3,254.16 |
$3,254.16 |
$3,254.16 |
$4,258.20
|
|
Disability dlco
|
$135.76 |
$135.76 |
$135.76 |
$293.76
|
|
Disaccharidases
|
$83.26 |
$83.26 |
$83.26 |
$230.40
|
|
Discography cerv/thor spine
|
$1,964.86 |
$1,964.86 |
$1,964.86 |
$2,565.00
|
|
#d/lmeth-l-methamphetamine
|
$15.41 |
$15.41 |
$15.41 |
$72.14
|
|
Dmpk gene detc abnor allele
|
$177.55 |
$177.55 |
$177.55 |
$313.60
|
|
Dna antibody native/double stranded
|
$16.55 |
$16.55 |
$16.55 |
$100.00
|
|
Dna gardnerella
|
$25.11 |
$25.11 |
$25.11 |
$61.83
|
|
Dna trichomonas
|
$17.02 |
$17.02 |
$17.02 |
$63.00
|
|
Doppler echo complete
|
$259.00 |
$259.00 |
$259.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$576.20 |
$576.20 |
$576.20 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$294.84 |
$294.84 |
$294.84 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$190.94 |
$190.94 |
$190.94 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$81,250.48 |
$81,250.48 |
$81,250.48 |
$34,278.00
|
|
Dpyd gene common variants
|
$226.80 |
$226.80 |
$226.80 |
$423.60
|
|
Drainage of kidney lesion
|
$1,082.19 |
$1,082.19 |
$1,082.19 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$64.80 |
$64.80 |
$64.80 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,315.97 |
$1,315.97 |
$1,315.97 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$1,133.14 |
$1,133.14 |
$1,133.14 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$466.67 |
$466.67 |
$466.67 |
$1,044.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$250.29 |
$250.29 |
$250.29 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$140.94 |
$140.94 |
$140.94 |
$349.50
|
|
Dressing change not for burn w/anes 15852
|
$523.88 |
$523.88 |
$523.88 |
$755.08
|
|
Droperidol 2.5 mg/ml injection solution
|
$4.17 |
$4.17 |
$4.17 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$3,437.32 |
$3,437.32 |
$3,437.32 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$156.56 |
$156.56 |
$156.56 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$1,438.40 |
$1,438.40 |
$1,438.40 |
$569.75
|
|
Drug assay caffeine
|
$26.68 |
$26.68 |
$26.68 |
$80.00
|
|
Drug assay posaconazole
|
$27.14 |
$27.14 |
$27.14 |
$96.75
|
|
Drug assay vedolizumab
|
$72.91 |
$72.91 |
$72.91 |
$154.00
|
|
Drug assay voriconazole
|
$29.21 |
$29.21 |
$29.21 |
$96.75
|
|
Drug of abuse screen urine
|
$8.74 |
$8.74 |
$8.74 |
$67.89
|
|
Drug screening tapentadol
|
$12.88 |
$12.88 |
$12.88 |
$47.03
|
|
Drug test prsmv instrmnt
|
$11.96 |
$11.96 |
$11.96 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$103.27 |
$103.27 |
$103.27 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$1,955.18 |
$1,955.18 |
$1,955.18 |
$2,980.00
|
|
Ductogram sgl duct
|
$147.49 |
$147.49 |
$147.49 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$673.00 |
$673.00 |
$673.00 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$418.07 |
$418.07 |
$418.07 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$203.11 |
$203.11 |
$203.11 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$302.02 |
$302.02 |
$302.02 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$289.54 |
$289.54 |
$289.54 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$170.72 |
$170.72 |
$170.72 |
$401.20
|
|
Ecg/1-3 leads/tracing only 93041
|
$40.74 |
$40.74 |
$40.74 |
$132.08
|
|
Ecg external < 48 hours recording
|
$163.22 |
$163.22 |
$163.22 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$243.82 |
$243.82 |
$243.82 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$129.77 |
$129.77 |
$129.77 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$93.09 |
$93.09 |
$93.09 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$672.35 |
$672.35 |
$672.35 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$257.25 |
$257.25 |
$257.25 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$128.80 |
$128.80 |
$128.80 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$840.70 |
$840.70 |
$840.70 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$321.65 |
$321.65 |
$321.65 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$139.65 |
$139.65 |
$139.65 |
$371.25
|
|
Echo exam of fetal heart
|
$624.89 |
$624.89 |
$624.89 |
$904.80
|
|
Echo exam of fetal heart
|
$192.44 |
$192.44 |
$192.44 |
$431.41
|
|
Echo exam uterus 76831-
|
$345.63 |
$345.63 |
$345.63 |
$561.00
|
|
Echograp trans r pros study
|
$291.43 |
$291.43 |
$291.43 |
$468.00
|
|
Echo guidance radiotherapy
|
$802.96 |
$802.96 |
$802.96 |
$812.00
|
|
Echo guide for amniocentesis
|
$199.08 |
$199.08 |
$199.08 |
$455.57
|
|
Echo stress
|
$344.05 |
$344.05 |
$344.05 |
$1,609.44
|
|
Echo tee guidance
|
$373.10 |
$373.10 |
$373.10 |
$1,878.84
|
|
Echo tee probe placement image acquisition interpretation & report
|
$834.35 |
$834.35 |
$834.35 |
$1,913.60
|
|
Echo transthoracic
|
$378.00 |
$378.00 |
$378.00 |
$1,361.75
|
|
Echo transthoracic
|
$289.80 |
$289.80 |
$289.80 |
$1,052.40
|
|
Ecmo/ecls daily mgmt-venous 33948
|
$645.55 |
$645.55 |
$645.55 |
$3,099.00
|
|
Ecmo/ecls initiation artery 33947
|
$754.96 |
$754.96 |
$754.96 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$679.46 |
$679.46 |
$679.46 |
$4,084.29
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$972.97 |
$972.97 |
$972.97 |
$2,660.16
|
|
Eeg 41-60 minutes 95812-26
|
$725.21 |
$725.21 |
$725.21 |
$934.05
|
