|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$19.50 |
$19.50 |
$19.50 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$19.50 |
$19.50 |
$19.50 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$68.90 |
$68.90 |
$68.90 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$169.65 |
$169.65 |
$169.65 |
$79.30
|
|
Diab manage trn ind/group
|
$70.20 |
$70.20 |
$70.20 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$342.55 |
$342.55 |
$342.55 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$1,315.60 |
$1,315.60 |
$1,315.60 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$502.45 |
$502.45 |
$502.45 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$386.75 |
$386.75 |
$386.75 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$799.50 |
$799.50 |
$799.50 |
$259.00
|
|
Dialysis one evaluation
|
$2,562.30 |
$2,562.30 |
$2,562.30 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$9.75 |
$9.75 |
$9.75 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$47.36 |
$47.36 |
$47.36 |
$79.71
|
|
Dicyclomine injection
|
$145.55 |
$145.55 |
$145.55 |
$154.33
|
|
Diffusing capacity
|
$291.85 |
$291.85 |
$291.85 |
$336.80
|
|
Digital analysis of eeg
|
$809.90 |
$809.90 |
$809.90 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$455.07 |
$455.07 |
$455.07 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$13,232.89 |
$13,232.89 |
$13,232.89 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$170.95 |
$170.95 |
$170.95 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$4,075.34 |
$4,075.34 |
$4,075.34 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,080.30 |
$1,080.30 |
$1,080.30 |
$1,866.73
|
|
Dilate urethra stricture
|
$677.30 |
$677.30 |
$677.30 |
$343.55
|
|
Dilation of salivary duct
|
$1,284.40 |
$1,284.40 |
$1,284.40 |
$790.00
|
|
Dilat xst trc ndurlgc px
|
$4,056.65 |
$4,056.65 |
$4,056.65 |
$3,900.60
|
|
Dimecaprol injection
|
$185.21 |
$185.21 |
$185.21 |
$314.63
|
|
Dimethyl sulfoxide 50% 50 ml
|
$42.85 |
$42.85 |
$42.85 |
$1,258.20
|
|
Disaccharidases
|
$692.25 |
$692.25 |
$692.25 |
$230.40
|
|
Discography cerv/thor spine
|
$4,941.30 |
$4,941.30 |
$4,941.30 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$4,197.05 |
$4,197.05 |
$4,197.05 |
$1,579.93
|
|
Dna antibody native/double stranded
|
$43.55 |
$43.55 |
$43.55 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$19.50 |
$19.50 |
$19.50 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2,593.36 |
$2,593.36 |
$2,593.36 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$19.50 |
$19.50 |
$19.50 |
$65.40
|
|
Doppler echo complete
|
$936.00 |
$936.00 |
$936.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$5,673.85 |
$5,673.85 |
$5,673.85 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$662.35 |
$662.35 |
$662.35 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$361.40 |
$361.40 |
$361.40 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$51,608.70 |
$51,608.70 |
$51,608.70 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$3,849.04 |
$3,849.04 |
$3,849.04 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$910.94 |
$910.94 |
$910.94 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$373.30 |
$373.30 |
$373.30 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$254.09 |
$254.09 |
$254.09 |
$89.34
|
|
Dpyd gene common variants
|
$527.80 |
$527.80 |
$527.80 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,935.05 |
$1,935.05 |
$1,935.05 |
$800.00
|
|
Drainage external ear complex 69005
|
$3,366.35 |
$3,366.35 |
$3,366.35 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$598.65 |
$598.65 |
$598.65 |
$790.40
|
|
Drainage of arm bursa 23931
|
$4,648.80 |
$4,648.80 |
$4,648.80 |
$2,271.01
|
|
Drainage of kidney lesion
|
$1,711.45 |
$1,711.45 |
$1,711.45 |
$1,506.00
|
|
Drainage of nose lesion sept 30020
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$781.44
|
|
Drain blood from under nail 11740
|
$286.00 |
$286.00 |
$286.00 |
$182.40
|
|
Drain cath image guided visceral pq
|
$1,996.80 |
$1,996.80 |
$1,996.80 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,307.80 |
$1,307.80 |
$1,307.80 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$596.70 |
$596.70 |
$596.70 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$5,048.55 |
$5,048.55 |
$5,048.55 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$537.55 |
$537.55 |
$537.55 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$622.70 |
$622.70 |
$622.70 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$622.05 |
$622.05 |
$622.05 |
$541.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$8,281.65 |
$8,281.65 |
$8,281.65 |
$3,789.86
|
|
Drill hole implt ventricular cath/device 61107
|
$8,514.35 |
$8,514.35 |
$8,514.35 |
$1,485.75
|
|
Drng of eyelid abscess 67700
|
$912.60 |
$912.60 |
$912.60 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$4,427.80 |
$4,427.80 |
$4,427.80 |
$2,079.50
|
|
Drng of scrotum abscess 55100
|
$2,243.80 |
$2,243.80 |
$2,243.80 |
$1,997.89
|
|
Dronabinol 2.5mg oral
|
$59.54 |
$59.54 |
$59.54 |
$17.00
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$4,117.75 |
$4,117.75 |
$4,117.75 |
$1,818.32
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$189.15 |
$189.15 |
$189.15 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$40.95 |
$40.95 |
$40.95 |
$193.15
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$10,494.90 |
$10,494.90 |
$10,494.90 |
$7,465.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$376.50
|
|
Drug admin & hemodynmic meas
|
$676.65 |
$676.65 |
$676.65 |
$569.75
|
|
Drug assay caffeine
|
$52.65 |
$52.65 |
$52.65 |
$80.00
|
|
Drug assay rufinamide
|
$230.10 |
$230.10 |
$230.10 |
$87.10
|
|
Drug assay vedolizumab
|
$308.10 |
$308.10 |
$308.10 |
$154.00
|
|
Drug assay voriconazole
|
$113.75 |
$113.75 |
$113.75 |
$96.75
|
|
Drug of abuse screen urine
|
$577.85 |
$577.85 |
$577.85 |
$67.89
|
|
Drug screening tapentadol
|
$18.85 |
$18.85 |
$18.85 |
$47.03
|
|
Drug screen quant tiagabine
|
$134.55 |
$134.55 |
$134.55 |
$107.59
|
|
Drug test def 15-21 classes
|
$504.40 |
$504.40 |
$504.40 |
$322.50
|
|
Drug test def 1-7 classes
|
$469.95 |
$469.95 |
$469.95 |
$263.25
|
|
Drug test def 8-14 classes
|
$42.90 |
$42.90 |
$42.90 |
$289.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$247.65 |
$247.65 |
$247.65 |
$278.85
|
|
Drvvt confirm - quest
|
$92.30 |
$92.30 |
$92.30 |
$109.20
|
|
Dstrj nulyt agt gnclr nrv
|
$5,335.20 |
$5,335.20 |
$5,335.20 |
$2,980.00
|
|
Ductogram sgl duct
|
$739.05 |
$739.05 |
$739.05 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$750.75 |
$750.75 |
$750.75 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$360.75 |
$360.75 |
$360.75 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$760.50 |
$760.50 |
$760.50 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$748.15 |
$748.15 |
$748.15 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,095.25 |
$1,095.25 |
$1,095.25 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$800.80 |
$800.80 |
$800.80 |
$401.20
|
|
Ear irrigation 69209
|
$193.05 |
$193.05 |
$193.05 |
$154.70
|
|
Ecallantide injection
|
$17,047.76 |
$17,047.76 |
$17,047.76 |
$13,357.14
|
|
Ecg/1-3 leads/tracing only 93041
|
$135.20 |
$135.20 |
$135.20 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$296.40 |
$296.40 |
$296.40 |
$412.88
|
|
Ecg external < 48 hours recording
|
$1,332.50 |
$1,332.50 |
$1,332.50 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,202.50 |
$1,202.50 |
$1,202.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$1,332.50 |
$1,332.50 |
$1,332.50 |
$147.28
|
|
Echocardiogram (Heart Ultrasound)
|
$2,720.25 |
$2,720.25 |
$2,720.25 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$762.45 |
$762.45 |
$762.45 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$653.90 |
$653.90 |
$653.90 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,742.65 |
$1,742.65 |
$1,742.65 |
$1,944.80
|