|
Decalcification
|
$11.60 |
$11.60 |
$11.60 |
$75.38
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,110.08 |
$1,110.08 |
$1,110.08 |
$510.95
|
|
Deferoxamine 500 mg solution for injection
|
$2,940.71 |
$2,940.71 |
$2,940.71 |
$116.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$495.16 |
$495.16 |
$495.16 |
$193.05
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$77,419.74 |
$77,419.74 |
$77,419.74 |
$7,744.96
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$399.93 |
$399.93 |
$399.93 |
$460.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$5,441.63 |
$5,441.63 |
$5,441.63 |
$121.30
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$119.86 |
$119.86 |
$119.86 |
$24.28
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$354.79 |
$354.79 |
$354.79 |
$57.07
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$354.79 |
$354.79 |
$354.79 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$89.43 |
$89.43 |
$89.43 |
$49.68
|
|
Dextrose 5 % IV bolus
|
$354.79 |
$354.79 |
$354.79 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$70.02 |
$70.02 |
$70.02 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$164.89 |
$164.89 |
$164.89 |
$78.41
|
|
Diagnostic anoscopy spx 46600
|
$333.94 |
$333.94 |
$333.94 |
$228.48
|
|
Diagnostic digital breast tomosynthesis bil
|
$550.39 |
$550.39 |
$550.39 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$550.39 |
$550.39 |
$550.39 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$1,704.92 |
$1,704.92 |
$1,704.92 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$1,499.40 |
$1,499.40 |
$1,499.40 |
$295.10
|
|
Dialysis one evaluation
|
$1,290.24 |
$1,290.24 |
$1,290.24 |
$827.97
|
|
Diatrizoate meglumine 18 % urethral solution
|
$191.62 |
$191.62 |
$191.62 |
$106.27
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$272.96 |
$272.96 |
$272.96 |
$70.87
|
|
Dicyclomine injection
|
$1,177.79 |
$1,177.79 |
$1,177.79 |
$211.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$116.23 |
$116.23 |
$116.23 |
$64.31
|
|
Digoxin total therapeutic drug level
|
$700.51 |
$700.51 |
$700.51 |
$102.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$86.10 |
$86.10 |
$86.10 |
$25.12
|
|
Disaccharidases
|
$955.16 |
$955.16 |
$955.16 |
$223.80
|
|
Dna antibody native/double stranded
|
$47.71 |
$47.71 |
$47.71 |
$101.40
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$1,536.27 |
$1,536.27 |
$1,536.27 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,747.37 |
$1,747.37 |
$1,747.37 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$461.00 |
$461.00 |
$461.00 |
$74.39
|
|
Doppler echo complete
|
$1,651.57 |
$1,651.57 |
$1,651.57 |
$635.20
|
|
Doppler intravascular pressure flow initial vessel
|
$2,432.09 |
$2,432.09 |
$2,432.09 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,670.19 |
$2,670.19 |
$2,670.19 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$2,070.24 |
$2,070.24 |
$2,070.24 |
$482.03
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$114,615.40 |
$114,615.40 |
$114,615.40 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$450.71 |
$450.71 |
$450.71 |
$264.42
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$19,989.46 |
$19,989.46 |
$19,989.46 |
$2,469.31
|
|
Dpyd gene common variants
|
$524.43 |
$524.43 |
$524.43 |
$380.50
|
|
Drainage external ear complex 69005
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$2,924.22
|
|
Drainage external ear simple 69000
|
$1,835.55 |
$1,835.55 |
$1,835.55 |
$809.25
|
|
Drainage of nose lesion int 30000
|
$750.38 |
$750.38 |
$750.38 |
$548.00
|
|
Drain blood from under nail 11740
|
$333.94 |
$333.94 |
$333.94 |
$190.10
|
|
Drain finger abscess;simple 26010
|
$636.93 |
$636.93 |
$636.93 |
$492.81
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$1,000.15 |
$1,000.15 |
$1,000.15 |
$407.19
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$923.44 |
$923.44 |
$923.44 |
$360.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,150.39 |
$1,150.39 |
$1,150.39 |
$530.40
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$1,638.03 |
$1,638.03 |
$1,638.03 |
$4,069.80
|
|
Drng of eyelid abscess 67700
|
$927.81 |
$927.81 |
$927.81 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$1,917.33
|
|
Droperidol 2.5 mg/ml injection solution
|
$139.80 |
$139.80 |
$139.80 |
$36.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1,932.18 |
$1,932.18 |
$1,932.18 |
$9,414.77
|
|
Drug assay posaconazole
|
$342.66 |
$342.66 |
$342.66 |
$96.39
|
|
Drug assay voriconazole
|
$317.15 |
$317.15 |
$317.15 |
$96.75
|
|
Drug of abuse screen urine
|
$334.50 |
$334.50 |
$334.50 |
$63.75
|
|
Drug test prsmv instrmnt
|
$661.43 |
$661.43 |
$661.43 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$661.44 |
$661.44 |
$661.44 |
$278.85
|
|
Duplex scan bilateral study 93985
|
$3,842.04 |
$3,842.04 |
$3,842.04 |
$673.00
|
|
Duplex scan unilateral study 93986
|
$3,265.95 |
$3,265.95 |
$3,265.95 |
$383.40
|
|
Dup scan/hemodialysis access 93990
|
$822.98 |
$822.98 |
$822.98 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$4,909.62 |
$4,909.62 |
$4,909.62 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$125,845.37 |
$125,845.37 |
$125,845.37 |
$8,841.54
|
|
Ear irrigation 69209
|
$172.73 |
$172.73 |
$172.73 |
$158.40
|
|
Ecg 12 lead tracing only
|
$437.29 |
$437.29 |
$437.29 |
$245.30
|
|
Echocardiogram (Heart Ultrasound)
|
$13,083.37 |
$13,083.37 |
$13,083.37 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$638.20 |
$638.20 |
$638.20 |
$462.56
|
|
Echocardiography transthoracic 2d followup/limited
|
$3,310.93 |
$3,310.93 |
$3,310.93 |
$737.75
|
|
Echocardiograpy doppler follow up/limited study
|
$957.31 |
$957.31 |
$957.31 |
$353.46
|
|
Echo tee probe placement image acquisition interpretation & report
|
$8,733.48 |
$8,733.48 |
$8,733.48 |
$1,885.56
|
|
Echo transesophageal intraop
|
$8,750.94 |
$8,750.94 |
$8,750.94 |
$1,571.70
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$3,366.93 |
$3,366.93 |
$3,366.93 |
$1,022.30
|
|
Eeg 41-60 minutes 95812-26
|
$2,668.45 |
$2,668.45 |
$2,668.45 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$2,539.95 |
$2,539.95 |
$2,539.95 |
$1,025.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,402.76 |
$1,402.76 |
$1,402.76 |
$861.12
|
|
Eeg/record in coma or sleep only 95822
|
$4,486.67 |
$4,486.67 |
$4,486.67 |
$911.00
|
|
Eeg recording awake and asleep
|
$2,577.15 |
$2,577.15 |
$2,577.15 |
$1,030.27
|
|
Eeg wo vid ea 12-26hr unmntr
|
$9,262.45 |
$9,262.45 |
$9,262.45 |
$1,194.00
|
|
Electrical stimulation/unattended 97014
|
$252.66 |
$252.66 |
$252.66 |
$82.20
|
|
Electrolyte panel
|
$722.12 |
$722.12 |
$722.12 |
$88.78
|
|
Embo or occlude vascular arterial s&i
|
$65,915.42 |
$65,915.42 |
$65,915.42 |
$16,031.73
|
|
Endoluminl ivus oct c 1st
|
$8,898.99 |
$8,898.99 |
$8,898.99 |
$3,316.48
|
|
Endoscopy swallow (fees) vid
|
$515.06 |
$515.06 |
$515.06 |
$408.20
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$1,053.48 |
$1,053.48 |
$1,053.48 |
$116.08
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$3,262.62 |
$3,262.62 |
$3,262.62 |
$881.50
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$7,462.69 |
$7,462.69 |
$7,462.69 |
$799.45
|
|
Epstein barr early antigen antibody
|
$41.33 |
$41.33 |
$41.33 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$53.10 |
$53.10 |
$53.10 |
$79.95
|
|
Epstein barr viral capsid antigen antibody igm
|
$63.00 |
$63.00 |
$63.00 |
$91.01
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$1,769.48 |
$1,769.48 |
$1,769.48 |
$357.88
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$43,576.27 |
$43,576.27 |
$43,576.27 |
$6,313.52
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$17,557.89 |
$17,557.89 |
$17,557.89 |
$3,078.07
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,096.25 |
$1,096.25 |
$1,096.25 |
$334.75
|
|
ER Visit (level 1, minor)
|
$344.60 |
$344.60 |
$344.60 |
$276.70
|
|
ER Visit (level 2)
|
$746.62 |
$746.62 |
$746.62 |
$483.20
|
|
ER Visit (level 3)
|
$1,340.10 |
$1,340.10 |
$1,340.10 |
$850.50
|
|
ER Visit (level 4)
|
$1,991.01 |
$1,991.01 |
$1,991.01 |
$1,351.35
|
|
ER Visit (level 5, high severity)
|
$4,722.24 |
$4,722.24 |
$4,722.24 |
$1,973.60
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$735.70 |
$735.70 |
$735.70 |
$247.00
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln
|
$2,174.08 |
$2,174.08 |
$2,174.08 |
$755.59
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$1,581.37 |
$1,581.37 |
$1,581.37 |
$547.14
|