|
Dalbavancin 500 mg intravenous solution
|
$6,288.75 |
$6,288.75 |
$6,288.75 |
$3,753.91
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$717.73 |
$717.73 |
$717.73 |
$544.35
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$1,122.95 |
$1,122.95 |
$1,122.95 |
$194.08
|
|
Dch glucoscan
|
$132.92 |
$132.92 |
$132.92 |
$23.25
|
|
Dch pulmonary stress test
|
$7,609.35 |
$7,609.35 |
$7,609.35 |
$964.41
|
|
Dch validity tests
|
$168.30 |
$168.30 |
$168.30 |
$25.00
|
|
Decitabine 50 mg intravenous solution
|
$3,285.16 |
$3,285.16 |
$3,285.16 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$469.27 |
$469.27 |
$469.27 |
$112.87
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,443.55 |
$1,443.55 |
$1,443.55 |
$465.34
|
|
Dextran 40 infusion
|
$359.31 |
$359.31 |
$359.31 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$60.78 |
$60.78 |
$60.78 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$25.12 |
$25.12 |
$25.12 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$95.13 |
$95.13 |
$95.13 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$120.56 |
$120.56 |
$120.56 |
$68.25
|
|
Diagnostic Mammogram (both breasts)
|
$1,806.98 |
$1,806.98 |
$1,806.98 |
$403.32
|
|
Diagnostic radio unlisted proc
|
$8,953.55 |
$8,953.55 |
$8,953.55 |
$236.93
|
|
Dicyclomine injection
|
$302.03 |
$302.03 |
$302.03 |
$210.00
|
|
Diffusing capacity
|
$1,364.92 |
$1,364.92 |
$1,364.92 |
$357.50
|
|
Digital analysis of eeg
|
$1,033.46 |
$1,033.46 |
$1,033.46 |
$641.56
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$57.81 |
$57.81 |
$57.81 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$12,490.22 |
$12,490.22 |
$12,490.22 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$941.82 |
$941.82 |
$941.82 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$641.88 |
$641.88 |
$641.88 |
$308.90
|
|
Dimenhydrinate injection
|
$57.32 |
$57.32 |
$57.32 |
$24.68
|
|
Dimethyl sulfoxide 50% 50 ml
|
$263.76 |
$263.76 |
$263.76 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$26.49 |
$26.49 |
$26.49 |
$22.58
|
|
Disability dlco
|
$2,363.10 |
$2,363.10 |
$2,363.10 |
$302.40
|
|
Dna probe chlamydia
|
$4.50 |
$4.50 |
$4.50 |
$82.20
|
|
Dna probe gc
|
$5.62 |
$5.62 |
$5.62 |
$88.67
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$40.67 |
$40.67 |
$40.67 |
$98.43
|
|
Dolasetron mesylate
|
$193.48 |
$193.48 |
$193.48 |
$76.59
|
|
Doppler echo complete
|
$616.87 |
$616.87 |
$616.87 |
$644.00
|
|
Dornase alfa non-comp unit
|
$1,333.41 |
$1,333.41 |
$1,333.41 |
$500.29
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$269.09 |
$269.09 |
$269.09 |
$89.34
|
|
Dpyd gene common variants
|
$203.63 |
$203.63 |
$203.63 |
$380.50
|
|
Droperidol 2.5 mg/ml injection solution
|
$10.90 |
$10.90 |
$10.90 |
$33.99
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$853.47 |
$853.47 |
$853.47 |
$189.68
|
|
Drug assay caffeine
|
$149.34 |
$149.34 |
$149.34 |
$86.45
|
|
Drvvt confirm - quest
|
$548.02 |
$548.02 |
$548.02 |
$102.30
|
|
Dup scan/hemodialysis access 93990
|
$1,280.42 |
$1,280.42 |
$1,280.42 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,154.02 |
$1,154.02 |
$1,154.02 |
$750.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,412.79 |
$2,412.79 |
$2,412.79 |
$885.60
|
|
Ecg/1-3 leads/tracing only 93041
|
$426.40 |
$426.40 |
$426.40 |
$129.83
|
|
Ecg external < 48 hours recording
|
$4,049.14 |
$4,049.14 |
$4,049.14 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$2,991.96 |
$2,991.96 |
$2,991.96 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$8,156.45 |
$8,156.45 |
$8,156.45 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$410.72 |
$410.72 |
$410.72 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$4,968.81 |
$4,968.81 |
$4,968.81 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$2,207.04 |
$2,207.04 |
$2,207.04 |
$354.90
|
|
Echo exam uterus 76831-
|
$4,906.47 |
$4,906.47 |
$4,906.47 |
$547.23
|
|
Echograp trans r pros study
|
$9,851.92 |
$9,851.92 |
$9,851.92 |
$445.25
|
|
Echo guidance radiotherapy
|
$10,732.33 |
$10,732.33 |
$10,732.33 |
$769.18
|
|
Echo guide for amniocentesis
|
$10,732.33 |
$10,732.33 |
$10,732.33 |
$377.11
|
|
Echo guide for artery repair
|
$3,848.45 |
$3,848.45 |
$3,848.45 |
$676.80
|
|
Echo stress
|
$6,333.94 |
$6,333.94 |
$6,333.94 |
$1,607.45
|
|
Echo tee guidance
|
$10,543.69 |
$10,543.69 |
$10,543.69 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,851.45 |
$1,851.45 |
$1,851.45 |
$1,938.95
|
|
Echo transesophageal intraop
|
$6,527.48 |
$6,527.48 |
$6,527.48 |
$1,571.70
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$4,479.96 |
$4,479.96 |
$4,479.96 |
$1,020.09
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$24,461.25 |
$24,461.25 |
$24,461.25 |
$17,641.10
|
|
Eeg 41-60 minutes 95812-26
|
$1,557.25 |
$1,557.25 |
$1,557.25 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$2,818.71 |
$2,818.71 |
$2,818.71 |
$1,048.30
|
|
Eeg during surgery
|
$737.96 |
$737.96 |
$737.96 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$3,058.17 |
$3,058.17 |
$3,058.17 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$1,792.24 |
$1,792.24 |
$1,792.24 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$2,353.60 |
$2,353.60 |
$2,353.60 |
$911.00
|
|
Eeg recording awake and asleep
|
$3,385.80 |
$3,385.80 |
$3,385.80 |
$1,030.27
|
|
Electrolyte panel
|
$1,972.01 |
$1,972.01 |
$1,972.01 |
$86.33
|
|
Electron microscopy diagnostic
|
$37.84 |
$37.84 |
$37.84 |
$1,006.20
|
|
Electrophysiologic study
|
$25,748.10 |
$25,748.10 |
$25,748.10 |
$6,758.40
|
|
Electrophysiology evaluation
|
$36,751.90 |
$36,751.90 |
$36,751.90 |
$8,979.45
|
|
Electrophysiology evaluation
|
$40,425.51 |
$40,425.51 |
$40,425.51 |
$11,542.01
|
|
Electrophysiology evaluation
|
$58,394.17 |
$58,394.17 |
$58,394.17 |
$8,393.40
|
|
Electrophysiology evaluation
|
$31,500.90 |
$31,500.90 |
$31,500.90 |
$6,516.00
|
|
Electrophysiology evaluation
|
$44,468.08 |
$44,468.08 |
$44,468.08 |
$2,630.40
|
|
Electrophys map 3d add-on
|
$57,164.45 |
$57,164.45 |
$57,164.45 |
$6,534.00
|
|
Embolization s&i
|
$3,843.28 |
$3,843.28 |
$3,843.28 |
$2,745.08
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$2,573.67 |
$2,573.67 |
$2,573.67 |
$436.64
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$1,850.52 |
$1,850.52 |
$1,850.52 |
$512.85
|
|
Emg cranial nerve bilateral
|
$2,467.51 |
$2,467.51 |
$2,467.51 |
$518.00
|
|
Emg needle test 1-extremity
|
$907.72 |
$907.72 |
$907.72 |
$340.80
|
|
Emg needle test 4-extremities
|
$2,467.51 |
$2,467.51 |
$2,467.51 |
$547.00
|
|
Encephalitis, western equine igg/igm
|
$16.29 |
$16.29 |
$16.29 |
$50.35
|
|
Ep & ablate supravent arrhyt
|
$130,920.47 |
$130,920.47 |
$130,920.47 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$227,077.29 |
$227,077.29 |
$227,077.29 |
$30,975.00
|
|
Ep induct arrhy by elect pacing
|
$9,334.16 |
$9,334.16 |
$9,334.16 |
$2,753.40
|
|
Epinephrine 1 mg/ml im kit - adult
|
$76.21 |
$76.21 |
$76.21 |
$25.61
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$360.23 |
$360.23 |
$360.23 |
$135.20
|
|
Epstein barr early antigen antibody
|
$120.84 |
$120.84 |
$120.84 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$140.95 |
$140.95 |
$140.95 |
$82.55
|
|
Ercp biliary & pancreas
|
$10,893.34 |
$10,893.34 |
$10,893.34 |
$922.35
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,427.58 |
$1,427.58 |
$1,427.58 |
$364.08
|
|
ER Visit (level 2)
|
$1,040.63 |
$1,040.63 |
$1,040.63 |
$481.37
|
|
ER Visit (level 3)
|
$1,478.52 |
$1,478.52 |
$1,478.52 |
$850.50
|
|
ER Visit (level 4)
|
$1,849.75 |
$1,849.75 |
$1,849.75 |
$1,334.25
|
|
ER Visit (level 5, high severity)
|
$2,321.33 |
$2,321.33 |
$2,321.33 |
$1,930.40
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$719.40 |
$719.40 |
$719.40 |
$232.84
|
|
Esophageal dilat s&i
|
$2,216.79 |
$2,216.79 |
$2,216.79 |
$525.00
|
|
Esophagus motility study
|
$3,074.58 |
$3,074.58 |
$3,074.58 |
$1,274.00
|
|
Esoph balloon distension tst
|
$3,074.58 |
$3,074.58 |
$3,074.58 |
$780.00
|