|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,380.49 |
$1,380.49 |
$1,380.49 |
$798.23
|
|
Debride nail1-5 11720
|
$164.56 |
$164.56 |
$164.56 |
$173.25
|
|
Debride nail6 or more 11721
|
$139.09 |
$139.09 |
$139.09 |
$196.56
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,316.06 |
$1,316.06 |
$1,316.06 |
$640.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,463.20 |
$1,463.20 |
$1,463.20 |
$1,161.05
|
|
Decalcification
|
$57.39 |
$57.39 |
$57.39 |
$75.38
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$951.72 |
$951.72 |
$951.72 |
$510.95
|
|
Deferoxamine 500 mg solution for injection
|
$339.79 |
$339.79 |
$339.79 |
$112.87
|
|
Delivery of placenta 59414
|
$7,971.33 |
$7,971.33 |
$7,971.33 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$394.95 |
$394.95 |
$394.95 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,987.79 |
$7,987.79 |
$7,987.79 |
$7,737.00
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$399.93 |
$399.93 |
$399.93 |
$460.50
|
|
Design mlc device for imrt
|
$2,268.57 |
$2,268.57 |
$2,268.57 |
$1,641.90
|
|
Desmopressin 4 mcg/ml injection solution
|
$573.74 |
$573.74 |
$573.74 |
$148.77
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,732.70 |
$3,732.70 |
$3,732.70 |
$3,375.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$690.67 |
$690.67 |
$690.67 |
$225.60
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$28.59 |
$28.59 |
$28.59 |
$23.79
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$135.29 |
$135.29 |
$135.29 |
$46.35
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$135.29 |
$135.29 |
$135.29 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$39.51 |
$39.51 |
$39.51 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$135.29 |
$135.29 |
$135.29 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$64.34 |
$64.34 |
$64.34 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$164.89 |
$164.89 |
$164.89 |
$79.30
|
|
Diagnostic digital breast tomosynthesis bil
|
$264.79 |
$264.79 |
$264.79 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$264.79 |
$264.79 |
$264.79 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$705.06 |
$705.06 |
$705.06 |
$421.20
|
|
Diagnostic Mammogram (one breast)
|
$581.37 |
$581.37 |
$581.37 |
$291.90
|
|
Dialysis one evaluation
|
$1,753.02 |
$1,753.02 |
$1,753.02 |
$827.97
|
|
Diatrizoate meglumine 18 % urethral solution
|
$191.62 |
$191.62 |
$191.62 |
$112.61
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$44.79 |
$44.79 |
$44.79 |
$70.40
|
|
Dicyclomine injection
|
$143.91 |
$143.91 |
$143.91 |
$210.83
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$28.10 |
$28.10 |
$28.10 |
$62.20
|
|
Digoxin total therapeutic drug level
|
$1,367.70 |
$1,367.70 |
$1,367.70 |
$102.00
|
|
Dilat xst trc new access rcs
|
$8,304.10 |
$8,304.10 |
$8,304.10 |
$4,881.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$24.07 |
$24.07 |
$24.07 |
$23.90
|
|
Disaccharidases
|
$459.51 |
$459.51 |
$459.51 |
$224.58
|
|
Dna antibody native/double stranded
|
$127.67 |
$127.67 |
$127.67 |
$101.40
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$545.00 |
$545.00 |
$545.00 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$496.24 |
$496.24 |
$496.24 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$171.13 |
$171.13 |
$171.13 |
$69.47
|
|
Doppler echo complete
|
$799.50 |
$799.50 |
$799.50 |
$643.75
|
|
Doppler intravascular pressure flow initial vessel
|
$3,421.20 |
$3,421.20 |
$3,421.20 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,051.03 |
$1,051.03 |
$1,051.03 |
$694.85
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,045.26 |
$1,045.26 |
$1,045.26 |
$482.03
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$25,883.50 |
$25,883.50 |
$25,883.50 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$144.42 |
$144.42 |
$144.42 |
$252.80
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$4,945.79 |
$4,945.79 |
$4,945.79 |
$2,469.31
|
|
Dpyd gene common variants
|
$1,107.56 |
$1,107.56 |
$1,107.56 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$2,207.15 |
$2,207.15 |
$2,207.15 |
$820.50
|
|
Drainage external ear complex 69005
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$2,924.22
|
|
Drainage external ear simple 69000
|
$1,601.44 |
$1,601.44 |
$1,601.44 |
$815.00
|
|
Drainage of arm bursa 23931
|
$4,990.49 |
$4,990.49 |
$4,990.49 |
$2,271.01
|
|
Drainage of mouth lesion
|
$9,703.14 |
$9,703.14 |
$9,703.14 |
$3,837.72
|
|
Drain blood from under nail 11740
|
$279.83 |
$279.83 |
$279.83 |
$190.10
|
|
Drain cath image guided visceral pq
|
$6,376.15 |
$6,376.15 |
$6,376.15 |
$2,996.80
|
|
Drain finger abscess;simple 26010
|
$636.93 |
$636.93 |
$636.93 |
$490.80
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$448.91 |
$448.91 |
$448.91 |
$403.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$568.76 |
$568.76 |
$568.76 |
$359.45
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$1,265.74 |
$1,265.74 |
$1,265.74 |
$3,789.86
|
|
Drng of eyelid abscess 67700
|
$927.81 |
$927.81 |
$927.81 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$1,472.99 |
$1,472.99 |
$1,472.99 |
$1,917.33
|
|
Droperidol 2.5 mg/ml injection solution
|
$31.26 |
$31.26 |
$31.26 |
$35.43
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$487.36 |
$487.36 |
$487.36 |
$223.81
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1,493.05 |
$1,493.05 |
$1,493.05 |
$7,721.16
|
|
Drug assay vedolizumab
|
$106.31 |
$106.31 |
$106.31 |
$169.26
|
|
Drug of abuse screen urine
|
$735.56 |
$735.56 |
$735.56 |
$63.75
|
|
Drug test def 1-7 classes
|
$294.66 |
$294.66 |
$294.66 |
$263.86
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$1,367.70 |
$1,367.70 |
$1,367.70 |
$280.95
|
|
Duplex scan bilateral study 93985
|
$1,848.33 |
$1,848.33 |
$1,848.33 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$1,571.19 |
$1,571.19 |
$1,571.19 |
$392.15
|
|
Dup scan/hemodialysis access 93990
|
$2,181.10 |
$2,181.10 |
$2,181.10 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$2,263.95 |
$2,263.95 |
$2,263.95 |
$750.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$3,452.72 |
$3,452.72 |
$3,452.72 |
$885.87
|
|
Durvalumab 50 mg/ml intravenous solution
|
$28,417.50 |
$28,417.50 |
$28,417.50 |
$8,841.54
|
|
Dxa bone density axl vrt fx
|
$490.41 |
$490.41 |
$490.41 |
$374.00
|
|
Dx bronchoscope/lavage 31624
|
$5,306.55 |
$5,306.55 |
$5,306.55 |
$2,626.00
|
|
Ear irrigation 69209
|
$316.03 |
$316.03 |
$316.03 |
$155.20
|
|
Ecg 12 lead tracing only
|
$625.75 |
$625.75 |
$625.75 |
$245.00
|
|
Ecg < 30 days transmission & analysis
|
$218.43 |
$218.43 |
$218.43 |
$441.40
|
|
Ecg external < 48 hours recording
|
$753.46 |
$753.46 |
$753.46 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,970.35 |
$1,970.35 |
$1,970.35 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$2,980.91 |
$2,980.91 |
$2,980.91 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$307.02 |
$307.02 |
$307.02 |
$462.80
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,592.83 |
$1,592.83 |
$1,592.83 |
$762.45
|
|
Echocardiograpy doppler follow up/limited study
|
$765.20 |
$765.20 |
$765.20 |
$354.90
|
|
Echo stress
|
$3,285.59 |
$3,285.59 |
$3,285.59 |
$1,607.45
|
|
Echo tee probe placement image acquisition interpretation & report
|
$4,201.50 |
$4,201.50 |
$4,201.50 |
$1,907.26
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,476.41 |
$1,476.41 |
$1,476.41 |
$1,031.85
|
|
Eeg 41-60 minutes 95812-26
|
$1,283.74 |
$1,283.74 |
$1,283.74 |
$934.05
|
|
Eeg during surgery
|
$2,463.37 |
$2,463.37 |
$2,463.37 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,898.80 |
$1,898.80 |
$1,898.80 |
$861.12
|
|
Eeg/record in coma or sleep only 95822
|
$2,158.45 |
$2,158.45 |
$2,158.45 |
$911.00
|
|
Eeg recording awake and asleep
|
$1,898.80 |
$1,898.80 |
$1,898.80 |
$1,025.76
|
|
Eeg without vid 2-12 hr unmntr
|
$681.02 |
$681.02 |
$681.02 |
$555.00
|
|
Ehrlicha chaffeensis amp prb
|
$123.34 |
$123.34 |
$123.34 |
$105.00
|
|
Electrical stimulation/unattended 97014
|
$294.63 |
$294.63 |
$294.63 |
$82.20
|
|
Electrolyte panel
|
$380.58 |
$380.58 |
$380.58 |
$92.30
|
|
Electron microscopy diagnostic
|
$1,732.55 |
$1,732.55 |
$1,732.55 |
$1,006.20
|
|
Embo or occlude vascular arterial s&i
|
$46,092.05 |
$46,092.05 |
$46,092.05 |
$16,031.73
|
|
Embo or occlude vascular hemorrhage s&i
|
$44,628.81 |
$44,628.81 |
$44,628.81 |
$15,027.40
|