|
Diazepam 5 mg/ml injection solution (wrapper)
|
$18.56 |
$18.56 |
$18.56 |
$72.34
|
|
Dicyclomine injection
|
$47.16 |
$47.16 |
$47.16 |
$211.81
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$12.08 |
$12.08 |
$12.08 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$8,930.80 |
$8,930.80 |
$8,930.80 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$62.52 |
$62.52 |
$62.52 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$30.96 |
$30.96 |
$30.96 |
$334.68
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$35.52 |
$35.52 |
$35.52 |
$26.87
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$25.96 |
$25.96 |
$25.96 |
$106.59
|
|
Disaccharidases
|
$34.50 |
$34.50 |
$34.50 |
$223.80
|
|
Dna antibody native/double stranded
|
$57.36 |
$57.36 |
$57.36 |
$102.60
|
|
Dna probe chlamydia
|
$30.00 |
$30.00 |
$30.00 |
$82.20
|
|
Dna probe gc
|
$30.00 |
$30.00 |
$30.00 |
$88.67
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$93.96 |
$93.96 |
$93.96 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$21.44 |
$21.44 |
$21.44 |
$712.02
|
|
Dolasetron mesylate
|
$26.68 |
$26.68 |
$26.68 |
$76.59
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$3.99 |
$3.99 |
$3.99 |
$84.30
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$461.20 |
$461.20 |
$461.20 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$461.20 |
$461.20 |
$461.20 |
$482.03
|
|
Dornase alfa non-comp unit
|
$97.00 |
$97.00 |
$97.00 |
$479.80
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$326.36 |
$326.36 |
$326.36 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$52.92 |
$52.92 |
$52.92 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$411.60 |
$411.60 |
$411.60 |
$2,417.38
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.12 |
$0.12 |
$0.12 |
$99.99
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$643.80 |
$643.80 |
$643.80 |
$9,390.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$6.40 |
$6.40 |
$6.40 |
$39.60
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$119.76 |
$119.76 |
$119.76 |
$18,384.03
|
|
Drug assay voriconazole
|
$24.60 |
$24.60 |
$24.60 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$35.04 |
$35.04 |
$35.04 |
$83.85
|
|
Drug of abuse screen urine
|
$14.84 |
$14.84 |
$14.84 |
$63.75
|
|
Drug screen quant tiagabine
|
$30.35 |
$30.35 |
$30.35 |
$91.80
|
|
Drug test def 1-7 classes
|
$59.20 |
$59.20 |
$59.20 |
$250.52
|
|
Drug test prsmv instrmnt
|
$14.84 |
$14.84 |
$14.84 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$931.72 |
$931.72 |
$931.72 |
$278.85
|
|
Drvvt confirm - quest
|
$33.60 |
$33.60 |
$33.60 |
$101.66
|
|
Ductogram sgl duct
|
$286.00 |
$286.00 |
$286.00 |
$413.91
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$416.80 |
$416.80 |
$416.80 |
$757.57
|
|
Durvalumab 50 mg/ml intravenous solution
|
$71.96 |
$71.96 |
$71.96 |
$10,021.12
|
|
Dxa bone density axl vrt fx
|
$324.40 |
$324.40 |
$324.40 |
$374.00
|
|
Echocardiogram (Heart Ultrasound)
|
$1,785.20 |
$1,785.20 |
$1,785.20 |
$2,049.45
|
|
Echo exam of eye thickness
|
$8.74 |
$8.74 |
$8.74 |
$32.37
|
|
Echo exam of fetal heart
|
$355.60 |
$355.60 |
$355.60 |
$855.38
|
|
Echo exam of fetal heart
|
$187.60 |
$187.60 |
$187.60 |
$503.80
|
|
Echo exam of fetal heart
|
$353.20 |
$353.20 |
$353.20 |
$431.41
|
|
Echo exam of fetal heart
|
$144.00 |
$144.00 |
$144.00 |
$323.40
|
|
Echo exam uterus 76831-
|
$547.20 |
$547.20 |
$547.20 |
$547.20
|
|
Echograp trans r pros study
|
$462.80 |
$462.80 |
$462.80 |
$459.40
|
|
Echo guidance radiotherapy
|
$1,910.00 |
$1,910.00 |
$1,910.00 |
$774.80
|
|
Echo guide for amniocentesis
|
$1,272.80 |
$1,272.80 |
$1,272.80 |
$384.65
|
|
Echo guide for artery repair
|
$1,016.00 |
$1,016.00 |
$1,016.00 |
$680.28
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,283.20 |
$1,283.20 |
$1,283.20 |
$1,871.10
|
|
Echo transthoracic
|
$742.00 |
$742.00 |
$742.00 |
$1,492.50
|
|
Echo transthoracic
|
$1,945.60 |
$1,945.60 |
$1,945.60 |
$953.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$730.80 |
$730.80 |
$730.80 |
$1,014.01
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$49.80 |
$49.80 |
$49.80 |
$18,038.06
|
|
Efgartigimod alfa-fcab 20 mg/ml intravenous solution
|
$35.58 |
$35.58 |
$35.58 |
$13,756.97
|
|
Egfr gene com variants
|
$177.20 |
$177.20 |
$177.20 |
$619.04
|
|
Electrolyte panel
|
$20.60 |
$20.60 |
$20.60 |
$86.33
|
|
Electron microscopy diagnostic
|
$295.72 |
$295.72 |
$295.72 |
$966.69
|
|
Electrophysiology evaluation
|
$10,085.20 |
$10,085.20 |
$10,085.20 |
$7,769.30
|
|
Electrophysiology evaluation
|
$9,945.20 |
$9,945.20 |
$9,945.20 |
$6,516.00
|
|
Electrophys map 3d add-on
|
$9,132.80 |
$9,132.80 |
$9,132.80 |
$6,534.00
|
|
Elotuzumab 300 mg intravenous solution
|
$13.68 |
$13.68 |
$13.68 |
$8,397.94
|
|
Elranatamab-bcmm 40 mg/ml subcutaneous solution
|
$205.20 |
$205.20 |
$205.20 |
$283.76
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$36.31 |
$36.31 |
$36.31 |
$10,962.88
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$21.44 |
$21.44 |
$21.44 |
$121.63
|
|
Entamoeba histolytica ag eia - sendout
|
$5.77 |
$5.77 |
$5.77 |
$66.47
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$70.28 |
$70.28 |
$70.28 |
$195.23
|
|
Epoetin alfa, 100 units esrd
|
$8.54 |
$8.54 |
$8.54 |
$41.32
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$20.60 |
$20.60 |
$20.60 |
$918.00
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$12.16 |
$12.16 |
$12.16 |
$950.55
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$38.92 |
$38.92 |
$38.92 |
$136.00
|
|
Epstein barr early antigen antibody
|
$33.56 |
$33.56 |
$33.56 |
$72.08
|
|
Epstein barr nuclear antigen antibody
|
$33.56 |
$33.56 |
$33.56 |
$81.81
|
|
Epstein barr viral capsid antigen antibody igm
|
$43.44 |
$43.44 |
$43.44 |
$95.04
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$28.84 |
$28.84 |
$28.84 |
$363.57
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$17.89 |
$17.89 |
$17.89 |
$6,313.52
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$134.38 |
$134.38 |
$134.38 |
$3,855.08
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$59.60 |
$59.60 |
$59.60 |
$364.08
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$1.23 |
$1.23 |
$1.23 |
$540.00
|
|
Established Patient Office Visit (level 1)
|
$172.80 |
$172.80 |
$172.80 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$158.00 |
$158.00 |
$158.00 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$237.20 |
$237.20 |
$237.20 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$291.60 |
$291.60 |
$291.60 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$426.80 |
$426.80 |
$426.80 |
$287.10
|
|
Estradiol total
|
$257.68 |
$257.68 |
$257.68 |
$153.00
|
|
Estradiol valerate 10 mg inj
|
$5.64 |
$5.64 |
$5.64 |
$63.50
|
|
Estrogens total-sendout
|
$52.24 |
$52.24 |
$52.24 |
$89.25
|
|
Ethylene glycol -sendout
|
$7.99 |
$7.99 |
$7.99 |
$75.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$46.88 |
$46.88 |
$46.88 |
$213.17
|
|
Euflexxa inj per dose
|
$192.15 |
$192.15 |
$192.15 |
$727.80
|
|
Eval/fit voice prosthesis iii, st
|
$244.80 |
$244.80 |
$244.80 |
$370.41
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$228.96 |
$228.96 |
$228.96 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$275.60 |
$275.60 |
$275.60 |
$347.75
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$144.00 |
$144.00 |
$144.00 |
$458.73
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$218.40 |
$218.40 |
$218.40 |
$102.78
|
|
F-18 fluciclovine per mci
|
$7,624.40 |
$7,624.40 |
$7,624.40 |
$1,307.52
|
|
Facial bones <3
|
$298.40 |
$298.40 |
$298.40 |
$248.60
|
|
Factor ix
|
$101.84 |
$101.84 |
$101.84 |
$131.30
|
|
Factor ix idelvion inj
|
$5.16 |
$5.16 |
$5.16 |
$5.05
|
|
Factor ix recombinant nos
|
$1.60 |
$1.60 |
$1.60 |
$3.04
|
