|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$157.00 |
$157.00 |
$157.00 |
$43.65
|
|
Dextrose 5 % IV bolus
|
$144.00 |
$144.00 |
$144.00 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$33.75 |
$33.75 |
$33.75 |
$107.50
|
|
Diab manage trn ind/group
|
$312.75 |
$312.75 |
$312.75 |
$49.50
|
|
Diagnostic Mammogram (both breasts)
|
$1,259.50 |
$1,259.50 |
$1,259.50 |
$421.20
|
|
Dialysis one evaluation
|
$1,156.75 |
$1,156.75 |
$1,156.75 |
$827.97
|
|
Diatrizoate meglumine 18 % urethral solution
|
$153.00 |
$153.00 |
$153.00 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$50.00 |
$50.00 |
$50.00 |
$70.99
|
|
Dicyclomine injection
|
$211.00 |
$211.00 |
$211.00 |
$210.00
|
|
Diffusing capacity
|
$1,265.75 |
$1,265.75 |
$1,265.75 |
$357.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$20.00 |
$20.00 |
$20.00 |
$56.30
|
|
Digoxin immune fab 40 mg intravenous solution
|
$8,476.50 |
$8,476.50 |
$8,476.50 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$156.00 |
$156.00 |
$156.00 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$357.25 |
$357.25 |
$357.25 |
$308.90
|
|
Dimenhydrinate injection
|
$36.00 |
$36.00 |
$36.00 |
$24.68
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$7.50 |
$7.50 |
$7.50 |
$2.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$8.00 |
$8.00 |
$8.00 |
$23.22
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$326.75 |
$326.75 |
$326.75 |
$100.80
|
|
Disability dlco
|
$1,003.75 |
$1,003.75 |
$1,003.75 |
$302.90
|
|
Disaccharidases
|
$198.25 |
$198.25 |
$198.25 |
$224.58
|
|
Dna antibody native/double stranded
|
$110.75 |
$110.75 |
$110.75 |
$101.40
|
|
Dna probe chlamydia
|
$3.75 |
$3.75 |
$3.75 |
$82.20
|
|
Dna probe gc
|
$3.75 |
$3.75 |
$3.75 |
$88.67
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$3,392.00 |
$3,392.00 |
$3,392.00 |
$712.02
|
|
Doppler echo complete
|
$2,645.00 |
$2,645.00 |
$2,645.00 |
$644.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,253.25 |
$1,253.25 |
$1,253.25 |
$495.00
|
|
Dornase alfa non-comp unit
|
$675.25 |
$675.25 |
$675.25 |
$498.89
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$111.00 |
$111.00 |
$111.00 |
$244.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$10.00 |
$10.00 |
$10.00 |
$35.62
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$44.13 |
$44.13 |
$44.13 |
$327.39
|
|
Drug assay voriconazole
|
$74.50 |
$74.50 |
$74.50 |
$96.75
|
|
Drug test def 22+ classes
|
$1,126.00 |
$1,126.00 |
$1,126.00 |
$246.92
|
|
Drug test def 8-14 classes
|
$715.75 |
$715.75 |
$715.75 |
$172.25
|
|
Duplex scan bilateral study 93985
|
$1,200.50 |
$1,200.50 |
$1,200.50 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$577.50 |
$577.50 |
$577.50 |
$392.15
|
|
Dup scan/hemodialysis access 93990
|
$4,091.75 |
$4,091.75 |
$4,091.75 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$3,961.25 |
$3,961.25 |
$3,961.25 |
$886.60
|
|
Ecg external < 48 hours recording
|
$6,059.50 |
$6,059.50 |
$6,059.50 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$4,625.75 |
$4,625.75 |
$4,625.75 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$10,957.00 |
$10,957.00 |
$10,957.00 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$2,010.75 |
$2,010.75 |
$2,010.75 |
$463.45
|
|
Echocardiography transthoracic 2d followup/limited
|
$5,633.50 |
$5,633.50 |
$5,633.50 |
$773.30
|
|
Echograp trans r pros study
|
$4,707.75 |
$4,707.75 |
$4,707.75 |
$458.25
|
|
Echo guide for amniocentesis
|
$1,887.00 |
$1,887.00 |
$1,887.00 |
$377.11
|
|
Echo guide for artery repair
|
$5,631.75 |
$5,631.75 |
$5,631.75 |
$677.60
|
|
Echo stress
|
$7,563.50 |
$7,563.50 |
$7,563.50 |
$1,607.45
|
|
Echo tee guidance
|
$9,203.00 |
$9,203.00 |
$9,203.00 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$8,735.50 |
$8,735.50 |
$8,735.50 |
$1,925.93
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$1,025.40
|
|
Edetate calcium disodium inj
|
$188.50 |
$188.50 |
$188.50 |
$6,086.32
|
|
Eeg 41-60 minutes 95812-26
|
$1,465.50 |
$1,465.50 |
$1,465.50 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$8,975.25 |
$8,975.25 |
$8,975.25 |
$1,048.30
|
|
Eeg during surgery
|
$5,816.50 |
$5,816.50 |
$5,816.50 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$5,809.25 |
$5,809.25 |
$5,809.25 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$2,910.75 |
$2,910.75 |
$2,910.75 |
$1,086.80
|
|
Eeg recording awake and asleep
|
$8,490.50 |
$8,490.50 |
$8,490.50 |
$1,030.27
|
|
Egfr gene com variants
|
$285.75 |
$285.75 |
$285.75 |
$646.75
|
|
Electrolyte panel
|
$261.25 |
$261.25 |
$261.25 |
$88.20
|
|
Electrophysiologic study
|
$11,239.00 |
$11,239.00 |
$11,239.00 |
$6,758.40
|
|
Electrophysiology evaluation
|
$44,214.00 |
$44,214.00 |
$44,214.00 |
$9,067.30
|
|
Electrophysiology evaluation
|
$43,997.00 |
$43,997.00 |
$43,997.00 |
$11,630.85
|
|
Electrophysiology evaluation
|
$13,757.75 |
$13,757.75 |
$13,757.75 |
$8,393.40
|
|
Electrophysiology evaluation
|
$39,140.25 |
$39,140.25 |
$39,140.25 |
$6,516.00
|
|
Electrophysiology evaluation
|
$6,053.00 |
$6,053.00 |
$6,053.00 |
$2,845.10
|
|
Electrophysiology evaluation
|
$4,289.00 |
$4,289.00 |
$4,289.00 |
$2,630.40
|
|
Embolization s&i
|
$13,710.00 |
$13,710.00 |
$13,710.00 |
$2,869.75
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$2,287.50 |
$2,287.50 |
$2,287.50 |
$434.00
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$2,730.25 |
$2,730.25 |
$2,730.25 |
$512.85
|
|
Emg needle test 1-extremity
|
$1,801.50 |
$1,801.50 |
$1,801.50 |
$340.80
|
|
Emg needle test 4-extremities
|
$3,570.50 |
$3,570.50 |
$3,570.50 |
$547.00
|
|
Endo cath bile duct s&i
|
$6,467.50 |
$6,467.50 |
$6,467.50 |
$569.40
|
|
Entamoeba histolytica ag eia - sendout
|
$48.00 |
$48.00 |
$48.00 |
$66.60
|
|
Ep & ablate supravent arrhyt
|
$116,827.50 |
$116,827.50 |
$116,827.50 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$116,827.50 |
$116,827.50 |
$116,827.50 |
$30,975.00
|
|
Epoetin alfa, 100 units esrd
|
$15.00 |
$15.00 |
$15.00 |
$41.32
|
|
Epstein barr early antigen antibody
|
$95.75 |
$95.75 |
$95.75 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$95.75 |
$95.75 |
$95.75 |
$81.81
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$551.00 |
$551.00 |
$551.00 |
$323.00
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$165.00 |
$165.00 |
$165.00 |
$240.87
|
|
Esophageal dilat s&i
|
$2,665.00 |
$2,665.00 |
$2,665.00 |
$525.00
|
|
Esophagus motility study
|
$5,939.00 |
$5,939.00 |
$5,939.00 |
$1,289.20
|
|
Estradiol total
|
$52.75 |
$52.75 |
$52.75 |
$153.00
|
|
Estrogens total-sendout
|
$25.75 |
$25.75 |
$25.75 |
$85.20
|
|
Ethanolamine oleate 100 mg
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$1,011.00
|
|
Ethylene glycol -sendout
|
$17.75 |
$17.75 |
$17.75 |
$77.40
|
|
Euglobulin lysis
|
$66.25 |
$66.25 |
$66.25 |
$38.35
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$535.75 |
$535.75 |
$535.75 |
$221.00
|
|
Evaluation of speech fluency 92521
|
$170.00 |
$170.00 |
$170.00 |
$350.00
|
|
Evoked potentials upper limbs
|
$4,710.75 |
$4,710.75 |
$4,710.75 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$5,985.00 |
$5,985.00 |
$5,985.00 |
$852.80
|
|
External chromosome analysis 20-25 cells
|
$41.00 |
$41.00 |
$41.00 |
$389.35
|
|
F-18 fdg pet diag
|
$2,431.00 |
$2,431.00 |
$2,431.00 |
$609.85
|
|
Facial bones <3
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$241.75
|
|
Factor ix complex
|
$3.00 |
$3.00 |
$3.00 |
$3.23
|
|
Factor viii
|
$4.00 |
$4.00 |
$4.00 |
$1.60
|
|
Factor viii recombinant nos
|
$3.50 |
$3.50 |
$3.50 |
$4.80
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$12.50 |
$12.50 |
$12.50 |
$22.23
|
|
Feeding tube reposition
|
$13,242.50 |
$13,242.50 |
$13,242.50 |
$438.70
|
|
Felbamate (felbatol(r)) - sendout
|
$21.50 |
$21.50 |
$21.50 |
$66.43
|
|
Fetal biophys profile w/nst 76818
|
$3,351.25 |
$3,351.25 |
$3,351.25 |
$541.74
|
