|
Dextrose 5 % IV bolus
|
$215.80 |
$215.80 |
$215.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$26.65 |
$26.65 |
$26.65 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$309.40 |
$309.40 |
$309.40 |
$79.30
|
|
Diagnostic digital breast tomosynthesis bil
|
$162.50 |
$162.50 |
$162.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$162.50 |
$162.50 |
$162.50 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$560.30 |
$560.30 |
$560.30 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$432.25 |
$432.25 |
$432.25 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,437.85 |
$3,437.85 |
$3,437.85 |
$5,741.00
|
|
Dialysis one evaluation
|
$2,858.70 |
$2,858.70 |
$2,858.70 |
$936.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$230.75 |
$230.75 |
$230.75 |
$79.71
|
|
Dicyclomine injection
|
$318.50 |
$318.50 |
$318.50 |
$154.33
|
|
Diffusing capacity
|
$326.30 |
$326.30 |
$326.30 |
$336.80
|
|
Digital analysis of eeg
|
$904.80 |
$904.80 |
$904.80 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$1,078.35 |
$1,078.35 |
$1,078.35 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$21,362.25 |
$21,362.25 |
$21,362.25 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$199.55 |
$199.55 |
$199.55 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$778.70 |
$778.70 |
$778.70 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,217.45 |
$1,217.45 |
$1,217.45 |
$1,866.73
|
|
Dilate esophagus
|
$1,421.55 |
$1,421.55 |
$1,421.55 |
$2,142.40
|
|
Dilator fascial 10fx20cm
|
$1,030.90 |
$1,030.90 |
$1,030.90 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$12,504.05 |
$12,504.05 |
$12,504.05 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$21,035.30 |
$21,035.30 |
$21,035.30 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$2.60 |
$2.60 |
$2.60 |
$45.60
|
|
Dimecaprol injection
|
$473.20 |
$473.20 |
$473.20 |
$314.63
|
|
Dimethyl sulfoxide 50% 50 ml
|
$859.30 |
$859.30 |
$859.30 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$24.70 |
$24.70 |
$24.70 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$114.40 |
$114.40 |
$114.40 |
$98.15
|
|
Disability dlco
|
$680.55 |
$680.55 |
$680.55 |
$293.76
|
|
Disaccharidases
|
$656.50 |
$656.50 |
$656.50 |
$230.40
|
|
Discography cerv/thor spine
|
$3,250.00 |
$3,250.00 |
$3,250.00 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$4,258.80 |
$4,258.80 |
$4,258.80 |
$1,579.93
|
|
Dist revas ligation hemo
|
$27,662.05 |
$27,662.05 |
$27,662.05 |
$6,396.89
|
|
Dlyd plmt xtn prosth ea addl
|
$10,671.05 |
$10,671.05 |
$10,671.05 |
$1,810.80
|
|
Dna antibody native/double stranded
|
$87.10 |
$87.10 |
$87.10 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$669.50 |
$669.50 |
$669.50 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$31.85 |
$31.85 |
$31.85 |
$949.39
|
|
Docetaxel (docivyx), 1 mg
|
$242.45 |
$242.45 |
$242.45 |
$108.86
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$185.25 |
$185.25 |
$185.25 |
$65.40
|
|
Doppler echo complete
|
$1,043.90 |
$1,043.90 |
$1,043.90 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$4,404.40 |
$4,404.40 |
$4,404.40 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$830.70 |
$830.70 |
$830.70 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$403.65 |
$403.65 |
$403.65 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$86,724.95 |
$86,724.95 |
$86,724.95 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$973.70 |
$973.70 |
$973.70 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$48.75 |
$48.75 |
$48.75 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,415.70 |
$1,415.70 |
$1,415.70 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$2.60 |
$2.60 |
$2.60 |
$89.34
|
|
Dpyd gene common variants
|
$362.05 |
$362.05 |
$362.05 |
$423.60
|
|
Drainage of kidney lesion
|
$3,857.10 |
$3,857.10 |
$3,857.10 |
$1,506.00
|
|
Drainage of pelvis lesion 26990
|
$5,941.00 |
$5,941.00 |
$5,941.00 |
$3,863.70
|
|
Drain blood from under nail 11740
|
$303.55 |
$303.55 |
$303.55 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,418.95 |
$1,418.95 |
$1,418.95 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$2,250.30 |
$2,250.30 |
$2,250.30 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,210.30 |
$1,210.30 |
$1,210.30 |
$1,044.00
|
|
Drain lower leg lesion 27603
|
$3,858.40 |
$3,858.40 |
$3,858.40 |
$3,994.09
|
|
Drain ostomy pouch w/flange
|
$9.75 |
$9.75 |
$9.75 |
$8.80
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$728.65 |
$728.65 |
$728.65 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$693.55 |
$693.55 |
$693.55 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,098.50 |
$1,098.50 |
$1,098.50 |
$541.00
|
|
Dressing change not for burn w/anes 15852
|
$1,734.20 |
$1,734.20 |
$1,734.20 |
$755.08
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$39,711.10 |
$39,711.10 |
$39,711.10 |
$3,789.86
|
|
Drm agrft f/s/n/h/f/g/m ea
|
$4,966.00 |
$4,966.00 |
$4,966.00 |
$3,808.00
|
|
Drm agrft t/a/l ea addl
|
$4,215.90 |
$4,215.90 |
$4,215.90 |
$1,793.59
|
|
Droperidol 2.5 mg/ml injection solution
|
$102.05 |
$102.05 |
$102.05 |
$31.25
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$1,380.60 |
$1,380.60 |
$1,380.60 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$193.15
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$18,339.75 |
$18,339.75 |
$18,339.75 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$62,936.25 |
$62,936.25 |
$62,936.25 |
$7,465.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$43,844.45 |
$43,844.45 |
$43,844.45 |
$376.50
|
|
Drug admin & hemodynmic meas
|
$257.40 |
$257.40 |
$257.40 |
$569.75
|
|
Drug assay caffeine
|
$199.55 |
$199.55 |
$199.55 |
$80.00
|
|
Drug assay posaconazole
|
$628.55 |
$628.55 |
$628.55 |
$96.75
|
|
Drug of abuse screen urine
|
$14.30 |
$14.30 |
$14.30 |
$67.89
|
|
Drug screening tapentadol
|
$7.15 |
$7.15 |
$7.15 |
$47.03
|
|
Drug/substance nos 4-6
|
$7.15 |
$7.15 |
$7.15 |
$72.14
|
|
Drug test def 22+ classes
|
$221.65 |
$221.65 |
$221.65 |
$426.24
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$369.20 |
$369.20 |
$369.20 |
$278.85
|
|
Dstr mal les s/n/h/f/g >4.0
|
$1,147.25 |
$1,147.25 |
$1,147.25 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$1,655.55 |
$1,655.55 |
$1,655.55 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$1,127.10 |
$1,127.10 |
$1,127.10 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$1,784.25 |
$1,784.25 |
$1,784.25 |
$886.40
|
|
Ductogram sgl duct
|
$744.25 |
$744.25 |
$744.25 |
$469.80
|
|
Duodenal motility study
|
$1,352.00 |
$1,352.00 |
$1,352.00 |
$1,143.10
|
|
Duplex scan bilateral study 93985
|
$836.55 |
$836.55 |
$836.55 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$403.00 |
$403.00 |
$403.00 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$848.90 |
$848.90 |
$848.90 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$833.30 |
$833.30 |
$833.30 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,221.35 |
$1,221.35 |
$1,221.35 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$345.80 |
$345.80 |
$345.80 |
$8,445.90
|
|
Dx intraop epcar Ultrasound chd i&r
|
$976.95 |
$976.95 |
$976.95 |
$465.29
|
|
Dx intraop epicar car Ultrasound chd
|
$976.95 |
$976.95 |
$976.95 |
$558.11
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$976.95 |
$976.95 |
$976.95 |
$558.11
|
|
Ecallantide injection
|
$3,913.65 |
$3,913.65 |
$3,913.65 |
$13,357.14
|
|
Ecg/1-3 leads/tracing only 93041
|
$157.30 |
$157.30 |
$157.30 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$315.25 |
$315.25 |
$315.25 |
$412.88
|
|
Ecg external < 48 hours recording
|
$1,485.90 |
$1,485.90 |
$1,485.90 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,341.60 |
$1,341.60 |
$1,341.60 |
$541.20
|
|
Ecg external >7 days up to 15 days recording
|
$446.55 |
$446.55 |
$446.55 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$4,108.65 |
$4,108.65 |
$4,108.65 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$851.50 |
$851.50 |
$851.50 |
$720.60
|
