|
Dornase alfa non-comp unit
|
$197.52 |
$197.52 |
$197.52 |
$356.00
|
|
Dornhoffer fixed part w/window
|
$30,998.00 |
$30,998.00 |
$30,998.00 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$561.55 |
$561.55 |
$561.55 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$227.56 |
$227.56 |
$227.56 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,197.72 |
$1,197.72 |
$1,197.72 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$112.19 |
$112.19 |
$112.19 |
$89.34
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,981.00 |
$1,981.00 |
$1,981.00 |
$800.00
|
|
Drainage external ear simple 69000
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$790.40
|
|
Drainage of bone lesion
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$3,153.60
|
|
Drainage of eye
|
$6,348.00 |
$6,348.00 |
$6,348.00 |
$2,415.65
|
|
Drainage of eye
|
$5,364.00 |
$5,364.00 |
$5,364.00 |
$3,170.00
|
|
Drainage of eye
|
$6,348.00 |
$6,348.00 |
$6,348.00 |
$3,494.40
|
|
Drainage of kidney lesion
|
$5,400.00 |
$5,400.00 |
$5,400.00 |
$1,506.00
|
|
Drainage of nose lesion int 30000
|
$713.00 |
$713.00 |
$713.00 |
$548.00
|
|
Drainage of pelvis bursa
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$2,840.80
|
|
Drainage of pelvis lesion 26990
|
$8,167.00 |
$8,167.00 |
$8,167.00 |
$3,863.70
|
|
Drainage of rectal abscess
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$2,135.10
|
|
Drainage of rectal abscess 45020
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,816.64
|
|
Drain blood from under nail 11740
|
$276.00 |
$276.00 |
$276.00 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,731.00 |
$2,731.00 |
$2,731.00 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$3,275.00 |
$3,275.00 |
$3,275.00 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$2,205.00 |
$2,205.00 |
$2,205.00 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$428.40
|
|
Drain lower leg bursa
|
$6,905.00 |
$6,905.00 |
$6,905.00 |
$4,289.60
|
|
Drain lower leg lesion 27603
|
$8,060.00 |
$8,060.00 |
$8,060.00 |
$3,994.09
|
|
Drain neck/chest lesion 21501
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,339.00
|
|
Drain shoulder bursa 23031
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$3,322.80
|
|
Drain shoulder lesion
|
$10,002.00 |
$10,002.00 |
$10,002.00 |
$3,904.61
|
|
Drain thigh/knee lesion 27301
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$1,294.00 |
$1,294.00 |
$1,294.00 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$71.00 |
$71.00 |
$71.00 |
$349.50
|
|
Dressing change not for burn w/anes 15852
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$755.08
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$134.68 |
$134.68 |
$134.68 |
$3,789.86
|
|
Drng hand tendon sheath 26020
|
$5,130.00 |
$5,130.00 |
$5,130.00 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$4,345.00 |
$4,345.00 |
$4,345.00 |
$2,079.50
|
|
Drng of hydrocele 55000
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$867.90
|
|
Drng of pelvic abscess transrectal 45000
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$2,295.30
|
|
Drng of scrotum abscess 55100
|
$4,484.00 |
$4,484.00 |
$4,484.00 |
$1,997.89
|
|
Drng salivary gland submax/subling 42310
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$799.40
|
|
Dronabinol 2.5mg oral
|
$30.97 |
$30.97 |
$30.97 |
$17.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$24.17 |
$24.17 |
$24.17 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$2,623.50 |
$2,623.50 |
$2,623.50 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$6.32 |
$6.32 |
$6.32 |
$119.50
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$160.30 |
$160.30 |
$160.30 |
$7,465.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$4,072.20 |
$4,072.20 |
$4,072.20 |
$376.50
|
|
Drug admin & hemodynmic meas
|
$257.00 |
$257.00 |
$257.00 |
$569.75
|
|
Drug assay posaconazole
|
$131.00 |
$131.00 |
$131.00 |
$96.75
|
|
Drug assay rufinamide
|
$107.00 |
$107.00 |
$107.00 |
$87.10
|
|
Drug assay vedolizumab
|
$153.00 |
$153.00 |
$153.00 |
$154.00
|
|
Drug assay voriconazole
|
$122.00 |
$122.00 |
$122.00 |
$96.75
|
|
Drug of abuse screen urine
|
$71.00 |
$71.00 |
$71.00 |
$67.89
|
|
Drug test def 15-21 classes
|
$759.00 |
$759.00 |
$759.00 |
$322.50
|
|
Drug test def 1-7 classes
|
$253.00 |
$253.00 |
$253.00 |
$263.25
|
|
Drug test def 22+ classes
|
$1,012.00 |
$1,012.00 |
$1,012.00 |
$426.24
|
|
Drug test def 8-14 classes
|
$507.00 |
$507.00 |
$507.00 |
$289.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$125.00 |
$125.00 |
$125.00 |
$278.85
|
|
Drvvt confirm - quest
|
$300.00 |
$300.00 |
$300.00 |
$109.20
|
|
Dstrj nulyt agt gnclr nrv
|
$8,936.00 |
$8,936.00 |
$8,936.00 |
$2,980.00
|
|
Duplex scan bilateral study 93985
|
$560.00 |
$560.00 |
$560.00 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$269.00 |
$269.00 |
$269.00 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$582.00 |
$582.00 |
$582.00 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$2,417.00 |
$2,417.00 |
$2,417.00 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,285.00 |
$2,285.00 |
$2,285.00 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$210.73 |
$210.73 |
$210.73 |
$8,445.90
|
|
Dxa bone density axl vrt fx
|
$388.00 |
$388.00 |
$388.00 |
$401.20
|
|
Dx bronchoscope/brush 31623
|
$3,126.00 |
$3,126.00 |
$3,126.00 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$3,126.00 |
$3,126.00 |
$3,126.00 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$3,007.00 |
$3,007.00 |
$3,007.00 |
$2,410.50
|
|
Dx intraop epcar Ultrasound chd i&r
|
$928.00 |
$928.00 |
$928.00 |
$465.29
|
|
Dx intraop epicar car Ultrasound chd
|
$1,228.00 |
$1,228.00 |
$1,228.00 |
$558.11
|
|
Dx intraop thoracic aorta Ultrasound
|
$742.00 |
$742.00 |
$742.00 |
$558.11
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$558.11
|
|
Ear cartilage graft
|
$15,440.00 |
$15,440.00 |
$15,440.00 |
$6,385.40
|
|
Ear irrigation 69209
|
$222.00 |
$222.00 |
$222.00 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$135.00 |
$135.00 |
$135.00 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$254.00 |
$254.00 |
$254.00 |
$412.88
|
|
Ecg external < 48 hours recording
|
$720.00 |
$720.00 |
$720.00 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$107.00 |
$107.00 |
$107.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$177.00 |
$177.00 |
$177.00 |
$173.40
|
|
Ecg record/review
|
$1,103.00 |
$1,103.00 |
$1,103.00 |
$371.28
|
|
Echocardiogram (Heart Ultrasound)
|
$4,390.00 |
$4,390.00 |
$4,390.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$4,390.00 |
$4,390.00 |
$4,390.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$5,737.00 |
$5,737.00 |
$5,737.00 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$4,390.00 |
$4,390.00 |
$4,390.00 |
$371.25
|
|
Echo exam of fetal heart
|
$258.00 |
$258.00 |
$258.00 |
$431.41
|
|
Echo exam uterus 76831-
|
$947.00 |
$947.00 |
$947.00 |
$561.00
|
|
Echograp trans r pros study
|
$1,517.00 |
$1,517.00 |
$1,517.00 |
$468.00
|
|
Echo guidance radiotherapy
|
$440.00 |
$440.00 |
$440.00 |
$812.00
|
|
Echo guide for amniocentesis
|
$717.00 |
$717.00 |
$717.00 |
$455.57
|
|
Echo guide for artery repair
|
$2,214.00 |
$2,214.00 |
$2,214.00 |
$696.30
|
|
Echo guide for heart biopsy
|
$1,270.00 |
$1,270.00 |
$1,270.00 |
$666.40
|
|
Echo stress
|
$2,306.00 |
$2,306.00 |
$2,306.00 |
$1,609.44
|
|
Echo tee guidance
|
$3,057.00 |
$3,057.00 |
$3,057.00 |
$1,878.84
|
|
Echo tee probe placement image acquisition interpretation & report
|
$4,446.00 |
$4,446.00 |
$4,446.00 |
$1,913.60
|
|
Echo transesophageal
|
$6,794.00 |
$6,794.00 |
$6,794.00 |
$1,650.00
|
|
Echo transesophageal intraop
|
$4,446.00 |
$4,446.00 |
$4,446.00 |
$1,578.00
|
