|
Diabetes (HbA1c) Test
|
$61.76 |
$61.76 |
$61.76 |
$79.20
|
|
Diab manage trn ind/group
|
$14.72 |
$14.72 |
$14.72 |
$56.55
|
|
Diag laparo separate proc 49320
|
$260.48 |
$260.48 |
$260.48 |
$6,904.15
|
|
Diagnostic anoscopy spx 46600
|
$79.36 |
$79.36 |
$79.36 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$41.28 |
$41.28 |
$41.28 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$41.28 |
$41.28 |
$41.28 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$110.40 |
$110.40 |
$110.40 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$174.08 |
$174.08 |
$174.08 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$228.16 |
$228.16 |
$228.16 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$173.44 |
$173.44 |
$173.44 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$34.88 |
$34.88 |
$34.88 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$469.76 |
$469.76 |
$469.76 |
$5,419.00
|
|
Dialysis one evaluation
|
$406.08 |
$406.08 |
$406.08 |
$919.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$39.50 |
$39.50 |
$39.50 |
$74.76
|
|
Dicyclomine injection
|
$34.95 |
$34.95 |
$34.95 |
$153.29
|
|
Diffusing capacity
|
$186.56 |
$186.56 |
$186.56 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$12.16 |
$12.16 |
$12.16 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$72.64 |
$72.64 |
$72.64 |
$102.00
|
|
Dilate urethra stricture
|
$49.60 |
$49.60 |
$49.60 |
$490.00
|
|
Dilation/female urethra/initial 53660
|
$33.28 |
$33.28 |
$33.28 |
$235.61
|
|
Dilator fascial 10fx20cm
|
$1,016.96 |
$1,016.96 |
$1,016.96 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$12.05 |
$12.05 |
$12.05 |
$47.94
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$14.52 |
$14.52 |
$14.52 |
$17.75
|
|
Disability dlco
|
$170.24 |
$170.24 |
$170.24 |
$282.40
|
|
Disaccharidases
|
$214.40 |
$214.40 |
$214.40 |
$216.00
|
|
Discography cerv/thor spine
|
$759.68 |
$759.68 |
$759.68 |
$2,565.00
|
|
Diverticulectomy/hypophar/esoph 43130
|
$301.12 |
$301.12 |
$301.12 |
$6,465.11
|
|
Division of fallopian tube 58605
|
$272.96 |
$272.96 |
$272.96 |
$832.00
|
|
Dlyd plmt xtn prosth ea addl
|
$100.48 |
$100.48 |
$100.48 |
$1,582.68
|
|
Dmd dup/delet analysis
|
$272.00 |
$272.00 |
$272.00 |
$404.03
|
|
Dna antibody native/double stranded
|
$13.44 |
$13.44 |
$13.44 |
$97.50
|
|
Dna gardnerella
|
$18.24 |
$18.24 |
$18.24 |
$62.50
|
|
Dna trichomonas
|
$28.48 |
$28.48 |
$28.48 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$52.15 |
$52.15 |
$52.15 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4.46 |
$4.46 |
$4.46 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$18.54 |
$18.54 |
$18.54 |
$65.40
|
|
Doppler echo complete
|
$305.28 |
$305.28 |
$305.28 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$305.28 |
$305.28 |
$305.28 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$213.76 |
$213.76 |
$213.76 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$145.28 |
$145.28 |
$145.28 |
$471.17
|
|
Dornhoffer fixed part w/window
|
$3,429.76 |
$3,429.76 |
$3,429.76 |
$34,278.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$43.52 |
$43.52 |
$43.52 |
$423.95
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$27.19 |
$27.19 |
$27.19 |
$84.80
|
|
Dpyd gene common variants
|
$139.20 |
$139.20 |
$139.20 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$274.88 |
$274.88 |
$274.88 |
$800.00
|
|
Drainage external ear complex 69005
|
$921.92 |
$921.92 |
$921.92 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$400.32 |
$400.32 |
$400.32 |
$789.60
|
|
Drainage of kidney lesion
|
$614.72 |
$614.72 |
$614.72 |
$1,506.00
|
|
Drainage of mouth lesion
|
$281.92 |
$281.92 |
$281.92 |
$1,752.89
|
|
Drainage of pelvis lesion 26990
|
$565.44 |
$565.44 |
$565.44 |
$3,958.50
|
|
Drainage of prostate abscess
|
$422.08 |
$422.08 |
$422.08 |
$4,081.37
|
|
Drainage of throat abscess
|
$647.36 |
$647.36 |
$647.36 |
$6,465.11
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,085.44 |
$1,085.44 |
$1,085.44 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$1,565.12 |
$1,565.12 |
$1,565.12 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$393.92 |
$393.92 |
$393.92 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$119.04 |
$119.04 |
$119.04 |
$419.00
|
|
Drain neck/chest lesion 21501
|
$280.32 |
$280.32 |
$280.32 |
$3,339.00
|
|
Drain ovarn cyst abd
|
$1,809.28 |
$1,809.28 |
$1,809.28 |
$3,964.27
|
|
Drain penis lesion
|
$241.92 |
$241.92 |
$241.92 |
$2,112.60
|
|
Drain shoulder lesion
|
$199.04 |
$199.04 |
$199.04 |
$3,904.61
|
|
Drain thigh/knee lesion 27301
|
$417.28 |
$417.28 |
$417.28 |
$3,620.47
|
|
Drng of finger abscess comp 26011
|
$154.56 |
$154.56 |
$154.56 |
$1,943.50
|
|
Drng of ovarian cyst(s) 58800
|
$257.92 |
$257.92 |
$257.92 |
$3,474.84
|
|
Drng of scrotum abscess 55100
|
$137.60 |
$137.60 |
$137.60 |
$1,917.33
|
|
Drng open retroperitoneal abscess 49060
|
$850.56 |
$850.56 |
$850.56 |
$1,924.00
|
|
Drng peritoneal abscess open 49020
|
$1,237.12 |
$1,237.12 |
$1,237.12 |
$2,520.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$15.69 |
$15.69 |
$15.69 |
$31.07
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$2,255.36 |
$2,255.36 |
$2,255.36 |
$1,956.48
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$9,828.16 |
$9,828.16 |
$9,828.16 |
$8,040.27
|
|
Drug admin & hemodynmic meas
|
$547.52 |
$547.52 |
$547.52 |
$569.75
|
|
Drug assay caffeine
|
$25.92 |
$25.92 |
$25.92 |
$83.40
|
|
Drug assay vedolizumab
|
$24.96 |
$24.96 |
$24.96 |
$152.79
|
|
Drug of abuse screen urine
|
$11.84 |
$11.84 |
$11.84 |
$63.75
|
|
Drug screening tapentadol
|
$6.88 |
$6.88 |
$6.88 |
$36.00
|
|
Drug screen quant tiagabine
|
$27.84 |
$27.84 |
$27.84 |
$114.62
|
|
Drug test prsmv instrmnt
|
$65.92 |
$65.92 |
$65.92 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$320.64 |
$320.64 |
$320.64 |
$278.85
|
|
Drvvt confirm - quest
|
$17.28 |
$17.28 |
$17.28 |
$109.20
|
|
Ductogram sgl duct
|
$134.72 |
$134.72 |
$134.72 |
$463.10
|
|
Duplex scan bilateral study 93985
|
$271.36 |
$271.36 |
$271.36 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$135.68 |
$135.68 |
$135.68 |
$360.75
|
|
Dup scan/hemodialysis access 93990
|
$170.88 |
$170.88 |
$170.88 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$427.52 |
$427.52 |
$427.52 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$342.72 |
$342.72 |
$342.72 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$2,704.61 |
$2,704.61 |
$2,704.61 |
$7,973.90
|
|
Dx bronchoscope/wash 31622
|
$1,825.28 |
$1,825.28 |
$1,825.28 |
$2,322.60
|
|
Dx laryngoscopy w/oper scope
|
$124.80 |
$124.80 |
$124.80 |
$2,607.00
|
|
Ear and throat examination
|
$77.76 |
$77.76 |
$77.76 |
$602.63
|
|
Ear canal biopsy 69105
|
$842.88 |
$842.88 |
$842.88 |
$1,889.50
|
|
Ecg 12 lead tracing only
|
$135.68 |
$135.68 |
$135.68 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$27.20 |
$27.20 |
$27.20 |
$135.80
|
|
Ecg external < 48 hours recording
|
$359.68 |
$359.68 |
$359.68 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$256.32 |
$256.32 |
$256.32 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$33.92 |
$33.92 |
$33.92 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$93.12 |
$93.12 |
$93.12 |
$161.85
|
|
Ecg record/review
|
$155.52 |
$155.52 |
$155.52 |
$251.20
|
|
Ecg/review interpret only
|
$18.88 |
$18.88 |
$18.88 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$614.40 |
$614.40 |
$614.40 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$305.28 |
$305.28 |
$305.28 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$76.16 |
$76.16 |
$76.16 |
$1,943.50
|
