|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,287.27 |
$1,287.27 |
$1,287.27 |
|
|
Dextran 40 infusion
|
$214.13 |
$214.13 |
$214.13 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$14.75 |
$14.75 |
$29.10 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$14.87 |
$14.87 |
$44.10 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$13.76 |
$13.76 |
$99.87 |
|
|
Dextrose 5 % IV bolus
|
$13.81 |
$13.81 |
$13.81 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$83.52 |
$83.52 |
$139.50 |
|
|
Diabetes (HbA1c) Test
|
$61.76 |
$61.76 |
$67.50 |
|
|
Diab manage trn ind/group
|
$14.72 |
$14.72 |
$14.72 |
|
|
Diag bronchoscope/catheter
|
$4,758.00 |
$4,758.00 |
$4,758.00 |
|
|
Diag laparo separate proc 49320
|
$260.48 |
$260.48 |
$260.48 |
|
|
Diagnostic anoscopy & biopsy
|
$1,905.00 |
$1,905.00 |
$1,905.00 |
|
|
Diagnostic anoscopy spx 46600
|
$79.36 |
$79.36 |
$206.25 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$41.28 |
$41.28 |
$702.75 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$41.28 |
$41.28 |
$553.50 |
|
|
Diagnostic laryngoscopy 31505
|
$110.40 |
$110.40 |
$526.50 |
|
|
Diagnostic laryngoscopy 31575
|
$174.08 |
$174.08 |
$370.50 |
|
|
Diagnostic Mammogram (both breasts)
|
$228.16 |
$228.16 |
$540.75 |
|
|
Diagnostic Mammogram (one breast)
|
$173.44 |
$173.44 |
$393.00 |
|
|
Diagnostic radio unlisted proc
|
$34.88 |
$34.88 |
$87.00 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$469.76 |
$469.76 |
$5,770.50 |
|
|
Dialysis one evaluation
|
$406.08 |
$406.08 |
$1,059.00 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$152.93 |
$152.93 |
$152.93 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$39.50 |
$39.50 |
$106.76 |
|
|
Dicyclomine injection
|
$34.95 |
$34.95 |
$117.24 |
|
|
Difelikefalin, esrd on dialy
|
$354.75 |
$354.75 |
$354.75 |
|
|
Diffusing capacity
|
$186.56 |
$186.56 |
$264.00 |
|
|
Digital analysis of eeg
|
$980.25 |
$980.25 |
$980.25 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$12.16 |
$12.16 |
$326.04 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,642.91 |
$11,642.91 |
$11,642.91 |
|
|
Digoxin total therapeutic drug level
|
$72.64 |
$72.64 |
$129.75 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$249.45 |
$249.45 |
$249.45 |
|
|
Dilate biliary duct/ampulla
|
$1,334.25 |
$1,334.25 |
$1,334.25 |
|
|
Dilate esophagus 1/mult pass
|
$2,283.00 |
$2,283.00 |
$2,283.00 |
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,102.50 |
$1,102.50 |
$1,102.50 |
|
|
Dilate ic vasospasm ea add vsl same territory
|
$550.50 |
$550.50 |
$550.50 |
|
|
Dilate ic vasospasm init
|
$1,566.00 |
$1,566.00 |
$1,566.00 |
|
|
Dilate urethra stricture
|
$49.60 |
$49.60 |
$49.60 |
|
|
Dilation/female urethra/initial 53660
|
$33.28 |
$33.28 |
$268.50 |
|
|
Dilator fascial 10fx20cm
|
$736.88 |
$736.88 |
$1,016.96 |
|
|
Dilat xst trc ndurlgc px
|
$6,298.50 |
$6,298.50 |
$6,298.50 |
|
|
Diltiazem 5 mg/ml intravenous solution
|
$12.05 |
$12.05 |
$73.73 |
|
|
Dimecaprol injection
|
$379.18 |
$379.18 |
$379.18 |
|
|
Dimenhydrinate injection
|
$43.96 |
$43.96 |
$43.96 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,711.37 |
$1,711.37 |
$1,711.37 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.34 |
$7.34 |
$14.52 |
|
|
Dipyridamole injection
|
$64.34 |
$64.34 |
$64.34 |
|
|
Disability dlco
|
$170.24 |
$170.24 |
$279.75 |
|
|
Disaccharidases
|
$113.25 |
$113.25 |
$214.40 |
|
|
Discography cerv/thor spine
|
$759.68 |
$759.68 |
$5,006.25 |
|
|
Diverticulectomy/hypophar/esoph 43130
|
$301.12 |
$301.12 |
$301.12 |
|
|
Division of fallopian tube 58605
|
$272.96 |
$272.96 |
$272.96 |
|
|
#d/lmeth-l-methamphetamine
|
$86.25 |
$86.25 |
$86.25 |
|
|
Dlyd plmt xtn prosth ea addl
|
$100.48 |
$100.48 |
$100.48 |
|
|
Dmd dup/delet analysis
|
$27.75 |
$27.75 |
$272.00 |
|
|
Dna antibody native/double stranded
|
$13.44 |
$13.44 |
$105.00 |
|
|
Dna gardnerella
|
$18.24 |
$18.24 |
$105.75 |
|
|
Dna probe chlamydia
|
$122.25 |
$122.25 |
$122.25 |
|
|
Dna probe gc
|
$132.75 |
$132.75 |
$132.75 |
|
|
Dna trichomonas
|
$28.48 |
$28.48 |
$105.75 |
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$52.15 |
$52.15 |
$126.15 |
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4.46 |
$4.46 |
$1,211.80 |
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$18.54 |
$18.54 |
$73.88 |
|
|
Doppler echo complete
|
$305.28 |
$305.28 |
$382.50 |
|
|
Doppler intravascular pressure flow initial vessel
|
$305.28 |
$305.28 |
$675.00 |
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$213.76 |
$213.76 |
$468.00 |
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$145.28 |
$145.28 |
$373.50 |
|
|
Dornhoffer fixed part w/window
|
$3,429.76 |
$3,429.76 |
$12,072.00 |
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$26,019.13 |
$26,019.13 |
$26,019.13 |
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$43.52 |
$43.52 |
$649.25 |
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,301.21 |
$2,301.21 |
$2,301.21 |
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$27.19 |
$27.19 |
$84.33 |
|
|
Dpyd gene common variants
|
$139.20 |
$139.20 |
$139.20 |
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$274.88 |
$274.88 |
$1,030.50 |
|
|
Drainage ext aud canal abscess 69020
|
$1,030.50 |
$1,030.50 |
$1,030.50 |
|
|
Drainage external ear complex 69005
|
$921.92 |
$921.92 |
$921.92 |
|
|
Drainage external ear simple 69000
|
$400.32 |
$400.32 |
$2,059.50 |
|
|
Drainage mouth roof lesion
|
$603.00 |
$603.00 |
$603.00 |
|
|
Drainage of kidney lesion
|
$614.72 |
$614.72 |
$2,059.50 |
|
|
Drainage of mouth lesion
|
$648.75 |
$648.75 |
$648.75 |
|
|
Drainage of mouth lesion
|
$281.92 |
$281.92 |
$281.92 |
|
|
Drainage of pelvis lesion 26990
|
$565.44 |
$565.44 |
$565.44 |
|
|
Drainage of prostate abscess
|
$422.08 |
$422.08 |
$422.08 |
|
|
Drainage of prostate abscess
|
$6,298.50 |
$6,298.50 |
$6,298.50 |
|
|
Drainage of rectal abscess
|
$3,024.75 |
$3,024.75 |
$3,024.75 |
|
|
Drainage of throat abscess
|
$647.36 |
$647.36 |
$647.36 |
|
|
Drain blood from under nail 11740
|
$137.25 |
$137.25 |
$137.25 |
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,085.44 |
$1,085.44 |
$4,138.50 |
|
|
Drain cath image guided visceral pq
|
$1,565.12 |
$1,565.12 |
$4,845.75 |
|
|
Drain cerebro spinal fluid 62272
|
$393.92 |
$393.92 |
$1,953.75 |
|
|
Drain finger abscess;simple 26010
|
$119.04 |
$119.04 |
$606.75 |
|
|
Drain neck/chest lesion 21501
|
$280.32 |
$280.32 |
$280.32 |
|
|
Drain ovarn cyst abd
|
$1,809.28 |
$1,809.28 |
$5,478.00 |
|
|
Drain penis lesion
|
$241.92 |
$241.92 |
$241.92 |
|
|
Drain shoulder lesion
|
$199.04 |
$199.04 |
$199.04 |
|
|
Drain thigh/knee lesion 27301
|
$417.28 |
$417.28 |
$5,572.50 |
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$549.00 |
$549.00 |
$549.00 |
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$520.50 |
$520.50 |
$520.50 |
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$11.25 |
$11.25 |
$11.25 |
|
|
Drng hand tendon sheath 26020
|
$6,339.00 |
$6,339.00 |
$6,339.00 |
|