|
Destruction anal lesion(s) smpl chem 46900
|
$678.30 |
$678.30 |
$678.30 |
$557.90
|
|
Destruction benign lesions < 14 lesions
|
$154.70 |
$154.70 |
$154.70 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$2,856.00 |
$2,856.00 |
$2,856.00 |
$1,626.35
|
|
Detect agent nos dna dir
|
$105.00 |
$105.00 |
$105.00 |
$145.80
|
|
Detect agnt mult dna direc
|
$209.30 |
$209.30 |
$209.30 |
$166.77
|
|
Devel tst phys/qhp 1st hr
|
$399.00 |
$399.00 |
$399.00 |
$350.40
|
|
Device ablt adv novasure
|
$23,484.99 |
$23,484.99 |
$23,484.99 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,992.30 |
$6,992.30 |
$6,992.30 |
$4,200.00
|
|
Device intraute mirena
|
$6,680.10 |
$6,680.10 |
$6,680.10 |
$2,125.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$199.50 |
$199.50 |
$199.50 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$368.20 |
$368.20 |
$368.20 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$32.55 |
$32.55 |
$32.55 |
$6.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$458.85 |
$458.85 |
$458.85 |
$21.20
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$997.15 |
$997.15 |
$997.15 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$309.05 |
$309.05 |
$309.05 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$279.65 |
$279.65 |
$279.65 |
$42.50
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$515.02 |
$515.02 |
$515.02 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$442.92 |
$442.92 |
$442.92 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$163.10 |
$163.10 |
$163.10 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$116.90 |
$116.90 |
$116.90 |
$79.20
|
|
Diag laparo separate proc 49320
|
$30,756.28 |
$30,756.28 |
$30,756.28 |
$6,904.15
|
|
Diagnostic anoscopy
|
$618.80 |
$618.80 |
$618.80 |
$392.70
|
|
Diagnostic anoscopy & biopsy
|
$3,735.90 |
$3,735.90 |
$3,735.90 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$261.80 |
$261.80 |
$261.80 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$112.70 |
$112.70 |
$112.70 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$102.20 |
$102.20 |
$102.20 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$513.80 |
$513.80 |
$513.80 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$464.80 |
$464.80 |
$464.80 |
$312.72
|
|
Diagnostic radio unlisted proc
|
$5,055.40 |
$5,055.40 |
$5,055.40 |
$243.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,066.70 |
$3,066.70 |
$3,066.70 |
$5,663.50
|
|
Dialysis one evaluation
|
$1,488.90 |
$1,488.90 |
$1,488.90 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$584.50 |
$584.50 |
$584.50 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$1,661.80 |
$1,661.80 |
$1,661.80 |
$77.25
|
|
Dicyclomine injection
|
$320.95 |
$320.95 |
$320.95 |
$150.91
|
|
Diffusing capacity
|
$403.90 |
$403.90 |
$403.90 |
$335.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$148.22 |
$148.22 |
$148.22 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$13,474.82 |
$13,474.82 |
$13,474.82 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$140.00 |
$140.00 |
$140.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$422.62 |
$422.62 |
$422.62 |
$297.86
|
|
Dilate urethra stricture
|
$1,451.10 |
$1,451.10 |
$1,451.10 |
$496.00
|
|
Dilate urethra stricture
|
$89,208.53 |
$89,208.53 |
$89,208.53 |
$3,863.60
|
|
Dilation of anal sphincter
|
$9,625.01 |
$9,625.01 |
$9,625.01 |
$1,995.20
|
|
Dilation of cervical canal 57800
|
$4,780.30 |
$4,780.30 |
$4,780.30 |
$4,376.00
|
|
Dilation of rectal stricture 45910
|
$8,290.47 |
$8,290.47 |
$8,290.47 |
$2,263.80
|
|
Dilation of salivary duct
|
$6,040.30 |
$6,040.30 |
$6,040.30 |
$750.00
|
|
Dilator fascial 10fx20cm
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$3,789.80 |
$3,789.80 |
$3,789.80 |
$3,883.16
|
|
Dilat xst trc new access rcs
|
$7,464.80 |
$7,464.80 |
$7,464.80 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$387.62 |
$387.62 |
$387.62 |
$46.56
|
|
Dimethyl sulfoxide 50% 50 ml
|
$4,727.45 |
$4,727.45 |
$4,727.45 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.17 |
$7.17 |
$7.17 |
$18.35
|
|
Disaccharidases
|
$623.70 |
$623.70 |
$623.70 |
$224.31
|
|
Dissolve clot heart vessel
|
$1,688.40 |
$1,688.40 |
$1,688.40 |
$1,560.00
|
|
Dlyd plmt xtn prosth ea addl
|
$4,795.00 |
$4,795.00 |
$4,795.00 |
$1,875.00
|
|
Dmd dup/delet analysis
|
$644.70 |
$644.70 |
$644.70 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$316.40 |
$316.40 |
$316.40 |
$313.60
|
|
Dna antibody native/double stranded
|
$102.90 |
$102.90 |
$102.90 |
$100.00
|
|
Dna gardnerella
|
$139.30 |
$139.30 |
$139.30 |
$61.80
|
|
Dna trichomonas
|
$143.50 |
$143.50 |
$143.50 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$332.67 |
$332.67 |
$332.67 |
$98.29
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2,609.07 |
$2,609.07 |
$2,609.07 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$164.32 |
$164.32 |
$164.32 |
$67.28
|
|
Doppler echo complete
|
$1,038.10 |
$1,038.10 |
$1,038.10 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$4,260.20 |
$4,260.20 |
$4,260.20 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$762.30 |
$762.30 |
$762.30 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$223.30 |
$223.30 |
$223.30 |
$473.76
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$35,172.55 |
$35,172.55 |
$35,172.55 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$457.97 |
$457.97 |
$457.97 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$6,324.50 |
$6,324.50 |
$6,324.50 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$139.30 |
$139.30 |
$139.30 |
$84.80
|
|
Dpyd gene common variants
|
$1,582.70 |
$1,582.70 |
$1,582.70 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$308.70 |
$308.70 |
$308.70 |
$794.82
|
|
Drainage ext aud canal abscess 69020
|
$1,531.60 |
$1,531.60 |
$1,531.60 |
$914.34
|
|
Drainage external ear complex 69005
|
$3,717.00 |
$3,717.00 |
$3,717.00 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$231.00 |
$231.00 |
$231.00 |
$779.45
|
|
Drainage mouth roof lesion
|
$1,015.00 |
$1,015.00 |
$1,015.00 |
$405.60
|
|
Drainage of eye
|
$5,379.50 |
$5,379.50 |
$5,379.50 |
$2,415.65
|
|
Drainage of kidney lesion
|
$2,650.90 |
$2,650.90 |
$2,650.90 |
$1,506.00
|
|
Drainage of mouth lesion
|
$751.80 |
$751.80 |
$751.80 |
$535.20
|
|
Drainage of nose lesion int 30000
|
$742.70 |
$742.70 |
$742.70 |
$548.00
|
|
Drainage of salivary gland
|
$5,553.10 |
$5,553.10 |
$5,553.10 |
$4,560.40
|
|
Drainage of urethra abscess 53060
|
$3,805.20 |
$3,805.20 |
$3,805.20 |
$2,424.12
|
|
Drain bladder by trocar/cath
|
$556.50 |
$556.50 |
$556.50 |
$1,198.14
|
|
Drain blood from under nail 11740
|
$249.20 |
$249.20 |
$249.20 |
$177.04
|
|
Drain cath image guided visceral pq
|
$5,957.92 |
$5,957.92 |
$5,957.92 |
$2,885.30
|
|
Drain finger abscess;simple 26010
|
$657.30 |
$657.30 |
$657.30 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$5,505.50 |
$5,505.50 |
$5,505.50 |
$3,824.50
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$679.70 |
$679.70 |
$679.70 |
$394.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$202.30 |
$202.30 |
$202.30 |
$352.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$3,215.13 |
$3,215.13 |
$3,215.13 |
$5,857.52
|
|
Drill hole implt ventricular cath/device 61107
|
$1,912.40 |
$1,912.40 |
$1,912.40 |
$1,485.75
|
|
Drng hand tendon sheath 26020
|
$3,556.00 |
$3,556.00 |
$3,556.00 |
$3,839.54
|
|
Drng of finger abscess comp 26011
|
$3,997.70 |
$3,997.70 |
$3,997.70 |
$2,029.60
|
|
Drng of hydrocele 55000
|
$2,342.20 |
$2,342.20 |
$2,342.20 |
$832.60
|
|
Drng of ovarian cyst(s) 58800
|
$5,700.80 |
$5,700.80 |
$5,700.80 |
$3,474.84
|
|
Drng of scrotum abscess 55100
|
$13,537.71 |
$13,537.71 |
$13,537.71 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$397.42 |
$397.42 |
$397.42 |
$31.26
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,960.17 |
$1,960.17 |
$1,960.17 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$487.54 |
$487.54 |
$487.54 |
$8,040.27
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$640.58 |
$640.58 |
$640.58 |
$400.98
|