|
Diagnostic Mammogram (one breast)
|
$264.96 |
$264.96 |
$264.96 |
$301.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$58.18 |
$58.18 |
$58.18 |
$74.76
|
|
Dicyclomine injection
|
$134.78 |
$134.78 |
$134.78 |
$153.29
|
|
Diffusing capacity
|
$468.72 |
$468.72 |
$468.72 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$19.01 |
$19.01 |
$19.01 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$172.08 |
$172.08 |
$172.08 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$516.67 |
$516.67 |
$516.67 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$108.00 |
$108.00 |
$108.00 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$0.26 |
$0.26 |
$0.26 |
$47.94
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$12.96 |
$12.96 |
$12.96 |
$17.75
|
|
Disaccharidases
|
$439.20 |
$439.20 |
$439.20 |
$216.00
|
|
Dna antibody native/double stranded
|
$162.00 |
$162.00 |
$162.00 |
$97.50
|
|
Dna gardnerella
|
$117.36 |
$117.36 |
$117.36 |
$62.50
|
|
Dna probe chlamydia
|
$105.12 |
$105.12 |
$105.12 |
$79.38
|
|
Dna probe gc
|
$92.88 |
$92.88 |
$92.88 |
$80.80
|
|
Dna trichomonas
|
$117.36 |
$117.36 |
$117.36 |
$67.80
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$454.32 |
$454.32 |
$454.32 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$779.76 |
$779.76 |
$779.76 |
$471.17
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.87 |
$0.87 |
$0.87 |
$84.80
|
|
Dpyd gene common variants
|
$236.88 |
$236.88 |
$236.88 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,391.76 |
$1,391.76 |
$1,391.76 |
$800.00
|
|
Drainage external ear simple 69000
|
$1,391.76 |
$1,391.76 |
$1,391.76 |
$789.60
|
|
Drainage of arm bursa 23931
|
$3,704.40 |
$3,704.40 |
$3,704.40 |
$2,197.48
|
|
Drainage of mouth lesion
|
$250.56 |
$250.56 |
$250.56 |
$489.00
|
|
Drainage of mouth lesion
|
$3,087.36 |
$3,087.36 |
$3,087.36 |
$1,752.89
|
|
Drainage of urethra abscess 53060
|
$2,212.56 |
$2,212.56 |
$2,212.56 |
$2,424.12
|
|
Drain blood from under nail 11740
|
$138.96 |
$138.96 |
$138.96 |
$170.50
|
|
Drain finger abscess;simple 26010
|
$418.32 |
$418.32 |
$418.32 |
$419.00
|
|
Drain thigh/knee lesion 27301
|
$5,292.72 |
$5,292.72 |
$5,292.72 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$262.80 |
$262.80 |
$262.80 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$222.48 |
$222.48 |
$222.48 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$431.28 |
$431.28 |
$431.28 |
$523.00
|
|
Drng of finger abscess comp 26011
|
$3,211.20 |
$3,211.20 |
$3,211.20 |
$1,943.50
|
|
Drng of scrotum abscess 55100
|
$3,165.12 |
$3,165.12 |
$3,165.12 |
$1,917.33
|
|
Droperidol 2.5 mg/ml injection solution
|
$36.76 |
$36.76 |
$36.76 |
$31.07
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$12.96 |
$12.96 |
$12.96 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$756.00 |
$756.00 |
$756.00 |
$289.05
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$338.40 |
$338.40 |
$338.40 |
$400.98
|
|
Drug assay vedolizumab
|
$228.96 |
$228.96 |
$228.96 |
$152.79
|
|
Drug test def 1-7 classes
|
$173.52 |
$173.52 |
$173.52 |
$250.52
|
|
Drug test def 22+ classes
|
$311.04 |
$311.04 |
$311.04 |
$423.00
|
|
Drug test prsmv instrmnt
|
$257.76 |
$257.76 |
$257.76 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$269.28 |
$269.28 |
$269.28 |
$278.85
|
|
Drvvt confirm - quest
|
$86.40 |
$86.40 |
$86.40 |
$109.20
|
|
Ductogram sgl duct
|
$469.44 |
$469.44 |
$469.44 |
$463.10
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,463.12 |
$2,463.12 |
$2,463.12 |
$887.25
|
|
Ear irrigation 69209
|
$114.48 |
$114.48 |
$114.48 |
$149.76
|
|
Ecg 12 lead tracing only
|
$326.88 |
$326.88 |
$326.88 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$173.52 |
$173.52 |
$173.52 |
$135.80
|
|
Ecg external < 48 hours recording
|
$300.24 |
$300.24 |
$300.24 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$426.96 |
$426.96 |
$426.96 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$2,833.92 |
$2,833.92 |
$2,833.92 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$326.88 |
$326.88 |
$326.88 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,967.12 |
$2,967.12 |
$2,967.12 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$768.24 |
$768.24 |
$768.24 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,105.92 |
$1,105.92 |
$1,105.92 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$280.80 |
$280.80 |
$280.80 |
$362.50
|
|
Echo stress
|
$2,567.52 |
$2,567.52 |
$2,567.52 |
$1,592.05
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,766.88 |
$1,766.88 |
$1,766.88 |
$985.15
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$154.08 |
$154.08 |
$154.08 |
$87.84
|
|
Electrolyte panel
|
$230.40 |
$230.40 |
$230.40 |
$84.24
|
|
Endo abl/incom vein/ext/laser/#1 36478
|
$8,025.84 |
$8,025.84 |
$8,025.84 |
$5,119.50
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$7.38 |
$7.38 |
$7.38 |
$109.71
|
|
Epidural/lumbar/sacral/ea add level64484
|
$1,593.36 |
$1,593.36 |
$1,593.36 |
$1,141.80
|
|
Ep induct arrhy by elect pacing
|
$2,324.88 |
$2,324.88 |
$2,324.88 |
$2,635.75
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$4.75 |
$4.75 |
$4.75 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$3.41 |
$3.41 |
$3.41 |
$393.15
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$5.04 |
$5.04 |
$5.04 |
$34.13
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$38.12 |
$38.12 |
$38.12 |
$809.08
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$92.36 |
$92.36 |
$92.36 |
$1,289.71
|
|
Epstein barr early antigen antibody
|
$60.48 |
$60.48 |
$60.48 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$139.68 |
$139.68 |
$139.68 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$112.32 |
$112.32 |
$112.32 |
$91.00
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$239.85 |
$239.85 |
$239.85 |
$222.98
|
|
ER Visit (level 1, minor)
|
$303.84 |
$303.84 |
$303.84 |
$246.24
|
|
ER Visit (level 2)
|
$476.64 |
$476.64 |
$476.64 |
$452.20
|
|
ER Visit (level 3)
|
$763.20 |
$763.20 |
$763.20 |
$770.04
|
|
ER Visit (level 4)
|
$1,163.52 |
$1,163.52 |
$1,163.52 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$1,656.00 |
$1,656.00 |
$1,656.00 |
$1,820.02
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$12.96 |
$12.96 |
$12.96 |
$553.88
|
|
Established Patient Office Visit (level 1)
|
$185.04 |
$185.04 |
$185.04 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$198.00 |
$198.00 |
$198.00 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$236.88 |
$236.88 |
$236.88 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$336.24 |
$336.24 |
$336.24 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$424.80 |
$424.80 |
$424.80 |
$280.33
|
|
Estradiol total
|
$131.04 |
$131.04 |
$131.04 |
$146.50
|
|
Estrogens total-sendout
|
$97.92 |
$97.92 |
$97.92 |
$96.20
|
|
Evaluation of speech fluency 92521
|
$282.96 |
$282.96 |
$282.96 |
$311.50
|
|
Evoked oa emissions ltd
|
$336.24 |
$336.24 |
$336.24 |
$234.32
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,706.40 |
$1,706.40 |
$1,706.40 |
$1,247.50
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$1,012.86
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$759.60 |
$759.60 |
$759.60 |
$1,294.80
|
|
Exc tr-ext mal+marg tal >4 cm 11606
|
$3,140.64 |
$3,140.64 |
$3,140.64 |
$1,917.33
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$3,672.00 |
$3,672.00 |
$3,672.00 |
$4,048.38
|
|
Explore penetrating wnd/extremity 20103
|
$1,749.60 |
$1,749.60 |
$1,749.60 |
$1,788.80
|
|
Explore wound neck 20100
|
$550.08 |
$550.08 |
$550.08 |
$1,185.00
|
|
External chromosome analysis 20-25 cells
|
$450.00 |
$450.00 |
$450.00 |
$384.15
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$406.80 |
$406.80 |
$406.80 |
$454.20
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$84.96 |
$84.96 |
$84.96 |
$108.60
|
|
Facial bones <3
|
$289.44 |
$289.44 |
$289.44 |
$252.60
|