|
Debr musc/fascia 20sq cm/< 11043
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$1,160.00
|
|
Decalcification
|
$66.96 |
$66.96 |
$66.96 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$638.64 |
$638.64 |
$638.64 |
$543.00
|
|
Degarelix 120 mg subcutaneous solution
|
$20.69 |
$20.69 |
$20.69 |
$1,807.08
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$108.03 |
$108.03 |
$108.03 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$278.64 |
$278.64 |
$278.64 |
$408.10
|
|
Dermagraft
|
$79.92 |
$79.92 |
$79.92 |
$85.00
|
|
Desoxycorticosterone
|
$215.28 |
$215.28 |
$215.28 |
$109.28
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$198.00 |
$198.00 |
$198.00 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$0.27 |
$0.27 |
$0.27 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$3.24 |
$3.24 |
$3.24 |
$21.17
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$32.40 |
$32.40 |
$32.40 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$133.20 |
$133.20 |
$133.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$159.84 |
$159.84 |
$159.84 |
$79.20
|
|
Diagnostic laryngoscopy 31505
|
$419.04 |
$419.04 |
$419.04 |
$236.60
|
|
Diagnostic Mammogram (both breasts)
|
$537.84 |
$537.84 |
$537.84 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$498.96 |
$498.96 |
$498.96 |
$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
|
$349.92 |
$349.92 |
$349.92 |
$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
|
$178.56 |
$178.56 |
$178.56 |
$102.00
|
|
Dilation salivary duct 42650
|
$3,729.60 |
$3,729.60 |
$3,729.60 |
$2,498.32
|
|
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
|
$321.84 |
$321.84 |
$321.84 |
$216.00
|
|
Dna antibody native/double stranded
|
$293.04 |
$293.04 |
$293.04 |
$97.50
|
|
Dna gardnerella
|
$42.48 |
$42.48 |
$42.48 |
$62.50
|
|
Dna trichomonas
|
$42.48 |
$42.48 |
$42.48 |
$67.80
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$26.94 |
$26.94 |
$26.94 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$6.55 |
$6.55 |
$6.55 |
$65.40
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,216.08 |
$1,216.08 |
$1,216.08 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$555.12 |
$555.12 |
$555.12 |
$471.17
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$36.19 |
$36.19 |
$36.19 |
$423.95
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.87 |
$0.87 |
$0.87 |
$84.80
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,519.92 |
$1,519.92 |
$1,519.92 |
$800.00
|
|
Drainage external ear simple 69000
|
$1,519.92 |
$1,519.92 |
$1,519.92 |
$789.60
|
|
Drainage of arm bursa 23931
|
$3,499.92 |
$3,499.92 |
$3,499.92 |
$2,197.48
|
|
Drainage of urethra abscess 53060
|
$4,425.12 |
$4,425.12 |
$4,425.12 |
$2,424.12
|
|
Drain blood from under nail 11740
|
$278.64 |
$278.64 |
$278.64 |
$170.50
|
|
Drain finger abscess;simple 26010
|
$908.64 |
$908.64 |
$908.64 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$522.72 |
$522.72 |
$522.72 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$474.48 |
$474.48 |
$474.48 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$863.28 |
$863.28 |
$863.28 |
$523.00
|
|
Drng of eyelid abscess 67700
|
$645.84 |
$645.84 |
$645.84 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$3,499.92 |
$3,499.92 |
$3,499.92 |
$1,943.50
|
|
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
|
$23.04 |
$23.04 |
$23.04 |
$127.14
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$338.40 |
$338.40 |
$338.40 |
$400.98
|
|
Drug assay posaconazole
|
$168.48 |
$168.48 |
$168.48 |
$96.75
|
|
Drug assay vedolizumab
|
$317.52 |
$317.52 |
$317.52 |
$152.79
|
|
Drug assay voriconazole
|
$256.32 |
$256.32 |
$256.32 |
$96.75
|
|
Drug/substance nos 4-6
|
$54.00 |
$54.00 |
$54.00 |
$72.14
|
|
Drug test def 1-7 classes
|
$144.00 |
$144.00 |
$144.00 |
$250.52
|
|
Drug test def 22+ classes
|
$270.72 |
$270.72 |
$270.72 |
$423.00
|
|
Drug test prsmv instrmnt
|
$276.48 |
$276.48 |
$276.48 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$274.32 |
$274.32 |
$274.32 |
$278.85
|
|
Drvvt confirm - quest
|
$95.76 |
$95.76 |
$95.76 |
$109.20
|
|
Ductogram sgl duct
|
$835.92 |
$835.92 |
$835.92 |
$463.10
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,664.64 |
$1,664.64 |
$1,664.64 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$149.86 |
$149.86 |
$149.86 |
$7,973.90
|
|
Ear irrigation 69209
|
$128.16 |
$128.16 |
$128.16 |
$149.76
|
|
Ecg 12 lead tracing only
|
$257.76 |
$257.76 |
$257.76 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$128.16 |
$128.16 |
$128.16 |
$135.80
|
|
Ecg external < 48 hours recording
|
$677.52 |
$677.52 |
$677.52 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$884.88 |
$884.88 |
$884.88 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$2,491.20 |
$2,491.20 |
$2,491.20 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$657.36 |
$657.36 |
$657.36 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$3,080.88 |
$3,080.88 |
$3,080.88 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$454.32 |
$454.32 |
$454.32 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$671.04 |
$671.04 |
$671.04 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$197.28 |
$197.28 |
$197.28 |
$362.50
|
|
Echo exam uterus 76831-
|
$758.16 |
$758.16 |
$758.16 |
$523.71
|
|
Echo guide for amniocentesis
|
$1,231.92 |
$1,231.92 |
$1,231.92 |
$456.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$696.96 |
$696.96 |
$696.96 |
$835.00
|
|
Eeg recording awake and asleep
|
$696.96 |
$696.96 |
$696.96 |
$931.20
|
|
Ehrlicha chaffeensis amp prb
|
$235.44 |
$235.44 |
$235.44 |
$93.00
|
|
Electrical stimulation/unattended 97014
|
$87.84 |
$87.84 |
$87.84 |
$79.20
|
|
Electrolyte panel
|
$140.40 |
$140.40 |
$140.40 |
$84.24
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$5.40 |
$5.40 |
$5.40 |
$109.71
|
|
Epidrm a-grft face/nck/hf/g 15115
|
$4,605.12 |
$4,605.12 |
$4,605.12 |
$2,478.85
|
|
Epidrm a-grft f/n/hf/g addl
|
$2,302.56 |
$2,302.56 |
$2,302.56 |
$1,148.00
|
|
Epidrm agrft t/a/l 1st 100
|
$4,605.12 |
$4,605.12 |
$4,605.12 |
$2,710.80
|
|
Epidrm autogrft t/a/l add-on
|
$2,302.56 |
$2,302.56 |
$2,302.56 |
$1,113.83
|
|
Epidural/lumbar/sacral/ea add level64484
|
$614.88 |
$614.88 |
$614.88 |
$1,141.80
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$4.75 |
$4.75 |
$4.75 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$5.18 |
$5.18 |
$5.18 |
$25.30
|
|
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
|
$92.37 |
$92.37 |
$92.37 |
$1,289.71
|
|
Epstein barr early antigen antibody
|
$120.24 |
$120.24 |
$120.24 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$82.08 |
$82.08 |
$82.08 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$82.08 |
$82.08 |
$82.08 |
$91.00
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$202.31 |
$202.31 |
$202.31 |
$222.98
|
|
ER Visit (level 1, minor)
|
$246.24 |
$246.24 |
$246.24 |
$246.24
|
|
ER Visit (level 2)
|
$429.84 |
$429.84 |
$429.84 |
$452.20
|
|
ER Visit (level 3)
|
$629.28 |
$629.28 |
$629.28 |
$770.04
|
|
ER Visit (level 4)
|
$849.60 |
$849.60 |
$849.60 |
$1,273.68
|
