|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$78.83 |
$78.83 |
$78.83 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$78.65 |
$78.67 |
$78.67 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$49.75 |
$79.76 |
$79.76 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$78.86 |
$78.86 |
$78.86 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$541.20 |
$541.20 |
$541.20 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$250.80 |
$250.80 |
$250.80 |
$70.00
|
|
Diagnostic digital breast tomosynthesis bil
|
$53.40 |
$53.40 |
$53.40 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$53.40 |
$53.40 |
$53.40 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$841.80 |
$841.80 |
$841.80 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$378.00 |
$378.00 |
$378.00 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$276.60 |
$276.60 |
$276.60 |
$276.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$11,889.00 |
$11,889.00 |
$11,889.00 |
$9,395.77
|
|
Dialysis one evaluation
|
$1,568.40 |
$1,568.40 |
$1,863.60 |
$920.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$122.25 |
$122.25 |
$122.25 |
$58.24
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$80.83 |
$80.83 |
$80.83 |
$42.12
|
|
Dicyclomine injection
|
$193.54 |
$193.54 |
$193.54 |
$153.53
|
|
Diffusing capacity
|
$413.40 |
$413.40 |
$413.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$151.79 |
$191.62 |
$191.62 |
$29.85
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,815.78 |
$6,815.78 |
$6,815.78 |
$6,815.78
|
|
Digoxin total therapeutic drug level
|
$220.80 |
$220.80 |
$220.80 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$308.90 |
$308.90 |
$308.90 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,873.20 |
$1,873.20 |
$1,873.20 |
$1,866.73
|
|
Dilation of salivary duct
|
$1,088.40 |
$1,088.40 |
$1,088.40 |
$599.72
|
|
Dilat xst trc ndurlgc px
|
$3,591.00 |
$3,591.00 |
$3,591.00 |
$4,031.47
|
|
Dimecaprol injection
|
$199.46 |
$199.46 |
$199.46 |
$147.91
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,001.55 |
$1,001.55 |
$1,001.55 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$38.75 |
$38.80 |
$38.80 |
$9.29
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$43.03 |
$43.03 |
$43.03 |
$67.32
|
|
Disability dlco
|
$711.60 |
$711.60 |
$711.60 |
$289.08
|
|
Disaccharidases
|
$306.60 |
$306.60 |
$306.60 |
$224.58
|
|
Discography cerv/thor spine
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$2,161.44
|
|
Dissolve clot heart vessel
|
$1,178.40 |
$1,178.40 |
$1,178.40 |
$1,623.17
|
|
Dna antibody native/double stranded
|
$321.00 |
$321.00 |
$321.00 |
$101.40
|
|
Dna gardnerella
|
$84.60 |
$84.60 |
$84.60 |
$67.68
|
|
Dna probe chlamydia
|
$252.00 |
$252.00 |
$252.00 |
$98.40
|
|
Dna trichomonas
|
$84.60 |
$84.60 |
$84.60 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$101.04 |
$101.04 |
$101.04 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$472.96 |
$472.96 |
$472.96 |
$131.40
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$104.59 |
$104.59 |
$104.59 |
$60.21
|
|
Doppler echo complete
|
$720.00 |
$720.00 |
$720.00 |
$517.94
|
|
Doppler intravascular pressure flow initial vessel
|
$6,969.00 |
$6,969.00 |
$6,969.00 |
$3,026.62
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,071.60 |
$1,071.60 |
$1,071.60 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$685.80 |
$686.40 |
$750.00 |
$463.20
|
|
Doripenem 50 mg/ml inj 10 ml
|
$129.74 |
$129.74 |
$129.74 |
$70.91
|
|
Dornhoffer fixed part w/window
|
$44,316.00 |
$44,316.00 |
$44,316.00 |
$53,356.20
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$17,344.68 |
$17,344.68 |
$17,344.68 |
$326.36
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$1,988.63 |
$1,988.63 |
$1,988.63 |
$97.83
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$99.43 |
$99.43 |
$99.43 |
$715.22
|
|
Drainage lymph node lesion 38300
|
$3,882.00 |
$3,882.00 |
$3,882.00 |
$1,779.65
|
|
Drainage of kidney lesion
|
$1,619.40 |
$1,619.40 |
$1,619.40 |
$1,578.89
|
|
Drain cath image guided visceral pq
|
$3,448.80 |
$3,448.80 |
$3,448.80 |
$2,999.34
|
|
Drain cerebro spinal fluid 62272
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
$1,025.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$712.20 |
$712.20 |
$712.20 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$533.40 |
$533.40 |
$533.40 |
$353.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$415.80 |
$415.80 |
$415.80 |
$515.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$5,568.00 |
$5,568.00 |
$5,568.00 |
$5,715.36
|
|
Drill hole implt ventricular cath/device 61107
|
$4,552.80 |
$4,552.80 |
$4,552.80 |
$1,737.06
|
|
Drng ovary abscess perqt 58822
|
$4,839.60 |
$4,839.60 |
$4,839.60 |
$3,547.20
|
|
Dronabinol 2.5mg oral
|
$20.03 |
$20.03 |
$20.03 |
$3.39
|
|
Droperidol 2.5 mg/ml injection solution
|
$40.32 |
$40.32 |
$43.80 |
$32.82
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$3,325.20 |
$3,325.20 |
$3,325.20 |
$57.00
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$1,662.60 |
$1,662.60 |
$1,662.60 |
$983.03
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$5,020.80 |
$5,020.80 |
$7,852.80 |
$367.29
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$5,301.00 |
$5,301.00 |
$5,301.00 |
$12,735.45
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$7,038.60 |
$7,038.60 |
$7,038.60 |
$448.16
|
|
Drug admin & hemodynmic meas
|
$291.00 |
$291.00 |
$291.00 |
$612.15
|
|
Drug assay caffeine
|
$346.80 |
$346.80 |
$346.80 |
$89.17
|
|
Drug of abuse screen urine
|
$354.00 |
$354.00 |
$354.00 |
$58.50
|
|
Drug test def 1-7 classes
|
$378.60 |
$378.60 |
$378.60 |
$316.80
|
|
Drug test def 8-14 classes
|
$378.60 |
$378.60 |
$378.60 |
$249.10
|
|
Drug test prsmv instrmnt
|
$354.00 |
$354.00 |
$354.00 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$354.00 |
$354.00 |
$354.00 |
$278.85
|
|
Drvvt confirm - quest
|
$288.00 |
$288.00 |
$288.00 |
$108.55
|
|
Ductogram sgl duct
|
$258.00 |
$258.00 |
$258.00 |
$346.42
|
|
Duplex scan bilateral study 93985
|
$1,201.20 |
$1,201.20 |
$1,447.80 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$600.60 |
$600.60 |
$724.20 |
$357.60
|
|
Dup scan/hemodialysis access 93990
|
$787.80 |
$787.80 |
$787.80 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$959.40 |
$959.40 |
$959.40 |
$740.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,493.40 |
$1,493.40 |
$1,493.40 |
$852.57
|
|
Dxa bone density axl vrt fx
|
$466.80 |
$466.80 |
$466.80 |
$365.14
|
|
Dx aly aud oi snd prcsr 1st
|
$98.40 |
$98.40 |
$98.40 |
$184.26
|
|
Ear irrigation 69209
|
$175.80 |
$175.80 |
$175.80 |
$152.50
|
|
Ear protector evaluation
|
$95.40 |
$95.40 |
$95.40 |
$65.00
|
|
Ecg 12 lead tracing only
|
$301.20 |
$301.20 |
$301.20 |
$222.30
|
|
Ecg external < 48 hours recording
|
$408.00 |
$408.00 |
$816.00 |
$461.76
|
|
Ecg external > 48 hours up to 7 days recording
|
$384.00 |
$384.00 |
$384.00 |
$180.00
|
|
Ecg external >7 days up to 15 days recording
|
$766.20 |
$766.20 |
$766.20 |
$213.20
|
|
Echocardiogram (Heart Ultrasound)
|
$2,351.40 |
$2,352.00 |
$2,352.00 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$606.60 |
$606.60 |
$606.60 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$720.60 |
$720.60 |
$720.60 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$356.40 |
$356.40 |
$356.40 |
$348.80
|
|
Echo exam of eye
|
$164.40 |
$164.40 |
$164.40 |
$119.66
|
|
Echo exam of eye thickness
|
$129.00 |
$129.00 |
$129.00 |
$32.37
|
|
Echo exam of fetal heart
|
$324.60 |
$324.60 |
$324.60 |
$855.38
|
|
Echo exam of fetal heart
|
$324.60 |
$324.60 |
$324.60 |
$429.87
|
|
Echo exam uterus 76831-
|
$325.80 |
$325.80 |
$325.80 |
$497.93
|
|
Echograp trans r pros study
|
$753.00 |
$753.00 |
$753.00 |
$406.33
|
|
Echo guidance radiotherapy
|
$1,666.80 |
$1,666.80 |
$1,666.80 |
$655.00
|
|
Echo guide for amniocentesis
|
$257.40 |
$257.40 |
$257.40 |
$355.17
|
|
Echo guide for artery repair
|
$324.60 |
$324.60 |
$324.60 |
$687.35
|
