|
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
|
$390.00 |
$390.00 |
$390.00 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$191.62 |
$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
|
$235.20 |
$235.20 |
$235.20 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$308.90 |
$308.90 |
$308.90 |
$297.86
|
|
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 |
$38.75 |
$38.75 |
$9.29
|
|
Disability dlco
|
$513.00 |
$513.00 |
$513.00 |
$289.08
|
|
Disaccharidases
|
$376.20 |
$376.20 |
$376.20 |
$224.58
|
|
Discography cerv/thor spine
|
$1,591.80 |
$1,591.80 |
$1,591.80 |
$2,161.44
|
|
Dna antibody native/double stranded
|
$251.40 |
$251.40 |
$251.40 |
$101.40
|
|
Dna gardnerella
|
$60.60 |
$60.60 |
$60.60 |
$67.68
|
|
Dna probe chlamydia
|
$198.00 |
$198.00 |
$198.00 |
$98.40
|
|
Dna probe gc
|
$320.40 |
$320.40 |
$320.40 |
$88.67
|
|
Dna trichomonas
|
$60.60 |
$60.60 |
$60.60 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$99.10 |
$99.10 |
$99.10 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$3,324.62 |
$3,324.62 |
$3,324.62 |
$131.40
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$65.76 |
$65.76 |
$65.76 |
$60.21
|
|
Doppler echo complete
|
$945.60 |
$945.60 |
$945.60 |
$517.94
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$969.60 |
$969.60 |
$969.60 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$637.20 |
$637.20 |
$637.20 |
$463.20
|
|
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)
|
$190.78 |
$190.78 |
$190.78 |
$97.83
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$99.43 |
$99.43 |
$99.43 |
$715.22
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$441.60 |
$441.60 |
$441.60 |
$353.60
|
|
Droperidol 2.5 mg/ml injection solution
|
$40.32 |
$40.32 |
$40.32 |
$32.82
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$3,483.60 |
$3,483.60 |
$3,483.60 |
$12,735.45
|
|
Drug of abuse screen urine
|
$141.60 |
$141.60 |
$141.60 |
$58.50
|
|
Drug test def 1-7 classes
|
$393.00 |
$393.00 |
$393.00 |
$316.80
|
|
Drug test def 8-14 classes
|
$393.00 |
$393.00 |
$393.00 |
$249.10
|
|
Drug test prsmv instrmnt
|
$141.60 |
$141.60 |
$141.60 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$207.00 |
$207.00 |
$207.00 |
$278.85
|
|
Drvvt confirm - quest
|
$295.20 |
$295.20 |
$295.20 |
$108.55
|
|
Dup scan/hemodialysis access 93990
|
$802.20 |
$802.20 |
$802.20 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,363.20 |
$1,363.20 |
$1,363.20 |
$852.57
|
|
Ear irrigation 69209
|
$183.00 |
$183.00 |
$183.00 |
$152.50
|
|
Ecg 12 lead tracing only
|
$330.60 |
$330.60 |
$330.60 |
$222.30
|
|
Ecg external < 48 hours recording
|
$1,060.80 |
$1,060.80 |
$1,060.80 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,060.80 |
$1,060.80 |
$1,060.80 |
$541.73
|
|
Ecg external > 48 hours up to 7 days recording
|
$460.80 |
$460.80 |
$460.80 |
$180.00
|
|
Ecg external >7 days up to 15 days recording
|
$922.20 |
$922.20 |
$922.20 |
$213.20
|
|
Echocardiogram (Heart Ultrasound)
|
$2,727.60 |
$2,727.60 |
$2,727.60 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$763.20 |
$763.20 |
$763.20 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$786.00 |
$786.00 |
$786.00 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$463.80 |
$463.80 |
$463.80 |
$348.80
|
|
Echo transthoracic
|
$1,605.60 |
$1,605.60 |
$1,605.60 |
$1,361.75
|
|
Echo transthoracic
|
$1,029.00 |
$1,029.00 |
$1,029.00 |
$765.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,311.00 |
$1,311.00 |
$1,311.00 |
$997.40
|
|
Eeg 41-60 minutes 95812-26
|
$1,630.80 |
$1,630.80 |
$1,630.80 |
$934.05
|
|
Eeg over 1 hour 95813 - 26
|
$1,806.00 |
$1,806.00 |
$1,806.00 |
$1,072.93
|
|
Eeg recording awake and asleep
|
$1,130.40 |
$1,130.40 |
$1,130.40 |
$937.95
|
|
Eeg without vid ea 12-26hr cont
|
$3,587.40 |
$3,587.40 |
$3,587.40 |
$1,584.70
|
|
Electrical stimulation/unattended 97014
|
$82.80 |
$82.80 |
$82.80 |
$79.20
|
|
Electrolyte panel
|
$179.40 |
$179.40 |
$179.40 |
$68.56
|
|
Electron microscopy diagnostic
|
$2,028.60 |
$2,028.60 |
$2,028.60 |
$1,107.84
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$304.20 |
$304.20 |
$304.20 |
$447.50
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$459.60 |
$459.60 |
$459.60 |
$482.30
|
|
Emg needle test 1-extremity
|
$153.00 |
$153.00 |
$153.00 |
$362.25
|
|
Emg needle test 4-extremities
|
$610.80 |
$610.80 |
$610.80 |
$547.00
|
|
Emg thor paraspinal without t1/t2
|
$153.00 |
$153.00 |
$153.00 |
$309.83
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$43.20 |
$43.20 |
$43.20 |
$43.20
|
|
Entamoeba histolytica ag eia - sendout
|
$126.00 |
$126.00 |
$126.00 |
$68.90
|
|
Enzyme histochemistry
|
$348.00 |
$348.00 |
$348.00 |
$506.35
|
|
Epidrm agrft t/a/l 1st 100
|
$4,566.60 |
$4,566.60 |
$4,566.60 |
$2,710.80
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$195.23 |
$195.23 |
$195.23 |
$161.59
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,074.20 |
$1,074.20 |
$1,074.20 |
$336.66
|
|
Epstein barr early antigen antibody
|
$210.00 |
$210.00 |
$210.00 |
$85.20
|
|
Epstein barr nuclear antigen antibody
|
$191.40 |
$191.40 |
$191.40 |
$88.80
|
|
Epstein barr viral capsid antigen antibody igm
|
$262.20 |
$262.20 |
$262.20 |
$112.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$15.59 |
$15.59 |
$15.59 |
$62.40
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$296.58 |
$296.58 |
$296.58 |
$296.58
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$364.08 |
$364.08 |
$364.08 |
$138.28
|
|
ER Visit (level 1, minor)
|
$307.20 |
$307.20 |
$307.20 |
$270.00
|
|
ER Visit (level 2)
|
$569.40 |
$569.40 |
$569.40 |
$469.39
|
|
ER Visit (level 3)
|
$875.40 |
$875.40 |
$875.40 |
$821.52
|
|
ER Visit (level 4)
|
$1,751.40 |
$1,751.40 |
$1,751.40 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$2,190.60 |
$2,190.60 |
$2,190.60 |
$1,900.20
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$128.06 |
$128.06 |
$128.06 |
$195.33
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$45.48 |
$45.48 |
$45.48 |
$406.83
|
|
Established Patient Office Visit (level 1)
|
$216.00 |
$216.00 |
$216.00 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$253.20 |
$253.20 |
$253.20 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$318.00 |
$318.00 |
$318.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$384.60 |
$384.60 |
$384.60 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$618.00 |
$618.00 |
$618.00 |
$270.09
|
|
Estradiol total
|
$395.40 |
$395.40 |
$395.40 |
$142.20
|
|
Estrogens total-sendout
|
$287.40 |
$287.40 |
$287.40 |
$111.00
|
|
Ethanolamine oleate 100 mg
|
$933.59 |
$933.59 |
$933.59 |
$1,597.69
|
|
Ethylene glycol -sendout
|
$270.00 |
$270.00 |
$270.00 |
$81.25
|
|
Etoposide 20 mg/ml intravenous solution
|
$1.82 |
$1.82 |
$1.82 |
$20.35
|
|
Evaluation of speech fluency 92521
|
$181.80 |
$181.80 |
$181.80 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$141.60 |
$141.60 |
$141.60 |
$325.65
|
|
Event monitor
|
$729.60 |
$729.60 |
$729.60 |
$228.60
|
|
Exc benign tal 0.5 < cm 11400
|
$2,816.40 |
$2,816.40 |
$2,816.40 |
$805.70
|
|
External chromosome analysis 20-25 cells
|
$935.40 |
$935.40 |
$935.40 |
$457.50
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$904.20 |
$904.20 |
$904.20 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$202.80 |
$202.80 |
$202.80 |
$102.50
|
|
Facial bones <3
|
$235.80 |
$235.80 |
$235.80 |
$216.45
|
|
Factor ix
|
$411.00 |
$411.00 |
$411.00 |
$139.75
|
