|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$151.50 |
$151.50 |
$151.50 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,951.40 |
$7,951.40 |
$7,951.40 |
$6,324.98
|
|
Depo-estradiol cypionate inj
|
$883.18 |
$883.18 |
$883.18 |
$71.51
|
|
Design mlc device for imrt
|
$1,372.75 |
$1,372.75 |
$1,372.75 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$871.53 |
$871.53 |
$871.53 |
$89.78
|
|
Developmental screen/score/document 96110
|
$7.00 |
$7.00 |
$7.00 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$69.12 |
$69.12 |
$69.12 |
$337.50
|
|
Device ablt adv novasure
|
$18,900.00 |
$18,900.00 |
$18,900.00 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$8,000.00 |
$8,000.00 |
$8,000.00 |
$4,200.00
|
|
Device intraute mirena
|
$1,447.36 |
$1,447.36 |
$1,447.36 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$7,845.15 |
$7,845.15 |
$7,845.15 |
$2,541.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$30.80 |
$30.80 |
$30.80 |
$200.00
|
|
Dexamethasone 4 mg tablet
|
$47.72 |
$47.72 |
$47.72 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$86.54 |
$86.54 |
$86.54 |
$21.17
|
|
Dexamethasone intra implant
|
$2,565.05 |
$2,565.05 |
$2,565.05 |
$2,538.20
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,297.86 |
$1,297.86 |
$1,297.86 |
$858.00
|
|
Dextran 40 infusion
|
$98.50 |
$98.50 |
$98.50 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$64.00 |
$64.00 |
$64.00 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$64.50 |
$64.50 |
$64.50 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$122.62 |
$122.62 |
$122.62 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$90.50 |
$90.50 |
$90.50 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$112.00 |
$112.00 |
$112.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$37.62 |
$37.62 |
$37.62 |
$79.20
|
|
Diab manage trn ind/group
|
$21.50 |
$21.50 |
$21.50 |
$56.55
|
|
Diagnostic digital breast tomosynthesis bil
|
$35.00 |
$35.00 |
$35.00 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$35.00 |
$35.00 |
$35.00 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$223.50 |
$223.50 |
$223.50 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$187.50 |
$187.50 |
$187.50 |
$301.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$115.15 |
$115.15 |
$115.15 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$93.45 |
$93.45 |
$93.45 |
$74.76
|
|
Dicyclomine injection
|
$61.76 |
$61.76 |
$61.76 |
$153.29
|
|
Diffusing capacity
|
$220.00 |
$220.00 |
$220.00 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$659.84 |
$659.84 |
$659.84 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,163.82 |
$11,163.82 |
$11,163.82 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$99.50 |
$99.50 |
$99.50 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$583.71 |
$583.71 |
$583.71 |
$297.86
|
|
Dilate urethra stricture
|
$47.60 |
$47.60 |
$47.60 |
$490.00
|
|
Dilator fascial 10fx20cm
|
$334.76 |
$334.76 |
$334.76 |
$402.10
|
|
Dimethyl sulfoxide 50% 50 ml
|
$810.75 |
$810.75 |
$810.75 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$19.90 |
$19.90 |
$19.90 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$25.58 |
$25.58 |
$25.58 |
$17.75
|
|
Disability dlco
|
$165.00 |
$165.00 |
$165.00 |
$282.40
|
|
Disaccharidases
|
$30.00 |
$30.00 |
$30.00 |
$216.00
|
|
Dna antibody native/double stranded
|
$43.50 |
$43.50 |
$43.50 |
$97.50
|
|
Dna gardnerella
|
$46.50 |
$46.50 |
$46.50 |
$62.50
|
|
Dna trichomonas
|
$80.12 |
$80.12 |
$80.12 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$228.38 |
$228.38 |
$228.38 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$275.05 |
$275.05 |
$275.05 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$134.30 |
$134.30 |
$134.30 |
$65.40
|
|
Doppler echo complete
|
$444.38 |
$444.38 |
$444.38 |
$540.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$474.88 |
$474.88 |
$474.88 |
$471.17
|
|
Dornhoffer fixed part w/window
|
$48,698.50 |
$48,698.50 |
$48,698.50 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$28,933.80 |
$28,933.80 |
$28,933.80 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$619.80 |
$619.80 |
$619.80 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$299.92 |
$299.92 |
$299.92 |
$1,718.24
|
|
Drain cerebro spinal fluid 62272
|
$144.38 |
$144.38 |
$144.38 |
$1,044.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$324.50 |
$324.50 |
$324.50 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$335.75 |
$335.75 |
$335.75 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$577.00 |
$577.00 |
$577.00 |
$523.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$16,171.18 |
$16,171.18 |
$16,171.18 |
$8,131.20
|
|
Dronabinol 2.5mg oral
|
$17.00 |
$17.00 |
$17.00 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$62.12 |
$62.12 |
$62.12 |
$31.07
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$16,014.15 |
$16,014.15 |
$16,014.15 |
$8,040.27
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$13,304.50 |
$13,304.50 |
$13,304.50 |
$400.98
|
|
Drug of abuse screen urine
|
$19.00 |
$19.00 |
$19.00 |
$63.75
|
|
Drug test def 1-7 classes
|
$125.88 |
$125.88 |
$125.88 |
$250.52
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$108.50 |
$108.50 |
$108.50 |
$278.85
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$538.50 |
$538.50 |
$538.50 |
$887.25
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$8,148.82 |
$8,148.82 |
$8,148.82 |
$23,482.80
|
|
Durvalumab 50 mg/ml intravenous solution
|
$28,477.76 |
$28,477.76 |
$28,477.76 |
$7,973.90
|
|
Ecallantide injection
|
$41,575.76 |
$41,575.76 |
$41,575.76 |
$13,353.39
|
|
Ecg 12 lead tracing only
|
$131.25 |
$131.25 |
$131.25 |
$226.50
|
|
Ecg external < 48 hours recording
|
$388.00 |
$388.00 |
$388.00 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$418.50 |
$418.50 |
$418.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$79.50 |
$79.50 |
$79.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$87.50 |
$87.50 |
$87.50 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$1,361.00 |
$1,361.00 |
$1,361.00 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$367.50 |
$367.50 |
$367.50 |
$469.95
|
|
Echocardiography transthoracic 2d followup/limited
|
$531.00 |
$531.00 |
$531.00 |
$703.25
|
|
Echocardiograpy doppler follow up/limited study
|
$311.00 |
$311.00 |
$311.00 |
$362.50
|
|
Echo exam of fetal heart
|
$260.00 |
$260.00 |
$260.00 |
$939.00
|
|
Echo exam of fetal heart
|
$137.15 |
$137.15 |
$137.15 |
$431.41
|
|
Echo guide for amniocentesis
|
$128.70 |
$128.70 |
$128.70 |
$456.30
|
|
Echo transthoracic
|
$789.00 |
$789.00 |
$789.00 |
$953.10
|
|
Eculizumab injection
|
$16,330.48 |
$16,330.48 |
$16,330.48 |
$17,032.68
|
|
Eeg 41-60 minutes 95812-26
|
$874.50 |
$874.50 |
$874.50 |
$920.00
|
|
Eeg monitor/record/awake/drowsy 95816
|
$675.00 |
$675.00 |
$675.00 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$400.40 |
$400.40 |
$400.40 |
$1,102.05
|
|
Eeg recording awake and asleep
|
$364.98 |
$364.98 |
$364.98 |
$931.20
|
|
Efgartigimod alfa-fcab 20 mg/ml intravenous solution
|
$15,501.95 |
$15,501.95 |
$15,501.95 |
$12,999.80
|
|
Elec analys infus pump w/reprog 62368
|
$42.88 |
$42.88 |
$42.88 |
$616.11
|
|
Electrd sq emblem s-icd
|
$15,092.00 |
$15,092.00 |
$15,092.00 |
$10,243.24
|
|
Electric stim/w chemodenervation 95873
|
$69.55 |
$69.55 |
$69.55 |
$166.40
|
|
Electrolyte panel
|
$33.50 |
$33.50 |
$33.50 |
$84.24
|
|
Elosulfase alfa, injection
|
$2,653.85 |
$2,653.85 |
$2,653.85 |
$2,635.83
|
|
Elotuzumab 300 mg intravenous solution
|
$7,477.60 |
$7,477.60 |
$7,477.60 |
$5,523.02
|
|
Elranatamab-bcmm 40 mg/ml subcutaneous solution
|
$32,652.80 |
$32,652.80 |
$32,652.80 |
$16,066.72
|
|
Emb without cervical dilation 58100
|
$62.12 |
$62.12 |
$62.12 |
$370.50
|
|
Endocervical curettage 57505
|
$62.48 |
$62.48 |
$62.48 |
$1,035.00
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$10,559.75 |
$10,559.75 |
$10,559.75 |
$8,452.00
|