|
Device intraute mirena
|
$1,544.80 |
$1,544.80 |
$1,544.80 |
$2,125.00
|
|
Device sut capio slim opn
|
$6,063.04 |
$6,063.04 |
$6,063.04 |
$1,860.95
|
|
Dev interrog remote 1/2/mlt
|
$115.20 |
$115.20 |
$115.20 |
$115.20
|
|
Devise bowel pouch
|
$3,464.00 |
$3,464.00 |
$3,464.00 |
$3,464.00
|
|
Devlopment test interpt&rep
|
$364.34 |
$364.34 |
$364.34 |
$109.46
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$317.55 |
$317.55 |
$317.55 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$111.88 |
$111.88 |
$111.88 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$5.82 |
$5.82 |
$5.82 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$18.71 |
$18.71 |
$18.71 |
$20.76
|
|
Dexamethasone panel
|
$324.00 |
$324.00 |
$324.00 |
$223.39
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$259.20 |
$259.20 |
$259.20 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$48.00 |
$48.00 |
$48.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$48.00 |
$48.00 |
$48.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$48.00 |
$48.00 |
$48.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$48.00 |
$48.00 |
$48.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$56.00 |
$56.00 |
$56.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$33.57 |
$33.57 |
$33.57 |
$79.30
|
|
Diabetes training group per 30 min g0109
|
$36.00 |
$36.00 |
$36.00 |
$35.43
|
|
Diab manage trn ind/group
|
$54.99 |
$54.99 |
$54.99 |
$54.99
|
|
Diab shoe for density insert
|
$178.40 |
$178.40 |
$178.40 |
$147.56
|
|
Diag bronchoscope/catheter
|
$448.00 |
$448.00 |
$448.00 |
$2,360.15
|
|
Diag laparo separate proc 49320
|
$807.20 |
$807.20 |
$807.20 |
$7,104.72
|
|
Diagnostic anoscopy
|
$355.20 |
$355.20 |
$355.20 |
$392.70
|
|
Diagnostic anoscopy & biopsy
|
$496.80 |
$496.80 |
$496.80 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$252.00 |
$252.00 |
$252.00 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$382.40 |
$382.40 |
$382.40 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$382.40 |
$382.40 |
$382.40 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$212.80 |
$212.80 |
$212.80 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$403.24 |
$403.24 |
$403.24 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$326.36 |
$326.36 |
$326.36 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$273.31 |
$273.31 |
$273.31 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$9,774.64 |
$9,774.64 |
$9,774.64 |
$5,741.00
|
|
Dialysis one evaluation
|
$2,673.25 |
$2,673.25 |
$2,673.25 |
$936.00
|
|
Dialysis repeated eval
|
$280.00 |
$280.00 |
$280.00 |
$1,332.80
|
|
Dialysis training complete
|
$789.60 |
$789.60 |
$789.60 |
$783.36
|
|
Dialysis training incompl
|
$172.00 |
$172.00 |
$172.00 |
$391.67
|
|
Diathermy eg microwave
|
$13.60 |
$13.60 |
$13.60 |
$29.68
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$89.72 |
$89.72 |
$89.72 |
$79.71
|
|
Dicyclomine injection
|
$132.40 |
$132.40 |
$132.40 |
$154.33
|
|
Diffusing capacity
|
$407.72 |
$407.72 |
$407.72 |
$336.80
|
|
Digital analysis of eeg
|
$605.60 |
$605.60 |
$605.60 |
$593.40
|
|
Digit nerve surgery add-on
|
$450.40 |
$450.40 |
$450.40 |
$1,832.59
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$137.60 |
$137.60 |
$137.60 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$66.43 |
$66.43 |
$66.43 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$309.20 |
$309.20 |
$309.20 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,273.60 |
$1,273.60 |
$1,273.60 |
$1,866.73
|
|
Dilate esophagus
|
$2,142.40 |
$2,142.40 |
$2,142.40 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$420.80 |
$420.80 |
$420.80 |
$1,548.00
|
|
Dilate tear duct opening
|
$454.40 |
$454.40 |
$454.40 |
$454.40
|
|
Dilate urethra stricture
|
$212.00 |
$212.00 |
$212.00 |
$513.00
|
|
Dilate urethra stricture
|
$200.80 |
$200.80 |
$200.80 |
$200.80
|
|
Dilate urethra stricture
|
$164.00 |
$164.00 |
$164.00 |
$3,863.60
|
|
Dilate urethra stricture
|
$344.80 |
$344.80 |
$344.80 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$174.40 |
$174.40 |
$174.40 |
$235.61
|
|
Dilation of anal sphincter
|
$416.80 |
$416.80 |
$416.80 |
$2,166.04
|
|
Dilation of cervical canal 57800
|
$172.80 |
$172.80 |
$172.80 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$476.80 |
$476.80 |
$476.80 |
$2,491.80
|
|
Dilation of salivary duct
|
$296.80 |
$296.80 |
$296.80 |
$790.00
|
|
Dilation of urethra
|
$172.00 |
$172.00 |
$172.00 |
$172.00
|
|
Dilation of urethra
|
$97.60 |
$97.60 |
$97.60 |
$2,424.12
|
|
Dilation of vagina
|
$328.80 |
$328.80 |
$328.80 |
$4,446.00
|
|
Dilation salivary duct 42650
|
$193.60 |
$193.60 |
$193.60 |
$2,675.71
|
|
Dilation/urethral strict/male/ini 53620
|
$366.40 |
$366.40 |
$366.40 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$138.80 |
$138.80 |
$138.80 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$3,903.54 |
$3,903.54 |
$3,903.54 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$6,567.08 |
$6,567.08 |
$6,567.08 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$2.89 |
$2.89 |
$2.89 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$746.40 |
$746.40 |
$746.40 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.60 |
$0.60 |
$0.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$74.84 |
$74.84 |
$74.84 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$62.40 |
$62.40 |
$62.40 |
$98.15
|
|
Direct advanced life support
|
$236.00 |
$236.00 |
$236.00 |
$236.00
|
|
Dir nsl mucous membrane test
|
$76.80 |
$76.80 |
$76.80 |
$76.80
|
|
Disability dlco
|
$425.15 |
$425.15 |
$425.15 |
$293.76
|
|
Disaccharidases
|
$64.28 |
$64.28 |
$64.28 |
$230.40
|
|
Disarticulation sho sec clsr
|
$2,300.80 |
$2,300.80 |
$2,300.80 |
$2,300.80
|
|
Discectomy ant dcmprn cord thoracic 1 ntrspc 63077
|
$3,636.00 |
$3,636.00 |
$3,636.00 |
$3,636.00
|
|
Discography cerv/thor spine
|
$3,834.20 |
$3,834.20 |
$3,834.20 |
$2,565.00
|
|
Dise eval slp do brth flx dx
|
$288.80 |
$288.80 |
$288.80 |
$1,120.00
|
|
Dissolve clot heart vessel
|
$813.60 |
$813.60 |
$813.60 |
$1,579.93
|
|
Dist revas ligation hemo
|
$5,588.80 |
$5,588.80 |
$5,588.80 |
$6,396.89
|
|
Diverticulectomy/hypophar/esoph 43130
|
$1,943.20 |
$1,943.20 |
$1,943.20 |
$6,547.81
|
|
Division of fallopian tube 58605
|
$832.00 |
$832.00 |
$832.00 |
$976.50
|
|
#d/lmeth-l-methamphetamine
|
$72.14 |
$72.14 |
$72.14 |
$72.14
|
|
Dlyd plmt xtn prosth ea addl
|
$4,420.93 |
$4,420.93 |
$4,420.93 |
$1,810.80
|
|
Dmd dup/delet analysis
|
$267.84 |
$267.84 |
$267.84 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$153.56 |
$153.56 |
$153.56 |
$313.60
|
|
Dna antibody native/double stranded
|
$48.57 |
$48.57 |
$48.57 |
$100.00
|
|
Dna gardnerella
|
$50.40 |
$50.40 |
$50.40 |
$61.83
|
|
Dna probe chlamydia
|
$57.60 |
$57.60 |
$57.60 |
$82.20
|
|
Dna probe gc
|
$58.40 |
$58.40 |
$58.40 |
$79.38
|
|
Dna trichomonas
|
$50.40 |
$50.40 |
$50.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$81.12 |
$81.12 |
$81.12 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4.00 |
$4.00 |
$4.00 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$70.92 |
$70.92 |
$70.92 |
$65.40
|
|
Doppler echo complete
|
$887.53 |
$887.53 |
$887.53 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$2,042.48 |
$2,042.48 |
$2,042.48 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,073.02 |
$1,073.02 |
$1,073.02 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$655.84 |
$655.84 |
$655.84 |
$481.65
|
|
Dornase alfa non-comp unit
|
$45.38 |
$45.38 |
$45.38 |
$356.00
|
