|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$12,573.08 |
$12,573.08 |
$12,573.08 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$122.00 |
$122.00 |
$122.00 |
$142.38
|
|
Device ablt adv novasure
|
$5,926.35 |
$5,926.35 |
$5,926.35 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,470.00 |
$2,470.00 |
$2,470.00 |
$4,200.00
|
|
Device intraute mirena
|
$6,362.20 |
$6,362.20 |
$6,362.20 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,764.08 |
$3,764.08 |
$3,764.08 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$172.25 |
$172.25 |
$172.25 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$13.00 |
$13.00 |
$13.00 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$20.20 |
$20.20 |
$20.20 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$884.80 |
$884.80 |
$884.80 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$35.00 |
$35.00 |
$35.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$35.00 |
$35.00 |
$35.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$30.00 |
$30.00 |
$30.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$185.90 |
$185.90 |
$185.90 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$547.30 |
$547.30 |
$547.30 |
$79.30
|
|
Diab manage trn ind/group
|
$79.30 |
$79.30 |
$79.30 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$209.30 |
$209.30 |
$209.30 |
$195.50
|
|
Diagnostic Mammogram (both breasts)
|
$445.90 |
$445.90 |
$445.90 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$297.05 |
$297.05 |
$297.05 |
$314.00
|
|
Diathermy eg microwave
|
$65.65 |
$65.65 |
$65.65 |
$29.68
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$250.05 |
$250.05 |
$250.05 |
$79.71
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$25.30 |
$25.30 |
$25.30 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$91.65 |
$91.65 |
$91.65 |
$102.07
|
|
Dilator fascial 10fx20cm
|
$342.50 |
$342.50 |
$342.50 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$41.90 |
$41.90 |
$41.90 |
$45.60
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$3.70 |
$3.70 |
$3.70 |
$18.32
|
|
Dis site tele svcs rhc/fqhc
|
$139.75 |
$139.75 |
$139.75 |
$96.75
|
|
Dna antibody native/double stranded
|
$101.40 |
$101.40 |
$101.40 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$103.75 |
$103.75 |
$103.75 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2,567.60 |
$2,567.60 |
$2,567.60 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$65.00 |
$65.00 |
$65.00 |
$65.40
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$588.25 |
$588.25 |
$588.25 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$444.60 |
$444.60 |
$444.60 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$24,000.60 |
$24,000.60 |
$24,000.60 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$36,812.65 |
$36,812.65 |
$36,812.65 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$1,578.20 |
$1,578.20 |
$1,578.20 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$7,093.75 |
$7,093.75 |
$7,093.75 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$28.30 |
$28.30 |
$28.30 |
$89.34
|
|
Drain blood from under nail 11740
|
$133.00 |
$133.00 |
$133.00 |
$182.40
|
|
Drain chst dry seal exp thorastat
|
$143.78 |
$143.78 |
$143.78 |
$119.43
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$870.15 |
$870.15 |
$870.15 |
$3,789.86
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$3,635.67 |
$3,635.67 |
$3,635.67 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$162.87 |
$162.87 |
$162.87 |
$119.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$27.87 |
$27.87 |
$27.87 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$33.44 |
$33.44 |
$33.44 |
$193.15
|
|
Drsg sht 5.625x4.625in std
|
$95.08 |
$95.08 |
$95.08 |
$123.24
|
|
Drsg surg adh 11x11 3/4 occl drap wnd 28x30
|
$1.90 |
$1.90 |
$1.90 |
$19.10
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$112.68 |
$112.68 |
$112.68 |
$94.94
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$55.69 |
$55.69 |
$55.69 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$5,917.86 |
$5,917.86 |
$5,917.86 |
$7,465.97
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$13.39 |
$13.39 |
$13.39 |
$1.00
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$308.74 |
$308.74 |
$308.74 |
$376.50
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$137.15 |
$137.15 |
$137.15 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$7,528.59 |
$7,528.59 |
$7,528.59 |
$2,980.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,101.10 |
$1,101.10 |
$1,101.10 |
$904.78
|
|
Duragen 1x1 5ea/bx
|
$1,337.70 |
$1,337.70 |
$1,337.70 |
$10,564.87
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$178.45 |
$178.45 |
$178.45 |
$16,549.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$13,206.10 |
$13,206.10 |
$13,206.10 |
$8,445.90
|
|
Ear irrigation 69209
|
$464.10 |
$464.10 |
$464.10 |
$154.70
|
|
Ecg/1-3 leads/interp & report only 93042
|
$14.30 |
$14.30 |
$14.30 |
$16.00
|
|
Ecg < 30 days transmission & analysis
|
$477.75 |
$477.75 |
$477.75 |
$412.88
|
|
Ecg external < 48 hours recording
|
$451.10 |
$451.10 |
$451.10 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$500.50 |
$500.50 |
$500.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$219.70 |
$219.70 |
$219.70 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$458.25 |
$458.25 |
$458.25 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,527.50 |
$1,527.50 |
$1,527.50 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$910.00 |
$910.00 |
$910.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$341.25 |
$341.25 |
$341.25 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,943.50 |
$1,943.50 |
$1,943.50 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$696.15 |
$696.15 |
$696.15 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$292.50 |
$292.50 |
$292.50 |
$371.25
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$18,199.20 |
$18,199.20 |
$18,199.20 |
$19,540.29
|
|
Efgartigimod alfa-fcab 20 mg/ml intravenous solution
|
$18,942.60 |
$18,942.60 |
$18,942.60 |
$13,130.61
|
|
EKG (Electrocardiogram)
|
$81.25 |
$81.25 |
$81.25 |
$89.60
|
|
EKG tracing for initial prev
|
$62.40 |
$62.40 |
$62.40 |
$81.76
|
|
EKG (Tracing Only)
|
$945.10 |
$945.10 |
$945.10 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$237.25 |
$237.25 |
$237.25 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$327.60 |
$327.60 |
$327.60 |
$364.20
|
|
Electrd sq emblem s-icd
|
$7,007.00 |
$7,007.00 |
$7,007.00 |
$10,243.24
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$81.25 |
$81.25 |
$81.25 |
$87.49
|
|
Electrolyte panel
|
$63.05 |
$63.05 |
$63.05 |
$79.30
|
|
Elotuzumab 300 mg intravenous solution
|
$9,470.30 |
$9,470.30 |
$9,470.30 |
$5,761.81
|
|
Elranatamab-bcmm 40 mg/ml subcutaneous solution
|
$42,858.30 |
$42,858.30 |
$42,858.30 |
$14,606.11
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$321.10 |
$321.10 |
$321.10 |
$394.80
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$12,640.50 |
$12,640.50 |
$12,640.50 |
$8,222.82
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$37.65 |
$37.65 |
$37.65 |
$112.79
|
|
Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution
|
$50,429.90 |
$50,429.90 |
$50,429.90 |
$30,598.85
|
|
Epidural/lumbar/sacral/ea add level64484
|
$410.00 |
$410.00 |
$410.00 |
$1,182.00
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$58.00 |
$58.00 |
$58.00 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$50.40 |
$50.40 |
$50.40 |
$31.76
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$50.40 |
$50.40 |
$50.40 |
$507.10
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$190.90 |
$190.90 |
$190.90 |
$33.60
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$1,405.00 |
$1,405.00 |
$1,405.00 |
$256.27
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$865.80
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$4,916.35 |
$4,916.35 |
$4,916.35 |
$1,329.09
|
|
Epstein barr early antigen antibody
|
$94.25 |
$94.25 |
$94.25 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$107.90 |
$107.90 |
$107.90 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$120.90 |
$120.90 |
$120.90 |
$85.50
|