|
Dextrose 5 % IV bolus
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$164.80 |
$164.80 |
$164.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$68.80 |
$68.80 |
$68.80 |
$79.30
|
|
Diab manage trn ind/group
|
$67.20 |
$67.20 |
$67.20 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$220.00 |
$220.00 |
$220.00 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$290.40 |
$290.40 |
$290.40 |
$242.14
|
|
Diagnostic Mammogram (both breasts)
|
$517.60 |
$517.60 |
$517.60 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$508.00 |
$508.00 |
$508.00 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$69.20 |
$69.20 |
$69.20 |
$79.71
|
|
Diffusing capacity
|
$366.40 |
$366.40 |
$366.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$62.92 |
$62.92 |
$62.92 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$99.20 |
$99.20 |
$99.20 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$102.60 |
$102.60 |
$102.60 |
$297.86
|
|
Dilate esophagus
|
$2,577.60 |
$2,577.60 |
$2,577.60 |
$2,142.40
|
|
Dilation/urethral strict/male/ini 53620
|
$1,504.80 |
$1,504.80 |
$1,504.80 |
$1,372.80
|
|
Diltiazem 5 mg/ml intravenous solution
|
$61.23 |
$61.23 |
$61.23 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$515.85 |
$515.85 |
$515.85 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.20 |
$1.20 |
$1.20 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$60.64 |
$60.64 |
$60.64 |
$18.32
|
|
Disability dlco
|
$302.40 |
$302.40 |
$302.40 |
$293.76
|
|
Dna antibody native/double stranded
|
$111.20 |
$111.20 |
$111.20 |
$100.00
|
|
Dna probe chlamydia
|
$122.40 |
$122.40 |
$122.40 |
$82.20
|
|
Dna probe gc
|
$119.20 |
$119.20 |
$119.20 |
$79.38
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$145.91 |
$145.91 |
$145.91 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$119.91 |
$119.91 |
$119.91 |
$65.40
|
|
Doppler echo complete
|
$748.80 |
$748.80 |
$748.80 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$888.80 |
$888.80 |
$888.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$530.40 |
$530.40 |
$530.40 |
$481.65
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$73.84 |
$73.84 |
$73.84 |
$89.34
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$606.40 |
$606.40 |
$606.40 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$757.60 |
$757.60 |
$757.60 |
$964.00
|
|
Drainage external ear simple 69000
|
$785.60 |
$785.60 |
$785.60 |
$790.40
|
|
Drain blood from under nail 11740
|
$195.20 |
$195.20 |
$195.20 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$451.20 |
$451.20 |
$451.20 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$4,856.80 |
$4,856.80 |
$4,856.80 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$393.60 |
$393.60 |
$393.60 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$359.20 |
$359.20 |
$359.20 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$578.40 |
$578.40 |
$578.40 |
$541.00
|
|
Dressing change not for burn w/anes 15852
|
$585.60 |
$585.60 |
$585.60 |
$755.08
|
|
Drng of finger abscess comp 26011
|
$2,197.60 |
$2,197.60 |
$2,197.60 |
$2,079.50
|
|
Drng of scrotum abscess 55100
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$63.48 |
$63.48 |
$63.48 |
$31.25
|
|
Drug assay caffeine
|
$93.60 |
$93.60 |
$93.60 |
$80.00
|
|
Drug of abuse screen urine
|
$58.40 |
$58.40 |
$58.40 |
$67.89
|
|
Drug screen quant tiagabine
|
$71.20 |
$71.20 |
$71.20 |
$107.59
|
|
Drug test prsmv instrmnt
|
$103.20 |
$103.20 |
$103.20 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$304.80 |
$304.80 |
$304.80 |
$278.85
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$959.20 |
$959.20 |
$959.20 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$904.78
|
|
Ear irrigation 69209
|
$132.00 |
$132.00 |
$132.00 |
$154.70
|
|
Ecg external < 48 hours recording
|
$633.60 |
$633.60 |
$633.60 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$732.80 |
$732.80 |
$732.80 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$181.60 |
$181.60 |
$181.60 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$218.40 |
$218.40 |
$218.40 |
$173.40
|
|
Ecg record/review
|
$180.80 |
$180.80 |
$180.80 |
$371.28
|
|
Echocardiogram (Heart Ultrasound)
|
$2,319.20 |
$2,319.20 |
$2,319.20 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$1,033.60 |
$1,033.60 |
$1,033.60 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$640.00 |
$640.00 |
$640.00 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,617.60 |
$2,617.60 |
$2,617.60 |
$1,944.80
|
|
Echocardiograpy doppler follow up/limited study
|
$465.60 |
$465.60 |
$465.60 |
$371.25
|
|
Echo exam of fetal heart
|
$1,549.60 |
$1,549.60 |
$1,549.60 |
$904.80
|
|
Echo exam of fetal heart
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
$538.27
|
|
Echo exam of fetal heart
|
$750.40 |
$750.40 |
$750.40 |
$431.41
|
|
Echo exam of fetal heart
|
$571.20 |
$571.20 |
$571.20 |
$318.34
|
|
Echo exam uterus 76831-
|
$887.20 |
$887.20 |
$887.20 |
$561.00
|
|
Echo guide for amniocentesis
|
$650.40 |
$650.40 |
$650.40 |
$455.57
|
|
Echo guide villus sampling
|
$744.00 |
$744.00 |
$744.00 |
$362.88
|
|
Echo stress
|
$2,123.20 |
$2,123.20 |
$2,123.20 |
$1,609.44
|
|
Echo transthoracic
|
$2,024.00 |
$2,024.00 |
$2,024.00 |
$1,361.75
|
|
Echo transthoracic
|
$1,454.40 |
$1,454.40 |
$1,454.40 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,628.00 |
$1,628.00 |
$1,628.00 |
$1,033.00
|
|
Eeg recording awake and asleep
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$931.20
|
|
EKG tracing for initial prev
|
$122.40 |
$122.40 |
$122.40 |
$81.76
|
|
EKG (Tracing Only)
|
$284.80 |
$284.80 |
$284.80 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$300.00 |
$300.00 |
$300.00 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$360.80 |
$360.80 |
$360.80 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$129.60 |
$129.60 |
$129.60 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$95.20 |
$95.20 |
$95.20 |
$81.75
|
|
Electrolyte panel
|
$41.60 |
$41.60 |
$41.60 |
$79.30
|
|
Emb without cervical dilation 58100
|
$340.80 |
$340.80 |
$340.80 |
$373.60
|
|
Endoscopy swallow (fees) vid
|
$430.40 |
$430.40 |
$430.40 |
$402.35
|
|
Endoscpy nsl/sns w/cntrl nsl hmrrgh
|
$4,064.80 |
$4,064.80 |
$4,064.80 |
$2,787.20
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$121.73 |
$121.73 |
$121.73 |
$112.79
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$68.51 |
$68.51 |
$68.51 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$69.36 |
$69.36 |
$69.36 |
$31.76
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$64.90 |
$64.90 |
$64.90 |
$507.10
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$66.56 |
$66.56 |
$66.56 |
$33.60
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$800.00 |
$800.00 |
$800.00 |
$1,329.09
|
|
Epstein barr nuclear antigen antibody
|
$82.40 |
$82.40 |
$82.40 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$115.20 |
$115.20 |
$115.20 |
$85.50
|
|
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution
|
$1,399.51 |
$1,399.51 |
$1,399.51 |
$2,488.75
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$199.46 |
$199.46 |
$199.46 |
$232.12
|
|
ER Visit (level 1, minor)
|
$301.60 |
$301.60 |
$301.60 |
$252.60
|
|
ER Visit (level 2)
|
$488.80 |
$488.80 |
$488.80 |
$463.00
|
|
ER Visit (level 3)
|
$837.60 |
$837.60 |
$837.60 |
$812.18
|
|
ER Visit (level 4)
|
$1,318.40 |
$1,318.40 |
$1,318.40 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$1,871.60
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$508.67 |
$508.67 |
$508.67 |
$516.71
|
|
Established Patient Office Visit (level 1)
|
$329.60 |
$329.60 |
$329.60 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$167.20 |
$167.20 |
$167.20 |
$139.20
|
