|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$2,467.00 |
$2,467.00 |
$2,467.00 |
$1,899.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$83.00 |
$83.00 |
$83.00 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$504.00 |
$504.00 |
$504.00 |
$1,165.50
|
|
Decalcification
|
$176.00 |
$176.00 |
$176.00 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$224.90 |
$224.90 |
$224.90 |
$1,073.52
|
|
Deferoxamine 500 mg solution for injection
|
$65.35 |
$65.35 |
$65.35 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$4,556.35 |
$4,556.35 |
$4,556.35 |
$1,856.85
|
|
Delayed breast prosthesis 19342
|
$35,865.50 |
$35,865.50 |
$35,865.50 |
$7,906.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$320.00 |
$320.00 |
$320.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$15,865.45 |
$15,865.45 |
$15,865.45 |
$6,324.98
|
|
Deodorant ostmy adapt lube 8ml
|
$0.10 |
$0.10 |
$0.10 |
$1.98
|
|
Desmopressin 4 mcg/ml injection solution
|
$42.90 |
$42.90 |
$42.90 |
$91.84
|
|
Device ablt adv novasure
|
$9,596.13 |
$9,596.13 |
$9,596.13 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,999.50 |
$3,999.50 |
$3,999.50 |
$4,200.00
|
|
Device intraute mirena
|
$3,250.58 |
$3,250.58 |
$3,250.58 |
$2,125.00
|
|
Device sut capio slim opn
|
$2,360.40 |
$2,360.40 |
$2,360.40 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$6,094.92 |
$6,094.92 |
$6,094.92 |
$2,515.00
|
|
Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr
|
$21.00 |
$21.00 |
$21.00 |
$21.00
|
|
Dexamethasone 4 mg tablet
|
$28.80 |
$28.80 |
$28.80 |
$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
|
|
Dextran 40 infusion
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$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)
|
$270.00 |
$270.00 |
$270.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$245.00 |
$245.00 |
$245.00 |
$79.30
|
|
Diag laparo separate proc 49320
|
$24,453.90 |
$24,453.90 |
$24,453.90 |
$7,104.72
|
|
Diagnostic laryngoscopy 31575
|
$217.00 |
$217.00 |
$217.00 |
$338.00
|
|
Dialysis one evaluation
|
$1,730.00 |
$1,730.00 |
$1,730.00 |
$936.00
|
|
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
|
$11.50 |
$11.50 |
$11.50 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$13,725.30 |
$13,725.30 |
$13,725.30 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$316.00 |
$316.00 |
$316.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$358.75 |
$358.75 |
$358.75 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$423.05 |
$423.05 |
$423.05 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$8.85 |
$8.85 |
$8.85 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$3.40 |
$3.40 |
$3.40 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$3.70 |
$3.70 |
$3.70 |
$18.32
|
|
Dna antibody native/double stranded
|
$154.00 |
$154.00 |
$154.00 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$183.75 |
$183.75 |
$183.75 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$115.00 |
$115.00 |
$115.00 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$91.25 |
$91.25 |
$91.25 |
$65.40
|
|
Doppler echo complete
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$2,214.00 |
$2,214.00 |
$2,214.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$867.00 |
$867.00 |
$867.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$804.00 |
$804.00 |
$804.00 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$74,450.39 |
$74,450.39 |
$74,450.39 |
$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 cath image guided visceral pq
|
$572.00 |
$572.00 |
$572.00 |
$2,903.44
|
|
Drain chst dry seal exp thorastat
|
$212.98 |
$212.98 |
$212.98 |
$119.43
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$1,504.70 |
$1,504.70 |
$1,504.70 |
$3,789.86
|
|
Droperidol 2.5 mg/ml injection solution
|
$44.55 |
$44.55 |
$44.55 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$5,886.99 |
$5,886.99 |
$5,886.99 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$241.26 |
$241.26 |
$241.26 |
$119.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$53.60 |
$53.60 |
$53.60 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$64.30 |
$64.30 |
$64.30 |
$193.15
|
|
Drsg sht 5.625x4.625in std
|
$123.24 |
$123.24 |
$123.24 |
$123.24
|
|
Drsg surg adh 11x11 3/4 occl drap wnd 28x30
|
$0.73 |
$0.73 |
$0.73 |
$19.10
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$146.06 |
$146.06 |
$146.06 |
$94.94
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$72.19 |
$72.19 |
$72.19 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$9,582.38 |
$9,582.38 |
$9,582.38 |
$7,465.97
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$25.75 |
$25.75 |
$25.75 |
$1.00
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$381.35 |
$381.35 |
$381.35 |
$376.50
|
|
Drug assay posaconazole
|
$495.00 |
$495.00 |
$495.00 |
$96.75
|
|
Drug assay vedolizumab
|
$192.00 |
$192.00 |
$192.00 |
$154.00
|
|
Drug assay voriconazole
|
$239.00 |
$239.00 |
$239.00 |
$96.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$21,627.71 |
$21,627.71 |
$21,627.71 |
$278.85
|
|
Duplex scan bilateral study 93985
|
$337.00 |
$337.00 |
$337.00 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$337.00 |
$337.00 |
$337.00 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$489.72
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,889.00 |
$1,889.00 |
$1,889.00 |
$904.78
|
|
Duragen 1x1 5ea/bx
|
$2,313.19 |
$2,313.19 |
$2,313.19 |
$10,564.87
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$264.34 |
$264.34 |
$264.34 |
$16,549.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$13,206.10 |
$13,206.10 |
$13,206.10 |
$8,445.90
|
|
Dx bronchoscope/lavage 31624
|
$4,149.00 |
$4,149.00 |
$4,149.00 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$4,511.00 |
$4,511.00 |
$4,511.00 |
$2,410.50
|
|
Ecg external < 48 hours recording
|
$731.00 |
$731.00 |
$731.00 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,058.00 |
$1,058.00 |
$1,058.00 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$92.00 |
$92.00 |
$92.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$152.00 |
$152.00 |
$152.00 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,452.00 |
$2,452.00 |
$2,452.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$3,587.00 |
$3,587.00 |
$3,587.00 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,524.00 |
$1,524.00 |
$1,524.00 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$647.00 |
$647.00 |
$647.00 |
$371.25
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$751.34
|
|
Echo tee guidance
|
$2,776.00 |
$2,776.00 |
$2,776.00 |
$1,878.84
|
|
Echo tee probe placement image acquisition interpretation & report
|
$3,157.00 |
$3,157.00 |
$3,157.00 |
$1,913.60
|
|
Echo transesophageal
|
$1,605.00 |
$1,605.00 |
$1,605.00 |
$602.00
|
|
Echo transesophageal intraop
|
$325.00 |
$325.00 |
$325.00 |
$1,578.00
|
|
Echo transthoracic
|
$1,973.00 |
$1,973.00 |
$1,973.00 |
$1,361.75
|
|
Echo transthoracic
|
$1,347.00 |
$1,347.00 |
$1,347.00 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$3,553.00 |
$3,553.00 |
$3,553.00 |
$1,033.00
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$18,199.20 |
$18,199.20 |
$18,199.20 |
$19,540.29
|