|
Deamidated gliadin antibody iga
|
$11.40 |
$11.40 |
$11.40 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$66.60 |
$66.60 |
$66.60 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$186.00 |
$186.00 |
$186.00 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$1,486.80 |
$1,486.80 |
$1,486.80 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$838.80 |
$838.80 |
$838.80 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$872.40 |
$872.40 |
$872.40 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$838.80 |
$838.80 |
$838.80 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$838.80 |
$838.80 |
$838.80 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$838.80 |
$838.80 |
$838.80 |
$1,160.00
|
|
Decalcification
|
$28.20 |
$28.20 |
$28.20 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$385.80 |
$385.80 |
$385.80 |
$1,073.52
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,392.60 |
$7,392.60 |
$7,392.60 |
$6,324.98
|
|
Design mlc device for imrt
|
$4,338.00 |
$4,338.00 |
$4,338.00 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$2,074.80 |
$2,074.80 |
$2,074.80 |
$89.78
|
|
Destroy cervthor facet jnt 64633
|
$2,589.60 |
$2,589.60 |
$2,589.60 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$1,295.40 |
$1,295.40 |
$1,295.40 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$50.40 |
$50.40 |
$50.40 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$30.00 |
$30.00 |
$30.00 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$58.20 |
$58.20 |
$58.20 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,295.40 |
$1,295.40 |
$1,295.40 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,589.60 |
$2,589.60 |
$2,589.60 |
$3,202.98
|
|
Device intraute mirena
|
$3,258.00 |
$3,258.00 |
$3,258.00 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$79.20 |
$79.20 |
$79.20 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$4.20 |
$4.20 |
$4.20 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$18.00 |
$18.00 |
$18.00 |
$21.17
|
|
Dexmedetomidine film, 1 mcg
|
$422.40 |
$422.40 |
$422.40 |
$171.39
|
|
Dhea-s (dehydroepiand sulfate)
|
$288.60 |
$288.60 |
$288.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$80.40 |
$80.40 |
$80.40 |
$79.20
|
|
Diagnostic laryngoscopy 31575
|
$366.00 |
$366.00 |
$366.00 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$475.20 |
$475.20 |
$475.20 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$475.20 |
$475.20 |
$475.20 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$113.40 |
$113.40 |
$113.40 |
$214.08
|
|
Dialysis one evaluation
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$116.40 |
$116.40 |
$116.40 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$91.80 |
$91.80 |
$91.80 |
$74.76
|
|
Dicyclomine injection
|
$268.20 |
$268.20 |
$268.20 |
$153.29
|
|
Diffusing capacity
|
$184.20 |
$184.20 |
$184.20 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$19.20 |
$19.20 |
$19.20 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$12,133.20 |
$12,133.20 |
$12,133.20 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$185.40 |
$185.40 |
$185.40 |
$102.00
|
|
Diltiazem 5 mg/ml intravenous solution
|
$45.60 |
$45.60 |
$45.60 |
$47.94
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$4.80 |
$4.80 |
$4.80 |
$17.75
|
|
Disability dlco
|
$184.20 |
$184.20 |
$184.20 |
$282.40
|
|
Dna antibody native/double stranded
|
$288.60 |
$288.60 |
$288.60 |
$97.50
|
|
Dna gardnerella
|
$37.20 |
$37.20 |
$37.20 |
$62.50
|
|
Dna trichomonas
|
$37.20 |
$37.20 |
$37.20 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$42.60 |
$42.60 |
$42.60 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,451.40 |
$1,451.40 |
$1,451.40 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$65.40 |
$65.40 |
$65.40 |
$65.40
|
|
Doppler intravascular pressure flow initial vessel
|
$3,046.80 |
$3,046.80 |
$3,046.80 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$205.20 |
$205.20 |
$205.20 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$223.80 |
$223.80 |
$223.80 |
$471.17
|
|
Dornase alfa non-comp unit
|
$886.80 |
$886.80 |
$886.80 |
$446.75
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$39,990.60 |
$39,990.60 |
$39,990.60 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$81.60 |
$81.60 |
$81.60 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$8,077.80 |
$8,077.80 |
$8,077.80 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$96.60 |
$96.60 |
$96.60 |
$84.80
|
|
Drainage external ear complex 69005
|
$3,782.40 |
$3,782.40 |
$3,782.40 |
$2,726.90
|
|
Drainage of kidney lesion
|
$1,070.40 |
$1,070.40 |
$1,070.40 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$126.00 |
$126.00 |
$126.00 |
$170.50
|
|
Drain cath image guided visceral pq
|
$2,985.00 |
$2,985.00 |
$2,985.00 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$917.40 |
$917.40 |
$917.40 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$278.40 |
$278.40 |
$278.40 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$246.00 |
$246.00 |
$246.00 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$199.20 |
$199.20 |
$199.20 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$448.20 |
$448.20 |
$448.20 |
$523.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$31.07
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$193.15 |
$193.15 |
$193.15 |
$289.05
|
|
Drug admin & hemodynmic meas
|
$248.40 |
$248.40 |
$248.40 |
$569.75
|
|
Drug of abuse screen urine
|
$123.00 |
$123.00 |
$123.00 |
$63.75
|
|
Drug test def 15-21 classes
|
$146.40 |
$146.40 |
$146.40 |
$263.25
|
|
Drug test def 1-7 classes
|
$203.40 |
$203.40 |
$203.40 |
$250.52
|
|
Drug test def 8-14 classes
|
$156.60 |
$156.60 |
$156.60 |
$282.00
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$220.80 |
$220.80 |
$220.80 |
$278.85
|
|
Drvvt confirm - quest
|
$213.60 |
$213.60 |
$213.60 |
$109.20
|
|
Duplex scan bilateral study 93985
|
$356.40 |
$356.40 |
$356.40 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$178.80 |
$178.80 |
$178.80 |
$360.75
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$754.20 |
$754.20 |
$754.20 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$11,861.40 |
$11,861.40 |
$11,861.40 |
$7,973.90
|
|
Dxa bone density axl vrt fx
|
$279.60 |
$279.60 |
$279.60 |
$392.60
|
|
Ear irrigation 69209
|
$110.40 |
$110.40 |
$110.40 |
$149.76
|
|
Ecg 12 lead tracing only
|
$234.60 |
$234.60 |
$234.60 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$106.20 |
$106.20 |
$106.20 |
$135.80
|
|
Ecg external < 48 hours recording
|
$127.20 |
$127.20 |
$127.20 |
$462.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$51.60 |
$51.60 |
$51.60 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$82.20 |
$82.20 |
$82.20 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$2,640.00 |
$2,640.00 |
$2,640.00 |
$2,001.17
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,742.00 |
$2,742.00 |
$2,742.00 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$702.00 |
$702.00 |
$702.00 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,348.20 |
$1,348.20 |
$1,348.20 |
$851.50
|
|
Echo guide for artery repair
|
$828.60 |
$828.60 |
$828.60 |
$664.00
|
|
Echo stress
|
$397.80 |
$397.80 |
$397.80 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,717.80 |
$1,717.80 |
$1,717.80 |
$1,849.50
|
|
Eeg 41-60 minutes 95812-26
|
$694.80 |
$694.80 |
$694.80 |
$920.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$402.00 |
$402.00 |
$402.00 |
$1,000.42
|
|
Eeg monitor/record/awake/drowsy 95816
|
$78.60 |
$78.60 |
$78.60 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$708.00 |
$708.00 |
$708.00 |
$1,102.05
|
|
Eeg/record in coma or sleep only 95822
|
$776.40 |
$776.40 |
$776.40 |
$907.80
|
|
Eeg recording awake and asleep
|
$540.00 |
$540.00 |
$540.00 |
$931.20
|
|
Eeg without vid 2-12 hr unmntr
|
$183.60 |
$183.60 |
$183.60 |
$601.30
|
