|
Daptomycin 500 mg/10 ml intravenous solution
|
$93.64 |
$93.64 |
$93.64 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$3,530.83 |
$3,530.83 |
$3,530.83 |
$6,281.29
|
|
Dch glucoscan
|
$45.00 |
$45.00 |
$45.00 |
$29.16
|
|
Dch validity tests
|
$16.00 |
$16.00 |
$16.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$34.25 |
$34.25 |
$34.25 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$250.70 |
$250.70 |
$250.70 |
$284.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,287.15 |
$1,287.15 |
$1,287.15 |
$1,165.50
|
|
Decalcification
|
$127.20 |
$127.20 |
$127.20 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$393.65 |
$393.65 |
$393.65 |
$572.95
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$492.30 |
$492.30 |
$492.30 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,851.78 |
$2,851.78 |
$2,851.78 |
$6,324.98
|
|
Desmopressin 4 mcg/ml injection solution
|
$2,036.48 |
$2,036.48 |
$2,036.48 |
$91.84
|
|
Destroy cervthor facet jnt 64633
|
$5,408.25 |
$5,408.25 |
$5,408.25 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1.00 |
$1.00 |
$1.00 |
$1,441.44
|
|
Destruction by injection tx of nerve 64630
|
$2,596.95 |
$2,596.95 |
$2,596.95 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,410.15 |
$2,410.15 |
$2,410.15 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,597.10 |
$6,597.10 |
$6,597.10 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$277.75 |
$277.75 |
$277.75 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$456.70 |
$456.70 |
$456.70 |
$350.40
|
|
Device ablt adv novasure
|
$1,962.05 |
$1,962.05 |
$1,962.05 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,465.00 |
$1,465.00 |
$1,465.00 |
$4,200.00
|
|
Device intraute mirena
|
$1,846.97 |
$1,846.97 |
$1,846.97 |
$2,125.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$228.35 |
$228.35 |
$228.35 |
$199.50
|
|
Dexamethasone 4 mg tablet
|
$3.44 |
$3.44 |
$3.44 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$37.78 |
$37.78 |
$37.78 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$25.19 |
$25.19 |
$25.19 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$28.96 |
$28.96 |
$28.96 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$21.90 |
$21.90 |
$21.90 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$30.25 |
$30.25 |
$30.25 |
$79.30
|
|
Diagnostic digital breast tomosynthesis bil
|
$84.75 |
$84.75 |
$84.75 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$84.75 |
$84.75 |
$84.75 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$395.80 |
$395.80 |
$395.80 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$279.55 |
$279.55 |
$279.55 |
$314.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$98.79 |
$98.79 |
$98.79 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$169.55 |
$169.55 |
$169.55 |
$79.71
|
|
Diffusing capacity
|
$410.95 |
$410.95 |
$410.95 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.93 |
$6.93 |
$6.93 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$7,563.47 |
$7,563.47 |
$7,563.47 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$237.95 |
$237.95 |
$237.95 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$255.76 |
$255.76 |
$255.76 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$96.78 |
$96.78 |
$96.78 |
$402.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$5.89 |
$5.89 |
$5.89 |
$18.32
|
|
Disability dlco
|
$248.10 |
$248.10 |
$248.10 |
$293.76
|
|
Disaccharidases
|
$590.30 |
$590.30 |
$590.30 |
$230.40
|
|
Dna antibody native/double stranded
|
$71.70 |
$71.70 |
$71.70 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$201.49 |
$201.49 |
$201.49 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,784.48 |
$1,784.48 |
$1,784.48 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$71.78 |
$71.78 |
$71.78 |
$65.40
|
|
Doppler echo complete
|
$444.90 |
$444.90 |
$444.90 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$611.85 |
$611.85 |
$611.85 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$593.25 |
$593.25 |
$593.25 |
$481.65
|
|
Dornase alfa non-comp unit
|
$457.71 |
$457.71 |
$457.71 |
$356.00
|
|
Dornhoffer fixed part w/window
|
$395.00 |
$395.00 |
$395.00 |
$34,278.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$121.70 |
$121.70 |
$121.70 |
$89.34
|
|
Drainage of kidney lesion
|
$3,105.10 |
$3,105.10 |
$3,105.10 |
$1,506.00
|
|
Drain cath image guided visceral pq
|
$4,233.40 |
$4,233.40 |
$4,233.40 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,121.20 |
$1,121.20 |
$1,121.20 |
$1,044.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$2,776.01 |
$2,776.01 |
$2,776.01 |
$3,789.86
|
|
Droperidol 2.5 mg/ml injection solution
|
$53.55 |
$53.55 |
$53.55 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$330.01 |
$330.01 |
$330.01 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$2,580.30 |
$2,580.30 |
$2,580.30 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$1,218.00 |
$1,218.00 |
$1,218.00 |
$569.75
|
|
Drug assay posaconazole
|
$164.40 |
$164.40 |
$164.40 |
$96.75
|
|
Drug assay vedolizumab
|
$96.40 |
$96.40 |
$96.40 |
$154.00
|
|
Drug assay voriconazole
|
$296.60 |
$296.60 |
$296.60 |
$96.75
|
|
Drug of abuse screen urine
|
$32.75 |
$32.75 |
$32.75 |
$67.89
|
|
Drug test prsmv instrmnt
|
$50.90 |
$50.90 |
$50.90 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$189.40 |
$189.40 |
$189.40 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$5,074.65 |
$5,074.65 |
$5,074.65 |
$2,980.00
|
|
Ductogram sgl duct
|
$1,409.90 |
$1,409.90 |
$1,409.90 |
$469.80
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,233.10 |
$1,233.10 |
$1,233.10 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,407.45 |
$1,407.45 |
$1,407.45 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$397.65 |
$397.65 |
$397.65 |
$401.20
|
|
Ecg external < 48 hours recording
|
$135.00 |
$135.00 |
$135.00 |
$467.40
|
|
Ecg external > 48 hours up to 7 days recording
|
$43.00 |
$43.00 |
$43.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$43.00 |
$43.00 |
$43.00 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,780.25 |
$1,780.25 |
$1,780.25 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$1,017.35 |
$1,017.35 |
$1,017.35 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$382.45 |
$382.45 |
$382.45 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,780.25 |
$1,780.25 |
$1,780.25 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,052.60 |
$1,052.60 |
$1,052.60 |
$866.87
|
|
Echo exam of eye
|
$152.00 |
$152.00 |
$152.00 |
$172.00
|
|
Echo exam of eye thickness
|
$29.00 |
$29.00 |
$29.00 |
$40.30
|
|
Echo exam uterus 76831-
|
$924.60 |
$924.60 |
$924.60 |
$561.00
|
|
Echo guide for amniocentesis
|
$1,155.80 |
$1,155.80 |
$1,155.80 |
$455.57
|
|
Echo guide for artery repair
|
$784.25 |
$784.25 |
$784.25 |
$696.30
|
|
Echo stress
|
$556.85 |
$556.85 |
$556.85 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,213.30 |
$2,213.30 |
$2,213.30 |
$1,913.60
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,000.95 |
$1,000.95 |
$1,000.95 |
$1,033.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$1,497.10 |
$1,497.10 |
$1,497.10 |
$994.15
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,208.15 |
$1,208.15 |
$1,208.15 |
$835.00
|
|
Eeg/record in coma or sleep only 95822
|
$3,739.20 |
$3,739.20 |
$3,739.20 |
$871.00
|
|
Eeg recording awake and asleep
|
$1,532.20 |
$1,532.20 |
$1,532.20 |
$931.20
|
|
Eeg without vid ea 12-26hr cont
|
$1,289.00 |
$1,289.00 |
$1,289.00 |
$1,584.70
|
|
Eeg without vid ea 12-26hr intmt
|
$1,289.00 |
$1,289.00 |
$1,289.00 |
$1,584.70
|
|
Eeg wo vid 2-12hr intmt mntr
|
$671.00 |
$671.00 |
$671.00 |
$721.76
|
|
Eeg wo vid ea 12-26hr unmntr
|
$1,289.00 |
$1,289.00 |
$1,289.00 |
$1,632.95
|
|
E equine encephalitis igg
|
$83.20 |
$83.20 |
$83.20 |
$51.84
|
|
Ehrlicha chaffeensis amp prb
|
$378.85 |
$378.85 |
$378.85 |
$93.00
|
|
EKG (Tracing Only)
|
$287.70 |
$287.70 |
$287.70 |
$226.50
|