|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$262.10 |
$262.10 |
$262.10 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$819.60 |
$819.60 |
$819.60 |
$1,165.50
|
|
Decalcification
|
$81.15 |
$81.15 |
$81.15 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$892.33 |
$892.33 |
$892.33 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$534.80 |
$534.80 |
$534.80 |
$572.95
|
|
Degarelix 120 mg subcutaneous solution
|
$2,201.30 |
$2,201.30 |
$2,201.30 |
$1,856.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$54.80 |
$54.80 |
$54.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,230.42 |
$4,230.42 |
$4,230.42 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$93.60 |
$93.60 |
$93.60 |
$401.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$677.85 |
$677.85 |
$677.85 |
$666.75
|
|
Destruction benign lesions < 14 lesions
|
$213.25 |
$213.25 |
$213.25 |
$240.24
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$9,038.64 |
$9,038.64 |
$9,038.64 |
$4,200.00
|
|
Device intraute mirena
|
$1,489.51 |
$1,489.51 |
$1,489.51 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$380.60 |
$380.60 |
$380.60 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$1.03 |
$1.03 |
$1.03 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$20.28 |
$20.28 |
$20.28 |
$20.76
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$12.92 |
$12.92 |
$12.92 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$85.75 |
$85.75 |
$85.75 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$165.00 |
$165.00 |
$165.00 |
$79.30
|
|
Diab manage trn ind/group
|
$30.80 |
$30.80 |
$30.80 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$70.60 |
$70.60 |
$70.60 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$266.20 |
$266.20 |
$266.20 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$266.20 |
$266.20 |
$266.20 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$204.65 |
$204.65 |
$204.65 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$117.30 |
$117.30 |
$117.30 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$397.95 |
$397.95 |
$397.95 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$214.25 |
$214.25 |
$214.25 |
$314.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$97.20 |
$97.20 |
$97.20 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$195.05 |
$195.05 |
$195.05 |
$79.71
|
|
Diffusing capacity
|
$268.75 |
$268.75 |
$268.75 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$38.72 |
$38.72 |
$38.72 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,099.62 |
$6,099.62 |
$6,099.62 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$206.30 |
$206.30 |
$206.30 |
$102.07
|
|
Dilation/urethral strict/male/ini 53620
|
$77.60 |
$77.60 |
$77.60 |
$1,372.80
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$8.25 |
$8.25 |
$8.25 |
$18.32
|
|
Disability dlco
|
$192.55 |
$192.55 |
$192.55 |
$293.76
|
|
Disaccharidases
|
$139.45 |
$139.45 |
$139.45 |
$230.40
|
|
Dna antibody native/double stranded
|
$95.80 |
$95.80 |
$95.80 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$231.78 |
$231.78 |
$231.78 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$100.39 |
$100.39 |
$100.39 |
$65.40
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$641.85 |
$641.85 |
$641.85 |
$481.65
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,028.02 |
$2,028.02 |
$2,028.02 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$110.43 |
$110.43 |
$110.43 |
$89.34
|
|
Dpyd gene common variants
|
$437.00 |
$437.00 |
$437.00 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$227.05 |
$227.05 |
$227.05 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$252.30 |
$252.30 |
$252.30 |
$964.00
|
|
Drainage external ear complex 69005
|
$164.40 |
$164.40 |
$164.40 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$211.90 |
$211.90 |
$211.90 |
$790.40
|
|
Drainage mouth roof lesion
|
$290.15 |
$290.15 |
$290.15 |
$405.60
|
|
Drainage of arm bursa 23931
|
$275.00 |
$275.00 |
$275.00 |
$2,271.01
|
|
Drainage of mouth lesion
|
$230.90 |
$230.90 |
$230.90 |
$535.20
|
|
Drainage of mouth lesion
|
$366.40 |
$366.40 |
$366.40 |
$3,837.72
|
|
Drainage of nose lesion int 30000
|
$213.20 |
$213.20 |
$213.20 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$112.25 |
$112.25 |
$112.25 |
$781.44
|
|
Drainage of pelvis bursa
|
$1,671.30 |
$1,671.30 |
$1,671.30 |
$2,840.80
|
|
Drain blood from under nail 11740
|
$56.85 |
$56.85 |
$56.85 |
$182.40
|
|
Drain cath image guided visceral pq
|
$794.15 |
$794.15 |
$794.15 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$147.05 |
$147.05 |
$147.05 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$223.25 |
$223.25 |
$223.25 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$453.25 |
$453.25 |
$453.25 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$271.20 |
$271.20 |
$271.20 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$582.95 |
$582.95 |
$582.95 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$301.50 |
$301.50 |
$301.50 |
$541.00
|
|
Drng of eyelid abscess 67700
|
$203.10 |
$203.10 |
$203.10 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$252.30 |
$252.30 |
$252.30 |
$2,079.50
|
|
Drng of scrotum abscess 55100
|
$309.05 |
$309.05 |
$309.05 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$67.76 |
$67.76 |
$67.76 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$299.36 |
$299.36 |
$299.36 |
$1,818.32
|
|
Drug assay posaconazole
|
$154.40 |
$154.40 |
$154.40 |
$96.75
|
|
Drug assay vedolizumab
|
$96.40 |
$96.40 |
$96.40 |
$154.00
|
|
Drug assay voriconazole
|
$131.05 |
$131.05 |
$131.05 |
$96.75
|
|
Drug test prsmv instrmnt
|
$126.45 |
$126.45 |
$126.45 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$310.70 |
$310.70 |
$310.70 |
$278.85
|
|
Dry needling (97799)
|
$750.65 |
$750.65 |
$750.65 |
$114.27
|
|
Ductogram sgl duct
|
$487.05 |
$487.05 |
$487.05 |
$469.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$310.85 |
$310.85 |
$310.85 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$956.80 |
$956.80 |
$956.80 |
$401.20
|
|
Dx bronchoscope/wash 31622
|
$780.80 |
$780.80 |
$780.80 |
$2,410.50
|
|
Ear irrigation 69209
|
$35.25 |
$35.25 |
$35.25 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$192.55 |
$192.55 |
$192.55 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$306.20 |
$306.20 |
$306.20 |
$412.88
|
|
Ecg external < 48 hours recording
|
$318.25 |
$318.25 |
$318.25 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$369.05 |
$369.05 |
$369.05 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$426.50 |
$426.50 |
$426.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$426.50 |
$426.50 |
$426.50 |
$173.40
|
|
Ecg/review interpret only
|
$331.55 |
$331.55 |
$331.55 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$2,275.60 |
$2,275.60 |
$2,275.60 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$1,152.60 |
$1,152.60 |
$1,152.60 |
$720.60
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,983.50 |
$1,983.50 |
$1,983.50 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$952.70 |
$952.70 |
$952.70 |
$866.87
|
|
Echo exam uterus 76831-
|
$919.55 |
$919.55 |
$919.55 |
$561.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,370.75 |
$1,370.75 |
$1,370.75 |
$1,913.60
|
|
E equine encephalitis igg
|
$63.25 |
$63.25 |
$63.25 |
$51.84
|
|
Egd/insert intraluminal tube/cath 43241
|
$131.05 |
$131.05 |
$131.05 |
$2,244.82
|
|
Ehrlicha chaffeensis amp prb
|
$121.10 |
$121.10 |
$121.10 |
$93.00
|
|
EKG (Tracing Only)
|
$314.20 |
$314.20 |
$314.20 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$238.20 |
$238.20 |
$238.20 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$381.90 |
$381.90 |
$381.90 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$133.10 |
$133.10 |
$133.10 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$133.10 |
$133.10 |
$133.10 |
$81.75
|