|
Disability dlco
|
$62.40 |
$62.40 |
$62.40 |
$293.76
|
|
Disaccharidases
|
$64.80 |
$64.80 |
$64.80 |
$230.40
|
|
Discography cerv/thor spine
|
$0.60 |
$0.60 |
$0.60 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$0.60 |
$0.60 |
$0.60 |
$1,579.93
|
|
Dna antibody native/double stranded
|
$49.80 |
$49.80 |
$49.80 |
$100.00
|
|
Dna gardnerella
|
$194.40 |
$194.40 |
$194.40 |
$61.83
|
|
Dna probe chlamydia
|
$72.60 |
$72.60 |
$72.60 |
$82.20
|
|
Dna probe gc
|
$72.60 |
$72.60 |
$72.60 |
$79.38
|
|
Dna trichomonas
|
$72.60 |
$72.60 |
$72.60 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$31.20 |
$31.20 |
$31.20 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$0.60 |
$0.60 |
$0.60 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$2.40 |
$2.40 |
$2.40 |
$65.40
|
|
Doppler echo complete
|
$66.00 |
$66.00 |
$66.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$0.60 |
$0.60 |
$0.60 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$571.80 |
$571.80 |
$571.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$375.00 |
$375.00 |
$375.00 |
$481.65
|
|
Doripenem 50 mg/ml inj 10 ml
|
$43.20 |
$43.20 |
$43.20 |
$73.80
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$279.00 |
$279.00 |
$279.00 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$232.80 |
$232.80 |
$232.80 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$642.60 |
$642.60 |
$642.60 |
$1,718.24
|
|
Drainage of kidney lesion
|
$0.60 |
$0.60 |
$0.60 |
$1,506.00
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$0.60 |
$0.60 |
$0.60 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$0.60 |
$0.60 |
$0.60 |
$2,903.44
|
|
Droperidol 2.5 mg/ml injection solution
|
$7.80 |
$7.80 |
$7.80 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$573.00 |
$573.00 |
$573.00 |
$1,818.32
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$237.60 |
$237.60 |
$237.60 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$423.60 |
$423.60 |
$423.60 |
$193.15
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$10,534.20 |
$10,534.20 |
$10,534.20 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$0.60 |
$0.60 |
$0.60 |
$569.75
|
|
Drug assay caffeine
|
$24.00 |
$24.00 |
$24.00 |
$80.00
|
|
Drug of abuse screen urine
|
$16.20 |
$16.20 |
$16.20 |
$67.89
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$103.80 |
$103.80 |
$103.80 |
$278.85
|
|
Drvvt confirm - quest
|
$81.00 |
$81.00 |
$81.00 |
$109.20
|
|
Ductogram sgl duct
|
$196.20 |
$196.20 |
$196.20 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$1,144.20 |
$1,144.20 |
$1,144.20 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$643.20 |
$643.20 |
$643.20 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$679.20 |
$679.20 |
$679.20 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$732.60 |
$732.60 |
$732.60 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$840.00 |
$840.00 |
$840.00 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$1,036.80 |
$1,036.80 |
$1,036.80 |
$8,445.90
|
|
Ecg/1-3 leads/tracing only 93041
|
$33.00 |
$33.00 |
$33.00 |
$132.08
|
|
Ecg external < 48 hours recording
|
$66.00 |
$66.00 |
$66.00 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$331.80 |
$331.80 |
$331.80 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$66.00 |
$66.00 |
$66.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$66.00 |
$66.00 |
$66.00 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$405.00 |
$405.00 |
$405.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$139.20 |
$139.20 |
$139.20 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$33.00 |
$33.00 |
$33.00 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$405.00 |
$405.00 |
$405.00 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$139.20 |
$139.20 |
$139.20 |
$866.87
|
|
Echo guide for artery repair
|
$0.60 |
$0.60 |
$0.60 |
$696.30
|
|
Echo stress
|
$398.40 |
$398.40 |
$398.40 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$398.40 |
$398.40 |
$398.40 |
$1,913.60
|
|
Echo transthoracic
|
$298.80 |
$298.80 |
$298.80 |
$1,361.75
|
|
Echo transthoracic
|
$132.60 |
$132.60 |
$132.60 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$298.80 |
$298.80 |
$298.80 |
$1,033.00
|
|
Ecmo/ecls remove perph cannula 0-5yrs perq 33965
|
$0.60 |
$0.60 |
$0.60 |
$520.80
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$0.60 |
$0.60 |
$0.60 |
$1,660.50
|
|
Eeg monitor/record/awake/drowsy 95816
|
$421.80 |
$421.80 |
$421.80 |
$835.00
|
|
Eeg recording awake and asleep
|
$501.00 |
$501.00 |
$501.00 |
$931.20
|
|
Egfr gene com variants
|
$909.60 |
$909.60 |
$909.60 |
$672.88
|
|
EKG (Tracing Only)
|
$79.20 |
$79.20 |
$79.20 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$89.40 |
$89.40 |
$89.40 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$106.80 |
$106.80 |
$106.80 |
$364.20
|
|
Electrd sq emblem s-icd
|
$6,672.00 |
$6,672.00 |
$6,672.00 |
$10,243.24
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$22.80 |
$22.80 |
$22.80 |
$87.49
|
|
Electrolyte panel
|
$12.60 |
$12.60 |
$12.60 |
$79.30
|
|
Electron microscopy diagnostic
|
$649.20 |
$649.20 |
$649.20 |
$1,011.98
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$8,975.40
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$10,724.84
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$6,760.00
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$5,883.66
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$2,559.70
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$2,914.40
|
|
Electrophysiology evaluation
|
$0.60 |
$0.60 |
$0.60 |
$1,844.00
|
|
Elotuzumab 300 mg intravenous solution
|
$3,061.20 |
$3,061.20 |
$3,061.20 |
$5,761.81
|
|
Embolization s&i
|
$0.60 |
$0.60 |
$0.60 |
$3,215.00
|
|
Embo or occlude vascular arterial s&i
|
$0.60 |
$0.60 |
$0.60 |
$16,031.73
|
|
Embo or occlude vascular hemorrhage s&i
|
$0.60 |
$0.60 |
$0.60 |
$14,586.00
|
|
Embo or occlude vascular tumor/organ/infarct s&i
|
$0.60 |
$0.60 |
$0.60 |
$15,101.00
|
|
Embo or occlude vascular venous s&i
|
$0.60 |
$0.60 |
$0.60 |
$14,741.00
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$163.80 |
$163.80 |
$163.80 |
$502.80
|
|
Endoluminal bx biliary tree
|
$0.60 |
$0.60 |
$0.60 |
$2,379.30
|
|
Endoluminl ivus oct c 1st
|
$0.60 |
$0.60 |
$0.60 |
$3,306.60
|
|
Endoluminl ivus oct c ea
|
$0.60 |
$0.60 |
$0.60 |
$2,158.95
|
|
Endovasc visc aorta 2 graft
|
$0.60 |
$0.60 |
$0.60 |
$7,081.75
|
|
Endovas iliac a device addon
|
$0.60 |
$0.60 |
$0.60 |
$950.38
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$36.60 |
$36.60 |
$36.60 |
$8,222.82
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$35.40 |
$35.40 |
$35.40 |
$112.79
|
|
Entamoeba histolytica ag eia - sendout
|
$64.80 |
$64.80 |
$64.80 |
$56.89
|
|
Enzyme histochemistry
|
$81.00 |
$81.00 |
$81.00 |
$455.91
|
|
Ep & ablate supravent arrhyt
|
$0.60 |
$0.60 |
$0.60 |
$26,193.60
|
|
Ep & ablate ventric tachy
|
$0.60 |
$0.60 |
$0.60 |
$27,778.40
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$33.00 |
$33.00 |
$33.00 |
$256.27
|
|
Epoetin alfa, 100 units esrd
|
$164.40 |
$164.40 |
$164.40 |
$6.00
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$667.20 |
$667.20 |
$667.20 |
$1,329.09
|
|
Epstein barr early antigen antibody
|
$53.40 |
$53.40 |
$53.40 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$53.40 |
$53.40 |
$53.40 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$76.20 |
$76.20 |
$76.20 |
$85.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$62.40 |
$62.40 |
$62.40 |
$427.26
|