|
Drng salivary gland submax/subling 42310
|
$741.60 |
$741.60 |
$741.60 |
|
|
Dronabinol 2.5mg oral
|
$1.87 |
$1.87 |
$7.81 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$9.91 |
$9.91 |
$22.40 |
|
|
Drop lock knee
|
$193.79 |
$193.79 |
$193.79 |
|
|
Drop lock retainer each
|
$50.26 |
$50.26 |
$50.26 |
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$364.00 |
$845.60 |
$845.60 |
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$31.96 |
$171.12 |
$171.12 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$15.12 |
$76.80 |
$171.12 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$15.12 |
$21.84 |
$171.12 |
|
|
Drsg surg adh 11x11 3/4 occl drap wnd 28x30
|
$21.51 |
$21.51 |
$21.51 |
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$33.60 |
$171.12 |
$1,853.60 |
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Drug admin & hemodynmic meas
|
$118.11 |
$379.00 |
$951.00 |
|
|
Drug assay caffeine
|
$16.67 |
$53.23 |
$127.00 |
|
|
Drug assay posaconazole
|
$37.41 |
$91.00 |
$228.80 |
|
|
Drug assay rufinamide
|
$37.41 |
$72.30 |
$152.80 |
|
|
Drug assay vedolizumab
|
$53.23 |
$53.23 |
$521.60 |
|
|
Drug assay voriconazole
|
$37.41 |
$82.00 |
$190.40 |
|
|
Drug asy hydroxychloroquine
|
$25.72 |
$25.72 |
$25.72 |
|
|
Drug of abuse screen urine
|
$6.11 |
$39.00 |
$44.00 |
|
|
Drug screening tapentadol
|
$18.94 |
$18.94 |
$18.94 |
|
|
Drug screen quant tiagabine
|
$12.69 |
$37.41 |
$37.41 |
|
|
Drug test def 15-21 classes
|
$274.26 |
$274.26 |
$274.26 |
|
|
Drug test def 1-7 classes
|
$78.54 |
$157.91 |
$196.00 |
|
|
Drug test def 22+ classes
|
$18.88 |
$318.08 |
$340.75 |
|
|
Drug test def 8-14 classes
|
$187.60 |
$216.09 |
$216.09 |
|
|
Drug test def simple all cl
|
$85.75 |
$85.75 |
$85.75 |
|
|
Drug test prsmv instrmnt
|
$7.99 |
$23.65 |
$474.40 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$40.32 |
$85.75 |
$953.60 |
|
|
Drvvt confirm - quest
|
$18.80 |
$24.81 |
$304.00 |
|
|
Dry needling (97799)
|
$45.92 |
$138.00 |
$138.00 |
|
|
Dstrj extensive retinopathy
|
$5,405.82 |
$5,405.82 |
$5,405.82 |
|
|
Dstrj nulyt agt gnclr nrv
|
$2,685.07 |
$5,707.00 |
$7,434.00 |
|
|
Dstr mal les s/n/h/f/g >4.0
|
$558.97 |
$558.97 |
$558.97 |
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$558.97 |
$558.97 |
$558.97 |
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$1,016.25 |
$1,016.25 |
$1,016.25 |
|
|
Dstry eye lesn,fdr vssl tech
|
$756.27 |
$756.27 |
$756.27 |
|
|
Ductogram sgl duct
|
$157.92 |
$588.00 |
$855.00 |
|
|
Duodenal exclusion
|
$2,528.66 |
$2,528.66 |
$2,528.66 |
|
|
Duodenal motility study
|
$513.11 |
$513.11 |
$513.11 |
|
|
Duplex scan bilateral study 93985
|
$328.08 |
$508.00 |
$1,181.60 |
|
|
Duplex scan unilateral study 93986
|
$143.75 |
$227.00 |
$788.00 |
|
|
Dup scan/hemodialysis access 93990
|
$143.75 |
$320.00 |
$843.00 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$147.11 |
$356.00 |
$1,058.00 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$239.12 |
$859.00 |
$2,101.60 |
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$119.05 |
$119.05 |
$119.05 |
|
|
Dxa bone density axl vrt fx
|
$126.56 |
$326.00 |
$1,317.60 |
|
|
Dx aly aud oi snd prcsr 1st
|
$176.93 |
$176.93 |
$176.93 |
|
|
Dx aly aud oi snd prcsr each
|
$19.21 |
$19.21 |
$43.95 |
|
|
Dx bronchoscope/brush 31623
|
$2,447.43 |
$2,447.43 |
$2,447.43 |
|
|
Dx bronchoscope/lavage 31624
|
$2,447.43 |
$2,858.00 |
$3,610.00 |
|
|
Dx bronchoscope/wash 31622
|
$2,447.43 |
$6,532.00 |
$7,443.00 |
|
|
Dx dark adaptation exam i&r
|
$614.27 |
$614.27 |
$614.27 |
|
|
Dx duod intub w/asp spec 43756
|
$1,247.13 |
$1,247.13 |
$1,247.13 |
|
|
Dx duod intub w/asp specs
|
$1,247.13 |
$1,247.13 |
$1,247.13 |
|
|
Dx gastr intub w/asp spec
|
$296.91 |
$296.91 |
$296.91 |
|
|
Dx gastr intub w/asp specs
|
$176.93 |
$176.93 |
$176.93 |
|
|
Dx laryngoscopy newborn
|
$537.80 |
$537.80 |
$537.80 |
|
|
Dx laryngoscopy w/oper scope
|
$2,447.43 |
$2,447.43 |
$2,447.43 |
|
|
Dynamic cavernosometry
|
$343.55 |
$343.55 |
$343.55 |
|
|
Dynamic surface emg
|
$296.91 |
$296.91 |
$296.91 |
|
|
Ear and throat examination
|
$741.60 |
$741.60 |
$741.60 |
|
|
Ear canal biopsy 69105
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
|
|
Ear cartilage graft
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
|
|
Ear irrigation 69209
|
$81.12 |
$308.62 |
$346.00 |
|
|
Ear protector evaluation
|
$51.36 |
$51.36 |
$51.36 |
|
|
Ecallantide injection
|
$800.05 |
$800.05 |
$800.05 |
|
|
Ecg/1-3 leads/interp & report only 93042
|
$9.91 |
$9.91 |
$9.91 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$81.12 |
$81.12 |
$111.20 |
|
|
Ecg < 30 days transmission & analysis
|
$130.73 |
$175.28 |
$613.60 |
|
|
Ecg external < 48 hours recording
|
$116.56 |
$264.00 |
$690.00 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$81.12 |
$264.00 |
$779.00 |
|
|
Ecg external > 48 hours up to 7 days recording
|
$51.36 |
$123.00 |
$230.00 |
|
|
Ecg external >7 days up to 15 days recording
|
$51.36 |
$200.00 |
$360.80 |
|
|
Ecg record/review
|
$228.11 |
$228.11 |
$228.11 |
|
|
Ecg/review interpret only
|
$29.61 |
$33.06 |
$93.52 |
|
|
Echocardiogram (Heart Ultrasound)
|
$751.34 |
$2,039.00 |
$2,796.00 |
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$259.28 |
$869.00 |
$1,791.00 |
|
|
Echocardiography doppler color flow mapping
|
$27.13 |
$202.00 |
$999.20 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,009.56 |
$2,591.00 |
$2,945.00 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$479.72 |
$1,245.00 |
$2,265.00 |
|
|
Echocardiograpy doppler follow up/limited study
|
$24.03 |
$100.00 |
$633.60 |
|
|
Echo exam of eye
|
$143.75 |
$143.75 |
$143.75 |
|
|
Echo exam of eye
|
$143.75 |
$143.75 |
$143.75 |
|
|
Echo exam of eye
|
$119.66 |
$119.66 |
$119.66 |
|
|
Echo exam of eye thickness
|
$39.77 |
$39.77 |
$39.77 |
|
|
Echo exam of fetal heart
|
$482.72 |
$1,377.00 |
$2,525.00 |
|
|
Echo exam of fetal heart
|
$328.08 |
$771.00 |
$1,753.00 |
|
|
Echo exam of fetal heart
|
$104.72 |
$560.00 |
$1,177.60 |
|
|
Echo exam of fetal heart
|
$81.76 |
$569.00 |
$801.00 |
|
|
Echo exam uterus 76831-
|
$152.75 |
$968.00 |
$1,195.20 |
|
|
Echograp trans r pros study
|
$143.75 |
$436.00 |
$946.00 |
|
|
Echo guidance radiotherapy
|
$94.07 |
$1,137.00 |
$3,478.00 |
|
|
Echo guide for amniocentesis
|
$25.72 |
$602.00 |
$1,195.20 |
|
|
Echo guide for artery repair
|
$296.91 |
$296.91 |
$5,948.80 |
|
