|
Diagnostic laryngoscopy 31575
|
$516.80 |
$516.80 |
$516.80 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$588.00 |
$588.00 |
$588.00 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$458.40 |
$458.40 |
$458.40 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$311.20 |
$311.20 |
$311.20 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$11,752.00 |
$11,752.00 |
$11,752.00 |
$5,741.00
|
|
Dialysis one evaluation
|
$920.00 |
$920.00 |
$920.00 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$21.00 |
$21.00 |
$21.00 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$51.16 |
$51.16 |
$51.16 |
$79.71
|
|
Dicyclomine injection
|
$60.95 |
$60.95 |
$60.95 |
$154.33
|
|
Diffusing capacity
|
$362.40 |
$362.40 |
$362.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$53.60 |
$53.60 |
$53.60 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,449.75 |
$3,449.75 |
$3,449.75 |
$10,279.62
|
|
Dilate esophagus 1/mult pass
|
$2,041.60 |
$2,041.60 |
$2,041.60 |
$1,548.00
|
|
Dilate urethra stricture
|
$767.20 |
$767.20 |
$767.20 |
$513.00
|
|
Dilate urethra stricture
|
$5,869.60 |
$5,869.60 |
$5,869.60 |
$3,863.60
|
|
Dilation/urethral strict/male/ini 53620
|
$2,644.80 |
$2,644.80 |
$2,644.80 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$636.80 |
$636.80 |
$636.80 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$56.74 |
$56.74 |
$56.74 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$579.96 |
$579.96 |
$579.96 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$4.83 |
$4.83 |
$4.83 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$50.79 |
$50.79 |
$50.79 |
$18.32
|
|
Disability dlco
|
$526.40 |
$526.40 |
$526.40 |
$293.76
|
|
Discography cerv/thor spine
|
$2,961.60 |
$2,961.60 |
$2,961.60 |
$2,565.00
|
|
Dlyd plmt xtn prosth ea addl
|
$9,068.00 |
$9,068.00 |
$9,068.00 |
$1,810.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$122.51 |
$122.51 |
$122.51 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$166.06 |
$166.06 |
$166.06 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$54.76 |
$54.76 |
$54.76 |
$65.40
|
|
Doppler echo complete
|
$817.60 |
$817.60 |
$817.60 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$4,272.00 |
$4,272.00 |
$4,272.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$849.60 |
$849.60 |
$849.60 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$761.60 |
$761.60 |
$761.60 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$45,080.00 |
$45,080.00 |
$45,080.00 |
$34,278.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$66.51 |
$66.51 |
$66.51 |
$89.34
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$794.40 |
$794.40 |
$794.40 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,044.80 |
$1,044.80 |
$1,044.80 |
$964.00
|
|
Drainage external ear complex 69005
|
$2,900.80 |
$2,900.80 |
$2,900.80 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$748.80 |
$748.80 |
$748.80 |
$790.40
|
|
Drainage mouth roof lesion
|
$528.80 |
$528.80 |
$528.80 |
$405.60
|
|
Drainage of arm bursa 23931
|
$3,006.40 |
$3,006.40 |
$3,006.40 |
$2,271.01
|
|
Drainage of eye
|
$3,377.60 |
$3,377.60 |
$3,377.60 |
$2,415.65
|
|
Drainage of eye
|
$5,138.40 |
$5,138.40 |
$5,138.40 |
$3,170.00
|
|
Drainage of kidney lesion
|
$1,933.60 |
$1,933.60 |
$1,933.60 |
$1,506.00
|
|
Drainage of mouth lesion
|
$3,721.60 |
$3,721.60 |
$3,721.60 |
$3,837.72
|
|
Drainage of mouth lesion
|
$2,811.20 |
$2,811.20 |
$2,811.20 |
$905.30
|
|
Drainage of urethra abscess 53060
|
$2,186.40 |
$2,186.40 |
$2,186.40 |
$2,424.12
|
|
Drain bladder by trocar/cath
|
$4,228.00 |
$4,228.00 |
$4,228.00 |
$1,203.94
|
|
Drain blood from under nail 11740
|
$193.60 |
$193.60 |
$193.60 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,525.60 |
$2,525.60 |
$2,525.60 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$3,932.00 |
$3,932.00 |
$3,932.00 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,433.60 |
$1,433.60 |
$1,433.60 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$1,972.80 |
$1,972.80 |
$1,972.80 |
$428.40
|
|
Drain lower leg lesion 27603
|
$3,357.60 |
$3,357.60 |
$3,357.60 |
$3,994.09
|
|
Drain thigh/knee lesion 27301
|
$6,492.00 |
$6,492.00 |
$6,492.00 |
$3,986.00
|
|
Drain thyroid/tongue cyst
|
$1,691.20 |
$1,691.20 |
$1,691.20 |
$1,752.89
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$428.80 |
$428.80 |
$428.80 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$442.40 |
$442.40 |
$442.40 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$485.60 |
$485.60 |
$485.60 |
$541.00
|
|
Dressing change not for burn w/anes 15852
|
$1,920.80 |
$1,920.80 |
$1,920.80 |
$755.08
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$176.06 |
$176.06 |
$176.06 |
$3,789.86
|
|
Drill hole implt ventricular cath/device 61107
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
$1,485.75
|
|
Drng hand tendon sheath 26020
|
$4,788.00 |
$4,788.00 |
$4,788.00 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$709.60 |
$709.60 |
$709.60 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$1,972.80 |
$1,972.80 |
$1,972.80 |
$2,079.50
|
|
Drng of hydrocele 55000
|
$1,056.80 |
$1,056.80 |
$1,056.80 |
$867.90
|
|
Drng of mouth lesion 40801
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$1,350.97
|
|
Drng of palm multi bursas 26030
|
$5,200.00 |
$5,200.00 |
$5,200.00 |
$3,839.54
|
|
Drng of palm single bursa 26025
|
$4,783.20 |
$4,783.20 |
$4,783.20 |
$3,839.54
|
|
Drng of scrotum abscess 55100
|
$1,873.60 |
$1,873.60 |
$1,873.60 |
$1,997.89
|
|
Drng salivary gland simple 42300
|
$3,281.60 |
$3,281.60 |
$3,281.60 |
$2,039.50
|
|
Droperidol 2.5 mg/ml injection solution
|
$51.31 |
$51.31 |
$51.31 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,392.89 |
$1,392.89 |
$1,392.89 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$54.55 |
$54.55 |
$54.55 |
$119.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$220.85 |
$220.85 |
$220.85 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$111.56 |
$111.56 |
$111.56 |
$193.15
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$190.67 |
$190.67 |
$190.67 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$891.20 |
$891.20 |
$891.20 |
$569.75
|
|
Dry needling (97799)
|
$120.00 |
$120.00 |
$120.00 |
$114.27
|
|
Dstrj nulyt agt gnclr nrv
|
$3,996.00 |
$3,996.00 |
$3,996.00 |
$2,980.00
|
|
Dup scan/hemodialysis access 93990
|
$659.20 |
$659.20 |
$659.20 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$691.20 |
$691.20 |
$691.20 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$809.60 |
$809.60 |
$809.60 |
$904.78
|
|
Duragen 1x1 5ea/bx
|
$53.44 |
$53.44 |
$53.44 |
$10,564.87
|
|
Dx bronchoscope/brush 31623
|
$3,239.20 |
$3,239.20 |
$3,239.20 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$3,534.40 |
$3,534.40 |
$3,534.40 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$2,828.80 |
$2,828.80 |
$2,828.80 |
$2,410.50
|
|
Ear irrigation 69209
|
$158.40 |
$158.40 |
$158.40 |
$154.70
|
|
Ecallantide injection
|
$14,577.51 |
$14,577.51 |
$14,577.51 |
$13,357.14
|
|
Ecg/1-3 leads/tracing only 93041
|
$196.80 |
$196.80 |
$196.80 |
$132.08
|
|
Ecg external < 48 hours recording
|
$552.00 |
$552.00 |
$552.00 |
$467.40
|
|
Ecg external > 48 hours up to 7 days recording
|
$412.00 |
$412.00 |
$412.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$432.80 |
$432.80 |
$432.80 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$992.00 |
$992.00 |
$992.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$741.60 |
$741.60 |
$741.60 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,629.60 |
$2,629.60 |
$2,629.60 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$504.00 |
$504.00 |
$504.00 |
$371.25
|
|
Echo exam of fetal heart
|
$1,369.60 |
$1,369.60 |
$1,369.60 |
$904.80
|
|
Echo exam of fetal heart
|
$720.80 |
$720.80 |
$720.80 |
$431.41
|
|
Echo exam uterus 76831-
|
$676.00 |
$676.00 |
$676.00 |
$561.00
|