|
D&c/diagnostic/therapeutic/non ob 58120
|
$3,304.00 |
$3,304.00 |
$3,304.00 |
$3,774.81
|
|
Dch glucoscan
|
$36.80 |
$36.80 |
$36.80 |
$29.16
|
|
Deamidated gliadin antibody iga
|
$54.40 |
$54.40 |
$54.40 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$844.80 |
$844.80 |
$844.80 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$352.80 |
$352.80 |
$352.80 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$912.00 |
$912.00 |
$912.00 |
$835.20
|
|
Decalcification
|
$73.60 |
$73.60 |
$73.60 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$2,057.12 |
$2,057.12 |
$2,057.12 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$541.60 |
$541.60 |
$541.60 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$209.28 |
$209.28 |
$209.28 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$2,072.15 |
$2,072.15 |
$2,072.15 |
$1,856.85
|
|
Delivery of placenta 59414
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$182.40 |
$182.40 |
$182.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$5,159.32 |
$5,159.32 |
$5,159.32 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$475.20 |
$475.20 |
$475.20 |
$401.60
|
|
Desmopressin 4 mcg/ml injection solution
|
$42.02 |
$42.02 |
$42.02 |
$91.84
|
|
Device intraute mirena
|
$752.95 |
$752.95 |
$752.95 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$117.60 |
$117.60 |
$117.60 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$5.48 |
$5.48 |
$5.48 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$39.39 |
$39.39 |
$39.39 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$401.58 |
$401.58 |
$401.58 |
$884.80
|
|
Dhea-s (dehydroepiand sulfate)
|
$143.20 |
$143.20 |
$143.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$67.20 |
$67.20 |
$67.20 |
$79.30
|
|
Diab manage trn ind/group
|
$60.80 |
$60.80 |
$60.80 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$282.40 |
$282.40 |
$282.40 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$436.80 |
$436.80 |
$436.80 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$356.00 |
$356.00 |
$356.00 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$494.40 |
$494.40 |
$494.40 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$386.40 |
$386.40 |
$386.40 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$223.20 |
$223.20 |
$223.20 |
$259.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$42.59 |
$42.59 |
$42.59 |
$79.71
|
|
Dicyclomine injection
|
$49.60 |
$49.60 |
$49.60 |
$154.33
|
|
Diffusing capacity
|
$305.60 |
$305.60 |
$305.60 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$35.64 |
$35.64 |
$35.64 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$134.40 |
$134.40 |
$134.40 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$149.44 |
$149.44 |
$149.44 |
$297.86
|
|
Diltiazem 5 mg/ml intravenous solution
|
$35.73 |
$35.73 |
$35.73 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$4.80 |
$4.80 |
$4.80 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$35.20 |
$35.20 |
$35.20 |
$18.32
|
|
Disaccharidases
|
$230.40 |
$230.40 |
$230.40 |
$230.40
|
|
Dna antibody native/double stranded
|
$103.20 |
$103.20 |
$103.20 |
$100.00
|
|
Dna gardnerella
|
$101.60 |
$101.60 |
$101.60 |
$61.83
|
|
Dna trichomonas
|
$101.60 |
$101.60 |
$101.60 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$77.56 |
$77.56 |
$77.56 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,205.48 |
$1,205.48 |
$1,205.48 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$139.40 |
$139.40 |
$139.40 |
$65.40
|
|
Doppler echo complete
|
$791.20 |
$791.20 |
$791.20 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$660.80 |
$660.80 |
$660.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$432.80 |
$432.80 |
$432.80 |
$481.65
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$15,594.79 |
$15,594.79 |
$15,594.79 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$325.49 |
$325.49 |
$325.49 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,925.79 |
$2,925.79 |
$2,925.79 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$48.40 |
$48.40 |
$48.40 |
$89.34
|
|
Drainage external ear simple 69000
|
$771.20 |
$771.20 |
$771.20 |
$790.40
|
|
Drain blood from under nail 11740
|
$332.00 |
$332.00 |
$332.00 |
$182.40
|
|
Drain cath image guided visceral pq
|
$2,621.60 |
$2,621.60 |
$2,621.60 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,624.00 |
$1,624.00 |
$1,624.00 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$597.60 |
$597.60 |
$597.60 |
$428.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$428.80 |
$428.80 |
$428.80 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$530.40 |
$530.40 |
$530.40 |
$541.00
|
|
Drng of finger abscess comp 26011
|
$814.40 |
$814.40 |
$814.40 |
$2,079.50
|
|
Droperidol 2.5 mg/ml injection solution
|
$40.58 |
$40.58 |
$40.58 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$696.80 |
$696.80 |
$696.80 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$144.80 |
$144.80 |
$144.80 |
$7,465.97
|
|
Drug assay posaconazole
|
$71.20 |
$71.20 |
$71.20 |
$96.75
|
|
Drug assay vedolizumab
|
$232.80 |
$232.80 |
$232.80 |
$154.00
|
|
Drug assay voriconazole
|
$71.20 |
$71.20 |
$71.20 |
$96.75
|
|
Drug of abuse screen urine
|
$58.40 |
$58.40 |
$58.40 |
$67.89
|
|
Drug test prsmv instrmnt
|
$162.40 |
$162.40 |
$162.40 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$440.80 |
$440.80 |
$440.80 |
$278.85
|
|
Dry needling (97799)
|
$108.00 |
$108.00 |
$108.00 |
$114.27
|
|
Duplex scan bilateral study 93985
|
$872.80 |
$872.80 |
$872.80 |
$691.08
|
|
Dup scan/hemodialysis access 93990
|
$605.60 |
$605.60 |
$605.60 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$740.80 |
$740.80 |
$740.80 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$665.60 |
$665.60 |
$665.60 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$6,540.48 |
$6,540.48 |
$6,540.48 |
$8,445.90
|
|
Ear irrigation 69209
|
$145.60 |
$145.60 |
$145.60 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$147.20 |
$147.20 |
$147.20 |
$132.08
|
|
Ecg external < 48 hours recording
|
$264.00 |
$264.00 |
$264.00 |
$467.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,196.00 |
$2,196.00 |
$2,196.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$1,147.20 |
$1,147.20 |
$1,147.20 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$607.20 |
$607.20 |
$607.20 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,542.40 |
$2,542.40 |
$2,542.40 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,436.80 |
$1,436.80 |
$1,436.80 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$453.60 |
$453.60 |
$453.60 |
$371.25
|
|
Echo exam of fetal heart
|
$1,267.20 |
$1,267.20 |
$1,267.20 |
$904.80
|
|
Echo exam uterus 76831-
|
$376.80 |
$376.80 |
$376.80 |
$561.00
|
|
Echo guide for amniocentesis
|
$288.00 |
$288.00 |
$288.00 |
$455.57
|
|
Echo stress
|
$2,101.60 |
$2,101.60 |
$2,101.60 |
$1,609.44
|
|
Echo transthoracic
|
$1,880.00 |
$1,880.00 |
$1,880.00 |
$1,361.75
|
|
Echo transthoracic
|
$1,424.80 |
$1,424.80 |
$1,424.80 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,603.20 |
$1,603.20 |
$1,603.20 |
$1,033.00
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,085.60 |
$1,085.60 |
$1,085.60 |
$835.00
|
|
Eeg recording awake and asleep
|
$1,182.40 |
$1,182.40 |
$1,182.40 |
$931.20
|
|
Egd remove foreign body
|
$2,920.00 |
$2,920.00 |
$2,920.00 |
$1,571.40
|
|
Egfr gene com variants
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$672.88
|
|
EKG tracing for initial prev
|
$132.80 |
$132.80 |
$132.80 |
$81.76
|
|
EKG (Tracing Only)
|
$221.60 |
$221.60 |
$221.60 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$220.00 |
$220.00 |
$220.00 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$267.20 |
$267.20 |
$267.20 |
$364.20
|