|
Debride nail1-5 11720
|
$148.80 |
$148.80 |
$148.80 |
$149.60
|
|
Debride nail6 or more 11721
|
$169.60 |
$169.60 |
$169.60 |
$169.80
|
|
Decalcification
|
$35.20 |
$35.20 |
$35.20 |
$68.34
|
|
Deferoxamine 500 mg solution for injection
|
$77.88 |
$77.88 |
$77.88 |
$95.85
|
|
Delivery of placenta 59414
|
$3,486.40 |
$3,486.40 |
$3,486.40 |
$2,912.46
|
|
Demonstrate use home inr mon
|
$278.40 |
$278.40 |
$278.40 |
$294.75
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$204.00 |
$204.00 |
$204.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,710.85 |
$2,710.85 |
$2,710.85 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$388.80 |
$388.80 |
$388.80 |
$401.60
|
|
Desmopressin 4 mcg/ml injection solution
|
$71.59 |
$71.59 |
$71.59 |
$91.84
|
|
Destruction benign lesions < 14 lesions
|
$248.80 |
$248.80 |
$248.80 |
$240.24
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$425.60 |
$425.60 |
$425.60 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$57.82 |
$57.82 |
$57.82 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$60.80 |
$60.80 |
$60.80 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$80.00 |
$80.00 |
$80.00 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$80.00 |
$80.00 |
$80.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$80.00 |
$80.00 |
$80.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$254.40 |
$254.40 |
$254.40 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$117.60 |
$117.60 |
$117.60 |
$79.30
|
|
Diab manage trn ind/group
|
$63.20 |
$63.20 |
$63.20 |
$54.99
|
|
Diagnostic digital breast tomosynthesis unil
|
$172.00 |
$172.00 |
$172.00 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$487.20 |
$487.20 |
$487.20 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$444.00 |
$444.00 |
$444.00 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$67.04 |
$67.04 |
$67.04 |
$79.71
|
|
Dicyclomine injection
|
$74.94 |
$74.94 |
$74.94 |
$154.33
|
|
Diffusing capacity
|
$336.80 |
$336.80 |
$336.80 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$62.34 |
$62.34 |
$62.34 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$130.40 |
$130.40 |
$130.40 |
$102.07
|
|
Dilate esophagus
|
$3,694.40 |
$3,694.40 |
$3,694.40 |
$2,142.40
|
|
Diltiazem 5 mg/ml intravenous solution
|
$60.66 |
$60.66 |
$60.66 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$5.10 |
$5.10 |
$5.10 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$60.76 |
$60.76 |
$60.76 |
$18.32
|
|
Disability dlco
|
$296.80 |
$296.80 |
$296.80 |
$293.76
|
|
Dna antibody native/double stranded
|
$158.40 |
$158.40 |
$158.40 |
$100.00
|
|
Dna probe chlamydia
|
$151.20 |
$151.20 |
$151.20 |
$82.20
|
|
Dna probe gc
|
$140.00 |
$140.00 |
$140.00 |
$79.38
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$208.25 |
$208.25 |
$208.25 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$132.54 |
$132.54 |
$132.54 |
$65.40
|
|
Doppler echo complete
|
$787.20 |
$787.20 |
$787.20 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,136.80 |
$1,136.80 |
$1,136.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$771.20 |
$771.20 |
$771.20 |
$481.65
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$72.48 |
$72.48 |
$72.48 |
$89.34
|
|
Drainage ext aud canal abscess 69020
|
$776.80 |
$776.80 |
$776.80 |
$964.00
|
|
Drainage external ear simple 69000
|
$864.00 |
$864.00 |
$864.00 |
$790.40
|
|
Drain blood from under nail 11740
|
$192.00 |
$192.00 |
$192.00 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$458.40 |
$458.40 |
$458.40 |
$428.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$358.40 |
$358.40 |
$358.40 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$365.60 |
$365.60 |
$365.60 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$738.40 |
$738.40 |
$738.40 |
$541.00
|
|
Drng of eyelid abscess 67700
|
$516.80 |
$516.80 |
$516.80 |
$655.72
|
|
Drug assay vedolizumab
|
$194.40 |
$194.40 |
$194.40 |
$154.00
|
|
Drug assay voriconazole
|
$106.40 |
$106.40 |
$106.40 |
$96.75
|
|
Drug of abuse screen urine
|
$58.40 |
$58.40 |
$58.40 |
$67.89
|
|
Drug test prsmv instrmnt
|
$208.80 |
$208.80 |
$208.80 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$196.80 |
$196.80 |
$196.80 |
$278.85
|
|
Duplex scan bilateral study 93985
|
$918.40 |
$918.40 |
$918.40 |
$691.08
|
|
Dup scan/hemodialysis access 93990
|
$720.00 |
$720.00 |
$720.00 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,016.80 |
$1,016.80 |
$1,016.80 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,354.40 |
$1,354.40 |
$1,354.40 |
$904.78
|
|
Ear irrigation 69209
|
$155.20 |
$155.20 |
$155.20 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$164.00 |
$164.00 |
$164.00 |
$132.08
|
|
Ecg external < 48 hours recording
|
$536.80 |
$536.80 |
$536.80 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$676.80 |
$676.80 |
$676.80 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$190.40 |
$190.40 |
$190.40 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$239.20 |
$239.20 |
$239.20 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,535.20 |
$2,535.20 |
$2,535.20 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$966.40 |
$966.40 |
$966.40 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$756.00 |
$756.00 |
$756.00 |
$511.55
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,284.80 |
$1,284.80 |
$1,284.80 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$496.00 |
$496.00 |
$496.00 |
$371.25
|
|
Echo exam of fetal heart
|
$1,704.00 |
$1,704.00 |
$1,704.00 |
$904.80
|
|
Echo exam of fetal heart
|
$748.80 |
$748.80 |
$748.80 |
$431.41
|
|
Echo stress
|
$2,185.60 |
$2,185.60 |
$2,185.60 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$3,103.20 |
$3,103.20 |
$3,103.20 |
$1,913.60
|
|
Echo transthoracic
|
$2,436.80 |
$2,436.80 |
$2,436.80 |
$1,361.75
|
|
Echo transthoracic
|
$1,518.40 |
$1,518.40 |
$1,518.40 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,782.40 |
$1,782.40 |
$1,782.40 |
$1,033.00
|
|
Eeg 41-60 minutes 95812-26
|
$1,295.20 |
$1,295.20 |
$1,295.20 |
$934.05
|
|
Eeg monitor/record/awake/drowsy 95816
|
$1,184.80 |
$1,184.80 |
$1,184.80 |
$835.00
|
|
Eeg recording awake and asleep
|
$1,242.40 |
$1,242.40 |
$1,242.40 |
$931.20
|
|
EKG tracing for initial prev
|
$203.20 |
$203.20 |
$203.20 |
$81.76
|
|
EKG (Tracing Only)
|
$278.40 |
$278.40 |
$278.40 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$372.00 |
$372.00 |
$372.00 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$446.40 |
$446.40 |
$446.40 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$111.20 |
$111.20 |
$111.20 |
$87.49
|
|
Electrolyte panel
|
$127.20 |
$127.20 |
$127.20 |
$79.30
|
|
Endo abl/incom vein/ext/rad fre/#1 36475
|
$7,245.60 |
$7,245.60 |
$7,245.60 |
$5,515.40
|
|
Endovenous rf abl vein addl
|
$5,305.60 |
$5,305.60 |
$5,305.60 |
$3,156.02
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$68.23 |
$68.23 |
$68.23 |
$112.79
|
|
Epinephrine 1 mg/ml im kit - adult
|
$62.08 |
$62.08 |
$62.08 |
$31.76
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$61.17 |
$61.17 |
$61.17 |
$33.60
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$588.00 |
$588.00 |
$588.00 |
$1,329.09
|
|
Epstein barr nuclear antigen antibody
|
$171.20 |
$171.20 |
$171.20 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$162.40 |
$162.40 |
$162.40 |
$85.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$106.80 |
$106.80 |
$106.80 |
$427.26
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$2,688.18 |
$2,688.18 |
$2,688.18 |
$3,838.45
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$79.08 |
$79.08 |
$79.08 |
$232.12
|
|
ER Visit (level 1, minor)
|
$323.20 |
$323.20 |
$323.20 |
$252.60
|
|
ER Visit (level 2)
|
$464.00 |
$464.00 |
$464.00 |
$463.00
|
|
ER Visit (level 3)
|
$704.80 |
$704.80 |
$704.80 |
$812.18
|
