|
Dest mal lesion feenlm 0.6-1cm 17281
|
$93.60 |
$93.60 |
$93.60 |
$440.00
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$107.90 |
$107.90 |
$107.90 |
$408.50
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$97.50 |
$97.50 |
$97.50 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$121.55 |
$121.55 |
$121.55 |
$275.88
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$180.05 |
$180.05 |
$180.05 |
$274.80
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$107.25 |
$107.25 |
$107.25 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$125.45 |
$125.45 |
$125.45 |
$313.60
|
|
Destroy premlg lesns;1st lesn 17000
|
$43.55 |
$43.55 |
$43.55 |
$199.50
|
|
Destruct ben lesion 15/> 17111
|
$66.30 |
$66.30 |
$66.30 |
$250.20
|
|
Destruction 2-14 lesions 17003
|
$9.10 |
$9.10 |
$9.10 |
$78.61
|
|
Destruction anal lesion(s)
|
$16,816.12 |
$16,816.12 |
$16,816.12 |
$3,035.44
|
|
Destruction benign lesions < 14 lesions
|
$54.60 |
$54.60 |
$54.60 |
$231.52
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$31,824.53 |
$31,824.53 |
$31,824.53 |
$3,101.88
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$108.55 |
$108.55 |
$108.55 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$130.65 |
$130.65 |
$130.65 |
$470.51
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$358.80 |
$358.80 |
$358.80 |
$461.12
|
|
Destruction mal lsn t/a/l >4cm
|
$121.55 |
$121.55 |
$121.55 |
$578.40
|
|
Destruction penis lesion(s) chem 54050
|
$85.15 |
$85.15 |
$85.15 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$15,221.73 |
$15,221.73 |
$15,221.73 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$78.00 |
$78.00 |
$78.00 |
$442.61
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$310.05 |
$310.05 |
$310.05 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$7.15 |
$7.15 |
$7.15 |
$8.23
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,296.75 |
$1,296.75 |
$1,296.75 |
$465.34
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$130.00 |
$130.00 |
$130.00 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$130.00 |
$130.00 |
$130.00 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$130.00 |
$130.00 |
$130.00 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$130.00 |
$130.00 |
$130.00 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$219.70 |
$219.70 |
$219.70 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$124.80 |
$124.80 |
$124.80 |
$70.00
|
|
Diag laparo separate proc 49320
|
$20,192.52 |
$20,192.52 |
$20,192.52 |
$6,376.26
|
|
Diagnostic laryngoscopy 31575
|
$445.90 |
$445.90 |
$445.90 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$401.70 |
$401.70 |
$401.70 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$308.10 |
$308.10 |
$308.10 |
$276.60
|
|
Dialysis one evaluation
|
$123.50 |
$123.50 |
$123.50 |
$920.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$29.90 |
$29.90 |
$29.90 |
$58.24
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$69.55 |
$69.55 |
$69.55 |
$42.12
|
|
Dicyclomine injection
|
$63.37 |
$63.37 |
$63.37 |
$153.53
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.15 |
$7.15 |
$7.15 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$159.90 |
$159.90 |
$159.90 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$126.75 |
$126.75 |
$126.75 |
$297.86
|
|
Diltiazem 5 mg/ml intravenous solution
|
$48.75 |
$48.75 |
$48.75 |
$49.92
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,371.69 |
$2,371.69 |
$2,371.69 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$9.29
|
|
Disaccharidases
|
$75.40 |
$75.40 |
$75.40 |
$224.58
|
|
Dna antibody native/double stranded
|
$145.60 |
$145.60 |
$145.60 |
$101.40
|
|
Dna gardnerella
|
$59.80 |
$59.80 |
$59.80 |
$67.68
|
|
Dna trichomonas
|
$59.80 |
$59.80 |
$59.80 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$95.06 |
$95.06 |
$95.06 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$284.05 |
$284.05 |
$284.05 |
$131.40
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$64.19 |
$64.19 |
$64.19 |
$60.21
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,008.15 |
$1,008.15 |
$1,008.15 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$495.30 |
$495.30 |
$495.30 |
$463.20
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$19,947.98 |
$19,947.98 |
$19,947.98 |
$326.36
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$435.23 |
$435.23 |
$435.23 |
$97.83
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,039.05 |
$2,039.05 |
$2,039.05 |
$715.22
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$78.52 |
$78.52 |
$78.52 |
$81.30
|
|
Drainage external ear simple 69000
|
$633.10 |
$633.10 |
$633.10 |
$800.00
|
|
Drainage of kidney lesion
|
$4,260.35 |
$4,260.35 |
$4,260.35 |
$1,578.89
|
|
Drain bladder by trocar/cath
|
$21,675.11 |
$21,675.11 |
$21,675.11 |
$948.13
|
|
Drain cath image guided visceral pq
|
$4,175.20 |
$4,175.20 |
$4,175.20 |
$2,999.34
|
|
Drill hole implt ventricular cath/device 61107
|
$26,139.94 |
$26,139.94 |
$26,139.94 |
$1,737.06
|
|
Droperidol 2.5 mg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$32.82
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$31.85 |
$31.85 |
$31.85 |
$1,459.20
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$27.30 |
$27.30 |
$27.30 |
$57.00
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$163.80 |
$163.80 |
$163.80 |
$448.16
|
|
Drug admin & hemodynmic meas
|
$1,353.95 |
$1,353.95 |
$1,353.95 |
$612.15
|
|
Drug assay caffeine
|
$32.50 |
$32.50 |
$32.50 |
$89.17
|
|
Drug assay posaconazole
|
$139.75 |
$139.75 |
$139.75 |
$96.75
|
|
Drug assay vedolizumab
|
$174.20 |
$174.20 |
$174.20 |
$172.90
|
|
Drug assay voriconazole
|
$136.50 |
$136.50 |
$136.50 |
$96.75
|
|
Drug of abuse screen urine
|
$87.75 |
$87.75 |
$87.75 |
$58.50
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$148.20 |
$148.20 |
$148.20 |
$278.85
|
|
Duplex scan bilateral study 93985
|
$287.95 |
$287.95 |
$287.95 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$192.40 |
$192.40 |
$192.40 |
$357.60
|
|
Dup scan/hemodialysis access 93990
|
$249.60 |
$249.60 |
$249.60 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$700.05 |
$700.05 |
$700.05 |
$740.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,645.15 |
$1,645.15 |
$1,645.15 |
$852.57
|
|
Durvalumab 50 mg/ml intravenous solution
|
$7,161.10 |
$7,161.10 |
$7,161.10 |
$137.19
|
|
Dxa bone density axl vrt fx
|
$224.25 |
$224.25 |
$224.25 |
$365.14
|
|
Dx bronchoscope/brush 31623
|
$16,301.19 |
$16,301.19 |
$16,301.19 |
$2,283.00
|
|
Dx bronchoscope/lavage 31624
|
$25,420.56 |
$25,420.56 |
$25,420.56 |
$2,858.00
|
|
Dx bronchoscope/wash 31622
|
$16,596.64 |
$16,596.64 |
$16,596.64 |
$2,512.54
|
|
Ecg 12 lead tracing only
|
$239.85 |
$239.85 |
$239.85 |
$222.30
|
|
Ecg external < 48 hours recording
|
$344.50 |
$344.50 |
$344.50 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$926.90 |
$926.90 |
$926.90 |
$541.73
|
|
Echocardiogram (Heart Ultrasound)
|
$2,038.40 |
$2,038.40 |
$2,038.40 |
$2,021.12
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,452.75 |
$1,452.75 |
$1,452.75 |
$1,899.00
|
|
Echocardiography transthoracic 2d followup/limited
|
$603.85 |
$603.85 |
$603.85 |
$720.60
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$783.25 |
$783.25 |
$783.25 |
$840.00
|
|
Echo exam of fetal heart
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$855.38
|
|
Echo exam of fetal heart
|
$906.75 |
$906.75 |
$906.75 |
$481.55
|
|
Echo exam of fetal heart
|
$1,021.80 |
$1,021.80 |
$1,021.80 |
$429.87
|
|
Echo exam of fetal heart
|
$906.75 |
$906.75 |
$906.75 |
$318.34
|
|
Echo guide for artery repair
|
$668.85 |
$668.85 |
$668.85 |
$687.35
|
|
Echo stress
|
$1,134.90 |
$1,134.90 |
$1,134.90 |
$1,401.00
|
|
Echo tee guidance
|
$559.00 |
$559.00 |
$559.00 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,846.00 |
$1,846.00 |
$1,846.00 |
$1,946.10
|
|
Echo transesophageal
|
$1,156.35 |
$1,156.35 |
$1,156.35 |
$1,737.60
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,153.75 |
$1,153.75 |
$1,153.75 |
$997.40
|