|
Debr musc/fascia 20sq cm/< 11043
|
$874.38 |
$874.38 |
$874.38 |
$1,160.00
|
|
Decalcification
|
$70.21 |
$70.21 |
$70.21 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$323.77 |
$323.77 |
$323.77 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$454.30 |
$454.30 |
$454.30 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$28.41 |
$28.41 |
$28.41 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$411.24 |
$411.24 |
$411.24 |
$1,807.08
|
|
Delivery of placenta 59414
|
$3,288.66 |
$3,288.66 |
$3,288.66 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$153.40 |
$153.40 |
$153.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$1,155.25 |
$1,155.25 |
$1,155.25 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$228.92 |
$228.92 |
$228.92 |
$408.10
|
|
Depo-estradiol cypionate inj
|
$24.08 |
$24.08 |
$24.08 |
$71.51
|
|
Dermagraft
|
$2,230.20 |
$2,230.20 |
$2,230.20 |
$85.00
|
|
Design mlc device for imrt
|
$3,543.54 |
$3,543.54 |
$3,543.54 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$44.33 |
$44.33 |
$44.33 |
$89.78
|
|
Des thora aorta rpr without left sub art 33881
|
$2,245.54 |
$2,245.54 |
$2,245.54 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$1,263.78 |
$1,263.78 |
$1,263.78 |
$2,727.20
|
|
Destroy cervthor facet jnt 64633
|
$931.02 |
$931.02 |
$931.02 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$306.21 |
$306.21 |
$306.21 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$428.93 |
$428.93 |
$428.93 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
$3,202.98
|
|
Device ablt adv novasure
|
$7,475.95 |
$7,475.95 |
$7,475.95 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,692.17 |
$2,692.17 |
$2,692.17 |
$4,200.00
|
|
Device intraute mirena
|
$644.98 |
$644.98 |
$644.98 |
$2,125.00
|
|
Device sut capio slim opn
|
$876.44 |
$876.44 |
$876.44 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$1,447.86 |
$1,447.86 |
$1,447.86 |
$2,541.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$227.15 |
$227.15 |
$227.15 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$0.81 |
$0.81 |
$0.81 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$1.55 |
$1.55 |
$1.55 |
$21.17
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$295.99 |
$295.99 |
$295.99 |
$858.00
|
|
Dextran 40 infusion
|
$0.04 |
$0.04 |
$0.04 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$0.01 |
$0.01 |
$0.01 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$0.01 |
$0.01 |
$0.01 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$0.01 |
$0.01 |
$0.01 |
$47.48
|
|
Dhea-s (dehydroepiand sulfate)
|
$57.23 |
$57.23 |
$57.23 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$57.82 |
$57.82 |
$57.82 |
$79.20
|
|
Diagnostic digital breast tomosynthesis bil
|
$41.30 |
$41.30 |
$41.30 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$41.30 |
$41.30 |
$41.30 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$167.56 |
$167.56 |
$167.56 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$331.58 |
$331.58 |
$331.58 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$292.05 |
$292.05 |
$292.05 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$263.14 |
$263.14 |
$263.14 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$36.58 |
$36.58 |
$36.58 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$874.97 |
$874.97 |
$874.97 |
$5,419.00
|
|
Dialysis one evaluation
|
$2,265.60 |
$2,265.60 |
$2,265.60 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.08 |
$0.08 |
$0.08 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$9.74 |
$9.74 |
$9.74 |
$74.76
|
|
Dicyclomine injection
|
$22.68 |
$22.68 |
$22.68 |
$153.29
|
|
Diffusing capacity
|
$469.64 |
$469.64 |
$469.64 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$68.22 |
$68.22 |
$68.22 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$2,831.95 |
$2,831.95 |
$2,831.95 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$89.68 |
$89.68 |
$89.68 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$26.99 |
$26.99 |
$26.99 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$3,515.22 |
$3,515.22 |
$3,515.22 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$573.48 |
$573.48 |
$573.48 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$2,676.83 |
$2,676.83 |
$2,676.83 |
$4,061.71
|
|
Dilat xst trc new access rcs
|
$2,676.83 |
$2,676.83 |
$2,676.83 |
$4,213.20
|
|
Dimethyl sulfoxide 50% 50 ml
|
$7.88 |
$7.88 |
$7.88 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.62 |
$1.62 |
$1.62 |
$17.75
|
|
Disability dlco
|
$284.97 |
$284.97 |
$284.97 |
$282.40
|
|
Disaccharidases
|
$483.21 |
$483.21 |
$483.21 |
$216.00
|
|
Dise eval slp do brth flx dx
|
$3,581.89 |
$3,581.89 |
$3,581.89 |
$1,120.00
|
|
Dissolve clot heart vessel
|
$620.09 |
$620.09 |
$620.09 |
$1,579.93
|
|
Dna antibody native/double stranded
|
$48.97 |
$48.97 |
$48.97 |
$97.50
|
|
Dna gardnerella
|
$85.55 |
$85.55 |
$85.55 |
$62.50
|
|
Dna trichomonas
|
$92.04 |
$92.04 |
$92.04 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$0.21 |
$0.21 |
$0.21 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$37.68 |
$37.68 |
$37.68 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$0.37 |
$0.37 |
$0.37 |
$65.40
|
|
Doppler echo complete
|
$370.52 |
$370.52 |
$370.52 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$4,387.24 |
$4,387.24 |
$4,387.24 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$879.10 |
$879.10 |
$879.10 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$348.10 |
$348.10 |
$348.10 |
$471.17
|
|
Dornhoffer fixed part w/window
|
$16,195.58 |
$16,195.58 |
$16,195.58 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$668.85 |
$668.85 |
$668.85 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$114.48 |
$114.48 |
$114.48 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$27.09 |
$27.09 |
$27.09 |
$1,718.24
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$323.91 |
$323.91 |
$323.91 |
$800.00
|
|
Drainage external ear simple 69000
|
$329.81 |
$329.81 |
$329.81 |
$789.60
|
|
Drainage of arm bursa 23931
|
$1,593.00 |
$1,593.00 |
$1,593.00 |
$2,197.48
|
|
Drainage of eye
|
$624.22 |
$624.22 |
$624.22 |
$2,360.00
|
|
Drainage of kidney lesion
|
$676.14 |
$676.14 |
$676.14 |
$1,506.00
|
|
Drainage of nose lesion int 30000
|
$221.25 |
$221.25 |
$221.25 |
$491.40
|
|
Drain blood from under nail 11740
|
$81.42 |
$81.42 |
$81.42 |
$170.50
|
|
Drain cath image guided visceral pq
|
$2,869.76 |
$2,869.76 |
$2,869.76 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$516.25 |
$516.25 |
$516.25 |
$1,044.00
|
|
Drain chst dry seal exp thorastat
|
$129.76 |
$129.76 |
$129.76 |
$119.43
|
|
Drain finger abscess;simple 26010
|
$323.91 |
$323.91 |
$323.91 |
$419.00
|
|
Drain thigh/knee lesion 27301
|
$1,741.09 |
$1,741.09 |
$1,741.09 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$318.01 |
$318.01 |
$318.01 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$233.05 |
$233.05 |
$233.05 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$409.46 |
$409.46 |
$409.46 |
$523.00
|
|
Drng of eyelid abscess 67700
|
$358.13 |
$358.13 |
$358.13 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$1,228.97 |
$1,228.97 |
$1,228.97 |
$1,943.50
|
|
Drng of scrotum abscess 55100
|
$1,414.82 |
$1,414.82 |
$1,414.82 |
$1,917.33
|
|
Drng salivary gland simple 42300
|
$684.40 |
$684.40 |
$684.40 |
$2,133.48
|
|
Dronabinol 2.5mg oral
|
$1.88 |
$1.88 |
$1.88 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$2.49 |
$2.49 |
$2.49 |
$31.07
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$643.92 |
$643.92 |
$643.92 |
$1,956.48
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$2,741.96 |
$2,741.96 |
$2,741.96 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$2,163.92 |
$2,163.92 |
$2,163.92 |
$289.05
|