|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,358.75 |
$2,358.75 |
$2,358.75 |
$3,202.98
|
|
Destruction premal lesions 15/> 17004
|
$362.10 |
$362.10 |
$362.10 |
$436.64
|
|
Destruction vag lesions simple 57061
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,815.20
|
|
Detect agent nos dna dir
|
$105.40 |
$105.40 |
$105.40 |
$115.20
|
|
Detect agnt mult dna direc
|
$157.25 |
$157.25 |
$157.25 |
$162.00
|
|
Device ablt adv novasure
|
$10,770.44 |
$10,770.44 |
$10,770.44 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,878.55 |
$3,878.55 |
$3,878.55 |
$4,200.00
|
|
Device intraute mirena
|
$3,716.78 |
$3,716.78 |
$3,716.78 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,262.66 |
$1,262.66 |
$1,262.66 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$2,114.38 |
$2,114.38 |
$2,114.38 |
$2,541.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$255.00 |
$255.00 |
$255.00 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$462.40 |
$462.40 |
$462.40 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$131.97 |
$131.97 |
$131.97 |
$21.17
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$2,132.10 |
$2,132.10 |
$2,132.10 |
$858.00
|
|
Dextran 40 infusion
|
$175.74 |
$175.74 |
$175.74 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$175.74 |
$175.74 |
$175.74 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$175.74 |
$175.74 |
$175.74 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$175.74 |
$175.74 |
$175.74 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$175.74 |
$175.74 |
$175.74 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$209.95 |
$209.95 |
$209.95 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$117.30 |
$117.30 |
$117.30 |
$79.20
|
|
Diab manage trn ind/group
|
$28.05 |
$28.05 |
$28.05 |
$56.55
|
|
Diag bronchoscope/catheter
|
$1,632.00 |
$1,632.00 |
$1,632.00 |
$2,766.40
|
|
Diag laparo separate proc 49320
|
$756.50 |
$756.50 |
$756.50 |
$6,904.15
|
|
Diagnostic anoscopy spx 46600
|
$292.40 |
$292.40 |
$292.40 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$334.90 |
$334.90 |
$334.90 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$261.80 |
$261.80 |
$261.80 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$218.45 |
$218.45 |
$218.45 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$309.40 |
$309.40 |
$309.40 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$261.80 |
$261.80 |
$261.80 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$261.80 |
$261.80 |
$261.80 |
$301.55
|
|
Dialysis one evaluation
|
$3,330.30 |
$3,330.30 |
$3,330.30 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$84.58 |
$84.58 |
$84.58 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$155.34 |
$155.34 |
$155.34 |
$74.76
|
|
Dicyclomine injection
|
$326.74 |
$326.74 |
$326.74 |
$153.29
|
|
Diffusing capacity
|
$541.45 |
$541.45 |
$541.45 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$537.30 |
$537.30 |
$537.30 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$20,399.62 |
$20,399.62 |
$20,399.62 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$136.00 |
$136.00 |
$136.00 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$4,759.66 |
$4,759.66 |
$4,759.66 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$1,866.73
|
|
Dilate esophagus
|
$686.80 |
$686.80 |
$686.80 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$1,105.85 |
$1,105.85 |
$1,105.85 |
$1,484.17
|
|
Dilate urethra stricture
|
$368.05 |
$368.05 |
$368.05 |
$490.00
|
|
Dilate urethra stricture
|
$280.50 |
$280.50 |
$280.50 |
$200.80
|
|
Dilation/female urethra/initial 53660
|
$234.60 |
$234.60 |
$234.60 |
$235.61
|
|
Dilation/urethral strict/male/ini 53620
|
$2,325.60 |
$2,325.60 |
$2,325.60 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$826.20 |
$826.20 |
$826.20 |
$402.10
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,269.16 |
$2,269.16 |
$2,269.16 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$84.58 |
$84.58 |
$84.58 |
$17.75
|
|
Disability dlco
|
$643.45 |
$643.45 |
$643.45 |
$282.40
|
|
Disaccharidases
|
$796.45 |
$796.45 |
$796.45 |
$216.00
|
|
Dna antibody native/double stranded
|
$316.20 |
$316.20 |
$316.20 |
$97.50
|
|
Dna gardnerella
|
$88.40 |
$88.40 |
$88.40 |
$62.50
|
|
Dna probe chlamydia
|
$124.10 |
$124.10 |
$124.10 |
$79.38
|
|
Dna probe gc
|
$99.45 |
$99.45 |
$99.45 |
$80.80
|
|
Dna trichomonas
|
$209.10 |
$209.10 |
$209.10 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$175.74 |
$175.74 |
$175.74 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2,171.04 |
$2,171.04 |
$2,171.04 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$175.74 |
$175.74 |
$175.74 |
$65.40
|
|
Doppler echo complete
|
$315.35 |
$315.35 |
$315.35 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$721.65 |
$721.65 |
$721.65 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$759.90 |
$759.90 |
$759.90 |
$471.17
|
|
Dornhoffer fixed part w/window
|
$23,332.62 |
$23,332.62 |
$23,332.62 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$48,179.66 |
$48,179.66 |
$48,179.66 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$824.59 |
$824.59 |
$824.59 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$6,441.30 |
$6,441.30 |
$6,441.30 |
$1,718.24
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$492.15 |
$492.15 |
$492.15 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$566.95 |
$566.95 |
$566.95 |
$914.34
|
|
Drainage external ear simple 69000
|
$447.10 |
$447.10 |
$447.10 |
$789.60
|
|
Drainage mouth roof lesion
|
$385.90 |
$385.90 |
$385.90 |
$390.39
|
|
Drainage of arm bursa 23931
|
$728.45 |
$728.45 |
$728.45 |
$2,197.48
|
|
Drainage of nose lesion sept 30020
|
$657.05 |
$657.05 |
$657.05 |
$781.44
|
|
Drainage of rectal abscess
|
$821.95 |
$821.95 |
$821.95 |
$2,111.46
|
|
Drain blood from under nail 11740
|
$136.85 |
$136.85 |
$136.85 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$3,159.45 |
$3,159.45 |
$3,159.45 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$1,676.20 |
$1,676.20 |
$1,676.20 |
$2,850.35
|
|
Drain chst dry seal exp thorastat
|
$186.94 |
$186.94 |
$186.94 |
$119.43
|
|
Drain finger abscess;simple 26010
|
$842.35 |
$842.35 |
$842.35 |
$419.00
|
|
Drain lower leg lesion 27603
|
$3,062.55 |
$3,062.55 |
$3,062.55 |
$3,858.40
|
|
Drain neck/chest lesion 21501
|
$3,008.15 |
$3,008.15 |
$3,008.15 |
$3,339.00
|
|
Drain thigh/knee lesion 27301
|
$2,051.05 |
$2,051.05 |
$2,051.05 |
$3,620.47
|
|
Drain thyroid/tongue cyst
|
$847.45 |
$847.45 |
$847.45 |
$1,752.89
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$384.20 |
$384.20 |
$384.20 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$264.35 |
$264.35 |
$264.35 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$577.15 |
$577.15 |
$577.15 |
$523.00
|
|
Dressing change not for burn w/anes 15852
|
$621.35 |
$621.35 |
$621.35 |
$755.08
|
|
Drng appendix abscess open 44900
|
$1,795.20 |
$1,795.20 |
$1,795.20 |
$1,453.80
|
|
Drng of eyelid abscess 67700
|
$691.90 |
$691.90 |
$691.90 |
$648.00
|
|
Drng of hydrocele 55000
|
$250.75 |
$250.75 |
$250.75 |
$832.60
|
|
Drng of scrotum abscess 55100
|
$1,229.10 |
$1,229.10 |
$1,229.10 |
$1,917.33
|
|
Dronabinol 2.5mg oral
|
$1,376.32 |
$1,376.32 |
$1,376.32 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$84.58 |
$84.58 |
$84.58 |
$31.07
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,016.82 |
$1,016.82 |
$1,016.82 |
$1,956.48
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$3,950.28 |
$3,950.28 |
$3,950.28 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$3,117.52 |
$3,117.52 |
$3,117.52 |
$289.05
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$12,942.05 |
$12,942.05 |
$12,942.05 |
$8,040.27
|
|
Drug assay caffeine
|
$83.30 |
$83.30 |
$83.30 |
$83.40
|
|
Drug assay voriconazole
|
$192.10 |
$192.10 |
$192.10 |
$96.75
|
|
Drug of abuse screen urine
|
$204.85 |
$204.85 |
$204.85 |
$63.75
|
