|
Destruct cut vasl lesions 10-50cm 17107
|
$564.00 |
$564.00 |
$564.00 |
|
|
Destruct cut vasl lesions <10cm 17106
|
$150.36 |
$150.36 |
$814.30 |
|
|
Destruct cut vasl lesions >50cm 17108
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
|
|
Destruction 2-14 lesions 17003
|
$3.72 |
$72.24 |
$77.19 |
|
|
Destruction anal lesion(s) smpl chem 46900
|
$92.50 |
$92.50 |
$92.50 |
|
|
Destruction benign lesions < 14 lesions
|
$137.26 |
$161.28 |
$170.98 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$428.93 |
$1,509.48 |
$3,993.13 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,227.20 |
$1,509.48 |
$3,993.13 |
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$130.18 |
$130.18 |
$130.18 |
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$159.56 |
$159.56 |
$159.56 |
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$123.85 |
$123.85 |
$123.85 |
|
|
Destruction mal lsn t/a/l >4cm
|
$146.00 |
$146.00 |
$146.00 |
|
|
Destruction premal lesions 15/> 17004
|
$91.30 |
$357.84 |
$378.48 |
|
|
Destruction vag lesions simple 57061
|
$2,268.00 |
$2,268.00 |
$2,295.00 |
|
|
Detect agent nos dna dir
|
$53.95 |
$80.64 |
$105.40 |
|
|
Detect agnt mult dna direc
|
$155.40 |
$155.40 |
$157.25 |
|
|
Determination venous press
|
$317.20 |
$317.20 |
$317.20 |
|
|
Device ablt adv novasure
|
$5,321.87 |
$5,828.71 |
$10,770.44 |
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,916.46 |
$2,098.98 |
$3,878.55 |
|
|
Device intraute mirena
|
$502.86 |
$1,836.53 |
$3,716.78 |
|
|
Device sut capio slim opn
|
$623.91 |
$742.74 |
$7,700.70 |
|
|
Device tiss remov myosure reach
|
$1,044.75 |
$1,227.00 |
$6,766.86 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$57.96 |
$57.96 |
$255.00 |
|
|
Dexamethasone 4 mg tablet
|
$0.63 |
$228.48 |
$462.40 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$1.21 |
$65.21 |
$131.97 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$230.77 |
$1,053.51 |
$2,132.10 |
|
|
Dextran 40 infusion
|
$0.04 |
$86.84 |
$175.74 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$0.01 |
$86.84 |
$175.74 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$0.01 |
$86.84 |
$175.74 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$0.01 |
$86.84 |
$175.74 |
|
|
Dextrose 5 % IV bolus
|
$86.84 |
$86.84 |
$175.74 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$16.60 |
$141.96 |
$209.95 |
|
|
Diabetes (HbA1c) Test
|
$18.39 |
$81.06 |
$117.30 |
|
|
Diab manage trn ind/group
|
$25.20 |
$25.20 |
$53.07 |
|
|
Diag bronchoscope/catheter
|
$1,612.80 |
$1,824.90 |
$1,824.90 |
|
|
Diag laparo separate proc 49320
|
$738.70 |
$747.60 |
$756.50 |
|
|
Diagnostic anoscopy spx 46600
|
$46.16 |
$238.14 |
$298.80 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$29.00 |
$42.00 |
$334.90 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$28.14 |
$29.00 |
$261.80 |
|
|
Diagnostic laryngoscopy 31505
|
$54.84 |
$96.18 |
$218.45 |
|
|
Diagnostic laryngoscopy 31575
|
$155.88 |
$252.00 |
$342.82 |
|
|
Diagnostic Mammogram (both breasts)
|
$128.10 |
$214.00 |
$357.73 |
|
|
Diagnostic Mammogram (one breast)
|
$100.38 |
$193.00 |
$316.23 |
|
|
Diagnostic radio unlisted proc
|
$32.94 |
$45.36 |
$45.36 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$874.97 |
$3,521.28 |
$3,856.64 |
|
|
Dialysis one evaluation
|
$1,695.12 |
$1,846.00 |
$3,480.19 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.06 |
$41.79 |
$84.58 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$7.59 |
$76.76 |
$155.34 |
|
|
Dicyclomine injection
|
$17.69 |
$161.45 |
$326.74 |
|
|
Diffusing capacity
|
$259.34 |
$383.00 |
$541.45 |
|
|
Digital analysis of eeg
|
$499.56 |
$499.56 |
$499.56 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$53.19 |
$265.49 |
$537.30 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$2,207.96 |
$10,079.82 |
$20,399.62 |
|
|
Digoxin total therapeutic drug level
|
$32.49 |
$91.14 |
$136.00 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$21.04 |
$2,351.83 |
$4,759.66 |
|
|
Dilate biliary duct/ampulla
|
$203.74 |
$1,196.16 |
$3,515.22 |
|
|
Dilate esophagus
|
$678.72 |
$678.72 |
$686.80 |
|
|
Dilate esophagus 1/mult pass
|
$378.42 |
$378.42 |
$1,177.77 |
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$3,769.50 |
$7,378.56 |
$7,378.56 |
|
|
Dilate ic vasospasm ea add vsl same territory
|
$3,769.50 |
$5,903.10 |
$5,903.10 |
|
|
Dilate ic vasospasm init
|
$3,769.50 |
$14,759.22 |
$14,759.22 |
|
|
Dilate urethra stricture
|
$191.94 |
$191.94 |
$399.23 |
|
|
Dilate urethra stricture
|
$132.94 |
$231.00 |
$303.78 |
|
|
Dilate urethra stricture
|
$177.10 |
$177.10 |
$212.00 |
|
|
Dilation/female urethra/initial 53660
|
$116.38 |
$126.50 |
$234.60 |
|
|
Dilation of anal sphincter
|
$2,048.38 |
$2,048.38 |
$2,048.38 |
|
|
Dilation of rectal stricture 45910
|
$2,875.54 |
$2,875.54 |
$2,875.54 |
|
|
Dilation of salivary duct
|
$82.26 |
$162.12 |
$162.12 |
|
|
Dilation of urethra
|
$110.86 |
$110.86 |
$132.50 |
|
|
Dilation/urethral strict/male/ini 53620
|
$409.86 |
$844.62 |
$2,524.03 |
|
|
Dilator fascial 10fx20cm
|
$408.24 |
$486.00 |
$1,050.46 |
|
|
Dilat xst trc ndurlgc px
|
$1,491.84 |
$1,491.84 |
$2,676.83 |
|
|
Dilat xst trc new access rcs
|
$2,509.50 |
$2,509.50 |
$2,676.83 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$6.15 |
$1,121.24 |
$2,269.16 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.27 |
$41.79 |
$84.58 |
|
|
Disability dlco
|
$213.50 |
$254.94 |
$643.45 |
|
|
Disaccharidases
|
$200.86 |
$504.42 |
$796.45 |
|
|
Discography cerv/thor spine
|
$396.50 |
$396.50 |
$1,180.35 |
|
|
Dise eval slp do brth flx dx
|
$226.59 |
$1,086.54 |
$3,703.31 |
|
|
Dissolve clot heart vessel
|
$212.10 |
$212.10 |
$2,493.66 |
|
|
Dist revas ligation hemo
|
$3,518.34 |
$3,518.34 |
$6,932.66 |
|
|
Dlyd plmt xtn prosth ea addl
|
$390.00 |
$669.48 |
$740.14 |
|
|
Dna antibody native/double stranded
|
$29.90 |
$47.62 |
$316.20 |
|
|
Dna gardnerella
|
$40.32 |
$46.50 |
$88.45 |
|
|
Dna probe chlamydia
|
$53.95 |
$79.38 |
$124.10 |
|
|
Dna probe gc
|
$53.95 |
$79.38 |
$99.45 |
|
|
Dna trichomonas
|
$41.91 |
$127.26 |
$209.10 |
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$0.16 |
$86.84 |
$175.74 |
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$29.38 |
$1,072.75 |
$2,171.04 |
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$0.29 |
$86.84 |
$175.74 |
|
|
Doppler echo complete
|
$250.50 |
$354.90 |
$456.29 |
|
|
Doppler intravascular pressure flow initial vessel
|
$2,080.26 |
$2,080.26 |
$4,387.24 |
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$456.96 |
$608.98 |
$944.89 |
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$259.90 |
$334.74 |
$759.90 |
|
|
Dornhoffer fixed part w/window
|
$11,529.06 |
$13,725.07 |
$145,637.66 |
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$521.48 |
$23,806.42 |
$48,179.66 |
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$89.25 |
$407.45 |
$824.59 |
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$21.12 |
$3,182.76 |
$6,441.30 |
|
|
Dpyd gene common variants
|
$386.92 |
$386.92 |
$386.92 |
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$139.55 |
$450.66 |
$877.79 |
|