|
Diagnostic laryngoscopy 31505
|
$391.05 |
$391.05 |
$391.05 |
|
|
Diagnostic laryngoscopy 31575
|
$411.75 |
$411.75 |
$411.75 |
|
|
Diagnostic Mammogram (both breasts)
|
$1,021.80 |
$1,021.80 |
$1,021.80 |
|
|
Diagnostic Mammogram (one breast)
|
$854.40 |
$854.40 |
$854.40 |
|
|
Diagnostic radio unlisted proc
|
$1,366.35 |
$1,366.35 |
$1,366.35 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,902.65 |
$3,902.65 |
$3,902.65 |
|
|
Dialysis one evaluation
|
$1,196.55 |
$1,196.55 |
$1,196.55 |
|
|
Dialysis repeated eval
|
$3,796.60 |
$3,796.60 |
$3,796.60 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$134.50 |
$134.50 |
$134.50 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$250.52 |
$250.52 |
$250.52 |
|
|
Dicyclomine injection
|
$198.50 |
$198.50 |
$198.50 |
|
|
Diffusing capacity
|
$303.45 |
$303.45 |
$303.45 |
|
|
Digital analysis of eeg
|
$1,992.90 |
$1,992.90 |
$1,992.90 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$55.99 |
$55.99 |
$55.99 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$17,849.20 |
$17,849.20 |
$17,849.20 |
|
|
Digoxin total therapeutic drug level
|
$270.00 |
$270.00 |
$270.00 |
|
|
Dilate biliary duct/ampulla
|
$2,676.40 |
$2,676.40 |
$2,676.40 |
|
|
Dilate esophagus
|
$2,745.45 |
$2,745.45 |
$2,745.45 |
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,659.40 |
$1,659.40 |
$1,659.40 |
|
|
Dilate ic vasospasm ea add vsl same territory
|
$1,659.40 |
$1,659.40 |
$1,659.40 |
|
|
Dilate ic vasospasm init
|
$1,659.40 |
$1,659.40 |
$1,659.40 |
|
|
Dilation/female urethra/initial 53660
|
$288.15 |
$288.15 |
$288.15 |
|
|
Dilation of cervical canal 57800
|
$5,113.90 |
$5,113.90 |
$5,113.90 |
|
|
Dilation/urethral strict/male/ini 53620
|
$1,241.20 |
$1,241.20 |
$1,241.20 |
|
|
Dilator fascial 10fx20cm
|
$179.00 |
$179.00 |
$179.00 |
|
|
Dilat xst trc ndurlgc px
|
$9,587.85 |
$9,587.85 |
$9,587.85 |
|
|
Dilat xst trc new access rcs
|
$9,587.85 |
$9,587.85 |
$9,587.85 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$4,419.22 |
$4,419.22 |
$4,419.22 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$30.64 |
$30.64 |
$30.64 |
|
|
Disability dlco
|
$558.70 |
$558.70 |
$558.70 |
|
|
Disaccharidases
|
$897.25 |
$897.25 |
$897.25 |
|
|
Discography cerv/thor spine
|
$5,936.70 |
$5,936.70 |
$5,936.70 |
|
|
Dna antibody native/double stranded
|
$247.05 |
$247.05 |
$247.05 |
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$1,043.39 |
$1,043.39 |
$1,043.39 |
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4,739.59 |
$4,739.59 |
$4,739.59 |
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$201.05 |
$201.05 |
$201.05 |
|
|
Doppler echo complete
|
$915.55 |
$915.55 |
$915.55 |
|
|
Doppler intravascular pressure flow initial vessel
|
$2,317.60 |
$2,317.60 |
$2,317.60 |
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,099.20 |
$1,099.20 |
$1,099.20 |
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,012.70 |
$1,012.70 |
$1,012.70 |
|
|
Dornase alfa non-comp unit
|
$1,361.75 |
$1,361.75 |
$1,361.75 |
|
|
Dornhoffer fixed part w/window
|
$28,350.00 |
$28,350.00 |
$28,350.00 |
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$2,677.49 |
$2,677.49 |
$2,677.49 |
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$4,485.65 |
$4,485.65 |
$4,485.65 |
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$880.52 |
$880.52 |
$880.52 |
|
|
Dpyd gene common variants
|
$1,096.20 |
$1,096.20 |
$1,096.20 |
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,138.25 |
$1,138.25 |
$1,138.25 |
|
|
Drainage ext aud canal abscess 69020
|
$1,214.35 |
$1,214.35 |
$1,214.35 |
|
|
Drainage external ear complex 69005
|
$2,809.25 |
$2,809.25 |
$2,809.25 |
|
|
Drainage external ear simple 69000
|
$837.95 |
$837.95 |
$837.95 |
|
|
Drainage lymph node lesion 38300
|
$4,263.10 |
$4,263.10 |
$4,263.10 |
|
|
Drainage mouth roof lesion
|
$659.55 |
$659.55 |
$659.55 |
|
|
Drainage of arm bursa 23931
|
$2,419.30 |
$2,419.30 |
$2,419.30 |
|
|
Drainage of kidney lesion
|
$1,820.40 |
$1,820.40 |
$1,820.40 |
|
|
Drainage of mouth lesion
|
$358.55 |
$358.55 |
$358.55 |
|
|
Drainage of mouth lesion
|
$4,602.25 |
$4,602.25 |
$4,602.25 |
|
|
Drainage of mouth lesion
|
$913.60 |
$913.60 |
$913.60 |
|
|
Drainage of mouth lesion
|
$8,529.90 |
$8,529.90 |
$8,529.90 |
|
|
Drainage of nose lesion int 30000
|
$624.55 |
$624.55 |
$624.55 |
|
|
Drainage of pelvis bursa
|
$2,291.55 |
$2,291.55 |
$2,291.55 |
|
|
Drainage of pelvis lesion 26990
|
$1,641.65 |
$1,641.65 |
$1,641.65 |
|
|
Drain bladder by trocar/cath
|
$503.65 |
$503.65 |
$503.65 |
|
|
Drain blood from under nail 11740
|
$165.45 |
$165.45 |
$165.45 |
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$4,094.75 |
$4,094.75 |
$4,094.75 |
|
|
Drain cath image guided visceral pq
|
$6,610.20 |
$6,610.20 |
$6,610.20 |
|
|
Drain cerebro spinal fluid 62272
|
$1,284.65 |
$1,284.65 |
$1,284.65 |
|
|
Drain finger abscess;simple 26010
|
$495.85 |
$495.85 |
$495.85 |
|
|
Drain lower leg bursa
|
$4,768.30 |
$4,768.30 |
$4,768.30 |
|
|
Drain lower leg lesion 27603
|
$4,501.40 |
$4,501.40 |
$4,501.40 |
|
|
Drain neck/chest lesion 21501
|
$4,706.15 |
$4,706.15 |
$4,706.15 |
|
|
Drain ovarn cyst abd
|
$4,404.55 |
$4,404.55 |
$4,404.55 |
|
|
Drain thyroid/tongue cyst
|
$1,407.20 |
$1,407.20 |
$1,407.20 |
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$478.85 |
$478.85 |
$478.85 |
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$327.20 |
$327.20 |
$327.20 |
|
|
Dress/debrid prtl-thick burn l 16030
|
$591.20 |
$591.20 |
$591.20 |
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$3,780.00 |
$3,780.00 |
$3,780.00 |
|
|
Drill hole evac+/drg subdural hematoma 61108
|
$722.50 |
$722.50 |
$722.50 |
|
|
Drill hole implt ventricular cath/device 61107
|
$722.50 |
$722.50 |
$722.50 |
|
|
Drng hand tendon sheath 26020
|
$3,620.00 |
$3,620.00 |
$3,620.00 |
|
|
Drng of eyelid abscess 67700
|
$618.50 |
$618.50 |
$618.50 |
|
|
Drng of finger abscess comp 26011
|
$2,956.15 |
$2,956.15 |
$2,956.15 |
|
|
Drng of hydrocele 55000
|
$1,318.25 |
$1,318.25 |
$1,318.25 |
|
|
Drng of mouth lesion 40801
|
$858.60 |
$858.60 |
$858.60 |
|
|
Drng of scrotum abscess 55100
|
$2,703.90 |
$2,703.90 |
$2,703.90 |
|
|
Drng open retroperitoneal abscess 49060
|
$1,905.70 |
$1,905.70 |
$1,905.70 |
|
|
Drng peritoneal abscess open 49020
|
$1,905.70 |
$1,905.70 |
$1,905.70 |
|
|
Drng salivary gland simple 42300
|
$2,217.50 |
$2,217.50 |
$2,217.50 |
|
|
Drng salivary gland submax/subling 42310
|
$940.60 |
$940.60 |
$940.60 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$108.21 |
$108.21 |
$108.21 |
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$4,938.00 |
$4,938.00 |
$4,938.00 |
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$336.20 |
$336.20 |
$336.20 |
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$1,723.88 |
$1,723.88 |
$1,723.88 |
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$15,495.00 |
$15,495.00 |
$15,495.00 |
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$290.30 |
$290.30 |
$290.30 |
|
|
Drug admin & hemodynmic meas
|
$612.15 |
$612.15 |
$612.15 |
|
|
Drug assay posaconazole
|
$258.95 |
$258.95 |
$258.95 |
|
|
Drug assay vedolizumab
|
$84.45 |
$84.45 |
$84.45 |
|
|
Drug assay voriconazole
|
$219.45 |
$219.45 |
$219.45 |
|
|
Drug of abuse screen urine
|
$35.55 |
$35.55 |
$35.55 |
|