|
Diagnostic Mammogram (both breasts)
|
$128.33 |
$128.33 |
$128.33 |
$424.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$7,145.00
|
|
Dialysis one evaluation
|
$173.24 |
$173.24 |
$173.24 |
$842.10
|
|
Diffusing capacity
|
$147.51 |
$147.51 |
$147.51 |
$360.10
|
|
Digoxin total therapeutic drug level
|
$14.61 |
$14.61 |
$14.61 |
$102.00
|
|
Dilate biliary duct/ampulla
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,304.60
|
|
Dilate esophagus
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,003.04
|
|
Dilate esophagus 1/mult pass
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,484.17
|
|
Dilate tear duct opening
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$454.40
|
|
Dilate urethra stricture
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$514.79
|
|
Dilate urethra stricture
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$185.58
|
|
Dilate urethra stricture
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,745.07
|
|
Dilate urethra stricture
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$207.39
|
|
Dilation of anal sphincter
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,395.28
|
|
Dilation of cervical canal 57800
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,096.04
|
|
Dilation of rectal stricture 45910
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,395.28
|
|
Dilation of salivary duct
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$599.72
|
|
Dilation of urethra
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$172.00
|
|
Dilation of urethra
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,507.31
|
|
Dilation of vagina
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,522.35
|
|
Dilation salivary duct 42650
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,744.44
|
|
Dilation/urethral strict/male/ini 53620
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,550.25
|
|
Dilat xst trc ndurlgc px
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,020.00
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$32.34 |
$32.34 |
$32.34 |
$106.59
|
|
Disability dlco
|
$100.96 |
$100.96 |
$100.96 |
$307.58
|
|
Disaccharidases
|
$24.39 |
$24.39 |
$24.39 |
$223.80
|
|
Disarticulation sho sec clsr
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,164.64
|
|
Dise eval slp do brth flx dx
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,908.75
|
|
Dissolve clot heart vessel
|
$319.93 |
$319.93 |
$319.93 |
$1,396.47
|
|
Dist revas ligation hemo
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,988.54
|
|
Diverticulectomy/hypophar/esoph 43130
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,817.32
|
|
Dmd dup/delet analysis
|
$306.90 |
$306.90 |
$306.90 |
$385.02
|
|
Dmpk gene detc abnor allele
|
$150.70 |
$150.70 |
$150.70 |
$318.75
|
|
Dna antibody native/double stranded
|
$15.11 |
$15.11 |
$15.11 |
$102.60
|
|
Dna gardnerella
|
$22.06 |
$22.06 |
$22.06 |
$67.68
|
|
Dna probe chlamydia
|
$25.03 |
$25.03 |
$25.03 |
$82.20
|
|
Dna probe gc
|
$29.57 |
$29.57 |
$29.57 |
$88.67
|
|
Dna trichomonas
|
$22.06 |
$22.06 |
$22.06 |
$68.75
|
|
Doppler echo complete
|
$213.72 |
$213.72 |
$213.72 |
$608.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$261.09 |
$261.09 |
$261.09 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$170.78 |
$170.78 |
$170.78 |
$482.03
|
|
Dornhoffer fixed part w/window
|
$11,218.98 |
$11,218.98 |
$11,218.98 |
$28,091.95
|
|
Dpyd gene common variants
|
$192.29 |
$192.29 |
$192.29 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$820.50
|
|
Drainage ext aud canal abscess 69020
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$900.80
|
|
Drainage external ear complex 69005
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,967.58
|
|
Drainage external ear simple 69000
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$809.25
|
|
Drainage lymph node lesion 38300
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,170.64
|
|
Drainage lymph node lesion 38305
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,167.89
|
|
Drainage mouth roof lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$474.39
|
|
Drainage of arm bursa 23931
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,419.30
|
|
Drainage of bladder abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,167.89
|
|
Drainage of eye
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,503.62
|
|
Drainage of eye
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,702.25
|
|
Drainage of eye
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,172.80
|
|
Drainage of forearm bursa
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,893.86
|
|
Drainage of kidney lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,706.65
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$455.56
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,752.89
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,320.03
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,986.00
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,022.40
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$799.40
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$6,547.81
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,837.72
|
|
Drainage of mouth lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,357.20
|
|
Drainage of nose lesion int 30000
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$755.95
|
|
Drainage of pelvis bursa
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,893.86
|
|
Drainage of pelvis lesion 26990
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,969.00
|
|
Drainage of prostate abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,891.34
|
|
Drainage of prostate abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,786.00
|
|
Drainage of prostate abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,081.37
|
|
Drainage of rectal abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,299.90
|
|
Drainage of rectal abscess 45020
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,245.23
|
|
Drainage of salivary gland
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,837.72
|
|
Drainage of salivary gland
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$629.60
|
|
Drainage of throat abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$6,499.33
|
|
Drainage of urethra abscess
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,820.84
|
|
Drainage of urethra abscess 53060
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,459.34
|
|
Drainage of urinary leakage
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,057.60
|
|
Drainage of urinary leakage
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,424.12
|
|
Drain bladder by trocar/cath
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,126.11
|
|
Drain blood from under nail 11740
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$190.33
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,614.66
|
|
Drain cath image guided visceral pq
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,073.90
|
|
Drain cerebro spinal fluid 62272
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,113.06
|
|
Drain chest lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,594.44
|
|
Drain finger abscess;simple 26010
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$492.81
|
|
Drain lower leg bursa
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,839.54
|
|
Drain lower leg lesion 27603
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,631.18
|
|
Drain neck/chest lesion 21501
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,386.84
|
|
Drain ovarn cyst abd
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,762.53
|
|
Drain ovary abscess open
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,762.53
|
|
Drain penis lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,005.32
|
|
Drain shoulder bone lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,206.33
|
|
Drain shoulder bursa 23031
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,719.83
|
|
Drain shoulder lesion
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,571.53
|
