|
Destruction laser surgery anal lesions 46917
|
$3,245.23 |
$3,245.23 |
$7,499.82 |
|
|
Destruction les conjunctiva
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$472.79 |
$472.79 |
$1,107.30 |
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$472.79 |
$472.79 |
$1,107.30 |
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$472.79 |
$472.79 |
$1,107.30 |
|
|
Destruction mal lsn t/a/l >4cm
|
$472.79 |
$472.79 |
$1,107.30 |
|
|
Destruction penis lesion(s) chem 54050
|
$472.79 |
$472.79 |
$1,188.79 |
|
|
Destruction penis lesion(s) exten 54065
|
$1,697.14 |
$2,164.64 |
$2,699.50 |
|
|
Destruction premal lesions 15/> 17004
|
$436.81 |
$472.79 |
$1,623.00 |
|
|
Destruction rectal tumor 45190
|
$3,245.23 |
$3,245.23 |
$7,499.82 |
|
|
Destruction vag lesions complex 57065
|
$3,762.53 |
$3,762.53 |
$8,188.62 |
|
|
Destruction vag lesions simple 57061
|
$3,762.53 |
$3,762.53 |
$8,188.62 |
|
|
Destruct penis les/smp/electrodesi 54055
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
|
|
Detect agent nos dna dir
|
$30.03 |
$30.03 |
$30.03 |
|
|
Detect agnt mult dna direc
|
$43.67 |
$43.67 |
$178.69 |
|
|
Determination venous press
|
$194.12 |
$194.12 |
$384.00 |
|
|
Determine refractive state
|
$166.00 |
$166.00 |
$222.00 |
|
|
Developmental screen/score/document 96110
|
$45.00 |
$142.38 |
$457.00 |
|
|
Devel tst phys/qhp 1st hr
|
$185.15 |
$185.15 |
$481.90 |
|
|
Device ablt adv novasure
|
$8,775.00 |
$8,775.00 |
$10,800.00 |
|
|
Device intraute mirena
|
$1,773.21 |
$2,565.91 |
$4,048.77 |
|
|
Device tiss remov myosure reach
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
|
|
Devlopment test interpt&rep
|
$109.46 |
$109.46 |
$109.46 |
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$162.48 |
$195.78 |
$240.96 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$104.19 |
$104.19 |
$962.00 |
|
|
Dexametha opth insert 0.1 mg
|
$138.62 |
$138.62 |
$1,613.50 |
|
|
Dexamethasone 4 mg tablet
|
$0.80 |
$5.17 |
$5.17 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.06 |
$0.32 |
$9.32 |
|
|
Dexamethasone intra implant
|
$205.62 |
$205.62 |
$4,805.50 |
|
|
Dexamethasone panel
|
$161.88 |
$161.88 |
$161.88 |
|
|
Dexmedetomidine film, 1 mcg
|
$0.78 |
$0.78 |
$349.13 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$87.49 |
$87.49 |
$1,551.60 |
|
|
Dextran 40 infusion
|
$0.24 |
$0.24 |
$0.24 |
|
|
Dextran 75 infusion
|
$1.15 |
$1.15 |
$1.15 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$0.04 |
$0.04 |
$32.60 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$5.00 |
$5.00 |
$5.00 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$0.02 |
$5.19 |
$35.00 |
|
|
Dextrose 5 % IV bolus
|
$5.00 |
$5.00 |
$5.00 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$5.00 |
$22.23 |
$247.84 |
|
|
Diabetes (HbA1c) Test
|
$9.71 |
$9.71 |
$327.00 |
|
|
Diabetes training group per 30 min g0109
|
$35.25 |
$35.25 |
$91.00 |
|
|
Diab manage trn ind/group
|
$17.07 |
$18.05 |
$794.18 |
|
|
Diag bronchoscope/catheter
|
$2,040.67 |
$2,040.67 |
$2,040.67 |
|
|
Diag laparo separate proc 49320
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
|
|
Diagnostic anoscopy
|
$472.21 |
$472.21 |
$1,500.00 |
|
|
Diagnostic anoscopy & biopsy
|
$1,395.28 |
$1,395.28 |
$5,249.42 |
|
|
Diagnostic anoscopy spx 46600
|
$84.60 |
$152.54 |
$360.21 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$74.11 |
$76.37 |
$1,902.00 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$76.37 |
$79.23 |
$951.00 |
|
|
Diagnostic laryngoscopy 31505
|
$229.74 |
$229.74 |
$923.00 |
|
|
Diagnostic laryngoscopy 31575
|
$179.40 |
$229.74 |
$1,565.00 |
|
|
Diagnostic Mammogram (both breasts)
|
$176.84 |
$184.35 |
$1,591.00 |
|
|
Diagnostic Mammogram (one breast)
|
$140.49 |
$145.38 |
$1,111.00 |
|
|
Diagnostic radio unlisted proc
|
$104.19 |
$104.19 |
$248.30 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$6,547.37 |
$6,547.37 |
$8,058.30 |
|
|
Dialysis one evaluation
|
$503.90 |
$503.90 |
$2,238.60 |
|
|
Dialysis training complete
|
$1,033.55 |
$1,033.55 |
$1,272.06 |
|
|
Dialysis training incompl
|
$1,033.55 |
$1,033.55 |
$1,272.06 |
|
|
Diathermy eg microwave
|
$8.26 |
$8.51 |
$8.71 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.18 |
$0.22 |
$0.25 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$22.64 |
$22.64 |
$90.60 |
|
|
Dicyclomine injection
|
$137.54 |
$137.54 |
$200.80 |
|
|
Difelikefalin, esrd on dialy
|
$0.15 |
$0.15 |
$403.85 |
|
|
Diffusing capacity
|
$139.21 |
$227.90 |
$1,558.00 |
|
|
Digital analysis of eeg
|
$1,479.00 |
$1,479.00 |
$1,500.00 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$4.01 |
$4.01 |
$33.00 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,888.10 |
$4,888.10 |
$15,652.39 |
|
|
Digoxin total therapeutic drug level
|
$13.28 |
$13.28 |
$170.00 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$110.40 |
$164.78 |
$232.32 |
|
|
Dilate biliary duct/ampulla
|
$542.37 |
$542.37 |
$602.49 |
|
|
Dilate esophagus
|
$2,244.82 |
$2,244.82 |
$4,441.33 |
|
|
Dilate esophagus 1/mult pass
|
$424.80 |
$1,109.47 |
$2,195.76 |
|
|
Dilate ic vasospasm init
|
$2,650.22 |
$2,650.22 |
$2,650.22 |
|
|
Dilate tear duct opening
|
$440.81 |
$472.21 |
$472.21 |
|
|
Dilate urethra stricture
|
$287.81 |
$287.81 |
$917.40 |
|
|
Dilate urethra stricture
|
$152.54 |
$152.54 |
$335.52 |
|
|
Dilate urethra stricture
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
|
|
Dilate urethra stricture
|
$287.81 |
$287.81 |
$287.81 |
|
|
Dilation/female urethra/initial 53660
|
$185.15 |
$185.15 |
$482.35 |
|
|
Dilation of anal sphincter
|
$1,395.28 |
$1,395.28 |
$1,395.28 |
|
|
Dilation of cervical canal 57800
|
$1,493.19 |
$3,762.53 |
$8,188.62 |
|
|
Dilation of rectal stricture 45910
|
$1,395.28 |
$1,395.28 |
$3,186.98 |
|
|
Dilation of salivary duct
|
$602.63 |
$602.63 |
$602.63 |
|
|
Dilation of urethra
|
$152.54 |
$152.54 |
$335.52 |
|
|
Dilation of urethra
|
$2,424.12 |
$2,424.12 |
$2,424.12 |
|
|
Dilation of vagina
|
$3,762.53 |
$3,762.53 |
$7,627.40 |
|
|
Dilation salivary duct 42650
|
$1,752.89 |
$1,752.89 |
$3,453.20 |
|
|
Dilation/urethral strict/male/ini 53620
|
$789.86 |
$789.86 |
$789.86 |
|
|
Dilator fascial 10fx20cm
|
$103.20 |
$103.20 |
$103.20 |
|
|
Dilat xst trc ndurlgc px
|
$498.60 |
$4,081.37 |
$5,335.69 |
|
|
Dilat xst trc new access rcs
|
$4,081.37 |
$4,081.37 |
$9,142.27 |
|
|
Dimecaprol injection
|
$183.58 |
$183.58 |
$183.58 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$45.49 |
$715.90 |
$1,121.44 |
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.05 |
$0.15 |
$9.60 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$0.96 |
$1.46 |
$9.82 |
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$91.44 |
$98.56 |
$372.88 |
|
|
Dipyridamole injection
|
$1.34 |
$1.44 |
$6.03 |
|
|
Dir nsl mucous membrane test
|
$46.45 |
$46.45 |
$46.45 |
|
|
Disability dlco
|
$185.15 |
$220.60 |
$1,253.00 |
|
|
Disaccharidases
|
$22.17 |
$22.17 |
$368.74 |
|
