|
Diagnostic anoscopy spx 46600
|
$531.20 |
$531.20 |
$531.20 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$332.80 |
$332.80 |
$332.80 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$270.40 |
$270.40 |
$270.40 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$569.60 |
$569.60 |
$569.60 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$789.60 |
$789.60 |
$789.60 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$474.40 |
$474.40 |
$474.40 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$394.40 |
$394.40 |
$394.40 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$317.60 |
$317.60 |
$317.60 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$14,204.00 |
$14,204.00 |
$14,204.00 |
$5,741.00
|
|
Dialysis one evaluation
|
$920.00 |
$920.00 |
$920.00 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$18.00 |
$18.00 |
$18.00 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$41.45 |
$41.45 |
$41.45 |
$79.71
|
|
Dicyclomine injection
|
$298.17 |
$298.17 |
$298.17 |
$154.33
|
|
Difelikefalin, esrd on dialy
|
$444.00 |
$444.00 |
$444.00 |
$264.88
|
|
Diffusing capacity
|
$402.40 |
$402.40 |
$402.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$371.64 |
$371.64 |
$371.64 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,604.30 |
$6,604.30 |
$6,604.30 |
$10,279.62
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$925.51 |
$925.51 |
$925.51 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$4,451.20 |
$4,451.20 |
$4,451.20 |
$1,866.73
|
|
Dilate esophagus
|
$2,228.80 |
$2,228.80 |
$2,228.80 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$1,620.00 |
$1,620.00 |
$1,620.00 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,523.20 |
$1,523.20 |
$1,523.20 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$5,250.40 |
$5,250.40 |
$5,250.40 |
$5,151.95
|
|
Dilate urethra stricture
|
$622.40 |
$622.40 |
$622.40 |
$513.00
|
|
Dilate urethra stricture
|
$2,410.40 |
$2,410.40 |
$2,410.40 |
$3,863.60
|
|
Dilation/female urethra/initial 53660
|
$222.40 |
$222.40 |
$222.40 |
$235.61
|
|
Dilation of anal sphincter
|
$2,541.60 |
$2,541.60 |
$2,541.60 |
$2,166.04
|
|
Dilation of cervical canal 57800
|
$3,652.00 |
$3,652.00 |
$3,652.00 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$3,159.20 |
$3,159.20 |
$3,159.20 |
$2,491.80
|
|
Dilation of urethra
|
$2,871.20 |
$2,871.20 |
$2,871.20 |
$2,424.12
|
|
Dilation/urethral strict/male/ini 53620
|
$2,622.40 |
$2,622.40 |
$2,622.40 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$716.40 |
$716.40 |
$716.40 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$4,952.80 |
$4,952.80 |
$4,952.80 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$4,952.80 |
$4,952.80 |
$4,952.80 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$16.80 |
$16.80 |
$16.80 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$976.00 |
$976.00 |
$976.00 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.20 |
$1.20 |
$1.20 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$16.80 |
$16.80 |
$16.80 |
$18.32
|
|
Dipyridamole injection
|
$16.80 |
$16.80 |
$16.80 |
$48.04
|
|
Disability dlco
|
$404.00 |
$404.00 |
$404.00 |
$293.76
|
|
Dise eval slp do brth flx dx
|
$2,142.40 |
$2,142.40 |
$2,142.40 |
$1,120.00
|
|
Dist revas ligation hemo
|
$6,732.80 |
$6,732.80 |
$6,732.80 |
$6,396.89
|
|
Dlyd plmt xtn prosth ea addl
|
$8,000.00 |
$8,000.00 |
$8,000.00 |
$1,810.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$85.27 |
$85.27 |
$85.27 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,279.00 |
$1,279.00 |
$1,279.00 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$54.81 |
$54.81 |
$54.81 |
$65.40
|
|
Doppler echo complete
|
$794.40 |
$794.40 |
$794.40 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$3,796.00 |
$3,796.00 |
$3,796.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$828.80 |
$828.80 |
$828.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$716.80 |
$716.80 |
$716.80 |
$481.65
|
|
Dornase alfa non-comp unit
|
$221.19 |
$221.19 |
$221.19 |
$356.00
|
|
Dornhoffer fixed part w/window
|
$56,064.00 |
$56,064.00 |
$56,064.00 |
$34,278.00
|
|
Dorsi & plantar flex ass/res
|
$115.76 |
$115.76 |
$115.76 |
$163.44
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$386.56 |
$386.56 |
$386.56 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,289.30 |
$1,289.30 |
$1,289.30 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$65.60 |
$65.60 |
$65.60 |
$89.34
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$800.80 |
$800.80 |
$800.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$900.80 |
$900.80 |
$900.80 |
$964.00
|
|
Drainage external ear complex 69005
|
$2,552.00 |
$2,552.00 |
$2,552.00 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$874.40 |
$874.40 |
$874.40 |
$790.40
|
|
Drainage mouth roof lesion
|
$570.40 |
$570.40 |
$570.40 |
$405.60
|
|
Drainage of arm bursa 23931
|
$2,540.00 |
$2,540.00 |
$2,540.00 |
$2,271.01
|
|
Drainage of eye
|
$3,220.80 |
$3,220.80 |
$3,220.80 |
$2,415.65
|
|
Drainage of eye
|
$3,413.60 |
$3,413.60 |
$3,413.60 |
$3,170.00
|
|
Drainage of kidney lesion
|
$1,608.80 |
$1,608.80 |
$1,608.80 |
$1,506.00
|
|
Drainage of mouth lesion
|
$4,173.60 |
$4,173.60 |
$4,173.60 |
$2,320.03
|
|
Drainage of mouth lesion
|
$3,232.80 |
$3,232.80 |
$3,232.80 |
$3,837.72
|
|
Drainage of mouth lesion
|
$2,571.20 |
$2,571.20 |
$2,571.20 |
$905.30
|
|
Drainage of nose lesion int 30000
|
$244.00 |
$244.00 |
$244.00 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$1,550.40 |
$1,550.40 |
$1,550.40 |
$781.44
|
|
Drainage of rectal abscess
|
$1,626.40 |
$1,626.40 |
$1,626.40 |
$2,135.10
|
|
Drain bladder by trocar/cath
|
$3,232.00 |
$3,232.00 |
$3,232.00 |
$1,203.94
|
|
Drain blood from under nail 11740
|
$459.20 |
$459.20 |
$459.20 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,133.60 |
$2,133.60 |
$2,133.60 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$2,557.60 |
$2,557.60 |
$2,557.60 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$598.40 |
$598.40 |
$598.40 |
$428.40
|
|
Drain lower leg lesion 27603
|
$3,213.60 |
$3,213.60 |
$3,213.60 |
$3,994.09
|
|
Drain neck/chest lesion 21501
|
$3,377.60 |
$3,377.60 |
$3,377.60 |
$3,339.00
|
|
Drain thigh/knee lesion 27301
|
$3,280.80 |
$3,280.80 |
$3,280.80 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$776.80 |
$776.80 |
$776.80 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$632.00 |
$632.00 |
$632.00 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$796.80 |
$796.80 |
$796.80 |
$541.00
|
|
Dressing change not for burn w/anes 15852
|
$637.60 |
$637.60 |
$637.60 |
$755.08
|
|
Drill hole implt ventricular cath/device 61107
|
$3,304.80 |
$3,304.80 |
$3,304.80 |
$1,485.75
|
|
Drng of eyelid abscess 67700
|
$664.00 |
$664.00 |
$664.00 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$2,029.60 |
$2,029.60 |
$2,029.60 |
$2,079.50
|
|
Drng of hydrocele 55000
|
$886.40 |
$886.40 |
$886.40 |
$867.90
|
|
Drng of mouth lesion 40801
|
$1,467.20 |
$1,467.20 |
$1,467.20 |
$1,350.97
|
|
Drng of scrotum abscess 55100
|
$2,204.80 |
$2,204.80 |
$2,204.80 |
$1,997.89
|
|
Drng salivary gland simple 42300
|
$1,863.20 |
$1,863.20 |
$1,863.20 |
$2,039.50
|
|
Droperidol 2.5 mg/ml injection solution
|
$25.55 |
$25.55 |
$25.55 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$2,405.87 |
$2,405.87 |
$2,405.87 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$61.36 |
$61.36 |
$61.36 |
$119.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$233.35 |
$233.35 |
$233.35 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$135.80 |
$135.80 |
$135.80 |
$193.15
|
|
Drsg sht 5.625x4.625in std
|
$34.44 |
$34.44 |
$34.44 |
$123.24
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$74.86 |
$74.86 |
$74.86 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$215.53 |
$215.53 |
$215.53 |
$7,465.97
|