|
Dch glucoscan
|
$19.50 |
$19.50 |
$19.50 |
$29.16
|
|
Dch pulmonary stress test
|
$1,923.75 |
$1,923.75 |
$1,923.75 |
$963.30
|
|
Dch validity tests
|
$18.00 |
$18.00 |
$18.00 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$1,809.00 |
$1,809.00 |
$1,809.00 |
$5,121.00
|
|
Deamidated gliadin antibody iga
|
$30.00 |
$30.00 |
$30.00 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$319.50 |
$319.50 |
$319.50 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$3,915.75 |
$3,915.75 |
$3,915.75 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$915.75 |
$915.75 |
$915.75 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,160.00 |
$2,160.00 |
$2,160.00 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$778.50 |
$778.50 |
$778.50 |
$835.20
|
|
Debride nail1-5 11720
|
$222.75 |
$222.75 |
$222.75 |
$149.60
|
|
Debride nail6 or more 11721
|
$308.25 |
$308.25 |
$308.25 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$798.75 |
$798.75 |
$798.75 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$997.50 |
$997.50 |
$997.50 |
$1,165.50
|
|
Decalcification
|
$35.25 |
$35.25 |
$35.25 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$634.17 |
$634.17 |
$634.17 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$609.75 |
$609.75 |
$609.75 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$102.84 |
$102.84 |
$102.84 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$3,396.16 |
$3,396.16 |
$3,396.16 |
$1,856.85
|
|
Delivery of placenta 59414
|
$924.75 |
$924.75 |
$924.75 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$6,758.25 |
$6,758.25 |
$6,758.25 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$196.50 |
$196.50 |
$196.50 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$12,371.55 |
$12,371.55 |
$12,371.55 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$168.00 |
$168.00 |
$168.00 |
$401.60
|
|
Dermagraft
|
$100.50 |
$100.50 |
$100.50 |
$85.00
|
|
Dermapure 1 square cm
|
$5,197.50 |
$5,197.50 |
$5,197.50 |
$3,300.73
|
|
Derm-maxx, per sq cm
|
$7,762.50 |
$7,762.50 |
$7,762.50 |
$1.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$172.46 |
$172.46 |
$172.46 |
$91.84
|
|
Desoxycorticosterone
|
$84.00 |
$84.00 |
$84.00 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$6,309.00 |
$6,309.00 |
$6,309.00 |
$5,267.20
|
|
Destroy cervthor facet jnt 64633
|
$1,967.25 |
$1,967.25 |
$1,967.25 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,535.25 |
$1,535.25 |
$1,535.25 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$199.50 |
$199.50 |
$199.50 |
$202.40
|
|
Destroy vulva lesion simple 56501
|
$3,215.25 |
$3,215.25 |
$3,215.25 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$228.00 |
$228.00 |
$228.00 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$83.25 |
$83.25 |
$83.25 |
$78.61
|
|
Destruction anal lesion(s)
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$3,711.00
|
|
Destruction anal lesion(s) smpl chem 46900
|
$468.00 |
$468.00 |
$468.00 |
$557.90
|
|
Destruction benign lesions < 14 lesions
|
$268.50 |
$268.50 |
$268.50 |
$240.24
|
|
Destruction by injection tx of nerve 64630
|
$2,203.50 |
$2,203.50 |
$2,203.50 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,463.25 |
$1,463.25 |
$1,463.25 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,343.75 |
$2,343.75 |
$2,343.75 |
$3,296.80
|
|
Destruction mal lsn t/a/l >4cm
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$569.80
|
|
Detect agnt mult dna direc
|
$115.50 |
$115.50 |
$115.50 |
$166.77
|
|
Determine refractive state
|
$18.00 |
$18.00 |
$18.00 |
$21.50
|
|
Devel tst phys/qhp 1st hr
|
$439.50 |
$439.50 |
$439.50 |
$350.40
|
|
Device ablt adv novasure
|
$11,239.88 |
$11,239.88 |
$11,239.88 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$5,175.00 |
$5,175.00 |
$5,175.00 |
$4,200.00
|
|
Device intraute mirena
|
$4,491.10 |
$4,491.10 |
$4,491.10 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,454.07 |
$1,454.07 |
$1,454.07 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$1,070.85 |
$1,070.85 |
$1,070.85 |
$2,515.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$183.00 |
$183.00 |
$183.00 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$412.50 |
$412.50 |
$412.50 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$554.26 |
$554.26 |
$554.26 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$16.28 |
$16.28 |
$16.28 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$465.34 |
$465.34 |
$465.34 |
$884.80
|
|
Dextran 40 infusion
|
$225.55 |
$225.55 |
$225.55 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$22.19 |
$22.19 |
$22.19 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$22.19 |
$22.19 |
$22.19 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$36.98 |
$36.98 |
$36.98 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$22.19 |
$22.19 |
$22.19 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$204.00 |
$204.00 |
$204.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$89.25 |
$89.25 |
$89.25 |
$79.30
|
|
Diab manage trn ind/group
|
$57.75 |
$57.75 |
$57.75 |
$54.99
|
|
Diag bronchoscope/catheter
|
$2,379.00 |
$2,379.00 |
$2,379.00 |
$2,360.15
|
|
Diagnostic anoscopy spx 46600
|
$249.00 |
$249.00 |
$249.00 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$196.50 |
$196.50 |
$196.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$164.25 |
$164.25 |
$164.25 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$422.25 |
$422.25 |
$422.25 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$524.25 |
$524.25 |
$524.25 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$418.50 |
$418.50 |
$418.50 |
$314.00
|
|
Dialysis repeated eval
|
$4,711.50 |
$4,711.50 |
$4,711.50 |
$1,332.80
|
|
Dialysis training incompl
|
$1,392.00 |
$1,392.00 |
$1,392.00 |
$391.67
|
|
Diatrizoate meglumine 18 % urethral solution
|
$58.24 |
$58.24 |
$58.24 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$143.84 |
$143.84 |
$143.84 |
$79.71
|
|
Dicyclomine injection
|
$310.41 |
$310.41 |
$310.41 |
$154.33
|
|
Diffusing capacity
|
$211.50 |
$211.50 |
$211.50 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$472.14 |
$472.14 |
$472.14 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$17,050.66 |
$17,050.66 |
$17,050.66 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$104.25 |
$104.25 |
$104.25 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$297.86 |
$297.86 |
$297.86 |
$297.86
|
|
Dilate esophagus 1/mult pass
|
$1,208.25 |
$1,208.25 |
$1,208.25 |
$1,548.00
|
|
Dilation of rectal stricture 45910
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$2,491.80
|
|
Dilator fascial 10fx20cm
|
$291.87 |
$291.87 |
$291.87 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$107.23 |
$107.23 |
$107.23 |
$45.60
|
|
Dimenhydrinate injection
|
$17.32 |
$17.32 |
$17.32 |
$30.48
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,501.55 |
$2,501.55 |
$2,501.55 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$36.98 |
$36.98 |
$36.98 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$5.92 |
$5.92 |
$5.92 |
$18.32
|
|
Dipyridamole injection
|
$64.49 |
$64.49 |
$64.49 |
$48.04
|
|
Disability dlco
|
$207.75 |
$207.75 |
$207.75 |
$293.76
|
|
Disaccharidases
|
$1,265.25 |
$1,265.25 |
$1,265.25 |
$230.40
|
|
Discography cerv/thor spine
|
$2,062.50 |
$2,062.50 |
$2,062.50 |
$2,565.00
|
|
Dlyd plmt xtn prosth ea addl
|
$3,828.75 |
$3,828.75 |
$3,828.75 |
$1,810.80
|
|
Dmd dup/delet analysis
|
$2,106.00 |
$2,106.00 |
$2,106.00 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$442.50 |
$442.50 |
$442.50 |
$313.60
|
|
Dna antibody native/double stranded
|
$135.75 |
$135.75 |
$135.75 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$130.35 |
$130.35 |
$130.35 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,164.72 |
$1,164.72 |
$1,164.72 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$98.91 |
$98.91 |
$98.91 |
$65.40
|
