|
Dilate esophagus 1/mult pass
|
$88.50 |
$88.50 |
$88.50 |
$1,484.17
|
|
Dilate tear duct opening
|
$85.00 |
$85.00 |
$85.00 |
$472.21
|
|
Dilate urethra stricture
|
$239.50 |
$239.50 |
$239.50 |
$490.00
|
|
Dilate urethra stricture
|
$58.50 |
$58.50 |
$58.50 |
$200.80
|
|
Dilate urethra stricture
|
$69.00 |
$69.00 |
$69.00 |
$3,863.60
|
|
Dilation/female urethra/initial 53660
|
$45.50 |
$45.50 |
$45.50 |
$235.61
|
|
Dilation of anal sphincter
|
$203.00 |
$203.00 |
$203.00 |
$1,969.12
|
|
Dilation of rectal stricture 45910
|
$226.50 |
$226.50 |
$226.50 |
$1,395.28
|
|
Dilation of urethra
|
$44.00 |
$44.00 |
$44.00 |
$172.00
|
|
Diltiazem 5 mg/ml intravenous solution
|
$4.86 |
$4.86 |
$4.86 |
$47.94
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,005.50 |
$1,005.50 |
$1,005.50 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.00 |
$1.00 |
$1.00 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.50 |
$1.50 |
$1.50 |
$17.75
|
|
Disability dlco
|
$185.00 |
$185.00 |
$185.00 |
$282.40
|
|
Disaccharidases
|
$415.00 |
$415.00 |
$415.00 |
$216.00
|
|
Dis site tele svcs rhc/fqhc
|
$91.00 |
$91.00 |
$91.00 |
$94.80
|
|
Dist revas ligation hemo
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$6,396.89
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1.00 |
$1.00 |
$1.00 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$16.13 |
$16.13 |
$16.13 |
$65.40
|
|
Doppler echo complete
|
$21.00 |
$21.00 |
$21.00 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$26.00 |
$26.00 |
$26.00 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$14.50 |
$14.50 |
$14.50 |
$471.17
|
|
Double transfer toe-hand
|
$4,159.00 |
$4,159.00 |
$4,159.00 |
$7,413.38
|
|
Dpyd gene common variants
|
$800.00 |
$800.00 |
$800.00 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$957.00 |
$957.00 |
$957.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$158.00 |
$158.00 |
$158.00 |
$914.34
|
|
Drainage external ear simple 69000
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$789.60
|
|
Drainage lymph node lesion 38300
|
$257.50 |
$257.50 |
$257.50 |
$3,088.80
|
|
Drainage mouth roof lesion
|
$327.00 |
$327.00 |
$327.00 |
$390.39
|
|
Drainage of arm bursa 23931
|
$1,627.00 |
$1,627.00 |
$1,627.00 |
$2,197.48
|
|
Drainage of eye
|
$87.00 |
$87.00 |
$87.00 |
$2,360.00
|
|
Drainage of eye
|
$492.50 |
$492.50 |
$492.50 |
$3,222.78
|
|
Drainage of forearm bursa
|
$434.00 |
$434.00 |
$434.00 |
$2,054.00
|
|
Drainage of mouth lesion
|
$227.00 |
$227.00 |
$227.00 |
$489.00
|
|
Drainage of mouth lesion
|
$383.50 |
$383.50 |
$383.50 |
$3,544.29
|
|
Drainage of nose lesion int 30000
|
$132.00 |
$132.00 |
$132.00 |
$491.40
|
|
Drainage of pelvis lesion 26990
|
$789.00 |
$789.00 |
$789.00 |
$3,958.50
|
|
Drainage of rectal abscess
|
$208.00 |
$208.00 |
$208.00 |
$2,111.46
|
|
Drain blood from under nail 11740
|
$171.50 |
$171.50 |
$171.50 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$222.50 |
$222.50 |
$222.50 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$206.00 |
$206.00 |
$206.00 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$951.00 |
$951.00 |
$951.00 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$297.00 |
$297.00 |
$297.00 |
$419.00
|
|
Drain lower leg lesion 27603
|
$446.00 |
$446.00 |
$446.00 |
$3,858.40
|
|
Drain neck/chest lesion 21501
|
$391.50 |
$391.50 |
$391.50 |
$3,339.00
|
|
Drain ovary abscess open
|
$366.50 |
$366.50 |
$366.50 |
$3,762.53
|
|
Drain shoulder lesion
|
$293.50 |
$293.50 |
$293.50 |
$3,904.61
|
|
Drain thigh/knee lesion 27301
|
$583.00 |
$583.00 |
$583.00 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$123.50 |
$123.50 |
$123.50 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$259.00 |
$259.00 |
$259.00 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$595.50 |
$595.50 |
$595.50 |
$523.00
|
|
Dressing change not for burn w/anes 15852
|
$708.00 |
$708.00 |
$708.00 |
$755.08
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$8,131.20
|
|
Drill hole implt ventricular cath/device 61107
|
$916.50 |
$916.50 |
$916.50 |
$1,515.00
|
|
Drng hand tendon sheath 26020
|
$637.00 |
$637.00 |
$637.00 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$122.50 |
$122.50 |
$122.50 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$2,497.50 |
$2,497.50 |
$2,497.50 |
$1,943.50
|
|
Drng of hydrocele 55000
|
$94.00 |
$94.00 |
$94.00 |
$832.60
|
|
Drng of mouth lesion 40801
|
$227.00 |
$227.00 |
$227.00 |
$1,262.76
|
|
Drng of scrotum abscess 55100
|
$197.50 |
$197.50 |
$197.50 |
$1,917.33
|
|
Drng open retroperitoneal abscess 49060
|
$1,253.50 |
$1,253.50 |
$1,253.50 |
$1,924.00
|
|
Drng peritoneal abscess open 49020
|
$1,818.00 |
$1,818.00 |
$1,818.00 |
$2,520.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$2.37 |
$2.37 |
$2.37 |
$31.07
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$489.50 |
$489.50 |
$489.50 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$731.88 |
$731.88 |
$731.88 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$119.50 |
$119.50 |
$119.50 |
$289.05
|
|
Drug assay posaconazole
|
$150.00 |
$150.00 |
$150.00 |
$96.75
|
|
Drug assay rufinamide
|
$51.00 |
$51.00 |
$51.00 |
$85.80
|
|
Drug of abuse screen urine
|
$56.50 |
$56.50 |
$56.50 |
$63.75
|
|
Drug screening tapentadol
|
$5.00 |
$5.00 |
$5.00 |
$36.00
|
|
Drug test def 15-21 classes
|
$160.00 |
$160.00 |
$160.00 |
$263.25
|
|
Drug test def 1-7 classes
|
$200.50 |
$200.50 |
$200.50 |
$250.52
|
|
Drug test def 22+ classes
|
$289.50 |
$289.50 |
$289.50 |
$423.00
|
|
Drug test def 8-14 classes
|
$90.00 |
$90.00 |
$90.00 |
$282.00
|
|
Drug test prsmv instrmnt
|
$143.50 |
$143.50 |
$143.50 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$376.04 |
$376.04 |
$376.04 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$162.00 |
$162.00 |
$162.00 |
$3,020.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$424.50 |
$424.50 |
$424.50 |
$887.25
|
|
Dx bronchoscope/brush 31623
|
$146.50 |
$146.50 |
$146.50 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$148.00 |
$148.00 |
$148.00 |
$2,365.20
|
|
Dx bronchoscope/wash 31622
|
$147.50 |
$147.50 |
$147.50 |
$2,322.60
|
|
Dx gastr intub w/asp spec
|
$420.00 |
$420.00 |
$420.00 |
$441.60
|
|
Dx laryngoscopy newborn
|
$386.00 |
$386.00 |
$386.00 |
$707.25
|
|
Ear irrigation 69209
|
$172.00 |
$172.00 |
$172.00 |
$149.76
|
|
Ecg 12 lead tracing only
|
$98.00 |
$98.00 |
$98.00 |
$226.50
|
|
Ecg/1-3 leads/interp & report only 93042
|
$8.50 |
$8.50 |
$8.50 |
$16.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$49.50 |
$49.50 |
$49.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$84.00 |
$84.00 |
$84.00 |
$161.85
|
|
Ecg/review interpret only
|
$29.00 |
$29.00 |
$29.00 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$1,435.50 |
$1,435.50 |
$1,435.50 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$4.00 |
$4.00 |
$4.00 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,339.50 |
$1,339.50 |
$1,339.50 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$229.00 |
$229.00 |
$229.00 |
$703.25
|
|
Echocardiograpy doppler follow up/limited study
|
$9.00 |
$9.00 |
$9.00 |
$362.50
|
|
Echo exam of eye
|
$36.50 |
$36.50 |
$36.50 |
$172.00
|
|
Echo exam of eye
|
$88.50 |
$88.50 |
$88.50 |
$168.00
|
|
Echo exam of eye thickness
|
$9.50 |
$9.50 |
$9.50 |
$50.91
|
|
Echo exam uterus 76831-
|
$42.50 |
$42.50 |
$42.50 |
$523.71
|
|
Echo stress
|
$82.50 |
$82.50 |
$82.50 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$128.50 |
$128.50 |
$128.50 |
$1,849.50
|
