|
Dialysis circuit perm vascular embolization 36909
|
$15,156.00 |
$15,156.00 |
$15,156.00 |
$5,382.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$82.44 |
$82.44 |
$82.44 |
$114.18
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$27.78 |
$27.78 |
$27.78 |
$74.02
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.24 |
$6.24 |
$6.24 |
$68.22
|
|
Digoxin immune fab 40 mg intravenous solution
|
$21,487.68 |
$21,487.68 |
$21,487.68 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$156.00 |
$156.00 |
$156.00 |
$99.35
|
|
Dilate biliary duct/ampulla
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$1,866.73
|
|
Dilate esophagus 1/mult pass
|
$6,415.20 |
$6,415.20 |
$6,415.20 |
$1,484.17
|
|
Dilator fascial 10fx20cm
|
$832.93 |
$832.93 |
$832.93 |
$408.24
|
|
Dilat xst trc ndurlgc px
|
$33,226.25 |
$33,226.25 |
$33,226.25 |
$3,903.54
|
|
Dilat xst trc new access rcs
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,213.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$48.22
|
|
Dimenhydrinate injection
|
$29.70 |
$29.70 |
$29.70 |
$30.48
|
|
Dimethyl sulfoxide 50% 50 ml
|
$3,292.68 |
$3,292.68 |
$3,292.68 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$17.75
|
|
Disaccharidases
|
$175.20 |
$175.20 |
$175.20 |
$222.63
|
|
Discography cerv/thor spine
|
$2,692.80 |
$2,692.80 |
$2,692.80 |
$2,418.00
|
|
Dise eval slp do brth flx dx
|
$6,120.96 |
$6,120.96 |
$6,120.96 |
$1,120.00
|
|
Dmd dup/delet analysis
|
$499.20 |
$499.20 |
$499.20 |
$385.02
|
|
Dna antibody native/double stranded
|
$51.60 |
$51.60 |
$51.60 |
$100.00
|
|
Dna gardnerella
|
$33.60 |
$33.60 |
$33.60 |
$62.50
|
|
Dna trichomonas
|
$33.60 |
$33.60 |
$33.60 |
$67.20
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$180.48 |
$180.48 |
$180.48 |
$99.10
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$64.32 |
$64.32 |
$64.32 |
$69.47
|
|
Dornase alfa non-comp unit
|
$603.60 |
$603.60 |
$603.60 |
$429.81
|
|
Dornhoffer fixed part w/window
|
$67,573.67 |
$67,573.67 |
$67,573.67 |
$34,278.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$78.24 |
$78.24 |
$78.24 |
$84.80
|
|
Dpyd gene common variants
|
$351.60 |
$351.60 |
$351.60 |
$377.47
|
|
Drainage of arm bursa 23931
|
$3,010.80 |
$3,010.80 |
$3,010.80 |
$2,175.00
|
|
Drainage of kidney lesion
|
$1,361.40 |
$1,361.40 |
$1,361.40 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$283.80 |
$283.80 |
$283.80 |
$171.20
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,327.20 |
$1,327.20 |
$1,327.20 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$4,383.60 |
$4,383.60 |
$4,383.60 |
$2,839.24
|
|
Drain cerebro spinal fluid 62272
|
$352.80 |
$352.80 |
$352.80 |
$1,039.80
|
|
Drain finger abscess;simple 26010
|
$460.80 |
$460.80 |
$460.80 |
$426.40
|
|
Drain thigh/knee lesion 27301
|
$6,279.60 |
$6,279.60 |
$6,279.60 |
$3,606.86
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$700.20 |
$700.20 |
$700.20 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$978.00 |
$978.00 |
$978.00 |
$338.25
|
|
Dress/debrid prtl-thick burn l 16030
|
$798.00 |
$798.00 |
$798.00 |
$515.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$32,557.04 |
$32,557.04 |
$32,557.04 |
$5,857.52
|
|
Drill hole implt ventricular cath/device 61107
|
$5,064.60 |
$5,064.60 |
$5,064.60 |
$1,519.57
|
|
Drng hand tendon sheath 26020
|
$6,061.80 |
$6,061.80 |
$6,061.80 |
$3,839.54
|
|
Drng of finger abscess comp 26011
|
$3,687.00 |
$3,687.00 |
$3,687.00 |
$1,917.33
|
|
Droperidol 2.5 mg/ml injection solution
|
$6.00 |
$6.00 |
$6.00 |
$31.07
|
|
Drop lock knee
|
$204.95 |
$204.95 |
$204.95 |
$204.95
|
|
Drop lock retainer each
|
$70.12 |
$70.12 |
$70.12 |
$70.12
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$6,822.97 |
$6,822.97 |
$6,822.97 |
$1,956.48
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$4,523.50 |
$4,523.50 |
$4,523.50 |
$2,567.36
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$18,303.94 |
$18,303.94 |
$18,303.94 |
$143.50
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$4,277.66 |
$4,277.66 |
$4,277.66 |
$242.40
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$25,588.77 |
$25,588.77 |
$25,588.77 |
$25,588.77
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$36,446.01 |
$36,446.01 |
$36,446.01 |
$7,612.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$25,691.11 |
$25,691.11 |
$25,691.11 |
$400.98
|
|
Drug assay caffeine
|
$67.80 |
$67.80 |
$67.80 |
$80.00
|
|
Drug assay posaconazole
|
$79.80 |
$79.80 |
$79.80 |
$96.39
|
|
Drug assay rufinamide
|
$169.20 |
$169.20 |
$169.20 |
$81.60
|
|
Drug assay vedolizumab
|
$77.40 |
$77.40 |
$77.40 |
$141.75
|
|
Drug assay voriconazole
|
$72.60 |
$72.60 |
$72.60 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$234.60 |
$234.60 |
$234.60 |
$66.43
|
|
Drug of abuse screen urine
|
$10.80 |
$10.80 |
$10.80 |
$61.60
|
|
Drug screen quant tiagabine
|
$133.20 |
$133.20 |
$133.20 |
$108.48
|
|
Drug test def 1-7 classes
|
$223.80 |
$223.80 |
$223.80 |
$263.25
|
|
Drug test prsmv instrmnt
|
$11.40 |
$11.40 |
$11.40 |
$78.65
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$141.60 |
$141.60 |
$141.60 |
$280.95
|
|
Drvvt confirm - quest
|
$87.00 |
$87.00 |
$87.00 |
$101.66
|
|
Ductogram sgl duct
|
$810.60 |
$810.60 |
$810.60 |
$452.50
|
|
Duragen 1x1 5ea/bx
|
$17,796.20 |
$17,796.20 |
$17,796.20 |
$11,009.65
|
|
Dxa bone density axl vrt fx
|
$723.60 |
$723.60 |
$723.60 |
$397.65
|
|
Dx bronchoscope/brush 31623
|
$60,111.47 |
$60,111.47 |
$60,111.47 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$60,111.47 |
$60,111.47 |
$60,111.47 |
$2,358.80
|
|
Dx bronchoscope/wash 31622
|
$6,727.20 |
$6,727.20 |
$6,727.20 |
$2,238.00
|
|
Echograp trans r pros study
|
$222.00 |
$222.00 |
$222.00 |
$459.40
|
|
Echo guidance radiotherapy
|
$637.20 |
$637.20 |
$637.20 |
$812.00
|
|
Echo guide for artery repair
|
$2,596.20 |
$2,596.20 |
$2,596.20 |
$660.00
|
|
Ecmo/ecls remove cent cannula 6yrs&older 33986
|
$2,974.80 |
$2,974.80 |
$2,974.80 |
$1,282.40
|
|
Ecmo/ecls remove prph cannula 6yrs&older open 33984
|
$2,974.80 |
$2,974.80 |
$2,974.80 |
$1,057.76
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$2,974.80 |
$2,974.80 |
$2,974.80 |
$1,362.00
|
|
Ecmo/ecls repos cent cnula 6yrs&older 33964
|
$2,711.40 |
$2,711.40 |
$2,711.40 |
$1,128.60
|
|
Ecmo/ecls repos perph cnula 6yrs&older opn 33962
|
$2,711.40 |
$2,711.40 |
$2,711.40 |
$925.55
|
|
Ecmo/ecls repos perph cnula 6yrs&older perq 33958
|
$2,711.40 |
$2,711.40 |
$2,711.40 |
$1,116.00
|
|
E equine encephalitis igg
|
$70.20 |
$70.20 |
$70.20 |
$49.40
|
|
Egd control bleeding any
|
$12,909.31 |
$12,909.31 |
$12,909.31 |
$2,547.00
|
|
Egd dilate stricture
|
$6,091.78 |
$6,091.78 |
$6,091.78 |
$2,244.82
|
|
Egd endo mucosal resection
|
$15,543.40 |
$15,543.40 |
$15,543.40 |
$2,430.40
|
|
Egd endoscopic stent place
|
$17,038.47 |
$17,038.47 |
$17,038.47 |
$3,857.25
|
|
Egd guide wire insertion
|
$7,599.05 |
$7,599.05 |
$7,599.05 |
$1,664.00
|
|
Egd remove foreign body
|
$4,949.46 |
$4,949.46 |
$4,949.46 |
$1,473.45
|
|
Egd remove lesion snare
|
$13,346.60 |
$13,346.60 |
$13,346.60 |
$2,506.40
|
|
Egd Ultrasound exam duodenum/jejunum
|
$9,984.94 |
$9,984.94 |
$9,984.94 |
$2,244.82
|
|
Egd Ultrasound fine needle bx/aspir
|
$13,012.57 |
$13,012.57 |
$13,012.57 |
$2,392.00
|
|
Egd Ultrasound fine needle bx/aspir
|
$20,870.53 |
$20,870.53 |
$20,870.53 |
$2,912.00
|
|
Egd Ultrasound transmural injxn/mark
|
$6,621.48 |
$6,621.48 |
$6,621.48 |
$3,103.10
|
|
Egd varices ligation
|
$8,918.50 |
$8,918.50 |
$8,918.50 |
$2,234.01
|
|
Egd w/transmural drain cyst
|
$26,519.66 |
$26,519.66 |
$26,519.66 |
$4,379.25
|
|
Egfr gene com variants
|
$639.00 |
$639.00 |
$639.00 |
$639.00
|
|
Ehrlicha chaffeensis amp prb
|
$93.00 |
$93.00 |
$93.00 |
$93.00
|
|
Eia hiv-1/hiv-2 screen
|
$15.60 |
$15.60 |
$15.60 |
$36.40
|
|
Electrd sq emblem s-icd
|
$14,144.54 |
$14,144.54 |
$14,144.54 |
$10,206.00
|
|
Electrical stimulation/unattended 97014
|
$117.00 |
$117.00 |
$117.00 |
$77.33
|
|
Electrolyte panel
|
$34.80 |
$34.80 |
$34.80 |
$83.20
|
