|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$134.40 |
$203.40 |
$203.40 |
$186.00
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,864.12 |
$14,902.92 |
$14,902.92 |
$6,324.98
|
|
Depo-estradiol cypionate inj
|
$144.48 |
$144.48 |
$147.42 |
$84.00
|
|
Dermagraft
|
$3,647.66 |
$3,647.66 |
$3,647.66 |
$85.00
|
|
Dermapure 1 square cm
|
$5,235.32 |
$5,235.32 |
$5,235.32 |
$3,822.00
|
|
Descend thora aorta rpr/lt sub art 33880
|
$38,138.40 |
$38,138.40 |
$38,138.40 |
$6,687.93
|
|
Design mlc device for imrt
|
$612.60 |
$612.60 |
$612.60 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$18.06 |
$42.90 |
$67.08 |
$89.78
|
|
Desoxycorticosterone
|
$83.40 |
$83.40 |
$83.40 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$30,004.80 |
$30,004.80 |
$30,004.80 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$5,980.20 |
$5,980.20 |
$5,980.20 |
$2,906.00
|
|
Destroy cervthor facet jnt 64633
|
$3,018.00 |
$3,018.00 |
$5,218.38 |
$2,998.30
|
|
Destroy cth facet jnt addl 64634
|
$1,509.60 |
$1,509.60 |
$5,218.38 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$481.20 |
$481.20 |
$481.20 |
$199.50
|
|
Destroy vulva lesion simple 56501
|
$15,606.72 |
$15,606.72 |
$15,606.72 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$518.40 |
$518.40 |
$518.40 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$364.20 |
$364.20 |
$364.20 |
$72.60
|
|
Destruction anal lesion(s)
|
$14,413.44 |
$14,413.44 |
$14,413.44 |
$3,711.00
|
|
Destruction benign lesions < 14 lesions
|
$516.00 |
$758.40 |
$758.40 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$2,273.40 |
$2,273.40 |
$2,273.40 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,577.40 |
$1,577.40 |
$10,384.27 |
$1,612.80
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,153.00 |
$3,153.00 |
$10,384.27 |
$3,153.00
|
|
Device ablt adv novasure
|
$12,727.47 |
$12,727.47 |
$12,727.47 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,560.55 |
$6,560.55 |
$6,560.55 |
$4,200.00
|
|
Device sut capio slim opn
|
$3,002.11 |
$3,002.11 |
$3,002.11 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$2,430.68 |
$2,430.68 |
$2,430.68 |
$2,541.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$256.80 |
$256.80 |
$503.40 |
$222.50
|
|
Dexamethasone 4 mg tablet
|
$3.00 |
$3.06 |
$71.58 |
$5.98
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$6.00 |
$15.78 |
$284.76 |
$21.17
|
|
Dexamethasone intra implant
|
$6,590.40 |
$6,590.40 |
$6,590.40 |
$2,538.20
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$842.88 |
$842.88 |
$842.88 |
$875.14
|
|
Dextran 40 infusion
|
$279.30 |
$279.30 |
$279.30 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$37.80 |
$37.80 |
$40.80 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$37.80 |
$37.80 |
$40.80 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.80 |
$37.80 |
$40.80 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$37.80 |
$37.80 |
$40.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$139.80 |
$139.80 |
$139.80 |
$111.50
|
|
Diabetes (HbA1c) Test
|
$90.60 |
$90.60 |
$90.60 |
$79.30
|
|
Diag laparo separate proc 49320
|
$17,087.02 |
$17,087.02 |
$28,187.74 |
$6,904.15
|
|
Diagnostic Mammogram (both breasts)
|
$212.40 |
$369.00 |
$369.00 |
$397.95
|
|
Diagnostic Mammogram (one breast)
|
$335.40 |
$335.40 |
$335.40 |
$297.05
|
|
Diagnostic radio unlisted proc
|
$772.80 |
$772.80 |
$772.80 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$15,156.00 |
$15,156.00 |
$15,156.00 |
$5,543.85
|
|
Diatrizoate meglumine 18 % urethral solution
|
$147.72 |
$147.72 |
$147.72 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$35.40 |
$35.40 |
$37.98 |
$74.02
|
|
Dicyclomine injection
|
$51.66 |
$51.66 |
$78.96 |
$153.29
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.00 |
$6.24 |
$6.24 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$18,204.84 |
$21,487.68 |
$21,487.68 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$156.00 |
$156.00 |
$156.00 |
$100.20
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$220.50 |
$220.50 |
$220.50 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$1,866.73
|
|
Dilate esophagus 1/mult pass
|
$6,994.98 |
$7,137.90 |
$8,690.76 |
$1,484.17
|
|
Dilation of anal sphincter
|
$15,160.08 |
$15,160.08 |
$15,160.08 |
$1,969.12
|
|
Dilator fascial 10fx20cm
|
$832.93 |
$832.93 |
$832.93 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,213.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$47.94 |
$51.54 |
$51.54 |
$47.94
|
|
Dimenhydrinate injection
|
$29.70 |
$29.70 |
$29.70 |
$30.48
|
|
Dimethyl sulfoxide 50% 50 ml
|
$3,064.98 |
$3,064.98 |
$3,292.68 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$17.75
|
|
Dipyridamole injection
|
$95.04 |
$95.04 |
$95.04 |
$46.97
|
|
Disaccharidases
|
$175.20 |
$175.20 |
$175.20 |
$207.24
|
|
Discography cerv/thor spine
|
$2,692.80 |
$2,919.00 |
$2,919.00 |
$2,481.50
|
|
Dise eval slp do brth flx dx
|
$7,366.48 |
$7,366.48 |
$8,558.80 |
$1,120.00
|
|
Dlyd plmt xtn prosth ea addl
|
$2,916.00 |
$2,916.00 |
$2,916.00 |
$1,517.50
|
|
Dmd dup/delet analysis
|
$499.20 |
$499.20 |
$499.20 |
$404.03
|
|
Dna antibody native/double stranded
|
$51.60 |
$58.20 |
$58.20 |
$94.60
|
|
Dna gardnerella
|
$33.60 |
$33.60 |
$33.60 |
$62.50
|
|
Dna trichomonas
|
$33.60 |
$33.60 |
$33.60 |
$67.73
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$163.80 |
$180.48 |
$180.48 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$555.90 |
$1,020.00 |
$2,244.60 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$59.88 |
$71.10 |
$71.10 |
$65.40
|
|
Dornase alfa non-comp unit
|
$561.84 |
$603.60 |
$603.60 |
$446.75
|
|
Dornhoffer fixed part w/window
|
$67,573.67 |
$67,573.67 |
$67,573.67 |
$34,278.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$1,357.26 |
$1,357.26 |
$1,357.26 |
$423.95
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$78.24 |
$110.64 |
$118.86 |
$84.80
|
|
Dpyd gene common variants
|
$351.60 |
$351.60 |
$351.60 |
$380.50
|
|
Drainage of kidney lesion
|
$648.60 |
$1,361.40 |
$1,361.40 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$283.80 |
$283.80 |
$283.80 |
$171.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,327.20 |
$2,786.40 |
$2,786.40 |
$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
|
$740.40 |
$740.40 |
$740.40 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$5,084.70 |
$5,084.70 |
$5,084.70 |
$419.00
|
|
Drain lower leg lesion 27603
|
$18,198.00 |
$18,198.00 |
$18,198.00 |
$3,858.40
|
|
Drain neck/chest lesion 21501
|
$19,415.23 |
$19,415.23 |
$21,602.28 |
$3,339.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$700.20 |
$700.20 |
$700.20 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$600.00 |
$978.00 |
$978.00 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$798.00 |
$798.00 |
$798.00 |
$523.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$32,557.04 |
$32,557.04 |
$32,557.04 |
$8,131.20
|
|
Drill hole implt ventricular cath/device 61107
|
$5,064.60 |
$5,064.60 |
$5,064.60 |
$1,497.00
|
|
Drng hand tendon sheath 26020
|
$24,779.04 |
$24,779.04 |
$24,779.04 |
$3,839.54
|
|
Drng of scrotum abscess 55100
|
$15,665.70 |
$15,665.70 |
$15,665.70 |
$1,956.40
|
|
Drng peritoneal abscess open 49020
|
$5,998.80 |
$5,998.80 |
$5,998.80 |
$2,520.00
|
|
Dronabinol 2.5mg oral
|
$50.58 |
$50.58 |
$51.60 |
$10.10
|
|
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 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$18,303.94 |
$18,303.94 |
$18,303.94 |
$143.50
|
