|
Dest mal lesion feenlm 0.6-1cm 17281
|
$489.00 |
$489.00 |
$489.00 |
$362.58
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$485.25 |
$485.25 |
$485.25 |
$273.72
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$379.50 |
$379.50 |
$379.50 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$429.75 |
$429.75 |
$429.75 |
$311.20
|
|
Dest mal lesion tal <0.5 17260
|
$366.75 |
$366.75 |
$366.75 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$379.50 |
$379.50 |
$379.50 |
$274.80
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$332.25 |
$332.25 |
$332.25 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$455.25 |
$455.25 |
$455.25 |
$364.50
|
|
Destroy cervthor facet jnt 64633
|
$2,381.25 |
$2,381.25 |
$2,381.25 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,879.50 |
$1,879.50 |
$1,879.50 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$199.50 |
$199.50 |
$199.50 |
$202.40
|
|
Destroy vulva lesion simple 56501
|
$5,054.25 |
$5,054.25 |
$5,054.25 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$288.75 |
$288.75 |
$288.75 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$992.25 |
$992.25 |
$992.25 |
$966.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$666.75 |
$666.75 |
$666.75 |
$666.75
|
|
Destruct cut vasl lesions >50cm 17108
|
$1,442.25 |
$1,442.25 |
$1,442.25 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$83.25 |
$83.25 |
$83.25 |
$78.61
|
|
Destruction anal lesion(s)
|
$3,711.00 |
$3,711.00 |
$3,711.00 |
$3,711.00
|
|
Destruction anal lesion(s) smpl chem 46900
|
$468.00 |
$468.00 |
$468.00 |
$557.90
|
|
Destruction benign lesions < 14 lesions
|
$455.25 |
$455.25 |
$455.25 |
$240.24
|
|
Destruction by injection tx of nerve 64630
|
$912.00 |
$912.00 |
$912.00 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,879.50 |
$1,879.50 |
$1,879.50 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,325.75 |
$2,325.75 |
$2,325.75 |
$3,296.80
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$481.50 |
$481.50 |
$481.50 |
$482.00
|
|
Destruction mal lsn t/a/l >4cm
|
$1,347.00 |
$1,347.00 |
$1,347.00 |
$569.80
|
|
Destruction premal lesions 15/> 17004
|
$451.50 |
$451.50 |
$451.50 |
$442.61
|
|
Detect agnt mult dna direc
|
$162.00 |
$162.00 |
$162.00 |
$166.77
|
|
Determine refractive state
|
$18.00 |
$18.00 |
$18.00 |
$21.50
|
|
Developmental screen/score/document 96110
|
$573.75 |
$573.75 |
$573.75 |
$142.38
|
|
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
|
$187.50 |
$187.50 |
$187.50 |
$199.50
|
|
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)
|
$249.75 |
$249.75 |
$249.75 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$114.75 |
$114.75 |
$114.75 |
$79.30
|
|
Diab manage trn ind/group
|
$57.75 |
$57.75 |
$57.75 |
$54.99
|
|
Diag bronchoscope/catheter
|
$4,125.75 |
$4,125.75 |
$4,125.75 |
$2,360.15
|
|
Diagnostic anoscopy spx 46600
|
$181.50 |
$181.50 |
$181.50 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$70.50 |
$70.50 |
$70.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$57.00 |
$57.00 |
$57.00 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$592.50 |
$592.50 |
$592.50 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$338.25 |
$338.25 |
$338.25 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$520.50 |
$520.50 |
$520.50 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$371.25 |
$371.25 |
$371.25 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$564.75 |
$564.75 |
$564.75 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$10,461.00 |
$10,461.00 |
$10,461.00 |
$5,741.00
|
|
Dialysis repeated eval
|
$4,188.75 |
$4,188.75 |
$4,188.75 |
$1,332.80
|
|
Dialysis training incompl
|
$2,907.00 |
$2,907.00 |
$2,907.00 |
$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
|
$529.50 |
$529.50 |
$529.50 |
$336.80
|
|
Digital analysis of eeg
|
$830.25 |
$830.25 |
$830.25 |
$593.40
|
|
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
|
$138.75 |
$138.75 |
$138.75 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$297.86 |
$297.86 |
$297.86 |
$297.86
|
|
Dilate esophagus 1/mult pass
|
$1,617.00 |
$1,617.00 |
$1,617.00 |
$1,548.00
|
|
Dilate urethra stricture
|
$407.25 |
$407.25 |
$407.25 |
$513.00
|
|
Dilation/female urethra/initial 53660
|
$387.75 |
$387.75 |
$387.75 |
$235.61
|
|
Dilation of cervical canal 57800
|
$5,438.25 |
$5,438.25 |
$5,438.25 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$1,375.50 |
$1,375.50 |
$1,375.50 |
$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
|
$534.00 |
$534.00 |
$534.00 |
$293.76
|
|
Disaccharidases
|
$1,266.75 |
$1,266.75 |
$1,266.75 |
$230.40
|
|
Discography cerv/thor spine
|
$2,840.25 |
$2,840.25 |
$2,840.25 |
$2,565.00
|
|
Dlyd plmt xtn prosth ea addl
|
$6,681.75 |
$6,681.75 |
$6,681.75 |
$1,810.80
|
|
Dmd dup/delet analysis
|
$2,106.00 |
$2,106.00 |
$2,106.00 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$522.75 |
$522.75 |
$522.75 |
$313.60
|
|
Dna antibody native/double stranded
|
$131.25 |
$131.25 |
$131.25 |
$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
|
|
Doppler echo complete
|
$714.75 |
$714.75 |
$714.75 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$3,066.75 |
$3,066.75 |
$3,066.75 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,047.75 |
$1,047.75 |
$1,047.75 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$864.75 |
$864.75 |
$864.75 |
$481.65
|
|
Dornase alfa non-comp unit
|
$479.80 |
$479.80 |
$479.80 |
$356.00
|
|
Dornhoffer fixed part w/window
|
$77,636.25 |
$77,636.25 |
$77,636.25 |
$34,278.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$901.65 |
$901.65 |
$901.65 |
$450.14
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$89.34 |
$89.34 |
$89.34 |
$89.34
|
|
Dpyd gene common variants
|
$354.00 |
$354.00 |
$354.00 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$800.00
|
