|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$79.20 |
$79.20 |
$79.20 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$79.20 |
$79.20 |
$79.20 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$63.00 |
$63.00 |
$63.00 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$79.20 |
$79.20 |
$79.20 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$247.80 |
$247.80 |
$247.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$94.80 |
$94.80 |
$94.80 |
$79.20
|
|
Diag laparo separate proc 49320
|
$30,760.02 |
$30,760.02 |
$30,760.02 |
$6,904.15
|
|
Diagnostic anoscopy spx 46600
|
$339.60 |
$339.60 |
$339.60 |
$190.68
|
|
Diagnostic laryngoscopy 31505
|
$282.60 |
$282.60 |
$282.60 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$550.80 |
$550.80 |
$550.80 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$313.20 |
$313.20 |
$313.20 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$660.60 |
$660.60 |
$660.60 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$223.80 |
$223.80 |
$223.80 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$16,479.60 |
$16,479.60 |
$16,479.60 |
$5,419.00
|
|
Dialysis one evaluation
|
$1,200.60 |
$1,200.60 |
$1,200.60 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$861.12 |
$861.12 |
$861.12 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$153.00 |
$153.00 |
$153.00 |
$74.76
|
|
Dicyclomine injection
|
$354.54 |
$354.54 |
$354.54 |
$153.29
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$25.02 |
$25.02 |
$25.02 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$79,981.92 |
$79,981.92 |
$79,981.92 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$273.60 |
$273.60 |
$273.60 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$762.30 |
$762.30 |
$762.30 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$4,758.60 |
$4,758.60 |
$4,758.60 |
$1,866.73
|
|
Dilate esophagus
|
$11,570.97 |
$11,570.97 |
$11,570.97 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$14,947.23 |
$14,947.23 |
$14,947.23 |
$1,484.17
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$458.40 |
$458.40 |
$458.40 |
$3,033.08
|
|
Dilate ic vasospasm ea add vsl same territory
|
$162.00 |
$162.00 |
$162.00 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$458.40 |
$458.40 |
$458.40 |
$5,250.40
|
|
Dilate urethra stricture
|
$471.60 |
$471.60 |
$471.60 |
$490.00
|
|
Dilation/urethral strict/male/ini 53620
|
$1,227.00 |
$1,227.00 |
$1,227.00 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$958.46 |
$958.46 |
$958.46 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$62,630.89 |
$62,630.89 |
$62,630.89 |
$4,061.71
|
|
Dilat xst trc new access rcs
|
$5,704.80 |
$5,704.80 |
$5,704.80 |
$4,213.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$207.48 |
$207.48 |
$207.48 |
$47.94
|
|
Dimethyl sulfoxide 50% 50 ml
|
$13,266.90 |
$13,266.90 |
$13,266.90 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$10.98 |
$10.98 |
$10.98 |
$17.75
|
|
Dipyridamole injection
|
$399.18 |
$399.18 |
$399.18 |
$47.87
|
|
Disaccharidases
|
$206.40 |
$206.40 |
$206.40 |
$216.00
|
|
Discography cerv/thor spine
|
$4,005.60 |
$4,005.60 |
$4,005.60 |
$2,565.00
|
|
Dlyd plmt xtn prosth ea addl
|
$2,533.80 |
$2,533.80 |
$2,533.80 |
$1,582.68
|
|
Dmd dup/delet analysis
|
$496.20 |
$496.20 |
$496.20 |
$404.03
|
|
Dmpk gene detc abnor allele
|
$859.80 |
$859.80 |
$859.80 |
$313.60
|
|
Dna antibody native/double stranded
|
$223.20 |
$223.20 |
$223.20 |
$97.50
|
|
Dna gardnerella
|
$57.00 |
$57.00 |
$57.00 |
$62.50
|
|
Dna probe chlamydia
|
$287.40 |
$287.40 |
$287.40 |
$79.38
|
|
Dna trichomonas
|
$124.20 |
$124.20 |
$124.20 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$527.22 |
$527.22 |
$527.22 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2,556.00 |
$2,556.00 |
$2,556.00 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$259.08 |
$259.08 |
$259.08 |
$65.40
|
|
Doppler intravascular pressure flow initial vessel
|
$11,205.00 |
$11,205.00 |
$11,205.00 |
$2,777.60
|
|
Dornase alfa non-comp unit
|
$2,431.98 |
$2,431.98 |
$2,431.98 |
$446.75
|
|
Dornhoffer fixed part w/window
|
$77,758.31 |
$77,758.31 |
$77,758.31 |
$34,278.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$102,497.94 |
$102,497.94 |
$102,497.94 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$1,192.80 |
$1,192.80 |
$1,192.80 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$3,834.00 |
$3,834.00 |
$3,834.00 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$478.68 |
$478.68 |
$478.68 |
$84.80
|
|
Dpyd gene common variants
|
$201.60 |
$201.60 |
$201.60 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$936.00 |
$936.00 |
$936.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$568.80 |
$568.80 |
$568.80 |
$914.34
|
|
Drainage external ear complex 69005
|
$2,694.60 |
$2,694.60 |
$2,694.60 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$16,416.60 |
$16,416.60 |
$16,416.60 |
$789.60
|
|
Drainage mouth roof lesion
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$390.39
|
|
Drainage of arm bursa 23931
|
$2,509.20 |
$2,509.20 |
$2,509.20 |
$2,197.48
|
|
Drainage of bladder abscess
|
$1,962.60 |
$1,962.60 |
$1,962.60 |
$3,127.88
|
|
Drainage of kidney lesion
|
$2,655.00 |
$2,655.00 |
$2,655.00 |
$1,506.00
|
|
Drainage of mouth lesion
|
$4,940.40 |
$4,940.40 |
$4,940.40 |
$3,900.60
|
|
Drainage of mouth lesion
|
$802.20 |
$802.20 |
$802.20 |
$962.40
|
|
Drainage of nose lesion sept 30020
|
$843.00 |
$843.00 |
$843.00 |
$781.44
|
|
Drainage of pelvis lesion 26990
|
$5,521.80 |
$5,521.80 |
$5,521.80 |
$3,958.50
|
|
Drainage of rectal abscess
|
$1,985.40 |
$1,985.40 |
$1,985.40 |
$2,111.46
|
|
Drainage of rectal abscess 45020
|
$3,220.80 |
$3,220.80 |
$3,220.80 |
$3,769.20
|
|
Drain bladder by trocar/cath
|
$1,371.00 |
$1,371.00 |
$1,371.00 |
$1,203.94
|
|
Drain blood from under nail 11740
|
$436.80 |
$436.80 |
$436.80 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$6,905.40 |
$6,905.40 |
$6,905.40 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$4,115.40 |
$4,115.40 |
$4,115.40 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$29,106.40 |
$29,106.40 |
$29,106.40 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$5,734.20 |
$5,734.20 |
$5,734.20 |
$419.00
|
|
Drain lower leg lesion 27603
|
$19,559.82 |
$19,559.82 |
$19,559.82 |
$3,858.40
|
|
Drain ovarn cyst abd
|
$4,909.80 |
$4,909.80 |
$4,909.80 |
$3,964.27
|
|
Drain ovary abscess open
|
$4,909.80 |
$4,909.80 |
$4,909.80 |
$3,762.53
|
|
Drain pancreatic pseudocyst 48510
|
$4,366.80 |
$4,366.80 |
$4,366.80 |
$2,690.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$856.80 |
$856.80 |
$856.80 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$816.60 |
$816.60 |
$816.60 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,045.80 |
$1,045.80 |
$1,045.80 |
$523.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$37,464.01 |
$37,464.01 |
$37,464.01 |
$8,131.20
|
|
Drill hole implt ventricular cath/device 61107
|
$7,349.40 |
$7,349.40 |
$7,349.40 |
$1,515.00
|
|
Drng appendix abscess open 44900
|
$3,259.20 |
$3,259.20 |
$3,259.20 |
$1,453.80
|
|
Drng hand tendon sheath 26020
|
$12,348.78 |
$12,348.78 |
$12,348.78 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$785.40 |
$785.40 |
$785.40 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$3,428.40 |
$3,428.40 |
$3,428.40 |
$1,943.50
|
|
Drng of mouth lesion 40801
|
$843.00 |
$843.00 |
$843.00 |
$1,262.76
|
|
Drng of ovarian cyst(s) 58800
|
$4,909.80 |
$4,909.80 |
$4,909.80 |
$3,474.84
|
|
Drng of pelvic abscess transrectal 45000
|
$2,523.60 |
$2,523.60 |
$2,523.60 |
$2,111.46
|
|
Drng of scrotum abscess 55100
|
$1,287.60 |
$1,287.60 |
$1,287.60 |
$1,917.33
|
|
Drng open retroperitoneal abscess 49060
|
$5,003.40 |
$5,003.40 |
$5,003.40 |
$1,924.00
|
|
Drng open subdiaphragmatic/subphrenic absc 49040
|
$4,066.20 |
$4,066.20 |
$4,066.20 |
$1,800.00
|
|
Drng ovary abscess perqt 58822
|
$2,989.80 |
$2,989.80 |
$2,989.80 |
$2,161.64
|
|
Drng peritoneal abscess open 49020
|
$6,527.40 |
$6,527.40 |
$6,527.40 |
$2,520.00
|
|
Dronabinol 2.5mg oral
|
$30.60 |
$30.60 |
$30.60 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$22.02 |
$22.02 |
$22.02 |
$31.07
|