|
Device intraute mirena
|
$2,918.95 |
$2,918.95 |
$2,918.95 |
$2,125.00
|
|
Dev interrog remote 1/2/mlt
|
$55.20 |
$55.20 |
$55.20 |
$115.20
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$543.36 |
$543.36 |
$543.36 |
$200.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$70.21 |
$70.21 |
$70.21 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$244.80 |
$244.80 |
$244.80 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$63.26 |
$63.26 |
$63.26 |
$21.17
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$19.01 |
$19.01 |
$19.01 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$12.38 |
$12.38 |
$12.38 |
$45.40
|
|
Dhea-s (dehydroepiand sulfate)
|
$88.02 |
$88.02 |
$88.02 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$38.67 |
$38.67 |
$38.67 |
$79.20
|
|
Diab manage trn ind/group
|
$29.51 |
$29.51 |
$29.51 |
$56.55
|
|
Diag laparo separate proc 49320
|
$505.92 |
$505.92 |
$505.92 |
$6,904.15
|
|
Diagnostic anoscopy spx 46600
|
$307.68 |
$307.68 |
$307.68 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$71.52 |
$71.52 |
$71.52 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$58.08 |
$58.08 |
$58.08 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$321.12 |
$321.12 |
$321.12 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$197.76 |
$197.76 |
$197.76 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$322.56 |
$322.56 |
$322.56 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$78.86 |
$78.86 |
$78.86 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$349.92 |
$349.92 |
$349.92 |
$214.08
|
|
Diatrizoate meglumine 18 % urethral solution
|
$81.60 |
$81.60 |
$81.60 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$106.55 |
$106.55 |
$106.55 |
$74.76
|
|
Diffusing capacity
|
$203.52 |
$203.52 |
$203.52 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$18.19 |
$18.19 |
$18.19 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$10,608.86 |
$10,608.86 |
$10,608.86 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$54.44 |
$54.44 |
$54.44 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$338.02 |
$338.02 |
$338.02 |
$297.86
|
|
Dilate urethra stricture
|
$135.36 |
$135.36 |
$135.36 |
$490.00
|
|
Dilate urethra stricture
|
$96.48 |
$96.48 |
$96.48 |
$3,863.60
|
|
Dilate urethra stricture
|
$249.12 |
$249.12 |
$249.12 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$116.64 |
$116.64 |
$116.64 |
$235.61
|
|
Dilation of anal sphincter
|
$2,019.84 |
$2,019.84 |
$2,019.84 |
$1,969.12
|
|
Dilation of cervical canal 57800
|
$120.00 |
$120.00 |
$120.00 |
$4,376.00
|
|
Dilation of urethra
|
$114.72 |
$114.72 |
$114.72 |
$172.00
|
|
Dilation of vagina
|
$199.20 |
$199.20 |
$199.20 |
$3,786.00
|
|
Dilation salivary duct 42650
|
$114.72 |
$114.72 |
$114.72 |
$2,498.32
|
|
Dilation/urethral strict/male/ini 53620
|
$259.68 |
$259.68 |
$259.68 |
$1,372.80
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$2.00 |
$2.00 |
$2.00 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$73.39 |
$73.39 |
$73.39 |
$17.75
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$26.88 |
$26.88 |
$26.88 |
$91.53
|
|
Disability dlco
|
$344.64 |
$344.64 |
$344.64 |
$282.40
|
|
Disaccharidases
|
$212.17 |
$212.17 |
$212.17 |
$216.00
|
|
Dis site tele svcs rhc/fqhc
|
$124.32 |
$124.32 |
$124.32 |
$94.80
|
|
Diverticulectomy/hypophar/esoph 43130
|
$1,216.80 |
$1,216.80 |
$1,216.80 |
$6,465.11
|
|
Division of fallopian tube 58605
|
$519.84 |
$519.84 |
$519.84 |
$832.00
|
|
Dna antibody native/double stranded
|
$68.69 |
$68.69 |
$68.69 |
$97.50
|
|
Dna gardnerella
|
$39.41 |
$39.41 |
$39.41 |
$62.50
|
|
Dna trichomonas
|
$39.41 |
$39.41 |
$39.41 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$105.60 |
$105.60 |
$105.60 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4,468.49 |
$4,468.49 |
$4,468.49 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$47.40 |
$47.40 |
$47.40 |
$65.40
|
|
Doppler echo complete
|
$353.76 |
$353.76 |
$353.76 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$199.20 |
$199.20 |
$199.20 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$125.76 |
$125.76 |
$125.76 |
$471.17
|
|
Dornase alfa non-comp unit
|
$324.90 |
$324.90 |
$324.90 |
$446.75
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$115.20 |
$115.20 |
$115.20 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$3,281.28 |
$3,281.28 |
$3,281.28 |
$1,718.24
|
|
Dpyd gene common variants
|
$344.16 |
$344.16 |
$344.16 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,317.60 |
$1,317.60 |
$1,317.60 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$357.12 |
$357.12 |
$357.12 |
$914.34
|
|
Drainage external ear complex 69005
|
$337.44 |
$337.44 |
$337.44 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$1,184.64 |
$1,184.64 |
$1,184.64 |
$789.60
|
|
Drainage of arm bursa 23931
|
$2,811.36 |
$2,811.36 |
$2,811.36 |
$2,197.48
|
|
Drainage of forearm bursa
|
$577.92 |
$577.92 |
$577.92 |
$2,054.00
|
|
Drainage of kidney lesion
|
$1,198.56 |
$1,198.56 |
$1,198.56 |
$1,506.00
|
|
Drainage of mouth lesion
|
$348.96 |
$348.96 |
$348.96 |
$489.00
|
|
Drainage of mouth lesion
|
$601.44 |
$601.44 |
$601.44 |
$3,900.60
|
|
Drainage of mouth lesion
|
$710.88 |
$710.88 |
$710.88 |
$3,544.29
|
|
Drainage of nose lesion int 30000
|
$406.56 |
$406.56 |
$406.56 |
$491.40
|
|
Drainage of nose lesion sept 30020
|
$995.52 |
$995.52 |
$995.52 |
$781.44
|
|
Drainage of pelvis lesion 26990
|
$5,361.60 |
$5,361.60 |
$5,361.60 |
$3,958.50
|
|
Drainage of prostate abscess
|
$691.20 |
$691.20 |
$691.20 |
$3,863.60
|
|
Drainage of rectal abscess 45020
|
$871.68 |
$871.68 |
$871.68 |
$3,769.20
|
|
Drain blood from under nail 11740
|
$214.71 |
$214.71 |
$214.71 |
$170.50
|
|
Drain cath image guided visceral pq
|
$1,019.04 |
$1,019.04 |
$1,019.04 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$459.36 |
$459.36 |
$459.36 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$527.52 |
$527.52 |
$527.52 |
$419.00
|
|
Drain lower leg bursa
|
$690.72 |
$690.72 |
$690.72 |
$3,958.50
|
|
Drain lower leg lesion 27603
|
$806.40 |
$806.40 |
$806.40 |
$3,858.40
|
|
Drain neck/chest lesion 21501
|
$751.68 |
$751.68 |
$751.68 |
$3,339.00
|
|
Drain ovarn cyst abd
|
$660.48 |
$660.48 |
$660.48 |
$3,964.27
|
|
Drain penis lesion
|
$464.16 |
$464.16 |
$464.16 |
$2,112.60
|
|
Drain shoulder lesion
|
$674.88 |
$674.88 |
$674.88 |
$3,904.61
|
|
Drain thigh/knee lesion 27301
|
$4,751.52 |
$4,751.52 |
$4,751.52 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$345.60 |
$345.60 |
$345.60 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$345.60 |
$345.60 |
$345.60 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$642.24 |
$642.24 |
$642.24 |
$523.00
|
|
Dressing change not for burn w/anes 15852
|
$67.68 |
$67.68 |
$67.68 |
$755.08
|
|
Drm agrft f/s/n/h/f/g/m ea
|
$2,925.12 |
$2,925.12 |
$2,925.12 |
$3,808.00
|
|
Drm agrft t/a/l ea addl
|
$1,594.08 |
$1,594.08 |
$1,594.08 |
$1,793.59
|
|
Drng hand tendon sheath 26020
|
$865.92 |
$865.92 |
$865.92 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$431.52 |
$431.52 |
$431.52 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$729.12 |
$729.12 |
$729.12 |
$1,943.50
|
|
Drng of hydrocele 55000
|
$184.32 |
$184.32 |
$184.32 |
$832.60
|
|
Drng of mouth lesion 40801
|
$446.40 |
$446.40 |
$446.40 |
$1,262.76
|
|
Drng of palm multi bursas 26030
|
$765.60 |
$765.60 |
$765.60 |
$3,839.54
|
|
Drng of scrotum abscess 55100
|
$2,755.20 |
$2,755.20 |
$2,755.20 |
$1,917.33
|
|
Drng open retroperitoneal abscess 49060
|
$1,669.44 |
$1,669.44 |
$1,669.44 |
$1,924.00
|
|
Drng peritoneal abscess open 49020
|
$2,431.68 |
$2,431.68 |
$2,431.68 |
$2,520.00
|
|
Drng salivary gland submax/subling 42310
|
$262.08 |
$262.08 |
$262.08 |
$741.60
|