|
Diabetes (HbA1c) Test
|
$86.40 |
$86.40 |
$86.40 |
$79.30
|
|
Diagnostic anoscopy spx 46600
|
$42.00 |
$42.00 |
$42.00 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$385.20 |
$385.20 |
$385.20 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$583.20 |
$583.20 |
$583.20 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$475.80 |
$475.80 |
$475.80 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$255.00 |
$255.00 |
$255.00 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$5,382.00 |
$5,382.00 |
$5,382.00 |
$5,741.00
|
|
Dialysis one evaluation
|
$750.00 |
$750.00 |
$750.00 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.60 |
$0.60 |
$0.60 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$26.80 |
$26.80 |
$26.80 |
$79.71
|
|
Dicyclomine injection
|
$195.20 |
$195.20 |
$195.20 |
$154.33
|
|
Diffusing capacity
|
$339.60 |
$339.60 |
$339.60 |
$336.80
|
|
Digital analysis of eeg
|
$555.60 |
$555.60 |
$555.60 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$28.80 |
$28.80 |
$28.80 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,093.60 |
$6,093.60 |
$6,093.60 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$126.00 |
$126.00 |
$126.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$276.00 |
$276.00 |
$276.00 |
$297.86
|
|
Dilation of rectal stricture 45910
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$2,491.80
|
|
Dilator fascial 10fx20cm
|
$918.60 |
$918.60 |
$918.60 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$1,995.60 |
$1,995.60 |
$1,995.60 |
$3,900.60
|
|
Dimenhydrinate injection
|
$12.40 |
$12.40 |
$12.40 |
$30.48
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$9.60 |
$9.60 |
$9.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.80 |
$1.80 |
$1.80 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$24.60 |
$24.60 |
$24.60 |
$98.15
|
|
Disability dlco
|
$217.20 |
$217.20 |
$217.20 |
$293.76
|
|
Disaccharidases
|
$267.60 |
$267.60 |
$267.60 |
$230.40
|
|
Dlyd plmt xtn prosth ea addl
|
$874.20 |
$874.20 |
$874.20 |
$1,810.80
|
|
Dna antibody native/double stranded
|
$105.60 |
$105.60 |
$105.60 |
$100.00
|
|
Dna gardnerella
|
$255.60 |
$255.60 |
$255.60 |
$61.83
|
|
Dna trichomonas
|
$266.40 |
$266.40 |
$266.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$59.40 |
$59.40 |
$59.40 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$6,028.20 |
$6,028.20 |
$6,028.20 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$43.80 |
$43.80 |
$43.80 |
$65.40
|
|
Doppler echo complete
|
$629.40 |
$629.40 |
$629.40 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$904.20 |
$904.20 |
$904.20 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$457.20 |
$457.20 |
$457.20 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$325.80 |
$325.80 |
$325.80 |
$481.65
|
|
Dornase alfa non-comp unit
|
$170.40 |
$170.40 |
$170.40 |
$356.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$544.20 |
$544.20 |
$544.20 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$319.80 |
$319.80 |
$319.80 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,720.20 |
$1,720.20 |
$1,720.20 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.40 |
$0.40 |
$0.40 |
$89.34
|
|
Dpyd gene common variants
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$595.20 |
$595.20 |
$595.20 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$3,558.00 |
$3,558.00 |
$3,558.00 |
$964.00
|
|
Drainage external ear complex 69005
|
$2,578.80 |
$2,578.80 |
$2,578.80 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$909.00 |
$909.00 |
$909.00 |
$790.40
|
|
Drainage of kidney lesion
|
$1,225.20 |
$1,225.20 |
$1,225.20 |
$1,506.00
|
|
Drainage of nose lesion int 30000
|
$3,421.20 |
$3,421.20 |
$3,421.20 |
$548.00
|
|
Drainage of rectal abscess
|
$4,599.00 |
$4,599.00 |
$4,599.00 |
$2,135.10
|
|
Drain blood from under nail 11740
|
$319.20 |
$319.20 |
$319.20 |
$182.40
|
|
Drain cath image guided visceral pq
|
$3,876.60 |
$3,876.60 |
$3,876.60 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,192.20 |
$1,192.20 |
$1,192.20 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$366.00 |
$366.00 |
$366.00 |
$428.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$411.00 |
$411.00 |
$411.00 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$408.60 |
$408.60 |
$408.60 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$3,558.00 |
$3,558.00 |
$3,558.00 |
$541.00
|
|
Drill hole implt ventricular cath/device 61107
|
$3,817.20 |
$3,817.20 |
$3,817.20 |
$1,485.75
|
|
Drng of eyelid abscess 67700
|
$7,993.20 |
$7,993.20 |
$7,993.20 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$3,515.40 |
$3,515.40 |
$3,515.40 |
$2,079.50
|
|
Drng of scrotum abscess 55100
|
$1,258.80 |
$1,258.80 |
$1,258.80 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$22.60 |
$22.60 |
$22.60 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$2,401.80 |
$2,401.80 |
$2,401.80 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$14,389.80 |
$14,389.80 |
$14,389.80 |
$7,465.97
|
|
Drug assay rufinamide
|
$516.00 |
$516.00 |
$516.00 |
$87.10
|
|
Drug assay vedolizumab
|
$106.20 |
$106.20 |
$106.20 |
$154.00
|
|
Drug asy hydroxychloroquine
|
$39.00 |
$39.00 |
$39.00 |
$66.43
|
|
Drug of abuse screen urine
|
$53.40 |
$53.40 |
$53.40 |
$67.89
|
|
Drug screen quant tiagabine
|
$148.80 |
$148.80 |
$148.80 |
$107.59
|
|
Drug test def 1-7 classes
|
$399.60 |
$399.60 |
$399.60 |
$263.25
|
|
Drug test def 8-14 classes
|
$399.60 |
$399.60 |
$399.60 |
$289.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$399.60 |
$399.60 |
$399.60 |
$278.85
|
|
Drvvt confirm - quest
|
$169.20 |
$169.20 |
$169.20 |
$109.20
|
|
Duplex scan unilateral study 93986
|
$493.80 |
$493.80 |
$493.80 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$1,017.60 |
$1,017.60 |
$1,017.60 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$703.80 |
$703.80 |
$703.80 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$887.40 |
$887.40 |
$887.40 |
$904.78
|
|
Duragen 1x1 5ea/bx
|
$411.00 |
$411.00 |
$411.00 |
$10,564.87
|
|
Durvalumab 50 mg/ml intravenous solution
|
$7,687.20 |
$7,687.20 |
$7,687.20 |
$8,445.90
|
|
Dx bronchoscope/brush 31623
|
$983.40 |
$983.40 |
$983.40 |
$2,120.32
|
|
Dx bronchoscope/lavage 31624
|
$1,773.00 |
$1,773.00 |
$1,773.00 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$2,520.60 |
$2,520.60 |
$2,520.60 |
$2,410.50
|
|
Ear irrigation 69209
|
$120.00 |
$120.00 |
$120.00 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$42.60 |
$42.60 |
$42.60 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$2,844.00 |
$2,844.00 |
$2,844.00 |
$412.88
|
|
Ecg external < 48 hours recording
|
$214.20 |
$214.20 |
$214.20 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$368.40 |
$368.40 |
$368.40 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$75.60 |
$75.60 |
$75.60 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$74.40 |
$74.40 |
$74.40 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,464.00 |
$1,464.00 |
$1,464.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$387.00 |
$387.00 |
$387.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$544.20 |
$544.20 |
$544.20 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,483.80 |
$1,483.80 |
$1,483.80 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$387.00 |
$387.00 |
$387.00 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$307.80 |
$307.80 |
$307.80 |
$371.25
|
|
Echo exam of fetal heart
|
$833.40 |
$833.40 |
$833.40 |
$904.80
|
|
Echo exam of fetal heart
|
$804.60 |
$804.60 |
$804.60 |
$431.41
|
|
Echo exam uterus 76831-
|
$476.40 |
$476.40 |
$476.40 |
$561.00
|
|
Echograp trans r pros study
|
$463.80 |
$463.80 |
$463.80 |
$468.00
|
|
Echo guide for artery repair
|
$775.80 |
$775.80 |
$775.80 |
$696.30
|
