|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$411.00 |
$411.00 |
$411.00 |
$3,296.80
|
|
Destruction mal lsn t/a/l >4cm
|
$280.80 |
$280.80 |
$280.80 |
$569.80
|
|
Destruction premal lesions 15/> 17004
|
$175.20 |
$175.20 |
$175.20 |
$442.61
|
|
Detect agnt mult dna direc
|
$186.00 |
$186.00 |
$186.00 |
$166.77
|
|
Device intraute mirena
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$104.40 |
$104.40 |
$104.40 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$3.60 |
$3.60 |
$3.60 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$12.00 |
$12.00 |
$12.00 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,192.20 |
$1,192.20 |
$1,192.20 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$6.60 |
$6.60 |
$6.60 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$6.60 |
$6.60 |
$6.60 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$29.40 |
$29.40 |
$29.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$6.00 |
$6.00 |
$6.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$156.00 |
$156.00 |
$156.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$75.00 |
$75.00 |
$75.00 |
$79.30
|
|
Diab manage trn ind/group
|
$135.60 |
$135.60 |
$135.60 |
$54.99
|
|
Diag laparo separate proc 49320
|
$625.80 |
$625.80 |
$625.80 |
$7,104.72
|
|
Diagnostic anoscopy spx 46600
|
$264.00 |
$264.00 |
$264.00 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$847.20 |
$847.20 |
$847.20 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$691.80 |
$691.80 |
$691.80 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$259.20 |
$259.20 |
$259.20 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$105.60 |
$105.60 |
$105.60 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$458.40 |
$458.40 |
$458.40 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$360.00 |
$360.00 |
$360.00 |
$314.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$11.40 |
$11.40 |
$11.40 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$34.80 |
$34.80 |
$34.80 |
$79.71
|
|
Dicyclomine injection
|
$105.00 |
$105.00 |
$105.00 |
$154.33
|
|
Diffusing capacity
|
$136.20 |
$136.20 |
$136.20 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.20 |
$7.20 |
$7.20 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,537.20 |
$4,537.20 |
$4,537.20 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$91.80 |
$91.80 |
$91.80 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,475.40 |
$1,475.40 |
$1,475.40 |
$297.86
|
|
Dilation of anal sphincter
|
$298.20 |
$298.20 |
$298.20 |
$2,166.04
|
|
Dilation salivary duct 42650
|
$80.40 |
$80.40 |
$80.40 |
$2,675.71
|
|
Dilation/urethral strict/male/ini 53620
|
$583.20 |
$583.20 |
$583.20 |
$1,372.80
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$13.80 |
$13.80 |
$13.80 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$40.80 |
$40.80 |
$40.80 |
$98.15
|
|
Disability dlco
|
$90.00 |
$90.00 |
$90.00 |
$293.76
|
|
Dis site tele svcs rhc/fqhc
|
$71.40 |
$71.40 |
$71.40 |
$96.75
|
|
Dna antibody native/double stranded
|
$99.00 |
$99.00 |
$99.00 |
$100.00
|
|
Dna probe chlamydia
|
$180.60 |
$180.60 |
$180.60 |
$82.20
|
|
Dna probe gc
|
$180.60 |
$180.60 |
$180.60 |
$79.38
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$20.40 |
$20.40 |
$20.40 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$45.60 |
$45.60 |
$45.60 |
$949.39
|
|
Dolasetron mesylate
|
$30.60 |
$30.60 |
$30.60 |
$44.65
|
|
Domicil/r-home visit est pat
|
$77.40 |
$77.40 |
$77.40 |
$117.00
|
|
Domicil/r-home visit est pat
|
$107.40 |
$107.40 |
$107.40 |
$183.60
|
|
Domicil/r-home visit est pat
|
$151.20 |
$151.20 |
$151.20 |
$259.80
|
|
Domicil/r-home visit est pat
|
$220.20 |
$220.20 |
$220.20 |
$372.60
|
|
Domicil/r-home visit new pat
|
$94.80 |
$94.80 |
$94.80 |
$110.40
|
|
Domicil/r-home visit new pat
|
$128.40 |
$128.40 |
$128.40 |
$159.00
|
|
Domicil/r-home visit new pat
|
$174.60 |
$174.60 |
$174.60 |
$271.80
|
|
Domicil/r-home visit new pat
|
$222.00 |
$222.00 |
$222.00 |
$360.60
|
|
Domicil/r-home visit new pat
|
$268.20 |
$268.20 |
$268.20 |
$418.80
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$17.40 |
$17.40 |
$17.40 |
$65.40
|
|
Doppler echo complete
|
$135.60 |
$135.60 |
$135.60 |
$558.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$276.00 |
$276.00 |
$276.00 |
$481.65
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$104.40 |
$104.40 |
$104.40 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$6,031.80 |
$6,031.80 |
$6,031.80 |
$1,718.24
|
|
Drainage ext aud canal abscess 69020
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$964.00
|
|
Drainage external ear complex 69005
|
$287.40 |
$287.40 |
$287.40 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$588.00 |
$588.00 |
$588.00 |
$790.40
|
|
Drainage lymph node lesion 38300
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$3,088.80
|
|
Drainage lymph node lesion 38305
|
$816.60 |
$816.60 |
$816.60 |
$3,170.64
|
|
Drainage mouth roof lesion
|
$154.80 |
$154.80 |
$154.80 |
$405.60
|
|
Drainage of kidney lesion
|
$148.80 |
$148.80 |
$148.80 |
$1,506.00
|
|
Drainage of mouth lesion
|
$165.00 |
$165.00 |
$165.00 |
$535.20
|
|
Drainage of mouth lesion
|
$424.80 |
$424.80 |
$424.80 |
$1,008.80
|
|
Drainage of mouth lesion
|
$612.00 |
$612.00 |
$612.00 |
$6,781.90
|
|
Drainage of mouth lesion
|
$660.00 |
$660.00 |
$660.00 |
$3,459.00
|
|
Drainage of prostate abscess
|
$552.00 |
$552.00 |
$552.00 |
$3,863.60
|
|
Drainage of throat abscess
|
$2,662.20 |
$2,662.20 |
$2,662.20 |
$6,499.33
|
|
Drain bladder by trocar/cath
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,203.94
|
|
Drain blood from under nail 11740
|
$220.20 |
$220.20 |
$220.20 |
$182.40
|
|
Drain cerebro spinal fluid 62272
|
$123.00 |
$123.00 |
$123.00 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$823.20 |
$823.20 |
$823.20 |
$428.40
|
|
Drain lower leg lesion 27603
|
$670.80 |
$670.80 |
$670.80 |
$3,994.09
|
|
Drain ovarn cyst abd
|
$733.20 |
$733.20 |
$733.20 |
$3,786.00
|
|
Drain shoulder lesion
|
$509.40 |
$509.40 |
$509.40 |
$3,904.61
|
|
Drain thyroid/tongue cyst
|
$280.80 |
$280.80 |
$280.80 |
$1,752.89
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$483.00 |
$483.00 |
$483.00 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$266.40 |
$266.40 |
$266.40 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$541.00
|
|
Dressing change not for burn w/anes 15852
|
$208.80 |
$208.80 |
$208.80 |
$755.08
|
|
Drng hand tendon sheath 26020
|
$790.80 |
$790.80 |
$790.80 |
$3,839.54
|
|
Drng of finger abscess comp 26011
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$2,079.50
|
|
Drng of salivary cyst 42409
|
$418.80 |
$418.80 |
$418.80 |
$3,819.23
|
|
Drng of scrotum abscess 55100
|
$1,029.00 |
$1,029.00 |
$1,029.00 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$6.60 |
$6.60 |
$6.60 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$180.60 |
$180.60 |
$180.60 |
$1,818.32
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$165.60 |
$165.60 |
$165.60 |
$53.60
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$3,286.80 |
$3,286.80 |
$3,286.80 |
$7,465.97
|
|
Drug test def 1-7 classes
|
$502.80 |
$502.80 |
$502.80 |
$263.25
|
|
Drug test def 22+ classes
|
$835.20 |
$835.20 |
$835.20 |
$426.24
|
|
Drug test prsmv instrmnt
|
$100.80 |
$100.80 |
$100.80 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$265.80 |
$265.80 |
$265.80 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$219.60 |
$219.60 |
$219.60 |
$2,980.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$509.40 |
$509.40 |
$509.40 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$10,483.80 |
$10,483.80 |
$10,483.80 |
$8,445.90
|
|
Ear canal biopsy 69105
|
$94.80 |
$94.80 |
$94.80 |
$1,889.50
|
