|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$24.60 |
$24.60 |
$24.60 |
$98.15
|
|
Disability dlco
|
$173.40 |
$173.40 |
$173.40 |
$293.76
|
|
Disaccharidases
|
$304.80 |
$304.80 |
$304.80 |
$230.40
|
|
Dlyd plmt xtn prosth ea addl
|
$1,597.80 |
$1,597.80 |
$1,597.80 |
$1,810.80
|
|
Dna antibody native/double stranded
|
$192.00 |
$192.00 |
$192.00 |
$100.00
|
|
Dna gardnerella
|
$268.20 |
$268.20 |
$268.20 |
$61.83
|
|
Dna trichomonas
|
$278.40 |
$278.40 |
$278.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$337.20 |
$337.20 |
$337.20 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$5,133.60 |
$5,133.60 |
$5,133.60 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$81.60 |
$81.60 |
$81.60 |
$65.40
|
|
Doppler echo complete
|
$495.00 |
$495.00 |
$495.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$537.00 |
$537.00 |
$537.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$291.00 |
$291.00 |
$291.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$201.60 |
$201.60 |
$201.60 |
$481.65
|
|
Dornase alfa non-comp unit
|
$197.60 |
$197.60 |
$197.60 |
$356.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$574.20 |
$574.20 |
$574.20 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$554.40 |
$554.40 |
$554.40 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,819.20 |
$1,819.20 |
$1,819.20 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1.40 |
$1.40 |
$1.40 |
$89.34
|
|
Dpyd gene common variants
|
$1,535.40 |
$1,535.40 |
$1,535.40 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$541.20 |
$541.20 |
$541.20 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$2,312.40 |
$2,312.40 |
$2,312.40 |
$964.00
|
|
Drainage external ear simple 69000
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$790.40
|
|
Drainage mouth roof lesion
|
$4,356.00 |
$4,356.00 |
$4,356.00 |
$405.60
|
|
Drainage of arm bursa 23931
|
$4,234.20 |
$4,234.20 |
$4,234.20 |
$2,271.01
|
|
Drainage of kidney lesion
|
$2,310.60 |
$2,310.60 |
$2,310.60 |
$1,506.00
|
|
Drainage of mouth lesion
|
$3,332.40 |
$3,332.40 |
$3,332.40 |
$3,837.72
|
|
Drainage of mouth lesion
|
$3,332.40 |
$3,332.40 |
$3,332.40 |
$3,459.00
|
|
Drainage of nose lesion int 30000
|
$9,740.40 |
$9,740.40 |
$9,740.40 |
$548.00
|
|
Drainage of rectal abscess 45020
|
$4,045.80 |
$4,045.80 |
$4,045.80 |
$3,816.64
|
|
Drain blood from under nail 11740
|
$384.60 |
$384.60 |
$384.60 |
$182.40
|
|
Drain cath image guided visceral pq
|
$8,322.60 |
$8,322.60 |
$8,322.60 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$2,310.60 |
$2,310.60 |
$2,310.60 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$288.00 |
$288.00 |
$288.00 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$5,296.20 |
$5,296.20 |
$5,296.20 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$407.40 |
$407.40 |
$407.40 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$407.40 |
$407.40 |
$407.40 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$2,313.60 |
$2,313.60 |
$2,313.60 |
$541.00
|
|
Drng hand tendon sheath 26020
|
$4,104.60 |
$4,104.60 |
$4,104.60 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$5,268.60 |
$5,268.60 |
$5,268.60 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$2,149.20 |
$2,149.20 |
$2,149.20 |
$2,079.50
|
|
Drng of scrotum abscess 55100
|
$3,037.80 |
$3,037.80 |
$3,037.80 |
$1,997.89
|
|
Drng salivary gland submax/subling 42310
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$799.40
|
|
Droperidol 2.5 mg/ml injection solution
|
$22.80 |
$22.80 |
$22.80 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$2,423.40 |
$2,423.40 |
$2,423.40 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$33,291.60 |
$33,291.60 |
$33,291.60 |
$7,465.97
|
|
Drug assay rufinamide
|
$568.20 |
$568.20 |
$568.20 |
$87.10
|
|
Drug assay vedolizumab
|
$120.00 |
$120.00 |
$120.00 |
$154.00
|
|
Drug test def 1-7 classes
|
$475.80 |
$475.80 |
$475.80 |
$263.25
|
|
Drug test def 8-14 classes
|
$465.60 |
$465.60 |
$465.60 |
$289.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$151.80 |
$151.80 |
$151.80 |
$278.85
|
|
Drvvt confirm - quest
|
$154.80 |
$154.80 |
$154.80 |
$109.20
|
|
Duplex scan bilateral study 93985
|
$615.00 |
$615.00 |
$615.00 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$615.00 |
$615.00 |
$615.00 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$241.20 |
$241.20 |
$241.20 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$241.20 |
$241.20 |
$241.20 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,007.40 |
$1,007.40 |
$1,007.40 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$215.40 |
$215.40 |
$215.40 |
$8,445.90
|
|
Dx bronchoscope/lavage 31624
|
$4,190.40 |
$4,190.40 |
$4,190.40 |
$2,446.60
|
|
Dx bronchoscope/wash 31622
|
$3,196.20 |
$3,196.20 |
$3,196.20 |
$2,410.50
|
|
Ear irrigation 69209
|
$139.80 |
$139.80 |
$139.80 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$76.20 |
$76.20 |
$76.20 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$1,615.80 |
$1,615.80 |
$1,615.80 |
$412.88
|
|
Ecg external < 48 hours recording
|
$539.40 |
$539.40 |
$539.40 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$539.40 |
$539.40 |
$539.40 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$58.80 |
$58.80 |
$58.80 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$58.80 |
$58.80 |
$58.80 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,495.80 |
$1,495.80 |
$1,495.80 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$489.00 |
$489.00 |
$489.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$500.40 |
$500.40 |
$500.40 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,495.80 |
$1,495.80 |
$1,495.80 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$489.00 |
$489.00 |
$489.00 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$486.00 |
$486.00 |
$486.00 |
$371.25
|
|
Echo exam of fetal heart
|
$777.60 |
$777.60 |
$777.60 |
$904.80
|
|
Echo exam of fetal heart
|
$793.80 |
$793.80 |
$793.80 |
$431.41
|
|
Echograp trans r pros study
|
$507.60 |
$507.60 |
$507.60 |
$468.00
|
|
Echo guide for amniocentesis
|
$511.80 |
$511.80 |
$511.80 |
$455.57
|
|
Echo guide for artery repair
|
$939.00 |
$939.00 |
$939.00 |
$696.30
|
|
Echo stress
|
$696.00 |
$696.00 |
$696.00 |
$1,609.44
|
|
Echo tee guidance
|
$894.00 |
$894.00 |
$894.00 |
$1,878.84
|
|
Echo tee probe placement image acquisition interpretation & report
|
$888.00 |
$888.00 |
$888.00 |
$1,913.60
|
|
Echo transesophageal
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$1,650.00
|
|
Echo transesophageal intraop
|
$2,853.60 |
$2,853.60 |
$2,853.60 |
$1,578.00
|
|
Echo transthoracic
|
$766.80 |
$766.80 |
$766.80 |
$1,361.75
|
|
Echo transthoracic
|
$520.80 |
$520.80 |
$520.80 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$811.20 |
$811.20 |
$811.20 |
$1,033.00
|
|
Ecmo/ecls initiation artery 33947
|
$1,314.60 |
$1,314.60 |
$1,314.60 |
$3,950.10
|
|
Ecmo/ecls initiation venous 33946
|
$1,189.80 |
$1,189.80 |
$1,189.80 |
$4,084.29
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$1,660.80 |
$1,660.80 |
$1,660.80 |
$2,660.16
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$376.00 |
$376.00 |
$376.00 |
$19,540.29
|
|
Eculizumab injection
|
$42,307.80 |
$42,307.80 |
$42,307.80 |
$16,330.48
|
|
Eeg 41-60 minutes 95812-26
|
$274.80 |
$274.80 |
$274.80 |
$934.05
|
|
Eeg during surgery
|
$694.80 |
$694.80 |
$694.80 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$245.40 |
$245.40 |
$245.40 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$441.00 |
$441.00 |
$441.00 |
$1,119.54
|
|
Eeg phys/qhp 2-12 hr w/veeg
|
$615.00 |
$615.00 |
$615.00 |
$660.00
|
|
Eeg/record in coma or sleep only 95822
|
$245.40 |
$245.40 |
$245.40 |
$871.00
|
|
Eeg recording awake and asleep
|
$715.80 |
$715.80 |
$715.80 |
$931.20
|
|
Eeg without vid 2-12hr cont mntr
|
$615.00 |
$615.00 |
$615.00 |
$895.20
|
|
Eeg without vid 2-12 hr unmntr
|
$615.00 |
$615.00 |
$615.00 |
$721.76
|
