|
Dexamethasone 4 mg tablet
|
$0.81 |
$0.81 |
$0.81 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$12.47 |
$12.47 |
$12.47 |
$20.52
|
|
Dexamethasone panel
|
$111.78 |
$111.78 |
$111.78 |
$223.39
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$321.20 |
$321.20 |
$321.20 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$4.83 |
$4.83 |
$4.83 |
$36.00
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$13.68 |
$13.68 |
$13.68 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$4.83 |
$4.83 |
$4.83 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$146.30 |
$146.30 |
$146.30 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$63.91 |
$63.91 |
$63.91 |
$79.20
|
|
Diab manage trn ind/group
|
$40.04 |
$40.04 |
$40.04 |
$54.99
|
|
Diag bronchoscope/catheter
|
$107.87 |
$107.87 |
$107.87 |
$2,379.00
|
|
Diag laparo separate proc 49320
|
$214.36 |
$214.36 |
$214.36 |
$7,104.72
|
|
Diagnostic anoscopy
|
$60.26 |
$60.26 |
$60.26 |
$363.30
|
|
Diagnostic anoscopy & biopsy
|
$79.81 |
$79.81 |
$79.81 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$26.68 |
$26.68 |
$26.68 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$665.28 |
$665.28 |
$665.28 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$332.64 |
$332.64 |
$332.64 |
$76.37
|
|
Diagnostic laryngoscopy 31505
|
$568.26 |
$568.26 |
$568.26 |
$258.30
|
|
Diagnostic laryngoscopy 31575
|
$568.26 |
$568.26 |
$568.26 |
$338.25
|
|
Diagnostic Mammogram (both breasts)
|
$446.60 |
$446.60 |
$446.60 |
$421.20
|
|
Diagnostic Mammogram (one breast)
|
$358.82 |
$358.82 |
$358.82 |
$314.16
|
|
Diagnostic radio unlisted proc
|
$354.20 |
$354.20 |
$354.20 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$12,512.50 |
$12,512.50 |
$12,512.50 |
$6,185.00
|
|
Dialysis one evaluation
|
$55.20 |
$55.20 |
$55.20 |
$936.00
|
|
Dialysis repeated eval
|
$78.43 |
$78.43 |
$78.43 |
$1,267.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$27.10 |
$27.10 |
$27.10 |
$79.71
|
|
Dicyclomine injection
|
$31.39 |
$31.39 |
$31.39 |
$154.14
|
|
Diffusing capacity
|
$278.74 |
$278.74 |
$278.74 |
$337.60
|
|
Digital analysis of eeg
|
$408.10 |
$408.10 |
$408.10 |
$576.69
|
|
Digit nerve surgery add-on
|
$115.46 |
$115.46 |
$115.46 |
$1,832.59
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$554.36 |
$554.36 |
$554.36 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$20,020.35 |
$20,020.35 |
$20,020.35 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$87.78 |
$87.78 |
$87.78 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$105.74 |
$105.74 |
$105.74 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$85.79 |
$85.79 |
$85.79 |
$1,866.73
|
|
Dilate esophagus
|
$55.43 |
$55.43 |
$55.43 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$51.06 |
$51.06 |
$51.06 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$166.06 |
$166.06 |
$166.06 |
$3,183.60
|
|
Dilate ic vasospasm ea add vsl same territory
|
$83.03 |
$83.03 |
$83.03 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$236.44 |
$236.44 |
$236.44 |
$5,250.40
|
|
Dilate tear duct opening
|
$50.14 |
$50.14 |
$50.14 |
$454.40
|
|
Dilate urethra stricture
|
$41.17 |
$41.17 |
$41.17 |
$513.00
|
|
Dilate urethra stricture
|
$34.50 |
$34.50 |
$34.50 |
$200.80
|
|
Dilate urethra stricture
|
$40.94 |
$40.94 |
$40.94 |
$3,863.60
|
|
Dilate urethra stricture
|
$46.00 |
$46.00 |
$46.00 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$26.68 |
$26.68 |
$26.68 |
$235.61
|
|
Dilation of anal sphincter
|
$110.40 |
$110.40 |
$110.40 |
$2,166.04
|
|
Dilation of cervical canal 57800
|
$31.05 |
$31.05 |
$31.05 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$125.35 |
$125.35 |
$125.35 |
$2,263.80
|
|
Dilation of salivary duct
|
$51.06 |
$51.06 |
$51.06 |
$750.00
|
|
Dilation of urethra
|
$25.76 |
$25.76 |
$25.76 |
$172.00
|
|
Dilation of urethra
|
$23.92 |
$23.92 |
$23.92 |
$2,424.12
|
|
Dilation of vagina
|
$84.18 |
$84.18 |
$84.18 |
$4,446.00
|
|
Dilation salivary duct 42650
|
$38.41 |
$38.41 |
$38.41 |
$2,498.32
|
|
Dilation/urethral strict/male/ini 53620
|
$55.89 |
$55.89 |
$55.89 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$105.64 |
$105.64 |
$105.64 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$96.60 |
$96.60 |
$96.60 |
$3,903.54
|
|
Dilat xst trc new access rcs
|
$161.00 |
$161.00 |
$161.00 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$7.33 |
$7.33 |
$7.33 |
$45.06
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.42 |
$2.42 |
$2.42 |
$18.00
|
|
Disability dlco
|
$371.91 |
$371.91 |
$371.91 |
$294.55
|
|
Disaccharidases
|
$146.30 |
$146.30 |
$146.30 |
$224.58
|
|
Disarticulation sho sec clsr
|
$309.35 |
$309.35 |
$309.35 |
$2,300.80
|
|
Disarticulation shoulder
|
$730.02 |
$730.02 |
$730.02 |
$13,116.76
|
|
Discectomy ant dcmprn cord thoracic 1 ntrspc 63077
|
$946.45 |
$946.45 |
$946.45 |
$3,636.00
|
|
Discectomy ant dcmprn cord thoracic ea ntrsp 63078
|
$133.40 |
$133.40 |
$133.40 |
$316.10
|
|
Discography cerv/thor spine
|
$7,856.31 |
$7,856.31 |
$7,856.31 |
$2,565.00
|
|
Dise eval slp do brth flx dx
|
$62.56 |
$62.56 |
$62.56 |
$1,120.00
|
|
Dissect brain w/scope
|
$995.67 |
$995.67 |
$995.67 |
$2,321.68
|
|
Dis site tele svcs rhc/fqhc
|
$66.24 |
$66.24 |
$66.24 |
$94.80
|
|
Dissolve clot heart vessel
|
$237.13 |
$237.13 |
$237.13 |
$1,579.93
|
|
Dist revas ligation hemo
|
$722.43 |
$722.43 |
$722.43 |
$6,396.89
|
|
Div aberrant vsl w/reanast
|
$733.24 |
$733.24 |
$733.24 |
$1,644.05
|
|
Diverticulectomy/hypophar/esoph 43130
|
$512.44 |
$512.44 |
$512.44 |
$6,465.11
|
|
Division of fallopian tube 58605
|
$217.58 |
$217.58 |
$217.58 |
$832.00
|
|
Dlyd plmt xtn prosth ea addl
|
$186.30 |
$186.30 |
$186.30 |
$1,810.80
|
|
Dmpk gene charac alleles
|
$189.52 |
$189.52 |
$189.52 |
$367.20
|
|
Dmpk gene detc abnor allele
|
$94.76 |
$94.76 |
$94.76 |
$313.60
|
|
Dna antibody native/double stranded
|
$90.86 |
$90.86 |
$90.86 |
$100.00
|
|
Dna gardnerella
|
$131.67 |
$131.67 |
$131.67 |
$62.50
|
|
Dna probe chlamydia
|
$15.64 |
$15.64 |
$15.64 |
$79.38
|
|
Dna probe gc
|
$18.40 |
$18.40 |
$18.40 |
$79.38
|
|
Dna trichomonas
|
$131.67 |
$131.67 |
$131.67 |
$66.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$32.20 |
$32.20 |
$32.20 |
$94.53
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$15.90 |
$15.90 |
$15.90 |
$65.40
|
|
Doppler echo complete
|
$1,203.51 |
$1,203.51 |
$1,203.51 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$45.54 |
$45.54 |
$45.54 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$572.11 |
$572.11 |
$572.11 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$472.01 |
$472.01 |
$472.01 |
$481.65
|
|
Double transfer toe-hand
|
$2,448.81 |
$2,448.81 |
$2,448.81 |
$6,308.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$19.78 |
$19.78 |
$19.78 |
$450.14
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.23 |
$0.23 |
$0.23 |
$89.34
|
|
Dpyd gene common variants
|
$511.28 |
$511.28 |
$511.28 |
$429.25
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$2,058.21 |
$2,058.21 |
$2,058.21 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$2,058.21 |
$2,058.21 |
$2,058.21 |
$973.71
|
|
Drainage external ear complex 69005
|
$104.42 |
$104.42 |
$104.42 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$2,058.21 |
$2,058.21 |
$2,058.21 |
$794.82
|
|
Drainage lymph node lesion 38300
|
$135.93 |
$135.93 |
$135.93 |
$3,088.80
|
|
Drainage lymph node lesion 38305
|
$321.77 |
$321.77 |
$321.77 |
$3,167.89
|
|
Drainage mouth roof lesion
|
$679.91 |
$679.91 |
$679.91 |
$411.68
|