|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$5,863.00 |
$5,863.00 |
$5,863.00 |
$3,295.50
|
|
Destruction mal lsn t/a/l >4cm
|
$467.00 |
$467.00 |
$467.00 |
$569.80
|
|
Destruction penis lesion(s) exten 54065
|
$598.33 |
$598.33 |
$598.33 |
$2,507.31
|
|
Detect agent nos dna dir
|
$198.00 |
$198.00 |
$198.00 |
$148.50
|
|
Determine refractive state
|
$23.50 |
$23.50 |
$23.50 |
$19.80
|
|
Developmental screen/score/document 96110
|
$13.00 |
$13.00 |
$13.00 |
$141.93
|
|
Device ablt adv novasure
|
$2,597.50 |
$2,597.50 |
$2,597.50 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$396.21 |
$396.21 |
$396.21 |
$4,200.00
|
|
Device intraute mirena
|
$2,869.50 |
$2,869.50 |
$2,869.50 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$1,335.00 |
$1,335.00 |
$1,335.00 |
$2,466.14
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$94.00 |
$94.00 |
$94.00 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$8.51 |
$8.51 |
$8.51 |
$6.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$6.08 |
$6.08 |
$6.08 |
$21.26
|
|
Dexamethasone intra implant
|
$441.50 |
$441.50 |
$441.50 |
$2,356.90
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$60.00 |
$60.00 |
$60.00 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$31.00 |
$31.00 |
$31.00 |
$111.78
|
|
Diabetes (HbA1c) Test
|
$74.00 |
$74.00 |
$74.00 |
$79.20
|
|
Diag laparo separate proc 49320
|
$1,868.67 |
$1,868.67 |
$1,868.67 |
$6,904.15
|
|
Diagnostic anoscopy
|
$513.50 |
$513.50 |
$513.50 |
$391.20
|
|
Diagnostic digital breast tomosynthesis bil
|
$394.50 |
$394.50 |
$394.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$331.50 |
$331.50 |
$331.50 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$229.50 |
$229.50 |
$229.50 |
$238.58
|
|
Diagnostic laryngoscopy 31575
|
$337.00 |
$337.00 |
$337.00 |
$327.60
|
|
Diagnostic Mammogram (both breasts)
|
$329.50 |
$329.50 |
$329.50 |
$409.50
|
|
Diagnostic Mammogram (one breast)
|
$258.50 |
$258.50 |
$258.50 |
$310.20
|
|
Diagnostic radio unlisted proc
|
$94.00 |
$94.00 |
$94.00 |
$255.00
|
|
Dialysis one evaluation
|
$527.50 |
$527.50 |
$527.50 |
$923.00
|
|
Dialysis repeated eval
|
$1,419.50 |
$1,419.50 |
$1,419.50 |
$1,332.80
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$32.04 |
$32.04 |
$32.04 |
$74.76
|
|
Dicyclomine injection
|
$16.54 |
$16.54 |
$16.54 |
$150.40
|
|
Diffusing capacity
|
$34.50 |
$34.50 |
$34.50 |
$335.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.47 |
$6.47 |
$6.47 |
$65.91
|
|
Digoxin total therapeutic drug level
|
$37.50 |
$37.50 |
$37.50 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$97.50 |
$97.50 |
$97.50 |
$297.86
|
|
Dilate urethra stricture
|
$320.00 |
$320.00 |
$320.00 |
$495.00
|
|
Dilate urethra stricture
|
$153.00 |
$153.00 |
$153.00 |
$200.80
|
|
Dilate urethra stricture
|
$2,194.33 |
$2,194.33 |
$2,194.33 |
$3,863.60
|
|
Dilate urethra stricture
|
$287.00 |
$287.00 |
$287.00 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$148.00 |
$148.00 |
$148.00 |
$236.46
|
|
Dilation of cervical canal 57800
|
$3,720.50 |
$3,720.50 |
$3,720.50 |
$4,376.00
|
|
Dilation of urethra
|
$153.00 |
$153.00 |
$153.00 |
$172.00
|
|
Dilation/urethral strict/male/ini 53620
|
$801.50 |
$801.50 |
$801.50 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$221.35 |
$221.35 |
$221.35 |
$403.61
|
|
Dilat xst trc new access rcs
|
$4,484.00 |
$4,484.00 |
$4,484.00 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$20.17 |
$20.17 |
$20.17 |
$42.04
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,508.50 |
$1,508.50 |
$1,508.50 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.00 |
$1.00 |
$1.00 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.50 |
$2.50 |
$2.50 |
$18.35
|
|
Disaccharidases
|
$447.50 |
$447.50 |
$447.50 |
$222.63
|
|
Dise eval slp do brth flx dx
|
$661.00 |
$661.00 |
$661.00 |
$1,120.00
|
|
Dna antibody native/double stranded
|
$70.50 |
$70.50 |
$70.50 |
$100.00
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$717.70 |
$717.70 |
$717.70 |
$944.35
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$120.00 |
$120.00 |
$120.00 |
$65.40
|
|
Doppler echo complete
|
$1,321.50 |
$1,321.50 |
$1,321.50 |
$546.42
|
|
Doppler intravascular pressure flow initial vessel
|
$955.50 |
$955.50 |
$955.50 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$193.00 |
$193.00 |
$193.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$149.00 |
$149.00 |
$149.00 |
$479.46
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$46,252.48 |
$46,252.48 |
$46,252.48 |
$23,126.24
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$39.38 |
$39.38 |
$39.38 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$868.50 |
$868.50 |
$868.50 |
$1,718.24
|
|
Dpyd gene common variants
|
$800.00 |
$800.00 |
$800.00 |
$386.12
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$964.00 |
$964.00 |
$964.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$964.00 |
$964.00 |
$964.00 |
$906.00
|
|
Drainage external ear complex 69005
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,876.50
|
|
Drainage external ear simple 69000
|
$964.00 |
$964.00 |
$964.00 |
$785.60
|
|
Drainage of eye
|
$3,207.50 |
$3,207.50 |
$3,207.50 |
$2,415.65
|
|
Drainage of eye
|
$2,652.50 |
$2,652.50 |
$2,652.50 |
$3,170.00
|
|
Drainage of forearm bursa
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$2,054.00
|
|
Drainage of nose lesion sept 30020
|
$678.50 |
$678.50 |
$678.50 |
$781.44
|
|
Drain blood from under nail 11740
|
$172.50 |
$172.50 |
$172.50 |
$177.10
|
|
Drain cath image guided visceral pq
|
$1,761.50 |
$1,761.50 |
$1,761.50 |
$2,885.30
|
|
Drain cerebro spinal fluid 62272
|
$957.50 |
$957.50 |
$957.50 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$352.00 |
$352.00 |
$352.00 |
$435.32
|
|
Drain lower leg bursa
|
$3,760.50 |
$3,760.50 |
$3,760.50 |
$3,958.50
|
|
Drain neck/chest lesion 21501
|
$3,338.50 |
$3,338.50 |
$3,338.50 |
$3,339.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$300.50 |
$300.50 |
$300.50 |
$394.80
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$343.00 |
$343.00 |
$343.00 |
$351.45
|
|
Dress/debrid prtl-thick burn l 16030
|
$563.00 |
$563.00 |
$563.00 |
$530.40
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$6,501.85
|
|
Drill hole implt ventricular cath/device 61107
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,503.60
|
|
Drng hand tendon sheath 26020
|
$3,760.50 |
$3,760.50 |
$3,760.50 |
$3,839.54
|
|
Drng of eyelid abscess 67700
|
$393.00 |
$393.00 |
$393.00 |
$656.88
|
|
Drng of finger abscess comp 26011
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,048.00
|
|
Drng of hydrocele 55000
|
$900.50 |
$900.50 |
$900.50 |
$854.50
|
|
Drng of mouth lesion 40801
|
$783.00 |
$783.00 |
$783.00 |
$1,350.97
|
|
Drng of scrotum abscess 55100
|
$2,005.00 |
$2,005.00 |
$2,005.00 |
$1,977.60
|
|
Drng salivary gland simple 42300
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$2,039.50
|
|
Droperidol 2.5 mg/ml injection solution
|
$9.71 |
$9.71 |
$9.71 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$647.59 |
$647.59 |
$647.59 |
$1,882.80
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$112.48
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$289.05
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$244.50 |
$244.50 |
$244.50 |
$8,040.27
|
|
Drug admin & hemodynmic meas
|
$155.50 |
$155.50 |
$155.50 |
$590.00
|
|
Drug assay posaconazole
|
$161.50 |
$161.50 |
$161.50 |
$96.00
|
|
Drug assay rufinamide
|
$51.00 |
$51.00 |
$51.00 |
$78.00
|
|
Drug assay vedolizumab
|
$455.00 |
$455.00 |
$455.00 |
$157.00
|
|
Drug assay voriconazole
|
$119.50 |
$119.50 |
$119.50 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$108.50 |
$108.50 |
$108.50 |
$66.43
|
|
Drug screening tapentadol
|
$5.00 |
$5.00 |
$5.00 |
$37.24
|
