|
Destruction vag lesions simple 57061
|
$83.72 |
$83.72 |
$83.72 |
$4,006.38
|
|
Destruct penis les/smp/electrodesi 54055
|
$70.98 |
$70.98 |
$70.98 |
$2,837.09
|
|
Detect agent nos dna dir
|
$23.40 |
$23.40 |
$23.40 |
$115.20
|
|
Detect agnt mult dna direc
|
$34.32 |
$34.32 |
$34.32 |
$157.25
|
|
Determination venous press
|
$5.98 |
$5.98 |
$5.98 |
$166.56
|
|
Determine refractive state
|
$14.30 |
$14.30 |
$14.30 |
$20.50
|
|
Devel tst phys/qhp 1st hr
|
$88.66 |
$88.66 |
$88.66 |
$345.50
|
|
Device ablt adv novasure
|
$4,625.00 |
$4,625.00 |
$4,625.00 |
$6,237.48
|
|
Device intraute mirena
|
$1,105.31 |
$1,105.31 |
$1,105.31 |
$2,143.02
|
|
Dev interrog remote 1/2/mlt
|
$26.26 |
$26.26 |
$26.26 |
$115.20
|
|
Devise bowel pouch
|
$1,034.28 |
$1,034.28 |
$1,034.28 |
$3,464.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$36.66 |
$36.66 |
$36.66 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$6.76 |
$6.76 |
$6.76 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$0.95 |
$0.95 |
$0.95 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$6.83 |
$6.83 |
$6.83 |
$20.52
|
|
Dexamethasone panel
|
$126.36 |
$126.36 |
$126.36 |
$223.39
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$363.09 |
$363.09 |
$363.09 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$8.19 |
$8.19 |
$8.19 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$10.92 |
$10.92 |
$10.92 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$5.01 |
$5.01 |
$5.01 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$6.37 |
$6.37 |
$6.37 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$140.60 |
$140.60 |
$140.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$61.42 |
$61.42 |
$61.42 |
$79.20
|
|
Diag bronchoscope/catheter
|
$4,849.22 |
$4,849.22 |
$4,849.22 |
$2,379.00
|
|
Diag laparo separate proc 49320
|
$242.32 |
$242.32 |
$242.32 |
$7,104.72
|
|
Diagnostic anoscopy
|
$68.12 |
$68.12 |
$68.12 |
$363.30
|
|
Diagnostic anoscopy & biopsy
|
$90.22 |
$90.22 |
$90.22 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$362.60 |
$362.60 |
$362.60 |
$195.50
|
|
Diagnostic digital breast tomosynthesis unil
|
$69.94 |
$69.94 |
$69.94 |
$76.37
|
|
Diagnostic laryngoscopy 31505
|
$546.12 |
$546.12 |
$546.12 |
$258.30
|
|
Diagnostic laryngoscopy 31575
|
$546.12 |
$546.12 |
$546.12 |
$338.25
|
|
Diagnostic Mammogram (both breasts)
|
$34.32 |
$34.32 |
$34.32 |
$421.20
|
|
Diagnostic Mammogram (one breast)
|
$27.82 |
$27.82 |
$27.82 |
$314.16
|
|
Diagnostic radio unlisted proc
|
$340.40 |
$340.40 |
$340.40 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$12,025.00 |
$12,025.00 |
$12,025.00 |
$6,185.00
|
|
Dialysis one evaluation
|
$1,197.32 |
$1,197.32 |
$1,197.32 |
$936.00
|
|
Dialysis repeated eval
|
$88.66 |
$88.66 |
$88.66 |
$1,267.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$30.63 |
$30.63 |
$30.63 |
$79.71
|
|
Dicyclomine injection
|
$76.49 |
$76.49 |
$76.49 |
$154.14
|
|
Diffusing capacity
|
$6.50 |
$6.50 |
$6.50 |
$337.60
|
|
Digital analysis of eeg
|
$72.80 |
$72.80 |
$72.80 |
$576.69
|
|
Digit nerve surgery add-on
|
$130.52 |
$130.52 |
$130.52 |
$1,832.59
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$651.68 |
$651.68 |
$651.68 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$22,631.70 |
$22,631.70 |
$22,631.70 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$84.36 |
$84.36 |
$84.36 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$119.53 |
$119.53 |
$119.53 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$7,442.92 |
$7,442.92 |
$7,442.92 |
$1,866.73
|
|
Dilate esophagus
|
$62.66 |
$62.66 |
$62.66 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$57.72 |
$57.72 |
$57.72 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$9,534.90 |
$9,534.90 |
$9,534.90 |
$3,183.60
|
|
Dilate ic vasospasm ea add vsl same territory
|
$9,534.90 |
$9,534.90 |
$9,534.90 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$10,011.46 |
$10,011.46 |
$10,011.46 |
$5,250.40
|
|
Dilate tear duct opening
|
$56.68 |
$56.68 |
$56.68 |
$454.40
|
|
Dilate urethra stricture
|
$46.54 |
$46.54 |
$46.54 |
$513.00
|
|
Dilate urethra stricture
|
$39.00 |
$39.00 |
$39.00 |
$200.80
|
|
Dilate urethra stricture
|
$46.28 |
$46.28 |
$46.28 |
$3,863.60
|
|
Dilate urethra stricture
|
$52.00 |
$52.00 |
$52.00 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$30.16 |
$30.16 |
$30.16 |
$235.61
|
|
Dilation of anal sphincter
|
$124.80 |
$124.80 |
$124.80 |
$2,166.04
|
|
Dilation of cervical canal 57800
|
$35.10 |
$35.10 |
$35.10 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$141.70 |
$141.70 |
$141.70 |
$2,263.80
|
|
Dilation of salivary duct
|
$57.72 |
$57.72 |
$57.72 |
$750.00
|
|
Dilation of urethra
|
$29.12 |
$29.12 |
$29.12 |
$172.00
|
|
Dilation of urethra
|
$27.04 |
$27.04 |
$27.04 |
$2,424.12
|
|
Dilation of vagina
|
$95.16 |
$95.16 |
$95.16 |
$4,446.00
|
|
Dilation salivary duct 42650
|
$43.42 |
$43.42 |
$43.42 |
$2,498.32
|
|
Dilation/urethral strict/male/ini 53620
|
$63.18 |
$63.18 |
$63.18 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$119.42 |
$119.42 |
$119.42 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$9,698.44 |
$9,698.44 |
$9,698.44 |
$3,903.54
|
|
Dilat xst trc new access rcs
|
$9,698.44 |
$9,698.44 |
$9,698.44 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$10.38 |
$10.38 |
$10.38 |
$45.06
|
|
Dimecaprol injection
|
$154.04 |
$154.04 |
$154.04 |
$293.38
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.74 |
$2.74 |
$2.74 |
$18.00
|
|
Dipyridamole injection
|
$18.02 |
$18.02 |
$18.02 |
$48.04
|
|
Disability dlco
|
$8.58 |
$8.58 |
$8.58 |
$294.55
|
|
Disaccharidases
|
$140.60 |
$140.60 |
$140.60 |
$224.58
|
|
Disarticulation sho sec clsr
|
$349.70 |
$349.70 |
$349.70 |
$2,300.80
|
|
Disarticulation shoulder
|
$825.24 |
$825.24 |
$825.24 |
$13,116.76
|
|
Discectomy ant dcmprn cord thoracic 1 ntrspc 63077
|
$1,069.90 |
$1,069.90 |
$1,069.90 |
$3,636.00
|
|
Discectomy ant dcmprn cord thoracic ea ntrsp 63078
|
$150.80 |
$150.80 |
$150.80 |
$316.10
|
|
Discography cerv/thor spine
|
$7,550.22 |
$7,550.22 |
$7,550.22 |
$2,565.00
|
|
Dise eval slp do brth flx dx
|
$70.72 |
$70.72 |
$70.72 |
$1,120.00
|
|
Dissect brain w/scope
|
$1,125.54 |
$1,125.54 |
$1,125.54 |
$2,321.68
|
|
Dis site tele svcs rhc/fqhc
|
$74.88 |
$74.88 |
$74.88 |
$94.80
|
|
Dissolve clot heart vessel
|
$7,559.10 |
$7,559.10 |
$7,559.10 |
$1,579.93
|
|
Dist revas ligation hemo
|
$816.66 |
$816.66 |
$816.66 |
$6,396.89
|
|
Div aberrant vsl w/reanast
|
$828.88 |
$828.88 |
$828.88 |
$1,644.05
|
|
Diverticulectomy/hypophar/esoph 43130
|
$579.28 |
$579.28 |
$579.28 |
$6,465.11
|
|
Division of fallopian tube 58605
|
$245.96 |
$245.96 |
$245.96 |
$832.00
|
|
Dlyd plmt xtn prosth ea addl
|
$4,046.32 |
$4,046.32 |
$4,046.32 |
$1,810.80
|
|
Dmd dup/delet analysis
|
$784.40 |
$784.40 |
$784.40 |
$463.20
|
|
Dmpk gene charac alleles
|
$214.24 |
$214.24 |
$214.24 |
$367.20
|
|
Dmpk gene detc abnor allele
|
$385.54 |
$385.54 |
$385.54 |
$313.60
|
|
Dna antibody native/double stranded
|
$87.32 |
$87.32 |
$87.32 |
$100.00
|
|
Dna gardnerella
|
$126.54 |
$126.54 |
$126.54 |
$62.50
|
|
Dna probe chlamydia
|
$17.68 |
$17.68 |
$17.68 |
$79.38
|
|
Dna probe gc
|
$20.80 |
$20.80 |
$20.80 |
$79.38
|
|
Dna trichomonas
|
$126.54 |
$126.54 |
$126.54 |
$66.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$36.40 |
$36.40 |
$36.40 |
$94.53
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$20.70 |
$20.70 |
$20.70 |
$65.40
|