|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,470.60 |
$1,470.60 |
$1,470.60 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$728.40 |
$728.40 |
$728.40 |
$1,165.50
|
|
Decalcification
|
$388.20 |
$388.20 |
$388.20 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$141.60 |
$141.60 |
$141.60 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$653.40 |
$653.40 |
$653.40 |
$572.95
|
|
Degarelix 120 mg subcutaneous solution
|
$78.60 |
$78.60 |
$78.60 |
$1,856.85
|
|
Delivery of placenta 59414
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$419.40 |
$419.40 |
$419.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$10,269.00 |
$10,269.00 |
$10,269.00 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$589.80 |
$589.80 |
$589.80 |
$401.60
|
|
Design mlc device for imrt
|
$5,968.20 |
$5,968.20 |
$5,968.20 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$2,755.80 |
$2,755.80 |
$2,755.80 |
$91.84
|
|
Desoxycorticosterone
|
$398.40 |
$398.40 |
$398.40 |
$109.28
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$258.60 |
$258.60 |
$258.60 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$246.00 |
$246.00 |
$246.00 |
$408.50
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$134.40 |
$134.40 |
$134.40 |
$311.20
|
|
Destroy cervthor facet jnt 64633
|
$3,434.40 |
$3,434.40 |
$3,434.40 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$3,434.40 |
$3,434.40 |
$3,434.40 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$141.00 |
$141.00 |
$141.00 |
$202.40
|
|
Destruct ben lesion 15/> 17111
|
$120.60 |
$120.60 |
$120.60 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$64.20 |
$64.20 |
$64.20 |
$78.61
|
|
Destruction anal lesion(s)
|
$1,638.00 |
$1,638.00 |
$1,638.00 |
$3,363.79
|
|
Destruction benign lesions < 14 lesions
|
$141.00 |
$141.00 |
$141.00 |
$240.24
|
|
Destruction by injection tx of nerve 64630
|
$4,695.00 |
$4,695.00 |
$4,695.00 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,434.40 |
$3,434.40 |
$3,434.40 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,434.40 |
$3,434.40 |
$3,434.40 |
$3,296.80
|
|
Destruction cryosurgery anal lesion(s) simpl 46916
|
$118.80 |
$118.80 |
$118.80 |
$375.87
|
|
Destruction penis lesion(s) chem 54050
|
$229.20 |
$229.20 |
$229.20 |
$332.00
|
|
Destruction premal lesions 15/> 17004
|
$258.60 |
$258.60 |
$258.60 |
$442.61
|
|
Device ablt adv novasure
|
$9,649.20 |
$9,649.20 |
$9,649.20 |
$6,237.48
|
|
Device intraute mirena
|
$4,133.60 |
$4,133.60 |
$4,133.60 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,707.20 |
$2,707.20 |
$2,707.20 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$121.20 |
$121.20 |
$121.20 |
$227.25
|
|
Dexametha opth insert 0.1 mg
|
$477.60 |
$477.60 |
$477.60 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$5.40 |
$5.40 |
$5.40 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$1.80 |
$1.80 |
$1.80 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,087.80 |
$1,087.80 |
$1,087.80 |
$884.80
|
|
Dextran 40 infusion
|
$645.60 |
$645.60 |
$645.60 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$37.20 |
$37.20 |
$37.20 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$29.00 |
$29.00 |
$29.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$60.40 |
$60.40 |
$60.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$26.80 |
$26.80 |
$26.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$184.20 |
$184.20 |
$184.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$165.60 |
$165.60 |
$165.60 |
$79.30
|
|
Diab manage trn ind/group
|
$93.00 |
$93.00 |
$93.00 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$87.60 |
$87.60 |
$87.60 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$256.80 |
$256.80 |
$256.80 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$483.00 |
$483.00 |
$483.00 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$316.80 |
$316.80 |
$316.80 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,309.60 |
$3,309.60 |
$3,309.60 |
$5,741.00
|
|
Dialysis one evaluation
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.80 |
$0.80 |
$0.80 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$127.20 |
$127.20 |
$127.20 |
$79.71
|
|
Dicyclomine injection
|
$494.40 |
$494.40 |
$494.40 |
$154.33
|
|
Diffusing capacity
|
$412.20 |
$412.20 |
$412.20 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$34.00 |
$34.00 |
$34.00 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$16,441.80 |
$16,441.80 |
$16,441.80 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$126.00 |
$126.00 |
$126.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$924.80 |
$924.80 |
$924.80 |
$297.86
|
|
Dilate esophagus 1/mult pass
|
$3,526.20 |
$3,526.20 |
$3,526.20 |
$1,548.00
|
|
Dilator fascial 10fx20cm
|
$127.80 |
$127.80 |
$127.80 |
$402.10
|
|
Dimenhydrinate injection
|
$13.20 |
$13.20 |
$13.20 |
$30.48
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$9.60 |
$9.60 |
$9.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$16.80 |
$16.80 |
$16.80 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$24.60 |
$24.60 |
$24.60 |
$98.15
|
|
Disability dlco
|
$234.00 |
$234.00 |
$234.00 |
$293.76
|
|
Disaccharidases
|
$88.80 |
$88.80 |
$88.80 |
$230.40
|
|
Dna antibody native/double stranded
|
$249.60 |
$249.60 |
$249.60 |
$100.00
|
|
Dna gardnerella
|
$255.60 |
$255.60 |
$255.60 |
$61.83
|
|
Dna trichomonas
|
$266.40 |
$266.40 |
$266.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$81.00 |
$81.00 |
$81.00 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$88.20 |
$88.20 |
$88.20 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$56.40 |
$56.40 |
$56.40 |
$65.40
|
|
Doppler intravascular pressure flow initial vessel
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,081.80 |
$1,081.80 |
$1,081.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$759.60 |
$759.60 |
$759.60 |
$481.65
|
|
Dornase alfa non-comp unit
|
$236.00 |
$236.00 |
$236.00 |
$356.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$544.20 |
$544.20 |
$544.20 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$364.20 |
$364.20 |
$364.20 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,245.20 |
$2,245.20 |
$2,245.20 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1.20 |
$1.20 |
$1.20 |
$89.34
|
|
Dpyd gene common variants
|
$2,476.80 |
$2,476.80 |
$2,476.80 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$964.00
|
|
Drainage external ear complex 69005
|
$7,126.80 |
$7,126.80 |
$7,126.80 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$591.60 |
$591.60 |
$591.60 |
$790.40
|
|
Drainage mouth roof lesion
|
$4,695.00 |
$4,695.00 |
$4,695.00 |
$405.60
|
|
Drainage of kidney lesion
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$1,506.00
|
|
Drainage of mouth lesion
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,837.72
|
|
Drainage of nose lesion int 30000
|
$10,044.00 |
$10,044.00 |
$10,044.00 |
$548.00
|
|
Drainage of pelvis lesion 26990
|
$3,355.20 |
$3,355.20 |
$3,355.20 |
$3,863.70
|
|
Drainage of rectal abscess 45020
|
$5,376.00 |
$5,376.00 |
$5,376.00 |
$3,816.64
|
|
Drain blood from under nail 11740
|
$247.20 |
$247.20 |
$247.20 |
$182.40
|
|
Drain cath image guided visceral pq
|
$4,627.80 |
$4,627.80 |
$4,627.80 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,260.60 |
$1,260.60 |
$1,260.60 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$589.80 |
$589.80 |
$589.80 |
$428.40
|
|
Drain thigh/knee lesion 27301
|
$5,397.60 |
$5,397.60 |
$5,397.60 |
$3,986.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$825.60 |
$825.60 |
$825.60 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$589.80 |
$589.80 |
$589.80 |
$349.50
|
