|
Deamidated gliadin antibody iga
|
$44.00 |
$44.00 |
$44.00 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$323.20 |
$323.20 |
$323.20 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$742.40 |
$742.40 |
$742.40 |
$835.20
|
|
Decalcification
|
$56.80 |
$56.80 |
$56.80 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$596.00 |
$596.00 |
$596.00 |
$572.95
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$210.40 |
$210.40 |
$210.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,979.88 |
$3,979.88 |
$3,979.88 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$450.40 |
$450.40 |
$450.40 |
$401.60
|
|
Developmental screen/score/document 96110
|
$98.40 |
$98.40 |
$98.40 |
$142.38
|
|
Device intraute mirena
|
$366.21 |
$366.21 |
$366.21 |
$2,125.00
|
|
Dexamethasone 4 mg tablet
|
$1.20 |
$1.20 |
$1.20 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$63.92 |
$63.92 |
$63.92 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$148.40 |
$148.40 |
$148.40 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$148.40 |
$148.40 |
$148.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$148.40 |
$148.40 |
$148.40 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$112.00 |
$112.00 |
$112.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$54.40 |
$54.40 |
$54.40 |
$79.30
|
|
Diab manage trn ind/group
|
$44.80 |
$44.80 |
$44.80 |
$54.99
|
|
Diagnostic Mammogram (both breasts)
|
$573.60 |
$573.60 |
$573.60 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$470.40 |
$470.40 |
$470.40 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$808.80 |
$808.80 |
$808.80 |
$259.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$69.54 |
$69.54 |
$69.54 |
$79.71
|
|
Diffusing capacity
|
$240.00 |
$240.00 |
$240.00 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$247.78 |
$247.78 |
$247.78 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$75.20 |
$75.20 |
$75.20 |
$102.07
|
|
Dilate esophagus
|
$3,169.60 |
$3,169.60 |
$3,169.60 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$2,649.60 |
$2,649.60 |
$2,649.60 |
$1,548.00
|
|
Diltiazem 5 mg/ml intravenous solution
|
$68.48 |
$68.48 |
$68.48 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.20 |
$1.20 |
$1.20 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$60.58 |
$60.58 |
$60.58 |
$18.32
|
|
Dna antibody native/double stranded
|
$80.80 |
$80.80 |
$80.80 |
$100.00
|
|
Dna probe chlamydia
|
$82.40 |
$82.40 |
$82.40 |
$82.20
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$253.06 |
$253.06 |
$253.06 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$277.12 |
$277.12 |
$277.12 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$188.68 |
$188.68 |
$188.68 |
$65.40
|
|
Doppler echo complete
|
$712.80 |
$712.80 |
$712.80 |
$558.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$450.40 |
$450.40 |
$450.40 |
$481.65
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$73.84 |
$73.84 |
$73.84 |
$89.34
|
|
Drainage external ear simple 69000
|
$810.40 |
$810.40 |
$810.40 |
$790.40
|
|
Drainage mouth roof lesion
|
$439.20 |
$439.20 |
$439.20 |
$405.60
|
|
Drain blood from under nail 11740
|
$215.20 |
$215.20 |
$215.20 |
$182.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$310.40 |
$310.40 |
$310.40 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$352.00 |
$352.00 |
$352.00 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$440.00 |
$440.00 |
$440.00 |
$541.00
|
|
Drng of eyelid abscess 67700
|
$615.20 |
$615.20 |
$615.20 |
$655.72
|
|
Droperidol 2.5 mg/ml injection solution
|
$65.08 |
$65.08 |
$65.08 |
$31.25
|
|
Drug assay vedolizumab
|
$176.80 |
$176.80 |
$176.80 |
$154.00
|
|
Drug of abuse screen urine
|
$49.60 |
$49.60 |
$49.60 |
$67.89
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$269.60 |
$269.60 |
$269.60 |
$278.85
|
|
Drvvt confirm - quest
|
$124.00 |
$124.00 |
$124.00 |
$109.20
|
|
Duplex scan bilateral study 93985
|
$858.40 |
$858.40 |
$858.40 |
$691.08
|
|
Dup scan/hemodialysis access 93990
|
$676.80 |
$676.80 |
$676.80 |
$489.72
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,112.00 |
$1,112.00 |
$1,112.00 |
$904.78
|
|
Ear irrigation 69209
|
$85.60 |
$85.60 |
$85.60 |
$154.70
|
|
Ecg external < 48 hours recording
|
$496.80 |
$496.80 |
$496.80 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$668.80 |
$668.80 |
$668.80 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$200.00 |
$200.00 |
$200.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$240.80 |
$240.80 |
$240.80 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$2,126.40 |
$2,126.40 |
$2,126.40 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$976.80 |
$976.80 |
$976.80 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$656.80 |
$656.80 |
$656.80 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,540.80 |
$2,540.80 |
$2,540.80 |
$1,944.80
|
|
Echocardiograpy doppler follow up/limited study
|
$467.20 |
$467.20 |
$467.20 |
$371.25
|
|
Echo exam uterus 76831-
|
$877.60 |
$877.60 |
$877.60 |
$561.00
|
|
Echo guide for transfusion
|
$892.80 |
$892.80 |
$892.80 |
$332.39
|
|
Echo stress
|
$2,027.20 |
$2,027.20 |
$2,027.20 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,965.60 |
$2,965.60 |
$2,965.60 |
$1,913.60
|
|
Echo transthoracic
|
$2,040.00 |
$2,040.00 |
$2,040.00 |
$1,361.75
|
|
Echo transthoracic
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,611.20 |
$1,611.20 |
$1,611.20 |
$1,033.00
|
|
Eeg 41-60 minutes 95812-26
|
$1,232.80 |
$1,232.80 |
$1,232.80 |
$934.05
|
|
Eeg monitor/record/awake/drowsy 95816
|
$987.20 |
$987.20 |
$987.20 |
$835.00
|
|
Eeg recording awake and asleep
|
$1,184.80 |
$1,184.80 |
$1,184.80 |
$931.20
|
|
EKG tracing for initial prev
|
$78.40 |
$78.40 |
$78.40 |
$81.76
|
|
EKG (Tracing Only)
|
$261.60 |
$261.60 |
$261.60 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$241.60 |
$241.60 |
$241.60 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$308.80 |
$308.80 |
$308.80 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$113.60 |
$113.60 |
$113.60 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$99.20 |
$99.20 |
$99.20 |
$81.75
|
|
Electrolyte panel
|
$56.80 |
$56.80 |
$56.80 |
$79.30
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$78.97 |
$78.97 |
$78.97 |
$112.79
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$67.75 |
$67.75 |
$67.75 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$61.88 |
$61.88 |
$61.88 |
$31.76
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$97.12 |
$97.12 |
$97.12 |
$33.60
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$294.00 |
$294.00 |
$294.00 |
$1,329.09
|
|
Epstein barr nuclear antigen antibody
|
$72.80 |
$72.80 |
$72.80 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$76.80 |
$76.80 |
$76.80 |
$85.50
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$2,779.35 |
$2,779.35 |
$2,779.35 |
$3,838.45
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$123.64 |
$123.64 |
$123.64 |
$232.12
|
|
ER Visit (level 1, minor)
|
$268.80 |
$268.80 |
$268.80 |
$252.60
|
|
ER Visit (level 2)
|
$431.20 |
$431.20 |
$431.20 |
$463.00
|
|
ER Visit (level 3)
|
$684.80 |
$684.80 |
$684.80 |
$812.18
|
|
ER Visit (level 4)
|
$1,360.80 |
$1,360.80 |
$1,360.80 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$1,895.20 |
$1,895.20 |
$1,895.20 |
$1,871.60
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$305.50 |
$305.50 |
$305.50 |
$516.71
|
|
Esophageal motility
|
$1,055.20 |
$1,055.20 |
$1,055.20 |
$655.45
|
|
Esophagoscopy flex remove fb
|
$1,930.40 |
$1,930.40 |
$1,930.40 |
$2,089.60
|
|
Established Patient Office Visit (level 1)
|
$144.00 |
$144.00 |
$144.00 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$166.40 |
$166.40 |
$166.40 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$199.20 |
$199.20 |
$199.20 |
$186.94
|