|
Dalbavancin 500 mg intravenous solution
|
$1,856.69 |
$1,856.69 |
$1,856.69 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$141.66 |
$141.66 |
$141.66 |
$168.53
|
|
Dark field exam spec collj
|
$6.30 |
$6.30 |
$6.30 |
$31.20
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$1,271.85 |
$1,271.85 |
$1,271.85 |
$3,774.81
|
|
Dch pulmonary stress test
|
$247.50 |
$247.50 |
$247.50 |
$963.30
|
|
Dch validity tests
|
$4.35 |
$4.35 |
$4.35 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$74.55 |
$74.55 |
$74.55 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$156.75 |
$156.75 |
$156.75 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$76.95 |
$76.95 |
$76.95 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$306.75 |
$306.75 |
$306.75 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$27.45 |
$27.45 |
$27.45 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$294.90 |
$294.90 |
$294.90 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$304.65 |
$304.65 |
$304.65 |
$810.50
|
|
Debride nail1-5 11720
|
$16.50 |
$16.50 |
$16.50 |
$148.80
|
|
Debride nail6 or more 11721
|
$24.90 |
$24.90 |
$24.90 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$294.75 |
$294.75 |
$294.75 |
$1,012.80
|
|
Debride skin bone at fx site
|
$362.55 |
$362.55 |
$362.55 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$113.40 |
$113.40 |
$113.40 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$345.30 |
$345.30 |
$345.30 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$31.20 |
$31.20 |
$31.20 |
$114.10
|
|
Debr musc/fascia 20sq cm/< 11043
|
$290.10 |
$290.10 |
$290.10 |
$1,160.00
|
|
Decalcification
|
$9.00 |
$9.00 |
$9.00 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$261.75 |
$261.75 |
$261.75 |
$543.00
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$1,478.40 |
$1,478.40 |
$1,478.40 |
$4,914.00
|
|
Deep muscle biopsy 20205
|
$1,124.85 |
$1,124.85 |
$1,124.85 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$31.67 |
$31.67 |
$31.67 |
$95.85
|
|
Delivery of placenta 59414
|
$863.40 |
$863.40 |
$863.40 |
$3,070.56
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$565.65 |
$565.65 |
$565.65 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$34.80 |
$34.80 |
$34.80 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$205.50 |
$205.50 |
$205.50 |
$408.10
|
|
Dermagraft
|
$23.40 |
$23.40 |
$23.40 |
$85.00
|
|
Dermapure 1 square cm
|
$140.32 |
$140.32 |
$140.32 |
$3,822.00
|
|
Descend thora aorta rpr/lt sub art 33880
|
$997.95 |
$997.95 |
$997.95 |
$6,687.93
|
|
Design mlc device for imrt
|
$391.95 |
$391.95 |
$391.95 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,107.93 |
$1,107.93 |
$1,107.93 |
$89.78
|
|
Desoxycorticosterone
|
$33.15 |
$33.15 |
$33.15 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$823.20 |
$823.20 |
$823.20 |
$2,727.20
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$83.55 |
$83.55 |
$83.55 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$91.95 |
$91.95 |
$91.95 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$101.10 |
$101.10 |
$101.10 |
$408.50
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$83.55 |
$83.55 |
$83.55 |
$273.72
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$91.95 |
$91.95 |
$91.95 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$101.10 |
$101.10 |
$101.10 |
$317.00
|
|
Dest mal lesion tal <0.5 17260
|
$83.55 |
$83.55 |
$83.55 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$91.95 |
$91.95 |
$91.95 |
$262.60
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$101.10 |
$101.10 |
$101.10 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$111.15 |
$111.15 |
$111.15 |
$364.50
|
|
Destroy cervthor facet jnt 64633
|
$1,285.95 |
$1,285.95 |
$1,285.95 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$761.70 |
$761.70 |
$761.70 |
$1,441.44
|
|
Destroy internal hemorrhoids destroy 46930
|
$387.00 |
$387.00 |
$387.00 |
$1,344.85
|
|
Destroy premlg lesns;1st lesn 17000
|
$99.60 |
$99.60 |
$99.60 |
$199.50
|
|
Destroy vulva lesion extensive 56515
|
$1,369.20 |
$1,369.20 |
$1,369.20 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$373.50 |
$373.50 |
$373.50 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$83.55 |
$83.55 |
$83.55 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$247.65 |
$247.65 |
$247.65 |
$966.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$159.90 |
$159.90 |
$159.90 |
$660.00
|
|
Destruct cut vasl lesions >50cm 17108
|
$780.45 |
$780.45 |
$780.45 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$27.60 |
$27.60 |
$27.60 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$39.15 |
$39.15 |
$39.15 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$168.60 |
$168.60 |
$168.60 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$421.20 |
$421.20 |
$421.20 |
$3,202.98
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$111.15 |
$111.15 |
$111.15 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$122.25 |
$122.25 |
$122.25 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$122.25 |
$122.25 |
$122.25 |
$472.79
|
|
Destruction mal lsn t/a/l >4cm
|
$134.55 |
$134.55 |
$134.55 |
$569.80
|
|
Destruction penis lesion(s) chem 54050
|
$159.90 |
$159.90 |
$159.90 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$780.45 |
$780.45 |
$780.45 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$159.90 |
$159.90 |
$159.90 |
$436.64
|
|
Destruction vag lesions complex 57065
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$3,762.53
|
|
Destruction vag lesions simple 57061
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$3,815.20
|
|
Detect agnt mult dna direc
|
$70.20 |
$70.20 |
$70.20 |
$162.00
|
|
Developmental screen/score/document 96110
|
$40.65 |
$40.65 |
$40.65 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$67.20 |
$67.20 |
$67.20 |
$337.50
|
|
Device ablt adv novasure
|
$6,885.23 |
$6,885.23 |
$6,885.23 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,578.00 |
$3,578.00 |
$3,578.00 |
$4,200.00
|
|
Device tiss remov myosure reach
|
$1,223.52 |
$1,223.52 |
$1,223.52 |
$2,541.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$33.75 |
$33.75 |
$33.75 |
$200.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$69.30 |
$69.30 |
$69.30 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$0.25 |
$0.25 |
$0.25 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$16.75 |
$16.75 |
$16.75 |
$21.17
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$7.26 |
$7.26 |
$7.26 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$7.26 |
$7.26 |
$7.26 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$7.26 |
$7.26 |
$7.26 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$7.26 |
$7.26 |
$7.26 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$38.85 |
$38.85 |
$38.85 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$16.95 |
$16.95 |
$16.95 |
$79.20
|
|
Diab manage trn ind/group
|
$100.20 |
$100.20 |
$100.20 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$138.30 |
$138.30 |
$138.30 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$156.15 |
$156.15 |
$156.15 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$103.95 |
$103.95 |
$103.95 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$51.30 |
$51.30 |
$51.30 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$85.50 |
$85.50 |
$85.50 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$74.10 |
$74.10 |
$74.10 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$63.90 |
$63.90 |
$63.90 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,533.70 |
$3,533.70 |
$3,533.70 |
$5,419.00
|
|
Dialysis one evaluation
|
$194.55 |
$194.55 |
$194.55 |
$919.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$68.03 |
$68.03 |
$68.03 |
$74.76
|
|
Dicyclomine injection
|
$177.39 |
$177.39 |
$177.39 |
$153.29
|
|
Diffusing capacity
|
$100.35 |
$100.35 |
$100.35 |
$332.00
|
