|
Dexrazoxane hcl 250 mg intravenous solution
|
$468.78 |
$468.78 |
$468.78 |
$858.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$16.20 |
$16.20 |
$16.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$29.40 |
$29.40 |
$29.40 |
$79.20
|
|
Diagnostic laryngoscopy 31575
|
$91.80 |
$91.80 |
$91.80 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$104.40 |
$104.40 |
$104.40 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$81.30 |
$81.30 |
$81.30 |
$301.55
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,371.70 |
$3,371.70 |
$3,371.70 |
$5,419.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$116.21 |
$116.21 |
$116.21 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$58.65 |
$58.65 |
$58.65 |
$74.76
|
|
Dicyclomine injection
|
$42.86 |
$42.86 |
$42.86 |
$153.29
|
|
Diffusing capacity
|
$77.10 |
$77.10 |
$77.10 |
$332.00
|
|
Digital analysis of eeg
|
$133.20 |
$133.20 |
$133.20 |
$605.60
|
|
Digoxin immune fab 40 mg intravenous solution
|
$5,085.42 |
$5,085.42 |
$5,085.42 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$40.20 |
$40.20 |
$40.20 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$107.35 |
$107.35 |
$107.35 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$532.80 |
$532.80 |
$532.80 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$378.00 |
$378.00 |
$378.00 |
$402.10
|
|
Dilat xst trc new access rcs
|
$3,004.80 |
$3,004.80 |
$3,004.80 |
$4,213.20
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,271.48 |
$1,271.48 |
$1,271.48 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$23.37 |
$23.37 |
$23.37 |
$17.75
|
|
Disability dlco
|
$99.30 |
$99.30 |
$99.30 |
$282.40
|
|
Dna antibody native/double stranded
|
$7.20 |
$7.20 |
$7.20 |
$97.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$83.98 |
$83.98 |
$83.98 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4,977.73 |
$4,977.73 |
$4,977.73 |
$904.81
|
|
Dolasetron mesylate
|
$40.59 |
$40.59 |
$40.59 |
$44.65
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$18.75 |
$18.75 |
$18.75 |
$65.40
|
|
Doppler echo complete
|
$69.30 |
$69.30 |
$69.30 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$815.40 |
$815.40 |
$815.40 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$141.30 |
$141.30 |
$141.30 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$79.50 |
$79.50 |
$79.50 |
$471.17
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$12,299.75 |
$12,299.75 |
$12,299.75 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$268.93 |
$268.93 |
$268.93 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,476.85 |
$2,476.85 |
$2,476.85 |
$1,718.24
|
|
Dpyd gene common variants
|
$252.00 |
$252.00 |
$252.00 |
$380.50
|
|
Drainage of kidney lesion
|
$804.00 |
$804.00 |
$804.00 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$227.70 |
$227.70 |
$227.70 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$795.60 |
$795.60 |
$795.60 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$817.80 |
$817.80 |
$817.80 |
$2,850.35
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$388.80 |
$388.80 |
$388.80 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$92.10 |
$92.10 |
$92.10 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$388.80 |
$388.80 |
$388.80 |
$523.00
|
|
Drng hand tendon sheath 26020
|
$915.30 |
$915.30 |
$915.30 |
$3,839.54
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$546.06 |
$546.06 |
$546.06 |
$127.14
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$3,812.28 |
$3,812.28 |
$3,812.28 |
$8,040.27
|
|
Drug admin & hemodynmic meas
|
$118.20 |
$118.20 |
$118.20 |
$569.75
|
|
Drug test def 1-7 classes
|
$72.60 |
$72.60 |
$72.60 |
$250.52
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$156.00 |
$156.00 |
$156.00 |
$278.85
|
|
Drvvt confirm - quest
|
$60.90 |
$60.90 |
$60.90 |
$109.20
|
|
Ductogram sgl duct
|
$109.80 |
$109.80 |
$109.80 |
$463.10
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$249.30 |
$249.30 |
$249.30 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$4,390.86 |
$4,390.86 |
$4,390.86 |
$7,973.90
|
|
Ear irrigation 69209
|
$27.00 |
$27.00 |
$27.00 |
$149.76
|
|
Ecg 12 lead tracing only
|
$47.10 |
$47.10 |
$47.10 |
$226.50
|
|
Ecg external < 48 hours recording
|
$156.30 |
$156.30 |
$156.30 |
$462.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$156.30 |
$156.30 |
$156.30 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$156.30 |
$156.30 |
$156.30 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$374.70 |
$374.70 |
$374.70 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$69.60 |
$69.60 |
$69.60 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$374.70 |
$374.70 |
$374.70 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$235.50 |
$235.50 |
$235.50 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$235.50 |
$235.50 |
$235.50 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$34.80 |
$34.80 |
$34.80 |
$362.50
|
|
Echo exam of fetal heart
|
$84.90 |
$84.90 |
$84.90 |
$431.41
|
|
Echo guide for amniocentesis
|
$121.50 |
$121.50 |
$121.50 |
$456.30
|
|
Echo stress
|
$26.86 |
$26.86 |
$26.86 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$360.30 |
$360.30 |
$360.30 |
$1,849.50
|
|
Echo transesophageal
|
$360.30 |
$360.30 |
$360.30 |
$1,559.35
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$235.50 |
$235.50 |
$235.50 |
$985.15
|
|
E coli 0157 ag ia
|
$34.50 |
$34.50 |
$34.50 |
$72.15
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$6,669.11 |
$6,669.11 |
$6,669.11 |
$18,199.20
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$238.80 |
$238.80 |
$238.80 |
$1,000.42
|
|
Eeg monitor/record/awake/drowsy 95816
|
$180.30 |
$180.30 |
$180.30 |
$835.00
|
|
Eeg/record in coma or sleep only 95822
|
$201.90 |
$201.90 |
$201.90 |
$907.80
|
|
Eeg recording awake and asleep
|
$203.70 |
$203.70 |
$203.70 |
$931.20
|
|
E equine encephalitis igg
|
$7.80 |
$7.80 |
$7.80 |
$49.92
|
|
Egfr gene com variants
|
$216.00 |
$216.00 |
$216.00 |
$657.00
|
|
Elec analys infus pump w/reprog 62368
|
$560.10 |
$560.10 |
$560.10 |
$616.11
|
|
Elect analysis of infusion pump 62367
|
$560.10 |
$560.10 |
$560.10 |
$563.20
|
|
Elect anlys sp inf pmp w/reprg&fill 62369
|
$560.10 |
$560.10 |
$560.10 |
$616.11
|
|
Electrd sq emblem s-icd
|
$6,000.00 |
$6,000.00 |
$6,000.00 |
$10,243.24
|
|
Electrolyte panel
|
$19.50 |
$19.50 |
$19.50 |
$84.24
|
|
Electrophysiology evaluation
|
$439.80 |
$439.80 |
$439.80 |
$2,821.00
|
|
Elotuzumab 300 mg intravenous solution
|
$3,164.18 |
$3,164.18 |
$3,164.18 |
$5,523.02
|
|
Elranatamab-bcmm 40 mg/ml subcutaneous solution
|
$14,606.11 |
$14,606.11 |
$14,606.11 |
$16,066.72
|
|
Embo or occlude vascular arterial s&i
|
$3,371.70 |
$3,371.70 |
$3,371.70 |
$15,768.75
|
|
Embo or occlude vascular hemorrhage s&i
|
$3,371.70 |
$3,371.70 |
$3,371.70 |
$14,586.00
|
|
Embo or occlude vascular venous s&i
|
$3,371.70 |
$3,371.70 |
$3,371.70 |
$14,586.00
|
|
Encephalitis, california igg/igm
|
$10.80 |
$10.80 |
$10.80 |
$53.55
|
|
Encephalitis, western equine igg/igm
|
$7.80 |
$7.80 |
$7.80 |
$53.10
|
|
Endo cath bile duct s&i
|
$167.40 |
$167.40 |
$167.40 |
$694.06
|
|
Endo cath panc duct s&i
|
$92.10 |
$92.10 |
$92.10 |
$672.43
|
|
Endoluminal bx biliary tree
|
$534.00 |
$534.00 |
$534.00 |
$2,476.50
|
|
Endoluminal bx urtr rnl plvs
|
$994.80 |
$994.80 |
$994.80 |
$2,290.60
|
|
Endoluminl ivus oct c 1st
|
$348.60 |
$348.60 |
$348.60 |
$3,315.00
|
|
Endoluminl ivus oct c ea
|
$174.00 |
$174.00 |
$174.00 |
$2,203.49
|
|
Endoscopy swallow (fees) vid
|
$87.30 |
$87.30 |
$87.30 |
$402.35
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$4,307.88 |
$4,307.88 |
$4,307.88 |
$8,452.00
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$55.76 |
$55.76 |
$55.76 |
$109.71
|
|
Enzyme histochemistry
|
$102.00 |
$102.00 |
$102.00 |
$471.60
|
|
Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution
|
$16,849.46 |
$16,849.46 |
$16,849.46 |
$30,598.85
|