|
Developmental screen/score/document 96110
|
$39.79 |
$39.79 |
$39.79 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$66.01 |
$66.01 |
$66.01 |
$337.50
|
|
Device ablt adv novasure
|
$10,557.35 |
$10,557.35 |
$10,557.35 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$5,486.26 |
$5,486.26 |
$5,486.26 |
$4,200.00
|
|
Device tiss remov myosure reach
|
$1,876.06 |
$1,876.06 |
$1,876.06 |
$2,541.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$33.12 |
$33.12 |
$33.12 |
$200.00
|
|
Dexamethasone 4 mg tablet
|
$0.40 |
$0.40 |
$0.40 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$14.51 |
$14.51 |
$14.51 |
$21.18
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$11.13 |
$11.13 |
$11.13 |
$39.60
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$11.13 |
$11.13 |
$11.13 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$11.13 |
$11.13 |
$11.13 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$38.18 |
$38.18 |
$38.18 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$16.56 |
$16.56 |
$16.56 |
$79.20
|
|
Diagnostic anoscopy spx 46600
|
$135.70 |
$135.70 |
$135.70 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$50.14 |
$50.14 |
$50.14 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$83.95 |
$83.95 |
$83.95 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$72.68 |
$72.68 |
$72.68 |
$301.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$34.36 |
$34.36 |
$34.36 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$63.99 |
$63.99 |
$63.99 |
$74.17
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$4.49 |
$4.49 |
$4.49 |
$68.22
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,068.24 |
$4,068.24 |
$4,068.24 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$23.00 |
$23.00 |
$23.00 |
$102.00
|
|
Dilate urethra stricture
|
$208.38 |
$208.38 |
$208.38 |
$490.00
|
|
Dilate urethra stricture
|
$53.82 |
$53.82 |
$53.82 |
$200.80
|
|
Dilation of cervical canal 57800
|
$1,321.35 |
$1,321.35 |
$1,321.35 |
$4,376.00
|
|
Dilation of urethra
|
$53.82 |
$53.82 |
$53.82 |
$172.00
|
|
Dilator fascial 10fx20cm
|
$595.86 |
$595.86 |
$595.86 |
$402.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.33 |
$6.33 |
$6.33 |
$17.75
|
|
Dis site tele svcs rhc/fqhc
|
$70.15 |
$70.15 |
$70.15 |
$94.80
|
|
#d/lmeth-l-methamphetamine
|
$6.90 |
$6.90 |
$6.90 |
$72.14
|
|
Dmd dup/delet analysis
|
$215.05 |
$215.05 |
$215.05 |
$404.03
|
|
Dmpk gene detc abnor allele
|
$172.50 |
$172.50 |
$172.50 |
$313.60
|
|
Dna antibody native/double stranded
|
$23.69 |
$23.69 |
$23.69 |
$95.80
|
|
Dna gardnerella
|
$34.50 |
$34.50 |
$34.50 |
$62.50
|
|
Dna probe chlamydia
|
$34.50 |
$34.50 |
$34.50 |
$79.38
|
|
Dna probe gc
|
$34.50 |
$34.50 |
$34.50 |
$80.80
|
|
Dna trichomonas
|
$34.50 |
$34.50 |
$34.50 |
$67.80
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$11.13 |
$11.13 |
$11.13 |
$65.40
|
|
Doppler echo complete
|
$220.11 |
$220.11 |
$220.11 |
$531.50
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$247.71 |
$247.71 |
$247.71 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$225.17 |
$225.17 |
$225.17 |
$470.05
|
|
Dpyd gene common variants
|
$220.11 |
$220.11 |
$220.11 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$65.32 |
$65.32 |
$65.32 |
$800.00
|
|
Drainage external ear complex 69005
|
$663.32 |
$663.32 |
$663.32 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$55.89 |
$55.89 |
$55.89 |
$789.60
|
|
Drainage mouth roof lesion
|
$144.67 |
$144.67 |
$144.67 |
$390.39
|
|
Drainage of arm bursa 23931
|
$663.32 |
$663.32 |
$663.32 |
$2,197.48
|
|
Drainage of urethra abscess 53060
|
$860.89 |
$860.89 |
$860.89 |
$2,424.12
|
|
Drain blood from under nail 11740
|
$40.25 |
$40.25 |
$40.25 |
$171.20
|
|
Drain cerebro spinal fluid 62272
|
$356.96 |
$356.96 |
$356.96 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$128.34 |
$128.34 |
$128.34 |
$424.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$224.02 |
$224.02 |
$224.02 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$74.52 |
$74.52 |
$74.52 |
$345.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$100.28 |
$100.28 |
$100.28 |
$523.00
|
|
Drill hole implt ventricular cath/device 61107
|
$262.20 |
$262.20 |
$262.20 |
$1,515.00
|
|
Drng of eyelid abscess 67700
|
$201.94 |
$201.94 |
$201.94 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$696.44 |
$696.44 |
$696.44 |
$1,943.50
|
|
Drng of hydrocele 55000
|
$283.13 |
$283.13 |
$283.13 |
$832.60
|
|
Drng of scrotum abscess 55100
|
$349.60 |
$349.60 |
$349.60 |
$1,935.96
|
|
Droperidol 2.5 mg/ml injection solution
|
$19.80 |
$19.80 |
$19.80 |
$31.07
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$2.99 |
$2.99 |
$2.99 |
$127.14
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$333.55 |
$333.55 |
$333.55 |
$8,040.27
|
|
Drug assay posaconazole
|
$20.93 |
$20.93 |
$20.93 |
$96.75
|
|
Drug assay rufinamide
|
$34.04 |
$34.04 |
$34.04 |
$85.80
|
|
Drug assay vedolizumab
|
$32.66 |
$32.66 |
$32.66 |
$152.79
|
|
Drug assay voriconazole
|
$34.04 |
$34.04 |
$34.04 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$14.49 |
$14.49 |
$14.49 |
$66.43
|
|
Drug of abuse screen urine
|
$18.86 |
$18.86 |
$18.86 |
$63.75
|
|
Drug screening tapentadol
|
$14.49 |
$14.49 |
$14.49 |
$36.00
|
|
Drug/substance nos 4-6
|
$17.02 |
$17.02 |
$17.02 |
$72.14
|
|
Drug test def 15-21 classes
|
$208.84 |
$208.84 |
$208.84 |
$263.25
|
|
Drug test def 1-7 classes
|
$100.74 |
$100.74 |
$100.74 |
$246.00
|
|
Drug test def 22+ classes
|
$270.94 |
$270.94 |
$270.94 |
$423.00
|
|
Drug test def 8-14 classes
|
$155.02 |
$155.02 |
$155.02 |
$282.00
|
|
Drug test prsmv instrmnt
|
$25.07 |
$25.07 |
$25.07 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$100.51 |
$100.51 |
$100.51 |
$278.85
|
|
Drvvt confirm - quest
|
$15.41 |
$15.41 |
$15.41 |
$109.20
|
|
Dstrj nulyt agt gnclr nrv
|
$816.04 |
$816.04 |
$816.04 |
$3,020.80
|
|
Dstr mal les s/n/h/f/g >4.0
|
$132.02 |
$132.02 |
$132.02 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$109.25 |
$109.25 |
$109.25 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$120.06 |
$120.06 |
$120.06 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$132.02 |
$132.02 |
$132.02 |
$849.50
|
|
Dup scan/hemodialysis access 93990
|
$225.17 |
$225.17 |
$225.17 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$225.17 |
$225.17 |
$225.17 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$337.87 |
$337.87 |
$337.87 |
$887.25
|
|
Dxa bone density axl vrt fx
|
$62.79 |
$62.79 |
$62.79 |
$392.60
|
|
Dx bronchoscope/brush 31623
|
$696.90 |
$696.90 |
$696.90 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$769.58 |
$769.58 |
$769.58 |
$2,369.64
|
|
Dx bronchoscope/wash 31622
|
$521.18 |
$521.18 |
$521.18 |
$2,322.60
|
|
Ear irrigation 69209
|
$47.38 |
$47.38 |
$47.38 |
$150.00
|
|
Ecg 12 lead tracing only
|
$69.69 |
$69.69 |
$69.69 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$242.65 |
$242.65 |
$242.65 |
$135.80
|
|
Ecg external < 48 hours recording
|
$242.65 |
$242.65 |
$242.65 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$242.65 |
$242.65 |
$242.65 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$158.93 |
$158.93 |
$158.93 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$158.93 |
$158.93 |
$158.93 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$439.99 |
$439.99 |
$439.99 |
$2,020.00
|
|
Echocardiography doppler color flow mapping
|
$110.17 |
$110.17 |
$110.17 |
$467.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$172.04 |
$172.04 |
$172.04 |
$705.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$284.05 |
$284.05 |
$284.05 |
$851.50
|