|
Debride/subq tissue/ea add 20sq cm 11045
|
$489.56 |
$489.56 |
$489.56 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$538.44 |
$538.44 |
$538.44 |
|
|
Decalcification
|
$51.62 |
$51.62 |
$51.62 |
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$359.58 |
$359.58 |
$359.58 |
|
|
Deferoxamine 500 mg solution for injection
|
$20.33 |
$20.33 |
$20.33 |
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$54.38 |
$54.38 |
$54.38 |
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$60.74 |
$128.94 |
$130.50 |
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$63.98 |
$63.98 |
$67.19 |
|
|
Depo-estradiol cypionate inj
|
$87.27 |
$87.27 |
$87.27 |
|
|
Design mlc device for imrt
|
$997.56 |
$997.56 |
$997.56 |
|
|
Desmopressin 4 mcg/ml injection solution
|
$43.59 |
$43.59 |
$43.59 |
|
|
Detect agnt mult dna direc
|
$166.77 |
$166.77 |
$166.77 |
|
|
Developmental screen/score/document 96110
|
$189.75 |
$199.26 |
$199.26 |
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,262.37 |
$3,262.37 |
$3,996.00 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$69.42 |
$69.42 |
$69.42 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.53 |
$1.61 |
$1.61 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$504.81 |
$504.81 |
$504.81 |
|
|
Dextran 40 infusion
|
$83.91 |
$83.91 |
$83.91 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$46.35 |
$46.35 |
$46.35 |
|
|
Dextrose 5 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$71.87 |
$71.87 |
$71.87 |
|
|
Diabetes (HbA1c) Test
|
$41.96 |
$41.96 |
$71.00 |
|
|
Diab manage trn ind/group
|
$36.50 |
$36.50 |
$36.50 |
|
|
Diag bronchoscope/catheter
|
$1,345.43 |
$1,345.43 |
$1,345.43 |
|
|
Diagnostic anoscopy spx 46600
|
$426.99 |
$426.99 |
$426.99 |
|
|
Diagnostic laryngoscopy 31505
|
$132.83 |
$132.84 |
$132.84 |
|
|
Diagnostic laryngoscopy 31575
|
$585.17 |
$585.17 |
$585.17 |
|
|
Diagnostic Mammogram (both breasts)
|
$244.26 |
$244.26 |
$244.26 |
|
|
Diagnostic Mammogram (one breast)
|
$215.58 |
$215.58 |
$215.58 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$7,822.05 |
$7,822.05 |
$7,822.05 |
|
|
Dialysis one evaluation
|
$753.99 |
$753.99 |
$855.18 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.39 |
$0.39 |
$0.39 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$10.77 |
$10.77 |
$10.77 |
|
|
Dicyclomine injection
|
$180.66 |
$180.66 |
$180.66 |
|
|
Diffusing capacity
|
$263.46 |
$263.46 |
$263.46 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$11.82 |
$11.82 |
$296.01 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$10,279.62 |
$10,279.62 |
$10,279.62 |
|
|
Digoxin total therapeutic drug level
|
$44.45 |
$44.45 |
$44.45 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$321.30 |
$321.30 |
$321.30 |
|
|
Dilate biliary duct/ampulla
|
$1,345.59 |
$1,345.59 |
$1,345.59 |
|
|
Dilate esophagus
|
$758.39 |
$758.39 |
$758.39 |
|
|
Dilate esophagus 1/mult pass
|
$840.86 |
$840.86 |
$895.29 |
|
|
Dilation of rectal stricture 45910
|
$2,659.16 |
$2,659.16 |
$2,659.16 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,493.66 |
$1,493.66 |
$1,493.66 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$4.64 |
$4.64 |
$4.64 |
|
|
Disability dlco
|
$194.73 |
$204.50 |
$289.08 |
|
|
Disaccharidases
|
$247.73 |
$247.73 |
$247.73 |
|
|
Discography cerv/thor spine
|
$725.16 |
$725.16 |
$725.16 |
|
|
Dna antibody native/double stranded
|
$36.84 |
$36.84 |
$36.84 |
|
|
Dna trichomonas
|
$55.58 |
$55.58 |
$55.58 |
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$16.53 |
$16.53 |
$16.53 |
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$32.70 |
$32.70 |
$32.70 |
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$2.97 |
$2.97 |
$2.97 |
|
|
Doppler echo complete
|
$351.80 |
$689.00 |
$689.00 |
|
|
Doppler intravascular pressure flow initial vessel
|
$582.05 |
$582.05 |
$582.05 |
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$272.96 |
$272.97 |
$347.09 |
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$272.97 |
$272.97 |
$347.09 |
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$15.05 |
$15.05 |
$15.05 |
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$723.86 |
$723.86 |
$723.86 |
|
|
Drainage of kidney lesion
|
$1,179.68 |
$1,179.68 |
$1,179.68 |
|
|
Drainage of rectal abscess
|
$1,636.65 |
$1,636.65 |
$1,636.65 |
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,587.32 |
$1,587.32 |
$1,587.32 |
|
|
Drain cath image guided visceral pq
|
$1,587.32 |
$1,587.32 |
$1,587.32 |
|
|
Drain lower leg lesion 27603
|
$1,765.02 |
$1,765.02 |
$1,765.02 |
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$165.56 |
$165.56 |
$165.56 |
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$159.72 |
$159.72 |
$159.72 |
|
|
Droperidol 2.5 mg/ml injection solution
|
$22.86 |
$22.86 |
$22.86 |
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$28.95 |
$28.95 |
$28.95 |
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$31.34 |
$31.34 |
$31.34 |
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$276.84 |
$323.00 |
$3,163.50 |
|
|
Drug admin & hemodynmic meas
|
$6,066.62 |
$6,066.62 |
$6,066.62 |
|
|
Drug assay voriconazole
|
$466.46 |
$466.46 |
$466.46 |
|
|
Drug test def 15-21 classes
|
$96.39 |
$96.39 |
$96.39 |
|
|
Drug test def 1-7 classes
|
$416.19 |
$416.19 |
$416.19 |
|
|
Drug test def 8-14 classes
|
$48.93 |
$48.93 |
$96.39 |
|
|
Drug test prsmv instrmnt
|
$58.79 |
$58.79 |
$58.79 |
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$495.35 |
$495.35 |
$495.36 |
|
|
Drvvt confirm - quest
|
$101.66 |
$101.66 |
$101.66 |
|
|
Ductogram sgl duct
|
$186.77 |
$186.77 |
$186.77 |
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$246.02 |
$293.79 |
$293.79 |
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$384.66 |
$384.66 |
$570.89 |
|
|
Durvalumab 50 mg/ml intravenous solution
|
$177.44 |
$177.44 |
$177.44 |
|
|
Dx bronchoscope/brush 31623
|
$1,739.00 |
$1,860.63 |
$1,860.63 |
|
|
Dx bronchoscope/lavage 31624
|
$1,739.00 |
$1,860.63 |
$1,860.63 |
|
|
Dx bronchoscope/wash 31622
|
$1,739.00 |
$1,860.63 |
$1,860.63 |
|
|
Ecg 12 lead tracing only
|
$106.86 |
$106.86 |
$106.86 |
|
|
Ecg/1-3 leads/tracing only 93041
|
$106.85 |
$106.85 |
$106.85 |
|
|
Ecg external < 48 hours recording
|
$377.12 |
$395.99 |
$395.99 |
|
|
Ecg external < 48 hours scanning analysis w/report
|
$588.86 |
$589.04 |
$589.04 |
|
|
Echocardiogram (Heart Ultrasound)
|
$1,221.23 |
$1,221.23 |
$1,618.32 |
|
|
Echocardiography doppler color flow mapping
|
$336.15 |
$336.15 |
$336.15 |
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,376.90 |
$1,376.90 |
$1,738.13 |
|
|
Echocardiography transthoracic 2d followup/limited
|
$489.71 |
$489.71 |
$556.50 |
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,108.32 |
$1,108.32 |
$1,108.32 |
|
|
Echocardiograpy doppler follow up/limited study
|
$313.40 |
$313.40 |
$313.40 |
|
|
Echo exam uterus 76831-
|
$361.50 |
$361.50 |
$361.50 |
|
|
Echograp trans r pros study
|
$241.58 |
$241.58 |
$253.65 |
|
|
Echo guidance radiotherapy
|
$247.55 |
$247.55 |
$247.55 |
|
|
Echo guide for amniocentesis
|
$163.43 |
$163.43 |
$163.43 |
|
|
Echo stress
|
$902.61 |
$902.61 |
$902.61 |
|