|
Dentoalveolar/drain abs/cyst/hema 41800
|
$217.20 |
$217.20 |
$217.20 |
$414.78
|
|
Deodorant ostmy adapt lube 8ml
|
$1.98 |
$1.98 |
$1.98 |
$1.98
|
|
Depo-estradiol cypionate inj
|
$16.04 |
$16.04 |
$16.04 |
$69.99
|
|
Dermagraft
|
$193.11 |
$193.11 |
$193.11 |
$85.00
|
|
Dermapure 1 square cm
|
$608.85 |
$608.85 |
$608.85 |
$1,915.73
|
|
Desmopressin 4 mcg/ml injection solution
|
$68.79 |
$68.79 |
$68.79 |
$74.09
|
|
Destroy cervthor facet jnt 64633
|
$3,138.15 |
$3,138.15 |
$3,138.15 |
$2,998.30
|
|
Destroy cth facet jnt addl 64634
|
$1,569.15 |
$1,569.15 |
$1,569.15 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$226.20 |
$226.20 |
$226.20 |
$199.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,569.15 |
$1,569.15 |
$1,569.15 |
$1,626.95
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,138.15 |
$3,138.15 |
$3,138.15 |
$3,148.11
|
|
Device ablt adv novasure
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,867.20 |
$4,867.20 |
$4,867.20 |
$4,285.86
|
|
Device intraute mirena
|
$2,236.07 |
$2,236.07 |
$2,236.07 |
$2,161.20
|
|
Device sut capio slim opn
|
$1,894.50 |
$1,894.50 |
$1,894.50 |
$1,936.74
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$143.25 |
$143.25 |
$143.25 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$33.77 |
$33.77 |
$33.77 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$20.52 |
$20.52 |
$20.52 |
$22.05
|
|
Dexmedetomidine film, 1 mcg
|
$56.70 |
$56.70 |
$56.70 |
$171.39
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,086.05 |
$1,086.05 |
$1,086.05 |
$842.88
|
|
Dextran 40 infusion
|
$100.80 |
$100.80 |
$100.80 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$35.57
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$30.00 |
$30.00 |
$30.00 |
$42.32
|
|
Dhea-s (dehydroepiand sulfate)
|
$82.95 |
$82.95 |
$82.95 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$133.20 |
$133.20 |
$133.20 |
$79.30
|
|
Diab manage trn ind/group
|
$84.00 |
$84.00 |
$84.00 |
$57.75
|
|
Diab shoe for density insert
|
$147.56 |
$147.56 |
$147.56 |
$147.56
|
|
Diagnostic anoscopy spx 46600
|
$136.80 |
$136.80 |
$136.80 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$163.35 |
$163.35 |
$163.35 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$163.05 |
$163.05 |
$163.05 |
$367.50
|
|
Diagnostic Mammogram (both breasts)
|
$366.15 |
$366.15 |
$366.15 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$366.15 |
$366.15 |
$366.15 |
$310.00
|
|
Dialysis one evaluation
|
$2,127.45 |
$2,127.45 |
$2,127.45 |
$842.10
|
|
Dialysis repeated eval
|
$2,195.40 |
$2,195.40 |
$2,195.40 |
$1,087.50
|
|
Diatrizoate meglumine 18 % urethral solution
|
$900.00 |
$900.00 |
$900.00 |
$114.18
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$84.83 |
$84.83 |
$84.83 |
$74.02
|
|
Dicyclomine injection
|
$90.79 |
$90.79 |
$90.79 |
$157.16
|
|
Diffusing capacity
|
$159.45 |
$159.45 |
$159.45 |
$331.76
|
|
Digital analysis of eeg
|
$407.40 |
$407.40 |
$407.40 |
$605.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$297.50 |
$297.50 |
$297.50 |
$69.88
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,553.01 |
$4,553.01 |
$4,553.01 |
$8,843.78
|
|
Digoxin total therapeutic drug level
|
$284.70 |
$284.70 |
$284.70 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$322.92 |
$322.92 |
$322.92 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$3,895.65 |
$3,895.65 |
$3,895.65 |
$1,924.05
|
|
Dilate esophagus 1/mult pass
|
$562.65 |
$562.65 |
$562.65 |
$1,484.17
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$7,703.40 |
$7,703.40 |
$7,703.40 |
$3,641.30
|
|
Dilate ic vasospasm ea add vsl same territory
|
$7,703.40 |
$7,703.40 |
$7,703.40 |
$1,950.85
|
|
Dilate ic vasospasm init
|
$12,849.75 |
$12,849.75 |
$12,849.75 |
$5,741.00
|
|
Dilation/urethral strict/male/ini 53620
|
$1,600.35 |
$1,600.35 |
$1,600.35 |
$1,386.89
|
|
Dilator fascial 10fx20cm
|
$596.68 |
$596.68 |
$596.68 |
$402.10
|
|
Dimenhydrinate injection
|
$31.55 |
$31.55 |
$31.55 |
$30.48
|
|
Dimethyl sulfoxide 50% 50 ml
|
$27.53 |
$27.53 |
$27.53 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$17.38
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$151.14 |
$151.14 |
$151.14 |
$98.15
|
|
Disability dlco
|
$132.60 |
$132.60 |
$132.60 |
$280.00
|
|
Disaccharidases
|
$642.75 |
$642.75 |
$642.75 |
$203.08
|
|
Dissolve clot heart vessel
|
$2,139.30 |
$2,139.30 |
$2,139.30 |
$1,623.17
|
|
Division of fallopian tube 58605
|
$2,714.25 |
$2,714.25 |
$2,714.25 |
$832.00
|
|
Dna antibody native/double stranded
|
$164.55 |
$164.55 |
$164.55 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$100.80 |
$100.80 |
$100.80 |
$99.10
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,105.40 |
$1,105.40 |
$1,105.40 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$57.75 |
$57.75 |
$57.75 |
$65.00
|
|
Doppler echo complete
|
$963.30 |
$963.30 |
$963.30 |
$557.05
|
|
Doppler intravascular pressure flow initial vessel
|
$2,781.60 |
$2,781.60 |
$2,781.60 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$849.60 |
$849.60 |
$849.60 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$791.40 |
$791.40 |
$791.40 |
$476.45
|
|
Dornhoffer fixed part w/window
|
$34,278.00 |
$34,278.00 |
$34,278.00 |
$34,278.00
|
|
Dorsi & plantar flex ass/res
|
$163.50 |
$163.50 |
$163.50 |
$163.50
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$526.65 |
$526.65 |
$526.65 |
$433.58
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,312.74 |
$1,312.74 |
$1,312.74 |
$1,718.24
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$914.34
|
|
Drainage external ear complex 69005
|
$2,428.35 |
$2,428.35 |
$2,428.35 |
$2,809.25
|
|
Drainage external ear simple 69000
|
$631.80 |
$631.80 |
$631.80 |
$789.60
|
|
Drainage mouth roof lesion
|
$286.50 |
$286.50 |
$286.50 |
$405.60
|
|
Drainage of arm bursa 23931
|
$1,611.00 |
$1,611.00 |
$1,611.00 |
$2,362.62
|
|
Drainage of kidney lesion
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$1,534.80
|
|
Drainage of mouth lesion
|
$3,261.15 |
$3,261.15 |
$3,261.15 |
$3,848.00
|
|
Drainage of nose lesion int 30000
|
$424.80 |
$424.80 |
$424.80 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$462.15 |
$462.15 |
$462.15 |
$781.44
|
|
Drainage of urethra abscess 53060
|
$3,933.90 |
$3,933.90 |
$3,933.90 |
$2,424.12
|
|
Drain blood from under nail 11740
|
$97.35 |
$97.35 |
$97.35 |
$173.21
|
|
Drain cath image guided visceral pq
|
$3,207.15 |
$3,207.15 |
$3,207.15 |
$2,881.20
|
|
Drain cerebro spinal fluid 62272
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$258.15 |
$258.15 |
$258.15 |
$442.00
|
|
Drain lower leg lesion 27603
|
$4,191.30 |
$4,191.30 |
$4,191.30 |
$3,994.09
|
|
Drain neck/chest lesion 21501
|
$1,689.60 |
$1,689.60 |
$1,689.60 |
$3,334.38
|
|
Drain ostomy pouch w/flange
|
$7.86 |
$7.86 |
$7.86 |
$8.80
|
|
Drain thigh/knee lesion 27301
|
$4,191.30 |
$4,191.30 |
$4,191.30 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$235.35 |
$235.35 |
$235.35 |
$397.15
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$235.35 |
$235.35 |
$235.35 |
$359.20
|
|
Dress/debrid prtl-thick burn l 16030
|
$449.25 |
$449.25 |
$449.25 |
$530.40
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$388.88 |
$388.88 |
$388.88 |
$6,438.00
|
|
Drng hand tendon sheath 26020
|
$1,924.65 |
$1,924.65 |
$1,924.65 |
$3,958.50
|
|
Drng of eyelid abscess 67700
|
$360.45 |
$360.45 |
$360.45 |
$684.95
|
|
Drng of finger abscess comp 26011
|
$1,051.50 |
$1,051.50 |
$1,051.50 |
$1,917.33
|
|
Drng of pelvic abscess transrectal 45000
|
$2,635.50 |
$2,635.50 |
$2,635.50 |
$1,645.43
|
|
Drng of scrotum abscess 55100
|
$1,051.50 |
$1,051.50 |
$1,051.50 |
$1,956.40
|
|
Drng open subdiaphragmatic/subphrenic absc 49040
|
$2,068.50 |
$2,068.50 |
$2,068.50 |
$1,890.00
|