|
Device intraute mirena
|
$2,082.22 |
$2,082.22 |
$2,236.07 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,894.50 |
$1,894.50 |
$1,894.50 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,541.00 |
$2,541.00 |
$2,541.00 |
$2,515.00
|
|
Dev interrog remote 1/2/mlt
|
$127.80 |
$127.80 |
$127.80 |
$115.20
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$203.19 |
$203.19 |
$203.19 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$143.25 |
$143.25 |
$220.43 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$33.77 |
$33.77 |
$85.86 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$20.52 |
$20.52 |
$27.00 |
$20.76
|
|
Dexmedetomidine film, 1 mcg
|
$56.70 |
$56.70 |
$56.70 |
$171.39
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,086.05 |
$1,086.05 |
$1,268.38 |
$884.80
|
|
Dextran 40 infusion
|
$100.80 |
$100.80 |
$151.20 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$28.80 |
$28.80 |
$30.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$28.80 |
$28.80 |
$30.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$30.00 |
$30.00 |
$31.32 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$28.80 |
$28.80 |
$28.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$82.95 |
$82.95 |
$157.70 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$111.51 |
$111.51 |
$133.20 |
$79.30
|
|
Diabetes training group per 30 min g0109
|
$32.81 |
$32.81 |
$32.81 |
$35.43
|
|
Diab manage trn ind/group
|
$59.36 |
$59.36 |
$84.00 |
$54.99
|
|
Diab shoe for density insert
|
$147.56 |
$147.56 |
$147.56 |
$147.56
|
|
Diagnostic anoscopy spx 46600
|
$136.80 |
$136.80 |
$358.84 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$117.94 |
$117.94 |
$117.94 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$75.93 |
$75.93 |
$75.93 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$163.35 |
$163.35 |
$325.51 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$163.05 |
$163.05 |
$450.28 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$340.20 |
$340.20 |
$366.15 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$272.16 |
$272.16 |
$366.15 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$99.90 |
$99.90 |
$2,679.11 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$10,842.14 |
$10,842.14 |
$10,842.14 |
$5,741.00
|
|
Dialysis one evaluation
|
$1,775.84 |
$1,775.84 |
$2,127.45 |
$936.00
|
|
Dialysis repeated eval
|
$1,087.50 |
$1,087.50 |
$2,195.40 |
$1,332.80
|
|
Diatrizoate meglumine 18 % urethral solution
|
$149.04 |
$149.04 |
$900.00 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$84.83 |
$84.83 |
$135.30 |
$79.71
|
|
Dicyclomine injection
|
$90.79 |
$90.79 |
$229.36 |
$154.33
|
|
Diffusing capacity
|
$159.45 |
$159.45 |
$395.37 |
$336.80
|
|
Digital analysis of eeg
|
$407.40 |
$407.40 |
$744.70 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$297.50 |
$297.50 |
$371.87 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,553.01 |
$4,553.01 |
$8,613.00 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$140.84 |
$140.84 |
$284.70 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$322.92 |
$322.92 |
$357.05 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,866.73 |
$1,866.73 |
$3,895.65 |
$1,866.73
|
|
Dilate esophagus
|
$1,641.50 |
$1,641.50 |
$1,641.50 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$562.65 |
$562.65 |
$1,484.17 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$4,322.56 |
$4,322.56 |
$4,322.56 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$1,670.90 |
$1,670.90 |
$1,670.90 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$9,260.60 |
$9,260.60 |
$9,260.60 |
$5,151.95
|
|
Dilate urethra stricture
|
$514.79 |
$514.79 |
$577.80 |
$513.00
|
|
Dilate urethra stricture
|
$3,745.07 |
$3,745.07 |
$3,745.07 |
$3,863.60
|
|
Dilation/female urethra/initial 53660
|
$204.60 |
$204.60 |
$204.60 |
$235.61
|
|
Dilation of cervical canal 57800
|
$4,715.67 |
$4,715.67 |
$4,715.67 |
$4,446.00
|
|
Dilation/urethral strict/male/ini 53620
|
$1,386.89 |
$1,386.89 |
$1,600.35 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$596.68 |
$596.68 |
$1,277.43 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$7,694.84 |
$7,694.84 |
$7,694.84 |
$3,900.60
|
|
Diltiazem 5 mg/ml intravenous solution
|
$138.24 |
$138.24 |
$138.24 |
$45.60
|
|
Dimecaprol injection
|
$457.03 |
$457.03 |
$457.03 |
$314.63
|
|
Dimenhydrinate injection
|
$31.55 |
$31.55 |
$31.55 |
$30.48
|
|
Dimethyl sulfoxide 50% 50 ml
|
$27.53 |
$27.53 |
$1,258.20 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$10.84 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$151.14 |
$151.14 |
$151.14 |
$98.15
|
|
Disability dlco
|
$132.60 |
$132.60 |
$356.06 |
$293.76
|
|
Disaccharidases
|
$338.63 |
$338.63 |
$642.75 |
$230.40
|
|
Discography cerv/thor spine
|
$2,050.91 |
$2,050.91 |
$2,050.91 |
$2,565.00
|
|
Dise eval slp do brth flx dx
|
$244.89 |
$244.89 |
$244.89 |
$1,120.00
|
|
Dissolve clot heart vessel
|
$2,139.30 |
$2,139.30 |
$2,604.47 |
$1,579.93
|
|
Division of fallopian tube 58605
|
$2,714.25 |
$2,714.25 |
$2,714.25 |
$976.50
|
|
Dlyd plmt xtn prosth ea addl
|
$1,380.35 |
$1,380.35 |
$1,380.35 |
$1,810.80
|
|
Dmpk gene detc abnor allele
|
$7,487.95 |
$7,487.95 |
$7,487.95 |
$313.60
|
|
Dna antibody native/double stranded
|
$141.17 |
$141.17 |
$164.55 |
$100.00
|
|
Dna gardnerella
|
$61.20 |
$61.20 |
$61.20 |
$61.83
|
|
Dna probe chlamydia
|
$114.48 |
$114.48 |
$114.48 |
$82.20
|
|
Dna probe gc
|
$101.97 |
$101.97 |
$101.97 |
$79.38
|
|
Dna trichomonas
|
$63.00 |
$63.00 |
$63.00 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$100.80 |
$100.80 |
$146.40 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,105.40 |
$1,105.40 |
$1,290.00 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$57.75 |
$57.75 |
$76.20 |
$65.40
|
|
Doppler echo complete
|
$938.80 |
$938.80 |
$963.30 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$2,781.60 |
$2,781.60 |
$3,563.60 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$849.60 |
$849.60 |
$881.26 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$608.33 |
$608.33 |
$791.40 |
$481.65
|
|
Dornase alfa non-comp unit
|
$350.67 |
$350.67 |
$350.67 |
$356.00
|
|
Dornhoffer fixed part w/window
|
$34,278.00 |
$34,278.00 |
$50,985.00 |
$34,278.00
|
|
Dorsi & plantar flex ass/res
|
$163.50 |
$163.50 |
$163.50 |
$163.44
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$20,843.62 |
$20,843.62 |
$20,843.62 |
$23,613.78
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$526.65 |
$526.65 |
$740.18 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,312.74 |
$1,312.74 |
$2,278.13 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$97.79 |
$97.79 |
$97.79 |
$89.34
|
|
Dpyd gene common variants
|
$851.19 |
$851.19 |
$851.19 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$866.92 |
$866.92 |
$1,053.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,053.00 |
$1,053.00 |
$3,325.73 |
$964.00
|
|
Drainage external ear complex 69005
|
$2,428.35 |
$2,428.35 |
$3,541.97 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$631.80 |
$631.80 |
$984.69 |
$790.40
|
|
Drainage mouth roof lesion
|
$286.50 |
$286.50 |
$641.66 |
$405.60
|
|
Drainage of arm bursa 23931
|
$1,611.00 |
$1,611.00 |
$3,155.93 |
$2,271.01
|
|
Drainage of eye
|
$1,824.02 |
$1,824.02 |
$1,824.02 |
$2,415.65
|
|
Drainage of kidney lesion
|
$1,053.00 |
$1,053.00 |
$1,719.93 |
$1,506.00
|
|
Drainage of mouth lesion
|
$1,576.20 |
$1,576.20 |
$1,576.20 |
$535.20
|
|
Drainage of mouth lesion
|
$3,021.62 |
$3,021.62 |
$3,021.62 |
$2,320.03
|
|
Drainage of mouth lesion
|
$2,295.40 |
$2,295.40 |
$3,261.15 |
$3,837.72
|
|
Drainage of mouth lesion
|
$583.82 |
$583.82 |
$583.82 |
$905.30
|
|
Drainage of mouth lesion
|
$6,781.90 |
$6,781.90 |
$6,781.90 |
$6,781.90
|
