|
Declotting thrombolytic agent implanted vas access device 36
|
$172.94 |
$172.94 |
$172.94 |
$534.80
|
|
Degarelix 120 mg subcutaneous solution
|
$685.79 |
$685.79 |
$685.79 |
$1,963.06
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$183.75 |
$183.75 |
$183.75 |
$193.05
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,304.05 |
$2,304.05 |
$2,304.05 |
$7,933.81
|
|
Dermagraft
|
$1,178.50 |
$1,178.50 |
$1,178.50 |
$383.00
|
|
Design mlc device for imrt
|
$2,198.79 |
$2,198.79 |
$2,198.79 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$64.68 |
$64.68 |
$64.68 |
$111.80
|
|
Detect agnt mult dna direc
|
$60.17 |
$60.17 |
$60.17 |
$109.60
|
|
Device tiss remov myosure reach
|
$1,449.79 |
$1,449.79 |
$1,449.79 |
$2,229.99
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$36.05 |
$36.05 |
$36.05 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$2.71 |
$2.71 |
$2.71 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$10.29 |
$10.29 |
$10.29 |
$26.80
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$551.88 |
$551.88 |
$551.88 |
$506.33
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$23.97 |
$23.97 |
$23.97 |
$57.07
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$23.83 |
$23.83 |
$23.83 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$23.60 |
$23.60 |
$23.60 |
$49.75
|
|
Dhea-s (dehydroepiand sulfate)
|
$43.75 |
$43.75 |
$43.75 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$44.10 |
$44.10 |
$44.10 |
$78.40
|
|
Diagnostic anoscopy spx 46600
|
$95.13 |
$95.13 |
$95.13 |
$242.45
|
|
Diagnostic laryngoscopy 31575
|
$806.05 |
$806.05 |
$806.05 |
$381.00
|
|
Diagnostic Mammogram (both breasts)
|
$815.15 |
$815.15 |
$815.15 |
$421.26
|
|
Diagnostic Mammogram (one breast)
|
$537.95 |
$537.95 |
$537.95 |
$297.05
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$36.75 |
$36.75 |
$36.75 |
$72.34
|
|
Dicyclomine injection
|
$87.47 |
$87.47 |
$87.47 |
$211.68
|
|
Diffusing capacity
|
$103.64 |
$103.64 |
$103.64 |
$360.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$10.66 |
$10.66 |
$10.66 |
$66.86
|
|
Digoxin total therapeutic drug level
|
$98.35 |
$98.35 |
$98.35 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$156.12 |
$156.12 |
$156.12 |
$321.30
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$7.89 |
$7.89 |
$7.89 |
$2.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$5.88 |
$5.88 |
$5.88 |
$25.12
|
|
Disaccharidases
|
$32.13 |
$32.13 |
$32.13 |
$224.31
|
|
Discography cerv/thor spine
|
$936.81 |
$936.81 |
$936.81 |
$2,344.44
|
|
Dna antibody native/double stranded
|
$135.45 |
$135.45 |
$135.45 |
$102.60
|
|
Dna probe chlamydia
|
$40.35 |
$40.35 |
$40.35 |
$82.20
|
|
Dna probe gc
|
$40.84 |
$40.84 |
$40.84 |
$88.67
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$68.43 |
$68.43 |
$68.43 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,314.32 |
$1,314.32 |
$1,314.32 |
$771.27
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$40.90 |
$40.90 |
$40.90 |
$79.61
|
|
Doppler echo complete
|
$358.79 |
$358.79 |
$358.79 |
$608.25
|
|
Doppler intravascular pressure flow initial vessel
|
$34.02 |
$34.02 |
$34.02 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$848.75 |
$848.75 |
$848.75 |
$697.66
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$543.20 |
$543.20 |
$543.20 |
$495.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$50.08 |
$50.08 |
$50.08 |
$279.10
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$79.14 |
$79.14 |
$79.14 |
$2,469.31
|
|
Drainage of kidney lesion
|
$438.80 |
$438.80 |
$438.80 |
$1,619.40
|
|
Drain cerebro spinal fluid 62272
|
$443.84 |
$443.84 |
$443.84 |
$1,113.06
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$252.81 |
$252.81 |
$252.81 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$246.40 |
$246.40 |
$246.40 |
$365.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$504.09 |
$504.09 |
$504.09 |
$540.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$8.41 |
$8.41 |
$8.41 |
$39.60
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$6,470.83 |
$6,470.83 |
$6,470.83 |
$2,567.36
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$2,995.28 |
$2,995.28 |
$2,995.28 |
$318.13
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$1,702.28 |
$1,702.28 |
$1,702.28 |
$5,041.36
|
|
Drug admin & hemodynmic meas
|
$378.32 |
$378.32 |
$378.32 |
$528.50
|
|
Drug assay voriconazole
|
$104.30 |
$104.30 |
$104.30 |
$96.75
|
|
Drug test def 15-21 classes
|
$101.50 |
$101.50 |
$101.50 |
$142.17
|
|
Drug test def 1-7 classes
|
$250.95 |
$250.95 |
$250.95 |
$263.86
|
|
Drug test def 22+ classes
|
$28.70 |
$28.70 |
$28.70 |
$246.92
|
|
Drug test def 8-14 classes
|
$58.10 |
$58.10 |
$58.10 |
$172.25
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$133.00 |
$133.00 |
$133.00 |
$280.11
|
|
Drvvt confirm - quest
|
$18.27 |
$18.27 |
$18.27 |
$101.66
|
|
Dup scan/hemodialysis access 93990
|
$314.37 |
$314.37 |
$314.37 |
$499.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$755.30 |
$755.30 |
$755.30 |
$759.85
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$445.20 |
$445.20 |
$445.20 |
$890.55
|
|
Durvalumab 50 mg/ml intravenous solution
|
$3,357.42 |
$3,357.42 |
$3,357.42 |
$9,080.81
|
|
Ecg 12 lead tracing only
|
$289.10 |
$289.10 |
$289.10 |
$245.30
|
|
Ecg/1-3 leads/tracing only 93041
|
$199.15 |
$199.15 |
$199.15 |
$129.83
|
|
Ecg external < 48 hours recording
|
$284.55 |
$284.55 |
$284.55 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$284.55 |
$284.55 |
$284.55 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$2,250.57 |
$2,250.57 |
$2,250.57 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$311.85 |
$311.85 |
$311.85 |
$463.45
|
|
Echocardiography transthoracic 2d followup/limited
|
$656.60 |
$656.60 |
$656.60 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$263.34 |
$263.34 |
$263.34 |
$353.46
|
|
Echo guide for amniocentesis
|
$282.56 |
$282.56 |
$282.56 |
$377.11
|
|
Echo guide for artery repair
|
$229.32 |
$229.32 |
$229.32 |
$680.28
|
|
Echo stress
|
$988.47 |
$988.47 |
$988.47 |
$1,586.90
|
|
Echo tee probe placement image acquisition interpretation & report
|
$845.40 |
$845.40 |
$845.40 |
$1,851.45
|
|
Echo transesophageal
|
$561.02 |
$561.02 |
$561.02 |
$913.33
|
|
Echo transesophageal
|
$294.84 |
$294.84 |
$294.84 |
$572.25
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$746.03 |
$746.03 |
$746.03 |
$1,011.36
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$250.11 |
$250.11 |
$250.11 |
$1,025.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$606.01 |
$606.01 |
$606.01 |
$861.12
|
|
Eeg recording awake and asleep
|
$586.90 |
$586.90 |
$586.90 |
$1,030.27
|
|
E equine encephalitis igg
|
$54.60 |
$54.60 |
$54.60 |
$48.73
|
|
Egfr gene com variants
|
$252.32 |
$252.32 |
$252.32 |
$615.57
|
|
Electrical stimulation/unattended 97014
|
$34.97 |
$34.97 |
$34.97 |
$82.20
|
|
Electrolyte panel
|
$78.28 |
$78.28 |
$78.28 |
$88.20
|
|
Electron microscopy diagnostic
|
$512.05 |
$512.05 |
$512.05 |
$981.50
|
|
Embo or occlude vascular arterial s&i
|
$6,489.00 |
$6,489.00 |
$6,489.00 |
$16,031.73
|
|
Embo or occlude vascular hemorrhage s&i
|
$4,178.48 |
$4,178.48 |
$4,178.48 |
$15,027.40
|
|
Embo or occlude vascular venous s&i
|
$3,793.23 |
$3,793.23 |
$3,793.23 |
$15,038.25
|
|
Emb without cervical dilation 58100
|
$60.48 |
$60.48 |
$60.48 |
$397.66
|
|
Endoluminl ivus oct c 1st
|
$2,412.55 |
$2,412.55 |
$2,412.55 |
$3,316.48
|
|
Endoluminl ivus oct c ea
|
$1,833.65 |
$1,833.65 |
$1,833.65 |
$2,294.50
|
|
Endovas iliac a device addon
|
$1,722.11 |
$1,722.11 |
$1,722.11 |
$1,764.36
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$1,821.78 |
$1,821.78 |
$1,821.78 |
$9,592.21
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$129.38 |
$129.38 |
$129.38 |
$121.63
|
|
Epoetin alfa, 100 units esrd
|
$961.85 |
$961.85 |
$961.85 |
$41.32
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$397.16 |
$397.16 |
$397.16 |
$884.44
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$517.88 |
$517.88 |
$517.88 |
$823.43
|
