|
Diagnostic anoscopy spx 46600
|
$97.20 |
$97.20 |
$97.20 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$149.40 |
$149.40 |
$149.40 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$433.80 |
$433.80 |
$433.80 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$340.80 |
$340.80 |
$340.80 |
$301.55
|
|
Dialysis one evaluation
|
$2,635.20 |
$2,635.20 |
$2,635.20 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$447.12 |
$447.12 |
$447.12 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$64.60 |
$64.60 |
$64.60 |
$74.76
|
|
Dicyclomine injection
|
$129.15 |
$129.15 |
$129.15 |
$153.29
|
|
Diffusing capacity
|
$642.60 |
$642.60 |
$642.60 |
$332.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$27,158.04 |
$27,158.04 |
$27,158.04 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$53.40 |
$53.40 |
$53.40 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$551.25 |
$551.25 |
$551.25 |
$297.86
|
|
Dilation of vagina
|
$9,743.46 |
$9,743.46 |
$9,743.46 |
$3,786.00
|
|
Dilation/urethral strict/male/ini 53620
|
$521.40 |
$521.40 |
$521.40 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$1,650.16 |
$1,650.16 |
$1,650.16 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$119.81 |
$119.81 |
$119.81 |
$47.94
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$48.00 |
$48.00 |
$48.00 |
$17.75
|
|
Dipyridamole injection
|
$117.02 |
$117.02 |
$117.02 |
$47.87
|
|
Disaccharidases
|
$114.60 |
$114.60 |
$114.60 |
$216.00
|
|
Dise eval slp do brth flx dx
|
$5,865.83 |
$5,865.83 |
$5,865.83 |
$1,120.00
|
|
Dist revas ligation hemo
|
$20,716.56 |
$20,716.56 |
$20,716.56 |
$6,396.89
|
|
Dmpk gene detc abnor allele
|
$431.40 |
$431.40 |
$431.40 |
$313.60
|
|
Dna antibody native/double stranded
|
$70.20 |
$70.20 |
$70.20 |
$97.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$409.50 |
$409.50 |
$409.50 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$207.38 |
$207.38 |
$207.38 |
$65.40
|
|
Doppler echo complete
|
$1,312.80 |
$1,312.80 |
$1,312.80 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$4,588.20 |
$4,588.20 |
$4,588.20 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$444.00 |
$444.00 |
$444.00 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$640.80 |
$640.80 |
$640.80 |
$471.17
|
|
Dornase alfa non-comp unit
|
$1,404.59 |
$1,404.59 |
$1,404.59 |
$446.75
|
|
Dornhoffer fixed part w/window
|
$133,874.25 |
$133,874.25 |
$133,874.25 |
$34,278.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$253.68 |
$253.68 |
$253.68 |
$84.80
|
|
Dpyd gene common variants
|
$669.60 |
$669.60 |
$669.60 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$541.20 |
$541.20 |
$541.20 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$541.20 |
$541.20 |
$541.20 |
$914.34
|
|
Drainage external ear complex 69005
|
$1,456.80 |
$1,456.80 |
$1,456.80 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$541.20 |
$541.20 |
$541.20 |
$789.60
|
|
Drainage mouth roof lesion
|
$174.00 |
$174.00 |
$174.00 |
$390.39
|
|
Drainage of arm bursa 23931
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$2,197.48
|
|
Drainage of mouth lesion
|
$962.40 |
$962.40 |
$962.40 |
$962.40
|
|
Drainage of rectal abscess
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$2,111.46
|
|
Drain blood from under nail 11740
|
$272.40 |
$272.40 |
$272.40 |
$170.50
|
|
Drain cath image guided visceral pq
|
$3,176.40 |
$3,176.40 |
$3,176.40 |
$2,850.35
|
|
Drain cerebro spinal fluid 62272
|
$1,105.80 |
$1,105.80 |
$1,105.80 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$603.60 |
$603.60 |
$603.60 |
$419.00
|
|
Drain neck/chest lesion 21501
|
$11,942.66 |
$11,942.66 |
$11,942.66 |
$3,339.00
|
|
Drain thigh/knee lesion 27301
|
$15,704.30 |
$15,704.30 |
$15,704.30 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$392.40 |
$392.40 |
$392.40 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$286.20 |
$286.20 |
$286.20 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$311.40 |
$311.40 |
$311.40 |
$523.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$64,500.72 |
$64,500.72 |
$64,500.72 |
$8,131.20
|
|
Drng of eyelid abscess 67700
|
$221.40 |
$221.40 |
$221.40 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$2,401.20 |
$2,401.20 |
$2,401.20 |
$1,943.50
|
|
Drng of scrotum abscess 55100
|
$3,495.60 |
$3,495.60 |
$3,495.60 |
$1,917.33
|
|
Dronabinol 2.5mg oral
|
$65.18 |
$65.18 |
$65.18 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$31.07
|
|
Drop lock knee
|
$406.04 |
$406.04 |
$406.04 |
$204.95
|
|
Drop lock retainer each
|
$138.92 |
$138.92 |
$138.92 |
$70.12
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$13,517.40 |
$13,517.40 |
$13,517.40 |
$1,956.48
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$8,961.77 |
$8,961.77 |
$8,961.77 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$36,263.03 |
$36,263.03 |
$36,263.03 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$8,474.74 |
$8,474.74 |
$8,474.74 |
$289.05
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$50,695.45 |
$50,695.45 |
$50,695.45 |
$171.12
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$72,205.37 |
$72,205.37 |
$72,205.37 |
$8,040.27
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$50,898.21 |
$50,898.21 |
$50,898.21 |
$400.98
|
|
Drug assay caffeine
|
$90.60 |
$90.60 |
$90.60 |
$83.40
|
|
Drug assay rufinamide
|
$62.40 |
$62.40 |
$62.40 |
$85.80
|
|
Drug assay vedolizumab
|
$460.20 |
$460.20 |
$460.20 |
$152.79
|
|
Drug assay voriconazole
|
$90.60 |
$90.60 |
$90.60 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$127.80 |
$127.80 |
$127.80 |
$66.43
|
|
Drug of abuse screen urine
|
$53.40 |
$53.40 |
$53.40 |
$63.75
|
|
Drug test def 1-7 classes
|
$600.60 |
$600.60 |
$600.60 |
$250.52
|
|
Drug test prsmv instrmnt
|
$372.60 |
$372.60 |
$372.60 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$660.60 |
$660.60 |
$660.60 |
$278.85
|
|
Drvvt confirm - quest
|
$118.80 |
$118.80 |
$118.80 |
$109.20
|
|
Dstrj nulyt agt gnclr nrv
|
$3,745.80 |
$3,745.80 |
$3,745.80 |
$3,020.80
|
|
Duragen 1x1 5ea/bx
|
$35,257.12 |
$35,257.12 |
$35,257.12 |
$10,163.72
|
|
Durvalumab 50 mg/ml intravenous solution
|
$24,479.56 |
$24,479.56 |
$24,479.56 |
$7,973.90
|
|
Dx bronchoscope/lavage 31624
|
$5,466.62 |
$5,466.62 |
$5,466.62 |
$2,365.20
|
|
Dx bronchoscope/wash 31622
|
$7,419.62 |
$7,419.62 |
$7,419.62 |
$2,322.60
|
|
Dx laryngoscopy w/oper scope
|
$20,643.17 |
$20,643.17 |
$20,643.17 |
$2,607.00
|
|
Ear irrigation 69209
|
$48.00 |
$48.00 |
$48.00 |
$149.76
|
|
Ecg 12 lead tracing only
|
$226.20 |
$226.20 |
$226.20 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$190.80 |
$190.80 |
$190.80 |
$135.80
|
|
Ecg < 30 days transmission & analysis
|
$393.60 |
$393.60 |
$393.60 |
$487.60
|
|
Ecg external < 48 hours recording
|
$525.00 |
$525.00 |
$525.00 |
$462.00
|
|
Echocardiogram (Heart Ultrasound)
|
$3,630.60 |
$3,630.60 |
$3,630.60 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$672.60 |
$672.60 |
$672.60 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,967.60 |
$2,967.60 |
$2,967.60 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,197.00 |
$1,197.00 |
$1,197.00 |
$703.25
|
|
Echocardiograpy doppler follow up/limited study
|
$402.00 |
$402.00 |
$402.00 |
$362.50
|
|
Echo exam of fetal heart
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$939.00
|
|
Echo exam of fetal heart
|
$405.60 |
$405.60 |
$405.60 |
$524.55
|
|
Echo exam of fetal heart
|
$223.20 |
$223.20 |
$223.20 |
$431.41
|
|
Echo exam of fetal heart
|
$223.20 |
$223.20 |
$223.20 |
$323.40
|
|
Echo exam uterus 76831-
|
$190.80 |
$190.80 |
$190.80 |
$523.71
|
|
Echo guide for amniocentesis
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$456.30
|
|
Echo guide for artery repair
|
$640.80 |
$640.80 |
$640.80 |
$664.00
|
|
Echo guide villus sampling
|
$372.60 |
$372.60 |
$372.60 |
$362.88
|