|
Destroy premlg lesns;1st lesn 17000
|
$50.40 |
$50.40 |
$50.40 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$30.00 |
$30.00 |
$30.00 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$58.20 |
$58.20 |
$58.20 |
$235.13
|
|
Device intraute mirena
|
$3,258.00 |
$3,258.00 |
$3,258.00 |
$2,125.00
|
|
Dexamethasone 4 mg tablet
|
$6.00 |
$6.00 |
$6.00 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$33.00 |
$33.00 |
$33.00 |
$21.17
|
|
Dexmedetomidine film, 1 mcg
|
$422.40 |
$422.40 |
$422.40 |
$171.39
|
|
Dhea-s (dehydroepiand sulfate)
|
$288.60 |
$288.60 |
$288.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$80.40 |
$80.40 |
$80.40 |
$79.20
|
|
Diag laparo separate proc 49320
|
$1,051.80 |
$1,051.80 |
$1,051.80 |
$6,904.15
|
|
Diagnostic laryngoscopy 31505
|
$94.20 |
$94.20 |
$94.20 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$193.20 |
$193.20 |
$193.20 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$475.20 |
$475.20 |
$475.20 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$475.20 |
$475.20 |
$475.20 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$113.40 |
$113.40 |
$113.40 |
$214.08
|
|
Dialysis one evaluation
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$919.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$91.80 |
$91.80 |
$91.80 |
$74.76
|
|
Dicyclomine injection
|
$268.20 |
$268.20 |
$268.20 |
$153.29
|
|
Diffusing capacity
|
$184.20 |
$184.20 |
$184.20 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$19.20 |
$19.20 |
$19.20 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$12,133.20 |
$12,133.20 |
$12,133.20 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$185.40 |
$185.40 |
$185.40 |
$102.00
|
|
Dilate esophagus
|
$220.20 |
$220.20 |
$220.20 |
$2,142.40
|
|
Dilation of cervical canal 57800
|
$150.00 |
$150.00 |
$150.00 |
$4,376.00
|
|
Dilation salivary duct 42650
|
$730.80 |
$730.80 |
$730.80 |
$2,498.32
|
|
Dilator fascial 10fx20cm
|
$308.70 |
$308.70 |
$308.70 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$22.20 |
$22.20 |
$22.20 |
$47.94
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$4.80 |
$4.80 |
$4.80 |
$17.75
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$16.80 |
$16.80 |
$16.80 |
$91.53
|
|
Dise eval slp do brth flx dx
|
$66.00 |
$66.00 |
$66.00 |
$1,120.00
|
|
Dna antibody native/double stranded
|
$288.60 |
$288.60 |
$288.60 |
$97.50
|
|
Dna gardnerella
|
$37.20 |
$37.20 |
$37.20 |
$62.50
|
|
Dna trichomonas
|
$37.20 |
$37.20 |
$37.20 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$42.60 |
$42.60 |
$42.60 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,834.20 |
$1,834.20 |
$1,834.20 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$65.40 |
$65.40 |
$65.40 |
$65.40
|
|
Doppler echo complete
|
$637.20 |
$637.20 |
$637.20 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$3,046.80 |
$3,046.80 |
$3,046.80 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$205.20 |
$205.20 |
$205.20 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$223.80 |
$223.80 |
$223.80 |
$471.17
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$81.60 |
$81.60 |
$81.60 |
$423.95
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$96.60 |
$96.60 |
$96.60 |
$84.80
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$253.20 |
$253.20 |
$253.20 |
$800.00
|
|
Drainage external ear complex 69005
|
$3,782.40 |
$3,782.40 |
$3,782.40 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$291.60 |
$291.60 |
$291.60 |
$789.60
|
|
Drainage of mouth lesion
|
$497.40 |
$497.40 |
$497.40 |
$2,423.85
|
|
Drainage of mouth lesion
|
$496.80 |
$496.80 |
$496.80 |
$6,781.90
|
|
Drainage of nose lesion int 30000
|
$184.80 |
$184.80 |
$184.80 |
$491.40
|
|
Drainage of nose lesion sept 30020
|
$232.20 |
$232.20 |
$232.20 |
$781.44
|
|
Drain blood from under nail 11740
|
$126.00 |
$126.00 |
$126.00 |
$170.50
|
|
Drain cath image guided visceral pq
|
$2,985.00 |
$2,985.00 |
$2,985.00 |
$2,850.35
|
|
Drain finger abscess;simple 26010
|
$278.40 |
$278.40 |
$278.40 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$246.00 |
$246.00 |
$246.00 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$199.20 |
$199.20 |
$199.20 |
$344.00
|
|
Drng of mouth lesion 40801
|
$1,438.20 |
$1,438.20 |
$1,438.20 |
$1,262.76
|
|
Drng salivary gland simple 42300
|
$1,911.00 |
$1,911.00 |
$1,911.00 |
$2,133.48
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$193.15 |
$193.15 |
$193.15 |
$289.05
|
|
Drug admin & hemodynmic meas
|
$248.40 |
$248.40 |
$248.40 |
$569.75
|
|
Drug of abuse screen urine
|
$123.00 |
$123.00 |
$123.00 |
$63.75
|
|
Drug test def 1-7 classes
|
$320.40 |
$320.40 |
$320.40 |
$250.52
|
|
Drug test def 8-14 classes
|
$156.60 |
$156.60 |
$156.60 |
$282.00
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$358.20 |
$358.20 |
$358.20 |
$278.85
|
|
Drvvt confirm - quest
|
$213.60 |
$213.60 |
$213.60 |
$109.20
|
|
Duplex scan bilateral study 93985
|
$356.40 |
$356.40 |
$356.40 |
$690.95
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$754.20 |
$754.20 |
$754.20 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$11,861.40 |
$11,861.40 |
$11,861.40 |
$7,973.90
|
|
Dxa bone density axl vrt fx
|
$279.60 |
$279.60 |
$279.60 |
$392.60
|
|
Dx bronchoscope/wash 31622
|
$516.00 |
$516.00 |
$516.00 |
$2,322.60
|
|
Dx laryngoscopy w/oper scope
|
$536.40 |
$536.40 |
$536.40 |
$2,607.00
|
|
Ear and throat examination
|
$175.20 |
$175.20 |
$175.20 |
$602.63
|
|
Ear cartilage graft
|
$1,546.20 |
$1,546.20 |
$1,546.20 |
$6,385.40
|
|
Ear irrigation 69209
|
$221.40 |
$221.40 |
$221.40 |
$149.76
|
|
Ecg 12 lead tracing only
|
$234.60 |
$234.60 |
$234.60 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$106.20 |
$106.20 |
$106.20 |
$135.80
|
|
Ecg external < 48 hours recording
|
$127.20 |
$127.20 |
$127.20 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$452.40 |
$452.40 |
$452.40 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$51.60 |
$51.60 |
$51.60 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$82.20 |
$82.20 |
$82.20 |
$161.85
|
|
Ecg/review interpret only
|
$42.00 |
$42.00 |
$42.00 |
$57.60
|
|
Echocardiogram (Heart Ultrasound)
|
$2,640.00 |
$2,640.00 |
$2,640.00 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$782.40 |
$782.40 |
$782.40 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,742.00 |
$2,742.00 |
$2,742.00 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$702.00 |
$702.00 |
$702.00 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,348.20 |
$1,348.20 |
$1,348.20 |
$851.50
|
|
Echograp trans r pros study
|
$192.00 |
$192.00 |
$192.00 |
$459.40
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,717.80 |
$1,717.80 |
$1,717.80 |
$1,849.50
|
|
Echo transesophageal
|
$433.20 |
$433.20 |
$433.20 |
$664.39
|
|
Echo transthoracic
|
$816.60 |
$816.60 |
$816.60 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$141.90 |
$141.90 |
$141.90 |
$985.15
|
|
Eeg/record in coma or sleep only 95822
|
$776.40 |
$776.40 |
$776.40 |
$907.80
|
|
Eeg recording awake and asleep
|
$540.00 |
$540.00 |
$540.00 |
$931.20
|
|
Efgartigimod alfa-fcab 20 mg/ml intravenous solution
|
$22,947.00 |
$22,947.00 |
$22,947.00 |
$12,999.80
|
|
Egfr gene com variants
|
$2,470.20 |
$2,470.20 |
$2,470.20 |
$657.00
|
|
EKG (Electrocardiogram)
|
$143.40 |
$143.40 |
$143.40 |
$89.60
|
|
Electrical stimulation/unattended 97014
|
$246.00 |
$246.00 |
$246.00 |
$79.20
|
|
Electroconvulsive therapy 90870
|
$993.60 |
$993.60 |
$993.60 |
$1,180.80
|
|
Electrolyte panel
|
$115.20 |
$115.20 |
$115.20 |
$84.24
|
|
Embo or occlude vascular venous s&i
|
$20,542.20 |
$20,542.20 |
$20,542.20 |
$14,586.00
|
|
Emb/throm/fempop/aor/ilia/leg inc 34201
|
$1,808.40 |
$1,808.40 |
$1,808.40 |
$7,651.38
|
|
Emb/throm/pop-tib-pero art/leg inc 34203
|
$1,675.20 |
$1,675.20 |
$1,675.20 |
$6,708.28
|
