|
Destroy vulva lesion simple 56501
|
$212.00 |
$212.00 |
$212.00 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$247.20 |
$247.20 |
$247.20 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$546.40 |
$546.40 |
$546.40 |
$966.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$424.80 |
$424.80 |
$424.80 |
$666.75
|
|
Destruct cut vasl lesions >50cm 17108
|
$812.00 |
$812.00 |
$812.00 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$3.20 |
$3.20 |
$3.20 |
$78.61
|
|
Destruction anal lesion(s)
|
$232.00 |
$232.00 |
$232.00 |
$3,711.00
|
|
Destruction anal lesion(s) smpl chem 46900
|
$234.40 |
$234.40 |
$234.40 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$308.00 |
$308.00 |
$308.00 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$335.20 |
$335.20 |
$335.20 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$93.60 |
$93.60 |
$93.60 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$311.20 |
$311.20 |
$311.20 |
$3,296.80
|
|
Destruction penis lesion(s) chem 54050
|
$168.80 |
$168.80 |
$168.80 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$268.00 |
$268.00 |
$268.00 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$146.40 |
$146.40 |
$146.40 |
$442.61
|
|
Destruction vag lesions complex 57065
|
$300.80 |
$300.80 |
$300.80 |
$3,762.53
|
|
Destruction vag lesions simple 57061
|
$185.60 |
$185.60 |
$185.60 |
$3,815.20
|
|
Destruct penis les/smp/electrodesi 54055
|
$152.80 |
$152.80 |
$152.80 |
$2,837.09
|
|
Detect agent nos dna dir
|
$316.80 |
$316.80 |
$316.80 |
$150.60
|
|
Determine refractive state
|
$28.80 |
$28.80 |
$28.80 |
$19.80
|
|
Developmental screen/score/document 96110
|
$21.60 |
$21.60 |
$21.60 |
$136.64
|
|
Device ablt adv novasure
|
$644.91 |
$644.91 |
$644.91 |
$6,148.80
|
|
Device intraute mirena
|
$2,915.20 |
$2,915.20 |
$2,915.20 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$132.00 |
$132.00 |
$132.00 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$168.80 |
$168.80 |
$168.80 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$6.48 |
$6.48 |
$6.48 |
$20.52
|
|
Dexamethasone intra implant
|
$471.20 |
$471.20 |
$471.20 |
$2,538.20
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$24.00 |
$24.00 |
$24.00 |
$47.66
|
|
Dhea-s (dehydroepiand sulfate)
|
$68.00 |
$68.00 |
$68.00 |
$113.40
|
|
Diabetes (HbA1c) Test
|
$20.00 |
$20.00 |
$20.00 |
$79.52
|
|
Diag laparo separate proc 49320
|
$3,964.63 |
$3,964.63 |
$3,964.63 |
$6,904.15
|
|
Diagnostic anoscopy
|
$156.00 |
$156.00 |
$156.00 |
$391.20
|
|
Diagnostic anoscopy spx 46600
|
$204.00 |
$204.00 |
$204.00 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$64.80 |
$64.80 |
$64.80 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$64.80 |
$64.80 |
$64.80 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$108.80 |
$108.80 |
$108.80 |
$319.80
|
|
Diagnostic Mammogram (both breasts)
|
$240.00 |
$240.00 |
$240.00 |
$407.04
|
|
Diagnostic Mammogram (one breast)
|
$188.00 |
$188.00 |
$188.00 |
$310.20
|
|
Dialysis circuit perm vascular embolization 36909
|
$335.20 |
$335.20 |
$335.20 |
$5,663.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$34.18 |
$34.18 |
$34.18 |
$76.76
|
|
Dicyclomine injection
|
$17.64 |
$17.64 |
$17.64 |
$153.53
|
|
Diffusing capacity
|
$96.00 |
$96.00 |
$96.00 |
$337.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$3.40 |
$3.40 |
$3.40 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$25.60 |
$25.60 |
$25.60 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$104.00 |
$104.00 |
$104.00 |
$304.16
|
|
Dilate biliary duct/ampulla
|
$220.00 |
$220.00 |
$220.00 |
$1,866.73
|
|
Dilate esophagus 1/mult pass
|
$132.00 |
$132.00 |
$132.00 |
$1,484.17
|
|
Dilate tear duct opening
|
$122.40 |
$122.40 |
$122.40 |
$472.21
|
|
Dilate urethra stricture
|
$383.20 |
$383.20 |
$383.20 |
$496.00
|
|
Dilate urethra stricture
|
$88.00 |
$88.00 |
$88.00 |
$200.80
|
|
Dilate urethra stricture
|
$104.00 |
$104.00 |
$104.00 |
$3,863.60
|
|
Dilate urethra stricture
|
$383.20 |
$383.20 |
$383.20 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$68.00 |
$68.00 |
$68.00 |
$235.61
|
|
Dilation of anal sphincter
|
$301.60 |
$301.60 |
$301.60 |
$1,969.12
|
|
Dilation of rectal stricture 45910
|
$338.40 |
$338.40 |
$338.40 |
$1,645.43
|
|
Dilation of urethra
|
$65.60 |
$65.60 |
$65.60 |
$172.00
|
|
Dilation/urethral strict/male/ini 53620
|
$1,068.80 |
$1,068.80 |
$1,068.80 |
$1,372.80
|
|
Diltiazem 5 mg/ml intravenous solution
|
$3.79 |
$3.79 |
$3.79 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,608.80 |
$1,608.80 |
$1,608.80 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.60 |
$1.60 |
$1.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.40 |
$2.40 |
$2.40 |
$17.75
|
|
Disability dlco
|
$516.00 |
$516.00 |
$516.00 |
$292.03
|
|
Disaccharidases
|
$664.00 |
$664.00 |
$664.00 |
$224.58
|
|
Dist revas ligation hemo
|
$1,995.20 |
$1,995.20 |
$1,995.20 |
$6,396.89
|
|
Dna antibody native/double stranded
|
$288.00 |
$288.00 |
$288.00 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$66.00 |
$66.00 |
$66.00 |
$99.10
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$75.17 |
$75.17 |
$75.17 |
$944.35
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$25.80 |
$25.80 |
$25.80 |
$65.40
|
|
Doppler echo complete
|
$31.20 |
$31.20 |
$31.20 |
$551.40
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$331.20 |
$331.20 |
$331.20 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$204.00 |
$204.00 |
$204.00 |
$481.65
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$27,751.49 |
$27,751.49 |
$27,751.49 |
$23,613.78
|
|
Double transfer toe-hand
|
$6,308.00 |
$6,308.00 |
$6,308.00 |
$7,413.38
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$35.76 |
$35.76 |
$35.76 |
$435.74
|
|
Dpyd gene common variants
|
$1,280.00 |
$1,280.00 |
$1,280.00 |
$386.00
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,160.80 |
$1,160.80 |
$1,160.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$230.40 |
$230.40 |
$230.40 |
$901.80
|
|
Drainage external ear simple 69000
|
$206.40 |
$206.40 |
$206.40 |
$779.45
|
|
Drainage lymph node lesion 38300
|
$383.20 |
$383.20 |
$383.20 |
$3,088.80
|
|
Drainage mouth roof lesion
|
$174.40 |
$174.40 |
$174.40 |
$401.50
|
|
Drainage of arm bursa 23931
|
$279.20 |
$279.20 |
$279.20 |
$2,209.90
|
|
Drainage of eye
|
$129.60 |
$129.60 |
$129.60 |
$2,360.00
|
|
Drainage of eye
|
$717.60 |
$717.60 |
$717.60 |
$3,222.78
|
|
Drainage of forearm bursa
|
$643.20 |
$643.20 |
$643.20 |
$2,054.00
|
|
Drainage of mouth lesion
|
$363.20 |
$363.20 |
$363.20 |
$489.00
|
|
Drainage of mouth lesion
|
$563.20 |
$563.20 |
$563.20 |
$3,544.29
|
|
Drainage of nose lesion int 30000
|
$194.40 |
$194.40 |
$194.40 |
$548.00
|
|
Drainage of pelvis lesion 26990
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$3,863.70
|
|
Drainage of rectal abscess
|
$1,946.40 |
$1,946.40 |
$1,946.40 |
$2,111.46
|
|
Drain blood from under nail 11740
|
$281.60 |
$281.60 |
$281.60 |
$173.21
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$337.60 |
$337.60 |
$337.60 |
$2,658.46
|
|
Drain cath image guided visceral pq
|
$311.20 |
$311.20 |
$311.20 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$1,595.20 |
$1,595.20 |
$1,595.20 |
$1,045.65
|
|
Drain finger abscess;simple 26010
|
$308.00 |
$308.00 |
$308.00 |
$428.40
|
|
Drain lower leg lesion 27603
|
$664.00 |
$664.00 |
$664.00 |
$3,994.09
|
|
Drain neck/chest lesion 21501
|
$581.60 |
$581.60 |
$581.60 |
$3,339.00
|
|
Drain ovary abscess open
|
$548.00 |
$548.00 |
$548.00 |
$3,762.53
|
|
Drain shoulder lesion
|
$440.00 |
$440.00 |
$440.00 |
$3,638.88
|
|
Drain thigh/knee lesion 27301
|
$874.40 |
$874.40 |
$874.40 |
$3,638.88
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$184.80 |
$184.80 |
$184.80 |
$394.80
|
