|
Diltiazem 5 mg/ml intravenous solution
|
$5.00 |
$5.00 |
$5.00 |
$42.04
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,508.50 |
$1,508.50 |
$1,508.50 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.00 |
$1.00 |
$1.00 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.50 |
$2.50 |
$2.50 |
$19.01
|
|
Disability dlco
|
$698.00 |
$698.00 |
$698.00 |
$293.76
|
|
Disaccharidases
|
$415.00 |
$415.00 |
$415.00 |
$223.80
|
|
Discography cerv/thor spine
|
$2,126.00 |
$2,126.00 |
$2,126.00 |
$2,628.00
|
|
Dlyd plmt xtn prosth ea addl
|
$1,396.50 |
$1,396.50 |
$1,396.50 |
$1,631.87
|
|
Dmpk gene detc abnor allele
|
$287.50 |
$287.50 |
$287.50 |
$313.60
|
|
Dna antibody native/double stranded
|
$98.00 |
$98.00 |
$98.00 |
$100.00
|
|
Dna gardnerella
|
$118.00 |
$118.00 |
$118.00 |
$61.20
|
|
Dna trichomonas
|
$118.00 |
$118.00 |
$118.00 |
$66.05
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$491.15 |
$491.15 |
$491.15 |
$944.35
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$60.00 |
$60.00 |
$60.00 |
$65.40
|
|
Doppler echo complete
|
$250.50 |
$250.50 |
$250.50 |
$548.00
|
|
Doppler intravascular pressure flow initial vessel
|
$1,928.50 |
$1,928.50 |
$1,928.50 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$591.50 |
$591.50 |
$591.50 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$337.50 |
$337.50 |
$337.50 |
$481.65
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$84.60 |
$84.60 |
$84.60 |
$423.95
|
|
Dpyd gene common variants
|
$800.00 |
$800.00 |
$800.00 |
$386.12
|
|
Drainage external ear simple 69000
|
$821.50 |
$821.50 |
$821.50 |
$779.45
|
|
Drainage of arm bursa 23931
|
$8,589.00 |
$8,589.00 |
$8,589.00 |
$2,209.90
|
|
Drainage of eye
|
$5,265.00 |
$5,265.00 |
$5,265.00 |
$2,360.00
|
|
Drainage of forearm bursa
|
$1,963.50 |
$1,963.50 |
$1,963.50 |
$2,054.00
|
|
Drainage of kidney lesion
|
$819.50 |
$819.50 |
$819.50 |
$1,534.80
|
|
Drainage of pelvis lesion 26990
|
$3,303.00 |
$3,303.00 |
$3,303.00 |
$3,863.70
|
|
Drain blood from under nail 11740
|
$157.50 |
$157.50 |
$157.50 |
$173.21
|
|
Drain cath image guided visceral pq
|
$1,757.50 |
$1,757.50 |
$1,757.50 |
$2,869.76
|
|
Drain cerebro spinal fluid 62272
|
$814.50 |
$814.50 |
$814.50 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$7,131.25 |
$7,131.25 |
$7,131.25 |
$428.40
|
|
Drain lower leg bursa
|
$3,955.00 |
$3,955.00 |
$3,955.00 |
$3,958.50
|
|
Drain lower leg lesion 27603
|
$6,744.50 |
$6,744.50 |
$6,744.50 |
$3,986.00
|
|
Drain neck/chest lesion 21501
|
$8,883.50 |
$8,883.50 |
$8,883.50 |
$3,338.50
|
|
Drain shoulder lesion
|
$6,185.00 |
$6,185.00 |
$6,185.00 |
$3,638.88
|
|
Drain thigh/knee lesion 27301
|
$8,369.50 |
$8,369.50 |
$8,369.50 |
$3,638.88
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$343.50 |
$343.50 |
$343.50 |
$393.60
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$392.00 |
$392.00 |
$392.00 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$488.00 |
$488.00 |
$488.00 |
$524.04
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$6,501.85
|
|
Drill hole implt ventricular cath/device 61107
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,503.60
|
|
Drng hand tendon sheath 26020
|
$6,200.50 |
$6,200.50 |
$6,200.50 |
$3,839.54
|
|
Drng of finger abscess comp 26011
|
$5,928.00 |
$5,928.00 |
$5,928.00 |
$1,994.16
|
|
Drng of hydrocele 55000
|
$4,233.50 |
$4,233.50 |
$4,233.50 |
$854.50
|
|
Drng of scrotum abscess 55100
|
$6,570.50 |
$6,570.50 |
$6,570.50 |
$1,956.40
|
|
Drng peritoneal abscess open 49020
|
$3,800.00 |
$3,800.00 |
$3,800.00 |
$2,520.00
|
|
Dronabinol 2.5mg oral
|
$10.50 |
$10.50 |
$10.50 |
$11.40
|
|
Droperidol 2.5 mg/ml injection solution
|
$8.19 |
$8.19 |
$8.19 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,160.51 |
$1,160.51 |
$1,160.51 |
$1,902.96
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$489.50 |
$489.50 |
$489.50 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$166.50 |
$166.50 |
$166.50 |
$127.14
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$289.05
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$5,067.35 |
$5,067.35 |
$5,067.35 |
$7,886.74
|
|
Drug admin & hemodynmic meas
|
$1,192.00 |
$1,192.00 |
$1,192.00 |
$593.27
|
|
Drug assay posaconazole
|
$632.00 |
$632.00 |
$632.00 |
$96.39
|
|
Drug assay rufinamide
|
$51.00 |
$51.00 |
$51.00 |
$80.64
|
|
Drug assay vedolizumab
|
$207.00 |
$207.00 |
$207.00 |
$157.00
|
|
Drug assay voriconazole
|
$19.50 |
$19.50 |
$19.50 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$160.50 |
$160.50 |
$160.50 |
$66.43
|
|
Drug of abuse screen urine
|
$20.50 |
$20.50 |
$20.50 |
$67.50
|
|
Drug screening tapentadol
|
$18.50 |
$18.50 |
$18.50 |
$36.30
|
|
Drug screen quant tiagabine
|
$50.00 |
$50.00 |
$50.00 |
$114.62
|
|
Drug test def 15-21 classes
|
$393.50 |
$393.50 |
$393.50 |
$274.26
|
|
Drug test def 1-7 classes
|
$238.00 |
$238.00 |
$238.00 |
$263.25
|
|
Drug test def 22+ classes
|
$489.00 |
$489.00 |
$489.00 |
$426.24
|
|
Drug test def 8-14 classes
|
$152.00 |
$152.00 |
$152.00 |
$282.00
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$336.00 |
$336.00 |
$336.00 |
$278.85
|
|
Dry needling (97799)
|
$66.00 |
$66.00 |
$66.00 |
$114.27
|
|
Dstrj nulyt agt gnclr nrv
|
$4,033.50 |
$4,033.50 |
$4,033.50 |
$2,967.48
|
|
Dstr mal les s/n/h/f/g >4.0
|
$573.00 |
$573.00 |
$573.00 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$492.50 |
$492.50 |
$492.50 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$840.00 |
$840.00 |
$840.00 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$840.00 |
$840.00 |
$840.00 |
$849.50
|
|
Ductogram sgl duct
|
$468.00 |
$468.00 |
$468.00 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$467.00 |
$467.00 |
$467.00 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$206.00 |
$206.00 |
$206.00 |
$362.70
|
|
Dup scan/hemodialysis access 93990
|
$313.50 |
$313.50 |
$313.50 |
$486.02
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$371.50 |
$371.50 |
$371.50 |
$757.57
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$826.50 |
$826.50 |
$826.50 |
$890.55
|
|
Durvalumab 50 mg/ml intravenous solution
|
$25,767.96 |
$25,767.96 |
$25,767.96 |
$7,973.90
|
|
Dxa bone density axl vrt fx
|
$277.00 |
$277.00 |
$277.00 |
$397.65
|
|
Dx bronchoscope/brush 31623
|
$2,046.50 |
$2,046.50 |
$2,046.50 |
$2,040.67
|
|
Dx bronchoscope/lavage 31624
|
$2,457.88 |
$2,457.88 |
$2,457.88 |
$2,333.10
|
|
Dx bronchoscope/wash 31622
|
$3,732.17 |
$3,732.17 |
$3,732.17 |
$2,293.80
|
|
Dx laryngoscopy newborn
|
$470.00 |
$470.00 |
$470.00 |
$707.25
|
|
Dx laryngoscopy w/oper scope
|
$4,093.00 |
$4,093.00 |
$4,093.00 |
$2,607.00
|
|
Ear canal biopsy 69105
|
$2,663.50 |
$2,663.50 |
$2,663.50 |
$1,889.50
|
|
Ear irrigation 69209
|
$253.00 |
$253.00 |
$253.00 |
$150.00
|
|
Ecg 12 lead tracing only
|
$139.00 |
$139.00 |
$139.00 |
$226.50
|
|
Ecg/1-3 leads/tracing only 93041
|
$119.50 |
$119.50 |
$119.50 |
$135.20
|
|
Ecg < 30 days transmission & analysis
|
$739.00 |
$739.00 |
$739.00 |
$503.10
|
|
Ecg external < 48 hours recording
|
$390.50 |
$390.50 |
$390.50 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$390.50 |
$390.50 |
$390.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$62.00 |
$62.00 |
$62.00 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$116.50 |
$116.50 |
$116.50 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$1,496.00 |
$1,496.00 |
$1,496.00 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$169.00 |
$169.00 |
$169.00 |
$485.25
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$1,496.00 |
$1,496.00 |
$1,496.00 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$617.50 |
$617.50 |
$617.50 |
$711.00
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$664.00 |
$664.00 |
$664.00 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$529.50 |
$529.50 |
$529.50 |
$362.50
|
