|
Dermapure 1 square cm
|
$119.50 |
$119.50 |
$119.50 |
$3,822.00
|
|
Derm autograft face/nck/hf/g
|
$784.50 |
$784.50 |
$784.50 |
$4,055.70
|
|
Desmopressin 4 mcg/ml injection solution
|
$5.00 |
$5.00 |
$5.00 |
$91.56
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$90.00 |
$90.00 |
$90.00 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$122.00 |
$122.00 |
$122.00 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$140.50 |
$140.50 |
$140.50 |
$408.50
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$108.50 |
$108.50 |
$108.50 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$124.50 |
$124.50 |
$124.50 |
$317.00
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$90.00 |
$90.00 |
$90.00 |
$262.60
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$125.50 |
$125.50 |
$125.50 |
$364.50
|
|
Destroy cervthor facet jnt 64633
|
$198.00 |
$198.00 |
$198.00 |
$3,122.45
|
|
Destroy cth facet jnt addl 64634
|
$69.50 |
$69.50 |
$69.50 |
$1,441.44
|
|
Destroy internal hemorrhoids destroy 46930
|
$1,190.50 |
$1,190.50 |
$1,190.50 |
$1,395.28
|
|
Destroy premlg lesns;1st lesn 17000
|
$235.50 |
$235.50 |
$235.50 |
$203.04
|
|
Destroy vulva lesion extensive 56515
|
$221.00 |
$221.00 |
$221.00 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$136.50 |
$136.50 |
$136.50 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$85.00 |
$85.00 |
$85.00 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$369.50 |
$369.50 |
$369.50 |
$966.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$284.00 |
$284.00 |
$284.00 |
$666.75
|
|
Destruct cut vasl lesions >50cm 17108
|
$545.50 |
$545.50 |
$545.50 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$140.00 |
$140.00 |
$140.00 |
$78.61
|
|
Destruction anal lesion(s)
|
$140.00 |
$140.00 |
$140.00 |
$3,711.00
|
|
Destruction anal lesion(s) smpl chem 46900
|
$143.50 |
$143.50 |
$143.50 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$864.50 |
$864.50 |
$864.50 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$202.00 |
$202.00 |
$202.00 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,233.00 |
$3,233.00 |
$3,233.00 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$8,798.50 |
$8,798.50 |
$8,798.50 |
$3,296.80
|
|
Destruction mal lsn t/a/l >4cm
|
$158.00 |
$158.00 |
$158.00 |
$569.80
|
|
Destruction penis lesion(s) chem 54050
|
$110.00 |
$110.00 |
$110.00 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$179.00 |
$179.00 |
$179.00 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$101.00 |
$101.00 |
$101.00 |
$442.61
|
|
Destruction vag lesions complex 57065
|
$193.00 |
$193.00 |
$193.00 |
$3,762.53
|
|
Destruction vag lesions simple 57061
|
$118.00 |
$118.00 |
$118.00 |
$3,815.20
|
|
Destruct penis les/smp/electrodesi 54055
|
$99.50 |
$99.50 |
$99.50 |
$2,837.09
|
|
Detect agent nos dna dir
|
$198.00 |
$198.00 |
$198.00 |
$150.60
|
|
Determine refractive state
|
$20.50 |
$20.50 |
$20.50 |
$19.80
|
|
Developmental screen/score/document 96110
|
$13.50 |
$13.50 |
$13.50 |
$136.64
|
|
Device ablt adv novasure
|
$2,093.00 |
$2,093.00 |
$2,093.00 |
$6,148.80
|
|
Device intraute mirena
|
$1,822.00 |
$1,822.00 |
$1,822.00 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$9.50 |
$9.50 |
$9.50 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$4.41 |
$4.41 |
$4.41 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$3.09 |
$3.09 |
$3.09 |
$20.52
|
|
Dexamethasone intra implant
|
$294.50 |
$294.50 |
$294.50 |
$2,538.20
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$14.63 |
$14.63 |
$14.63 |
$47.66
|
|
Dhea-s (dehydroepiand sulfate)
|
$99.50 |
$99.50 |
$99.50 |
$113.40
|
|
Diabetes (HbA1c) Test
|
$57.00 |
$57.00 |
$57.00 |
$79.52
|
|
Diag laparo separate proc 49320
|
$369.00 |
$369.00 |
$369.00 |
$6,904.15
|
|
Diagnostic anoscopy
|
$428.00 |
$428.00 |
$428.00 |
$391.20
|
|
Diagnostic anoscopy spx 46600
|
$44.50 |
$44.50 |
$44.50 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$93.50 |
$93.50 |
$93.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$60.00 |
$60.00 |
$60.00 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$240.50 |
$240.50 |
$240.50 |
$319.80
|
|
Diagnostic Mammogram (both breasts)
|
$234.00 |
$234.00 |
$234.00 |
$407.04
|
|
Diagnostic Mammogram (one breast)
|
$185.00 |
$185.00 |
$185.00 |
$310.20
|
|
Dialysis circuit perm vascular embolization 36909
|
$210.00 |
$210.00 |
$210.00 |
$5,663.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$21.36 |
$21.36 |
$21.36 |
$76.76
|
|
Dicyclomine injection
|
$11.03 |
$11.03 |
$11.03 |
$153.53
|
|
Diffusing capacity
|
$141.00 |
$141.00 |
$141.00 |
$337.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$8.50 |
$8.50 |
$8.50 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$58.00 |
$58.00 |
$58.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$65.00 |
$65.00 |
$65.00 |
$304.16
|
|
Dilate biliary duct/ampulla
|
$139.50 |
$139.50 |
$139.50 |
$1,866.73
|
|
Dilate esophagus 1/mult pass
|
$156.33 |
$156.33 |
$156.33 |
$1,484.17
|
|
Dilate tear duct opening
|
$78.00 |
$78.00 |
$78.00 |
$472.21
|
|
Dilate urethra stricture
|
$245.50 |
$245.50 |
$245.50 |
$496.00
|
|
Dilate urethra stricture
|
$56.00 |
$56.00 |
$56.00 |
$200.80
|
|
Dilate urethra stricture
|
$67.00 |
$67.00 |
$67.00 |
$3,863.60
|
|
Dilate urethra stricture
|
$245.50 |
$245.50 |
$245.50 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$43.00 |
$43.00 |
$43.00 |
$235.61
|
|
Dilation of anal sphincter
|
$178.50 |
$178.50 |
$178.50 |
$1,969.12
|
|
Dilation of rectal stricture 45910
|
$203.00 |
$203.00 |
$203.00 |
$1,645.43
|
|
Dilation of urethra
|
$41.50 |
$41.50 |
$41.50 |
$172.00
|
|
Dilation/urethral strict/male/ini 53620
|
$673.00 |
$673.00 |
$673.00 |
$1,372.80
|
|
Diltiazem 5 mg/ml intravenous solution
|
$4.17 |
$4.17 |
$4.17 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,005.50 |
$1,005.50 |
$1,005.50 |
$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)
|
$1.50 |
$1.50 |
$1.50 |
$17.75
|
|
Disability dlco
|
$249.00 |
$249.00 |
$249.00 |
$292.03
|
|
Disaccharidases
|
$415.00 |
$415.00 |
$415.00 |
$224.58
|
|
Dis site tele svcs rhc/fqhc
|
$103.00 |
$103.00 |
$103.00 |
$94.80
|
|
Dist revas ligation hemo
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$6,396.89
|
|
Dna antibody native/double stranded
|
$22.00 |
$22.00 |
$22.00 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$11.25 |
$11.25 |
$11.25 |
$99.10
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$147.59 |
$147.59 |
$147.59 |
$944.35
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$16.13 |
$16.13 |
$16.13 |
$65.40
|
|
Doppler echo complete
|
$18.00 |
$18.00 |
$18.00 |
$551.40
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$207.00 |
$207.00 |
$207.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$277.50 |
$277.50 |
$277.50 |
$481.65
|
|
Double transfer toe-hand
|
$4,001.00 |
$4,001.00 |
$4,001.00 |
$7,413.38
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$12.27 |
$12.27 |
$12.27 |
$435.74
|
|
Dpyd gene common variants
|
$800.00 |
$800.00 |
$800.00 |
$386.00
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$121.00 |
$121.00 |
$121.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$145.50 |
$145.50 |
$145.50 |
$901.80
|
|
Drainage external ear simple 69000
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$779.45
|
|
Drainage lymph node lesion 38300
|
$220.00 |
$220.00 |
$220.00 |
$3,088.80
|
|
Drainage mouth roof lesion
|
$112.00 |
$112.00 |
$112.00 |
$401.50
|
|
Drainage of arm bursa 23931
|
$1,744.00 |
$1,744.00 |
$1,744.00 |
$2,209.90
|
|
Drainage of eye
|
$91.00 |
$91.00 |
$91.00 |
$2,360.00
|
|
Drainage of eye
|
$475.50 |
$475.50 |
$475.50 |
$3,222.78
|
|
Drainage of forearm bursa
|
$390.00 |
$390.00 |
$390.00 |
$2,054.00
|
