|
Destruction vag lesions simple 57061
|
$1,997.60 |
$1,997.60 |
$1,997.60 |
$4,006.38
|
|
Destruct penis les/smp/electrodesi 54055
|
$2,235.20 |
$2,235.20 |
$2,235.20 |
$2,837.09
|
|
Developmental screen/score/document 96110
|
$53.60 |
$53.60 |
$53.60 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$495.20 |
$495.20 |
$495.20 |
$350.40
|
|
Device ablt adv novasure
|
$2,804.36 |
$2,804.36 |
$3,649.27 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,080.00 |
$6,080.00 |
$6,080.00 |
$4,200.00
|
|
Device intraute mirena
|
$1,167.41 |
$1,167.41 |
$1,167.41 |
$2,125.00
|
|
Device sut capio slim opn
|
$905.07 |
$905.07 |
$905.07 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$1,324.53 |
$1,324.53 |
$1,820.88 |
$2,515.00
|
|
Dev interrog remote 1/2/mlt
|
$52.80 |
$52.80 |
$546.94 |
$115.20
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$232.80 |
$232.80 |
$232.80 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$536.92 |
$536.92 |
$536.92 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$0.86 |
$0.86 |
$0.86 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$21.18 |
$21.18 |
$21.18 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$48.00 |
$48.00 |
$48.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$48.00 |
$48.00 |
$48.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$18.40 |
$18.40 |
$18.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$48.00 |
$48.00 |
$48.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$9.35 |
$9.35 |
$274.72 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$125.40 |
$125.40 |
$129.30 |
$79.30
|
|
Diabetes training group per 30 min g0109
|
$71.20 |
$71.20 |
$71.20 |
$35.43
|
|
Diab manage trn ind/group
|
$190.89 |
$190.89 |
$190.89 |
$54.99
|
|
Diag laparo separate proc 49320
|
$2,986.40 |
$2,986.40 |
$2,986.40 |
$7,104.72
|
|
Diagnostic anoscopy spx 46600
|
$384.45 |
$384.45 |
$2,102.24 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$249.60 |
$249.60 |
$249.60 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$154.40 |
$154.40 |
$154.40 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$139.15 |
$139.15 |
$263.20 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$301.40 |
$301.40 |
$716.44 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$366.30 |
$366.30 |
$462.40 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$183.70 |
$183.70 |
$367.20 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,269.20 |
$3,269.20 |
$11,977.03 |
$5,741.00
|
|
Dialysis one evaluation
|
$407.00 |
$407.00 |
$800.68 |
$936.00
|
|
Dialysis repeated eval
|
$2,153.80 |
$2,153.80 |
$2,153.80 |
$1,332.80
|
|
Dialysis training complete
|
$1,641.60 |
$1,641.60 |
$1,641.60 |
$783.36
|
|
Dialysis training incompl
|
$356.80 |
$356.80 |
$1,497.10 |
$391.67
|
|
Diatrizoate meglumine 18 % urethral solution
|
$2.40 |
$2.40 |
$2.40 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$94.27 |
$94.27 |
$94.27 |
$79.71
|
|
Dicyclomine injection
|
$204.52 |
$204.52 |
$204.52 |
$154.33
|
|
Diffusing capacity
|
$383.71 |
$383.71 |
$383.71 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$125.12 |
$125.12 |
$125.12 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$7,993.40 |
$7,993.40 |
$7,993.40 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$134.75 |
$134.75 |
$176.28 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$176.08 |
$176.08 |
$176.08 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$3,570.05 |
$3,570.05 |
$4,738.67 |
$1,866.73
|
|
Dilate esophagus
|
$1,216.00 |
$1,216.00 |
$1,216.00 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$643.20 |
$643.20 |
$643.20 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$2,249.50 |
$2,249.50 |
$2,249.50 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$2,249.50 |
$2,249.50 |
$2,249.50 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$4,224.00 |
$4,224.00 |
$4,224.00 |
$5,151.95
|
|
Dilate urethra stricture
|
$1,274.76 |
$1,274.76 |
$1,274.76 |
$513.00
|
|
Dilate urethra stricture
|
$394.40 |
$394.40 |
$394.40 |
$200.80
|
|
Dilate urethra stricture
|
$310.40 |
$310.40 |
$310.40 |
$3,863.60
|
|
Dilate urethra stricture
|
$526.40 |
$526.40 |
$526.40 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$329.60 |
$329.60 |
$329.60 |
$235.61
|
|
Dilation of anal sphincter
|
$498.40 |
$498.40 |
$498.40 |
$2,166.04
|
|
Dilation of cervical canal 57800
|
$9,022.21 |
$9,022.21 |
$9,022.21 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$962.40 |
$962.40 |
$962.40 |
$2,491.80
|
|
Dilation of salivary duct
|
$525.60 |
$525.60 |
$653.95 |
$790.00
|
|
Dilation of urethra
|
$321.60 |
$321.60 |
$321.60 |
$172.00
|
|
Dilation salivary duct 42650
|
$837.60 |
$837.60 |
$837.60 |
$2,675.71
|
|
Dilation/urethral strict/male/ini 53620
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$82.05 |
$82.05 |
$151.27 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$3,837.90 |
$3,837.90 |
$3,837.90 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$6,455.90 |
$6,455.90 |
$6,455.90 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$2.45 |
$2.45 |
$2.45 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.80 |
$0.80 |
$0.80 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$73.88 |
$73.88 |
$73.88 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$180.80 |
$180.80 |
$180.80 |
$98.15
|
|
Dir nsl mucous membrane test
|
$60.00 |
$60.00 |
$60.00 |
$76.80
|
|
Disaccharidases
|
$132.32 |
$132.32 |
$358.05 |
$230.40
|
|
Disarticulation sho sec clsr
|
$4,586.40 |
$4,586.40 |
$4,586.40 |
$2,300.80
|
|
Disarticulation shoulder
|
$14,510.40 |
$14,510.40 |
$14,510.40 |
$13,116.76
|
|
Discography cerv/thor spine
|
$1,162.15 |
$1,162.15 |
$2,440.84 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$2,070.20 |
$2,070.20 |
$3,472.20 |
$1,579.93
|
|
Div aberrant vsl w/reanast
|
$11,364.00 |
$11,364.00 |
$11,364.00 |
$1,644.05
|
|
Diverticulectomy/hypophar/esoph 43130
|
$3,136.80 |
$3,136.80 |
$3,136.80 |
$6,547.81
|
|
#d/lmeth-l-methamphetamine
|
$156.00 |
$156.00 |
$156.00 |
$72.14
|
|
Dlyd plmt xtn prosth ea addl
|
$6,312.15 |
$6,312.15 |
$10,027.60 |
$1,810.80
|
|
Dmd dup/delet analysis
|
$837.08 |
$837.08 |
$837.08 |
$418.50
|
|
Dmpk gene detc abnor allele
|
$411.04 |
$411.04 |
$411.04 |
$313.60
|
|
Dna antibody native/double stranded
|
$158.03 |
$158.03 |
$187.55 |
$100.00
|
|
Dna gardnerella
|
$28.05 |
$28.05 |
$97.60 |
$61.83
|
|
Dna trichomonas
|
$28.05 |
$28.05 |
$97.60 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$78.92 |
$78.92 |
$78.92 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$37.28 |
$37.28 |
$37.28 |
$65.40
|
|
Doppler echo complete
|
$455.40 |
$455.40 |
$626.13 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$1,775.95 |
$1,775.95 |
$3,966.93 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$664.95 |
$664.95 |
$2,014.46 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$218.90 |
$218.90 |
$1,121.16 |
$481.65
|
|
Dornase alfa non-comp unit
|
$50.04 |
$50.04 |
$50.04 |
$356.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$45.69 |
$45.69 |
$45.69 |
$450.14
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1.12 |
$1.12 |
$1.12 |
$89.34
|
|
Dpyd gene common variants
|
$524.48 |
$524.48 |
$613.80 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$885.37 |
$885.37 |
$885.37 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$843.21 |
$843.21 |
$843.21 |
$964.00
|
|
Drainage external ear complex 69005
|
$5,073.45 |
$5,073.45 |
$5,073.45 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$566.50 |
$566.50 |
$885.37 |
$790.40
|
|
Drainage mouth roof lesion
|
$1,984.39 |
$1,984.39 |
$1,984.39 |
$405.60
|
|
Drainage of arm bursa 23931
|
$1,775.95 |
$1,775.95 |
$2,468.64 |
$2,271.01
|
|
Drainage of bladder abscess
|
$1,533.12 |
$1,533.12 |
$1,533.12 |
$3,127.88
|
