|
Delivery of placenta 59414
|
$635.00 |
$635.00 |
$635.00 |
$2,993.25
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$70.00 |
$70.00 |
$70.00 |
$192.72
|
|
Dermagraft
|
$85.00 |
$85.00 |
$85.00 |
$85.00
|
|
Design mlc device for imrt
|
$1,785.00 |
$1,785.00 |
$1,785.00 |
$1,641.90
|
|
Device tiss remov myosure reach
|
$1,270.00 |
$1,270.00 |
$1,270.00 |
$2,529.60
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$270.00 |
$270.00 |
$270.00 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$137.50 |
$137.50 |
$137.50 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$82.50 |
$82.50 |
$82.50 |
$79.30
|
|
Diagnostic anoscopy spx 46600
|
$160.00 |
$160.00 |
$160.00 |
$195.50
|
|
Diagnostic Mammogram (both breasts)
|
$282.50 |
$282.50 |
$282.50 |
$399.94
|
|
Diagnostic Mammogram (one breast)
|
$412.50 |
$412.50 |
$412.50 |
$310.00
|
|
Dialysis one evaluation
|
$650.00 |
$650.00 |
$650.00 |
$842.10
|
|
Diffusing capacity
|
$285.00 |
$285.00 |
$285.00 |
$331.76
|
|
Digoxin total therapeutic drug level
|
$77.50 |
$77.50 |
$77.50 |
$99.59
|
|
Dilator fascial 10fx20cm
|
$560.00 |
$560.00 |
$560.00 |
$402.10
|
|
Disability dlco
|
$240.00 |
$240.00 |
$240.00 |
$280.00
|
|
Disaccharidases
|
$357.50 |
$357.50 |
$357.50 |
$203.08
|
|
Discography cerv/thor spine
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$2,375.10
|
|
Dna antibody native/double stranded
|
$100.00 |
$100.00 |
$100.00 |
$100.00
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$45.07 |
$45.07 |
$45.07 |
$944.35
|
|
Doppler echo complete
|
$345.00 |
$345.00 |
$345.00 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$540.00 |
$540.00 |
$540.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$362.50 |
$362.50 |
$362.50 |
$476.45
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$605.83 |
$605.83 |
$605.83 |
$23,613.78
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,380.83 |
$1,380.83 |
$1,380.83 |
$1,718.24
|
|
Dpyd gene common variants
|
$175.00 |
$175.00 |
$175.00 |
$362.05
|
|
Drainage of kidney lesion
|
$2,170.00 |
$2,170.00 |
$2,170.00 |
$1,534.80
|
|
Drain blood from under nail 11740
|
$75.00 |
$75.00 |
$75.00 |
$173.21
|
|
Drain cath image guided visceral pq
|
$2,785.00 |
$2,785.00 |
$2,785.00 |
$2,881.20
|
|
Drain cerebro spinal fluid 62272
|
$910.00 |
$910.00 |
$910.00 |
$1,044.00
|
|
Drain chst dry seal exp thorastat
|
$160.00 |
$160.00 |
$160.00 |
$119.43
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$207.50 |
$207.50 |
$207.50 |
$397.15
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$157.50 |
$157.50 |
$157.50 |
$355.80
|
|
Dress/debrid prtl-thick burn l 16030
|
$252.50 |
$252.50 |
$252.50 |
$526.40
|
|
Drug assay caffeine
|
$80.00 |
$80.00 |
$80.00 |
$81.61
|
|
Drug assay posaconazole
|
$100.00 |
$100.00 |
$100.00 |
$91.00
|
|
Drug assay rufinamide
|
$135.00 |
$135.00 |
$135.00 |
$88.20
|
|
Drug assay vedolizumab
|
$272.50 |
$272.50 |
$272.50 |
$136.08
|
|
Drug assay voriconazole
|
$137.50 |
$137.50 |
$137.50 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$345.00 |
$345.00 |
$345.00 |
$66.43
|
|
Drug of abuse screen urine
|
$7.50 |
$7.50 |
$7.50 |
$59.60
|
|
Drug screen quant tiagabine
|
$115.00 |
$115.00 |
$115.00 |
$107.80
|
|
Drug test def 15-21 classes
|
$322.50 |
$322.50 |
$322.50 |
$274.26
|
|
Drug test def 22+ classes
|
$140.00 |
$140.00 |
$140.00 |
$276.30
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$352.50 |
$352.50 |
$352.50 |
$278.85
|
|
Dry needling (97799)
|
$152.50 |
$152.50 |
$152.50 |
$114.27
|
|
Duplex scan bilateral study 93985
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$673.00
|
|
Duplex scan unilateral study 93986
|
$730.00 |
$730.00 |
$730.00 |
$392.15
|
|
Dup scan/hemodialysis access 93990
|
$600.00 |
$600.00 |
$600.00 |
$499.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$745.00 |
$745.00 |
$745.00 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$710.00 |
$710.00 |
$710.00 |
$890.55
|
|
Durvalumab 50 mg/ml intravenous solution
|
$199.78 |
$199.78 |
$199.78 |
$7,619.12
|
|
Ear irrigation 69209
|
$30.00 |
$30.00 |
$30.00 |
$150.00
|
|
Ecg 12 lead tracing only
|
$120.00 |
$120.00 |
$120.00 |
$226.50
|
|
Ecg < 30 days transmission & analysis
|
$395.00 |
$395.00 |
$395.00 |
$429.00
|
|
Ecg external < 48 hours recording
|
$440.00 |
$440.00 |
$440.00 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$535.00 |
$535.00 |
$535.00 |
$535.00
|
|
Echocardiogram (Heart Ultrasound)
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$2,030.14
|
|
Echocardiography doppler color flow mapping
|
$525.00 |
$525.00 |
$525.00 |
$500.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$800.00 |
$800.00 |
$800.00 |
$692.40
|
|
Echocardiograpy doppler follow up/limited study
|
$335.00 |
$335.00 |
$335.00 |
$356.40
|
|
Echo exam uterus 76831-
|
$475.00 |
$475.00 |
$475.00 |
$560.50
|
|
Echograp trans r pros study
|
$670.00 |
$670.00 |
$670.00 |
$462.80
|
|
Echo guide for amniocentesis
|
$375.00 |
$375.00 |
$375.00 |
$399.50
|
|
Echo guide for artery repair
|
$660.00 |
$660.00 |
$660.00 |
$660.00
|
|
Echo stress
|
$2,030.00 |
$2,030.00 |
$2,030.00 |
$1,586.90
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$1,871.10
|
|
Echo transthoracic
|
$950.00 |
$950.00 |
$950.00 |
$950.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$964.50
|
|
Eeg 41-60 minutes 95812-26
|
$920.00 |
$920.00 |
$920.00 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$865.00 |
$865.00 |
$865.00 |
$970.07
|
|
Eeg monitor/record/awake/drowsy 95816
|
$680.00 |
$680.00 |
$680.00 |
$859.80
|
|
Eeg over 1 hour 95813 - 26
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$1,165.44
|
|
Eeg/record in coma or sleep only 95822
|
$865.00 |
$865.00 |
$865.00 |
$930.80
|
|
Eeg recording awake and asleep
|
$740.00 |
$740.00 |
$740.00 |
$937.95
|
|
Eeg without vid 2-12hr cont mntr
|
$1,070.00 |
$1,070.00 |
$1,070.00 |
$755.48
|
|
Eeg without vid 2-12 hr unmntr
|
$1,070.00 |
$1,070.00 |
$1,070.00 |
$586.80
|
|
Eeg without vid ea 12-26hr cont
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$1,456.65
|
|
Eeg without vid ea 12-26hr intmt
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$1,343.48
|
|
Eeg wo vid 2-12hr intmt mntr
|
$1,070.00 |
$1,070.00 |
$1,070.00 |
$671.00
|
|
Eeg wo vid ea 12-26hr unmntr
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$1,284.80
|
|
Egfr gene com variants
|
$427.50 |
$427.50 |
$427.50 |
$594.10
|
|
Ehrlicha chaffeensis amp prb
|
$47.50 |
$47.50 |
$47.50 |
$92.40
|
|
Elec analys infus pump w/reprog 62368
|
$555.00 |
$555.00 |
$555.00 |
$606.10
|
|
Electrical stimulation/unattended 97014
|
$55.00 |
$55.00 |
$55.00 |
$79.20
|
|
Electrolyte panel
|
$57.50 |
$57.50 |
$57.50 |
$84.24
|
|
Electron microscopy diagnostic
|
$960.00 |
$960.00 |
$960.00 |
$960.00
|
|
Elotuzumab 300 mg intravenous solution
|
$16.87 |
$16.87 |
$16.87 |
$5,523.02
|
|
Emboli detcj wo IV mbubb njx
|
$630.00 |
$630.00 |
$630.00 |
$484.25
|
|
Embolization s&i
|
$3,575.00 |
$3,575.00 |
$3,575.00 |
$3,099.00
|
|
Emb without cervical dilation 58100
|
$257.50 |
$257.50 |
$257.50 |
$379.80
|
|
Endo abl/incom vein/ext/laser/#1 36478
|
$8,520.00 |
$8,520.00 |
$8,520.00 |
$5,160.00
|
|
Endo abl/incom vein/ext/rad fre/#1 36475
|
$5,150.00 |
$5,150.00 |
$5,150.00 |
$5,339.00
|
|
Endo cath panc duct s&i
|
$485.00 |
$485.00 |
$485.00 |
$662.81
|
|
Endoluminal bx urtr rnl plvs
|
$3,260.00 |
$3,260.00 |
$3,260.00 |
$2,290.60
|
|
Enfortumab vedotin-ejfv 20 mg intravenous solution
|
$58.30 |
$58.30 |
$58.30 |
$7,865.99
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$3.09 |
$3.09 |
$3.09 |
$109.06
|
|
Enzyme histochemistry
|
$265.00 |
$265.00 |
$265.00 |
$456.30
|
|
Epstein barr early antigen antibody
|
$37.50 |
$37.50 |
$37.50 |
$59.00
|
|
Epstein barr nuclear antigen antibody
|
$47.50 |
$47.50 |
$47.50 |
$78.80
|
