|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$34.98 |
$34.98 |
$34.98 |
$106.59
|
|
Dir nsl mucous membrane test
|
$49.29 |
$49.29 |
$49.29 |
$46.45
|
|
Disability dlco
|
$607.91 |
$607.91 |
$607.91 |
$307.58
|
|
Disaccharidases
|
$335.49 |
$335.49 |
$335.49 |
$223.80
|
|
Dissolve clot heart vessel
|
$3,787.91 |
$3,787.91 |
$3,787.91 |
$1,396.47
|
|
Dlyd plmt xtn prosth ea addl
|
$2,867.83 |
$2,867.83 |
$2,867.83 |
$2,001.55
|
|
Dna antibody native/double stranded
|
$111.30 |
$111.30 |
$111.30 |
$102.60
|
|
Dna gardnerella
|
$51.41 |
$51.41 |
$51.41 |
$67.68
|
|
Dna probe chlamydia
|
$119.78 |
$119.78 |
$119.78 |
$82.20
|
|
Dna probe gc
|
$146.81 |
$146.81 |
$146.81 |
$88.67
|
|
Dna trichomonas
|
$104.94 |
$104.94 |
$104.94 |
$68.75
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$46.64 |
$46.64 |
$46.64 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$3.79 |
$3.79 |
$3.79 |
$712.02
|
|
Dolasetron mesylate
|
$10.07 |
$10.07 |
$10.07 |
$76.59
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$3.22 |
$3.22 |
$3.22 |
$84.30
|
|
Doppler echo complete
|
$1,038.27 |
$1,038.27 |
$1,038.27 |
$608.25
|
|
Doppler intravascular pressure flow initial vessel
|
$3,158.27 |
$3,158.27 |
$3,158.27 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$514.10 |
$514.10 |
$514.10 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$392.20 |
$392.20 |
$392.20 |
$482.03
|
|
Dornase alfa non-comp unit
|
$88.51 |
$88.51 |
$88.51 |
$479.80
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$12.35 |
$12.35 |
$12.35 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$928.56 |
$928.56 |
$928.56 |
$2,417.38
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$191.86 |
$191.86 |
$191.86 |
$820.50
|
|
Drainage ext aud canal abscess 69020
|
$205.11 |
$205.11 |
$205.11 |
$900.80
|
|
Drainage external ear complex 69005
|
$180.20 |
$180.20 |
$180.20 |
$2,967.58
|
|
Drainage external ear simple 69000
|
$148.40 |
$148.40 |
$148.40 |
$809.25
|
|
Drainage lymph node lesion 38300
|
$205.64 |
$205.64 |
$205.64 |
$3,170.64
|
|
Drainage of arm bursa 23931
|
$324.89 |
$324.89 |
$324.89 |
$2,419.30
|
|
Drainage of kidney lesion
|
$1,909.06 |
$1,909.06 |
$1,909.06 |
$1,706.65
|
|
Drainage of mouth lesion
|
$253.34 |
$253.34 |
$253.34 |
$455.56
|
|
Drainage of nose lesion int 30000
|
$255.46 |
$255.46 |
$255.46 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$249.10 |
$249.10 |
$249.10 |
$755.95
|
|
Drainage of rectal abscess
|
$260.23 |
$260.23 |
$260.23 |
$2,299.90
|
|
Drainage of salivary gland
|
$181.79 |
$181.79 |
$181.79 |
$629.60
|
|
Drain bladder by trocar/cath
|
$170.66 |
$170.66 |
$170.66 |
$1,126.11
|
|
Drain blood from under nail 11740
|
$29.15 |
$29.15 |
$29.15 |
$190.33
|
|
Drain cath image guided visceral pq
|
$4,459.95 |
$4,459.95 |
$4,459.95 |
$3,073.90
|
|
Drain cerebro spinal fluid 62272
|
$934.39 |
$934.39 |
$934.39 |
$1,113.06
|
|
Drain finger abscess;simple 26010
|
$269.77 |
$269.77 |
$269.77 |
$492.81
|
|
Drain lower leg lesion 27603
|
$355.10 |
$355.10 |
$355.10 |
$3,631.18
|
|
Drain neck/chest lesion 21501
|
$286.73 |
$286.73 |
$286.73 |
$3,386.84
|
|
Drain shoulder lesion
|
$391.67 |
$391.67 |
$391.67 |
$3,571.53
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$623.81 |
$623.81 |
$623.81 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$583.00 |
$583.00 |
$583.00 |
$365.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$692.18 |
$692.18 |
$692.18 |
$554.40
|
|
Dressing change not for burn w/anes 15852
|
$159.00 |
$159.00 |
$159.00 |
$790.56
|
|
Drng of eyelid abscess 67700
|
$324.36 |
$324.36 |
$324.36 |
$747.00
|
|
Drng of finger abscess comp 26011
|
$451.03 |
$451.03 |
$451.03 |
$2,048.00
|
|
Drng of hydrocele 55000
|
$77.91 |
$77.91 |
$77.91 |
$832.60
|
|
Drng of mouth lesion 40801
|
$224.19 |
$224.19 |
$224.19 |
$1,145.97
|
|
Drng salivary gland simple 42300
|
$308.99 |
$308.99 |
$308.99 |
$2,133.48
|
|
Dronabinol 2.5mg oral
|
$3.36 |
$3.36 |
$3.36 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$20.08 |
$20.08 |
$20.08 |
$39.60
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$822.03 |
$822.03 |
$822.03 |
$3,374.24
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$9.01 |
$9.01 |
$9.01 |
$468.29
|
|
Drsg sht 5.625x4.625in std
|
$18.02 |
$18.02 |
$18.02 |
$80.11
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$367.29 |
$367.29 |
$367.29 |
$6,581.45
|
|
Drug admin & hemodynmic meas
|
$364.64 |
$364.64 |
$364.64 |
$528.50
|
|
Drug assay caffeine
|
$114.48 |
$114.48 |
$114.48 |
$81.61
|
|
Drug assay posaconazole
|
$47.70 |
$47.70 |
$47.70 |
$96.39
|
|
Drug assay rufinamide
|
$46.64 |
$46.64 |
$46.64 |
$93.60
|
|
Drug assay vedolizumab
|
$69.43 |
$69.43 |
$69.43 |
$164.16
|
|
Drug assay voriconazole
|
$265.00 |
$265.00 |
$265.00 |
$96.75
|
|
Drug of abuse screen urine
|
$73.14 |
$73.14 |
$73.14 |
$63.75
|
|
Drug screen quant tiagabine
|
$60.95 |
$60.95 |
$60.95 |
$91.80
|
|
Drug test def 15-21 classes
|
$250.16 |
$250.16 |
$250.16 |
$144.42
|
|
Drug test def 22+ classes
|
$325.95 |
$325.95 |
$325.95 |
$246.92
|
|
Drug test def 8-14 classes
|
$184.97 |
$184.97 |
$184.97 |
$172.25
|
|
Drug test prsmv instrmnt
|
$58.30 |
$58.30 |
$58.30 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$668.86 |
$668.86 |
$668.86 |
$278.85
|
|
Drvvt confirm - quest
|
$60.95 |
$60.95 |
$60.95 |
$101.66
|
|
Dstrj nulyt agt gnclr nrv
|
$385.31 |
$385.31 |
$385.31 |
$3,390.00
|
|
Ductogram sgl duct
|
$298.39 |
$298.39 |
$298.39 |
$413.91
|
|
Duplex scan bilateral study 93985
|
$1,529.05 |
$1,529.05 |
$1,529.05 |
$673.00
|
|
Duplex scan unilateral study 93986
|
$1,018.13 |
$1,018.13 |
$1,018.13 |
$394.00
|
|
Dup scan/hemodialysis access 93990
|
$714.44 |
$714.44 |
$714.44 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$1,876.20 |
$1,876.20 |
$1,876.20 |
$757.57
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,561.38 |
$1,561.38 |
$1,561.38 |
$903.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$127.78 |
$127.78 |
$127.78 |
$10,021.12
|
|
Dxa bone density axl vrt fx
|
$48.76 |
$48.76 |
$48.76 |
$374.00
|
|
Dx bronchoscope/brush 31623
|
$3,904.51 |
$3,904.51 |
$3,904.51 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$3,903.98 |
$3,903.98 |
$3,903.98 |
$2,780.40
|
|
Dx bronchoscope/wash 31622
|
$3,904.51 |
$3,904.51 |
$3,904.51 |
$2,587.60
|
|
Ear canal biopsy 69105
|
$176.49 |
$176.49 |
$176.49 |
$1,768.50
|
|
Ear irrigation 69209
|
$27.03 |
$27.03 |
$27.03 |
$165.42
|
|
Ear protector evaluation
|
$68.37 |
$68.37 |
$68.37 |
$65.00
|
|
Ecg 12 lead tracing only
|
$349.80 |
$349.80 |
$349.80 |
$245.00
|
|
Ecg/1-3 leads/interp & report only 93042
|
$70.49 |
$70.49 |
$70.49 |
$16.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$206.17 |
$206.17 |
$206.17 |
$129.83
|
|
Ecg < 30 days transmission & analysis
|
$487.60 |
$487.60 |
$487.60 |
$429.00
|
|
Ecg external < 48 hours recording
|
$1,277.30 |
$1,277.30 |
$1,277.30 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$120.31 |
$120.31 |
$120.31 |
$567.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$1,302.21 |
$1,302.21 |
$1,302.21 |
$162.78
|
|
Ecg external >7 days up to 15 days recording
|
$1,302.21 |
$1,302.21 |
$1,302.21 |
$200.00
|
|
Echocardiogram (Heart Ultrasound)
|
$3,501.71 |
$3,501.71 |
$3,501.71 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$677.87 |
$677.87 |
$677.87 |
$469.95
|
|
Echocardiography transthoracic 2d followup/limited
|
$2,528.10 |
$2,528.10 |
$2,528.10 |
$724.20
|
|
Echocardiograpy doppler follow up/limited study
|
$485.48 |
$485.48 |
$485.48 |
$353.46
|
|
Echo exam of fetal heart
|
$416.58 |
$416.58 |
$416.58 |
$855.38
|
|
Echo exam of fetal heart
|
$311.64 |
$311.64 |
$311.64 |
$503.80
|
