|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$30.85 |
$38.08 |
$70.07 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$5.70 |
$69.96 |
$106.83 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$18.40 |
$69.96 |
$100.42 |
|
|
Dextrose 5 % IV bolus
|
$4.24 |
$69.96 |
$107.80 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$8.52 |
$137.50 |
$274.72 |
|
|
Diabetes (HbA1c) Test
|
$34.20 |
$82.50 |
$193.18 |
|
|
Diabetes training group per 30 min g0109
|
$71.20 |
$71.20 |
$71.20 |
|
|
Diab manage trn ind/group
|
$39.22 |
$45.00 |
$190.89 |
|
|
Diag laparo separate proc 49320
|
$590.52 |
$590.52 |
$2,986.40 |
|
|
Diagnostic anoscopy spx 46600
|
$50.60 |
$160.00 |
$2,102.24 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$19.25 |
$19.25 |
$323.40 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$19.25 |
$19.25 |
$154.40 |
|
|
Diagnostic laryngoscopy 31505
|
$77.38 |
$263.20 |
$344.52 |
|
|
Diagnostic laryngoscopy 31575
|
$86.39 |
$235.40 |
$716.44 |
|
|
Diagnostic Mammogram (both breasts)
|
$241.15 |
$399.30 |
$725.61 |
|
|
Diagnostic Mammogram (one breast)
|
$127.05 |
$342.10 |
$581.40 |
|
|
Diagnostic radio unlisted proc
|
$123.49 |
$590.00 |
$634.15 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$796.40 |
$6,662.04 |
$18,335.00 |
|
|
Dialysis one evaluation
|
$74.80 |
$706.49 |
$845.00 |
|
|
Dialysis repeated eval
|
$531.30 |
$531.30 |
$2,153.80 |
|
|
Dialysis training complete
|
$746.90 |
$746.90 |
$1,641.60 |
|
|
Dialysis training incompl
|
$356.80 |
$356.80 |
$1,497.10 |
|
|
Diathermy eg microwave
|
$18.02 |
$47.50 |
$47.50 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.32 |
$0.32 |
$510.98 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$17.38 |
$56.32 |
$94.27 |
|
|
Dicyclomine injection
|
$55.91 |
$153.53 |
$409.46 |
|
|
Diffusing capacity
|
$157.30 |
$285.00 |
$393.80 |
|
|
Digital analysis of eeg
|
$531.30 |
$818.85 |
$1,622.33 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.50 |
$32.34 |
$670.86 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,878.14 |
$7,993.40 |
$15,458.43 |
|
|
Digoxin total therapeutic drug level
|
$51.87 |
$77.50 |
$284.57 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$90.95 |
$240.87 |
$491.40 |
|
|
Dilate biliary duct/ampulla
|
$1,276.77 |
$4,815.00 |
$5,852.79 |
|
|
Dilate esophagus
|
$1,009.12 |
$1,009.12 |
$1,216.00 |
|
|
Dilate esophagus 1/mult pass
|
$117.99 |
$1,605.00 |
$8,583.78 |
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,340.37 |
$1,895.00 |
$7,788.35 |
|
|
Dilate ic vasospasm ea add vsl same territory
|
$696.95 |
$1,895.00 |
$7,788.35 |
|
|
Dilate ic vasospasm init
|
$1,394.43 |
$1,895.00 |
$15,576.70 |
|
|
Dilate urethra stricture
|
$283.29 |
$492.36 |
$1,274.76 |
|
|
Dilate urethra stricture
|
$67.84 |
$67.84 |
$394.40 |
|
|
Dilate urethra stricture
|
$310.40 |
$310.40 |
$310.40 |
|
|
Dilate urethra stricture
|
$94.34 |
$94.34 |
$526.40 |
|
|
Dilation/female urethra/initial 53660
|
$77.91 |
$77.91 |
$329.60 |
|
|
Dilation of anal sphincter
|
$498.40 |
$498.40 |
$498.40 |
|
|
Dilation of cervical canal 57800
|
$3,065.00 |
$3,065.00 |
$9,022.21 |
|
|
Dilation of rectal stricture 45910
|
$962.40 |
$962.40 |
$962.40 |
|
|
Dilation of salivary duct
|
$333.37 |
$333.37 |
$653.95 |
|
|
Dilation of urethra
|
$71.02 |
$71.02 |
$321.60 |
|
|
Dilation salivary duct 42650
|
$59.89 |
$837.60 |
$1,015.48 |
|
|
Dilation/urethral strict/male/ini 53620
|
$73.67 |
$73.67 |
$1,939.20 |
|
|
Dilator fascial 10fx20cm
|
$82.05 |
$147.84 |
$560.00 |
|
|
Dilat xst trc ndurlgc px
|
$2,075.00 |
$2,719.20 |
$8,539.08 |
|
|
Dilat xst trc new access rcs
|
$3,110.00 |
$3,110.00 |
$8,714.64 |
|
|
Diltiazem 5 mg/ml intravenous solution
|
$0.32 |
$0.65 |
$2.45 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$728.75 |
$864.69 |
$1,105.82 |
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.80 |
$0.80 |
$1.06 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.63 |
$24.43 |
$73.88 |
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$34.98 |
$71.82 |
$180.80 |
|
|
Dipyridamole injection
|
$3.71 |
$3.71 |
$3.71 |
|
|
Dir nsl mucous membrane test
|
$49.29 |
$49.29 |
$60.00 |
|
|
Disability dlco
|
$163.02 |
$240.00 |
$607.91 |
|
|
Disaccharidases
|
$132.32 |
$357.50 |
$527.78 |
|
|
Disarticulation sho sec clsr
|
$4,586.40 |
$4,586.40 |
$4,586.40 |
|
|
Disarticulation shoulder
|
$14,510.40 |
$14,510.40 |
$14,510.40 |
|
|
Discography cerv/thor spine
|
$1,023.00 |
$1,940.00 |
$3,359.40 |
|
|
Dissolve clot heart vessel
|
$943.25 |
$1,905.51 |
$3,787.91 |
|
|
Div aberrant vsl w/reanast
|
$11,364.00 |
$11,364.00 |
$11,364.00 |
|
|
Diverticulectomy/hypophar/esoph 43130
|
$3,136.80 |
$3,136.80 |
$3,136.80 |
|
|
Division of fallopian tube 58605
|
$920.00 |
$920.00 |
$920.00 |
|
|
#d/lmeth-l-methamphetamine
|
$156.00 |
$156.00 |
$156.00 |
|
|
Dlyd plmt xtn prosth ea addl
|
$730.00 |
$1,631.87 |
$10,027.60 |
|
|
Dmd dup/delet analysis
|
$368.28 |
$368.28 |
$837.08 |
|
|
Dmpk gene detc abnor allele
|
$368.94 |
$368.94 |
$411.04 |
|
|
Dna antibody native/double stranded
|
$33.63 |
$100.00 |
$335.50 |
|
|
Dna gardnerella
|
$28.05 |
$62.50 |
$138.60 |
|
|
Dna probe chlamydia
|
$119.78 |
$119.78 |
$119.78 |
|
|
Dna probe gc
|
$146.81 |
$146.81 |
$146.81 |
|
|
Dna trichomonas
|
$28.05 |
$62.50 |
$138.60 |
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$20.69 |
$60.54 |
$228.85 |
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2.10 |
$3.79 |
$609.69 |
|
|
Dolasetron mesylate
|
$10.07 |
$10.07 |
$11.97 |
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$3.22 |
$3.35 |
$92.23 |
|
|
Doppler echo complete
|
$303.60 |
$456.06 |
$1,038.27 |
|
|
Doppler intravascular pressure flow initial vessel
|
$1,345.14 |
$1,775.95 |
$6,603.45 |
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$514.10 |
$552.75 |
$2,014.46 |
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$63.80 |
$369.36 |
$1,121.16 |
|
|
Dornase alfa non-comp unit
|
$50.04 |
$88.51 |
$103.28 |
|
|
Dornhoffer fixed part w/window
|
$24,768.76 |
$24,768.76 |
$50,536.80 |
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$452.98 |
$593.96 |
$32,375.09 |
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$5.13 |
$29.26 |
$171.92 |
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$189.43 |
$722.64 |
$6,157.46 |
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1.12 |
$1.23 |
$1.28 |
|
|
Dpyd gene common variants
|
$175.00 |
$253.08 |
$822.36 |
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$191.86 |
$1,354.10 |
$1,663.86 |
|
|
Drainage ext aud canal abscess 69020
|
$205.11 |
$1,325.28 |
$1,489.40 |
|
|
Drainage external ear complex 69005
|
$180.20 |
$1,871.10 |
$5,073.45 |
|
|
Drainage external ear simple 69000
|
$148.40 |
$812.46 |
$1,489.40 |
|
|
Drainage lymph node lesion 38300
|
$205.64 |
$205.64 |
$205.64 |
|
|
Drainage mouth roof lesion
|
$337.15 |
$460.68 |
$1,984.39 |
|
|
Drainage of arm bursa 23931
|
$324.89 |
$1,871.10 |
$2,599.30 |
|
