|
Culture anaerobic additional method definitive id each
|
$29.85 |
$29.85 |
$29.85 |
$84.76
|
|
Culture anaerobic except blood
|
$93.86 |
$93.86 |
$93.86 |
$121.22
|
|
Culture bacteria anaerobic
|
$7.34 |
$7.34 |
$7.34 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$15.94 |
$15.94 |
$15.94 |
$52.50
|
|
Culture body fluid
|
$69.07 |
$69.07 |
$69.07 |
$126.75
|
|
Culture fungi definitive id mold
|
$34.91 |
$34.91 |
$34.91 |
$80.00
|
|
Culture fungi definitive id yeast
|
$34.41 |
$34.41 |
$34.41 |
$80.00
|
|
Culture fungi other (except blood)
|
$19.73 |
$19.73 |
$19.73 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$14.93 |
$14.93 |
$14.93 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$16.19 |
$16.19 |
$16.19 |
$100.00
|
|
Culture mycoplasma any source
|
$15.94 |
$15.94 |
$15.94 |
$83.21
|
|
Culture quantitative aerobic other source
|
$15.43 |
$15.43 |
$15.43 |
$87.02
|
|
Culture screening strep group a
|
$33.14 |
$33.14 |
$33.14 |
$84.60
|
|
Culture typing glc/hplc
|
$9.61 |
$9.61 |
$9.61 |
$53.75
|
|
Culture typing immunologic
|
$21.50 |
$21.50 |
$21.50 |
$44.00
|
|
Culture urine each isolate
|
$6.32 |
$6.32 |
$6.32 |
$55.50
|
|
Cutter lead
|
$6,071.35 |
$6,071.35 |
$6,071.35 |
$6,581.45
|
|
Cv line/pic reposition
|
$608.61 |
$608.61 |
$608.61 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$10.43 |
$10.43 |
$10.43 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$8.79 |
$8.79 |
$8.79 |
$72.36
|
|
Cyclosporine 2 hour
|
$9.16 |
$9.16 |
$9.16 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$21,887.91 |
$21,887.91 |
$21,887.91 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$304.67 |
$304.67 |
$304.67 |
$524.00
|
|
Cyp2c9 gene com variants
|
$113.92 |
$113.92 |
$113.92 |
$275.10
|
|
Cyp2d6 gene com variants
|
$293.60 |
$293.60 |
$293.60 |
$570.70
|
|
Cyp3a4 gene common variants
|
$113.92 |
$113.92 |
$113.92 |
$241.24
|
|
Cyp3a5 gene common variants
|
$113.92 |
$113.92 |
$113.92 |
$245.31
|
|
Cystatin c
|
$8.85 |
$8.85 |
$8.85 |
$77.60
|
|
Cystic fibrosis cftr
|
$521.88 |
$521.88 |
$521.88 |
$1,104.40
|
|
Cystine urine quantitative
|
$14.38 |
$14.38 |
$14.38 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$260.61 |
$260.61 |
$260.61 |
$586.95
|
|
Cystostomy cystotomy w/drainage 51040
|
$907.68 |
$907.68 |
$907.68 |
$4,129.45
|
|
Cytogenetics 25-99
|
$40.18 |
$40.18 |
$40.18 |
$189.80
|
|
Cytogenomic neo microra alys
|
$1,212.81 |
$1,212.81 |
$1,212.81 |
$2,198.00
|
|
Cytogenom microarray copy nmbr var
|
$585.90 |
$585.90 |
$585.90 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$8.94 |
$8.94 |
$8.94 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$9.09 |
$9.09 |
$9.09 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$36.46 |
$36.46 |
$36.46 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$29.99 |
$29.99 |
$29.99 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$22.93 |
$22.93 |
$22.93 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$61.74 |
$61.74 |
$61.74 |
$135.20
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$9.21 |
$9.21 |
$9.21 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$71.54 |
$71.54 |
$71.54 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$80.16 |
$80.16 |
$80.16 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$42.73 |
$42.73 |
$42.73 |
$96.20
|
|
Cytotoxic antibody screening
|
$13.41 |
$13.41 |
$13.41 |
$133.25
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$0.37 |
$0.37 |
$0.37 |
$6,281.29
|
|
Dch pulmonary stress test
|
$44.42 |
$44.42 |
$44.42 |
$963.30
|
|
Dch validity tests
|
$3.07 |
$3.07 |
$3.07 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$1,777.47 |
$1,777.47 |
$1,777.47 |
$5,121.00
|
|
Deamidated gliadin antibody iga
|
$8.79 |
$8.79 |
$8.79 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$58.65 |
$58.65 |
$58.65 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$343.42 |
$343.42 |
$343.42 |
$835.20
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$147.84 |
$147.84 |
$147.84 |
$663.30
|
|
Decalcification
|
$10.54 |
$10.54 |
$10.54 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$162.01 |
$162.01 |
$162.01 |
$572.95
|
|
Delivery of placenta 59414
|
$2,732.58 |
$2,732.58 |
$2,732.58 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$2,036.50 |
$2,036.50 |
$2,036.50 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$93.80 |
$93.80 |
$93.80 |
$185.17
|
|
Design mlc device for imrt
|
$661.69 |
$661.69 |
$661.69 |
$1,753.00
|
|
Desoxycorticosterone
|
$14.69 |
$14.69 |
$14.69 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$1,664.74 |
$1,664.74 |
$1,664.74 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$671.44 |
$671.44 |
$671.44 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$589.20 |
$589.20 |
$589.20 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,778.70 |
$1,778.70 |
$1,778.70 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$76.52 |
$76.52 |
$76.52 |
$142.38
|
|
Device ablt adv novasure
|
$1,945.44 |
$1,945.44 |
$1,945.44 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,334.36 |
$2,334.36 |
$2,334.36 |
$4,200.00
|
|
Device sut capio slim opn
|
$3,045.54 |
$3,045.54 |
$3,045.54 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,334.36 |
$2,334.36 |
$2,334.36 |
$2,515.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.03 |
$0.03 |
$0.03 |
$20.76
|
|
Dhea-s (dehydroepiand sulfate)
|
$10.59 |
$10.59 |
$10.59 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$27.97 |
$27.97 |
$27.97 |
$79.30
|
|
Diagnostic laryngoscopy 31575
|
$142.60 |
$142.60 |
$142.60 |
$338.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,132.98 |
$3,132.98 |
$3,132.98 |
$5,741.00
|
|
Diathermy eg microwave
|
$11.96 |
$11.96 |
$11.96 |
$29.68
|
|
Diffusing capacity
|
$22.54 |
$22.54 |
$22.54 |
$336.80
|
|
Digital analysis of eeg
|
$649.63 |
$649.63 |
$649.63 |
$593.40
|
|
Digoxin total therapeutic drug level
|
$8.37 |
$8.37 |
$8.37 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,471.32 |
$1,471.32 |
$1,471.32 |
$1,866.73
|
|
Dilate esophagus
|
$396.09 |
$396.09 |
$396.09 |
$2,142.40
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$4,759.52 |
$4,759.52 |
$4,759.52 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$4,759.52 |
$4,759.52 |
$4,759.52 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$6,346.03 |
$6,346.03 |
$6,346.03 |
$5,151.95
|
|
Dilator fascial 10fx20cm
|
$362.38 |
$362.38 |
$362.38 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$1,078.31 |
$1,078.31 |
$1,078.31 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$1,827.67 |
$1,827.67 |
$1,827.67 |
$4,258.20
|
|
Disability dlco
|
$13.44 |
$13.44 |
$13.44 |
$293.76
|
|
Disaccharidases
|
$57.20 |
$57.20 |
$57.20 |
$230.40
|
|
Discography cerv/thor spine
|
$909.82 |
$909.82 |
$909.82 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$1,396.47 |
$1,396.47 |
$1,396.47 |
$1,579.93
|
|
#d/lmeth-l-methamphetamine
|
$10.59 |
$10.59 |
$10.59 |
$72.14
|
|
Dna antibody native/double stranded
|
$9.24 |
$9.24 |
$9.24 |
$100.00
|
|
Dna gardnerella
|
$15.43 |
$15.43 |
$15.43 |
$61.83
|
|
Dna trichomonas
|
$15.43 |
$15.43 |
$15.43 |
$63.00
|
|
Doppler echo complete
|
$236.49 |
$236.49 |
$236.49 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$1,010.52 |
$1,010.52 |
$1,010.52 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$311.16 |
$311.16 |
$311.16 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$266.11 |
$266.11 |
$266.11 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$57,598.05 |
$57,598.05 |
$57,598.05 |
$34,278.00
|
