|
Cystic fibrosis cftr
|
$1,231.10 |
$1,231.10 |
$1,231.10 |
$1,041.95
|
|
Cystine urine quantitative
|
$104.00 |
$104.00 |
$104.00 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$246.35 |
$246.35 |
$246.35 |
$487.04
|
|
Cystorrhaphy wound simple 51860
|
$11,250.54 |
$11,250.54 |
$11,250.54 |
$4,296.14
|
|
Cysto rx balo cath urtl strx
|
$8,683.56 |
$8,683.56 |
$8,683.56 |
$6,853.60
|
|
Cystoscopy and treatment
|
$4,775.97 |
$4,775.97 |
$4,775.97 |
$3,970.98
|
|
Cystoscopy and treatment
|
$4,918.76 |
$4,918.76 |
$4,918.76 |
$4,846.99
|
|
Cystoscopy and treatment
|
$5,769.46 |
$5,769.46 |
$5,769.46 |
$4,846.99
|
|
Cystoscopy and treatment
|
$6,475.26 |
$6,475.26 |
$6,475.26 |
$5,949.75
|
|
Cystoscopy and treatment
|
$3,908.31 |
$3,908.31 |
$3,908.31 |
$2,355.42
|
|
Cystoscopy and treatment
|
$4,771.60 |
$4,771.60 |
$4,771.60 |
$2,331.55
|
|
Cystoscopy and treatment
|
$4,529.78 |
$4,529.78 |
$4,529.78 |
$2,269.38
|
|
Cystoscopy and treatment
|
$8,683.32 |
$8,683.32 |
$8,683.32 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$2,887.13 |
$2,887.13 |
$2,887.13 |
$1,633.60
|
|
Cystoscopy chemodenervation
|
$4,466.24 |
$4,466.24 |
$4,466.24 |
$2,412.45
|
|
Cystoscopy implant stent
|
$6,803.86 |
$6,803.86 |
$6,803.86 |
$3,817.53
|
|
Cystoscopy removal of clots
|
$5,391.29 |
$5,391.29 |
$5,391.29 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$5,798.26 |
$5,798.26 |
$5,798.26 |
$3,416.48
|
|
Cystouretero & or pyeloscope
|
$3,971.03 |
$3,971.03 |
$3,971.03 |
$4,061.71
|
|
Cystouretero w/biopsy
|
$5,971.01 |
$5,971.01 |
$5,971.01 |
$4,447.24
|
|
Cysto/uretero w/lithotripsy
|
$11,311.56 |
$11,311.56 |
$11,311.56 |
$7,372.68
|
|
Cystouretero w/lithotripsy
|
$10,865.58 |
$10,865.58 |
$10,865.58 |
$7,372.68
|
|
Cystouretero w/stone remove
|
$5,014.02 |
$5,014.02 |
$5,014.02 |
$4,846.99
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,979.80 |
$3,979.80 |
$3,979.80 |
$2,874.36
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$3,985.40 |
$3,985.40 |
$3,985.40 |
$3,970.98
|
|
Cysto w/renal stricture tx
|
$18,331.22 |
$18,331.22 |
$18,331.22 |
$2,582.14
|
|
Cytarabine 20 mg/ml injection solution
|
$48.31 |
$48.31 |
$48.31 |
$59.31
|
|
Cytogenetics 25-99
|
$131.30 |
$131.30 |
$131.30 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$91.00 |
$91.00 |
$91.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$78.65 |
$78.65 |
$78.65 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$92.95 |
$92.95 |
$92.95 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$43.55 |
$43.55 |
$43.55 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$45.50 |
$45.50 |
$45.50 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$70.20 |
$70.20 |
$70.20 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$79.95 |
$79.95 |
$79.95 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$62.40 |
$62.40 |
$62.40 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$98.80 |
$98.80 |
$98.80 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$143.00 |
$143.00 |
$143.00 |
$205.00
|
|
Cytopath smear other source
|
$68.90 |
$68.90 |
$68.90 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$98.80 |
$98.80 |
$98.80 |
$95.00
|
|
Cytopath tbs c/v manual
|
$55.25 |
$55.25 |
$55.25 |
$57.94
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$1,225.86
|
|
Dalbavancin 500 mg intravenous solution
|
$3,226.46 |
$3,226.46 |
$3,226.46 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$92.62 |
$92.62 |
$92.62 |
$1.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$25,572.72 |
$25,572.72 |
$25,572.72 |
$15,683.37
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$7,798.05 |
$7,798.05 |
$7,798.05 |
$4,542.99
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$26,100.75 |
$26,100.75 |
$26,100.75 |
$14,514.57
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$311.67 |
$311.67 |
$311.67 |
$130.13
|
|
D&c after delivery 59160
|
$3,777.64 |
$3,777.64 |
$3,777.64 |
$3,441.98
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$3,988.43 |
$3,988.43 |
$3,988.43 |
$3,627.00
|
|
Dch glucoscan
|
$1.95 |
$1.95 |
$1.95 |
$28.10
|
|
Dch pulmonary stress test
|
$686.40 |
$686.40 |
$686.40 |
$964.41
|
|
Dch validity tests
|
$40.30 |
$40.30 |
$40.30 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$197.60 |
$197.60 |
$197.60 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$208.00 |
$208.00 |
$208.00 |
$313.30
|
|
Decalcification
|
$5,470.71 |
$5,470.71 |
$5,470.71 |
$72.15
|
|
Decitabine 50 mg intravenous solution
|
$234.00 |
$234.00 |
$234.00 |
$225.55
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$263.90 |
$263.90 |
$263.90 |
$482.35
|
|
Deferoxamine 500 mg solution for injection
|
$107.20 |
$107.20 |
$107.20 |
$47.62
|
|
Degarelix 120 mg subcutaneous solution
|
$3,474.01 |
$3,474.01 |
$3,474.01 |
$2,303.24
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$126.10 |
$126.10 |
$126.10 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$8,090.10 |
$8,090.10 |
$8,090.10 |
$4,681.80
|
|
Depo-estradiol cypionate inj
|
$796.39 |
$796.39 |
$796.39 |
$337.07
|
|
Design mlc device for imrt
|
$35,160.48 |
$35,160.48 |
$35,160.48 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$463.12 |
$463.12 |
$463.12 |
$37.26
|
|
Desoxycorticosterone
|
$87.75 |
$87.75 |
$87.75 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$2,568.11 |
$2,568.11 |
$2,568.11 |
$2,963.07
|
|
Destroy cth facet jnt addl 64634
|
$2,568.11 |
$2,568.11 |
$2,568.11 |
$1,441.44
|
|
Destroy vulva lesion extensive 56515
|
$5,952.89 |
$5,952.89 |
$5,952.89 |
$2,108.87
|
|
Destroy vulva lesion simple 56501
|
$6,183.84 |
$6,183.84 |
$6,183.84 |
$3,458.00
|
|
Destruction anal lesion(s)
|
$5,952.89 |
$5,952.89 |
$5,952.89 |
$3,035.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,601.99 |
$2,601.99 |
$2,601.99 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,598.70 |
$2,598.70 |
$2,598.70 |
$3,101.88
|
|
Destruction laser surgery anal lesions 46917
|
$4,499.50 |
$4,499.50 |
$4,499.50 |
$2,770.80
|
|
Developmental screen/score/document 96110
|
$203.45 |
$203.45 |
$203.45 |
$126.75
|
|
Dexamethasone 4 mg tablet
|
$50.39 |
$50.39 |
$50.39 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$7.15 |
$7.15 |
$7.15 |
$8.23
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$617.50 |
$617.50 |
$617.50 |
$465.34
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$37.50 |
$37.50 |
$37.50 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$37.50 |
$37.50 |
$37.50 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.50 |
$37.50 |
$37.50 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$37.50 |
$37.50 |
$37.50 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$79.30 |
$79.30 |
$79.30 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$55.25 |
$55.25 |
$55.25 |
$70.00
|
|
Diab manage trn ind/group
|
$64.35 |
$64.35 |
$64.35 |
$56.55
|
|
Diag laparo separate proc 49320
|
$6,713.90 |
$6,713.90 |
$6,713.90 |
$6,376.26
|
|
Diagnostic Mammogram (both breasts)
|
$175.50 |
$175.50 |
$175.50 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$162.50 |
$162.50 |
$162.50 |
$276.60
|
|
Dialysis one evaluation
|
$713.05 |
$713.05 |
$713.05 |
$920.00
|
|
Diathermy eg microwave
|
$29.90 |
$29.90 |
$29.90 |
$17.37
|
|
Diatrizoate meglumine 18 % urethral solution
|
$100.03 |
$100.03 |
$100.03 |
$58.24
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$13.00 |
$13.00 |
$13.00 |
$42.12
|
|
Diffusing capacity
|
$308.75 |
$308.75 |
$308.75 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.15 |
$7.15 |
$7.15 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$63.05 |
$63.05 |
$63.05 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$120.41 |
$120.41 |
$120.41 |
$297.86
|
|
Dilate esophagus
|
$4,905.07 |
$4,905.07 |
$4,905.07 |
$2,003.04
|
|
Dilate esophagus 1/mult pass
|
$4,214.62 |
$4,214.62 |
$4,214.62 |
$1,349.05
|
|
Diltiazem 5 mg/ml intravenous solution
|
$35.24 |
$35.24 |
$35.24 |
$49.92
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,253.11 |
$2,253.11 |
$2,253.11 |
$1,001.55
|
