|
Cyclosporine oral 100 mg
|
$68.43 |
$68.43 |
$68.43 |
$34.88
|
|
Cystatin c
|
$9.12 |
$9.12 |
$9.12 |
$77.50
|
|
Cystic fibrosis cftr
|
$319.96 |
$319.96 |
$319.96 |
$1,100.00
|
|
Cystine urine quantitative
|
$12.16 |
$12.16 |
$12.16 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$216.60 |
$216.60 |
$216.60 |
$542.10
|
|
Cystoscopy and treatment
|
$1,071.03 |
$1,071.03 |
$1,071.03 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$217.55 |
$217.55 |
$217.55 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$520.60 |
$520.60 |
$520.60 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$19.00 |
$19.00 |
$19.00 |
$89.94
|
|
Cytogenomic neo microra alys
|
$773.68 |
$773.68 |
$773.68 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$1,080.91 |
$1,080.91 |
$1,080.91 |
$1,433.77
|
|
Cytog genom-wid alys hem mal
|
$720.29 |
$720.29 |
$720.29 |
$1,263.53
|
|
Cytomegalovirus (cmv) antibody igg
|
$17.48 |
$17.48 |
$17.48 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$23.56 |
$23.56 |
$23.56 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$26.41 |
$26.41 |
$26.41 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$15.77 |
$15.77 |
$15.77 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$20.52 |
$20.52 |
$20.52 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$11.97 |
$11.97 |
$11.97 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$14.25 |
$14.25 |
$14.25 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$48.26 |
$48.26 |
$48.26 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$26.41 |
$26.41 |
$26.41 |
$209.23
|
|
Cytopath smear other source
|
$36.67 |
$36.67 |
$36.67 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$11.78 |
$11.78 |
$11.78 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$19.00 |
$19.00 |
$19.00 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,334.57 |
$1,334.57 |
$1,334.57 |
$3,024.59
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,174.51 |
$1,174.51 |
$1,174.51 |
$168.53
|
|
Daptomycin (xellia) unrefrig
|
$47.45 |
$47.45 |
$47.45 |
$56.19
|
|
Dark field exam without collj
|
$25.65 |
$25.65 |
$25.65 |
$28.80
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$271.57 |
$271.57 |
$271.57 |
$257.10
|
|
Dch pulmonary stress test
|
$359.29 |
$359.29 |
$359.29 |
$963.30
|
|
Dch validity tests
|
$38.38 |
$38.38 |
$38.38 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$7.22 |
$7.22 |
$7.22 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$142.69 |
$142.69 |
$142.69 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$90.82 |
$90.82 |
$90.82 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$395.01 |
$395.01 |
$395.01 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$146.11 |
$146.11 |
$146.11 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$395.01 |
$395.01 |
$395.01 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$146.11 |
$146.11 |
$146.11 |
$810.50
|
|
Debride nail1-5 11720
|
$35.15 |
$35.15 |
$35.15 |
$148.80
|
|
Debride nail6 or more 11721
|
$35.15 |
$35.15 |
$35.15 |
$169.60
|
|
Debride skin bone at fx site
|
$680.96 |
$680.96 |
$680.96 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$146.11 |
$146.11 |
$146.11 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$230.09 |
$230.09 |
$230.09 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$146.11 |
$146.11 |
$146.11 |
$1,160.00
|
|
Decalcification
|
$7.22 |
$7.22 |
$7.22 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$775.92 |
$775.92 |
$775.92 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$223.06 |
$223.06 |
$223.06 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$108.65 |
$108.65 |
$108.65 |
$95.85
|
|
Delivery of placenta 59414
|
$786.79 |
$786.79 |
$786.79 |
$3,070.56
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$49.40 |
$49.40 |
$49.40 |
$408.10
|
|
Dermagraft
|
$123.12 |
$123.12 |
$123.12 |
$85.00
|
|
Design mlc device for imrt
|
$142.12 |
$142.12 |
$142.12 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$847.42 |
$847.42 |
$847.42 |
$89.78
|
|
Desoxycorticosterone
|
$325.85 |
$325.85 |
$325.85 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$425.60 |
$425.60 |
$425.60 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$128.25 |
$128.25 |
$128.25 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$37.81 |
$37.81 |
$37.81 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$18.43 |
$18.43 |
$18.43 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$38.95 |
$38.95 |
$38.95 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$451.06 |
$451.06 |
$451.06 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$830.11 |
$830.11 |
$830.11 |
$3,202.98
|
|
Detect agent nos dna dir
|
$14.25 |
$14.25 |
$14.25 |
$115.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$17.48 |
$17.48 |
$17.48 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$184.53 |
$184.53 |
$184.53 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$89.52 |
$89.52 |
$89.52 |
$21.17
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$172.25 |
$172.25 |
$172.25 |
$858.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$81.70 |
$81.70 |
$81.70 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$89.87 |
$89.87 |
$89.87 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$65.36 |
$65.36 |
$65.36 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$98.04 |
$98.04 |
$98.04 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$61.18 |
$61.18 |
$61.18 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$38.19 |
$38.19 |
$38.19 |
$79.20
|
|
Diagnostic digital breast tomosynthesis bil
|
$19.95 |
$19.95 |
$19.95 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$19.95 |
$19.95 |
$19.95 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$100.89 |
$100.89 |
$100.89 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$149.91 |
$149.91 |
$149.91 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$119.89 |
$119.89 |
$119.89 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$69.92 |
$69.92 |
$69.92 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$1,582.32 |
$1,582.32 |
$1,582.32 |
$5,419.00
|
|
Dialysis one evaluation
|
$298.30 |
$298.30 |
$298.30 |
$919.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$175.61 |
$175.61 |
$175.61 |
$74.76
|
|
Dicyclomine injection
|
$102.82 |
$102.82 |
$102.82 |
$153.29
|
|
Diffusing capacity
|
$115.14 |
$115.14 |
$115.14 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$19.00 |
$19.00 |
$19.00 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$38.38 |
$38.38 |
$38.38 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$346.31 |
$346.31 |
$346.31 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$463.60 |
$463.60 |
$463.60 |
$1,866.73
|
|
Dilate urethra stricture
|
$68.78 |
$68.78 |
$68.78 |
$490.00
|
|
Dilation/urethral strict/male/ini 53620
|
$473.67 |
$473.67 |
$473.67 |
$1,372.80
|
|
Dilat xst trc ndurlgc px
|
$1,157.67 |
$1,157.67 |
$1,157.67 |
$4,061.71
|
|
Dilat xst trc new access rcs
|
$1,948.07 |
$1,948.07 |
$1,948.07 |
$4,213.20
|
|
Dimenhydrinate injection
|
$19.00 |
$19.00 |
$19.00 |
$30.48
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.38 |
$0.38 |
$0.38 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$30.32 |
$30.32 |
$30.32 |
$17.75
|
|
Dipyridamole injection
|
$49.59 |
$49.59 |
$49.59 |
$47.87
|
|
Disability dlco
|
$65.74 |
$65.74 |
$65.74 |
$282.40
|
|
Disaccharidases
|
$116.47 |
$116.47 |
$116.47 |
$216.00
|
|
Discography cerv/thor spine
|
$790.02 |
$790.02 |
$790.02 |
$2,565.00
|
|
Dna antibody native/double stranded
|
$63.27 |
$63.27 |
$63.27 |
$97.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$101.89 |
$101.89 |
$101.89 |
$98.43
|