|
Culture afb any source
|
$71.50 |
$71.50 |
$71.50 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$65.65 |
$65.65 |
$65.65 |
$73.00
|
|
Culture anaerobic except blood
|
$112.45 |
$112.45 |
$112.45 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$18.20 |
$18.20 |
$18.20 |
$49.40
|
|
Culture body fluid
|
$141.05 |
$141.05 |
$141.05 |
$111.15
|
|
Culture fungi definitive id mold
|
$58.50 |
$58.50 |
$58.50 |
$70.00
|
|
Culture fungi definitive id yeast
|
$32.50 |
$32.50 |
$32.50 |
$68.00
|
|
Culture fungi other (except blood)
|
$92.30 |
$92.30 |
$92.30 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$89.05 |
$89.05 |
$89.05 |
$74.75
|
|
Culture mycoplasma any source
|
$108.55 |
$108.55 |
$108.55 |
$94.00
|
|
Culture screening strep group a
|
$111.15 |
$111.15 |
$111.15 |
$76.00
|
|
Culture typing immunologic
|
$35.75 |
$35.75 |
$35.75 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$733.20 |
$733.20 |
$733.20 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$35.75 |
$35.75 |
$35.75 |
$100.20
|
|
Culture urine each isolate
|
$75.40 |
$75.40 |
$75.40 |
$44.80
|
|
Cyanocobalamin unsat binding capacity
|
$39.00 |
$39.00 |
$39.00 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$21.59 |
$21.59 |
$21.59 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$72.15 |
$72.15 |
$72.15 |
$91.20
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,074.57 |
$1,074.57 |
$1,074.57 |
$2.42
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$224.14 |
$224.14 |
$224.14 |
$179.92
|
|
Cyclosporine 2 hour
|
$156.00 |
$156.00 |
$156.00 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$9.97 |
$9.97 |
$9.97 |
$4.42
|
|
Cyclosporine oral 100 mg
|
$498.13 |
$498.13 |
$498.13 |
$19.50
|
|
Cyp2c19 gene com variants
|
$642.20 |
$642.20 |
$642.20 |
$583.20
|
|
Cyp3a4 gene common variants
|
$438.75 |
$438.75 |
$438.75 |
$245.31
|
|
Cystatin c
|
$94.90 |
$94.90 |
$94.90 |
$83.20
|
|
Cystic fibrosis cftr
|
$1,041.95 |
$1,041.95 |
$1,041.95 |
$1,041.95
|
|
Cystine urine quantitative
|
$87.75 |
$87.75 |
$87.75 |
$112.50
|
|
Cytarabine 20 mg/ml injection solution
|
$54.05 |
$54.05 |
$54.05 |
$59.31
|
|
Cytogenetics 25-99
|
$156.00 |
$156.00 |
$156.00 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$77.35 |
$77.35 |
$77.35 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$81.25 |
$81.25 |
$81.25 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$117.00 |
$117.00 |
$117.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$42.25 |
$42.25 |
$42.25 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$52.65 |
$52.65 |
$52.65 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$157.95 |
$157.95 |
$157.95 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$95.55 |
$95.55 |
$95.55 |
$129.90
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$96.20 |
$96.20 |
$96.20 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$251.55 |
$251.55 |
$251.55 |
$205.00
|
|
Cytopath smear other source
|
$81.90 |
$81.90 |
$81.90 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$96.20 |
$96.20 |
$96.20 |
$95.00
|
|
Cytopath tbs c/v manual
|
$55.90 |
$55.90 |
$55.90 |
$57.94
|
|
Dalbavancin 500 mg intravenous solution
|
$3,584.95 |
$3,584.95 |
$3,584.95 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$92.62 |
$92.62 |
$92.62 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$7,798.05 |
$7,798.05 |
$7,798.05 |
$4,542.99
|
|
Dch validity tests
|
$39.00 |
$39.00 |
$39.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$167.05 |
$167.05 |
$167.05 |
$53.95
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$106.60 |
$106.60 |
$106.60 |
$677.54
|
|
Debridement (>20 cm) charge pt
|
$215.15 |
$215.15 |
$215.15 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$657.15 |
$657.15 |
$657.15 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$135.85 |
$135.85 |
$135.85 |
$717.92
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$206.70 |
$206.70 |
$206.70 |
$779.35
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$57.20 |
$57.20 |
$57.20 |
$728.40
|
|
Debr musc/fascia 20sq cm/< 11043
|
$464.10 |
$464.10 |
$464.10 |
$1,101.10
|
|
Decalcification
|
$58.50 |
$58.50 |
$58.50 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$223.60 |
$223.60 |
$223.60 |
$482.35
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$117.65 |
$117.65 |
$117.65 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,401.10 |
$4,401.10 |
$4,401.10 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$358.80 |
$358.80 |
$358.80 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$796.39 |
$796.39 |
$796.39 |
$337.07
|
|
Desoxycorticosterone
|
$74.10 |
$74.10 |
$74.10 |
$109.28
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$200.20 |
$200.20 |
$200.20 |
$307.26
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$251.55 |
$251.55 |
$251.55 |
$440.00
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$287.95 |
$287.95 |
$287.95 |
$408.50
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$186.55 |
$186.55 |
$186.55 |
$286.20
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$199.55 |
$199.55 |
$199.55 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$239.20 |
$239.20 |
$239.20 |
$275.88
|
|
Dest mal lesion tal <0.5 17260
|
$135.85 |
$135.85 |
$135.85 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$195.00 |
$195.00 |
$195.00 |
$274.80
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$224.25 |
$224.25 |
$224.25 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$243.75 |
$243.75 |
$243.75 |
$313.60
|
|
Destroy premlg lesns;1st lesn 17000
|
$100.10 |
$100.10 |
$100.10 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$14.30 |
$14.30 |
$14.30 |
$78.61
|
|
Destruction anal lesion(s)
|
$431.60 |
$431.60 |
$431.60 |
$2,154.21
|
|
Destruction benign lesions < 14 lesions
|
$177.45 |
$177.45 |
$177.45 |
$231.52
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$279.50 |
$279.50 |
$279.50 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$138.45 |
$138.45 |
$138.45 |
$470.51
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$261.95 |
$261.95 |
$261.95 |
$461.12
|
|
Destruction mal lsn t/a/l >4cm
|
$302.90 |
$302.90 |
$302.90 |
$578.40
|
|
Destruction premal lesions 15/> 17004
|
$299.65 |
$299.65 |
$299.65 |
$442.61
|
|
Developmental screen/score/document 96110
|
$126.75 |
$126.75 |
$126.75 |
$126.75
|
|
Dexamethasone 4 mg tablet
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$9.26 |
$9.26 |
$9.26 |
$8.23
|
|
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
|
|
Dhea-s (dehydroepiand sulfate)
|
$110.50 |
$110.50 |
$110.50 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$46.15 |
$46.15 |
$46.15 |
$70.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$59.80 |
$59.80 |
$59.80 |
$42.12
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.15 |
$7.15 |
$7.15 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$75.40 |
$75.40 |
$75.40 |
$92.95
|
|
Dilate esophagus 1/mult pass
|
$263.90 |
$263.90 |
$263.90 |
$1,349.05
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,253.11 |
$2,253.11 |
$2,253.11 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$9.29 |
$9.29 |
$9.29 |
$9.29
|
|
Dna antibody native/double stranded
|
$121.55 |
$121.55 |
$121.55 |
$101.40
|
|
Dna gardnerella
|
$39.00 |
$39.00 |
$39.00 |
$67.68
|
|
Dna probe chlamydia
|
$59.80 |
$59.80 |
$59.80 |
$98.40
|
|
Dna probe gc
|
$96.20 |
$96.20 |
$96.20 |
$88.67
|
|
Dna trichomonas
|
$39.00 |
$39.00 |
$39.00 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$123.50 |
$123.50 |
$123.50 |
$95.06
|
