|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,415.40 |
$1,415.40 |
$1,415.40 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$602.00 |
$602.00 |
$602.00 |
$456.00
|
|
CT scan for therapy guide
|
$265.65 |
$265.65 |
$265.65 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,623.55 |
$3,623.55 |
$3,623.55 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,034.15 |
$3,034.15 |
$3,034.15 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,948.45 |
$1,948.45 |
$1,948.45 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$2,381.40 |
$2,381.40 |
$2,381.40 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$2,091.95 |
$2,091.95 |
$2,091.95 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,145.90 |
$1,145.90 |
$1,145.90 |
$400.20
|
|
CT t-spine w /wo contrast
|
$2,538.90 |
$2,538.90 |
$2,538.90 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$2,340.80 |
$2,340.80 |
$2,340.80 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,869.70 |
$1,869.70 |
$1,869.70 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$2,538.90 |
$2,538.90 |
$2,538.90 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$153.65 |
$153.65 |
$153.65 |
$63.75
|
|
Culture afb any source
|
$283.15 |
$283.15 |
$283.15 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$234.50 |
$234.50 |
$234.50 |
$77.31
|
|
Culture anaerobic except blood
|
$342.65 |
$342.65 |
$342.65 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$79.80 |
$79.80 |
$79.80 |
$52.80
|
|
Culture body fluid
|
$161.00 |
$161.00 |
$161.00 |
$130.50
|
|
Culture fungi definitive id mold
|
$214.55 |
$214.55 |
$214.55 |
$70.00
|
|
Culture fungi definitive id yeast
|
$153.65 |
$153.65 |
$153.65 |
$80.60
|
|
Culture fungi other (except blood)
|
$210.00 |
$210.00 |
$210.00 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$210.00 |
$210.00 |
$210.00 |
$77.40
|
|
Culture quantitative aerobic other source
|
$176.75 |
$176.75 |
$176.75 |
$87.02
|
|
Culture screening strep group a
|
$130.20 |
$130.20 |
$130.20 |
$81.60
|
|
Culture typing immunologic
|
$195.30 |
$195.30 |
$195.30 |
$41.60
|
|
Culture urine each isolate
|
$45.50 |
$45.50 |
$45.50 |
$46.20
|
|
Curette/treat cornea
|
$551.95 |
$551.95 |
$551.95 |
$1,317.39
|
|
Curette/treat cornea
|
$1,611.05 |
$1,611.05 |
$1,611.05 |
$2,818.14
|
|
Cutter lead
|
$13,715.63 |
$13,715.63 |
$13,715.63 |
$5,538.98
|
|
Cv line/pic reposition
|
$2,541.70 |
$2,541.70 |
$2,541.70 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$33.37 |
$33.37 |
$33.37 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$31.50 |
$31.50 |
$31.50 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,587.77 |
$1,587.77 |
$1,587.77 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$6.71 |
$6.71 |
$6.71 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$98.64 |
$98.64 |
$98.64 |
$179.10
|
|
Cyclosporine 2 hour
|
$36.55 |
$36.55 |
$36.55 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$2.48 |
$2.48 |
$2.48 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$8.79 |
$8.79 |
$8.79 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$22,282.07 |
$22,282.07 |
$22,282.07 |
$22,594.80
|
|
Cystatin c
|
$29.05 |
$29.05 |
$29.05 |
$82.26
|
|
Cystogram >= 3 views supervision & interpretation
|
$476.70 |
$476.70 |
$476.70 |
$539.55
|
|
Cystoscopy and treatment
|
$1,407.70 |
$1,407.70 |
$1,407.70 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,377.60 |
$1,377.60 |
$1,377.60 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$541.10 |
$541.10 |
$541.10 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$1,407.70 |
$1,407.70 |
$1,407.70 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$1,198.05 |
$1,198.05 |
$1,198.05 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$1,600.55 |
$1,600.55 |
$1,600.55 |
$3,774.40
|
|
Cystouretero & or pyeloscope
|
$1,407.70 |
$1,407.70 |
$1,407.70 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$1,407.70 |
$1,407.70 |
$1,407.70 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$1,377.60 |
$1,377.60 |
$1,377.60 |
$2,874.36
|
|
Cytarabine 20 mg/ml injection solution
|
$104.01 |
$104.01 |
$104.01 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$21.00 |
$21.00 |
$21.00 |
$101.25
|
|
Cytopath fl nongyn filter
|
$52.50 |
$52.50 |
$52.50 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$79.80 |
$79.80 |
$79.80 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$79.80 |
$79.80 |
$79.80 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$42.70 |
$42.70 |
$42.70 |
$124.80
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$115.15 |
$115.15 |
$115.15 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$75.25 |
$75.25 |
$75.25 |
$205.00
|
|
Cytopath smear other source
|
$42.70 |
$42.70 |
$42.70 |
$85.80
|
|
Cytopath smear other source
|
$75.25 |
$75.25 |
$75.25 |
$122.19
|
|
Dacarbazine 100 mg intravenous solution
|
$100.73 |
$100.73 |
$100.73 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,294.90 |
$1,294.90 |
$1,294.90 |
$2,526.62
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$113.80 |
$113.80 |
$113.80 |
$315.32
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$18,316.22 |
$18,316.22 |
$18,316.22 |
$28,415.40
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$479.33 |
$479.33 |
$479.33 |
$260.95
|
|
D&c after delivery 59160
|
$2,345.35 |
$2,345.35 |
$2,345.35 |
$3,762.53
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$2,907.10 |
$2,907.10 |
$2,907.10 |
$3,774.81
|
|
Dch glucoscan
|
$17.85 |
$17.85 |
$17.85 |
$24.85
|
|
Dch pulmonary stress test
|
$1,110.55 |
$1,110.55 |
$1,110.55 |
$964.41
|
|
Dch validity tests
|
$24.50 |
$24.50 |
$24.50 |
$25.20
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$667.80 |
$667.80 |
$667.80 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$452.90 |
$452.90 |
$452.90 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,792.70 |
$1,792.70 |
$1,792.70 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$204.05 |
$204.05 |
$204.05 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$204.05 |
$204.05 |
$204.05 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$602.00 |
$602.00 |
$602.00 |
$810.50
|
|
Debride nail1-5 11720
|
$602.00 |
$602.00 |
$602.00 |
$173.25
|
|
Debride nail6 or more 11721
|
$602.00 |
$602.00 |
$602.00 |
$195.20
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$602.00 |
$602.00 |
$602.00 |
$1,265.16
|
|
Debride skin bone at fx site
|
$3,021.20 |
$3,021.20 |
$3,021.20 |
$3,278.34
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$204.05 |
$204.05 |
$204.05 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$602.00 |
$602.00 |
$602.00 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$177.10 |
$177.10 |
$177.10 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,083.95 |
$1,083.95 |
$1,083.95 |
$1,193.40
|
|
Decalcification
|
$37.80 |
$37.80 |
$37.80 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$251.69 |
$251.69 |
$251.69 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$602.00 |
$602.00 |
$602.00 |
$545.90
|
|
Decompress fasciotomyhand 26037
|
$2,531.20 |
$2,531.20 |
$2,531.20 |
$3,594.44
|
|
Decompression of lower leg
|
$3,137.40 |
$3,137.40 |
$3,137.40 |
$3,839.54
|
|
Decompression of thigh/knee
|
$3,137.40 |
$3,137.40 |
$3,137.40 |
$3,839.54
|
|
Deferoxamine 500 mg solution for injection
|
$124.79 |
$124.79 |
$124.79 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$2,554.13 |
$2,554.13 |
$2,554.13 |
$2,086.82
|
|
Delivery of placenta 59414
|
$3,343.20 |
$3,343.20 |
$3,343.20 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$496.30 |
$496.30 |
$496.30 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$12,397.98 |
$12,397.98 |
$12,397.98 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$602.00 |
$602.00 |
$602.00 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$176.41 |
$176.41 |
$176.41 |
$132.72
|
|
Derma-fat-fascia graft 15770
|
$3,147.55 |
$3,147.55 |
$3,147.55 |
$4,326.42
|
|
Dermagraft
|
$1,912.31 |
$1,912.31 |
$1,912.31 |
$1,912.31
|
