|
Culture anaerobic additional method definitive id each
|
$38.52 |
$38.52 |
$38.52 |
$77.31
|
|
Culture anaerobic except blood
|
$89.09 |
$89.09 |
$89.09 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$53.30 |
$53.30 |
$53.30 |
$52.80
|
|
Culture body fluid
|
$151.33 |
$151.33 |
$151.33 |
$130.50
|
|
Culture fungi definitive id mold
|
$47.46 |
$47.46 |
$47.46 |
$70.00
|
|
Culture fungi definitive id yeast
|
$26.85 |
$26.85 |
$26.85 |
$80.60
|
|
Culture fungi other (except blood)
|
$93.75 |
$93.75 |
$93.75 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$73.53 |
$73.53 |
$73.53 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$67.30 |
$67.30 |
$67.30 |
$84.75
|
|
Culture mycoplasma any source
|
$14.01 |
$14.01 |
$14.01 |
$90.37
|
|
Culture quantitative aerobic other source
|
$206.95 |
$206.95 |
$206.95 |
$87.02
|
|
Culture screening strep group a
|
$74.30 |
$74.30 |
$74.30 |
$81.60
|
|
Culture typing added method
|
$2.22 |
$2.22 |
$2.22 |
$34.45
|
|
Culture typing immunologic
|
$55.63 |
$55.63 |
$55.63 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$82.47 |
$82.47 |
$82.47 |
$124.40
|
|
Culture urine each isolate
|
$59.91 |
$59.91 |
$59.91 |
$46.20
|
|
Cutter lead
|
$6,863.91 |
$6,863.91 |
$6,863.91 |
$5,538.98
|
|
Cv line/pic reposition
|
$2,540.95 |
$2,540.95 |
$2,540.95 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$466.80 |
$466.80 |
$466.80 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$9.73 |
$9.73 |
$9.73 |
$80.05
|
|
Cyclophosphamide 25 mg capsule
|
$27.62 |
$27.62 |
$27.62 |
$23.49
|
|
Cyclosporine 2 hour
|
$5.84 |
$5.84 |
$5.84 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$3.51 |
$3.51 |
$3.51 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$12.06 |
$12.06 |
$12.06 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$31,580.97 |
$31,580.97 |
$31,580.97 |
$22,594.80
|
|
Cyp2c19 gene com variants
|
$114.14 |
$114.14 |
$114.14 |
$567.75
|
|
Cyp2c9 gene com variants
|
$68.48 |
$68.48 |
$68.48 |
$275.10
|
|
Cystine urine quantitative
|
$7.15 |
$7.15 |
$7.15 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$470.31 |
$470.31 |
$470.31 |
$539.55
|
|
Cystoscopy and treatment
|
$3,639.88 |
$3,639.88 |
$3,639.88 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$880.70 |
$880.70 |
$880.70 |
$1,610.20
|
|
Cytogenom microarray copy nmbr var
|
$651.50 |
$651.50 |
$651.50 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$12.45 |
$12.45 |
$12.45 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$5.87 |
$5.87 |
$5.87 |
$96.80
|
|
Cytopath fl nongyn filter
|
$73.53 |
$73.53 |
$73.53 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$118.65 |
$118.65 |
$118.65 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$95.70 |
$95.70 |
$95.70 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$42.79 |
$42.79 |
$42.79 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$57.58 |
$57.58 |
$57.58 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$155.60 |
$155.60 |
$155.60 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$159.49 |
$159.49 |
$159.49 |
$205.00
|
|
Cytopath smear other source
|
$19.84 |
$19.84 |
$19.84 |
$85.80
|
|
Cytopath smear other source
|
$58.74 |
$58.74 |
$58.74 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$24.51 |
$24.51 |
$24.51 |
$95.89
|
|
Cytp urine 3-5 probes cmptr
|
$173.89 |
$173.89 |
$173.89 |
$690.00
|
|
Dalbavancin 500 mg intravenous solution
|
$2,782.13 |
$2,782.13 |
$2,782.13 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$832.08 |
$832.08 |
$832.08 |
$315.32
|
|
Darbepoetin alfa, esrd use
|
$1,445.53 |
$1,445.53 |
$1,445.53 |
$3.04
|
|
Dch pulmonary stress test
|
$801.34 |
$801.34 |
$801.34 |
$964.41
|
|
Dch validity tests
|
$17.51 |
$17.51 |
$17.51 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$3.78 |
$3.78 |
$3.78 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$176.61 |
$176.61 |
$176.61 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,240.91 |
$1,240.91 |
$1,240.91 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$330.27 |
$330.27 |
$330.27 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$564.44 |
$564.44 |
$564.44 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$616.18 |
$616.18 |
$616.18 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$265.69 |
$265.69 |
$265.69 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$817.68 |
$817.68 |
$817.68 |
$1,193.40
|
|
Decalcification
|
$42.79 |
$42.79 |
$42.79 |
$73.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$238.46 |
$238.46 |
$238.46 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$194.89 |
$194.89 |
$194.89 |
$110.82
|
|
Delivery of placenta 59414
|
$2,208.36 |
$2,208.36 |
$2,208.36 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$275.03 |
$275.03 |
$275.03 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,335.29 |
$3,335.29 |
$3,335.29 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$297.59 |
$297.59 |
$297.59 |
$460.50
|
|
Dermagraft
|
$3,121.73 |
$3,121.73 |
$3,121.73 |
$1,912.31
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,323.77 |
$1,323.77 |
$1,323.77 |
$102.32
|
|
Desoxycorticosterone
|
$13.13 |
$13.13 |
$13.13 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$1,943.45 |
$1,943.45 |
$1,943.45 |
$5,698.68
|
|
Destroy cervthor facet jnt 64633
|
$2,891.83 |
$2,891.83 |
$2,891.83 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$1,927.89 |
$1,927.89 |
$1,927.89 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,927.89 |
$1,927.89 |
$1,927.89 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,891.83 |
$2,891.83 |
$2,891.83 |
$3,375.00
|
|
Device ablt adv novasure
|
$11,601.93 |
$11,601.93 |
$11,601.93 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$5,278.73 |
$5,278.73 |
$5,278.73 |
$4,298.87
|
|
Device intraute mirena
|
$1,312.88 |
$1,312.88 |
$1,312.88 |
$2,618.91
|
|
Device sut capio slim opn
|
$3,121.73 |
$3,121.73 |
$3,121.73 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,121.73 |
$3,121.73 |
$3,121.73 |
$2,440.98
|
|
Dexamethasone 4 mg tablet
|
$3.51 |
$3.51 |
$3.51 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$19.45 |
$19.45 |
$19.45 |
$30.00
|
|
Dextran 40 infusion
|
$48.24 |
$48.24 |
$48.24 |
$171.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$30.35 |
$30.35 |
$30.35 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$23.34 |
$23.34 |
$23.34 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$201.90 |
$201.90 |
$201.90 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$30.35 |
$30.35 |
$30.35 |
$68.93
|
|
Diabetes (HbA1c) Test
|
$211.62 |
$211.62 |
$211.62 |
$78.03
|
|
Diab manage trn ind/group
|
$63.41 |
$63.41 |
$63.41 |
$49.50
|
|
Diag bronchoscope/catheter
|
$1,837.64 |
$1,837.64 |
$1,837.64 |
$2,040.67
|
|
Diagnostic laryngoscopy 31575
|
$256.74 |
$256.74 |
$256.74 |
$385.20
|
|
Dialysis circuit perm vascular embolization 36909
|
$848.41 |
$848.41 |
$848.41 |
$7,145.00
|
|
Dialysis one evaluation
|
$949.55 |
$949.55 |
$949.55 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$98.42 |
$98.42 |
$98.42 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$46.30 |
$46.30 |
$46.30 |
$72.34
|
|
Dicyclomine injection
|
$157.16 |
$157.16 |
$157.16 |
$211.81
|
|
Diffusing capacity
|
$252.08 |
$252.08 |
$252.08 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$245.46 |
$245.46 |
$245.46 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,687.72 |
$3,687.72 |
$3,687.72 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$171.94 |
$171.94 |
$171.94 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$2,197.47 |
$2,197.47 |
$2,197.47 |
$334.68
|
|
Dilate biliary duct/ampulla
|
$825.85 |
$825.85 |
$825.85 |
$2,304.60
|