|
Cyclosporine modified 25 mg capsule
|
$4.36 |
$4.36 |
$4.36 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$13.08 |
$13.08 |
$13.08 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$36,998.96 |
$36,998.96 |
$36,998.96 |
$22,594.80
|
|
Cyp2c19 gene com variants
|
$159.91 |
$159.91 |
$159.91 |
$567.75
|
|
Cyp2c9 gene com variants
|
$95.94 |
$95.94 |
$95.94 |
$275.10
|
|
Cystine urine quantitative
|
$10.01 |
$10.01 |
$10.01 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$537.92 |
$537.92 |
$537.92 |
$539.55
|
|
Cystoscopy (Bladder Scope)
|
$1,232.79 |
$1,232.79 |
$1,232.79 |
$1,610.20
|
|
Cytarabine 20 mg/ml injection solution
|
$53.41 |
$53.41 |
$53.41 |
$89.95
|
|
Cytogenom microarray copy nmbr var
|
$912.77 |
$912.77 |
$912.77 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$17.44 |
$17.44 |
$17.44 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$8.22 |
$8.22 |
$8.22 |
$96.80
|
|
Cytopath fl nongyn filter
|
$93.74 |
$93.74 |
$93.74 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$124.26 |
$124.26 |
$124.26 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$201.65 |
$201.65 |
$201.65 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$97.01 |
$97.01 |
$97.01 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$21.26 |
$21.26 |
$21.26 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$166.23 |
$166.23 |
$166.23 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$177.13 |
$177.13 |
$177.13 |
$205.00
|
|
Cytopath smear other source
|
$22.89 |
$22.89 |
$22.89 |
$85.80
|
|
Cytopath smear other source
|
$75.76 |
$75.76 |
$75.76 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$31.61 |
$31.61 |
$31.61 |
$95.89
|
|
Cytp urine 3-5 probes cmptr
|
$243.62 |
$243.62 |
$243.62 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$57.77 |
$57.77 |
$57.77 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$3,818.82 |
$3,818.82 |
$3,818.82 |
$2,526.62
|
|
Dalbavancin 500 mg intravenous solution
|
$3,410.61 |
$3,410.61 |
$3,410.61 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,020.24 |
$1,020.24 |
$1,020.24 |
$315.32
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$18,823.21 |
$18,823.21 |
$18,823.21 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$8,858.43 |
$8,858.43 |
$8,858.43 |
$5,546.48
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$333.54 |
$333.54 |
$333.54 |
$260.95
|
|
Dch validity tests
|
$72.49 |
$72.49 |
$72.49 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$5.30 |
$5.30 |
$5.30 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$312.29 |
$312.29 |
$312.29 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,719.48 |
$1,719.48 |
$1,719.48 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$457.80 |
$457.80 |
$457.80 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$798.43 |
$798.43 |
$798.43 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$586.97 |
$586.97 |
$586.97 |
$810.50
|
|
Debride nail1-5 11720
|
$249.61 |
$249.61 |
$249.61 |
$173.25
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$422.38 |
$422.38 |
$422.38 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,197.37 |
$1,197.37 |
$1,197.37 |
$1,193.40
|
|
Decalcification
|
$104.64 |
$104.64 |
$104.64 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$4,040.63 |
$4,040.63 |
$4,040.63 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$386.95 |
$386.95 |
$386.95 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$61.59 |
$61.59 |
$61.59 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$1,894.42 |
$1,894.42 |
$1,894.42 |
$2,086.82
|
|
Delivery of placenta 59414
|
$1,309.09 |
$1,309.09 |
$1,309.09 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$204.38 |
$204.38 |
$204.38 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$5,227.64 |
$5,227.64 |
$5,227.64 |
$7,933.81
|
|
Dermagraft
|
$4,101.67 |
$4,101.67 |
$4,101.67 |
$1,912.31
|
|
Design mlc device for imrt
|
$816.96 |
$816.96 |
$816.96 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,623.01 |
$1,623.01 |
$1,623.01 |
$102.32
|
|
Desoxycorticosterone
|
$18.39 |
$18.39 |
$18.39 |
$109.28
|
|
Device ablt adv novasure
|
$4,101.67 |
$4,101.67 |
$4,101.67 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$5,332.28 |
$5,332.28 |
$5,332.28 |
$4,298.87
|
|
Device sut capio slim opn
|
$4,101.67 |
$4,101.67 |
$4,101.67 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,154.46 |
$3,154.46 |
$3,154.46 |
$2,440.98
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$256.70 |
$256.70 |
$256.70 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$54.50 |
$54.50 |
$54.50 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$35.43 |
$35.43 |
$35.43 |
$30.00
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$3,665.67 |
$3,665.67 |
$3,665.67 |
$560.92
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$35.43 |
$35.43 |
$35.43 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$35.43 |
$35.43 |
$35.43 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$268.69 |
$268.69 |
$268.69 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$35.43 |
$35.43 |
$35.43 |
$68.93
|
|
Diabetes (HbA1c) Test
|
$107.91 |
$107.91 |
$107.91 |
$78.03
|
|
Diagnostic laryngoscopy 31575
|
$312.83 |
$312.83 |
$312.83 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$492.14 |
$492.14 |
$492.14 |
$424.00
|
|
Dialysis one evaluation
|
$625.66 |
$625.66 |
$625.66 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$35.43 |
$35.43 |
$35.43 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$56.68 |
$56.68 |
$56.68 |
$72.34
|
|
Dicyclomine injection
|
$192.39 |
$192.39 |
$192.39 |
$211.81
|
|
Diffusing capacity
|
$359.70 |
$359.70 |
$359.70 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$300.84 |
$300.84 |
$300.84 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,520.78 |
$4,520.78 |
$4,520.78 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$140.07 |
$140.07 |
$140.07 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$2,693.94 |
$2,693.94 |
$2,693.94 |
$334.68
|
|
Dilator fascial 10fx20cm
|
$956.48 |
$956.48 |
$956.48 |
$305.68
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$35.43 |
$35.43 |
$35.43 |
$26.87
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$130.80 |
$130.80 |
$130.80 |
$106.59
|
|
Disability dlco
|
$293.76 |
$293.76 |
$293.76 |
$307.58
|
|
Disaccharidases
|
$71.94 |
$71.94 |
$71.94 |
$223.80
|
|
Dna antibody native/double stranded
|
$6.76 |
$6.76 |
$6.76 |
$102.60
|
|
Dna gardnerella
|
$41.97 |
$41.97 |
$41.97 |
$67.68
|
|
Dna probe gc
|
$143.34 |
$143.34 |
$143.34 |
$88.67
|
|
Dna trichomonas
|
$41.97 |
$41.97 |
$41.97 |
$68.75
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$178.76 |
$178.76 |
$178.76 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$5,202.03 |
$5,202.03 |
$5,202.03 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$53.96 |
$53.96 |
$53.96 |
$84.30
|
|
Doppler echo complete
|
$661.09 |
$661.09 |
$661.09 |
$608.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$989.72 |
$989.72 |
$989.72 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$673.08 |
$673.08 |
$673.08 |
$482.03
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$25,770.33 |
$25,770.33 |
$25,770.33 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$117.18 |
$117.18 |
$117.18 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$7,760.26 |
$7,760.26 |
$7,760.26 |
$2,417.38
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$99.74 |
$99.74 |
$99.74 |
$99.99
|
|
Dpyd gene common variants
|
$131.89 |
$131.89 |
$131.89 |
$380.50
|
|
Drain blood from under nail 11740
|
$225.63 |
$225.63 |
$225.63 |
$190.33
|
|
Drain cath image guided visceral pq
|
$2,850.35 |
$2,850.35 |
$2,850.35 |
$3,073.90
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$388.04 |
$388.04 |
$388.04 |
$420.00
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$388.04 |
$388.04 |
$388.04 |
$365.60
|