|
Culture bact stool aero addl path ea
|
$103.79 |
$103.79 |
$103.79 |
$52.80
|
|
Culture body fluid
|
$224.56 |
$224.56 |
$224.56 |
$130.50
|
|
Culture fungi definitive id mold
|
$16.98 |
$16.98 |
$16.98 |
$70.00
|
|
Culture fungi definitive id yeast
|
$98.94 |
$98.94 |
$98.94 |
$80.60
|
|
Culture fungi skin/hair/nail
|
$107.19 |
$107.19 |
$107.19 |
$77.40
|
|
Culture mycoplasma any source
|
$34.92 |
$34.92 |
$34.92 |
$90.37
|
|
Culture quantitative aerobic other source
|
$82.45 |
$82.45 |
$82.45 |
$87.02
|
|
Culture screening strep group a
|
$116.89 |
$116.89 |
$116.89 |
$81.60
|
|
Culture typing immunologic
|
$10.67 |
$10.67 |
$10.67 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$82.59 |
$82.59 |
$82.59 |
$124.40
|
|
Culture urine each isolate
|
$70.33 |
$70.33 |
$70.33 |
$46.20
|
|
Culture virus isolation
|
$2.63 |
$2.63 |
$2.63 |
$39.20
|
|
Cutter lead
|
$6,581.45 |
$6,581.45 |
$6,581.45 |
$5,538.98
|
|
Cv line/pic reposition
|
$1,319.20 |
$1,319.20 |
$1,319.20 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$12.61 |
$12.61 |
$12.61 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$11.00 |
$11.00 |
$11.00 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$376.36 |
$376.36 |
$376.36 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$41.23 |
$41.23 |
$41.23 |
$23.49
|
|
Cyclosporine 2 hour
|
$7.28 |
$7.28 |
$7.28 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$8.73 |
$8.73 |
$8.73 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$1,630.57 |
$1,630.57 |
$1,630.57 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$24,448.85 |
$24,448.85 |
$24,448.85 |
$22,594.80
|
|
Cystatin c
|
$4.85 |
$4.85 |
$4.85 |
$82.26
|
|
Cystogram >= 3 views supervision & interpretation
|
$872.03 |
$872.03 |
$872.03 |
$539.55
|
|
Cystometrogram w/up 51727
|
$928.29 |
$928.29 |
$928.29 |
$857.38
|
|
Cystoscopy and treatment
|
$3,590.46 |
$3,590.46 |
$3,590.46 |
$2,424.12
|
|
Cystoscopy and treatment
|
$2,798.94 |
$2,798.94 |
$2,798.94 |
$3,174.25
|
|
Cystoscopy and treatment
|
$2,798.94 |
$2,798.94 |
$2,798.94 |
$3,219.80
|
|
Cystoscopy (Bladder Scope)
|
$928.29 |
$928.29 |
$928.29 |
$1,610.20
|
|
Cystoscopy chemodenervation
|
$2,831.92 |
$2,831.92 |
$2,831.92 |
$2,412.45
|
|
Cytarabine 20 mg/ml injection solution
|
$30.56 |
$30.56 |
$30.56 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$16.49 |
$16.49 |
$16.49 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$4.85 |
$4.85 |
$4.85 |
$96.80
|
|
Cytopath c/v index add-on
|
$10.19 |
$10.19 |
$10.19 |
$29.60
|
|
Cytopathology cellular enhancement technique non-gyn
|
$94.58 |
$94.58 |
$94.58 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$90.21 |
$90.21 |
$90.21 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$90.21 |
$90.21 |
$90.21 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$97.00 |
$97.00 |
$97.00 |
$124.80
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$184.79 |
$184.79 |
$184.79 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$191.09 |
$191.09 |
$191.09 |
$205.00
|
|
Cytopath smear other source
|
$127.56 |
$127.56 |
$127.56 |
$85.80
|
|
Cytopath smear other source
|
$95.55 |
$95.55 |
$95.55 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$90.21 |
$90.21 |
$90.21 |
$95.89
|
|
Dalbavancin 500 mg intravenous solution
|
$2,657.80 |
$2,657.80 |
$2,657.80 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$315.32
|
|
Dch validity tests
|
$86.82 |
$86.82 |
$86.82 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$4.54 |
$4.54 |
$4.54 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$109.13 |
$109.13 |
$109.13 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,280.47 |
$2,280.47 |
$2,280.47 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$532.05 |
$532.05 |
$532.05 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$942.84 |
$942.84 |
$942.84 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$592.67 |
$592.67 |
$592.67 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$258.02 |
$258.02 |
$258.02 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,519.99 |
$1,519.99 |
$1,519.99 |
$1,193.40
|
|
Decalcification
|
$76.15 |
$76.15 |
$76.15 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$2,657.80 |
$2,657.80 |
$2,657.80 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$637.78 |
$637.78 |
$637.78 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$94.09 |
$94.09 |
$94.09 |
$110.82
|
|
Delivery of placenta 59414
|
$2,503.57 |
$2,503.57 |
$2,503.57 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$114.46 |
$114.46 |
$114.46 |
$196.26
|
|
Depo-estradiol cypionate inj
|
$168.78 |
$168.78 |
$168.78 |
$132.72
|
|
Descend thora aorta rpr/lt sub art 33880
|
$2,941.04 |
$2,941.04 |
$2,941.04 |
$5,702.04
|
|
Desmopressin 4 mcg/ml injection solution
|
$213.89 |
$213.89 |
$213.89 |
$102.32
|
|
Des thora aorta rpr without left sub art 33881
|
$2,586.99 |
$2,586.99 |
$2,586.99 |
$5,698.68
|
|
Destroy vulva lesion simple 56501
|
$2,343.04 |
$2,343.04 |
$2,343.04 |
$3,691.50
|
|
Device ablt adv novasure
|
$5,060.98 |
$5,060.98 |
$5,060.98 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,581.45 |
$6,581.45 |
$6,581.45 |
$4,298.87
|
|
Device intraute mirena
|
$939.93 |
$939.93 |
$939.93 |
$2,618.91
|
|
Device sut capio slim opn
|
$1,360.43 |
$1,360.43 |
$1,360.43 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,892.13 |
$3,892.13 |
$3,892.13 |
$2,440.98
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$141.62 |
$141.62 |
$141.62 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$3.88 |
$3.88 |
$3.88 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$22.31 |
$22.31 |
$22.31 |
$30.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$50.44 |
$50.44 |
$50.44 |
$60.00
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.83 |
$37.83 |
$37.83 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$37.83 |
$37.83 |
$37.83 |
$68.93
|
|
Diabetes (HbA1c) Test
|
$116.40 |
$116.40 |
$116.40 |
$78.03
|
|
Diagnostic anoscopy spx 46600
|
$207.58 |
$207.58 |
$207.58 |
$245.35
|
|
Diagnostic Mammogram (both breasts)
|
$214.86 |
$214.86 |
$214.86 |
$424.00
|
|
Diagnostic radio unlisted proc
|
$67.90 |
$67.90 |
$67.90 |
$239.25
|
|
Dialysis circuit perm vascular embolization 36909
|
$5,619.21 |
$5,619.21 |
$5,619.21 |
$7,145.00
|
|
Dialysis one evaluation
|
$1,501.08 |
$1,501.08 |
$1,501.08 |
$842.10
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$35.41 |
$35.41 |
$35.41 |
$72.34
|
|
Dicyclomine injection
|
$146.96 |
$146.96 |
$146.96 |
$211.81
|
|
Diffusing capacity
|
$267.72 |
$267.72 |
$267.72 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$419.53 |
$419.53 |
$419.53 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$2,657.80 |
$2,657.80 |
$2,657.80 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$203.22 |
$203.22 |
$203.22 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$248.81 |
$248.81 |
$248.81 |
$334.68
|
|
Dilate biliary duct/ampulla
|
$4,912.57 |
$4,912.57 |
$4,912.57 |
$2,304.60
|
|
Dilate esophagus
|
$1,760.55 |
$1,760.55 |
$1,760.55 |
$2,003.04
|
|
Dilator fascial 10fx20cm
|
$363.75 |
$363.75 |
$363.75 |
$305.68
|
|
Dilat xst trc ndurlgc px
|
$2,988.09 |
$2,988.09 |
$2,988.09 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$2,988.09 |
$2,988.09 |
$2,988.09 |
$5,020.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$12.61 |
$12.61 |
$12.61 |
$26.87
|
|
Disability dlco
|
$265.78 |
$265.78 |
$265.78 |
$307.58
|
|
Disaccharidases
|
$158.02 |
$158.02 |
$158.02 |
$223.80
|
|
Discography cerv/thor spine
|
$1,895.38 |
$1,895.38 |
$1,895.38 |
$2,404.00
|
|
Dissolve clot heart vessel
|
$4,113.29 |
$4,113.29 |
$4,113.29 |
$1,396.47
|
|
Dlyd plmt xtn prosth ea addl
|
$2,068.04 |
$2,068.04 |
$2,068.04 |
$2,001.55
|