|
Cystic fibrosis cftr
|
$176.70 |
$176.70 |
$176.70 |
$1,041.95
|
|
Cystine urine quantitative
|
$16.71 |
$16.71 |
$16.71 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$425.76 |
$425.76 |
$425.76 |
$539.55
|
|
Cytarabine 20 mg/ml injection solution
|
$17.58 |
$17.58 |
$17.58 |
$99.40
|
|
Cytogenetics 25-99
|
$13.95 |
$13.95 |
$13.95 |
$180.32
|
|
Cytogenetics 3-5
|
$48.83 |
$48.83 |
$48.83 |
$127.64
|
|
Cytomegalovirus (cmv) antibody igg
|
$2.79 |
$2.79 |
$2.79 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$2.79 |
$2.79 |
$2.79 |
$96.80
|
|
Cytopath fl nongyn filter
|
$92.63 |
$92.63 |
$92.63 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$98.49 |
$98.49 |
$98.49 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$16.47 |
$16.47 |
$16.47 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$44.09 |
$44.09 |
$44.09 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$120.25 |
$120.25 |
$120.25 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$60.27 |
$60.27 |
$60.27 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$2.44 |
$2.44 |
$2.44 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$92.91 |
$92.91 |
$92.91 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$121.37 |
$121.37 |
$121.37 |
$205.00
|
|
Cytopath smear other source
|
$51.34 |
$51.34 |
$51.34 |
$85.80
|
|
Cytopath smear other source
|
$76.17 |
$76.17 |
$76.17 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$60.55 |
$60.55 |
$60.55 |
$95.89
|
|
Dacarbazine 100 mg intravenous solution
|
$17.58 |
$17.58 |
$17.58 |
$73.20
|
|
Dactinomycin 0.5 mg intravenous solution
|
$18.14 |
$18.14 |
$18.14 |
$3,019.83
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$575.30 |
$575.30 |
$575.30 |
$267.00
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$962.55 |
$962.55 |
$962.55 |
$5,500.25
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$173.54 |
$173.54 |
$173.54 |
$300.73
|
|
Dch validity tests
|
$21.77 |
$21.77 |
$21.77 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$2.71 |
$2.71 |
$2.71 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$106.58 |
$106.58 |
$106.58 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,669.82 |
$1,669.82 |
$1,669.82 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$323.64 |
$323.64 |
$323.64 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$834.77 |
$834.77 |
$834.77 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$415.44 |
$415.44 |
$415.44 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$207.86 |
$207.86 |
$207.86 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$646.73 |
$646.73 |
$646.73 |
$1,193.40
|
|
Decalcification
|
$17.86 |
$17.86 |
$17.86 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$1,255.50 |
$1,255.50 |
$1,255.50 |
$759.04
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$504.99 |
$504.99 |
$504.99 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$40.18 |
$40.18 |
$40.18 |
$102.84
|
|
Degarelix 120 mg subcutaneous solution
|
$631.38 |
$631.38 |
$631.38 |
$1,856.85
|
|
Delivery of placenta 59414
|
$2,011.32 |
$2,011.32 |
$2,011.32 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$145.92 |
$145.92 |
$145.92 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$1,944.63 |
$1,944.63 |
$1,944.63 |
$7,236.00
|
|
Depo-estradiol cypionate inj
|
$68.36 |
$68.36 |
$68.36 |
$99.44
|
|
Design mlc device for imrt
|
$1,100.38 |
$1,100.38 |
$1,100.38 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$86.77 |
$86.77 |
$86.77 |
$103.49
|
|
Detect agent nos dna dir
|
$111.33 |
$111.33 |
$111.33 |
$67.15
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,240.53 |
$4,240.53 |
$4,240.53 |
$4,298.87
|
|
Device intraute mirena
|
$1,047.65 |
$1,047.65 |
$1,047.65 |
$2,251.39
|
|
Device sut capio slim opn
|
$876.62 |
$876.62 |
$876.62 |
$1,946.41
|
|
Device tiss remov myosure reach
|
$1,482.89 |
$1,482.89 |
$1,482.89 |
$2,541.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$276.77 |
$276.77 |
$276.77 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$2.24 |
$2.24 |
$2.24 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$9.21 |
$9.21 |
$9.21 |
$27.00
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$592.60 |
$592.60 |
$592.60 |
$731.92
|
|
Dextran 40 infusion
|
$43.25 |
$43.25 |
$43.25 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$15.07 |
$15.07 |
$15.07 |
$43.65
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$15.07 |
$15.07 |
$15.07 |
$47.40
|
|
Dextrose 5 % IV bolus
|
$15.07 |
$15.07 |
$15.07 |
$58.36
|
|
Dhea-s (dehydroepiand sulfate)
|
$55.53 |
$55.53 |
$55.53 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$103.23 |
$103.23 |
$103.23 |
$78.03
|
|
Diagnostic laryngoscopy 31575
|
$138.11 |
$138.11 |
$138.11 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$229.34 |
$229.34 |
$229.34 |
$424.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$4,676.88 |
$4,676.88 |
$4,676.88 |
$7,145.00
|
|
Dialysis one evaluation
|
$1,815.18 |
$1,815.18 |
$1,815.18 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$68.08 |
$68.08 |
$68.08 |
$106.27
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$14.51 |
$14.51 |
$14.51 |
$79.50
|
|
Dicyclomine injection
|
$59.71 |
$59.71 |
$59.71 |
$204.52
|
|
Diffusing capacity
|
$319.74 |
$319.74 |
$319.74 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$169.92 |
$169.92 |
$169.92 |
$69.88
|
|
Digoxin immune fab 40 mg intravenous solution
|
$1,977.84 |
$1,977.84 |
$1,977.84 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$190.28 |
$190.28 |
$190.28 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$101.00 |
$101.00 |
$101.00 |
$321.30
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$5,102.08 |
$5,102.08 |
$5,102.08 |
$4,322.56
|
|
Dilate ic vasospasm ea add vsl same territory
|
$5,102.08 |
$5,102.08 |
$5,102.08 |
$2,299.05
|
|
Dilate ic vasospasm init
|
$10,203.87 |
$10,203.87 |
$10,203.87 |
$6,280.95
|
|
Dilator fascial 10fx20cm
|
$179.68 |
$179.68 |
$179.68 |
$330.94
|
|
Dilat xst trc ndurlgc px
|
$1,881.86 |
$1,881.86 |
$1,881.86 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$1,881.86 |
$1,881.86 |
$1,881.86 |
$5,020.00
|
|
Dimenhydrinate injection
|
$7.26 |
$7.26 |
$7.26 |
$22.36
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.26 |
$7.26 |
$7.26 |
$25.12
|
|
Disability dlco
|
$178.01 |
$178.01 |
$178.01 |
$307.58
|
|
Disaccharidases
|
$58.59 |
$58.59 |
$58.59 |
$223.80
|
|
Discography cerv/thor spine
|
$1,703.86 |
$1,703.86 |
$1,703.86 |
$2,404.00
|
|
Dissolve clot heart vessel
|
$522.01 |
$522.01 |
$522.01 |
$1,396.47
|
|
Dlyd plmt xtn prosth ea addl
|
$2,001.55 |
$2,001.55 |
$2,001.55 |
$2,001.55
|
|
Dna antibody native/double stranded
|
$104.35 |
$104.35 |
$104.35 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$33.76 |
$33.76 |
$33.76 |
$99.10
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$676.30 |
$676.30 |
$676.30 |
$733.75
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$15.07 |
$15.07 |
$15.07 |
$76.20
|
|
Doppler echo complete
|
$505.27 |
$505.27 |
$505.27 |
$608.25
|
|
Doppler intravascular pressure flow initial vessel
|
$2,022.75 |
$2,022.75 |
$2,022.75 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$697.23 |
$697.23 |
$697.23 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$444.17 |
$444.17 |
$444.17 |
$482.03
|
|
Dornhoffer fixed part w/window
|
$37,141.60 |
$37,141.60 |
$37,141.60 |
$33,604.20
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$8,729.64 |
$8,729.64 |
$8,729.64 |
$30,164.70
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$315.27 |
$315.27 |
$315.27 |
$363.59
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,404.43 |
$2,404.43 |
$2,404.43 |
$2,278.13
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$31.25 |
$31.25 |
$31.25 |
$89.34
|
|
Dpyd gene common variants
|
$67.52 |
$67.52 |
$67.52 |
$380.50
|
|
Drainage of kidney lesion
|
$693.60 |
$693.60 |
$693.60 |
$1,706.65
|