|
Culture aerobic additional method definitive id each
|
$79.36 |
$79.36 |
$79.36 |
$63.75
|
|
Culture afb any source
|
$9.10 |
$9.10 |
$9.10 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$93.55 |
$93.55 |
$93.55 |
$77.31
|
|
Culture anaerobic except blood
|
$586.04 |
$586.04 |
$586.04 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$60.79 |
$60.79 |
$60.79 |
$52.80
|
|
Culture body fluid
|
$586.04 |
$586.04 |
$586.04 |
$130.50
|
|
Culture fungi definitive id mold
|
$38.79 |
$38.79 |
$38.79 |
$70.00
|
|
Culture fungi definitive id yeast
|
$70.62 |
$70.62 |
$70.62 |
$80.60
|
|
Culture fungi other (except blood)
|
$217.31 |
$217.31 |
$217.31 |
$105.60
|
|
Culture mycoplasma any source
|
$13.11 |
$13.11 |
$13.11 |
$90.37
|
|
Culture screening strep group a
|
$305.76 |
$305.76 |
$305.76 |
$81.60
|
|
Culture typing immunologic
|
$49.51 |
$49.51 |
$49.51 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$61.99 |
$61.99 |
$61.99 |
$124.40
|
|
Cutter lead
|
$4,631.18 |
$4,631.18 |
$4,631.18 |
$5,538.98
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$13.84 |
$13.84 |
$13.84 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$9.10 |
$9.10 |
$9.10 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$884.16 |
$884.16 |
$884.16 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$45.14 |
$45.14 |
$45.14 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$144.88 |
$144.88 |
$144.88 |
$179.10
|
|
Cyclosporine 2 hour
|
$5.46 |
$5.46 |
$5.46 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$9.47 |
$9.47 |
$9.47 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$37.13 |
$37.13 |
$37.13 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$20,422.59 |
$20,422.59 |
$20,422.59 |
$22,594.80
|
|
Cystatin c
|
$3.64 |
$3.64 |
$3.64 |
$82.26
|
|
Cystic fibrosis cftr
|
$236.60 |
$236.60 |
$236.60 |
$1,041.95
|
|
Cystogram >= 3 views supervision & interpretation
|
$381.48 |
$381.48 |
$381.48 |
$539.55
|
|
Cytarabine 20 mg/ml injection solution
|
$23.66 |
$23.66 |
$23.66 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$19.11 |
$19.11 |
$19.11 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$3.64 |
$3.64 |
$3.64 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$37.09 |
$37.09 |
$37.09 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$27.24 |
$27.24 |
$27.24 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$27.24 |
$27.24 |
$27.24 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$7.34 |
$7.34 |
$7.34 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$118.92 |
$118.92 |
$118.92 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$37.09 |
$37.09 |
$37.09 |
$205.00
|
|
Cytopath smear oth prep screen & interp
|
$17.00 |
$17.00 |
$17.00 |
$95.89
|
|
Cytp urine 3-5 probes cmptr
|
$167.44 |
$167.44 |
$167.44 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$42.23 |
$42.23 |
$42.23 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$49.14 |
$49.14 |
$49.14 |
$2,526.62
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,555.01 |
$1,555.01 |
$1,555.01 |
$315.32
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$468.84 |
$468.84 |
$468.84 |
$260.95
|
|
Deamidated gliadin antibody iga
|
$3.54 |
$3.54 |
$3.54 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$128.86 |
$128.86 |
$128.86 |
$262.60
|
|
Decalcification
|
$20.86 |
$20.86 |
$20.86 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$316.68 |
$316.68 |
$316.68 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$103.38 |
$103.38 |
$103.38 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$1,707.16 |
$1,707.16 |
$1,707.16 |
$2,086.82
|
|
Delivery of placenta 59414
|
$2,664.48 |
$2,664.48 |
$2,664.48 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$144.15 |
$144.15 |
$144.15 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$7,933.81
|
|
Depo-estradiol cypionate inj
|
$184.92 |
$184.92 |
$184.92 |
$132.72
|
|
Dermagraft
|
$2,738.74 |
$2,738.74 |
$2,738.74 |
$1,912.31
|
|
Design mlc device for imrt
|
$471.38 |
$471.38 |
$471.38 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,380.29 |
$1,380.29 |
$1,380.29 |
$102.32
|
|
Device ablt adv novasure
|
$10,179.63 |
$10,179.63 |
$10,179.63 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,561.38 |
$3,561.38 |
$3,561.38 |
$4,298.87
|
|
Device intraute mirena
|
$2,832.29 |
$2,832.29 |
$2,832.29 |
$2,618.91
|
|
Device sut capio slim opn
|
$2,738.74 |
$2,738.74 |
$2,738.74 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,738.74 |
$2,738.74 |
$2,738.74 |
$2,440.98
|
|
Dexamethasone 4 mg tablet
|
$3.64 |
$3.64 |
$3.64 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$24.39 |
$24.39 |
$24.39 |
$30.00
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,602.33 |
$1,602.33 |
$1,602.33 |
$560.92
|
|
Dextran 40 infusion
|
$101.92 |
$101.92 |
$101.92 |
$171.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$29.12 |
$29.12 |
$29.12 |
$60.00
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$28.40 |
$28.40 |
$28.40 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$28.40 |
$28.40 |
$28.40 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$2.19 |
$2.19 |
$2.19 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$319.96 |
$319.96 |
$319.96 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$403.32 |
$403.32 |
$403.32 |
$424.00
|
|
Dialysis one evaluation
|
$566.75 |
$566.75 |
$566.75 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$184.19 |
$184.19 |
$184.19 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$38.95 |
$38.95 |
$38.95 |
$72.34
|
|
Dicyclomine injection
|
$293.75 |
$293.75 |
$293.75 |
$211.81
|
|
Diffusing capacity
|
$324.69 |
$324.69 |
$324.69 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$459.37 |
$459.37 |
$459.37 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$416.06 |
$416.06 |
$416.06 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$272.64 |
$272.64 |
$272.64 |
$334.68
|
|
Dilator fascial 10fx20cm
|
$255.90 |
$255.90 |
$255.90 |
$305.68
|
|
Diltiazem 5 mg/ml intravenous solution
|
$53.15 |
$53.15 |
$53.15 |
$60.25
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$9.83 |
$9.83 |
$9.83 |
$26.87
|
|
Disability dlco
|
$326.51 |
$326.51 |
$326.51 |
$307.58
|
|
Dna antibody native/double stranded
|
$3.64 |
$3.64 |
$3.64 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$91.37 |
$91.37 |
$91.37 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,828.74 |
$1,828.74 |
$1,828.74 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$50.96 |
$50.96 |
$50.96 |
$84.30
|
|
Doppler echo complete
|
$1,106.93 |
$1,106.93 |
$1,106.93 |
$608.25
|
|
Doppler intravascular pressure flow initial vessel
|
$2,174.90 |
$2,174.90 |
$2,174.90 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$854.31 |
$854.31 |
$854.31 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$555.47 |
$555.47 |
$555.47 |
$482.03
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$852.13 |
$852.13 |
$852.13 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$2,417.38
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$84.45 |
$84.45 |
$84.45 |
$99.99
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$7,830.01 |
$7,830.01 |
$7,830.01 |
$9,390.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$12.02 |
$12.02 |
$12.02 |
$39.60
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$1,245.61 |
$1,245.61 |
$1,245.61 |
$1,778.40
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$17,205.92 |
$17,205.92 |
$17,205.92 |
$18,384.03
|
|
Drug admin & hemodynmic meas
|
$1,714.81 |
$1,714.81 |
$1,714.81 |
$528.50
|
|
Drug assay posaconazole
|
$20.75 |
$20.75 |
$20.75 |
$96.39
|