|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,037.00 |
$2,037.00 |
$2,037.00 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,949.15 |
$1,949.15 |
$1,949.15 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,890.35 |
$1,890.35 |
$1,890.35 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$2,493.75 |
$2,493.75 |
$2,493.75 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$2,365.65 |
$2,365.65 |
$2,365.65 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,908.55 |
$1,908.55 |
$1,908.55 |
$400.20
|
|
CT t-spine w /wo contrast
|
$2,605.75 |
$2,605.75 |
$2,605.75 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$2,014.25 |
$2,014.25 |
$2,014.25 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,807.05 |
$1,807.05 |
$1,807.05 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$2,596.30 |
$2,596.30 |
$2,596.30 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$45.85 |
$45.85 |
$45.85 |
$63.75
|
|
Culture afb any source
|
$168.00 |
$168.00 |
$168.00 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$67.55 |
$67.55 |
$67.55 |
$77.31
|
|
Culture anaerobic except blood
|
$265.30 |
$265.30 |
$265.30 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$65.80 |
$65.80 |
$65.80 |
$52.80
|
|
Culture body fluid
|
$169.40 |
$169.40 |
$169.40 |
$130.50
|
|
Culture fungi definitive id mold
|
$33.95 |
$33.95 |
$33.95 |
$70.00
|
|
Culture fungi definitive id yeast
|
$51.10 |
$51.10 |
$51.10 |
$80.60
|
|
Culture fungi other (except blood)
|
$154.35 |
$154.35 |
$154.35 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$169.05 |
$169.05 |
$169.05 |
$77.40
|
|
Culture mycoplasma any source
|
$57.75 |
$57.75 |
$57.75 |
$90.37
|
|
Culture screening strep group a
|
$120.40 |
$120.40 |
$120.40 |
$81.60
|
|
Culture typing immunologic
|
$12.25 |
$12.25 |
$12.25 |
$41.60
|
|
Curette/treat cornea
|
$708.75 |
$708.75 |
$708.75 |
$1,317.39
|
|
Curette/treat cornea
|
$1,910.30 |
$1,910.30 |
$1,910.30 |
$2,818.14
|
|
Cutter lead
|
$13,715.63 |
$13,715.63 |
$13,715.63 |
$5,538.98
|
|
Cv line/pic reposition
|
$2,343.95 |
$2,343.95 |
$2,343.95 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$33.05 |
$33.05 |
$33.05 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$90.30 |
$90.30 |
$90.30 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$527.00 |
$527.00 |
$527.00 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$218.69 |
$218.69 |
$218.69 |
$179.10
|
|
Cyclosporine modified 25 mg capsule
|
$0.61 |
$0.61 |
$0.61 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$4.38 |
$4.38 |
$4.38 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$22,282.07 |
$22,282.07 |
$22,282.07 |
$22,594.80
|
|
Cystogram >= 3 views supervision & interpretation
|
$441.35 |
$441.35 |
$441.35 |
$539.55
|
|
Cystometrogram w/up 51727
|
$1,681.40 |
$1,681.40 |
$1,681.40 |
$857.38
|
|
Cystoscopy and treatment
|
$2,029.65 |
$2,029.65 |
$2,029.65 |
$4,081.37
|
|
Cystoscopy and treatment
|
$5,535.95 |
$5,535.95 |
$5,535.95 |
$4,081.37
|
|
Cystoscopy and treatment
|
$5,535.95 |
$5,535.95 |
$5,535.95 |
$4,081.37
|
|
Cystoscopy and treatment
|
$5,535.95 |
$5,535.95 |
$5,535.95 |
$4,846.99
|
|
Cystoscopy and treatment
|
$3,071.60 |
$3,071.60 |
$3,071.60 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$1,374.10 |
$1,374.10 |
$1,374.10 |
$1,610.20
|
|
Cystoscopy chemodenervation
|
$4,092.20 |
$4,092.20 |
$4,092.20 |
$2,412.45
|
|
Cystoscopy inject material
|
$5,866.70 |
$5,866.70 |
$5,866.70 |
$5,110.00
|
|
Cystoscopy removal of clots
|
$2,029.65 |
$2,029.65 |
$2,029.65 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$2,918.30 |
$2,918.30 |
$2,918.30 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$1,628.90 |
$1,628.90 |
$1,628.90 |
$3,774.40
|
|
Cystouretero & or pyeloscope
|
$2,484.30 |
$2,484.30 |
$2,484.30 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$2,029.65 |
$2,029.65 |
$2,029.65 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$4,306.05 |
$4,306.05 |
$4,306.05 |
$2,874.36
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$3,795.75 |
$3,795.75 |
$3,795.75 |
$3,970.98
|
|
Cytarabine 20 mg/ml injection solution
|
$110.89 |
$110.89 |
$110.89 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$26.25 |
$26.25 |
$26.25 |
$101.25
|
|
Cytopathology cellular enhancement technique non-gyn
|
$150.85 |
$150.85 |
$150.85 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$88.20 |
$88.20 |
$88.20 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$150.85 |
$150.85 |
$150.85 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$225.05 |
$225.05 |
$225.05 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$214.20 |
$214.20 |
$214.20 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$239.40 |
$239.40 |
$239.40 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$362.25 |
$362.25 |
$362.25 |
$205.00
|
|
Dacarbazine 100 mg intravenous solution
|
$91.38 |
$91.38 |
$91.38 |
$82.91
|
|
Dalbavancin 500 mg intravenous solution
|
$3,593.07 |
$3,593.07 |
$3,593.07 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,618.65 |
$1,618.65 |
$1,618.65 |
$315.32
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$18,316.22 |
$18,316.22 |
$18,316.22 |
$28,415.40
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$250.29 |
$250.29 |
$250.29 |
$260.95
|
|
D&c after delivery 59160
|
$2,732.10 |
$2,732.10 |
$2,732.10 |
$3,762.53
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$3,679.90 |
$3,679.90 |
$3,679.90 |
$3,774.81
|
|
Dch glucoscan
|
$36.75 |
$36.75 |
$36.75 |
$24.85
|
|
Dch validity tests
|
$55.65 |
$55.65 |
$55.65 |
$25.20
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$872.55 |
$872.55 |
$872.55 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$70.00 |
$70.00 |
$70.00 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,344.30 |
$2,344.30 |
$2,344.30 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$222.25 |
$222.25 |
$222.25 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$215.60 |
$215.60 |
$215.60 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$578.90 |
$578.90 |
$578.90 |
$810.50
|
|
Debride nail1-5 11720
|
$92.40 |
$92.40 |
$92.40 |
$173.25
|
|
Debride nail6 or more 11721
|
$184.10 |
$184.10 |
$184.10 |
$195.20
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$782.25 |
$782.25 |
$782.25 |
$1,265.16
|
|
Debride skin bone at fx site
|
$3,951.85 |
$3,951.85 |
$3,951.85 |
$3,278.34
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$292.60 |
$292.60 |
$292.60 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$912.80 |
$912.80 |
$912.80 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$163.10 |
$163.10 |
$163.10 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$578.90 |
$578.90 |
$578.90 |
$1,193.40
|
|
Decalcification
|
$123.90 |
$123.90 |
$123.90 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$6,204.08 |
$6,204.08 |
$6,204.08 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,065.40 |
$1,065.40 |
$1,065.40 |
$545.90
|
|
Decompress fasciotomyhand 26037
|
$1,824.55 |
$1,824.55 |
$1,824.55 |
$3,594.44
|
|
Decompression of lower leg
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$3,839.54
|
|
Decompression of thigh/knee
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$3,839.54
|
|
Deep muscle biopsy 20205
|
$7,548.80 |
$7,548.80 |
$7,548.80 |
$3,370.52
|
|
Deferoxamine 500 mg solution for injection
|
$148.04 |
$148.04 |
$148.04 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$2,554.13 |
$2,554.13 |
$2,554.13 |
$2,086.82
|
|
Delivery of placenta 59414
|
$3,535.00 |
$3,535.00 |
$3,535.00 |
$3,271.20
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$3,222.10 |
$3,222.10 |
$3,222.10 |
$7,763.47
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$329.35 |
$329.35 |
$329.35 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$12,397.98 |
$12,397.98 |
$12,397.98 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$473.20 |
$473.20 |
$473.20 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$176.41 |
$176.41 |
$176.41 |
$132.72
|
|
Derma-fat-fascia graft 15770
|
$3,684.10 |
$3,684.10 |
$3,684.10 |
$4,326.42
|