|
Cyclosporine 250 mg/5 ml intravenous solution
|
$73.22 |
$73.22 |
$73.22 |
$140.78
|
|
Cyclosporine 2 hour
|
$0.91 |
$0.91 |
$0.91 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$7.91 |
$7.91 |
$7.91 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$3.29 |
$3.29 |
$3.29 |
$34.88
|
|
Cylinder pump set 20cm titan zero angl
|
$171.15 |
$171.15 |
$171.15 |
$22,803.38
|
|
Cystatin c
|
$1.89 |
$1.89 |
$1.89 |
$77.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$125.86 |
$125.86 |
$125.86 |
$542.10
|
|
Cytomegalovirus (cmv) antibody igg
|
$3.22 |
$3.22 |
$3.22 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$0.56 |
$0.56 |
$0.56 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$3.26 |
$3.26 |
$3.26 |
$159.45
|
|
Cytopathology concentration technique smears & interpretation
|
$3.84 |
$3.84 |
$3.84 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$4.20 |
$4.20 |
$4.20 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$1.74 |
$1.74 |
$1.74 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$8.25 |
$8.25 |
$8.25 |
$209.23
|
|
Cytopath smear oth prep screen & interp
|
$4.71 |
$4.71 |
$4.71 |
$96.20
|
|
Dalbavancin 500 mg intravenous solution
|
$12.88 |
$12.88 |
$12.88 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.21 |
$0.21 |
$0.21 |
$168.53
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4.06 |
$4.06 |
$4.06 |
$6,072.48
|
|
Dch validity tests
|
$2.87 |
$2.87 |
$2.87 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$2.08 |
$2.08 |
$2.08 |
$43.60
|
|
Debridement (>20 cm) charge pt
|
$42.42 |
$42.42 |
$42.42 |
$260.61
|
|
Decalcification
|
$0.65 |
$0.65 |
$0.65 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$41.65 |
$41.65 |
$41.65 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$5.11 |
$5.11 |
$5.11 |
$1,807.08
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$30.24 |
$30.24 |
$30.24 |
$185.17
|
|
Dermagraft
|
$16.87 |
$16.87 |
$16.87 |
$85.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$1.26 |
$1.26 |
$1.26 |
$89.78
|
|
Detect agent nos dna dir
|
$3.85 |
$3.85 |
$3.85 |
$115.20
|
|
Device sut capio slim opn
|
$113.75 |
$113.75 |
$113.75 |
$1,894.50
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.14 |
$0.14 |
$0.14 |
$21.17
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$82.81 |
$82.81 |
$82.81 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$78.26 |
$78.26 |
$78.26 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$60.41 |
$60.41 |
$60.41 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$82.81 |
$82.81 |
$82.81 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$0.49 |
$0.49 |
$0.49 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$30.24 |
$30.24 |
$30.24 |
$79.20
|
|
Dialysis one evaluation
|
$214.20 |
$214.20 |
$214.20 |
$919.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$1.26 |
$1.26 |
$1.26 |
$74.76
|
|
Dicyclomine injection
|
$58.03 |
$58.03 |
$58.03 |
$153.29
|
|
Diffusing capacity
|
$77.98 |
$77.98 |
$77.98 |
$332.00
|
|
Digital analysis of eeg
|
$139.02 |
$139.02 |
$139.02 |
$605.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$40.81 |
$40.81 |
$40.81 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$779.03 |
$779.03 |
$779.03 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$38.29 |
$38.29 |
$38.29 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$49.77 |
$49.77 |
$49.77 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$250.60 |
$250.60 |
$250.60 |
$402.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$36.75 |
$36.75 |
$36.75 |
$17.75
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$37.38 |
$37.38 |
$37.38 |
$91.53
|
|
Dipyridamole injection
|
$91.91 |
$91.91 |
$91.91 |
$47.87
|
|
Dna antibody native/double stranded
|
$8.75 |
$8.75 |
$8.75 |
$97.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$139.23 |
$139.23 |
$139.23 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$17.43 |
$17.43 |
$17.43 |
$904.81
|
|
Dolasetron mesylate
|
$3.43 |
$3.43 |
$3.43 |
$44.65
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$0.77 |
$0.77 |
$0.77 |
$65.40
|
|
Doppler echo complete
|
$168.28 |
$168.28 |
$168.28 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$135.87 |
$135.87 |
$135.87 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$91.49 |
$91.49 |
$91.49 |
$471.17
|
|
Doripenem 50 mg/ml inj 10 ml
|
$0.70 |
$0.70 |
$0.70 |
$73.80
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$154.56 |
$154.56 |
$154.56 |
$423.95
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.14 |
$0.14 |
$0.14 |
$84.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$46.97 |
$46.97 |
$46.97 |
$31.07
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$254.38 |
$254.38 |
$254.38 |
$1,956.48
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$14.63 |
$14.63 |
$14.63 |
$8,040.27
|
|
Drug asy hydroxychloroquine
|
$5.69 |
$5.69 |
$5.69 |
$66.43
|
|
Drug test prsmv instrmnt
|
$28.49 |
$28.49 |
$28.49 |
$90.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$130.97 |
$130.97 |
$130.97 |
$278.85
|
|
Dup scan/hemodialysis access 93990
|
$204.33 |
$204.33 |
$204.33 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$197.75 |
$197.75 |
$197.75 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$101.15 |
$101.15 |
$101.15 |
$887.25
|
|
Ecg 12 lead tracing only
|
$102.48 |
$102.48 |
$102.48 |
$226.50
|
|
Echocardiogram (Heart Ultrasound)
|
$624.33 |
$624.33 |
$624.33 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$131.11 |
$131.11 |
$131.11 |
$469.95
|
|
Echocardiography transthoracic 2d followup/limited
|
$132.16 |
$132.16 |
$132.16 |
$703.25
|
|
Echo stress
|
$265.02 |
$265.02 |
$265.02 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$848.47 |
$848.47 |
$848.47 |
$1,849.50
|
|
Eeg 41-60 minutes 95812-26
|
$140.28 |
$140.28 |
$140.28 |
$920.00
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$418.53 |
$418.53 |
$418.53 |
$1,000.42
|
|
Eeg during surgery
|
$106.54 |
$106.54 |
$106.54 |
$797.30
|
|
Eeg monitoring/function test
|
$624.05 |
$624.05 |
$624.05 |
$1,548.52
|
|
Eeg monitoring/giving drugs
|
$399.49 |
$399.49 |
$399.49 |
$809.86
|
|
Eeg monitor/record/awake/drowsy 95816
|
$276.22 |
$276.22 |
$276.22 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$197.33 |
$197.33 |
$197.33 |
$1,102.05
|
|
Eeg/record in coma or sleep only 95822
|
$291.69 |
$291.69 |
$291.69 |
$907.80
|
|
Eeg recording awake and asleep
|
$276.22 |
$276.22 |
$276.22 |
$931.20
|
|
Eeg without vid ea 12-26hr cont
|
$241.85 |
$241.85 |
$241.85 |
$1,460.20
|
|
Eeg wo vid 2-12hr intmt mntr
|
$126.07 |
$126.07 |
$126.07 |
$671.00
|
|
Eeg wo vid ea 12-26hr unmntr
|
$228.41 |
$228.41 |
$228.41 |
$1,502.40
|
|
Electrolyte panel
|
$61.04 |
$61.04 |
$61.04 |
$84.24
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$27.93 |
$27.93 |
$27.93 |
$375.20
|
|
Emg needle test 1-extremity
|
$91.98 |
$91.98 |
$91.98 |
$334.34
|
|
Emg needle test 4-extremities
|
$29.82 |
$29.82 |
$29.82 |
$547.00
|
|
Endo cath bile duct s&i
|
$222.67 |
$222.67 |
$222.67 |
$694.06
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$6.02 |
$6.02 |
$6.02 |
$109.71
|
|
Epinephrine 1 mg/ml im kit - pediatric
|
$0.21 |
$0.21 |
$0.21 |
$393.15
|
|
Epoetin alfa, 100 units esrd
|
$1.96 |
$1.96 |
$1.96 |
$4.82
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$8.96 |
$8.96 |
$8.96 |
$809.08
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$35.49 |
$35.49 |
$35.49 |
$1,289.71
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$9.80 |
$9.80 |
$9.80 |
$129.30
|
|
Epstein barr nuclear antigen antibody
|
$0.63 |
$0.63 |
$0.63 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$0.54 |
$0.54 |
$0.54 |
$91.00
|
