|
Cystine urine quantitative
|
$56.06 |
$56.06 |
$56.06 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$357.90 |
$357.90 |
$357.90 |
$586.95
|
|
Cytogenetics 25-99
|
$83.46 |
$83.46 |
$83.46 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$44.34 |
$44.34 |
$44.34 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$45.08 |
$45.08 |
$45.08 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$70.42 |
$70.42 |
$70.42 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$105.62 |
$105.62 |
$105.62 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$39.77 |
$39.77 |
$39.77 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$51.51 |
$51.51 |
$51.51 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$51.51 |
$51.51 |
$51.51 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$58.68 |
$58.68 |
$58.68 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$224.29 |
$224.29 |
$224.29 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$70.42 |
$70.42 |
$70.42 |
$213.85
|
|
Cytopath smear other source
|
$46.29 |
$46.29 |
$46.29 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$44.34 |
$44.34 |
$44.34 |
$96.20
|
|
Cytp urine 3-5 probes cmptr
|
$324.04 |
$324.04 |
$324.04 |
$664.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$3.68 |
$3.68 |
$3.68 |
$6,281.29
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$108.20 |
$108.20 |
$108.20 |
$259.58
|
|
Dch validity tests
|
$6.05 |
$6.05 |
$6.05 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$43.60 |
$43.60 |
$43.60 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$74.36 |
$74.36 |
$74.36 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$333.87 |
$333.87 |
$333.87 |
$835.20
|
|
Debride nail1-5 11720
|
$15.59 |
$15.59 |
$15.59 |
$149.60
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$74.25 |
$74.25 |
$74.25 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$289.22 |
$289.22 |
$289.22 |
$1,149.50
|
|
Decalcification
|
$16.02 |
$16.02 |
$16.02 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$297.07 |
$297.07 |
$297.07 |
$572.95
|
|
Delivery of placenta 59414
|
$1,422.85 |
$1,422.85 |
$1,422.85 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$132.72 |
$132.72 |
$132.72 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$158.95 |
$158.95 |
$158.95 |
$401.60
|
|
Device sut capio slim opn
|
$6,195.30 |
$6,195.30 |
$6,195.30 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$6,905.81 |
$6,905.81 |
$6,905.81 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$314.07 |
$314.07 |
$314.07 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$2.39 |
$2.39 |
$2.39 |
$5.85
|
|
Dhea-s (dehydroepiand sulfate)
|
$41.27 |
$41.27 |
$41.27 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$18.48 |
$18.48 |
$18.48 |
$79.30
|
|
Diagnostic anoscopy spx 46600
|
$42.76 |
$42.76 |
$42.76 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$50.80 |
$50.80 |
$50.80 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$207.74 |
$207.74 |
$207.74 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$338.95 |
$338.95 |
$338.95 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$224.93 |
$224.93 |
$224.93 |
$314.00
|
|
Diffusing capacity
|
$258.93 |
$258.93 |
$258.93 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$32.65 |
$32.65 |
$32.65 |
$102.07
|
|
Dilator fascial 10fx20cm
|
$1,072.03 |
$1,072.03 |
$1,072.03 |
$402.10
|
|
Disability dlco
|
$259.56 |
$259.56 |
$259.56 |
$293.76
|
|
Disaccharidases
|
$222.99 |
$222.99 |
$222.99 |
$230.40
|
|
Dna antibody native/double stranded
|
$45.82 |
$45.82 |
$45.82 |
$100.00
|
|
Dna gardnerella
|
$60.12 |
$60.12 |
$60.12 |
$61.83
|
|
Dna trichomonas
|
$40.75 |
$40.75 |
$40.75 |
$63.00
|
|
Doppler echo complete
|
$425.73 |
$425.73 |
$425.73 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$622.52 |
$622.52 |
$622.52 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$404.85 |
$404.85 |
$404.85 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$117,167.14 |
$117,167.14 |
$117,167.14 |
$34,278.00
|
|
Dpyd gene common variants
|
$331.80 |
$331.80 |
$331.80 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$129.27 |
$129.27 |
$129.27 |
$800.00
|
|
Drainage external ear simple 69000
|
$189.13 |
$189.13 |
$189.13 |
$790.40
|
|
Drainage mouth roof lesion
|
$108.65 |
$108.65 |
$108.65 |
$405.60
|
|
Drainage of arm bursa 23931
|
$243.45 |
$243.45 |
$243.45 |
$2,271.01
|
|
Drain blood from under nail 11740
|
$32.70 |
$32.70 |
$32.70 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$144.36 |
$144.36 |
$144.36 |
$428.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$153.39 |
$153.39 |
$153.39 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$99.19 |
$99.19 |
$99.19 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$198.37 |
$198.37 |
$198.37 |
$541.00
|
|
Drng of scrotum abscess 55100
|
$174.54 |
$174.54 |
$174.54 |
$1,997.89
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$4,956.78 |
$4,956.78 |
$4,956.78 |
$1,818.32
|
|
Drug assay caffeine
|
$71.46 |
$71.46 |
$71.46 |
$80.00
|
|
Drug assay posaconazole
|
$72.69 |
$72.69 |
$72.69 |
$96.75
|
|
Drug assay voriconazole
|
$78.23 |
$78.23 |
$78.23 |
$96.75
|
|
Drug of abuse screen urine
|
$23.41 |
$23.41 |
$23.41 |
$67.89
|
|
Drug screening tapentadol
|
$34.50 |
$34.50 |
$34.50 |
$47.03
|
|
Drug test prsmv instrmnt
|
$32.03 |
$32.03 |
$32.03 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$276.58 |
$276.58 |
$276.58 |
$278.85
|
|
Ductogram sgl duct
|
$273.57 |
$273.57 |
$273.57 |
$469.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$768.43 |
$768.43 |
$768.43 |
$904.78
|
|
Ecg/1-3 leads/tracing only 93041
|
$100.92 |
$100.92 |
$100.92 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$404.21 |
$404.21 |
$404.21 |
$412.88
|
|
Ecg external < 48 hours recording
|
$259.98 |
$259.98 |
$259.98 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$388.11 |
$388.11 |
$388.11 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$335.50 |
$335.50 |
$335.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$252.55 |
$252.55 |
$252.55 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,855.92 |
$1,855.92 |
$1,855.92 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$419.46 |
$419.46 |
$419.46 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$336.07 |
$336.07 |
$336.07 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,319.90 |
$2,319.90 |
$2,319.90 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$524.80 |
$524.80 |
$524.80 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$289.67 |
$289.67 |
$289.67 |
$371.25
|
|
Echo exam uterus 76831-
|
$486.10 |
$486.10 |
$486.10 |
$561.00
|
|
Echo guide for amniocentesis
|
$391.84 |
$391.84 |
$391.84 |
$455.57
|
|
Echo transthoracic
|
$672.77 |
$672.77 |
$672.77 |
$1,361.75
|
|
Echo transthoracic
|
$518.53 |
$518.53 |
$518.53 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$590.63 |
$590.63 |
$590.63 |
$1,033.00
|
|
E equine encephalitis igg
|
$48.03 |
$48.03 |
$48.03 |
$51.84
|
|
Egfr gene com variants
|
$615.57 |
$615.57 |
$615.57 |
$672.88
|
|
EKG (Tracing Only)
|
$191.40 |
$191.40 |
$191.40 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$258.96 |
$258.96 |
$258.96 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$319.38 |
$319.38 |
$319.38 |
$364.20
|
|
Electrd sq emblem s-icd
|
$6,195.30 |
$6,195.30 |
$6,195.30 |
$10,243.24
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$95.21 |
$95.21 |
$95.21 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$76.45 |
$76.45 |
$76.45 |
$81.75
|
|
Electrolyte panel
|
$48.05 |
$48.05 |
$48.05 |
$79.30
|
