|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$19.86 |
$19.86 |
$19.86 |
$140.80
|
|
Culture urine each isolate
|
$3.62 |
$3.62 |
$3.62 |
$55.50
|
|
Cutter lead
|
$8,420.39 |
$8,420.39 |
$8,420.39 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,209.19 |
$1,209.19 |
$1,209.19 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$14.98 |
$14.98 |
$14.98 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$1.27 |
$1.27 |
$1.27 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$11.10 |
$11.10 |
$11.10 |
$72.36
|
|
Cyclosporine 2 hour
|
$13.17 |
$13.17 |
$13.17 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$26,478.71 |
$26,478.71 |
$26,478.71 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$121.63 |
$121.63 |
$121.63 |
$524.00
|
|
Cyp2c9 gene com variants
|
$72.98 |
$72.98 |
$72.98 |
$275.10
|
|
Cyp2d6 gene com variants
|
$188.07 |
$188.07 |
$188.07 |
$570.70
|
|
Cyp3a4 gene common variants
|
$72.98 |
$72.98 |
$72.98 |
$241.24
|
|
Cyp3a5 gene common variants
|
$72.98 |
$72.98 |
$72.98 |
$245.31
|
|
Cystatin c
|
$12.71 |
$12.71 |
$12.71 |
$77.60
|
|
Cystic fibrosis cftr
|
$208.08 |
$208.08 |
$208.08 |
$1,104.40
|
|
Cystine urine quantitative
|
$20.66 |
$20.66 |
$20.66 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$305.83 |
$305.83 |
$305.83 |
$586.95
|
|
Cysto rx balo cath urtl strx
|
$3,292.66 |
$3,292.66 |
$3,292.66 |
$6,853.60
|
|
Cytogenetics 25-99
|
$62.59 |
$62.59 |
$62.59 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$11.10 |
$11.10 |
$11.10 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$11.29 |
$11.29 |
$11.29 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$116.87 |
$116.87 |
$116.87 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$79.22 |
$79.22 |
$79.22 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$29.83 |
$29.83 |
$29.83 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$133.01 |
$133.01 |
$133.01 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$138.39 |
$138.39 |
$138.39 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$44.01 |
$44.01 |
$44.01 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$168.22 |
$168.22 |
$168.22 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$282.64 |
$282.64 |
$282.64 |
$213.85
|
|
Cytopath smear other source
|
$155.50 |
$155.50 |
$155.50 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$160.88 |
$160.88 |
$160.88 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$0.66 |
$0.66 |
$0.66 |
$62.41
|
|
Dch validity tests
|
$1.41 |
$1.41 |
$1.41 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$10.91 |
$10.91 |
$10.91 |
$43.35
|
|
Decalcification
|
$24.30 |
$24.30 |
$24.30 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$162.20 |
$162.20 |
$162.20 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$3.60 |
$3.60 |
$3.60 |
$95.85
|
|
Delivery of placenta 59414
|
$1,393.08 |
$1,393.08 |
$1,393.08 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$61.06 |
$61.06 |
$61.06 |
$185.17
|
|
Destruction by injection tx of nerve 64630
|
$555.93 |
$555.93 |
$555.93 |
$1,646.40
|
|
Device ablt adv novasure
|
$1,422.47 |
$1,422.47 |
$1,422.47 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,237.54 |
$3,237.54 |
$3,237.54 |
$4,200.00
|
|
Device sut capio slim opn
|
$4,666.74 |
$4,666.74 |
$4,666.74 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,237.54 |
$3,237.54 |
$3,237.54 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$139.63 |
$139.63 |
$139.63 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$15.21 |
$15.21 |
$15.21 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$6.81 |
$6.81 |
$6.81 |
$79.30
|
|
Diagnostic laryngoscopy 31575
|
$182.42 |
$182.42 |
$182.42 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$407.04 |
$407.04 |
$407.04 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$179.49 |
$179.49 |
$179.49 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$4,787.89 |
$4,787.89 |
$4,787.89 |
$5,741.00
|
|
Diffusing capacity
|
$142.80 |
$142.80 |
$142.80 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$12.03 |
$12.03 |
$12.03 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$2,150.06 |
$2,150.06 |
$2,150.06 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$502.58 |
$502.58 |
$502.58 |
$402.10
|
|
Disability dlco
|
$112.20 |
$112.20 |
$112.20 |
$293.76
|
|
Disaccharidases
|
$82.17 |
$82.17 |
$82.17 |
$230.40
|
|
Dna antibody native/double stranded
|
$11.47 |
$11.47 |
$11.47 |
$100.00
|
|
Dna gardnerella
|
$13.05 |
$13.05 |
$13.05 |
$61.83
|
|
Dna trichomonas
|
$8.84 |
$8.84 |
$8.84 |
$63.00
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$0.36 |
$0.36 |
$0.36 |
$949.39
|
|
Doppler echo complete
|
$293.04 |
$293.04 |
$293.04 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$1,148.80 |
$1,148.80 |
$1,148.80 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$324.14 |
$324.14 |
$324.14 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$209.92 |
$209.92 |
$209.92 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$88,258.61 |
$88,258.61 |
$88,258.61 |
$34,278.00
|
|
Dpyd gene common variants
|
$72.98 |
$72.98 |
$72.98 |
$423.60
|
|
Drainage of kidney lesion
|
$953.87 |
$953.87 |
$953.87 |
$1,506.00
|
|
Drain cath image guided visceral pq
|
$998.79 |
$998.79 |
$998.79 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$411.34 |
$411.34 |
$411.34 |
$1,044.00
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$3,733.80 |
$3,733.80 |
$3,733.80 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$170.07 |
$170.07 |
$170.07 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$2,867.84 |
$2,867.84 |
$2,867.84 |
$569.75
|
|
Drug assay caffeine
|
$26.33 |
$26.33 |
$26.33 |
$80.00
|
|
Drug assay posaconazole
|
$26.79 |
$26.79 |
$26.79 |
$96.75
|
|
Drug assay voriconazole
|
$28.83 |
$28.83 |
$28.83 |
$96.75
|
|
Drug of abuse screen urine
|
$8.63 |
$8.63 |
$8.63 |
$67.89
|
|
Drug screening tapentadol
|
$12.71 |
$12.71 |
$12.71 |
$47.03
|
|
Drug test prsmv instrmnt
|
$11.80 |
$11.80 |
$11.80 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$101.92 |
$101.92 |
$101.92 |
$278.85
|
|
Dstrj nulyt agt gnclr nrv
|
$1,723.36 |
$1,723.36 |
$1,723.36 |
$2,980.00
|
|
Ductogram sgl duct
|
$218.30 |
$218.30 |
$218.30 |
$469.80
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$332.02 |
$332.02 |
$332.02 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$318.30 |
$318.30 |
$318.30 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$252.68 |
$252.68 |
$252.68 |
$401.20
|
|
Ecg/1-3 leads/tracing only 93041
|
$41.72 |
$41.72 |
$41.72 |
$132.08
|
|
Ecg external < 48 hours recording
|
$181.04 |
$181.04 |
$181.04 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$270.44 |
$270.44 |
$270.44 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$143.93 |
$143.93 |
$143.93 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$103.26 |
$103.26 |
$103.26 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$760.72 |
$760.72 |
$760.72 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$291.06 |
$291.06 |
$291.06 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$145.73 |
$145.73 |
$145.73 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$951.19 |
$951.19 |
$951.19 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$363.92 |
$363.92 |
$363.92 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$158.00 |
$158.00 |
$158.00 |
$371.25
|
|
Echo exam uterus 76831-
|
$440.00 |
$440.00 |
$440.00 |
$561.00
|
|
Echo guide for amniocentesis
|
$253.44 |
$253.44 |
$253.44 |
$455.57
|
|
Echo stress
|
$389.27 |
$389.27 |
$389.27 |
$1,609.44
|
