|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$547.65 |
$547.65 |
$547.65 |
$1,215.06
|
|
CT heart w/evaluation of calcium without contrast
|
$71.71 |
$71.71 |
$71.71 |
$150.00
|
|
CT limited or localized follow-up study
|
$428.98 |
$428.98 |
$428.98 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$663.93 |
$663.93 |
$663.93 |
$1,818.96
|
|
CT scan for therapy guide
|
$149.90 |
$149.90 |
$149.90 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$860.22 |
$860.22 |
$860.22 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$716.85 |
$716.85 |
$716.85 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$573.48 |
$573.48 |
$573.48 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$1,275.75 |
$1,275.75 |
$1,275.75 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$916.92 |
$916.92 |
$916.92 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$44.29 |
$44.29 |
$44.29 |
$72.00
|
|
Culture afb any source
|
$27.09 |
$27.09 |
$27.09 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$50.74 |
$50.74 |
$50.74 |
$84.76
|
|
Culture anaerobic except blood
|
$12.47 |
$12.47 |
$12.47 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$27.09 |
$27.09 |
$27.09 |
$52.50
|
|
Culture body fluid
|
$48.16 |
$48.16 |
$48.16 |
$126.75
|
|
Culture fungi definitive id mold
|
$59.34 |
$59.34 |
$59.34 |
$80.00
|
|
Culture fungi definitive id yeast
|
$26.66 |
$26.66 |
$26.66 |
$80.00
|
|
Culture fungi other (except blood)
|
$33.54 |
$33.54 |
$33.54 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$25.37 |
$25.37 |
$25.37 |
$74.75
|
|
Culture mycoplasma any source
|
$27.09 |
$27.09 |
$27.09 |
$83.21
|
|
Culture quantitative aerobic other source
|
$26.23 |
$26.23 |
$26.23 |
$87.02
|
|
Culture screening strep group a
|
$28.38 |
$28.38 |
$28.38 |
$84.60
|
|
Culture typing immunologic
|
$36.55 |
$36.55 |
$36.55 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$58.91 |
$58.91 |
$58.91 |
$140.80
|
|
Culture urine each isolate
|
$10.75 |
$10.75 |
$10.75 |
$55.50
|
|
Cutter lead
|
$15,784.22 |
$15,784.22 |
$15,784.22 |
$6,581.45
|
|
Cv line/pic reposition
|
$822.61 |
$822.61 |
$822.61 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$21.78 |
$21.78 |
$21.78 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$24.42 |
$24.42 |
$24.42 |
$72.36
|
|
Cyclosporine 2 hour
|
$19.14 |
$19.14 |
$19.14 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$30,618.06 |
$30,618.06 |
$30,618.06 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$269.50 |
$269.50 |
$269.50 |
$524.00
|
|
Cyp2c9 gene com variants
|
$161.70 |
$161.70 |
$161.70 |
$275.10
|
|
Cyp2d6 gene com variants
|
$416.72 |
$416.72 |
$416.72 |
$570.70
|
|
Cyp3a4 gene common variants
|
$161.70 |
$161.70 |
$161.70 |
$241.24
|
|
Cyp3a5 gene common variants
|
$161.70 |
$161.70 |
$161.70 |
$245.31
|
|
Cystatin c
|
$18.48 |
$18.48 |
$18.48 |
$77.60
|
|
Cystic fibrosis cftr
|
$461.08 |
$461.08 |
$461.08 |
$1,104.40
|
|
Cystine urine quantitative
|
$30.03 |
$30.03 |
$30.03 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$242.55 |
$242.55 |
$242.55 |
$586.95
|
|
Cytogenetics 25-99
|
$57.34 |
$57.34 |
$57.34 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$24.42 |
$24.42 |
$24.42 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$24.83 |
$24.83 |
$24.83 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$48.38 |
$48.38 |
$48.38 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$72.58 |
$72.58 |
$72.58 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$27.33 |
$27.33 |
$27.33 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$35.39 |
$35.39 |
$35.39 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$35.39 |
$35.39 |
$35.39 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$40.32 |
$40.32 |
$40.32 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$154.11 |
$154.11 |
$154.11 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$48.38 |
$48.38 |
$48.38 |
$213.85
|
|
Cytopath smear other source
|
$31.81 |
$31.81 |
$31.81 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$30.46 |
$30.46 |
$30.46 |
$96.20
|
|
Dch validity tests
|
$4.31 |
$4.31 |
$4.31 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$24.01 |
$24.01 |
$24.01 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$73.40 |
$73.40 |
$73.40 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$1,044.73 |
$1,044.73 |
$1,044.73 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$112.33 |
$112.33 |
$112.33 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$400.49 |
$400.49 |
$400.49 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$273.50 |
$273.50 |
$273.50 |
$835.20
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$60.83 |
$60.83 |
$60.83 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$737.04 |
$737.04 |
$737.04 |
$1,165.50
|
|
Decalcification
|
$12.82 |
$12.82 |
$12.82 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$3.24 |
$3.24 |
$3.24 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$186.04 |
$186.04 |
$186.04 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$0.87 |
$0.87 |
$0.87 |
$95.85
|
|
Delivery of placenta 59414
|
$1,035.82 |
$1,035.82 |
$1,035.82 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$126.74 |
$126.74 |
$126.74 |
$185.17
|
|
Design mlc device for imrt
|
$224.22 |
$224.22 |
$224.22 |
$1,753.00
|
|
Device sut capio slim opn
|
$5,396.28 |
$5,396.28 |
$5,396.28 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$6,905.81 |
$6,905.81 |
$6,905.81 |
$2,515.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.66 |
$0.66 |
$0.66 |
$20.76
|
|
Dhea-s (dehydroepiand sulfate)
|
$22.11 |
$22.11 |
$22.11 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$9.90 |
$9.90 |
$9.90 |
$79.30
|
|
Diab manage trn ind/group
|
$19.49 |
$19.49 |
$19.49 |
$54.99
|
|
Diagnostic laryngoscopy 31575
|
$124.82 |
$124.82 |
$124.82 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$297.29 |
$297.29 |
$297.29 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$197.28 |
$197.28 |
$197.28 |
$314.00
|
|
Diffusing capacity
|
$177.55 |
$177.55 |
$177.55 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$17.49 |
$17.49 |
$17.49 |
$102.07
|
|
Dilator fascial 10fx20cm
|
$1,072.03 |
$1,072.03 |
$1,072.03 |
$402.10
|
|
Disability dlco
|
$177.98 |
$177.98 |
$177.98 |
$293.76
|
|
Disaccharidases
|
$150.48 |
$150.48 |
$150.48 |
$230.40
|
|
Dna antibody native/double stranded
|
$25.23 |
$25.23 |
$25.23 |
$100.00
|
|
Dna gardnerella
|
$38.70 |
$38.70 |
$38.70 |
$61.83
|
|
Dna trichomonas
|
$26.23 |
$26.23 |
$26.23 |
$63.00
|
|
Doppler echo complete
|
$286.54 |
$286.54 |
$286.54 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$393.50 |
$393.50 |
$393.50 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$255.91 |
$255.91 |
$255.91 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$102,055.86 |
$102,055.86 |
$102,055.86 |
$34,278.00
|
|
Dpyd gene common variants
|
$161.70 |
$161.70 |
$161.70 |
$423.60
|
|
Drainage of kidney lesion
|
$1,152.76 |
$1,152.76 |
$1,152.76 |
$1,506.00
|
|
Drain cath image guided visceral pq
|
$1,274.17 |
$1,274.17 |
$1,274.17 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$83.92 |
$83.92 |
$83.92 |
$1,044.00
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$4,604.70 |
$4,604.70 |
$4,604.70 |
$1,818.32
|
|
Drug assay caffeine
|
$38.28 |
$38.28 |
$38.28 |
$80.00
|
|
Drug assay posaconazole
|
$38.94 |
$38.94 |
$38.94 |
$96.75
|
|
Drug assay vedolizumab
|
$104.61 |
$104.61 |
$104.61 |
$154.00
|
|
Drug assay voriconazole
|
$41.91 |
$41.91 |
$41.91 |
$96.75
|
