|
Culture anaerobic additional method definitive id each
|
$309.93 |
$309.93 |
$309.93 |
$78.65
|
|
Culture anaerobic except blood
|
$351.73 |
$351.73 |
$351.73 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$151.04 |
$151.04 |
$151.04 |
$52.65
|
|
Culture body fluid
|
$400.56 |
$400.56 |
$400.56 |
$130.50
|
|
Culture fungi definitive id mold
|
$36.13 |
$36.13 |
$36.13 |
$70.00
|
|
Culture fungi definitive id yeast
|
$37.86 |
$37.86 |
$37.86 |
$80.40
|
|
Culture fungi other (except blood)
|
$359.54 |
$359.54 |
$359.54 |
$104.00
|
|
Culture mycobacteria definitive id each isolate
|
$233.76 |
$233.76 |
$233.76 |
$88.14
|
|
Culture mycoplasma any source
|
$246.24 |
$246.24 |
$246.24 |
$90.37
|
|
Culture quantitative aerobic other source
|
$158.24 |
$158.24 |
$158.24 |
$85.80
|
|
Culture screening strep group a
|
$106.08 |
$106.08 |
$106.08 |
$80.60
|
|
Culture typing added method
|
$123.84 |
$123.84 |
$123.84 |
$34.45
|
|
Culture typing immunologic
|
$82.88 |
$82.88 |
$82.88 |
$43.46
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$3,488.96 |
$3,488.96 |
$3,488.96 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$561.44 |
$561.44 |
$561.44 |
$124.02
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$173.66 |
$173.66 |
$173.66 |
$27.88
|
|
Cyclic citrullinated peptide antibody
|
$45.33 |
$45.33 |
$45.33 |
$82.00
|
|
Cyclosporine 2 hour
|
$288.80 |
$288.80 |
$288.80 |
$119.40
|
|
Cyclosporine oral 100 mg
|
$84.27 |
$84.27 |
$84.27 |
$43.04
|
|
Cystatin c
|
$296.32 |
$296.32 |
$296.32 |
$82.26
|
|
Cystine urine quantitative
|
$367.68 |
$367.68 |
$367.68 |
$103.35
|
|
Cytarabine 20 mg/ml injection solution
|
$137.54 |
$137.54 |
$137.54 |
$79.98
|
|
Cytomegalovirus (cmv) antibody igg
|
$230.24 |
$230.24 |
$230.24 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$269.60 |
$269.60 |
$269.60 |
$98.35
|
|
Cyto/molecular report
|
$156.70 |
$156.70 |
$156.70 |
$144.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$807.52 |
$807.52 |
$807.52 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$324.16 |
$324.16 |
$324.16 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$552.48 |
$552.48 |
$552.48 |
$142.94
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$318.00 |
$318.00 |
$318.00 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$2,198.56 |
$2,198.56 |
$2,198.56 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$179.68 |
$179.68 |
$179.68 |
$205.00
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$86,694.06 |
$86,694.06 |
$86,694.06 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$41,409.32 |
$41,409.32 |
$41,409.32 |
$5,546.48
|
|
Deamidated gliadin antibody iga
|
$184.48 |
$184.48 |
$184.48 |
$43.60
|
|
Decalcification
|
$100.19 |
$100.19 |
$100.19 |
$75.38
|
|
Deferoxamine 500 mg solution for injection
|
$2,328.68 |
$2,328.68 |
$2,328.68 |
$116.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$711.85 |
$711.85 |
$711.85 |
$193.05
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$65,489.42 |
$65,489.42 |
$65,489.42 |
$7,744.96
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,651.84 |
$1,651.84 |
$1,651.84 |
$460.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$4,601.49 |
$4,601.49 |
$4,601.49 |
$121.30
|
|
Destroy cervthor facet jnt 64633
|
$27,260.96 |
$27,260.96 |
$27,260.96 |
$3,003.84
|
|
Destroy cth facet jnt addl 64634
|
$2,256.50 |
$2,256.50 |
$2,256.50 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,515.82 |
$2,515.82 |
$2,515.82 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,291.07 |
$6,291.07 |
$6,291.07 |
$3,375.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$96.92 |
$96.92 |
$96.92 |
$24.28
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$286.28 |
$286.28 |
$286.28 |
$57.07
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$286.28 |
$286.28 |
$286.28 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$71.35 |
$71.35 |
$71.35 |
$49.68
|
|
Dextrose 5 % IV bolus
|
$286.28 |
$286.28 |
$286.28 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$77.81 |
$77.81 |
$77.81 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$65.61 |
$65.61 |
$65.61 |
$78.41
|
|
Dialysis one evaluation
|
$1,964.60 |
$1,964.60 |
$1,964.60 |
$827.97
|
|
Diatrizoate meglumine 18 % urethral solution
|
$465.30 |
$465.30 |
$465.30 |
$106.27
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$227.78 |
$227.78 |
$227.78 |
$70.87
|
|
Dicyclomine injection
|
$932.36 |
$932.36 |
$932.36 |
$211.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$93.95 |
$93.95 |
$93.95 |
$64.31
|
|
Digoxin total therapeutic drug level
|
$662.48 |
$662.48 |
$662.48 |
$102.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$69.32 |
$69.32 |
$69.32 |
$25.12
|
|
Disaccharidases
|
$354.72 |
$354.72 |
$354.72 |
$223.80
|
|
Dna antibody native/double stranded
|
$48.09 |
$48.09 |
$48.09 |
$101.40
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$1,235.09 |
$1,235.09 |
$1,235.09 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,416.91 |
$1,416.91 |
$1,416.91 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$371.33 |
$371.33 |
$371.33 |
$74.39
|
|
Doppler echo complete
|
$1,602.88 |
$1,602.88 |
$1,602.88 |
$635.20
|
|
Doppler intravascular pressure flow initial vessel
|
$11,832.42 |
$11,832.42 |
$11,832.42 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,279.03 |
$1,279.03 |
$1,279.03 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$389.59 |
$389.59 |
$389.59 |
$482.03
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$94,333.11 |
$94,333.11 |
$94,333.11 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$363.59 |
$363.59 |
$363.59 |
$264.42
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$16,330.53 |
$16,330.53 |
$16,330.53 |
$2,469.31
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$9,453.76 |
$9,453.76 |
$9,453.76 |
$820.50
|
|
Drainage external ear simple 69000
|
$2,124.65 |
$2,124.65 |
$2,124.65 |
$809.25
|
|
Drainage of arm bursa 23931
|
$21,695.04 |
$21,695.04 |
$21,695.04 |
$2,271.01
|
|
Drainage of kidney lesion
|
$3,510.21 |
$3,510.21 |
$3,510.21 |
$1,619.40
|
|
Drain blood from under nail 11740
|
$1,651.84 |
$1,651.84 |
$1,651.84 |
$190.10
|
|
Drain cath image guided visceral pq
|
$21,695.04 |
$21,695.04 |
$21,695.04 |
$2,999.34
|
|
Drain finger abscess;simple 26010
|
$2,810.24 |
$2,810.24 |
$2,810.24 |
$492.81
|
|
Drain neck/chest lesion 21501
|
$9,467.71 |
$9,467.71 |
$9,467.71 |
$3,293.25
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$2,810.24 |
$2,810.24 |
$2,810.24 |
$407.19
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$2,810.24 |
$2,810.24 |
$2,810.24 |
$360.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,342.12 |
$1,342.12 |
$1,342.12 |
$530.40
|
|
Drng of finger abscess comp 26011
|
$21,695.04 |
$21,695.04 |
$21,695.04 |
$1,917.33
|
|
Drng of scrotum abscess 55100
|
$21,695.04 |
$21,695.04 |
$21,695.04 |
$1,997.89
|
|
Droperidol 2.5 mg/ml injection solution
|
$113.23 |
$113.23 |
$113.23 |
$36.32
|
|
Drug admin & hemodynmic meas
|
$794.28 |
$794.28 |
$794.28 |
$528.50
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$994.24 |
$994.24 |
$994.24 |
$278.85
|
|
Drvvt confirm - quest
|
$287.68 |
$287.68 |
$287.68 |
$101.66
|
|
Duplex scan unilateral study 93986
|
$1,774.24 |
$1,774.24 |
$1,774.24 |
$383.40
|
|
Dup scan/hemodialysis access 93990
|
$1,774.24 |
$1,774.24 |
$1,774.24 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$3,738.08 |
$3,738.08 |
$3,738.08 |
$887.25
|
|
Durvalumab 50 mg/ml intravenous solution
|
$103,576.07 |
$103,576.07 |
$103,576.07 |
$8,841.54
|
|
Dx bronchoscope/lavage 31624
|
$23,069.12 |
$23,069.12 |
$23,069.12 |
$2,636.40
|
|
Ear irrigation 69209
|
$884.32 |
$884.32 |
$884.32 |
$158.40
|
|
Ecg 12 lead tracing only
|
$944.04 |
$944.04 |
$944.04 |
$245.30
|
|
Ecg/1-3 leads/tracing only 93041
|
$884.32 |
$884.32 |
$884.32 |
$129.83
|
|
Echocardiogram (Heart Ultrasound)
|
$8,052.31 |
$8,052.31 |
$8,052.31 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$1,408.32 |
$1,408.32 |
$1,408.32 |
$462.56
|
|
Echocardiography transthoracic 2d followup/limited
|
$3,738.08 |
$3,738.08 |
$3,738.08 |
$737.75
|
|
Echocardiograpy doppler follow up/limited study
|
$610.27 |
$610.27 |
$610.27 |
$353.46
|
|
Echo stress
|
$7,821.44 |
$7,821.44 |
$7,821.44 |
$1,593.60
|