|
Cytarabine 20 mg/ml injection solution
|
$186.00 |
$186.00 |
$186.00 |
$66.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$1,204.00 |
$1,204.00 |
$1,204.00 |
$101.25
|
|
Cytomegalovirus dfa
|
$502.00 |
$502.00 |
$502.00 |
$51.20
|
|
Cytopath c/v index add-on
|
$260.00 |
$260.00 |
$260.00 |
$29.60
|
|
Cytopath fl nongyn filter
|
$170.00 |
$170.00 |
$170.00 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$342.00 |
$342.00 |
$342.00 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$917.00 |
$917.00 |
$917.00 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$109.00 |
$109.00 |
$109.00 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$1,602.00 |
$1,602.00 |
$1,602.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$424.00 |
$424.00 |
$424.00 |
$203.08
|
|
Dacarbazine 100 mg intravenous solution
|
$540.00 |
$540.00 |
$540.00 |
$61.64
|
|
Dactinomycin 0.5 mg intravenous solution
|
$248.00 |
$248.00 |
$248.00 |
$2,281.50
|
|
Dalbavancin 500 mg intravenous solution
|
$14,140.78 |
$14,140.78 |
$14,140.78 |
$3,753.91
|
|
Daptomycin (xellia) unrefrig
|
$5,061.00 |
$5,061.00 |
$5,061.00 |
$0.04
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$3,875.00 |
$3,875.00 |
$3,875.00 |
$194.08
|
|
Debridement (>20 cm) charge pt
|
$597.00 |
$597.00 |
$597.00 |
$262.60
|
|
Decalcification
|
$694.00 |
$694.00 |
$694.00 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$10,775.00 |
$10,775.00 |
$10,775.00 |
$1,026.60
|
|
Depo-estradiol cypionate inj
|
$380.00 |
$380.00 |
$380.00 |
$87.27
|
|
Desoxycorticosterone
|
$541.00 |
$541.00 |
$541.00 |
$109.28
|
|
Dextran 40 infusion
|
$2,682.00 |
$2,682.00 |
$2,682.00 |
$173.97
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$333.00 |
$333.00 |
$333.00 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$225.00 |
$225.00 |
$225.00 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$458.00 |
$458.00 |
$458.00 |
$107.50
|
|
Diagnostic Mammogram (both breasts)
|
$606.00 |
$606.00 |
$606.00 |
$403.32
|
|
Diatrizoate meglumine 18 % urethral solution
|
$78.00 |
$78.00 |
$78.00 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$191.00 |
$191.00 |
$191.00 |
$67.89
|
|
Dicyclomine injection
|
$726.00 |
$726.00 |
$726.00 |
$210.00
|
|
Diffusing capacity
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$357.50
|
|
Digital analysis of eeg
|
$5,455.00 |
$5,455.00 |
$5,455.00 |
$641.56
|
|
Digoxin immune fab 40 mg intravenous solution
|
$37,185.00 |
$37,185.00 |
$37,185.00 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$708.00 |
$708.00 |
$708.00 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$257.00 |
$257.00 |
$257.00 |
$308.90
|
|
Dimenhydrinate injection
|
$84.00 |
$84.00 |
$84.00 |
$24.68
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$25.00 |
$25.00 |
$25.00 |
$1.62
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$513.00 |
$513.00 |
$513.00 |
$100.80
|
|
Disability dlco
|
$1,934.00 |
$1,934.00 |
$1,934.00 |
$302.40
|
|
Dna antibody native/double stranded
|
$737.00 |
$737.00 |
$737.00 |
$101.40
|
|
Dna gardnerella
|
$384.00 |
$384.00 |
$384.00 |
$66.05
|
|
Dna trichomonas
|
$384.00 |
$384.00 |
$384.00 |
$68.50
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4,633.00 |
$4,633.00 |
$4,633.00 |
$712.02
|
|
Dolasetron mesylate oral
|
$1,785.00 |
$1,785.00 |
$1,785.00 |
$910.67
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,439.00 |
$2,439.00 |
$2,439.00 |
$681.20
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$4,275.00 |
$4,275.00 |
$4,275.00 |
$490.82
|
|
Dornase alfa non-comp unit
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$500.29
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$69.27 |
$69.27 |
$69.27 |
$89.34
|
|
Dronabinol 2.5mg oral
|
$161.00 |
$161.00 |
$161.00 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$268.00 |
$268.00 |
$268.00 |
$33.99
|
|
Drug assay caffeine
|
$160.00 |
$160.00 |
$160.00 |
$86.45
|
|
Drug of abuse screen urine
|
$668.00 |
$668.00 |
$668.00 |
$63.75
|
|
Drug test def 1-7 classes
|
$877.00 |
$877.00 |
$877.00 |
$263.86
|
|
Drug test prsmv instrmnt
|
$668.00 |
$668.00 |
$668.00 |
$78.65
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,318.00 |
$2,318.00 |
$2,318.00 |
$885.60
|
|
Ecg/1-3 leads/tracing only 93041
|
$978.00 |
$978.00 |
$978.00 |
$129.83
|
|
Ecg external < 48 hours recording
|
$1,855.00 |
$1,855.00 |
$1,855.00 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,855.00 |
$1,855.00 |
$1,855.00 |
$567.00
|
|
Echocardiography doppler color flow mapping
|
$1,981.00 |
$1,981.00 |
$1,981.00 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$5,415.00 |
$5,415.00 |
$5,415.00 |
$773.30
|
|
Echo exam of fetal heart
|
$11,793.00 |
$11,793.00 |
$11,793.00 |
$855.38
|
|
Echo exam of fetal heart
|
$1,830.00 |
$1,830.00 |
$1,830.00 |
$481.55
|
|
Echo exam of fetal heart
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$431.41
|
|
Echo exam of fetal heart
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$323.40
|
|
Echo exam uterus 76831-
|
$1,354.00 |
$1,354.00 |
$1,354.00 |
$547.23
|
|
Echo guide for amniocentesis
|
$1,694.00 |
$1,694.00 |
$1,694.00 |
$377.11
|
|
Echo stress
|
$15,150.00 |
$15,150.00 |
$15,150.00 |
$1,607.45
|
|
Echo tee guidance
|
$5,500.00 |
$5,500.00 |
$5,500.00 |
$2,007.00
|
|
Echo transesophageal
|
$1,676.00 |
$1,676.00 |
$1,676.00 |
$913.33
|
|
Echo transesophageal intraop
|
$10,046.00 |
$10,046.00 |
$10,046.00 |
$1,571.70
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$6,325.00 |
$6,325.00 |
$6,325.00 |
$1,020.09
|
|
Edetate calcium disodium inj
|
$753.00 |
$753.00 |
$753.00 |
$6,086.32
|
|
Eeg 41-60 minutes 95812-26
|
$5,069.00 |
$5,069.00 |
$5,069.00 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$6,248.00 |
$6,248.00 |
$6,248.00 |
$1,048.30
|
|
Eeg over 1 hour 95813 - 26
|
$7,391.00 |
$7,391.00 |
$7,391.00 |
$1,100.40
|
|
Eeg recording awake and asleep
|
$4,748.00 |
$4,748.00 |
$4,748.00 |
$1,030.27
|
|
Electrolyte panel
|
$2,837.00 |
$2,837.00 |
$2,837.00 |
$86.33
|
|
Electrophysiologic study
|
$22,686.00 |
$22,686.00 |
$22,686.00 |
$6,758.40
|
|
Electrophysiology evaluation
|
$11,209.00 |
$11,209.00 |
$11,209.00 |
$6,516.00
|
|
Electrophysiology evaluation
|
$11,605.00 |
$11,605.00 |
$11,605.00 |
$2,845.10
|
|
Electrophysiology evaluation
|
$3,616.00 |
$3,616.00 |
$3,616.00 |
$2,630.40
|
|
Electrophysiology evaluation
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$1,869.13
|
|
Electrophys map 3d add-on
|
$30,751.00 |
$30,751.00 |
$30,751.00 |
$6,534.00
|
|
Embolization s&i
|
$9,787.00 |
$9,787.00 |
$9,787.00 |
$2,745.08
|
|
Endo cath bile duct s&i
|
$4,260.00 |
$4,260.00 |
$4,260.00 |
$545.37
|
|
Endo cath panc duct s&i
|
$4,260.00 |
$4,260.00 |
$4,260.00 |
$637.65
|
|
Endoscopy swallow (fees) vid
|
$3,642.00 |
$3,642.00 |
$3,642.00 |
$420.00
|
|
Enzyme histochemistry
|
$175.00 |
$175.00 |
$175.00 |
$460.32
|
|
Ep & ablate supravent arrhyt
|
$72,149.00 |
$72,149.00 |
$72,149.00 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$72,149.00 |
$72,149.00 |
$72,149.00 |
$30,975.00
|
|
Ep induct arrhy by elect pacing
|
$3,616.00 |
$3,616.00 |
$3,616.00 |
$2,753.40
|
|
Epstein barr early antigen antibody
|
$1,373.00 |
$1,373.00 |
$1,373.00 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$654.00 |
$654.00 |
$654.00 |
$82.55
|
|
Ercp biliary & pancreas
|
$4,260.00 |
$4,260.00 |
$4,260.00 |
$922.35
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,041.00 |
$1,041.00 |
$1,041.00 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$644.00 |
$644.00 |
$644.00 |
$232.84
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$540.00 |
$540.00 |
$540.00 |
$562.34
|
|
Esophageal dilat s&i
|
$2,277.00 |
$2,277.00 |
$2,277.00 |
$525.00
|
|
Established Patient Office Visit (level 1)
|
$728.00 |
$728.00 |
$728.00 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$1,547.00 |
$1,547.00 |
$1,547.00 |
$186.04
|
