|
Culture bact stool aero addl path ea
|
$127.00 |
$127.00 |
$127.00 |
$52.50
|
|
Culture fungi definitive id mold
|
$76.00 |
$76.00 |
$76.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$285.00 |
$285.00 |
$285.00 |
$80.00
|
|
Culture fungi other (except blood)
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$25.00 |
$25.00 |
$25.00 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$76.00 |
$76.00 |
$76.00 |
$100.00
|
|
Culture quantitative aerobic other source
|
$35.00 |
$35.00 |
$35.00 |
$87.02
|
|
Culture typing added method
|
$27.00 |
$27.00 |
$27.00 |
$42.60
|
|
Culture typing immunologic
|
$419.00 |
$419.00 |
$419.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$24.00 |
$24.00 |
$24.00 |
$140.80
|
|
Culture urine each isolate
|
$1,432.00 |
$1,432.00 |
$1,432.00 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$63.00 |
$63.00 |
$63.00 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$161.00 |
$161.00 |
$161.00 |
$72.36
|
|
Cyclosporine 2 hour
|
$893.00 |
$893.00 |
$893.00 |
$130.40
|
|
Cygnus matrix, per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$295.20
|
|
Cygnus, per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$356.54
|
|
Cystatin c
|
$12.00 |
$12.00 |
$12.00 |
$77.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$3,950.00 |
$3,950.00 |
$3,950.00 |
$586.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$204.00 |
$204.00 |
$204.00 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$240.00 |
$240.00 |
$240.00 |
$100.00
|
|
Cytopathology concentration technique smears & interpretation
|
$441.00 |
$441.00 |
$441.00 |
$135.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$1,704.00 |
$1,704.00 |
$1,704.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$2,321.00 |
$2,321.00 |
$2,321.00 |
$213.85
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,662.00 |
$1,662.00 |
$1,662.00 |
$171.19
|
|
Debridement (>20 cm) charge pt
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$284.00
|
|
Decalcification
|
$380.00 |
$380.00 |
$380.00 |
$68.34
|
|
Derma-gide, 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Dermapure 1 square cm
|
$1.00 |
$1.00 |
$1.00 |
$3,300.73
|
|
Dermavest, plurivest sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Derm-maxx, per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$2,598.00 |
$2,598.00 |
$2,598.00 |
$91.84
|
|
Device intraute mirena
|
$5,244.00 |
$5,244.00 |
$5,244.00 |
$2,125.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$1,484.00 |
$1,484.00 |
$1,484.00 |
$42.25
|
|
Dextrose 5 % IV bolus
|
$977.00 |
$977.00 |
$977.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$311.00 |
$311.00 |
$311.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$936.00 |
$936.00 |
$936.00 |
$79.30
|
|
Diagnostic Mammogram (both breasts)
|
$1,646.00 |
$1,646.00 |
$1,646.00 |
$420.35
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$219.00 |
$219.00 |
$219.00 |
$79.71
|
|
Dicyclomine injection
|
$232.00 |
$232.00 |
$232.00 |
$154.33
|
|
Diffusing capacity
|
$1,724.00 |
$1,724.00 |
$1,724.00 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$63.00 |
$63.00 |
$63.00 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$9,887.00 |
$9,887.00 |
$9,887.00 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$406.00 |
$406.00 |
$406.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$417.00 |
$417.00 |
$417.00 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$198.00 |
$198.00 |
$198.00 |
$18.32
|
|
Dipyridamole injection
|
$4,747.00 |
$4,747.00 |
$4,747.00 |
$48.04
|
|
Disability dlco
|
$1,702.00 |
$1,702.00 |
$1,702.00 |
$293.76
|
|
Dna antibody native/double stranded
|
$204.00 |
$204.00 |
$204.00 |
$100.00
|
|
Doppler echo complete
|
$3,030.00 |
$3,030.00 |
$3,030.00 |
$558.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$2,643.00 |
$2,643.00 |
$2,643.00 |
$481.65
|
|
Dornase alfa non-comp unit
|
$525.00 |
$525.00 |
$525.00 |
$356.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$636.00 |
$636.00 |
$636.00 |
$89.34
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$3,789.86
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$119.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$193.15
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$94.94
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$7,465.97
|
|
Drsg wound/burn 18x10cm suprathel resorb cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$376.50
|
|
Drug asy hydroxychloroquine
|
$808.50 |
$808.50 |
$808.50 |
$66.43
|
|
Drug of abuse screen urine
|
$864.00 |
$864.00 |
$864.00 |
$67.89
|
|
Drug test def 1-7 classes
|
$3.00 |
$3.00 |
$3.00 |
$263.25
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$7,136.00 |
$7,136.00 |
$7,136.00 |
$904.78
|
|
Echocardiogram (Heart Ultrasound)
|
$12,943.00 |
$12,943.00 |
$12,943.00 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$3,556.00 |
$3,556.00 |
$3,556.00 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$2,025.00 |
$2,025.00 |
$2,025.00 |
$511.55
|
|
Echo exam uterus 76831-
|
$4,428.00 |
$4,428.00 |
$4,428.00 |
$561.00
|
|
Echo stress
|
$7,059.00 |
$7,059.00 |
$7,059.00 |
$1,609.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$11,318.00 |
$11,318.00 |
$11,318.00 |
$1,913.60
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$7,817.00 |
$7,817.00 |
$7,817.00 |
$1,033.00
|
|
Egfr gene com variants
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$672.88
|
|
EKG (Tracing Only)
|
$1,577.00 |
$1,577.00 |
$1,577.00 |
$226.50
|
|
Electrolyte panel
|
$864.00 |
$864.00 |
$864.00 |
$79.30
|
|
Endo cath bile duct s&i
|
$4,811.00 |
$4,811.00 |
$4,811.00 |
$714.24
|
|
Epstein barr early antigen antibody
|
$8.00 |
$8.00 |
$8.00 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$50.00 |
$50.00 |
$50.00 |
$76.86
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$461.00 |
$461.00 |
$461.00 |
$232.12
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$363.00 |
$363.00 |
$363.00 |
$223.99
|
|
Estradiol total
|
$1,809.00 |
$1,809.00 |
$1,809.00 |
$152.10
|
|
Estrogens total-sendout
|
$19.00 |
$19.00 |
$19.00 |
$97.50
|
|
Ethylene glycol -sendout
|
$14.00 |
$14.00 |
$14.00 |
$86.04
|
|
Etoposide 20 mg/ml intravenous solution
|
$35.00 |
$35.00 |
$35.00 |
$235.20
|
|
Evaluation of speech fluency 92521
|
$676.00 |
$676.00 |
$676.00 |
$302.50
|
|
External pretreatment of serum for use in antibody identification by dilution
|
$68.00 |
$68.00 |
$68.00 |
$63.70
|
|
Face, Eye Socket and Neck MRI (with and without contrast)
|
$3,484.00 |
$3,484.00 |
$3,484.00 |
$2,821.87
|
|
Face, Eye Socket and Neck MRI (without contrast)
|
$2,902.00 |
$2,902.00 |
$2,902.00 |
$1,883.25
|
|
Factor ix
|
$273.00 |
$273.00 |
$273.00 |
$162.50
|
|
Factor viii
|
$48.00 |
$48.00 |
$48.00 |
$148.00
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$3.00 |
$3.00 |
$3.00 |
$22.20
|
|
Fat/lipids feces qualitative
|
$5.00 |
$5.00 |
$5.00 |
$36.00
|
|
Fatty acids nonesterified
|
$35.91 |
$35.91 |
$35.91 |
$72.15
|
|
Ferritin
|
$664.00 |
$664.00 |
$664.00 |
$102.48
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,243.00 |
$1,243.00 |
$1,243.00 |
$1,636.50
|
|
#_fet/norfentcnfrmur
|
$91.00 |
$91.00 |
$91.00 |
$95.68
|
|
Fibrin degradation products
|
$361.00 |
$361.00 |
$361.00 |
$75.02
|
|
Fibrinogen activity
|
$1,325.00 |
$1,325.00 |
$1,325.00 |
$87.00
|
|
Flow cytometry marker each additional
|
$107.00 |
$107.00 |
$107.00 |
$97.50
|
|
Flow cytometry one marker technical component
|
$238.00 |
$238.00 |
$238.00 |
$285.00
|
