|
Culture mycoplasma any source
|
$37.80 |
$37.80 |
$37.80 |
$90.37
|
|
Culture typing immunologic
|
$796.49 |
$796.49 |
$796.49 |
$41.19
|
|
Culture urine each isolate
|
$1,196.60 |
$1,196.60 |
$1,196.60 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$28.67 |
$28.67 |
$28.67 |
$26.73
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$261.47 |
$261.47 |
$261.47 |
$150.79
|
|
Cystatin c
|
$84.21 |
$84.21 |
$84.21 |
$82.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$5,168.30 |
$5,168.30 |
$5,168.30 |
$527.50
|
|
Cytopath c/v index add-on
|
$65.74 |
$65.74 |
$65.74 |
$29.60
|
|
Cytopathology cellular enhancement technique non-gyn
|
$278.03 |
$278.03 |
$278.03 |
$163.43
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$296.80 |
$296.80 |
$296.80 |
$75.60
|
|
Cytopath tbs c/v manual
|
$116.48 |
$116.48 |
$116.48 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$136.71 |
$136.71 |
$136.71 |
$61.64
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$640.55 |
$640.55 |
$640.55 |
$194.08
|
|
Dch glucoscan
|
$353.16 |
$353.16 |
$353.16 |
$23.25
|
|
Dch pulmonary stress test
|
$10,226.74 |
$10,226.74 |
$10,226.74 |
$964.41
|
|
Dch validity tests
|
$1,810.88 |
$1,810.88 |
$1,810.88 |
$25.00
|
|
Debridement (>20 cm) charge pt
|
$594.59 |
$594.59 |
$594.59 |
$262.60
|
|
Deferoxamine 500 mg solution for injection
|
$352.80 |
$352.80 |
$352.80 |
$112.87
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$11,558.66 |
$11,558.66 |
$11,558.66 |
$7,737.00
|
|
Devel tst phys/qhp 1st hr
|
$1,111.25 |
$1,111.25 |
$1,111.25 |
$343.20
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$556.36 |
$556.36 |
$556.36 |
$196.30
|
|
Dextran 40 infusion
|
$396.90 |
$396.90 |
$396.90 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$58.61 |
$58.61 |
$58.61 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$15.23 |
$15.23 |
$15.23 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$17.75 |
$17.75 |
$17.75 |
$68.25
|
|
Diabetes (HbA1c) Test
|
$1,020.04 |
$1,020.04 |
$1,020.04 |
$78.03
|
|
Diatrizoate meglumine 18 % urethral solution
|
$612.41 |
$612.41 |
$612.41 |
$122.25
|
|
Dicyclomine injection
|
$413.44 |
$413.44 |
$413.44 |
$210.00
|
|
Diffusing capacity
|
$1,317.69 |
$1,317.69 |
$1,317.69 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$28.67 |
$28.67 |
$28.67 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$17,050.99 |
$17,050.99 |
$17,050.99 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$1,626.77 |
$1,626.77 |
$1,626.77 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,521.45 |
$1,521.45 |
$1,521.45 |
$308.90
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,188.50 |
$1,188.50 |
$1,188.50 |
$1,001.55
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$14.33 |
$14.33 |
$14.33 |
$1.62
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$41.90 |
$41.90 |
$41.90 |
$22.58
|
|
Disability dlco
|
$1,317.69 |
$1,317.69 |
$1,317.69 |
$302.40
|
|
Dna probe chlamydia
|
$4.32 |
$4.32 |
$4.32 |
$82.20
|
|
Dna probe gc
|
$4.32 |
$4.32 |
$4.32 |
$88.67
|
|
Dolasetron mesylate oral
|
$910.67 |
$910.67 |
$910.67 |
$910.67
|
|
Doppler echo complete
|
$2,121.94 |
$2,121.94 |
$2,121.94 |
$644.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$3,631.41 |
$3,631.41 |
$3,631.41 |
$490.82
|
|
Dornase alfa non-comp unit
|
$512.66 |
$512.66 |
$512.66 |
$500.29
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$50.96 |
$50.96 |
$50.96 |
$89.34
|
|
Dronabinol 2.5mg oral
|
$69.46 |
$69.46 |
$69.46 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$27.56 |
$27.56 |
$27.56 |
$33.99
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$6,179.60 |
$6,179.60 |
$6,179.60 |
$327.39
|
|
Drug of abuse screen urine
|
$100.00 |
$100.00 |
$100.00 |
$63.75
|
|
Drug test prsmv instrmnt
|
$95.00 |
$95.00 |
$95.00 |
$78.65
|
|
Drvvt confirm - quest
|
$74.32 |
$74.32 |
$74.32 |
$102.30
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$8,823.39 |
$8,823.39 |
$8,823.39 |
$750.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$5,934.85 |
$5,934.85 |
$5,934.85 |
$885.60
|
|
Ecg external < 48 hours recording
|
$2,519.11 |
$2,519.11 |
$2,519.11 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,466.55 |
$1,466.55 |
$1,466.55 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$8,360.76 |
$8,360.76 |
$8,360.76 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$2,836.22 |
$2,836.22 |
$2,836.22 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$3,061.88 |
$3,061.88 |
$3,061.88 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$2,836.22 |
$2,836.22 |
$2,836.22 |
$354.90
|
|
Echo guidance radiotherapy
|
$3,876.75 |
$3,876.75 |
$3,876.75 |
$769.18
|
|
Echo guide for amniocentesis
|
$465.10 |
$465.10 |
$465.10 |
$377.11
|
|
Echo guide for artery repair
|
$2,346.66 |
$2,346.66 |
$2,346.66 |
$676.80
|
|
Echo stress
|
$11,869.44 |
$11,869.44 |
$11,869.44 |
$1,607.45
|
|
Echo tee guidance
|
$32,630.11 |
$32,630.11 |
$32,630.11 |
$2,007.00
|
|
Echo transthoracic
|
$621.60 |
$621.60 |
$621.60 |
$944.14
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$4,414.25 |
$4,414.25 |
$4,414.25 |
$1,020.09
|
|
Eeg 41-60 minutes 95812-26
|
$3,272.27 |
$3,272.27 |
$3,272.27 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$3,590.00 |
$3,590.00 |
$3,590.00 |
$1,048.30
|
|
Eeg during surgery
|
$6,417.73 |
$6,417.73 |
$6,417.73 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$3,272.27 |
$3,272.27 |
$3,272.27 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$2,021.10 |
$2,021.10 |
$2,021.10 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$3,901.67 |
$3,901.67 |
$3,901.67 |
$911.00
|
|
Eeg recording awake and asleep
|
$3,272.27 |
$3,272.27 |
$3,272.27 |
$1,030.27
|
|
Electrolyte panel
|
$3,901.65 |
$3,901.65 |
$3,901.65 |
$86.33
|
|
Electron microscopy diagnostic
|
$290.52 |
$290.52 |
$290.52 |
$1,006.20
|
|
Electrophysiologic study
|
$12,492.57 |
$12,492.57 |
$12,492.57 |
$6,758.40
|
|
Electrophysiology evaluation
|
$38,341.42 |
$38,341.42 |
$38,341.42 |
$11,542.01
|
|
Electrophysiology evaluation
|
$22,444.78 |
$22,444.78 |
$22,444.78 |
$8,393.40
|
|
Electrophysiology evaluation
|
$18,964.50 |
$18,964.50 |
$18,964.50 |
$6,516.00
|
|
Electrophysiology evaluation
|
$14,793.83 |
$14,793.83 |
$14,793.83 |
$2,845.10
|
|
Electrophys map 3d add-on
|
$9,650.36 |
$9,650.36 |
$9,650.36 |
$6,534.00
|
|
Embolization s&i
|
$17,913.15 |
$17,913.15 |
$17,913.15 |
$2,745.08
|
|
Emg cranial nerve bilateral
|
$477.54 |
$477.54 |
$477.54 |
$518.00
|
|
Endo cath bile duct s&i
|
$2,056.52 |
$2,056.52 |
$2,056.52 |
$545.37
|
|
Ep & ablate supravent arrhyt
|
$82,957.51 |
$82,957.51 |
$82,957.51 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$95,974.58 |
$95,974.58 |
$95,974.58 |
$30,975.00
|
|
Ep induct arrhy by elect pacing
|
$26,507.86 |
$26,507.86 |
$26,507.86 |
$2,753.40
|
|
Epoetin alfa, 100 units esrd
|
$602.59 |
$602.59 |
$602.59 |
$41.32
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$911.77 |
$911.77 |
$911.77 |
$364.08
|
|
ER Visit (level 1, minor)
|
$2,113.10 |
$2,113.10 |
$2,113.10 |
$271.88
|
|
ER Visit (level 2)
|
$3,191.21 |
$3,191.21 |
$3,191.21 |
$481.37
|
|
ER Visit (level 3)
|
$6,037.42 |
$6,037.42 |
$6,037.42 |
$850.50
|
|
ER Visit (level 4)
|
$6,442.79 |
$6,442.79 |
$6,442.79 |
$1,334.25
|
|
ER Visit (level 5, high severity)
|
$7,762.39 |
$7,762.39 |
$7,762.39 |
$1,930.40
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$534.47 |
$534.47 |
$534.47 |
$232.84
|
|
Esophagus motility study
|
$4,279.30 |
$4,279.30 |
$4,279.30 |
$1,274.00
|
|
Esoph imped function test
|
$1,562.48 |
$1,562.48 |
$1,562.48 |
$597.03
|
|
Ethanolamine oleate 100 mg
|
$3,410.03 |
$3,410.03 |
$3,410.03 |
$933.59
|
|
Ethylene glycol -sendout
|
$16.39 |
$16.39 |
$16.39 |
$78.00
|
|
Etoposide 20 mg/ml intravenous solution
|
$103.82 |
$103.82 |
$103.82 |
$213.17
|
|
Eval/fit voice prosthesis iii, st
|
$370.41 |
$370.41 |
$370.41 |
$375.20
|
