|
Culture screening strep group a
|
$196.95 |
$196.95 |
$196.95 |
$84.60
|
|
Culture typing immunologic
|
$54.60 |
$54.60 |
$54.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$282.10 |
$282.10 |
$282.10 |
$140.80
|
|
Culture urine each isolate
|
$187.20 |
$187.20 |
$187.20 |
$55.50
|
|
Cutter lead
|
$24,864.45 |
$24,864.45 |
$24,864.45 |
$6,581.45
|
|
Cyanocobalamin unsat binding capacity
|
$31.20 |
$31.20 |
$31.20 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$66.95 |
$66.95 |
$66.95 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$134.55 |
$134.55 |
$134.55 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$20.80 |
$20.80 |
$20.80 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$31.20 |
$31.20 |
$31.20 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$562.25 |
$562.25 |
$562.25 |
$140.78
|
|
Cyclosporine 2 hour
|
$503.10 |
$503.10 |
$503.10 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$15.60 |
$15.60 |
$15.60 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$55.25 |
$55.25 |
$55.25 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$46,228.65 |
$46,228.65 |
$46,228.65 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$278.20 |
$278.20 |
$278.20 |
$524.00
|
|
Cyp2d6 gene com variants
|
$351.65 |
$351.65 |
$351.65 |
$570.70
|
|
Cystatin c
|
$110.50 |
$110.50 |
$110.50 |
$77.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$818.35 |
$818.35 |
$818.35 |
$586.95
|
|
Cytarabine 20 mg/ml injection solution
|
$20.80 |
$20.80 |
$20.80 |
$90.00
|
|
Cytarabine liposome inj
|
$22,715.55 |
$22,715.55 |
$22,715.55 |
$4,529.43
|
|
Cytogenetics 25-99
|
$594.75 |
$594.75 |
$594.75 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$117.65 |
$117.65 |
$117.65 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$35.10 |
$35.10 |
$35.10 |
$100.00
|
|
Cytomegalovirus imm IV /vial
|
$9,030.45 |
$9,030.45 |
$9,030.45 |
$3,072.34
|
|
Cyto/molecular report
|
$37.70 |
$37.70 |
$37.70 |
$144.75
|
|
Cytopath fl nongyn filter
|
$429.65 |
$429.65 |
$429.65 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$515.45 |
$515.45 |
$515.45 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$49.40 |
$49.40 |
$49.40 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$34.45 |
$34.45 |
$34.45 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$536.25 |
$536.25 |
$536.25 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$416.00 |
$416.00 |
$416.00 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$246.35 |
$246.35 |
$246.35 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$255.45 |
$255.45 |
$255.45 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$417.95 |
$417.95 |
$417.95 |
$213.85
|
|
Cytopath smear other source
|
$555.75 |
$555.75 |
$555.75 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$285.35 |
$285.35 |
$285.35 |
$96.20
|
|
Cytotoxic antibody screening
|
$547.95 |
$547.95 |
$547.95 |
$193.80
|
|
Dacarbazine 100 mg intravenous solution
|
$59.15 |
$59.15 |
$59.15 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$3,463.85 |
$3,463.85 |
$3,463.85 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$83.85 |
$83.85 |
$83.85 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2.60 |
$2.60 |
$2.60 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$300.95 |
$300.95 |
$300.95 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$52.00 |
$52.00 |
$52.00 |
$6,281.29
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$1,188.20 |
$1,188.20 |
$1,188.20 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$531.70 |
$531.70 |
$531.70 |
$259.58
|
|
Dch pulmonary stress test
|
$2,206.75 |
$2,206.75 |
$2,206.75 |
$963.30
|
|
Deamidated gliadin antibody iga
|
$22.75 |
$22.75 |
$22.75 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$262.60 |
$262.60 |
$262.60 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,582.10 |
$1,582.10 |
$1,582.10 |
$835.20
|
|
Decalcification
|
$102.70 |
$102.70 |
$102.70 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$95.55 |
$95.55 |
$95.55 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$924.95 |
$924.95 |
$924.95 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$146.25 |
$146.25 |
$146.25 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$50.05 |
$50.05 |
$50.05 |
$1,856.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$193.05 |
$193.05 |
$193.05 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$167.70 |
$167.70 |
$167.70 |
$6,324.98
|
|
Dermagraft
|
$7,159.10 |
$7,159.10 |
$7,159.10 |
$85.00
|
|
Derm-maxx, per sq cm
|
$12,972.05 |
$12,972.05 |
$12,972.05 |
$1.00
|
|
Description not available
|
$19.50 |
$19.50 |
$19.50 |
$19.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$115.05 |
$115.05 |
$115.05 |
$91.84
|
|
Detect agent nos dna dir
|
$326.30 |
$326.30 |
$326.30 |
$138.00
|
|
Device ablt adv novasure
|
$19,318.00 |
$19,318.00 |
$19,318.00 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$181.35 |
$181.35 |
$181.35 |
$4,200.00
|
|
Device intraute mirena
|
$3,365.70 |
$3,365.70 |
$3,365.70 |
$2,125.00
|
|
Device sut capio slim opn
|
$7,201.35 |
$7,201.35 |
$7,201.35 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$6,752.20 |
$6,752.20 |
$6,752.20 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$493.35 |
$493.35 |
$493.35 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$3.90 |
$3.90 |
$3.90 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$33.80 |
$33.80 |
$33.80 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,893.45 |
$1,893.45 |
$1,893.45 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$215.80 |
$215.80 |
$215.80 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$215.80 |
$215.80 |
$215.80 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$185.25 |
$185.25 |
$185.25 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$215.80 |
$215.80 |
$215.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$26.65 |
$26.65 |
$26.65 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$309.40 |
$309.40 |
$309.40 |
$79.30
|
|
Diab manage trn ind/group
|
$45.50 |
$45.50 |
$45.50 |
$54.99
|
|
Diagnostic digital breast tomosynthesis bil
|
$162.50 |
$162.50 |
$162.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$162.50 |
$162.50 |
$162.50 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$560.30 |
$560.30 |
$560.30 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$432.25 |
$432.25 |
$432.25 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$230.75 |
$230.75 |
$230.75 |
$79.71
|
|
Dicyclomine injection
|
$318.50 |
$318.50 |
$318.50 |
$154.33
|
|
Diffusing capacity
|
$326.30 |
$326.30 |
$326.30 |
$336.80
|
|
Digital analysis of eeg
|
$904.80 |
$904.80 |
$904.80 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$1,078.35 |
$1,078.35 |
$1,078.35 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$25,496.90 |
$25,496.90 |
$25,496.90 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$199.55 |
$199.55 |
$199.55 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$778.70 |
$778.70 |
$778.70 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$1,030.90 |
$1,030.90 |
$1,030.90 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$2.60 |
$2.60 |
$2.60 |
$45.60
|
|
Dimecaprol injection
|
$473.20 |
$473.20 |
$473.20 |
$314.63
|
|
Dimethyl sulfoxide 50% 50 ml
|
$859.30 |
$859.30 |
$859.30 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$24.70 |
$24.70 |
$24.70 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$114.40 |
$114.40 |
$114.40 |
$98.15
|
|
Disability dlco
|
$680.55 |
$680.55 |
$680.55 |
$293.76
|
|
Disaccharidases
|
$656.50 |
$656.50 |
$656.50 |
$230.40
|
|
Discography cerv/thor spine
|
$3,250.00 |
$3,250.00 |
$3,250.00 |
$2,565.00
|
|
Dna antibody native/double stranded
|
$87.10 |
$87.10 |
$87.10 |
$100.00
|