|
Cyclosporine 250 mg/5 ml intravenous solution
|
$562.25 |
$562.25 |
$605.00 |
$140.78
|
|
Cyclosporine 2 hour
|
$503.10 |
$503.10 |
$915.00 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$15.60 |
$15.60 |
$46.00 |
$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 |
$207.00 |
$77.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$818.35 |
$818.35 |
$818.35 |
$586.95
|
|
Cystometrogram w/up 51727
|
$2,029.95 |
$2,029.95 |
$2,029.95 |
$908.59
|
|
Cysto rx balo cath urtl strx
|
$14,281.80 |
$14,281.80 |
$14,281.80 |
$6,853.60
|
|
Cystoscopy and treatment
|
$10,247.90 |
$10,247.90 |
$10,247.90 |
$4,081.37
|
|
Cystoscopy and treatment
|
$5,917.60 |
$5,917.60 |
$5,917.60 |
$4,638.40
|
|
Cystoscopy and treatment
|
$9,149.40 |
$9,149.40 |
$9,149.40 |
$5,304.00
|
|
Cystoscopy and treatment
|
$10,247.90 |
$10,247.90 |
$10,247.90 |
$5,995.60
|
|
Cystoscopy and treatment
|
$14,706.90 |
$14,706.90 |
$14,706.90 |
$6,593.60
|
|
Cystoscopy and treatment
|
$6,144.45 |
$6,144.45 |
$6,144.45 |
$3,320.50
|
|
Cystoscopy and treatment
|
$5,968.95 |
$5,968.95 |
$5,968.95 |
$4,045.60
|
|
Cystoscopy and treatment
|
$5,917.60 |
$5,917.60 |
$5,917.60 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$1,977.30 |
$1,977.30 |
$1,977.30 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$5,811.65 |
$5,811.65 |
$5,811.65 |
$2,874.36
|
|
Cystoscopy & ureter catheter
|
$5,968.95 |
$5,968.95 |
$5,968.95 |
$3,728.50
|
|
Cystouretero & or pyeloscope
|
$2,444.65 |
$2,444.65 |
$2,444.65 |
$4,315.98
|
|
Cystourethroscop/calib/dilat stric 52281
|
$5,917.60 |
$5,917.60 |
$5,917.60 |
$3,245.90
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$5,917.60 |
$5,917.60 |
$5,917.60 |
$4,057.50
|
|
Cytarabine 20 mg/ml injection solution
|
$18.85 |
$18.85 |
$18.85 |
$90.00
|
|
Cytarabine liposome inj
|
$17,596.80 |
$17,596.80 |
$17,596.80 |
$4,529.43
|
|
Cytogenetics 25-99
|
$594.75 |
$594.75 |
$594.75 |
$189.80
|
|
Cytomegalovirus ag ia
|
$64.00 |
$64.00 |
$64.00 |
$38.58
|
|
Cytomegalovirus (cmv) antibody igg
|
$117.65 |
$117.65 |
$117.65 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$35.10 |
$35.10 |
$1,004.00 |
$100.00
|
|
Cytomegalovirus dfa
|
$493.00 |
$493.00 |
$493.00 |
$77.40
|
|
Cytomegalovirus imm IV /vial
|
$9,030.45 |
$9,030.45 |
$9,030.45 |
$3,072.34
|
|
Cytomeg dna dir probe
|
$154.00 |
$154.00 |
$154.00 |
$178.88
|
|
Cyto/molecular report
|
$37.70 |
$37.70 |
$37.70 |
$144.75
|
|
Cytopath c/v index add-on
|
$257.00 |
$257.00 |
$257.00 |
$34.20
|
|
Cytopath fl nongyn filter
|
$429.65 |
$429.65 |
$429.65 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$392.00 |
$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 |
$1,602.00 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$416.00 |
$416.00 |
$889.00 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$111.00 |
$246.35 |
$246.35 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$255.45 |
$255.45 |
$1,551.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$417.95 |
$417.95 |
$418.00 |
$213.85
|
|
Cytopath smear other source
|
$398.00 |
$555.75 |
$555.75 |
$92.50
|
|
Cytopath smear other source
|
$203.00 |
$203.00 |
$203.00 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$285.35 |
$285.35 |
$418.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$104.00 |
$104.00 |
$104.00 |
$59.28
|
|
Cytotoxic antibody screening
|
$547.95 |
$547.95 |
$547.95 |
$193.80
|
|
Dacarbazine 100 mg intravenous solution
|
$54.60 |
$54.60 |
$544.00 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$250.00 |
$3,047.85 |
$3,047.85 |
$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 |
$5,064.00 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$252.20 |
$252.20 |
$96,549.00 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$44.20 |
$44.20 |
$44.20 |
$6,281.29
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$995.80 |
$995.80 |
$88,215.00 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$477.10 |
$477.10 |
$3,878.00 |
$259.58
|
|
Dbrdmt prmlg les w/pdt
|
$161.20 |
$161.20 |
$161.20 |
$468.00
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$6,806.80 |
$6,806.80 |
$6,806.80 |
$3,774.81
|
|
Dch pulmonary stress test
|
$2,206.75 |
$2,206.75 |
$2,206.75 |
$963.30
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$12,273.95 |
$12,273.95 |
$12,273.95 |
$5,121.00
|
|
Deamidated gliadin antibody iga
|
$22.75 |
$22.75 |
$22.75 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$726.05 |
$726.05 |
$726.05 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$262.60 |
$262.60 |
$509.60 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$5,292.30 |
$5,292.30 |
$5,292.30 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$793.65 |
$793.65 |
$793.65 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,464.80 |
$2,464.80 |
$2,464.80 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,582.10 |
$1,582.10 |
$1,582.10 |
$835.20
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$2,080.00 |
$2,080.00 |
$2,080.00 |
$1,163.24
|
|
Debride skin bone at fx site
|
$4,382.95 |
$4,382.95 |
$4,382.95 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$793.65 |
$793.65 |
$793.65 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,990.95 |
$1,990.95 |
$1,990.95 |
$1,149.50
|
|
Debr inf skin add-on 11001
|
$364.65 |
$364.65 |
$364.65 |
$124.08
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,508.65 |
$1,508.65 |
$1,508.65 |
$1,165.50
|
|
Decalcification
|
$102.70 |
$102.70 |
$676.00 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$86.45 |
$86.45 |
$86.45 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$924.95 |
$924.95 |
$924.95 |
$572.95
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$11,532.30 |
$11,532.30 |
$11,532.30 |
$4,914.00
|
|
Decompression of lower leg
|
$18,983.25 |
$18,983.25 |
$18,983.25 |
$3,969.00
|
|
Decompression of lower leg
|
$18,983.25 |
$18,983.25 |
$18,983.25 |
$3,839.54
|
|
Deep muscle biopsy 20205
|
$2,101.45 |
$2,101.45 |
$2,101.45 |
$3,386.84
|
|
Deferoxamine 500 mg solution for injection
|
$146.25 |
$146.25 |
$265.00 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$44.85 |
$44.85 |
$44.85 |
$1,856.85
|
|
Delay flap arms/legs
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$4,054.55
|
|
Delay flap eye/nos/ear/lip
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$2,371.50
|
|
Delay flap fccnaxghf 15620
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$2,837.09
|
|
Delay flap trunk 15600
|
$11,737.05 |
$11,737.05 |
$11,737.05 |
$4,332.25
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$24,336.00 |
$24,336.00 |
$24,336.00 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$193.05 |
$193.05 |
$440.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$137.15 |
$137.15 |
$137.15 |
$6,324.98
|
|
Dermabrasion other than face
|
$7,902.70 |
$7,902.70 |
$7,902.70 |
$3,214.40
|
|
Dermabrasion segmental face 15781
|
$2,074.15 |
$2,074.15 |
$2,074.15 |
$1,290.07
|
|
Dermabrasion total face
|
$7,902.70 |
$7,902.70 |
$7,902.70 |
$3,425.00
|
|
Derma-gide, 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Dermagraft
|
$7,159.10 |
$7,159.10 |
$7,159.10 |
$85.00
|
|
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 |
$12,972.05 |
$12,972.05 |
$1.00
|
|
Descend thora aorta rpr/lt sub art 33880
|
$17,497.35 |
$17,497.35 |
$17,497.35 |
$6,288.45
|
