|
Culture typing added method
|
$31.50 |
$31.50 |
$31.50 |
$34.45
|
|
Culture urine each isolate
|
$1,628.15 |
$1,628.15 |
$1,628.15 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$11.00 |
$11.00 |
$11.00 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$117.95 |
$117.95 |
$117.95 |
$85.03
|
|
Cyclosporine 2 hour
|
$27.00 |
$27.00 |
$27.00 |
$119.40
|
|
Cystatin c
|
$46.70 |
$46.70 |
$46.70 |
$82.50
|
|
Cytomegalovirus (cmv) antibody igg
|
$148.50 |
$148.50 |
$148.50 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$174.55 |
$174.55 |
$174.55 |
$101.94
|
|
Cytopath c/v index add-on
|
$73.60 |
$73.60 |
$73.60 |
$29.60
|
|
Cytopath fl nongyn filter
|
$332.10 |
$332.10 |
$332.10 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$353.95 |
$353.95 |
$353.95 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$1,437.25 |
$1,437.25 |
$1,437.25 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$1,468.40 |
$1,468.40 |
$1,468.40 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$1,717.25 |
$1,717.25 |
$1,717.25 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$1,717.25 |
$1,717.25 |
$1,717.25 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$2,339.25 |
$2,339.25 |
$2,339.25 |
$203.08
|
|
Cytopath smear other source
|
$1,154.70 |
$1,154.70 |
$1,154.70 |
$85.80
|
|
Cytopath smear other source
|
$1,603.10 |
$1,603.10 |
$1,603.10 |
$135.27
|
|
Cytopath tbs c/v manual
|
$73.60 |
$73.60 |
$73.60 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$362.00 |
$362.00 |
$362.00 |
$61.64
|
|
Dactinomycin 0.5 mg intravenous solution
|
$252.00 |
$252.00 |
$252.00 |
$2,281.50
|
|
Dalbavancin 500 mg intravenous solution
|
$6,400.00 |
$6,400.00 |
$6,400.00 |
$3,753.91
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,126.00 |
$4,126.00 |
$4,126.00 |
$5,500.25
|
|
Dch validity tests
|
$718.80 |
$718.80 |
$718.80 |
$25.00
|
|
Decalcification
|
$243.00 |
$243.00 |
$243.00 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$1,936.80 |
$1,936.80 |
$1,936.80 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$796.00 |
$796.00 |
$796.00 |
$112.87
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$11,748.00 |
$11,748.00 |
$11,748.00 |
$7,737.00
|
|
Device intraute mirena
|
$5,000.00 |
$5,000.00 |
$5,000.00 |
$2,289.60
|
|
Dextran 40 infusion
|
$324.00 |
$324.00 |
$324.00 |
$173.97
|
|
Dextrose 5 % IV bolus
|
$520.45 |
$520.45 |
$520.45 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$228.60 |
$228.60 |
$228.60 |
$107.50
|
|
Diab manage trn ind/group
|
$49.65 |
$49.65 |
$49.65 |
$49.50
|
|
Diagnostic Mammogram (both breasts)
|
$1,510.80 |
$1,510.80 |
$1,510.80 |
$403.32
|
|
Dialysis one evaluation
|
$2,280.10 |
$2,280.10 |
$2,280.10 |
$827.97
|
|
Dicyclomine injection
|
$282.00 |
$282.00 |
$282.00 |
$210.00
|
|
Diffusing capacity
|
$1,751.40 |
$1,751.40 |
$1,751.40 |
$357.50
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,772.00 |
$4,772.00 |
$4,772.00 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$637.10 |
$637.10 |
$637.10 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$532.00 |
$532.00 |
$532.00 |
$308.90
|
|
Dimethyl sulfoxide 50% 50 ml
|
$648.00 |
$648.00 |
$648.00 |
$1,001.55
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$7.75 |
$7.75 |
$7.75 |
$1.62
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$169.00 |
$169.00 |
$169.00 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$211.00 |
$211.00 |
$211.00 |
$100.80
|
|
Disability dlco
|
$1,542.45 |
$1,542.45 |
$1,542.45 |
$302.40
|
|
Disaccharidases
|
$145.60 |
$145.60 |
$145.60 |
$224.58
|
|
Discography cerv/thor spine
|
$13,338.60 |
$13,338.60 |
$13,338.60 |
$2,360.70
|
|
Dna antibody native/double stranded
|
$12.55 |
$12.55 |
$12.55 |
$101.40
|
|
Doppler echo complete
|
$2,149.25 |
$2,149.25 |
$2,149.25 |
$644.00
|
|
Dornase alfa non-comp unit
|
$356.00 |
$356.00 |
$356.00 |
$500.29
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1,725.40 |
$1,725.40 |
$1,725.40 |
$89.34
|
|
Droperidol 2.5 mg/ml injection solution
|
$52.20 |
$52.20 |
$52.20 |
$33.99
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$139.00 |
$139.00 |
$139.00 |
$5,085.77
|
|
Drug assay caffeine
|
$136.05 |
$136.05 |
$136.05 |
$86.45
|
|
Drug test prsmv instrmnt
|
$66.15 |
$66.15 |
$66.15 |
$78.65
|
|
Drvvt confirm - quest
|
$185.45 |
$185.45 |
$185.45 |
$102.30
|
|
Dup scan/hemodialysis access 93990
|
$1,196.35 |
$1,196.35 |
$1,196.35 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$4,852.20 |
$4,852.20 |
$4,852.20 |
$750.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$16,835.15 |
$16,835.15 |
$16,835.15 |
$885.60
|
|
Ecg/1-3 leads/tracing only 93041
|
$671.45 |
$671.45 |
$671.45 |
$129.83
|
|
Ecg external < 48 hours recording
|
$12,030.40 |
$12,030.40 |
$12,030.40 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$691.40 |
$691.40 |
$691.40 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$14,176.30 |
$14,176.30 |
$14,176.30 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$3,923.30 |
$3,923.30 |
$3,923.30 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$4,070.25 |
$4,070.25 |
$4,070.25 |
$773.30
|
|
Echo exam uterus 76831-
|
$2,788.30 |
$2,788.30 |
$2,788.30 |
$547.23
|
|
Echo guide for artery repair
|
$7,492.35 |
$7,492.35 |
$7,492.35 |
$676.80
|
|
Echo stress
|
$12,141.35 |
$12,141.35 |
$12,141.35 |
$1,607.45
|
|
Echo tee probe placement image acquisition interpretation & report
|
$14,474.20 |
$14,474.20 |
$14,474.20 |
$1,938.95
|
|
Echo transesophageal
|
$2,314.15 |
$2,314.15 |
$2,314.15 |
$1,734.10
|
|
Echo transthoracic
|
$8,133.30 |
$8,133.30 |
$8,133.30 |
$1,475.25
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$8,133.30 |
$8,133.30 |
$8,133.30 |
$1,020.09
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$26,460.00 |
$26,460.00 |
$26,460.00 |
$17,641.10
|
|
Eeg 41-60 minutes 95812-26
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$4,244.65 |
$4,244.65 |
$4,244.65 |
$1,048.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$4,659.25 |
$4,659.25 |
$4,659.25 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$911.00
|
|
Eeg recording awake and asleep
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$1,030.27
|
|
Egfr gene com variants
|
$1,051.65 |
$1,051.65 |
$1,051.65 |
$646.75
|
|
Electroconvulsive therapy 90870
|
$6,071.25 |
$6,071.25 |
$6,071.25 |
$1,130.00
|
|
Electrolyte panel
|
$1,252.40 |
$1,252.40 |
$1,252.40 |
$86.33
|
|
Electron microscopy diagnostic
|
$1,289.15 |
$1,289.15 |
$1,289.15 |
$1,006.20
|
|
Electrophysiologic study
|
$18,122.00 |
$18,122.00 |
$18,122.00 |
$6,758.40
|
|
Electrophysiology evaluation
|
$18,122.00 |
$18,122.00 |
$18,122.00 |
$8,979.45
|
|
Electrophysiology evaluation
|
$18,122.00 |
$18,122.00 |
$18,122.00 |
$11,542.01
|
|
Electrophysiology evaluation
|
$18,122.00 |
$18,122.00 |
$18,122.00 |
$8,393.40
|
|
Electrophysiology evaluation
|
$18,122.00 |
$18,122.00 |
$18,122.00 |
$6,516.00
|
|
Electrophysiology evaluation
|
$5,235.85 |
$5,235.85 |
$5,235.85 |
$2,630.40
|
|
Electrophysiology evaluation
|
$254.40 |
$254.40 |
$254.40 |
$1,869.13
|
|
Electrophys map 3d add-on
|
$17,392.80 |
$17,392.80 |
$17,392.80 |
$6,534.00
|
|
Embolization s&i
|
$41,184.40 |
$41,184.40 |
$41,184.40 |
$2,745.08
|
|
Emg needle test 1-extremity
|
$665.80 |
$665.80 |
$665.80 |
$340.80
|
|
Endoscopy swallow (fees) vid
|
$405.95 |
$405.95 |
$405.95 |
$420.00
|
|
Ep & ablate supravent arrhyt
|
$95,840.65 |
$95,840.65 |
$95,840.65 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$95,840.65 |
$95,840.65 |
$95,840.65 |
$30,975.00
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$89.00 |
$89.00 |
$89.00 |
$135.20
|
|
Epstein barr early antigen antibody
|
$136.05 |
$136.05 |
$136.05 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$158.10 |
$158.10 |
$158.10 |
$82.55
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$570.00 |
$570.00 |
$570.00 |
$364.08
|
